Revision and extension of Eco-LCA metrics for sustainability assessment of the energy and chemical processes.

PubMed

Yang, Shiying; Yang, Siyu; Kraslawski, Andrzej; Qian, Yu

2013-12-17

Ecologically based life cycle assessment (Eco-LCA) is an appealing approach for the evaluation of resources utilization and environmental impacts of the process industries from an ecological scale. However, the aggregated metrics of Eco-LCA suffer from some drawbacks: the environmental impact metric has limited applicability; the resource utilization metric ignores indirect consumption; the renewability metric fails to address the quantitative distinction of resources availability; the productivity metric seems self-contradictory. In this paper, the existing Eco-LCA metrics are revised and extended for sustainability assessment of the energy and chemical processes. A new Eco-LCA metrics system is proposed, including four independent dimensions: environmental impact, resource utilization, resource availability, and economic effectiveness. An illustrative example of comparing assessment between a gas boiler and a solar boiler process provides insight into the features of the proposed approach.

Prototype Development of a Tradespace Analysis Tool for Spaceflight Medical Resources.

PubMed

Antonsen, Erik L; Mulcahy, Robert A; Rubin, David; Blue, Rebecca S; Canga, Michael A; Shah, Ronak

2018-02-01

The provision of medical care in exploration-class spaceflight is limited by mass, volume, and power constraints, as well as limitations of available skillsets of crewmembers. A quantitative means of exploring the risks and benefits of inclusion or exclusion of onboard medical capabilities may help to inform the development of an appropriate medical system. A pilot project was designed to demonstrate the utility of an early tradespace analysis tool for identifying high-priority resources geared toward properly equipping an exploration mission medical system. Physician subject matter experts identified resources, tools, and skillsets required, as well as associated criticality scores of the same, to meet terrestrial, U.S.-specific ideal medical solutions for conditions concerning for exploration-class spaceflight. A database of diagnostic and treatment actions and resources was created based on this input and weighed against the probabilities of mission-specific medical events to help identify common and critical elements needed in a future exploration medical capability. Analysis of repository data demonstrates the utility of a quantitative method of comparing various medical resources and skillsets for future missions. Directed database queries can provide detailed comparative estimates concerning likelihood of resource utilization within a given mission and the weighted utility of tangible and intangible resources. This prototype tool demonstrates one quantitative approach to the complex needs and limitations of an exploration medical system. While this early version identified areas for refinement in future version development, more robust analysis tools may help to inform the development of a comprehensive medical system for future exploration missions.Antonsen EL, Mulcahy RA, Rubin D, Blue RS, Canga MA, Shah R. Prototype development of a tradespace analysis tool for spaceflight medical resources. Aerosp Med Hum Perform. 2018; 89(2):108-114.

Optimization in the utility maximization framework for conservation planning: a comparison of solution procedures in a study of multifunctional agriculture

PubMed Central

Stoms, David M.; Davis, Frank W.

2014-01-01

Quantitative methods of spatial conservation prioritization have traditionally been applied to issues in conservation biology and reserve design, though their use in other types of natural resource management is growing. The utility maximization problem is one form of a covering problem where multiple criteria can represent the expected social benefits of conservation action. This approach allows flexibility with a problem formulation that is more general than typical reserve design problems, though the solution methods are very similar. However, few studies have addressed optimization in utility maximization problems for conservation planning, and the effect of solution procedure is largely unquantified. Therefore, this study mapped five criteria describing elements of multifunctional agriculture to determine a hypothetical conservation resource allocation plan for agricultural land conservation in the Central Valley of CA, USA. We compared solution procedures within the utility maximization framework to determine the difference between an open source integer programming approach and a greedy heuristic, and find gains from optimization of up to 12%. We also model land availability for conservation action as a stochastic process and determine the decline in total utility compared to the globally optimal set using both solution algorithms. Our results are comparable to other studies illustrating the benefits of optimization for different conservation planning problems, and highlight the importance of maximizing the effectiveness of limited funding for conservation and natural resource management. PMID:25538868

Optimization in the utility maximization framework for conservation planning: a comparison of solution procedures in a study of multifunctional agriculture

USGS Publications Warehouse

Kreitler, Jason R.; Stoms, David M.; Davis, Frank W.

2014-01-01

Quantitative methods of spatial conservation prioritization have traditionally been applied to issues in conservation biology and reserve design, though their use in other types of natural resource management is growing. The utility maximization problem is one form of a covering problem where multiple criteria can represent the expected social benefits of conservation action. This approach allows flexibility with a problem formulation that is more general than typical reserve design problems, though the solution methods are very similar. However, few studies have addressed optimization in utility maximization problems for conservation planning, and the effect of solution procedure is largely unquantified. Therefore, this study mapped five criteria describing elements of multifunctional agriculture to determine a hypothetical conservation resource allocation plan for agricultural land conservation in the Central Valley of CA, USA. We compared solution procedures within the utility maximization framework to determine the difference between an open source integer programming approach and a greedy heuristic, and find gains from optimization of up to 12%. We also model land availability for conservation action as a stochastic process and determine the decline in total utility compared to the globally optimal set using both solution algorithms. Our results are comparable to other studies illustrating the benefits of optimization for different conservation planning problems, and highlight the importance of maximizing the effectiveness of limited funding for conservation and natural resource management.

Effect of provider volume on resource utilization for surgical procedures of the knee.

PubMed

Jain, Nitin; Pietrobon, Ricardo; Guller, Ulrich; Shankar, Anoop; Ahluwalia, Ajit S; Higgins, Laurence D

2005-05-01

Operating-room time and patient disposition on discharge are important determinants of healthcare resource utilization and cost. We examined the relation between these determinants and hospital/surgeon volume for anterior cruciate ligament (ACL) reconstruction and meniscectomy procedures. Patients undergoing ACL reconstruction (18,390 cases) and meniscectomy (123,012 cases) were extracted from the State Ambulatory Surgery Databases for the years 1997-2000. Surgeon and hospital volume were divided into low-, intermediate-, and high-volume categories. Multivariate logistic regression models were used to estimate the adjusted association between surgeon and hospital volume and patient discharge status and operating-room time. Patients undergoing ACL reconstruction or meniscectomy performed by low-volume surgeons were significantly more likely to be non-routinely discharged as compared to high-volume surgeons (adjusted odds ratio 3.5, 95% confidence interval 1.7-7.2 for ACL reconstruction; adjusted odds ratio 2.0, 95% confidence interval 1.6-2.3 for meniscectomy). The mean operating-room time for performing ACL reconstruction or meniscectomy was significantly higher in low- and intermediate-volume surgeons and hospitals as compared to high-volume surgeons and hospitals (p < or = 0.001). High-volume providers utilize healthcare resources more efficiently. Our findings may help surgeons and hospitals in optimizing resource utilization and cost for routinely-performed ambulatory surgery procedures.

Weight Loss Surgery Reduces Healthcare Resource Utilization and All-Cause Inpatient Mortality in Morbid Obesity: a Propensity-Matched Analysis.

PubMed

Krishna, Somashekar G; Rawal, Varun; Durkin, Claire; Modi, Rohan M; Hinton, Alice; Cruz-Monserrate, Zobeida; Conwell, Darwin L; Hussan, Hisham

2018-06-21

There is a lack of population studies evaluating the impact of bariatric surgery (BRS) on all-cause inpatient mortality. We sought to determine the impact of prior BRS on all-cause mortality and healthcare utilization in hospitalized patients. We analyzed the National Inpatient Sample database from 2007 to 2013. Participants were adult (≥ 18 years) inpatients admitted with a diagnosis of morbid obesity or a history of BRS. Propensity score-matched analyses were performed to compare mortality and healthcare resource utilization (hospital length of stay and cost). There were 9,044,103 patient admissions with morbid obesity and 1,066,779 with prior BRS. A propensity score-matched cohort analysis demonstrated that prior BRS was associated with decreased mortality (OR = 0.58; 95% CI [0.54, 0.63]), shorter length of stay (0.59 days; P < 0.001), and lower hospital costs ($2152; P < 0.001) compared to morbid obesity. A subgroup of propensity score-matched analysis among patients with high-risk of mortality (leading ten causes of mortality in morbid obesity) revealed a consistently significant reduction in odds of mortality for patients with prior BRS (OR = 0.82; 95% CI [0.72, 0.92]). Hospitalized patients with a history of BRS have lower all-cause mortality and healthcare resource utilization compared to those who are morbidly obese. These observations support the continued application of BRS as an effective and resource-conscious treatment for morbid obesity.

Resource Utilization Related to Atrial Fibrillation After Coronary Artery Bypass Grafting

PubMed Central

Hravnak, Marilyn; Hoffman, Leslie A.; Saul, Melissa I.; Zullo, Thomas G.; Whitman, Gayle R.

2013-01-01

Background Studies of resource utilization by patients with new-onset atrial fibrillation after coronary artery bypass grafting have addressed only length of stay and bed charges. Objective To compare resource utilization between patients with new-onset atrial fibrillation and patients without atrial fibrillation after isolated coronary artery bypass grafting. Methods Retrospective review of clinical and administrative electronic databases for 720 subjects who underwent isolated coronary artery bypass grafting with cardiopulmonary bypass in 25 months at one medical center. The prevalence of atrial fibrillation was determined, and resource utilization in various hospital cost centers was compared between subjects with and without atrial fibrillation. Results The prevalence of new-onset atrial fibrillation was 33.1%. Compared with subjects without atrial fibrillation, subjects with atrial fibrillation had a longer stay (5.8 ± 2.4 vs 4.4 ± 1.2 days, P< .001), more days receiving mechanical ventilation (P=.002) and oxygen therapy (P< .001), and higher rates of readmission to the intensive care unit (4.6% vs 0.2%, P< .001). Subjects with atrial fibrillation also had more laboratory tests (P< .001) and more days receiving cardiac drugs, heparin, diuretics, and electrolytes. Subjects with atrial fibrillation had higher total postoperative charges ($57261 ± $17 101 vs $50905 ± $10062, P= .001), a mean difference of $6356. The mean differences were greatest for bed charges ($1642), laboratory charges ($1215), pharmacy ($989), and respiratory care ($582). Conclusion The economic impact of atrial fibrillation after coronary artery bypass grafting has been underestimated. PMID:12022486

Dynamic Resource Management for Parallel Tasks in an Oversubscribed Energy-Constrained Heterogeneous Environment

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

Imam, Neena; Koenig, Gregory A; Machovec, Dylan

2016-01-01

Abstract: The worth of completing parallel tasks is modeled using utility functions, which monotonically-decrease with time and represent the importance and urgency of a task. These functions define the utility earned by a task at the time of its completion. The performance of such a system is measured as the total utility earned by all completed tasks over some interval of time (e.g., 24 hours). To maximize system performance when scheduling dynamically arriving parallel tasks onto a high performance computing (HPC) system that is oversubscribed and energy-constrained, we have designed, analyzed, and compared different heuristic techniques. Four utility-aware heuristics (i.e.,more » Max Utility, Max Utility-per-Time, Max Utility-per-Resource, and Max Utility-per-Energy), three FCFS-based heuristics (Conservative Backfilling, EASY Backfilling, and FCFS with Multiple Queues), and a Random heuristic were examined in this study. A technique that is often used with the FCFS-based heuristics is the concept of a permanent reservation. We compare the performance of permanent reservations with temporary place-holders to demonstrate the advantages that place-holders can provide. We also present a novel energy filtering technique that constrains the maximum energy-per-resource used by each task. We conducted a simulation study to evaluate the performance of these heuristics and techniques in an energy-constrained oversubscribed HPC environment. With place-holders, energy filtering, and dropping tasks with low potential utility, our utility-aware heuristics are able to significantly outperform the existing FCFS-based techniques.« less

Impact of Lumbar Fusion on Health Care Resource Utilization.

PubMed

Mina, Curtis; Carreon, Leah Y; Glassman, Steven D

2016-02-01

A longitudinal cohort. The aim of this study was to determine the extent of health care resource utilization decrease 2 years after lumbar spinal fusion. Despite the assumption that surgery will minimize the need for ongoing nonsurgical treatment, the impact of lumbar fusion on subsequent health care resource utilization has not been effectively studied. Patients who had continuous coverage by a major insurer during the year before decompression and posterolateral instrumented spinal fusion, and the 2 and a half years following were identified. All charges processed during this time-period were collected. Charges associated with the index surgery, the 90-day postoperative period, and those unrelated to spinal care were excluded. Associations with Oswestry Disability Index (ODI) score improvement at 2 years after surgery and health care resource utilization were determined. Sixty-six patients were included in the analysis. The mean age was 59 years and 39% were males. There was a decrease in health care utilization costs 1 year after surgery ($3267.59) compared with pre-op ($4246.32), but this was not statistically significant (P = 0.197). There was a statistically significant decrease in costs during the second year after surgery ($1420.97) compared with either pre-op (P = 0.000) or 1-year costs (P = 0.001). No statistically significant correlations could be found between change in ODI scores and costs incurred at either year post-op. Health care utilization decreased at 1 year and significantly at 2 years after lumbar fusion. However, there was no correlation between use of nonsurgical resources and clinical outcome based on ODI scores. This raises the question as to whether these resources were used in a rational manner. This cooperative study between a major insurer and a tertiary spine center provides improved insight into the cost profile of lumbar fusion surgery. Further study is needed to determine whether ongoing post-op treatment is necessary or simply established practice. 2.

Decentralization and equity of resource allocation: evidence from Colombia and Chile.

PubMed Central

Bossert, Thomas J.; Larrañaga, Osvaldo; Giedion, Ursula; Arbelaez, José Jesus; Bowser, Diana M.

2003-01-01

OBJECTIVE: To investigate the relation between decentralization and equity of resource allocation in Colombia and Chile. METHODS: The "decision space" approach and analysis of expenditures and utilization rates were used to provide a comparative analysis of decentralization of the health systems of Colombia and Chile. FINDINGS: Evidence from Colombia and Chile suggests that decentralization, under certain conditions and with some specific policy mechanisms, can improve equity of resource allocation. In these countries, equitable levels of per capita financial allocations at the municipal level were achieved through different forms of decentralization--the use of allocation formulae, adequate local funding choices and horizontal equity funds. Findings on equity of utilization of services were less consistent, but they did show that increased levels of funding were associated with increased utilization. This suggests that improved equity of funding over time might reduce inequities of service utilization. CONCLUSION: Decentralization can contribute to, or at least maintain, equitable allocation of health resources among municipalities of different incomes. PMID:12751417

Incremental healthcare resource utilization and costs in US patients with Cushing's disease compared with diabetes mellitus and population controls.

PubMed

Broder, Michael S; Neary, Maureen P; Chang, Eunice; Ludlam, William H

2015-12-01

Resource utilization and costs in Cushing's disease (CD) patients have not been studied extensively. We compared CD patients with diabetes mellitus (DM) patients and population-based controls to characterize differences in utilization and costs. Using 2008-2012 MarketScan® database, we identified three patient groups: (1) CD patients; (2) DM patients; and (3) population-based control patients without CD. DM and control patients were matched to CD patients by age, gender, region, and review year in a 2:1 ratio. Outcomes included annual healthcare resource utilization and costs. There were 1852 CD patients, 3704 DM patients and 3704 controls. Mean age was 42.9 years; 78.2 % were female. CD patients were hospitalized more frequently (19.3 %) than DM patients (11.0 %, p < .001) or controls (5.6 %, p < .001). CD patients visited the ED more frequently (25.4 %) than DM patients (21.1 %, p < .001) or controls (14.3 %, p < .001). CD patients had more office visits than DM patients (19.1 vs. 10.7, p < .001) or controls (7.1, p < .001). CD patients on average filled more prescriptions than DM patients (51.7 vs. 42.7, p < .001) or controls (20.5, p < .001). Mean total healthcare costs for CD patients were $26,269 versus $12,282 for DM patients (p < .001) and $5869 for controls (p < .001). CD patients had significantly higher annual rates of healthcare resource utilization compared to matched DM patients and population controls without CD. CD patient costs were double DM costs and quadruple control costs. This study puts into context the additional burdens of CD over DM, a common, chronic endocrine condition affecting multiple organ systems, and population controls.

An element search ant colony technique for solving virtual machine placement problem

NASA Astrophysics Data System (ADS)

Srija, J.; Rani John, Rose; Kanaga, Grace Mary, Dr.

2017-09-01

The data centres in the cloud environment play a key role in providing infrastructure for ubiquitous computing, pervasive computing, mobile computing etc. This computing technique tries to utilize the available resources in order to provide services. Hence maintaining the resource utilization without wastage of power consumption has become a challenging task for the researchers. In this paper we propose the direct guidance ant colony system for effective mapping of virtual machines to the physical machine with maximal resource utilization and minimal power consumption. The proposed algorithm has been compared with the existing ant colony approach which is involved in solving virtual machine placement problem and thus the proposed algorithm proves to provide better result than the existing technique.

Effects of adjusting cropping systems on utilization efficiency of climatic resources in Northeast China under future climate scenarios

NASA Astrophysics Data System (ADS)

Guo, Jianping; Zhao, Junfang; Xu, Yanhong; Chu, Zheng; Mu, Jia; Zhao, Qian

Quantitatively evaluating the effects of adjusting cropping systems on the utilization efficiency of climatic resources under climate change is an important task for assessing food security in China. To understand these effects, we used daily climate variables obtained from the regional climate model RegCM3 from 1981 to 2100 under the A1B scenario and crop observations from 53 agro-meteorological experimental stations from 1981 to 2010 in Northeast China. Three one-grade zones of cropping systems were divided by heat, water, topography and crop-type, including the semi-arid areas of the northeast and northwest (III), the one crop area of warm-cool plants in semi-humid plain or hilly regions of the northeast (IV), and the two crop area in irrigated farmland in the Huanghuaihai Plain (VI). An agro-ecological zone model was used to calculate climatic potential productivities. The effects of adjusting cropping systems on climate resource utilization in Northeast China under the A1B scenario were assessed. The results indicated that from 1981 to 2100 in the III, IV and VI areas, the planting boundaries of different cropping systems in Northeast China obviously shifted toward the north and the east based on comprehensively considering the heat and precipitation resources. However, due to high temperature stress, the climatic potential productivity of spring maize was reduced in the future. Therefore, adjusting the cropping system is an effective way to improve the climatic potential productivity and climate resource utilization. Replacing the one crop in one year model (spring maize) by the two crops in one year model (winter wheat and summer maize) significantly increased the total climatic potential productivity and average utilization efficiencies. During the periods of 2011-2040, 2041-2070 and 2071-2100, the average total climatic potential productivities of winter wheat and summer maize increased by 9.36%, 11.88% and 12.13% compared to that of spring maize, respectively. Additionally, compared with spring maize, the average utilization efficiencies of thermal resources of winter wheat and summer maize dramatically increased by 9.2%, 12.1% and 12.0%, respectively. The increases in the average utilization efficiencies of precipitation resources of winter wheat and summer maize were 1.78 kg hm-2 mm-1, 2.07 kg hm-2 mm-1 and 1.92 kg hm-2 mm-1 during 2011-2040, 2041-2070 and 2071-2100, respectively. Our findings highlight that adjusting cropping systems can dominantly contribute to utilization efficiency increases of agricultural climatic resources in Northeast China in the future.

In-Situ Resource Utilization for Space Exploration: Resource Processing, Mission-Enabling Technologies, and Lessons for Sustainability on Earth and Beyond

NASA Technical Reports Server (NTRS)

Hepp, A. F.; Palaszewski, B. A.; Landis, G. A.; Jaworske, D. A.; Colozza, A. J.; Kulis, M. J.; Heller, R. S.

2015-01-01

As humanity begins to reach out into the solar system, it has become apparent that supporting a human or robotic presence in transit andor on station requires significant expendable resources including consumables (to support people), fuel, and convenient reliable power. Transporting all necessary expendables is inefficient, inconvenient, costly, and, in the final analysis, a complicating factor for mission planners and a significant source of potential failure modes. Over the past twenty-five years, beginning with the Space Exploration Initiative, researchers at the NASA Glenn Research Center (GRC), academic collaborators, and industrial partners have analyzed, researched, and developed successful solutions for the challenges posed by surviving and even thriving in the resource limited environment(s) presented by near-Earth space and non-terrestrial surface operations. In this retrospective paper, we highlight the efforts of the co-authors in resource simulation and utilization, materials processing and consumable(s) production, power systems and analysis, fuel storage and handling, propulsion systems, and mission operations. As we move forward in our quest to explore space using a resource-optimized approach, it is worthwhile to consider lessons learned relative to efficient utilization of the (comparatively) abundant natural resources and improving the sustainability (and environment) for life on Earth. We reconsider Lunar (and briefly Martian) resource utilization for potential colonization, and discuss next steps moving away from Earth.

In-Situ Resource Utilization for Space Exploration: Resource Processing, Mission-Enabling Technologies, and Lessons for Sustainability on Earth and Beyond

NASA Technical Reports Server (NTRS)

Hepp, A. F.; Palaszewski, B. A.; Landis, G. A.; Jaworske, D. A.; Colozza, A. J.; Kulis, M. J.; Heller, Richard S.

2014-01-01

As humanity begins to reach out into the solar system, it has become apparent that supporting a human or robotic presence in transit and/or on station requires significant expendable resources including consumables (to support people), fuel, and convenient reliable power. Transporting all necessary expendables is inefficient, inconvenient, costly, and, in the final analysis, a complicating factor for mission planners and a significant source of potential failure modes. Over the past twenty-five years, beginning with the Space Exploration Initiative, researchers at the NASA Glenn Research Center (GRC), academic collaborators, and industrial partners have analyzed, researched, and developed successful solutions for the challenges posed by surviving and even thriving in the resource limited environment(s) presented by near-Earth space and non-terrestrial surface operations. In this retrospective paper, we highlight the efforts of the co-authors in resource simulation and utilization, materials processing and consumable(s) production, power systems and analysis, fuel storage and handling, propulsion systems, and mission operations. As we move forward in our quest to explore space using a resource-optimized approach, it is worthwhile to consider lessons learned relative to efficient utilization of the (comparatively) abundant natural resources and improving the sustainability (and environment) for life on Earth. We reconsider Lunar (and briefly Martian) resource utilization for potential colonization, and discuss next steps moving away from Earth.

Cost and resource utilization in cervical cancer management: a real-world retrospective cost analysis.

PubMed

Cromwell, I; Ferreira, Z; Smith, L; van der Hoek, K; Ogilvie, G; Coldman, A; Peacock, S J

2016-02-01

We set out to assess the health care resource utilization and cost of cervical cancer from the perspective of a single-payer health care system. Retrospective observational data for women diagnosed with cervical cancer in British Columbia between 2004 and 2009 were analyzed to calculate patient-level resource utilization patterns from diagnosis to death or 5-year discharge. Domains of resource use within the scope of this cost analysis were chemotherapy, radiotherapy, and brachytherapy administered by the BC Cancer Agency; resource utilization related to hospitalization and outpatient visits as recorded by the B.C. Ministry of Health; medically required services billed under the B.C. Medical Services Plan; and prescriptions dispensed under British Columbia's health insurance programs. Unit costs were applied to radiotherapy and brachytherapy, producing per-patient costs. The mean cost per case of treating cervical cancer in British Columbia was $19,153 (standard error: $3,484). Inpatient hospitalizations, at 35%, represented the largest proportion of the total cost (95% confidence interval: 32.9% to 36.9%). Costs were compared for subgroups of the total cohort. As health care systems change the way they manage, screen for, and prevent cervical cancer, cost-effectiveness evaluations of the overall approach will require up-to-date data for resource utilization and costs. We provide information suitable for such a purpose and also identify factors that influence costs.

Information-seeking behavior and the use of online resources: a snapshot of current health sciences faculty.

PubMed

De Groote, Sandra L; Shultz, Mary; Blecic, Deborah D

2014-07-01

The research assesses the information-seeking behaviors of health sciences faculty, including their use of online databases, journals, and social media. A survey was designed and distributed via email to 754 health sciences faculty at a large urban research university with 6 health sciences colleges. Twenty-six percent (198) of faculty responded. MEDLINE was the primary database utilized, with 78.5% respondents indicating they use the database at least once a week. Compared to MEDLINE, Google was utilized more often on a daily basis. Other databases showed much lower usage. Low use of online databases other than MEDLINE, link-out tools to online journals, and online social media and collaboration tools demonstrates a need for meaningful promotion of online resources and informatics literacy instruction for faculty. Library resources are plentiful and perhaps somewhat overwhelming. Librarians need to help faculty discover and utilize the resources and tools that libraries have to offer.

Assessing In-Hospital Outcomes and Resource Utilization After Primary Total Joint Arthroplasty Among Underweight Patients.

PubMed

Anoushiravani, Afshin A; Sayeed, Zain; Chambers, Monique C; Gilbert, Theodore J; Scaife, Steven L; El-Othmani, Mouhanad M; Saleh, Khaled J

2016-07-01

Poor nutritional status is a preventable condition frequently associated with low body mass index (BMI). The purpose of this study is to comparatively analyze low (≤19 kg/m(2)) and normal (19-24.9 kg/m(2)) BMI cohorts, examining if a correlation between BMI, postoperative outcomes, and resource utilization exists. Discharge data from the 2006-2012 National Inpatient Sample were used for this study. A total of 3550 total hip arthroplasty (THA) and 1315 total knee arthroplasty (TKA) patient samples were divided into 2 cohorts, underweight (≤19 kg/m(2)) and normal BMI (19-24.9 kg/m(2)). Using the Elixhauser Comorbidity Index, all cohorts were matched for 27 comorbidities. In-hospital postoperative outcomes and resource utilization among the cohorts was then comparatively analyzed. Multivariate analyses and chi-squared tests were generated using SAS software. Significance was assigned at P < .05. Underweight patients undergoing THA were at higher risk of developing postoperative anemia and sustaining cardiac complications. In addition, underweight patients had a decreased risk of developing postoperative infection. Resource utilization in terms of length of stay and hospital charge were all higher in the underweight THA cohort. Similarly, in the underweight TKA cohort, a greater risk for the development of hematoma/seroma and postoperative anemia was observed. Underweight TKA patients incurred higher hospital charge and were more likely to be discharged to skilled nursing facilities. Our results indicate that low-BMI patients were more likely to have postoperative complications and greater resource utilization. This serves a purpose in allowing orthopedic surgeons to better predict patient outcomes and improve treatment pathways designed toward helping various patient demographics. Copyright © 2016 Elsevier Inc. All rights reserved.

Plant genotypic diversity reduces the rate of consumer resource utilization

PubMed Central

McArt, Scott H.; Thaler, Jennifer S.

2013-01-01

While plant species diversity can reduce herbivore densities and herbivory, little is known regarding how plant genotypic diversity alters resource utilization by herbivores. Here, we show that an invasive folivore—the Japanese beetle (Popillia japonica)—increases 28 per cent in abundance, but consumes 24 per cent less foliage in genotypic polycultures compared with monocultures of the common evening primrose (Oenothera biennis). We found strong complementarity for reduced herbivore damage among plant genotypes growing in polycultures and a weak dominance effect of particularly resistant genotypes. Sequential feeding by P. japonica on different genotypes from polycultures resulted in reduced consumption compared with feeding on different plants of the same genotype from monocultures. Thus, diet mixing among plant genotypes reduced herbivore consumption efficiency. Despite positive complementarity driving an increase in fruit production in polycultures, we observed a trade-off between complementarity for increased plant productivity and resistance to herbivory, suggesting costs in the complementary use of resources by plant genotypes may manifest across trophic levels. These results elucidate mechanisms for how plant genotypic diversity simultaneously alters resource utilization by both producers and consumers, and show that population genotypic diversity can increase the resistance of a native plant to an invasive herbivore. PMID:23658201

Plant genotypic diversity reduces the rate of consumer resource utilization.

PubMed

McArt, Scott H; Thaler, Jennifer S

2013-07-07

While plant species diversity can reduce herbivore densities and herbivory, little is known regarding how plant genotypic diversity alters resource utilization by herbivores. Here, we show that an invasive folivore--the Japanese beetle (Popillia japonica)--increases 28 per cent in abundance, but consumes 24 per cent less foliage in genotypic polycultures compared with monocultures of the common evening primrose (Oenothera biennis). We found strong complementarity for reduced herbivore damage among plant genotypes growing in polycultures and a weak dominance effect of particularly resistant genotypes. Sequential feeding by P. japonica on different genotypes from polycultures resulted in reduced consumption compared with feeding on different plants of the same genotype from monocultures. Thus, diet mixing among plant genotypes reduced herbivore consumption efficiency. Despite positive complementarity driving an increase in fruit production in polycultures, we observed a trade-off between complementarity for increased plant productivity and resistance to herbivory, suggesting costs in the complementary use of resources by plant genotypes may manifest across trophic levels. These results elucidate mechanisms for how plant genotypic diversity simultaneously alters resource utilization by both producers and consumers, and show that population genotypic diversity can increase the resistance of a native plant to an invasive herbivore.

Impact of solifenacin on resource utilization, work productivity and health utility in overactive bladder patients switching from tolterodine ER.

PubMed

Zinner, Norman; Noe, Les; Rasouliyan, Lawrence; Marshall, Thomas; Seifeldin, Raafat

2008-06-01

Assess changes in resource utilization, work and activity impairment, and health utility among OAB patients continuing to have urgency symptoms with tolterodine ER 4 mg and willing to try solifenacin 5/10 mg. This was an open-label, non-comparative, flexible-dosing, multicenter, 12-week study assessing the efficacy and safety of solifenacin 5/10 mg/day. Patients receiving tolterodine ER 4 mg/day for >/=4 weeks but continuing to experience residual urgency symptoms (>/=3 urgency episodes/24 h) were enrolled into the study. After a 14-day washout, patients began treatment with solifenacin 5 mg/day with dosing adjustments allowed at Weeks 4 and 8. Outcomes were assessed using the Work Productivity and Activity Impairment Questionnaire - Specific Health Problem (WPAI-SHP), Health Utilities Index (HUI), and a resource utilization questionnaire administered at Pre-Washout and Week 12. Patients (n=440) reported significantly fewer physician office visits (p<0.0001), UTIs (p<0.0001), and pads/diapers (p=0.0009) during the study period while receiving solifenacin 5/10 mg/day, compared with the Pre-Washout period when receiving tolterodine ER 4 mg/day. After 12 weeks of treatment with solifenacin 5/10 mg/day, patients reported a reduction in work time missed (p=0.0017), less impairment while working (p<0.0001), less overall work impairment (p<0.0001) and a reduction in activity impairment (p<0.0001) compared to Pre-Washout. There was no significant difference in health utility scores. Treatment-emergent adverse events were mostly anticholinergic in nature, and were mild to moderate in severity. Overall, solifenacin 5/10 mg/day improved work productivity, activity participation, and reduced medical care use in OAB patients who continued to have urgency symptoms with tolterodine ER 4 mg/day and wished to switch to solifenacin 5/10 mg. This was an open-label, non-comparative study; therefore, further research is needed to confirm these results.

Assessment and comparison of three high-aluminum fly ash utilization scenarios in Inner Mongolia, China using an eco-efficiency indicator.

PubMed

Yang, Shuo; Lin, Ling; Li, Shao Peng; Li, Qiang; Wang, Xiu Teng; Sun, Liang

2017-05-01

Utilization of fly ash is of great importance in China in the context of resource and environmental crises. Different fly ash utilization processes are proposed, and some have been practically applied. However, none of these fly ash utilization pathways has been evaluated comprehensively by integrating both environmental and economic perspectives. In this study, three high-aluminum fly ash utilization methods in Mongolia were assessed and compared based on the concept of eco-efficiency. The environmental assessment was conducted in accordance with life-cycle assessment principles, and a monetization-weighting approach was applied to obtain social willingness-to-pay as a reflection of environmental impact. The environmental assessment results revealed that the reuse of fly ash had significant advantage for saving primary resource, while solid waste, depletion of water, and global warming were the three highest environmental impacts from the life cycle perspective. The economic performance assessment showed positive net profits for fly ash utilization, but high value-added products were not necessarily indicative of better economic performance due to the relatively high operation cost. Comparison of the eco-efficiency indicators (EEIs) implied that the process of scenario 1#, which produced mullite ceramic and active calcium silicate, was the most recommended out of the three scenarios on the present scale. This judgment was consistent with the evaluation of the resource utilization rate. The present study showed that the EEI could be used to compare different fly ash utilization processes in a comprehensive and objective manner, thus providing definitive and insightful suggestions for decision-making and technical improvement.

Load Forecasting in Electric Utility Integrated Resource Planning

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

Carvallo, Juan Pablo; Larsen, Peter H.; Sanstad, Alan H

Integrated resource planning (IRP) is a process used by many vertically-integrated U.S. electric utilities to determine least-cost/risk supply and demand-side resources that meet government policy objectives and future obligations to customers and, in many cases, shareholders. Forecasts of energy and peak demand are a critical component of the IRP process. There have been few, if any, quantitative studies of IRP long-run (planning horizons of two decades) load forecast performance and its relationship to resource planning and actual procurement decisions. In this paper, we evaluate load forecasting methods, assumptions, and outcomes for 12 Western U.S. utilities by examining and comparing plansmore » filed in the early 2000s against recent plans, up to year 2014. We find a convergence in the methods and data sources used. We also find that forecasts in more recent IRPs generally took account of new information, but that there continued to be a systematic over-estimation of load growth rates during the period studied. We compare planned and procured resource expansion against customer load and year-to-year load growth rates, but do not find a direct relationship. Load sensitivities performed in resource plans do not appear to be related to later procurement strategies even in the presence of large forecast errors. These findings suggest that resource procurement decisions may be driven by other factors than customer load growth. Our results have important implications for the integrated resource planning process, namely that load forecast accuracy may not be as important for resource procurement as is generally believed, that load forecast sensitivities could be used to improve the procurement process, and that management of load uncertainty should be prioritized over more complex forecasting techniques.« less

Healthcare resource utilization with ixazomib or placebo plus lenalidomide-dexamethasone in the randomized, double-blind, phase 3 TOURMALINE-MM1 study in relapsed/refractory multiple myeloma.

PubMed

Hari, Parameswaran; Lin, Huamao Mark; Zhu, Yanyan; Berg, Deborah; Richardson, Paul G; Moreau, Philippe

2018-05-29

The aim of this analysis was to assess healthcare resource utilization in the pivotal phase 3 TOURMALINE-MM1 study of the oral proteasome inhibitor ixazomib or placebo plus lenalidomide and dexamethasone (Rd) in relapsed and/or refractory multiple myeloma (RRMM). In this double-blind, placebo-controlled, randomized study (NCT01564537), 722 patients with RRMM following 1-3 prior lines of therapy received Rd plus ixazomib (ixazomib-Rd; n = 360) or matching placebo (placebo-Rd; n = 362) until disease progression or unacceptable toxicity. Healthcare resource utilization data were captured on Day 1 of each 28-day cycle, every 4 weeks during follow-up for progression-free survival, and every 12 weeks during subsequent follow-up, and included medical encounters (length of stay, inpatient, outpatient, and reason) and number of missing days from work or other activities for patients and caregivers. Exposure-adjusted rates of hospitalization were similar between the ixazomib-Rd and placebo-Rd arms, at 0.530 and 0.564 per patient year (ppy), respectively, as were outpatient visit rates (3.305 and 3.355 ppy). Mean length of hospitalization per patient was 10.0 and 10.8 days, respectively. In both arms, hospitalization and outpatient visit rates were higher in patients with two or three prior lines of treatment (ixazomib-Rd: 0.632 and 3.909 ppy; placebo-Rd: 0.774 and 3.539 ppy) compared with patients with one prior line (ixazomib-Rd: 0.460 and 2.888 ppy; placebo-Rd: 0.436 and 3.243 ppy). Patients and their caregivers who missed any work or other activity missed a median of 7 and 5 days in the ixazomib-Rd arm, respectively, vs 8 and 4 days with placebo-Rd. The study was not powered for a statistical comparison of healthcare resource utilization between treatment arms, nor did it capture costs associated with utilization of the identified healthcare resources. This pre-specified analysis demonstrated that the all-oral triplet regimen of ixazomib added to Rd did not increase healthcare resource utilization compared with placebo-Rd.

Ecological distinctions between sympatric species of Saguinus and Sciurus.

PubMed

Garber, P A; Sussman, R W

1984-10-01

Tamarins are small New World monkeys that have been described as "squirrellike." Squirrels, along with bats and birds, are the taxa most likely to utilize resources similar to those used by primates in the tropical forest canopy. In this paper we compare differences in ecology, diet, locomotion, and habitat utilization between sympatric populations of tamarins (Saguinus oedipus) and tree squirrels (Sciurus granatensis) in Panama. Data presented indicate that although there is some degree of resource overlap, patterns of habitat utilization differ significantly. Rather than being "squirrellike," the Panamanian tamarin exhibits a pattern of locomotor and feeding behavior consistent with that found in other arboreal primates.

Survey of resource opportunities and critical evaluation of economic requirements

NASA Technical Reports Server (NTRS)

Clark, Benton C.

1991-01-01

A series of mission analyses were performed to evaluate human mission to Mars and the moon with and without the aid of planetary resource utilization. The types of trade studies that are considered include the use of resources to manufacture propellant, food, habitat atmospheric gases, and lander habitat structure. Also, the potential for export of resources from the moon, Mars, Phobos, Deimos, and selected asteroids is also examined. In all cases, mass leveraging is evaluated. For certain cases, economic factors are evaluated as well. It is concluded that some uses are highly leveraging on the mission, whereas others have lesser impact and, therefore, should be afforded lesser priority in resource utilization studies. This survey is made with a consistent set of scaling laws for spacecraft propulsion and habitation systems and subsystems, and therefore, provides a rational basis for comparing different resource locations and use strategies.

An Examination of Resource Allocation Strategies That Promote Student Achievement: Case Studies of Rural Elementary Schools in Hawaii

ERIC Educational Resources Information Center

Acopan-Tuasivi, C. K.

2012-01-01

This study presents case studies of rural elementary schools in Hawaii that examine resource allocation strategies that promote student achievement. The combined frame work of the Evidence Based Model (Odden & Picus, 2008) and the 10 Strategies for Doubling Student Performance (Odden, 2009) were utilized to compare actual school resources and…

Health care resource utilization and characteristics of patients with eosinophilic asthma in secondary health care in Finland.

PubMed

Mäkelä, Mika J; Christensen, Helene Nordahl; Karlsson, Antti; Rastogi, Sarang; Kettunen, Kirsi

2018-01-01

Background : Eosinophilic airway inflammation is common in asthma patients and appears to be associated with severe exacerbations and loss of asthma control. Objective : To describe the resource utilization and clinical characteristics of patients with eosinophilic asthma. Design : Asthma patients ≥18 years with ≥1 blood eosinophil count in secondary care (South West Finland) during 2003‒2013 were included. Clinical characteristics (age, lung function, body mass index, and comorbidities) and asthma-related resource utilization (hospital admissions, outpatient visits, and emergency room [ER] visits) were retrieved. Resource utilization rates were compared for patients with blood eosinophil ≤ or >300 cells/μL, using adjusted negative binomial regression models. Results : Overall, 4,357 eligible patients were identified (mean age 60 years, females 68%), of which 1,927 (44%) had >300 eosinophil cells/μL blood. Patients with ≤300 and >300 eosinophil counts, exhibited similar clinical characteristics, including advanced age, poor lung function, and overweight. Comorbidities such as pneumonia, sinusitis, and nasal polyps, were more frequent among those with >300 eosinophil cells/μL blood compared with patients with lower counts. Eosinophil counts >300 cells/μL were associated with greater hospital admissions (rate ratio [RR] [95% confidence interval CI]: 1.13 [1.02;1.24]) and outpatient visits (RR [95% CI]: 1.11 [1.03;1.20]) compared with patients with lower eosinophil counts. Rates of ER visits were similar between the patient groups (RR [95% CI]: 0.99 [0.87;1.12]). Conclusions : Hospital admissions and outpatient visits occurred more often for patients with eosinophil counts >300 cells/µL, than for patients with lower eosinophil counts. Routine blood eosinophil screening might be useful to identify patients with an eosinophilic phenotype eligible for more targeted treatments.

Variables Associated With Inpatient and Outpatient Resource Utilization Among Medicare Beneficiaries With Nonalcoholic Fatty Liver Disease With or Without Cirrhosis.

PubMed

Sayiner, Mehmet; Otgonsuren, Munkhzul; Cable, Rebecca; Younossi, Issah; Afendy, Mariam; Golabi, Pegah; Henry, Linda; Younossi, Zobair M

2017-03-01

Nonalcoholic fatty liver disease (NAFLD) is one of the leading causes of chronic liver disease worldwide with tremendous clinical burden. The economic burden of NAFLD is not well studied. To assess the economic burden of NAFLD. Medicare beneficiaries (January 1, 2010 to December 31, 2010) with NAFLD diagnosis by International Classification of Diseases, Ninth Revision codes in the absence of other liver diseases were selected. Inpatient and outpatient resource utilization parameters were total charges and total provider payments. NAFLD patients with compensated cirrhosis (CC) were compared with decompensated cirrhosis (DC). A total of 976 inpatients and 4742 outpatients with NAFLD were included-87% were white, 36% male, 30% had cardiovascular disease (CVD) or metabolic syndrome conditions, and 12% had cirrhosis. For inpatients, median total hospital charge was $36,289. NAFLD patients with cirrhosis had higher charges and payments than noncirrhotic NAFLD patients ($61,151 vs. $33,863 and $18,804 vs. $10,146, P<0.001). Compared with CC, NAFLD patients with DC had higher charges and payments (P<0.02). For outpatients, median total charge was $9,011. NAFLD patients with cirrhosis had higher charges and payments than noncirrhotic NAFLD patients ($12,049 vs. $8,830 and $2,586 vs. $1,734, P<0.001). Compared with CC, DC patients had higher total charges ($15,187 vs. $10,379, P=0.04). In multivariate analysis, variables associated with increased inpatient resource utilization were inpatient mortality, DC, and CVD; for outpatients, having CVD, obesity, and hypertension (all P<0.001). NAFLD is associated with significant economic burden to Medicare. Presence of cirrhosis and CVD are associated with increased resource utilization.

Variables Associated With Inpatient and Outpatient Resource Utilization Among Medicare Beneficiaries With Nonalcoholic Fatty Liver Disease With or Without Cirrhosis

PubMed Central

Sayiner, Mehmet; Otgonsuren, Munkhzul; Cable, Rebecca; Younossi, Issah; Afendy, Mariam; Golabi, Pegah; Henry, Linda

2017-01-01

Background: Nonalcoholic fatty liver disease (NAFLD) is one of the leading causes of chronic liver disease worldwide with tremendous clinical burden. The economic burden of NAFLD is not well studied. Goal: To assess the economic burden of NAFLD. Study: Medicare beneficiaries (January 1, 2010 to December 31, 2010) with NAFLD diagnosis by International Classification of Diseases, Ninth Revision codes in the absence of other liver diseases were selected. Inpatient and outpatient resource utilization parameters were total charges and total provider payments. NAFLD patients with compensated cirrhosis (CC) were compared with decompensated cirrhosis (DC). Results: A total of 976 inpatients and 4742 outpatients with NAFLD were included—87% were white, 36% male, 30% had cardiovascular disease (CVD) or metabolic syndrome conditions, and 12% had cirrhosis. For inpatients, median total hospital charge was $36,289. NAFLD patients with cirrhosis had higher charges and payments than noncirrhotic NAFLD patients ($61,151 vs. $33,863 and $18,804 vs. $10,146, P<0.001). Compared with CC, NAFLD patients with DC had higher charges and payments (P<0.02). For outpatients, median total charge was $9,011. NAFLD patients with cirrhosis had higher charges and payments than noncirrhotic NAFLD patients ($12,049 vs. $8,830 and $2,586 vs. $1,734, P<0.001). Compared with CC, DC patients had higher total charges ($15,187 vs. $10,379, P=0.04). In multivariate analysis, variables associated with increased inpatient resource utilization were inpatient mortality, DC, and CVD; for outpatients, having CVD, obesity, and hypertension (all P<0.001). Conclusions: NAFLD is associated with significant economic burden to Medicare. Presence of cirrhosis and CVD are associated with increased resource utilization. PMID:27332747

Real-world health outcomes in adults with moderate-to-severe psoriasis in the United States: a population study using electronic health records to examine patient-perceived treatment effectiveness, medication use, and healthcare resource utilization.

PubMed

Armstrong, April W; Foster, Shonda A; Comer, Brian S; Lin, Chen-Yen; Malatestinic, William; Burge, Russel; Goldblum, Orin

2018-06-28

Little is known regarding real-world health outcomes data among US psoriasis patients, but electronic health records (EHR) that collect structured data at point-of-care may provide opportunities to investigate real-world health outcomes among psoriasis patients. Our objective was to investigate patient-perceived treatment effectiveness, patterns of medication use (duration, switching, and/or discontinuation), healthcare resource utilization, and medication costs using real-world data from psoriasis patients. Data for adults (≥18-years) with a dermatology provider-given diagnosis of psoriasis from 9/2014-9/2015 were obtained from dermatology practices using a widely used US dermatology-specific EHR containing over 500,000 psoriasis patients. Disease severity was captured by static physician's global assessment and body surface area. Patient-perceived treatment effectiveness was assessed by a pre-defined question. Treatment switching and duration were documented. Reasons for discontinuations were assessed using pre-defined selections. Healthcare resource utilization was defined by visit frequency and complexity. From 82,621 patients with psoriasis during the study period, patient-perceived treatment effectiveness was investigated in 2200 patients. The proportion of patients reporting "strongly agree" when asked if their treatment was effective was highest for biologics (73%) and those reporting treatment adherence (55%). In 16,000 patients who received oral systemics and 21,087 patients who received biologics, median treatment duration was longer for those who received biologics (160 vs. 113 days, respectively). Treatment switching was less frequent among patients on systemic monotherapies compared to those on combination therapies. The most common reason for discontinuing biologics was loss of efficacy; the most common reason for discontinuing orals was side effects. In 28,754 patients, higher disease severity was associated with increased healthcare resource utilization (increased visit frequency and complexity). When compared between treatment groups (n = 10,454), healthcare resource utilization was highest for phototherapy. Annual medication costs were higher for biologics ($21,977) than oral systemics ($3413). Real-world research using a widely implemented dermatology EHR provided valuable insights on patient perceived treatment effectiveness, patterns of medication usage, healthcare resource utilization, and medication costs for psoriasis patients in the US. This study and others utilizing EHRs for real-world research may assist clinical and payer decisions regarding the management of psoriasis.

Predictors of resource utilization in transsphenoidal surgery for Cushing disease.

PubMed

Little, Andrew S; Chapple, Kristina

2013-08-01

The short-term cost associated with subspecialized surgical care is an increasingly important metric and economic concern. This study sought to determine factors associated with hospital charges in patients undergoing transsphenoidal surgery for Cushing disease in an effort to identify the drivers of resource utilization. The authors analyzed the Nationwide Inpatient Sample (NIS) hospital discharge database from 2007 to 2009 to determine factors that influenced hospital charges in patients who had undergone transsphenoidal surgery for Cushing disease. The NIS discharge database approximates a 20% sample of all inpatient admissions to nonfederal US hospitals. A multistep regression model was developed that adjusted for patient demographics, acuity measures, comorbidities, hospital characteristics, and complications. In 116 hospitals, 454 transsphenoidal operations were performed. The mean hospital charge was $48,272 ± $32,060. A multivariate regression model suggested that the primary driver of resource utilization was length of stay (LOS), followed by surgeon volume, hospital characteristics, and postoperative complications. A 1% increase in LOS increased hospital charges by 0.60%. Patient charges were 13% lower when performed by high-volume surgeons compared with low-volume surgeons and 22% lower in large hospitals compared with small hospitals. Hospital charges were 12% lower in cases with no postoperative neurological complications. The proposed model accounted for 46% of hospital charge variance. This analysis of hospital charges in transsphenoidal surgery for Cushing disease suggested that LOS, hospital characteristics, surgeon volume, and postoperative complications are important predictors of resource utilization. These findings may suggest opportunities for improvement.

Health care resource utilization and direct medical costs for patients with schizophrenia initiating treatment with atypical versus typical antipsychotics in Tianjin, China.

PubMed

He, Xiaoning; Wu, Jing; Jiang, Yawen; Liu, Li; Ye, Wenyu; Xue, Haibo; Montgomery, William

2015-04-09

It is uncertain whether the extra acquisition costs of atypical antipsychotics over typical antipsychotics are offset by their other reduced resource use especially in hospital services in China. This study compared the psychiatric-related health care resource utilization and direct medical costs for patients with schizophrenia initiating atypical or typical antipsychotics in Tianjin, China. Data were obtained from the Tianjin Urban Employee Basic Medical Insurance database (2008-2010). Adult patients with schizophrenia with ≥1 prescription for antipsychotics after ≥90-day washout and 12-month continuous enrollment after first prescription was included. Psychiatric-related resource utilization and direct medical costs of the atypical and typical cohorts were estimated during the 12-month follow-up period. Logistic regressions, ordinary least square (OLS), and generalized linear models (GLM) were employed to estimate differences of resource utilization and costs between the two cohorts. One-to-one propensity score matching was conducted as a sensitivity analysis. 1131 patients initiating either atypical (N = 648) or typical antipsychotics (N = 483) were identified. Compared with the typical cohort, the atypical cohort had a lower likelihood of hospitalization (45.8% vs. 56.7%, P < 0.001; adjusted OR: 0.58, P < 0.001) over the follow-up period. Medication costs for the atypical cohort were higher than the typical cohort ($438 vs. $187, P < 0.001); however, their non-medication medical costs were significantly lower ($1223 vs. $1704, P < 0.001). The total direct medical costs were similar between the atypical and typical cohorts before ($1661 vs. $1892, P = 0.100) and after matching ($1711 vs. 1868, P = 0.341), consistent with the results from OLS and GLM models for matched cohorts. The atypical cohort had similar total direct medical costs compared to the typical cohort. Higher medication costs associated with atypical antipsychotics were offset by a reduction in non-medication medical costs, driven by fewer hospitalizations.

Effect of video server topology on contingency capacity requirements

NASA Astrophysics Data System (ADS)

Kienzle, Martin G.; Dan, Asit; Sitaram, Dinkar; Tetzlaff, William H.

1996-03-01

Video servers need to assign a fixed set of resources to each video stream in order to guarantee on-time delivery of the video data. If a server has insufficient resources to guarantee the delivery, it must reject the stream request rather than slowing down all existing streams. Large scale video servers are being built as clusters of smaller components, so as to be economical, scalable, and highly available. This paper uses a blocking model developed for telephone systems to evaluate video server cluster topologies. The goal is to achieve high utilization of the components and low per-stream cost combined with low blocking probability and high user satisfaction. The analysis shows substantial economies of scale achieved by larger server images. Simple distributed server architectures can result in partitioning of resources with low achievable resource utilization. By comparing achievable resource utilization of partitioned and monolithic servers, we quantify the cost of partitioning. Next, we present an architecture for a distributed server system that avoids resource partitioning and results in highly efficient server clusters. Finally, we show how, in these server clusters, further optimizations can be achieved through caching and batching of video streams.

Effect of Psychotherapy on Health Care Utilization in Children With Inflammatory Bowel Disease and Depression.

PubMed

Keerthy, Divya; Youk, Ada; Srinath, Arvind I; Malas, Nasuh; Bujoreanu, Simona; Bousvaros, Athos; Keljo, David; DeMaso, David R; Szigethy, Eva M

2016-12-01

Pediatric patients with inflammatory bowel disease (IBD) are at an increased risk of developing depression compared with community controls. Depression often negatively influences illness behaviors such as resource utilization. We sought to investigate the effects of treating depression on utilization of medical resources in depressed pediatric patients with IBD by comparing rates of health care utilization 1 year before and after psychotherapy. Two hundred seventeen subjects ages 9 to 17 years with IBD and depression received 3 months of psychotherapy for depression as part of a multicenter randomized controlled trial. Of these 217 subjects, 70 had utilization data available 1 year prior and 1 year after receiving 3 months of psychotherapy. Primary outcomes included frequency of hospitalizations, inpatient hospital days, outpatient gastrointestinal visits, and number of emergency room visits, radiological examinations, and endoscopies. Within subject analyses were completed comparing health care utilization 12 months before psychotherapy compared with the 12 months after the conclusion of psychotherapy. Fifty-one and 19 patients had CD and UC, respectively. A total of 55.7% of patients had major depression and 44.3% had minor depression. Overall, all study measures of health care utilization were significantly reduced after psychotherapy (P < 0.01)-including gastrointestinal-related (mean values) hospitalization frequency, inpatient days, outpatient visit, emergency room visits, radiological examinations, and endoscopies. Psychotherapy for comorbid depression in pediatric patients with IBD is associated with decreased GI-related health care utilization. The present study highlights the importance of screening for depression in a pediatric population with IBD, and that psychotherapy may be a reasonable adjunctive treatment for pediatric patients with IBD and comorbid depression.

Women with urinary incontinence in Spain: Health-related quality of life and the use of healthcare resources.

PubMed

Villoro, Renata; Merino, María; Hidalgo-Vega, Alvaro; Jiménez, Margarita; Martínez, Lucía; Aracil, Javier

2016-12-01

To describe Health-Related Quality of Life (HRQOL) and healthcare resource utilization in women aged 60 and over in Spain. Descriptive analysis of primary data from the Spanish National Health Survey, 2012. Utility indices were obtained through the EQ5D5L questionnaire included in the survey, and utilization rates of consultations, hospitalizations, emergency services, and medication intake. HRQOL and utilization rates were systematically compared between women diagnosed with UI, women diagnosed with other chronic conditions (OCC) and healthy women of the same age. Utility indices were 0.47 in UI women versus 0.78 and 0.96 in women diagnosed with OCC and healthy women, respectively. Each year 351,675 Quality Adjusted Life Years are lost in Spain due to UI in the population of women aged 60 and over. Resource utilization of these women was significantly higher than that of other women. UI has a larger impact on both HRQOL and healthcare consumption in women who are aged 60 and over, than OCC. Appropriate treatment of UI might entail an important gain in terms of HRQOL and a significant reduction in healthcare consumption in Spain. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Beyond perforation: Influence of peritoneal contamination on clinical severity and resource utilization in children with perforated appendicitis.

PubMed

Feng, Christina; Anandalwar, Seema; Sidhwa, Feroze; Glass, Charity; Karki, Mahima; Zurakowski, David; Rangel, Shawn J

2016-11-01

The purpose of the study was to explore the relationship between the degree of peritoneal contamination and postoperative resource utilization in children with complicated appendicitis. Intraoperative findings were collected prospectively at a single children's hospital from 2012 to 2014. The degree of peritoneal contamination was categorized as either "localized" (confined to the right lower quadrant and pelvis) or "extensive" (extending to the liver). Imaging utilization, postoperative length of stay (pLOS), hospital cost, and readmission rates were compared between groups. Of 88 patients with complicated appendicitis, 38% had extensive contamination. Preoperative characteristics were similar between groups. Patients with extensive contamination had higher rates of postoperative imaging (58.8% vs 27.7%, P<0.01), a 50% longer median pLOS (6days [IQR 4-9] vs 4days [IQR 2-5], P=0.003), a 30% higher median hospital cost ($17,663 [IQR $12,564-$23,697] vs $13,516 [IQR $10,546-$16,686], P=0.004), and a nearly four-fold higher readmission rate (20.6% vs 5.6%, P=0.04) compared to children with localized contamination. Extensive peritoneal contamination is associated with significantly higher resource utilization compared to localized contamination in children with complicated appendicitis. These findings may have important severity-adjustment implications for reimbursement and readmission rate reporting for hospitals that serve populations where late presentation is common. Copyright © 2016 Elsevier Inc. All rights reserved.

Dynamic Resource Adjustment to Provide Seamless Streaming Services on Multimedia Mobile Cellular Networks

NASA Astrophysics Data System (ADS)

Lin, Chow-Sing; Yen, Fang-Zhi

With the rapid advances in wireless network communication, multimedia presentation has become more applicable. However, due to the limited wireless network resource and the mobility of Mobile Host (MH), QoS for wireless streaming is much more difficult to maintain. How to decrease Call Dropping Probability (CDP) in multimedia traffic while still keeping acceptable Call Block Probability (CBP) without sacrificing QoS has become an significant issue in providing wireless streaming services. In this paper, we propose a novel Dynamic Resources Adjustment (DRA) algorithm, which can dynamically borrow idle reserved resources in the serving cell or the target cell for handoffing MHs to compensate the shortage of bandwidth in media streaming. The experimental simulation results show that compared with traditional No Reservation (NR), and Resource Reservation in the six neighboring cells (RR-nb), and Resource Reservation in the target cell (RR-t), our proposed DRA algorithm can fully utilize unused reserved resources to effectively decrease the CDP while still keeping acceptable CBP with high bandwidth utilization.

A population-based analysis of healthcare utilization of persons with back disorders: results from the Canadian Community Health Survey 2000-2001.

PubMed

Lim, Kim-Lian; Jacobs, Philip; Klarenbach, Scott

2006-01-15

A retrospective, population-based analysis. To analyze the utilization of a variety of healthcare services for persons with and without a chronic back disorder, and to identify factors associated with specific patterns of healthcare resource use. Although there have been studies of how chronic back disorders influence the use of specific healthcare services, we do not currently have a broad, population-based overview of how this condition influences healthcare service utilization. Person-level data were taken from the 2000-2001 Canadian Community Health Survey (CCHS), a nationwide cross-sectional survey of health determinants, health status, and health system utilization of Canadians. A series of binary logistic regressions examining healthcare resource utilization were performed on a full study sample (n = 113,229), as well as a restricted sample (n = 36,713) with attention focused on subjects with a single diagnosis of a chronic back disorder. Persons with chronic back disorders were more likely to use physician resources (multivariate odds ratio [OR] = 1.2; 95% confidence interval, 1.1-1.2), and nonphysician resources (OR range, 2.1-3.6) compared with persons without the condition, with chiropractic care having an odds ratio of 3.6 (95% confidence interval, 3.5-3.8). Higher socioeconomic status, the presence of activity-limiting pain, and depressive symptoms were associated with a significant increase in utilization of almost all healthcare services. With increasing disability as indicated by the presence of pain and functional limitations, and the presence of depressive symptoms, the higher the utilization of physician and nonphysician resources, with the exception of chiropractic care, which appears to be used by those with less severe symptoms. Lower socioeconomic status was associated with significantly lower receipt of services for almost all healthcare providers.

Differences in resource use and costs of dementia care between European countries: baseline data from the ICTUS study.

PubMed

Gustavsson, A; Jonsson, L; Rapp, T; Reynish, E; Ousset, P J; Andrieu, S; Cantet, C; Winblad, B; Vellas, B; Wimo, A

2010-10-01

This study aimed to estimate the costs of formal and informal care of patients with Alzheimer's disease, to compare care costs across European countries and identify potential differences in cost patterns between countries and regions. The ICTUS study is a prospective, naturalistic observational study conducted in specialised memory clinics in 12 European countries. In total, 1385 patients diagnosed with Alzheimer's disease were enrolled at baseline. All subjects had a reliable informant (primary caregiver) and informed consent was obtained from patients or their primary caregiver. Resource utilization data was captured with the RUD Lite (Resource Utilization in Dementia) instrument and caregiver burden with the Zarit Burden Interview (ZBI). Patient disease severity was measured with the Mini-Mental State Examination (MMSE), Alzheimer's Disease Assessment Scale-Cognitive subscale (ADAS-cog), Katz´ index (PADL), Instrumental activities of daily living (IADL) scale and Neuropsychiatric inventory (NPI). The mean annual cost of care per patient was estimated to €7,820 (95% CI: €7,194-€8,446), whereof 54% were costs of informal care, 16% direct medical costs and 30% community care costs. There were substantial differences in total resource utilization and also in the balance between formal and informal care between Northern, Western and Southern Europe. PADL scores were strongly associated with formal care costs while IADL scores correlated strongly with informal care costs. Costs of Alzheimer's disease are high across European countries. Activities of daily living is an important determinant of care costs. Formal care service use is lower and informal care higher in Southern Europe compared to Western and Northern Europe. Differences in resource utilization patterns are important to consider in international studies of dementia care costs as well as in economic evaluations of new treatments for dementia.

The efficacy and resource utilization of remifentanil and fentanyl in fast-track coronary artery bypass graft surgery: a prospective randomized, double-blinded controlled, multi-center trial.

PubMed

Cheng, D C; Newman, M F; Duke, P; Wong, D T; Finegan, B; Howie, M; Fitch, J; Bowdle, T A; Hogue, C; Hillel, Z; Pierce, E; Bukenya, D

2001-05-01

We compared (a) the perioperative complications; (b) times to eligibility for, and actual time of the following: extubation, less intense monitoring, intensive care unit (ICU), and hospital discharge; and (c) resource utilization of nursing ratio for patients receiving either a typical fentanyl/isoflurane/propofol regimen or a remifentanil/isoflurane/propofol regimen for fast-track cardiac anesthesia in 304 adults by using a prospective randomized, double-blinded, double-dummy trial. There were no differences in demographic data, or perioperative mortality and morbidity between the two study groups. The mini-mental status examination at postoperative Days 1 to 3 were similar between the two groups. The eligible and actual times for extubation, less intense monitoring, ICU discharge, and hospital discharge were not significantly different. Further analyses revealed no differences in times for extubation and resource utilization after stratification by preoperative risk scores, age, and country. The nurse/patient ratio was similar between the remifentanil/isoflurane/propofol and fentanyl/isoflu-rane/propofol groups during the initial ICU phase and less intense monitoring phase. Increasing preoperative risk scores and older age (>70 yr) were associated with longer times until extubation (eligible), ICU discharge (eligible and actual), and hospital discharge (eligible and actual). Times until extubation (eligible and actual) and less intense monitoring (eligible) were significantly shorter in Canadian patients than United States' patients. However, there was no difference in hospital length of stay in Canadian and United States' patients. We conclude that both anesthesia techniques permit early and similar times until tracheal extubation, less intense monitoring, ICU and hospital discharge, and reduced resource utilization after coronary artery bypass graft surgery. An ultra-short opioid technique was compared with a standard fast-track small-dose opioid technique in coronary artery bypass graft patients in a prospective randomized, double-blinded controlled study. The postoperative recovery and resource utilization, including stratification of preoperative risk score, age, and country, were analyzed.

Utility competition, DSM, and piano bars: The fatal flaw

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

Studness, C.M.

1993-08-01

This article is an economic analysis of demand side management (DSM). The author contends that utilities and regulators have lost sight of their primary mission of providing electric power as efficiently as possible; DSM conflicts with this mission. DSM measures have not be submitted to a market test, so utilities are not necessarily providing the customers with what they want. This situation is compared to the airline industry before deregulation, when airlines provided expensive services that customers did not want. Also, with present technology, DSM measures consume more in total resources than it what it costs to produce electricity, therebymore » depleting the nation's resources at a greater rate.« less

Decision making for multiple utilization of water resources in New Zealand

NASA Astrophysics Data System (ADS)

Memon, Pyar Ali

1989-09-01

The Clutha is the largest river in New Zealand. The last two decades have witnessed major conflicts centered on the utilization of the water resources of the upper Clutha river. These conflicts have by no means been finally resolved. The focus of this article is on institutional arrangements for water resource management on the Clutha, with particular reference to the decision-making processes that have culminated in the building of the high dam. It critically evaluates recent experiences and comments on future prospects for resolving resource use conflicts rationally through planning for multiple utilization in a climate of market led policies of the present government. The study demonstrates the inevitable conflicts that can arise within a public bureaucracy that combines dual responsibilities for policy making and operational functions. Hitherto, central government has been able to manipulate the water resource allocation process to its advantage because of a lack of clear separation between its two roles as a policy maker and developer. The conflicts that have manifested themselves during the last two decades over the Clutha should be seen as part of a wider public debate during the last two decades concerning resource utilization in New Zealand. The Clutha controversy was preceded by comparable concerns over the rising of the level of Lake Manapouri during the 1960s and has been followed by the debate over the “think big” resource development projects during the 1980s. The election of the fourth Labour government in 1983 has heralded a political and economic policy shift in New Zealand towards minimizing the role of public intervention in resource allocation and major structural reforms in the relative roles of central and regional government in resource management. The significance of these changes pose important implications for the future management of the Clutha.

Comparative study on legislation of utilization of construction wastes as resources in china and abroad

NASA Astrophysics Data System (ADS)

Wenfeng, Liu; Zhaomeng, Wang; Hongmei, Hou

2018-05-01

The dilemma of the “Building wastes Besieged City” has gradually become a national problem. Historical experience in the world shows that establishing a systematic and complete legal system is an effective way and powerful weapon to ensure the comprehensive utilization of building wastes resources. Based on the domestic conditions, the state focuses on the problems and learns from the legislation experience of Chinese and foreign construction wastes recycling laws and regulations, to design the legal system form multiple fields, multiple angles, and multiple levels as much as possible to achieve maximum environmental, social, and economic benefits. This article mainly summarizes the characteristics and outstanding experience of the legislation of the comprehensive utilization of construction wastes as resources in foreign countries, as well as the existing problems of Chinese relevant legal regulations, and provides reference for future research and implementation of relevant legislation.

A comparison of resource utilization following chemotherapy for acute myeloid leukemia in children discharged versus children that remain hospitalized during neutropenia

PubMed Central

Getz, Kelly D; Miller, Tamara P; Seif, Alix E; Li, Yimei; Huang, Yuan-Shung; Bagatell, Rochelle; Fisher, Brian T; Aplenc, Richard

2015-01-01

Comparisons of early discharge and outpatient postchemotherapy supportive care in pediatric acute myeloid leukemia (AML) patients are limited. We used data from the Pediatric Health Information System on a cohort of children treated for newly diagnosed AML to compare course-specific mortality and resource utilization in patients who were discharged after chemotherapy to outpatient management during neutropenia relative to patients who remained hospitalized. Patients were categorized at each course as early or standard discharge. Discharges within 3 days after chemotherapy completion were considered “early”. Resource utilization was determined based on daily billing data and reported as days of use per 1000 hospital days. Inpatient mortality, occurrence of intensive care unit (ICU)-level care, and duration of hospitalization were compared using logistic, log-binomial and linear regression methods, respectively. Poisson regression with inpatient days as offset was used to compare resource use by discharge status. The study population included 996 patients contributing 2358 treatment courses. Fewer patients were discharged early following Induction I (7%) than subsequent courses (22–24%). Across courses, patients discharged early experienced high readmission rates (69–84%), yet 9–12 fewer inpatient days (all P < 0.001). Inpatient mortality was low across courses and did not differ significantly by discharge status. The overall risk for ICU-level care was 116% higher for early compared to standard discharge patients (adjusted risk ratio: 2.16, 95% confidence interval: 1.50, 3.11). Rates of antibiotic, vasopressor, and supplemental oxygen use were consistently elevated for early discharge patients. Despite similar inpatient mortality to standard discharge patients, early discharge patients may be at greater risk for life-threatening chemotherapy-related complications, including infections. PMID:26105201

A Comparative Assessment of Higher Education Financing in Six Arab Countries

ERIC Educational Resources Information Center

El-Araby, Ashraf

2011-01-01

This study analyses the policies for financing higher education in six Arab countries: Egypt, Jordan, Lebanon, Morocco, Syria, and Tunisia. It assesses the adequacy of spending on higher education, the efficiency with which resources are utilized, and the equity implications of resource allocations. Based on six detailed case studies, this…

Resource Allocation in Dynamic Environments

DTIC Science & Technology

2012-10-01

Utility Curve for the TOC Camera 42 Figure 20: Utility Curves for Ground Vehicle Camera and Squad Camera 43 Figure 21: Facial - Recognition Utility...A Facial - Recognition Server (FRS) can receive images from smartphones the squads use, compare them to a local database, and then return the...fallback. In addition, each squad has the ability to capture images with a smartphone and send them to a Facial - Recognition Server in the TOC to

Productivity, Quality, and Patient Satisfaction

PubMed Central

Fairchild, David G; McLoughlin, Karen Sax; Gharib, Soheyla; Horsky, Jan; Portnow, Michelle; Richter, James; Gagliano, Nancy; Bates, David W

2001-01-01

CONTEXT Although few data are available, many believe that part-time primary care physicians (PCPs) are less productive and provide lower quality care than full-time PCPs. Some insurers exclude part-time PCPs from their provider networks. OBJECTIVE To compare productivity, qualtiy of preventive care, patient satisfaction, and risk-adjusted resource utilization of part-time and full-time PCPs. DESIGN Retrospective cohort study. SETTING Boston. PARTICIPANTS PCPs affiliated with 2 academic outpatient primary care networks. MEASUREMENTS PCP productivity, patient satisfaction, resource utilization, and compliance with screening guidelines. RESULTS Part-time PCP productivity was greater than that of full-time PCPs (2.1 work relative value units (RVUs)/bookable clinical hour versus 1.3 work RVUs/bookable clinical hour, P < .01). A similar proportion of part-time PCPs (80%) and full-time PCPs (75%) met targets for mammography, Pap smears, and cholesterol screening (P = .67). After adjusting for clinical case mix, practice location, gender, board certification status, and years in practice, resource utilization of part-time PCPs ($138 [95% confidence interval (CI), $108 to $167]) was similar to that of full-time PCPs ($139 [95% CI, $108 to $170], P = .92). Patient satisfation was similar for part-time and full-time PCPs. CONCLUSIONS In these academic primary care practices, rates of patient satisfaction, compliance with screenig guidelines, and resource utilization were similar for part-time PCPs compared to full-time PCPs. Productivity per clinical hour was markedly higher for part-time PCPs are atleast as efficient as full-time PCPs and that the quality of their work is similar. PMID:11679033

The association between use of mealtime insulin pens versus vials and healthcare charges and resource utilization in patients with type 2 diabetes: a retrospective cohort study.

PubMed

Eby, Elizabeth L; Boye, Kristina S; Lage, Maureen J

2013-10-01

To compare all-cause and diabetes-related resource utilization and healthcare charges among adults with type 2 diabetes mellitus who initiated therapy with mealtime insulin disposable pens or vials. Data were obtained from the Innovus inVision database from January 1, 2006 through June 30, 2010. Generalized linear models with a gamma distribution and log link estimated the association between medical charges and use of mealtime insulin pens vs vials in the 1 year post-index date, while generalized linear models with a negative binomial distribution estimated resource utilization. Controlling for patient characteristics, general health, and patient copayments, insulin therapy initiation with disposable pens, compared to vials, was associated with significantly fewer all-cause hospitalizations (1.45 vs. 1.66; p < 0.0001) as well as a significantly shorter hospital length of stay (2.16 days vs. 3.53 days; p < 0.0001). Pen use, compared to vials, was also associated with significantly fewer diabetes-related hospitalizations (1.36 vs. 1.47; p < 0.0001), and shorter hospital length of stay (1.12 days vs. 1.72 days; p < 0.0001). Despite higher diabetes-related drug charges ($3593 vs. $2755; p < 0.0001) associated with the use of pens, results showed significantly lower all-cause total healthcare charges ($42,150 vs. $53,340; p < 0.0001) and significantly lower diabetes-related total healthcare charges ($12,722 vs. $14,540; p < 0.0001) for patients who initiated therapy on mealtime insulin with pens compared to vials. Data were drawn from administrative claims and included only patients with medical and outpatient prescription drug benefit coverage. Hence, the results may not be generalizable. The retrospective analyses relied on diagnostic codes to identify patients, assess patient general health, and determine other values, rather than formal, clinical assessments. The analyses did not include indirect healthcare costs. The administration of mealtime insulin via disposable pens, compared to vials, was associated with a significant reduction in all-cause and diabetes-related resource utilization and total healthcare charges.

[Calculation model of urban water resources ecological footprint and its application: a case study in Shenyang City of Northeast China].

PubMed

Wang, Jian; Zhang, Chao-Xing; Yu, Ying-Tan; Li, Fa-Yun; Ma, Fang

2012-08-01

Water resources ecological footprint can directly reflect the pressure of human social and economic activities to water resources, and provide important reference for the rational utilization of water resources. Based on the existing ecological footprint models and giving full consideration of the water resources need of urban ecological system, this paper established a new calculation model of urban water resources ecological footprint, including domestic water account, process water account, public service water account, and ecological water requirement account. According to the actual situation of Shenyang City, the key parameters of the model were determined, and the water resources ecological footprint and ecological carrying capacity of the City were calculated and analyzed. From 2000 to 2009, the water resources ecological footprint per capita of the City presented an overall decreasing trend, but still had an annual ecological deficit. As compared to that in 2000, the water resources ecological footprint per capita was decreased to 0.31 hm2 in 2005, increased slightly in 2006 and 2007, and remained stable in 2008 and 2009, which suggested that the sustainable utilization of water resources in Shenyang City had definite improvement, but was still in an unsustainable development situation.

Changing Management of the Patent Ductus Arteriosus: Effect on Neonatal Outcomes and Resource Utilization.

