Diabetic foot ulcers in conjunction with lower limb lymphedema: pathophysiology and treatment procedures

Directory of Open Access Journals (Sweden)

Kanapathy M

2015-08-01

Full Text Available Muholan Kanapathy,1 Mark J Portou,1,2 Janice Tsui,1,2 Toby Richards1,21Division of Surgery and Interventional Science, University College London, 2Department of Vascular Surgery, Royal Free London NHS Foundation Trust Hospital, London, UKAbstract: Diabetic foot ulcers (DFUs are complex, chronic, and progressive wounds, and have a significant impact on morbidity, mortality, and quality of life. A particular aspect of DFU that has not been reviewed extensively thus far is its management in conjunction with peripheral limb edema. Peripheral limb edema is a feature of diabetes that has been identified as a significant risk factor for amputation in patients with DFU. Three major etiological factors in development of lymphedema with concurrent DFU are diabetic microangiopathy, failure of autonomic regulation, and recurrent infection. This review outlines the pathophysiology of lymphedema formation in patients with DFU and highlights the cellular and immune components of impaired wound healing in lymphedematous DFU. We then discuss the principles of management of DFU in conjunction with lymphedema.Keywords: diabetic foot ulcer, lymphedema, chronic wound, wound management

Isolated primary lymphedema tarda of the upper limb.

Science.gov (United States)

Shariati, Farzaneh; Ravari, Hasan; Kazemzadeh, Gholamhossein; Sadeghi, Ramin

2013-03-01

Primary lymphedema tarda is considered as a congenital disease with late presentation. Primary lymphedema tarda usually affects lower limbs, and primary lymphedema tarda of the upper limbs usually accompanies lower limb lymphedema. In the current case report, we present an 80-year-old male patient with isolated left upper limb swelling that lymphoscintigraphy imaging proved to be lymphedema.

Symptom report in detecting breast cancer-related lymphedema

Directory of Open Access Journals (Sweden)

Fu MR

2015-10-01

Full Text Available Mei R Fu,1 Deborah Axelrod,2,3 Charles M Cleland,1 Zeyuan Qiu,4 Amber A Guth,2,3 Robin Kleinman,2 Joan Scagliola,2 Judith Haber1 1College of Nursing, New York University, 2Department of Surgery, NYU School of Medicine, 3NYU Clinical Cancer Center, New York, NY, 4Department of Chemistry and Environmental Science, New Jersey Institute of Technology, Newark, NJ, USA Abstract: Breast cancer-related lymphedema is a syndrome of abnormal swelling coupled with multiple symptoms resulting from obstruction or disruption of the lymphatic system associated with cancer treatment. Research has demonstrated that with increased number of symptoms reported, breast cancer survivors' limb volume increased. Lymphedema symptoms in the affected limb may indicate a latent stage of lymphedema in which changes cannot be detected by objective measures. The latent stage of lymphedema may exist months or years before overt swelling occurs. Symptom report may play an important role in detecting lymphedema in clinical practice. The purposes of this study were to: 1 examine the validity, sensitivity, and specificity of symptoms for detecting breast cancer-related lymphedema and 2 determine the best clinical cutoff point for the count of symptoms that maximized the sum of sensitivity and specificity. Data were collected from 250 women, including healthy female adults, breast cancer survivors with lymphedema, and those at risk for lymphedema. Lymphedema symptoms were assessed using a reliable and valid instrument. Validity, sensitivity, and specificity were evaluated using logistic regression, analysis of variance, and areas under receiver operating characteristic curves. Count of lymphedema symptoms was able to differentiate healthy adults from breast cancer survivors with lymphedema and those at risk for lymphedema. A diagnostic cutoff of three symptoms discriminated breast cancer survivors with lymphedema from healthy women with a sensitivity of 94% and a specificity of 97

Usability and feasibility of health IT interventions to enhance Self-Care for Lymphedema Symptom Management in breast cancer survivors

Directory of Open Access Journals (Sweden)

Mei R. Fu, PhD, RN, FAAN

2016-09-01

Conclusions: This usability study provided evidence on breast cancer survivor's acceptance and highly positive evaluation of TOLF's usability as well as feasibility of using technologically-driven delivery model to enhance self-care strategies for lymphedema symptom management.

Gigantic Suprapubic Lymphedema: A Case Study

Directory of Open Access Journals (Sweden)

Roozbeh Tanhaeivash

2016-08-01

Full Text Available We present the first case study of idiopathic gigantic suprapubic lymphedema and buried penis treated with puboscrotal reconstruction in a patient with initial extreme obesity after an extensive weight reduction (120 kg. Massive localized lymphedema of the suprapubic region should be differentiated from the scrotal type. Severe lymphedema could not resolve on its own and weight reduction does not seem to be helpful in such cases.

Upper limb lymphedema after breast cancer treatment

International Nuclear Information System (INIS)

Ben Salah, H.; Bahri, M.; Jbali, B.; Daoud, J.; Guermazi, M.; Frikha, M.

2012-01-01

Purpose. - To study the frequency and risk factors for upper limb lymphedema through a series of patients treated for breast cancer. Patients and methods. - It is a retrospective study about 222 patients treated for breast cancer during the period between February 1993 and December 2003 in Sfax hospitals. Average age was 51 years (27-92 years). Tumour was T2 in 59% of cases. All patients had surgery with lymph node dissection. Infiltrating ductal carcinoma was the most frequent histological type (80% of cases), with predominant SBR II grade (62%). The mean number of removed lymph nodes was 12 (2-33). Axillary lymph node metastasis was detected in 124 patients. Radiotherapy was delivered in 200 patients, including axillary irradiation in 30 cases. The mean follow-up was 68 months (12-120). Results. - Lymphedema appeared in 23% of cases (51 patients), 14 months after surgery (mean period). Lymphedema affected the brachium in 17% of cases, the forearm in 12% of cases and all upper limb in 71% of cases. Fifty percent of patients had rehabilitation. However, improvement of lymphedema was obtained in 18 cases. Parameters predicting lymphedema were studied. Significant risk factors were obesity, infection and a number of removed lymph node above 10. The type of surgery, axillary irradiation and shoulder abduction deficit did not predict lymphedema. Conclusion. - Lymphedema of the arm is a frequent consequence of breast cancer treatment. The risk of lymphedema is correlated with obesity, infection and a number of removed lymph node above 10. (authors)

Intensive treatment of leg lymphedema

Directory of Open Access Journals (Sweden)

Pereira de Godoy Jose

2010-01-01

Full Text Available Background: Despite of all the problems caused by lymphedema, this disease continues to affect millions of people worldwide. Thus, the identification of the most efficacious forms of treatment is necessary. Aim: The aim of this study was to evaluate a novel intensive outpatient treatment for leg lymphedema. Methods: Twenty-three legs of 19 patients were evaluated in a prospective randomized study. The inclusion criteria were patients with Grade II and III lymphedema, where the difference, measured by volumetry, between the affected limb below the knee and the healthy limb was greater than 1.5 kg. Intensive treatment was carried out for 6- to 8-h sessions in the outpatient clinic. Analysis of variance was utilized for statistical analysis with an alpha error of 5% (P-value < 0.05 being considered significant. Results: All limbs had significant reductions in size with the final mean loss being 81.1% of the volume of edema. The greatest losses occurred in the first week (P-value < 0.001. Losses of more than 90% of the lymphedema occurred in 9 (39.13% patients; losses of more than 80% in 13 (56.52%, losses of more than 70% in 17 (73.91% and losses of more than 50% were recorded for 95.65% of the patients; only 1 patient lost less than 50% (37.9% of the edema. Conclusion: The intensive treatment of lymphedema in the outpatient clinic can produce significant reductions in the volume of edema over a short period of time and can be recommended for any grade of lymphedema, in particular the more advanced degrees.

Evaluating the Burden of Lymphedema Due to Lymphatic Filariasis in 2005 in Khurda District, Odisha State, India.

Directory of Open Access Journals (Sweden)

Victoria Walsh

2016-08-01

Full Text Available Over 1.1 billion people worldwide are at risk for lymphatic filariasis (LF, and the global burden of LF-associated lymphedema is estimated at 16 million affected people, yet country-specific estimates are poor.A house-to-house morbidity census was conducted to assess the burden and severity of lymphedema in a population of 1,298,576 persons living in the LF-endemic district of Khurda in Odisha State, India. The burden of lymphedema in Khurda is widespread geographically, and 1.3% (17,036 of the total population report lymphedema. 51.3% of the patients reporting lymphedema were female, mean age 49.4 years (1-99. Early lymphedema (Dreyer stages 1 & 2 was reported in two-thirds of the patients. Poisson regression analysis was conducted in order to determine risk factors for advanced lymphedema (Dreyer stages 4-7. Increasing age was significantly associated with advanced lymphedema, and persons 70 years and older had a prevalence three times greater than individuals ages 15-29 (aPR: 3.21, 95% CI 2.45, 4.21. The number of adenolymphangitis (ADL episodes reported in the previous year was also significantly associated with advanced lymphedema (aPR 4.65, 95% CI 2.97-7.30. This analysis is one of the first to look at potential risk factors for advanced lymphedema using morbidity census data from an entire district in Odisha State, India.These data highlight the magnitude of lymphedema in LF-endemic areas and emphasize the need to develop robust estimates of numbers of individuals with lymphedema in order to identify the extent of lymphedema management services needed in these regions.

Financial cost of lymphedema borne by women with breast cancer

Science.gov (United States)

Xu, Ying; Kalfa, Senia; Koelmeyer, Louise; Parkinson, Bonny; Mackie, Helen; Viveros, Hector; Gollan, Paul; Taksa, Lucy

2016-01-01

Abstract Objective Our study examines the financial cost of lymphedema following a diagnosis of breast cancer and addresses a significant knowledge gap regarding the additional impact of lymphedema on breast cancer survivors. Methods An online national survey was conducted with 361 women who had either breast cancer without lymphedema (BC) (group 1, n = 209) or breast cancer with lymphedema (BC+LE) (group 2, n = 152). Participant recruitment was supported by the Breast Cancer Network Australia and the Australasian Lymphology Association. Results Both breast cancer and lymphedema result in significant out‐of‐pocket financial costs borne by women. Of patients with BC+LE, 80% indicated that their breast cancer diagnosis had affected them financially compared with 67% in the BC group (P < .020). For patients with lymphedema, over half (56%) indicated that this specific additional diagnosis to their breast cancer affected them financially and that costs increased with lymphedema severity. The cost of compression garments formed a large proportion of these costs (40.1%). The average number of attendances to a therapist each year was 5.8 (range, 0‐45). Twenty‐five patients (16.4%) had an episode of cellulitis in the past year. The incidence of cellulitis was 7.7% in 91 patients with subclinical or mild lymphedema compared with 29.5% of 61 patients with more extensive lymphedema (P < .001). The average out‐of‐pocket financial cost of lymphedema care borne by women was A$977 per annum, ranging from A$207 for subclinical lymphedema to over A$1400 for moderate or severe lymphedema. Conclusions This study identifies an additional detrimental effect of lymphedema on women in terms of financial costs. PMID:27479170

The prevention of the primary lymphedema

International Nuclear Information System (INIS)

Benda, K.; Lebloch, D.; Bendova, M.

1998-01-01

The endangered familiar members of the ailing with the primary lymphedema are clinically examined (anamnesis, physical examination of the extremities and biochemical examination) and by radionuclide lymphography of the extremities. For the proved latent stadium of the lymphedema the complex of preventive therapy is recommended. (authors)

Hereditary Lymphedema of the Leg – A Case Report

Directory of Open Access Journals (Sweden)

Birgit Heinig

2017-07-01

Full Text Available Primary of hereditary lymphedema is a rare but progressive disease. It is yet not curable. We present a 48-year-old male patient with hereditary lymphedema of his left leg, that was realised by minor trauma (able twist when he was seven years old. He had never been treated for lymphedema but experienced multiple erysipelas during his life. After diagnostic procedures to exclude other causes of leg swelling, the diagnosis of hereditary lymphedema of the leg, stage III was confirmed. We initialized complex decongestive therapy. During two weeks of intensive treatment, the circumference of the left leg could be reduced by 10 cm. This case illustrates the "natural course" hereditary lymphedema. But it raises the hope that even after decades of ignorance, the patients benefits from complex decongestive treatment. Therapeutic nihilism is unnecessary and poses lymphedema patients to risks of infection and secondary malignancies like Stewart-Trewes syndrome.

Breast Cancer-Related Arm Lymphedema: Incidence Rates, Diagnostic Techniques, Optimal Management and Risk Reduction Strategies

Energy Technology Data Exchange (ETDEWEB)

Shah, Chirag [Department of Radiation Oncology, William Beaumont Hospital, Royal Oak, MI (United States); Vicini, Frank A., E-mail: fvicini@beaumont.edu [Department of Radiation Oncology, William Beaumont Hospital, Royal Oak, MI (United States)

2011-11-15

As more women survive breast cancer, long-term toxicities affecting their quality of life, such as lymphedema (LE) of the arm, gain importance. Although numerous studies have attempted to determine incidence rates, identify optimal diagnostic tests, enumerate efficacious treatment strategies and outline risk reduction guidelines for breast cancer-related lymphedema (BCRL), few groups have consistently agreed on any of these issues. As a result, standardized recommendations are still lacking. This review will summarize the latest data addressing all of these concerns in order to provide patients and health care providers with optimal, contemporary recommendations. Published incidence rates for BCRL vary substantially with a range of 2-65% based on surgical technique, axillary sampling method, radiation therapy fields treated, and the use of chemotherapy. Newer clinical assessment tools can potentially identify BCRL in patients with subclinical disease with prospective data suggesting that early diagnosis and management with noninvasive therapy can lead to excellent outcomes. Multiple therapies exist with treatments defined by the severity of BCRL present. Currently, the standard of care for BCRL in patients with significant LE is complex decongestive physiotherapy (CDP). Contemporary data also suggest that a multidisciplinary approach to the management of BCRL should begin prior to definitive treatment for breast cancer employing patient-specific surgical, radiation therapy, and chemotherapy paradigms that limit risks. Further, prospective clinical assessments before and after treatment should be employed to diagnose subclinical disease. In those patients who require aggressive locoregional management, prophylactic therapies and the use of CDP can help reduce the long-term sequelae of BCRL.

Breast Cancer-Related Arm Lymphedema: Incidence Rates, Diagnostic Techniques, Optimal Management and Risk Reduction Strategies

International Nuclear Information System (INIS)

Shah, Chirag; Vicini, Frank A.

2011-01-01

As more women survive breast cancer, long-term toxicities affecting their quality of life, such as lymphedema (LE) of the arm, gain importance. Although numerous studies have attempted to determine incidence rates, identify optimal diagnostic tests, enumerate efficacious treatment strategies and outline risk reduction guidelines for breast cancer–related lymphedema (BCRL), few groups have consistently agreed on any of these issues. As a result, standardized recommendations are still lacking. This review will summarize the latest data addressing all of these concerns in order to provide patients and health care providers with optimal, contemporary recommendations. Published incidence rates for BCRL vary substantially with a range of 2–65% based on surgical technique, axillary sampling method, radiation therapy fields treated, and the use of chemotherapy. Newer clinical assessment tools can potentially identify BCRL in patients with subclinical disease with prospective data suggesting that early diagnosis and management with noninvasive therapy can lead to excellent outcomes. Multiple therapies exist with treatments defined by the severity of BCRL present. Currently, the standard of care for BCRL in patients with significant LE is complex decongestive physiotherapy (CDP). Contemporary data also suggest that a multidisciplinary approach to the management of BCRL should begin prior to definitive treatment for breast cancer employing patient-specific surgical, radiation therapy, and chemotherapy paradigms that limit risks. Further, prospective clinical assessments before and after treatment should be employed to diagnose subclinical disease. In those patients who require aggressive locoregional management, prophylactic therapies and the use of CDP can help reduce the long-term sequelae of BCRL.

Low level laser therapy (photobiomodulation) for the management of breast cancer-related lymphedema: an update

Science.gov (United States)

Baxter, G. David; Liu, Lizhou; Chapple, Cathy; Petrich, Simone; Anders, Juanita J.; Tumilty, Steve

2018-04-01

Breast cancer related lymphedema (BCRL) is prevalent among breast cancer survivors, and may be painful and disfiguring with associated psychological impact. Previous research shows increasing use of low level laser therapy (LLLT), now commonly referred to as photobiomodulation (PBM) therapy for managing BCRL, in countries including the United States and Australia. However, conclusions were limited by the paucity, heterogeneity, and poor quality of previous studies. LLLT (PBM) has been barely used in clinical practice in New Zealand, and no clinical studies on LLLT (PBM) for BCRL have been conducted in this country. In order to promote this potentially useful treatment modality for BCRL patients, the Laser Lymphedema Trial Team at the University of Otago conducted a program to assess the effectiveness of LLLT (PBM) in management of BCRL. The program comprises three phases including a systematic review (completed), a feasibility study (completed), and a full-scale randomized controlled trial (proposed). This current paper provides an update on the program. Based upon the systematic review, LLLT (PBM) is considered a potentially effective treatment approach for women with BCRL; the review also indicated the need for further research including exploration of the relevance of dosage and other LLLT (PBM) parameters. The feasibility study demonstrated that it is feasible to conduct a fully powered RCT to definitively test the effectiveness of the additional use of LLLT (PBM) in the management of BCRL, and 114 participants will be needed at baseline in the main study. Currently, the full-scale RCT is under preparation.

Twisting Tourniquet© Technique: introducing Schnogh, a novel device and its effectiveness in treating primary and secondary lymphedema of extremities

International Nuclear Information System (INIS)

Chanwimalueang, Narumon; Ekataksin, Wichai; Piyaman, Parkpoom; Pattanapen, Gedsuda; Hanboon, Borimas K

2015-01-01

Twisting Tourniquet © or in Thai “Schnogh” is a new invention for compression therapy of lymphedema. Twisting Tourniquet © Technique (TTT) is totally noninvasive for lymphedema management. After the amazing successful evidence in the first series of 28 patients, we have conducted preliminary studies in lymphedema clinics. It was found that the combination of gradually increasing constriction force by Schnogh until desired pressure was reached and maintained for 15 min, followed by a 5-min release, doing repeatedly this compression-decompression for at least 10 sessions a day, can generate acceptable results. The aim of the study was to evaluate the scientific effectiveness and establish a treatment protocol of TTT proposed as a therapeutic approach for clinical management of lymphedema. During 2006–2013, from over 3500 patients, 647 with primary/secondary lymphedema passed inclusion criteria, 307 for upper, and 340 for lower extremity. In the 5-day course of TTT, each day patients underwent 10 sessions of a 15-min compression followed by a 5-min decompression. Vegan diet was encouraged as an adjuvant therapy. Among lymphedema patients whose spectrum of edema severity ranged from mild to gigantic, TTT yielded an average volume reduction rate (VR) at 50.2% and 55.6%, making the average edema reduction volume attained at 463 and 1856 mL for upper and lower limb, respectively. The uniformed practice by Schnogh which supports a continual compression–decompression maneuver over 3.5 h daily for five consecutive days could induce an average VR at above half of the swelling in extremities of 647 patients. Schnogh is therefore effective in clinical management of lymphedema under TTT treatment of fibroblastic interstitium

Hereditary lymphedema of the leg – A Case Report

NARCIS (Netherlands)

Heinig, Birgit; Lotti, T.; Tchernev, Georgi; Wollina, Uwe

2017-01-01

Primary of hereditary lymphedema is a rare but progressive disease. It is yet not curable. We present a 48-year-old male patient with hereditary lymphedema of his left leg, that was realised by minor trauma (able twist) when he was seven years old. He had never been treated for lymphedema but

Excision of Elephantiasis Nostras Verrucosa Lesions in a Patient With Hereditary Lymphedema: Case Report and Review of the Literature.

Science.gov (United States)

Pitcher, Austin A; Pagan, Carlos A; Small, Kevin; Otterburn, David M

2015-01-01

Elephantiasis nostras verrucosa (ENV) is a rare cutaneous sequela of chronic lymphedema. Treatment of ENV remains poorly elucidated but has historically involved conservative management aimed at relieving the underlying lymphedema, with a few cases managed by surgical intervention. We report a case of a 27-year-old male with primary lymphedema complicated by large painful ENV lesions on his left foot that we excised surgically with good functional and cosmetic results as validated by the patient. To our knowledge, this is the first report of a case of ENV with a pedunculated morphology and the presence of a deep invasive stalk. Copyright © 2015 American College of Foot and Ankle Surgeons. Published by Elsevier Inc. All rights reserved.

Prevalence and risk factors for development of lymphedema following breast cancer treatment

International Nuclear Information System (INIS)

Deo, S.V.S.; Ray, S.; Kar, M.; Asthana, S.; Rath, G.K.; Shukla, N.K.; Raina, V.

2004-01-01

BACKGROUND: Early detection and multimodality therapy has resulted in an overall improvement of survival among breast cancer patients. Despite a significant shift in the treatment approach from radical mastectomy to breast conservation a significant number of patients develop lymphedema. This study was conducted to evaluate the prevalence and risk factors for development of lymphedema. SETTINGS AND DESIGN: Retrospective analysis for prevalence of lymphedema in a tertiary care regional cancer centre. MATERIAL AND METHODS: Three hundred treated breast cancer patients with a minimum follow up of one year were evaluated for the prevalence and risk factors for lymphedema. Lymphedema was assessed using a serial circumferential measurement method. More than 3 cm difference in circumference is considered as clinical significant lymphedema. Univariate and multivariate analysis were performed for evaluating the risk factors by using the Chi square test and Cox logistic regression analysis. RESULTS: The prevalence of clinically significant lymphedema was 33.5 % and 17.2 % had severe lymphedema. The prevalence of lymphedema was 13.4 % in patients treated with surgery only where as the prevalence was 42.4% in patients treated with surgery and radiotherapy. Stage of the disease, body surface area> 1.5 m 2 , presence of co-morbid conditions, post operative radiotherapy and anthracycline based chemotherapy were significant risk factors in univariate analysis where as axillary irradiation and presence of co-morbid conditions have emerged as independent risk factors in multivariate analysis (P < 0.001). CONCLUSION: Post treatment lymphedema continues to be a significant problem following breast cancer therapy. Presence of co-morbid conditions and axillary radiation significantly increases the risk of lymphedema. A combination of axillary dissection and axillary radiation should be avoided whenever feasible to avoid lymphedema. (author)

Lymphedema-lymphangiectasia-mental retardation (Hennekam) syndrome: A review

NARCIS (Netherlands)

van Balkom, Inge D. C.; Alders, Mariel; Allanson, Judith; Bellini, Carlo; Frank, Ulrich; de Jong, Greetje; Kolbe, Ingeborg; Lacombe, Didier; Rockson, Stan; Rowe, Peter; Wijburg, Frits; Hennekam, Raoul C. M.

2002-01-01

The Hennekam syndrome is an infrequently reported heritable entity characterized by lymphedema, lymphangiectasia, and developmental delay. Here we add an additional 8 patients, and compare their findings to the 16 cases from the literature. The lymphedema is usually congenital, can be markedly

VEGF-C gene therapy augments postnatal lymphangiogenesis and ameliorates secondary lymphedema

Science.gov (United States)

Yoon, Young-sup; Murayama, Toshinori; Gravereaux, Edwin; Tkebuchava, Tengiz; Silver, Marcy; Curry, Cynthia; Wecker, Andrea; Kirchmair, Rudolf; Hu, Chun Song; Kearney, Marianne; Ashare, Alan; Jackson, David G.; Kubo, Hajime; Isner, Jeffrey M.; Losordo, Douglas W.

2003-01-01

Although lymphedema is a common clinical condition, treatment for this disabling condition remains limited and largely ineffective. Recently, it has been reported that overexpression of VEGF-C correlates with increased lymphatic vessel growth (lymphangiogenesis). However, the effect of VEGF-C–induced lymphangiogenesis on lymphedema has yet to be demonstrated. Here we investigated the impact of local transfer of naked plasmid DNA encoding human VEGF-C (phVEGF-C) on two animal models of lymphedema: one in the rabbit ear and the other in the mouse tail. In a rabbit model, following local phVEGF-C gene transfer, VEGFR-3 expression was significantly increased. This gene transfer led to a decrease in thickness and volume of lymphedema, improvement of lymphatic function demonstrated by serial lymphoscintigraphy, and finally, attenuation of the fibrofatty changes of the skin, the final consequences of lymphedema. The favorable effect of phVEGF-C on lymphedema was reconfirmed in a mouse tail model. Immunohistochemical analysis using lymphatic-specific markers: VEGFR-3, lymphatic endothelial hyaluronan receptor-1, together with the proliferation marker Ki-67 Ab revealed that phVEGF-C transfection potently induced new lymphatic vessel growth. This study, we believe for the first time, documents that gene transfer of phVEGF-C resolves lymphedema through direct augmentation of lymphangiogenesis. This novel therapeutic strategy may merit clinical investigation in patients with lymphedema. PMID:12618526

Lymphedema and employability - Review and results of a survey of Austrian experts.

Science.gov (United States)

Neubauer, Markus; Schoberwalter, Dieter; Cenik, Fadime; Keilani, Mohammad; Crevenna, Richard

2017-03-01

Literature about lymphedema and its influence on the ability to work and employability is limited. The aim of the present study was to investigate the opinion of Austrian experts on factors influencing the ability to work and employability in patients suffering from lymphedema. A self-administered questionnaire consisting of 6 questions was sent to 12 Austrian lymphedema experts with 6 different specializations from May to August 2016. These experts were asked about suitable and unsuitable professions, the possible influence of lymphedema on the ability to work and employability as well as about existing and additional measures to improve the return to work. The reply rate was 100% (12 out of 12). All experts agreed that lymphedema can restrict the ability to work and employability. The leading reason for limited ability to work and employability was restricted mobility or function of the affected limb along with time-consuming therapeutic modalities, pain and psychological stress. The most suitable job named was teacher and the most unsuitable job named was cook. As easements for return to work, early rehabilitation, self-management, coping strategies, patient education, employer's goodwill and employer's cooperation were reported. Furthermore, experts stressed the need for an adjustment of the legal framework as well as low-barrier and more therapy offers. Adjusted work demands seem to be of greater importance to support the ability to work and employability than recommendations for specific job profiles alone. Experts suggest an adjustment of the legal framework for affected patients, claiming a right for early rehabilitation as well as for life-long therapy. Even though some clinically useful conclusions may be drawn from this article, further research in the field is warranted.

Far-Infrared Radiation Thermotherapy Improves Tissue Fibrosis in Chronic Extremity Lymphedema.

Science.gov (United States)

Li, Ke; Zhang, Zheng; Liu, Ning Fei; Sadigh, Parviz; Evans, Verity Joyce; Zhou, Huihong; Gao, Weiqing; Zhang, Yi Xin

2017-09-29

Fibrosis can enhance the exacerbation of lymphedema, which becomes obvious in late stage II-III lymphedema. However, whether far-infrared radiation thermotherapy (FIRT) can cure lymphedema fibrosis is still lack of research. This research was to investigate the therapeutic effect of FIRT on tissue fibrosis in the treatment of Late stage II-III lymphedema. Patients accepted only FIRT for a total of 20 sessions. The treatment session duration was 2 hours, and a stable machine temperature of 42°C was maintained throughout treatments. Clinical evaluation and laboratory evaluation were conducted before and after FIRT. Clinical outcome measures included circumference of affected extremity, skin elasticity, ultrasound, patients' subjective assessment, and quality of life (QOL). Laboratory outcome measures included serum and local lymphedema tissue fluid concentrations of fibrosis associated cytokines, tissue growth factor beta-1 (TGF-β1), interleukin (IL)-1β, IL-4, IL-18, and caspase-1. Between 2015 and 2016, clinical evaluation of 64 patients with late stage II-III lymphedema was conducted. From this group, 12 cases (18.75%) underwent simultaneous laboratory evaluation. Circumferences of affected extremities improved significantly following treatment (p pain, discomfort, and numbness (p effective treatment for lymphedema tissue fibrosis; it reduces the concentration of fibrosis cytokines in local lymphedema tissues. Consequently, this treatment can reduce the density of fibrosed tissue in the affected extremity, increase skin elasticity, significantly improve clinical symptoms, and improve QOL of patients.

Prospective Lymphedema Surveillance in a Clinic Setting

Directory of Open Access Journals (Sweden)

Janet Chance-Hetzler

2015-08-01

Full Text Available The potential impact of breast cancer-related lymphedema (LE is quite extensive, yet it often remains under-diagnosed until the later stages. This project examines the effectiveness of prospective surveillance in post-surgical breast cancer patients. A retrospective analysis of 49 out of 100 patients enrolled in a longitudinal prospective study at a Midwestern breast center evaluates: (1 time required for completion of bilateral limb measurements and Lymphedema Breast Cancer Questionnaire (LBCQ; (2 referral to LE management with limb volume increase (LVI and/or LBCQ symptoms; and (3 cost of LE management at lower LVI (≥5%–≤10% versus traditional (≥10%. Findings revealed a visit timeframe mean of 40.3 min (range = 25–60; 43.6% of visits were ≤30-min timeframe. Visit and measurement times decreased as clinic staff gained measurement experience; measurement time mean was 17.9 min (range = 16.9–18.9. LBCQ symptoms and LVI were significantly (p < 0.001 correlated to LE referral; six of the nine patients referred (67% displayed both LBCQ symptoms/LVI. Visits with no symptoms reported did not result in referral, demonstrating the importance of using both indicators when assessing early LE. Lower threshold referral provides compelling evidence of potential cost savings over traditional threshold referral with reported costs of: $3755.00 and $6353.00, respectively (40.9% savings.

Efficacy of complete decongestive therapy and manual lymphatic drainage on treatment-related lymphedema in breast cancer

International Nuclear Information System (INIS)

Koul, Rashmi; Dufan, Tarek; Russell, Catherine; Guenther, Wanda; Nugent, Zoan; Sun Xuyan; Cooke, Andrew L.

2007-01-01

Objective: To evaluate the results of combined decongestive therapy and manual lymphatic drainage in patients with breast cancer-related lymphedema. Methods and Materials: The data from 250 patients were reviewed. The pre- and posttreatment volumetric measurements were compared, and the correlation with age, body mass index, and type of surgery, chemotherapy, and radiotherapy was determined. The Spearman correlation coefficients and Wilcoxon two-sample test were used for statistical analysis. Results: Of the 250 patients, 138 were included in the final analysis. The mean age at presentation was 54.3 years. Patients were stratified on the basis of the treatment modality used for breast cancer management. Lymphedema was managed with combined decongestive therapy in 55%, manual lymphatic drainage alone in 32%, and the home program in 13%. The mean pretreatment volume of the affected and normal arms was 2929 and 2531 mL. At the end of 1 year, the posttreatment volume of the affected arm was 2741 mL. The absolute volume of the affected arm was reduced by a mean of 188 mL (p < 0.0001). The type of surgery (p = 0.0142), age (p = 0.0354), and body mass index (p < 0.0001) were related to the severity of lymphedema. Conclusion: Combined decongestive therapy and manual lymphatic drainage with exercises were associated with a significant reduction in the lymphedema volume

Efficacy of night-time compression for breast cancer related lymphedema (LYNC): protocol for a multi-centre, randomized controlled efficacy trial

International Nuclear Information System (INIS)

McNeely, Margaret L.; Campbell, Kristin L.; Webster, Marc; Kuusk, Urve; Tracey, Karen; Mackey, John

2016-01-01

Lymphedema is a prevalent long-term effect of breast cancer treatment that is associated with reduced quality of life. More recent observational data suggest that the addition of night-time compression to day-time use of a compression garment results in better long-term control of arm lymphedema. The primary objectives of the randomized controlled phase of the trial are to determine the efficacy of night-time compression on arm lymphedema volume maintenance and quality of life in breast cancer survivors who have completed intensive reduction treatment for their lymphedema. The study will be a parallel 3-arm, multi-centre randomized fast-track trial. A total of 120 women with breast cancer related lymphedema will be recruited from 3 centres in Canada and randomized to group 1: Day-time compression garment alone or Group 2: Day-time compression garment + night-time compression bandaging or Group 3: Day-time compression garment + use of a night-time compression system garment. The duration of the primary intervention period will be 12 weeks. The follow-up period after the intervention (weeks 13 to 24) will follow a longitudinal observational design. The primary outcome variables: differences from baseline to week 12 in arm volume and quality of life (Lymphoedema Functioning, Disability and Health Questionnaire: Lymph-ICF). Secondary outcomes include bioimpedance analysis, sleep disturbance and self-efficacy. All measurements are standardized and will be performed prior to randomization, and at weeks 6, 12, 18 and 24. The use of night-time compression as a self-management strategy for chronic breast cancer related lymphedema is seen as an innovative approach to improve long-term control over the condition. This trial aims to advance the knowledge on self-management strategies for lymphedema

Factors Associated With External and Internal Lymphedema in Patients With Head-and-Neck Cancer

Energy Technology Data Exchange (ETDEWEB)

Deng Jie, E-mail: jie.deng@vanderbilt.edu [School of Nursing, Vanderbilt University, Nashville, Tennessee (United States); Ridner, Sheila H. [School of Nursing, Vanderbilt University, Nashville, Tennessee (United States); Vanderbilt-Ingram Cancer Center, Nashville, Tennessee (United States); Dietrich, Mary S. [School of Nursing, Vanderbilt University, Nashville, Tennessee (United States); Vanderbilt-Ingram Cancer Center, Nashville, Tennessee (United States); Department of Biostatistics, School of Medicine, Vanderbilt University, Nashville, Tennessee (United States); Wells, Nancy; Wallston, Kenneth A. [School of Nursing, Vanderbilt University, Nashville, Tennessee (United States); Sinard, Robert J.; Cmelak, Anthony J.; Murphy, Barbara A. [Vanderbilt-Ingram Cancer Center, Nashville, Tennessee (United States)

2012-11-01

Purpose: The purpose of this study was to examine factors associated with the presence of secondary external and internal lymphedema in patients with head-and-neck cancer (HNC). Methods and Materials: The sample included 81 patients {>=}3 months after HNC treatment. Physical and endoscopic examinations were conducted to determine if participants had external, internal, and/or combined head-and-neck lymphedema. Logistic regression analysis was used to examine the factors associated with the presence of lymphedema. Results: The following factors were statistically significantly associated with presence of lymphedema: (1) location of tumor associated with presence of external (P=.009) and combined lymphedema (P=.032); (2) time since end of HNC treatment associated with presence of external (P=.004) and combined lymphedema (P=.005); (3) total dosage of radiation therapy (P=.010) and days of radiation (P=.017) associated with the presence of combined lymphedema; (4) radiation status of surgical bed was associated with the presence of internal lymphedema, including surgery with postoperative radiation (P=.030) and (salvage) surgery in the irradiated field (P=.008); and (5) number of treatment modalities associated with external (P=.002), internal (P=.039), and combined lymphedema (P=.004). No demographic, health behavior-related, or comorbidity factors were associated with the presence of lymphedema in the sample. Conclusions: Select tumor and treatment parameters are associated with increased occurrence of lymphedema in patients with HNC. Larger and longitudinal studies are needed to identify adjusted effects and causative risk factors contributing to the development of lymphedema in patients with HNC.

Factors Associated With External and Internal Lymphedema in Patients With Head-and-Neck Cancer

International Nuclear Information System (INIS)

Deng Jie; Ridner, Sheila H.; Dietrich, Mary S.; Wells, Nancy; Wallston, Kenneth A.; Sinard, Robert J.; Cmelak, Anthony J.; Murphy, Barbara A.

2012-01-01

Purpose: The purpose of this study was to examine factors associated with the presence of secondary external and internal lymphedema in patients with head-and-neck cancer (HNC). Methods and Materials: The sample included 81 patients ≥3 months after HNC treatment. Physical and endoscopic examinations were conducted to determine if participants had external, internal, and/or combined head-and-neck lymphedema. Logistic regression analysis was used to examine the factors associated with the presence of lymphedema. Results: The following factors were statistically significantly associated with presence of lymphedema: (1) location of tumor associated with presence of external (P=.009) and combined lymphedema (P=.032); (2) time since end of HNC treatment associated with presence of external (P=.004) and combined lymphedema (P=.005); (3) total dosage of radiation therapy (P=.010) and days of radiation (P=.017) associated with the presence of combined lymphedema; (4) radiation status of surgical bed was associated with the presence of internal lymphedema, including surgery with postoperative radiation (P=.030) and (salvage) surgery in the irradiated field (P=.008); and (5) number of treatment modalities associated with external (P=.002), internal (P=.039), and combined lymphedema (P=.004). No demographic, health behavior-related, or comorbidity factors were associated with the presence of lymphedema in the sample. Conclusions: Select tumor and treatment parameters are associated with increased occurrence of lymphedema in patients with HNC. Larger and longitudinal studies are needed to identify adjusted effects and causative risk factors contributing to the development of lymphedema in patients with HNC.

Factors associated with external and internal lymphedema in patients with head-and-neck cancer.

Science.gov (United States)

Deng, Jie; Ridner, Sheila H; Dietrich, Mary S; Wells, Nancy; Wallston, Kenneth A; Sinard, Robert J; Cmelak, Anthony J; Murphy, Barbara A

2012-11-01

The purpose of this study was to examine factors associated with the presence of secondary external and internal lymphedema in patients with head-and-neck cancer (HNC). The sample included 81 patients ≥3 months after HNC treatment. Physical and endoscopic examinations were conducted to determine if participants had external, internal, and/or combined head-and-neck lymphedema. Logistic regression analysis was used to examine the factors associated with the presence of lymphedema. The following factors were statistically significantly associated with presence of lymphedema: (1) location of tumor associated with presence of external (P=.009) and combined lymphedema (P=.032); (2) time since end of HNC treatment associated with presence of external (P=.004) and combined lymphedema (P=.005); (3) total dosage of radiation therapy (P=.010) and days of radiation (P=.017) associated with the presence of combined lymphedema; (4) radiation status of surgical bed was associated with the presence of internal lymphedema, including surgery with postoperative radiation (P=.030) and (salvage) surgery in the irradiated field (P=.008); and (5) number of treatment modalities associated with external (P=.002), internal (P=.039), and combined lymphedema (P=.004). No demographic, health behavior-related, or comorbidity factors were associated with the presence of lymphedema in the sample. Select tumor and treatment parameters are associated with increased occurrence of lymphedema in patients with HNC. Larger and longitudinal studies are needed to identify adjusted effects and causative risk factors contributing to the development of lymphedema in patients with HNC. Copyright © 2012 Elsevier Inc. All rights reserved.

Mutations in the VEGFR3 signaling pathway explain 36% of familial lymphedema

DEFF Research Database (Denmark)

Mendola, A; Schlögel, M J; Ghalamkarpour, A

2013-01-01

Lymphedema is caused by dysfunction of lymphatic vessels, leading to disabling swelling that occurs mostly on the extremities. Lymphedema can be either primary (congenital) or secondary (acquired). Familial primary lymphedema commonly segregates in an autosomal dominant or recessive manner. It can...... of these putative genes. We screened 78 index patients from families with inherited lymphedema for mutations in FLT4, GJC2, FOXC2, SOX18, GATA2, CCBE1, and PTPN14. Altogether, we discovered 28 mutations explaining 36% of the cases. Additionally, 149 patients with sporadic primary lymphedema were screened for FLT4......, FOXC2, SOX18, CCBE1, and PTPN14. Twelve mutations were found that explain 8% of the cases. Still unidentified is the genetic cause of primary lymphedema in 64% of patients with a family history and 92% of sporadic cases. Identification of those genes is important for understanding of etiopathogenesis...

Cell therapy for the treatment of lower limb lymphedema. Case report

International Nuclear Information System (INIS)

Goicoechea Diaz, Pedro; Hernandez Ramirez, Porfirio; Artaza Sanz, Heriberto

2010-01-01

Although lymphedema is a common disabling disease causing significant morbidity for affected patients, treatment for this condition remains limited and largely ineffective. Some reported data suggest that some bone-marrow derived cells may play a role in lymphangiogenesis. It appears that blood vessels and lymphatic vessels might use the same population of cells for vasculogenesis and lymphangiogenesis. Therefore, adult stem cell therapy could be a new useful strategy for the treatment of lymphedema. We report a resolution of a severe lower limb bilateral lymphedema after implantation of autologous adult stem cells derived from bone marrow. As far as we know, this is the first reported case with chronic lower limb lymphedema treated successfully with autologous cell therapy. This procedure is a low-cost, relatively simple and easy to perform option that opens new ways for the treatment of lymphedema

Clinical and diagnostic aspects of lymphedema.

Science.gov (United States)

Keo, Hong H; Gretener, Silvia B; Staub, Daniel

2017-07-01

Lymphedema is a chronic, progressive, and common but often unrecognized condition. The diagnosis of lymphatic disease on clinical grounds alone remains a challenge. Without proper diagnosis, therapy is often delayed, allowing disease progression. There is a need for a practical diagnostic algorithm and its imaging technique to guide clinical decision-making. The aim of this topical review is to provide a practical approach for assessing patients with suspected lymphedema and to give a critical appraisal of currently available imaging modalities that are applied in clinical practice to diagnose and map lymphatic disease.

Quantitative lymphoscintigraphy in post-mastectomy lymphedema: correlation with circumferential measurements

Energy Technology Data Exchange (ETDEWEB)

Choi, Joon Young; Lee, Kyung Han; Kim, Sang Eun; Kim, Byung Tae; Hwang, Jee Hea; Lee, Byung Boong [Samsung Medical Center, Seoul (Korea, Republic of)

1997-07-01

An objective measure for the severity and progression is important for the management of lymphedema. To evaluate the usefulness of lympho-scintigraphy in this regard, we compared various quantitative indices from upper extremity lymphoscintigraphy with circumferential measurements, before and after physiotheraphy. Upper extremity lymphoscintigraphy was performed in 38 patients with unilateral postmastectomy lymphedema. Tc-99m antimony sulfide colloid (37 MBq) was injected s.c. into the second and third interdigital spaces. The injection sites were imaged immediately after injection. After standardized exercise for 15 min, upper extremity images were acquired 30 min, 1 hr and 2 hr after injection. The clearance of the injection site (CL), and % uptake in regional lymph nodes (%LN) and soft tissue of the extremity (i.e., the degree of dermal backflow) (%EXT) compared to the initial injection site were calculated. Circumference of each extremity was measured at 7 levels; the severity of lymphedema was expressed as the percentage difference of total circumferential difference (TCD) between healthy and edematous extremities compared to the total circumference of healthy extremity (%TCD). In 19 patients who received physiotherapy, the therapeutic effect was measured by % decrease of TCD (%DTCD) before and after therapy (Raines. et al., 1977). The quantitative indices calculated in the image at 2 hr p.i. had better correlation with either %TCD or %DTCD than those from earlier images (Table). The CL, %LN and %EXT of edematous extremity had a significant correlation with TCD. The %EXT was correlated best with either TCD or %DTCD. The results suggest that the %EXT which corresponds to the degree of dermal backflow may be a simple and useful quantitative index for evaluating the severity and progression in lymphedema and predicting the effect of therapy.

Quantitative lymphoscintigraphy in post-mastectomy lymphedema: correlation with circumferential measurements

International Nuclear Information System (INIS)

Choi, Joon Young; Lee, Kyung Han; Kim, Sang Eun; Kim, Byung Tae; Hwang, Jee Hea; Lee, Byung Boong

1997-01-01

An objective measure for the severity and progression is important for the management of lymphedema. To evaluate the usefulness of lympho-scintigraphy in this regard, we compared various quantitative indices from upper extremity lymphoscintigraphy with circumferential measurements, before and after physiotheraphy. Upper extremity lymphoscintigraphy was performed in 38 patients with unilateral postmastectomy lymphedema. Tc-99m antimony sulfide colloid (37 MBq) was injected s.c. into the second and third interdigital spaces. The injection sites were imaged immediately after injection. After standardized exercise for 15 min, upper extremity images were acquired 30 min, 1 hr and 2 hr after injection. The clearance of the injection site (CL), and % uptake in regional lymph nodes (%LN) and soft tissue of the extremity (i.e., the degree of dermal backflow) (%EXT) compared to the initial injection site were calculated. Circumference of each extremity was measured at 7 levels; the severity of lymphedema was expressed as the percentage difference of total circumferential difference (TCD) between healthy and edematous extremities compared to the total circumference of healthy extremity (%TCD). In 19 patients who received physiotherapy, the therapeutic effect was measured by % decrease of TCD (%DTCD) before and after therapy (Raines. et al., 1977). The quantitative indices calculated in the image at 2 hr p.i. had better correlation with either %TCD or %DTCD than those from earlier images (Table). The CL, %LN and %EXT of edematous extremity had a significant correlation with TCD. The %EXT was correlated best with either TCD or %DTCD. The results suggest that the %EXT which corresponds to the degree of dermal backflow may be a simple and useful quantitative index for evaluating the severity and progression in lymphedema and predicting the effect of therapy

The Health Deviation of Post-Breast Cancer Lymphedema: Symptom Assessment and Impact on Self-Care Agency.

Science.gov (United States)

Armer, Jane M; Henggeler, Mary H; Brooks, Constance W; Zagar, Eris A; Homan, Sherri; Stewart, Bob R

2008-01-01

(38-39% lymphedema occurrence), with symptom report being the earliest predictor of lymphedema occurrence than any other measurement. Findings verify the importance of subjective assessment by symptom report of limb changes and SCD following breast cancer treatment as an essential tool in early detection and treatment of lymphedema. Findings also support the importance of pre-operative baseline measurements, symptom history, and SCA for later post-op comparisons. These preliminary findings underscore the importance of strengthening SCA by educating breast cancer survivors. Self assessment, early detection, and early treatment hold the best promise for optimal management of this chronic condition, limiting detrimental effects on SCA, and improving quality of life and physiological and psychosocial well-being. These findings lay the foundation for a clinical research program in breast cancer lymphedema based on SCDNT in which education in and awareness for self-report of lymphedema-associated symptoms is a first step in screening. Increasing patient knowledge through education will increase SCA by identifying ane providing information to meet self-care requisites (SCR) related to the health deviation of lymphedema. The nurse has the opportunity to assist patients in developing self-care actions as needed to meet universal and health deviation therapeutic requisites to address self-care demands following breast cancer treatment.

Lymphedema Risk Reduction Practices

Science.gov (United States)

... Question Corner (68) Research (38) Insurance (46) Inspirational Patients (8) LymphLink Articles (174) FAQ's (6) Position Papers (9) LSAP Perspective (9) FOLLOW US! Sign up for our mailing list. twitter Facebook LinkedIn Copyright ©2018 National Lymphedema Network ...

Surgical treatment of lymphedema of the penis and scrotum.

Science.gov (United States)

Modolin, Miguel; Mitre, Anuar Ibrahim; da Silva, José Carlos Faes; Cintra, Wilson; Quagliano, Ana Paula; Arap, Sami; Ferreira, Marcus Castro

2006-08-01

Lymphedema of the penis and scrotum, regardless of its etiology, is determined by reduced lymphatic flow with subsequent enlargement of the penis and scrotum. The clinical course of this condition is characterized by extreme discomfort for patients, with limitation of local hygiene, ambulation, sexual intercourse, and voiding in the standing position. The purpose of the present study is to present the experience and results of the treatment of lymphedema of the penis and scrotum by removing affected tissues and correcting the penoscrotal region. Seventeen patients with lymphedema of the penis and scrotum were treated with a modified Charles procedure, which consists of the excision of the affected skin followed by scrotoplasty and midline suture simulating the scrotal raphe. The penis is covered with a split-thickness skin graft by means of a zigzag suture on its ventral surface. Regression of symptoms and improvement of previous clinical conditions were verified in the follow-up which ranged from 6 months to 6 years. One patient who had undergone lymphadenectomy with radiation therapy due to penile cancer had recurrent scrotum lymphedema. The modified Charles procedure for the treatment of penoscrotal lymphedema is easily reproducible and allows better local hygiene, easier ambulation, voiding in the standing position, resuming sexual intercourse, and finally, better cosmetic results in the affected area with remarkable improvement in quality of life.

Localized lymphedema (elephantiasis): a case series and review of the literature.

Science.gov (United States)

Lu, Song; Tran, Tien Anh; Jones, David M; Meyer, Dale R; Ross, Jeffrey S; Fisher, Hugh A; Carlson, John Andrew

2009-01-01

Lymphedema typically affects a whole limb. Rarely, lymphedema can present as a circumscribed plaque or an isolated skin tumor. To describe the clinical and pathologic characteristics and etiologic factors of localized lymphedema. Case-control study of skin biopsy and excision specimens histologically diagnosed with lymphedema and presenting as a localized skin tumor identified during a 4-year period. We identified 24 cases of localized lymphedema presenting as solitary large polyps (11), solid or papillomatous plaques (7), pendulous swellings (4), or tumors mimicking sarcoma (2). Patients were 18 females and 6 males with a mean age of 41 years (range 16-74). Anogenital involvement was most frequent (75%)--mostly vulva (58%), followed by eyelid (13%), thigh (8%) and breast (4%). Causative factors included injury due to trauma, surgery or childbirth (54%), chronic inflammatory disease (rosacea, Crohn's disease) (8%), and bacterial cellulitis (12%). Eighty-five percent of these patients were either overweight (50%) or obese (35%). Compared with a series of 80 patients with diffuse lymphedema, localized lymphedema patients were significantly younger (41 vs. 62 years old, p = 0.0001), had no history of cancer treatment (0% vs. 18%, p = 0.03), and had an injury to the affected site (54% vs. 6%, p = 0.0001). Histologically, all cases exhibited dermal edema, fibroplasia, dilated lymphatic vessels, uniformly distributed stromal cells and varying degrees of papillated epidermal hyperplasia, inflammatory infiltrates and hyperkeratosis. Tumor size significantly and positively correlated with history of cellulitis, obesity, dense inflammatory infiltrates containing abundant plasma cells, and lymphoid follicles (p elephantiasis.

A randomized controlled trial of expressive writing in breast cancer survivors with lymphedema.

Science.gov (United States)

Sohl, Stephanie J; Dietrich, Mary S; Wallston, Kenneth A; Ridner, Sheila H

2017-07-01

Breast cancer survivors who develop lymphedema report poorer quality of life (QoL) than those without lymphedema. Expressive writing is a potential intervention to address QoL. Adult women (N = 107) with breast cancer and chronic Stage II lymphedema were randomised to writing about thoughts and feelings specific to lymphedema and its treatment (intervention) or about daily activities (control) for four, 20-min sessions. Outcome measures were several indicators of QoL assessed at baseline, one, three, and six months post-intervention (total scores and subscales of Upper Limb Lymphedema 27 and Functional Assessment of Cancer Therapy-Breast). Hypothesised moderators of change in QoL were dispositional optimism, avoidant behaviours, and time since lymphedema diagnosis. There was no statistically significant intent-to-treat main effects of expressive writing on QoL. Statistically significant moderating effects on change in different indicators of QoL were observed for all three moderators. Expressive writing was more effective for improving QoL in women who were higher on optimism, lower on avoidance and had less time since a lymphedema diagnosis. These results provide further evidence that there are subsets of individuals for whom expressive writing is more effective. Future research may investigate targeting expressive writing based on identified moderators.

Readability Assessment of Patient Information about Lymphedema and Its Treatment.

Science.gov (United States)

Seth, Akhil K; Vargas, Christina R; Chuang, Danielle J; Lee, Bernard T

2016-02-01

Patient use of online resources for health information is increasing, and access to appropriately written information has been associated with improved patient satisfaction and overall outcomes. The American Medical Association and the National Institutes of Health recommend that patient materials be written at a sixth-grade reading level. In this study, the authors simulated a patient search of online educational content for lymphedema and evaluated readability. An online search for the term "lymphedema" was performed, and the first 12 hits were identified. User and location filters were disabled and sponsored results were excluded. Patient information from each site was downloaded and formatted into plain text. Readability was assessed using established tests: Coleman-Liau, Flesch-Kincaid, Flesch Reading Ease Index, FORCAST Readability Formula, Fry Graph, Gunning Fog Index, New Dale-Chall Formula, New Fog Count, Raygor Readability Estimate, and Simple Measure of Gobbledygook Readability Formula. There were 152 patient articles downloaded; the overall mean reading level was 12.6. Individual website reading levels ranged from 9.4 (cancer.org) to 16.7 (wikipedia.org). There were 36 articles dedicated to conservative treatments for lymphedema; surgical treatment was mentioned in nine articles across four sites. The average reading level for conservative management was 12.7, compared with 15.6 for surgery (p readability, and surgeons should direct patients to sites appropriate for their level. There is limited information about surgical treatment available on the most popular sites; this information is significantly harder to read than sections on conservative measures.

Measurement Properties of Instruments for Measuring of Lymphedema: Systematic Review.

Science.gov (United States)

Hidding, Janine T; Viehoff, Peter B; Beurskens, Carien H G; van Laarhoven, Hanneke W M; Nijhuis-van der Sanden, Maria W G; van der Wees, Philip J

2016-12-01

Lymphedema is a common complication of cancer treatment, resulting in swelling and subjective symptoms. Reliable and valid measurement of this side effect of medical treatment is important. The purpose of this study was to provide best evidence regarding which measurement instruments are most appropriate in measuring lymphedema in its different stages. The PubMed and Web of Science databases were used, and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed. Clinical studies on measurement instruments assessing lymphedema were reviewed using the Quality Assessment of Diagnostic Accuracy Studies-2 (QUADAS-2) scoring instrument for quality assessment. Data on reliability, concurrent validity, convergent validity, sensitivity, specificity, applicability, and costs were extracted. Pooled data showed good intrarater intraclass correlation coefficients (ICCs) (.89) for bioimpedance spectroscopy (BIS) in the lower extremities and high intrarater and interrater ICCs for water volumetry, tape measurement, and perometry (.98-.99) in the upper extremities. In the upper extremities, the standard error of measurement was 3.6% (σ=0.7%) for water volumetry, 5.6% (σ=2.1%) for perometry, and 6.6% (σ=2.6%) for tape measurement. Sensitivity of tape measurement in the upper extremities, using different cutoff points, varied from 0.73 to 0.90, and specificity values varied from 0.72 to 0.78. No uniform definition of lymphedema was available, and a gold standard as a reference test was lacking. Items concerning risk of bias were study design, patient selection, description of lymphedema, blinding of test outcomes, and number of included participants. Measurement instruments with evidence for good reliability and validity were BIS, water volumetry, tape measurement, and perometry, where BIS can detect alterations in extracellular fluid in stage 1 lymphedema and the other measurement instruments can detect alterations in volume

[What physiotherapeutic method for the treatment of post-mastectomy lymphedema is the most effective?

Science.gov (United States)

Grushina, T I

volume of the upper limb decreased on the average for all stages of lymphedema by 37.7±9.3% under effect of pneumatic compression alone, by 49.5±10.7% under the influence of its combination with electrotherapy, by 59.9±5.4% under the action of the combination of pneumatic compression with magnetotherapy, and by 76.3±7.3% after the application of all the three techniques together (pmagnetic therapy was most efficient for the management of grade III-IV lymphedema. The proposed method of combined physiotherapy looks very encouraging for the treatment of late lymphedema but does not completely solve all problems pertaining to the management of this pathological condition.

Analysis of factors related to arm weakness in patients with breast cancer-related lymphedema.

Science.gov (United States)

Lee, Daegu; Hwang, Ji Hye; Chu, Inho; Chang, Hyun Ju; Shim, Young Hun; Kim, Jung Hyun

2015-08-01

The aim of this study was to evaluate the ratio of significant weakness in the affected arm of breast cancer-related lymphedema patients to their unaffected side. Another purpose was to identify factors related to arm weakness and physical function in patients with breast cancer-related lymphedema. Consecutive patients (n = 80) attended a single evaluation session following their outpatient lymphedema clinic visit. Possible independent factors (i.e., lymphedema, pain, psychological, educational, and behavioral) were evaluated. Handgrip strength was used to assess upper extremity muscle strength and the disabilities of arm, shoulder, and hand (DASH) questionnaire was used to assess upper extremity physical function. Multivariate logistic regression was performed using factors that had significant differences between the handgrip weakness and non-weakness groups. Out of the 80 patients with breast cancer-related lymphedema, 29 patients (36.3 %) had significant weakness in the affected arm. Weakness of the arm with lymphedema was not related to lymphedema itself, but was related to the fear of using the affected limb (odds ratio = 1.76, 95 % confidence interval = 1.30-2.37). Fears of using the affected limb and depression significantly contributed to the variance in DASH scores. Appropriate physical and psychological interventions, including providing accurate information and reassurance of physical activity safety, are necessary to prevent arm weakness and physical dysfunction in patients with breast cancer-related lymphedema.

