Aims:To Study the religious and ideological views and practice of PalliativeCare physician towards Euthanasia.Materials and Methods:An...Full Text Available
This article is a story of networking of palliativecare at the corporate level. This gives an insight that if you have will and dedication then you can imagine and make it true that networking can...Full Text Available
Paediatric palliativecare is a holistic approach aimed at addressing the complex issues related to the care of children and families facing chronic life limiting illnesses. The needs of children are...Full Text Available
Goals of workThe goal of this study was to evaluate, at a population level, the association between specialized palliativecare services (SPCS) and short- and long-term caregiver...Full Text Available
BackgroundLung volume reduction surgery is effective at improving lung function, quality of life, and mortality in carefully selected individuals with advanced emphysema. Recently,...Full Text Available
Caring for a child with a potentially fatal medical condition is a challenge for parents or caregivers. The ability to measure parental self-efficacy in pediatric palliativecare may be an important component of targeting supportive services that address individual needs of families. Therefore, the goal was to develop a Pediatric PalliativeCare Parental Self-Efficacy Measure (PCPEM). First, a list of questions were generated that asked parents their level of confidence in carrying out tasks involved in caring for a child with a potentially fatal medical condition in 6 palliativecare domains: 1) medical discussion/decisions; 2) symptom management/medication; 3) daily activities; 4) feelings/concerns; 5) spirituality; and 6) end-of-life care. The PCPEM was narrowed to 58 questions after expert ...
The overarching goal of medical training is to nurture the growth of knowledgeable, caring and insightful clinicians guided by the ideals of medical professionalism. Recent definitions of professional...Full Text Available
ObjectiveTo investigate the prevalence of complicating and concurrent morbidities in older diabetic patients and to evaluate to what extent their occurrence affects the burden of...Full Text Available
The purpose of this study was to evaluate the safety and efficacy of TACE with microspheres preloaded with doxorubicin in unresectable intrahepatic cholangiocarcinoma (UCH). Twenty patients with UCH were observed; 9 refused, preferring other palliativecare or chemotherapy, and 11 agreed to be treated with one or more cycles of DC beads loaded with doxorubicin (100-150 mg) in a TACE procedure between February 2006 and September 2007. A total of 29 individual TACE procedures were performed. Follow-up imaging was performed on all patients before, immediately after, and 4 weeks after each TACE procedure to evaluate the response and need for further treatment. Each patient received i.v hydration, antibiotics, and medications against nausea and pain before TACE. Survival rate was calculated using Kaplan-Meier survival curve. A response rate of 100% followed RECIST criteria was observed. Eight of eleven patients are alive, with a median survival of ...
A 67-year-old man presented with gastrointestinal bleeding resulting from a fistula between the aortic stump and the fourth part of the duodenum 14 months after an axillobifemoral bypass, graft excision, and aortic stump closure for aortic graft infection. The patient initially refused any attempt at definitive surgical treatment so coil embolization of the aortic stump was performed via a brachial approach. Coil embolization may be a useful adjunct in the management of such difficult problems. This approach may buy time and allow careful planning of a definitive treatment or may serve as a palliative procedure in inoperable patients. PMID:15947052
Oral mucositis associated with head and neck radiotherapy can substantially hinder completion of cancer therapy. Alleviation of this often severe stomatitis can provide enhanced patient comfort and facilitate appropriate care. A double-blind format was used in a pilot project to measure, against a control rinse, the effectiveness of an oral rinse consisting of hydrocortisone, nystatin, tetracycline, and diphenhydramine in controlling radiation-related mucositis. A combination of clinical evaluation and patient responses to a questionnaire was used to judge the results of the topical medications. Patients using the experimental medication developed less mucositis than did patients in the control group.
Purpose Skilled placement of peripherally inserted central catheters (PICC) has a profound impact on patient well-being and costs of care. The use of ultrasound-guided methods and prescribed training for cannulation skills are evidence-based practice recommendations. The purpose of this study was to compare two methods of PICC instruction on the acquisition of applied skills. Methods Residents were randomly assigned to one of two groups (N?=?16/16) of this blind-rater study and were trained to perform ultrasound-guided PICC cannulation using either simulation or apprenticeship methods. All residents were assessed placing a PICC in applied clinical patient care. Results Residents who completed simulation training had significantly better transfer of skills to applied clinical practice than ...
The Sultanate of Oman has a relatively young national health care system that could demonstrate its high performance at an international level. Emergency medicine as a specialty has developed rapidly in the country over the last decade. This has involved the parallel development of local emergency residency training, prehospital emergency care, and emergency nursing programs. This article reviews the progress of emergency care practice in this country from a general primary care system toward becoming an established specialty in hospital, prehospital, and private emergency care settings. It also describes aspects of undergraduate, postgraduate, and continuous emergency medicine education in the country. Further, a glimpse into academic emergency medicine and emergency nursing is provided. ...
Comprehensive geriatric care should receive nation-wide attention in order to realize its objectives. An analysis of patient problems at the Geriatirc Clinic, Tygerberg Hospital and Goodwood Aftercare Hospital is presented. The training of personnel, with full motivation of the community, to render health services to the aged is discussed. PMID:7368010
The objective of this study was to evaluate the association between the number of blood cultures collected and the appropriateness of care for suspected bacteremic community-acquired urinary tract infection (UTI) in the elderly. We retrospectively evaluated the medical records of 129 patients with UTI >65?years old admitted to a large community-based training hospital in Japan from 1 January 2006 to 31 December 2009. We assessed the association between the number of blood cultures collected and the appropriateness of care received, as well as other factors. Two-thirds of the patients were women, and patients >85?years old accounted for 45.0% of the cases. Most of the organisms isolated from the urine and blood were Escherichia coli (65.4?67.0%). More than two blood cultures were collected ...
Material related to routine as well as sensitive aspects of parent/day care center relationships is presented in this training module, one of a series providing staff development information for programs operated for dependents of military personnel. The module offers a brief discussion of ways caregivers can help parents feel at ease about leaving their children in child care and presents a set of multiple-choice skill-building exercises for effectively working with parents. Exercises focus on various topics, including how parents can be approached when their child may have a health problem, when child abuse or neglect is suspected, and when parental cooperation is needed to stop a child's undesirable or disruptive behavior. Exercises are also devoted to the questions of whether or not caregivers should act as advisors to parents or tell parents about their child's behavior at the center. Concluding exercises indicate how ...
National efforts to improve the quality and safety of health care present challenges for medical education and training. Today's doctors need to be skilled communicators who know how to identify, prevent and manage adverse events and near misses, how to use evidence and information, how to work safely in a team, how to practise ethically, and how to be workplace teachers and learners. These competencies (knowledge, skills and attitudes) are set out in the National Patient Safety Education Framework (NPSF) of the Australian Council for Safety and Quality in Health Care. The NPSF is designed to help medical schools, vocational colleges, health organisations and private practitioners develop curricula to enable health professionals to work safely. The NPSF describes what doctors (depending on their level of knowledge and experience) can do to demonstrate competencies in a range of quality and safety activities. Medical ...
The Belgian Malinois dog was introduced into the Department of Defense Military Working Dog Program in 1984. All dogs are purchased in Europe and have adapted well to the rigorous training requirements of the program. Most veterinary problems seen in this breed are related to kennel confinement and include traumatic dental disease, tail lesions, a variety of dermatologic conditions, and an inability to gain weight. Epilepsy is a breed problem and has been seen in this population, as has gastric dilatation/volvulus. Both elbow and hip dysplasia exist in the Malinois breed. PMID:1900116
In recent years, several groups, including the physician assistant, health information management, ophthalmic medical technician/technologist, and athletic training review committees, have left the Commission on Accreditation of Allied Health Education Programs (CAAHEP) system to form their own, profession-specific accrediting bodies. Their motivation was typically a desire for greater professional visibility and autonomy. Combined, these professions represented one third of the CAAHEP's programs. This article reviews the history of allied health and examines current attempts to bring cohesion and identity to this increasingly fractured segment of the U.S. health care system. PMID:18444439
PURPOSE We wanted to examine how coordinated care is implemented in primary care practices to address patients' health behavior change needs. METHODS Site visit notes, documents, interviews, and online implementation diaries were collected from July 2005 to September 2007 from practice-based research networks (PBRNs) participating in Prescription for Health: Promoting Healthy Behaviors in Primary Care Research Networks (P4H). An iterative group process was used to conduct a cross-case comparative analysis of 9 interventions. Published patient outcomes reports from P4H interventions were referenced to provide information on intervention effectiveness. RESULTS In-practice health risk assessment (HRA) and brief counseling, coupled with referral and outreach to a valued and known counseling resource, emerged as the best way to consistently coordinate and encourage follow-through for health behavior counseling. Findings from ...
In 2000, the Accreditation Council of Graduate Medical Education (ACGME) laid out a definition of competence that included six specific areas of focus: patient care (including clinical reasoning), medical knowledge, practice-based learning and improvement, interpersonal and communication skills, professionalism, and systems-based practice. The ACGME's intention was to mandate increasingly reliable and valid assessment measures to be used by all training programs over the next decade, with the goal of providing "more credible, accurate, reliable and useful educational outcome data." In this article, the authors will review definitions of competency according to the new ACGME standards and examine the assessment tools currently available, including global evaluations, 360-degree evaluations, checklists, standardized examinations and direct observations. The authors will provide an overview of critical considerations in different assessment ...
This case study, conducted from an interpretive paradigm, illuminates contextual factors related to the tutor experience when senior undergraduate dental hygiene students served as tutors for beginning undergraduate dental hygiene students, or sophomores, in a 1-semester, 2-hour long problem-based learning (PBL) course in a Baccalaureate Dental Hygiene (BDH) curriculum during the spring semester of 2008. Data were collected using various sources and methods. Six tutors and three administrators were interviewed, tutees completed an anonymous questionnaire, the tutorial process and tutor training sessions were observed, and related documents were examined. Data analysis included open and axial coding, creation of tutor profiles, and identification of patterns. Tutor behaviors varied with respect to the nature of intervention (e.g., telling, asking, clarifying, acknowledging), emphasis (process, content, social), and facilitation style (directive, suggestive, ...
A ten week old girl who had previously undergone a palliative procedure for the hypoplastic left heart syndrome had unrelieved aortic coarctation that did not respond to standard balloon dilatation....Full Text Available
Incidence of esophageal cancer (EC) is rising more rapidly in the Western world than that of any other cancer. Despite advances in therapy, more than 50% of patients have incurable disease at the time...Full Text Available
AIM: To evaluate the efficacy of self expandable metallic stents (SEMS) in patients with malignant esophageal obstruction and fistulas.METHODS: SEMS were implanted in the presence of fluoroscopic...Full Text Available
The heterogeneity of metastatic breast cancer mandates the need to select therapies taking into account tumor and patient characteristics. Chemotherapy is indicated in the palliative setting especially...Full Text Available
Data on French nuclear electricity generation sites, nuclear power plant operations personnel, operation simulators, nuclear training centers and training statistics are presented.
ObjectiveTo evaluate the primary care communications initiative, which introduced NHSnet to primary care in Scotland.DesignSemi-structured telephone...Full Text Available
PurposeDescription and analysis of the effects and side-effects of integrated mental health care in the Netherlands.Context of caseDue...Full Text Available
This DOE handbook describes a systematic method for establishing and maintaining training programs that meet the requirements and expectations of DOE Orders 5480.18B and 5480.20. The systematic approach to training includes 5 phases: Analysis, design, development, implementation, and evaluation.
The purpose of the Joint Task Force Headquarters Master Training Guide (JTF HQ MTG) is to provide a descriptive, performance-oriented training guide to assist leaders in training their units. It also serves as a guide for the JTF Headquarters in actual op...
The factors which must be considered in the process of adapting United States nuclear utility training programs to the needs of a European utility are discussed. Following a review of the present situation and drawing up of a new training program, the management commitments in terms of personnel and finance must be considered. Short term, medium and long term programs are outlined. The long term objectives should include the establishment of a total training centre. This facility should be capable of providing all the training necessary to operate a power plant safely. This would include specific simulator training, classroom training for operators, technician training, staff training, management training etc. In addition to a simulator, it should include an emergency response facility to ...
This paper describes how a computerized MIS is used to assist HMO management to conduct utilization and quality of care review activities in a prepaid medical care network. The HMO is a ‘network’...Full Text Available
BackgroundExisting studies concerning the health care use of homeless people describe higher utilisation rates for hospital-based care and emergency care, and lower rates for primary...Full Text Available
BackgroundWe examined whether older adults who had continuity of care with a primary care physician (PCP) had lower mortality.MethodsSecondary analyses...Full Text Available
The Training Department at the Point Lepreau GS has been developing and improving its training for technical support staff. A generic set of objectives are being used as the basis for a systematic approach to training. The program covers general and job specific knowledge and skills using a mix of classroom instruction, mentoring and continuing training seminars. This paper describes experience, success and the challenges in the development, delivery and evaluation of the training program. (author)
Parenting programmes are effective interventions for preventing and treating conduct problems in young children. Up to 20% of children in disadvantaged areas have conduct disorder. Recent government initiatives such as targeting early years services to designated disadvantaged Flying Start areas in Wales have resulted in increased nursery-care provision for pre-schoolers, yet little has been done to equip nursery staff with effective child behaviour management strategies. The purpose of this non-randomised trial platform study was to establish the feasibility of delivery and the effectiveness of the new Incredible Years Toddler Parent Programme in supporting nursery staff in managing difficult behaviour in the nursery. The Parent Programme is a 12-session (a two-hour session/week) course for carers/parents of children aged one to three years old, which encourages carers to: establish positive relationships with children through play and child-centred activities; ...
For the recruitment, training and position qualification of the simulator instructors and feedback of training effect, the management approaches are formulated in 'The System for Simulator Training and Licensing Examination of Daya Bay Nuclear Power Station Operators'. The concrete requirements on the professional knowledge, work experience and foreign language ability of a simulator instructor are put forward. The process of instructor training is designed. The training items include the trainer training, pedagogy training, time management training, operation activities training during outage of unit, 'shadow' training and on-the-jot training on simulator courses. Job rotation is realized between simulator instructor and licensing personnel on site. New ...
Severe accident management can be defined as the use of existing and alternative resources, systems, and actions to prevent or mitigate a core-melt accident in nuclear power plants. TRAIN (Training pRogram for AMP In NPP), developed for training control room staff and the technical group, is introduced in this report. The TRAIN composes of phenomenological knowledge base (KB), accident sequence KB and accident management procedures with AM strategy control diagrams and information needs. This TRAIN might contribute to training them by obtaining phenomenological knowledge of severe accidents, understanding plant vulnerabilities, and solving problems under high stress. 24 refs., 76 figs., 102 tabs. (Author)
Objective: To explore the interventional method to treat biliary recurrent jaundice after T tube drainage in patients with malignant obstructive jaundice due to cholangiocarcinoma. Methods: 7 biliary metallic stents were placed in 7 patients with recurrent jaundice after T-tube drainage in cholangiocarcinoma cases. Results: Stent placement was once successful in all 7 cases with successful rate of 100%. For all cases, TBIL, ALT, GTP and AKP values 7 days postoperatively were significantly lower than that of preoperation together with subsidence of jaundice satisfactorily for 100% after the treatment. Conclusions: Percutaneous placement of biliary metallic stents was effective economic, minimal invasive and safe for palliation of biliary recurrent jaundice after T tube drainage in cholangiocarcinoma-induced obstructive jaundice
Background The Norwood procedure consists of three palliative operations, performed in neonates with hypoplastic left heart syndrome. Especially the first stage (Norwood I) is associated with the highest mortality rates in paediatric cardiac surgery (up to 25%). During surgery, the aorta is reconstructed and a systemic-to-pulmonary shunt is applied. Originally the modified Blalock-Taussig shunt was used, but recently the right-ventricle-to-pulmonary-artery shunt is increasingly being employed. We reviewed the results of our operative strategy, where an individualised choice of shunt is made. Furthermore, attempts to reduce interstage mortality (between Norwood I and II) were assessed. Methods All neonates who underwent Norwood stage I palliation from August 2004 until November 2010 were in...
The Northwest Foster Care Alumni Study examined the relation between experiences in foster care and depression among young adults who spent at least a year in foster care as adolescents. Results indicate that preparation for leaving foster care, nurturing supports from the foster family, school stability, access to tutoring, access to therapeutic service and support, and a shorter and more stable placement history were associated with a lower probability of depression in young adulthood. Results provide evidence that suggest ways to improve practice to decrease rates of depression among alumni of care. (Contains 2 tables.)
Purpose - The article discusses how care programmes and integrated care pathways can be linked, finding ways to improve healthcare process professional and logistical quality from a supply chain and a network point-of-view. Design/methodology/approach - The authors argue that owing to cost containment goals and increasing healthcare demand, healthcare services systems are challenged to improve service quality, whilst at the same time finding ways to improve delivery processes. It explores if the combination of two instruments, care programmes and integrated care pathways, can meet both goals. This combination is illustrated by an example from the Institute of Mental Health Care Eindhoven en de Kempen. Findings - Analysis suggests that care programmes can be combined with integrated care pa...
... 2010-10-01 false Training specific to locomotive engineers and other operating personnel. 236.1047 ...Control Systems § 236.1047 Training specific to locomotive engineers and other operating personnel. (a)...
This document establishes the minimum training requirements for the Plutonium Finishing Plant (PFP) personnel who are responsible for management of dangerous waste. The training plan outlines training requirements for handling of solid dangerous waste during generator accumulation and liquid dangerous waste during treatment and storage operations. The implementation of this training plan will ensure the PFP facility compliance with the training plan requirements of Dangerous Waste Regulation. Chapter 173-303-330. Washington Administrative Code (WAC). The requirements for such compliance is described in Section 11.0 of WHC-CM-7-5 Environmental Compliance Manual.
BackgroundDepression is a common illness, often treated in primary care. Many studies have reported undertreatment with antidepressants in primary care. Recently, some studies also...Full Text Available
BackgroundLittle is known about differences in professional care seeking based on marital status. The few existing studies show more professional care seeking among the divorced...Full Text Available
"Correctional Health Care: Implications for Public Health Policy" is the first in a series of articles that examines the special health care needs of persons who are incarcerated in America's correctional...Full Text Available
BackgroundUntil now only limited research has been done on the prevalence of chronic pain in primary care. The aim of this investigation was to study the health care utilisation...Full Text Available
Six patient assessment systems that have explicit decision rules for replicating team judgments on level of care patient placement were selected for analysis. The six were selected because of their...Full Text Available
BackgroundThe Emergency Care Summary (ECS) was introduced in 2006 to allow aspects of the general practitioner (GP; family doctor, equivalent to primary care physician) medical record...Full Text Available
partnerships led to the passage of a legislation creating a stormwater authority with Baldwin County, AL. The Coastal Training Program provides up-to-date scientific information...