PubMed

Chock, Valerie Y; Goel, Veena V; Palma, Jonathan P; Luh, Thomas M; Wang, Nichole A; Gaskari, Shabnam; Punn, Rajesh; Silverman, Norman H; Benitz, William E

2017-08-01

Objective  This historical cohort study investigated how a shift toward a more conservative approach of awaiting spontaneous closure of the patent ductus arteriosus (PDA) in preterm infants has affected neonatal outcomes and resource utilization. Methods  We retrospectively studied very low birth weight infants diagnosed with a PDA by echocardiogram (ECHO) in 2006-2008 (era 1), when medical or surgical PDA management was emphasized, to those born in 2010-2012 (era 2) when conservative PDA management was encouraged. Multiple regression analyses adjusted for gestational age were performed to assess differences in clinical outcomes and resource utilization between eras. Results  More infants in era 2 (35/89, 39%) compared with era 1 (22/120, 18%) had conservative PDA management ( p  < 0.01). Despite no difference in surgical ligation rate, infants in era 2 had ligation later (median 24 vs. 8 days, p  < 0.0001). There was no difference in clinical outcomes between eras, while number of ECHOs per patient was the only resource measure that increased in era 2 (median 3 vs. 2 ECHOs, p  = 0.003). Conclusion  In an era of more conservative PDA management, no increase in adverse clinical outcomes or significant change in resource utilization was found. Conservative PDA management may be a safe alternative for preterm infants. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Estimating the Value of Improved Distributed Photovoltaic Adoption Forecasts for Utility Resource Planning

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

Gagnon, Pieter; Barbose, Galen L.; Stoll, Brady

Misforecasting the adoption of customer-owned distributed photovoltaics (DPV) can have operational and financial implications for utilities; forecasting capabilities can be improved, but generally at a cost. This paper informs this decision-space by using a suite of models to explore the capacity expansion and operation of the Western Interconnection over a 15-year period across a wide range of DPV growth rates and misforecast severities. The system costs under a misforecast are compared against the costs under a perfect forecast, to quantify the costs of misforecasting. Using a simplified probabilistic method applied to these modeling results, an analyst can make a first-ordermore » estimate of the financial benefit of improving a utility’s forecasting capabilities, and thus be better informed about whether to make such an investment. For example, under our base assumptions, a utility with 10 TWh per year of retail electric sales who initially estimates that DPV growth could range from 2% to 7.5% of total generation over the next 15 years could expect total present-value savings of approximately $4 million if they could reduce the severity of misforecasting to within ±25%. Utility resource planners can compare those savings against the costs needed to achieve that level of precision, to guide their decision on whether to make an investment in tools or resources.« less

Impact of unilateral conductive hearing loss due to aural atresia on academic performance in children.

PubMed

Kesser, Bradley W; Krook, Kaelyn; Gray, Lincoln C

2013-09-01

This study evaluates the effect of unilateral conductive hearing loss secondary to aural atresia on elementary school children's academic performance. Case control survey and review of audiometric data. One hundred thirty-two surveys were mailed to families of children with aural atresia, and 48 surveys were sent to families of children with unilateral sensorineural hearing loss (SNHL) to identify rates of grade retention, use of any resource, and behavioral problems. Audiometric data of the cohort were tabulated. Of the 40 atresia patients, none repeated a grade, but 65% needed some resources: 12.5% currently use a hearing aid, 32.5% use(d) a frequency-modulated system in school, 47.5% had an Individualized Education Plan, and 45% utilized speech therapy. Compared to the unilateral SNHL group and a cohort of children with unilateral SNHL in an earlier study, children with unilateral atresia were less likely to repeat a grade. Children in both unilateral atresia and SNHL groups were more likely to utilize some resource in the academic setting compared to the unilateral SNHL children in the prior study. Unilateral conductive hearing loss due to aural atresia has an impact on academic performance in children, although not as profound when compared to children with unilateral SNHL. The majority of these children with unilateral atresia utilize resources in the school setting. Parents, educators, and health care professionals should be aware of the impact of unilateral conductive hearing loss and offer appropriate habilitative services. Copyright © 2013 The American Laryngological, Rhinological and Otological Society, Inc.

Utility and direct costs: ankylosing spondylitis compared with rheumatoid arthritis.

PubMed

Verstappen, S M M; Jacobs, J W G; van der Heijde, D M; van der Linden, Sj; Verhoef, C M; Bijlsma, J W J; Boonen, A

2007-06-01

To compare utility and disease-specific direct costs between patients with ankylosing spondylitis (AS) and patients with rheumatoid arthritis (RA) in the Netherlands. Patients with AS and those with RA completed questions on disease characteristics, the EuroQol-5D (EQ-5D) to assess utility, and questionnaire resource utilisation. Resource utilisation was assessed prospectively in AS, but retrospectively in RA. True cost estimates (2003) were used to calculate the costs. Differences in disease characteristics between AS and RA were described, and determinants of EQ-5D utility and costs were explored by Cox proportional hazard regressions. 576 patients with RA and 132 with AS completed the questionnaires. EQ-5D utility (0.63 vs 0.7) was lower, and annual direct costs higher in RA (euro5167 vs euro2574). In multivariate Cox proportional hazard regressions, there was no difference in utility between the diagnostic groups, but patients with RA incurred higher direct costs after controlling for age, gender and disease duration. In patients with RA and patients with AS, who are under the care of a rheumatologist, utility is equally reduced, but healthcare costs are higher in RA after controlling for age, gender and disease duration. These data can be helpful to provide insights into the differences and similarities between the healthcare needs of both patient groups and to identify issues for further research and for policy in healthcare organisations.

[Research on resources chemistry of Chinese medicinal materials and resources recycling utilization ways and goals and tasks].

PubMed

Duan, Jin-ao; Su, Shu-lan; Guo, Sheng; Jiang, Shu; Liu, Pei; Yan, Hui; Qian, Da-wei; Zhu, Hua-xu; Tang, Yu-ping; Wu, Qi-nan

2015-09-01

The objects of research on the resources chemistry of Chinese medicinal materials (RCCMM) are promotion of efficient production, rational utilization and improving quality of CMM and natural products. The development of TCM cause depends on the efficient utilization and sustainable development of CMM, hinges on the technologies and methods for using and discovering medicinal biological resources, stand or fall on the extension of industy chains, detailed utilizaion of resource chemical components by multi-way, multi-level. All of these may help to the recycling utilization and sound development of RCMM. In this article, five respects were discussed to the RCCMM researches and resources recycling utilization ways and goals and tasks. First, based on the principle of resource scarcity, discovering or replacing CMM resources, protecting the rare or endangered species or resources. Second, based on the multifunctionality of CMM, realizing the value-added and value compensation, and promoting the utilization efficiency through systermatic and detailed exploitation and utilization. Third, based on the resource conservation and environment-friendly, reducing raw material consumption, lowering cost, promoting recycling utilization and elevating utilization efficiency. Fourth, based on the stratege of turning harm into good, using the invasive alien biological resources by multi-ways and enriching the medicial resources. Fifth, based on the method of structure modification of chemical components, exploring and enhancing the utility value of resouces chemical substances. These data should provide references and attention for improving the utilization efficiency, promoting the development of recycling economy, and changing the mode of economic growth of agriculture and industry of CMM fundamentally.

The utilization of solar energy to help meet our nation's energy needs

NASA Technical Reports Server (NTRS)

Thomas, R. L.

1973-01-01

The nation's energy needs, domestic energy resources, and possible future energy resources are briefly discussed in this paper. Three potential solutions, coal, nuclear and solar are compared as to benefits and problems. The paper primarily discusses the options available in using solar energy as a natural energy resource. These options are discussed under the generation of electricity, heating and cooling of buildings, and the production of clean fuel.

Using Probability of Exceedance to Compare the Resource Risk of Renewable and Gas-Fired Generation

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

Bolinger, Mark

Of the myriad risks surrounding long-term investments in power plants, resource risk is one of the most difficult to mitigate, and is also perhaps the risk that most-clearly distinguishes renewable generation from natural gas-fired generation. For renewable generators like wind and solar projects, resource risk manifests as a quantity risk—i.e., the risk that the quantity of wind and insolation will be less than expected.i For gas-fired generators (i.e., a combined-cycle gas turbine or “CCGT”), resource risk manifests primarily as a price risk—i.e., the risk that natural gas will cost more than expected. Most often, resource risk—and natural gas price riskmore » in particular—falls disproportionately on utility ratepayers, who are typically not well-equipped to manage this risk. As such, it is incumbent upon utilities, regulators, and policymakers to ensure that resource risk is taken into consideration when making or approving resource decisions, or enacting policies that influence the development of the electricity sector more broadly.« less

Analysis of Water Resource Utilization Potential for Jiangsu Coastal Area ' in Nantong City

NASA Astrophysics Data System (ADS)

Ren, Li; Liu, Jin-Tao; Ni, Jian-Jun

2015-04-01

Along with the advance of the growth of population and social economy, requirements for water quality and quantity in coastal areas is getting higher and higher, but due to the uneven distribution of rainfall years and water exploitation, use and management level, the influence of the shortage of water resources is increasingly prominent, seriously restricting the social and economic sustainable development in this region. Accordingly, water resource utilization potential in Jiangsu coastal region is vital for water security in the region. Taking Nantong City as the study area, the regional water resources development and utilization status were evaluated. In this paper, the meaning of water resources, water resources development and utilization, and water resources development and utilization of the three stages of concepts such as system were discussed. Then the development and utilization of regional water resource evaluation were carried out, and the significance of regional society, economy, resources and environment and its development status quo of water resources were exploited. According to conditions and area source, an evaluation index system for development and utilization of water resources of Nantong was built up. The index layer was composed of 16 indicators. In this study, analytic hierarchy process (AHP) was used to determine of weights of indicators at all levels in the index system. Multistage fuzzy comprehensive evaluation model was selected to evaluate the water resources development and utilization status of Nantong, and then water resource utilization potential of Nantong was analyzed.

Exploring patterns in resource utilization prior to the formal identification of homelessness in recently returned veterans.

PubMed

Gundlapalli, Adi V; Redd, Andrew; Carter, Marjorie E; Palmer, Miland; Peterson, Rachel; Samore, Matthew H

2014-01-01

There are limited data on resources utilized by US Veterans prior to their identification as being homeless. We performed visual analytics on longitudinal medical encounter data prior to the official recognition of homelessness in a large cohort of OEF/OIF Veterans. A statistically significant increase in numbers of several categories of visits in the immediate 30 days prior to the recognition of homelessness was noted as compared to an earlier period. This finding has the potential to inform prediction algorithms based on structured data with a view to intervention and mitigation of homelessness among Veterans.

Knowledge Acquisition: Utilizing the Internet To Access Educational Data.

ERIC Educational Resources Information Center

Slowinski, Joseph

The information rich environment of the World Wide Web provides a wealth of opportunities for international and comparative scholars of education to access a variety of electronic resources. These resources come in the form of reports, papers, policy positions, and others, many of which are available full-text if one knows where and how to locate…

Economic Evaluation Plan (EEP) for A Very Early Rehabilitation Trial (AVERT): An international trial to compare the costs and cost-effectiveness of commencing out of bed standing and walking training (very early mobilization) within 24 h of stroke onset with usual stroke unit care.

PubMed

Sheppard, Lauren; Dewey, Helen; Bernhardt, Julie; Collier, Janice M; Ellery, Fiona; Churilov, Leonid; Tay-Teo, Kiu; Wu, Olivia; Moodie, Marj

2016-06-01

A key objective of A Very Early Rehabilitation Trial is to determine if the intervention, very early mobilisation following stroke, is cost-effective. Resource use data were collected to enable an economic evaluation to be undertaken and a plan for the main economic analyses was written prior to the completion of follow up data collection. To report methods used to collect resource use data, pre-specify the main economic evaluation analyses and report other intended exploratory analyses of resource use data. Recruitment to the trial has been completed. A total of 2,104 participants from 56 stroke units across three geographic regions participated in the trial. Resource use data were collected prospectively alongside the trial using standardised tools. The primary economic evaluation method is a cost-effectiveness analysis to compare resource use over 12 months with health outcomes of the intervention measured against a usual care comparator. A cost-utility analysis is also intended. The primary outcome in the cost-effectiveness analysis will be favourable outcome (modified Rankin Scale score 0-2) at 12 months. Cost-utility analysis will use health-related quality of life, reported as quality-adjusted life years gained over a 12 month period, as measured by the modified Rankin Scale and the Assessment of Quality of Life. Outcomes of the economic evaluation analysis will inform the cost-effectiveness of very early mobilisation following stroke when compared to usual care. The exploratory analysis will report patterns of resource use in the first year following stroke. © 2016 World Stroke Organization.

Application of cooperative and non-cooperative games in large-scale water quantity and quality management: a case study.

PubMed

Mahjouri, Najmeh; Ardestani, Mojtaba

2011-01-01

In this paper, two cooperative and non-cooperative methodologies are developed for a large-scale water allocation problem in Southern Iran. The water shares of the water users and their net benefits are determined using optimization models having economic objectives with respect to the physical and environmental constraints of the system. The results of the two methodologies are compared based on the total obtained economic benefit, and the role of cooperation in utilizing a shared water resource is demonstrated. In both cases, the water quality in rivers satisfies the standards. Comparing the results of the two mentioned approaches shows the importance of acting cooperatively to achieve maximum revenue in utilizing a surface water resource while the river water quantity and quality issues are addressed.

Concurrent negotiation and coordination for grid resource coallocation.

PubMed

Sim, Kwang Mong; Shi, Benyun

2010-06-01

Bolstering resource coallocation is essential for realizing the Grid vision, because computationally intensive applications often require multiple computing resources from different administrative domains. Given that resource providers and consumers may have different requirements, successfully obtaining commitments through concurrent negotiations with multiple resource providers to simultaneously access several resources is a very challenging task for consumers. The impetus of this paper is that it is one of the earliest works that consider a concurrent negotiation mechanism for Grid resource coallocation. The concurrent negotiation mechanism is designed for 1) managing (de)commitment of contracts through one-to-many negotiations and 2) coordination of multiple concurrent one-to-many negotiations between a consumer and multiple resource providers. The novel contributions of this paper are devising 1) a utility-oriented coordination (UOC) strategy, 2) three classes of commitment management strategies (CMSs) for concurrent negotiation, and 3) the negotiation protocols of consumers and providers. Implementing these ideas in a testbed, three series of experiments were carried out in a variety of settings to compare the following: 1) the CMSs in this paper with the work of others in a single one-to-many negotiation environment for one resource where decommitment is allowed for both provider and consumer agents; 2) the performance of the three classes of CMSs in different resource market types; and 3) the UOC strategy with the work of others [e.g., the patient coordination strategy (PCS )] for coordinating multiple concurrent negotiations. Empirical results show the following: 1) the UOC strategy achieved higher utility, faster negotiation speed, and higher success rates than PCS for different resource market types; and 2) the CMS in this paper achieved higher final utility than the CMS in other works. Additionally, the properties of the three classes of CMSs in different kinds of resource markets are also verified.

A Comparative Study of the Literature on the Dissemination and Utilization of Scientific Knowledge.

ERIC Educational Resources Information Center

Havelock, Ronald G.; And Others

This report provides a framework for understanding the processes of innovation, dissemination, and knowledge utilization (D&U) and it reviews the relevant literature in education and other fields of practice within this framework. D&U is viewed as a transfer of messages by various media between resource systems and users. Major sections analyze…

Effectiveness of community-based mangrove management for sustainable resource use and livelihood support: A case study of four villages in Central Java, Indonesia.

PubMed

Damastuti, Ekaningrum; de Groot, Rudolf

2017-12-01

Community-Based Mangrove Management (CBMM) is implemented with different approaches and outcomes. This study examined the effectiveness of various CBMM practices to achieve sustainable management of mangrove resources. We analyzed local mangrove resource management strategies in four coastal villages (e.g. Sriwulan, Bedono, Timbulsloko, and Surodadi) on Central Java, Indonesia. Local data on institutions, socio-economic conditions and mangrove resources utilization was collected through participatory resource mapping and interviews with 16 key actors and 500 households. The main differences in CBMM-practices that affect the outcomes in each village were the type of community participation, the level of organizational and economic assistance from external institutions, the magnitude of the rehabilitation project, the time selected for rehabilitation and the maintenance strategies applied in each village. Surodadi achieved most in terms of both efficient resource utilization and local livelihood improvement. Bedono's management strategy was most effective in extending and maintaining the rehabilitated mangrove areas but less in terms of livelihood support while the strategy applied in Timbulsloko resulted in higher resource utilization compared to Surodadi. Sriwulan failed on most criteria. This study suggests that combining the management strategies practiced in Bedono and Surodadi and adding external scientific and technological assistance, income diversification, institutional reinforcement and continuous monitoring of the functioning of local institutions can improve the CBMM performance to sustainably manage mangrove resources and improve livelihoods. Copyright © 2017 Elsevier Ltd. All rights reserved.

Applications of satellite image processing to the analysis of Amazonian cultural ecology

NASA Technical Reports Server (NTRS)

Behrens, Clifford A.

1991-01-01

This paper examines the application of satellite image processing towards identifying and comparing resource exploitation among indigenous Amazonian peoples. The use of statistical and heuristic procedures for developing land cover/land use classifications from Thematic Mapper satellite imagery will be discussed along with actual results from studies of relatively small (100 - 200 people) settlements. Preliminary research indicates that analysis of satellite imagery holds great potential for measuring agricultural intensification, comparing rates of tropical deforestation, and detecting changes in resource utilization patterns over time.

Scale and modeling issues in water resources planning

USGS Publications Warehouse

Lins, H.F.; Wolock, D.M.; McCabe, G.J.

1997-01-01

Resource planners and managers interested in utilizing climate model output as part of their operational activities immediately confront the dilemma of scale discordance. Their functional responsibilities cover relatively small geographical areas and necessarily require data of relatively high spatial resolution. Climate models cover a large geographical, i.e. global, domain and produce data at comparatively low spatial resolution. Although the scale differences between model output and planning input are large, several techniques have been developed for disaggregating climate model output to a scale appropriate for use in water resource planning and management applications. With techniques in hand to reduce the limitations imposed by scale discordance, water resource professionals must now confront a more fundamental constraint on the use of climate models-the inability to produce accurate representations and forecasts of regional climate. Given the current capabilities of climate models, and the likelihood that the uncertainty associated with long-term climate model forecasts will remain high for some years to come, the water resources planning community may find it impractical to utilize such forecasts operationally.

Exploration of sustainable development by applying green economy indicators.

PubMed

Chen, Yungkun; Chen, Chia-Yon; Hsieh, Tsuifang

2011-11-01

Following the global trend of sustainable development, development of green economy is the best way of slowing the negative ecological and environmental impact. This research establishes the Taiwan's green economic indicators based on the ecological footprint and energy analysis. The results are as follows: Taiwan's ecological footprint in 2008 intensity index was at 4.364; ecological overshoot index was at 3.364, showing that Taiwan's ecological system is in overload state. Moreover, this study utilizes energy analysis model to study the sustainable development of Taiwan. Findings showed that total energy use in 2008 was 3.14 × 10(23) sej (solar energy joule, sej), energy of renewable resources was 1.30 × 10(22) sej, energy of nonrenewable resources was 2.26 × 10(23) sej, energy of products from renewable resources was 1.30 × 10(22)sej, energy of currency flow was 8.02 × 10(22) sej and energy of wastes flow was 6.55 × 10(22) sej. Taiwan's energy per capita and the utilization rate of energy is lower while the environmental loading rate is significantly higher comparing to some other countries. The foregoing findings indicate that Taiwan currently belongs to an economic development pattern based on high resource consumption. The economic development is mainly established on the exploitation and utilization of nonrenewable resources. Therefore, Taiwan should change the development pattern, regulate the industrial structure, promote the utilization rate of resources, develop green pollution-free products, and enhance the sustainable development of ecological economic system.

Modelling the cost-utility of bio-electric stimulation therapy compared to standard care in the treatment of elderly patients with chronic non-healing wounds in the UK.

PubMed

Clegg, John P; Guest, Julian F

2007-04-01

To estimate the cost-utility of bio-electric stimulation therapy (Posifect) compared to standard care in elderly patients with chronic, non-healing wounds of > 6 months duration, from the perspective of the National Health Service (NHS) in the UK. Clinical and resource use data from a 16 week clinical evaluation of bio-electric stimulation therapy among patients who had recalcitrant wounds were combined with utility data obtained from a standard gamble analysis to construct a 16 week Markov model. The model considers the decision by a clinician to continue with a patient's previous care plan or treat with bio-electric stimulation therapy. Unit resource costs at 2005/2006 prices were applied to the resource utilisation estimates within the model, enabling the cost-utility of bio-electric stimulation therapy compared to standard care to be estimated. The acquisition cost of Posifect had not been decided at the time of performing this study. Hence, the base case analysis used a cost of 50 pounds per dressing. 33% of all wounds are expected to heal within 16 weeks after the start of bio-electric stimulation therapy. Consequently, using bio-electric stimulation therapy is expected to lead to a 51% decrease in the number of domiciliary clinician visits, from 4.7 to 2.3 per week. The model also showed that using bio-electric stimulation therapy instead of patients' standard care is expected to reduce the NHS cost of managing them by 16% from 2287 pounds (95% CI: 1838 pounds; 2735 pounds) to 1921 pounds (95% CI: 1609 pounds; 2233 pounds) and result in a health gain of 0.023 QALYs over 16 weeks. Hence, bio-electric stimulation therapy was found to be a dominant treatment. Sensitivity analyses demonstrated that the cost-utility of using bio-electric stimulation therapy relative to standard care is very sensitive to the acquisition cost of the therapy, the acquisition cost of patients' drugs and the number of clinician visits and less sensitive to utility values and the acquisition cost of other dressings. Within the limitations of the model, bio-electric stimulation therapy is expected to afford the NHS a cost-effective dressing compared to standard care in the management of chronic non-healing wounds of > 6 months duration. Bio-electric stimulation therapy's acquisition cost is expected to be offset by a reduction in the requirement for domiciliary clinician visits, leading to a release of NHS resources for use elsewhere in the system, thereby generating an increase in NHS efficiency.

Productivity, quality, and patient satisfaction: comparison of part-time and full-time primary care physicians.

PubMed

Fairchild, D G; McLoughlin, K S; Gharib, S; Horsky, J; Portnow, M; Richter, J; Gagliano, N; Bates, D W

2001-10-01

Although few data are available, many believe that part-time primary care physicians (PCPs) are less productive and provide lower quality care than full-time PCPs. Some insurers exclude part-time PCPs from their provider networks. To compare productivity, quality of preventive care, patient satisfaction, and risk-adjusted resource utilization of part-time and full-time PCPs. Retrospective cohort study. Boston. PCPs affiliated with 2 academic outpatient primary care networks. PCP productivity, patient satisfaction, resource utilization, and compliance with screening guidelines. Part-time PCP productivity was greater than that of full-time PCPs (2.1 work relative value units (RVUs)/bookable clinical hour versus 1.3 work RVUs/bookable clinical hour, P< .01). A similar proportion of part-time PCPs (80%) and full-time PCPs (75%) met targets for mammography, Pap smears, and cholesterol screening (P = .67). After adjusting for clinical case mix, practice location, gender, board certification status, and years in practice, resource utilization of part-time PCPs (138 dollars [95% confidence interval (CI), 108 dollars to 167 dollars]) was similar to that of full-time PCPs (139 dollars [95% CI, 108 dollars to 170 dollars], P = .92). Patient satisfaction was similar for part-time and full-time PCPs. In these academic primary care practices, rates of patient satisfaction, compliance with screening guidelines, and resource utilization were similar for part-time PCPs compared to full-time PCPs. Productivity per clinical hour was markedly higher for part-time PCPs. Despite study limitations, these data suggest that academic part-time PCPs are at least as efficient as full-time PCPs and that the quality of their work is similar.

Measuring Resource Utilization: A Systematic Review of Validated Self-Reported Questionnaires.

PubMed

Leggett, Laura E; Khadaroo, Rachel G; Holroyd-Leduc, Jayna; Lorenzetti, Diane L; Hanson, Heather; Wagg, Adrian; Padwal, Raj; Clement, Fiona

2016-03-01

A variety of methods may be used to obtain costing data. Although administrative data are most commonly used, the data available in these datasets are often limited. An alternative method of obtaining costing is through self-reported questionnaires. Currently, there are no systematic reviews that summarize self-reported resource utilization instruments from the published literature.The aim of the study was to identify validated self-report healthcare resource use instruments and to map their attributes.A systematic review was conducted. The search identified articles using terms like "healthcare utilization" and "questionnaire." All abstracts and full texts were considered in duplicate. For inclusion, studies had to assess the validity of a self-reported resource use questionnaire, to report original data, include adult populations, and the questionnaire had to be publically available. Data such as type of resource utilization assessed by each questionnaire, and validation findings were extracted from each study.In all, 2343 unique citations were retrieved; 2297 were excluded during abstract review. Forty-six studies were reviewed in full text, and 15 studies were included in this systematic review. Six assessed resource utilization of patients with chronic conditions; 5 assessed mental health service utilization; 3 assessed resource utilization by a general population; and 1 assessed utilization in older populations. The most frequently measured resources included visits to general practitioners and inpatient stays; nonmedical resources were least frequently measured. Self-reported questionnaires on resource utilization had good agreement with administrative data, although, visits to general practitioners, outpatient days, and nurse visits had poorer agreement.Self-reported questionnaires are a valid method of collecting data on healthcare resource utilization.

Resection of pediatric lung malformations: National trends in resource utilization & outcomes.

PubMed

Wagenaar, Amy E; Tashiro, Jun; Satahoo, Shevonne S; Sola, Juan E; Neville, Holly L; Hogan, Anthony R; Perez, Eduardo A

2016-09-01

We sought to determine factors influencing survival and resource utilization in patients undergoing surgical resection of congenital lung malformations (CLM). Additionally, we used propensity score-matched analysis (PSMA) to compare these outcomes for thoracoscopic versus open surgical approaches. Kids' Inpatient Database (1997-2009) was used to identify congenital pulmonary airway malformation (CPAM) and pulmonary sequestration (PS) patients undergoing resection. Open and thoracoscopic CPAM resections were compared using PSMA. 1547 cases comprised the cohort. In-hospital survival was 97%. Mortality was higher in small vs. large hospitals, p<0.005. Survival, pneumothorax (PTX), and thoracoscopic procedure rates were higher, while transfusion rates and length of stay (LOS) were lower, in children ≥3 vs. <3months (p<0.001). Multivariate analysis demonstrated longer LOS for older patients and Medicaid patients (all p<0.005). Total charges (TC) were higher for Western U.S., older children, and Medicaid patients (p<0.02). PSMA for thoracoscopy vs. thoracotomy in CPAM patients showed no difference in outcomes. CLM resections have high associated survival. Children <3months of age had higher rates of thoracotomy, transfusion, and mortality. Socioeconomic status, age, and region were independent indicators for resource utilization. Extent of resection was an independent prognostic indicator for in-hospital survival. On PSMA, thoracoscopic resection does not affect outcomes. Copyright © 2016. Published by Elsevier Inc.

[Effects of cropping patterns on photosynthesis characteristics of summer maize and its utilization of solar and heat resources].

PubMed

Zhu, Yuan-Gang; Dong, Shu-Ting; Zhang, Ji-Wang; Liu, Peng; Yang, Jin-Sheng; Jia, Chun-Lan; Liu, Jing-Guo; Li, Deng-Hai

2010-06-01

In order to investigate the effects of interplanting and direct seeding on the photosynthesis characteristics of summer maize and its utilization of solar and heat resources, two summer maize cultivars (Zhengdan 958 and Denghai 661) were planted in the farmlands of Denghai Seed Co. Ltd in Laizhou City of Shandong Province, with 67500 plants x hm(-2) and three sowing dates. The above-ground biomass, plant growth rate, leaf area index, and net photosynthetic rate per ear leaf were measured to reveal the photosynthesis characteristics of test cultivars. In the meantime, the characters of grain-filling were simulated by Richards' model, and the solar resource utilization efficiency of the cultivars was calculated, in combining with meteorological data. Comparing with interplanting, direct seeding increased the grain yield by 1.17%-3.33%, but decreased the thousand-grain weight significantly. Growth stages were extended under earlier sowing. The leaf area index and net photosynthetic rate from flowering to 30 d after anthesis were significantly higher under direct seeding than under interplanting, but after then, they decreased faster. Direct seeding induced a higher accumulation of dry matter and a faster plant growth rate before and after flowering. Under direct seeding, the maximum grain-filling rate reached earlier, the starting potential was higher, but the grain-filling period, active grain-filling period, and W(max) were lower, compared with those under interplanting. Also under direct seeding, the total accumulative temperature and solar radiation during growth period decreased by 150-350 degrees C x d and 200-400 MJ x m(-2), respectively, but the solar resource utilization efficiency of grain increased by 10.5%-24.7%. All the results suggested that direct seeding was superior to interplanting for the summer maize production under field condition. In order to enhance solar and heat utilization efficiency and excavate yield potential, it would be essential to improve the leaf photosynthesis efficiency and postpone leaf aging.

Recovery and Utilization of Extraterrestrial Resources

NASA Technical Reports Server (NTRS)

2004-01-01

This special bibliography includes the extraction, processing, and utilization of lunar, planetary, and asteroid resources; mining and excavation equipment, oxygen and propellant production; and in situ resource utilization.

How Accurate are Self-Reports? An Analysis of Self-Reported Healthcare Utilization and Absence When Compared to Administrative Data

PubMed Central

Short, Meghan E.; Pei, Xiaofei; Tabrizi, Maryam J.; Ozminkowski, Ronald J.; Gibson, Teresa B.; DeJoy, Dave M.; Wilson, Mark G.

2009-01-01

Objective To determine the accuracy of self-reported healthcare utilization and absence reported on health risk assessments (HRAs) against administrative claims and human resource records. Methods Self-reported values of healthcare utilization and absenteeism were analyzed for concordance to administrative claims values. Percent agreement, Pearson’s correlations, and multivariate logistic regression models examined the level of agreement and characteristics of participants with concordance. Results Self-report and administrative data showed greater concordance for monthly compared to yearly healthcare utilization metrics. Percent agreement ranged from 30 to 99% with annual doctor visits having the lowest percent agreement. Younger people, males, those with higher education, and healthier individuals more accurately reported their healthcare utilization and absenteeism. Conclusions Self-reported healthcare utilization and absenteeism may be used as a proxy when medical claims and administrative data are unavailable, particularly for shorter recall periods. PMID:19528832

Resource Utilization Associated with Extracardiac Co-morbid Conditions Following Congenital Heart Surgery in Infancy.

PubMed

Tuomela, Krista E; Gordon, John B; Cassidy, Laura D; Johaningsmeir, Sarah; Ghanayem, Nancy S

2017-06-01

Congenital heart disease (CHD) is often associated with chronic extracardiac co-morbid conditions (ECC). The presence of ECC has been associated with greater resource utilization during the operative period; however, the impact beyond hospital discharge has not been described. This study sought to understand the scope of chronic ECC in infants with CHD as well as to describe the impact of ECC on resource utilization after discharge from the index cardiac procedure. IRB approved this retrospective study of infants <1 year who had cardiac surgery from 2006 and 2011. Demographics, diagnoses, procedures, STAT score, and ECC were extracted from the medical record. Administrative data provided frequency of clinic and emergency room visits, admissions, cumulative hospital days, and hospital charges for 2 years after discharge from the index procedure. Data were compared using Mann-Whitney Rank Sum Test with p < 0.05 considered significant. ECC occurred in 55% (481/876) of infants. Median STAT score was higher in the group with ECC (3 vs. 2, p < 0.001). Resource utilization after discharge from the index procedure as defined by median hospital charges (78 vs. 10 K, p < 0.001 and unplanned hospital days 4 vs. 0, p < 0.001) was higher in those with ECC, and increased with the greater number of ECC, even after accounting for surgical complexity. STAT score and the presence of multiple ECC were associated with higher resource utilization following the index cardiac surgical procedure. These data may be helpful in deciding which children might benefit from a cardiac complex care program that partners families and providers to improve health and decrease healthcare costs.

Interhospital transfer of critically ill and injured children: an evaluation of transfer patterns, resource utilization, and clinical outcomes.

PubMed

Odetola, Folafoluwa O; Davis, Matthew M; Cohn, Lisa M; Clark, Sarah J

2009-03-01

To describe patterns of transfer, resource utilization, and clinical outcomes associated with interhospital transfer of critically ill and injured children. Secondary analysis of administrative claims data. Children 0 to 18 years in the Michigan Medicaid program who underwent interhospital transfer for intensive care from January 1, 2002 to December 31, 2004. The 3 sources of transfer from referring hospitals were: emergency department (ED), ward, or intensive care unit (ICU). Mortality and duration of hospital stay at the receiving hospitals. Of 1643 interhospital transfer admissions to intensive care at receiving hospitals, 62%, 31%, and 7% were from the ED, ward, and ICU of referring hospitals, respectively. Nineteen percent had comorbid illness, while 11% had organ dysfunction at the referring hospital. After controlling for comorbid illness, patient age, and pretransfer organ dysfunction; compared with ED transfers, mortality in the receiving hospital was higher for ward transfers (odds ratio [OR], 1.76; 95% confidence interval [CI], 1.02-3.03) but not for ICU transfers. Also, compared with ED transfers, hospital stay was longer by 1.5 days for ward transfers and by 13.5 days for ICU transfers. In this multiyear, statewide sample, mortality and resource utilization were higher among children who underwent interhospital transfer to intensive care after initial hospitalization, compared with those transferred directly from emergency to intensive care. Decision-making underlying initial triage and subsequent interhospital transfer of critically ill children warrants further study. (c) 2009 Society of Hospital Medicine.

Societal burden and economics of vascular dementia: preliminary results from a Swedish-population-based study.

PubMed

Wimo, Anders; Winblad, Bengt

2003-01-01

Knowledge about the health economic implications of vascular dementia (VaD) is insufficient. The impact of cardiovascular comorbidities must also be taken into consideration when resource utilization and costs in patients with VaD are analyzed. It is also of great importance that the analysis be done from a societal perspective. In the rural Nordanstig cohort of the Kungsholmen project in Sweden, the major cost drivers in the RUD (Resource Utilization in Dementia) instrument were used. The cost from a societal perspective was 23% higher for patients with VaD compared with patients with Alzheimer's disease ( p = .02).

In-situ Resource Utilization (ISRU) and Lunar Surface Systems

NASA Technical Reports Server (NTRS)

Sanders, Jerry; Larson, Bill; Sacksteder, Kurt

2007-01-01

This viewgraph presentation reviews the benefits of In-Situ Resource Utilization (ISRU) on the surface of the moon. Included in this review is the commercialization of Lunar ISRU. ISRU will strongly influence architecture and critical technologies. ISRU is a critical capability and key implementation of the Vision for Space Exploration (VSE). ISRU will strongly effects lunar outpost logistics, design and crew safety. ISRU will strongly effect outpost critical technologies. ISRU mass investment is minimal compared to immediate and long-term architecture delivery mass and reuse capabilities provided. Therefore, investment in ISRU constitutes a commitment to the mid and long term future of human exploration.

Workplace productivity, employment issues, and resource utilization in patients with bipolar I disorder.

PubMed

McMorris, Barbara J; Downs, Kristen E; Panish, Jessica M; Dirani, Riad

2010-03-01

To collect workplace productivity and healthcare utilization data from subjects with bipolar I disorder and compare the results with those from normative subjects. A cross sectional survey was administered to patients and recruiting physicians. Data collected included employment status, Endicott Workplace Productivity Scale (EWPS) results, healthcare resource utilization, and quality-of-life. In comparison with normative subjects, bipolar I subjects reported lower levels of work productivity (measured by the EWPS). Bipolar I subjects also reported more frequent outpatient visits and more prescribed pharmaceuticals. Bipolar I subjects were more likely to miss work, have worked reduced hours due to medical or mental health issues, receive disability payments, been involved in a crime, be uninsured or covered by Medicare, or have been fired or laid off. The study groups were age- and gender-matched to reduce the impact of selection bias associated with a non-randomized study design. Other potential limitations affecting the results of the study include recall bias and possibly an impact of different data collection methods (e.g. Internet versus telephone). Bipolar I disorder is associated with a negative effect on work productivity and resource utilization and is an appropriate disease management target for employers and healthcare decision makers.

Demand-Side Management and Integrated Resource Planning: Findings from a Survey of 24 Electric Utilities

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

Schweitzer, M.

1991-01-01

Integrated resource planning differs from traditional utility planning practices primarily in its increased attention to demand-side management (DSM) programs and its integration of supply- and demand-side resources into a combined resource portfolio. This report details the findings from an Oak Ridge National Laboratory (ORNL) survey of 24 electric utilities that have well-developed integrated planning processes. These utilities account for roughly one-third of total capacity, electricity generation, and DSM-program expenditures nationwide. The ORNL survey was designed to obtain descriptive data on a national sample of utilities and to test a number of hypothesized relationships between selected utility characteristics and the mixmore » of resources selected for the integrated plan, with an emphasis on the use of DSM resources and the processes by which they are chosen. The survey solicited information on each utility's current and projected resource mix, operating environment, procedures used to screen potential DSM resources, techniques used to obtain public input and to integrate supply- and demand-side options into a unified plan, and procedures used in the final selection of resources for the plan.« less

Performance evaluation of multi-stratum resources integration based on network function virtualization in software defined elastic data center optical interconnect.

PubMed

Yang, Hui; Zhang, Jie; Ji, Yuefeng; Tian, Rui; Han, Jianrui; Lee, Young

2015-11-30

Data center interconnect with elastic optical network is a promising scenario to meet the high burstiness and high-bandwidth requirements of data center services. In our previous work, we implemented multi-stratum resilience between IP and elastic optical networks that allows to accommodate data center services. In view of this, this study extends to consider the resource integration by breaking the limit of network device, which can enhance the resource utilization. We propose a novel multi-stratum resources integration (MSRI) architecture based on network function virtualization in software defined elastic data center optical interconnect. A resource integrated mapping (RIM) scheme for MSRI is introduced in the proposed architecture. The MSRI can accommodate the data center services with resources integration when the single function or resource is relatively scarce to provision the services, and enhance globally integrated optimization of optical network and application resources. The overall feasibility and efficiency of the proposed architecture are experimentally verified on the control plane of OpenFlow-based enhanced software defined networking (eSDN) testbed. The performance of RIM scheme under heavy traffic load scenario is also quantitatively evaluated based on MSRI architecture in terms of path blocking probability, provisioning latency and resource utilization, compared with other provisioning schemes.

Measuring resource utilization in patient-oriented comparative effectiveness research: a psychometric study of the Resource Utilization Questionnaire.

PubMed

Smaldone, Arlene; Tsimicalis, Argerie; Stone, Patricia W

2011-01-01

In the United States, rising health care costs have led to discussion about bending the cost curve. To understand the true burden of disease and its treatment, costs of care, including those incurred by patients and their families, must be comprehensively assessed using psychometrically sound instruments. The Resource Utilization Questionnaire (RUQ) is a 21-item self-report questionnaire first developed to measure the costs incurred by families of infants who had required intensive care during the newborn period. The purpose of this article is to describe the conceptualization of resource utilization and costs and other methodological issues in conducting economic analyses, the process of adapting the RUQ for use in children and families with Type 1 diabetes mellitus (T1DM), and the psychometric evaluation to establish content and criterion validity of the instrument. The finalized modified RUQ for T1DM (mRUQ-T1DM) contained 25 items reflecting direct (5 items) and nondirect (3 items) health care, patient/family time (8 items), and patient/family productivity (9 items) costs using a 3-month recall. The mRUQ-T1DM validly measures cost incurred by children and families with T1DM and is easily completed by parents. Furthermore, the mRUQ-T1DM may be adapted for use in other populations using a similar process.

Resource utilization for non-operative cervical radiculopathy: Management by surgeons versus non-surgeons.

PubMed

Chung, Sophie H; Bohl, Daniel D; Paul, Jonathan T; Rihn, Jeffrey A; Harrop, James S; Ghogawala, Zoher; Hilibrand, Alan S; Grauer, Jonathan N

2017-07-01

To compare the estimated resource utilization for non-operative treatment of cervical radiculopathy if managed by surgeons versus non-surgeons. A Cervical Spine Research Society-sponsored survey was administered at a national spine surgery conference to surgeons and non-surgeons, as classified above. The survey asked questions regarding resource utilization and perceived costs for the "average patient" with cervical radiculopathy managed non-operatively. Resource utilization and perceived costs were compared between surgeon and non-surgeon participants, and between private practice and academic and/or hybrid groups that combine academic and private practices. In total, 101 of the 125 conference attendees participated in the survey (return rate 80.8%, of which 60% were surgeons). Surgeon and non-surgeon estimates for duration of non-operative care did not differ (3.3 versus 4.2 months, p=0.071). Estimates also did not differ for estimated number of physical therapy visits (10.5 versus 10.5, p=0.983), cervical injections (1.4 versus 1.7, p=0.272), chiropractic visits (3.1 versus 3.7, p=0.583), or perceived days off from work (14.9 versus 16.3, p=0.816). The only difference identified was that surgeon estimates of the number of physician visits while providing non-operative care were lower than non-surgeon estimates (3.2 versus 4.0, p=0.018). In terms of estimated costs, surgeon and non-surgeon were mostly similar (only difference being that surgeon estimates for the total cost of physician visits per patient were lower than non-surgeon estimates ($382 versus $579, p=0.007). Surgeon estimates for the percent of their patients that go on to receive surgery within 6 months were higher than non-surgeon estimates (28.6% versus 18.8%, p=0.018). Similarly, surgeon estimates for the percent of their patients to go on to receive surgery within 2 years were higher than non-surgeon estimates (37.8% versus 24.8%, p=0.013). Academic/hybrid and private practice group resource utilization estimates and costs were also compared, and no significant differences were found in any comparisons. Additionally, no significant differences were found in these groups for duration of non-operative care, or the estimates of the percent of patients who go on to receive surgery within 6 months or two years. These data suggest that patients with cervical radiculopathy managed by surgeons and those by non-surgeons have overall similar resource utilization during a non-operative trial. This suggests that relatively similar care is provided regardless of whom initiates the non-operative trial (surgeon or non-surgeon). Although surgeons thought their patients more likely to undergo surgery following a non-operative trial, this may be a bias due to patient referral-specifically, surgeons may be more likely than non-surgeons to manage patients with more severe or longer-standing radiculopathy. Copyright © 2017 Elsevier B.V. All rights reserved.

Health care resource use, health care expenditures and absenteeism costs associated with osteoarthritis in US healthcare system.

PubMed

Menon, J; Mishra, P

2018-04-01

We determined incremental health care resource utilization, incremental health care expenditures, incremental absenteeism, and incremental absenteeism costs associated with osteoarthritis. Medical Expenditure Panel Survey (MEPS) for 2011 was used as data source. Individuals 18 years or older and employed during 2011 were eligible for inclusion in the sample for analyses. Individuals with osteoarthritis were identified based on ICD-9-CM codes. Incremental health care resource utilization included annual hospitalization, hospital days, emergency room visits and outpatient visits. Incremental health expenditures included annual inpatient, outpatient, emergency room, medications, miscellaneous and annual total expenditures. Of the total sample, 1354 were diagnosed with osteoarthritis, and compared to non osteoarthritis individuals. Incremental resource utilization, expenditures, absenteeism and absenteeism costs were estimated using regression models, adjusting for age, gender, sex, region, marital status, insurance coverage, comorbidities, anxiety, asthma, hypertension and hyperlipidemia. Regression models revealed incremental mean annual resource use associated with osteoarthritis of 0.07 hospitalizations, equal to 70 additional hospitalizations per 100 osteoarthritic patients annually, and 3.63 outpatient visits, equal to 363 additional visits per 100 osteoarthritic patients annually. Mean annual incremental total expenditures associated with osteoarthritis were $2046. Annually, mean incremental expenditures were largest for inpatient expenditures at $826, followed by mean incremental outpatient expenditures of $659, and mean incremental medication expenditures of $325. Mean annual incremental absenteeism was 2.2 days and mean annual incremental absenteeism costs were $715.74. Total direct expenditures were estimated at $41.7 billion. Osteoarthritis was associated with significant incremental health care resource utilization, expenditures, absenteeism and absenteeism costs. Copyright © 2017 Osteoarthritis Research Society International. Published by Elsevier Ltd. All rights reserved.

Avian Monitoring and Risk Assessment at the San Gorgonio Wind Resource Area

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

Anderson, R.; Tom, J.; Neumann, N.

2005-08-01

The primary objective of this study at the San Gorgonio Wind Resource Area was to estimate and compare bird utilization, fatality rates, and the risk index among factors including bird taxonomic groups, wind turbine and reference areas, wind turbine sizes and types, and geographic locations. The key questions addressed to meet this objective include: (1) Are there any differences in the level of bird activity, called ''utilization rate'' or ''use'', with the operating wind plant and within the surrounding undeveloped areas (reference area)?; (2) Are there any differences in the rate of bird fatalities (or avian fatality) within the operatingmore » wind plant or the surrounding undeveloped areas (reference area)?; (3) Does bird use, fatality rates, or bird risk index vary according to the geographic location, type and size of wind turbine, and/or type of bird within the operating wind plant and surrounding undeveloped areas (reference area)?; and (4) How do raptor fatality rates at San Gorgonio compare to other wind projects with comparable data?« less

Utilization of health resources in South Asian, Chinese and white patients with diabetes mellitus.

PubMed

Yang, Jiao; Nijjar, Aman; Quan, Hude; Shah, Baiju R; Rabi, Doreen; Ignaszewski, Andrew; Khan, Nadia A

2014-07-01

We sought to determine whether there are differences in health resource utilization among South Asian (SA), Chinese and White patients with newly diagnosed diabetes mellitus. We used province-wide administrative data from British Columbia, Canada (1997-2006) to determine proportion of patients with ≥2 visits/year for all outpatient and family physician (FP) visits, proportion of patients with at least one annual visit to specialists, ophthalmology/optometry and hospital admissions by ethnic group. There were 9529 South Asian, 14,084 Chinese and 143,630 White patients with newly diagnosed diabetes in the study. Over 90% of each of the ethnic groups visited their FP ≥2 visits/year. Chinese patients were less likely to visit FP, ophthalmology/optometrists and specialists compared to White patients. SA patients had fewer ophthalmology/optometry visits compared to White populations. White patients had higher rates of hospitalization. Although all groups had high proportion of patients with appropriate frequency of FP visits, other aspects of health care utilization varied significantly by ethnicity. Copyright © 2013 Primary Care Diabetes Europe. Published by Elsevier Ltd. All rights reserved.

Interference between a fast-paced spatial puzzle task and verbal memory demands.

PubMed

Epling, Samantha L; Blakely, Megan J; Russell, Paul N; Helton, William S

2017-06-01

Research continues to provide evidence that people are poor multi-taskers. Cognitive resource theory is a common explanation for the inability to efficiently perform multiple tasks at the same time. This theory proposes that one's limited supply of cognitive resources can be utilized faster than it is replenished, which results in a performance decline, particularly when these limited resources must be allocated among multiple tasks. Researchers have proposed both domain-specific, for example, spatial versus verbal processing resources, and domain general cognitive resources. In the present research, we investigated whether a spatial puzzle task performed simultaneously with a verbal recall task would impair performance in either task or both tasks, compared to performance on the tasks individually. As hypothesized, a reduction in word recall was found when dual-tasking, though performance on the puzzle task did not significantly differ between the single- and dual-task conditions. This is consistent, in part, with both a general resource theory and a Multiple Resource Theory, but further work is required to better understand the cognitive processing system. The employment of the recall task in the dual-task paradigm with a variety of secondary tasks will help to continue mapping out the specificity (or lack thereof) of cognitive resources utilized in various mental and physical tasks.

State and Local Tax Performance, 1981 (Basic Tabulations).

ERIC Educational Resources Information Center

Quindry, Kenneth E.; Schoening, Niles C.

Fiscal year 1981 state and local tax performance data are presented, which indicate comparative utilization of taxable resources. Estimates are provided of tax ability for 15 major taxes and total taxes, and tax ability to tax collections for the 50 states and their subdivisions is compared. Tables include the following: population, personal…

"Not Homeless Yet. I'm Kind of Couch Surfing": Finding Identities for People at a Homeless Shelter.

PubMed

Terui, Sachiko; Hsieh, Elaine

2016-01-01

The meanings of homelessness are fluid and socially constructed, providing resources and limitations for individuals to negotiate their identities and relationships in everyday life. In this study, we examine the strategies and corresponding resources utilized by people who are homeless to cope with the labeling of a homeless identity and to redefine their identities. We used constant comparative analysis to examine in-depth interviews with 16 participants (male = 11, female = 5) who access a local homeless shelter in the southwest United States for resources. We identified three strategies that homeless people adopt to cope with the labeling of homeless identity: (a) differentiating oneself from others who are homeless, (b) prioritizing certain aspects of life, and (c) embracing the status of homelessness. Although these strategies have been identified in previous literature, the authors extend this line of research by identifying the common resources people who are homeless utilize when adopting these strategies, which entail important implications for theory development and practical implications.

International Comparison of Water Resources Utilization Efficiency in the Silk Road Economic Belt

NASA Astrophysics Data System (ADS)

Yan, Long; Ma, Jing; Deng, Wei; Wang, Yong

2018-03-01

In order to get knowledge of the standard of water utilization of the Silk Road Economic Belt from international point of view, the paper analyzes the annual variation of water resources utilization in the Silk Road Economic Belt, and compares with other typical countries. The study shows that Water resources utilization efficiency has been greatly improved in recent 20 years and the water consumption per USD 10000 of GDP has been declined 87.97%. the improvement of industrial water consumption efficiency is the key driving factors for substantial decrease in water consumption.The comparison of water utilization and human development shows that the higher HDI the country is, the more efficient water utilization the country has. water consumption per USD 10000 of GDP in country with HDI>0.9 is 194m³, being 8.5% of that in country with HDI from 0.5 to 0.6. On the premise of maintaining the stable economic and social development of the Silk Road Economic Belt, the realization of the control target of total water consumption must depend on the strict control over the disorderly expansion of irrigated area, the change in the mode of economic growth, the implementation of the development strategy for new industrialization and urbanization, vigorous development of the processing industry with low water consumption as well as the high-tech and high value-added industry. Only in this way, the control target of total water consumption can be realized in the process of completing the industrialization task.

Stream-based Hebbian eigenfilter for real-time neuronal spike discrimination

PubMed Central

2012-01-01

Background Principal component analysis (PCA) has been widely employed for automatic neuronal spike sorting. Calculating principal components (PCs) is computationally expensive, and requires complex numerical operations and large memory resources. Substantial hardware resources are therefore needed for hardware implementations of PCA. General Hebbian algorithm (GHA) has been proposed for calculating PCs of neuronal spikes in our previous work, which eliminates the needs of computationally expensive covariance analysis and eigenvalue decomposition in conventional PCA algorithms. However, large memory resources are still inherently required for storing a large volume of aligned spikes for training PCs. The large size memory will consume large hardware resources and contribute significant power dissipation, which make GHA difficult to be implemented in portable or implantable multi-channel recording micro-systems. Method In this paper, we present a new algorithm for PCA-based spike sorting based on GHA, namely stream-based Hebbian eigenfilter, which eliminates the inherent memory requirements of GHA while keeping the accuracy of spike sorting by utilizing the pseudo-stationarity of neuronal spikes. Because of the reduction of large hardware storage requirements, the proposed algorithm can lead to ultra-low hardware resources and power consumption of hardware implementations, which is critical for the future multi-channel micro-systems. Both clinical and synthetic neural recording data sets were employed for evaluating the accuracy of the stream-based Hebbian eigenfilter. The performance of spike sorting using stream-based eigenfilter and the computational complexity of the eigenfilter were rigorously evaluated and compared with conventional PCA algorithms. Field programmable logic arrays (FPGAs) were employed to implement the proposed algorithm, evaluate the hardware implementations and demonstrate the reduction in both power consumption and hardware memories achieved by the streaming computing Results and discussion Results demonstrate that the stream-based eigenfilter can achieve the same accuracy and is 10 times more computationally efficient when compared with conventional PCA algorithms. Hardware evaluations show that 90.3% logic resources, 95.1% power consumption and 86.8% computing latency can be reduced by the stream-based eigenfilter when compared with PCA hardware. By utilizing the streaming method, 92% memory resources and 67% power consumption can be saved when compared with the direct implementation of GHA. Conclusion Stream-based Hebbian eigenfilter presents a novel approach to enable real-time spike sorting with reduced computational complexity and hardware costs. This new design can be further utilized for multi-channel neuro-physiological experiments or chronic implants. PMID:22490725

Comparison of direct and indirect methods of estimating health state utilities for resource allocation: review and empirical analysis.

PubMed

Arnold, David; Girling, Alan; Stevens, Andrew; Lilford, Richard

2009-07-22

Utilities (values representing preferences) for healthcare priority setting are typically obtained indirectly by asking patients to fill in a quality of life questionnaire and then converting the results to a utility using population values. We compared such utilities with those obtained directly from patients or the public. Review of studies providing both a direct and indirect utility estimate. Papers reporting comparisons of utilities obtained directly (standard gamble or time tradeoff) or indirectly (European quality of life 5D [EQ-5D], short form 6D [SF-6D], or health utilities index [HUI]) from the same patient. PubMed and Tufts database of utilities. Sign test for paired comparisons between direct and indirect utilities; least squares regression to describe average relations between the different methods. Mean utility scores (or median if means unavailable) for each method, and differences in mean (median) scores between direct and indirect methods. We found 32 studies yielding 83 instances where direct and indirect methods could be compared for health states experienced by adults. The direct methods used were standard gamble in 57 cases and time trade off in 60(34 used both); the indirect methods were EQ-5D (67 cases), SF-6D (13), HUI-2 (5), and HUI-3 (37). Mean utility values were 0.81 (standard gamble) and 0.77 (time tradeoff) for the direct methods; for the indirect methods: 0.59(EQ-5D), 0.63 (SF-6D), 0.75 (HUI-2) and 0.68 (HUI-3). Direct methods of estimating utilities tend to result in higher health ratings than the more widely used indirect methods, and the difference can be substantial.Use of indirect methods could have important implications for decisions about resource allocation: for example, non-lifesaving treatments are relatively more favoured in comparison with lifesaving interventions than when using direct methods.

Chile rural electrification cooperation

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

Flowers, L.

1997-12-01

The author describes a joint program to use renewables for rural electrification projects in Chile. The initial focus was in a limited part of the country, involving wind mapping, pilot project planning, training, and development of methodologies for comparative evaluations of resources. To this point three wind hybrid systems have been installed in one region, as a part of the regional private utility, and three additional projects are being designed. Additional resource assessment and training is ongoing. The author points out the difficulties in working with utilities, the importance of signed documentation, and the need to look at these programsmore » as long term because of the time involved in introducing such new technologies.« less

A comparison of home care clients and nursing home residents: can community based care keep the elderly and disabled at home?

PubMed

Shugarman, L R; Fries, B E; James, M

1999-01-01

Admission cohorts from the Michigan Medicaid Home and Community-Based Waiver program and Ohio nursing homes were compared on measures of resource utilization including a modified Resource Utilization Groups (RUG-III) system, Activities of Daily Living (ADLs), and overall case mix. We found that, contrary to previous research, the two samples were remarkably similar across RUG-III categories. However, the nursing home sample was more functionally impaired on measures of ADL functioning and overall case mix. Results of this study may inform policymakers and providers of the potential for maintaining the appropriate population in the home with government-funded home care.

[Application of synthetic biology to sustainable utilization of Chinese materia medica resources].

PubMed

Huang, Lu-Qi; Gao, Wei; Zhou, Yong-Jin

2014-01-01

Bioactive natural products are the material bases of Chinese materia medica resources. With successful applications of synthetic biology strategies to the researches and productions of taxol, artemisinin and tanshinone, etc, the potential ability of synthetic biology in the sustainable utilization of Chinese materia medica resources has been attracted by many researchers. This paper reviews the development of synthetic biology, the opportunities of sustainable utilization of Chinese materia medica resources, and the progress of synthetic biology applied to the researches of bioactive natural products. Furthermore, this paper also analyzes how to apply synthetic biology to sustainable utilization of Chinese materia medica resources and what the crucial factors are. Production of bioactive natural products with synthetic biology strategies will become a significant approach for the sustainable utilization of Chinese materia medica resources.

Scoping study of integrated resource planning needs in the public utility sector

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

Garrick, C J; Garrick, J M; Rue, D R

Integrated resource planning (IRP) is an approach to utility resource planning that integrates the evaluation of supply- and demand-site options for providing energy services at the least cost. Many utilities practice IRP; however, most studies about IRP focus on investor-owned utilities (IOUs). This scoping study investigates the IRP activities and needs of public utilities (not-for-profit utilities, including federal, state, municipal, and cooperative utilities). This study (1) profiles IRP-related characteristics of the public utility sector, (2) articulates the needs of public utilities in understanding and implementing IRP, and (3) identifies strategies to advance IRP principles in public utility planning.

Determinants of resource needs and utilization among refugees over time.

PubMed

Wright, A Michelle; Aldhalimi, Abir; Lumley, Mark A; Jamil, Hikmet; Pole, Nnamdi; Arnetz, Judith E; Arnetz, Bengt B

2016-04-01

This study examined refugees' resource needs and utilization over time, investigated the relationships between pre-displacement/socio-demographic variables and resource needs and utilization, and explored the role of resource needs and utilization on psychiatric symptom trajectories. Iraqi refugees to the United States (N = 298) were assessed upon arrival and at 1-year intervals for 2 years for socio-demographic variables and pre-displacement trauma experiences, their need for and utilization of 14 different resources, and PTSD and depressive symptoms. Although refugees reported reduction of some needs over time (e.g., need for cash assistance declined from 99 to 71 %), other needs remained high (e.g., 99 % of refugees reported a need for health care at the 2-year interview). Generally, the lowest needs were reported after 2 years, and the highest utilization occurred during the first year post-arrival. Pre-displacement trauma exposure predicted high health care needs but not high health care utilization. Both high need for and use of health care predicted increasing PTSD and depressive symptoms. Specifically, increased use of psychological care across the three measurement waves predicted more PTSD and depression symptoms at the 2-year interview. Differences emerged between need for and actual use of resources, especially for highly trauma-exposed refugees. Resettlement agencies and assistance programs should consider the complex relationships between resource needs, resource utilization, and mental health during the early resettlement period.

Determinants of Resource Needs and Utilization Among Refugees Over Time

PubMed Central

Wright, A. Michelle; Aldhalimi, Abir; Lumley, Mark A.; Jamil, Hikmet; Pole, Nnamdi; Arnetz, Judith E.; Arnetz, Bengt B.

2015-01-01

Purpose This study examined refugees’ resource needs and utilization over time, investigated the relationships between pre-displacement/socio-demographic variables and resource needs and utilization, and explored the role of resource needs and utilization on psychiatric symptom trajectories. Methods Iraqi refugees to the United States (N=298) were assessed upon arrival and at 1-year intervals for two years for socio-demographic variables and pre-displacement trauma experiences, their need for and utilization of 14 different resources, and PTSD and depressive symptoms. Results Although refugees reported reduction of some needs over time (e.g., need for cash assistance declined from 99% to 71%), other needs remained high (e.g., 99% of refugees reported a need for health care at the 2-year interview). Generally, the lowest needs were reported after 2 years, and the highest utilization occurred during the first year post-arrival. Pre-displacement trauma exposure predicted high health care needs but not high health care utilization. Both high need for and use of health care predicted increasing PTSD and depressive symptoms. Specifically, increased use of psychological care across the three measurement waves predicted more PTSD and depression symptoms at the 2-year interview. Conclusions Differences emerged between need for and actual use of resources, especially for highly trauma-exposed refugees. Resettlement agencies and assistance programs should consider the complex relationships between resource needs, resource utilization, and mental health during the early resettlement period. PMID:26370213

Robust Models for Operator Workload Estimation

DTIC Science & Technology

2015-03-01

piloted aircraft (RPA) simultaneously, a vast improvement in resource utilization compared to existing operations that require several operators per...into distinct cognitive channels (visual, auditory, spatial, etc.) based on our ability to multitask effectively as long as no one channel is

Using incentives to improve resource utilization: a quasi-experimental evaluation of an ICU quality improvement program

PubMed Central

Murphy, David J.; Lyu, Peter F.; Gregg, Sara R.; Martin, Greg S.; Hockenberry, Jason M.; Coopersmith, Craig M.; Sterling, Michael; Buchman, Timothy G.; Sevransky, Jonathan

2015-01-01

Objective Healthcare systems strive to provide quality care at lower cost. Arterial blood gas testing (ABGs), chest radiographs (CXRs), and red blood cell transfusions (RBCs) provide an important example of opportunities to reduce excess resource utilization within the ICU. We describe the effect of a multifaceted quality improvement program designed to decrease avoidable ABGs, CXRs, and RBCs utilization on utilization of these resources and patient outcomes. Design Prospective pre-post cohort study Setting Seven ICUs in an academic healthcare system Patients All adult ICU patients admitted to study ICUs during consecutive baseline (n=7,357), intervention (n=7,553), and follow up (n=7,657) years between September 2010 and August 2013. Interventions A multifaceted quality improvement program including provider education, audit and feedback, and unit-based provider financial incentives targeting ABG, CXR, and RBC utilization. Measurements and Main Results The primary outcome was the number of orders for ABGs, CXRs, and RBCs per patient. Compared to the baseline period, unadjusted ABG, CXR, and RBC utilization in the intervention period was reduced by 42%, 26%, and 17%, respectively (p<0.01). After adjusting for potentially relevant patient factors, the intervention was associated with 128 fewer ABGs, 73 fewer CXRs, and 16 fewer RBCs per 100 patients (p<0.01). This effect was durable during the follow up year. This reduction yielded an approximate net savings of $1.5 M in direct costs over the intervention and follow-up years after accounting for the direct costs of the program. Unadjusted hospital mortality decreased from 7% in the baseline period to 5.2% in the intervention period (p<0.01). This reduction remained significant after adjusting for patient factors (OR= 0.43, P<0.01). Conclusions Implementation of a multifaceted quality improvement program including financial incentives was associated with significant improvements in resource utilization. Our findings provide evidence supporting the safety, effectiveness, and sustainability of incentive-based quality improvement interventions. PMID:26496444

A cost-utility analysis of a comprehensive orthogeriatric care for hip fracture patients, compared with standard of care treatment.

PubMed

Ginsberg, Gary; Adunsky, Abraham; Rasooly, Iris

2013-01-01

The economic burden associated with hip fractures calls for the investigation of innovative new cost-utility forms of organisation and integration of services for these patients. To carry out a cost-utility analysis integrating epidemiological and economic aspects for hip fracture patients treated within a comprehensive orthogeriatric model (COGM) of care, as compared with standard of care model (SOCM). A demonstration study conducted in a major tertiary medical centre, operating both a COGM ward and standard orthopaedic and rehabilitation wards. Data was collected on the clinical outcomes and health care costs of the two different treatment modalities, in order to calculate the absolute cost and disability-adjusted life years (DALY) ratio. The COGM model used 23% fewer resources per patient ($14,919 vs. $19,363) than the SOCM model and to avert 0.226 additional DALY per patient, mainly as a result of lower 1-year mortality rates among COGM patients (14.8% vs. 17.3%). A comprehensive ortho-geriatric care modality is more cost-effective, providing additional quality-adjusted life years (QALY) while using fewer resources compared with standard of care approach. The results should assist health policy-makers in optimising healthcare use and healthcare planning.

Validation of the Integrated Medical Model Using Historical Space Flight Data

NASA Technical Reports Server (NTRS)

Kerstman, Eric L.; Minard, Charles G.; FreiredeCarvalho, Mary H.; Walton, Marlei E.; Myers, Jerry G., Jr.; Saile, Lynn G.; Lopez, Vilma; Butler, Douglas J.; Johnson-Throop, Kathy A.

2010-01-01

The Integrated Medical Model (IMM) utilizes Monte Carlo methodologies to predict the occurrence of medical events, utilization of resources, and clinical outcomes during space flight. Real-world data may be used to demonstrate the accuracy of the model. For this analysis, IMM predictions were compared to data from historical shuttle missions, not yet included as model source input. Initial goodness of fit test-ing on International Space Station data suggests that the IMM may overestimate the number of occurrences for three of the 83 medical conditions in the model. The IMM did not underestimate the occurrence of any medical condition. Initial comparisons with shuttle data demonstrate the importance of understanding crew preference (i.e., preferred analgesic) for accurately predicting the utilization of re-sources. The initial analysis demonstrates the validity of the IMM for its intended use and highlights areas for improvement.

Systematic analysis of annual health resource utilization and costs in hospitalized patients with inflammatory bowel disease in Switzerland.

PubMed

Schoepfer, Alain; Vavricka, Stephan R; Brüngger, Beat; Reich, Oliver; Blozik, Eva; Bähler, Caroline

2018-05-11

Real-life data on health resource utilization and costs of hospitalized patients with inflammatory bowel disease are lacking in Switzerland. We aimed to assess health resource utilization and costs during a 1-year follow-up period starting with an index hospitalization. On the basis of claims data of the Helsana health insurance group, health resource utilization was assessed and costs reimbursed by mandatory basic health insurance [in Swiss Francs (CHF); 1 CHF=0.991 US$] were calculated during a 1-year follow-up period starting with an index hospitalization in the time period between 1 January 2013 and 31 December 2014. Of 202 002 patients with at least one hospitalization in 2013-2014, a total of 270 (0.13%) patients had inflammatory bowel disease as main diagnosis [112 (41.5%) ulcerative colitis (UC), 158 (58.5%) Crohn's disease (CD), 154/270 (57.0%) females]. In comparison with patients with UC, patients with CD were significantly more frequently treated with biologics (45.6 vs. 20.5%, P<0.001) and more frequently underwent surgery during index hospitalization (27.8 vs. 9.8%, P=0.002). Compared with patients with UC, those with CD had significantly more consultations [odds ratio (OR): 1.06, 95% confidence interval (CI): 1.01-1.12, P=0.016], higher median annual total costs (OR: 1.25, 95% CI: 1.05-1.48, P=0.012), and higher outpatient costs (OR: 1.33, 95% CI: 1.07-1.66, P=0.011). In the bivariate model, median total costs for patients with CD and those with UC were 24 270 and 17 270 CHF, respectively (P=0.032). When compared with patients with UC, hospitalized patients with CD have during a 1-year follow-up a higher rate of outpatient consultations and generate higher costs.

Water Quality Response to Forest Biomass Utilization

Treesearch

Benjamin Rau; Augustine Muwamba; Carl Trettin; Sudhanshu Panda; Devendra Amatya; Ernest Tollner

2017-01-01

Forested watersheds provide approximately 80% of freshwater drinking resources in the United States (Fox et al. 2007). The water originating from forested watersheds is typically of high quality when compared to agricul¬tural watersheds, and concentrations of nitrogen and phosphorus are nine times higher, on average, in agricultur¬al watersheds when compared to...

Application of fuel cells with heat recovery for integrated utility systems

NASA Technical Reports Server (NTRS)

Shields, V.; King, J. M., Jr.

1975-01-01

This paper presents the results of a study of fuel cell powerplants with heat recovery for use in an integrated utility system. Such a design provides for a low pollution, noise-free, highly efficient integrated utility. Use of the waste heat from the fuel cell powerplant in an integrated utility system for the village center complex of a new community results in a reduction in resource consumption of 42 percent compared to conventional methods. In addition, the system has the potential of operating on fuels produced from waste materials (pyrolysis and digester gases); this would provide further reduction in energy consumption.

Associations between hours worked, symptoms and health resource utilization among full-time male Japanese workers.

PubMed

Sato, Keiko; Yamazaki, Shin; Hayashino, Yasuaki; Takegami, Misa; Tokuda, Yasuharu; Takahashi, Osamu; Shimbo, Takuro; Hinohara, Shigeaki; Fukui, Tsuguya; Fukuhara, Shunichi

2011-01-01

To investigate the association between hours worked, symptoms experienced, and health resource utilization. Data were collected from a nationally representative sample of households in Japan. We studied full-time male workers aged 18-65 yr who worked 100 h or more per month. First, we examined the association between hours worked and symptoms experienced. Second, we examined the association between hours worked and the type of health resource utilized, such as physician visits, over-the-counter (OTC) medication use, dietary supplement use, and complementary and alternative medicine (CAM) provider visits. We used a multivariable negative binominal model in each analysis. Of the 762 male workers, 598 reported experiencing symptoms at least once a month. We categorized participants based on the number of hours worked per month (h/mo): 100-200 h/mo, 201-250 h/mo, and over 250 h/mo. Compared with those working 201-250 h/mo, those working 100-200 h/mo had more frequent physician visits (rate ratio:1.67, 95% CI: 1.17 to 2.38) and those working over 250 h/mo had significantly lower rates of CAM provider visits and tended to use dietary supplements for symptoms. Participants who worked 201-250 h/mo used OTC medication most frequently. No significant association was observed between the number of hours worked and number of symptoms experienced. The more hours worked by full-time male workers, the more likely they were to use health resources that had a lower time requirement. Greater attention should be paid to patterns of health resource utilization among workers and their consequent influence on long-term health status.

The legal regime for moon resource utilization, with particular emphasis on environmental protection, and comparable solutions adopted for deep seabed activities

NASA Astrophysics Data System (ADS)

Viikari, L.

This paper will examine the resource utilization regime as established by the body of international space law and by the 1979 Moon Treaty in particular, as well as the current problems pertaining to it. A particular area of interest is environmental protection vis-à-vis resource utilization. A potential source of fruitful analogy is provided by the deep seabed mineral utilization regime, as established by the 1982 United Nations Convention on the Law of the Sea, the 1994 New York Agreement amending it, and the recent 2000 Mining Code as the first part of more detailed regulations that will eventually govern exploration for and exploitation of all deep seabed minerals. Such comparison seems advantageous, because several developments in the field of using the space environment are showing obvious similarities with previous developments in the law of the sea regarding deep seabed resource management. The Moon and the deep seabed (and their natural resources) are also the only environs explicitly proclaimed as the common heritage of mankind. On the other hand, both domains are increasingly affected by commercializat ion and privatization, too. A recent new (legally non-binding) instrument for space activities is the 1996 Declaration on International Cooperation in the Exploration and Use of Outer Space for the Benefit and in the Interests of All States, Taking into Particular Account the Needs of Developing Countries. It attempts at an important compromise regarding the Common Heritage provision, offering a means to share benefits while recognizing market principles. These principles very much resemble the previous solutions adopted by the 1994 New York Agreement for the deep seabed. The paper attempts to reflect in particular upon the experience available from such developments.

Measuring the Efficient Utilization of Medical Personnel at Navy Military Treatment Facilities

DTIC Science & Technology

1990-06-01

measures of effectiveness (MOE) for utilizing manpower at a medical treatment facility by analyzing data from Navy hospitals. The MOE will be able to...at Navy facili- ties will be used to compare alternative MOEs., The data resources are categorized into expenditures, Naval health-care statistics ...of years., At the Office of the Chief of Naval Operations, OP-801 maintains financial data of medical budgets, 2. NAVAL HEALTH-CARE STATISTICS The

In-Situ Resource Utilization (ISRU) Capability Roadmap Progress Review

NASA Technical Reports Server (NTRS)

Sanders, Gerald B.; Duke, Michael

2005-01-01

A progress review on In-Situ Resource Utilization (ISRU) capability is presented. The topics include: 1) In-Situ Resource Utilization (ISRU) Capability Roadmap: Level 1; 2) ISRU Emphasized Architecture Overview; 3) ISRU Capability Elements: Level 2 and below; and 4) ISRU Capability Roadmap Wrap-up.

Burden of illness and health care resource utilization in adult psychiatric outpatients with attention-deficit/hyperactivity disorder in Europe.

PubMed

Karlsdotter, Kristina; Bushe, Chris; Hakkaart, L; Sobanski, Esther; Kan, C C; Lebrec, Jeremie; Kraemer, Susanne; Dieteren, Nicole A H M; Deberdt, Walter

2016-09-01

To assess the burden of illness and health care resource utilization of adult nonpsychotic psychiatric outpatients with attention-deficit/hyperactivity disorder (ADHD) in Europe. This was a multicountry, cross-sectional, observational study where unselected routine patients from clinical psychiatric outpatient settings were screened and assessed for ADHD. Patients were evaluated using the Clinical Global Impressions of Severity (CGI-S) scale, the Sheehan Disability Scale (SDS), and the EuroQol-5 Dimensions questionnaire. Data on comorbidities, functional impairment, and health care resource utilization were captured. The study enrolled 2284 patients, of whom 1986 completed the study. The prevalence of ADHD was 17.4%, of whom 46.0% had a previous ADHD diagnosis. Patients with ADHD had a high clinical burden with psychiatric comorbidities, especially depression (43.0%) and anxiety disorders (36.4%). Substance abuse (9.2% vs. 3.4%) and alcohol abuse (10.3% vs. 5.2%) were more common in the ADHD cohort vs. the non-ADHD cohort. Only 11.5% of the patients with ADHD had no other psychiatric disorder. Various measures indicated a significantly poorer level of functioning for patients with ADHD than without ADHD, as indicated by higher scores for CGI-S (3.8 vs. 3.3) and SDS (18.9 vs. 11.6) and higher percentages of debt (35.5% vs. 24.3%) and criminality (13.8% vs. 6.1%). Lastly, the health care resource utilization was considerable and similar between adult psychiatric outpatients diagnosed and not diagnosed with ADHD. Although care was taken when choosing the sites for this study, to make it representative of the general outpatient adult psychiatric population, caution should be advised in generalizing the findings of our study to the general ADHD or psychiatric outpatient population. This was an observational study, thus no inference on causality can be drawn. Having ADHD imposes a considerable health and social burden on patient and health care resource utilization comparable to other chronic psychiatric disorders.

Evaluation of Resource Utilization and Treatment Patterns in Patients with Actinic Keratosis in the United States.

