Implementing a Cancer Fast-track programme between primary and specialised care in Catalonia(Spain): amixed methods study

BACKGROUND: The Cancer Fast-track Programme's aim was to reduce the time that elapsed between well-founded suspicion of breast, colorectal and lung cancer and the start of initial treatment in Catalonia (Spain). We sought to analyse its implementation and overall effectiveness. METHODS: A quantitative analysis of the programme was performed using data generated by the hospitals on the basis of seven fast-track monitoring indicators for the period 2006-2009. In addition, we conducted a qualitative study, based on 83 semistructured interviews with primary and specialised health professionals and health administrators, to obtain their perception of the programme's implementation. RESULTS: About half of all new patients with breast, lung or colorectal cancer were diagnosed via the fast track, though the cancer detection rate declined across the period. Mean time from detection of suspected cancer in primary care to start of initial treatment was 32 days for breast, 30 for colorectal and 37 for lung cancer (2009). Professionals associated with the implementation of the programme showed that general practitioners faced with suspicion of cancer had changed their conduct with the aim of preventing lags. Furthermore, hospitals were found to have pursued three specific implementation strategies (top-down, consensus-based and participatory), which made for the cohesion and sustainability of the circuits. CONCLUSION: The programme has contributed to speeding up diagnostic assessment and treatment of patients with suspicion of cancer, and to clarifying the patient pathway between primary and specialised care.

Avaliação técnica e econômica da extração de madeira de eucalipto com "Track-Skidder" em região montanhosa

O presente estudo teve como objetivo central avaliar técnica e economicamente atividades de extração em área montanhosa, utilizando um trator florestal arrastador com esteiras (Track-Skidder). O estudo foi conduzido em povoamentos de eucalipto de uma empresa florestal do Estado de Minas Gerais, nos quais o sistema de colheita foi o de árvore inteira, sendo o sistema mecanizado utilizado nas suas atividades de corte, extração e traçamento. A avaliação técnica consistiu em detectar e dimensionar os fatores de interrupções operacionais e mecânicas, como também em determinar os índices de produtividade, eficiência operacional, disponibilidade mecânica e grau de utilização. A avaliação econômica consistiu na determinação dos custos operacionais, bem como em determinar a distribuição destes custos. As áreas de estudo foram estratificadas em três níveis de declividades e três níveis de distâncias de extração. De acordo com o estudo os estratos de menor declividade e distância de extração apresentaram melhor produtividade em relação aos estratos de maior declividade e distância de extração. Ao final do período de avaliação a máquina atingiu disponibilidade mecânica de 79% e eficiência operacional de 76%. Seu custo operacional foi de US$57,00 por hora efetiva, sendo a depreciação e os juros os maiores elementos deste custo.

A chart of the southern part of South America : with the track of the centurion from the island of St. Catherines to the island of Juan Fernandes in which is inserted the variation and soundings observ'd on board her, together with her deviation from her estimated course in passing round Cap Horn, occasiond by the force of the currents / R. W. Seale sculp

Nimeketiedot nimiönkehyksissä

Spitzbergen 1873 : track of the Diana 1873

Kartta kuuluu A. E. Nordenskiöldin kokoelmaan

Application and development of numerical methods for the modelling of innovative gas cooled fission reactors

