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Sample records for ten case studies

  1. Frictional amyloidosis in Oman - A study of ten cases

    Directory of Open Access Journals (Sweden)

    Mysore Venkataram

    2002-01-01

    Full Text Available Macular amyloidosis is an important cause for cutaneous pigmentation, the aetiology of which is poorly understood. Friction has recently been implicated the causation of early lesions, referred to as frictional amyloidosis. Confirmation of diagnosis by the detect on of amyloid using histochemical stains is inconsistent. Ten patients with pigmentation suggestive of macular amyloidosis were studied with detailed history, clinical examination, biopsy for histochemistry and electron microscopy. Nine out of ten patients had a history of prolonged friction with various objects such as bath sponges, brushes, towels, plant sticks and leaves. Amyloid was demonstrated by histochemical staining in only six out of ten cases. In the remaining four cases, amyloid was detected by electron microscopy. These consisted of aggregates of non-branching, extracellular, intertwining fibres measuring between 200-500 nm in length and between 20-25 nm in diameter. The study confirms the role of friction in the causation of this condition. Histochemical stains are not always successful in the detection of amyloid and electron microscopy is helpful for confirming its presence. The term frictional amyloidosis aptly describes the condition.

  2. Making a difference: Ten case studies of DSM/IRP interactive efforts and related advocacy group activities

    Energy Technology Data Exchange (ETDEWEB)

    English, M.; Schexnayder, S.; Altman, J. [Tennessee Univ., Knoxville, TN (United States). Energy, Environment and Resources Center; Schweitzer, M. [Oak Ridge National Lab., TN (United States)

    1994-03-01

    This report discusses the activities of organizations that seek to promote integrated resource planning and aggressive, cost-effective demand-side management by utilities. The activities of such groups -- here called energy efficiency advocacy groups (EEAGs) -- are examined in ten detailed am studies. Nine of the cases involve some form of interactive effort between investor-owned electric utilities and non-utility to develop policies, plans, or programs cooperatively. Many but not all of the interactive efforts examined are formal collaboratives. In addition, all ten cases include discussion of other EEAG activities, such as coalition-building, research, participation in statewide energy planning, and intervention in regulatory proceedings.

  3. The acute radiation syndrome: A study of ten cases and a review of the problem

    Energy Technology Data Exchange (ETDEWEB)

    Hempelmann, L.H.; Lisco, H.

    1950-03-17

    In this report ten cases of acute radiation syndrome are described resulting from two accidents occurring at the Los Alamos Scientific Laboratory of unique nature involving fissionable material. These cases are described in considerable detail. The report comprises ten sections. This volume, part II of the report, is comprised of sections entitled: (1) the Biological Basis for the Clinical Response seen in the Acute radiation Syndrome, (2) Clinical Signs and Symptoms, (3) Discussion of Hematological Findings, (4) Chemistry of the Blood and Urine, (5) Discussion of Pathological Findings, and (6) Reconsiderations of the Calculated Radiation Doses in Terms of the Observed Biological Response of the Patients. This report was prepared primarily for the clinician who is interested in radiation injuries and therefore emphasis has been placed on the correlation of clinical and pathological changes with the type of cytogenetic change known to be produced by ionizing radiation.

  4. Keys to success: Ten case studies of effective weatherization programs

    Energy Technology Data Exchange (ETDEWEB)

    Brown, M.A.; Berry, L.G.; Kolb, J.O.; White, D.L. [Oak Ridge National Lab., TN (United States); Kinney, L.F.; Wilson, T. [Synertech Systems Corp., Syracuse, NY (United States)

    1993-11-01

    In 1990, DOE initiated a nationwide evaluation of its Weatherization Program, with assistance from Oak Ridge National Laboratory and an advisory group of 40 weatherization professionals, program managers, and researchers. The evaluation is comprised of three impact studies covering the Program`s major market segments: Single-family homes, mobile homes, and dwellings in small (2 to 4-unit) multifamily buildings (the Single-Family Study), Single-family homes heated primarily with fuel oil (the Fuel-Oil Study), and Dwellings in buildings with five or more units (the Multifamily Study). The Single-Family Study, the subject of this report, is a critical part of this coordinated evaluation effort. Its focus on single-family dwellings, mobile homes, and dwellings in small multifamily buildings covers 83% of the income-eligible population and 96% of the dwellings weatherized during Program Year 1989. The first phase of the Single-Family Study involved the analysis of a massive data base of information collected from 368 local weatherization agencies and 543 electric and gas utilities. This analysis resulted in energy-saving and cost-effectiveness estimates for the Weatherization Program and the identification of a set of ten high-performing agencies located throughout the country. The second phase, which is the subject of this report, involves a ``process`` evaluation of these ten high performers, aimed at identifying those weatherization practices that explain their documented success.

  5. Investigation of a cluster of ten cases of Hodgkin's disease in an occupational setting

    NARCIS (Netherlands)

    Swaen, G.M.H.; Slangen, J.J.M.; Ott, M.G.; Kusters, E.; van den Langenbergh, G.; Arends, J.W.; Zober, A.

    1996-01-01

    The objective of this study was to identify occupational exposures that might be etiologically linked to an unusual cluster of ten cases of Hodgkin's disease. The cases were identified within the active workforce of a large chemical manufacturing firm over a 23-year period by the medical director of

  6. transverse patella fracture in a ten year old boy: case report

    African Journals Online (AJOL)

    report a case of a transverse patella fracture in a ten year old boy. He presented with ... fall, he reported that he had pain and swelling which resolved ... radiographs of the patient's right (normal) knee. Figure 1 ... the limb splinted in a back slab.

  7. Adult Klebsiella pneumoniae meningitis in Qatar:clinical pattern of ten cases

    Institute of Scientific and Technical Information of China (English)

    Fahmi Yousef Khan; Mohammed Abukhattab; Mohammed AbuKamar; Deshmukh Anand

    2014-01-01

    Objective: To describe the clinical presentation, underlying diseases, antimicrobial susceptibility, treatment and outcome of Klebsiella pneumoniae meningitis patients. Methods:This retrospective study involved all patients with 15 years of age or older who admitted to Hamad General Hospital with culture proven Klebsiella pneumoniae meningitis from January 1, 2007 to December 31, 2012. Results: A total of ten cases were identified (nine males and one female). Their mean age was (43.3±12.8) years. Eight patients (80%) had nosocomial meningitis with neurosurgery being the most frequent associated condition. Fever and altered consciousness were the most frequent symptom. Cerebrospinal fluid showed elevated protein and glucose levels. Gram stain showed Gram-negative rods in 50%of cases, while positive cerebrospinal fluid culture results were found in all patients. Multidrug resistance was observed in two cases, and all patients had received appropriate empirical and definitive antibiotic treatments. The mean duration of intravenous antimicrobial treatment was (19.3±7.0) d and all patients with external ventricular drains underwent removal of the device, while in-hospital mortality was 50%. Conclusions: The number of cases was too small to come up with therapeutic and prognostic conclusions. Further large-scale prospective study is needed.

  8. Adult Klebsiella pneumoniae meningitis in Qatar:clinical pattern of ten cases

    Institute of Scientific and Technical Information of China (English)

    Fahmi; Yousef; Khan; Mohammed; Abukhattab; Mohanuned; Abukamar; Deshmukh; Anand

    2014-01-01

    Objective:To describe the clinical presentation,underlying diseases,antimicrobial susceptibility,treatment and outcome of Klebsiella pneumoniae meningitis patients.Methods:This retrospective study involved all patients with 15 years of age or older who admit ted to Hamad General Hospital with culture proven Klebsiella pneumoniae meningitis from January 1,2007 to December 31,2012.Results:A total of ten cases were identified mine males and one female).Their mean age was i43.3±12.8) years.Eight patients(80%) had nosocomial meningitis with neurosurgery being the most frequent associated condition.Fever and altered consciousness were the most frequent symptom.Cerebrospinal fluid showed elevated protein and glucose levels.Oram slain showed Gram—negative rods in 50%of cases,while positive cerebrospinal fluid culture results were found in all patients.Multidrug resistance was observed in two cases,and all patients had received appropriate empirical and definitive antibiotic treatments.The mean duration of intravenous antimicrobial treatment was(19.3±7.0) d and all patients with external ventricular drains underwent removal of the device,while in—hospital mortality was 50%.Conclusions:The number of cases was too small to come up with therapeutic and prognostic conclusions.Further large-scale prospective study is needed.

  9. Transverse patella fracture in a ten year old boy: case report ...

    African Journals Online (AJOL)

    Patella fractures are rare in children. Transverse fractures in particular are an uncommon pattern. We report a case of a transverse patella fracture in a ten year old boy. He presented with inability to actively extend his left knee, two months after a fall. On evaluation he was found to have a transverse fracture of his left patella.

  10. Spontaneous Mediastinitis in a Ten-year-old Girl: A Case Report

    International Nuclear Information System (INIS)

    Cho, Kyung Eun; Kim, Ji Hong; Yoon, Choon Sik; Lee, Mi Jung; Kim, Myung Joon

    2011-01-01

    Acute suppurative mediastinitis is an uncommon, life threatening condition with a mortality rate of up to 40%. It is mainly caused by esophageal perforation or post-operative complications, and acute mediastinitis not caused by trauma or surgery is rare. To the best of our knowledge, no cases of spontaneous mediastinal abscess in children have been reported in the English medical literature. We report here on a case of an acute mediastinal abscess in a ten-year-old girl and there was no demonstrable clinical or radiologic etiology for infection

  11. Spontaneous Mediastinitis in a Ten-year-old Girl: A Case Report

    Energy Technology Data Exchange (ETDEWEB)

    Cho, Kyung Eun; Kim, Ji Hong; Yoon, Choon Sik [Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul (Korea, Republic of); Lee, Mi Jung; Kim, Myung Joon [Severance Hospital, Yonsei University College of Medicine, Seoul (Korea, Republic of)

    2011-01-15

    Acute suppurative mediastinitis is an uncommon, life threatening condition with a mortality rate of up to 40%. It is mainly caused by esophageal perforation or post-operative complications, and acute mediastinitis not caused by trauma or surgery is rare. To the best of our knowledge, no cases of spontaneous mediastinal abscess in children have been reported in the English medical literature. We report here on a case of an acute mediastinal abscess in a ten-year-old girl and there was no demonstrable clinical or radiologic etiology for infection

  12. Comparative study between manual therapy and TENS Burst in patients with tension-type cephalalgia

    Directory of Open Access Journals (Sweden)

    Denise Vasconcelos Fernandes

    Full Text Available Introduction Cephalgia or cephalalgia is one of the most common symptoms in the general population. Objective To compare the efficacy of physical therapy modalities, through manual therapy and the effect of Transcutaneous Nerve Stimulation (TENS for tension-type cephalalgia. Materials and methods The study was compounded by 60 subjects, but only 40 of them completed it, due to the exclusion criteria. These were divided into control group and intervention group. The control group received treatment — manual therapy. The intervention group received TENS Burst. Patients underwent ten sessions of treatment, made at every two days on a week, lasting 30 minutes each session. Results The characteristics related to lifestyle, postural issues and range of motion are responsible for the main causes of tension-type cephalalgia. Discussion treatments showed effective results in all cases in relation to pain intensity, but the use of manual therapy techniques give the patient a better quality of life compared to the use of TENS. Final considerations The treatment of this condition deserves analysis and studies; however, there are only a few studying physical therapy techniques, especially regarding to the use of TENS.

  13. Stevens Johnson syndrome, toxic epidermal necrolysis and SJS-TEN overlap: A retrospective study of causative drugs and clinical outcome

    Directory of Open Access Journals (Sweden)

    Sharma Vinod

    2008-01-01

    Full Text Available Background and Aims: Stevens Johnson syndrome (SJS, toxic epidermal necrolysis (TEN and SJS-TEN overlap are serious adverse cutaneous drug reactions. Drugs are often implicated in these reactions. Methods: A retrospective analysis of inpatients′ data with these dermatological diagnoses were carried out for three years, to study the causative drugs, clinical outcome, and mortality in these conditions. Results: Thirty patients (15 TEN, nine SJS-TEN overlap, and six SJS were admitted. In 21 cases, multiple drugs were implicated whereas single drugs were responsible in nine. Anticonvulsants (35.08% were the most commonly implicated drugs followed by antibiotics (33.33% and NSAIDS (24.56%. Twenty-five patients recovered whereas five died (four TEN, one SJS-TEN overlap. Conclusion: Anticonvulsants, antibiotics and NSAIDs were the most frequently implicated drugs. TEN causes higher mortality than both SJS and SJS-TEN overlap.

  14. Ganglion cysts at the gastrocnemius origin: a series of ten cases

    International Nuclear Information System (INIS)

    James, S.L.J.; Connell, D.A.; Saifuddin, A.; Bell, J.

    2007-01-01

    To describe ganglion cysts arising close to the origin of the medial and lateral head of gastrocnemius as identified on magnetic resonance (MR) imaging. We present a series of ten cases of ganglion cysts arising close to the gastrocnemius origin from the medial and lateral femoral condyles. These were collected over a 6-year period from our imaging database. All patients attended for routine MR imaging of the knee with a variety of clinical presentations. Data collected included patient demographics, ganglion size, ganglion site, clinical presentation and ancillary MR imaging findings. The ten patients in this series consisted of seven males and three females, five right and five left knees, age range 27-68 years, mean age 40.6 years. The mean maximal dimension of the ganglion cysts was 26 mm, range 15-40 mm. The medial gastrocnemius origin was involved in eight patients and the lateral origin in two patients. The MR imaging findings consisted of both uni- and multi-loculated cysts, often containing numerous septations with fluid signal characteristics. The cysts were extra-capsular with no clear communication with the joint. One patient presented with a popliteal soft tissue mass and none of the cases required surgical intervention for cyst removal. MR imaging may identify ganglion cysts arising in an intra- or extra-articular site around the knee. This series documents the MR imaging characteristics of ganglion cysts arising close to the gastrocnemius origin and discusses the relevance of this imaging finding. (orig.)

  15. Colorectal carcinoma in a ten-year-old girl: A case report

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    Sarbani Chattopadhyay

    2012-01-01

    Full Text Available Colorectal carcinoma is very rare in childhood. In this case report, we depict a ten-year-old girl who presented with features of intestinal obstruction which turned out to be due to poorly differentiated mucin secreting adenocarcinoma of descending colon. Only increased awareness of this malignancy in this age-group and a high index of suspicion can help when a child complains of persistent pain of abdomen, altered bowel habits or rectal bleeding, and may provide diagnosis at an earlier stage, thereby improving the prognosis.

  16. A Ten Year Analysis of Fatal Peripheral Vascular Injuries Autopsy Study

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    Salim Tuncer

    2016-04-01

    Full Text Available Aim: Peripheral vascular injuries are usually associated with fatal injuries. Early diagnosis and intervention are so vital for improving a favorable outcome for traumatic vascular injuries. As a preventable cause of death, we aimed to evaluate peripheral vascular injuries in overall deaths in ten year period, 2003-2012. Material and Method: A retrospective evaluation was made of 2845 death cases which had post-mortem examination and autopsy from the 10-year period of 2003-2012 in Eskisehir, Turkey. The mean age of the cases included in the study was 32.5±7.9 years with the highest rate of cases occurring in the 30-39 years age group. Males constituted 89.2% of the victims. The most frequent manner of death was homicide 83.8%.The femoral artery was the most commonly injured vessel 29 cases (78.4%. In this study it was identified that, 33 patients (89.3% died before any medical intervention could be performed. Discussion: Our study shows that, peripheral vascular injuries most commonly caused by sharp objects. The injuries have a low mortality rate when early intervention is made. Autopsies are conducted is very important to explain not only the cause of death but also the treatment process, which would clear the cases of any potential malpractice or negligence claims.

  17. Critical Studies on Men in Ten European Countries

    DEFF Research Database (Denmark)

    Pringle, Keith; Hearn, Jeff (and 13 other network partners)

    2002-01-01

    This article is one the work of The European Research Network on Men in Europe project “The Social Problem and Societal Problematization of Men and Masculinities” (2000-2003), funded by the European Commission. The Network comprises women and men researchers with range of disciplinary backgrounds...... of statistical sources on men's practices in the ten countries, are presented. This is the second of four articles reviewing critical studies on men in the ten countries through different methods and approaches....

  18. Prognostic factors in children with acute lymphoblastic leukemia: a ten year study

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    Oloomi yazdi Z.

    2008-06-01

    Full Text Available Background: Acute lymphoblastic leukemia (ALL is the most common cancer in the pediatric population. With modern treatments, the chance of the complete recovery is nearly 100%. The most important prognostic factors are appropriate treatment protocol and determination of patient risk factors based on clinical, morphological, immunological and cytological characteristics. In this study we reviewed frequency of these factors, like as age, gender, the primary white blood cell number, sub- group on the base of FAB classification, immunophenotype and the clinical progress. Methods: In this retrospective study, we reviewed 877 pediatric patients with the diagnosis of ALL between the years of 1994 and 2004. In these patients the age, gender, primary WBC count, sub-group based on the FAB classification, immunophenotype and the clinical progress in 177 patient with acute lymphoblastic leukemia at Imam Khomeini Hospital between the years of 1994 to 2004 were determined. Results: Of these patients, 1.6% was younger than one year, 24.8% more than ten years old and 73.6% were between the ages of one and ten years; 63.8% were male. WBC counts were above 50,000/ul in 28.8% of the patients. FAB classifications included L1 in 80.2%, L2 in 17.5% and L3 in 2.3% of the patients. Immunophenotypes included pre-B cell in 63.8%, early pre-B cell in 23.1%, T cell in 12.3% and mature B cell in 0.8% of the patients. Marker CD10+ was detected in 88.1% of the B cell cases. In this study group, 74% of the patients recovered, 16.3% died and 16.5% relapsed.Conclusions: The prevalence of FAB-L1 and pre-B cell cases in this study is greater than a previous study, while the prevalence of FAB-L2 and early pre-B cell cases is less than that of the previous study.

  19. The Impact of Introducing Malaria Rapid Diagnostic Tests on Fever Case Management: A Synthesis of Ten Studies from the ACT Consortium.

    Science.gov (United States)

    Bruxvoort, Katia J; Leurent, Baptiste; Chandler, Clare I R; Ansah, Evelyn K; Baiden, Frank; Björkman, Anders; Burchett, Helen E D; Clarke, Siân E; Cundill, Bonnie; DiLiberto, Debora D; Elfving, Kristina; Goodman, Catherine; Hansen, Kristian S; Kachur, S Patrick; Lal, Sham; Lalloo, David G; Leslie, Toby; Magnussen, Pascal; Mangham-Jefferies, Lindsay; Mårtensson, Andreas; Mayan, Ismail; Mbonye, Anthony K; Msellem, Mwinyi I; Onwujekwe, Obinna E; Owusu-Agyei, Seth; Rowland, Mark W; Shakely, Delér; Staedke, Sarah G; Vestergaard, Lasse S; Webster, Jayne; Whitty, Christopher J M; Wiseman, Virginia L; Yeung, Shunmay; Schellenberg, David; Hopkins, Heidi

    2017-10-01

    Since 2010, the World Health Organization has been recommending that all suspected cases of malaria be confirmed with parasite-based diagnosis before treatment. These guidelines represent a paradigm shift away from presumptive antimalarial treatment of fever. Malaria rapid diagnostic tests (mRDTs) are central to implementing this policy, intended to target artemisinin-based combination therapies (ACT) to patients with confirmed malaria and to improve management of patients with nonmalarial fevers. The ACT Consortium conducted ten linked studies, eight in sub-Saharan Africa and two in Afghanistan, to evaluate the impact of mRDT introduction on case management across settings that vary in malaria endemicity and healthcare provider type. This synthesis includes 562,368 outpatient encounters (study size range 2,400-432,513). mRDTs were associated with significantly lower ACT prescription (range 8-69% versus 20-100%). Prescribing did not always adhere to malaria test results; in several settings, ACTs were prescribed to more than 30% of test-negative patients or to fewer than 80% of test-positive patients. Either an antimalarial or an antibiotic was prescribed for more than 75% of patients across most settings; lower antimalarial prescription for malaria test-negative patients was partly offset by higher antibiotic prescription. Symptomatic management with antipyretics alone was prescribed for fewer than 25% of patients across all scenarios. In community health worker and private retailer settings, mRDTs increased referral of patients to other providers. This synthesis provides an overview of shifts in case management that may be expected with mRDT introduction and highlights areas of focus to improve design and implementation of future case management programs.

  20. Feasibility study of Transcutaneous Electrical Nerve Stimulation (TENS) for cancer bone pain.

    Science.gov (United States)

    Bennett, Michael I; Johnson, Mark I; Brown, Sarah R; Radford, Helen; Brown, Julia M; Searle, Robert D

    2010-04-01

    This multicenter study assessed the feasibility of conducting a phase III trial of transcutaneous electrical nerve stimulation (TENS) in patients with cancer bone pain recruited from palliative care services. Eligible patients received active and placebo TENS for 1 hour at site of pain in a randomized crossover design; median interval between applications 3 days. Responses assessed at 30 and 60 minutes included numerical and verbal ratings of pain at rest and on movement, and pain relief. Recruitment, tolerability, adverse events, and effectiveness of blinding were also evaluated. Twenty-four patients were randomised and 19 completed both applications. The intervention was well tolerated. Five patients withdrew: 3 due to deteriorating performance status, and 2 due to increased pain (1 each following active and placebo TENS). Confidence interval estimation around the differences in outcomes between active and placebo TENS suggests that TENS has the potential to decrease pain on movement more than pain on rest. Nine patients did not consider that a placebo was used; the remaining 10 correctly identified placebo TENS. Feasibility studies are important in palliative care prior to undertaking clinical trials. Our findings suggest that further work is required on recruitment strategies and refining the control arm before evaluating TENS in cancer bone pain. Cancer bone pain is common and severe, and partly mediated by hyperexcitability. Animal studies suggest that Transcutaneous Electrical Nerve Stimulation can reduce hyperalgesia. This study examined the feasibility of evaluating TENS in patients with cancer bone pain in order to optimize methods before a phase III trial. Copyright 2010 American Pain Society. Published by Elsevier Inc. All rights reserved.

  1. Granulocyte colony-stimulating factor in toxic epidermal necrolysis (TEN) and Chelsea & Westminster TEN management protocol [corrected].

    Science.gov (United States)

    de Sica-Chapman, A; Williams, G; Soni, N; Bunker, C B

    2010-04-01

    Toxic epidermal necrolysis (TEN) is a rare but life-threatening, allergic drug reaction. Skin blistering with epidermal and mucosal necrolysis with subsequent detachment from an inflamed underlying dermis is a hallmark of the condition. The pathogenesis of TEN is not well understood, accounting for controversies about its management and significant delay in initiating potentially beneficial therapy. There are no management protocols based on a robust evidence base. Prompt recognition of the diagnosis and consensus on early management initiatives are necessary in order to improve outcomes and survival in TEN. To date, TEN management has been directed at arresting the allergic reaction and treating the complications. We have identified a need for specific medical interventions to accelerate wound regeneration. This approach has not previously been adopted in the management of TEN. We observed that in two cases of severe TEN, dramatic re-epithelialization and recovery coincided with the introduction of granulocyte colony-stimulating factor (G-CSF) for neutropenia. We explain how addition of the G-CSF promotes recovery from TEN by enhanced bioregeneration of the damaged tissues through accelerated re-epithelialization. G-CSF has been used for severe neutropenia in TEN, but we recommend and explain why, as in our Chelsea and Westminster protocol, G-CSF should be considered in treating severe TEN irrespective of the severity of neutropenia.

  2. Performance Analysis of Ten Common QRS Detectors on Different ECG Application Cases

    Directory of Open Access Journals (Sweden)

    Feifei Liu

    2018-01-01

    Full Text Available A systematical evaluation work was performed on ten widely used and high-efficient QRS detection algorithms in this study, aiming at verifying their performances and usefulness in different application situations. Four experiments were carried on six internationally recognized databases. Firstly, in the test of high-quality ECG database versus low-quality ECG database, for high signal quality database, all ten QRS detection algorithms had very high detection accuracy (F1 >99%, whereas the F1 results decrease significantly for the poor signal-quality ECG signals (all 95% except RS slope algorithm with 94.24% on normal ECG database and 94.44% on arrhythmia database. Thirdly, for the paced rhythm ECG database, all ten algorithms were immune to the paced beats (>94% except the RS slope method, which only output a low F1 result of 78.99%. At last, the detection accuracies had obvious decreases when dealing with the dynamic telehealth ECG signals (all <80% except OKB algorithm with 80.43%. Furthermore, the time costs from analyzing a 10 s ECG segment were given as the quantitative index of the computational complexity. All ten algorithms had high numerical efficiency (all <4 ms except RS slope (94.07 ms and sixth power algorithms (8.25 ms. And OKB algorithm had the highest numerical efficiency (1.54 ms.

  3. Is TENS purely a placebo effect? A controlled study on chronic low back pain.

    Science.gov (United States)

    Marchand, S; Charest, J; Li, J; Chenard, J R; Lavignolle, B; Laurencelle, L

    1993-07-01

    Although high-frequency low-intensity transcutaneous electric nerve stimulation (TENS) has been extensively used to relieve low back pain, experimental studies of its effectiveness have yielded contradictory findings mainly due to methodological problems in pain evaluation and placebo control. In the present study, separate visual analog scales (VAS) were used to measure the sensory-discriminative and motivational-affective components of low back pain. Forty-two subjects were randomly assigned to 1 of 3 groups: TENS, placebo-TENS, and no treatment (control). In order to measure the short-term effect of TENS, VAS pain ratings were taken before and after each treatment session. Also, to measure long-term effects, patients rated their pain at home every 2 h throughout a 3-day period before and 1 week, 3 months and 6 months after the treatment sessions. In comparing the pain evaluations made immediately before and after each treatment session, TENS and placebo-TENS significantly reduced both the intensity and unpleasantness of chronic low back pain. TENS was significantly more efficient than placebo-TENS in reducing pain intensity but not pain unpleasantness. TENS also produced a significant additive effect over repetitive treatment sessions for pain intensity and relative pain unpleasantness. This additive effect was not found for placebo-TENS. When evaluated at home, pain intensity was significantly reduced more by TENS than placebo-TENS 1 week after the end of treatment, but not 3 months and 6 months later. At home evaluation of pain unpleasantness in the TENS group was never different from the placebo-TENS group.(ABSTRACT TRUNCATED AT 250 WORDS)

  4. Astrophysical parameters of ten poorly studied open star clusters

    International Nuclear Information System (INIS)

    Tadross, Ashraf Latif; El-Bendary, Reda; Osman, Anas; Ismail, Nader; Bakry, Abdel Aziz

    2012-01-01

    We present the fundamental parameters of ten open star clusters, nominated from Kronberger et al. who presented some newly discovered stellar groups on the basis of the Two Micron All Sky Survey photometry and Digitized Sky Survey visual images. Star counts and photometric parameters (radius, membership, distance, color excess, age, luminosity function, mass function, total mass, and dynamical relaxation time) have been determined for these ten clusters for the first time. In order to calibrate our procedures, the main parameters (distance, age, and color excess) have been re-estimated for another five clusters, which are also studied by Kronberger et al. (research papers)

  5. How could she? Psychosocial analysis of ten homicide cases committed by women.

    Science.gov (United States)

    Hellen, Florence; Lange-Asschenfeldt, Christian; Ritz-Timme, Stefanie; Verhülsdonk, Sandra; Hartung, Benno

    2015-11-01

    Ten percent of all homicide perpetrators are female and homicidal acts committed by women are mostly a result of interpersonal conflicts. We carried out a retrospective psychosocial analysis of ten homicide cases committed by women with an urban mid-European background. We evaluated characteristic determinants regarding 1) deed circumstances and motives, 2) the perpetrators, and 3) the victims. Results were compared with the literature on female and male homicides. Autopsy records of the Institute of Legal Medicine of the University Hospital of Düsseldorf, Germany, during the time period from 2006 to 2011 were searched for homicides committed by female perpetrators. Prosecution files were reviewed for further information. The sample comprised N = 10 female homicide perpetrators and eleven victims. The mentioned determinants of the homicide were fairly consistent. All deeds occurred in the domestic context; they were mostly unplanned. All perpetrators were socially isolated and faced socially challenging situations. Most perpetrators were of low socioeconomic status. Furthermore, all victims were helpless and/or dependent on the perpetrator. The presence of a major psychiatric disorder was uncommon and, in contrast to male perpetrators, most women had no previous convictions. The potential value of these core findings in our sample regarding prevention is discussed. Copyright © 2015 Elsevier Ltd and Faculty of Forensic and Legal Medicine. All rights reserved.

  6. PURPA Resource Development in the Pacific Northwest : Case Studies of Ten Electricity Generating Powerplants.

    Energy Technology Data Exchange (ETDEWEB)

    Washington State Energy Office.

    1990-07-01

    The case studies in this document describe the Public Utilities, Regulatory Policies Act (PURPA) development process for a variety of generating technologies. Developer interactions with regulatory agencies and power purchasers are described in some detail. Equipment, installation, and maintenance costs are identified; power marketing considerations are taken into account; and potential environmental impacts, with corresponding mitigation approaches and practices are summarized. The project development case studies were prepared by the energy agencies of the four Northwest states, under contract to the Bonneville Power Administration.

  7. Prevalence of oral squamous cell carcinoma cases for ten years in Qazvin province (2003-13

    Directory of Open Access Journals (Sweden)

    F. Keshani

    2017-06-01

    Full Text Available Background: Human cancers comprise a large group of diseases that despite modern methods of diagnosis and advanced treatment techniques its mortality rate is high. Considering the role of environmental and cultural factors in the prevalence of oral cancer, epidemiological studies have a great importance. Objective: The aim of this research was to determine the prevalence of oral squamous cell carcinoma (OSCC in the province of Qazvin in a period of ten years. Methods: In this descriptive - analytical study, the documents of 88 patients with OSCC that were recorded by the Qazvin Cancer Registry Center during 2003-13, were used. Demographic data including age, sex and location of lesions were extracted from patient records. Data analysis were performed using chi-square, t-test and fisher exact test. Findings: Among the 88 patients, the average age was 64.3±17.7. The male to female ratio was 1 to 1.37 and the most involved area was tongue with 39 cases (63.9%, and the lowest was upper lip with 1 case (1.6%. The most of the patients were in the age between 70-80 years old. Conclusions: Pattern of OSCC in this study was similar to the other studies but the number of females and the mean age of patient had increased. Also, the mean age of patients was increased in eight decades and the most involved area tongue was reported.

  8. HIPs at Ten

    Science.gov (United States)

    Kuh, George; O'Donnell, Ken; Schneider, Carol Geary

    2017-01-01

    2017 is the anniversary of the introduction of what are now commonly known as high-impact practices (HIPs). Many of the specific activities pursued under the HIPs acronym have been around in some form for decades, such as study abroad, internships, and student-faculty research. It was about ten years ago that, after conferring HIPs at Ten with…

  9. Marked seasonality of Cyclospora cayetanensis infections: ten-year observation of hospital cases, Honduras.

    Science.gov (United States)

    Kaminsky, Rina Girard; Lagos, Javier; Raudales Santos, Gabriela; Urrutia, Samuel

    2016-02-04

    Document seasonality occurrence and epidemiologic characteristics of Cyclospora cayetanensis infections during a 10-year period from patients consulting at the University Hospital, Honduras. Retrospective non interventional hospital-based study analyzed laboratory results from the period 2002 to 2011 of fresh and Ziehl-Nielsen carbolfuchsin stained routine stool samples received for parasitologic examination. Sporadically a sample with numerous oocysts was allowed to sporulate in 2.5 % potassium dichromate confirming the presence of bi-cystic bi-zoic oocysts. A total of 35,157 fecal samples were examined during a ten-year span, of which a third (28.4 %) was stained by the Ziehl-Neelsen carbolfuchsin method diagnosing a total of 125 (1.3 %) C.cayetanensis infections. A statistically significant apparent seasonality was observed most years during May to August (range p < 0.036-0.001), with 83.3 % of 125 cases occurring in those rainy months. All C. cayetanensis cases came from urban poor neighborhoods; male/female relation was 1:1 except in 2006, when all patients were females (p = 0.05; r(2) = 22,448). Forty four point eight percent of the stool samples were diarrheic or liquid and 65.6 % infections were identified in children 10 years old or less. Enteric helminths and protozoa co-infected Cyclospora positive patients in 52 instances.: 8 % Ascaris lumbricoides, 8 % Giardia duodenalis, 23.2 % Blastocystis spp. and less frequently Entamoeba histolytica/E. dispar, Strongyloides stercoralis, and Trichuris trichiura. Results suggest a seasonal pattern for Cyclospora infections diagnosed in a clinical setting during the rainy months in Tegucigalpa and surrounding areas. Community studies should be conducted to support or dispute these observations.

  10. Mucinous carcinoid of the ovary: report of a case with metastasis in the contralateral ovary after ten years

    Directory of Open Access Journals (Sweden)

    Patricia C. Ewing

    2010-09-01

    Full Text Available Monodermal teratomas of the ovary can take the form of carcinoid tumors of which there are several types, mucinous carcinoid being the least common. Very few cases of primary mucinous carcinoid of the ovary have been reported in the literature and the behavior of these tumors over the long term is unclear. We describe a case of primary mucinous carcinoid of the ovary in a 39-year-old woman treated with unilateral salpingo-oophorectomy, where a metastasis occurred in the contralateral ovary ten years later. This case demonstrates that mucinous carcinoid of the ovary can metastasize even after a long interval, and careful follow-up of patients, particularly those treated conservatively, is appropriate.

  11. Models and impact of patient and public involvement in studies carried out by the Medical Research Council Clinical Trials Unit at University College London: findings from ten case studies.

    Science.gov (United States)

    South, Annabelle; Hanley, Bec; Gafos, Mitzy; Cromarty, Ben; Stephens, Richard; Sturgeon, Kate; Scott, Karen; Cragg, William J; Tweed, Conor D; Teera, Jacqueline; Vale, Claire L

    2016-07-29

    Patient and public involvement (PPI) in studies carried out by the UK Medical Research Council Clinical Trials Unit (MRC CTU) at University College London varies by research type and setting. We developed a series of case studies of PPI to document and share good practice. We used purposive sampling to identify studies representing the scope of research at the MRC CTU and different approaches to PPI. We carried out semi-structured interviews with staff and patient representatives. Interview notes were analysed descriptively to categorise the main aims and motivations for involvement; activities undertaken; their impact on the studies and lessons learned. We conducted 19 interviews about ten case studies, comprising one systematic review, one observational study and 8 randomised controlled trials in HIV and cancer. Studies were either open or completed, with start dates between 2003 and 2011. Interviews took place between March and November 2014 and were updated in summer 2015 where there had been significant developments in the study (i.e. if the study had presented results subsequent to the interview taking place). A wide range of PPI models, including representation on trial committees or management groups, community engagement, one-off task-focused activities, patient research partners and participant involvement had been used. Overall, interviewees felt that PPI had a positive impact, leading to improvements, for example in the research question; study design; communication with potential participants; study recruitment; confidence to carry out or complete a study; interpretation and communication of results; and influence on future research. A range of models of PPI can benefit clinical studies. Researchers should consider different approaches to PPI, based on the desired impact and the people they want to involve. Use of multiple models may increase the potential impacts of PPI in clinical research.

  12. Randomised Controlled Trial Study of the Effect of TENS and NSAID ...

    African Journals Online (AJOL)

    Randomised Controlled Trial Study of the Effect of TENS and NSAID (Opoid) Drug in the Management of Post Operative Gynaecological Pain. AAG Jimoh, LO Omokanye, GA Salaudeen, ZA Suleiman, K Durowade, EO Adewara ...

  13. Etiologic Causes and Epidemiological Characteristics of Patients with Intraocular Foreign Bodies: Retrospective Analysis of 1340 Cases over Ten Years

    Directory of Open Access Journals (Sweden)

    Lin Li

    2018-01-01

    Full Text Available Objective. Patients with intraocular foreign bodies were retrospectively analyzed. Population characteristics, pathogenic factors, and the outcomes during the past ten years were discussed. Design. Retrospective case series study. Method. Medical records of 1340 patients hospitalized in Beijing Tongren Hospital from January 1, 2004, to December 31, 2013, were collected. Results. Average age was 33.0 ± 13.8 (1–76 years old in 1340 patients. There were more males (1270, 94.8% than females (70, 5.2%. Patients from outside of Beijing (82.1%, n=1100 prevailed. Farmers (32.1%, n=430 and workers (22.3%, n=299 were the top two affected professions. Leading two causes were splashing of foreign bodies (SFB (58.6%, n=785 and explosives (31.8%, n=426. More males than females were injured by SFB (59.4% versus 44.3%, P=0.009. Firework injury was the commonest (41.6% versus 3.1%–15.3%, P<0.05 in patients under nine. The annual percentages in patients over 50 increased (P<0.001 and in patients by explosives decreased (P=0.027. Conclusion. Most patients in this study were young males from outside of Beijing and farmers. SFB accounted most for patients over 10 years old and fireworks for those under ten. Patients over 50 increased while those by explosives decreased annually over the period.

  14. The Result of The Treatment of Infantile Spasm After Two Year Follow-Up Review Of 45 Cases in Ten Past Years

    Directory of Open Access Journals (Sweden)

    A Nasirian

    2001-06-01

    Full Text Available In the past ten years, 45 cases of infantile spasm treated in our center. From these patients, 15 cases received only steroid, other 15 cases only clonazepam, and the rest, a combination of clonazepam and steroid. All patients were observed for two years. This is a retrospective study, the data being extracted from patients record. A number of patients were treated in ambulatory and the others were patients of the hospital. The result of comparison of optimal control of seizures are as follow: 1 In only steroid group 27 percent of the patients were free of seizure, 2 In only clonazepam group 28 percent showed no seizure, 3 in combined clonazepam and steroid group 39% were seizure-free. Based on this trial we believe that treatment of infantile spasm with combined steroid and clonazepam is better than any of them alone. Considering these results, we believe that the treatment of infantile spasm with a combination of steroid and clonazepam is preferable to these drugs.

  15. Femoral shaft fractures in children, treaties with elastic nails of titanium - TENs

    International Nuclear Information System (INIS)

    Solano Urrutia, Antonio Luis; Gallon, Luis Alfonso; Echandia, Carlos

    2003-01-01

    Femoral shaft fractures are a common and temporarily disabling injury in children. Recent advances in orthopedic traumatology have led us at the Hospital Universitario del Valle, in Cali, Colombia, to perform a case series observational study with the use of a more aggressive approach with the new endomedullar titanium nails (TENs) in children suffering femur shaft fractures, in a closed procedure performed under image intensification. The main purpose of this study was to evaluate the outcome of 30 children treated with these nails. Pediatric femoral shaft fractures are more common in males with approximately a 2.75:1 male to female ratio. The age distribution is bimodal, with peaks in the younger than 5 years and mid-teenage groups (10-14 years) because of the increased incidence of high-energy trauma in teenage children (mean age: 9 years). Overall, TENs allowed rapid mobilization with few complications. The results were excellent or satisfactory in our cases. No child lost rotational alignment in the postoperative period. Irritation of the soft tissue near the knee by the nail tip occurred in one patient. As indications, implantation technique, and aftercare are refined, TENs may prove to be the ideal implant to stabilize most pediatric femur shaft fractures, avoiding the prolonged immobilization and complications of traction and spica cast

  16. External radiotherapy prior to thyroid cancer: A case-control study

    International Nuclear Information System (INIS)

    Hallquist, A.; Loefroth, P.O.; Hardell, L.

    1993-01-01

    The aim of this investigation was to study previous radiotherapy of malignant diseases as a risk factor for thyroid cancer. By using the Swedish Cancer Registry all cases of thyroid cancer with another malignant disease at least one year previously and living within the catchment area of the hospital were traced. During 1959-1989 a total of 1056 cases of thyroid cancer were identified. Of these, 37 had had another previous malignant disease and they constituted the cases in this study. As controls four persons with at least two malignant diseases, thyroid cancer excluded, were selected for each case from the same cancer registry. Ten (27.0%) of the 37 patients with thyroid cancer as a second tumor had earlier been irradiated with the treatment dose including the thyroid gland as compared with 34 (24.5%) of the 139 control patients. Eight of the ten cases with previous irradiation of the thyroid gland had papillary cancer. The median latency was 13 years. The estimated radiation dose in the thyroid varied between 3 and 40 Gy. External radiotherapy gave a crude odds ratio of 1.1 with 95% confidence interval = 0.5-2.8 for thyroid cancer. The weighted odds ratio was calculated to 2.3 with confidence interval = 0.5-8.9. This case-control study gave a nonsignificantly increased odds ratio for thyroid cancer in patients with external radiotherapy including the thyroid gland. 26 refs., 4 tabs

  17. Case report on xeroderma pigmentosum with squamous cell carcinoma in a ten year old child

    Directory of Open Access Journals (Sweden)

    Uday Kumar Sonnappa

    2018-04-01

    Full Text Available Xeroderma pigmentosum (XPis a rare inherited skin disorder characterized by a heightened sensitivity to the DNA damaging effects of ultraviolet radiation (UV. The main source of UV is the sun. The symptoms of XP can be seen in any sun-exposed area of the body. The effects are greatest on the skin, the eyelids and the surface of the eyes but the tip of the tongue may also be damaged. In addition, approximately 25% of XP patients also develop abnormalities of the nervous system manifesting as progressive neuro-degeneration with hearing loss. People with XP have a 10,000-fold increased risk for developing skin cancer including basal cell carcinoma, squamous cell carcinoma and melanoma. They also have a 2000-fold increased risk for cancer of the eye and surrounding ocular tissues. These symptoms appear early in life, typically before age 10 years. This case is being presented to highlight the rarity of a case of xeroderma pigmentosum with squamous cell carcinoma in a ten year old child.

  18. Subtotal Hemispherectomy, Report of Ten Cases

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    N. O. Ameli

    1960-01-01

    Full Text Available 10 cases submitted to subtotal hemispheretomy are discussed. In selected group of infantile hemiplegia where epilepsy and behaviour disturbances are pr~sent, and investigations prove that the other hemisphere is farly normal, thts operation is of greatt benefit. Ne,vertheless long follow-up of these cases IS necessary before a final judgement can be passed. Age should.be no barrier to selection, as those of 18 - 25 have benefited as much as young children

  19. Transcutaneous electrical nerve stimulation (TENS) for chronic low back pain.

    Science.gov (United States)

    Milne, S; Welch, V; Brosseau, L; Saginur, M; Shea, B; Tugwell, P; Wells, G

    2001-01-01

    Low back pain (LBP) affects a large proportion of the population. Transcutaneous electrical nerve stimulation (TENS) was introduced more than 30 years ago as an alternative therapy to pharmacological treatments for chronic pain. However, despite its widespread use, the effectiveness of TENS is still controversial. The aim of this systematic review was to determine the efficacy of TENS in the treatment of chronic LBP. We searched MEDLINE, EMBASE, PEDro and the Cochrane Controlled Trials Register up to June 1, 2000. Only randomized controlled clinical trials of TENS for the treatment of patients with a clinical diagnosis of chronic LBP were included. Abstracts were excluded unless further data could be obtained from the authors. Two reviewers independently selected trials and extracted data using predetermined forms. Heterogeneity was tested with Cochran's Q test. A fixed effects model was used throughout for continuous variables, except where heterogeneity existed, in which case, a random effects model was used. Results are presented as weighted mean differences (WMD) with 95% confidence intervals (95% CI), where the difference between the treated and control groups was weighted by the inverse of the variance. Standardized mean differences (SMD) were calculated by dividing the difference between the treated and control by the baseline variance. SMD were used when different scales were used to measure the same concept. Dichotomous outcomes were analyzed with odds ratios. Five trials were included, with 170 subjects randomized to the placebo group receiving sham-TENS and 251 subjects receiving active TENS (153 for conventional mode, 98 for acupuncture-like TENS). The schedule of treatments varied greatly between studies ranging from one treatment/day for two consecutive days, to three treatments/day for four weeks. There were no statistically significant differences between the active TENS group when compared to the placebo TENS group for any outcome measures

  20. Ten Tonne Plan: Education for Sustainability from a Whole Systems Thinking Perspective

    Science.gov (United States)

    Lewis, Elaine; Mansfield, Caroline; Baudains, Catherine

    2014-01-01

    The "Ten Tonne Plan" is a greenhouse gas emissions reduction initiative that aimed to reduce school emissions by 10 tonnes (metric tons) in one year. A case study was conducted on the impact of this initiative at a primary school in Western Australia. Research investigated student, staff, parent, and community partner perceptions…

  1. The application of the Ten Group classification system (TGCS in caesarean delivery case mix adjustment. A multicenter prospective study.

    Directory of Open Access Journals (Sweden)

    Gianpaolo Maso

    Full Text Available BACKGROUND: Caesarean delivery (CD rates are commonly used as an indicator of quality in obstetric care and risk adjustment evaluation is recommended to assess inter-institutional variations. The aim of this study was to evaluate whether the Ten Group classification system (TGCS can be used in case-mix adjustment. METHODS: Standardized data on 15,255 deliveries from 11 different regional centers were prospectively collected. Crude Risk Ratios of CDs were calculated for each center. Two multiple logistic regression models were herein considered by using: Model 1- maternal (age, Body Mass Index, obstetric variables (gestational age, fetal presentation, single or multiple, previous scar, parity, neonatal birth weight and presence of risk factors; Model 2- TGCS either with or without maternal characteristics and presence of risk factors. Receiver Operating Characteristic (ROC curves of the multivariate logistic regression analyses were used to assess the diagnostic accuracy of each model. The null hypothesis that Areas under ROC Curve (AUC were not different from each other was verified with a Chi Square test and post hoc pairwise comparisons by using a Bonferroni correction. RESULTS: Crude evaluation of CD rates showed all centers had significantly higher Risk Ratios than the referent. Both multiple logistic regression models reduced these variations. However the two methods ranked institutions differently: model 1 and model 2 (adjusted for TGCS identified respectively nine and eight centers with significantly higher CD rates than the referent with slightly different AUCs (0.8758 and 0.8929 respectively. In the adjusted model for TGCS and maternal characteristics/presence of risk factors, three centers had CD rates similar to the referent with the best AUC (0.9024. CONCLUSIONS: The TGCS might be considered as a reliable variable to adjust CD rates. The addition of maternal characteristics and risk factors to TGCS substantially increase the

  2. Implementation fidelity of self-administered transcutaneous electrical nerve stimulation (TENS) in patients with chronic back pain: an observational study.

    Science.gov (United States)

    Pallett, Edward J; Rentowl, Patricia; Johnson, Mark I; Watson, Paul J

    2014-03-01

    The efficacy of transcutaneous electrical nerve stimulation (TENS) for pain relief has not been reliably established. Inconclusive findings could be due to inadequate TENS delivery and inappropriate outcome assessment. Electronic monitoring devices were used to determine patient compliance with a TENS intervention and outcome assessment protocol, to record pain scores before, during, and after TENS, and measure electrical output settings. Patients with chronic back pain consented to use TENS daily for 2 weeks and to report pain scores before, during, and after 1-hour treatments. A ≥ 30% reduction in pain scores was used to classify participants as TENS responders. Electronic monitoring devices "TLOG" and "TSCORE" recorded time and duration of TENS use, electrical settings, and pain scores. Forty-two patients consented to participate. One of 35 (3%) patients adhered completely to the TENS use and pain score reporting protocol. Fourteen of 33 (42%) were TENS responders according to electronic pain score data. Analgesia onset occurred within 30 to 60 minutes for 13/14 (93%) responders. It was not possible to correlate TENS amplitude, frequency, or pulse width measurements with therapeutic response. Findings from TENS research studies depend on the timing of outcome assessment; pain should be recorded during stimulation. TENS device sophistication might be an issue and parameter restriction should be considered. Careful protocol design is required to improve adherence and monitoring is necessary to evaluate the validity of findings. This observational study provides objective evidence to support concerns about poor implementation fidelity in TENS research.

  3. Ten Years toward Equity: Preliminary Results from a Follow-Up Case Study of Academic Computing Culture

    Directory of Open Access Journals (Sweden)

    Tanya L. Crenshaw

    2017-05-01

    Full Text Available Just over 10 years ago, we conducted a culture study of the Computer Science Department at the flagship University of Illinois at Urbana-Champaign, one of the top five computing departments in the country. The study found that while the department placed an emphasis on research, it did so in a way that, in conjunction with a lack of communication and transparency, devalued teaching and mentoring, and negatively impacted the professional development, education, and sense of belonging of the students. As one part of a multi-phase case study spanning over a decade, this manuscript presents preliminary findings from our latest work at the university. We detail early comparisons between data gathered at the Department of Computer Science at the University of Illinois at Urbana-Champaign in 2005 and our most recent pilot case study, a follow-up research project completed in 2016. Though we have not yet completed the full data collection, we find it worthwhile to reflect on the pilot case study data we have collected thus far. Our data reveals improvements in the perceptions of undergraduate teaching quality and undergraduate peer mentoring networks. However, we also found evidence of continuing feelings of isolation, incidents of bias, policy opacity, and uneven policy implementation that are areas of concern, particularly with respect to historically underrepresented groups. We discuss these preliminary follow-up findings, offer research and methodological reflections, and share next steps for applied research that aims to create positive cultural change in computing.