PubMed

Asche, Carl V; Zografos, Panagiotis; Norlin, Jenny M; Urbanek, Bill; Mamay, Carl; Makin, Charles; Erntoft, Sandra; Chen, Chi-Chang; Hines, Dionne M; Mark Siegel, Daniel

2016-01-01

To compare health care resource utilization and treatment patterns between patients with actinic keratosis (AK) treated with ingenol mebutate gel (IngMeb) and those treated with other field-directed AK therapies. A retrospective, propensity-score-matched, cohort study compared refill/repeat and adding-on/switching patterns and outpatient visits and prescriptions (health care resource utilization) over 6 months in patients receiving IngMeb versus those receiving imiquimod, 5-fluorouracil, diclofenac sodium, and methyl aminolevulinate or aminolevulinic acid photodynamic therapy (MAL/ALA-PDT). The final sample analyzed included four matched treatment cohort pairs (IngMeb and comparator; n = 790-971 per treatment arm). Refill rates were similar except for imiquimod (15% vs. 9% for imiquimod and IngMeb, respectively; P < 0.05). MAL/ALA-PDT treatment repetition rates were higher than IngMeb refill rates (20% vs. 10%; P < 0.05). Topical agent add-on/switch rates were comparable. PDT had higher switch rates than did IngMeb (5% vs. 2%; P < 0.05). The IngMeb cohort had a significantly lower proportion of patients with at least one AK-related outpatient visit during the 6-month follow-up than did any other cohort: versus imiquimod (50% vs. 66%; P < 0.0001), versus 5-fluorouracil (50% vs. 69%; P < 0.0001), versus diclofenac sodium (51% vs. 56%; P = 0.034), and versus MAL/ALA-PDT (50% vs. 100%; P < 0.0001). There were significantly fewer AK-related prescriptions among patients receiving IngMeb than among patients in other cohorts. Results based on the first 6 months after treatment initiation suggested that most field-directed AK therapies had clinically comparable treatment patterns except imiquimod, which was associated with higher refill rates, and PDT, which was associated with significantly more frequent treatment sessions and higher switching rates. IngMeb was also associated with significantly fewer outpatient visits than were other field-directed therapies. Copyright © 2016. Published by Elsevier Inc.

Symbiosis of sea anemones and hermit crabs: different resource utilization patterns in the Aegean Sea

NASA Astrophysics Data System (ADS)

Vafeiadou, Anna-Maria; Antoniadou, Chryssanthi; Chintiroglou, Chariton

2012-09-01

The small-scale distribution and resource utilization patterns of hermit crabs living in symbiosis with sea anemones were investigated in the Aegean Sea. Four hermit crab species, occupying shells of nine gastropod species, were found in symbiosis with the sea anemone Calliactis parasitica. Shell resource utilization patterns varied among hermit crabs, with Dardanus species utilizing a wide variety of shells. The size structure of hermit crab populations also affected shell resource utilization, with small-sized individuals inhabiting a larger variety of shells. Sea anemone utilization patterns varied both among hermit crab species and among residence shells, with larger crabs and shells hosting an increased abundance and biomass of C. parasitica. The examined biometric relationships suggested that small-sized crabs carry, proportionally to their weight, heavier shells and increased anemone biomass than larger ones. Exceptions to the above patterns are related either to local resource availability or to other environmental factors.

The utilization of oncology web-based resources in Spanish-speaking Internet users.

PubMed

Simone, Charles B; Hampshire, Margaret K; Vachani, Carolyn; Metz, James M

2012-12-01

There currently are few web-based resources written in Spanish providing oncology-specific information. This study examines utilization of Spanish-language oncology web-based resources and evaluates oncology-related Internet browsing practices of Spanish-speaking patients. OncoLink (http://www.oncolink.org) is the oldest and among the largest Internet-based cancer information resources. In September 2005, OncoLink pioneered OncoLink en español (OEE) (http://es.oncolink.org), a Spanish translation of OncoLink. Internet utilization data on these sites for 2006 to 2007 were compared. Visits to OncoLink rose from 4,440,843 in 2006 to 5,125,952 in 2007. OEE had 204,578 unique visitors and 240,442 visits in 2006, and 351,228 visitors and 412,153 visits in 2007. Although there was no time predilection for viewing OncoLink, less relative browsing on OEE was conducted during weekends and early morning hours. Although OncoLink readers searched for information on the most common cancers in the United States, OEE readers most often search for gastric, vaginal, osteosarcoma, leukemia, penile, cervical, and testicular malignancies. Average visit duration on OEE was shorter, and fewer readers surveyed OEE more than 15 minutes (4.5% vs. 14.9%, P < 0.001). Spanish-speaking users of web-based oncology resources are increasingly using the Internet to supplement their cancer knowledge. Limited available resources written in Spanish contribute to disparities in information access and disease outcomes. Spanish-speaking oncology readers differ from English-speaking readers in day and time of Internet browsing, visit duration, Internet search patterns, and types of cancers searched. By acknowledging these differences, content of web-based oncology resources can be developed to best target the needs of Spanish-speaking viewers.

The Utilization of Oncology Web-based Resources in Spanish-speaking Internet Users

PubMed Central

Simone, Charles B.; Hampshire, Margaret K.; Vachani, Carolyn; Metz, James M.

2011-01-01

Objectives: There currently are few web-based resources written in Spanish providing oncology-specific information. This study examines utilization of Spanish-language oncology web-based resources and evaluates oncology-related Internet browsing practices of Spanish-speaking patients. Methods: OncoLink (http://www.oncolink.org) is the oldest and among the largest Internet-based cancer information resources. In 9/2005, OncoLink pioneered OncoLink en español (OEE) (http://es.oncolink.org), a Spanish translation of OncoLink. Internet utilization data on these sites for 2006-2007 were compared. Results: Visits to OncoLink rose from 4,440,843 in 2006 to 5,125,952 in 2007. OEE had 204,578 unique visitors and 240,442 visits in 2006, and 351,228 visitors and 412,153 visits in 2007. While there was no time predilection for viewing OncoLink, less relative browsing on OEE was conducted during weekends and early morning hours. While OncoLink readers searched for information on the most common cancers in the United States, OEE readers most often search for gastric, vaginal, osteosarcoma, leukemia, penile, cervical, and testicular malignancies. Average visit duration on OEE was shorter, and fewer readers surveyed OEE >15 minutes (4.5% vs. 14.9%, p<0.001). Conclusions: Spanish-speaking users of web-based oncology resources are increasingly using the Internet to supplement their cancer knowledge. Limited available resources written in Spanish contribute to disparities in information access and disease outcomes. Spanish-speaking oncology readers differ from English-speaking readers in day and time of Internet browsing, visit duration, Internet search patterns, and types of cancers searched. By acknowledging these differences, content of web-based oncology resources can be developed to best target the needs of Spanish-speaking viewers. PMID:21654312

An Architecture for Cross-Cloud System Management

NASA Astrophysics Data System (ADS)

Dodda, Ravi Teja; Smith, Chris; van Moorsel, Aad

The emergence of the cloud computing paradigm promises flexibility and adaptability through on-demand provisioning of compute resources. As the utilization of cloud resources extends beyond a single provider, for business as well as technical reasons, the issue of effectively managing such resources comes to the fore. Different providers expose different interfaces to their compute resources utilizing varied architectures and implementation technologies. This heterogeneity poses a significant system management problem, and can limit the extent to which the benefits of cross-cloud resource utilization can be realized. We address this problem through the definition of an architecture to facilitate the management of compute resources from different cloud providers in an homogenous manner. This preserves the flexibility and adaptability promised by the cloud computing paradigm, whilst enabling the benefits of cross-cloud resource utilization to be realized. The practical efficacy of the architecture is demonstrated through an implementation utilizing compute resources managed through different interfaces on the Amazon Elastic Compute Cloud (EC2) service. Additionally, we provide empirical results highlighting the performance differential of these different interfaces, and discuss the impact of this performance differential on efficiency and profitability.

Predisposing characteristics, enabling resources and need as predictors of utilization and clinical outcomes for veterans receiving mental health services.

PubMed

Fasoli, DiJon R; Glickman, Mark E; Eisen, Susan V

2010-04-01

Though demand for mental health services (MHS) among US veterans is increasing, MHS utilization per veteran is decreasing. With health and social service needs competing for limited resources, it is important to understand the association between patient factors, MHS utilization, and clinical outcomes. We use a framework based on Andersen's behavioral model of health service utilization to examine predisposing characteristics, enabling resources, and clinical need as predictors of MHS utilization and clinical outcomes. This was a prospective observational study of veterans receiving inpatient or outpatient MHS through Veterans Administration programs. Clinician ratings (Global Assessment of Functioning [GAF]) and self-report assessments (Behavior and Symptom Identification Scale-24) were completed for 421 veterans at enrollment and 3 months later. Linear and logistic regression analyses were conducted to examine: (1) predisposing characteristics, enabling resources, and need as predictors of MHS inpatient, residential, and outpatient utilization and (2) the association between individual characteristics, utilization, and clinical outcomes. Being older, female, having greater clinical need, lack of enabling resources (employment, stable housing, and social support), and easy access to treatment significantly predicted greater MHS utilization at 3-month follow-up. Less clinical need and no inpatient psychiatric hospitalization predicted better GAF and Behavior and Symptom Identification Scale-24 scores. White race and residential treatment also predicted better GAF scores. Neither enabling resources, nor number of outpatient mental health visits predicted clinical outcomes. This application of Andersen's behavioral model of health service utilization confirmed associations between some predisposing characteristics, need, and enabling resources on MHS utilization but only predisposing characteristics, need, and utilization were associated with clinical outcomes.

Using Forecasting to Predict Long-Term Resource Utilization for Web Services

ERIC Educational Resources Information Center

Yoas, Daniel W.

2013-01-01

Researchers have spent years understanding resource utilization to improve scheduling, load balancing, and system management through short-term prediction of resource utilization. Early research focused primarily on single operating systems; later, interest shifted to distributed systems and, finally, into web services. In each case researchers…

Resource Utilization by Native and Invasive Earthworms and Their Effects on Soil Carbon and Nitrogen Dynamics in Puerto Rican Soils

Treesearch

Ching-Yu Huang; Grizelle Gonzalez; Paul F. Hendrix

2016-01-01

Resource utilization by earthworms affects soil C and N dynamics and further colonization of invasive earthworms. By applying 13C-labeled Tabebuia heterophylla leaves and 15N-labeled Andropogon glomeratus grass, we investigated resource utilization by three earthworm species (...

NASA In-Situ Resource Utilization Project-and Seals Challenges

NASA Technical Reports Server (NTRS)

Sacksteder, Kurt; Linne, Diane

2006-01-01

A viewgraph presentation on NASA's In-Situ Resource Utilization Project and Seals Challenges is shown. The topics include: 1) What Are Space Resources?; 2) Space Resource Utilization for Exploration; 3) ISRU Enables Affordable, Sustainable & Flexible Exploration; 4) Propellant from the Moon Could Revolutionize Space Transportation; 5) NASA ISRU Capability Roadmap Study, 2005; 6) Timeline for ISRU Capability Implementation; 7) Lunar ISRU Implementation Approach; 8) ISRU Technical-to-Mission Capability Roadmap; 9) ISRU Resources & Products of Interest; and 10) Challenging Seals Requirements for ISRU.

Resource utilization patterns using non-invasive ventilation in neonates with respiratory distress syndrome.

PubMed

Chavez, Thomas A; Lakshmanan, Ashwini; Figueroa, Lizzette; Iyer, Narayan; Stavroudis, Theodora A; Garingo, Arlene; Friedlich, Philippe S; Ramanathan, Rangasamy

2018-05-24

To describe the frequency of non-invasive ventilation (NIV) and endotracheal intubation use in neonates diagnosed with respiratory distress syndrome (RDS); to describe resources utilization (length of stay (LOS), charges, costs) among NIV and intubated RDS groups. Retrospective study from the national Kid's Inpatient Database of the Healthcare Cost and Utilization Project, for the years 1997-2012. Propensity scoring and multivariate regression analysis used to describe differences. A total of 595,254 out of 42,912,090 cases were identified with RDS. There was an increase in NIV use from 6% in 1997 to 17% in 2012. After matching, patients receiving NIV only were associated with shorter LOS: (95%CI) 25 (25.3,25.7) vs. 35 (34.2,34.9) days, decreased costs: ($/1k) 46.1 (45.5,46.8) vs. 65.0 (64.1,66.0), decreased charges: 130.3 (128.6,132.1) vs. 192.1 (189.5,194.6) compared to intubated neonates. There was a three-fold increase in NIV use within the 15-year study period. NIV use was associated with decreased LOS, charges and costs compared to intubated patients.

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

Wu, Hao; Ren, Shangping; Garzoglio, Gabriele

Cloud bursting is one of the key research topics in the cloud computing communities. A well designed cloud bursting module enables private clouds to automatically launch virtual machines (VMs) to public clouds when more resources are needed. One of the main challenges in developing a cloud bursting module is to decide when and where to launch a VM so that all resources are most effectively and efficiently utilized and the system performance is optimized. However, based on system operational data obtained from FermiCloud, a private cloud developed by the Fermi National Accelerator Laboratory for scientific workflows, the VM launching overheadmore » is not a constant. It varies with physical resource utilization, such as CPU and I/O device utilizations, at the time when a VM is launched. Hence, to make judicious decisions as to when and where a VM should be launched, a VM launching overhead reference model is needed. In this paper, we first develop a VM launching overhead reference model based on operational data we have obtained on FermiCloud. Second, we apply the developed reference model on FermiCloud and compare calculated VM launching overhead values based on the model with measured overhead values on FermiCloud. Our empirical results on FermiCloud indicate that the developed reference model is accurate. We believe, with the guidance of the developed reference model, efficient resource allocation algorithms can be developed for cloud bursting process to minimize the operational cost and resource waste.« less

Job Scheduling with Efficient Resource Monitoring in Cloud Datacenter

PubMed Central

Loganathan, Shyamala; Mukherjee, Saswati

2015-01-01

Cloud computing is an on-demand computing model, which uses virtualization technology to provide cloud resources to users in the form of virtual machines through internet. Being an adaptable technology, cloud computing is an excellent alternative for organizations for forming their own private cloud. Since the resources are limited in these private clouds maximizing the utilization of resources and giving the guaranteed service for the user are the ultimate goal. For that, efficient scheduling is needed. This research reports on an efficient data structure for resource management and resource scheduling technique in a private cloud environment and discusses a cloud model. The proposed scheduling algorithm considers the types of jobs and the resource availability in its scheduling decision. Finally, we conducted simulations using CloudSim and compared our algorithm with other existing methods, like V-MCT and priority scheduling algorithms. PMID:26473166

Job Scheduling with Efficient Resource Monitoring in Cloud Datacenter.

PubMed

Loganathan, Shyamala; Mukherjee, Saswati

2015-01-01

Cloud computing is an on-demand computing model, which uses virtualization technology to provide cloud resources to users in the form of virtual machines through internet. Being an adaptable technology, cloud computing is an excellent alternative for organizations for forming their own private cloud. Since the resources are limited in these private clouds maximizing the utilization of resources and giving the guaranteed service for the user are the ultimate goal. For that, efficient scheduling is needed. This research reports on an efficient data structure for resource management and resource scheduling technique in a private cloud environment and discusses a cloud model. The proposed scheduling algorithm considers the types of jobs and the resource availability in its scheduling decision. Finally, we conducted simulations using CloudSim and compared our algorithm with other existing methods, like V-MCT and priority scheduling algorithms.

Efficient Resources Provisioning Based on Load Forecasting in Cloud

PubMed Central

Hu, Rongdong; Jiang, Jingfei; Liu, Guangming; Wang, Lixin

2014-01-01

Cloud providers should ensure QoS while maximizing resources utilization. One optimal strategy is to timely allocate resources in a fine-grained mode according to application's actual resources demand. The necessary precondition of this strategy is obtaining future load information in advance. We propose a multi-step-ahead load forecasting method, KSwSVR, based on statistical learning theory which is suitable for the complex and dynamic characteristics of the cloud computing environment. It integrates an improved support vector regression algorithm and Kalman smoother. Public trace data taken from multitypes of resources were used to verify its prediction accuracy, stability, and adaptability, comparing with AR, BPNN, and standard SVR. Subsequently, based on the predicted results, a simple and efficient strategy is proposed for resource provisioning. CPU allocation experiment indicated it can effectively reduce resources consumption while meeting service level agreements requirements. PMID:24701160

Comparative economics of space resource utilization

NASA Technical Reports Server (NTRS)

Cutler, Andrew Hall

1991-01-01

Physical economic factors such as mass payback ratio, total payback ratio, and capital payback time are discussed and used to compare the economics of using resources from the Moon, Mars and its moons, and near Earth asteroids to serve certain near term markets such as propellant in low Earth orbit or launched mass reduction for lunar and Martian exploration. Methods for accounting for the time cost of money in simple figures of merit such as MPRs are explored and applied to comparisons such as those between lunar, Martian, and asteroidal resources. Methods for trading off capital and operating costs to compare schemes with substantially different capital to operating cost ratio are presented and discussed. Areas where further research or engineering would be extremely useful in reducing economic uncertainty are identified, as are areas where economic merit is highly sensitive to engineering performance - as well as areas where such sensitivity is surprisingly low.

Exploring the cost-utility of stratified primary care management for low back pain compared with current best practice within risk-defined subgroups.

PubMed

Whitehurst, David G T; Bryan, Stirling; Lewis, Martyn; Hill, Jonathan; Hay, Elaine M

2012-11-01

Stratified management for low back pain according to patients' prognosis and matched care pathways has been shown to be an effective treatment approach in primary care. The aim of this within-trial study was to determine the economic implications of providing such an intervention, compared with non-stratified current best practice, within specific risk-defined subgroups (low-risk, medium-risk and high-risk). Within a cost-utility framework, the base-case analysis estimated the incremental healthcare cost per additional quality-adjusted life year (QALY), using the EQ-5D to generate QALYs, for each risk-defined subgroup. Uncertainty was explored with cost-utility planes and acceptability curves. Sensitivity analyses were performed to consider alternative costing methodologies, including the assessment of societal loss relating to work absence and the incorporation of generic (ie, non-back pain) healthcare utilisation. The stratified management approach was a cost-effective treatment strategy compared with current best practice within each risk-defined subgroup, exhibiting dominance (greater benefit and lower costs) for medium-risk patients and acceptable incremental cost to utility ratios for low-risk and high-risk patients. The likelihood that stratified care provides a cost-effective use of resources exceeds 90% at willingness-to-pay thresholds of £4000 (≈ 4500; $6500) per additional QALY for the medium-risk and high-risk groups. Patients receiving stratified care also reported fewer back pain-related days off work in all three subgroups. Compared with current best practice, stratified primary care management for low back pain provides a highly cost-effective use of resources across all risk-defined subgroups.

The increased cost of ventral hernia recurrence: a cost analysis.

PubMed

Davila, D G; Parikh, N; Frelich, M J; Goldblatt, M I

2016-12-01

Over 300,000 ventral hernia repairs (VHRs) are performed each year in the US. We sought to assess the economic burden related to ventral hernia recurrences with a focused comparison of those with the initial open versus laparoscopic surgery. The Premier Alliance database from 2009 to 2014 was utilized to obtain patient demographics and comorbid indices, including the Charlson comorbidity index (CCI). Total hospital cost and resource expenses during index laparoscopic and open VHRs and subsequent recurrent repairs were also obtained. The sample was separated into laparoscopic and open repair groups from the initial operation. Adjusted and propensity score matched cost outcome data were then compared amongst groups. One thousand and seventy-seven patients were used for the analysis with a recurrence rate of 3.78 %. For the combined sample, costs were significantly higher during recurrent hernia repair hospitalization ($21,726 versus $19,484, p < 0.0001). However, for index laparoscopic repairs, both the adjusted total hospital cost and department level costs were similar during the index and the recurrent visit. The costs and resource utilization did not go up due to recurrence, even though these patients had greater severity during the recurrent visit (CCI score 0.92 versus 1.06; p = 0.0092). Using a matched sample, the total hospital recurrence cost was higher for the initial open group compared to laparoscopic group ($14,520 versus $12,649; p = 0.0454). Based on our analysis, need for recurrent VHR adds substantially to total hospital costs and resource utilization. Following initial laparoscopic repair, however, the total cost of recurrent repair is not significantly increased, as it is following initial open repair. When comparing the initial laparoscopic repair versus open, the cost of recurrence was higher for the prior open repair group.

Costs of cloud computing for a biometry department. A case study.

PubMed

Knaus, J; Hieke, S; Binder, H; Schwarzer, G

2013-01-01

"Cloud" computing providers, such as the Amazon Web Services (AWS), offer stable and scalable computational resources based on hardware virtualization, with short, usually hourly, billing periods. The idea of pay-as-you-use seems appealing for biometry research units which have only limited access to university or corporate data center resources or grids. This case study compares the costs of an existing heterogeneous on-site hardware pool in a Medical Biometry and Statistics department to a comparable AWS offer. The "total cost of ownership", including all direct costs, is determined for the on-site hardware, and hourly prices are derived, based on actual system utilization during the year 2011. Indirect costs, which are difficult to quantify are not included in this comparison, but nevertheless some rough guidance from our experience is given. To indicate the scale of costs for a methodological research project, a simulation study of a permutation-based statistical approach is performed using AWS and on-site hardware. In the presented case, with a system utilization of 25-30 percent and 3-5-year amortization, on-site hardware can result in smaller costs, compared to hourly rental in the cloud dependent on the instance chosen. Renting cloud instances with sufficient main memory is a deciding factor in this comparison. Costs for on-site hardware may vary, depending on the specific infrastructure at a research unit, but have only moderate impact on the overall comparison and subsequent decision for obtaining affordable scientific computing resources. Overall utilization has a much stronger impact as it determines the actual computing hours needed per year. Taking this into ac count, cloud computing might still be a viable option for projects with limited maturity, or as a supplement for short peaks in demand.

Outcomes and resource utilization associated with underage drinking at a level I trauma center.

PubMed

Psoter, Kevin J; Roudsari, Bahman S; Mack, Christopher; Vavilala, Monica S; Jarvik, Jeffrey G

2014-08-01

To examine the association of blood alcohol content (BAC) on hospital-based outcomes and imaging utilization for patients <21 years admitted to a level I trauma center. Retrospective analysis of alcohol-involved injuries in patients 13-20 years, admitted to a level I trauma center from 1996 to 2010. An injury was considered alcohol involved if the patient had a BAC > 0. Multivariable logistic regression was used to compare mortality, discharge destination (home and skilled nursing facility), intensive care unit admission, and operating room use between patients with and without positive BAC for patients 13-15, 16-17, and 18-20 years. Multivariable linear regression was used to compare length of hospitalization. Finally, multivariable negative binomial regression evaluated radiology resource utilization (x-ray, computed tomography [CT], and magnetic resonance imaging). A total of 7,663 patients, 13-20 years old, were admitted over the study period. A positive BAC was reported in 19% of these patients. In general, the presence of alcohol was not associated with mortality rate, length of hospitalization, intensive care unit, and operating room use or discharge status for any age group. However, the presence of alcohol was associated with higher utilization of head (incidence rate ratio [IRR] 1.13, 95% confidence interval [CI] 1.02-1.26), cervical spine (IRR 1.10, 95% CI 1.01-1.22), and thoracic (IRR 1.30, 95% CI 1.05-1.63) CTs in young adults 18-20 years. No differences in CT use were observed in patients 13-15 or 16-17 years. Positive BAC was not significantly associated with adverse outcomes or resource utilization in younger trauma patients. However, the use of certain body region CTs was associated with positive BAC in patients 18-20 years. Copyright © 2014 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

FPGA implementation for real-time background subtraction based on Horprasert model.

PubMed

Rodriguez-Gomez, Rafael; Fernandez-Sanchez, Enrique J; Diaz, Javier; Ros, Eduardo

2012-01-01

Background subtraction is considered the first processing stage in video surveillance systems, and consists of determining objects in movement in a scene captured by a static camera. It is an intensive task with a high computational cost. This work proposes an embedded novel architecture on FPGA which is able to extract the background on resource-limited environments and offers low degradation (produced because of the hardware-friendly model modification). In addition, the original model is extended in order to detect shadows and improve the quality of the segmentation of the moving objects. We have analyzed the resource consumption and performance in Spartan3 Xilinx FPGAs and compared to others works available on the literature, showing that the current architecture is a good trade-off in terms of accuracy, performance and resources utilization. With less than a 65% of the resources utilization of a XC3SD3400 Spartan-3A low-cost family FPGA, the system achieves a frequency of 66.5 MHz reaching 32.8 fps with resolution 1,024 × 1,024 pixels, and an estimated power consumption of 5.76 W.

FPGA Implementation for Real-Time Background Subtraction Based on Horprasert Model

PubMed Central

Rodriguez-Gomez, Rafael; Fernandez-Sanchez, Enrique J.; Diaz, Javier; Ros, Eduardo

2012-01-01

Background subtraction is considered the first processing stage in video surveillance systems, and consists of determining objects in movement in a scene captured by a static camera. It is an intensive task with a high computational cost. This work proposes an embedded novel architecture on FPGA which is able to extract the background on resource-limited environments and offers low degradation (produced because of the hardware-friendly model modification). In addition, the original model is extended in order to detect shadows and improve the quality of the segmentation of the moving objects. We have analyzed the resource consumption and performance in Spartan3 Xilinx FPGAs and compared to others works available on the literature, showing that the current architecture is a good trade-off in terms of accuracy, performance and resources utilization. With less than a 65% of the resources utilization of a XC3SD3400 Spartan-3A low-cost family FPGA, the system achieves a frequency of 66.5 MHz reaching 32.8 fps with resolution 1,024 × 1,024 pixels, and an estimated power consumption of 5.76 W. PMID:22368487

The Conservation and Protection: The Development and Utilization of Human Resources.

ERIC Educational Resources Information Center

Lippitt, Ronald

The three dimensions of the quality of the environment for human resource development are discussed as issues of opportunity versus deprivation, issues of growth inducing versus growth destroying interventions, and issues of utilization versus non-utilization of human resources. Both pathology and potential are illustrated by descriptions of our…

18 CFR 2.78 - Utilization and conservation of natural resources-natural gas.

Code of Federal Regulations, 2011 CFR

2011-04-01

... conservation of natural resources-natural gas. 2.78 Section 2.78 Conservation of Power and Water Resources... INTERPRETATIONS Statements of General Policy and Interpretations Under the Natural Gas Act § 2.78 Utilization and conservation of natural resources—natural gas. (a)(1) The national interests in the development and utilization...

The Japanese Surgical Reimbursement System Fails to Reflect Resource Utilization.

PubMed

Nakata, Yoshinori; Watanabe, Yuichi; Otake, Hiroshi; Nakamura, Toshihito; Oiso, Giichiro; Sawa, Tomohiro

2015-01-01

The goal of this study was to examine the current Japanese surgical payment system from the viewpoint of resource utilization. We collected data from surgical records in Teikyo University's electronic medical record system from April 1 through September 30, 2013. We defined the decision-making unit as a surgeon with the highest academic rank in the surgery. Inputs were defined as: 1) the number of medical doctors who assisted surgery and 2) the time of operation from skin incision to closure. An output was defined as the surgical fee. We calculated each surgeon's efficiency score using the output-oriented Banker-Charnes-Cooper model of data envelopment analysis. We compared the efficiency scores of each surgical specialty using the Kruskal-Wallis and Steel methods. We analyzed 2,825 surgical procedures performed by 103 surgeons. The difference in efficiency scores was significant (P = 0.0001). The thoracic surgeons were the most efficient and were more efficient than plastic, obstetric and gynecologic, urologic, otorhinolaryngologic, orthopedic, general, and emergency surgeons (P < 0.05). We demonstrated that surgeons' efficiency in operating rooms was significantly different among surgical specialties. This suggests that the Japanese surgical reimbursement scales fails to reflect resource utilization. © The Author(s) 2015.

[Adapting health services to the specific needs and utilization patterns of the new Spaniards. 2008 SESPAS Report].

PubMed

Ribera, Berta; Casal, Bruno; Cantarero, David; Pascual, Marta

2008-04-01

Because of the progressive increase in the number of immigrants and the uncertainty about the capacity of the Spanish health service to deal with the quantitative and qualitative increases in demand, the possibility of introducing changes to adapt our services to the new situation should be considered. Beginning with an analysis of the factors that influence health status and use of the health service, based on the National Health Survey (NHS), the European Statistics on Income and Living Conditions (EU-SILC) and the European Community Household Panel (ECHP), we compare the health profiles and patterns of medical resources utilization between the national and foreign populations. The pattern of demand for health services in the immigrant population corresponds basically to the needs of a young population in good health. According to NHS data, resource utilization among immigrants can even be lower than that among the national population. Assessing the link between health status and demand for healthcare from a dynamic point of view, by identifying variations in patterns of health and patterns of demand for healthcare, is important to identify imbalances in resources and to establish an appropriate hierarchy of preventive and treatment priorities.

Study on the Water Resource Sustainable Utilization Evaluation Index System in Jiangsu Coast Reclamation Region

NASA Astrophysics Data System (ADS)

Ren, L.

2016-12-01

As a comprehensive system, there are many subsystems such as water resource subsystem, social subsystem, economic subsystem and ecological subsystem in water resource sustainable utilization system. In this paper, an evaluation system including three levels is set up according to the metric demands of sustainable water resource utilization in Jiangsu coast reclamation region, namely the target level, the rule level, and the index level. Considering the large number of the indexes, the analytic hierarchy process is used to determine the weights of all these subsystems in the total goal of water sustainable utilization. By analyzing these weights, the attributes of water resource itself is found to be the most important aspect for the evaluation of sustainable utilization in Jiangsu coast reclamation region, and the second important aspect is the situation of the eco-environment.

The Software Management Environment (SME)

NASA Technical Reports Server (NTRS)

Valett, Jon D.; Decker, William; Buell, John

1988-01-01

The Software Management Environment (SME) is a research effort designed to utilize the past experiences and results of the Software Engineering Laboratory (SEL) and to incorporate this knowledge into a tool for managing projects. SME provides the software development manager with the ability to observe, compare, predict, analyze, and control key software development parameters such as effort, reliability, and resource utilization. The major components of the SME, the architecture of the system, and examples of the functionality of the tool are discussed.

A hybrid geothermal energy conversion technology: Auxiliary heating of geothermally preheated water or CO2 - a potential solution for low-temperature resources

NASA Astrophysics Data System (ADS)

Saar, Martin; Garapati, Nagasree; Adams, Benjamin; Randolph, Jimmy; Kuehn, Thomas

2016-04-01

Safe, sustainable, and economic development of deep geothermal resources, particularly in less favourable regions, often requires employment of unconventional geothermal energy extraction and utilization methods. Often "unconventional geothermal methods" is synonymously and solely used as meaning enhanced geothermal systems, where the permeability of hot, dry rock with naturally low permeability at greater depths (4-6 km), is enhanced. Here we present an alternative unconventional geothermal energy utilization approach that uses low-temperature regions that are shallower, thereby drastically reducing drilling costs. While not a pure geothermal energy system, this hybrid approach may enable utilization of geothermal energy in many regions worldwide that can otherwise not be used for geothermal electricity generation, thereby increasing the global geothermal resource base. Moreover, in some realizations of this hybrid approach that generate carbon dioxide (CO2), the technology may be combined with carbon dioxide capture and storage (CCS) and CO2-based geothermal energy utilization, resulting in a high-efficiency (hybrid) geothermal power plant with a negative carbon footprint. Typically, low- to moderate-temperature geothermal resources are more effectively used for direct heat energy applications. However, due to high thermal losses during transport, direct use requires that the heat resource is located near the user. Alternatively, we show here that if such a low-temperature geothermal resource is combined with an additional or secondary energy resource, the power production is increased compared to the sum from two separate (geothermal and secondary fuel) power plants (DiPippo et al. 1978) and the thermal losses are minimized because the thermal energy is utilized where it is produced. Since Adams et al. (2015) found that using CO2 as a subsurface working fluid produces more net power than brine at low- to moderate-temperature geothermal resource conditions, we compare over a range of parameters the net power and efficiencies of hybrid geothermal power plants that use brine or CO2 as the subsurface working fluid, that are then heated further with a secondary energy source that is unspecified here. Parameters varied include the subsurface working fluid (brine vs. CO2), geothermal reservoir depth (2.5-4.5 km), and turbine inlet temperature (200-600°C) after auxiliary heating. The hybrid power plant is numerically modeled using an iterative coupling approach of TOUGH2-ECO2N/ECO2H (Pruess, 2004) for simulation of the subsurface reservoir and Engineering Equation Solver for well bore fluid flow and surface power plant performance. We find that hybrid power plants that are CO2-based (subsurface) systems produce more net power than the sum of the power produced by individual power plants at low turbine inlet temperatures and brine based systems produce more power at high turbine inlet temperatures. Specifically, our results indicate that geothermal hybrid plants that are CO2-based are more efficient than brine-based systems when the contribution of the geothermal resource energy is higher than 48%.

[Utilization suitability of forest resources in typical forest zone of Changbai Mountains].

PubMed

Hao, Zhanqing; Yu, Deyong; Xiong, Zaiping; Ye, Ji

2004-10-01

Conservation of natural forest does not simply equal to no logging. The Northeast China Forest Region has a logging quota of mature forest as part of natural forest conservation project. How to determine the logging spots rationally and scientifically is very important. Recent scientific theories of forest resources management advocate that the utilization of forest resources should stick to the principle of sustaining use, and pay attention to the ecological function of forest resources. According to the logging standards, RS and GIS techniques can be used to detect the precise location of forest resources and obtain information of forest areas and types, and thus, provide more rational and scientific support for space choice about future utilization of forest resources. In this paper, the Lushuihe Forest Bureau was selected as a typical case in Changbai Mountains Forest Region to assess the utilization conditions of forest resources, and some advices on spatial choice for future management of forest resources in the study area were offered.

The utilization of poisons information resources in Australasia.

PubMed

Fountain, J S; Reith, D M; Holt, A

2014-02-01

To identify poisons information resources most commonly utilized by Australasian Emergency Department staff, and examine attitudes regarding the benefits and user experience of the electronic products used. A survey tool was mailed to six Emergency Departments each in New Zealand and Australia to be answered by medical and nursing staff. Eighty six (71.7%) responses were received from the 120 survey forms sent: 70 (81%) responders were medical staff, the remainder nursing. Electronic resources were the most accessed poisons information resource in New Zealand; Australians preferring discussion with a colleague; Poisons Information Centers were the least utilized resource in both countries. With regard to electronic resources, further differences were recognized between countries in: ease of access, ease of use, quality of information and quantity of information, with New Zealand better in all four themes. New Zealand ED staff favored electronic poisons information resources while Australians preferred discussion with a colleague. That Poisons Information Centers were the least utilized resource was surprising. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

Generic antiepileptic drugs and associated medical resource utilization in the United States.

PubMed

Labiner, D M; Paradis, P E; Manjunath, R; Duh, M S; Lafeuille, M-H; Latrémouille-Viau, D; Lefebvre, P; Helmers, S L

2010-05-18

To evaluate whether generic substitution was associated with any difference in medical resource utilization for 5 widely used antiepileptic drugs (AEDs) in the United States. Health insurance claims from PharMetrics Database, representing over 90 health plans between January 2000 and October 2007, were analyzed. Adult patients with epilepsy, continuously treated with carbamazepine, gabapentin, phenytoin, primidone, or zonisamide, were selected. An open-cohort design was used to classify patients into mutually exclusive periods of brand vs generic use of AEDs. Pharmacy and medical utilization were compared between the 2 periods with multivariate regression analyses. Results were stratified into epilepsy-related medical services, and stable (< or = 2 outpatient visits per year and no emergency room visit) vs unstable epilepsy. Time-to-event analyses were also performed for all services and epilepsy-related endpoints. A total of 18,125 patients were observed in the stable group and 15,500 patients in the unstable group. After adjustment of covariates, periods of generic AED treatment were associated with increased use of all prescription drugs (incidence rate ratio [IRR] [95% confidence interval (CI)] = 1.13 [1.13-1.14]) and higher epilepsy-related medical utilization rates (hospitalizations: IRR [95% CI] = 1.24 [1.19-1.30]; outpatient visits: IRR [95% CI] = 1.14 [1.13-1.16]; lengths of hospital stays: IRR [95% CI] = 1.29 [1.27-1.32]). Generic-use periods were associated with increased utilization rates in stable and unstable patients and with 20% increased risk of injury, compared to periods with brand use of AEDs. Generic antiepileptic drug use was associated with significantly greater medical utilization and risk of epilepsy-related medical events, compared to brand use. This relationship was observed even in patients characterized as stable. AED = antiepileptic drug; CI = confidence interval; ER = emergency room; HR = hazard ratio; ICD = International Classification of Diseases; IRR = incidence rate ratio.

Asthma Outcomes: Healthcare Utilization and Costs

PubMed Central

Akinbami, Lara J.; Sullivan, Sean D.; Campbell, Jonathan D.; Grundmeier, Robert W.; Hartert, Tina V.; Lee, Todd A.; Smith, Robert A.

2014-01-01

Background Measures of healthcare utilization and indirect impact of asthma morbidity are used to assess clinical interventions and estimate cost. Objective National Institutes of Health (NIH) institutes and other federal agencies convened an expert group to propose standardized measurement, collection, analysis, and reporting of healthcare utilization and cost outcomes in future asthma studies. Methods We used comprehensive literature reviews and expert opinion to compile a list of asthma healthcare utilization outcomes that we classified as core (required in future studies), supplemental (used according to study aims and standardized) and emerging (requiring validation and standardization). We also have identified methodology to assign cost to these outcomes. This work was discussed at an NIH-organized workshop in March 2010 and finalized in September 2011. Results We identified 3 ways to promote comparability across clinical trials for measures of healthcare utilization, resource use, and cost: (1) specify the study perspective (patient, clinician, payer, society), (2) standardize the measurement period (ideally, 12 months), and (3) use standard units to measure healthcare utilization and other asthma-related events. Conclusions Large clinical trials and observational studies should collect and report detailed information on healthcare utilization, intervention resources, and indirect impact of asthma, so that costs can be calculated and cost-effectiveness analyses can be conducted across several studies. Additional research is needed to develop standard, validated survey instruments for collection of provider-reported and participant-reported data regarding asthma-related health care. PMID:22386509

Job satisfaction in relation to energy resource consciousness and perceptions of energy utilization in selected Illinois manufacturing firms

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

Haynes, T.S.

1986-01-01

This study was developed through a synthesis and review of literature and research related to the current status of job satisfaction, energy resources, and perceptions of how energy is utilized in the manufacturing work environment. This synthesis and review revolved around several proven contributing factors of job satisfaction, such as age, education, and challenge from work itself. Quality of work life programs and their components are discussed in relation to their impact on job satisfaction. The nature of energy resource utilization is traced back through history with an emphasis on the limitations of current resources and options for the future.more » The review highlights the current debate over what should be the future path of energy resource development. The concept of satisfaction of human needs is reviewed and related to job satisfaction and energy resources. The purpose of this research study was to contribute to the understanding of how perceptions of energy resources relate to job satisfaction. Results of the study indicated that there were no significant differences between an individual's energy resource consciousness and perceptions of energy utilization in the work place, energy resource consciousness and job satisfaction, and job satisfaction and perceptions of energy utilization in the workplace.« less

Youth Physical Activity Resources Use and Activity Measured by Accelerometry

PubMed Central

Maslow, Andréa L.; Colabianchi, Natalie

2014-01-01

Objectives To examine whether utilization of physical activity resources (eg, parks) was associated with daily physical activity measured by accelerometry. Methods 111 adolescents completed a travel diary with concurrent accelerometry. The main exposure was self-reported utilization of a physical activity resource (none/1+ resources). The main outcomes were total minutes spent in daily 1) moderate-vigorous physical activity and 2) vigorous physical activity. Results Utilizing a physical activity resource was significantly associated with total minutes in moderate-vigorous physical activity. African-Americans and males had significantly greater moderate-vigorous physical activity. Conclusions Results from this study support the development and use of physical activity resources. PMID:21204684

Resources and training in outpatient substance abuse treatment facilities.

PubMed

Lehman, Wayne E K; Becan, Jennifer E; Joe, George W; Knight, Danica K; Flynn, Patrick M

2012-03-01

The exposure to new clinical interventions through formalized training and the utilization of strategies learned through training are two critical components of the program change process. This study considers the combined influence of actual program fiscal resources and counselors' perceptions of workplace resources on two mechanisms of training: exposure and utilization. Data were collected from 323 counselors nested within 59 programs located in nine states. Multilevel analysis revealed that training exposure and training utilization represent two distinct constructs that are important at different stages in the Program Change Model. Training exposure is associated primarily with physical and financial resources, whereas utilization is associated with professional community and job burnout. These results suggest that financial resources are important in initial exposure to new interventions but that successful utilization of new techniques depends in part on the degree of burnout and collaboration experienced by counselors. Copyright © 2012 Elsevier Inc. All rights reserved.

Resources and Training in Outpatient Substance Abuse Treatment Facilities

PubMed Central

Lehman, Wayne E. K.; Becan, Jennifer E.; Joe, George W.; Knight, Danica K.; Flynn, Patrick M.

2011-01-01

The exposure to new clinical interventions through formalized training and the utilization of strategies learned through training are two critical components of the program change process. The current study considers the combined influence of actual program fiscal resources and counselors’ perceptions of workplace resources on two mechanisms of training: exposure and utilization. Data were collected from 323 counselors nested within 59 programs located in 9 states. Multilevel analysis revealed that training exposure and training utilization represent two distinct constructs that are important at different stages in the Program Change Model. Training exposure is associated primarily with physical and financial resources, whereas utilization is associated with professional community and job burnout. These results suggest that financial resources are important in initial exposure to new interventions, but that successful utilization of new techniques depends in part on the degree of burnout and collaboration experienced by counselors. PMID:22154031

Impact of treatment policies on patient outcomes and resource utilization in acute cholecystitis in Japanese hospitals

PubMed Central

Sekimoto, Miho; Imanaka, Yuichi; Hirose, Masahiro; Ishizaki, Tatsuro; Murakami, Genki; Fukata, Yushi

2006-01-01

Background Although currently available evidence predominantly recommends early laparoscopic cholecystectomy (LC) for the treatment of acute cholecystitis, this strategy has not been widely adopted in Japan. Herein, we describe a hospital-based study of patients with acute cholecystitis in 9 Japanese teaching hospitals in order to evaluate the impact of different institutional strategies in treating acute cholecystitis on overall patient outcomes and medical resource utilization. Methods From an administrative database and chart review, we identified 228 patients diagnosed with acute cholecystitis who underwent cholecystectomy between April 2001 and June 2003. In order to examine the relationship between hospitals' propensity to perform LC and patient outcomes and/or medical resource utilization, we divided the hospitals into three groups according to the observed to expected ratio of performing LC (LC propensity), and compared the postoperative complication rate, length of hospitalization (LOS), and medical charges. Results No hospital adopted the policy of early surgery, and the mean overall LOS among the subjects was 30.9 days. The use of laparoscopic surgery varied widely across the hospitals; the adjusted rates of LC to total cholecystectomies ranged from 9.5% to 77%. Although intra-operative complication rate was significantly higher among patients whom LC was initially attempted when compared to those whom OC was initially attempted (9.7% vs. 0%), there was no significant association between LC propensity and postoperative complication rates. Although the postoperative time to oral intake and postoperative LOS was significantly shorter in hospitals with high use of LC, the overall LOS did not differ among hospital groups with different LC propensities. Medical charges were not associated with LC propensity. Conclusion Under the prevailing policy of delayed surgery, in terms of the postoperative complication rate and medical resource utilization, our study did not show the superiority of LC in treating acute cholecystitis patients. The timing of surgery and discharge was mainly determined by the institutional policy in Japan, rather than by the clinical course of the patient; however, considering the substantially less postoperative pain and shorter recovery time of LC compared to OC, LC should be actively applied for the treatment of acute cholecystitis. If the policy of early surgery were universally applied, the advantage of LC over OC may be more clearly demonstrated. PMID:16569249

Impact of treatment policies on patient outcomes and resource utilization in acute cholecystitis in Japanese hospitals.

PubMed

Sekimoto, Miho; Imanaka, Yuichi; Hirose, Masahiro; Ishizaki, Tatsuro; Murakami, Genki; Fukata, Yushi

2006-03-29

Although currently available evidence predominantly recommends early laparoscopic cholecystectomy (LC) for the treatment of acute cholecystitis, this strategy has not been widely adopted in Japan. Herein, we describe a hospital-based study of patients with acute cholecystitis in 9 Japanese teaching hospitals in order to evaluate the impact of different institutional strategies in treating acute cholecystitis on overall patient outcomes and medical resource utilization. From an administrative database and chart review, we identified 228 patients diagnosed with acute cholecystitis who underwent cholecystectomy between April 2001 and June 2003. In order to examine the relationship between hospitals' propensity to perform LC and patient outcomes and/or medical resource utilization, we divided the hospitals into three groups according to the observed to expected ratio of performing LC (LC propensity), and compared the postoperative complication rate, length of hospitalization (LOS), and medical charges. No hospital adopted the policy of early surgery, and the mean overall LOS among the subjects was 30.9 days. The use of laparoscopic surgery varied widely across the hospitals; the adjusted rates of LC to total cholecystectomies ranged from 9.5% to 77%. Although intra-operative complication rate was significantly higher among patients whom LC was initially attempted when compared to those whom OC was initially attempted (9.7% vs. 0%), there was no significant association between LC propensity and postoperative complication rates. Although the postoperative time to oral intake and postoperative LOS was significantly shorter in hospitals with high use of LC, the overall LOS did not differ among hospital groups with different LC propensities. Medical charges were not associated with LC propensity. Under the prevailing policy of delayed surgery, in terms of the postoperative complication rate and medical resource utilization, our study did not show the superiority of LC in treating acute cholecystitis patients. The timing of surgery and discharge was mainly determined by the institutional policy in Japan, rather than by the clinical course of the patient; however, considering the substantially less postoperative pain and shorter recovery time of LC compared to OC, LC should be actively applied for the treatment of acute cholecystitis. If the policy of early surgery were universally applied, the advantage of LC over OC may be more clearly demonstrated.

The incidence and relevance of site-reported vs. patient-reported angina: insights from the ABSORB II randomized trial comparing Absorb everolimus-eluting bioresorbable scaffold with XIENCE everolimus-eluting metallic stent.

PubMed

Grundeken, Maik J; White, Roseann M; Hernandez, John B; Dudek, Dariusz; Cequier, Angel; Haude, Michael; van Boven, Adrianus J; Piek, Jan J; Helqvist, Steffen; Sabate, Manel; Baumbach, Andreas; Suwannasom, Pannipa; Ishibashi, Yuki; Staehr, Peter; Veldhof, Susan; Cheong, Wai-Fung; de Winter, Robbert J; Garcia-Garcia, Hector M; Wykrzykowska, Joanna J; Onuma, Yoshinobu; Serruys, Patrick W; Chevalier, Bernard

2016-04-01

In the ABSORB II trial, comparing Absorb™ bioresorbable vascular scaffold with metallic XIENCE™ everolimus-eluting stent (EES), a difference was found in site-reported new or worsening angina using adverse event (AE) reporting. However, the clinical relevance of this site-reported angina is unclear. The aim of the present study was therefore to investigate the clinical relevance of site-reported angina by evaluating its relation with cardiac endpoints, cardiovascular resource utilization (including diagnostics and treatment), positive exercise stress tolerance tests (ETTs), and Seattle Angina Questionnaire (SAQ). Site-reported new or worsening angina was captured on cardiac AE forms. There was a wide variation in the total number of days with site-reported angina (overall interquartile range 35-279 days). Patients with site-reported angina showed higher rates of cardiovascular events [including the patient-oriented composite endpoint of all deaths, all myocardial infarctions (MI), or all revascularizations (21.1 vs. 4.2%, P < 0.0001), all MIs (2.3 vs. 0%, P = 0.03), and all revascularizations (21.1 vs. 0.7%, P < 0.0001)], cardiovascular resource utilization (including stress tests, anti-anginal medication, diagnostic angiographies, and hospitalization), and positive ETTs (51.9 vs. 14.9%, P < 0.001), compared with those without site-reported angina. Furthermore, an event-based analysis of the SAQ showed that patients with ongoing angina within the recall period of 4 weeks prior to the SAQ assessment have clinically and statistically significant decrements of >14 points in SAQ scores compared with those with no reported angina. We showed that the site-reported angina through AE reporting may be clinically relevant because of their relation with cardiovascular events (mostly repeat revascularizations), cardiovascular resource utilization, ETT, and SAQ. https://clinicaltrials.gov/ct2/show/NCT01425281; Unique identifier: NCT01425281.

Fracture risk and healthcare resource utilization and costs among osteoporosis patients with type 2 diabetes mellitus and without diabetes mellitus in Japan: retrospective analysis of a hospital claims database.

PubMed

Sato, Masayo; Ye, Wenyu; Sugihara, Tomoko; Isaka, Yoshitaka

2016-11-25

Osteoporosis, osteoporosis-related fractures, and diabetes are considerable health burdens in Japan. Diabetes in patients with osteoporosis has been reported to be associated with increased fracture risk. This retrospective analysis of a Japanese hospital claims database investigated the real-world effect of type 2 diabetes mellitus (T2DM) on the incidence of clinical fractures, costs, and healthcare resource utilization in patients with osteoporosis and a subgroup of patients prescribed raloxifene. Women aged ≥50 years diagnosed with osteoporosis who had a first prescription claim for osteoporosis treatment with a pre-index period ≥12 months and a post-index period of 30 months were selected from a database extract (April 2008-July 2013). Patients prescribed raloxifene were classed as a subgroup. Patients diagnosed with T2DM constituted the T2DM group; all other patients (excluding patients with type 1 diabetes mellitus) constituted the non-diabetes mellitus (non-DM) group. Groups were matched by exact matching, using selected baseline characteristics. Patient demographic and clinical characteristics were compared using chi-squared tests, t-tests, or Wilcoxon rank sum tests. Time to first fracture was examined using Kaplan-Meier survival analysis. Overall, the T2DM and non-DM groups had 7580 and 7979 patients, respectively; following matching, there were 3273 patients per group. In the raloxifene subgroup, the T2DM and non-DM groups had 668 and 699 patients, respectively; following matching, there were 239 patients per group. At baseline, the T2DM group (overall and raloxifene subgroup) had significantly higher healthcare resource utilization and comorbidities. During the post-index period, a similar pattern was observed in the overall group, even after matching; the T2DM group also had a higher incidence of fracture. In the raloxifene subgroup, after matching, there were no significant differences in fracture incidence or costs and fewer differences in healthcare resource utilization between the T2DM and non-DM groups. These findings suggest that comorbid T2DM increases fracture incidence in patients with osteoporosis, compared with patients without DM. Increases in fracture incidence were accompanied by greater costs and healthcare resource utilization, which are important considerations for clinical practice in Japan. Further research investigating the use of raloxifene for treatment of osteoporosis with comorbid T2DM may also be warranted.

Comparative evaluation of solar, fission, fusion, and fossil energy resources. Part 1: Solar energy

NASA Technical Reports Server (NTRS)

Williams, J. R.

1974-01-01

The utilization of solar energy to meet the energy needs of the U.S. is discussed. Topics discussed include: availability of solar energy, solar energy collectors, heating for houses and buildings, solar water heater, electric power generation, and ocean thermal power.

FPGA Implementation of Optimal 3D-Integer DCT Structure for Video Compression

PubMed Central

2015-01-01

A novel optimal structure for implementing 3D-integer discrete cosine transform (DCT) is presented by analyzing various integer approximation methods. The integer set with reduced mean squared error (MSE) and high coding efficiency are considered for implementation in FPGA. The proposed method proves that the least resources are utilized for the integer set that has shorter bit values. Optimal 3D-integer DCT structure is determined by analyzing the MSE, power dissipation, coding efficiency, and hardware complexity of different integer sets. The experimental results reveal that direct method of computing the 3D-integer DCT using the integer set [10, 9, 6, 2, 3, 1, 1] performs better when compared to other integer sets in terms of resource utilization and power dissipation. PMID:26601120

MIUS community conceptual design study

NASA Technical Reports Server (NTRS)

Fulbright, B. E.

1976-01-01

The feasibility, practicality, and applicability of the modular integrated utility systems (MIUS) concept to a satellite new-community development with a population of approximately 100,000 were analyzed. Two MIUS design options, the 29-MIUS-unit (option 1) and the 8-MIUS-unit (option 2) facilities were considered. Each resulted in considerable resource savings when compared to a conventional utility system. Economic analyses indicated that the total cash outlay and operations and maintenance costs for these two options were considerably less than for a conventional system. Computer analyses performed in support of this study provided corroborative data for the study group. An environmental impact assessment was performed to determine whether the MIUS meets or will meet necessary environmental standards. The MIUS can provide improved efficiency in the conservation of natural resources while not adversely affecting the physical environment.

Environmental implications of increased biomass energy use

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

Miles, T.R. Sr.; Miles, T.R. Jr.

1992-03-01

This study reviews the environmental implications of continued and increased use of biomass for energy to determine what concerns have been and need to be addressed and to establish some guidelines for developing future resources and technologies. Although renewable biomass energy is perceived as environmentally desirable compared with fossil fuels, the environmental impact of increased biomass use needs to be identified and recognized. Industries and utilities evaluating the potential to convert biomass to heat, electricity, and transportation fuels must consider whether the resource is reliable and abundant, and whether biomass production and conversion is environmentally preferred. A broad range ofmore » studies and events in the United States were reviewed to assess the inventory of forest, agricultural, and urban biomass fuels; characterize biomass fuel types, their occurrence, and their suitability; describe regulatory and environmental effects on the availability and use of biomass for energy; and identify areas for further study. The following sections address resource, environmental, and policy needs. Several specific actions are recommended for utilities, nonutility power generators, and public agencies.« less

Using a Radiofrequency Identification System for Improving the Patient Discharge Process: A Simulation Study.

PubMed

Shim, Sung J; Kumar, Arun; Jiao, Roger

2016-01-01

A hospital is considering deploying a radiofrequency identification (RFID) system and setting up a new "discharge lounge" to improve the patient discharge process. This study uses computer simulation to model and compare the current process and the new process, and it assesses the impact of the RFID system and the discharge lounge on the process in terms of resource utilization and time taken in the process. The simulation results regarding resource utilization suggest that the RFID system can slightly relieve the burden on all resources, whereas the RFID system and the discharge lounge together can significantly mitigate the nurses' tasks. The simulation results in terms of the time taken demonstrate that the RFID system can shorten patient wait times, staff busy times, and bed occupation times. The results of the study could prove helpful to others who are considering the use of an RFID system in the patient discharge process in hospitals or similar processes.

Comparison between Canadian Triage and Acuity Scale and Taiwan Triage System in emergency departments.

PubMed

Ng, Chip-Jin; Hsu, Kuang-Hung; Kuan, Jen-Tze; Chiu, Te-Fa; Chen, Wei-Kong; Lin, Hung-Jung; Bullard, Michael J; Chen, Jih-Chang

2010-11-01

Since the implementation of National Health Insurance in Taiwan, Emergency Department (ED) volume has progressively increased, and the current triage system is insufficient and needs modification. This study compared the prioritization and resource utilization differences between the four-level Taiwan Triage System (TTS) and the standardized five-level Canadian Triage and Acuity Scale (CTAS) among ED patients. This was a prospective observational study. All adult ED patients who presented to three different medical centers during the study period were included. Patients were independently triaged by the duty triage nurse using TTS, and a single trained research nurse using CTAS with a computer support software system. Hospitalization, length of stay (LOS), and medical resource consumption were analyzed by comparing TTS and CTAS by acuity levels. There was significant disparity in patient prioritization between TTS and CTAS among the 1851 enrolled patients. With TTS, 7.8%, 46.1%, 45.9% and 0.2% were assigned to levels 1, 2, 3, and 4, respectively. With CTAS, 3.5%, 24.4%, 44.3%, 22.4% and 5.5% were assigned to levels 1, 2, 3, 4, and 5, respectively. The hospitalization rate, LOS, and medical resource consumption differed significantly between the two triage systems and correlated better with CTAS. CTAS provided better discrimination for ED patient triage, and also showed greater validity when predicting hospitalization, LOS, and medical resource consumption. An accurate five-level triage scale appeared superior in predicting patient acuity and resource utilization. Copyright © 2010 Formosan Medical Association & Elsevier. Published by Elsevier B.V. All rights reserved.

Comparing the costs of alternative models of end-of-life care.

PubMed

McBride, Tom; Morton, Alec; Nichols, Andy; van Stolk, Christian

2011-01-01

This study explores the financial consequences of decreased acute care utilization and expanded community-based care for patients at the end of life in England. A Markov model based on cost and utilization data was used to estimate the costs of care for cancer and organ failure in the last year of life and to simulate reduced acute care utilization. We estimated at pounds 1.8 billion the cost to the taxpayer of care for the 127,000 patients dying from cancer in 2006. The equivalent cost for the 30,000 people dying from organ failure was pounds 553 million. Resources of pounds 16 to pounds 171 million could be released for cancer. People generally prefer to die outside hospital. Our results suggest that reducing reliance on acute care could release resources and better meet peoples' preferences. Better data on the cost-effectiveness of interventions are required. Similar models would be useful to decision-makers evaluating changes in service provision.

Maximizing Resource Utilization in Video Streaming Systems

ERIC Educational Resources Information Center

Alsmirat, Mohammad Abdullah

2013-01-01

Video streaming has recently grown dramatically in popularity over the Internet, Cable TV, and wire-less networks. Because of the resource demanding nature of video streaming applications, maximizing resource utilization in any video streaming system is a key factor to increase the scalability and decrease the cost of the system. Resources to…

18 CFR 2.78 - Utilization and conservation of natural resources-natural gas.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 18 Conservation of Power and Water Resources 1 2013-04-01 2013-04-01 false Utilization and conservation of natural resources-natural gas. 2.78 Section 2.78 Conservation of Power and Water Resources FEDERAL ENERGY REGULATORY COMMISSION, DEPARTMENT OF ENERGY GENERAL RULES GENERAL POLICY AND...

18 CFR 2.78 - Utilization and conservation of natural resources-natural gas.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 18 Conservation of Power and Water Resources 1 2012-04-01 2012-04-01 false Utilization and conservation of natural resources-natural gas. 2.78 Section 2.78 Conservation of Power and Water Resources FEDERAL ENERGY REGULATORY COMMISSION, DEPARTMENT OF ENERGY GENERAL RULES GENERAL POLICY AND...

18 CFR 2.78 - Utilization and conservation of natural resources-natural gas.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 18 Conservation of Power and Water Resources 1 2010-04-01 2010-04-01 false Utilization and conservation of natural resources-natural gas. 2.78 Section 2.78 Conservation of Power and Water Resources FEDERAL ENERGY REGULATORY COMMISSION, DEPARTMENT OF ENERGY GENERAL RULES GENERAL POLICY AND...

18 CFR 2.78 - Utilization and conservation of natural resources-natural gas.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 18 Conservation of Power and Water Resources 1 2014-04-01 2014-04-01 false Utilization and conservation of natural resources-natural gas. 2.78 Section 2.78 Conservation of Power and Water Resources FEDERAL ENERGY REGULATORY COMMISSION, DEPARTMENT OF ENERGY GENERAL RULES GENERAL POLICY AND...

Water transparency drives intra-population divergence in Eurasian Perch (Perca fluviatilis).

PubMed

Bartels, Pia; Hirsch, Philipp E; Svanbäck, Richard; Eklöv, Peter

2012-01-01

Trait combinations that lead to a higher efficiency in resource utilization are important drivers of divergent natural selection and adaptive radiation. However, variation in environmental features might constrain foraging in complex ways and therefore impede the exploitation of critical resources. We tested the effect of water transparency on intra-population divergence in morphology of Eurasian perch (Perca fluviatilis) across seven lakes in central Sweden. Morphological divergence between near-shore littoral and open-water pelagic perch substantially increased with increasing water transparency. Reliance on littoral resources increased strongly with increasing water transparency in littoral populations, whereas littoral reliance was not affected by water transparency in pelagic populations. Despite the similar reliance on pelagic resources in pelagic populations along the water transparency gradient, the utilization of particular pelagic prey items differed with variation in water transparency in pelagic populations. Pelagic perch utilized cladocerans in lakes with high water transparency and copepods in lakes with low water transparency. We suggest that under impaired visual conditions low utilization of littoral resources by littoral perch and utilization of evasive copepods by pelagic perch may lead to changes in morphology. Our findings indicate that visual conditions can affect population divergence in predator populations through their effects on resource utilization.

Outside the operating room: How a robotics program changed resource utilization on the inpatient Ward.

PubMed

Leung, Annie; Abitbol, Jeremie; Ramana-Kumar, Agnihotram V; Fadlallah, Bassam; Kessous, Roy; Cohen, Sabine; Lau, Susie; Salvador, Shannon; Gotlieb, Walter H

2017-04-01

To analyze the changes in the composition of the gynecologic oncology inpatient ward following the implementation of a robotic surgery program and its impact on inpatient resource utilization and costs. Retrospective review of the medical charts of patients admitted onto the gynecologic oncology ward the year prior to and five years after the implementation of robotics. The following variables were collected: patient characteristics, hospitalization details (reason for admission and length of hospital stay), and resource utilization (number of hospitalization days, consultations, and imaging). Following the introduction of robotic surgery, there were more admissions for elective surgery yet these accounted for only 21% of the inpatient ward in terms of number of hospital days, compared to 36% prior to the robotic program. This coincided with a sharp increase in the overall number of patients operated on by a minimally invasive approach (15% to 76%, p<0.0001). The cost per surgical admission on the inpatient ward decreased by 59% ($9827 vs. $4058) in the robotics era. The robotics program contributed to a ward with higher proportion of patients with complex comorbidities (Charlson≥5: RR 1.06), Stage IV disease (RR 1.30), and recurrent disease (RR 1.99). Introduction of robotic surgery allowed for more patients to be treated surgically while simultaneously decreasing inpatient resource use. With more patients with non-surgical oncological issues and greater medical complexity, the gynecologic oncology ward functions more like a medical rather than surgical ward after the introduction of robotics, which has implications for hospital-wide resource planning. Copyright © 2017 Elsevier Inc. All rights reserved.

Framework for Shared Drinking Water Risk Assessment.

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

Lowry, Thomas Stephen; Tidwell, Vincent C.; Peplinski, William John

Central to protecting our nation's critical infrastructure is the development of methodologies for prioritizing action and supporting resource allocation decisions associated with risk-reduction initiatives. Toward this need a web-based risk assessment framework that promotes the anonymous sharing of results among water utilities is demonstrated. Anonymous sharing of results offers a number of potential advantages such as assistance in recognizing and correcting bias, identification of 'unknown, unknowns', self-assessment and benchmarking for the local utility, treatment of shared assets and/or threats across multiple utilities, and prioritization of actions beyond the scale of a single utility. The constructed framework was demonstrated for threemore » water utilities. Demonstration results were then compared to risk assessment results developed using a different risk assessment application by a different set of analysts.« less

Neutron probes for the Construction and Resource Utilization eXplorer (CRUX)

NASA Technical Reports Server (NTRS)

Elphic, R. C.; Hahn, S.; Lawrence, D. J.; Feldman, W. C.; Johnson, J. B.; Haldemann, A. F. C.

2006-01-01

The Construction and Resource Utilization eXplorer (CRUX) project is developing a flexible integrated suite of instruments with data fusion software and an executive controller for in situ regolith resource assessment and characterization.

Multiple Intimate Partner Violence Experiences: Knowledge, Access, Utilization and Barriers to Utilization of Resources by Women of the African Diaspora.

PubMed

Sabri, Bushra; Huerta, Julia; Alexander, Kamila A; St Vil, Noelle M; Campbell, Jacquelyn C; Callwood, Gloria B

2015-11-01

This study examined knowledge, access, utilization, and barriers to use of resources among Black women exposed to multiple types of intimate partner violence in Baltimore, Maryland and the U.S. Virgin Islands (USVI). We analyzed quantitative survey data collected by 163 women recruited from primary care, prenatal or family planning clinics in Baltimore and the USVI. In addition we analyzed qualitative data from in-depth interviews with 11 women. Quantitative data were analyzed using descriptive statistics and qualitative data were analyzed using thematic analysis. A substantial proportion of Black women with multiple types of violence experiences lacked knowledge of, did not have access to, and did not use resources. Barriers to resource use were identified at the individual, relationship, and community levels. There is need for programs to develop awareness, promote access and utilization of resources, and eliminate barriers to resource use among abused Black women.

Using a geographic information system to enhance patient access to point-of-care diagnostics in a limited-resource setting.

PubMed

Ferguson, William J; Kemp, Karen; Kost, Gerald

2016-03-01

Rapid and accurate diagnosis drives evidence-based care in health. Point-of-care testing (POCT) aids diagnosis by bringing advanced technologies closer to patients. Health small-world networks are constrained by natural connectivity in the interactions between geography of resources and social forces. Using a geographic information system (GIS) we can understand how populations utilize their health networks, visualize their inefficiencies, and compare alternatives. This project focuses on cardiac care resource in rural Isaan, Thailand. A health care access analysis was created using ArcGIS Network Analyst 10.1 from data representing aggregated population, roads, health resource facilities, and diagnostic technologies. The analysis quantified cardiac health care access and identified ways to improve it using both widespread and resource-limited strategies. Results indicated that having diagnostic technologies closer to populations streamlines critical care paths. GIS allowed us to compare the effectiveness of the implementation strategies and put into perspective the benefits of adopting rapid POCT within health networks. Geospatial analyses derive high impact by improving alternative diagnostic placement strategies in limited-resource settings and by revealing deficiencies in health care access pathways. Additionally, the GIS provides a platform for comparing relative costs, assessing benefits, and improving outcomes. This approach can be implemented effectively by health ministries seeking to enhance cardiac care despite limited resources.

The Implementation of Career Education through the Mesa Center for Career Development.

ERIC Educational Resources Information Center

Booth, George, Comp.

Efforts of the Center for Career Development (Mesa, Arizona) to compare various strategies for promoting available career education materials and services in the Mesa Public Schools (to determine which strategies are more effective in increasing utilization of career education resources) are described. After identifying the career education…

Downsizings, Mergers, and Acquisitions: Perspectives of Human Resource Development Practitioners

ERIC Educational Resources Information Center

Shook, LaVerne; Roth, Gene

2011-01-01

Purpose: This paper seeks to provide perspectives of HR practitioners based on their experiences with mergers, acquisitions, and/or downsizings. Design/methodology/approach: This qualitative study utilized interviews with 13 HR practitioners. Data were analyzed using a constant comparative method. Findings: HR practitioners were not involved in…

Greening Industrial Production through Waste Recovery: "Comprehensive Utilization of Resources" in China.

PubMed

Zhu, Junming; Chertow, Marian R

2016-03-01

Using nonhazardous wastes as inputs to production creates environmental benefits by avoiding disposal impacts, mitigating manufacturing impacts, and conserving virgin resources. China has incentivized reuse since the 1980s through the "Comprehensive Utilization of Resources (CUR)" policy. To test whether and to what extent environmental benefits are generated, 862 instances in Jiangsu, China are analyzed, representing eight industrial sectors and 25 products that qualified for tax relief through CUR. Benefits are determined by comparing life cycle inventories for the same product from baseline and CUR-certified production, adjusted for any difference in the use phase. More than 50 million tonnes of solid wastes were reused, equivalent to 51% of the provincial industrial total. Benefits included reduction of 161 petajoules of energy, 23 million tonnes of CO2 equivalent, 75 000 tonnes of SO2 equivalent, 33 000 tonnes of NOX, and 28 000 tonnes of PM10 equivalent, which were 2.5%-7.3% of the provincial industrial consumption and emissions. The benefits vary substantially across industries, among products within the same industry, and when comparing alternative reuse processes for the same waste. This first assessment of CUR results shows that CUR has established a firm foundation for a circular economy, but also suggest additional opportunities to refine incentives under CUR to increase environmental gain.

Generalized anxiety disorder in urban China: Prevalence, awareness, and disease burden.

PubMed

Yu, Wei; Singh, Shikha Satendra; Calhoun, Shawna; Zhang, Hui; Zhao, Xiahong; Yang, Fengchi

2018-07-01

Limited published research has quantified the Generalized Anxiety Disorder (GAD) prevalence and its burden in China. This study aimed to fill in the knowledge gap and to evaluate the burden of GAD among adults in urban China. This study utilized existing data from the China National Health and Wellness Survey (NHWS) 2012-2013. Prevalence of self-reported diagnosed and undiagnosed GAD was estimated. Diagnosed and undiagnosed GAD respondents were compared with non-anxious respondents in terms of health-related quality of life (HRQoL), resource utilization, and work productivity and activity impairment using multivariate generalized linear models. A multivariate logistic model assessed the risk factors for GAD. The prevalence of undiagnosed/diagnosed GAD was 5.3% in urban China with only 0.5% of GAD respondents reporting a diagnosis. Compared with non-anxious respondents, both diagnosed and undiagnosed GAD respondents had significantly lower HRQoL, more work productivity and activity impairment, and greater healthcare resource utilization in the past six months. Age, gender, marital status, income level, insurance status, smoking, drinking and exercise behaviors, and comorbidity burdens were significantly associated with GAD. This was a patient-reported study; data are therefore subject to recall bias. The survey was limited to respondents in urban China; therefore, these results focused on urban China and may be under- or over-estimating GAD prevalence in China. Causal inferences cannot be made given the cross-sectional nature of the study. GAD may be substantially under-diagnosed in urban China. More healthcare resources should be invested to alleviate the burden of GAD. Copyright © 2018 Elsevier B.V. All rights reserved.

Forest biological diversity interactions with resource utilization

Treesearch

S.T. Mok

1992-01-01

The most important forest resources of the Asia-Pacific region are the highly diverse rain forests. Utilization of the resource is a natural and inevitable consequence of the region's socio-economic development. The sustainable management and development of forest resources in the region can be achieved by implementing conservational forestry, which is based on...

Blood transfusion is associated with infection and increased resource utilization in combat casualties.

PubMed

Dunne, James R; Riddle, Mark S; Danko, Janine; Hayden, Rich; Petersen, Kyle

2006-07-01

Combat casualty care has made significant advances in recent years, including administration of blood products in far-forward locations. However, recent studies have shown blood transfusion to be a significant risk factor for infection and increased resource utilization in critically injured patients. We therefore sought to investigate the incidence of blood transfusion and its association with infection and resource utilization in combat casualties. Prospective data were collected and retrospectively reviewed on 210 critically injured patients admitted to the USNS Comfort over a 7-week period during the 2003 assault phase of Operation Iraqi Freedom. Patients were stratified by age, gender, and injury severity score (ISS). Multivariate regression analyses were used to assess blood transfusion and hematocrit (HCT) as independent risk factors for infection and intensive care unit (ICU) admission controlling for age, gender, and ISS. The study cohort had a mean age of 30 +/- 2 years, a mean ISS of 14 +/- 3, 84 per cent were male, and 88 per cent sustained penetrating trauma. Blood transfusion was required in 44 per cent (n = 93) of the study cohort. Transfused patients had a higher ISS (18 +/- 4 vs. 10 +/- 3, P < 0.01), a higher pulse rate (105 +/- 4 vs. 93 +/- 3, P < 0.0001), and a lower admission HCT (27 +/- 1 vs. 33 +/- 2, P < 0.0001) compared with patients not transfused. Patients receiving blood transfusion had an increased infection rate (69% vs. 18%, P < 0.0001), ICU admission rate (52% vs. 21%, P < 0.0001), and ICU length of stay (6.7 +/- 2.1 days vs. 1.4 +/- 0.5 days, P < 0.0001) compared with nontransfused patients. However, there was no significant difference in mortality between transfused and nontransfused patients. Multivariate binomial regression analysis identified blood transfusion and HCT as independent risk factors for infection (P < 0.01) and blood transfusion as an independent risk factor for ICU admission (P < 0.05). Combat casualties have a high incidence of blood transfusion. Blood transfusion is an independent risk factor for infection and increased resource utilization. Therefore, consideration should be given to the use of alternative blood substitutes and recombinant human erythropoietin in the treatment and management of combat casualties.

A Retrospective Cohort Study of Patients with Type 2 Diabetes in China: Associations of Hypoglycemia with Health Care Resource Utilization and Associated Costs.

PubMed

Yi, Yingping; Li, Yawei; Hou, Anran; Ge, Yanqiu; Xu, Yuan; Xiong, Gang; Yang, Xinlei; Acevedo, Stephanie Ann; Shi, Lizheng; Xu, Hua

2018-06-01

This study aimed to examine the associations of hypoglycemia with health care resource utilization (HCRU) and health care costs among patients with type 2 diabetes mellitus (T2DM) in China. This retrospective cohort study was conducted with 23,680 T2DM patients >18 years old who visited the Second Affiliated Hospital of Nanchang University between 1 January 2011 and 31 December 2015. Univariate descriptive statistics were used to relate the HCRU and associated costs to patient characteristics, and regression analysis was used to examine the association between hypoglycemia and HCRU, controlling for other confounding factors. In the T2DM patients with or without insulin treatment, when compared with nonhypoglycemic patients, hypoglycemia was associated with more medical visits (all T2DM patients 19.48 vs. 10.46, insulin users 23.45 vs. 14.12) and higher diabetes-related medical costs (all T2DM patients ¥5187.54 vs. ¥3525.00, insulin users ¥6948.84 vs. ¥3401.15) and medication costs (T2DM patients ¥1349.40 vs. ¥641.92, insulin users: ¥1363.87 vs. ¥853.96). Controlling for age, gender, and Charlson comorbidity index (CCI) score, hypoglycemia and insulin intake were associated with greater health care resource utilization. As compared to nonhypoglycemic patients, hypoglycemic T2DM patients and those on insulin therapy performed more outpatient visits (proportions of hypoglycemic vs nonhypoglycemic T2DM patients performing 3+ visits: 72.69% vs. 65.49%; proportions of hypoglycemic vs nonhypoglycemic patients on insulin therapy performing 3+ visits: 78.26% vs. 71.73%) and were hospitalized more often (proportions of hypoglycemic vs nonhypoglycemic T2DM patients with 3+ admissions 75.90% vs. 50.24%; proportions of hypoglycemic vs nonhypoglycemic patients on insulin therapy with 3+ admissions: 83.19% vs. 58.51%). Hypoglycemia in diabetes patients was associated with increased healthcare resource utilization and health-related expenditure, especially for patients on insulin treatment. Insulin treatment regimens should be more individualized and account for hypoglycemia risk.

