42 CFR 456.709 - Retrospective drug use review.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 42 Public Health 4 2014-10-01 2014-10-01 false Retrospective drug use review. 456.709 Section 456... (CONTINUED) MEDICAL ASSISTANCE PROGRAMS UTILIZATION CONTROL Drug Use Review (DUR) Program and Electronic Claims Management System for Outpatient Drug Claims § 456.709 Retrospective drug use review. (a) General...

42 CFR 456.703 - Drug use review program.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 42 Public Health 4 2012-10-01 2012-10-01 false Drug use review program. 456.703 Section 456.703... (CONTINUED) MEDICAL ASSISTANCE PROGRAMS UTILIZATION CONTROL Drug Use Review (DUR) Program and Electronic Claims Management System for Outpatient Drug Claims § 456.703 Drug use review program. (a) General...

42 CFR 456.703 - Drug use review program.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 42 Public Health 4 2013-10-01 2013-10-01 false Drug use review program. 456.703 Section 456.703... (CONTINUED) MEDICAL ASSISTANCE PROGRAMS UTILIZATION CONTROL Drug Use Review (DUR) Program and Electronic Claims Management System for Outpatient Drug Claims § 456.703 Drug use review program. (a) General...

42 CFR 456.703 - Drug use review program.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 42 Public Health 4 2011-10-01 2011-10-01 false Drug use review program. 456.703 Section 456.703... (CONTINUED) MEDICAL ASSISTANCE PROGRAMS UTILIZATION CONTROL Drug Use Review (DUR) Program and Electronic Claims Management System for Outpatient Drug Claims § 456.703 Drug use review program. (a) General...

42 CFR 456.709 - Retrospective drug use review.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 42 Public Health 4 2013-10-01 2013-10-01 false Retrospective drug use review. 456.709 Section 456... (CONTINUED) MEDICAL ASSISTANCE PROGRAMS UTILIZATION CONTROL Drug Use Review (DUR) Program and Electronic Claims Management System for Outpatient Drug Claims § 456.709 Retrospective drug use review. (a) General...

42 CFR 456.709 - Retrospective drug use review.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 42 Public Health 4 2012-10-01 2012-10-01 false Retrospective drug use review. 456.709 Section 456... (CONTINUED) MEDICAL ASSISTANCE PROGRAMS UTILIZATION CONTROL Drug Use Review (DUR) Program and Electronic Claims Management System for Outpatient Drug Claims § 456.709 Retrospective drug use review. (a) General...

42 CFR 456.702 - Definitions.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 42 Public Health 4 2014-10-01 2014-10-01 false Definitions. 456.702 Section 456.702 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS UTILIZATION CONTROL Drug Use Review (DUR) Program and Electronic Claims Management System...

42 CFR 456.700 - Scope.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 42 Public Health 4 2012-10-01 2012-10-01 false Scope. 456.700 Section 456.700 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS UTILIZATION CONTROL Drug Use Review (DUR) Program and Electronic Claims Management System...

42 CFR 456.702 - Definitions.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 42 Public Health 4 2012-10-01 2012-10-01 false Definitions. 456.702 Section 456.702 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS UTILIZATION CONTROL Drug Use Review (DUR) Program and Electronic Claims Management System...

42 CFR 456.700 - Scope.

Code of Federal Regulations, 2014 CFR

2014-10-01

... ASSISTANCE PROGRAMS UTILIZATION CONTROL Drug Use Review (DUR) Program and Electronic Claims Management System... optional point-of-sale electronic claims management system for processing claims for covered outpatient... 42 Public Health 4 2014-10-01 2014-10-01 false Scope. 456.700 Section 456.700 Public Health...

42 CFR 456.702 - Definitions.

Code of Federal Regulations, 2010 CFR

2010-10-01

... ASSISTANCE PROGRAMS UTILIZATION CONTROL Drug Use Review (DUR) Program and Electronic Claims Management System for Outpatient Drug Claims § 456.702 Definitions. For purposes of this subpart— Abuse is defined as in..., experienced by a patient, due to a course of drug therapy. Appropriate and medically necessary means drug...

Mutant Potential Ubiquitination Sites in Dur3p Enhance the Urea and Ethyl Carbamate Reduction in a Model Rice Wine System.

PubMed

Zhang, Peng; Du, Guocheng; Zou, Huijun; Xie, Guangfa; Chen, Jian; Shi, Zhongping; Zhou, Jingwen

2017-03-01

Ubiquitination can significantly affect the endocytosis and degradation of plasma membrane proteins. Here, the ubiquitination of a Saccharomyces cerevisiae urea plasma membrane transporter (Dur3p) was altered. Two potential ubiquitination sites, lysine residues K556 and K571, of Dur3p were predicted and replaced by arginine, and the effects of these mutations on urea utilization and formation under different nitrogen conditions were investigated. Compared with Dur3p, the Dur3p K556R mutant showed a 20.1% decrease in ubiquitination level in yeast nitrogen base medium containing urea and glutamine. It also exhibited a >75.8% decrease in urea formation in yeast extract-peptone-dextrose medium and 41.3 and 55.4% decreases in urea and ethyl carbamate formation (a known carcinogen), respectively, in a model rice wine system. The results presented here show that the mutation of Dur3p ubiquitination sites could significantly affect urea utilization and formation. Modifying the ubiquitination of specific transporters might have promising applications in rationally engineering S. cerevisiae strains to efficiently use specific nitrogen sources.

The effect of the introduction of a nationwide DUR system where local DUR systems are operating--The Korean experience.

PubMed

Yang, Ju-Hyun; Kim, Mira; Park, Young-Taek; Lee, Eui-Kyung; Jung, Chai Young; Kim, Sukil

2015-11-01

Outpatient clinics in Korea usually have local DUR (drug utilisation review) systems, which are integrated with EMRs or health insurance claims submission systems. Whenever, the government announces a list of drug contraindications, each local DUR system loads the list and applies it in practice. In December 2010, a nationwide DUR system was introduced. This study is to investigate the impact of the nationwide DUR system on prescribing practices where local DUR systems are already operating. Between January 2009 and December 2012 the monthly number of drugs per prescription was retrieved from the health insurance claims data warehouse at the Health Insurance Review and Assessment (HIRA). The monthly proportions of 3 DDI (drug-drug interaction) pairs, 6 drug-age contraindications, and 3 drug-pregnancy contraindications from January 2007 to December 2012, at the outpatient clinic level, were also retrieved. An interrupted time series analysis was used for controlling government announcements of drug contraindications. There was no difference in the number of drugs per prescription before and after the introduction of the nationwide DUR system. Most proportions of the 3 DDI pairs, 6 drug-age contraindications, and 3 drug-pregnancy contraindications, were significantly reduced following the government announcement of drug contraindications in the short term and/or long term. The number of drugs per prescription was not related to the nationwide DUR introduction in places where local DUR systems are operating. The introduction of duplicate guidelines, in locations where the guidelines were already well followed, is considered to be the main reason for this. Furthermore, the Doctor's ignorance of alerts, and their continued substitution of regulated drugs, for non-regulated drugs, likely played a role in nullifying the effectiveness of the nationwide DUR system. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Evaluation of conformity of a first prescription of lipid-based formulation of amphotericin B in a university-teaching pediatric hospital.

PubMed

Agogué, Claire; Bussières, Jean-François; Dehaut, Catherine; Lebel, Denis; Brochet, Marie-Sophie

2006-04-01

Invasive fungal infections are an important cause of morbidity and mortality in immunodeficient children. Amphotericin B is an important therapeutic agent for the treatment of invasive fungal infections but is associated with significant toxicities and high acquisition costs. The purpose of this study was to evaluate physician adherence to a local guideline for the use of lipid-based amphotericin B. The study was approved through Pharmacology & Therapeutics (P&T) committee activities. A retrospective drug utilization review (DUR) was conducted. All orders written between January 1, 2003, and December 31, 2004, were reviewed. Demographic and descriptive clinical data were collected as well as variables related to the drug order process. Conformity rates were calculated for the primary objective criteria (authorized prescribers - infectious disease members; recommended drug of choice-Abelcet; accepted indications; and presence of underlying conditions). A total of 109 orders for 70 patients were reviewed by a single research assistant for a 2-year period. Global conformity rate for all four criteria was calculated at 7.3%. Non-conformity was mostly associated with the absence of underlying conditions (e.g., prerenal insufficiency or presence of nephrotoxicity due to amphotericin B desoxycholate) in 84.5% of the cases. Infusionrelated adverse drug reactions partly explained a switch to a non-formulary lipid-based amphotericin B product. External factors (newly published results since the adoption of the guideline and continuous marketing practices) and internal factors (availability of non-formulary process, inefficient DUR process) could have contributed to non-adherence to a local guideline. This study shows low adherence to P&T committee drug guidelines on lipid-based amphotericin B. Continuous and efficient DUR processes should be in place to monitor drug guideline adherence.

Methodological survey of designed uneven randomization trials (DU-RANDOM): a protocol.

PubMed

Wu, Darong; Akl, Elie A; Guyatt, Gordon H; Devereaux, Philip J; Brignardello-Petersen, Romina; Prediger, Barbara; Patel, Krupesh; Patel, Namrata; Lu, Taoying; Zhang, Yuan; Falavigna, Maicon; Santesso, Nancy; Mustafa, Reem A; Zhou, Qi; Briel, Matthias; Schünemann, Holger J

2014-01-23

Although even randomization (that is, approximately 1:1 randomization ratio in study arms) provides the greatest statistical power, designed uneven randomization (DUR), (for example, 1:2 or 1:3) is used to increase participation rates. Until now, no convincing data exists addressing the impact of DUR on participation rates in trials. The objective of this study is to evaluate the epidemiology and to explore factors associated with DUR. We will search for reports of RCTs published within two years in 25 general medical journals with the highest impact factor according to the Journal Citation Report (JCR)-2010. Teams of two reviewers will determine eligibility and extract relevant information from eligible RCTs in duplicate and using standardized forms. We will report the prevalence of DUR trials, the reported reasons for using DUR, and perform a linear regression analysis to estimate the association between the randomization ratio and the associated factors, including participation rate, type of informed consent, clinical area, and so on. A clearer understanding of RCTs with DUR and its association with factors in trials, for example, participation rate, can optimize trial design and may have important implications for both researchers and users of the medical literature.

Constructing a Real-Time Prescription Drug Monitoring System

PubMed Central

Lee, Youn Tae; Jo, Emmanuel C.

2016-01-01

Objectives The objective of this investigation was to demonstrate the possibility of the construction of a real-time prescription drug monitoring system (PDMOS) using data from the nationwide Drug Utilization Review (DUR) system in Korea. Methods The DUR system collects information on drug prescriptions issued by healthcare practitioners and on drugs dispensed by pharmacies. PDMOS was constructed using this data. The screen of PDMOS is designed to exhibit the number of drug prescriptions, the number of prescriptions dispensed by pharmacies, and the dispensed prescription drug costs on a daily and weekly basis. Data was sourced from the DUR system between June 1, 2016 and July 18, 2016. The TOGA solution developed by the EYEQMC Co. Ltd. of Seoul, Korea was used to produce the screen shots. Results Prescription numbers by medical facilities were more numerous than the number of prescriptions dispensed by pharmacies, as expected. The number of prescriptions per day was between 2 to 3 million. The prescriptions issued by primary care clinics were most numerous, at 75% of the total number of prescriptions. Daily prescription drug costs were found to be approximately US $50 million. The prescription drug costs were highest on Mondays and were reduced towards the end of the week. Prescriptions and dispensed prescriptions numbered approximately 1,200 and 1,000 million, respectively. Conclusions The construction of a real-time PDMOS has been successful to provide daily and weekly information. There was a lag time of only one day at the national level in terms of information extraction, and scarcely any time was required to load the data. Therefore, this study highlights the potential of constructing a PDMOS to monitor the estimate the number of prescriptions and the resulting expenditures from prescriptions. PMID:27525159

Drug utilisation review (DUR) of the third generation cephalosporins. Focus on ceftriaxone, ceftazidime and cefotaxime.

PubMed

Adu, A; Armour, C L

1995-09-01

Six parenteral third generation cephalosporins have been introduced into clinical use in the past 10 years. The 3 most frequently available agents are cefotaxime, ceftriaxone and ceftazidime. These 3 third generation cephalosporins are characterised by a broad spectrum of activity and increased stability to beta-lactamases compared with the first and second generation cephalosporins. However, there are growing numbers of reports of resistance to these agents with increasing use. The major differences in the properties of the 3 agents are the long half-life of ceftriaxone and its dual route of elimination. Ceftazidime is best restricted to Pseudomonas aeruginosa infections where other agents are contraindicated or ineffective. Cefotaxime and ceftriaxone can be used in nosocomial Gram-negative infections where P. aeruginosa can be ruled out. The types and incidences of adverse drug reactions are not different for the 3 agents. A number of drug utilisation review (DUR) studies of these agents in the hospital setting have reported a considerable incidence of inappropriate use and substantial avoidable costs. There are methodological problems with most of the DUR studies, especially the criteria and the methods of cost estimation. The use of pharmacoeconomic methodology could ensure more realistic cost estimation; however, outcome data are, in most cases, not available.

The Novel Candida albicans Transporter Dur31 Is a Multi-Stage Pathogenicity Factor

PubMed Central

Mayer, François L.; Wilson, Duncan; Jacobsen, Ilse D.; Miramón, Pedro; Große, Katharina; Hube, Bernhard

2012-01-01

Candida albicans is the most frequent cause of oral fungal infections. However, the exact pathogenicity mechanisms that this fungus employs are largely unknown and many of the genes expressed during oral infection are uncharacterized. In this study we sought to functionally characterize 12 previously unknown function genes associated with oral candidiasis. We generated homozygous knockout mutants for all 12 genes and analyzed their interaction with human oral epithelium in vitro. Eleven mutants caused significantly less epithelial damage and, of these, deletion of orf19.6656 (DUR31) elicited the strongest reduction in pathogenicity. Interestingly, DUR31 was not only involved in oral epithelial damage, but in multiple stages of candidiasis, including surviving attack by human neutrophils, endothelial damage and virulence in vivo. In silico analysis indicated that DUR31 encodes a sodium/substrate symporter with 13 transmembrane domains and no human homologue. We provide evidence that Dur31 transports histatin 5. This is one of the very first examples of microbial driven import of this highly cytotoxic antimicrobial peptide. Also, in contrast to wild type C. albicans, dur31Δ/Δ was unable to actively increase local environmental pH, suggesting that Dur31 lies in the extracellular alkalinization hyphal auto-induction pathway; and, indeed, DUR31 was required for morphogenesis. In agreement with this observation, dur31Δ/Δ was unable to assimilate the polyamine spermidine. PMID:22438810

Residual oxygen time model for oxygen partial pressure near 130 kPa (1.3 atm).

PubMed

Shykoff, Barbara E

2015-01-01

A two-part residual oxygen time model predicts the probability of detectible pulmonary oxygen toxicity P(P[O2tox]) after dives with oxygen partial pressure (PO2) approximately 130 kPa, and provides a tool to plan dive series with selected risk of P[O2tox]. Data suggest that pulmonary oxygen injury at this PO2 is additive between dives. Recovery begins after a delay and continues during any following dive. A logistic relation expresses P(P[O2tox]) as a function of dive duration (T(dur)) [hours]: P(P[O2tox]) = 100/[1+exp (3.586-0.49 x T(dur))] This expression maps T(dur) to P(P[O2tox]) or, in the linear mid-portion of the curve, P(P[O2tox]) usefully to T(dur). For multiple dives or during recovery, it maps to an equivalent dive duration, T(eq). T(eq) was found after second dives of duration T(dur 2). Residual time from the first dive t(r) = T(eq) - T(dur2). With known t(r), t and T(dur) a recovery model was fitted. t(r) = T(dur) x exp [-k x((t-5)/T(dur)2], where t = t - 5 hours, k = 0.149 for resting, and 0.047 for exercising divers, and t represents time after surfacing. The fits were assessed for 1,352 man-dives. Standard deviations of the residuals were 8.5% and 18.3% probability for resting or exercise dives, respectively.

Urea retranslocation from senescing Arabidopsis leaves is promoted by DUR3-mediated urea retrieval from leaf apoplast

PubMed Central

Bohner, Anne; Kojima, Soichi; Hajirezaei, Mohammad; Melzer, Michael; von Wirén, Nicolaus

2015-01-01

In plants, urea derives either from root uptake or protein degradation. Although large quantities of urea are released during senescence, urea is mainly seen as a short-lived nitrogen (N) catabolite serving urease-mediated hydrolysis to ammonium. Here, we investigated the roles of DUR3 and of urea in N remobilization. During natural leaf senescence urea concentrations and DUR3 transcript levels showed a parallel increase with senescence markers like ORE1 in a plant age- and leaf age-dependent manner. Deletion of DUR3 decreased urea accumulation in leaves, whereas the fraction of urea lost to the leaf apoplast was enhanced. Under natural and N deficiency-induced senescence DUR3 promoter activity was highest in the vasculature, but was also found in surrounding bundle sheath and mesophyll cells. An analysis of petiole exudates from wild-type leaves revealed that N from urea accounted for >13% of amino acid N. Urea export from senescent leaves further increased in ureG-2 deletion mutants lacking urease activity. In the dur3 ureG double insertion line the absence of DUR3 reduced urea export from leaf petioles. These results indicate that urea can serve as an early metabolic marker for leaf senescence, and that DUR3-mediated urea retrieval contributes to the retranslocation of N from urea during leaf senescence. PMID:25440717

42 CFR 456.719 - Funding for DUR program.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 42 Public Health 4 2012-10-01 2012-10-01 false Funding for DUR program. 456.719 Section 456.719 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES... Claims Management System for Outpatient Drug Claims § 456.719 Funding for DUR program. FFP is available...

42 CFR 456.719 - Funding for DUR program.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 42 Public Health 4 2014-10-01 2014-10-01 false Funding for DUR program. 456.719 Section 456.719 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES... Claims Management System for Outpatient Drug Claims § 456.719 Funding for DUR program. FFP is available...

Light exposure enhances urea absorption in the fluted giant clam, Tridacna squamosa, and up-regulates the protein abundance of a light-dependent urea active transporter, DUR3-like, in its ctenidium.

PubMed

Chan, Christabel Y L; Hiong, Kum C; Boo, Mel V; Choo, Celine Y L; Wong, Wai P; Chew, Shit F; Ip, Yuen K

2018-04-19

Giant clams live in nutrient-poor reef waters of the Indo-Pacific and rely on symbiotic dinoflagellates ( Symbiodinium spp., also known as zooxanthellae) for nutrients. As the symbionts are nitrogen deficient, the host clam has to absorb exogenous nitrogen and supply it to them. This study aimed to demonstrate light-enhanced urea absorption in the fluted giant clam, Tridacna squamosa , and to clone and characterize the urea active transporter DUR3-like from its ctenidium (gill). The results indicate that T. squamosa absorbs exogenous urea, and the rate of urea uptake in the light was significantly higher than that in darkness. The DUR3-like coding sequence obtained from its ctenidium comprised 2346 bp, encoding a protein of 782 amino acids and 87.0 kDa. DUR3-like was expressed strongly in the ctenidium, outer mantle and kidney. Twelve hours of exposure to light had no significant effect on the transcript level of ctenidial DUR3-like However, between 3 and 12 h of light exposure, DUR3-like protein abundance increased progressively in the ctenidium, and became significantly greater than that in the control at 12 h. DUR3-like had an apical localization in the epithelia of the ctenidial filaments and tertiary water channels. Taken together, these results indicate that DUR3-like might participate in light-enhanced urea absorption in the ctenidium of T. squamosa When made available to the symbiotic zooxanthellae that are known to possess urease, the absorbed urea can be metabolized to NH 3 and CO 2 to support amino acid synthesis and photosynthesis, respectively, during insolation. © 2018. Published by The Company of Biologists Ltd.

The relationship between movement speed and duration during soccer matches.

PubMed

Roecker, Kai; Mahler, Hubert; Heyde, Christian; Röll, Mareike; Gollhofer, Albert

2017-01-01

The relationship between the time duration of movement (t(dur)) and related maximum possible power output has been studied and modeled under many conditions. Inspired by the so-called power profiles known for discontinuous endurance sports like cycling, and the critical power concept of Monod and Scherrer, the aim of this study was to evaluate the numerical characteristics of the function between maximum horizontal movement velocity (HSpeed) and t(dur) in soccer. To evaluate this relationship, GPS data from 38 healthy soccer players and 82 game participations (≥30 min active playtime) were used to select maximum HSpeed for 21 distinct t(dur) values (between 0.3 s and 2,700 s) based on moving medians with an incremental t(dur) window-size. As a result, the relationship between HSpeed and Log(t(dur)) appeared reproducibly as a sigmoidal decay function, and could be fitted to a five-parameter equation with upper and lower asymptotes, and an inflection point, power and decrease rate. Thus, the first three parameters described individual characteristics if evaluated using mixed-model analysis. This study shows for the first time the general numerical relationship between t(dur) and HSpeed in soccer games. In contrast to former descriptions that have evaluated speed against power, HSpeed against t(dur) always yields a sigmoidal shape with a new upper asymptote. The evaluated curve fit potentially describes the maximum moving speed of individual players during the game, and allows for concise interpretations of the functional state of team sports athletes.

The relationship between movement speed and duration during soccer matches

PubMed Central

Mahler, Hubert; Heyde, Christian; Röll, Mareike; Gollhofer, Albert

2017-01-01

The relationship between the time duration of movement (t(dur)) and related maximum possible power output has been studied and modeled under many conditions. Inspired by the so-called power profiles known for discontinuous endurance sports like cycling, and the critical power concept of Monod and Scherrer, the aim of this study was to evaluate the numerical characteristics of the function between maximum horizontal movement velocity (HSpeed) and t(dur) in soccer. To evaluate this relationship, GPS data from 38 healthy soccer players and 82 game participations (≥30 min active playtime) were used to select maximum HSpeed for 21 distinct t(dur) values (between 0.3 s and 2,700 s) based on moving medians with an incremental t(dur) window-size. As a result, the relationship between HSpeed and Log(t(dur)) appeared reproducibly as a sigmoidal decay function, and could be fitted to a five-parameter equation with upper and lower asymptotes, and an inflection point, power and decrease rate. Thus, the first three parameters described individual characteristics if evaluated using mixed-model analysis. This study shows for the first time the general numerical relationship between t(dur) and HSpeed in soccer games. In contrast to former descriptions that have evaluated speed against power, HSpeed against t(dur) always yields a sigmoidal shape with a new upper asymptote. The evaluated curve fit potentially describes the maximum moving speed of individual players during the game, and allows for concise interpretations of the functional state of team sports athletes. PMID:28742832

Constitutive expression of the DUR1,2 gene in an industrial yeast strain to minimize ethyl carbamate production during Chinese rice wine fermentation.

PubMed

Wu, Dianhui; Li, Xiaomin; Lu, Jian; Chen, Jian; Zhang, Liang; Xie, Guangfa

2016-01-01

Urea and ethanol are the main precursors of ethyl carbamate (EC) in Chinese rice wine. During fermentation, urea is generated from arginine by arginase in Saccharomyces cerevisiae, and subsequently cleaved by urea amidolyase or directly transported out of the cell into the fermentation liquor, where it reacts with ethanol to form EC. To reduce the amount of EC in Chinese rice wine, we metabolically engineered two yeast strains, N85(DUR1,2) and N85(DUR1,2)-c, from the wild-type Chinese rice wine yeast strain N85. Both new strains were capable of constitutively expressing DUR1,2 (encodes urea amidolyase) and thus enhancing urea degradation. The use of N85(DUR1,2) and N85(DUR1,2)-c reduced the concentration of EC in Chinese rice wine fermented on a small-scale by 49.1% and 55.3%, respectively, relative to fermentation with the parental strain. All of the engineered strains showed good genetic stability and minimized the production of urea during fermentation, with no exogenous genes introduced during genetic manipulation, and were therefore suitable for commercialization to increase the safety of Chinese rice wine. © FEMS 2015. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

42 CFR 456.716 - DUR Board.

Code of Federal Regulations, 2011 CFR

2011-10-01

... using an electronic claims management (ECM) system, apply software approved by the Board. (iii) If prospective DUR is not conducted through an ECM system, as part of general compliance monitoring, ensure that...

42 CFR 456.716 - DUR Board.

Code of Federal Regulations, 2010 CFR

2010-10-01

... using an electronic claims management (ECM) system, apply software approved by the Board. (iii) If prospective DUR is not conducted through an ECM system, as part of general compliance monitoring, ensure that...

The Utilization of the Behavioral Sciences in Long Range Forecasting and Policy Planning

DTIC Science & Technology

1973-07-30

73 - December 31, 1973. The report will be divided into six major sections. The first will describe the analysis initiated and completed dur- ing...the half year. Results of special significance will be highlighted. Methodological problems that have arisen during the analysis will be discussed...of this analysis has been the development of a modular computer simula- tion of such operations. The oil simulation module Is then to be used

Metabolic Engineering of the Regulators in Nitrogen Catabolite Repression To Reduce the Production of Ethyl Carbamate in a Model Rice Wine System

PubMed Central

Zhao, Xinrui; Zou, Huijun; Fu, Jianwei; Chen, Jian

2014-01-01

Rice wine has been one of the most popular traditional alcoholic drinks in China. However, the presence of potentially carcinogenic ethyl carbamate (EC) in rice wine has raised a series of food safety issues. During rice wine production, the key reason for EC formation is urea accumulation, which occurs because of nitrogen catabolite repression (NCR) in Saccharomyces cerevisiae. NCR represses urea utilization by retaining Gln3p in the cytoplasm when preferred nitrogen sources are present. In order to increase the nuclear localization of Gln3p, some possible phosphorylation sites on the nuclear localization signal were mutated and the nuclear localization regulation signal was truncated, and the disruption of URE2 provided an additional method of reducing urea accumulation. By combining these strategies, the genes involved in urea utilization (DUR1,2 and DUR3) could be significantly activated in the presence of glutamine. During shake flask fermentations of the genetically modified strains, very little urea accumulated in the medium. Furthermore, the concentrations of urea and EC were reduced by 63% and 72%, respectively, in a model rice wine system. Examination of the normal nutrients in rice wine indicated that there were few differences in fermentation characteristics between the wild-type strain and the genetically modified strain. These results show that metabolic engineering of the NCR regulators has great potential as a method for eliminating EC during rice wine production. PMID:24185848

Metabolic engineering of the regulators in nitrogen catabolite repression to reduce the production of ethyl carbamate in a model rice wine system.

PubMed

Zhao, Xinrui; Zou, Huijun; Fu, Jianwei; Zhou, Jingwen; Du, Guocheng; Chen, Jian

2014-01-01

Rice wine has been one of the most popular traditional alcoholic drinks in China. However, the presence of potentially carcinogenic ethyl carbamate (EC) in rice wine has raised a series of food safety issues. During rice wine production, the key reason for EC formation is urea accumulation, which occurs because of nitrogen catabolite repression (NCR) in Saccharomyces cerevisiae. NCR represses urea utilization by retaining Gln3p in the cytoplasm when preferred nitrogen sources are present. In order to increase the nuclear localization of Gln3p, some possible phosphorylation sites on the nuclear localization signal were mutated and the nuclear localization regulation signal was truncated, and the disruption of URE2 provided an additional method of reducing urea accumulation. By combining these strategies, the genes involved in urea utilization (DUR1,2 and DUR3) could be significantly activated in the presence of glutamine. During shake flask fermentations of the genetically modified strains, very little urea accumulated in the medium. Furthermore, the concentrations of urea and EC were reduced by 63% and 72%, respectively, in a model rice wine system. Examination of the normal nutrients in rice wine indicated that there were few differences in fermentation characteristics between the wild-type strain and the genetically modified strain. These results show that metabolic engineering of the NCR regulators has great potential as a method for eliminating EC during rice wine production.

Geologic map of the Weka Dur gold deposit, Badakhshan Province, Afghanistan, modified from the 1967 original map compilation of M.P. Guguev and others

USGS Publications Warehouse

Peters, Stephen G.; Stettner, Will R.; Masonic, Linda M.

2014-01-01

The Weka Dur gold deposit lies in a cluster of other gold deposits in Badakhshan Province (Ragh district), such as the Kadar, Nesheb Dur, and Rishaw gold occurrences. These gold occurrences lie within a zone of late Hercynian folding and are most likely related to fluids that originated from orogenic processes. The Weka Dur deposit is the largest recorded gold occurrence in Afghanistan and is hosted in Proterozoic mica schist and amphibolite that is intruded by diabase dikes and other intrusive rocks. The tabular orebody is 350 meters (m) long and 2 m wide and can be traced downdip for 110 m. Mineralization consists of ochreous, brecciated schists containing high gold concentrations along gently and steeply dipping fissures. The brecciated rocks grade to 46.7 grams per ton (g/t) silver and contain arsenopyrite, galena, chalcopyrite, and scheelite. Trenches and adits were constructed, mapped, and sampled during the 1960s. Calculated resources are 958.3 kilograms of gold, averaging 4.1 g/t gold.

Effect of lung-protective ventilation-induced respiratory acidosis on the duration of neuromuscular blockade by rocuronium.

PubMed

Taguchi, Shinya; Ono, Kazumi; Hidaka, Hidekuni; Koyama, Yusuke

2016-12-01

The purpose of this study was to elucidate whether lung-protective ventilation-induced respiratory acidosis increased the duration of neuromuscular blockade by rocuronium. A total of 72 patients were enrolled. After the induction of general anesthesia, rocuronium 0.6 mg/kg real body weight was administered. Tidal volume and positive end-expiratory pressure were randomly assigned as either 10 ml/kg predicted body weight and 0 cmH 2 O (group S) or 6 ml/kg and 5 cmH 2 O (group L), respectively. Respiratory rate was started at 10/min. Neuromuscular blockade was monitored by acceleromyography at the adductor pollicis with train-of-four stimulation. The time from the initial bolus injection of rocuronium to first recovery of the first twitch was defined as DUR1. Immediately, rocuronium 0.15 mg/kg was administered. The time from first recovery of the first twitch to second recovery of the first twitch was defined as DUR2. We also measured arterial pH (pH1 and pH2, respectively). Data from 66 patients (33 each in groups L and S) were eventually available. pH1 and pH2 were significantly lower in group L compared with group S [pH1: 7.308 (7.288-7.334) vs. 7.439 (7.423-7.466); p < 0.01, pH2: 7.306 (7.285-7.330) vs. 7.453 (7.436-7.476); p < 0.01]. DUR1 and DUR2 were significantly prolonged in group L compared with group S [DUR1: 31 (24-36) vs. 24 (20-30) min; p = 0.029, DUR2: 19 (15-22) vs. 15 (12-17) min; p = 0.020]. Lung-protective ventilation-induced respiratory acidosis increased the duration of neuromuscular blockade by rocuronium.

AGARD/SMP Review Damage Tolerance for Engine Structures. 3. Component Behaviour and Life Management

DTIC Science & Technology

1990-06-01

Life Management (Revue AGARD/SMP - ToIrance aux Dommages pour les Composants de Moteurs 3. Le Comportement des Composants et la Gestion %𔄀 de Leur Dur...Structures 3. Component Behaviour and Life Management . (Revue AGARD/SMP - ToI~rance aux Dommages pour les Compos ants de Moteurs 3. Le Comportement...engine parts. The present report includes the papers presented during Workshop Ill which was devoted to Component Behaviour and Life Management . It also

Improving Military Integration in Coalitions in Africa

DTIC Science & Technology

2014-12-01

of California, Santa Cruz , April 3, 2009), http://history.ucsc.edu/undergraduate/undergraduate-research/electronic- journal/journal-pdfs/Edwards2009...44 José Manuel Durão Barroso, François Hollande, and Dioncounda Traoré, “International Donors...media/Brief_28.pdf. Barroso, José Manuel Durão, François Hollande, and Dioncounda Traoré. “International Donors Conference Joint Chairs’ Conclusions

A meta-analysis of lasalocid effects on rumen measures, beef and dairy performance, and carcass traits in cattle.

PubMed

Golder, H M; Lean, I J

2016-01-01

The effects of lasalocid on rumen measures, beef and dairy performance, and carcass traits were evaluated using meta-analysis. Meta-regression was used to investigate sources of heterogeneity. Ten studies (20 comparisons) were used in the meta-analysis on rumen measures. Lasalocid increased total VFA and ammonia concentrations by 6.46 and 1.44 m, respectively. Lasalocid increased propionate and decreased acetate and butyrate molar percentage (M%) by 4.62, 3.18, and 0.83%, respectively. Valerate M% and pH were not affected. Meta-regression found butyrate M% linearly increased with duration of lasalocid supplementation (DUR; = 0.017). When >200 mg/d was fed, propionate and valerate M% were higher and acetate M% was lower ( = 0.042, = 0.017, and = 0.005, respectively). Beef performance was assessed using 31 studies (67 comparisons). Lasalocid increased ADG by 40 g/d, improved feed-to-gain ratio (F:G) by 410 g/kg, and improved feed efficiency (FE; combined measure of G:F and the inverse of F:G). Lasalocid did not affect DMI, but heterogeneity in DMI was influenced by DUR ( = 0.004) and the linear effect of entry BW ( = 0.011). The combination of ≤100 vs. >100 d DUR and entry BW ≤275 vs. >275 kg showed that cattle ≤275 kg at entry fed lasalocid for >100 d had the lowest DMI. Heterogeneity of ADG was influenced by the linear effect of entry BW ( = 0.028) but not DUR. Combining entry BW ≤275 vs. >275 kg and DUR showed that cattle entering at >275 kg fed ≤100 d had the highest ADG. The FE ( = 0.025) and F:G ( = 0.015) linearly improved with dose, and entry BW >275 kg improved F:G ( = 0.038). Fourteen studies (25 comparisons) were used to assess carcass traits. Lasalocid increased HCW by 4.73 kg but not dressing percentage, mean fat cover, or marbling score. Heterogeneity of carcass traits was low and not affected by DUR or dose. Seven studies (11 comparisons) were used to assess dairy performance but the study power was relatively low and the evidence base is limited. Lasalocid decreased DMI in total mixed ration-fed cows by 0.89 kg/d but had no effect on milk yield, milk components, or component yields. Dose linearly decreased DMI ( = 0.049). The DUR did not affect heterogeneity of dairy measures. This work showed that lasalocid improved ADG, HCW, FE, and F:G for beef production. These findings may reflect improved energy efficiency from increased propionate M% and decreased acetate and butyrate M%. Large dairy studies are required for further evaluation of effects of lasalocid on dairy performance.

CFD Simulations of a Ferry in Head Seas

DTIC Science & Technology

2011-03-01

la durée de vie en fatigue globale du navire. Il est important, pour la conception, l’exploitation et la gestion du cycle de ...vibration de frottement qui exerce une contrainte sur la structure de coque primaire et qui a un effet défavorable sur la durée de vie en fatigue globale du ...laquelle ne peut simuler directement la physique du tossage. Le présent rapport contient les résultats d’une étude faisant

Selection and life history traits of tebufenozide-resistant sugarcane borer (Lepidoptera: Crambidae).

PubMed

Akbar, W; Ottea, J A; Beuzelin, J M; Reagan, T E; Huang, F

2008-12-01

Varying susceptibility to tebufenozide was recorded in the sugarcane borer, Diatraea saccharalis (F.) (Lepidoptera: Crambidae), collected from Louisiana sugarcane locations with different selection pressures. Results from diet incorporation bioassays with tebufenozide indicated significant increases in LC50 (3.78-fold) and LC90 (7-fold) values for a colony from Duson (DU), an area with higher selection pressure, compared with a colony from Alexandria (ALEX), an area with no selection pressure. Differences were not detected in LC50 values among colonies from areas where use of tebufenozide was discontinued or rotated with other chemistries. Selections with tebufenozide of DU larvae over 12 generations resulted in a highly resistant colony (DU-R) with 27.1- and 83.3-fold increases in LC50 and LC90 values, respectively. Comparison of pupal weight, days to pupation, and emergence after exposure to an equitoxic (LC20) concentration of tebufenozide revealed a decrease in pupal weight (34 and 33% for males and females, respectively), and an increase in days to pupation (47 and 40% for males and females, respectively), and emergence (43 and 33% for males and females, respectively) for the DU-R colony compared with the parent DU colony. Fecundity of DU-R females decreased to 72 eggs per female compared with 180 (DU) and 261 (ALEX). Egg viability of the ALEX and DU colonies was 61 and 56%, respectively, whereas only 27% of eggs laid by females from the DU-R colony hatched. These results are discussed in terms of their practical implications for control of D. saccharalis in Louisiana sugarcane.

National Dam Safety Program. Tivoli Lake Dam (Inventory Number N.Y. 52), Hudson River Basin, Rockland County, New York. Phase I Inspection Report,

DTIC Science & Technology

1980-09-30

3/8" pea gravel., Apply I coat of Uniweld or Sika Dur Hi-Mod over old concrete to insure the proper bonding. V 2. Repeat process one for section over...Bay 1. 3. Chip out cracked concrete along Bays 7 and 8, apply one coat Colma Joint Primer and fill with Colma Joint Sealer (As manufactured by Sika ) 4...deck. Cracked concrete should be repaired with Sika Dur. Hi-Mod and application of low slump nonshrink grout’ made with antihydro cement

Feasibility and preliminary effects of resistance training and nutritional supplements during versus after radiotherapy in patients with head and neck cancer: A pilot randomized trial.

PubMed

Sandmael, Jon Arne; Bye, Asta; Solheim, Tora Skeidsvoll; Stene, Guro Birgitte; Thorsen, Lene; Kaasa, Stein; Lund, Jo-Åsmund; Oldervoll, Line Merethe

2017-11-15

Patients with head and neck cancer (HNC) experience involuntary weight loss that has a negative impact on physical function, morbidity, and survival. The objective of the current study was to evaluate the feasibility of an exercise and nutrition intervention during radiotherapy (RT) compared with after RT, and to examine preliminary effects on skeletal muscle mass. Patients with HNC were randomized to an exercise and nutrition intervention during RT (EN-DUR) or after RT (EN-AF). The EN-DUR intervention was conducted at a hospital and the EN-AF intervention took place at a rehabilitation center. The interventions consisted of progressive resistance training (PRT) and oral nutritional supplements (ONS). Feasibility outcomes were tracked weekly and muscle mass was measured by computed tomography scans before and after RT and at 2 months follow-up. Of the 50 eligible patients, 41 (82%) agreed to participate. 90% of patients completed the EN-DUR intervention and the adherence to PRT and ONS was 81% and 57%, respectively. 52% of patients attended the EN-AF intervention and adherence to PRT and ONS was 94% and 76%, respectively. The EN-DUR demonstrated a trend toward mitigating loss of muscle mass during RT and the EN-AF demonstrated a similar trend after RT. No difference in muscle mass was detected between the groups from baseline to week 14. An exercise and nutrition intervention is feasible for patients with HNC during RT, and the intervention is potentially effective in mitigating loss of muscle mass both during and after RT. Future trials should assess the feasibility and effects of extended interventions during and after treatment. Cancer 2017;123:4440-8. © 2017 American Cancer Society. © 2017 American Cancer Society.

Prise en charge diagnostique et thérapeutique de la tuberculose ganglionnaire en Tunisie

PubMed Central

Ben Brahim, Hajer; Kooli, Ikbel; Aouam, Abir; Toumi, Adnene; Loussaief, Chawki; Koubaa, Jamel; Chakroun, Mohamed

2014-01-01

La tuberculose ganglionnaire est la localisation extra-pulmonaire la plus fréquente de la tuberculose. Nous nous proposons dans ce travail d’étudier les modalités diagnostiques, thérapeutiques et évolutives de cette localisation. Il s'agit d'une étude rétrospective portant sur 100 cas de tuberculose ganglionnaire. L’âge moyen était de 35 ± 15 ans (15-85 ans). Aucun malade n’était VIH positif. L'aire cervicale était la plus touchée (93 cas). L'intradermo-réaction à la tuberculine était positive dans 76/91 cas (83,5%). L'examen bactériologique des prélèvements au niveau des ganglions atteints avait mis en évidence des bacilles acido-alcoolo-résistants à l'examen direct dans 2/31 cas (6,4%) et la culture avait isolé Mycobacteruim tuberculosis dans 1/31 cas (3,2%). La cytoponction ganglionnaire (FNAC) était évocatrice de tuberculose dans 35/42 cas (83,3%). La biopsie ganglionnaire était réalisée dans 69 cas et avait permis de retenir le diagnostic de tuberculose dans tous les cas. La FNAC, comparativement à la biopsie, avait permis de raccourcir significativement le délai de la prise en charge (15,1 vs 22,8 jours; p=0,001) et la durée d'hospitalisation (17,3 vs 24,6; p=0,004). La durée moyenne du traitement antituberculeux était de 9,8 ± 4,6 mois (7 à 44 mois). Le traitement chirurgical initial avait raccourci significativement la durée du traitement médical. Il n'avait pas d'impact sur le taux de guérison. Nous avons noté 10 cas de réponse paradoxale aux antituberculeux, quatre cas de résistance clinique et une rechute dans deux cas. La tuberculose ganglionnaire pose un problème diagnostique et thérapeutique. La microbiologie est d'un faible apport. La FNAC est un moyen diagnostique très utiles dans les pays endémiques et à faibles ressources. Un traitement médical seul permet d’éviter les inconvénients de la chirurgie. PMID:25829976

Glossary of Terms and Definitions Concerning the Safety and Suitability for Service of Munitions, Explosives and Related Products (Glossaire de Termes et Definitions sur la Securite et L’Aptitude au Service de Munitions, Matieres Explosives et Produits Associes)

DTIC Science & Technology

2002-04-01

de mines à la mar jettisoned mine L lancement launch largage jettison largage de détresse en condition de sécurité safe...configuration logistique Etat des conditions d’un matériel prévu pour le stockage et le transport par voies de communication. Pour les munition...durée de vie en service, durée de vie opérationnelle, cycle de vie, conditions de stockage et de transit] ANNEX C to /ANNEXE C à

Dual-phase 99mTc-MIBI imaging and the expressions of P-gp, GST-π, and MRP1 in hyperparathyroidism.

PubMed

Xue, Jianjun; Liu, Yan; Yang, Danrong; Yu, Yan; Geng, Qianqian; Ji, Ting; Yang, Lulu; Wang, Qi; Wang, Yuanbo; Lu, Xueni; Yang, Aimin

2017-10-01

The aim of this study was to further elucidate the mechanisms of dual-phase technetium-99m methoxyisobutylisonitrile (Tc-MIBI) parathyroid imaging by exploring the association between early uptake results (EUR), delayed uptake results (DUR), and the retention index (RI) in dual-phase Tc-MIBI parathyroid imaging and P glycoprotein (P-gp), multidrug resistance-associated protein 1 (MRP1), and glutathione S-transferase-π (GST-π) expression in hyperparathyroidism (HPT). Preoperative dual-phase (early and delayed) Tc-MIBI imaging was performed on 74 patients undergoing parathyroidectomy for HPT. EUR, DUR, and RI were calculated. P-gp, MRP1, and GST-π expressions were assessed using immunohistochemistry in resected tissue from HPT and control patients. The association between P-gp, MRP1, and GST-π expressions and EUR, DUR, and RI in HPT was evaluated. The positive rate of dual-phase T c-MIBI imaging was 91.89% (68/74) and the false-negative rate was 8.11% (6/74). P-gp and GST-π expressions were higher in tissues resected from control compared with HPT patients (47.37 and 81.5%, P<0.05); there was no difference in MRP1. EUR were associated with P-gp and GST-π expressions, and DUR were associated with MRP1 expression. There was a significant difference in MRP1 expression between RI greater than or equal to 0 and RI less than 0. There was no relationship between the sensitivity of dual-phase Tc-MIBI imaging and P-gp, MRP1, and GST-π expressions in resected parathyroid tissue. The six false-negative HPT cases consisted of three P-gp (-)/MRP1 (-) tissues, three P-gp (-)/GST-π (-) tissues, and four MRP1 (-)/GST-π (-) tissues. As P-gp and GST-π expressions were higher in tissues resected from control compared with HPT patients, Tc-MIBI may wash out faster from normal parathyroid tissue surrounding the lesion compared with the lesion itself, facilitating detection.

Recurrent themes in the history of the home use of electrical stimulation: Transcranial direct current stimulation (tDCS) and the medical battery (1870-1920).

PubMed

Wexler, Anna

In recent years, neuroscientists and ethicists have warned of the dangers of the unsupervised home use of transcranial direct current stimulation (tDCS), in which individuals stimulate their own brains with low levels of electricity for self-improvement purposes. Although the home use of tDCS is often referred to as a novel phenomenon, in reality the late nineteenth and early twentieth century saw a proliferation of electrical stimulation devices for home use. In particular, the use of an object known as the medical battery bears a number of striking similarities to the modern-day use of tDCS. This article reviews a number of features thought to be unique to the present day home use of brain stimulation, with a particular focus on analogies between tDCS and the medical battery. Archival research was conducted at the Bakken Museum and at the American Medical Association's Historical Health Fraud Archives. Many of the features characterizing the contemporary home use tDCS-a do-it-yourself (DIY) movement, anti-medical establishment themes, conflicts between lay and professional usage-are a repetition of themes that occurred a century ago with regard to the medical battery. A number of features, however, seem to be unique to the present, such as the dominant discourse about risk and safety, the division between cranial and non-cranial stimulation, and utilization for cognitive enhancement purposes. Viewed in the long durée, the contemporary use of electrical stimulation at home is not a novel phenomenon, but rather the latest wave in a series of ongoing attempts by lay individuals to utilize electricity for therapeutic purposes. Copyright © 2016 Elsevier Inc. All rights reserved.

A preliminary review of coal exploration activities conducted by the government of Armenia and the coal resource potential of Armenia

USGS Publications Warehouse

Warwick, Peter D.; Pierce, B.S.; Landis, E.R.

1993-01-01

A coal resource assessment team from the U.S. Geological Survey (USGS), in cooperation with the Armenian Department of Underground Resources (DUR) and elements of the Ministry of Energy and Fuel, has completed an initial visit to Armenia under the auspices of the U.S. Agency for International Development JUSAID). The visit included discussions of the coal resources, identification of problems associated with on-going exploration and development activities, and field visits to selected solid fuel areas. The USGS team will return in November with a draft of the final report for discussion of conclusions and recommendations with Armenian counterparts, representatives of USAID, and the American Embassy. The final report, which will contain tabulated coal-sample analytical results and detailed recommendations, will be submitted to the USAID by the end of December 1993.Preliminary conclusions are that: 1) Armenia has usable deposits of coal that could form a viable, though relatively small, component of Armenia's energy budget; 2) on-going exploration and development activities must be augmented and expedited to increase understanding of the coal resource potential and subsequent utilization; 3) deficiencies in supplies (primarily fuel) and equipment (replacement of aging parts and units) have greatly reduced the gathering of necessary resource data; and 4) training of Armenian counterparts in conducting and managing coal exploration activities is desirable.

A Fish Assemblage from the Middle Eocene from Libya (Dur At-Talah) and the Earliest Record of Modern African Fish Genera

PubMed Central

Otero, Olga; Pinton, Aurélie; Cappetta, Henri; Adnet, Sylvain; Valentin, Xavier; Salem, Mustapha; Jaeger, Jean-Jacques

2015-01-01

In the early nineteen sixties, Arambourg and Magnier found some freshwater fish (i.e., Polypterus sp., Siluriformes indet. and Lates sp.) mixed with marine members in an Eocene vertebrate assemblage at Gebel Coquin, in the southern Libyan Desert. This locality, aged ca 37–39Ma and now known under the name of Dur At-Talah, has been recently excavated. A new fish assemblage, mostly composed of teeth, was collected by the Mission Paléontologique Franco-Libyenne. In this paper, we describe freshwater fish members including a dipnoan (Protopterus sp.), and several actinopterygians: bichir (Polypterus sp.), aba fish (Gymnarchus sp.), several catfishes (Chrysichthys sp. and a mochokid indet.), several characiforms (including the tiger fish Hydrocynus sp., and one or two alestin-like fish), and perciforms (including the snake-head fish Parachanna sp. and at least one cichlid). Together with the fossiliferous outcrops at Birket Qarun in Egypt, the Libyan site at Dur At-Talah reduces a 10-Ma chronological gap in the fossil record of African freshwater fish. Their fish assemblages overlap in their composition and thus constitute a rather homogenous, original and significant amount of new elements regarding the Paleogene African ichthyofauna. This supports the establishment of the modern African freshwater fish fauna during this time period because these sites mostly contain the earliest members known in modern genera. PMID:26674637

A Fish Assemblage from the Middle Eocene from Libya (Dur At-Talah) and the Earliest Record of Modern African Fish Genera.

PubMed

Otero, Olga; Pinton, Aurélie; Cappetta, Henri; Adnet, Sylvain; Valentin, Xavier; Salem, Mustapha; Jaeger, Jean-Jacques

2015-01-01

In the early nineteen sixties, Arambourg and Magnier found some freshwater fish (i.e., Polypterus sp., Siluriformes indet. and Lates sp.) mixed with marine members in an Eocene vertebrate assemblage at Gebel Coquin, in the southern Libyan Desert. This locality, aged ca 37-39Ma and now known under the name of Dur At-Talah, has been recently excavated. A new fish assemblage, mostly composed of teeth, was collected by the Mission Paléontologique Franco-Libyenne. In this paper, we describe freshwater fish members including a dipnoan (Protopterus sp.), and several actinopterygians: bichir (Polypterus sp.), aba fish (Gymnarchus sp.), several catfishes (Chrysichthys sp. and a mochokid indet.), several characiforms (including the tiger fish Hydrocynus sp., and one or two alestin-like fish), and perciforms (including the snake-head fish Parachanna sp. and at least one cichlid). Together with the fossiliferous outcrops at Birket Qarun in Egypt, the Libyan site at Dur At-Talah reduces a 10-Ma chronological gap in the fossil record of African freshwater fish. Their fish assemblages overlap in their composition and thus constitute a rather homogenous, original and significant amount of new elements regarding the Paleogene African ichthyofauna. This supports the establishment of the modern African freshwater fish fauna during this time period because these sites mostly contain the earliest members known in modern genera.