Project methodology, analysis of the occupational and training situation, task analysis process, design process for a systematic training plan specific to the job position are described.
Different aspects of overall evaluation of training programmes and processes as well as role of evaluation in the quality assurance process are considered.
The conceptual basis for many effective language-training programs are based on Skinner's (1957) analysis of verbal behavior. Skinner described...Full Text Available
OBJECTIVES:To investigate the effect of opioid receptor blockade on the myocardial protection conferred by chronic exercise and to compare exercise training with different strategies...Full Text Available
OBJECTIVETo examine psychometric properties of the Confidence in Diabetes Self-Care (CIDS) scale, a newly developed instrument assessing diabetes-specific self-efficacy...Full Text Available
AbstractObjective: This study examined the effectiveness of a telephone-based referral-care management (TBR-CM) intervention on psychiatric health...Full Text Available
... Harbor Township Vineland Voorhees Pediatric Partner Hospitals AtlantiCare Regional Medical Center- City Campus, Atlantic City AtlantiCare Regional Medical Center - ...
OBJECTIVETo evaluate trends in costs of ambulatory care related to female pelvic floor disorders (PFD) in the United States.STUDY DESIGNFull Text Available
OBJECTIVE AND DESIGNThis study used qualitative and quantitative methods to examine the reasons primary care physicians and nurses offered for their inability to initiate guideline-concordant...Full Text Available
The current state and need for radiation protection training in Finland have been surveyed by the Radiation and Nuclear Safety Authority STUK. The survey sought to determine whether the current requirements for radiation protection training had been met, and to promote radiation protection training. Details of the scope and quality of present radiation protection training were requested from all educational institutes and organizations providing radiation protection training. The survey covered both basic and further training, special training of radiation safety officers, and supplementary training. The questionnaire was sent to 77 educational organization units, 66 per cent of which responded. Radiation workers and radiation safety officers were asked about radiation protection knowledge and needs for additional ...
As the nuclear world is changing, the non-proliferation and safeguard systems have to change along the global development. Nuclear security as well as safety must be involved in all phases. Thus, modernization of thinking is a must. State system of accounting for and control of nuclear material (SSAC) is a basis, but now it is time to move ahead. Safeguards is not any more only to verify the declared nuclear materials but it is to inform the international safeguards society transparently but confidentially about the nuclear fuel cycle related activities and trade, and to confirm that there are no undeclared activities related to the nuclear fuel cycle in the states. Only strong SSAC with enhanced capabilities, activities and rights can meet the demand. The proliferation of nuclear weapons is a threat that also urges cooperation at all levels. International, regional and state systems must work closely together, and there is need and space for everyone. State systems must step forward ...
(1) To determine the accuracy of computed tomography (CT) in the evaluation of ligament tear and avulsion in patients with tibial plateau fracture. (2) To evaluate whether the presence or severity of fracture gap and articular depression can predict meniscal injury. A fellowship-trained musculoskeletal radiologist retrospectively reviewed knee CT and MRI examinations of 41 consecutive patients presenting to a level 1 trauma center with tibial plateau fractures. Fracture gap, articular depression, ligament tear and footprint avulsions were assessed on CT examinations. The MRI studies were examined for osseous and soft tissue injuries, including meniscal tear, meniscal displacement, ligament tear, and ligament avulsion. CT demonstrated torn ligaments with 80% sensitivity and 98% specificity. Only 2% of ligaments deemed intact on careful CT evaluation had partial or complete tears on MRI. Although the degree of fracture gap and articular ...
This article is a case study of an Internet chat room outreach project in Perth, Western Australia. The CyberReach project sought to adapt current peer based health promotion outreach, training and supervision frameworks to an online outreach setting in a way that was effective and supported by the online community. It targeted marginalised groups to trial the provision of online mental and sexual health promotion incorporating a participatory action research model into its development and implementation. Three 6-week trial periods were conducted and significant changes were made in response to changes in the online environment and to improve sustainability and effectiveness of the protocols. Four themes arose from CyberReach's experience: online group processes are unique due to the creation of extensive personal networks and occurrence of disclosure without face-to-face contact across potentially large geographic barriers; flexibility is required to adapt to ...
To compare clinical effectiveness of Viabil-covered stents versus uncovered metallic Wallstents, for palliation of malignant jaundice due to extrahepatic cholangiocarcinoma, 60 patients were enrolled in a prospective and randomized study. In half of the patients a bare Wallstent was used, and in the other half a Viabil biliary stent. Patients were followed up until death. Primary patency, survival, complication rates, and mean cost were calculated in both groups. Stent dysfunction occurred in 9 (30%) patients in the bare stent group after a mean period of 133.1 days and in 4 (13.3%) patients in the covered stent group after a mean of 179.5 days. The incidence of stent dysfunction was significantly lower in the covered stent group (P = 0.046). Tumor ingrowth occurred exclusively in the bare stent group (P = 0.007). Median survival was 180.5 days for the Wallstent and 243.5 days for the Viabil group (P = 0.039). Complications and mean cost were similar in the two ...
The incidence of hepatocellular carcinoma (HCC) is increasing in developed countries and the general status of HCC patients is now by far better than a few years ago, allowing physicians to propose some different treatments of these patients. Among these treatments, intra-arterial injection of 131-iodine-labelled Lipiodol could be used in palliative, curative or adjuvant settings. After a brief summary of the modalities of this treatment, requiring the collaboration of Gastro-enterologists, Oncologists, Radiologists and Nuclear Medicine physicians, the different possibilities of therapeutic uses of this new approach are described and an outlook of these developments is proposed. (author)
Carcinoma en cuirasse of the breast, which invades the skin via lymphatics and may encase the entire thorax and abdomen, is poorly controlled by surgery, chemotherapy, or conventional irradiation. Palliation of patients with breast carcinoma en cuirasse is a difficult clinical problem which must be effectively managed over extended periods due to the indolent nature of this disease. The management of three cases is reported, and the new technique of rotational subtotal skin electron-beam therapy (SSEBT) is presented. (author).
Self-expanding metallic stent insertion has been widely applied for the palliative treatment of malignant esophageal strictures. Although it is known as an easy, safe, and effective procedure, complications are well known and include things such as stent migration and esophageal stent occlusion caused by tumor in growth. However, metallic stent fractures have been rarely reported in the esophagus, especially for nitinol stents. We report a case of a stent fracture associated with migration in a patient with a malignant esophageal stricture near the gastroesophageal junction. It is highly probable that the stent fracture was due to chemical erosion of the stent caused by gastric juice
The aim of this retrospective study was to determine the safety and efficacy of chemoembolization (TACE) as palliative treatment for patients with unresectable intrahepatic cholangiocarcinoma (CCA) and to compare the results with those in the literature. Fifteen patients with histology-proven CCA (5 men, 10 women) had received palliative treatment with TACE over a 6-year period. The treatment protocol comprised repeated TACE at a minimum of 8-week intervals. TACE was performed with a mixture of 10 ml Lipiodol and 10 mg mitomycin C injected into the tumor-supplying vessels. Follow-up investigations after 8-10 weeks comprised contrast-enhanced multislice spiral CT and laboratory control. Statistical evaluation included survival analysis using the Kaplan-Meier method. During the investigation period 58 TACEs (3.9 #+-# 3.8; 1-15) were performed in 15 patients. Mean tumor size was 10.8 #+-# 4.6 cm (range, 2.0-18.0 cm). Unifocal tumor disease was ...
To evaluate repeated hepatic intraarterial chemotherapy (HIC) as a palliative treatment option for unresectable cholangiocarcinoma and liver metastases of various origins that were progressive under systemic chemotherapy. Between 2002 and 2006, 55 patients were treated in 4-week intervals (mean five sessions). Combined gemcitabine/mitomycin was administered intraarterially within 1 h. Tumor response was evaluated after the third session according to RECIST. Treated tumor entities were colorectal carcinoma (CRC) (n = 12), breast cancer (BC) (n = 12), cholangiocarcinoma (CCC) (n = 10), pancreatic (n = 4), ovarian (n = 3), gastric, cervical, papillary (each n = 2), prostate, esophageal carcinoma, leiomyosarcoma (each n = 1), cancer of unknown primacy (CUP) (n = 5). All patients tolerated the treatment well without any major side effects or complications. In total, there were 1 complete response (CR), 19 partial responses (PR), 19 stable (SD) and 16 progressive ...
To evaluate the feasibility and clinical effectiveness of using a polyurethane-covered expandable nitinol stent in the palliative treatment of malignant duodenal obstruction. Under fluoroscopic guidance, a polyurethane-covered expandable nitinol stent was placed in 12 consecutive patients with malignant duodenal obstructions. All presented with severe nausea and recurrent vomiting. The underlying causes of obstruction were duodenal carcinoma (n=4), pancreatic carcinoma (n=4), gall bladder carcinoma (n=2), distal CBD carcinoma (n=1), and uterine cervical carcinoma (n=1). The sites of obstruction were part I (n=1), part II (n=8), and III (n=3). Due to pre-existing jaundice, eight patients with part II obstructions underwent biliary decompression prior to stent placement. An introducer sheath with a 6-mm outer diameter and stents 16 mm in diameter were employed, and to place the stent, and after-loading technique was used. Stent placement was technically successful in ...
Exercise training is known to induce an increase in free radical production potentially leading to enhanced muscle injury. Vitamins C and E are well known antioxidants that may prevent muscle cell damage....Full Text Available
... t.., tt:,tifv! th - cui,nt !shor tfal 1 in breaching capAbiii tN wi h i- 1!,-ia . ~ ... Before the 1967 war, the Israeli Training ... trained Arab opponents. ...
Separate groups of rats received 500 trials of lever-press training under autoshaping (food delivery followed 10-second lever presentations, or occurred immediately following a response); operant conditioning...Full Text Available
A report is made of operant conditoning procedures used in the determination of auditory, olfactory and visual acuity measures in the German Shepherd. An account is given of a procedure for semi-automatic training of dogs to search for, detect, and object...
Experience of the Westinghouse Water Reactors Division with indoctrination and training of quality engineers includes training of personnel from Westinghouse divisions in the USA and overseas as well as of customers' personnel. A written plan is prepared for each trainee in order to fit the training to the individual's needs, and to cover the full range of information and activities. The trainee is also given work assignments, working closely with experienced quality engineers. He may prepare inspection plans and audit check lists, assist in the preparation of QA training modules, write procedures, and perform supplier surveillance and data analyses, or make special studies of operating systems. The trainee attends seminars and special courses on work-related technical subjects. Throughout the training period, emphasis is placed on inculcating an attitude of team work in the trainee ...
Locomotive drivers in the steam engine era were exposed to asbestos during their vocational training for two years while training in workshops. Later in their career they had exposure to coal and diesel...Full Text Available
PurposeTo study informal skill transfer via staff networks as a complement to formal training among afterschool childcare providers implementing a health promotion...Full Text Available
BackgroundSeveral kinds of anti-oxidants have drawn a lot of intension for their benefits on vascular protection. In addition, it has been demonstrated that exercise training could...Full Text Available
Exercise-training might be a logical method to reverse muscle atrophy and weakness in patients treated with glucocorticoids. The purpose of the present investigation was to establish whether a treatment...Full Text Available
AimsTo determine the effect of exercise training on clinical events and health-related quality of life (HRQoL) of patients with systolic heart failure.Methods...Full Text Available
OBJECTIVES: The ability to maximally generate active muscle tension during resistance training has been established to be a primary determinant for strength development. The influence of intrasession...Full Text Available
Objective: The aim of this study was to investigate the impact of a program of repeated assessments, feedback, and training on the quality of coded clinical data in general practice.Design:...Full Text Available
BACKGROUNDPediatric transfusion medicine (PTM) is a subspecialty of transfusion medicine (TM) with no formal training program and few specialists. The Pediatric Transfusion...Full Text Available
... counseling, some training, and assure the general health and welfare of the command. ... publications, promotions, OERs/NCOER's (Officer Efficiency ...
... program incorporates the proven concepts of advanced distributed learning, modeling and simulation, and electronic digital libraries (Figure 1) to ...
The work reported included workshop-style, hands-on training sessions to reach three hundred residents of the Detroit area. The training was for teaching low-cost weatherization applications; teaching/constructing/installing thermal shades; and teaching/constructing/installing vertical wall solar air panels. All activities under the grant are summarized, including number and type of workshops, number of participants trained, etc. The organizations which actively supported and contributed to the program are identified, and the program's efforts and accomplishments are evaluated. (LEW)
The study examines the question of whether or not civilian marketing practices and principles can be applied in the military care setting. Using the NRMC Great Lakes as a basis, the answer is yes--consumers of military medical care are ready to be the rec...
The paper describes the possibilities of using data warehousing and OLAP technologies in public health care in general and then our own experience with these technologies gained during the implementation...Full Text Available
BackgroundMost studies on children with chronic fatigue syndrome (CFS)/myalgic encephalomyelitis (ME) have been undertaken in tertiary care and little is known about their management...Full Text Available
By analyzing the data of 459 patients who completed the Supportive Care Needs Survey (SCNS), the prevalence, medical and non-medical predictors of unmet needs were investigated. Breast cancer patients...Full Text Available
BackgroundInternationally, there is increasing use of telephone consultations, particularly for triaging requests for acute care. However, little is known about how this mode of...Full Text Available
BackgroundWith a growing number of genetic tests becoming available to the health and consumer markets, genetic health care providers in Canada are faced with the challenge of developing...Full Text Available
Objectives To evaluate the extent to which intensive care units participating in the initial Keystone ICU project sustained reductions in rates of catheter related bloodstream infections.Design...Full Text Available
Fresh blood has many potential advantages over older blood, but there is no evidence that these properties translate into clinical benefit for intensive care patients. The observational multicenter...Full Text Available
Digital information flow within the intensive care unit (ICU) continues to grow, with advances in technology and computational biology. Recent developments in the integration and archiving of these...Full Text Available
BackgroundNew Zealand's Primary Health Care Strategy (NZPHCS) was introduced in 2002. Its features are substantial increases in government funding delivered as capitation payments,...Full Text Available
Psychology as both a science and a profession has been closely identified with other disciplines in the broad field of health since the turn of the present century. Recent advances in health care have...Full Text Available
OBJECTIVES:To investigate the prevalence of potential drug interactions at the intensive care unit of a university hospital in Brazil and to analyze their clinical significance.METHODS:This...Full Text Available
The objective of this study was to evaluate the effect of pregabalin in painful cervical or lumbosacral radiculopathy treated in Primary Care settings under routine clinical practice. An observational,...Full Text Available
ObjectiveTo identify patient-care practices related to an increased prevalence of hepatitis C virus (HCV) infection among chronic hemodialysis patients.Full Text Available
The outcome of patients admitted to intensive care units is known to be influenced by such factors as age, previous health status, severity of disease, and diagnosis. To estimate the outcome of such...Full Text Available
ObjectiveTo report the outcome of children with life-threatening asthma (LTA) admitted to a university Pediatric Intensive Care Unit (PICU).MethodsRetrospective...Full Text Available
Background Little is known about how migrants adapt to first-world public health systems. In Norway, patients are assigned a registered general practitioner (RGP) to provide basic care...Full Text Available
This article explores the effects of reimbursement and utilization control policies on utilization patterns and spending for physician and hospital outpatient services under state Medicaid programs....Full Text Available
OBJECTIVE. This study was conducted to determine whether an index for measuring quality of care for psychiatric emergencies is reliable and valid. DATA SOURCES/STUDY SETTING. The study used primary...Full Text Available
OBJECTIVE: To examine primary care physicians' management of rheumatoid arthritis, ascertain the determinants of management and compare management with that recommended by a current practice panel....Full Text Available
This paper summarizes the findings for the African Region of the WPA Task Force on Steps, Obstacles and Mistakes to Avoid in the Implementation of Community Mental Health Care. We present an overview...Full Text Available
BackgroundIntegration of medical care across clinicians and settings could enhance the quality of care for patients. To date, there is limited data on the levels of integration in...Full Text Available
IntroductionThe aim of the study was to assess and classify incidents of electromagnetic interference (EMI) by second-generation and third-generation mobile phones on critical care...Full Text Available
Electronic personal health records (ePHRs) can potentially maximize access and coordination of health information and improve patient/clinician collaboration, patient self-management, and health outcomes....Full Text Available
BackgroundThe Government has invested £7 million (approx. $11.5 million) to connect all Primary Care Practices in Scotland to the National Health Service...Full Text Available
PURPOSE This study was designed to evaluate the impact of electronic medical record (EMR) implementation on quality of diabetes care.METHODS We conducted a 5-year longitudinal...Full Text Available
Objectives:Despite its impact on health policy, the relationship between geographical proximity and health care seeking has received scant attention in the medical literature. This...Full Text Available
OBJECTIVE--To review findings from studies of the influence of desktop computers on primary care consultations. DESIGN--Systematic review of world reports from 1984 to 1994. SETTING--The computerised...Full Text Available
Emergency Departments (ED) are fast-paced, information-intensive environments where patient care team members must address their information needs quickly and accurately. We conducted a qualitative...Full Text Available
The method of linear analogue self-assessment (LASA) was used to quantify the views concerning day care which were held by patients attending a geriatric day hospital. The results suggest that day hospitals...Full Text Available
ObjectivesTo assess Croatian community pharmacists' patient care competencies using the General Level Framework (GLF).MethodsThe competencies of...Full Text Available
PURPOSE We wanted to assess computer capabilities in a primary care practice-based research network and to understand how receptive the practices were to new ideas for automation of practice...Full Text Available
Quality research, requiring large numbers of participants, in the intensive care unit (ICU) population requires multicentre collaboration. Although logistically challenging, this methodology reduces...Full Text Available
BACKGROUND. Diabetes can be effectively treated and monitored in general practice. Postgraduate medical education at a local level is required to support this strategic shift of medical care from hospital...Full Text Available
Despite an accumulating body of literature addressing racial/ethnic disparities in children’s health and health care, there have been few published studies of interventions that have...Full Text Available
Will the aging of Canada's population bankrupt the health care system? In this issue (see pages 1555 to 1560) Dr. Marie Demers reports that the increase in physician service costs for elderly people...Full Text Available
PURPOSE The Wells rule is widely used for clinical assessment of patients with suspected deep vein thrombosis (DVT), especially in the secondary care setting. Recently a new clinical decision...Full Text Available
BackgroundThe Canadian Emergency Department Triage and Acuity Scale (CTAS) is a well recognized and validated triage system that prioritizes patient care by severity of illness....Full Text Available
Patients do considerable information work. Technologies that help patients manage health information so they can play active roles in their health-care, such as personal health records, provide...Full Text Available
Very few areas of medical science have experienced more rapid development of new and beneficial treatment approaches during the past two decades than the disciplines required for total care of patients...Full Text Available
This article compared conceptual and empirical strengths of alternative methods for estimating racial disparities using non-linear models of health care access. Three methods were presented...Full Text Available
ObjectiveTo estimate the joint effect of a multifaceted access intervention on primary care physician (PCP) productivity in a large, integrated prepaid group practice.Data...Full Text Available
OBJECTIVE: To increase cost-efficiency while maintaining the standard of medical care, an accelerated surgical stay program for patients having breast surgery was instituted. SUMMARY BACKGROUND DATA:...Full Text Available
...dates of the implementation of the standard unique health identifier for health care providers. 162.404 Section 162.404 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES ADMINISTRATIVE DATA...