  4. Transcutaneous electrical nerve stimulation (TENS) for neuropathic pain in adults.

    Science.gov (United States)

    Gibson, William; Wand, Benedict M; O'Connell, Neil E

    2017-09-14

    Neuropathic pain, which is due to nerve disease or damage, represents a significant burden on people and society. It can be particularly unpleasant and achieving adequate symptom control can be difficult. Non-pharmacological methods of treatment are often employed by people with neuropathic pain and may include transcutaneous electrical nerve stimulation (TENS). This review supersedes one Cochrane Review 'Transcutaneous electrical nerve stimulation (TENS) for chronic pain' (Nnoaham 2014) and one withdrawn protocol 'Transcutaneous electrical nerve stimulation (TENS) for neuropathic pain in adults' (Claydon 2014). This review replaces the original protocol for neuropathic pain that was withdrawn. To determine the analgesic effectiveness of TENS versus placebo (sham) TENS, TENS versus usual care, TENS versus no treatment and TENS in addition to usual care versus usual care alone in the management of neuropathic pain in adults. We searched CENTRAL, MEDLINE, Embase, PsycINFO, AMED, CINAHL, Web of Science, PEDro, LILACS (up to September 2016) and various clinical trials registries. We also searched bibliographies of included studies for further relevant studies. We included randomised controlled trials where TENS was evaluated in the treatment of central or peripheral neuropathic pain. We included studies if they investigated the following: TENS versus placebo (sham) TENS, TENS versus usual care, TENS versus no treatment and TENS in addition to usual care versus usual care alone in the management of neuropathic pain in adults. Two review authors independently screened all database search results and identified papers requiring full-text assessment. Subsequently, two review authors independently applied inclusion/exclusion criteria to these studies. The same review authors then independently extracted data, assessed for risk of bias using the Cochrane standard tool and rated the quality of evidence using GRADE. We included 15 studies with 724 participants. We found a

  5. Extraskeletal mesenchymal chondrosarcoma: an imaging review of ten new patients

    Energy Technology Data Exchange (ETDEWEB)

    Hashimoto, N.; Joyama, S.; Araki, N. [Osaka Medical Center for Cancer and Cardiovascular Disease, Department of Orthopedic Surgery, Osaka (Japan); Ueda, T.; Yoshikawa, H. [Osaka University Graduate School of Medicine, Department of Orthopedic Surgery, Osaka (Japan); Beppu, Y. [National Cancer Center Hospital, Department of Orthopedic Surgery, Tokyo (Japan); Tatezaki, S. [Chiba Cancer Center Hospital, Department of Orthopedic Surgery, Chiba (Japan); Matsumoto, S. [Cancer Institute Hospital, Japanese Foundation for Cancer Research Hospital, Department of Orthopedic Surgery, Tokyo (Japan); Nakanishi, K. [Osaka Seamen' s Insurance Hospital, Department of Radiology, Osaka (Japan); Tomita, Y. [Osaka University Graduate School of Medicine, Department of Pathology, Osaka (Japan)

    2005-12-01

    Extraskeletal mesenchymal chondrosarcoma (EMC) is a rare soft-tissue tumor that most arises in young adults. Because of its rarity, few imaging studies have been reported to date. The purpose of this study was to elucidate the imaging features of this tumor. We conducted a multi-institutional study in cooperation with five referral cancer centers in Japan. Imaging findings of ten new EMC cases, including conventional radiography, computed tomography (CT), and magnetic resonance imaging (MRI), performed at each institute, were reviewed along with clinical features. Ten patients with EMC, who had been treated at each hospital from 1990 to 2001, participated in this study. Soft-tissue masses with well-demarcated, dense and granular calcification were most frequently observed on plain radiographs and CT scans. T2-weighted MR images most clearly depicted a two-component structure composed of calcified and uncalcified areas, and enhanced MRI showed inhomogeneous enhancement in both areas. Although the sensitivity and specificity of these findings are unknown, they might be characteristic and have diagnostic value for this rare tumor. (orig.)

  6. What can be learned from practical cases of green economy? –studies from five European countries

    NARCIS (Netherlands)

    Pitkänen, K.; Antikainen, R.; Droste, N.; Loiseau, E.; Saikku, L.; Aissani, L.; Hansjürgens, B.; Kuikman, P.J.; Leskinen, P.; Thomsen, M.

    2016-01-01

    The transition to green economies has been mediated by concrete cases and experiments in a variety of different industrial and social sectors. What is lacking, is research that would synthesize key findings and “lessons learned” across a variety of cases. In this study, we explore ten cases of

  7. Ten principles of good interdisciplinary team work.

    Science.gov (United States)

    Nancarrow, Susan A; Booth, Andrew; Ariss, Steven; Smith, Tony; Enderby, Pam; Roots, Alison

    2013-05-10

    Interdisciplinary team work is increasingly prevalent, supported by policies and practices that bring care closer to the patient and challenge traditional professional boundaries. To date, there has been a great deal of emphasis on the processes of team work, and in some cases, outcomes. This study draws on two sources of knowledge to identify the attributes of a good interdisciplinary team; a published systematic review of the literature on interdisciplinary team work, and the perceptions of over 253 staff from 11 community rehabilitation and intermediate care teams in the UK. These data sources were merged using qualitative content analysis to arrive at a framework that identifies characteristics and proposes ten competencies that support effective interdisciplinary team work. Ten characteristics underpinning effective interdisciplinary team work were identified: positive leadership and management attributes; communication strategies and structures; personal rewards, training and development; appropriate resources and procedures; appropriate skill mix; supportive team climate; individual characteristics that support interdisciplinary team work; clarity of vision; quality and outcomes of care; and respecting and understanding roles. We propose competency statements that an effective interdisciplinary team functioning at a high level should demonstrate.

  8. Socio-Demographic Determinants of Eclampsia in Calabar; A Ten ...

    African Journals Online (AJOL)

    A ten-year review of the socio-demographic determinants of eclampsia was ... had past histories of eclampsia, while in 7 (18.4%) cases history of change of ... no formal education and 34.25% were subsistence farmers living in the suburbs of ...

  9. Clinical experience with TENS and TENS combined with nitrous oxide-oxygen. Report of 371 patients.

    OpenAIRE

    Quarnstrom, F. C.; Milgrom, P.

    1989-01-01

    Transcutaneous electrical nerve stimulation (TENS) alone or TENS combined with nitrous oxide-oxygen (N2O) was administered for restorative dentistry without local anesthesia to 371 adult patients. A total of 55% of TENS alone and 84% of TENS/N2O visits were rated successful. A total of 53% of TENS alone and 82% of TENS/N2O patients reported slight or no pain. In multivariable analyses, pain reports were related to the anesthesia technique and patient fear and unrelated to sex, race, age, toot...

  10. How did General Surgery Department of a Training Hospital Change in Ten Years?

    Directory of Open Access Journals (Sweden)

    Zafer Ergül

    2012-07-01

    Full Text Available  Aim: To investigate the changes in a training hospital’s surgical patient profile in ten years. To delineate the effects of the transfer of Social Security Institution Hospitals to the Ministry of Health on this process. Material and Method: Ten-year apart, two-year periods were selected and all elective and emergency cases were retrospectively searched. In between periods, the hospital was transferred from Social Security Institution Hospital to the Ministry of Health and then became a trauma center. The indications, techniques, the number of performed surgeries, and the patient related factors were compared. The ratio of the number emergency cases and the number of cases performed by residents in training to the total number of cases were investigated. Results: The number of elective and emergent operations during the former and the latter periods were 2668 and 2041, respectively. The percentage of the decrease was 23.5%. After ten years, the patients were younger, more commonly male, emergency cases were more common, and operations performed primarily by the residents in training were less frequent than the former period (p<0,05. Oncological surgery of stomach, colon-rectum, breast, thyroid and primary-metastatic-malign carcinoma were more frequent during former period whereas urgent operations except peptic ulcer perforation and upper gastrointestinal bleeding and benign anorectal diseases were more common during later period (p<0,05. Discussion: The comparison revealed a significant decrease in the number of operations in ten years. The number of oncological patients increased whereas the number of emergency cases declined. The changes were thought to be related more to the transition in health and becoming a trauma center than to major developments in the country and the world.

  11. High Intensity Laser Therapy (HILT) versus TENS and NSAIDs in low back pain: clinical study

    Science.gov (United States)

    Zati, Allesandro; Fortuna, Damiano; Valent, A.; Filippi, M. V.; Bilotta, Teresa W.

    2004-09-01

    Low back pain, caused by lumbar disc herniation, is prevalently treated with a conservative approach. In this study we valued the efficacy of High Intensity Laser Therapy (HILT), compared with accepted therapies such as TENS and NSAIDs. Laser therapy obtained similar results in the short term, but better clinical effect over time than TENS and NSAIDs. In conclusion high intensity laser therapy appears to be a interesting new treatment, worthy of further research.

  12. Exploring Community College Peer Mentoring Practices within Central California: A Multiple Case Study

    Science.gov (United States)

    Brown, Lenis Colton

    2017-01-01

    The purpose of this qualitative, multiple case study was to illuminate the prevalence and configurations of peer mentoring programs at Central California Community Colleges with emphasis on how the programs impacted student retention. The study's sample was drawn from ten campuses and five centers that operate within five California Community…

  13. Transcutaneous electrical nerve stimulation (TENS) for chronic low-back pain.

    Science.gov (United States)

    Khadilkar, A; Milne, S; Brosseau, L; Robinson, V; Saginur, M; Shea, B; Tugwell, P; Wells, G

    2005-07-20

    Chronic low-back pain (LBP) affects a significant proportion of the population. Transcutaneous electrical nerve stimulation (TENS) was introduced more than 30 years ago as an adjunct to the pharmacological management of pain. However, despite its widespread use, the usefulness of TENS in chronic LBP is still controversial. The aim of this systematic review was to determine the effectiveness of TENS in the management of chronic LBP. We searched the Cochrane Central Register of Controlled Trials (Issue 2, 2005), MEDLINE, EMBASE and PEDro up to April 1, 2005. Only randomized controlled clinical trials (RCTs) evaluating the effect of TENS on chronic LBP were included. Abstracts were excluded unless further data could be obtained from the authors. Two reviewers independently selected trials and extracted data using predetermined forms. Heterogeneity was tested with Cochrane's Q test. A fixed effect model was used throughout for calculating continuous variables, except where heterogeneity existed, in which case, a random effects model was used. Results are presented as weighted mean differences (WMD) with 95% confidence intervals (95% CI), where the difference between the treated and control groups was weighted by the inverse of the variance. Standardized mean differences (SMD) were calculated by dividing the difference between the treated and control by the baseline variance. SMD were used when different scales were used to measure the same concept. Dichotomous outcomes were analyzed with odds ratios. The only two RCTs (175 patients) meeting eligibility criteria differed in study design, methodological quality, inclusion and exclusion criteria, type and method of TENS application, treatment schedule, co-interventions and final outcomes. In one RCT, TENS produced significantly greater pain relief than the placebo control. However, in the other RCT, no statistically significant differences between treatment and control groups were shown for multiple outcome measures. Pre

  14. Reverse shoulder arthroplasty in young patient with achondroplasia - Ten year follow up: Case report.

    Science.gov (United States)

    van den Broek, M; Verborgt, O; Declercq, G

    2017-11-01

    Skeletal dysplasia in achondroplasia can affect all body joints - including the glenohumeral joint - and is prone to develop to degenerative osteoarthritis (OA). This may cause pain and mobility problems at young age. Surgical treatment is challenging due to the dysplastic anatomy of the shoulder joint - with a dysplastic deformed short humerus, a small, hypoplastic medialized glenoid and lateralized acromion - and the long life expectancy of these patients. The indications for reverse shoulder arthroplasty (RSA) evolved during years with rotator cuff tears and rotator cuff arthropathy in combination with or without glenohumeral OA as the main indicator, with good short to mid-term results. Long term results of RSA are rarely found in literature, especially in young patients. The use of a RSA in glenohumeral OA with an intact rotator cuff has rarely been reported. In this case report we present the ten-year clinical and radiographic results of a RSA for the treatment of degenerative OA with glenohumeral dysplasia in a young patient with achondroplasia. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

  15. Clinical Study on Five Cases of Carpal tunnel syndrome

    Directory of Open Access Journals (Sweden)

    Kim Il Hwan

    2001-12-01

    Full Text Available Objections : The purpose of the study was to evaluate the effectiveness of treating the carpal tunnel syndrome by using both the Herbal Acupuncture and herbal medicine therapy on five cases. Methods : For the Herbal Acupuncture, Jungseonguhhyl No. 1 and Hwanglyunhaedoktang were used. For the herbal medicine, Dangguihwalhyul-tang was used. The patients were treated once in every two days; the result was evaluated after ten treatments. Patients' conditions were monitored through their testimony, phalen's test, nerve conduction study and electromyography. Results : In all five cases, the patients showed improvement; in four cases, the patients no longer had most of the clinical symptoms. Based on the result of the nerve conduction study, for the four cases in which the patients no longer displayed most of the clinical symptoms, their nerve conduction rate improved; for the remaining one case, the patient's nerve conduction rate deteriorated. Conclusions : The results of this study demonstrate that combining the Herbal Acupuncture and herbal medicine therapy can have noticeable effects in treating the carpal tunnel syndrome; developing more variety of the herbal acupuncture would lead to even better treatment results.

  16. Ten design lessons from the literature on child development and children’s use of technology

    CSIR Research Space (South Africa)

    Gelderblom, H

    2009-06-01

    Full Text Available sampling, data collection and data analysis [15]. We used multiple case sampling [28] to establish a trustworthy profile of five to eight year old children and reputational case selection [28] to choose the relevant theories of development, research... here will confirm. For this paper we selected, from the complete framework, ten themes to focus on. We present the guidelines associated with these themes as ten ‘lessons’ grounded in respected theoretical or empirical research results...

  17. Transcutaneous electrical nerve stimulation (TENS) for pain relief in labour.

    Science.gov (United States)

    Dowswell, Therese; Bedwell, Carol; Lavender, Tina; Neilson, James P

    2009-04-15

    Transcutaneous nerve stimulation (TENS) has been proposed as a means of reducing pain in labour. The TENS unit emits low-voltage electrical impulses which vary in frequency and intensity. During labour, TENS electrodes are generally placed on the lower back, although TENS may be used to stimulate acupuncture points or other parts of the body. The physiological mechanisms whereby TENS relieves pain are uncertain. The TENS unit is frequently operated by women, which may increase sense of control in labour. To assess the effects of TENS on pain in labour. We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (November 2008). Randomised controlled trials comparing women receiving TENS for pain relief in labour versus routine care, alternative pharmacological methods of pain relief, or placebo devices. We included all types of TENS machines. Two review authors assessed for inclusion all trials identified by the search strategy, carried out data extraction and assessed risk of bias. We have recorded reasons for excluding studies. The search identified 25 studies; we excluded six and included 19 studies including 1671 women. Fifteen examined TENS applied to the back, two to acupuncture points and two to the cranium. Overall, there was little difference in pain ratings between TENS and control groups, although women receiving TENS to acupuncture points were less likely to report severe pain (risk ratio 0.41, 95% confidence interval 0.32 to 0.55). The majority of women using TENS said they would be willing to use it again in a future labour. Where TENS was used as an adjunct to epidural analgesia there was no evidence that it reduced pain. There was no consistent evidence that TENS had any impact on interventions and outcomes in labour. There was little information on outcomes for mothers and babies. No adverse events were reported. There is only limited evidence that TENS reduces pain in labour and it does not seem to have any impact (either positive or

  18. Ten cases of severe oral lichen planus showing granular C3 deposition in oral mucosal basement membrane zone.

    Science.gov (United States)

    Hashimoto, Takashi; Fukuda, Aoi; Himejima, Akio; Morita, Shosuke; Tsuruta, Daisuke; Koga, Hiroshi; Krol, Rafal P; Ishii, Norito

    2015-01-01

    Oral lichen planus (OLP) may show depositions of immunoglobulins and complement components in oral mucosal basement membrane zone (BMZ) in direct immunofluorescence, although these finding are not frequently seen. We collected and examined ten cases of severe OLP showing granular C3 deposition in BMZ. In addition to clinical, histopathological and direct immunofluorescence assessments, we performed various immune-serological tests, including indirect immunofluorescence of normal human skin and 1M NaCl-split skin, immunoblotting of normal human epidermal and dermal extracts, recombinant proteins of BP180 NC16a and C-terminal domains, concentrated culture supernatant of HaCaT cells and purified human laminin-332, and enzyme-linked immunosorbent assays for BP230 and BP180. Direct immunofluorescence showed C3 deposition in BMZ exclusively of granular pattern in 7 cases and of both granular and linear patterns in 3 cases. The 10 cases showed no positive reactivity for either IgG or IgA antibodies in any immuno-serological tests. Detailed analyses of clinical, histopathological and immunological findings revealed striking female prevalence, although other parameters were in general characteristic of OLP. Granular C3 deposition in oral BMZ may be one of the characteristic features of severe OLP, although mechanisms for C3 deposition and its pathogenic role in OLP are currently unknown.

  19. The role of acupuncture in controlling the gagging reflex using a review of ten cases.

    Science.gov (United States)

    Fiske, J; Dickinson, C

    2001-06-09

    The gagging reflex is a physiological reaction which safeguards the airway from foreign bodies. In some people this response is exaggerated to the extent that the acceptance/provision of dental treatment is not possible. The aim of this paper is to review the role of acupuncture in controlling gagging as a safe, cheap, quick and relatively non-invasive technique. Ten people agreed to try ear acupuncture to control gagging during dental treatment. Prior to treatment the severity of gagging was assessed. Acupuncture needles were inserted into a specific anti-gagging point on each ear, manipulated briefly and left in situ. Dental treatment was then carried out and the effectiveness of the acupuncture in preventing gagging was assessed. After treatment, the needles were removed and the patient discharged. All acupuncture was carried out by a dentist trained in its use. Four people had a severe gag reflex which made treatment impossible and six had a very severe reflex which made treatment impossible and affected their dental attendance. Ear acupuncture completely controlled the gag reflex in eight cases (23 treatment episodes) and partially controlled the reflex in two cases (two treatment episodes). Dental treatment could be carried out in all cases and at all visits. The cost of materials was 0.2 pounds per person per visit. Additional clinical time was in the order of 2-3 minutes. There were no adverse reactions to the technique and, on all occasions, patients were fit to leave the surgery and travel home unaccompanied. Ear acupuncture was successful in controlling the gag reflex. It is a safe, quick, inexpensive and relatively noninvasive technique. A controlled clinical trial is required to investigate any placebo effect.

  20. Perinatal Mortality And Pregnancy Wastage In Ten Punjab Villages During 1991-1996 - A Population Based Study

    Directory of Open Access Journals (Sweden)

    Sachar R.K

    1998-01-01

    Full Text Available Research question: What is the extent of perinatal mortality and pregnancy wastage in rural Punjab and what are risk factors for the same. Objective: To quantify the perinatal; wastage and risk factors including the prevalence of these factors to determine the loss attributable to these factors in ten Punjab villages during the period 1991-1996. Study Design: Case control. Sample Size: 2519 pregnant women with Known outcome of pregnancy. Study Variables: Cause, timing and factors affecting perinatal mortality and pregnancy wastage (viz Wt.<40kg; Ht, <152cm,BMI, <20 illiteracy, birth to conception interval <100wks, Prematurity (Gestation <37 wks. Registered in IIIrd trimester, Registered in IInd Trimester, Home delivery. Outcome variables: Contribution of these factors in perinatal loss and pregnancy wastage. Analysis; Percentages, Odds ratio, confidence interval and population attributable risk%. Results: The perinatal mortality rate was 34.57/1000 and pregnancy wastage was 7.23%. Prematurity was the leading cause of perinatal loss. 31.25% of perinatal deaths took place within 24 hours and 87.5% within 96 hours. In case of perinatal mortality the odds ration were significant (p<0.05 for the following risk factors: weight, height, body mass index, illiteracy, birth to conception interval <1000 weeks, prematurity, registration of pregnancy in IInd trimester, registration of pregnancy in IIIrd trimester, home delivery. In case of pregnancy wastage the odds ratio were significant for the following risk factors: weight, height, body mass index, illiteracy, birth to conception interval <100weeks, prematurity, past history of abortion and low socio-economic status.

  1. Comparison of the refractive error changes among young children in ten years interval

    Directory of Open Access Journals (Sweden)

    Hai-Yan Li

    2013-07-01

    Full Text Available AIM: To compare the optometric examination results of myopic young children between those diagnosed in the period from 1998 to 2000 and those diagnosed in the period from 2008 to 2010; and to find out the causes of myopia and factors that worsen the condition, and suggest methods of its prevention and treatment.METHODS: This study was a retrospective case study. We randomly selected sample from out-patient department register of cases and divided them into two main groups, ‘ten year before group'(TYBG(1998/2000 year casesand ‘ten years later group'(2008/2010 year cases(TYLG. Each group was further subdivided into three sub-groups by age: under-six years old children group(CG, seven-twelve years old primary-school group(PSGand thirteen-eighteen years old middle-school group(MSG. The optometric examination results were statistically analyzed.RESULTS: The difference of the mean dioptre between the TYBG and TYLG was strongly statistically significant, also forward-lead trend of age when children suffered from myopia was found(P0.01. There was a significant increase of dioptre among PSG and MSG in TYLG compared to TYBG(PCONCLUSION: Our study shows that the age of getting myopia was forward lead, the dioptre increases by 1.00 degree and the prevalence of myopia is increasing gradually. This situation may due to the modern life style and changes of living standard of the population. Therefore, prevention of myopia should concentrate more on younger children at kindergarten and primary school stage students.

  2. Firework injuries: a ten-year study.

    Science.gov (United States)

    Puri, Vinita; Mahendru, Sanjay; Rana, Roshani; Deshpande, Manish

    2009-09-01

    Fireworks are used worldwide to celebrate popular events (e.g. festivals, official celebrations, weddings). The festival of lights (Diwali) is celebrated with fireworks in India. During this period, many patients from all age groups present to hospital with injuries due to fireworks. Prevalence, period of occurrence, sex and age variation, adult supervision, causative fireworks, mode of lighting, age groups prone to injury, patterns of injury caused by individual fireworks, and the body parts injured were studied. One hundred and fifty-seven cases (92 retrospective, 65 prospective) with injury due to fireworks presenting to the Department of Plastic Surgery at KEM Hospital between 1997 and 2006 were studied. The prevalence of injuries has decreased steadily over the last 10 years (41 cases in 1997, 3 cases in 2006). The maximum number of injuries (35%) was seen in the age group 5-14 years; 92% of these children were unsupervised. The commonest cause of injury was firework misuse (41% of cases), followed by device failure (35%). Device failure was commonest with flares/fountains (ground firework emitting sparks upwards) and aerial devices. Flare/fountains caused most injury (39%), sparklers the least (0.6%). Flare/fountains, ground spinners, sparklers, and gunpowder (explosive material from cracker, obtained by tearing paper wrapper and obtaining chemicals) caused only soft tissue burns; stringbombs (high-intensity fire cracker made by wrapping chemicals with jute strings/coir in layers) and rockets (aerial device that zooms upwards and bursts) caused blast injuries, leading to soft tissue disruption and bony injuries. Emergency surgery was done if indicated: tendon and/or neurovascular repair, fracture fixation, flap cover or amputation. Superficial burns were treated with dressings. Certain wounds needed only thorough cleansing of the wound and primary suturing. We concluded that, over a 10-year period, the prevalence of firework injury decreased due to increased

  3. Journalists and Olympic athletes: a Norwegian case study of ambivalent relationship

    OpenAIRE

    Kristiansen, Elsa; Hanstad, Dag Vidar

    2012-01-01

    © 2012 Human Kinetics This case study explores the relationship between media and sport. More specifically, it examines the association (i.e., the contact and communication) between Norwegian journalists and athletes during the 2010 Olympic Winter Games in Vancouver, Canada. Ten athletes and three journalists were interviewed about their relationship. To regulate and improve the journalist–athlete relationship during special events like the Olympics, media rules have been formulated. In re...

  4. Transcutaneous electrical nerve stimulation (TENS) for pain management in labour

    Science.gov (United States)

    Dowswell, Therese; Bedwell, Carol; Lavender, Tina; Neilson, James P

    2014-01-01

    Background Transcutaneous nerve stimulation (TENS) has been proposed as a means of reducing pain in labour. The TENS unit emits low-voltage electrical impulses which vary in frequency and intensity. During labour, TENS electrodes are generally placed on the lower back, although TENS may be used to stimulate acupuncture points or other parts of the body. The physiological mechanisms whereby TENS relieves pain are uncertain. TENS machines are frequently operated by women, which may increase a sense of control in labour. Objectives To assess the effects of TENS on pain in labour. Search methods We searched the Cochrane Pregnancy and Childbirth Group’s Trials Register (30 April 2011) and reference lists of retrieved papers. Selection criteria Randomised controlled trials comparing women receiving TENS for pain management in labour versus routine care, alternative non-pharmacological methods of pain relief, or placebo devices. We included all types of TENS machines. Data collection and analysis Two review authors assessed for inclusion all trials identified by the search strategy, carried out data extraction and assessed risk of bias. We have recorded reasons for excluding studies. Main results Seventeen trials with 1466 women contribute data to the review. Thirteen examined TENS applied to the back, two to acupuncture points, and two to the cranium. Overall, there was little difference in pain ratings between TENS and control groups, although women receiving TENS to acupuncture points were less likely to report severe pain (average risk ratio 0.41, 95% confidence interval 0.31 to 0.54; measured in two studies). The majority of women using TENS said they would be willing to use it again in a future labour. Where TENS was used as an adjunct to epidural analgesia there was no evidence that it reduced pain. There was no consistent evidence that TENS had any impact on interventions and outcomes in labour. There was little information on outcomes for mothers and babies. No

  5. Can iridology detect susceptibility to cancer? A prospective case-controlled study.

    Science.gov (United States)

    Münstedt, Karsten; El-Safadi, Samer; Brück, Friedel; Zygmunt, Marek; Hackethal, Andreas; Tinneberg, Hans-Rudolf

    2005-06-01

    This prospective case-control study aimed to investigate the value of iridology as a diagnostic tool in detecting some common cancers. One hundred ten (110) subjects were enrolled in the study: 68 subjects had histologically proven cancers of the breast, ovary, uterus, prostate, or colorectum, and 42 were control subjects. All subjects were examined by an experienced practitioner of iridology, who was unaware of their gender or medical details. He was allowed to suggest up to five diagnoses for each subject and his results were then compared with each subject's medical diagnosis to determine the accuracy of iridology in detecting malignancy. Iridology identified the correct diagnosis in only 3 cases (sensitivity, 0.04). Iridology was of no value in diagnosing the cancers investigated in this study.

  6. Medical school attrition-beyond the statistics a ten year retrospective study.

    Science.gov (United States)

    Maher, Bridget M; Hynes, Helen; Sweeney, Catherine; Khashan, Ali S; O'Rourke, Margaret; Doran, Kieran; Harris, Anne; Flynn, Siun O'

    2013-01-31

    Medical school attrition is important--securing a place in medical school is difficult and a high attrition rate can affect the academic reputation of a medical school and staff morale. More important, however, are the personal consequences of dropout for the student. The aims of our study were to examine factors associated with attrition over a ten-year period (2001-2011) and to study the personal effects of dropout on individual students. The study included quantitative analysis of completed cohorts and qualitative analysis of ten-year data. Data were collected from individual student files, examination and admission records, exit interviews and staff interviews. Statistical analysis was carried out on five successive completed cohorts. Qualitative data from student files was transcribed and independently analysed by three authors. Data was coded and categorized and key themes were identified. Overall attrition rate was 5.7% (45/779) in 6 completed cohorts when students who transferred to other medical courses were excluded. Students from Kuwait and United Arab Emirates had the highest dropout rate (RR = 5.70, 95% Confidence Intervals 2.65 to 12.27;p psychological morbidity in 40% (higher than other studies). Qualitative analysis revealed recurrent themes of isolation, failure, and despair. Student Welfare services were only accessed by one-third of dropout students. While dropout is often multifactorial, certain red flag signals may alert us to risk of dropout including non-EU origin, academic struggling, absenteeism, social isolation, depression and leave of absence. Psychological morbidity amongst dropout students is high and Student Welfare services should be actively promoted. Absenteeism should prompt early intervention. Behind every dropout statistic lies a personal story. All medical schools have a duty of care to support students who leave the medical programme.

  7. Ten patients with refractory status epilepticus in an intensive care department

    NARCIS (Netherlands)

    ter Maaten, JC; van Schijndel, RJM; Heimans, JJ; Schreuder, WO

    1998-01-01

    Status epilepticus (SE) is a serious disease, associated with a high morbidity and mortality, particularly if refractory to initial therapy. We describe the clinical manifestations and outcome in ten cases with refractory SE admitted to our medical intensive care unit. Three of these selected group

  8. A ten-step process to develop case management plans.

    Science.gov (United States)

    Tahan, Hussein A

    2002-01-01

    The use of case management plans has contained cost and improved quality of care successfully. However, the process of developing these plans remains a great challenge for healthcare executives, in this article, the author presents the answer to this challenge by discussing a 10-step formal process that administrators of patient care services and case managers can adapt to their institutions. It also can be used by interdisciplinary team members as a practical guide to develop a specific case management plan. This process is applicable to any care setting (acute, ambulatory, long term, and home care), diagnosis, or procedure. It is particularly important for those organizations that currently do not have a deliberate and systematic process to develop case management plans and are struggling with how to improve the efficiency and productivity of interdisciplinary teams charged with developing case management plans.

  9. Venom ophthalmia caused by venoms of spitting elapid and other snakes: Report of ten cases with review of epidemiology, clinical features, pathophysiology and management.

    Science.gov (United States)

    Chu, Edward R; Weinstein, Scott A; White, Julian; Warrell, David A

    2010-09-01

    Venom ophthalmia caused by venoms of spitting elapid and other snakes: report of ten cases with review of epidemiology, clinical features, pathophysiology and management. Chu, ER, Weinstein, SA, White, J and Warrell, DA. Toxicon XX:xxx-xxx. We present ten cases of ocular injury following instillation into the eye of snake venoms or toxins by spitting elapids and other snakes. The natural history of spitting elapids and the toxinology of their venoms are reviewed together with the medical effects and management of venom ophthalmia in humans and domestic animals including both direct and allergic effects of venoms. Although the clinical features and management of envenoming following bites by spitting elapids (genera Naja and Hemachatus) are well documented, these snakes are also capable of "spraying" venom towards the eyes of predators, a defensive strategy that causes painful and potentially blinding ocular envenoming (venom ophthalmia). Little attention has been given to the detailed clinical description, clinical evolution and efficacy of treatment of venom ophthalmia and no clear management guidelines have been formulated. Knowledge of the pathophysiology of ocular envenoming is based largely on animal studies and a limited body of clinical information. A few cases of ocular exposure to venoms from crotaline viperids have also been described. Venom ophthalmia often presents with pain, hyperemia, blepharitis, blepharospasm and corneal erosions. Delay or lack of treatment may result in corneal opacity, hypopyon and/or blindness. When venom is "spat" into the eye, cranial nerve VII may be affected by local spread of venom but systemic envenoming has not been documented in human patients. Management of venom ophthalmia consists of: 1) urgent decontamination by copious irrigation 2) analgesia by vasoconstrictors with weak mydriatic activity (e.g. epinephrine) and limited topical administration of local anesthetics (e.g. tetracaine) 3) exclusion of corneal abrasions

  10. A Ten Year Descriptive Study of Adult Leukaemia at Al-Jomhori Teaching Hospital in Sana'a, Yemen

    Directory of Open Access Journals (Sweden)

    Jameel Al-Ghazaly

    2014-12-01

    Full Text Available Background: There is scarcity of data of the epidemiology of leukaemia in Arab countries including Yemen. Understanding patterns of leukaemia underpins epidemiology and can provide insight into disease etiology. The aim of this research is to determine the epidemiologic pattern of adult leukaemia in Yemen. Methods: The research is a descriptive cross-sectional study. We analyzed the data of 702 adult patients with leukaemia, who were newly diagnosed over a ten-year period between October 1999 and October 2009 at the referral haematology centre in Sana’a at Al-Jomhori Teaching Hospital, according to type of leukaemia, age, sex, geographic distribution and time of diagnosis. Results: Acute Myeloid Leukaemia (AML was found to be the most common (45.1% followed by Chronic Myeloid Leukaemia (CML (26.5%, Acute Lymphoid Leukaemia (ALL (17.7% and Chronic Lymphoid Leukaemia (CLL (10.7%, respectively. There was an almost equal prevalence of AML and CML for males and females but males had significantly more cases of ALL and CLL (p =0.008. A significant variation in geographic pattern showed that the highest number of cases is seen the Central mountainous region and the least number of cases in the South-eastern region which is coastal and lowland (p<0.001. The seasonal variation showed that higher number of ALL cases was seen in the summer months (33% compared with other seasons (21% in the spring, 24.2% in autumn and 21.8% in winter. Conclusions: The pattern of adult leukaemia in Yemen is different from that seen in western countries which could be attributed to different environmental exposure. The geographic pattern indicates a possible role of certain environmental factors which warrant further investigations. The pattern of seasonal variation needs further studies for evaluating the seasonality.

  11. Impact of glutathione transferases genes polymorphisms in nevirapine adverse reactions: a possible role for GSTM1 in SJS/TEN susceptibility.

    Science.gov (United States)

    Ciccacci, Cinzia; Latini, Andrea; Politi, Cristina; Mancinelli, Sandro; Marazzi, Maria C; Novelli, Giuseppe; Palombi, Leonardo; Borgiani, Paola

    2017-10-01

    Nevirapine (NVP) is used in developing countries as first-line treatment of HIV infection. Unfortunately, its use is associated with common serious adverse drug reactions, such as liver toxicity and the most severe and rare Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN). GSTT1 and GSTM1 genes code for enzymes involved in the metabolism of a wide range of drugs. We hypothesized that this gene variability could be implicated in NVP adverse reactions. We analyzed the GSTM1 and GSTT1 null genotypes by multiplex PCR in a population of 181 patients from Mozambique, treated with NVP. A case/control association study was performed. We also counted the number of risk alleles in SJS/TEN patients and in controls, including the GSTM1 null genotype and four previously identified risk alleles in CYP2B6, HCP5, and TRAF3IP2 genes. Among patients, 27 had developed SJS/TEN and 76 had developed hepatotoxicity during the treatment. The GSTM1 null genotype was more frequent in the cases with SJS/TEN than in the controls (OR = 2.94, P = 0.027). This association is also observed when other risk factors are taken into account, by a multivariate analysis (P = 0.024 and OR = 3.58). The risk allele counting analysis revealed a significantly higher risk for SJS/TEN in patients carrying three or four risk alleles. Moreover, all subjects with five or six risk alleles developed SJS/TEN, while subjects without any risk alleles were present only in the control group. We observed an association between GSTM1 and SJS/TEN susceptibility. Moreover, GSTM1 contributes to the definition of a genetic risk profile for SJS/TEN susceptibility.

  12. Female entrepreneurship in developing countries,  Barriers and Motivation : Case Study, Egypt and Brazil

    OpenAIRE

    Moustafa, Gihan; Santos, Ajoqué

    2016-01-01

    Entrepreneurship accounted by women has become important all over the world, especially in developing countries where it plays not only an economic role but a social role as well, changing communities and consequently, the whole society. The purpose of this paper is to identify the main motivation and barriers faced by women in developing countries, especially concerning the case study, namely Brazil and Egypt. In order to accomplish that, a deep literature review has been done and ten cases ...

  13. "Take ten minutes": a dedicated ten minute medication review reduces polypharmacy in the elderly.

    LENUS (Irish Health Repository)

    Walsh, E K

    2012-02-01

    Multiple and inappropriate medications are often the cause for poor health status in the elderly. Medication reviews can improve prescribing. This study aimed to determine if a ten minute medication review by a general practitioner could reduce polypharmacy and inappropriate prescribing in elderly patients. A prospective, randomised study was conducted. Patients over the age of 65 (n = 50) underwent a 10-minute medication review. Inappropriate medications, dosage errors, and discrepancies between prescribed versus actual medication being consumed were recorded. A questionnaire to assess satisfaction was completed following review. The mean number of medications taken by patients was reduced (p < 0.001). A medication was stopped in 35 (70%) patients. Inappropriate medications were detected in 27 (54%) patients and reduced (p < 0.001). Dose errors were detected in 16 (32%). A high level of patient satisfaction was reported. A ten minute medication review reduces polypharmacy, improves prescribing and is associated with high levels of patient satisfaction.

  14. "Take ten minutes": a dedicated ten minute medication review reduces polypharmacy in the elderly.

    LENUS (Irish Health Repository)

    Walsh, E K

    2010-09-01

    Multiple and inappropriate medications are often the cause for poor health status in the elderly. Medication reviews can improve prescribing. This study aimed to determine if a ten minute medication review by a general practitioner could reduce polypharmacy and inappropriate prescribing in elderly patients. A prospective, randomised study was conducted. Patients over the age of 65 (n = 50) underwent a 10-minute medication review. Inappropriate medications, dosage errors, and discrepancies between prescribed versus actual medication being consumed were recorded. A questionnaire to assess satisfaction was completed following review. The mean number of medications taken by patients was reduced (p < 0.001). A medication was stopped in 35 (70%) patients. Inappropriate medications were detected in 27 (54%) patients and reduced (p < 0.001). Dose errors were detected in 16 (32%). A high level of patient satisfaction was reported. A ten minute medication review reduces polypharmacy, improves prescribing and is associated with high levels of patient satisfaction.

  15. Enabling frameworks for low-carbon technology transfer to small emerging economies: Analysis of ten case studies in Chile

    International Nuclear Information System (INIS)

    Pueyo, Ana

    2013-01-01

    Technology transfer is crucial to reduce the carbon intensity of developing countries. Enabling frameworks need to be in place to allow foreign technologies to flow, to be absorbed and to bring about technological change in the recipient country. This paper contributes to identifying these enabling factors by analysing 10 case studies of low-carbon technology transfer processes based in Chile. Our findings show the importance of strong economic and institutional fundamentals, a sound knowledge base, a sizable and stable demand and a functioning local industry. Policy recommendations are derived to improve the penetration of foreign low-carbon technologies in developing countries, focusing on the particularities of small and medium emerging economies. - Highlights: ► We analyse 10 case studies of low carbon technology transfer to Chile. ► We identify enablers of technology transfer to developing countries. ► We provide policy recommendations focusing on small and medium economies.

  16. Chern-Simons gauge theory: Ten years after

    International Nuclear Information System (INIS)

    Labastida, J. M. F.

    1999-01-01

    A brief review on the progress made in the study of Chern-Simons gauge theory since its relation to knot theory was discovered ten years ago is presented. Emphasis is made on the analysis of the perturbative study of the theory and its connection to the theory of Vassiliev invariants. It is described how the study of the quantum field theory for three different gauge fixings leads to three different representations for Vassiliev invariants. Two of these gauge fixings lead to well known representations: the covariant Landau gauge corresponds to the configuration space integrals while the non-covariant light-cone gauge to the Kontsevich integral. The progress made in the analysis of the third gauge fixing, the non-covariant temporal gauge, is described in detail. In this case one obtains combinatorial expressions, instead of integral ones, for Vassiliev invariants. The approach based on this last gauge fixing seems very promising to obtain a full combinatorial formula. We collect the combinatorial expressions for all the Vassiliev invariants up to order four which have been obtained in this approach

  17. Effects of transcutaneous electrical nerve stimulation (TENS) on arterial stiffness and blood pressure in resistant hypertensive individuals: study protocol for a randomized controlled trial.

    Science.gov (United States)

    Vilela-Martin, José Fernando; Giollo-Junior, Luiz Tadeu; Chiappa, Gaspar Rogério; Cipriano-Junior, Gerson; Vieira, Paulo José Cardoso; dos Santos Ricardi, Fábio; Paz-Landim, Manoel Ildefonso; de Andrade, Days Oliveira; Cestário, Elizabeth do Espírito Santo; Cosenso-Martin, Luciana Neves; Yugar-Toledo, Juan Carlos; Cipullo, José Paulo

    2016-03-29

    Resistant hypertension (RH) treatment requires an adequate and intense therapeutic approach. However, the results are not always satisfactory despite intensive treatment. Of the different pathophysiological mechanisms involved in the pathogenesis of RH, sympathetic overstimulation and therapies that block the sympathetic system have been widely studied. These approaches, however, are invasive and expensive. Another possible approach is by transcutaneous electrical nerve stimulation (TENS), a noninvasive method that modulates activity by using low-frequency transcutaneous electrical stimulation to inhibit primary afferent pathways. Thus, the current study will evaluate the effect of applying TENS in the cervicothoracic region of subjects with RH and will seek to develop a new low-cost and readily available therapy to treat this group of hypertensive individuals. This is a randomized, single blind (subject), parallel-assignment study controlled with a sham group and including participants aged 40 to 70 years with resistant hypertension. The trial has two arms: the treatment and control (sham group). The treatment group will be submitted to the stimulation procedure (TENS). The sham group will not be submitted to stimulation. The primary outcomes will be a reduction in the peripheral blood pressure and adverse events. The secondary outcomes will be a reduction the central blood pressure. The study will last 30 days. The sample size was calculated assuming an alpha error of 5 % to reject the null hypothesis with a statistical power of 80 %, thereby resulting in 28 participants per group (intervention versus sham). In recent decades, RH has become very common and costly. Adequate control requires several drugs, and in many cases, treatment is not successful. Sympathetic nervous system inhibition by renal denervation and central inhibition have significant effects in reducing BP; however, these treatments are costly and invasive. Another type of sympathetic nervous

  18. Ground-source heat pump case studies and utility programs

    Energy Technology Data Exchange (ETDEWEB)

    Lienau, P.J.; Boyd, T.L.; Rogers, R.L.

    1995-04-01

    Ground-source heat pump systems are one of the promising new energy technologies that has shown rapid increase in usage over the past ten years in the United States. These systems offer substantial benefits to consumers and utilities in energy (kWh) and demand (kW) savings. The purpose of this study was to determine what existing monitored data was available mainly from electric utilities on heat pump performance, energy savings and demand reduction for residential, school and commercial building applications. In order to verify the performance, information was collected for 253 case studies from mainly utilities throughout the United States. The case studies were compiled into a database. The database was organized into general information, system information, ground system information, system performance, and additional information. Information was developed on the status of demand-side management of ground-source heat pump programs for about 60 electric utility and rural electric cooperatives on marketing, incentive programs, barriers to market penetration, number units installed in service area, and benefits.

  19. COMPARATIVE STUDY BETWEEN TITANIUM ELASTIC NAILING (TENS AND DYNAMIC COMPRESSION PLATING (DCP IN THE TREATMENT OF FEMORAL DIAPHYSEAL FRACTURES IN CHILDREN

    Directory of Open Access Journals (Sweden)

    Ramasubba Reddy

    2015-08-01

    Full Text Available BACKGROUND : Orthopaedic surgeons have long maintained that all children who have sustained a diaphyseal fracture of femur recover with c onservative treatment, given the excellent remodeling ability of immature bone in children. Angulations, shortenings and malrotations are not always corrected by conservative treatment. Of many surgical options, titanium elastic nailing has been the newer implant which is being used regularly. Although good results have been reported with elastic intramedullary nails, plate fixation continues to be a viable alternative in surgical treatment of femoral shaft fractures. However there are not many studies comp aring the efficiency of titanium elastic nailing and plating for femoral diaphyseal fractures in pediatric age group. AIM : The present study aims to compare the surgical management of diaphyseal fractures of femur in children with Dynamic Compression Plati ng versus Titanium Elastic Nailing. DESIGN : This is a prospective study . MATERIALS AND METHODS : This prospective study was conducted in a tertiary hospital. Patients who presented to the out - patient department and casualty of the hospital with femoral diap hyseal fractures during April 2012 to June 2014 were considered for the study. Subjects fulfilling the predetermined inclusion and exclusion criteria were included in the study. STATISTICAL METHODS : Fisher Exact test, Chi - Square Test, Student t test (Two t ailed, independent . RESULTS : Patients in the age group of 6 - 14 years were considered for the study, Patients were divided into two groups and treated with DCP/TENS. The duration of surgery, hospital stay, and, amount of blood loss was minimal in TENS grou p. Callus was seen early in TENS group. Radiological union was early in TENS group by 2 - 3 weeks. Outcome was better in patients treated with TENS (Excellent - 70%; Satisfactory – 30%; Poor - 0% in comparison to DCP (Excellent - 70%; Satisfactory - 25%; Poor - 5%. CO NCLUSION : TENS

  20. EEG Correlates of Ten Positive Emotions.

    Science.gov (United States)

    Hu, Xin; Yu, Jianwen; Song, Mengdi; Yu, Chun; Wang, Fei; Sun, Pei; Wang, Daifa; Zhang, Dan

    2017-01-01

    Compared with the well documented neurophysiological findings on negative emotions, much less is known about positive emotions. In the present study, we explored the EEG correlates of ten different positive emotions (joy, gratitude, serenity, interest, hope, pride, amusement, inspiration, awe, and love). A group of 20 participants were invited to watch 30 short film clips with their EEGs simultaneously recorded. Distinct topographical patterns for different positive emotions were found for the correlation coefficients between the subjective ratings on the ten positive emotions per film clip and the corresponding EEG spectral powers in different frequency bands. Based on the similarities of the participants' ratings on the ten positive emotions, these emotions were further clustered into three representative clusters, as 'encouragement' for awe, gratitude, hope, inspiration, pride, 'playfulness' for amusement, joy, interest, and 'harmony' for love, serenity. Using the EEG spectral powers as features, both the binary classification on the higher and lower ratings on these positive emotions and the binary classification between the three positive emotion clusters, achieved accuracies of approximately 80% and above. To our knowledge, our study provides the first piece of evidence on the EEG correlates of different positive emotions.

  1. Effects of tripolar TENS on slow and fast motoneurons: a preliminary study using H-reflex recovery curve method.

    Science.gov (United States)

    Simorgh, L; Torkaman, G; Firoozabadi, S M

    2008-01-01

    This study aimed at examining the effect of tripolar TENS of vertebral column on the activity of slow and fast motoneurons on 10 healthy non-athlete women aged 22.7 +/- 2.21 yrs. H-reflex recovery curve of soleus (slow) and gastrocnemius (fast) muscles were recorded before and after applying tripolar TENS. For recording of this curve, rectangular paired stimuli were applied on tibial nerve (with 40-520 ISI, frequency of 0.2 Hz and pulse width of 600 micros). Our findings showed that maximum H-reflex recovery in gastrocnemius muscle appeared in the shorter ISI, while in soleus muscle, it appeared in the longer ISI and its amplitude slightly decreased after applying tripolar TENS. It is suggested that tripolar TENS excites not only the skin but also Ia and Ib afferents in the dorsal column. A Synaptic interaction of these afferents in spinal cord causes the inhibition of type I MNs and facilitation of type II MNs. This effect can be used in muscle tone modulation.

  2. Case Study: Testing with Case Studies

    Science.gov (United States)

    Herreid, Clyde Freeman

    2015-01-01

    This column provides original articles on innovations in case study teaching, assessment of the method, as well as case studies with teaching notes. This month's issue discusses using case studies to test for knowledge or lessons learned.

  3. Geothermal Exploration Case Studies on OpenEI (Presentation)

    Energy Technology Data Exchange (ETDEWEB)

    Young, K.; Bennett, M.; Atkins, D.