New Apterodontinae (Hyaenodontida) from the Eocene Locality of Dur At-Talah (Libya): Systematic, Paleoecological and Phylogenetical Implications

PubMed Central

Grohé, Camille; Morlo, Michael; Chaimanee, Yaowalak; Blondel, Cécile; Coster, Pauline; Valentin, Xavier; Salem, Mustapha; Bilal, Awad A.; Jaeger, Jean-Jacques; Brunet, Michel

2012-01-01

The African Hyaenodontida, mainly known from the Late Eocene and Early Oligocene Fayum depression in Egypt, show a very poor diversity in oldest Paleogene localities. Here we report new hyaenodontidans found in the late Middle Eocene deposits of Dur At-Talah (Central Libya), known to have recorded the earliest radiation of African anthropoids. The new hyaenodontidan remains are represented by dental and postcranial specimens comprising the historical material discovered by R.J.G. Savage in the last century and that of the recent Franco-Libyan campaigns. This material includes two apterodontines, in particular a subcomplete skeleton of Apterodon langebadreae nov. sp., bringing new postcranial elements to the fossil record of the genus Apterodon. Anatomical analysis of the postcranial remains of Dur At-Talah suggests a semi-aquatic lifestyle for Apterodon, a completely unusual locomotion pattern among hyaenodontidans. We also perform the first cladistic analysis of hyaenodontidans including apterodontines: Apterodon and Quasiapterodon appear close relatives to “hyainailourines”, in particular to the African Oligo-Miocene Metasinopa species. Apterodon langebadreae nov. sp. could be the most primitive species of the genus, confirming an African origin of the Apterodontinae and a further dispersion event to Europe before the early Oligocene. These data enhance our knowledge of early hyaenodontidan diversification into Africa and underline how crucial is the understanding of their evolutionary history for the improvement of Paleogene paleobiogeographic scenarii. PMID:23185292

Avanafil

MedlinePlus

... taking or have recently taken riociguat (Adempas) or nitrates such as isosorbide dinitrate (Dilatrate-SR, Isordil, in ... and nitroglycerin (Minitran, Nitro-Dur, Nitromist, Nitrostat, others). Nitrates come as tablets, sublingual (under the tongue) tablets, ...

Effect of once daily and twice daily sustained release theophylline formulations on daytime variation of bronchial hyperresponsiveness in asthmatic patients

PubMed Central

Ferrari, M.; Olivieri, M.; Lampronti, G.; Bonazza, L.; Biasin, C.; Nacci, P.; Talamini, G.; Lo, C

1997-01-01

BACKGROUND: Previous studies evaluating spirometric values and symptoms have shown that once daily theophylline administered in the evening produces greater stabilisation of the airway function in asthmatic patients than the prototype theophylline given twice a day. The aim of this study was to compare the effects on bronchial responsiveness to methacholine of an ultrasustained release theophylline formulation (Diffumal-24, Malesci, Florence, Italy) administered once a day, a sustained release theophylline formulation (Theo-Dur, Recordati, Milan, Italy) administered twice a day, and placebo. METHODS: The study was performed in 12 adult patients with asthma using a randomised, double blind, three phase, cross-over design. Each phase lasted seven days and was followed or preceded by at least three days of theophylline washout. Diffumal-24 was administered once a day at 20.00 hours whereas Theo-Dur was given twice a day at 08.00 hours and 20.00 hours. In each patient the total daily dose of theophylline was the same during both phases. The dose of the two active preparations was titrated to individual needs before the beginning of the study and then given in divided or once daily doses. At 08.00, 14.00, and 20.00 hours on day 7 of each phase serum theophylline concentrations were measured and spirometric tests (FEV1) and bronchial challenge with methacholine were also performed. RESULTS: When the administration of Diffumal-24 was compared with that of Theo-Dur, a higher serum theophylline concentration of the former was seen in the morning whereas at 20.00 hours the reverse was true. Compared with placebo, at 08.00 hours Diffumal-24 improved FEV1 whereas Theo-Dur did not (difference between treatments 0.29 1, 95% CI 0.12 to 0.45). At 08.00 hours Diffumal-24 decreased bronchial sensitivity to methacholine, expressed as a natural logarithm of PD20, to a greater extent than Theo-Dur (difference between treatments 0.54 log units, 95% CI 0.016 to 1.08). The morning advantage observed with Diffumal-24 administration was not associated with a deterioration in the state of the airway during the daytime, the protective activity against methacholine during the 12 hours of the monitoring period being constant. Furthermore there was no difference in the mean FEV1 between the two treatments at 14.00 and 20.00 hours. CONCLUSIONS: In adults with stable bronchial asthma treatment with a single dose of Diffumal-24 administered in the evening improved airflow obstruction and reduced bronchial hyperresponsiveness. 




 PMID:9487345

Toward tsunami early warning system in Indonesia by using rapid rupture durations estimation

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

Madlazim

2012-06-20

Indonesia has Indonesian Tsunami Early Warning System (Ina-TEWS) since 2008. The Ina-TEWS has used automatic processing on hypocenter; Mwp, Mw (mB) and Mj. If earthquake occurred in Ocean, depth < 70 km and magnitude > 7, then Ina-TEWS announce early warning that the earthquake can generate tsunami. However, the announcement of the Ina-TEWS is still not accuracy. Purposes of this research are to estimate earthquake rupture duration of large Indonesia earthquakes that occurred in Indian Ocean, Java, Timor sea, Banda sea, Arafura sea and Pasific ocean. We analyzed at least 330 vertical seismogram recorded by IRIS-DMC network using a directmore » procedure for rapid assessment of earthquake tsunami potential using simple measures on P-wave vertical seismograms on the velocity records, and the likelihood that the high-frequency, apparent rupture duration, T{sub dur}. T{sub dur} can be related to the critical parameters rupture length (L), depth (z), and shear modulus ({mu}) while T{sub dur} may be related to wide (W), slip (D), z or {mu}. Our analysis shows that the rupture duration has a stronger influence to generate tsunami than Mw and depth. The rupture duration gives more information on tsunami impact, Mo/{mu}, depth and size than Mw and other currently used discriminants. We show more information which known from the rupture durations. The longer rupture duration, the shallower source of the earthquake. For rupture duration greater than 50 s, the depth less than 50 km, Mw greater than 7, the longer rupture length, because T{sub dur} is proportional L and greater Mo/{mu}. Because Mo/{mu} is proportional L. So, with rupture duration information can be known information of the four parameters. We also suggest that tsunami potential is not directly related to the faulting type of source and for events that have rupture duration greater than 50 s, the earthquakes generated tsunami. With available real-time seismogram data, rapid calculation, rupture duration discriminant can be completed within 4-5 min after an earthquake occurs and thus can aid in effective, accuracy and reliable tsunami early warning for Indonesia region.« less

Test report : alternative fuels propulsion durability evaluation

DOT National Transportation Integrated Search

2012-08-28

This document, prepared by Honeywell Aerospace, Phoenix, AZ (Honeywell), contains the final : test report (public version) for the U.S. Department of Transportation/Federal Aviation : Administration (USDOT/FAA) Alternative Fuels Propulsion Engine Dur...

Position Measurement Standard Evaluation

DOT National Transportation Integrated Search

1975-02-01

The objectives of the Position Measurement Standard Program were to collect navigation data from three DME receivers and a low-frequency GLOBAL Navigation system, and evaluate their relative performance against a reference radar. Flight test data dur...

Characterizing spatial and temporal patterns of intermittent rivers

NASA Astrophysics Data System (ADS)

de Vries, Stefan B.; Hoeve, Jasper; Sauquet, Eric; Leigh, Catherine; Bonada, Núria; Fike, Kimberly; Dahm, Clifford; Booij, Martijn J.; Datry, Thibault

2015-04-01

Intermittent rivers (IRs) support high biodiversity due to their dynamic alternations between terrestrial and aquatic phases. They represent a large proportion of the river network. However the current knowledge on these ecosystems is limited. The international research project "Intermittent River Biodiversity Analysis and Synthesis" (IRBAS, www.irbas.fr) aims to collect and analyze data on IR biodiversity from France, Spain, North America and Australia. These activities ultimately should help in identifying relationships between flow regime components and ecological responses. The IRBAS project will provide guidelines for policy-makers and resource managers for effective water and habitat management, restoration and preservation. This work examines one of the aspects in the IRBAS project: studying the large-scale spatial distribution of IRs as well as the year-to-year variability of zero-flow events. IRs were described by two variables: the frequency of periods without flow (FREQ) per time period (months or years) and the total number of zero-flow days (DUR) in a specified time window (month or year). Daily discharge data from more than 1700 gauging stations with no significant human influence on flow were collected from France, Spain, Australia and conterminous United States. A minimum length of 30 years of data starting from 1970 was required with less than 5% of missing data. Climate data for France and Australia were also collected. A classification of perennial versus intermittent rivers was defined, with 455 stations out of the 1684 considered "intermittent", i.e. the gauging station records had, on average, at least 5 zero-flow days per year. The analysis of the subset of IRs showed that: - Greater than 50% of the IRs in the database is located in Australia, where only 35% of the stations are considered perennial. In Spain the proportion of IRs reaches 25%. The proportion of intermittent rivers in France (7%) is certainly underestimated as a consequence of the monitoring strategy, i.e. gauging stations have been primarily installed to measure perennial flows of medium size basins and most of the IRs remain ungauged. This is also true in the US where ~ 7% of the current and historical gage network is on intermittent rivers. - Intermittence of rivers demonstrates high seasonality which varies from one country to another. - Links between climate variability and intermittence are not straightforward. No relation was found between annual DUR and annual precipitation in France whereas DUR was significantly correlated with precipitation in Australia. Potential evapotranspiration was correlated with DUR for France, but not for Australia, where the results were more obscure. - No spatially coherent trends in flow intermittence were identified in Spain, France or the USA. Significant trends according to the Mann Kendall test were found in Australia and results suggest trends in yearly DUR consistent with observed changes in rainfall in Western Australia during the last few decades. The El Nino cycle is one of the possible sources of variability in intermittency patterns.

Evaluation of raised pavement markers for roadway delineation.

DOT National Transportation Integrated Search

1976-01-01

Reduced visibility on the highway due to adverse weather conditions results in an inability of motorists to readily observe pavement markings, signs, and vehicles. The condition that presents the most serious restriction is fog, although rainfall dur...

Evaluation of serum theophylline concentrations following administration of sustained-release beads in applesauce to asthmatic preschool children.

PubMed

Leeder, J S; Robertson, C; Correia, J; Isles, A F; Levison, H; Macleod, S M

1986-02-01

A sustained-release theophylline preparation (Theo-Dur Sprinkle) was evaluated in young asthmatic patients aged 1 to 6 years and receiving a daily dose of 23.4 +/- 2.0 mg/kg (mean +/- SD) to determine, on the basis of serial serum concentrations obtained over a 12-hour dosing interval at steady state, the suitability of such a product in patients likely to metabolize the drug very rapidly. Peak theophylline concentrations of 15.1 +/- 4.1 mg/L were achieved 5.5 +/- 1.5 hours after dosing. The mean maximum to minimum concentration difference was 6.9 +/- 2.2 mg/L for the dosing interval studied. Fluctuations in theophylline concentration less than 100% were achieved in nine of the 12 study patients. Use of the "sprinkle-technique" with Theo-Dur Sprinkle appears to be a simple and effective method of maintaining acceptable fluctuations in serum theophylline concentrations in preschool asthmatic children.

Effects of manipulating the duration and intensity of aerobic training sessions on the physical performance of rats.

PubMed

Teixeira-Coelho, Francisco; Fonseca, Cletiana Gonçalves; Barbosa, Nicolas Henrique Santos; Vaz, Filipe Ferreira; Cordeiro, Letícia Maria de Souza; Coimbra, Cândido Celso; Pires, Washington; Soares, Danusa Dias; Wanner, Samuel Penna

2017-01-01

This study investigated the effects of manipulating the load components of aerobic training sessions on the physical performance of rats. To achieve this purpose, adult male Wistar rats were divided into four groups: an untrained control (CON) group and training groups with a predominant overload in intensity (INT) or duration (DUR) or alternating and similar overloads in intensity and duration (ID). Prior to, during, and after 8 weeks of the control or training protocols, the performance of the rats (evaluated by their workload) was determined during fatiguing, incremental-speed treadmill running. Two additional incremental running tests were performed prior to and at the end of the protocols to measure the peak rate of oxygen consumption (VO2peak). As expected, the rats in the trained groups exhibited increased performance, whereas the untrained rats showed stable performance throughout the 8 weeks. Notably, the performance gain exhibited by the DUR rats reached a plateau after the 4th week. This plateau was not present in the INT or ID rats, which exhibited increased performance at the end of training protocol compared with the DUR rats. None of the training protocols changed the VO2peak values; however, these values were attained at faster speeds, which indicated increased running economy. In conclusion, our findings demonstrate that the training protocols improved the physical performance of rats, likely resulting from enhanced running economy. Furthermore, compared with overload in duration, overload in the intensity of training sessions was more effective at inducing performance improvements across the 8 weeks of the study.

Effects of manipulating the duration and intensity of aerobic training sessions on the physical performance of rats

PubMed Central

Teixeira-Coelho, Francisco; Fonseca, Cletiana Gonçalves; Barbosa, Nicolas Henrique Santos; Vaz, Filipe Ferreira; Cordeiro, Letícia Maria de Souza; Coimbra, Cândido Celso; Pires, Washington; Soares, Danusa Dias

2017-01-01

This study investigated the effects of manipulating the load components of aerobic training sessions on the physical performance of rats. To achieve this purpose, adult male Wistar rats were divided into four groups: an untrained control (CON) group and training groups with a predominant overload in intensity (INT) or duration (DUR) or alternating and similar overloads in intensity and duration (ID). Prior to, during, and after 8 weeks of the control or training protocols, the performance of the rats (evaluated by their workload) was determined during fatiguing, incremental-speed treadmill running. Two additional incremental running tests were performed prior to and at the end of the protocols to measure the peak rate of oxygen consumption (VO2peak). As expected, the rats in the trained groups exhibited increased performance, whereas the untrained rats showed stable performance throughout the 8 weeks. Notably, the performance gain exhibited by the DUR rats reached a plateau after the 4th week. This plateau was not present in the INT or ID rats, which exhibited increased performance at the end of training protocol compared with the DUR rats. None of the training protocols changed the VO2peak values; however, these values were attained at faster speeds, which indicated increased running economy. In conclusion, our findings demonstrate that the training protocols improved the physical performance of rats, likely resulting from enhanced running economy. Furthermore, compared with overload in duration, overload in the intensity of training sessions was more effective at inducing performance improvements across the 8 weeks of the study. PMID:28841706

2009 summer transportation institute.

DOT National Transportation Integrated Search

2010-01-01

Missouri LTAP at Missouri S&T has hosted a USDOT Summer Transportation Institute (STI) for the past several years. The program : has been very successful and was again offered in Summer 2009. The STI is a 2-week intensive learning experience held dur...

Volpe Center Office of Research and Technology Applications (ORTA) : FY 2013 Annual Report

DOT National Transportation Integrated Search

2013-12-01

Technology transfer activities performed by the Volpe National Transportation Systems Center during fiscal year 2013 in fulfillment of statutory Office of Research and Technology Applications (ORTA) responsibilities are summarized in this report. Dur...

Connecticut's 2003 impaired-driving high-visibility enforcement campaign

DOT National Transportation Integrated Search

2007-02-01

In 2003, Connecticut initiated a publicity and enforcement campaign to reduce impaired driving and alcohol-related fatalities, particularly among men 21 to 34 years old. The State spent nearly 4 million dollars on the campaign. The campaign began dur...

An introduction to human systems integration (HSI) in the U.S. railroad industry.

DOT National Transportation Integrated Search

2007-04-01

Human systems integration (HSI) is a systematic, organization-wide approach to : implementing new technologies and modernizing existing systems. It is a combination of : managerial philosophy, methods, techniques, and tools designed to emphasize, dur...

42 CFR 456.711 - Educational program.

Code of Federal Regulations, 2013 CFR

2013-10-01

... care educational institutions, State medical societies or State pharmacists associations/societies, or... to physicians and pharmacists in the State concerning the duties and powers of the DUR Board and the... prescribers and pharmacists who have been targeted for educational intervention on optimal prescribing...

42 CFR 456.711 - Educational program.

Code of Federal Regulations, 2010 CFR

2010-10-01

... care educational institutions, State medical societies or State pharmacists associations/societies, or... to physicians and pharmacists in the State concerning the duties and powers of the DUR Board and the... prescribers and pharmacists who have been targeted for educational intervention on optimal prescribing...

42 CFR 456.711 - Educational program.

Code of Federal Regulations, 2011 CFR

2011-10-01

... care educational institutions, State medical societies or State pharmacists associations/societies, or... to physicians and pharmacists in the State concerning the duties and powers of the DUR Board and the... prescribers and pharmacists who have been targeted for educational intervention on optimal prescribing...

42 CFR 456.711 - Educational program.

Code of Federal Regulations, 2014 CFR

2014-10-01

... care educational institutions, State medical societies or State pharmacists associations/societies, or... to physicians and pharmacists in the State concerning the duties and powers of the DUR Board and the... prescribers and pharmacists who have been targeted for educational intervention on optimal prescribing...

42 CFR 456.711 - Educational program.

Code of Federal Regulations, 2012 CFR

2012-10-01

... care educational institutions, State medical societies or State pharmacists associations/societies, or... to physicians and pharmacists in the State concerning the duties and powers of the DUR Board and the... prescribers and pharmacists who have been targeted for educational intervention on optimal prescribing...

Marine transportation : federal financing and an infrastructure investment framework

DOT National Transportation Integrated Search

2002-09-01

During fiscal years 1999, 2000, and 2001, federal expenditures for the : commercial marine transportation system averaged $3.9 billion per year. : Funding for about 80 percent of these expenditures came from the U.S. : Treasurys general fund.6 Dur...

FDP - CENTER FOR ENVIRONMENTAL SCIENCE

EPA Science Inventory

The suite of instruments that supported the research described here, collectively called the “Urban Atmosphere Observatory” (UAO), was located on the roof of the Geophysical Science Building on the campus of the University of Chicago. The following sensors operated at UAO dur...

Effect of asphalt rejuvenating agent on aged reclaimed asphalt pavement and binder properties.

DOT National Transportation Integrated Search

2016-11-01

Hot in-place recycling (HIR) preserves distressed asphalt pavements while minimizing use of virgin binder : and aggregates. The final quality of an HIR mixture depends on the characteristics of the original binder, aging of the : pavement surface dur...

Evaluation of energy absorbers for use in a roadside/median barrier.

DOT National Transportation Integrated Search

2014-02-01

Several types of elastomeric energy absorbers were evaluated for use in a Manual for Assessing Safety Hardware (MASH) : Test Level 4 (TL-4) energy-absorbing, urban roadside/median barrier. Twelve dynamic bogie tests were conducted on 60- : and 80-dur...

A quantitative microbial risk assessment for center pivot irrigation of dairy wastewaters

USDA-ARS?s Scientific Manuscript database

In the western United States where livestock wastewaters are commonly land applied, there are concerns over individuals being exposed to airborne pathogens. In response, a quantitative microbial risk assessment (QMRA) was performed to estimate infectious risks from inhaling pathogens aerosolized dur...

Best practices of using shotcrete for wall fascia and slope stabilization (phase 1 study)

DOT National Transportation Integrated Search

2017-06-01

Shotcrete has become attractive and holds potential to replace cast-in-place (CIP) concrete for elements like retaining walls and slope stabilization. However, this practice is still limited due to concerns of drying shrinkage cracking, long-term dur...

Technological Change in the U.S. Automobile Industry : Assessing Past Federal Initiatives

DOT National Transportation Integrated Search

1979-01-01

In the future, further reduction in fatalities, fuel consumption and emissions dur to automobile use will be needed. To insure that these goals are achieved, it is necessary to understand more thoroughly the role of the federal initiatives and regula...

What's Manifest in the History of SciTech: Reflections on The History Manifesto.

PubMed

Kevles, Daniel J

2016-06-01

Making nuts-and-bolts public policy is not--and never has been--the long suit of professional historians, but general historical work, whatever its durée, has done a good deal to shape discourse on public issues. Jo Guldi and David Armitage neglect that fact, as well as the opinion-shaping influence of history conveyed via nonprint media. They also ignore the large body of scholarship produced in all media during recent decades in the history of science, technology, and science-related medicine (SciTech), even though SciTech itself looms enormously large in the modern era as an instrument of national and international security, a driver of the economy, and a transformer of medicine, public health, and the environment. Much of this scholarship, even though of short durée, can illuminate salient contemporary issues, including innovation; patronage and practice; government and policy; imperialism and globalization; intellectual property; science and religion; and human rights, environment, energy, and disasters.

Prevention of GABA reduction during dough fermentation using a baker's yeast dal81 mutant.

PubMed

Ando, Akira; Nakamura, Toshihide

2016-10-01

γ-Aminobutyric acid (GABA) is consumed by yeasts during fermentation. To prevent GABA reduction in bread dough, a baker's yeast mutant AY77 deficient in GABA assimilation was characterized and utilized for wheat dough fermentation. An amber mutation in the DAL81 gene, which codes for a positive regulator of multiple nitrogen degradation pathways, was found in the AY77 strain. The qPCR analyses of genes involved in nitrogen utilization showed that transcriptional levels of the UGA1 and DUR3 genes encoding GABA transaminase and urea transporter, respectively, are severely decreased in the AY77 cells. The AY77 strain cultivated by fed-batch culture using cane molasses exhibited inferior gas production during dough fermentation compared to that of wild-type strain AY13. However, when fed with molasses containing 0.5% ammonium sulfate, the mutant strain exhibited gas production comparable to that of the AY13 strain. In contrast to the AY13 strain, which completely consumed GABA in dough within 5 h, the AY77 strain consumed no GABA under either culture condition. Dough fermentation with the dal81 mutant strain should be useful for suppression of GABA reduction in breads. Copyright © 2016 The Society for Biotechnology, Japan. Published by Elsevier B.V. All rights reserved.

The use of solar energy for heating an asphalt storage tank.

DOT National Transportation Integrated Search

1984-01-01

10,000 gal. asphalt storage tank was equipped with a solar heating system and instrumented to determine its effectiveness over a 12.5-month period. An evaluation of the data indicated that the solar system conserved 25,126 kWh of electrical power dur...

Cellulose supplementation early in life ameliorates colitis in adult mice

USDA-ARS?s Scientific Manuscript database

Decreased consumption of dietary fibers, such as cellulose, has been proposed to promote the emergence of inflammatory bowel diseases (Crohn disease and ulcerative colitis) where intestinal microbes are recognized to play an etiologic role. However, it is not known if transient fiber consumption dur...

Gasification of blended animal manures to produce synthesis gas and activated charcoal

USDA-ARS?s Scientific Manuscript database

Blended swine solids, chicken litter, and hardwood are renewable and expensive sources to produce combined heat and power (CHP), fuels and related chemicals. The therrmochemical pathway to gasify manure has the added advantage of destroying harmful pathogens and pharmaceutically active compounds dur...

Inhibitory activity of chelating agent against bacteria associated with poultry processing

USDA-ARS?s Scientific Manuscript database

Ethylenediaminetetraacetic acid (EDTA) and ethylenediamine-N, N’-disuccinic acid (EDDS) are chelating agents that can bind minerals that produce water hardness. By sequestering minerals in hard water, chelators reduce water hardness and increase the ability of cleansers to remove dirt and debris dur...

Investigations Regarding Anesthesia during Hypovolemic Conditions.

DTIC Science & Technology

1983-09-25

Wilson N, Ngsee J, Turnbull KW, Leighton K: Haemodynamics and plasma vasopressin responses with high-dose fentanyl anaesthesia dur- ing aorto-coronary...on the binding of CO2 to human haemoglobin and , . . 5. Christiansen J, Douglas CG, and Haldane on CO2 transport in the circulating blood. JS: The

Use of cultivated plants and non-plant remedies for human and animal home-medication in Liubań district, Belarus.

PubMed

Sõukand, Renata; Hrynevich, Yanina; Prakofjewa, Julia; Valodzina, Tatsiana; Vasilyeva, Iryna; Paciupa, Jury; Shrubok, Aliaksandra; Hlushko, Aliaksei; Knureva, Yana; Litvinava, Yulia; Vyskvarka, Siarhei; Silivonchyk, Hanna; Paulava, Alena; Kõiva, Mare; Kalle, Raivo

2017-10-03

To use any domestic remedy, specific knowledge and skills are required. Simple logic dictates that the use of wild plants in the context of limited interaction with nature requires prior identification, while in the case of non-plant remedies and cultivated plants this step can be omitted. This paper aims to document the current and past uses of non-plant remedies and cultivated plants in the study region for human/animal medication; to analyze the human medicinal and veterinary use areas in the context of the remedy groups; to qualitatively compare the results with relevant historical publications; and to compare the intensity and purpose of use between the remedy groups. During field studies 134 semi-structured interviews were conducted with locals from 11 villages in the Liubań district of Belarus. Currently used home-remedies as well as those used in the past were documented by employing the folk history method. The subject was approached through health-related uses, not by way of remedies. Interview records were digitalized and structured in Detailed Use Records in order to ascertain local perceptions. An Informant Consensus Factor (FIC) was calculated for remedy groups as well as for different use categories. In the human medication area the use of nearby remedies was neither very diverse nor numerous: 266 DUR for 45 taxa belonging to 27 families were recorded for cultivated plants along with 188 DUR for 58 different non-plant remedies. The FIC values for both remedy groups were lower than for wild plants. In the ethnoveterinary medicine use area there were 48 DUR referring to the use of 14 cultivated plant taxa from 12 families and 72 DUR referring to the use of 31 non-plant remedies. The FIC value for the whole veterinary use area of cultivated plants was relatively low, yet similar to the FIC of wild plants. Differences between remedy groups were pronounced, indicating that in domestic human medicine cultivated plants and non-plant remedies are either remarkably less important than wild ones or not considered worth talking about. In ethnoveterinary medicine non-plant remedies are almost equally important as wild plants, while cultivated plants are the least used. People in study area seem to still more often rely on, or are more willing to talk to strangers about, wild plants, as promoted by both official medicine and popular literature.

42 CFR 456.712 - Annual report.

Code of Federal Regulations, 2013 CFR

2013-10-01

... program. (2) A description of how pharmacies performing prospective DUR without computers are expected to...) A description of the steps taken by the State Agency to monitor compliance by pharmacies with the... entities such as the Medicaid Fraud Control Unit and State Board of Pharmacy. The annual report also must...

42 CFR 456.712 - Annual report.

Code of Federal Regulations, 2014 CFR

2014-10-01

... program. (2) A description of how pharmacies performing prospective DUR without computers are expected to...) A description of the steps taken by the State Agency to monitor compliance by pharmacies with the... entities such as the Medicaid Fraud Control Unit and State Board of Pharmacy. The annual report also must...

42 CFR 456.712 - Annual report.

Code of Federal Regulations, 2010 CFR

2010-10-01

... program. (2) A description of how pharmacies performing prospective DUR without computers are expected to...) A description of the steps taken by the State Agency to monitor compliance by pharmacies with the... entities such as the Medicaid Fraud Control Unit and State Board of Pharmacy. The annual report also must...

42 CFR 456.712 - Annual report.

Code of Federal Regulations, 2011 CFR

2011-10-01

... program. (2) A description of how pharmacies performing prospective DUR without computers are expected to...) A description of the steps taken by the State Agency to monitor compliance by pharmacies with the... entities such as the Medicaid Fraud Control Unit and State Board of Pharmacy. The annual report also must...

42 CFR 456.712 - Annual report.

Code of Federal Regulations, 2012 CFR

2012-10-01

... program. (2) A description of how pharmacies performing prospective DUR without computers are expected to...) A description of the steps taken by the State Agency to monitor compliance by pharmacies with the... entities such as the Medicaid Fraud Control Unit and State Board of Pharmacy. The annual report also must...

Parental tobacco smoke exposure: Epigenetics and the developmental origins of health and disease

EPA Science Inventory

Epigenetic programming is an important mechanism underlying the Developmental Origins of Health and Disease (DOHaD). Much of the research in this area has focused on maternal nutrition. Parental smoking has emerged as a prime example of how exposure to environmental toxicants dur...

Identification of a new species of Aphis (Hemiptera: Aphididae) based on distinct morphology

USDA-ARS?s Scientific Manuscript database

Aphis elena Lagos-Kutz and Voegtlin, sp. nov. (Hemiptera: Aphididae), is described from specimens collected in Illinois, USA, on the North American native plant, Pycnanthemum virginianum (L.) T. Dur. & B.D. Jacks. ex B.L. Rob. & Fernald (Family: Lamiaceae). Both apterous and alate viviparae are desc...

Modeling the impact of roadway emissions in light wind, stable and transition conditions

EPA Science Inventory

This paper examines the processes that govern air pollution dispersion under light wind, stable and transition conditions by using a state-of-the-art dispersion model to interpret measurements from a tracer experiment conducted next to US highway 99 in Sacramento in 1981–1982 dur...

The Secret Driving Force Behind Mongolia’s Successful Democracy

DTIC Science & Technology

2016-03-01

and media representatives from Myanmar dur- ing a recent visit to Mongolia, I was asked many questions regarding issues that we take for granted. As...the head of the Mongolian- Myanmar parliamentary group, I extended my best wishes to the Myanmar people’s effort to reform their country into a

E. coli release from streambed to water column during base flow periods: a modeling study

USDA-ARS?s Scientific Manuscript database

Microbial quality of stream water is important for recreation, irrigation, and other uses. It is usually evaluated by concentrations of fecal indicator bacteria (FIB) such as E. coli. Streambed sediments have been shown to harbor large FIB populations that could be released into the water column dur...

Sacroiliites infectieuses dans le centre tunisien: étude rétrospective de 25 cas

PubMed Central

Bellazreg, Foued; Alaya, Zeineb; Hattab, Zouhour; Lasfar, Nadia Ben; Ayeche, Mohamed Laziz Ben; Bouajina, Elyes; Letaief, Amel; Hachfi, Wissem

2016-01-01

Les sacroiliites infectieuses sont rares mais peuvent se compliquer de séquelles fonctionnelles invalidantes. Décrire les caractéristiques cliniques et bactériologiques des sacroiliites infectieuses chez les patients suivis à Sousse, Centre Tunisien. Etude rétrospective, descriptive, des cas de sacroiliites infectieuses chez les patients hospitalisés à Sousse entre 2000 et 2015. Le diagnostic a été retenu devant des signes cliniques, d'imagerie, et microbiologiques évocateurs. Vingt-cinq patients, 10 hommes et 15 femmes, d’âge moyen 41 ans (19-78) ont été inclus. Les sacroiliites étaient dues à des bactéries pyogènes dans 14 cas (56%), brucelliennes dans 6 cas (24%), et tuberculeuses dans 5 cas (20%). La durée moyenne d’évolution était de 61, 45 et 402 jours respectivement. Les signes cliniques les plus fréquents étaient les douleurs fessières (92%) et la fièvre (88%). La radiographie standard était anormale dans 75% des cas. La TDM et l'IRM sacro-iliaques dans tous les cas. Le diagnostic a été confirmé bactériologiquement dans 24 cas (96%). La durée moyenne d'antibiothérapie était de 83 jours dans les sacroiliites à pyogènes, et de 102 jours dans les SI brucelliennes. L’évolution était favorable chez 12 patients (48%), 9 patients (36%) ont gardé une douleur sacro-iliaque séquellaire, et 4 patients (16%) sont décédés. Dans notre étude, la durée d’évolution de la sacroiliite infectieuse ne permettait pas de prédire la bactérie responsable, d'où la nécessité d'obtenir une documentation bactériologique afin de prescrire une antibiothérapie appropriée. PMID:27583067

Does permanent atrial fibrillation modify response to cardiac resynchronization therapy in heart failure patients?

PubMed

Abreu, Ana; Oliveira, Mário; Silva Cunha, Pedro; Santa Clara, Helena; Portugal, Guilherme; Gonçalves Rodrigues, Inês; Santos, Vanessa; Morais, Luís; Selas, Mafalda; Soares, Rui; Branco, Luísa; Ferreira, Rui; Mota Carmo, Miguel

2017-10-01

The benefits of cardiac resynchronization therapy (CRT) documented in heart failure (HF) may be influenced by atrial fibrillation (AF). We aimed to compare CRT response in patients in AF and in sinus rhythm (SR). We prospectively studied 101 HF patients treated by CRT. Rates of clinical, echocardiographic and functional response, baseline NYHA class and variation, left ventricular ejection fraction, volumes and mass, atrial volumes, cardiopulmonary exercise test (CPET) duration (CPET dur), peak oxygen consumption (VO 2 max) and ventilatory efficiency (VE/VCO 2 slope) were compared between AF and SR patients, before and at three and six months after implantation of a CRT device. All patients achieved ≥95% biventricular pacing, and 5.7% underwent atrioventricular junction ablation. Patients were divided into AF (n=35) and SR (n=66) groups; AF patients were older, with larger atrial volumes and lower CPET dur and VO 2 max before CRT. The percentages of clinical and echocardiographic responders were similar in the two groups, but there were more functional responders in the AF group (71% vs. 39% in SR patients; p=0.012). In SR patients, left atrial volume and left ventricular mass were significantly reduced (p=0.015 and p=0.021, respectively), whereas in AF patients, CPET dur (p=0.003) and VO 2 max (p=0.001; 0.083 age-adjusted) showed larger increases. Clinical and echocardiographic response rates were similar in SR and AF patients, with a better functional response in AF. Improvement in left ventricular function and volumes occurred in both groups, but left ventricular mass reduction and left atrial reverse remodeling were seen exclusively in SR patients (ClinicalTrials.gov identifier: NCT02413151; FCT code: PTDC/DES/120249/2010). Copyright © 2017 Sociedade Portuguesa de Cardiologia. Publicado por Elsevier España, S.L.U. All rights reserved.

Functional expression of a heterologous nickel-dependent, ATP-independent urease in Saccharomyces cerevisiae.

PubMed

Milne, N; Luttik, M A H; Cueto Rojas, H F; Wahl, A; van Maris, A J A; Pronk, J T; Daran, J M

2015-07-01

In microbial processes for production of proteins, biomass and nitrogen-containing commodity chemicals, ATP requirements for nitrogen assimilation affect product yields on the energy producing substrate. In Saccharomyces cerevisiae, a current host for heterologous protein production and potential platform for production of nitrogen-containing chemicals, uptake and assimilation of ammonium requires 1 ATP per incorporated NH3. Urea assimilation by this yeast is more energy efficient but still requires 0.5 ATP per NH3 produced. To decrease ATP costs for nitrogen assimilation, the S. cerevisiae gene encoding ATP-dependent urease (DUR1,2) was replaced by a Schizosaccharomyces pombe gene encoding ATP-independent urease (ure2), along with its accessory genes ureD, ureF and ureG. Since S. pombe ure2 is a Ni(2+)-dependent enzyme and Saccharomyces cerevisiae does not express native Ni(2+)-dependent enzymes, the S. pombe high-affinity nickel-transporter gene (nic1) was also expressed. Expression of the S. pombe genes into dur1,2Δ S. cerevisiae yielded an in vitro ATP-independent urease activity of 0.44±0.01 µmol min(-1) mg protein(-1) and restored growth on urea as sole nitrogen source. Functional expression of the Nic1 transporter was essential for growth on urea at low Ni(2+) concentrations. The maximum specific growth rates of the engineered strain on urea and ammonium were lower than those of a DUR1,2 reference strain. In glucose-limited chemostat cultures with urea as nitrogen source, the engineered strain exhibited an increased release of ammonia and reduced nitrogen content of the biomass. Our results indicate a new strategy for improving yeast-based production of nitrogen-containing chemicals and demonstrate that Ni(2+)-dependent enzymes can be functionally expressed in S. cerevisiae. Copyright © 2015 International Metabolic Engineering Society. Published by Elsevier Inc. All rights reserved.

Translations on USSR Science and Technology, Biomedical and Behavioral Sciences, Number 41

DTIC Science & Technology

1978-08-07

virus infection was detected more often dur- ing an aggravation of chronic bronchitis and in patients with frequent pneu- monias in anamnesis . We also...laboratory examination hepatitis in anamnesis was detected in k (3.03/0 donors and in 13 (8.02$) members of their families. Spleno- megaly was noted in 7

An Evaluation of Perceptions of Form, Fit, Function (F3) Standardization on the Standard Inertial Navigation Unit (STD INU) Program.

DTIC Science & Technology

1987-12-01

support durring the first few years of operations, which provides an incentive for such innovations and defers the acquisition of AGE until the equipment...along with number of standard avionics programs worked and the ranks of each individual. Table 5. Expierence With Avionics Standardization Years

Prevalence of Toxoplasma gondii antibodies in domestic donkeys (Equus asinus) in Durango, Mexico slaughtered for human consumption

USDA-ARS?s Scientific Manuscript database

Background: Nothing is known about Toxoplasma gondii prevalence in donkeys in Mexico. Meat from donkey is consumed by humans in Mexico and also exported to other countries. We sought to determine the presence of antibodies against T. gondii in 239 domestic donkeys (Equus asinus) for slaughter in Dur...

Gas Chromatography-Mass Spectrometry Facility: Recent Improvements and Applications.

DTIC Science & Technology

1980-03-01

such as l- octanol despite continuous heavy use. The dur- ability of the high temperature silanized columns over a long period has not yet been fully... Octanone 4 2-Ethyl-2-hexenal 5 5-Nonanone 6 2-Nonanone 7 Linalool 8 Isopulegol 9 Unknown terpene alcohol 10 Terpinenol-4 11 2 ,6-Dimethylaniline (12 2

Ocean Data Assimilation: A Coastal Application

DTIC Science & Technology

2009-01-01

tcchnique with a semi-implicit formulation for the vertical acoustic modes (Ho- dur 1997; Hodur et al. 2002; Doyle et al. 2(08). A Robert time filter...r;,d i<l tion pyrometer was used to me<lsure SST with O. loe precision and O.SoC absolute ;Iccuracy. Sample ::l ircrllft p;Jths for J 3 August 2003

Validating the Use of "D" for Measuring Lexical Diversity in Low-Income Kindergarten Children

ERIC Educational Resources Information Center

Lai, Stephanie A.; Schwanenflugel, Paula J.

2016-01-01

Purpose: Children from low--socioeconomic status families often perform poorly on standardized vocabulary assessments. The primary purpose of the study was to determine whether lexical diversity as measured by "D" (Malvern, Richards, Chipere, & Durán, 2004) serves as a valid measure of vocabulary in at-risk, low-income, predominantly…

The Anatomy Lecture Then and Now: A Foucauldian Analysis

ERIC Educational Resources Information Center

Friesen, Norm; Roth, Wolff-Michael

2014-01-01

Although there are many points of continuity, there are also a number of changes in the pedagogical form of the anatomy lecture over the longue durée, over centuries of epistemic change, rather than over years or decades. The article begins with an analysis of the physical and technical arrangements of the early modern anatomy lecture, showing how…

Effects of early cholesterol intake on cholesterol 7 alpha hydroxylase (Cyp7a1) expression in piglets receiving sow's breast milk or infant formula until weaning

USDA-ARS?s Scientific Manuscript database

Unlike breast milk, infant formulas are not rich in cholesterol. To compensate for the dietary loss, hepatic cholesterol synthesis is increased in formula-fed infants. Observational studies have reported significant increases in serum cholesterol and triglycerides in adults that received formula dur...

A Struggle of Civilization against Barbarism: About Universities as Autonomous Zones

ERIC Educational Resources Information Center

Drainville, André C.

2016-01-01

This paper takes a longue durée look at universities at the core of the world economy, where the modern idea of intellectuals as trustees of the reflexive structures of society has achieved its most enduring institutional form. To wrest thinking away from a conformism that makes us see universities as nothing more than organisations amongst…

Development and Testing of a Sustained Release System for the Prevention of Malaria.

DTIC Science & Technology

1979-09-01

linear function of time to 100% excretion the extrapolated dur- ation of the control group would be 517 days (203 days/0.393). As used in leprosy ...use in leprosy treatment, the suspending vehicle is 40% benzyl benzoate, 60% castor oil. Solubility of WR-4593 in water is given as 3.0 pg/ml while in

The study of microstructure of wear-resistant coatings applied for protection from abrasive wear of horizontal and tilt drilling drill bits

NASA Astrophysics Data System (ADS)

Markova, I. Yu; Zakharova, E. S.; Maslov, A. L.; Polushin, N. I.; Laptev, A. I.; SOvchinnikova, M.

2017-05-01

Drill bits of the cutting type over the period of their existence have undergone significant changes - from the use of carbide cutters to diamond composite PDC elements, in which the diamond layer is applied to a hardmetal substrate. Using such elements, it was possible to significantly increase the service life of the drill bits, however, during work, there is a significant abrasive deterioration of the bit body, which does not fully realize the advantages of PDC elements. Therefore, to protect the body from wear use special wear-resistant coatings. This work is devoted to research of microstructural coatings, namely coatings brands WokaDur NiA, HR-6750, HR-6750 with sublayer Rock Dur 47 on various steel substrates which applied by the gas-thermal spraying in Ltd “Oerlikon Metko Rus”. They were examined with the use of scanning electron microscopy, X-ray phase analysis and a Vickers micro-hardness tester. It was established that the microhardness of the coating matrix is 590-660 HV, and the microhardness of tungsten carbide particles reinforcing the coating, is 2145-2455 HV.

The galenic plague: a breakdown of the imperial pathocoenosis. Pathocoenosis and longue durée.

PubMed

Gourevitch, Danielle

2005-01-01

Is 'pathocoenosis', a notion conceived and a word coined by Mirko Grmek (1969), useful as far as ancient history is concerned? The author is interested in Galenic pathocoenosis, that of doctor Galen and his Emperor Marcus Aurelius (IInd cent. A.D.), when a new 'pestilence' or 'plague' (smallpox?) devastated the whole empire, from Mesopotamia to the Danube at least.

Measurement of dimensional stability

NASA Technical Reports Server (NTRS)

Jacobs, S. F.; Berthold, J. W., III; Norton, M.

1975-01-01

A technique was developed for measuring, with a precision of one part 10 to the 9th power, changes in physical dimensions delta L/L. Measurements have commenced on five materials: Heraeus-Schott Homosil (vitreous silica), Corning 7940 (vitreous silica), Corning ULE 7971 (titanium silicate), Schott Zero-Dur, and Owens-Illinois Cer-Vit C-101. The study was extended to include Universal Cyclops Invar LR-35 and Simonds-Saw Superinvar.

Two new synanthropic species of Anyphaena Sundevall (Araneae: Anyphaenidae) associated to houses in Mexico City.

PubMed

Durán-Barrón, César G; Pérez, Tila M; Brescovit, Antonio D

2016-04-12

The family Anyphaenidae is composed by 56 genera and 542 species worldwide (World Spider Catalog 2015). These spiders, known as "ghost spiders", are wandering hunters living in a variety of environments, from forests to deserts, and can be quite abundant in different crops such as cotton, sorghum and rice (Brescovit 1996; Young & Edwards 1990; Taylor & Pfannenstiel 2008). They typically live on vegetation, among dead leaves or under loose bark and rocks (Richman & Ubick 2005) but synanthropic associations have been reported for a few species (Jiménez 1998; Guarisco 1999; Durán-Barrón et al. 2009). The genus Anyphaena has 81 species widely distributed in Asia, Central Europe, North America and Mexico (Brescovit 1996; Richman & Ubick 2005; World Spider Catalog 2015). The species from Noth America and Mexico were revised by Platnick (1974) who recognized four species groups (accentuata, celer, pectorosa and pacifica). Platnick (1977), Platnick & Lau (1975) and Brescovit & Lise (1989) complemented the revision of the genus in Central America. Presently, there are 27 species of Anyphaena recorded in Mexico (World Spider Catalog 2015), 24 of them from the celer group. Here, two new species of Anyphaena are described based in material collected during an inventory of spiders associated to houses in Mexico City, carried out by Durán-Barrón et al. (2009). Both species have the diagnostic characters of the members of the pacifica group as defined by Platnick (1974), such as the lack of leg coxal spurs and the presence of a lightly sclerotized atrium in the female epigynum. These species represent the first record of the pacifica group in Mexico. The occurrence of Anyphaenidae associated to houses was reported in Mexico by Durán-Barrón et al. (2009), who recorded Anyphaena obregon Platnick & Lau, 1975 and Hibana futilis (Banks, 1898) as frequent inhabitants inside houses. The species herein described are reported solely from urban areas and can be also characterized as frequent in these anthropic environments.

Multi-functionality of the few: current and past uses of wild plants for food and healing in Liubań region, Belarus.

PubMed

Sõukand, Renata; Hrynevich, Yanina; Vasilyeva, Iryna; Prakofjewa, Julia; Vnukovich, Yuriy; Paciupa, Jury; Hlushko, Aliaksei; Knureva, Yana; Litvinava, Yulia; Vyskvarka, Siarhei; Silivonchyk, Hanna; Paulava, Alena; Kõiva, Mare; Kalle, Raivo

2017-02-08

This study examined the use of wild plants in the food, medicinal and veterinary areas within a small territory limited to one village council in the Liubań district of Belarus. The objectives of the research were to document the current and past uses of wild plants in this region for food and human/animal medication; to analyse the food, medicinal and veterinary areas in the context of wild plants; and to qualitatively compare the results with relevant publications concerning the wild food plants of Belarus. Fieldwork was carried out as a practical part of a development cooperation project in May 2016 in 11 villages of the Liubań district. One hundred thirty-four respondents were selected randomly. Information about local uses of wild plants was obtained via semi-structured interviews and the folk-history method. Interview records were digitalized and the data structured in Detailed Use Records (DUR), which were divided into food, medicinal and veterinary areas and then analysed to ascertain local perceptions. A total of 2252 DUR of wild plants were recorded. Eighty-eight wild plant taxa belonging to 45 plant families were used across all three areas. Of these, 58 taxa were used in the food, 74 in the medicinal and 23 in the veterinary areas. A relatively high percentage of the taxa were used in both the food and medicinal areas (55%) and an even greater percentage in both the medicinal and veterinary areas (87%). Comparison with earlier research on wild food plants shows the considerable difference among seldom-mentioned taxa or uses, showing possible regional differences despite the homogenization of the population during the Soviet era. As the majority of taxa with overlapping uses belonged to the most utilized plants, there appears to be clear a tendency to use plants in several different areas once they are brought into the home. This may be due to the need to maximize the versatility of limited resources. While the number of wild taxa used is relatively high, the mean number of taxa used per person is quite low, which indicates the relatively minor importance of wild plants in the respective areas in the study region. The low importance of snacks signals that unintended contact with nature has been lost.

Medical Surveillance Monthly Report. Volume 21, Number 6

DTIC Science & Technology

2014-06-01

presentations of diarrhea and vomiting (e.g., botulism, brucellosis, hep- atitis A, trichinosis, and typhoid fever ). For the purposes of this report...norovirus, salmonellosis, shigellosis, trichinosis, and typhoid fever . Informa- tion on GI outbreaks that occurred dur- ing the surveillance period, but... Typhoid fever 8 5 1 . 2 Listeriosis 4 1 1 1 1 Cholera 3 3 . . . Vibrio parahaemolyticus 3 2 . 1 . Trichinosis 3 1 1 1 . Botulism 2 . 2 . . Cyclospora

Traces of Old and New Center-Periphery Dynamics in Language-in-Education Policy and Practice: Insights from a Linguistic Ethnographic Study in Timor-Leste

ERIC Educational Resources Information Center

Da Costa Cabral, Ildegrada; Martin-Jones, Marilyn

2017-01-01

This article reveals how center-periphery relations have unfolded, over time, in language policy processes in one nation--Timor-Leste--on the global periphery. We take a "longue durée" perspective on the language policy processes at work in this historical context, showing how different regimes of language were imposed, in the past, by…

High Frontier: The Journal for Space and Cyberspace Professionals. Volume 6, Number 4, August 2010

DTIC Science & Technology

2010-08-01

information that warfighters rely on is likely to be useless (a three-way disaster is, anyway, logically impossible; if the global information grid...processing, exploitation, and dissemination (TCPED) of information . Space and cyber systems collectively provide the core functionality of the TCPED...rather than crisis management procedures. Space and cyber operations have several similarities dur- ing and can be extremely useful for informing Phase

National Energy Policy: Report of the National Energy Policy Development Group

DTIC Science & Technology

2001-05-01

and the environ- ment. Oil spill technology has improved dur- ing the last decade and will continue to do so. Risk assessments ...chemical intermediate in paper pulping and ore refining, and as a solvent. Transportation Sector: Private and public vehicles that move people and ...Energy Security and International Relationships Appendix One Summary of Report Recommendations Appendix Two Glossary 1 2 3 4 5 6 7 8 NATIONAL

Inclusive Security and Peaceful Societies: Exploring the Evidence

DTIC Science & Technology

2016-03-01

655 mothers to deradicalize 1,024 young men and boys , rehabilitating INCLUSIVE SECURITY AND PEACEFUL SOCIETIES PRISM 6, no. 1 FEATURES | 23 The...approaches to breaking impasses dur- ing a stalled peace process, from nonviolent sit-ins to unorthodox tactics like blocking doors or even withholding sex ...Processes,” (New York: International Peace Institute, 2015). 9 Valerie Hudson, Bonnie Ballif-Spanvill, Mary Caprioli, and Chad F. Emmett, Sex and

PRESENTED AT COPENHAGEN WORKSHOP ON ENVIRONMENTAL, REPRODUCTIVE HEALTH AND FERTILITY, COPENHAGEN, DENMARK, 1/15-18/2005: GST M1 GENOTYPE INFLUENCES SPERM DNA DAMAGE ASSOCIATED WITH EXPOSURE TO AIR POLLUTION

EPA Science Inventory

Exposure to episodic air pollution in the Czech Republic has been associated with abnormal semen quality and sperm DNA damage (EHP 108:887;2000). A subsequent longitudinal study evaluated semen from 36 men sampled up to 7 times over a period of two years to capture exposures dur...

