Measuring access: how accurate are patient-reported waiting times?

Introduction: A national audit of waiting times in England’s genitourinary medicine clinics measures patient access. Data are collected by patient questionnaires, which rely upon patients’ recollection of first contact with health services, often several days previously. The aim of this study was to assess the accuracy of patient-reported waiting times. Methods: Data on true waiting times were collected at the time of patient booking over a three-week period and compared with patient-reported data collected upon clinic attendance. Factors contributing to patient inaccuracy were explored. Results: Of 341 patients providing initial data, 255 attended; 207 as appointments and 48 ‘walk-in’. The accuracy of patient-reported waiting times overall was 52% (133/255). 85% of patients (216/255) correctly identified themselves as seen within or outside of 48 hours. 17% of patients (17/103) seen within 48 hours reported a longer waiting period, whereas 20% of patients (22/108) reporting waits under 48 hours were seen outside that period. Men were more likely to overestimate their waiting time (10.4% versus 3.1% p<0.02). The sensitivity of patient-completed questionnaires as a tool for assessing waiting times of less than 48 hours was 83.5%. The specificity and positive predictive value were 85.5% and 79.6%, respectively. Conclusion: The overall accuracy of patient reported waiting times was poor. Although nearly one in six patients misclassified themselves as being seen within or outside of 48 hours, given the under and overreporting rates observed, the overall impact on Health Protection Agency waiting time data is likely to be limited

Cost Effectiveness of Bio-Gas Systems for Dairy Farms

Considerable attention has recently been focused on the development of farm management practices that utilize the total resource potential of animal wastes. In addition to the fertilizer value of manure, energy in the form of bio-gas can be generated from manure wastes by an anaerobic digestion process. The purpose of this economic analysis was to evaluate the feasibility of producing energy from the anaerobic digestion of dairy-cow manure. Anaerobic digestion systems were rationally designed for several farm management practices on Vermont dairy farms. These designs were sized to accommodate dairy herds of 20, 50, 100, and 200 cows for both free- and tie-stall arrangements. The realistic evaluation of the potential of any energy source must include a cost effectiveness analysis. This 1974 economic analysis, with selected 1977 cost updatings, included considerations of both the total annual financial investment and the unit cost of net energy production. Minimum unit costs of net energy production for 1977 prices are approximately $0.19 per kwh for the 20-cow operation, but these values decrease with increasing herd size to$0.05 per kwh for the 200-cow dairy farm. At the present time, the generation of bio-gas from the anaerobic digestion of dairy farm manures becomes economically feasible as an alternate source of energy for dairy farms in excess of 200 cows

Generating socially appropriate tutorial dialog

Analysis of student-tutor coaching dialogs suggest that good human tutors attend to and attempt to influence the motivational state of learners. Moreover, they are sensitive to the social face of the learner, and seek to mitigate the potential face threat of their comments. This paper describes a dialog generator for pedagogical agents that takes motivation and face threat factors into account. This enables the agent to interact with learners in a socially appropriate fashion, and foster intrinsic motivation on the part of the learner, which in turn may lead to more positive learner affective states

Primary care consultations and costs among HIV-positive individulas in UK primary care 1995-2005: a cohort study

Objectives: To investigate the role of primary care in the management of HIV and estimate primary care-associated costs at a time of rising prevalence. Methods: Retrospective cohort study between 1995 and 2005, using data from general practices contributing data to the UK General Practice Research Database. Patterns of consultation and morbidity and associated consultation costs were analysed among all practice-registered patients for whom HIV-positive status was recorded in the general practice record. Results: 348 practices yielded 5504 person-years (py) of follow-up for known HIV-positive patients, who consult in general practice frequently (4.2 consultations/py by men, 5.2 consultations/py by women, in 2005) for a range of conditions. Consultation rates declined in the late 1990s from 5.0 and 7.3 consultations/py in 1995 in men and women, respectively, converging to rates similar to the wider population. Costs of consultation (general practitioner and nurse, combined) reflect these changes, at £100.27 for male patients and £117.08 for female patients in 2005. Approximately one in six medications prescribed in primary care for HIV-positive individuals has the potential for major interaction with antiretroviral medications. Conclusion: HIV-positive individuals known in general practice now consult on a similar scale to the wider population. Further research should be undertaken to explore how primary care can best contribute to improving the health outcomes of this group with chronic illness. Their substantial use of primary care suggests there may be potential to develop effective integrated care pathways

A Study of the Formation of Single- and Double-Walled Carbon Nanotubes by a CVD Method