Transnodal Lymphangiography in the Diagnosis and Treatment of Genital Lymphedema

Energy Technology Data Exchange (ETDEWEB)

Gomez, F. M., E-mail: gomez_fermun@gva.es; Martinez-Rodrigo, J.; Marti-Bonmati, L. [Hospital Universitario y Politecnico La Fe, Servicio de Radiologia (Spain); Santos, E. [University of Pittsburgh, Department of Radiology (United States); Forner, I. [Hospital Universitario y Politecnico La Fe, Servicio de Medicina Fisica y Rehabilitacion (Spain); Lloret, M.; Perez-Enguix, D.; Garcia-Marcos, R. [Hospital Universitario y Politecnico La Fe, Servicio de Radiologia (Spain)

2012-12-15

Purpose: To report the success of groin nodal lymphography in the diagnosis and treatment of genital lymphedema. Methods and Materials: We present one female (8 years old [patient no. 1]) and two male (69 and [patient no. 2] 31 years old [patient no. 3], respectively) patients with genital lymphedema in whom conservative treatment failed. The girl also had lymphorrhagia. Genital lymphedema was caused by radical cystectomy (patient no. 2), lymphatic hyperplasia (patient no. 1), and idiopathic lymphangitis (patient no. 3). All of them underwent ultrasound-guided bilateral groin lymph node puncture. Afterward, 4-8 ml Lipiodol Ultra-Fluide (Guerbet) were injected at a rate of 0.2 ml/s. Lipiodol progression was assessed by fluoroscopy. Computed tomography scan of the abdomen and pelvis was performed immediately after and again at 24 h after the procedure to confirm the leak. The follow-up period was 15, 13, and 9 months, respectively. Technical success was considered as bilateral pelvic and abdominal filling of lymphatic vessels. Therapeutic success was considered as improvement or disappearance of genital lymphedema and/or lymphorrhagia. Results: Lipiodol leak to the scrotum was observed in patients no. 2 and 3. Lymphaticopelvic fistula and genital lymphatic hyperplasia were seen in patient no. 1. Genital lymphedema diminished within 1 week and almost disappeared in two cases (patients no. 1 and 3) or significantly improved (patient no. 2). lymphorrhagia also resolved in patient no. 1. No recurrence or worsening was detected during follow-up. Conclusion: Therapeutic lymphangiography by lymph node injection seems to be effective to treat genital lymphedema. Lymph node puncture lymphangiography is feasible and less cumbersome than pedal lymphangiography.

Transnodal Lymphangiography in the Diagnosis and Treatment of Genital Lymphedema

International Nuclear Information System (INIS)

Gómez, F. M.; Martínez-Rodrigo, J.; Martí-Bonmatí, L.; Santos, E.; Forner, I.; Lloret, M.; Pérez-Enguix, D.; García-Marcos, R.

2012-01-01

Purpose: To report the success of groin nodal lymphography in the diagnosis and treatment of genital lymphedema. Methods and Materials: We present one female (8 years old [patient no. 1]) and two male (69 and [patient no. 2] 31 years old [patient no. 3], respectively) patients with genital lymphedema in whom conservative treatment failed. The girl also had lymphorrhagia. Genital lymphedema was caused by radical cystectomy (patient no. 2), lymphatic hyperplasia (patient no. 1), and idiopathic lymphangitis (patient no. 3). All of them underwent ultrasound-guided bilateral groin lymph node puncture. Afterward, 4–8 ml Lipiodol Ultra-Fluide (Guerbet) were injected at a rate of 0.2 ml/s. Lipiodol progression was assessed by fluoroscopy. Computed tomography scan of the abdomen and pelvis was performed immediately after and again at 24 h after the procedure to confirm the leak. The follow-up period was 15, 13, and 9 months, respectively. Technical success was considered as bilateral pelvic and abdominal filling of lymphatic vessels. Therapeutic success was considered as improvement or disappearance of genital lymphedema and/or lymphorrhagia. Results: Lipiodol leak to the scrotum was observed in patients no. 2 and 3. Lymphaticopelvic fistula and genital lymphatic hyperplasia were seen in patient no. 1. Genital lymphedema diminished within 1 week and almost disappeared in two cases (patients no. 1 and 3) or significantly improved (patient no. 2). lymphorrhagia also resolved in patient no. 1. No recurrence or worsening was detected during follow-up. Conclusion: Therapeutic lymphangiography by lymph node injection seems to be effective to treat genital lymphedema. Lymph node puncture lymphangiography is feasible and less cumbersome than pedal lymphangiography.

Sensitivity and specificity of fluorescence microlymphography for detecting lymphedema of the lower extremity.

Science.gov (United States)

Keo, Hong H; Schilling, Marianne; Büchel, Roland; Gröchenig, Ernst; Engelberger, Rolf P; Willenberg, Torsten; Baumgartner, Iris; Gretener, Silvia B

2013-06-01

Fluorescence microlymphography (FML) is used to visualize the lymphatic capillaries. A maximum spread of the fluorescence dye of ≥ 12 mm has been suggested for the diagnosis of lymphedema. However, data on sensitivity and specificity are lacking. The aim of this study was to investigate the accuracy of FML for diagnosing lymphedema in patients with leg swelling. Patients with lower extremity swelling were clinically assessed and separated into lymphedema and non-lymphatic edema groups. FML was studied in all affected legs and the maximum spread of lymphatic capillaries was measured. Test accuracy and receiver operator characteristic (ROC) analysis was performed to assess possible threshold values that predict lymphedema. Between March 2008 and August 2011 a total of 171 patients (184 legs) with a median age of 43.5 (IQR 24, 54) years were assessed. Of those, 94 (51.1%) legs were diagnosed with lymphedema. The sensitivity, specificity, positive and negative likelihood ratio and positive and negative predictive value were 87%, 64%, 2.45, 0.20, 72% and 83% for the 12-mm cut-off level and 79%, 83%, 4.72, 0.26, 83% and 79% for the 14-mm cut-off level, respectively. The area under the ROC curve was 0.82 (95% CI: 0.76, 0.88). Sensitivity was higher in the secondary versus primary lymphedema (95.0% vs 74.3%, p = 0.045). No major adverse events were observed. In conclusion, FML is a simple and safe technique for detecting lymphedema in patients with leg swelling. A cut-off level of ≥ 14-mm maximum spread has a high sensitivity and high specificity of detecting lymphedema and should be chosen.

Effect of physical therapy on breast cancer related lymphedema

DEFF Research Database (Denmark)

Tambour, Mette; Tange, Berit; Christensen, Robin Daniel Kjersgaard

2014-01-01

BACKGROUND: Physical therapy treatment of patients with lymphedema includes treatment based on the principles of 'Complete Decongestive Therapy' (CDT). CDT consists of the following components; skin care, manual lymphatic drainage, bandaging and exercises. The scientific evidence regarding what...... trial. A total of 160 breast cancer patients with arm lymphedema will be recruited from 3 hospitals and randomized into one of two treatment groups A: Complete Decongestive Therapy including manual drainage or B: Complete Decongestive Therapy without manual lymphatic drainage. The intervention period...... type of treatment is most effective is sparse. The objective of this study is to investigate whether CDT is equally effective if it includes manual lymphatic drainage or not in the treatment of arm lymphedema among patients with breast cancer. METHODS/DESIGN: A randomized, single-blind, equivalence...

Lymphedema Fat Graft: An Ideal Filler for Facial Rejuvenation

Directory of Open Access Journals (Sweden)

Fabio Nicoli

2014-09-01

Full Text Available Lymphedema is a chronic disorder characterized by lymph stasis in the subcutaneous tissue. Lymphatic fluid contains several components including hyaluronic acid and has many important properties. Over the past few years, significant research has been performed to identify an ideal tissue to implant as a filler. Because of its unique composition, fat harvested from the lymphedema tissue is an interesting topic for investigation and has significant potential for application as a filler, particularly in facial rejuvenation. Over a 36-month period, we treated and assessed 8 patients with lymphedematous limbs who concurrently underwent facial rejuvenation with lymphedema fat (LF. We conducted a pre- and post-operative satisfaction questionnaire survey and a histological assessment of the harvested LF fat. The overall mean general appearance score at an average of 6 months after the procedure was 7.2±0.5, demonstrating great improvement. Patients reported significant improvement in their skin texture with a reading of 8.5±0.7 and an improvement in their self-esteem. This study demonstrates that LF as an ideal autologous injectable filler is clinically applicable and easily available in patients with lymphedema. We recommend the further study and clinical use of this tissue as it exhibits important properties and qualities for future applications and research.

The effect of prophylactic lymphovenous anastomosis and shunts for preventing cancer-related lymphedema

DEFF Research Database (Denmark)

Jørgensen, Mads G; Toyserkani, Navid M; Sørensen, Jens A

2018-01-01

BACKGROUND: Lymphedema is one of the most dreaded side effects to any cancer treatment involving lymphadenectomy. Progressed lymphedema is adversely complex and currently there is no widely acknowledged curative treatment. Therefore recent focus has shifted to risk reduction and prevention. It has...... with prophylactic LVA had a significant reduction in lymphedema incidence (Relative risk: 0.33, 95%CI: 0.19 to 0.56) when compared to patients receiving no prophylactic treatment (P 

Quantitative Lymphoscintigraphy to Predict the Possibility of Lymphedema Development After Breast Cancer Surgery: Retrospective Clinical Study.

Science.gov (United States)

Kim, Paul; Lee, Ju Kang; Lim, Oh Kyung; Park, Heung Kyu; Park, Ki Deok

2017-12-01

To predict the probability of lymphedema development in breast cancer patients in the early post-operation stage, we investigated the ability of quantitative lymphoscintigraphic assessment. This retrospective study included 201 patients without lymphedema after unilateral breast cancer surgery. Lymphoscintigraphy was performed between 4 and 8 weeks after surgery to evaluate the lymphatic system in the early postoperative stage. Quantitative lymphoscintigraphy was performed using four methods: ratio of radiopharmaceutical clearance rate of the affected to normal hand; ratio of radioactivity of the affected to normal hand; ratio of radiopharmaceutical uptake rate of the affected to normal axilla (RUA); and ratio of radioactivity of the affected to normal axilla (RRA). During a 1-year follow-up, patients with a circumferential interlimb difference of 2 cm at any measurement location and a 200-mL interlimb volume difference were diagnosed with lymphedema. We investigated the difference in quantitative lymphoscintigraphic assessment between the non-lymphedema and lymphedema groups. Quantitative lymphoscintigraphic assessment revealed that the RUA and RRA were significantly lower in the lymphedema group than in the non-lymphedema group. After adjusting the model for all significant variables (body mass index, N-stage, T-stage, type of surgery, and type of lymph node surgery), RRA was associated with lymphedema (odds ratio=0.14; 95% confidence interval, 0.04-0.46; p=0.001). In patients in the early postoperative stage after unilateral breast cancer surgery, quantitative lymphoscintigraphic assessment can be used to predict the probability of developing lymphedema.

"You're naked, you're vulnerable": Sexual well-being and body image of women with lower limb lymphedema.

Science.gov (United States)

Winch, Caleb J; Sherman, Kerry A; Smith, Katriona M; Koelmeyer, Louise A; Mackie, Helen; Boyages, John

2016-09-01

Lower-limb lymphedema is an incurable illness manifesting as visible swelling enlarging the leg(s) and/or feet, buttocks, and genitals. This study used semi-structured interviews and thematic analysis to explore sexual well-being among women with primary (congenital) lymphedema (n=11) or secondary lymphedema associated with gynecological cancer (n=8). Five themes (subthemes) summarized women's responses, with Attractiveness and Confidence (Publicly Unattractive, Privately Unconfident, Lymphedema or Aging?) describing women's central concern. These body image-related concerns accounted for sexual well-being in association with Partner Support (Availability of Support, Languages of Support, Fears About Support) and the degree of Functional Interruptions (Lymphedema in Context, Enduring Impacts, Overcoming Interruptions). Successful Lymphedema Coping (Control, Acceptance) and self-perceived ability to fulfill a valued Sexual Role also affected sexual well-being. Few differences between women with primary versus secondary lymphedema were evident. Lymphedema clinicians should screen for sexual concerns and have referral options available. Copyright © 2016 Elsevier Ltd. All rights reserved.

Surgical treatment of lymphedema of the penis and scrotum

OpenAIRE

Modolin,Miguel; Mitre,Anuar Ibrahim; Silva,José Carlos Faes da; Cintra,Wilson; Quagliano,Ana Paula; Arap,Sami; Ferreira,Marcus Castro

2006-01-01

PURPOSE: Lymphedema of the penis and scrotum, regardless of its etiology, is determined by reduced lymphatic flow with subsequent enlargement of the penis and scrotum. The clinical course of this condition is characterized by extreme discomfort for patients, with limitation of local hygiene, ambulation, sexual intercourse, and voiding in the standing position. The purpose of the present study is to present the experience and results of the treatment of lymphedema of the penis and scrotum by r...

Risk factors for self-reported arm lymphedema among female breast cancer survivors: a prospective cohort study.

Science.gov (United States)

Togawa, Kayo; Ma, Huiyan; Sullivan-Halley, Jane; Neuhouser, Marian L; Imayama, Ikuyo; Baumgartner, Kathy B; Smith, Ashley Wilder; Alfano, Catherine M; McTiernan, Anne; Ballard-Barbash, Rachel; Bernstein, Leslie

2014-08-22

Lymphedema is a potentially debilitating condition that occurs among breast cancer survivors. This study examines the incidence of self-reported lymphedema, timing of lymphedema onset, and associations between sociodemographic, clinical and lifestyle factors and lymphedema risk across racial-ethnic groups using data from a multicenter, multiethnic prospective cohort study of breast cancer survivors, the Health, Eating, Activity and Lifestyle Study. A total of 666 women diagnosed with breast cancer staged as in situ, localized or regional disease at ages 35 to 64 years were recruited through the Surveillance, Epidemiology, and End Results registries in New Mexico (non-Hispanic white and Hispanic white), Los Angeles County (black), and Western Washington (non-Hispanic white) and followed for a median of 10.2 years. We evaluated sociodemographic factors, breast cancer- and treatment-related factors, comorbidities, body mass index (BMI), hormonal factors, and lifestyle factors in relation to self-reported lymphedema by fitting Cox proportional hazards models, estimating hazard ratios (HR) and 95% confidence intervals (CI). Over the follow-up period, 190 women (29%) reported lymphedema. The median time from breast cancer diagnosis to onset of lymphedema was 10.5 months (range: 0.5 to 134.9 months). Factors independently associated with lymphedema were total/modified radical mastectomy (versus partial/less than total mastectomy; HR = 1.37, 95% CI: 1.01 to 1.85), chemotherapy (versus no chemotherapy; HR = 1.48, 95% CI: 1.09 to 2.02), no lymph nodes removed (versus ≥10 lymph nodes removed; HR = 0.17, 95% CI: 0.08 to 0.33), pre-diagnostic BMI ≥30 kg/m2 (versus BMI race/ethnicity showed that hypertension and chemotherapy were lymphedema risk factors only for black women. Breast cancer patients who have undergone extensive surgery or extensive lymph node dissection, or who have a higher BMI should be closely monitored for detection and treatment of lymphedema. Further

Upper extremity lymphedema: presence and effect on functioning five years after breast cancer treatment.

Science.gov (United States)

Shigaki, Cheryl L; Madsen, Richard; Wanchai, Ausanee; Stewart, Bob R; Armer, Jane M

2013-11-01

Our goal was to explore the effects of lymphedema on long-term adjustment among breast cancer survivors, in terms of functioning in important life environments. Limb volume measurements and psychosocial survey data were collected from women shortly after undergoing surgical intervention for breast cancer and annually thereafter. A subset of these women were selected for the current study because they had preoperative limb volume measurement data, which is best suited to determine presence and severity of lymphedema. Our final sample of 61 women had both the arm measurements (preoperative and 5-year) and survey data (baseline and 5-year) needed for this study, which comprises a secondary cross-sectional analysis of longitudinal data. A correlational approach was used to explore associations among lymphedema (presence, severity, and whether the participant met the criteria for lymphedema at any assessment point since their treatment for breast cancer) and outcome variables (physical functioning, vocational functioning, social functioning, domestic functioning, and sexual functioning). Each of the three measures of lymphedema was significantly correlated with domestic functioning, but not with functioning in other common environments. Long-term breast cancer survivors are at risk for developing secondary conditions, such as lymphedema, to which they must learn to adjust and adapt. Lymphedema may increase risk for compromised functioning in everyday environments, a problem which lies at the heart of rehabilitation. Breast cancer survivorship, therefore, fits well within the scope of a rehabilitation framework. PsycINFO Database Record (c) 2013 APA, all rights reserved.

FILAR I AL LYMPHEDEMA LOWER LIMB DEBULKING 34 CASES

Directory of Open Access Journals (Sweden)

Baburao

2015-10-01

Full Text Available There are various treatment options in the management of filarial lymphedema of the lower extremities. The end point, regardless of the method adopted is a reduction of the girth of the limb, prevention of future increases in limb girth, prevention of recurrent episodes of streptococcal cellulitis; more important the treatment method used should not lead to any secondary problems that may far out shadow the primary co Majority of the methods adopted are mainly of the secondary prevention kind; very few of the procedures to date cure the disease condition. A few of the methods have been historically found to be more effective than the others; this may be real or apparent as the methodology of - reporting swelling in the lower limb may not have been consistent and there are too many variables to consider. This study seeks to evaluate the efficacy of one such treatment protocol for the management of filarial lymphedema of the lower limb 80 patients were admitted for filarial lymphedema of the lower limbs from 2005 to 2015 Of these 42 patients underwent surgical treatment; operative records for 8 of these patients was insufficient to analyse; among the remaining 34 patients 19 patients were unavailable for review. This left us a patient population of 15 for the final analysis . The surgical treatment of all of the 15 patients was identical, after preop preparation by using compression ba n dages to soften the edema along with a period of bed rest debulking of excess skin and subcutaneous tissue and primary closure was done. The intro operative application of Esmarch bandages helped in expelling fluid from the tissues and this ensured that closure was obtained with no tension at the margins. Patients were kept for at least 5 days post op before discharge; the routine use of compression crepe bandages postop along with bed rest ensured that we did not have a single case of skin necrosis or wound disruption in the postop period. All patients were given

The effect of mechanical lymph drainage accompanied with heat on lymphedema.

Science.gov (United States)

Mariana, Valente Flávia; de Fátima, Guerreiro Godoy Maria; Maria, Pereira de Godoy José

2011-11-01

Thermotherapy has been indicated by some researchers as a treatment for lymphedema. A study comparing temperatures demonstrated that a temperature of 40°C significantly increased the transportation of lymph compared to other temperatures assessed. The aim of this study was to evaluate the possible benefits of mechanical lymph drainage accompanied with heat in the treatment of lymphedema of the lower limbs. In a cross-over randomized study, the effect of heat on lymph drainage was evaluated in the treatment of leg lymphedema. The study, performed in the Godoy Clinic in São Jose do Rio Preto, Brazil, involved seven patients (two males and five females) with leg lymphedema. The patients' ages ranged from 18 to 79 years old with a mean of 48.5 years. The subjects underwent a total of 38 assessments including 19 evaluations of mechanical lymph drainage alone and 19 combined with thermotherapy. Heat was applied using an electric blanket which was wrapped around the legs of the patients. The volume of legs was evaluated by water plethysmography before and after treatment sessions. The paired t-test was used for statistical analysis with an alpha error of p = 0.05 being considered as acceptable. No statistically significant differences were evidenced between mechanical lymph drainage alone and lymph drainage combined with thermotherapy. There was no obvious synergic effect in the immediate post-treatment period when heat was combined with mechanical lymph drainage in the treatment of lymphedema.

Lower limb lymphedema: experiences and perceptions of cancer patients in the late palliative stage.

Science.gov (United States)

Frid, Marianne; Strang, Peter; Friedrichsen, Maria J; Johansson, Karin

2006-01-01

Lower limb lymphedema (LLL) is a common but neglected problem in palliative cancer patients. No studies have focused on these patients' experiences of lymphedema. The aims of this study were to explore patients' experiences regarding LLL and how they manage to deal with this in the late palliative stage. Thirteen patients with cancer-related LLL were included to satisfy a maximum variation sampling strategy. Interviews were analyzed using a qualitative phenomenographic method. LLL influenced the patients' thoughts about the future. Body image was often strongly influenced. Interactions with other persons were perceived as both positive and negative, and a range of coping strategies were expressed. LLL can exert a considerable influence on the physical experiences and the psychosocial situation of cancer patients in palliative care. Areas in need of increased education, attention, and further research are highlighted.

Exercise barriers self-efficacy: development and validation of a subcale for individuals with cancer-related lymphedema.

Science.gov (United States)

Buchan, Jena; Janda, Monika; Box, Robyn; Rogers, Laura; Hayes, Sandi

2015-03-18

No tool exists to measure self-efficacy for overcoming lymphedema-related exercise barriers in individuals with cancer-related lymphedema. However, an existing scale measures confidence to overcome general exercise barriers in cancer survivors. Therefore, the purpose of this study was to develop, validate and assess the reliability of a subscale, to be used in conjunction with the general barriers scale, for determining exercise barriers self-efficacy in individuals facing lymphedema-related exercise barriers. A lymphedema-specific exercise barriers self-efficacy subscale was developed and validated using a cohort of 106 cancer survivors with cancer-related lymphedema, from Brisbane, Australia. An initial ten-item lymphedema-specific barrier subscale was developed and tested, with participant feedback and principal components analysis results used to guide development of the final version. Validity and test-retest reliability analyses were conducted on the final subscale. The final lymphedema-specific subscale contained five items. Principal components analysis revealed these items loaded highly (>0.75) on a separate factor when tested with a well-established nine-item general barriers scale. The final five-item subscale demonstrated good construct and criterion validity, high internal consistency (Cronbach's alpha = 0.93) and test-retest reliability (ICC = 0.67, p exercise barriers self-efficacy in individuals with cancer-related lymphedema. This scale can be used in conjunction with an existing general exercise barriers scale to enhance exercise adherence in this understudied patient group.

Volume and Tissue Composition Changes Measured with Dual-Energy X-Ray Absorptiometry in Melanoma-Related Limb Lymphedema

DEFF Research Database (Denmark)

Gjorup, Caroline A; Hendel, Helle W; Zerahn, Bo

2017-01-01

Abstracts Background: The aim of this cross-sectional study was to investigate the volume, fat mass, and lean mass in both upper and lower limbs measured with dual-energy X-ray absorptiometry (DXA) in melanoma patients with melanoma-related limb lymphedema. METHODS AND RESULTS: Four hundred thirty...... lymphedema was diagnosed on the basis of history and characteristic physical findings on the clinical examination. The inter-limb differences in volume, fat mass, and lean mass measured with DXA were categorized as none/mild, moderate, or severe according to reference values (taking handedness into account......, and the majority of lymphedemas were categorized as mild. The increase in the volume of limbs with lymphedema was primarily due to an increase in fat mass. CONCLUSION: There is a high prevalence of melanoma-related limb lymphedema. The increase in volume in the limb with lymphedema is primarily due to an increase...

Predictors of Lymphedema Following Breast Cancer Surgery

National Research Council Canada - National Science Library

Swenson, Karen K

2006-01-01

.... Cases will be identified in the physical therapy or cancer centers. Controls will be identified using the oncology registry and include patients with breast cancer surgery who have not developed lymphedema...

Diagnostic accuracy of fluorescence microlymphography for detecting limb lymphedema.

Science.gov (United States)

Keo, H H; Husmann, M; Groechenig, E; Willenberg, T; Gretener, S B

2015-04-01

Fluorescence microlymphography (FML) is a minimally invasive technique for visualization of the cutaneous lymphatic network. The aim of the study was to assess the accuracy and safety of FML in patients with unilateral lymphedema. This was a cross sectional study. Patients with unilateral leg swelling were assessed and compared with the unaffected contralateral limb. FML was performed in all index legs and the contralateral leg by injecting 0.1 mL of fluorescein isothiocyanate (FITC)-labeled dextran intradermally in both limbs at the same level. The most prominent swelling of the affected limb was the anatomical reference. The spread of the dye in the lymphatic capillaries of the skin was measured in all dimensions by epiluminator intravital microscopy and the maximum dye spread value 10 min after injection was used for statistical analysis. The contralateral leg served as control. Test accuracy and receiver operator characteristic (ROC) analysis was performed to assess threshold values that best predict lymphedema. Between March 2008 and February 2014 seventy patients with unilateral chronic leg swelling were clinically diagnosed with lymphedema. The median age was 45 (IQR 27-56) years. Of those, 46 (65.7%) were female and 71.4% had primary and 28.6% secondary lymphedema. Sensitivity, specificity, positive and negative likelihood ratio, and positive and negative predictive value were 94.3%, 78.6%, 4.40, 0.07, 81.5%, and 93.2% for the 12 mm cut off level and 91.4%, 85.7%, 6.40, 0.10, 86.5%, and 90.9% for the 14 mm cut off level, respectively. The area under the ROC curve was 0.89 (95% CI: 0.83-0.95). No major adverse events were observed. FML is an almost atraumatic and safe technique for detecting lymphedema in patients with leg swelling. In this series the greatest accuracy was observed at a cut off level of ≥14 mm maximum spread. Copyright © 2015 European Society for Vascular Surgery. Published by Elsevier Ltd. All rights reserved.

Effects of Kinesio Taping on breast cancer-related lymphedema: A meta-analysis in clinical trials.

Science.gov (United States)

Kasawara, Karina Tamy; Mapa, Jéssica Monique Rossetti; Ferreira, Vilma; Added, Marco Aurélio Nemitalla; Shiwa, Silvia Regina; Carvas, Nelson; Batista, Patricia Andrade

2018-05-01

Lymphedema is known as a secondary complication of breast cancer treatment, caused by reduction on lymphatic flow and lymph accumulation on interstitial space. The Kinesio Taping (KT) has become an alternative treatment for lymphedema volume reduction. The objective of the study was to evaluate the literature through a systematic review on KT effects on lymphedema related to breast cancer. Search strategies were performed by the following keywords: "Kinesio Taping," "Athletic Tape," "Cancer," "Neoplasm," "Lymphedema," and "Mastectomy" with derivations and different combinations. The following databases were accessed: SCIELO, LILACS, MEDLINE via PubMed, and PEDro, between 2009 and 2016. Studies published in English, Portuguese, and Spanish were considered for inclusion. The studies' methodological quality was assessed by the PEDro scale. Seven studies were identified by the search strategy and eligibility. All of them showed positive effect in reducing lymphedema (perimeter or volume) before versus after treatment. However, with no effects comparing the KT versus control group or others treatments (standardized mean difference = 0.04, confidence interval 95%: -0.24; 0.33), the average score of the PEDro scale was 4.71 points. KT was effective on postmastectomy lymphedema related to breast cancer; however, it is not more efficient than other treatments.

Giant lymphedema of the penis and scrotum: a case report

OpenAIRE

Vives, Franklin; Garc?a-Perdomo, Herney Andr?s; Ocampo-Fl?rez, Ginna Marcela

2016-01-01

Lymphedema of the penis and scrotum is a rare entity characterized by enlargement of the skin and subcutaneous tissue of the genital region due to lymphatic drainage impairment. This clinical condition is more frequent in tropical countries due to a higher incidence of filariasis, which, in turn, is the main etiology. We describe the case of a 33-year-old man with large lymphedema of the scrotum and penis due to an acute and chronic inflammatory process, foreign body granuloma, and marked hya...

Risk factors for breast cancer-related upper extremity lymphedema: a meta-analysis

International Nuclear Information System (INIS)

Xie Yuhuan; Guo Qi; Liu Fenghua; Zhu Yaqun; Tian Ye

2014-01-01

Objective: To systematically evaluate the risk factors for upper extremity lymphedema after breast cancer treatment and the strength of their associations. Methods: PubMed, Ovid, EMbase, and the Cochrane Library were searched to identify clinical trials published up to December 2012. The quality of included studies was assessed by the Newcastle-Ottawa Scale;data analysis was performed by Stata 10.0 and RevMan 5.2; the strength of associations between risk factors and breast cancer-related upper extremity lymphedema was described as odds ratio (OR) and 95% confidence intervals (CI). Results: Twenty-two studies involving 10106 patients were included in the meta-analysis. The risk factors for upper extremity lymphedema after breast cancer treatment mainly included axillary lymph node dissection (OR=2.72, 95% CI=1.06-6.99, P=0.038), hypertension (OR=1.84, 95% CI=1.38-2.44, P=0.000), body mass index (OR=1.68, 95% CI=1.22-2.32, P=0.001), and radiotherapy (OR=1.65, 95% CI=1.20-2.25, P=0.002), while no significant associations were found for such factors as chemotherapy, age, number of positive lymph nodes, and number of dissected lymph nodes. Conclusions: The incidence of upper extremity lymphedema is high among patients with breast cancer after treatment, and axillary lymph node dissection, hypertension,body mass index, and radiotherapy are the main risk factors for lymphedema after breast cancer treatment. (authors)

VEGF-C gene therapy augments postnatal lymphangiogenesis and ameliorates secondary lymphedema

OpenAIRE

Yoon, Young-sup; Murayama, Toshinori; Gravereaux, Edwin; Tkebuchava, Tengiz; Silver, Marcy; Curry, Cynthia; Wecker, Andrea; Kirchmair, Rudolf; Hu, Chun Song; Kearney, Marianne; Ashare, Alan; Jackson, David G.; Kubo, Hajime; Isner, Jeffrey M.; Losordo, Douglas W.

2003-01-01

Although lymphedema is a common clinical condition, treatment for this disabling condition remains limited and largely ineffective. Recently, it has been reported that overexpression of VEGF-C correlates with increased lymphatic vessel growth (lymphangiogenesis). However, the effect of VEGF-C–induced lymphangiogenesis on lymphedema has yet to be demonstrated. Here we investigated the impact of local transfer of naked plasmid DNA encoding human VEGF-C (phVEGF-C) on two animal models of lymphed...

Tissue dielectric constant and circumference measurement in the follow-up of treatment-related changes in lower-limb lymphedema.

Science.gov (United States)

Tugral, Alper; Viren, Tuomas; Bakar, Yesim

2018-02-01

Lymphedema of lower limbs is a chronic condition that requires life-long management. Therapeutic effect of complex decongestive physiotherapy (CDP) is most often followed by circumference measurements (CM). However, the CM measurements are not specific to interstitial tissue fluid and have problems in sensitivity and objectivity. The aim of present study was to evaluate the therapeutic effect of CDP with a new tissue water specific measurement technique, in patients with lower limb lymphedema (LLL). A total of 17 patients with unilateral LLL (11 primary, 6 secondary lymphedema) were recruited in this study. CDP was applied for 5 days a week for 4 weeks. CM measurement of both limbs was performed at nine sites along limb by tape measure. Percentage skin water content (PWC) of thigh, calf and ankle was measured in affected lymphedema limb and contralateral limb with MoistureMeterD Compact (MMDC) device. Inter-limb PWC ratio was calculated by dividing affected side's PWC value with PWC of contralateral limb. Patients were asked to fullfill the Lymph Quality of Life Questionnaire. Significant reduction of circumference after CDP was detected at all nine measurement sites along lower limb (Pwater at thigh, calf and ankle measurement sites after CDP (Plimb PWC ratios demonstrated significant reduction of edema between affected and contraletral limbs post-treatment (Plimb PWC ratios were meaningful tools to follow the effect of therapautic intervention. Compared with CM measurements the TDC technique offered easier, quicker, objective and more practical measurements for routine assessments of LLL.

Efficacy and safety of far infrared radiation in lymphedema treatment: clinical evaluation and laboratory analysis.

Science.gov (United States)

Li, Ke; Zhang, Zheng; Liu, Ning Fei; Feng, Shao Qing; Tong, Yun; Zhang, Ju Fang; Constantinides, Joannis; Lazzeri, Davide; Grassetti, Luca; Nicoli, Fabio; Zhang, Yi Xin

2017-04-01

Swelling is the most common symptom of extremities lymphedema. Clinical evaluation and laboratory analysis were conducted after far infrared radiation (FIR) treatment on the main four components of lymphedema: fluid, fat, protein, and hyaluronan. Far infrared radiation is a kind of hyperthermia therapy with several and additional benefits as well as promoting microcirculation flow and improving collateral lymph circumfluence. Although FIR therapy has been applied for several years on thousands of lymphedema patients, there are still few studies that have reported the biological effects of FIR on lymphatic tissue. In this research, we investigate the effects of far infrared rays on the major components of lymphatic tissue. Then, we explore the effectiveness and safety of FIR as a promising treatment modality of lymphedema. A total of 32 patients affected by lymphedema in stage II and III were treated between January 2015 and January 2016 at our department. After therapy, a significant decrease of limb circumference measurements was noted and improving of quality of life was registered. Laboratory examination showed the treatment can also decrease the deposition of fluid, fat, hyaluronan, and protein, improving the swelling condition. We believe FIR treatment could be considered as both an alternative monotherapy and a useful adjunctive to the conservative or surgical lymphedema procedures. Furthermore, the real and significant biological effects of FIR represent possible future applications in wide range of the medical field.

Lymphedema secondary to filariasis

International Nuclear Information System (INIS)

Leonard, J.C.; Humphrey, G.B.; Basmadjian, G.

1985-01-01

A 1-year-old immunodeficient boy developed brawny edema of the left foot. Lymphoscintigraphy revealed no evidence of left inguinal activity following pedal injection of Tc-99m-Sn phosphate. Over the next two months, the patient developed lymphedema on the right and repeat scintigraphy demonstrated no movement of isotope from the dorsum of either foot. Subsequent studies identified microfilaria in a nocturnal blood smear, which were thought to represent Brugia beaveri acquired by mosquito transmission in Oklahoma

Evaluation of Clinical Manifestations in Patients with Severe Lymphedema with and without CCBE1 Mutations

NARCIS (Netherlands)

Alders, M.; Mendola, A.; Adès, L.; Al Gazali, L.; Bellini, C.; Dallapiccola, B.; Edery, P.; Frank, U.; Hornshuh, F.; Huisman, S. A.; Jagadeesh, S.; Kayserili, H.; Keng, W. T.; Lev, D.; Prada, C. E.; Sampson, J. R.; Schmidtke, J.; Shashi, V.; van Bever, Y.; van der Aa, N.; Verhagen, J. M.; Verheij, J. B.; Vikkula, M.; Hennekam, R. C.

2013-01-01

The lymphedema-lymphangiectasia-intellectual disability (Hennekam) syndrome (HS) is characterised by a widespread congenital lymph vessel dysplasia manifesting as congenital lymphedema of the limbs and intestinal lymphangiectasia, accompanied by unusual facial morphology, variable intellectual

Readability, complexity, and suitability analysis of online lymphedema resources.

Science.gov (United States)

Tran, Bao Ngoc N; Singh, Mansher; Lee, Bernard T; Rudd, Rima; Singhal, Dhruv

2017-06-01

Over 72% of Americans use online health information to assist in health care decision-making. Previous studies of lymphedema literature have focused only on reading level of patient-oriented materials online. Findings indicate they are too advanced for most patients to comprehend. This, more comprehensive study, expands the previous analysis to include critical elements of health materials beyond readability using assessment tools to report on the complexity and density of data as well as text design, vocabulary, and organization. The top 10 highest ranked websites on lymphedema were identified using the most popular search engine (Google). Website content was analyzed for readability, complexity, and suitability using Simple Measure of Gobbledygook, PMOSE/iKIRSCH, and Suitability Assessment of Materials (SAM), respectively. PMOSE/iKIRSCH and SAM were performed by two independent raters. Fleiss' kappa score was calculated to ensure inter-rater reliability. Online lymphedema literature had a reading grade level of 14.0 (SMOG). Overall complexity score was 6.7 (PMOSE/iKIRSCH) corresponding to "low" complexity and requiring a 8th-12th grade education. Fleiss' kappa score was 80% (P = 0.04, "substantial" agreement). Overall suitability score was 45% (SAM) correlating to the lowest level of "adequate" suitability. Fleiss' kappa score was 76% (P = 0.06, "substantial" agreement). Online resources for lymphedema are above the recommended levels for readability and complexity. The suitability level is barely adequate for the intended audience. Overall, these materials are too sophisticated for the average American adult, whose literacy skills are well documented. Further efforts to revise these materials are needed to improve patient comprehension and understanding. Copyright © 2017 Elsevier Inc. All rights reserved.

Patient compliance with a health care provider referral for an occupational therapy lymphedema consult.

Science.gov (United States)

Dominick, Sally A; Natarajan, Loki; Pierce, John P; Madanat, Hala; Madlensky, Lisa

2014-07-01

Limited information exists on breast cancer patients' compliance to attend outpatient appointments with an occupational therapy (OT) lymphedema specialist. The objectives of this study were (1) to examine patient compliance with a health care provider referral for an OT lymphedema consult and (2) to identify potential barriers to compliance. A retrospective chart review of female breast cancer patients at the UC San Diego Health System was conducted. Electronic medical records were queried for breast cancer patients, who received a health care provider referral for an OT lymphedema consult between June 1, 2010 and December 31, 2011. Descriptive statistics and Fisher's exact chi-square tests were used to examine how specific participant characteristics were associated with attending an OT appointment. A total of 210 female patients received an OT referral from a health care provider related to their breast cancer diagnosis. Forty-three (20.5%) patients did not attend an OT appointment. Non-attenders were more likely to have had fewer lymph nodes removed (Pcancer patients attended recommended OT lymphedema consults, a substantial number of women might benefit from further education about OT for lymphedema prevention following breast cancer treatment. Further research to understand barriers to attendance is recommended, particularly among women with only sentinel nodes removed.

MR imaging, proton MR spectroscopy, ultrasonographic, histologic findings in patients with chronic lymphedema.

Science.gov (United States)

Fumiere, E; Leduc, O; Fourcade, S; Becker, C; Garbar, C; Demeure, R; Wilputte, F; Leduc, A; Delcour, C

2007-12-01

Lymphedema is a progressive disease with multiple alterations occurring in the dermis. We undertook this study using high-frequency ultrasonography (US), magnetic resonance imaging, proton MR spectroscopy and histology to examine structural changes occurring in the subcutaneous tissue and precisely describe the nature of intralobular changes in chronic lymphedema. Four cutaneous and subcutaneous tissue biopsies from patients with chronic lymphedema during lymphonodal transplantation were studied. We performed US with a 13.5 MHz transducer, TSE T1 and TSE T2 magnetic resonance images with and without fat-suppression, MR Chemical Shift Imaging Spectroscopy and histological evaluation on these biopsies. We found that normal subcutaneous septa are seen as hyperechogenic lines in US and hyposignal lines in MRI and that hyperechogenic subcutis in US can be due to interlobular and intralobular water accumulation and/or to interlobular and intralobular fibrosis. Our study also confirms the usefulness of MR spectroscopy to assess water or fat content of soft tissue. Thus, multiple imaging modalities may be necessary to precisely delineate the nature of tissue alterations in chronic lymphedema.

Risk of secondary lymphedema in breast cancer survivors is related to serum phospholipid fatty acid desaturation.

Science.gov (United States)

Ryu, Eunjung; Yim, Seung Yun; Do, Hyun Ju; Lim, Jae-Young; Yang, Eun Joo; Shin, Min-Jeong; Lee, Seung-Min

2016-09-01

Secondary lymphedema is a common irreversible side effect of breast cancer surgery. We investigated if risk of secondary lymphedema in breast cancer survivors was related to changes in serum phospholipid fatty acid composition. Study subjects were voluntarily recruited into the following three groups: breast cancer survivors who had sentinel lymph node biopsy without lymphedema (SLNB), those who had auxillary lymph node dissection without lymphedema (ALND), and those who had ALND with lymphedema (ALND + LE). Body mass index (BMI), serum lipid profiles, bioimpedance data with single-frequency bioimpedance analysis (SFBIA), and serum phospholipid compositions were analyzed and compared among the groups. BMI, serum total cholesterol (total-C), and low-density lipoprotein cholesterol (LDL-C) and SFBIA ratios increased only in the ALND + LE. High polyunsaturated fatty acids (PUFAs) and high C20:4 to C18:2 n-6 PUFAs (arachidonic acid [AA]/linoleic acid [LA]) was detected in the ALND and ALND + LE groups compared to SLNB. The ALND + LE group showed increased activity indices for delta 6 desaturase (D6D) and D5D and increased ratio of AA to eicosapentaenoic acid (AA/EPA) compared to the ALND and SLNB groups. Correlation and regression analysis indicated that D6D, D5D, and AA/EPA were associated with SFBIA ratios. We demonstrated that breast cancer survivors with lymphedema had elevated total PUFAs, fatty acid desaturase activity indices, and AA/EPA in serum phospholipids. Our findings suggested that desaturation extent of fatty acid composition might be related to the risk of secondary lymphedema in breast cancer survivors.

Bioelectrical impedance for detecting and monitoring lymphedema in patients with breast cancer. Preliminary results of the florence nightingale breast study group.

Science.gov (United States)

Erdogan Iyigun, Zeynep; Selamoglu, Derya; Alco, Gul; Pilancı, Kezban Nur; Ordu, Cetin; Agacayak, Filiz; Elbüken, Filiz; Bozdogan, Atilla; Ilgun, Serkan; Guler Uysal, Fusun; Ozmen, Vahit

2015-03-01

The aim of this study was to evaluate the efficacy of bioimpedance spectroscopy for the follow-up of patients with lymphedema in Turkey and its benefits in the diagnosis of stage 0, 1, and 2 lymphedema in patients who are under treatment for breast cancer. Thirty-seven female patients with breast cancer who underwent surgical procedures in our Breast Health Centre were followed up for lymphedema using bioimpedance, and clinical measurements were taken for a minimum period of 1 year at 3-month intervals. Patients who had been monitored regularly between November, 2011, and September, 2013, were enrolled to the study. In total, 8 patients developed lymphedema with an overall rate of 21.6%. Among the 8 patients who developed lymphedema, 4 had Stage 2, 1 had Stage 1, and 3 had Stage 0 lymphedema. Stage 0 lymphedema could not be detected with clinical measurements. During the patients' 1-year follow-up period using measurements of bioimpedance, a statistically significant relationship was observed between the occurrence of lymphedema and the disease characteristics. including the number of the extracted and remaining lymph nodes and the region of radiotherapy (p=0.042, p=0.024, p=0.040). Bioimpedance analysis seems to be a practical and reliable method for the early diagnosis of lymphedema. It is believed that regular monitoring of patients in the high-risk group using bioimpedance analyses increases the ability to treat lymphedema.

Effects of Clinical Pilates Exercises on Patients Developing Lymphedema after Breast Cancer Treatment: A Randomized Clinical Trial.

Science.gov (United States)

Şener, Hülya Özlem; Malkoç, Mehtap; Ergin, Gülbin; Karadibak, Didem; Yavuzşen, Tuğba

2017-01-01

The aim of the present study was to compare the effects of clinical Pilates exercises with those of the standard lymphedema exercises on lymphedema developing after breast cancer treatment. The study comprised 60 female patients with a mean age of 53.2±7.7 years who developed lymphedema after having breast cancer treatment. The patients were randomized into two groups: the clinical Pilates exercise group (n=30), and the control group (n=30). Before, and at the 8th week of treatment, the following parameters were measured: the severity of lymphedema, limb circumferences, body image using the Social Appearance Anxiety Scale, quality of life with the European Organization for Research and Treatment of Cancer (EORTC) quality of life questionnaire (QLQ-BR23), and upper extremity function using the Disabilities of the Arm, Shoulder and Hand (DASH) outcome measure. Both groups performed one-hour exercises three days a week for 8 weeks. After treatment, the symptoms recovered significantly in both groups. Reductions in the severity of lymphedema, improvements in the social appearance anxiety scale scores, quality of life scores, and upper extremity functions scores in the clinical Pilates exercise group were greater than those in the control group. Clinical Pilates exercises were determined to be more effective on the symptoms of patients with lymphedema than were standard lymphedema exercises. Clinical Pilates exercises could be considered a safe model and would contribute to treatment programs.

Acute Truncal Lymphedema Secondary to Axillary Metastatic Melanoma Presenting Like Cellulitis

Directory of Open Access Journals (Sweden)

Shelley J. E. Hwang

2017-01-01

Full Text Available There are reported cases of diphencyprone used in treating cutaneous metastases of melanoma. Here, we report a patient with previous primary melanoma on his left back treated with surgical excision and lymphadenectomy, followed by radiotherapy for the recurrent tumor on the primary site. Despite radiotherapy and treatment with dabrafenib and trametinib, in-transit metastases have developed and topical diphencyprone was applied to these metastases. Six weeks later, the patient developed fever and a spreading erythematous tender indurated plaque covering the left side of the body including axillae, back, and flank, clinically suggestive of cellulitis. Systemic antibiotic therapy did not improve the condition and a biopsy showed sparse lymphocytic infiltrate. With the diagnosis of possible acute lymphedema, a CT scan was requested that showed significant axillary lymph node metastasis. The fever was considered secondary to dabrafenib and trametinib therapy. This case highlights that, in patients with lymphadenectomy, atypical forms of lymphedema on the body may appear. Truncal lymphedema is an infrequent event.

Surgical-site infection following lymph node excision indicates susceptibility for lymphedema

DEFF Research Database (Denmark)

Jørgensen, Mads Gustaf; Toyserkani, Navid Mohamadpour; Thomsen, Jørn Bo

2018-01-01

BACKGROUND AND OBJECTIVES: Cancer-related lymphedema is a common complication following lymph node excision. Prevention of lymphedema is essential, as treatment options are limited. Known risk factors are firmly anchored to the cancer treatment itself; however potentially preventable factors...... such as seroma and surgical-site infection (SSI) have yet to be asserted. METHODS: All malignant melanoma patients treated with sentinel lymph node biopsy (SNB) and/or complete lymph node dissection (CLND) in the axilla or groin between January 2008 and December 2014 were retrospectively identified. Identified...

Effect of lymphedema treatment. The interim report of prospective study at multiple facilities

International Nuclear Information System (INIS)

Hamamoto, Takako; Ogata, Minako; Satoh, Kayoko; Ashino, Yoshikazu

2009-01-01

We are in the process of analyzing the effect of complex physical therapy (CPT) for the patients of secondary lymphedema associated with cancer treatment. At this time, we present an interim report of the past 3 months started in March 2009. We classified the lymphedema stage into four stages based on the International Society of Lymphology criterion using the imaging diagnosis (ultrasonography (US), CT, etc.) in addition to a conventional observation. We also classified the CPT treatment period into two in accordance with water retention in the subcutaneous adipose tissue of the limbs. CPT was performed by the specialist of lymphedema treatment. We used the change in volume of limbs and quality of life (QOL) evaluation by SF-36 and Skindex29 for analysis. On this report, the volume of limbs, which has lymphedema and an improvement on SF-36, did not change significantly. This may have been resulted from not having enough follow-up period and lack of few cases at each stage in the analysis. However, we confirmed that the general and emotion evaluation on Skindex29 showed a meaningful change. We are still planning to accumulate more cases and study them for further detailed analysis. (author)

[Exudative enteropathy in congenital lymphedema-lymphangiectasia syndrome].

Science.gov (United States)

Heruth, M; Müller, P; Liebscher, L; Kurze, G; Richter, T

2006-01-01

Congenital peripheral elephantiasiformic alterations are very rare in paediatric patients. In a patient with lymphangiectasia-lymphedema syndrome we demonstrate over a 8-year follow-up that not only cosmetic and social indications for surgical treatments but also internal care become important during the course. We report on a boy with congenital lymphedemas of the extremities and the genital region, which were several times surgically treated. The patient became symptomatic firstly with tetanic cramps caused by malabsorption syndrome due to intestinal lymphangiectasia at the age of 6 years. Synopsis of clinical and laboratory findings and the patient's course are pointing to a mild Hennekam syndrome with still unknown aetiology. The boy developed adequately with permanent oral substitution of electrolytes and vitamins, protein-rich diet, supplementation of medium-chain fatty acids and compressing bandages. Infusions of human albumin to correct persistent hypalbuminemia as well as cytostatic treatment with cyclophosphamide as a formal trial were ineffective and are not advisable, therefore.

Giant cell angiofibroma or localized periorbital lymphedema?

Science.gov (United States)

Lynch, Michael C; Chung, Catherine G; Specht, Charles S; Wilkinson, Michael; Clarke, Loren E

2013-12-01

Giant cell angiofibroma represents a rare soft tissue neoplasm with a predilection for the orbit. We recently encountered a mass removed from the lower eyelid of a 56-year-old female that histopathologically resembled giant cell angiofibroma. The process consisted of haphazardly arranged CD34-positive spindled and multinucleated cells within an edematous, densely vascular stroma. However, the patient had recently undergone laryngectomy and radiotherapy for a laryngeal squamous cell carcinoma. A similar mass had arisen on the contralateral eyelid, and both had developed several months post-therapy. Lymphedema of the orbit can present as tumor-like nodules and in some cases may share histopathologic features purported to be characteristic of giant cell angiofibroma. A relationship between giant cell angiofibroma and lymphedema has not been established, but our case suggests there may be one. The potential overlap of these two conditions should be recognized, as should other entities that may enter the differential diagnosis. © 2013 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Upper extremity function and quality of life in patients with breast cancer related lymphedema

Directory of Open Access Journals (Sweden)

Bojinović-Rodić Dragana

2016-01-01

Full Text Available Background/Aim. Upper limb lymphedema is one of the most frequent chronic complications after breast cancer treatment with a significant impact on the upper extremity function and quality of life (QoL. The aim of this study was to estimate health-related quality of life (HRQoL in patients with breast-cancer-related lymphedema and its correlation with upper limb function and the size of edema. Methods. The cross-sectional study included 54 breast-cancer-related lymphedema patients. The quality of life was evaluated by the Short Form 36-Item Health Survey (SF-36. Upper limb function was assessed by the Quick Disability of the Arm, Shoulder and Hand questionnaire (Quick DASH. The size of lymphedema was determined by the arm circumference. Results. The higher HRQoL score was assessed for mental health (47.0 ± 12.2 than for physical one (42.2 ± 7.5. The highest values of SF-36 were found in the domains of Mental Health (67.7 ± 22.9 and Social Function (70.1 ± 23.1. The lowest scores were registered in the domains of Role Physical (46.9 ± 39.1 and General Health (49.3 ± 20.1. Upper extremity function statistically significantly correlated with the domains Role Physical, Bodily Pain and Physical Composite Summary and also, with the domain Role Emotional (p 0.05. Conclusions. Physical disability in patients with breast cancer-related lymphedema influences quality of life more than mental health. Upper limb function has a significant impact on quality of life, not only on the physical, but also on the mental component. The presence of breast-cancer-related lymphedema certainly affects upper limb function and quality of life, but in this study no significant correlation between the size of edema and quality of life was found.

The Impact of Radiation Therapy on the Risk of Lymphedema After Treatment for Breast Cancer: A Prospective Cohort Study

Energy Technology Data Exchange (ETDEWEB)

Warren, Laura E.G.; Miller, Cynthia L. [Department of Radiation Oncology, Massachusetts General Hospital, Boston, Massachusetts (United States); Horick, Nora [Department of Biostatistics, Massachusetts General Hospital, Boston, Massachusetts (United States); Skolny, Melissa N.; Jammallo, Lauren S.; Sadek, Betro T.; Shenouda, Mina N. [Department of Radiation Oncology, Massachusetts General Hospital, Boston, Massachusetts (United States); O' Toole, Jean A. [Department of Physical and Occupational Therapy, Massachusetts General Hospital, Boston, Massachusetts (United States); MacDonald, Shannon M. [Department of Radiation Oncology, Massachusetts General Hospital, Boston, Massachusetts (United States); Specht, Michelle C. [Division of Surgical Oncology, Massachusetts General Hospital, Boston, Massachusetts (United States); Taghian, Alphonse G., E-mail: ataghian@partners.org [Department of Radiation Oncology, Massachusetts General Hospital, Boston, Massachusetts (United States)

2014-03-01

Purpose/Objective: Lymphedema after breast cancer treatment can be an irreversible condition with a negative impact on quality of life. The goal of this study was to identify radiation therapy-related risk factors for lymphedema. Methods and Materials: From 2005 to 2012, we prospectively performed arm volume measurements on 1476 breast cancer patients at our institution using a Perometer. Treating each breast individually, 1099 of 1501 patients (73%) received radiation therapy. Arm measurements were performed preoperatively and postoperatively. Lymphedema was defined as ≥10% arm volume increase occurring >3 months postoperatively. Univariate and multivariate Cox proportional hazard models were used to evaluate risk factors for lymphedema. Results: At a median follow-up time of 25.4 months (range, 3.4-82.6 months), the 2-year cumulative incidence of lymphedema was 6.8%. Cumulative incidence by radiation therapy type was as follows: 3.0% no radiation therapy, 3.1% breast or chest wall alone, 21.9% supraclavicular (SC), and 21.1% SC and posterior axillary boost (PAB). On multivariate analysis, the hazard ratio for regional lymph node radiation (RLNR) (SC ± PAB) was 1.7 (P=.025) compared with breast/chest wall radiation alone. There was no difference in lymphedema risk between SC and SC + PAB (P=.96). Other independent risk factors included early postoperative swelling (P<.0001), higher body mass index (P<.0001), greater number of lymph nodes dissected (P=.018), and axillary lymph node dissection (P=.0001). Conclusions: In a large cohort of breast cancer patients prospectively screened for lymphedema, RLNR significantly increased the risk of lymphedema compared with breast/chest wall radiation alone. When considering use of RLNR, clinicians should weigh the potential benefit of RLNR for control of disease against the increased risk of lymphedema.

Study Regarding the Effectiveness of Manual Lymphatic Drainage in the Case of Patients with Breast Cancer that Present Lymphedema

Directory of Open Access Journals (Sweden)

Alexandru MIOC

2013-06-01

Full Text Available Lymphedema is defined as a persistent increase of tissue volume caused by the blocked or absent lymphatic drainage. The purpose of this study is to analyse the effectiveness of lymphatic drainage in the treatment of lymphedema after a mastectomy, with the aim of reducing the volume of the lymphedema and improving overall symptomatology, as well as providing information regarding the impact of this treatment on quality-of-life and the physical limitations of these patients. With these objectives in mind, a series of articles evaluating the effectiveness of manual lymphatic drainage in the case of patients with breast cancer and lymphedema have been studied. The parameters under observation were: duration of lymphedema reduction and improved symptomatology (pain, a feeling of swelling of the upper limb, functional limitation, and patient dissatisfaction towards their body image. Following this analysis, one can conclude that the association of manual lymphatic drainage to physical exercise and physiotherapy has produced changes in the volume of the limb affected by the lymphedema; however, its isolated use has not resulted in significant changes.

Modifiable Risk Factors for Lymphedema in Breast Cancer Survivors

National Research Council Canada - National Science Library

Rossing, Mary A; Malone, Kathleen E

2004-01-01

.... In this study, we will assess whether modifiable factors, including body weight, physical activity, smoking and breast reconstruction, influence risk of arm lymphedema among women treated for breast cancer...

Modifiable Risk Factors for Lymphedema in Breast Cancer Survivors

National Research Council Canada - National Science Library

Rossing, Mary

2003-01-01

.... In this study, we will assess whether modifiable factors, including body weight, physical activity, smoking and breast reconstruction, influence risk of arm Lymphedema among women treated for breast cancer...

Prevalence of lymphedema in women undergoing treatment for breast cancer in a referral center in southeastern Brazil

Directory of Open Access Journals (Sweden)

Paiva Daniella MF

2013-02-01

Full Text Available Abstract Background Lymphedema is a highly prevalent condition in women who have undergone treatment for breast cancer. Lymphedema negatively affects the quality of life. The objective of this study was to estimate the prevalence of lymphedema and associated factors in women treated for breast cancer in the municipality of Juiz de Fora. Methods We performed a cross-sectional study that evaluated 250 women who were being treated for breast cancer. Pre-screening of the sample by analysis of medical records was performed to select women who met the inclusion criteria as follows: women who had an operation more than 6 months ago; absence of active disease, locoregional or distant; the absence of functional change in the affected limb before surgery, which could lead to swelling of the limb; and simulating or masking symptoms of lymphedema, such as bursitis, tendonitis, and work-related musculoskeletal disorders. Women with bilateral breast cancer, absence of axillary intervention (partial or complete axillary dissection and/or SLN biopsy, active disease in the region, or lympho-venous alteration of the limb before surgery were excluded. Data were collected from the medical records of the selected cases, and they subsequently underwent an interview and a physical assessment. Results The prevalence of lymphedema was 44.8%. There were medical records on the presence of this condition in 5.4% of cases. With regard to shoulder joint mobility, restrictions on abduction movements, internal and external rotation, and anterior shoulder adduction were significantly associated with lymphedema. Variables, including the presence of seroma, vascular changes, time elapsed after surgery, episodes of redness in the extremities, and cuticle removal from the hand with pliers were considered as major associated factors for lymphedema (p Conclusions The prevalence of 44.8% for lymphedema found in this study is considered to be relevant because it is a morbidity that

Giant lymphedema of the penis and scrotum: a case report.

