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Increased Utilization (increased + utilization)
Selected AbstractsRobotics in urologic surgery: An evolving new technologyINTERNATIONAL JOURNAL OF UROLOGY, Issue 7 2006FATIH ATUG Abstract, Rapid technological developments in the past two decades have produced new inventions such as robots and incorporated them into our daily lives. Today, robots perform vital functions in homes, outer space, hospitals and on military instillations. The development of robotic surgery has given hospitals and health care providers a valuable tool that is making a profound impact on highly technical surgical procedures. The field of urology is one area of medicine that has adopted and incorporated robotic surgery into its armamentarium. Innovative robotic urologic surgical applications and techniques are being developed and reported everyday. Increased utilization and development will ultimately fuel the discovery of newer applications of robotic systems in urologic surgery. Herein we provide an overview of the history, development, and applications of robotics in surgery with a focus on urologic surgery. [source] Effects of Fungal Phytase on Utilization of Dietary Protein and Minerals, and Dephosphorylation of Phytic Acid in the Alimentary Tract of Channel Catfish Ictalurus punctatus Fed an All-Plant-Protein DietJOURNAL OF THE WORLD AQUACULTURE SOCIETY, Issue 1 2002Weibing Yan A feeding trial was conducted to quantify the effects of phytase at levels of 0, 500, 1,000, 2,000, 4,000, and 8,000 units (U) per kg diet on utilization of dietary protein and minerals by fingerling (12 g) channel catfish Ictalurus punctatus fed an all-plant-protein diet composed of soybean meal, corn, and wheat middlings. The effects of phytase on dephosphorylation of phytic acid (phytate) in the alimentary tract of catfish also were determined. After 14 wk, mean weight gains (30.2,43.9 g/fish), feed conversion ratios (2.27,2.40 g feed consumed/g weight gain), protein efficiency ratios (1.47,1.61 g weight gaid/g protein consumed), and dietary protein retentions (23.8,26.7%) did not differ significantly (P > 0.05) among treatment groups. A digestibility trial conducted after the feeding trial showed no difference (P > 0.05) in mean digestibility of diet dry matter (49.0,58.3%) or crude protein (85.4-88.5%) among treatment groups. Concentrations of ash (46.7,48.6%), calcium (Ca, 17.9,18.5%), phosphorus (P, 9.1,9.5%), and manganese (Mn, 65.5,74.1 mg/kg) were significantly higher (P , 0.05) in bone of fish fed , 500 U/kg than in bone of fish fed 0 U/kg (ash, 43.5%; Ca, 16.4%; P, 8.4%; and Mn, 49.0 ma/kg), but concentrations of these minerals did not differ (P > 0.05) in bone of fish fed , 500 Uk/g. The magnesium (Mg) content of bone did not differ (P > 0.05) between fish fed 0 U/kg (0.29%) or 500 U/kg (0.34%), but was significantly lower in fish fed 0 U/kg than in fish fed , 1,000 U/kg (0.35,37%). Bone Mg levels did not differ (P > 0.05) among fish fed , 500 U/kg. The amount of zinc (Zn) in bone of fish fed 8,000 U/kg (153.3 mg/kg) was significantly higher than that in fish fed 0 U/kg (115.7 mg/kg) or 500 U/kg (130.3 mg/ kg), but did not differ from Zn levels in bone of fish fed 1,000,4,000 U/kg (134.5,135.8 mg/ kg). Dephosphorylation of phytate occurred primarily in the stomach within 2,8 h after diet ingestion, depending on the level of phytase supplementation. Initial levels of total phytate in the diet decreased 32,94% in stomach contents of fish fed l,000,8,000 U/kg within 2 h after feeding. Eight hours after feeding, stomach contents of fish fed , 1,000 U/kg contained less than 6% of initial total dietary phytate. Stomach contents of fish fed 500 U/kg retained 92% of initial total dietary phytate 2 h after feeding and 15% of total dietary phytate 8 h after feeding. Results of this study indicate that phytase supplementation at levels up to 8,000 U/kg diet did not increase weight gain or improve dietary protein utilization of channel catfish fed an all-plant-protein diet. Addition of phytase at a level of 1,000 U/kg diet was sufficient to significantly increase the Ca, P, Mg, and Mn content of bone, relative to fish fed an unsupplemented diet, and significantly decrease the quantity of total phytate in feces. A phytase level of 8,000 U/kg diet significantly increased the bioavailability of naturally occurring Zn in feed ingredients and increased the rate of phytate dephosphorylation in the stomach, compared with a diet containing no added phytase. Increased utilization of naturally occurring minerals in feed ingredients reduces the need for mineral supplements in diets and results in decreased elimination of minerals in