China Report, Economic Affairs.

DTIC Science & Technology

1985-01-16

indirect benefits ( ecological benefits). For example, they regulate the climate, conserve water and soil, beautify the environment, and cleanse the...mankind’s need for wood and wooden articles will not only not decline, but will rapidly grow. Therefore, the possibility of using forests as a source...lack firewood for 90 to 150 days dur- ing the year. In areas with serious shortage, they are actually without fire- wood half the time every year

Physiological Tolerance to Uncompensable Heat Stress: Effects of Exercise Intensity, Protective Clothing, and Climate

DTIC Science & Technology

1994-01-01

Physiological tolerance to uncompensable heat stress: effects of exercise intensity, protective clothing , and climate SCOTT J. MONTAIN, MICHAEL N...effects of exercise 26), there remains little information to predict the inci- intensity, protective clothing , and climate. J. AppL PhysioL dence of...that pre- exercise intensity, protective clothing level, and climate on dict the physiological responses and work capability dur- physiological tolerance

Moving Forward, Looking Back--Historical Perspective, "Big History" and the Return of the "Longue Durée": Time to Develop Our Scale Hopping Muscles

ERIC Educational Resources Information Center

Hawkey, Kate

2015-01-01

"Big history" is a term receiving a great deal of attention at present, particularly in North America where considerable sums of money have been invested in designing curricula and assessment tools to help teachers teach history at far larger scales of time than normal. Hawkey considers the pros and cons of incorporating components of…

The Feasibility and Usability of the Read It Again Dual Language and Literacy Curriculum

ERIC Educational Resources Information Center

Durán, Lillian K.; Gorman, Brenda K.; Kohlmeier, Theresa; Callard, Chase

2016-01-01

The purpose of this paper is to describe the components, usability, and feasibility of a new Read it Again-Dual Language curriculum (RIA-DL; Durán et al. n.d.). The RIA-DL is based on the Read it Again-PreK! (Justice and McGinty 2009) and adapted to meet the unique needs of Spanish-English bilingual preschoolers. The curriculum targets…

Nanoparticles and Ocean Optics

DTIC Science & Technology

2008-09-30

Form 298 (Rev. 8-98) Prescribed by ANSI Std Z39-18 quent dilution experiments have included eukaryotic hosts ( Emiliania huxleyi) and its specific...the Gulf of Maine. This virus (ø 43) infected the coccolithophore, Emiliania huxleyi, at a rapid rate that we have never observed in a eukaryotic...2008). The paper describes how viruses infecting the marine coccolithophore, Emiliania huxleyi, were isolated from waters of the Gulf of Maine dur­

Holocene Millennial-scale Surface and Bottom Water Variability, Feni Drift, NE Atlantic Ocean: Foraminiferal Assemblages

NASA Astrophysics Data System (ADS)

Lassen, S. J.; Richter, T. O.; de Stigter, H. C.; van Weering, T. C. E.; de Haas, H.

A high-resolution sediment core from Feni Drift (ENAM9606, 56N 14W, 2543 m wa- ter depth) was investigated for planktonic and benthic foraminiferal assemblages dur- ing the last 12,000 years. During the Preboreal, peak abundances of T.quinqueloba indicate the passage of the Arctic front over the core site. Holocene planktonic foraminiferal assemblages indicate a gradual warming trend of surface water masses punctuated by a major cooling (8,200ky event s.l.), and possibly a slight cooling dur- ing the last 3,000 years. The interval from 10 to 5kyrs shows higher and fluctuating abundances of T.quinqueloba and G.bulloides, which suggest proximity of the subarc- tic front and enhanced spring blooms compared to the upper Holocene. Abundance peaks of N.pachyderma(s) and/or T.quinqueloba indicate a series of millennial-scale cooling events during the entire Holocene, which can be correlated to similar episodes previously described from other locations in the North Atlantic and Norwegian- Greenland Sea. Benthic foraminiferal assemblages indicate a gradual transition from seasonal, spring-bloom related food supply in the Lower Holocene (dominance of the phytodetritus species E.exigua) to possibly lower, but more sustained food supply in the Upper Holocene (dominance of C.obtusa and C.laevigata).

Tolerance to acetic acid is improved by mutations of the TATA-binding protein gene.

PubMed

An, Jieun; Kwon, Hyeji; Kim, Eunjung; Lee, Young Mi; Ko, Hyeok Jin; Park, Hongjae; Choi, In-Geol; Kim, Sooah; Kim, Kyoung Heon; Kim, Wankee; Choi, Wonja

2015-03-01

Screening a library of overexpressing mutant alleles of the TATA-binding gene SPT15 yielded two Saccharomyces cerevisiae strains (MRRC 3252 and 3253) with enhanced tolerance to acetic acid. They were also tolerant to propionic acid and hydrogen peroxide. Transcriptome profile analysis identified 58 upregulated genes and 106 downregulated genes in MRRC 3252. Stress- and protein synthesis-related transcription factors were predominantly enriched in the upregulated and downregulated genes respectively. Eight deletion mutants for some of the highly downregulated genes were acetic acid-tolerant. The level of intracellular reactive oxygen species was considerably lessened in MRRC 3252 and 3253 upon exposure to acetic acid. Metabolome profile analysis revealed that intracellular concentrations of 5 and 102 metabolites were increased and decreased, respectively, in MRRC 3252, featuring a large increase of urea and a significant decrease of amino acids. The dur1/2Δmutant, in which the urea degradation gene DUR1/2 is deleted, displayed enhanced tolerance to acetic acid. Enhanced tolerance to acetic acid was also observed on the medium containing a low concentration of amino acids. Taken together, this study identified two SPT15 alleles, nine gene deletions and low concentration of amino acids in the medium that confer enhanced tolerance to acetic acid. © 2014 Society for Applied Microbiology and John Wiley & Sons Ltd.

Air Break During Preoxygenation and Risk of Altitude Decompression Sickness

DTIC Science & Technology

2010-10-01

examination and were representative of the USAF rated aircrew popula- tion. They were not allowed to participate in scuba div- ing, hyperbaric exposures, or...subjects dur- ing the hypobaric exposures and the subjects were not questioned about how they felt during the altitude ex- posures. Each subject was...to consult with the physicians in Hyperbaric Medicine within the same building. Endpoints of the exposures were: 1) comple- tion of the scheduled

Interpolation of the Radial Velocity Data from Coastal HF Radars

DTIC Science & Technology

2013-01-01

practical applications and may help to solve many environmental problems caused by human activity. References [1] Alvera -Azcarate A., A. Barth, M. Rixen...surface temperature, Ocean Modelling, 9,325-346. [2] Alvera -Azcarate, A., A. Barth,. J.-M. Beckers, and R. H. Weisber, 2007: Multivari- ate...predictions from the global Navy Coastal Ocean Model (NCOM) dur- ing 1998-2001,7. Atmos. Oceanic TechnoL, 21(12), 1876-1894. [4] Barth, A., Alvera

Noise Abatement and Internal Vibrational Absorption in Potential Structural Materials

DTIC Science & Technology

1975-03-01

martensitic transformation tempera- ture ranges. In contrast, much acoustic activity was detected dur- ing transformation in experiments using 7^ P...S0 Hi alloys in which "burst-type" martensitic transformation is known to occur (4). The above experiments indicate that the mechanism of... martensitic trans- formation in the highly damping NiTi alloys is of the thermo-elas- tic mode. In order to establish a stable transformation behavior as

A Study of Patient’s Self-Image during Orthodontic Treatment.

DTIC Science & Technology

1985-06-01

Orthodontic Treatment 4. PERFORMING ORG. REPORT NUMMER 7. AUTHOR(a) U. CONTRACT OR GRANT NUMBER(@) Brian B. Jacobus, Jr. . PERFORMING ORGANIZATION NAME AND...with a correction of the patient’s malocclusion through orthodontic treatment. A study was done to determine what changes occur in the orthodontic ...patient’s self-image dur S ing orthodontic treatment. A questionnaire requiring re- sponses pertaining to self-image was distributed to three hundred

JPRS Report, Soviet Union, Economic Affairs

DTIC Science & Technology

1988-08-18

nonreproducible and their depletion dur- ing the planned period can demand increasing expendi- tures on extraction or import and so forth). With such...fabrics, of oil on the production of dyes, of electric motors on the extraction and pumping of oil, of wire on electric motor winding, and so...exactly what amount should coal prices be raised and how to take into account in profit taxes extraction conditions, which even in two mines located next

Interim Report on Scientific Basis for Paint Stripping: Mechanism of Methylene Chloride Based Paint Removers

DTIC Science & Technology

2010-10-18

NICK N ESTERUK JACK KELLEY TOM B RASWELL U.S. Army Research Laboratory Aberdeen Proving Ground, Maryland October 18, 2010 Approved for public ...release; distribution is unlimited. REPORT DOCUMENTATION PAGE Form Approved OMS No. 0704-0188 PUblIC reporting DUrClen lOr lOIS COIlBC\\lOn... public release; distribution is unlimited. 13. SUPPLEMENTARY NOTES ·Science Applications International Corporation (SAIC), 4555 Overlook Ave, SW, Bldg

Anti PD-L1 DUrvalumab combined with Cetuximab and RadiOtherapy in locally advanced squamous cell carcinoma of the head and neck: A phase I/II study (DUCRO).

PubMed

Bonomo, Pierluigi; Desideri, Isacco; Loi, Mauro; Mangoni, Monica; Sottili, Mariangela; Marrazzo, Livia; Talamonti, Cinzia; Greto, Daniela; Pallotta, Stefania; Livi, Lorenzo

2018-02-01

Head and neck squamous cell carcinoma (HNSCC) has been increasingly recognized as an immune suppressive malignancy. The efficacy of immune checkpoint inhibitors (ICI's) in the context of recurrent/metastatic (R/M) setting anticipates the possible integration of immunotherapy into the therapeutic armamentarium of locally advanced disease. Durvalumab (DUR) is a humanized monoclonal IgG1, anti-PD-L1 antibody with promising data in R/M HNSCC. The aim of our study is to test the antitumor activity of a combined regimen incorporating an immune checkpoint inhibitor into a conventional bio-radiation strategy for the cure of unfavorable locally advanced HNSCC. In this open label, multi-center, single-arm, phase I/II study, enrolled patients will receive Radiotherapy (RT) (69.9 Gy/2.12 Gy in 33 fractions) with concurrent Cetuximab (CTX) (400 mg/m 2 1 week before RT start followed by 250 mg/m 2 weekly) and DUR (fixed dose of 1500 mg every 4 weeks starting from RT-CTX week 1) followed by adjuvant DUR (to a maximum of 6 months after completion of RT-CTX). Primary endpoint of the study is 2-year progression-free survival (PFS). A safety run-in is planned after the enrollment of first 12, 24 and 36 patients. Patients affected by high-risk (≥N2a or ≥T3, any N) larynx, hypopharynx and HPV negative oropharynx or HPV-positive oropharynx (≥T2, ≥N2b, ≥10 pack/years) will be eligible. Conventional intensification strategies failed to provide any benefit for the cure of locally advanced HNSCC. For the still prevalent HPV-negative population and the high risk-HPV positive disease, there is an unmet need for alternative treatment paradigms. Potentially, the inhibition of the PD-1/PD-L1 checkpoint may synergize with both CTX and RT through immunologic interplay, ultimately aiming to reverse the HNSCC-induced immune suppression. The DUCRO study will seek to demonstrate if such a strategy may be safe and active. NCT number: NCT03051906Eudract number: 2016-004668-20.

Millennium Cohort: Enrollment Begins A 21-Year Contribution to Understanding the Impact of Military Service

DTIC Science & Technology

2007-01-01

10.1016/j.jclinepi.2006.05.009population [13,14]. Others suggest that the psychological and physical effects of deployment may have a greater im- pact on...missions may all contribute to increased symptom reporting or psychological distress dur- ing and after deployment [17e25]. Observations that U.S...panic syndrome, other anxiety syndrome, bulimia nervosa, alcohol abuse, and binge-eating disorders, (overall accuracy 5 0.85, 85%); (sensitivity 5

Medical Surveillance Monthly Report

DTIC Science & Technology

2016-10-01

women aged 30–70 years suffering from OSA.2 The prevalence of OSA has been ris- ing and is associated with changing obe- sity prevalence, as obesity is...information on the burden of disease in military subpopulations and the associa- tion of obesity with OSA. M E T H O D S The surveillance period for this...of the Defense Manpower Data Center), marital status, and obesity sta- tus. To calculate obese person-time dur- ing the surveillance period

Air and Space Power Journal. Volume 16, Number 3, Fall 2002

DTIC Science & Technology

2002-01-01

undersea sensor grid. The prehostilities phase of any crisis is a prime period for special operations—especially in the ISR role. SOF operations...application abound: Adolf Hitler’s references to the Luftwaffe dur­ ing the reoccupation of the Rhineland in 1936 or the Munich crisis of 1938...Kennedy’s reliance on Strategic Air Command’s B-52s and missile force during the Cuban missile crisis of 1962, among others. Although the framework

Fiscally Sound Options for a Flawed Tanker Recapitalization Strategy

DTIC Science & Technology

2011-01-01

estimated that the last aircraft will not be replaced until it is more than 100 years old. From a pure time perspective, this would be analogous to flying... aircraft .3 Dur- ing congressional testimony, Gen Duncan McNabb, commander of US Transporta- tion Command, reiterated the importance of air refueling: “My...31.5 billion contract to Boeing in February 2011 to build 179 KC-X aircraft .8 However, this acquisition falls 236 air- craft short of recapitalizing

Effects of inspiratory impedance on the carotid-cardiac baroreflex response in humans.

DTIC Science & Technology

2004-08-01

seems con- traindicated, it is similar to the concurrent elevation in HR and arterial blood pressure responses observed dur- ing physical exercise.Two...expect withdrawal of vagal activity and no significant change in sympathetic activity with heart rate below 100 bpm during physical exercise [31]. To... quadriplegics . Am J Physiol Regulatory Integrative Comp Physiol 260: R576–R580 7. Convertino VA, Doerr DF, Eckberg DL, Fritsch JM, Vernikos-Danellis J

ROAM mutations causing increased expression of yeast genes: their activation by signals directed toward conjugation functions and their formation by insertion of tyl repetitive elements

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

Errede, B.; Cardillo, T.S.; Wever, G.

1980-01-01

Mechanisms available to eukaryotic organisms for the coordinate regulation of gene expression are being examined by genetic and biochemical characterization of an unusual mutation, CYC7-H2, which causes overproduction of iso-2-cytochrome c in the yeast Saccharomyces cerevisiae. The CYC7-H2 mutation causes approximately a twenty fold overproduction of iso-2-cytochrome c in haploid strains but only a one to four fold overproduction in MATa/MAT..cap alpha.. diploid strains. This regulation of overproduction has been characterized as a response to signals controlling conjugation in yeast. The CYC7-H2 mutation is closely related to other regulatory mutations occurring at the cargA, cargB and DUR1,2 loci which aremore » the structural genes for arginase, ornithine transaminase and urea amidolyase, respectively. Similar to the CYC7-H2 mutation, the mutations designated cargA/sup +/O/sup h/, cargB/sup +/O/sup h/ and durO/sup h/ cause constitutive production of their respective gene products at much lower levels in MATa/MAT..cap alpha.. diploid strains than in the corresponding haploid strains. Observations characterizing the regulation of overproduction in the CYC7-H2 mutant are presented with the additional and parallel observations for the O/sup h/ mutants.« less

Reading The History Manifesto as a Historian of Mathematics in Ancient China.

PubMed

Chemla, Karine

2016-06-01

The History Manifesto invites historians to consider the social and political responsibilities attached to their profession. This general concern is equally meaningful for the field of history and for the history and philosophy of science and technology. The specific concerns that motivate Jo Guldi and David Armitage lead them to advocate the "longue durée" and to insist primarily on social inequality, climate change, and governance. The concern on which this response to The History Manifesto centers is historians' social.responsibility in the waging of wars and their ethical responsibility at least not to contribute to mounting tensions. For the historian Lucien Febvre, in the immediate aftermath of World War II, a history of science and culture practiced in a certain way had a specific part to play in this regard. Febvre's practice of long-term history differed from Fernand Braudel's approach to the longue durée, in the tradition of which Guldi and Armitage situate their manifesto. This essay suggests that a historical approach to long-term history, sensitive to the concern Febvre voiced, might be helpful. It argues that long-term histories of science and technology practiced in a certain way have contributed to shaping collectives that perceive themselves as communities. Critical analysis of our practices as historians could certainly help develop awareness in our field in this respect.

ADDRESSING THE DEFICIT: Updating the Budgetary Implications of Selected GAO Work

DTIC Science & Technology

1996-06-01

DGPS DI DLA DOD DOE DOT DUR EDWAA EM EPA FAIR FAA FAS FDIC FHWA FY GAO GSA HACCP HCFA HHS HMO HUD IDB IFAD INS IRS JCT...Marti, the broadcasts are constantly and effectively jammed , USIA’S research data shows that, mainly as a result of the jamming , the number of Cubans...hours (from 3:30 am to 8:00 am), but Cuban jamming also expanded. In an attempt to overcome jamming , TV Marti has plans to convert from VHF to UHF

Single-Nutrient Effects on Immunologic Functions. Report of a Workshop Sponsored by the Department of Food and Nutrition and Its Nutrition Advisory Group of the American Medical Association

DTIC Science & Technology

1981-01-02

brucellosis, dur- in control subjects. Persistent leuko- min E in healthy volunteers inhibit ing iron repletion therapy .’" cytosis in magnesium-deficient...isoniazid reaction. An anergic patient could be liferative responsiveness of lympho- therapy (pyridoxine deficiency). studied further by purposeful der...suppressive therapy , a high-PUFA sons currently consume large quanti- ty to generate a localized inflammato- diet caused an additional delay in the ties of

Medical Surveillance Monthly Report (MSMR). Volume 23, Number 2, February 2016

DTIC Science & Technology

2016-05-06

the past 20 years.3 Th e expansion of the cur- rent epidemic that began in the early 2000s was primarily attributable to increased cases among men...disease screening. In the early 20th century, it was estimated that 5% of Army enlistees had evidence of some type of venereal disease.11 Wasserman...conjunction with early screening dur- ing World War II, led to near eradica- tion of syphilis among active duty Army soldiers.11 Screening for syphilis in

Specialists Meeting on Helicopter Design Mission Load Spectra

DTIC Science & Technology

1976-08-01

partement Scientifique AEROSPATIAI*E - B.P n0 13 13 722 -AINN 1I INTRODUCTION Si 1e princips g~ndral de d~tarmination des dur~ea de vie des pibcea d’h...reprdsentatives de l’utilisation h 6valuer un certain nombro do jauges.extensom~triques. Coa jauges , placgos sur chacun des 4ldmonte critiquos au point do Vuo...sensitivity. 1. INTRODUCTION The design of the fatigue critical components of a helicopter, which are mainly the blades, the hub, and the drive system

Ion Deposited Carbon Coatings.

DTIC Science & Technology

1983-07-01

levels correspondant i la transition entre les nivellux 2 piao and 5 d, of the kr-ypton-86 atom. 2 p,,, et 5 d5, de l’atow~e krypton 86. kilogram (kg...6gal A la [Mafsse (II prototype inItern ational du the kilogram. (The international prototype of kilogrananric. the kilogram is at particular cylinder...seconde (s) The second is the duration of 9 192 631 770 La seconde est IaI dur&e de 9 192 63 1 770 periods of the radiation corresponding to the perioiles

Command Flight Path Display. Phase I and II. Appendix F.

DTIC Science & Technology

1983-09-01

AD -R145 858 COMMAND FLIGHT PATH DISPLAY PHASE I AND 11 APPENDIX F / (U) SYSTEMS ASSOCIATES INC LONG BEACH CA RESOURCE MANAGEMENT SYSTEMS DIY SEP...34- (Appendix F) .ś. SYSTEMS ASSOCIATES INC* of CALIFORNIA t. Resource Management Systems Division DTICL it~~~ll ELECTE 1 o..-- , ~SEP 2 4 1984...Availability Codos Avail and/or Dist Special "i j L i 7 7 .... Contained in this appendix are the various plots generated dur- ing data reduction. Parameters

National Space Council Users' Advisory Group

NASA Image and Video Library

2018-06-19

Users' Advisory Group member Faith Ozmen, CEO of the Sierra Nevada Corporation is seen durring the first meeting of the National Space Council Users' Advisory Group, Tuesday, June 19, 2018 at NASA Headquarters in Washington. The Users' Advisory Group will advise and inform the National Space Council on a broad range of aerospace topics, including the impacts of U.S. and international laws and regulations, national security space priorities, scientific and human space exploration priorities, and ways to bolster support. Photo Credit: (NASA/Joel Kowsky)

Environmental & Water Quality Operational Studies: Improved Description of Selective Withdrawal through Point Sinks.

DTIC Science & Technology

1987-03-01

Sink’ by G. A. Lawrence," Second International Symposium on Stratified Flows, Trondheim, Norway. Hino, M ., and Furusawa , M . 1969. "Experiments on...Hydrulic LaoratryInvironmental Laboratory 6c ADDRESS (01y. Stat,, aed lV~IP b ADDRESS (CRY. Stat, M ad Wd) PO Box 631 PO Box631 Vicksburg, NS 39180-0631...than 1 cm dur- ing testing and that diffuse interfaces resulted in an experimentally 11 / , . .. , n_ .. mm m m I n ---- mm __ro ___ III I IIIIIj .4

Development of Equipment for Explosive Drilling.

DTIC Science & Technology

1976-06-01

create an .eplosive drillirg capabilityw. Saftey . capsule procu-iIbility- & a xplos ive loading of the "apout* %mrs ,rie conaldelo tion dur!in design...the Mobile Drill Company , installed. 1he drill is driven through a power take-off arrangement by the truck motor. This equipment was recrnmnended by... applied in an axial direction. Its motion is also pr-vented by a lock created by a bzl held in engagement with a groove in the pin by a spring clip. When

The Pentomic Era. The U. S. Army Between Korea and Vietnam

DTIC Science & Technology

1986-01-01

Army recruiters advertise their Service’s commit. ment to high technology by carrying replicas of the NIKE Ajax missile on top of their sedans in the...by replacing the olive drab uniform 23 US Army recruiters advertise their Service’s commitment to high technology 25 Secretary of Defense Charles E...Staff, 1955-59 45 A NIKE missila guards America in 1957 79 A NIKE missile knocks down a B-17 drone 81 The Army shows off its new NIKE Ajax missile dur

Influence of Obstructive Jaundice on Pharmacodynamics of Rocuronium

PubMed Central

Lin, Mi-Jia; Tan, Bo; Qiu, Hai-Bo; Yu, Wei-Feng

2013-01-01

Background Anesthetics are variable in patients with obstructive jaundice. The minimum alveolar concentration awake of desflurane is reduced in patients with obstructive jaundice, while it has no effect on pharmacodynamics and pharmacokinetics of propofol. In this study, we investigated the influence of obstructive jaundice on the pharmacodynamics and blood concentration of rocuronium. Methods Included in this study were 26 control patients and 27 patients with obstructive jaundice. Neuromuscular block of rocuronium was monitored by acceleromyography. Onset time, spontaneous recovery of the height of twitch first (T1) to 25% of the final T1 value (Duration 25%, Dur 25%), recovery index (RI), and spontaneous recovery of train-of-four (TOF) ratios to 70% were measured. The plasma rocuronium concentrations were determined by high performance liquid chromatography using berberine as an internal standard. Results There was no significant difference in onset time between the two groups. The Dur 25%, the recovery index and the time of recovery of the TOF ratios to 70% were all prolonged in the obstructive jaundice group compared with the control group. The plasma concentration of rocuronium at 60, 90 and 120 min after bolus administration was significantly higher in the obstructive jaundice group. Conclusions The neuromuscular blockade by rocuronium is prolonged in obstructive jaundice patients, and therefore precautions should be taken in case of postoperative residual neuromuscular block. The possible reason is impedance of rocuronium excretion due to biliary obstruction and increased plasma unbound rocuronium because of free bilirubin competing with it for albumin binding. PMID:24147111

Influence of obstructive jaundice on pharmacodynamics of rocuronium.

PubMed

Wang, Zhen-Meng; Zhang, Peng; Lin, Mi-Jia; Tan, Bo; Qiu, Hai-Bo; Yu, Wei-Feng

2013-01-01

Anesthetics are variable in patients with obstructive jaundice. The minimum alveolar concentration awake of desflurane is reduced in patients with obstructive jaundice, while it has no effect on pharmacodynamics and pharmacokinetics of propofol. In this study, we investigated the influence of obstructive jaundice on the pharmacodynamics and blood concentration of rocuronium. Included in this study were 26 control patients and 27 patients with obstructive jaundice. Neuromuscular block of rocuronium was monitored by acceleromyography. Onset time, spontaneous recovery of the height of twitch first (T1) to 25% of the final T1 value (Duration 25%, Dur 25%), recovery index (RI), and spontaneous recovery of train-of-four (TOF) ratios to 70% were measured. The plasma rocuronium concentrations were determined by high performance liquid chromatography using berberine as an internal standard. There was no significant difference in onset time between the two groups. The Dur 25%, the recovery index and the time of recovery of the TOF ratios to 70% were all prolonged in the obstructive jaundice group compared with the control group. The plasma concentration of rocuronium at 60, 90 and 120 min after bolus administration was significantly higher in the obstructive jaundice group. The neuromuscular blockade by rocuronium is prolonged in obstructive jaundice patients, and therefore precautions should be taken in case of postoperative residual neuromuscular block. The possible reason is impedance of rocuronium excretion due to biliary obstruction and increased plasma unbound rocuronium because of free bilirubin competing with it for albumin binding.

Alterations in the Aedes aegypti Transcriptome during Infection with West Nile, Dengue and Yellow Fever Viruses

PubMed Central

Colpitts, Tonya M.; Cox, Jonathan; Vanlandingham, Dana L.; Feitosa, Fabiana M.; Cheng, Gong; Kurscheid, Sebastian; Wang, Penghua; Krishnan, Manoj N.; Higgs, Stephen; Fikrig, Erol

2011-01-01

West Nile (WNV), dengue (DENV) and yellow fever (YFV) viruses are (re)emerging, mosquito-borne flaviviruses that cause human disease and mortality worldwide. Alterations in mosquito gene expression common and unique to individual flaviviral infections are poorly understood. Here, we present a microarray analysis of the Aedes aegypti transcriptome over time during infection with DENV, WNV or YFV. We identified 203 mosquito genes that were ≥5-fold differentially up-regulated (DUR) and 202 genes that were ≥10-fold differentially down-regulated (DDR) during infection with one of the three flaviviruses. Comparative analysis revealed that the expression profile of 20 DUR genes and 15 DDR genes was quite similar between the three flaviviruses on D1 of infection, indicating a potentially conserved transcriptomic signature of flaviviral infection. Bioinformatics analysis revealed changes in expression of genes from diverse cellular processes, including ion binding, transport, metabolic processes and peptidase activity. We also demonstrate that virally-regulated gene expression is tissue-specific. The overexpression of several virally down-regulated genes decreased WNV infection in mosquito cells and Aedes aegypti mosquitoes. Among these, a pupal cuticle protein was shown to bind WNV envelope protein, leading to inhibition of infection in vitro and the prevention of lethal WNV encephalitis in mice. This work provides an extensive list of targets for controlling flaviviral infection in mosquitoes that may also be used to develop broad preventative and therapeutic measures for multiple flaviviruses. PMID:21909258

Alterations in the Aedes aegypti transcriptome during infection with West Nile, dengue and yellow fever viruses.

PubMed

Colpitts, Tonya M; Cox, Jonathan; Vanlandingham, Dana L; Feitosa, Fabiana M; Cheng, Gong; Kurscheid, Sebastian; Wang, Penghua; Krishnan, Manoj N; Higgs, Stephen; Fikrig, Erol

2011-09-01

West Nile (WNV), dengue (DENV) and yellow fever (YFV) viruses are (re)emerging, mosquito-borne flaviviruses that cause human disease and mortality worldwide. Alterations in mosquito gene expression common and unique to individual flaviviral infections are poorly understood. Here, we present a microarray analysis of the Aedes aegypti transcriptome over time during infection with DENV, WNV or YFV. We identified 203 mosquito genes that were ≥ 5-fold differentially up-regulated (DUR) and 202 genes that were ≥ 10-fold differentially down-regulated (DDR) during infection with one of the three flaviviruses. Comparative analysis revealed that the expression profile of 20 DUR genes and 15 DDR genes was quite similar between the three flaviviruses on D1 of infection, indicating a potentially conserved transcriptomic signature of flaviviral infection. Bioinformatics analysis revealed changes in expression of genes from diverse cellular processes, including ion binding, transport, metabolic processes and peptidase activity. We also demonstrate that virally-regulated gene expression is tissue-specific. The overexpression of several virally down-regulated genes decreased WNV infection in mosquito cells and Aedes aegypti mosquitoes. Among these, a pupal cuticle protein was shown to bind WNV envelope protein, leading to inhibition of infection in vitro and the prevention of lethal WNV encephalitis in mice. This work provides an extensive list of targets for controlling flaviviral infection in mosquitoes that may also be used to develop broad preventative and therapeutic measures for multiple flaviviruses.

L’évaluation systématique des instruments pour mesurer la douleur chez les personnes âgées ayant des capacités réduites à communiquer*

PubMed Central

Aubin, Michèle; Giguère, Anik; Hadjistavropoulos, Thomas; Verreault, René

2007-01-01

La douleur chronique est souvent sous-détectée et insuffisamment traitée dans les milieux de soins de longue durée. Les outils d’autorapport (ou autoévaluation) de la douleur, comme l’échelle visuelle analogique, n’ont été validés que partiellement chez les populations âgées, en raison de la prévalence élevée de déficits visuels, auditifs, moteurs et cognitifs que l’on y trouve. Des outils d’observation des patients ont été développés pour pallier ces difficultés d’utilisation des échelles d’autorapport de la douleur. Le présent projet vise l’identification de ces échelles et leur évaluation sur la base de la validité de contenu (12 questions), de la validité de construit (12 questions), de la fiabilité (13 questions) et de l’utilité clinique (10 questions). Parmi les 24 instruments recensés, plusieurs apparaissent prometteurs pour évaluer la douleur chez les personnes âgées atteintes de démence sévère. Des efforts additionnels de validation sont cependant requis avant leur intégration à la pratique régulière en soins de longue durée. PMID:17717611

Microfiltration of skim milk and modified skim milk using a 0.1-µm ceramic uniform transmembrane pressure system at temperatures of 50, 55, 60, and 65°C.

PubMed

Hurt, E E; Adams, M C; Barbano, D M

2015-02-01

Increasing the temperature of microfiltration (MF) to >50°C may allow for operation at higher fluxes and reduce the bacterial growth during MF. However, there is a concern that operating at higher temperatures could cause calcium phosphate precipitation that would lead to membrane fouling. Our objective was to determine the effect of operating a 0.1-µm ceramic uniform transmembrane pressure MF unit at temperatures of 50, 55, 60, and 65°C on membrane fouling and serum protein (SP) removal from skim milk with and without removal of low-molecular-weight soluble milk components by ultrafiltration (UF) before MF at a flux of 54kg/m(2) per hour. For each replicate, 1,000kg of pasteurized skim milk was split into 2 batches. One batch was ultrafiltered (with diafiltration) to remove an average of 89±2% of the lactose and a percentage of the soluble calcium and phosphorus. The retentate from UF was diluted back to the protein concentration of skim milk, creating the diluted UF retentate (DUR). On subsequent days, both the DUR and skim milk were run on the MF unit with the flux maintained at 54kg/m(2) per hour and a concentration factor of 3× and the system run in recycle mode. The temperature of MF was increased in 5°C steps from 50 to 65°C, with a 1-h stabilization period after each increase. During the run, transmembrane pressure was monitored and permeate and retentate samples were taken and analyzed to determine if any changes in SP, calcium, or phosphorus passage through the membrane occurred. Increasing temperature of MF from 50 to 65°C at a flux of 54kg/m(2) per hour did not produce a large increase in membrane fouling when using either skim milk or a DUR as the MF feed type as measured by changes in transmembrane pressure. Increasing the temperature to 65°C only caused a slight reduction in calcium concentration in the permeate (11±3%) that was similar between the 2MF feed types. Increasing processing temperature reduced the percentage of SP removal by the process, but the increased temperature also caused a decrease in casein contamination in the permeate with no evidence of membrane fouling. Copyright © 2015 American Dairy Science Association. Published by Elsevier Inc. All rights reserved.

Spaceborne Ocean Intelligence Network: SOIN - Fiscal Year 10/11 Year-End Summary

DTIC Science & Technology

2011-10-01

la Reine (en droit du Canada), telle que représentée par le ministre de ...d’ouverture (RSO) de RADARSAT-2. La phase II en cours, d’une durée de trois ans, portera sur l’opérationnalisation et la mise en œuvre des capacités du RSRO...gouvernementales en observation de la Terre (IGOT). Le présent rapport donne un résumé des activités et des réalisations du projet durant l’exercice

L'Aventure du LHC

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

None

2010-06-11

Cette présentation s’adressera principalement aux personnes qui ont construit le LHC. La construction du LHC fut longue et difficile. De nombreux problèmes sont apparus en cours de route. Tous ont été résolus grâce au dévouement et à l’engagement du personnel et des collaborateurs. Je reviendrai sur les coups durs et les réussites qui ont marqués ces 15 dernières années et je vous montrerai combien cette machine, le fruit de vos efforts, est extraordinaire.

Two Dimensional Movement Patterns of Juvenile Winter Run and Late Fall Run Chinook Salmon at the Fremont Weir, Sacramento River, CA

DTIC Science & Technology

2017-07-01

ER D C/ EL T R- 17 -1 0 Two-Dimensional Movement Patterns of Juvenile Winter- Run and Late-Fall- Run Chinook Salmon at the Fremont Weir...default. ERDC/EL TR-17-10 July 2017 Two-Dimensional Movement Patterns of Juvenile Winter- Run and Late-Fall- Run Chinook Salmon at the Fremont Weir...Sacramento River, smaller winter- run Chinook and larger late-fall- run Chinook salmon were tagged and released into a 2D telemetry array dur- ing the

Analysis of Human Communication during Assembly Tasks.

DTIC Science & Technology

1986-06-01

AD-A7l 43 ANALYSIS OF HUMAN COMMUNICATION DURING ASSEMBLY TASKS in1(U) CRNEGIE-MELLO UNIY PITTSBURGH PA ROBOTICS INST UNCLSSIIEDK S BARBER ET AL...ao I Dur~~~~IngAbcbyTs; 7c .S:in i lSAo .0. Analysis of Human Communication During Assembly Tasks K. Suzanne Barber and Gerald J. Agin CMU-RI-TR-86-1...TYPE or REPORT & PE-Rioo CevCZaz Analysis of Human Communication During Assembly Inlterim Tasks I . PERFORMING 00RG. REPORT NUMBER 1. £UT~oOR~e) IL

Construction Productivity Advancement Research (CPAR) Program: Improved Materials and Processes for Sealing and Resealing Joints in Portland Cement Concrete Pavements - Field Evaluation

DTIC Science & Technology

1993-10-01

sealant was determined by noting the type and number of defects each sealant incurred. Figure 4 provides a sample evaluation sheet used dur- ing the field...was conducted by visually inspect- ing the mater~al for defects . If any defects were noted, the type of defect was described and the quant~ty of that... defect was measured. The quantity of the defect was dividted by the total quantity of sealant and the result reported as percent defect . Adhesion and

[Not Available].

PubMed

Chaibdraa, A; Bentakouk, M C

2008-03-31

Le pronostic des brûlures est souvent tributaire de complications infectieuses. Les objectifs de cette étude préliminaire rétrospective sont une évaluation de la flore microbienne et ses fluctuations selon la durée d'hospitalisation chez les patients du Centre des brûlés adultes de Annaba (Algérie). Ce travail porte sur 633 prélèvements microbiologiques positifs obtenus entre juin 2003 (inauguration du service) et décembre 2005. Selon le site de prélèvement la répartition est: cutané (78%), hémoculture (9%), prélèvement trachéo-bronchique (4%), uroculture (3%), sonde urinaire (3%), cathéter(3%). Les germes isolés sont: les staphylocoques (58%), les Pseudomonas (20%), le Candida albicans (5%), l'Acinetobacter (3%) et les autres germes (14%). Parmi les staphylocoques et les Pseudomonas recensés, respectivement 19% et 11% sont isolés la première semaine, contre 43% et 52% au-delà de 21 jours. Ces résultats confrontés aux données de la littérature confirment la prédominance du staphylocoque et du Pseudomonas. Le risque de contamination à partir des techniques invasives de réanimation est commun à toutes les équipes. La prolifération bactérienne est en relation avec la durée d'hospitalisation. Ces constatations doivent nous inciter à tirer bénéfice de l'expérience des autres services, en particulier sur les moyens, accessibles, de prévention de l'infection nosocomiale.

Functional analysis of TamA, a coactivator of nitrogen-regulated gene expression in Aspergillus nidulans.

PubMed

Small, A J; Todd, R B; Zanker, M C; Delimitrou, S; Hynes, M J; Davis, M A

2001-06-01

The tam A gene of Aspergillus nidulans encodes a 739-amino acid protein with similarity to Uga35p/Dal81p/DurLp of Saccharomyces cerevisiae. It has been proposed that TamA functions as a co-activator of AreA, the major nitrogen regulatory protein in A. nidulans. Because AreA functions as a transcriptional activator under nitrogen-limiting conditions, we investigated whether TamA was also present in the nucleus. We found that a GFP-TamA fusion protein was predominantly localised to the nucleus in the presence and absence of ammonium, and that AreA was not required for this distribution. As the predicted DNA-binding domain of TamA is not essential for function, we have used a number of approaches to further define functionally important regions. We have cloned the tamA gene of A. oryzae and compared its functional and sequence characteristics with those of A. nidulans tamA and S. cerevisiae UGA35/DAL81/DURL. The Aspergillus homologues are highly conserved and functionally interchangeable, whereas the S. cerevisiae gene does not complement a tamA mutant when expressed in A. nidulans. Uga35p/Dal81p/DurLp was also found to be unable to recruit AreA. The sequence changes in a number of tamA mutant alleles were determined, and altered versions of TamA were tested for tamA complementation and interaction with AreA. Changes in most regions of TamA appeared to destroy its function, suggesting that the overall conformation of the protein may be critical for its activity.

The City’s Many Faces: Proceedings of the RAND Arroyo-MCWL-J8 UWG Urban Operations Conference, April 13-14 1999

DTIC Science & Technology

1999-04-14

fact, learn much about the many faces a city can present dur- ing military urban operations. Nearly a third of those at the podium had " seen the urban...Monrovia, and Freetown were but a sampling of the world’s metropolises that had seen U.S. forces in their streets during the decade before. Equally as...propulsion This shows you the Army investment strategy. Many of you have probably seen this. I’ve overlaid it with a few pictures that reach out into

Effect of Variables Independent of Performance on Promotion Rates to Major, Lieutenant Colonel, and Colonel in the Marine Corps

DTIC Science & Technology

1992-09-01

1 54. 1 71. 50s css/3:Cfautsbulation (count) tables For ALS-N &MARSTAT-M &SOURCE-USNA & DEGREE-UNDRG3RAD SELECTED DUrYSTA QUA FMF NON HOM REC 104 3...MARS1’AT-M & SOURCE- USNA __________________& DEGREE-UNDRGRAD ____ ________ SELECTED DUTrYSTA QUA FMF NON HQM REC 104 1 2.9 29. 62. 6.7 0 N so 33...M & SOURCE-OCS ___________________& DEGREE-ADVANCED ____ ________ SELECrED DUTrYSTA QUA FMF NON HOM REC N 72 7 2241 1 1 Y 198 471 104 16 3 X~SELECMD

Guidebook for Integrating a Micro Unmanned Aerial System (UAS) into Police and Emergency Operations

DTIC Science & Technology

2012-10-01

operate and must fly at higher altitudes . The fact that manned aircraft can carry personnel onboard also provides benefits as they can make on the...coûteux à utiliser et ils doivent voler à des altitudes plus élevées. Le fait que les aéronefs avec pilote à bord puissent transporter du personnel à...durée à très basse altitude permettant de prendre des photos de très près. Suffisamment petits pour tenir dans une valise, les micro-UAS sont très

The Dependency of the United States on Foreign Markets for Strategic Raw Materials and Its Effect on National Strategy

DTIC Science & Technology

1989-02-16

resources.. to expand its mi I i tar’Y po,,ier iAji tr, very fe. worr i es. Sub .equer t to the Second .or 1 War , howe,.er-, the instruments :,f + wa r h a...of America during the American Civil Wbar an: Japan dur i ng the Second IWor l d War . CONFEDERATE STATES OF AMERICA The American Civil War is an...THE DEPENDENCY OF THE UNITED STATES ON FOREIGN MARKETS FOR STRATEGIC RAW MATERIALS AND ITS EFFECT ON NATIONAL STRATEGY C) A Monograph N’ by

Identifying and managing inappropriate hospital utilization: a policy synthesis.

PubMed Central

Payne, S M

1987-01-01

Utilization review, the assessment of the appropriateness and efficiency of hospital care through review of the medical record, and utilization management, deliberate action by payers or hospital administrators to influence providers of hospital services to increase the efficiency and effectiveness with which services are provided, are valuable but relatively unfamiliar strategies for containing hospital costs. The purpose of this synthesis is to increase awareness of the scope of and potential for these approaches among health services managers and administrators, third-party payers, policy analysts, and health services researchers. The synthesis will assist the reader to trace the conceptual context and the historical development of utilization review from unstructured methods using individual physicians' professional judgment to structured methods using explicit criteria; to establish the context of utilization review and clarify its uses; to understand the concepts and tools used in assessing the efficiency of hospital use; and to select, design, and evaluate utilization review and utilization management programs. The extent of inappropriate (medical unnecessary) hospital utilization and the factors associated with it are described. Implications for managers, providers, and third-party payers in targeting utilization review and in designing and evaluating utilization management programs are discussed. PMID:3121538

42 CFR 456.200 - Scope.

Code of Federal Regulations, 2010 CFR

2010-10-01

... ASSISTANCE PROGRAMS UTILIZATION CONTROL Utilization Control: Mental Hospitals Utilization Review (ur) Plan... requirements for a written utilization review (UR) plan for each mental hospital providing Medicaid services...

No regional difference in cisatracurium dose-response and time-course-of-action between patients in China and Bosnia.

PubMed

Dahaba, A A; Suljevic, I; Bornemann, H; Wu, X-M; Metzler, H

2011-03-01

Variability in drug response could result from a variety of genetic and environmental factors that are often hard to define or quantify. A number of studies demonstrated regional geographic variations in potency of neuromuscular blocking agents (NMBAs). The aim of our study was to compare dose-response and time-course-of-action of cisatracurium besylate, an NMBA eliminated via the Hoffman degradation, in two countries with different life habits, diet, and ambient conditions; being Han Chinese in China and Caucasians in Bosnia. Neuromuscular block of cisatracurium 20 µg kg(-1), followed by four incremental 10 µg kg(-1) doses, and the remainder of 100 µg kg(-1) was evaluated using the Relaxometer mechanomyograph (Groningen University, Groningen, The Netherlands). Dose-response curves were created using log-dose-probit-response transformation. There were no significant differences in cisatracurium mean (95% confidence intervals) ED(50), ED(90), and ED(95) (effective doses for 50%, 90%, and 95% first twitch depression) in Caucasian [39.1 (35.7-42.3), 50.6 (45.5-54.3), and 54.4 (49.8-58.9) µg kg(-1)] compared with Chinese patients [39.2 (35.1-43.1), 52.4 (47.9-56.8), and 56.9 (52.8-61.9) µg kg(-1)], respectively. There were no significant differences in mean (sd) Dur(25) and Dur(0.9) (time until 25% first twitch and 0.9 train-of-four ratio recoveries) in Caucasian [47.1 (6.4) and 77.5 (9.1) min)] compared with Chinese patients [(45.9 (4.7) and 72.3 (9.1) min)], respectively. Cisatracurium dose-response relationship and time-course-of-action were not influenced by geographic location. Thus, cisatracurium would not require dose adjustments between patients living in the two geographic locations.

Hydroponics versus field lysimeter studies of urea, ammonium and nitrate uptake by oilseed rape (Brassica napus L.).

PubMed

Arkoun, Mustapha; Sarda, Xavier; Jannin, Laëtitia; Laîné, Philippe; Etienne, Philippe; Garcia-Mina, José-Maria; Yvin, Jean-Claude; Ourry, Alain

2012-09-01

N-fertilizer use efficiencies are affected by their chemical composition and suffer from potential N-losses by volatilization. In a field lysimeter experiment, (15)N-labelled fertilizers were used to follow N uptake by Brassica napus L. and assess N-losses by volatilization. Use of urea with NBPT (urease inhibitor) showed the best efficiency with the lowest N losses (8% of N applied compared with 25% with urea alone). Plants receiving ammonium sulphate, had similar yield achieved through a better N mobilization from vegetative tissues to the seeds, despite a lower N uptake resulting from a higher volatilization (43% of applied N). Amounts of (15)N in the plant were also higher when plants were fertilized with ammonium nitrate but N-losses reached 23% of applied N. In parallel, hydroponic experiments showed a deleterious effect of ammonium and urea on the growth of oilseed rape. This was alleviated by the nitrate supply, which was preferentially taken up. B. napus was also characterized by a very low potential for urea uptake. BnDUR3 and BnAMT1, encoding urea and ammonium transporters, were up-regulated by urea, suggesting that urea-grown plants suffered from nitrogen deficiency. The results also suggested a role for nitrate as a signal for the expression of BnDUR3, in addition to its role as a major nutrient. Overall, the results of the hydroponic study showed that urea itself does not contribute significantly to the N nutrition of oilseed rape. Moreover, it may contribute indirectly since a better use efficiency for urea fertilizer, which was further increased by the application of a urease inhibitor, was observed in the lysimeter study.

Etude Bacteriologique sur 30 Mois dans un Service de Brulés

PubMed Central

Chaibdraa, A.; Bentakouk, M.C.

2008-01-01

Summary Le pronostic des brûlures est souvent tributaire de complications infectieuses. Les objectifs de cette étude préliminaire rétrospective sont une évaluation de la flore microbienne et ses fluctuations selon la durée d'hospitalisation chez les patients du Centre des brûlés adultes de Annaba (Algérie). Ce travail porte sur 633 prélèvements microbiologiques positifs obtenus entre juin 2003 (inauguration du service) et décembre 2005. Selon le site de prélèvement la répartition est: cutané (78%), hémoculture (9%), prélèvement trachéo-bronchique (4%), uroculture (3%), sonde urinaire (3%), cathéter(3%). Les germes isolés sont: les staphylocoques (58%), les Pseudomonas (20%), le Candida albicans (5%), l'Acinetobacter (3%) et les autres germes (14%). Parmi les staphylocoques et les Pseudomonas recensés, respectivement 19% et 11% sont isolés la première semaine, contre 43% et 52% au-delà de 21 jours. Ces résultats confrontés aux données de la littérature confirment la prédominance du staphylocoque et du Pseudomonas. Le risque de contamination à partir des techniques invasives de réanimation est commun à toutes les équipes. La prolifération bactérienne est en relation avec la durée d'hospitalisation. Ces constatations doivent nous inciter à tirer bénéfice de l'expérience des autres services, en particulier sur les moyens, accessibles, de prévention de l'infection nosocomiale. PMID:21991102

Acute water quality criteria for polycyclic aromatic hydrocarbons, pesticides, plastic additives, and 4-Nonylphenol in seawater.

PubMed

Durán, I; Beiras, R

2017-05-01

Probabilistic environmental quality criteria for Naphthalene (Nap), Phenanthrene (Phe), Fluoranthene (Flu), Pyrene (Pyr), Triclosan (TCS), Tributyltin (TBT), Chlorpyrifos (CPY), Diuron (DUR), γ-Hexaclorocyclohexane (γ-HCH), Bisphenol A (BPA) and 4-Nonylphenol (4-NP) were derived from acute toxicity data using saltwater species representative of marine ecosystems, including algae, mollusks, crustaceans, echinoderms and chordates. Preferably, data concerns sublethal endpoints and early life stages from bioassays conducted in our laboratory, but the data set was completed with a broad literature survey. The Water Quality Criteria (WQC) obtained for TBT (7.1·10 -3  μg L -1 ) and CPY (6.6· 10 -3  μg L -1 ) were orders of magnitude lower than those obtained for PAHs (ranging from 3.75 to 45.2 μg L -1 ), BPA (27.7 μg L -1 ), TCS (8.66 μg L -1 ) and 4-NP (1.52 μg L -1 ). Critical values for DUR and HCH were 0.1 and 0.057 μg L -1 respectively. Within this context, non-selective toxicants could be quantitatively defined as those showing a maximum variability in toxicity thresholds (TT) of 3 orders of magnitude across the whole range of marine diversity, and a cumulative distribution of the TT fitting to a single log-logistic curve, while for selective toxicants variability was consistently found to span 5 orders of magnitude and the TT distribution showed a bimodal pattern. For the latter, protective WQC must be derived taking into account the SSD of the sensitive taxa only. Copyright © 2017 Elsevier Ltd. All rights reserved.