    2014-03-01

    The U.S. Geological Survey (USGS) resource assessment (Williams et al., 2008) outlined a mean 30 GWe of undiscovered hydrothermal resource in the western United States. One goal of the U.S. Department of Energy's (DOE) Geothermal Technology Office (GTO) is to accelerate the development of this undiscovered resource. DOE has focused efforts on helping industry identify hidden geothermal resources to increase geothermal capacity in the near term. Increased exploration activity will produce more prospects, more discoveries, and more readily developable resources. Detailed exploration case studies akin to those found in oil and gas (e.g. Beaumont and Foster, 1990-1992) will give developers central location for information gives models for identifying new geothermal areas, and guide efficient exploration and development of these areas. To support this effort, the National Renewable Energy Laboratory (NREL) has been working with GTO to develop a template for geothermal case studies on the Geothermal Gateway on OpenEI. In 2012, the template was developed and tested with two case studies: Raft River Geothermal Area (http://en.openei.org/wiki/Raft_River_Geothermal_Area) and Coso Geothermal Area (http://en.openei.org/wiki/Coso_Geothermal_Area). In 2013, ten additional case studies were completed, and Semantic MediaWiki features were developed to allow for more data and the direct citations of these data. These case studies are now in the process of external peer review. In 2014, NREL is working with universities and industry partners to populate additional case studies on OpenEI. The goal is to provide a large enough data set to start conducting analyses of exploration programs to identify correlations between successful exploration plans for areas with similar geologic occurrence models.

  4. Effect of burst TENS and conventional TENS combined with cryotherapy on pressure pain threshold: randomised, controlled, clinical trial.

    Science.gov (United States)

    Macedo, L B; Josué, A M; Maia, P H B; Câmara, A E; Brasileiro, J S

    2015-06-01

    To assess the immediate effect of conventional and burst transcutaneous electrical nerve stimulation (TENS) in combination with cryotherapy on pain threshold and tolerance in healthy individuals. Randomised, controlled trial. University laboratory. One hundred and twelve healthy women. Volunteers were allocated at random to seven groups (n=16): (1) control, (2) placebo TENS, (3) conventional TENS, (4) burst TENS, (5) cryotherapy, (6) cryotherapy in combination with burst TENS, and (7) cryotherapy in combination with conventional TENS. Pain threshold and tolerance were measured by applying a pressure algometer at the lateral epicondyle of the humerus, before and after each intervention. The primary outcome measure was pressure pain threshold. A significant increase in pain threshold and tolerance at the 5% level of significance was recorded as follows: burst TENS {pain threshold: mean difference 1.3 [95% confidence interval (CI) 1.4 to 1.2]; pain tolerance: mean difference 3.8 (95% CI 3.9 to 3.7)}, cryotherapy [pain threshold: mean difference 1.3 (95% CI 1.4 to 1.2); pain tolerance: mean difference 1.9 (95% CI 1.8 to 2.0)] and cryotherapy in combination with burst TENS [pain threshold: mean difference 2.6 (95% CI 2.4 to 2.8); pain tolerance: mean difference 4.9 (95% CI 5.0 to 4.8)]. Cryotherapy in combination with burst TENS provided greater analgesia compared with the other groups (Pcryotherapy in combination with burst TENS to reduce induced pain, and suggest a potentiating effect when these techniques are combined. No such association was found between cryotherapy and conventional TENS. Copyright © 2014 Chartered Society of Physiotherapy. Published by Elsevier Ltd. All rights reserved.

  5. TENS (transcutaneous electrical nerve stimulation) for labour pain.

    Science.gov (United States)

    Francis, Richard

    2012-05-01

    Because TENS is applied inconsistently and not always in line with optimal TENS application theory, this may explain why TENS for labour pain appears to be effective in some individuals and not in others. This article reviews TENS theory, advises upon optimal TENS application for labour pain and discusses some of the limitations of TENS research on labour pain. TENS application for labour pain may include TENS applied to either side of the lower spine, set to 200 mus pulse duration and 100 pulses per second. As pain increases, TENS intensity should be increased and as pain decreases, TENS intensity should be reduced to maintain a strong but pain free intensity of stimulation. This application may particularly reduce back pain during labour.

  6. Different mechanisms for the short-term effects of real versus sham transcutaneous electrical nerve stimulation (TENS) in patients with chronic pain: a pilot study.

    Science.gov (United States)

    Oosterhof, Jan; Wilder-Smith, Oliver H; Oostendorp, Rob A; Crul, Ben J

    2012-01-01

    Transcutaneous electrical nerve stimulation (TENS) has existed since the early 1970s. However, randomized placebo controlled studies show inconclusive results in the treatment of chronic pain. These results could be explained by assuming that TENS elicits a placebo response. However, in animal research TENS has been found to decrease hyperalgesia, which contradicts this assumption. The aim of this study is to use quantitative sensory testing to explore changes in pain processing during sham versus real TENS in patients with chronic pain. Patients with chronic pain (N = 20) were randomly allocated to real TENS or sham TENS application. Electrical pain thresholds (EPTs) were determined inside and outside the segment stimulated, before and after the first 20 minutes of the intervention, and after a period of 10 days of daily real/sham TENS application. Pain relief did not differ significantly for real versus sham TENS. However, by comparing time courses of EPTs, it was found that EPT values outside the segment of stimulation increased for sham TENS, whereas for real TENS these values decreased. There were, however, no differences for EPT measurements inside the segment stimulated. These results illustrate the importance of including mechanism-reflecting parameters in addition to symptoms when conducting pain research.

  7. Potential of public transit as a transportation control measure: Case studies

    Energy Technology Data Exchange (ETDEWEB)

    Sillings, M.

    1998-07-01

    This report is the final product of the Clean Air Project of the National Association of Regional Councils/NARC. It documents a nationwide study of transit projects and programs initiated in the wake of the 1990 Clean Air Act Amendments/CAAA and the Intermodal Surface Transportation Efficiency Act of 1991/ISTEA. The study purpose was to assess the experience, limitations, and value of public transit as a potential transportation control measure/TCM, i.e., generates significant air quality benefits by eliminating or reducing emissions from motor vehicles. Four in-depth case studies and six additional projects featured as innovations in transportation are offered as examples investigating the potential of transit as a TCM. These case studies and innovations highlight the efforts of ten metropolitan areas and transit agencies which have succeed in developing and implementing innovative transit strategies.

  8. Transcutaneous electric nerve stimulation (TENS) for cancer pain in adults.

    Science.gov (United States)

    Hurlow, Adam; Bennett, Michael I; Robb, Karen A; Johnson, Mark I; Simpson, Karen H; Oxberry, Stephen G

    2012-03-14

    Cancer-related pain is complex and multi-dimensional but the mainstay of cancer pain management has predominantly used a biomedical approach. There is a need for non-pharmacological and innovative approaches. Transcutaneous Electric Nerve Stimulation (TENS) may have a role in pain management but the effectiveness of TENS is currently unknown. This is an update of the original review published in Issue 3, 2008. The aim of this systematic review was to determine the effectiveness of TENS for cancer-related pain in adults. The initial review searched The Cochrane Library, MEDLINE, EMBASE, CINAHL, PsychINFO, AMED and PEDRO databases in April 2008. We performed an updated search of CENTRAL, MEDLINE, EMBASE, CINAHL and PEDRO databases in November 2011. We included only randomised controlled trials (RCTS) investigating the use of TENS for the management of cancer-related pain in adults. The search strategy identified a further two studies for possible inclusion. One of the review authors screened each abstract using a study eligibility tool. Where eligibility could not be determined, a second author assessed the full paper. One author used a standardised data extraction sheet to collect information on the studies and independently assess the quality of the studies using the validated five-point Oxford Quality Scale. The small sample sizes and differences in patient study populations of the three included studies (two from the original review and a third included in this update) prevented meta-analysis. For the original review the search strategy identified 37 possible published studies; we divided these between two pairs of review authors who decided on study selection; all four review authors discussed and agreed final scores. Only one additional RCT met the eligibility criteria (24 participants) for this updated review. Although this was a feasibility study, not designed to investigate intervention effect, it suggested that TENS may improve bone pain on movement in a

  9. Chernobyl ten years after

    International Nuclear Information System (INIS)

    1996-01-01

    The accident in the fourth reactor plant in Chernobyl in Ukraine occurred ten years years ago, caused the death of 31 people while the health consequences have turned out to be difficult to assess. This review describes the accident, its consequences and effects to health, studies carried out at the present state as well as the comparison with the other accidents and disaster. (author)

  10. Hypoalgesia in response to transcutaneous electrical nerve stimulation (TENS) depends on stimulation intensity.

    Science.gov (United States)

    Moran, Fidelma; Leonard, Tracey; Hawthorne, Stephanie; Hughes, Ciara M; McCrum-Gardner, Evie; Johnson, Mark I; Rakel, Barbara A; Sluka, Kathleen A; Walsh, Deirdre M

    2011-08-01

    Transcutaneous electrical nerve stimulation (TENS) is an electrophysical modality used for pain management. This study investigated the dose response of different TENS intensities on experimentally induced pressure pain. One hundred and thirty TENS naïve healthy individuals (18-64 years old; 65 males, 65 females) were randomly allocated to 5 groups (n = 26 per group): Strong Non Painful TENS; Sensory Threshold TENS; Below Sensory Threshold TENS; No Current Placebo TENS; and Transient Placebo TENS. Active TENS (80 Hz) was applied to the forearm for 30 minutes. Transient Placebo TENS was applied for 42 seconds after which the current amplitude automatically reset to 0 mA. Pressure pain thresholds (PPT) were recorded from 2 points on the hand and forearm before and after TENS to measure hypoalgesia. There were significant differences between groups at both the hand and forearm (ANOVA; P = .005 and .002). At 30 minutes, there was a significant hypoalgesic effect in the Strong Non Painful TENS group compared to: Below Sensory Threshold TENS, No Current Placebo TENS and Transient Placebo TENS groups (P TENS and No Current Placebo TENS groups at the hand (P = .001). There was no significant difference between Strong Non Painful TENS and Sensory Threshold TENS groups. The area under the curve for the changes in PPT significantly correlated with the current amplitude (r(2) = .33, P = .003). These data therefore show that there is a dose-response effect of TENS with the largest effect occurring with the highest current amplitudes. This study shows a dose response for the intensity of TENS for pain relief with the strongest intensities showing the greatest effect; thus, we suggest that TENS intensity should be titrated to achieve the strongest possible intensity to achieve maximum pain relief. Copyright © 2011 American Pain Society. Published by Elsevier Inc. All rights reserved.

  11. Medical School Attrition-Beyond the Statistics A Ten Year Retrospective Study

    Directory of Open Access Journals (Sweden)

    Maher Bridget M

    2013-01-01

    Full Text Available Abstract Background Medical school attrition is important - securing a place in medical school is difficult and a high attrition rate can affect the academic reputation of a medical school and staff morale. More important, however, are the personal consequences of dropout for the student. The aims of our study were to examine factors associated with attrition over a ten-year period (2001–2011 and to study the personal effects of dropout on individual students. Methods The study included quantitative analysis of completed cohorts and qualitative analysis of ten-year data. Data were collected from individual student files, examination and admission records, exit interviews and staff interviews. Statistical analysis was carried out on five successive completed cohorts. Qualitative data from student files was transcribed and independently analysed by three authors. Data was coded and categorized and key themes were identified. Results Overall attrition rate was 5.7% (45/779 in 6 completed cohorts when students who transferred to other medical courses were excluded. Students from Kuwait and United Arab Emirates had the highest dropout rate (RR = 5.70, 95% Confidence Intervals 2.65 to 12.27;p  Absenteeism was documented in 30% of students, academic difficulty in 55.7%, social isolation in 20%, and psychological morbidity in 40% (higher than other studies. Qualitative analysis revealed recurrent themes of isolation, failure, and despair. Student Welfare services were only accessed by one-third of dropout students. Conclusions While dropout is often multifactorial, certain red flag signals may alert us to risk of dropout including non-EU origin, academic struggling, absenteeism, social isolation, depression and leave of absence. Psychological morbidity amongst dropout students is high and Student Welfare services should be actively promoted. Absenteeism should prompt early intervention. Behind every dropout statistic lies a personal story. All

  12. Powers of ten

    CERN Document Server

    1979-01-01

    Powers of Ten is a 1977 short documentary film written and directed by Charles Eames and his wife, Ray. The film depicts the relative scale of the Universe in factors of ten (see also logarithmic scale and order of magnitude). The idea for the film appears to have come from the 1957 book Cosmic View by Kees Boeke. The film begins with an aerial image of a man reclining on a blanket; the view is that of one meter across. The viewpoint, accompanied by expository voiceover, then slowly zooms out to a view ten meters across ( or 101 m in standard form), revealing that the man is picnicking in a park with a female companion. The zoom-out continues, to a view of 100 meters (102 m), then 1 kilometer (103 m), and so on, increasing the perspective—the picnic is revealed to be taking place near Soldier Field on Chicago's waterfront—and continuing to zoom out to a field of view of 1024 meters, or the size of the observable universe. The camera then zooms back in to the picnic, and then to views of negative pow...

  13. Large-Scale Participation: A Case Study of a Participatory Approach to Developing a New Public Library

    DEFF Research Database (Denmark)

    Dalsgaard, Peter; Eriksson, Eva

    2013-01-01

    In this paper, we present a case study of a participatory project that focuses on interaction in large-scale design, namely, the development of the new Urban Mediaspace Aarhus. This project, which has been under way for ten years, embodies a series of issues that arise when participatory design...

  14. High School Learners' Mental Construction during Solving Optimisation Problems in Calculus: A South African Case Study

    Science.gov (United States)

    Brijlall, Deonarain; Ndlovu, Zanele

    2013-01-01

    This qualitative case study in a rural school in Umgungundlovu District in KwaZulu-Natal, South Africa, explored Grade 12 learners' mental constructions of mathematical knowledge during engagement with optimisation problems. Ten Grade 12 learners who do pure Mathemat-ics participated, and data were collected through structured activity sheets and…

  15. Using Narrative Case Studies in an Online World Religions Course to Stimulate Deep Learning about Islam

    Science.gov (United States)

    Elliott, Sherman Lee

    2010-01-01

    The purpose of this action research was to examine how a narrative case study in an online asynchronous world religions course affected learners' understandings, appreciation, and respect for the beliefs and values of others. The world religions course examined a variety of religions including Islam. Ten participants received information about the…

  16. Mercury Studies around the Mediterranean Sea Basin: Ten years of Measurements and Modeling results

    Directory of Open Access Journals (Sweden)

    Sprovieri F.

    2013-04-01

    Full Text Available Only a few years ago the presence of Reactive Gaseous Mercury (RGM was believed to be almost exclusively the result of anthropogenic emissions and that sustained high RGM concentrations in the MBL were not considered likely. During the past ten years, an in-depth investigation was carried out in the Marine Boundary Layer (MBL of the Mediterranean Sea to quantify and possibly explain spatial and temporal patterns of Hg-species concentrations. This paper provides an overview of modeling results and atmospheric measurements performed during several cruise campaigns performed aboard the Research Vessel (RV URANIA of the CNR over the Mediterranean sea basin. RGM concentrations have been modelled using a photochemical box model of the MBL and compared to measured data obtained during the research cruises. The comparison results supports the hypothesis that there are daytime mercury oxidation reactions occurring which have not yet been identified. Major findings of key studies carried out during ten years of ship-borne activities have been highlighted.

  17. Endovascular treatment of false-aneurysm ten years after dacron patch aortoplasty for coarctation of the aortic isthmus. Report of a case.

    Science.gov (United States)

    Illuminati, Giulio; Pacilè, Maria Antonietta; Palumbo, Piergaspare; Salvatori, Filippo Maria; Vietri, Francesco

    2013-01-01

    False aneurysm degeneration is a known complication of patch aortoplasty for coarctation of the aortic isthmus. Open surgical treatment consists of prosthetic graft repair of the involved aorta, often requires circulatory arrest to achieve a safe proximal aortic control and perform proximal anastomosis, and finally is associated with substantial perioperative morbidity. Endografting of the diseased aorta is a valuable alternative to open repair, when feasible, with good short and long term results. We now report one more case of false aneurysm ten years after Dacron patch aortoplasty for isthmic coarctation in a 26-year-old woman, successfully treated by endovascular repair via the left common iliac artery, and a complete exclusion of the aneurysm at two year follow-up.

  18. Randomised controlled trial comparing the effectiveness of electroacupuncture and TENS for low back pain: a preliminary study for a pragmatic trial.

    Science.gov (United States)

    Tsukayama, Hiroshi; Yamashita, Hitoshi; Amagai, Hitoshi; Tanno, Yasuo

    2002-12-01

    The objective of this study was to compare the effectiveness of electroacupuncture and TENS for low back pain when the electroacupuncture is applied in a clinically realistic manner. The study was designed as an evaluator-blinded randomised controlled trial (RCT). The study was performed at the Tsukuba College of Technology Clinic in Japan. Twenty subjects, who suffered from low back pain (LBP) without sciatica, were recruited, using leaflets in Tsukuba city. Subjects were allocated to either an electroacupuncture (EA) group (10 patients) or a transcutaneous electrical nerve stimulation (TENS) group (10 patients). The procedure for EA was in accordance with standard practice at our clinic. The main outcome measures were a pain relief scale (100 mm visual analogue scale: VAS) and a LBP score recommended by the Japanese Orthopaedic Association (JOA Score). Mean VAS value during the 2-weeks experimental period of the EA group was significantly smaller than that of the TENS group (65 mm vs 86 mm; 95% CI, 4.126 - 37.953). JOA Score in the EA group improved significantly while that in the TENS group showed no change. Although some placebo effect may be included, EA appeared more useful than TENS in the short-term effect on low back pain. We suggest that more realistic acupuncture interventions based on standard practice should be employed in pragmatic RCTs.

  19. Breath-hold two-dimensional MR angiography of coronary arteries. Comparison with conventional coronary angiography in ten cases

    International Nuclear Information System (INIS)

    Li Liwei; Zhang Wanshi; Liu Chaozhong; Lu Xiaoyan; Xu Jiaxing

    1997-01-01

    Purpose: To assess the diagnostic value of two-dimensional coronary magnetic resonance (MR) angiography in patients evaluated for ischemic heart disease. Materials and methods: Ten patients who underwent selective cardiac catheterization with coronary MR angiography were evaluated with two-dimensional coronary MR angiography. Coronary MR angiography was performed with breath-hold fat-suppressed ECG-gated Turbo-FLASH with K-space segmentation using a 1.5 T imager. Results: The left main coronary artery, proximal left anterior descending artery, circumflex artery and right coronary artery were demonstrated in all cases. Continuous segments (mean) of left anterior descending, circumflex and right coronary arteries visualized on MRA were 6.72 +- 3.16 cm, 3.67 +- 4.81 cm and 7.93 +- 3.12 cm respectively. The overall sensitivity for detection of hemodynamically significant coronary artery lesion (≥50%) was 62.5% respectively. Conclusion: Breath-hold two-dimensional coronary MR angiography was useful in showing relatively long segments of the main coronary arteries and also has potential in depicting hemodynamically significant coronary artery lesions

  20. Ten Lessons from Ten Years PPP Experience in Belgium

    NARCIS (Netherlands)

    Willems, T.; Verhoest, K.; Voets, J.; Coppens, T.; van Dooren, W.; van den Hurk, M.

    2017-01-01

    In 2004 Flanders, the northern region of Belgium launched a range of large public–private partnership (PPP) projects for a total value of 6 billion euros. Ten years later, PPP has become a well-embedded procurement method for long-term public infrastructure projects. This article makes a critical

  1. Analyzing the Study of Using Acupuncture in Delivery in the Past Ten Years in China

    Directory of Open Access Journals (Sweden)

    Yingru Chen

    2014-01-01

    Full Text Available The use of acupuncture in inducing delivery has a long history in China. With progress over time, it has been applied in many aspects. For further study of acupuncture in delivery, this paper analyzed the papers using acupuncture in delivery in the past ten years in mainland China. 87 literatures were picked out by searching relevant electronic databases and bibliographies of relevant journals. The analysis showed randomized controlled trials that were the major type of research, while preclinical researches and literature reviews only account for around ten percent, respectively. Clinical researches indicated that acupuncture can relieve labor pain, promote maternal uterine contraction, shorten birth process, and treat postpartum disorders. Preclinical researches found that acupuncture can adjust certain hormones and improve uterus contraction of late-stage pregnant rats. However, due to lack of large multicenter randomized controlled clinical trials, standardized evaluations of clinical effects in clinical researches and detailed mechanism study in preclinical researches and unequivocal conclusions about the effectiveness, efficacy, and mechanisms of acupuncture in this field cannot be obtained from those researches yet. Further clinical and preclinical studies about the use of acupuncture in delivery with improved methodology is still needed.

  2. Successful weight maintainers among young adults-A ten-year prospective population study.

    Science.gov (United States)

    Kärkkäinen, Ulla; Mustelin, Linda; Raevuori, Anu; Kaprio, Jaakko; Keski-Rahkonen, Anna

    2018-03-07

    To assess factors associated with successful weight maintenance over ten years in a prospective general population sample of young adults. Our study comprised 2452 women and 2227 men born in 1975-1979 (mean age at baseline 24 years, attrition 27.1%). Weight maintenance was defined as weight maintained within ±5% of baseline body mass index (BMI). We examined the role of various sociodemographic and lifestyle factors in successful weight maintenance. Relatively few young adults were able to maintain their weight over ten years (28.6% of women vs. 23.0% of men); net weight loss was uncommon (7.5% and 3.8%). Most participants gained weight (mean annual weight gain was 0.9 kg in women and 1.0 kg in men). Among women, exercise was associated with successful weight maintenance, but having two or more children, frequent use of sweet drinks, irregular eating, history of dieting (intentional weight loss) and low life satisfaction were associated with weight gain. Among men, higher baseline BMI and higher education were associated with successful weight maintenance, whereas irregular eating, history of dieting and smoking were associated with weight gain. Only about a quarter of young adults were able to resist weight gain. Regular eating and having no history of dieting were associated with successful weight maintenance in young women and men. Copyright © 2018 Elsevier Ltd. All rights reserved.

  3. Diseases of poultry in Akure, Nigeria: a ten year analysis of clinical ...

    African Journals Online (AJOL)

    An analysis of poultry diseases diagnosed at the avian clinic of Veterinary Hospital of the Ministry of Agriculture and Natural Resources, Akure, Ondo-State, was carried out using data from 22,927 cases reported at the clinic over a period of ten years. The commonest diseases reported were Newcastle, 9.8%, chronic ...

  4. At-Risk Phenotype of Neurofibromatose-1 Patients: A Multicentre Case-Control Study

    Directory of Open Access Journals (Sweden)

    Ferkal Salah

    2011-07-01

    Full Text Available Abstract Objectives To assess associations between subcutaneous neurofibromas (SC-NFs and internal neurofibromas in patients with neurofibromatosis type 1 (NF-1 and to determine whether the association between SC-NFs and peripheral neuropathy was ascribable to internal neurofibromas. Patients and methods Prospective multicentre case-control study. Between 2005 and 2008, 110 NF-1 adults having two or more SC-NFs were individually matched for age, sex and hospital with 110 controls who had no SC-NF. Patients underwent standardized MRI of the spinal cord, nerve roots and sciatic nerves and an electrophysiological study. Analyses used adjusted multinomial logistic regression (ORa to estimate the risk of the presence of internal neurofibromas or peripheral neuropathies associated with patients presented 2 to 9 SC-NFs, at least 10 SC-NFs as compared to patients without any (referential category. Results Cases had a mean age of 41 (± 13 years; 85 (80% had two to nine SC-NFs and 21 (19% at least ten SC-NFs. SC-NFs were more strongly associated with internal neurofibromas in patients with ten or more SC-NFs than in patients with fewer NF-SCs (e.g., sciatic nerve, aOR = 29.1 [8.5 to 100] vs. 4.3 [2.1 to 9.0]. The association with SC-NFs was stronger for diffuse, intradural, and > 3 cm internal neurofibromas than with other internal neurofibromas. Axonal neuropathy with slowed conduction velocities (SCV was more strongly associated with having at least ten SC-NFs (aOR = 29.9, 5.5 to 162.3 than with having fewer SC-NFs (aOR = 4.4, 0.9 to 22.0. Bivariate analyses showed that the association between axonal neuropathy with SCV and sciatic neurofibromas was mediated by the association between SC-NFs and sciatic neurofibromas. Conclusion The at-risk phenotype of NF-1 patients (i.e. NF-1 patients with SC-NFs is ascribable to associations linking SC-NFs to internal neurofibromas at risk for malignant transformation and to axonal neuropathies with slowed

  5. Adjunct High Frequency Transcutaneous Electric Stimulation (TENS) for Postoperative Pain Management during Weaning from Epidural Analgesia Following Colon Surgery: Results from a Controlled Pilot Study.

    Science.gov (United States)

    Bjerså, Kristofer; Jildenstaal, Pether; Jakobsson, Jan; Egardt, Madelene; Fagevik Olsén, Monika

    2015-12-01

    The potential benefit of nonpharmacological adjunctive therapy is not well-studied following major abdominal surgery. The aim of the present study was to investigate transcutaneous electrical nerve stimulation (TENS) as a complementary nonpharmacological analgesia intervention during weaning from epidural analgesia (EDA) after open lower abdominal surgery. Patients were randomized to TENS and sham TENS during weaning from EDA. The effects on pain at rest, following short walk, and after deep breath were assessed by visual analog scale (VAS) grading. Number of patients assessed was lower than calculated because of change in clinical routine. Pain scores overall were low. A trend of lower pain scores was observed in the active TENS group of patients; a statistical significance between the groups was found for the pain lying prone in bed (p TENS use in postoperative pain management during weaning from EDA after open colon surgery. Further studies are warranted in order to verify the potential beneficial effects from TENS during weaning from EDA after open, lower abdominal surgery. Copyright © 2015 American Society for Pain Management Nursing. Published by Elsevier Inc. All rights reserved.

  6. Karyological studies in ten different populations of desert lily aloe vera from pakistan

    International Nuclear Information System (INIS)

    Jahan, B.; Vahidy, A.A.

    2014-01-01

    To enhance theoretical basis of Aloe feeding and provide cytological basement, the karyotype and morphology of mitotic chromosomes, ten different populations of Aloe vera collected from various geographical locations of Karachi, Pakistan were studied by aceto-orcein staining technique. The results showed that chromosome number of Aloe vera is 2n=14. The karyotype is bimodal and consists of 14 chromosomes (8 large and 6 small) predominantly with submedian, median and subterminal centromere. Average chromosome lengths among populations ranged from 7.95-2.36 micro m. (author)

  7. Gurya cutting and female genital fistulas in Niger: ten cases.

    Science.gov (United States)

    Ouedraogo, Itengre; McConley, Regina; Payne, Christopher; Heller, Alison; Wall, L Lewis

    2018-03-01

    The objective was to determine the contribution of female genital cutting to genital fistula formation in Niger from the case records of a specialist fistula hospital. A retrospective review was undertaken of the records of 360 patients seen at the Danja Fistula Center, Danja, Niger, between March 2014 and September 2016. Pertinent clinical and socio-demographic data were abstracted from the cases identified. A total of 10 fistulas resulting from gurya cutting was obtained: 9 cases of urethral loss and 1 rectovaginal fistula. In none of the cases was genital cutting performed for obstructed labor or as part of ritual coming-of-age ceremonies, but all cutting procedures were considered "therapeutic" within the local cultural context as treatment for dyspareunia, lack of interest in or unwillingness to engage in sexual intercourse, or female behavior that was deemed to be culturally inappropriate by the male spouse, parents, or in-laws. Clinical cure (fistula closed and the patient continent) was obtained in all 10 cases, although 3 women required more than one operation. Gurya cutting is an uncommon, but preventable, cause of genital fistulas in Niger. The socio-cultural context which gives rise to gurya cutting is explored in some detail.

  8. Cost-effectiveness analysis of HLA-B*5801 testing in preventing allopurinol-induced SJS/TEN in Thai population.

    Directory of Open Access Journals (Sweden)

    Surasak Saokaew

    Full Text Available BACKGROUND: Stevens-Johnson syndrome (SJS and Toxic Epidermal Necrolysis (TEN, caused by allopurinol therapy, are strongly associated with the human leukocyte antigen (HLA, HLA-B*5801. Identification of HLA-B*5801 genotype before prescribing allopurinol offers the possibility of avoiding allopurinol-induced SJS/TEN. As there is a paucity of evidence about economic value of such testing, this study aims to determine the cost-effectiveness of HLA-B*5801 testing compared with usual care (no genetic testing before allopurinol administration in Thailand. METHODS AND FINDING: A decision analytical and Markov model was used to estimate life time costs and outcomes represented as quality adjusted life years (QALYs gained. The model was populated with relevant information of the association between gene and allopurinol-induced SJS/TEN, test characteristics, costs, and epidemiologic data for Thailand from a societal perspective. Input data were obtained from the literature and a retrospective database analysis. The results were expressed as incremental cost per QALY gained. A base-case analysis was performed for patients at age 30. A series of sensitivity analyses including scenario, one-way, and probabilistic sensitivity analyses were constructed to explore the robustness of the findings. Based on a hypothetical cohort of 1,000 patients, the incremental total cost was 923,919 THB (USD 29,804 and incremental QALY was 5.89 with an ICER of 156,937.04 THB (USD 5,062 per QALY gained. The cost of gout management, incidence of SJS/TEN, case fatality rate of SJS/TEN, and cost of genetic testing are considered very influential parameters on the cost-effectiveness value of HLA-B*5801 testing. CONCLUSIONS: The genetic testing for HLA-B*5801 before allopurinol administration is considered a highly potential cost-effective intervention in Thailand. The findings are sensitive to a number of factors. In addition to cost-effectiveness findings, consideration of other

  9. Effect of TENS on pain in relation to central sensitization in patients with osteoarthritis of the knee: study protocol of a randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Beckwée David

    2012-02-01

    Full Text Available Abstract Background Central sensitization has recently been documented in patients with knee osteoarthritis (OAk. So far, the presence of central sensitization has not been considered as a confounding factor in studies assessing the pain inhibitory effect of tens on osteoarthritis of the knee. The purpose of this study is to explore the pain inhibitory effect of burst tens in OAk patients and to explore the prognostic value of central sensitization on the pain inhibitory effect of tens in OAk patients. Methods Patients with knee pain due to OAk will be recruited through advertisements in local media. Temporal summation, before and after a heterotopic noxious conditioning stimulation, will be measured. In addition, pain on a numeric rating score, WOMAC subscores for pain and function and global perceived effect will be assessed. Patients will be randomly allocated to one of two treatment groups (tens, sham tens. Follow-up measurements will be scheduled after a period of 6 and 12 weeks. Discussion Tens influences pain through the electrical stimulation of low-threshold A-beta cutaneous fibers. The responsiveness of central pain-signaling neurons of centrally sensitized OAk patients may be augmented to the input of these electrical stimuli. This would encompass an adverse therapy effect of tens. To increase treatment effectiveness it might be interesting to identify a subgroup of symptomatic OAk patients, i.e., non-sensitized patients, who are likely to benefit from burst tens. Trial Registration ClinicalTrials.gov: NCT01390285

  10. Nonlinear dynamics in ecosystem response to climatic change: Case studies and policy implications

    Science.gov (United States)

    Burkett, Virginia R.; Wilcox, Douglas A.; Stottlemyer, Robert; Barrow, Wylie; Fagre, Dan; Baron, Jill S.; Price, Jeff; Nielsen, Jennifer L.; Allen, Craig D.; Peterson, David L.; Ruggerone, Greg; Doyle, Thomas

    2005-01-01

    Many biological, hydrological, and geological processes are interactively linked in ecosystems. These ecological phenomena normally vary within bounded ranges, but rapid, nonlinear changes to markedly different conditions can be triggered by even small differences if threshold values are exceeded. Intrinsic and extrinsic ecological thresholds can lead to effects that cascade among systems, precluding accurate modeling and prediction of system response to climate change. Ten case studies from North America illustrate how changes in climate can lead to rapid, threshold-type responses within ecological communities; the case studies also highlight the role of human activities that alter the rate or direction of system response to climate change. Understanding and anticipating nonlinear dynamics are important aspects of adaptation planning since responses of biological resources to changes in the physical climate system are not necessarily proportional and sometimes, as in the case of complex ecological systems, inherently nonlinear.

  11. The Supersymmetric Top-Ten Lists

    OpenAIRE

    Haber, Howard E.

    1993-01-01

    Ten reasons are given why supersymmetry is the leading candidate for physics beyond the Standard Model. Ultimately, the experimental discovery of supersymmetric particles at future colliders will determine whether supersymmetry is relevant for TeV scale physics. The grand hope of supersymmetry enthusiasts is to connect TeV scale supersymmetry with Planck scale physics. The ten most pressing theoretical problems standing in the way of this goal are briefly described.

  12. Ten cases of metastatic cervical cancer with the treatment of permanent 125I seeds interstitial implants

    International Nuclear Information System (INIS)

    Zhang Hongwei; Li Naibin; Li Qingxin; Liu Huiping; Meng Hui; Chao Dong

    2011-01-01

    Objective: To investigate the clinical effect of permanent 125 I seeds interstitial implants for metastatic cervical cancer. Methods: Under the guidance of the B-sonography, 125 I seeds were implanted into the eleven cervical lymph nodes of ten patients who had been given tumor resection. The pain relief and tumor size were observed in regular follow-up after one-month treatment. Results: All the patients were followed up for 6-14 months,and the postoperative recovery was good with no complication. One month after the implantation, the pain symptom was alleviated entirely in two nodes and partly in nine nodes. The tumor size shrank in ten nodes while there was no change in one node after one month. Conclusion: Permanent 125 I seeds interstitial implants for metastatic cervical cancer is a safe, minimally invasive and effective treatment. (authors)

  13. Spectrum of fungal keratitis:clinicopathologic study of 44 cases

    Directory of Open Access Journals (Sweden)

    Rajpal Singh Punia

    2014-02-01

    Full Text Available AIM:To determine the causative agents of fungal keratitis and study the predisposing factors over a period of ten years in a single tertiary care hospital.METHODS:A retrospective analysis of fungal corneal ulcers was done from 2003-2012. Patients’ clinical data were noted from the file records. Correlation of histopathological diagnosis was done with the report on fungal culture.RESULTS: Mycotic keratitis was established in 44 cases by a positive fungal culture. Direct microscopic examination of potassium hydroxide (KOH mounts revealed fungal elements in 39 cases while 40 cases showed fungus on Gram stained smears. Males (54.55% were more commonly affected than the females (45.45%. The age ranged from 18 to 82 years. Most common age group to be involved was 41-60 years. Predisposing risk factors were seen in 34 (77.27% cases. Most common findings on clinical examination were anterior chamber reaction and conjunctival injection seen in all the cases. Other common findings were stromal infiltration and hypopyon seen in 20 (45.45% and 18 (40.91% cases respectively. On histopathological examination the fungus was typed, as aspergillus in 34 cases while no definite typing was possible in 10 cases. The predominant isolate was aspergillus flavus (59.09% followed by fusarium (15.91%. Mixed fungal and bacterial infection was seen in 3 (6.82% cases.CONCLUSION:Although culture is the gold standard for definitive diagnosis of fungal keratitis, direct microscopic examination of corneal scrapings or histomorphological evaluation of biopsies allow a rapid preliminary diagnosis. Early administration of antifungal treatment helps in preventing dreadful complications.

  14. Feet swelling in a multistage ultraendurance triathlete: a case study

    Directory of Open Access Journals (Sweden)

    Knechtle B

    2015-10-01

    Full Text Available Beat Knechtle,1 Matthias Alexander Zingg,2 Patrizia Knechtle,1 Thomas Rosemann,2 Christoph Alexander Rüst2 1Gesundheitszentrum St Gallen, St Gallen, 2Institute of Primary Care, University of Zurich, Zurich, Switzerland Abstract: Recent studies investigating ultraendurance athletes showed an association between excessive fluid intake and swelling of the lower limbs such as the feet. To date, this association has been investigated in single-stage ultraendurance races, but not in multistage ultraendurance races. In this case study, we investigated a potential association between fluid intake and feet swelling in a multistage ultraendurance race such as a Deca Iron ultratriathlon with ten Ironman triathlons within 10 consecutive days. A 49-year-old well-experienced ultratriathlete competed in autumn 2013 in the Deca Iron ultratriathlon held in Lonata del Garda, Italy, and finished the race as winner within 129:33 hours:minutes. Changes in body mass (including body fat and lean body mass, foot volume, total body water, and laboratory measurements were assessed. Food and fluid intake during rest and competing were recorded, and energy and fluid turnovers were estimated. During the ten stages, the volume of the feet increased, percentage body fat decreased, creatinine and urea levels increased, hematocrit and hemoglobin values decreased, and plasma [Na+] remained unchanged. The increase in foot volume was significantly and positively related to fluid intake during the stages. The poststage volume of the foot was related to poststage total body water, poststage creatinine, and poststage urea. This case report shows that the volume of the foot increased during the ten stages, and the increase in volume was significantly and positively related to fluid intake during the stages. Furthermore, the poststage volume of the foot was related to poststage total body water, poststage creatinine, and poststage urea. The continuous feet swelling during the race was

  15. ALGORITHMS FOR TETRAHEDRAL NETWORK (TEN) GENERATION

    Institute of Scientific and Technical Information of China (English)

    2000-01-01

    The Tetrahedral Network(TEN) is a powerful 3-D vector structure in GIS, which has a lot of advantages such as simple structure, fast topological relation processing and rapid visualization. The difficulty of TEN application is automatic creating data structure. Al though a raster algorithm has been introduced by some authors, the problems in accuracy, memory requirement, speed and integrity are still existent. In this paper, the raster algorithm is completed and a vector algorithm is presented after a 3-D data model and structure of TEN have been introducted. Finally, experiment, conclusion and future work are discussed.

  16. The five times ten things everyone should have had in their hands before they are ten and two years old.

    Science.gov (United States)

    Hut, R.; Poot, A.

    2017-12-01

    To train the young ones to become people that make stuff, I present the five times ten things we use a lot that everyone should have used before they are ten and two years old. I will bring at least two times ten of these things and show them live to you! And: I will bring a large paper for you to bring home with those five times ten things on it to put in the hands of your kids!

  17. [Entomological investigations conducted around ten cases of yellow fever in 2009 in the Denguélé sanitary region, Côte-d'Ivoire].

    Science.gov (United States)

    Konan, Y L; Fofana, D; Coulibaly, Z I; Diallo, A; Koné, A B; Doannio, J M C; Ekra, K D; Odéhouri-Koudou, P

    2011-10-01

    In November 2009, ten suspicious cases of yellow fever, including six deaths, were notified in the region of Denguélé, in the northwest of Côte-d'Ivoire. In order to evaluate the extent of yellow fever virus circulation and the risk for local people, a mission of entomological investigation was carried out by the Ministry of Health and Public Hygiene of Côte-d'Ivoire. Entomological investigations were conducted in the villages of confirmed cases (Banakoro and Tron-Touba) and the centers of consultation and hospitalization of cases during illness. Breteau index and recipient index were quasi nil. Aedes aegypti was absent among the captured mosquitoes. On the other hand, Aedes luteocephalus and Aedes opok were present at Banakoro and Tron-Touba with respective average biting rates of 0.8 and 0.6 bite/man/twilight. This situation of epidemic in the northwest of Côte-d'Ivoire could be explained by the deterioration of Denguélé region's health system which is a consequence of the war started in the country in 2002 and which has lowered the immunity of the population.

  18. Mobile and Social: Ten Best Practices for Designing Mobile Applications

    Directory of Open Access Journals (Sweden)

    Liviu LICA

    2010-01-01

    Full Text Available This paper gives ten best practices for designing mobile applications that have social-networking functions. The need for such an approach is given by the rapid growth in impor-tance of both social networks and mobile applications. In order to make it easy to follow where the best practices come from, the paper starts with a look at why social networks are more than just a buzz word and at how the field of mobile applications is evolving. It also shows how and why the two fields go together so well. To further make the point, there is a case study of four interesting mobile applications that are textbooks examples of successful applications. The best practices are based on research done for this article and on the extensive knowledge of the author.

  19. Nonresponse Error in Mail Surveys: Top Ten Problems

    Directory of Open Access Journals (Sweden)

    Jeanette M. Daly

    2011-01-01

    Full Text Available Conducting mail surveys can result in nonresponse error, which occurs when the potential participant is unwilling to participate or impossible to contact. Nonresponse can result in a reduction in precision of the study and may bias results. The purpose of this paper is to describe and make readers aware of a top ten list of mailed survey problems affecting the response rate encountered over time with different research projects, while utilizing the Dillman Total Design Method. Ten nonresponse error problems were identified, such as inserter machine gets sequence out of order, capitalization in databases, and mailing discarded by postal service. These ten mishaps can potentiate nonresponse errors, but there are ways to minimize their frequency. Suggestions offered stem from our own experiences during research projects. Our goal is to increase researchers' knowledge of nonresponse error problems and to offer solutions which can decrease nonresponse error in future projects.

  20. Radiology and pathology of malignant fibrous histiocytomas of the soft tissues a report of ten cases

    International Nuclear Information System (INIS)

    Fischer, H.J.; Lois, J.F.; Gomes, A.S.; Mirra, J.M.; Deutsch, L.S.

    1985-01-01

    Malignant fibrous histiocytomas (MFH) are believed to originate from histiocytes and are composed of malignant cells with spindle or round shapes. We evaluated ten MFH of the soft tissues by plain roentgenograms, computed tomography (CT), and angiography and subdivided them into four grades of anaplasia and five predominant histologic variants. The variants of MFH demonstrated different vascular patterns. The extension of the lesions could be determinded by CT and angiography. CT is the method of choice in the assessment of size and extent of MFH of the soft tissues. When intra-arterial chemotherapy is indicated the angiograms obtained at each catheter placement may substitute CT in follow-up studies obviating additional diagnostic procedures. (orig.)

  1. Radiology and pathology of malignant fibrous histiocytomas of the soft tissues; a report of ten cases

    Energy Technology Data Exchange (ETDEWEB)

    Fischer, H.J.; Lois, J.F.; Gomes, A.S.; Mirra, J.M.; Deutsch, L.S.

    1985-03-01

    Malignant fibrous histiocytomas (MFH) are believed to originate from histiocytes and are composed of malignant cells with spindle or round shapes. We evaluated ten MFH of the soft tissues by plain roentgenograms, computed tomography (CT), and angiography and subdivided them into four grades of anaplasia and five predominant histologic variants. The variants of MFH demonstrated different vascular patterns. The extension of the lesions could be determinded by CT and angiography. CT is the method of choice in the assessment of size and extent of MFH of the soft tissues. When intra-arterial chemotherapy is indicated the angiograms obtained at each catheter placement may substitute CT in follow-up studies obviating additional diagnostic procedures.

  2. Tens bij bevallingen

    NARCIS (Netherlands)

    Tuin-Nuis, F.D.F.

    2000-01-01

    TENS (Transcutane Electrische Neuro Stimulatie) is een pijnverlichtingsmethode die berust op de Gate Control Theory van Melzack en Wall. Door middel van electrische pulsen via de huid zou de geleiding van nociceptieve signalen (pijnprikkels) worden beïnvloed en zou het lichaam endorfinen aanmaken:

  3. Assessing the effects of transcutaneous electrical nerve stimulation (TENS) in post-thoracotomy analgesia.

    Science.gov (United States)

    Ferreira, Fabiana Cristina; Issy, Adriana Machado; Sakata, Rioko Kimiko

    2011-01-01

    Transcutaneous electrical nerve stimulation (TENS) is commonly used to treat musculoskeletal pain, but it may also be indicated for postoperative analgesia. The objective of this study was to evaluate the analgesic effects of TENS on post-thoracotomy. Thirty patients between 18 and 60 years of age undergoing thoracotomy for lung cancer resection on the second postoperative day were included in this study. Patients were divided into two groups (G1 and G2). G1 patients were treated with TENS; and in G2 (without TENS) electrodes were placed but the equipment was not turned on. TENS was maintained for one hour. The visual analogue scale was used to evaluate the analgesic effects on three moments: before TENS (M0), immediately after TENS (M1), and one hour later (M2), with the patient at rest, elevation of the upper limbs, change in decubitus, and coughing. The intensity of pain at rest was higher in G2 immediately after TENS, but not one hour after the procedure. There was no difference between both groups with elevation of the upper limbs, decubitus change, and coughing. With the use of TENS for one hour on the second post-thoracotomy day in patients who received fentanyl (50 μg) associated with bupivacaine (5 mL), a reduction in pain intensity was observed at rest immediately after TENS; with elevation of the upper limbs, change in decubitus, and coughing, a reduction in pain severity was not observed. Copyright © 2011 Elsevier Editora Ltda. All rights reserved.

  4. A critical comparison of ten disposable cup LCAs

    NARCIS (Netherlands)

    Harst, van der E.J.M.; Potting, J.

    2013-01-01

    Disposable cups can be made from conventional petro-plastics, bioplastics, or paperboard (coated with petro-plastics or bioplastics). This study compared ten life cycle assessment (LCA) studies of disposable cups with the aim to evaluate the robustness of their results. The selected studies have

  5. A Case Study on Collective Cognition and Operation in Team-Based Computer Game Design by Middle-School Children

    Science.gov (United States)

    Ke, Fengfeng; Im, Tami

    2014-01-01

    This case study examined team-based computer-game design efforts by children with diverse abilities to explore the nature of their collective design actions and cognitive processes. Ten teams of middle-school children, with a high percentage of minority students, participated in a 6-weeks, computer-assisted math-game-design program. Essential…

  6. Design and Evaluation on the Mobile Application of Transcutaneous Electrical Nerve Stimulation (TENS).

    Science.gov (United States)

    Cheng, Ching-Lung; Lee, Li-Hui; Cheng, Yu-Ting

    2017-01-01

    This study aims to design a transcutaneous electrical nerve stimulation Application (TENS App) according to the suggestions from potential users. To the best of our knowledge, this is the first App including meridian and acupoints for TENS. After its development, there are eight participants recruited for evaluating the usability. Despite two out of eight users reporting that the typical TENS system requires lower cost and has better functionality than TENS App, the results show that almost seventy percent of participants have a better perception of TENS App on price, functionality, convenience, operational ability, and quality. However, participants still reported concerns about the safety issue of adopting TENS App. Therefore, for people who are the first time or unfamiliar with TENS App, instructions from occupational or physical therapists are recommended. We conclude that by using TENS App, users can not only use the portable electrotherapy devices at anyplace, but also reduce their outpatient visits.

  7. Assistive technology for promoting adaptive skills of children with cerebral palsy: ten cases evaluation.

    Science.gov (United States)

    Stasolla, Fabrizio; Caffò, Alessandro O; Perilli, Viviana; Boccasini, Adele; Damiani, Rita; D'Amico, Fiora

    2018-05-06

    To extend the use of assistive technology for promoting adaptive skills of children with cerebral palsy. To assess its effects on positive participation of ten participants involved. To carry out a social validation recruiting parents, physiotherapists and support teachers as external raters. A multiple probe design was implemented for Studies I and II. Study I involved five participants exposed to a combined program aimed at enhancing choice process of preferred items and locomotion fluency. Study II involved five further children for a combined intervention finalized at ensuring them with literacy access and ambulation responses. Study III recruited 60 external raters for a social validation assessment. All participants improved their performance, although differences among children occurred. Indices of positive participation increased as well. Social raters favorably scored the use of both technology and programs. Assistive technology-based programs were effective for promoting independence of children with cerebral palsy. Implications for Rehabilitation A basic form of assistive technology such as a microswitch-based program may be useful and helpful for supporting adaptive skills of children with cerebral palsy and different levels of functioning. The same program may improve the participants' indices of positive participation and constructive engagement with beneficial effects on their quality of life. The positive social rating provided by external experts sensitive to the matter may recommend a favorable acceptance and implementation of the program in daily settings.

  8. Malaria in pregnancy; facts from the parasitology laboratory: a ten-year study in Abuja, North Central Nigeria

    Directory of Open Access Journals (Sweden)

    Ibecheozor, N.K.O

    2014-09-01

    Full Text Available Malaria, which is transmitted by female Anopheles mosquitoes, is the major cause of mortality among the pregnant women in the sub-Saharan Africa. A ten year study of malaria in pregnancy was carried out in Abuja, North Central Nigeria. Thick and thin blood films were stained with the Giemsa methodology. Of the 16760 pregnant women blood samples, 4571 (27.3% were positive for malaria parasites caused by Plasmodium falciparum. Of the 4571 positive cases, 75 (1.7% had parasite density of >5000 parasites/µl of blood; 148 (3.2% had between 500-5000 parasites/µl of blood; 520 (11.4% had between 50 - 500 parasites/µl of blood; while 3828 (83.7% had between 5-50 parasites/µl of blood. With the current estimate of over 4500 deaths of pregnant women in Nigeria due to malaria annually, we must make deliberate efforts to stop these unacceptable and painful losses. The continued use of malaria rapid diagnostic tests (M-RDTs methodologies should be discontinued because of its negative implications. Therefore, the microscopic laboratory diagnostic component should be included in ANC at all level of health care facility.