feces. Thus, use of phytase in catfish feeds can be expected to provide both economic and environmental benefits. [source] Using web-based technology in laboratory instruction to reduce costsCOMPUTER APPLICATIONS IN ENGINEERING EDUCATION, Issue 4 2002Rita M. Powell Abstract The authors report the results of a project to reemphasize high quality, hands-on laboratory courses in the engineering curriculum while reducing their costs through the application of web-based teaching tools. The project resulted in substantial gains in productivity of faculty and staff, increased utilization of laboratory space, cost reductions in equipment, and improved quality of learning for our students. © 2003 Wiley Periodicals, Inc. Comput Appl Eng Educ 10: 204,214, 2002; Published online in Wiley InterScience (www.interscience.wiley.com); DOI 10.1002/cae.10029 [source] Heart Failure Drug Utilization Patterns for Medicaid Patients Before and After a Heart Failure-Related HospitalizationCONGESTIVE HEART FAILURE, Issue 3 2005Patricia A. Howard PharmD The authors examined heart failure (HF) drug utilization patterns in Medicaid patients before and after a HF-related hospitalization. This was a retrospective claims analysis of Kansas Medicaid beneficiaries hospitalized for HF between July 1, 2000, and March 31, 2001. HF drugs were tracked 6 months prior and 6 months following the admission. Angiotensin-converting enzyme (ACE) inhibitor doses were compared with target ranges. The cohort of 135 patients had a mean age of 53.6 years and was predominantly female (66.7%) and Caucasian (70.4%) with a high prevalence of cardiovascular comorbidities. Before hospitalization, less than one third of patients were receiving ACE inhibitors, angiotensin receptor blockers, , blockers, digoxin, or vasodilators. Following hospitalization, increased utilization was observed for , blockers, digoxin, and angiotensin receptor blockers, but overall usage remained low. ACE inhibitors and vasodilator use remained constant. ACE-inhibitor doses were below target ranges before and after hospitalization. In this Medicaid cohort, HF-related hospitalizations did not lead to improved HF therapy. [source] The effects of Taiwan's National Health Insurance on access and health status of the elderlyHEALTH ECONOMICS, Issue 3 2007Likwang Chen Abstract The primary objective of this paper is to evaluate the impact of Taiwan's National Health Insurance program (NHI), established in 1995, on improving elderly access to care and health status. Further, we estimate the extent to which NHI reduces gaps in access and health across income groups. Using data from a longitudinal survey, we adopt a difference-in-difference methodology to estimate the causal effect of Taiwan's NHI. Our results show that Taiwan's NHI has significantly increased utilization of both outpatient and inpatient care among the elderly, and such effects were more salient for people in the low- or middle-income groups. Our findings also reveal that although Taiwan's NHI greatly increased the utilization of both outpatient and inpatient services, this increased utilization of health services did not reduce mortality or lead to better self-perceived general health status for Taiwanese elderly. Measures more sensitive than mortality and self-perceived general health may be necessary for discerning the health effects of NHI. Alternatively, the lack of NHI effects on health may reflect other quality and efficiency problems inherent in the system not yet addressed by NHI. Copyright © 2006 John Wiley & Sons, Ltd. [source] What Happens When Hospital-Based Skilled Nursing Facilities Close?HEALTH SERVICES RESEARCH, Issue 6p1 2005A Propensity Score Analysis Objective. To assess the effects of hospital-based skilled nursing facility (HBSNF) closures on health care utilization, spending, and outcomes among Medicare fee-for-service beneficiaries. Data Sources. One hundred percent Medicare fee-for-service claims files for 1997,2002 were merged with Medicare Provider of Services files and beneficiary-level enrollment records. Study Design. Medicare spending, the use of postacute care, and health outcomes, were compared among hospitals that did and did not close their HBSNFs between 1997 and 2001. Hospitals were stratified according to propensity scores (i.e., predicted probability of closure from a logistic regression) and analyses were conducted within these strata. Principal Findings. HBSNF closures were associated with increased utilization of alternative postacute care settings, and longer acute care hospital stays. Because of increased use of alternative settings, HBSNF closures were associated with a slight increase in total Medicare spending. There