Science.gov (United States)

Vives, Franklin; García-Perdomo, Herney Andrés; Ocampo-Flórez, Ginna Marcela

2016-01-01

Lymphedema of the penis and scrotum is a rare entity characterized by enlargement of the skin and subcutaneous tissue of the genital region due to lymphatic drainage impairment. This clinical condition is more frequent in tropical countries due to a higher incidence of filariasis, which, in turn, is the main etiology. We describe the case of a 33-year-old man with large lymphedema of the scrotum and penis due to an acute and chronic inflammatory process, foreign body granuloma, and marked hyalinization. Four consecutive surgical interventions were necessary to remove the great part of the affected tissue, which enabled satisfactory results and improved the patient's quality of life.

Refractory lymphedema of the hand: an unusual presentation of recurrent herpes simplex virus infection

Directory of Open Access Journals (Sweden)

Ali Majdzadeh

2016-07-01

Full Text Available Introduction: Herpes Simplex Virus (HSV infection of the hand resulting in lymphatic complications such as lymphangitis and lymphedema is exceedingly uncommon. Although these complications typically resolve in 21 days, they can be persistent and may not resolve even with antiviral use, thereby mimicking dyshidrotic eczema or a bacterial event and often being misdiagnosed and inappropriately treated as such. We report a case of frequently recurring HSV infection of the hand over a long period of time resulting in refractory lymphedema which did not resolve with antiviral treatment. We further endeavor to raise awareness about this highly unusual presentation of HSV infection. A comprehensive review of the literature was conducted for similar cases using PubMed and Medline. Case Report: This is the first reported case with nearly a decade-long interval between the onset of primary HSV infection and the development of chronic lymphedema. Although valacyclovir significantly reduced the episodic aggravation of the lymphedema, it did not entirely resolve it. Similar cases of persistent lymphedema also included a long history of untreated and recurrent HSV infection of the hand, suggesting that this lymphatic outcome may be circumvented by prompt treatment with antivirals. Conclusion: This case report not only presents a highly uncommon lymphatic manifestation and unusual timeline of exacerbation of the very common HSV infection, but also highlights the importance and benefits of early initiation of antiviral therapy and the prevention of reactivation.

Helium Neon laser therapy for post mastectomy lymphedema and ...

African Journals Online (AJOL)

Mohamed M. Khalaf

2012-12-08

Dec 8, 2012 ... mastectomy lymphedema and shoulder mobility. Mohamed M. Khalaf *. ,1 .... neurological and orthopedic problems, or diabetes. The patients were ... included 15 patients who received placebo laser therapy in addition to ...

Stewart-Treves Syndrome on the Lower Extremity Associated to Idiopathic Chronic Lymphedema Visualized on FDG PET/CT

DEFF Research Database (Denmark)

Brittain, Jane Maestri; Nymark, Tine; Hildebrandt, Malene Grubbe

2017-01-01

Angiosarcomas are highly malignant and rare tumors of vascular or lymphatic endothelial cell origin with a poor prognosis. Lymphangiosarcoma associated with chronic lymphedema is known as Stewart-Treves syndrome. Stewart-Treves syndrome is primarily described in patients with lymphedema of an upper...... extremity occurring after breast cancer surgery including radical axillary lymph node dissection and subsequent radiotherapy. It is rarely described in the presence of idiopathic chronic lymphedema of the lower extremities. We present a case of lymphangiosarcoma visualized on F-FDG PET/CT, where Stewart...

Imaging findings of adiposis dolorosa vs. massive localized lymphedema

Energy Technology Data Exchange (ETDEWEB)

Petscavage-Thomas, Jonelle M.; Bernard, Stephanie A.; Bennett, Jennifer [Milton S. Hershey Medical Center, Department of Radiology, H066, 500 University Drive, P.O. Box 850, Hershey, PA (United States); Walker, Eric A. [Milton S. Hershey Medical Center, Department of Radiology, H066, 500 University Drive, P.O. Box 850, Hershey, PA (United States); Uniformed Services University of the Health Sciences, Department of Radiology and Nuclear Medicine, Bethesda, MD (United States)

2015-06-01

Adiposis dolorosa (Dercum's disease) is a condition of benign, painful subcutaneous lipomatous lesions associated with weakness, endocrine and lipid abnormalities, and mental disturbances. There is little information documenting the cross-sectional imaging findings that differentiate it from lipomatous and neoplastic soft tissue masses, or massive localized lymphedema. The purpose of this study was to provide a radiological case series of adiposis dolorosa. A 10-year retrospective review of the picture archiving and communications system was performed. Two musculoskeletal radiologists reviewed images to confirm and document imaging features, location, size, and patient demographics. Medical records were reviewed to characterize patients into three groups: one group met at least three of the four criteria of Dercum's syndrome, the second group met less than three criteria, and the third group had clinical diagnosis of cellulitis of the lower extremity. Seventeen cases (25 masses) of adiposis dolorosa were found, nine cases of which met at least three criteria of Dercum's syndrome. All cases in the first two groups demonstrated skin thickening and lymphedema of subcutaneous fat, which was fluid attenuation on CT and low or intermediate T1-weighted and high STIR/T2-weighted MR signal. Two cases with pathology showed mild fatty infiltration with fibrous septa, and the third case showed massive localized lymphedema. The third group of ten cellulitis patients demonstrated non-mass-like subcutaneous edema with similar CT attenuation and MR signal characteristics to the first two groups, but differed by the presence of post-contrast enhancement and non-mass-like appearance in 90 %. Imaging findings of adiposis dolorosa and massive localized lymphedema overlap, as do the symptoms and pathological features. Due to the mass-like engorgement of the soft tissues and pain, patients will often undergo imaging to exclude neoplasm or infection. Knowledge of these

Dermal collagen and lipid deposition correlate with tissue swelling and hydraulic conductivity in murine primary lymphedema.

Science.gov (United States)

Rutkowski, Joseph M; Markhus, Carl Erik; Gyenge, Christina C; Alitalo, Kari; Wiig, Helge; Swartz, Melody A

2010-03-01

Primary lymphedema is a congenital pathology of dysfunctional lymphatic drainage characterized by swelling of the limbs, thickening of the dermis, and fluid and lipid accumulation in the underlying tissue. Two mouse models of primary lymphedema, the Chy mouse and the K14-VEGFR-3-Ig mouse, both lack dermal lymphatic capillaries and exhibit a lymphedematous phenotype attributable to disrupted VEGFR-3 signaling. Here we show that the differences in edematous tissue composition between these two models correlated with drastic differences in hydraulic conductivity. The skin of Chy mice possessed significantly higher levels of collagen and fat, whereas K14-VEGFR-3-Ig mouse skin composition was relatively normal, as compared with their respective wild-type controls. Functionally, this resulted in a greatly increased dermal hydraulic conductivity in K14-VEGFR3-Ig, but not Chy, mice. Our data suggest that lymphedema associated with increased collagen and lipid accumulation counteracts an increased hydraulic conductivity associated with dermal swelling, which in turn further limits interstitial transport and swelling. Without lipid and collagen accumulation, hydraulic conductivity is increased and overall swelling is minimized. These opposing tissue responses to primary lymphedema imply that tissue remodeling--predominantly collagen and fat deposition--may dictate tissue swelling and govern interstitial transport in lymphedema.

Otophyma: a case report and review of the literature of lymphedema (elephantiasis) of the ear.

Science.gov (United States)

Carlson, J Andrew; Mazza, Jill; Kircher, Kenneth; Tran, Tien Anh

2008-02-01

Phymas (swellings, masses, or bulbs) are considered the end-stage of rosacea and mostly affect the nose (rhinophyma), and rarely involve the chin (gnatophyma), the cheek (metophyma), eyelids (blepharophyma), or ears (otophyma). Herein, we report the case of a 57-year-old man who developed unilateral enlargement of his left ear over 2 years. Biopsy revealed changes of rosaceous lymphedema associated with Demodex infestation. Corticosteroid and minocycline therapies resulted in partial reduction of the ear enlargement. Literature review examining for cases of lymphedema (elephantiasis) of the ear revealed that chronic inflammatory disorders (rosacea (most frequent), psoriasis, eczema), bacterial cellulitis (erysipelas), pediculosis, trauma, and primary (congenital) lymphedema can all lead to localized, lymphedematous enlargement of the ear. Depending on the severity, medical treatment directed at the inflammatory condition for mild, diffuse enlargement to surgical debulking for extensive diffuse enlargement or tumor formation can improve the signs and symptoms of otophyma. Decreased immune surveillance secondary to rosaceous lymphedema may explain why Demodex infestation is common in rosacea and support the suspicion that phymatous skin is predisposed to skin cancer development.

Tc-99m-Human Serum Albumin Transit Time as a Measure of Arm Breast Cancer-Related Lymphedema

DEFF Research Database (Denmark)

Toyserkani, Navid M; Hvidsten, Svend; Tabatabaeifar, Siavosh

2017-01-01

34-68 years, with unilateral arm lymphedema following breast cancer treatment underwent bilateral lymphoscintigraphy using intradermal injection in both hands of technetium-99m-labeled human serum albumin and sequential 5 min imaging for 5 hours. The mean transit time (MTT) in the arms was calculated...... based on time activity curves generated from injection site and arm regions. Visual lymphedema scoring was performed based on dermal backflow and lymph node presence. Excess arm volume was calculated from circumference measurements. RESULTS: The MTT (mean ± SD) was significantly longer in the lymphedema...

Acupotomy and venesection in Upper Limb Lymphedema and Peripheral neuropathy following Breast Cancer Surgery

Directory of Open Access Journals (Sweden)

Jang Eun-ha

2009-12-01

Full Text Available Purpose: In order to estimate clinical effects of acupotomy and venesection in a patient with peripheral neuropathy and upper limb lymphedema following breast cancer surgery. Methods: From 17th August, 2009 to 29th August 2009, 1 female patient with peripheral neuropathy and upper limb lymphedema following breast cancer surgery was treated with general oriental medicine therapy(acupuncture, moxibustion, cupping, physical therapy, herbal medication and acupotomy with venesection. Results: The patient's chief complaints- Lt hand numbness, Lt arm edema, Lt. wrist flexion limitation - were notably improved. Conclusions : This study demonstrates that oriental medical treatment with acupotomy and venesection therapy has significant effect in improving symptoms of peripheral neuropathy and upper limb lymphedema following breast cancer surgery, as though we had not wide experience in this treatment, more research is needed.

Liquid silicone used for esthetic purposes as a potentiator for occurrence of post-radiotherapy genital lymphedema: case report

Directory of Open Access Journals (Sweden)

Raíssa Quaiatti Antonelli

Full Text Available ABSTRACT CONTEXT: Lymphedema consists of extracellular fluid retention caused by lymphatic obstruction. In chronic forms, fat and fibrous tissue accumulation is observed. Genital lymphedema is a rare condition in developed countries and may have primary or acquired etiology. It generally leads to urinary, sexual and social impairment. Clinical treatment usually has low effectiveness, and surgical resection is frequently indicated. CASE REPORT: We report a case of a male-to-female transgender patient who was referred for treatment of chronic genital lymphedema. She had a history of pelvic radiotherapy to treat anal cancer and of liquid silicone injections to the buttock and thigh regions for esthetic purposes. Radiological examinations showed signs both of tissue infiltration by liquid silicone and of granulomas, lymphadenopathy and lymphedema. Surgical treatment was performed on the area affected, in which lymphedematous tissue was excised from the scrotum while preserving the penis and testicles, with satisfactory results. Histopathological examination showed alterations compatible with tissue infiltration by exogenous material, along with chronic lymphedema. CONCLUSION: Genital lymphedema may be caused by an association of lesions due to liquid silicone injections and radiotherapy in the pelvic region. Cancer treatment decisions for patients who previously underwent liquid silicone injection should take this information into account, since it may represent a risk factor for radiotherapy complications.

Shoulder Pain after Fall, Septic Shock, and Pyomyositis Associated with Breast Cancer Chemotherapy and Lymphedema

Directory of Open Access Journals (Sweden)

Hiromitsu Kitayama

2016-11-01

Full Text Available Background: As a symptom of pyomyositis, sepsis usually follows local inflammation signs. Here, we report pyomyositis with lymphedema of upper extremity in which septic shock and poor local findings initially presented during chemotherapy for breast cancer. Case Report: An 80-year-old woman presented with chronic right shoulder pain during chemotherapy for the recurrent disease. She had a history of postmastectomy lymphedema, diabetes mellitus, and repeated hyaluronic acid injections to the shoulder joint. The pain suddenly worsened with septic shock and no apparent local signs. Magnetic resonance imaging revealed myonecrosis, and no pus was yielded by ultrasound-guided needle aspiration. After 2 weeks of recovery by conservative medical management, surgical drainage was performed. Late formulated massive intramuscular pus showed severe neutrophil infiltration and myonecrosis. Conclusion: Pyomyositis can develop into septic shock with poor local signs. Myelosuppression after chemotherapy can cause myonecrosis without macroabscess, and magnetic resonance imaging was useful for the diagnosis of this condition. When unspecified local pain appears during cancer chemotherapy we should consider this disease, too.

Impairment of Lymph Drainage in Subfascial Compartment of Forearm in Breast Cancer-Related Lymphedema

OpenAIRE

STANTON, A.W.B.; MELLOR, R.H.; COOK, G.J.; SVENSSON, W.E.; PETERS, A.M.; LEVICK, J.R.; MORTIMER, P.S.

2003-01-01

Background: In arm lymphedema secondary to axillary surgery and radiotherapy (breast cancer-related lymphedema), the swelling is largely epifascial and lymph flow per unit epifascial volume is impaired. The subfascial muscle compartment is not measurably swollen despite the iatrogenic damage to its axillary drainage pathway, but this could be due to its low compliance. Our aim was to test the hypothesis that subfascial lymph drainage too is impaired.

Study Regarding the Effectiveness of Manual Lymphatic Drainage in the Case of Patients with Breast Cancer that Present Lymphedema

OpenAIRE

Alexandru MIOC; Corina PANTEA

2013-01-01

Lymphedema is defined as a persistent increase of tissue volume caused by the blocked or absent lymphatic drainage. The purpose of this study is to analyse the effectiveness of lymphatic drainage in the treatment of lymphedema after a mastectomy, with the aim of reducing the volume of the lymphedema and improving overall symptomatology, as well as providing information regarding the impact of this treatment on quality-of-life and the physical limitations of these patients. With these objectiv...

Recurrent furunculosis as a cause of isolated penile lymphedema: a case report

Directory of Open Access Journals (Sweden)

Sood Suneet

2010-06-01

Full Text Available Abstract Introduction Isolated lymphedema of the penis is extremely rare: combined involvement of the scrotum and penis is the norm. Furunculosis as a cause is not, to our knowledge, previously reported. We present a case of isolated penile lymphedema that responded to excision of lymphedematous tissue and reconstruction with flaps. Case presentation A 32-year-old Arab man presented with a three-year history of a gradually increasing, painless penile swelling. Our patient's main complaint was non-erectile sexual dysfunction. The swelling was preceded by at least three prior episodes of severe furunculosis at the penile root. He had no other contributory past medical or family history. On examination there was gross penile enlargement, maximally at the mid shaft, associated with thickened skin at the sites of prior furunculosis. The glans and scrotum were normal. Both testes were palpable. Serology for filariasis, and urinary tract ultrasound and computed tomography scan were normal. The clinical diagnosis was lymphedema following recurrent penile furunculosis. At operation the lymphedematous tissues were removed. Closure of the penile shaft was accomplished by bilateral advancement of flaps from both ends of the penis. He resumed normal sexual activity one month after surgery. At 12 months, he had a good cosmetic result, with no signs of recurrence. Conclusions Furunculosis at the penile root may result in lymphedema confined to the penile shaft, sparing the scrotum. Excision of abnormal tissue and cover with a skin flap gave excellent cosmetic results, and allowed satisfactory sexual activity.

[Current wound care in patients with elephantiasis--third-stage lymphedema].

Science.gov (United States)

Rucigaj, Tanja Planinsek; Slana, Ana; Leskovec, Nada Kecelj

2012-10-01

Lymphedema resulting from fluid accumulation due to impairment in the lymphatic system drainage leads to enlargement of the body part involved. If left untreated, in its third stage it results in elephantiasis. Elephantiasis is frequently accompanied by papillomatosis and lymphocutaneous fistulas with lymphorrhoea, erosions and ulcers, frequently with the loss of function in the respective part of the body. Unlike other chronic wounds, wound healing in lymphedema is highly dependent on the use of combined therapies because local treatment with modern supportive dressings and compression therapy with adhesive and non-adhesive short-stretch systems is only part of the complete treatment. This treatment also includes sub-bandage foamy materials, kinesitherapy with tapes (kinesiotaping), intermittent local application of high-pressure oxygen, breathing exercise, and manual lymph drainage and exercises.

Filarial lymphedema is characterized by antigen-specific Th1 and th17 proinflammatory responses and a lack of regulatory T cells.

Directory of Open Access Journals (Sweden)

Subash Babu

Full Text Available Lymphatic filariasis can be associated with development of serious pathology in the form of lymphedema, hydrocele, and elephantiasis in a subset of infected patients.To elucidate the role of CD4(+ T cell subsets in the development of lymphatic pathology, we examined specific sets of cytokines in individuals with filarial lymphedema in response to parasite antigen (BmA and compared them with responses from asymptomatic infected individuals. We also examined expression patterns of Toll-like receptors (TLR1-10 and Nod-like receptors (Nod1, Nod2, and NALP3 in response to BmA. BmA induced significantly higher production of Th1-type cytokines-IFN-gamma and TNF-alpha-in patients with lymphedema compared with asymptomatic individuals. Notably, expression of the Th17 family of cytokines-IL-17A, IL-17F, IL-21, and IL-23-was also significantly upregulated by BmA stimulation in lymphedema patients. In contrast, expression of Foxp3, GITR, TGFbeta, and CTLA-4, known to be expressed by regulatory T cells, was significantly impaired in patients with lymphedema. BmA also induced significantly higher expression of TLR2, 4, 7, and 9 as well Nod1 and 2 mRNA in patients with lymphedema compared with asymptomatic controls.Our findings implicate increased Th1/Th17 responses and decreased regulatory T cells as well as regulation of Toll- and Nod-like receptors in pathogenesis of filarial lymphedema.

Arm Volumetry Versus Upper Extremity Lymphedema Index: Validity of Upper Extremity Lymphedema Index for Body-Type Corrected Arm Volume Evaluation.

Science.gov (United States)

Yamamoto, Nana; Yamamoto, Takumi; Hayashi, Nobuko; Hayashi, Akitatsu; Iida, Takuya; Koshima, Isao

2016-06-01

Volumetry, measurement of extremity volume, is a commonly used method for upper extremity lymphedema (UEL) evaluation. However, comparison between different patients with different physiques is difficult with volumetry, because body-type difference greatly affects arm volume. Seventy arms of 35 participants who had no history of arm edema or breast cancer were evaluated. Arm volume was calculated using a summed truncated cone model, and UEL index was calculated using circumferences and body mass index (BMI). Examinees' BMI was classified into 3 groups, namely, low BMI (BMI, 25 kg/m). Arm volume and UEL index were compared with corresponding BMI groups. Mean (SD) arm volume was 1090.9 (205.5) mL, and UEL index 96.9 (5.6). There were significant differences in arm volume between BMI groups [low BMI vs middle BMI vs high BMI, 945.2 (107.4) vs 1045.2 (87.5) vs 1443.1 (244.4) mL, P 0.5]. Arm volume significantly increased with increase of BMI, whereas UEL index stayed constant regardless of BMI. Upper extremity lymphedema index would allow better body-type corrected arm volume evaluation compared with arm volumetry.

Breast Cancer-Related Lymphedema: Implications for Family Leisure Participation

Science.gov (United States)

Radina, M. Elise

2009-01-01

An estimated 20% of breast cancer survivors face the chronic condition of breast cancer-related lymphedema. This study explored the ways in which women with this condition experienced changes in their participation in family leisure as one indicator of family functioning. Participants (N = 27) were interviewed regarding lifestyles before and after…

Liposuction for Advanced Lymphedema: A Multidisciplinary Approach for Complete Reduction of Arm and Leg Swelling.

Science.gov (United States)

Boyages, John; Kastanias, Katrina; Koelmeyer, Louise A; Winch, Caleb J; Lam, Thomas C; Sherman, Kerry A; Munnoch, David Alex; Brorson, Håkan; Ngo, Quan D; Heydon-White, Asha; Magnussen, John S; Mackie, Helen

2015-12-01

This research describes and evaluates a liposuction surgery and multidisciplinary rehabilitation approach for advanced lymphedema of the upper and lower extremities. A prospective clinical study was conducted at an Advanced Lymphedema Assessment Clinic (ALAC) comprised of specialists in plastic surgery, rehabilitation, imaging, oncology, and allied health, at Macquarie University, Australia. Between May 2012 and 31 May 2014, a total of 104 patients attended the ALAC. Eligibility criteria for liposuction included (i) unilateral, non-pitting, International Society of Lymphology stage II/III lymphedema; (ii) limb volume difference greater than 25 %; and (iii) previously ineffective conservative therapies. Of 55 eligible patients, 21 underwent liposuction (15 arm, 6 leg) and had at least 3 months postsurgical follow-up (85.7 % cancer-related lymphedema). Liposuction was performed under general anesthesia using a published technique, and compression garments were applied intraoperatively and advised to be worn continuously thereafter. Limb volume differences, bioimpedance spectroscopy (L-Dex), and symptom and functional measurements (using the Patient-Specific Functional Scale) were taken presurgery and 4 weeks postsurgery, and then at 3, 6, 9, and 12 months postsurgery. Mean presurgical limb volume difference was 45.1 % (arm 44.2 %; leg 47.3 %). This difference reduced to 3.8 % (arm 3.6 %; leg 4.3 %) by 6 months postsurgery, a mean percentage volume reduction of 89.6 % (arm 90.2 %; leg 88.2 %) [p multidisciplinary team is essential.

Measurement Properties of Instruments for Measuring of Lymphedema: Systematic Review

NARCIS (Netherlands)

Hidding, J.T.; Viehoff, P.B.; Beurskens, C.H.G.; Laarhoven, H.W. van; Sanden, M.W. van der; Wees, P.J. van der

2016-01-01

BACKGROUND: Lymphedema is a common complication of cancer treatment, resulting in swelling and subjective symptoms. Reliable and valid measurement of this side effect of medical treatment is important. PURPOSE: The purpose of this study was to provide best evidence regarding which measurement

Debulking surgery for elephantiasis nostras with large ectatic podoplanin-negative lymphatic vessels in patients with lipo-lymphedema.

Science.gov (United States)

Wollina, Uwe; Heinig, Birgit; Schönlebe, Jaqueline; Nowak, Andreas

2014-01-01

Elephantiasis nostras is a rare complication in advanced lipo-lymphedema. While lipedema can be treated by liposuction and lymphedema by decongestive lymphatic therapy, elephantiasis nostras may need debulking surgery. We present 2 cases of advanced lipo-lymphedema complicated by elephantiasis nostras. After tumescent microcannular laser-assisted liposuction both patients underwent a debulking surgery with a modification of Auchincloss-Kim's technique. Histologic examination of the tissue specimen was performed. The surgical treatment was well tolerated and primary healing was uneventful. After primary wound healing and ambulation of the patients, a delayed ulceration with lymphorrhea developed. It was treated by surgical necrectomy and vacuum-assisted closure leading to complete healing. Mobility of the leg was much improved. Histologic examination revealed massive ectatic lymphatic vessels nonreactive for podoplanin. Debulking surgery can be an adjuvant technique for elephantiasis nostras in advanced lipo-lymphedema. Although delayed postoperative wound healing problems were observed, necrectomy and vacuum-assisted closure achieved a complete healing. Histologic data suggest that the ectatic lymphatic vessels in these patients resemble finding in podoplanin knockout mice. The findings would explain the limitations of decongestive lymphatic therapy and tumescent liposuction in such patients and their predisposition to relapsing erysipelas.

Evaluation of kinesthetic sense and hand function in women with breast cancer-related lymphedema.

Science.gov (United States)

Karadibak, Didem; Yavuzsen, Tugba

2015-06-01

[Purpose] This study evaluated the functional ability and kinesthetic sense of the hands of women with breast cancer-related lymphedema. [Subjects and Methods] Fifty-seven women experiencing lymphedema after breast surgery and adjuvant radiotherapy were included. The patients were divided into two groups: women with hand edema (HE+, n = 29) and without hand edema (HE-, n = 28) after breast cancer treatment. Arm edema severity, hand size, functional mobility and kinesthetic sense of the hand, and daily living skills were evaluated. [Results] The mean age of the patients was 55.8 years. In both groups, functional mobility, kinesthetic sense, and daily living skills decreased significantly with increasing edema severity. However, there was no significant difference between groups with respect to functional mobility or daily living skills. The kinesthetic sense of the hand was better in the HE- group than the HE+ group. There was a significant negative relationship between the severity of edema and hand function. [Conclusion] Breast cancer-related lymphedema can negatively impact women's functional mobility and kinesthetic sense of the hands as well as daily living skills.

Seroma indicates increased risk of lymphedema following breast cancer treatment

DEFF Research Database (Denmark)

Toyserkani, Navid Mohamadpour; Jørgensen, Mads Gustaf; Haugaard, Karen

2017-01-01

in one of the largest retrospective cohort studies. Material and methods We included all patients with unilateral breast cancer treated in the period of 2008-2014. Data regarding treatment and breast cancer characteristics were retrieved from the national breast cancer registry. Data regarding lymphedema...

Adaptive Immune Responses Regulate the Pathophysiology of Lymphedema

Science.gov (United States)

2012-09-01

A, Hennig B (2000) Effect of complex decongestive physiotherapy on gene expression for the inflammatory response in peripheral lymphedema. Lymphology...pharmacologic antagonism of lysophosphatidic acid receptor 1 in a mouse model of scleroderma. Arthritis Rheum 63: 1405-1415. 51. Romani L, Mencacci A, Grohmann...severe disease in collagen-induced arthritis . Arthritis Rheum 48: 1452-1460. 29. Nakamura K, Radhakrishnan K, Wong YM, Rockson SG (2009) Anti

Impact of an educational program on the quality of life of patients with lymphedema: A preliminary evaluation.

Science.gov (United States)

Blaise, Sophie; Satger, Bernadette; Pernod, Gilles; Richaud, Cécile; Villemur, Béatrice; Carpentier, Patrick H

2017-09-01

We report on the preliminary evaluation of a well-designed program, Living with Lymphedema. This longitudinal cohort study assessed patients' quality of life using questionnaires. Our main objective was to evaluate the satisfaction of the patients and their adherence to the program. This was done using a specific questionnaire of satisfaction as well as by noting patients' adherence to the program (number of patients attending all three consultations). The secondary objective was to assess the effect of the program on the patient's quality of life. The assessment criteria were the evolution of the Medical Outcomes Study 36-Item Short Form Health Survey and EuroQol questionnaire scores between the first (C1) and third (C3) consultations. The Living with Lymphedema program targeted all patients with lymphedema in the Grenoble (France) conurbation and within the GRANTED health care network that includes vascular medicine specialists, primary care physicians, physical therapists, and dietitians in the Alpine region of France. All studied patients were ambulatory patients. The GRANTED network took care only of the educational aspect of the disease. All patients with primary or secondary lymphedema were offered the Living with Lymphedema program, whatever their age and the location of the lymphedema (upper or lower limbs). The collection of patient data conformed to the ethical and administrative regulations of the regional health authority. Grenoble Institutional Review Board (CPP Sud-Est V; No. 5891) approval for the study was specifically obtained for this evaluation on December 24, 2012. The program was built around one-to-one consultations, group workshops, and more specialized appointments. It was complementary to the routine medical care received by the patient (not evaluated in this study). It proposed three individual "educational" consultations, seven group workshops, and two specialized consultations with a dietitian. All the consultations or workshops were

High-resolution 3D volumetry versus conventional measuring techniques for the assessment of experimental lymphedema in the mouse hindlimb

Science.gov (United States)

Frueh, Florian S.; Körbel, Christina; Gassert, Laura; Müller, Andreas; Gousopoulos, Epameinondas; Lindenblatt, Nicole; Giovanoli, Pietro; Laschke, Matthias W.; Menger, Michael D.

2016-01-01

Secondary lymphedema is a common complication of cancer treatment characterized by chronic limb swelling with interstitial inflammation. The rodent hindlimb is a widely used model for the evaluation of novel lymphedema treatments. However, the assessment of limb volume in small animals is challenging. Recently, high-resolution three-dimensional (3D) imaging modalities have been introduced for rodent limb volumetry. In the present study we evaluated the validity of microcomputed tomography (μCT), magnetic resonance imaging (MRI) and ultrasound in comparison to conventional measuring techniques. For this purpose, acute lymphedema was induced in the mouse hindlimb by a modified popliteal lymphadenectomy. The 4-week course of this type of lymphedema was first assessed in 6 animals. In additional 12 animals, limb volumes were analyzed by μCT, 9.4 T MRI and 30 MHz ultrasound as well as by planimetry, circumferential length and paw thickness measurements. Interobserver correlation was high for all modalities, in particular for μCT analysis (r = 0.975, p < 0.001). Importantly, caliper-measured paw thickness correlated well with μCT (r = 0.861), MRI (r = 0.821) and ultrasound (r = 0.800). Because the assessment of paw thickness represents a time- and cost-effective approach, it may be ideally suited for the quantification of rodent hindlimb lymphedema. PMID:27698469

Chylous pleural effusion associated with primary lymphedema and lymphangioma-like malformations

NARCIS (Netherlands)

Bresser, P.; Kromhout, J. G.; Reekers, J. A.; Verhage, T. L.

1993-01-01

We describe a patient with a chylous pleural effusion associated with primary lymphedema of his right leg and abdominal wall. On evaluation a generalized, severe hypoplasia of the lymphatic system turned out to be associated with hyperplastic, lymphangioma-like malformations

Clinical effectiveness of decongestive treatments on excess arm volume and patient-centered outcomes in women with early breast cancer-related arm lymphedema: a systematic review

Science.gov (United States)

Jeffs, Eunice; Ream, Emma; Taylor, Cath; Bick, Debra

2018-01-01

ABSTRACT Objective: To identify the effect of decongestive lymphedema treatment on excess arm volume or patient-centered outcomes in women presenting within either 12 months or a mean nine months of developing arm lymphedema following breast cancer treatment. Introduction: Lymphedema is a common consequence of breast cancer treatment requiring life-long treatment to reduce symptoms and prevent complications. Currently, evidence to inform the optimal decongestive lymphedema treatment package is lacking. Inclusion criteria: The review included studies on women who received lymphedema treatment within either 12 months or a mean of nine months of developing unilateral breast cancer-related arm lymphedema. The intervention was any decongestive lymphedema treatment delivered with the purpose of reducing arm lymphedema, compared to another form of lymphedema treatment (whether self or practitioner-administered), placebo or no treatment. The clinical outcome was excess arm volume; patient-centered outcomes were health-related quality of life, arm heaviness, arm function, patient-perceived benefit and satisfaction with treatment. Experimental study designs were eligible, including randomized and non-randomized controlled trials, quasi-experimental, prospective and retrospective before and after studies were considered. Methods: A three-step search strategy was utilized to find published and unpublished studies. The search identified studies published from the inception of each database to July 6, 2016. Reference lists were scanned to identify further eligible studies. Studies were critically appraised using appropriate standardized critical appraisal instruments from the Joanna Briggs Institute. Details describing each study and treatment results regarding outcomes of interest were extracted from papers included in the review using appropriate standardized data extraction tools from the Joanna Briggs Institute. Due to heterogeneity in included studies, results for similar

Basic Elements of Knowledge Management

Directory of Open Access Journals (Sweden)

Marcin W. Staniewski

2007-10-01

Full Text Available The article is a review of basic knowledge management terminology. It presents such a description as: knowledge resources levels (data, information, knowledge, and wisdom, knowledge sources (internal, external, and knowledge typology (implicit, tacit or individual, social. Moreover the article characterizes knowledge management process, knowledge management system and main knowledge management strategies (codification, personalization. At the end of the article there is mentioned the knowledge creating process (the concept of knowledge creation spiral and the role of Intelligence Technology (IT and organizational culture as main elements supporting knowledge management implementation in organizations.

Autosomal recessive intestinal lymphangiectasia and lymphedema, with facial anomalies and mental retardation

NARCIS (Netherlands)

Hennekam, R. C.; Geerdink, R. A.; Hamel, B. C.; Hennekam, F. A.; Kraus, P.; Rammeloo, J. A.; Tillemans, A. A.

1989-01-01

We report on two male and two female relatives with intestinal lymphangiectasia; severe lymphedema of limbs, genitalia, and face; facial anomalies; seizures; mild growth retardation; and moderate mental retardation. Main facial anomalies are a flat face, flat nasal bridge, hypertelorism, small

Mapping the geographical distribution of podoconiosis in Cameroon using parasitological, serological, and clinical evidence to exclude other causes of lymphedema.

Directory of Open Access Journals (Sweden)

Kebede Deribe

2018-01-01

Full Text Available Podoconiosis is a non-filarial elephantiasis, which causes massive swelling of the lower legs. It was identified as a neglected tropical disease by WHO in 2011. Understanding of the geographical distribution of the disease is incomplete. As part of a global mapping of podoconiosis, this study was conducted in Cameroon to map the distribution of the disease. This mapping work will help to generate data on the geographical distribution of podoconiosis in Cameroon and contribute to the global atlas of podoconiosis.We used a multi-stage sampling design with stratification of the country by environmental risk of podoconiosis. We sampled 76 villages from 40 health districts from the ten Regions of Cameroon. All individuals of 15-years old or older in the village were surveyed house-to-house and screened for lymphedema. A clinical algorithm was used to reliably diagnose podoconiosis, excluding filarial-associated lymphedema. Individuals with lymphoedema were tested for circulating Wuchereria bancrofti antigen and specific IgG4 using the Alere Filariasis Test Strips (FTS test and the Standard Diagnostics (SD BIOLINE lymphatic filariasis IgG4 test (Wb123 respectively, in addition to thick blood films. Presence of DNA specific to W. bancrofti was checked on night blood using a qPCR technique.Overall, 10,178 individuals from 4,603 households participated in the study. In total, 83 individuals with lymphedema were identified. Of the 83 individuals with lymphedema, two were found to be FTS positive and all were negative using the Wb123 test. No microfilaria of W. bancrofti were found in the night blood of any individual with clinical lymphedema. None were found to be positive for W. bancrofti using qPCR. Of the two FTS positive cases, one was positive for Mansonella perstans DNA, while the other harbored Loa loa microfilaria. Overall, 52 people with podoconiosis were identified after applying the clinical algorithm. The overall prevalence of podoconiosis was

Therapeutic Effects of Saireito (Chai-Ling-Tang, a Traditional Japanese Herbal Medicine, on Lymphedema Caused by Radiotherapy: A Case Series Study

Directory of Open Access Journals (Sweden)

Aiko Nagai

2013-01-01

Full Text Available Despite the development of radiotherapy machines and technologies, a proportion of patients suffer from radiation-induced lymphedema. Saireito (SRT is a traditional Japanese herbal medicine that has been used for treating edema and inflammation in conditions such as nephritic disease. This study investigated the effect of SRT on lymphedema caused by radiotherapy. Four patients were treated with SRT at a dose of 9 g/day. The severity of lymphedema was evaluated using the Common Terminology Criteria for Adverse Events version 4 and Numerical Rating Scale before and after SRT treatment. After the treatment with SRT, 2 of 4 patients (50% showed apparent improvement in lymphedema. One of the cases had difficulty in wearing the custom-made thermoplastic cast, but after SRT administration, he could wear the mask easily. One case decided to stop taking SRT 3 days after initiation because cough and fever appeared. In conclusion, it is important to control the side effects of radiotherapy, which leads to improved tumor control rates. Prospective randomized studies are necessary to confirm the findings of this case series study.

Streptococcal toxic-shock syndrome due to Streptococcus dysgalactiae subspecies equisimilis in breast cancer-related lymphedema: a case report.

Science.gov (United States)

Sumazaki, Makoto; Saito, Fumi; Ogata, Hideaki; Yoshida, Miho; Kubota, Yorichika; Magoshi, Syunsuke; Kaneko, Hironori

2017-07-14

Breast cancer-related lymphedema often causes cellulitis and is one of the most common complications after breast cancer surgery. Streptococci are the major pathogens underlying such cellulitis. Among the streptococci, the importance of the Lancefield groups C and G is underappreciated; most cases involve Streptococcus dysgalactiae subspecies equisimilis. Despite having a relatively weak toxicity compared with group A streptococci, Streptococcus dysgalactiae subspecies equisimilis is associated with a mortality rate that is as high as that of group A streptococci in cases of invasive infection because Streptococcus dysgalactiae subspecies equisimilis mainly affects elderly individuals who already have various comorbidities. An 83-year-old Japanese woman with breast cancer-related lymphedema in her left upper limb was referred to our hospital with high fever and acute pain with erythema in her left arm. She showed septic shock with disseminated intravascular coagulation. Blood culture showed positive results for Streptococcus dysgalactiae subspecies equisimilis, confirming a diagnosis of streptococcal toxic-shock syndrome. She survived after successful intensive care. To the best of our knowledge, this case represents the first report of Streptococcus dysgalactiae subspecies equisimilis-induced streptococcal toxic-shock syndrome in a patient with breast cancer-related lymphedema. Breast cancer-related lymphedema is a common problem, and we must pay attention to invasive streptococcal soft tissue infections, particularly in elderly patients with chronic disease.

Accurate Prediction of Submental Lymph Nodes Using Magnetic Resonance Imaging for Lymphedema Surgery

Directory of Open Access Journals (Sweden)

Mora-Ortiz Asuncion, MD

2018-03-01

Conclusions:. The preoperative MRI is a useful tool for the detection of mean 7.2 submental lymph nodes. Mean 72.2% of submental lymph nodes can be successfully transferred for extremity lymphedema with optimal functional recovery.

Heavy resistance training and lymphedema

DEFF Research Database (Denmark)

Bloomquist, Kira; Karlsmark, Tonny; Christensen, Karl Bang

2014-01-01

BACKGROUND: There is limited knowledge regarding progressive resistance training during adjuvant chemotherapy and the risk of developing breast cancer-related lymphedema (BCRL). Furthermore, no studies have investigated the safety of resistance training with heavy loads (> 80% 1 repetition maximum......) in this population. 'Body and Cancer' is a six-week, nine-hour weekly, supervised, multimodal exercise intervention utilizing progressive resistance training with heavy loads for cancer patients undergoing chemotherapy. The purpose of the present study was to estimate the prevalence of BCRL in former participants......, and identify associations between progressive resistance training with heavy loads, and the development of BCRL. MATERIAL AND METHODS: This was a descriptive study. POPULATION: Women treated for breast cancer (n = 149), who had participated in the 'Body and Cancer' exercise intervention between 1 January 2010...

Comparison of the effectiveness of complex decongestive therapy and compression bandaging as a method of treatment of lymphedema in the elderly

Directory of Open Access Journals (Sweden)

Zasadzka E

2018-05-01

Full Text Available Ewa Zasadzka,1 Tomasz Trzmiel,1 Maria Kleczewska,2 Mariola Pawlaczyk1 1Department of Geriatric Medicine and Gerontology, Karol Marcinkowski University of Medical Sciences, Poznan, Poland; 2Day Rehabilitation Center, Hospicjum Palium, Poznań, Poland Background: Lymphedema is a chronic condition which significantly lowers the quality of patient life, particularly among elderly populations, whose mobility and physical function are often reduced. Objectives: The aim of the study was to compare the effectiveness of multi-layer compression bandaging (MCB and complex decongestive therapy (CDT, and to show that MCB is a cheaper, more accessible and less labor intensive method of treating lymphedema in elderly patients. Patients and methods: The study included 103 patients (85 women and 18 men aged ≥60 years, with unilateral lower limb lymphedema. The subjects were divided into two groups: 50 treated with CDT and 53 with MCB. Pre- and post-treatment BMI, and average and maximum circumference of the edematous extremities were analyzed. Results: Reduction in swelling in both groups was achieved after 15 interventions. Both therapies demonstrated similar efficacy in reducing limb volume and circumference, but MCB showed greater efficacy in reducing the maximum circumference. Conclusion: Compression bandaging is a vital component of CDT. Maximum lymphedema reduction during therapy and maintaining its effect cannot be achieved without it. It also demonstrates its effectiveness as an independent method, which can reduce therapy cost and accessibility. Keywords: lymphedema, elderly, therapy, compression bandaging

Clinical significance of a proposed lymphoscintigrpahic functional grade system in patients with extremity lymphedema of stage i

International Nuclear Information System (INIS)

Choi, Joan Young; Hwang, Ji Hye; Kim, Dong Ik; Cho, Young Seok; Lee, Su Jin; Choi, Yong; Choe, Yeam Seong; Lee, Kyung Han; Kim, Byung Tae

2005-01-01

We proposed a new lymphoscintigrpahic functional grade (LGr) system in extremity lymphedema, and investigated the association between the LGr and a long-term response to physical therapy in patients with extremity lymphedema of stage I. The subjects were 20 patients with unilateral extremity lymphedema of stage I, who underwent pre-treatment extremity lymphoscintigraphy using Tc-99m antimony sulfur colloid, and were treated by complex decongestive physical therapy (CDPT). A proposed lymphoscintigrpahic functional grade system consisted of LGr 0 to LGr 4 according to the ilioinguinal nodal uptake, amount of dermal backflow, and uptake pattern of main and collateral lymphatics : LGr 0 = normal, LGr 1 = decreased lymphatic function without dermal backflow, LGr 2 = decreased lymphatic function with dermal backflow, LGr 3 = non - visualization of main lymphatics with dermal backflow, and LGr 4 = no significant lymphatic transport from injection site. LGr 2 was divided into 2A and 2B based on the amount of dermal backflow. A physician who is a lymphedema specialist determined the long-term outcome to CDPT with normalized response (NR), good response (GR) and poor response (PR) based on the change of edema volume reduction, skin status and occurrence of dermatolymphangioadenitis after the clinical follow-up for more than 1 year. Therapeutic responses were NR in 2 patients. GR in 9 patients and PR in 9 patients. Baseline LGrs were 1 in 7 patients, 2A in 4 patients, 2B in 5 patients, 3 in 2 patients, and 4 in 2 patients. There was a significant relationship between therapeutic response and LGr (p=0.003). In other words, 10 of 11 patients (91%) with LGr 1 or 2A showed NR. or GR. On the contrary, 8 of 9 patients (89%) with LGr 2B, 3 or 4 showed PR. Patients with unilateral extremity lymphedema of stage I had different lymphoscintigrpahic functional grades. This grade system may be useful to predict the response to physical therapy in such patients

Clinical significance of a proposed lymphoscintigrpahic functional grade system in patients with extremity lymphedema of stage i

Energy Technology Data Exchange (ETDEWEB)

Choi, Joan Young; Hwang, Ji Hye; Kim, Dong Ik; Cho, Young Seok; Lee, Su Jin; Choi, Yong; Choe, Yeam Seong; Lee, Kyung Han; Kim, Byung Tae [Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul (Korea, Republic of)

2005-07-01

We proposed a new lymphoscintigrpahic functional grade (LGr) system in extremity lymphedema, and investigated the association between the LGr and a long-term response to physical therapy in patients with extremity lymphedema of stage I. The subjects were 20 patients with unilateral extremity lymphedema of stage I, who underwent pre-treatment extremity lymphoscintigraphy using Tc-99m antimony sulfur colloid, and were treated by complex decongestive physical therapy (CDPT). A proposed lymphoscintigrpahic functional grade system consisted of LGr 0 to LGr 4 according to the ilioinguinal nodal uptake, amount of dermal backflow, and uptake pattern of main and collateral lymphatics : LGr 0 = normal, LGr 1 = decreased lymphatic function without dermal backflow, LGr 2 = decreased lymphatic function with dermal backflow, LGr 3 = non - visualization of main lymphatics with dermal backflow, and LGr 4 = no significant lymphatic transport from injection site. LGr 2 was divided into 2A and 2B based on the amount of dermal backflow. A physician who is a lymphedema specialist determined the long-term outcome to CDPT with normalized response (NR), good response (GR) and poor response (PR) based on the change of edema volume reduction, skin status and occurrence of dermatolymphangioadenitis after the clinical follow-up for more than 1 year. Therapeutic responses were NR in 2 patients. GR in 9 patients and PR in 9 patients. Baseline LGrs were 1 in 7 patients, 2A in 4 patients, 2B in 5 patients, 3 in 2 patients, and 4 in 2 patients. There was a significant relationship between therapeutic response and LGr (p=0.003). In other words, 10 of 11 patients (91%) with LGr 1 or 2A showed NR. or GR. On the contrary, 8 of 9 patients (89%) with LGr 2B, 3 or 4 showed PR. Patients with unilateral extremity lymphedema of stage I had different lymphoscintigrpahic functional grades. This grade system may be useful to predict the response to physical therapy in such patients.

Quality of life of women with lymphedema after surgery for breast cancer

Directory of Open Access Journals (Sweden)

Marislei Sanches Panobianco

2014-06-01

Full Text Available This study evaluated the quality of life of 20 women with post-mastectomy lymphedema due to breast cancer, using the Flanagan’s Adapted Quality of Life Scale (1 and the Visual Analogue Scale (2, with data collection from July to December 2009 in the countryside of the state of São Paulo. It was observed a lower quality of life concerning participation in recreational and work activities, and better quality of life was related to relationship with friends; listening to music, reading, watching TV and going to the movies. Cronbach's alpha of Scale 1 was 0.86 and the average of Scale 2 was 6.26. Overall, the scales showed satisfactory results of quality of life, but low values showed factors that must be worked out, such as participation in sports, work and learning activities. Thus, lymphedema interferes with the quality of life, indicating a need for early intervention in order to help women achieve better quality of life.

Elephantiasis nostras verrucosa or "mossy foot lesions" in lymphedema praecox: report of a case.

Science.gov (United States)

Duckworth, Amy L; Husain, Jugnoo; Deheer, Patrick

2008-01-01

Elephantiasis nostras verrucosa is a rare disorder that results from chronic obstructive lymphedema. It is characterized clinically by deforming, nonpitting edema; malodorous hyperkeratosis with generalized lichenification; cobblestoned papules; and verrucous changes, that often result in extreme enlargement of the involved body part. Although elephantiasis nostras verrucosa is striking in clinical appearance, biopsy reveals only moderately abnormal findings: pseudoepitheliomatous hyperplasia with dilated lymphatic spaces in the dermis, accompanied by chronic inflammation and fibroblast proliferation. The term elephantiasis nostras (nostras means "from our region") has traditionally been used to differentiate temperate zone disease from the classic disease process, elephantiasis tropica, which is defined by chronic filarial lymphatic obstruction caused by Wuchereria bancrofti, Wuchereria malayi, or Wuchereria pacifica. We present a case report of elephantiasis nostras verrucosa arising as a result of lymphedema praecox.

Flap Lymphedema after Successful Reconstruction of the Chronic Inguinal Wound with a Vertical Rectus Abdominis Flap (VRAM

Directory of Open Access Journals (Sweden)

Yalcin Kulahci

2012-07-01

Full Text Available The reconstruction of extensive and complex wounds represents a challenging problem for reconstructive surgeon. The reconstructive options to provide cover-age following debridment of these complicated wounds are local, distant flaps, or freetissue transfer. Vertical rectus abdominis flaps have been used succes-sully to repair defects in the groin, hip, perineal, trunk, and breast regions. We encountered flap lymphedema after successful reconstruction of the chronic in-guinal wound with a vertical rectus abdominis (VRAM flap. As far as were able to ascertain, there is no report in the literature related to flap lymphedema.

Standardized Method for Quantification of Developing Lymphedema in Patients Treated for Breast Cancer

International Nuclear Information System (INIS)

Ancukiewicz, Marek; Russell, Tara A.; Otoole, Jean; Specht, Michelle; Singer, Marybeth; Kelada, Alexandra; Murphy, Colleen D.; Pogachar, Jessica; Gioioso, Valeria; Patel, Megha; Skolny, Melissa; Smith, Barbara L.; Taghian, Alphonse G.

2011-01-01

Purpose: To develop a simple and practical formula for quantifying breast cancer-related lymphedema, accounting for both the asymmetry of upper extremities' volumes and their temporal changes. Methods and Materials: We analyzed bilateral perometer measurements of the upper extremity in a series of 677 women who prospectively underwent lymphedema screening during treatment for unilateral breast cancer at Massachusetts General Hospital between August 2005 and November 2008. Four sources of variation were analyzed: between repeated measurements on the same arm at the same session; between both arms at baseline (preoperative) visit; in follow-up measurements; and between patients. Effects of hand dominance, time since diagnosis and surgery, age, weight, and body mass index were also analyzed. Results: The statistical distribution of variation of measurements suggests that the ratio of volume ratios is most appropriate for quantification of both asymmetry and temporal changes. Therefore, we present the formula for relative volume change (RVC): RVC = (A 2 U 1 )/(U 2 A 1 ) - 1, where A 1 , A 2 are arm volumes on the side of the treated breast at two different time points, and U 1 , U 2 are volumes on the contralateral side. Relative volume change is not significantly associated with hand dominance, age, or time since diagnosis. Baseline weight correlates (p = 0.0074) with higher RVC; however, baseline body mass index or weight changes over time do not. Conclusions: We propose the use of the RVC formula to assess the presence and course of breast cancer-related lymphedema in clinical practice and research.

Lymphedema of the arm and breast in irradiated breast cancer patients: risks in an era of dramatically changing axillary surgery.

Science.gov (United States)

Goffman, Thomas E; Laronga, Christine; Wilson, Lori; Elkins, David

2004-01-01

The purpose of this study was to assess risk for lymphedema of the breast and arm in radiotherapy patients in an era of less extensive axillary surgery. Breast cancer patients treated for cure were reviewed, with a minimum follow-up of 1.5 years from the end of treatment. Clinical, surgical, and radiation-related variables were tested for statistical association with arm and breast lymphedema using regression analyses, t-tests, and chi-squared analyses. Between January 1998 and June 2001, 240 women received radiation for localized breast cancer in our center. The incidence of lymphedema of the ipsilateral breast, arm, and combined (breast and arm) was 9.6%, 7.6%, and 1.8%, respectively, with a median follow-up of 27 months. For breast edema, t-test and multivariate analysis showed body mass index (BMI) to be significant (p = 0.043, p = 0.0038), as was chi-squared and multivariate testing for site of tumor in the breast (p = 0.0043, p = 0.0035). For arm edema, t-test and multivariate analyses showed the number of nodes removed to be significant (p = 0.0040, p = 0.0458); the size of the tumor was also significant by multivariate analyses (p = 0.0027). Tumor size appeared significant because a number of very large cancers failed locally and caused cancer-related obstructive lymphedema. In our center, even modern, limited level 1-2 axillary dissection and tangential irradiation carries the risk of arm lymphedema that would argue in favor of sentinel node biopsy. For breast edema, disruption of draining lymphatics by surgery and radiation with boost to the upper outer quadrant increased risk, especially for the obese. Fortunately both breast and arm edema benefited from manual lymphatic drainage.

Usability of advanced pneumatic compression to treat cancer-related head and neck lymphedema: A feasibility study.

Science.gov (United States)

Mayrovitz, Harvey N; Ryan, Shelly; Hartman, James M

2018-01-01

This functional usability study assessed ease of use, fit, comfort, and potential clinical benefits of advanced pneumatic compression treatment of cancer-related head and neck lymphedema. Patient-reported comfort and other treatment aspects were evaluated and multiple face and neck measurements were obtained on 44 patients with head and neck lymphedema before and after 1 treatment session to assess usability and treatment-related lymphedema changes. A majority of the patients (82%) reported the treatment was comfortable; most patients (61%) reported feeling better after treatment, and 93% reported that they would be likely to use this therapy at home. One treatment produced overall small but highly statistically significant reductions in composite metrics (mean ± SD) of the face (82.5 ± 4.3 cm vs 80.9 ± 4.1 cm; P < .001) and neck (120.4 ± 12.2 cm vs 119.2 ± 12.1 cm; P < .001) with no adverse events. Results found the treatment to be safe, easy to use, and well tolerated while demonstrating edema reduction after a single initial treatment. © 2017 The Authors Head & Neck Published by Wiley Periodicals, Inc.

Correlates of Lymphedema in Women with Breast Cancer: a Case Control Study in Shiraz, Southern Iran.

Science.gov (United States)

Honarvar, Behnam; Sayar, Negin; Tahmasebi, Sedigheh; Zakeri, Zeinab; Talei, Asra; Rostami, Sara; Khademi, Sahar; Sabzi Sarvestani, Amene; Sekhavati, Eghbal

2016-01-01

Globally, the burden of breast cancer (BC) continues to increase. BC related lymphedema (BCRL) is currently non curable and as a life time risk it affects at least 25% of BC patients. Knowing more about BCRL and appropriate control of its modifiable risk factors can improve quality of life (QOL) of the affected patients. In this case control study to detect factors, 400 women with BCRL (as the case group) and 283 patients with BC without lymphedema (as the control group) that were referred to Shiraz University of Medical Sciences affiliated BC clinic center were assessed. The data were analyzed in SPSS. The mean age of the case group was 52.3±11.0 years and of the control group was 50.1±10.9 years. In patients with BCRL, 203(50.7%) had left (Lt) side BC and in non- lymphedema group 151 (53.3%) had Lt side BC. Out of all BCRL patients, 204 (51%) had lymphedema in all parts of their affected upper extremities, 100 (25%) had swelling in the arm and forearm and 23 (5.7%) had edema in both the upper extremity and trunk. Edema, heaviness, concern about changing body image, pain and paresthesia were the most common signs/symptoms among patients with BCRL. In BCRL patients, the difference of circumference between the affected upper limb and non-affected limb was 4.4±2.5 cm and the difference in volume displacement was 528.7±374.4 milliliters. Multiple variable analysis showed that moderate to severe activity (OR; odds ratio =14, 95% CI: 2.6-73.3 ), invasiveness of BC (OR =13.7, 95% CI: 7.3-25.6), modified radical mastectomy (OR=4.3, 95% CI: 2.3-7.9), BMI =>25 (OR=4.2, 95% CI: 2-8.7), radiotherapy (OR=3.9, 95% CI: 1.8-8.2 ), past history of limb damage (OR=1.7, 95% CI: 0.9-3.1) and the number of excised lymph nodes (OR=1.06, 95% CI: 1.02-1.09) were the significant predictors of lymphedema in women with BC. Modifiable risk factors of BCRL such as non-guided moderate to severe physical activity, high BMI and trauma to the limb should be controlled as early as possible in

Paediatric airway management: basic aspects

DEFF Research Database (Denmark)

Holm-Knudsen, R J; Rasmussen, L S

2009-01-01

Paediatric airway management is a great challenge, especially for anaesthesiologists working in departments with a low number of paediatric surgical procedures. The paediatric airway is substantially different from the adult airway and obstruction leads to rapid desaturation in infants and small...... children. This paper aims at providing the non-paediatric anaesthesiologist with a set of safe and simple principles for basic paediatric airway management. In contrast to adults, most children with difficult airways are recognised before induction of anaesthesia but problems may arise in all children...

Streptococcal toxic shock syndrome occurred during postoperative radiotherapy in a cancer patient with preexisting lymphedema and chronic illness -case report-

Energy Technology Data Exchange (ETDEWEB)

Jang, Ji Young; Oh, Yoon Kyeong; Kim, Dong Min [Chosun University College of Medicine, Gwangju (Korea, Republic of)

2006-12-15

A case is reported of a man with malignant fibrous histiocytoma (MFH) in right thigh who developed streptococcal toxic shock syndrome (STSS) during postoperative radiotherapy. Before radiotherapy, a patient complained wax and wane lymphedema following wide excision of tumor mass which was confirmed as MFH. He took some nonsteroidal antiinflammatory drug (NSAID) for about one month. He suffered preexisting hepatitis C virus (HCV) infection, diabetes and well-controlled hypertension. The patient received conventional radiotherapy to right thigh with a total dose of 32.4 Gy at 1.8 Gy per day. At last radiotherapy fraction, cutaneous erythematous inflammation was suddenly developed at his affected thigh. At that time, he also complained of oliguria, fever and chills. The patient was consulted to internal medicine for adequate evaluation and management. The patient was diagnosed as suggested septic shock and admitted without delay. At admission, he showed hypotension, oliguria, constipation, abnormal renal and liver function. As a result of blood culture, Streptococcus pyogenes was detected. The patient was diagnosed to STSS. He was treated with adequate intravenous antibiotics and fluid support. STSS is one of oncologic emergencies and requires immediate medical intervention to prevent loss of life. In this patient, underlying HCV infection, postoperative lymphedema, prolonged NSAID medication, and radiotherapy may have been multiple precipitating factors of STSS.

Administration of rocuronium based on real body weight versus fat-free mass in patients with lymphedema.