  9. Meta-analysis of shared genetic architecture across ten pediatric autoimmune diseases

    Science.gov (United States)

    Li, Yun R; Li, Jin; Zhao, Sihai D; Bradfield, Jonathan P; Mentch, Frank D; Maggadottir, S Melkorka; Hou, Cuiping; Abrams, Debra J; Chang, Diana; Gao, Feng; Guo, Yiran; Wei, Zhi; Connolly, John J; Cardinale, Christopher J; Bakay, Marina; Glessner, Joseph T; Li, Dong; Kao, Charlly; Thomas, Kelly A; Qiu, Haijun; Chiavacci, Rosetta M; Kim, Cecilia E; Wang, Fengxiang; Snyder, James; Richie, Marylyn D; Flatø, Berit; Førre, Øystein; Denson, Lee A; Thompson, Susan D; Becker, Mara L; Guthery, Stephen L; Latiano, Anna; Perez, Elena; Resnick, Elena; Russell, Richard K; Wilson, David C; Silverberg, Mark S; Annese, Vito; Lie, Benedicte A; Punaro, Marilynn; Dubinsky, Marla C; Monos, Dimitri S; Strisciuglio, Caterina; Staiano, Annamaria; Miele, Erasmo; Kugathasan, Subra; Ellis, Justine A; Munro, Jane E; Sullivan, Kathleen E; Wise, Carol A; Chapel, Helen; Cunningham-Rundles, Charlotte; Grant, Struan F A; Orange, Jordan S; Sleiman, Patrick M A; Behrens, Edward M; Griffiths, Anne M; Satsangi, Jack; Finkel, Terri H; Keinan, Alon; Prak, Eline T Luning; Polychronakos, Constantin; Baldassano, Robert N; Li, Hongzhe; Keating, Brendan J; Hakonarson, Hakon

    2016-01-01

    Genome-wide association studies (GWASs) have identified hundreds of susceptibility genes, including shared associations across clinically distinct autoimmune diseases. We performed an inverse χ2 meta-analysis across ten pediatric-age-of-onset autoimmune diseases (pAIDs) in a case-control study including more than 6,035 cases and 10,718 shared population-based controls. We identified 27 genome-wide significant loci associated with one or more pAIDs, mapping to in silico–replicated autoimmune-associated genes (including IL2RA) and new candidate loci with established immunoregulatory functions such as ADGRL2, TENM3, ANKRD30A, ADCY7 and CD40LG. The pAID-associated single-nucleotide polymorphisms (SNPs) were functionally enriched for deoxyribonuclease (DNase)-hypersensitivity sites, expression quantitative trait loci (eQTLs), microRNA (miRNA)-binding sites and coding variants. We also identified biologically correlated, pAID-associated candidate gene sets on the basis of immune cell expression profiling and found evidence of genetic sharing. Network and protein-interaction analyses demonstrated converging roles for the signaling pathways of type 1, 2 and 17 helper T cells (TH1, TH2 and TH17), JAK-STAT, interferon and interleukin in multiple autoimmune diseases. PMID:26301688

  10. Modulation of laser-evoked potentials and pain perception by transcutaneous electrical nerve stimulation (TENS): a placebo-controlled study in healthy volunteers.

    Science.gov (United States)

    Vassal, François; Créac'h, C; Convers, Ph; Laurent, B; Garcia-Larrea, L; Peyron, R

    2013-09-01

    To investigate the effects of transcutaneous electrical nerve stimulation (TENS) on brain nociceptive responses (laser-evoked potentials, LEPs) and pain perception. Twenty healthy subjects were included. Nociceptive CO(2)-laser pulses were sequentially delivered to the dorsum of both feet. The amplitude of LEPs and nociceptive thresholds were collected in three consecutive conditions: T1: "sham" TENS (2 Hz/low-intensity) positioned heterotopically, over the left thigh; T2: "active" TENS (120 Hz/low-intensity) applied homotopically, over the left common peroneal nerve; and T3: "sham" TENS (replication of condition T1). Compared with "sham" TENS, "active" TENS significantly decreased the LEPs amplitude. This effect was observed exclusively when "active" TENS was applied ipsilaterally to the painful stimulus. Nociceptive thresholds increased with sessions in both limbs, but the increase observed during the "active" condition of TENS (T2) exceeded significantly that observed during the condition T3 only on the foot ipsilateral to TENS. Compared with a credible placebo TENS, high-frequency TENS induced a significant attenuation of both the acute pain and LEPs induced by noxious stimuli applied on the same dermatome. This modulation of subjective and objective concomitants of pain processing reflects a real neurophysiological TENS-related effect on nociceptive transmission. Copyright © 2013 International Federation of Clinical Neurophysiology. Published by Elsevier Ireland Ltd. All rights reserved.

  11. Increasing intensity of TENS prevents analgesic tolerance in rats

    Science.gov (United States)

    Sato, Karina L.; Sanada, Luciana S.; Rakel, Barbara A.; Sluka, Kathleen A.

    2012-01-01

    Transcutaneous electrical nerve stimulation (TENS) reduces hyperalgesia and pain. Both low frequency (LF) and high frequency (HF) TENS, delivered at the same intensity (90% motor threshold (MT)) daily, result in analgesic tolerance with repeated use by the 5th day of treatment. Thecurrentstudytestedif 1) increasingintensityby 10% per daypreventsthedevelopmentoftolerance to repeated TENS, and 2) iflowerintensity TENS (50 % MT) produces an equivalentreduction in hyperalgesia when compared to 90% MT TENS. Sprague-Dawley rats with unilateral knee joint inflammation (3% carrageenan) were separated according to the intensity of TENS used: Sham, 50% LF, 50% HF, 90% LF, 90% HF, and increased intensity by 10% per day (LF and HF). The reduced mechanical withdrawal threshold following the induction of inflammation was reversed by application of TENS applied at 90% MT and increasing intensity for the first 4 days. On the 5th day, the groups that received 90% MT intensity showed tolerance. Nevertheless, the group that received an increased intensity on each day still showed a reversal of the mechanical withdrawal threshold with TENS. These results show that the development of tolerance can be delayed by increasing intensity of TENS. PMID:22858165

  12. CASE STUDY CRITIQUE; UPPER CLINCH CASE STUDY

    Science.gov (United States)

    Case study critique: Upper Clinch case study (from Research on Methods for Integrating Ecological Economics and Ecological Risk Assessment: A Trade-off Weighted Index Approach to Integrating Economics and Ecological Risk Assessment). This critique answers the questions: 1) does ...

  13. Effect of transcutaneous electric nerve stimulation (TENS on hormones profile in subjects with primary dysmenorrhoea - a preliminary study

    Directory of Open Access Journals (Sweden)

    S. R. A. Akinbo

    2007-01-01

    as the occurrence of painful menstrual cramps of uterine origin which occurs in the absence of any underlying disease. The pathogenesis is unclear, but uterine hyperactivity, elevated prostaglandin and leukotrienes levels, and hormonal level fluctuations have all been implicated. The objective of this study was to evaluate the effect of TENS on the hormones cortisol and prolactin in individuals with PD. Methods: Plasma levels of cortisol and prolactin were studied in twenty-one (21 subjects with PD by obtaining blood samples from each subject pre-and post-TENS therapy on the first day of menstruation. The mean age of subjects was 23 (+ 2 years.  The Visual Analogue Scale (VAS was used to assess the pre-and post-treatment pain intensity.  The TENS unit was applied for a duration of 30 minutes. Results: A paired t-test showed that there was an overall reduction in the mean cortisol and prolactin from  pre treatment values of 28.45µg/dl ((5.27 and 56.81ng/ml ((31.86 to post treatment values of 27.33µg/dl ((5.13 and 53.23ng/ml ((37.63 respectively. However, these differences were not statistically significant (P>0.05.  Pain intensity was significantly reduced comparing pre and post treatment VAS scores (P = 0.001. Conclusion: The probable mechanism by which TENS effected alterations in cortisol and prolactin levels and pain reduction in subjects with PD might be through the opioid-modulating analgesia system, which releases B-endorphins and other endogenous opiates in response to pain.  This is because there is a close relationship between B-endorphin, cortisol and neurons, which secrete dopamine into the hypothalamic-pituitary-portal system.

  14. Are intra-articular corticosteroid injections better than conventional TENS in treatment of rotator cuff tendinitis in the short run? A randomized study.

    Science.gov (United States)

    Eyigor, C; Eyigor, S; Kivilcim Korkmaz, O

    2010-09-01

    Rotator cuff problems are common causes of pain and restriction of movement in shoulder. The aim of this study to compare the effect of intra-articular injection of corticosteroid and conventional transcutaneous electrical nerve stimulator (TENS) treatment in treatment of rotator cuff tendinitis. Subjects were randomly allocated into Group 1 (intra-articular injection of corticosteroid) and Group 2 (conventional transcutaneous electrical nerve stimulation-TENS). Outcome measurements were performed using the Visual Analogue Scale (VAS) for pain, range of motion (ROM), the Shoulder Disability Questionnaire (SDQ), the Short Form-36 (SF-36), and Beck Depression Scale (BDS) questionnaires and paracetamol consumption. In both groups, significant improvement was observed in all weeks in VAS, ROM and SDQ scores (P0.05). In both treatment groups, paracetamol consumption decreased in time (Protator cuff tendinitis. When two treatments are compared, it may be concluded that intra-articular steroid injection was more effective especially in the first weeks regarding pain, ROM and disability. Otherwise, use of TENS allow to patients to increase activity level, improve function and quality of life like that in our study. TENS, as it is cheaper, non-invasive, more easily performed and efficient, may be preferable for the treatment of shoulder pain. Further studies are needed to include these results in the prospective treatment guidelines.

  15. Effects of transcutaneous electrical nerve stimulation (TENS) on cognition and behaviour in aging

    NARCIS (Netherlands)

    Scherder, E.J A; van Someren, E.W J; Bouma, J.M.; van der Berg, M

    2000-01-01

    In previous studies, transcutaneous electrical nerve stimulation (TENS) improved cognition and behaviour in patients with Alzheimer's disease (AD). The rationale underlying these studies was that TENS could activate, e.g. the septo-hippocampal region and the hypothalamus through direct and indirect

  16. Effects of Transcutaneous Electrical Nerve Stimulation (TENS) on cognition and behaviour in aging

    NARCIS (Netherlands)

    Scherder, E.J.A.; Bouma, A.; van den Berg, M.

    2000-01-01

    In previous studies, transcutaneous electrical nerve stimulation (TENS) improved cognition and behaviour in patients with Alzheimer's disease (AD). The rationale underlying these studies was that TENS could activate, e.g. the septo-hippocampal region and the hypothalamus through direct and indirect

  17. Indexes of the Proceedings for the Ten International Symposia on Detonation 1951-93

    Energy Technology Data Exchange (ETDEWEB)

    Deal, William E.; Ramsay, John B.; Roach, Alita M.; Takala, Bruce E.

    1998-09-01

    The Proceedings of the ten Detonation Symposia have become the major archival source of information of international research in explosive phenomenology, theory, experimental techniques, numerical modeling, and high-rate reaction chemistry. In many cases, they contain the original reference or the only reference to major progress in the field. For some papers, the information is more complete than the complementary article appearing in a formal journal; yet for others, authors elected to publish only an abstract in the Proceedings. For the large majority of papers, the Symposia Proceedings provide the only published reference to a body of work. This report indexes the ten existing Proceedings of the Detonation Symposia by paper titles, topic phrases, authors, and first appearance of acronyms and code names.

  18. Developing and pretesting case studies in dental and dental hygiene education: using the diffusion of innovations model.

    Science.gov (United States)

    Cragun, Deborah L; DeBate, Rita DiGioacchino; Severson, Herbert H; Shaw, Tracy; Christiansen, Steve; Koerber, Anne; Tomar, Scott L; Brown, Kelli McCormack; Tedesco, Lisa A; Hendricson, William D

    2012-05-01

    Case-based learning offers exposure to clinical situations that health professions students may not encounter in their training. The purposes of this study were to apply the Diffusion of Innovations conceptual framework to 1) identify characteristics of case studies that would increase their adoption among dental and dental hygiene faculty members and 2) develop and pretest interactive web-based case studies on sensitive oral-systemic health issues. The formative study spanned two phases using mixed methods (Phase 1: eight focus groups and four interviews; Phase 2: ten interviews and satisfaction surveys). Triangulation of quantitative and qualitative data revealed the following positive attributes of the developed case studies: relative advantage of active learning and modeling; compatibility with a variety of courses; observability of case-related knowledge and skills; independent learning; and modifiability for use with other oral-systemic health issues. These positive attributes are expected to increase the likelihood that dental and dental hygiene faculty members will adopt the developed case study once it is available for use. The themes identified in this study could be applied to the development of future case studies and may provide broader insight that might prove useful for exploring differences in case study use across dental and dental hygiene curricula.

  19. Different mechanisms for the short-term effects of real versus sham transcutaneous electrical nerve stimulation (TENS) in patients with chronic pain: a pilot study.

    NARCIS (Netherlands)

    Oosterhof, J.; Wilder-Smith, O.H.G.; Oostendorp, R.A.B.; Crul, B.J.P.

    2012-01-01

    Transcutaneous electrical nerve stimulation (TENS) has existed since the early 1970s. However, randomized placebo controlled studies show inconclusive results in the treatment of chronic pain. These results could be explained by assuming that TENS elicits a placebo response. However, in animal

  20. Treatment of Idiopathic Chronic Orchialgia with Transcutaneous Electrical Nerve Stimulation (TENS:A Preliminary Result

    Directory of Open Access Journals (Sweden)

    Ekrem Akdeniz

    2016-01-01

    Full Text Available Purpose: Unilateral or bilateral testicular pain lasting more than 3 months is called as chronic orchialgia. Aproximately 25-50% of chronic orchialgia is idiopatic origin. This study aimed the effectiveness of Transcutaneous Electrical Nerve Stimulation (TENS therapy due to Idiopathic Chronic Orchialgia (ICO. Methods: Five patients were included into this study with ICO that diagnosed with physical examination, urine analyses, urinary system x-ray film, and scrotal doppler ultrasound. Medical history revealed that multiple conservative therapy attempts failed to alleviate the pain. Two of the patients had right sided ICO. Traditional TENS device is placed to the most painful points. TENS applied 3 times in a week with duration 30 minutes for 4 weeks. Before and after TENS application, patients were evaluated by using Visual Analog Scale (VAS at first and third months. Results: Median age of patients was 26.20±2.38 (22-30. Mean VAS value was 6.52 ± 0.89 before the procedure. After 1 month VAS value was 3.82 ± 0.83 (p0.05. None of the patients needed any analgesics after during the one month. No complications, hyperemia or hypoesthesia of the scrotal or penile skin, occurred after the procedure. Conclusion: TENS reduces pain by increasing endorphin release in the spinal cord dorsal horn. TENS is very effective method for first 1 month in patients with ICO but its effect reduces by the time. There is no standard therapeutic protocol for idiopathic chronic orchialgia. Therefore TENS may be an alternative for patients who do not benefit from medical therapy and do not want invasive procedures. Short-term use of TENS and low number of the patients are the limitations of this study. Randomized, placebo-controlled, and longer follow-up period studies are needed to better assess the efficacy of TENS for ICO.

  1. MRI in patients with portal hypertension (preoperative and postoperative studies). The first 15 cases

    Energy Technology Data Exchange (ETDEWEB)

    Pozzato, A; Cattoni, F; Baldini, U and others

    1987-01-01

    Fifteen patients with portal hypertension were examined by magnetic resonance imaging (MRI) using spin-echo sequences. Sagittal and transaxial images were obtained in all cases. Ten subjects have been evaluated after portosystemic shunt operations (6 portocaval and 4 splenorenal shunts); 5 patients were studied by MRI before shunt placements. Angiographic correlation was obtained in 15 cases. In each of the preoperative examinations, MRI accurately depicted inferior vena cava, portal vein and splenic vein. Shunt patency was documented in 10/10 postoperative studies: portacaval shunts patency was better determined in the transaxial plane while splenorenal shunts were better demonstrted in the sagittal plane. Thus, MRI seems to be an accurate and noninvasive method for detecting portosystemic shunt patency without the use of intravenous contrast media and without patient exposure to radiation.

  2. Extraskeletal Ewing's Sarcoma: insight into a ten years follow-up.

    Science.gov (United States)

    Zitelli, A; Manfredelli, S; Brunotti, G; Marcantonio, M; Pontone, S; Angelici, A

    2013-01-01

    Extraskeletal Ewing's sarcoma is a rare malignant soft tissue tumor, classified within the Ewing's Sarcoma Family Tumors. While the classical Ewing's Sarcoma affects mainly the bone during youth, the Extraskeletal histotype differs for age incidence, primary location and prognosis. Peak incidence and typical location are during adolescence and in the extremities respectively. We report a 30 year old woman case with a positive outcome after ten years from first diagnosis of Extraskeletal Ewing's sarcoma. Treatment was achieved through surgical resection plus adjuvant chemoradiotherapy derived from EW93 and IRS III trials. Conclusion. Our report represents an unusual case due to age of presentation, neoplasm location and long survival reached. In last decades several trials results demonstrated that long survival could be achieved by combined surgery and adjuvant multi-drug treatment.

  3. Transcutaneous Electrical Nerve Stimulation (TENS) reduces pain, fatigue, and hyperalgesia while restoring central inhibition in primary fibromyalgia

    Science.gov (United States)

    Dailey, Dana L; Rakel, Barbara A; Vance, Carol GT; Liebano, Richard E; Anand, Amrit S; Bush, Heather M; Lee, Kyoung S; Lee, Jennifer E; Sluka, Kathleen A

    2014-01-01

    Because TENS works by reducing central excitability and activating central inhibition pathways, we tested the hypothesis that TENS would reduce pain and fatigue and improve function and hyperalgesia in people with fibromyalgia who have enhanced central excitability and reduced inhibition. The current study used a double-blinded randomized, placebo controlled cross-over design to test effects of a single treatment of TENS in people with fibromyalgia. Three treatments were assessed in random order: active TENS, placebo TENS, no TENS. The following measures were assessed before and after each TENS treatment: pain and fatigue at rest and movement, pressure pain thresholds (PPTs), 6 minute walk test (6MWT), range of motion (ROM), five time sit to stand test (FTSTS), and single leg stance (SLS). Conditioned pain modulation (CPM) was completed at end of testing. There was a significant decrease in pain and fatigue with movement for active TENS compared to placebo and no TENS. PPTs increased at site of TENS (spine) and outside site of TENS (leg) when compared to placebo TENS or no TENS. During Active TENS CPM was significantly stronger compared to placebo TENS and no TENS. No changes in functional tasks were observed with TENS. Thus, the current study suggests TENS has short-term efficacy in relieving symptoms of fibromyalgia while the stimulator is active. Future clinical trials should examine the effects of repeated daily delivery of TENS, similar to how TENS is used clinically, on pain, fatigue, function and quality of life in individuals with fibromyalgia. PMID:23900134

  4. Prehospital trauma care reduces mortality. Ten-year results from a time-cohort and trauma audit study in Iraq

    Directory of Open Access Journals (Sweden)

    Murad Mudhafar K

    2012-02-01

    Full Text Available Abstract Background Blunt implementation of Western trauma system models is not feasible in low-resource communities with long prehospital transit times. The aims of the study were to evaluate to which extent a low-cost prehospital trauma system reduces trauma deaths where prehospital transit times are long, and to identify specific life support interventions that contributed to survival. Methods In the study period from 1997 to 2006, 2,788 patients injured by land mines, war, and traffic accidents were managed by a chain-of-survival trauma system where non-graduate paramedics were the key care providers. The study was conducted with a time-period cohort design. Results 37% of the study patients had serious injuries with Injury Severity Score ≥ 9. The mean prehospital transport time was 2.5 hours (95% CI 1.9 - 3.2. During the ten-year study period trauma mortality was reduced from 17% (95% CI 15 -19 to 4% (95% CI 3.5 - 5, survival especially improving in major trauma victims. In most patients with airway problems, in chest injured, and in patients with external hemorrhage, simple life support measures were sufficient to improve physiological severity indicators. Conclusion In case of long prehospital transit times simple life support measures by paramedics and lay first responders reduce trauma mortality in major injuries. Delegating life-saving skills to paramedics and lay people is a key factor for efficient prehospital trauma systems in low-resource communities.

  5. A study on effects of organizational learning on organizational innovation: A case study of insurance industry

    Directory of Open Access Journals (Sweden)

    Maryam Marvasti

    2014-03-01

    Full Text Available This paper presents an empirical investigation to study the relationship between organization learning and organization innovation in one of Iranian insurance firm. The proposed study selects a sample of 300 employees who work for different positions for the case study of this paper and using Pearson correlation as well as Freedman tests determines the relationship and ranks different components of the survey. The results of this implementation have indicated that organization innovation influences on organizational learning, data distribution, interpretation and memory significantly but the effect of organizational innovation on data collection cannot be confirmed when the level of significance is five or even ten percent. The implementation of Freedman test has also indicated that Information interpretation is number priority followed by information learning, organizational distribution and organizational memory.

  6. Use of interactive lecture demonstrations: A ten year study

    Directory of Open Access Journals (Sweden)

    Manjula D. Sharma

    2010-10-01

    Full Text Available The widely held constructivist view of learning advocates student engagement via interactivity. Within the physics education research community, several specific interactive strategies have been developed to enhance conceptual understanding. One such strategy, the Interactive Lecture Demonstration (ILD is designed for large lecture classes and, if measured using specific conceptual surveys, is purported to provide learning gains of up to 80%. This paper reports on learning gains for two different Projects over ten years. In Project 1, the ILDs were implemented from 1999 to 2001 with students who had successfully completed senior high school physics. The learning gains for students not exposed to the ILDs were in the range 13% to 16% while those for students exposed to the ILDs was 31% to 50%. In Project 2, the ILDs were implemented from 2007 to 2009 with students who had not studied senior high school physics. Since the use of ILDs in Project 1 had produced positive results, ethical considerations dictated that all students be exposed to ILDs. The learning gains were from 28% to 42%. On the one hand it is pleasing to note that there is an increase in learning gains, yet on the other, we note that the gains are nowhere near the claimed 80%. This paper also reports on teacher experiences of using the ILDs, in Project 2.

  7. Using Significant Geologic Hazards and Disasters to Focus Geoethics Case Studies

    Science.gov (United States)

    Cronin, V. S.

    2015-12-01

    Ethics education since classical times has involved the consideration of stories, parables, myths, fables, allegories and histories. These are the ancient equivalents of case studies. Modern case studies are used in applied-ethics courses in law, engineering, business, and science. When used in a geoscience course, geoethical case studies can enrich a student's understanding of the relationships between issues of geoscience, engineering, sociology, business, public policy and law - all with an ethical dimension. Perhaps more importantly, real cases affected real people. Students develop a strong empathetic connection to the people involved, enhancing students' drive to understand the interconnected layers of the cases. Students might begin to appreciate that geoscientists can help to avoid or alleviate human suffering -- that their careers can have meaning and purpose beyond simply earning a paycheck. Geologic disasters in which losses could have been predicted, avoided or minimized are quite effective as cases. Coupling a "disaster" case with a comparable "hazard" case is particularly effective. For example, there are many places along the San Andreas Fault in California where [1] significant coseismic displacement has occurred during historical times, [2] structures that are still inhabited were built along or across active traces prior to the Alquist-Priolo Earthquake Fault Zoning Act in 1971, and [3] inhabited structures have been built legally since 1971 within a few tens of feet of active traces. The question students confront is whether society ought to allow habitable structures to be built very near to a major active fault. This topic allows students to work with issues of law, history, seismology, seismic site response, crustal deformation adjacent to active faults, building codes and, ultimately, ethics. Similar progressions can be developed for other major geologic hazards, both natural and man-made, such as floods, landslides, erosion along rivers and

  8. The TEN-T core network and the Fehmarnbelt region

    DEFF Research Database (Denmark)

    Guasco, Clement Nicolas

    This note is a snapshot picture, taken in early 2014, that places the Green STRING corridor project within the context of the TEN-T strategy and gives a summarized overview on the impact of this strategy in the region. Chapter 1 contains a summary of the TEN-T strategy today, chapter 2 presents...... the sources used for this note, chapter 3 presents all the relevant EU regulations with direct impact on the development of TEN-T corridors, chapter 4 gives practical examples of the challenges for the development of TEN-T corridors, chapter 5 pre-sents the national initiatives related to the TEN-T corridor...

  9. Fluoroscopically guided closed reduction and internal fixation of fractures of the lateral portion of the humeral condyle: prospective clinical study of the technique and results in ten dogs.

    Science.gov (United States)

    Cook, J L; Tomlinson, J L; Reed, A L

    1999-01-01

    To report a technique for fluoroscopically guided closed reduction with internal fixation of fractures of the lateral portion of the humeral condyle (FLHC) and determine the long-term results in 10 clinical cases. Prospective clinical case study. Ten dogs with 11 fractures. Fractures of the lateral portion of the humeral condyle were stabilized with transcondylar screws and Kirschner wires. Closed reduction and implant placement were achieved using intraoperative fluoroscopic guidance. After fracture repair, postoperative radiographs were evaluated for articular alignment and implant placement. Dogs were evaluated after surgery by means of lameness scores, elbow range of motion (ROM), radiographic assessment, and owner evaluation of function. Postoperative reduction was considered anatomic in 6 fractures with all other fractures having ROM values between affected and unaffected elbows. All of the dogs in this study regained 90-100% of full function, based on owner assessment. Fluoroscopic guidance for closed reduction and internal fixation of FLHC in dogs is an effective technique.

  10. CYSTINURIA - A TEN-YEAR FOLLOW-UP OF THE PATIENTS

    Directory of Open Access Journals (Sweden)

    Anđelka Slavković

    2001-09-01

    Full Text Available In the period from 1991 to 2001 there were four patients followed up who suffered from cystinuria and cystine calcinosis. The therapy consisting of the cystine dilution in the urine by a great taking-in of liquids and the urine alkalization was combined with alphamercaptopropione glycine and captoprile that bind cystine as well as a respective diet. Alphamercaptopropione glycine leads to the reduction of the already-formed calculus and their easier treatment in the case of a possible need for extracorporeal lithotripsy (ESWEL. During the ten-year follow-up of a small series of patients there were no complications related to the medicament treatment.

  11. Study on dosimetry systems for a few tens MeV/u ion beams

    Energy Technology Data Exchange (ETDEWEB)

    Kojima, Takuji; Sunaga, Hiromi; Takizawa, Haruki; Tachibana, Hiroyuki [Japan Atomic Energy Research Inst., Takasaki, Gunma (Japan). Takasaki Radiation Chemistry Research Establishment

    1997-03-01

    A combined measurement system consisting of a total calorimeter, a Faraday cup and thin film dosimeters have been developed and tested using a simultaneous irradiation apparatus to measure absorbed dose for a few tens MeV/u ion beams of the TIARA AVF cyclotron. (author)

  12. Transcutaneous electric nerve stimulation (TENS) in dentistry- A review.

    Science.gov (United States)

    Kasat, Vikrant; Gupta, Aditi; Ladda, Ruchi; Kathariya, Mitesh; Saluja, Harish; Farooqui, Anjum-Ara

    2014-12-01

    Transcutaneous electric nerve stimulation (TENS) is a non-pharmacological method which is widely used by medical and paramedical professionals for the management of acute and chronic pain in a variety of conditions. Similarly, it can be utilized for the management of pain during various dental procedures as well as pain due to various conditions affecting maxillofacial region. This review aims to provide an insight into clinical research evidence available for the analgesic and non analgesic uses of TENS in pediatric as well as adult patients related to the field of dentistry. Also, an attempt is made to briefly discuss history of therapeutic electricity, mechanism of action of TENS, components of TENs equipment, types, techniques of administration, advantages and contradictions of TENS. With this we hope to raise awareness among dental fraternity regarding its dental applications thereby increasing its use in dentistry. Key words:Dentistry, pain, TENS.

  13. Age Group Comparisons of TENS Response Among Individuals With Chronic Axial Low Back Pain.

    Science.gov (United States)

    Simon, Corey B; Riley, Joseph L; Fillingim, Roger B; Bishop, Mark D; George, Steven Z

    2015-12-01

    Chronic low back pain (CLBP) is a highly prevalent and disabling musculoskeletal pain condition among older adults. Transcutaneous electrical nerve stimulation (TENS) is commonly used to treat CLBP, however response to TENS in older adults compared with younger adults is untested. In a dose-response study stratified by age, 60 participants with axial CLBP (20 young, 20 middle-aged, 20 older) received four 20-minute sessions of high-frequency high-intensity TENS over a 2- to 3-week period in a laboratory-controlled setting. Experimental measures of pain sensitivity (mechanical pressure pain detection threshold) and central pain excitability (phasic heat temporal summation and heat aftersensations) were assessed before and after TENS. Episodic or immediate axial CLBP relief was assessed after TENS via measures of resting pain, movement-evoked-pain, and self-reported disability. Cumulative or prolonged axial CLBP relief was assessed by comparing daily pain reports across sessions. Independent of age, individuals experienced episodic increase in the pressure pain detection threshold and reduction in aftersensation after TENS application. Similarly, all groups, on average, experienced episodic axial CLBP relief via improved resting pain, movement-evoked pain, and disability report. Under this design, no cumulative effect was observed as daily pain did not improve for any age group across the 4 sessions. However, older adults received higher TENS amplitude across all sessions to achieve TENS responses similar to those in younger adults. These findings suggest that older adults experience similar episodic axial CLBP relief to that of younger individuals after high-frequency, high-intensity TENS when higher dose parameters are used. This study examined age group differences in experimental and axial CLBP response to TENS, delivered under the current recommended parameters of strong, but tolerable amplitude. Older adults had comparable TENS response although at higher TENS

  14. Real or Illusory? Case Studies on the Public Perception of Environmental Health Risks in the North West of England

    Science.gov (United States)

    Stewart, Alex G; Luria, Paolo; Reid, John; Lyons, Mary; Jarvis, Richard

    2010-01-01

    Applied research in a public health setting seeks to provide professionals with insights and knowledge into complex environmental issues to guide actions that reduce inequalities and improve health. We describe ten environmental case studies that explore the public perception of health risk. We employed logical analysis of components of each case study and comparative information to generate new evidence. The findings highlight how concerns about environmental issues measurably affect people’s wellbeing and led to the development of new understanding about the benefits of taking an earlier and more inclusive approach to risk communication that can now be tested further. PMID:20617024

  15. Pathological characteristics and clinical specifications in gastroenteropancreatic neuroendocrine tumors: a study of 68 cases.

    Science.gov (United States)

    Stoica-Mustafa, Elena; Pechianu, C; Iorgescu, Andreea; Hortopan, Monica; Dima, Simona Olimpia; Tomulescu, V; Dumitraşcu, T; Ungureanu, C; Andronesi, D; Popescu, I; Herlea, V

    2012-01-01

    Gastroenteropancreatic neuroendocrine tumors (GEP-NETs) represent a group of tumors, having their origin in cells of diffuse endocrine system, with particular clinical course, diagnosis and treatment. In our study, were included 68 patients with neuroendocrine digestive tumors admitted, diagnosed and treated in Fundeni Clinical Institute, Bucharest, in the last ten years--2000-2010 (retrospective study). Thirty-three (49%) patients were males, 35 (51%) females, and the main age was 58.9 years. In 62 (90.3%) cases was possible to find the primary tumor. The examined tumors had different localizations: pancreas--32 (47.04%) cases (head--17 (24.99%) cases, and body and tail--15 (22.05%) cases), stomach--7 (10.29%) cases, small intestine--7 (10.29%) cases, 6 (8.82%) cases--unknown primary site (diagnosis was established on metastases), right colon--6 (8.82%) cases, liver--6 (8.82%) cases, rectum--2 (2.94%) cases, and retroperitoneum--2 (2.94%) cases. Microscopic examination revealed 59 (86.8%) malignant tumors and 9 (13.2%) benign tumors. Using WHO 2000 Classification, 28 cases of malignant tumors were well-differentiated neuroendocrine carcinomas, and 31 cases were poor differentiated neuroendocrine carcinomas. From malignant cases, 25 (42.3%) have distant metastases and 15 (25.9%) lymph node metastases. Cases of gastroenteropancreatic neuroendocrine tumors included in our study had clinical and histopathological features in correspondence with data from literature--slight predominance in women, predominance in 5th and 6th decades of life, the most frequent localizations were at pancreatic level--both head and body and tail, but the rarest were in colon and retroperitoneum. Most of the cases studied, were malignant tumors, from these more than a half were poor differentiated, and a quarter of them having lymph node or distant metastases.

  16. Transcutaneous electrical nerve stimulation (TENS) versus placebo for chronic low-back pain.

    Science.gov (United States)

    Khadilkar, Amole; Odebiyi, Daniel Oluwafemi; Brosseau, Lucie; Wells, George A

    2008-10-08

    Transcutaneous electrical nerve stimulation (TENS) was introduced more than 30 years ago as a therapeutic adjunct to the pharmacological management of pain. However, despite widespread use, its effectiveness in chronic low-back pain (LBP) is still controversial. To determine whether TENS is more effective than placebo for the management of chronic LBP. The Cochrane Central Register of Controlled Trials, MEDLINE, EMBASE, PEDro and CINAHL were searched up to July 19, 2007. Only randomized controlled clinical trials (RCTs) comparing TENS to placebo in patients with chronic LBP were included. Two review authors independently selected the trials, assessed their methodological quality and extracted relevant data. If quantitative meta-analysis was not possible, a qualitative synthesis was performed, taking into consideration 5 levels of evidence as recommended by the Cochrane Collaboration Back Review Group. Four high-quality RCTs (585 patients) met the selection criteria. Clinical heterogeneity prevented the use of meta-analysis. Therefore, a qualitative synthesis was completed. There was conflicting evidence about whether TENS was beneficial in reducing back pain intensity and consistent evidence in two trials (410 patients) that it did not improve back-specific functional status. There was moderate evidence that work status and the use of medical services did not change with treatment. Conflicting results were obtained from two studies regarding generic health status, with one study showing no improvement on the modified Sickness Impact Profile and another study showing significant improvements on several, but not all subsections of the SF-36 questionnaire. Multiple physical outcome measures lacked statistically significant improvement relative to placebo. In general, patients treated with acupuncture-like TENS responded similarly to those treated with conventional TENS. However, in two of the trials, an inadequate stimulation intensity was used for acupuncture

  17. The risks of Euro adoption in Romania – an analysis based on ten criteria

    Directory of Open Access Journals (Sweden)

    Marius-Corneliu MARINAŞ

    2013-01-01

    Full Text Available In this study, I have proposed and examined ten criteria to analyze the challenges of joining at Monetary Union, explaining the need to include them in government and multinational companies’ strategies. The criteria adopted in the case of Romania concern the potential impact of Euro adoption on economic activities, the common monetary policy effects on the Romanian economy, synchronization with the Euro area, labour market flexibility, as a tool of shocks adjustment etc. After stating each criterion, I have made a brief analysis of how that could affect the balance of costs and benefits of giving up own currency, using conclusions of the optimum currency areas theory.

  18. School Psychologists' Job Satisfaction: Ten Years Later

    OpenAIRE

    Worrell, Travis G.

    2004-01-01

    School Psychologistsâ Job Satisfaction: Ten Years Later (ABSTRACT) This study was designed to replicate nationwide surveys completed in 1982 and 1992. The purpose was to examine and describe the levels of job satisfaction and the relationship between the variables in a national sample of school psychologists belonging to the National Association of School Psychologists (NASP). The sample for this study consisted of respondents who reported being full-time school practitioners. ...

  19. Primary lymphoma of the central nervous system: a clinical-pathological and immunohistochemical study of ten autopsy cases Linfoma primário do sistema nervoso central: estudo clínico-patológico e imuno-histoquímico de dez casos de necropsia

    Directory of Open Access Journals (Sweden)

    Henrique Costa

    2006-12-01

    Full Text Available CONTEXT: Primary central nervous system lymphomas (PCNSL are a rare subgroup of lymphomas generally associated with HIV and EBV. OBJECTIVE: To study ten autopsy cases of PCNSL, to describe the neuropathological findings, to characterize the phenotype of the neoplastic cells, to detect EBV in the lesion and to compare the findings with the clinical and laboratory data of the patients. METHOD: The clinical, histological and immunohistochemical data of ten cases of PCNSL, eight cases from patients with AIDS, identified among 265 autopsies of these patients were analyzed. RESULTS: Seven patients were males and the mean age was 40.9 years. The most frequent symptomatology was focal neurologic deficit (70%. Six patients presented with only one lesion. Histologically, densely cellular and polymorphous neoplasms with angiocentrism were observed, in 90% of cases. An association with other diseases was observed in four cases. Most patients had diffuse large B cell non-Hodgkin’s lymphoma. EBV was detected by immunohistochemistry in only one case. The lack of detection of the virus might have been due to the long time of fixation of the brain which might have inactivate epitopes therefore compromising the testing. CONCLUSION: In the present series, PCNSL presented with focal symptoms, with unifocal or multifocal lesions, with a predominant B-cell CD20 positive phenotype, rarely associated with EBV.CONTEXTO: Linfoma primário do sistema nervoso central (LP-SNC é raro subgrupo de linfomas relacionado à AIDS, geralmente associado EBV. OBJETIVO: Identificar os achados clínico-patológicos dos pacientes com LP-SNC. MÉTODO: Foram analisados dados clínicos, histológicos e imuno-histoquímicos de dez necrópsias de LP-SNC, oito deles de pacientes com AIDS, identificados entre 265 autopsias destes. RESULTADOS: Sete pacientes foram masculinos e a idade média foi 40,9 anos. A sintomatologia neurológica mais freqüente era focal (70%. Seis exibiram les

  20. Ten steps to successful software process improvement

    Science.gov (United States)

    Kandt, R. K.

    2003-01-01

    This paper identifies ten steps for managing change that address organizational and cultural issues. Four of these steps are critical, that if not done, will almost guarantee failure. This ten-step program emphasizes the alignment of business goals, change process goals, and the work performed by the employees of an organization.

  1. Lifeline electric rates and alternative approaches to the problems of low-income ratepayers. Ten case studies of implemented programs

    Energy Technology Data Exchange (ETDEWEB)

    1980-07-01

    Program summaries, issue developments, governmental processes, and impacts are discussed for 10 case studies dealing with lifeline electric rates and alternative approaches to the problems of low-income ratepayers, namely; the Boston Edison rate freeze; the California lifeline; Florida Power and Light conservation rate; the Iowa-Illinois Gas and Electric small-use rate; the Maine demonstration lifeline program; the Massachusetts Electric Company A-65 rate; the Michigan optional senior citizen rate; the Narragansett Electric Company A-65 SSI rate; the Northern States Power Company conservation rate break; and the Potomac Electric Power Company rate freeze. (MCW)

  2. Reliability and validity of ten consumer activity trackers

    NARCIS (Netherlands)

    Kooiman, Thea; Dontje, Manon L.; Sprenger, Siska; Krijnen, Wim; van der Schans, Cees; de Groot, Martijn

    2015-01-01

    Background: Activity trackers can potentially stimulate users to increase their physical activity behavior. The aim of this study was to examine the reliability and validity of ten consumer activity trackers for measuring step count in both laboratory and free-living conditions. Method: Healthy

  3. Optimal duration of ultra low frequency-transcutaneous electrical nerve stimulation (ULF-TENS) therapy for muscular relaxation in neuromuscular occlusion: A preliminary clinical study.

    Science.gov (United States)

    Esclassan, Rémi; Rumerio, Anaïs; Monsarrat, Paul; Combadazou, Jean Claude; Champion, Jean; Destruhaut, Florent; Ghrenassia, Christophe

    2017-05-01

    The primary aim of this work was to determine the duration of ultra-low-frequency transcutaneous electrical nerve stimulation (ULF-TENS) application necessary to achieve sufficient relaxation of the masticatory muscles. A secondary aim was to analyze the influence of stimulation on muscle relaxation in pathological subjects and determine whether ULF-TENS has a noteworthy impact on muscle relaxation. Sixteen adult subjects with temporomandibular disorders (TMD) and muscle pain and a group of four control subjects were included in this study. ULF-TENS was applied, and muscular activities of the masseter, temporal, and sternocleidomastoid muscles (SCM) were recorded for 60 min. Significant relaxation was achieved in the TMD group from 20, 40, and 60 min for the temporal, masseter, and SCM muscles (p TENS application would last 40 min to obtain sufficient muscle relaxation both in patients with masticatory system disorders and healthy subjects, a time constraint that is consistent with everyday clinical practice.

  4. Antihypertensive effect of low-frequency transcutaneous electrical nerve stimulation (TENS) in comparison with drug treatment.

    Science.gov (United States)

    Silverdal, Jonas; Mourtzinis, Georgios; Stener-Victorin, Elisabet; Mannheimer, Clas; Manhem, Karin

    2012-10-01

    Hypertension is a major risk factor for vascular disease, yet blood pressure (BP) control is unsatisfactory low, partly due to side-effects. Transcutaneous electrical nerve stimulation (TENS) is well tolerated and studies have demonstrated BP reduction. In this study, we compared the BP lowering effect of 2.5 mg felodipin once daily with 30 min of bidaily low-frequency TENS in 32 adult hypertensive subjects (mean office BP 152.7/90.0 mmHg) in a randomized, crossover design. Office BP and 24-h ambulatory BP monitoring (ABPM) were performed at baseline and at the end of each 4-week treatment and washout period. Felodipin reduced office BP by 10/6 mmHg (p TENS reduced office BP by 5/1.5 mmHg (p TENS washout, BP was further reduced and significantly lower than at baseline, but at levels similar to BP after felodipin washout and therefore reasonably caused by factors other than the treatment per se. ABPM revealed a significant systolic reduction of 3 mmHg by felodipin, but no significant changes were noted after TENS. We conclude that our study does not present any solid evidence of BP reduction of TENS.

  5. Gardner's syndrome: a ten year follow up survey of 12 subjects in a family

    International Nuclear Information System (INIS)

    Lu Kaimin; Si Liya; Wu Zhiqiang; Lu Xuan; Meng Liancheng

    1998-01-01

    Purpose: To study the development of Gardner's syndrome by following up 12 subjects in a family for ten years. Methods: 12 subjects with Gardner's syndrome of 4 generations in a family were studied. Six were male and six female. The age of the patients was from 9 to 74 years, with average of 38 years. The examinations consisted of air-barium double contrast radiography of colon, fiber-optic colonoscopy, plain X-ray and body photography. Results: Triology was present in 8 cases (66.7%) and the double signs in 4 cases (33.3%). 4 patients (33.3%) died of malignant degeneration of colonic polyp in 10 years, all occurring in rectum and sigmoid colon, the oldest one was 74 years and the youngest 35 years. Conclusion: The incidence of malignant degeneration of colonic polyp is very high in patients with Gardner's syndrome and may occur in patients older than 30 years, with the peak incidence in the sixth decade. Preventive resection of colonic polyp is still the best treatment

  6. A Review of Ten Years of the Study for Monitoring Antimicrobial Resistance Trends (SMART from 2002 to 2011

    Directory of Open Access Journals (Sweden)

    Douglas Biedenbach

    2013-11-01

    Full Text Available Surveillance of antimicrobial agent resistance provides important information to guide microbiologists and infectious disease specialists understanding of the control and the spread of resistance mechanisms within the local environment. Continued monitoring of antimicrobial resistance patterns in the community and in local hospital environments is essential to guide effective empiric therapy. The Study for Monitoring Antimicrobial Resistance Trends (SMART has monitored the in vitro susceptibility patterns of clinical Gram-negative bacilli to antimicrobial agents collected worldwide from intra-abdominal infections since 2002 and urinary tract infections since 2009. Resistance trends, with a particular focus on carbapenem resistance and the rate of extended-spectrum β-lactamases (ESBLs, were analyzed. Isolates from intra-abdominal infections (n = 92,086 and urinary-tract infections (n = 24,705 were collected and tested using Clinical and Laboratory Standards Institute methods. This review presents carbapenem susceptibility and ESBL rates over ten years of SMART study analysis, including key publications during this period. The SMART study has proved to be a valuable resource in determining pathogen prevalence and antibiotic susceptibility over the last ten years and continues to provide evidence for regulatory susceptibility breakpoints and clinical decision making.

  7. A Review of Ten Years of the Study for Monitoring Antimicrobial Resistance Trends (SMART) from 2002 to 2011.

    Science.gov (United States)

    Morrissey, Ian; Hackel, Meredith; Badal, Robert; Bouchillon, Sam; Hawser, Stephen; Biedenbach, Douglas

    2013-11-01

    Surveillance of antimicrobial agent resistance provides important information to guide microbiologists and infectious disease specialists understanding of the control and the spread of resistance mechanisms within the local environment. Continued monitoring of antimicrobial resistance patterns in the community and in local hospital environments is essential to guide effective empiric therapy. The Study for Monitoring Antimicrobial Resistance Trends (SMART) has monitored the in vitro susceptibility patterns of clinical Gram-negative bacilli to antimicrobial agents collected worldwide from intra-abdominal infections since 2002 and urinary tract infections since 2009. Resistance trends, with a particular focus on carbapenem resistance and the rate of extended-spectrum β-lactamases (ESBLs), were analyzed. Isolates from intra-abdominal infections (n = 92,086) and urinary-tract infections (n = 24,705) were collected and tested using Clinical and Laboratory Standards Institute methods. This review presents carbapenem susceptibility and ESBL rates over ten years of SMART study analysis, including key publications during this period. The SMART study has proved to be a valuable resource in determining pathogen prevalence and antibiotic susceptibility over the last ten years and continues to provide evidence for regulatory susceptibility breakpoints and clinical decision making.

  8. The origin of the future ten questions for the next ten years

    CERN Document Server

    Gribbin, John

    2006-01-01

    How did the universe begin? Where do galaxies come from? How do stars and planets form? Where do the material particles we are made of come from? How did life begin? Today we have only provisional answers to such questions. But scientific progress will improve these answers dramatically over the next ten years, predicts John Gribbin in this riveting book. He focuses on what we know—or think we know—about ten controversial, unanswered issues in the physical sciences and explains how current cutting-edge research may yield solutions in the very near future. With his trademark facility for engaging readers with or without a scientific background, the author explores ideas concerning the creation of the universe, the possibility of other forms of life, and the fate of the expanding cosmos. He examines “theories of everything,” including grand unified theories and string theory, and he discusses the Big Bang theory, the origin of structure and patterns of matter in the galaxies, and dark mass and dark ene...

  9. VINKA, ten years on. Main scientific results

    International Nuclear Information System (INIS)

    1979-01-01

    The VINKA facility in the TRITON swimming-pool reactor at Fontenay-aux-Roses allows the irradiation of solids at low temperatures in order to study crystalline defects. After ten years of operation the main scientific results obtained in the fields of creep and growth (chapter I), point defects (chapter II), amorphisation (chapter III) and dechanneling of particles (chapter IV) are summarised [fr

  10. The medium-term effects of diadynamic currents in chronic low back pain; TENS versus diadynamic currents: A randomised, follow-up study.

    Science.gov (United States)

    Sayilir, Selcuk; Yildizgoren, Mustafa Turgut

    2017-11-01

    The aims of the study were to evaluate the medium-term effects of diadynamic (DD) currents on relieving symptoms/improving physical functionality in patients with chronic low back pain (LBP) and to compare the efficacy of DD versus TENS. The patients were divided into two groups as the TENS group (n = 26) and the DD group (n = 29). Additional treatment of hot pack + therapeutic ultrasound was applied to all patients. The therapy programs were administered as a total of 10 sessions over a period of 2 weeks. Roland Morris Disability Questionnaire (RDQ), Oswestry Disability Index and Visual Analog Scale (VAS) values were recorded. Both groups showed significant improvements in VAS and RDQ scores after one month of the therapies (all p TENS and DD currents in chronic LBP can lead to reduced pain, and improved physical functions. Hence, DD currents can be used as an adjuvant therapy for rehabilitation of chronic LBP. Copyright © 2017 Elsevier Ltd. All rights reserved.

  11. The evaluation of complex interventions in palliative care: an exploration of the potential of case study research strategies.