are no statistically robust associations between HBSNF closures and changes in either mortality or rehospitalization. Conclusions. HBSNF closures altered utilization patterns, but there is no indication that closures adversely affect beneficiaries' health outcomes. [source] Improved quality of root fillings provided by general dental practitioners educated in nickel,titanium rotary instrumentationINTERNATIONAL ENDODONTIC JOURNAL, Issue 4 2007A. Molander Abstract Aim, To test the hypothesis that an increased utilization of nickel,titanium rotary instrumentation (NTRI) by general dental practitioners will lead to an increased frequency of good quality root fillings. A second aim was to determine whether the educational format would exert influence on the quality. Methodology, Dentists were assigned at random to three intervention groups: a 4-h lecture (L-group, n = 40); a 4-h lecture plus a full day hands-on course (LH-group, n = 40); or a control group receiving no instruction (n = 68). The control group received education later on in the study. Radiographs of two root filled molar teeth per dentist were selected at random before the start of the education program and after a 6-month clinical learning period. Using length, seal and shape of root-fillings a 5-level variable was created. Results, The rate of good quality root fillings increased after the introduction of NTRI. Calculated over all types of roots the frequency of excellent (score 1) root fillings increased from 31% to 51% (P = 0.006) in the L-group and from 27% to 47% (P = 0.016) in the LH-group. The frequency of low quality root-fillings (score 5) dropped in the L-group from 22% to 16% (P = 0.29) and in the LH-group from 13% to 9% (P = 0.48). No statistically significant difference was seen among the controls. Conclusions, When NTRI technology replaced manual stainless steel techniques the rate of good quality root fillings increased. A significant drop in the rate of low quality root fillings was not found. [source] An efficient architecture for Bandwidth Brokers in DiffServ networksINTERNATIONAL JOURNAL OF NETWORK MANAGEMENT, Issue 1 2008Ch. Bouras In this article we examine the architecture of an entity used for automatic management and provisioning of resources for DiffServ networks. We examine the existing literature and implementations in this area, focusing on the design choices made, and we propose an architecture for the design of Bandwidth Brokers that combines an adaptive admission control algorithm for increased utilization of network resources and a mechanism for reducing the complexity overhead that intends to be both simple and effective. Specifically, we present a novel architecture for the admission control module that aims at achieving a satisfactory balance between maximizing the resource utilization for the network provider and minimizing the overhead of the module. We complement our theoretical discussion with extensive experimental simulations for the proposed Bandwidth Broker components and analysis of the results. The simulations study the possible configurations of the proposed algorithm and also compare it with alternative admission control policies. Copyright © 2007 John Wiley & Sons, Ltd. [source] National study of information seeking behavior of academic researchers in the United StatesJOURNAL OF THE AMERICAN SOCIETY FOR INFORMATION SCIENCE AND TECHNOLOGY, Issue 5 2010Xi Niu As new technologies and information delivery systems emerge, the way in which individuals search for information to support research, teaching, and creative activities is changing. To understand different aspects of researchers' information-seeking behavior, this article surveyed 2,063 academic researchers in natural science, engineering, and medical science from five research universities in the United States. A Web-based, in-depth questionnaire was designed to quantify researchers' information searching, information use, and information storage behaviors. Descriptive statistics are reported. Additionally, analysis of results is broken out by institutions to compare differences among universities. Significant findings are reported, with the biggest changes because of increased utilization of electronic methods for searching, sharing, and storing scholarly content, as well as for utilizing library services. Generally speaking, researchers in the five universities had similar information-seeking behavior, with small differences because of varying academic unit structures and myriad library services provided at the individual institutions. [source] Change in live donor characteristics over the last 25 years: A single centre experienceNEPHROLOGY, Issue 7 2008MOHD O KAISAR