Science.gov (United States)

Jing, Zhang; Muheremu, Aikeremujiang; Liu, Pengfei; Hu, Xiaoyun; Binjiang, Zhao

2017-12-01

Objective To compare the clinical pharmacokinetics of rocuronium when applied according to fat-free mass versus real body weight during anesthetic induction of patients with lymphedema. Methods Sixty patients with lymphedema (age, 18-60 years; American Society of Anesthesiologists physical status, I-II) undergoing elective surgery with general anesthesia were randomly divided into two groups. Rocuronium was administered based on the fat-free mass in 30 patients and real body weight in 30 patients. General anesthesia was induced with propofol and remifentanil by target-controlled infusion. Intubation was attempted when the onset time (T1) (time from end of bolus injection to 100% twitch depression) reached maximal inhibition, and respiratory support with mechanical ventilation was then applied. The T1, clinical duration (time from end of bolus injection to recovery of twitch tension to 25% of control), recovery index (time from 25% to 75% of recovery of T1), and dosage were recorded. Results Complete data were recorded for 59 patients, and there were no significant differences in the general condition, intubation condition, or median duration of action of rocuronium between the two groups. However, the median T1, recovery index, and dosage of rocuronium were significantly different. Conclusion Good intubation conditions and a shortened clinical duration can be obtained for patients with lymphedema when induction with rocuronium is based on the fat-free mass.

Linking Theory with Practice in Basic Management

Science.gov (United States)

Carroll, Archie B.

1974-01-01

Instructors of management in higher education have not been cautious in explaining the relation between practice and theory in their basic courses. The author distinguished between the two in suggesting that management theory is based on observed practices and may or may not have broader application. (AG)

Pilot Study: The Effectiveness of Complex Decongestive Therapy for Lymphedema in Palliative Care Patients with Advanced Cancer.

LENUS (Irish Health Repository)

Cobbe, Sinead

2017-12-05

Complex decongestive therapy (CDT) is a regimen of physical treatment for lymphedema. Its effectiveness is unknown in advanced cancer patients. This study evaluates effectiveness of CDT in this population.

Basic research needs for management and disposal of DOE wastes

International Nuclear Information System (INIS)

Grazis, B.M.; Schulz, W.W.

1991-04-01

This document was chartered by the Department of Energy (DOE), Office of Energy Research. It identifies and describes 87 basic research needs in support of advanced technology for management and disposal of Department of Energy radioactive, hazardous chemical, and mixed wastes. A team of scientists and engineers from several DOE laboratories and sites, from academia, and from industry identified and described the basic research needs called out in this report. Special efforts were made to ensure that basic research needs related to management and disposal of any hazardous chemical wastes generated at nonnuclear DOE sites and facilities were properly identified. It is hoped that scientists in both DOE and nongovernment laboratories and institutions will find this document useful when formulating research efforts relevant to waste management and disposal. For management and disposal of DOE radioactive and mixed wastes, basic research needs are identified in nine separate action areas. Basic research needs for management and disposal of DOE hazardous chemical wastes are identified in five action areas. Sufficient description and background information are provided in the report for each particular research need to enable qualified and imaginative scientists to conceive research efforts and programs that will meet the need. 28 refs., 7 tabs

Fatores associados ao linfedema em pacientes com câncer de mama Associated factors of lymphedema in breast cancer patients

Directory of Open Access Journals (Sweden)

Daniella Marta Ferreira de Paiva

2011-02-01

Full Text Available OBJETIVO: determinar a prevalência e os fatores associados ao linfedema em pacientes com câncer de mama. MÉTODOS: este estudo de corte transversal incluiu 250 mulheres com mais de seis meses de tratamento para o câncer de mama, que compareceram ao Ambulatório de Mastologia e Oncologia para consulta de seguimento em um Centro de Referência em Oncologia, em Juiz de Fora, Minas Gerais. Elas foram entrevistadas e submetidas à avaliação física. Foram colhidos dados de prontuário relacionados ao tratamento da neoplasia, à intervenção axilar e ao tumor. Diagnosticou-se linfedema quando a diferença entre os membros superiores foi maior ou igual a 2 cm pela perimetria. Os grupos de mulheres com e sem linfedema foram comparados em relação aos possíveis fatores de risco, e as medidas de tendência central, dispersão e prevalência foram obtidas admitindo o nível de significância de 95%. RESULTADOS: Cento e doze mulheres (44,8% apresentaram linfedema. Foi encontrada diferença significativa entre os grupos de mulheres com e sem linfedema em relação à mediana de linfonodos retirados (p=0,02; apresentação de trombose linfática superficial no braço homolateral à cirurgia (pPURPOSE: to determine the prevalence of lymphedema and its associated factors in breast cancer patients. METHODS: Two hundred and fifty women that had undergone more than six months of breast cancer treatment and were being treated at an oncology reference hospital in Juiz de Fora, Minas Gerais, Brazil. They were interviewed and submitted to physical evaluation. Data from the patients' medical records regarding the treatment of breast cancer, the extent of axillary intervention and the tumor were analyzed. Lymphedema was diagnosed when the difference between both upper limbs was 2 cm or more by perimetry. The groups of women with and without lymphedema were compared regarding the possible risk factors, and central tendency, dispersion, and prevalence were

[The application of impulse magnetic therapy for the treatment of the patients presenting with lymphedema of the lower extremities].

Science.gov (United States)

Kulchitskaya, D B; Gerasimenko, M Yu; Aphanova, T V; Konchugova, T V

The principal objective of the present work was to evaluate the influence of impulse magnetic therapy on the state of the microcirculatory system in the patients presenting with lymphedema of the lower extremities. The study included 59 patients with stage of 1 and 2 lymphedema who were divided into two groups. Those comprising the first group had impulse magnetic therapy applied to their lower extremities while the patients making up the second group served as controls. All the patients were examined with the use of the laser Doppler flowmetry (LDF) that revealed the initially present pathological changes in the microcirculatory system of their lower extremities. The study has demonstrated that the application of impulse magnetic therapy produced a positive effect on all the constituent components of the microcirculatory blood stream of the patients suffering from lymphedema of the lower extremities. Specifically, the initially increased arteriolar tonus was decreased, the blood flow in the capillary vessels was improved, and congestive phenomena in the venular segments of the microcirculation blood stream were markedly reduced. The results of the LDF examination in the control group gave no evidence of significant changes in the patients' microcirculatory system. The results of the LDF examination of the patients of the control group suggested the absence of any appreciable changes in the microcirculatory system. The present study has demonstrated the advisability of the application of impulse magnetic therapy for the treatment of the patients presenting with lymphedema of the lower extremities as a minimally invasive technique for the evaluation of the condition of the microcirculatory system and the objective assessment of the effectiveness of the outcomes of physiotherapy in the patients with vascular pathology.

Management of Refractive Errors And Low Vision Among Basic ...

African Journals Online (AJOL)

The study sought to discuss the management of refractive errors and low vision among basic school children in the Atwima district. A sample of 1,177 public basic school children aged between 5-19 years was randomly selected from ten basic schools for examination. Thirteen key informants in the district were purposively ...

Interstitial MR lymphangiography in patients with lower extremity lymphedema: a preliminary report

International Nuclear Information System (INIS)

Lu Qing; Xu Jianrong; Liu Ningfei

2009-01-01

Objective: To assess the feasibility of interstitial MR lymphangiography (MRL) with subcutaneous injection of a commercially available, non-ionic, extracellular paramagnetic contrast agent, to visualize lymphatic vessels in patients with primary lymphedema. Methods: Forty lower extremities in 31 patients with clinically advanced stages of primary lymphedema were examined with magnetic resonance lymphangiography. A 1 ml mixed liquor of gadobenate dimeglumine and mepivacainhydrochloride were injected subcutaneously into the dorsal aspect of both feet. For MRL, a 3D fast spoiled gradient-recalled echo T 1 -weighted images with a fat saturation technique (T 1 high resolution isotropic volume excitation, THRIVE) were performed after subcutaneous application of the contrast material. To outline lymphatic vessels, source images were used to reconstruct images of MIP. The SNR and CNR of enhanced lymphatic vessels and veins were measured and calculated respectively. The significance of the differences of the data comparisons was assessed using an unpaired student t test. Results: Of the 40 lower extremities, the beaded appearance of dilated lymphatic vessels was detected in 36 lower legs (90.0%) and 17 upper legs (42.5%). The numbers of the dilated lymphatic vessels displayed in all segments of lower extremities added up to 365 and its mean diameter was (3.4±0.1) mm on MRL MIP image. The average SNR and CNR were 257±130, 207±113 in the dilated lymphatic vessels and 218±129, 152±113 in the vein respectively, which was statistically significant (SNR t=-2.649, CNR t=-3.404, P<0.01). Contrast enhancement was observed in 30/40 inguinal lymph node groups (75.0%). In 26 lower extremities (65.0%) collateral vessels with dermal back-flow areas between lymphatic vessels were seen. Conclusions: As a novel tool to image the pathologically modified lymphatic vessels in patients with clinically advanced stage of primary lymphedema, magnetic resonance lymphangiography is a safe

Influence of adjuvant irradiation on the development of late arm lymphedema and impaired shoulder mobility after mastectomy for carcinoma of the breast

International Nuclear Information System (INIS)

Ryttov, N.; Holm, N.V.; Qvist, N.; Blichert-Toft, M.; Odense Univ. Hospital

1988-01-01

The influence of postoperative radiation therapy on development of late arm lymphedema and shoulder joint disability following mastectomy was evaluated from a series of 57 women with operable carcinoma of the breast. The patients were divided into three groups. Common for all three groups was mastectomy and partial axillary dissection. In addition one group received postoperative irradiation plus systemic therapy and another group systemic therapy alone. The incidence of late arm lymphedema/impaired shoulder mobility was 11%/4% in the group of patients undergoing surgery alone, 46%/38% in the group of patients receiving adjuvant irradiation and 6%/12% in the group of patients receiving adjuvant systemic therapy. It is concluded that adjuvant irradiation to the axilla in patients with metastatic lymph nodes highly increases the risk of late physical sequelae following modified radical mastectomy. Adjuvant systemic therapy can be administered to high risk patients without increasing the risk of late arm lymphedema and shoulder disability. (orig.)

Lymphoscintigraphy in the diagnosis of extremity lymphedema

International Nuclear Information System (INIS)

Yang Meifang; Lu Gang; Li Fang; Tian Jian

1994-01-01

Lymphoscintigraphy, using 99m Tc labeled antimony sulfur colloid and 99m Tc labeled dextran, was performed on 25 patients with swelling of upper or lower extremities for diagnosis of lymphedema. Five different lymphoscintigraphic patterns were identified, that is normal (4 cases), collaterals (2 cases), mixed (13 cases), dermal backflow (4 cases) and no backflow pattern (2 cases). Eight patients underwent operations for lympho-venous anastomoses on the involved extremity. The results indicate that lymphoscintigraphy has many advantages, such as simplicity and non-invasiveness, safety and reliability, being able to differentiate properties of extremity edema, to provide the information of morphologic changes and dynamically display lymphatic drainage and obstructive extent in the lymphatic system. The procedure is valuable for determination of the treatment modalities and the selection of patient for lymphatic microsurgery

The effect of relaxation techniques on edema, anxiety and depression in post-mastectomy lymphedema patients undergoing comprehensive decongestive therapy: A clinical trial.

Science.gov (United States)

Abbasi, Bahareh; Mirzakhany, Navid; Angooti Oshnari, Leila; Irani, Ashkan; Hosseinzadeh, Samaneh; Tabatabaei, Seyed Mehdi; Haghighat, Shahpar

2018-01-01

Lymphedema is sometimes accompanied by high degrees of anxiety and depression. This study aimed to assess the effects of relaxation techniques on the level of edema, anxiety and depression in women undergoing Comprehensive Decongestive Therapy (CDT). This clinical trial compared two treatment methods in 31 women with post-mastectomy lymphedema, including 15 cases who received CDT and 16 who received RCDT (Relaxation plus CDT). The edema volume, anxiety and depression scores were compared at the first and last sessions of the first phase of the treatment and six weeks afterwards. The edema, anxiety and depression scores were 63.6%, 54.1% and 65.5% in the RCDT group and 60.7%, 31.4% and 35.2% in the CDT group. There were significant differences between the two groups in terms of the reduction in depression (p = 0.024) and anxiety (p = 0.011) scores throughout the study. This significant relationship was due to the differences in the depression score in the 3rd and 9th weeks of the study between the two groups. Similarly, anxiety levels differed significantly between the two groups at the 9th week of the study (P = 0.013). Relaxation techniques reduced the anxiety and depression scores and the volume of edema in the patients with lymphedema. The addition of this intervention to the therapeutic package for lymphedema patients requires further studies in terms of cost-effectiveness.

Basic management of medical emergencies: recognizing a patient's distress.

Science.gov (United States)

Reed, Kenneth L

2010-05-01

Medical emergencies can happen in the dental office, possibly threatening a patient's life and hindering the delivery of dental care. Early recognition of medical emergencies begins at the first sign of symptoms. The basic algorithm for management of all medical emergencies is this: position (P), airway (A), breathing (B), circulation (C) and definitive treatment, differential diagnosis, drugs, defibrillation (D). The dentist places an unconscious patient in a supine position and comfortably positions a conscious patient. The dentist then assesses airway, breathing and circulation and, when necessary, supports the patient's vital functions. Drug therapy always is secondary to basic life support (that is, PABCD). Prompt recognition and efficient management of medical emergencies by a well-prepared dental team can increase the likelihood of a satisfactory outcome. The basic algorithm for managing medical emergencies is designed to ensure that the patient's brain receives a constant supply of blood containing oxygen.

Microsurgery guided by sequential preoperative lymphography using {sup 68}Ga-NEB PET and MRI in patients with lower-limb lymphedema

Energy Technology Data Exchange (ETDEWEB)

Long, Xiao; Gao, Chao; Yang, Elan [Peking Union Medical College Hospital Chinese Academy of Medical Sciences and Peking Union Medical College, Department of Plastic Surgery, Beijing (China); Zhang, Jingjing [Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Department of Nuclear Medicine, Beijing (China); National Institute of Biomedical Imaging and Bioengineering (NIBIB), National Institutes of Health (NIH), Laboratory of Molecular Imaging and Nanomedicine LOMIN, Bethesda, MD (United States); Zhang, Daming; Xue, Huadan [Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Department of Radiology, Beijing (China); Chi, Chongwei [Institute of Automation Chinese Academy of Sciences Beijing, Key Laboratory of Molecular Imaging of Chinese Academy of Sciences, Beijing (China); Lang, Lixin; Niu, Gang; Chen, Xiaoyuan [National Institute of Biomedical Imaging and Bioengineering (NIBIB), National Institutes of Health (NIH), Laboratory of Molecular Imaging and Nanomedicine LOMIN, Bethesda, MD (United States); Zhu, Zhaohui; Li, Fang [Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Department of Nuclear Medicine, Beijing (China)

2017-08-15

The popularity of contemporary microsurgical techniques in treatment of lower-limb lymphedema calls for better visualization of the lymphatic system, both preoperatively and intra-operatively. The aim of this prospective study was to investigate the feasibility of a novel combination of {sup 68}Ga-NEB positron emission tomography (PET) with magnetic resonance lymphography (MRL) in evaluating lymphedema and guiding surgical intervention. A total of 11 patients (F 9, M 2, age range 29-69 y) with lower-limb lymphedema classified into stage I to III were recruited. PET acquisition was performed at 30, 60 and 90 min after subcutaneous injection of the albumin-binding radiotracer {sup 68}Ga-NEB into the bilateral first web spaces of the feet. All the patients were also subjected to {sup 99m}Tc-sulfur colloid (SC) lymphoscintigraphy for comparison. Gd-DTPA-enhanced magnetic resonance imaging (MRI) was performed using sequences specialized for lymphatic vessel scans. All the patients underwent surgical interventions within a week. The surgical approach includes the use of a linear marker for edema localization and indocyanine green (ICG) lymphography with a near-infrared surgical navigation system intra-operatively. Lymph transport in lymphatic channels was clearly observed by visualization of {sup 68}Ga-NEB activity in the lymphatic vessels and within lymph nodes for all 11 patients as well as the visualization of the edema section plane with dermal backflow (DB), abnormally increased and disconnected uptake along the lymphatic channels. Preoperative {sup 68}Ga-NEB PET combined with MRL provides advantageous three-dimensional images, higher temporal resolution, significantly shorter time lapse before image acquisition after tracer injection and more accurate pathological lymphatic vessel distribution than {sup 99m}Tc-SC lymphoscintigraphy combined with MRI. This study documented an effective imaging pattern to combine {sup 68}Ga-NEB PET and MRL in patients with lower

Bioimpedance to screen for abdominal fat in patients with breast cancer treatment-related lymphedema.

Science.gov (United States)

de Fátima Guerreiro Godoy, Maria; Silva, Edivandra Buzato; de Godoy, Jose Maria Pereira

2016-07-28

One of the dreaded complications after the treatment of breast cancer is lymphedema. Therapies used in the treatment of breast cancer such as surgery, radiotherapy, hormone therapy and chemotherapy may be adversely affected by obesity. The objective of this study was to use bioimpedance to assess abdominal fat in women with breast cancer treatment-related lymphedema and suggest this as a screening method. Forty-five female patients with clinical diagnosis of breast cancer treatment-related lymphedema were evaluated in this quantitative cross-sectional study. A control group, composed of 38 patients with varicose veins and women attending a social support group, was matched for age and body mass index (BMI). All participants were submitted to a bioimpedance evaluation (In Body S 10), with particular attention being paid to abdominal fat and their BMI. The unpaired t -test, Fisher Exact test and Mann-Whitney test were used for statistical analysis and an alpha error of 5%. There was no significant difference (p -value = 0.23) in the mean BMI between the study group (27.79 kg∕m2) and the control group (28.80 kg∕m2). The mean abdominal circumference, a measure of abdominal fat, of the women in the study group was 130.54 cm2 and for the control group it was 102.24 cm2 (p -value = 0.0037). Thus the study group had more abdominal fat (p -value = 0.0003). Moreover, on comparing obese patients in the two groups, the study group had more abdominal fat (p -value = 0.02). However, no significant difference was observed comparing non-obese patients (p -value = 0.6). The comparison of obese patients with non-obese patients in the control group identifies an association between obesity and abdominal fat (p -value abdominal fat than the general population with bioimpedance.

Compulsive masturbation and chronic penile lymphedema.

Science.gov (United States)

Calabrò, Rocco Salvatore; Galì, Alessandro; Marino, Silvia; Bramanti, Placido

2012-06-01

Chronic penile lymphedema arises from the abnormal retention of lymphatic fluid in the subcutaneous tissues and may be secondary to local and systemic medical conditions such as sexually transmitted diseases, filariasis, malignancy, local radiotherapy, and surgery. This case report aims to consider compulsive masturbation as a possible cause of chronic penile edema. A 40-year-old man was referred to our institute for behavioral disturbance, including compulsive masturbation. Neuropsychiatric evaluation showed moderate mental retardation, mild dysarthria and limb incoordination, anxiety, depressed mood, and impulse dyscontrol. Brain MRI pointed out diffuse white matter lesions. Urogenital examination revealed an uncircumcised penis with non-tender edema of the shaft and prepuce with areas of lichenification. Since the most common local and systemic causes of edema were excluded, chronic penile edema due to compulsive masturbation was diagnosed and the compulsive behavior treated with an antidepressant and low-dose neuroleptics. Compulsive masturbation should be taken into account when counselling patients with penile edema.

Development of a Tissue-Engineered Lymphatic Graft Using Nanocomposite Polymer for the Treatment of Secondary Lymphedema.

Science.gov (United States)

Kanapathy, Muholan; Kalaskar, Deepak; Mosahebi, Afshin; Seifalian, Alexander M

2016-03-01

Damage of the lymphatic vessels, commonly due to surgical resection for cancer treatment, leads to secondary lymphedema. Tissue engineering approach offers a possible solution to reconstruct this damage with the use of lymphatic graft to re-establish the lymphatic flow, hence preventing lymphedema. The aim of this study is to develop a tissue-engineered lymphatic graft using nanocomposite polymer and human dermal lymphatic endothelial cells (HDLECs). A nanocomposite polymer, the polyhedral oligomeric silsequioxane-poly(carbonate-urea)urethane (POSS-PCU), which has enhanced mechanical, chemical, and physical characteristics, was used to develop the lymphatic graft. POSS-PCU has been used clinically for the world's first synthetic trachea, lacrimal duct, and is currently undergoing clinical trial for coronary artery bypass graft. Two designs and fabrication methods were used to manufacture the conduits. The fabrication method, the mechanical and physical properties, as well as the hydraulic conductivity were tested. This is followed by in vitro cell culture analysis to test the cytocompatibility of HDLEC with the polymer surface. Using the casted extrusion method, the nanocomposite lymphatic graft demonstrates desirable mechanical property and hydraulic conductivity to re-establish the lymphatic flow. The conduit has high tensile strength (casted: 74.86 ± 5.74 MPa vs. coagulated: 31.33 ± 3.71 MPa; P nanocomposite polymer. It displays excellent mechanical property and cytocompatibility to HDLECs, offering much promise for clinical applications and as a new treatment option for secondary lymphedema. Copyright © 2015 International Center for Artificial Organs and Transplantation and Wiley Periodicals, Inc.

The effects of complex exercise on shoulder range of motion and pain for women with breast cancer-related lymphedema: a single-blind, randomized controlled trial.

Science.gov (United States)

Park, Jin-Hyuck

2017-07-01

This study was to investigate the effects of complex exercise on shoulder range of motion and pain for women with breast cancer-related lymphedema. 69 women participated in this study and then they were randomly allocated to complex exercise group (n = 35) or the conventional decongestive therapy group (n = 34). All subjects received 8 sessions for 4 weeks. To identify the effects on shoulder range of motion and pain, goniometer and visual analog scale were used, respectively. The outcome measurements were performed before and after the 4 week intervention. After 4 weeks, complex exercise group had greater improvements in shoulder range of motion and pain compared with the conventional decongestive therapy group (p women with breast cancer-related lymphedema. Complex exercise would be useful to improve shoulder range of motion and pain of the women with breast cancer-related lymphedema.

A Scintigraphic Method for Quantitation of Lymphatic Function in Arm Lymphedema

DEFF Research Database (Denmark)

Hvidsten, Svend; Toyserkani, Navid M; Sørensen, Jens A

2018-01-01

) measure of lymph fluid passing through the arm. METHODS AND RESULTS: Eleven patients, aged 34-68 years, with unilateral arm lymphedema following breast cancer treatment underwent simultaneous bilateral lymphoscintigraphy using intradermal injection of 99mTc-labeled human serum albumin (HSA). Imaging...... was performed at 30-45 minute intervals for 5 hours. Time activity curves from each injection site and each arm region were recorded. The input into the arm region was obtained as the (minus) time derivative of the injection site activity curve. In the proposed model the arm activity curve was considered...

Improving traffic signal management and operations : a basic service model.

Science.gov (United States)

2009-12-01

This report provides a guide for achieving a basic service model for traffic signal management and : operations. The basic service model is based on simply stated and defensible operational objectives : that consider the staffing level, expertise and...

Verrucous lesions arising in lymphedema and diabetic neuropathy: Elephantiasis nostras verrucosa or verrucous skin lesions on the feet of patients with diabetic neuropathy?

Science.gov (United States)

Hotta, Eri; Asai, Jun; Okuzawa, Yasutaro; Hanada, Keiji; Nomiyama, Tomoko; Takenaka, Hideya; Katoh, Norito

2016-03-01

Verrucous skin lesions on the feet in diabetic neuropathy (VSLDN) develop in areas with sensory loss in diabetic patients. Although various types of chronic stimulation, such as pressure or friction, are considered an important factor in the development of such lesions, the precise pathogenesis of VSLDN remains obscure, and there is currently no established treatment for this disease. Here, we present a case of VSLDN on the dorsum of the right foot. However, because lymphedema was also observed at the same site, this lesion could also be diagnosed as elephantiasis nostras verrucosa arising in diabetic neuropathy. The lesion was successfully treated with a combination of elastic stocking and mixed killed bacterial suspension and hydrocortisone ointment, which suggested that VSLDN might have been exacerbated by the pre-existing lymphedema. Because various types of chronic stimulation can trigger VSLDN, treatment plans should be devised on a case-by-case basis. Therefore, it is important to investigate the presence of factors that can induce or exacerbate chronic inflammatory stimulation, such as lymphedema in our case, in each patient with VSLDN. © 2015 Japanese Dermatological Association.

No evidence of benefit from class-II compression stockings in the prevention of lower-limb lymphedema after inguinal lymph node dissection: results of a randomized controlled trial.

Science.gov (United States)

Stuiver, M M; de Rooij, J D; Lucas, C; Nieweg, O E; Horenblas, S; van Geel, A N; van Beurden, M; Aaronson, N K

2013-09-01

Graduated compression stockings have been advocated for prevention of lymphedema after inguinal lymph node dissection (ILND) although scientific evidence of their efficacy in preventing lymphedema is lacking. The primary objective of this study was to assess the efficacy of class II compression stockings for the prevention of lymphedema in cancer patients following ILND. Secondary objectives were to investigate the influence of stockings on the occurrence of wound complications and genital edema, health-related quality of life (HRQoL) and body image. Eighty patients (45 with melanoma, 35 with urogenital tumors) who underwent ILND at two specialized cancer centers were randomly allocated to class II compression stocking use for six months or to a usual care control group. Lymphedema of the leg and genital area, wound complications, HRQoL, and body image were assessed at regular intervals prior to and up to 12 months after ILND. No significant differences were observed between groups in the incidence of edema, median time to the occurrence of edema, incidence of genital edema, frequency of complications, HRQoL, or body image. Based on the results of the current study, routine prescription of class II graduated compression stockings after ILND should be questioned and alternative prevention strategies should be considered.

Surgical treatment of lymphedema of the penis and scrotum Tratamento cirúrgico do linfedema peno-escrotal

Directory of Open Access Journals (Sweden)

Miguel Modolin

2006-08-01

Full Text Available PURPOSE: Lymphedema of the penis and scrotum, regardless of its etiology, is determined by reduced lymphatic flow with subsequent enlargement of the penis and scrotum. The clinical course of this condition is characterized by extreme discomfort for patients, with limitation of local hygiene, ambulation, sexual intercourse, and voiding in the standing position. The purpose of the present study is to present the experience and results of the treatment of lymphedema of the penis and scrotum by removing affected tissues and correcting the penoscrotal region. MATERIALS AND METHODS: Seventeen patients with lymphedema of the penis and scrotum were treated with a modified Charles procedure, which consists of the excision of the affected skin followed by scrotoplasty and midline suture simulating the scrotal raphe. The penis is covered with a split-thickness skin graft by means of a zigzag suture on its ventral surface. RESULTS: Regression of symptoms and improvement of previous clinical conditions were verified in the follow-up which ranged from 6 months to 6 years. One patient who had undergone lymphadenectomy with radiation therapy due to penile cancer had recurrent scrotum lymphedema. CONCLUSIONS: The modified Charles procedure for the treatment of penoscrotal lymphedema is easily reproducible and allows better local hygiene, easier ambulation, voiding in the standing position, resuming sexual intercourse, and finally, better cosmetic results in the affected area with remarkable improvement in quality of life.INTRODUÇÃO: O linfedema peno-escrotal, independentemente da etiologia, é determinado pela redução do fluxo linfático com conseqüente aumento do volume do escroto e pênis. A evolução clínica da doença é caracterizada com extremo desconforto ao paciente, limitando a higiene local, a deambulação, o intercurso sexual e a micção em posição ortostática. OBJETIVO: Apresentar a experiência e resultados no tratamento da patologia com

Hydrops fetalis and pulmonary lymphangiectasia due to FOXC2 mutation: an autosomal dominant hereditary lymphedema syndrome with variable expression.

Science.gov (United States)

de Bruyn, Gwendolyn; Casaer, Alexandra; Devolder, Katrien; Van Acker, Geert; Logghe, Hilde; Devriendt, Koen; Cornette, Luc

2012-03-01

Non-immune hydrops fetalis may find its origin within genetically determined lymphedema syndromes, caused by mutations in FOXC2 and SOX-18. We describe a newborn girl, diagnosed with non-immune hydrops fetalis at a gestational age of 30 weeks. Family history revealed the presence of an autosomal dominant late-onset form of lymphedema of the lower limbs in her father, associated with an aberrant implantation of the eyelashes in some individuals. The newborn, hydropic girl suffered from severe pulmonary lymphangiectasia, resulting in terminal respiratory failure at the age of 3 months. Genetic analysis in both the father and the newborn girl demonstrated a heterozygous FOXC2 mutation, i.e., c.939C>A, p.Tyr313X. Her two older sisters are currently asymptomatic and the parents decided not to test them for the FOXC2 mutation. Patients with a mutation in the FOXC2 transcription factor usually show lower limb lymphedema with onset at or after puberty, together with distichiasis. However, the eye manifestations can be very mild and easily overlooked. The association between FOXC2 mutation and neonatal hydrops resulting in terminal respiratory failure is not reported so far. Therefore, in sporadic patients diagnosed with non-immune hydrops fetalis, lymphangiogenic genes should be systematically screened for mutations. In addition, all cases of fetal edema must prompt a thorough analysis of the familial pedigree, in order to detect familial patterns and to facilitate adequate antenatal counseling.

Lower limb lymphedema in gynecological cancer survivors--effect on daily life functioning.

Science.gov (United States)

Dunberger, Gail; Lindquist, Helene; Waldenström, Ann-Charlotte; Nyberg, Tommy; Steineck, Gunnar; Åvall-Lundqvist, Elisabeth

2013-11-01

Lower limb lymphedema (LLL) is a common condition after pelvic cancer treatment but few studies have evaluated its effect on the quality of life and its consequences on daily life activities among gynecological cancer survivors. We identified a cohort of 789 eligible women, treated with pelvic radiotherapy alone or as part of combined treatment of gynecological cancer, from 1991 to 2003 at two departments of gynecological oncology in Sweden. As a preparatory study, we conducted in-depth interviews with gynecological cancer survivors and constructed a study-specific questionnaire which we validated face-to-face. The questionnaire covered physical symptoms originating in the pelvis, demographic, psychological, and quality of life factors. In relation to the lymph system, 19 questions were asked. Six hundred sixteen (78 %) gynecological cancer survivors answered the questionnaire and participated in the study. Thirty-six percent (218/606) of the cancer survivors reported LLL. Overall quality of life was significantly lower among cancer survivors with LLL. They were also less satisfied with their sleep, more worried about recurrence of cancer, and more likely to interpret symptoms from the body as recurrence. Cancer survivors reported that LLL kept them from physical activity (45 %) and house work (29 %) and affected their ability to partake in social activities (27 %) or to meet friends (20 %). Lower limb lymphedema has a negative impact on quality of life among gynecological cancer survivors, affecting sleep and daily life activities, yet only a few seek professional help.

Hypohidrotic ectodermal dysplasia, osteopetrosis, lymphedema, and immunodeficiency in an infant with multiple opportunistic infections.

Science.gov (United States)

Carlberg, Valerie M; Lofgren, Sabra M; Mann, Julianne A; Austin, Jared P; Nolt, Dawn; Shereck, Evan B; Davila-Saldana, Blachy; Zonana, Jonathan; Krol, Alfons L

2014-01-01

Osteopetrosis, lymphedema, hypohidrotic ectodermal dysplasia, and immunodeficiency (OL-HED-ID) is a rare X-linked disorder with only three reported prior cases in the English-language literature. We describe a case of OL-HED-ID in a male infant who initially presented with congenital lymphedema, leukocytosis, and thrombocytopenia of unknown etiology at 7 days of age. He subsequently developed gram-negative sepsis and multiple opportunistic infections including high-level cytomegalovirus viremia and Pneumocystis jiroveci pneumonia. The infant was noted to have mildly xerotic skin, fine sparse hair, and periorbital wrinkling, all features suggestive of ectodermal dysplasia. Skeletal imaging showed findings consistent with osteopetrosis, and immunologic investigation revealed hypogammaglobulinemia and mixed T- and B-cell dysfunction. Genetic testing revealed a novel mutation in the nuclear factor kappa beta (NF-KB) essential modulator (NEMO) gene, confirming the diagnosis of OL-HED-ID. Mutations in the NEMO gene have been reported in association with hypohidrotic ectodermal dysplasia with immunodeficiency (HED-ID), OL-HED-ID, and incontinentia pigmenti. In this case, we report a novel mutation in the NEMO gene associated with OL-HED-ID. This article highlights the dermatologic manifestations of a rare disorder, OL-HED-ID, and underscores the importance of early recognition and prompt intervention to prevent life-threatening infections. © 2013 Wiley Periodicals, Inc.

Teaching Basic Probability in Undergraduate Statistics or Management Science Courses

Science.gov (United States)

Naidu, Jaideep T.; Sanford, John F.

2017-01-01

Standard textbooks in core Statistics and Management Science classes present various examples to introduce basic probability concepts to undergraduate business students. These include tossing of a coin, throwing a die, and examples of that nature. While these are good examples to introduce basic probability, we use improvised versions of Russian…

41 CFR 102-74.10 - What is the basic facility management policy?

Science.gov (United States)

2010-07-01

... facility management policy? 102-74.10 Section 102-74.10 Public Contracts and Property Management Federal Property Management Regulations System (Continued) FEDERAL MANAGEMENT REGULATION REAL PROPERTY 74-FACILITY MANAGEMENT General Provisions § 102-74.10 What is the basic facility management policy? Executive agencies...

The effectiveness of a clinical and home-based physical activity program and simple lymphatic drainage in the prevention of breast cancer-related lymphedema: A prospective randomized controlled study.

Science.gov (United States)

Dönmez, Ayşe Arıkan; Kapucu, Sevgisun

2017-12-01

To investigate the effectiveness of a clinical and home-based, nurse-led physical activity program (PAP) and simple lymphatic drainage (SLD) in the prevention of breast cancer-related lymphedema. A total of 52 breast cancer patients were randomized to either a PAP and SLD program (n = 25) or a control group (n = 27). Patients in both groups were also provided training for lymphedema. The PAP and SLD were administered through home visits by the investigators, twice a week for six weeks, in the intervention group. The control group did not undergo intervention. The circumference of the upper extremity, symptom severity, and physical function were measured in both groups. The upper extremity circumference increased by about two times from the baseline, in the control group, especially in the sixth week (p breast cancer surgery, starting from before surgery and continuing until after, to prevent breast cancer-related lymphedema. Copyright © 2017 Elsevier Ltd. All rights reserved.

Basic chemistry for radioactive waste management

International Nuclear Information System (INIS)

Eom, Tae Yoon; Park, Kyeong Kyun; Kim, Won Ho; Jee, Kwang Yong; Kim, Jong Koo; Park, Young Jae; Yoo, Man Soo; Jee, Chun Suk; Song, Byung Chul; Choi, Kyae Chun

1992-03-01

The goal of this study is to obtain the information about the chemical behavior of radionuclides in groundwater for the safety of radioactive waste management. The effect of o-phenanthroline and 2,2'-bipyridine on the adsorption of metal(II) (Mn, Fe, Co, Ni, and Cu) to silica gel surface, computer program for calculation of compound concentrations in multi-composition system, Np-237 reagent purification by anion exchange resin, characterization of installed basic photoacoustic spectrophotometer, and study of pH, ionic strength and metal ion adsorption on humic acid size distribution were described. (Author)

Significant Differences in Nurses’ Knowledge of Basic Wound Management

DEFF Research Database (Denmark)

Zarchi, Kian; Latif, Seemab; Haugaard, Vibeke B

2014-01-01

Wounds represent a growing healthcare problem due to an aging population. Nurses play a key role in wound management and their theoretical understanding of basic wound management may be expected to influence the quality of wound therapy fundamentally. In this study, we evaluated the level...... of knowledge of wound management in 136 Danish nurses working in 3 different settings: advanced wound care clinics, home care and general hospital departments. We found that hospital nurses had less theoretical knowledge than home care nurses and nurses working at advanced wound care clinics. We also found...... of wound management in Denmark and suggests how improvements might be achieved....

The aesthetic rationality of the popular expressive arts: Lifeworld communication among breast cancer survivors living with lymphedema

Science.gov (United States)

Quinlan, Elizabeth; Thomas, Roanne; Ahmed, Shahid; Fichtner, Pam; McMullen, Linda; Block, Janice

2014-01-01

The use of popular expressive arts as antidotes to the pathologies of the parallel processes of lifeworld colonization and cultural impoverishment has been under-theorized. This article enters the void with a project in which breast cancer survivors used collages and installations of everyday objects to solicit their authentic expression of the psycho-social impacts of lymphedema. The article enlists Jurgen Habermas' communicative action theory to explore the potential of these expressive arts to expand participants' meaningful engagement with their lifeworlds. The findings point to the unique non-linguistic discursivity of these non-institutional artistic forms as their liberating power to disclose silenced human needs: the images ‘spoke' for themselves for group members to recognize shared subjectivities. The authenticity claims inherent in the art forms fostered collective reflexivity and spontaneous, affective responses and compelled the group to create new collective understandings of the experience of living with lymphedema. The article contributes theoretical insights regarding the emancipatory potential of aesthetic-expressive rationality, an under-developed area of Habermasian theory of communicative action, and to the burgeoning literature on arts-based methods in social scientific research. PMID:25197263

The aesthetic rationality of the popular expressive arts: Lifeworld communication among breast cancer survivors living with lymphedema.

Science.gov (United States)

Quinlan, Elizabeth; Thomas, Roanne; Ahmed, Shahid; Fichtner, Pam; McMullen, Linda; Block, Janice

2014-08-01

The use of popular expressive arts as antidotes to the pathologies of the parallel processes of lifeworld colonization and cultural impoverishment has been under-theorized. This article enters the void with a project in which breast cancer survivors used collages and installations of everyday objects to solicit their authentic expression of the psycho-social impacts of lymphedema. The article enlists Jurgen Habermas' communicative action theory to explore the potential of these expressive arts to expand participants' meaningful engagement with their lifeworlds. The findings point to the unique non-linguistic discursivity of these non-institutional artistic forms as their liberating power to disclose silenced human needs: the images 'spoke' for themselves for group members to recognize shared subjectivities. The authenticity claims inherent in the art forms fostered collective reflexivity and spontaneous, affective responses and compelled the group to create new collective understandings of the experience of living with lymphedema. The article contributes theoretical insights regarding the emancipatory potential of aesthetic-expressive rationality, an under-developed area of Habermasian theory of communicative action, and to the burgeoning literature on arts-based methods in social scientific research.

Cell therapy for the treatment of lower limb lymphedema. Case report Terapia celular en el tratamiento de linfedema de miembros inferiores. Presentación de un caso

Directory of Open Access Journals (Sweden)

Pedro Goicoechea-Díaz

2010-12-01

Full Text Available Although lymphedema is a common disabling disease causing significant morbidity for affected patients, treatment for this condition remains limited and largely ineffective. Some reported data suggest that some bone-marrow derived cells may play a role in lymphangiogenesis. It appears that blood vessels and lymphatic vessels might use the same population of cells for vasculogenesis and lymphangiogenesis. Therefore, adult stem cell therapy could be a new useful strategy for the treatment of lymphedema. We report a resolution of a severe lower limb bilateral lymphedema after implantation of autologous adult stem cells derived from bone marrow. As far as we know, this is the first reported case with chronic lower limb lymphedema treated successfully with autologous cell therapy. This procedure is a low-cost, relatively simple and easy to perform option that opens new ways for the treatment of lymphedema.Aunque el linfedema es una enfermedad crónica inhabilitante común que causa morbilidad significativa en los pacientes afectados, el tratamiento para esta enfermedad se mantiene muy limitada y en la mayor parte de los casos resulta ineficaz. Algunos datos reportados sugieren que algunas de las células madre derivadas de la medula ósea pueden intervenir en la linfangiogénesis. Al parecer, los vasos sanguíneos y los vasos linfáticos podrían usar la misma población celular para la vasculogénesis y la linfangiogénesis. Por consiguiente, la terapia con células madre adultas podría ser una nueva estrategia útil para el tratamiento de linfedema. En el presente trabajo se informa la resolución de un linfedema bilateral severo de miembros inferiores después de la implantación de células madre autólogas derivadas de la médula ósea. Hasta donde sabemos, este es el primer caso de linfedema crónico de los miembros inferiores tratado exitosamente con células madre autólogas. Este método de tratamiento es económico, relativamente simple, f

Regional Distribution of Epifascial Swelling and Epifascial Lymph Drainage Rate Constants in Breast Cancer-Related Lymphedema

OpenAIRE

MODI, STEPHANIE; STANTON, ANTHONY W. B.; MELLOR, RUSSELL H.; MICHAEL PETERS, A.; RODNEY LEVICK, J.; MORTIMER, PETER S.

2005-01-01

Background: The view that breast cancer-related lymphedema (BCRL) is a simple, direct mechanical result of axillary lymphatic obstruction (‘stopcock’ mechanism) appears incomplete, because parts of the swollen limb (e.g., hand) can remain nonswollen. The lymph drainage rate constant (k) falls in the swollen forearm but not in the spared hand, indicating regional differences in lymphatic function. Here the generality of the hypothesis that regional epifascial lymphatic failure underlies region...

Reference Values for Assessment of Unilateral Limb Lymphedema with Dual-Energy X-Ray Absorptiometry

DEFF Research Database (Denmark)

Gjorup, Caroline A; Hendel, Helle W; Klausen, Tobias W

2018-01-01

INTRODUCTION: The clinical assessment of unilateral limb lymphedema is commonly based on measurements of interlimb volume differences. Reference values for interlimb percentage differences of the volume, fat mass, and lean mass measured with dual-energy X-ray absorptiometry (DXA) scan are, however...... is calculated as follows: ("Limb-of-interest"-contralateral)/contralateral × 100. The interlimb percentage differences for the limb-of-interest were stratified to upper (according to handedness) and lower limbs and categorized as none/mild, moderate, or severe, respectively, based on whether the value is below...

Role of lymphoscintigraphy in diagnosis and management of patients with leg swelling of unclear etiology

International Nuclear Information System (INIS)

Kalawat, Tek Chand; Chittoria, Ravi Kumar; Reddy, Praveen Kumar; Suneetha, Batchu; Narayan, Ravishwar; Ravi, Parthsarthi

2012-01-01

To study the utility of lymphoscintigraphy in detection of lymphatic obstruction in patients with leg swelling of unclear etiology, selection of site for nodo venous shunt procedure, and follow-up lymphoscintigraphic documentation of improved lymph flow in surgically treated limb. Twenty four consecutive patients with leg swelling, 10 male, 14 female with mean age 47 years, range from 13 years to 74 years underwent lymphoscintigraphy. All patients were referred from Department of Plastic Surgery, after initial work-up, and routine investigations to rule out the other causes of leg swelling. Both clinical and scintigraphic staging performed for all patients. All clinically and scintigraphically positive patients treated with decongestive lymphatic therapy (DLT). In addition to the DLT, those patients positive for unilateral or bilateral lymphedema, consented for surgical intervention, nodo venous shunt (NVS) in their only affected or one of the two affected lower limbs. Follow-up lymphoscintigraphy performed in operated cases after 3 months to 6 months of surgery, lymphoscintigraphy images of each patient in pre and post-surgery compared. In 20/24 cases (83%) of clinically positive leg swelling were found to be positive for lymphedema on lymphoscintigraphy and remaining, 4/24 were scintigraphically normal. Based on the clinical and lymphoscintigraphy staging, 03/20 cases (15%) had Grade I lymphedema, 01/20 (5%) Grade II lymphedema, 06/20 (30%) Grade III and remaining 10/20 (50%) had Grade IV lymphedema. 11/20 cases of Lymphedema (55%) were managed conservatively by only DLT and in remaining 09/20 cases (45%), who were case of Grade IV, lymphedema (five patients with unilateral and four patients with bilateral disease) initially treated with DLT, and on completion of DLT, undergone for NVS procedure, in their unilaterally affected lower limb or one of the two diseased lower limbs. All nine patients showed remarkable clinical improvement in leg swelling and their

41 CFR 102-80.10 - What are the basic safety and environmental management policies for real property?

Science.gov (United States)

2010-07-01

... safety and environmental management policies for real property? 102-80.10 Section 102-80.10 Public... MANAGEMENT REGULATION REAL PROPERTY 80-SAFETY AND ENVIRONMENTAL MANAGEMENT General Provisions § 102-80.10 What are the basic safety and environmental management policies for real property? The basic safety and...

Edema: diagnosis and management.

Science.gov (United States)

Trayes, Kathryn P; Studdiford, James S; Pickle, Sarah; Tully, Amber S

2013-07-15

Edema is an accumulation of fluid in the interstitial space that occurs as the capillary filtration exceeds the limits of lymphatic drainage, producing noticeable clinical signs and symptoms. The rapid development of generalized pitting edema associated with systemic disease requires timely diagnosis and management. The chronic accumulation of edema in one or both lower extremities often indicates venous insufficiency, especially in the presence of dependent edema and hemosiderin deposition. Skin care is crucial in preventing skin breakdown and venous ulcers. Eczematous (stasis) dermatitis can be managed with emollients and topical steroid creams. Patients who have had deep venous thrombosis should wear compression stockings to prevent postthrombotic syndrome. If clinical suspicion for deep venous thrombosis remains high after negative results are noted on duplex ultrasonography, further investigation may include magnetic resonance venography to rule out pelvic or thigh proximal venous thrombosis or compression. Obstructive sleep apnea may cause bilateral leg edema even in the absence of pulmonary hypertension. Brawny, nonpitting skin with edema characterizes lymphedema, which can present in one or both lower extremities. Possible secondary causes of lymphedema include tumor, trauma, previous pelvic surgery, inguinal lymphadenectomy, and previous radiation therapy. Use of pneumatic compression devices or compression stockings may be helpful in these cases.

Dynamic analysis of muscular lymphokinetic activities in the treatment of lymphedema of the upper limbs - doi:10.5020/18061230.2007.p233

Directory of Open Access Journals (Sweden)

Maria de Fátima Guerreiro Godoy

2012-01-01

Full Text Available The aim of the present study was to evaluate the resting and working pressures associated to a restrain mechanism, in patients suffering from lymphedema of the upper limbs, postbreast cancer treatment, whilst performing occupational and day-to-day self-care activities. Six female patients under treatment of lymphedema due to surgical, radiotherapeutic and chemotherapeutic treatment of breast cancer, in the age group between 32 and 76 years (mean 54 years old, ± 31.11 were selected. A compression sleeve of “gorgurão” (cotton-polyester material was applied as a restrain mechanism. The occupational and daily personal care activities evaluated were those common to all participants. These activities included washingup, cooking in a small pan, sweeping the floor using the affected arm, brushing the teeth, brushing the hair, washing small items of clothes, ironing clothes and making the bed. For statistical analysis, mean and standard deviation between resting pressures and minimum and maximum working pressures were determined. The two-tailed student t-test and variance analysis were used for repeated measurements. The Bonferroni limit was used in the analysis of the variables to calculate the alpha error, with a value of 5%, considered statistically significant. All of the analyzed activities associated to the “gorgurão” compression sleeve generated both resting and working pressures (p <0.005. In conclusion, the occupational daily life tasks used in the present study generate resting and working pressures and can be used as a form of treatment of the lymphedema.

Active exercises utilizing a facilitating device in the treatment of lymphedema resulting from breast cancer therapy

Directory of Open Access Journals (Sweden)

de Fátima Guerreiro Godoy, Maria

2010-01-01

Full Text Available The aim of this study was to evaluate the reduction in volume of arm lymphedema secondary to breast cancer therapy utilizing an exercise facilitating device. Twenty-one women with arm lymphedema resulting from the surgical and radiotherapeutic treatment of breast cancer were randomly selected. Evaluation was made by water-displacement volumetry before and after each session. The patients were submitted to a series of active exercises using a facilitating device for four 12-minute sessions with intervals of 3 minutes between sessions in the sitting position with alignment of the spinal column. The lymphedematous arm was maintained under compression using a cotton-polyester sleeve. The active exercising device used was a mobile flexion bar fixed on a metal base at a height of 30 cm from the tabletop and at a distance of 10 cm from the patient’s body. The paired t-test was utilized for statistical analysis with an alpha error of 5% (p-value ≤0.05 being considered significant. The initial mean volume of the arms was 2,089.9 and the final volume was 2,023.0 mL with a mean loss of 66.9 mL (p-value <0.001. In conclusion, active exercises utilizing facilitating devices can contribute to a reduction in size of lymphedematous limbs.

[Local planning: the speech of basic health care center manager].

Science.gov (United States)

Cubas, Márcia Regina

2005-01-01

As planning is understood as a management tool, this article offers an argument through the speech framework of Basic Health Care Center Managers in the city of Curitiba-PR, by means of the Collective Subject Speech Methodology on local planning aspects. Its purpose is to bring local managers to a reflection concerning their styles, practices and experiences, as well as to collaborate with central level leading teams towards building their planning processes in an upward, participatory, communicative and strategic way. Considerations of the speeches built from central ideas are presented: planning methodology; inter-sectoriality; territorial basis; team and community participation; training, autonomy and particular profile of local managers; the manager's agenda; and institutional culture.

Management Strategies in Basic Education and Participation of Parents

Directory of Open Access Journals (Sweden)

Johel Furguerle-Rangel

2016-05-01

Full Text Available In the educational process it is necessary to use management paradigms and active participation of parents. The objective was to determine the use of management strategies by the director of basic education and participation of parents in the educational process. It is a descriptive, transversal and field study, whose instrument was a questionnaire of 26 closed-questions.   The sample comprised 16 directors, 52 teachers and 62 parents. For most managers and faculty the technique of brainstorming, involvement in decision-making, continues knowledge management and radical change are crucial in the educational process of children.   But mothers and fathers believe that managerial groups do not use strategies properly except for reengineering.   The mother and fathers are mainly involved in education management but not in the learning process. It is recommended the deepening of policy management training teaching force, through continuous training provided by the government and the promotion of family participation in the teaching-learning process of children.

Physical Therapy Intervention to Augment Outcomes Of Lymph Node Transfer Surgery for a Breast Cancer Survivor with Secondary Upper Extremity Lymphedema: A Case Report.

Science.gov (United States)

McKey, Katelyn P; Alappattu, Meryl J

Lymphedema is an incurable complication of breast cancer treatment that affects roughly 20 percent of women. It is often managed via complete decongestive therapy, which includes manual lymph drainage, therapeutic compression, skin care, and exercise. Lymph node transfer is a new and expensive surgical intervention that uses one's own lymph nodes and implants them in the affected upper extremity. Previous research has investigated augmenting lymph node transfer surgery with complete decongestive therapy, but there is a lack of evidence regarding the success of focusing lymph drainage against the normal pressure gradient toward a surgical flap located on the wrist. The patient's main motivation for the surgical intervention was to alleviate her daily burden of complete decongestive therapy. The purpose of this case report was to compare the methods and results of pre-surgical complete decongestive physical therapy to a post-operation modified approach that directed lymph fluid away from the major lymphatic ducts and instead toward a surgical flap on the wrist of a patient with lymphedema. A 65-year-old female presented with secondary upper extremity lymphedema following breast cancer treatment. Her circumferential measurements and L-Dex score corroborated this diagnosis, and she had functional deficits in upper extremity range of motion. She was seen for 10 visits of traditional complete decongestive therapy prior to her lymph node transfer surgery and 24 treatments of modified complete decongestive therapy over the course of six months following surgery. At six months, the patient had minor improvements in the Functional Assessment of Chronic Illness Therapy-Fatigue, Disabilities of the Arm, Shoulder and Hand questionnaire, range of motion, and upper extremity strength. However, her circumferential measurements and L-Dex scores showed a meaningful increase in limb girth. The patient's smallest upper extremity volumes were documented before the operation after two

A basic framework for managing time of nuclear plant projects

International Nuclear Information System (INIS)

Beck, J.R.

1987-01-01

One of the crucial problems that faces managers of nuclear power plant projects is how to obtain more effective and efficient utilization of their company's resources. Analysis of this problem showed that improvement was necessary in the time management area. Time management is one of the primary functions of project groups. Much has been written about planning and scheduling, and there are many modern techniques (CPM, PERT, etc.) available to a project group to manage time. So, why is time management still a problem? One reason is that nuclear projects are generally very complex and involve many organizations requiring the same resources. It is the intent of this paper to present a comprehensive and basic framework on which to either build a time management system or use as a basis to assess an existing system

Fatores de risco para linfedema após câncer de mama: uma revisão da literatura Risk factors of arm lymphedema after breast cancer: a literature review

Directory of Open Access Journals (Sweden)

Anke Bergmann

2008-01-01

Full Text Available O linfedema representa uma das principais seqüelas do câncer de mama. Esta revisão da literatura visou discutir os principais fatores associados ao linfedema após o tratamento do câncer de mama. Foram selecionados 26 artigos publicados entre janeiro de 2000 e março de 2008 nas bases Medline e Lilacs, utilizando os descritores breast neoplasms, lymphedema, upper extremity, arm e risk factors. Sua revisão permitiu discutir os fatores relacionados ao linfedema, quanto a: clínica e paciente (tabagismo, escolaridade, etnia, comorbidades, hipertensão arterial, diabetes melito, menopausa, idade, peso corporal, índice de massa corporal, atividade física, membro dominante, restrição articular, infecção, seroma e trauma no membro superior; tratamento do câncer de mama (cirurgia, reconstrução mamária, número de linfonodos retirados, nível da linfadenectomia axilar, radioterapia, quimioterapia, hormonioterapia e tempo transcorrido após o tratamento; tumor (tamanho, grau, localização, comprometimento dos linfonodos axilares e estadiamento. A revisão feita indica que a linfadenectomia axilar, a radioterapia em cadeias de drenagem e a obesidade são fatores preponderantes do risco para desenvolvimento do linfedema.Arm lymphedema is one of the most frequent sequelae of breast cancer treatment. The purpose of this literature review was to discuss main risk factors of lymphedema after breast cancer treatment. The search in Medline and Lilacs databases, by means of key words breast neoplasms, lymphedema, upper extremity, arm, and risk factors, allowed selecting 26 studies published between January, 2000, and March, 2008. This review discusses factors linked to: clinic and the patient (smoking, education level, race/ethnicity, comorbidity, hypertension, diabetes, menopause, age, weight, body mass index, physical activity, handedness, impaired range of motion, infection, seroma and arm injuries; breast cancer treatment (type of surgery

Basic Graphical Data Management System (BAGDAMS version 1.0)

International Nuclear Information System (INIS)

Weindorf, J.W.

1979-06-01

BAGDAMS (BAsic Graphical DAta Management System) is a set of FORTRAN callable subroutines which provides mass storage data structuring and manipulation capabilities. Although primarily designed to facilitate the handling of graphical data files (files containing information to be displayed upon graphical hardware devices), BAGDAMS can also be used in many other applications requiring complex mass storage resident data structures. (author)

Composing hope through collage: A community-based intervention for cancer survivors living with lymphedema

Directory of Open Access Journals (Sweden)

Roanne Thomas

2016-07-01

Full Text Available Secondary lymphedema after cancer may result in distress, yet few interventions exist to support coping skills in this population. As part of a community-based intervention, we piloted the use of creative practices to promote active orientations to hope. A total of 19 participants completed the workshops; 11 collaged. The main themes address the collage processes as well as their content. The former addresses sub-themes such as selecting/composing. The latter includes sub-themes related to movement depicted in the collages. Collages and their associated discussions concretized hoping as an active and accessible process for participants living with two chronic illnesses.

Profile of Knowledge Management, Basic Sanitation and Attitudes towards Clean and Health Community in Kupang City

Science.gov (United States)

Nikmah; Ardi, Muhammad; Yahya, Mohamad; Upa, Muhamad D. Pua; Dirawan, Gufran Darma

2017-01-01

The objective of research is to describe the knowledge and attitude of basic sanitation management community in Kupang City. This type of research is a survey research using quantitative approach. Data were collected by using the instrument in the form of test knowledge of basic sanitation management and attitude questionnaire. The data was then…

Lymphedema during pregnancy - case study

Directory of Open Access Journals (Sweden)

Katarzyna Korabiusz

2017-06-01

Full Text Available Pregnancy is a period when woman’s body undergoes a lot of changes in her hormonal balance, lymphatic system, musculoskeletal system and cardiovascular system. As a result of disorders in defense mechanisms, a significant amount of liquid accumulates in spaces between tissues. A clinical manifestation of this condition is swelling located around ankles and lower legs. Sedentary lifestyle, unhealthy eating habits, excessive weight and pregnancy are also well known causes of lymphatic swelling. Comprehensive anti-swelling therapy that is used in treating lymphatic swelling in pregnant patients includes: patients’ education, manual lymphatic drainage, kinesitherapy, multilayer bandaging, skin care, drainage positions and kinesiotaping. Dissertation’s objective: Dissertation’s objective is to evaluate implementation of manual lymphatic drainage and anti-swelling kinesiotaping in pregnant woman with lymphatic swelling of lower legs. Research methods: Research methods were collected basing on: interview with a patient, medical documentation analysis and physical examination conduced before and after therapy. Research was conducted between 34th and 36th week of pregnancy. Case study: 38 year old patient in her fourth singleton pregnancy. Two prior pregnancies in 2009 and 2010 were delivered with C-section and one missed abortion in 2015 occurred. During this pregnancy patient gained over 30kg. She was diagnosed with lymphatic swelling of metatarsus, lower legs and ankles in 34th week of pregnancy. Lymphatic drainage of lower limbs and anti-swelling kinesiotaping was implemented. Results: After two weeks of therapy decrease in swelling was observed in left lower limb: in metatarsus by 8cm, in ankles by 9cm and in lower legs by 6cm. In right lower limb swelling decreased accordingly by 7cm, 10cm and 5cm. Conclusion: Anti-swelling lymphatic drainage, kinesiotherapy and kinesiotaping are effective physiotherapy methods used in treating lymphedema

Basic principles, contents, and benefits of an integrated management system

International Nuclear Information System (INIS)

Schwarzin, Juergen

2010-01-01

The basic principles and contents of an integrated management system are presented. The report focuses on the benefits and the experience accumulated in using an integrated management system. Integrated management systems are characterized by 2 features in particular: - On the one hand, by a system holistically controlling and describing all processes within a company which are necessary to achieve the company policy and company goals as defined. - On the other hand, it combines in one integrated management system various different aspects (such as quality, environmental protection, and safety) and the resulting requirements. Successful implementation of an integrated management system requires a clear commitment by company management to the integrated management system serving as a management tool. Implementation must be assigned the appropriate importance in the company. It must not be viewed as an instrument preserving 'status quo.' Instead, it must be seen as a tool for long-term improvement of the company. Application of the integrated management system minimizes the probability of occurrence of events, but is not able to reduce it to zero. (orig.)