Comparison of cost-utility between automated peritoneal dialysis and continuous ambulatory peritoneal dialysis.

PubMed

Cortés-Sanabria, Laura; Paredes-Ceseña, Carlos A; Herrera-Llamas, Rebeca M; Cruz-Bueno, Yolanda; Soto-Molina, Herman; Pazarín, Leonardo; Cortés, Margarita; Martínez-Ramírez, Héctor R

2013-11-01

The use of automated peritoneal dialysis (APD) is increasing compared to continuous ambulatory peritoneal dialysis (CAPD). Surprisingly, little data about health benefits and cost of APD exist, and virtually no information comparing the cost-utility between CAPD and APD is available. We undertook this study to evaluate and compare the health-related quality of life (HRQOL) and cost-utility indexes in patients on CAPD vs. This was a prospective cohort of patients initiating dialysis (2008-2009). Two questionnaires were self-administered: European Research Questionnaire Quality of Life (EQ-5D) and Kidney Disease Quality of Life (short form, KDQOL-SF, Rand, Santa Monica, CA). Direct medical costs (DMC) were determined from the health provider perspective including the following medical resource utilization: outpatient clinic/emergency care, dialysis procedures, medications, laboratory tests, hospitalization, and surgery. Cost-utility indexes were calculated dividing total mean cost by indicators of the HRQOL. One hundred twenty-three patients were evaluated: 77 on CAPD and 46 on APD. Results of the EQ-5D and KDQOL-SF questionnaires were significantly better in APD compared to the CAPD group. Main costs in both APD and CAPD were attributed to hospitalization and dialysis procedures followed by medication and surgery. Outpatient clinic visits and laboratory tests were significantly more costly in CAPD than in APD, whereas dialysis procedures were more expensive in the latter. Cost-utility indexes were significantly better in APD compared to CAPD. A significant cost-utility advantage of APD vs. CAPD was observed. The annual DMC per-patient were not different between groups but the HRQOL was better in the APD compared to the CAPD group. Copyright © 2013 IMSS. Published by Elsevier Inc. All rights reserved.

Descriptive epidemiology and prior healthcare utilization of patients in the Spine Patient Outcomes Research Trial's (SPORT) three observational cohorts: disc herniation, spinal stenosis, and degenerative spondylolisthesis.

PubMed

Cummins, Justin; Lurie, Jon D; Tosteson, Tor D; Hanscom, Brett; Abdu, William A; Birkmeyer, Nancy J O; Herkowitz, Harry; Weinstein, James

2006-04-01

Prospective observational cohorts. To describe sociodemographic and clinical features, and nonoperative (medical) resource utilization before enrollment, in patients who are candidates for surgical intervention for intervertebral disc herniation (IDH), spinal stenosis (SpS), and degenerative spondylolisthesis (DS) according to SPORT criteria. Intervertebral disc herniation, spinal stenosis, and degenerative spondylolisthesis with stenosis are the three most common diagnoses of low back and leg symptoms for which surgery is performed. There is a paucity of descriptive literature examining large patient cohorts for the relationships among baseline characteristics and medical resource utilization with these three diagnoses. The Spine Patient Outcomes Research Trial (SPORT) conducts three randomized and three observational cohort studies of surgical and nonsurgical treatments for patients with IDH, SpS, and DS. Baseline data include demographic information, prior treatments received, and functional status measured by SF-36 and the Oswestry Disability Index (ODI-AAOS/Modems version). The data presented represent all 1,411 patients (743 IDH, 365 SpS, 303 DS) enrolled in the SPORT observational cohorts. Multiple logistic regression was used to generate independent predictors of utilization adjusted for sociodemographic variables, diagnosis, and duration of symptoms. The average age was 41 years for the IDH group, 64 years for the SpS group, and 66 years for the DS group. At enrollment, IDH patients presented with the most pain as reported on the SF-36 (BP 26.3 vs. 33.2 SpS and 33.8 DS) and were the most impaired (ODI 51 vs. 42.3 SpS and 41.5 DS). IDH patients used more chiropractic treatment (42% vs. 33% SpS and 26% DS), had more Emergency Department (ED) visits (21% vs. 7% SpS and 4% DS), and used more opiate analgesics (49% vs. 29% SpS and 27% DS). After adjusting for age, gender, diagnosis, education, race, duration of symptoms, and compensation, Medicaid patients used significantly more opiate analgesics (58% Medicaid vs. 41% no insurance, 42% employer, 33% Medicare, and 32% private) and had more ED visits compared with other insurance types (31% Medicaid vs. 22% no insurance, 16% employer, 3% Medicare, and 11% private). IDH patients appear to have differences in sociodemographics, resource utilization, and functional impairment when compared with the SpS/DS patients. In addition, the differences in resource utilization for Medicaid patients may reflect differences in access to care. The data provided from these observational cohorts will serve as an important comparison to the SPORT randomized cohorts in the future.

Dialysis facility and patient characteristics associated with utilization of home dialysis.

PubMed

Walker, David R; Inglese, Gary W; Sloand, James A; Just, Paul M

2010-09-01

Nonmedical factors influencing utilization of home dialysis at the facility level are poorly quantified. Home dialysis is comparably effective and safe but less expensive to society and Medicare than in-center hemodialysis. Elimination of modifiable practice variation unrelated to medical factors could contribute to improvements in patient outcomes and use of scarce resources. Prevalent dialysis patient data by facility were collected from the 2007 ESRD Network's annual reports. Facility characteristic data were collected from Medicare's Dialysis Facility Compare file. A multivariate regression model was used to evaluate associations between the use of home dialysis and facility characteristics. The utilization of home dialysis was positively associated with facility size, percent patients employed full- or part-time, younger population, and years a facility was Medicare certified. Variables negatively associated include an increased number of hemodialysis patients per hemodialysis station, chain association, rural location, more densely populated zip code, a late dialysis work shift, and greater percent of black patients within a zip code. Improved understanding of factors affecting the frequency of use of home dialysis may help explain practice variations across the United States that result in an imbalanced use of medical resources within the ESRD population. In turn, this may improve the delivery of healthcare and extend the ability of an increasingly overburdened medical financing system to survive.

Direct medical costs and their predictors in the EMAR-II cohort: "Variability in the management of rheumatoid arthritis and spondyloarthritis in Spain".

PubMed

Leon, Leticia; Abasolo, Lydia; Fernandez-Gutierrez, Benjamin; Jover, Juan Angel; Hernandez-Garcia, Cesar

To analyze the resource utilization in rheumatoid arthritis (RA) patients and predictive factors in and patients treated with biological drugs and biologic-naïve. A cross-sectional study was performed in a sample including all regions and hospitals throughout the country. Sociodemographic data, disease activity parameters and treatment data were obtained. Resource utilization for two years of study was recorded and we made costs imputation. Correlation analyzes were performed on all RA patients and those treated with biological and biological naïve, to estimate the differences in resource utilization. Factors associated with increased resources utilization (costs) attending to treatment was analyzed by linear regression models. We included 1,095 RA patients, 26% male, mean age of 62±14 years. Mean of direct medical costs per patient was €24,291±€45,382. Excluding biological drugs, the average cost per patient was €3,742±€3,711. After adjustment, factors associated with direct medical costs for all RA patients were biologic drugs (P=.02) and disease activity (P=.004). In the biologic-naïve group, the predictor of direct medical costs was comorbidity (P<.001). In the biologic treatment group predictors were follow-up length of the disease (P=.04), age (P=.02) and disease activity (P=.007). Our data show a remarkable economic impact of RA. It is important to identify and estimate the economic impact of the disease, compare data from other geographic samples and to develop improvement strategies to reduce these costs and increase the quality of care. Copyright © 2016 Elsevier España, S.L.U. and Sociedad Española de Reumatología y Colegio Mexicano de Reumatología. All rights reserved.

Characteristics, resource utilization and safety profile of patients prescribed with neuropathic pain treatments: a real-world evidence study on general practices in Europe - the role of the lidocaine 5% medicated plaster.

PubMed

Katz, Pablo; Pegoraro, Valeria; Liedgens, Hiltrud

2017-08-01

To identify characteristics, resource utilization, and safety profile of patients prescribed with lidocaine 5% medicated plaster, pregabalin, gabapentin, amitriptyline and duloxetine when experiencing pain in the real-world setting of general practitioners (GPs) in Europe. Retrospective analysis on real world data from IMS Health Longitudinal Patient Database. Patients with at least one prescription of the drugs of interest during 2014 were selected and those with a non-neuropathic pain-related diagnosis were excluded. Patients' demographic and clinical characteristics, resource utilization data and adverse drug reactions (ADRs) as described in the leaflet were extracted. The association between treatments and ADR occurrence was evaluated applying multivariate logistic models. A total of 70,515 patients were selected from Italy, Germany, the UK, Spain and Belgium. Lidocaine 5% medicated plaster patients were the oldest in Italy, the UK and Spain and the most health impaired in Italy, Spain and Belgium. No relevant differences in the number of co-prescriptions, specialist visits, examinations and hospitalizations were found. Significantly less lidocaine 5% plasters patients experienced ADRs, with odds ratios in favor of lidocaine 5% medicated plasters ranging from 3.41 (p = .036) to 52.33 (p < .001). Evidence from daily clinical practice in GP settings agrees with the findings from more controlled clinical-trial settings, with lidocaine 5% medicated plaster patients showing a better safety profile, but also a comparable level of resource utilization. A possible re-evaluation of the scientific value coming from this retrospective study in building up a diagnostic as well as a therapeutic algorithm is suggested.

Healthcare Resource Utilization and Costs Associated with Recurrent Episodes of Atrial Fibrillation: The FRACTAL Registry

PubMed Central

REYNOLDS, MATTHEW R.; ESSEBAG, VIDAL; ZIMETBAUM, PETER; COHEN, DAVID J.

2007-01-01

Cost of Recurrent AF Introduction Drivers of cost in the atrial fibrillation (AF) population are not fully understood. We sought to characterize the resource utilization and costs of treating new-onset AF, with emphasis on the incremental costs associated with recurrent episodes of AF over time. Methods and Results An inception cohort of 973 AF patients was followed at 3–6 month intervals in an observational registry over a mean of 24 ± 9 months. AF therapies, clinical outcomes, and both inpatient and outpatient medical resource utilization were tracked at each follow-up interval. Registry patients were managed primarily with cardioversion and pharmacological therapy. Direct healthcare costs were calculated from a U.S. perspective by multiplying measures of resource utilization by representative price weights. Costs were compared among patients in whom the initial episode of AF became permanent and patients who initially achieved sinus rhythm and had either 0, 1–2, or ≥3 documented recurrences during follow-up. Mean annual costs for these four groups were $2,372, $3,385, $6,331, and $10,312 per patient per year, respectively (P < 0.001 for trend), with the largest variation related to hospital costs. In multivariable analysis controlling for demographic characteristics and baseline cardiac and comorbid conditions, each documented recurrence of AF was found to increase annual healthcare costs by ∼$1,600. Conclusion Following initial diagnosis, patients with AF treated with traditional therapies incur $4,000–$5,000 in annual direct healthcare costs. Costs are markedly higher in patients with multiple AF recurrences. These data may be helpful in evaluating the economic impact of new technologies for treating AF. PMID:17451468

Resource use and costs associated with opioid-induced constipation following total hip or total knee replacement surgery.

PubMed

Wittbrodt, Eric T; Gan, Tong J; Datto, Catherine; McLeskey, Charles; Sinha, Meenal

2018-01-01

Constipation is a well-known complication of surgery that can be exacerbated by opioid analgesics. This study evaluated resource utilization and costs associated with opioid-induced constipation (OIC). This retrospective, observational, and propensity-matched cohort study utilized the Premier Healthcare Database. The study included adults ≥18 years of age undergoing total hip or total knee replacement as inpatients who received an opioid analgesic and were discharged between January 1, 2012, and June 30, 2015. Diagnosis codes identified patients with OIC who were then matched 1:1 to patients without OIC. Generalized linear and logistic regression models were used to compare inpatient resource utilization, total hospital costs, inpatient mortality, and 30-day all-cause readmissions and emergency department visits. Of 788,448 eligible patients, 40,891 (5.2%) had OIC. Covariates were well balanced between matched patients with and without OIC (n=40,890 each). In adjusted analyses, patients with OIC had longer hospital lengths of stay (3.6 versus 3.3 days; p <0.001), higher total hospital costs (US$17,479 versus US$16,265; p <0.001), greater risk of intensive care unit admission (odds ratio [OR]=1.12, 95% CI: 1.01-1.24), and increased likelihood of 30-day hospital read-missions (OR=1.16, 95% CI: 1.11-1.22) and emergency department visits (OR=1.38, 95% CI: 1.07-1.79) than patients without OIC. No statistically significant difference was found with inpatient mortality (OR=0.89, 95% CI: 0.59-1.35). OIC was associated with greater resource utilization and hospital costs for patients undergoing primarily elective total hip or total knee replacement surgery. These results support OIC screening and management strategies as part of perioperative care management.

[Home health resource utilization measures using a case-mix adjustor model].

PubMed

You, Sun-Ju; Chang, Hyun-Sook

2005-08-01

The purpose of this study was to measure home health resource utilization using a Case-Mix Adjustor Model developed in the U.S. The subjects of this study were 484 patients who had received home health care more than 4 visits during a 60-day episode at 31 home health care institutions. Data on the 484 patients had to be merged onto a 60-day payment segment. Based on the results, the researcher classified home health resource groups (HHRG). The subjects were classified into 34 HHRGs in Korea. Home health resource utilization according to clinical severity was in order of Minimum (C0) < 'Low (C1) < 'Moderate (C2) < 'High (C3), according to dependency in daily activities was in order of Minimum (F0) < 'High (F3) < 'Medium (F2) < 'Low (F1) < 'Maximum (F4). Resource utilization by HHRGs was the highest 564,735 won in group C0F0S2 (clinical severity minimum, dependency in daily activity minimum, service utilization moderate), and the lowest 97,000 won in group C2F3S1, so the former was 5.82 times higher than the latter. Resource utilization in home health care has become an issue of concern due to rising costs for home health care. The results suggest the need for more analytical attention on the utilization and expenditures for home care using a Case-Mix Adjustor Model.

Pacific Northwest Laboratory Annual Report for 1978 to the DOE Assistant Secretary for Environment Part 2. Ecological Sciences.

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

Hanson, W.C.; Eberhardt, L.E.

1979-07-01

The objective of this research is to provide an integrated program of investigation for the definition of the ecological consequences of resource developments in northern Alaska. Qualitative and quantitative results are obtained that describe environmental costs incurred by petroleum resource extraction and transportation, including interaction of industrial activities with arctic foxes (Alopex lagopus), small mammals, and tundra-nesting birds in the Prudhoe Bay field and along the Trans-Alaska pipeline and haul road; similar information from the Colville River delta for comparative purposes; baseline information on moose (Alces alces) populations, caribou (Rangifer tarandus) range quality and use, and lichen communities that aremore » or will be impacted by resource developments; field experiments to determine lichen sensitivities to sulfur oxide concentrations likely to be encountered near pipeline pumping stations; food chain transfers of stable and radioactive elements that utilize a data base of some 19 years for comparative purposes; and evaluation of oil field development activities on rabies and other physiological phenomena in foxes. A significant fraction of the research is coordinated through university contracts that utilize academic researchers in specific areas of expertise. During 1978 research continued to emphasize investigations on the ecological consequences of petroleum resource development in northern Alaska. Studies were conducted this year on arctic foxes, tundra-nesting birds, small mammals, caribou, lichens, and fallout radionuclides in the lichen-caribou-Eskimo food web.« less

Can focused trauma education initiatives reduce mortality or improve resource utilization in a low-resource setting?

PubMed

Petroze, Robin T; Byiringiro, Jean Claude; Ntakiyiruta, Georges; Briggs, Susan M; Deckelbaum, Dan L; Razek, Tarek; Riviello, Robert; Kyamanywa, Patrick; Reid, Jennifer; Sawyer, Robert G; Calland, J Forrest

2015-04-01

Over 90% of injury deaths occur in low-income countries. Evaluating the impact of focused trauma courses in these settings is challenging. We hypothesized that implementation of a focused trauma education initiative in a low-income country would result in measurable differences in injury-related outcomes and resource utilization. Two 3-day trauma education courses were conducted in the Rwandan capital over a one-month period (October-November, 2011). An ATLS provider demonstration course was delivered to 24 faculty surgeons and 15 Rwandan trauma nurse auditors, and a Canadian Network for International Surgery Trauma Team Training (TTT) course was delivered to 25 faculty, residents, and nurses. Trauma registry data over the 6 months prior to the courses were compared to the 6 months afterward with emergency department (ED) mortality as the primary endpoint. Secondary endpoints included radiology utilization and early procedural interventions. Univariate analyses were conducted using χ(2) and Fisher's exact test. A total of 798 and 575 patients were prospectively studied during the pre-intervention and post-intervention periods, respectively. Overall mortality of injured patients decreased after education implementation from 8.8 to 6.3%, but was not statistically significant (p = 0.09). Patients with an initial Glasgow Coma Score (GCS) of 3-8 had the highest injury-related mortality, which significantly decreased from 58.5% (n = 55) to 37.1% (n = 23), (p = 0.009, OR 0.42, 95% CI 0.22-0.81). There was no statistical difference in the rates of early intubation, cervical collar use, imaging studies, or transfusion in the overall cohort or the head injury subset. When further stratified by GCS, patients with an initial GCS of 3-5 in the post-intervention period had higher utilization of head CT scans and chest X-rays. The mortality of severely injured patients decreased after initiation of focused trauma education courses, but no significant increase in resource utilization was observed. The explanation may be complex and multi-factorial. Long-term multidisciplinary efforts that pair training with changes in resources and mentorship may be needed to produce broad and lasting changes in the overall care system.

Perceived resource support for chronic illnesses among diabetics in north-western China.

PubMed

Zhong, Huiqin; Shao, Ya; Fan, Ling; Zhong, Tangshen; Ren, Lu; Wang, Yan

2016-06-01

A high level of social support can improve long-term diabetes self-management. Support from a single source has been evaluated. This study aims to analyze support from multiple and multilevel sources for diabetic patients by using the Chronic Illness Resources Survey (CIRS). Factors influencing the utilization of the CIRS were also evaluated. A total of 297 patients with diabetes were investigated using the CIRS and Perceived Diabetes Self-management Scale in Shihezi City, China. Descriptive statistics were used to explain demographic variables and scores of the scales. Factors affecting the utilization of chronic illness resources were determined through univariate analysis and then examined by multivariate logistic regression analysis. Of the 297 diabetic patients surveyed, 67% failed to reach the standard (more than 3 points) of utilizing chronic illness resources. Moreover, utilization of chronic illness resources was positively moderately correlated with self-management of diabetes (r = 0.75, P < 0.05). According to the multivariate logistic regression analysis, age (OR, 3.42; 95%CI, 1.19-9.84) and monthly income (OR, 5.27; 95%CI, 1.86-14.90) were significantly positively associated with the CIRS score. Individuals with high school (OR, 2.61; 95%CI, 1.13-6.05) and college (OR, 3.02; 95%CI, 1.13-8.04) degrees obtained higher scores in the survey than those with elementary school education. Results indicated that utilization of resources and support for chronic illness self-management, particularly personal adjustment and organization, were not ideal among diabetics in the communities of north-western China. Improved utilization of chronic illness resources was conducive for proper diabetes self-management. Furthermore, the level of utilization of chronic illness resources increased with age, literacy level, and monthly income.

[Essentials of pharmacophylogeny: knowledge pedigree, epistemology and paradigm shift].

PubMed

Hao, Da-cheng; Xiao, Pei-gen; Liu, Li-wei; Peng, Yong; He, Chun-nian

2015-09-01

Chinese materia medica resource (CMM resource) is the foundation of the development of traditional Chinese medicine. In the study of sustainable utilization of CMM resource, adopting innovative theory and method to find new CMM resource is one of hotspots and always highlighted. Pharmacophylogeny interrogates the phylogenetic relationship of medicinal organisms (especially medicinal plants), as well as the intrinsic correlation of morphological taxonomy, molecular phylogeny, chemical constituents, and therapeutic efficacy (ethnopharmacology and pharmacological activity). This new discipline may have the power to change the way we utilize medicinal plant resources and develop plant-based drugs. Phylogenomics is the crossing of evolutionary biology and genomics, in which genome data are utilized for evolutionary reconstructions. Phylogenomics can be integrated into the flow chart of drug discovery and development, and extends the field of pharmacophylogeny at the omic level, thus the concept of pharmacophylogenomics could be redefined in the context of plant pharmaceutical resources. This contribution gives a brief discourse of knowledge pedigree of pharmacophylogeny, epistemology and paradigm shift, highlighting the theoretical and practical values of pharmacophylogenomics. Many medicinally important tribes and genera, such as Clematis, Pulsatilla, Anemone, Cimicifugeae, Nigella, Delphinieae, Adonideae, Aquilegia, Thalictrum, and Coptis, belong to Ranunculaceae family. Compared to other plant families, Ranunculaceae has the most species that are recorded in China Pharmacopoeia (CP) 2010. However, many Ranunculaceae species, e. g., those that are closely related to CP species, as well as those endemic to China, have not been investigated in depth, and their phylogenetic relationship and potential in medicinal use remain elusive. As such, it is proposed to select Ranunculaceae to exemplify the utility of pharmacophylogenomics and to elaborate the new concept empirically. It is argued that phylogenetic and evolutionary relationship of medicinally important tribes and genera within Ranunculaceae could be elucidated at the genomic, transcriptomic, and metabolomic levels, from which the intrinsic correlation between medicinal plant genotype and metabolic phenotype, and between genetic diversity and chemodivesity of closely related taxa, could be revealed. This proof-of-concept study regards pharmacophylogenomics as the updated version of pharmacophylogeny and would enrich the intension and spread the extension of pharmacophylogeny. The interdisciplinary knowledge and techniques will be integrated in the proposed study to promote development of CMM resource discipline and to boost sustainable development of Chinese medicinal plant resources.

Comparative Genomics Unravels the Functional Roles of Co-occurring Acidophilic Bacteria in Bioleaching Heaps

PubMed Central

Zhang, Xian; Liu, Xueduan; Liang, Yili; Xiao, Yunhua; Ma, Liyuan; Guo, Xue; Miao, Bo; Liu, Hongwei; Peng, Deliang; Huang, Wenkun; Yin, Huaqun

2017-01-01

The spatial-temporal distribution of populations in various econiches is thought to be potentially related to individual differences in the utilization of nutrients or other resources, but their functional roles in the microbial communities remain elusive. We compared differentiation in gene repertoire and metabolic profiles, with a focus on the potential functional traits of three commonly recognized members (Acidithiobacillus caldus, Leptospirillum ferriphilum, and Sulfobacillus thermosulfidooxidans) in bioleaching heaps. Comparative genomics revealed that intra-species divergence might be driven by horizontal gene transfer. These co-occurring bacteria shared a few homologous genes, which significantly suggested the genomic differences between these organisms. Notably, relatively more genes assigned to the Clusters of Orthologous Groups category [G] (carbohydrate transport and metabolism) were identified in Sulfobacillus thermosulfidooxidans compared to the two other species, which probably indicated their mixotrophic capabilities that assimilate both organic and inorganic forms of carbon. Further inspection revealed distinctive metabolic capabilities involving carbon assimilation, nitrogen uptake, and iron-sulfur cycling, providing robust evidence for functional differences with respect to nutrient utilization. Therefore, we proposed that the mutual compensation of functionalities among these co-occurring organisms might provide a selective advantage for efficiently utilizing the limited resources in their habitats. Furthermore, it might be favorable to chemoautotrophs' lifestyles to form mutualistic interactions with these heterotrophic and/or mixotrophic acidophiles, whereby the latter could degrade organic compounds to effectively detoxify the environments. Collectively, the findings shed light on the genetic traits and potential metabolic activities of these organisms, and enable us to make some inferences about genomic and functional differences that might allow them to co-exist. PMID:28529505

Resource utilization and disability outcome assessment of combat casualties from Operation Iraqi Freedom and Operation Enduring Freedom.

PubMed

Masini, Brendan D; Waterman, Scott M; Wenke, Joseph C; Owens, Brett D; Hsu, Joseph R; Ficke, James R

2009-04-01

Injuries are common during combat operations. The high costs of extremity injuries both in resource utilization and disability are well known in the civilian sector. We hypothesized that, similarly, combat-related extremity injuries, when compared with other injures from the current conflicts in Iraq and Afghanistan, require the largest percentage of medical resources, account for the greatest number of disabled soldiers, and have greater costs of disability benefits. Descriptive epidemiologic study and cost analysis. The Department of Defense Medical Metrics (M2) database was queried for the hospital admissions and billing data of a previously published cohort of soldiers injured in Iraq and Afghanistan between October 2001 and January 2005 and identified from the Joint Theater Trauma Registry. The US Army Physical Disability Administration database was also queried for Physical Evaluation Board outcomes for these soldiers, allowing calculation of disability benefit cost. Primary body region injured was assigned using billing records that gave a primary diagnosis International Classification of Diseases Ninth Edition code, which was corroborated with Joint Theater Trauma Registry injury mechanisms and descriptions for accuracy. A total of 1333 soldiers had complete admission data and were included from 1566 battle injuries not returned to duty of 3102 total casualties. Extremity-injured patients had the longest average inpatient stay at 10.7 days, accounting for 65% of the $65.3-million total inpatient resource utilization, 64% of the 464 patients found "unfit for duty," and 64% of the $170-million total projected disability benefit costs. Extrapolation of data yields total disability costs for this conflict, approaching $2 billion. Combat-related extremity injuries require the greatest utilization of resources for inpatient treatment in the initial postinjury period, cause the greatest number of disabled soldiers, and have the greatest projected disability benefit costs. This study highlights the need for continued or increased funding and support for military orthopaedic surgeons and extremity trauma research efforts.

Which information resources are used by general practitioners for updating knowledge regarding diabetes?

PubMed

Tabatabaei-Malazy, Ozra; Nedjat, Saharnaz; Majdzadeh, Reza

2012-04-01

Little is known about the degree of utilization of information resources on diabetes by general practitioners (GPs) and its impact on their clinical behavior in developing countries. Such information is vital if GPs' diabetes knowledge is to be improved. This cross-sectional study recruited 319 GPs in the summer of 2008. Questions were about the updates on diabetes knowledge in the previous two years, utilization of information resources (domestic and foreign journals, congresses, the Internet, reference books, mass media, and peers), attitude toward the importance of each resource, and impact of each resource on clinical behavior. A total of 62% of GPs had used information resources for improving their knowledge on diabetes in the previous two years. Domestic journals accounted for the highest utilization (30%) and the highest importance score (83 points from 100); with the importance score not being affected by sex, years elapsed after graduation, and numbers of diabetic visits. Clinical behavior was not influenced by the information resources listed; whereas knowledge upgrade, irrespective of the sources utilized, had a significantly positive correlation with clinical behavior. Domestic journals constituted the main information resource utilized by the GPs; this resource, however, in tandem with the other information resources on diabetes exerted no significant impact on the GPs' clinical behavior. In contrast to the developed countries, clinical guidelines do not have any place as a source of information and or practice. Indubitably, the improvement of diabetes knowledge transfer requires serious interventions to improve information resources as well as the structure of scientific gatherings and collaborations.

Health care resource utilization and costs in a commercially insured population of patients with bipolar disorder type I and frequent psychiatric interventions.

PubMed

Bagalman, Erin; Muser, Erik; Choi, Jiyoon C; Durden, Emily; Macfadden, Wayne; Haskins, J Thomas; Dirani, Riad

2011-10-01

Bipolar disorder type I (BP-I) is one of the most expensive behavioral diagnoses in the United States. Characterizing patient populations that consume significant resources would be useful for designing and implementing additional resources and targeted interventions to reduce the costs of BP-I. This analysis compared the characteristics, health care resource utilization, and costs of commercially insured patients with BP-I (indicating a history of manic or mixed episodes) and frequent psychiatric interventions (FPIs) versus those without FPIs. This retrospective study used data from commercial insurance claims to identify adults with FPIs (≥2 clinically significant events [CSEs]) or without FPIs during a 12-month identification period (year 1). CSEs included emergency department (ED) visits or hospitalizations with a principal diagnosis of BP-I, the addition of a new medication to the observed treatment regimen, or a ≥50% increase in BP-I medication dose. Demographic and clinical characteristics were evaluated during the identification period, and health care resource utilization and costs were evaluated during a 12-month follow-up period (year 2). Data from 7620 patients with FPIs and 11,571 without FPIs were included (women, 67.1% and 59.9%, respectively; P < 0.001). Of patients with FPIs in the identification period, 22.2% continued to have FPIs in the follow-up period. In the follow-up period, the group with FPIs had a greater proportion of patients with psychiatric-related inpatient hospitalizations (14.6% vs 2.8%) and ED visits (11.6% vs 2.7%) [corrected], a longer mean hospital length of stay (11.74% vs 8.24 days) [corrected], and greater adjusted mean psychiatric-related costs ($6617 vs $3276) and all-cause health care costs ($14,091 vs $9357) compared with the group without FPIs (all, P < 0.001). The risks for a psychiatric-related hospitalization and an ED visit during the follow-up period were significantly greater in the group with FPIs compared with the group without (odds ratios, 4.86 and 3.76, respectively; both, P < 0.01). In this retrospective analysis, FPIs were associated with a greater number of FPIs during follow-up, ∼2-fold the psychiatric-related costs, and 1.5-fold the all-cause health care costs compared with no FPIs. These data highlight the economic burden of FPIs and the potential for health care cost reductions from improved management options in these patients. Copyright © 2011 Elsevier HS Journals, Inc. All rights reserved.

Ecosystem Modelling for Impact Assessment of Possible Methane Leakage during Methane Hydrate Utilization

NASA Astrophysics Data System (ADS)

Yamazaki, T.; Nakano, Y.; Monoe, D.; Oomi, T.; Doi, T.; Nakata, K.; Fukushima, T.

2005-05-01

Natural methane hydrate has been scientifically studied as a carbon reservoir globally. However, in Japan, the potential for energy resource has been industrially highlighted. There is less domestic oil and natural gas resources in Japan, but many potential deposition areas for methane hydrate in ocean around Japan are the reasons. Less CO2 discharge from methane compared with coal, oil and conventional natural gas when the same calorie value we get is considered as the advantage for energy resource. However, because methane hydrate distributes in shallower sediment layer in ocean floor, accidental leakage of methane may occur while we utilize methane hydrate. Methane itself has 21-times impact on the greenhouse effect, if it reaches the atmosphere. Therefore, it is necessary to estimate the behavior in the environment after the leakage, if we want to use methane hydrate as energy resource. The mass balance after leakage of methane on seafloor and in water column is numerically studied through the analyses of methane emissions from natural cold seepages and hydrothermal activities in this research. The outline structure of mass balance ecosystem model creating is introduced and some preliminary examination results from the test calculation are discussed.

In-situ Resource Utilization (ISRU) to Support the Lunar Outpost and the Rationale for Precursor Missions

NASA Technical Reports Server (NTRS)

Simon, Thomas M.

2008-01-01

One of the ways that the Constellation Program can differ from Apollo is to employ a live-off-the-land or In-Situ Resource Utilization (ISRU) supported architecture. The options considered over the past decades for using indigenous materials have varied considerably in terms of what resources to attempt to acquire, how much to acquire, and what the motivations are to acquiring these resources. The latest NASA concepts for supporting the lunar outpost have considered many of these plans and compared these options to customers requirements and desires. Depending on the architecture employed, ISRU technologies can make a significant contribution towards a sustainable and affordable lunar outpost. While extensive ground testing will reduce some mission risk, one or more flight demonstrations prior to the first crew's arrival will build confidence and increase the chance that outpost architects will include ISRU as part of the early outpost architecture. This presentation includes some of the options for using ISRU that are under consideration for the lunar outpost, the precursor missions that would support these applications, and a notional timeline to allow the lessons learned from the precursor missions to support outpost hardware designs.

The effect of participation in a weight loss programme on short-term health resource utilization.

PubMed

van Walraven, Carl; Dent, Robert

2002-02-01

Obese people consume significantly greater amounts of health resources. This study set out to determine if health resource utilization by obese people decreases after losing weight in a comprehensive medically supervised weight management programme. Four hundred and fifty-six patients enrolled in a single-centred, multifaceted weight loss programme in a universal health care system were studied. Patient information was anonymously linked with administrative databases to measure health resource utilization for 1 year before and after the programme. Mean body mass index (BMI) decreased by more than 15%. The mean annual physician visits (pre = 9.6, post = 9.4) did not change significantly after the programme. However, patients saw a significantly fewer number of different physicians per year following the programme (pre = 4.5, post = 3.9; P < 0.001). Mean annual number of emergency visits (pre = 0.2; post = 0.2) and hospital admissions (pre = 0.05; post = 0.08) did not change. Neither baseline BMI, nor its change during the programme, influenced changes in health resource utilization. Our study suggests that weight loss in a supervised weight management programme does not necessarily decrease short-term health resource utilization. Further study is required to determine if patients who maintain their weight loss experience a decrease in health utilization.

Water Transparency Drives Intra-Population Divergence in Eurasian Perch (Perca fluviatilis)

PubMed Central

Bartels, Pia; Hirsch, Philipp E.; Svanbäck, Richard; Eklöv, Peter

2012-01-01

Trait combinations that lead to a higher efficiency in resource utilization are important drivers of divergent natural selection and adaptive radiation. However, variation in environmental features might constrain foraging in complex ways and therefore impede the exploitation of critical resources. We tested the effect of water transparency on intra-population divergence in morphology of Eurasian perch (Perca fluviatilis) across seven lakes in central Sweden. Morphological divergence between near-shore littoral and open-water pelagic perch substantially increased with increasing water transparency. Reliance on littoral resources increased strongly with increasing water transparency in littoral populations, whereas littoral reliance was not affected by water transparency in pelagic populations. Despite the similar reliance on pelagic resources in pelagic populations along the water transparency gradient, the utilization of particular pelagic prey items differed with variation in water transparency in pelagic populations. Pelagic perch utilized cladocerans in lakes with high water transparency and copepods in lakes with low water transparency. We suggest that under impaired visual conditions low utilization of littoral resources by littoral perch and utilization of evasive copepods by pelagic perch may lead to changes in morphology. Our findings indicate that visual conditions can affect population divergence in predator populations through their effects on resource utilization. PMID:22912895

Healthcare resource use in advanced prostate cancer patients treated with docetaxel.

PubMed

Mehra, Maneesha; Wu, Ying; Dhawan, Ravinder

2012-01-01

Although the treatment of metastatic castrate-resistant prostate cancer (mCRPC) has improved with newer therapies, there is little understanding how these therapies have impacted resource use and associated expenditures; available estimates are dated. The current study examined contemporary healthcare utilization and associated costs for mCRPC patients and how these measures changed over time. This retrospective cohort analysis used medical and pharmaceutical insurance claims data from a large non-payer-owned integrated claims database of US commercial insurers. Amongst all patients with a prostate cancer diagnosis (n=256,464), those with ≥ 1 docetaxel claim (docetaxel cohort, n=3642) were identified as mCRPC patients. Within the docetaxel cohort, an additional 6-months follow-up cohort (n=2862) was identified, i.e., patients with at least 6 months of follow-up after the first docetaxel claim. Resource utilization and costs were identified for all-cause hospitalizations, emergency room (ER) visits, physician visits and ambulatory visits, and prostate cancer-related prescription treatments. Significant increases in the mean per-patient-per-month (PPPM) count for the docetaxel cohort were observed for all medical resources measured (hospitalizations and ER, physician, and ambulatory visits) in the post-docetaxel period compared with the pre-docetaxel period (p<0.0001); similar significant increases were observed for the 6-months follow-up cohort in the last 6 months (prior to lost to follow-up date) compared with the period preceding the last 6 months (p<0.0408 ambulatory visits, p<0.0001 all other resources). Total docetaxel cohort costs (mean [standard deviation]) rose from an average PPPM cost of US$2593 (3208) in the pre-docetaxel period to US$5847 (6990) in the post-docetaxel period (p<0.0001); each of the individual resources measured (hospitalization, all healthcare visits, and prescription costs) demonstrated significant increases (p<0.0001). Retrospective study design. This large database analysis showed a significant increase in use of healthcare resources and associated costs among mCRPC patients following first-line docetaxel treatment.

"Living off the land": resource efficiency of wetland wastewater treatment.

PubMed

Nelson, M; Odum, H T; Brown, M T; Alling, A

2001-01-01

Bioregenerative life support technologies for space application are advantageous if they can be constructed using locally available materials, and rely on renewable energy resources, lessening the need for launch and resupply of materials. These same characteristics are desirable in the global Earth environment because such technologies are more affordable by developing countries, and are more sustainable long-term since they utilize less non-renewable, imported resources. Subsurface flow wetlands (wastewater gardens(TM)) were developed and evaluated for wastewater recycling along the coast of Yucatan. Emergy evaluations, a measure of the environmental and human economic resource utilization, showed that compared to conventional sewage treatment, wetland wastewater treatment systems use far less imported and purchased materials. Wetland systems are also less energy-dependent, lessening dependence on electrical infrastructure, and require simpler maintenance since the system largely relies on the ecological action of microbes and plants for their efficacy. Detailed emergy evaluations showed that wetland systems use only about 15% the purchased emergy of conventional sewage systems, and that renewable resources contribute 60% of total emergy used (excluding the sewage itself) compared to less than 1% use of renewable resources in the high-tech systems. Applied on a larger scale for development in third world countries, wetland systems would require the electrical energy of conventional sewage treatment (package plants), and save of total capital and operating expenses over a 20-year timeframe. In addition, there are numerous secondary benefits from wetland systems including fiber/fodder/food from the wetland plants, creation of ecosystems of high biodiversity with animal habitat value, and aesthestic/landscape enhancement of the community. Wetland wastewater treatment is an exemplar of ecological engineering in that it creates an interface ecosystem to handle byproducts of the human economy, maximizing performance of the both the natural economy and natural ecosystems. Wetland systems accomplish this with far greater resource economy than other sewage treatment approaches, and thus offer benefits for both space and Earth applications. c 2001. COSPAR. Published by Elsevier Science Ltd. All rights reserved.

``Living off the land'': resource efficiency of wetland wastewater treatment

NASA Astrophysics Data System (ADS)

Nelson, M.; Odum, H. T.; Brown, M. T.; Alling, A.

Bioregenerative life support technologies for space application are advantageous if they can be constructed using locally available materials, and rely on renewable energy resources, lessening the need for launch and resupply of materials. These same characteristics are desirable in the global Earth environment because such technologies are more affordable by developing countries, and are more sustainable long-term since they utilize less non-renewable, imported resources. Subsurface flow wetlands (wastewater gardens™) were developed and evaluated for wastewater recycling along the coast of Yucatan. Emergy evaluations, a measure of the environmental and human economic resource utilization, showed that compared to conventional sewage treatment, wetland wastewater treatment systems use far less imported and purchased materials. Wetland systems are also less energy-dependent, lessening dependence on electrical infrastructure, and require simpler maintenance since the system largely relies on the ecological action of microbes and plants for their efficacy. Detailed emergy evaluations showed that wetland systems use only about 15% the purchased emergy of conventional sewage systems, and that renewable resources contribute 60% of total emergy used (excluding the sewage itself) compared to less than 1% use of renewable resources in the high-tech systems. Applied on a larger scale for development in third world countries, wetland systems would require 1/5 the electrical energy of conventional sewage treatment (package plants), and save 2/3 of total capital and operating expenses over a 20-year timeframe. In addition, there are numerous secondary benefits from wetland systems including fiber/fodder/food from the wetland plants, creation of ecosystems of high biodiversity with animal habitat value, and aesthestic/landscape enhancement of the community. Wetland wastewater treatment is an exemplar of ecological engineering in that it creates an interface ecosystem to handle byproducts of the human economy, maximizing performance of the both the natural economy and natural ecosystems. Wetland systems accomplish this with far greater resource economy than other sewage treatment approaches, and thus offer benefits for both space and Earth applications.

Implications of non-accidental trauma on resource utilization and outcomes.

PubMed

Litz, Cristen N; Amankwah, Ernest K; Danielson, Paul D; Chandler, Nicole M

2018-06-01

The purpose was to compare the resource utilization and outcomes between patients with suspected (SUSP) and confirmed (CONF) non-accidental trauma (NAT). The institutional trauma registry was reviewed for patients aged 0-18 years presenting from 2007 to 2012 with a diagnosis of suspicion for NAT. Patients with suspected and confirmed NAT were compared. There were 281 patients included. CONF presented with a higher heart rate (142 ± 27 vs 128 ± 23 bpm, p < 0.01), lower systolic blood pressure (100 ± 18 vs 105 ± 16 mm Hg, p = 0.03), and higher Injury Severity Score (15 ± 11 vs 9 ± 5, p < 0.01). SUSP received fewer consultations (1.6 ± 0.7 vs 2.4 ± 1.1, 95% CI - 0.58 to - 0.09, p < 0.01) and had a shorter length of stay (1.6 ± 1.3 vs 7.8 ± 9.8 days, 95% CI - 4.58 to - 0.72, p < 0.01). SUSP were more often discharged home (OR 94.22, 95% CI: 21.26-417.476, p < 0.01). CONF had a higher mortality rate (8.2 vs 0%, p < 0.01). Patients with confirmed NAT present with more severe injuries and require more hospital resources compared to patients in whom NAT is suspected and ruled out.

National Conference on Integrated Resource Planning: Proceedings

NASA Astrophysics Data System (ADS)

Until recently, state regulators have focused most of their attention on the development of least-cost or integrated resource planning (IRP) processes for electric utilities. A number of commissions are beginning to scrutinize the planning processes of local gas distribution companies (LDCs) because of the increased control that LDCs have over their purchased gas costs (as well as the associated risks) and because of questions surrounding the role and potential of gas end-use efficiency options. Traditionally, resource planning (LDCs) has concentrated on options for purchasing and storing gas. Integrated resource planning involves the creation of a process in which supply-side and demand-side options are integrated to create a resource mix that reliably satisfies customers' short-term and long-term energy service needs at the lowest cost. As applied to gas utilities, an integrated resource plan seeks to balance cost and reliability, and should not be interpreted simply as the search for lowest commodity costs. The National Association of Regulatory Utility Commissioners' (NARUC) Energy Conservation committee asked Lawrence Berkeley Laboratory (LBL) to survey state PUCs to determine the extent to which they have undertaken least cost planning for gas utilities. The survey included the following topics: status of state PUC least-cost planning regulations and practices for gas utilities; type and scope of natural gas DSM programs in effect, including fuel substitution; economic tests and analysis methods used to evaluate DSM programs; relationship between prudency reviews of gas utility purchasing practices and integrated resource planning; and key regulatory issues facing gas utilities during the next five years.

OUR's: Optimum Utilization of Resources; A Guide to Instructional Resources in Occupational Education. Research Pub. 77-1.

ERIC Educational Resources Information Center

Beamish, Eric; And Others

This resource guide contains over 300 entries which are available through the Optimum Utilization of Resources (OUR's) exchange system. The entries describe learning materials, such as slides, video tapes, audio tapes, films, print material, and computer assisted instructional programs, which have been developed primarily by faculty of the…

Favorable cardiovascular risk factor profile is associated with lower healthcare expenditure and resource utilization among adults with diabetes mellitus free of established cardiovascular disease: 2012 Medical Expenditure Panel Survey (MEPS).

PubMed

Feldman, David I; Valero-Elizondo, Javier; Salami, Joseph A; Rana, Jamal S; Ogunmoroti, Oluseye; Osondu, Chukwuemeka U; Spatz, Erica S; Virani, Salim S; Blankstein, Ron; Blaha, Michael J; Veledar, Emir; Nasir, Khurram

2017-03-01

Given the prevalence and economic burden of diabetes mellitus (DM), we studied the impact of a favorable cardiovascular risk factor (CRF) profile on healthcare expenditures and resource utilization among individuals without cardiovascular disease (CVD), by DM status. 25,317 participants were categorized into 3 mutually-exclusive strata: "Poor", "Average" and "Optimal" CRF profiles (≥4, 2-3, 0-1 CRF, respectively). Two-part econometric models were utilized to study cost data. Mean age was 45 (48% male), with 54% having optimal, 39% average, and 7% poor CRF profiles. Individuals with DM were more likely to have poor CRF profile vs. those without DM (OR 7.7, 95% CI 6.4, 9.2). Individuals with DM/poor CRF profile had a mean annual expenditure of $9,006, compared to $6,461 among those with DM/optimal CRF profile (p < 0.001). A favorable CRF profile is associated with significantly lower healthcare expenditures and utilization in CVD-free individuals across DM status, suggesting that these individuals require aggressive individualized prescriptions targeting lifestyle modifications and therapeutic treatments. Copyright © 2017 Elsevier B.V. All rights reserved.

Adaptive Resource Utilization Prediction System for Infrastructure as a Service Cloud.

PubMed

Zia Ullah, Qazi; Hassan, Shahzad; Khan, Gul Muhammad

2017-01-01

Infrastructure as a Service (IaaS) cloud provides resources as a service from a pool of compute, network, and storage resources. Cloud providers can manage their resource usage by knowing future usage demand from the current and past usage patterns of resources. Resource usage prediction is of great importance for dynamic scaling of cloud resources to achieve efficiency in terms of cost and energy consumption while keeping quality of service. The purpose of this paper is to present a real-time resource usage prediction system. The system takes real-time utilization of resources and feeds utilization values into several buffers based on the type of resources and time span size. Buffers are read by R language based statistical system. These buffers' data are checked to determine whether their data follows Gaussian distribution or not. In case of following Gaussian distribution, Autoregressive Integrated Moving Average (ARIMA) is applied; otherwise Autoregressive Neural Network (AR-NN) is applied. In ARIMA process, a model is selected based on minimum Akaike Information Criterion (AIC) values. Similarly, in AR-NN process, a network with the lowest Network Information Criterion (NIC) value is selected. We have evaluated our system with real traces of CPU utilization of an IaaS cloud of one hundred and twenty servers.

Adaptive Resource Utilization Prediction System for Infrastructure as a Service Cloud

PubMed Central

Hassan, Shahzad; Khan, Gul Muhammad

2017-01-01

Infrastructure as a Service (IaaS) cloud provides resources as a service from a pool of compute, network, and storage resources. Cloud providers can manage their resource usage by knowing future usage demand from the current and past usage patterns of resources. Resource usage prediction is of great importance for dynamic scaling of cloud resources to achieve efficiency in terms of cost and energy consumption while keeping quality of service. The purpose of this paper is to present a real-time resource usage prediction system. The system takes real-time utilization of resources and feeds utilization values into several buffers based on the type of resources and time span size. Buffers are read by R language based statistical system. These buffers' data are checked to determine whether their data follows Gaussian distribution or not. In case of following Gaussian distribution, Autoregressive Integrated Moving Average (ARIMA) is applied; otherwise Autoregressive Neural Network (AR-NN) is applied. In ARIMA process, a model is selected based on minimum Akaike Information Criterion (AIC) values. Similarly, in AR-NN process, a network with the lowest Network Information Criterion (NIC) value is selected. We have evaluated our system with real traces of CPU utilization of an IaaS cloud of one hundred and twenty servers. PMID:28811819

Recent Initiatives in the Republic of Srpska to Enhance Appropriate Use of Antibiotics in Ambulatory Care; Their Influence and Implications.

PubMed

Bojanić, Ljubica; Marković-Peković, Vanda; Škrbić, Ranko; Stojaković, Nataša; Ðermanović, Mirjana; Bojanić, Janja; Fürst, Jurij; Kurdi, Amanj B; Godman, Brian

2018-01-01

Introduction: There are increasing concerns world-wide with growing rates of antibiotic resistance necessitating urgent action. There have been a number of initiatives in the Republic of Srpska in recent years to address this and improve rational antibiotic prescribing and dispensing despite limited resources to fund multiple initiatives. Objective: Analyse antibiotic utilization patterns in the Republic of Srpska following these multiple initiatives as a basis for developing future programmes in the Republic if needed. Methods: Observational retrospective study of total outpatient antibiotic utilization from 2010 to 2015, based on data obtained from the Public Health Institute, alongside documentation of ongoing initiatives to influence utilization. The quality of antibiotic utilization principally assessed according to ESAC, ECDC, and WHO quality indicators and DU 90% (the drug utilization 90%) profile as well as vs. neighboring countries. Results: Following multiple initiatives, antibiotic utilization remained relatively stable in the Republic at 15.6 to 18.4 DIDs, with a decreasing trend in recent years, with rates comparable or lower than neighboring countries. Amoxicillin and the penicillins accounted for 29-40 and 50% of total utilization, respectively. Overall, limited utilization of co-amoxiclav (7-11%), cephalosporins, macrolides, and quinolones, as well as low use of third and fourth generation cephalosporins vs. first and second cephalosporins. However, increasing utilization of co-amoxiclav and azithromycin, as well as higher rates of quinolone utilization compared to some countries, was seen. Conclusions: Multiple interventions in the Republic of Srpska in recent years have resulted in one of the lowest utilization of antibiotics when compared with similar countries, acting as an exemplar to others. However, there are some concerns with current utilization of co-amoxiclav and azithromycin which are being addressed. This will be the subject of future research activities.

Studies on water resources carrying capacity in Tuhai river basin based on ecological footprint

NASA Astrophysics Data System (ADS)

Wang, Chengshuai; Xu, Lirong; Fu, Xin

2017-05-01

In this paper, the method of the water ecological footprint (WEF) was used to evaluate water resources carrying capacity and water resources sustainability of Tuhai River Basin in Shandong Province. The results show that: (1) The WEF had a downward trend in overall volatility in Tuhai River Basin from 2003 to 2011. Agricultural water occupies high proportion, which was a major contributor to the WEF, and about 86.9% of agricultural WEF was used for farmland irrigation; (2) The water resources carrying capacity had a downward trend in general, which was mostly affected by some natural factors in this basin such as hydrology and meteorology in Tuhai River Basin; (3) Based on analysis of water resources ecological deficit, it can be concluded that the water resources utilization mode was in an unhealthy pattern and it was necessary to improve the utilization efficiency of water resources in Tuhai River Basin; (4) In view of water resources utilization problems in the studied area, well irrigation should be greatly developed at the head of Yellow River Irrigation Area(YRIA), however, water from Yellow River should be utilized for irrigation as much as possible, combined with agricultural water-saving measures and controlled exploiting groundwater at the tail of YRIA. Therefore, the combined usage of surface water and ground water of YRIA is an important way to realize agricultural water saving and sustainable utilization of water resources in Tuhai River Basin.

The Utility of 5 Hypothetical Health States in Heart Failure Using Time Trade-Off (TTO) and EQ-5D-5L in Korea.

PubMed

Hong, Sung-Hyun; Lee, Jae-Yeon; Park, Sun-Kyeong; Nam, Jin Hyun; Song, Hyun Jin; Park, Sun-Young; Lee, Eui-Kyung

2018-05-26

Utility provides a preference for specific health state in economic evaluation, and they obtained from general population could be useful in respect of societal resource allocation. We aimed to investigate the utilities of health states for heart failure (HF), a major and growing public health problem, related to hospitalization and adverse drug effects by interrogating the general Korean population. Five health states for patients with HF were developed based on literature reviews: stable chronic heart failure (SCHF), hospitalization, SCHF + cough, SCHF + hypotension, and SCHF + hyperkalemia. We selected 100 individuals from the general population through quota sampling by age, sex, and region, and conducted face-to-face interviews. We measured utilities for 5 hypothetical health states of HF using both time trade-off (TTO) and EuroQol-5 dimensions-5 levels (EQ-5D-5L). Repeated-measures analysis of variance compared the utilities between all health states for each instrument. To identify the factors affecting the utility, a linear mixed model (LMM) analysis was performed. The mean utility value for SCHF, SCHF + cough, SCHF + hypotension, SCHF + hyperkalemia, and hospitalization was calculated as 0.815, 0.732, 0.646, 0.548, and 0.360, respectively, by using TTO. The respective values using EQ-5D-5L were 0.871, 0.793, 0.710, 0.589, and 0.215. The utilities for HF significantly differed between all health states in each instrument (p < 0.001). In LMM analysis, hospitalization had a significantly negative effect on the utilities of both instruments. The utilities decreased in order of SCHF, SCHF + cough, SCHF + hypotension, SCHF + hyperkalemia, and hospitalization. These results can be useful for decision making in resource allocation for HF interventions.

Cost-Effectiveness of Dabigatran Compared to Vitamin-K Antagonists for the Treatment of Deep Venous Thrombosis in the Netherlands Using Real-World Data.

PubMed

van Leent, Merlijn W J; Stevanović, Jelena; Jansman, Frank G; Beinema, Maarten J; Brouwers, Jacobus R B J; Postma, Maarten J

2015-01-01

Vitamin-K antagonists (VKAs) present an effective anticoagulant treatment in deep venous thrombosis (DVT). However, the use of VKAs is limited because of the risk of bleeding and the necessity of frequent and long-term laboratory monitoring. Therefore, new oral anticoagulant drugs (NOACs) such as dabigatran, with lower rates of (major) intracranial bleeding compared to VKAs and not requiring monitoring, may be considered. To estimate resource utilization and costs of patients treated with the VKAs acenocoumarol and phenprocoumon, for the indication DVT. Furthermore, a formal cost-effectiveness analysis of dabigatran compared to VKAs for DVT treatment was performed, using these estimates. A retrospective observational study design in the thrombotic service of a teaching hospital (Deventer, The Netherlands) was applied to estimate real-world resource utilization and costs of VKA monitoring. A pooled analysis of data from RE-COVER and RE-COVER II on DVT was used to reflect the probabilities for events in the cost-effectiveness model. Dutch costs, utilities and specific data on coagulation monitoring levels were incorporated in the model. Next to the base case analysis, univariate probabilistic sensitivity and scenario analyses were performed. Real-world resource utilization in the thrombotic service of patients treated with VKA for the indication of DVT consisted of 12.3 measurements of the international normalized ratio (INR), with corresponding INR monitoring costs of €138 for a standardized treatment period of 180 days. In the base case, dabigatran treatment compared to VKAs in a cohort of 1,000 DVT patients resulted in savings of €18,900 (95% uncertainty interval (UI) -95,832, 151,162) and 41 (95% UI -18, 97) quality-adjusted life-years (QALYs) gained calculated from societal perspective. The probability that dabigatran is cost-effective at a conservative willingness-to pay threshold of €20,000 per QALY was 99%. Sensitivity and scenario analyses also indicated cost savings or cost-effectiveness below this same threshold. Total INR monitoring costs per patient were estimated at minimally €138. Inserting these real-world data into a cost-effectiveness analysis for patients diagnosed with DVT, dabigatran appeared to be a cost-saving alternative to VKAs in the Netherlands in the base case. Cost savings or favorable cost-effectiveness were robust in sensitivity and scenario analyses. Our results warrant confirmation in other settings and locations.

Multiple Intimate Partner Violence Experiences: Knowledge, Access, Utilization and Barriers to Utilization of Resources by Women of the African Diaspora

PubMed Central

Sabri, Bushra; Huerta, Julia; Alexander, Kamila A.; St.Vil, Noelle M.; Campbell, Jacquelyn C.; Callwood, Gloria B.

2016-01-01

Objective This study examined knowledge, access, utilization, and barriers to use of resources among Black women exposed to multiple types of intimate partner violence in Baltimore, Maryland and the U.S. Virgin Islands (USVI). Methods We analyzed quantitative survey data collected by 163 women recruited from primary care, prenatal or family planning clinics in Baltimore and the USVI. In addition we analyzed qualitative data from in-depth interviews with 11 women. Quantitative data were analyzed using descriptive statistics and qualitative data were analyzed using thematic analysis. Results A substantial proportion of Black women with multiple types of violence experiences lacked knowledge of, did not have access to, and did not use resources. Barriers to resource use were identified at the individual, relationship, and community levels. Conclusion There is need for programs to develop awareness, promote access and utilization of resources, and eliminate barriers to resource use among abused Black women. PMID:26548679

Agricultural management legacy affects microbial energetics, resource utilization and active bacterial community membership during 13C-glucose consumption

NASA Astrophysics Data System (ADS)

Helgason, B. L.; Levy-Booth, D.; Arcand, M. M.

2017-12-01

Over the long-term, differences in soil management can result in fundamental changes in biogeochemical cycling. The Alternative Cropping Systems (ACS) Study at Scott, SK, Canada (est. 1994) compares organic (ORG) vs. conventionally (CON) managed crop rotations in a loamy Typic Borall. Nitrogen (N) and phosphorus (P) deficiency in the ORG systems have limited crop growth and thus plant carbon (C) inputs for over two decades, ultimately resulting in a C deficiency which has further altered biogeochemical cycling. We conducted a short-term microcosm experiment using 13C-glucose stable isotope probing (SIP) of DNA to test whether ORG soils have greater microbial C use efficiency due to long term resource limitation. Glucose-utilizing populations were dominated by Proteobacteria and Actinobacteria, with differing species-level identities and physiological capacities between CON and ORG systems. Of the 13C-utilizing taxa, relative abundance of Proteobacteria was greater in CON while Actinobacteria (and notably Firmicutes) were more dominant in ORG soils. Using isothermal calorimetry, we measured a thermodynamic efficiency (ηeff) of 0.68, which was not significantly different between soils indicating that the metabolic cost of glucose utilization was similar in CON and ORG soils. In spite of this, differential abundance analysis of 13C-labelled OTUs revealed that ORG soils had distinct active bacterial populations that were positively correlated with ηeff, ηsoil (glucose energy retained in soil) and primed soil organic matter (pSOM). In contrast, differentially abundant OTUs in the CON soils were negatively correlated with measures of thermodynamic efficiency but positively correlated with glucose-derived heat and CO2 production as well as NO3- and PO4- availability. ORG bacterial communities may co-metabolize other resources (N and P) from SOM to meet their metabolic requirements during glucose utilization, while the active bacteria in the CON soils could access these resources from existing available pools, resulting in similar ηeff during glucose utilization. Our work combining isothermal calorimetry coupled with 13C DNA-SIP demonstrates a legacy effect of agricultural management on fundamental aspects microbial ecology and bioenergetics of soil.

Framing Lumber from Building Removal: How do We Best Utilize This Untapped Structural Resource?

Treesearch

Robert H. Falk; Steven Cramer; James Evans

2013-01-01

Compared with other construction materials, wood products are environmentally attractive because they sequester carbon, are renewable, and are low in embodied energy. Lumber salvaged from building removal possesses these same qualities but with additional environmental attributes. In spite of the environmental attractiveness of reclaimed lumber, its widespread...

Using the Relationship between Vehicle Fuel Consumption and CO[subscript 2] Emissions to Illustrate Chemical Principles

ERIC Educational Resources Information Center

Oliver-Hoyo, Maria T.; Pinto, Gabriel

2008-01-01

This instructional resource utilizes consumer product information by which students compare theoretical stoichiometric calculations to CO[subscript 2] car emissions and fuel consumption data. Representing graphically the emission of CO[subscript 2] versus consumption of fuel provides a tangible way of connecting concepts studied in chemistry…

A Comparison of E-Learning in Scotland's Colleges and Secondary Schools: The Case of National Qualifications in "Core Skills"

ERIC Educational Resources Information Center

Davidson, J. K.; Elliot, D. L.

2007-01-01

This paper investigates and compares the utilization of online resources to support teaching and learning in two different educational sectors with overlapping student groups in Scotland: secondary schools and further education (FE) colleges. The online "Core Skills" materials included Numeracy, Communication, Information Technology…

The Human Resources of Science and Engineering - Today and Tomorrow.

ERIC Educational Resources Information Center

Scientific Manpower Commission, Washington, DC.

This publication is a collection of 15 illustrated papers presented at a symposium at the annual meeting of the American Association for the Advancement of Science, 1975. Manpower specialists examined the present utilization of manpower in each of several science and engineering fields. Past projections of supply and demand were compared with what…

Effectiveness of a Hybrid Classroom in the Delivery of Medical Terminology Course Content

ERIC Educational Resources Information Center

Martin, Jeffrey S.; Kreiger, Joan E.; Apicerno, Amy L

2015-01-01

Hybrid courses are emerging as a viable option for content delivery across college campuses. In an attempt to maximize learning outcomes while leveraging resources, one institution used several sections of a Medical Terminology course as a pilot. Traditional and hybrid course delivery were compared utilizing a quantitative research method to…

Regional Variation in Utilization, In-hospital Mortality, and Health-Care Resource Use of Transcatheter Aortic Valve Implantation in the United States.

PubMed

Gupta, Tanush; Kalra, Ankur; Kolte, Dhaval; Khera, Sahil; Villablanca, Pedro A; Goel, Kashish; Bortnick, Anna E; Aronow, Wilbert S; Panza, Julio A; Kleiman, Neal S; Abbott, J Dawn; Slovut, David P; Taub, Cynthia C; Fonarow, Gregg C; Reardon, Michael J; Rihal, Charanjit S; Garcia, Mario J; Bhatt, Deepak L

2017-11-15

We queried the National Inpatient Sample database from 2012 to 2014 to identify all patients aged ≥18 years undergoing transcatheter aortic valve implantation (TAVI) in the United States. Regional differences in TAVI utilization, in-hospital mortality, and health-care resource use were analyzed. Of 41,025 TAVI procedures in the United States between 2012 and 2014, 10,390 were performed in the Northeast, 9,090 in the Midwest, 14,095 in the South, and 7,450 in the West. Overall, the number of TAVI implants per million adults increased from 24.8 in 2012 to 63.2 in 2014. The utilization of TAVI increased during the study period in all 4 geographic regions, with the number of implants per million adults being highest in the Northeast, followed by the Midwest, South, and West, respectively. Overall in-hospital mortality was 4.2%. Compared with the Northeast, risk-adjusted in-hospital mortality was higher in the Midwest (adjusted odds ratio [aOR] 1.26 [1.07 to 1.48]) and the South (aOR 1.61 [1.40 to 1.85]) and similar in the West (aOR 1.00 [0.84 to 1.18]). Average length of stay was shorter in all other regions compared with the Northeast. Among patients surviving to discharge, disposition to a skilled nursing facility or home health care was most common in the Northeast, whereas home discharge was most common in the West. Average hospital costs were highest in the West. In conclusion, we observed significant regional differences in TAVI utilization, in-hospital mortality, and health-care resource use in the United States. The findings of our study may have important policy implications and should provide an impetus to understand the source of this regional variation. Copyright © 2017 Elsevier Inc. All rights reserved.

Favorable Cardiovascular Health Is Associated With Lower Health Care Expenditures and Resource Utilization in a Large US Employee Population: The Baptist Health South Florida Employee Study.

PubMed

Osondu, Chukwuemeka U; Aneni, Ehimen C; Valero-Elizondo, Javier; Salami, Joseph A; Rouseff, Maribeth; Das, Sankalp; Guzman, Henry; Younus, Adnan; Ogunmoroti, Oluseye; Feldman, Theodore; Agatston, Arthur S; Veledar, Emir; Katzen, Barry; Calitz, Chris; Sanchez, Eduardo; Lloyd-Jones, Donald M; Nasir, Khurram

2017-03-13

To examine the association of favorable cardiovascular health (CVH) status with 1-year health care expenditures and resource utilization in a large health care employee population. Employees of Baptist Health South Florida participated in a health risk assessment from January 1 through September 30, 2014. Information on dietary patterns, physical activity, blood pressure, blood glucose level, total cholesterol level, and smoking were collected. Participants were categorized into CVH profiles using the American Heart Association's ideal CVH construct as optimal (6-7 metrics), moderate (3-5 metrics), and low (0-2 metrics). Two-part econometric models were used to analyze health care expenditures. Of 9097 participants (mean ± SD age, 42.7±12.1 years), 1054 (11.6%) had optimal, 6945 (76.3%) had moderate, and 1098 (12.1%) had low CVH profiles. The mean annual health care expenditures among those with a low CVH profile was $10,104 (95% CI, $8633-$11,576) compared with $5824 (95% CI, $5485-$6164) and $4282 (95% CI, $3639-$4926) in employees with moderate and optimal CVH profiles, respectively. In adjusted analyses, persons with optimal and moderate CVH had a $2021 (95% CI, -$3241 to -$801) and $940 (95% CI, -$1560 to $80) lower mean expenditure, respectively, than those with low CVH. This trend remained even after adjusting for demographic characteristics and comorbid conditions as well as across all demographic subgroups. Similarly, health care resource utilization was significantly lower in those with optimal CVH profiles compared with those with moderate or low CVH profiles. Favorable CVH profile is associated with significantly lower total medical expenditures and health care utilization in a large, young, ethnically diverse, and fully insured employee population. Copyright © 2017 Mayo Foundation for Medical Education and Research. Published by Elsevier Inc. All rights reserved.

Act Your (Old) Age: Prescriptive, Ageist Biases Over Succession, Consumption, and Identity

PubMed Central

North, Michael S.; Fiske, Susan T.

2015-01-01

Perspectives on ageism have focused on descriptive stereotypes concerning what older people allegedly are. By contrast, we introduce prescriptive stereotypes that attempt to control how older people should be: encouraging active Succession of envied resources, preventing passive Consumption of shared resources, and avoidance of symbolic, ingroup identity resources. Six studies test these domains, utilizing vignette experiments and simulated behavioral interactions. Across studies, younger (compared with middle-aged and older) raters most resented elder violators of prescriptive stereotypes. Moreover, these younger participants were most polarized toward older targets (compared with middle-aged and younger analogues) – rewarding elders most for prescription adherences and punishing them most for violations. Taken together, these findings offer a novel approach to ageist prescriptions, which disproportionately target older people, are most endorsed by younger people, and suggest how elders shift from receiving the default prejudice of pity to either prescriptive resentment or reward. PMID:23471317

Impact of Friedreich’s Ataxia on health-care resource utilization in the United Kingdom and Germany

PubMed Central

2013-01-01

Background Friedreich’s Ataxia (FRDA) is a neurodegenerative disorder that causes progressive damage to the central and peripheral nervous systems having a significant impact upon quality of life. With little information in the literature, cross-sectional observational studies were conducted in the UK and Germany to collect data on resource use and the burden of the disease on individuals and their caregivers. Methods Cross-sectional observational studies were conducted in the UK and Germany to estimate the burden of FRDA on individuals and on the respective healthcare systems. A total of 75 individuals in the UK and 28 in Germany were recruited to the study. Participants in both countries were asked to complete a Patient and Caregiver Information Form (PCIF), regarding access to, and use of, healthcare resources, and the impact FRDA has on their lifestyle. In Germany, doctors were asked to complete a Patient Record Form (PRF). Analyses of annual direct and indirect resource utilization were conducted for both countries while costs were calculated for the UK only. These figures were compared to the costs associated with Parkinson’s disease; one of the most common neurodegenerative conditions and the one most similar in terms of disease progression. Results The results showed that the annual burden of FRDA is significant and falls on the health and social care sectors, on society, on caregivers and on the individuals themselves. In the UK FRDA had a total annual cost per person of between £11,818 and £18,774 depending on whether the cost of long-term unemployment was included. Typically the largest component of direct costs is associated with professional care. Given the high proportion of children and young adults recruited and the long disease duration, (typically 40-50 years for FRDA, compared with 20 years for Parkinson’s disease), these figures may underestimate the true burden of the disease. Conclusion It is hoped that these estimates of resource utilization, can help in understanding the previously unquantified burden of FRDA. Given the long disease duration, management strategies should seek to minimise the impact of the condition on individuals and their caregivers, while maximising quality of life. PMID:23448170

Auditing Practice Style Variation in Pediatric Inpatient Asthma Care.

PubMed

Silber, Jeffrey H; Rosenbaum, Paul R; Wang, Wei; Ludwig, Justin M; Calhoun, Shawna; Guevara, James P; Zorc, Joseph J; Zeigler, Ashley; Even-Shoshan, Orit

2016-09-01

Asthma is the most prevalent chronic illness among children, remaining a leading cause of pediatric hospitalizations and representing a major financial burden to many health care systems. To implement a new auditing process examining whether differences in hospital practice style may be associated with potential resource savings or inefficiencies in treating pediatric asthma admissions. A retrospective matched-cohort design study, matched for asthma severity, compared practice patterns for patients admitted to Children's Hospital Association hospitals contributing data to the Pediatric Hospital Information System (PHIS) database. With 3 years of PHIS data on 48 887 children, an asthma template was constructed consisting of representative children hospitalized for asthma between April 1, 2011, and March 31, 2014. The template was matched with either a 1:1, 2:1, or 3:1 ratio at each of 37 tertiary care children's hospitals, depending on available sample size. Treatment at each PHIS hospital. Cost, length of stay, and intensive care unit (ICU) utilization. After matching patients (n = 9100; mean [SD] age, 7.1 [3.6] years; 3418 [37.6%] females) to the template (n = 100, mean [SD] age, 7.2 [3.7] years; 37 [37.0%] females), there was no significant difference in observable patient characteristics at the 37 hospitals meeting the matching criteria. Despite similar characteristics of the patients, we observed large and significant variation in use of the ICUs as well as in length of stay and cost. For the same template-matched populations, comparing utilization between the 12.5th percentile (lower eighth) and 87.5th percentile (upper eighth) of hospitals, median cost varied by 87% ($3157 vs $5912 per patient; P < .001); total hospital length of stay varied by 47% (1.5 vs 2.2 days; P < .001); and ICU utilization was 254% higher (6.5% vs 23.0%; P < .001). Furthermore, the patterns of resource utilization by patient risk differed significantly across hospitals. For example, as patient risk increased one hospital displayed significantly increasing costs compared with their matched controls (comparative cost difference: lowest risk, -34.21%; highest risk, 53.27%; P < .001). In contrast, another hospital displayed significantly decreasing costs relative to their matched controls as patient risk increased (comparative cost difference: lowest risk, -10.12%; highest risk, -16.85%; P = .01). For children with asthma who had similar characteristics, we observed different hospital resource utilization; some values differed greatly, with important differences by initial patient risk. Through the template matching audit, hospitals and stakeholders can better understand where this excess variation occurs and can help to pinpoint practice styles that should be emulated or avoided.

Evolution of specialization in resource utilization in structured metapopulations.

PubMed

Nurmi, Tuomas; Geritz, Stefan; Parvinen, Kalle; Gyllenberg, Mats

2008-07-01

We study the evolution of resource utilization in a structured discrete-time metapopulation model with an infinite number of patches, prone to local catastrophes. The consumer faces a trade-off in the abilities to consume two resources available in different amounts in each patch. We analyse how the evolution of specialization in the utilization of the resources is affected by different ecological factors: migration, local growth, local catastrophes, forms of the trade-off and distribution of the resources in the patches. Our modelling approach offers a natural way to include more than two patch types into the models. This has not been usually possible in the previous spatially heterogeneous models focusing on the evolution of specialization.

Role of genomics in promoting the utilization of plant genetic resources in genebanks

PubMed Central

Wambugu, Peterson W; Ndjiondjop, Marie-Noelle

2018-01-01

Abstract Global efforts have seen the world’s plant genetic resources (PGRs) conserved in about 1625 germ plasm repositories. Utility of these resources is important in increasing the resilience and productivity of agricultural production systems. However, despite their importance, utility of these resources has been poor. This article reviews the real and potential application of the current advances in genomic technologies in improving the utilization of these resources. The actual and potential application of these genomic approaches in plant identification, phylogenetic analysis, analysing the genetic value of germ plasm, facilitating germ plasm selection in genebanks as well as instilling confidence in international germ plasm exchange system is discussed. We note that if genebanks are to benefit from this genomic revolution, there is need for fundamental changes in the way genebanks are managed, perceived, organized and funded. Increased collaboration between genebank managers and the user community is also recommended PMID:29688255

NEO Targets for Biological In Situ Resource Utilization

NASA Astrophysics Data System (ADS)

Grace, J. M.; Ernst, S. M.; Navarrete, J. U.; Gentry, D.

2014-12-01

We are investigating a mission architecture concept for low-cost pre-processing of materials on long synodic period asteroids using bioengineered microbes delivered by small spacecraft. Space exploration opportunities, particularly those requiring a human presence, are sharply constrained by the high cost of launching resources such as fuel, construction materials, oxygen, water, and foodstuffs. Near-Earth asteroids (NEAs) have been proposed for supporting a human space presence. However, the combination of high initial investment requirements, delayed potential return, and uncertainty in resource payoff currently prevents their effective utilization.Biomining is the process in which microorganisms perform useful material reduction, sequestration or separation. It is commonly used in terrestrial copper extraction. Compared to physical and chemical methods of extraction it is slow, but very low cost, thus rendering economical even very poor ores. These advantages are potentially extensible to asteroid in situ resource utilization (ISRU).One of the first limiting factors for the use of biology in these environments is temperature. A survey of NEA data was conducted to identify those NEAs whose projected interior temperatures remained within both potential (-5 - 100 ºC) and preferred (15 - 45 ºC) ranges for the minimum projected time per synodic period without exceeding 100 ºC at any point. Approximately 2800 of the 11000 NEAs (25%) are predicted to remain within the potential range for at least 90 days, and 120 (1%) in the preferred range.A second major factor is water availability and stability. We have evaluated a design for a small-spacecraft-based injector which forces low-temperature fluid into the NEA interior, creating potentially habitable microniches. The fluid contains microbes genetically engineered to accelerate the degradation rates of a desired fraction of the native resources, allowing for more efficient material extraction upon a subsequent encounter.

