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Contains fulltext : 138258.pdf (publisher's version ) (Open Access), BACKGROUND: There is a growing impetus to reorganize the hospital discharge process to reduce avoidable readmissions and costs. The aim of this study was to provide insight into hospital discharge problems and underlying causes, and to give an overview of solutions that guide providers and policy-makers in improving hospital discharge. METHODS: The Intervention Mapping framework was used. First, a problem analysis studying the scale, causes, and consequences of ineffective hospital discharge was carried out. The analysis was based on primary data from 26 focus group interviews and 321 individual interviews with patients and relatives, and involved hospital and community care providers. Second, improvements in terms of intervention outcomes, performance objectives and change objectives were specified. Third, 220 experts were consulted and a systematic review of effective discharge interventions was carried out to select theory-based methods and practical strategies required to achieve change and better performance. RESULTS: Ineffective discharge is related to factors at the level of the individual care provider, the patient, the relationship between providers, and the organisational and technical support for care providers. Providers can reduce hospital readmission rates and adverse events by focusing on high-quality discharge information, well-coordinated care, and direct and timely communication with their counterpart colleagues. Patients, or their carers, should participate in the discharge process and be well aware of their health status and treatment. Assessment by hospital care providers whether discharge information is accurate and understood by patients and their community counterparts, are important examples of overcoming identified barriers to effective discharge. Discharge templates, medication reconciliation, a liaison nurse or pharmacist, regular site visits and teach-back are identified as effective and promising strategies to achieve the desired behavi

The PUMA project, a Specific Targeted Research Project (STREP) of the European Union EURATOM 6th Framework Program, is mainly aimed at providing additional key elements for the utilisation and transmutation of plutonium and minor actinides (neptunium and americium) in contemporary and future (high temperature) gas-cooled reactor design, which are promising tools for improving the sustainability of the nuclear fuel cycle. PUMA would also contribute to the reduction of Pu and MA stockpiles and to the development of safe and sustainable reactors for C02-free energy generation. The project runs from September 1, 2006 until August 31, 2009. PUMA also contributes to technological goals of the Generation IV International Forum. It contributes to developing and maintaining the competence in reactor technology in the EU and addresses European stakeholders on key issues for the future of nuclear energy in the EU. An overview is presented of the status of the project at mid-term., QC 20141007

The potential of thorium fertile fuel has been evaluated for a graphite-moderated MHR (Modular Helium Reactor) from the perspective of a self-sustainable U233-Th fuel cycle in the MHR. The 3-D core analyses have been performed with the thermal-hydraulic-coupled computer code systems (HELIOS-MASTER). The feasibility of a self-sustainable U233-Th fuel cycle in MHR was evaluated for a simplified equilibrium fuel cycle. A mixed oxide fuel (ThO2-UO2) was used. Whole-core analysis was performed with the MASTER code for various core configurations. In the core analysis, a 3-batch radial fuel shuffling scheme was adopted to find an equilibrium fuel cycle. Three types of fuel blocks were considered: a homogeneous fuel arrangement and two seed-blanket arrangements. It was found that a near self-sustainable U233-Th fuel cycle (conversion ratio=0.95̃0.97) is feasible for the MHRs with the appropriate U-233 and Th-232 loadings. To achieve a high conversion ratio while maintaining a long cycle length, it is essential to maximize the thorium loading (̃30 tons) and at the same time soften the neutron spectrum to achieve sufficient reactivity. In order to achieve conversion ratios over 0.95 and an 18-month cycle length, the moderator volume needs to be increased with respect to the regular MHR design. Also, removing the inner graphite reflectors increases noticeably the core performance in terms of the conversion ratio and cycle length. A special seed-blanket block configuration (ISB, with seed and blanket fuels in the inner and outer regions of a block, respectively) provides a superior conversion ratio with respect to a homogeneously fueled block, whereas reversing the placement of seed and blanket in the ISB block configuration (with seed fuels in the outer zone) results in a worse performance. In the case of the U233-Th fuel cycle, the fissile (U233+U235) fraction in the discharged fuel is almost 90%. Denaturing of the uranium vector in the self-sustainable U233-Th fuel was inve, QC 20141007

Characteristic modes developed by Carbacz, Harrington and Mautz have long been used in the analysis of radiation and scattering from conducting bodies and apertures. For their computation, it is necessary to solve an eigensystem of the form Alpha chi=lambda Beta chi. If the matrices (Alpha, Beta) are Hermitian and Beta is positive definite, the generalized eigenvalue problem can be accurately solved using the simultaneous diagonalization technique (SDT). Because of numerical approximations and rounding sometimes it may happen that the matrices properties deteriorate and the SDT procedure becomes inapplicable. In this work a new technique, developed recently by Higham and Cheng is proposed as a method to solve these deteriorate cases. It is applied to the computation of the characteristic modes for some scattering problems. Results are analyzed and discussed., Prepared in cooperation with Universita della Calabria, Italy. Pub. in ACES Jnl., v17 n3 p232-238, Nov 2002. ISSN 1054-4887. This article is from ADA412338 Applied Computational Electromagnetics Society Journal. Volume 17, Number 3