The reduction in H2/CH4 atmosphere of aluminum-iron oxides produces metal particles small enough to catalyze the formation of single-walled carbon nanotubes. Several experiments have been made using the same temperature profile and changing only the maximum temperature (800-1070 °C). Characterizations of the catalyst materials are performed using notably 57Fe Mo¨ssbauer spectroscopy. Electron microscopy and a macroscopical method are used to characterize the nanotubes. The nature of the iron species (Fe3+, R-Fe, ç-Fe-C, Fe3C) is correlated to their location in the material. The nature of the particles responsible for the high-temperature formation of the nanotubes is probably an Fe-C alloy which is, however, found as Fe3C by postreaction analysis. Increasing the reduction temperature increases the reduction yield and thus favors the formation of surface-metal particles, thus producing more nanotubes. The obtained carbon nanotubes are mostly single-walled and double-walled with an average diameter close to 2.5 nm. Several formation mechanisms are thought to be active. In particular, it is shown that the second wall can grow inside the first one but that subsequent ones are formed outside. It is also possible that under given experimental conditions, the smallest (<2 nm) catalyst particles preferentially produce double-walled rather than single-walled carbon nanotubes

Perencanaan unit pengawasan mutu pabrik pembekuan udang windu block frozen (bf) head less (hl) dengan kapasitas bahan baku 15.000 kg/hari

Indonesia merupakan negara kepulauan yang kaya akan sumber daya alam di bidang perikanan. Salah satu contoh hasil perikanan Indonesia yang banyak diekspor ke luar negeri adalah udang tetapi udang mudah mengalami kerusakan (most perishable food) sehingga perlu dilakukan suatu proses yang dapat mempertahankan mutu bahan selama distribusi, yakni dengan pembekuan dalam bentuk Block Frozen (BF). Unit pengendalian mutu dibutuhkan agar mutu produk tetap bagus dan terjaga kualitasnya sehingga produk yang dihasilkan konsisten sesuai standar yang telah ditetapkan dan dapat diterima oleh konsumen. Unit pengawasan mutu direncanakan pada pabrik pembekuan udang windu block frozen head less dengan kapasitas bahan baku 15.000 kg/hari. Pengawasan mutu dilakukan terhadap bahan baku yang digunakan, proses produksi, serta produk akhir yang dihasilkan. Kelayakan suatu unit pengawasan mutu ditentukan oleh aspek teknis dan ekonomis. Aspek teknis meliputi sumber daya manusia, prosedur dan pelaksanaan kegiatan pengawasan mutu serta sarana dan prasarana yang digunakan. Aspek ekonomis meliputi total biaya unit pengawasan mutu yang direncanakan terhadap harga jual produk akhir. Perencanaan unit pengawasan mutu pembekuan udang windu block frozen head less dengan kapasitas bahan baku 15.000 kg/hari layak secara teknis karena sumber daya manusia yang digunakan berkualifikasi, prosedur dan pelaksanaan kegiatan pengawasan mutu sesuai dengan standar yang ditetapkan, letak ruang pengawasan mutu strategis sehingga kegiatan pengawasan mutu dapat berlangsung efektif dan efisien serta tersedianya sarana dan prasarana yang memadai dan lengkap. Unit pengawasan mutu dikatakan layak dari aspek ekonomis apabila tidak melebihi 4% dari total biaya produksi. Jadi, unit pengawasan mutu yang direncanakan dapat dikatakan layak secara ekonomis karena biaya unit pengawasan mutu per unit BF (1,814kg) adalah Rp. 264,99 dengan presentase sebesar 0,24% dari total biaya produksi

Evaluación de la viabilidad de distintas dietas para la producción de Lombrihumus con las especies Eisenia foetida y Eudrillus sp

The current environmental crisis has not left outside its scope the affectation to the health and fertility of the soil when causing an accelerated deterioration of its productive capacity directly affected to the agricultural yields at global level. In response and for the increase of the resilience of the agroecosystems to the unproductiveness of the soils the lombrihumus is used. In this study we test the adaptive and productive capacity of earthworms with different diets: fresh kitchen waste, wet paper, chopped grass and cow manure - control. Previously, the viability of care of the diets was determined with the characterization of waste produced by the campus canteen where the experiment was carried out. The red Californian (Eisenia foetida) and Cuban red (Eudrillus sp) species were used in canoes of one cubic meter (1 m3) where they were fed. The total production, the speed and percentage of assimilation of the diet were measured. In addition, the nutritional analysis of lombrihumus was performed for each treatment. The Variance Analysis (ANOVA) and the Minimum Significant Difference (DMS) were applied to the data obtained in the statistical program SPSS 23.0. The treatments T1 (fresh kitchen waste) and T2 (wet paper) showed significant results in the productive and nutritional aspects, so they can be used as a substitute for the T4 treatment (cow manure - control). The test should be repeated at different times of the year, variable environmental conditions, with a higher number of repetitions and a combination of treatments.La actual crisis medioambiental no ha dejado fuera de su alcance la afectación a la salud y fertilidad del suelo al causar un acelerado deterioro de su capacidad productiva afectado directamente a los rendimientos agrícolas a nivel global. En respuesta y para el aumento de la resiliencia de los agroecosistemas a la improductividad de los suelos se utiliza el lombrihumus. En este estudio testamos la capacidad de adaptación y productiva de las lombrices con distintas dietas: residuos frescos de cocina, papel húmedo, pasto picado y estiércol vacuno - testigo. Previamente se determinó la viabilidad de atención de las dietas con la caracterización de residuos producidos por el comedor universitario del campus donde se llevó el experimento. Se usaron las especies roja californiana (Eisenia foetida) y roja cubana (Eudrillus sp) en canoas de un metro cúbico (1 m3) donde se les suministro el alimento. Se midió la producción total, la velocidad y porcentaje de asimilación de la dieta. Complementariamente se realizó el análisis nutricional del lombrihumus por cada tratamiento. A los datos obtenidos se les aplico el Análisis de la Varianza (ANOVA) y la Diferencia Mínima Significativa (DMS) en el programa estadístico SPSS 23.0. Los tratamientos T1 (residuos frescos de cocina) y T2 (papel húmedo) mostraron resultados significativamente en los aspectos productivos y nutricionales, por ello pueden ser utilizados como sustito del tratamiento T4 (estiércol de vaca – testigo). Deben de repetirse el ensayo en distintas épocas del año, condiciones ambientales variables, con mayor número de repeticiones y combinación de los tratamientos

