Monitoring & Analysis Program of Prison Sites for the Texas Department of Criminal Justice

The Texas Department of Criminal Justice (TDCJ) and the Energy Systems Laboratory (ESL) at Texas A&M University have collaborated to extend the LoanSTAR Monitoring & Analysis Program to Texas' prison facilities. Data loggers are in place in eleven 1,000-bed prison units recording the energy use patterns of the administration, kitchen, laundry, medical, training, and inmate housing units. Specialized software has been developed that will allow TDCJ personnel to customize the data presentation and analysis in-house. A second effort involved the development of a Utility Billing Audit Database program. This database accepts customized entry of the utility bill calculation parameters from the utility company rate schedules and contracts, and provides storage of the parameters for monthly auditing of billed amounts. Storage of all the entered monthly data allows for exporting of the data to satisfy reporting requirements for the Texas State Agency Natural Resources End-Use Database (SANRED) (B. Hunn et a1 1995) and other internal TDCJ reporting needs. Bills for all monthly purchases of electricity, natural gas, water, waste water, and solid waste removal are audited using this software

Impure placebo as an unsound concept and other problems in the paper by Howick et al. : [eLetter]

Kommentti artikkeliin Placebo Use in the United Kingdom: Results from a National Survey of Primary Care Practitioners, Plos One 8(3):e58247. doi: 10.1371/journal.pone.0058247Howick et al. have reported the findings of a survey that addressed the use of placebos among primary care practitioners in the United Kingdom. They adopted methodology similar to that used in previous studies performed in other countries; however, the use of this approach also means that they repeated the conceptual confusion of the previous surveys. Therefore the findings are not useful. ... The paper’s main finding “placebos are commonly used in UK primary care” is not correct. Only 0.9% of the responding general practitioners reported using pure placebos frequently. The frequency with which impure placebos are used is irrelevant because the concept is useless, as described above. Misleading a patient by administering inert substances without the explicit consent of the patient is unethical. The authors' proposal to “develop ethical and cost-effective placebos” is not possible because saving money by misleading patients is unethical. There is substantial conceptual confusion in the area of placebo and placebo-effect research, and the paper by Howick et al. does not help to reduce this confusion.Non peer reviewe

Use of DOE-2 to Evaluate Evaporative Cooling in Texas Correctional Facilities

This study investigates the feasibility of using direct and indirect evaporative cooling systems for correctional facilities in two different Texas climatic regions with the DOE-2.1E hourly energy simulation program. The analysis is based on adding user defined functions to the DOE-2 SYSTEMS subprogram to simulate direct and indirect evaporative cooling configurations. The DOE-2 program was run with two weather tapes, one for Kingsville, Texas and one for Abilene, Texas during April, July, and October to resemble neutral, summer and winter weather conditions. The results showed that direct evaporative cooling is applicable in April for Abilene and October for Kingsville. The indirect evaporative cooling is feasible in July for Abilene and April for Kingsville

A diagnostic dilemma in breast pathology – benign fibroadenoma with multinucleated stromal giant cells

Fibroadenomas are common benign breast tumours that display a characteristic pathological morphology, although several epithelial and stromal variations exist. A very rare histological finding is the presence of multinucleated giant cells throughout the stroma of a benign fibroadenoma. Cells of this type, which are more commonly found incidentally within the interlobular stroma of breast tissue, are benign and should not be mistaken for malignant cells on microscopic examination. Unfortunately a lack of awareness of this pathological entity can lead to diagnostic confusion amongst pathologists resulting in the multinucleate giant cells being mistaken for highly mitotic cells and consequently the fibroadenoma being mistaken for a malignant lesion. This may have serious implications for the subsequent management of the patient. The presence of this unusual cell type in the stroma does not alter the prognosis of otherwise benign lesion. We encountered two such cases at our institution in a six month period recently. We present their histories along with relevant radiological, microscopic and immunohistochemical features, followed by a discussion of this unusual pathological entity