Surface and borehole neutron probes for the Construction and Resource Utilization eXplorer (CRUX)

NASA Technical Reports Server (NTRS)

Elphic, Richard C.; Hahn, Sangkoo; Lawrence, David J.; Feldman, William C.; Johnson, Jerome B.; Haldemann, Albert F. C.

2006-01-01

The Construction and Resource Utilization eXplorer (CRUX) project aims to develop an integrated, flexible suite of instruments with data fusion software and an executive controller for the purpose of in situ resource assessment and characterization for future space exploration.

Healthcare resource utilization and epidemiology of pediatric burn-associated hospitalizations, United States, 2000.

PubMed

Shields, Brenda J; Comstock, R Dawn; Fernandez, Soledad A; Xiang, Huiyun; Smith, Gary A

2007-01-01

The objective of this study was to describe the epidemiology and financial burden of burn-associated hospitalizations for children younger than 18 years in the United States. Retrospective data analysis of pediatric burn-associated hospitalizations was done using the Healthcare Cost and Utilization Project Kids' Inpatient Database for 2000. An estimated 10,000 children younger than 18 years were hospitalized for burn-associated injuries in the United States in 2000. These children spent an estimated 66,200 days in the hospital with associated hospital charges equal to USD 211,772,700. Total charges and length of stay for pediatric burn-associated hospitalizations in the United States during 2000 were associated with degree of burn, percentage of total body surface area burned, child's age, region of the United States, hospital location, and hospital type. Children 2 years old or younger were more likely to be nonwhite, be hospitalized for burns, and burn their hands/wrists, compared with children 3 to 17 years of age. Male children in both age groups were more likely to be hospitalized for burns than female children. Children 2 years old or younger were more likely to be burned by hot liquids/vapors and contact with hot substances/objects, while children 3 to 17 years were more likely to be burned by fire/flames. This study is the first national study on healthcare resource utilization for pediatric burn-associated hospitalizations to utilize the KID database. Burns are a major source of pediatric morbidity and are associated with significant national healthcare resource utilization annually. Future burn prevention efforts should emphasize implementing passive injury prevention strategies, especially for young children who are nonwhite and live in low-income communities.

The impact of age and gender on resource utilization and profitability in ED patients seen and released.

PubMed

Henneman, Philip L; Nathanson, Brian H; Ribeiro, Kara; Balasubramanian, Hari

2014-10-01

To determine how age and gender impact resource utilization and profitability in patients seen and released from an Emergency Department (ED). Billing data for patients seen and released from an Emergency Department (ED) with >100,000 annual visits between 2003 and 2009 were collected. Resource utilization was measured by length of stay (placement in ED bed to leaving the bed) and direct clinical costs (e.g., ED nursing salary and benefits, pharmacy and supply costs, etc.) estimated using relative value unit cost accounting. The primary outcome of profitability was defined as contribution margin per hour. A patient's contribution margin by insurance type (excluding self-pay) was determined by subtracting direct clinical costs from facility contractual revenue. Results are expressed as medians and US dollars. In 523 882 outpatient ED encounters, as patients' aged, length of stay and direct clinical cost increased while the contribution margin and contribution margin by hour decreased. Women of childbearing age (15-44) had higher median length of stay (2.1 hours), direct clinical cost ($149), and contribution margin per hour ($103/hour) than men of same age (1.7, $131, $85/hour, respectively). Resource utilization and profitability by gender were similar in children and adults over 45. Resource utilization increased and profitability decreased with increasing age in patients seen and released from an ED. The care of women of childbearing age resulted in higher resource utilization and higher profitability than men of the same age. No differences in resource utilization or profitability by gender were observed in children and adults over 45. Copyright © 2014 Elsevier Inc. All rights reserved.

Working memory management and predicted utility

PubMed Central

Chatham, Christopher H.; Badre, David

2013-01-01

Given the limited capacity of working memory (WM), its resources should be allocated strategically. One strategy is filtering, whereby access to WM is granted preferentially to items with the greatest utility. However, reallocation of WM resources might be required if the utility of maintained information subsequently declines. Here, we present behavioral, computational, and neuroimaging evidence that human participants track changes in the predicted utility of information in WM. First, participants demonstrated behavioral costs when the utility of items already maintained in WM declined and resources should be reallocated. An adapted Q-learning model indicated that these costs scaled with the historical utility of individual items. Finally, model-based neuroimaging demonstrated that frontal cortex tracked the utility of items to be maintained in WM, whereas ventral striatum tracked changes in the utility of items maintained in WM to the degree that these items are no longer useful. Our findings suggest that frontostriatal mechanisms track the utility of information in WM, and that these dynamics may predict delays in the removal of information from WM. PMID:23882196

Utilization of rapid response resources and outcomes in a comprehensive cancer center*.

PubMed

Austin, Charles A; Hanzaker, Chris; Stafford, Renae; Mayer, Celeste; Culp, Loc; Lin, Feng-Chang; Chang, Lydia

2014-04-01

To compare the differences in characteristics and outcomes of cancer center patients with other subspecialty medical patients reviewed by rapid response teams. A retrospective cohort study of hospitalized general medicine patients, subspecialty medicine patients, and oncology patients requiring rapid response team activation over a 2-year period from September 2009 to August 2011. Five hundred fifty-seven subspecialty medical patients required rapid response team intervention. A single academic medical center in the southeastern United States (800+ bed) with a dedicated 50-bed inpatient comprehensive cancer care center. Data abstraction from computerized medical records and a hospital quality improvement rapid response database. Of the 557 patients, 135 were cancer center patients. Cancer center patients had a significantly higher Charlson Comorbidity Score (4.4 vs 2.9, < 0.001). Cancer center patients had a significantly longer hospitalization period prior to rapid response team activation (11.4 vs 6.1 d, p < 0.001). There was no significant difference between proportions of patients requiring ICU transfer between the two groups (odds ratio, 1.2; 95% CI, 0.8-1.8). Cancer center patients had a significantly higher in-hospital mortality compared with the other subspecialty medical patients (33% vs 18%; odds ratio, 2.2; 95% CI, 1.50-3.5). If the rapid response team event required an ICU transfer, this finding was more pronounced (56% vs 23%; odds ratio, 4.0; 95% CI, 2.0-7.8). The utilization of rapid response team resources during the 2-year period studied was also much higher for the oncology patients with 37.34 activations per 1,000 patient discharges compared with 20.86 per 1,000 patient discharges for the general medical patients. Oncology patients requiring rapid response team activation have a significantly higher in-hospital mortality rate, particularly if the rapid response team requires ICU transfer. Oncology patients also utilize rapid response team resources at a much higher rate.

Heart failure in primary care: co-morbidity and utilization of health care resources.

PubMed

Carmona, Montserrat; García-Olmos, Luis M; García-Sagredo, Pilar; Alberquilla, Ángel; López-Rodríguez, Fernando; Pascual, Mario; Muñoz, Adolfo; Salvador, Carlos H; Monteagudo, José L; Otero-Puime, Ángel

2013-10-01

In order to ensure proper management of primary care (PC) services, the efficiency of the health professionals tasked with such services must be known. Patients with heart failure (HF) are characterized by advanced age, high co-morbidity and high resource utilization. To ascertain PC resource utilization by HF patients and variability in the management of such patients by GPs. Descriptive, cross-sectional study targeting a population attended by 129 GPs over the course of 1 year. All patients with diagnosis of HF in their clinical histories were included, classified using the Adjusted Clinical Group system and then grouped into six resource utilization bands (RUBs). Resource utilization and Efficiency Index were both calculated. One hundred per cent of patients with HF were ranked in RUBs 3, 4 and 5. The highest GP visit rate was 20 and the lowest in excess of 10 visits per year. Prescription drug costs for these patients ranged from €885 to €1422 per patient per year. Health professional efficiency varied notably, even after adjustment for co-morbidity (Efficiency Index Variation Ratio of 28.27 for visits and 404.29 for prescription drug cost). Patients with HF register a high utilization of resources, and there is great variability in the management of such patients by health professionals, which cannot be accounted for by the degree of case complexity.

Why Should I Use University Library Website Resources? Discipline Differences

ERIC Educational Resources Information Center

Kim, Yong-Mi

2011-01-01

Users across academic disciplines utilize different information sources based on the resource's usefulness and relevance. This study's findings show that users from arts and sciences disciplines are much more likely to utilize university library website resources and printed materials than business users who heavily rely on commercial websites.…

Ethnic Resources Utilization of Korean Immigrant Entrepreneurs in the Chicago Minority Area.

ERIC Educational Resources Information Center

Kim, Kwang Chung; Hurh, Won Moo

1985-01-01

Korean entrepreneurs rely heavily on their ethnic resources for both business formation and operation. While such resource utilization facilitates immigrants' business entry and gives them competitive advantage in the general marketplace, the same mechanism poses the problems of entra-ethnic business competition and precarious position as a…

44 CFR 206.34 - Request for utilization of Department of Defense (DOD) resources.

Code of Federal Regulations, 2014 CFR

2014-10-01

... Department of Defense (DOD) resources. 206.34 Section 206.34 Emergency Management and Assistance FEDERAL EMERGENCY MANAGEMENT AGENCY, DEPARTMENT OF HOMELAND SECURITY DISASTER ASSISTANCE FEDERAL DISASTER ASSISTANCE The Declaration Process § 206.34 Request for utilization of Department of Defense (DOD) resources. (a...

44 CFR 206.34 - Request for utilization of Department of Defense (DOD) resources.

Code of Federal Regulations, 2013 CFR

2013-10-01

... Department of Defense (DOD) resources. 206.34 Section 206.34 Emergency Management and Assistance FEDERAL EMERGENCY MANAGEMENT AGENCY, DEPARTMENT OF HOMELAND SECURITY DISASTER ASSISTANCE FEDERAL DISASTER ASSISTANCE The Declaration Process § 206.34 Request for utilization of Department of Defense (DOD) resources. (a...

44 CFR 206.34 - Request for utilization of Department of Defense (DOD) resources.

Code of Federal Regulations, 2011 CFR

2011-10-01

... Department of Defense (DOD) resources. 206.34 Section 206.34 Emergency Management and Assistance FEDERAL EMERGENCY MANAGEMENT AGENCY, DEPARTMENT OF HOMELAND SECURITY DISASTER ASSISTANCE FEDERAL DISASTER ASSISTANCE The Declaration Process § 206.34 Request for utilization of Department of Defense (DOD) resources. (a...

44 CFR 206.34 - Request for utilization of Department of Defense (DOD) resources.

Code of Federal Regulations, 2012 CFR

2012-10-01

... Department of Defense (DOD) resources. 206.34 Section 206.34 Emergency Management and Assistance FEDERAL EMERGENCY MANAGEMENT AGENCY, DEPARTMENT OF HOMELAND SECURITY DISASTER ASSISTANCE FEDERAL DISASTER ASSISTANCE The Declaration Process § 206.34 Request for utilization of Department of Defense (DOD) resources. (a...

44 CFR 206.34 - Request for utilization of Department of Defense (DOD) resources.

Code of Federal Regulations, 2010 CFR

2010-10-01

... Department of Defense (DOD) resources. 206.34 Section 206.34 Emergency Management and Assistance FEDERAL EMERGENCY MANAGEMENT AGENCY, DEPARTMENT OF HOMELAND SECURITY DISASTER ASSISTANCE FEDERAL DISASTER ASSISTANCE The Declaration Process § 206.34 Request for utilization of Department of Defense (DOD) resources. (a...

Battery cycle life balancing in a microgrid through flexible distribution of energy and storage resources

NASA Astrophysics Data System (ADS)

Khasawneh, Hussam J.; Illindala, Mahesh S.

2014-09-01

In this paper, a microgrid consisting of four fuel cell-battery hybrid Distributed Energy Resources (DERs) is devised for an industrial crusher-conveyor load. Each fuel cell was accompanied by a Li-ion battery to provide energy storage support under islanded condition of the microgrid since the fuel cells typically have poor transient response characteristics. After carrying out extensive modeling and analysis in MATLAB®, the battery utilization was found to vary significantly based on the DER's 'electrical' placement within the microgrid. This paper presents, under such conditions, a variety of battery life balancing solutions through the use of the new framework of Flexible Distribution of EneRgy and Storage Resources (FDERS). It is based on an in-situ reconfiguration approach through 'virtual' reactances that help in changing the 'electrical' position of each DER without physically displacing any component in the system. Several possible approaches toward balancing the battery utilization are compared in this paper taking advantage of the flexibility that FDERS offers. It was observed that the estimated battery life is dependent on factors such as cycling sequence, pattern, and occurrence.

Discolored Red Seaweed Pyropia yezoensis with Low Commercial Value Is a Novel Resource for Production of Agar Polysaccharides.

PubMed

Sasuga, Keiji; Yamanashi, Tomoya; Nakayama, Shigeru; Ono, Syuetsu; Mikami, Koji

2018-04-26

The red seaweed Pyropia yezoensis has been demonstrated to be a novel resource for the production of high-quality agar. P. yezoensis is grown for the food industry in large-scale Japanese mariculture operations. However, discolored P. yezoensis is mostly discarded as an industrial waste, although it has some kind of utility values. Here, we evaluated the utility of discolored P. yezoensis as a resource for agar production. The quality of agar from the discolored seaweed was comparable to that from normal seaweed. In addition, as a distinguishing characteristic, agar yield was higher from discolored seaweeds than from normal types. Moreover, we successfully used agar from discolored P. yezoensis for bacterial plate media and DNA electrophoresis gels without agarose purification. Thus, our results demonstrate that discolored P. yezoensis is suitable for agar production and use in life science research. Diverting discolored P. yezoensis from disposal to agar production provides a solution to the current industrial waste problem in mariculture, as well as a secure source of agar for research purposes.

Signatures from Tissue-specific MPSS Libraries Identify Transcripts Preferentially Expressed in the Mouse Inner Ear

PubMed Central

Peters, Linda M.; Belyantseva, Inna A.; Lagziel, Ayala; Battey, James F.; Friedman, Thomas B.; Morell, Robert J.

2007-01-01

Specialization in cell function and morphology is influenced by the differential expression of mRNAs, many of which are expressed at low abundance and restricted to certain cell types. Detecting such transcripts in cDNA libraries may require sequencing millions of clones. Massively parallel signature sequencing (MPSS) is well-suited for identifying transcripts that are expressed in discrete cell types and in low abundance. We have made MPSS libraries from microdissections of three inner ear tissues. By comparing these MPSS libraries to those of 87 other tissues included in the Mouse Reference Transcriptome (MRT) online resource, we have identified genes that are highly enriched in, or specific to, the inner ear. We show by RT-PCR and in situ hybridization that signatures unique to the inner ear libraries identify transcripts with highly specific cell-type localizations. These transcripts serve to illustrate the utility of a resource that is available to the research community. Utilization of these resources will increase the number of known transcription units and expand our knowledge of the tissue-specific regulation of the transcriptome. PMID:17049805

Economic impact of angina after an acute coronary syndrome: insights from the MERLIN-TIMI 36 trial.

PubMed

Arnold, Suzanne V; Morrow, David A; Lei, Yang; Cohen, David J; Mahoney, Elizabeth M; Braunwald, Eugene; Chan, Paul S

2009-07-01

Angina in patients with coronary artery disease is associated with worse quality of life; however, the relationship between angina frequency and resource utilization is unknown. Using data from the MERLIN-TIMI 36 trial, we assessed the association between the extent of angina after an acute coronary syndrome (ACS) and subsequent cardiovascular resource utilization among 5460 stable outpatients who completed the Seattle Angina Questionnaire at 4 months after an ACS and who were then followed for an additional 8 months. Angina frequency was categorized as none (score, 100; 2739 patients), monthly (score, 61 to 99; 1608 patients), weekly (score, 31 to 60; 854 patients), and daily (score, 0 to 30; 259 patients). Multivariable regression models evaluated the association between angina frequency and overall costs attributable to cardiovascular hospitalizations, outpatient visits and procedures, and medications. As compared with no angina, overall costs increased in a graded fashion with higher angina frequency-no angina, $2928 (reference); monthly angina, $3909 (adjusted relative cost ratio, 1.29; 95% CI, 1.21 to 1.39); weekly angina, $4558 (adjusted relative cost ratio, 1.52; 95% CI, 1.48 to 1.67); and daily angina, $6949 (adjusted relative cost ratio, 2.32; 95% CI, 2.01 to 2.69; P for trend <0.001). Differences in costs were attributable primarily to higher rates of ACS hospitalization and coronary revascularization among patients with more severe angina. Among stable outpatients after ACS, a direct graded relationship was found between higher angina frequency and healthcare costs. As compared with patients without angina, patients with daily angina had a >2-fold increase in resource utilization and incremental costs of $4000 after 8 months of follow-up.

Evaluation on equality and efficiency of health resources allocation and health services utilization in China.

PubMed

Sun, Jian; Luo, Hongye

2017-07-14

China is faced with a daunting challenge to equality and efficiency in health resources allocation and health services utilization in the context of rapid economic growth. This study sought to evaluate the equality and efficiency of health resources allocation and health services utilization in China. Demographic, economic, and geographic area data was sourced from China Statistical Yearbook 2012-2016. Data related to health resources and health services was obtained from China Health Statistics Yearbook 2012-2016. Furthermore, we evaluated the equality of health resources allocation based on Gini coefficient. Concentration index was used to measure the equality in utilization of health services. Data envelopment analysis (DEA) was employed to assess the efficiency of health resources allocation. From 2011 to 2015, the Gini coefficients for health resources by population ranged between 0.0644 and 0.1879, while the Gini coefficients for the resources by geographic area ranged from 0.6136 to 0.6568. Meanwhile, the concentration index values for health services utilization ranged from -0.0392 to 0.2110. Moreover, in 2015, 10 provinces (32.26%) were relatively efficient in terms of health resources allocation, while 7 provinces (22.58%) and 14 provinces (45.16%) were weakly efficient and inefficient, respectively. There exist distinct regional disparities in the distribution of health resources in China, which are mainly reflected in the geographic distribution of health resources. Furthermore, the people living in the eastern developed areas are more likely to use outpatient care, while the people living in western underdeveloped areas are more likely to use inpatient care. Moreover, the efficiency of health resources allocation in 21 provinces (67.74%) of China was low and needs to be improved. Thus, the government should pay more attention to the equality based on geographic area, guide patients to choose medical treatment rationally, and optimize the resource investments for different provinces.

Accounting utility for determining individual usage of production level software systems

NASA Technical Reports Server (NTRS)

Garber, S. C.

1984-01-01

An accounting package was developed which determines the computer resources utilized by a user during the execution of a particular program and updates a file containing accumulated resource totals. The accounting package is divided into two separate programs. The first program determines the total amount of computer resources utilized by a user during the execution of a particular program. The second program uses these totals to update a file containing accumulated totals of computer resources utilized by a user for a particular program. This package is useful to those persons who have several other users continually accessing and running programs from their accounts. The package provides the ability to determine which users are accessing and running specified programs along with their total level of usage.

Web-based educational activities developed by the Society for Neuroscience in Anesthesiology and Critical Care (SNACC): the experience of process, utilization, and expert evaluation.

PubMed

Sharma, Deepak; Bilotta, Federico; Moore, Laurel E; Bebawy, John F; Flexman, Alana M; Rochlen, Lauryn; Gorji, Reza; Avitsian, Rafi

2014-01-01

Web-based delivery of educational material by scientific societies appears to have increased recently. However, the utilization of such efforts by the members of professional societies is unknown. We report the experience with delivery of educational resources on the Web site of the Society for Neuroscience in Anesthesiology and Critical Care (SNACC), and utilization of those resources by members. Three web-based educational initiatives were developed over 1 year to be disseminated through the SNACC Web site (http://www.snacc.org) for society members: (1) The SNACC Bibliography; (2) "Chat with the Author"; and (3) Clinical Case Discussions. Content experts and authors of important new research publications were invited to contribute. Member utilization data were abstracted with the help of the webmaster. For the bibliography, there were 1175 page requests during the 6-month period after its launch by 122/664 (19%) distinct SNACC members. The bibliography was utilized by 107/553 (19%) of the active members and 15/91 (16.5%) of the trainee members. The "Chats with the Authors" were viewed by 56 (9%) members and the Clinical Case Discussions by 51 (8%) members. Educational resources can be developed in a timely manner utilizing member contributions without additional financial implications. However, the member utilization of these resources was lower than expected. These are first estimates of utilization of web-based educational resources by members of a scientific society. Further evaluation of such utilization by members of other societies as well as measures of the effectiveness and impact of such activities is needed.

Online Prediction of Health Care Utilization in the Next Six Months Based on Electronic Health Record Information: A Cohort and Validation Study.

PubMed

Hu, Zhongkai; Hao, Shiying; Jin, Bo; Shin, Andrew Young; Zhu, Chunqing; Huang, Min; Wang, Yue; Zheng, Le; Dai, Dorothy; Culver, Devore S; Alfreds, Shaun T; Rogow, Todd; Stearns, Frank; Sylvester, Karl G; Widen, Eric; Ling, Xuefeng

2015-09-22

The increasing rate of health care expenditures in the United States has placed a significant burden on the nation's economy. Predicting future health care utilization of patients can provide useful information to better understand and manage overall health care deliveries and clinical resource allocation. This study developed an electronic medical record (EMR)-based online risk model predictive of resource utilization for patients in Maine in the next 6 months across all payers, all diseases, and all demographic groups. In the HealthInfoNet, Maine's health information exchange (HIE), a retrospective cohort of 1,273,114 patients was constructed with the preceding 12-month EMR. Each patient's next 6-month (between January 1, 2013 and June 30, 2013) health care resource utilization was retrospectively scored ranging from 0 to 100 and a decision tree-based predictive model was developed. Our model was later integrated in the Maine HIE population exploration system to allow a prospective validation analysis of 1,358,153 patients by forecasting their next 6-month risk of resource utilization between July 1, 2013 and December 31, 2013. Prospectively predicted risks, on either an individual level or a population (per 1000 patients) level, were consistent with the next 6-month resource utilization distributions and the clinical patterns at the population level. Results demonstrated the strong correlation between its care resource utilization and our risk scores, supporting the effectiveness of our model. With the online population risk monitoring enterprise dashboards, the effectiveness of the predictive algorithm has been validated by clinicians and caregivers in the State of Maine. The model and associated online applications were designed for tracking the evolving nature of total population risk, in a longitudinal manner, for health care resource utilization. It will enable more effective care management strategies driving improved patient outcomes.

Online Prediction of Health Care Utilization in the Next Six Months Based on Electronic Health Record Information: A Cohort and Validation Study

PubMed Central

Hu, Zhongkai; Hao, Shiying; Jin, Bo; Shin, Andrew Young; Zhu, Chunqing; Huang, Min; Wang, Yue; Zheng, Le; Dai, Dorothy; Culver, Devore S; Alfreds, Shaun T; Rogow, Todd; Stearns, Frank

2015-01-01

Background The increasing rate of health care expenditures in the United States has placed a significant burden on the nation’s economy. Predicting future health care utilization of patients can provide useful information to better understand and manage overall health care deliveries and clinical resource allocation. Objective This study developed an electronic medical record (EMR)-based online risk model predictive of resource utilization for patients in Maine in the next 6 months across all payers, all diseases, and all demographic groups. Methods In the HealthInfoNet, Maine’s health information exchange (HIE), a retrospective cohort of 1,273,114 patients was constructed with the preceding 12-month EMR. Each patient’s next 6-month (between January 1, 2013 and June 30, 2013) health care resource utilization was retrospectively scored ranging from 0 to 100 and a decision tree–based predictive model was developed. Our model was later integrated in the Maine HIE population exploration system to allow a prospective validation analysis of 1,358,153 patients by forecasting their next 6-month risk of resource utilization between July 1, 2013 and December 31, 2013. Results Prospectively predicted risks, on either an individual level or a population (per 1000 patients) level, were consistent with the next 6-month resource utilization distributions and the clinical patterns at the population level. Results demonstrated the strong correlation between its care resource utilization and our risk scores, supporting the effectiveness of our model. With the online population risk monitoring enterprise dashboards, the effectiveness of the predictive algorithm has been validated by clinicians and caregivers in the State of Maine. Conclusions The model and associated online applications were designed for tracking the evolving nature of total population risk, in a longitudinal manner, for health care resource utilization. It will enable more effective care management strategies driving improved patient outcomes. PMID:26395541

NASA Space Engineering Research Center for utilization of local planetary resources

NASA Technical Reports Server (NTRS)

Ramohalli, Kumar; Lewis, John S.

1990-01-01

The University of Arizona and NASA have joined to form the UA/NASA Space Engineering Research Center. The purpose of the Center is to discover, characterize, extract, process, and fabricate useful products from the extraterrestrial resources available in the inner solar system (the moon, Mars, and nearby asteroids). Individual progress reports covering the center's research projects are presented and emphasis is placed on the following topics: propellant production, oxygen production, ilmenite, lunar resources, asteroid resources, Mars resources, space-based materials processing, extraterrestrial construction materials processing, resource discovery and characterization, mission planning, and resource utilization.

Costing for long-term care: the development of Scottish health service resource utilization groups as a casemix instrument.

PubMed

Urquhart, J; Kennie, D C; Murdoch, P S; Smith, R G; Lennox, I

1999-03-01

to create a casemix measure with a limited number of categories which discriminate in terms of resource use and will assist in the development of a currency for contracting for the provision of health care. nursing staff completed a questionnaire providing clinical data and also gave estimates of relative patient resource use; ward-based costs were collected from appropriate unit managers. National Health Service continuing-care wards in 50 Scottish hospitals. 2783 long-stay patients aged 65 years and over. inter-rater reliability was assessed using 1402 patients; percentage agreement between raters for individual variables varied from 68% for feeding to 97% for clinically complex treatments. Nursing costs gave 62% agreement given categories of high, medium and low. The Scottish health service resource utilization groups (SHRUG) measure was developed using 606 cases, and 67% consistency was achieved for the five categories. The relative weights for the SHRUG categories ranged from 0.56 to 1.41. The five categories explain 35% of variance in costs. the five SHRUG casemix categories show good discrimination in terms of costs. The SHRUG measure compares favourably with diagnosis-related groups in the acute sector and with other casemix instruments for long-term care previously piloted in the UK. SHRUG is a useful measurement instrument in assessing the resource needs of elderly people in long-term care.

MROrchestrator: A Fine-Grained Resource Orchestration Framework for MapReduce Clusters

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

Sharma, Bikash; Prabhakar, Ramya; Kandemir, Mahmut

2012-01-01

Efficient resource management in data centers and clouds running large distributed data processing frameworks like MapReduce is crucial for enhancing the performance of hosted applications and boosting resource utilization. However, existing resource scheduling schemes in Hadoop MapReduce allocate resources at the granularity of fixed-size, static portions of nodes, called slots. In this work, we show that MapReduce jobs have widely varying demands for multiple resources, making the static and fixed-size slot-level resource allocation a poor choice both from the performance and resource utilization standpoints. Furthermore, lack of co-ordination in the management of mul- tiple resources across nodes prevents dynamic slotmore » reconfigura- tion, and leads to resource contention. Motivated by this, we propose MROrchestrator, a MapReduce resource Orchestrator framework, which can dynamically identify resource bottlenecks, and resolve them through fine-grained, co-ordinated, and on- demand resource allocations. We have implemented MROrches- trator on two 24-node native and virtualized Hadoop clusters. Experimental results with a suite of representative MapReduce benchmarks demonstrate up to 38% reduction in job completion times, and up to 25% increase in resource utilization. We further show how popular resource managers like NGM and Mesos when augmented with MROrchestrator can hike up their performance.« less

Current NASA Plans for Mars In Situ Resource Utilization

NASA Technical Reports Server (NTRS)

Sanders, Gerald

2018-01-01

The presentation is to provide relevant information to the NASA funded Center for the Utilization of Biological Engineering in Space (CUBES) Institute. The presentation cover the following: 1) What is In Situ Resource Utilization (ISRU), 2) What are the resources of interest at the Moon and Mars, 3) ISRU-related mission requirements and ISRU economics, 4) Challenges and Risk for ISRU, 5) Concept of Operation for Mars ISRU Systems, 6) Current State of the Art (SOA) in ISRU, and 7) Current ISRU development and mission status.

Networking Micro-Processors for Effective Computer Utilization in Nursing

PubMed Central

Mangaroo, Jewellean; Smith, Bob; Glasser, Jay; Littell, Arthur; Saba, Virginia

1982-01-01

Networking as a social entity has important implications for maximizing computer resources for improved utilization in nursing. This paper describes the one process of networking of complementary resources at three institutions. Prairie View A&M University, Texas A&M University and the University of Texas School of Public Health, which has effected greater utilization of computers at the college. The results achieved in this project should have implications for nurses, users, and consumers in the development of computer resources.

2010 Perinatal GBS Prevention Guideline and Resource Utilization

PubMed Central

Mukhopadhyay, Sagori; Dukhovny, Dmitry; Mao, Wenyang; Eichenwald, Eric C.

2014-01-01

OBJECTIVES: To quantify differences in early-onset sepsis (EOS) evaluations, evaluation-associated resource utilization, and EOS cases detected, when comparing time periods before and after the implementation of an EOS algorithm based on the Centers for Disease Control and Prevention (CDC) 2010 guidelines for prevention of perinatal Group B Streptococcus (GBS) disease. METHODS: Retrospective cohort study of infants born at ≥36 weeks’ gestation from 2009 to 2012 in a single tertiary care center. One 12-month period during which EOS evaluations were based on the CDC 2002 guideline was compared with a second 12-month period during which EOS evaluations were based on the CDC 2010 guideline. A cost minimization analysis was performed to determine the EOS evaluation-associated costs and resources during each time period. RESULTS: During the study periods, among well-appearing infants ≥36 weeks’ gestation, EOS evaluations for inadequate GBS prophylaxis decreased from 32/1000 to <1/1000 live births; EOS evaluation-associated costs decreased by $6994 per 1000 live births; and EOS evaluation-associated work hours decreased by 29 per 1000 live births. We found no increase in EOS evaluations for other indications, total NICU admissions, frequency of infants evaluated for symptoms before hospital discharge, or incidence of EOS during the 2 study periods. CONCLUSIONS: Implementation of an EOS algorithm based on CDC 2010 GBS guidelines resulted in a 25% decrease in EOS evaluations performed among well-appearing infants ≥36 weeks’ gestation, attributable to decreased evaluation of infants born in the setting of inadequate indicated GBS prophylaxis. This resulted in significant changes in EOS evaluation-associated resource expenditures. PMID:24446442

Implementing a Universal Well-Being Assessment to Mitigate Barriers to Resident Utilization of Mental Health Resources.

PubMed

Sofka, Sarah; Grey, Carl; Lerfald, Nathan; Davisson, Laura; Howsare, Janie

2018-02-01

Physician utilization of well-being resources remains low despite efforts to promote use of these resources. We implemented a well-being assessment for internal medicine residents to improve access and use of mental health services. We scheduled all postgraduate year 1 (PGY-1) and PGY-2 residents at West Virginia University for the assessment at our faculty and staff assistance program (FSAP). While the assessment was intended to be universal (all residents), we allowed residents to "opt out." The assessment visit consisted of an evaluation by a licensed therapist, who assisted residents with a wellness plan. Anonymous surveys were distributed to all residents, and means were compared by Student's t test. Thirty-eight of 41 PGY-1 and PGY-2 residents (93%) attended the scheduled appointments. Forty-two of 58 residents (72%, including PGY-3s) completed the survey. Of 42 respondents, 28 (67%) attended the assessment sessions, and 14 (33%) did not. Residents who attended the sessions gave mean ratings of 7.8 for convenience (1, not convenient, to 9, very convenient), and 7.9 for feeling embarrassed if colleagues knew they attended (1, very embarrassed, to 9, not embarrassed). Residents who attended the assessment sessions reported they were more likely to use FSAP services in the future, compared with those who did not attend ( P  < .001). Offering residents a well-being assessment may have mitigated barriers to using counseling resources. The majority of residents who participated had a positive view of the program and indicated they would return to FSAP if they felt they needed counseling.

Resource utilization groups (RUGs): defining chronic care, rehabilitation and nursing home case mix in Canada.

PubMed

Botz, C K; Bestard, S; Demaray, M; Molloy, G

1993-01-01

The two major purposes of this study were: (1) to evaluate Resource Utilization Groups (RUGs III) as a unified method for classifying all residential, chronic care and rehabilitation patients at the St. Joseph's Health Centre, London, and (2) to compare the potential funding implications of RUGs and other patient/resident classification systems. RUGs were used to classify a total of 336 patients/residents in residential, extended care, chronic care and rehabilitation beds at the Health Centre. Patients were also concurrently classified according to the Alberta Long Term Care Classification System and the Medicus Long Term Care System. Results show that RUGs provide relatively more credit for higher acuity patients than do the Alberta or Medicus systems. If used as a basis for funding, chronic care and rehabilitation hospitals would be entitled to more funding (relative to residential/nursing homes) under RUGs than under the other two patient classification mechanisms.

Developing Intelligent System Dynamic Management Instruments on Water-Food-Energy Nexus in Response to Urbanization

NASA Astrophysics Data System (ADS)

Tsai, W. P.; Chang, F. J.; Lur, H. S.; Fan, C. H.; Hu, M. C.; Huang, T. L.

2016-12-01

Water, food and energy are the most essential natural resources needed to sustain life. Water-Food-Energy Nexus (WFE Nexus) has nowadays caught global attention upon natural resources scarcity and their interdependency. In the past decades, Taiwan's integrative development has undergone drastic changes due to population growth, urbanization and excessive utilization of natural resources. The research intends to carry out interdisciplinary studies on WFE Nexus based on data collection and analysis as well as technology innovation, with a mission to develop a comprehensive solution to configure the synergistic utilization of WFE resources in an equal and secure manner for building intelligent dynamic green cities. This study aims to establish the WFE Nexus through interdisciplinary research. This study will probe the appropriate and secure resources distribution and coopetition relationship by applying and developing techniques of artificial intelligence, system dynamics, life cycle assessment, and synergy management under data mining, system analysis and scenario analysis. The issues of synergy effects, economic benefits and sustainable social development will be evaluated as well. First, we will apply the system dynamics to identify the interdependency indicators of WFE Nexus in response to urbanization and build the dynamic relationship among food production, irrigation water resource and energy consumption. Then, we conduct comparative studies of WFE Nexus between the urbanization and the un-urbanization area (basin) to provide a referential guide for optimal resource-policy nexus management. We expect to the proposed solutions can help achieve the main goals of the research, which is the promotion of human well-being and moving toward sustainable green economy and prosperous society.

Dialysis Facility and Patient Characteristics Associated with Utilization of Home Dialysis

PubMed Central

Walker, David R.; Inglese, Gary W.; Sloand, James A.

2010-01-01

Background and objectives: Nonmedical factors influencing utilization of home dialysis at the facility level are poorly quantified. Home dialysis is comparably effective and safe but less expensive to society and Medicare than in-center hemodialysis. Elimination of modifiable practice variation unrelated to medical factors could contribute to improvements in patient outcomes and use of scarce resources. Design, setting, participants, & measurements: Prevalent dialysis patient data by facility were collected from the 2007 ESRD Network’s annual reports. Facility characteristic data were collected from Medicare’s Dialysis Facility Compare file. A multivariate regression model was used to evaluate associations between the use of home dialysis and facility characteristics. Results: The utilization of home dialysis was positively associated with facility size, percent patients employed full- or part-time, younger population, and years a facility was Medicare certified. Variables negatively associated include an increased number of hemodialysis patients per hemodialysis station, chain association, rural location, more densely populated zip code, a late dialysis work shift, and greater percent of black patients within a zip code. Conclusions: Improved understanding of factors affecting the frequency of use of home dialysis may help explain practice variations across the United States that result in an imbalanced use of medical resources within the ESRD population. In turn, this may improve the delivery of healthcare and extend the ability of an increasingly overburdened medical financing system to survive. PMID:20634324

Optimizing health information technology's role in enabling comparative effectiveness research.

PubMed

Navathe, Amol S; Conway, Patrick H

2010-12-01

Health information technology (IT) is a key enabler of comparative effectiveness research (CER). Health IT standards for data sharing are essential to advancing the research data infrastructure, and health IT is critical to the next step of incorporating clinical data into data sources. Four key principles for advancement of CER are (1) utilization of data as a strategic asset, (2) leveraging public-private partnerships, (3) building robust, scalable technology platforms, and (4) coordination of activities across government agencies. To maximize the value of the resources, payers and providers must contribute data to initiatives, engage with government agencies on lessons learned, continue to develop new technologies that address key challenges, and utilize the data to improve patient outcomes and conduct research.

Utilization potential evaluation of plant resources in the dry-hot valley of Jinsha River

NASA Astrophysics Data System (ADS)

Xi, Rong; Xu, Naizhong; Liu, Shengxiang; Ren, Tingyan

2017-08-01

Plant resources in the dry-hot valley of Jinsha River are endemic to a class of district. The article adopts the analytic hierarchy process method to evaluate the exploitation and utilization potential of plant resources of thirty typical plant resources on the basis of their characteristics in the dry-hot valley of Jinsha River, which provide scientific evidence for quantitative evaluation of regional plant resources, and we also suggest pathways offering protection and development.

Resource Legacies of Organic and Conventional Management Differentiate Soil Microbial Carbon Use

PubMed Central

Arcand, Melissa M.; Levy-Booth, David J.; Helgason, Bobbi L.

2017-01-01

Long-term contrasts in agricultural management can shift soil resource availability with potential consequences to microbial carbon (C) use efficiency (CUE) and the fate of C in soils. Isothermal calorimetry was combined with 13C-labeled glucose stable isotope probing (SIP) of 16S rRNA genes to test the hypothesis that organically managed soils would support microbial communities with greater thermodynamic efficiency compared to conventional soils due to a legacy of lower resource availability and a resultant shift toward communities supportive of more oligotrophic taxa. Resource availability was greater in conventionally managed soils, with 3.5 times higher available phosphorus, 5% more nitrate, and 36% more dissolved organic C. The two management systems harbored distinct glucose-utilizing populations of Proteobacteria and Actinobacteria, with a higher Proteobacteria:Actinobacteria ratio (2.4 vs. 0.7) in conventional soils. Organically managed soils also harbored notable activity of Firmicutes. Thermodynamic efficiency indices were similar between soils, indicating that glucose was metabolized at similar energetic cost. However, differentially abundant glucose utilizers in organically managed soils were positively correlated with soil organic matter (SOM) priming and negatively correlated to soil nutrient and carbon availability, respiration, and heat production. These correlation patterns were strongly reversed in the conventionally managed soils indicating clear differentiation of microbial functioning related to soil resource availability. Fresh C addition caused proportionally more priming of SOM decomposition (57 vs. 51%) in organically managed soils likely due to mineralization of organic nutrients to satisfy microbial demands during glucose utilization in these more resource deprived soils. The additional heat released from SOM oxidation may explain the similar community level thermodynamic efficiencies between management systems. Restoring fertility to soils with a legacy of nutrient limitation requires a balanced supply of both nutrients and energy to protect stable SOM from microbial degradation. These results highlight the need to consider managing C for the energy it provides to ıcritical biological processes that underpin soil health. PMID:29230199

Scheduling in the Face of Uncertain Resource Consumption and Utility

NASA Technical Reports Server (NTRS)

Koga, Dennis (Technical Monitor); Frank, Jeremy; Dearden, Richard

2003-01-01

We discuss the problem of scheduling tasks that consume a resource with known capacity and where the tasks have varying utility. We consider problems in which the resource consumption and utility of each activity is described by probability distributions. In these circumstances, we would like to find schedules that exceed a lower bound on the expected utility when executed. We first show that while some of these problems are NP-complete, others are only NP-Hard. We then describe various heuristic search algorithms to solve these problems and their drawbacks. Finally, we present empirical results that characterize the behavior of these heuristics over a variety of problem classes.

Roundwood markets and utilization in West Virginia and Ohio

Treesearch

Shawn T. Grushecky; Jan Wiedenbeck; Ben Spong

2011-01-01

West Virginia and Ohio have similar forest resources and extensive forest-based economies. Roundwood is harvested throughout this central Appalachian region and supports a diverse primary and secondary forest products sector. The objective of this research was to investigate the utilization of the forest resource harvested in West Virginia and Ohio. Utilization and...

Comparing the Effect of EDPA and FDPA on University Students' Examination Results

ERIC Educational Resources Information Center

Kamarulzaman, Mohammad Shah; Shaari, Ahmad Jelani

2015-01-01

It has been long accepted that students are themselves great resources when it comes to developing questions and activity guidelines. The present study utilizes a strategic understanding of how students can be encouraged to perform better in preparation for exams, by allowing them to frame their own subject wise questions. The application of drill…

Assessment of 2001 NLCD percent tree and impervious cover estimates

Treesearch

Eric Greenfield; David J. Nowak; Jeffrey T. Walton

2009-01-01

The 2001 National Land Cover Database (NLCD) tree and impervious cover maps provide an opportunity to extract basic land-cover information helpful for natural resource assessments. To determine the potential utility and limitations of the 2001 NLCD data, this exploratory study compared 2001 NLCD-derived values of overall percent tree and impervious cover within...

Efficient Nash Equilibrium Resource Allocation Based on Game Theory Mechanism in Cloud Computing by Using Auction

PubMed Central

Nezarat, Amin; Dastghaibifard, GH

2015-01-01

One of the most complex issues in the cloud computing environment is the problem of resource allocation so that, on one hand, the cloud provider expects the most profitability and, on the other hand, users also expect to have the best resources at their disposal considering the budget constraints and time. In most previous work conducted, heuristic and evolutionary approaches have been used to solve this problem. Nevertheless, since the nature of this environment is based on economic methods, using such methods can decrease response time and reducing the complexity of the problem. In this paper, an auction-based method is proposed which determines the auction winner by applying game theory mechanism and holding a repetitive game with incomplete information in a non-cooperative environment. In this method, users calculate suitable price bid with their objective function during several round and repetitions and send it to the auctioneer; and the auctioneer chooses the winning player based the suggested utility function. In the proposed method, the end point of the game is the Nash equilibrium point where players are no longer inclined to alter their bid for that resource and the final bid also satisfies the auctioneer’s utility function. To prove the response space convexity, the Lagrange method is used and the proposed model is simulated in the cloudsim and the results are compared with previous work. At the end, it is concluded that this method converges to a response in a shorter time, provides the lowest service level agreement violations and the most utility to the provider. PMID:26431035

Efficient Nash Equilibrium Resource Allocation Based on Game Theory Mechanism in Cloud Computing by Using Auction.

PubMed

Nezarat, Amin; Dastghaibifard, G H

2015-01-01

One of the most complex issues in the cloud computing environment is the problem of resource allocation so that, on one hand, the cloud provider expects the most profitability and, on the other hand, users also expect to have the best resources at their disposal considering the budget constraints and time. In most previous work conducted, heuristic and evolutionary approaches have been used to solve this problem. Nevertheless, since the nature of this environment is based on economic methods, using such methods can decrease response time and reducing the complexity of the problem. In this paper, an auction-based method is proposed which determines the auction winner by applying game theory mechanism and holding a repetitive game with incomplete information in a non-cooperative environment. In this method, users calculate suitable price bid with their objective function during several round and repetitions and send it to the auctioneer; and the auctioneer chooses the winning player based the suggested utility function. In the proposed method, the end point of the game is the Nash equilibrium point where players are no longer inclined to alter their bid for that resource and the final bid also satisfies the auctioneer's utility function. To prove the response space convexity, the Lagrange method is used and the proposed model is simulated in the cloudsim and the results are compared with previous work. At the end, it is concluded that this method converges to a response in a shorter time, provides the lowest service level agreement violations and the most utility to the provider.

The burden of atopic dermatitis in US adults: Health care resource utilization data from the 2013 National Health and Wellness Survey.

PubMed

Eckert, Laurent; Gupta, Shaloo; Amand, Caroline; Gadkari, Abhijit; Mahajan, Puneet; Gelfand, Joel M

2018-01-01

There is a lack of data on the burden of atopic dermatitis (AD) in adults relative to the general population. To characterize the AD burden in adult patients relative to both matched non-AD controls and matched patients with psoriasis in terms of comorbidities, health care resource utilization (HCRU), and costs. Adults (≥18 years) who self-reported a diagnosis of AD or psoriasis and adult non-AD controls were identified from the 2013 US National Health and Wellness Survey. Patients with AD were propensity score-matched with non-AD controls and patients with psoriasis on demographic variables. Patient-reported outcomes were analyzed between matched cohorts. Patients with AD had a significantly greater risk for atopic comorbidities, as well as significantly greater HCRU and total cost compared with non-AD controls. The burden of AD was generally comparable to that of psoriasis, although patients with AD reported increased use of emergency room visits compared with patients with psoriasis. Patient-reported data are susceptible to recall bias and erroneous classification. Adult patients with AD reported a substantial disease burden, suggesting an unmet need for more effective AD treatment options. Copyright © 2017 American Academy of Dermatology, Inc. Published by Elsevier Inc. All rights reserved.

Resource reduction in pediatric chest pain: Standardized clinical assessment and management plan.

PubMed

Saleeb, Susan F; McLaughlin, Sarah R; Graham, Dionne A; Friedman, Kevin G; Fulton, David R

2018-01-01

Using a Standardized Clinical Assessment and Management Plan (SCAMP) for pediatric patients presenting to clinic with chest pain, we evaluated the cost impact associated with implementation of the care algorithm. Prior to introduction of the SCAMP, we analyzed charges for 406 patients with chest pain, seen in 2009, and predicted 21% reduction of overall charges had the SCAMP methodology been used. The SCAMP recommended an echocardiogram for history, examination, or ECG findings suggestive of a cardiac etiology for chest pain. Resource utilization was reviewed for 1517 patients (7-21 years) enrolled in the SCAMP from July 2010 to April 2014. Compared to the 2009 historic cohort, patients evaluated by the SCAMP had higher rates of exertional chest pain (45% vs 37%) and positive family history (5% vs 1%). The SCAMP cohort had fewer abnormal physical examination findings (1% vs 6%) and abnormal electrocardiograms (3% vs 5%). Echocardiogram use increased in the SCAMP cohort compared to the 2009 historic cohort (45% vs 41%), whereas all other ancillary testing was reduced: exercise stress testing (4% SCAMP vs 28% historic), Holter (4% vs 7%), event monitors (3% vs 10%), and MRI (1% vs 2%). Total charges were reduced by 22% ($822 625) by use of the Chest Pain SCAMP, despite a higher percentage of patients for whom echocardiogram was recommended compared to the historic cohort. The Chest Pain SCAMP effectively streamlines cardiac testing and reduces resource utilization. Further reductions can be made by algorithm refinement regarding echocardiograms for exertional symptoms. © 2017 Wiley Periodicals, Inc.

Cost of achieving equivalent outcomes in sicker patients after liver transplant.

PubMed

Dhar, Vikrom K; Wima, Koffi; Kim, Young; Hoehn, Richard S; Jung, Andrew D; Ertel, Audrey E; Diwan, Tayyab S; Paterno, Flavio; Shah, Shimul A

2018-03-01

We aimed to characterize variability in cost after straightforward orthotopic liver transplant (OLT). Using the University HealthSystem Consortium and Scientific Registry of Transplant Recipients databases, we identified patients who underwent OLT between 2011 and 2014. Patients meeting criteria for straightforward OLT, defined as length of stay < 14 days with discharge to home, were selected (n = 5763) and grouped into tertiles (low, medium, high) according to cost of perioperative stay. Patients undergoing straightforward OLT were of similar demographics regardless of cost. High cost patients were more likely to require preoperative hemodialysis, had higher severity of illness, and higher model for end-stage liver disease (MELD) (p < 0.01). High cost patients required greater utilization of resources including lab tests, blood transfusions, and opioids (p < 0.01). Despite having higher burden of disease and requiring increased resource utilization, high cost OLT patients with a straightforward perioperative course were shown to have identical 2-year graft and overall survival compared to lower cost patients (p = 0.82 and p = 0.63), respectively. Providing adequate perioperative care for OLT patients with higher severity of illness and disease burden requires increased cost and resource utilization; however, doing so provides these patients with long term survival equivalent to more routine patients. Copyright © 2017 International Hepato-Pancreato-Biliary Association Inc. Published by Elsevier Ltd. All rights reserved.

Pneumatic Planetary Regolith Feed System for In-Situ Resource Utilization

NASA Technical Reports Server (NTRS)

Mantovani, James G.; Mueller, Robert P.; Townsend, Ivan I.; Craft, Jack; Zacny, Kris

2010-01-01

The NASA In-situ Resource Utilization (ISRU) project requires a regolith feed system that can transfer lunar regolith several meters vertically into a chemical reactor for oxygen production on the moon.

Integrating market processes into utility resource planning

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

Kahn, E.P.

1992-11-01

Integrated resource planning has resulted in an abundance of alternatives for meeting existing and new demand for electricity services: (1) utility demand-side management (DSM) programs, (2) DSM bidding, (3) competitive bidding for private power supplies, (4) utility re-powering, and (5) new utility construction. Each alternative relies on a different degree of planning for implementation and, therefore, each alternative relies on markets to a greater or lesser degree. This paper shows how the interaction of planning processes and market forces results in resource allocations among the alternatives. The discussion focuses on three phenomena that are driving forces behind the unanticipated consequences'more » of contemporary integrated resource planning efforts. These forces are: (1) large-scale DSM efforts, (2) customer bypass, and (3) large-scale independent power projects. 22 refs., 3 figs., 2 tabs.« less

Utilization characteristics and importance of woody biomass resources on the rural-urban fringe in botswana.

PubMed

Nkambwe, Musisi; Sekhwela, Mogodisheng B M

2006-02-01

This article examines the utilization characteristics and importance of woody biomass resources in the rural-urban fringe zones of Botswana. In the literature for Africa, attention has been given to the availability and utilization of biomass in either urban or rural environments, but the rural-urban fringe has been neglected. Within southern Africa, this neglect is not justified; the rural-urban fringe, not getting the full benefits available in urban environments in Botswana, has developed problems in woody biomass availability and utilization that require close attention. In this article, socioeconomic data on the importance of woody biomass in the Batlokwa Tribal Territory, on the rural-urban fringe of Gaborone, Botswana, were collected together with ecologic data that reveal the utilization characteristics and potential for regrowth of woody biomass. The analysis of these results show that local woody biomass is very important in the daily lives of communities in the rural-urban fringe zones and that there is a high level of harvesting. However, there is no effort in planning land use in the tribal territory to either conserve this resource or provide alternatives to its utilization. The future of woody biomass resources in Botswana's rural-urban fringe is uncertain. The investigators recommend that a comprehensive policy for the development of the rural-urban fringe consider the importance of this resource. The neglect of this resource will have far-reaching implications on the livelihoods of residents as well as the environment in this zone.

Research on the coordination framework for water resources utilization on the interests of mutual compensation in Lancang-Mekong River

NASA Astrophysics Data System (ADS)

Wang, Y.; Fang, D., VI; Xu, J.; Dong, Q.

2017-12-01

The Lancang-Mekong River is an important international river, cascaded hydropower stations development in which attracts the attention of downstream countries. In this paper, we proposed a coordination framework for water resources utilization on the interests of mutual compensation to relieve the conflict of upstream and downstream countries. Firstly, analyze the benefits and risks caused by the cascaded hydropower stations development and the evolution process of water resources use conflict between upstream and downstream countries. Secondly, evaluate the benefits and risks of flood control, water supply, navigation and power generation based on the energy theory of cascaded hydropower stations development in Lancang-Mekong River. Thirdly, multi-agent cooperation motivation and cooperation conditions between upstream and downstream countries in Lancang-Mekong River is given. Finally, the coordination framework for water resources utilization on the interests of mutual compensation in Lancang-Mekong River is presented. This coordination framework for water resources utilization can increase comprehensive benefits in Lancang-Mekong River.

Cost, healthcare resource utilization, and adherence of individuals with diabetes using U-500 or U-100 insulin: a retrospective database analysis.

PubMed

Eby, Elizabeth L; Wang, Ping; Curtis, Bradley H; Xie, Jin; Haldane, Diane C; Idris, Iskandar; Peters, Anne L; Hood, Robert C; Jackson, Jeffrey A

2013-01-01

To describe costs, healthcare resource utilization, and adherence of US patients receiving human regular U-500 insulin (U-500R), compared to patients receiving high-dose (>200 units/day) U-100 insulins (U-100) by subcutaneous injection for the treatment of diabetes. A retrospective analysis of data from Thomson Reuters MarketScan Research Databases (7/1/2008 to 12/31/2010). Difference-in-differences analyses were conducted on cost (medical, pharmacy, and overall costs) and on healthcare resource utilization variables (overall, diabetes-related, and non-diabetes-related medical visits). Adherence rates to the index insulins were assessed by proportion of days covered (PDC). Seven hundred and eleven (19%) patients in the U-500R cohort and 1508 (6%) patients in the U-100 cohort met selection criteria. Propensity score matching resulted in 684 matched pairs. Mean change in annualized pharmacy costs was in favor of the U-500R vs the U-100 cohort (-$1258 vs $3345, a difference of -$4603, p < 0.0001). Mean overall cost increase in the U-500R vs the U-100 cohort was also lower ($1999 vs $9104, a difference of -$7105, p = 0.005). The proportion of patients with at least one coded hypoglycemic event during the 12-month post-index period was higher in the U-500R vs the U-100 cohort (17.1% vs 11.7%, p < 0.005), but neither hypoglycemia rate (2.73 vs 2.90 events per person) nor hypoglycemia-specific costs (mean $1669 vs $1543) were significantly different. No significant differences were noted between cohorts for change (post-pre) in any resource utilization category. PDC was greater in the U-500R vs the U-100 cohort (65.2% vs 39.5%, p < 0.0001). Claims data are not as accurate as empirical evaluation by a clinician. Glycemic control data were not available for this analysis. In patients requiring high-dose insulin, treatment with U-500R vs high-dose U-100 insulins is associated with significant decreases in pharmacy and overall costs, slightly higher hypoglycemia incidence, no difference in hypoglycemia-specific costs or in resource utilization, and better adherence.

A cognitive gateway-based spectrum sharing method in downlink round robin scheduling of LTE system

NASA Astrophysics Data System (ADS)

Deng, Hongyu; Wu, Cheng; Wang, Yiming

2017-07-01

A key technique of LTE is how to allocate efficiently the resource of radio spectrum. Traditional Round Robin (RR) scheduling scheme may lead to too many resource residues when allocating resources. When the number of users in the current transmission time interval (TTI) is not the greatest common divisor of resource block groups (RBGs), and such a phenomenon lasts for a long time, the spectrum utilization would be greatly decreased. In this paper, a novel spectrum allocation scheme of cognitive gateway (CG) was proposed, in which the LTE spectrum utilization and CG’s throughput were greatly increased by allocating idle resource blocks in the shared TTI in LTE system to CG. Our simulation results show that the spectrum resource sharing method can improve LTE spectral utilization and increase the CG’s throughput as well as network use time.

Iceland's Central Highlands: Nature conservation, ecotourism, and energy resource utilization

Treesearch

Bjorn Gunnarsson; Maria-Victoria Gunnarsson

2002-01-01

Iceland’s natural resources include an abundance of geothermal energy and hydropower, of which only 10 to 15 percent is currently being utilized. These are clean, renewable sources of energy. The cost to convert these resources to electricity is relatively low, making them attractive and highly marketable for industrial development, particularly for heavy industry....

Instructional Strategies and Resource Utility in Language Teaching among Basic Educators in 21st Century Nigeria

ERIC Educational Resources Information Center

Ofodu, Graceful Onovughe

2012-01-01

Learning in the twenty-first century demands learning skills, strategies and utilizing resources which learners can deploy when they leave the school environment. The paper investigates the instructional strategies and resources employed by teachers in teaching and learning English Studies at the basic level of Nigeria's educational system. It…

Developing Technologies for Space Resource Utilization: Concept for a Planetary Engineering Research Institute

NASA Astrophysics Data System (ADS)

Blacic, J. D.; Dreesen, D.; Mockler, T.

2000-01-01

There are two principal factors that control the economics and ultimate utilization of space resources: 1) space transportation, and 2) space resource utilization technologies. Development of space transportation technology is driven by major government (military and civilian) programs and, to a lesser degree, private industry-funded research. Communication within the propulsion and spacecraft engineering community is aided by an effective independent professional organization, the American Institute of Aeronautics and Astronautics (AIAA). The many aerospace engineering programs in major university engineering schools sustain professional-level education in these fields. NASA does an excellent job of public education in space science and engineering at all levels. Planetary science, a precursor and supporting discipline for space resource utilization, has benefited from the establishment of the Lunar and Planetary Institute (LPI) which has served, since the early post-Apollo days, as a focus for both professional and educational development in the geosciences of the Moon and other planets. The closest thing the nonaerospace engineering disciplines have had to this kind of professional nexus is the sponsorship by the American Society of Civil Engineers of a series of space engineering conferences that have had a predominantly space resource orientation. However, many of us with long-standing interests in space resource development have felt that an LPI-like, independent institute was needed to focus and facilitate both research and education on the specific engineering disciplines needed to develop space resource utilization technologies on an on-going basis.

Health care resource utilization in adults with congenital heart disease.

PubMed

Mackie, Andrew S; Pilote, Louise; Ionescu-Ittu, Raluca; Rahme, Elham; Marelli, Ariane J

2007-03-15

The number of adults with congenital heart disease (CHD) is increasing. However, rates of health care resource utilization in this population are unknown. The objectives of this study were to describe the use of general health care resources in adults with CHD and to examine the impact of CHD severity on resource utilization. The study consisted of adults alive in 1996 who had > or = 1 diagnosis of a CHD lesion conforming to the International Classification of Disease, Ninth Revision, in the physician's claims database of the province of Quebec from 1983 to 2000. From 1996 to 2000, rates of health care utilization were measured. The impact of the severity of CHD on the use of health care resources was determined using multivariate models to adjust for age, gender, Charlson co-morbidity score, and duration of follow-up. The study population consisted of 22,096 adults with CHD (42% men). From 1996 to 2000, 87% received outpatient care from specialists, 68% visited emergency rooms, 51% were hospitalized, and 16% were admitted to critical care units. Patients with severe CHD had higher adjusted rates of outpatient cardiologist care (rate ratio [RR] 2.24, 95% confidence interval [CI] 2.06 to 2.45), emergency department utilization (RR 1.09, 95% CI 1.03 to 1.17), hospitalization (RR 1.30, 95% CI 1.19 to 1.43), and days in critical care (RR 2.12, 95% CI 1.80 to 2.50) than patients with other congenital cardiac lesions. Hospitalization rates were higher than in the general Quebec adult population (RR 2.08, 95% CI 2.00 to 2.17). In conclusion, adults with CHD have high rates of health care resource utilization, particularly those with severe lesions. Appropriate resource allocation is required to serve this growing population.

Profiles of service utilization and the resultant economic impact in preschoolers with attention deficit/hyperactivity disorder.

PubMed

Marks, David J; Mlodnicka, Agnieszka; Bernstein, Melissa; Chacko, Anil; Rose, Scott; Halperin, Jeffrey M

2009-07-01

To examine whether preschool children with Attention deficit/hyperactivity disorder (ADHD) utilize more speech and language therapy (ST), occupational therapy (OT), and physical therapy (PT) services and are more likely to be placed in special education (SPED) classrooms as compared to their peers. Corresponding financial consequences were also examined. The amount of ST, OT, and PT, as well as SPED placements, was examined in 3- and 4-year-old children with and without ADHD (n = 109 and n = 97, respectively) during the baseline portion of an ongoing, 5-year longitudinal study. Costs for individual services and aggregate cost were determined per child and compared across groups. Preschool children with ADHD were more likely to receive individual and multiple services. Higher rates of service utilization translated into increased costs for each individual service with the exception of PT. A comprehensive understanding of service utilization in the early years of development is important in addressing the increased service use in the preschool years and assist in guiding allocation of resources.

Research on elastic resource management for multi-queue under cloud computing environment

NASA Astrophysics Data System (ADS)

CHENG, Zhenjing; LI, Haibo; HUANG, Qiulan; Cheng, Yaodong; CHEN, Gang

2017-10-01

As a new approach to manage computing resource, virtualization technology is more and more widely applied in the high-energy physics field. A virtual computing cluster based on Openstack was built at IHEP, using HTCondor as the job queue management system. In a traditional static cluster, a fixed number of virtual machines are pre-allocated to the job queue of different experiments. However this method cannot be well adapted to the volatility of computing resource requirements. To solve this problem, an elastic computing resource management system under cloud computing environment has been designed. This system performs unified management of virtual computing nodes on the basis of job queue in HTCondor based on dual resource thresholds as well as the quota service. A two-stage pool is designed to improve the efficiency of resource pool expansion. This paper will present several use cases of the elastic resource management system in IHEPCloud. The practical run shows virtual computing resource dynamically expanded or shrunk while computing requirements change. Additionally, the CPU utilization ratio of computing resource was significantly increased when compared with traditional resource management. The system also has good performance when there are multiple condor schedulers and multiple job queues.

Prior hospitalization and age as predictors of mental health resource utilization in Israel.

PubMed

Ginsberg, G; Lerner, Y; Mark, M; Popper, M

1997-03-01

A two-part demand model based on data from a psychiatric case registry was estimated in order to search for predictors of hospital-based psychiatric care utilization. Using only age as an independent variable, explanation of future resource utilization is considerably weaker than when number of cumulative days of psychiatric hospital-based service use during the previous five years is also included. Only a small marginal gain is achieved by also adding diagnoses. Prospective remuneration by capitating sick funds according to age and past hospital-based service utilization records is recommended to avoid the twin pitfalls of cream-skimming and a distorted allocation of resources for psychiatric services.

The economic burden of end-of-life care in metastatic breast cancer.

PubMed

Bramley, Thomas; Antao, Vincent; Lunacsek, Orsolya; Hennenfent, Kristin; Masaquel, Anthony

2016-11-01

To assess end-of-life (EOL) total healthcare costs and resource utilization during the last 6 months of claims follow-up among patients with metastatic breast cancer (MBC) who received systemic anti-neoplastic therapy. Newly diagnosed females with MBC initiating treatment January 1, 2003-June 30, 2011 were identified in a large commercial claims database. Two cohorts were defined based on a proxy measure for EOL 1 month prior to the end of last recorded follow-up within the study period: patients who were assumed dead at end of claims follow-up (EOL cohort) and patients who were alive (no-end-of-life [NEOL] cohort). Proxy measures for EOL were obtained from published literature and clinical expert opinion. Cost and resource utilization were evaluated for the 6 months prior to end of claims follow-up. Baseline variables, resource utilization, and costs were compared between cohorts with univariate statistical tests. Adjusted relative risks were calculated for resource utilization measures. A covariate-adjusted generalized linear model evaluated 6-month total healthcare costs. Of the 3,878 females included, 18.5% (n = 718) met the criteria for EOL. Mean observational time (MBC onset to end of claims follow-up) was shorter for the EOL cohort (EOL, 32 months vs NEOL, 35 months; p < 0.001). In adjusted analyses, the EOL cohort had 4.15 times higher 6-month total healthcare costs (EOL, $72,112 vs NEOL, $17,137; p < 0.001). NEOL month-to-month mean total healthcare costs fluctuated between $2336-$3145, while EOL costs increased steadily from $8,956 in the sixth month prior to death to $19,326 in the last month of life. The adjusted relative risk of inpatient, hospice and emergency department utilization was >2 times higher in the EOL cohort (p < 0.001). Potential EOL presented a greater economic burden in the 6 months prior to death. EOL month-to-month costs increased precipitously in the last 2 months of life and were driven by acute inpatient care.

Costs, resource utilization, and treatment patterns for patients with metastatic melanoma in a commercially insured setting.

PubMed

Toy, Edmond L; Vekeman, Francis; Lewis, Michael C; Oglesby, Alan K; Duh, Mei Sheng

2015-08-01

To estimate real-world healthcare costs, resource utilization, and treatment patterns among metastatic melanoma (MM) patients who received a therapy recommended in current treatment guidelines during 2011 and 2012, following approval in the US of novel therapies (ipilimumab and vemurafenib). Administrative claims data were used in a retrospective, longitudinal, open cohort study. Adult MM patients were identified using ICD-9 codes. Therapy-based patient cohorts and index dates were defined by the first receipt of a therapy of interest: ipilimumab, vemurafenib, paclitaxel (alone and in combination), interleukin-2, dacarbazine (alone and in combination), or temozolomide. The follow-up period extended until the end of eligibility or data availability. A multivariate regression model was used to compare outcomes of the ipilimumab and vemurafenib cohorts, controlling for baseline and demographic characteristics. Direct healthcare costs (2013 US dollars) and utilization (incidence rates) were measured on a per-patient-per-month (PPPM) basis for each treatment cohort. Treatment patterns were assessed, including the frequency of patients receiving a second therapy of interest. The study population included 834 patients (265 ipilimumab, 234 vemurafenib, 174 paclitaxel, 104 interleukin-2, 46 dacarbazine, and 11 temozolomide). Costs ranged from $10,879 PPPM (temozolomide) to $35,472 PPPM (ipilimumab). Adjusted total costs were $18,337 PPPM higher for the ipilimumab vs. the vemurafenib cohort (p < 0.001), primarily due to higher outpatient costs. Multivariate analysis did not find significant differences in resource utilization between ipilimumab and vemurafenib, except that ipilimumab patients had fewer outpatient visits (excluding treatment visits). Ipilimumab and vemurafenib patients received a second therapy of interest (12% and 11%, respectively) less frequently than interleukin-2 and dacarbazine patients. The cost and resource utilization burden of MM is high and varies substantially across treatment cohorts. The two novel therapies, ipilimumab and vemurafenib, have quickly been adopted and are the most frequently used therapies. The results observed during the approximately 6 month follow-up period may not be representative of the full clinical experience of patients with MM.

Volatile Extractor (PVEx) for Planetary In Situ Resource Utilization

NASA Astrophysics Data System (ADS)

Zacny, K.; Morrison, P.; Vendiola, V.; Paz, A.

2017-02-01

Here we present a trade study and final approach for efficient extraction of volatiles from planetary regolith for the purpose of In Situ Resource Utilization. The project is SBIR funded and hardware is being fabricated.

Utilizing Existing Clinical and Population Biospecimen Resources for Discovery or Validation of Markers for Early Cancer Detection

Cancer.gov

Utilizing Existing Clinical and Population Biospecimen Resources for Discovery or Validation of Markers for Early Cancer Detection, a 2013 workshop sponsored by the Epidemiology and Genomics Research Program.

The aquatic animals' transcriptome resource for comparative functional analysis.

PubMed

Chou, Chih-Hung; Huang, Hsi-Yuan; Huang, Wei-Chih; Hsu, Sheng-Da; Hsiao, Chung-Der; Liu, Chia-Yu; Chen, Yu-Hung; Liu, Yu-Chen; Huang, Wei-Yun; Lee, Meng-Lin; Chen, Yi-Chang; Huang, Hsien-Da

2018-05-09

Aquatic animals have great economic and ecological importance. Among them, non-model organisms have been studied regarding eco-toxicity, stress biology, and environmental adaptation. Due to recent advances in next-generation sequencing techniques, large amounts of RNA-seq data for aquatic animals are publicly available. However, currently there is no comprehensive resource exist for the analysis, unification, and integration of these datasets. This study utilizes computational approaches to build a new resource of transcriptomic maps for aquatic animals. This aquatic animal transcriptome map database dbATM provides de novo assembly of transcriptome, gene annotation and comparative analysis of more than twenty aquatic organisms without draft genome. To improve the assembly quality, three computational tools (Trinity, Oases and SOAPdenovo-Trans) were employed to enhance individual transcriptome assembly, and CAP3 and CD-HIT-EST software were then used to merge these three assembled transcriptomes. In addition, functional annotation analysis provides valuable clues to gene characteristics, including full-length transcript coding regions, conserved domains, gene ontology and KEGG pathways. Furthermore, all aquatic animal genes are essential for comparative genomics tasks such as constructing homologous gene groups and blast databases and phylogenetic analysis. In conclusion, we establish a resource for non model organism aquatic animals, which is great economic and ecological importance and provide transcriptomic information including functional annotation and comparative transcriptome analysis. The database is now publically accessible through the URL http://dbATM.mbc.nctu.edu.tw/ .

Computer-Assisted Instruction: Decision Handbook.

DTIC Science & Technology

1985-04-01

to feelings of " depersonalization " or "dehumanization." The approach is to document investigations of attitudes toward CBI held by students and...utilized within a computer-based training system that includes management of student progress, training resources, testing, and instructional materials...training time. As compared to programmed texts and workbookl, students were more attentive and stayed on task. The attentiveness to PLATO materials

Occupational Analysis for Human Resource Development: A Review of Utility of the Task Inventory. Research Report No. 25.

ERIC Educational Resources Information Center

Moore, Brian E.

A review of the issues concerning the field of occupational analysis was undertaken in order to indicate the comparative strengths and weaknesses of the task inventory (TI). Specifically, the significance of the TI was assessed for reliability and validity, job analysis and evaluation, occupational restructuring and career ladder development, and…

Resource Collaboration: The Benefits of Utilizing Child Life Specialists When Dealing with Pediatric Stress

ERIC Educational Resources Information Center

Kaddoura, Mahmoud; Cormier, Katie; Leduc, Joshua

2013-01-01

Introduction: In pediatric hospitals there are varying opinions regarding who is part of the healthcare team. Each specialty has a different view on the various aspects of care. Objective: The study explores healthcare providers' diverse points-of-view on stress and compares coping strategies to obtain the most effective way to reduce stress in…

Appropriate Importation and Effective Utilization of Top Quality Foreign Higher Education Resources for Sino-Foreign Cooperation in Running Schools

ERIC Educational Resources Information Center

Jinhui, Lin; Zhiping, Liu

2009-01-01

The appropriate importation and effective utilization of superior-quality foreign higher education resources are crucial to enhance the level and quality of school administration cooperation with foreign partners because it can not only make up for the shortage in domestic education resources and push forward China's higher education reform but…

Accounting for fuel price risk: Using forward natural gas prices instead of gas price forecasts to compare renewable to natural gas-fired generation

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

Bolinger, Mark; Wiser, Ryan; Golove, William

2003-08-13

Against the backdrop of increasingly volatile natural gas prices, renewable energy resources, which by their nature are immune to natural gas fuel price risk, provide a real economic benefit. Unlike many contracts for natural gas-fired generation, renewable generation is typically sold under fixed-price contracts. Assuming that electricity consumers value long-term price stability, a utility or other retail electricity supplier that is looking to expand its resource portfolio (or a policymaker interested in evaluating different resource options) should therefore compare the cost of fixed-price renewable generation to the hedged or guaranteed cost of new natural gas-fired generation, rather than to projectedmore » costs based on uncertain gas price forecasts. To do otherwise would be to compare apples to oranges: by their nature, renewable resources carry no natural gas fuel price risk, and if the market values that attribute, then the most appropriate comparison is to the hedged cost of natural gas-fired generation. Nonetheless, utilities and others often compare the costs of renewable to gas-fired generation using as their fuel price input long-term gas price forecasts that are inherently uncertain, rather than long-term natural gas forward prices that can actually be locked in. This practice raises the critical question of how these two price streams compare. If they are similar, then one might conclude that forecast-based modeling and planning exercises are in fact approximating an apples-to-apples comparison, and no further consideration is necessary. If, however, natural gas forward prices systematically differ from price forecasts, then the use of such forecasts in planning and modeling exercises will yield results that are biased in favor of either renewable (if forwards < forecasts) or natural gas-fired generation (if forwards > forecasts). In this report we compare the cost of hedging natural gas price risk through traditional gas-based hedging instruments (e.g., futures, swaps, and fixed-price physical supply contracts) to contemporaneous forecasts of spot natural gas prices, with the purpose of identifying any systematic differences between the two. Although our data set is quite limited, we find that over the past three years, forward gas prices for durations of 2-10 years have been considerably higher than most natural gas spot price forecasts, including the reference case forecasts developed by the Energy Information Administration (EIA). This difference is striking, and implies that resource planning and modeling exercises based on these forecasts over the past three years have yielded results that are biased in favor of gas-fired generation (again, presuming that long-term stability is desirable). As discussed later, these findings have important ramifications for resource planners, energy modelers, and policy-makers.« less

Temporal Changes in Prescription of Neuropharmacologic Drugs and Utilization of Resources Related to Neurologic Morbidity in Mechanically Ventilated Children With Bronchiolitis.

PubMed

Shein, Steven L; Slain, Katherine; Wilson-Costello, Deanne; McKee, Bryan; Rotta, Alexandre T

2017-12-01

Critically ill children with bronchiolitis may require neuropharmacologic medications and support for neuro-functional sequelae, but current practices are not well described. We aimed to describe recent trends in neuropharmacology and utilization of neuro-rehabilitation resources in mechanically ventilated children with bronchiolitis. Analysis of the multicenter Pediatric Health Information System database. Forty-seven U.S. children's hospitals. PICU patients less than 2 years old with bronchiolitis undergoing mechanical ventilation between 2006 and 2015. None. Annual rates of utilization of neuropharmacologic medications (sedatives, analgesics, etc) and of neuro-rehabilitation services (physical therapy, neurologic consultation, etc) over the 10-year study period were compared. Neuropharmacologic medications prescribed on greater than or equal to 2 days were extracted. Utilization of MRI of the brain, neurologic consultation, swallow evaluation, occupational therapy, and physical therapy was also extracted. Among 12,508 subjects, the median age was 2.8 months, ~50% had comorbid conditions, and the median duration of mechanical ventilation was 7 days. The percentage of children prescribed greater than or equal to five drugs/drug classes increased over the study period from 36.5% to 55.8% (p < 0.001). There were significant increases over time in utilization of 10 of the 15 individual drugs/drug classes analyzed. More than half of subjects (6,294 [50.3%]) received at least one service that evaluates/treats neurologic morbidity. There were significant increases in the use of greater than or equal to one service (36.3% in 2006 to 59.6% in 2015; p < 0.001) and in the use of greater than or equal to two services (20.8% to 34.8%; p < 0.001). Utilization of each of the five individual resources increased significantly during the study period, but use of vasoactive medications and mortality did not. Prescription of neuropharmacologic agents increased over time using metrics of both overall drug burden and specific drug usage. Concurrently, the utilization of services that evaluate and/or treat neurologic morbidity was common and also increased over time.