Observational Requirements for High-Fidelity Reverberation Mapping

NASA Technical Reports Server (NTRS)

Horne, Keith; Peterson, Bradley M.; Collier, Stefan J.; Netzer, Hagai

2004-01-01

We present a series of simulations to demonstrate that high-fidelity velocity-delay maps of the emission-line regions in active galactic nuclei can be obtained from time-resolved spectrophotometric data sets like those that will arise from the proposed Kronos satellite. While previous reverberation-mapping experiments have established the size scale R of the broad emission-line regions from the mean time delay tau = R/c between the line and continuum variations and have provided strong evidence for supermassive black holes, the detailed structure and kinematics of the broad-line region remain ambiguous and poorly constrained. Here we outline the technical improvements that will be required to successfully map broad-line regions by reverberation techniques. For typical AGN continuum light curves, characterized by power-law power spectra P (f) is proportional to f(exp -alpha) with a = -1.5 +/- 0.5, our simulations show that a small UV/optical spectrometer like Kronos will clearly distinguish between currently viable alternative kinematic models. From spectra sampled at time intervals Delta t and sustained for a total duration T(sub dur), we can reconstruct high-fidelity velocity-delay maps with velocity resolution comparable to that of the spectra, and delay resolution Delta tau approx. 2 Delta t, provided T(sub dur) exceeds the broad-line region light crossing time by at least a factor of three. Even very complicated kinematical models, such as a Keplerian flow with superimposed spiral wave pattern, are resolved in maps from our simulated Kronos datasets. Reverberation mapping with Kronos data is therefore likely deliver the first clear maps of the geometry and kinematics in the broad emission-line regions 1-100 microarcseconds from supermassive black holes.

Characteristics of private-sector managed care for mental health and substance abuse treatment.

PubMed

Garnick, D W; Hendricks, A M; Dulski, J D; Thorpe, K E; Horgan, C

1994-12-01

This study examined diversity during the late 1980s in managed care programs for mental health, alcohol abuse, and drug abuse to identify ways in which research can generate more meaningful data on the effectiveness of utilization review programs. Telephone interviews were conducted with representatives of utilization review programs for employee health insurance plans in 31 firms that employed 2.1 million people in 1990. Questions addressed qualifications of personnel, clinical criteria to authorize care, integration with employee assistance plans, penalties for not complying with utilization review procedures, outpatient review, and carve out of mental health and substance abuse review. Large variations in utilization review programs were found. Programs employed a range of review personnel and used a variety of clinical criteria to authorize care. More than two-thirds did not carve out mental health and substance abuse review from medical-surgical review. Some firms' employee assistance plans were integrated with utilization review programs, while others remained unintegrated. Penalties for not following program procedures varied widely, as did review of outpatient services. Because of trends toward even more diversity in utilization review programs in the 1990s, research that identifies the specific features of managed care programs that hold most promise for controlling costs while maintaining quality of care will increasingly be needed.

42 CFR 488.64 - Remote facility variances for utilization review requirements.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 42 Public Health 5 2010-10-01 2010-10-01 false Remote facility variances for utilization review... PROCEDURES Special Requirements § 488.64 Remote facility variances for utilization review requirements. (a... such facility or direct responsibility for the care of the patients being reviewed or, in the case of a...

Noise Levels and Data Correction Analysis for Seven General Aviation Propeller Aircraft.

DTIC Science & Technology

1980-09-01

31-1 60 M, NORTH THRESHOLD RNWY. 13 DATE: JUNE 19,1978 EVENT EPNL DBA(M) DBD (M) OASPL PNL(M) PNLT(M) DUR(P) TC AEPNL * I APPROACH 2 87.2 78.7 85.6...DOT/TSC 10/18/78 SUMMARY NOISE LEVEL. DATA AS MEASURED * SITE NO. 31-2 2000 M. NORTH THRESHOLD RNWY. 13 DATE: JUNE 19,1978 EVENT EPNL DBA(M) DBD (M...DOT/TSC 11/13/78 SUMMARY NOISE LEVEL DATA AS MEASURED SITE NO, 31-3 3485 M, NORTH THRESHOLD RNWY. 13 DATE: JUNE 19P1978 EVENT EPNL DBA(M) DBD (M) OASPL

Bowen and Drew durring EVA 1

NASA Image and Video Library

2011-02-28

ISS026-E-030864 (28 Feb. 2011) --- NASA astronauts Steve Bowen (foreground) and Alvin Drew, both STS-133 mission specialists, participate in the mission?s first session of extravehicular activity (EVA) as construction and maintenance continue on the International Space Station. During the six-hour, 34-minute spacewalk, Bowen and Drew installed the J612 power extension cable, move a failed ammonia pump module to the External Stowage Platform 2 on the Quest Airlock for return to Earth at a later date, installed a camera wedge on the right hand truss segment, installed extensions to the mobile transporter rail and exposed the Japanese ?Message in a Bottle? experiment to space.

Bowen and Drew durring EVA 1

NASA Image and Video Library

2011-02-28

ISS026-E-030716 (28 Feb. 2011) --- NASA astronauts Steve Bowen (foreground) and Alvin Drew, both STS-133 mission specialists, participate in the mission?s first session of extravehicular activity (EVA) as construction and maintenance continue on the International Space Station. During the six-hour, 34-minute spacewalk, Bowen and Drew installed the J612 power extension cable, move a failed ammonia pump module to the External Stowage Platform 2 on the Quest Airlock for return to Earth at a later date, installed a camera wedge on the right hand truss segment, installed extensions to the mobile transporter rail and exposed the Japanese ?Message in a Bottle? experiment to space.

Bowen durring EVA 1

NASA Image and Video Library

2011-02-28

ISS026-E-030715 (28 Feb. 2011) --- NASA astronauts Steve Bowen and Alvin Drew (mostly obscured at center right), both STS-133 mission specialists, participate in the mission?s first session of extravehicular activity (EVA) as construction and maintenance continue on the International Space Station. During the six-hour, 34-minute spacewalk, Bowen and Drew installed the J612 power extension cable, move a failed ammonia pump module to the External Stowage Platform 2 on the Quest Airlock for return to Earth at a later date, installed a camera wedge on the right hand truss segment, installed extensions to the mobile transporter rail and exposed the Japanese ?Message in a Bottle? experiment to space.

Bowen and Drew durring EVA 1

NASA Image and Video Library

2011-02-28

ISS026-E-030869 (28 Feb. 2011) --- NASA astronaut Steve Bowen, STS-133 mission specialist, participates in the mission?s first session of extravehicular activity (EVA) as construction and maintenance continue on the International Space Station. During the six-hour, 34-minute spacewalk, Bowen and NASA astronaut Alvin Drew (out of frame), mission specialist, installed the J612 power extension cable, move a failed ammonia pump module to the External Stowage Platform 2 on the Quest Airlock for return to Earth at a later date, installed a camera wedge on the right hand truss segment, installed extensions to the mobile transporter rail and exposed the Japanese ?Message in a Bottle? experiment to space.

Bowen durring EVA 1

NASA Image and Video Library

2011-02-28

ISS026-E-030865 (28 Feb. 2011) --- NASA astronauts Steve Bowen and Alvin Drew (mostly obscured at center right), both STS-133 mission specialists, participate in the mission?s first session of extravehicular activity (EVA) as construction and maintenance continue on the International Space Station. During the six-hour, 34-minute spacewalk, Bowen and Drew installed the J612 power extension cable, move a failed ammonia pump module to the External Stowage Platform 2 on the Quest Airlock for return to Earth at a later date, installed a camera wedge on the right hand truss segment, installed extensions to the mobile transporter rail and exposed the Japanese ?Message in a Bottle? experiment to space.

Bowen and Drew durring EVA 1

NASA Image and Video Library

2011-02-28

ISS026-E-030710 (28 Feb. 2011) --- NASA astronauts Steve Bowen and Alvin Drew (mostly obscured at center), both STS-133 mission specialists, participate in the mission?s first session of extravehicular activity (EVA) as construction and maintenance continue on the International Space Station. During the six-hour, 34-minute spacewalk, Bowen and Drew installed the J612 power extension cable, move a failed ammonia pump module to the External Stowage Platform 2 on the Quest Airlock for return to Earth at a later date, installed a camera wedge on the right hand truss segment, installed extensions to the mobile transporter rail and exposed the Japanese ?Message in a Bottle? experiment to space.

Bowen and Drew durring EVA 1

NASA Image and Video Library

2011-02-28

ISS026-E-030711 (28 Feb. 2011) --- NASA astronauts Steve Bowen and Alvin Drew (partially obscured at center), both STS-133 mission specialists, participate in the mission?s first session of extravehicular activity (EVA) as construction and maintenance continue on the International Space Station. During the six-hour, 34-minute spacewalk, Bowen and Drew installed the J612 power extension cable, move a failed ammonia pump module to the External Stowage Platform 2 on the Quest Airlock for return to Earth at a later date, installed a camera wedge on the right hand truss segment, installed extensions to the mobile transporter rail and exposed the Japanese ?Message in a Bottle? experiment to space.

Dose mapping using MCNP code and experiment for SVST-Co-60/B irradiator in Vietnam.

PubMed

Tran, Van Hung; Tran, Khac An

2010-06-01

By using MCNP code and ethanol-chlorobenzene (ECB) dosimeters the simulations and measurements of absorbed dose distribution in a tote-box of the Cobalt-60 irradiator, SVST-Co60/B at VINAGAMMA have been done. Based on the results Dose Uniformity Ratios (DUR), positions and values of minimum and maximum dose extremes in a tote-box, and efficiency of the irradiator for the different dummy densities have been gained. There is a good agreement between simulation and experimental results in comparison and they have valuable meanings for operation of the irradiator. Copyright 2010 Elsevier Ltd. All rights reserved.

Numerical Study of Primary Blast Injury to Human and Sheep Lung Induced by Simple and Complex Blast Loadings

DTIC Science & Technology

2009-12-01

ont été soumis à des ondes de choc de types simple et complexe. Le but principal de cette étude est de vérifier si les dommages observés dans les...poumons du mouton correspondent à ceux de l’humain. Dans le cas d’ondes de choc simples, neuf courbes qui représentent le niveau de seuil, 1 % et 50...poumons du mouton dépendent plus de la durée et de l’orientation de l’onde de choc . Dans le cas d’ondes de choc complexes, trois courbes ont été

L'Aventure du LHC

ScienceCinema

None

2018-05-16

Cette présentation s’adressera principalement aux personnes qui ont construit le LHC. La construction du LHC fut longue et difficile. De nombreux problèmes sont apparus en cours de route. Tous ont été résolus grâce au dévouement et à l’engagement du personnel et des collaborateurs. Je reviendrai sur les coups durs et les réussites qui ont marqués ces 15 dernières années et je vous montrerai combien cette machine, le fruit de vos efforts, est extraordinaire.

Nurses' ethical conflicts in performance of utilization reviews.

PubMed

Bell, Sue Ellen

2003-09-01

This article describes the ethical conflicts that a sample of US nurse utilization reviewers faced in their work, and also each nurse's self-reported ethical orientation that was used to resolve the dilemmas. Data were collected from a sample of 97 registered nurses who were working at least 20 hours per week as utilization reviewers. Respondents were recruited from three managed care organizations that conduct utilization reviews in a large midwestern city. A cross-sectional survey design was used to collect demographic data and to ask closed-response, short-answer and open-ended questions. Ethical conflicts reported by nurses were similar across utilization review settings and many were justice orientated. Self-reported ethical orientations were similar across organizations, with beneficence dominating. Implications of these findings are discussed.

Improving utility of evidence synthesis for healthy public policy: the three Rs (relevance, rigor, and readability [and resources]).

PubMed

Thomson, Hilary

2013-08-01

Systematic reviews have the potential to promote knowledge exchange between researchers and decision-makers. Review planning requires engagement with evidence users to ensure preparation of relevant reviews, and well-conducted reviews should provide accessible and reliable synthesis to support decision-making. Yet, systematic reviews are not routinely referred to by decision-makers, and innovative approaches to improve the utility of reviews is needed. Evidence synthesis for healthy public policy is typically complex and methodologically challenging. Although not lessening the value of reviews, these challenges can be overwhelming and threaten their utility. Using the interrelated principles of relevance, rigor, and readability, and in light of available resources, this article considers how utility of evidence synthesis for healthy public policy might be improved.

Improving Utility of Evidence Synthesis for Healthy Public Policy: the Three Rs (Relevance, Rigor, and Readability [and Resources])

PubMed Central

2013-01-01

Systematic reviews have the potential to promote knowledge exchange between researchers and decision-makers. Review planning requires engagement with evidence users to ensure preparation of relevant reviews, and well-conducted reviews should provide accessible and reliable synthesis to support decision-making. Yet, systematic reviews are not routinely referred to by decision-makers, and innovative approaches to improve the utility of reviews is needed. Evidence synthesis for healthy public policy is typically complex and methodologically challenging. Although not lessening the value of reviews, these challenges can be overwhelming and threaten their utility. Using the interrelated principles of relevance, rigor, and readability, and in light of available resources, this article considers how utility of evidence synthesis for healthy public policy might be improved. PMID:23763400

42 CFR 488.64 - Remote facility variances for utilization review requirements.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 42 Public Health 5 2014-10-01 2014-10-01 false Remote facility variances for utilization review requirements. 488.64 Section 488.64 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF... PROCEDURES Special Requirements § 488.64 Remote facility variances for utilization review requirements. (a...

42 CFR 488.64 - Remote facility variances for utilization review requirements.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 42 Public Health 5 2012-10-01 2012-10-01 false Remote facility variances for utilization review requirements. 488.64 Section 488.64 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF... PROCEDURES Special Requirements § 488.64 Remote facility variances for utilization review requirements. (a...

42 CFR 488.64 - Remote facility variances for utilization review requirements.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 42 Public Health 5 2011-10-01 2011-10-01 false Remote facility variances for utilization review requirements. 488.64 Section 488.64 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF... PROCEDURES Special Requirements § 488.64 Remote facility variances for utilization review requirements. (a...

42 CFR 488.64 - Remote facility variances for utilization review requirements.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 42 Public Health 5 2013-10-01 2013-10-01 false Remote facility variances for utilization review requirements. 488.64 Section 488.64 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF... PROCEDURES Special Requirements § 488.64 Remote facility variances for utilization review requirements. (a...

Summary of 1990 Medicaid drug rebate legislation. ASHP Government Affairs Division.

PubMed

1991-01-01

Provisions of the federal Omnibus Budget Reconciliation Act of 1990 that are designed to control federal and state outlays for prescription drugs by requiring rebates from drug manufacturers to state Medicaid programs are described, and their potential effects on pharmacy practice in organized health-care settings are discussed. As of January 1, 1991, for a manufacturer's drug product line to be eligible for any coverage under Medicaid, the manufacturer must provide rebates to all state Medicaid programs. Health maintenance organizations are exempt from the law. Hospitals that dispense outpatient drugs to Medicaid patients under a formulary system and that bill Medicaid not more than purchase costs are exempt. The law requires no immediate action by hospitals and other organized care settings; action may be required when provisions of the law concerning drug-use review programs and patient counseling become effective. If a state enters a rebate agreement, its Medicaid plan must permit coverage of all of a manufacturer's prescription drug products, but the law does not affect formulary systems of individual health-care institutions. Formulary issues, the scope of hospital exemption, and pharmacist participation in DUR activities and patient counseling need to be clarified as state Medicaid plans are amended to comply with the law; pharmacists in organized health-care settings can best influence these changes through action at the state level.

42 CFR 456.614 - Inspections by utilization review committee.

Code of Federal Regulations, 2010 CFR

2010-10-01

... HUMAN SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS UTILIZATION CONTROL Inspections of Care in Intermediate Care Facilities and Institutions for Mental Diseases § 456.614 Inspections by utilization review...

42 CFR 476.160 - General quality of care review procedures.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 42 Public Health 4 2013-10-01 2013-10-01 false General quality of care review procedures. 476.160... SERVICES (CONTINUED) QUALITY IMPROVEMENT ORGANIZATIONS UTILIZATION AND QUALITY CONTROL REVIEW Review Responsibilities of Utilization and Quality Control Quality Improvement Organizations (QIOs) Qio Review Functions...

41 CFR 109-43.5002 - Reviews to determine need for retaining items.

Code of Federal Regulations, 2010 CFR

2010-07-01

... REGULATIONS UTILIZATION AND DISPOSAL 43-UTILIZATION OF PERSONAL PROPERTY 43.50-Utilization of Personal.... Procedures and practices shall require an initial review at the time the plant is placed in standby to... special reviews when a change in start-up time is made or when circumstances warrant. Such procedures...

41 CFR 109-43.5002 - Reviews to determine need for retaining items.

Code of Federal Regulations, 2011 CFR

2011-01-01

... REGULATIONS UTILIZATION AND DISPOSAL 43-UTILIZATION OF PERSONAL PROPERTY 43.50-Utilization of Personal.... Procedures and practices shall require an initial review at the time the plant is placed in standby to... special reviews when a change in start-up time is made or when circumstances warrant. Such procedures...

Lexical shifts, substantive changes, and continuity in State of the Union discourse, 1790–2014

PubMed Central

Rule, Alix; Cointet, Jean-Philippe; Bearman, Peter S.

2015-01-01

This study reveals that the entry into World War I in 1917 indexed the decisive transition to the modern period in American political consciousness, ushering in new objects of political discourse, a more rapid pace of change of those objects, and a fundamental reframing of the main tasks of governance. We develop a strategy for identifying meaningful categories in textual corpora that span long historic durées, where terms, concepts, and language use changes. Our approach is able to account for the fluidity of discursive categories over time, and to analyze their continuity by identifying the discursive stream as the object of interest. PMID:26261302

Bowen and Drew durring EVA 1

NASA Image and Video Library

2011-02-28

ISS026-E-030708 (28 Feb. 2011) --- NASA astronauts Steve Bowen and Alvin Drew (partially obscured at center right), both STS-133 mission specialists, participate in the mission’s first session of extravehicular activity (EVA) as construction and maintenance continue on the International Space Station. During the six-hour, 34-minute spacewalk, Bowen and Drew installed the J612 power extension cable, move a failed ammonia pump module to the External Stowage Platform 2 on the Quest Airlock for return to Earth at a later date, installed a camera wedge on the right hand truss segment, installed extensions to the mobile transporter rail and exposed the Japanese “Message in a Bottle” experiment to space.

Darnton’s Cats, Bacon’s Rifle, and History of Science 101.

PubMed

Küçük, Harun

2016-12-01

Many of us who teach History of Science 101 courses face a situation where we must tell our story without relying on students’ prior knowledge of, say, the significance of ancient Greece and China, premodern and modern colonialism, or Marx. This leaves us needing a clear and punchy basic message, supported by a solid, well-structured, and inclusive story line that also doubles as world history. This response takes a look at the prospects and problems of longue durée histories of science from the perspective of cultural history. It voices sympathy toward Frans van Lunteren’s project and presents a small sample of potential difficulties involved in matching machines with historical periods.

State-of-the-Art for Assessing Earthquake Hazards in the United States. Report 25. Parameters for Specifying Intensity-Related Earthquake Ground Motions.

DTIC Science & Technology

1987-09-01

and Sponheuer, W. 1969. Scale of Seismic Intensity: Proc. Fourth World Conf. on Earthquake Engineering, Santiago, Chile . Murphy, J. R., and O’Brien, L...Predom V/H el, V/I Vel V/H Displ V/H sec VIH Period Period Predom Accel cm/sec Vel cm Disp .05 Dur sec sec Period S11 2 0.48 MODIFIED MERCALLI INTENSITY...0.1 0. 0.16 142.20 Long. Vert Hor Vert Ratio Ratio Vert Ratio Vert r io Du r atio Predom Predom VIH Acce V/H Vel V /H Dspi V H sec 1, H Period Period

Effect of Deregulation in the Telecommunications Industry on Military Base Telephone Communications.

DTIC Science & Technology

1983-03-01

a s stell11 n=etwcrk in srder to antar -,nt, the long d iS -c s market - In addiio n co he z ccal I e 1eph one ma~ke=t *whcre_ : ow opi:ates. Other...ra n out. By 1910 +he i-ndzp=-dans: (%:Dn-Bell) ele- ph.-one companias accounted fc=r. ne ar=l"y h ..f o f th4 - eieohcrn, * market , anI rates had...vazious ?ffc---;s of tne3 challz-cqers to ant er the stablished markets of thh, commcM Car:4=erS. 2 DurJig te thirties and f3_ i s s, t:hs only s

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.

42 CFR 476.96 - Review period and reopening of initial denial determinations and changes as a result of DRG...

Code of Federal Regulations, 2010 CFR

2010-10-01

... MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) QUALITY IMPROVEMENT ORGANIZATIONS UTILIZATION AND QUALITY CONTROL REVIEW Review Responsibilities of Utilization and Quality Control Quality Improvement Organizations (QIOs) Qio Review Functions § 476.96 Review period and reopening of...

Utility installation review system : implementation report.

DOT National Transportation Integrated Search

2009-03-01

Each year, the Texas Department of Transportation (TxDOT) issues thousands of approvals that enable new : utility installations to occupy the state right of way (ROW). The current utility installation review process : relies on the physical delivery ...

42 CFR 476.73 - Notification of QIO designation and implementation of review.

Code of Federal Regulations, 2010 CFR

2010-10-01

... of review. 476.73 Section 476.73 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) QUALITY IMPROVEMENT ORGANIZATIONS UTILIZATION AND QUALITY CONTROL REVIEW Review Responsibilities of Utilization and Quality Control Quality Improvement...

42 CFR 456.507 - Review and granting of waiver requests.

Code of Federal Regulations, 2010 CFR

2010-10-01

... SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS UTILIZATION CONTROL Utilization Review Plans: FFP, Waivers, and Variances for Hospitals and Mental Hospitals Ur Plan: Waiver of Requirements § 456.507 Review and...

Utility installation review (UIR) system training materials.

DOT National Transportation Integrated Search

2008-10-01

The Texas Department of Transportation (TxDOT) issues thousands of approvals every year that : enable new utility installations to occupy the state right-of-way (ROW). The utility installation : review process currently in place is manual, tedious, a...

A compilation of research working groups on drug utilisation across Europe

PubMed Central

2014-01-01

Background The assessment of the benefit-risk of medicines needs careful consideration concerning their patterns of utilization. Systems for the monitoring of medicines consumption have been established in many European countries, and several international groups have identified and described them. No other compilation of European working groups has been published. As part of the PROTECT project, as a first step in searching for European data sources on the consumption of five selected groups of medicines, we aimed to identify and describe the main characteristics of the existing collaborative European working groups. Findings Google and bibliographic searches (PubMed) of articles containing information on databases and other sources of drug consumption data were conducted. For each working group the main characteristics were recorded. Nineteen selected groups were identified, focusing on: a) general drug utilisation (DU) research (EuroDURG, CNC, ISPE’S SIG-DUR, EURO-MED-STAT, PIPERSKA Group, NorPEN, ENCePP, DURQUIM), b) specific DU research: b.1) antimicrobial drugs (ARPAC, ESAC, ARPEC, ESGAP, HAPPY AUDIT), b.2) cardiovascular disease (ARITMO, EUROASPIRE), b.3) paediatrics (TEDDY), and b.4) mental health/central nervous system effects (ESEMeD, DRUID, TUPP/EUPoMMe). Information on their aims, methods and activities is presented. Conclusions We assembled and updated information on European working groups in DU research and in the utilisation of five selected groups of drugs for the PROTECT project. This information should be useful for academic researchers, regulatory and health authorities, and pharmaceutical companies conducting and interpreting post-authorisation and safety studies. European health authorities should encourage national research and collaborations in this important field for public health. PMID:24625054

The history of soil erosion: Interpreting historical sources, buried soils and colluvial sediments as archives of past soil erosion and human-environment interactions in the Longue Durée

NASA Astrophysics Data System (ADS)

Dotterweich, Markus

2015-04-01

Soil erosion threatens the environment and the sustainability of agricultural practices since the earliest societies started modifying their natural environment in the Neolithic. Almost all farming-based cultures in the world, from large civilizations to peasant groups on little islands, have suffered from soil erosion by water. The amounts of soil erosion varied largely through time and space, and extreme events have left a wide variety of imprints on the landscape over millennia. Eroded hillslopes and gullies, deposited sediments in sinks like lakes, footslopes, valleys, floodplains, and river deltas are geomorphic legacies that have been linked to changes in land use and climate by many studies during the last decades. However, a standardized analysis and interpretation of these geomorphic legacies is problematic because of the variety of methodological approaches and the nonlinearity between soil erosion, climate, and land use. Cascading effects, land use structures, soil management, soil conservation strategies, and long-term system changes have produced different signals over time. Historical records are crucial and an invaluable source to provide alternative proxies about soil erosion in the past. Direct observations of individual soil erosion events may restrict the deposition of a distinct sediment package to a certain time span. They also expand the range of alternative interpretations, particularly with respect to the long-term effects of soil erosion to ecosystem services and socioeconomic processes. However, historical records also need critical analyses regarding their origin, intention, and quality. They were often created in the context of personal interests or political issues rather than being based on scientific facts; and it is often unclear if they represent certain events, narratives, or vague assumptions. This presentation will present and discuss examples of geomorphic evidences and historical records of past soil erosion for the deciphering of human-environment interactions in the Longue Durée.

Studies on transposable elements in yeast. I. ROAM mutations causing increased expression of yeast genes: their activation by signals directed toward conjugation functions and their formation by insertion of Tyl repetitive elements

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

Errede, B.; Cardillo, T.S.; Wever, G.

1981-01-01

Mechanisms available to eukaryotic organisms for the coordinate regulation of gene expression are being examined by genetic and biochemical characterization of an unusual mutation, CYC7-H2, which causes over-production of iso-2-cytochrome c in the yeast Saccharomyces cerevisiae. The CYC7-H2 mutation causes overproduction in haploid strains but only a 1- to 40-fold overproduction in MATa/MAT..cap alpha.. diploid strains. This regulation of overproduction has been characterized as a response to signals controlling conjugation in yeast. Furthermore, the abnormal controlling region has been identified as an insertion of a transposable and reiterated Ty1 element adjacent to the structural gene. Therefore, we suggest that Ty1more » elements or portions of Ty1 elements occur adjacent to some of the genes required for conjugation and that they normally function to control expression of this process. The suggested role of reiterated sequences may represent a general mechanism of coordinate regulation in eukaryotes. The CYC7-H2 mutation is closely related to other regulatory mutations occurring at the cargA, cargB and DUR1,2 loci. Similar to the CYC7-H2 mutation, the mutations designated cargA/sup +/O/sup h/, cargB/sup +/O/sup h/, and durO/sup h/ cause constitutive production of their respective gene products at much lower levels of MATa/MAT..cap alpha.. diploid strains than in the corresponding haploid strains. A consistent relationship between conjugation competence and the level of overproduction in all four mutants has been established. Observations characterizing the regulation of overproduction in the CYC7-H2 mutant are presented with the additional and parallel observations for the O/sup h/ mutants. Together these results provide a demonstration of the specificity and equivalence of regulatory control exhibited by ROAM mutants.« less

42 CFR 476.104 - Coordination of activities.

Code of Federal Regulations, 2010 CFR

2010-10-01

... Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) QUALITY IMPROVEMENT ORGANIZATIONS UTILIZATION AND QUALITY CONTROL REVIEW Review Responsibilities of Utilization and Quality Control Quality Improvement Organizations (QIOs) Qio Review Functions...

42 CFR 476.104 - Coordination of activities.

Code of Federal Regulations, 2012 CFR

2012-10-01

... (CONTINUED) QUALITY IMPROVEMENT ORGANIZATIONS UTILIZATION AND QUALITY CONTROL REVIEW Review Responsibilities of Utilization and Quality Control Quality Improvement Organizations (QIOs) Qio Review Functions... coordinate its activities (including information exchanges) with the activities of— (a) Medicare fiscal...

42 CFR 476.104 - Coordination of activities.

Code of Federal Regulations, 2013 CFR

2013-10-01

... (CONTINUED) QUALITY IMPROVEMENT ORGANIZATIONS UTILIZATION AND QUALITY CONTROL REVIEW Review Responsibilities of Utilization and Quality Control Quality Improvement Organizations (QIOs) Qio Review Functions... coordinate its activities (including information exchanges) with the activities of— (a) Medicare...

42 CFR 476.104 - Coordination of activities.

Code of Federal Regulations, 2011 CFR

2011-10-01

... (CONTINUED) QUALITY IMPROVEMENT ORGANIZATIONS UTILIZATION AND QUALITY CONTROL REVIEW Review Responsibilities of Utilization and Quality Control Quality Improvement Organizations (QIOs) Qio Review Functions... coordinate its activities (including information exchanges) with the activities of— (a) Medicare fiscal...

42 CFR 476.83 - Initial denial determinations.

Code of Federal Regulations, 2010 CFR

2010-10-01

....83 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) QUALITY IMPROVEMENT ORGANIZATIONS UTILIZATION AND QUALITY CONTROL REVIEW Review Responsibilities of Utilization and Quality Control Quality Improvement Organizations (QIOs) Qio Review Functions...

42 CFR 476.100 - Use of norms and criteria.

Code of Federal Regulations, 2010 CFR

2010-10-01

... Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) QUALITY IMPROVEMENT ORGANIZATIONS UTILIZATION AND QUALITY CONTROL REVIEW Review Responsibilities of Utilization and Quality Control Quality Improvement Organizations (QIOs) Qio Review Functions...

42 CFR 456.614 - Inspections by utilization review committee.

Code of Federal Regulations, 2011 CFR

2011-10-01

....614 Section 456.614 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS UTILIZATION CONTROL Inspections of Care in Intermediate Care Facilities and Institutions for Mental Diseases § 456.614 Inspections by utilization review...

42 CFR 456.614 - Inspections by utilization review committee.

Code of Federal Regulations, 2013 CFR

2013-10-01

....614 Section 456.614 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS UTILIZATION CONTROL Inspections of Care in Intermediate Care Facilities and Institutions for Mental Diseases § 456.614 Inspections by utilization review...

42 CFR 456.614 - Inspections by utilization review committee.

Code of Federal Regulations, 2014 CFR

2014-10-01

....614 Section 456.614 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS UTILIZATION CONTROL Inspections of Care in Intermediate Care Facilities and Institutions for Mental Diseases § 456.614 Inspections by utilization review...

42 CFR 456.614 - Inspections by utilization review committee.

Code of Federal Regulations, 2012 CFR

2012-10-01

....614 Section 456.614 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS UTILIZATION CONTROL Inspections of Care in Intermediate Care Facilities and Institutions for Mental Diseases § 456.614 Inspections by utilization review...

A Practical Guide to Conducting a Systematic Review and Meta-analysis of Health State Utility Values.

PubMed

Petrou, Stavros; Kwon, Joseph; Madan, Jason

2018-05-10

Economic analysts are increasingly likely to rely on systematic reviews and meta-analyses of health state utility values to inform the parameter inputs of decision-analytic modelling-based economic evaluations. Beyond the context of economic evaluation, evidence from systematic reviews and meta-analyses of health state utility values can be used to inform broader health policy decisions. This paper provides practical guidance on how to conduct a systematic review and meta-analysis of health state utility values. The paper outlines a number of stages in conducting a systematic review, including identifying the appropriate evidence, study selection, data extraction and presentation, and quality and relevance assessment. The paper outlines three broad approaches that can be used to synthesise multiple estimates of health utilities for a given health state or condition, namely fixed-effect meta-analysis, random-effects meta-analysis and mixed-effects meta-regression. Each approach is illustrated by a synthesis of utility values for a hypothetical decision problem, and software code is provided. The paper highlights a number of methodological issues pertinent to the conduct of meta-analysis or meta-regression. These include the importance of limiting synthesis to 'comparable' utility estimates, for example those derived using common utility measurement approaches and sources of valuation; the effects of reliance on limited or poorly reported published data from primary utility assessment studies; the use of aggregate outcomes within analyses; approaches to generating measures of uncertainty; handling of median utility values; challenges surrounding the disentanglement of utility estimates collected serially within the context of prospective observational studies or prospective randomised trials; challenges surrounding the disentanglement of intervention effects; and approaches to measuring model validity. Areas of methodological debate and avenues for future research are highlighted.

42 CFR 456.125 - Time limits for admission review.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 42 Public Health 4 2010-10-01 2010-10-01 false Time limits for admission review. 456.125 Section... SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS UTILIZATION CONTROL Utilization Control: Hospitals Ur Plan: Review of Need for Admission 1 § 456.125 Time limits for admission review. Except as required under § 456...

42 CFR 456.125 - Time limits for admission review.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 42 Public Health 4 2011-10-01 2011-10-01 false Time limits for admission review. 456.125 Section... SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS UTILIZATION CONTROL Utilization Control: Hospitals Ur Plan: Review of Need for Admission 1 § 456.125 Time limits for admission review. Except as required under § 456...

42 CFR 456.523 - Revised UR plan.

Code of Federal Regulations, 2010 CFR

2010-10-01

...) MEDICAL ASSISTANCE PROGRAMS UTILIZATION CONTROL Utilization Review Plans: FFP, Waivers, and Variances for Hospitals and Mental Hospitals Ur Plan: Remote Facility Variances from Time Requirements § 456.523 Revised... control over the utilization of services; and (2) Conducts reviews in a way that improves the quality of...

42 CFR 456.523 - Revised UR plan.

Code of Federal Regulations, 2011 CFR

2011-10-01

...) MEDICAL ASSISTANCE PROGRAMS UTILIZATION CONTROL Utilization Review Plans: FFP, Waivers, and Variances for Hospitals and Mental Hospitals Ur Plan: Remote Facility Variances from Time Requirements § 456.523 Revised... control over the utilization of services; and (2) Conducts reviews in a way that improves the quality of...

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.

Vers la diode laser organique ?

NASA Astrophysics Data System (ADS)

Horowitz, G.

1998-06-01

The recent report of a laser effect in polyparaphenylenevinylene has raised up a great interest. Here, we review the works in that field. Stimulated emission (SE) in conjugated polymers (PCs) manifests itself by a spectral narrowing and a shortening of the emission life time. By putting the emitting medium into microcavity, an increase of the emission directionality has also been reported. We also give results on SE in sexithiophene (6T) single crystals. An analysis of the emitting levels shows that we are dealing with a four level system, which could account for the low excitation threshold. L'annonce récente d'un possible effet laser dans le polyparaphénylè nevinylène (PPV) a suscité un grand intérêt. Nous faisons ici le point sur les travaux dans ce domaine. L'émission stimulée (ES) dans les polymères conjugués (PC) se manifeste par un rétrécissement spectral et un raccourcissement de la durée de vie d'émission. En plaçant le milieu émissif dans une micro-cavité, une augmentation de la directionnalité de l'émission a été observée. Nous donnons par ailleurs des résultats sur l'ES dans des monocristaux de sexithiophène (6T). L'analyse des niveaux émissifs montre qu'il s'agit . d'un système à quatre niveaux, ce qui pourrait expliquer le faible seuil d'excitation.

42 CFR 476.72 - Review of the quality of care of risk-basis health maintenance organizations and competitive...

Code of Federal Regulations, 2012 CFR

2012-10-01

... 42 Public Health 4 2012-10-01 2012-10-01 false Review of the quality of care of risk-basis health... MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) QUALITY IMPROVEMENT ORGANIZATIONS UTILIZATION AND QUALITY CONTROL REVIEW Review Responsibilities of Utilization and Quality Control...

42 CFR 456.233 - Initial continued stay review date.

Code of Federal Regulations, 2010 CFR

2010-10-01

... SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS UTILIZATION CONTROL Utilization Control: Mental Hospitals... must provide that— (a) When a recipient is admitted to the mental hospital under admission review... will be reviewed; (b) If an individual applies for Medicaid while in the mental hospital, the committee...

Medical Utilization of Kiosks in the Delivery of Patient Education: A Systematic Review

PubMed Central

Yvonne Chan, Yu-Feng; Nagurka, Roxanne; Bentley, Suzanne; Ordonez, Edgardo; Sproule, William

2014-01-01

Background: The utilization of kiosks has previously been shown to be effective for collecting information, delivering educational modules, and providing access to health information. We discuss a review of current literature for the utilization of kiosks for the delivery of patient education. Methods: The criteria for inclusion in this literature review were: (1) study discusses the utilization of kiosks for patient health education; (2) study discusses the use of touch screens for patient health information; (3) published in English. Our review includes searches via MEDLINE databases and Google Scholar for the years 1996-2014. Results: Overall, 167 articles were screened for final eligibility, and after discarding duplicates and non-eligible studies with abstract. Full-text review of 28 articles was included in the final analysis. Conclusion: The review of available literature demonstrates the effectiveness of touch screen kiosks to educate patients and to improve healthcare, both at a performance and cost advantage over other modes of patient education. PMID:25097831

32 CFR 199.15 - Quality and utilization review peer review organization program.

Code of Federal Regulations, 2013 CFR

2013-07-01

... Director, OCHAMPUS. These contractors may include contractors that have exclusive functions in the area of utilization and quality review, fiscal intermediary contractors (which perform these functions along with a... functions concerning management of the delivery and financing of health care services under CHAMPUS...

42 CFR 456.231 - Continued stay review required.

Code of Federal Regulations, 2010 CFR

2010-10-01

... (CONTINUED) MEDICAL ASSISTANCE PROGRAMS UTILIZATION CONTROL Utilization Control: Mental Hospitals Ur Plan... a review of each recipient's continued stay in the mental hospital to decide whether it is needed...

42 CFR 456.434 - Subsequent continued stay review dates.

Code of Federal Regulations, 2011 CFR

2011-10-01

... SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS UTILIZATION CONTROL Utilization Control: Intermediate Care... in accordance with § 456.435. (b) The group assigns a subsequent continued stay review date each time...) More frequently than every six months if indicated at the time of continued stay review; and (c) The...

42 CFR 456.434 - Subsequent continued stay review dates.

Code of Federal Regulations, 2010 CFR

2010-10-01

... SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS UTILIZATION CONTROL Utilization Control: Intermediate Care... in accordance with § 456.435. (b) The group assigns a subsequent continued stay review date each time...) More frequently than every six months if indicated at the time of continued stay review; and (c) The...

ETV Programmes: Review of Research.

ERIC Educational Resources Information Center

Chaudhary, Sohanvir; Panda, Santosh

1997-01-01

Reviews research on educational television (ETV), focusing on teacher and student attitudes; impact on children and teachers and in-service education in media; and utilization. Also reviews a few studies on the impact and utilization of educational radio broadcasts. Draws broad conclusions about the use, design, and learning process of ETV. (PEN)

42 CFR 476.93 - Opportunity to discuss proposed initial denial determination and changes as a result of a DRG...

Code of Federal Regulations, 2010 CFR

2010-10-01

... MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) QUALITY IMPROVEMENT ORGANIZATIONS UTILIZATION AND QUALITY CONTROL REVIEW Review Responsibilities of Utilization and Quality Control Quality Improvement Organizations (QIOs) Qio Review Functions § 476.93 Opportunity to discuss proposed...

42 CFR 476.85 - Conclusive effect of QIO initial denial determinations and changes as a result of DRG validations.

Code of Federal Regulations, 2010 CFR

2010-10-01

... MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) QUALITY IMPROVEMENT ORGANIZATIONS UTILIZATION AND QUALITY CONTROL REVIEW Review Responsibilities of Utilization and Quality Control Quality Improvement Organizations (QIOs) Qio Review Functions § 476.85 Conclusive effect of QIO initial...

Analysis of instruments measuring nurses' attitudes towards research utilization: a systematic review.

PubMed

Frasure, Jamey

2008-01-01

This paper is a report of a systematic review describing instruments used to measure nurses' attitudes towards research utilization. Researchers need to have the tools to measure nurses' attitudes. However, limited literature critically analyses instruments and the concepts that comprise nurses' attitudes towards research utilization. A search of the literature from 1982 to 2007 was performed using the Cumulative Index to Nursing and Allied Health Literature, Health and Psychosocial Instruments, PubMed and MEDLINE data bases. The search terms were nursing research, research utilization, instruments, and nurses' attitudes. A total of 186 sources were identified, of which 25 were reviewed. Fourteen instruments met the criteria for in-depth critical analysis of psychometric properties and concepts, and were included in the final review. Each instrument item was judged to be relevant to direct, indirect, persuasive and overall research utilization as defined by Estabrooks. Instruments were arranged from the strongest to the weakest reliability of the subscales to determine the instrument with the strongest psychometric properties. Indirect and overall research utilization was measured by all of the instruments. Ten instruments measured direct research utilization and nine instruments measured persuasive research utilization. The Research Utilization in Nursing Survey by Estabrooks, as adapted by Kenny, was an instrument with strong psychometric properties measuring all four concepts of nurses' attitudes towards using and participating in research and was clinically feasible. Many published instruments are available for use by nurse researchers to measure nurses' attitude towards research utilization, but only one has been subjected to rigorous testing: the Research Utilization in Nursing Survey by Estabrooks.

42 CFR 456.133 - Subsequent continued stay review dates.

Code of Federal Regulations, 2010 CFR

2010-10-01

... SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS UTILIZATION CONTROL Utilization Control: Hospitals Ur Plan....128 and 456.134(a); (b) The committee assigns a subsequent review date each time it decides under...

42 CFR 456.133 - Subsequent continued stay review dates.

Code of Federal Regulations, 2011 CFR

2011-10-01

... SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS UTILIZATION CONTROL Utilization Control: Hospitals Ur Plan....128 and 456.134(a); (b) The committee assigns a subsequent review date each time it decides under...

Utilization and Limitations of the American College Health Association's National College Health Assessment Instrument: A Systematic Review

ERIC Educational Resources Information Center

Rahn, Rhonda N.; Pruitt, Buster; Goodson, Patricia

2016-01-01

Objective: To analyze the literature in which researchers have utilized the National College Health Assessment (NCHA) I or the NCHA II. Participants and Methods: The authors selected peer-reviewed articles published between 2004 and July 2013 utilizing a single search term: National College Health Assessment. Articles were assessed for instrument…

Integrated concurrent utilization quality review, Part one.

PubMed

Caterinicchio, R P

1987-01-01

This article is the first of a two-part series which argues for the concurrent management of the appropriateness, necessity, and quality of patient care. Intensifying scrutiny by the credentialing groups, the PROs and all third-party payors underscores the vital need to implement cost-effective information systems which integrate the departmentalized functions of patient-physician profiling, DRG case-mix analyses, length of stay monitoring, pre-admission/admission and continued stay review, discharge planning, risk management, incident reporting and quality review. In the domain of physician performance regarding admitting and practice patterns, the ability to exercise concurrent utilization-quality review means early detection and prevention of events which would otherwise result in denials of payment and/or compromised patient care. Concurrent utilization-quality review must, by definition, be managerially invasive and focused; hence, it is integral to maintaining the integrity of the services and product lines offered by the provider. In fact, if PPO status is a marketing agenda, then the institutional objectives of cost-effectiveness, productivity, value, and competitiveness can only be achieved through concurrent utilization-quality review.

Piketty's challenge for sociology.

PubMed

Savage, Mike

2014-12-01

This paper argues that Piketty's book should not simply be seen as that of an economist, but that it contains significant resources for sociologists to draw upon. These are firstly, this approach to social science and his use of visualizations which chime closely with recent claims about the power of description. Secondly I consider his conceptualization of time and history - which in rebutting epochal arguments about the speed of contemporary change allows for a much better appreciation of the 'long durée'; and finally his conceptualization of social classes and privilege through his elaboration of a sociology of accumulation and inheritance. In all these ways, Piketty's work assists in developing an account of elites and wealth which should be highly productive for future sociology. © London School of Economics and Political Science 2014.

The Longue Durée of Black Lives Matter.

PubMed

Nelson, Alondra

2016-10-01

Black Lives Matter was first articulated just a few years ago, but it has been the leitmotif of antiracist struggles for generations. The Movement for Black Lives extends the work of previous movements that challenged forms of oppression that act on Black bodies with impunity. It should be understood in the context of Ida B. Wells' anti-lynching campaign, Fannie Lou Hamer's reproductive justice demands, and the Black Panther Party's health activism. The 50th anniversary of the Black Panther Party is an occasion to recall that its work confronted the callous neglect and the corporeal surveillance and abuse of poor Black communities. Similar demands have been the centrifugal force of social movements that for centuries have refused to have Black lives cast beyond the human boundary.

The Longue Durée of Black Lives Matter

PubMed Central

2016-01-01

Black Lives Matter was first articulated just a few years ago, but it has been the leitmotif of antiracist struggles for generations. The Movement for Black Lives extends the work of previous movements that challenged forms of oppression that act on Black bodies with impunity. It should be understood in the context of Ida B. Wells’ anti-lynching campaign, Fannie Lou Hamer’s reproductive justice demands, and the Black Panther Party’s health activism. The 50th anniversary of the Black Panther Party is an occasion to recall that its work confronted the callous neglect and the corporeal surveillance and abuse of poor Black communities. Similar demands have been the centrifugal force of social movements that for centuries have refused to have Black lives cast beyond the human boundary. PMID:27626337

Perspective sur les ruptures d’approvisionnement de médicaments en établissement de santé de 2006 à 2010

PubMed Central

Bussières, Jean-François; Chiveri, Andrei; Lebel, Denis

2011-01-01

RÉSUMÉ Contexte: Si les ruptures d’approvisionnement de médicaments font partie de la réalité de la pratique pharmaceutique depuis plusieurs décennies, elles deviennent une préoccupation quotidienne pour les pharmaciens dans les années 2000 et dépassent les frontières de la littérature pharmaceutique. Objectif: L’objectif principal de cette étude était de quantifier le nombre de médicaments en rupture de stock par année et la durée de ces interruptions. L’objectif secondaire visait à décrire le nombre de médicaments en rupture de stock par fabricant et par classe thérapeutique. Méthode: Cette étude descriptive et rétrospective des ruptures d’approvisionnement en médicaments a porté sur l’ensemble des médicaments à contrat pour les hôpitaux des régions administratives de Montréal, de Laval et de l’Estrie, au Québec. Le nombre de ruptures de stocks, le nombre de jours de rupture de stock et leur durée moyenne par année ont été calculés par fabricant et par classe thérapeutique. De plus, la proportion de produits en rupture de stock et la proportion de jours de rupture de stocks ont été déterminées par classe thérapeutique. Les données ont été analysées à l’aide de statistiques descriptives (c.-à-d. somme, moyenne, écart-type, médiane, intervalle). Résultats: Entre le 1er janvier 2006 et le 31 août 2010 (une période de 56 mois), 2400 ruptures de stocks ont été dénombrées pour un total de 258 105 jours de rupture de stocks (durée moyenne de 108 jours, écart-type de 130 jours et intervalle de 5 à 1623 jours). Un total de 70 fabricants étaient impliqués dans la survenue de toutes les ruptures d’approvisionnement de médicaments relevées durant cette période. Cinquante pour cent (50 %) des ruptures de stocks et des jours de rupture de stocks provenaient de quatre fabricants. Les interruptions étudiées touchaient la majorité des classes thérapeutiques de médicaments disponibles sur le marché. Toutefois, 50 % des ruptures de stocks provenaient de trois classes thérapeutiques (médicaments du système nerveux central, agents anti-infectieux et médicaments cardiovasculaires). Conclusion: Il s’agit des premières données canadiennes publiées sur l’étendue des ruptures d’approvisionnement sur le marché hospitalier. L’étude a démontré que les ruptures de stocks touchent la plupart des fabricants et la majorité des classes thérapeutiques. D’autres études sont nécessaires afin d’explorer les causes et les conséquences des ruptures d’approvisionnement en établissements de santé. PMID:22479098

Individual determinants of research utilization by nurses: a systematic review update.

PubMed

Squires, Janet E; Estabrooks, Carole A; Gustavsson, Petter; Wallin, Lars

2011-01-05

Interventions that have a better than random chance of increasing nurses' use of research are important to the delivery of quality patient care. However, few reports exist of successful research utilization in nursing interventions. Systematic identification and evaluation of individual characteristics associated with and predicting research utilization may inform the development of research utilization interventions. To update the evidence published in a previous systematic review on individual characteristics influencing research utilization by nurses. As part of a larger systematic review on research utilization instruments, 12 online bibliographic databases were searched. Hand searching of specialized journals and an ancestry search was also conducted. Randomized controlled trials, clinical trials, and observational study designs examining the association between individual characteristics and nurses' use of research were eligible for inclusion. Studies were limited to those published in the English, Danish, Swedish, and Norwegian languages. A vote counting approach to data synthesis was taken. A total of 42,770 titles were identified, of which 501 were retrieved. Of these 501 articles, 45 satisfied our inclusion criteria. Articles assessed research utilization in general (n = 39) or kinds of research utilization (n = 6) using self-report survey measures. Individual nurse characteristics were classified according to six categories: beliefs and attitudes, involvement in research activities, information seeking, education, professional characteristics, and socio-demographic/socio-economic characteristics. A seventh category, critical thinking, emerged in studies examining kinds of research utilization. Positive relationships, at statistically significant levels, for general research utilization were found in four categories: beliefs and attitudes, information seeking, education, and professional characteristics. The only characteristic assessed in a sufficient number of studies and with consistent findings for the kinds of research utilization was attitude towards research; this characteristic had a positive association with instrumental and overall research utilization. This review reinforced conclusions in the previous review with respect to positive relationships between general research utilization and: beliefs and attitudes, and current role. Furthermore, attending conferences/in-services, having a graduate degree in nursing, working in a specialty area, and job satisfaction were also identified as individual characteristics important to research utilization. While these findings hold promise as potential targets of future research utilization interventions, there were methodological problems inherent in many of the studies that necessitate their findings be replicated in further research using more robust study designs and multivariate assessment methods.