Performance and hormones were determined in eight middle- and nine long-distance runners after an increase in training volume (ITV, February 1989) or intensity (ITI, February 1990). Seven runners participated...Full Text Available
The primary objectives of this study were to test two utility analysis models, the Cascio-Ramos Estimate of Performance in Dollars (CREPID) model and Godkewitsch financial utility analysis model and to determine their appropriateness as tools for evaluating training. This study was conducted in conjunction with Philadelphia Electric Company's Nuclear Training Group. Job performance of nuclear maintenance workers was assessed to document the impact of the training program. Assessment of job performance covered six job performance themes. Additionally, front-line nuclear maintenance supervisors were interviewed to determine their perceptions of the nuclear maintenance training. A comparison of supervisor's perceptions and outcomes of the utility analysis models was made to determine the appropriateness of utility analysis as quantitative tools for evaluating the nuclear maintenance ...
This conference brought together those persons in the nuclear industry who have a vital interest in the training and licensing of nuclear reactor and nuclear fuel processing plant operators, senior operators, and support personnel for the purpose of an exchange of ideas and information related to the various aspects of training, retraining, examination, and licensing. The document contains 64 papers; each paper was abstracted for the data.
A generic insensitive fuze train to initiate insensitive high explosives, such as PBXW-124. The insensitive fuze train uses a slapper foil to initiate sub-gram quantities of an explosive, such as HNS-IV or PETN. This small amount of explosive drives a larger metal slapper onto a booster charge of an insensitive explosive, such as UF-TATB. The booster charge initiates a larger charge of an explosive, such as LX-17, which in turn, initiates the insensitive high explosive, such as PBXW-124.
Free-electron-laser (FEL) oscillators require a train of high-brightness bunches. Conventional subharmonic bunchers are currently used with rf linacs to generate pulse trains, but the resulting dilution of the transverse phase space and lower beam brightness are unacceptable for high-performance FELs. Recent developments suggest that photoemitters of high quantum efficiency combined with rapid acceleration can produce pulse trains of higher brightness than has been achieved before.
...DEPARTMENT OF THE ARMY MILITARY RESERVATIONS AND...REGULATIONS AFFECTING MILITARY RESERVATIONS ...or guide service, dog training for reimbursement...non-profit organizations working in the public...profit, including dog training for reimbursement...non-profit organizations working in the public...
... Title : Mental Health and Resilience: Soldiers' Perceptions about Psychotherapy, Medications, and Barriers to Care in the United States Military. ...
The spectrum of training aids used in the nuclear industry runs the gamut from the very basic (i.e., valve training aids - gate, globe, check) to the highly complex (i.e., nuclear full scope simulator). Designing and purchasing the best training aids take much time, detailed investigation, and good understanding of plant operations. The training aid that has given the New York Power Authority the best results has been the motor operator valve (MOV) trainer. Some of the items that make the MOV trainer a good choice are: (1) large number of MOVs in the plant, (2) importance of MOVs to safe plant operation, (3) detailed MOV procedures used by the plant, (4) history of MOV problems, and (5) ability to demonstrate important concepts and operation - hammer blow effect, torque and limit switch adjustment and functions, and actual sequence of operation of the limitorque valve operator.
An artificial neural network (ANN), trained as an inverse of the controlled plant, to function as a power system stabilizer (PSS) is presented in this paper. In order to make the proposed ANN PSS work properly, it was trained over the full working range of the generating unit with a large variety of disturbances. Data used to train the ANN PSS consists of the control input and the synchronous machine response with an adaptive PSS (APSS) controlling the generator. During training, the ANN was required to memorize the reverse input/output mapping of the synchronous machine. After the training, the output of the synchronous machine was applied as the input of the ANN PSS and the output of the ANN PSS was used as the control signal. Simulation results show that the proposed ANN PSS can provide good damping of the power system over a wide operating range and significantly improve the ...
Exercise training associated with robust conditioning can be useful for the study of molecular mechanisms underlying exercise-induced cardiac hypertrophy. A swimming apparatus is described to control training regimens in terms of duration, load, and frequency of exercise. Mice were submitted to 60- vs 90-min session/day, once vs twice a day, with 2 or 4% of the weight of the mouse or no workload attached to the tail, for 4 vs 6 weeks of exercise training. Blood pressure was unchanged in all groups while resting heart rate decreased in the trained groups (8-18%). Skeletal muscle citrate synthase activity, measured spectrophotometrically, increased (45-58%) only as a result of duration and frequency-controlled exercise training, indicating that endurance conditioning was obtained. In groups which received duration and endurance conditioning, cardiac weight (14-25%) and myocyte ...
Abstract An increase in chronic disease prevalence is contributing to health care cost growth and decreased quality of life in industrialized nations worldwide. Inadequate management of chronic diseases is a leading cause of hospitalizations and, thus, avoidable expenditures. In this study, we evaluated the impact of nurse-delivered care calls, the primary intervention of a proactive chronic care management (CCM) program, in a population aged 65 and older in Germany. In this analysis, hospital admission rates were evaluated among program enrollees who were diagnosed with diabetes, heart failure, coronary heart disease, or chronic obstructive pulmonary disease. The Intervention group comprised those members who participated in care calls (n?=?13,486), whereas the Comparison group included e...
The key to the future for electric utilities will not be found in legislation or regulation. Title VII of the Energy Policy Act of 1992 will prove to be just as ineffectual in improving the industry's position as was the Public Utility Regulatory Policies Act of 1978. These legislative palliatives, which produced so much commotion and so many reams of heated commentary, are largely irrelevant to a successful future for electric utilities. The key will be found in economics, not in law, and the future will lie in completing Thomas A. Edison's century-old vision for the industry, half of which the industry has heretofore ignored. The industry must embrace the complete vision and evolve from electric utilities into [open quotes]end-use energy utilities.[close quotes
The incidence of hilar cholangiocarcinoma is very rare worldwide. Radical resection is the only prognostic factor for long survival in patients with hilar cholangiocarcinoma. Postoperative radiation therapy can improve local control and survival rates for patients with palliative resection, but it remains controversial in patients with radical resection. Biliary drainage can effectively release bile duct obstruction for the majority of patients with locally advanced disease, and may even prolong survival when combined with radiation therapy. Radiation therapy includes extrernal beam therapy alone, external beam therapy with intraluminal brachytheapy and new radiation technique, such as three dimentional conformal therapy and intensity modulated radiation therapy. The propective randomized clinical study is needed for further investigation in the role of combined modality therapy especially for hilar cholangiocarcinoma. (authors)
Objective To report the clinical response to image-guided percutaneous cryotherapy (IPC) for the palliative management of localized metastases in patients with gynecologic malignancies. Methods Institutional review board approval and patient consent were obtained. Gynecologic oncology patients were identified from our institution's cryotherapy database from August 2003 to August 2007. Cryotherapy was performed with 2.4?mm diameter probes (Endocare, Irvine, CA) with ultrasound or computerized tomography (CT) guidance under conscious sedation and local anesthesia. Follow-up was conducted by imaging studies and clinical encounters, using Response Evaluation Criteria in Solid Tumors (RECIST criteria). Results Twenty-eight ablation sessions were performed for 41 metastatic foci in 15 patients w...
The paper discusses a number of recent studies investigating into the energy conservation and environmental impacts of electric heating systems (off-peak storage systems). In future, i.e. in and after 1993, off-peak storage systems will be evaluated through comparative analyses of oil-fired heating systems, pollutant emission analyses, the eventual success of pollution abatement measures designed for power plant emissions to keep within the legal limiting values, and the possible abandonment of pollution abatement measures abroad. Opposing the electric heating studies submitted by the electric power industry the author refutes their favourable results referring to the palliative selection of inadequate or vague parameters. Assuming average power plant pollutant emissions of 180 mg/standard/sup 3/ the nitrogen oxide emissions of oil-fired heating systems (134.1 kg/Tj) are found to be below those of off-peak storage systems (242.5 kg/Tj).
A 21-year-old woman developed midesophageal stricture two weeks after ingestion of aluminium phosphide (AlP) tablets. Aluminium phosphide is a lethal protoplasmic toxin and is also the most common cause of suicidal poisoning in northern India. Upper gastrointestinal endoscopy (UGIE) showed a tight esophageal stricture 29?cm from the incisors with a circumferential ulcer. Dilatation up to 17?mm was done using Savary-Gilliard dilators. She had repeated dilatations three times at nearly two-week intervals. In view of the resistant stricture, a silicone Polyflex stent was placed across the stricture and removed after 3?months; there was no recurrence of stricture even after three months of follow-up. Patients with recurrent esophageal stricture and those with fistula may benefit from silicone ...
The effect of 10 wk endurance swim training on 3-O-methylglucose (3-MG) uptake (at 40 mM 3-MG) in skeletal muscle was studied in the perfused rat hindquarter. Training resulted in an increase of approximately 33% for maximum insulin-stimulated 3-MG transport in fast-twitch red fibers and an increase of approximately 33% for contraction-stimulated transport in slow-twitch red fibers compared with nonexercised sedentary muscle. A fully additive effect of insulin and contractions was observed both in trained and untrained muscle. Compared with transport in control rats subjected to an almost exhaustive single exercise session the day before experiment both maximum insulin- and contraction-stimulated transport rates were increased in all muscle types in trained rats. Accordingly, the increased glucose transport capacity in trained muscle was not due to a residual effect of the last ...
We wanted to determine the technical and clinical efficacy of using a PTFE-covered self-expandable nitinol stent for the palliative treatment of malignant biliary obstruction. Thirty-seven patients with common bile duct strictures caused by malignant disease were treated by placing a total of 37 nitinol PTFE stents. These stents were covered with PTFE with the exception of the last 5 mm at each end; the stent had an unconstrained diameter of 10 mm and a total length of 50 80 mm. The patient survival rate and stent patency rate were calculated by performing Kaplan-Meier survival analysis. The bilirubin, serum amylase and lipase levels before and after stent placement were measured and then compared using a Wilcoxon signed-rank test. The average follow-up duration was 27.9 weeks (range: 2 81 weeks). Placement was successful in all cases. Seventy-six percent of the patients (28/37) experienced adequate palliative drainage for the remainder of ...
We wanted to determine the technical and clinical efficacy of placing a self-expandable PTFE-covered nitinol stent for the management of inoperable malignant biliary obstruction. Thirty six patients with inoperable malignant biliary obstructions were treated by placement of self-expandable PTFE-covered nitinol stents (S and G Biotech Corporation, Seongnam, Korea). Clinical evaluation was done with assessment of the serum bilirubin and alkaline phosphatase levels, which were measured before and after stent placement within 1 week, at 1 month and at 3 months. The patient survival rate and stent patency rate were calculated with performing Kaplan-Meier survival analysis. Successful stent placement was achieved in all the patients without procedure-related complication. Pancreatitis as an early complication occurred in two cases. The serum bilirubin and alkaline phosphatase levels were significantly decreased after the procedure. During the follow-up, recurrent obstructive jaundice ...
Inferior vena cava (IVC) obstruction is a well-described clinical entity. Most IVC obstructions from malignant neoplasms are a direct result of tumor compression [Oviedo J, Cerda S. Vascular invasion by hepatocellular carcinoma. Arch Pathol Lab Med 2001;125: 454-5; Furui S, Sawada S, et al. Gianturco stent placement in malignant caval obstruction: analysis of factors for predicting the outcome. Radiology 1995;195:147-52; Fletcher WS, Lakin PC, et al. Results of treatment of inferior vena cava syndrome with expandable metallic stents. Arch Surg 1998;133:935-8]. The symptoms of IVC obstruction include progressive ascites, scrotal edema and lower body edema. These constellations of symptoms are described as IVC syndrome and are devastating to a patient with end-stage cancer. We describe a palliative therapy utilizing Luminexx nitinol self-expanding stents to treat intracaval hepatoma thrombus obstructing the IVC. The procedure is rapidly performed, technically ...
We wanted to evaluate the long-term results of a dual expandable nitinol stent for the palliative treatment of malignant gastroduodenal strictures. The dual stent consists of two stents; an outer partially nylon covered stent and an inner bare nitinol stent. The outer stent was placed into the stricture and this was followed by coaxial placement of the inner bare stent. Using fluoroscopic guidance, dual expandable stents were placed in 86 patients with inoperable malignant gastroduodenal strictures. The technical and clinical success, the complication, survival and the stent patency were evaluated during the follow-up period. Stent placement was technically successful in 83 of the 86 patients. After stent placement, 74 of the 85 patients showed improvement of their symptoms. During the mean follow-up period of 133 days, 24 patients (28%) developed recurrent symptoms due to incomplete expansion (n=1), stent migration (n=4), food impaction (n=2), granulation tissue ...
Two US DOE projects in the Pacific Northwest offer unique on-the-scene training opportunities at sodium-cooled fast-reactor plants: the Fast Flux Test Facility (FFTF) near Richland, Washington, which has operated successfully in a wide range of irradiation test programs since 1980; and the Experimental Breeder Reactor II (EBR-II) near Idaho Falls, Idaho, which has been in operation for approximately 20 years. Training programs have been especially designed to take advantage of this plant experience. Available courses are described.
At the importance increase of UT (ultrasonic testing) with the application of rules on fitness-for-service for nuclear power plants, JAPEIC (Japan power engineering and inspection corporation) started education training for defect detection and sizing technique. Weld joints specimen with EDM (Electro-Discharged Machining) notches, fatigue cracks and intergranular stress corrosion cracks were tested and practiced repeatedly based on a modified ultrasonic method and the defect size measuring accuracy of the trainees was surely improved. Results of the blind test confirmed effectiveness of education training. (T. Tanaka)
A novel way to extract relevant parameters associated with the outgoing ions from nuclear reactions, obtained by digitizing the signals provided by a Bragg curve spectrometer (BCS) is presented. This allowed the implementation of a more thorough pulse-shape analysis. Due to the complexity of this task, it was required to take advantage of new and more powerful computational paradigms. This was fulfilled using a back-propagation artificial neural network (ANN) as a pattern identifier. Over training of ANNs is a common problem during the training stage. In the performance of the ANN there is a compromise between its size and the size of the training set. Here, this effect will be illustrated in relation to the problem of Bragg Curve (BC) identification. (Author)
This paper deals with an artificial neural network (ANN) based adaptive conventional power system stabilizer (PSS). The ANN comprises an input layer, a hidden layer and an output layer. The input vector to the ANN comprises real power (P) and reactive power (Q), while the output vector comprises optimum PSS parameters. A systematic approach for generating training set covering wide range of operating conditions, is presented. The ANN has been trained using back-propagation training algorithm. Investigations reveal that the dynamic performance of ANN based adaptive conventional PSS is quite insensitive to wide variations in loading conditions.
AbstractOBJECTIVETo provide an overview of the 2009 edition of the Rourke Baby Record (RBR), which incorporates recent research in the literature relating to preventive health care for children aged 0 to 5 years.QUALITY OF EVIDENCERecommendations are identified as supported by good, fair, or consensus evidence, according to the classification of the Canadian Task Force on Preventive Health Care.MAIN MESSAGENew information and recommendations are given for growth monitoring, nutrition, developmental surveillance, physical examination maneuvers, immunization schedules, and advice for parents. Anticipatory guidance updates relate to injury prevention, infant swaddling, literacy facilitation, nonparental child care, parenting skills programs, serum lead levels, over-the-counter cough and cold medications, pacifiers, antipyretics, insect repellents, and dental care and oral health. The 2009 RBR is available ...
The health politics and policy communities are still struggling with the question of "what went wrong" in the 1993-94 health care reform effort. Here I identify which Americans were politically active and inactive during the health care reform debate to explore the role political participation may have had in determining the outcome of the debate. Using data from a national and California random-sample telephone surveys, and controlling for other demographic attributes, I found that those who engaged in political activity specifically related to health care reform were disproportionately more likely to be self-identified conservatives, less likely to favor an employer mandate plan, more likely to be fifty to sixty-four years old, more likely to be men, and more likely to have greater interest in and knowledge of the health care issue. Even in California, where a single-payer proposal was on the November ...
... 7th Joint Task Force Augmentation Team Schwetzingen ... Headquarters 85th Division Training Support, Detach 2 ... 20th Special Forces Company A ...
Recent studies have shown that there is a wide variety of approaches to education and training of the Qualified Expert across the European Union. National education and training programmes show often large differences in content, duration, level, the introduction of practical work, etc. As they stand, such differences are a barrier to the mutual recognition of the Qualified Expert status and, in part, are contributing to a perceived shortage in expertise in radiation protection and safety. The overall aim of ENETRAP is to determine mechanisms that in the longer term will facilitate better integration of education and training activities (with a view to mutual recognition across the European Union) and to ensure the ongoing provision of the necessary competence and expertise at the level of the Qualified Expert. The ENETRAP project is a 6FP coordination action. It started in April 2005 and runs over a period of 24 months. ...
Nat'l Training Center Contact Us Directory Email Us BLM > Socioeconomic Impacts > Timber Print Page Socioeconomic Impacts from Timber BLM-administered lands yielded $337...
Background:To encourage evidence-based practice, an Annals of Internal Medicine editorial called for a new professional on clinical teams: an informationist trained...Full Text Available
This article discusses issues in teaching secure coding in the context of both academic institutions and training organizations. The emphasis is on the importance of assurance. There is also some discussion of the role of checklists.