    Science.gov (United States)

    Walshe, Catherine

    2011-12-01

    Complex, incrementally changing, context dependent and variable palliative care services are difficult to evaluate. Case study research strategies may have potential to contribute to evaluating such complex interventions, and to develop this field of evaluation research. This paper explores definitions of case study (as a unit of study, a process, and a product) and examines the features of case study research strategies which are thought to confer benefits for the evaluation of complex interventions in palliative care settings. Ten features of case study that are thought to be beneficial in evaluating complex interventions in palliative care are discussed, drawing from exemplars of research in this field. Important features are related to a longitudinal approach, triangulation, purposive instance selection, comprehensive approach, multiple data sources, flexibility, concurrent data collection and analysis, search for proving-disproving evidence, pattern matching techniques and an engaging narrative. The limitations of case study approaches are discussed including the potential for subjectivity and their complex, time consuming and potentially expensive nature. Case study research strategies have great potential in evaluating complex interventions in palliative care settings. Three key features need to be exploited to develop this field: case selection, longitudinal designs, and the use of rival hypotheses. In particular, case study should be used in situations where there is interplay and interdependency between the intervention and its context, such that it is difficult to define or find relevant comparisons.

  12. A Ten-Year Reflection

    Science.gov (United States)

    Phillip, Cyndi

    2016-01-01

    Five initiatives launched during Cyndi Phillip's term as American Association of School Librarians (AASL) President (2006-2007) continue to have an impact on school librarians ten years later. They include the rewriting of AASL's learning standards, introduction of the SKILLS Act, the presentation of the Crystal Apple Award to Scholastic Library…

  13. The Ten-Minute Neighbourhood Is [not] a Basic Planning Unit for Happiness in Egypt

    Directory of Open Access Journals (Sweden)

    Abeer Mohamed Elshater

    2016-04-01

    Full Text Available This paper investigates the relationship between inhabitants’ happiness and the right to the city in the status quo of Egyptian neighborhoods. Although services are easily accessible, by ten-minute walks in a suitable ambience, happiness is not achieved. The research aims to, first, review the literature that provides a guideline for ten-minute neighborhoods. Second, this study conducts a comparative content analysis of recent online articles on the right to the city. Third, the study tests findings from Egyptian neighborhood settings. The idea of a ten-minute neighborhood is manageable. The hypothesis concerns a compliant design. It is a logical assumption that people who live within ten minutes walking distance of essential facilities in their area can minimize several problems and maximize a healthy lifestyle. The supposed issue causes the right to the city to affect the relationship between ten-minute neighborhoods and citizens’ happiness. This assumption can be established through site observation and oriented questionnaires. This paper contributes by presenting new planning units that suit the current context of the old cities in the Middle East and North Africa region, based on walking distances of ten minutes or less with reference to the right to the city. This planning unit can result in citizens’ happiness.

  14. Choledochal cysts: our ten year experience.

    LENUS (Irish Health Repository)

    Cianci, F

    2012-04-01

    We present our experience in the management of choledochal cysts from 1999 to 2009. A retrospective review of all charts with a diagnosis of choledochal cysts in our institution in this ten-year period. Data was collated using Excel. A total of 17 patients were diagnosed with choledochal cyst: 9 females and 8 males. The average age at diagnosis was 28 months (range from 0 to 9 years). The most common presenting symptoms were obstructive jaundice 6 (35%) and abdominal pain and vomiting 4 (23%). Ultrasound (US) was the initial diagnostic test in all cases with 4 patients requiring further investigations. All patients underwent Roux-en-Y Hepaticojejunostomy. The average length of stay was 11 days. Patients were followed up with Liver Function Tests (LFTS) and US 4-6 weeks post-operatively. Three patients developed complications including post-op collection, high drain output requiring blood transfusion and adhesive bowel obstruction. Our overall experience with choledochal cyst patients has been a positive one with effective management and low complication rates.

  15. TRANSCUTANEOUS ELECTRIC NERVE STIMULATION IN MODULATION OF PAIN OF TENDER POINTS IN SYNDROME FIBROMYALGIA: CASE STUDY

    Directory of Open Access Journals (Sweden)

    Isabel Mara Magalhães Rori

    2008-08-01

    Full Text Available The Fibromyalgia is a syndrome of pain and chronic diffuse, characterized by the presence of at least 11 of 18 points called anatomically specific tender points, painful on palpation. As the pain diffuse the main symptom of fibromyalgia. The current treatment is focused mainly to the reduction of symptoms. Physiotherapy has animportant role in improving the control of pain. This study aimed to verify the effectiveness of the main TENS of low frequency and high intensity in modulating pain of tender points of patients with fibromyalgia. For this was a case study of patient R. S. S., 38-yearold female carrier of the syndrome of fibromyalgia attended school in the clinic of the Faculty of Integrated Ceará (FISIOFIC. The patient was treated with the TENS-pain Acupuncture points in a total of twelve care and pain assessed before starting treatment and after three attendants. There was a significant reduction in pain intensity at 77.7% of the tender points in the second evaluation and 88.8% of the points in the other assessments. It was concluded that there was a reduction in the pain of tender points of the patient showing the analgesia promoted by TENS, so it should be used as a complementary treatment programs associated with other treatments and also served as a good technique to locate the tender points.

  16. Supersymmetric gauged scale covariance in ten and lower dimensions

    International Nuclear Information System (INIS)

    Nishino, Hitoshi; Rajpoot, Subhash

    2004-01-01

    We present globally supersymmetric models of gauged scale covariance in ten, six, and four dimensions. This is an application of a recent similar gauging in three dimensions for a massive self-dual vector multiplet. In ten dimensions, we couple a single vector multiplet to another vector multiplet, where the latter gauges the scale covariance of the former. Due to scale covariance, the system does not have a Lagrangian formulation, but has only a set of field equations, like Type IIB supergravity in ten dimensions. As by-products, we construct similar models in six dimensions with N=(2,0) supersymmetry, and four dimensions with N=1 supersymmetry. We finally get a similar model with N=4 supersymmetry in four dimensions with consistent interactions that have never been known before. We expect a series of descendant theories in dimensions lower than ten by dimensional reductions. This result also indicates that similar mechanisms will work for other vector and scalar multiplets in space-time lower than ten dimensions

  17. Bayesian approach to the assessment of the population-specific risk of inhibitors in hemophilia A patients: a case study.

    Science.gov (United States)

    Cheng, Ji; Iorio, Alfonso; Marcucci, Maura; Romanov, Vadim; Pullenayegum, Eleanor M; Marshall, John K; Thabane, Lehana

    2016-01-01

    Developing inhibitors is a rare event during the treatment of hemophilia A. The multifacets and uncertainty surrounding the development of inhibitors further complicate the process of estimating inhibitor rate from the limited data. Bayesian statistical modeling provides a useful tool in generating, enhancing, and exploring the evidence through incorporating all the available information. We built our Bayesian analysis using three study cases to estimate the inhibitor rates of patients with hemophilia A in three different scenarios: Case 1, a single cohort of previously treated patients (PTPs) or previously untreated patients; Case 2, a meta-analysis of PTP cohorts; and Case 3, a previously unexplored patient population - patients with baseline low-titer inhibitor or history of inhibitor development. The data used in this study were extracted from three published ADVATE (antihemophilic factor [recombinant] is a product of Baxter for treating hemophilia A) post-authorization surveillance studies. Noninformative and informative priors were applied to Bayesian standard (Case 1) or random-effects (Case 2 and Case 3) logistic models. Bayesian probabilities of satisfying three meaningful thresholds of the risk of developing a clinical significant inhibitor (10/100, 5/100 [high rates], and 1/86 [the Food and Drug Administration mandated cutoff rate in PTPs]) were calculated. The effect of discounting prior information or scaling up the study data was evaluated. Results based on noninformative priors were similar to the classical approach. Using priors from PTPs lowered the point estimate and narrowed the 95% credible intervals (Case 1: from 1.3 [0.5, 2.7] to 0.8 [0.5, 1.1]; Case 2: from 1.9 [0.6, 6.0] to 0.8 [0.5, 1.1]; Case 3: 2.3 [0.5, 6.8] to 0.7 [0.5, 1.1]). All probabilities of satisfying a threshold of 1/86 were above 0.65. Increasing the number of patients by two and ten times substantially narrowed the credible intervals for the single cohort study (1.4 [0.7, 2

  18. Vaccine-induced toxic epidermal necrolysis: A case and systematic review.

    Science.gov (United States)

    Chahal, Dev; Aleshin, Maria; Turegano, Mamina; Chiu, Melvin; Worswick, Scott

    2018-01-15

    Erythema multiforme (EM), Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are cutaneous hypersensitivityreactions that develop in response to specific triggers such as medications and certain infections. Vaccines, which undergo rigorous safety testing prior to use in humans, are a rare cause of SJS/TEN and little is known about the frequency of such events and corresponding pathogenesis. Herein, we discuss a case of suspected TEN in a 19-year-old woman who received the meningococcal B vaccine (the first report of such an association) and conduct a systematic review of the associated literature. We also discuss management of this patient with a single dose of etanercept. Relevant literature was searched using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) method. A total of 29 articles reporting EM, SJS, or TEN following vaccination were included from >5 countries. Of the 29, 22 articles reported EM, 6/29 reported SJS, and 4/29 reported TEN (3 articlesreported cases of both EM and SJS/TEN). We suggest consideration of vaccines as an etiology for cases of SJS or TEN that begin with an EM-like presentation, and provide further evidence for the use of etanercept as a viable treatment for TEN.

  19. Japanese hospitals--culture and competition: a study of ten hospitals.

    Science.gov (United States)

    Anbäcken, O

    1994-01-01

    Japanese health care is characterized by a pluralistic system with a high degree of private producers. Central government regulates the prices and the financing system. All citizens are covered by a mandatory employment-based health insurance operating on a non-profit basis. The consumer has a free choice of physician and hospital. A comparison between Japan, Sweden and some other countries shows significant dissimilarities in the length of stay, number of treatments per hospital bed and year and the staffing of hospitals. About 80 per cent of the hospitals and 94 per cent of the clinics are privately owned. The typical private hospital owned by a physician has less than 100 beds. In this paper, data collected (1992/93) in an empirical study of Japanese hospitals and their leadership is presented. Also discussed are the hospitals' style of management, tools and strategies for competition and competences--personal and formal skills required of the leadership in the hospital. There follows a study of ten hospitals, among which hospital directors and chief physicians were interviewed. Interviews are also made with key persons in the Ministry of Health and Welfare and other organizations in the health care field. The result is also analysed from a cultural perspective--'what kind of impact does the Japanese culture have on the health care organization?' and/or 'what kind of sub-culture is developed in the Japanese hospitals'. Some comparisons are made with Sweden, USA, Canada and Germany. The different roles of the professions in the hospital are included in the study as well as the incentives for different kinds of strategies--specialization, growing in size, investments in new equipment, different kind of ownership and hospitals. Another issue discussed is the attempt to uncover whether there is an implicit distribution of specialties--silent agreements between hospitals, etc.

  20. Affordances: Ten Years On

    Science.gov (United States)

    Brown, Jill P.; Stillman, Gloria

    2014-01-01

    Ten years ago the construct, affordance, was rising in prominence in scholarly literature. A proliferation of different uses and meanings was evident. Beginning with its origin in the work of Gibson, we traced its development and use in various scholarly fields. This paper revisits our original question with respect to its utility in mathematics…

  1. Case Study of Multi-Unit Risk: Multi-Unit Station Black-Out

    Energy Technology Data Exchange (ETDEWEB)

    Oh, Kyemin; Jang, Seung-cheol [KAERI, Daejeon (Korea, Republic of); Heo, Gyunyoung [Kyung Hee University, Yongin (Korea, Republic of)

    2015-05-15

    After Fukushima Daiichi Accident, importance and public concern for Multi-Unit Risk (MUR) or Probabilistic Safety Assessment (PSA) have been increased. Most of nuclear power plant sites in the world have more than two units. These sites have been facing the problems of MUR or accident such as Fukushima. In case of South Korea, there are generally more than four units on the same site and even more than ten units are also expected. In other words, sites in South Korea also have been facing same problems. Considering number of units on the same site, potential of these problems may be larger than other countries. The purpose of this paper is to perform case study based on another paper submitted in the conference. MUR is depended on various site features such as design, shared systems/structures, layout, environmental condition, and so on. Considering various dependencies, we assessed Multi-Unit Station Black-out (MSBO) accident based on Hanul Unit 3 and 4 model. In this paper, case study for multi-unit risk or PSA had been performed. Our result was incomplete to assess total multi-unit risk because of two challenging issues. First, economic impact had not been evaluated to estimate multi-unit risk. Second, large uncertainties were included in our result because of various assumptions. These issues must be resolved in the future.

  2. Case Study of Multi-Unit Risk: Multi-Unit Station Black-Out

    International Nuclear Information System (INIS)

    Oh, Kyemin; Jang, Seung-cheol; Heo, Gyunyoung

    2015-01-01

    After Fukushima Daiichi Accident, importance and public concern for Multi-Unit Risk (MUR) or Probabilistic Safety Assessment (PSA) have been increased. Most of nuclear power plant sites in the world have more than two units. These sites have been facing the problems of MUR or accident such as Fukushima. In case of South Korea, there are generally more than four units on the same site and even more than ten units are also expected. In other words, sites in South Korea also have been facing same problems. Considering number of units on the same site, potential of these problems may be larger than other countries. The purpose of this paper is to perform case study based on another paper submitted in the conference. MUR is depended on various site features such as design, shared systems/structures, layout, environmental condition, and so on. Considering various dependencies, we assessed Multi-Unit Station Black-out (MSBO) accident based on Hanul Unit 3 and 4 model. In this paper, case study for multi-unit risk or PSA had been performed. Our result was incomplete to assess total multi-unit risk because of two challenging issues. First, economic impact had not been evaluated to estimate multi-unit risk. Second, large uncertainties were included in our result because of various assumptions. These issues must be resolved in the future

  3. Chapter Ten

    African Journals Online (AJOL)

    User

    differences in behavior. Research motivated from this perspective focuses on ways to ... work serves as a case study for the way cultural psychology can provide a framework for better understanding ...... emotion, and motivation. Psychological ...

  4. Age Group Comparisons of TENS Response among Individuals with Chronic Axial Low Back Pain

    OpenAIRE

    Simon, Corey B.; Riley, Joseph L.; Fillingim, Roger B.; Bishop, Mark D.; George, Steven Z.

    2015-01-01

    Chronic low back pain (CLBP) is a highly prevalent and disabling musculoskeletal pain condition among older adults. Transcutaneous electrical nerve stimulation (TENS) is commonly used to treat CLBP, however, TENS response for older adults compared to younger adults is untested. In a dose-response study stratified by age, sixty participants with axial CLBP (20 young, 20 middle-aged, 20 older) received four 20-minute sessions of high frequency, high intensity TENS over a two to three-week perio...

  5. Clinico-MRI study of hemispheric disorder in long-term follow-up cases of multiple system atrophy

    International Nuclear Information System (INIS)

    Konagaya, Masaaki; Miwa, Shigeru; Matsuoka, Yukihiko; Konagaya, Yoko

    1998-01-01

    Twelve cases of multiple system atrophy (MSA) were studied for clinical and MRI findings of the cerebral hemispheric involvement. The subjects consisted of five olivopontocerebellar atrophy (OPCA) type and seven striatonigral degeneration (SND) type. The age at onset was 56.7±8.0 (M±SD) years, duration of illness at the first MRI study 3.2±1.1 years, duration of illness at the last study 8.1±2.2 years, and the following up duration 4.9±2.0 years. The grasping phenomenon was observed in 70% of the cases examined, snout reflex in 80%, slowness of verbal response in 88%, and decrease of spontaneous speech in 100%. Three cases finally fell into the state of mutism. Three out of ten cases were categorized as dementia by HDS-R (Hasegawa Dementia Scale-Revised) test. Besides the progression of the pontocerebellar atrophy and putaminal changes, MRI study revealed progressive frontal lobe atrophy in most cases. At six years after the onset, SND type showed significantly higher incidence of conspicuous frontal lobe atrophy and dilatation of the Sylvian fissure than OPCA type. Cerebral ventricular dilatation was common feature, and atrophy of the temporal and occipital lobes were observed in several cases. We indicated the possible involvement of the cerebral hemisphere, especially the frontal lobe, and higher nervous function in MSA. (author)

  6. Clinico-MRI study of hemispheric disorder in long-term follow-up cases of multiple system atrophy

    Energy Technology Data Exchange (ETDEWEB)

    Konagaya, Masaaki; Miwa, Shigeru; Matsuoka, Yukihiko [Suzuka National Hospital, Mie (Japan); Konagaya, Yoko

    1998-12-01

    Twelve cases of multiple system atrophy (MSA) were studied for clinical and MRI findings of the cerebral hemispheric involvement. The subjects consisted of five olivopontocerebellar atrophy (OPCA) type and seven striatonigral degeneration (SND) type. The age at onset was 56.7{+-}8.0 (M{+-}SD) years, duration of illness at the first MRI study 3.2{+-}1.1 years, duration of illness at the last study 8.1{+-}2.2 years, and the following up duration 4.9{+-}2.0 years. The grasping phenomenon was observed in 70% of the cases examined, snout reflex in 80%, slowness of verbal response in 88%, and decrease of spontaneous speech in 100%. Three cases finally fell into the state of mutism. Three out of ten cases were categorized as dementia by HDS-R (Hasegawa Dementia Scale-Revised) test. Besides the progression of the pontocerebellar atrophy and putaminal changes, MRI study revealed progressive frontal lobe atrophy in most cases. At six years after the onset, SND type showed significantly higher incidence of conspicuous frontal lobe atrophy and dilatation of the Sylvian fissure than OPCA type. Cerebral ventricular dilatation was common feature, and atrophy of the temporal and occipital lobes were observed in several cases. We indicated the possible involvement of the cerebral hemisphere, especially the frontal lobe, and higher nervous function in MSA. (author)

  7. Indicator-based assessment of marine biological diversity – lessons from 10 case studies across the European Seas

    Directory of Open Access Journals (Sweden)

    Laura Uusitalo

    2016-09-01

    Full Text Available The Marine Strategy Framework Directive requires the environmental status of European marine waters to be assessed using biodiversity as one out of 11 descriptors, but the complexity of marine biodiversity and its large span across latitudinal and salinity gradients have been a challenge to the scientific community aiming to produce approaches for integrating information from a broad range of indicators. The Nested Environmental status Assessment Tool (NEAT, developed for the integrated assessment of the status of marine waters, was applied to ten marine ecosystems to test its applicability and compare biodiversity assessments across the four European regional seas. We evaluate the assessment results as well as the assessment designs of the ten cases, and how the assessment design, particularly the choices made regarding the area and indicator selection, affected the results. The results show that only 2 out of the 10 case study areas show more than 50 % probability of being in good status in respect of biodiversity. No strong pattern among the ecosystem components across the case study areas could be detected, but marine mammals, birds, and benthic vegetation indicators tended to indicate poor status while zooplankton indicators indicated good status when included into the assessment. The analysis shows that the assessment design, including the selection of indicators, their target values, geographical resolution and habitats to be assessed, has potentially a high impact on the result, and the assessment structure needs to be understood in order to make an informed assessment. Moreover, recommendations are provided for the best practice of using NEAT for marine status assessments.

  8. Ten Things Every Professor Should Know about Assessment

    Science.gov (United States)

    Wolf, Kenneth; Dunlap, Joanna; Stevens, Ellen

    2012-01-01

    This article describes ten key assessment practices for advancing student learning that all professors should be familiar with and strategically incorporate in their classrooms and programs. Each practice or concept is explained with examples and guidance for putting it into practice. The ten are: learning outcomes, performance assessments,…

  9. A 10 year follow-up study after Roux-Elmslie-Trillat treatment for cases of patellar instability.

    Science.gov (United States)

    Endres, Stefan; Wilke, Axel

    2011-02-18

    A retrospective study concerning patients presenting with patella instability, treated using a Roux-Elmslie-Trillat reconstruction operation and followed up for 10 years following surgery, is presented. Pre-operative and follow-up radiographic evaluation included the weight-bearing anteroposterior and merchant views. Evaluation was carried out using the Insall-Salvati index, sulcus and congruence angle. The Roux-Elmslie-Trillat reconstruction operation was performed on 18 patients. The clinical evaluation at follow-up was performed using the Knee-Society-Score (KSS) and Tegner-Score. Subjective results of the operation were classed as excellent or good in 16 of the 18 patients ten years after surgery; persistent instability of the patella was recorded in only one of the 18 patients. The majority of patients returned to the same level of sporting activity after surgery as they had participated in before injury. The Roux-Elmslie-Trillat procedure could be recommended in cases presenting with an increased q-angle, trochlea dysplasia or failed soft tissue surgery. In the present study the majority of patients report a return to previous sporting activity ten years after surgery.

  10. Complete ten-year follow-up after endovascular abdominal aortic aneurysm repair: Survival and causes of death

    International Nuclear Information System (INIS)

    Wibmer, Andreas; Nolz, Richard; Teufelsbauer, Harald; Kretschmer, Georg; Prusa, Alexander M.; Funovics, Martin; Lammer, Johannes; Schoder, Maria

    2012-01-01

    Purpose: To analyze the hazard and causes of death after endovascular aneurysm repair (EVAR) of abdominal aortic aneurysms during a complete ten year follow-up. Methods: This is a retrospective clinical study of 130 consecutive patients undergoing EVAR between 1995 and 1998. One-hundred twenty-one patients (93.1%) were treated with first-generation stentgrafts and nine patients (6.9%) received second-generation devices. All patients completed a follow-up of at least 10 years, unless death occurred before then. Time and causes of death were provided by the Austrian central register of deaths. Results: The median follow-up was 7.6 years, and the 130 patients had 968.5 person-years of follow-up. The ten-year mortality rate was 62.3%. Cardiovascular events were the most frequent causes of death, with a 3.9 incidence rate per 100 person-years. Cancer death and death due to other causes occurred in 2.1 and 1.8 cases per 100 person-years, respectively. Lethal late aneurysm rupture happened in 4.6% (n = 6), which corresponds to an annual incidence rate of 0.6 per 100 person-years. All of those patients had been treated with first-generation devices. Conclusions: Cardiovascular events were the most frequent cause of death after EVAR, followed by malignancy and other diseases. The risk of dying from secondary rupture was clearly lower than that of death due to other reasons during ten years after EVAR, even in patients with first-generation stentgrafts.

  11. Anti-stress effects of transcutaneous electrical nerve stimulation (TENS) on colonic motility in rats.

    Science.gov (United States)

    Yoshimoto, Sazu; Babygirija, Reji; Dobner, Anthony; Ludwig, Kirk; Takahashi, Toku

    2012-05-01

    Disorders of colonic motility may contribute to symptoms in patients with irritable bowel syndrome (IBS), and stress is widely believed to play a major role in developing IBS. Stress increases corticotropin releasing factor (CRF) of the hypothalamus, resulting in acceleration of colonic transit in rodents. In contrast, hypothalamic oxytocin (OXT) has an anti-stress effect via inhibiting CRF expression and hypothalamic-pituitary-adrenal axis activity. Although transcutaneous electrical nerve stimulation (TENS) and acupuncture have been shown to have anti-stress effects, the mechanism of the beneficial effects remains unknown. We tested the hypothesis that TENS upregulates hypothalamic OXT expression resulting in reduced CRF expression and restoration of colonic dysmotility in response to chronic stress. Male SD rats received different types of stressors for seven consecutive days (chronic heterotypic stress). TENS was applied to the bilateral hind limbs every other day before stress loading. Another group of rats did not receive TENS treatment. TENS significantly attenuated accelerated colonic transit induced by chronic heterotypic stress, which was antagonized by a central injection of an OXT antagonist. Immunohistochemical study showed that TENS increased OXT expression and decreased CRF expression at the paraventricular nucleus (PVN) following chronic heterotypic stress. It is suggested that TENS upregulates hypothalamic OXT expression which acts as an anti-stressor agent and mediates restored colonic dysmotility following chronic stress. TENS may be useful to treat gastrointestinal symptoms associated with stress.

  12. Long-term effects of a ten-year osteoporosis intervention program in a Swedish population—A cross-sectional study

    Directory of Open Access Journals (Sweden)

    Ann-Charlotte Grahn Kronhed

    2017-03-01

    Full Text Available The aim of the study was to explore long-term effects seven years after the completion of a ten-year community-based osteoporosis intervention program in Vadstena, Sweden. The association between calcaneal bone mineral density and several life style factors, and the impact of risk factors for sustaining a fracture after the age of 50 were also studied. Previous participants in the intervention group, and matched subjects were invited to calcaneal bone mass measurement by a portable device including the dual X-ray and laser (DXL technology by Calscan, and to complete a questionnaire in 2006. A total of 417 persons (63% of those invited in the intervention (I group, and 120 persons (47% of those invited in the control (C group participated. Mean age was 63 years (37–94 years. There was somewhat more knowledge of osteoporosis in the I-group (M = 18 than in the C-group (M = 17 (p −2.5. The long-term effects of a ten-year, community-based, osteoporosis intervention program on knowledge and behavior were modest seven years after its completion.

  13. Case report

    African Journals Online (AJOL)

    ebutamanya

    2015-10-09

    Oct 9, 2015 ... Aguas SC, Quarracino MC, Lence AN, Lanfranchi-Tizeira HE. Primary melanoma of the oral cavity: ten cases and review of. 177 cases from literature. Medicina oral, patologia oral y cirugia bucal. 2009;14(6):E265-71. PubMed | Google. Scholar. 6. Rapidis AD, Apostolidis C, Vilos G, Valsamis S. Primary.

  14. Case Study Research Methodology

    Directory of Open Access Journals (Sweden)

    Mark Widdowson

    2011-01-01

    Full Text Available Commenting on the lack of case studies published in modern psychotherapy publications, the author reviews the strengths of case study methodology and responds to common criticisms, before providing a summary of types of case studies including clinical, experimental and naturalistic. Suggestions are included for developing systematic case studies and brief descriptions are given of a range of research resources relating to outcome and process measures. Examples of a pragmatic case study design and a hermeneutic single-case efficacy design are given and the paper concludes with some ethical considerations and an exhortation to the TA community to engage more widely in case study research.

  15. Transcutaneous electrical nerve stimulation (TENS) for pain control after vaginal delivery and cesarean section.

    Science.gov (United States)

    Kayman-Kose, Seda; Arioz, Dagistan Tolga; Toktas, Hasan; Koken, Gulengul; Kanat-Pektas, Mine; Kose, Mesut; Yilmazer, Mehmet

    2014-10-01

    The present study aims to determine the efficiency and reliability of transcutaneous electrical nerve stimulation (TENS) in the management of pain related with uterine contractions after vaginal delivery and the pain related with both abdominal incision uterine contractions after cesarean section. A hundred healthy women who underwent cesarean section under general anesthesia were randomly assigned to the placebo group (Group 1) or the TENS group (Group 2), while 100 women who delivered by vaginal route without episiotomy were randomized into the placebo group (Group 3) or the TENS group (Group 4). The patients in Group 2 had statistically lower visual analog scale (VAS) and verbal numerical scale (VNS) scores than the patients in Group 1 (p TENS (p = 0.006). The need for analgesics at the eighth hour of vaginal delivery was statistically similar in the patients who were treated with TENS and the patients who received placebo (p = 0.830). TENS is an effective, reliable, practical and easily available modality of treatment for postpartum pain.

  16. TRANSCUTANEOUS ELECTRICAL NERVE-STIMULATION (TENS) IN RAYNAUDS-PHENOMENON

    NARCIS (Netherlands)

    MULDER, P; DOMPELING, EC; VANSLOCHTERENVANDERBOOR, JC; KUIPERS, WD; SMIT, AJ

    Transcutaneous nerve stimulation (TENS) has been described as resulting in vasodilatation. The effect of 2 Hz TENS of the right hand during forty-five minutes on skin temperature and plethysmography of the third digit of both hands and feet and on transcutaneous oxygen tension (TcpO2) of the right

  17. The use of transcutaneous electrical nerve stimulation (tens in the treatment of the spasticity - a review

    Directory of Open Access Journals (Sweden)

    Dahyan Wagner da Silva Silveira

    2008-01-01

    Full Text Available This study it has as objective to argue the job of TENS in the spasticity, observing the main parameters, form of application and the mechanism for which TENS it acts in the spasticity. One is about a bibliographical revision based in the literature specialized selected scientific articles through search in the data base of scielo and of bireme, from the sources Medline and Lilacs. The studies found on the job of TENS in the spasticity, had pointed mainly that this chain reduces the spasticity significantly, in lower degrees. The stimulation electrical parameters had disclosed that TENS it (about 100Hz of raised frequency provides one better effect in the reduction of the spasticity. The types of TENS more used had been the conventional and the soon-intense one, however some studies had not presented the used duration of pulse, limit the determination of one better modality of TENS. Few studies had explained the mechanism of performance of the current related one. The ones that had made it, had pointed the release of opioid endogenous (Dynorphins for the central nervous system as main mechanism of performance, however this contrasts with the neurophysiologic bases of the high-frequency stimulation, that demonstrated better resulted in the joined studies. Still it is necessary more studies on the job of this modality of stimulation electrical in the spasticity, since important parameters as duration of pulse, time of application, numbers of attendance and performance mechanism remains without scientific evidence.

  18. Tumors of the liver; a ten year study in Children Medical Center

    Directory of Open Access Journals (Sweden)

    Farahmand F

    2007-06-01

    Full Text Available Background: The aim of this study was to review the frequency, histopathology and outcome in children with tumors of the liver. Methods: Included in this retrospective/descriptive study were 30 children treated for liver tumors from 1375-1384 (ca. 1996-2005, at Children’s Hospital Medical Center, Tehran, Iran. We included the clinical, radiologic, and pathologic data of our patients, focusing on the frequency, etiology and outcome. Results: Patient ages ranged from three months to 12 years (median 3.8 years, with 18 males (60% and 12 females (40%. Of these, 17 patients had hepatoblastoma (55.66%, including 13 males and four females, with an age range of six months to five years. Four cases (13.33% had neuroblastoma. Hepatocellular carcinoma (HCC was found in three cases (10%, all of whom were carriers of hepatitis B. Two cases (6.66% were diagnosed with mesenchymal hamartoma, two cases (6.66% with hemangioendothelioma and two cases (6.66% with rhabdomyosarcoma and leiomyosarcoma of the biliary tract. Abdominal swelling and hepatomegaly were seen in all of patients. Jaundice was observed in two cases. Serum alpha-fetoprotein levels greater than 500 ng/ml were seen in 17 cases (56.66%. All patients were receiving specific treatment. The three-year survival rate was 65% for hepatoblastoma and 2% for HCC Conclusion: With the introduction of specific treatment, the survival rate for children with tumors of the liver has significantly increased. Further improvement can be achieved using diagnostic biopsy for hepatoblastoma, although it may result in complications, and preoperative chemotherapy followed by complete surgical excision (per International Society of Pediatric Oncology guidelines, yielding an outstanding survival rate of 80%.

  19. Project management case studies

    CERN Document Server

    Kerzner, Harold R

    2013-01-01

    A new edition of the most popular book of project management case studies, expanded to include more than 100 cases plus a ""super case"" on the Iridium Project Case studies are an important part of project management education and training. This Fourth Edition of Harold Kerzner''s Project Management Case Studies features a number of new cases covering value measurement in project management. Also included is the well-received ""super case,"" which covers all aspects of project management and may be used as a capstone for a course. This new edition:Contains 100-plus case studies drawn from re

  20. Ten years' experience in determining internal contamination among plutonium laboratory workers

    International Nuclear Information System (INIS)

    Deworm, J.; Fieuw, G.

    1976-01-01

    Glove boxes in plutonium laboratories are fitted with ''sniffers'' (air samplers), which evaluate atmospheric contamination. The results of the measurements over a ten-year period of operation are available, and cases of detection in this way of air contamination exceeding the maximum permissible concentrations are exceptional. During contamination aerodynamic particle diameters of 1 - 4 μm were measured. The concentration and characteristics of the aerosol have made it possible to ascertain the inhalable fraction and to estimate the pulmonary and systemic burden in workers. The workers exposed in the laboratories undergo a urine test each month. The results obtained show that there is little risk of internal contamination without the person concerned being aware of an abnormal situation. In the majority of cases it is possible to take proper precautions and to collect the data necessary for evaluating the body burden. Three cases of specific contamination are examined in detail: contamination by plutonium and americium from a non-identified source, detected by routine urine analysis; contamination by inhalation of plutonium; an injury to the left forefinger, accompanied by plutonium contamination. (author)

  1. Ten years of health workforce planning in the Netherlands: a tentative evaluation of GP planning as an example.

    NARCIS (Netherlands)

    Greuningen, M. van; Batenburg, R.S.; Velden, L.F.J. van der

    2012-01-01

    INTRODUCTION: In many countries, health-care labour markets are constantly being challenged by an alternation of shortage and oversupply. Avoiding these cyclic variations is a major challenge. In the Netherlands, a workforce planning model has been used in health care for ten years. Case description

  2. ABACC ten years applying safeguards

    International Nuclear Information System (INIS)

    Palacios, Elias

    2001-01-01

    The Argentinian-Brazilian Agency for Accounting and Control of nuclear special materials has been in operations for ten years. The rational behind the creation and the work performed by the Agency during the last decade is described. (author)

  3. Ten-year clinico-statistical study of oral squamous cell carcinoma

    International Nuclear Information System (INIS)

    Aoki, Shinjiro; Kawabe, Ryoichi; Chikumaru, Hiroshi; Saito, Tomokatsu; Hirota, Makoto; Miyake, Tetsumi; Omura, Susumu; Fujita, Kiyohide

    2003-01-01

    This clinico-statistical study includes 232 cases of oral squamous cell carcinoma that underwent radical treatment in the Department of Oral and Maxillofacial Surgery, Yokohama City University Hospital, during the decade from 1991 to 2000. Surgery was principally adopted as the first line for treatment in 199 cases, and radiotherapy in 33 cases. The 5-year overall survival rate was 73.4%. The results according to stage were as follows: stage I, 87.5%; Stage II, 77.9%; Stage III, 63.5%; and Stage IV A, 44.7%. The primary sites were classified as follows: upper gingiva, 85.2%; tongue, 73.7%; floor of mouth, 68.9%; lower gingiva, 66.3%; buccal mucosa, 63.9%; and hard palate, 50%. For tongue cancer, the 5-year overall survival rates by stage were: Stage I, 90.8%; Stage II, 82.1%; Stage III, 40.3%; and Stage IV A, 45.7%. Statistical significance was seen between cases of Stages I and II and those of Stages III and IV A stage. For lower gingival cancer, the 5-year overall survival rates by stage were: Stage I, 90.8%; Stage II, 82.1%; Stage III, 40.3%; and Stage IV A, 45.7%. Even in Stage I lower gingival cancers had unfavorable clinical outcomes. Preventive neck dissections were performed on 52 N 0 neck patients, but clinically negative nodes however showed metastasis in 14 patients (26.9%). (author)

  4. Research on pinch devices of tens of kA to MA

    Energy Technology Data Exchange (ETDEWEB)

    Soto, L.; Silva, P.; Moreno, J.; Silvester, G.; Zambra, M. [Comision Chilena de Energia Nuclear, Santiago (Chile); Pavez, C.; Saavedra, R. [Univ. de Concepcion (Chile); Bruzzone, H. [Pladema (Antiqua and Barbuda)]|[Univ. de Mar del Plata and CONICET (Argentina); Barbaglia, M. [Pladema (Antiqua and Barbuda); Mayer, R. [Pladema (Antiqua and Barbuda)]|[Inst. Balseiro, Bariloche, CNEA and CONICET (Argentina); Sidelnikov, Y.; Kies, W. [Heinrich-Heine-Univ., Duesseldorf (Germany)

    2004-07-01

    At present the Plasma Physics and Plasma Technology Group of the Comision Chilena de Energia Nuclear (CCHEN) has the experimental facilities in order to study dense transient discharges in a wide range of energy and current, namely: (I) energy from tens of joules to hundred of kilojoules, (II) current from tens of kiloamperes to some mega-amperes. Also several diagnostics have been implemented. An overview of the work being carried out on dense pinch discharges at the Comision Chilena de Energia Nuclear is presented. (orig.)

  5. Research on pinch devices of tens of kA to MA

    International Nuclear Information System (INIS)

    Soto, L.; Silva, P.; Moreno, J.; Silvester, G.; Zambra, M.; Pavez, C.; Saavedra, R.; Bruzzone, H.; Barbaglia, M.; Mayer, R.; Sidelnikov, Y.; Kies, W.

    2004-01-01

    At present the Plasma Physics and Plasma Technology Group of the Comision Chilena de Energia Nuclear (CCHEN) has the experimental facilities in order to study dense transient discharges in a wide range of energy and current, namely: (I) energy from tens of joules to hundred of kilojoules, (II) current from tens of kiloamperes to some mega-amperes. Also several diagnostics have been implemented. An overview of the work being carried out on dense pinch discharges at the Comision Chilena de Energia Nuclear is presented. (orig.)

  6. Using TENS for pain control: the state of the evidence

    Science.gov (United States)

    Vance, Carol GT; Dailey, Dana L; Rakel, Barbara A; Sluka, Kathleen A

    2014-01-01

    Summary Transcutaneous electrical nerve stimulation (TENS) is a nonpharmacological intervention that activates a complex neuronal network to reduce pain by activating descending inhibitory systems in the central nervous system to reduce hyperalgesia. The evidence for TENS efficacy is conflicting and requires not only description but also critique. Population-specific systemic reviews and meta-analyses are emerging, indicating both HF and LF TENS being shown to provide analgesia, specifically when applied at a strong, nonpainful intensity. The purpose of this article is to provide a critical review of the latest basic science and clinical evidence for TENS. Additional research is necessary to determine if TENS has effects specific to mechanical stimuli and/or beyond reduction of pain and will improve activity levels, function and quality of life. PMID:24953072

  7. The effect of low-frequency TENS in the treatment of neuropathic pain in patients with spinal cord injury.

    Science.gov (United States)

    Celik, E C; Erhan, B; Gunduz, B; Lakse, E

    2013-04-01

    Prospective, randomized and controlled study. The aim of the study was to investigate the effect of low-frequency transcutaneous electrical nerve stimulation (LF-TENS) in the treatment of neuropathic pain in patients with spinal cord injury (SCI). A total of 33 SCI patients with neuropathic pain were included in the study. History, duration, localization and characteristics of pain were recorded. Visual analog scale (VAS) was used to investigate the effect of LF-TENS four times during the day. Patients were randomly assigned to study and control groups. The study group was treated with 30 min of LF-TENS daily for 10 days while the placebo group with 30 min of sham TENS. The mean age of the patients was 36.55±10.36 years. Out of 33 patients, 7 were tetraplegic and 26 were paraplegic. Twenty-three patients had complete SCI while 10 patients had incomplete injuries. Two groups were similar with respect to age, gender, duration, level and severity of injury. In the LF-TENS treatment group, a statistically significant reduction of the VAS values was observed, however, such an effect was not evident in the control group. This study revealed that in treatment of neuropathic pain of SCI patients, LF-TENS may be effective. This article presents LF-TENS may effectively complement pharmacological treatment in patients with SCI and neuropathic pain.

  8. The application of the 'ten-day rule' in radiopharmaceutical investigations

    International Nuclear Information System (INIS)

    Ellis, R.E.; Nordin, B.E.C.; Tothill, P.; Veall, N.

    1977-01-01

    The working party first classified subjects who are investigated using radiopharmaceuticals into three groups, being (a) patients and other subjects who are asked to volunteer as controls for research studies, (b) patients on whom research investigations are being conducted which are relevant to their clinical condition but which are not strictly necessary for their management, and (c) patients on whom investigations are required for their proper management. The application of the 'ten-day rule' in relation to the use of radiopharmaceuticals is complicated by the fact that the total radiation dose is received over a time given by the effective life of the radiopharmaceutical in the organ, which may be a substantial part or even longer of the menstrual cycle. The activities of the radiopharmaceuticals normally administered are tabulted together with their effective half-lives and resulting gonad doses, and those radiopharmaceuticals requiring consideration of the implementation of the 'ten-day rule' for patients in groups (b) and (c) are identified. When the administration of therapeutic quantities of radiopharmaceuticals is being contemplated it is particularly important to take into account the applicability or otherwise of the 'ten-day rule'. It is recommended that the 'ten-day rule' should be strictly applied to all radiopharmaceutical administrations to women of child-bearing age who are volunteers for research purposes (group(a)). (U.K.)

  9. Ten Tips for Parents to Help Their Children Avoid Teen Pregnancy

    Science.gov (United States)

    ... we do » Resource library » Ten tips for parents Ten Tips for Parents to Help Their Children Avoid Teen Pregnancy Publication Created with Sketch. Ten Tips for Parents to Help Their Children Avoid ...

  10. [Case and studies].

    Science.gov (United States)

    Schubert, András

    2015-11-15

    Case studies and case reports form an important and ever growing part of scientific and scholarly literature. The paper deals with the share and citation rate of these publication types on different fields of research. In general, evidence seems to support the opinion that an excessive number of such publications may negatively influence the impact factor of the journal. In the literature of scientometrics, case studies (at least the presence of the term "case study" in the titles of the papers) have a moderate share, but their citation rate is practically equal to that of other publication types.

  11. [Comparison of the analgesic effect of interferential current (IFC) and TENS in patients with low back pain].

    Science.gov (United States)

    Grabiańska, Ewa; Leśniewicz, Joanna; Pieszyński, Ireneusz; Kostka, Joanna

    2015-01-01

    Electrotherapy, including theTENS and interferential current (IFC) is one of the most frequently used treatments in physical therapy in patients with low back pain. The aim of this study was to assess the influence of TENS and IFC on pain relief and to compare the analgesic efficacy of the two currents. Sixty patients aged 53.5 ± 12.5, with low back pain, were randomly divided into two groups: IFC (gr. I) and TENS (gr. II). Depending on the groups, patients were given series of ten 20-minute sessions using either IF orTENS currents. In all patients VAS and Laitinen modified scale were taken before and after treatment. After 2-weeks therapy there was improvement in the VAS and Laitinen scale (all components) in both groups, except for the part of the Laitinen scale on the reduction of activity in the group II (TENS). There was no statistically significant difference between the TENS and IF groups in reducing the intensity and other aspects of pain (frequency, pain medication and activity limitation) under the influence of therapy (p > 0.05). Interferential current and TENS therapy are effective for pain relief in patients with low back pain. The study showed equal analgesic efficacy of both treatments.

  12. Results of experimental radiobiological studies made within ten-kilometer zone of Chernobyl accident

    International Nuclear Information System (INIS)

    Pelevina, I.I.; Ryabov, I.N.; Ryabtsev, I.A.; Gulev, B.F.; Gotlib, V.Ya.; Afanas'ev, G.G.; Vasilenko, S.N.; Gumenyuk, M.L.; AN SSSR, Moscow; AN SSSR, Moscow; Institut Biofiziki, Moscow; Akademiya Meditsinskikh Nauk SSSR, Obninsk

    1991-01-01

    A study was made of the effect of high radioactive contamination on the animal organism (C57BL/6 mice) and Hela cell culture within the ten-kilometer zone of the Chernobyl A.P.S. accident. The total radiation dose, as calculated by γ-component, was 0.09 to 2 Gy. A long-term exposure of mice within the zone (cumulative dose of 1.18 to 2 Gy) caused a significant decrease in bone marrow stem potencies and changes in the brain vascular system; subsequent acute exposure of animals increased interferon titres in the serum to a much greater extent than a single acute exposure did. As to Hela cells, irradiation there of with doses of 0.09 to 0.4 Gy during 15-20 postirradiation generations caused a decrease in the proliferative activity, an emergence of cells with micronuclei and of giant cells

  13. Efficacy of the use of two simultaneously TENS devices for fibromyalgia pain.

    Science.gov (United States)

    Lauretti, Gabriela Rocha; Chubaci, Eliana Fazuoli; Mattos, Anita Leocadia

    2013-08-01

    Fibromyalgia is characterized by a range of symptoms that include muscle pain, fatigue and sleep disorders. Transcutaneous electrical nerve stimulation (TENS) is an established method for pain relief. The purpose of the study was to evaluate the effectiveness and safety of the use of two simultaneously new TENS devices for fibromyalgia pain. After Ethics approval and informed consent, 39 patients were prospectively divided into three groups to evaluate TENS device, applied simultaneously in each patient: (1) at the lower back (perpendicular to the vertebrae canal, at the level of the 5th lumbar vertebrae) and (2) centrally above and below the space between the C7 and T1 spinous processes. The devices were applied for 20 min at 12-h interval during 7 consecutive days. For the placebo group (PG), the devices did not transmitted electrical stimulus. The single-TENS group (STG) (n = 13) had one active and one placebo TENS. The DTG applied both active TENS devices at the low back and cervical areas. Diclofenac was used as rescue analgesic. The efficacy measures were pain relief, reduction in use of daily analgesic tablets, quality of sleep and fatigue. The evaluation within groups revealed that patients from DPG refereed no pain relief when compared to their previous VAS pain score (8 cm, p > 0.05), while patients from the STG refereed improvement of 2.5 cm in the pain VAS (previous 8.5 cm compared to 6 cm after treatment) (p pain (previous 8.5-4.3 cm) (p STG > PG (p TENS improved pain relief in fibromyalgia pain, pain and fatigue were further improved when two active devices were simultaneously applied at the low back and cervical area, with no side effects.

  14. Translating the Elements of Health Governance for Integrated Care from Theory to Practice: A Case Study Approach.

    Science.gov (United States)

    Nicholson, Caroline; Hepworth, Julie; Burridge, Letitia; Marley, John; Jackson, Claire

    2018-01-31

    Against a paucity of evidence, a model describing elements of health governance best suited to achieving integrated care internationally was developed. The aim of this study was to explore how health meso-level organisations used, or planned to use, the governance elements. A case study design was used to offer two contrasting contexts of health governance. Semi-structured interviews were conducted with participants who held senior governance roles. Data were thematically analysed to identify if the elements of health governance were being used, or intended to be in the future. While all participants agreed that the ten elements were essential to developing future integrated care, most were not used. Three major themes were identified: (1) organisational versus system focus, (2) leadership and culture, and, (3) community (dis)engagement. Several barriers and enablers to the use of the elements were identified and would require addressing in order to make evidence-based changes. Despite a clear international policy direction in support of integrated care this study identified a number of significant barriers to its implementation. The study reconfirmed that a focus on all ten elements of health governance is essential to achieve integrated care.

  15. A case-control study on risk factors of breast cancer in Han Chinese women.

    Science.gov (United States)

    Liu, Li-Yuan; Wang, Fei; Cui, Shu-De; Tian, Fu-Guo; Fan, Zhi-Min; Geng, Cui-Zhi; Cao, Xu-Chen; Yang, Zhen-Lin; Wang, Xiang; Liang, Hong; Wang, Shu; Jiang, Hong-Chuan; Duan, Xue-Ning; Wang, Hai-Bo; Li, Guo-Lou; Wang, Qi-Tang; Zhang, Jian-Guo; Jin, Feng; Tang, Jin-Hai; Li, Liang; Zhu, Shi-Guang; Zuo, Wen-Shu; Yu, Li-Xiang; Xiang, Yu-Juan; Zhou, Fei; Li, Liang; Zhang, Qiang; Fu, Qin-Ye; Ma, Zhong-Bing; Gao, De-Zong; Li, Yu-Yang; Liu, Lu; Ye, Chun-Miao; Wang, Yong-Jiu; Zhou, Wen-Zhong; Yu, Zhi-Gang

    2017-11-14

    This study aimed to investigate risk factors associated with breast cancer among Han Chinese women in northern and eastern China. A matched case-control study involving 1489 patients with breast cancer and 1489 controls was conducted across 21 hospitals in 11 provinces in China, from April 2012 to April 2013. We developed a structured questionnaire to record information from face-to-face interviews with participants. Student's t-tests, Pearson's chi-square tests, and univariate and multivariate conditional logistic regression analyses were used to identify variables with significant differences between the case and control groups. Ten variables were identified (P ratio, menopause, family history of breast cancer, present life satisfaction, sleep satisfaction, milk products, behavior prevention scores, and awareness of breast cancer. We identified a comprehensive range of factors related to breast cancer, among which several manageable factors may contribute to breast cancer prevention. Further prospective studies concerning psychological interventions, sleep regulation, health guidance, and physical exercise are required. A screening model for high-risk populations should be put on the agenda.

  16. Building theories from case study research: the progressive case study

    NARCIS (Netherlands)

    Steenhuis, H.J.; de Bruijn, E.J.

    2006-01-01

    Meredith (1998) argues for more case and field research studies in the field of operations management. Based on a literature review, we discuss several existing approaches to case studies and their characteristics. These approaches include; the Grounded Theory approach which proposes no prior

  17. Transcutaneous electrical nerve stimulation (TENS) accelerates cutaneous wound healing and inhibits pro-inflammatory cytokines.