SUMMARY: Aim: While deceased donor kidney transplantation rates have remained stagnant, live donor kidney transplantation (LDKT) rates have increased significantly over the last decade, and are now a major component of renal transplantation programmes worldwide. Additionally, there has been an increased utilization of more marginal donors, including donors who are obese, older and subjects with well-controlled hypertension. Method: A retrospective audit of all live donors at the Princess Alexandra Hospital Renal Transplantation unit was performed from 24 August 1982 to 29 May 2007 to assess any change in donor characteristics over time. Results: There were 373 live donor operations. Over the last 25 years there has been a significant increase in the number of donors who are either older or obese. Furthermore, there is a greater proportion of spousal and emotionally related LDKT. Conclusion: It is imperative that donors, in particular marginal donors, are followed up long-term to determine their risk of kidney and cardiovascular disease and initiation of appropriate treatment if required. [source] Nitrogen balance and ,15N: why you're not what you eat during pregnancyRAPID COMMUNICATIONS IN MASS SPECTROMETRY, Issue 23 2004Benjamin T. Fuller Carbon (13C/12C) and nitrogen (15N/14N) stable isotope ratios were longitudinally measured in human hair that reflected the period from pre-conception to delivery in 10 pregnant women. There was no significant change in the ,13C results, but all subjects showed a decrease in ,15N values (,0.3 to ,1.1,) during gestation. The mechanisms causing this decrease in hair ,15N have not been fully elucidated. However, since the ,15N values of dietary nitrogen and urea nitrogen are significantly lower compared to maternal tissues, it is hypothesized that the increased utilization of dietary and urea nitrogen for tissue synthesis during pregnancy resulted in a reduction of the steady state diet to a body trophic level effect by approximately 0.5,1,. An inverse correlation (R2,=,0.67) between hair ,15N and weight gain was also found, suggesting that positive nitrogen balance results in a reduction of ,15N values independent of diet. These results indicate that ,15N measurements have the ability to monitor not only dietary inputs, but also the nitrogen balance of an organism. A potential application of this technique is the detection of fertility patterns in modern and ancient species that have tissues that linearly record stable isotope ratios through time. Copyright © 2004 John Wiley & Sons, Ltd. [source] Design and implementation of training to improve management of pediatric overweightTHE JOURNAL OF CONTINUING EDUCATION IN THE HEALTH PROFESSIONS, Issue 4 2005Continuing Medical Education, Luke Beno MD Chief Abstract Introduction: Clinicians report a low proficiency in treating overweight children and using behavioral management strategies. This paper documents the design and implementation of a training program to improve clinicians' skills in the assessment and behavioral management of pediatric overweight. Methods: Two one-hour CME trainings were designed using published guidelines, research findings, and expert committee recommendations. The trainings were provided to clinicians of a managed care pediatric department, utilizing novel screening and counseling tools, and interactive exercises. Surveys and focus groups were conducted 3 and 6 months post intervention to examine clinician attitudes and practices regarding the screening and counseling tools. Results: Post intervention, the majority of clinicians agreed that the clinical practice guidelines (Pediatric Obesity Practice Resource) and BMI-for-age percentile provided useful information for clinical practice. Clinicians reported an increased utilization of the recommended screening tools and changes in office practices to implement these tools. They offered suggestions to improve the ease of use of the tools and to overcome perceived clinician and/or patient barriers. Discussion: A brief, cost effective, multi-faceted training and provision of counseling tools were perceived as helpful to clinical practice. Useful lessons were learned about tool design and ways to fit tools into practice. Training the entire health care team is advantageous to the adoption of new tools and practices. [source] Disparities in the Utilization of Live Donor Renal TransplantationAMERICAN JOURNAL OF TRANSPLANTATION, Issue 5 2009J. L. Gore Despite universal payer coverage with Medicare, sociodemographic disparities confound the care of patients with renal failure. We sought to determine whether adults who realize access to kidney transplantation suffer inequities in the