Innovative gas cooled reactors, such as the pebble bed reactor (PBR) and the gas cooled fast reactor (GFR) offer higher efficiency and new application areas for nuclear energy. Numerical methods were applied and developed to analyse the specific features of these reactor types with fully three dimensional calculation models. In the first part of this thesis, discrete element method (DEM) was used for a physically realistic modelling of the packing of fuel pebbles in PBR geometries and methods were developed for utilising the DEM results in subsequent reactor physics and thermal-hydraulics calculations. In the second part, the flow and heat transfer for a single gas cooled fuel rod of a GFR were investigated with computational fluid dynamics (CFD) methods. An in-house DEM implementation was validated and used for packing simulations, in which the effect of several parameters on the resulting average packing density was investigated. The restitution coefficient was found out to have the most significant effect. The results can be utilised in further work to obtain a pebble bed with a specific packing density. The packing structures of selected pebble beds were also analysed in detail and local variations in the packing density were observed, which should be taken into account especially in the reactor core thermal-hydraulic analyses. Two open source DEM codes were used to produce stochastic pebble bed configurations to add realism and improve the accuracy of criticality calculations performed with the Monte Carlo reactor physics code Serpent. Russian ASTRA criticality experiments were calculated. Pebble beds corresponding to the experimental specifications within measurement uncertainties were produced in DEM simulations and successfully exported into the subsequent reactor physics analysis. With the developed approach, two typical issues in Monte Carlo reactor physics calculations of pebble bed geometries were avoided. A novel method was developed and implemented as a MATLAB code to calculate porosities in the cells of a CFD calculation mesh constructed over a pebble bed obtained from DEM simulations. The code was further developed to distribute power and temperature data accurately between discrete based reactor physics and continuum based thermal-hydraulics models to enable coupled reactor core calculations. The developed method was also found useful for analysing sphere packings in general. CFD calculations were performed to investigate the pressure losses and heat transfer in three dimensional air cooled smooth and rib roughened rod geometries, housed inside a hexagonal flow channel representing a sub-channel of a single fuel rod of a GFR. The CFD geometry represented the test section of the L-STAR experimental facility at Karlsruhe Institute of Technology and the calculation results were compared to the corresponding experimental results. Knowledge was gained of the adequacy of various turbulence models and of the modelling requirements and issues related to the specific application. The obtained pressure loss results were in a relatively good agreement with the experimental data. Heat transfer in the smooth rod geometry was somewhat under predicted, which can partly be explained by unaccounted heat losses and uncertainties. In the rib roughened geometry heat transfer was severely under predicted by the used realisable k − epsilon turbulence model. An additional calculation with a v2 − f turbulence model showed significant improvement in the heat transfer results, which is most likely due to the better performance of the model in separated flow problems. Further investigations are suggested before using CFD to make conclusions of the heat transfer performance of rib roughened GFR fuel rod geometries. It is suggested that the viewpoints of numerical modelling are included in the planning of experiments to ease the challenging model construction and simulations and to avoid introducing additional sources of uncertainties. To facilitate the use of advanced calculation approaches, multi-physical aspects in experiments should also be considered and documented in a reasonable detail.

Track of HSMS Sophia tracing the extent of navigable water along the main northern ice between Spitzbergen and Greenland September 1868 : also showing the nature of the ice and temperature and depth of the sea

Kartta kuuluu A. E. Nordenskiöldin kokoelmaan

1976 Brock Track Team

Pictured here are Marg Stride, Bryan Stride and Kathy Prosser of the 1976 Brock University Track Team.

1976 Brock Track Team

Pictured here are Marg Stride, Bryan Stide and Kathy Prosser.

Track and Field Team (1981-82)

Back Row: Al Pedler (Coach), Murray McEachern, John Popham, David Heyworth, Colin Harris, George Nixon Middle Row: Renee Traver, Wendy Wells Front Row: Maggie Swan, Debbie Belair, Katherine Coy

Organizational commitment and perceived relatedness as correlates of the intention to continue officiating in track and field