The Fibromyalgia Decomposition Phenomenon:A Reflexive Thematic Analysis

Research is needed that can provide an illustration of the different biopsychosocial and environmental experiences of people with fibromyalgia to consider how healthcare professionals can best engage with the challenges that are faced. Qualitative research is well-positioned to do this. The current study used interpretive hermeneutic phenomenology situated within a pragmatic worldview, the aim being to obtain a deeper exploration of the fibromyalgia experience prior to commencing a novel intervention. A purposive sample of individuals with fibromyalgia were selected to undertake a single interview. The interviews were analysed using a thematic analysis. The themes identified key processes of the experience. A total of 16 participants (mean age: 47.1 years) took part. Three themes and 15 sub-themes were identified, together with a process linking different experiences together. The research from this small cohort provides a clear identification of multiple components influencing the experience of fibromyalgia and the decisions around lifestyle and choices made. From this, a novel decomposition/recomposition spiral has been identified, which will benefit patients and healthcare professionals alike. An earlier diagnosis and, thus, earlier and broader treatment options can help to improve functional outcomes

Computer Energy Modeling Techniques for Simulation Large Scale Correctional Institutes in Texas

Building energy simulation programs have undergone an increase in use for evaluating energy consumption and energy conservation retrofits in buildings. Utilization of computer simulation programs for large facilities with multiple buildings, however, has been relatively rare. Due to the immense size of certain facilities such as college campuses and correctional institutes, simulating energy consumption for the entire campus and reporting the energy use by individual building is a time consuming task. Initially, many computer simulation programs were designed to operate on the assumption that the user is simulating one building. Provisions are not usually made to knit together outputs from multiple buildings. Furthermore, programs such as DOE-2 have limits to the number of walls, windows, and zones that can be simulated in one run. This paper presents a methodology to model an entire campus by simulating each building as a single zone consistent with electrical feeders instead of as a separate entity. Since most simulation programs calculate energy use by means of one-dimensional heat transfer, utilizing this method becomes a practical solution, particularly if the facility does not contain buildings with complex internal systems. The energy use can then be extracted from the individual simulations and combined with specially written data handling scripts into a whole-campus energy use. The methods are presented using the DOE-2.1E building energy simulation program to model a 1,000 bed case study correctional unit located in Texas

Primary care management for optimized antithrombotic treatment [PICANT]: study protocol for a cluster-randomized controlled trial

Background: Antithrombotic treatment is a continuous therapy that is often performed in general practice and requires careful safety management. The aim of this study is to investigate whether a best practice model that applies major elements of case management, including patient education, can improve antithrombotic management in primary health care in terms of reducing major thromboembolic and bleeding events. Methods: This 24-month cluster-randomized trial will be performed in 690 adult patients from 46 practices. The trial intervention will be a complex intervention involving general practitioners, health care assistants and patients with an indication for oral anticoagulation. To assess adherence to medication and symptoms in patients, as well as to detect complications early, health care assistants will be trained in case management and will use the Coagulation-Monitoring-List (Co-MoL) to regularly monitor patients. Patients will receive information (leaflets and a video), treatment monitoring via the Co-MoL and be motivated to perform self-management. Patients in the control group will continue to receive treatment-as-usual from their general practitioners. The primary endpoint is the combined endpoint of all thromboembolic events requiring hospitalization, and all major bleeding complications. Secondary endpoints are mortality, hospitalization, strokes, major bleeding and thromboembolic complications, severe treatment interactions, the number of adverse events, quality of anticoagulation, health-related quality of life and costs. Further secondary objectives will be investigated to explain the mechanism by which the intervention is effective: patients' assessment of chronic illness care, self-reported adherence to medication, general practitioners' and health care assistants' knowledge, patients' knowledge and satisfaction with shared decision making. Practice recruitment is expected to take place between July and December 2012. Recruitment of eligible patients will start in July 2012. Assessment will occur at three time points: baseline (T0), follow-up after 12 (T1) and after 24 months (T2). Discussion: The efficacy and effectiveness of individual elements of the intervention, such as antithrombotic interventions, self-management concepts in orally anticoagulated patients and the methodological tool, case-management, have already been extensively demonstrated. This project foresees the combination of several proven instruments, as a result of which we expect to profit from a reduction in the major complications associated with antithrombotic treatment