utilization of live donor renal transplantation (LDRT). We identified adults undergoing primary renal transplantation in 2004,2006 from the United Network for Organ Sharing (UNOS). We modeled receipt of live versus deceased donor renal transplant on multilevel multivariate models that examined recipient, center and UNOS region-specific covariates. Among 41 090 adult recipients identified, 39% underwent LDRT. On multivariate analysis, older recipients (OR 0.62, 95% CI 0.56,0.68 for 50,59 year-olds vs. 18,39 year-old recipients), those of African American ethnicity (OR 0.54, 95% CI 0.50,0.59 vs. whites) and of lower socioeconomic status (OR 0.72, 95% CI 0.67,0.79 for high school-educated vs. college-educated recipients; OR 0.78, 95% CI 0.71,0.87 for lowest vs. highest income quartile) had lower odds of LDRT. These characteristics accounted for 14.2% of the variation in LDRT, more than recipient clinical variables, transplant center characteristics and UNOS region level variation. We identified significant racial and socioeconomic disparities in the utilization of LDRT. Educational initiatives and dissemination of processes that enable increased utilization of LDRT may address these disparities. [source] Generation, Capture, and Utilization of Industrial Carbon DioxideCHEMSUSCHEM CHEMISTRY AND SUSTAINABILITY, ENERGY & MATERIALS, Issue 3 2010Andrew Abstract As a carbon-based life form living in a predominantly carbon-based environment, it is not surprising that we have created a carbon-based consumer society. Our principle sources of energy are carbon-based (coal, oil, and gas) and many of our consumer goods are derived from organic (i.e., carbon-based) chemicals (including plastics, fabrics and materials, personal care and cleaning products, dyes, and coatings). Even our large-volume inorganic-chemicals-based industries, including fertilizers and construction materials, rely on the consumption of carbon, notably in the form of large amounts of energy. The environmental problems which we now face and of which we are becoming increasingly aware result from a human-induced disturbance in the natural carbon cycle of the Earth caused by transferring large quantities of terrestrial carbon (coal, oil, and gas) to the atmosphere, mostly in the form of carbon dioxide. Carbon is by no means the only element whose natural cycle we have disturbed: we are transferring significant quantities of elements including phosphorus, sulfur, copper, and platinum from natural sinks or ores built up over millions of years to unnatural fates in the form of what we refer to as waste or pollution. However, our complete dependence on the carbon cycle means that its disturbance deserves special attention, as is now manifest in indicators such as climate change and escalating public concern over global warming. As with all disturbances in materials balances, we can seek to alleviate the problem by (1),dematerialization: a reduction in consumption; (2),rematerialization: a change in what we consume; or (3),transmaterialization: changing our attitude towards resources and waste. The "low-carbon" mantra that is popularly cited by organizations ranging from nongovernmental organizations to multinational companies and from local authorities to national governments is based on a combination of (1) and (2) (reducing carbon consumption though greater efficiency and lower per capita consumption, and replacing fossil energy sources with sources such as wind, wave, and solar, respectively). "Low carbon" is of inherently less value to the chemical and plastics industries at least in terms of raw materials although a version of (2), the use of biomass, does apply, especially if we use carbon sources that are renewable on a human timescale. There is however, another renewable, natural source of carbon that is widely available and for which greater utilization would help restore material balance and the natural cycle for carbon in terms of resource and waste. CO2, perhaps the most widely discussed and feared chemical in modern society, is as fundamental to our survival as water, and like water we need to better understand the human as well as natural production and consumption of CO2 so that we can attempt to get these into a sustainable balance. Current utilization of this valuable resource by the chemical industry is only 90,megatonne per year, compared to the 26.3,gigatonne CO2 generated annually by combustion of fossil fuels for energy generation, as such significant opportunities exist for increased utilization of CO2 generated from industrial processes. It is also essential that renewable energy is used if CO2 is to be utilized as a C1 building block. [source] | ||||||||||||||||