Medical emergencies in the dental surgery. Part 1: Preparation of the office and basic management.

Science.gov (United States)

Malamed, Stanley F

2015-12-01

Medical emergencies can and do happen in the dental surgery. In the 20- to 30-year practice lifetime of the typical dentist, he/she will encounter between five and seven emergency situations. Being prepared in advance of the emergency increases the likelihood of a successful outcome. PURPOSE OF THE PAPER: To prepare members of the dental office staff to be able to promptly recognize and efficiently manage those medical emergency situations that can occur in the dental office environment. Preparation of the dental office to promptly recognize and efficiently manage medical emergencies is predicated on successful implementation of the following four steps: basic life support for ALL members of the dental office staff; creation of a dental office emergency team; activation of emergency medial services (EMS) when indicated; and basic emergency drugs and equipment. The basic emergency algorithm (P->C->A->B->D) is designed for implementation in all emergency situations. Prompt implementation of the basic emergency management protocol can significantly increase the likelihood of a successful result when medical emergencies occur in the dental office environment.

Qualitative and quantitative lymphoscintigraphy in the evaluation of lower limbs lymphedema

International Nuclear Information System (INIS)

Dalia, Roberta Maria; Martins, Glaucia Ribeiro P.; Barbosa, Rodolfo; Lima, Carla Flavia de; Siqueira, Cristiano Ferrari

2005-01-01

The purpose of this study was to prove the efficiency of qualitative and quantitative lymphoscintigraphy in the diagnosis of the lower extremity lymphedema. Seventy-seven patients had been studied, most of then (85.7%) were female. Patients' ages ranged from 18 to 82 years. All patients underwent a bilateral lymphoscintigraphy. Images were recorded with a dual-detector instrument in the whole-body scanning mode. Feet and inguinal static views were acquired within 15 minutes and three hours after radiopharmaceutical injection. Two nuclear doctors evaluated the lymphoscintigrams qualitatively. Quantitative studies of the radiopharmaceutical absorption and the lymph node chain uptake were also obtained. Of the 154 evaluated members, 21.44% (n = 33) were classified as normal, 61.68% (n = 95) as mildly altered and 16.88% (n = 26) much altered. Quantitation of lymphatic chain uptake may be a more sensitive approach to the diagnosis of lymphatic impairment than the qualitative analysis. (author)

BASIC ACTUAL AND EFFECTIVENESS OF LEADERSHIP STYLES OF CONSTRUCTION PROJECT MANAGERS IN SURABAYA

Directory of Open Access Journals (Sweden)

Andi Andi

2004-01-01

Full Text Available Leading is one of the most important facets in managing construction projects, and behaving as an effective leader is a vital project manager’s responsibility to ensure that work efforts of other persons are directed toward the accomplishment of organizational objectives. This paper aims to determine basic and actual leadership styles of construction project managers in Surabaya. The effectiveness of the actual leadership style is also examined. To accomplish the objective, the paper first briefly reviews the ways in which leadership is approached. Data were then collected through an empirical survey to 46 project managers, taking Fiedler and Hersey-Blanchard’s models as the point of departure. The results indicate that the basic leadership of project managers in Surabaya falls slightly on task-oriented behavior. Meanwhile selling is the most common style used as actual leadership in practice. The paper discusses the effectiveness of the styles adopted and situational variables affecting.

Complementary, alternative, and other noncomplete decongestive therapy treatment methods in the management of lymphedema: a systematic search and review.

Science.gov (United States)

Rodrick, Julia R; Poage, Ellen; Wanchai, Ausanee; Stewart, Bob R; Cormier, Janice N; Armer, Jane M

2014-03-01

(1) To provide a critical analysis of the contemporary published research that pertains to complementary, alternative, and other noncomplete decongestive therapies for treatment of lymphedema (LE), and (2) to provide practical applications of that evidence to improve care of patients with or at risk for LE. TYPE: This study meets the defining criteria as a systematic search and review because it includes varied study types. All studies that met the inclusion criteria were evaluated for weight of evidence and value. The systematic search and review includes articles published in the contemporary literature (2004-2012). Publications published from 2004-2011 were retrieved from 11 major medical indices by using search terms for LE and management approaches. Literature archives were examined through 2012. Data extraction included study design, objectives pertaining to LE, number and characteristics of participants, interventions, and outcomes. Study strengths and weaknesses were summarized. Study evidence was categorized according to the Oncology Nursing Society Putting Evidence into Practice level-of-evidence guidelines after achieving consensus among the authors. No authors participated in development of nor benefitted from the review of these modality methods or devices. Extracted data from 85 studies were reviewed in 4 subcategories: botanical, pharmaceutical, physical agent modality, and modalities of contemporary value. After review, 47 articles were excluded, which left 16 articles on botanicals and pharmaceuticals and 22 articles for physical agent modality and/or modalities of contemporary value. Pharmaceuticals were later excluded. The authors concluded that botanicals had generated sufficient studies to support a second, more specific systematic review; thus, botanicals are reported elsewhere. It was found that limited high-level evidence was available for all categories. Well-constructed randomized controlled trials related specifically to LE were limited

Safety of Weightlifting Among Women with or at Risk for Breast Cancer–Related Lymphedema: Musculoskeletal Injuries and Health Care Use in a Weightlifting Rehabilitation Trial

Science.gov (United States)

Brown, Justin C.; Troxel, Andrea B.

2012-01-01

Introduction. It has been noted that only 14% of all clinical trials are translated into practice. The objective of this paper is to promote translation of an efficacious rehabilitative exercise program for breast cancer survivors by clarifying for clinicians the safety profile of participants (e.g., rates of musculoskeletal injury and referral to medical professionals), and to use this evidence to make recommendations on the appropriate training of health and fitness staff who would be capable of safely, effectively, and sustainably delivering the program. Methods. Breast cancer survivors with and at risk for lymphedema were randomized to twice-weekly weightlifting or standard care for 1 year. An injury survey and health care evaluation were administered after 1 year and in 3-month intervals, respectively. Results. The cumulative incidence and rate of injury were higher in the weightlifting than in the control group. The injury rates were 2.3 and 0.3 per 1,000 bouts of weightlifting among breast cancer survivors with and at risk for lymphedema, respectively. Among breast cancer survivors with or at risk for lymphedema, 20.9% in the weightlifting group had an encounter with a health care provider that required cessation or dose modification of weightlifting. Conclusion. Despite the demonstrated efficacy of weightlifting, musculoskeletal injuries and other health problems did occur. Therefore, for the successful translation of this rehabilitative intervention into clinical practice, health and fitness professionals working with breast cancer survivors need the knowledge, skills, and abilities that clarify their scope of practice to address these health care needs. PMID:22752068

Safety of weightlifting among women with or at risk for breast cancer-related lymphedema: musculoskeletal injuries and health care use in a weightlifting rehabilitation trial.

Science.gov (United States)

Brown, Justin C; Troxel, Andrea B; Schmitz, Kathryn H

2012-01-01

It has been noted that only 14% of all clinical trials are translated into practice. The objective of this paper is to promote translation of an efficacious rehabilitative exercise program for breast cancer survivors by clarifying for clinicians the safety profile of participants (e.g., rates of musculoskeletal injury and referral to medical professionals), and to use this evidence to make recommendations on the appropriate training of health and fitness staff who would be capable of safely, effectively, and sustainably delivering the program. Breast cancer survivors with and at risk for lymphedema were randomized to twice-weekly weightlifting or standard care for 1 year. An injury survey and health care evaluation were administered after 1 year and in 3-month intervals, respectively. The cumulative incidence and rate of injury were higher in the weightlifting than in the control group. The injury rates were 2.3 and 0.3 per 1,000 bouts of weightlifting among breast cancer survivors with and at risk for lymphedema, respectively. Among breast cancer survivors with or at risk for lymphedema, 20.9% in the weightlifting group had an encounter with a health care provider that required cessation or dose modification of weightlifting. Despite the demonstrated efficacy of weightlifting, musculoskeletal injuries and other health problems did occur. Therefore, for the successful translation of this rehabilitative intervention into clinical practice, health and fitness professionals working with breast cancer survivors need the knowledge, skills, and abilities that clarify their scope of practice to address these health care needs.

Teaching Management and Implementation of Pedagogical Classroom Projects in Basic Education

Directory of Open Access Journals (Sweden)

Waldemar Antonio Guerrero Matos

2006-11-01

Full Text Available The present article diffuses the results of the oriented study to determine the relationship between the administration of the educational one and the execution of the pedagogic projects of classroom in Basic Education. Theoretically it was based on the constructivismo and the contributions of the National Basic Curriculum. The investigation type was descriptive. The results allowed to corroborate in the teachers, weaknesses in the execution of the Pedagogic Projects of Classroom, evidencing difficulties to the moment to apply the pedagogic abilities. Therefore it is recommended to carry out courses of upgrade to manage with effectiveness this strategy of planning constructivist.

Basic concepts in the management of heart failure in general clinical ...

African Journals Online (AJOL)

Basic concepts in the management of heart failure in general clinical practice. KO Ogunyankin. Abstract. No Abstract. Full Text: EMAIL FULL TEXT EMAIL FULL TEXT · DOWNLOAD FULL TEXT DOWNLOAD FULL TEXT · AJOL African Journals Online. HOW TO USE AJOL... for Researchers · for Librarians · for Authors ...

Ultrasonographic, quantitative comparison of lower extremity lymphedema versus normal control. Technical note with case reports

Directory of Open Access Journals (Sweden)

Vanessa Lôbo de Carvalho

2018-01-01

Full Text Available Characterization of tissue by ultrasonography (CATUS is a modern-day research endeavor intended to improve visual perception and image quantification. Visual perception increases with color. Quantification focuses on pixel echo brightnesses. A previously presented case report demonstrated reappearance of lymphatic channels a few days after manual drainage. Ultrasonographic images (US of lymphatic leg and foot were quantitated and compared to a normal extremity based on proportions of pixels in specific brightness intervals. Anatomy evaluated included control- subcutaneous and lymphatic compartments. US with 256 brightness levels were obtained at the proximal, mid and distal leg and foot. Control and lymphatic Gray Scale Medians (GSM and histograms were compared using t-test and Chi-square statistics. Average GSM was 97±9 (SD (82-114, n=12 images for control, greater than 51±15 (24-69, n=12 for lymphedematous leg/foot (P99% of pixels with brightness in the muscle-fiber range (41-196, in contrast to 62% for the lymphatic extremity (P<0.001. Lymphedema averaged 7%, 3%, 15% and 14% of pixels in blood, blood/fat, fat and fat/muscle-like regions (0-4, 5-7, 8-26, 27- 40 brightness intervals. Such regions were visually interpreted as lymphatic channels or lakes. Visual perception by colorization is subjective, but most people perceives details better, for example, during the day than at night. Furthermore, US images have 16 times more shades of gray, 256, than that perceived by the human visual system, 16 on average. Colorization improved perception of lymphatic channels and lakes by transforming blood echoes into red and lymphatic liquid with echoes similar to fat into yellow. Pixel proportions in low brightness intervals were higher in the lymphatic than in the normal extremity. Lymphedema severity was quantified. The CATUS technique may be used to monitor treatment effects or disease evolution.

[Managing the basic health unit in tuberculosis control: a field of challenges].

Science.gov (United States)

Protti, Simone Teresinha; da Silva, Laís Mara Caetano; Palha, Pedro Fredemir; Villa, Tereza Cristina Scatena; Ruffino-Neto, Antonio; Nogueira, Jordana de Almeida; de Sá, Lenilde Duarte

2010-09-01

In this study we analyzed the management of Basic Health Units in terms of Tuberculosis (TB) control in a city in the interior of São Paulo state. Fourteen managers participated in the study. A closed questionnaire was administered and an open question was also applied. The interview was carried out after obtaining free and informed consent. Data analysis was performed using the Statsoft software Statistica 8.0 and thematic content analysis was used for the qualitative data. It was found there is a clear technical-bureaucratic management, deficient in the activity planning and organization dimensions at the BHU. Hence, health care managers in this study should include management aspects of planning and organization as ways to make TB control feasible.

Surgical repair of idiopathic scrotal elephantiasis.

Science.gov (United States)

Zacharakis, Evangelos; Dudderidge, Tim; Zacharakis, Emmanouil; Ioannidis, Evangelos

2008-02-01

Scrotal lymphedema (scrotal elephantiasis) is uncommon outside of filariasis endemic regions. We present a case of a 65-year-old with idiopathic lymphedema of the scrotum and functional impairment of the penis. The patient underwent surgical excision of the edematous subcutaneous tissues and plastic reconstruction of his penis and scrotum. Three years later, the patient showed no signs of local recurrence, had complete restoration of urinary and sexual function and was extremely satisfied with the result. Surgical management was an effective strategy in the management of scrotal lymphedema in this case.

Development of a participatory Management approach of the Committee for Basic Education School under the Nongbualamphu Primary Educational Service Area Office 2

Directory of Open Access Journals (Sweden)

Jirayu Prommajak

2016-10-01

Full Text Available This study aimed: 1 study the present state and adverse conditions of administration with the participation of the basic education in schools. 2 Development of a participatory Management approach of the Committee for Basic Education school under the Nongbualamphu Primary Educational Service Area Office 2. Split data into 2 phases. Phase 1: The sample used for this research consisted of 128 members of the committee on basic education in school under the Nongbualamphu Primary Educational Service Area Office 2. Selected by using stratified random sampling. Instruments used included a set of rating scale questionnaires. Phase 2: Data from the interviews using a structured questionnaire and focus group discussion. The basic statistics used for analyzing the collected data were percentage, means and standard deviation. The results of this study were as follows: 1. On the present state administration with the participation of the basic education commission in schools underunder the Nongbualamphu Primary Educational Service Area Office 2 overall participation in management is moderate. Considering the individual aspects, found that the academic administration overall participation in management and budget management were moderate. The personnel management and general and administrative overall participation in management at a high level. 2. Adverse conditions of administration with the participation of the school board for basic education in schools underunder the Nongbualamphu Primary Educational Service Area Office 2 overall in a high level. Considering the individual aspects, found that the school board in basic education is desirable to participate in the management of all aspects. 3. Development of a participatory management approach of the committee for basic education school under the Nongbualamphu Primary Educational Service Area Office 2 is a developmental process management principles PDCA, 5 steps. Step 1: Creating a common understanding Step

Incidence and risk factors for lower limb lymphedema after gynecologic cancer surgery with initiation of periodic complex decongestive physiotherapy.

Science.gov (United States)

Deura, Imari; Shimada, Muneaki; Hirashita, Keiko; Sugimura, Maki; Sato, Seiya; Sato, Shinya; Oishi, Tetsuro; Itamochi, Hiroaki; Harada, Tasuku; Kigawa, Junzo

2015-06-01

Lower limb lymphedema (LLL) is one of the most frequent postoperative complications of retroperitoneal lymphadenectomy for gynecologic cancer. LLL often impairs quality of life, activities of daily living, sleep, and sex in patients with gynecologic cancer. We conducted this study to evaluate the incidence and risk factors for LLL after gynecologic cancer surgery in patients who received assessment and periodic complex decongestive physiotherapy (CDP). We retrospectively reviewed 126 cases of gynecologic cancer that underwent surgery involving retroperitoneal lymphadenectomy at Tottori University Hospital between 2009 and 2012. All patients received physical examinations to detect LLL and underwent CDP by nurse specialists within several months after surgery. The International Society of Lymphology staging of lymphedema severity was used as the diagnostic criteria. Of 126 patients, 57 (45.2%) had LLL, comprising 45 and 12 patients with stage 1 and stage 2 LLL, respectively. No patient had stage 3 LLL. LLL was present in 37 (29.4%) patients at the initial physical examination. Multivariate analysis revealed that adjuvant concurrent chemoradiotherapy and age ≥ 55 years were independent risk factors for ≥ stage 2 LLL. To minimize the incidence of ≥ stage 2 LLL, gynecologic oncologists should be vigilant for this condition in patients who are ≥ 55 years and in those who undergo adjuvant chemoradiotherapy. Patients should be advised to have a physical assessment for LLL and to receive education about CDP immediately after surgery involving retroperitoneal lymphadenectomy for gynecologic cancer.

Elephantiasis, elastin, and chronic wound healing: 19th century and contemporary viewpoints relevant to hypotheses concerning lymphedema, leprosy, erysipelas, and psoriasis--review and reflections.

Science.gov (United States)

Ryan, T J

2009-03-01

Both wound healing and lymphedema have fibrosis of the skin in common. They also share destruction of elastin by elastases from neutrophils as a significant feature. These are not new observations, and the writings of Unna and Kaposi are recalled. The contemporary observations on elastin by Gerli and his team are discussed in the light of these much earlier opinions.

Immune proteins and other biochemical constituents of peripheral lymph in patients with malignancy and postirradiation lymphedema

International Nuclear Information System (INIS)

Olszewski, W.L.; Norske Radiumhospital, Oslo. Lab. of Hematology and Lymphology); Loe, K.; Engeset, A.

1978-01-01

Concentrations of immunoglobulins and complement proteins were studied in a group of 33 patients with localized tumors and lymphoproliferative disorders. Generally, low levels have been found, in many cases below the lowest limit of the control group. The reductions in concentration were more pronounced in patients with lympho-proliferative disorders than with solid tumors. The most reduced were lgM, Clg and total complement hemolytic activity. In a group of 8 patients with lymphedema of lower extremity complicating therapy for uterine cancer an increase of IgM and IgA and decrease in hemolytic activity were found. This indicates the existence of a chronic inflammatory process typical for tissues deprived in lymphatic outflow. (orig.) [de

Basic Burns Management E-Learning: A New Teaching Tool.

Science.gov (United States)

Egro, Francesco M

Burns teaching is organized only in a few medical schools in the United Kingdom. An e-learning tutorial was developed with the objective of incorporating burns teaching within the medical school curriculum. A 33-webpage e-learning was created, covering topics such as local and general response to burns, assessment of burns, first aid, primary and secondary survey, and referral guidelines. Medical student satisfaction was then evaluated using a 12-question feedback survey rated based on a Likert scale from 1 (very poor) to 5 (very good). The 12-question survey was completed by a total of 18 medical students ranging from second to fourth years (second = 17%, third = 22%, fourth = 61%). While only a couple of students had received prior burns teaching, 50% of the cohort had an interest to pursue surgery as a career. The majority of students (72%) would be interested to have an e-learning module on basic burns management in their medical curriculum. The means of all domains specific to the e-learning were rated as "good" or "very good." Students' rating for ease of use was 87%, usefulness was 88%, relevance to the medical curriculum was 90%, clarity and quality of content were 78% and 83%, respectively, design was 79%, and the overall satisfaction with this e-learning was 87%. The "Basic Burns Management" e-learning tutorial can provide an efficient and effective means of information delivery to medical students and junior doctors, allowing easy and fast incorporation of burns teaching within the medical curriculum and in other medical teaching settings.

Fourth annual workshop on management in basic and applied research environments

Energy Technology Data Exchange (ETDEWEB)

Bodnarczuk, M.W. [ed.

1993-11-01

The struggle to develop quality management concepts that ``map`` onto the cultural and work practices found in basic and applied research environments has been (for better or for worse) an attempt to differentiate basic and applied research from the nuclear industry. In the first (1990) edition of this ``Music Book`` proceedings, almost every laboratory that participated had a quality program that was traceable to, based on, influenced by, or in reaction to the nuclear quality standard ASME-NQA-1. This 1993 edition of the ``Music Book`` is very different in that almost every laboratory has developed a quality program that is based on, traceable to, or heavily influenced by DOE 5700.6C (Quality Assurance) and the DOE Standard; Implementation Guide for Quality Assurance Programs for Basic and Applied Research (DOE-ER-STD-6001-92). In order to construct a context for what follows and properly introduce the contents of this book, we want to briefly recount some of the highlights of the events that brought about this change, from the perspective of one who participated in the process.

CRITIQUES TOWARDS COSO’S ENTERPRISE RISK MANAGEMENT (ERM) FRAMEWORK IN ITS BASIC ASSUMPTIONS

OpenAIRE

Kurniawanti, Ika Atma

2010-01-01

Most professionals in internal control, risk management and other similar bailiwickshave agreed that Enterprise Risk Management discourses would’ve invariablyreferred to what the COSO had produced recently: the framework underlying ERM.But this paper takes a bit different stance that views several problematic issuesstem from unclear conceptions of either the basic premise underlying ERM or thenature of some ERM’s components outlined by COSO. This paper notes that, atleast, there are three poi...

Guide to Understanding Lymphedema

Science.gov (United States)

... ACTH CAF CMF FAC TAC TC TCH TH THP Radiation Therapy Whole Breast Radiation Partial Breast Radiation ... Basics Treatments and Your Bone Health Bone Health Tests Improving Bone Health Medicines To Protect Bones Diet, ...

An Agent-Based Approach for Evaluating Basic Design Options of Management Accounting Systems

Directory of Open Access Journals (Sweden)

Friederike Wall

2013-12-01

Full Text Available This paper investigates the effectiveness of reducing errors in management accounting systems with respect to organizational performance. In particular, different basic design options of management accounting systems of how to improve the information base by measurements of actual values are analyzed in different organizational contexts. The paper applies an agent-based simulation based on the idea of NK fitness landscapes. The results provide broad, but no universal support for conventional wisdom that lower inaccuracies of accounting information lead to more effective adaptation processes. Furthermore, results indicate that the effectiveness of improving the management accounting system subtly interferes with the complexity of the interactions within the organization and the coordination mode applied

Physical activity and lower limb lymphedema among uterine cancer survivors.

Science.gov (United States)

Brown, Justin C; John, Gabriella M; Segal, Saya; Chu, Christina S; Schmitz, Kathryn H

2013-11-01

Physical activity (PA) is known to provide physical and mental health benefits to uterine cancer survivors. However, it is unknown if PA is associated with lower limb lymphedema (LLL), an accumulation of protein-rich fluid in the lower limbs. Therefore, we sought to examine the association between PA and LLL in uterine cancer survivors, with a focus on walking. We conducted a cross-sectional study using mailed surveys among uterine cancer survivors who received care at a university-based cancer center. We asked about PA, walking, and LLL symptoms using validated self-report questionnaires. PA was calculated using MET-hours per week, and walking was calculated using blocks per day. The response rate to our survey was 43%. Among the 213 uterine cancer survivors in our survey, 36% were classified as having LLL. Compared with participants who reported trend = 0.003). Stratified analyses suggested the association between PA and LLL existed only among women with body mass index (BMI) trend = 0.007) compared with women with BMI ≥ 30 kg · m (P trend = 0.47). Compared with participants who reported trend trend = 0.007) and women with BMI ≥ 30 kg · m (P trend = 0.03). Participation in higher levels of PA or walking is associated with reduced proportions of LLL in dose-response fashion. These findings should be interpreted as preliminary and should be investigated in future studies.

Management of Universal Basic Education Scheme (U.B.E.) for Qualitative Education in Nigeria

Science.gov (United States)

Omotayo, Dare Michael; Ihebereme, Chioma; Maduewesi, Sir B. U.

2008-01-01

Since independence, Nigeria has been searching diligently for a viable educational system capable of enhancing the socio-economic and political values inherent in the country. This paper discusses concepts such as management, qualitative education and Universal Basic Education. In addition to the above, the paper also examines the National…

Contributions of basic nuclear physics to the nuclear waste management

Science.gov (United States)

Flocard, Hubert

2002-04-01

Nuclear fission is presently a contested method of electricity production. The issue of nuclear waste management stands out among the reasons why. On the other hand, the nuclear industry has demonstrated its capacity to reliably generate cheap electricity while producing negligible amounts of greenhouse gases. These assets explain why this form of energy is still considered among the options for the long term production of electricity at least in developed countries. However, in order to tackle the still not adequately answered question of the waste, new schemes may have to be considered. Among those which have been advanced recently, the less polluting cycles such as those based on Thorium rather than Uranium and/or the transmutation of the minor actinides and some long lived fission products of the present cycle have been actively investigated. In both cases, it turns that the basic knowledge underlying these methods is either missing or incomplete. This situation opens a window of opportunity for useful contributions from basic nuclear physicists. This article describes some of them and presents the ongoing activities as well as some of the projects put forth for the short or medium term. .

Basic Sciences Fertilizing Clinical Microbiology and Infection Management.

Science.gov (United States)

Baquero, Fernando

2017-08-15

Basic sciences constitute the most abundant sources of creativity and innovation, as they are based on the passion of knowing. Basic knowledge, in close and fertile contact with medical and public health needs, produces distinct advancements in applied sciences. Basic sciences play the role of stem cells, providing material and semantics to construct differentiated tissues and organisms and enabling specialized functions and applications. However, eventually processes of "practice deconstruction" might reveal basic questions, as in de-differentiation of tissue cells. Basic sciences, microbiology, infectious diseases, and public health constitute an epistemological gradient that should also be an investigational continuum. The coexistence of all these interests and their cross-fertilization should be favored by interdisciplinary, integrative research organizations working simultaneously in the analytical and synthetic dimensions of scientific knowledge. © The Author 2017. Published by Oxford University Press for the Infectious Diseases Society of America.

Establishing and Sustaining a Prospective Screening Program for Breast Cancer-Related Lymphedema at the Massachusetts General Hospital: Lessons Learned

Directory of Open Access Journals (Sweden)

Cheryl Brunelle

2015-05-01

Full Text Available There has been an increasing call to prospectively screen patients with breast cancer for the development of breast cancer-related lymphedema (BCRL following their breast cancer treatment. While the components of a prospective screening program have been published, some centers struggle with how to initiate, establish, and sustain a screening program of their own. The intent of this manuscript is to share our experience and struggles in establishing a prospective surveillance program within the infrastructure of our institution. It is our hope that by sharing our history other centers can learn from our mistakes and successes to better design their own prospective screening program to best serve their patient population.

Genetic parameters for chronic progressive lymphedema in Belgian Draught Horses.

Science.gov (United States)

De Keyser, K; Janssens, S; Peeters, L M; Foqué, N; Gasthuys, F; Oosterlinck, M; Buys, N

2014-12-01

Genetic parameters for chronic progressive lymphedema (CPL)-associated traits in Belgian Draught Horses were estimated, using a multitrait animal model. Clinical scores of CPL in the four limbs/horse (CPLclin ), skinfold thickness and hair samples (hair diameter) were studied. Due to CPLclin uncertainty in younger horses (progressive CPL character), a restricted data set (D_3+) was formed, excluding records from horses under 3 years from the complete data set (D_full). Age, gender, coat colour and limb hair pigmentation were included as fixed, permanent environment and date of recording as random effects. Higher CPLclin certainty (D_3+) increased heritability coefficients of, and genetic correlations between traits, with CPLclin heritabilities (SE) for the respective data sets: 0.11 (0.06) and 0.26 (0.05). A large proportion of the CPLclin variance was attributed to the permanent environmental effect in D_full, but less in D_3+. Date of recording explained a proportion of variance from 0.09 ± 0.03 to 0.61 ± 0.08. Additive genetic correlations between CPLclin and both skinfold thickness and hair diameter showed the latter two traits cannot be used as a direct diagnostic aid for CPL. Due to the relatively low heritability of CPLclin , selection should focus on estimated breeding values (from repeated clinical examinations) to reduce CPL occurrence in the Belgian Draught Horse. © 2014 Blackwell Verlag GmbH.

Basic planning and work performance of Hanford Site environmental management activities

International Nuclear Information System (INIS)

Piper, L.L.

1997-01-01

This document provides an overview of the basic planning and work of the Department of Energy Richland Operations Office (DOE-RL). It defines key terms, concepts, and processes used in Hanford's Environmental Management (EM) activities. It is not intended to provide complete details on the topics discussed. It does, however, provide a roadmap of the overall process so that opportunities for tribal, regulator, and public involvement can be clearly identified. Many documents are referenced in this plan. Each is described in some detail in Section 5, and cross-references to that section are provided throughout the discussion in Sections 1 through 4

Lower limb gigantism, lymphedema, and painful varicosities following a thigh vascular access graft.

Science.gov (United States)

Thompson, Michael; Mathuram Thiyagarajan, Umasankar; Akoh, Jacob A

2014-07-01

Prosthetic arteriovenous grafts (AVGs) are associated with greater morbidity than autogenous arteriovenous fistulas (AVFs), but their use is indicated when AVF formation is not possible. This report adds to the literature a case of lower limb gigantism, painful varicosities, and lymphedema following long-term use of AVG in the upper thigh. The patient's past medical history included renal transplantation on the same side well before the AVG was inserted and right leg deep vein thrombosis. Suspicion of AVG thrombosis was excluded by Doppler ultrasound, which demonstrated an access flow of 1700 mL/min. A computed tomography (CT) scan of the abdomen and pelvis did not identify the cause of her symptoms. Whereas functional incompetence of the iliac vein valve might be responsible for the varicosities, the extent of hypertrophy in this case raises the suspicion of lymphatic blockage possibly secondary to groin dissection undertaken at the time of graft insertion, in addition to the previous dissection at the time of transplantation. This case highlights the need for minimal groin dissection during AVG insertion, particularly in patients with a history of previous abdominopelvic surgery. © 2014 International Society for Hemodialysis.

Basic stress-management in piano performance, composing and improvising : Based on personal experiences and self-reflection

OpenAIRE

Kushniruk, Tetyana

2016-01-01

There is a lot of information and it is not always easy to find the right bits, and to apply them. Therefore, stress-management in music world is underdeveloped. Musicians struggle in situations, where even basic psychophysical knowledge would already relieve the stress considerably. Thus, this paper aims to help musicians of all levels with as simple, universal, efficient stress-management tips as possible, without any medicine involved. The end aim is to help with the organization of person...

Waste management plan for pipeline construction works: basic guideline for its preparation

Energy Technology Data Exchange (ETDEWEB)

Serricchio, Claudio; Caldas, Flaviana V [Petroleo Brasileiro S.A. (PETROBRAS), Rio de Janeiro, RJ (Brazil); Souza, Izabel C.A. de; Araujo, Ronaldo G. de [TELSAN, Rio de Janeiro, RJ (Brazil); Souza, Tania Mara [IMC-SASTE, Sao Paulo,SP (Brazil); Veronez, Fernanda A [Bourscheid, Porto Alegre, RS (Brazil)

2009-07-01

During the stage of implementation of the land pipes enterprise, one of the main environmental aspects to be considered was the creation of solid and liquid waste. To mitigate the possible impacts to the environment, the main adopted mitigate measure was the implementation of a Waste Management Plan - WMP. Thus, the management of waste from pipes construction has the challenge of a great variety of stages and phases for the implementation of pipes and the diversity of local situations related to the topographic and hydro-geologic conditions. Considering the peculiarity of the pipes activities, this article proposes the elaboration of a Basic Guide to be used as reference for the creation of WMP's for similar enterprises, using as foundation the data from the three Gas Pipelines: Cabiunas - Vitoria; Vitoria - Cacimbas and Cacimbas - Catu. After the analysis of the three mentioned enterprises, it was verified that the waste management generated on the building and assembling of the land pipes normally occurs in accord with previous planning, but there's no systematization for the waste to be better recycled and reutilized, thus mitigating their creation. (author)

[Clinical Management: Basics and organization].

Science.gov (United States)

Torres, Juan; Mingo, Carlos

2015-01-01

Many strategies have been proposed over the last years to ensure the Health Care System sustainability, mainly after the recent global economic crisis. One of the most attractive approaches is clinical management, which is a way of organizing health care units based on active participation of professionals who receive the transference of responsibilities dispoto achieve the objectives with the mission of ensuring a proper patient centered care, taking into consideration the rational use of resources (Efficiency) For the start up of Health Care structures based on clinical management, it is necessary a previous management culture within the departments involved and the center's executive board. Furthermore, to achieve the objectives proposed various tools must be used, such as evidence based medicine, clinical practice variability analysis, process management, in addition of quality and safety strategies. The units involved have to propose a management plan that will result in a management contract with the center's executive board. This agreement will establish some activity, expense and quality objectives that will be quantifiable through various indicators. Risk transference to the unit must include certain budget allocation and incentive decision capacity. Clinical management must not be employed as a savings tool from the part of macro and meso management. There is not a health care structure based on clinical management that have a general character for all health care organizations, existing a great variability in the adoption of various organizational formulas, so that every center must perform its own analysis and decide the most adequate model. In our country there are many clinical management experiences, although there is a long way to go.

The RSZ BASIC programming language manual

Science.gov (United States)

Stattel, R. J.; Niswander, J. K.; Kochhar, A. K.

1980-01-01

The RSZ BASIC interactive language is described. The RSZ BASIC interpreter is resident in the Telemetry Data Processor, a system dedicated to the processing and displaying of PCM telemetry data. A series of working examples teaches the fundamentals of RSZ BASIC and shows how to construct, edit, and manage storage of programs.

Flexitouch® Home Maintenance Therapy or Standard Home Maintenance Therapy in Treating Patients With Lower-Extremity Lymphedema Caused by Treatment for Cervical Cancer, Vulvar Cancer, or Endometrial Cancer

Science.gov (United States)

2014-12-29

Lymphedema; Stage 0 Cervical Cancer; Stage 0 Uterine Corpus Cancer; Stage 0 Vulvar Cancer; Stage I Uterine Corpus Cancer; Stage I Vulvar Cancer; Stage IA Cervical Cancer; Stage IB Cervical Cancer; Stage II Uterine Corpus Cancer; Stage II Vulvar Cancer; Stage IIA Cervical Cancer; Stage IIB Cervical Cancer; Stage III Cervical Cancer; Stage III Uterine Corpus Cancer; Stage III Vulvar Cancer; Stage IV Uterine Corpus Cancer; Stage IVA Cervical Cancer; Stage IVB Cervical Cancer; Stage IVB Vulvar Cancer

Reconstrucción en linfedema peneano y escrotal secundario a hernia inguinal bilateral gigante Reconstruction in penile and scrotal lymphedema secondary to billateral giant inguinal hernia

Directory of Open Access Journals (Sweden)

A. Fernández García

2009-12-01

Full Text Available El linfedema peneano y escrotal tiene consecuencias funcionales, estéticas, sociales y psicológicas significativas para el paciente que lo padece. Es una enfermedad infrecuente en los países desarrollados, aunque relativamente prevalente en los países tropicales. Su causa más común es la filariasis, aunque en nuestra práctica diaria se asocia más frecuentemente a cirugía, radioterapia, procesos inflamatorios y neoplásicos. Presentamos un caso singular de linfedema penoescrotal secundario a cirugía por hernia inguinal gigante bilateral que persistía un año después de la intervención. El tratamiento quirúrgico consistió en la exéresis de toda la piel linfedematosa del escroto involucrada y el uso de colgajos de piel escrotal posterior para la cobertura testicular. En un segundo tiempo quirúrgico se llevó a cabo una extirpación total de la piel del pene y del tejido subcutáneo superficial a la fascia de Buck. Empleamos injertos de piel de grosor parcial para cubrir el pene denudado. El resultado estético postoperatorio fue aceptable y los resultados funcionales y psicológicos son satisfactorios para el paciente 3 años después de la cirugía.Lymphedema of the penis and scrotum has important functional, cosmetic, social, psychological consequences for the affected patient. It is a rare disease in the developed countries, although it is relatively frequent in tropical countries. Globally, the most common cause is filariasis, although in our practice it is most frecuently associated to surgery, radiotherapy, inflammatory and neoplasic diseases. We report one rare case of penoscrotal lymphedema due to billateral giant inguinal hernia reconstrction. The lymphedema was persistent one year after the repair of the billateral hernia. The technique of reconstruction consisted of excision of all involved lymphedematous skin of the scrotum, and use of posterior scrotal flaps for testicular coverage. In a second surgical time, a total

Basics of theory of ecological crisis management

Directory of Open Access Journals (Sweden)

Stajić Ljubomir

2013-01-01

Full Text Available Today, it is clear that environmental accidents and processes represent, not only potential but also real causes of crises on which states must be aware of. The formation of the ecological crisis is growing exponentially, along with their consequences. The problem with the environmental crisisis lies not in the fact that they exist, but how we treat them. Exploring the causes of the crisis requires an interdisciplinary approach. At the micro level, this approach focuses on the role of individuals. At the middle level of research, focus is on organizational factors and processes that may play important role in causing the crisis. Macro level of approach lists possible causes that seem to make the crisis more or less inevitable and unavoidable features of the modern world. The crisis is also characterized by negative effects (perturbations, deregulation, conflict, confused action, intense stress, which leads to reckless actions and positive effects (mobilization, solidarity, cooperation, improved adaptation to the environment, experiential learning. Furthermore, ecological crisis represents an emergency situation whose beginning and duration are not predetermined. Anti-crisis measures have failed mainly because of the numerous factors influencing on one hand, on a complexity of the crisis and, on the other hand, because of its continuously changing factors throughout the duration of the crisis. Managing ecological crisis occurs, therefore, as a permanently professional inventive and complicated process which aims to prevent the escalation of the crisis, as well as the elimination of the expected and actual negative consequences of the crisis. Mismanagement of such crisis drains system resources, interferes with its function and organization, impacts on the financial opportunities while achieving positive goals. Extreme mismanagement can lead to the entropy of the system itself. The purpose of this paper is to elaborate basic facts of managing

Waste management plan for pipeline construction works: basic guideline for its preparation

Energy Technology Data Exchange (ETDEWEB)

Serricchio, Claudio; Caldas, Flaviana V. [Petroleo Brasileiro S.A. (PETROBRAS), Rio de Janeiro, RJ (Brazil); Souza, Izabel C.A. de; Araujo, Ronaldo G. de [TELSAN, Rio de Janeiro, RJ (Brazil); Souza, Tania Mara [IMC-SASTE, Sao Paulo,SP (Brazil); Veronez, Fernanda A. [Bourscheid, Porto Alegre, RS (Brazil)

2009-07-01

During the stage of implementation of the land pipes enterprise, one of the main environmental aspects to be considered was the creation of solid and liquid waste. To mitigate the possible impacts to the environment, the main adopted mitigate measure was the implementation of a Waste Management Plan - WMP. Thus, the management of waste from pipes construction has the challenge of a great variety of stages and phases for the implementation of pipes and the diversity of local situations related to the topographic and hydro-geologic conditions. Considering the peculiarity of the pipes activities, this article proposes the elaboration of a Basic Guide to be used as reference for the creation of WMP's for similar enterprises, using as foundation the data from the three Gas Pipelines: Cabiunas - Vitoria; Vitoria - Cacimbas and Cacimbas - Catu. After the analysis of the three mentioned enterprises, it was verified that the waste management generated on the building and assembling of the land pipes normally occurs in accord with previous planning, but there's no systematization for the waste to be better recycled and reutilized, thus mitigating their creation. (author)

Educational Project Management Instructional System. Module Two. Project Management Basic Principles. Volume I--Lessons 1 to 6. Volume II--Lessons 7 to 12. Volume III--Case Simulation.

Science.gov (United States)

Cummings, C. Peter; Cook, Desmond L.

This module is the second in a self-instructional program designed to train public school personnel in how to manage educational projects. The purpose of this module is to provide current or potential project directors with the basic knowledge, skills, abilities, and sensitivities needed to manage a local educational project. In the areas of…

Virtual patients: an effective educational intervention to improve paediatric basic specialist trainee education in the management of suspected child abuse?

LENUS (Irish Health Repository)

McEvoy, M M

2011-09-01

Child abuse is a particularly difficult subject to teach at both undergraduate and postgraduate level. Most doctors are dissatisfied with their training in child abuse recognition and management. We developed an interactive video based Virtual Patient to provide formal training for paediatric Basic Specialist Trainees in the recognition of suspected child abuse. The Virtual Patient case revolves around the management of suspected physical abuse in a seven month old child, who initially presents to the Emergency Department with viral upper respiratory tract symptoms. This Virtual Patient was used to facilitate a case discussion with Basic Specialist Trainees. A questionnaire was developed to determine their perception of the value of the Virtual Patient as an educational tool. Twenty five Basic Specialist Trainees completed the questionnaire. Upon completion of the case, 23\\/25 (92%) participants reported greater self confidence in their ability to recognize cases of suspected child abuse and 24\\/25 (96%) of participants reported greater self confidence in their ability to report cases of suspected child abuse. Basic Specialist Trainees perceived the Virtual Patient to be a useful educational tool. Virtual Patients may have a role to play in enhancing postgraduate training in the recognition of suspected child abuse.

The use of a basic safety investment model in a practical risk management context

International Nuclear Information System (INIS)

Aven, Terje; Hiriart, Yolande

2011-01-01

We consider a basic model in economic safety analysis: a firm is willing to invest an amount x in safety measures to avoid an accident A, which in the case of occurrence, leads to a loss of size L. The probability of an accident is a function of x. The optimal value of x is determined by minimizing the expected costs. In the paper, we re-examine this model by adopting a practical risk/safety management perspective. We question how this model can be used for guiding the firm and regulators in determining the proper level of investment in safety. Attention is given to issues like how to determine the probability of an accident and how to take into account uncertainties that extend beyond the expected value. It is concluded that the model, with suitable extensions and if properly implemented, provides a valuable decision support tool. By focusing on investment levels and stimulating thereby the generation of alternative risk-reducing measures, the model is considered particularly useful in risk reduction (ALARP) processes. - Highlights: → It is shown how to use a basic investment model in a practical risk management setting. → The model may be a valuable decision support tool if properly implemented. → It guides decision makers on risk reduction and how to determine what is ALARP. → The model stimulates the generation of alternative risk-reducing measures.

The needs of basic chemistry studies for nuclear waste management issues

International Nuclear Information System (INIS)

Guillaumont, R.

2004-01-01

There are several strategies to manage the radioactive matter which has taken the status of 'ultimate radwaste'. They are based on combinations of the three primary strategies: 'Wait for Decay', 'Concentrate and Confine' and 'Disperse and Dilute' the radio-toxic radionuclides and chemo-toxic elements. They are, or will be used for safe storage (interim and long term) or safe disposal of nuclear wastes. The chemical needs to apply these strategies are on materials for isolation, matrices for confinement and on the numerous aspects of the migration of the elements, both in the lithosphere and in the biosphere. According to the ultimate fate of long lived radionuclides which will be finally released into the environment, migration studies of elements are, or should be, the driving force of research in nuclear wastes management. The chemical needs for improving our present basic knowledge related to this field will be reviewed, with emphasis on some new topics and on the effects of concentration of the elements when they migrate. The necessity to open some 'dark boxes' will be outlined. The paper does not intend to give programs of researches but only tracks for future research. (authors)

Accounting & Finance; a Basic Introduction

NARCIS (Netherlands)

drs. Ewoud Jansen

2011-01-01

The book is about finance and accounting, subjects widely discussed in many other books. What sets this book apart from most others is that it discusses all the basic aspects of finance and accounting in one single textbook. Three areas of interest are discussed: Financial Management; Management

49 CFR 633.21 - Basic requirement.

Science.gov (United States)

2010-10-01

..., DEPARTMENT OF TRANSPORTATION PROJECT MANAGEMENT OVERSIGHT Project Management Plans § 633.21 Basic requirement. (a) If a project meets the definition of major capital project, the recipient shall submit a project management plan prepared in accordance with § 633.25 of this part, as a condition of Federal financial...

5 CFR 551.401 - Basic principles.

Science.gov (United States)

2010-01-01

... 5 Administrative Personnel 1 2010-01-01 2010-01-01 false Basic principles. 551.401 Section 551.401 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT CIVIL SERVICE REGULATIONS PAY ADMINISTRATION UNDER THE FAIR LABOR STANDARDS ACT Hours of Work General Provisions § 551.401 Basic principles. (a) All time...

Race/ethnicity, genetic ancestry, and breast cancer-related lymphedema in the Pathways Study.

Science.gov (United States)

Kwan, Marilyn L; Yao, Song; Lee, Valerie S; Roh, Janise M; Zhu, Qianqian; Ergas, Isaac J; Liu, Qian; Zhang, Yali; Kutner, Susan E; Quesenberry, Charles P; Ambrosone, Christine B; Kushi, Lawrence H

2016-08-01

Breast cancer-related lymphedema (BCRL) is a serious chronic condition after breast cancer (BC) surgery and treatment. It is unclear if BCRL risk varies by race/ethnicity. In a multiethnic prospective cohort study of 2953 BC patients, we examined the association of self-reported BCRL status with self-reported race/ethnicity and estimated genetic ancestry. Hazard ratios (HR) and 95 % confidence intervals (CI) were calculated by multivariable Cox proportional hazards models, with follow-up starting 6 months post-BC diagnosis. Estimates were further stratified by body mass index (BMI). By 48 months of follow-up, 342 (11.6 %) women reported having BCRL. Younger age at BC diagnosis, higher BMI at baseline, and lower physical activity were associated with greater BCRL risk. African American (AA) women had a 2-fold increased risk of BCRL compared with White women (HR = 2.04; 95 % CI 1.35-3.08). African genetic ancestry was also associated with an increased risk (HR = 2.50; 95 % CI 1.43, 4.36). Both risks were attenuated but remained elevated after adjusting for known risk factors and became more pronounced when restricted to the nonobese women (adjusted HR = 2.31 for AA and HR = 3.70 for African ancestry, both p ancestry data, with a potential ancestry-obesity interaction.

Management options for implementing a basic and applied research program responsive to CS technology base needs. Task VIII. Review existing CS materials R and D programs

Energy Technology Data Exchange (ETDEWEB)

1980-02-28

Possibilities for setting up a basic and applied research program that would be responsive to the Conservation and Solar energy base needs are considered with emphasis on the area of materials research. Several organizational arrangements for the implementation of this basic and applied research program are described and analyzed. The key functions of the system such as resources allocation, and program coordination and management follow from two fundamental characteristics: assignment of lead responsibility (CS and the Office of Energy Research, ER); and nature of the organizational chain-of-command. Three options are categorized in terms of these two characteristics and discussed in detail. The first option retains lead responsibility in ER, with CS personnel exercising sign-off authority and filling the coordination role. Option 2 places lead responsibility with CS program office management, and utilizes the existing chain-of-command, but adds a Basic and Applied Research Division to each program office. Option 3 also places lead responsibility with CS, but within a new Office of Basic and Applied Research, which would include a Research Coordinator to manage interactions with ER, and Research Managers for each CS program area. (MCW)

Current best practice in the management of Turner syndrome

Science.gov (United States)

Shankar, Roopa Kanakatti; Backeljauw, Philippe F.

2017-01-01

Turner syndrome (TS) is characterized by partial or complete loss of the second X-chromosome in phenotypic females resulting in a constellation of clinical findings that may include lymphedema, cardiac anomalies, short stature, primary ovarian failure and neurocognitive difficulties. Optimizing health care delivery is important to enable these individuals achieve their full potential. We review the current best practice management recommendations for individuals with TS focusing on the latest consensus opinion in regard to genetic diagnosis, treatment of short stature, estrogen supplementation, addressing psychosocial issues, as well screening for other comorbidities. A multidisciplinary approach and a well-planned transition to adult follow-up care will improve health care delivery significantly for this population. PMID:29344338

[Quality Management for Surgeons: The Knowledge of Basic Contexts and Innovative Strategies Promotes the Competitiveness of Clinical Department].

Science.gov (United States)

Hellmann, Wolfgang

2017-12-01

Efficient quality management aiming to achieve high quality in patient care is crucial to the success of a surgery department. This requires the knowledge of relevant terms und contexts of quality management. Implementation remains difficult in the light of demographic change and skills shortage. If a hospital has an efficient internal quality management in place, this should be used as a supplementary instrument. Otherwise it is the (sole) task of a specialist department to ensure quality for patients, employees, and cooperative partners. This paper provides basic knowledge on quality management, risk management, and quality assurance in the context of relevant medical terms. It demonstrates new ways for implementation on the level of a surgery department, and introduces a new model of quality. Georg Thieme Verlag KG Stuttgart · New York.

The needs of basic chemistry studies for nuclear waste management issues

Energy Technology Data Exchange (ETDEWEB)

Guillaumont, R

2004-07-01

There are several strategies to manage the radioactive matter which has taken the status of 'ultimate radwaste'. They are based on combinations of the three primary strategies: 'Wait for Decay', 'Concentrate and Confine' and 'Disperse and Dilute' the radio-toxic radionuclides and chemo-toxic elements. They are, or will be used for safe storage (interim and long term) or safe disposal of nuclear wastes. The chemical needs to apply these strategies are on materials for isolation, matrices for confinement and on the numerous aspects of the migration of the elements, both in the lithosphere and in the biosphere. According to the ultimate fate of long lived radionuclides which will be finally released into the environment, migration studies of elements are, or should be, the driving force of research in nuclear wastes management. The chemical needs for improving our present basic knowledge related to this field will be reviewed, with emphasis on some new topics and on the effects of concentration of the elements when they migrate. The necessity to open some 'dark boxes' will be outlined. The paper does not intend to give programs of researches but only tracks for future research. (authors)

A3byComp: A Support tool for Basic Implementation of Competency Management Systems in Social Entities

Directory of Open Access Journals (Sweden)

Daniel CLAVERO HERRERO

2015-12-01

Full Text Available The importance of managing processes related to people working in institutions within the scope of FEAPS evidenced by the increasing incorporation into the strategy of the organizations policies aimed at improving the working conditions of workers and in the development of competence management systems aimed at promoting professional development, which aims greater effectiveness and efficiency in providing support for improving the quality of life of people with disabilities and their families. At the same time, banks have highlighted the need for specific instruments and tools that facilitate the implementation of these systems. In Extremadura, it has been developed a software tool for the implementation of basic competence management systems called A3byComp that has been freely available to the entire network promoting industry collaboration aimed mutual learning.

Private management of public schools of Basic Education: a new market under the auspices of the State

Directory of Open Access Journals (Sweden)

Bruno Gawryszewski

2017-09-01

Full Text Available This paper aims to present the private management of public schools of Basic Education as one of the pillars that support a private-market agenda in the Brazilian contemporary field, based on the belief of greater efficiency and quality in order to ensure equal opportunity to all. The theoretical and methodological approach was the analysis of the current Brazilian situation included in the structural crisis of the capital, followed by the examination of private management in American schools, known as charter schools, and initiatives for the education networks in Brazil. We conclude by stating that the private management of public schools can be seen as a resource to prevent the cyclical crises of capital, which has opened up new market opportunities in the education field under the auspices of the Brazilian state.

Basic concepts and definitions of clinical management

Directory of Open Access Journals (Sweden)

Angélica Román

2012-06-01

Full Text Available Management is leading, administering resources, and achieving the goals and objectives that have been set. In the Chilean health care system, management can be subdivided in three main levels – macro-management, meso-management and micro-management. Managing health care is also about epidemiological changes, information and technology innovations, patient groups demanding better services, but mostly about a huge escalation in costs that is not necessarily substantiated by evidence on more efficiency in health outcomes.Clinical management is more than a management tool. It is a cultural change that will provide new values to professional practice and to the organization as a whole. However, clinical management demands more commitment on behalf of the human teams that need to learn how to lead and to be led. These teams will be called upon to help in the decision-making process for the betterment of the institution.

Disease: H00535 [KEGG MEDICUS

Lifescience Database Archive (English)

Full Text Available H00535 Lymphedemas, including: Lymphedema, hereditary I; Lymphedema-distichiasis s...yndrome; Hypotrichosis-lymphedema-telangiectasia syndrome (HLTS); Hennekam syndrome Lymphoedemas are develop... The dilated lymphatic channels that are not connected to the lymphatic vessels cause these edema...s. LD patients develop extra eyelashes, Hypotrichosis-lymphedema-telangiectasia syndrome (HL...TS) is associated with sparse hair and cutaneous telangiectasias, and Hennekam lymphangiectasia-lymphedema s

Basic research for environmental restoration

International Nuclear Information System (INIS)

1990-12-01

The Department of Energy (DOE) is in the midst of a major environmental restoration effort to reduce the health and environmental risks resulting from past waste management and disposal practices at DOE sites. This report describes research needs in environmental restoration and complements a previously published document, DOE/ER-0419, Evaluation of Mid-to-Long Term Basic Research for Environmental Restoration. Basic research needs have been grouped into five major categories patterned after those identified in DOE/ER-0419: (1) environmental transport and transformations; (2) advanced sampling, characterization, and monitoring methods; (3) new remediation technologies; (4) performance assessment; and (5) health and environmental effects. In addition to basic research, this document deals with education and training needs for environmental restoration. 2 figs., 6 tabs

Basic research for environmental restoration

Energy Technology Data Exchange (ETDEWEB)

1990-12-01

The Department of Energy (DOE) is in the midst of a major environmental restoration effort to reduce the health and environmental risks resulting from past waste management and disposal practices at DOE sites. This report describes research needs in environmental restoration and complements a previously published document, DOE/ER-0419, Evaluation of Mid-to-Long Term Basic Research for Environmental Restoration. Basic research needs have been grouped into five major categories patterned after those identified in DOE/ER-0419: (1) environmental transport and transformations; (2) advanced sampling, characterization, and monitoring methods; (3) new remediation technologies; (4) performance assessment; and (5) health and environmental effects. In addition to basic research, this document deals with education and training needs for environmental restoration. 2 figs., 6 tabs.

Influência da fisioterapia complexa descongestiva associada à ingestão de triglicerídeos de cadeia média no tratamento do linfedema de membro superior Influence of complex descongestive physical therapy associated with intake of medium-chain triglycerides for treating upper-limb lymphedema

Directory of Open Access Journals (Sweden)

J Oliveira

2008-02-01

Full Text Available OBJETIVO: Verificar a influência da utilização da fisioterapia complexa descongestiva associada à dietoterapia com triglicerídeos de cadeia média (TCM como forma de intervenção no linfedema de membro superior (MS. MÉTODOS: Para a avaliação do linfedema, foram utilizadas cirtometria, volumetria, pregas cutâneas e quantidade de água corporal total. A Escala Visual Análoga (EVA foi utilizada para avaliar as sensações de desconforto, peso e dor no MS. Participaram deste estudo dez mulheres mastectomizadas com linfedema de MS homolateral à cirurgia, com idade média de 65,9 ± 10,4 anos e índice de massa corpórea (IMC de 26,8 ± 3,0kg/m² que, após avaliação nutricional, foram divididas aleatoriamente em dois grupos: Grupo Controle (n= 5, submetido ao tratamento fisioterapêutico constando da terapia complexa descongestiva (massagem clássica, drenagem linfática manual, bandagem compressiva e cuidados com a pele três vezes na semana, durante quatro semanas; Grupo TCM (n= 5, submetido ao mesmo protocolo fisioterapêutico somado ao tratamento dietético diário com ingestão de TCM, por quatro semanas. RESULTADOS: Ao final da intervenção, a análise da cirtometria e da volumetria mostraram diferenças significativas entre os grupos (OBJECTIVE: To investigate the influence of complex decongestive physical therapy (CDP in association with diet therapy using medium-chain triglycerides (MCT, as an intervention in cases of upper-limb lymphedema. METHODS: The lymphedema was evaluated by measuring circumferences, volumes, skin folds and whole-body water content. Feelings of discomfort, pain and heaviness in the arms were evaluated using a visual analog scale. Ten women who had undergone mastectomy and presented upper-limb lymphedema homolateral to the surgery participated in this study. Their mean age was 65.9 ± 10.4 years and their mean body mass index (BMI was 26.8 ± 3.0kg/m². After nutritional evaluation, they were randomly

5 CFR 534.603 - Rates of basic pay.

Science.gov (United States)

2010-01-01

... 5 Administrative Personnel 1 2010-01-01 2010-01-01 false Rates of basic pay. 534.603 Section 534.603 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT CIVIL SERVICE REGULATIONS PAY UNDER OTHER SYSTEMS Pay for Administrative Appeals Judge Positions § 534.603 Rates of basic pay. (a) The...