Carbon Nanotubes by a CVD Method. Part II: Formation of Nanotubes from (Mg, Fe)O Catalysts

The aim of this paper is to study the formation of carbon nanotubes (CNTs) from different Fe/MgO oxide powders that were prepared by combustion synthesis and characterized in detail in a companion paper. Depending on the synthesis conditions, several iron species are present in the starting oxides including Fe2+ ions, octahedral Fe3+ ions, Fe3+ clusters, and MgFe2O4-like nanoparticles. Upon reduction during heating at 5 °C/min up to 1000 °C in H2/CH4 of the oxide powders, the octahedral Fe3+ ions tend to form Fe2+ ions, which are not likely to be reduced to metallic iron whereas the MgFe2O4-like particles are directly reduced to metallic iron. The reduced phases are R-Fe, Fe3C, and ç-Fe-C. Fe3C appears as the postreaction phase involved in the formation of carbon filaments (CNTs and thick carbon nanofibers). Thick carbon nanofibers are formed from catalyst particles originating from poorly dispersed species (Fe3+ clusters and MgFe2O4-like particles). The nanofiber outer diameter is determined by the particle size. The reduction of the iron ions and clusters that are well dispersed in the MgO lattice leads to small catalytic particles (<5 nm), which tend to form SWNTS and DWNTs with an inner diameter close to 2 nm. Well-dispersed MgFe2O4-like particles can also be reduced to small metal particles with a narrow size distribution, producing SWNTs and DWNTs. The present results will help in tailoring oxide precursors for the controlled formation of CNTs

Fe/Co Alloys for the Catalytic Chemical Vapor Deposition Synthesis of Single- and Double-Walled Carbon Nanotubes (CNTs). 1. The CNT−Fe/Co−MgO System

Mg0.90FexCoyO (x + y ) 0.1) solid solutions were synthesized by the ureic combustion route. Upon reduction at 1000 °C in H2-CH4 of these powders, Fe/Co alloy nanoparticles are formed, which are involved in the formation of carbon nanotubes, which are mostly single and double walled, with an average diameter close to 2.5 nm. Characterizations of the materials are performed using 57Fe Mo¨ssbauer spectroscopy and electron microscopy, and a well-established macroscopic method, based on specific-surface-area measurements, was applied to quantify the carbon quality and the nanotubes quantity. A detailed investigation of the Fe/Co alloys’ formation and composition is reported. An increasing fraction of Co2+ ions hinders the dissolution of iron in the MgO lattice and favors the formation of MgFe2O4-like particles in the oxide powders. Upon reduction, these particles form R-Fe/Co particles with a size and composition (close to Fe0.50Co0.50) adequate for the increased production of carbon nanotubes. However, larger particles are also produced resulting in the formation of undesirable carbon species. The highest CNT quantity and carbon quality are eventually obtained upon reduction of the iron-free Mg0.90Co0.10O solid solution, in the absence of clusters of metal ions in the starting material. Introduction Catalyti

#Bieber + #Blast = #BieberBlast: Early Prediction of Popular Hashtag Compounds

Compounding of natural language units is a very common phenomena. In this paper, we show, for the first time, that Twitter hashtags which, could be considered as correlates of such linguistic units, undergo compounding. We identify reasons for this compounding and propose a prediction model that can identify with 77.07% accuracy if a pair of hashtags compounding in the near future (i.e., 2 months after compounding) shall become popular. At longer times T = 6, 10 months the accuracies are 77.52% and 79.13% respectively. This technique has strong implications to trending hashtag recommendation since newly formed hashtag compounds can be recommended early, even before the compounding has taken place. Further, humans can predict compounds with an overall accuracy of only 48.7% (treated as baseline). Notably, while humans can discriminate the relatively easier cases, the automatic framework is successful in classifying the relatively harder cases.Comment: 14 pages, 4 figures, 9 tables, published in CSCW (Computer-Supported Cooperative Work and Social Computing) 2016. in Proceedings of 19th ACM conference on Computer-Supported Cooperative Work and Social Computing (CSCW 2016