Individual determinants of research utilization by nurses: a systematic review update

PubMed Central

2011-01-01

Background Interventions that have a better than random chance of increasing nurses' use of research are important to the delivery of quality patient care. However, few reports exist of successful research utilization in nursing interventions. Systematic identification and evaluation of individual characteristics associated with and predicting research utilization may inform the development of research utilization interventions. Objective To update the evidence published in a previous systematic review on individual characteristics influencing research utilization by nurses. Methods As part of a larger systematic review on research utilization instruments, 12 online bibliographic databases were searched. Hand searching of specialized journals and an ancestry search was also conducted. Randomized controlled trials, clinical trials, and observational study designs examining the association between individual characteristics and nurses' use of research were eligible for inclusion. Studies were limited to those published in the English, Danish, Swedish, and Norwegian languages. A vote counting approach to data synthesis was taken. Results A total of 42,770 titles were identified, of which 501 were retrieved. Of these 501 articles, 45 satisfied our inclusion criteria. Articles assessed research utilization in general (n = 39) or kinds of research utilization (n = 6) using self-report survey measures. Individual nurse characteristics were classified according to six categories: beliefs and attitudes, involvement in research activities, information seeking, education, professional characteristics, and socio-demographic/socio-economic characteristics. A seventh category, critical thinking, emerged in studies examining kinds of research utilization. Positive relationships, at statistically significant levels, for general research utilization were found in four categories: beliefs and attitudes, information seeking, education, and professional characteristics. The only characteristic assessed in a sufficient number of studies and with consistent findings for the kinds of research utilization was attitude towards research; this characteristic had a positive association with instrumental and overall research utilization. Conclusions This review reinforced conclusions in the previous review with respect to positive relationships between general research utilization and: beliefs and attitudes, and current role. Furthermore, attending conferences/in-services, having a graduate degree in nursing, working in a specialty area, and job satisfaction were also identified as individual characteristics important to research utilization. While these findings hold promise as potential targets of future research utilization interventions, there were methodological problems inherent in many of the studies that necessitate their findings be replicated in further research using more robust study designs and multivariate assessment methods. PMID:21208425

Measurement properties of self-report physical activity assessment tools in stroke: a protocol for a systematic review

PubMed Central

Martins, Júlia Caetano; Aguiar, Larissa Tavares; Nadeau, Sylvie; Scianni, Aline Alvim; Teixeira-Salmela, Luci Fuscaldi; Faria, Christina Danielli Coelho de Morais

2017-01-01

Introduction Self-report physical activity assessment tools are commonly used for the evaluation of physical activity levels in individuals with stroke. A great variety of these tools have been developed and widely used in recent years, which justify the need to examine their measurement properties and clinical utility. Therefore, the main objectives of this systematic review are to examine the measurement properties and clinical utility of self-report measures of physical activity and discuss the strengths and limitations of the identified tools. Methods and analysis A systematic review of studies that investigated the measurement properties and/or clinical utility of self-report physical activity assessment tools in stroke will be conducted. Electronic searches will be performed in five databases: Medical Literature Analysis and Retrieval System Online (MEDLINE) (PubMed), Excerpta Medica Database (EMBASE), Physiotherapy Evidence Database (PEDro), Literatura Latino-Americana e do Caribe em Ciências da Saúde (LILACS) and Scientific Electronic Library Online (SciELO), followed by hand searches of the reference lists of the included studies. Two independent reviewers will screen all retrieve titles, abstracts, and full texts, according to the inclusion criteria and will also extract the data. A third reviewer will be referred to solve any disagreement. A descriptive summary of the included studies will contain the design, participants, as well as the characteristics, measurement properties, and clinical utility of the self-report tools. The methodological quality of the studies will be evaluated using the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) checklist and the clinical utility of the identified tools will be assessed considering predefined criteria. This systematic review will follow the Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) statement. Discussion This systematic review will provide an extensive review of the measurement properties and clinical utility of self-report physical activity assessment tools used in individuals with stroke, which would benefit clinicians and researchers. Trial registration number PROSPERO CRD42016037146. PMID:28193848

Simulation modeling for stratified breast cancer screening - a systematic review of cost and quality of life assumptions.

PubMed

Arnold, Matthias

2017-12-02

The economic evaluation of stratified breast cancer screening gains momentum, but produces also very diverse results. Systematic reviews so far focused on modeling techniques and epidemiologic assumptions. However, cost and utility parameters received only little attention. This systematic review assesses simulation models for stratified breast cancer screening based on their cost and utility parameters in each phase of breast cancer screening and care. A literature review was conducted to compare economic evaluations with simulation models of personalized breast cancer screening. Study quality was assessed using reporting guidelines. Cost and utility inputs were extracted, standardized and structured using a care delivery framework. Studies were then clustered according to their study aim and parameters were compared within the clusters. Eighteen studies were identified within three study clusters. Reporting quality was very diverse in all three clusters. Only two studies in cluster 1, four studies in cluster 2 and one study in cluster 3 scored high in the quality appraisal. In addition to the quality appraisal, this review assessed if the simulation models were consistent in integrating all relevant phases of care, if utility parameters were consistent and methodological sound and if cost were compatible and consistent in the actual parameters used for screening, diagnostic work up and treatment. Of 18 studies, only three studies did not show signs of potential bias. This systematic review shows that a closer look into the cost and utility parameter can help to identify potential bias. Future simulation models should focus on integrating all relevant phases of care, using methodologically sound utility parameters and avoiding inconsistent cost parameters.

Performance and safety of holmium: YAG laser optical fibers.

PubMed

Knudsen, Bodo E; Glickman, Randolph D; Stallman, Kenneth J; Maswadi, Saher; Chew, Ben H; Beiko, Darren T; Denstedt, John D; Teichman, Joel M H

2005-11-01

Lower-pole ureteronephroscopy requires transmission of holmium:YAG energy along a deflected fiber. Current ureteroscopes are capable of high degrees of deflection, which may stress laser fibers beyond safe limits during lower-pole use. We hypothesized that optical fiber and safety measures differ among manufacturers. Small (200-273-microm) and medium-diameter (300-400-microm) Ho:YAG fibers were tested in a straight and 180 degrees bent configuration. Energy transmission was measured by an energy detector. Fiber durability was assessed by firing the laser in sequentially tighter bending diameters. The fibers were bent to 180 degrees with a diameter of 6 cm and run at 200- to 4000-mJ pulse energy to determine the minimum energy required to fracture the fiber. The bending diameter was decreased by 1-cm increments and testing repeated until a bending diameter of 1 cm was reached. The maximum deflection of the ACMI DUR-8E ureteroscope with each fiber in the working channel was recorded. The flow rate through the working channel of the DUR-8E was measured for each fiber. The mean energy transmission differed among fibers (P < 0.001). The Lumenis SL 200 and the InnovaQuartz 400 were the best small and medium-diameter fibers, respectively, in resisting thermal breakdown (P < 0.01). The Dornier Lightguide Super 200 fractured repeatedly at a bend diameter of 2 cm and with the lowest energy (200 mJ). The other small fibers fractured only at a bend diameter of 1 cm. The Sharplan 200 and InnovaQuartz Sureflex 273T were the most flexible fibers, the Lumenis SL 365 the least. The flow rate was inversely proportional to four times the power of the diameter of the fiber. Optical performance and safety differ among fibers. Fibers transmit various amounts of energy to their cladding when bent. During lower-pole nephroscopy with the fiber deflected, there is a risk of fiber fracture from thermal breakdown and laser-energy transmission to the endoscope. Some available laser fibers carry a risk of ureteroscope damage.

42 CFR 480.101 - Scope and definitions.

Code of Federal Regulations, 2010 CFR

2010-10-01

... ORGANIZATION REVIEW INFORMATION Utilization and Quality Control Quality Improvement Organizations (QIOs... Quality Control Quality Improvement Organization (QIO) (or the review component of a QIO subcontractor) in... sought under Title XVIII of the Act. Aggregate statistical data means any utilization, admission...

42 CFR 476.70 - Statutory bases and applicability.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 476.70 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) QUALITY IMPROVEMENT ORGANIZATIONS UTILIZATION AND QUALITY CONTROL REVIEW Review Responsibilities of Utilization and Quality Control Quality Improvement Organizations (QIOs) General Provisions § 476...

42 CFR 476.76 - Cooperation with health care facilities.

Code of Federal Regulations, 2010 CFR

2010-10-01

... Section 476.76 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) QUALITY IMPROVEMENT ORGANIZATIONS UTILIZATION AND QUALITY CONTROL REVIEW Review Responsibilities of Utilization and Quality Control Quality Improvement Organizations (QIOs) General Provisions...

The PSRO hospital review system.

PubMed

Goran, M J; Roberts, J S; Kellogg, M A; Fielding, J; Jessee, W

1975-04-01

The 1972 Social Security amendments contained the landmark Professional Standards Review Organization (PSRO) provisions as well as several sections upgrading existing utilization review (UR) requirements under Medicare and Medicaid. With issuance of the PSRO Program Manual and the recent publication of the new UR regulations, HEW for the first time has brought Medicare and Medicaid hospital review requirements into conformity and made them compatible with and supportive of the PSRO program. This article defines the PSRO hospital review system, describes how the three major components-concurrent review, medical care evaluation studies, and profile analysis-interrelate and provides examples of each of these components. Under utilization review requirements or PSRO, hospitals will be required to implement an integrated system of review designed to assure appropriate utilization practices and improve the quality of care. These aims are to be accomplished through the application of concepts of peer review, the use of norms, criteria, and standards, the identification of deficiencies in the quality, administration, or appropriateness of health care services, and their correction through linkage with programs of continuing medical education. Although PSROs are initially responsible for review in hospitals, they will likely provide the locus for a community-wide system of peer review for all services provided under National Health Insurance.

Effect of mHealth in improving antenatal care utilization and skilled birth attendance in low- and middle-income countries: a systematic review protocol.

PubMed

Abraha, Yosef G; Gebrie, Serebe A; Garoma, Desalegn A; Deribe, Fasil M; Tefera, Mamuye H; Morankar, Sudhakar

2017-07-01

The objective of this review is to identify and synthesize the best available evidence on the effect of mobile health (mHealth) interventions in antenatal care utilization and skilled birth attendance in low- and middle-income countries.More specifically, the review questions are as follows.

Making genomic medicine evidence-based and patient-centered: a structured review and landscape analysis of comparative effectiveness research.

PubMed

Phillips, Kathryn A; Deverka, Patricia A; Sox, Harold C; Khoury, Muin J; Sandy, Lewis G; Ginsburg, Geoffrey S; Tunis, Sean R; Orlando, Lori A; Douglas, Michael P

2017-10-01

Comparative effectiveness research (CER) in genomic medicine (GM) measures the clinical utility of using genomic information to guide clinical care in comparison to appropriate alternatives. We summarized findings of high-quality systematic reviews that compared the analytic and clinical validity and clinical utility of GM tests. We focused on clinical utility findings to summarize CER-derived evidence about GM and identify evidence gaps and future research needs. We abstracted key elements of study design, GM interventions, results, and study quality ratings from 21 systematic reviews published in 2010 through 2015. More than half (N = 13) of the reviews were of cancer-related tests. All reviews identified potentially important clinical applications of the GM interventions, but most had significant methodological weaknesses that largely precluded any conclusions about clinical utility. Twelve reviews discussed the importance of patient-centered outcomes, although few described evidence about the impact of genomic medicine on these outcomes. In summary, we found a very limited body of evidence about the effect of using genomic tests on health outcomes and many evidence gaps for CER to address.Genet Med advance online publication 13 April 2017.

A systematic review of health economic models and utility estimation methods in schizophrenia.

PubMed

Németh, Bertalan; Fasseeh, Ahmad; Molnár, Anett; Bitter, István; Horváth, Margit; Kóczián, Kristóf; Götze, Árpád; Nagy, Balázs

2018-06-01

There is a growing need for economic evaluations describing the disease course, as well as the costs and clinical outcomes related to the treatment of schizophrenia. Areas covered: A systematic review on studies describing health economic models in schizophrenia and a targeted literature review on utility mapping algorithms in schizophrenia were carried out. Models found in the review were collated and assessed in detail according to their type and various other attributes. Fifty-nine studies were included in the review. Modeling techniques varied from simple decision trees to complex simulation models. The models used various clinical endpoints as value drivers, 47% of the models used quality-adjusted life years, and eight percent used disability-adjusted life years to measure benefits, while others applied various clinical outcomes. Most models considered patients switching between therapies, and therapeutic adherence, compliance or persistence. The targeted literature review identified four main approaches to map PANSS scores to utility values. Expert commentary: Health economic models developed for schizophrenia showed great variability, with simulation models becoming more frequently used in the last decade. Using PANSS scores as the basis of utility estimations is justifiable.

Controlled trials to improve antibiotic utilization: a systematic review of experience, 1984-2004.

PubMed

Parrino, Thomas A

2005-02-01

To review the effectiveness of interventions designed to improve antibiotic prescribing patterns in clinical practice and to draw inferences about the most practical methods for optimizing antibiotic utilization in hospital and ambulatory settings. A literature search using online databases for the years 1975-2004 identified controlled trials of strategies for improving antibiotic utilization. Due to variation in study settings and design, quantitative meta-analysis was not feasible. Therefore, a qualitative literature review was conducted. Forty-one controlled trials met the search criteria. Interventions consisted of education, peer review and feedback, physician participation, rewards and penalties, administrative methods, and combined approaches. Social marketing directed at patients and prescribers was effective in varying contexts, as was implementation of practice guidelines. Authorization systems with structured order entry, formulary restriction, and mandatory consultation were also effective. Peer review and feedback were more effective when combined with dissemination of relevant information or social marketing than when used alone. Several practices were effective in improving antibiotic utilization: social marketing, practice guidelines, authorization systems, and peer review and feedback. Online systems providing clinical information, structured order entry, and decision support may be the most promising approach. Further studies, including economic analyses, are needed to confirm or refute this hypothesis.

Making genomic medicine evidence-based and patient-centered: a structured review and landscape analysis of comparative effectiveness research

PubMed Central

Phillips, Kathryn A.; Deverka, Patricia A.; Sox, Harold C.; Khoury, Muin J.; Sandy, Lewis G.; Ginsburg, Geoffrey S.; Tunis, Sean R.; Orlando, Lori A.; Douglas, Michael P.

2017-01-01

Comparative effectiveness research (CER) in genomic medicine (GM) measures the clinical utility of using genomic information to guide clinical care in comparison to appropriate alternatives. We summarized findings of high-quality systematic reviews that compared the analytic and clinical validity and clinical utility of GM tests. We focused on clinical utility findings to summarize CER-derived evidence about GM and identify evidence gaps and future research needs. We abstracted key elements of study design, GM interventions, results, and study quality ratings from 21 systematic reviews published in 2010 through 2015. More than half (N = 13) of the reviews were of cancer-related tests. All reviews identified potentially important clinical applications of the GM interventions, but most had significant methodological weaknesses that largely precluded any conclusions about clinical utility. Twelve reviews discussed the importance of patient-centered outcomes, although few described evidence about the impact of genomic medicine on these outcomes. In summary, we found a very limited body of evidence about the effect of using genomic tests on health outcomes and many evidence gaps for CER to address. Genet Med advance online publication 13 April 2017 PMID:28406488

Health State Utility Value in Chronic Obstructive Pulmonary Disease (COPD); The Challenge of Heterogeneity: A Systematic Review and Meta-Analysis.

PubMed

Moayeri, Foruhar; Hsueh, Ya-Seng Arthur; Clarke, Philip; Hua, Xinyang; Dunt, David

2016-06-01

Chronic obstructive pulmonary disease (COPD) has a considerable impact on quality of life and well-being of patients. Health state utility value (HSUV) is a recognized measure for health economic appraisals and is extensively used as an indicator for decision-making studies. This study is a systematic review of literature aimed to estimate mean utility value in COPD using meta-analysis and explore degree of heterogeneity in the utility values across a variety of clinical and study characteristic. The literature review covers studies that used EQ-5D to estimate utility value for patient level research in COPD. Studies that reported utility values elicited by EQ-5D in COPD patients were selected for random-effect meta-analysis addressing inter-study heterogeneity and subgroup analyses. Thirty-two studies were included in the general utility meta-analysis. The estimated general utility value was 0.673 (95% CI 0.653 to 0.693). Meta-analyses of COPD stages utility values showed influence of airway obstruction on utility value. The utility values ranged from 0.820 (95% CI 0.767 to 0.872) for stage I to 0.624 (95% CI 0.571 to 0.677) for stage IV. There was substantial heterogeneity in utility values: I(2) = 97.7%. A more accurate measurement of utility values in COPD is needed to refine valid and generalizable scores of HSUV. Given the limited success of the factors studied to reduce heterogeneity, an approach needs to be developed how best to use mean utility values for COPD in health economic evaluation.

42 CFR 476.82 - Continuation of functions not assumed by QIOs.

Code of Federal Regulations, 2010 CFR

2010-10-01

....82 Section 476.82 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) QUALITY IMPROVEMENT ORGANIZATIONS UTILIZATION AND QUALITY CONTROL REVIEW Review Responsibilities of Utilization and Quality Control Quality Improvement Organizations (QIOs...

42 CFR 476.80 - Coordination with Medicare fiscal intermediaries and carriers.

Code of Federal Regulations, 2010 CFR

2010-10-01

... and carriers. 476.80 Section 476.80 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) QUALITY IMPROVEMENT ORGANIZATIONS UTILIZATION AND QUALITY CONTROL REVIEW Review Responsibilities of Utilization and Quality Control Quality Improvement...

A Systematic Review of the Impact of Alcohol Use Disorders on HIV Treatment Outcomes, Adherence to Antiretroviral Therapy and Health Care Utilization *

PubMed Central

Azar, Marwan M.; Springer, Sandra A.; Meyer, Jaimie P.; Altice, Frederick L.

2010-01-01

Background Alcohol use disorders (AUDs) are highly prevalent and associated with non-adherence to antiretroviral therapy, decreased health care utilization and poor HIV treatment outcomes among HIV-infected individuals. Objectives To systematically review studies assessing the impact of AUDs on: (1) medication adherence, (2) health care utilization and (3) biological treatment outcomes among people living with HIV/AIDS (PLWHA). Data Sources Six electronic databases and Google Scholar were queried for articles published in English, French and Spanish from 1988 to 2010. Selected references from primary articles were also examined. Review Methods Selection criteria included: 1) AUD and adherence (N=20); 2) AUD and health services utilization (N=11); or 3) AUD with CD4 count or HIV-1 RNA treatment outcomes (N=10). Reviews, animal studies, non-peer reviewed documents and ongoing studies with unpublished data were excluded. Studies that did not differentiate HIV+ from HIV- status and those that did not distinguish between drug and alcohol use were also excluded. Data were extracted, appraised and summarized. Data Synthesis and Conclusions Our findings consistently support an association between AUDs and decreased adherence to antiretroviral therapy and poor HIV treatment outcomes among HIV-infected individuals. Their effect on health care utilization, however, was variable. PMID:20705402

42 CFR 456.236 - Continued stay review process.

Code of Federal Regulations, 2012 CFR

2012-10-01

....236 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS UTILIZATION CONTROL Utilization Control: Mental Hospitals Ur Plan... physician members of the committee, one of whom is knowledgeable in the treatment of mental diseases, review...

42 CFR 456.236 - Continued stay review process.

Code of Federal Regulations, 2014 CFR

2014-10-01

....236 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS UTILIZATION CONTROL Utilization Control: Mental Hospitals Ur Plan... physician members of the committee, one of whom is knowledgeable in the treatment of mental diseases, review...

Leadership Principles Leveraged from Key Civil War Battles

DTIC Science & Technology

2017-05-15

primary research method utilized for this research paper. The purpose of the literature review was to find data and information regarding analysis of...review was the primary research method utilized for this research paper. The purpose of the literature review was to find data and information...data generation and analysis. Organizational Research Methods , 15 (2), 316-335. Becker, W.S. & Burke, M.J. (2014). Instructional staff

Measurement properties of self-report physical activity assessment tools in stroke: a protocol for a systematic review.

PubMed

Martins, Júlia Caetano; Aguiar, Larissa Tavares; Nadeau, Sylvie; Scianni, Aline Alvim; Teixeira-Salmela, Luci Fuscaldi; Faria, Christina Danielli Coelho de Morais

2017-02-13

Self-report physical activity assessment tools are commonly used for the evaluation of physical activity levels in individuals with stroke. A great variety of these tools have been developed and widely used in recent years, which justify the need to examine their measurement properties and clinical utility. Therefore, the main objectives of this systematic review are to examine the measurement properties and clinical utility of self-report measures of physical activity and discuss the strengths and limitations of the identified tools. A systematic review of studies that investigated the measurement properties and/or clinical utility of self-report physical activity assessment tools in stroke will be conducted. Electronic searches will be performed in five databases: Medical Literature Analysis and Retrieval System Online (MEDLINE) (PubMed), Excerpta Medica Database (EMBASE), Physiotherapy Evidence Database (PEDro), Literatura Latino-Americana e do Caribe em Ciências da Saúde (LILACS) and Scientific Electronic Library Online (SciELO), followed by hand searches of the reference lists of the included studies. Two independent reviewers will screen all retrieve titles, abstracts, and full texts, according to the inclusion criteria and will also extract the data. A third reviewer will be referred to solve any disagreement. A descriptive summary of the included studies will contain the design, participants, as well as the characteristics, measurement properties, and clinical utility of the self-report tools. The methodological quality of the studies will be evaluated using the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) checklist and the clinical utility of the identified tools will be assessed considering predefined criteria. This systematic review will follow the Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) statement. This systematic review will provide an extensive review of the measurement properties and clinical utility of self-report physical activity assessment tools used in individuals with stroke, which would benefit clinicians and researchers. PROSPERO CRD42016037146. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

The validity and clinical utility of the Disabilities of the Arm Shoulder and Hand questionnaire for hand injuries in developing country contexts: A systematic review.

PubMed

de Klerk, Susan; Buchanan, Helen; Jerosch-Herold, Christina

Systematic review. The Disabilities of the Arm Shoulder and Hand Questionnaire has multiple language versions from many countries around the world. In addition there is extensive research evidence of its psychometric properties. The purpose of this study was to systematically review the evidence available on the validity and clinical utility of the Disabilities of the Arm Shoulder and Hand as a measure of activity and participation in patients with musculoskeletal hand injuries in developing country contexts. We registered the review with international prospective register of systematic reviews prior to conducting a comprehensive literature search and extracting descriptive data. Two reviewers independently assessed methodological quality with the Consensus-Based Standards for the Selection of Health Measurement Instruments critical appraisal tool, the checklist to operationalize measurement characteristics of patient-rated outcome measures and the multidimensional model of clinical utility. Fourteen studies reporting 12 language versions met the eligibility criteria. Two language versions (Persian and Turkish) had an overall rating of good, and one (Thai) had an overall rating of excellent for cross-cultural validity. The remaining 9 language versions had an overall poor rating for cross-cultural validity. Content and construct validity and clinical utility yielded similar results. Poor quality ratings for validity and clinical utility were due to insufficient documentation of results and inadequate psychometric testing. With the increase in migration and globalization, hand therapists are likely to require a range of culturally adapted and translated versions of the Disabilities of the Arm Shoulder and Hand. Recommendations include rigorous application and reporting of cross-cultural adaptation, appropriate psychometric testing, and testing of clinical utility in routine clinical practice. Copyright © 2017 Hanley & Belfus. Published by Elsevier Inc. All rights reserved.

Should "standard gamble" and "'time trade off" utility measurement be used more in mental health research?

PubMed

Flood, Chris

2010-06-01

This review and discussion paper demonstrates that utility and preference measurement in mental health research is increasing. However there is still a general reluctance around using the methods due to methodological challenges and concerns around the capacity of users to understand utility methods during the research process. This paper sets out to describe and review some of the previously documented difficulties of using utility measurements in mental health services research and to highlight where they have been used successfully as measures. Additionally the paper aims to discuss a means of improving the methods used to capture service user utility and preference measurement and why decision making would be better informed as a result. International literature on utility measurement is reviewed, specifically examining the use of standard gamble and time trade off methods in mental health. Utility measurement in mental health is increasing though as the review demonstrates, concerns still exist over its application. A number of methods can be used to improve the approach overall and these are discussed as well as specific areas worthy of utility measurement including 'disutility' of admission, medication and medication side effects. Overall this paper argues that it is necessary to persist with efforts to conduct utility measurement calculation albeit with a critical eye on the methods in an attempt to ensure improvements are continually made. Utility and preference scores may be limited in that they only provide a rough score but they are defended as a means of providing some form of strength of preference for health states. The review is limited to English only texts. The debate on whether to use standard gamble and time trade off has implications for health services resource allocations, decision making, health economics research, policy making and health services research generally involving psychiatric service users. The paper argues that the absence of utility measurement in mental health runs the risk of mental health being disadvantaged in decisions around resource allocation. Institutions involved in decision making like the United Kingdom's National Institute for Health and Clinical Excellence, would be better served in their decision making and calculation of Quality Adjusted Life Years if more utility measurement in psychiatric research was carried out. Other arguments for using utility measurement include the desirability of using utility measurement to elicit a patient dimension of risk. Future utility research should aim for better involvement of service users in the design stage, the changing of time frames offered to users in health state scenarios used, a greater need for comparative work of utilities scoring across illness and between standard gamble and time trade off and more staff training in the use of utility methodology with mental health service users.

Instruments to assess patient comfort during hospitalization: A psychometric review.

PubMed

Lorente, Sonia; Losilla, Josep-Maria; Vives, Jaume

2018-05-01

To analyse the psychometric properties and the utility of instruments used to measure patient comfort, physical, social, psychospiritual and/or environmental, during hospitalization. There are no systematic reviews nor psychometric reviews of instruments used to measure comfort, which is considered an indicator of quality in health care associated with quicker discharges, increased patient satisfaction and better cost-benefit ratios for the institution. Psychometric review. MEDLINE, CINAHL, PsycINFO, Web of Knowledge, ProQuest Thesis&Dissertations, Google. We limited our search to studies published between 1990-2015. The psychometric analysis was performed using the COnsensus-based Standards for the selection of health status Measurement INstruments (COSMIN), along with the Quality Criteria for Measurement Properties. The utility of the instruments was assessed according to their cost-efficiency, acceptability and educational impact. Protocol registration in PROSPERO, CRD42016036290. Instruments reviewed showed moderate methodological quality and their utility was poorly reported. Thus, we cannot recommend any questionnaire without reservations, but the Comfort Scale, the General Comfort Questionnaire and their adaptations in adults and older patients, the Psychosocial Comfort Scale and the Incomfort des Patients de Reanimation are the most recommendable instruments to measure comfort. The methodology of the studies should be more rigorous and authors should adequately report the utility of instruments. This review provides a strategy to select the most suitable instrument to assess patient comfort according to their psychometric properties and utility, which is crucial for nurses, clinicians, researchers and institutions. © 2017 John Wiley & Sons Ltd.

42 CFR 456.234 - Subsequent continued stay review dates.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 42 Public Health 4 2010-10-01 2010-10-01 false Subsequent continued stay review dates. 456.234 Section 456.234 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS UTILIZATION CONTROL Utilization Control: Mental Hospitals...

42 CFR 456.236 - Continued stay review process.

Code of Federal Regulations, 2010 CFR

2010-10-01

... (CONTINUED) MEDICAL ASSISTANCE PROGRAMS UTILIZATION CONTROL Utilization Control: Mental Hospitals Ur Plan... each continued stay of a recipient in the mental hospital, the committee, subgroup or designee reviews... committee, subgroup or designee finds that a recipient's continued stay in the mental hospital is needed...

42 CFR 476.90 - Lack of cooperation by a health care facility or practitioner.

Code of Federal Regulations, 2010 CFR

2010-10-01

... practitioner. 476.90 Section 476.90 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) QUALITY IMPROVEMENT ORGANIZATIONS UTILIZATION AND QUALITY CONTROL REVIEW Review Responsibilities of Utilization and Quality Control Quality Improvement Organizations (QIOs...

42 CFR 476.86 - Correlation of Title XI functions with Title XVIII functions.

Code of Federal Regulations, 2010 CFR

2010-10-01

... functions. 476.86 Section 476.86 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) QUALITY IMPROVEMENT ORGANIZATIONS UTILIZATION AND QUALITY CONTROL REVIEW Review Responsibilities of Utilization and Quality Control Quality Improvement Organizations (QIOs...

How to interpret a healthcare economic analysis.

PubMed

Brown, Melissa M; Brown, Gary C

2005-06-01

The purpose of the review is to present guidelines to help the clinician to interpret healthcare economic analyses and review pertinent recent analysis in the ophthalmic literature. There are four variants of healthcare economic analyses: (1) cost-minimization analysis; (2) cost-benefit analysis; (3) cost-effectiveness analysis and (4) cost-utility analysis. Cost-utility utility analysis has assumed an increasingly important role in healthcare, with increasing number of analyses occurring in the peer-reviewed ophthalmic literature. These include cost-utility analyses of cataract surgery in the first and second eyes, amblyopia treatment, and cost-utility analyses encompassing the vitreoretinal interventions of the following: (1) laser photocoagulation for exudative macular degeneration; (2) laser treatment for diabetic retinopathy; (3) laser photocoagulation for branch retinal vein obstruction; (4) diabetic vitrectomy; (5) treatment of proliferative retinopathy of prematurity and (6) treatment of retinal detachment associated with proliferative vitreoretinopathy. As an increasing number of cost-utility analyses become available they will provide the information system for the practice of value-based medicine, or medicine based upon the patient-perceived value conferred by interventions. Increasing numbers of cost-utility analysis in the ophthalmic literature suggest that ophthalmic interventions, including vitreoretinal interventions, are cost effective. Cost-utility analysis is a major tool in value-based medicine, the practice of medicine based upon the patient-perceived value conferred by healthcare interventions.

Pain assessment for people with dementia: a systematic review of systematic reviews of pain assessment tools.

PubMed

Lichtner, Valentina; Dowding, Dawn; Esterhuizen, Philip; Closs, S José; Long, Andrew F; Corbett, Anne; Briggs, Michelle

2014-12-17

There is evidence of under-detection and poor management of pain in patients with dementia, in both long-term and acute care. Accurate assessment of pain in people with dementia is challenging and pain assessment tools have received considerable attention over the years, with an increasing number of tools made available. Systematic reviews on the evidence of their validity and utility mostly compare different sets of tools. This review of systematic reviews analyses and summarises evidence concerning the psychometric properties and clinical utility of pain assessment tools in adults with dementia or cognitive impairment. We searched for systematic reviews of pain assessment tools providing evidence of reliability, validity and clinical utility. Two reviewers independently assessed each review and extracted data from them, with a third reviewer mediating when consensus was not reached. Analysis of the data was carried out collaboratively. The reviews were synthesised using a narrative synthesis approach. We retrieved 441 potentially eligible reviews, 23 met the criteria for inclusion and 8 provided data for extraction. Each review evaluated between 8 and 13 tools, in aggregate providing evidence on a total of 28 tools. The quality of the reviews varied and the reporting often lacked sufficient methodological detail for quality assessment. The 28 tools appear to have been studied in a variety of settings and with varied types of patients. The reviews identified several methodological limitations across the original studies. The lack of a 'gold standard' significantly hinders the evaluation of tools' validity. Most importantly, the samples were small providing limited evidence for use of any of the tools across settings or populations. There are a considerable number of pain assessment tools available for use with the elderly cognitive impaired population. However there is limited evidence about their reliability, validity and clinical utility. On the basis of this review no one tool can be recommended given the existing evidence.

Value-based medicine and ophthalmology: an appraisal of cost-utility analyses.

PubMed

Brown, Gary C; Brown, Melissa M; Sharma, Sanjay; Brown, Heidi; Smithen, Lindsay; Leeser, David B; Beauchamp, George

2004-01-01

To ascertain the extent to which ophthalmologic interventions have been evaluated in value-based medicine format. Retrospective literature review. Papers in the healthcare literature utilizing cost-utility analysis were reviewed by researchers at the Center for Value-Based Medicine, Flourtown, Pennsylvania. A literature review of papers addressing the cost-utility analysis of ophthalmologic procedures in the United States over a 12-year period from 1992 to 2003 was undertaken using the National Library of Medicine and EMBASE databases. The cost-utility of ophthalmologic interventions in inflation-adjusted (real) year 2003 US dollars expended per quality-adjusted life-year (dollars/QALY) was ascertained in all instances. A total of 19 papers were found, including a total of 25 interventions. The median cost-utility of ophthalmologic interventions was 5,219 dollars/QALY, with a range from 746 dollars/QALY to 6.5 million dollars/QALY. The majority of ophthalmologic interventions are especially cost-effective by conventional standards. This is because of the substantial value that ophthalmologic interventions confer to patients with eye diseases for the resources expended.

VALUE-BASED MEDICINE AND OPHTHALMOLOGY: AN APPRAISAL OF COST-UTILITY ANALYSES

PubMed Central

Brown, Gary C; Brown, Melissa M; Sharma, Sanjay; Brown, Heidi; Smithen, Lindsay; Leeser, David B; Beauchamp, George

2004-01-01

ABSTRACT Purpose To ascertain the extent to which ophthalmologic interventions have been evaluated in value-based medicine format. Methods Retrospective literature review. Papers in the healthcare literature utilizing cost-utility analysis were reviewed by researchers at the Center for Value-Based Medicine, Flourtown, Pennsylvania. A literature review of papers addressing the cost-utility analysis of ophthalmologic procedures in the United States over a 12-year period from 1992 to 2003 was undertaken using the National Library of Medicine and EMBASE databases. The cost-utility of ophthalmologic interventions in inflation-adjusted (real) year 2003 US dollars expended per quality-adjusted life-year ($/QALY) was ascertained in all instances. Results A total of 19 papers were found, including a total of 25 interventions. The median cost-utility of ophthalmologic interventions was $5,219/QALY, with a range from $746/QALY to $6.5 million/QALY. Conclusions The majority of ophthalmologic interventions are especially cost-effective by conventional standards. This is because of the substantial value that ophthalmologic interventions confer to patients with eye diseases for the resources expended. PMID:15747756

Equity in maternal health care service utilization: a systematic review for developing countries.

PubMed

Çalışkan, Zafer; Kılıç, Dilek; Öztürk, Selcen; Atılgan, Emre

2015-11-01

The objective was to explore progress of equity in the utilization of maternal health care services in developing countries since maternal care is a crucial factor in reducing maternal mortality, which is targeted by the Millennium Development Goal 5. A systematic review of quantitative studies was done. PubMed Central, Web of Science, and Science Direct databases were searched for peer-reviewed and English-language articles published between 2005 and 2015. Thirty-six articles were included in the review. The results reveal the lack of equity in the utilization of maternal health care in developing countries. Thirty-three out of 36 studies found evidence supporting severe inequities while three studies found evidence of equity or at least improvement in terms of equity. Most of the literature devoted to utilization of maternal health care generally provides information on the level of maternal care used and ignore the equity problem. Research in this area should focus not only on the level of maternal care used but also on the most disadvantaged segments of the population in terms of utilization of maternal care in order to reach the set targets.

Federal policies to promote the widespread utilization of photovoltaic systems. Supplement: Review and critique

NASA Technical Reports Server (NTRS)

Smith, J. L.

1980-01-01

Review comments of the Congressional report entitled 'Federal Policies to Promote the Widespread Utilization of Photovoltaic Systems' are presented. Responses to the review comments by the Jet Propulsion Laboratory, preparer of the Congressional report, are also presented. The Congressional report discussed various issues related to promoting the deployment of photovoltaic systems through the Federal Photovoltaic Program. Various program strategies and funding levels were examined.

42 CFR 456.23 - Post-payment review process.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 42 Public Health 4 2010-10-01 2010-10-01 false Post-payment review process. 456.23 Section 456.23 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS UTILIZATION CONTROL Utilization Control: All Medicaid Services § 456...

Impact of comorbidity and healthcare utilization on colorectal cancer stage at diagnosis: literature review

PubMed Central

Corkum, Mark; Urquhart, Robin; Burge, Fred; Porter, Geoffrey; Johnston, Grace

2013-01-01

Purpose Individuals diagnosed with cancer close to death have low access to enrollment in palliative care programs. The purpose of this literature review was to assess the usefulness of pre-diagnostic comorbidity and healthcare utilization as indicators of late-stage colorectal cancer (CRC) diagnosis, to help with early identification of individuals who may benefit from palliative care. Methods A literature search was conducted in relevant databases using title/abstract terms which included “cancer,” “stage,” “diagnosis,” “determinants,” “predictors,” and “associated.” Included studies examined whether comorbidity and/or healthcare utilization had an impact on the stage at which CRC was diagnosed. A standardized data abstraction form was used to assess the eligibility of each study. Thirteen articles were included in the literature review. These studies were assessed and synthesized using qualitative methodology. Results We found much heterogeneity among study variables. The findings of this literature review point to the presence of comorbidity and non-emergent healthcare utilization as having no association with late-stage diagnosis. Conversely, emergency room presentation (ERP) was associated with late-stage diagnosis. Conclusions The results of this literature review did not find strong evidence to suggest that comorbidity and healthcare utilization are potential indicators of late-stage diagnosis. However, ERP may be useful as a flag for consideration of prompt referral to palliative care. Additional research is required to identify potential indicators of late-stage diagnosis that may be available in administrative databases, particularly in the area of healthcare utilization. PMID:22101505

U.S. Refining Capacity Utilization

EIA Publications

1995-01-01

This article briefly reviews recent trends in domestic refining capacity utilization and examines in detail the differences in reported crude oil distillation capacities and utilization rates among different classes of refineries.

Establishing benchmarks and metrics for disruptive technologies, inappropriate and obsolete tests in the clinical laboratory.

PubMed

Kiechle, Frederick L; Arcenas, Rodney C; Rogers, Linda C

2014-01-01

Benchmarks and metrics related to laboratory test utilization are based on evidence-based medical literature that may suffer from a positive publication bias. Guidelines are only as good as the data reviewed to create them. Disruptive technologies require time for appropriate use to be established before utilization review will be meaningful. Metrics include monitoring the use of obsolete tests and the inappropriate use of lab tests. Test utilization by clients in a hospital outreach program can be used to monitor the impact of new clients on lab workload. A multi-disciplinary laboratory utilization committee is the most effective tool for modifying bad habits, and reviewing and approving new tests for the lab formulary or by sending them out to a reference lab. Copyright © 2013 Elsevier B.V. All rights reserved.

A systematic review of utility values for chemotherapy-related adverse events.

PubMed

Shabaruddin, Fatiha H; Chen, Li-Chia; Elliott, Rachel A; Payne, Katherine

2013-04-01

Chemotherapy offers cancer patients the potential benefits of improved mortality and morbidity but may cause detrimental outcomes due to adverse drug events (ADEs), some of which requiring time-consuming, resource-intensive and costly clinical management. To appropriately assess chemotherapy agents in an economic evaluation, ADE-related parameters such as the incidence, (dis)utility and cost of ADEs should be reflected within the model parameters. To date, there has been no systematic summary of the existing literature that quantifies the utilities of ADEs due to healthcare interventions in general and chemotherapy treatments in particular. This review aimed to summarize the current evidence base of reported utility values for chemotherapy-related ADEs. A structured electronic search combining terms for utility, utility valuation methods and generic terms for cancer treatment was conducted in MEDLINE and EMBASE in June 2011. Inclusion criteria were: (1) elicitation of utility values for chemotherapy-related ADEs and (2) primary data. Two reviewers identified studies and extracted data independently. Any disagreements were resolved by a third reviewer. Eighteen studies met the inclusion criteria from the 853 abstracts initially identified, collectively reporting 218 utility values for chemotherapy-related ADEs. All 18 studies used short descriptions (vignettes) to obtain the utility values, with nine studies presenting the vignettes used in the valuation exercises. Of the 218 utility values, 178 were elicited using standard gamble (SG) or time trade-off (TTO) approaches, while 40 were elicited using visual analogue scales (VAS). There were 169 utility values of specific chemotherapy-related ADEs (with the top ten being anaemia [34 values], nausea and/or vomiting [32 values], neuropathy [21 values], neutropenia [12 values], diarrhoea [12 values], stomatitis [10 values], fatigue [8 values], alopecia [7 values], hand-foot syndrome [5 values] and skin reaction [5 values]) and 49 of non-specific chemotherapy-related adverse events. In most cases, it was difficult to directly compare the utility values as various definitions and study-specific vignettes were used for the ADEs of interest. This review was designed to provide an overall description of existing literature reporting utility values for chemotherapy-related ADEs. The findings were not exhaustive and were limited to publications that could be identified using the search strategy employed and those reported in the English language. This review identified wide ranges in the utility values reported for broad categories of specific chemotherapy-related ADEs. There were difficulties in comparing the values directly as various study-specific definitions were used for these ADEs and most studies did not make the vignettes used in the valuation exercises available. It is recommended that a basic minimum requirement be developed for the transparent reporting of study designs eliciting utility values, incorporating key criteria such as reporting how the vignettes were developed and presenting the vignettes used in the valuation tasks as well as valuing and reporting the utility values of the ADE-free base states. It is also recommended, in the future, for studies valuing the utilities of chemotherapy-related ADEs to define the ADEs according to the National Cancer Institute (NCI) definitions for chemotherapy-related ADEs as the use of the same definition across studies would ease the comparison and selection of utility values and make the overall inclusion of adverse events within economic models of chemotherapy agents much more straightforward.

A review of utility issues for the integration of wind electric generators

NASA Technical Reports Server (NTRS)

Reddoch, T. W.; Barnes, P. R.

1982-01-01

A review of issues and concerns of the electric utility industry for the integration of wind electric generation is offered. The issues have been categorized in three major areas: planning, operations, and dynamic interaction. Representative studies have been chosen for each area to illustrate problems and to alleviate some concerns. The emphasis of this paper is on individual large wind turbines (WTs) and WT arrays for deployment at the bulk level in a utility system.

Cost-Utility Analysis of Cancer Prevention, Treatment, and Control: A Systematic Review.

PubMed

Winn, Aaron N; Ekwueme, Donatus U; Guy, Gery P; Neumann, Peter J

2016-02-01

Substantial innovation related to cancer prevention and treatment has occurred in recent decades. However, these innovations have often come at a significant cost. Cost-utility analysis provides a useful framework to assess if the benefits from innovation are worth the additional cost. This systematic review on published cost-utility analyses related to cancer care is from 1988 through 2013. Analyses were conducted in 2013-2015. This review analyzed data from the Tufts Medical Center Cost-Effectiveness Analysis Registry (www.cearegistry.org), a comprehensive registry with detailed information on 4,339 original cost-utility analyses published in the peer-reviewed medical and economic literature through 2013. There were 721 cancer-related cost-utility analyses published from 1998 through 2013, with roughly 12% of studies focused on primary prevention and 17% focused on secondary prevention. The most often studied cancers were breast cancer (29%); colorectal cancer (11%); and prostate cancer (8%). The median reported incremental cost-effectiveness ratios (in 2014 U.S. dollars) were $25,000 for breast cancer, $24,000 for colorectal cancer, and $34,000 for prostate cancer. The current evidence indicates that there are many interventions that are cost effective across cancer sites and levels of prevention. However, the results highlight the relatively small number of cancer cost-utility analyses devoted to primary prevention compared with secondary or tertiary prevention. Copyright © 2016 American Journal of Preventive Medicine. All rights reserved.

42 CFR 456.171 - Medicaid agency review of need for admission.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 42 Public Health 4 2010-10-01 2010-10-01 false Medicaid agency review of need for admission. 456.171 Section 456.171 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS UTILIZATION CONTROL Utilization Control: Mental...

42 CFR 476.90 - Lack of cooperation by a health care facility or practitioner.

Code of Federal Regulations, 2011 CFR

2011-10-01

... HEALTH AND HUMAN SERVICES (CONTINUED) QUALITY IMPROVEMENT ORGANIZATIONS UTILIZATION AND QUALITY CONTROL REVIEW Review Responsibilities of Utilization and Quality Control Quality Improvement Organizations (QIOs... and a reasonable amount of time to respond to a request for information about a claim, and if the...

42 CFR 476.88 - Examination of the operations and records of health care facilities and practitioners.

Code of Federal Regulations, 2010 CFR

2010-10-01

... SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) QUALITY IMPROVEMENT ORGANIZATIONS UTILIZATION AND QUALITY CONTROL REVIEW Review Responsibilities of Utilization and Quality Control Quality... information on charges) that are pertinent to health care services furnished to Medicare beneficiaries and are...

The Influence of Peer Reviewer Expertise on the Evaluation of Research Funding Applications

PubMed Central

Sullivan, Joanne H.; Glisson, Scott R.

2016-01-01

Although the scientific peer review process is crucial to distributing research investments, little has been reported about the decision-making processes used by reviewers. One key attribute likely to be important for decision-making is reviewer expertise. Recent data from an experimental blinded review utilizing a direct measure of expertise has found that closer intellectual distances between applicant and reviewer lead to harsher evaluations, possibly suggesting that information is differentially sampled across subject-matter expertise levels and across information type (e.g. strengths or weaknesses). However, social and professional networks have been suggested to play a role in reviewer scoring. In an effort to test whether this result can be replicated in a real-world unblinded study utilizing self-assessed reviewer expertise, we conducted a retrospective multi-level regression analysis of 1,450 individual unblinded evaluations of 725 biomedical research funding applications by 1,044 reviewers. Despite the large variability in the scoring data, the results are largely confirmatory of work from blinded reviews, by which a linear relationship between reviewer expertise and their evaluations was observed—reviewers with higher levels of self-assessed expertise tended to be harsher in their evaluations. However, we also found that reviewer and applicant seniority could influence this relationship, suggesting social networks could have subtle influences on reviewer scoring. Overall, these results highlight the need to explore how reviewers utilize their expertise to gather and weight information from the application in making their evaluations. PMID:27768760

Utilization of Liposuction for Delayed Morel-Lavallée Lesion: A Case Report and Review.

PubMed

Gardner, Preston; Flis, Diana; Chaiyasate, Kongkrit

2017-01-01

Morel-Lavallée lesions are irregularly occurring and often overlooked results of traumatic injuries, resulting in potential long-term encapsulation of fluid between soft-tissue layers. The objective in this review was to discuss the delayed presentation of a Morel-Lavallée lesion and operative utility of liposuction in the patient's treatment and review literature with particular focus on diagnosis and therapeutic interventions. The reviewed case demonstrates the presentation and successful therapy of a young female presenting with a MLL and contour deformity.

24 CFR 990.185 - Utilities expense level: Incentives for energy conservation/rate reduction.

Code of Federal Regulations, 2011 CFR

2011-04-01

...) Utility benchmarking. HUD will pursue benchmarking utility consumption at the project level as part of the... convene a meeting with representation of appropriate stakeholders to review utility benchmarking options so that HUD may determine whether or how to implement utility benchmarking to be effective in FY 2011...

24 CFR 990.185 - Utilities expense level: Incentives for energy conservation/rate reduction.

Code of Federal Regulations, 2010 CFR

2010-04-01

...) Utility benchmarking. HUD will pursue benchmarking utility consumption at the project level as part of the... convene a meeting with representation of appropriate stakeholders to review utility benchmarking options so that HUD may determine whether or how to implement utility benchmarking to be effective in FY 2011...

Drug utilization and medication costs at the end of life.

PubMed

Pont, Lisa; Jansen, Kristian; Schaufel, Margrete Aase; Haugen, Dagny Faksvåg; Ruths, Sabine

2016-01-01

In the end stages of life, drug treatment goals shift to symptom control and quality of life and as such changes in drug utilization are expected. The aim of this paper is to review the extent to which costs are considered in drug utilization research at the end of life, with a particular focus on the outcome measures being used. This systematic review identified seven studies across varied settings studies reporting both drug utilization and medication cost outcome measures. The main factors identified that impacted medication use and cost were the time period considered and the provision of specialist palliative care services. Combining drug utilization and medication cost outcomes is critical for the allocation of healthcare resources and the development of a sound health policy.

Health utility of patients with Crohn's disease and ulcerative colitis: a systematic review and meta-analysis.

PubMed

Malinowski, Krzysztof Piotr; Kawalec, Paweł

2016-08-01

The aim of this systematic review was to collect and summarize the current data on the utilities of patients with Crohn's disease (CD) and ulcerative colitis (UC). A meta-analysis of the obtained utilities was performed using a random-effects model and meta-regression by the disease type and severity. A bootstrap analysis was performed as it does not require assumption on distribution of the data. The highest utility among patients with CD and UC was observed when the diseases were in remission. The meta-regression analysis showed that both disease severity and an instrument/method/questionnaire used to obtain utilities were significant predictors of utility. Utility was the lowest for severe disease and the highest for disease in remission, the association was more notable in patients with CD compared with UC. Expert commentary: The issue of patients' utility is important for healthcare decision makers but it has not been fully investigated and requires further study.

The dynamics of utilization review: a case study of 44 Massachusetts hospitals.

PubMed

Gertman, P M; Egdahl, R E

1978-10-01

Utilization review programs have existed on a national basis for over a decade, but relatively little is known about the patients who are scrutinized and what actions are taken to correct unnecessary use. In the fall of 1976, 44 of the 122 Massachusetts hospitals participated in a two-week in depth study of their utilization review activities. Over 22,000 admission and extended stay reviews were performed during this time period, and of these, 2,120 patients' continued stays in the hospital were questioned. In five admission review cases and 79 extended stay review cases, the UR committee formally terminated continued health insurance benefits, and in 12 admission reviews and 74 extended stay reviews, questioning by the UR committee led the attending physician to discharge the patient earlier than would have otherwise occurred. Ninety-four percent of the terminations occurred in Medicare patients and the median age of these patients exceeded 80 years. For medical patients, a disproportionate share of all those cases questioned and of those terminated occurred in chronic illness categories, such as cancer, heart failure, and organic brain syndromes. A higher than expected percentage of surgical cases questioned by the UR committee were in neurosurgical, cardiovascular and orthopedic procedure groups. The frequency with which UR committees identified and acted upon cases suggests that effective self-policing is occurring. A large portion of the utilization problem, however, may be related to the unavailability of appropriate sub-acute care for patients with chronic medical illness or surgical procedures which require long postoperative rehabilitation and recuperation.

45 CFR 1356.71 - Federal review of the eligibility of children in foster care and the eligibility of foster care...

Code of Federal Regulations, 2010 CFR

2010-10-01

... by ACF statistical staff from the Adoption and Foster Care Analysis and Reporting System (AFCARS... primary review utilizing probability sampling methodologies. Usually, the chosen methodology will be simple random sampling, but other probability samples may be utilized, when necessary and appropriate. (3...

42 CFR 476.94 - Notice of QIO initial denial determination and changes as a result of a DRG validation.

Code of Federal Regulations, 2010 CFR

2010-10-01

... & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) QUALITY IMPROVEMENT ORGANIZATIONS UTILIZATION AND QUALITY CONTROL REVIEW Review Responsibilities of Utilization and Quality Control Quality... validation; (2) For day outliers in hospitals, the date on which the stay or services in the facility will...