    Science.gov (United States)

    Gürgen, Seren Gülşen; Sayın, Oya; Cetin, Ferihan; Tuç Yücel, Ayşe

    2014-06-01

    The purpose of this study was to evaluate transcutaneous electrical nerve stimulation (TENS) and other common treatment methods used in the process of wound healing in terms of the expression levels of pro-inflammatory cytokines. In the study, 24 female and 24 male adult Wistar-Albino rats were divided into five groups: (1) the non-wounded group having no incision wounds, (2) the control group having incision wounds, (3) the TENS (2 Hz, 15 min) group, (4) the physiological saline (PS) group and (5) the povidone iodine (PI) group. In the skin sections, interleukin-1 beta (IL-1β), interleukin-6 (IL-6), and tumor necrosis factor-α (TNF-α) were assessed with enzyme-linked immunosorbent assay and immunohistochemical methods. In the non-wounded group, the expression of IL-1β, IL-6, and TNF-α signaling molecules was weaker in the whole tissue; however, in the control group, significant inflammatory response occurred, and strong cytokine expression was observed in the dermis, granulation tissue, hair follicles, and sebaceous glands (P TENS group, the decrease in TNF-α, IL-1β, and IL-6 immunoreaction in the skin was significant compared to the other forms of treatment (P TENS group suggest that TENS shortened the healing process by inhibating the inflammation phase.

  18. Promoting student case creation to enhance instruction of clinical reasoning skills: a pilot feasibility study.

    Science.gov (United States)

    Chandrasekar, Hamsika; Gesundheit, Neil; Nevins, Andrew B; Pompei, Peter; Bruce, Janine; Merrell, Sylvia Bereknyei

    2018-01-01

    It is a common educational practice for medical students to engage in case-based learning (CBL) exercises by working through clinical cases that have been developed by faculty. While such faculty-developed exercises have educational strengths, there are at least two major drawbacks to learning by this method: the number and diversity of cases is often limited; and students decrease their engagement with CBL cases as they grow accustomed to the teaching method. We sought to explore whether student case creation can address both of these limitations. We also compared student case creation to traditional clinical reasoning sessions in regard to tutorial group effectiveness, perceived gains in clinical reasoning, and quality of student-faculty interaction. Ten first-year medical students participated in a feasibility study wherein they worked in small groups to develop their own patient case around a preassigned diagnosis. Faculty provided feedback on case quality afterwards. Students completed pre- and post-self-assessment surveys. Students and faculty also participated in separate focus groups to compare their case creation experience to traditional CBL sessions. Students reported high levels of team engagement and peer learning, as well as increased ownership over case content and understanding of clinical reasoning nuances. However, students also reported decreases in student-faculty interaction and the use of visual aids ( P study suggest that student-generated cases can be a valuable adjunct to traditional clinical reasoning instruction by increasing content ownership, encouraging student-directed learning, and providing opportunities to explore clinical nuances. However, these gains may reduce student-faculty interaction. Future studies may be able to identify an improved model of faculty participation, the ideal timing for incorporation of this method in a medical curriculum, and a more rigorous assessment of the impact of student case creation on the

  19. The use of transcutaneous electrical nerve stimulation (TENS) for pain relief in labour: a review of the evidence.

    Science.gov (United States)

    Bedwell, Carol; Dowswell, Therese; Neilson, James P; Lavender, Tina

    2011-10-01

    to assess the effects of transcutaneous electrical nerve stimulation (TENS) for pain relief in labour. studies were identified from a search of the Cochrane Pregnancy and Childbirth Group's Trials Register (November 2008). randomised controlled trials comparing women receiving TENS for pain relief in labour vs routine care or placebo devices. All types of TENS machines were included. two review authors assessed all trials identified by the search strategy, carried out data extraction and assessed risk of bias. 14 studies including 1256 women were included: 11 examined TENS applied to the back, two to acupuncture points and one to the cranium. Overall, there was little difference in satisfaction with pain relief or in pain ratings between TENS and control groups, although women receiving TENS to acupuncture points were less likely to report severe pain (risk ratio 0.41, 95% confidence interval 0.32-0.55). The majority of women using TENS would use it again in a future labour. There was no evidence that TENS had any impact on interventions and outcomes in labour. There was little information on outcomes for mothers and infants. No adverse events were reported. there is only limited evidence that TENS reduces pain in labour and it does not seem to have any impact on other outcomes for mothers or infants. The use of TENS at home in early labour has not been evaluated. Although the guidelines of the National Institute for Health and Clinical Excellence recommend that TENS should not be offered to women in labour, women appear to be choosing it and midwives are supporting them in their choice. Given the absence of adverse effects and the limited evidence base, it seems unreasonable to deny women that choice. More robust studies of effectiveness are needed. Copyright © 2009 Elsevier Ltd. All rights reserved.

  20. ANALGETSKI UCINAK TRANSAKUTNE ELEKTRICNE NERVNE STIMULACIJE (TENS)

    OpenAIRE

    ĆURKOVIĆ, B.

    1984-01-01

    Transkutana električna nervna stimulacija. (TENS) danas je široko prihvaćen terapijski postupak za suzbijanje boli. Način njezina djelovanja nije još jasno definiran, premda se većina autora priklanja centralnom mehranizmu smanjenja boli. Rezultati, u literaturi, variraju od nesignifikantno boljeg učinka od placeba do 95°/o dobrog analgetskog djelovanja. U Zavodu za reumatske bolesti i rehabilitaciju Kliničkog bolničkog centra, Zagreb, evaluiran je učinak TENS-a u bolesnika s križ...

  1. A Study in Critical Listening Using Eight to Ten Year Olds in an Analysis of Commercial Propaganda Emanating from Television.

    Science.gov (United States)

    Cook, Jimmie Ellis

    Selected eight to ten year old Maryland children were used in this study measuring the effect of lessons in becoming aware of propaganda employed by commercial advertisers in television programs. Sixteen 45-minute lessons directed to the propaganda techniques of Band Wagon, Card Stacking, Glittering Generalities, Name Calling, Plain Folks,…

  2. What is case management in palliative care? An expert panel study

    Directory of Open Access Journals (Sweden)

    van der Plas Annicka G M

    2012-06-01

    Full Text Available Abstract Background Case management is a heterogeneous concept of care that consists of assessment, planning, implementing, coordinating, monitoring, and evaluating the options and services required to meet the client's health and service needs. This paper describes the result of an expert panel procedure to gain insight into the aims and characteristics of case management in palliative care in the Netherlands. Methods A modified version of the RAND®/University of California at Los Angeles (UCLA appropriateness method was used to formulate and rate a list of aims and characteristics of case management in palliative care. A total of 76 health care professionals, researchers and policy makers were invited to join the expert panel, of which 61% participated in at least one round. Results Nine out of ten aims of case management were met with agreement. The most important areas of disagreement with regard to characteristics of case management were hands-on nursing care by the case manager, target group of case management, performance of other tasks besides case management and accessibility of the case manager. Conclusions Although aims are agreed upon, case management in palliative care shows a high level of variability in implementation choices. Case management should aim at maintaining continuity of care to ensure that patients and those close to them experience care as personalised, coherent and consistent.

  3. Top ten most accessed AMOR articles in 2015/2016

    Directory of Open Access Journals (Sweden)

    Editorial Office

    2016-12-01

    Full Text Available In 2015/2016, Advances in Modern Oncology Research published a total of 67 articles over eight issues in two separate volumes. These published articles, consisting of editorials, reviews, case reports, and original research, have collectively accumulated 26,320 views as of December 2016. A total of 54 authors and 160 peer-reviewers from across the globe contributed to the journal in its first full year of publication. The journal’s top ten most accessed articles are:1. Indoles as anticancer agents (Vol. 1 Issue 1 2. Pharmacometrics and systems pharmacology of immune checkpoint inhibitor nivolumab in cancer translational medicine (Vol. 2 Issue 1 3. Hepatocellular carcinoma (HCC; aetiological considerations (Vol. 1 Issue 1 4. Oligoadenylate synthetase 1 (OAS1 expression in human breast and prostate cancer cases, and its regulation by sex steroid hormones (Vol. 2 Issue 2 5. Antiproliferative effects of cembranoid derivatives obtained from Red Sea soft coral Sarcophyton glaucum on human colorectal cancer cell lines (Vol. 1 Issue 1 6. Paraneoplastic pemphigus: A trait d’union between dermatology and oncology (Vol. 1 Issue 2 7. Cancer cell metastasis; perspectives from the focal adhesion (Vol. 1 Issue 1 8. Threshold-based parametric analysis of diffusion-weighted magnetic resonance imaging at 3.0 Tesla to identify men with prostate cancer (Vol. 1 Issue 2 9. Economic burden of patients with inoperable advanced breast cancer receiving early or late capecitabine or trastuzumab as second-line treatment: A population-based study (Vol. 1 Issue 2 10. Non-coding RNAs: New therapeutic targets and opportunities for hepatocellular carcinoma (Vol. 2 Issue 1

  4. An investigation into the effects of frequency-modulated transcutaneous electrical nerve stimulation (TENS) on experimentally-induced pressure pain in healthy human participants.

    Science.gov (United States)

    Chen, Chih-Chung; Johnson, Mark I

    2009-10-01

    Frequency-modulated transcutaneous electrical nerve stimulation (TENS) delivers currents that fluctuate between preset boundaries over a fixed period of time. This study compared the effects of constant-frequency TENS and frequency-modulated TENS on blunt pressure pain in healthy human volunteers. Thirty-six participants received constant-frequency TENS (80 pps), frequency-modulated TENS (20 to 100 pps), and placebo (no current) TENS at a strong nonpainful intensity in a randomized cross-over manner. Pain threshold was taken from the forearm using pressure algometry. There were no statistical differences between constant-frequency TENS and frequency-modulated TENS after 20 minutes (OR = 1.54; CI, 0.29, 8.23, P = 1.0). Both constant-frequency TENS and frequency-modulated TENS were superior to placebo TENS (OR = 59.5, P TENS does not influence hypoalgesia to any greater extent than constant-frequency TENS when currents generate a strong nonpainful paraesthesia at the site of pain. The finding that frequency-modulated TENS and constant-frequency TENS were superior to placebo TENS provides further evidence that a strong yet nonpainful TENS intensity is a prerequisite for hypoalgesia. This study provides evidence that TENS, delivered at a strong nonpainful intensity, increases pain threshold to pressure algometry in healthy participants over and above that seen with placebo (no current) TENS. Frequency-modulated TENS does not increase hypoalgesia to any appreciable extent to that seen with constant-frequency TENS.

  5. Six to Ten Digits Multiplication Fun Learning Using Puppet Prototype

    Science.gov (United States)

    Islamiah Rosli, D.'oria; Ali, Azita; Peng, Lim Soo; Sujardi, Imam; Usodo, Budi; Adie Perdana, Fengky

    2017-01-01

    Logic and technical subjects require students to understand basic knowledge in mathematic. For instance, addition, minus, division and multiplication operations need to be mastered by students due to mathematic complexity as the learning mathematic grows higher. Weak foundation in mathematic also contribute to high failure rate in mathematic subjects in schools. In fact, students in primary schools are struggling to learn mathematic because they need to memorize formulas, multiplication or division operations. To date, this study will develop a puppet prototyping for learning mathematic for six to ten digits multiplication. Ten participants involved in the process of developing the prototype in this study. Students involved in the study were those from the intermediate class students whilst teachers were selected based on their vast knowledge and experiences and have more than five years of experience in teaching mathematic. Close participatory analysis will be used in the prototyping process as to fulfil the requirements of the students and teachers whom will use the puppet in learning six to ten digit multiplication in mathematic. Findings showed that, the students had a great time and fun learning experience in learning multiplication and they able to understand the concept of multiplication using puppet. Colour and materials of the puppet also help to attract student attention during learning. Additionally, students able to visualized and able to calculate accurate multiplication value and the puppet help them to recall in multiplying and adding the digits accordingly.

  6. Formal Food-related Networks in Ireland: A Case Study Analysis

    Directory of Open Access Journals (Sweden)

    Maeve Henchion

    2012-03-01

    Full Text Available  Strategic networking is of crucial importance for innovation in small and medium sized enterprises (SMEs as it enables these companies access external resources and overcome internal constraints. However, SMEs often lack the skills and competencies to engage in and benefit from networks. Consequently SMEs often fail in establishing strategic and efficient networks. To date, there is limited guidance available on the optimal design of such networks. Furthermore, limited guidance is available on the number of networks, and level of engagement therein, that companies should be involved with. Using case studies across a range of formal networks within the food sector in Ireland, insights into the success factors and barriers to network learning are presented, which provide a foundation for such guidelines. Three case studies were selected for analysis in Ireland. Up to ten in-depth interviews were scheduled with the network managers and key informants from the triple helix (i.e. policy, research and industry sectors within each formal network. Initially, interviewees were identified as a result of a review of secondary sources and personal knowledge of the authors. The snowball sampling technique was then employed to identify additional interviewees within each network. The findings from this study revealed that some formal networks had a strong institutional influence, including significant financial inputs, whilst others had bottom-up origins. Many networks had strong levels of interaction prior to formalisation, which provided solid trust-based foundations. Innovation and/or learning were not the expressed objectives of all networks at the outset. However, interviewees across all three networks felt that positive impacts had been achieved in these areas. Whilst being involved in a broad network can provide access to a wider range of ideas, these case studies suggest that being involved in a smaller, dense network, with high levels of IP

  7. Ten-year-olds' reflections on their life in preschool

    DEFF Research Database (Denmark)

    Broström, Stig

    2016-01-01

    What do children think of their time in preschool? In the present study, twelve ten-year-old children collected data from their classmates. The children tend to remember their friends, and reflect on what games they played and with whom. Only about one in three respondents even mentioned the day...

  8. Changes in users' Web search performance after ten years ...

    African Journals Online (AJOL)

    The changes in users' Web search performance using search engines over ten years was investigated in this study. Matched data obtained from samples in 2000 and 2010 were used for the comparative analysis. The patterns of Web search engine use suggested a dominance in using a particular search engine. Statistical ...

  9. TENS and heat therapy for pain relief and quality of life improvement in individuals with primary dysmenorrhea: A systematic review.

    Science.gov (United States)

    Igwea, Sylvester Emeka; Tabansi-Ochuogu, Chidinma Samantha; Abaraogu, Ukachukwu Okoroafor

    2016-08-01

    The present systematic review aimed to synthesize evidence for the effectiveness of TENS and heat therapy interventions from randomized trials. Six relevant databases were searched for studies on TENS and heat therapy for primary dysmenorrhea. Menstrual pain intensity and quality of life were the primary and secondary outcomes respectively. The search yielded 46 citations from which six studies on TENS and three studies on heat therapy were systematically reviewed. On the PEDRO quality scale, the trials methodological quality was 4.8 out of 10 for TENS and 6.3 out of 10 for heat therapy. TENS and heat therapy both showed evidence of pain reduction, but no study included quality of life as an outcome. Meta-analysis was not possible due to substantial heterogeneity in included studies. TENS and heat therapy show potential as adjunct remedies in the management of primary dysmenorrhea, but rigorous high quality trials are still needed to made conclusive recommendation. Copyright © 2016 Elsevier Ltd. All rights reserved.

  10. Targeted/exome sequencing identified mutations in ten Chinese patients diagnosed with Noonan syndrome and related disorders

    Directory of Open Access Journals (Sweden)

    Shanshan Xu

    2017-10-01

    Full Text Available Abstract Background Noonan syndrome (NS and Noonan syndrome with multiple lentigines (NSML are autosomal dominant developmental disorders. NS and NSML are caused by abnormalities in genes that encode proteins related to the RAS-MAPK pathway, including PTPN11, RAF1, BRAF, and MAP2K. In this study, we diagnosed ten NS or NSML patients via targeted sequencing or whole exome sequencing (TS/WES. Methods TS/WES was performed to identify mutations in ten Chinese patients who exhibited the following manifestations: potential facial dysmorphisms, short stature, congenital heart defects, and developmental delay. Sanger sequencing was used to confirm the suspected pathological variants in the patients and their family members. Results TS/WES revealed three mutations in the PTPN11 gene, three mutations in RAF1 gene, and four mutations in BRAF gene in the NS and NSML patients who were previously diagnosed based on the abovementioned clinical features. All the identified mutations were determined to be de novo mutations. However, two patients who carried the same mutation in the RAF1 gene presented different clinical features. One patient with multiple lentigines was diagnosed with NSML, while the other patient without lentigines was diagnosed with NS. In addition, a patient who carried a hotspot mutation in the BRAF gene was diagnosed with NS instead of cardiofaciocutaneous syndrome (CFCS. Conclusions TS/WES has emerged as a useful tool for definitive diagnosis and accurate genetic counseling of atypical cases. In this study, we analyzed ten Chinese patients diagnosed with NS and related disorders and identified their correspondingPTPN11, RAF1, and BRAF mutations. Among the target genes, BRAF showed the same degree of correlation with NS incidence as that of PTPN11 or RAF1.

  11. Individual Correlates of Podoconiosis in Areas of Varying Endemicity: A Case-Control Study

    Science.gov (United States)

    Molla, Yordanos B.; Le Blond, Jennifer S.; Wardrop, Nicola; Baxter, Peter; Atkinson, Peter M.; Newport, Melanie J.; Davey, Gail

    2013-01-01

    Background Podoconiosis is a non-filarial form of elephantiasis resulting in lymphedema of the lower legs. Previous studies have suggested that podoconiosis arises from the interplay of individual and environmental factors. Here, our aim was to understand the individual-level correlates of podoconiosis by comparing 460 podoconiosis-affected individuals and 707 unaffected controls. Methods/principal findings This was a case-control study carried out in six kebeles (the lowest governmental administrative unit) in northern Ethiopia. Each kebele was classified into one of three endemicity levels: ‘low’ (prevalence 5%). A total of 142 (30.7%) households had two or more cases of podoconiosis. Compared to controls, the majority of the cases, especially women, were less educated (OR = 1.7, 95% CI = 1.3 to 2.2), were unmarried (OR = 3.4, 95% CI = 2.6–4.6) and had lower income (t = −4.4, p<0.0001). On average, cases started wearing shoes ten years later than controls. Among cases, age of first wearing shoes was positively correlated with age of onset of podoconiosis (r = 0.6, t = 12.5, p<0.0001). Among all study participants average duration of shoe wearing was less than 30 years. Between both cases and controls, people in ‘high’ and ‘medium’ endemicity kebeles were less likely than people in ‘low’ endemicity areas to ‘ever’ have owned shoes (OR = 0.5, 95% CI = 0.4–0.7). Conclusions Late use of shoes, usually after the onset of podoconiosis, and inequalities in education, income and marriage were found among cases, particularly among females. There were clustering of cases within households, thus interventions against podoconiosis will benefit from household-targeted case tracing. Most importantly, we identified a secular increase in shoe-wearing over recent years, which may give opportunities to promote shoe-wearing without increasing stigma among those at high risk of podoconiosis. PMID:24340109

  12. Individual correlates of podoconiosis in areas of varying endemicity: a case-control study.

    Directory of Open Access Journals (Sweden)

    Yordanos B Molla

    Full Text Available Podoconiosis is a non-filarial form of elephantiasis resulting in lymphedema of the lower legs. Previous studies have suggested that podoconiosis arises from the interplay of individual and environmental factors. Here, our aim was to understand the individual-level correlates of podoconiosis by comparing 460 podoconiosis-affected individuals and 707 unaffected controls.This was a case-control study carried out in six kebeles (the lowest governmental administrative unit in northern Ethiopia. Each kebele was classified into one of three endemicity levels: 'low' (prevalence 5%. A total of 142 (30.7% households had two or more cases of podoconiosis. Compared to controls, the majority of the cases, especially women, were less educated (OR = 1.7, 95% CI = 1.3 to 2.2, were unmarried (OR = 3.4, 95% CI = 2.6-4.6 and had lower income (t = -4.4, p<0.0001. On average, cases started wearing shoes ten years later than controls. Among cases, age of first wearing shoes was positively correlated with age of onset of podoconiosis (r = 0.6, t = 12.5, p<0.0001. Among all study participants average duration of shoe wearing was less than 30 years. Between both cases and controls, people in 'high' and 'medium' endemicity kebeles were less likely than people in 'low' endemicity areas to 'ever' have owned shoes (OR = 0.5, 95% CI = 0.4-0.7.Late use of shoes, usually after the onset of podoconiosis, and inequalities in education, income and marriage were found among cases, particularly among females. There were clustering of cases within households, thus interventions against podoconiosis will benefit from household-targeted case tracing. Most importantly, we identified a secular increase in shoe-wearing over recent years, which may give opportunities to promote shoe-wearing without increasing stigma among those at high risk of podoconiosis.

  13. How the Big Ten West Was Won: Football Recruiting

    Directory of Open Access Journals (Sweden)

    Diehl Kevin A.

    2017-06-01

    Full Text Available The paper analyses the 2017 Big Ten West Division football cycle models recruiting. The top ten recruit scores [(Rivals.com * 100 + [100 (outside surrounding; 75 (surrounding] + extra credit walk-ons (100; 75] allow proper ranking: Iowa, Nebraska, Wisconsin, Northwestern, Illinois, Minnesota, and Purdue.

  14. 2012 Ten-year scheme of network development

    International Nuclear Information System (INIS)

    2012-01-01

    RTE, an independent subsidiary of EDF, is the French electricity transmission system operator. It is a public service company responsible for operating, maintaining and developing the high and extra high voltage network. It guarantees the reliability and proper operation of the power network. RTE transports electricity between electricity suppliers (French and European) and consumers, whether they are electricity distributors or industrial consumers directly connected to the transmission system. The mission of RTE is to balance the electricity supply and demand in real time. With the support of the government authorities, RTE prepares a ten-year scheme of network development in France; This document presents the main electricity transport infrastructures to foresee within the ten coming years and lists the network development investments which must be realised and implemented within 3 years. The document is updated each year and comes to complement at the national level the European ten year network development plan (TYNDP) and the European regional plans as provided for in the 2009/72/CE European directive

  15. Ten-year scheme of network development - 2011

    International Nuclear Information System (INIS)

    2011-01-01

    RTE, an independent subsidiary of EDF, is the French electricity transmission system operator. It is a public service company responsible for operating, maintaining and developing the high and extra high voltage network. It guarantees the reliability and proper operation of the power network. RTE transports electricity between electricity suppliers (French and European) and consumers, whether they are electricity distributors or industrial consumers directly connected to the transmission system. The mission of RTE is to balance the electricity supply and demand in real time. With the support of the government authorities, RTE prepares a ten-year scheme of network development in France; This document presents the main electricity transport infrastructures to foresee within the ten coming years and lists the network development investments which must be realised and implemented within 3 years. The document is updated each year and comes to complement at the national level the European ten year network development plan (TYNDP) and the European regional plans as provided for in the 2009/72/CE European directive

  16. A 10 year follow-up study after Roux-Elmslie-Trillat treatment for cases of patellar instability

    Directory of Open Access Journals (Sweden)

    Wilke Axel

    2011-02-01

    Full Text Available Abstract Background A retrospective study concerning patients presenting with patella instability, treated using a Roux-Elmslie-Trillat reconstruction operation and followed up for 10 years following surgery, is presented. Methods Pre-operative and follow-up radiographic evaluation included the weight-bearing anteroposterior and merchant views. Evaluation was carried out using the Insall-Salvati index, sulcus and congruence angle. The Roux-Elmslie-Trillat reconstruction operation was performed on 18 patients. The clinical evaluation at follow-up was performed using the Knee-Society-Score (KSS and Tegner-Score. Results Subjective results of the operation were classed as excellent or good in 16 of the 18 patients ten years after surgery; persistent instability of the patella was recorded in only one of the 18 patients. The majority of patients returned to the same level of sporting activity after surgery as they had participated in before injury. Conclusions The Roux-Elmslie-Trillat procedure could be recommended in cases presenting with an increased q-angle, trochlea dysplasia or failed soft tissue surgery. In the present study the majority of patients report a return to previous sporting activity ten years after surgery.

  17. Natural course of hematogenous pyogenic osteomyelitis (a retrospective study of 110 cases.

    Directory of Open Access Journals (Sweden)

    Kharbanda Y

    1991-04-01

    Full Text Available Hundred and ten consecutive cases in acute and various stages of chronicity were studied. Incidence regarding age, sex, bone affected and complications was established. The optimum way to manage osteomyelitis in different stages was sought. It was found that in acute stage early decompression of bone leads to resolution of disease. Hip involvement leads to necrosis of capital epiphysis and should be treated on an emergency basis. In the sub-acute stage it is necessary to protect the weakened bone. In chronic stage, we suggest sequestrectomy only after adequate involucrum has formed properly. Antibiotics in acute stage should be instituted as early as possible and should be continued for three weeks after the fever subsides. Antibiotics in sub-acute and chronic stage are given only in cases of reactivation of infection and around the time of surgery. Surgery, when required should be performed without too much soft tissue damage especially the covering periosteum. But repeated surgery should be avoided as they lead to cicatrization of muscles and further sequestration of bone.

  18. Social relationships and depression: ten-year follow-up from a nationally representative study.

    Science.gov (United States)

    Teo, Alan R; Choi, Hwajung; Valenstein, Marcia

    2013-01-01

    Social network characteristics have long been associated with mental health, but their longitudinal impact on depression is less known. We determined whether quality of social relationships and social isolation predicts the development of depression. The sample consisted of a cohort of 4,642 American adults age 25-75 who completed surveys at baseline in 1995-1996 and at ten-year follow-up. Quality of relationships was assessed with non-overlapping scales of social support and social strain and a summary measure of relationship quality. Social isolation was measured by presence of a partner and reported frequency of social contact. The primary outcome was past year major depressive episode at ten-year follow-up. Multivariable logistic regression was conducted, adjusting for the presence of potential confounders. Risk of depression was significantly greater among those with baseline social strain (OR, 1.99; 95% CI, 1.47-2.70), lack of social support (OR, 1.79; 95% CI, 1.37-2.35), and poor overall relationship quality (OR 2.60; 95% CI, 1.84-3.69). Those with the lowest overall quality of social relationships had more than double the risk of depression (14.0%; 95% CI, 12.0-16.0; psocial relationships is a major risk factor for major depression. Depression interventions should consider targeting individuals with low quality of social relationships.

  19. Top-Ten IT Issues: 2009

    Science.gov (United States)

    Agee, Anne Scrivener; Yang, Catherine

    2009-01-01

    This article presents the top-ten IT-related issues in terms of strategic importance to the institution, as revealed by the tenth annual EDUCAUSE Current Issues Survey. These IT-related issues include: (1) Funding IT; (2) Administrative/ERP Information Systems; (3) Security; (4) Infrastructure/Cyberinfrastructure; (5) Teaching and Learning with…

  20. Effects of transcutaneous electrical nerve stimulation (TENS) on proinflammatory cytokines: protocol for systematic review.

    Science.gov (United States)

    Almeida, Tábata Cristina do Carmo; Figueiredo, Francisco Winter Dos Santos; Barbosa Filho, Valter Cordeiro; de Abreu, Luiz Carlos; Fonseca, Fernando Luiz Affonso; Adami, Fernando

    2017-07-11

    Pain reduction can be achieved by lowering proinflammatory cytokine levels in the blood. Transcutaneous electrical nerve stimulation (TENS) is a non-invasive physiotherapeutic resource for pain management, but evidence on the effectiveness of this device at reducing proinflammatory cytokines in the blood is unclear. This study systematically reviews the literature on the effect of TENS on proinflammatory cytokines. A systematic review protocol was developed based on searches of articles in six electronic databases and references of retrieved articles, contact with authors, and repositories of clinical trials. Eligibility criteria: publication in peer-reviewed journals, randomized clinical trials, use of TENS in the experimental group, and pre- and post-measurements of proinflammatory cytokines in the blood. Selection of the studies and extraction of the data will be carried out by two reviewers independently. Characteristics of the study, participants, interventions and outcomes were extracted and described. Assessments were performed on the risk of bias, level of evidence and the size of the intervention effect in the studies, according to GRADE guidelines and the Cochrane Handbook for Systematic Reviews. Clinical and statistical assessments compared the effects of the interventions (meta-analysis), taking into consideration any influencing characteristics of the studies (e.g., methods and application sites). We anticipate that this review will strengthen evidence-based knowledge of the effect of TENS on proinflammatory cytokines and, as a result, direct new studies to benefit patients with specific pathologies. PROSPERO, CRD42017060379 .

  1. Association of Parkinsonism or Parkinson Disease with Polypharmacy in the Year Preceding Diagnosis: A Nested Case-Control Study in South Korea.

    Science.gov (United States)

    Park, Hae-Young; Park, Ji-Won; Sohn, Hyun Soon; Kwon, Jin-Won

    2017-11-01

    Published studies on the association between polypharmacy and parkinsonism or Parkinson disease are very limited. The objective of this study was to investigate whether polypharmacy is associated with parkinsonism or Parkinson disease in elderly patients. From a South Korean national health insurance sample cohort database for 2002-2013, we matched parkinsonism cases (defined by diagnosis codes for parkinsonism/Parkinson disease) and Parkinson disease cases (patients who had records for both Parkinson disease diagnosis and anti-Parkinson disease drug prescriptions) with controls. Logistic regression analysis evaluated the associations of parkinsonism/Parkinson disease with polypharmacy (i.e., five or more prescribed daily drugs) during the year preceding parkinsonism/Parkinson disease diagnosis, medications potentially associated with parkinsonism, and comorbidity status (using the Charlson Comorbidity Index score and hospitalization records). The study population included 6209 cases and 24,836 controls for parkinsonism and 1331 cases and 5324 controls for Parkinson disease. In univariate logistic regression, odds ratios for parkinsonism/Parkinson disease increased significantly with increased polypharmacy, medications potentially associated with parkinsonism, Charlson Comorbidity Index score, or prior hospitalizations. In multiple logistic regression, odds ratios for parkinsonism/Parkinson disease (adjusted for medications potentially associated with parkinsonism and comorbidities) also increased with increased polypharmacy. Odds ratios (95% confidence interval) for Parkinson disease were higher than those for parkinsonism with stronger statistical significance: 1.41 (1.28-1.55) and 2.17 (1.84-2.57) for parkinsonism and 2.87 (2.30-3.58) and 4.75 (3.39-6.66) for Parkinson disease for between five and ten prescribed daily drugs and ten or more drugs, respectively. Polypharmacy in the year preceding diagnosis may be associated with an increased risk for parkinsonism

  2. Creative accounting in the British Industrial Revolution: Cotton manufacturers and the ‘Ten Hours’ Movement.

    OpenAIRE

    Toms, Steven; Shepherd, Alice

    2013-01-01

    The paper examines an early case of creative accounting, and how, during British industrialization, accounting was enlisted by the manufacturers’ interest to resist demands, led by the ‘Ten hours’ movement, for limiting the working day. In contrast to much of the prior literature, which argues that entrepreneurs made poor use of accounting techniques in the British industrial revolution, the paper shows that there was considerable sophistication in their application to specific purposes, incl...

  3. Fabrication of ten-fold photonic quasicrystalline structures

    Directory of Open Access Journals (Sweden)

    XiaoHong Sun

    2015-05-01

    Full Text Available Compared to periodic crystals, quasicrystals have higher point group symmetry and are more favorable in achieving complete band-gaps. In this report, a top-cut prism interferometer is designed to fabricate ten-fold photonic quasicrystalline structures. By optimizing the exposing conditions and material characteristics, appropriate quasicrystals have been obtained in the SU8 photoresist films. Atomic Force Microscopy and laser diffraction are used to characterize the fabricated structures. The measurement results show the consistence between the theoretical design and experiments. This will provide guidance for the large-area and fast production of ten-fold quasicrystalline structures with high quality.

  4. Imaging diagnosis and clinical findings of cerebral venous thrombosis in full-term neonates without brain damage: a ten-year review

    International Nuclear Information System (INIS)

    Monteiro, Alexandra Maria Vieira; Lima, Claudio Marcio Amaral de Oliveira; Ribeiro, Erica Barreiros; Lins, Maria Cristina; Miranda, Silvia; Miranda, Luis Eduardo

    2010-01-01

    Objective: to describe and compare imaging methods and clinical findings of cerebral venous thrombosis in four full-term neonates without brain damage, admitted to a neonatal intensive care unit. Materials and methods: ten-year review of four cases diagnosed with cerebral venous thrombosis by transfontanellar ultrasonography associated with Doppler fluxometry and confirmed by magnetic resonance imaging/magnetic resonance angiography in correlation with clinical findings and neurological progression. Results: ultrasonography presented normal results in 75% of cases and magnetic resonance imaging in 100%. Doppler fluxometry and magnetic resonance angiography were abnormal in 100% of cases. Hypoxia (100%) and early seizures (100%) were predominant among clinical findings with evoked potential changes in 50% of cases. In the assessment of the neuro development all the areas remained within normality parameters up to the conclusion of the present study. Conclusion: ultrasonography in association with Doppler can identify changes related to cerebral venous thrombosis and should be complemented with magnetic resonance imaging that is the gold standard for diagnosis in these cases. (author)

  5. Maternity Nurses' Perceptions of Implementation of the Ten Steps to Successful Breastfeeding.

    Science.gov (United States)

    Cunningham, Emilie M; Doyle, Eva I; Bowden, Rodney G

    The purpose of this study was to determine maternity nurses' perceptions of implementing the Ten Steps to Successful Breastfeeding. An online survey and a focus group were used to evaluate perceptions of maternity nurses of implementing the Ten Steps to Successful Breastfeeding in an urban Texas hospital at the onset of the project initiation. Responses were transcribed and coded using Nvivo software. Thematic analysis was conducted and consensus was reached among the research team to validate themes. Twenty-eight maternity nurses participated. Nurses perceived a number of barriers to implementing the Ten Steps to Successful Breastfeeding including nurse staffing shortages, variations in practice among nurses, different levels of nurse education and knowledge about breastfeeding, lack of parental awareness and knowledge about breastfeeding, culture, and postpartum issues such as maternal fatigue, visitors, and routine required procedures during recovery care that interfered with skin-to-skin positioning. Maternity nurses desired more education about breastfeeding; specifically, a hands-on approach, rather than formal classroom instruction, to be able to promote successful implementation of the Ten Steps. More education on breastfeeding for new mothers, their families, and healthcare providers was recommended. Nurse staffing should be adequate to support nurses in their efforts to promote breastfeeding. Skin-to-skin positioning should be integrated into the recovery period. Hospital leadership support for full implementation and policy adherence is essential. Challenges in implementing the Ten Steps were identified along with potential solutions.

  6. Exposure to magnetic fields of railway engine drivers: A case study in Italy

    International Nuclear Information System (INIS)

    Contessa, G. M.; Falsaperla, R.; Brugaletta, V.; Rossi, P.

    2010-01-01

    A case study of exposure assessment of railway workers to static and extremely low frequency (ELF) magnetic fields is presented. A measurement campaign was conducted in aboard Italian main line trains. All measurements were performed on board during regular service (two engine drivers were simultaneously present), in all places potentially accessible to personnel, considering routes ranging from a few tens of kilometres to hundreds of kilometres. The measurement protocol was mostly based on broadband metres and personal metres were employed to assess individual exposure. Surveys on static and ELF magnetic fields were performed for seven different models of engine or electrified train. Traction motors were fed by alternating current (AC) current, except for two engines, where AC current fed only auxiliary services. The final result is that the average exposure to static magnetic field was a little higher than the background geomagnetic field; occasionally in few areas it could reach levels of the order of milli-tesla. The average exposure to ELF magnetic fields was in the order of 1-2 μT, with higher levels (few micro-tesla) only for one engine; occasionally in hot spots, close to wiring or specific equipment, the field values could reach several tens of micro-tesla. (authors)

  7. Posterior urethral obstruction: Prenatal sonographic findings and clinical outcome in 12 cases

    International Nuclear Information System (INIS)

    Russ, P.D.; Hayden, S.A.; Pretorius, D.H.; Manco-Johnson, M.L.

    1986-01-01

    Twelve cases of fetal urethral obstruction were reviewed retrospectively. A dilated posterior urethra was identified in eight fetuses (67%) and an enlarged bladder in 11 (92%). Ureterectasis, pyelocalicectasis, increased renal echogenicity, and renal cysts suggest abnormal renal development. Ureterectasis was demonstrated in seven fetuses (58%) and pyelocalicectasis in ten (83%). Renal echogenicity was increased in eight of ten cases (80%) and renal cysts were identified in two cases. Decreased amniotic fluid volume complicated ten pregnancies (83%). There were six live births, but only two neonates survived more than 5 weeks. Pulmonary immaturity contributed to the four postnatal deaths

  8. Ten into four won't go

    International Nuclear Information System (INIS)

    Freedman, D.Z.; West, P.C.

    1989-01-01

    It is shown that nontrivial spontaneous compactification of ten-dimensional N = 1 supergravity with or without Yang-Mills matter is not possible unless maximal symmetry (i.e. Lorentz invariance) is violated in the four-dimensional spacetime

  9. SHORT TERM EFFECT OF ACUPUNCTURE-TENS ON LUNG FUNCTIONS AND DYSPNEA FOR SUBJECTS WITH MODERATE COPD

    Directory of Open Access Journals (Sweden)

    Vinod Babu. K

    2015-10-01

    Full Text Available Background: Acupuncture TENS is used to improve pain instead of invasive acupuncture. Acupuncture shown to improve dyspnoea and lung functions in COPD (Chronic Obstructive Pulmonary Disease patients. The purpose of the study is to determine Short term effectiveness of Acupuncture-TENS in reducing dyspnea and improving lung functions for subjects with moderate COPD. Method: An experimental study design, selected 30 geriatric subjects with COPD randomized 15 subjects into each Study and Control group. Study group received Acu-TENS for 45 minutes for total 5 sessions, while control group received placebo TENS. Outcome measurements such as breathlessness using Modified Borg Scale (MBS, Lung functions using Pulmonary Function Test (PFT was measured before and after intervention. Results: Analysis from pre-intervention to post-intervention within study group found that there is statistically significant change in means of MBS, FEV1, FEV1/FVC ratio and within control group there is a statistically significant change in means of MBS, but there is no statistically significant change in means of FEV1, FVC and FEV1/FVC ratio. When post-intervention means were compared between the groups there is no statistically significant difference in means of MBS and FEV1, FVC and FEV1/FVC ratio. Conclusion: It is concluded that one week of Acu-TENS on EXL1 point found no significant effect on improving dyspnea and lung functions in subjects with moderate COPD in geriatric populations.

  10. Ten-year study on varieties of parotid tumors in pediatrics

    International Nuclear Information System (INIS)

    Verdecia Cannizares, Caridad; Cubero Melendez, Osiris; Alonso Pirez, Magda; Portugues Diaz, Andres Manuel

    2011-01-01

    Parotid tumors are uncommon because they account for 0.5 % of all types of cancer in pediatrics. They generally occur as increased local asymptomatic volume, occasionally accompanied by pain and inflammatory signs. A retrospective, longitudinal and descriptive study was carried out to determine the frequency and forms of presentation of parotid tumors diagnosed in 0-18 years-old patients, who had been admitted to the oncological surgery service of 'William Soler' pediatric hospital from February 2001 to December 2010. The variables taken into account were sex, forms of presentation, response to treatment as well as the histological variants presented, with the objective of giving information about these variants of parotid tumors in pediatrics, which, despite their rareness, represent a high risk group when occur. Seven patients were diagnosed, of whom 3 were pleomorphic adenomas, one adenocarcinoma, one mucoepidermoid carcinoma of the gland, one parotid Hodgkin lymphoma and one mixed tumor with atypical cells of the gland. The onset of all the tumors was the presence of a parotid mass in 6 asymptomatic cases and in one case suffering local pain. They were all performed gland ultrasound and aspiration fine needle biopsy. Males prevailed over the females (ratio of 5:2) and the average age of presentation was 12.3 years. Surgery is the main therapeutic weapon in most of cases. It was recommended to closely follow the patients because of their high rate of local recurrence

  11. Case history studies of energy conservation improvements in the meat industry

    Energy Technology Data Exchange (ETDEWEB)

    1982-06-01

    Presented are case histories for ten energy-efficient technologies implemented by the meat industry. For each case is presented: the name and location of the plant, name of plant employee contact with address and telephone number, energy consumption and costs at the plant before and after implementation of energy-conserving technology, description of the investment decision process, and changes in production or product quality as a result of the new equipment. The measures presented are: continuous rendering, high-pressure return on the boiler, heat recovery from condensate return and flash steam, continuous whole blood processing, preheating of process water with recovered refrigeration waste heat, continuous rendering of poultry scraps, electrical stimulation of beef, preheating and storing process water with recovered refrigeration waste heat, microcomputer control system, and housekeeping improvements. (LEW)

  12. Ten-year in vivo wear measurement of a fully congruent mobile bearing unicompartmental knee arthroplasty.

    Science.gov (United States)

    Price, A J; Short, A; Kellett, C; Beard, D; Gill, H; Pandit, H; Dodd, C A F; Murray, D W

    2005-11-01

    Polyethylene particulate wear debris continues to be implicated in the aetiology of aseptic loosening following knee arthroplasty. The Oxford unicompartmental knee arthroplasty employs a spherical femoral component and a fully congruous meniscal bearing to increase contact area and theoretically reduce the potential for polyethylene wear. This study measures the in vivo ten-year linear wear of the device, using a roentgenstereophotogrammetric technique. In this in vivo study, seven medial Oxford unicompartmental prostheses, which had been implanted ten years previously were studied. Stereo pairs of radiographs were acquired for each patient and the films were analysed using a roentgen stereophotogrammetric analysis calibration and a computer-aided design model silhouette-fitting technique. Penetration of the femoral component into the original volume of the bearing was our estimate of linear wear. In addition, eight control patients were examined less than three weeks post-insertion of an Oxford prosthesis, where no wear would be expected. The control group showed no measured wear and suggested a system accuracy of 0.1 mm. At ten years, the mean linear wear rate was 0.02 mm/year. The results from this in vivo study confirm that the device has low ten-year linear wear in clinical practice. This may offer the device a survival advantage in the long term.

  13. Retrospective comparative ten-year study of cumulative survival rates of remaining teeth in large edentulism treated with implant-supported fixed partial dentures or removable partial dentures.

    Science.gov (United States)

    Yamazaki, Seiya; Arakawa, Hikaru; Maekawa, Kenji; Hara, Emilio Satoshi; Noda, Kinji; Minakuchi, Hajime; Sonoyama, Wataru; Matsuka, Yoshizo; Kuboki, Takuo

    2013-07-01

    This study aimed to compare the survival rates of remaining teeth between implant-supported fixed dentures (IFDs) and removable partial dentures (RPDs) in patients with large edentulous cases. The second goal was to assess the risk factors for remaining tooth loss. The study subjects were selected among those who received prosthodontic treatment at Okayama University Dental Hospital for their edentulous space exceeding at least four continuous missing teeth. Twenty-one patients were included in the IFD group and 82 patients were included in the RPD group. Survival rates of remaining teeth were calculated in three subcategories: (1) whole remaining teeth, (2) adjacent teeth to intended edentulous space, and (3) opposing teeth to intended edentulous space. The ten-year cumulative survival rate of the whole remaining teeth was significantly higher in the IFD group (40.0%) than in the RPD group (24.4%). On the other hand, there was no significant difference between two groups in the survival rate of teeth adjacent or opposing to intended edentulous space. A Cox proportional hazard analysis revealed that RPD restoration and gender (male) were the significant risk factors for remaining tooth loss (whole remaining teeth). These results suggest that IFD treatment can reduce the incidence of remaining tooth loss in large edentulous cases. Copyright © 2013 Japan Prosthodontic Society. Published by Elsevier Ltd. All rights reserved.

  14. Ten years medical follow-up of four persons accidentally exposed to 60Co γ-rays

    International Nuclear Information System (INIS)

    Liu, Liqun; Zhao, Wenzheng; Wang, Jingying

    1984-01-01

    Four cases of acute radiation injury resulting from accidental exposure to a 60 Co source in February, 1972, were subject to early medical examination, and followed-up for 10 years. Their whole body exposure doses were estimated to be 55-147 rads. The results showed that in the individuals who had received a single dose below 147 rads, the temporary clinical picture, and the injuries in hemopoietic function and male reproductive system were all recoverable, but the chromosome aberrations yield returned to normal slowly. Ten years after the accident, all these 4 cases were in good health, and no cataract or malignant diseases were observed. No obvious abnormalities were found in their children. (author)

  15. Fish intake and ovarian cancer risk: a meta-analysis of 15 case-control and cohort studies.

    Directory of Open Access Journals (Sweden)

    Pei-yue Jiang

    Full Text Available BACKGROUND: Previous epidemiological studies have shown that fish consumption may modify the risk of ovarian cancer. However, these studies yielded controversial results. The present meta-analysis was undertaken to evaluate the relationship between fish intake and ovarian cancer risk. METHODS: A literature search was carried out using Pubmed, Embase, and Cochrane Library Central database for all relevant studies up to August 2013. We pooled the relative risks (RR from individual studies using fixed-effect or random-effect model, and carried out heterogeneity and publication bias analyses. RESULTS: A total of 15 (ten case-control, and five cohort studies were included in the present meta-analysis, representing data for 889,033 female subjects and 6,087 ovarian cancer cases. We found that total fish intake was not significantly associated with the risk of ovarian cancer among cohort studies (RR = 1.04 95% CI [0.89, 1.22] as well as case-control studies (RR = 0.90, 95% CI [0.73,1.12]. There was no evidence of publication bias as suggested by Begg's test (P = 0.55 and Egger's test(P = 0.29. CONCLUSIONS: The present meta-analysis showed that total fish consumption was not significantly associated with the risk of ovarian cancer. Further analysis on different fish species and food preparation methods should be conducted in future studies.

  16. A ten-year study of penetrating injuries of the colon.

    Science.gov (United States)

    Adesanya, Adedoyin A; Ekanem, Ekanem E

    2004-12-01

    Colon injury has been associated with a high risk of septic complications and mortality. We prospectively studied the pattern, management, outcome, and prognostic factors in patients who sustained penetrating colon injuries. Sixty patients who presented to our hospital with penetrating colon injuries over a ten-year period (1992 to 2001) were studied. Colon wounds were caused by gunshots in 55 (91.7 percent) patients and knife stabs in 5 (8.3 percent). There was a delay of more than 12 hours before laparotomy in 30 (50 percent) patients. Moderate or major fecal contamination of the peritoneal cavity occurred in 58 (96.7 percent) patients. The average penetrating abdominal trauma index score was 25.9 and 20 (33.3 percent) patients sustained Flint Grade 3 colon injury. Associated intra-abdominal injuries occurred in the small bowel (73.3 percent), liver (25 percent), stomach (23.3 percent), and mesentery (16.7 percent). Right colon wounds (35) were managed by primary repair in 24 (68.6 percent) patients and proximal diverting colostomy in 11 (31.4 percent), whereas left colon wounds (25) were managed by diverting colostomy in 22 (88.0 percent) patients and primary repair in 3 (12.0 percent) patients. Common complications included wound infection (56.7 percent), septicemia (31.7 percent), and enterocutaneous fistula (16.7 percent). The overall mortality rate was 33.3 percent and colon injury-related mortality was 21.7 percent. Presence of destructive colon injury was associated with a greater than fourfold increased incidence of death. Other significant risk factors included shock on admission, major fecal contamination, duration of operation more than four hours, penetrating abdominal trauma index score >25, and more than two postoperative complications. There was no difference in outcome between patients who had primary repair and those undergoing diverting colostomy. Colostomy closure-related morbidity was 21 percent and mortality was 5.3 percent. A more liberal

  17. Transcutaneous Electrical Nerve Stimulation (TENS) and Laryngeal Manual Therapy (LMT): Immediate Effects in Women With Dysphonia.

    Science.gov (United States)

    Conde, Mariana de Cásisa Macedo; Siqueira, Larissa Thaís Donalonso; Vendramini, José Eduardo; Brasolotto, Alcione Ghedini; Guirro, Rinaldo Roberto de Jesus; Silverio, Kelly Cristina Alves

    2018-05-01

    This study aimed to verify the immediate effect of low-frequency transcutaneous electrical nerve stimulation (TENS) and laryngeal manual therapy (LMT) in musculoskeletal pain, voice quality, and self-reported signs in women with dysphonia. Thirty women with behavioral dysphonia were randomly divided into the TENS group and the LMT group. All participants fulfilled the pain survey and had their voices recorded to posterior perceptual and acoustic analysis before and after intervention. The TENS group received a unique low-frequency TENS session (20 minutes). The LMT group received LMT (20 minutes) with soft and superficial massage in the sternocleidomastoid muscle, suprahyoid muscles, and larynx. Afterward, the volunteers reported their voice, larynx, breathing, and articulatory signs. Pre and post data were compared by parametric and nonparametric tests. After TENS, a decrease in pain intensity in the posterior or anterior region of the neck, shoulders, upper or lower back, and masseter was observed. After LMT, a decrease in pain intensity in the neck anterior region, shoulders, lower back, and temporal region was observed. Also, after TENS, there was an improvement in vowel /a/ instability; after LMT, there was a general improvement in voice quality, decrease in tension, and decrease in breathiness in speech. Positive voice and laryngeal signs were reported after TENS, and positive laryngeal signs and articulation were reported after LMT. TENS and LMT may be used in voice treatment of women with behavioral dysphonia, and both may be considered important therapy resources that reduce musculoskeletal pain and cause positive laryngeal signs. Both TENS and LMT are able to partially improve voice quality, but TENS presented better results. Copyright © 2018 The Voice Foundation. Published by Elsevier Inc. All rights reserved.