Objectives: To evaluate the training of pharmacists in Accra, Ghana, in the syndromic management of STIs. Methods: We randomly selected 50 pharmacy outlets that had...Full Text Available
The effect of exercise training prior to acute myocardial infarction (AMI) on left ventricular (LV) remodeling is poorly understood. This study investigated the protective effect of 3 weeks of swimming exercise training prior to AMI on cardiac morphology and function. Male Sprague-Dawley rats (n = 35) were randomly assigned to 3 groups: swimming training (n = 14, 90 min, 5 days/wk, 3 wk), sedentary (n =14), and controls (n = 7, no exercise, no MI). At the end of the training/sedentary period, rats were subjected to AMI (ExMI and SedMI) induced by surgical ligation of the left coronary artery. Thereafter, the rats remained sedentary for a 4-wk recovery period. Trans-thoracic echocardiography was performed in each group at the end of the exercise/sedentary period (pre-AMI), 24 hr after AMI, and following recovery (4 wk after AMI). No differences were observed in LV dimensions and function pre-AMI among ...
... Developed from federally funded research, testing and training programs ... al-Qa'ida's closest ally Tehrik-e-Taliban Pakistan's (or TTP's) attempt to ...
Two third-grade Taiwanese students at risk for emotional and behavioral disorders participated in a pull-out, small-group social skills training program developed to promote their skill acquisition and maintenance. Using a multiple baseline across skills design, the authors demonstrated that both participants made marked performance improvement in all three targeted social skills of on-task, appropriate conflict resolution, and cooperation during the intervention condition. Maintenance and follow-up data showed that both participants sustained their use of taught social skills in the training setting and their third-grade classroom, respectively. Social validity measures, including peer sociometric ratings and consumer satisfaction questionnaires and interviews, supported the positive effects of the social skills training program for both participants. Implications for research and practice are discussed. (Contains 2 tables ...
Unlike the conventional automotive, modem railway trains are designed with non-openable windows; and a mechanical ventilation and air-conditioning (MVAC) system is installed in each train compartment for better indoor air quality as well as to provide a thermally comfortable environment. The ventilation rate is no doubt a critical element in the design of a MVAC system, especially in Hong Kong where the daily passenger load is extremely heavy. Earlier studies illustrated that carbon dioxide can be controlled at 1000 ppm by increasing the ventilation rate to 25.2 m{sup 3} h{sup -1}; however, it will also lead to an increase in energy consumption. In this paper, the electrical energy consumption at various ventilation rates was studied, and the cost of maintaining a low carbon dioxide level was estimated These provide solid information for the local railway companies to improve the air quality inside the train compartments. ...
Typing Workshop": [Introductions] [Intro, DNA Basics, and Historical Perspective] [DNA Extraction] [Validation and QA/QC] [DNA Quantitation] [PCR Amplification] [STR Loci and Kits]...
Provisions (a) NPDES field personnel shall be currently trained and certified in CPR and basic first-aid procedures. (b) NPDES field personnel shall be aware of the...
... The study cohort consisted of 2,123 military working dogs that were ... maintained at the Department of Defense Military Working Dog Training Center ...
... Air Station, Oahu, Kahuku Training Area ... K-Pier, Hawaii, Bradshaw Army Airfield, Hawaii (R&S ... impact area); Makua Military Reservation, Oahu (R&S ...
Jun 30, 2003 ... He graduated from training with top honors and served as a parachute rigger and paratrooper for the 82nd airborne division at Fort Bragg, ...
This paper presents a dynamic displacement influence line method for moving load identification on bridge. The finite element model of Poyang Lake continuous truss bridge-train systems is established and the dispersed modal shapes are acquired by modal analysis. Multi-axle moving train loads are identified with simulated annealing genetic algorithm by minimizing the errors between the measured displacements and the reconstructed displacements from the identified moving loads. In the identification process, the dynamic displacement influence line technique is used to calculate the time history displacement responses of the bridge to avoid solving equations of motion of the bridge repetitively. Several important parameters of the bridge-train system are discussed to investigate their effects...
Explore security settings for home equipment, learn how to browse safely and securely, and keep your computer up to date and secure. Explore different account ...
This is a presentation on Human Factors in reactor operations. It discusses issues that deal with power plant operations, training and design, operational effectiveness and safety, supporting people to achieve effective and error free performance.
Improving employees' posture may decrease the risk of musculoskeletal disorders. The current paper is a systematic replication and extension of Sigurdsson...Full Text Available
Abstract During the past few years, laparoscopy has become the gold standard for some surgical procedures and its applications continue to expand. Because of multiple factors such as loss of tactile perception, two-dimensional visualization of the three-dimensional surgical field, and demanding bimanual hand-eye coordination, special training is required to achieve proficiency with laparoscopy. In this study, as the first step toward evidence-based development of strategies to improve the quality of laparoscopy training from brain activity and behavior relationships, a laparoscopy training simulator was developed for use in functional MRI. Experiments confirmed the functional MRI compatibility of the device. Representative behavioral and functional MRI results for two subjects showed the f...
... 2. Help women become accepted by providing job-related training, creating flexible work groups with good climates, and encourage supervisors to ...
... Ready-to-Eat (MRE) VIII operational ration was evaluated at a field training exercise (Market Square II) with troops of the 82nd Airborne Division. ...
... the more the populace backs the TTP or, at ... the FATA, which does not wholly belong to Pakistan. ... While Congress authorizes and funds SA and the ...
Cardiopulmonary resuscitation - adult; Rescue breathing and chest compressions - adult; Resuscitation - cardiopulmonary - adult ... CPR can be lifesaving, but it is best performed by those who have been trained in an ...
Curriculums The Epilepsy Foundation, in partnership with CDC, is conducting a national education and outreach program to educate and train law enforcement officers, police...
Malignancies Breast Malignancies Bladder, Prostate, and Testicular Malignancies Uses of Cancer Registry Data Brain Tumor Reporting Training Materials Overview Presentation and...
Malignancies Breast Malignancies Bladder, Prostate, and Testicular Malignancies Uses of Cancer Registry Data Brain Tumor Reporting Training Materials Overview Presentation and...
Malignancies Breast Malignancies Bladder, Prostate, and Testicular Malignancies Uses of Cancer Registry Data Brain Tumor Reporting Training Materials Overview Presentation and...
... proficiency, most Army personnel must shoot to the same standards required of ... Wild- flecken was to provide this standard range, but its scores ... I3a I] ...
Training of health professionals commonly involves multiple sites in order to best utilize the available clinical material. However, this makes it difficult to achieve continuity in the presentation...Full Text Available
...QUALIFICATION AND CERTIFICATION OF LOCOMOTIVE ENGINEERS Implementation of the Certification...operations and certifies locomotive engineers from a different railroad...designated supervisor of locomotive engineers or a certified train...
The objectives of this paper are to: quickly outline the extent of the care gap in osteoporosis; define T-2 (knowledge) translation and its relationship to quality improvement; discuss the barriers to best practice in osteoporosis care after a fracture; convey the importance of rigor in design and evaluation of translational interventions by drawing upon examples from the broader literature; describe in some detail a series of post-fracture intervention trials conducted in Alberta, Canada; and make some conclusions specifically about osteoporosis interventions and more generally about T-2 translational research.
... Ashton WS, Puntel RA, Wiswell TE. A rapid and readily available repair of the peripherally inserted central catheter in the nursery. NEONATAL INTENSIVE CARE 11 ...
Patients rely on their primary care physician to manage multiple, often chronic medical conditions that require prescription medications. Balancing the risk to benefit of treatments can be challenging...Full Text Available
During an outbreak of Flavobacterium meningosepticum septicaemia in a neonatal intensive care unit 9 infants were treated with intravenous trimethoprim sulphamethoxazole. Bacteriological cure was achieved...Full Text Available
A questionnaire on the development of specialist clinics was distributed to the members of the Association of British Neurologists and completed by 104 members (85 consultants). Half of the respondents...Full Text Available
ERDMANN A.L., DE ANDRADE S.R., FERREIRA DE MELLO A.L., KLOCK P., DO NASCIMENTO K.C., SANTOS KOERICH M. & STEIN BACKES D. (2011) Practices for caring in nursing: Brazilian research groups. International Nursing Review58, 379-385 Background:- The present study considers the production of knowledge and the interactions in the environment of research and their relationships in the system of caring in nursing and health. Aim:- To elaborate a theoretical model of the organization of the practices used for caring, based on the experiences made by the research groups of administration and management in nursing, in Brazil. Methods:- The study is based on grounded theory. Twelve leaders of research groups, working as professors in public universities in the south and the south-east of Brazil, distri...
Sepsis has continuously been a leading cause of neonatal morbidity and mortality despite current advances in chemotherapy and patient intensive care facilities. Neonates are at high risk for...Full Text Available
BackgroundAs long-term nursing home care is likely to increase with the aging of the population, identifying chronic medical conditions is of particular interest. Although need factors...Full Text Available
A Health Care Establishment (HCE) is an establishment where medical services are rendered. The above services are provided by the health care personnel. The infrastructure of a HCE may include Information Technology (IT) equipment that stores and processes HC information. Previously, IT equipment consisted solely of stand-alone systems, whereas in recent years, the trend has been towards computer networks and distributed systems in HCEs. The spread of distributed information technology in HCEs have necessitated the implementation of Security in HCISs, to assure confidentiality, integrity and availability of HCE information. This paper discusses the issues of Security and Network Security in Health Care Information Systems (HCISs). It also suggests a method in establishing Network Security Guidelines and describes Principles for the provision of Network Security in HCEs. PMID:10163736
... 82 Ibid, 200. 83 Ibid, 200. 84 Ibid, 201. 43 Page 49. care to hunt down and execute all that claimed to be from the house of David. They considered ...
A Health Care Establishment (HCE) is an establishment where medical services are rendered. These services are provided by the health care personnel. The infrastructure of a HCE may include Information Technology (IT) equipment that stores and processes HC information. The spread of distributed information technology in HCEs have necessitated the implementation of Network Security in Health Care Information System (HCISs), to assure confidentiality, integrity and availability of HC information being transmitted across HC networks. This paper presents a road map in implementing Network Security guidelines for the provision of Network Security in HCEs, work carried out within the Secure Environment for Information Systems in Medicine (SEISMED) project under the Advanced Informatics in Medicine (AIM) programme. PMID:8591295
... dressing changes and site care, mid-line placement, placement of peripherally inserted central catheters, heparin locks, and patient education. ...
PurposeHealth information technology (HIT) and physician career satisfaction are associated with higher-quality medical care. However, the link between HIT and physician...Full Text Available
The economics of medical computer networks are presented in context with the patient care and administrative goals of medical networks. Design alternatives and network topologies are discussed with...Full Text Available
Summary Objective To evaluate the cost-effectiveness of an educational outreach intervention to improve primary respiratory care by South African nurses. Methods Cost-effectiveness analysis alongside a pragmatic cluster randomised controlled trial, with individual patient data. The intervention, the Practical Approach to Lung Health in South Africa (PALSA), comprised educational outreach based on syndromic clinical practice guidelines for tuberculosis, asthma, chronic obstructive pulmonary disease, pneumonia and other respiratory diseases. The study included 1999 patients aged 15 or over with cough or difficult breathing, attending 40 primary care clinics staffed by nurses in the Free State province. They were interviewed at first presentation, and 1856 (93%) were interviewed 3 months late...
BackgroundAlthough advances in rehydration therapy have made cholera a treatable disease with low case-fatality in settings with appropriate medical care, cholera continues...Full Text Available
In contrast to the increasing availability of information pertaining to the care of children with chronic kidney disease (CKD) from large-scale observational and interventional studies, epidemiological...Full Text Available
Brief admission of the new diabetic child and of a parent to an enlightened hospital for stabilisation, preliminary education, and familiarisation with hospital and community staff is well worth while....Full Text Available
Background Increasing numbers of cancer patients are using the Internet, but little is known about their attitudes toward online health care.Full Text Available
of injuries, disabilities, and deaths; and 3. Encourage professionals from a wide spectrum of disciplines such as engineering, bioengineering, medicine, health care, public...
This bibliography of nonserial publications consists of 610 annotations. It is intended as a guide to the development of a collection for librarians and for health professionals in research and education....Full Text Available
OBJECTIVE: To evaluate the effectiveness of a program to improve hypertension control practices in primary care. DESIGN: Retrospective quasi-experimental study. SETTING: Three hospital-based family...Full Text Available
Nuclear knowledge is the basis for almost all nuclear activities, and education and training are the most fundamental means to transfer knowledge from one generation to the next. Understanding means and trends in knowledge transfer through education and training thus deserves a closer examination. In the past years, a number of trends and questions in nuclear knowledge, education and training have emerged. With declining student enrolment numbers and a general stagnation of the use of nuclear power in some of the IAEA's Member States, the issue of a slow erosion of the knowledge base and the possibility of loosing knowledge has become increasingly important, in particular if seen against the background of a possible renaissance of nuclear power in the future. In other Member States, an expansion of nuclear power is expected, with a corresponding need for human resources. As a result, in many Member States education and ...
σ-Receptor (σR) antagonists have been reported to block certain effects of psychostimulant drugs. The present study examined the effects of σR ligands in rats trained to self-administer...Full Text Available
Japan`s coke industry was developed as the basic part for iron and steel industry. The paper addresses two factors as a characteristic of Japan-unique management. One topic is operation management and equipment management of coke factory; the second topic is human resource training in a company that lies under each management. The concepts and actual methods of these topics are introduced by showing examples. The paper discusses the improvement of the working environment and measures for future employment caused by the aging problem in Japan. 5 figs.
...who trains at the University, lines up in the pole vault alongside Steve Lewis in the men's competition, who also trains at the Loughborough High performance Athletics Centre. Loughborough alumni Victoria Barr, Hayley Jones, Lee McConnell and Kim Wall are all in the British women's 4x400m relay ...
United States Air Force security forces have a central role in force protection. Their missions include military police services, installation security, air base defense, military working dog functions, and combat arms training and maintenance. Surveys in...
The method of life-cycle assessment (LCA) has been applied to cars with different power trains. As an example, the results for greenhouse gas (GHG) emissions are presented. They show possibilities and limits for the reduction of these emissions in the transportation sector by means of advanced technology. (author) 2 figs., 4 refs.
This booklet familiarizes the reader with DOE's Quality Assurance Rule and Order. Underlying this Training Briefing is the premise that the Rule and Order have antecedents going back to the original Quality Assurance Programs that were written when nuclear power was just being developed for commercial purposes. While a lot has changed since then, much has not.
The purpose is to provide a source of information that can be used to assist personnel in the planning, training, and execution of radiological work using the principles of ALARA. This document is not intended to replace HNF or WHC Control Manual requirements. The ALARA Tools-List provides detailed information on the use and procurement of engineered controls, mockup training guidelines, and good radiological work practices that have been proven to be ALARA.
Diethyl phthalate (DEP) and di-n-butyl phthalate (DnBP) are used extensively in personal care products, including fragrances (DEP) and nail polish (DnBP). Between May 2003 and...Full Text Available
Implementing a successful local area network for a publications work-group isn't as simple as the scarcity of information on the subject would suggest. Making a network work for your requires careful planning, developing and acquiring network expertise, transforming your group's patterns of working together, and carefully managing the human and technological resources.
Implementing a successful local area network for a publications work-group isn`t as simple as the scarcity of information on the subject would suggest. Making a network work for your requires careful planning, developing and acquiring network expertise, transforming your group`s patterns of working together, and carefully managing the human and technological resources.
BackgroundInformal payments for health care are common in most former communist countries. This paper explores the demand side of these payments in Albania. By using data from the...Full Text Available
BackgroundEffectiveness of services for patients diagnosed with severe mental illness (SMI) may improve when treatment plans are needs based. A regional Cumulative Needs for Care...Full Text Available
Objective: To explore the interventional treatment for biliary re-stenosis after metallic stents placement in patients due to cholangiocarcinoma and evaluate its therapeutic effect. Methods: Percutaneous metallic stents placement or combined with continuously infusion arterial chemotherapeutic and chemotherapeutic embolization were performed in 12 patients with biliary re-stenosis using 12 metallic stents. Results: Once stent placement was 100% successful in all 12 cases, TBIL, ALT, GTP and AKP values 7 days postoperatively were significantly lower than that in preoperation. Jaundice was reduced satisfactorily in 12 patients. 3 patients were undergone continuously arterial chemotherapeutics infusion and chemotherapeutic embolization 4 weeks after stents placement. Conclusions: Percutaneous replacement of biliary metallic stents was effective and safe for palliation of malignant biliary re-stenosis and would be much better when combined with continuously arterial ...
The mortality in undrained abdominal abscesses is high with a mortality rate ranging between 45 and 100%. The outcome in abdominal abscesses, however, has improved due to advances in image guided percutaneous interventional techniques. The main indications for the catheter drainage include treatment or palliation of sepsis associated with an infected fluid collection, and alleviation of the symptoms that may be caused by fluid collections by virtue of their size, like pancreatic pseudocele or lymphocele. The single liver abscesses may be drained with ultrasound guidance only, whereas the multiple abscesses usually require computed tomography (CT) guidance and placement of multiple catheters. The pancreatic abscesses are generally drained routinely and urgently. Non-infected pancreatic pseudocysts may be simply observed unless they are symptomatic or cause problems such as pain or obstruction of the biliary or the gastrointestinal tract. Percutaneous routes that ...
The Zollinger-Ellison syndrome (ZES) is taken as an example of the diagnostic and therapeutic strategy in gastro-entero-pancreatic endocrine tumours, given the standard characteristics of this procedure, whatever the nature of the primitive tumour. Management of ZES includes: anatomical localization of gastrinoma and of possible metastases, in 60 % of cases this step conditioning therapeutic indications and chances of cure; search of a type 1-multiple endocrine neoplasia (MEN A), in 25 % of cases; therapeutic indications: ablative surgery with curative intent in case of gastrinoma and of resectable liver metastases, palliative treatment otherwise: anti-secretory drugs, somatostatin analogues, chemotherapy and interferon {alpha}; long-term follow-up of patients with resected tumour. At each step, somatostatin receptor scintigraphy with indium 111-pentetreotide does play a pivotal role. (author). 110 refs.
MRI provides a non-invasive diagnostic tool complementing echocardiography on one hand, and showing advantages over echocardiography, on the other hand, especially after corrective procedures. The multiple different MRI sequences need to be adapted to examinations of children and patients with congenital heart disease (CHD), and can be used to detect morphologic changes, blood-flow in the heart and thoracic vessels and diastolic or systolic function of myocardium. Several factors determine the success of the examination of a complex congenital heart disease or a postoperative situs. Pediatric radiologists and radiologists experienced in congenital heart diseases have to work in close cooperation. Echocardiography should be performed before MRI. The results of prior examinations and the clinical history of the patients, including possible palliative or reconstructive operations, must be available before MRI to guide the planning of the examination. With a systematic ...