Review of the Technology-Utilization Level of String Instrument Teachers

ERIC Educational Resources Information Center

Döger, Didem; Kiliç, Ilgim

2016-01-01

The purpose of this study is to determine the technology-utilization level of Fine Arts High School string instrument teachers. A pattern based on descriptive method has been used to conduct the researchers. Research data has been collected via literature review and questionnaire developed and prepared by the researcher. SPSS program has been…

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

Cost-utility and cost-effectiveness studies of telemedicine, electronic, and mobile health systems in the literature: a systematic review.

PubMed

de la Torre-Díez, Isabel; López-Coronado, Miguel; Vaca, Cesar; Aguado, Jesús Saez; de Castro, Carlos

2015-02-01

A systematic review of cost-utility and cost-effectiveness research works of telemedicine, electronic health (e-health), and mobile health (m-health) systems in the literature is presented. Academic databases and systems such as PubMed, Scopus, ISI Web of Science, and IEEE Xplore were searched, using different combinations of terms such as "cost-utility" OR "cost utility" AND "telemedicine," "cost-effectiveness" OR "cost effectiveness" AND "mobile health," etc. In the articles searched, there were no limitations in the publication date. The search identified 35 relevant works. Many of the articles were reviews of different studies. Seventy-nine percent concerned the cost-effectiveness of telemedicine systems in different specialties such as teleophthalmology, telecardiology, teledermatology, etc. More articles were found between 2000 and 2013. Cost-utility studies were done only for telemedicine systems. There are few cost-utility and cost-effectiveness studies for e-health and m-health systems in the literature. Some cost-effectiveness studies demonstrate that telemedicine can reduce the costs, but not all. Among the main limitations of the economic evaluations of telemedicine systems are the lack of randomized control trials, small sample sizes, and the absence of quality data and appropriate measures.

Anesthésie d’un greffé cardiaque en chirurgie non cardiaque: à propos d’un cas clinique et revue de la littérature

PubMed Central

Nassirou, Oumarou Mahamane Mamane; Jaafari, Abdelhamid; Chlouchi, Abdellatif; Bensghir, Mustapha; Haimeur, Charki

2016-01-01

Le nombre et la durée de survie des patients transplantés cardiaque sont en augmentation. Une partie de ces patients se présentent régulièrement pour une chirurgie générale en dehors de la transplantation cardiaque. L’anesthésie chez ces patients peut être difficile en raison des particularités physiologiques du cœur dénervé et de la gestion du traitement immunosuppresseur avec le risque de rejet et d’infection. Nous discutons la prise en charge anesthésique à travers un cas d’un patient âgé de 60 ans transplanté cardiaque devant subir une chirurgie de cure d’éventration abdominale et une revue de la littérature. PMID:28154639

Tribological tests of wear-resistant coatings used in the production of drill bits of horizontal and inclined drilling

NASA Astrophysics Data System (ADS)

Maslov, A. L.; Markova, I. Yu; Zakharova, E. S.; Polushin, N. I.; Laptev, A. I.

2017-05-01

It is known that modern drilling bit body undergoes significant abrasive wear in the contact area with the solid and the retracted cuttings. For protection of the body rationally use wear-resistant coating, which is welded directly to the body of bit. Before mass use of the developed coverings they need to be investigated by various methods that it was possible to characterize coatings and on the basis of the obtained data to perform optimization of both composition of coatings and technology. Such methods include microstructural studies tribological tests, crack resistance and others. This work is devoted to the tribological tests of imported brand of coatings WokaDur NiA and and domestic brand of coating HR-6750 (both brands manufactured by Ltd “Oerlikon Metco Rus”), used to protect the bit body from abrasive wear.

Hacking the quantum revolution: 1925-1975

NASA Astrophysics Data System (ADS)

Schweber, Silvan S.

2015-01-01

I argue that the quantum revolution should be seen as an Ian Hacking type of scientific revolution: a profound, longue durée, multidisciplinary process of transforming our understanding of physical nature, with deep-rooted social components from the start. The "revolution" exhibits a characteristic style of reasoning - the hierarchization of physical nature - and developed and uses a specific language - quantum field theory (QFT). It is by virtue of that language that the quantum theory has achieved some of its deepest insights into the description of the dynamics of the physical world. However, the meaning of what a quantum field theory is and what it describes has deeply altered, and one now speaks of "effective" quantum field theories. Interpreting all present day quantum field theories as but "effective" field theories sheds additional light on Phillip Anderson's assertion that "More is different". This important element is addressed in the last part of the paper.

Leaking Containers: Success and Failure in Controlling the Mosquito Aedes aegypti in Brazil.

PubMed

Löwy, Ilana

2017-04-01

In 1958, the Pan American Health Organization declared that Brazil had successfully eradicated the mosquito Aedes aegypti, responsible for the transmission of yellow fever, dengue fever, chikungunya, and Zika virus. Yet in 2016 the Brazilian minister of health described the situation of dengue fever as "catastrophic." Discussing the recent epidemic of Zika virus, which amplified the crisis produced by the persistence of dengue fever, Brazil's president declared in January 2016 that "we are in the process of losing the war against the mosquito Aedes aegypti." I discuss the reasons for the failure to contain Aedes in Brazil and the consequences of this failure. A longue durée perspective favors a view of the Zika epidemic that does not present it as a health crisis to be contained with a technical solution alone but as a pathology that has the persistence of deeply entrenched structural problems and vulnerabilities.

Kyste hydatique à localisation costo vertébrale

PubMed Central

Marouf, Rachid

2014-01-01

L'hydatidose est une affection parasitaire due à la contamination de l'homme par la forme larvaire de ténia échinococcus granulosus, la forme costo vertébrale est une localisation très rare qui représente 0,18 à 1,21% de l'ensemble des localisations hydatiques. Nous rapportons le cas d'une femme de 32 ans qui présente un kyste hydatique multi vésiculaire à localisation costovertébrale, traité par chirurgie radicale associée à un traitement médical anti parasitaire pour une durée de 6 mois, avec bonne évolution. L'atteinte costo-vertébrale par la maladie hydatique est rare et l’évolution est insidieuse. Malgré un traitement chirurgical radical, la fréquence des récidives rend le pronostic sombre. PMID:25922632

Sexing Berlin?

PubMed

Dahlke, Birgit

2011-01-01

Berlin has always been a literary space of extremely diverse political and cultural projections. This essay investigates why after the unification of East and West Berlin the city has been imagined as a play zone of sexual self-fulfilment by authors such as Inka Parei, Tanja Dückers, Kathrin Röggla, Judith Hermann and Julia Franck. Have such erotic adventures replaced political vision in our post-utopian decade? What is the purpose of the laboured allegorisation of the fall of the wall in Durs Grünbein's essays or in the novels of Katja Lange-Müller and Thomas Hettche? The sexification of historical and political processes recalls similar stereotypes in the East German literature of the 1980s: the metropolis as a whore in works by Heiner Müller or Wolf Biermann, but also by younger authors of the independent literary scene in Berlin like Uwe Kolbe or Frank-Wolf Matthies.

Compte rendu de la table ronde du 36ème Congrès de la SFB à Cassis (1-3 Juin 2016), première partie: brûlures chimiques, brûlures électriques

PubMed Central

Le Floch, R.; Laguerre, J.; Perrot, P.

2016-01-01

Summary La table ronde du congrès 2016 de la SFB a duré toute la journée du 2 juin et portait sur les brûlures non thermiques. A la différence du résumé concernant les brûlures radiques, qui est en cours de réalisation par les auteurs des communications, celui-ci a été commis par les auteurs de cet article, à partir des notes prises en séance et de la vidéo réalisée pendant la communication. Le lecteur voulant approfondir le sujet pourra se rapprocher de l’auteur de la communication, systématiquement cité. PMID:28289367

Effect of Microbial Interaction on Urea Metabolism in Chinese Liquor Fermentation.

PubMed

Wu, Qun; Lin, Jianchun; Cui, Kaixiang; Du, Rubin; Zhu, Yang; Xu, Yan

2017-12-20

Urea is the primary precursor of the carcinogen ethyl carbamate in fermented foods. Understanding urea metabolism is important for controlling ethyl carbamate production. Using Chinese liquor as a model system, we used metatranscriptome analysis to investigate urea metabolism in spontaneous food fermentation processes. Saccharomyces cerevisiae was dominant in gene transcription for urea biosynthesis and degradation. Lysinibacillus sphaericus was dominant for urea degradation. S. cerevisiae degraded 18% and L. sphaericus degraded 13% of urea in their corresponding single cultures, whereas they degraded 56% of urea in coculture after 12 h. Compared to single cultures, transcription of CAR1, DAL2, and argA, which are related to urea biosynthesis, decreased by 51, 36, and 69% in coculture, respectively. Transcription of DUR1 and ureA, which are related to urea degradation, increased by 227 and 70%, respectively. Thus, coexistence of the two strains promoted degradation of urea via transcriptional regulation of genes related to urea metabolism.

Obtaining a critical care pharmacist position: a marketing case study.

PubMed

Stratton, T P; Wu, B; Nakagawa, R S

1993-06-01

Marketing theory is used to explain how Pharmacy Department managers at a Vancouver-area hospital secured a new ICU pharmacist position in a period of severe fiscal constraint. Market segmentation, target marketing and pull marketing strategy were combined to obtain support for the new position. Improved drug information services for ICU nurses were promoted to Nursing Administration and enhanced pharmacotherapy monitoring was promoted to the two critical care physicians primarily responsible for patient care in the ICU. These physicians and Nursing Administration voiced their support for the new position to the V.P. of Nursing (the functional officer for Pharmacy), who then promoted the new position to Hospital Administration. A half-time DUR commitment by the ICU pharmacist was offered to Hospital Administration, expanding this already successful service and guaranteeing cost recovery for the new position. Hospital Administration approved the new ICU clinical pharmacist position in a budget which saw other hospital departments lose several positions.

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

Madlazim,, E-mail: m-lazim@physics.its.ac.id; Hariyono, E., E-mail: m-lazim@physics.its.ac.id

The purpose of the study was to estimate P-wave rupture durations (T{sub dur}), dominant periods (T{sub d}) and exceeds duration (T{sub 50Ex}) simultaneously for local events, shallow earthquakes which occurred off the coast of Indonesia. Although the all earthquakes had parameters of magnitude more than 6,3 and depth less than 70 km, part of the earthquakes generated a tsunami while the other events (Mw=7.8) did not. Analysis using Joko Tingkir of the above stated parameters helped understand the tsunami generation of these earthquakes. Measurements from vertical component broadband P-wave quake velocity records and determination of the above stated parameters canmore » provide a direct procedure for assessing rapidly the potential for tsunami generation. The results of the present study and the analysis of the seismic parameters helped explain why the events generated a tsunami, while the others did not.« less

Best Practices in School-to-Careers: The Utilities Industry.

ERIC Educational Resources Information Center

National Employer Leadership Council, Washington, DC.

This document highlights the school-to-careers (STC) partnerships connecting workplace experiences to classroom learning to prepare students for successful employment in the utilities industry. First, the current state of the utilities industry and careers in the utilities industry are reviewed. Next, the following organizations and employers are…

Home Health Care Utilization: A Review of the Research for Social Work

ERIC Educational Resources Information Center

Kadushin, Goldie

2004-01-01

The author reviewed the literature to identify the variables associated with home health care utilization using the Andersen-Newman model as a framework for analysis. Sixty-four studies published between 1985 and 2000 were identified through PUBMED, Sociofile, and PsycINFO databases. Home health care was defined as in-home skilled nursing,…

The Dynamics of Mobile Learning Utilization in Vocational Education: Frame Model Perspective Review

ERIC Educational Resources Information Center

Mahande, Ridwan Daud; Susanto, Adhi; Surjono, Herman Dwi

2017-01-01

This study aimed to describe the dynamics of content aspects, user aspects and social aspects of mobile learning utilization (m-learning) in vocational education from the FRAME Model perspective review. This study was quantitative descriptive research. The population in this study was teachers and students of state vocational school and private…

Music Therapy with Children: A Review of Clinical Utility and Application to Special Populations.

ERIC Educational Resources Information Center

Yeaw, John David Andrew

This paper reviews the effectiveness of music therapy in treating children with psychiatric and developmental problems. The clinical utility of music therapy is first evaluated by examining the foundational effects of music on affect and behavior. Next, the two broad approaches to music therapy, active and passive music therapy, are discussed.…

Unmanned Maritime Systems Incremental Acquisition Approach

DTIC Science & Technology

2016-12-01

We find that current UMS acquisitions are utilizing previous acquisition reforms, but could benefit from additional contractor peer competition and...peer review. Additional cost and schedule benefits could result from contractor competition during build processes in each incremental process. We...acquisitions are utilizing previous acquisition reforms, but could benefit from additional contractor peer competition and peer review. Additional

Delivery of health services to migrant and seasonal farmworkers.

PubMed

Arcury, Thomas A; Quandt, Sara A

2007-01-01

Farmworkers are low-paid, uninsured employees in an extremely hazardous industry, and they provide an essential service for U.S. society. This review evaluates the delivery of health services to farmworkers. It describes the farmworker population in the United States, noting characteristics (e.g., migratory and immigration status) that limit their access to and utilization of health services. It describes the health services needs of this population, including occupational health, mental health, oral health, and chronic disease treatment. Cultural, structural, legal, financial, and geographic barriers to health services utilization are described. Existing research on health services utilization among farmworkers is discussed. Programs that have been developed to address the barriers to health services utilization among farmworkers are reviewed. Finally, research needed to improve knowledge of farmworker health services utilization is suggested. These research needs include formal evaluations of existing programs and basic research to characterize the health services utilization patterns of farmworkers.

76 FR 80729 - Intergovernmental Review

Federal Register 2010, 2011, 2012, 2013, 2014

2011-12-27

... Rural Utilities Service 7 CFR Part 4274 Intergovernmental Review AGENCIES: Rural Housing Service, Rural... reference to RD Instruction 1940-J, Intergovernmental Review.'' This action is necessary since the affected... offices have current guidance on intergovernmental review of proposed projects being reviewed pursuant to...

Factors influencing utilization of hospital services by adult sickle cell disease patients: a systematic review.

PubMed

Benenson, Irina; Jadotte, Yuri; Echevarria, Mercedes

2017-03-01

Painful vaso-occlusive crisis is a hallmark of sickle cell disease (SCD) that commonly results in utilization of hospital services. Recurrent use of hospital services by SCD patients is associated with high healthcare costs and adverse clinical outcomes. Understanding the factors influencing the pattern of utilization is a first step in improving medical care of this patient population while reducing healthcare expenditures. The primary objective of this systematic review was to determine what modifiable and non-modifiable factors influence utilization of hospital services by adult SCD patients. Adult SCD patients of both sexes who utilized hospital services for acute or emergency care. Non-modifiable and modifiable factors influencing utilization of hospital services. Prospective and retrospective cohort studies, case-control and analytical cross-sectional studies. The primary outcome of interest was high utilization of hospital services by adult SCD patients based on non-modifiable and modifiable factors measured as an odds ratio (analytical outcome). The secondary outcome was the prevalence of non-modifiable and modifiable factors among SCD patients who utilized hospital services measured as an event rate (descriptive outcome). A comprehensive multi-step search was undertaken to find both published and unpublished studies. Only studies published in the English language were included. The search was not limited by year of publication. Retrieved papers were assessed for methodological quality using standardized critical appraisal instruments from the Joanna Briggs Institute Meta Analysis of Statistics Assessment and Review Instrument. Data were extracted using a researcher-developed tool. Included studies were combined in a statistical meta-analysis. The meta-analysis was based on a random effect model. For studies that did not allow statistical pooling, the findings have been presented in a narrative form. Fourteen studies were included in this review. The analysis demonstrated that male patients accounted for 40.8% (95% confidence interval [CI] 0.370-0.447) of all utilizing patients. Sickle cell disease patients who were publically insured accounted for 76.5% (95% CI 0.632-0.861) of all patients who had hospital encounters. Patients aged 25-35 years had the highest rate of utilization, and the rate of utilization declined in patients older than 50 years. High utilizing patients had more diagnoses of acute chest syndrome and sepsis than patients who were moderate or low utilizers. The majority of SCD patients who utilized hospital services were women, young people and publically insured individuals. Patients with particularly high level of utilization had more frequent diagnoses of acute chest syndrome and sepsis.

Facilities Utilization Program Implementation Handbook

NASA Technical Reports Server (NTRS)

1987-01-01

This Facilities Utilization Program Implementation Handbook (FUPIH) prescribes procedures for the review and the reporting on the utilization of NASA facilities. The Directors of NASA Field Installations should designate an Installation Official responsible for coordinating the assignment of buildings space and implementing the facilities utilization reviews and annual report preparation. The individual designated shall be known as the 'Facilities Utilization Officer (FUO).' Functional responsibilities of the FUO are detailed in NASA Management Instruction (NMI) 7234.1. It is recognized that titles used in the implementation of the Facilities Utilization Program may vary between field installations. The Facilities Utilization Program (FUP) is designed to provide a uniform and orderly process for meeting or addressing the following objectives: the establishment of sound facilities requirements to meet NASA's programmatic and institutional needs; the optimum allocation of available facilities and related resources to meet these requirements; and the early identification and request for required additional facilities resources. The detailed review and reporting system enacted by NMI 7234.1 should encourage more comprehensive utilization planning for all NASA facilities and ensure, to the maximum extent practicable, that all such facilities are put to their highest and best use consistent with NASA programmatic and institutional priorities. A principal purpose of the FUP is the early identification of NASA facilities which may be or may become underutilized or excess to NASA needs and to provide a timely reference point from which corrective actions (i.e., consolidation, elimination of duplication, improved utilization of disposal) may be taken. Because the supply of this handbook is limited, distribution should be controlled at the field installation level.

Étude par diffraction des rayons X de la nitruration plasma d'un acier 304L Influence sur l'oxydation à 1000 ^{circ}C

NASA Astrophysics Data System (ADS)

Marot, L.; Buscail, H.; Straboni, A.; Riffard, F.; Caudron, E.; Cueff, R.

2002-07-01

This work presents the influence of various nitridation parameters on the 304L steel oxidation at 1000 ^{circ}C, in air under atmospheric pressure. Nitridation temperatures were ranging between 300 ^{circ}C and 430 ^{circ}C with exposure times lasting from 2 to 8 hours. At 300 and 430 ^{circ}C, the nitridation treatment leads to the solid solution surface formation γ-N without any nitride formation. After oxidation at 1000 ^{circ}C of blank specimens, X ray diffraction reveals the FeCr2O4 spinel formation. This oxide does not act as a good diffusion barrier. With nitrogen treated specimens, the higher the nitridation temperature is and the longer the exposure time is, better is the oxidation behaviour at 1000 ^{circ}C. We then observe that the Cr{1,3}Fe{0,7}O3 oxide is more present in the oxide sale from the very beginning of the oxidation test which is correlated to a final lower mass gain. Cette étude porte sur l'influence des paramètres de nitruration plasma sur l'oxydation de l'acier 304L à 1000 ^{circ}C, sous air, à la pression atmosphérique. Les températures employées lors de la nitruration ont été de 300 ^{circ}C et 430 ^{circ}C pour des durées de nitruration variant entre 2 et 8 heures. A 300 et 430 ^{circ}C, la nitruration conduit à la formation d'une solution solide γ-N en surface sans provoquer la formation de nitrures. Après oxydation à 1000 ^{circ}C du 304L non nitruré, la diffraction des rayons X révèle la formation d'une couche de type spinelle FeCr2O4 qui ne semble pas jouer le rôle de barrière de diffusion. Pour les échantillons préalablement nitrurés, plus la température de nitruration est élevée et plus la durée du traitement est longue, meilleur est le comportement en oxydation. Nous observons alors l'oxyde Cr{1,3}Fe{0,7}O3 en proportion importante dès le début de l'oxydation et une prise de masse finale plus faible.

Morbidité et mortalité des nouveau-nés hospitalisés sur 10 années à la Clinique El Fateh-Suka (Ouagadougou, Burkina Faso)

PubMed Central

Nagalo, Kisito; Dao, Fousséni; Tall, François Housséini; Yé, Diarra

2013-01-01

Introduction La mortalité néonatale demeure un problème majeur de santé publique dans les pays en développement. Notre étude avait pour but de déterminer la morbidité et la mortalité des nouveau-nés à Ouagadougou, Burkina Faso. Méthodes Une étude rétrospective sur 10 années a permis d'inclure tous les nouveau-nés admis dans l'Unité de Néonatologie de la Clinique El Fateh-Suka. Résultats Au total, 697 nouveau-nés étaient hospitalisés sur la période d'étude. Les principaux diagnostics étaient les infections néonatales (23.5%), les anomalies liées à la durée de la gestation et à la croissance du fætus (17.9%) et le paludisme congénital (15.1%). Les 91 (13.1%) décès étaient dus aux anomalies liées à la durée de la grossesse et à la croissance du fætus (46.1%), à l'hypoxie intra-utérine et à l'asphyxie obstétricale (20,9%) et aux infections néonatales (17.6%). Ces décès survenaient dans 81.3% dans les 72 heures, dans 93.4% des cas dans la première semaine d'hospitalisation. Le facteur de risque associé à ces décès était la voie basse d'accouchement (p = 0.02). Conclusion Cette étude a identifié des pathologies évitables déjà décrites comme les principales causes d'hospitalisations et de décès néonatals. La voie basse d'accouchement était le facteur de risque associé à ces décès, ce qui n'avait pas encore été rapporté. Les efforts pour améliorer la qualité des services de soins périnatals doivent être intensifiés afin de réduire la mortalité néonatale dans les pays en développement. PMID:23785558

Detection of atherosclerotic plaques in ApoE-deficient mice using (99m)Tc-duramycin.

PubMed

Liu, Zhonglin; Larsen, Brandon T; Lerman, Lilach O; Gray, Brian D; Barber, Christy; Hedayat, Ahmad F; Zhao, Ming; Furenlid, Lars R; Pak, Koon Y; Woolfenden, James M

2016-08-01

Apoptosis of macrophages and smooth muscle cells is linked to atherosclerotic plaque destabilization. The apoptotic cascade leads to exposure of phosphatidylethanolamine (PE) on the outer leaflet of the cell membrane, thereby making apoptosis detectable using probes targeting PE. The objective of this study was to exploit capabilities of a PE-specific imaging probe, (99m)Tc-duramycin, in localizing atherosclerotic plaque and assessing plaque evolution in apolipoprotein-E knockout (ApoE(-/-)) mice. Atherosclerosis was induced in ApoE(-/-) mice by feeding an atherogenic diet. (99m)Tc-duramycin images were acquired using a small-animal SPECT imager. Six ApoE(-/-) mice at 20weeks of age (Group I) were imaged and then sacrificed for ex vivo analyses. Six additional ApoE(-/-) mice (Group II) were imaged at 20 and 40weeks of age before sacrifice. Six ApoE wild-type (ApoE(+/+)) mice (Group III) were imaged at 40weeks as controls. Five additional ApoE(-/-) mice (40weeks of age) (Group IV) were imaged with a (99m)Tc-labeled inactive peptide, (99m)Tc-LinDUR, to assess (99m)Tc-duramycin targeting specificity. Focal (99m)Tc-duramycin uptake in the ascending aorta and aortic arch was detected at 20 and 40weeks in the ApoE(-/-) mice but not in ApoE(+/+) mice. (99m)Tc-duramycin uptake in the aortic lesions increased 2.2-fold on quantitative imaging in the ApoE(-/-) mice between 20 and 40weeks. Autoradiographic and histological data indicated significantly increased (99m)Tc-duramycin uptake in the ascending aorta and aortic arch associated with advanced plaques. Quantitative autoradiography showed that the ratio of activity in the aortic arch to descending thoracic aorta, which had no plaques or radioactive uptake, was 2.1 times higher at 40weeks than at 20weeks (6.62±0.89 vs. 3.18±0.29, P<0.01). There was barely detectable focal uptake of (99m)Tc-duramycin in the aortic arch of ApoE(+/+) mice. No detectable (99m)Tc-LinDUR uptake was observed in the aortas of ApoE(-/-) mice. PE-targeting properties of (99m)Tc-duramycin in the atherosclerotic mouse aortas were noninvasively characterized. (99m)Tc-duramycin is promising in localizing advanced atherosclerotic plaques. Copyright © 2016 Elsevier Inc. All rights reserved.

Review of utility values for economic modeling in type 2 diabetes.

PubMed

Beaudet, Amélie; Clegg, John; Thuresson, Per-Olof; Lloyd, Adam; McEwan, Phil

2014-06-01

Economic analysis in type 2 diabetes mellitus (T2DM) requires an assessment of the effect of a wide range of complications. The objective of this article was to identify a set of utility values consistent with the National Institute for Health and Care Excellence (NICE) reference case and to critically discuss and illustrate challenges in creating such a utility set. A systematic literature review was conducted to identify studies reporting utility values for relevant complications. The methodology of each study was assessed for consistency with the NICE reference case. A suggested set of utility values applicable to modeling was derived, giving preference to studies reporting multiple complications and correcting for comorbidity. The review considered 21 relevant diabetes complications. A total of 16,574 articles were identified; after screening, 61 articles were assessed for methodological quality. Nineteen articles met NICE criteria, reporting utility values for 20 of 21 relevant complications. For renal transplant, because no articles meeting NICE criteria were identified, two articles using other methodologies were included. Index value estimates for T2DM without complication ranged from 0.711 to 0.940. Utility decrement associated with complications ranged from 0.014 (minor hypoglycemia) to 0.28 (amputation). Limitations associated with the selection of a utility value for use in economic modeling included variability in patient recruitment, heterogeneity in statistical analysis, large variability around some point estimates, and lack of recent data. A reference set of utility values for T2DM and its complications in line with NICE requirements was identified. This research illustrates the challenges associated with systematically selecting utility data for economic evaluations. Copyright © 2014 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

Health State Utility Values for Age-Related Macular Degeneration: Review and Advice.

PubMed

Butt, Thomas; Tufail, Adnan; Rubin, Gary

2017-02-01

Health state utility values are a major source of uncertainty in economic evaluations of interventions for age-related macular degeneration (AMD). This review identifies and critiques published utility values and methods for eliciting de novo utility values in AMD. We describe how utility values have been used in healthcare decision making and provide guidance on the choice of utility values for future economic evaluations for AMD. Literature was searched using PubMed, and health technology assessments (HTA) were searched using HTA agency websites to identify articles reporting utility values or approaches to derive utility values in AMD and articles applying utilities for use in healthcare decision making relating to treatments for AMD. A total of 70 studies qualified for data extraction, 22 of which were classified as containing utility values and/or elicitation methods, and 48 were classified as using utility values in decision making. A large number of studies have elicited utility values for AMD, although those applied to decision making have focused on a few of these. There is an appreciation of the challenges in the measurement and valuation of health states, with recent studies addressing challenges such as the insensitivity of generic health-related quality of life (HRQoL) questionnaires and utility in the worse-seeing eye. We would encourage careful consideration when choosing utility values in decision making and an explicit critique of their applicability to the decision problem.

Food interactions with sustained-release theophylline preparations. A review.

PubMed

Jonkman, J H

1989-03-01

Currently, theophylline is being used predominantly as sustained-release capsules or tablets. In the mid-seventies the first preparations for use with a dosage interval of 12 hours (twice-daily preparations) were introduced. Since 1983, theophylline preparations that can be given with an interval of 24 hours (once-daily preparations) have become available. The release of theophylline from some of these products can be influenced (either increased or decreased) by concomitant intake of food. With some preparations the composition of the meal (especially the fat content) has an influence on the degree of effect. The consequence may be an effect on the rate of absorption or on the amount absorbed, or both simultaneously. This could result in an unexpected shift of the plasma theophylline concentration. Such a shift is therapeutically undesirable, because theophylline has a fairly narrow therapeutic range. A review is given of those food interactions with the sustained-release theophylline preparations, both twice-daily and once-daily products, that are currently on the world market. Special attention is paid to the specific (bio)pharmaceutical characteristics of the different products, and to the influence of the composition and timing of the meals. For each preparation the effect of food on the following pharmacokinetic parameters is discussed: area under the plasma concentration-time curve, peak plasma drug concentration and time to reach this peak. Where possible, the results for both adults and children are discussed. There are indications that children are more susceptible to food-effects than adults. The regulatory aspects are mentioned briefly. Clinically important effects of food have been observed with the following twice-daily products: 'Theo-Dur Sprinkle', 'Theolair SR' (= 'Nuelin SR') and 'Theograd'. Pronounced effects could have an even greater impact with once-daily preparations, as the total daily dose will be given at a single time. A particularly sudden release of a major part of the dose ('dose-dumping') may result in toxic plasma concentrations. Among these products, clinically important effects in children have been reported with 'Theo-24' and 'Uniphyl'.

Factors Involved in Access and Utilization of Adult Hearing Healthcare: A Systematic Review

PubMed Central

Barnett, Margaret; Hixon, Brian; Okwiri, Neville; Irungu, Catherine; Ayugi, John; Thompson, Robin; Shinn, Jennifer B.; Bush, Matthew L.

2016-01-01

Objective/Hypothesis Hearing loss is a public health concern yet hearing healthcare disparities exist and influence utilization of rehabilitation services. The objective of this review was to systematically analyze the published literature on motivators, barriers, and compliance factors affecting adult patient access and utilization of hearing rehabilitation healthcare. Data Sources and Study Eligibility Criteria Pubmed, PsychINFO, CINAHL, Web of Science were searched for relevant articles. Eligible studies were those containing original, peer-reviewed research in English pertaining to factors affecting adult hearing healthcare access and utilization of hearing aids and cochlear implantation. The search encompassed 1990-2015. Study Appraisal and Synthesis Methods Two investigators independently reviewed all articles and extracted data. Specific variables regarding access to care and compliance to recommended care were extracted from each study. Results Thirty articles were reviewed. The factors affecting access and utilization of hearing rehabilitation could be classified into motivators, barriers, and compliance in treatment or device use. The key motivators to seek care include degree of hearing loss, self-efficacy, family support, and self-recognition of hearing loss. The primary barriers to care were financial limitations, stigma of hearing devices, inconvenience, competing chronic health problems, and unrealistic expectations. Compliance is most affected by self-efficacy, education level, and engagement in the rehabilition process. Conclusion Accessing hearing healthcare is complicated by multiple factors. Considering the current climate in healthcare policy and legislation towards improved access of care, a deeper understanding of motivators, barriers and compliance factors can aid in delivery of effective and efficient hearing healthcare. PMID:27545324

Factors involved in access and utilization of adult hearing healthcare: A systematic review.

PubMed

Barnett, Margaret; Hixon, Brian; Okwiri, Neville; Irungu, Catherine; Ayugi, John; Thompson, Robin; Shinn, Jennifer B; Bush, Matthew L

2017-05-01

Hearing loss is a public health concern, yet hearing healthcare disparities exist and influence utilization of rehabilitation services. The objective of this review was to systematically analyze the published literature on motivators, barriers, and compliance factors affecting adult patient access and utilization of hearing rehabilitation healthcare. Pubmed, PsychINFO, CINAHL, and Web of Science were searched for relevant articles. Eligible studies were those containing original, peer-reviewed research in English pertaining to factors affecting adult hearing healthcare access and utilization of hearing aids and cochlear implantation. The search encompassed 1990 to 2015. Two investigators independently reviewed all articles and extracted data. Specific variables regarding access to care and compliance to recommended care were extracted from each study. Thirty articles were reviewed. The factors affecting access and utilization of hearing rehabilitation could be classified into motivators, barriers, and compliance in treatment or device use. The key motivators to seek care include degree of hearing loss, self-efficacy, family support, and self-recognition of hearing loss. The primary barriers to care were financial limitations, stigma of hearing devices, inconvenience, competing chronic health problems, and unrealistic expectations. Compliance is most affected by self-efficacy, education level, and engagement in the rehabilitation process. Accessing hearing healthcare is complicated by multiple factors. Considering the current climate in healthcare policy and legislation toward improved access of care, a deeper understanding of motivators, barriers, and compliance factors can aid in delivery of effective and efficient hearing healthcare. Laryngoscope, 127:1187-1194, 2017. © 2016 The American Laryngological, Rhinological and Otological Society, Inc.

Controlling inpatient psychiatric utilization through managed care.

PubMed

Wickizer, T M; Lessler, D; Travis, K M

1996-03-01

There is little current understanding of how managed care strategies affect hospital inpatient psychiatric care for mentally ill patients. This study examined one prominent form of managed care, utilization management, which reviews requests for psychiatric care and authorizes provision of care deemed appropriate and clinically necessary. The authors analyzed data on 2,265 utilization management reviews conducted during 1989-1992 for patients insured by a single large commercial insurance company. Three utilization management procedures were examined: preadmission review, continued-stay review, and case management. The performance indicators analyzed included percent of admission requests granted, number of days requested and approved, and number of treatment extensions granted. Utilization management initially approved inpatient psychiatric treatment for nearly all (98.8%) of the patients but authorized, on average, only one-third of the days requested (6.9 versus 19.0). On average, 23.5 (total) days of care were requested and 16.8 days were approved. Care for patients with alcohol or drug dependence diagnoses was more restricted than was care for other patients. These data suggest that managed care does restrict inpatient psychiatric care, primarily by managing length of stay. The fact that almost all patients were approved for the same initial length of stay implies adherence to strict treatment protocols that do not distinguish among different clinical or patient factors. There is a need for careful study of the effects of managed care on outcomes and quality of psychiatric care.

42 CFR 456.181 - Reports of evaluations and plans of care.

Code of Federal Regulations, 2011 CFR

2011-10-01

... SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS UTILIZATION CONTROL Utilization Control: Mental Hospitals... and plan of care must be entered in the applicant's or recipient's record— (a) At the time of... evaluation or plan. Utilization Review (UR) Plan: General Requirements ...

42 CFR 456.381 - Reports of evaluations and plans of care.

Code of Federal Regulations, 2011 CFR

2011-10-01

... SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS UTILIZATION CONTROL Utilization Control: Intermediate Care... evaluation and plan of care must be entered in the applicant's or recipient's record— (a) At the time of... plan. Utilization Review (UR) Plan: General Requirement ...

42 CFR 456.381 - Reports of evaluations and plans of care.

Code of Federal Regulations, 2010 CFR

2010-10-01

... SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS UTILIZATION CONTROL Utilization Control: Intermediate Care... evaluation and plan of care must be entered in the applicant's or recipient's record— (a) At the time of... plan. Utilization Review (UR) Plan: General Requirement ...

Energy and water quality management systems for water utility's operations: a review.

PubMed

Cherchi, Carla; Badruzzaman, Mohammad; Oppenheimer, Joan; Bros, Christopher M; Jacangelo, Joseph G

2015-04-15

Holistic management of water and energy resources is critical for water utilities facing increasing energy prices, water supply shortage and stringent regulatory requirements. In the early 1990s, the concept of an integrated Energy and Water Quality Management System (EWQMS) was developed as an operational optimization framework for solving water quality, water supply and energy management problems simultaneously. Approximately twenty water utilities have implemented an EWQMS by interfacing commercial or in-house software optimization programs with existing control systems. For utilities with an installed EWQMS, operating cost savings of 8-15% have been reported due to higher use of cheaper tariff periods and better operating efficiencies, resulting in the reduction in energy consumption of ∼6-9%. This review provides the current state-of-knowledge on EWQMS typical structural features and operational strategies and benefits and drawbacks are analyzed. The review also highlights the challenges encountered during installation and implementation of EWQMS and identifies the knowledge gaps that should motivate new research efforts. Copyright © 2015 Elsevier Ltd. All rights reserved.

Skill Acquisition and Utilization During Evidence-Based Psychosocial Treatments for Childhood Disruptive Behavior Problems: A Review and Meta-analysis

PubMed Central

Higa, Janelle; Trentacosta, Christopher J.; Herschell, Amy D.; Kolko, David J.

2013-01-01

We review 85 empirical articles published since 2000 that measured the acquisition and/or utilization of parent management skills and/or child cognitive-behavioral skills in the context of an evidence-based treatment (EBT) for childhood behavior problems. Results showed that: (1) there are no standardized measures of skill acquisition or skill utilization that are used across treatments, (2) little is known about predictors, correlates, or outcomes associated with skill acquisition and utilization, and (3) few studies systematically examined techniques to enhance the acquisition and utilization of specific skills. Meta-analytic results from a subset of 68 articles (59 studies) showed an overall treatment–control ES =.31, p < .01 for skill acquisition and ES =.20, p = ns for skill utilization. We recommend that future research focus on the following three areas: (1) development of standardized measures of skill acquisition and utilization from a “common elements” perspective that can used across EBTs; (2) assessment of the predictors, correlates, and outcomes associated with skill acquisition and utilization; and (3) development of innovative interventions to enhance the acquisition and utilization of cognitive-behavioral and parent management skills. PMID:23649324

A review of mobile applications to help adolescent and young adult cancer patients

PubMed Central

Wesley, Kimberly M; Fizur, Philip J

2015-01-01

Objective To review research articles utilizing mobile applications with adolescent and young adult (AYA) cancer patients. Materials and methods We identified articles via online searches and reference lists (eg, PsycInfo, PubMed). Articles were reviewed by two study team members for target population, stated purpose, technological utilization, sample size, demographic characteristics, and outcome data. Strengths and weaknesses of each study were described. Results Of 19 identified manuscripts, six met full inclusion criteria for this review (four smartphone applications and two tablet applications). One additional article that included an application not specific to oncology but included AYA patients with cancer within the target sample was also reviewed. Uses of these applications included symptom tracking, pain management, monitoring of eating habits following bone marrow transplant, monitoring of mucositis, and improving medication management. Utility results from pilot studies are presented. Conclusion Mobile applications are growing in number and increasingly available to AYAs with and without chronic illness. These applications may prove useful in helping to support AYAs throughout their cancer treatment and beyond. However, few applications provide empirical data supporting their utility. Numerous strengths and benefits of these applications include increased accessibility to educational resources and self-management strategies, more frequent physical and emotional symptom tracking, and increased access to peer support. Despite these strengths, numerous limitations are identified, highlighting the need for future research in this area. PMID:26316835

Synthetic Biology and Metabolic Engineering for Marine Carotenoids: New Opportunities and Future Prospects

PubMed Central

Wang, Chonglong; Kim, Jung-Hun; Kim, Seon-Won

2014-01-01

Carotenoids are a class of diverse pigments with important biological roles such as light capture and antioxidative activities. Many novel carotenoids have been isolated from marine organisms to date and have shown various utilizations as nutraceuticals and pharmaceuticals. In this review, we summarize the pathways and enzymes of carotenoid synthesis and discuss various modifications of marine carotenoids. The advances in metabolic engineering and synthetic biology for carotenoid production are also reviewed, in hopes that this review will promote the exploration of marine carotenoid for their utilizations. PMID:25233369

Synthetic biology and metabolic engineering for marine carotenoids: new opportunities and future prospects.

PubMed

Wang, Chonglong; Kim, Jung-Hun; Kim, Seon-Won

2014-09-17

Carotenoids are a class of diverse pigments with important biological roles such as light capture and antioxidative activities. Many novel carotenoids have been isolated from marine organisms to date and have shown various utilizations as nutraceuticals and pharmaceuticals. In this review, we summarize the pathways and enzymes of carotenoid synthesis and discuss various modifications of marine carotenoids. The advances in metabolic engineering and synthetic biology for carotenoid production are also reviewed, in hopes that this review will promote the exploration of marine carotenoid for their utilizations.

Proceedings of the 1999 U.S. DOE Hydrogen Program Review

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

NREL

2000-08-28

The Proceedings of the 1999 US Department of Energy (DOE) Hydrogen Program Review serve as an important technology reference for the DOE Hydrogen Program. This document contains technical progress reports on 60 research and technology validation projects funded by the DOE Hydrogen Program in Fiscal Year 1999, in support of its mission to make hydrogen a cost-effective energy carrier for utility, building, and transportation applications. Each year, the Program conducts a rigorous review of its portfolio of projects, utilizing teams of experts to provide vital feedback on the progress of research.

NOX EMISSION CONTROL OPTIONS FOR COAL-FIRED ELECTRIC UTILITY BOILERS

EPA Science Inventory

The paper reviews NOx control options for coal-fired electric utility boilers. (NOTE: Acid Rain NOx regulations, the Ozone Transport Commission's NOx Budget Program, revision of the New Source Performance Standards (NSPS) for NOx emissions from utility sources, and Ozone Transpor...

Energy minimization strategies and renewable energy utilization for desalination: a review.

PubMed

Subramani, Arun; Badruzzaman, Mohammad; Oppenheimer, Joan; Jacangelo, Joseph G

2011-02-01

Energy is a significant cost in the economics of desalinating waters, but water scarcity is driving the rapid expansion in global installed capacity of desalination facilities. Conventional fossil fuels have been utilized as their main energy source, but recent concerns over greenhouse gas (GHG) emissions have promoted global development and implementation of energy minimization strategies and cleaner energy supplies. In this paper, a comprehensive review of energy minimization strategies for membrane-based desalination processes and utilization of lower GHG emission renewable energy resources is presented. The review covers the utilization of energy efficient design, high efficiency pumping, energy recovery devices, advanced membrane materials (nanocomposite, nanotube, and biomimetic), innovative technologies (forward osmosis, ion concentration polarization, and capacitive deionization), and renewable energy resources (solar, wind, and geothermal). Utilization of energy efficient design combined with high efficiency pumping and energy recovery devices have proven effective in full-scale applications. Integration of advanced membrane materials and innovative technologies for desalination show promise but lack long-term operational data. Implementation of renewable energy resources depends upon geography-specific abundance, a feasible means of handling renewable energy power intermittency, and solving technological and economic scale-up and permitting issues. Copyright © 2011 Elsevier Ltd. All rights reserved.

Silk-based delivery systems of bioactive molecules

PubMed Central

Numata, Keiji; Kaplan, David L

2010-01-01

Silks are biodegradable, biocompatible, self-assemblying proteins that can also be tailored via genetic engineering to contain specific chemical features, offering utility for drug and gene delivery. Silkworm silk has been used in biomedical sutures for decades and has recently achieved Food and Drug Administration approval for expanded biomaterials device utility. With the diversity and control of size, structure and chemistry, modified or recombinant silk proteins can be designed and utilized in various biomedical application, such as for the delivery of bioactive molecules. This review focuses on the biosynthesis and applications of silk-based multi-block copolymer systems and related silk protein drug delivery systems. The utility of these systems for the delivery of small molecule drugs, proteins and genes are reviewed. PMID:20298729

Validity and reliability of an application review process using dedicated reviewers in one stage of a multi-stage admissions model.

PubMed

Zeeman, Jacqueline M; McLaughlin, Jacqueline E; Cox, Wendy C

2017-11-01

With increased emphasis placed on non-academic skills in the workplace, a need exists to identify an admissions process that evaluates these skills. This study assessed the validity and reliability of an application review process involving three dedicated application reviewers in a multi-stage admissions model. A multi-stage admissions model was utilized during the 2014-2015 admissions cycle. After advancing through the academic review, each application was independently reviewed by two dedicated application reviewers utilizing a six-construct rubric (written communication, extracurricular and community service activities, leadership experience, pharmacy career appreciation, research experience, and resiliency). Rubric scores were extrapolated to a three-tier ranking to select candidates for on-site interviews. Kappa statistics were used to assess interrater reliability. A three-facet Many-Facet Rasch Model (MFRM) determined reviewer severity, candidate suitability, and rubric construct difficulty. The kappa statistic for candidates' tier rank score (n = 388 candidates) was 0.692 with a perfect agreement frequency of 84.3%. There was substantial interrater reliability between reviewers for the tier ranking (kappa: 0.654-0.710). Highest construct agreement occurred in written communication (kappa: 0.924-0.984). A three-facet MFRM analysis explained 36.9% of variance in the ratings, with 0.06% reflecting application reviewer scoring patterns (i.e., severity or leniency), 22.8% reflecting candidate suitability, and 14.1% reflecting construct difficulty. Utilization of dedicated application reviewers and a defined tiered rubric provided a valid and reliable method to effectively evaluate candidates during the application review process. These analyses provide insight into opportunities for improving the application review process among schools and colleges of pharmacy. Copyright © 2017 Elsevier Inc. All rights reserved.

Utility interface issues for grid-connected photovoltaic systems

NASA Astrophysics Data System (ADS)

Chu, D.; Key, T.; Fitzer, J.

Photovoltaic (PV) balance-of-system research and development has focused on interconnection with the utility grid as the most promising future application for photovoltaic energy production. These sysems must be compatible with the existing utility grid to be accepted. Compatibility encompasses many technical, economic and institutional issues, from lineman safety to revenue metering and power quality. This paper reviews DOE/PV sponsored research for two of the technical interconnection issues: harmonic injection, and power factor control. Explanations and rationale behind these two issues will be reviewed, and the status of current research and plans for required future work will be presented.

A Study of Alternate Approaches to Utilization Review of Laboratory Services within an Army Medical Center

DTIC Science & Technology

1983-06-06

solubility Hgb F quantitation, alkali denaturation Clot retraction Unstable Ggb studies Cryofibrinogen Methemoglobin Parasitology Blood , Occult and Gross...Performance Standards ........ .................... ... 24 4 Types of Information to be Recorded Under Course of Treatment . 25 5 Factors Contributing to...examine external environmental factors implicating the need for utilization review of ancillary services within an Army Medical Center. (Hereinafter the

The Effect of Utilization Review on Emergency Department Operations.

PubMed

Desai, Shoma; Gruber, Phillip F; Eiting, Erick; Seabury, Seth A; Mack, Wendy J; Voyageur, Christian; Vasquez, Veronica; Kim, Hyung T; Terp, Sophie

2017-11-01

Increasingly, hospitals are using utilization review software to reduce hospital admissions in an effort to contain costs. Such practices have the potential to increase the number of unsafe discharges, particularly in public safety-net hospitals. Utilization review software tools are not well studied with regard to their effect on emergency department (ED) operations. We study the effect of prospectively used admission decision support on ED operations. In 2012, Los Angeles County + University of Southern California Medical Center implemented prospective use of computerized admission criteria. After implementation, only ED patients meeting primary review (diagnosis-based criteria) or secondary review (medical necessity as determined by an on-site emergency physician) were assigned inpatient beds. Data were extracted from electronic medical records from September 2011 through December 2013. Outcomes included operational metrics, 30-day ED revisits, and 30-day admission rates. Excluding a 6-month implementation period, monthly summary metrics were compared pre- and postimplementation with nonparametric and negative binomial regression methods. All adult ED visits, excluding incarcerated and purely behavioral health visits, were analyzed. The primary outcomes were disposition rates. Secondary outcomes were 30-day ED revisits, 30-day admission rate among return visitors to the ED, and estimated cost. Analysis of 245,662 ED encounters was performed. The inpatient admission rate decreased from 14.2% to 12.8%. Increases in discharge rate (82.4% to 83.4%) and ED observation unit utilization (2.5% to 3.4%) were found. Thirty-day revisits increased (20.4% to 24.4%), although the 30-day admission rate decreased (3.2% to 2.8%). Estimated cost savings totaled $193.17 per ED visit. The prospective application of utilization review software in the ED led to a decrease in the admission rate. This was tempered by a concomitant increase in ED observation unit utilization and 30-day ED revisits. Cost savings suggest that resources should be redirected to the more highly affected ED and ED observation unit, although more work is needed to confirm the generalizability of these findings. Copyright © 2017 American College of Emergency Physicians. Published by Elsevier Inc. All rights reserved.

42 CFR 456.520 - Definitions.

Code of Federal Regulations, 2010 CFR

2010-10-01

... ASSISTANCE PROGRAMS UTILIZATION CONTROL Utilization Review Plans: FFP, Waivers, and Variances for Hospitals and Mental Hospitals Ur Plan: Remote Facility Variances from Time Requirements § 456.520 Definitions...

42 CFR 456.500 - Purpose.

Code of Federal Regulations, 2010 CFR

2010-10-01

... ASSISTANCE PROGRAMS UTILIZATION CONTROL Utilization Review Plans: FFP, Waivers, and Variances for Hospitals and Mental Hospitals § 456.500 Purpose. For hospitals and mental hospitals, this subpart— (a...

MENU OF NOX EMISSION CONTROL OPTIONS FOR COAL-FIRED ELECTRIC UTILITY BOILERS

EPA Science Inventory

The paper reviews NOx control options for coal-fired electric utility boilers. (NOTE: Acid Rain NOx regulations, the Ozone Transport Commission's NOx Budget Program, revision of the New Source Performance Standards (NSPS) for NOx emissions from utility sources, and Ozone Transpor...

[Utilization of dental services for children: a review of the influencing factors and the possible improvements].

PubMed

Cheng, M L; Si, Y

2017-05-09

It has been reported that children's oral health conditions are correlated with their attendance to dental health services. Evaluating the influencing factors of utilization of dental services for children may give ways to improve the services per se, and furtherly the children's oral health. The present review retrieved and summarized domestic and foreign studies on the utilization of oral health services for children based on the Andersen behavior model. It was concluded that the utilization of dental services for children was affected by demographic characteristics, social structure, health belief, family factors, community factors and perceived/evaluated needs. To improve the utilization of dental services for children, effort should be made by means of changing caregivers' health belief, developing oral health insurance system, setting up regular oral health resources and increasing the financial support for oral health services by government.

Evidence-based nursing practice: both state of the art in general and specific to pressure sores.

PubMed

Buss, I C; Halfens, R J; Abu-Saad, H H; Kok, G

1999-01-01

The importance of research-based practice in nursing has been frequently stressed, and a number of nursing studies have been conducted whose results enable nursing to improve knowledge and practice. This study reports a literature review in which the current status of knowledge and research utilization with regard to pressure sores is described. This review first gives an overview of studies on knowledge utilization in general and shows that the spontaneous diffusion of knowledge is inappropriate. Furthermore, an overview of planned research utilization activities focusing on pressure sore prevention and treatment in nursing is presented. The results of these studies show that planned research utilization activities performed in individual organizations lead to positive outcomes in almost all cases. Therefore, it could be concluded that implementing planned research utilization activities in individual health care institutions seems to be an effective strategy to decrease pressure sore incidence and prevalence rates.