Teaching evidence-based medicine: Impact on students' literature use and inpatient clinical documentation.

PubMed

Sastre, Elizabeth Ann; Denny, Joshua C; McCoy, Jacob A; McCoy, Allison B; Spickard, Anderson

2011-01-01

Effective teaching of evidence-based medicine (EBM) to medical students is important for lifelong self-directed learning. We implemented a brief workshop designed to teach literature searching skills to third-year medical students. We assessed its impact on students' utilization of EBM resources during their clinical rotation and the quality of EBM integration in inpatient notes. We developed a physician-led, hands-on workshop to introduce EBM resources to all internal medicine clerks. Pre- and post-workshop measures included student's attitudes to EBM, citations of EBM resources in their clinical notes, and quality of the EBM component of the discussion in the note. Computer log analysis recorded students' online search attempts. After the workshop, students reported improved comfort using EBM and increased utilization of EBM resources. EBM integration into the discussion component of the notes also showed significant improvement. Computer log analysis of students' searches demonstrated increased utilization of EBM resources following the workshop. We describe the successful implementation of a workshop designed to teach third-year medical students how to perform an efficient EBM literature search. We demonstrated improvements in students' confidence regarding EBM, increased utilization of EBM resources, and improved integration of EBM into inpatient notes.

Health services and policy research in hepatology.

PubMed

Talwalkar, Jayant A

2014-05-01

This article examines recent health services and policy research studies in hepatology and liver transplantation. Critical issues include access to medical care, timeliness of referral and consultation, resource utilization in clinical practice, comparative effectiveness research, and the evaluation of care delivery models. Despite policymaking efforts, there continues to be unwarranted variation in access to subspecialty care and liver transplantation services based on race and geographic location. Variations in primary care and specialist awareness of practice guidelines for liver disease contribute to disparities in appropriateness and timeliness of treatments. Defining the cost-effectiveness of increased resource utilization for novel antiviral therapies and liver transplantation continues to stimulate controversy. Few comparative effectiveness studies in hepatology exist to date, yet a growing number of analyses using national datasets will help inform policy in this arena. Identifying care delivery models that demonstrate high value for populations with chronic liver disease is critical in the context of recent healthcare reform efforts. Health services and policy research is a growing field of investigation in hepatology and liver transplantation. Further emphasis on research training and workforce development in this area will be critical for understanding and improving patient-centered outcomes for this population.

A Comparative Toxidrome Analysis of Human Organophosphate and Nerve Agent Poisonings Using Social Media

PubMed Central

Colman, E

2017-01-01

Here we utilized social media to compare the toxidrome of three lethal chemical exposures worldwide. YouTube videos were the main source from which the data were collected, but published reports and news were also utilized to fill in some gaps. All videos were organized in a database detailing symptoms and severity of each victim, along with demographics such as approximate age and gender. Each symptom was rated as mild, moderate, or severe and corresponding pie graphs for each incident were compared. The videos displayed symptoms ranging from mild to severe cholinergic toxicity and life‐threatening convulsions. Social media may represent an important resource in developing a viable approach to the early detection and identification of chemical exposure, reinforce our preparedness for better antidotes, long‐term follow up, and training about deadly chemical nerve agent attacks. PMID:28238224

Data-Based Locally Directed Evaluation of Vocational Education Programs. Component 5. Analysis of Community Resources Utilization.

ERIC Educational Resources Information Center

Florida State Univ., Tallahassee. Program of Vocational Education.

Part of a system by which local education agency (LEA) personnel may evaluate secondary and postsecondary vocational education programs, this fifth of eight components focuses on an analysis of the utilization of community resources. Utilization of the component is designed to open communication channels among all segments of the community so that…

Study on the Potential Development of Rainwater Utilization in the Hilly City of Southern China

NASA Astrophysics Data System (ADS)

Fu, Xiaoran; Liu, Jiahong; Shao, Weiwei; Zhang, Haixing

2017-12-01

Aimed at the current flood problems and the contradiction between supply and demand of water resources in the southern cities of China, the comprehensive utilization of Urban Rainwater Resources (URRs) is a significant solution. At present, the research on the comprehensive utilization system of urban rainwater resources in China is still immature, especially the lack of a comprehensive method for the comprehensive utilization of the rainwater and flood resources in the south. Based on the current mode for utilization of URRs at home and abroad, Fenghuang County in Hunan Province was taken as a case of study, which is a typical mountainous city in the southern China. And the potential development of URRs was simulated and evaluated with a comparison of before and after the exploitation and utilization of URRs in this paper. The reduction effect of flood and waterlogging on the ancient city area is analyzed from SWMM. The simulation results show that the potential of exploitation and utilization of URRs in Fenghuang county is remarkable under the mode of exploitation and utilization which is given priority to flood prevention and control, and the annual development potential is 4.865×105 m3. The rainwater utilization measures of flood control effect is obvious with this mode, and the relevant research results can provide theoretical and technical support for enhancing urban water security capability, water conservation capacity, and disaster mitigation of urban flood.

Patient reported burden of asthma on resource use and productivity across 11 countries in Europe.

PubMed

Fletcher, Monica; Jha, Ashok; Dunlop, William; Heron, Louise; Wolfram, Verena; Van der Molen, Thys; Price, David

2015-04-01

Asthma affects 30 million people in Western Europe, leading to substantial burden on healthcare systems and economies. REcognise Asthma and LInk to Symptoms and Experience (REALISE™) was a large European survey across 11 countries assessing patient attitudes and behaviors towards their asthma. The present study utilizes REALISE™ data to understand resource use and absenteeism in asthma. Data were collected on absenteeism and healthcare resource use from 8000 asthma patients (aged 18-50 years) across the 11 countries. All data were patient reported. Odds ratios (ORs) were calculated against the country with the lowest proportion of respondents for hospitalization (as a proxy for lowest resource use). Patient characteristics were broadly similar across countries. However, self-reported asthma control status varied. More than 50% of respondents in most countries considered primary healthcare professionals (HCPs), i.e., general practitioners and nurses, the main HCP they see about their asthma. However, in some countries, specialists or nurses were considered the main HCP. Hospitalization was lowest amongst patients in the Netherlands. Resource use and productivity loss varied widely across the countries; ORs for hospitalization ranged from 1 in Sweden to 4 in Norway and for productivity loss from 0.6 in Sweden to 2.6 in Italy, compared with the Netherlands. This study quantified utilization of healthcare resources in asthma (number of visits of HCPs, hospitalization, and accident and emergency visits) as well as absenteeism and showed that differences exist across countries. The differences in primary care and specialist use suggest a possible difference in healthcare delivery across countries. Mundipharma International Limited, Cambridge, UK.

Stable isotope analysis of larval mosquito diets in agricultural wetlands in the coastal plain of Georgia, U.S.A.

PubMed

Young, Gina Botello; Golladay, Stephen; Covich, Alan; Blackmore, Mark

2014-12-01

Previous studies have used C and N isotope ratios to investigate the use of different food resources such as plant and animal detritus by container-breeding mosquitoes. This study is the first to report on the potential food resources assimilated by larval mosquitoes in agricultural and reference wetlands. Larval mosquitoes (Diptera: Culcidae) were sampled, along with their potential food resources, from agricultural and reference wetland habitats throughout a seasonal hydroperiod. IsoSource mixing model results indicated that food resources had greater δ(15) N isotope values in agricultural wetlands compared with cypress-gum swamps. In February, Aedes vexans (Meigen) and Culex territans Walker larvae fed primarily on lower quality food resources (coarse particulate organic matter and sediment) based on C:N. In contrast, higher quality food resources (fine particulate organic matter) were utilized by Anopheles spp. throughout the study and by Psorophora columbiae (Dyer and Knab) in May. This research contributes to a more comprehensive understanding of the food resources available and assimilated by larval mosquitoes in agricultural wetlands. © 2014 The Society for Vector Ecology.

Population-based learning of load balancing policies for a distributed computer system

NASA Technical Reports Server (NTRS)

Mehra, Pankaj; Wah, Benjamin W.

1993-01-01

Effective load-balancing policies use dynamic resource information to schedule tasks in a distributed computer system. We present a novel method for automatically learning such policies. At each site in our system, we use a comparator neural network to predict the relative speedup of an incoming task using only the resource-utilization patterns obtained prior to the task's arrival. Outputs of these comparator networks are broadcast periodically over the distributed system, and the resource schedulers at each site use these values to determine the best site for executing an incoming task. The delays incurred in propagating workload information and tasks from one site to another, as well as the dynamic and unpredictable nature of workloads in multiprogrammed multiprocessors, may cause the workload pattern at the time of execution to differ from patterns prevailing at the times of load-index computation and decision making. Our load-balancing policy accommodates this uncertainty by using certain tunable parameters. We present a population-based machine-learning algorithm that adjusts these parameters in order to achieve high average speedups with respect to local execution. Our results show that our load-balancing policy, when combined with the comparator neural network for workload characterization, is effective in exploiting idle resources in a distributed computer system.

Equity in the allocation of public sector financial resources in low- and middle-income countries: a systematic literature review.

PubMed

Anselmi, Laura; Lagarde, Mylene; Hanson, Kara

2015-05-01

This review aims to identify, assess and analyse the evidence on equity in the distribution of public health sector expenditure in low- and middle-income countries. Four bibliographic databases and five websites were searched to identify quantitative studies examining equity in the distribution of public health funding in individual countries or groups of countries. Two different types of studies were identified: benefit incidence analysis (BIA) and resource allocation comparison (RAC) studies. Quality appraisal and data synthesis were tailored to each study type to reflect differences in the methods used and in the information provided. We identified 39 studies focusing on African, Asian and Latin American countries. Of these, 31 were BIA studies that described the distribution, typically across socio-economic status, of individual monetary benefit derived from service utilization. The remaining eight were RAC studies that compared the actual expenditure across geographic areas to an ideal need-based distribution. Overall, the quality of the evidence from both types of study was relatively weak. Looking across studies, the evidence confirms that resource allocation formulae can enhance equity in resource allocation across geographic areas and that the poor benefits proportionally more from primary health care than from hospital expenditure. The lack of information on the distribution of benefit from utilization in RAC studies and on the countries' approaches to resource allocation in BIA studies prevents further policy analysis. Additional research that relates the type of resource allocation mechanism to service provision and to the benefit distribution is required for a better understanding of equity-enhancing resource allocation policies. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine © The Author 2014; all rights reserved.

7 CFR 2.20 - Under Secretary for Natural Resources and Environment.

Code of Federal Regulations, 2013 CFR

2013-01-01

... several surveying and monitoring activities related to environmental improvement. All are designed to... to: renewable resource management research, renewable resource environmental research; renewable resource protection research; renewable resource utilization research, and renewable resource assessment...

7 CFR 2.20 - Under Secretary for Natural Resources and Environment.

Code of Federal Regulations, 2010 CFR

2010-01-01

... several surveying and monitoring activities related to environmental improvement. All are designed to... to: renewable resource management research, renewable resource environmental research; renewable resource protection research; renewable resource utilization research, and renewable resource assessment...

American College of Cardiology/American Heart Association preoperative assessment guidelines reduce resource utilization before aortic surgery.

PubMed

Froehlich, James B; Karavite, Dean; Russman, Pamela L; Erdem, Nurum; Wise, Chris; Zelenock, Gerald; Wakefield, Thomas; Stanley, James; Eagle, Kim A

2002-10-01

Methods used for evaluation of cardiac risk before noncardiac surgery vary widely. We evaluated the effect over time on practice and resource utilization of implementing the American College of Cardiology/American Heart Association Guidelines on Preoperative Risk Assessment. We compared 102 historical control patients who underwent elective abdominal aortic surgery (from January 1993 to December 1994) with 94 consecutive patients after guideline implementation (from July 1995 to December 1996) and 104 patients in a late after guideline implementation (from July 1, 1997, to September 30, 1998). Resource use (testing, revascularization, and costs) and outcomes (perioperative death and myocardial infarction) were examined. Patients with and without clinical markers of risk for perioperative cardiac complications were compared. The use of preoperative stress testing (88% to 47%; P <.00001), cardiac catheterization (24% to 11%; P <.05), and coronary revascularization (25% to 2%; P <.00001) decreased between control and postguideline groups, respectively. These changes persisted in the late postguideline group. Mean preoperative evaluation costs also fell ($1087 versus $171; P <.0001). Outcomes of death (4% versus 3% versus 2%) and myocardial infarction (7% versus 3% versus 5%) were not significantly different between control, postguideline, and late postguideline groups, respectively. Stress test rates were similar for patients at low risk versus high risk in the historical control group (84% versus 91%; P =.29) but lower for patients at low risk after guideline implementation (31% versus 61%; P =.003). Implementation of the American College of Cardiology/American Heart Association cardiac risk assessment guidelines appropriately reduced resource use and costs in patients who underwent elective aortic surgery without affecting outcomes. This effect was sustained 2 years after guideline implementation.

The Caspian Sea Negotiation Support System 2.0

NASA Astrophysics Data System (ADS)

Rouhani, O. M.; Madani, K.

2012-12-01

The Caspian Sea is one of the most resourceful (both in energy and biological resources) areas of the world. The share allocation of Caspian Sea has been the subject of many disputes. Up to now, the negotiations to reach an agreement regarding the ownership status of the sea have not been completely successful. To facilitate reaching an agreement among littoral countries, research studies can provide valuable information. Researchers should examine different options for dividing the sea closely and determine the benefits of each of the options for the parties involved. Following an earlier effort, Caspian Sea Negotiation Support System is further developed in this regard. The model estimates countries' areal and utility shares under different legal methods/scenarios, attempting to minimize transportation costs of exploiting the resource. The applied model is more efficient than the earlier model and the used data includes more variables/attributes such as depth, the differentiation between gas and oil, and various fish resources than the previously employed data. Consequently, the estimates are calculated in more details than are calculated in the earlier study. The results still show a high sensitivity of outputs to the proposed division rules, suggesting a need to clarify the countries' utility and areal shares under any suggested legal regime. Compared to the previous results, the new results confirm the significant effect of the addition of the more variables/attributes to the analysis, in terms of the areal shares and allocations, valuation of resources, and asset management.

Books, children, dogs, artists: library programs for the entire family.

PubMed

Haver, Mary Katherine

2014-01-01

The promotion of library resources and services is a continuous process for all libraries, especially hospital family resource center libraries. Like public libraries, a family resource center can utilize programs as a pathway for connecting with and developing awareness of library resources and services available to patient families. This column describes the programs currently offered for All Children's Hospital Johns Hopkins Medicine patient families, marketing initiatives to promote these programs, and utilization of grant funding to supplement a program.

The Main Problems in the Development of Geothermal Energy Industry in China

NASA Astrophysics Data System (ADS)

Yan, Jiahong; Wang, Shejiao; Li, Feng

2017-04-01

As early as 1980-1985, the geothermal energy research group of the Institute of Geology and Geophisics (Chinese Academy of Sciences) has proposed to pay attention to geothermal energy resources in oil fields. PetroChina began to study the geothermal energy resources in the region of Beijing-Tianjin-Hebei from 1995. Subsequently, the geothermal resources in the Huabei, Daqing and Liaohe oil regions were evaluated. The total recoverable hot water of the three oilfields reached 19.3 × 1011m3. PetroChina and Kenya have carried out geothermal energy development and utilization projects, with some relevant technical achievements.On the basis of many years' research on geothermal energy, we summarized the main problems in the formation and development of geothermal energy in China. First of all, China's geothermal resources research is still unable to meet the needs of the geothermal energy industry. Secondly, the development and utilization of geothermal energy requires multi-disciplinary cooperation. Thirdly, the development and utilization of geothermal energy needs consideration of local conditions. Finally, the development and utilization of geothermal energy resources requires the effective management of local government.

Protein-energy wasting significantly increases healthcare utilization and costs among patients with chronic kidney disease: a propensity-score matched cohort study.

PubMed

Chao, Chia-Ter; Tang, Chao-Hsiun; Cheng, Rhoda Wen-Yi; Wang, Michael Yao-Hsien; Hung, Kuan-Yu

2017-09-01

Disease-related malnutrition is highly prevalent, and has prognostic implications for patients with chronic kidney disease (CKD); however, few studies have investigated the impact of malnutrition, or protein-energy wasting (PEW), on healthcare utilization and medical expenditure among CKD patients. Using claim data from the National Health Insurance in Taiwan, this study identified patients with CKD between 2009-2013 and categorized them into those with mild, moderate, or severe CKD. Cases with PEW after CKD was diagnosed were propensity-score matched with controls in a 1:4 ratio. Healthcare resource utilization metrics were compared, including outpatient and emergency department visits, frequency and duration of hospitalization, and the cumulative costs associated with different CKD severity. From among 347,501 CKD patients, eligible cohorts of 66,872 with mild CKD (49.2%), 27,122 with moderate CKD (19.9%), and 42,013 with severe CKD (30.9%) were selected. Malnourished CKD patients had significantly higher rates of hospitalization (p < .001 for all severities) and re-admission (p = .015 for mild CKD, p = .002 for severe CKD) than non-malnourished controls. Cumulative medical costs for outpatient and emergency visits, and hospitalization, were significantly higher among all malnourished CKD patients than non-malnourished ones (p < .001); total medical costs were also higher among malnourished patients with mild (62.9%), moderate (59.6%), or severe (43.6%) CKD compared to non-malnourished patients (p < .001). In a nationally-representative cohort, CKD patients with PEW had significantly more healthcare resource utilization and higher aggregate medical costs than those without, across the spectrum of CKD: preventing PEW in CKD patients should receive high priority if we would like to reduce medical costs.

A study on low-cost, high-accuracy, and real-time stereo vision algorithms for UAV power line inspection

NASA Astrophysics Data System (ADS)

Wang, Hongyu; Zhang, Baomin; Zhao, Xun; Li, Cong; Lu, Cunyue

2018-04-01

Conventional stereo vision algorithms suffer from high levels of hardware resource utilization due to algorithm complexity, or poor levels of accuracy caused by inadequacies in the matching algorithm. To address these issues, we have proposed a stereo range-finding technique that produces an excellent balance between cost, matching accuracy and real-time performance, for power line inspection using UAV. This was achieved through the introduction of a special image preprocessing algorithm and a weighted local stereo matching algorithm, as well as the design of a corresponding hardware architecture. Stereo vision systems based on this technique have a lower level of resource usage and also a higher level of matching accuracy following hardware acceleration. To validate the effectiveness of our technique, a stereo vision system based on our improved algorithms were implemented using the Spartan 6 FPGA. In comparative experiments, it was shown that the system using the improved algorithms outperformed the system based on the unimproved algorithms, in terms of resource utilization and matching accuracy. In particular, Block RAM usage was reduced by 19%, and the improved system was also able to output range-finding data in real time.

Improving salinity tolerance of plants through conventional breeding and genetic engineering: An analytical comparison.

PubMed

Ashraf, Muhammad; Akram, Nudrat Aisha

2009-01-01

The last century has witnessed a substantial improvement in yield potential, quality and disease resistance in crops. This was indeed the outcome of conventional breeding, which was achieved with little or no knowledge of underlying physiological and biochemical phenomena related to a trait. Also the resources utilized on programs involving conventional breeding were not of great magnitude. Plant breeders have also been successful during the last century in producing a few salt-tolerant cultivars/lines of some potential crops through conventional breeding, but this again has utilized modest resources. However, this approach seems now inefficient due to a number of reasons, and alternatively, genetic engineering for improving crop salt tolerance is being actively followed these days by the plant scientists, world-over. A large number of transgenic lines with enhanced salt tolerance of different crops can be deciphered from the literature but up to now only a very few field-tested cultivars/lines are known despite the fact that considerable resources have been expended on the sophisticated protocols employed for generating such transgenics. This review analytically compares the achievements made so far in terms of producing salt-tolerant lines/cultivars through conventional breeding or genetic engineering.

Favorable Cardiovascular Risk Profile Is Associated With Lower Healthcare Costs and Resource Utilization: The 2012 Medical Expenditure Panel Survey.

PubMed

Valero-Elizondo, Javier; Salami, Joseph A; Ogunmoroti, Oluseye; Osondu, Chukwuemeka U; Aneni, Ehimen C; Malik, Rehan; Spatz, Erica S; Rana, Jamal S; Virani, Salim S; Blankstein, Ron; Blaha, Michael J; Veledar, Emir; Nasir, Khurram

2016-03-01

The American Heart Association's 2020 Strategic Goals emphasize the value of optimizing risk factor status to reduce the burden of morbidity and mortality. In this study, we aimed to quantify the overall and marginal impact of favorable cardiovascular risk factor (CRF) profile on healthcare expenditure and resource utilization in the United States among those with and without cardiovascular disease (CVD). The study population was derived from the 2012 Medical Expenditure Panel Survey (MEPS). Direct and indirect costs were calculated for all-cause healthcare resource utilization. Variables of interest included CVD diagnoses (coronary artery disease, stroke, peripheral artery disease, dysrhythmias, or heart failure), ascertained by International Classification of Diseases, Ninth Edition, Clinical Modification codes, and CRF profile (hypertension, diabetes mellitus, hypercholesterolemia, smoking, physical activity, and obesity). Two-part econometric models were used to study expenditure data. The final study sample consisted of 15 651 MEPS participants (58.5±12 years, 54% female). Overall, 5921 (37.8%) had optimal, 7002 (44.7%) had average, and 2728 (17.4%) had poor CRF profile, translating to 54.2, 64.1, and 24.9 million adults in United States, respectively. Significantly lower health expenditures were noted with favorable CRF profile across CVD status. Among study participants with established CVD, overall healthcare expenditures with optimal and average CRF profile were $5946 and $3731 less compared with those with poor CRF profile. The respective differences were $4031 and $2560 in those without CVD. Favorable CRF profile is associated with significantly lower medical expenditure and healthcare utilization among individuals with and without established CVD. © 2016 American Heart Association, Inc.

Spectrum Sharing Based on a Bertrand Game in Cognitive Radio Sensor Networks

PubMed Central

Zeng, Biqing; Zhang, Chi; Hu, Pianpian; Wang, Shengyu

2017-01-01

In the study of power control and allocation based on pricing, the utility of secondary users is usually studied from the perspective of the signal to noise ratio. The study of secondary user utility from the perspective of communication demand can not only promote the secondary users to meet the maximum communication needs, but also to maximize the utilization of spectrum resources, however, research in this area is lacking, so from the viewpoint of meeting the demand of network communication, this paper designs a two stage model to solve spectrum leasing and allocation problem in cognitive radio sensor networks (CRSNs). In the first stage, the secondary base station collects the secondary network communication requirements, and rents spectrum resources from several primary base stations using the Bertrand game to model the transaction behavior of the primary base station and secondary base station. The second stage, the subcarriers and power allocation problem of secondary base stations is defined as a nonlinear programming problem to be solved based on Nash bargaining. The simulation results show that the proposed model can satisfy the communication requirements of each user in a fair and efficient way compared to other spectrum sharing schemes. PMID:28067850

Increasing the appeal and utilization of services for alcohol and drug problems: what consumers and their social networks prefer.

PubMed

Tucker, Jalie A; Foushee, H Russell; Simpson, Cathy A

2009-01-01

A large gap exists in the United States between population need and the utilization of treatment services for substance-related problems. Surveying consumer preferences may provide valuable information for developing more attractive services with greater reach and impact on population health. A state-level telephone survey using random digit dialling sampling methods assessed preferences for available professional, mutual help, and lay resources, as well as innovative computerized and self-help resources that enhance anonymity (N=439 households in Alabama). Respondents preferred help that involved personal contact compared to computerized help or self-help, but were indifferent whether personalized help was dispensed by professional or lay providers. Attractive service features included lower cost, insurance coverage, confidentiality, rapid and convenient appointments, and addressing functional problems and risks of substance misuse. Respondents in households with a member who misused substances rated services more negatively, especially if services had been used. The findings highlight the utility of viewing substance misusers and their social networks as consumers, and the implications for improving the system of care and for designing and marketing services that are responsive to user preferences are discussed.

Neck hematoma after major head and neck surgery: Risk factors, costs, and resource utilization.

PubMed

Shah-Becker, Shivani; Greenleaf, Erin K; Boltz, Melissa M; Hollenbeak, Christopher S; Goyal, Neerav

2018-06-01

Postoperative cervical hematoma after major head and neck surgery is a feared complication. However, risk factors for developing this complication and attributable costs are not well-established. The Nationwide Inpatient Sample database was utilized compare patients with and without postoperative cervical hematoma. Logistic regression was used to analyze risk factors for hematoma formation and 30-day mortality. Total inpatient length of stay (LOS) and costs were fit to generalized linear models. Of 32 071 patients, 1098 (3.4%) experienced a postoperative cervical hematoma. Male sex (odds ratio [OR] 1.38; P < .0001), black race (OR 1.35; P = .010), 4 or more comorbidities (OR 1.66; P < .0001), or presence of a preoperative coagulopathy (OR 6.76; P < .0001) were associated. Postoperative cervical hematoma was associated with 540% increased odds of death (P < .0001). The LOS and total excess costs were 5.14 days (P < .0001) and $17 887.40 (P < .0001), respectively. Although uncommon, postoperative cervical hematoma is a life-threatening complication of head and neck surgery with significant implications for outcomes and resource utilization. © 2018 Wiley Periodicals, Inc.

The utility of rapid antigen detection testing for the diagnosis of streptococcal pharyngitis in low-resource settings.

PubMed

Rimoin, Anne W; Walker, Christa L Fischer; Hamza, Hala S; Elminawi, Nevine; Ghafar, Hadeer Abdel; Vince, Adriana; da Cunha, Antonia L A; Qazi, Shamim; Gardovska, Dace; Steinhoff, Mark C

2010-12-01

To evaluate the utility of rapid antigen detection testing (RADT) for the diagnosis of group A streptococcal (GAS) pharyngitis in pediatric outpatient clinics in four countries with varied socio-economic and geographic profiles. We prospectively evaluated the utility of a commercial RADT in children aged 2-12 years presenting with symptoms of pharyngitis to urban outpatient clinics in Brazil, Croatia, Egypt, and Latvia between August 2001 and December 2005. We compared the performance of the RADT to culture using diagnostic and agreement statistics, including sensitivity, specificity, and positive and negative predictive values. The Centor scores for GAS diagnosis were used to assess the potential effect of spectrum bias on RADT results. Two thousand four hundred and seventy-two children were enrolled at four sites. The prevalence of GAS by throat culture varied by country (range 24.5-39.4%) and by RADT (range 23.9-41.8%). Compared to culture, RADT sensitivity ranged from 72.4% to 91.8% and specificity ranged from 85.7% to 96.4%. The positive predictive value ranged from 67.9% to 88.6% and negative predictive value ranged from 88.1% to 95.7%. In limited-resource regions where microbiological diagnosis is not feasible or practical, RADTs should be considered an option that can be performed in a clinic and provide timely results. Copyright © 2010 International Society for Infectious Diseases. Published by Elsevier Ltd. All rights reserved.

Costs and Resource Utilization Among Medicaid Patients with Schizophrenia Treated with Paliperidone Palmitate or Oral Atypical Antipsychotics.

PubMed

Pesa, Jacqueline A; Muser, Erik; Montejano, Leslie B; Smith, David M; Meyers, Oren I

Non-adherence to antipsychotic therapy among patients with schizophrenia is a key driver of relapse, which can lead to costly inpatient stays. Long-acting injectables (LAIs) may improve adherence, thus reducing hospitalizations, but inpatient cost reductions need to be balanced against higher drug acquisition costs of LAIs. Real-world evidence is needed to help quantify the economic value of oral atypical antipsychotics compared with LAIs. The objective of this study was to compare healthcare costs and resource utilization between once-monthly paliperidone palmitate (PP) and oral antipsychotic therapy (OAT) in a population of Medicaid beneficiaries with schizophrenia. A retrospective, observational study was performed using Truven Health MarketScan Medicaid claims data from 2009 to 2012. Marginal structural modeling, a form of weighted repeated measures analysis to control for differences between cohorts and time-varying confounding, was used to estimate monthly costs of care in 2012 US dollars and resource utilization over a 12-month period for patients in each cohort. While per-month mental-health prescription costs were US$1019 higher in the PP cohort, approximately 55 % of this premium was offset by lower inpatient and outpatient care costs, producing a mean monthly total cost differential of US$434 (95 % CI 298-569, p  < 0.0001) for all-cause costs and US$463 (95 % CI 374-552, p  < 0.0001) for mental-health-related costs. Use of PP also resulted in a 0.44 and 0.47 reduction in the odds of all-cause and mental-health-related hospitalizations and a 0.09 reduction in the odds of all-cause emergency department visits ( p  < 0.0001, p  < 0.0001, and p  = 0.0134, respectively) over the 12-month follow-up period. Treatment with long-acting injectable antipsychotics, such as PP, may reduce inpatient and outpatient healthcare services utilization and associated costs. These findings also suggest that patients with schizophrenia taking once-monthly PP may stand a lower risk of hospitalization than patients on OAT.

Burden of uncontrolled epilepsy in patients requiring an emergency room visit or hospitalization.

PubMed

Manjunath, Ranjani; Paradis, Pierre Emmanuel; Parisé, Hélène; Lafeuille, Marie-Hélène; Bowers, Brian; Duh, Mei Sheng; Lefebvre, Patrick; Faught, Edward

2012-10-30

To quantify the clinical and economic burden of uncontrolled epilepsy in patients requiring emergency department (ED) visit or hospitalization. Health insurance claims from a 5-state Medicaid database (1997Q1-2009Q2) and 55 self-insured US companies ("employer," 1999Q1 and 2008Q4) were analyzed. Adult patients with epilepsy receiving antiepileptic drugs (AED) were selected. Using a retrospective matched-cohort design, patients were categorized into cohorts of "uncontrolled" (≥ 2 changes in AED therapy, then ≥ 1 epilepsy-related ED visit/hospitalization within 1 year) and "well-controlled" (no AED change, no epilepsy-related ED visit/hospitalization) epilepsy. Matched cohorts were compared for health care resource utilization and costs using multivariate conditional regression models and nonparametric methods. From 110,312 (Medicaid) and 36,529 (employer) eligible patients, 3,454 and 602 with uncontrolled epilepsy were matched 1:1 to patients with well-controlled epilepsy, respectively. In both populations, uncontrolled epilepsy cohorts presented about 2 times more fractures and head injuries (all p values < 0.0001) and higher health care resource utilization (ranges of adjusted incidence rate ratios [IRRs] [all-cause utilization]: AEDs = 1.8-1.9, non-AEDs = 1.3-1.5, hospitalizations = 5.4-6.7, length of hospital stays = 7.3-7.7, ED visits = 3.7-5.0, outpatient visits = 1.4-1.7, neurologist visits = 2.3-3.1; all p values < 0.0001) than well-controlled groups. Total direct health care costs were higher in patients with uncontrolled epilepsy (adjusted cost difference [95% confidence interval (CI)] Medicaid = $12,258 [$10,482-$14,083]; employer = $14,582 [$12,019-$17,097]) vs well-controlled patients. Privately insured employees with uncontrolled epilepsy lost 2.5 times more work days, with associated indirect costs of $2,857 (95% CI $1,042-$4,581). Uncontrolled epilepsy in patients requiring ED visit or hospitalization was associated with significantly greater health care resource utilization and increased direct and indirect costs compared to well-controlled epilepsy in both publicly and privately insured settings.

Geothermal development plan: Yuma County

NASA Astrophysics Data System (ADS)

White, D. H.; Goldstone, L. A.

1982-08-01

The potential for utilizing geothermal energy was evaluated. Four potential geothermal resource areas with temperatures less than 900C (1940F) were identified, and in addition, two areas are inferred to contain geothermal resources with intermediate temperature potential. The resource areas are isolated. One resource site contains a hot dry rock resource. Anticipated population growth in the county is expected to be 2% per year over the next 40 years. The primary employment sector is agriculture, though some light industry is located in the county. Water supplies are found to be adequate to support future growth without adverse affect on agriculture. In addition, several agricultural processors were found, concentrated in citrus processing and livestock raising. It is suggested that by the year 2000, geothermal energy may economically provide the energy equivalent of 53,000 barrels of oil per year to the industrial sector if developed privately. Geothermal utilization projections increase to 132,000 barrels of oil per year by 2000 if a municipal utility developed the resource.

Burden of Surgical Site Infections Associated with Arthroplasty and the Contribution of Staphylococcus aureus.

PubMed

Patel, Harshila; Khoury, Hanane; Girgenti, Douglas; Welner, Sharon; Yu, Holly

2016-02-01

Patients undergoing arthroplasty are at considerable risk of experiencing post-operative complications, including surgical site infections (SSIs). In addition to potential economic consequences, SSIs can have a negative impact on patient outcomes and may potentially be life-threatening. Staphylococcus aureus has been consistently shown as the leading cause of SSIs associated with orthopedic surgery, with an important contribution from methicillin-resistant S. aureus (MRSA). This study evaluated the global burden of SSIs among patients undergoing orthopedic surgical procedures, and specifically those undergoing knee and hip arthroplasties. An extensive search of PubMed and recent conference proceedings was conducted. English articles published between 2003 and 2013 pertaining to SSI epidemiology, patient outcomes, and healthcare resource utilization and costs were reviewed. Overall, 81 studies were included, mainly from North America and Europe. Median SSI and S. aureus SSI rates, calculated as percentage of all arthroplasty procedures, were 1.7% (range: 0.25%-4.4%; 15 studies) and 0.6% (range: 0.1%-23%), respectively. Median SSI rates were 1.3% (range: 0.05%-19%; 22 studies) after knee arthroplasty, and 2.1% (range: 0.05%-28%; 24 studies) after hip arthroplasty. S. aureus SSI rates ranged from 0.2%-2.4% and 0.18%-3.8% for patients undergoing knee and hip arthroplasty, respectively. The percentage of S. aureus SSIs because of MRSA varied widely within each patient category. SSI-related mortality data (14 studies) showed that in-hospital mortality rates were low (1.2%-2.5%), but increased with time after index arthroplasty procedure (up to 56% over 1 y). Studies assessing healthcare resource utilization (n = 21) revealed that developing post-orthopedic SSIs resulted in a two- to three-fold increase in length of hospital stay (LOS) compared with non-infected patients (median LOS: 18.9 d vs. 6 d for non-SSI patients). Patients with SSIs because of methicillin-resistant staphylococci incurred greater mean LOS compared with SSIs because of methicillin-sensitive organisms. Readmission rates reported in 11 studies indicate a greater likelihood in the presence of SSIs; comparison across studies was not feasible because of differences in data reporting. Consistent with increased healthcare resource utilization (LOS and readmission) associated with SSIs, cost studies (n = 23) revealed that the presence of SSIs was associated with up to three-fold cost increase compared with the absence of SSI across all orthopedic patient categories assessed. SSIs are associated with increased morbidity, mortality rates, healthcare resource utilization, and costs. Despite the relatively low SSI incidence following orthopedic surgery and specifically arthroplasty, preventive methods, specifically those targeting S. aureus, would serve to minimize costs and improve patient outcomes.

The Impact of Thoracoscopic Surgery on Payment and Health Care Utilization After Lung Resection.

PubMed

Watson, Thomas J; Qiu, Jiejing

2016-04-01

Lung resection by video-assisted thoracoscopic surgery (VATS) is associated with multiple clinical benefits compared with resection by thoracotomy (OPEN). Less is known about reimbursements, costs, and resource use with each approach. This study used a commercial insurance claims database to examine differences between VATS and OPEN lung resections in payment, health care utilization, and estimated days off work for health care visits. All adult inpatient discharges for patients undergoing VATS or OPEN lung resection in 2010 were identified from the Truven MarketScan Database (Ann Arbor, MI). A total of 2,611 patients underwent lobectomy (VATS, 270; OPEN, 669) or wedge resection (VATS, 1,332; OPEN, 340). After adjustment, OPEN lobectomies had a longer length of stay (mean difference, 1.79 days) and higher payment to hospitals (mean difference, $3,497) and physicians (mean difference, $433) compared with VATS. Similar findings were noted after wedge resections. OPEN lobectomies had 1.28-times and 1.14-times more health care utilization days within 90 days and 365 days, respectively, after the operation compared with VATS, translating into increased expenditures of $3,260 at 90 days and $822 at 365 days for OPEN procedures. No significant differences in utilization were noted between OPEN and VATS wedge resections, except for fewer outpatient visits within 90 days in the OPEN group. Compared with an OPEN approach, lobectomy and wedge resection by VATS were associated with lower hospital and physician payments. In addition, lobectomy by VATS was associated with less health care utilization in the early postoperative period and during the first year after the operation. These payment and utilization reductions are important in an era of value-based purchasing in health care. Copyright © 2016 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

The soft constraints hypothesis: a rational analysis approach to resource allocation for interactive behavior.

PubMed

Gray, Wayne D; Sims, Chris R; Fu, Wai-Tat; Schoelles, Michael J

2006-07-01

Soft constraints hypothesis (SCH) is a rational analysis approach that holds that the mixture of perceptual-motor and cognitive resources allocated for interactive behavior is adjusted based on temporal cost-benefit tradeoffs. Alternative approaches maintain that cognitive resources are in some sense protected or conserved in that greater amounts of perceptual-motor effort will be expended to conserve lesser amounts of cognitive effort. One alternative, the minimum memory hypothesis (MMH), holds that people favor strategies that minimize the use of memory. SCH is compared with MMH across 3 experiments and with predictions of an Ideal Performer Model that uses ACT-R's memory system in a reinforcement learning approach that maximizes expected utility by minimizing time. Model and data support the SCH view of resource allocation; at the under 1000-ms level of analysis, mixtures of cognitive and perceptual-motor resources are adjusted based on their cost-benefit tradeoffs for interactive behavior. ((c) 2006 APA, all rights reserved).

The cost-utility of rotavirus vaccination with Rotarix (RIX4414) in the Netherlands.

PubMed

Goossens, Lucas M A; Standaert, Baudouin; Hartwig, Nico; Hövels, Anke M; Al, Maiwenn J

2008-02-20

The objective of this study was to estimate the cost-utility of mass vaccination of 0-4-year-old children with Rotarix in the Netherlands. We used a Markov process with Dutch data on incidence, resource use and costs (GP, hospitalisation, productivity loss and household costs) to compare vaccination to conventional treatment from a societal perspective. Utility loss due to rotavirus-induced diarrhoea was measured using EQ5D, with GPs and paediatricians serving as proxies to fill out the questions. As the costs of a vaccination course ranged from 90 euro to 100 euro per child, the cost-utility ratio varied from 21,900 euro to 35,076 euro per QALY gained. Based on the current study, it is clear that mass vaccination with Rotarix against rotavirus gastroenteritis can be attractive, from an economic and a health care perspective.

Network bandwidth utilization forecast model on high bandwidth networks

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

Yoo, Wuchert; Sim, Alex

With the increasing number of geographically distributed scientific collaborations and the scale of the data size growth, it has become more challenging for users to achieve the best possible network performance on a shared network. We have developed a forecast model to predict expected bandwidth utilization for high-bandwidth wide area network. The forecast model can improve the efficiency of resource utilization and scheduling data movements on high-bandwidth network to accommodate ever increasing data volume for large-scale scientific data applications. Univariate model is developed with STL and ARIMA on SNMP path utilization data. Compared with traditional approach such as Box-Jenkins methodology,more » our forecast model reduces computation time by 83.2%. It also shows resilience against abrupt network usage change. The accuracy of the forecast model is within the standard deviation of the monitored measurements.« less

Network Bandwidth Utilization Forecast Model on High Bandwidth Network

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

Yoo, Wucherl; Sim, Alex

With the increasing number of geographically distributed scientific collaborations and the scale of the data size growth, it has become more challenging for users to achieve the best possible network performance on a shared network. We have developed a forecast model to predict expected bandwidth utilization for high-bandwidth wide area network. The forecast model can improve the efficiency of resource utilization and scheduling data movements on high-bandwidth network to accommodate ever increasing data volume for large-scale scientific data applications. Univariate model is developed with STL and ARIMA on SNMP path utilization data. Compared with traditional approach such as Box-Jenkins methodology,more » our forecast model reduces computation time by 83.2percent. It also shows resilience against abrupt network usage change. The accuracy of the forecast model is within the standard deviation of the monitored measurements.« less

In-Situ Resource Utilization: Laying the Foundation for "Living off the Land"

NASA Technical Reports Server (NTRS)

Kaplan, D. I.

2000-01-01

The technology to manufacture rocket propellants, breathing and life-support gases, fuel cell reagents, and other consumables on Mars using indigenous Martian resources as feedstock in the production process is known as In-Situ Resource Utilization (ISRU). Several studies of the long-term, committed exploration of Mars by humans show that ISRU is essential ... an enabling technology. The recognized value of ISRU to human exploration is reflected in the NASA Strategic Plan. In the description of the "Strategies and Outcomes" of the Human Exploration and Development of Space (HEDS) Enterprise, the NASA Strategic Plan states: The [HEDS] Enterprise relies on the robotic missions of the Space Science Enterprise to provide extensive knowledge of the geology, environment, and resources of planetary bodies. The Space Science Enterprise missions will also demonstrate the feasibility of utilizing local resources to "live off the land."

Study on the Forming Process and Exploration of Concept of Human-Water Harmonization of Sustainable Development

NASA Astrophysics Data System (ADS)

Liu, Fang; Si, Liqi

2018-05-01

According to Maslow's hierarchy of needs, the process of human development and utilization of water resources can be divided into three stages: engineering water conservancy, resource water conservancy and harmonious coexistence between man and water. These three stages reflect the transformation of the idea of human development and utilization of water resources and eventually reach the state of harmony between human being and water. At the same time, this article draws on the experiences of water management under the thinking of sustainable development in the United States, Western Europe, Northern Europe and Africa. Finally, this paper points out that we need to realize the harmonious coexistence between man and water and sustainable development of water resources in the process of development and utilization of water resources, which is the inevitable requirement of the economic and social development.

Healthcare utilization in adults with opioid dependence receiving extended release naltrexone compared to treatment as usual.

PubMed

Soares, William E; Wilson, Donna; Rathlev, Niels; Lee, Joshua D; Gordon, Michael; Nunes, Edward V; O'Brien, Charles P; Friedmann, Peter D

2018-02-01

Opioid use disorders have reached epidemic proportions, with overdose now the leading cause of accidental death in the United States. Extended release naltrexone (XR-NTX) has emerged as a medication treatment that reduces opioid use and craving. However, the effect of XR-NTX therapy on acute healthcare utilization, including emergency department visits and inpatient hospitalizations, remains uncertain. The objective of the current study is to evaluate hospital-based healthcare resource utilization in adults involved in the criminal justice system with a history of opioid use disorder randomized to XR-NTX therapy compared with treatment as usual (TAU) during a 6-month treatment phase and 12months post-treatment follow up. This retrospective exploratory analysis uses data collected in a published randomized trial. Comparisons of the number of emergency department visits and hospital admissions (for drug detox, psychiatric care and other medical reasons) were performed using chi square tests for any admission and negative binomial models for number of admissions. Of the 308 participants randomized, 96% had utilization data (76% complete 6months, 67% complete follow up). No significant differences were seen in overall healthcare utilization (IRR=0.88, 95%CI 0.63-1.23, p=0.45), or substance use-related drug detox hospitalizations (IRR=0.83, 95%CI 0.32-2.16, p=0.71). Despite having more participants report chronic medical problems at baseline (43% vs. 32%, p=0.05), those receiving XR-NTX generally experienced equivalent or lower rates of healthcare utilization compared to TAU. The XR-NTX group had significantly lower medical/surgical related hospital admissions (IRR=0.55, 95%CI 0.30-1.00, p=0.05) during the course of the entire study. XR-NTX did not significantly increase rates of healthcare utilization compared to TAU. Provider concerns regarding healthcare utilization should not preclude the consideration of XR-NTX as therapy for opioid use disorders. Copyright © 2018 Elsevier Inc. All rights reserved.

Assessing the Utility of Temporally Dynamic Terrain Indices in Alaskan Moose Resource Selection

NASA Astrophysics Data System (ADS)

Jennewein, J. S.; Hebblewhite, M.; Meddens, A. J.; Gilbert, S.; Vierling, L. A.; Boelman, N.; Eitel, J.

2017-12-01

The accelerated warming in arctic and boreal regions impacts ecosystem structure and plant species distribution, which have secondary effects on wildlife. In summer months, moose (Alces alces) are especially vulnerable to changes in the availability and quality of forage and foliage cover due to their thermoregulatory needs and high energetic demands post calving. Resource selection functions (RSFs) have been used with great success to model such tradeoffs in habitat selection. Recently, RSFs have expanded to include more dynamic representations of habitat selection through the use of time-varying covariates such as dynamic habitat indices. However, to date few studies have investigated dynamic terrain indices, which incorporate long-term, highly-dynamic meteorological data (e.g., albedo, air temperature) and their utility in modeling habitat selection. The purpose of this study is to compare two dynamic terrain indices (i.e., solar insolation and topographic wetness) to their static counterparts in Alaskan moose resource selection over a ten-year period (2008-2017). Additionally, the utility of a dynamic wind-shelter index is assessed. Three moose datasets (n=130 total), spanning a north-to-south gradient in Alaska, are analyzed independently to assess location-specific resource selection. The newly-released, high-resolution Arctic Digital Elevation Model (5m2) is used as the terrain input into both dynamic and static indices. Dynamic indices are programmed with meteorological data from the North American Regional Analysis (NARR) and NASA's Goddard Earth Sciences Data and Information Services Center (GES-DISC) databases. Static wetness and solar insolation indices are estimated using only topographic parameters (e.g., slope, aspect). Preliminary results from pilot analyses suggest that dynamic terrain indices may provide novel insights into resource selection of moose that could not be gained when using static counterparts. Future applications of such dynamic terrain indices that incorporate time-varying meteorological data may be increasingly important in modelling habitat selection under continued climate change scenarios.

Outcomes and Resource Utilization of Endoscopic Mass-Closure Technique for Laryngeal Clefts.

PubMed

Balakrishnan, Karthik; Cheng, Esther; de Alarcon, Alessandro; Sidell, Douglas R; Hart, Catherine K; Rutter, Michael J

2015-07-01

To compare resource utilization and clinical outcomes between endoscopic mass-closure and open techniques for laryngeal cleft repair. Case series with chart review. Tertiary academic children's hospital. Pediatric patients undergoing repair for Benjamin-Inglis type 1-3 laryngeal clefts over a 15-year period. All 20 patients undergoing endoscopic repair were included. Eight control patients undergoing open repair were selected using matching by age and cleft type. Demographic, clinical, and resource utilization data were collected. Twenty-eight patients were included (20 endoscopic, 8 open). Mean age, rates of tracheostomy and vocal fold immobility, and distribution of cleft types were not different between the 2 groups (all P > .2). Mean operative time (P = .004) and duration of hospital stay (P < .001) were significantly shorter in the endoscopic group. All repairs were intact in both groups at final postoperative endoscopy. Rates of persistent laryngeal penetration or aspiration on swallow study were not different between groups (P = 1.000), although results were available for only 11 patients. Endoscopic laryngeal cleft repair using a mass-closure technique provides a durable result while requiring significantly shorter operative times and hospital stays than open repair and avoiding the potential morbidity of laryngofissure. However, open repair may allow the simultaneous performance of other airway reconstructive procedures and may be a useful salvage technique when endoscopic repair fails. Postoperative swallowing results require further study. © American Academy of Otolaryngology—Head and Neck Surgery Foundation 2015.

Temporal trends in early clinical outcomes and health care resource utilization for liver transplantation in the United States.

PubMed

Scarborough, John E; Pietrobon, Ricardo; Marroquin, Carlos E; Tuttle-Newhall, Janet E; Kuo, Paul C; Collins, Bradley H; Desai, Dev M; Pappas, Theodore N

2007-01-01

Procedures such as liver transplantation, which entail large costs while benefiting only a small percentage of the population, are being increasingly scrutinized by third-party payors. The purpose of our study was to conduct a longitudinal analysis of the early clinical outcomes and health care resource utilization for liver transplantation in the United States. The Nationwide Inpatient Sample database was used to conduct a longitudinal analysis of the clinical outcome and resource utilization data for liver transplantation procedures in adult recipients performed in the United States over three time periods (Period I: 1988-1993; Period II: 1994-1998: Period III: 1999-2003). Compared to Period I, adult liver transplant recipients were more likely to be male, older, and non-White in Period III. Recipients were more likely to have at least one major comorbidity preoperatively than in Period I. The in-hospital mortality rate after liver transplantation decreased significantly from Period I to Period III, but the major intraoperative and postoperative complication rates increased over the same time period. Mean length of hospital stay decreased over the 15-year period, but the percentage of patients with a non-routine discharge status increased. Our findings indicate that the rate of postoperative complications and non-routine discharges after liver transplantation is increasing. However, these negative changes in the cost-outcomes relationship for liver transplantation are balanced by improving postoperative survival rates and reductions in the length of hospital stay.

A Decision Support System For The Real-Time Allocation Of The Water Resource Of The Tarim River Basin, China

NASA Astrophysics Data System (ADS)

Wei, J.; Wang, G.; Liu, R.

2008-12-01

The Tarim River Basin is the longest inland river in China. Due to water scarcity, ecologically-fragile is becoming a significant constraint to sustainable development in this region. To effectively manage the limited water resources for ecological purposes and for conventional water utilization purposes, a real-time water resources allocation Decision Support System (DSS) has been developed. Based on workflows of the water resources regulations and comprehensive analysis of the efficiency and feasibility of water management strategies, the DSS includes information systems that perform data acquisition, management and visualization, and model systems that perform hydrological forecast, water demand prediction, flow routing simulation and water resources optimization of the hydrological and water utilization process. An optimization and process control strategy is employed to dynamically allocate the water resources among the different stakeholders. The competitive targets and constraints are taken into considered by multi-objective optimization and with different priorities. The DSS of the Tarim River Basin has been developed and been successfully utilized to support the water resources management of the Tarim River Basin since 2005.

FIREX mission requirements document for renewable resources

NASA Technical Reports Server (NTRS)

Carsey, F.; Dixon, T.

1982-01-01

The initial experimental program and mission requirements for a satellite synthetic aperture radar (SAR) system FIREX (Free-Flying Imaging Radar Experiment) for renewable resources is described. The spacecraft SAR is a C-band and L-band VV polarized system operating at two angles of incidence which is designated as a research instrument for crop identification, crop canopy condition assessments, soil moisture condition estimation, forestry type and condition assessments, snow water equivalent and snow wetness assessments, wetland and coastal land type identification and mapping, flood extent mapping, and assessment of drainage characteristics of watersheds for water resources applications. Specific mission design issues such as the preferred incidence angles for vegetation canopy measurements and the utility of a dual frequency (L and C-band) or dual polarization system as compared to the baseline system are addressed.

A Study of Aerospace Education Workshops Which Utilize NASA Materials and Resource Personnel

ERIC Educational Resources Information Center

Helton, Robert Dale

1974-01-01

Reports findings from two questionnaires administered to participants of aerospace workshops which utilized the National Aeronautics and Space Administration (NASA) materials and resource personnel. The findings gave a broad picture of aerospace workshops across the United States. (BR)

An Assessment of Water Demand and Availability to meet Construction and Operational Needs for Large Utility-Scale Solar Projects in the Southwestern United States

NASA Astrophysics Data System (ADS)

Klise, G. T.; Tidwell, V. C.; Macknick, J.; Reno, M. D.; Moreland, B. D.; Zemlick, K. M.

2013-12-01

In the Southwestern United States, there are many large utility-scale solar photovoltaic (PV) and concentrating solar power (CSP) facilities currently in operation, with even more under construction and planned for future development. These are locations with high solar insolation and access to large metropolitan areas and existing grid infrastructure. The Bureau of Land Management, under a reasonably foreseeable development scenario, projects a total of almost 32 GW of installed utility-scale solar project capacity in the Southwest by 2030. To determine the potential impacts to water resources and the potential limitations water resources may have on development, we utilized methods outlined by the Bureau of Land Management (BLM) to determine potential water use in designated solar energy zones (SEZs) for construction and operations & maintenance (O&M), which is then evaluated according to water availability in six Southwestern states. Our results indicate that PV facilities overall use less water, however water for construction is high compared to lifetime operational water needs. There is a transition underway from wet cooled to dry cooled CSP facilities and larger PV facilities due to water use concerns, though some water is still necessary for construction, operations, and maintenance. Overall, ten watersheds, 9 in California, and one in New Mexico were identified as being of particular concern because of limited water availability. Understanding the location of potentially available water sources can help the solar industry determine locations that minimize impacts to existing water resources, and help understand potential costs when utilizing non-potable water sources or purchasing existing appropriated water. Sandia National Laboratories is a multi-program laboratory managed and operated by Sandia Corporation, a wholly owned subsidiary of Lockheed Martin Corporation, for the U.S. Department of Energy's National Nuclear Security Administration under contract DE-AC04-94AL85000.

Association of hypoglycaemia severity with clinical, patient‐reported and economic outcomes in US patients with type 2 diabetes using basal insulin

PubMed Central

Lee, Lulu K.; Gupta, Shaloo; Preblick, Ron

2018-01-01

Aims To evaluate the clinical and patient‐reported outcomes and healthcare utilization and costs associated with patient‐reported hypoglycaemia in US adults with type 2 diabetes (T2D) treated with basal insulin. Materials and methods This was an observational, cross‐sectional, survey‐based study of adults with T2D on basal insulin ± oral antidiabetes drugs (OADs) or rapid‐acting/premixed insulin, who had in the past ever experienced hypoglycaemia, using US data from the National Health and Wellness Survey. Eligible patients were categorized as having no hypoglycaemia (38.7%), non‐severe hypoglycaemia (55.1%), or severe hypoglycaemia (6.2%) in the preceding 3 months. Outcomes included health‐related quality of life (HRQoL), work productivity and activity impairment, healthcare resource utilization, and estimated direct and indirect costs. Multivariable regression models were performed to control for patient characteristics. Results Patients who experienced severe hypoglycaemia had significantly (P < .05) lower HRQoL scores, greater overall impairment of work productivity and activity, greater healthcare resource utilization, and higher costs compared with those who experienced non‐severe or no hypoglycaemia. Patients with non‐severe hypoglycaemia also reported an impact on the number of provider visits, indirect costs, and HRQoL. Conclusions Patients with T2D using basal insulin ± OADs or rapid‐acting/premixed insulin in the United States who experienced severe hypoglycaemia had greater impairment of activity and work productivity, utilized more healthcare resources, and incurred higher associated costs than those with non‐severe or no hypoglycaemia. The study also demonstrated the impact that non‐severe hypoglycaemic events have on economic and HRQoL outcomes. Reducing the incidence and severity of hypoglycaemia could lead to clinically meaningful improvements in HRQoL and may result in lower healthcare utilization and associated costs. PMID:29316141

Surfer: An Extensible Pull-Based Framework for Resource Selection and Ranking

NASA Technical Reports Server (NTRS)

Zolano, Paul Z.

2004-01-01

Grid computing aims to connect large numbers of geographically and organizationally distributed resources to increase computational power; resource utilization, and resource accessibility. In order to effectively utilize grids, users need to be connected to the best available resources at any given time. As grids are in constant flux, users cannot be expected to keep up with the configuration and status of the grid, thus they must be provided with automatic resource brokering for selecting and ranking resources meeting constraints and preferences they specify. This paper presents a new OGSI-compliant resource selection and ranking framework called Surfer that has been implemented as part of NASA's Information Power Grid (IPG) project. Surfer is highly extensible and may be integrated into any grid environment by adding information providers knowledgeable about that environment.

Academic interventions for students in introductory biology while concurrently enrolled in developmental courses: An action research study

NASA Astrophysics Data System (ADS)

Barnes, William D.

Each fall semester, approximately half of the students enrolled in the introductory biology course of a small rural college are concurrently enrolled in at least one developmental education math or English course. The resulting grades of D, F and Withdraw for this cohort will be as high as 50% for those enrolled in one developmental course and 65% for those enrolled in two. The purpose of this study was to provide academic interventions such as use of online supplemental learning materials and resources, as well as to emphasize the Campus Tutoring and Learning Center (CTLC) as a resource, for students in the introductory biology course in order to analyze the impact on the learning outcomes of the developmental students. The approach used was an action research model utilizing a pretest-posttest experimental design with the treatment group receiving weekly reminders regarding the availability and value of utilizing the CTLC and the control group receiving only an initial invitation to visit the CTLC. The results found a statistically significant effect ( p < .05) on student use of the CTLC in the treatment group as compared to the control. This suggests that faculty emphasis of campus learning resources can have a positive impact on student behavior. The effect of online supplemental learning materials and resources, including use of the CTLC, on student learning outcomes was found to be statistically insignificant ( p > .05).

Relationship of Somatic Symptoms With Depression Severity, Quality of Life, and Health Resources Utilization in Patients With Major Depressive Disorder Seeking Primary Health Care in Spain

PubMed Central

García-Campayo, Javier; Ayuso-Mateos, José Luis; Caballero, Luis; Romera, Irene; Aragonés, Enric; Rodríguez-Artalejo, Fernando; Quail, Deborah; Gilaberte, Inmaculada

2008-01-01

Objective: To investigate the relationship between the characteristics of somatic symptoms and depression severity, quality of life (QOL), and health resources utilization in patients with major depressive disorder (MDD) in primary care setting. Method: This cross-sectional, nationwide epidemiologic study, carried out in 1150 primary care patients with DSM-IV–defined MDD, evaluated the characteristics of somatic symptoms by means of the Standardized Polyvalent Psychiatric Interview. Depression severity and QOL were evaluated by means of the Zung Self-Rating Depression Scale (SDS) and the Physical and Mental Component Summaries of the Medical Outcomes Study 12-item Short-Form Health Survey. Health resources utilization was measured in terms of doctor consultations and hospitalizations. The associations were assessed by means of adjusted analyses. The study was carried out from April 2004 to July 2004. Results: Disability associated with somatic symptoms and number of somatic symptoms were strongly associated with increased depression severity (2.45 and 0.29 increase in SDS score, respectively) and health resources utilization (odds ratios of 1.42 and 1.04, respectively). Associated disability, frequency, and persistence during leisure time of somatic symptoms were strongly associated with poorer QOL. In contrast, we found a weaker relationship between duration and intensity of somatic symptoms and depression severity, QOL, and health resources utilization. Conclusions: Of the studied somatic symptom characteristics, somatic symptom–associated disability and number of somatic symptoms are strongly associated with increased depression severity and health resources utilization, as well as with decreased QOL. Our results may help physicians identify relevant characteristics of somatic symptoms to more effectively diagnose and treat depression in primary care patients. PMID:19158973

Measuring Academic Library Efficiency and Alignment with Institutional Resource Utilization Priorities Using Data Envelopment Analysis: An Analysis of Institutions of Higher Education in Texas and Their Libraries

ERIC Educational Resources Information Center

Shupala, Christine M.

2012-01-01

Academic and library administrators are increasingly required to demonstrate efficiency in programs, services, and operations as well as effectiveness. An important component of efficiency measurement is identification of a relevant peer group against which to compare the administrative unit to determine relative efficiency. The two-fold purpose…

Cost-utility of laparoscopic Nissen fundoplication versus proton pump inhibitors for chronic and controlled gastroesophageal reflux disease: a 3-year prospective randomized controlled trial and economic evaluation.

PubMed

Goeree, Ron; Hopkins, Rob; Marshall, John K; Armstrong, David; Ungar, Wendy J; Goldsmith, Charles; Allen, Christopher; Anvari, Mehran

2011-01-01

Very few randomized controlled trials (RCTs) have compared laparoscopic Nissen fundoplication (LNF) to proton pump inhibitors (PPI) medical management for patients with chronic gastroesophageal reflux disease (GERD). Larger RCTs have been relatively short in duration, and have reported mixed results regarding symptom control and effect on quality of life (QOL). Economic evaluations have reported conflicting results. To determine the incremental cost-utility of LNF versus PPI for treating patients with chronic and controlled GERD over 3 years from the societal perspective. Economic evaluation was conducted alongside a RCT that enrolled 104 patients from October 2000 to September 2004. Primary study outcome was GERD symptoms (secondary outcomes included QOL and cost-utility). Resource utilization and QOL data collected at regular follow-up intervals determined incremental cost/QALY gained. Stochastic uncertainty was assessed using bootstrapping and methodologic assumptions were assessed using sensitivity analysis. No statistically significant differences in GERD symptom scores, but LNF did result in fewer heartburn days and improved QOL. Costs were higher for LNF patients by $3205/patient over 3 years but QOL was also higher as measured by either QOL instrument. Based on total costs, incremental cost-utility of LNF was $29,404/QALY gained using the Health Utility Index 3. Cost-utility results were sensitive to the utility instrument used ($29,404/QALY for Health Utility Index 3, $31,117/QALY for the Short Form 6D, and $76,310/QALY for EuroQol 5D) and if current lower prices for PPIs were used in the analysis. Results varied depending on resource use/costs included in the analysis, the QOL instrument used, and the cost of PPIs; however, LNF was generally found to be a cost-effective treatment for patients with symptomatic controlled GERD requiring long-term management. Copyright © 2011 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

Public health impact of Rotarix vaccination among commercially insured children in the United States.

PubMed

Krishnarajah, Girishanthy; Kageleiry, Andrew; Korves, Caroline; Lefebvre, Patrick; Duh, Mei S

2017-09-05

This study (NCT01915888) assessed public health impact of Rotarix, GSK [RV1] vaccination. Children born between 2007-2011 were identified from Truven Commercial Claims and Encounters Databases and observed until earlier of plan disenrollment or five years old. Children receiving one or two doses of RV1 during the vaccination window were assigned to incomplete and complete vaccination cohorts, respectively. Children without rotavirus (RV) vaccination (RV1 OR RotaTeq, Merck & Co., Inc. [RV5]) were assigned to the unvaccinated cohort. Claims with International Classification of Disease 9th edition (ICD-9) codes for diarrhea and RV infections were identified. First RV episode incidence, RV-related and diarrhea-related healthcare resource utilization were compared. Multivariate Poisson regression with generalized estimating equations was used to generate 95% confidence intervals (CIs) around incidence rate ratios (IRR) between cohorts while adjusting for gender, age and calendar year. Mean costs for first RV and diarrhea episodes were calculated with adjustment for gender and birth year; bootstrapping was used to determine statistically significant differences between cohorts. Incidence of first RV episodes was significantly reduced in complete and incomplete vaccination cohorts compared to the unvaccinated cohort (IRR=0.17 [95%CI: 0.09-0.30] and IRR=0.19 [95%CI: 0.06-0.58], respectively). RV-related inpatient, outpatient and emergency room (ER) visits were significantly lower for complete vaccination versus unvaccinated cohort. Diarrhea-related inpatient and ER visit rates were significantly lower for complete vaccination versus unvaccinated cohorts; outpatient rates were similar. RV-related and diarrhea-related resource utilization rates were significantly lower or no different for incomplete vaccination versus unvaccinated cohort. Compared with unvaccinated children, adjusted mean cost for first RV episode and first diarrhea episode per 1000 persons was $11,511 (95%CI: $9855-$12,024) and $46,772 (95%CI: $26,268-$66,604) lower, respectively, for completely vaccinated children. RV1 vaccination confers benefits in reduction of RV incidence, RV- and diarrhea-related healthcare resource utilization, and RV- and diarrhea-related healthcare costs. Copyright © 2017 GlaxoSmithKline. Published by Elsevier Ltd.. All rights reserved.

Adherence to disease-modifying therapies and its impact on relapse, health resource utilization, and costs among patients with multiple sclerosis.

PubMed

Burks, Jack; Marshall, Thomas S; Ye, Xiaolan

2017-01-01

To evaluate adherence to disease-modifying therapies (DMTs) among patients with multiple sclerosis (MS) initiating oral and injectable DMTs, and to estimate the impact of adherence on relapse, health resource utilization, and medical costs. Commercially insured MS patients (aged 18-65 years, two or more MS diagnoses, one or more DMT claims) with continuous eligibility 12 months before and after the first DMT claim date (index date) and no DMT claim during the pre-index period were identified from a large commerical claims database for the period from January 1, 2008, to September 30, 2015. Adherence to the index DMT was measured by the 12-month post-index proportion of days covered (PDC) and compared between oral and injectable DMT initiators. After adjustment for sex, age at index DMT, and comorbidities, regression models examined the relationship between adherence and relapse risk, MS-related health resource utilization, and non-drug medical costs (2015 US$). The study covered 12,431 patients and nine DMTs. Adherence to the index DMT did not differ significantly between oral (n=1,018) and injectable (n=11,413) DMTs when assessed by mean PDC (0.7257±0.2934 vs 0.7259±0.2869, respectively; P =0.0787), or percentages achieving PDC ≥0.8 (61.4% vs 58.6%, respectively; P =0.0806). Compared to non-adherence, adherence to DMT significantly reduced the likelihood of relapse in the post-index 12 months by 42%, hospitalization by 52%, and emergency visits by 38% (all, P <0.0001). Adherent patients would be expected to have on average 0.7 fewer outpatient visits annually versus non-adherent patients ( P <0.0001). Based on the differences in predicted mean costs, adherence (vs non-adherence) would decrease the total annual medical care costs by $5,816 per patient, including hospitalization costs by $1,953, emergency visits by $171, and outpatient visits by $2,802. Adherence remains suboptimal but comparable between oral and injectable DMTs. Potential health and economic benefits underscore the importance of improving adherence in MS.

Adherence to disease-modifying therapies and its impact on relapse, health resource utilization, and costs among patients with multiple sclerosis

PubMed Central

Burks, Jack; Marshall, Thomas S; Ye, Xiaolan

2017-01-01

Purpose To evaluate adherence to disease-modifying therapies (DMTs) among patients with multiple sclerosis (MS) initiating oral and injectable DMTs, and to estimate the impact of adherence on relapse, health resource utilization, and medical costs. Patients and methods Commercially insured MS patients (aged 18–65 years, two or more MS diagnoses, one or more DMT claims) with continuous eligibility 12 months before and after the first DMT claim date (index date) and no DMT claim during the pre-index period were identified from a large commerical claims database for the period from January 1, 2008, to September 30, 2015. Adherence to the index DMT was measured by the 12-month post-index proportion of days covered (PDC) and compared between oral and injectable DMT initiators. After adjustment for sex, age at index DMT, and comorbidities, regression models examined the relationship between adherence and relapse risk, MS-related health resource utilization, and non-drug medical costs (2015 US$). Results The study covered 12,431 patients and nine DMTs. Adherence to the index DMT did not differ significantly between oral (n=1,018) and injectable (n=11,413) DMTs when assessed by mean PDC (0.7257±0.2934 vs 0.7259±0.2869, respectively; P=0.0787), or percentages achieving PDC ≥0.8 (61.4% vs 58.6%, respectively; P=0.0806). Compared to non-adherence, adherence to DMT significantly reduced the likelihood of relapse in the post-index 12 months by 42%, hospitalization by 52%, and emergency visits by 38% (all, P<0.0001). Adherent patients would be expected to have on average 0.7 fewer outpatient visits annually versus non-adherent patients (P<0.0001). Based on the differences in predicted mean costs, adherence (vs non-adherence) would decrease the total annual medical care costs by $5,816 per patient, including hospitalization costs by $1,953, emergency visits by $171, and outpatient visits by $2,802. Conclusion Adherence remains suboptimal but comparable between oral and injectable DMTs. Potential health and economic benefits underscore the importance of improving adherence in MS. PMID:28496344

In Situ Resource Utilization (ISRU II) Technical Interchange Meeting

NASA Technical Reports Server (NTRS)

Kaplan, David (Compiler); Saunders, Stephen R. (Compiler)

1997-01-01

This volume contains extended abstracts that have been accepted for presentation at the In Situ Resource Utilization (ISRU II) Technical Interchange Meeting, November 18-19, 1997, at the Lunar and Planetary Institute, Houston, Texas. Included are topics which include: Extraterrestrial resources, in situ propellant production, sampling of planetary surfaces, oxygen production, water vapor extraction from the Martian atmosphere, gas generation, cryogenic refrigeration, and propellant transport and storage.

Integrating fisheries approaches and household utility models for improved resource management.

PubMed

Milner-Gulland, E J

2011-01-25

Natural resource management is littered with cases of overexploitation and ineffectual management, leading to loss of both biodiversity and human welfare. Disciplinary boundaries stifle the search for solutions to these issues. Here, I combine the approach of management strategy evaluation, widely applied in fisheries, with household utility models from the conservation and development literature, to produce an integrated framework for evaluating the effectiveness of competing management strategies for harvested resources against a range of performance metrics. I demonstrate the strengths of this approach with a simple model, and use it to examine the effect of manager ignorance of household decisions on resource management effectiveness, and an allocation tradeoff between monitoring resource stocks to reduce observation uncertainty and monitoring users to improve compliance. I show that this integrated framework enables management assessments to consider household utility as a direct metric for system performance, and that although utility and resource stock conservation metrics are well aligned, harvest yield is a poor proxy for both, because it is a product of household allocation decisions between alternate livelihood options, rather than an end in itself. This approach has potential far beyond single-species harvesting in situations where managers are in full control; I show that the integrated approach enables a range of management intervention options to be evaluated within the same framework.

Resource utilization in primary repair of cleft lip.

PubMed

Owusu, James A; Liu, Meixia; Sidman, James D; Scott, Andrew R

2013-03-01

To determine national variations in resource utilization for primary repair of cleft lip, identify patient and institutional factors associated with high resource use, and estimate the current incidence of cleft lip in the United States. Retrospective analysis of a national, pediatric database (2009 Kids' Inpatient Database [KID]). Patients aged 1 year and younger were selected using international classification of disease codes for cleft lip and procedure codes for cleft lip repair. A number of demographic variables were analyzed, and hospital charges were considered as a measure of resource utilization. There were 1318 patients identified. The national incidence was 0.09%, with a male to female ratio of 1.8:1. Regional incidence varied from 0.07% (Northeast) to 0.10% (West). The mean age at surgery was 4.2 months. The average length of stay was 1.4 days. The national average hospital charge was $20,147, ranging from $14,635 (South) to $23,663 (West). Teaching hospitals charge an average of $9764 higher than nonteaching hospitals. The strongest predictor of charge was length of stay, increasing charge by $8102 for every additional hospital day (P < .01). Regional variations exist in resource utilization for primary cleft lip repair. Resource use is higher in the West and among teaching hospitals.

[Relationships between urbanization and water resource utilization in Dongting Lake District of South-central China].

PubMed

Li, Jing-Zhi; Zhu, Xiang; Li, Jing-Bao; Xu, Mei

2013-06-01

By using analytic hierarchy process and entropy method, the evaluation index system and the response relationship model of comprehensive development level of urbanization and comprehensive development and utilization potential of water resources in Dongting Lake District were constructed, with the key affecting factors, their change characteristics, and response characteristics from 2001 to 2010 analyzed. During the study period, the Dongting Lake District was undergoing a rapid development of urbanization, and at a scale expansion stage. The economic and social development level was lagged behind the population and area increase, and the quality and efficiency of urbanization were still needed to be improved. With the advance of urbanization, the water consumption increased yearly, and the water resources utilization efficiency and management level improved steadily. However, the background condition of water resources and their development and utilization level were more affected by hydrological environment rather than urbanization. To a certain extent, the development of urbanization in 2001, 2002, 2005, 2006, 2007, 2009 was slowed down by the shortage of water resources. At present, Dongting Lake region was confronted with the dual task of improving the level and quality of urbanization, and hence, it would be necessary to reform the traditional epitaxial expansion of urbanization and to enhance the water resource support capability.

Evaluation of Cities in the Context of Energy Efficient Urban Planning Approach

NASA Astrophysics Data System (ADS)

Handan Yücel Yıldırım, H.; Burcu Gültekin, Arzuhan; Tanrıvermiş, Harun

2017-10-01

Due to the increase in energy need with urbanization as a result of industrialization and rapid population growth, preservation of natural resources has become impossible. As the energy generated particularly from non-renewable natural resources that are in danger of depletion such as coal, natural gas, petroleum is limited, and as environmental issues caused by energy resources increase, means of safe and continuous access to energy are searched in the world. Owing to the limited energy resources and energy dependence on foreign sources in the world, particularly in European Union countries, efforts of increasing the share of renewable energy sources in energy consumption increased in all industries, including urban planning as well. Concordantly, it is necessary to develop policies and approaches that enable utilization of domestic resources complying with the country’s conditions, and monitor developments in energy. Such policies and approaches, which must be implemented in urban planning as well, have great importance in terms of not deteriorating habitable environments of future generations while utilizing present-day energy resources, prevalence of utilization of renewable energy sources, and utilization of energy effectively. For that purpose, this paper puts forward a conceptual framework covering the principles, strategies, and methods on energy efficient urban planning approach, and discusses the energy efficient urban area examples within the scope of the suggested framework.

Planetary science and resource utilization at a lunar outpost - Chemical analytical facility requirements

NASA Technical Reports Server (NTRS)

Taylor, Lawrence A.

1992-01-01

Unresolved issues of lunar geology are reviewed and the role of a lunar outpost in helping to address them is considered. Plans for in situ resource utilization of lunar materials are examined. Concepts for a lunar outpost are described.

Resource utilization in children with tuberous sclerosis complex and associated seizures: a retrospective chart review study.