Rapid corrosion of PWR steam generator carbon steel support structures and consequential denting of steam generator tubes led to considerable investigation of the mechanism of corrosion and for palliatives. The basic mechanism is now fairly well understood. Chloride present in the boiler feedwater from condenser leakage is concentrated in the support plate crevice as a result of the superheat present. This leads to the formation of a low pH acid ferrous chloride environment either through the hydrolysis of a weak base chloride such as MgCl_2 or the combined action of a neutral chloride with an oxidizing agent. Rapid attack of the carbon steel ensues with the Fe_3O_4 corrosion product forming at the metal/oxide interface. This oxide has a volume approximately twice that of the steel consumed and thus eventually fills the crevice between the tube and the support plate. Oxide growth continues leading to compression of the Alloy 600 primary tube and to distortion and ...
To evaluate the efficacy of newly designed covered and non-covered coated colorectal stents for colonic decompression. Twenty-six patients, (15 palliative cases and 11 preoperative) underwent treatment for the relief of colorectal obstruction using metallic stents positioned under fluoroscopic guidance. In 24 of the 26, primary colorectal carcinoma was diagnosed, and in the remaining two, recurrent colorectal carcinoma. Twenty-one patients were randomly selected to receive either a type A or type B stent; for the remaining five, type C was used. Type A, an uncovered nitinol wire stent, was lightly coated to ensure structural integrity. Type B (flare type) and C (shoulder type) stents were polyurethane covered and their diameter was 24 and 26mm, respectively. The rates of technical success, clinical success, and complications were analyzed using the chi-square test, and to analyse the mean period of patency, the Kaplan-Meier method was used. Thirty of 31 attempted ...
Smugglers, who make use of the Ukraine-Slovak border for their business, might be satisfied after last week. The Slovak government ordered the switching off of scanning equipment monitoring the movement of goods by train through the Matovce border line. The modern equipment was substituted by people, who aren't able to check freight cars as effectively as gadgets. Not only in Ukraine are they celebrating this success in corruption, who demanded the shut-off of the scanning equipment The bosses on the Slovak side are also rubbing their hands. As told to TREND by Margareta Grecova, spokeswoman for Cargo Slovakia, 90% of goods that cross through the border at Matovce are unloaded. The most frequently transported commodities are ore, coal, chemical and petroleum products. Smugglers put their consignments among iron ore and coal. They prefer goods with high consumer taxes. Besides alcohol, there are mainly cigarettes. These are put into boxes which are concealed in ...
Cardiac contractile function is dependent on the integrity and function of the sarcolemmal membrane. Swimming exercise training is known to increase cardiac contractile performance. The purpose of the present study was to examine whether a swimming exercise program would alter sarcolemmal enzyme activity, ion flux, and composition in rat hearts. After approximately 11 wk of exercise training, cardiac myosin and actomyosin Ca2+-adenosinetriphosphatase (ATPase) activity was significantly higher in exercised rat hearts than in sedentary control rat hearts. Glycogen content was increased in plantaris and gastrocnemius muscles from exercised animals as was succinic dehydrogenase activity in gastrocnemius muscle of exercised rats in comparison to sedentary rat preparations. Sarcolemmal vesicles were isolated from hearts of exercise-trained and control rats. Sarcolemmal Na+-K+-ATPase and K+-p-nitrophenylphosphatase activities, ...
This paper overviews the curricula of nuclear medicine (NM) undergraduate training in 34 Central and Eastern European (CEE) and 37 European Union (EU) medical faculties. The data show enormous variation in the number of hours devoted to nuclear medicine, varying between 1-2 to 40 hours and highly differentiated concepts/ideas of nuclear medicine training in particular countries. In most EU countries this teaching is integrated with that of radiology or clinical modules, also with training in clinical physiology. In many CEE countries teaching and testing of NM are independent, although integration with other teaching modules is frequent. The paper discusses the differences in particular approaches to nuclear medicine teaching. (author)
Summary We describe the initiation and establishment of The University of Zambia - University College London Medical School (UNZA-UCLMS) Research and Training Project, an entirely African scientist-led, south-north partnership. In its 16 year existence, the project, by successfully obtaining competitive grant funding, has transformed itself into one of Africa's most productive African-led R&D programmes with training and visible research outputs. The project serves as a role model and now networks R&D and training activities with six southern African (10 institutions) and six European countries. This project case study illustrates that deep commitment is essential for success and that the factors which facilitate success in R&D in Africa need to be evaluated. The long-term prospects for su...
In this paper, we develop a batch fuzzy learning vector quantization algorithm that attempts to solve certain problems related to the implementation of fuzzy clustering in image compression. The algorithm's structure encompasses two basic components. First, a modified objective function of the fuzzy c-means method is reformulated and then is minimized by means of an iterative gradient-descent procedure. Second, the overall training procedure is equipped with a systematic strategy for the transition from fuzzy mode, where each training vector is assigned to more than one codebook vectors, to crisp mode, where each training vector is assigned to only one codebook vector. The algorithm is fast and easy to implement. Finally, the simulation results show that the method is efficient and appears...
It was recognized from the early days of commissioning of Bruce B that Control Maintenance staff would require a level of expertise to be able to maintain Special Safety Systems in proper running order. In the early 80's this was achieved through hands on experience during the original commissioning, troubleshooting and placing of the various systems in service. Control maintenance procedures were developed and implemented as the new systems came available for commissioning, as were operating manuals,training manuals etc. Under the development of the Maintenance Manager, a Conduct of Maintenance section was organized. One of the responsibilities of this section was to develop a series of Maintenance Administrative Procedures (MAPs) that set the standards for maintenance activities including training.
The Interim Examination and Maintenance (IEM) Cell is located within the Fast Flux Test Facility (FFTF) Reactor Containment Building. This cell is a complex vertical hot cell whose purpose is to process reactor experiments and to perform maintenance on reactor and refueling components. Because access to this very complex cell is limited, a mock-up called the IEM Training Facility (IEMTF) has been developed. The IEMTF provides the IEM cell with many valuable benefits. Four of these benefits are: (1) development of alternate processing methods; (2) hands-on evaluation of equipment problems; (3) a ready source of verified parts, and (4) training facilities for IEM Cell technicians.
This document presents the results of a review of publicly available information on energy use in health care facilities. The information contained in this document and in the sources cited herein provides the background and context for efforts to reduce energy use and costs in health care. Recognizing the breadth and diversity of relevant information, the author acknowledges that the report is likely not comprehensive. It is intended only to present a broad picture of what is currently known about health care energy use. This review was conducted as part of a 'High Performance Health Care Buildings' research study funded by the California Energy Commission. The study was motivated by the recognition that health care facilities collectively account for a substantial fraction of total commercial building energy use, due in large part to the very high energy ...
Objectives This paper examines the determinants of the insureds decision to use their health insurance card when seeking outpatient and inpatient health care in Vietnam. Methods Uses Vietnams latest Household Living Standard Survey data and random-intercept logistic regression to assess the influence of the observed individual, household and commune/ward factors on the insureds decision to access health insurance benefits while controlling for the unobserved commune/ward-specific factors. Results Compared to the compulsory enrollees, the voluntary enrollees and the beneficiaries of the Health Care Fund for the Poor are less likely to use their card when seeking inpatient care. An individuals likelihood of accessing insurance benefits varies inversely with income and the level of education,...
Given the concern over the potential for health risks associated with certain ingredients (e.g., phthalates) in personal care products, usage patterns of 30 types of personal care products (e.g., shampoo, sunscreen, fragrance, etc.) were collected in 604 California households through a telephone interview. Preferences in selecting products, e.g., scented or unscented, aerosol, and brand loyalty, were also investigated. Participants were recruited in three age groups, children (mostly preschoolers), their parents, and adults age 55 or older. Use frequencies of various product types varied by sex, age group, race, education, and climatic region. Product use by parent and child from the same household were correlated. Use frequencies of products in the same class (e.g., skincare) were moderat...
Participants in the conference selected to attend two different working group sessions. The working groups discussed different perspectives of system-based approaches to osteoporosis and fracture care. The group on postfracture case management recommended that nurse case managers be used to improve communication among patients, orthopaedic surgeons, and those providing ongoing clinical care. The hospital working group discussed the impact of and barriers to improved postfracture management in the hospital setting. The health systems group emphasized the difference between a closed system in which long-term benefits of interventions were more likely to be appreciated than in fee for service systems. The health information technology group discussed the advantages and challenges of electroni...
Opinion statement Because a minority of patients with D-transposition of the great arteries are diagnosed in utero by ultrasound, most present after delivery with cyanosis. In the absence of apparent lung disease, cyanotic neonates suspected of having a cardiac lesion should be immediately transferred to an intensive care unit at a pediatric tertiary care center for monitoring, resuscitation, and to define the cardiac anatomy and physiology. A prostaglandin E-1 infusion is usually initiated to maintain ductal patency and promote intra-cardiac mixing. In the past, balloon atrial septostomy (BAS) was routinely performed to enlarge the atrial septal defect and improve intra-cardiac mixing while the infants awaited surgery. Recent literature has reported an increase risk of stroke in neonates ...
Objectives Vietnamese patients? views on healthcare are changing as surgical interventions become more commonplace, but their views on perioperative care have remained largely unstudied during this period of rapid change. This study assesses Vietnamese patients? impression of anesthesia safety and postoperative pain in relation to clinical outcomes with the aim of improving patient-centered perioperative care. Methods The study cohort consisted of 180 hospitalized patients who were followed for 24?h following abdominal surgery. The assessments of these patients on the use of anesthesia and postoperative pain were measured by means of a 5-point Likert scale survey. Perioperative events were recorded on standardized forms by medical staff. The relationship between relevant factors affecting ...
To determine the proportion of rheumatoid arthritis (RA) patients receiving preventive health care according to US Preventive Services Task Force recommendations compared with a community-based population sample, with emphasis on dyslipidemia testing, given the increased risk of cardiovascular disease (CVD) in RA patients. Patients with RA (ICD-9 code 714.0 at ?2 office visits with a rheumatologist) and a primary care physician (PCP) at the Geisinger Health System (GHS) were identified through electronic health records. The records were searched back from 3/31/08 for the length of time required to satisfy each outcome measure. Percentages were compared with population testing rates using the Pearson Chi-square test. Eight hundred and thirty-one RA patients were compared to 169,476 subjects...
Objective. Preterm neonates are susceptible to infection due to a combination of sub-optimal immunity and increased exposure to invasive organisms. Invasive fungal infections are associated with significant morbidity and mortality among preterm infants cared for in the neonatal intensive care unit (NICU). Mannose-binding lectin (MBL) is a component of the innate immune system, which may be especially important in the neonatal setting. The objective of this study was to investigate the presence of any association between MBL gene polymorphism and nosocomial invasive fungal infection in preterm neonates. Methods. Codon 54 (B allele) polymorphism in exon 1 of the MBL gene was investigated in 31 patients diagnosed as nosocomial invasive fungal infection and 30 control preterm neonates. Results...
Despite the many advances in scientific research over the last several decades, cutting edge technologies and therapeutics often take many years to find their way into widespread use. The dissemination and uptake of best practices into clinical care is sometimes a neglected component of research that is essential to improve the population?s health. Type 2 translational research, sometimes called ?Proof in Practice Research,? seeks to maximize the yield of what has been learned from the bench and from carefully controlled clinical trials and to extend those benefits to a larger population. One aspect of type 2 translational research, sometimes called evidence implementation or implementation science, applies what has been learned about clinical medicine to achieve best practices across prov...
Reliable exposure information for cosmetic and other personal care products and ingredients is needed in order to conduct safety assessments. Essential information includes both the amount of product applied, and the frequency of use. To obtain current data, studies to assess consumer use practices were undertaken. Six widely used personal care product types were included in the studies. Five of the products were cosmetics (spray perfume, hairspray, liquid foundation, shampoo, body wash) and one product was a cosmetic/over-the-counter drug product (solid antiperspirant). Three hundred and sixty women, ages 19-65 years, who regularly use the products of interest, were recruited at 10 different geographical locations within the US. The number of recruits was chosen to ensure a minimum of thr...
AbstractBACKGROUND: Disparities in treatment and mortality for colorectal cancer (CRC) may reflect differences in access to specialized care or other characteristics of the area where an individual lives. METHODS: Surveillance, Epidemiology and End Results Program-Medicare data for seniors diagnosed with CRC were linked to area measures of the sociodemographic characteristics and the capacity of surgeons, medical oncologists, and radiation oncologists. Outcomes included receipt of stage-appropriate CRC care and mortality. RESULTS: After adjustment, blacks and Hispanics were less likely than whites to undergo surgery (odds ratio [OR] 0.57, 95% confidence interval (CI) 0.52-0.63 and OR 0.82, 95% CI 0.70-0.95, respectively). Individuals who lived in areas with the highest tertile of surgeon c...
Background ?Guidelines for safe and effective management and use of point of care testing? have been recently launched in Ireland. Aims To survey point of care testing (POCT) services in the Republic of Ireland. Methods A questionnaire covering accreditation status, existence of POCT committees, quality management systems, and staff resources was distributed by the Irish External Quality Assessment Scheme (IEQAS). Results Of those that returned completed questionnaires, 56% had assigned specific POCT responsibilities to designated staff. Most support was for blood gases and glucose analysis. Compared with other published studies, Irish laboratories gave similar support for blood gases, less for glucose and much less for urinalysis. Conclusions This survey demonstrated poor IT support for P...
A critical research priority for our field is to develop treatments that enhance cognitive functioning in schizophrenia and thereby attenuate the functional losses associated with the illness. In this...Full Text Available
Examines the effects of computer-based manufacturing technologies on employment opportunities and job skills. Describes the establishment of the Industrial Technology Institute in Michigan to develop and utilize advanced manufacturing technologies, and the institute's relationship to the state's community colleges. Reviews lessons learned from interinstitutional cooperation. Highlights future challenges. (DMM)
Bellevue Hospital, the oldest public hospital in the United States and a lineal descendant of an infirmary for slaves, accepted its first African-American resident, Dr. Ubert Conrad Vincent, in 1918....Full Text Available
BackgroundTo investigate the feasibility, the ease of implementation, and the extent to which community health workers with little experience of data collection could be trained...Full Text Available
The purpose of this study was to determine whether resistance exercise training-induced reductions in inflammation are mediated via melanocortin 3 receptor expression in obese (BMI 32.7 ± 3.7)...Full Text Available
Isokinetic training and assessment of the knee joint has been the mainstay of rehabilitation, especially in patients with anterior cruciate ligament deficiency. Besides the original shin pad used, the...Full Text Available
ObjectivesModernising Medical Careers (MMC) emerged in response to acknowledged problems in training in the Senior House Officer grade. The objective of this study was to assess...Full Text Available
Main results of 15-year SSTC NRS activity in the field of technical support of regulatory authority are presented. The article also described management policy, quality assurance system, personnel training system and international co-operation of SSTC. (author)
Sedentary adult males with spinal lesions, all habitual wheelchair users, were allocated to exercise (n = 11) and control (n = 4) groups. A Cybex II dynamometer was used to assess peak power, average...Full Text Available
A preventive medicine program of rubella control for trainees at the Air Force Military Training Center, Lackland AFB, Texas, was begun in October 1977. Incoming trainees were screened for rubella susceptibility,...Full Text Available
The coking plant is described with some details of coal supplies and coke quality. Engineering improvements to the by-product system and coke oven machines, major repair of two batteries, installation of a PLC-based monitoring and control system, and training of personnel are dealt with at greater length.
To evaluate whether children with and without autism could exhibit (a) functional equivalence in the course of yoked repeated-reversal training and (b) reversal learning set, 6 children, in...Full Text Available
Stroke-prone spontaneously hypertensive rats (SHRSP) induce spontaneous osteoporosis. To elucidate the specific characteristics of bone metabolism, the SHRSP was compared with age matched Wistar-Kyoto (WKY) rats. We investigated the effects of prolonged swimming exercise training on bone mineral density (BMD) and metabolism in the SHRSP. Seven-week-old male SHRSP and WKY were divided into three groups; the sedentary control WKY group (n = 6, WKY), the sedentary control SHRSP group (n = 6, SP) and the swimming exercise training SHRSP group (n = 6, SWIM) (in pool with 60 min./day, 5 days/week for 12 weeks). The femoral BMD, bone mineral content (BMC), strength, Ca and P contents (%) of SHRSP were approximately 17, 27, 25, 20 and 9%, respectively, lower than that of WKY (p swimming exercise training in the SHRSP induces more cruelly hypophosphatemia, and leading to osteopenia eventually. We conclude that SHRSP induces ...
The brain’s ability to bind incoming auditory and visual stimuli depends critically on the temporal structure of this information. Specifically, there exists a temporal window of audiovisual...Full Text Available
Oct 11, 1993 ... Lease: Meadowgreen,3-2.5-2, 2 storyon cuI- ..... also will have the Lunar Landing Training Vehicle elevated over the center of the ...
...In your area Get connected Farmers & growers news Training & events Poultry (laying) Poultry production can be a profitable enterprise for organic farmers and eggs are ... To find out more about organic poultry production download our free comprehensive introductory guide: Organic poultry production - an introductory guide [PDF, ...
Our primary objective was to determine whether recent procurements of military working dogs by the 341st Training Squadron complied with section 10a, title 41, United States Code (41 U.S.C. 10a commonly known as the Buy American Act) and other procurement...
Acquisition of three-alternative simultaneous matching-to-sample and oddity-from-sample was investigated. Five goldfish were trained on matching and five on oddity for a minimum of 70 days. Subsequently,...Full Text Available
Established Investigators (K18) (PAR-09-090) NIH: Career Enhancement Award for Stem Cell Research (K18) (PA-09-110) NIDCD: NIDCD Research Career Enhancement Award for Established...
A strain of Neurospora crassa was isolated by training the mould to grow on media containing high concentrations of Co2+. This strain, the CoR strain, exhibited...Full Text Available
... 3 3 0 Short weekend leave 4 2 2 ... 30 30 0 Stay at sick bay 31 32 -1 ... fers massive losses of effectiveness in training. At this point, the predictive ...
NASA Administrator Charles Bolden, who flew four space shuttle missions, talks about how space travel changed his life and how he applies his astronaut training to his work as the head of the space agency.
How can the inhabitants of the European Union be brought closer together? One way of doing it is to expand and improve the trans-European railway network and to have interoperable highspeed trains connecting Europe's major centres. (orig.)
BackgroundEpidemiological studies showed that physical exercise, specifically moderate lifelong training, is protective against cardiovascular morbidity and mortality. Most experimental...Full Text Available
This is the final Report for the technical ''on-the-job traning'' for the Wolsung CANDU nuclear power plant which is the first Pressurized Heavy Water Reactor setting up in Korea. The technical ''on-the-job traning'' was established to increase the capabi...