  18. Case-control study for colorectal cancer genetic susceptibility in EPICOLON: previously identified variants and mucins

    Directory of Open Access Journals (Sweden)

    Moreno Victor

    2011-08-01

    Full Text Available Abstract Background Colorectal cancer (CRC is the second leading cause of cancer death in developed countries. Familial aggregation in CRC is also important outside syndromic forms and, in this case, a polygenic model with several common low-penetrance alleles contributing to CRC genetic predisposition could be hypothesized. Mucins and GALNTs (N-acetylgalactosaminyltransferase are interesting candidates for CRC genetic susceptibility and have not been previously evaluated. We present results for ten genetic variants linked to CRC risk in previous studies (previously identified category and 18 selected variants from the mucin gene family in a case-control association study from the Spanish EPICOLON consortium. Methods CRC cases and matched controls were from EPICOLON, a prospective, multicenter, nationwide Spanish initiative, comprised of two independent stages. Stage 1 corresponded to 515 CRC cases and 515 controls, whereas stage 2 consisted of 901 CRC cases and 909 controls. Also, an independent cohort of 549 CRC cases and 599 controls outside EPICOLON was available for additional replication. Genotyping was performed for ten previously identified SNPs in ADH1C, APC, CCDN1, IL6, IL8, IRS1, MTHFR, PPARG, VDR and ARL11, and 18 selected variants in the mucin gene family. Results None of the 28 SNPs analyzed in our study was found to be associated with CRC risk. Although four SNPs were significant with a P-value ADH1C (OR = 1.63, 95% CI = 1.06-2.50, P-value = 0.02, recessive, rs1800795 in IL6 (OR = 1.62, 95% CI = 1.10-2.37, P-value = 0.01, recessive, rs3803185 in ARL11 (OR = 1.58, 95% CI = 1.17-2.15, P-value = 0.007, codominant, and rs2102302 in GALNTL2 (OR = 1.20, 95% CI = 1.00-1.44, P-value = 0.04, log-additive 0, 1, 2 alleles], only rs3803185 achieved statistical significance in EPICOLON stage 2 (OR = 1.34, 95% CI = 1.06-1.69, P-value = 0.01, recessive. In the joint analysis for both stages, results were only significant for rs3803185 (OR = 1

  19. Case-control study for colorectal cancer genetic susceptibility in EPICOLON: previously identified variants and mucins

    International Nuclear Information System (INIS)

    Abulí, Anna; Morillas, Juan D; Rigau, Joaquim; Latorre, Mercedes; Fernández-Bañares, Fernando; Peña, Elena; Riestra, Sabino; Payá, Artemio; Jover, Rodrigo; Xicola, Rosa M; Llor, Xavier; Fernández-Rozadilla, Ceres; Carvajal-Carmona, Luis; Villanueva, Cristina M; Moreno, Victor; Piqué, Josep M; Carracedo, Angel; Castells, Antoni; Andreu, Montserrat; Ruiz-Ponte, Clara; Castellví-Bel, Sergi; Alonso-Espinaco, Virginia; Muñoz, Jenifer; Gonzalo, Victoria; Bessa, Xavier; González, Dolors; Clofent, Joan; Cubiella, Joaquin

    2011-01-01

    Colorectal cancer (CRC) is the second leading cause of cancer death in developed countries. Familial aggregation in CRC is also important outside syndromic forms and, in this case, a polygenic model with several common low-penetrance alleles contributing to CRC genetic predisposition could be hypothesized. Mucins and GALNTs (N-acetylgalactosaminyltransferase) are interesting candidates for CRC genetic susceptibility and have not been previously evaluated. We present results for ten genetic variants linked to CRC risk in previous studies (previously identified category) and 18 selected variants from the mucin gene family in a case-control association study from the Spanish EPICOLON consortium. CRC cases and matched controls were from EPICOLON, a prospective, multicenter, nationwide Spanish initiative, comprised of two independent stages. Stage 1 corresponded to 515 CRC cases and 515 controls, whereas stage 2 consisted of 901 CRC cases and 909 controls. Also, an independent cohort of 549 CRC cases and 599 controls outside EPICOLON was available for additional replication. Genotyping was performed for ten previously identified SNPs in ADH1C, APC, CCDN1, IL6, IL8, IRS1, MTHFR, PPARG, VDR and ARL11, and 18 selected variants in the mucin gene family. None of the 28 SNPs analyzed in our study was found to be associated with CRC risk. Although four SNPs were significant with a P-value < 0.05 in EPICOLON stage 1 [rs698 in ADH1C (OR = 1.63, 95% CI = 1.06-2.50, P-value = 0.02, recessive), rs1800795 in IL6 (OR = 1.62, 95% CI = 1.10-2.37, P-value = 0.01, recessive), rs3803185 in ARL11 (OR = 1.58, 95% CI = 1.17-2.15, P-value = 0.007, codominant), and rs2102302 in GALNTL2 (OR = 1.20, 95% CI = 1.00-1.44, P-value = 0.04, log-additive 0, 1, 2 alleles], only rs3803185 achieved statistical significance in EPICOLON stage 2 (OR = 1.34, 95% CI = 1.06-1.69, P-value = 0.01, recessive). In the joint analysis for both stages, results were only significant for rs3803185 (OR = 1.12, 95% CI = 1

  20. Final report on case studies

    DEFF Research Database (Denmark)

    Ljungberg, Daniel; McKelvey, Maureen; Lassen, Astrid Heidemann

    2012-01-01

    Case study as a research design means investigating a single or multiple instance(s) or setting(s) (i.e. a case) and its entire context to explain a phenomenon and its processes. This is achieved through detailed understanding, usually comprised of multiple sources of information. In this way, case...... studies attempt to provide as a complete an understanding of a (complex) phenomenon as possible. Within the AEGIS project, survey and case study research are complementary. They are complementary in the sense that the former can provide more generalizable evidence on a phenomenon in terms of cross......-sectional data, while the latter can provide more in-depth (qualitative) understanding on specific issues. In systematically examining the case studies, however, this report goes beyond a typical single case study. Here we provide a synthesis of 86 case studies. Multiple case studies, following similar focus...

  1. Large scale exact quantum dynamics calculations: Ten thousand quantum states of acetonitrile

    Science.gov (United States)

    Halverson, Thomas; Poirier, Bill

    2015-03-01

    'Exact' quantum dynamics (EQD) calculations of the vibrational spectrum of acetonitrile (CH3CN) are performed, using two different methods: (1) phase-space-truncated momentum-symmetrized Gaussian basis and (2) correlated truncated harmonic oscillator basis. In both cases, a simple classical phase space picture is used to optimize the selection of individual basis functions-leading to drastic reductions in basis size, in comparison with existing methods. Massive parallelization is also employed. Together, these tools-implemented into a single, easy-to-use computer code-enable a calculation of tens of thousands of vibrational states of CH3CN to an accuracy of 0.001-10 cm-1.

  2. Cause-Specific Mortality in HIV-Positive Patients Who Survived Ten Years after Starting Antiretroviral Therapy

    DEFF Research Database (Denmark)

    Trickey, Adam; May, Margaret T; Vehreschild, Jorg-Janne

    2016-01-01

    OBJECTIVES: To estimate mortality rates and prognostic factors in HIV-positive patients who started combination antiretroviral therapy between 1996-1999 and survived for more than ten years. METHODS: We used data from 18 European and North American HIV cohort studies contributing to the Antiretro......OBJECTIVES: To estimate mortality rates and prognostic factors in HIV-positive patients who started combination antiretroviral therapy between 1996-1999 and survived for more than ten years. METHODS: We used data from 18 European and North American HIV cohort studies contributing...... to the Antiretroviral Therapy Cohort Collaboration. We followed up patients from ten years after start of combination antiretroviral therapy. We estimated overall and cause-specific mortality rate ratios for age, sex, transmission through injection drug use, AIDS, CD4 count and HIV-1 RNA. RESULTS: During 50,593 person...... years 656/13,011 (5%) patients died. Older age, male sex, injecting drug use transmission, AIDS, and low CD4 count and detectable viral replication ten years after starting combination antiretroviral therapy were associated with higher subsequent mortality. CD4 count at ART start did not predict...

  3. Self-esteem and depression: ten year follow-up of mothers and offspring.

    Science.gov (United States)

    Miller, L; Warner, V; Wickramaratne, P; Weissman, M

    1999-01-01

    The association between maternal bonding style, offspring low self-esteem and offspring depression status was assessed by maternal depression status. Sixty mothers and 137 offspring were independently assessed over the course of a ten year follow-up study. Assessments included the Schedule for Affective Disorders and Schizophrenia (SADS-LA), Schedule for Affective Disorders and Schizophrenia for School-Aged Children (K-SADS), the Coopersmith Self-Esteem Inventory (CSEI) and the Parental Bonding Instrument (PBI). Among daughters of mothers with a history of depression, maternal affectionless-control was associated with daughter low self-esteem which was associated with daughter depression at ten year follow-up. Among daughters of mothers without a history of depression, maternal affectionless-control was not associated with daughter low self-esteem, which was not associated with daughter depression at ten year follow-up but which was associated with a history of childhood depression. None of these associations were found to be significant among sons. As self-esteem was not measured at ten year follow-up, among offspring the stability of self-esteem could not be assessed, nor could the association between adult self-esteem and adult depression. Clinical presentation of low self-esteem in girls should be assessed in the context of maternal depression status.

  4. Case report

    African Journals Online (AJOL)

    abp

    2013-05-21

    May 21, 2013 ... Imperforate Hymen - a rare cause of acute abdominal pain and tenesmus: case report and review of .... did a ten year retrospective analysis of the data of 15 patients treated for ... Low back pain (38-40%) [4, 13, 14]. Occurs as ...

  5. Mid-term evaluation of ten National Research schools

    DEFF Research Database (Denmark)

    Gustafsson, Göran; Dahl, Hanne Marlene; Gustafsson, Christina

    the scheme was launched, the Research Council has issued three calls for proposals and allocated grants to a total of 22 national research schools. Five were started up in 2009, ten in 2013 and seven in 2015. A Nordic scientific programme committee was appointed in 2013, with responsibility for assessing...... grant applications, monitoring the progress of the FORSKERSKOLER scheme and serving as the evaluation panel for the mid-term evaluation in 2013 and in 2016/2017. The task of the evaluation panel has been to: 1) evaluate the quality of and progress achieved by the ten research schools which were awarded...... funding in 2012 and launched in 2013; and 2) to provide recommendations as to whether funding should be continued to cover the full eight-year period or terminated after five years. Continued funding is recommended for all ten schools to cover the full eight-year period, according to the proposed budget...

  6. Ten out of ten for LHC decapole magnets

    CERN Multimedia

    2001-01-01

    CERN's Albert Ijspeert (left) and Avinash Puntambekar of the Indian CAT laboratory with the ten Indian decapole magnets on the test bench. Tests will be carried out by the LHC-MTA group. A batch of 10 superconducting decapole magnets for the LHC has just arrived at CERN from India. These will be used to correct for slight imperfections in the dipole magnets that will steer proton beams around CERN's new accelerator. All magnets have slight imperfections in the fields they produce, and in the LHC dipoles these will be corrected for using sextupoles and decapoles. The sextupoles were the first LHC magnets to be given the production green-light following successful tests of pre-series magnets last year (Bulletin 21/2000, 22 May 2000). Now it is the turn of pre-series decapoles to go on trial at CERN. Of the LHC's 1232 dipole magnets, half will use sextupole correctors only and the other half will use both sextupoles and decapoles. That means that a total of 616 pairs of decapoles are needed. Like the sextupole...

  7. A chemical reaction in the movie The Ten Commandments

    Directory of Open Access Journals (Sweden)

    López Pérez, José Pedro;

    2012-04-01

    Full Text Available The study of natural sciences in the second year of Secondary Education must be complemented with a visit to the laboratory, where experiments should be permormed. The curriculum emphasizes the initial basis of Chemistry and the study of reactions. In this paper we describe a laboratory experience, useful for understanding the concept of chemical change. Also, we present the hypothesis that a chemical reaction was used in the classic movie The Ten Commandments.

  8. Breastfeeding Practices and Barriers to Implementing the Ten Steps to Successful Breastfeeding in Mississippi Hospitals.

    Science.gov (United States)

    Alakaam, Amir; Lemacks, Jennifer; Yadrick, Kathleen; Connell, Carol; Choi, Hwanseok Winston; Newman, Ray G

    2018-05-01

    Mississippi has the lowest rates of breastfeeding in the United States at 6 and 12 months. There is growing evidence that the rates and duration of infant breastfeeding improve after hospitals implement the Ten Steps to Successful Breastfeeding; moreover, the Ten Steps approach is considered the standard model for evaluation of breastfeeding practices in birthplaces. Research aim: This study aimed to examine the implementation level of the Ten Steps and identify barriers to implementing the Ten Steps in Mississippi hospitals. A cross-sectional self-report survey was used to answer the research aim. Nurse managers of the birthing and maternity units of all 43 Mississippi hospitals that provided birthing and maternity care were recruited. A response rate of 72% ( N = 31) was obtained. Implementation of the Ten Steps in these hospitals was categorized as low, partial, moderate, or high. The researcher classified implementation in 29% of hospitals as moderate and in 71% as partial. The hospital level of implementation was significantly positively associated with the hospital delivery rate along with the hospital cesarean section rate per year. The main barriers for the implementation process of the Ten Steps reported were resistance to new policies, limited financial and human resources, and lack of support from national and state governments. Breastfeeding practices in Mississippi hospitals need to be improved. New policies need to be established in Mississippi to encourage hospitals to adopt the Ten Steps policies and practice in the maternity and birthing units.

  9. [Case-non case studies: Principles, methods, bias and interpretation].

    Science.gov (United States)

    Faillie, Jean-Luc

    2017-10-31

    Case-non case studies belongs to the methods assessing drug safety by analyzing the disproportionality of notifications of adverse drug reactions in pharmacovigilance databases. Used for the first time in the 1980s, the last few decades have seen a significant increase in the use of this design. The principle of the case-non case study is to compare drug exposure in cases of a studied adverse reaction with that of cases of other reported adverse reactions and called "non cases". Results are presented in the form of a reporting odds ratio (ROR), the interpretation of which makes it possible to identify drug safety signals. This article describes the principle of the case-non case study, the method of calculating the ROR and its confidence interval, the different modalities of analysis and how to interpret its results with regard to the advantages and limitations of this design. Copyright © 2017 Société française de pharmacologie et de thérapeutique. Published by Elsevier Masson SAS. All rights reserved.

  10. Identification of ten variants associated with risk of estrogen-receptor-negative breast cancer

    Science.gov (United States)

    Milne, Roger L; Kuchenbaecker, Karoline B; Michailidou, Kyriaki; Beesley, Jonathan; Kar, Siddhartha; Lindström, Sara; Hui, Shirley; Lemaçon, Audrey; Soucy, Penny; Dennis, Joe; Jiang, Xia; Rostamianfar, Asha; Finucane, Hilary; Bolla, Manjeet K; McGuffog, Lesley; Wang, Qin; Aalfs, Cora M; Adams, Marcia; Adlard, Julian; Agata, Simona; Ahmed, Shahana; Ahsan, Habibul; Aittomäki, Kristiina; Al-Ejeh, Fares; Allen, Jamie; Ambrosone, Christine B; Amos, Christopher I; Andrulis, Irene L; Anton-Culver, Hoda; Antonenkova, Natalia N; Arndt, Volker; Arnold, Norbert; Aronson, Kristan J; Auber, Bernd; Auer, Paul L; Ausems, Margreet G E M; Azzollini, Jacopo; Bacot, François; Balmaña, Judith; Barile, Monica; Barjhoux, Laure; Barkardottir, Rosa B; Barrdahl, Myrto; Barnes, Daniel; Barrowdale, Daniel; Baynes, Caroline; Beckmann, Matthias W; Benitez, Javier; Bermisheva, Marina; Bernstein, Leslie; Bignon, Yves-Jean; Blazer, Kathleen R; Blok, Marinus J; Blomqvist, Carl; Blot, William; Bobolis, Kristie; Boeckx, Bram; Bogdanova, Natalia V; Bojesen, Anders; Bojesen, Stig E; Bonanni, Bernardo; Børresen-Dale, Anne-Lise; Bozsik, Aniko; Bradbury, Angela R; Brand, Judith S; Brauch, Hiltrud; Brenner, Hermann; Bressac-de Paillerets, Brigitte; Brewer, Carole; Brinton, Louise; Broberg, Per; Brooks-Wilson, Angela; Brunet, Joan; Brüning, Thomas; Burwinkel, Barbara; Buys, Saundra S; Byun, Jinyoung; Cai, Qiuyin; Caldés, Trinidad; Caligo, Maria A; Campbell, Ian; Canzian, Federico; Caron, Olivier; Carracedo, Angel; Carter, Brian D; Castelao, J Esteban; Castera, Laurent; Caux-Moncoutier, Virginie; Chan, Salina B; Chang-Claude, Jenny; Chanock, Stephen J; Chen, Xiaoqing; Cheng, Ting-Yuan David; Chiquette, Jocelyne; Christiansen, Hans; Claes, Kathleen B M; Clarke, Christine L; Conner, Thomas; Conroy, Don M; Cook, Jackie; Cordina-Duverger, Emilie; Cornelissen, Sten; Coupier, Isabelle; Cox, Angela; Cox, David G; Cross, Simon S; Cuk, Katarina; Cunningham, Julie M; Czene, Kamila; Daly, Mary B; Damiola, Francesca; Darabi, Hatef; Davidson, Rosemarie; De Leeneer, Kim; Devilee, Peter; Dicks, Ed; Diez, Orland; Ding, Yuan Chun; Ditsch, Nina; Doheny, Kimberly F; Domchek, Susan M; Dorfling, Cecilia M; Dörk, Thilo; dos-Santos-Silva, Isabel; Dubois, Stéphane; Dugué, Pierre-Antoine; Dumont, Martine; Dunning, Alison M; Durcan, Lorraine; Dwek, Miriam; Dworniczak, Bernd; Eccles, Diana; Eeles, Ros; Ehrencrona, Hans; Eilber, Ursula; Ejlertsen, Bent; Ekici, Arif B; Engel, Christoph; Eriksson, Mikael; Fachal, Laura; Faivre, Laurence; Fasching, Peter A; Faust, Ulrike; Figueroa, Jonine; Flesch-Janys, Dieter; Fletcher, Olivia; Flyger, Henrik; Foulkes, William D; Friedman, Eitan; Fritschi, Lin; Frost, Debra; Gabrielson, Marike; Gaddam, Pragna; Gammon, Marilie D; Ganz, Patricia A; Gapstur, Susan M; Garber, Judy; Garcia-Barberan, Vanesa; García-Sáenz, José A; Gaudet, Mia M; Gauthier-Villars, Marion; Gehrig, Andrea; Georgoulias, Vassilios; Gerdes, Anne-Marie; Giles, Graham G; Glendon, Gord; Godwin, Andrew K; Goldberg, Mark S; Goldgar, David E; González-Neira, Anna; Goodfellow, Paul; Greene, Mark H; Grip, Mervi; Gronwald, Jacek; Grundy, Anne; Gschwantler-Kaulich, Daphne; Guénel, Pascal; Guo, Qi; Haeberle, Lothar; Hahnen, Eric; Haiman, Christopher A; Håkansson, Niclas; Hallberg, Emily; Hamann, Ute; Hamel, Nathalie; Hankinson, Susan; Hansen, Thomas V O; Harrington, Patricia; Hart, Steven N; Hartikainen, Jaana M; Healey, Catherine S; Hein, Alexander; Helbig, Sonja; Henderson, Alex; Heyworth, Jane; Hicks, Belynda; Hillemanns, Peter; Hodgson, Shirley; Hogervorst, Frans B; Hollestelle, Antoinette; Hooning, Maartje J; Hoover, Bob; Hopper, John L; Hu, Chunling; Huang, Guanmengqian; Hulick, Peter J; Humphreys, Keith; Hunter, David J; Imyanitov, Evgeny N; Isaacs, Claudine; Iwasaki, Motoki; Izatt, Louise; Jakubowska, Anna; James, Paul; Janavicius, Ramunas; Janni, Wolfgang; Jensen, Uffe Birk; John, Esther M; Johnson, Nichola; Jones, Kristine; Jones, Michael; Jukkola-Vuorinen, Arja; Kaaks, Rudolf; Kabisch, Maria; Kaczmarek, Katarzyna; Kang, Daehee; Kast, Karin; Keeman, Renske; Kerin, Michael J; Kets, Carolien M; Keupers, Machteld; Khan, Sofia; Khusnutdinova, Elza; Kiiski, Johanna I; Kim, Sung-Won; Knight, Julia A; Konstantopoulou, Irene; Kosma, Veli-Matti; Kristensen, Vessela N; Kruse, Torben A; Kwong, Ava; Lænkholm, Anne-Vibeke; Laitman, Yael; Lalloo, Fiona; Lambrechts, Diether; Landsman, Keren; Lasset, Christine; Lazaro, Conxi; Le Marchand, Loic; Lecarpentier, Julie; Lee, Andrew; Lee, Eunjung; Lee, Jong Won; Lee, Min Hyuk; Lejbkowicz, Flavio; Lesueur, Fabienne; Li, Jingmei; Lilyquist, Jenna; Lincoln, Anne; Lindblom, Annika; Lissowska, Jolanta; Lo, Wing-Yee; Loibl, Sibylle; Long, Jirong; Loud, Jennifer T; Lubinski, Jan; Luccarini, Craig; Lush, Michael; MacInnis, Robert J; Maishman, Tom; Makalic, Enes; Kostovska, Ivana Maleva; Malone, Kathleen E; Manoukian, Siranoush; Manson, JoAnn E; Margolin, Sara; Martens, John W M; Martinez, Maria Elena; Matsuo, Keitaro; Mavroudis, Dimitrios; Mazoyer, Sylvie; McLean, Catriona; Meijers-Heijboer, Hanne; Menéndez, Primitiva; Meyer, Jeffery; Miao, Hui; Miller, Austin; Miller, Nicola; Mitchell, Gillian; Montagna, Marco; Muir, Kenneth; Mulligan, Anna Marie; Mulot, Claire; Nadesan, Sue; Nathanson, Katherine L; Neuhausen, Susan L; Nevanlinna, Heli; Nevelsteen, Ines; Niederacher, Dieter; Nielsen, Sune F; Nordestgaard, Børge G; Norman, Aaron; Nussbaum, Robert L; Olah, Edith; Olopade, Olufunmilayo I; Olson, Janet E; Olswold, Curtis; Ong, Kai-ren; Oosterwijk, Jan C; Orr, Nick; Osorio, Ana; Pankratz, V Shane; Papi, Laura; Park-Simon, Tjoung-Won; Paulsson-Karlsson, Ylva; Lloyd, Rachel; Pedersen, Inge Søkilde; Peissel, Bernard; Peixoto, Ana; Perez, Jose I A; Peterlongo, Paolo; Peto, Julian; Pfeiler, Georg; Phelan, Catherine M; Pinchev, Mila; Plaseska-Karanfilska, Dijana; Poppe, Bruce; Porteous, Mary E; Prentice, Ross; Presneau, Nadege; Prokofieva, Darya; Pugh, Elizabeth; Pujana, Miquel Angel; Pylkäs, Katri; Rack, Brigitte; Radice, Paolo; Rahman, Nazneen; Rantala, Johanna; Rappaport-Fuerhauser, Christine; Rennert, Gad; Rennert, Hedy S; Rhenius, Valerie; Rhiem, Kerstin; Richardson, Andrea; Rodriguez, Gustavo C; Romero, Atocha; Romm, Jane; Rookus, Matti A; Rudolph, Anja; Ruediger, Thomas; Saloustros, Emmanouil; Sanders, Joyce; Sandler, Dale P; Sangrajrang, Suleeporn; Sawyer, Elinor J; Schmidt, Daniel F; Schoemaker, Minouk J; Schumacher, Fredrick; Schürmann, Peter; Schwentner, Lukas; Scott, Christopher; Scott, Rodney J; Seal, Sheila; Senter, Leigha; Seynaeve, Caroline; Shah, Mitul; Sharma, Priyanka; Shen, Chen-Yang; Sheng, Xin; Shimelis, Hermela; Shrubsole, Martha J; Shu, Xiao-Ou; Side, Lucy E; Singer, Christian F; Sohn, Christof; Southey, Melissa C; Spinelli, John J; Spurdle, Amanda B; Stegmaier, Christa; Stoppa-Lyonnet, Dominique; Sukiennicki, Grzegorz; Surowy, Harald; Sutter, Christian; Swerdlow, Anthony; Szabo, Csilla I; Tamimi, Rulla M; Tan, Yen Y; Taylor, Jack A; Tejada, Maria-Isabel; Tengström, Maria; Teo, Soo H; Terry, Mary B; Tessier, Daniel C; Teulé, Alex; Thöne, Kathrin; Thull, Darcy L; Tibiletti, Maria Grazia; Tihomirova, Laima; Tischkowitz, Marc; Toland, Amanda E; Tollenaar, Rob A E M; Tomlinson, Ian; Tong, Ling; Torres, Diana; Tranchant, Martine; Truong, Thérèse; Tucker, Kathy; Tung, Nadine; Tyrer, Jonathan; Ulmer, Hans-Ulrich; Vachon, Celine; van Asperen, Christi J; Van Den Berg, David; van den Ouweland, Ans M W; van Rensburg, Elizabeth J; Varesco, Liliana; Varon-Mateeva, Raymonda; Vega, Ana; Viel, Alessandra; Vijai, Joseph; Vincent, Daniel; Vollenweider, Jason; Walker, Lisa; Wang, Zhaoming; Wang-Gohrke, Shan; Wappenschmidt, Barbara; Weinberg, Clarice R; Weitzel, Jeffrey N; Wendt, Camilla; Wesseling, Jelle; Whittemore, Alice S; Wijnen, Juul T; Willett, Walter; Winqvist, Robert; Wolk, Alicja; Wu, Anna H; Xia, Lucy; Yang, Xiaohong R; Yannoukakos, Drakoulis; Zaffaroni, Daniela; Zheng, Wei; Zhu, Bin; Ziogas, Argyrios; Ziv, Elad; Zorn, Kristin K; Gago-Dominguez, Manuela; Mannermaa, Arto; Olsson, Håkan; Teixeira, Manuel R; Stone, Jennifer; Offit, Kenneth; Ottini, Laura; Park, Sue K; Thomassen, Mads; Hall, Per; Meindl, Alfons; Schmutzler, Rita K; Droit, Arnaud; Bader, Gary D; Pharoah, Paul D P; Couch, Fergus J; Easton, Douglas F; Kraft, Peter; Chenevix-Trench, Georgia; García-Closas, Montserrat; Schmidt, Marjanka K; Antoniou, Antonis C; Simard, Jacques

    2018-01-01

    Most common breast cancer susceptibility variants have been identified through genome-wide association studies (GWAS) of predominantly estrogen receptor (ER)-positive disease1. We conducted a GWAS using 21,468 ER-negative cases and 100,594 controls combined with 18,908 BRCA1 mutation carriers (9,414 with breast cancer), all of European origin. We identified independent associations at P < 5 × 10−8 with ten variants at nine new loci. At P < 0.05, we replicated associations with 10 of 11 variants previously reported in ER-negative disease or BRCA1 mutation carrier GWAS and observed consistent associations with ER-negative disease for 105 susceptibility variants identified by other studies. These 125 variants explain approximately 14% of the familial risk of this breast cancer subtype. There was high genetic correlation (0.72) between risk of ER-negative breast cancer and breast cancer risk for BRCA1 mutation carriers. These findings may lead to improved risk prediction and inform further fine-mapping and functional work to better understand the biological basis of ER-negative breast cancer. PMID:29058716

  11. Socialism. Grade Ten, Unit Two, 10.2. Comprehensive Social Studies Curriculum for the Inner City.

    Science.gov (United States)

    Malone, Helen

    The socialism unit of the tenth grade level of the FICSS series (Focus on Inner City Social Studies -- see SO 008 271) explores a selected history of socialist thought and the theoretical model of socialism. Three case studies of socialism are explored: Great Britain, Sweden, and Israel. The case studies are designed to answer questions concerning…

  12. Transcutaneous Electrical Nerve Stimulation (TENS) reduces pain, fatigue, and hyperalgesia while restoring central inhibition in primary fibromyalgia

    OpenAIRE

    Dailey, Dana L; Rakel, Barbara A; Vance, Carol GT; Liebano, Richard E; Anand, Amrit S; Bush, Heather M; Lee, Kyoung S; Lee, Jennifer E; Sluka, Kathleen A

    2013-01-01

    Because TENS works by reducing central excitability and activating central inhibition pathways, we tested the hypothesis that TENS would reduce pain and fatigue and improve function and hyperalgesia in people with fibromyalgia who have enhanced central excitability and reduced inhibition. The current study used a double-blinded randomized, placebo controlled cross-over design to test effects of a single treatment of TENS in people with fibromyalgia. Three treatments were assessed in random or...

  13. Clinical and economic impact of TENS in patients with chronic low back pain: analysis of a nationwide database.

    Science.gov (United States)

    Pivec, Robert; Stokes, Michael; Chitnis, Abhishek S; Paulino, Carl B; Harwin, Steven F; Mont, Michael A

    2013-12-01

    This study evaluated patients who were given transcutaneous electrical nerve stimulation (TENS) compared with a matched group without TENS prior to intervention and at 1-year follow-up. Patients who were treated with TENS had significantly fewer hospital and clinic visits, used less diagnostic imaging (31 vs 46 events per 100 patients), had fewer physical therapy visits (94 vs 107), and required less back surgery (7.5 vs 9.2 surgeries) than patients receiving other treatment modalities. Total annual costs for chronic low back pain patients without neurological involvement were lower in TENS patients ($17,957 vs $17,986 for non-TENS), even when the cost of the device was taken into account.

  14. Ten years after the Jali Commission

    African Journals Online (AJOL)

    Ten years have lapsed since the Jali Commission's final report became publicly available, and it is therefore an .... as the 'core business' of the department. This was seen as .... the 2009/10–2013/14 DCS Strategic Plan did the department ...

  15. Early Predictors of Ten-Year Course in First-Episode Psychosis

    DEFF Research Database (Denmark)

    Friis, Svein; Melle, Ingrid; Johannessen, Jan Olav

    2016-01-01

    , five, and ten years (N=186 at ten years). Time in psychosis was defined as time with scores ≥4 on any of the Positive and Negative Syndrome Scale items P1, P3, P5, P6, and G9. Evaluations were retrospective, based on clinical interviews and all available clinical information. During the first two years......, patients were also evaluated by their clinicians at least biweekly. Baseline and early-course predictors of long-term course were identified with linear mixed-model analyses. RESULTS: Four variables provided significant, additive predictions of longer time in psychosis during the ten-year follow...

  16. Use of 3D-computed tomography angiography for planning the surgical removal of pineal region meningiomas using Poppen's approach: a report of ten cases and a literature review

    Directory of Open Access Journals (Sweden)

    Li Ye

    2011-06-01

    Full Text Available Abstract Background There are several treatment approaches for pineal region meningiomas, such as Poppen's approach, Krause's approach and combinations of the two approaches. We present our experience with the use of 3D-computed tomography angiography for planning the surgical removal of pineal region meningiomas using a suboccipital transtentorial approach (Poppen's approach and evaluate the role of Poppen's approach. Methods During the period from January 2005 to June 2010, ten patients presented to us with pineal region meningioma. MRI was routinely used to define the tumor size, position, and its relevant complications while 3D-CTA was applied to define the blood supply of the tumor and the venous complex (VC shift before operations. Most of the meningiomas had developed at both sides of the tentorial plane and extended laterally with typical characteristics of a pineal region tumor. Results All tumors were completely removed surgically without any injury to the VC. Postoperative intracranial infection occurred in one case who recovered after antibiotics were given. Postoperative intraventricular hemorrhage and pneumocephalus were found in one case, but fully recovered after conservative treatment. In the nine cases of concurrent hydrocephalus, this was gradually relieved in eight patients and the single case that became aggravated was successfully treated with ventriculoperitoneal shunt. Moreover, the follow-up MRI examinations did not indicate any recurrence of the meningiomas. Conclusion We found that the use of Poppen's approach is strongly supported for the successful removal of pineal region meningiomas without serious complications.

  17. Ten years of nuclear power

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1964-08-15

    Ten years have elapsed since the world's first nuclear power station began to supply electricity in Russia, and this in turn marked the end of a twelve year stage following the first controlled nuclear chain reaction at Chicago. These periods mark major stages in the development of atomic energy from the realm of abstract ideas to that of everyday industrial application. They followed a period of fundamental research and laboratory work, culminating in Enrico Fermi's demonstration of a system whereby the forces of the atom could be brought under control. Then it was necessary to find ways and means of using the chain reaction for practical purposes and on an industrial scale. And after this had been shown in 1954 to be technically possible, it had still to be developed into an economic process. The nuclear power station has proved itself from the technical and engineering standpoint. The third phase of development has been to bring it to the stage of being economically competitive with alternative sources of energy, and it would appear that we are now reaching that goal - though more slowly than had been envisaged ten years ago

  18. Ten successful years

    DEFF Research Database (Denmark)

    Enehaug, Heidi

    2017-01-01

    The article examines three concepts closely related to the Nordic sociotechnical tradition: responsible autonomy, learning, and control. The longitudinal case study analyses the implementation of a 6-hour workday and the development of responsible autonomy, employee control, and productive organi...

  19. Von Blüten, Göttern und Gelehrten

    OpenAIRE

    Zotter, Astrid

    2013-01-01

    Der Sanskrittext Puṣpacintāmaṇi (PuCi) behandelt Blüten als Darbringungen (upacāra) im wichtigsten hinduistischen Verehrungsritual, der pūjā. In ca. 400 Strophen werden über 200 Namen von Blüten genannt und für verschiedene Gottheiten und pūjās als geeignete oder ungeeignete Gaben vorgeschrieben. Der Text ist eine Kompilation (Nibandha), in der die Inhalte aus 47 namentlich genannten Quellentexten referiert werden. Ziel der Dissertation ist es nicht nur, diesen Text, der 1966 zum ersten Ma...

  20. The reliability and validity of self-reported reproductive history and obstetric morbidity amongst birth to ten mothers in Soweto

    Directory of Open Access Journals (Sweden)

    GTH Ellison

    2000-09-01

    Full Text Available Objective: To assess whether self-reports of reproductive history and obstetric morbidity provide an accurate basis for clinical decision-making. Setting, participants and methods: Self-reports of maternal age and reproductive history, together with clinical measurements of five medical disorders, were abstracted from the obstetric notes of 517 mothers whose children were enrolled in the Birth to Ten study. These data were compared to self-reported information collected by interview during the Birth to Ten study. Findings: The reliability of self-reported age and gravidity was high (R=0.810-0.993, yet self-reports of previous miscarriages, terminations, premature- and stillbirths were only fairly reliable (Kappa=0.48-0.50. Self-reported diabetes and high blood pressure had specificities of more than 95% for glycosuria, hypertension and pre-eclampsia. However, the specificity of self-reported oedema for hypertensive disorders and the specificity of self-reported urinary tract infection for STD seropositivity were only around 65%. Conclusions: The modest reliability and limited validity of self-reported obstetric morbidity undermines the clinical utility of this information. Recommendations: These results strengthen the case for providing mothers with “Home-based Maternal Records” to facilitate access to accurate obstetric information during subsequent clinical consultations.

  1. Pessimism and the risk for coronary heart disease among middle-aged and older Finnish men and women: a ten-year follow-up study.

    Science.gov (United States)

    Pänkäläinen, Mikko T; Kerola, Tuomas V; Hintikka, Jukka J

    2015-10-02

    Despite the growth in knowledge about coronary heart disease (CHD) risk factors, and the advances made in preventing and treating them, the incidence of CHD is still notably quite high. Research has concentrated on the physiological factors that present risks for CHD, but there is an increasing amount of evidence for the connection of mental health, personal traits and CHD. Data on the connection of disposition (optimism or pessimism) and CHD are relatively scarce. The aim of this study was to investigate the long-term connection between optimism, pessimism and the risk for having CHD. This was a ten-year prospective cohort study on a regional sample of three cohorts aged 52-56, 62-66 and 72-76 years at baseline (N = 2815). The study groups were personally interviewed four times (in 2002, 2005, 2008 and 2012). The revised Life Orientation Test (LOT-R) was completed at the first appointment to determine the level of dispositional optimism or pessimism. During the ten-year follow-up, the incidence of new cases of coronary heart diseases was measured. The association between dispositional optimism/pessimism and the incidence of CHD during the follow-up was studied with logistic regression. Those who developed coronary heart disease during the ten-year follow-up were significantly more pessimistic at baseline than the other subjects. Using multivariate logistic regression models separately for men and women, we noticed no elevated risk for CHD in the pessimistic women compared to the non-pessimistic women. However, among men in the highest quartile of pessimism, the risk for CHD was approximately four-fold (OR 4.11, 95 % CI 1.68-11.04) that of the men in the lowest quartile. Optimism did not seem to have any role in the risk for developing CHD. Our main finding is that pessimism seemed to be a clear risk factor for coronary heart disease in men even after adjusting for classical well-known risk factors while optimism did not seem to be a protective factor

  2. Case-control studies in neurosurgery.

    Science.gov (United States)

    Nesvick, Cody L; Thompson, Clinton J; Boop, Frederick A; Klimo, Paul

    2014-08-01

    Observational studies, such as cohort and case-control studies, are valuable instruments in evidence-based medicine. Case-control studies, in particular, are becoming increasingly popular in the neurosurgical literature due to their low cost and relative ease of execution; however, no one has yet systematically assessed these types of studies for quality in methodology and reporting. The authors performed a literature search using PubMed/MEDLINE to identify all studies that explicitly identified themselves as "case-control" and were published in the JNS Publishing Group journals (Journal of Neurosurgery, Journal of Neurosurgery: Pediatrics, Journal of Neurosurgery: Spine, and Neurosurgical Focus) or Neurosurgery. Each paper was evaluated for 22 descriptive variables and then categorized as having either met or missed the basic definition of a case-control study. All studies that evaluated risk factors for a well-defined outcome were considered true case-control studies. The authors sought to identify key features or phrases that were or were not predictive of a true case-control study. Those papers that satisfied the definition were further evaluated using the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) checklist. The search detected 67 papers that met the inclusion criteria, of which 32 (48%) represented true case-control studies. The frequency of true case-control studies has not changed with time. Use of odds ratios (ORs) and logistic regression (LR) analysis were strong positive predictors of true case-control studies (for odds ratios, OR 15.33 and 95% CI 4.52-51.97; for logistic regression analysis, OR 8.77 and 95% CI 2.69-28.56). Conversely, negative predictors included focus on a procedure/intervention (OR 0.35, 95% CI 0.13-0.998) and use of the word "outcome" in the Results section (OR 0.23, 95% CI 0.082-0.65). After exclusion of nested case-control studies, the negative correlation between focus on a procedure

  3. Kaluza-Klein supergravity in ten dimensions

    International Nuclear Information System (INIS)

    Huq, M.; Namazie, M.A.

    1983-11-01

    We construct a massive version of N=2 supergravity in ten dimensions by compactification of the eleven dimensional, N=1 theory. This theory describes the usual N=2 massless super-multiplet, in addition to which there is an infinite tower of massive, charged N=2 supermultiplets. (author)

  4. Ten themes of viscous liquid dynamics

    DEFF Research Database (Denmark)

    Dyre, J. C.

    2007-01-01

    Ten ‘themes' of viscous liquid physics are discussed with a focus on how they point to a general description of equilibrium viscous liquid dynamics (i.e., fluctuations) at a given temperature. This description is based on standard time-dependent Ginzburg-Landau equations for the density fields...

  5. Ten-year scheme of network development - 2013 edition

    International Nuclear Information System (INIS)

    2013-01-01

    RTE, an independent subsidiary of EDF, is the French electricity transmission system operator. It is a public service company responsible for operating, maintaining and developing the high and extra high voltage network. It guarantees the reliability and proper operation of the power network. RTE transports electricity between electricity suppliers (French and European) and consumers, whether they are electricity distributors or industrial consumers directly connected to the transmission system. The mission of RTE is to balance the electricity supply and demand in real time. With the support of the government authorities, RTE prepares a ten-year scheme of network development in France; This document presents the main electricity transport infrastructures to foresee within the ten coming years and lists the network development investments which must be realised and implemented within 3 years. The document is updated each year and comes to complement at the national level the European ten year network development plan (TYNDP) and the European regional plans as provided for in the 2009/72/CE European directive

  6. A ten year study of STD Cases in an urban clinic in Calcutta

    Directory of Open Access Journals (Sweden)

    Ghosh Sadhana

    1994-01-01

    Full Text Available Total 16440 patients attended the STD clinic during the 10 years period of study from 1984 to 1993. From 1988 number of STD caes were gradually decreasing probably due to less promiscuity in fear of AIDS and different measures taken to prevent transmission of HIV infection. But it does not lessen the importance of STD control, because syphilis is still prevalent (8% with congenital syphilis. Peak in the incidence of chancroid (15% is alarming as this may lead to increased transmission of HIV infection in near future. Male unmarried constituted the bulk of STD sufferers (44% and married males (34%, while female unmarried and married patients were 1% and 20% respectively, 5.7% of antenatal mothers were strongly seroreactive for syphilis. Therefore all antenatal mothers should be screened for STD and routine serological test for syphilis should be done.

  7. A single trial of transcutaneous electrical nerve stimulation (TENS) improves spasticity and balance in patients with chronic stroke.

    Science.gov (United States)

    Cho, Hwi-young; In, Tae Sung; Cho, Ki Hun; Song, Chang Ho

    2013-03-01

    Spasticity management is pivotal for achieving functional recovery of stroke patients. The purpose of this study was to investigate the effects of a single trial of transcutaneous electrical nerve stimulation (TENS) on spasticity and balance in chronic stroke patients. Forty-two chronic stroke patients were randomly allocated into the TENS (n = 22) or the placebo-TENS (n = 20) group. TENS stimulation was applied to the gastrocnemius for 60 min at 100 Hz, 200 µs with 2 to 3 times the sensory threshold (the minimal threshold in detecting electrical stimulation for subjects) after received physical therapy for 30 min. In the placebo-TENS group, electrodes were placed but no electrical stimulation was administered. For measuring spasticity, the resistance encountered during passive muscle stretching of ankle joint was assessed using the Modified Ashworth Scale, and the Hand held dynamometer was used to assess the resistive force caused by spasticity. Balance ability was measured using a force platform that measures postural sway generated by postural imbalance. The TENS group showed a significantly greater reduction in spasticity of the gastrocnemius, compared to the placebo-TENS group (p TENS resulted in greater balance ability improvements, especially during the eyes closed condition (p TENS provides an immediately effective means of reducing spasticity and of improving balance in chronic stroke patients. The present data may be useful to establish the standard parameters for TENS application in the clinical setting of stroke.

  8. Interest of Grade Ten Students toward Physics among Other Science Subjects, Case of Wolaita Soddo Town Governmental Secondary Schools, Ethiopia

    Science.gov (United States)

    Hamelo, Shewangzaw

    2016-01-01

    This paper has proposed to investigate the interest in students towards physics among other science subjects. The investigation was carried out with 490 samples of grade ten students in Wolaita Soddo town governmental schools. Thus, overall result indicates that the interest in students towards physics is low and students hate to learn physics in…

  9. Transcutaneous electrical nerve stimulation (TENS) improves the diabetic cytopathy (DCP) via up-regulation of CGRP and cAMP.

    Science.gov (United States)

    Ding, Liucheng; Song, Tao; Yi, Chaoran; Huang, Yi; Yu, Wen; Ling, Lin; Dai, Yutian; Wei, Zhongqing

    2013-01-01

    The objective of this study was to investigate the effects and mechanism of Transcutaneous Electrical Nerve Stimulation (TENS) on the diabetic cytopathy (DCP) in the diabetic bladder. A total of 45 rats were randomly divided into diabetes mellitus (DM)/TENS group (n=15), DM group (n=15) and control group (n=15). The rats in the DM/TENS and TENS groups were electronically stimulated (stimulating parameters: intensity-31 V, frequency-31 Hz, and duration of stimulation of 15 min) for three weeks. Bladder histology, urodynamics and contractile responses to field stimulation and carbachol were determined. The expression of calcitonin gene-related peptide (CGRP) was analyzed by RT-PCR and Western blotting. The results showed that contractile responses of the DM rats were ameliorated after 3 weeks of TENS. Furthermore, TENS significantly increased bladder wet weight, volume threshold for micturition and reduced PVR, V% and cAMP content of the bladder. The mRNA and protein levels of CGRP in dorsal root ganglion (DRG) in the DM/TENS group were higher than those in the DM group. TENS also significantly up-regulated the cAMP content in the bladder body and base compared with diabetic rats. We conclude that TENS can significantly improve the urine contractility and ameliorate the feeling of bladder fullness in DM rats possibly via up-regulation of cAMP and CGRP in DRG.

  10. Vadose Zone Journal: The first ten years

    NARCIS (Netherlands)

    Vrugt, J.A.; Or, D.; Young, M.H.

    2013-01-01

    Celebrating ten years of publication, the authors introduce a special section commemorating the anniversary of Vadose Zone Journal and reviewing the journal’s role in an evolving understanding of vadose zone science.

  11. Dosimetry results for Big Ten and related benchmarks

    International Nuclear Information System (INIS)

    Hansen, G.E.; Gilliam, D.M.

    1980-01-01

    Measured average reaction cross sections for the Big Ten central flux spectrum are given together with calculated values based on the U.S. Evaluated Nuclear Data File ENDF/B-IV. Central reactivity coefficients for 233 U, 235 U, 239 Pu, 6 Li and 10 B are given to check consistency of bias between measured and calculated reaction cross sections for these isotopes. Spectral indexes for the Los Alamos 233 U, 235 U and 239 Pu metal critical assemblies are updated, utilizing the Big Ten measurements and interassembly calibrations, and their implications for inelastic scattering are reiterated

  12. Case Study: Mini-Case Studies: Small Infusions of Active Learning for Large-Lecture Courses

    Science.gov (United States)

    Carloye, Lisa

    2017-01-01

    In this article, the author introduces the usage of case studies to be an excellent method for engaging students through stories. The author notes she developed a series of mini-case studies that can be implemented, with a little advance preparation, within a 10- to 15-minute window during lecture. What makes them "mini" case studies?…

  13. Responses of streamflow and sediment load to climate change and human activity in the Upper Yellow River, China: a case of the Ten Great Gullies Basin.

    Science.gov (United States)

    Liu, Tong; Huang, He Qing; Shao, Mingan; Yao, Wenyi; Gu, Jing; Yu, Guoan

    2015-01-01

    Soil erosion and land desertification are the most serious environmental problems globally. This study investigated the changes in streamflow and sediment load from 1964 to 2012 in the Ten Great Gullies area of the Upper Yellow River. Tests for gradual trends (Mann-Kendall test) and abrupt changes (Pettitt test) identify that significant declines in streamflow and sediment load occurred in 1997-1998 in two typical gullies. A comparison of climatic variability before and after the change points shows no statistically significant trends in annual precipitation and potential evapotranspiration. Human activities have been very active in the region and during 1990-2010, 146.01 and 197.62 km2 of land were converted, respectively, to forests and grassland, with corresponding increases of 87.56 and 77.05%. In addition, a large number of check dams have been built up in the upper reaches of the ten gullies. These measures were likely responsible for the significant decline in the annual streamflow and sediment load over the last 49 years.