Determinants of basic public health services provision by village doctors in China: using non-communicable diseases management as an example.

Science.gov (United States)

Li, Tongtong; Lei, Trudy; Xie, Zheng; Zhang, Tuohong

2016-02-04

To ensure equity and accessibility of public health care in rural areas, the Chinese central government has launched a series of policies to motivate village doctors to provide basic public health services. Using chronic disease management and prevention as an example, this study aims to identify factors associated with village doctors' basic public health services provision and to formulate targeted interventions in rural China. Data was obtained from a survey of village doctors in three provinces in China in 2014. Using a multistage sampling process, data was collected through the self-administered questionnaire. The data was then analyzed using multilevel logistic regression models. The high-level basic public health services for chronic diseases (BPHS) provision rate was 85.2% among the 1149 village doctors whom were included in the analysis. Among individual level variables, more education, more training opportunities, receiving more public health care subsidy (OR = 3.856, 95 % CI: 1.937-7.678, and OR = 4.027, 95% CI: 1.722-9.420), being under integrated management (OR = 1.978, 95% CI: 1.132-3.458), and being a New Cooperative Medical Scheme insurance program-contracted provider (OR = 2.099, 95% CI: 1.187-3.712) were associated with the higher BPHS provision by village doctors. Among county level factors, Foreign Direct Investment Index showed a significant negative correlation with BPHS provision, while the government funding for BPHS showed no correlation (P > 0.100). Increasing public health care subsidies received by individual village doctors, availability and attendance of training opportunities, and integrated management and NCMS contracting of village clinics are important factors in increasing BPHS provision in rural areas.

Organization structure of a basic school of arts

OpenAIRE

Sinkulová, Iveta

2012-01-01

TITLE: Organization Structure of a Basic School of Arts AUTHOR: Iveta Sinkulová ABSTRACT: My bachelor thesis "Organization Structure of a Basic School of Arts" sets a goal to research which organization structures are applied at basic schools of arts, how the jobs of headmaster and heads of departments are incorporated into the Org Chart and which tasks are delegated to them in terms of the management of teaching process. The first thing performed was descriptive research. Then the work of de...

The Basic Framework for Robot Applicability Enhancement of Nuclear Risk Management in Nuclear Power Plants

Energy Technology Data Exchange (ETDEWEB)

Choi, Young; Jeong, Kungmin [Korea Atomic Energy Research Institute, Daejeon (Korea, Republic of); Kim, Inn Seock [bISSA Technology, Inc., Germantown (United States)

2015-05-15

Beyond-design-basis external events such as the one having occurred at the Fukushima Daiichi Nuclear Power Plant typically pose considerable challenges to the plant personnel because of the harsh environments caused by the events (e.g., extreme terrains, high radiation, radioactive rubbles, high heat, and explosive environment). Therefore, remote response techniques by use of robotic systems are needed to help the plant personnel cope with the extreme events. In this study the basic framework for enhancing robotic applicability to disaster management was developed using the analytic technique of Master Logic Diagram (MLD) and Goal-Tree Success-Tree (GTST). The users of robots have to devise a sound maintenance program, otherwise their unscheduled downtime may increase beyond limit, consequently defeating the purpose of robot applications. In addition, maintainability could be enhanced by designing for ease of diagnosis, and ease of access and repair. Ways to upgrade maintainability could be devised by evaluating maintainability in the design stage. The basic framework discussed herein shall be used by the KAERI's robotics team as a fundamental framework in enhancing the applicability of disaster robots in the hazardous environment caused by extreme events.

Teacher Effectiveness as Correlate of Students' Cognitive Achievement at Upper Basic Education in Basic Technology

Science.gov (United States)

Owoh, Titus M.

2016-01-01

This study sought to find out the relationship between students perception of their teacher effectiveness and academic achievement in Basic Technology. Teacher's personality, teaching techniques/classroom management strategy and appearance, all integrate to make for teacher effectiveness. To carry out this research, two research questions and one…

THE BASIC PRINCIPLES OF THE INTEGRATED MANAGEMENT OF THE PROCESS OF ASSEMBLY AND THREADING

Directory of Open Access Journals (Sweden)

Anton Skorkin

2017-11-01

Full Text Available The subject matter of this article is the issues related to the integrated management of assembling operations of fastening and threading elements at all stages of their implementation. The goal is to develop the generalized structure of the data management system of the process of assembly and threading. The objectives are: to justify the principles of managing the assembly and threading process at each stage of the assembly to improve the efficiency of these operations, to study the power, accuracy and performance characteristics of the connections and to draw the conclusion that suggested the theory of assembly management is efficient. The following results are obtained. The article presents the analytical dependencies of the force indexes of threading in the course of the package and sheet assembly, including the tightening force while joining; the assembly of a multilayered package of dissimilar sheet materials was analyzed. On the basis of the theoretical analysis, the dependences of the power indices of threading during the package and sheet assembly were determined. The assembly of the package of sheet materials was investigated, including a multilayered package of dissimilar materials of a “metal-plastic” type. Conclusions. The process of assembling threaded joints with the use of management principles was used; these principles enable increasing the efficiency of the assembly process, reducing the complexity of the basic operations, and improving the quality of the joints obtained. The use adaptive control of the screwing speed on the main threading transitions is suggested for reducing the torque.  The technology of making threaded joints with given properties is developed, the main ways of increasing the efficiency of assembly and threading processes are determined on the basis of the integrated control system for the assembly process.

Basic criteria for a sustainable water management at the U.S.-México border: the case of ambos Nogales

Directory of Open Access Journals (Sweden)

Luis Ernesto Cervera Gómez

2003-01-01

Full Text Available This article aims to analyze some basic criteria for a sustainable use of water in an international watershed shared by Mexico and the United States. The study area comprises the region of Ambos Nogales, which is located inside the Upper Santa Cruz River Basin. This portion of the watershed represents the main ecosystem and the main source of water for urban and rural populations located in this region. Following criteria of sustainability the authors revise and adapt to the case of Ambos Nogales, a set of guidelines proposed by the Pacific Institute for Studies in Development, Environment, and Security. These guidelines include the following elements: basic water requirements needed to maintain quality of life in the population and the health of ecosystems; water quality that meets certain minimum standards; human actions and their impact on long-term renewability of freshwater stocks and flows; collection of data concerning water resources, use and quality of water; institutional mechanisms to prevent and resolve conflicts; and a democratic process of water-planning and decision-making. These twin cities have a long history of cooperation and conflict linked to water resources, which makes available enough information to create a diagnostic about the water management inside a binational arena, and allowing to explore possibilities for a better water resources management under a sustainable regime and from an international perspective. Keywords: Sustainability, binational water management, ambos Nogales region.

Database basic design for safe management radioactive waste

International Nuclear Information System (INIS)

Son, D. C.; Ahn, K. I.; Jung, D. J.; Cho, Y. B.

2003-01-01

As the amount of radioactive waste and related information to be managed are increasing, some organizations are trying or planning to computerize the management on radioactive waste. When we consider that information on safe management of radioactive waste should be used in association with national radioactive waste management project, standardization of data form and its protocol is required, Korea Institute of Nuclear Safety(KINS) will establish and operate nationwide integrated database in order to effectively manage a large amount of information on national radioactive waste. This database allows not only to trace and manage the trend of radioactive waste occurrence and in storage but also to produce reliable analysis results for the quantity accumulated. Consequently, we can provide necessary information for national radioactive waste management policy and related industry's planing. This study explains the database design which is the essential element for information management

THE METHOD OF MULTIPLE SPATIAL PLANNING BASIC MAP

OpenAIRE

Zhang, C.; Fang, C.

2018-01-01

The “Provincial Space Plan Pilot Program” issued in December 2016 pointed out that the existing space management and control information management platforms of various departments were integrated, and a spatial planning information management platform was established to integrate basic data, target indicators, space coordinates, and technical specifications. The planning and preparation will provide supportive decision support, digital monitoring and evaluation of the implementation of the p...

Basic principles

International Nuclear Information System (INIS)

Wilson, P.D.

1996-01-01

Some basic explanations are given of the principles underlying the nuclear fuel cycle, starting with the physics of atomic and nuclear structure and continuing with nuclear energy and reactors, fuel and waste management and finally a discussion of economics and the future. An important aspect of the fuel cycle concerns the possibility of ''closing the back end'' i.e. reprocessing the waste or unused fuel in order to re-use it in reactors of various kinds. The alternative, the ''oncethrough'' cycle, discards the discharged fuel completely. An interim measure involves the prolonged storage of highly radioactive waste fuel. (UK)

Farm Management Basic Core Curriculum. Kansas Postsecondary Farm and Ranch Management Project.

Science.gov (United States)

Albracht, James, Ed.

Thirty-five units of instruction are included in this core curriculum in farm management for postsecondary farm and ranch management programs. Units of instruction are divided into 12 instructional areas: (1) Introduction to Financial Management, (2) Farm Business Arrangement, (3) Credit Management, (4) Budgeting, (5) Recordkeeping, (6) Record…

Basic Project Management Methodologies for Survey Researchers.

Science.gov (United States)

Beach, Robert H.

To be effective, project management requires a heavy dependence on the document, list, and computational capability of a computerized environment. Now that microcomputers are readily available, only the rediscovery of classic project management methodology is required for improved resource allocation in small research projects. This paper provides…

The management of human resources in the Basic Units of Cooperative Production in Cuba: An essential challenge

Directory of Open Access Journals (Sweden)

Deysi Alfonso Porraspita

2018-02-01

Full Text Available The socioeconomic structure of Cuba has undergone a stage of profound transformation, with various factors that have intervened in this process, where different forms of business structures have converged, one of which has been represented by the cooperative sector, fundamentally developed in agriculture from the country. In this scenario the issue of the effectiveness of these entities has been subject to dissimilar analyzes and debates from different sides, where what is related to the human factor has played an essential role, this implies a detailed observation of the adequate management of human resources in the integral management of these organizations. In this line, the fundamental challenge will be to manage human resources in a way that contributes to the continuous improvement of the Cooperative Production Units as one of the representative structures of the agrarian cooperative sector in Cuba. Carrying out an analysis highlighting the importance of the management of human resources as a contribution to affectivity of the Basic Units of Cooperative production constituted the objective of the work. Through analysis, synthesis and use of the logical historical in the system analysis, the work addressed the theoretical pillars and methodological aspects that support the management of human resources in the cooperative entities analyzed as a tribute to the effectiveness of their results.

Workplace Basics: The Skills Employers Want.

Science.gov (United States)

Carnevale, Anthony P.; And Others

1989-01-01

Identifies the basic skills needed by workers to function in today's high technology workplace. Examines ways of training employees in learning and communication skills, adaptability, personal management, group effectiveness, and organizational leadership. Describes the eight-step training approach used by Mazda Motor Manufacturing Corporation.…

Basic Management Functions in Culture and Arts Organisations

Directory of Open Access Journals (Sweden)

Dragoljub Raduški

2016-04-01

Full Text Available In the last fifty years management has become a significant factor in the development of sectors that have no profit characteristics. The culture and arts organisations are aware of the need for management. However, various specific aspects of the artistic practice are the key issue regarding the implementation of management in culture and arts. The main problem in obtaining positive outcomes is the correct adjustment of management and art functions having in mind the relationship between the two. The management functions need to be implemented and applied in such a manner that art activities should not be compromised. Due to project orientation, lack of funding and environment changes, entrepreneurship has assumed a significant role in achieving the goals of culture and arts organisations. In less developed countries, the functions of management are not implemented in arts and culture to their full potential. One reason is the importance a given society assigns to arts and culture. Still, implementation of management is the fundamental assumption of faster development of artistic, organisational and technical modernization and financial stabilisation of culture and arts organisations.

The Method of Multiple Spatial Planning Basic Map

Science.gov (United States)

Zhang, C.; Fang, C.

2018-04-01

The "Provincial Space Plan Pilot Program" issued in December 2016 pointed out that the existing space management and control information management platforms of various departments were integrated, and a spatial planning information management platform was established to integrate basic data, target indicators, space coordinates, and technical specifications. The planning and preparation will provide supportive decision support, digital monitoring and evaluation of the implementation of the plan, implementation of various types of investment projects and space management and control departments involved in military construction projects in parallel to approve and approve, and improve the efficiency of administrative approval. The space planning system should be set up to delimit the control limits for the development of production, life and ecological space, and the control of use is implemented. On the one hand, it is necessary to clarify the functional orientation between various kinds of planning space. On the other hand, it is necessary to achieve "multi-compliance" of various space planning. Multiple spatial planning intergration need unified and standard basic map(geographic database and technical specificaton) to division of urban, agricultural, ecological three types of space and provide technical support for the refinement of the space control zoning for the relevant planning. The article analysis the main space datum, the land use classification standards, base map planning, planning basic platform main technical problems. Based on the geographic conditions, the results of the census preparation of spatial planning map, and Heilongjiang, Hainan many rules combined with a pilot application.

Maintenance information management using access/visual basic

International Nuclear Information System (INIS)

Memory A, Michael; Cumbia W, Brad

1998-01-01

The Accelerator Electronic Support Group (AES) is the group responsible for maintaining over 100 subsystems of the Nuclear Physics Accelerator at Jefferson Lab. Presently, there are 30 employees in the AES group. It is each individual's responsibility to make entries into the AES Database. This Access/Visual Basic based database is the center for all work performed to the Accelerator by the AES group. At any time, an AES technologist can supply valuable information needed to track pending maintenance, data analysis of recurring problems, inventory tracking and the ability to export all of this information to a web based electronic log generated by Jefferson Lab Operations Group

Quality management tool

Energy Technology Data Exchange (ETDEWEB)

Lee, Tae Hun

2011-09-15

This book introduces basic conception of quality with characteristic, price, cost, and function, basic conception on quality management, introduction and operation of quality management, quality guaranteed and claim like handling of claim of goods, standards, and quality guaranteed method, basic tools of quality management such as Pareto diagram, characteristic diagram, cause-and-effect, fish born diagram check sheet histogram scatter diagram graph and stratification new seven tools of QC, quality deployment function and measurement system.

Quality management tool

International Nuclear Information System (INIS)

Lee, Tae Hun

2011-09-01

This book introduces basic conception of quality with characteristic, price, cost, and function, basic conception on quality management, introduction and operation of quality management, quality guaranteed and claim like handling of claim of goods, standards, and quality guaranteed method, basic tools of quality management such as Pareto diagram, characteristic diagram, cause-and-effect, fish born diagram check sheet histogram scatter diagram graph and stratification new seven tools of QC, quality deployment function and measurement system.

Basic concepts of philosophy of management and corporations

DEFF Research Database (Denmark)

Rendtorff, Jacob Dahl

2013-01-01

This chapter presents some fundamental concepts of the philosophy of management and corporations by addressing the problem of corporate legitimacy and Immanuel Kant’s distinction between theoretical, practical, and aesthetic reason and judgment. This chapter begins with a general definition...... of philosophy of management and corporations and continues by presenting its ontological and epistemological underpinnings. This approach is used to address the relation between economics, business ethics, and philosophy of management. Finally, ethical and aesthetic judgment is presented as the mediator between...... theoretical, aesthetic, and practical reason in philosophy of management....

THE METHOD OF MULTIPLE SPATIAL PLANNING BASIC MAP

Directory of Open Access Journals (Sweden)

C. Zhang

2018-04-01

Full Text Available The “Provincial Space Plan Pilot Program” issued in December 2016 pointed out that the existing space management and control information management platforms of various departments were integrated, and a spatial planning information management platform was established to integrate basic data, target indicators, space coordinates, and technical specifications. The planning and preparation will provide supportive decision support, digital monitoring and evaluation of the implementation of the plan, implementation of various types of investment projects and space management and control departments involved in military construction projects in parallel to approve and approve, and improve the efficiency of administrative approval. The space planning system should be set up to delimit the control limits for the development of production, life and ecological space, and the control of use is implemented. On the one hand, it is necessary to clarify the functional orientation between various kinds of planning space. On the other hand, it is necessary to achieve “multi-compliance” of various space planning. Multiple spatial planning intergration need unified and standard basic map(geographic database and technical specificaton to division of urban, agricultural, ecological three types of space and provide technical support for the refinement of the space control zoning for the relevant planning. The article analysis the main space datum, the land use classification standards, base map planning, planning basic platform main technical problems. Based on the geographic conditions, the results of the census preparation of spatial planning map, and Heilongjiang, Hainan many rules combined with a pilot application.

Factors Associated With the Development of Breast Cancer-Related Lymphedema After Whole-Breast Irradiation

Energy Technology Data Exchange (ETDEWEB)

Shah, Chirag; Wilkinson, John Ben; Baschnagel, Andrew [Department of Radiation Oncology, William Beaumont Hospital, Royal Oak, MI (United States); Ghilezan, Mihai [Department of Radiation Oncology, William Beaumont Hospital, Royal Oak, MI (United States); William Beaumont School of Medicine, Oakland University, Royal Oak, MI (United States); Riutta, Justin; Dekhne, Nayana; Balaraman, Savitha [Beaumont Cancer Institute, William Beaumont Hospital, Royal Oak, MI (United States); William Beaumont School of Medicine, Oakland University, Royal Oak, MI (United States); Mitchell, Christina; Wallace, Michelle [Department of Radiation Oncology, William Beaumont Hospital, Royal Oak, MI (United States); Vicini, Frank, E-mail: fvicini@beaumont.edu [Department of Radiation Oncology, William Beaumont Hospital, Royal Oak, MI (United States); Beaumont Cancer Institute, William Beaumont Hospital, Royal Oak, MI (United States); William Beaumont School of Medicine, Oakland University, Royal Oak, MI (United States)

2012-07-15

Purpose: To determine the rates of breast cancer-related lymphedema (BCRL) in patients undergoing whole-breast irradiation as part of breast-conserving therapy (BCT) and to identify clinical, pathologic, and treatment factors associated with its development. Methods and Materials: A total of 1,861 patients with breast cancer were treated at William Beaumont Hospital with whole-breast irradiation as part of their BCT from January 1980 to February 2006, with 1,497 patients available for analysis. Determination of BCRL was based on clinical assessment. Differences in clinical, pathologic, and treatment characteristics between patients with BCRL and those without BCRL were evaluated, and the actuarial rates of BCRL by regional irradiation technique were determined. Results: The actuarial rate of any BCRL was 7.4% for the entire cohort and 9.9%, 14.7%, and 8.3% for patients receiving a supraclavicular field, posterior axillary boost, and internal mammary irradiation, respectively. BCRL was more likely to develop in patients with advanced nodal status (11.4% vs. 6.3%, p = 0.001), those who had a greater number of lymph nodes removed (14 nodes) (9.5% vs. 6.0%, p = 0.01), those who had extracapsular extension (13.4% vs. 6.9%, p = 0.009), those with Grade II/III disease (10.8% vs. 2.9%, p < 0.001), and those who received adjuvant chemotherapy (10.5% vs. 6.7%, p = 0.02). Regional irradiation showed small increases in the rates of BCRL (p = not significant). Conclusions: These results suggest that clinically detectable BCRL will develop after traditional BCT in up to 10% of patients. High-risk subgroups include patients with advanced nodal status, those with more nodes removed, and those who receive chemotherapy, with patients receiving regional irradiation showing a trend toward increased rates.

Managing complex, high risk projects a guide to basic and advanced project management

CERN Document Server

Marle, Franck

2016-01-01

Maximizing reader insights into project management and handling complexity-driven risks, this book explores propagation effects, non-linear consequences, loops, and the emergence of positive properties that may occur over the course of a project. This book presents an introduction to project management and analysis of traditional project management approaches and their limits regarding complexity. It also includes overviews of recent research works about project complexity modelling and management as well as project complexity-driven issues. Moreover, the authors propose their own new approaches, new methodologies and new tools which may be used by project managers and/or researchers and/or students in the management of their projects. These new elements include project complexity definitions and frameworks, multi-criteria approaches for project complexity measurement, advanced methodologies for project management (propagation studies to anticipate potential behaviour of the project, and clustering approaches...

Five Basic Microcomputer Applications for Marketing Educators.

Science.gov (United States)

James, Richard F.

The microcomputer has five basic applications in marketing education--a remedial/tutorial application, instructional purposes, simulation, the project data base, and classroom management. Examples of word processing applications of a microcomputer are updating annual training plans and producing letters to advisory committee members, parents, and…

Construction of irradiated material examination facility-basic design

International Nuclear Information System (INIS)

Ro, Seung Gy; Kim, Eun Ka; Hong, Gye Won; Herr, Young Hoi; Hong, Kwon Pyo; Lee, Myeong Han; Baik, Sang Youl; Choo, Yong Sun; Baik, Seung Je

1989-02-01

The basic design of the hot cell facility which has the main purpose of doing mechanical and physical property tests of irradiated materials, the examination process, and the annexed facility has been made. Also basic and detall designs for the underground excavation work have been performed. The project management and tasks required for the license application have been carried out in due course. The facility is expected to be completed by the end of 1992, if the budgetary support is sufficient. (Author)

41 CFR 102-85.25 - What is the basic principle governing OAs?

Science.gov (United States)

2010-07-01

... Property Management Regulations System (Continued) FEDERAL MANAGEMENT REGULATION REAL PROPERTY 85-PRICING POLICY FOR OCCUPANCY IN GSA SPACE Pricing Policy-General § 102-85.25 What is the basic principle...

5 CFR 841.703 - Increases on basic annuities and survivor annuities.

Science.gov (United States)

2010-01-01

... 5 Administrative Personnel 2 2010-01-01 2010-01-01 false Increases on basic annuities and survivor annuities. 841.703 Section 841.703 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT (CONTINUED) CIVIL... Adjustments § 841.703 Increases on basic annuities and survivor annuities. (a) Except as provided in §§ 841...

Illustrating the (in)visible: Understanding the impact of loss in adults living with secondary lymphedema after cancer

Science.gov (United States)

Thomas, Roanne; Hamilton, Ryan

2014-01-01

Life with a disability is often riddled with paradoxes, one of which is being visibly marked, while personal experiences, losses, and challenges remain hidden. Our article draws attention to this paradox among people who live with secondary lymphedema after cancer (SLC). SLC is a relatively unfamiliar chronic condition within medical and lay discourses of cancer, which proves challenging for the many cancer survivors who are in search of information and understanding. Thirteen men and women with SLC were recruited from two research sites (Fredericton, NB, and Ottawa, ON, Canada) to participate in semi-structured interviews about the physical and psychosocial aspects of SLC. Using a methodology of interpretive description, our analysis of participant interviews reveals the complex ways in which men and women felt both visible and invisible within various contexts. We discuss three majors themes: (in)visibility and appearance related to material losses; (in)visibility and action connected to visible losses in function, as well as invisible struggles to care for oneself; and the loss of present and future well-being, as SLC renders some limitations visible while potentially obscuring a hopeful future indefinitely. Our research indicates that timely diagnosis of SLC would be an immediate first step in recognizing the physical and emotional dimensions of the condition. To accomplish this, increased awareness is needed. To enhance quality of life for those living with SLC, the development of new resources and psychosocial supports is also required. PMID:25148936

Basic standards for radiation protection

International Nuclear Information System (INIS)

Webb, G.A.M.

1982-01-01

The basic standards for radiation protection have been based, for many years, on the recommendations of the International Commission of Radiological Protection. The three basic standards recommended by the Commission may be summarized as ''justification, optimization of protection and adherence to dose limitations. The applications of these basic principles to different aspects of protection are briefly summarized and the particular ways in which they have been applied to waste described in more detail. The application of dose limits, both in the control of occupational exposure and in regulating routine discharges of radioactive effluents is straight forward in principle although the measurement and calculational requirements may be substantial. Secondary standards such as derived limits may be extremely useful and the principles underlying their derivation will be described. Optimization of protection is inherently a more difficult concept to apply in protection and the various techniques used will be outlined by with particular emphasis on the use of cost benefit analysis are recommended by the ICRP. A review will be given of the problems involved in extending these basic concepts of the ICRP to probabilistic analyses such as those required for assessing the consequences of accidents or disruptive events in long term repositories. The particular difficulties posed by the very long timescales involved in the assessment of waste management practices will be discussed in some detail. (orig./RW)

Disease: H00540 [KEGG MEDICUS

Lifescience Database Archive (English)

Full Text Available H00540 Osteoporosis, lymphedema, anhydrotic ectodermal dysplasia with immunodefici...ency (OLEDAID); Ectodermal dysplasia, anhidrotic, with immunodeficiency, osteopetrosis, and lymphedema A rar...e X-linked recessive syndrome 'Osteoporosis, lymphedema, anhydrotic ectodermal dysplasia with immunodeficien

Total Quality Management in a Knowledge Management Perspective.

Science.gov (United States)

Johannsen, Carl Gustav

2000-01-01

Presents theoretical considerations on both similarities and differences between information management and knowledge management and presents a conceptual model of basic knowledge management processes. Discusses total quality management and quality control in the context of information management. (Author/LRW)

How does technology impact on the self-beliefs of adult basic education learners?

OpenAIRE

Nwosu, Uchenna June

2010-01-01

Non-peer-reviewed Adult Basic Education learners return to education to solve a problem of inadequacy in life hence many adult basic education learners engage in the learning of basic skills to meet their needs in life than for the education itself. Due to feelings of inadequacy, in many instances the adult basic education learner displays low beliefs in abilities and capabilities which if not properly managed and enhanced can negatively impact on learning and consequently the mee...

Essentials of Risk Management. Strategic Decisions. Board Basics.

Science.gov (United States)

Sonenstein, Burton; Kumin, Laura A.

1998-01-01

This booklet, intended for trustees of institutions of higher education, offers some instruction on the principles of risk management. Introductory information provides a definition of risk management, which is seen as a planning and strategic function, not solely as a financial or safety assessment. Individual sections then address the following…

Basic Knowledge about Metal Stent Development

Directory of Open Access Journals (Sweden)

Seok Jeong

2016-03-01

Full Text Available Biliary self-expandable metal stents (SEMS, a group of non-vascular stents, have been used in the palliative management of biliary obstruction around the world. However, there are still unmet needs in the clinical application of biliary SEMS. Comprehensive understanding of the SEMS is required to resolve the drawbacks and difficulties of metal stent development. The basic structure of SEMS, including the materials and knitting methods of metal wires, covering materials, and radiopaque markers, are discussed in this review. What we know about the physical and mechanical properties of the SEMS is very important. With an understanding of the basic knowledge of metal stents, hurdles such as stent occlusion, migration, and kinking can be overcome to develop more ideal SEMS.

Safety research basic plan of JNC

Energy Technology Data Exchange (ETDEWEB)

NONE

1999-03-01

Japan Nuclear Cycle Development Institute (JNC) formally succeeded to Power Reactor and Nuclear Fuel Development Corporation (PNC) on October, 1 1998. This report describes the basic plan for major program of JNC which consists of two parts: management philosophy of the new institute and the latest revised medium term program. In the first part, the primary mission of JNC is to perform its R and D concentrating on fast breeder reactor and its fuel cycle, and treatment and disposal of high-level radioactive wastes, while at the same time giving special consideration to safety. In the second, individual programs in the new basic plan are discussed in detail. The outline and schedule of each program are also attached in the table form. (H. Itami)

Proceeding of the Scientific Meeting and Presentation on Basic Research in Nuclear of the Scientific and Technology Part II : Nuclear Chemistry; Process Technology and Radioactive Waste Management; Environment

International Nuclear Information System (INIS)

Sudjatmoko; Karmanto, Eko Edy; Endang-Supartini

1996-04-01

Scientific Meeting and Presentation on Basic Research in Nuclear Science and Technology is a routine activity was held by Yogyakarta Nuclear Research Centre, National Atomic Energy Agency (BATAN) for monitoring the research activity which achieved in BATAN. The Proceeding contains a proposal about basic which has Nuclear Chemistry, Process Technology, Radioactive Waste Management and Environment. This proceeding is the second part from two part which published in series. There are 61 articles which have separated index

The articulated action plan (par in municipalities in Mato Grosso do Sul State and its implications for the democratic management of basic education - doi: 10.4025/actascieduc.v34i2.17546

Directory of Open Access Journals (Sweden)

Regina Tereza Cestari de Oliveira

2012-11-01

Full Text Available The paper analyzes the implications of the Articulated Action Plan (PAR, a component of the Education Development Plan (PDE, to the democratic management of basic education, within the context of the educational policy, during President Luiz Inácio Lula da Silva’s second government term (2007-2010. It presents research findings through the examination of documentary sources, focusing on the actions defined by the municipalities in the state of Mato Grosso do Sul, within PAR’s Educational Management Dimension. These actions, in alignment with the guidelines of the plan called All for Education, indicate the limits and possibilities of building a democratic management of basic education, depending on the implementation by the municipalities, as they exercise their autonomy.  

Lymphatic compensation during the postoperative period after breast cancer treatment with axillary dissection

Directory of Open Access Journals (Sweden)

Mariana Maia Freire de Oliveira

2015-06-01

Full Text Available Lymphedema secondary to breast cancer causes physical and psychological morbidity and compromises quality of life. The objective of this literature review was to study lymphatic compensation after surgery for breast cancer and the factors that influence this process, with a view to understanding the etiopathogenesis of lymphedema. Articles indexed on Pubmed published from 1985 to 2012 were reviewed. According to the literature, lymphangiogenesis reduces damage to lymph vessels; there is little evidence that Vascular Endothelial Growth Factor is elevated in women with lymphedema; lymphovenous communications can be observed 60 days after surgery; women without lymphedema have acquired alternative mechanisms for removal of proteins from the interstitial space; and active exercise stimulates lymphatic and venous pumping. Health professionals should teach these patients about the risk factors for lymphedema. The effects of lymphangiogenesis, proteolysis and lymphovenous communications on development of lymphedema should be studied, since these events are intimately related.

Management of soils polluted by activities of a basic nuclear installations. Guide Nr 24, Release of the 2016/08/30

International Nuclear Information System (INIS)

2016-01-01

After having indicated the relevant regulatory texts and guides related to sanitation and dismantling, and having stated definitions of some important terms, this guide addresses the sanitation or soil management approach to be adopted as soon as a soil pollution requires it. This pollution can be radioactive or chemical, and the case of a pollution going out of the installation is also included. Legal responsibility is outlined. The guide aims then at detailing the articulation between the various concerned and relevant documents for the management of a radioactive or chemical pollution related to the activities of a basic nuclear installation (BNI), and at detailing ASN expectations in this respect. Thus, it recalls the adopted management approach and methodological tools: diagnosis, interpretation of environment condition, management plan. It describes the approach related to soil sanitation: diagnosis, document to be produced, field and additional investigations, implementation of the reference approach for a complete removal of pollution, actions to be undertaken when the application of the reference approach is impossible, end of sanitation works. The third part discusses the methodology of soil sanitation by excavation by distinguishing three defence lines, by discussing the management of excavated soils (management modalities, warehousing within the installation). Administrative procedures to be applied before, during and after sanitation works are then presented. Specific management approaches are indicated for a BNI being operated or being dismantled. Actions of information are also indicated. Finally, requirements in terms of quality assurance are evoked

Feasibility study of axillary reverse mapping lymphoscintigraphy in carcinoma breast: A concept toward preventing lymphedema

International Nuclear Information System (INIS)

Gandhi, Sunny J.; Satish, C.; Sundaram, Palaniswamy Shanmuga; Subramanyam, Padma; Vijaykumar, D. K.

2016-01-01

In the surgery of breast cancer, axillary reverse mapping (ARM) is the identification and preservation of arm draining lymph node (ARM node) during an axillary dissection. The assumption is that the ARM node is different from node draining breast and is unlikely to be involved even in the patients with axillary nodal metastases. If we can identify and preserve ARM node using lymphoscintigraphy; morbidity of lymphedema, as seen with axillary dissection, may be avoided. Pathologically proven 50 breast cancer patients undergoing initial surgery (cTx-4, cN0-2, and Mx-0) were included in this study. Less than 37 MBq, 0.5 ml in equally divided doses of filtered 99mTc sulfur colloid was injected intradermally into the second and third web spaces. ARM nodes in the axilla were identified with the help of Gamma Probe intraoperatively; however, their location was noted with the reference to specific anatomical landmarks and sent for histopathological examination after excision. The ARM node was successfully identified in 47/50 cases (sensitivity - 94%). In 40 out of 47 cases (85%), the location of the ARM node was found to lateral to the subscapular pedicle, above the second intercostobrachial nerve and just below the axillary vein. Of the 47 patients in whom ARM node/s were identified, metastasis was noted in 5 of them (10%). Four out of these 5 patients had the pN3 disease. ARM node exists, and it is feasible to identify ARM node using radio isotope technique with an excellent sensitivity. ARM node seems to have a fairly constant location in more than 80% cases. It is involved with metastasis (10% cases) only when there are multiple lymph nodal metastases in the axilla

Mantle cell lymphoma relapsing at the lymphedematous arm.

Directory of Open Access Journals (Sweden)

Giuseppina Massini

2013-02-01

Full Text Available Lymphedema (LE is a chronic medical condition characterized by lymphatic fluid retention, resulting in tissue swelling. Cancer treatments involving lymph nodes can damage lymph drainage routes, causing accumulation of lymph fluid in the interstitial tissue of related limbs and body areas and secondary LE.  Basically, the LE has a negative impact on physical and mental quality of life. Moreover, 0.07-0.04% of long term survivors (most patients undergone mastectomy can develop the Stewart-Treves syndrome,  a rare and aggressive multifocal lymphangiosarcoma arising within the LE region. Here we describe a   45-year-old woman  with a massive LE of the left arm,  as a consequence of previous breast cancer,  who  was diagnosed after 4 years  of stage IV mantle cell lymphoma (MCL . The patient after obtaining complete remission with chemotherapy and ABMT  relapsed of MCL in lymphedema site.

41 CFR 102-76.10 - What basic design and construction policy governs Federal agencies?

Science.gov (United States)

2010-07-01

... 41 Public Contracts and Property Management 3 2010-07-01 2010-07-01 false What basic design and... Management Federal Property Management Regulations System (Continued) FEDERAL MANAGEMENT REGULATION REAL... must be timely, efficient, and cost effective. (b) Use a distinguished architectural style and form in...

[Basic research on digital logistic management of hospital].

Science.gov (United States)

Cao, Hui

2010-05-01

This paper analyzes and explores the possibilities of digital information-based management realized by equipment department, general services department, supply room and other material flow departments in different hospitals in order to optimize the procedures of information-based asset management. There are various analytical methods of medical supplies business models, providing analytical data for correct decisions made by departments and leaders of hospital and the governing authorities.

Anticipatory Enrollment Management: Another Level of Enrollment Management

Science.gov (United States)

Dennis, Marguerite J.

2012-01-01

Building on the principles of Enrollment Management (EM) and Strategic Enrollment Management (SEM), Anticipatory Enrollment Management (AEM) offers another level of managing enrollment: anticipating future enrollment. AEM is grounded in the basic principles of Customer Relationship Management (CRM) and includes strategic out-reach to parents and…

Positron emission tomography basic sciences

CERN Document Server

Townsend, D W; Valk, P E; Maisey, M N

2003-01-01

Essential for students, science and medical graduates who want to understand the basic science of Positron Emission Tomography (PET), this book describes the physics, chemistry, technology and overview of the clinical uses behind the science of PET and the imaging techniques it uses. In recent years, PET has moved from high-end research imaging tool used by the highly specialized to an essential component of clinical evaluation in the clinic, especially in cancer management. Previously being the realm of scientists, this book explains PET instrumentation, radiochemistry, PET data acquisition and image formation, integration of structural and functional images, radiation dosimetry and protection, and applications in dedicated areas such as drug development, oncology, and gene expression imaging. The technologist, the science, engineering or chemistry graduate seeking further detailed information about PET, or the medical advanced trainee wishing to gain insight into the basic science of PET will find this book...

Basic needs of Universiti Utara Malaysia students

Science.gov (United States)

Ismail, Suzilah; Ahmad, Yuhaniz; Enn, Chang Tzu

2017-11-01

Basic needs are defined as goods or services that are essential for human to live and function. Wants on the other hand, are goods or services that are not necessary but we desire or wish for in order to fulfil our needs. In university, students' needs and wants are not always easily detectable due to different generations of students. The students' desires are also caused by peer interactions, course needs and cultural differences. For example older generations requires typewriter but new generations need a laptop. Many university students have difficulty to differentiate between basic needs and wants. This leads to financial management problem which can affect their academic performance. The purpose of this study is to identify students of Universiti Utara Malaysia (UUM) basic needs. Based on past studies conducted by 3 universities, 12 items related to students' basic needs were identified. However, only 9 items are considered relevant to UUM students. A study on a focus group consist of 18 students from different background was conducted to validate the 9 items of basic needs by using in depth interviews. The findings indicated food, clothing, books, stationery, photocopying, printing & binding, information & communication technology (ICT), mobile phone bills, transportation and others (which includes toiletries, groceries, sport, & entertainment) as the 9 items. The findings also revealed that student basic needs for ICT are not only laptop and printer but also a smartphone. As for clothing, requirements are different according to programs the student majors in. A business student need full business attire, law students need a proper robe for moot courts and curriculum activities require the students to be in uniform. These are basic needs and not desires or wants.

Achieving year 2000 readiness: basic processes

International Nuclear Information System (INIS)

1999-03-01

This document provides an approach or addressing safety and operability concerns related to Year 2000 (Y2K). Although it was prepared for nuclear power plants the methods described are applicable to other nuclear installations and to other industrial concerns. The basic goal was to provide a brief but comprehensive approach that may be used to discover, understand and correct the Y2K related problems. The document relies on certain basic expectations of the facility that would apply to any programme: ownership, management, knowledgeable participants, thorough application of the approach, documentation of efforts, quality assurance of products and compliance with all regulatory requirements. The IAEA has and will continue to be involved with Member States to assist them in implementing this document and achieving Y2K Readiness

Achieving year 2000 readiness: basic processes

Energy Technology Data Exchange (ETDEWEB)

NONE

1999-03-01

This document provides an approach or addressing safety and operability concerns related to Year 2000 (Y2K). Although it was prepared for nuclear power plants the methods described are applicable to other nuclear installations and to other industrial concerns. The basic goal was to provide a brief but comprehensive approach that may be used to discover, understand and correct the Y2K related problems. The document relies on certain basic expectations of the facility that would apply to any programme: ownership, management, knowledgeable participants, thorough application of the approach, documentation of efforts, quality assurance of products and compliance with all regulatory requirements. The IAEA has and will continue to be involved with Member States to assist them in implementing this document and achieving Y2K Readiness 12 refs, 3 figs

[Idiopathic scrotal elephantiasis. A case report].

Science.gov (United States)

López-Caballero, Ignacio; Sánchez-Ruvalcaba, Itzel; Sánchez-Martinez, Luis Carlos; Hernández-Ordoñez, Octavio; Gómez-Lara, Miguel; Flores-Carrillo, Víctor

2014-01-01

Penoscrotal lymphedema (scrotal elephantiasis) is a condition that has been described in areas in which filariasis is endemic. This paper presents a case of a 45-year-old man with idiopathic lymphedema isolated to the scrotum. After acquired causes of lymphedema were ruled out, the patient was treated with scrotectomy and penoscrotal reconstruction. Currently, the patient is receiving follow-up care without evidence of recurrence. Penoscrotal lymphedema may cause symptoms of weakness, immobility and emotional disturbance. Surgery procedure provides a satisfactory cosmetical and functional outcome.

41 CFR 102-73.10 - What is the basic real estate acquisition policy?

Science.gov (United States)

2010-07-01

... ESTATE ACQUISITION General Provisions § 102-73.10 What is the basic real estate acquisition policy? When... real estate and related services in an efficient and cost effective manner. ... 41 Public Contracts and Property Management 3 2010-07-01 2010-07-01 false What is the basic real...

Building Action for Stability in Communities (BASIC) : Training for ...

International Development Research Centre (IDRC) Digital Library (Canada)

The BASIC approach combines demographic, health and environmental management tools to increase community stability and wellbeing. Following the training, the participants will undertake community population appraisals, environmental planning and health service delivery planning in their own communities. Two pilot ...

Health insurance basic actuarial models

CERN Document Server

Pitacco, Ermanno

2014-01-01

Health Insurance aims at filling a gap in actuarial literature, attempting to solve the frequent misunderstanding in regards to both the purpose and the contents of health insurance products (and ‘protection products’, more generally) on the one hand, and the relevant actuarial structures on the other. In order to cover the basic principles regarding health insurance techniques, the first few chapters in this book are mainly devoted to the need for health insurance and a description of insurance products in this area (sickness insurance, accident insurance, critical illness covers, income protection, long-term care insurance, health-related benefits as riders to life insurance policies). An introduction to general actuarial and risk-management issues follows. Basic actuarial models are presented for sickness insurance and income protection (i.e. disability annuities). Several numerical examples help the reader understand the main features of pricing and reserving in the health insurance area. A short int...

Hygiene Basics

Science.gov (United States)

... Staying Safe Videos for Educators Search English Español Hygiene Basics KidsHealth / For Teens / Hygiene Basics What's in this article? Oily Hair Sweat ... smell, anyway? Read below for information on some hygiene basics — and learn how to deal with greasy ...

Problems associated with basic oral surgical techniques

International Nuclear Information System (INIS)

Kapatkin, A.S.; Marretta, S.M.; Schloss, A.J.

1990-01-01

The veterinarian must be able to diagnose several types of dental problems. History, physical examination, clinical pathology, and radiography are important in making an accurate diagnosis. Basic oral surgery includes various extraction techniques and management of their associated complications. Knowledge of dental anatomy and proper surgical technique can make an extraction curative rather than a frustrating procedure with multiple complications

Idiopathic scrotal elephantiasis.

Science.gov (United States)

Hornberger, Brad J; Elmore, James M; Roehrborn, Claus G

2005-02-01

Scrotal lymphedema (scrotal elephantiasis) is a condition that has historically been described in areas endemic to filariasis. We present a unique case of a 22-year-old man with idiopathic lymphedema isolated to the scrotum. After acquired causes of lymphedema were ruled out, the patient was treated with scrotectomy and scrotal reconstruction.

Basic electrotechnology

CERN Document Server

Ashen, R A

2013-01-01

BASIC Electrotechnology discusses the applications of Beginner's All-purpose Symbolic Instruction Code (BASIC) in engineering, particularly in solving electrotechnology-related problems. The book is comprised of six chapters that cover several topics relevant to BASIC and electrotechnology. Chapter 1 provides an introduction to BASIC, and Chapter 2 talks about the use of complex numbers in a.c. circuit analysis. Chapter 3 covers linear circuit analysis with d.c. and sinusoidal a.c. supplies. The book also discusses the elementary magnetic circuit theory. The theory and performance of two windi

Importance of tree basic density in biomass estimation and associated uncertainties

DEFF Research Database (Denmark)

Njana, Marco Andrew; Meilby, Henrik; Eid, Tron

2016-01-01

Key message Aboveground and belowground tree basic densities varied between and within the three mangrove species. If appropriately determined and applied, basic density may be useful in estimation of tree biomass. Predictive accuracy of the common (i.e. multi-species) models including aboveground...... of sustainable forest management, conservation and enhancement of carbon stocks (REDD+) initiatives offer an opportunity for sustainable management of forests including mangroves. In carbon accounting for REDD+, it is required that carbon estimates prepared for monitoring reporting and verification schemes...... and examine uncertainties in estimation of tree biomass using indirect methods. Methods This study focused on three dominant mangrove species (Avicennia marina (Forssk.) Vierh, Sonneratia alba J. Smith and Rhizophora mucronata Lam.) in Tanzania. A total of 120 trees were destructively sampled for aboveground...

A randomized cross-over trial to detect differences in arm volume after low- and heavy-load resistance exercise among patients receiving adjuvant chemotherapy for breast cancer at risk for arm lymphedema

DEFF Research Database (Denmark)

Bloomquist, Kira; Hayes, Sandi; Adamsen, Lis

2016-01-01

changes after resistance exercise with heavy loads in this population. The purpose of this study is to determine acute changes in arm volume after a session of low- and heavy-load resistance exercise among women undergoing adjuvant chemotherapy for breast cancer at risk for arm lymphedema. METHODS....../DESIGN: This is a randomized cross-over trial. PARTICIPANTS: Women receiving adjuvant chemotherapy for breast cancer who have undergone axillary lymph node dissection will be recruited from rehabilitation centers in the Copenhagen area. INTERVENTION: Participants will be randomly assigned to engage in a low- (two sets of 15...... was calculated based on changes in L-Dex scores between baseline and 72-hours post exercise sessions. DISCUSSION: Findings from this study are relevant for exercise prescription guidelines, as well as recommendations regarding participating in activities of daily living for women following surgery for breast...

Disease: H01876 [KEGG MEDICUS

Lifescience Database Archive (English)

Full Text Available H01876 Microcephaly with or without chorioretinopathy, lymphedema, or mental retar...dation (MCLMR); Microcephaly, lymphedema, chorioretinal dysplasia (MLCRD) syndrome; Chorioretinal dysplasia,... microcephaly, and mental retardation (CDMMR) syndrome Microcephaly with or without chorioretinopathy, lymphoedema...ondition characterised by variable expression of microcephaly, eye problems including chorioretinopathy, congenital lymphoedema...s divided into two distinct entities: microcephaly, lymphedema, chorioretinal dys

Irrigation water management: Basic principles and applications

OpenAIRE

Ella, Victor B.

2007-01-01

This presentation defines the term, irrigation, as well as explains the common methods of irrigation in attempt to define the fundamental principles needed to wisely design an irrigation system. It outlines a typical drip irrigation set-up, and discusses management of an irrigation system, including water volume application suggestions. LTRA-5 (Agroforestry and Sustainable Vegetable Production)

Microsoft® Visual Basic® 2010 Step by Step

CERN Document Server

Halvorson, Michael

2010-01-01

Your hands-on, step-by-step guide to learning Visual Basic® 2010. Teach yourself the essential tools and techniques for Visual Basic® 2010-one step at a time. No matter what your skill level, you'll find the practical guidance and examples you need to start building professional applications for Windows® and the Web. Discover how to: Work in the Microsoft® Visual Studio® 2010 Integrated Development Environment (IDE)Master essential techniques-from managing data and variables to using inheritance and dialog boxesCreate professional-looking UIs; add visual effects and print supportBuild com

Project management as steppingstone of enterprises

OpenAIRE

Andreeva, T.; Petrovska, T.; Tytar, T.

2011-01-01

Actual problems of project management in enterprises in order to achieve their goals. The basic members of the organization and implementation of project and the methodology for their implementation. The basic principles of project management are included.

The relationship between basic need satisfaction and emotional eating.

Science.gov (United States)

Timmerman, G M; Acton, G J

2001-01-01

Eating in response to emotions may lead to the consumption of excessive calories which typically leads to weight gain. This study examined the relationship between basic need satisfaction as identified by Maslow's hierarchy and emotional eating. According to Modeling and Role-Modeling theory, when lack of basic need satisfaction functions as a stressor, individuals may be more likely to engage in emotional eating as a substitute for fulfilling their needs in order to maintain homeostasis. The Basic Need Satisfaction Inventory (BNSI) had a strong, negative correlation (r = -.49; p need satisfaction, the more likely one engaged in emotional eating. In predicting EES score, 27.7% of the variance was explained by the self-esteem subscale of BNSI. This study supports looking at underlying issues contributing to weight gain in order to develop effective interventions for weight management.

Cash Management.

Science.gov (United States)

Fischer, Mary L.; Ostrom, John S.

1982-01-01

Elements of an effective management program for colleges and universities are examined. Five basic purposes of an effective program of cash management are identified: developing accurate cash projections, managing cash receipts, controlling cash disbursements, establishing sound banking relationships, and investing funds. It is suggested that all…

Basic research on maxillofacial implants

International Nuclear Information System (INIS)

Matsui, Yoshiro

2001-01-01

Osseointegrated implants have begun to be used not only in general practice in dentistry but also in various clinical situations in the maxillofacial region. The process has yielded three problems: the spread of application, new materials and diagnostic methods, and management for difficult situations. This paper presents basic data and clinical guidelines for new applications, it investigates the characteristics of the materials and the usefulness of a new diagnostic method, and it studies effective techniques for difficult cases. The results obtained are as follows: Investigations into the spreading application. The lateral and superior orbital rim have sufficient bone thickness and width for the implant body to be placed. Osseointegrated implants, especially by the fixed bridge technique, are not recommended in the craniofacial bone and jaws of young children. Implant placement into bone after/before irradiation must be performed in consideration of impaired osteogenesis, the decrease of trabecular bone, and the time interval between implantation and irradiation. Investigations into materials and diagnostic methods. Hydroxyapatite-coated and titanium implants should be selected according to the characteristics of the materials. A dental simulating soft may also be applicable in the craniofacial region. Investigations into the management of difficult cases. Hyperbaric oxygen therapy (HBO), bone morphogenetic protein (BMP), and tissue engineering should be useful for improving the quality and increasing the quantity of bone where implants are placed. Soft tissue around implants placed in the reconstructed area should be replaced with mucosal tissue. The data obtained here should be useful for increasing the efficiency of osseointegrated implants, but further basic research is required in the future. (author)

Basic research on maxillofacial implants

Energy Technology Data Exchange (ETDEWEB)

Matsui, Yoshiro [Showa Univ., Tokyo (Japan). School of Dentistry

2001-11-01

Osseointegrated implants have begun to be used not only in general practice in dentistry but also in various clinical situations in the maxillofacial region. The process has yielded three problems: the spread of application, new materials and diagnostic methods, and management for difficult situations. This paper presents basic data and clinical guidelines for new applications, it investigates the characteristics of the materials and the usefulness of a new diagnostic method, and it studies effective techniques for difficult cases. The results obtained are as follows: Investigations into the spreading application. The lateral and superior orbital rim have sufficient bone thickness and width for the implant body to be placed. Osseointegrated implants, especially by the fixed bridge technique, are not recommended in the craniofacial bone and jaws of young children. Implant placement into bone after/before irradiation must be performed in consideration of impaired osteogenesis, the decrease of trabecular bone, and the time interval between implantation and irradiation. Investigations into materials and diagnostic methods. Hydroxyapatite-coated and titanium implants should be selected according to the characteristics of the materials. A dental simulating soft may also be applicable in the craniofacial region. Investigations into the management of difficult cases. Hyperbaric oxygen therapy (HBO), bone morphogenetic protein (BMP), and tissue engineering should be useful for improving the quality and increasing the quantity of bone where implants are placed. Soft tissue around implants placed in the reconstructed area should be replaced with mucosal tissue. The data obtained here should be useful for increasing the efficiency of osseointegrated implants, but further basic research is required in the future. (author)

Study on the philosophy of containment basic design

Energy Technology Data Exchange (ETDEWEB)

NONE

2013-08-15

The Fukushima Dai-ichi NPS of Tokyo Electric Power Co. was attacked by a historical tsunami caused by an earthquake on March 11, 2011. It resulted in an unprecedented serious accident that extended over multiple reactors simultaneously, even though accident management for prevention and mitigation against severe accident had been voluntarily implemented in the NPS. The present study addresses the basic functional aspects of the containment system for the management of energy, radionuclide and combustible gases under severe accident conditions. Particular consideration is given to the severe accident conditions reflecting the lessons learned from the Fukushima Dai-ichi accident. (author)

A basic toxicity classification of radionuclides

International Nuclear Information System (INIS)

1963-01-01

In the course of its work in the field of health and safety the International Atomic Energy Agency has often met the practical requirement for grading radionuclides in order of their relative radiotoxicities. This need was particularly evident when the Agency's Basic Safety Standards for the protection of health against ionizing radiation were in preparation, when it was necessary to exempt quantities of radionuclides from inclusion in the norms. A basic toxicity grading might be of help to laboratories in meeting some of their requirements in problems related to waste management as well as for the design of experimental facilities. It should also serve as a basis for the development of safety criteria for laboratory equipment and procedures for handling and transporting various quantities and kinds of radionuclides. The purpose of the present Report is to make a toxicity grading of the radionuclides according to the risk of biological injury which they may cause when they have become incorporated in the human body. 4 refs, 4 tabs

A basic toxicity classification of radionuclides

Energy Technology Data Exchange (ETDEWEB)

1963-04-01

In the course of its work in the field of health and safety the International Atomic Energy Agency has often met the practical requirement for grading radionuclides in order of their relative radiotoxicities. This need was particularly evident when the Agency's Basic Safety Standards for the protection of health against ionizing radiation were in preparation, when it was necessary to exempt quantities of radionuclides from inclusion in the norms. A basic toxicity grading might be of help to laboratories in meeting some of their requirements in problems related to waste management as well as for the design of experimental facilities. It should also serve as a basis for the development of safety criteria for laboratory equipment and procedures for handling and transporting various quantities and kinds of radionuclides. The purpose of the present Report is to make a toxicity grading of the radionuclides according to the risk of biological injury which they may cause when they have become incorporated in the human body. 4 refs, 4 tabs.

FUNCTION of MANAGEMENT IN SPORT

Directory of Open Access Journals (Sweden)

Srećko Novaković

2011-03-01

Full Text Available In the sport management coordination represents the basic deposit of management, and terms through numerous activities. Brother-in-law activity in sport has the specific management so speak about the management of sport event, management of sports facilities, management of management to the human activities, financial management in sport etc. The sportively management has presumed the specific management related to sports activities whose basic task of coordinations of sports activities. Management of sport organisations have been confided sport managers of special profile which differs towards the type of sport, rank of contest etc. The sport managers could utter survived the statement that in sport have not been educated special diameters manager, besides sport coaches. Specifically, in the role of manager in sport prevails almost all diameters of professional in professional or the volunteer relationship.

Battle Management as a Basic Air Force Doctrine Operational Function

National Research Council Canada - National Science Library

Rhone, Jon M

2008-01-01

According to JP 1-02, Department of Defense Dictionary of Military and Associated Terms, battle management is "The management of activities within the operational environment, based on the commands...

Manage Stress

Science.gov (United States)

... Manage Stress Print This Topic En español Manage Stress Browse Sections The Basics Overview Signs and Health ... and Health Effects What are the signs of stress? When people are under stress, they may feel: ...

Basic approaches to understanding the definition of crisis management

OpenAIRE

Miroshnichenko, Y.; Pidgorna, O.

2014-01-01

This article considers the problem has been in the interpretation of the concept of "crisis management" as the international experience, and in the works of Ukrainian scientists who reviewed this term in his works. Today, in modern literature not reflect differences between bail and normal controls. The authors focus not on measures to resolve the crisis, and the events of his early prevention mechanisms or bankruptcy. To achieve this aim almost all management theory and practice, while the s...

Basic analysis on the load management in consumer section

Energy Technology Data Exchange (ETDEWEB)

Tezuka, Tetsuo; Nishikawa, Eiichi

1988-05-01

The load management of the energy (electric power, gas and oil products) in consumer section means to move demand characteristics in desirable directions. The demand characteristics are represented by the energy consumption characteristics along time and their annual sum. The load management is analyzed here from a more practical point of view. As the total thermal demand has been fixed to some extent from the aspect of a total system, the trade-off occurs among objectives of industries. For the quantitative consistency, the model analysis is effective. Changes in the consumers' attitude have been observed as indicated by the cogeneration, heat storage technology and automatic energy management by consumers. Techniques for changing the demand characteristics include the charging system, financial aids for equipment installation, favorable provisions in taxation, law revision and marketing. Stable supply and improved consumption are the future tasks. (2 figs, 6 tabs, 28 refs)

Measuring and managing progress in the establishment of basic health services: the Afghanistan health sector balanced scorecard.

Science.gov (United States)

Hansen, Peter M; Peters, David H; Niayesh, Haseebullah; Singh, Lakhwinder P; Dwivedi, Vikas; Burnham, Gilbert

2008-01-01

The Ministry of Public Health (MOPH) of Afghanistan has adopted the Balanced Scorecard (BSC) as a tool to measure and manage performance in delivery of a Basic Package of Health Services. Based on results from the 2004 baseline round, the MOPH identified eight of the 29 indicators on the BSC as priority areas for improvement. Like the 2004 round, the 2005 and 2006 BSCs involved a random selection of more than 600 health facilities, 1700 health workers and 5800 patient-provider interactions. The 2005 and 2006 BSCs demonstrated substantial improvements in all eight of the priority areas compared to 2004 baseline levels, with increases in median provincial scores for presence of active village health councils, availability of essential drugs, functional laboratories, provider knowledge, health worker training, use of clinical guidelines, monitoring of tuberculosis treatment, and provision of delivery care. For three of the priority indicators-drug availability, health worker training and provider knowledge-scores remained unchanged or decreased between 2005 and 2006. This highlights the need to ensure that early gains achieved in establishment of health services in Afghanistan are maintained over time. The use of a coherent and balanced monitoring framework to identify priority areas for improvement and measure performance over time reflects an objectives-based approach to management of health services that is proving to be effective in a difficult environment. 2007 John Wiley & Sons, Ltd

Stem Cell Basics

Science.gov (United States)

... Tips Info Center Research Topics Federal Policy Glossary Stem Cell Information General Information Clinical Trials Funding Information Current ... Basics » Stem Cell Basics I. Back to top Stem Cell Basics I. Introduction: What are stem cells, and ...