This paper describes the Fast Flux Test Facility (FFTF) Operations initial training program utilizing the Operator Training Simulator (OTS). The OTS is a computer-driven system that provides real time response of essential FFTF plant functions to a control room mockup. The FFTF, a 400 Megawatt, three-loop, sodium-cooled fast test reactor will test fuels, materials and equipment for the U.S. Liquid Metal Fast Breeder Reactor Program. Construction is expected to be completed in August 1978. Initial criticality is expected in early 1979. This schedule will require FFTF control room operators to be fully qualified to operate the facility by late 1979. Because FFTF is like no other U.S. nuclear reactor, existing U.S. utility plants could not be depended on to provide highly experienced people to operate FFTF. Therefore, an Operator Training Simulator has been built. The OTS will play a vital role in the formal operator ...
Gradual occlusion (O) of the swine left circumflex coronary artery (LCX) with an ameroid occluder results in complete O within 3 weeks, collateral vessel development, and compensatory hypertrophy....Full Text Available
BACKGROUND: : Skills related to cardiopulmonary resuscitation (CPR) and automated external defibrillator (AED) use by lay responders decay rapidly after training, and efforts are required to maintain competence among trainees. We examined whether repeated viewing of a reminder video on a mobile phone would be an effective means of maintaining CPR and AED skills in lay responders. METHODS: : In a single-blind case-control study, 75 male students received training in CPR and AED use. They were allocated either to the control or to the video-reminded group, who received a memory card containing a video clip about CPR and AED use for their mobile phone, which they were repeatedly encouraged to watch by SMS text message. CPR and AED skills were assessed in scenario format by examiners immediately and 3 months after initial training. RESULTS: : Three months after initial training, the video-reminded group ...
... impact criterion, as demonstrated by the materials research community. These include training ... designing new materials or new processing/fabrication routes to existing materials; exploring and ...
Research indicates that diesel equipment can be used safely in undergound coal mines provided that certain conditions prevail. These conditions are: the machines and engines are approved for underground use, an adequate maintenance and training program is in effect, an adequate monitoring system with proper instrumentation is used, and adequate ventilation is maintained.
This multiauthored text is aimed particularly toward the resident or registrar training in diagnostic radiology. This is a text book on the entire scope of diagnostic imaging. It includes techniques and imaging modalities of all the systems, head, face and neck. The book covers the entire gamut of diagnostic radiology.
Seven high-school trainees each conducted training sessions with two profoundly retarded children. Each trainee was asked to teach one child to follow the instruction "Bring ball" and the other child...Full Text Available
Objective: Hamstring injuries can be quite debilitating and often result in chronic problems. Eccentric muscle actions are often the last line of defense against muscle injury...Full Text Available
For over 20 years advocates of computer assisted instruction (CAI) have been proclaiming impending revolutionary developments in the educational process, yet progress in acceptance has been slow. This...Full Text Available
Human resource competence building and continued enhancement of performance is the most vital input for safe and reliable operations of a Nuclear Power Plant. Integrated planning leading to the decision of timely selection of optimum number of fresh people and deployment of experienced manpower with desired lead time is inevitable to achieve the above objective. For safe and reliable plant operation human performance analysis followed by suggestive measures to improve the same is needed. Corrective or strengthening input may be in terms of training, work environment, motivations, organizational culture and climate, leadership and prevailing environmental force and bio-rhythm of individuals with critical days are to be worked out The adequacy in training and development not only gives safe and reliable plant operations but results in greater employee satisfaction and self esteem as well. As of date, in the present vibrant global scenario, only ...
New neurons are generated in the granule cell layer of the dentate gyrus (GCL) throughout adulthood. This process is modulated by many environmental and neurochemical factors. We previously...Full Text Available
After discrimination training on a multiple variable-interval extinction schedule of food reinforcement, pigeons were placed on the uncued or mixed version of the same schedule and allowed to make...Full Text Available
Proposals that adaptation with left-shifting prisms induces neglect-like symptoms in normal individuals rely on a dissociation between the post-adaptation performance of individuals trained...Full Text Available
The Marcy Wedge-Pro (MWP), a device used in training by tennis players, was employed in the assessment of tennis elbow. The MWP was used to measure the ability of patients to perform wrist extension...Full Text Available
The non-licensed operator on the job training model presently considered for development and implementation at C.N. Almaraz (CNA) has the primary objective of imparting practical knowledge and skills to the trainee on a per system basis and specific to the job position. This model is somewhat different in scope from the OJT process used in U.S. stations because the learning process is not done on a task per task basis, but rather on the concept of learning collectively all the knowledge and skills required by the specific-system job. This model arose primarily from two thoughts. First, the knowledge and skills have been obtained from a detailed job and task analysis process which will result in the learning of many required knowledge and skills divided by three categories: components, systems and academics. Secondly, the OJT most commonly used in the U.S. requires that the respective station department administers and implements the OJT program. In the U.S. this ...
Specific objectives were to: (1) develop and refine a methodology that can be used to evaluate the feasibility of MAG-LEV trains; (2) apply this methodology to the state of Oklahoma. The methodology is based on an aggregate econometric demand model and mathematical programming. A city-pair network is constructed to evaluate alternative MAG-LEV routes between Oklahoma City and nine other cites in and out of the state of Oklahoma. Results obtained from the aggregate econometric demand model indicates that MAG-LEV trains would attract significant ridership along different types of origin-destination routes. All nine corridors exhibit induced demand for MAG-LEV trains as well as attracting riderships from other modes. Based on the results of both single and multiobjective LP models, fixed-capital-cost requirements and annual operating cost for each of the above corridors are estimated, and by using different scenarios for ...
particle mass with diameter smaller than 2.5 microns.) Our expectation has been that California's ...... MODIS Aqua and Terra products to visualize the movement of ...... correlation in hydrometeor (cloud and precipitation) occurrence, ...
...competent person shall inspect haulage equipment before each shift. (ii...used. (2) Powered mobile haulage equipment shall have suitable means of... (3)(i) Power mobile haulage equipment, including trains, shall...
DescriptionM291272: National herpetofauna monitoring programme: map-based online data entry and volunteer training, 2008 1. Background The Herpetological Conservation Trust (the HCT) has been working in partnership with Natural England and others, including the voluntary Amphibian and Reptile Groups of the UK (ARG UK), to develop a national surveillance system for herpetofauna. The National Amphibian and Reptile Recording Scheme (NARRS) is an umbrella for existing survey initiatives as well as new schem [continued...
In November 1977, 627 soldiers belonging primarily to the First Battalion, 82nd Airborne Division, stationed at Fort Bragg, were sent to the Canal Zone, Panama, for jungle warfare training. A medical surveillance program incorporating pre- and post-evaluations over a 6-month period with dermatologic examinations, questionnaires, and serologic tests was established. Ten cases of cutaneous leishmaniasis (1.6/100 men) were diagnosed by positive Leishmania culture. The demonstrated lack of sensitivity and specificity of the indirect fluorescent antibody test and the direct agglutination test render these serological methods useless as diagnostic screening methods in the early stages of this disease. PMID:7406101
Supplementing the collection of artificial neural network methodologies devised for monitoring energy producing installations, a general regression artificial neural network is proposed for the identification of the two-phase flow that occurs in the coolant channels of boiling water reactors. The utilization of a limited number of image features derived from radiography images affords the proposed approach with efficiency and non-invasiveness. Additionally, the application of counter-clustering to the input patterns prior to training accomplishes an 80% reduction in network size as well as in training and test time. Cross-validation tests confirm accurate on-line flow regime identification.
Supplementing the collection of artificial neural network methodologies devised for monitoring energy producing installations, a general regression artificial neural network is proposed for the identification of the two-phase flow that occurs in the coolant channels of boiling water reactors. The utilization of a limited number of image features derived from radiography images affords the proposed approach with efficiency and non-invasiveness. Additionally, the application of counter-clustering to the input patterns prior to training accomplishes an 80% reduction in network size as well as in training and test time. Cross-validation tests confirm accurate on-line flow regime identification.
BackgroundHow socio-demographic factors influence women's autonomy in decision making on health care including purchasing goods and visiting family and relatives are very poorly...Full Text Available
A public health emergency such as an influenza pandemic will lead to shortages of mechanical ventilators, critical care beds, and other potentially life saving treatments. This will raise difficult...Full Text Available
... be able to watch the many intricate steps Dr. Richard Alexander must accomplish to remove the cancer. ... door to informed medical care. Now let's join Dr. Richard Alexander at the University of Maryland Medical ...
Patient decision support systems have a promising role in the delivery of health care. However, the best approach for further development of these systems is a matter of speculation. To help chart a...Full Text Available
BackgroundStrategies to accurately identify the occurrence of specific health care events in administrative data is central to many quality improvement and research efforts. Many...Full Text Available
Patients who fail to attend initial appointments reduce clinic efficiency. To maximize attendance by newly referred outpatients, we introduced a mandatory group orientation clinic for all new patients...Full Text Available
Objective To establish current practice in the use of Read codes for diabetes.Design Cross sectional study.Setting 17 practices in the Battersea...Full Text Available
Personal Health Records (PHRs) are increasingly recognized as a strategy to improve patient-provider communication, availability of health information, and quality of care, by making the delivery of...Full Text Available
Albeit the considerable progress that has been made both in our understanding of the pathophysiology of acute renal failure (ARF) and in its treatment (continuous renal replacement therapies), the morbidity...Full Text Available
Femur fractures typically affect elderly patients with multiple co-morbidities. Pain control can be difficult, requiring intensive nursing and physician care as elderly patients may manifest cardiovascular...Full Text Available
Over 30 months 9292 consecutive patients admitted to nine coronary care units with suspected myocardial infarction were considered for admission to a randomised double blind study comparing the effect...Full Text Available
OBJECTIVE: The objective was to define and characterize the costs associated with trauma care at a level I trauma center. Once the costs were identified, attending physician-led teams were designed...Full Text Available
BackgroundThere has been substantial research on psychosocial and health care determinants of health disparities in the United States (US) but less on the role of modifiable risk...Full Text Available
BackgroundDespite having the largest population in Africa, Nigeria has no accurate population based data to plan and evaluate eye care services. A national survey was undertaken...Full Text Available
The Joint Commission on Accreditation of Hospitals (JCAH) has continuously emphasized improvement in the quality of care provided in hospitals as the central purpose of the accreditation process. In...Full Text Available
Patient-centered interdisciplinary health care for children with chronic medical disorders represents an evolution from the traditional “stop and go” treatment for acute illnesses. This...Full Text Available
This Mini-Computer-Assisted Nursing Management System allows nursing to control staffing costs and more effectively relate staffing to patient care requirements. Nursing resources are prospectively...Full Text Available
BackgroundPatients’ general tendency to adhere to health care provider-recommended treatments is associated with a number of health outcomes, but whether it influences pain...Full Text Available
BackgroundThe link between maternal factors and birth outcomes is well established. Substantial changes in society and medical care over time have influenced women's reproductive...Full Text Available
Although the demand for use of information technology within the healthcare industry is intensifying, relatively little has been written about guidelines to optimize IT investments. A technology architecture...Full Text Available
Abstract The Read Thesaurus (Version 3 of the Read Codes) is a controlled medical vocabulary produced during the Clinical Terms Projects with the involvement of over 2,000 health care...Full Text Available
BackgroundAdolescents have been identified as a high-risk group for poor adherence to and defaulting from combination antiretroviral therapy (cART) care. However, data on outcomes...Full Text Available
Skin cancers in skin of color often present atypically or with advanced stage in comparison to Caucasian patients. Health care providers must maintain a high index of suspicion when examining...Full Text Available
Dental caries continues to be a common chronic disease among various population groups. Patient care can be improved with detection at the earliest stage. However, current techniques do not...Full Text Available
BackgroundSeverely disabling chronic pain in the adult population is strongly associated with a range of negative health consequences for individuals and high health care costs,...Full Text Available
ObjectiveTo implement a role-reversal exercise to increase first-year pharmacy students' awareness of communication barriers in the health care setting, especially for deaf and hard-of-hearing...Full Text Available
Percutaneous tracheostomy is a routine procedure in intensive care units. In cases of very low position of the larynx, cervical spine deformation, morbid obesity, or neck tumor, performance of the classic...Full Text Available
BackgroundInternet education is increasingly provided to health professionals, but little is known about the most effective strategies for delivering the content. The purpose of...Full Text Available
ObjectiveTo test whether a disclosure intervention improves subjective health and reduces medical consumption and sick leave in somatising patients in general practice.DesignNon-blind...Full Text Available
Background In May 2000, AstraZeneca launched a Web service for asthma patients and health-care providers called LinkMedica, which includes an asthma diary for...Full Text Available
Continuing Medical Education (CME) is a requirement among practicing physicians to promote continuous enhancement of clinical knowledge to reflect new developments in medical care. Previous research...Full Text Available
ObjectiveThe authors present an Electronic Healthcare Record (EHR) server, designed and developed as a proof of concept of the revised prEN13606:2005 European standard concerning...Full Text Available
The current obesity pandemic is expected to result in considerable downstream morbidity, mortality and incremental costs to health care systems around the world. The major metabolic complications of...Full Text Available
BackgroundMefloquine has historically been considered safe and well-tolerated for long-term malaria chemoprophylaxis, but its prescribing requires careful attention to rule out contraindications...Full Text Available
ObjectiveComputerized physician order entry with clinical decision support has been shown to improve medication safety in adult inpatients, but few data are available regarding its...Full Text Available
ObjectivesPericardial tamponade after cardiac surgery is difficult to diagnose, thereby rendering timing of rethoracotomy hard. We aimed at identifying factors predicting the outcome...Full Text Available
This program focused on practice-level service change as a means of improving patient care and developing leadership skills of 19 general practitioners (GPs) and aimed to: promote and support change...Full Text Available
AimsTo describe nurse burnout, job dissatisfaction, and quality of care in Japanese hospitals, and to determine how these outcomes are associated with work environment...Full Text Available
In terms of managing thrombotic disorders, genotype-based individualized patient care emerged as early as 1994 when the association of factor V Leiden (G1691A), and later, prothrombin (G20210A),...Full Text Available
BACKGROUND:Reports indicate that characteristics of older adults with chronic pain may be different than those of younger persons.OBJECTIVE:To study...Full Text Available
An outbreak with a multiresistant Klebsiella pneumoniae (MRKP) strain among seven patients admitted to the adult intensive care unit (ICU) of a regional teaching hospital in The Netherlands...Full Text Available
BackgroundOral cancer is as prevalent as cervical and testicular cancer in the United Kingdom. Nursing staff provide the oral health care for the patient population in hospital....Full Text Available
BackgroundNorway, and particularly Oslo, has the highest reported incidence of hip fractures in the world. It is increasingly common to care for older hip fracture patients in orthogeriatric...Full Text Available
...Programme Manager Interests Multilevel Statistical Modelling Geography of Health and Health Care Geographical Data Analysis Census Data Analysis Health Services Research (in particular Research Design, Statistical Analysis and Epidemiology) people/mgould.html Homepage | Contacts | Site Map | Privacy Statement | Webmaster | ...
...research and publications and some who are accredited by the British Association of Sport and Exercise Sciences (BASES), which enables them to work with high performance athletes . We care about your progress and welfare. As our recent QAA review noted \\
Out of nearly 900 women in a research study of human immunodeficiency virus infection in pregnancy, 8 were subsequently found not to be infected. Misdiagnoses could have resulted from (a) laboratory...Full Text Available
Laparoscopic colon surgery for select cancers is slowly evolving as the standard of care but minimally invasive approaches for rectal cancer have been viewed with significant skepticism. This procedure...Full Text Available
We report on the presentation and management of a patient with herniation of the rectum following a coccygectomy. We used an abdominal approach and careful pelvic dissection to define the defect in...Full Text Available
The needs of hospitalized geriatric patients differ from the needs of hospitalized younger adults. In an attempt to improve systems of care for the older adult, the Centers for Medicare and Medicaid...Full Text Available
... the nest with young when the female left (male meadow voles were in the nest with young too infrequently ... prairie voles, whereas the number of checks that male meadow voles were in the nest increased s...
PurposeTo assess the prevalence and the dosimetric and clinical predictors of mandibular osteoradionecrosis (ORN) in patients with head and neck (HN) cancer who underwent...Full Text Available
Background and ObjectiveCervical cancer is one of the leading causes of morbidity and mortality amongst the gynecological cancers worldwide, especially in developing countries. It...Full Text Available
ObjectiveTo investigate possible differences in operative delivery rate among low-risk women, randomised to an alongside midwifery-led unit or to standard obstetric units within...Full Text Available
ObjectivesIn 2003, the Omani Ministry of Health Child Health Care Program initiated a national Birth Defects (BD) Register. This paper reviews the magnitude and risk factors of birth...Full Text Available
BackgroundThe prevalence of tobacco use among individuals with mental illness remains a serious public health concern. Tobacco control has received little attention in community...Full Text Available
The Clinical Summary is a Web-based application for accessing the clinical database at the Massachusetts General Hospital. The application has been developed to give physicians in our health care community...Full Text Available
Policies and regulations in the current health care environment have impacted the manner in which patient data - especially protected health information (PHI) - are handled in the clinical and...Full Text Available
ObjectiveMany hospitals utilize antimicrobial management teams (AMTs) to improve patient care. However, most function with minimal computer support. We evaluated the effectiveness...Full Text Available
PURPOSE We wanted to assess the impact of an electronic health record–based diabetes clinical decision support system on control of hemoglobin A1c (glycated hemoglobin),...Full Text Available
We previously demonstrated the ability to create engineered arteries by carefully controlling the mechanical environment of intact arteries perfused ex vivo, yielding engineered arteries...Full Text Available
Giardiasis is recognized as a worldwide public health problem. Seroprevalence data from both the developing and developed world show high rates of carriage in populations at risk for fecal-oral transmission,...Full Text Available
BackgroundSarcoma encompasses an uncommon group of cancer and the data is insufficient from Pakistan. We report our four years experience of Sarcoma of soft tissues and bones.MethodsThis...Full Text Available
BackgroundMany interventions found to be effective in health services research studies fail to translate into meaningful patient care outcomes across multiple contexts. Health services...Full Text Available
ObjectiveWhile essential for patient care, information related to medication is often written as free text in clinical records and, therefore, difficult to use in computerized systems....Full Text Available
ObjectiveThe study aimed to examine the effect of household and community characteristics on financial catastrophe and impoverishment due to health payment in Western and Central...Full Text Available
Background:The minimum hemoglobin cutoff for blood donation in India is 12.5 gm% for both male and female donors and the minimum donation interval is 3 months. Donation...Full Text Available
Ever-changing audio technology requires that National Library Service NLS always be aware of developments and prepare carefully for any systematic changes that may be desired or required. Usefulness, cost effectiveness, thoughtful stewardship, and educate...