PubMed

Lennert, Barb; Farrelly, Eileen; Sacco, Patricia; Pira, Geraldine; Frost, Michael

2013-04-01

Seizures are a hallmark manifestation of tuberous sclerosis complex, yet data characterizing resource utilization are lacking. This retrospective chart review was performed to assess the economic burden of tuberous sclerosis complex with neurologic manifestations. Demographic and resource utilization data were collected for 95 patients for up to 5 years after tuberous sclerosis complex diagnosis. Mean age at diagnosis was 3.1 years, with complex partial and infantile spasms as the most common seizure types. In the first 5 years post-diagnosis, 83.2% required hospitalization, 30.5% underwent surgery, and the majority of patients (90.5%) underwent ≥3 testing procedures. In 79 patients with a full 5 years of data, hospitalizations, intensive care unit stays, diagnostic testing, and rehabilitation services decreased over the 5-year period. Resource utilization is cost-intensive in children with tuberous sclerosis complex and associated seizures during the first few years following diagnosis. Improving seizure control and reducing health care costs in this population remain unmet needs.

7 CFR 2.20 - Under Secretary for Natural Resources and Environment.

Code of Federal Regulations, 2014 CFR

2014-01-01

... to: renewable resource management research, renewable resource environmental research; renewable resource protection research; renewable resource utilization research, and renewable resource assessment research (16 U.S.C. 1641-1647). (x) Use authorities and means available to disseminate the knowledge and...

The utilization of nonterrestrial materials. [resources for solar power satellite construction

NASA Technical Reports Server (NTRS)

1981-01-01

The development of research and technology programs on the user of nonterrestrial materials for space applications was considered with emphasis on the space power satellite system as a model of large space systems for which the use of nonterrestrial materials may be economically viable. Sample topics discussed include the mining of raw materials and the conversion of raw materials into useful products. These topics were considered against a background of the comparative costs of using terrestrial materials. Exploratory activities involved in the preparation of a nonterrestrial materials utilization program, and the human factors involved were also addressed. Several recommendations from the workshop are now incorporated in NASA activities.

Cognitive status is a determinant of health resource utilization among individuals with a history of falls: a 12-month prospective cohort study.

PubMed

Davis, J C; Dian, L; Khan, K M; Bryan, S; Marra, C A; Hsu, C L; Jacova, P; Chiu, B K; Liu-Ambrose, T

2016-03-01

Falls are a costly public health problem worldwide. The literature is devoid of prospective data that identifies factors among fallers that significantly drive health care resource utilization. We found that cognitive function--specifically, executive functions--and cognitive status are significant determinants of health resource utilization among older fallers. Although falls are costly, there are no prospective data examining factors among fallers that drive health care resource utilization. We identified key determinants of health resource utilization (HRU) at 6 and 12 months among older adults with a history of falls. Specifically, with the increasing recognition that cognitive impairment is associated with increased falls risk, we investigated cognition as a potential driver of health resource utilization. This 12-month prospective cohort study at the Vancouver Falls Prevention Clinic (n = 319) included participants with a history of at least one fall in the previous 12 months. Based on their cognitive status, participants were divided into two groups: (1) no mild cognitive impairment (MCI) and (2) MCI. We constructed two linear regression models with HRU at 6 and 12 months as the dependent variables for each model, respectively. Predictors relating to mobility, global cognition, executive functions, and cognitive status (MCI versus no MCI) were examined. Age, sex, comorbidities, depression status, and activities of daily living were included regardless of statistical significance. Global cognition, comorbidities, working memory, and cognitive status (MCI versus no MCI ascertained using the Montreal Cognitive Assessment (MoCA)) were significant determinants of total HRU at 6 months. The number of medical comorbidities and global cognition were significant determinants of total HRU at 12 months. MCI status was a determinant of HRU at 6 months among older adults with a history of falls. As such, efforts to minimize health care resource use related to falls, it is important to tailor future interventions to be effective for people with MCI who fall. ClinicalTrials.gov Identifier: NCT01022866.

Variations in resource utilization among medical specialties and systems of care. Results from the medical outcomes study.

PubMed

Greenfield, S; Nelson, E C; Zubkoff, M; Manning, W; Rogers, W; Kravitz, R L; Keller, A; Tarlov, A R; Ware, J E

1992-03-25

To examine whether specialty and system of care exert independent effects on resource utilization. Cross-sectional analysis of just over 20,000 patients (greater than or equal to 18 years of age) who visited providers' offices during 9-day periods in 1986. Patient- and physician-provided information was obtained by self-administered questionnaires. Offices of 349 physicians practicing family medicine, internal medicine, endocrinology, and cardiology within health maintenance organizations, large multispecialty groups, and solo practices or small single-specialty group practices in three major US cities. Indicators of the intensity of resource utilization were examined among four medical specialties (family practice, general internal medicine, cardiology, and endocrinology) and five systems of care (health maintenance organization, multispecialty group-fee-for-service, multispecialty group-prepaid; solo practice and single-specialty group-fee-for-service, and solo practice and single-specialty group-prepaid) before and after controlling for the mix of patients seen in these offices. The indicators of resource utilization were hospitalizations, annual office visits, prescription drugs, and common tests and procedures, with rates estimated on both a per-visit and per-year basis. Variation in patient mix was a major determinant of the large variations in resource use. However, increased utilization was also independently related to specialty (cardiology and endocrinology), fee-for-service payment plan, and solo and single-specialty group practice arrangements. After adjusting for patient mix, solo practice/single-specialty groups-fee-for-service had 41% more hospitalizations than health maintenance organizations. General internists had utilization rates somewhat greater than family physicians on some indicators. Although variations in patient mix should be a major determinant of variations in resource use, the independent effects of specialty training, payment system, and practice organization on utilization rates need further explication. The 2- and 4-year outcomes now being analyzed will provide information critical to interpretation of the variations reported herein.

Are the kids alright? Review books and the internet as the most common study resources for the general surgery clerkship.

PubMed

Taylor, Janice A; Shaw, Christiana M; Tan, Sanda A; Falcone, John L

2018-01-01

To define resources deemed most important to medical students on their general surgery clerkship, we evaluated their material utilization. A prospective study was conducted amongst third-year medical students using a 20-item survey. Descriptive statistics were performed on the demographics. Kruskal-Wallis and Mann-Whitney analyses were performed on the Likert responses (α = 0.05). Survey response was 69.2%. Use of review books and Internet was significantly higher compared to all other resources (p < 0.05). Wikipedia was the most used Internet source (39.1%). 56% never used textbooks. Analyses of surgery subject exam (NBME) results or intended specialty with resources used showed no statistical relationship (all p > 0.05). Resources used by students reflect access to high-yield material and increased Internet use. The Internet and review books were used more than the recommended textbook; NBME results were not affected. Understanding study habits and resource use will help guide curricular development and students' self-regulated learning. Copyright © 2017 Elsevier Inc. All rights reserved.

Analysis of Low-Temperature Utilization of Geothermal Resources

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

Anderson, Brian

Full realization of the potential of what might be considered “low-grade” geothermal resources will require that we examine many more uses for the heat than traditional electricity generation. To demonstrate that geothermal energy truly has the potential to be a national energy source we will be designing, assessing, and evaluating innovative uses for geothermal-produced water such as hybrid biomass-geothermal cogeneration of electricity and district heating and efficiency improvements to the use of cellulosic biomass in addition to utilization of geothermal in district heating for community redevelopment projects. The objectives of this project were: 1) to perform a techno-economic analysis ofmore » the integration and utilization potential of low-temperature geothermal sources. Innovative uses of low-enthalpy geothermal water were designed and examined for their ability to offset fossil fuels and decrease CO2 emissions. 2) To perform process optimizations and economic analyses of processes that can utilize low-temperature geothermal fluids. These processes included electricity generation using biomass and district heating systems. 3) To scale up and generalize the results of three case study locations to develop a regionalized model of the utilization of low-temperature geothermal resources. A national-level, GIS-based, low-temperature geothermal resource supply model was developed and used to develop a series of national supply curves. We performed an in-depth analysis of the low-temperature geothermal resources that dominate the eastern half of the United States. The final products of this study include 17 publications, an updated version of the cost estimation software GEOPHIRES, and direct-use supply curves for low-temperature utilization of geothermal resources. The supply curves for direct use geothermal include utilization from known hydrothermal, undiscovered hydrothermal, and near-hydrothermal EGS resources and presented these results at the Stanford Geothermal Workshop. We also have incorporated our wellbore model into TOUGH2-EGS and began coding TOUGH2-EGS with the wellbore model into GEOPHIRES as a reservoir thermal drawdown option. Additionally, case studies for the WVU and Cornell campuses were performed to assess the potential for district heating and cooling at these two eastern U.S. sites.« less

2006 Pacific Northwest Loads and Resources Study.

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

United States. Bonneville Power Administration.

2006-03-01

The Pacific Northwest Loads and Resources Study (White Book), which is published annually by the Bonneville Power Administration (BPA), establishes one of the planning bases for supplying electricity to customers. The White Book contains projections of regional and Federal system load and resource capabilities, along with relevant definitions and explanations. The White Book also contains information obtained from formalized resource planning reports and data submittals including those from individual utilities, the Northwest Power and Conservation Council (Council), and the Pacific Northwest Utilities Conference Committee (PNUCC). The White Book is not an operational planning guide, nor is it used for determiningmore » BPA revenues, although the database that generates the data for the White Book analysis contributes to the development of BPA's inventory and ratemaking processes. Operation of the Federal Columbia River Power System (FCRPS) is based on a set of criteria different from that used for resource planning decisions. Operational planning is dependent upon real-time or near-term knowledge of system conditions that include expectations of river flows and runoff, market opportunities, availability of reservoir storage, energy exchanges, and other factors affecting the dynamics of operating a power system. The load resource balance of both the Federal system and the region is determined by comparing resource availability to an expected level of total retail electricity consumption. Resources include projected energy capability plus contract purchases. Loads include a forecast of retail obligations plus contract obligations. Surplus energy is available when resources are greater than loads. This surplus energy could be marketed to increase revenues. Energy deficits occur when resources are less than loads. These energy deficits will be met by any combination of the following: better-than-critical water conditions, demand-side management and conservation programs, permanent loss of loads due to economic conditions or closures, additional contract purchases, and/or the addition of new generating resources. This study incorporates information on Pacific Northwest (PNW) regional retail loads, contract obligations, and contract resources. This loads and resources analysis simulates the operation of the power system in the PNW. The simulated hydro operation incorporates plant characteristics, streamflows, and non-power requirements from the current Pacific Northwest Coordination Agreement (PNCA). Additional resource capability estimates were provided by BPA, PNW Federal agency, public agency, cooperative, U.S. Bureau of Reclamation (USBR), and investor-owned utility (IOU) customers furnished through annual PNUCC data submittals for 2005 and/or direct submittals to BPA. The 2006 White Book is presented in two documents: (1) this summary document of Federal system and PNW region loads and resources, and (2) a technical appendix which presents regional loads, grouped by major PNW utility categories, and detailed contract and resource information. The technical appendix is available only in electronic form. Individual customer information for marketer contracts is not detailed due to confidentiality agreements. The 2006 White Book analysis updates the 2004 White Book. This analysis shows projections of the Federal system and region's yearly average annual energy consumption and resource availability for the study period, OY 2007-2016. The study also presents projections of Federal system and region expected 1-hour monthly peak demand, monthly energy demand, monthly 1-hour peak generating capability, and monthly energy generation for OY 2007, 2011, and 2016. BPA is investigating a new approach in capacity planning depicting the monthly Federal system 120-hour peak generating capability and 120-hour peak surplus/deficit for OY 2007, 2011, and 2016. This document analyzes the PNW's projected loads and available generating resources in two parts: (1) the loads and resources of the Federal system, for which BPA is the marketing agency; and (2) the larger PNW regional power system loads and resources that include the Federal system as well other PNW entities.« less

Resource utilization model for the algorithm to architecture mapping model

NASA Technical Reports Server (NTRS)

Stoughton, John W.; Patel, Rakesh R.

1993-01-01

The analytical model for resource utilization and the variable node time and conditional node model for the enhanced ATAMM model for a real-time data flow architecture are presented in this research. The Algorithm To Architecture Mapping Model, ATAMM, is a Petri net based graph theoretic model developed at Old Dominion University, and is capable of modeling the execution of large-grained algorithms on a real-time data flow architecture. Using the resource utilization model, the resource envelope may be obtained directly from a given graph and, consequently, the maximum number of required resources may be evaluated. The node timing diagram for one iteration period may be obtained using the analytical resource envelope. The variable node time model, which describes the change in resource requirement for the execution of an algorithm under node time variation, is useful to expand the applicability of the ATAMM model to heterogeneous architectures. The model also describes a method of detecting the presence of resource limited mode and its subsequent prevention. Graphs with conditional nodes are shown to be reduced to equivalent graphs with time varying nodes and, subsequently, may be analyzed using the variable node time model to determine resource requirements. Case studies are performed on three graphs for the illustration of applicability of the analytical theories.

A Group Based Key Sharing and Management Algorithm for Vehicular Ad Hoc Networks

PubMed Central

Moharram, Mohammed Morsi; Azam, Farzana

2014-01-01

Vehicular ad hoc networks (VANETs) are one special type of ad hoc networks that involves vehicles on roads. Typically like ad hoc networks, broadcast approach is used for data dissemination. Blind broadcast to each and every node results in exchange of useless and irrelevant messages and hence creates an overhead. Unicasting is not preferred in ad-hoc networks due to the dynamic topology and the resource requirements as compared to broadcasting. Simple broadcasting techniques create several problems on privacy, disturbance, and resource utilization. In this paper, we propose media mixing algorithm to decide what information should be provided to each user and how to provide such information. Results obtained through simulation show that fewer number of keys are needed to share compared to simple broadcasting. Privacy is also enhanced through this approach. PMID:24587749

Equilibrium in a Production Economy

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

Chiarolla, Maria B., E-mail: maria.chiarolla@uniroma1.it; Haussmann, Ulrich G., E-mail: uhaus@math.ubc.ca

2011-06-15

Consider a closed production-consumption economy with multiple agents and multiple resources. The resources are used to produce the consumption good. The agents derive utility from holding resources as well as consuming the good produced. They aim to maximize their utility while the manager of the production facility aims to maximize profits. With the aid of a representative agent (who has a multivariable utility function) it is shown that an Arrow-Debreu equilibrium exists. In so doing we establish technical results that will be used to solve the stochastic dynamic problem (a case with infinite dimensional commodity space so the General Equilibriummore » Theory does not apply) elsewhere.« less

Resource utilization, costs and treatment patterns of switching and discontinuing treatment of MS patients with high relapse activity.

PubMed

Raimundo, Karina; Tian, Haijun; Zhou, Huanxue; Zhang, Xin; Kahler, Kristijan H; Agashivala, Neetu; Kim, Edward

2013-04-08

Multiple sclerosis (MS) is a chronic disease that affects mainly adults in the prime of their lives. However, few studies report the impact of high annual relapse rates on outcomes. The purpose of this study was to identify high relapse activity (HRA) in patients with MS, comparing differences in outcomes between patients with and without HRA. A retrospective longitudinal study was conducted using the MarketScan® Commercial Claims and Encounters and Medicare Supplemental Database. Patients had to have at least one ICD-9 for MS (340.XX) in 2009 and one in 2008, be older than 18 years, and have continuous enrolment in the years 2009-2010. HRA was defined as having ≥2 relapses in 2009. Multivariate analyses compared all-cause and MS-specific emergency room (ER) visits, hospitalizations, and all-cause costs, excluding disease modifying therapy (DMT) costs, in 2010 between patients with and without HRA, controlling for baseline characteristics. A subgroup analysis using treatment exposure was also performed. 19,219 patients were included: 5.3% (n=1,017) had ≥2 relapses in 2009. Patients with HRA were more likely to have all-cause and MS-specific resource utilization than patients without HRA. Mean total all-cause non DMT costs were $12,057 higher for the HRA group. In the subgroup analysis, HRA treatment-naïve patients were more likely to start treatment, and HRA treatment-experienced patients were more likely to discontinue or switch index DMT (P<0.01). Patients with ≥2 relapses annually have higher resource utilization and costs. The difference in cost was over twice as large in treatment-naïve patients versus treatment-experienced patients. HRA was also associated with an increased likelihood of starting DMT treatment (treatment-naïve patients), and switching or discontinuing DMT therapy (treatment-experienced patients).

Society of Thoracic Surgeons Risk Score Predicts Hospital Charges and Resource Utilization After Aortic Valve Replacement

PubMed Central

Arnaoutakis, George J.; George, Timothy J.; Alejo, Diane E.; Merlo, Christian A.; Baumgartner, William A.; Cameron, Duke E.; Shah, Ashish S.

2011-01-01

Context The impact of Society of Thoracic Surgeons (STS) predicted mortality risk score on resource utilization after aortic valve replacement (AVR) has not been previously studied. Objective We hypothesize that increasing STS risk scores in patients having AVR are associated with greater hospital charges. Design, Setting, and Patients Clinical and financial data for patients undergoing AVR at a tertiary care, university hospital over a ten-year period (1/2000–12/2009) were retrospectively reviewed. The current STS formula (v2.61) for in-hospital mortality was used for all patients. After stratification into risk quartiles (Q), index admission hospital charges were compared across risk strata with Rank-Sum tests. Linear regression and Spearman’s coefficient assessed correlation and goodness of fit. Multivariable analysis assessed relative contributions of individual variables on overall charges. Main Outcome Measures Inflation-adjusted index hospitalization total charges Results 553 patients had AVR during the study period. Average predicted mortality was 2.9% (±3.4) and actual mortality was 3.4% for AVR. Median charges were greater in the upper Q of AVR patients [Q1–3,$39,949 (IQR32,708–51,323) vs Q4,$62,301 (IQR45,952–97,103), p=<0.01]. On univariate linear regression, there was a positive correlation between STS risk score and log-transformed charges (coefficient: 0.06, 95%CI 0.05–0.07, p<0.01). Spearman’s correlation R-value was 0.51. This positive correlation persisted in risk-adjusted multivariable linear regression. Each 1% increase in STS risk score was associated with an added $3,000 in hospital charges. Conclusions This study showed increasing STS risk score predicts greater charges after AVR. As competing therapies such as percutaneous valve replacement emerge to treat high risk patients, these results serve as a benchmark to compare resource utilization. PMID:21497834

The Future of Electricity Resource Planning

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

Kahrl, Fredrich; Mills, Andrew; Lavin, Luke

Electricity resource planning is the process of identifying longer-term investments to meet electricity reliability requirements and public policy goals at a reasonable cost. Resource planning processes provide a forum for regulators, electric utilities, and electricity industry stakeholders to evaluate the economic, environmental, and social benefits and costs of different investment options. By facilitating a discussion on future goals, challenges and strategies, resource planning processes often play an important role in shaping utility business decisions. Resource planning emerged more than three decades ago in an era of transition, where declining electricity demand and rising costs spurred fundamental changes in electricity industrymore » regulation and structure. Despite significant changes in the industry, resource planning continues to play an important role in supporting investment decision making. Over the next two decades, the electricity industry will again undergo a period of transition, driven by technological change, shifting customer preferences and public policy goals. This transition will bring about a gradual paradigm shift in resource planning, requiring changes in scope, approaches and methods. Even as it changes, resource planning will continue to be a central feature of the electricity industry. Its functions — ensuring the reliability of high voltage (“bulk”) power systems, enabling oversight of regulated utilities and facilitating low-cost compliance with public policy goals — are likely to grow in importance as the electricity industry enters a new period of technological, economic and regulatory change. This report examines the future of electricity resource planning in the context of a changing electricity industry. The report examines emerging issues and evolving practices in five key areas that will shape the future of resource planning: (1) central-scale generation, (2) distributed generation, (3) demand-side resources, (4) transmission and (5) uncertainty and risk management. The analysis draws on a review of recent resource plans for 10 utilities that reflect some of the U.S. electricity industry’s extensive diversity.« less

Clinical outcomes and health care utilization pre- and post-laparoscopic radiofrequency ablation of symptomatic fibroids and laparoscopic myomectomy: a randomized trial of uterine-sparing techniques (TRUST) in Canada.

PubMed

Rattray, Darrien D; Weins, Laura; Regush, Lexy C; Bowen, James M; O'Reilly, Daria; Thiel, John A

2018-01-01

The objective of this study was to compare laparoscopic ultrasound-guided radiofrequency ablation of fibroids (Lap-RFA) and laparoscopic myomectomy in terms of 1) health care utilization and 2) serious complication rates. The secondary objectives were comparison of subject responses to validated symptom and quality-of-life questionnaires. We hypothesized that Lap-RFA health care utilization and clinical outcomes would not be worse than those of laparoscopic myomectomy in the aggregate. Post-market, randomized, prospective, multicenter, longitudinal, non-inferiority interventional comparative evaluation of health care utilization and clinical outcomes in premenopausal women with symptomatic uterine fibroids who desired uterine conservation was conducted. Both procedures were planned as outpatient day surgeries. Health care resource utilization was measured during the procedure day and at 1 week, 1 and 3 months post-surgery. Symptom severity and quality of life were based on patients' responses to the Uterine Fibroid Symptom Severity and Quality-of-Life Questionnaire, EuroQol-5D-visual analog scale general health status and menstrual impact questionnaires, and time from work. Forty-five participants provided written informed consent and were enrolled (Lap-RFA, n=23; myomectomy, n=22) in Canada. Hospitalization time (primary endpoint) was 6.7±3.0 hours for the Lap-RFA group and 9.9±10.7 hours for the myomectomy group (Wilcoxon, p =0.0004). Intraoperative blood loss was lesser for Lap-RFA subjects: 25.2±21.6 versus 82.4±62.5 mL ( p =0.0002). Lap-RFA procedures took lesser time than myomectomy procedures: 70.0 versus 86.5 minutes ( p =0.018), and Lap-RFA required -34.9% (130 fewer) units of surgical equipment. At 3 months, both cohorts reported the same significant symptom severity reduction (-44.8%; p <0.0001). Lap-RFA subjects also took lesser time from work: 11.1±7.6 versus 18.5±10.6 days ( p =0.0193). One myomectomy subject was hospitalized overnight after experiencing a 20-second asystole during the procedure. One Lap-RFA subject underwent a reintervention. The combined per patient direct and indirect costs of the two procedures were comparable: Lap-RFA (CAD $5,224.96) and myomectomy (CAD $5,321.96). Compared to myomectomy, Lap-RFA is associated with significantly lesser intraoperative blood loss, shorter procedure and hospitalization times, lesser consumption/use of disposable and reusable surgery equipment, reduced health care resource utilization, and faster return to work through 3 months posttreatment. Direct and indirect costs of Lap-RFA and myomectomy are comparable.

7 CFR 2.20 - Under Secretary for Natural Resources and Environment.

Code of Federal Regulations, 2012 CFR

2012-01-01

... cooperated in shall include, but not be limited to: renewable resource management research, renewable resource environmental research; renewable resource protection research; renewable resource utilization research, and renewable resource assessment research (16 U.S.C. 1641-1647). (x) Use authorities and means...

7 CFR 2.20 - Under Secretary for Natural Resources and Environment.

Code of Federal Regulations, 2011 CFR

2011-01-01

... cooperated in shall include, but not be limited to: renewable resource management research, renewable resource environmental research; renewable resource protection research; renewable resource utilization research, and renewable resource assessment research (16 U.S.C. 1641-1647). (x) Use authorities and means...

Multiobjective Resource-Constrained Project Scheduling with a Time-Varying Number of Tasks

PubMed Central

Abello, Manuel Blanco

2014-01-01

In resource-constrained project scheduling (RCPS) problems, ongoing tasks are restricted to utilizing a fixed number of resources. This paper investigates a dynamic version of the RCPS problem where the number of tasks varies in time. Our previous work investigated a technique called mapping of task IDs for centroid-based approach with random immigrants (McBAR) that was used to solve the dynamic problem. However, the solution-searching ability of McBAR was investigated over only a few instances of the dynamic problem. As a consequence, only a small number of characteristics of McBAR, under the dynamics of the RCPS problem, were found. Further, only a few techniques were compared to McBAR with respect to its solution-searching ability for solving the dynamic problem. In this paper, (a) the significance of the subalgorithms of McBAR is investigated by comparing McBAR to several other techniques; and (b) the scope of investigation in the previous work is extended. In particular, McBAR is compared to a technique called, Estimation Distribution Algorithm (EDA). As with McBAR, EDA is applied to solve the dynamic problem, an application that is unique in the literature. PMID:24883398

Rangeland and Oak Relationships

Treesearch

Dick R. McCleery

1991-01-01

Hardwood rangelands are becoming an endangered resource on the Central Coast of California. Straightforward inventory processes and management guidelines on which to base sound management decisions provide the landowner the tools to protect and utilize these important hardwood resources. Utilizing a WOODLAND INFORMATION STICK and a ZIG ZAG TRANSECT, landowners can...

Maize Genetic Resources Collections – Utilizing a Treasure Trove

USDA-ARS?s Scientific Manuscript database

The maize genetic resource collection managed by the USDA-ARS's National Plant Germplasm System is heavily utilized by researchers and educators. A collection of landraces, inbred lines from public and private sector sources, synthetics and key populations, it serves both as a living snapshot of th...

Medical Resource Utilization by Taiwanese Psychiatric Inpatients under the National Health Insurance System.

PubMed

Lee, Chiachi Bonnie; Li, Chung-Yi; Lin, Chih-Ming

2016-12-01

The length of stay in Taiwan's psychiatric facilities is unusually long compared with that of other countries. To identify factors associated with the high length of stay in the acute and chronic psychiatric wards of a public psychiatric hospital. The present study consisted of 912 inpatients discharged from a public psychiatric hospital in Northern Taiwan in 2005. Demographic characteristics, discharge diagnoses, and medical resource utilization were retrieved from the inpatient claim data of the National Health Insurance Database. Multivariate logistic regression models were performed to identify significant predictors for a long length of stay (LOS). Covariate adjusted odds ratios and a 95% confidence interval (CI) were applied to explore the effects of financial barriers, demographic, and diagnostic characteristics, and readmission for medical care. A median LOS of 35.0 days and median medical charge of USD 3,271.50 were reported. A greater likelihood of a high degree of medical care was found among patients who were exempt from copayments, were diagnosed with schizophrenia, had a co-morbidity factor, and were admitted from emergency visits. The results showed that patients in the 45--60 year age group had a higher risk of long LOS than those in the 18--30 year age group. A longer LOS in Taiwan might reflect more free access to hospitals and further extensive utilization of medical facilities under the National Health Insurance system. It was noted that age, sex, disease characteristics, and insurance policies were associated with a high medical utilization. However, the lack of a copayment may partially explain the long LOS in our study. Other causes, such as inadequate supplies of resources for psychiatric services, may also deserve closer study. A failure to adjust for potentially confounding factors might limit interpretation of the observed relationship between such potential factors and medical resource utilization. These findings support the future planning of specific care policies in mental health services in Taiwan. While an exemption in copayment aims to remove financial barriers for indigent people, it contributed to the extended LOS. To make psychiatric care more efficient, facilities in the community must be strengthened, patients must be directed to appropriate care to avoid emergency check-ins, and the reimbursement policy must be geared to facilitate the efficient delivery of care. Our study calls for further research on the role of resource allocation, incentives for efficient delivery of care, and the frequency of hospitalization, in particular, on the long LOS of psychiatric patients in Taiwan.

Study on Equity and Efficiency of Health Resources and Services Based on Key Indicators in China

PubMed Central

Zhang, Xinyu; Zhao, Lin; Cui, Zhuang; Wang, Yaogang

2015-01-01

Background This study aims to evaluate the dialectical relationship between equity and efficiency of health resource allocation and health service utilization in China. Methods We analyzed the inequity of health resource allocation and health service utilization based on concentration index (CI) and Gini coefficient. Data envelopment analysis (DEA) was used to evaluate the inefficiency of resource allocation and service utilization. Factor Analysis (FA) was used to determine input/output indicators. Results The CI of Health Institutions, Beds in Health Institutions, Health Professionals and Outpatient Visits were -0.116, -0.012, 0.038, and 0.111, respectively. Gini coefficient for the 31 provinces varied between 0.05 and 0.43; out of these 23 (742%) were observed to be technically efficient constituting the “best practice frontier”. The other 8 (25.8%) provinces were technically inefficient. Conclusions Health professionals and outpatient services are focused on higher income levels, while the Health Institutions and Beds in Health Institutions were concentrated on lower income levels. In China, a few provinces attained a basic balance in both equity and efficiency in terms of current health resource and service utilization, thus serving as a reference standard for other provinces. PMID:26679187

Study on Equity and Efficiency of Health Resources and Services Based on Key Indicators in China.

PubMed

Zhang, Xinyu; Zhao, Lin; Cui, Zhuang; Wang, Yaogang

2015-01-01

This study aims to evaluate the dialectical relationship between equity and efficiency of health resource allocation and health service utilization in China. We analyzed the inequity of health resource allocation and health service utilization based on concentration index (CI) and Gini coefficient. Data envelopment analysis (DEA) was used to evaluate the inefficiency of resource allocation and service utilization. Factor Analysis (FA) was used to determine input/output indicators. The CI of Health Institutions, Beds in Health Institutions, Health Professionals and Outpatient Visits were -0.116, -0.012, 0.038, and 0.111, respectively. Gini coefficient for the 31 provinces varied between 0.05 and 0.43; out of these 23 (742%) were observed to be technically efficient constituting the "best practice frontier". The other 8 (25.8%) provinces were technically inefficient. Health professionals and outpatient services are focused on higher income levels, while the Health Institutions and Beds in Health Institutions were concentrated on lower income levels. In China, a few provinces attained a basic balance in both equity and efficiency in terms of current health resource and service utilization, thus serving as a reference standard for other provinces.

Pneumatic Regolith Transfer Systems for In Situ Resource Utilization

NASA Technical Reports Server (NTRS)

Mueller, R. P.; Townsend, I. I.; Mantovani, J. G.; Zacny, Kris A.; Craft, Jack

2010-01-01

This slide presentation reviews the testing of a pneumatic system for transfering regolith, to be used for In Situ Resource Utilization (ISRU). Using both the simulated microgravity of parabolic flight and ground testing, the tests demonstrated that lunar regolith can be conveyed pneumatically into a simulated ISRU oxygen production plant reactor. The ground testing also demonstrated that the regolith can be expelled from the ISRU reactor for disposal or for other resource processing.

An approach to modeling and optimization of integrated renewable energy system (ires)

NASA Astrophysics Data System (ADS)

Maheshwari, Zeel

The purpose of this study was to cost optimize electrical part of IRES (Integrated Renewable Energy Systems) using HOMER and maximize the utilization of resources using MATLAB programming. IRES is an effective and a viable strategy that can be employed to harness renewable energy resources to energize remote rural areas of developing countries. The resource- need matching, which is the basis for IRES makes it possible to provide energy in an efficient and cost effective manner. Modeling and optimization of IRES for a selected study area makes IRES more advantageous when compared to hybrid concepts. A remote rural area with a population of 700 in 120 households and 450 cattle is considered as an example for cost analysis and optimization. Mathematical models for key components of IRES such as biogas generator, hydropower generator, wind turbine, PV system and battery banks are developed. A discussion of the size of water reservoir required is also presented. Modeling of IRES on the basis of need to resource and resource to need matching is pursued to help in optimum use of resources for the needs. Fixed resources such as biogas and water are used in prioritized order whereas movable resources such as wind and solar can be used simultaneously for different priorities. IRES is cost optimized for electricity demand using HOMER software that is developed by the NREL (National Renewable Energy Laboratory). HOMER optimizes configuration for electrical demand only and does not consider other demands such as biogas for cooking and water for domestic and irrigation purposes. Hence an optimization program based on the need-resource modeling of IRES is performed in MATLAB. Optimization of the utilization of resources for several needs is performed. Results obtained from MATLAB clearly show that the available resources can fulfill the demand of the rural areas. Introduction of IRES in rural communities has many socio-economic implications. It brings about improvement in living environment and community welfare by supplying the basic needs such as biogas for cooking, water for domestic and irrigation purposes and electrical energy for lighting, communication, cold storage, educational and small- scale industrial purposes.

International Comparison of Poststroke Resource Use: A Longitudinal Analysis in Europe.

PubMed

Matchar, David B; Bilger, Marcel; Do, Young K; Eom, Kirsten

2015-10-01

Long-term costs often represent a large proportion of the total costs induced by stroke, but data on long-term poststroke resource use are sparse, especially regarding the trajectory of costs by severity. We used a multinational longitudinal survey to estimate patterns of poststroke resource use by degree of functional disability and to compare resource use between regions. The Survey of Health, Ageing and Retirement in Europe (SHARE) is a multinational database of adults 50 years and older, which includes demographic information about respondents, age when stroke first occurred, current activity of daily living (ADL) limitations, and health care resource use in the year before interview. We modeled resource use with a 2-part regression for number of hospital days, home nursing hours, and paid and unpaid home caregiving hours. After accounting for time since stroke, number of strokes and comorbidities, age, gender, and European regions, we found that poststroke resource use was strongly associated with ADL limitations. The duration since the stroke event was significantly associated only with inpatient care, and informal help showed significant regional heterogeneity across all ADL limitation levels. Poststroke physical deficits appear to be a strong driver of long-term resource utilization; treatments that decrease such deficits offer substantial potential for downline cost savings. Analyzing internationally comparable panel data, such as SHARE, provide valuable insight into long-term cost of stroke. More comprehensive international comparisons will require registries with follow-up, particularly for informal and formal home-based care. Copyright © 2015 National Stroke Association. Published by Elsevier Inc. All rights reserved.

Scheduling in the Face of Uncertain Resource Consumption and Utility

NASA Technical Reports Server (NTRS)

Frank, Jeremy; Dearden, Richard

2003-01-01

We discuss the problem of scheduling tasks that consume uncertain amounts of a resource with known capacity and where the tasks have uncertain utility. In these circumstances, we would like to find schedules that exceed a lower bound on the expected utility when executed. We show that the problems are NP- complete, and present some results that characterize the behavior of some simple heuristics over a variety of problem classes.

The goal of value-based medicine analyses: comparability. The case for neovascular macular degeneration.

PubMed

Brown, Gary C; Brown, Melissa M; Brown, Heidi C; Kindermann, Sylvia; Sharma, Sanjay

2007-01-01

To evaluate the comparability of articles in the peer-reviewed literature assessing the (1) patient value and (2) cost-utility (cost-effectiveness) associated with interventions for neovascular age-related macular degeneration (ARMD). A search was performed in the National Library of Medicine database of 16 million peer-reviewed articles using the key words cost-utility, cost-effectiveness, value, verteporfin, pegaptanib, laser photocoagulation, ranibizumab, and therapy. All articles that used an outcome of quality-adjusted life-years (QALYs) were studied in regard to (1) percent improvement in quality of life, (2) utility methodology, (3) utility respondents, (4) types of costs included (eg, direct healthcare, direct nonhealthcare, indirect), (5) cost bases (eg, Medicare, National Health Service in the United Kingdom), and (6) study cost perspective (eg, government, societal, third-party insurer). To qualify as a value-based medicine analysis, the patient value had to be measured using the outcome of the QALYs conferred by respective interventions. As with value-based medicine analyses, patient-based time tradeoff utility analysis had to be utilized, patient utility respondents were necessary, and direct medical costs were used. Among 21 cost-utility analyses performed on interventions for neovascular macular degeneration, 15 (71%) met value-based medicine criteria. The 6 others (29%) were not comparable owing to (1) varying utility methodology, (2) varying utility respondents, (3) differing costs utilized, (4) differing cost bases, and (5) varying study perspectives. Among value-based medicine studies, laser photocoagulation confers a 4.4% value gain (improvement in quality of life) for the treatment of classic subfoveal choroidal neovascularization. Intravitreal pegaptanib confers a 5.9% value gain (improvement in quality of life) for classic, minimally classic, and occult subfoveal choroidal neovascularization, and photodynamic therapy with verteporfin confers a 7.8% to 10.7% value gain for the treatment of classic subfoveal choroidal neovascularization. Intravitreal ranibizumab therapy confers greater than a 15% value gain for the treatment of subfoveal occult and minimally classic subfoveal choroidal neovascularization. The majority of cost-utility studies performed on interventions for neovascular macular degeneration are value-based medicine studies and thus are comparable. Value-based analyses of neovascular ARMD monotherapies demonstrate the power of value-based medicine to improve quality of care and concurrently maximize the efficacy of healthcare resource use in public policy. The comparability of value-based medicine cost-utility analyses has important implications for overall practice standards and public policy. The adoption of value-based medicine standards can greatly facilitate the goal of higher-quality care and maximize the best use of healthcare funds.

THE GOAL OF VALUE-BASED MEDICINE ANALYSES: COMPARABILITY. THE CASE FOR NEOVASCULAR MACULAR DEGENERATION

PubMed Central

Brown, Gary C.; Brown, Melissa M.; Brown, Heidi C.; Kindermann, Sylvia; Sharma, Sanjay

2007-01-01

Purpose To evaluate the comparability of articles in the peer-reviewed literature assessing the (1) patient value and (2) cost-utility (cost-effectiveness) associated with interventions for neovascular age-related macular degeneration (ARMD). Methods A search was performed in the National Library of Medicine database of 16 million peer-reviewed articles using the key words cost-utility, cost-effectiveness, value, verteporfin, pegaptanib, laser photocoagulation, ranibizumab, and therapy. All articles that used an outcome of quality-adjusted life-years (QALYs) were studied in regard to (1) percent improvement in quality of life, (2) utility methodology, (3) utility respondents, (4) types of costs included (eg, direct healthcare, direct nonhealthcare, indirect), (5) cost bases (eg, Medicare, National Health Service in the United Kingdom), and (6) study cost perspective (eg, government, societal, third-party insurer). To qualify as a value-based medicine analysis, the patient value had to be measured using the outcome of the QALYs conferred by respective interventions. As with value-based medicine analyses, patient-based time tradeoff utility analysis had to be utilized, patient utility respondents were necessary, and direct medical costs were used. Results Among 21 cost-utility analyses performed on interventions for neovascular macular degeneration, 15 (71%) met value-based medicine criteria. The 6 others (29%) were not comparable owing to (1) varying utility methodology, (2) varying utility respondents, (3) differing costs utilized, (4) differing cost bases, and (5) varying study perspectives. Among value-based medicine studies, laser photocoagulation confers a 4.4% value gain (improvement in quality of life) for the treatment of classic subfoveal choroidal neovascularization. Intravitreal pegaptanib confers a 5.9% value gain (improvement in quality of life) for classic, minimally classic, and occult subfoveal choroidal neovascularization, and photodynamic therapy with verteporfin confers a 7.8% to 10.7% value gain for the treatment of classic subfoveal choroidal neovascularization. Intravitreal ranibizumab therapy confers greater than a 15% value gain for the treatment of subfoveal occult and minimally classic subfoveal choroidal neovascularization. Conclusions The majority of cost-utility studies performed on interventions for neovascular macular degeneration are value-based medicine studies and thus are comparable. Value-based analyses of neovascular ARMD monotherapies demonstrate the power of value-based medicine to improve quality of care and concurrently maximize the efficacy of healthcare resource use in public policy. The comparability of value-based medicine cost-utility analyses has important implications for overall practice standards and public policy. The adoption of value-based medicine standards can greatly facilitate the goal of higher-quality care and maximize the best use of healthcare funds. PMID:18427606

Evaluation of the treatment patterns and economic burden of dysmenorrhea in Japanese women, using a claims database.

PubMed

Akiyama, Sayako; Tanaka, Erika; Cristeau, Olivier; Onishi, Yoshie; Osuga, Yutaka

2017-01-01

This study aimed to describe treatment patterns and estimate health care resource utilization and associated costs among Japanese women with dysmenorrhea, using a claims database. This was a retrospective analysis using health insurance data from the Japan Medical Data Center, assessing female patients aged 18-49 years with newly diagnosed primary or secondary dysmenorrhea. Treatment pattern analyses focused on hormonal medications, analgesics, hemostatic agents, traditional Chinese medicine (TCM), and gynecological surgeries. Data were collected on health care resource utilization and costs associated with medications, imaging procedures, and inpatient and outpatient care in both patients and matched controls. The analysis included 6,315 women with dysmenorrhea (3,441 primary; 2,874 secondary). The most commonly prescribed initial therapies were low-dose estrogen progestins (LEPs, 37.7%) and TCM (30.0%), with substantial differences between primary (LEPs: 27.4%, TCM: 38.8%) and secondary (LEPs: 50.2%, TCM: 19.5%) dysmenorrhea cohorts. Surgery was conducted in <5% of all patients. Both primary and secondary cohorts of dysmenorrhea had significantly higher mean total health care costs compared to controls within the 1-year period following diagnosis (Case-primary: 191,680 JPY [1,916 USD]; secondary: 246,488 JPY [2,465 USD], Control-primary: 83,615 JPY [836 USD]; secondary: 90,711 JPY [907 USD]) ( p <0.0001). After adjusting for baseline characteristics, these costs were 2.2 and 2.9 times higher for primary and secondary dysmenorrhea cohorts, respectively, compared with matched controls, (both p <0.0001). The main driver of these excess costs was outpatient care, with eight additional physician visits per year among dysmenorrhea patients compared to controls ( p <0.0001). Considerable heterogeneity in treatment patterns was observed, with relatively low utilization of LEPs in patients with primary dysmenorrhea and those treated by internal medicine physicians. Total annual health care costs were approximately 2-3 times higher in patients with dysmenorrhea compared to women without the condition.

Evaluation of the treatment patterns and economic burden of dysmenorrhea in Japanese women, using a claims database

PubMed Central

Akiyama, Sayako; Tanaka, Erika; Cristeau, Olivier; Onishi, Yoshie; Osuga, Yutaka

2017-01-01

Purpose This study aimed to describe treatment patterns and estimate health care resource utilization and associated costs among Japanese women with dysmenorrhea, using a claims database. Methods This was a retrospective analysis using health insurance data from the Japan Medical Data Center, assessing female patients aged 18–49 years with newly diagnosed primary or secondary dysmenorrhea. Treatment pattern analyses focused on hormonal medications, analgesics, hemostatic agents, traditional Chinese medicine (TCM), and gynecological surgeries. Data were collected on health care resource utilization and costs associated with medications, imaging procedures, and inpatient and outpatient care in both patients and matched controls. Results The analysis included 6,315 women with dysmenorrhea (3,441 primary; 2,874 secondary). The most commonly prescribed initial therapies were low-dose estrogen progestins (LEPs, 37.7%) and TCM (30.0%), with substantial differences between primary (LEPs: 27.4%, TCM: 38.8%) and secondary (LEPs: 50.2%, TCM: 19.5%) dysmenorrhea cohorts. Surgery was conducted in <5% of all patients. Both primary and secondary cohorts of dysmenorrhea had significantly higher mean total health care costs compared to controls within the 1-year period following diagnosis (Case-primary: 191,680 JPY [1,916 USD]; secondary: 246,488 JPY [2,465 USD], Control-primary: 83,615 JPY [836 USD]; secondary: 90,711 JPY [907 USD]) (p<0.0001). After adjusting for baseline characteristics, these costs were 2.2 and 2.9 times higher for primary and secondary dysmenorrhea cohorts, respectively, compared with matched controls, (both p<0.0001). The main driver of these excess costs was outpatient care, with eight additional physician visits per year among dysmenorrhea patients compared to controls (p<0.0001). Conclusion Considerable heterogeneity in treatment patterns was observed, with relatively low utilization of LEPs in patients with primary dysmenorrhea and those treated by internal medicine physicians. Total annual health care costs were approximately 2–3 times higher in patients with dysmenorrhea compared to women without the condition. PMID:28579813

18 CFR 292.303 - Electric utility obligations under this subpart.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 18 Conservation of Power and Water Resources 1 2010-04-01 2010-04-01 false Electric utility obligations under this subpart. 292.303 Section 292.303 Conservation of Power and Water Resources FEDERAL... energy or capacity under this subpart as if the qualifying facility were supplying energy or capacity...

18 CFR Appendix 1 to Part 301 - ASC Utility Filing Template

Code of Federal Regulations, 2013 CFR

2013-04-01

... 18 Conservation of Power and Water Resources 1 2013-04-01 2013-04-01 false ASC Utility Filing Template 1 Appendix 1 to Part 301 Conservation of Power and Water Resources FEDERAL ENERGY REGULATORY COMMISSION, DEPARTMENT OF ENERGY REGULATIONS FOR FEDERAL POWER MARKETING ADMINISTRATIONS AVERAGE SYSTEM COST...

18 CFR Appendix 1 to Part 301 - ASC Utility Filing Template

Code of Federal Regulations, 2010 CFR

2010-04-01

... 18 Conservation of Power and Water Resources 1 2010-04-01 2010-04-01 false ASC Utility Filing Template 1 Appendix 1 to Part 301 Conservation of Power and Water Resources FEDERAL ENERGY REGULATORY COMMISSION, DEPARTMENT OF ENERGY REGULATIONS FOR FEDERAL POWER MARKETING ADMINISTRATIONS AVERAGE SYSTEM COST...

18 CFR Appendix 1 to Part 301 - ASC Utility Filing Template

Code of Federal Regulations, 2014 CFR

2014-04-01

... 18 Conservation of Power and Water Resources 1 2014-04-01 2014-04-01 false ASC Utility Filing Template 1 Appendix 1 to Part 301 Conservation of Power and Water Resources FEDERAL ENERGY REGULATORY COMMISSION, DEPARTMENT OF ENERGY REGULATIONS FOR FEDERAL POWER MARKETING ADMINISTRATIONS AVERAGE SYSTEM COST...

18 CFR Appendix 1 to Part 301 - ASC Utility Filing Template

Code of Federal Regulations, 2012 CFR

2012-04-01

... 18 Conservation of Power and Water Resources 1 2012-04-01 2012-04-01 false ASC Utility Filing Template 1 Appendix 1 to Part 301 Conservation of Power and Water Resources FEDERAL ENERGY REGULATORY COMMISSION, DEPARTMENT OF ENERGY REGULATIONS FOR FEDERAL POWER MARKETING ADMINISTRATIONS AVERAGE SYSTEM COST...

18 CFR Appendix 1 to Part 301 - ASC Utility Filing Template

Code of Federal Regulations, 2011 CFR

2011-04-01

... 18 Conservation of Power and Water Resources 1 2011-04-01 2011-04-01 false ASC Utility Filing Template 1 Appendix 1 to Part 301 Conservation of Power and Water Resources FEDERAL ENERGY REGULATORY COMMISSION, DEPARTMENT OF ENERGY REGULATIONS FOR FEDERAL POWER MARKETING ADMINISTRATIONS AVERAGE SYSTEM COST...

A lightweight distributed framework for computational offloading in mobile cloud computing.

PubMed

Shiraz, Muhammad; Gani, Abdullah; Ahmad, Raja Wasim; Adeel Ali Shah, Syed; Karim, Ahmad; Rahman, Zulkanain Abdul

2014-01-01

The latest developments in mobile computing technology have enabled intensive applications on the modern Smartphones. However, such applications are still constrained by limitations in processing potentials, storage capacity and battery lifetime of the Smart Mobile Devices (SMDs). Therefore, Mobile Cloud Computing (MCC) leverages the application processing services of computational clouds for mitigating resources limitations in SMDs. Currently, a number of computational offloading frameworks are proposed for MCC wherein the intensive components of the application are outsourced to computational clouds. Nevertheless, such frameworks focus on runtime partitioning of the application for computational offloading, which is time consuming and resources intensive. The resource constraint nature of SMDs require lightweight procedures for leveraging computational clouds. Therefore, this paper presents a lightweight framework which focuses on minimizing additional resources utilization in computational offloading for MCC. The framework employs features of centralized monitoring, high availability and on demand access services of computational clouds for computational offloading. As a result, the turnaround time and execution cost of the application are reduced. The framework is evaluated by testing prototype application in the real MCC environment. The lightweight nature of the proposed framework is validated by employing computational offloading for the proposed framework and the latest existing frameworks. Analysis shows that by employing the proposed framework for computational offloading, the size of data transmission is reduced by 91%, energy consumption cost is minimized by 81% and turnaround time of the application is decreased by 83.5% as compared to the existing offloading frameworks. Hence, the proposed framework minimizes additional resources utilization and therefore offers lightweight solution for computational offloading in MCC.

A Lightweight Distributed Framework for Computational Offloading in Mobile Cloud Computing

PubMed Central

Shiraz, Muhammad; Gani, Abdullah; Ahmad, Raja Wasim; Adeel Ali Shah, Syed; Karim, Ahmad; Rahman, Zulkanain Abdul

2014-01-01

The latest developments in mobile computing technology have enabled intensive applications on the modern Smartphones. However, such applications are still constrained by limitations in processing potentials, storage capacity and battery lifetime of the Smart Mobile Devices (SMDs). Therefore, Mobile Cloud Computing (MCC) leverages the application processing services of computational clouds for mitigating resources limitations in SMDs. Currently, a number of computational offloading frameworks are proposed for MCC wherein the intensive components of the application are outsourced to computational clouds. Nevertheless, such frameworks focus on runtime partitioning of the application for computational offloading, which is time consuming and resources intensive. The resource constraint nature of SMDs require lightweight procedures for leveraging computational clouds. Therefore, this paper presents a lightweight framework which focuses on minimizing additional resources utilization in computational offloading for MCC. The framework employs features of centralized monitoring, high availability and on demand access services of computational clouds for computational offloading. As a result, the turnaround time and execution cost of the application are reduced. The framework is evaluated by testing prototype application in the real MCC environment. The lightweight nature of the proposed framework is validated by employing computational offloading for the proposed framework and the latest existing frameworks. Analysis shows that by employing the proposed framework for computational offloading, the size of data transmission is reduced by 91%, energy consumption cost is minimized by 81% and turnaround time of the application is decreased by 83.5% as compared to the existing offloading frameworks. Hence, the proposed framework minimizes additional resources utilization and therefore offers lightweight solution for computational offloading in MCC. PMID:25127245

A Complex Systems Model Approach to Quantified Mineral Resource Appraisal

USGS Publications Warehouse

Gettings, M.E.; Bultman, M.W.; Fisher, F.S.

2004-01-01

For federal and state land management agencies, mineral resource appraisal has evolved from value-based to outcome-based procedures wherein the consequences of resource development are compared with those of other management options. Complex systems modeling is proposed as a general framework in which to build models that can evaluate outcomes. Three frequently used methods of mineral resource appraisal (subjective probabilistic estimates, weights of evidence modeling, and fuzzy logic modeling) are discussed to obtain insight into methods of incorporating complexity into mineral resource appraisal models. Fuzzy logic and weights of evidence are most easily utilized in complex systems models. A fundamental product of new appraisals is the production of reusable, accessible databases and methodologies so that appraisals can easily be repeated with new or refined data. The data are representations of complex systems and must be so regarded if all of their information content is to be utilized. The proposed generalized model framework is applicable to mineral assessment and other geoscience problems. We begin with a (fuzzy) cognitive map using (+1,0,-1) values for the links and evaluate the map for various scenarios to obtain a ranking of the importance of various links. Fieldwork and modeling studies identify important links and help identify unanticipated links. Next, the links are given membership functions in accordance with the data. Finally, processes are associated with the links; ideally, the controlling physical and chemical events and equations are found for each link. After calibration and testing, this complex systems model is used for predictions under various scenarios.

Future directions: Integrated resource planning

NASA Astrophysics Data System (ADS)

Bauer, D. C.; Eto, J.

Integrated resource planning or IRP is the process for integrating supply- and demand-side resources to provide energy services at a cost that balances the interests of all stakeholders. It now is the resource planning process used by electric utilities in over 30 states. The goals of IRP have evolved from least cost planning and encouragement of demand-side management to broader, more complex issues including core competitive business activity, risk management and sharing, accounting for externalities, and fuel switching between gas and electricity. IRP processes are being extended to other interior regions of the country, to non-investor owned utilities, and to regional (rather than individual utility) planning bases, and to other fuels (natural gas). The comprehensive, multi-valued, and public reasoning characteristics of IRP could be extended to applications beyond energy, e.g., transportation, surface water management, and health care in ways suggested.

Martian resource locations: Identification and optimization

NASA Astrophysics Data System (ADS)

Chamitoff, Gregory; James, George; Barker, Donald; Dershowitz, Adam

2005-04-01

The identification and utilization of in situ Martian natural resources is the key to enable cost-effective long-duration missions and permanent human settlements on Mars. This paper presents a powerful software tool for analyzing Martian data from all sources, and for optimizing mission site selection based on resource collocation. This program, called Planetary Resource Optimization and Mapping Tool (PROMT), provides a wide range of analysis and display functions that can be applied to raw data or imagery. Thresholds, contours, custom algorithms, and graphical editing are some of the various methods that can be used to process data. Output maps can be created to identify surface regions on Mars that meet any specific criteria. The use of this tool for analyzing data, generating maps, and collocating features is demonstrated using data from the Mars Global Surveyor and the Odyssey spacecraft. The overall mission design objective is to maximize a combination of scientific return and self-sufficiency based on utilization of local materials. Landing site optimization involves maximizing accessibility to collocated science and resource features within a given mission radius. Mission types are categorized according to duration, energy resources, and in situ resource utilization. Preliminary optimization results are shown for a number of mission scenarios.

Utilization of information technology in eastern North Carolina physician practices: determining the existence of a digital divide.

PubMed

Rosenthal, David A; Layman, Elizabeth J

2008-02-13

The United States Department of Health and Human Services (DHHS) has emphasized the importance of utilizing health information technologies, thus making the availability of electronic resources critical for physicians across the country. However, few empirical assessments exist regarding the current status of computerization and utilization of electronic resources in physician offices and physicians' perceptions of the advantages and disadvantages of computerization. Through a survey of physicians' utilization and perceptions of health information technology, this study found that a "digital divide" existed for eastern North Carolina physicians in smaller physician practices. The physicians in smaller practices were less likely to utilize or be interested in utilizing electronic health records, word processing applications, and the Internet.

Fuel Pellets from Wheat Straw: The Effect of Lignin Glass Transition and Surface Waxes on Pelletizing Properties

Treesearch

Wolfgang Stelte; Craig Clemons; Jens K. Holm; Jesper Ahrenfeldt; Ulrik B. Henriksen; Anand R. Sanadi

2012-01-01

The utilization of wheat straw as a renewable energy resource is limited due to its low bulk density. Pelletizing wheat straw into fuel pellets of high density increases its handling properties but is more challenging compared to pelletizing wood biomass. Straw has a lower lignin content and a high concentration of hydrophobic waxes on its outer surface that may limit...

Coherent-state information concentration and purification in atomic memory

NASA Astrophysics Data System (ADS)

Herec, Jiří; Filip, Radim

2006-12-01

We propose a feasible method of coherent-state information concentration and purification utilizing quantum memory. The method allows us to optimally concentrate and purify information carried by many noisy copies of an unknown coherent state (randomly distributed in time) to a single copy. Thus nonclassical resources and operations can be saved, if we compare information processing with many noisy copies and a single copy with concentrated and purified information.

Mechanical power efficiency of modified turbine blades

NASA Astrophysics Data System (ADS)

Mahmud, Syahir; Sampebatu, Limbran; Kwang, Suendy Ciayadi

2017-01-01

Abstract-The problem of energy crisis has become one of the unsolved issues until today. Indonesia has a lot of non-conventional energy sources that does not utilized effectively yet. For that the available resources must utilized efficiently due to the energy crisis and the growing energy needs. Among the abundant resources of energy, one potential source of energy is hydroelectric energy. This research compares the mechanical power efficiency generated by the Darrieus turbine, Savonius turbine and the Darrieus-Savonius turbine. The comparation of the mechanical power amongst the three turbine starts from the measurement of the water flow rate, water temperature, turbine rotation and force on the shaft on each type of turbine. The comparison will show the mechanical power efficiency of each turbine to find the most efficient turbine that can work optimally. The results show that with 0.637m/s flow velocity and 44.827 Watt of water flow power, the Darrieus-Savonius turbine can generate power equal to 29.927 Watt and shaft force around by 17 N. The Darrieus-Savonius turbine provides around 66.76% efficiency betwen the three turbines; Darrieus turbine, Savonius turbine and the Darrieus-Savonius turbine. Overall, the Darrieus Savonius turbine has the ability to work optimally at the research location.

Laboratory experiments to investigate sublimation rates of water ice in nighttime lunar regolith

NASA Astrophysics Data System (ADS)

Piquette, Marcus; Horányi, Mihály; Stern, S. Alan

2017-09-01

The existence of water ice on the lunar surface has been a long-standing topic with implications for both lunar science and in-situ resource utilization (ISRU). Cold traps on the lunar surface may have conditions necessary to retain water ice, but no laboratory experiments have been conducted to verify modeling results. We present an experiment testing the ability to thermally control bulk samples of lunar regolith simulant mixed with water ice under vacuum in an effort to constrain sublimation rates. The simulant used was JSC-1A lunar regolith simulant developed by NASA's Johnson Space Center. Samples with varying ratios of water ice and JSC-1A regolith simulant, totally about 1 kg, were placed under vacuum and cooled to 100 K to simulate conditions in lunar cold traps. The resulting sublimation of water ice over an approximately five-day period was measured by comparing the mass of the samples before and after the experimental run. Our results indicate that water ice in lunar cold traps is stable on timescales comparable to the lunar night, and should continue to be studied as possible resources for future utilization. This experiment also gauges the efficacy of the synthetic lunar atmosphere mission (SLAM) as a low-cost water resupply mission to lunar outposts.

Resource Utilization After Snakebite Severity Score Implementation into Treatment Algorithm of Crotaline Bite.

PubMed

Fowler, Amanda L; Hughes, Darrel W; Muir, Mark T; VanWert, Elizabeth M; Gamboa, Conrado D; Myers, John G

2017-12-01

Crotaline envenomation clinical manifestations vary considerably among patients. Current recommendations for treatment with Crotalidae polyvalent immune Fab require assessment of envenomation control. Determining control of envenomation, particularly when patients are evaluated by different providers in separate clinical settings, can be difficult. To determine if a difference in total vials of Crotalidae antivenin therapy exists between pre-protocol and post-Snakebite Severity Score (SSS) protocol. Retrospective medical record review at an academic medical and regional Level I trauma center. Resource utilization in patients with a diagnosis of "snakebite" was compared between patients treated pre- and post-SSS protocol implementation. One hundred forty-six patients were included in the evaluation. One hundred twenty-seven (87.0%) patients received antivenin, n = 80 (90.9%) in the pre-protocol group and n = 47 (81.0%) in the post-protocol group. Median total number of antivenin vials per patient was lower in the post-protocol group than the pre-protocol group, 16 (10-24 interquartile range) vs. 12 (10-16 interquartile range), p = 0.006. This decreased utilization correlates to an approximate $13,200 savings per patient. Hospital and intensive care unit length of stay, opioid use, incidence of blood product transfusion, need for surgical intervention, or need for intubation were not different between groups. A snakebite protocol with SSS utilization to guide antivenin administration results in significantly decreased antivenin therapy in snakebite patients without increase in other health care utilization. Copyright © 2017 Elsevier Inc. All rights reserved.

A Delphi study assessing the utility of quality improvement tools and resources in Australian primary care.

PubMed

Upham, Susan J; Janamian, Tina; Crossland, Lisa; Jackson, Claire L

2016-04-18

To determine the relevance and utility of online tools and resources to support organisational performance development in primary care and to complement the Primary Care Practice Improvement Tool (PC-PIT). A purposively recruited Expert Advisory Panel of 12 end users used a modified Delphi technique to evaluate 53 tools and resources identified through a previously conducted systematic review. The panel comprised six practice managers and six general practitioners who had participated in the PC-PIT pilot study in 2013-2014. Tools and resources were reviewed in three rounds using a standard pre-tested assessment form. Recommendations, scores and reasons for recommending or rejecting each tool or resource were analysed to determine the final suite of tools and resources. The evaluation was conducted from November 2014 to August 2015. Recommended tools and resources scored highly (mean score, 16/20) in Rounds 1 and 2 of review (n = 25). These tools and resources were perceived to be easily used, useful to the practice and supportive of the PC-PIT. Rejected resources scored considerably lower (mean score, 5/20) and were noted to have limitations such as having no value to the practice and poor utility (n = 6). A final review (Round 3) of 28 resources resulted in a suite of 21 to support the elements of the PC-PIT. This suite of tools and resources offers one approach to supporting the quality improvement initiatives currently in development in primary care reform.

Measures for increased nutrition and utilization of non-conventional food resources during disasters in Africa.

PubMed

Nur, I M

1999-01-01

The basic causes of the poor performance of the food and agricultural sector in the different parts of Africa are external, internal, and natural. The general recession in the Continent limits the capacity of the respective countries to import food to supplement inadequate domestic production and supplies. There are a number of nutritious food resources, both cultivated and gathered in the different ecological zones of Africa, whose production and consumption can be increased to ensure adequate food security and a nutritious diet, especially during disasters. These food resources could include: cereals, legumes, fruits, vegetables, fish, and insects. These food resources already are available over wide geographical areas in Africa and are utilized or utilized to a limited extent. Therefore, strategies to increase food supply, eradicate hunger and malnutrition, and keep people alive in times of disasters should have as a priority, the cultivation and consumption of non-conventional food resources in the respective communities and countries.

Reconciling resource utilization and resource selection functions

USGS Publications Warehouse

Hooten, Mevin B.; Hanks, Ephraim M.; Johnson, Devin S.; Alldredge, Mat W.

2013-01-01

Summary: 1. Analyses based on utilization distributions (UDs) have been ubiquitous in animal space use studies, largely because they are computationally straightforward and relatively easy to employ. Conventional applications of resource utilization functions (RUFs) suggest that estimates of UDs can be used as response variables in a regression involving spatial covariates of interest. 2. It has been claimed that contemporary implementations of RUFs can yield inference about resource selection, although to our knowledge, an explicit connection has not been described. 3. We explore the relationships between RUFs and resource selection functions from a hueristic and simulation perspective. We investigate several sources of potential bias in the estimation of resource selection coefficients using RUFs (e.g. the spatial covariance modelling that is often used in RUF analyses). 4. Our findings illustrate that RUFs can, in fact, serve as approximations to RSFs and are capable of providing inference about resource selection, but only with some modification and under specific circumstances. 5. Using real telemetry data as an example, we provide guidance on which methods for estimating resource selection may be more appropriate and in which situations. In general, if telemetry data are assumed to arise as a point process, then RSF methods may be preferable to RUFs; however, modified RUFs may provide less biased parameter estimates when the data are subject to location error.

Space Resource Utilization: Technologies and Potential Synergism with Terrestrial Mining

NASA Technical Reports Server (NTRS)

Sanders, Gerald B.

2015-01-01

Space Resources and Their Uses: The idea of using resources in space to support human exploration and settlement or for economic development and profit beyond the surface of Earth has been proposed and discussed for decades. Work on developing a method to extract oxygen from lunar regolith started even before humans set foot on the Moon for the first time. The use of space resources, commonly referred to as In Situ Resource Utilization (ISRU), involves the processes and operations to harness and utilize resources in space (both natural and discarded) to create products for subsequent use. Potential space resources include water, solar wind implanted volatiles (hydrogen, helium, carbon, nitrogen, etc.), vast quantities of metals and minerals in extraterrestrial soils, atmospheric constituents, unlimited solar energy, regions of permanent light and darkness, the vacuum and zero-gravity of space itself, trash and waste from human crew activities, and discarded hardware that has completed its primary purpose. ISRU covers a wide variety of concepts, technical disciplines, technologies, and processes. When considering all aspects of ISRU, there are 5 main areas that are relevant to human space exploration and the commercialization of space: 1. Resource Characterization and Mapping, 2. In Situ Consumables Production, 3. Civil Engineering and Construction, 4. In Situ Energy Production and Storage, and 5. In Situ Manufacturing.

Human Resource Development and New Technology in the Automobile Industry: A Case Study of Ford Motor Company's Dearborn Engine Plant. The Development and Utilization of Human Resources in the Context of Technological Change and Industrial Restructuring.

ERIC Educational Resources Information Center

Chen, Kan; And Others

This report centers around a plant-level study of the development and utilization of human resources in the context of technological change and industrial restructuring in the crankshaft production area of Ford Motor Company's Dearborn Engine Plant (DEP). The introductory chapter describes how the study was conducted, provides an introduction to…

Alternative scenarios utilizing nonterrestrial resources

NASA Technical Reports Server (NTRS)

Eldred, Charles H.; Roberts, Barney B.

1992-01-01

A collection of alternative scenarios that are enabled or substantially enhanced by the utilization of nonterrestrial resources is provided. We take a generalized approach to scenario building so that our report will have value in the context of whatever goals are eventually chosen. Some of the topics covered include the following: lunar materials processing; asteroid mining; lunar resources; construction of a large solar power station; solar dynamic power for the space station; reduced gravity; mission characteristics and options; and tourism.

Municipal Solid Waste Resources

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

None

2016-06-01

Municipal solid waste (MSW) is a source of biomass material that can be utilized for bioenergy production with minimal additional inputs. MSW resources include mixed commercial and residential garbage such as yard trimmings, paper and paperboard, plastics, rubber, leather, textiles, and food wastes. Waste resources such as landfill gas, mill residues, and waste grease are already being utilized for cost-effective renewable energy generation. MSW for bioenergy also represents an opportunity to divert greater volumes of residential and commercial waste from landfills.

Removing financial barriers to access reproductive, maternal and newborn health services: the challenges and policy implications for human resources for health

PubMed Central

2013-01-01

Background The last decade has seen widespread retreat from user fees with the intention to reduce financial constraints to users in accessing health care and in particular improving access to reproductive, maternal and newborn health services. This has had important benefits in reducing financial barriers to access in a number of settings. If the policies work as intended, service utilization rates increase. However this increases workloads for health staff and at the same time, the loss of user fee revenues can imply that health workers lose bonuses or allowances, or that it becomes more difficult to ensure uninterrupted supplies of health care inputs. This research aimed to assess how policies reducing demand-side barriers to access to health care have affected service delivery with a particular focus on human resources for health. Methods We undertook case studies in five countries (Ghana, Nepal, Sierra Leone, Zambia and Zimbabwe). In each we reviewed financing and HRH policies, considered the impact financing policy change had made on health service utilization rates, analysed the distribution of health staff and their actual and potential workloads, and compared remuneration terms in the public sectors. Results We question a number of common assumptions about the financing and human resource inter-relationships. The impact of fee removal on utilization levels is mostly not sustained or supported by all the evidence. Shortages of human resources for health at the national level are not universal; maldistribution within countries is the greater problem. Low salaries are not universal; most of the countries pay health workers well by national benchmarks. Conclusions The interconnectedness between user fee policy and HRH situations proves difficult to assess. Many policies have been changing over the relevant period, some clearly and others possibly in response to problems identified associated with financing policy change. Other relevant variables have also changed. However, as is now well-recognised in the user fee literature, co-ordination of health financing and human resource policies is essential. This appears less well recognised in the human resources literature. This coordination involves considering user charges, resource availability at health facility level, health worker pay, terms and conditions, and recruitment in tandem. All these policies need to be effectively monitored in their processes as well as outcomes, but sufficient data are not collected for this purpose. PMID:24053731

Removing financial barriers to access reproductive, maternal and newborn health services: the challenges and policy implications for human resources for health.

PubMed

McPake, Barbara; Witter, Sophie; Ensor, Tim; Fustukian, Suzanne; Newlands, David; Martineau, Tim; Chirwa, Yotamu

2013-09-22

The last decade has seen widespread retreat from user fees with the intention to reduce financial constraints to users in accessing health care and in particular improving access to reproductive, maternal and newborn health services. This has had important benefits in reducing financial barriers to access in a number of settings. If the policies work as intended, service utilization rates increase. However this increases workloads for health staff and at the same time, the loss of user fee revenues can imply that health workers lose bonuses or allowances, or that it becomes more difficult to ensure uninterrupted supplies of health care inputs.This research aimed to assess how policies reducing demand-side barriers to access to health care have affected service delivery with a particular focus on human resources for health. We undertook case studies in five countries (Ghana, Nepal, Sierra Leone, Zambia and Zimbabwe). In each we reviewed financing and HRH policies, considered the impact financing policy change had made on health service utilization rates, analysed the distribution of health staff and their actual and potential workloads, and compared remuneration terms in the public sectors. We question a number of common assumptions about the financing and human resource inter-relationships. The impact of fee removal on utilization levels is mostly not sustained or supported by all the evidence. Shortages of human resources for health at the national level are not universal; maldistribution within countries is the greater problem. Low salaries are not universal; most of the countries pay health workers well by national benchmarks. The interconnectedness between user fee policy and HRH situations proves difficult to assess. Many policies have been changing over the relevant period, some clearly and others possibly in response to problems identified associated with financing policy change. Other relevant variables have also changed.However, as is now well-recognised in the user fee literature, co-ordination of health financing and human resource policies is essential. This appears less well recognised in the human resources literature. This coordination involves considering user charges, resource availability at health facility level, health worker pay, terms and conditions, and recruitment in tandem. All these policies need to be effectively monitored in their processes as well as outcomes, but sufficient data are not collected for this purpose.

Species-specific variation in nesting and postfledging resource selection for two forest breeding migrant songbirds.

PubMed

Jenkins, Julianna M A; Thompson, Frank R; Faaborg, John

2017-01-01

Habitat selection is a fundamental component of community ecology, population ecology, and evolutionary biology and can be especially important to species with complex annual habitat requirements, such as migratory birds. Resource preferences on the breeding grounds may change during the postfledging period for migrant songbirds, however, the degree to which selection changes, timing of change, and whether all or only a few species alter their resource use is unclear. We compared resource selection for nest sites and resource selection by postfledging juvenile ovenbirds (Seiurus aurocapilla) and Acadian flycatchers (Empidonax virescens) followed with radio telemetry in Missouri mature forest fragments from 2012-2015. We used Bayesian discrete choice modeling to evaluate support for local vegetation characteristics on the probability of selection for nest sites and locations utilized by different ages of postfledging juveniles. Patterns of resource selection variation were species-specific. Resource selection models indicated that Acadian flycatcher habitat selection criteria were similar for nesting and dependent postfledging juveniles and selection criteria diverged when juveniles became independent from adults. After independence, flycatcher resource selection was more associated with understory foliage density. Ovenbirds differed in selection criteria between the nesting and postfledging periods. Fledgling ovenbirds selected areas with higher densities of understory structure compared to nest sites, and the effect of foliage density on selection increased as juveniles aged and gained independence. The differences observed between two sympatric forest nesting species, in both the timing and degree of change in resource selection criteria over the course of the breeding season, illustrates the importance of considering species-specific traits and postfledging requirements when developing conservation efforts, especially when foraging guilds or prey bases differ. We recommend that postfledging habitat selection be considered in future conservation efforts dealing with Neotropical migrants and other forest breeding songbirds.

Transporter engineering in biomass utilization by yeast.

PubMed

Hara, Kiyotaka Y; Kobayashi, Jyumpei; Yamada, Ryosuke; Sasaki, Daisuke; Kuriya, Yuki; Hirono-Hara, Yoko; Ishii, Jun; Araki, Michihiro; Kondo, Akihiko

2017-11-01

Biomass resources are attractive carbon sources for bioproduction because of their sustainability. Many studies have been performed using biomass resources to produce sugars as carbon sources for cell factories. Expression of biomass hydrolyzing enzymes in cell factories is an important approach for constructing biomass-utilizing bioprocesses because external addition of these enzymes is expensive. In particular, yeasts have been extensively engineered to be cell factories that directly utilize biomass because of their manageable responses to many genetic engineering tools, such as gene expression, deletion and editing. Biomass utilizing bioprocesses have also been developed using these genetic engineering tools to construct metabolic pathways. However, sugar input and product output from these cells are critical factors for improving bioproduction along with biomass utilization and metabolic pathways. Transporters are key components for efficient input and output activities. In this review, we focus on transporter engineering in yeast to enhance bioproduction from biomass resources. © FEMS 2017. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

What is the cost of providing outpatient HIV counseling and testing and antiretroviral therapy services in selected public health facilities in Nigeria?

PubMed

Aliyu, Husaina Bello; Chuku, Nkata Nwani; Kola-Jebutu, Abimbola; Abubakar, Zubaida; Torpey, Kwasi; Chabikuli, Otto Nzapfurundi

2012-10-01

Limited data on actual cost of providing HIV/AIDS services in Nigeria makes planning difficult. A study was conducted in 9 public health facilities supported by the Global HIV/AIDS Initiative Nigeria. The objective was to determine the cost of outpatient HIV Testing and Counseling (HTC) and antiretroviral therapy (ART) services per patient. Two tertiary and 7 secondary facilities were purposively selected across the six geopolitical regions. Facilities were distributed in urban and rural settings. Utilization and cost data for a 12-month period (January to December 2010) were analyzed. Cost elements included consumables, human resources, infrastructure, trainings, facility management, and Global HIV/AIDS Initiative Nigeria technical support. Total costs were apportioned based on percentage utilization by services, and unit costs were derived by dividing resource inputs by service outputs. Data were analyzed using Microsoft Excel 2003. A sensitivity analysis was also conducted for key assumptions. Mean costs for HTC and ART were US $7.4 and US $209.0, respectively. Costs were higher in Northern facilities (US $6.9, US $250.8), compared with Southern ones (US $6.7, US $194.7); and in tertiary facilities ($18.5, $338.4), compared with secondary ones ($6.3, $204.9). Major cost drivers for HTC and ART were human resources--ranging from 62% to 50%, and ARV drugs--ranging from 54% to 31%, respectively. Governments' ability to negotiate lower priced antiretroviral drugs will be central to reducing the cost of ART. Additionally, use of lower cadre staff to provide HTC will reduce costs and improves efficiency.