The objectives of the present study were to explore three components of organizational commitment (affective [AC], normative [NC] and continuance [CC] commitment; Allen & Meyer, 1991), perceived relatedness (Oeci & Ryan, 1985; 2002), and behavioural intention (Ajzen, 2002) within the context of volunteer track and field officiating. The objectives were examined in a 2-phase study. Ouring phase 1, experts (N = 10) with domain familiarity assessed the item content relevance and representation of modified organizational commitment (OC; Meyer, Allen & Smith, 1993) and perceived relatedness (La Guardia, Oeci, Ryan & Couchman, 2000) items. Fourteen of 26 (p < .05) items were relevant (Aiken's coefficient V) and NC (M = 3.88, SO = .64), CC (M = 3.63, SD = .52), and relatedness (M = 4.00, SD = .93) items had mean item content-representation ratings of either "good" or "very good" while AC (M = 2.50, SD = 0.58) was rated "fair". Participants in phase 2 (N = 80) responded to items measuring demographic variables, perceptions of OC to Athletics Canada, perceived relatedness to other track and field officials, and a measure of intention (yiu, Au & Tang, 2001) to continue officiating. Internal consistency reliability estimates (Cronbach's (1951) coefficient alpha) were as follows: (a) AC = .78, (b) CC = .85, (c) NC = .80 (d) perceived relatedness = .70 and, (e) intention = .92 in the present sample. Results suggest that the track and field officials felt only minimally committed to Athletics Canada (AC M = 3.90, SD = 1.23; NC M = 2.47, SD = 1.25; CC M = 3.32; SD = 1.34) and that their relationships with other track and field officials were strongly endorsed (M = 5.86, SD = 0.74). Bivariate correlations (Pearson r) indicated that perceived relatedness to other track and field officials demonstrated the strongest relationship with intention to continue officiating (r = .346, p < .05), while dimensions of OC were not significantly related to intention (all p's > .05). Together perceived relatedness (j3 = .339, p = .004), affective commitment (j3 = -.1 53, p = .308), normative commitment (j3 = -.024, p = .864) and continuance commitment (j3 = .186, P = .287) contribute to the prediction of intention to continued officiating (K = .139). These relationships remained unaffected by the inclusion of demographic (j3age = -.02; P years with Athletics Canada = -.13; bothp's > .05) or alternative commitment (j3sport = -.19; P role = .15; Pathletes = .20; all p' s > .05) considerations. Three open-ended questions elicited qualitative responses regarding participants' reasons for officiating. Responses reflecting initial reasons for officiating formed these higher order themes: convenience, helping reasons, extension of role, and intrinsic reasons. Responses reflecting reasons for continuing to officiate formed these higher order themes: track and field, to help, and personal benefits. Responses reflecting changes that would influence continued involvement were: political, organizational/structural, and personal. These results corroborate the findings of previous investigations which state that the reasons underpinning volunteer motivations change over time (Cuskelly et al., 2002). Overall, the results of this study suggest that track and field officials feel minimal commitment to the organization of Athletics Canada but a stronger bond with their fellow officials. Moreover, the degree to which track and field officials feel meaningfully connected to one another appears to exert a positive influence on their intentions to continue officiating. As such, it is suggested that in order to promote continued involvement, Athletics Canada increases its focus on fostering environments promoting positive interactions among officials.

Trends in fish prey capture by common terns following zebra mussel invasion : do terns track fish species abundance? /

The Common Tern (Sterna hirundo) is a ground nesting colonial seabird. Terns rely primarily on small prey fishes which they obtain through plunge diving for their survival as well as the survival of their offspring during the breeding season. The zebra mussel (Dreissena polymorpha) is a small bivalve mollusk that invaded North American waters in the late 1980's. Through its suspension feeding, the zebra mussel has the ability to alter the entire aquatic ecosystem, ultimately leading to a reduction in pelagic organisms including small prey fish. The objective of the study was to determine what (if any) indirect effects the invasion of the zebra mussel has had on fish prey captured by terns. The study took place in two separate two-year periods, 1990-91 and 1995-96 on a concrete breakwall off the north shore of Lake Erie near Port Colborne, Ontario. Daily nest checks revealed clutch initiation dates, egg-laying chronology, hatching success and morphological egg characteristics (length and breadth). Behavioural observations included time each sex spent in attendance with its brood, the frequency of feeding chicks and the prey species composition and size fed to chicks as well as to females (courtship feeding). Egg sizes did not differ between study periods, nor did feeding rates to chicks, suggesting that food was not a limiting resource. Terns spent less time with their broods (more time foraging) in the 1995-96 period. However, they also had significantly larger broods and fledged more offspring. The time of each individual foraging trip decreased, suggesting that fish were easier to obtain in 1995 and 1996. Lastly, kleptoparasitism rates decreased, suggesting that the costs of foraging (time, energy) actually decreased as fewer birds adopted this strategy to compensate for what I assumed to be a lack of available food (fish). The only significant difference between the periods of 1990, 1991 and 1995, 1996 was a change in diet. Terns delivered significantly fewer rainbow smelt and more emerald shiner in 1995 and 1996. However, the average size of fish delivered did not change. Thus, there was little impact on prey captured by Common Terns in Lake Erie since the invasion of the zebra mussel.

Stadium and track before renovation, Chapman College, Orange, California

Stadium and track before renovation, Hutton Sports Center, 219 E. Sycamore St., Chapman College, Orange, California. The Harold Hutton Sports Center, completed in 1978, is named in honor of this former trustee, and made possible by a gift from his wife, Betty Hutton Williams. The facility was renovated in the 1990s.