Total health care expenditure in 2006 was $2.1 trillion. This figure is estimated to double within the next few years as the cost of treating diabetes and other chronic conditions continues to rise....Full Text Available
It is usually very complex to design an Integrated Information System in a hospital that includes both in-patient and out-patient medical care data. The difficulty appears because each department...Full Text Available
PurposeTo develop a generic instrument for measuring short-term health status in the recovery period among patients undergoing abdominal and pelvic surgery.Full Text Available
BackgroundChina has had no effective and systematic information system to provide guidance for strengthening PHC (Primary Health Care) or account to citizens on progress. We report...Full Text Available
BACKGROUND AND AIMS:In view of increasing therapeutic efficacy, the delivery of hepatitis C virus (HCV) antiviral treatment is expected to increase. Yet practical experience reveals...Full Text Available
BackgroundEffective prevention of excessive alcohol use has the potential to reduce the public burden of disease considerably. We investigated the cost-effectiveness of Screening...Full Text Available
BackgroundMany health care professionals use spinal palpatory exams as a primary and well-accepted part of the evaluation of spinal pathology. However, few studies have explored...Full Text Available
The purpose of the meeting reported here was to develop a set of national evidence-based standards for assessing and managing patients with potentially resectable rectal cancer. This report represents...Full Text Available
ObjectivesTo see whether there are age variations in the relationships between having a close companion friend at church, health, and outpatient physician visits.Full Text Available
You receive an annuity if eligible -- requires 18 months service for FERS; and 60 ... You may use up to 104 hours of your accrued sick leave to care for sick family ...
Social support is a critical, yet underutilized resource when undergoing cancer care. Underutilization occurs in two conditions: (a) when patients fail to seek out information, material assistance,...Full Text Available
... yourself to call 911 until you have performed CPR for about 2 minutes. 3. Carefully place the ... more breaths. The chest should rise. 9. Continue CPR (30 chest compressions followed by 2 breaths, then ...
... and retrieve an AED until you have performed CPR for about 2 minutes. 3. Carefully place the ... more breaths. The chest should rise. 9. Continue CPR (30 chest compressions followed by 2 breaths, then ...
home when you are sick helps everyone you care about Questions & Answers Flu Vaccine: Q&A Vaccine Dosage & Administration Vaccine Supply for 2011-12 Season Vaccine Supply and...
home when you are sick helps everyone you care about Questions & Answers Flu Vaccine: Q&A Vaccine Dosage & Administration Vaccine Supply for 2011-12 Season Vaccine Supply and...
home when you are sick helps everyone you care about Questions & Answers Flu Vaccine: Q&A Vaccine Dosage & Administration Vaccine Supply for 2011-12 Season Vaccine Supply and...
Drownings in Recreational Water Settings - United States, 2001-2002 While immediate CPR can save someone's life, often medical care in the hospital cannot prevent serious...
Low bone mineral density (BMD) is prevalent in human immunodeficiency virus (HIV)–infected subjects. Initiation of antiretroviral therapy is associated with a 2%–6% decrease...Full Text Available
The aim of the overview is to give a perspective of global biobank development is given in a view of positioning biobanking as a key resource for healthcare to identify new potential markers that can...Full Text Available
The devastating earthquake in Sichuan, China on 12 May 2008 left thousands of survivors requiring medical care and intensive rehabilitation. In view of this great demand, the Chinese Speaking Orthopaedic...Full Text Available
Abstract This paper focuses on the basic principles of information technology (IT) organization within health sciences centers. The paper considers the placement of the leader of the...Full Text Available
IntroductionTransfusion is a common treatment in pediatric intensive care units (PICUs). Studies in adults suggest that prolonged storage of red blood cell units is associated with...Full Text Available
BACKGROUND:The value of other health care professionals is increasingly being recognized to compensate for the shortage of physicians in Canada. Chronic cough is one of the most...Full Text Available
BackgroundComputer-based health-risk assessments are electronic surveys which can be completed by patients privately, for example during their waiting time...Full Text Available
Validation of body-mass relationships requires a careful statistical analysis of data of normal weight individuals. BMI (ratio between body mass and square of body height) and BSI values (ratio between...Full Text Available
Careful measurements do not confirm an anomalous anisotropy in the angular distribution of fission fragments from the fast neutron fission of Americium 242. The energy range covered was 1.60-3.15 MeV. (AIP)
Information needs that arise when clinicians use clinical information systems often go unresolved, forcing clinicians to defer decisions or make them with incomplete knowledge. My research characterizes...Full Text Available
ContextWhile opioids are increasingly used for chronic non-cancer pain (CNCP), we know little about opioid dosing patterns among individuals with CNCP in usual care...Full Text Available
Alton Ochsner was a giant of American surgery. His career encompassed patient care, teaching, and research as symbolized on the original seal of the Ochsner Clinic. His ideas were innovative and groundbreaking...Full Text Available
This study describes instructions for after-hours care offered by family physicians' offices when patients telephone the practice. Randomly selected (n=1,680) Ontario family physicians and general practitioners...Full Text Available
Acute kidney injury (AKI) is a common clinical problem with significant clinical and economic consequences. A number of studies point to a rising incidence of AKI in the hospital and in the intensive...Full Text Available
Platelet reactivity plays a pivotal role in the pathogenesis of ischemic adverse events during and after acute coronary syndromes (ACS), and percutaneous coronary intervention (PCI). Glycoprotein (GP)...Full Text Available
BackgroundErrors have been the concern of providers and consumers of health care services. However, consumers' perception of medical errors in developing countries is rarely explored....Full Text Available
BackgroundIntrapartum fetal hypoxia remains an important cause of death and permanent handicap and in a significant proportion of cases there is evidence of suboptimal care related...Full Text Available
BackgroundParents of chronically ill children are at risk for a lower Health Related Quality of Life (HRQoL). Insight in the dynamics of factors influencing parental HRQoL is necessary...Full Text Available
BackgroundTraffic injuries can cause physical, psychological, and economical impairment, and affected individuals may also experience shortcomings in their post-accident care and...Full Text Available
Recent health care policies and regulations have impacted the manner in which patient data – especially protected health information (PHI) – are handled in both the clinical...Full Text Available
...2010-10-01 false Special rules relating to group health plans. 146.145 Section 146.145 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES REQUIREMENTS RELATING TO HEALTH CARE ACCESS REQUIREMENTS FOR THE GROUP HEALTH...
...discrimination against participants and beneficiaries based on a health factor. 146.121 Section 146.121 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES REQUIREMENTS RELATING TO HEALTH CARE ACCESS REQUIREMENTS FOR THE GROUP HEALTH...
...named Chair at Epworth Hospital Professor Nilmini Wickramasinghe has been named Chair, Health Information Management , at Epworth HealthCare. Related links School of Business ...the College of Business at RMIT University has been named Epworth Chair, Health Information Management , by Epworth HealthCare. Professor Wickramasinghe has more than ... Professor Wickramasinghersquo;s appointment as Epworth Chair, Health Information Management , will help to further strengthen this clinical academic alliance, with RMIT now ...
Aim.- To describe the clinical aspects of implantable cardioverter defibrillators care in Sweden with focus on organisation, the role and education of nurses, patient information and education and areas in need of improvement. Background.- Implantable cardioverter defibrillators implantations have developed rapidly in recent years and are now an established arrhythmia treatment. The expanding indication for implantable cardioverter defibrillators implantation demands new competencies and resources in the implantable cardioverter defibrillators team members. Methods.- Participants were recruited among physicians and nurses in all of the hospitals implanting implantable cardioverter defibrillators (n-=-16). Data were collected by a questionnaire. Additionally, all written educational materia...
For the performance assessment of radioactive and hazardous waste disposal sites, risk assessments are usually performed for the long term, i.e., over an interval in space and time for which one can predict movement and behavior of toxic agents in the environment. This approach is based on at least three implicit assumptions: One, that the engineering layout will take care of the immediate endangerment of potential receptors; two, that one has carefully evaluated just how far out in space and time the models can be extrapolated, and three, that one can evaluate potential health effects for very low exposures. A few of these aspects will be discussed here in the framework of the scientific method.
ICU telemedicine uses audiovisual conferencing technology to provide critical care from a remote location. Research is needed to best define the optimal use of ICU telemedicine, but efforts are hindered by methodological challenges and the lack of an organized delivery approach. We convened an interdisciplinary working group to develop a research agenda in ICU telemedicine, addressing both methodological and knowledge gaps in the field. To best inform clinical decision-making and health policy, future research should be organized around a conceptual framework that enables consistent descriptions of both the study setting and the telemedicine intervention. The framework should include standardized methods for assessing the preimplementation ICU environment and describing the telemedicine program. This framework will facilitate comparisons across studies and improve generalizability by permitting context-specific interpretation. Research based on this framework ...
ENEA (Italian National Agency for New Technologies, Energy and the Environment) is conducting a large research and development programme on innovative vehicles with high energy efficiency and low environmental impact. In particular conducts activities on electric and hybrid vehicles. Testing and evaluation activities play a strong role in this programme. A complete characterization chain has been then defined and set up with a network of facilities which covers main testing needs for single components, subsystems and complete vehicles, in simulated and real operating conditions. The test facility which has been realised is able to experiment and fully characterise complete drive-trains (and subsystems) for pure electric and hybrid vehicles. It is composed by a different section for each subsystem: 1) power generation; 2) energy storage and management; 3) driving motors. Each section acts as an experimental island, able to operate alone or jointly with the other ...
Patients suffering from depression frequently display hyperactivity of the hypothalamic-pituitary-adrenal axis (HPA) resulting in elevated cortisol levels. One main symptom of this condition is anhedonia. There is evidence that exercise training can be used as a rehabilitative intervention in the treatment of depressive disorders. In this scenario, the aim of the present study was to assess the effect of an aerobic exercise training protocol on the depressive-like behavior, anhedonia, induced by repeated dexamethasone administration. The study was carried out on adult male Wistar rats randomly divided into four groups: the "control group" (C), "exercise group" (E), "dexamethasone group" (D) and the "dexamethasone plus exercise group" (DE). The exercise training consisted of swimming (1 h/d, 5 d/wk) for 3 weeks, with an overload of 5% of the rat body weight. Every day rats were injected with either dexamethasone (D/DE) or ...
We carry out investigation on the establishment of a program to cultivate a nuclear fusion workforce effectively, which is the most important resource in the fusion energy development. Acquisition of fresh fusion technologies is essentially required to pursue R and D efficiently and to ensure fusion initiatives firmly in the international community. As the time has come to cultivate the fusion workforce and to enhance the workforce's expertise, the universities, research institutes and industries involved in fusion energy development are supposed to adjust fast technology shifts and to accommodate international trends toward collaboration. We establish systematic schemes to develop a professional workforce and to assign the right jobs to the right people timely through the research-academic-industry cooperation. After carrying out domestic and oversea surveys on the education and training programs of various institutes, we evaluate an over-all manpower ...
Purpose: To develop, test, evaluate and implement effective state-of-the-art teacher training in didactic skills and methods. The training concept should be designed and beneficial for medical teachers' postgraduate medical education (CME). Materials and methods: A 5-day workshop with 12 theoretical and 9 'hands-on' modules was designed and stepwise improved, according to the trainees' feedback. All trainees were trained in small groups (6 to 10 participants per workshop). The workshops consisted of mini-lectures, repeated micro teaching exercises and video-supported feedback concerning the following key-competencies: Communication of goals; methods to trigger interactivity; design of slides in power point presentations; effective feedback-techniques; and use of media, time-management, skills teaching, assessment methods (e.g. OSCE and others), evaluation and general presentation skills. The evaluation was based on two ...
The Geothermal Energy Association ({open_quotes}GEA{close_quotes}) will create and manage a Geothermal Heat Pump ({open_quotes}GHP{close_quotes}) Training Center to deliver GHP and HVAC courses throughout California in response to imminent demand driven by national promotion. GEA services include providing management structure, cadre, curricula, promotion and physical equipment. The Center is dedicated to infrastructure strengthening goals of the Geothermal Heat Pump Consortium, Inc. ({open_quotes}GHPC{close_quotes}), the California Energy Commission ({open_quotes}CEC{close_quotes}) and Interagency Geothermal Heat Pump Task Force, and Geothermal Energy Association ({open_quotes}GEA{close_quotes}). Second-half 1996 start-up is co-funded by GHPC, CEC, GEA and three California utilities. Initial support is to five utilities representing 70 percent of California power users. Goals include becoming market driven by year No. 3 and self-finding by year No. 5. AR ...
An ambitious development programme culminated in late 1989 with the most modern diesel train available today entering commercial service. At the root of its development lay an overall concept which aimed at meeting the present-day and future requirements of railway administrations. Higher passenger revenues, lower operating costs and reduced maintenance are the result. An IC trainset is 58.8 m long and consists of three cars: Two identical power cars and one intermediate car. Each three-car trainset has 144 seats, 16 of which are reserved for first class. Up to five three-car trainsets can be coupled rogether to form a 15-car trainset. Four air-cooled 8-cylinder diesel engines with a combined rating of 294 kW power each three-car trainset, i.e. there are two engines installed in each of the power cars. The train has a maximum speed of 180 km/h. (orig.).
Effects of swimming exercise training on left ventricular contraction and relaxation, the incidence of spontaneous defibrillation and the ventricular fibrillation threshold were studied in the isolated, perfused rat heart. The heart/body weight ratio was 4.8 +/- 0.4 x 10(-3) in swimmers compared with 3.9 +/- 0.6 x 10(-3) in sedentary controls (p less than 0.0005). The spontaneous heart rate was lower in isolated hearts of trained animals (222 +/- 18 bpm compared with 244 +/- 28, p less than 0.05). Left ventricular systolic pressure was higher in trained hearts and the rate of ventricular relaxation enhanced (p less than 0.05). The ventricular fibrillation threshold was 7.2 +/- 5.2 and 10.8 +/- 6.1 mamp in hearts of swimmers and controls, respectively, the difference not being significant. The incidence of spontaneous defibrillation was not significantly different between the two groups. It is concluded that, while swimming ...
For satisfaction of international growing demand for electrical energy it is impossible to ignore contribution of nuclear power. With an expected lifespan for nuclear plants estimated to 50-60 years of operation (years for decommissioning added), there is a need for a steady multi-generational stream of competent staff to ensure safe operations of nuclear plants. It is incumbent to governments to invest in education, research, and training for the three to five generations of people who will construct, operate and eventually decommission nuclear plants over the duration of their life cycle. To develop sustained nuclear programs it is necessary to carry out a lot of major problems, but three of them look like as most important: 1. Training a qualified and competent personal to ensure all nuclear activities; 2. Multilateral approach for nuclear fuel cycle, with a guaranteed framework for ensuring the supply of NPP owners with the necessary ...
This study examines some radiation accidents occurred in the past. This information has been systematically assessed to get global lessons. The experience feedback shows that the most of accidents happened in certain conditions. These conditions can be distributed in four categories: 1- perception and vigilance in occupation: accidental exposure happened by lack of vigilance in details and lack of vigilance and perception; 2- procedures: accidental exposure happened following a lack of procedures or control that were not enough complete, not enough documented or not completely implemented; 3- training and understanding: accidental exposures happened because the personnel was not enough qualified and educated, did not get the general training nor the the necessary specialized training; 4- liabilities: accidental exposures happened following lacks and ambiguity in the definition of functions of the personnel and in the ...
We wanted to evaluate the usefulness of a new type of a complex expandable nitinol stent that was designed to reduce the stent's propensity to migration during the treatment of malignant gastroduodenal obstructions. Two types of expandable nitinol stent were constructed by weaving a single thread of 0.2mm nitinol wire in a tubular configuration: an uncovered stent 18mm in diameter and a covered stent 16mm in diameter. Both ends of the covered stent were fabricated by coaxially inserting the covered stent into the tubular uncovered stent and then attaching the two stents together with using nylon monofilament. Under fluoroscopic guidance, the stent was placed in 29 consecutive patients (20 men and 9 women, mean age: 65 years) who were suffering with malignant gastric outlet obstruction (n=20), duodenal obstruction (n=6) or combined obstruction (n=3). Clinical improvement was assessed by comparing the food intake capacity before and after the procedure. The complications were ...
Total skin electron beam therapy (TSEB) was used in the treatment of 33 patients with lymphoma and 13 patients with leukemia involving extensive segments of the skin surface. Twenty-two of 23 had lesions as a primary manifestation of lymphoma (primary cutaneous lymphoma-PCL) and 11 developed cutaneous lesions following disseminated nodal lymphoma (secondary cutaneous lymphoma-SCL). A once weekly fractionation scheme was employed to irradiate the entire skin surface with 3.5 to 4 MeV electron beam from a 6 MeV linear accelerator. During each weekly session, 400 rad were delivered to the entire skin and a complete course consisted of 4-6 consecutive weekly sessions. The majority of patients have been previously treated elsewhere for various periods and all patients have been at risk for a median of 12 months, range from 12-117 months following TSEB. Striking predominance of the diffuse pattern (76%) was demonstrated in both the PCL and SCL. There was extracutaneous involvement in 63% ...
To investigate the problems of the Hanaro stent (Solco Intermed, Seoul, Korea) when used in the palliative treatment of patients with inoperable malignant biliary obstruction. Between January 2000 and May 2001, the treatment of 46 patients with malignant biliary obstruction involved percutaneous placement of the Hanaro stent. Five patients encountered problems during removal of the stent's introduction system. The causes of obstruction were pancreatic carcinoma (n=2), cholangiocarcinoma (n=2), and gastric carcinoma with biliary invasion (n=1). In one patient, percutaneous transhepatic cholangiography and stent insertion were performed as a one-step procedure, while the others underwent conventional percutaneous transhepatic biliary drainage for at least two days prior to stent insertion. A self-expandable Hanaro stent, 8-10 mm in deameter and 50-100 mm in lengh, and made from a strand of nitinol wire, was used in all cases. Among the five patients who ...
This paper reports the characteristics and local management of 826 acute wounds identified during an audit across all health care providers serving the population of Bradford, UK. Of the wounds encountered 303 were traumatic wounds and 237 primary closures with smaller numbers of other acute wound types. Of the 303 traumatic wounds 174 occurred in women (57.4%). Men predominated in the under 45s (65M:26F), this being largely accounted for by hand and finger trauma (n=62) particularly in patients of working age (M32:F12). Women predominated in the over 65s (50M:130F), this being largely accounted for by lower limb traumatic wounds (M24:F91), the majority of these being in patients 65 and over (M14:F82). In this sub-group of 96 patients 25 had wounds of 6 weeks or longer duration, only 3 had...