Management of basic education for ethnic groups in highland and border regions of Thailand

Directory of Open Access Journals (Sweden)

Phathombut Keawsomnuk

2017-05-01

The research findings revealed that the actors for advocacy policy in basic education for ethnic groups consist of: 1 the primary education service area, 2 community, 3 NGOs, 4 scholars, and 5 schools. This study indicated that the provision of basic education policy for ethnic groups must consist of knowledge from communities such as ethnic life styles integrated in the curriculum, and a special education mechanism and process for Thai ethnic groups, including facilitation of ethnic group participation in the abovementioned actors by various means.

Basic research on human reliability in nuclear power plants

International Nuclear Information System (INIS)

Zhang Li; Deng Zhiliang

1996-10-01

Human reliability in nuclear power plants is one of key factors in nuclear safety and economic operation. According to cognitive science, behaviour theory and ergonomic and on the bases of human cognitive behaviour characteristics, performance shaping factors, human error mechanisms and organization management, the project systematically studied the human reliability in nuclear power plant systems, established the basic theory and methods for analyzing human factor accidents and suggested feasible approaches and countermeasures for precaution against human factor accidents and improving human reliability. The achievement has been applied in operation departments, management departments and scientific research institutions of nuclear power, and has produced guiding significance and practical value to design, operation and management in nuclear power plants. (11 refs.)

Basic elements of a risk management program

International Nuclear Information System (INIS)

Ericson, D.M. Jr.; Varnado, G.B.

1991-01-01

The modern industrial manger faces the challenge of safely and efficiently operating increasingly complex, sophisticated, and expensive plants in an atmosphere of reduced resources and increased competition, and frequently with heightened political and public oversight. These political and public concerns have become especially significant where the Federal Government regulates and/or funds programs that have a significant potential for adverse public safety or environmental impacts. Under these circumstances, a major accident or environmental insult could translate into major programmatic delay, redirection, or even plant closing. After-the-fact (reactive) resolution of safety and/or environment problems is both costly and time-consuming process. Therefore, it is prudent for managers at all levels to initiate aggressive proactive efforts to identify and control the risks (hazards) associated with their programs. Unfortunately, risk is not a concept with a single, universally accepted definition. It is most often represented as the product of the probability of occurrence of undesired events and the resultant consequences of those events. The consequences of concern may include: loss of human health, reduction in life expectancy, or loss of life; material or financial losses; environmental damage; or even societal disturbances. This paper discusses risk management and systems safety interest in which has intensified over the post decade principally because of public perceptions of the risks associated with nuclear power and the disposal of hazardous chemical wastes

Race or Resource? BMI, Race, and Other Social Factors as Risk Factors for Interlimb Differences among Overweight Breast Cancer Survivors with Lymphedema

Directory of Open Access Journals (Sweden)

Lorraine T. Dean

2016-01-01

Full Text Available Introduction. High BMI is a risk factor for upper body breast cancer-related lymphedema (BCRL onset. Black cancer survivors are more likely to have high BMI than White cancer survivors. While observational analyses suggest up to 2.2 times increased risk of BCRL onset for Black breast cancer survivors, no studies have explored race or other social factors that may affect BCRL severity, operationalized by interlimb volume difference (ILD. Materials and Methods. ILD was measured by perometry for 296 overweight (25 > BMI 6 months from treatment in the WISER Survivor trial. Multivariable linear regression examined associations between social and physical factors and ILD. Results. Neither Black race (−0.26, p=0.89 nor BMI (0.22, p=0.10 was associated with ILD. Attending college (−4.89, p=0.03 was the strongest factor associated with ILD, followed by having more lymph nodes removed (4.75, p=0.01, >25% BCRL care adherence (4.10, p=0.01, and years since treatment (0.55, p<0.001. Discussion. Neither race nor BMI was associated with ILD among overweight cancer survivors. Education, a proxy for resource level, was the strongest factor associated with greater ILD. Tailoring physical activity and weight loss interventions designed to address BCRL severity by resource rather than race should be considered.

Pressure ulcers: Back to the basics.

Science.gov (United States)

Agrawal, Karoon; Chauhan, Neha

2012-05-01

Pressure ulcer in an otherwise sick patient is a matter of concern for the care givers as well as the medical personnel. A lot has been done to understand the disease process. So much so that USA and European countries have established advisory panels in their respective continents. Since the establishment of these organizations, the understanding of the pressure ulcer has improved significantly. The authors feel that the well documented and well publicized definition of pressure ulcer is somewhat lacking in the correct description of the disease process. Hence, a modified definition has been presented. This disease is here to stay. In the process of managing these ulcers the basic pathology needs to be understood well. Pressure ischemia is the main reason behind the occurrence of ulceration. Different extrinsic and intrinsic factors have been described in detail with review of literature. There are a large number of risk factors causing ulceration. The risk assessment scales have eluded the surgical literature and mostly remained in nursing books and websites. These scales have been reproduced for completion of the basics on decubitus ulcer. The classification of the pressure sores has been given in a comparative form to elucidate that most of the classifications are the same except for minor variations. The management of these ulcers is ever evolving but the age old saying of "prevention is better than cure" suits this condition the most.

Pressure ulcers: Back to the basics

Directory of Open Access Journals (Sweden)

Karoon Agrawal

2012-01-01

Full Text Available Pressure ulcer in an otherwise sick patient is a matter of concern for the care givers as well as the medical personnel. A lot has been done to understand the disease process. So much so that USA and European countries have established advisory panels in their respective continents. Since the establishment of these organizations, the understanding of the pressure ulcer has improved significantly. The authors feel that the well documented and well publicized definition of pressure ulcer is somewhat lacking in the correct description of the disease process. Hence, a modified definition has been presented. This disease is here to stay. In the process of managing these ulcers the basic pathology needs to be understood well. Pressure ischemia is the main reason behind the occurrence of ulceration. Different extrinsic and intrinsic factors have been described in detail with review of literature. There are a large number of risk factors causing ulceration. The risk assessment scales have eluded the surgical literature and mostly remained in nursing books and websites. These scales have been reproduced for completion of the basics on decubitus ulcer. The classification of the pressure sores has been given in a comparative form to elucidate that most of the classifications are the same except for minor variations. The management of these ulcers is ever evolving but the age old saying of "prevention is better than cure" suits this condition the most.

Pressure ulcers: Back to the basics

Science.gov (United States)

Agrawal, Karoon; Chauhan, Neha

2012-01-01

Pressure ulcer in an otherwise sick patient is a matter of concern for the care givers as well as the medical personnel. A lot has been done to understand the disease process. So much so that USA and European countries have established advisory panels in their respective continents. Since the establishment of these organizations, the understanding of the pressure ulcer has improved significantly. The authors feel that the well documented and well publicized definition of pressure ulcer is somewhat lacking in the correct description of the disease process. Hence, a modified definition has been presented. This disease is here to stay. In the process of managing these ulcers the basic pathology needs to be understood well. Pressure ischemia is the main reason behind the occurrence of ulceration. Different extrinsic and intrinsic factors have been described in detail with review of literature. There are a large number of risk factors causing ulceration. The risk assessment scales have eluded the surgical literature and mostly remained in nursing books and websites. These scales have been reproduced for completion of the basics on decubitus ulcer. The classification of the pressure sores has been given in a comparative form to elucidate that most of the classifications are the same except for minor variations. The management of these ulcers is ever evolving but the age old saying of “prevention is better than cure” suits this condition the most. PMID:23162223

Establishing the Basic Concepts of a Healthy Physical Education through an Expert Method

Directory of Open Access Journals (Sweden)

Carlos Javier López Gutiérrez

2011-11-01

Full Text Available This paper investigates the basic knowledge needed by the sports practitioner who wishes to have a healthy physical education. To determine the necessary basic knowledge, we used a methodology of standard expertise, delving further into the subject by means of a semistructured interview. The interview was taped, transcribed and analyzed through the program Nudist NVivo. We have grouped the common responses emerging from the analysis into different categories, thus obtaining a total of 9 basic considerations which should be habitually transmitted to Physical Education students, so that they may achieve adequate self-management in the practice of physical activity.

Basic concepts for crew resource management and non-technical skills.

Science.gov (United States)

Flin, Rhona; Maran, Nikki

2015-03-01

In this paper, we explain the conceptual background to non-technical skills and show how they can influence job performance in anaesthesia. We then describe the taxonomy of anaesthetists' non-technical skills (ANTS) and related systems, such as ANTS-AP for anaesthetic practitioners. We discuss the training courses that have been designed to teach these non-technical skills, which are called crew resource management (CRM), crisis resource management (CRM) or crisis avoidance resource management (CARMA). Finally, we discuss the application of non-technical skills assessment systems. Copyright © 2015 Elsevier Ltd. All rights reserved.

A Content Analysis on Management and Terms related with Management in the Quran

Directory of Open Access Journals (Sweden)

Kürşat ÖZDAŞLI

2014-05-01

Full Text Available Guidelines and principles feeding the system of belief have the power of diverting behaviors of an individual included in that system as well as being able to affect the management style of managers. Therefore, use of the term of management by basic sources of Islamic belief and which other sources it refers to along with the term of management will be helpful in understanding the holistic message given in terms of management in Islamic style, and approaching from a different aspect to the management literature. This study aims to reveal characteristics of management and related terms in basic Islamic sources, and with which words and in what aspects they are associated and used, and to see the perception of the religion of Islam on management. The content analysis conducted in this context included examination of the verses containing the terms of management, administration, leader, directing and steering

Stress Management

Science.gov (United States)

Healthy Lifestyle Stress management By Mayo Clinic Staff Stress basics Stress is a normal psychological and physical reaction to the demands of life. ... some people's alarm systems rarely shut off. Stress management gives you a range of tools to reset ...

Proceedings of the Scientific Meeting and Presentation on Basic Researchin Nuclear Science and Technology part II: Nuclear Chemistry, Process Technology, Radioactive Waste Management and Environment

International Nuclear Information System (INIS)

Sukarsono, R.; Karmanto, Eko-Edy; Suradjijo, Ganang

2000-01-01

Scientific Meeting and Presentation on Basic Research in Nuclear Scienceand Technology is an annual activity held by Centre for Research and Development of Advanced Technology, National Nuclear Energy Agency, for monitoring research activities achieved by the Agency. The papers presented in the meeting were collected into proceedings. These are the second part of the proceedings that contain 71 articles in the fields of nuclear chemistry, process technology, radioactive waste management, and environment (PPIN).

Basic hydraulics

CERN Document Server

Smith, P D

1982-01-01

BASIC Hydraulics aims to help students both to become proficient in the BASIC programming language by actually using the language in an important field of engineering and to use computing as a means of mastering the subject of hydraulics. The book begins with a summary of the technique of computing in BASIC together with comments and listing of the main commands and statements. Subsequent chapters introduce the fundamental concepts and appropriate governing equations. Topics covered include principles of fluid mechanics; flow in pipes, pipe networks and open channels; hydraulic machinery;

Anesthesia Basics

Science.gov (United States)

... Staying Safe Videos for Educators Search English Español Anesthesia Basics KidsHealth / For Teens / Anesthesia Basics What's in ... español Conceptos básicos sobre la anestesia What Is Anesthesia? No doubt about it, getting an operation can ...

Cancer pain management: Basic information for the young pain physicians

Directory of Open Access Journals (Sweden)

SPS Rana

2011-01-01

Full Text Available Cancer pain is multifactorial and complex. The impact of cancer pain is devastating, with increased morbidity and poor quality of life, if not treated adequately. Cancer pain management is a challenging task both due to disease process as well as a consequence of treatment-related side-effects. Optimization of analgesia with oral opioids, adjuvant analgesics, and advanced pain management techniques is the key to success for cancer pain. Early access of oral opioid and interventional pain management techniques can overcome the barriers of cancer pain, with improved quality of life. With timely and proper anticancer therapy, opioids, nerve blocks, and other non-invasive techniques like psychosocial care, satisfactory pain relief can be achieved in most of the patients. Although the WHO Analgesic Ladder is effective for more than 80% cancer pain, addition of appropriate adjuvant drugs along with early intervention is needed for improved Quality of Life. Effective cancer pain treatment requires a holistic approach with timely assessment, measurement of pain, pathophysiology involved in causing particular type of pain, and understanding of drugs to relieve pain with timely inclusion of intervention. Careful evaluation of psychosocial and mental components with good communication is necessary. Barriers to cancer pain management should be overcome with an interdisciplinary approach aiming to provide adequate analgesia with minimal side-effects. Management of cancer pain should comprise not only a physical component but also psychosocial and mental components and social need of the patient. With risk-benefit analysis, interventional techniques should be included in an early stage of pain treatment. This article summarizes the need for early and effective pain management strategies, awareness regarding pain control, and barriers of cancer pain.

Nuclear reactor engineering: Reactor design basics. Fourth edition, Volume One

International Nuclear Information System (INIS)

Glasstone, S.; Sesonske, A.

1994-01-01

This new edition of this classic reference combines broad yet in-depth coverage of nuclear engineering principles with practical descriptions of their application in design and operation of nuclear power plants. Extensively updated, the fourth edition includes new material on reactor safety and risk analysis, regulation, fuel management, waste management, and operational aspects of nuclear power. This volume contains the following: energy from nuclear fission; nuclear reactions and radiations; neutron transport; nuclear design basics; nuclear reactor kinetics and control; radiation protection and shielding; and reactor materials

Basic chemistry for radioactive waste management

International Nuclear Information System (INIS)

Eom, Tae Yoon; Kim, Sung Soo; Kim, Jeong Seok; Park, Soon Dal; Park, Yong Jun; Seo, Moo Yeul; Sohn, Se Chul; Song, Byung Chul; Lee, Chang Heun; Jun, Young Shin

1992-03-01

Chemical analysis on geological materials was performed for radioactive waste management. Seven major elements including Mn, Fe in JG-2, DWC-l, W-2 and BIR standard samples were determined by acid digestion decomposition and fusion method with sodium carbonate, respectively. About 40 trace elements including Na were determined by instrumental neutron activation analysis method. Retention times of lanthanides were measured by ion chromatography using α-hydroxyisobutyric acid and mandelic acid, respectively. This result gave good agreement between the measured value and the calculated by stepwise elution equation. Trace amount of gallium and indium in natural water were analysed by adsorptive stripping voltammetry using Morin as chelating agent. Detection limit of gallium and indium were 1.1 nM nd 2.6 nM in each. Low level of H-3 and C-14 in natural water were measured by liquid scintillation counting technique. Minimum detectable activity(MDA) by this method were shown to be 0.722 Bq/L and 0.111 Bq/L. (Author)

Financial derivatives in power marketing: The basics

International Nuclear Information System (INIS)

Ramesh, V.C.; Ghosh, K.

1996-01-01

With the ongoing changes in the power industry worldwide, electricity is beginning to be traded like other commodities. The use of financial derivative instruments in power markets is on the rise. The purpose of this paper is to explain the role of these derivatives in risk management which is vital for survival in the increasingly competitive industry. Starting with the familiar cash markets, the paper discusses the basics of futures, options, and swap markets as applied to electric energy trading

Institutional economic theory of assets privatization and nationalization: Basic imperatives

Directory of Open Access Journals (Sweden)

Sukharev Oleg S.

2015-01-01

Full Text Available Basic provisions, principles and criteria of institutional theory of privatization - nationalization and assets management in economy are introduced. Structural analysis of property, in the aspect of it s two basic elements, public and private property, is carried out and the model of interaction of public and private sectors is introduced. The main attention is focused on the efficiency estimation criteria of the functioning of property and to expediency substantiation of property privatization and nationalization. The optimum principle of property structure in economic system is suggested. peculiarities of privatization and nationalization in economic systems are analyzed proceeding from substantiation of theoretical criteria of privatization and nationalization in economy.

Basic Energy Conservation and Management--Part 2: HVAC

Science.gov (United States)

Krueger, Glenn

2012-01-01

Reducing school district energy expenditures has become a universal goal, and new technologies have brought greater energy efficiencies to the school environment. In Part 1 of this two-part series, the author discussed the steps required to establish an energy conservation and management program with an emphasis on lighting. In this article, he…

Risk Factors Affecting Breast Cancer-related Lymphedema: Serial Body Weight Change During Neoadjuvant Anthracycline Plus Cyclophosphamide Followed by Taxane.

Science.gov (United States)

Park, Sungmin; Lee, Jeong Eon; Yu, Jonghan; Paik, Hyun-June; Ryu, Jai Min; Kim, Isaac; Bae, Soo Youn; Lee, Se Kyung; Kim, Seok Won; Nam, Seok Jin; Kim, Eun-Kyu; Kang, Eunyoung; Yang, Eun Joo

2018-02-01

The aim of our study was to analyze the risk of lymphedema (LE) according to the clinicopathologic factors and to investigate the serial change in body weight during neoadjuvant anthracycline plus cyclophosphamide followed by taxane and its correlation with the incidence of LE. We performed a retrospective 2-center study of 406 patients who had undergone neoadjuvant chemotherapy (NAC) followed by surgery from 2007 to 2014. The regimen included 4 cycles of anthracycline plus cyclophosphamide, followed by 4 cycles of taxane. We investigated the presence and degree of LE using a telephone questionnaire assessment. Weight changes were calculated at each cycle of NAC, and the baseline and preoperative body weights were used to calculate the rate of change to account for the change in weight before and after NAC. Of the 406 patients, 270 answered the questionnaires, of whom 97 (35.9%) experienced LE. The increase in body weight was significant during the 4 cycles of taxane, but the change in weight was not significant during the 4 cycles of anthracycline plus cyclophosphamide. The change in body weight was most significant just after the fourth cycle of taxane (P weight was not a significant factor for the incidence of LE. Because a BMI ≥ 25 kg/m 2 was an independent factor of LE occurrence on multivariate analysis, patients with a preoperative BMI ≥ 25 kg/m 2 should be closely monitored for LE given their increased risk, and monitoring and education should be initiated before surgery and continued throughout the course of NAC. Copyright © 2017 The Authors. Published by Elsevier Inc. All rights reserved.

Linfedema em mulheres submetidas à cirurgia por câncer de mama

Directory of Open Access Journals (Sweden)

Priscila Lara Vieira Bonisson

2017-01-01

Full Text Available Objective: to estimate the prevalence and to identify possible factors associated with the occurrence of lymphedema in women undergoing treatment for breast cancer. Methods: a prevalence study with 125 women. An interview and a consultation of the medical record were carried out using a questionnaire. Univariate and multivariate analysis were performed through logistic regression. Results: a prevalence rate of 34.4% was found. Obesity, sentinel lymph node biopsy, radiotherapy, and the presence of some treatment complications were statistically significant for the occurrence of lymphedema. Conclusion: the prevalence of lymphedema in this study was high. The variables positively related to lymphedema, considered as associated factors, were: obesity, sentinel lymph node biopsy, radiotherapy and some treatment related complications (adhesion, retraction, paraesthesia, seroma, fibrosis, infection and dehiscence.

Information-seeking behavior of basic science researchers: implications for library services.

Science.gov (United States)

Haines, Laura L; Light, Jeanene; O'Malley, Donna; Delwiche, Frances A

2010-01-01

This study examined the information-seeking behaviors of basic science researchers to inform the development of customized library services. A qualitative study using semi-structured interviews was conducted on a sample of basic science researchers employed at a university medical school. The basic science researchers used a variety of information resources ranging from popular Internet search engines to highly technical databases. They generally relied on basic keyword searching, using the simplest interface of a database or search engine. They were highly collegial, interacting primarily with coworkers in their laboratories and colleagues employed at other institutions. They made little use of traditional library services and instead performed many traditional library functions internally. Although the basic science researchers expressed a positive attitude toward the library, they did not view its resources or services as integral to their work. To maximize their use by researchers, library resources must be accessible via departmental websites. Use of library services may be increased by cultivating relationships with key departmental administrative personnel. Despite their self-sufficiency, subjects expressed a desire for centralized information about ongoing research on campus and shared resources, suggesting a role for the library in creating and managing an institutional repository.

[Basic considerations during outsourcing of clinical data management services].

Science.gov (United States)

Shen, Tong; Liu, Yan

2015-11-01

With worldwide improvements in the regulations of international and domestic clinical trial conductions, the quality of clinical trials and trial data management are receiving a great deal of attention. To ensure the quality of clinical trials, maintain business flexibilities and effectively utilize internal and external resources, the outsourcing model is used in the management of clinical data in operation of pharmaceutical companies. The essential criteria of a successful outsourcing mode in clinical trial are selection of qualified contract research organizations (CRO); establishment of appropriate outsourcing model, and generation of effective quality control systems to ensure the authenticity, integrity and accuracy of the clinical trial data.

BASIC Programming.

Science.gov (United States)

Jennings, Carol Ann

Designed for use by both secondary- and postsecondary-level business teachers, this curriculum guide consists of 10 units of instructional materials dealing with Beginners All-Purpose Symbol Instruction Code (BASIC) programing. Topics of the individual lessons are numbering BASIC programs and using the PRINT, END, and REM statements; system…

Negative Effects of Learning Spreadsheet Management on Learning Database Management

Science.gov (United States)

Vágner, Anikó; Zsakó, László

2015-01-01

A lot of students learn spreadsheet management before database management. Their similarities can cause a lot of negative effects when learning database management. In this article, we consider these similarities and explain what can cause problems. First, we analyse the basic concepts such as table, database, row, cell, reference, etc. Then, we…

Process management practice

International Nuclear Information System (INIS)

Pyeon, In Beom

1983-04-01

This book gives descriptions of qualifying subject and test scope like production plan and control, economic feasibility, process management, quality management and operations research, industrial economics like materials and marketing management, production management such as meaning and goals of process management and production plan and control, basic economic concept, official interest and equivalence, and depreciation, and OR concept such as network analysis and PERT CPM and stimulation.

Apache Maven dependency management

CERN Document Server

Lalou, Jonathan

2013-01-01

An easy-to-follow, tutorial-based guide with chapters progressing from basic to advanced dependency management.If you are working with Java or Java EE projects and you want to take advantage of Maven dependency management, then this book is ideal for you. This book is also particularly useful if you are a developer or an architect. You should be well versed with Maven and its basic functionalities if you wish to get the most out of this book.

Sustainable Flow Management in a Danish Perspective

DEFF Research Database (Denmark)

Elle, Morten

1998-01-01

The paper discusses the basic results of the Sustainable Flow Management project in relation to future planning of energy and resource flows in municipalities......The paper discusses the basic results of the Sustainable Flow Management project in relation to future planning of energy and resource flows in municipalities...

Equine Management and Production. Vocational Agriculture Education.

Science.gov (United States)

Rudolph, James A.

This basic core of instruction for equine management and production is designed to assist instructors in preparing students for successful employment or management of a one- or two-horse operation. Contents include seven instructional areas totaling seventeen units of instruction: (1) Orientation (basic horse production; handling and grooming;…

A Basic Library for Savings and Loan Associations: A Bibliography.

Science.gov (United States)

Westfall, Elizabeth W.; Zimmerman, Anne R.

Recognizing that current and reliable sources of information are necessary for effective management and decision making, librarians of the Federal Home Loan Bank of San Francisco and the Federal Home Loan Bank in Seattle prepared this booklet listing what they feel are the basic books and periodicals essential to a savings and loan library…

Diversity management

OpenAIRE

Knákalová, Lucie

2009-01-01

The key topic of the work is diversity management, i.e. management of em-ployees" diversity within organization. Opening part of the work identifies the position of diversity within society and related phenomena such as stereotypes, biases and various forms of discrimination. Then the work discusses the role of diversity management in organizations, its principles and basic areas of focus. Attention is paid to certain social groups that the diversity management concept should especially deal ...

Assessment of time management attitudes among health managers.

Science.gov (United States)

Sarp, Nilgun; Yarpuzlu, Aysegul Akbay; Mostame, Fariba

2005-01-01

These days, working people are finding it difficult to manage their time, get more done at work, and find some balance in their work and personal lives. Successful time management is often suggested to be a product of organizing skills, however, what works for one person may not work for others. Context current competence assessment formats for physicians, health professionals, and managers during their training years reliably test core knowledge and basic skills. However, they may underemphasize some important domains of professional medical practice. Thus, in addition to assessments of basic skills, new formats that assess clinical reasoning, expert judgment, management of ambiguity, professionalism, time management, learning strategies, and teamwork to promise a multidimensional assessment while maintaining adequate reliability and validity in classic health education and health care institutional settings are needed to be worked on. It should be kept in mind that institutional support, reflection, and mentoring must accompany the development of assessment programs. This study was designed to describe the main factors that consume time, effective hours of work, time management opportunities, and attitudes and behaviors of health professionals and managers on time management concept through assessment by the assessment tool Time Management Inquiry Form (TMIQ-F). The study was conducted at the State Hospital, Social Security Hospital, and University Hospital at Kirikkale, Turkey between October 1999 and January 2000, including 143 subjects defined as medical managers and medical specialists. According to the results, a manager should give priority to the concept of planning, which may be counted among the efficient time management techniques, and educate him/herself on time management.

Proceedings of the Scientific Meeting and Presentation on Basic Research in Nuclear of the Science and Technology part III : Radioactive Waste Management and Environment

International Nuclear Information System (INIS)

Kamsul Abraha; Yateman Arryanto; Sri Jauhari S; Agus Taftazani; Kris Tri Basuki; Djoko Sardjono, Ign.; Sukarsono, R.; Samin; Syarip; Suryadi, MS; Sardjono, Y.; Tri Mardji Atmono; Dwiretnani Sudjoko; Tjipto Sujitno, BA.

2007-08-01

The Scientific Meeting and Presentation on Basic Research in Nuclear Science and Technology is a routine activity held by Centre for Accelerator Technology and Material Process, National Nuclear Energy Agency, for monitoring the research activity which achieved in National Nuclear Energy Agency. The Meeting was held in Yogyakarta on July 10, 2007. The proceedings contains papers presented on the meeting about Radioactive Waste Management and Environment and there are 25 papers which have separated index. The proceedings is the third part of the three parts which published in series. (PPIN)

Lymphatic Filariasis

Science.gov (United States)

... Evaluation and Treatment Care of Patients with Lymphedema, Elephantiasis or Hydrocele Publications Additional Resources Get Email Updates ... with the disease can suffer from lymphedema and elephantiasis and in men, swelling of the scrotum, called ...

Hydromechanics - basic properties

International Nuclear Information System (INIS)

Lee, Sung Tak; Lee, Je Geun

1987-03-01

This book tells of hydromechanics, which is about basic properties of hydromechanics such as conception, definition, mass, power and weight, and perfect fluid and perfect gas, hydrostatics with summary, basic equation of hydrostatics, relative balance of hydrostatics, and kinematics of hydromechanics, description method of floating, hydromechanics about basic knowledge, equation of moment, energy equation and application of Bernoulli equation, application of momentum theory, inviscid flow and fluid measuring.

An integrated course in pain management and palliative care bridging the basic sciences and pharmacy practice.

Science.gov (United States)

Kullgren, Justin; Radhakrishnan, Rajan; Unni, Elizabeth; Hanson, Eric

2013-08-12

To describe the development of an integrated pain and palliative care course and to investigate the long-term effectiveness of the course during doctor of pharmacy (PharmD) students' advanced pharmacy practice experiences (APPEs) and in their practice after graduation. Roseman University College of Pharmacy faculty developed a 3-week elective course in pain and palliative care by integrating relevant clinical and pharmaceutical sciences. Instructional strategies included lectures, team and individual activities, case studies, and student presentations. Students who participated in the course in 2010 and 2011 were surveyed anonymously to gain their perception about the class as well as the utility of the course during their APPEs and in their everyday practice. Traditional and nontraditional assessment of students confirmed that the learning outcomes objectives were achieved. Students taking the integrated course on pain management and palliative care achieved mastery of the learning outcome objectives. Surveys of students and practicing pharmacists who completed the course showed that the learning experience as well as retention was improved with the integrated mode of teaching. Integrating basic and clinical sciences in therapeutic courses is an effective learning strategy.

Business Modeling - Supply Chain Management

OpenAIRE

Abdillah, Leon

2017-01-01

BM-SCM consists of: 1) Introduction, 2) Basic Concepts, 3) Inventory Management, 4) Forecasting Material, 5) Requirements, ) Transportation Management, 7) Vendor Management, 8) Warehouse Management, 9) Cross Docking, 10) Third Party Logistics (3PLs), 11) IT in Supply Chain, and 12) Presentations.

Waste management

International Nuclear Information System (INIS)

Chmielewska, E.

2010-01-01

In this chapter formation of wastes and basic concepts of non-radioactive waste management are explained. This chapter consists of the following parts: People in Peril; Self-regulation of nature as a guide for minimizing and recycling waste; The current waste management situation in the Slovak Republic; Categorization and determination of the type of waste in legislative of Slovakia; Strategic directions waste management in the Slovak Republic.

[Systemic biopsychological perspective of basic emotions].

Science.gov (United States)

Poisson, Benoît

The systemic biopsychological perspective of basic emotions is a heuristic model that allows a better understanding of how people learn to adapt to their environment through different emotions that developed gradually along neurohormonal circuit myelination from birth until about the age of twenty-one. These same emotions, acting in complementarity, will allow the individual to maintain a balance throughout his life.Five basic emotions were retained in line with the five emotions related to neuronal circuits, which are defined in the literature, and these are the five circuits described by Panksepp as follows: aggressiveness (Rage, angry), stress (Fear- surprise), developed by LeDoux, reward (Seeking-joy), developed by Tassin, empathy (Panic-sadness), developed by Decety, and consciousness (consciousness-happiness), developed by Damasio.Several studies on myelination (Kinney, 1988, Parazzini, 2002, Deoni, 2012), Miller, 2012, and Welker, 2012) provide us with a scientific platform to determine the order of development of the neurohormonal circuits underlying basic emotions.Neurohormonal circuits development begins at conception and will continue up until the age of 20-30 years. This article specifically addresses the first three years of life. It offers a systemic biopsychological perspective of basic emotions developed from the latest data in neuroscience. These informations have been integrated into a coherent whole that allows understanding the origin, the development and the functioning of basic emotions.In addition to the information output from the thalamus to the midbrain that set in motion the somatic nervous system there exist, according to Roberge (1998), two other brain information sources that are managed by the hypothalamus (the limbic system). These two information sources allow the refining of the behavioural responses and they favour the homeostasis of the organism. The first information source goes from the midbrain to the hypothalamus to activate

Elephantiasis nostras verrucosa: a review.

Science.gov (United States)

Sisto, Krisanne; Khachemoune, Amor

2008-01-01

Elephantiasis nostras verrucosa (ENV) is a rare and dramatic sequela of chronic nonfilarial lymphedema. The condition is characterized by papules, verrucous lesions, enlargement, and woody fibrosis of the affected area. ENV is a progressive condition, and, without intervention, ongoing deformity and disability will result. Management of ENV is often challenging, but a variety of successful medical and surgical treatment strategies have been reported.

Basic molecular spectroscopy

CERN Document Server

Gorry, PA

1985-01-01

BASIC Molecular Spectroscopy discusses the utilization of the Beginner's All-purpose Symbolic Instruction Code (BASIC) programming language in molecular spectroscopy. The book is comprised of five chapters that provide an introduction to molecular spectroscopy through programs written in BASIC. The coverage of the text includes rotational spectra, vibrational spectra, and Raman and electronic spectra. The book will be of great use to students who are currently taking a course in molecular spectroscopy.

The Effect of Yoga on Arm Volume, Strength, and Range of Motion in Women at Risk for Breast Cancer-Related Lymphedema.

Science.gov (United States)

Mazor, Melissa; Lee, Jeannette Q; Peled, Anne; Zerzan, Sarah; Irwin, Chetan; Chesney, Margaret A; Serrurier, Katherine; Sbitany, Hani; Dhruva, Anand; Sacks, Devorah; Smoot, Betty

2018-02-01

To assess the feasibility, safety, and initial estimates of efficacy of a yoga program in postoperative care for women at high risk for breast cancer-related lymphedema (BCRL). Single-group pretest-post-test design. Patients were recruited from the University of California, San Francisco Carol Franc Buck Breast Care Center. Twenty-one women were enrolled in the study. Women were >18 years of age, had undergone surgical treatment for breast cancer, and were at high risk for BCRL. The women participated in an Ashtanga yoga intervention for 8 weeks. Sessions consisted of once/week instructor-led practice and once/week home practice. Particular attention was given to poses that emphasized upper body strength and flexibility, while avoiding significant time with the upper extremity (UE) in a dependent position. UE volume was assessed through circumferential forearm measurement, which was converted to volume using the formula for a truncated cone. Range of motion (ROM) was assessed for the shoulders, elbows, and wrists, using a standard goniometer. UE strength was assessed for shoulder abduction, elbow flexion, wrist flexion, and grip using a dynamometer. Twenty women completed the yoga intervention, with 17 returning for final assessment. Mean age was 52 (±9.1) years and body mass index was 24.8 (±5.1) kg/m 2 . Postintervention, mean volume in the at-risk UE was slightly reduced (p = 0.397). ROM for shoulder flexion (p yoga is feasible and safe for women who are at risk for BCRL and may result in small improvements in shoulder ROM and UE strength.

Implementation of Knowledge Management as Process to Management System of ÚJD SR

International Nuclear Information System (INIS)

Szabó, V.

2016-01-01

Full text: This presentation provides basic information about the development of staff’s knowledge management of Nuclear Regulatory Authority of Slovak Republic. It is a case study about implementation of knowledge management as process to the integrated management system for Slovak regulatory body. (author

Overview of Management Theory

Science.gov (United States)

1991-02-01

theory orients command leadership for the enormous task of managing organizations in our environment fraught with volatility, uncertainty...performance and organizational ethics. A THEORY OF MANAGEMENT BACKGROUND BASIC MANAGEMENT BEHAVIORAL Definitions FUNCTIONS ASPECTS History Planning Leadership ...the best way to manage in their theory of managerial leadership . To them, the 9,9 position on their model, "is acknowledged by managers as the

Competitiveness in organizational integrated computer system project management

Directory of Open Access Journals (Sweden)

Zenovic GHERASIM

2010-06-01

Full Text Available The organizational integrated computer system project management aims at achieving competitiveness by unitary, connected and personalised treatment of the requirements for this type of projects, along with the adequate application of all the basic management, administration and project planning principles, as well as of the basic concepts of the organisational information management development. The paper presents some aspects of organizational computer systems project management competitiveness with the specific reference to some Romanian companies’ projects.

Risk management at university

OpenAIRE

Ivanova, H.; Abramovich, S.

2013-01-01

This article observes the basic recommendations for the risk management system in higher education as an example Yanka Kupala State University of Grodno. Consider the risk-management standard that based in a process approach

Basic life support and children with profound and multiple learning disabilities.

Science.gov (United States)

Cash, Stefan; Shinnick-Page, Andrea

2008-10-01

Nurses and other carers of people with learning disabilities must be able to manage choking events and perform basic life support effectively. UK guidelines for assessment of airway obstruction and for resuscitation do not take account of the specific needs of people with profound multiple learning disability. For example, they fail to account for inhibited gag and coughing reflexes, limited body movements or chest deformity. There are no national guidelines to assist in clinical decisions and training for nurses and carers. Basic life support training for students of learning disability nursing at Birmingham City University is supplemented to address these issues. The authors ask whether such training should be provided for all nurses including those caring for children and young people. They also invite comment and discussion on questions related to chest compression and training in basic life support for a person in a seated position.

System description of the Basic MRS System for the FY 1990 Systems Integration Program studies

International Nuclear Information System (INIS)

McKee, R.W.; Young, J.R.; Konzek, G.J.

1991-07-01

This document provides both functional and physical descriptions of a conceptual high-level waste management system defined as a Basic MRS System. Its purpose is to provide a basis for required system computer modeling and system studies initiated in FY 1990 under the Systems Integration Program of the Office of Civilian Radioactive Waste Management Office (OCRWM). Two specific systems studies initiated in FY 1990, the Reference System Performance Evaluation and the Aggregate Receipt Rate Study, utilize the information in this document. The Basic MRS System is the current OCRWM reference high-level radioactive wastes repository system concept. It is designed to accept 3000 MTU per year of spent fuel and 400 equivalent MTU per year of high-level wastes. The Basic MRS System includes a storage-only MRS that provides for a limited amount of commercial spent fuel storage capacity prior to acceptance by the geologic repository for disposal. This document contains both functional descriptions of the processes in the waste management system and physical descriptions of the equipment and facilities necessary for performance of those processes. The basic MRS system contains all system components, from the waste storage facilities of the waste generators to the underground facilities for final disposal of the wastes. The major facilities in the system are the waste generator waste storage facilities, an MRS facility that provides interim storage wastes accepted from the waste generators, a repository facility that packages the wastes and then emplaces them in the geologic repository, and the transportation equipment and facilities for transporting the waste between these major facilities

Basic rocks in Finland

International Nuclear Information System (INIS)

Piirainen, T.; Gehoer, S.; Iljina, M.; Kaerki, A.; Paakkola, J.; Vuollo, J.

1992-10-01

Basic igneous rocks, containing less than 52% SiO 2 , constitute an important part of the Finnish Archaean and Proterozoic crust. In the Archaean crust exist two units which contain the majority of the basic rocks. The Arcaean basic rocks are metavolcanics and situated in the Greenstone Belts of Eastern Finland. They are divided into two units. The greenstones of the lower one are tholeiites, komatiites and basaltic komatiites. The upper consists of bimodal series of volcanics and the basic rocks of which are Fe-tholeiites, basaltic komatiites and komatiites. Proterozoic basic rocks are divided into seven groups according to their ages. The Proterozoic igneous activity started by the volominous basic magmatism 2.44 Ga ago. During this stage formed the layered intrusions and related dykes in the Northern Finland. 2.2 Ga old basic rocks are situated at the margins of Karelian formations. 2.1 Ga aged Fe-tholeiitic magmatic activity is widespread in Eastern and Northern Finland. The basic rocks of 1.97 Ga age group are met within the Karelian Schist Belts as obducted ophiolite complexes but they occur also as tholeiitic diabase dykes cutting the Karelian schists and Archean basement. The intrusions and the volcanics of the 1.9 Ga old basic igneous activity are mostly encountered around the Granitoid Complex of Central Finland. Subjotnian, 1.6 Ga aged tholeiitic diabases are situated around the Rapakivi massifs of Southern Finland, and postjotnian, 1.2 Ga diabases in Western Finland where they form dykes cutting Svecofennian rocks

Some Basic Principles of Fish processing in Nigeria

OpenAIRE

J.F.N. Abowei; C.C. Tawari

2011-01-01

Some basic principles offish processing in Nigeria is reviewed to provide information for fish culturist to effectively manage the processing of their products. Processing of fish into forms for human consumption or suitable to be used as a supplement in animal food has been neglected in fish culture practices. This may be due to the high technology required in some of the processes and the fact that those involved in actual fish production are ignorant of the different processing methods. In...

Management and leadership: analysis of nurse manager's knowledge.

Science.gov (United States)

Lourenço, Maria Regina; Shinyashiki, Gilberto Tadeu; Trevizan, Maria Auxiliadora

2005-01-01

Nurses have assumed management positions in many health institutions. To properly accomplish the demands of this role, it is important that they be competent in both management and leadership. For appropriate performance, knowledge of management and supervision styles is a priority. Therefore, the goal of this investigation is to identify the nurse manager's knowledge regarding management and leadership. A structured questionnaire containing twenty-seven questions was applied to twelve Brazilian nurse managers of primary care center called "Family Basic Health Units". Data analysis suggested that the nurse manager lower knowledge in management and leadership is related to visionary leadership, management and leadership conceptual differences, leader's behavior, and situational leadership. And, nurse manager greater knowledge is related to power; team work, and coherence between values and attitudes.

Strategies for Financing Universal Basic Education for Sustainable National Development in Nigeria

Science.gov (United States)

Abdullahi, N. J. K.; Abdulkareem, A. Y.

2017-01-01

This study investigated strategies of financing universal basic education for sustainable national development by school managers in North-Central Zone, Nigeria. Specifically the purpose was to determine the relationship between commercial based income and sustainable national development as well as to examine the relationship between agricultural…

Principles of project management

Science.gov (United States)

1982-01-01

The basic principles of project management as practiced by NASA management personnel are presented. These principles are given as ground rules and guidelines to be used in the performance of research, development, construction or operational assignments.

Basics and application of PSpice

International Nuclear Information System (INIS)

Choi, Pyeong; Cho, Yong Beom; Mok, Hyeong Su; Baek, Dong CHeol

2006-03-01

This book is comprised of nineteenth chapters, which introduces basics and application of PSpice. The contents of this book are PSpice?, PSpice introduction, PSpice simulation, DC analysis, parametric analysis, Transient analysis, parametric analysis and measurements, Monte Carlo analysis, changing of device characteristic, ABM application. The elementary laws of circuit, R.L.C. basic circuit, Diode basic cc circuit, Transistor and EET basic circuit, OP-Amp basic circuit, Digital basic circuit, Analog, digital circuit practice, digital circuit application and practice and ABM circuit application and practice.

Disease: H01017 [KEGG MEDICUS

Lifescience Database Archive (English)

Full Text Available H01017 Choanal atresia and lymphedema Choanal atresia and lymphoedema is a rare co...orderon ML, Weiss MH ... TITLE ... Choanal atresia and lymphedema. ... JOURNAL ... Ann Otol Rhinol Laryngol 100:661-4 (1991) DOI:10.1177/000348949110000812 ...

Lymphatic Vascular Regeneration : The Next Step in Tissue Engineering

NARCIS (Netherlands)

Huethorst, Eline; Krebber, Merle M; Fledderus, Joost O; Gremmels, Hendrik; Xu, Yan Juan; Pei, Jiayi; Verhaar, Marianne C; Cheng, Caroline

2016-01-01

The lymphatic system plays a crucial role in interstitial fluid drainage, lipid absorption, and immunological defense. Lymphatic dysfunction results in lymphedema, fluid accumulation, and swelling of soft tissues, as well as a potentially impaired immune response. Lymphedema significantly reduces

Systematic Review of Occupational Therapy and Adult Cancer Rehabilitation: Part 1. Impact of Physical Activity and Symptom Management Interventions.

Science.gov (United States)

Hunter, Elizabeth G; Gibson, Robert W; Arbesman, Marian; D'Amico, Mariana

This article is the first part of a systematic review of evidence for the effectiveness of cancer rehabilitation interventions within the scope of occupational therapy that address the activity and participation needs of adult cancer survivors. This article focuses on the importance of physical activity and symptom management. Strong evidence supports the use of exercise for cancer-related fatigue and indicates that lymphedema is not exacerbated by exercise. Moderate evidence supports the use of yoga to relieve anxiety and depression and indicates that exercise as a whole may contribute to a return to precancer levels of sexual activity. The results of this review support inclusion of occupational therapy in cancer rehabilitation and reveal a significant need for more research to explore ways occupational therapy can positively influence the outcomes of cancer survivors. Part 2 of the review also appears in this issue. Copyright © 2017 by the American Occupational Therapy Association, Inc.

ADULT BASIC LIFE SUPPORT ON NEAR DROWNING AT THE SCENE

Directory of Open Access Journals (Sweden)

Gd. Harry Kurnia Prawedana

2013-04-01

Full Text Available Indonesia is a popular tourist destination which has potential for drowning cases. Therefore, required knowledge of adult basic life support to be able to deal with such cases in the field. Basic life support in an act to maintain airway and assist breathing and circulation without the use of tools other than simple breathing aids. The most important factor that determines the outcome of drowning event is the duration and severity of hypoxia induced. The management of near drowning at the scene include the rescue of victim from the water, rescue breathing, chest compression, cleaning the vomit substances which allowing blockage of the airway, prevent loss of body heat, and transport the victim to nearest emergency department for evaluation and monitoring.

A New Method for Treatment of Lymphedema of Limbs: Standardized Manual Massage with a New Device Linforoll in Conservative and Surgical Therapy Protocols.

Science.gov (United States)

Olszewski, Waldemar L; Zaleska, Marzanna; Michelin, Sandro

2016-12-01

Edema fluid in lymphedematous limbs should be evacuated to sites where it can be absorbed. It should be moved either to the hypogastrium or arm/scapular regions along tissue channels or implanted silicon channels or through lymphovenous anastomoses. For that purpose, the manual lymphatic drainage of limb is an effective method. Standardization of manual massage applied force and timing becomes necessary. A device with known pressing area and continuously showing the applied force while moving it toward the root of the limb is needed. Moreover, force could be adjusted to the stiffness of the massaged tissues that varies at different levels of the limb. Results from such a device would be repeatable and reproducible by others. In this study we present data on tissue fluid hydromechanics obtained from 20 patients with obstructive limb lymphedema during massage with a massaging roller called Linforoll. Linforoll is composed of a hand piece with roller and pressure sensor connected wireless to the computer displaying the pressure curve of the applied force. Electron microscopy studies for checking eventual tissue changes were done. Linforoll provides the possibilities of: 1) regulating the applied force according to the hydromechanic conditions of the massaged tissues; 2) standardization of massage repeatable in the same patient; 3) decrease of limb volume; 4) evident increase in tissue elasticity; 5) application as a driving force for fluid flow along the surgically implanted tubing and vessels running to the lymphovenous shunts.

Geoengineering: Basic science and ongoing research efforts in China

Directory of Open Access Journals (Sweden)

Long Cao

2015-09-01

Full Text Available Geoengineering (also called climate engineering, which refers to large-scale intervention in the Earth's climate system to counteract greenhouse gas-induced warming, has been one of the most rapidly growing areas of climate research as a potential option for tackling global warming. Here, we provide an overview of the scientific background and research progress of proposed geoengineering schemes. Geoengineering can be broadly divided into two categories: solar geoengineering (also called solar radiation management, or SRM, which aims to reflect more sunlight to space, and carbon dioxide removal (CDR, which aims to reduce the CO2 content in the atmosphere. First, we review different proposed geoengineering methods involved in the solar radiation management and carbon dioxide removal schemes. Then, we discuss the fundamental science underlying the climate response to the carbon dioxide removal and solar radiation management schemes. We focus on two basic issues: 1 climate response to the reduction in solar irradiance and 2 climate response to the reduction in atmospheric CO2. Next, we introduce an ongoing geoengineering research project in China that is supported by National Key Basic Research Program. This research project, being the first coordinated geoengineering research program in China, will systematically investigate the physical mechanisms, climate impacts, and risk and governance of a few targeted geoengineering schemes. It is expected that this research program will help us gain a deep understanding of the physical science underlying geoengineering schemes and the impacts of geoengineering on global climate, in particular, on the Asia monsoon region.

Production management (2000)

International Nuclear Information System (INIS)

Jung, Chung Yeong

2000-08-01

This book includes basic concept of production management, production system, strategy and mission of production, decision of production management, operation of decision making, life cycle of items and development, value of productions, design for reliability of productions, equipment layout and manufacturing process, quantitative forecast, schedule plan, inventory system, concept, input and output of MRP, Montekalo simulation, quality management, and automation system.

Risk factors and a prediction model for lower limb lymphedema following lymphadenectomy in gynecologic cancer: a hospital-based retrospective cohort study.

Science.gov (United States)

Kuroda, Kenji; Yamamoto, Yasuhiro; Yanagisawa, Manami; Kawata, Akira; Akiba, Naoya; Suzuki, Kensuke; Naritaka, Kazutoshi

2017-07-25

Lower limb lymphedema (LLL) is a chronic and incapacitating condition afflicting patients who undergo lymphadenectomy for gynecologic cancer. This study aimed to identify risk factors for LLL and to develop a prediction model for its occurrence. Pelvic lymphadenectomy (PLA) with or without para-aortic lymphadenectomy (PALA) was performed on 366 patients with gynecologic malignancies at Yaizu City Hospital between April 2002 and July 2014; we retrospectively analyzed 264 eligible patients. The intervals between surgery and diagnosis of LLL were calculated; the prevalence and risk factors were evaluated using the Kaplan-Meier and Cox proportional hazards methods. We developed a prediction model with which patients were scored and classified as low-risk or high-risk. The cumulative incidence of LLL was 23.1% at 1 year, 32.8% at 3 years, and 47.7% at 10 years post-surgery. LLL developed after a median 13.5 months. Using regression analysis, body mass index (BMI) ≥25 kg/m 2 (hazard ratio [HR], 1.616; 95% confidence interval [CI], 1.030-2.535), PLA + PALA (HR, 2.323; 95% CI, 1.126-4.794), postoperative radiation therapy (HR, 2.469; 95% CI, 1.148-5.310), and lymphocyst formation (HR, 1.718; 95% CI, 1.120-2.635) were found to be independently associated with LLL; age, type of cancer, number of lymph nodes, retroperitoneal suture, chemotherapy, lymph node metastasis, herbal medicine, self-management education, or infection were not associated with LLL. The predictive score was based on the 4 associated variables; patients were classified as high-risk (scores 3-6) and low-risk (scores 0-2). LLL incidence was significantly greater in the high-risk group than in the low-risk group (HR, 2.19; 95% CI, 1.440-3.324). The cumulative incidence at 5 years was 52.1% [95% CI, 42.9-62.1%] for the high-risk group and 28.9% [95% CI, 21.1-38.7%] for the low-risk group. The area under the receiver operator characteristics curve for the prediction model was 0.631 at 1 year, 0

Basic stress analysis

CERN Document Server

Iremonger, M J

1982-01-01

BASIC Stress Analysis aims to help students to become proficient at BASIC programming by actually using it in an important engineering subject. It also enables the student to use computing as a means of learning stress analysis because writing a program is analogous to teaching-it is necessary to understand the subject matter. The book begins by introducing the BASIC approach and the concept of stress analysis at first- and second-year undergraduate level. Subsequent chapters contain a summary of relevant theory, worked examples containing computer programs, and a set of problems. Topics c

Health Insurance Basics

Science.gov (United States)

... Staying Safe Videos for Educators Search English Español Health Insurance Basics KidsHealth / For Teens / Health Insurance Basics What's ... thought advanced calculus was confusing. What Exactly Is Health Insurance? Health insurance is a plan that people buy ...

Nitrate Leaching Management

Science.gov (United States)

Nitrate (NO3) leaching is a significant nitrogen (N) loss process for agriculture that must be managed to minimize NO3 enrichment of groundwater and surface waters. Managing NO3 leaching should involve the application of basic principles of understanding the site’s hydrologic cycle, avoiding excess ...

THE FOUNDATION OF ENGLISH BASIC TERM ECONOMICS AND ITS DEVELOPMENT

Directory of Open Access Journals (Sweden)

Khudinsha, E.A.

2016-06-01

Full Text Available The article shows the peculiarities of the English basic economical term origin “economics”, the dynamics of this term development. The lexical unit “economics” was based by the borrowing from Greek and Latin languages and began to be used actively in the meaning of the management of the household and modified to the term “economics” (the main modern economical science component.

Management options for vulvar carcinoma in a low resource setting.

Science.gov (United States)

Eke, Ahizechukwu C; Alabi-Isama, Lilian I; Akabuike, Josephat C

2010-11-01

Vulvar carcinoma is a rare tumor of the female genital tract. In Nigeria, very few studies have looked at the management options for vulvar carcinoma. The objective of this study was therefore, to describe the management options available and the challenges in treating this malignancy in Nigeria. A descriptive study of all vulvar cancer cases managed at the Nnamdi Azikiwe University Teaching Hospital, Nnewi over a 12 year period (1998-2009). The theatre, ward register, histo-pathologic records and case notes of all women who had surgery for vulvar carcinomas were retrieved and socio-demographic characteristics, clinical presentation, type of surgery, histologic type and complications of treatment were retrieved and analyzed. There were 867 gynecological malignancies and vulval carcinoma accounted for 11 cases, giving a prevalence of 1.27%. The ages ranged from 54 to 79 years with a mean of 61.2 years. Parity was 2-14, with a mean of 6.7 ± 2.33. Most of the patients were of low socio-economic class. All the 11 patients had surgery as 1st line treatment. Radical vulvectomy was done for 6 cases since they presented in the advanced stage. The complications of surgery included hemorrhage (18.2%), chronic lymphedema, wound infection and anesthetic complications. There were no hospital mortalities. Late presentation, with stage III (45.4%) was the commonest stage at presentation while the majority of the vulvar carcinomas (72.7%) were of epithelial origin. Squamous cell carcinoma predominated (63.6%). Carcinoma of the vulva is a rare gynecological malignancy in Nigeria. Surgery and radiotherapy remains the mainstay of this disease in Nigeria and can be highly successful if patients present early.

Turn Management or Impression Management?

NARCIS (Netherlands)

ter Maat, Mark; Heylen, Dirk K.J.; Ruttkay, Z.M.; Kipp, M.; Nijholt, Antinus; Vilhjálmsson, H.H.

2009-01-01

We look at how some basic choices in the management of turns influence the impression that people get from an agent. We look at scales concerning personality, emotion and interpersonal stance. We do this by a person perception study, or rather an agent perception study, using simulated conversations

Internet quality management

International Nuclear Information System (INIS)

Park, Yeong Taek; Song, Hae Geun

2000-09-01

This book guides the useful application of internet quality management. It mentions understanding of modern quality management, which includes basics of quality management, six sigma quality innovation, best system, search way of quality information, consideration for effective information search, establishment of quality information center using bookmark, sites related quality by fields, journal sites related quality, sites related quality award,and web sites of the highest business.

Change management

OpenAIRE

Kebrlová, Linda

2010-01-01

This diploma thesis is focused on Change Management, for which I used translation "správa změn" in my thesis. The diploma thesis includes a proposal for solution of Change Management, which is based from elements of RUP (Rational Unified Process), and methodology and CMMI (Capability Maturity Model Integration). In the first chapter, entitled Software requirements, there are at first defined basic concepts related to Change Management. The chapter includes the definition of software requireme...

Basic safety principles of INSAG and their application in radioactive waste management

International Nuclear Information System (INIS)

Baer, A.J.

2000-01-01

The International Nuclear Safety Advisory Group (INSAG) has, in INSAG-11, attempted to show what safety principles are common to all applications of all sources of radiation. It has been considered that these general principles should apply to all industrial activities. A comparison of INSAG-11 with Article 11 of the Joint Convention on the Safety of Spent Fuel Management and on the Safety of Radioactive Waste Management (Joint Convention) shows that the management of radioactive waste is but a special case of industrial activity and follows the same safety rules. The importance of the Joint Convention comes, however, from the fact that it is a politically important document, requiring ratification by the parliaments of the contracting parties. The safe management of radioactive waste implies that five types of issue must be taken into consideration, not only technical and ethical ones, but also socio-political, economic and ecological ones. By comparison, sustainable development in its three dimensions (temporal, spatial and sectorial) has five components (ecology, economics, ethics, socio-politics and technology), just like the safe management of radioactive waste. The consequence of this is that if management is treated as a particular case of sustainable development, it will not be accepted by society. The conclusions are that technology alone can not ensure the safety of radioactive waste management and that society will always give priority to socio-political issues over technological ones. Furthermore, it is crucial that people involved in the management of radioactive waste learn to communicate better and to listen more attentively. Their efforts will only succeed when they incorporate all the components that determine the fabric of our society. (author)

New trends in the management of postpartum haemorrhage | Dyer ...

African Journals Online (AJOL)

New trends in the management of postpartum haemorrhage. ... Africa is poor access to basic obstetric care, blood products and basic commodities, such as electricity, for the refrigeration of blood and drugs such as oxytocin.1 Nevertheless, there are many areas where management, and hence outcomes, could be improved.

Embarrassment as a key to understanding cultural differences. Basic principles of cultural analysis

DEFF Research Database (Denmark)

Bouchet, Dominique

1995-01-01

I introduce here the principles I use in my investigation of intercultural marketing and management. I explain how I discovered them, and show how they spring from a theoretical understanding of the dynamic of cultural differences. One of the basic methodological principles for my analysis...

Communicative Management in Ambulatory Services: Prehospital Management Communication--Limits and Possibilities.

Science.gov (United States)

Nordby, Halvor

2015-01-01

Poor management communication in healthcare services affects employees' motivation, commitment, and, in the final instance, organizational performance and the quality of patient care. In any area of health management, good communication is, therefore, key to successful management. This article discusses how managers of ambulance stations should secure communication with their paramedic crews. The first part uses ethical concepts to analyze communicative disagreement in interactive dialogue between managers and paramedics. The second part outlines basic communication principles that can serve as conceptual tools for avoiding misinterpretation in prehospital manager-employee interaction.

Information Manager (The)

African Journals Online (AJOL)

The Information Manager is an Interdisciplinary Journal which provides a forum for the ... It serves as a forum for new research in information dissemination and communication processes in general, The basic focus of Information manager are: i. to ... Influence of Mac Arthur Journal Donation Project on Serial Resources of ...

Basic Cake Decorating Workbook.

Science.gov (United States)

Bogdany, Mel

Included in this student workbook for basic cake decorating are the following: (1) Drawings of steps in a basic way to ice a layer cake, how to make a paper cone, various sizes of flower nails, various sizes and types of tin pastry tubes, and special rose tubes; (2) recipes for basic decorating icings (buttercream, rose paste, and royal icing);…

From basic needs to basic rights.