An integrative review on coping skills in nursing students: implications for policymaking.

PubMed

Labrague, L J; McEnroe-Petitte, D M; Al Amri, M; Fronda, D C; Obeidat, A A

2018-06-01

This study critically appraised both quantitative and qualitative studies describing coping strategies utilized by nursing students when faced with stress. Stress in nursing students during clinical training is well documented in the nursing literature. The need to utilize positive-coping strategies is necessary to effectively deal with stress and its accompanying stressors. An integrative review method was used in this review. PsycINFO, PubMed, CINAHL (Cumulative Index to Nursing and Allied Health Literature), MEDLINE and Scopus were the databases used in searching for relevant literature using the following search terms; 'coping', 'nursing students', clinical training', 'ways of coping' and 'clinical practice'. A total of 27 studies published from 2001 to 2016 were included in this review. Findings demonstrated that nursing students utilized problem-focused coping strategies rather than emotion-focused coping strategies. Specific coping behaviours utilized included problem-solving behaviours, self-confident approaches and seeking of support from family and friends. The review contributes to the growing literature on coping strategies in nursing students and may have implications on nursing education and nursing policy. This review also demonstrated a scarcity of studies that links specific coping strategies to nursing school stressors and examines predictors of coping skills in nursing students. Institutionalization of structured student orientation programme, implementation of well-planned mentoring programmes and establishment of support unit/centres may be helpful in supporting nursing students during their clinical placement. By developing empirically based interventions, nursing faculty can assist nursing students in strengthening their positive-coping skills to effectively deal with various stressors encountered. © 2017 International Council of Nurses.

Cost-Utility Analysis of Cancer Prevention, Treatment, and Control

PubMed Central

Winn, Aaron N.; Ekwueme, Donatus U.; Guy, Gery P.; Neumann, Peter J.

2018-01-01

Context Substantial innovation related to cancer prevention and treatment has occurred in recent decades. However, these innovations have often come at a significant cost. Cost-utility analysis provides a useful framework to assess if the benefits from innovation are worth the additional cost. This systematic review on published cost-utility analyses related to cancer care is from 1988 through 2013. Analyses were conducted in 2013–2015. Evidence acquisition This review analyzed data from the Tufts Medical Center Cost-Effectiveness Analysis Registry (www.cearegistry.org), a comprehensive registry with detailed information on 4,339 original cost-utility analyses published in the peer-reviewed medical and economic literature through 2013. Evidence synthesis There were 721 cancer-related cost-utility analyses published from 1998 through 2013, with roughly 12% of studies focused on primary prevention and 17% focused on secondary prevention. The most often studied cancers were breast cancer (29%); colorectal cancer (11%); and prostate cancer (8%). The median reported incremental cost-effectiveness ratios (in 2014 U.S. dollars) were $25,000 for breast cancer, $24,000 for colorectal cancer, and $34,000 for prostate cancer. Conclusions The current evidence indicates that there are many interventions that are cost effective across cancer sites and levels of prevention. However, the results highlight the relatively small number of cancer cost-utility analyses devoted to primary prevention compared with secondary or tertiary prevention. PMID:26470806

42 CFR 456.505 - Applicability of waiver.

Code of Federal Regulations, 2010 CFR

2010-10-01

... (CONTINUED) MEDICAL ASSISTANCE PROGRAMS UTILIZATION CONTROL Utilization Review Plans: FFP, Waivers, and Variances for Hospitals and Mental Hospitals Ur Plan: Waiver of Requirements § 456.505 Applicability of...

42 CFR 456.521 - Conditions for granting variance requests.

Code of Federal Regulations, 2010 CFR

2010-10-01

... SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS UTILIZATION CONTROL Utilization Review Plans: FFP, Waivers, and Variances for Hospitals and Mental Hospitals Ur Plan: Remote Facility Variances from Time...

42 CFR 456.525 - Request for renewal of variance.

Code of Federal Regulations, 2010 CFR

2010-10-01

... SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS UTILIZATION CONTROL Utilization Review Plans: FFP, Waivers, and Variances for Hospitals and Mental Hospitals Ur Plan: Remote Facility Variances from Time...

42 CFR 456.525 - Request for renewal of variance.

Code of Federal Regulations, 2011 CFR

2011-10-01

... SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS UTILIZATION CONTROL Utilization Review Plans: FFP, Waivers, and Variances for Hospitals and Mental Hospitals Ur Plan: Remote Facility Variances from Time...

42 CFR 456.508 - Withdrawal of waiver.

Code of Federal Regulations, 2011 CFR

2011-10-01

... (CONTINUED) MEDICAL ASSISTANCE PROGRAMS UTILIZATION CONTROL Utilization Review Plans: FFP, Waivers, and..., 1978, as amended at 61 FR 38399, July 24, 1996] UR Plan: Remote Facility Variances from Time...

Silk-based delivery systems of bioactive molecules.

PubMed

Numata, Keiji; Kaplan, David L

2010-12-30

Silks are biodegradable, biocompatible, self-assembling proteins that can also be tailored via genetic engineering to contain specific chemical features, offering utility for drug and gene delivery. Silkworm silk has been used in biomedical sutures for decades and has recently achieved Food and Drug Administration approval for expanded biomaterials device utility. With the diversity and control of size, structure and chemistry, modified or recombinant silk proteins can be designed and utilized in various biomedical application, such as for the delivery of bioactive molecules. This review focuses on the biosynthesis and applications of silk-based multi-block copolymer systems and related silk protein drug delivery systems. The utility of these systems for the delivery of small molecule drugs, proteins and genes is reviewed. Copyright © 2010 Elsevier B.V. All rights reserved.

Ethanolamine utilization in Vibrio alginolyticus

PubMed Central

2012-01-01

Abstract Ethanolamine is used as an energy source by phylogenetically diverse bacteria including pathogens, by the concerted action of proteins from the eut-operon. Previous studies have revealed the presence of eutBC genes encoding ethanolamine-ammonia lyase, a key enzyme that breaks ethanolamine into acetaldehyde and ammonia, in about 100 bacterial genomes including members of gamma-proteobacteria. However, ethanolamine utilization has not been reported for any member of the Vibrio genus. Our comparative genomics study reveals the presence of genes that are involved in ethanolamine utilization in several Vibrio species. Using Vibrio alginolyticus as a model system we demonstrate that ethanolamine is better utilized as a nitrogen source than as a carbon source. Reviewers This article was reviewed by Dr. Lakshminarayan Iyer and Dr. Vivek Anantharaman (nominated by Dr. L Aravind). PMID:23234435

A scoping review of scoping reviews: advancing the approach and enhancing the consistency.

PubMed

Pham, Mai T; Rajić, Andrijana; Greig, Judy D; Sargeant, Jan M; Papadopoulos, Andrew; McEwen, Scott A

2014-12-01

The scoping review has become an increasingly popular approach for synthesizing research evidence. It is a relatively new approach for which a universal study definition or definitive procedure has not been established. The purpose of this scoping review was to provide an overview of scoping reviews in the literature. A scoping review was conducted using the Arksey and O'Malley framework. A search was conducted in four bibliographic databases and the gray literature to identify scoping review studies. Review selection and characterization were performed by two independent reviewers using pretested forms. The search identified 344 scoping reviews published from 1999 to October 2012. The reviews varied in terms of purpose, methodology, and detail of reporting. Nearly three-quarter of reviews (74.1%) addressed a health topic. Study completion times varied from 2 weeks to 20 months, and 51% utilized a published methodological framework. Quality assessment of included studies was infrequently performed (22.38%). Scoping reviews are a relatively new but increasingly common approach for mapping broad topics. Because of variability in their conduct, there is a need for their methodological standardization to ensure the utility and strength of evidence. © 2014 The Authors. Research Synthesis Methods published by John Wiley & Sons, Ltd.

Medicare program; acquisition, protection and disclosure of utilization and quality control peer review organization (PRO) information--HCFA. Proposed rule.

PubMed

1984-04-16

This proposal would govern the acquisition, protection and disclosure of information obtained or generated by Utilization and Quality Control Peer Review Organizations (PROs). The Peer Review Improvement Act of 1982 authorizes PROs to acquire information necessary to fulfill their duties and functions, places limits on the disclosure of PRO information, and establishes penalties for unauthorized disclosure. These regulations would implement the PROs' statutory right of access to necessary information and set forth their responsibilities to assure that information once acquired is adequately safeguarded, and used only for proper purposes.

System review: a method for investigating medical errors in healthcare settings.

PubMed

Alexander, G L; Stone, T T

2000-01-01

System analysis is a process of evaluating objectives, resources, structure, and design of businesses. System analysis can be used by leaders to collaboratively identify breakthrough opportunities to improve system processes. In healthcare systems, system analysis can be used to review medical errors (system occurrences) that may place patients at risk for injury, disability, and/or death. This study utilizes a case management approach to identify medical errors. Utilizing an interdisciplinary approach, a System Review Team was developed to identify trends in system occurrences, facilitate communication, and enhance the quality of patient care by reducing medical errors.

42 CFR 456.201 - UR plan required for inpatient mental hospital services.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 42 Public Health 4 2010-10-01 2010-10-01 false UR plan required for inpatient mental hospital... HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS UTILIZATION CONTROL Utilization Control: Mental Hospitals Utilization Review (ur) Plan: General Requirements § 456.201 UR plan required for...

A public utility model for managing public land recreation enterprises.

Treesearch

Tom Quinn

2002-01-01

Through review of relevant economic principles and judicial precedent, a case is made that public-land recreation enterprises are analogous to traditionally recognized public utilities. Given the historical concern over the societal value of recreation and associated pricing issues, public-land management policies failing to acknowledge these utility-like...

Case Studies of Water Utility Climate Change Vulnerability Assessment [External Review Draft Report

EPA Science Inventory

This report presents a series of case studies describing the approaches taken by four water utilities in the United States to assess their vulnerability to climate change. The report is not intended to be a comprehensive listing of assessment approaches or utilities conducting v...

77 FR 67380 - Submission for OMB Review; Comment Request: Ethical Dilemmas in Surgery and Utilization of...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-11-09

...; Comment Request: Ethical Dilemmas in Surgery and Utilization of Hospital Ethics Consultation Service: A..., unless it displays a currently valid OMB control number. Proposed Collection: Title: Ethical Dilemmas in Surgery and Utilization of Hospital Ethics Consultation Service: A Survey. Type of Information Collection...

75 FR 32494 - Energy Conservation for PHA-Owned or Leased Project-Audits, Utility Allowances

Federal Register 2010, 2011, 2012, 2013, 2014

2010-06-08

...-Owned or Leased Project-Audits, Utility Allowances AGENCY: Office of the Chief Information Officer, HUD... complete energy audits, benefit/cost analyses for individual vs. master metering. PHAs review tenant...-Audits, Utility Allowances. OMB Approval Number: 2577-0062. Form Numbers: HUD-50078. Description of the...

75 FR 77866 - Agency Information Collection Activities; Submission to OMB for Review and Approval; Comment...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-12-14

... Approval; Comment Request; NSPS for Electric Utility Steam Generating (Renewal) AGENCY: Environmental... the electronic docket, go to http://www.regulations.gov . Title: NSPS for Electric Utility Steam.../Affected Entities: Owners or operators of electric utility steam generating units. Estimated Number of...

Interventions to improve cultural competency in healthcare: a systematic review of reviews

PubMed Central

2014-01-01

Background Cultural competency is a recognized and popular approach to improving the provision of health care to racial/ethnic minority groups in the community with the aim of reducing racial/ethnic health disparities. The aim of this systematic review of reviews is to gather and synthesize existing reviews of studies in the field to form a comprehensive understanding of the current evidence base that can guide future interventions and research in the area. Methods A systematic review of review articles published between January 2000 and June 2012 was conducted. Electronic databases (including Medline, Cinahl and PsycINFO), reference lists of articles, and key websites were searched. Reviews of cultural competency in health settings only were included. Each review was critically appraised by two authors using a study appraisal tool and were given a quality assessment rating of weak, moderate or strong. Results Nineteen published reviews were identified. Reviews consisted of between 5 and 38 studies, included a variety of health care settings/contexts and a range of study types. There were three main categories of study outcomes: patient-related outcomes, provider-related outcomes, and health service access and utilization outcomes. The majority of reviews found moderate evidence of improvement in provider outcomes and health care access and utilization outcomes but weaker evidence for improvements in patient/client outcomes. Conclusion This review of reviews indicates that there is some evidence that interventions to improve cultural competency can improve patient/client health outcomes. However, a lack of methodological rigor is common amongst the studies included in reviews and many of the studies rely on self-report, which is subject to a range of biases, while objective evidence of intervention effectiveness was rare. Future research should measure both healthcare provider and patient/client health outcomes, consider organizational factors, and utilize more rigorous study designs. PMID:24589335

Review: Milking robot utilization, a successful precision livestock farming evolution.

PubMed

John, A J; Clark, C E F; Freeman, M J; Kerrisk, K L; Garcia, S C; Halachmi, I

2016-09-01

Automatic milking systems (AMS), one of the earliest precision livestock farming developments, have revolutionized dairy farming around the world. While robots control the milking process, there have also been numerous changes to how the whole farm system is managed. Milking is no longer performed in defined sessions; rather, the cow can now choose when to be milked in AMS, allowing milking to be distributed throughout a 24 h period. Despite this ability, there has been little attention given to milking robot utilization across 24 h. In order to formulate relevant research questions and improve farm AMS management there is a need to determine the current knowledge gaps regarding the distribution of robot utilization. Feed, animal and management factors and their interplay on levels of milking robot utilization across 24 h for both indoor and pasture-based systems are here reviewed. The impact of the timing, type and quantity of feed offered and their interaction with the distance of feed from the parlour; herd social dynamics, climate and various other management factors on robot utilization through 24 h are provided. This novel review draws together both the opportunities and challenges that exist for farm management to use these factors to improved system efficiency and those that exist for further research.

42 CFR 456.433 - Initial continued stay review date.

Code of Federal Regulations, 2010 CFR

2010-10-01

... SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS UTILIZATION CONTROL Utilization Control: Intermediate Care... after admission, if indicated at the time of admission; and (d) The group performing UR insures that the...

42 CFR 456.433 - Initial continued stay review date.

Code of Federal Regulations, 2011 CFR

2011-10-01

... SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS UTILIZATION CONTROL Utilization Control: Intermediate Care... after admission, if indicated at the time of admission; and (d) The group performing UR insures that the...

Using QALYs in telehealth evaluations: a systematic review of methodology and transparency.

PubMed

Bergmo, Trine S

2014-08-03

The quality-adjusted life-year (QALY) is a recognised outcome measure in health economic evaluations. QALY incorporates individual preferences and identifies health gains by combining mortality and morbidity into one single index number. A literature review was conducted to examine and discuss the use of QALYs to measure outcomes in telehealth evaluations. Evaluations were identified via a literature search in all relevant databases. Only economic evaluations measuring both costs and QALYs using primary patient level data of two or more alternatives were included. A total of 17 economic evaluations estimating QALYs were identified. All evaluations used validated generic health related-quality of life (HRQoL) instruments to describe health states. They used accepted methods for transforming the quality scores into utility values. The methodology used varied between the evaluations. The evaluations used four different preference measures (EQ-5D, SF-6D, QWB and HUI3), and utility scores were elicited from the general population. Most studies reported the methodology used in calculating QALYs. The evaluations were less transparent in reporting utility weights at different time points and variability around utilities and QALYs. Few made adjustments for differences in baseline utilities. The QALYs gained in the reviewed evaluations varied from 0.001 to 0.118 in implying a small but positive effect of telehealth intervention on patient's health. The evaluations reported mixed cost-effectiveness results. The use of QALYs in telehealth evaluations has increased over the last few years. Different methodologies and utility measures have been used to calculate QALYs. A more harmonised methodology and utility measure is needed to ensure comparability across telehealth evaluations.

Rocky Mountain spotted fever: 'starry sky' appearance with diffusion-weighted imaging in a child.

PubMed

Crapp, Seth; Harrar, Dana; Strother, Megan; Wushensky, Curtis; Pruthi, Sumit

2012-04-01

We present a case of Rocky Mountain spotted fever encephalitis in a child imaged utilizing diffusion-weighted MRI. Although the imaging and clinical manifestations of this entity have been previously described, a review of the literature did not reveal any such cases reported in children utilizing diffusion-weighted imaging. The imaging findings and clinical history are presented as well as a brief review of this disease.

A need for an augmented review when reviewing rehabilitation research.

PubMed

Gerber, Lynn H; Nava, Andrew; Garfinkel, Steven; Goel, Divya; Weinstein, Ali A; Cai, Cindy

2016-10-01

There is a need for additional strategies for performing systematic reviews (SRs) to improve translation of findings into practice and to influence health policy. SRs critically appraise research methodology and determine level of evidence of research findings. The standard type of SR identifies randomized controlled trials (RCTs) as providing the most valid data and highest level of evidence. RCTs are not among the most frequently used research design in disability and health research. RCTs usually measure impairments for the primary research outcome rather than improved function, participation or societal integration. It forces a choice between "validity" and "utility/relevance." Other approaches have effectively been used to assess the validity of alternative research designs, whose outcomes focus on function and patient-reported outcomes. We propose that utilizing existing evaluation tools that measure knowledge, dissemination and utility of findings, may help improve the translation of findings into practice and health policy. Copyright © 2016 Elsevier Inc. All rights reserved.

Economic evaluations and their use in infection prevention and control: a narrative review.

PubMed

Rennert-May, Elissa; Conly, John; Leal, Jenine; Smith, Stephanie; Manns, Braden

2018-01-01

The objective of this review is to provide a comprehensive overview of the different types of economic evaluations that can be utilized by Infection Prevention and Control practitioners with a particular focus on the use of the quality adjusted life year, and its associated challenges. We also highlight existing economic evaluations published within Infection Prevention and Control, research gaps and future directions. Narrative Review. To date the majority of economic evaluations within Infection Prevention and Control are considered partial economic evaluations. Acknowledging the challenges, which include variable utilities within infection prevention and control, a lack of randomized controlled trials, and difficulty in modelling infectious diseases in general, future economic evaluation studies should strive to be consistent with published guidelines for economic evaluations. This includes the use of quality adjusted life years. Further research is required to estimate utility scores of relevance within Infection Prevention and Control.

42 CFR 480.120 - Information subject to disclosure.

Code of Federal Regulations, 2013 CFR

2013-10-01

... IMPROVEMENT ORGANIZATION INFORMATION Utilization and Quality Control Quality Improvement Organizations (QIOs... explicitly identify individual patients, practitioners or reviewers; (8) Quality review study information... institutions has been deleted; and (9) Information describing the characteristics of a quality review study...

42 CFR 480.120 - Information subject to disclosure.

Code of Federal Regulations, 2012 CFR

2012-10-01

... IMPROVEMENT ORGANIZATION INFORMATION Utilization and Quality Control Quality Improvement Organizations (QIOs... explicitly identify individual patients, practitioners or reviewers; (8) Quality review study information... institutions has been deleted; and (9) Information describing the characteristics of a quality review study...

42 CFR 480.120 - Information subject to disclosure.

Code of Federal Regulations, 2014 CFR

2014-10-01

... IMPROVEMENT ORGANIZATION INFORMATION Utilization and Quality Control Quality Improvement Organizations (QIOs... explicitly identify individual patients, practitioners or reviewers; (8) Quality review study information... institutions has been deleted; and (9) Information describing the characteristics of a quality review study...

42 CFR 476.71 - QIO review requirements.

Code of Federal Regulations, 2010 CFR

2010-10-01

... care) for the palliation and management of terminal illness; (2) Whether the quality of the services... Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) QUALITY IMPROVEMENT ORGANIZATIONS UTILIZATION AND QUALITY CONTROL REVIEW Review Responsibilities...

Motivation for Healthy Behavior: A Review of Health Promotion Research

ERIC Educational Resources Information Center

Dunsmore, Sarah; Goodson, Patricia

2006-01-01

Authors reviewed the theoretical history of the "motivation" construct, and its utilization within past/current health behavior research. Textbooks and review articles functioned as sources for the theoretical history review. Research published within a 10-year period (1993-2002) in four health promotion journals (all with impact factors greater…

Implementing a Successful Faculty, Data Driven Model for Program Review.

ERIC Educational Resources Information Center

Beal, Suzanne; Davis, Shirley

Frederick Community College (Maryland) utilizes both the Instructional Accountability Program Review (IAPR) and the Career Program Review (CPR) to assess program outcomes and determine progress in meeting goals and objectives. The IAPR is a comprehensive review procedure conducted by faculty and associate deans to evaluate all transfer, career,…

Measurement properties, feasibility and clinical utility of the Doloplus-2 pain scale in older adults with cognitive impairment: a systematic review.

PubMed

Rostad, Hanne Marie; Utne, Inger; Grov, Ellen Karine; Puts, Martine; Halvorsrud, Liv

2017-11-02

The Doloplus-2 is a pain assessment scale for assessing pain in older adults with cognitive impairment. It is used in clinical practice and research. However, evidence for its measurement properties, feasibility and clinical utility remain incomplete. This systematic review synthesizes previous research on the measurement properties, feasibility and clinical utility of the scale. We conducted a systematic search in three databases (CINAHL, Medline and PsycINFO) for studies published in English, French, German, Dutch/Flemish or a Scandinavian language between 1990 and April 2017. We also reviewed the Doloplus-2 homepage and reference lists of included studies to supplement our search. Two reviewers independently reviewed titles and abstracts and performed the quality assessment and data abstraction. A total of 24 studies were included in this systematic review. The quality of the studies varied, but many lacked sufficient detail about the samples and response rates. The Doloplus-2 has been studied using diverse samples in a variety of settings; most study participants were in long-term care and in people with dementia. Sixteen studies addressed various aspects of the scale's feasibility and clinical utility, but their results are limited and inconsistent across settings and samples. Support for the scale's reliability, validity and responsiveness varied widely across the studies. Generally, the reliability coefficients reached acceptable benchmarks, but the evidence for different aspects of the scale's validity and responsiveness was incomplete. Additional high-quality studies are warranted to determine in which populations of older adults with cognitive impairment the Doloplus-2 is reliable, valid and feasible. The ability of the Doloplus-2 to meaningfully quantify pain, measure treatment response and improve patient outcomes also needs further investigation. PROSPERO reg. no.: CRD42016049697 registered 20. Oct. 2016.

Unmet reproductive health needs among women in some West African countries: a systematic review of outcome measures and determinants.

PubMed

Ayanore, Martin Amogre; Pavlova, Milena; Groot, Wim

2016-01-16

Identifying relevant measures of women's reproductive health needs is critical to improve women's chances of service utilization. The study aims to systematically review and analyze the adequacy of outcome measures and determinants applied in previous studies for assessing women reproductive health needs across West Africa. Evidence on outcomes and determinants of unmet reproductive health needs among women of childbearing age in diverse multicultural, religious, and ethnic settings in West African countries was systematically reviewed. The review included recent English language publications (from January 2009 - March 2014). Clinical studies particularly on obstetric care services and reproductive services in relation to HIV/AIDS were excluded. We acknowledge the possibility to have excluded non-English publications and yet-to-be-published articles related to the study aim and objectives. Outcomes and determinants were assessed and defined at three main levels; contraceptive use, obstetric care, and antenatal care utilization. Results show increasing unmet need for women's reproductive health needs. Socio-cultural norms and practices resulting in discontinuation of service use, economic constraints, travel distance to access services and low education levels of women were found to be key predictors of service utilization for contraception, antenatal and obstetric care services. Outcome measures were mainly assessed based on service utilization, satisfaction, cost, and quality of services available as core measures across the three levels assessed in this review. Evidence from this review indicates that currently applied measures of women's reproductive health needs might be inadequate in attaining best maternal outcomes since they appear rather broad. More support and research for developing and advancing context-related measures may help to improve women's maternal health.

42 CFR 456.524 - Notification of Administrator's action and duration of variance.

Code of Federal Regulations, 2010 CFR

2010-10-01

..., DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS UTILIZATION CONTROL Utilization Review Plans: FFP, Waivers, and Variances for Hospitals and Mental Hospitals Ur Plan: Remote...

Current state of virtual reality simulation in robotic surgery training: a review.

PubMed

Bric, Justin D; Lumbard, Derek C; Frelich, Matthew J; Gould, Jon C

2016-06-01

Worldwide, the annual number of robotic surgical procedures continues to increase. Robotic surgical skills are unique from those used in either open or laparoscopic surgery. The acquisition of a basic robotic surgical skill set may be best accomplished in the simulation laboratory. We sought to review the current literature pertaining to the use of virtual reality (VR) simulation in the acquisition of robotic surgical skills on the da Vinci Surgical System. A PubMed search was conducted between December 2014 and January 2015 utilizing the following keywords: virtual reality, robotic surgery, da Vinci, da Vinci skills simulator, SimSurgery Educational Platform, Mimic dV-Trainer, and Robotic Surgery Simulator. Articles were included if they were published between 2007 and 2015, utilized VR simulation for the da Vinci Surgical System, and utilized a commercially available VR platform. The initial search criteria returned 227 published articles. After all inclusion and exclusion criteria were applied, a total of 47 peer-reviewed manuscripts were included in the final review. There are many benefits to utilizing VR simulation for robotic skills acquisition. Four commercially available simulators have been demonstrated to be capable of assessing robotic skill. Three of the four simulators demonstrate the ability of a VR training curriculum to improve basic robotic skills, with proficiency-based training being the most effective training style. The skills obtained on a VR training curriculum are comparable with those obtained on dry laboratory simulation. The future of VR simulation includes utilization in assessment for re-credentialing purposes, advanced procedural-based training, and as a warm-up tool prior to surgery.

Image Sharing Technologies and Reduction of Imaging Utilization: A Systematic Review and Meta-analysis.

PubMed

Vest, Joshua R; Jung, Hye-Young; Ostrovsky, Aaron; Das, Lala Tanmoy; McGinty, Geraldine B

2015-12-01

Image sharing technologies may reduce unneeded imaging by improving provider access to imaging information. A systematic review and meta-analysis were conducted to summarize the impact of image sharing technologies on patient imaging utilization. Quantitative evaluations of the effects of PACS, regional image exchange networks, interoperable electronic heath records, tools for importing physical media, and health information exchange systems on utilization were identified through a systematic review of the published and gray English-language literature (2004-2014). Outcomes, standard effect sizes (ESs), settings, technology, populations, and risk of bias were abstracted from each study. The impact of image sharing technologies was summarized with random-effects meta-analysis and meta-regression models. A total of 17 articles were included in the review, with a total of 42 different studies. Image sharing technology was associated with a significant decrease in repeat imaging (pooled effect size [ES] = -0.17; 95% confidence interval [CI] = [-0.25, -0.09]; P < .001). However, image sharing technology was associated with a significant increase in any imaging utilization (pooled ES = 0.20; 95% CI = [0.07, 0.32]; P = .002). For all outcomes combined, image sharing technology was not associated with utilization. Most studies were at risk for bias. Image sharing technology was associated with reductions in repeat and unnecessary imaging, in both the overall literature and the most-rigorous studies. Stronger evidence is needed to further explore the role of specific technologies and their potential impact on various modalities, patient populations, and settings. Copyright © 2015 American College of Radiology. Published by Elsevier Inc. All rights reserved.

Image Sharing Technologies and Reduction of Imaging Utilization: A Systematic Review and Meta-analysis

PubMed Central

Vest, Joshua R.; Jung, Hye-Young; Ostrovsky, Aaron; Das, Lala Tanmoy; McGinty, Geraldine B.

2016-01-01

Introduction Image sharing technologies may reduce unneeded imaging by improving provider access to imaging information. A systematic review and meta-analysis were conducted to summarize the impact of image sharing technologies on patient imaging utilization. Methods Quantitative evaluations of the effects of PACS, regional image exchange networks, interoperable electronic heath records, tools for importing physical media, and health information exchange systems on utilization were identified through a systematic review of the published and gray English-language literature (2004–2014). Outcomes, standard effect sizes (ESs), settings, technology, populations, and risk of bias were abstracted from each study. The impact of image sharing technologies was summarized with random-effects meta-analysis and meta-regression models. Results A total of 17 articles were included in the review, with a total of 42 different studies. Image sharing technology was associated with a significant decrease in repeat imaging (pooled effect size [ES] = −0.17; 95% confidence interval [CI] = [−0.25, −0.09]; P < .001). However, image sharing technology was associated with a significant increase in any imaging utilization (pooled ES = 0.20; 95% CI = [0.07, 0.32]; P = .002). For all outcomes combined, image sharing technology was not associated with utilization. Most studies were at risk for bias. Conclusions Image sharing technology was associated with reductions in repeat and unnecessary imaging, in both the overall literature and the most-rigorous studies. Stronger evidence is needed to further explore the role of specific technologies and their potential impact on various modalities, patient populations, and settings. PMID:26614882

Yeast Genomics for Bread, Beer, Biology, Bucks and Breath

NASA Astrophysics Data System (ADS)

Sakharkar, Kishore R.; Sakharkar, Meena K.

The rapid advances and scale up of projects in DNA sequencing dur ing the past two decades have produced complete genome sequences of several eukaryotic species. The versatile genetic malleability of the yeast, and the high degree of conservation between its cellular processes and those of human cells have made it a model of choice for pioneering research in molecular and cell biology. The complete sequence of yeast genome has proven to be extremely useful as a reference towards the sequences of human and for providing systems to explore key gene functions. Yeast has been a ‘legendary model’ for new technologies and gaining new biological insights into basic biological sciences and biotechnology. This chapter describes the awesome power of yeast genetics, genomics and proteomics in understanding of biological function. The applications of yeast as a screening tool to the field of drug discovery and development are highlighted and the traditional importance of yeast for bakers and brewers is discussed.

Quantum Computational Universality of the 2D Cai-Miyake-D"ur-Briegel Quantum State

NASA Astrophysics Data System (ADS)

Wei, Tzu-Chieh; Raussendorf, Robert; Kwek, Leong Chuan

2012-02-01

Universal quantum computation can be achieved by simply performing single-qubit measurements on a highly entangled resource state, such as cluster states. Cai, Miyake, D"ur, and Briegel recently constructed a ground state of a two-dimensional quantum magnet by combining multiple Affleck-Kennedy-Lieb-Tasaki quasichains of mixed spin-3/2 and spin-1/2 entities and by mapping pairs of neighboring spin-1/2 particles to individual spin-3/2 particles [Phys. Rev. A 82, 052309 (2010)]. They showed that this state enables universal quantum computation by constructing single- and two-qubit universal gates. Here, we give an alternative understanding of how this state gives rise to universal measurement-based quantum computation: by local operations, each quasichain can be converted to a one-dimensional cluster state and entangling gates between two neighboring logical qubits can be implemented by single-spin measurements. Furthermore, a two-dimensional cluster state can be distilled from the Cai-Miyake-D"ur-Briegel state.

An olfactory receptor from Apolygus lucorum (Meyer-Dur) mainly tuned to volatiles from flowering host plants.

PubMed

Yan, Shu-Wei; Zhang, Jin; Liu, Yang; Li, Guo-Qing; Wang, Gui-Rong

2015-08-01

Apolygus lucorum (Meyer-Dür) (Hemiptera: Miridae) is one of the most serious agricultural pests, feeding on a wide range of cultivated plants, including cotton, cereals and vegetables in the north of China. This insect can frequently switch between habitats and host plants over seasons and prefer plants in bloom. A. lucorum relies heavily on olfaction to locate its host plants finely discriminating different plant volatiles in the environment. Despite its economical importance, research on the olfactory system of this species has been so far very limited. In this study, we have identified and characterized an olfactory receptor which is sensitively tuned to (Z)-3-Hexenyl acetate and several flowering compounds. Besides being present in the bouquet of some flowers, these compounds are produced by plants that have suffered attacks and are supposed to act as chemical messengers between plants. This OR may play an important role in the selection of host plants. Copyright © 2015 Elsevier Ltd. All rights reserved.

Novel Magnetic Nanomaterials Inspired by Magnetotactic Baterial: Topical Review

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

Prozorov, Tanya; Bazylinki, Dennis A.; Mallapragada, Surya K.

2013-05-14

Magnetotactic bacteria, known to produce magnetic nanocrystals with uniform shapes and sizes at physiological conditions, serve as an inspiration and source of a number of biological macromolecules used for the biomimetic synthesis of a variety of magnetic nanomaterials. This review discusses the current state of understanding of magnetosome biomineralization in magnetotactic bacteria, as well as the ways in which iron biomineralization processes can be utilized for tailored in vivo formation of complex magnetic nanomaterials, not occurring in magnetotactic bacteria naturally. The review assesses the current efforts on in vitro synthesis of a variety of magnetic nanoparticles using bioinspired approaches bymore » utilizing mineralization proteins from magnetotactic bacteria, and surveys biomimetic strategies for the rational synthesis of various magnetic nanomaterials under ambient conditions. Finally, this review presents magnetic characterization of nanoparticles, highlighting differences in magnetic behavior between magnetic nanoparticles produced using bioinspired in vivo and in vitro strategies, compared to those produced using conventional methods. This in turn impacts their utility in a wide range of applications for magnetic nanoparticles, which are examined in detail, where bioinspired synthesis methods have potentially provided added advantages.« less

42 CFR 456.234 - Subsequent continued stay review dates.

Code of Federal Regulations, 2011 CFR

2011-10-01

... SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS UTILIZATION CONTROL Utilization Control: Mental Hospitals... least every 90 days each time it decides under § 456.236 that the continued stay is needed; and (c) The...

42 CFR 456.506 - Waiver options for Medicaid agency.

Code of Federal Regulations, 2011 CFR

2011-10-01

... SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS UTILIZATION CONTROL Utilization Review Plans: FFP, Waivers... options for Medicaid agency. (a) The agency may apply for a waiver at any time it has the procedures...

42 CFR 480.116 - Notice to individuals and institutions under review.

Code of Federal Regulations, 2011 CFR

2011-10-01

... AND HUMAN SERVICES (CONTINUED) QUALITY IMPROVEMENT ORGANIZATIONS ACQUISITION, PROTECTION, AND DISCLOSURE OF QUALITY IMPROVEMENT ORGANIZATION REVIEW INFORMATION Utilization and Quality Control Quality... institutions under review with the following information— (a) The title and address of the person responsible...

Utility deregulation and AMR technology. [Automated Meter Reading

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

Moore, G.

1991-06-15

This article reviews the effects of deregulation on other utilities and services and examines how the electric utilities can avoid the worst of these effects and capitalize of the best aspects of competition in achieving marketing excellence. The article presents deregulation as a customer service and underscores the need for utilities to learn to compete aggressively and intelligently and provide additional services available through technology such as automated meter reading.

A systematic review of the psychometric properties of self-report research utilization measures used in healthcare

PubMed Central

2011-01-01

Background In healthcare, a gap exists between what is known from research and what is practiced. Understanding this gap depends upon our ability to robustly measure research utilization. Objectives The objectives of this systematic review were: to identify self-report measures of research utilization used in healthcare, and to assess the psychometric properties (acceptability, reliability, and validity) of these measures. Methods We conducted a systematic review of literature reporting use or development of self-report research utilization measures. Our search included: multiple databases, ancestry searches, and a hand search. Acceptability was assessed by examining time to complete the measure and missing data rates. Our approach to reliability and validity assessment followed that outlined in the Standards for Educational and Psychological Testing. Results Of 42,770 titles screened, 97 original studies (108 articles) were included in this review. The 97 studies reported on the use or development of 60 unique self-report research utilization measures. Seven of the measures were assessed in more than one study. Study samples consisted of healthcare providers (92 studies) and healthcare decision makers (5 studies). No studies reported data on acceptability of the measures. Reliability was reported in 32 (33%) of the studies, representing 13 of the 60 measures. Internal consistency (Cronbach's Alpha) reliability was reported in 31 studies; values exceeded 0.70 in 29 studies. Test-retest reliability was reported in 3 studies with Pearson's r coefficients > 0.80. No validity information was reported for 12 of the 60 measures. The remaining 48 measures were classified into a three-level validity hierarchy according to the number of validity sources reported in 50% or more of the studies using the measure. Level one measures (n = 6) reported evidence from any three (out of four possible) Standards validity sources (which, in the case of single item measures, was all applicable validity sources). Level two measures (n = 16) had evidence from any two validity sources, and level three measures (n = 26) from only one validity source. Conclusions This review reveals significant underdevelopment in the measurement of research utilization. Substantial methodological advances with respect to construct clarity, use of research utilization and related theory, use of measurement theory, and psychometric assessment are required. Also needed are improved reporting practices and the adoption of a more contemporary view of validity (i.e., the Standards) in future research utilization measurement studies. PMID:21794144

A review of patient-centred post-fracture interventions in the context of theories of health behaviour change.

PubMed

Sujic, R; Gignac, M A; Cockerill, R; Beaton, D E

2011-08-01

The purpose of this literature review is to determine whether and to what extent current post-fracture osteoporosis interventions utilize theories of health behaviour change and whether those that are theory-based are more successful in producing desired behaviour changes. Studies were identified by applying additional criteria to the final selection stage of a systematic review of non-surgical osteoporosis interventions in the orthopaedic environment. We identified 42 primary studies targeted at patients and improving post-fracture osteoporosis care. As well as describing the studies (in terms of design, population, interventions, outcomes), we focused on theoretical framework and elements of behaviour change models. The 42 studies included in this review utilized a variety of post-fracture interventions; however, none of them reported using an underlying theoretical base. Only three studies drew on what we felt to be elements of a theoretical framework. The lack of theoretically based studies points to a currently under-utilized area of behaviour change research that could be applied to post-fracture interventions in order to make them more effective. Despite an abundance of literature supporting theories of behaviour change, post-fracture osteoporosis interventions do not report utilizing these theories. Theories of behaviour change could be applied to post-fracture osteoporosis interventions to explain why patients initiate osteoporosis management. Future research should explore the application of theories of health behaviour change to post-fracture interventions.

A scoping review of scoping reviews: advancing the approach and enhancing the consistency

PubMed Central

Pham, Mai T; Rajić, Andrijana; Greig, Judy D; Sargeant, Jan M; Papadopoulos, Andrew; McEwen, Scott A

2014-01-01

Background The scoping review has become an increasingly popular approach for synthesizing research evidence. It is a relatively new approach for which a universal study definition or definitive procedure has not been established. The purpose of this scoping review was to provide an overview of scoping reviews in the literature. Methods A scoping review was conducted using the Arksey and O'Malley framework. A search was conducted in four bibliographic databases and the gray literature to identify scoping review studies. Review selection and characterization were performed by two independent reviewers using pretested forms. Results The search identified 344 scoping reviews published from 1999 to October 2012. The reviews varied in terms of purpose, methodology, and detail of reporting. Nearly three-quarter of reviews (74.1%) addressed a health topic. Study completion times varied from 2 weeks to 20 months, and 51% utilized a published methodological framework. Quality assessment of included studies was infrequently performed (22.38%). Conclusions Scoping reviews are a relatively new but increasingly common approach for mapping broad topics. Because of variability in their conduct, there is a need for their methodological standardization to ensure the utility and strength of evidence. © 2014 The Authors. Research Synthesis Methods published by John Wiley & Sons, Ltd. PMID:26052958

A systematic review of the quality of economic models comparing thrombosis inhibitors in patients with acute coronary syndrome undergoing percutaneous coronary intervention.

PubMed

Hatz, Maximilian H M; Leidl, Reiner; Yates, Nichola A; Stollenwerk, Björn

2014-04-01

Thrombosis inhibitors can be used to treat acute coronary syndromes (ACS). However, there are various alternative treatment strategies, of which some have been compared using health economic decision models. To assess the quality of health economic decision models comparing thrombosis inhibitors in patients with ACS undergoing percutaneous coronary intervention, and to identify areas for quality improvement. The literature databases MEDLINE, EMBASE, EconLit, National Health Service Economic Evaluation Database (NHS EED), Database of Abstracts of Reviews of Effects (DARE) and Health Technology Assessment (HTA). A review of the quality of health economic decision models was conducted by two independent reviewers, using the Philips checklist. Twenty-one relevant studies were identified. Differences were apparent regarding the model type (six decision trees, four Markov models, eight combinations, three undefined models), the model structure (types of events, Markov states) and the incorporation of data (efficacy, cost and utility data). Critical issues were the absence of particular events (e.g. thrombocytopenia, stroke) and questionable usage of utility values within some studies. As we restricted our search to health economic decision models comparing thrombosis inhibitors, interesting aspects related to the quality of studies of adjacent medical areas that compared stents or procedures could have been missed. This review identified areas where recommendations are indicated regarding the quality of future ACS decision models. For example, all critical events and relevant treatment options should be included. Models also need to allow for changing event probabilities to correctly reflect ACS and to incorporate appropriate, age-specific utility values and decrements when conducting cost-utility analyses.

Systematic donor selection review process improves cardiac transplant volumes and outcomes.

PubMed

Smith, Jason W; O'Brien, Kevin D; Dardas, Todd; Pal, Jay D; Fishbein, Daniel P; Levy, Wayne C; Mahr, Claudius; Masri, Sofia C; Cheng, Richard K; Stempien-Otero, April; Mokadam, Nahush A

2016-01-01

Heart transplant remains the definitive therapy for advanced heart failure patients but is limited by organ availability. We identified a large number of donor hearts from our organ procurement organization (OPO) being exported to other regions. We engaged a multidisciplinary team including transplant surgeons, cardiologists, and our OPO colleagues to identify opportunities to improve our center-specific organ utilization rate. We performed a retrospective analysis of donor offers before and after institution of a novel review process. Each donor offer made to our program was reviewed on a monthly basis from July 2013 to June 2014 and compared with the previous year. This review process resulted in a transplant utilization rate of 28% for period 1 versus 49% for period 2 (P = .007). Limiting the analysis to offers from our local OPO changed our utilization rate from 46% to 75% (P = .02). Transplant volume increased from 22 to 35 between the 2 study periods. Thirty-day and 1-year mortality were unchanged over the 2 periods. A total of 58 hearts were refused by our center and transplanted at other centers. During period 1, the 30-day and 1-year survival rates for recipients of those organs were 98% and 90%, respectively, comparable with our historical survival data. The simple process of systematically reviewing donor turndown events as a group tended to reduce variability, increase confidence in expanded criteria for donors, and resulted in improved donor organ utilization and transplant volumes. Copyright © 2016 The American Association for Thoracic Surgery. Published by Elsevier Inc. All rights reserved.

Suggested Guidelines for the Administrative Review Offices of Medical Education.

ERIC Educational Resources Information Center

Meleca, C. Benjamin

1987-01-01

A general description and guidelines are presented for a program review process for departments of medical education of the administrative units within colleges of medicine. After a discussion of the purposes of reviews, a suggested review process is described. The process to be utilized should be negotiated by the principle units, the…

75 FR 70268 - Submission for OMB Review; Comment Request; NIH NCI Central Institutional Review Board (CIRB...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-11-17

... number. Proposed Collection: Title: NIH NCI Central Institutional Review Board (CIRB). Type of... is absent of conflicts of interest with the protocols under review. Tools utilized to accomplish this... information on workflow and processes of CIRB operations as well as a non-disclosure agreement. A conflict of...

Reporting of Systematic Reviews of Micronutrients and Health: A Critical Appraisal

USDA-ARS?s Scientific Manuscript database

Context: Systematic review is a valuable tool for evaluating nutrition-related research and formulating nutrition recommendation. Lack of standardized criteria for generating these reviews has restricted their potential utility. Objective: To evaluate the characteristics and reporting quality of pub...

Design, Development and Utilization Perspectives on Database Management Systems

ERIC Educational Resources Information Center

Shneiderman, Ben

1977-01-01

This paper reviews the historical development of integrated data base management systems and examines competing approaches. Topics include management and utilization, implementation and design, query languages, security, integrity, privacy and concurrency. (Author/KP)

Second generation photodynamic agents: a review.

PubMed

Sternberg, E D; Dolphin, D

1993-10-01

Over the last decade, laser treatment of neoplastic diseases has become routine. The ability of these light-induced therapies to effect positive results is increased with the utilization of photosensitizing dyes. The approval of Photofrin in Canada as a first generation photodynamic therapeutic agent for the treatment of some forms of bladder cancer is being followed by the development of other agents with improved properties. At this time a number of second generation photosensitizing dyes are under study in phase I/II clinical trials. A review of the status of these trials along with mechanistic aspects is reviewed in this article. In addition, a review of the status of lasers to be utilized for photodynamic therapy gives some indication of which instruments could be considered for this therapy in the future.

A Review of the Oncology Patient's Challenges for Utilizing Fertility Preservation Services

PubMed Central

Flink, Dina M.; Sheeder, Jeanelle

2017-01-01

Purpose: The American Society of Clinical Oncology issued practice guidelines in 2006 to provide critical information about fertility impact to adolescents and young adults (AYA) at the time of cancer diagnosis. Survivors continue to express concerns about their long-term reproductive health after cancer therapy even as treatment options for fertility preservation evolve. An underutilization of fertility preservation methods by cancer patients continues to persist. A review of the literature cites barriers and challenges that limit fertility information and preservation options for AYA cancer patients. Methods: A review of medical literature was conducted to examine current practice for patients receiving fertility information and the barriers to patients receiving fertility preservation services. Results: A total of 69 publications were included in this review. The review summarizes (1) patient experiences with receiving fertility information and (2) patient desires, barriers, and challenges to utilizing fertility preservation services. Conclusions: Despite advances in fertility preservation, there are challenges for patients to utilizing fertility preservation services. Barriers include the following: urgency to initiate treatment, inadequate information, clinic time constraints, and perceptions around patients' gender, age, cost, parity, race, relationship, and sociodemographic status influence whether patients receive fertility preservation consultation. Patients report a lack of adequate information to make informed fertility decisions. PMID:27529573

Health state utilities among contemporary prostate cancer patients on active surveillance.

PubMed

Loeb, Stacy; Curnyn, Caitlin; Walter, Dawn; Fagerlin, Angela; Siebert, Uwe; Mühlberger, Nick; Braithwaite, R Scott; Schwartz, Mark D; Lepor, Herbert; Sedlander, Erica

2018-04-01

Active surveillance (AS) is the most rapidly expanding management option for favorable-risk prostate cancer (PCa). Early studies suggested substantial decrements in utility (quality of life weights) from disease-related anxiety. Our objective was to determine utilities for contemporary AS patients using different instruments. We performed a systematic review of PubMed, PMC and OVID for utility measurements in modern AS patients. We then examined utilities among 37 men on AS participating in focus groups between 2015-2016 using the generic EurQol five dimensions questionnaire (EQ-5D-3L) and Patient Oriented Prostate Utility Scale (PORPUS), a PCa-specific instrument. The systematic review found previous studies with utilities for PCa treatment and historical watchful waiting populations, but none specifically in contemporary AS. In our AS population, the mean EQ-5D-3L score was 0.90±0.16 (median, 1.00; range, 0.21-1.00) and PORPUS was 0.98±0.03 (median, 0.99; range, 0.84-1.00). The Spearman correlation between the EQ-5D-3L and PORPUS was 0.87 (P<0.0001), and 38% of patients had a difference >0.1 between instruments. Most contemporary AS patients had high utility scores suggesting that they perceive themselves in good health without a major decrement in quality of life from the disease. However, some patients had substantial differences in utility measured with generic versus disease-specific instruments. Further study is warranted into the optimal instrument for utility assessment in contemporary AS patients.

Etude des facteurs liés à l'observance au traitement antirétroviral chez les patients suivis à l'Unité de Prise En Charge du VIH/SIDA de l'Hôpital de District de Dschang, Cameroun

PubMed Central

Mbopi-Kéou, François-Xavier; Dempouo Djomassi, Lucienne; Monebenimp, Francisca

2012-01-01

Introduction Etudier les facteurs liés à l'observance au traitement antirétroviral chez les patients adultes suivis à l'Unité de Prise en Charge du VIH/SIDA (UPEC) de l'hôpital de District de Dschang. Méthodes Dans une étude descriptive transversale conduite à l'hôpital de District de Dschang, l'observance a été évaluée sur la base des déclarations des patients et sur la régularité du renouvellement de leurs ordonnances (observance calculée). Résultats Parmi les 389 patients répondant à nos critères d'inclusion, 356 ont été interrogés. La durée moyenne du suivi était de 27 mois. La moyenne d’âge était égale à 41 ans et le sexe ratio 2,46 en faveur du sexe féminin. Le statut sérologique était découvert pour 60,56% des patients à l'occasion d'un épisode maladif. Le niveau d'observance déclarée était significativement plus élevé que le niveau global de l'observance calculée (80,2% vs 51,5%, p<10−5). Les deux principales barrières à l'observance étaient l'oubli et le travail. Les patients référés dans cette UPEC étaient moins bien observants (p<10−4). L'observance au traitement antirétroviral était d'autant meilleure quand le taux de CD4 en début de traitement était élevé (p= 0,01) et que la durée du traitement était prolongée (p=0,00). Conclusion La discordance observée entre les résultats des deux méthodes utilisées pour estimer l'observance, tout en soulévant les contraintes liées à l’évaluation de l'observance thérapeutique, souligne l'importance des méthodes biologiques. Les facteurs individuels se sont avérés être les principales raisons de non-observance. Enfin, un accent devrait être mis sur les consultations d’éducation thérapeutique et le suivi psycho-social des patients sous traitement antirétroviral dans cette UPEC. PMID:22937195

76 FR 14895 - Submission for OMB Review; Comment Request

Federal Register 2010, 2011, 2012, 2013, 2014

2011-03-18

... DEPARTMENT OF AGRICULTURE Submission for OMB Review; Comment Request March 14, 2011. The Department of Agriculture has submitted the following information collection requirement(s) to OMB for review... agency, including whether the information will have practical utility; (b) the accuracy of the agency's...