The equivalence of numbers: The social value of avoiding health decline: An experimental web-based study

PubMed Central

Schwappach, David LB

2002-01-01

Background Health economic analysis aimed at informing policy makers and supporting resource allocation decisions has to evaluate not only improvements in health but also avoided decline. Little is known however, whether the "direction" in which changes in health are experienced is important for the public in prioritizing among patients. This experimental study investigates the social value people place on avoiding (further) health decline when directly compared to curative treatments in resource allocation decisions. Methods 127 individuals completed an interactive survey that was published in the World Wide Web. They were confronted with a standard gamble (SG) and three person trade-off tasks, either comparing improvements in health (PTO-Up), avoided decline (PTO-Down), or both, contrasting health changes of equal magnitude differing in the direction in which they are experienced (PTO-WAD). Finally, a direct priority ranking of various interventions was obtained. Results Participants strongly prioritized improving patients' health rather than avoiding decline. The mean substitution rate between health improvements and avoided decline (WAD) ranged between 0.47 and 0.64 dependent on the intervention. Weighting PTO values according to the direction in which changes in health are experienced improved their accuracy in predicting a direct prioritization ranking. Health state utilities obtained by the standard gamble method seem not to reflect social values in resource allocation contexts. Conclusion Results suggest that the utility of being cured of a given health state might not be a good approximation for the societal value of avoiding this health state, especially in cases of competition between preventive and curative interventions. PMID:11879529

iTools: a framework for classification, categorization and integration of computational biology resources.

PubMed

Dinov, Ivo D; Rubin, Daniel; Lorensen, William; Dugan, Jonathan; Ma, Jeff; Murphy, Shawn; Kirschner, Beth; Bug, William; Sherman, Michael; Floratos, Aris; Kennedy, David; Jagadish, H V; Schmidt, Jeanette; Athey, Brian; Califano, Andrea; Musen, Mark; Altman, Russ; Kikinis, Ron; Kohane, Isaac; Delp, Scott; Parker, D Stott; Toga, Arthur W

2008-05-28

The advancement of the computational biology field hinges on progress in three fundamental directions--the development of new computational algorithms, the availability of informatics resource management infrastructures and the capability of tools to interoperate and synergize. There is an explosion in algorithms and tools for computational biology, which makes it difficult for biologists to find, compare and integrate such resources. We describe a new infrastructure, iTools, for managing the query, traversal and comparison of diverse computational biology resources. Specifically, iTools stores information about three types of resources--data, software tools and web-services. The iTools design, implementation and resource meta-data content reflect the broad research, computational, applied and scientific expertise available at the seven National Centers for Biomedical Computing. iTools provides a system for classification, categorization and integration of different computational biology resources across space-and-time scales, biomedical problems, computational infrastructures and mathematical foundations. A large number of resources are already iTools-accessible to the community and this infrastructure is rapidly growing. iTools includes human and machine interfaces to its resource meta-data repository. Investigators or computer programs may utilize these interfaces to search, compare, expand, revise and mine meta-data descriptions of existent computational biology resources. We propose two ways to browse and display the iTools dynamic collection of resources. The first one is based on an ontology of computational biology resources, and the second one is derived from hyperbolic projections of manifolds or complex structures onto planar discs. iTools is an open source project both in terms of the source code development as well as its meta-data content. iTools employs a decentralized, portable, scalable and lightweight framework for long-term resource management. We demonstrate several applications of iTools as a framework for integrated bioinformatics. iTools and the complete details about its specifications, usage and interfaces are available at the iTools web page http://iTools.ccb.ucla.edu.

43 CFR 3280.2 - Definitions.

Code of Federal Regulations, 2013 CFR

2013-10-01

... OF THE INTERIOR MINERALS MANAGEMENT (3000) GEOTHERMAL RESOURCES UNIT AGREEMENTS Geothermal Resources... resulting in: (1) Diligent development; (2) Efficient exploration, production and utilization of the resource; (3) Conservation of natural resources; and (4) Prevention of waste. Reasonably proven to produce...

43 CFR 3280.2 - Definitions.

Code of Federal Regulations, 2012 CFR

2012-10-01

... OF THE INTERIOR MINERALS MANAGEMENT (3000) GEOTHERMAL RESOURCES UNIT AGREEMENTS Geothermal Resources... resulting in: (1) Diligent development; (2) Efficient exploration, production and utilization of the resource; (3) Conservation of natural resources; and (4) Prevention of waste. Reasonably proven to produce...

43 CFR 3280.2 - Definitions.

Code of Federal Regulations, 2014 CFR

2014-10-01

... OF THE INTERIOR MINERALS MANAGEMENT (3000) GEOTHERMAL RESOURCES UNIT AGREEMENTS Geothermal Resources... resulting in: (1) Diligent development; (2) Efficient exploration, production and utilization of the resource; (3) Conservation of natural resources; and (4) Prevention of waste. Reasonably proven to produce...

43 CFR 3280.2 - Definitions.

Code of Federal Regulations, 2011 CFR

2011-10-01

... OF THE INTERIOR MINERALS MANAGEMENT (3000) GEOTHERMAL RESOURCES UNIT AGREEMENTS Geothermal Resources... resulting in: (1) Diligent development; (2) Efficient exploration, production and utilization of the resource; (3) Conservation of natural resources; and (4) Prevention of waste. Reasonably proven to produce...

Space Resources Roundtable VI

NASA Technical Reports Server (NTRS)

2004-01-01

The topics addressed in the conference paper abstracts contained in this document include: extracting resources from the Moon and Mars, equipment for in situ resource utilization, mission planning for resource extraction, drilling on Mars, and simulants for lunar soil and minerals.

In-Situ Resource Utilization for the Moon, Mars and Beyond...

NASA Technical Reports Server (NTRS)

Trigwell, Steve

2010-01-01

For any future manned exploration to the moon, Mars, or beyond, there is a significant need to reduce the cost and logistics of transporting the raw materials such as oxygen, water, and fuel required to sustain human activity. Current research at Kennedy Space Center is focused on utilizing the resources at the destination to produce these requirements on-site, i.e. to live off the land. This program, known as In-situ Resource Utilization (ISRU), is the focus of the Applied Science and Technology research group here at KSC. This slide presentation will introduce the laboratories and highlight current research in ISRU to produce oxygen, water, and fuel components from lunar and Martian regolith.

Pediatric Emergency Research Canada (PERC): Patient/Family-Informed Research Priorities for Pediatric Emergency Medicine.

PubMed

Bialy, Liza; Plint, Amy C; Freedman, Stephen B; Johnson, David W; Curran, Janet A; Stang, Antonia S

2018-06-06

A growing body of literature supports patient and public involvement in the design, prioritization and dissemination of research and evidence based medicine. The objectives of this project were to engage patients and families in developing a prioritized list of research topics for Pediatric Emergency Medicine (PEM) and to compare results with prior research prioritization initiatives in the ED (emergency department) setting. We utilized a systematic process to combine administrative data on frequency of patient presentations to the ED with multiple stakeholder input including an initial stakeholder survey followed by a modified Delphi consensus methodology consisting of two web-based surveys and a face-to-face meeting. The prioritization process resulted in a ranked list of 15 research priorities. The top five priorities were mental health presentations, pain and sedation, practice tools, quality of care delivery and resource utilization. Mental health, pain and sedation, clinical prediction rules, respiratory illnesses /wheeze, patient safety/medication error and sepsis were identified as shared priorities with prior initiatives. Topics identified in our process that were not identified in prior work included resource utilization, ED communication, antibiotic stewardship and patient/family adherence with recommendations. This work identifies key priorities for research in PEM. Comparing our results with prior initiatives in the ED setting identified shared research priorities and opportunities for collaboration among PEM research networks. This work in particular makes an important contribution to the existing literature by including the patient/family perspective missing from prior work. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

Treatment patterns and healthcare resource utilization and costs in heavy menstrual bleeding: a Japanese claims database analysis.

PubMed

Akiyama, Sayako; Tanaka, Erika; Cristeau, Olivier; Onishi, Yoshie; Osuga, Yutaka

2018-06-01

Heavy menstrual bleeding (HMB) is a highly prevalent condition, characterized by excessive menstrual blood loss and cramping, that interferes with activities of daily life. The aim of this study was to investigate treatment patterns in HMB in Japan, and to assess healthcare resource utilization and costs among women newly-diagnosed with the condition. This study retrospectively analyzed health insurance data available in the Japan Medical Data Center (JMDC) database on women aged 18-49 years who were newly-diagnosed with primary or secondary HMB. Treatment patterns were analyzed, and healthcare utilization and costs were evaluated and compared to matched controls. The study included a total of 635 patients, 210 with primary HMB and 425 with secondary HMB. In the primary HMB cohort, 60.0% of patients received one or more pharmacological or surgical treatments, compared with 76.2% in the secondary HMB cohort. The most commonly prescribed medications in all patients were hemostatic agents (28.7%), traditional Chinese medicine (TCM) (12.1%), and low-dose estrogen progestins (LEPs) (10.1%). After adjustment for patient baseline characteristics, healthcare costs were 1.93-times higher in primary HMB cases (p < .0001) and 4.44-times higher in secondary HMB cases (p < .0001) vs healthy controls. Outpatient care was the main cost driver. The main limitations of this study are related to its retrospective nature, and the fact that only reimbursed medications were captured in the source database. A substantial proportion of HMB patients did not receive the recommended treatments. Healthcare costs were considerably increased in the presence of an HMB diagnosis.

[Comparison of potential yield and resource utilization efficiency of main food crops in three provinces of Northeast China under climate change].

PubMed

Wang, Xiao-yu; Yang, Xiao-guang; Sun, Shuang; Xie, Wen-juan

2015-10-01

Based on the daily data of 65 meteorological stations from 1961 to 2010 and the crop phenology data in the potential cultivation zones of thermophilic and chimonophilous crops in Northeast China, the crop potential yields were calculated through step-by-step correction method. The spatio-temporal distribution of the crop potential yields at different levels was analyzed. And then we quantified the limitations of temperature and precipitation on the crop potential yields and compared the differences in the climatic resource utilization efficiency. The results showed that the thermal potential yields of six crops (including maize, rice, spring wheat, sorghum, millet and soybean) during the period 1961-2010 deceased from west to east. The climatic potential yields of the five crops (spring wheat not included) were higher in the south than in the north. The potential yield loss rate due to temperature limitations of the six crops presented a spatial distribution pattern and was higher in the east than in the west. Among the six main crops, the yield potential loss rate due to temperature limitation of the soybean was the highest (51%), and those of the other crops fluctuated within the range of 33%-41%. The potential yield loss rate due to water limitation had an obvious regional difference, and was high in Songnen Plain and Changbai Mountains. The potential yield loss rate of spring wheat was the highest (50%), and those of the other four rainfed crops fluctuated within the range of 8%-10%. The solar energy utilization efficiency of the six main crops ranged from 0.9% to 2.7%, in the order of maize> sorghum>rice>millet>spring wheat>soybean. The precipitation utilization efficiency of the maize, sorghum, spring wheat, millet and soybean under rainfed conditions ranged from 8 to 35 kg . hm-2 . mm-1, in the order of maize>sorghum>spring wheat>millet>soybean. In those areas with lower efficiency of solar energy utilization and precipitation utilization, such as Changbai Mountains and the south of Lesser Khingan Mountains, measures could be taken to increase the efficiency of resource utilization such as rational close-planting, selection of droughtresistant varieties, proper and timely fertilization, farming for soil water storage, optimization of crop layout and so on.

Task 2 Report - A GIS-Based Technical Potential Assessment of Domestic Energy Resources for Electricity Generation.

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

Lee, Nathan; Grue, Nicholas W; Rosenlieb, Evan

The purpose of this report is to support the Lao Ministry of Energy and Mines in assessing the technical potential of domestic energy resources for utility scale electricity generation in the Lao PDR. Specifically, this work provides assessments of technical potential, and associated maps of developable areas, for energy technologies of interest. This report details the methodology, assumptions, and datasets employed in this analysis to provide a transparent, replicable process for future analyses. The methodology and results presented are intended to be a fundamental input to subsequent decision making and energy planning-related analyses. This work concentrates on domestic energy resourcesmore » for utility-scale electricity generation and considers solar photovoltaic, wind, biomass, and coal resources. This work does not consider potentially imported energy resources (e.g., natural gas) or domestic energy resources that are not present in sufficient quantity for utility-scale generation (e.g., geothermal resources). A technical potential assessment of hydropower resources is currently not feasible due to the absence of required data including site-level assessments of multiple characteristics (e.g., geology environment and access) as well as spatial data on estimated non-exploited hydropower resources. This report is the second output of the Energy Alternatives Study for the Lao PDR, a collaboration led by the Lao Ministry of Energy and Mines and the United States Agency for International Development under the auspices of the Smart Infrastructure for the Mekong program. The Energy Alternatives Study is composed of five successive tasks that collectively support the project's goals. This work is focused on Task 2 - Assess technical potential of domestic energy resources for electricity generation. The work was carried out by a team from the U.S. Department of Energy's National Renewable Energy Laboratory (NREL) in collaboration with the Lao Ministry of Energy and Mines and other Lao power sector stakeholders. and datasets employed in this analysis to provide a transparent, replicable process for future analyses. The methodology and results presented are intended to be a fundamental input to subsequent decision making and energy planning-related analyses. This work concentrates on domestic energy resources for utility-scale electricity generation and considers solar photovoltaic, wind, biomass, and coal resources. This work does not consider potentially imported energy resources (e.g., natural gas) or domestic energy resources that are not present in sufficient quantity for utility-scale generation (e.g., geothermal resources). A technical potential assessment of hydropower resources is currently not feasible due to the absence of required data including site-level assessments of multiple characteristics (e.g., geology environment and access) as well as spatial data on estimated non-exploited hydropower resources.« less

Remote Sensing Assessment of Lunar Resources: We Know Where to Go to Find What We Need

NASA Technical Reports Server (NTRS)

Gillis, J. J.; Taylor, G. J.; Lucey, P. G.

2004-01-01

The utilization of space resources is necessary to not only foster the growth of human activities in space, but is essential to the President s vision of a "sustained and affordable human and robotic program to explore the solar system and beyond." The distribution of resources will shape planning permanent settlements by affecting decisions about where to locate a settlement. Mapping the location of such resources, however, is not the limiting factor in selecting a site for a lunar base. It is indecision about which resources to use that leaves the location uncertain. A wealth of remotely sensed data exists that can be used to identify targets for future detailed exploration. Thus, the future of space resource utilization pre-dominantly rests upon developing a strategy for resource exploration and efficient methods of extraction.

Health resource utilization and costs during the first 90 days following robot-assisted hysterectomy.

PubMed

Dandolu, Vani; Pathak, Prathamesh

2018-06-01

To compare health resource utilization, costs and readmission rates between robot-assisted and non-robot-assisted hysterectomy during the 90 days following surgery. The study used 2008-2012 Truven Health MarketScan data. All patients admitted as inpatients with a CPT code for hysterectomy between January 2008 and September 2012 were identified and the first hysterectomy-related admission in each patient was included. Patients were categorized based on the route of their hysterectomy and the use of laparoscopy as: total abdominal hysterectomy, vaginal hysterectomy (VH), laparoscopy-assisted supracervical hysterectomy, laparoscopy-assisted vaginal hysterectomy' and total laparoscopic hysterectomy (TLH). Hospitalization costs, including hospital, physician, pharmacy and facility costs, were calculated for the index admissions and for the 90-day follow-up periods. Health resource utilization was determined in terms of inpatient readmissions, outpatient visits, and emergency room visits, RESULTS: There were 302,923 hysterectomies performed over 5 years for benign indications in the inpatient setting (55% abdominal, 17% vaginal, and 28% laparoscopic). Concurrent use of robot assistance steadily increased and was reported in 50% of TLH procedures in 2012. The rates of readmission overall were 4.9% for robot-assisted procedures and 4.3% for procedures without robot assistance (OR 0.89, CI 0.82-0.97). Readmission rates were lowest for VH (3.2%) and highest for TLH (5.6%). Following robot-assisted hysterectomy and VH, 8.3% and 4.6% of patients, respectively, had more than ten outpatient visits in the 90-day follow-up period. The average total cost for 90 days was $16,820 for robot-assisted hysterectomy and $13,031 for procedures without robot assistance. Of the additional costs for robot-assisted surgery, 25% were incurred in the 90-day follow-up period. The study using private insurance data found that robot-assisted hysterectomy was associated with higher health resource utilization and costs than other minimally invasive approaches. Given the high costs associated with robot-assisted hysterectomy, it is important to understand the specific indications for this approach and to identify the patients who may benefit.

Comparison of neurological healthcare oriented educational resources for patients on the internet.

PubMed

Punia, Vineet; Dagar, Anjali; Agarwal, Nitin; He, Wenzhuan; Hillen, Machteld

2014-12-01

The internet has become a major contributor to health literacy promotion. The average American reads at 7th-8th grade level and it is recommended to write patient education materials at or below 6th grade reading level. We tried to assess the level of literacy required to read and understand online patient education materials (OPEM) for neurological diseases from various internet resources. We then compared those to an assumed reference OPEM source, namely the patient education brochures from the American Academy of Neurology (AAN), the world's largest professional association of neurologists. Disease specific patient education brochures were downloaded from the AAN website. OPEM for these diseases were also accessed from other common online sources determined using a predefined criterion. All OPEM were converted to Microsoft Word (Microsoft Corp., Redmond, WA, USA) and their reading level was analyzed using Readability Studio Professional Edition version 2012.1 (Oleander Software, Vandalia, OH, USA). Descriptive analysis and analysis of variance were used to compare reading levels of OPEM from different resources. Medline Plus, Mayo clinic and Wikipedia qualified for OPEM analysis. All OPEM from these resources, including the AAN, were written above the recommended 6th grade reading level. They were also found to be "fairly difficult", "difficult" or "confusing" on the Flesch Reading Ease scale. AAN OPEM on average needed lower reading level, with Wikipedia OPEM being significantly (p<0.01) more difficult to read compared to the other three resources. OPEM on neurological diseases are being written at a level of reading complexity higher than the average American and the recommended reading levels. This may be undermining the utility of these resources. Copyright © 2014 Elsevier Ltd. All rights reserved.

A Comparative Toxidrome Analysis of Human Organophosphate and Nerve Agent Poisonings Using Social Media.

PubMed

Reddy, D S; Colman, E

2017-05-01

Here we utilized social media to compare the toxidrome of three lethal chemical exposures worldwide. YouTube videos were the main source from which the data were collected, but published reports and news were also utilized to fill in some gaps. All videos were organized in a database detailing symptoms and severity of each victim, along with demographics such as approximate age and gender. Each symptom was rated as mild, moderate, or severe and corresponding pie graphs for each incident were compared. The videos displayed symptoms ranging from mild to severe cholinergic toxicity and life-threatening convulsions. Social media may represent an important resource in developing a viable approach to the early detection and identification of chemical exposure, reinforce our preparedness for better antidotes, long-term follow up, and training about deadly chemical nerve agent attacks. © 2017 The Authors. Clinical and Translational Science published by Wiley Periodicals, Inc. on behalf of American Society for Clinical Pharmacology and Therapeutics.

Integrating Genomic Data Sets for Knowledge Discovery: An Informed Approach to Management of Captive Endangered Species.

PubMed

Irizarry, Kristopher J L; Bryant, Doug; Kalish, Jordan; Eng, Curtis; Schmidt, Peggy L; Barrett, Gini; Barr, Margaret C

2016-01-01

Many endangered captive populations exhibit reduced genetic diversity resulting in health issues that impact reproductive fitness and quality of life. Numerous cost effective genomic sequencing and genotyping technologies provide unparalleled opportunity for incorporating genomics knowledge in management of endangered species. Genomic data, such as sequence data, transcriptome data, and genotyping data, provide critical information about a captive population that, when leveraged correctly, can be utilized to maximize population genetic variation while simultaneously reducing unintended introduction or propagation of undesirable phenotypes. Current approaches aimed at managing endangered captive populations utilize species survival plans (SSPs) that rely upon mean kinship estimates to maximize genetic diversity while simultaneously avoiding artificial selection in the breeding program. However, as genomic resources increase for each endangered species, the potential knowledge available for management also increases. Unlike model organisms in which considerable scientific resources are used to experimentally validate genotype-phenotype relationships, endangered species typically lack the necessary sample sizes and economic resources required for such studies. Even so, in the absence of experimentally verified genetic discoveries, genomics data still provides value. In fact, bioinformatics and comparative genomics approaches offer mechanisms for translating these raw genomics data sets into integrated knowledge that enable an informed approach to endangered species management.

Integrating Genomic Data Sets for Knowledge Discovery: An Informed Approach to Management of Captive Endangered Species

PubMed Central

Irizarry, Kristopher J. L.; Bryant, Doug; Kalish, Jordan; Eng, Curtis; Schmidt, Peggy L.; Barrett, Gini; Barr, Margaret C.

2016-01-01

Many endangered captive populations exhibit reduced genetic diversity resulting in health issues that impact reproductive fitness and quality of life. Numerous cost effective genomic sequencing and genotyping technologies provide unparalleled opportunity for incorporating genomics knowledge in management of endangered species. Genomic data, such as sequence data, transcriptome data, and genotyping data, provide critical information about a captive population that, when leveraged correctly, can be utilized to maximize population genetic variation while simultaneously reducing unintended introduction or propagation of undesirable phenotypes. Current approaches aimed at managing endangered captive populations utilize species survival plans (SSPs) that rely upon mean kinship estimates to maximize genetic diversity while simultaneously avoiding artificial selection in the breeding program. However, as genomic resources increase for each endangered species, the potential knowledge available for management also increases. Unlike model organisms in which considerable scientific resources are used to experimentally validate genotype-phenotype relationships, endangered species typically lack the necessary sample sizes and economic resources required for such studies. Even so, in the absence of experimentally verified genetic discoveries, genomics data still provides value. In fact, bioinformatics and comparative genomics approaches offer mechanisms for translating these raw genomics data sets into integrated knowledge that enable an informed approach to endangered species management. PMID:27376076

Applying voting theory in natural resource management: a case of multiple-criteria group decision support.

PubMed

Laukkanen, Sanna; Kangas, Annika; Kangas, Jyrki

2002-02-01

Voting theory has a lot in common with utility theory, and especially with group decision-making. An expected-utility-maximising strategy exists in voting situations, as well as in decision-making situations. Therefore, it is natural to utilise the achievements of voting theory also in group decision-making. Most voting systems are based on a single criterion or holistic preference information on decision alternatives. However, a voting scheme called multicriteria approval is specially developed for decision-making situations with multiple criteria. This study considers the voting theory from the group decision support point of view and compares it with some other methods applied to similar purposes in natural resource management. A case study is presented, where the approval voting approach is introduced to natural resources planning and tested in a forestry group decision-making process. Applying multicriteria approval method was found to be a potential approach for handling some challenges typical for forestry group decision support. These challenges include (i) utilising ordinal information in the evaluation of decision alternatives, (ii) being readily understandable for and treating equally all the stakeholders in possession of different levels of knowledge on the subject considered, (iii) fast and cheap acquisition of preference information from several stakeholders, and (iv) dealing with multiple criteria.

More diesel generation could further fossil fuel economy

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

Jeffs, E.

1976-05-01

Following the introduction last year of their Seahorse medium-speed diesel engine, the manufacturers, Hawthorn Leslie (Engineers) Ltd., of Newcastle upon Tyne, have made an extensive analysis of the resource effectiveness of diesel-driven generating sets. Though directed towards the raising of funds to construct a demonstration power plant in the UK, the analysis is relevant elsewhere. In addition, the firm has now developed an energy recovery package for use with the basic engine to further improve the overall thermal efficiency of the system. Looked at in a British context, the basis of Hawthorn Leslie's case is this. The importance of coalmore » in electicity generation is evidence of its value as a national resource. Now that North Sea oil has emerged as a national energy resource, it must be used to the greatest effect; this means building diesel power stations to take over the mid-load cycle of utility operations. The analysis compares five prime movers: gas turbines, diesel engines, and steam turbines powered by oil- or coal-fired boilers, or thermal reactors. Capital and fixed running costs are shown. The diesel engine is the most efficient prime mover for electricity generation. With this novel energy recovery principle, greater utilization of fuel energy can be realized if direct heating is not required. (MCW)« less

The impact of morbid obesity on resource utilization after renal transplantation.

PubMed

Kim, Young; Chang, Alex L; Wima, Koffi; Ertel, Audrey E; Diwan, Tayyab S; Abbott, Daniel E; Shah, Shimul A

2016-12-01

A growing number of renal transplant recipients have a body mass index ≥40. While previous studies have shown that patient and graft survival are significantly decreased in renal transplant recipients with body mass indexes ≥40, less is known about perioperative outcomes and resource utilization in morbidly obese patients. We aimed to analyze the effects of morbid obesity on these parameters in renal transplant. Using a linkage between the Scientific Registry of Transplant Recipients and the databases of the University HealthSystem Consortium, we identified 29,728 adult renal transplant recipients and divided them into 2 cohorts based on body mass index (<40 vs ≥40 kg/m 2 ). The body mass index ≥40 group comprised 2.5% (n = 747) of renal transplant recipients studied. Body mass index ≥40 recipients incurred greater direct costs ($84,075 vs $79,580, P < .01), index admission costs ($91,169 vs $86,141, P < .01), readmission costs ($5,306 vs $4,596, P = .01), and combined costs ($99,590 vs $93,939, P < .001). Thirty-day readmission rates were also greater among body mass index ≥40 recipients (33.92% vs 26.9%, P < .01). Morbid obesity was not predictive of stay (odds ratio 1.01, P = .75). Morbidly obese renal transplant recipients incur greater costs and readmission rates compared with nonobese patients. Recognition of increased resource utilization should be accompanied by appropriate, risk-adjustment reimbursement. Copyright © 2016 Elsevier Inc. All rights reserved.

The association between psoriasis and health-related quality of life, work productivity, and healthcare resource use in Brazil.

PubMed

DiBonaventura, Marco; Carvalho, André Vicente Esteves de; Souza, Cacilda da Silva; Squiassi, Haline Bianca; Ferreira, Cristina Nunes

2018-03-01

Psoriasis is a chronic, immune mediated inflammatory condition that affects a significant amount of the global population. Yet geographic variability in the consequences of psoriasis warrants region-level analyses. The current study contributes to the psoriasis outcomes literature by offering a comprehensive assessment of the humanistic and economic burden in Brazil. The 2012 Brazil National Health and Wellness Survey (N=12,000) was used to assess health-related quality of life (Short Form-12, version 2), work productivity, and healthcare resource use associated with experiencing psoriasis vs. no psoriasis, along with varying levels of psoriasis severity. A total of 210 respondents reported diagnosis of psoriasis (N=157, 42, and 11 reporting mild, moderate, and severe psoriasis, respectively). Compared with controls, respondents with psoriasis reported diminished mental component summary scores and health utilities, as well as increased presenteeism, activity impairment, and physician visits over the past six months, adjusting for covariates. Among those with psoriasis, physical health decreased as psoriasis severity increased. Although work productivity and healthcare resource utilization did not differ with psoriasis severity, the high rates of productivity loss (e.g. 45.5% presenteeism in the severe psoriasis group) suggest an economic burden. Cost analyses were not performed, and cross-sectional patient-reported data limit causal conclusions and may reflect reporting biases. Nevertheless, these results suggest a significant burden to patients with psoriasis across both humanistic and economic outcomes. The association between psoriasis and mental health aspects and health utilities were particularly strong and exceeded what would be considered clinically meaningful.

Financial, Resource Utilization and Mortality Impacts of Teaching Hospital Status on Pediatric Patients Admitted for Sepsis.

PubMed

Hsu, Benson S; Meyer, Benjamin D; Lakhani, Saquib A

2017-08-01

With the changing healthcare landscape in the United States, teaching hospitals face increasing pressure to provide medical education as well as cost-effective care. Our study investigated the financial, resource utilization and mortality impact of teaching hospital status on pediatric patients admitted with sepsis. We conducted a retrospective, weighted statistical analysis of hospitalized children with the diagnosis of sepsis. The Agency for Healthcare Research and Quality 2009 Kids' Inpatient Database provided the data for analysis. Diagnosis of sepsis and severity of illness levels were based on All Patient Refined Diagnosis-Related Groups of 720: Septicemia and Disseminated Infections. Teaching hospital status was based on presence of training programs. Statistical analysis was conducted using STATA 12.1 (Stata Corporation, College Station, TX). Weighted analysis revealed 17,461 patients with sepsis-9982 in teaching and 7479 in nonteaching hospitals. When comparing all patients, length of stay (8.2 vs. 4.8, P < 0.001), number of procedures received (2.03 vs. 0.87, P < 0.001), mortality (4.7% vs. 1.6%, P < 0.001), costs per day ($2326 vs. $1736, P < 0.001) and total costs ($20,428 vs. $7960, P < 0.001) were higher in teaching hospitals. Even when stratified by severity classes, length of stay, number of procedures received and total costs were higher in teaching hospitals with no difference in mortality. Our study suggested that teaching hospitals provide pediatric inpatient care for sepsis at greater costs and resource utilization without a clear improvement in overall mortality rates in comparison with nonteaching hospitals.

Expected Utility Distributions for Flexible, Contingent Execution

NASA Technical Reports Server (NTRS)

Bresina, John L.; Washington, Richard

2000-01-01

This paper presents a method for using expected utility distributions in the execution of flexible, contingent plans. A utility distribution maps the possible start times of an action to the expected utility of the plan suffix starting with that action. The contingent plan encodes a tree of possible courses of action and includes flexible temporal constraints and resource constraints. When execution reaches a branch point, the eligible option with the highest expected utility at that point in time is selected. The utility distributions make this selection sensitive to the runtime context, yet still efficient. Our approach uses predictions of action duration uncertainty as well as expectations of resource usage and availability to determine when an action can execute and with what probability. Execution windows and probabilities inevitably change as execution proceeds, but such changes do not invalidate the cached utility distributions, thus, dynamic updating of utility information is minimized.

SLURM: Simple Linux Utility for Resource Management

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

Jette, M; Grondona, M

2002-12-19

Simple Linux Utility for Resource Management (SLURM) is an open source, fault-tolerant, and highly scalable cluster management and job scheduling system for Linux clusters of thousands of nodes. Components include machine status, partition management, job management, scheduling and stream copy modules. This paper presents an overview of the SLURM architecture and functionality.

SLURM: Simplex Linux Utility for Resource Management

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

Jette, M; Grondona, M

2003-04-22

Simple Linux Utility for Resource Management (SLURM) is an open source, fault-tolerant, and highly scalable cluster management and job scheduling system for Linux clusters of thousands of nodes. Components include machine status, partition management, job management, scheduling, and stream copy modules. This paper presents an overview of the SLURM architecture and functionality.

77 FR 65639 - Magnuson-Stevens Act Provisions; Fisheries Off the West Coast States; Pacific Coast Groundfish...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-10-30

... allocations to ensure full utilization of the resource. DATES: The reapportionment of whiting is effective from 1200 local time, October 4, 2012, until December 31, 2012, unless modified, superseded or.... Therefore, to ensure full utilization of the resource, NMFS reapportioned 28,000 mt to the shorebased IFQ...

Effect of Personality on the Use and Perceived Utility of Web-Based Health Resources

ERIC Educational Resources Information Center

Hruska, Natalie

2012-01-01

Studies document numerous threats to human health exacerbated by multiple factors, including inadequate access to health-related information. The Internet has developed as one resource to provide health information; however, there remains a significant gap in understanding how personality differences influence the use and perceived utility of the…

Careers Resource Project Utilizing a Mobile Unit Design. Final Report. Report No. 5-76T-D.

ERIC Educational Resources Information Center

Indiana Vocational Technical Coll., Evansville, IN.

A project was conducted to implement seven objectives: (1) through provision of career information, consultations, and inservice training, offer a systematic, articulated, and comprehensive (K-12) career education program to schools requesting assistance; (2) increase utilization and availability of vocational/career education resources in the…

Effect of vertical integration on the utilization of hardwood resources

Treesearch

Jan Wiedenbeck

2002-01-01

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

High School Administrative Staffing in Washington State: Principal Perspectives on Resource Needs and Utilization

ERIC Educational Resources Information Center

Steach, John C.

2011-01-01

This mixed methods study explored how high school principals prioritize their work and utilize available human resources to adjust to inadequate administrative staffing. Analysis of staffing levels across the state of Washington and specifically inside two eastern Washington districts framed interview questions for central office administration…

Utilization of Online Educational Resources in Teaching: A Moderated Mediation Perspective

ERIC Educational Resources Information Center

Kio, Su Iong; Lau, Meng Chan Virgina

2017-01-01

The study builds on a newly modified Technology Acceptance Model (TAM) to substantiate the motivation and operation of teachers' utilization of online learning resources. A "Comprehensiveness" construct is proposed in the modified TAM to reflect the breadth and depth of rich online knowledge. This new construct serves as the mediator…

Utility of LiDAR for large area forest inventory applications

Treesearch

Nicholas S. Skowronski; Andrew J. Lister

2012-01-01

Multi-resource inventory data are used in conjunction with Light Detection and Ranging (LiDAR) data from the Pennsylvania Department of Natural Resource's PAMAP Program to assess the utility of extensive LiDAR acquisitions for large area forest assessments. Background, justification, and initial study designs are presented. The proposed study will involve three...

LiDAR utility for natural resource managers

Treesearch

Andrew Thomas Hudak; Jeffrey Scott Evans; Alistair Mattthew Stuart Smith

2009-01-01

Applications of LiDAR remote sensing are exploding, while moving from the research to the operational realm. Increasingly, natural resource managers are recognizing the tremendous utility of LiDAR-derived information to make improved decisions. This review provides a cross-section of studies, many recent, that demonstrate the relevance of LiDAR across a suite of...

Predicting Resource Utilization of Elderly Burn Patients in the Baby Boomer Era

PubMed Central

Richards, Winston A.; Miggins, Makeesha; Liu, Huazhi; Mozingo, David W.; Ang, Darwin

2014-01-01

Background Census predictions for Florida suggest a threefold increase in the population 65 or older within 20 years. We predict resource utilization for this age group. Methods Using the Florida Agency for Healthcare Administration admission dataset we evaluated the effect of age on length of stay, hospital charges and discharge disposition while adjusting for clinical and demographic factors. Using U.S. Census Bureau data and burn incidence rates from this dataset we estimated future resource utilization. Results Elderly patients were discharged to home less often and were discharged to short term general hospitals, intermediate care facilities and skilled nursing facilities more often than the other age groups (p < 0.05). They also required home health care and IV medications significantly more often (p <0.05). Their length of stay was longer and total hospital charges were greater (p < 0.05) after adjusting for gender, race, Charleson comorbidity index, payer, TBSA burned and burn center treatment. Conclusions Our data show an age dependent increase in the utilization of post-hospitalization resources, LOS and total charges for elderly burn patients. PMID:23017253

A systematic literature review of the economic implications of chemotherapy-induced diarrhea and its impact on quality of life.

PubMed

Tarricone, Rosanna; Abu Koush, Dana; Nyanzi-Wakholi, Barbara; Medina-Lara, Antonieta

2016-03-01

Chemotherapy-induced diarrhea (CID) diminishes physical performance, raises anxiety and depression levels, and increases healthcare resource utilization. To understand the impact that CID has on health-related quality of life (HRQoL) and on healthcare resource utilization. Systematic searches were conducted in MEDLINE, EMBASE, DARE, and the NHS EED databases. A total of 22 articles were retrieved for full review (n=17, HRQoL; n=5 healthcare resource utilization). Only 2 studies had assessed HRQoL in patients experiencing CID, while cost studies demonstrated that CID episodes are unnecessarily expensive and can be avoided if diagnosed and treated early. Better management of CID has the potential to reduce overall economic burden and improve patients' HRQoL. Available evidence also relays the need to conduct larger studies that assess HRQoL and consider cost beyond direct medical costs in order to understand the full impact of CID on HRQoL and healthcare resource utilization. Crown Copyright © 2016. Published by Elsevier Ireland Ltd. All rights reserved.

ISRU: An Overview of NASA'S Current Development Activities and Long-Term Goals

NASA Technical Reports Server (NTRS)

Sanders, Gerald B.; Nicholson, Leonard S. (Technical Monitor)

2000-01-01

The concept of "living off the land" by utilizing the indigenous resources of the Moon, Mars, or other potential sites of robotic and human exploration has been termed In-Situ Resource Utilization (ISRU). It is fundamental to any program of extended human presence and operation on other extraterrestrial bodies that we learn how to utilize the indigenous resources. The chief benefits of ISRU are that it can reduce the mass, cost, and risk of robotic and human exploration while providing capabilities that enable the commercial development of space. In January 1997, the American Institute of Aeronautics and Astronautics (AIAA) Space Processing Technical Committee released a position paper entitled, "Need for A NASA Indigenous Space Resource Utilization (ISRU) Program". Besides outlining some of the potential advantages of incorporating ISRU into Lunar and Mars human mission plans and providing an overview of technologies and processes of interest, the position paper concluded with a list of seven recommendations to NASA. This paper will examine the seven recommendations proposed and provide an overview of NASA's current ISRU development activities and possible long term goals with respect to these recommendations.

Save water to save carbon and money: developing abatement costs for expanded greenhouse gas reduction portfolios.

PubMed

Stokes, Jennifer R; Hendrickson, Thomas P; Horvath, Arpad

2014-12-02

The water-energy nexus is of growing interest for researchers and policy makers because the two critical resources are interdependent. Their provision and consumption contribute to climate change through the release of greenhouse gases (GHGs). This research considers the potential for conserving both energy and water resources by measuring the life-cycle economic efficiency of greenhouse gas reductions through the water loss control technologies of pressure management and leak management. These costs are compared to other GHG abatement technologies: lighting, building insulation, electricity generation, and passenger transportation. Each cost is calculated using a bottom-up approach where regional and temporal variations for three different California water utilities are applied to all alternatives. The costs and abatement potential for each technology are displayed on an environmental abatement cost curve. The results reveal that water loss control can reduce GHGs at lower cost than other technologies and well below California's expected carbon trading price floor. One utility with an energy-intensive water supply could abate 135,000 Mg of GHGs between 2014 and 2035 and save--rather than spend--more than $130/Mg using the water loss control strategies evaluated. Water loss control technologies therefore should be considered in GHG abatement portfolios for utilities and policy makers.

Potential of derived lunar volatiles for life support

NASA Technical Reports Server (NTRS)

Bula, R. J.; Wittenberg, L. J.; Tibbitts, T. W.; Kulcinski, G. L.

1992-01-01

The lunar regolith contains small quantities of solar wind implanted volatile compounds that have vital, basic uses for maintaining life support systems of lunar or space settlements. Recent proposals to utilize the helium-3 isotope (He-3) derived from the lunar regolith as a fuel for fusion reactors would result in the availability of large quantities of other lunar volatile compounds. The quantities obtained would provide the annual life support replacement requirements of 1150 to 23,000 inhabitants per ton of He-3 recovered, depending on the volatile compound. Utilization of the lunar volatile compounds for life support depends on the costs, in terms of materials and energy, associated with their extraction from the lunar regolith as compared to the delivery costs of these compounds from Earth resources. Considering today's conservative estimated transportation costs ($10,000 dollars per kilogram) and regolith mining costs ($5 dollars per ton), the life support replacement requirements could be more economically supplied by recovering the lunar volatile compounds than transporting these materials from Earth resources, even before He-3 will be utilized as a fusion fuel. In addition, availability of lunar volatile compounds could have a significant cost impact on maintaining the life support systems of the space station and a Mars base.

Perfect quantum multiple-unicast network coding protocol

NASA Astrophysics Data System (ADS)

Li, Dan-Dan; Gao, Fei; Qin, Su-Juan; Wen, Qiao-Yan

2018-01-01

In order to realize long-distance and large-scale quantum communication, it is natural to utilize quantum repeater. For a general quantum multiple-unicast network, it is still puzzling how to complete communication tasks perfectly with less resources such as registers. In this paper, we solve this problem. By applying quantum repeaters to multiple-unicast communication problem, we give encoding-decoding schemes for source nodes, internal ones and target ones, respectively. Source-target nodes share EPR pairs by using our encoding-decoding schemes over quantum multiple-unicast network. Furthermore, quantum communication can be accomplished perfectly via teleportation. Compared with existed schemes, our schemes can reduce resource consumption and realize long-distance transmission of quantum information.

Effects of temperature on consumer-resource interactions.

PubMed

Amarasekare, Priyanga

2015-05-01

Understanding how temperature variation influences the negative (e.g. self-limitation) and positive (e.g. saturating functional responses) feedback processes that characterize consumer-resource interactions is an important research priority. Previous work on this topic has yielded conflicting outcomes with some studies predicting that warming should increase consumer-resource oscillations and others predicting that warming should decrease consumer-resource oscillations. Here, I develop a consumer-resource model that both synthesizes previous findings in a common framework and yields novel insights about temperature effects on consumer-resource dynamics. I report three key findings. First, when the resource species' birth rate exhibits a unimodal temperature response, as demonstrated by a large number of empirical studies, the temperature range over which the consumer-resource interaction can persist is determined by the lower and upper temperature limits to the resource species' reproduction. This contrasts with the predictions of previous studies, which assume that the birth rate exhibits a monotonic temperature response, that consumer extinction is determined by temperature effects on consumer species' traits, rather than the resource species' traits. Secondly, the comparative analysis I have conducted shows that whether warming leads to an increase or decrease in consumer-resource oscillations depends on the manner in which temperature affects intraspecific competition. When the strength of self-limitation increases monotonically with temperature, warming causes a decrease in consumer-resource oscillations. However, if self-limitation is strongest at temperatures physiologically optimal for reproduction, a scenario previously unanalysed by theory but amply substantiated by empirical data, warming can cause an increase in consumer-resource oscillations. Thirdly, the model yields testable comparative predictions about consumer-resource dynamics under alternative hypotheses for how temperature affects competitive and resource acquisition traits. Importantly, it does so through empirically quantifiable metrics for predicting temperature effects on consumer viability and consumer-resource oscillations, which obviates the need for parameterizing complex dynamical models. Tests of these metrics with empirical data on a host-parasitoid interaction yield realistic estimates of temperature limits for consumer persistence and the propensity for consumer-resource oscillations, highlighting their utility in predicting temperature effects, particularly warming, on consumer-resource interactions in both natural and agricultural settings. © 2014 The Author. Journal of Animal Ecology © 2014 British Ecological Society.

School Community Relations and Resources in Effective Schools.

ERIC Educational Resources Information Center

Michel, George J.

1985-01-01

Discusses resources available to schools operating as open and closed systems. Examines school/community relations and school effectiveness, schools as resource machines, and resources offered by teachers and parents. Stresses that broad concepts of community, good communication, and citizen involvement can utilize resources at high levels of…

Geothermal Exploration and Resource Assessment | Geothermal Technologies |

Science.gov Websites

, drilling, and resource assessments and the widespread adoption of under-utilized low-temperature resources -temperature geothermal resource technologies. Drilling The drilling of wells to find and develop geothermal low-temperature, sedimentary, co-produced, and enhanced geothermal system resources. We also work to

Reservoirs operation and water resources utilization coordination in Hongshuihe basin

NASA Astrophysics Data System (ADS)

Li, Chonghao; Chi, Kaige; Pang, Bo; Tang, Hongbin

2018-06-01

In the recent decade, the demand for water resources has been increasing with the economic development. The reservoirs of cascade hydropower stations in Hongshuihe basin, which are constructed with a main purpose of power generation, are facing more integrated water resources utilization problem. The conflict between power generation of cascade reservoirs and flood control, shipping, environmental protection and water supply has become increasingly prominent. This paper introduces the general situation and integrated water demand of cascade reservoirs in Hongshuihe basin, and it analyses the impact of various types of integrated water demand on power generation and supply. It establishes mathematic models, constrained by various types of integrated water demand, to guide the operation and water resources utilization management of cascade reservoirs in Hongshuihe basin. Integrated water coordination mechanism of Hongshuihe basin is also introduced. It provides a technical and management guide and demonstration for cascade reservoirs operation and integrated water management at home and abroad.

ScyFlow: An Environment for the Visual Specification and Execution of Scientific Workflows

NASA Technical Reports Server (NTRS)

McCann, Karen M.; Yarrow, Maurice; DeVivo, Adrian; Mehrotra, Piyush

2004-01-01

With the advent of grid technologies, scientists and engineers are building more and more complex applications to utilize distributed grid resources. The core grid services provide a path for accessing and utilizing these resources in a secure and seamless fashion. However what the scientists need is an environment that will allow them to specify their application runs at a high organizational level, and then support efficient execution across any given set or sets of resources. We have been designing and implementing ScyFlow, a dual-interface architecture (both GUT and APT) that addresses this problem. The scientist/user specifies the application tasks along with the necessary control and data flow, and monitors and manages the execution of the resulting workflow across the distributed resources. In this paper, we utilize two scenarios to provide the details of the two modules of the project, the visual editor and the runtime workflow engine.

Discussion of impact of relics activation on protection and utilization approaches-take the old summer palace as an example

NASA Astrophysics Data System (ADS)

Xiaoqi, J.

2015-08-01

As the popularization of cultural relics and the rapid development of cultural tourism industry, a large number of cultural relic tourism resources goes into public eyes. Activation of relics has became an important way for tourist to contact and understand culture relics. The way of how to properly interpret the historical sense and cultural uniqueness to the masses of tourists in order to achieve social service functions of relic resources has always been research focal point of site protection and utilization, so nowadays it has important significance to protection and utilization of heritage resources in our country. From the point of activation of relics and based on the analysis of resource characteristic, the paper in depth discuss ways of activation of relics of the Old Summer Palace, in order to provide reference for sustainable development of sites tourism in China.

Sustainability of coastal resource use in San Quintin, Mexico

USGS Publications Warehouse

Aguirre-Munoz, A.; Buddemeier, R.W.; Camacho-lbar, V.; Carriquiry, J.D.; Ibarra-Obando, S.E.; Massey, Barbara W.; Smith, S.V.; Wulff, F.

2001-01-01

San Quintin, Mexico, provides a useful site for integrated analyses of material fluxes and socioeconomic constraints in a geographically isolated system. Natural resource utilization on the land is dominated by groundwater exploitation for cultivation of horticulture crops (primarily tomatoes). Irrigation exceeds water recharge minus export by a factor of 6. Resource utilization in the bay is dominated by oyster culture; food for the oysters is provided by tidal exchange of bay and ocean water. Consideration of oyster respiration and system respiration suggests that the present level of aquaculture is about 40% of the sustainable level. A "physical unsustainability index" (PhUI) was developed to measure the proportional departure of utilization of the most limiting resource for sustainability: 6 on land; 0.4 in the bay. Based on PhUI and measures of economic development, we conclude that aquaculture is more viable than agriculture.

Sustainability of coastal resource use in San Quintin, Mexico.

PubMed

Aguirre-Muñoz, A; Buddemeier, R W; Camacho-Ibar, V; Carriquiry, J D; Ibarra-Obando, S E; Massey, B W; Smith, S V; Wulff, F

2001-05-01

San Quintin, Mexico, provides a useful site for integrated analyses of material fluxes and socioeconomic constraints in a geographically isolated system. Natural resource utilization on the land is dominated by groundwater exploitation for cultivation of horticulture crops (primarily tomatoes). Irrigation exceeds water recharge minus export by a factor of 6. Resource utilization in the bay is dominated by oyster culture; food for the oysters is provided by tidal exchange of bay and ocean water. Consideration of oyster respiration and system respiration suggests that the present level of aquaculture is about 40% of the sustainable level. A "physical unsustainability index" (PhUI) was developed to measure the proportional departure of utilization of the most limiting resource for sustainability: 6 on land; 0.4 in the bay. Based on PhUI and measures of economic development, we conclude that aquaculture is more viable than agriculture.

Assessing the coal resources of the United States

USGS Publications Warehouse

Gluskoter, Harold J.; Flores, R.M.; Hatch, J.; Kirschbaum, M.A.; Ruppert, L.F.; Warwick, Peter D.

1996-01-01

In 1994, coal production in the United States reached the highest level in history (slightly more than 909 million metric tons or one billion short tons), continuing the upward trend of coal production and utilization that began 34 years ago. Previous assessments of the coal resources of the United States, which were completed as early as 1909, clearly indicated that the total coal resources of the Nation are large and that utilization at the current rate will not soon deplete them.

Resource physiology of conifers: Acquisition, allocation, and utilization

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

Smith, W.K.; Hinckley, T.M.

1995-03-01

This book focuses on a synthetic view of the resource physiology of conifer trees with an emphasis on developing a perspective that can integrate across the biological hierarchy. This objective is in concert with more scientific goals of maintaining biological diversity and the sustainability of forest systems. The preservation of coniferous forest ecosystems is a major concern today. This volume deals with the topics of resource acquisition, allocation, and utilization in conifers. Selected papers are indexed separately for inclusion in the Energy Science and Technology Database.

iTools: A Framework for Classification, Categorization and Integration of Computational Biology Resources

PubMed Central

Dinov, Ivo D.; Rubin, Daniel; Lorensen, William; Dugan, Jonathan; Ma, Jeff; Murphy, Shawn; Kirschner, Beth; Bug, William; Sherman, Michael; Floratos, Aris; Kennedy, David; Jagadish, H. V.; Schmidt, Jeanette; Athey, Brian; Califano, Andrea; Musen, Mark; Altman, Russ; Kikinis, Ron; Kohane, Isaac; Delp, Scott; Parker, D. Stott; Toga, Arthur W.

2008-01-01

The advancement of the computational biology field hinges on progress in three fundamental directions – the development of new computational algorithms, the availability of informatics resource management infrastructures and the capability of tools to interoperate and synergize. There is an explosion in algorithms and tools for computational biology, which makes it difficult for biologists to find, compare and integrate such resources. We describe a new infrastructure, iTools, for managing the query, traversal and comparison of diverse computational biology resources. Specifically, iTools stores information about three types of resources–data, software tools and web-services. The iTools design, implementation and resource meta - data content reflect the broad research, computational, applied and scientific expertise available at the seven National Centers for Biomedical Computing. iTools provides a system for classification, categorization and integration of different computational biology resources across space-and-time scales, biomedical problems, computational infrastructures and mathematical foundations. A large number of resources are already iTools-accessible to the community and this infrastructure is rapidly growing. iTools includes human and machine interfaces to its resource meta-data repository. Investigators or computer programs may utilize these interfaces to search, compare, expand, revise and mine meta-data descriptions of existent computational biology resources. We propose two ways to browse and display the iTools dynamic collection of resources. The first one is based on an ontology of computational biology resources, and the second one is derived from hyperbolic projections of manifolds or complex structures onto planar discs. iTools is an open source project both in terms of the source code development as well as its meta-data content. iTools employs a decentralized, portable, scalable and lightweight framework for long-term resource management. We demonstrate several applications of iTools as a framework for integrated bioinformatics. iTools and the complete details about its specifications, usage and interfaces are available at the iTools web page http://iTools.ccb.ucla.edu. PMID:18509477

Use of Hawaii Analog Sites for Lunar Science and In-Situ Resource Utilization

NASA Astrophysics Data System (ADS)

Sanders, G. B.; Larson, W. E.; Picard, M.; Hamilton, J. C.

2011-10-01

In-Situ Resource Utilization (ISRU) and lunar science share similar objectives with respect to analyzing and characterizing the physical, mineral, and volatile materials and resources at sites of robotic and human exploration. To help mature and stress instruments, technologies, and hardware and to evaluate operations and procedures, space agencies have utilized demonstrations at analog sites on Earth before use in future missions. The US National Aeronautics and Space Administration (NASA), the Canadian Space Agency (CSA), and the German Space Agency (DLR) have utilized an analog site on the slope of Mauna Kea on the Big Island of Hawaii to test ISRU and lunar science hardware and operations in two previously held analog field tests. NASA and CSA are currently planning on a 3rd analog field test to be held in June, 2012 in Hawaii that will expand upon the successes from the previous two field tests.

Research on lunar and planet development and utilization

NASA Astrophysics Data System (ADS)

Iwata, Tsutomu; Etou, Takao; Imai, Ryouichi; Oota, Kazuo; Kaneko, Yutaka; Maeda, Toshihide; Takano, Yutaka

1992-08-01

Status of the study on unmanned and manned lunar missions, unmanned Mars missions, lunar resource development and utilization missions, remote sensing exploration missions, survey and review to elucidate the problems of research and development for lunar resource development and utilization, and the techniques and equipment for lunar and planet exploration are presented. Following items were studied respectively: (1) spacecraft systems for unmanned lunar missions, such as lunar observation satellites, lunar landing vehicles, lunar surface rovers, lunar surface hoppers, and lunar sample retrieval; (2) spacecraft systems for manned lunar missions, such as manned lunar bases, lunar surface operation robots, lunar surface experiment systems, manned lunar take-off and landing vehicles, and lunar freight transportation ships; (3) spacecraft systems for Mars missions, such as Mars satellites, Phobos and Deimos sample retrieval vehicles, Mars landing explorers, Mars rovers, Mars sample retrieval; (4) lunar resource development and utilization; and (5) remote sensing exploration technologies.

Use of Hawaii Analog Sites for Lunar Science and In-Situ Resource Utilization

NASA Technical Reports Server (NTRS)

Sanders, G. B.; Larson, W. E.; Picard, M.; Hamilton, J. C.

2011-01-01

In-Situ Resource Utilization (ISRU) and lunar science share similar objectives with respect to analyzing and characterizing the physical, mineral, and volatile materials and resources at sites of robotic and human exploration. To help mature and stress instruments, technologies, and hardware and to evaluate operations and procedures, space agencies have utilized demonstrations at analog sites on Earth before use in future missions. The US National Aeronautics and Space Administration (NASA), the Canadian Space Agency (CSA), and the German Space Agency (DLR) have utilized an analog site on the slope of Mauna Kea on the Big Island of Hawaii to test ISRU and lunar science hardware and operations in two previously held analog field tests. NASA and CSA are currently planning on a 3rd analog field test to be held in June, 2012 in Hawaii that will expand upon the successes from the previous two field tests.

A fuel cycle assessment guide for utility and state energy planners

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

Not Available

1994-07-01

This guide, one in a series of documents designed to help assess fuel cycles, is a framework for setting parameters, collecting data, and analyzing fuel cycles for supply-side and demand-side management. It provides an automated tool for entering comparative fuel cycle data that are meaningful to state and utility integrated resource planning, collaborative, and regional energy planning activities. It outlines an extensive range of energy technology characteristics and environmental, social, and economic considerations within each stage of a fuel cycle. The guide permits users to focus on specific stages or effects that are relevant to the technology being evaluated andmore » that meet the user`s planning requirements.« less

Hidden Costs: the ethics of cost-effectiveness analyses for health interventions in resource-limited settings

PubMed Central

Rutstein, Sarah E.; Price, Joan T.; Rosenberg, Nora E.; Rennie, Stuart M.; Biddle, Andrea K.; Miller, William C.

2017-01-01

Cost-effectiveness analysis (CEA) is an increasingly appealing tool for evaluating and comparing health-related interventions in resource-limited settings. The goal is to inform decision-makers regarding the health benefits and associated costs of alternative interventions, helping guide allocation of limited resources by prioritizing interventions that offer the most health for the least money. Although only one component of a more complex decision-making process, CEAs influence the distribution of healthcare resources, directly influencing morbidity and mortality for the world’s most vulnerable populations. However, CEA-associated measures are frequently setting-specific valuations, and CEA outcomes may violate ethical principles of equity and distributive justice. We examine the assumptions and analytical tools used in CEAs that may conflict with societal values. We then evaluate contextual features unique to resource-limited settings, including the source of health-state utilities and disability weights; implications of CEA thresholds in light of economic uncertainty; and the role of external donors. Finally, we explore opportunities to help align interpretation of CEA outcomes with values and budgetary constraints in resource-limited settings. The ethical implications of CEAs in resource-limited settings are vast. It is imperative that CEA outcome summary measures and implementation thresholds adequately reflect societal values and ethical priorities in resource-limited settings. PMID:27141969

Hidden costs: The ethics of cost-effectiveness analyses for health interventions in resource-limited settings.

PubMed

Rutstein, Sarah E; Price, Joan T; Rosenberg, Nora E; Rennie, Stuart M; Biddle, Andrea K; Miller, William C

2017-10-01

Cost-effectiveness analysis (CEA) is an increasingly appealing tool for evaluating and comparing health-related interventions in resource-limited settings. The goal is to inform decision-makers regarding the health benefits and associated costs of alternative interventions, helping guide allocation of limited resources by prioritising interventions that offer the most health for the least money. Although only one component of a more complex decision-making process, CEAs influence the distribution of health-care resources, directly influencing morbidity and mortality for the world's most vulnerable populations. However, CEA-associated measures are frequently setting-specific valuations, and CEA outcomes may violate ethical principles of equity and distributive justice. We examine the assumptions and analytical tools used in CEAs that may conflict with societal values. We then evaluate contextual features unique to resource-limited settings, including the source of health-state utilities and disability weights, implications of CEA thresholds in light of economic uncertainty, and the role of external donors. Finally, we explore opportunities to help align interpretation of CEA outcomes with values and budgetary constraints in resource-limited settings. The ethical implications of CEAs in resource-limited settings are vast. It is imperative that CEA outcome summary measures and implementation thresholds adequately reflect societal values and ethical priorities in resource-limited settings.

What Drives Country Differences in Cost of Alzheimer's Disease? An Explanation from Resource Use in the GERAS Study.

PubMed

Reed, Catherine; Happich, Michael; Argimon, Josep Maria; Haro, Josep Maria; Wimo, Anders; Bruno, Giuseppe; Dodel, Richard; Jones, Roy W; Vellas, Bruno; Belger, Mark

2017-01-01

Country differences in resource use and costs of Alzheimer's disease (AD) may be driven by differences in health care systems and resource availability. To compare country resource utilization drivers of societal costs for AD dementia over 18 months. GERAS is an observational study in France (n = 419), Germany (n = 550), and the UK (n = 526). Resource use of AD patients and caregivers contributing to >1% of total societal costs (year 2010) was assessed for country differences, adjusting for participant characteristics. Mean 18-month societal costs per patient were France €33,339, Germany €38,197, and UK €37,899 (£32,501). Caregiver time spent on basic and instrumental activities of daily living (ADL) contributed the most to societal costs (54% France, 64% Germany, 65% UK). Caregivers in France spent less time on ADL than UK caregivers and missed fewer work days than in other countries. Compared with other countries, patients in France used more community care services overall and were more likely to use home aid. Patients in Germany were least likely to use temporary accommodation or to be institutionalized at 18 months. UK caregivers spent the most time on instrumental ADL, UK patients used fewest outpatient resources, and UK patients/caregivers were most likely to receive financial support. Caregiver time on ADL contributed the most to societal costs and differed across countries, possibly due to use of community care services and institutionalization. Other resources had different patterns of use across countries, reflecting country-specific health and social care systems.

Pulmonary rehabilitation in COPD - available resources and utilization in Swedish primary and secondary care.

PubMed

Sundh, Josefin; Lindgren, Helena; Hasselgren, Mikael; Montgomery, Scott; Janson, Christer; Ställberg, Björn; Lisspers, Karin

2017-01-01

Pulmonary rehabilitation is effective in all stages of COPD. The availability and utilization of pulmonary rehabilitation resources, and the characteristics of COPD patients receiving rehabilitation, were investigated in primary and secondary care in central Sweden. Data on available pulmonary rehabilitation resources were collected using questionnaires, to 14 hospitals and 54 primary health care centers, and information on utilization of different rehabilitation professionals was obtained from questionnaires completed by 1,329 COPD patients from the same centers. Multivariable logistic regression examined associations with having received rehabilitation in the previous year. In primary care, nurse-based asthma/COPD clinics were common (87%), with additional separate access to other rehabilitation professionals. In secondary care, rehabilitation was more often offered as part of a multidisciplinary teamwork (71%). In total, 36% of the patients met an asthma/COPD nurse in the previous year. Utilization was lower in primary than in secondary care for physiotherapists (7% vs 16%), occupational therapists (3% vs 10%), nutritionists (5% vs 13%), and counselors (1% vs 4%). A higher COPD Assessment Test score and frequent exacerbations were associated with higher utilization of all rehabilitation professionals. Pulmonary rehabilitation resources are available but underutilized, and receiving rehabilitation is more common in severe COPD. Treatment recommendations need to be better implemented, especially in mild and moderate COPD.

Increasing Efficiency in Evaluation of Chronic Cough: A Multidisciplinary, Collaborative Approach.

PubMed

Patton, Cynthia M; Lim, Kaiser G; Ramlow, Luke W; White, Kathleen M

2015-01-01

Chronic cough is the most common reason for medical office visits in the United States. The typical patient has coughed more than 8 years and seen many specialists. This quality improvement project is an ambulatory clinic redesign to deliver efficient, patient-centered care with interspecialty collaboration. Methodology included the Institute for Healthcare Improvement collaborative model focused on Lean/Six Sigma and ADKAR (Awareness, Desire, Knowledge, Ability, Reinforcement) Change Management. Interventions targeted education to referring providers, implementation of software changes, building a collaborative interdepartmental scheduling decision tree, and an interclinic dashboard enhancing communication and decision support. Outcome measures compare group resource utilization, evidenced by the total number of specialist referrals for same indication of chronic cough (International Classification of Diseases, Ninth Revision: 786.2), and length of time to complete evaluation. A retrospective review of 165 medical records yielded 2 groups, "current care" (n = 67) and "intervention" (n = 68). The number of specialist referrals per patient was reduced in the intervention group (M = 1.22, SD = 0.48) compared with the current care group (M = 3.33, SD = 1.02). Length of itinerary was reduced in the intervention group (M = 11.90, SD = 12.13, GM = 6.82) compared with the current care group (M = 126.93, SD = 158.13, GM = 54.8). Multidisciplinary collaboration, communication, coordinating diagnosis, and management of multifactorial conditions, such as chronic cough, are associated with lower costs and decreased utilization of health care resources.

A randomized trial of povidone-iodine compared with iodine tincture for venipuncture site disinfection: effects on rates of blood culture contamination.

PubMed

Little, J R; Murray, P R; Traynor, P S; Spitznagel, E

1999-08-01

Contamination of blood cultures creates problems in their interpretation and unneeded resource utilization. Because skin flora comprise the major group of contaminant species, more effective skin disinfection at the venipuncture site could reduce contamination. We performed a randomized trial in adult inpatients at a tertiary care teaching hospital. Antecubital venipuncture sites were randomly disinfected with povidone-iodine or iodine tincture, and blood cultures (two bottles, 10 mL of blood) were drawn by professional phlebotomists. Scoring of contaminant species was restricted to skin flora. Hospital resource utilization was compared among patients with contaminated blood cultures and those with sterile blood cultures. Of the 3,851 blood cultures collected during the study, 120 (3.1%) were contaminated with skin flora. The contamination rate for blood cultures collected after povidone-iodine was 3.8% (74 of 1,947), compared with a rate of 2.4% (46 of 1,904, P = 0.01) after iodine tincture. The difference in mean total hospital costs for patients with contaminated blood cultures and those with sterile blood cultures was $4,100 (95% confidence interval: $740 to $7,400, P = 0.02). Iodine tincture is superior to povidone-iodine for venipuncture site antisepsis before blood culture sampling. Because of the high costs associated with contaminated blood cultures, hospitals should consider switching from povidone-iodine to iodine tincture. Reduction of the contamination rate may improve the quality of patient care and reduce hospital costs.

Healthcare resource utilization after medium-term residential assessment for epilepsy and psychogenic nonepileptic seizures.

PubMed

Anderson, James; Hill, Joanne; Alford, Max; Oto, Maria; Russell, Aline; Razvi, Saif

2016-09-01

Epilepsy and epilepsy mimics may lead to high healthcare resource utilization (HRU) including diagnostic resources. The William Quarrier Scottish Epilepsy Centre (SEC) provides medium-term residential assessment (MTRA; average length of stay: 28days) and treatment for complex presentations of epilepsy and related conditions (principally psychogenic nonepileptic seizures, PNES). We studied the effect of MTRA on HRU in a defined health board area in Scotland. A retrospective audit of individuals admitted to the SEC from a defined health board area using SEC and health board medical records. Neurological HRU assessed included emergency department visits, hospital admissions, outpatient clinic appointments, and brain imaging prior to and post-MTRA. Healthcare resource utilization was also compared with individuals referred but not admitted to the SEC because of individual circumstances and choice. Seventy-three individuals (51 female, average age: 37.51; 22 men, average age: 43.72) were identified from three years of admissions (1st April 2010 to 31st March 2013). Final diagnosis was epilepsy (ES), 32; ES and psychogenic nonepileptic seizures (ES+PNES), 17; and PNES alone, 24. Twenty-two individuals were identified as a comparison group (8 men, 14 women; average age: 37.21 and 43.90, respectively). Total average contacts per patient per year (CPY) was significantly different pre- and post-MTRA (4.16 vs. 1.32; t(72)=6.11, p<.0001, d=.72). Comparison of HRU in the first year of baseline and last full year of follow-up showed a post-MTRA reduction in HRU for PNES of 92.28%, for ES of 46.81%, and for ES+PNES of 28.3%. During the course of follow-up, PNES CPY continued to drop (1.13 first year vs. 0.10 at 3years post-MTRA). For individuals with epilepsy (with or without PNES), HRU use dropped significantly in the year after admission, and these gains remained stable (total first vs. third postdischarge CPY, 1.74 vs. 1.29). The participants in the comparison group, who were not admitted, had no comparable drop across the study period and were using significantly more resources at each follow-up point than those in the admitted group (F (1, 48)=44.45, p<.01, ηp(2)=.49). Medium-term residential assessment is associated with sustained reduction in HRU especially in patients with PNES. Overall HRU reduction was 68.27% following admission (d=.72). This suggests benefit from the MTRA model for people with complex presentations. Copyright © 2016 Elsevier Inc. All rights reserved.

Mercury in gray wolves (Canis lupus) in Alaska: Increased exposure through consumption of marine prey

USGS Publications Warehouse

McGrew, Ashley K.; Ballweber, Lora R.; Moses, Sara K.; Stricker, Craig A.; Beckmen, Kimberlee B.; Salman, Mo D.; O’Hara, Todd M.

2013-01-01

Mercury (Hg) bioaccumulates in the tissues of organismsand biomagnifies within food-webs. Graywolves (Canis lupus) in Alaska primarily acquire Hg through diet; therefore, comparing the extent of Hg exposure inwolves, in conjunction with stable isotopes, from interior and coastal regions of Alaska offers important insight into their feeding ecology. Liver, kidney, and skeletal muscle samples from 162 graywolves were analyzed for total mercury (THg) concentrations and stable isotopic signatures (δ13C, δ15N, and δ34S).Median hepatic THg concentrations were significantly higher in wolves with coastal access compared to wolves from interior Alaska. Stable isotope ratios, in conjunction with THg concentrations, provide strong evidence that coastal wolves are utilizing marine prey representing several trophic levels. The utilization of cross-ecosystem food resources by coastal wolves is clearly contributing to increased THg exposure, and may ultimately have negative health implications for these animals.

Utilization of patient resources in physiotherapy interventions: Analysis of the interaction concerning non-specific low back pain.

PubMed

Josephson, Iréne; Bülow, Pia H

2014-01-01

This paper reports on an empirical study in Sweden of how patient resources come into play in physiotherapy interventions. A qualitative analysis was conducted of five video-recorded first encounters between patients with non-specific low back pain (NSLBP) and physiotherapists in primary care, using Conservation of Resource Theory (COR) to identify and focus on how physiotherapists made use of patients' resources (objects, conditions, personal characteristics and energies). The findings reveal variations in how these resources are utilized during the intervention. Resources with implications for what happens in the examination room during the ongoing encounter and resources characterized by professional familiarity were both employed in the intervention. However, underutilized resources were featured in the broader lifeworld perspective of laypeople and of other professional frames. The findings raise questions about professional challenges that go beyond professional skills. This implies that professionals need to improve skills in understanding and integrating patient resources into interventions.

Measuring Road Network Vulnerability with Sensitivity Analysis

PubMed Central

Jun-qiang, Leng; Long-hai, Yang; Liu, Wei-yi; Zhao, Lin

2017-01-01

This paper focuses on the development of a method for road network vulnerability analysis, from the perspective of capacity degradation, which seeks to identify the critical infrastructures in the road network and the operational performance of the whole traffic system. This research involves defining the traffic utility index and modeling vulnerability of road segment, route, OD (Origin Destination) pair and road network. Meanwhile, sensitivity analysis method is utilized to calculate the change of traffic utility index due to capacity degradation. This method, compared to traditional traffic assignment, can improve calculation efficiency and make the application of vulnerability analysis to large actual road network possible. Finally, all the above models and calculation method is applied to actual road network evaluation to verify its efficiency and utility. This approach can be used as a decision-supporting tool for evaluating the performance of road network and identifying critical infrastructures in transportation planning and management, especially in the resource allocation for mitigation and recovery. PMID:28125706

Space Resource Roundtable Rationale

NASA Astrophysics Data System (ADS)

Duke, Michael

1999-01-01

Recent progress in the U.S. Space Program has renewed interest in space resource issues. The Lunar Prospector mission conducted in NASA's Discovery Program has yielded interesting new insights into lunar resource issues, particularly the possibility that water is concentrated in cold traps at the lunar poles. This finding has not yet triggered a new program of lunar exploration or development, however it opens the possibility that new Discovery Missions might be viable. Several asteroid missions are underway or under development and a mission to return samples from the Mars satellite, Phobos, is being developed. These exploration missions are oriented toward scientific analysis, not resource development and utilization, but can provide additional insight into the possibilities for mining asteroids. The Mars Surveyor program now includes experiments on the 2001 lander that are directly applicable to developing propellants from the atmosphere of Mars, and the program has solicited proposals for the 2003/2005 missions in the area of resource utilization. These are aimed at the eventual human exploration of Mars. The beginning of construction of the International Space Station has awakened interest in follow-on programs of human exploration, and NASA is once more studying the human exploration of Moon, Mars and asteroids. Resource utilization will be included as objectives by some of these human exploration programs. At the same time, research and technology development programs in NASA such as the Microgravity Materials Science Program and the Cross-Enterprise Technology Development Program are including resource utilization as a valid area for study. Several major development areas that could utilize space resources, such as space tourism and solar power satellite programs, are actively under study. NASA's interests in space resource development largely are associated with NASA missions rather than the economic development of resources for industrial processes. That is why there is an emphasis in NASA programs on propellant production on Mars - NASA plans missions to Mars, so could make use of those propellants. For other types of applications, however, it will be up to market forces to define the materials and products needed and develop the technologies for extracting them from space resources. Some leading candidates among the potential products from space resources are propellants for other space activities, water from the Moon for use in space, silicon for photovoltaic energy collection in space, and, eventually, He-3 from the Moon for fusion energy production. As the capabilities for manufacturing materials in space are opened up by research aboard the International Space Station, new opportunities for utilization of space resources may emerge. Whereas current research emphasizes increasing knowledge, one program objective should be the development of industrial production techniques for space. These will be based on the development of value-added processing in space, where materials are brought to the space facility, processed there, and returned to Earth. If enough such space processing is developed that the materials transportation requirements are measured in the hundreds of tons a year level, opportunities for substituting lunar materials may develop. The fundamental message is that it is not possible to develop space resources in a vacuum. One must have three things: a recoverable resource, technology to recover it, and a customer. Of these, the customer probably is the most important. All three must be integrated in a space resource program. That is what the Space Resource Roundtable, initiated with this meeting, will bring together.

Self-Management Plan, Perceived Quality of Life and Medical Resource Utilization of Asthmatic Children.

DTIC Science & Technology

1997-05-07

quality of life , however, has not been addressed. This descriptive, correlational study compared the perceived quality of life and number of...not adhere to a plan. Quality of life was measured using the Childhood Asthma Questionnaire, a valid and reliable quality of life measurement tool for...children of different ages. There were no significant differences between the Adherence and Non-adherence groups relative to quality of life

An Empirical Study of Logistics Organization, Electronic Linkage, and Performance

DTIC Science & Technology

1993-01-01

utilization of transportation resources, and improved quality management. Researchers have proposed an information technology (IT) implementation model for...management, more efficient utilization of transportation resources, and improved quality management. Researchers have proposed an information...coordination of (1) facility structure, (2) forecasting and order management, (3) transportation , (4) inventory, and (5) warehousing and packaging. The

A Multicase Study: Exploring Human Resource Information System Implementation and Utilization in Multinational Corporations in Kenya

ERIC Educational Resources Information Center

Nzyoka Yongo, Cyd W.

2016-01-01

Implementation and utilization of human resource information system (HRIS) though a very desirable prospect for many organizations, still remains a daunting task for many. This has been daunting because of prohibitive costs, security risks, top management resistance, employee attitudes, and so forth. Trends globally show that, organizations that…

Design Tools for Evaluating Multiprocessor Programs

DTIC Science & Technology

1976-07-01

than large uniprocessing machines, and 2. economies of scale in manufacturing. Perhaps the most compelling reason (possibly a consequence of the...speed, redundancy, (inefficiency, resource utilization, and economies of the components. [Browne 73, Lehman 66] 6. How can the system be scheduled...mejsures are interesting about the computation? Somn may be: speed, redundancy, (inefficiency, resource utilization, and economies of the components

The Resource Utilization of Women Who Use Violence in Intimate Relationships

ERIC Educational Resources Information Center

Swan, Suzanne C.; Sullivan, Tami P.

2009-01-01

Studies have found high rates of help seeking among domestic violence victims. However, little research has investigated the help-seeking patterns of women who use violence (many of whom are also abused). Understanding the resources utilized by women who are violent toward their partners may aid in designing interventions that will reduce the…