Science.gov (United States)

Facio, A

1995-06-01

After arriving at an understanding that basic rights refer to all human needs, it is clear that a recognition of the basic needs of female humans must precede the realization of their rights. The old Women in Development (WID) framework only understood women's needs from an androcentric perspective which was limited to practical interests. Instead, women's primary need is to be free from their subordination to men. Such an understanding places all of women's immediate needs in a new light. A human rights approach to development would see women not as beneficiaries but as people entitled to enjoy the benefits of development. Discussion of what equality before the law should mean to women began at the Third World Conference on Women in Nairobi where the issue of violence against women was first linked to development. While debate continues about the distinction between civil and political rights and economic, social, and cultural rights, the realities of women's lives do not permit such a distinction. The concept of the universality of human rights did not become codified until the UN proclaimed the Universal Declaration of Human Rights in 1948. The declaration has been criticized by feminists because the view of human rights it embodies has been too strongly influenced by a liberal Western philosophy which stresses individual rights and because it is ambiguous on the distinction between human rights and the rights of a citizen. The protection of rights afforded by the Declaration, however, should not be viewed as a final achievement but as an ongoing struggle. International conferences have led to an analysis of the human-rights approach to sustainable development which concludes that women continue to face the routine denial of their rights. Each human right must be redefined from the perspective of women's needs, which must also be redefined. Women must forego challenging the concept of the universality of human rights in order to overcome the argument of cultural

Integrated Urban Water Quality Management

DEFF Research Database (Denmark)

Rauch, W.; Harremoës, Poul

1995-01-01

The basic features of integrated urban water quality management by means of deterministic modeling are outlined. Procedures for the assessment of the detrimental effects in the recipient are presented as well as the basic concepts of an integrated model. The analysis of a synthetic urban drainage...... system provides useful information for water quality management. It is possible to identify the system parameters that contain engineering significance. Continuous simulation of the system performance indicates that the combined nitrogen loading is dominated by the wastewater treatment plant during dry...

Education: The Basics. The Basics

Science.gov (United States)

Wood, Kay

2011-01-01

Everyone knows that education is important, we are confronted daily by discussion of it in the media and by politicians, but how much do we really know about education? "Education: The Basics" is a lively and engaging introduction to education as an academic subject, taking into account both theory and practice. Covering the schooling system, the…

Body Basics Library

Science.gov (United States)

... Body Basics articles explain just how each body system, part, and process works. Use this medical library to find out about basic human anatomy, how ... Teeth Skin, Hair, and Nails Spleen and Lymphatic System ... Visit the Nemours Web site. Note: All information on TeensHealth® is for ...

Thermal management for LED applications

CERN Document Server

Poppe, András

2014-01-01

Thermal Management for LED Applications provides state-of-the-art information on recent developments in thermal management as it relates to LEDs and LED-based systems and their applications. Coverage begins with an overview of the basics of thermal management including thermal design for LEDs, thermal characterization and testing of LEDs, and issues related to failure mechanisms and reliability and performance in harsh environments. Advances and recent developments in thermal management round out the book with discussions on advances in TIMs (thermal interface materials) for LED applications, advances in forced convection cooling of LEDs, and advances in heat sinks for LED assemblies. This book also: Presents a comprehensive overview of the basics of thermal management as it relates to LEDs and LED-based systems Discusses both design and thermal management considerations when manufacturing LEDs and LED-based systems Covers reliability and performance of LEDs in harsh environments Has a hands-on applications a...

BODIES OF KNOWLEDGE IN PROJECT MANAGEMENT AND PROJECT QUALITY MANAGEMENT

Directory of Open Access Journals (Sweden)

Tamara Gvozdenovic

2008-03-01

Full Text Available One of the main trends is standardization of project management. Some of the most important bodies of knowledge in project management, which were created by professional associations for project management are given in this paper. The main of the project management, apart from minimization of time, resources and costs, is to finish the project in the required quality, i.e. it is very important during the whole process of project management to provide realizing the project without any deviations from the previously set quality standards. Basic processes of project quality management are: quality planning, quality assurance and quality control.

Endotracheal tube placement by EMT-Basics in a rural EMS system.

Science.gov (United States)

Pratt, Jeffrey C; Hirshberg, Alan J

2005-01-01

To evaluate the effectiveness of an intubation-training module and special-waiver project in which Emergency Medical Technician (EMT)-Basics were trained to perform endotracheal intubations in a rural community. This was a prospective observational study over a four-year period (July 1998 through May 2002) of all intubation attempts by EMT-Basics in the field. The authors observed intubation data, training methods, and quality-assurance methods of a special-waiver project agreed to by the State Department of Public Health to train and allow EMT-Basics to intubate patients. Data were from documentation unique to the project. Project documentation evaluated the placement and complication(s) of endotracheal tube (ETT) placement after arrival to the emergency department. An intubation attempt was defined as direct laryngoscopy. A successful attempt was defined as an appropriately sized ETT placed and secured in the trachea below the vocal cords and above the carina. Confirmation of placement in the field included accepted clinical methods and the use of qualitative colorimetric end-tidal carbon dioxide detectors. The EMT-Basics were trained using a paramedic curriculum, including operating room intubations on live adult patients. All patients were in either cardiopulmonary or respiratory arrest. Thirty-two intubations were performed by EMT-Basics. Thirty attempts were successful and two were unsuccessful (94%; 95% confidence interval [CI] 80-98%). Unsuccessful ETT placements were managed with accepted basic life support airway standards. There were no unrecognized esophageal ETT placements (0%; 95% CI 0-11%). This study demonstrated that with an intensive training program using selected highly motivated providers and close monitoring, a program of EMT-Basic ETT placement in a rural setting can achieve acceptable success rates in patients in cardiac or respiratory arrest.

Basic electronics

CERN Document Server

Holbrook, Harold D

1971-01-01

Basic Electronics is an elementary text designed for basic instruction in electricity and electronics. It gives emphasis on electronic emission and the vacuum tube and shows transistor circuits in parallel with electron tube circuits. This book also demonstrates how the transistor merely replaces the tube, with proper change of circuit constants as required. Many problems are presented at the end of each chapter. This book is comprised of 17 chapters and opens with an overview of electron theory, followed by a discussion on resistance, inductance, and capacitance, along with their effects on t

Basic education in communist Hungary. A commons approach

Directory of Open Access Journals (Sweden)

Ferenc Gyuris

2014-08-01

Full Text Available In commons research, the study of the ‘knowledge commons’ has emerged as a new field of interest over the last few years. Our paper begins by providing a brief overview of the state of research in the field, and proceeds by discussing some crucial but relatively underconceptualised issues. The difference between information and knowledge, and the ambiguities surrounding the claim that all sorts of knowledge can be considered part of the commons, are the focal point here. We also pay close attention to education, arguing that it is not a common good, but rather a common-pool resource institution that ensures that some forms of knowledge can be governed as a commons. With regard to these issues, the article provides a case study, one in which we analyse basic education in Communist Hungary, and look for evidence of the commons design principles as outlined in Elinor Ostrom’s IAD Framework. Given the complex nature of basic education, we investigate it from three points of view: as a service, as a set of physical structures (e.g. school buildings, and as a complex of organizational structures (e.g. legal and financial arrangements. On the basis of empirical findings we argue that basic education in the Stalinist epoch did not correspond to Ostromian design principles. Basic education, therefore, was not managed in an equitable way, and its geographical accessibility was uneven. During the ‘technocratic’ Communism of the 1960s, 1970s, and 1980s, the education system underwent important changes. However, though the circle of those who had some impact on the governance of education expanded, most individuals involved with the education system were still excluded. As a result, the commons approach did not become stronger in general, nor did spatial unevenness with respect to access to basic education decrease. The paper finishes with a brief conclusion of our findings and a discussion of some questions for future research.

Knowledge management and organizational learning

CERN Document Server

2009-01-01

Knowledge management (KM) is a set of relatively new organizational activities. This volume presents some 20 papers organized into five sections covering basic concepts of knowledge management. The volume editor is an esteemed name in the field..

Experiência de mulheres com linfedema pós-mastectomia: significado do sofrimento vivido Experiencia de mujeres con linfedema post-mastectomía: significado del sufrimiento vivido Experience of women with post-mastectomy lymphedema: the meaning of experienced suffering

Directory of Open Access Journals (Sweden)

Marislei Sanches Panobianco

2008-12-01

cotidiano y en el trabajo, alteraciones emocionales, cambios de hábitos, caracterizándose como un problema estigmatizante. Identificaron instituciones: ciencia, trabajo, servicios de salud y sociedad, que promovieron cuestionamientos, perjuicio, aislamiento, constreñimiento. La familia y el servicio de apoyo que frecuentaban fueron instituciones que posibilitaron aproximación social.Arm lymphedema affects approximately 40% of mastectomized women with axillary hollowness, increasing limb weight and volume, with subsequent professional, domestic, sexual and psychosocial problems. Current study analyzes the experience of women with post-mastectomy lymphedema and aims at understanding the meaning that foregrounds their experienced suffering. Analysis was based on an anthropological and interpretative approach, whereas data were submitted to thematic content analysis. Fourteen women, attending a rehabilitation unit for mastectomized women, where authors of current paper work, participated in the study, were selected. From the participants' point of view, characterizing a stigmatizing problem, lymphedema brings about concern with treatment and its maintenance, difficulty in daily life and work, emotional alterations, habits changes. The subjects identified institutions, such as science, place of work, health services and society, which develop negative conditions by their questioning, bias, isolation and embarrassment. The family and the support service they attended were institutions that favored social approximation.

Value Adding Management: A New Facilities Management Concept

DEFF Research Database (Denmark)

Jensen, Per Anker; Katchamart, Akarapong

2011-01-01

Purpose: To investigate how Facilities Management (FM) can add value and develop a management concept that can assist facilities managers in implementing value adding strategies and practices. Theory: The study is based on the management model for FM included in the European FM standards, recent...... is investigated, tested and discussed based on a case study of an international corporation. Findings: The study shows that the management model for FM creates a relevant starting point but also that stakeholder and relationship management is an essential aspect of Value Adding Management. The case study confirms...... the relevance of the basic concept and provides an important example of how Value Adding Management can be implemented and added value measured. Originality/value: The study develops a concept of Value Adding Management, which is new in FM literature. It is expected to increase the awareness of the impacts...

Basic Research Firing Facility

Data.gov (United States)

Federal Laboratory Consortium — The Basic Research Firing Facility is an indoor ballistic test facility that has recently transitioned from a customer-based facility to a dedicated basic research...

MANAGEMENT basic professional educational program IN THE CONDITIONS OF information and educational environment based on cloud TECHNOLOGIES

Directory of Open Access Journals (Sweden)

O. F. Bryksina

2016-01-01

Full Text Available The article substantiates the advantages of building information-educational environment of the basic professional educational program based on cloud technologies. Universal tool for building information-educational environment is Google Apps for Education services, which allows to organize the effective cooperation of all participants of the educational process, to plan collaborative activities, properly allocate resources and provide the solution of various learning tasks by necessary tools. Examples of using various Google-services in the organization of the collaborative activities of teachers of the department of applied informatics and information technologies in education of the Minin Nizhny Novgorod State Pedagogical University to improve implementation of the basic professional educational program in the direction of preparation "Information systems and technology". The core of the informational and educational environment of the basic professional educational program is Google-site that integrates different Google services and Google Apps applications.

Simba Study: Undergraduate module in simulation training and basic life support to improve undergraduate confidence in paediatrics

LENUS (Irish Health Repository)

Bruell, H

2013-08-20

There are significant differences in resuscitation algorithms for children versus adults. We aimed to enhance confidence of our students in the assessment and management of sick children by developing a simple program with emphasis on Basic Airway management, CPR, and clinical assessment and treatment of children using the A\\/B\\/C\\/D\\/E system. \\r\

Science as Knowledge, Practice, and Map Making: The Challenge of Defining Metrics for Evaluating and Improving DOE-Funded Basic Experimental Science

Energy Technology Data Exchange (ETDEWEB)

Bodnarczuk, M.

1993-03-01

Industrial R&D laboratories have been surprisingly successful in developing performance objectives and metrics that convincingly show that planning, management, and improvement techniques can be value-added to the actual output of R&D organizations. In this paper, I will discuss the more difficult case of developing analogous constructs for DOE-funded non-nuclear, non-weapons basic research, or as I will refer to it - basic experimental science. Unlike most industrial R&D or the bulk of applied science performed at the National Renewable Energy Laboratory (NREL), the purpose of basic experimental science is producing new knowledge (usually published in professional journals) that has no immediate application to the first link (the R) of a planned R&D chain. Consequently, performance objectives and metrics are far more difficult to define. My claim is that if one can successfully define metrics for evaluating and improving DOE-funded basic experimental science (which is the most difficult case), then defining such constructs for DOE-funded applied science should be much less problematic. With the publication of the DOE Standard - Implementation Guide for Quality Assurance Programs for Basic and Applied Research (DOE-ER-STD-6001-92) and the development of a conceptual framework for integrating all the DOE orders, we need to move aggressively toward the threefold next phase: (1) focusing the management elements found in DOE-ER-STD-6001-92 on the main output of national laboratories - the experimental science itself; (2) developing clearer definitions of basic experimental science as practice not just knowledge; and (3) understanding the relationship between the metrics that scientists use for evaluating the performance of DOE-funded basic experimental science, the management elements of DOE-ER-STD-6001-92, and the notion of continuous improvement.

A Management Development Course for Physicians

Science.gov (United States)

Plovnick, Mark S.; And Others

1977-01-01

Developed and tested by the Health Management Project at the MIT Sloan School of Management, this course was designed to provide a more accurate understanding of the relevance and usefulness of management education to physicians and to train physicians in some basic management skills. Its content and field tests are described. (LBH)

Implementation of Knowledge Management in Organizations

Science.gov (United States)

Winkler, Katrin; Mandl, Heinz

2007-01-01

In the context of learning implementation of new ideas e.g. knowledge management in organizations often is neglected. Concerning knowledge management measures we demonstrate its implementation in organizations. A theoretical framework was developed showing the necessary basic conditions for implementing knowledge management. Subsequently we…

Quality management and Juran's legacy

NARCIS (Netherlands)

Bisgaard, S.

2008-01-01

Quality management provides the framework for the industrial application of statistical quality control, design of experiments, quality improvement, and reliability methods. It is therefore helpful for quality engineers and statisticians to be familiar with basic quality management principles. In

CONCEPTUAL CLARIFICATION OF PLANNING AND STRATEGIC THINKING IN HUMAN RESOURCE MANAGEMENT

Directory of Open Access Journals (Sweden)

Matei ȘTEFAN

2013-10-01

Full Text Available Many of the concepts and techniques for strategic management have been developed and successfully applied within many companies. As managers are trying to manage better and to face the changes in economical climate, a company develops over four phases of strategic actions and management. These phases consist of basic financial planning, prognosis-based planning, external environment oriented planning and strategic management. Moreover, strategic management consists of four basic elements which ensure a structured format for examination of company strategies: scanning the business environment, strategy formulation, strategy implementation, evaluation and control.

Arm and shoulder morbidity in breast cancer patients after breast-conserving therapy versus mastectomy

Energy Technology Data Exchange (ETDEWEB)

Nesvold, Inger-Lise (Dept. of Cancer Rehabilitation-Physiotherapy, Rikshospitalet, Univ. of Oslo, Div. The Norwegian Radium Hospital, Montebello, Oslo (Norway)); Dahl, Alv A.; Fossaa, Sophie D. (Dept. of Clinical Cancer Research, Rikshospitalet, Univ. of Oslo: Division The Norwegian Radiumhospital, Montebello, Oslo (Norway)); Loekkevik, Erik (Dept. of Oncology, Rikshospitalet, Montebello, Oslo (Norway)); Marit Mengshoel, Anne (Inst. of Nursing and Health Sciences, Univ. of Oslo: Medical Faculty, Oslo (Norway))

2008-06-15

Introduction. The objective of this study was to compare the prevalence of late effects in the arm and shoulder in patients with breast cancer stage II who had radical modified mastectomy (RM) or breast-conserving therapy (BCT) followed by loco-regional adjuvant radiotherapy with or without chemotherapy/anti-oestrogen. Material and methods. All patients had axillary lymph node dissection. At a median of 47 months (range 32-87) post-surgery, 263 women (RM: n=186, BCT: n=77) were seen during an outpatient visit and had their arm and shoulder function and the presence of lymphedema assessed by a clinical examination, interview and self-rating. Volume calculation was used to measure lymphedema. Results. In the RM group 20% had developed arm lymphedema versus 8% in the BCT group (p=0.02). In multivariate analysis lymphedema was associated with a higher number of metastatic axillary lymph nodes [OR1.14, p=0.02], RM [OR 2.75, p=0.04] and increasing body mass index (BMI) [OR 1.11, p<0.01]. In the RM group 24% had a restricted range of motion in shoulder flexion compared to 7% in the BCT group (p<0.01). Shoulder pain was reported by 32% in the RM group and by 12% in the BCT group (p=0.001). Increasing observation time, RM, and increasing BMI were significantly associated with impaired arm/shoulder function. Discussion. Arm/shoulder problems including lymphedema were significantly more common after RM compared to BCT in irradiated breast cancer patients who have undergone axillary lymph node dissection. The performance of BCT should be encouraged when appropriate, to ensure a low prevalence of arm/shoulder morbidity including lymphedema

Arm and shoulder morbidity in breast cancer patients after breast-conserving therapy versus mastectomy

International Nuclear Information System (INIS)

Nesvold, Inger-Lise; Dahl, Alv A.; Fossaa, Sophie D.; Loekkevik, Erik; Marit Mengshoel, Anne

2008-01-01

Introduction. The objective of this study was to compare the prevalence of late effects in the arm and shoulder in patients with breast cancer stage II who had radical modified mastectomy (RM) or breast-conserving therapy (BCT) followed by loco-regional adjuvant radiotherapy with or without chemotherapy/anti-oestrogen. Material and methods. All patients had axillary lymph node dissection. At a median of 47 months (range 32-87) post-surgery, 263 women (RM: n=186, BCT: n=77) were seen during an outpatient visit and had their arm and shoulder function and the presence of lymphedema assessed by a clinical examination, interview and self-rating. Volume calculation was used to measure lymphedema. Results. In the RM group 20% had developed arm lymphedema versus 8% in the BCT group (p=0.02). In multivariate analysis lymphedema was associated with a higher number of metastatic axillary lymph nodes [OR1.14, p=0.02], RM [OR 2.75, p=0.04] and increasing body mass index (BMI) [OR 1.11, p<0.01]. In the RM group 24% had a restricted range of motion in shoulder flexion compared to 7% in the BCT group (p<0.01). Shoulder pain was reported by 32% in the RM group and by 12% in the BCT group (p=0.001). Increasing observation time, RM, and increasing BMI were significantly associated with impaired arm/shoulder function. Discussion. Arm/shoulder problems including lymphedema were significantly more common after RM compared to BCT in irradiated breast cancer patients who have undergone axillary lymph node dissection. The performance of BCT should be encouraged when appropriate, to ensure a low prevalence of arm/shoulder morbidity including lymphedema

Design of an integrated information management system for safe management of radioactive waste

International Nuclear Information System (INIS)

Son, Dong Chan; Hong, Suk Young; An, Kyoung Il

2003-05-01

An integrated data management system for the safe management of radioactive waste and spent fuel in Korea is developed to collect basic information, provide the framework for national regulation, and improve national competition and efficiency in the management of radioactive waste and spent fuel. This system can also provide public access to information such as a statistical graphs and integrated data from various waste generators to meet increased public needs and interests. Objectives can be summarized as: the five principles (independence, openness, clearance, efficiency and reliance) of safety regulation can be realized. Public understanding and reliance on the safety of spent fuel and radioactive waste management can be promoted by providing reliable information. Ensure an openness within the international nuclear community and efficiently support international agreements among contracting parties by operating safe and efficient management of spent fuel and radioactive waste (IAEA joint convention on the safety of spent fuel management and on the safety of radioactive waste management). The system can compensate for the imperfections in safe regulation of radioactive waste and spent fuel management related to waste generation, storage and disposal, and make it possible to holistic control. Re-organize the basic framework of KINS's intermediate and long term research organization and trends, regarding waste management policy is to integrate safe management and unit safe disposal

Design of an integrated information management system for safe management of radioactive waste

Energy Technology Data Exchange (ETDEWEB)

Son, Dong Chan; Hong, Suk Young; An, Kyoung Il [Daesang Information Technology Co., Ltd., Seoul (Korea, Republic of)] (and others)

2003-05-15

An integrated data management system for the safe management of radioactive waste and spent fuel in Korea is developed to collect basic information, provide the framework for national regulation, and improve national competition and efficiency in the management of radioactive waste and spent fuel. This system can also provide public access to information such as a statistical graphs and integrated data from various waste generators to meet increased public needs and interests. Objectives can be summarized as: the five principles (independence, openness, clearance, efficiency and reliance) of safety regulation can be realized. Public understanding and reliance on the safety of spent fuel and radioactive waste management can be promoted by providing reliable information. Ensure an openness within the international nuclear community and efficiently support international agreements among contracting parties by operating safe and efficient management of spent fuel and radioactive waste (IAEA joint convention on the safety of spent fuel management and on the safety of radioactive waste management). The system can compensate for the imperfections in safe regulation of radioactive waste and spent fuel management related to waste generation, storage and disposal, and make it possible to holistic control. Re-organize the basic framework of KINS's intermediate and long term research organization and trends, regarding waste management policy is to integrate safe management and unit safe disposal.

Basic stages of introduction of kontrolingu in management railway enterprises

OpenAIRE

Kokovikhina, O.

2011-01-01

In the article research existent approaches in relation to introduction of financial kontrolingu in activity of subjects of menage and ten stages of introduction of kontrolingu are offered in the management of railway transport enterprises.

Women in Management.

Science.gov (United States)

Van Antwerp, Dacia

1979-01-01

Discusses the special vocational needs of women who are planning careers in corporate management. Suggests three basic areas that counselors should cover with these clients: goals, expertise, and teamwork. (HMV)

Basic radiation oncology

International Nuclear Information System (INIS)

Beyzadeoglu, M. M.; Ebruli, C.

2008-01-01

Basic Radiation Oncology is an all-in-one book. It is an up-to-date bedside oriented book integrating the radiation physics, radiobiology and clinical radiation oncology. It includes the essentials of all aspects of radiation oncology with more than 300 practical illustrations, black and white and color figures. The layout and presentation is very practical and enriched with many pearl boxes. Key studies particularly randomized ones are also included at the end of each clinical chapter. Basic knowledge of all high-tech radiation teletherapy units such as tomotherapy, cyberknife, and proton therapy are also given. The first 2 sections review concepts that are crucial in radiation physics and radiobiology. The remaining 11 chapters describe treatment regimens for main cancer sites and tumor types. Basic Radiation Oncology will greatly help meeting the needs for a practical and bedside oriented oncology book for residents, fellows, and clinicians of Radiation, Medical and Surgical Oncology as well as medical students, physicians and medical physicists interested in Clinical Oncology. English Edition of the book Temel Radyasyon Onkolojisi is being published by Springer Heidelberg this year with updated 2009 AJCC Staging as Basic Radiation Oncology

Basic digital signal processing

CERN Document Server

Lockhart, Gordon B

1985-01-01

Basic Digital Signal Processing describes the principles of digital signal processing and experiments with BASIC programs involving the fast Fourier theorem (FFT). The book reviews the fundamentals of the BASIC program, continuous and discrete time signals including analog signals, Fourier analysis, discrete Fourier transform, signal energy, power. The text also explains digital signal processing involving digital filters, linear time-variant systems, discrete time unit impulse, discrete-time convolution, and the alternative structure for second order infinite impulse response (IIR) sections.

Managerialism and large-scale assessment: new modes of regulation of basic education

Directory of Open Access Journals (Sweden)

Maria de Fátima Cóssio

2014-12-01

Full Text Available This work is an effort of systematisation of the discussions undertaken in Advancing Educational Policy Seminar II PPGE/FaE/UFPel and aims at analyzing the intensification of evaluative mechanisms in the scenario of Brazilian basic education defending the thesis that is part of the process of reconfiguration of the public administration within the framework of the capitalist project and yours consequent changes in the role of the State to cope with the crises and breed new forms of regulation. Use the theorizing of Alfonso (2009, Ball (2004, 2005, 2011, Maroy (2011, Theodore (2011, in the understanding of new public management and adjustment modes, as well as the official and legal documents supporting the understanding of new public management and adjustment modes current policy. Analyzes the public management model assumed by central Governments since the mid 1990 identifing the Managerialism, considering the adoption of business principles and mechanisms of control and accountability within the public machine. Educational policies in force are currently grounded by induction to the improvement of quality indicators, measured through national exams combined to school censuses which result in basic education development index-IDEB. It is believed that the panacea of the evaluation reflects the Organization of systems, of schools and of the classroom, with implications in the curriculum, teaching and training work of students.

Radioactive waste management

International Nuclear Information System (INIS)

Syed Abdul Malik Syed Zain

2005-01-01

This chapter discussed the basic subjects covered in the radioactive waste management. The subjects are policy and legislation, pre-treatment, classification, segregation, treatment, conditioning, storage, siting and disposal, and quality assurance

Basic science right, not basic science lite: medical education at a crossroad.

Science.gov (United States)

Fincher, Ruth-Marie E; Wallach, Paul M; Richardson, W Scott

2009-11-01

This perspective is a counterpoint to Dr. Brass' article, Basic biomedical sciences and the future of medical education: implications for internal medicine. The authors review development of the US medical education system as an introduction to a discussion of Dr. Brass' perspectives. The authors agree that sound scientific foundations and skill in critical thinking are important and that effective educational strategies to improve foundational science education should be implemented. Unfortunately, many students do not perceive the relevance of basic science education to clinical practice.The authors cite areas of disagreement. They believe it is unlikely that the importance of basic sciences will be diminished by contemporary directions in medical education and planned modifications of USMLE. Graduates' diminished interest in internal medicine is unlikely from changes in basic science education.Thoughtful changes in education provide the opportunity to improve understanding of fundamental sciences, the process of scientific inquiry, and translation of that knowledge to clinical practice.

Computerized management support for swine breeding farms

NARCIS (Netherlands)

Huirne, R.B.M.

1990-01-01

1. INTRODUCTION

The investigations described in this thesis have been directed towards computerized management support for swine breeding farms, focused on sow productivity and profitability. The study is composed of three basic parts: (1) basic description and

Visual Basic 2012 programmer's reference

CERN Document Server

Stephens, Rod

2012-01-01

The comprehensive guide to Visual Basic 2012 Microsoft Visual Basic (VB) is the most popular programming language in the world, with millions of lines of code used in businesses and applications of all types and sizes. In this edition of the bestselling Wrox guide, Visual Basic expert Rod Stephens offers novice and experienced developers a comprehensive tutorial and reference to Visual Basic 2012. This latest edition introduces major changes to the Visual Studio development platform, including support for developing mobile applications that can take advantage of the Windows 8 operating system

Quantum electronics basic theory

CERN Document Server

Fain, V M; Sanders, J H

1969-01-01

Quantum Electronics, Volume 1: Basic Theory is a condensed and generalized description of the many research and rapid progress done on the subject. It is translated from the Russian language. The volume describes the basic theory of quantum electronics, and shows how the concepts and equations followed in quantum electronics arise from the basic principles of theoretical physics. The book then briefly discusses the interaction of an electromagnetic field with matter. The text also covers the quantum theory of relaxation process when a quantum system approaches an equilibrium state, and explai

Diagnosing Total Quality Management. Part I

NARCIS (Netherlands)

Bossink, B.A.G.; Gieskes, J.F.B.; Pas, T.N.M.

1992-01-01

From extensive literature research a total quality management (TQM) model is developed. This model describes the basic elements of the concept of TQM. It also provides the way in which the basic elements can be made operational in practice. Based on this model a quality-diagnostical instrument is

Diagnosing Total Quality Management - part 2

NARCIS (Netherlands)

Bossink, B.A.G.; Gieskes, J.F.B.; Pas, T.N.M.

1993-01-01

From extensive literature research a total quality management (TQM) model is developed. This model describes the basic elements of the concept of TQM. It also provides the way in which the basic elements can be made operational in practice. Based on this model a quality-diagnostical instrument is

Basic Business and Economics: Rationale for a Course in Small Business Management.

Science.gov (United States)

Swanson, Robert A.

1979-01-01

Stating that small business represents most of the nation's business but that business courses focus on corporate giants, the author presents arguments for a course in small business management. This course could prepare students for small business opportunities and provide an understanding of the nature of small business management and ownership.…

Development of a Standardized Job Description for Healthcare Managers of Metabolic Syndrome Management Programs in Korean Community Health Centers

Directory of Open Access Journals (Sweden)

Youngjin Lee, RN, PhD

2014-03-01

Conclusion: A job description for healthcare managers may provide basic data essential for the development of a job training program for healthcare managers working in community health promotion programs.

Basic infrastructure for a nuclear power project

International Nuclear Information System (INIS)

2006-06-01

There are several stages in the process of introducing nuclear power in a country. These include development of nuclear policies and regulations, feasibility studies, public consultations, technology evaluation, requests for proposals and evaluations, contracts and financing, supply, construction, commissioning, operation and finally decommissioning. This publication addresses the 'basic' infrastructure needs, which are adequate until the issue of the construction license. It is obvious that a fully developed nuclear infrastructure will be required for the further implementation stages of a nuclear power reactor. The officials and experts in each country will undertake the transition from a basic infrastructure to a fully developed infrastructure that covers the stages of construction, commissioning, operation and decommissioning. The publication is directed to provide guidance for assessing the basic infrastructure necessary for: - A host country to consider when engaging in the implementation of nuclear power, and - A supplier country to consider when assessing whether the recipient country is in an acceptable condition to begin the implementation of a nuclear power project. The target users are decision makers, advisers and senior managers in the governmental organizations, utilities, industrial organizations and regulatory bodies in the countries adopting nuclear power programmes or exporting supplies for these programmes. The governmental organizations that may find this publication useful include: Ministries of Economy, Energy, Foreign Affairs, Finance, Mining, Internal Affairs, Academic Institutions, Nuclear Energy Agencies and Environmental Agencies. This publication was produced within the IAEA programme directed to increase the capability of Member States to plan and implement nuclear power programmes and to establish and enhance national nuclear infrastructure. This publication should be used in conjunction with the IAEA Safety Standards Series and other

Trends in Energy Management Technology - Part 3: State of Practiceof Energy Management, Control, and Information Systems

Energy Technology Data Exchange (ETDEWEB)

Yee, Gaymond; Webster, Tom

2004-02-01

In this report, the third in a series, we provide an evaluation of several products that exemplify the current state of practice of Energy Management, Control, and Information Systems (EMCIS). The available features for these products are summarized and analyzed with regard to emerging trends in EMCIS and potential benefits to the federal sector. The first report [1] covered enabling technologies for emerging energy management systems. The second report [2] serves as a basic reference for building control system (BCS) networking fundamentals and includes an assessment of current approaches to open communications. Part 4 of this series will discuss applications software from a user's perspective. It is important for energy managers in the Federal sector to have a high level of knowledge and understanding of these complex energy management systems. This series of reports provides energy practitioners with some basic informational and educational tools to help make decisions relative to energy management systems design, specification, procurement, and energy savings potential.

Orofacial pain: basic mechanisms and implication for successful management Dores orofaciais: mecanismos básicos e implicações para um tratamento efetivo

Directory of Open Access Journals (Sweden)

Paulo César Rodrigues Conti

2003-03-01

Full Text Available Orofacial Pain is the field of dentistry devoted to the diagnosis and management of chronic, complex, facial pain and oromotor disorders. This specialty in dentistry has developed over a number of years out of the need for better understanding of a group of patients who somehow were not clearly suffering from dental pain disorders, but still did not seem to have a clearly defined medical problem. After a long period of treating patients based on the mechanicist aspect of the disease, our profession has realized the importance of basic knowledge and differencial diagnosis in order to proper manage these patients. This modification in the approach has caused severe changes in education as well as in clinical activities. Historically considered as a problem of occlusion, Orofacial Pain, including Temporomandibular Disorders (TMD has recently reached the status of "Specialty" in Brazil. Therefore, this paper aims to discuss the main differences between musculoskeletal and neuropathic pain and the importance of basic knowledge to perform successful management.Dor Orofacial é um campo da odontologia dedicado ao diagnóstico e tratamento de dores orofaciais crônicas e complexas, além d e desordens motoras. Essa especialidade odontológica tem se desenvolvido por vários anos com o objetivo de prover um melhor entendimento de um grupo de pacientes que, de alguma forma, não tinham dores de origem dentária e nem condições óbvias médicas que explicassem suas dores na face. Depois de um longo período propondo tratamentos baseados apenas no aspecto mecanicista da doença, nossa profissão percebeu a importância de entender mecanismos básicos de diagnóstico diferencial para melhor controlar esses casos. Essa mudança de mentalidade tem levado a modificações na educação em odontologia, assim como nos procedimentos clínicos executados. Historicamente considerada como um "problema de oclusão", as dores orofaciais obtiveram recentemente o

Time management

OpenAIRE

Hanus, Filip

2016-01-01

The diploma thesis applies to issues and methods of time management at work of ČSOB, a.s. managers in western area of the Czech Republic. The thesis is devided into two basic parts. First part is theoretical and methodological, second part contains of impractical research using questionnaires investigation and controlled conversation. First part of the thesis describes theoretical anchoring of the topic including methods of gathering data. Second part shortly introduces particular company and...

Managing Knowledge

OpenAIRE

Connolly, Niall

2013-01-01

This paper provides a perspective on what knowledge is, why knowledge is important, and how we might encourage good knowledge behaviours. A knowledge management framework is described, and although the framework is project management-centric the basic principles are transferrable to other contexts. From a strategic perspective, knowledge can be considered an asset that has the potential to provide a competitive advantage provided that it has intrinsic value, it is not easily accessible by ...

Research on the Countermeasures Based on TTPM Theory for the Improvement of the Basic Education Teachers Training Performance

Science.gov (United States)

Huabai, Bu; Dengyu, Zhang; Xiuying, Shen; Hao, Tu

2012-01-01

Many elements of the basic education teachers' training performance are embedded in the training interaction and sharing, so the enhancement of the training performance needs a whole process management and control. Based on TTPM theory, this paper has put forward four measures that must be pay attention to during the management of the basic…

Nurses' Educational Needs Assessment for Financial Management Education Using the Nominal Group Technique.

Science.gov (United States)

Noh, Wonjung; Lim, Ji Young

2015-06-01

The purpose of this study was to identify the financial management educational needs of nurses in order to development an educational program to strengthen their financial management competencies. Data were collected from two focus groups using the nominal group technique. The study consisted of three steps: a literature review, focus group discussion using the nominal group technique, and data synthesis. After analyzing the results, nine key components were selected: corporate management and accounting, introduction to financial management in hospitals, basic structure of accounting, basics of hospital accounting, basics of financial statements, understanding the accounts of financial statements, advanced analysis of financial statements, application of financial management, and capital financing of hospitals. The present findings can be used to develop a financial management education program to strengthen the financial management competencies of nurses. Copyright © 2015. Published by Elsevier B.V.

Management Information Systems Research.

Science.gov (United States)

Research on management information systems is illusive in many respects. Part of the basic research problem in MIS stems from the absence of standard...decision making. But the transition from these results to the realization of ’satisfactory’ management information systems remains difficult indeed. The...paper discusses several aspects of research on management information systems and reviews a selection of efforts that appear significant for future progress. (Author)

CT evaluation of soft tissue and muscle infection and inflammation: A systematic compartmental approach

Energy Technology Data Exchange (ETDEWEB)

Beauchamp, N.J. Jr. [Dept. of Radiology, and Radiological Science, The Johns Hopkins Medical Institutions, Baltimore, MD (United States); Scott, W.W. Jr. [Dept. of Radiology, and Radiological Science, The Johns Hopkins Medical Institutions, Baltimore, MD (United States); Gottlieb, L.M. [Dept. of Surgery, The Johns Hopkins Medical Institutions, Baltimore, MD (United States); Fishman, E.K. [Dept. of Surgery, The Johns Hopkins Medical Institutions, Baltimore, MD (United States)

1995-07-01

This essay presents a systematic approach to the evaluation of soft tissue and muscle infection by defining the various pathologic processes and then illustrating them through a series of CT studies with corresponding schematic diagrams. The specific processes discussed are cellulitis, lymphangitis/lymphedema, necrotizing fascitis, myositis/myonecrosis, and abscess. Key points in the differential diagnosis of these entities are discussed and illustrated. The clinical management of the specific pathologic processes is also discussed. (orig./MG)

CT evaluation of soft tissue and muscle infection and inflammation: A systematic compartmental approach

International Nuclear Information System (INIS)

Beauchamp, N.J. Jr.; Scott, W.W. Jr.; Gottlieb, L.M.; Fishman, E.K.

1995-01-01

This essay presents a systematic approach to the evaluation of soft tissue and muscle infection by defining the various pathologic processes and then illustrating them through a series of CT studies with corresponding schematic diagrams. The specific processes discussed are cellulitis, lymphangitis/lymphedema, necrotizing fascitis, myositis/myonecrosis, and abscess. Key points in the differential diagnosis of these entities are discussed and illustrated. The clinical management of the specific pathologic processes is also discussed. (orig./MG)

EFFECTIVE COMMUNICATION AND LABOR PERFORMANCE IN BASIC EDUCATION

Directory of Open Access Journals (Sweden)

Yumaira Matilde Quero Romero

2014-04-01

Full Text Available This research is correlational descriptive, is framed in positivist approach why a quantitative statistical analysis was used to process the data obtained from the subjects surveyed to measure the relationship of the variables: Effective Communication and Job Performance of Directors and their respective dimensions and indicators. The study design is not experimental, transeccioanal. A population census was performed by the population being comprised of 99 subjects, 9 of which belong to the management staff and 90 teachers of Basic Schools Altagracia parish, municipality Miranda, Zulia state. Type two survey instruments comprised of 39 itemes each designed to measure effective communication and job performance of managers of national primary schools of Altagracia parish, with alternatives of Likert responses which variables were always, sometimes, almost never, never the statistical analysis used to analyze the results in this research was descriptive, with frequency distribution per item. In conclusion a significant positive correlation at the level of 0.00 was detected.

Radionuclide lymphoscintigraphy in the evaluation of peripheral edema

International Nuclear Information System (INIS)

Kim, Soon; Zeon, Seok Kil

2000-01-01

It has been difficulty to visualize lymphatics in living patients. Conventional or direct lymphography has been the gold standard for delineation of the lymphatic system, but this procedure is invasive, difficulty to perform, and harmful to the lymphatic vascular endothelium. The aim of our study was to determine its severity, and to understand the drainage patterns on patients with peripheral edema by functional lymphatic studies. Tc-99m antimony sulfide colloid 25 MBq with 0.4 ml volume was injected intradermally in the first, second and third web space of the foot or hand in 40 patients with peripheral edema (5 in upper extremity and 35 in lower extremity). Initial flow after injection and whole body images at approximately 30 minutes. 1-4 hours were obtained. In 9/40 cases with peripheral edema normal lymphoscintigram were revealed, primary lymphedema was observed in 5/31 cases. The imaging patterns in primary lymphedema were absent (3 cases) or delayed (2 cases) transport, lymphatic duct dilatation (1), cutoff (1), decrease in size and number of lymph nodes (2). The Common caused of edema in secondry lymphedema (26/31) were carcinoma (13), inflammation (5), post-operation (5), and unknown origin (3). The common imaging findings in carcinoma showed non-visualization of lymph nodes (13), dermal backflow (8), collateral circulation (5), and in inflammation lymphatic obstruction (2), increase in size and number of lymph nodes (2), delayed transport (1), and in post-operation dermal backflow (3), delayed transport (2), decrease in number and size of lymph node (2) Clear images patterns were observed difference between primary lymphedema an secondary lymphedema. Radionuclide lymphoscintigraphy is essentially non-invasive, easy to perform repeatedly, and harmless to the lymphatic vascular endothelium for evaluation of a patient with lymphedema

Ways to rational management of accounts receivable at enterprises

Directory of Open Access Journals (Sweden)

Yevtushenko N. O.

2015-05-01

Full Text Available This article investigated the principal reasons of management problems an account receivable of enterprises. Credit politics of management is worked out by an account receivable of enterprises. Essence of the stages of construction of rational management an account receivable of enterprises is exposed. In the article are exposed the basic elements of control system for an account receivable such as mission, aims, strategy as politics of management. The basic stages of management politics are described for an account receivable of enterprises: analysis; organization of forming of principles of credit politics, terms of delivery of credit and procedure of collection of accounts receivable; planning of the use of modern forms of refunding, and similarly control.

The basic direction of integration of professional football of Germany in modern market [Osnovnye napravleniia integracii professional'nogo futbola germanii v sovremennyj rynok

Directory of Open Access Journals (Sweden)

Shtolze Peter.

2011-11-01

Full Text Available Considered change in control the system by professional football in Germany, conditioned influencing of modern market. Basic directions and marketing facilities are certain. It is set that basic directions integration in a modern market are professionalism of management football and use of marketing. Attention is accented on changes in the structure of management, creation of marketing departments, making up of the staff of clubs specialists in area of market management, introduction of the corporate beginnings in activity of clubs, use of services of market mediators, establishment of daughter's commercial firms. It is marked that marketing is supposed by activity of soccer organizations on such basic directions: work with an audience; sale of mediarights; work with sponsors and advertisers; merchandising. It is set that to weak positions of marketing it is necessary to take low economic efficiency of business partnership with the representatives of mass medias, insufficient return from merchandising.

The edema of the lower limb: investigations by dynamic and static lymphoscintigraphy

International Nuclear Information System (INIS)

Fritz, P.; Wildeshaus, K.H.; Winkel, K. zum.

1986-01-01

24 patients with edema of the lower limb after femoro-popliteal or femoro-crural bypass surgery were investigated by dynamic and static lymphoscintigraphy. In 20 patients contrast phlebography was also done. Venous drainage disturbences were not demonstrable. Legs with edema had a statistically significant lower drainage capacity for sup(99m)Tc sulfur microcolloid than contralateral legs. Velocity of prefascial lymphatic transport of radioactivity showed no significant differences between edematous and contralateral legs. Static lymphoscintigraphy demonstrated typical lymphedema associated-soft tissue findings in 83%. Diffuse retention of radiocolloid in the region of the edema and iatrogenic lesions of lymph vessels (dermal back flow) in the region of the surgical scar were found in 45% and 41% of cases, respectively. Based on the criteria of dynamic and static lymphoscintigraphy and the pathogenetic classification of lymphedema according to FOELDI, a dynamic insufficiency of lymph drainage must be assumed to be the cause of lymphedema after arterial reconstructions. Iatrogenic lymph vessel lesions also play a causative role. Dynamic and static lymphoscintigraphy gives valuable information for the differentiation between postreconstructive lymphedema of mechanical and functional origin. (Author)

Calculating cost savings in utilization management.

Science.gov (United States)

MacMillan, Donna

2014-01-01

A major motivation for managing the utilization of laboratory testing is to reduce the cost of medical care. For this reason it is important to understand the basic principles of cost accounting in the clinical laboratory. The process of laboratory testing includes three distinct components termed the pre-analytic, analytic and post-analytic phases. Utilization management efforts may impact the cost structure of these three phases in different ways depending on the specific details of the initiative. Estimates of cost savings resulting from utilization management programs reported in the literature have often been fundamentally flawed due to a failure to understand basic concepts such as the difference between laboratory costs versus charges and the impact of reducing laboratory test volumes on the average versus marginal cost structure in the laboratory. This article will provide an overview of basic cost accounting principles in the clinical laboratory including both job order and process cost accounting. Specific examples will be presented to illustrate these concepts in various different scenarios. © 2013.

Pembuatan Program Aplikasi Sistem Inventori Berbasis Visual Basic Pada Sinar Baru

OpenAIRE

Dessy, Dessy; Dewayani, Ery

2016-01-01

Application system inventory program based on visual basic on Sinar Baru for helping admin to manage in or out items systematically which it doesn't save and computerized well. The programming using System Development Life Cicle (SDLC). SDLC has four phases, that are: Planning Phase, Analysis Phase, Design Phase, and Implementation Phase. Another design that used for this program are flowchart, Context diagram, data flow diagram (DFD), Entity Relation Diagram (ERD), Relational Table .Visual B...

French regulations and waste management

International Nuclear Information System (INIS)

Sousselier, Y.

1985-01-01

The authors describe the organization and the role of safety authorities in France in matter of waste management. They precise the French policy in waste storage and treatment: basic objectives, optimization of waste management. The safety requirements are based upon the barrier principle. Safety requirements about waste conditioning and waste disposal are mentioned. In addition to the safety analysis and studies described above, the Protection and Nuclear Safety Institute assists the ministerial authorities in the drafting of ''basic safety rules (RFS)'', laying down safety objectives. Appendix 1 and Appendix 2 deal with safety aspects in spent fuel storage and in transportation of radioactive materials [fr

The Clinical Value, Principle, and Basic Practical Technique of Mindfulness Intervention.

Science.gov (United States)

Zou, Tao; Wu, Chenghan; Fan, Xiaoduo

2016-06-25

Mindfulness intervention is a psychotherapy based on the Buddhist practice of meditation, combining the theories and methodology of contemporary psychology. The empirical research in recent years has indicated that mindfulness intervention yields favorable results including reduction of depression relapse, alleviation of the symptoms of depression and anxiety, reduction of substance abuse, relief of pain, blood pressure management, enhancement of immunity, and improvement of sleep. Currently, mindfulness therapy has become the mainstream of psychotherapy in the realm of European and American psychotherapy. The fields of psychology and psychotherapy in China have also begun to introduce mindfulness intervention in recent years. However, there is a lack of relevant practice and research in the field of clinical mental health. This article will briefly introduce the concept of mindfulness, the basic mechanism of the intervention, and the basic skills and guidelines in clinical practice.

Development and design of an integrated information management system for safe management of radioactive waste

Energy Technology Data Exchange (ETDEWEB)

Son, Dong Chan; Hong, Suk Young; An, Kyoung Il [Daesang Information Technology Co., Ltd., Seoul (Korea, Republic of)

2004-05-15

An integrated data management system for the safe management of radioactive waste and spent fuel in Korea is developed to collect basic information, provide the framework for national regulation, and improve national competition and efficiency in the management of radioactive waste and spent fuel. This system can also provide public access to information such as a statistical graphs and integrated data from various waste generators to meet increased public needs and interests. Objectives can be summarized as; the five principles (independence, openness, clearance, efficiency and reliance) of safety regulation can be realized. Public understanding and reliance on the safety of spent fuel and radioactive waste management can be promoted by providing reliable information. Ensure an openness within the international nuclear community and efficiently support international agreements among contracting parties by operating safe and efficient management of spent fuel and radioactive waste (IAEA joint convention on the safety of spent fuel management and on the safety of radioactive waste management). The system can compensate for the imperfections In safe regulation of radioactive waste and spent fuel management related to waste generation, storage and disposal, and make it possible to holistic control. Re-organize the basic framework of KINS's intermediate and long term research organization and trends, regarding waste management policy is to integrate safe management and unit safe disposal.

Development and design of an integrated information management system for safe management of radioactive waste

International Nuclear Information System (INIS)

Son, Dong Chan; Hong, Suk Young; An, Kyoung Il

2004-05-01

An integrated data management system for the safe management of radioactive waste and spent fuel in Korea is developed to collect basic information, provide the framework for national regulation, and improve national competition and efficiency in the management of radioactive waste and spent fuel. This system can also provide public access to information such as a statistical graphs and integrated data from various waste generators to meet increased public needs and interests. Objectives can be summarized as; the five principles (independence, openness, clearance, efficiency and reliance) of safety regulation can be realized. Public understanding and reliance on the safety of spent fuel and radioactive waste management can be promoted by providing reliable information. Ensure an openness within the international nuclear community and efficiently support international agreements among contracting parties by operating safe and efficient management of spent fuel and radioactive waste (IAEA joint convention on the safety of spent fuel management and on the safety of radioactive waste management). The system can compensate for the imperfections In safe regulation of radioactive waste and spent fuel management related to waste generation, storage and disposal, and make it possible to holistic control. Re-organize the basic framework of KINS's intermediate and long term research organization and trends, regarding waste management policy is to integrate safe management and unit safe disposal

Brand Evaluation - A Basic Feature in Modern Brand Management

OpenAIRE

Cosmin IRIMIEŞ

2012-01-01

Defined as the sum of features that make a subject unique, the brand has turned into one of the most important characteristics of the way products, services and institutions conduct their public relations or are presented to the contemporary consumer. Taking into consideration that branding is an extremely flexible process and can be applied to a very wide range of subjects, the brand management has become one of the most important instruments of modern marketing and is used in every selling/...

Basic personality dimensions and vocational orientation with pupils of fourth grade of secondary school

Directory of Open Access Journals (Sweden)

Ranđelović Dušan

2009-01-01

Full Text Available The main goal of this research was to explore relationship between basic personality dimensions of 'Big Five' model of personality (neuroticism, extraversion, opennes, agreeableness and conscientiousness and thirteen different groups of activities which orienting pupils toward some vocations (administration, security, electrotechnics, creativity, culture, literature, science, helping jobs, agriculture, practical jobs, sport and management and services. The participants were 219 pupils of fourth grade of secondary school from different regions of Serbia (Central Serbia, Southern Serbia and Kosovo and Metohija. Two instruments had been used: Test of Personality (FMLI and Test of Vocational Orientation (TPO. The results show that there is significant correlation between basic personality dimensions and vocational orientation. There is positive significant correlation between neuroticism and choosing security, helping jobs, agriculture and practical jobs. Extraversion is in significant positive correlation with choosing administration, security, sport, management, services, culture and literature. Opennes is in significant positive correlation with choosing creativity, culture, literature, helping jobs and services. There is positive significant correlation between agreeableness and choosing helping jobs and negative significant correlation between aggreeableness and choosing security. Conscientiousness is in significant positive correlation with choosing management and science. Also, concerning choosing certain groups of activities there is statistical significant mean difference between male and female.

Construction management

CERN Document Server

Pellicer, Eugenio; Teixeira, José C; Moura, Helder P; Catalá, Joaquín

2014-01-01

The management of construction projects is a wide ranging and challenging discipline in an increasingly international industry, facing continual challenges and demands for improvements in safety, in quality and cost control, and in the avoidance of contractual disputes. Construction Management grew out of a Leonardo da Vinci project to develop a series of Common Learning Outcomes for European Managers in Construction. Financed by the European Union, the project aimed to develop a library of basic materials for developing construction management skills for use in a pan-European context. Focused exclusively on the management of the construction phase of a building project from the contractor's point of view, Construction Management covers the complete range of topics of which mastery is required by the construction management professional for the effective delivery of new construction projects. With the continued internationalisation of the construction industry, Construction Management will be required rea...

Comprehensive basic mathematics

CERN Document Server

Veena, GR

2005-01-01

Salient Features As per II PUC Basic Mathematics syllabus of Karnataka. Provides an introduction to various basic mathematical techniques and the situations where these could be usefully employed. The language is simple and the material is self-explanatory with a large number of illustrations. Assists the reader in gaining proficiency to solve diverse variety of problems. A special capsule containing a gist and list of formulae titled ''REMEMBER! Additional chapterwise arranged question bank and 3 model papers in a separate section---''EXAMINATION CORNER''.

Wind Energy Basics | NREL

Science.gov (United States)

Wind Energy Basics Wind Energy Basics We have been harnessing the wind's energy for hundreds of grinding grain. Today, the windmill's modern equivalent-a wind turbine can use the wind's energy to most energy. At 100 feet (30 meters) or more aboveground, they can take advantage of the faster and

Biomass Energy Basics | NREL

Science.gov (United States)

Biomass Energy Basics Biomass Energy Basics We have used biomass energy, or "bioenergy" keep warm. Wood is still the largest biomass energy resource today, but other sources of biomass can landfills (which are methane, the main component in natural gas) can be used as a biomass energy source. A

20 CFR 669.310 - What are the basic components of an NFJP service delivery strategy?

Science.gov (United States)

2010-04-01

... include: (a) A customer-centered case management approach; (b) The provision of workforce investment... 20 Employees' Benefits 3 2010-04-01 2010-04-01 false What are the basic components of an NFJP service delivery strategy? 669.310 Section 669.310 Employees' Benefits EMPLOYMENT AND TRAINING...

FEATURES OF LOGISTIC SYSTEM ADAPTIVE MANAGEMENT

Directory of Open Access Journals (Sweden)

Natalya VOZNENKO

2015-08-01

Full Text Available The study presents literature survey on enterprise logistic system adaptive management place and structure in the general enterprise management system. The theoretical basics of logistic system functioning, levels of its management and its effectiveness had been investigated. The role of adaptive management and its types had been scrutinized. The necessity of creating company’s adaptive regulator such as its economic mechanism had been proved.

Rapid Deterioration of Basic Life Support Skills in Dentists With Basic Life Support Healthcare Provider.

Science.gov (United States)

Nogami, Kentaro; Taniguchi, Shogo; Ichiyama, Tomoko

2016-01-01

The aim of this study was to investigate the correlation between basic life support skills in dentists who had completed the American Heart Association's Basic Life Support (BLS) Healthcare Provider qualification and time since course completion. Thirty-six dentists who had completed the 2005 BLS Healthcare Provider course participated in the study. We asked participants to perform 2 cycles of cardiopulmonary resuscitation on a mannequin and evaluated basic life support skills. Dentists who had previously completed the BLS Healthcare Provider course displayed both prolonged reaction times, and the quality of their basic life support skills deteriorated rapidly. There were no correlations between basic life support skills and time since course completion. Our results suggest that basic life support skills deteriorate rapidly for dentists who have completed the BLS Healthcare Provider. Newer guidelines stressing chest compressions over ventilation may help improve performance over time, allowing better cardiopulmonary resuscitation in dental office emergencies. Moreover, it may be effective to provide a more specialized version of the life support course to train the dentists, stressing issues that may be more likely to occur in the dental office.

Ecosystem-management-based Management Models of Fast-growing and High-yield Plantation and Its Eco-economic Benefits Analysis

Institute of Scientific and Technical Information of China (English)

无

2010-01-01

The paper expounded the basic concept and principles of ecosystem management,and analyzed the state and trend of industrial plantation ecosystem management in other countries.Based on the analysis of typical case studies,the eco-economic benefits were evaluated for the management models of fast-growing and high-yield plantations.

Basic Finance

Science.gov (United States)

Vittek, J. F.

1972-01-01

A discussion of the basic measures of corporate financial strength, and the sources of the information is reported. Considered are: balance sheet, income statement, funds and cash flow, and financial ratios.

Strategic personnel management in an educational institution

OpenAIRE

KOROTKOVA M.V.; RYBKINA M.V.; NIKITINA S.O.; SCHERNYKH A.V.

2016-01-01

The article analyzes the strategic human resource management in an educational institution. Analyzes the basic normative-legal documents regulating educational activities, including the part of management. Particular importance is given to the types of educational institutions (budgetary, state, and autonomous). The stages of strategic management of staff in educational institutions and development model of strategic management personnel are shown.

Terror in time: extending culturomics to address basic terror management mechanisms.

Science.gov (United States)

Dechesne, Mark; Bandt-Law, Bryn

2018-04-11

Building on Google's efforts to scan millions of books, this article introduces methodology using a database of annual word frequencies of the 40,000 most frequently occurring words in the American literature between 1800 and 2009. The current paper uses this methodology to replicate and identify terror management processes in historical context. Variation in frequencies of word usage of constructs relevant to terror management theory (e.g. death, worldview, self-esteem, relationships) are investigated over a time period of 209 years. Study 1 corroborated previous TMT findings and demonstrated that word use of constructs related to death and of constructs related to patriotism and romantic relationships significantly co-vary over time. Study 2 showed that the use of the word "death" most strongly co-varies over time with the use of medical constructs, but also co-varies with the use of constructs related to violence, relationships, religion, positive sentiment, and negative sentiment. Study 3 found that a change in the use of death related words is associated with an increase in the use of fear related words, but not in anxiety related words. Results indicate that the described methodology generates valuable insights regarding terror management theory and provide new perspectives for theoretical advances.

Introduction of quality management (1973)

International Nuclear Information System (INIS)

1973-03-01

This book deals with quality management, which indicates company activity, function and system, quality and price, basic, technology, production, policy and train of quality management, data experience and sense, data for analysis, about experiment plan, method for analysis, what is quality? standardization for process control, quality and check, education plan, practice of education, check of the result and reliability and quality management and assurance of reliability.

Solar Energy Basics | NREL

Science.gov (United States)

Solar Energy Basics Solar Energy Basics Solar is the Latin word for sun-a powerful source of energy that can be used to heat, cool, and light our homes and businesses. That's because more energy from the technologies convert sunlight to usable energy for buildings. The most commonly used solar technologies for