We analyzed the effects of the Colorado Medicaid Capitation Program on the duration and services of over 21,000 outpatient mental health episodes for young children. The study spanned a three year period before and after capitation was implemented, and compared episodes of outpatient care for children from 14 capitated Community Mental Health Centers (CMHCs) with those from three CMHCs that remained fee-for-service. Proportional hazards regressions revealed that capitation resulted in an increase in outpatient episode duration, over and above similar effects for the comparison fee-for-service episodes. The hypothesis that there were longer capitated episodes for children who were hospitalized was not supported. Children with behavioral and anxiety disorders had longer capitated episodes. Service intensity decreased over time in the managed care sites. Changes in case mix may have had an impact on changes in episode duration and service ...
The aims of the study were to develop and test the psychometric properties of the Thai Family Health Routines (TFHR) scale, a 70-item self-report questionnaire used to measure the health of Thai families through their routine behaviors in daily life. Development of the TFHR was based on the structural domains of Denham's Family Health Model. The TFHR scale was initially composed of 85 items and tested on 1,040 families living in the central region of Thailand. The confirmatory factor analysis, with an acceptable factor structure model, yielded 70 items aligned with six factors: self-care, safety and prevention, mental health behavior, family care, family caregiving, and illness care routines. The preliminary psychometric properties demonstrated that the TFHR scale had satisfactory internal consistency, criterion validity, and construct validity. The test results suggested that the TFHR scale has potential benefits for ...
Following the February 2011 earthquake in Christchurch, New Zealand (NZ), the authors participated in counselling local residents, and debriefing and supervising support teams. Indications were that risk for mental health disorders, including Post-Traumatic Stress Disorder (PTSD), may be elevated in residents, and that this risk may continue for some time. Patients may be de-prioritising their mental health issues when these become normalised throughout the city's population. The authors recommend that primary care patients are assessed using a brief, comprehensive tool (for example, the Case-finding and Help Assessment Tool) that targets many health and behavioural issues identified as increasing in the city following the earthquake. Anxiety and mood disorder symptoms may indicate assessment is appropriate to reduce harm arising from increased risk for PTSD. Concern also is raised for primary health care providers who may have experienced the ...
The article examines the contribution of the Military Medical Academy as an educational, research and medical institutions in the establishment and development of the national Russian manned spaceflight. Lists the names of the Academy's scientists, working in laboratories and in the Cosmonaut Training Center. In 1958 the academy was formed Department of Aviation Medicine from the research laboratories of aviation medicine, psychophysiology, and encephalography, a division of pressure chambers and furnaces. Direct contribution to the preparation of the first manned space flight made by graduates of the academy, E.A. Karpov (the first chief of Cosmonauts Training Center. Yuri Gagarin) and I.A. Kolosov. Over the half century history of the Russian Space Military Medical Academy, prepared and sent to the CPC Gagarin more than 110 of its graduates. PMID:21770320
The author says ''barehand'' methods, where specially trained utility workers are called in conductive suits to equalize voltage over their bodies, to maintain high-voltage transmission lines are on the rise. Utilities are building lines at higher voltages and selling more power to other utilities, making it highly inconvenient to take the lines out of service. However, some unions view the barehand work with less than enthusiasm. Touching lines energized at hundreds of thousands of volts demands flawless equipment and rigid work procedures followed to the letter. Some local unions contend that adequate safety procedures and training, and appropriate penalties for workplace negligence, should be in place before utilities may do barehand work. The author discusses some of the methods of barehand work and the equipment used, i.e. steel-mesh lineman's suit, bucket truck's boom, helicopters, and robots.
The focus of the May-June issue is on training and information technology. Major articles/reports in this issue include: Communicating effectively, by Alain Bucaille, AREVA; Reputation management, by Susan Brisset, Bruce Power; Contol room and HSI modernization guidance, by Joseph Naser, EPRI; How far are we from public acceptance, by Jennifer A. Biedscheid and Murthy Devarakonda, Washington TRU Solutions LLC; Spent fuel management options, by Brent W. Dixon and Steven J. Piet, Idaho National Laboratory; Industry Awards; A secure energy future for America, by George W. Bush, President, United States of America; Vision of the future of nuclear energy, by Anne Lauvergeon, AREVA; and, Plant profile: strategy for transition to digital, TXU Power.
The colour, odour, flavour and texture of a breaded turkey escalope irradiated at doses of 2 and 4 kGy was assessed using a trained sensory panel. Irradiation did not affect raw appearance but during storage the irradiated breaded products became paler than the control samples. The off odour of the raw irradiated products was stronger than that of the unirradiated samples. Irradiation also affected the odour, flavour and texture of the cooked products. Although the trained panelists were able to detect significant differences between irradiated and unirradiated breaded turkey escalopes, the numerical differences between treatments were often quite small. It is possible that an untrained consumer group would be unable to detect these differences. Further research is needed with consumer groups to establish if irradiated breaded products are acceptable. (author). 10 refs, 3 tabs.
Technology transfer is an integral part of Framatome's general approach to its Chinese partners for the Daya Bay, Ling Ao, and Qinshan phase 2 nuclear power plant projects. It has been the subject of major operations covering all activities relevant to project management, design and engineering, manufacturing, and maintenance know-how. This presentation is more particularly devoted to nuclear island maintenance knowledge, which has been extensively transferred by Framatome to the Daya Bay plant owner over a period of four years, through a program including the constitution of mixed Franco-Chinese teams to handle plant maintenance, shadow training of Chinese specialists in the maintenance work performed by Framatome or its subcontractors in France, and theoretical training sessions on equipment mockups in China and France. (author)
BACKGROUNDLifestyle modifications are successfully employed to treat obese and overweight women with polycystic ovary syndrome (PCOS). The aims of the current pilot study were (i) to compare the efficacy on reproductive functions of a structured exercise training (SET) programme with a diet programme in obese PCOS patients and (ii) to study their clinical, hormonal and metabolic effects to elucidate potentially different mechanisms of action.METHODSForty obese PCOS patients with anovulatory infertility underwent a SET programme (SET group, n = 20) and a hypocaloric hyperproteic diet (diet group, n = 20). Clinical, hormonal and metabolic data were assessed at baseline, and at 12- and 24-week follow-ups. Primary endpoint was cumulative pregnancy rate.RESULTSThe two groups had similar demogra...
This paper describes the simulation of the operating environment of the New York Power Pool (NYPP) within the Dispatcher Training Simulator facility at the New York State Electric and Gas Corporation (NYSEG). The NYSEG control center uses real-time data received from the NYPP control center to control its internal generation. In addition, the NYSEG dispatchers work very closely with the NYPP dispatchers. The exact emulation of the Generation Control functions of the NYPP EMS, and the associated data exchange with the NYSEG ECS, contribute greatly to the high degree of realism achieved in the NYSEG DTS facility. The accuracy of the power system simulation in the DTS has been validated against actual power system disturbances recorded at NYSEG.
This article presents an unsupervised algorithm for semantic annotation of morphological descriptions of whole organisms. The algorithm is able to annotate plain text descriptions with high accuracy at the clause level by exploiting the corpus itself. In other words, the algorithm does not need lexicons, syntactic parsers, training examples, or annotation templates. The evaluation on two real-life description collections in botany and paleontology shows that the algorithm has the following desirable features: (a) reduces/eliminates manual labor required to compile dictionaries and prepare source documents; (b) improves annotation coverage: the algorithm annotates what appears in documents and is not limited by predefined and often incomplete templates; (c) learns clean and reusable concept...
Health information technology initiatives created the framework for a national health information infrastructure that concomitantly fostered a need to build intellectual capacity within our current and future health information management (HIM) work force. Results from the 2008 HIM Educator Survey are discussed. Developed for voluntary electronic participation, the survey comprised a series of questions about educators' professional interests and responsibilities. Summary data from the 402 respondents are provided and highlight areas such as academic rank, teaching status, salary range, levels of interest in various issues, and use of virtual learning tools. Data from this survey provide insights into the concerns and challenges many HIM educators face in today's training institutions and suggest implications for future directions in work force training and professional development within the HIM field. PMID:19424453
Many real-world text classification tasks involve imbalanced training examples. The strategies proposed to address the imbalanced classification (e.g., resampling, instance weighting), however, have not been systematically evaluated in the text domain. In this paper, we conduct a comparative study on the effectiveness of these strategies in the context of imbalanced text classification using Support Vector Machines (SVM) classifier. SVM is the interest in this study for its good classification accuracy reported in many text classification tasks. We propose a taxonomy to organize all proposed strategies following the training and the test phases in text classification tasks. Based on the taxonomy, we survey the methods proposed to address the imbalanced classification. Among them, 10 common...
The majority of Brazilian big cities served by conventional railroad systems with routes starting in the center of the URBIS, destinate them the long distances transport of passengers and cargo. Actually, these systems are being transformed to become commuter trains which join a great capacity of transportation to a much lower costs of implantation than subway ones. The most important characteristic of this train, when talking about energy consumption, is the possibility of using different kinds of explosion engines from three cycles: Diesel, mixed (Diesel + Natural Gas), and Otto moved by natural gas, besides the traditional electric traction. The use of natural gas in Otto cycle engines shows itself competitive from the point of view of investments, operational costs and environmental preservation. (author). 10 refs., 1 fig
Mine rescue teams frequently must fight fires and guard against the propagation of fires or explosions during a rescue and recovery operation. The team's ability to fight fires depends a great deal on hands-on experience with different fire fighting agents and equipment. The team's work includes an assessment of fire conditions, mine fire gases and other potential hazards associated with fire fighting activity. This training module covers the underlying principles of the fire triangle and the different methods for controlling, containing and extinguishing fires in a mine. The manual also covers fire-fighting equipment, considerations involved in a sealing operation and the cause-effect of explosions.
We propose and analyze a novel regenerative amplifier free electron laser (FEL) to produce fully coherent x-ray pulses. The method makes use of narrow-bandwidth Bragg crystals to form an x-ray feedback loop around a relatively short undulator. Self-amplified spontaneous emission (SASE) from the leading electron bunch in a bunch train is spectrally filtered by the Bragg reflectors and is brought back to the beginning of the undulator to interact repeatedly with subsequent bunches in the bunch train. The FEL interaction with these short bunches not only amplifies the radiation intensity but also broadens its spectrum, allowing for effective transmission of the x-rays outside the crystal bandwidth. The spectral brightness of these x-ray pulses is about two to three orders of magnitude higher than that from a single-pass SASE FEL.
The wavelength of the free electron laser (FEL) in Osaka University can be continuously varied in the range of 5.0-20.0 #mu#m. The FEL has a double-pulse structure, consisting of a train of macropulses of pulse duration 12 #mu#s. Each macropulse contains a train of 330 micropulses of pulse duration 5 ps. The tunability and picosecond pulses afford new medical and biological applications. However, a macropulse of long pulse duration leads to undesirable secondary effects. Precise control of the macropulse duration is essential for the high-precision applications of the FEL. An FEL pulse control system using acousto-optic modulators has been developed to investigate mechanical (shock-wave) effects of the FEL on living tissues. With this system, we have controlled photoinduced shock waves and determine the mechanism of interaction during FEL-induced tissue ablation.
Three papers on the Egyptian educational system were delivered at the World Assembly of the International Council of Education for Teaching in Cairo, Egypt, in 1981. The first paper, "Recent Educational Reforms in Egypt," by M. M. Radwan, describes the changes in Egyptian education since 1952, including the adoption of universal basic education. The four authors (Hussein Fawzi Al Najjar, Mohamed Abdelmagid Ibrahim, Sayad M. Kheiralla, and Hassan Mostafa) of the second paper, "Egytian Education Today," focus on the Egyptian characteristics of the educational system, citing teacher education and the problem of illiteracy as outstanding national issues. In the third paper, "Educational Technology: Its Application to Inservice Teacher Training in Egypt," by Kamal Yousef Iskander, the use of educational technology in inservice teacher education is outlined, with reference to the problems anticipated in training 130,000 teachers for Egypt's new ...
The present study was designed to determine the exercise intensity equivalent to the metabolic aerobic/anaerobic transition of alloxan diabetic rats, through lactate minimum test (LMT), and to evaluate the effects of swimming exercise at this intensity (LM) on the glucose and protein metabolism of these animals. Adult male Wistar rats received alloxan (SD, alloxan-injected rats that remained sedentary) intravenously (30 mg kg?1 body weight) for diabetes induction. As controls (SC, vehicle-injected rats that remained sedentary), vehicle-injected rats were utilized. Two weeks later, the animals were submitted to oral glucose tolerance test (oGTT) and LMT. After the tests, some of the animals were submitted to swimming exercise training [TC (vehicle-injected rats that performed a 6-week exerc...
Purpose - Viewing creativity through the theoretical lens of the resource-based view, the paper attempts to answer a fundamental question: is design creativity a static or dynamic capability? If static, then firms need to acquire personnel who are already creative. If dynamic, then personnel's creative talents should be developed through training. Design/methodology/approach - In an exploratory controlled experiment of 74 design engineers from ten firms, two forms of training emphasizing design creativity as static or dynamic capability were applied. Creative designs developed by the participants were judged by professionals inside each organization. Results were analyzed using structural equation modeling. Findings - The exploratory findings support the notion that design creativity is a ...
Capturing the Daylight Dividend conducted activities to build market demand for daylight as a means of improving indoor environmental quality, overcoming technological barriers to effective daylighting, and informing and assisting state and regional market transformation and resource acquisition program implementation efforts. The program clarified the benefits of daylight by examining whole building systems energy interactions between windows, lighting, heating, and air conditioning in daylit buildings, and daylighting's effect on the human circadian system and productivity. The project undertook work to advance photosensors, dimming systems, and ballasts, and provided technical training in specifying and operating daylighting controls in buildings. Future daylighting work is recommended in metric development, technology development, testing, training, education, and outreach.
This paper presents the application of artificial neural networks to adiabatic flame temperature prediction of hydrocarbon fuels. The investigation was conducted over a wide range of operating conditions in terms of fuel composition, pressure and temperature of reactants, fuel-air equivalence ratio and fuel vapour fraction. Several neural network models for predicting the flame temperature for different applicable fuel ranges were built and examined. The proper preparation of network training data and the appropriate choice of network parameters for achieving better prediction accuracy are discussed. The neural network prediction results were compared with those calculated by a thermodynamic and chemical equilibrium-based computer code - the NASA program CET89. It was shown that trained neural network models can provide the adiabatic flame temperature prediction with a good level of accuracy over a wide range of operating conditions. 16 refs., ...
The paper describes two schemes that follow the model of Lamarckian evolution and combine differential evolution (DE), which is a population-based stochastic global search method, with the local optimization algorithm of conjugate gradients (CG). In the first, each offspring is fine-tuned by CG before competing with their parents. In the other CG is used to improve both parents and offspring in a manner that is completely seamless for individuals that survive more than one generation. Experiments involved training weights of feed-forward neural networks to solve three synthetic and four real-life problems. In six out of seven cases the DE?CG hybrid, which preserves and uses information on each solution?s local optimization process, outperformed two recent variants of DE.
The urine test strip is the most common test used to detect ketones in veterinary patients, but it can underestimate the degree of ketonuria and hence, ketonemia. Additionally, adequate urine samples for analysis may be difficult to obtain from dehydrated animals. The standard method used to detect and monitor ketonemia in human medicine is measurement of serum or whole blood beta-hydroxybutyrate (?HOB). A point-of-care (POC) analyzer has been validated for this purpose in humans. This study compared the accuracy of the POC device to an enzymatic reaction laboratory method for measurement of ?HOB in dogs. Although the POC sensor tended to overestimate ?HOB concentrations, there was good correlation (R(2) = 0.96) and good agreement between the 2 methods with a bias +/- precision of 0.0860 +/- 0.3410 mmol/L ?HOB. The POC ?HOB sensor can be useful for assessing ketonemia in dogs. PMID:21119867
This paper contributes to an understanding of pharmacogenomics-in-the-making by foregrounding a regulatory setting in which these technologies must be situated: decision-making about pharmaceutical reimbursement. Health care assessment organizations have been introduced in many countries to systematically address the issue of health care coverage. Using the example of Sweden, the process of deciding reimbursement status is shown to hinge on the creation of stable and clinically feasible categories of patients, diseases and drug responses. Through a series of analogous examples concerning conventional pharmaceuticals, it is argued that current mechanisms for categorizing reimbursable drugs could be upset when pharmacogenomic advances provide a means of making patients more specific objects ...
Summary This third paper, in a three-part CE series on the preventions of infection in patients with chronic kidney disease, focuses on surveillance and auditing of healthcare-associated infections within the renal care environment. The last decade has seen an increased awareness of the threat to patient safety from healthcare-associated infection (HCAI) and the emergence of multi-drug resistance organisms. Effective HCAI prevention strategies include adequate governance structures, access to expert advice, adherence to standard and transmission-based precautions, minimising the use of invasive medical devices, and surveillance. Surveillance data can be collected using outcome (e.g. infection) and/or process (e.g. hand hygiene compliance audit) measures. Establishing a surveillance program...
Purpose - The purpose of this paper is to explain some tax management complications for onshore and offshore hedge funds posed by US FIN 48, Uncertain Tax Positions, and to emphasize the hedge fund manager's responsibility for careful tax planning and compliance. Design/methodology/approach - The paper discusses a hedge fund's objective to deliver tax-efficient results to investors, explains the background of FIN 48, and illustrates five types of situations in which conservative auditors following FIN 48 may raise "red flags." Findings - With the advent of FIN 48's standards careful tax planning and compliance are more important than ever for a hedge fund. Significant complications may arise from unwise, tardy, or missed tax elections; filing an IRS Form 8275, Disclosure Statement, stating...
Abstract Background: This study involves a multicentre surveillance of tigecycline and tetracycline activity against Gram-negative and Gram-positive bacteria from primary care centres (PCCs), general hospital wards (GHWs) and intensive care units (ICUs) in Denmark (n == 9), Finland (n == 10), Norway (n == 7) and Sweden (n == 19). Methods: The hospitals were each asked to test 30 consecutive Gram-positive and 30 Gram-negative clinical isolates. Supportive information accompanying each isolate included the study centre, ward level (PCC, GHW, or ICU), patient identification and source of the isolate. Minimum inhibitory concentrations (MICs) for tetracycline and tigecycline were determined with the Etest. Results: The isolates collected comprised 1610 Gram-negative and 1767 Gram-positive clini...