7 CFR 1779.59 - Review of requirements.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 7 Agriculture 12 2010-01-01 2010-01-01 false Review of requirements. 1779.59 Section 1779.59 Agriculture Regulations of the Department of Agriculture (Continued) RURAL UTILITIES SERVICE, DEPARTMENT OF AGRICULTURE (CONTINUED) WATER AND WASTE DISPOSAL PROGRAMS GUARANTEED LOANS § 1779.59 Review of requirements...

Electrical deicing utilizing carbon fiber tape for asphalt approach and crosswalk phase I - literature review.

DOT National Transportation Integrated Search

2016-06-30

The purpose of this study is to provide a comprehensive literature review of electrical deicing technology for possible application in asphalt approach and crosswalks. A : thorough review of existing and emerging deicing technology for snow/ice melti...

FSSC Science Tools: Pulsar Analysis

NASA Technical Reports Server (NTRS)

Thompson, Dave

2010-01-01

This slide presentation reviews the typical pulsar analysis, giving tips for screening of the data, the use of time series analysis, and utility tools. Specific information about analyzing Vela data is reviewed.

75 FR 20568 - Agency Information Collection Activities Under OMB Review

Federal Register 2010, 2011, 2012, 2013, 2014

2010-04-20

...: The United Kingdom, Australia, Brazil, Germany, Canada, France, Spain, New Zealand, Singapore, Taiwan... time needed to review instructions; develop, acquire, install, and utilize technology and systems for...

42 CFR 456.238 - Time limits for final decision and notification of adverse decision.

Code of Federal Regulations, 2010 CFR

2010-10-01

..., DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS UTILIZATION CONTROL Utilization Control: Mental Hospitals Ur Plan: Review of Need for Continued Stay § 456.238 Time limits for...

Bellwether Social Studies Programs.

ERIC Educational Resources Information Center

Daetz, Denney

1985-01-01

Describes and reviews commercially-available computer software for social studies (SS). They are: "Jury Trial II" (utilizes artificial intelligence); "Africa" (utilizes creative graphics to teaching SS facts; "Revolutions: Past, Present and Future"; "The Other Side" (examines world peace using values…

A review of light-scattering techniques for the study of colloids in natural waters

USGS Publications Warehouse

Rees, T.F.

1987-01-01

In order to understand the movement of colloidal materials in natural waters, we first need to have a means of quantifying their physical characteristics. This paper reviews three techniques which utilize light-scattering phenomena to measure the translational diffusion coefficient, the rotational diffusion coefficient, and the electrophoretic mobility of colloids suspended in water. Primary emphasis is to provide sufficient theoretical detail so that hydrologists can evaluate the utility of photon correlation spectrometry, electrophoretic light scattering, and electric birefringence analysis. ?? 1987.

A Study to Determine the Cost of Quality Assurance to the Department of Surgery at US Army Medical Department Activity. Fort Benning, Georgia

DTIC Science & Technology

1984-07-01

to make maximum use of available time. General Surgery averaged ninety-six operative procedures per month during 1983, ophthalmology averaged fifteen...health care providers 2. Document evaluation of: a) Surgical care review (tissue review) b) Blood utilization c) Antibiotics utilization d) Pharmacy and...21. Number Surgical Procedures Performed 470 470 on Patients Undergoing all Types of Surgery APPENDIX L EXAMPLES OF AUDIT CRITERIA 103 SERVICE MONTH

Value-added uses for crude glycerol--a byproduct of biodiesel production

PubMed Central

2012-01-01

Biodiesel is a promising alternative, and renewable, fuel. As its production increases, so does production of the principle co-product, crude glycerol. The effective utilization of crude glycerol will contribute to the viability of biodiesel. In this review, composition and quality factors of crude glycerol are discussed. The value-added utilization opportunities of crude glycerol are reviewed. The majority of crude glycerol is used as feedstock for production of other value-added chemicals, followed by animal feeds. PMID:22413907

Does Methodological Guidance Produce Consistency? A Review of Methodological Consistency in Breast Cancer Utility Value Measurement in NICE Single Technology Appraisals.

PubMed

Rose, Micah; Rice, Stephen; Craig, Dawn

2018-06-01

Since 2004, National Institute for Health and Care Excellence (NICE) methodological guidance for technology appraisals has emphasised a strong preference for using the validated EuroQol 5-Dimensions (EQ-5D) quality-of-life instrument, measuring patient health status from patients or carers, and using the general public's preference-based valuation of different health states when assessing health benefits in economic evaluations. The aim of this study was to review all NICE single technology appraisals (STAs) for breast cancer treatments to explore consistency in the use of utility scores in light of NICE methodological guidance. A review of all published breast cancer STAs was undertaken using all publicly available STA documents for each included assessment. Utility scores were assessed for consistency with NICE-preferred methods and original data sources. Furthermore, academic assessment group work undertaken during the STA process was examined to evaluate the emphasis of NICE-preferred quality-of-life measurement methods. Twelve breast cancer STAs were identified, and many STAs used evidence that did not follow NICE's preferred utility score measurement methods. Recent STA submissions show companies using EQ-5D and mapping. Academic assessment groups rarely emphasized NICE-preferred methods, and queries about preferred methods were rare. While there appears to be a trend in recent STA submissions towards following NICE methodological guidance, historically STA guidance in breast cancer has generally not used NICE's preferred methods. Future STAs in breast cancer and reviews of older guidance should ensure that utility measurement methods are consistent with the NICE reference case to help produce consistent, equitable decision making.

Factors associated with institutional delivery service utilization in Ethiopia.

PubMed

Kebede, Alemi; Hassen, Kalkidan; Nigussie Teklehaymanot, Aderajew

2016-01-01

Most obstetric complications occur unpredictably during the time of delivery, but they can be prevented with proper medical care in the health facilities. Despite the Ethiopian government's efforts to expand health service facilities and promote health institution-based delivery service in the country, an estimated 85% of births still take place at home. The review was conducted with the aim of generating the best evidence on the determinants of institutional delivery service utilization in Ethiopia. The reviewed studies were accessed through electronic web-based search strategy from PubMed, HINARI, Mendeley reference manager, Cochrane Library for Systematic Reviews, and Google Scholar. Review Manager V5.3 software was used for meta-analysis. Mantel-Haenszel odds ratios (ORs) and their 95% confidence intervals (CIs) were calculated. Heterogeneity of the study was assessed using I (2) test. People living in urban areas (OR =13.16, CI =1.24, 3.68), with primary and above educational level of the mother and husband (OR =4.95, CI =2.3, 4. 8, and OR =4.43, CI =1.14, 3.36, respectively), who encountered problems during pregnancy (OR =2.83, CI =4.54, 7.39), and living at a distance <5 km from nearby health facility (OR =2.6, CI =3.33, 6.57) showed significant association with institutional delivery service utilization. Women's autonomy was not significantly associated with institutional delivery service utilization. Distance to health facility and problems during pregnancy were factors positively and significantly associated with institutional delivery service utilization. Promoting couples education beyond primary education regarding the danger signs of pregnancy and benefits of institutional delivery through available communication networks such as health development army and promotion of antenatal care visits and completion of four standard visits by pregnant women were recommended.

Ethical implications of digital images for teaching and learning purposes: an integrative review.

PubMed

Kornhaber, Rachel; Betihavas, Vasiliki; Baber, Rodney J

2015-01-01

Digital photography has simplified the process of capturing and utilizing medical images. The process of taking high-quality digital photographs has been recognized as efficient, timely, and cost-effective. In particular, the evolution of smartphone and comparable technologies has become a vital component in teaching and learning of health care professionals. However, ethical standards in relation to digital photography for teaching and learning have not always been of the highest standard. The inappropriate utilization of digital images within the health care setting has the capacity to compromise patient confidentiality and increase the risk of litigation. Therefore, the aim of this review was to investigate the literature concerning the ethical implications for health professionals utilizing digital photography for teaching and learning. A literature search was conducted utilizing five electronic databases, PubMed, Embase (Excerpta Medica Database), Cumulative Index to Nursing and Allied Health Literature, Educational Resources Information Center, and Scopus, limited to English language. Studies that endeavored to evaluate the ethical implications of digital photography for teaching and learning purposes in the health care setting were included. The search strategy identified 514 papers of which nine were retrieved for full review. Four papers were excluded based on the inclusion criteria, leaving five papers for final analysis. Three key themes were developed: knowledge deficit, consent and beyond, and standards driving scope of practice. The assimilation of evidence in this review suggests that there is value for health professionals utilizing digital photography for teaching purposes in health education. However, there is limited understanding of the process of obtaining and storage and use of such mediums for teaching purposes. Disparity was also highlighted related to policy and guideline identification and development in clinical practice. Therefore, the implementation of policy to guide practice requires further research.

Circulating Tumor DNA Analysis in Patients With Cancer: American Society of Clinical Oncology and College of American Pathologists Joint Review.

PubMed

Merker, Jason D; Oxnard, Geoffrey R; Compton, Carolyn; Diehn, Maximilian; Hurley, Patricia; Lazar, Alexander J; Lindeman, Neal; Lockwood, Christina M; Rai, Alex J; Schilsky, Richard L; Tsimberidou, Apostolia M; Vasalos, Patricia; Billman, Brooke L; Oliver, Thomas K; Bruinooge, Suanna S; Hayes, Daniel F; Turner, Nicholas C

2018-06-01

Purpose Clinical use of analytical tests to assess genomic variants in circulating tumor DNA (ctDNA) is increasing. This joint review from ASCO and the College of American Pathologists summarizes current information about clinical ctDNA assays and provides a framework for future research. Methods An Expert Panel conducted a literature review on the use of ctDNA assays for solid tumors, including pre-analytical variables, analytical validity, interpretation and reporting, and clinical validity and utility. Results The literature search identified 1,338 references. Of those, 390, plus 31 references supplied by the Expert Panel, were selected for full-text review. There were 77 articles selected for inclusion. Conclusion The evidence indicates that testing for ctDNA is optimally performed on plasma collected in cell stabilization or EDTA tubes, with EDTA tubes processed within 6 hours of collection. Some ctDNA assays have demonstrated clinical validity and utility with certain types of advanced cancer; however, there is insufficient evidence of clinical validity and utility for the majority of ctDNA assays in advanced cancer. Evidence shows discordance between the results of ctDNA assays and genotyping tumor specimens and supports tumor tissue genotyping to confirm undetected results from ctDNA tests. There is no evidence of clinical utility and little evidence of clinical validity of ctDNA assays in early-stage cancer, treatment monitoring, or residual disease detection. There is no evidence of clinical validity and clinical utility to suggest that ctDNA assays are useful for cancer screening, outside of a clinical trial. Given the rapid pace of research, re-evaluation of the literature will shortly be required, along with the development of tools and guidance for clinical practice.

Factors associated with institutional delivery service utilization in Ethiopia

PubMed Central

Kebede, Alemi; Hassen, Kalkidan; Nigussie Teklehaymanot, Aderajew

2016-01-01

Background Most obstetric complications occur unpredictably during the time of delivery, but they can be prevented with proper medical care in the health facilities. Despite the Ethiopian government’s efforts to expand health service facilities and promote health institution-based delivery service in the country, an estimated 85% of births still take place at home. Objective The review was conducted with the aim of generating the best evidence on the determinants of institutional delivery service utilization in Ethiopia. Methods The reviewed studies were accessed through electronic web-based search strategy from PubMed, HINARI, Mendeley reference manager, Cochrane Library for Systematic Reviews, and Google Scholar. Review Manager V5.3 software was used for meta-analysis. Mantel–Haenszel odds ratios (ORs) and their 95% confidence intervals (CIs) were calculated. Heterogeneity of the study was assessed using I2 test. Results People living in urban areas (OR =13.16, CI =1.24, 3.68), with primary and above educational level of the mother and husband (OR =4.95, CI =2.3, 4. 8, and OR =4.43, CI =1.14, 3.36, respectively), who encountered problems during pregnancy (OR =2.83, CI =4.54, 7.39), and living at a distance <5 km from nearby health facility (OR =2.6, CI =3.33, 6.57) showed significant association with institutional delivery service utilization. Women’s autonomy was not significantly associated with institutional delivery service utilization. Conclusion and recommendation Distance to health facility and problems during pregnancy were factors positively and significantly associated with institutional delivery service utilization. Promoting couples education beyond primary education regarding the danger signs of pregnancy and benefits of institutional delivery through available communication networks such as health development army and promotion of antenatal care visits and completion of four standard visits by pregnant women were recommended. PMID:27672342

The Effect of Formulary Restrictions on Patient and Payer Outcomes: A Systematic Literature Review.

PubMed

Park, Yujin; Raza, Syed; George, Aneesh; Agrawal, Rumjhum; Ko, John

2017-08-01

Formulary restrictions are implemented to reduce pharmacy costs and ensure appropriate use of pharmaceutical products. As adoption of formulary restrictions increases with rising pharmacy costs, there is a need to better understand the potential effect of formulary restrictions on patient and payer outcomes. To conduct a systematic literature review that assesses the effect of formulary restrictions on the following outcomes: medication adherence, clinical outcomes, treatment satisfaction, drug utilization, health care resource utilization, and economic outcomes. Studies published in 2005 or later were identified from the MEDLINE, Embase, and Cochrane databases and the National Health Service Economic Evaluation Database, using 2 sets of search terms. A total of 17 formulary restriction terms (e.g., step therapy [ST] and prior authorization [PA]) and 55 outcome terms were included, resulting in 935 unique search term combinations. Two reviewers independently conducted analyses of the titles, abstracts, and full-text articles. The search was limited to English-language articles that evaluated the effect of ST and/or PA placed by U.S. third-party payers on the following outcomes: patient outcomes (medication adherence, clinical outcomes, and treatment satisfaction) and payer outcomes (drug utilization, health care resource utilization, and economic outcomes). Of 2,321 reviewed articles, 59 articles met the study inclusion criteria. The included studies assessed the effect of ST (n = 18), PA (n = 35), or both (n = 6) on medication adherence (n = 14), clinical outcomes (n = 12), treatment satisfaction (n = 2), drug utilization (n = 39), health care resource utilization (n = 18), and economic outcomes (n = 42). The 59 articles measured 164 outcomes across the patient, health care resource utilization, and economic outcome categories of interest. Of the total number of outcomes, 50.6% (n = 83) were negative in direction or were unfavorable, whereas 40.2% (n = 66) were positive in direction or were favorable, when the perspectives of patients and payers were considered. Of the total number of drug utilization outcomes reported (n = 46), the majority showed lower drug utilization (> 90%). However, in some of the articles, pharmacy cost savings resulting from lower drug utilization appeared to be offset by increased medical costs. Formulary coverage decisions may have unintended consequences on patient and payer outcomes despite lower drug utilization and pharmacy cost savings; therefore, careful evaluation of restrictions before policy implementation and continued reevaluation after implementation is warranted. This study was funded by Novartis Pharmaceuticals. Park and Ko are employed by Novartis Pharmaceuticals in East Hanover, New Jersey, and Ko holds stock in Novartis. Raza, George, and Agrawal are employed by Novartis Healthcare in Hyderabad, India. Study concept and design were contributed primarily by Park and Ko, along with the other authors. Raza, George, and Agrawal collected the data, along with Park and Ko. Data interpretation was performed by Agrawal, Raza, George, Park, and Ko. The manuscript was written and revised by Raza, George, and Park, along with Ko and Agrawal. Results from this systematic literature review were presented at the AMCP Annual Meeting 2016; San Francisco, California; April 19-22, 2016.

Synchronous and Asynchronous Text-Based CMC in Educational Contexts: A Review of Recent Research

ERIC Educational Resources Information Center

Johnson, Genevieve, Marie

2006-01-01

This paper presents a review of recent research that examines the relative instructional utility of text-based synchronous and asynchronous computer-mediated communication (CMC). As a mechanism for limiting the number of studies reviewed as well as controlling for emergent technologies, only research published since 2000 was reviewed. The goal was…

44 CFR 12.14 - Annual comprehensive review.

Code of Federal Regulations, 2010 CFR

2010-10-01

... should be abolished. (b) Pertinent factors to be considered in the comprehensive review required by... programs or operations; (4) An evaluation of the utilization by the Agency of the committee's policy...

Enhancing rigor and practice of scoping reviews in social policy research: considerations from a worked example on the Americans with disabilities act.

PubMed

Harris, Sarah Parker; Gould, Robert; Fujiura, Glenn

2015-01-01

There is increasing theoretical consideration about the use of systematic and scoping reviews of evidence in informing disability and rehabilitation research and practice. Indicative of this trend, this journal published a piece by Rumrill, Fitzgerald and Merchant in 2010 explaining the utility and process for conducting reviews of intervention-based research. There is still need to consider how to apply such rigor when conducting more exploratory reviews of heterogeneous research. This article explores the challenges, benefits, and procedures for conducting rigorous exploratory scoping reviews of diverse evidence. The article expands upon Rumrill, Fitzgerald and Merchant's framework and considers its application to more heterogeneous evidence on the impact of social policy. A worked example of a scoping review of the Americans with Disabilities Act is provided with a procedural framework for conducting scoping reviews on the effects of a social policy. The need for more nuanced techniques for enhancing rigor became apparent during the review process. There are multiple methodological steps that can enhance the utility of exploratory scoping reviews. The potential of systematic consideration during the exploratory review process is shown as a viable method to enhance the rigor in reviewing diverse bodies of evidence.

An Integrative Review of Multicomponent Weight Management Interventions for Adults with Intellectual Disabilities

ERIC Educational Resources Information Center

Doherty, Alison J.; Jones, Stephanie P.; Chauhan, Umesh; Gibson, Josephine M. E.

2018-01-01

Background: Obesity is more prevalent in people with intellectual disabilities and increases the risk of developing serious medical conditions. UK guidance recommends multicomponent weight management interventions (MCIs), tailored for different population groups. Methods: An integrative review utilizing systematic review methodology was conducted…

Integration of utility and environmental activities in the project development process.

DOT National Transportation Integrated Search

2010-01-01

Two sources of delay during the project development process are utility adjustments and the environmental : review and clearance process. There are several efforts underway at the Texas Department of Transportation : (TxDOT) to optimize these process...

Bibliography of Literature for Avian Issues in Solar and Wind Energy and Other Activities

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

Walston, Leroy J.; White, Ellen M.; Meyers, Stephanie A.

2015-04-01

Utility-scale solar energy has been a rapidly expanding energy sector in the United States in recent years and is expected to continue to grow. In 2014, concerns were raised over the risk of avian fatalities associated with utility-scale solar plants. With funding from the U.S. Department of Energy SunShot Program, Argonne National Laboratory and the National Renewable Energy Laboratory studied the issue and released A Review of Avian Monitoring and Mitigation Information at Existing Utility-Scale Solar Facilities (ANL/EVS-15/2, March 2015). A comprehensive literature review included peer-reviewed journal articles on avian fatalities from solar energy facilities and other sources (e.g., windmore » energy, building collisions, etc.), project-specific technical reports on avian monitoring and fatality at solar facilities, information on mitigation measures and best management practices, and literature pertaining to avian behavioral patterns and habitat use. The source citations are listed in this bibliography; they are current through December 2014.« less

Review: Public perspectives on the utilization of human placentas in scientific research and medicine.

PubMed

Yoshizawa, R S

2013-01-01

Placental tissues are frequently utilized by scientists studying pregnancy and reproduction and in diverse fields including immunology, stem cell research, genetics, cancer research, and tissue engineering, as well as by clinicians in many therapies. Though the utilization of the human placenta in science and medicine has benefitted many people, little is known about public perspectives of this phenomenon. This review addresses placental donation, collection, and utilization in science and medicine, focusing on public perspectives. Cultural values and traditions, ethical paradigms and concerns, public understandings of science and medicine, and political considerations may impact perceptions of the utilization of the placenta in science and medicine, but systematic study is lacking. It is argued that knowledge of public views gained from empirical investigation may underpin the development of collection protocols and research projects that are more responsive to public will, spur more extensive utilization in science and medicine of this unique organ, and/or aid in the realization of the mobilization of knowledge about the placenta for clinical and educational ends. New avenues for research on public perspectives of the placenta are proposed. Copyright © 2012 Elsevier Ltd. All rights reserved.

42 CFR 480.135 - Disclosure necessary to perform review responsibilities.

Code of Federal Regulations, 2010 CFR

2010-10-01

... responsibilities. 480.135 Section 480.135 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF... DISCLOSURE OF QUALITY IMPROVEMENT ORGANIZATION REVIEW INFORMATION Utilization and Quality Control Quality... stage renal disease services. ...

42 CFR 480.135 - Disclosure necessary to perform review responsibilities.

Code of Federal Regulations, 2011 CFR

2011-10-01

... responsibilities. 480.135 Section 480.135 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF... DISCLOSURE OF QUALITY IMPROVEMENT ORGANIZATION REVIEW INFORMATION Utilization and Quality Control Quality... stage renal disease services. ...

11 CFR 9036.4 - Commission review of submissions.

Code of Federal Regulations, 2010 CFR

2010-01-01

..., in conducting its review, may utilize statistical sampling techniques. Based on the results of its... nonmatchable and the reason that it is not matchable; or if statistical sampling is used, the estimated amount...

Frequency of Binge Eating Episodes in Bulimia Nervosa and Binge Eating Disorder: Diagnostic Considerations

PubMed Central

Wilson, G. Terence; Sysko, Robyn

2013-01-01

Objective In DSM-IV, to be diagnosed with Bulimia Nervosa (BN) or the provisional diagnosis of Binge Eating Disorder (BED), an individual must experience episodes of binge eating is “at least twice a week” on average, for three or six months respectively. The purpose of this review was to examine the validity and utility of the frequency criterion for BN and BED. Method Published studies evaluating the frequency criterion were reviewed. Results Our review found little evidence to support the validity or utility of the DSM-IV frequency criterion of twice a week binge eating; however, the number of studies available for our review was limited. Conclusion A number of options are available for the frequency criterion in DSM-V, and the optimal diagnostic threshold for binge eating remains to be determined. PMID:19610014

32 CFR 199.15 - Quality and utilization review peer review organization program.

Code of Federal Regulations, 2012 CFR

2012-07-01

... different geographical locations or for different types of providers. (B) For healthcare services provided... TRICARE/CHAMPUS Policy Manual, or until the approved transplant occurs. (D) For healthcare services.... (3) Outlier review. Claims which qualify for additional payment as a long-stay outlier or as a cost...

32 CFR 199.15 - Quality and utilization review peer review organization program.

Code of Federal Regulations, 2014 CFR

2014-07-01

... different geographical locations or for different types of providers. (B) For healthcare services provided... TRICARE/CHAMPUS Policy Manual, or until the approved transplant occurs. (D) For healthcare services.... (3) Outlier review. Claims which qualify for additional payment as a long-stay outlier or as a cost...

Review of Empirical Research That Utilized the Bell Object Relations Inventory.

ERIC Educational Resources Information Center

Hansen, Joseph Wm.

This literature review examines how the Bell Object Relations Inventory (BORI) (M. Bell and others, 1986) has been used in the literature. General domains of BORI use include interpersonal relatedness, the measurement of religious dimensions, and the diagnosis and prediction of psychopathology. Specific areas are reviewed regarding the…

Women and Minorities in Engineering: A Review of the Literature

ERIC Educational Resources Information Center

Mamaril, Natasha J. A; Royal, Kenneth D.

2008-01-01

This review of the literature investigates the various factors identified by researchers to explain women's underrepresentation in the engineering field. Because a great deal of research has been published through the years, a compilation summary of existing research was necessary. This literature review utilized searches from thousands of…

Universal Adolescent Depression Prevention Programs: A Review

ERIC Educational Resources Information Center

Carnevale, Teresa D.

2013-01-01

Although the subject of adolescent depression has gained significant attention, little is being done in the way of primary prevention. The purpose of this article is to conduct a review of the literature through the lens of the Reach, Effectiveness, Adoption, Implementation and Maintenance framework. This review was conducted utilizing several…

Methods for Assessing Sleep in Children with Autism Spectrum Disorders: A Review

ERIC Educational Resources Information Center

Hodge, Danelle; Parnell, Andrea M. N.; Hoffman, Charles D.; Sweeney, Dwight P.

2012-01-01

A literature review completed by Bauer and Blunden (2008) determined that compared to objective measures, subjective assessments of sleep for typically developing children (e.g., parental reports) were of limited utility. No comparable literature review has been undertaken to determine whether subjective measures are appropriate for assessing…

A Systematic Review of Factors Utilized in Preconception Health Behavior Research

ERIC Educational Resources Information Center

Delissaint, Dieula; McKyer, E. Lisako J.

2011-01-01

This systematic review critically synthesizes the literature focusing on factors related to preconception health behaviors (PCHBs) among childbearing age women in the United States, developed countries, and developing countries. Ovid Medline and CINAHL databases were searched for peer-reviewed articles published between 1998 and 2008 relating to…

Evaluation of costs to process and manage utility and driveway permits.

DOT National Transportation Integrated Search

2014-10-01

Reviewing and processing utility and driveway permits at the Texas Department of Transportation (TxDOT) : requires a considerable amount of involvement and coordination by TxDOT personnel, both at the district : and division levels. Currently, TxDOT ...

42 CFR 480.101 - Scope and definitions.

Code of Federal Regulations, 2014 CFR

2014-10-01

... ORGANIZATION INFORMATION Utilization and Quality Control Quality Improvement Organizations (QIOs) General... governing— (1) Disclosure of information collected, acquired or generated by a Utilization and Quality... of the problem and follow-up. Quality review study information means all documentation related to the...

42 CFR 480.101 - Scope and definitions.

Code of Federal Regulations, 2013 CFR

2013-10-01

... ORGANIZATION INFORMATION Utilization and Quality Control Quality Improvement Organizations (QIOs) General... governing— (1) Disclosure of information collected, acquired or generated by a Utilization and Quality... of the problem and follow-up. Quality review study information means all documentation related to the...

42 CFR 480.101 - Scope and definitions.

Code of Federal Regulations, 2012 CFR

2012-10-01

... ORGANIZATION INFORMATION Utilization and Quality Control Quality Improvement Organizations (QIOs) General... governing— (1) Disclosure of information collected, acquired or generated by a Utilization and Quality... of the problem and follow-up. Quality review study information means all documentation related to the...

A review of screening mammography participation and utilization in Canada.

PubMed

Doyle, G P; Major, D; Chu, C; Stankiewicz, A; Harrison, M L; Pogany, L; Mai, V M; Onysko, J

2011-09-01

Participation rate is an important indicator for a screening program's effectiveness; however, the current approach to measuring participation rate in Canada is not comparable with other countries. The objective of this study is to review the measurement of screening mammography participation in Canada, make international comparisons, and propose alternative methods. Canadian breast cancer screening program data for women aged 50 to 69 years screened between 2004 and 2006 were extracted from the Canadian Breast Cancer Screening Database (CBCSD). The fee-for-services (FSS) mammography data (opportunistic screening mammography) were obtained from the provincial ministries of health. Both screening mammography program participation and utilization were examined over 24 and 30 months. Canada's screening participation rate increases from 39.4% for a 24-month cut-off to 43.6% for a 30-month cut-off. The 24-month mammography utilization rate is 63.1% in Canada, and the 30-month utilization rate is 70.4%. Due to the differences in health service delivery among Canadian provinces, both programmatic participation and overall utilization of mammography at 24 months and 30 months should be monitored.

40 CFR 52.2630 - Prevention of significant deterioration of air quality.

Code of Federal Regulations, 2014 CFR

2014-07-01

..., including Supplement A, in all PSD permit application reviews. The Division will utilize any future revisions to the Guideline in PSD permitting reviews as revisions become effective. [44 FR 51979, Sept. 6...

40 CFR 52.2630 - Prevention of significant deterioration of air quality.

Code of Federal Regulations, 2011 CFR

2011-07-01

..., including Supplement A, in all PSD permit application reviews. The Division will utilize any future revisions to the Guideline in PSD permitting reviews as revisions become effective. [44 FR 51979, Sept. 6...

40 CFR 52.2630 - Prevention of significant deterioration of air quality.

Code of Federal Regulations, 2012 CFR

2012-07-01

..., including Supplement A, in all PSD permit application reviews. The Division will utilize any future revisions to the Guideline in PSD permitting reviews as revisions become effective. [44 FR 51979, Sept. 6...

40 CFR 52.2630 - Prevention of significant deterioration of air quality.

Code of Federal Regulations, 2013 CFR

2013-07-01

..., including Supplement A, in all PSD permit application reviews. The Division will utilize any future revisions to the Guideline in PSD permitting reviews as revisions become effective. [44 FR 51979, Sept. 6...

Conceptual and empirical themes regarding the design of technology transfer programs : a review of wood utilization research in the United States

Treesearch

Paul V. Ellefson; Michael A. Kilgore; Kenneth E. Skog; Christopher D. Risbrudt

2011-01-01

Transfer of technologies produced by research is critical to innovation within all organizations. The intent of this paper is to take stock of the conceptual underpinnings of technology transfer processes as they relate to wood utilization research and to identify conditions that promote the successful transfer of research results. Conceptually, research utilization...

Determining level of care appropriateness in the patient journey from acute care to rehabilitation

PubMed Central

2011-01-01

Background The selection of patients for rehabilitation, and the timing of transfer from acute care, are important clinical decisions that impact on care quality and patient flow. This paper reports utilization review data on inpatients in acute care with stroke, hip fracture or elective joint replacement, and other inpatients referred for rehabilitation. It examines reasons why acute level of care criteria are not met and explores differences in decision making between acute care and rehabilitation teams around patient appropriateness and readiness for transfer. Methods Cohort study of patients in a large acute referral hospital in Australia followed with the InterQual utilization review tool, modified to also include reasons why utilization criteria are not met. Additional data on team decision making about appropriateness for rehabilitation, and readiness for transfer, were collected on a subset of patients. Results There were 696 episodes of care (7189 bed days). Days meeting acute level of care criteria were 56% (stroke, hip fracture and joint replacement patients) and 33% (other patients, from the time of referral). Most inappropriate days in acute care were due to delays in processes/scheduling (45%) or being more appropriate for rehabilitation or lower level of care (30%). On the subset of patients, the acute care team and the utilization review tool deemed patients ready for rehabilitation transfer earlier than the rehabilitation team (means of 1.4, 1.3 and 4.0 days from the date of referral, respectively). From when deemed medically stable for transfer by the acute care team, 28% of patients became unstable. From when deemed stable by the rehabilitation team or utilization review, 9% and 11%, respectively, became unstable. Conclusions A high proportion of patient days did not meet acute level of care criteria, due predominantly to inefficiencies in care processes, or to patients being more appropriate for an alternative level of care, including rehabilitation. The rehabilitation team was the most accurate in determining ongoing medical stability, but at the cost of a longer acute stay. To avoid inpatients remaining in acute care in a state of 'terra nullius', clinical models which provide rehabilitation within acute care, and more efficient movement to a rehabilitation setting, is required. Utilization review could have a decision support role in the determination of medical stability. PMID:22040281

Optical coherence tomography in gastroenterology: a review and future outlook

NASA Astrophysics Data System (ADS)

Tsai, Tsung-Han; Leggett, Cadman L.; Trindade, Arvind J.; Sethi, Amrita; Swager, Anne-Fré; Joshi, Virendra; Bergman, Jacques J.; Mashimo, Hiroshi; Nishioka, Norman S.; Namati, Eman

2017-12-01

Optical coherence tomography (OCT) is an imaging technique optically analogous to ultrasound that can generate depth-resolved images with micrometer-scale resolution. Advances in fiber optics and miniaturized actuation technologies allow OCT imaging of the human body and further expand OCT utilization in applications including but not limited to cardiology and gastroenterology. This review article provides an overview of current OCT development and its clinical utility in the gastrointestinal tract, including disease detection/differentiation and endoscopic therapy guidance, as well as a discussion of its future applications.

Medical diagnostics with mobile devices: Comparison of intrinsic and extrinsic sensing.

PubMed

Kwon, L; Long, K D; Wan, Y; Yu, H; Cunningham, B T

2016-01-01

We review the recent development of mobile detection instruments used for medical diagnostics, and consider the relative advantages of approaches that utilize the internal sensing capabilities of commercially available mobile communication devices (such as smartphones and tablet computers) compared to those that utilize a custom external sensor module. In this review, we focus specifically upon mobile medical diagnostic platforms that are being developed to serve the need in global health, personalized medicine, and point-of-care diagnostics. Copyright © 2016 Elsevier Inc. All rights reserved.

42 CFR 456.436 - Continued stay review process.

Code of Federal Regulations, 2010 CFR

2010-10-01

... (CONTINUED) MEDICAL ASSISTANCE PROGRAMS UTILIZATION CONTROL Utilization Control: Intermediate Care Facilities... mentally retarded, the recipient's qualified mental retardation professional, within 1 working day of its... final decision on the need for the continued stay; (g) If the attending physician or qualified mental...

42 CFR 456.520 - Definitions.

Code of Federal Regulations, 2011 CFR

2011-10-01

... ASSISTANCE PROGRAMS UTILIZATION CONTROL Utilization Review Plans: FFP, Waivers, and Variances for Hospitals and Mental Hospitals Ur Plan: Remote Facility Variances from Time Requirements § 456.520 Definitions... granted by the Administrator to the Medicaid agency for a specific remote facility to use time periods...

Three Techniques for Task Analysis: Examples from the Nuclear Utilities.

ERIC Educational Resources Information Center

Carlisle, Kenneth E.

1984-01-01

Discusses three task analysis techniques utilized at the Palo Verde Nuclear Generating Station to review training programs: analysis of (1) job positions, (2) procedures, and (3) instructional presentations. All of these include task breakdown, relationship determination, and task restructuring. (MBR)

Cost-Utility and Cost-Effectiveness Studies of Telemedicine, Electronic, and Mobile Health Systems in the Literature: A Systematic Review

PubMed Central

López-Coronado, Miguel; Vaca, Cesar; Aguado, Jesús Saez; de Castro, Carlos

2015-01-01

Abstract Objective: A systematic review of cost-utility and cost-effectiveness research works of telemedicine, electronic health (e-health), and mobile health (m-health) systems in the literature is presented. Materials and Methods: Academic databases and systems such as PubMed, Scopus, ISI Web of Science, and IEEE Xplore were searched, using different combinations of terms such as “cost-utility” OR “cost utility” AND “telemedicine,” “cost-effectiveness” OR “cost effectiveness” AND “mobile health,” etc. In the articles searched, there were no limitations in the publication date. Results: The search identified 35 relevant works. Many of the articles were reviews of different studies. Seventy-nine percent concerned the cost-effectiveness of telemedicine systems in different specialties such as teleophthalmology, telecardiology, teledermatology, etc. More articles were found between 2000 and 2013. Cost-utility studies were done only for telemedicine systems. Conclusions: There are few cost-utility and cost-effectiveness studies for e-health and m-health systems in the literature. Some cost-effectiveness studies demonstrate that telemedicine can reduce the costs, but not all. Among the main limitations of the economic evaluations of telemedicine systems are the lack of randomized control trials, small sample sizes, and the absence of quality data and appropriate measures. PMID:25474190

Social determinants of bone densitometry uptake for osteoporosis risk in patients aged 50yr and older: a systematic review.

PubMed

Brennan, Sharon L; Wluka, Anita E; Gould, Haslinda; Nicholson, Geoffrey C; Leslie, William D; Ebeling, Peter R; Oldenburg, Brian; Kotowicz, Mark A; Pasco, Julie A

2012-01-01

The World Health Organization identifies that osteoporosis is one of the leading health problems in the Western world. An increased risk of fragility fracture is observed in more socially disadvantaged individuals in most Western countries. Dual-energy X-ray absorptiometry (DXA) is currently the procedure of choice to diagnose osteoporosis and assess fracture risk. We systematically reviewed the literature regarding social determinants of DXA utilization for osteoporosis detection in patients aged 50yr and older using a computer-aided search of MEDLINE, EMBASE, CINAHL, and PsychINFO from January 1994 to December 2010. Five cross-sectional studies, incorporating 16 separate analyses, were identified for inclusion in this review. The best evidence analysis identified limited evidence for a positive association between either income or education with DXA utilization; furthermore, the best evidence analysis found no evidence for an association between either marital status or working status and DXA utilization. Further research is required to identify whether a relationship exists and elucidate reasons for disparities in DXA utilization between different social groups, such as choice and referral processes, as a necessary precursor in identifying modifiable determinants and appropriate strategies to promote preventive screening to identify fracture risk. Copyright © 2012 The International Society for Clinical Densitometry. Published by Elsevier Inc. All rights reserved.

Valorization of date palm (Phoenix dactylifera) fruit processing by-products and wastes using bioprocess technology - Review.

PubMed

Chandrasekaran, M; Bahkali, Ali H

2013-04-01

The date palm Phoenix dactylifera has played an important role in the day-to-day life of the people for the last 7000 years. Today worldwide production, utilization and industrialization of dates are continuously increasing since date fruits have earned great importance in human nutrition owing to their rich content of essential nutrients. Tons of date palm fruit wastes are discarded daily by the date processing industries leading to environmental problems. Wastes such as date pits represent an average of 10% of the date fruits. Thus, there is an urgent need to find suitable applications for this waste. In spite of several studies on date palm cultivation, their utilization and scope for utilizing date fruit in therapeutic applications, very few reviews are available and they are limited to the chemistry and pharmacology of the date fruits and phytochemical composition, nutritional significance and potential health benefits of date fruit consumption. In this context, in the present review the prospects of valorization of these date fruit processing by-products and wastes' employing fermentation and enzyme processing technologies towards total utilization of this valuable commodity for the production of biofuels, biopolymers, biosurfactants, organic acids, antibiotics, industrial enzymes and other possible industrial chemicals are discussed.

A multidisciplinary three-phase approach to improve the clinical utility of patient safety indicators.

PubMed

Najjar, Peter; Kachalia, Allen; Sutherland, Tori; Beloff, Jennifer; David-Kasdan, Jo Ann; Bates, David W; Urman, Richard D

2015-01-01

The AHRQ Patient Safety Indicators (PSIs) are used for calculation of risk-adjusted postoperative rates for adverse events. The payers and quality consortiums are increasingly requiring public reporting of hospital performance on these metrics. We discuss processes designed to improve the accuracy and clinical utility of PSI reporting in practice. The study was conducted at a 793-bed tertiary care academic medical center where PSI processes have been aggressively implemented to track patient safety events at discharge. A three-phased approach to improving administrative data quality was implemented. The initiative consisted of clinical review of all PSIs, documentation improvement, and provider outreach including active querying for patient safety events. This multidisciplinary effort to develop a streamlined process for PSI calculation reduced the reporting of miscoded PSIs and increased the clinical utility of PSI monitoring. Over 4 quarters, 4 of 41 (10%) PSI-11 and 9 of 138 (7%) PSI-15 errors were identified on review of clinical documentation and appropriate adjustments were made. A multidisciplinary, phased approach leveraging existing billing infrastructure for robust metric coding, ongoing clinical review, and frontline provider outreach is a novel and effective way to reduce the reporting of false-positive outcomes and improve the clinical utility of PSIs.

Valorization of date palm (Phoenix dactylifera) fruit processing by-products and wastes using bioprocess technology – Review

PubMed Central

Chandrasekaran, M.; Bahkali, Ali H.

2013-01-01

The date palm Phoenix dactylifera has played an important role in the day-to-day life of the people for the last 7000 years. Today worldwide production, utilization and industrialization of dates are continuously increasing since date fruits have earned great importance in human nutrition owing to their rich content of essential nutrients. Tons of date palm fruit wastes are discarded daily by the date processing industries leading to environmental problems. Wastes such as date pits represent an average of 10% of the date fruits. Thus, there is an urgent need to find suitable applications for this waste. In spite of several studies on date palm cultivation, their utilization and scope for utilizing date fruit in therapeutic applications, very few reviews are available and they are limited to the chemistry and pharmacology of the date fruits and phytochemical composition, nutritional significance and potential health benefits of date fruit consumption. In this context, in the present review the prospects of valorization of these date fruit processing by-products and wastes’ employing fermentation and enzyme processing technologies towards total utilization of this valuable commodity for the production of biofuels, biopolymers, biosurfactants, organic acids, antibiotics, industrial enzymes and other possible industrial chemicals are discussed. PMID:23961227

Health Worker mHealth Utilization: A Systematic Review

PubMed Central

White, Alice; Thomas, Deborah S.K.; Ezeanochie, Nnamdi; Bull, Sheana

2016-01-01

This systematic review describes mHealth interventions directed at healthcare workers in low resource settings from the PubMed database from March, 2009 to May, 2015. Thirty-one articles were selected for final review. Four categories emerged from the reviewed articles: data collection during patient visits; communication between health workers and patients; communication between health workers; and public health surveillance. Most studies used a combination of quantitative and qualitative methods to assess acceptability of use, barriers to use, changes in healthcare delivery, and improved health outcomes. Few papers included theory explicitly to guide development and evaluation of their mHealth programs. Overall, evidence indicated that mobile technology tools, such as smartphones and tablets, substantially benefit healthcare workers, their patients, and health care delivery. Limitations to mHealth tools included insufficient program use and sustainability, unreliable Internet and electricity, and security issues. Despite these limitations, this systematic review demonstrates the utility of using mHealth in low-resource settings and the potential for widespread health system improvements using technology. PMID:26955009

The impact of transitional care programs on health services utilization in community-dwelling older adults: a systematic review.

PubMed

Weeks, Lori E; Macdonald, Marilyn; Martin-Misener, Ruth; Helwig, Melissa; Bishop, Andrea; Iduye, Damilola F; Moody, Elaine

2018-02-01

The objective was to identify and synthesize the best available evidence on the impact of transitional care programs on various forms of health services utilization in community-dwelling older adults. There is growing evidence that transitional care programs can help address important challenges facing health care systems and our increasing older adult population in many countries by reducing unnecessary health service utilization. There is a need for a systematic review of the research evaluating the impact of transitional care programs on hospital and other health service usage. The review included studies on community-dwelling adults age 60 and over with at least one medical diagnosis, and which evaluated the outcomes of transitional care programs on health system utilization of older adults. The outcomes for this review were hospital usage including admissions and readmissions, emergency department usage, primary care/physician usage, nursing home usage, and home health care usage. The review considered experimental and epidemiological study designs including randomized controlled trials, non-randomized controlled trials, quasi-experimental studies, before and after studies, prospective and retrospective cohort studies, and case-control studies. A three-step search was utilized to find published and unpublished studies conducted in any country but reported in English. Six electronic databases were searched from inception of the database to May, 2016. A search for unpublished studies was also conducted. Methodological quality was assessed independently by two reviewers using the Joanna Briggs Institute critical appraisal checklist for systematic reviews and research synthesis. Quantitative data were extracted from included studies independently by the two reviewers using the standardized Joanna Briggs Institute data extraction tools. Due to the methodological heterogeneity of the included studies, a comprehensive meta-analysis for all outcomes was not possible. Meta-analysis was conducted for rehospitalization at 30, 90 and 180 days. A narrative summary of other quantitative findings was conducted. Twenty-three studies met the inclusion criteria and were included in the review. Nineteen of the studies were randomized controlled trials and four were case control studies, involving 20,997 participants in total with a mean age of 76. Meta-analysis found that transitional care significantly reduced hospital readmission rates at 30 days (odds ratio [OR] 0.75, 95% confidence intervals [CIs] 0.62-0.91, p < 0.01), 90 days (OR 0.77, 95% CIs 0.59-1.02, p = 0.04), and 180 days (OR 0.67, 95% CIs 0.46-0.99, p < 0.01). Narrative synthesis indicated little impact of transitional care on emergency department and nursing home usage, increased use of primary care/physician usage, and decreased home health care usage. Based on a review of 23 studies conducted in the USA, Hong Kong, Canada, Germany, the Netherlands, Sweden and Switzerland, we identified four major conclusions. First, transitional care reduces rehospitalization rates over time, with the largest effects seen at 30 days. Second, transitional care may increase the utilization of primary care services and thus have a favourable impact on preventative care. Third, transitional care may reduce home health usage. Fourth, transitional care interventions of one month or less appear to be as effective as longer interventions in reducing hospital usage.

Perspectives of The Interagency Nuclear Safety Review Panel (INSRP) on future nuclear powered space missions

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

Gray, L.B.; Pyatt, D.W.; Sholtis, J.A.

1993-01-10

The Interagency Nuclear Safety Review Panel (INSRP) has provided reviews of all nuclear powered spacecraft launched by the United States. The two most recent launches were Ulysses in 1990 and Galileo in 1989. One reactor was launched in 1965 (SNAP-10A). All other U.S. space missions have utilized radioisotopic thermoelectric generators (RTGs). There are several missions in the next few years that are to be nuclear powered, including one that would utilize the Topaz II reactor purchased from Russia. INSRP must realign itself to perform parallel safety assessments of a reactor powered space mission, which has not been done in aboutmore » thirty years, and RTG powered missions.« less

Responding to Community Needs through Community Follow-Up. Junior College Resource Review.

ERIC Educational Resources Information Center

Mehallis, Mantha Vlahos

This literature review examines the utilization of community needs assessment data in program planning and evaluation efforts at community colleges. The review first defines and looks at the purposes of community needs assessments, noting that while such studies are purported to facilitate the planning and evaluation of credit and non-credit…

"Clustering" Documents Automatically to Support Scoping Reviews of Research: A Case Study

ERIC Educational Resources Information Center

Stansfield, Claire; Thomas, James; Kavanagh, Josephine

2013-01-01

Background: Scoping reviews of research help determine the feasibility and the resource requirements of conducting a systematic review, and the potential to generate a description of the literature quickly is attractive. Aims: To test the utility and applicability of an automated clustering tool to describe and group research studies to improve…

A Systematic Review of Measures of Activity Limitation for Children with Cerebral Palsy

ERIC Educational Resources Information Center

Harvey, Adrienne; Robin, Jonathan; Morris, Meg E.; Graham, H. Kerr; Baker, Richard

2008-01-01

This systematic review critically appraises the literature on the psychometric properties and clinical utility of evaluative activity limitation outcome measures used for children with cerebral palsy (CP). The search strategy yielded 29 articles for eight outcome measures that met the inclusion criteria for the review. The Gross Motor Function…

10 CFR 170.21 - Schedule of fees for production and utilization facilities, review of standard referenced design...

Code of Federal Regulations, 2012 CFR

2012-01-01

..., Certification Full cost. Amendment, Renewal, Other Approvals Full cost. C. Test Facility/Research Reactor... of components requiring Commission and Executive Branch review, for example, actions under 10 CFR 110... export of reactor and other components requiring Executive Branch review, for example, those actions...

Peer Review of Report Modeling the Relationship Between Lead in Drinking Water and Blood Lead Levels in Children

EPA Science Inventory

EPA is peer reviewing the Agency’s report modeling the relationship between lead in drinking water and blood lead levels in children utilizing the Integrated Exposure Uptake Biokinetic (IEUBK) model. The report being peer reviewed may be used to inform the derivation of a concent...

Technology-Supported Learning in Secondary and Undergraduate Biological Education: Observations from Literature Review

ERIC Educational Resources Information Center

Lee, Silvia Wen-Yu; Tsai, Chin-Chung

2013-01-01

We conducted a literature review of using educational technology in biology learning from 2001 to 2010. A total of 36 empirical articles were included for review. Based upon the content analyses of these studies, such as technologies utilized, student sample, biological topics involved, the research purpose, and methodology, the following…

7 CFR 1730.23 - Review rating summary, RUS Form 300.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 7 Agriculture 11 2010-01-01 2010-01-01 false Review rating summary, RUS Form 300. 1730.23 Section 1730.23 Agriculture Regulations of the Department of Agriculture (Continued) RURAL UTILITIES SERVICE... § 1730.23 Review rating summary, RUS Form 300. RUS Form 300 in Appendix A shall be used when required by...

75 FR 56540 - Office of Governmentwide Policy: Submission for OMB Review; Information Collection, Real Property...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-09-16

... of Governmentwide Policy: Submission for OMB Review; Information Collection, Real Property Status... (GSA). ACTION: Submission for OMB Review; Comment Request and Final Notice of the Real Property Status... will be able to utilize a new standard form to collect information on the status of real property under...

78 FR 46373 - Agency Information Collection Activities; Submission for OMB Review; Comment Request; Domestic...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-07-31

... minimum wage an agricultural employer utilizing the H-2A program, allowing temporary employment of alien... for OMB Review; Comment Request; Domestic Agricultural In-Season Wage Report ACTION: Notice. SUMMARY...- Season Wage Report,'' to the Office of Management and Budget (OMB) for review and approval for use in...

Amyloid-β Positron Emission Tomography Imaging Probes: A Critical Review

PubMed Central

Kepe, Vladimir; Moghbel, Mateen C.; Långström, Bengt; Zaidi, Habib; Vinters, Harry V.; Huang, Sung-Cheng; Satyamurthy, Nagichettiar; Doudet, Doris; Mishani, Eyal; Cohen, Robert M.; Høilund-Carlsen, Poul F.; Alavi, Abass; Barrio, Jorge R.

2013-01-01

The rapidly rising prevalence and cost of Alzheimer’s disease (AD) in recent decades has made the imaging of amyloid-β (Aβ) deposits the focus of intense research. Several amyloid imaging probes with purported specificity for Aβ plaques are currently at various stages of FDA approval. However, a number of factors appear to preclude these probes from clinical utilization. As the available “amyloid specific” PET imaging probes have failed to demonstrate diagnostic value and have shown limited utility for monitoring therapeutic interventions in humans, a debate on their significance has emerged. The aim of this review is to identify and discuss critically the scientific issues contributing to the extensive inconsistencies reported in the literature on their purported in vivo amyloid specificity and potential utilization in patients. PMID:23648516

42 CFR 480.101 - Scope and definitions.

Code of Federal Regulations, 2011 CFR

2011-10-01

... (CONTINUED) QUALITY IMPROVEMENT ORGANIZATIONS ACQUISITION, PROTECTION, AND DISCLOSURE OF QUALITY IMPROVEMENT ORGANIZATION REVIEW INFORMATION Utilization and Quality Control Quality Improvement Organizations (QIOs... of the problem and follow-up. Quality review study information means all documentation related to the...