  14. Coffee Drinking and Mortality in Ten European Countries – the EPIC Study

    Science.gov (United States)

    Gunter, Marc J.; Murphy, Neil; Cross, Amanda J.; Dossus, Laure; Dartois, Laureen; Fagherazzi, Guy; Kaaks, Rudolf; Kühn, Tilman; Boeing, Heiner; Aleksandrova, Krasimira; Tjønneland, Anne; Olsen, Anja; Overvad, Kim; Larsen, Sofus Christian; Cornejo, Maria Luisa Redondo; Agudo, Antonio; Pérez, María José Sánchez; Altzibar, Jone M; Navarro, Carmen; Ardanaz, Eva; Khaw, Kay-Tee; Butterworth, Adam; Bradbury, Kathryn E; Trichopoulou, Antonia; Lagiou, Pagona; Trichopoulos, Dimitrios; Palli, Domenico; Grioni, Sara; Vineis, Paolo; Panico, Salvatore; Tumino, Rosario; Bueno-de-Mesquita, Bas; Siersema, Peter; Leenders, Max; Beulens, Joline WJ; Uiterwaal, Cuno U; Wallström, Peter; Nilsson, Lena Maria; Landberg, Rikard; Weiderpass, Elisabete; Skeie, Guri; Braaten, Tonje; Brennan, Paul; Licaj, Idlir; Muller, David C; Sinha, Rashmi; Wareham, Nick; Riboli, Elio

    2018-01-01

    Background How coffee consumption relates to mortality in diverse European populations, with variable coffee preparation methods and customs, is unclear. Objectives To examine whether coffee consumption is associated with all-cause and cause-specific mortality in men and women. Design Prospective cohort study. Setting Ten European countries. Participants A total of 521,330 men and women enrolled in the European Prospective Investigation into Cancer and Nutrition (EPIC). Main outcome measure Multivariable hazard ratios (HRs) and 95% confidence intervals(CIs) estimated using multivariable Cox proportional hazards models. The association of coffee with serum biomarkers of liver function, inflammation, and metabolic health was evaluated in the EPIC Biomarkers sub-cohort (n=14,800). Results During a mean follow-up of 16.4 years, 41,693 deaths occurred. Compared with non-consumers, participants in the highest quartile of coffee consumption experienced statistically significant lower all-cause mortality (Men: HR=0.88, 95%CI: 0.82–0.95; P-trendcoffee and circulatory disease mortality, (HR=0.78, 95%CI: 0.68–0.90; P-trendcoffee and ovarian cancer mortality (HR 1.12, 95% CI: 1.02–1.23 P-trend 0.001). In the EPIC-biomarkers sub-cohort, higher coffee consumption was associated with lower serum alkaline phosphatase, alanine transaminase, aspartate transaminase, and C-reactive protein. Limitation Reverse causality may have led to spurious findings; however, results did not differ following exclusion of participants who died within 8-years of baseline. The study is also limited by a single assessment of coffee drinking habits at baseline. Conclusions These results confirm prior findings on the reduced risk of mortality associated with coffee drinking but additionally show that this relationship does not vary by country where coffee preparation and drinking habits may differ. The study also reports novel inverse relationships between coffee drinking and digestive disease

  15. BioFleet case studies

    International Nuclear Information System (INIS)

    2007-01-01

    These six case studies examined the use of different biodiesel blends as fuel supply sources for businesses in British Columbia (BC). In the first case study, 6 municipalities participated in a pilot program designed to compare the performance of biodiesel and diesel fuels. Each municipality operated 2 base vehicles running on conventional diesel along with 2 similar vehicles which used biodiesel. Real time emissions tests and analyses of the vehicles using biodiesel were also conducted by 2 of the participating municipalities. All municipalities participating in the study agreed to purchase significant volumes of biodiesel. The second case study described a pilot study conducted by the City of Vancouver's equipment services branch in 2004. As a result of the study, the city now has over 530 types of equipment that use biodiesel. The third case study described a program designed by TSI Terminals in Vancouver to assess the emission reduction impact of using biodiesel at its port facility. Six different pieces of equipment were used to confirm that biodiesel could be used throughout the terminal. Test results confirmed that biodiesel blends could be used to reduce emissions. Overall emissions were reduced by 30 per cent. The fourth case study described a waste renderer that used a fleet of 36 trucks to deliver raw products to its plants. The company made the decision to use only biodiesel for its entire fleet of trucks. Since July 2005, the company has logged over 1.7 million km using biodiesel blends. The fifth case study described a salmon hatchery that switched from diesel to biodiesel in order to reduce emissions. The biodiesel blends are used to fuel the hatchery's 2 diesel generators. The hatchery has reduced emissions of greenhouse gases (GHGs) by an estimated 1800 tonnes annually. The sixth case study described how the Township of Langley has started using biodiesel for its entire fleet of of approximately 250 pieces of equipment. The township has not

  16. Termination of pregnancy among very preterm births and its impact on very preterm mortality : results from ten European population-based cohorts in the MOSAIC study

    NARCIS (Netherlands)

    Papiernik, E.; Zeitlin, J.; Delmas, D.; Draper, E. S.; Gadzinowski, J.; Kuenzel, W.; Cuttini, M.; Di Lallo, D.; Weber, T.; Kollee, L.; Bekaert, A.; Breart, G.

    Objective To study the impact of terminations of pregnancy (TOP) on very preterm mortality in Europe. Design European prospective population-based cohort study. Setting Ten regions from nine European countries participating in the MOSAIC (Models of OrganiSing Access to Intensive Care for very

  17. Immediate effects of tongue trills associated with transcutaneous electrical nerve stimulation (TENS).

    Science.gov (United States)

    Fabron, Eliana Maria Gradim; Petrini, Andressa Schweitzer; Cardoso, Vanessa de Moraes; Batista, João Carlos Torgal; Motonaga, Suely Mayumi; Marino, Viviane Cristina de Castro

    2017-06-08

    To investigate vocal quality variability after applying tongue trills associated with transcutaneous electrical nerve stimulation (TENS) on the larynx of women with normal laryngeal function. Additionally, to verify the effect of this technique over time on voice quality. Participants were 40 women (average 23.4 years) without vocal complaints. The procedure involved tongue trills with or without TENS for 3 minutes, rest and repeating the technique for another 2 minutes. The participants' voices were recorded before (Pre), after three minutes (Post 3min) and after two additional minutes (Post 5min) applying the technique. TENS with two electrodes was used on the thyroid cartilage. Self-assessment, acoustic and perceptual analysis were performed. When comparing tongue trills in isolation and associated with TENS, a greater sense of stability in phonation (self-assessment) and improvement in voice quality (perceptual evaluation) was observed in the combination technique. There was no statistical difference in acoustics findings between tongue trills in isolation and associated with TENS. When comparing the time effect of tongue trills with TENS in self-assessment there was a perception of less muscle tension (3min) and greater comfort during phonation (5 min); in the acoustic analysis, there was an increase of F0 (3 and 5 min) and intensity (5 min) when compared to Pre-moment; in the perceptual evaluation, better voice quality (3min). Comparing tongue trills in isolation and associated with TENS, there were changes in the comfort and muscle tension perception, as well as in vocal quality. On the other hand, tongue trills associated with TENS performed in 3 or 5 minutes resulted in beneficial effects on the voice identified in the assessments.

  18. Verhalen sprokkelen langs de frontlijn. Een kritische blik op Ten Oorlog

    Directory of Open Access Journals (Sweden)

    Hans Boers

    2015-03-01

    Full Text Available Gathering Stories along the Front: A Critical Look at Ten Oorlog [To War]This article reflects critically on the popular television programme Ten Oorlog, thereby examining the field of tension between history and entertainment, between historians and ‘the public’. History can be addressed via various television formats as an historical documentary or a travel programme. An analysis indicates the extent to which Ten Oorlog is inspired by these formats. However, the popular television programme from the outset was not conceived as a classic historical documentary and perhaps can best be described as a historical human interest programme as part of the large-scale commemoration of the First World War. How do history and entertainment relate to one another in this programme? Is there more emphasis on the historical context or on anecdotal stories? This analysis of Ten Oorlog illustrates the tense relation between historians and ‘the public’.Dit artikel werpt een kritische blik op het populaire televisieprogramma Ten Oorlog en gaat daarbij in op het spanningsveld tussen geschiedenis en entertainment, tussen historici en ‘het publiek’. Geschiedenis kan via verschillende formats zoals een historische documentaire of een reisprogramma aan bod komen op televisie. Een analyse van deze formats geeft aan in welke mate Ten Oorlog hierop geïnspireerd is. Het populaire televisieprogramma was echter van begin af aan niet als een klassieke historische documentaire bedoeld en kan misschien het bestomschreven worden als een historisch human interest programma, in het kader van de grootschalige herdenking van de Eerste Wereldoorlog. Hoe verhoudengeschiedenis en entertainment zich daarin? Helt de balans meer over naar historische omkadering of naar anekdotische verhalen? Deze analyse van Ten Oorlog illustreert de gespannen relatie tussen historici en het grote publiek.

  19. Taste intensities of ten vegetables commonly consumed in the Netherlands.

    Science.gov (United States)

    van Stokkom, V L; Teo, P S; Mars, M; de Graaf, C; van Kooten, O; Stieger, M

    2016-09-01

    Bitterness has been suggested to be the main reason for the limited palatability of several vegetables. Vegetable acceptance has been associated with preparation method. However, the taste intensity of a variety of vegetables prepared by different methods has not been studied yet. The objective of this study is to assess the intensity of the five basic tastes and fattiness of ten vegetables commonly consumed in the Netherlands prepared by different methods using the modified Spectrum method. Intensities of sweetness, sourness, bitterness, umami, saltiness and fattiness were assessed for ten vegetables (cauliflower, broccoli, leek, carrot, onion, red bell pepper, French beans, tomato, cucumber and iceberg lettuce) by a panel (n=9) trained in a modified Spectrum method. Each vegetable was assessed prepared by different methods (raw, cooked, mashed and as a cold pressed juice). Spectrum based reference solutions were available with fixed reference points at 13.3mm (R1), 33.3mm (R2) and 66.7mm (R3) for each taste modality on a 100mm line scale. For saltiness, R1 and R3 differed (16.7mm and 56.7mm). Mean intensities of all taste modalities and fattiness for all vegetables were mostly below R1 (13.3mm). Significant differences (p<0.05) within vegetables between preparation methods were found. Sweetness was the most intensive taste, followed by sourness, bitterness, fattiness, umami and saltiness. In conclusion, all ten vegetables prepared by different methods showed low mean intensities of all taste modalities and fattiness. Preparation method affected taste and fattiness intensity and the effect differed by vegetable type. Copyright © 2016 Elsevier Ltd. All rights reserved.

  20. CLINICAL-EVALUATION OF PAIN TREATMENT WITH ELECTROSTIMULATION - A STUDY OF TENS IN PATIENTS WITH DIFFERENT PAIN SYNDROMES

    NARCIS (Netherlands)

    MEYLER, WJ; DEJONGSTE, MJL; ROLF, CAM

    Objective: We evaluated the clinical efficacy and the unwanted side effects of transcutaneous electrical nerve stimulation (TENS) in a consecutive group of patients with intractable pain due to different pain syndromes. Methods: Two hundred eleven patients with different pain syndromes, coded

  1. A Ten Year Retrospective on Environmental Justice: What Have We Learned?

    International Nuclear Information System (INIS)

    Scott, Michael J.; Jaksch, John A.; Cort, Katherine A.

    2005-01-01

    Beginning in 1994, Executive Order 12898 has directed federal executive agencies to identify and address, as appropriate, disproportionately high and adverse health or environmental effects of their programs, policies, and activities on minority and low income populations. The policy behind the Executive Order was to prevent minority and low income groups from bearing disproportionate adverse environmental consequences of federal actions. During the last ten years, federal agencies have implemented Executive Order 12898, and some also have developed explicit procedures or guidance for the steps that need to be taken during the preparation of environmental impact statements. Based on the authors experience, the paper examines how environmental justice practice has evolved in the ten years since the original Executive Order was issued. This evolution has been both procedural and substantive. The paper examines how the actual practice of environmental justice analysis has progressed in federal agencies that deal with waste management issues. Reference is made to changes in case law and agency practice. The 2000 Census of Population and the ongoing development of geographic information systems in particular have made it easier to identify minority and low-income populations at risk. At the same time, a number of stakeholder groups have taken positions over specific federal actions that have given rise to novel issues and challenges for analysts. The paper discusses how NEPA practice is evolving to deal with these issues and challenges

  2. Developing and pilot testing of a tool for "clinicosocial case study" assessment of community medicine residents.

    Science.gov (United States)

    Gohel, Manisha; Singh, Uday Shankar; Bhanderi, Dinesh; Phatak, Ajay

    2016-01-01

    Practical and clinical skills teaching should constitute a core part of the postgraduate curriculum of Community Medicine. The clinicosocial case study is a method to enhance learners' skills but there is no generally accepted organized system of formative assessment and structured feedback to guide students. A new tool based on the principles of mini-Clinical Evaluation Exercise (mini CEX) was developed and pilot tested as a 'clinicosocial case study' assessment of community medicine residents with feedback as a core component. Ten core domains of clinicosocial skills were identified after reviewing the relevant literature and input from local experts in community medicine and medical education. We pilot tested the tool with eight faculty members to assess five residents during clinicosocial case presentations on a variety of topics. Kappa statistic and Bland Altman plots were used to assess agreement between faculty members' average assessment scores. Cronbach's alpha was used to test the internal consistency with faculty members as domains. All 95% confidence limits using the Bland-Altman method were within the predetermined limit of 2 points. The overall Kappa between two faculty members was fair ranging from 0.2 to 0.3. Qualitative feedback revealed that both faculty and residents were enthusiastic about the process but faculty suggested further standardization, while residents suggested streamlining of the process. This new assessment tool is available for objective and unbiased assessment of residents through 'clinicosocial case study,' which enriches learning through comprehensive feedback. Further validation in different settings is needed.

  3. The Ultrastructure Of Pollinia Of Ten Species Of Orchid In Substribe Aeridinae (ORCHIDACEAE)

    International Nuclear Information System (INIS)

    Sulistyono; Purbaningsih, Susiani; Pujoarianto, Agus

    2000-01-01

    Orchid taxonimy lags several decades behind the taxonomy of most other large interisting groups of plants. New methods and techiniques, like scanning and transmission electron microscope are rarely applied in orchid's taxonomy. It would be most benefical to orchid taxonomy if a better understanding of the pollinia could be obtained. The main purpose of this research is to study the ultrastructure pollinia of ten species of Aeridinae (Orchidaceae). The scanning electron microscope (SEM) has been used to study the pollinia of ten species of orchids in the substribe Aeridina. This work shows that the ultrastructure of the pollinias are different. Regarding at the number and the surface of pollinia in one flowe, the ten species of Aeridinae can be devided mto three main group: (1) the first group is the flowe with two pollinia with it surface porate : Ascocentrum miniatum; (2) the second group has the same number of pollinia, but with surface cleft : Phalaenopsis. Ph. amboinensis, Ph.cornu-cervi, Ph. Fuscata, Ph. Venosa, Rhychostylis retusa, Vanda limbota, and Vanda insignis: and the third (3)is the flower with four pollinia, unequel : Kingidium deliciosum

  4. Bayesian approach to the assessment of the population-specific risk of inhibitors in hemophilia A patients: a case study

    Directory of Open Access Journals (Sweden)

    Cheng J

    2016-10-01

    significant inhibitor (10/100, 5/100 [high rates], and 1/86 [the Food and Drug Administration mandated cutoff rate in PTPs] were calculated. The effect of discounting prior information or scaling up the study data was evaluated.Results: Results based on noninformative priors were similar to the classical approach. Using priors from PTPs lowered the point estimate and narrowed the 95% credible intervals (Case 1: from 1.3 [0.5, 2.7] to 0.8 [0.5, 1.1]; Case 2: from 1.9 [0.6, 6.0] to 0.8 [0.5, 1.1]; Case 3: 2.3 [0.5, 6.8] to 0.7 [0.5, 1.1]. All probabilities of satisfying a threshold of 1/86 were above 0.65. Increasing the number of patients by two and ten times substantially narrowed the credible intervals for the single cohort study (1.4 [0.7, 2.3] and 1.4 [1.1, 1.8], respectively. Increasing the number of studies by two and ten times for the multiple study scenarios (Case 2: 1.9 [0.6, 4.0] and 1.9 [1.5, 2.6]; Case 3: 2.4 [0.9, 5.0] and 2.6 [1.9, 3.5], respectively had a similar effect.Conclusion: Bayesian approach as a robust, transparent, and reproducible analytic method can be efficiently used to estimate the inhibitor rate of hemophilia A in complex clinical settings. Keywords: inhibitor rate, meta-analysis, multicentric study, Bayesian, hemophilia A

  5. MINI REVIEW ARTICLE:Immunohistochemistry of Epithelioid Soft Tissue Sarcomas, Literature Review Based on Case Studies

    Directory of Open Access Journals (Sweden)

    Megha Joshi

    2012-07-01

    Full Text Available Neoplasms with epithelioid histology may be diagnostically challenging. Immunohisto chemistry (IHC can aid in confirming thedifferential diagnosis of mesotheliomas, melanomas, lymphomas, and soft tissue sarcomas, all tumors that can present with an epithelioid histology. Immunohistochemistry can also assist in confirming the type of sarcomas. Using cases diagnosed in acommunity hospital setting over a ten year period, the use of IHC in sarcomas will be illustrated.

  6. Describing Case Study Method and Identifying the Factors that Contribute to the Successful Conduct of Case Studies

    OpenAIRE

    Ahmad H. Juma'h; Mustafa Cavus

    2001-01-01

    This article has attempted to describe case study, the limitations and critiques on case study methodology and how the proponents have responded to these. Our special focus have been on the debate on theory building from case study research, and a framework for conducting case study research as well as the factors for a successful case study research. The overall conclusion is that the case study has been inappropriately used to generate theories.

  7. Effective science teaching in a high poverty middle school: A case study

    Science.gov (United States)

    Meyer, Georgette Wright

    This qualitative case study described the characteristics of science teachers in a high poverty urban middle school whose 2010 scores on South Carolina's Palmetto Assessment of State Standards (PASS) ranked second in the state. Data was obtained through classroom observations, open-ended interviews, school documents, and photographs taken inside the school from ten participants, who were seven science teachers, a science coach, and two administrators. Findings revealed a school culture that pursued warm and caring relationships with students while communicating high expectations for achievement, strong central leadership who communicated their vision and continuously checked for its implementation through informal conversations, frequent classroom observations, and test score analysis. A link between participants' current actions and their perception of prior personal and professional experiences was found. Participants related their classroom actions to the lives of the students outside of school, and evidenced affection for their students.

  8. The timing of drug funding announcements relative to elections: a case study involving dementia medications.

    Directory of Open Access Journals (Sweden)

    Sudeep S Gill

    Full Text Available Following initial regulatory approval of prescription drugs, many factors may influence insurers and health systems when they decide whether to add these drugs to their formularies. The role of political pressures on drug funding announcements has received relatively little attention, and elections represent an especially powerful form of political pressure. We examined the temporal relationship between decisions to add one class of drugs to publicly funded formularies in Canada's ten provinces and elections in these jurisdictions.Dates of provincial formulary listings for cholinesterase inhibitors, which are drugs used to treat Alzheimer's disease and related dementias, were compared to the dates of provincial elections. Medical journal articles, media reports, and proceedings from provincial legislatures were reviewed to assemble information on the chronology of events. We tested whether there was a statistically significant increase in the probability of drug funding announcements within the 60-day intervals preceding provincial elections.Decisions to fund the cholinesterase inhibitors were made over a nine-year span from 1999 to 2007 in the ten provinces. In four of ten provinces, the drugs were added to formularies in a time period closely preceding a provincial election (P = 0.032; funding announcements in these provinces were made between 2 and 47 days prior to elections. Statements made in provincial legislatures highlight the key role of political pressures in these funding announcements.Impending elections appeared to affect the timing of drug funding announcements in this case study. Despite an established structure for evidence-based decision-making, drug funding remains a complex process open to influence from many sources. Awareness of such influences is critical to maintain effective drug policy and public health decision-making.

  9. The timing of drug funding announcements relative to elections: a case study involving dementia medications.

    Science.gov (United States)

    Gill, Sudeep S; Gupta, Neeraj; Bell, Chaim M; Rochon, Paula A; Austin, Peter C; Laupacis, Andreas

    2013-01-01

    Following initial regulatory approval of prescription drugs, many factors may influence insurers and health systems when they decide whether to add these drugs to their formularies. The role of political pressures on drug funding announcements has received relatively little attention, and elections represent an especially powerful form of political pressure. We examined the temporal relationship between decisions to add one class of drugs to publicly funded formularies in Canada's ten provinces and elections in these jurisdictions. Dates of provincial formulary listings for cholinesterase inhibitors, which are drugs used to treat Alzheimer's disease and related dementias, were compared to the dates of provincial elections. Medical journal articles, media reports, and proceedings from provincial legislatures were reviewed to assemble information on the chronology of events. We tested whether there was a statistically significant increase in the probability of drug funding announcements within the 60-day intervals preceding provincial elections. Decisions to fund the cholinesterase inhibitors were made over a nine-year span from 1999 to 2007 in the ten provinces. In four of ten provinces, the drugs were added to formularies in a time period closely preceding a provincial election (P = 0.032); funding announcements in these provinces were made between 2 and 47 days prior to elections. Statements made in provincial legislatures highlight the key role of political pressures in these funding announcements. Impending elections appeared to affect the timing of drug funding announcements in this case study. Despite an established structure for evidence-based decision-making, drug funding remains a complex process open to influence from many sources. Awareness of such influences is critical to maintain effective drug policy and public health decision-making.

  10. 42 CFR 414.232 - Special payment rules for transcutaneous electrical nerve stimulators (TENS).

    Science.gov (United States)

    2010-10-01

    ... nerve stimulators (TENS). 414.232 Section 414.232 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES... Special payment rules for transcutaneous electrical nerve stimulators (TENS). (a) General payment rule. Except as provided in paragraph (b) of this section, payment for TENS is made on a purchase basis with...

  11. Incidence of cancer in children residing in ten jurisdictions of the Mexican Republic: importance of the Cancer registry (a population-based study)

    International Nuclear Information System (INIS)

    Fajardo-Gutiérrez, Arturo; Juárez-Ocaña, Servando; González-Miranda, Guadalupe; Palma-Padilla, Virginia; Carreón-Cruz, Rogelio; Ortega-Alvárez, Manuel Carlos; Mejía-Arangure, Juan Manuel

    2007-01-01

    In 1996, Mexico started to register cases of childhood cancer. Here, we describe the incidence of cancer in children, residing in ten Mexican jurisdictions, who were treated by the Instituto Mexicano del Seguro Social (IMSS). New cases of childhood cancer, which were registered prospectively in nine principal Medical Centers of IMSS during the periods 1998–2000 (five jurisdictions) and 1996–2002 (five jurisdictions), were analyzed. Personnel were specifically trained to register, capture, and encode information. For each of these jurisdictions, the frequency, average annual age-standardized incidence (AAS) and average annual incidence per period by sex and, age, were calculated (rates per 1,000,000 children/years). In total 2,615 new cases of cancer were registered, with the male/female ratio generally >1, but in some tumors there were more cases in females (retinoblastoma, germ cells tumors). The principal groups of neoplasms in seven jurisdictions were leukemias, central nervous system tumors (CNS tumors), and lymphomas, and the combined frequency for these three groups was 62.6 to 77.2%. Most frequently found (five jurisdictions) was the North American-European pattern (leukemias-CNS tumors-lymphomas). Eight jurisdictions had AAS within the range reported in the world literature. The highest incidence was found for children underless than five year of age. In eight jurisdictions, leukemia had high incidence (>50). The AAS of lymphomas was between 1.9 to 28.6. Chiapas and Guerrero had the highest AAS of CNS tumors (31.9 and 30.3, respectively). The frequency and incidence of neuroblastoma was low. Chiapas had the highest incidence of retinoblastoma (21.8). Germ-cell tumors had high incidence. The North American-European pattern of cancers was the principal one found; the overall incidence was within the range reported worldwide. In general but particularly in two jurisdictions (Yucatán and Chiapas), it will be necessary to carry out studies concerning the

  12. Effect of Nock-Ten Tropical Cyclone on Atmospheric Condition and Distribution of Rainfall in Gorontalo, Ternate, and Sorong Regions

    Science.gov (United States)

    Lumbangaol, A.; Serhalawan, Y. R.; Endarwin

    2017-12-01

    Nock-Ten Tropical Cyclone is an atmospheric phenomenon that has claimed many lives in the Philippines. This super-typhoon cyclone grows in the Western Pacific Ocean, North of Papua. With the area directly contiguous to the trajectory of Nock-Ten Tropical Cyclone growth, it is necessary to study about the growth activity of this tropical cyclones in Indonesia, especially in 3 different areas, namely Gorontalo, Ternate, and Sorong. This study was able to determine the impact of Nock-Ten Tropical Cyclone on atmospheric dynamics and rainfall growth distribution based on the stages of tropical cyclone development. The data used in this study include Himawari-8 IR channel satellite data to see the development stage and movement track of Tropical Cyclone Nock-Ten, rainfall data from TRMM 3B42RT satellite product to know the rain distribution in Gorontalo, Ternate, and Sorong, and reanalysis data from ECMWF such as wind direction and speed, vertical velocity, and relative vorticity to determine atmospheric conditions at the time of development of the Nock-Ten Tropical Cyclone. The results of data analysis processed using GrADS application showed the development stage of Nock-Ten Tropical Cyclone has effect of changes in atmospheric dynamics condition and wind direction pattern. In addition, tropical cyclones also contribute to very light to moderate scale intensity during the cycle period of tropical cyclone development in all three regions.

  13. How To Set Up Your Own Small Business. Service Company Case Study. Manufacturing Firm Case Study. Retail Store Case Study.

    Science.gov (United States)

    Fallek, Max

    This collection of case studies is intended for use in a course in setting up a small business. The first, a case study of the process of setting up a service company, covers analyzing the pros and cons of starting one's own business, assessing the competition and local market, and selecting a site for and financing the business. The principal…

  14. Decreased Opioid Utilization and Cost at One Year in Chronic Low Back Pain Patients Treated with Transcutaneous Electric Nerve Stimulation (TENS).

    Science.gov (United States)

    Pivec, Robert; Minshall, Michael E; Mistry, Jaydev B; Chughtai, Morad; Elmallah, Randa K; Mont, Michael A

    2015-11-01

    Chronic low back pain (CLBP) may be treated without opioids through the use of transcutaneous electrical nerve stimulation (TENS). However, no study has evaluated its clinical effect and economic impact as measured by opioid utilization and costs. The purpose of this study was to evaluate patients who were given TENS for CLBP compared to a matched group without TENS at one-year follow-up, to determine differences between opioid consumption. Opioid utilization and costs in patients who did and did not receive TENS were extracted from a Medicare supplemental administrative claims database. Patients were selected if they had at least two ICD-9-CM coded claims for low back pain in a three-month period and were then propensity score matched at a 1:1 ratio between patients who received TENS and those who did not. There were 22,913 patients in each group who had a minimum follow-up of one year. There were no significant demographic or comorbidity differences with the exception that TENS patients had more episodes of back pain. Significantly fewer patients in the TENS group required opioids at final follow-up (57.7 vs. 60.3%). TENS patients also had significantly fewer annual per-patient opioid costs compared to non-TENS patients ($169 vs. $192). There were significantly lower event rates in TENS patients compared to non-TENS patients when measured by opioid utilization (characterized by frequency of prescription refills) (3.82 vs. 4.08, respectively) or pharmacy utilization (31.67 vs. 32.25). The TENS group also demonstrated a significantly lower cost of these utilization events ($44 vs. $49) and avoided more opioid events (20.4 events fewer per 100 patients annually). Treatment of CLBP with TENS demonstrated significantly fewer patients requiring opioids, fewer events where a patient required an opioid prescription, and lower per-patient costs. Since TENS is both non-invasive and a non-narcotic, it may potentially allow physicians to be more aggressive in treating CLBP

  15. Theory Testing Using Case Studies

    DEFF Research Database (Denmark)

    Møller, Ann-Kristina Løkke; Dissing Sørensen, Pernille

    2014-01-01

    The appropriateness of case studies as a tool for theory testing is still a controversial issue, and discussions about the weaknesses of such research designs have previously taken precedence over those about its strengths. The purpose of the paper is to examine and revive the approach of theory...... testing using case studies, including the associated research goal, analysis, and generalisability. We argue that research designs for theory testing using case studies differ from theorybuilding case study research designs because different research projects serve different purposes and follow different...... research paths....

  16. Enhancement of Entrepreneurial Leadership: A Case Focusing on a Model of Successful Conflict Management Skills

    Science.gov (United States)

    Leffel, Anita; Hallam, Cory; Darling, John

    2012-01-01

    The purpose of this paper is to present a case study focusing on a new technology start-up firm, founded by two graduate students, an engineer and a business major, who met during their university studies. The case is timely, in that only ten percent of new product introductions result in a profitable business. The causes of failure are numerous…

  17. Emission properties of Sm(III) complex having ten-coordination structure

    International Nuclear Information System (INIS)

    Hasegawa, Yasuchika; Tsuruoka, Shin-ichi; Yoshida, Takahiko; Kawai, Hideki; Kawai, Tsuyoshi

    2008-01-01

    Sammarium(III) complex having ten-coordination structure, bis-(1,10-phenanthroline)tris-(hexafluoroacetylacetonato)samarium(III) (Sm(hfa) 3 (phen) 2 ) was prepared by chelation of tris-(hexafluoroacetylacetonato) samarium(III) (Sm(hfa) 3 (H 2 O) 2 ) with 1,10-phenantroline (phen). The characteristic ten-coordination structure of Sm(hfa) 3 (phen) 2 was determined by 1 H NMR and elemental analyses. Strong deep-red emission (λ max =643 nm) and narrow emission band (FWHM=5 nm) of Sm(hfa) 3 (phen) 2 originated from electronic allowed transition from characteristics ten coordinate structure. The emission quantum yields Sm(hfa) 3 (phen) 2 excited at absorption bands of ligands and Sm(III) ion were found to be 0.36 and 1.4%, respectively

  18. Transcutaneous electrical nerve stimulation (TENS) for phantom pain and stump pain following amputation in adults.

    Science.gov (United States)

    Johnson, Mark I; Mulvey, Matthew R; Bagnall, Anne-Marie

    2015-08-18

    This is the first update of a Cochrane review published in Issue 5, 2010 on transcutaneous electrical nerve stimulation (TENS) for phantom pain and stump pain following amputation in adults. Pain may present in a body part that has been amputated (phantom pain) or at the site of amputation (stump pain), or both. Phantom pain and stump pain are complex and multidimensional and the underlying pathophysiology remains unclear. The condition remains a severe burden for those who are affected by it. The mainstay treatments are predominately pharmacological, with increasing acknowledgement of the need for non-drug interventions. TENS has been recommended as a treatment option but there has been no systematic review of available evidence. Hence, the effectiveness of TENS for phantom pain and stump pain is currently unknown. To assess the analgesic effectiveness of TENS for the treatment of phantom pain and stump pain following amputation in adults. For the original version of the review we searched the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, EMBASE, PsycINFO, AMED, CINAHL, PEDRO and SPORTDiscus (February 2010). For this update, we searched the same databases for relevant randomised controlled trials (RCTs) from 2010 to 25 March 2015. We only included RCTs investigating the use of TENS for the management of phantom pain and stump pain following an amputation in adults. Two review authors independently assessed trial quality and extracted data. We planned that where available and appropriate, data from outcome measures were to be pooled and presented as an overall estimate of the effectiveness of TENS. In the original review there were no RCTs that examined the effectiveness of TENS for the treatment of phantom pain and stump pain in adults. For this update, we did not identify any additional RCTs for inclusion. There were no RCTs to judge the effectiveness of TENS for the management of phantom pain and stump pain. The published literature on TENS

  19. Theory testing using case studies

    DEFF Research Database (Denmark)

    Dissing Sørensen, Pernille; Løkke Nielsen, Ann-Kristina

    2006-01-01

    on the strengths of theory-testing case studies. We specify research paths associated with theory testing in case studies and present a coherent argument for the logic of theoretical development and refinement using case studies. We emphasize different uses of rival explanations and their implications for research...... design. Finally, we discuss the epistemological logic, i.e., the value to larger research programmes, of such studies and, following Lakatos, conclude that the value of theory-testing case studies lies beyond naïve falsification and in their contribution to developing research programmes in a progressive......Case studies may have different research goals. One such goal is the testing of small-scale and middle-range theories. Theory testing refers to the critical examination, observation, and evaluation of the 'why' and 'how' of a specified phenomenon in a particular setting. In this paper, we focus...

  20. Humanities and Social Sciences Books of Ten National Disciplinary Associations, 2000-2009

    Science.gov (United States)

    Wiberley, Stephen E., Jr.

    2016-01-01

    Books are the most important medium of communication in the humanities, a major medium in the social sciences, and a central component of academic library collections. This study examined humanities and social sciences books that won prizes from ten leading United States disciplinary associations between 2000 and 2009. The study extends earlier…

  1. Five Misunderstandings About Case-Study Research

    DEFF Research Database (Denmark)

    Flyvbjerg, Bent

    2006-01-01

    This article examines five common misunderstandings about case-study research: (a) theoretical knowledge is more valuable than practical knowledge; (b) one cannot generalize from a single case, therefore, the single-case study cannot contribute to scientific development; (c) the case study is most...... useful for generating hypotheses, whereas other methods are more suitable for hypotheses testing and theory building; (d) the case study contains a bias toward verification; and (e) it is often difficult to summarize specific case studies. This article explains and corrects these misunderstandings one...

  2. Ten per cent more grain

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1967-08-15

    At a low estimate, ten per cent of stored grain is lost every year to insect pests. In this article, based on a lecture given earlier this year in Switzerland, Dr. Harry E. Goresline, Food Radiation Specialist of the Food and Agriculture Organisation, now assisting the Joint FAO/IAEA Division of Atomic Energy in Food and Agriculture, explains how use of radiation can help to prevent losses and the research which has taken place to ensure its safety

  3. High altitude pulmonary edema. Report of a case with familiar history

    International Nuclear Information System (INIS)

    Velasquez, Jurg Niederbacher; Rueda Manrique, Adriana L; Sanabria Pico, Carmen E

    1998-01-01

    We report the case of a ten years old child, who presented a high altitude pulmonary edema. His father had the same disorder ten years ago. In addition we review the physiopathology, diagnosis and management of this disease

  4. Lung Cancer Risk and Residential Exposure to Air Pollution: A Korean Population-Based Case-Control Study.

    Science.gov (United States)

    Lamichhane, Dirga Kumar; Kim, Hwan Cheol; Choi, Chang Min; Shin, Myung Hee; Shim, Young Mog; Leem, Jong Han; Ryu, Jeong Seon; Nam, Hae Seong; Park, Sung Min

    2017-11-01

    To investigate the association between long-term exposure to ambient air pollution and lung cancer incidence in Koreans. This was a population-based case-control study covering 908 lung cancer patients and 908 controls selected from a random sample of people within each Korean province and matched according to age, sex, and smoking status. We developed land-use regression models to estimate annual residential exposure to particulate matter (PM₁₀) and nitrogen dioxide (NO₂) over a 20-year exposure period. Logistic regression was used to estimate odds ratios (ORs) and their corresponding 95% confidence intervals (CI). Increases in lung cancer incidence (expressed as adjusted OR) were 1.09 (95% CI: 0.96-1.23) with a ten-unit increase in PM₁₀ (μg/m³) and 1.10 (95% CI: 1.00-1.22) with a ten-unit increase in NO₂ (ppb). Tendencies for stronger associations between air pollution and lung cancer incidence were noted among never smokers, among those with low fruit consumption, and among those with a higher education level. Air pollution was more strongly associated with squamous cell and small cell carcinomas than with adenocarcinoma of the lung. This study provides evidence that PM10 and NO₂ contribute to lung cancer incidence in Korea. © Copyright: Yonsei University College of Medicine 2017

  5. [10 cases of psychosis in Mapuche indians].

    Science.gov (United States)

    Biedermann, N; Barria, C; Maass, J; Steil, W

    1983-12-01

    Ten Mapuche indians have been studied with the purpose of observing the particularities of mental disorders in this ethnic group, composed of rural migrants. In each case a syndromatic and an etiological diagnosis has been made. Our cases correspond to six women and four men with an average age of 24.5 years. All are single with a low educational level. Our results show a great frequency of the acute oniroid psychotic syndrome. These results agree with a retrospective study made by Muñoz et al (1966) who found the same syndrome in 66.6% of their Mapuche patients against only 16.3% in non Mapuche chilean patients.

  6. TENS to the Lateral Aspect of the Knees During Stance Attenuates Postural Sway in Young Adults

    Directory of Open Access Journals (Sweden)

    Yocheved Laufer

    2007-01-01

    Full Text Available Somatosensory input is known to be essential for postural control. The present study examined the effects on postural sway of sensory input delivered via transcutaneous electrical nerve stimulation (TENS applied to the knees during stance. Electrodes from a dual-channel portable TENS unit were adhered to the skin overlying the lateral and medial aspect of both knees of 20 young healthy volunteers (mean age 24.0 years, standard deviation 4.0. Postural sway parameters were obtained during static bipedal stance with an AMTI force platform. Four stimulation conditions were tested with eyes open and with eyes closed: no TENS; TENS applied bilaterally; and TENS applied to either the right or the left knee. Participants underwent two eight-trial blocks, with each trial lasting 30 seconds. The order of conditions was randomized for each participant. Stimulation consisted of a biphasic symmetrical stimulus delivered at the sensory detection level, with a pulse duration of 200μsec and a pulse frequency of 100Hz. The application of TENS induced significant reductions in mean sway velocity and in the medio-lateral dispersion of the center of pressure, with no corresponding effect on the anterior-posterior dispersion. These findings suggest that electrical stimulation delivered at the sensory detection level to the lateral aspects of the knees may be effective in improving balance control, and that this effect may be directionally specific.

  7. Ten key issues in modern flow chemistry.

    Science.gov (United States)

    Wegner, Jens; Ceylan, Sascha; Kirschning, Andreas

    2011-04-28

    Ten essentials of synthesis in the flow mode, a new enabling technology in organic chemistry, are highlighted as flashlighted providing an insight into current and future issues and developments in this field. © The Royal Society of Chemistry 2011

  8. Ten Leading Causes of Death and Injury

    Science.gov (United States)

    ... Overdose Traumatic Brain Injury Violence Prevention Ten Leading Causes of Death and Injury Recommend on Facebook Tweet Share Compartir ... in Hospital Emergency Departments, United States – 2014 Leading Causes of Death Charts Causes of Death by Age Group 2016 [ ...

  9. Diagnosis of post-partum ovarian vein thrombophlebitis by color Doppler ultrasonography: about 10 cases.

    Science.gov (United States)

    Giraud, J R; Poulain, P; Renaud-Giono, A; Darnault, J P; Proudhon, J F; Grall, J Y; Mocquet, P Y

    1997-09-01

    Post-partum ovarian vein thrombosis is often overlooked or mistaken for other complications such as endometritis. Color Doppler ultrasonography is a very good diagnostic method when properly indicated and correctly interpreted according to clinical data. This study reports ten cases that were retrospectively studied, during which color Doppler ultrasonography was used. The clinical signs and the results are reviewed. The lesions were clearly visualized in eight of the ten cases; one of the two failures resulted from a methodological fault (uninterpretable result); the other one was due to the lack of experience of the operator and nonrecognition of the clinical signs. Thrombosis appears as a hypoechogenic and tubular image. This type of examination is particularly indicated in the presence of certain clinical signs that were observed in our cases: fever and iliac pain are the main precursor signs, often associated with abdominal meteorism and slow digestive transit; provoked cul-de-sac pain during vaginal probing was the only constant sign, sometimes associated with painful swelling.

  10. Measurement uncertainty and gauge capability of surface roughness measurements in the automotive industry: a case study

    International Nuclear Information System (INIS)

    Drégelyi-Kiss, Ágota; Czifra, Árpád

    2014-01-01

    The calculation methods of the capability of measurement processes in the automotive industry differ from each other. There are three main calculation methods: MSA, VDA 5 and the international standard, ISO 22514–7. During this research our aim was to compare the capability calculation methods in a case study. Two types of automotive parts (ten pieces of each) are chosen to examine the behaviour of the manufacturing process and to measure the required characteristics of the measurement process being evaluated. The measurement uncertainty of the measuring process is calculated according to the VDA 5 and ISO 22514–7, and MSA guidelines. In this study the conformance of a measurement process in an automotive manufacturing process is determined, and the similarities and the differences between the methods used are shown. (paper)

  11. Fuzzy-Set Case Studies

    Science.gov (United States)

    Mikkelsen, Kim Sass

    2017-01-01

    Contemporary case studies rely on verbal arguments and set theory to build or evaluate theoretical claims. While existing procedures excel in the use of qualitative information (information about kind), they ignore quantitative information (information about degree) at central points of the analysis. Effectively, contemporary case studies rely on…

  12. Promoting Breastfeeding-Friendly Hospital Practices: A Washington State Learning Collaborative Case Study.

    Science.gov (United States)

    Freney, Emily; Johnson, Donna; Knox, Isabella

    2016-05-01

    Hospital breastfeeding support practices can affect breastfeeding outcomes. Learning collaboratives are an increasingly common strategy to improve practices in health care and have been applied to breastfeeding in many cases. The aims of this study of the Evidence-Based Hospital Breastfeeding Support Learning Collaborative (EBBS LC) were to describe the perceptions of participants regarding the process and effectiveness of the EBBS LC, describe perceived barriers and facilitators to implementing the Ten Steps to Successful Breastfeeding, and identify additional actions and resources needed in future learning collaboratives. Qualitative, semistructured telephone interviews were conducted with 13 key staff who represented 16 of the 18 participating hospitals. The learning collaborative was perceived positively by participants, meeting the expectations of 9 and exceeding the expectations of 4 persons interviewed. The most beneficial aspect of the program was its collaborative nature, and the most difficult aspect was the time required to participate as well as technological difficulties. The key barriers were staff time, staff changes, cost, and the difficulty of changing the existing practices of hospitals and communities. The key facilitating factors were supportive management, participation in multiple breastfeeding quality improvement projects, collecting data on breastfeeding outcomes, tangible resources regarding the Ten Steps, and positive community response. Participants in the EBBS LC stated that they would like to see the Washington State Department of Health create a resource-rich, centralized source of information for participants. This learning collaborative approach was valued by participants. Future efforts can be guided by these evaluation findings. © The Author(s) 2015.

  13. Case Study: Guidelines for Producing Videos to Accompany Flipped Cases

    Science.gov (United States)

    Prud'homme-Généreux, Annie; Schiller, Nancy A.; Wild, John H.; Herreid, Clyde Freeman

    2017-01-01

    Three years ago, the "National Center for Case Study Teaching in Science" (NCCSTS) was inspired to merge the case study and flipped classroom approaches. The resulting project aimed to create the materials required to teach a flipped course in introductory biology by assigning videos as homework and case studies in the classroom. Three…

  14. Waiting Lists for Radiation Therapy: A Case Study

    Directory of Open Access Journals (Sweden)

    Singer Peter A

    2001-04-01

    Full Text Available Abstract Background Why waiting lists arise and how to address them remains unclear, and an improved understanding of these waiting list "dynamics" could lead to better management. The purpose of this study is to understand how the current shortage in radiation therapy in Ontario developed; the implications of prolonged waits; who is held accountable for managing such delays; and short, intermediate, and long-term solutions. Methods A case study of the radiation therapy shortage in 1998-99 at Princess Margaret Hospital, Toronto, Ontario, Canada. Relevant documents were collected; semi-structured, face-to-face interviews with ten administrators, health care workers, and patients were conducted, audio-taped and transcribed; and relevant meetings were observed. Results The radiation therapy shortage arose from a complex interplay of factors including: rising cancer incidence rates; broadening indications for radiation therapy; human resources management issues; government funding decisions; and responsiveness to previous planning recommendations. Implications of delays include poorer cancer control rates; patient suffering; and strained doctor-patient relationships. An incompatible relationship exists between moral responsibility, borne by government, and legal liability, borne by physicians. Short-term solutions include re-referral to centers with available resources; long-term solutions include training and recruiting health care workers, improving workload standards, increasing compensation, and making changes to the funding formula. Conclusion Human resource planning plays a critical role in the causes and solutions of waiting lists. Waiting lists have harsh implications for patients. Accountability relationships require realignment.

  15. Ten different hip resurfacing systems: biomechanical analysis of design and material properties.

    Science.gov (United States)

    Heisel, Christian; Kleinhans, Jennifer A; Menge, Michael; Kretzer, Jan Philippe

    2009-08-01

    This study gives an overview of the main macro- and microstructural differences of ten commercially available total hip resurfacing implants. The heads and cups of resurfacing hip implants from ten different manufacturers were analysed. The components were measured in a coordinate measuring machine. The microstructure of the heads and cups was inspected by scanning electron microscopy. The mean radial clearance was 84.86 microm (range: 49.47-120.93 microm). The implants were classified into three groups (low, medium and high clearance). All implants showed a deviation of roundness of less than 10 microm. It was shown that all implants differ from each other and a final conclusion about the ideal design and material combination cannot be given based on biomechanical data. Widespread use of specific designs can only be recommended if clinical long-term follow-up studies are performed and analysed for each design.

  16. Vaccine-induced toxic epidermal necrolysis: A case and systematic review

    OpenAIRE

    Chahal, Dev; Aleshin, Maria; Turegano, Mamina; Chiu, Melvin; Worswick, Scott

    2018-01-01

    Background: Erythema multiforme (EM), Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are cutaneous hypersensitivityreactions that develop in response to specific triggers such as medications and certain infections. Vaccines, which undergo rigorous safety testing prior to use in humans, are a rare cause of SJS/TEN and little is known about the frequency of such events and corresponding pathogenesis. Objective: Herein, we discuss a case of suspected TEN in a 19-yea...

  17. Radiology now. The ten day rule - principles and practice

    Energy Technology Data Exchange (ETDEWEB)

    Carmichael, J H.E. [Broadgreen Hospital, Liverpool (UK); Warrick, C K

    1978-11-01

    The ten day rule recommends that non-urgent diagnostic radiography of the abdomen in women of child-bearing capacity should be confined to the pre-ovulatory phase of the menstrual cycle. Arguments for and against this rule are reviewed. The attitudes and organization of radiographic practice in the UK differ from those in the USA. Assessment of the evidence for the hazards involved leads to the conclusion that the continued application of the ten day rule should be strongly recommended as an essential part of good radiological and radiographic practice.

  18. How green are the TEN-T core network corridors?

    DEFF Research Database (Denmark)

    Panagakos, George; Psaraftis, Harilaos N.

    defining this concept, identified the characteristics that distinguish a green corridor from an otherwise efficient one. The main thesis of this paper is that the „core network corridors‟ of the new TEN-T guidelines exhibit all these qualities and the vision of a green corridor network in Europe is close...... to reality. To support this thesis, and in continuation of the work of SuperGreen, the paper examines the proposed new „guidelines‟ for the development of the TEN-T after presenting a brief history of transport network development in Europe....

  19. Histological and microbiological aspects of actinomycetoma cases in Venezuela

    Directory of Open Access Journals (Sweden)

    José Antonio Serrano

    1988-08-01

    Full Text Available A ten year (1976-1986 review study of cases of Actinomycetoma in Venezuela was made through personal interview and clinical examinations, analysis of medical records of patients with actinomycetoma, histological studies of biopsy samples, as well as microbiological studies of isolates strain, also through out personal interviews with researchers and dermatologists who were sources of information on mycetoma cases. A total of 47 cases were recorded. As etiologic agent Actinomadura madurae was found in 20 cases - (42.5%, Nocardia brasiliensis in 13 cases (27.6%, Nocardia spp 7 cases (14.8%, Streptomyces somaliensis in 4 cases (8.5%, N. asteroides in 2 cases (4.2% and N. otitidis caviarum, (N. caviae in 1 case (2.1%. Most of the reported cases involved individuals living and working in rural areas, mostly males who outnumber females 4:1. The patients were 18 to 80 years old. A. madurae was reported as the most frequent etiologic agent. Most of the clinical cases were seen when the disease was well established. Twenty four of the forty seven cases reported were observed in Lara State, which represents a 51.0% of all the cases studied.

  20. Five misunderstandings about case study research

    DEFF Research Database (Denmark)

    Flyvbjerg, Bent

    2004-01-01

    This article examines five common misunderstandings about case-study research: (1) Theoretical knowledge is more valuable than practical knowledge; (2) One cannot generalize from a single case, therefore the single case study cannot contribute to scientific development; (3) The case study is most...... useful for generating hypotheses, while other methods aremore suitable for hypotheses testing and theory building; (4) The case study contains a bias toward verification; and (5) It is often difficult to summarize specific case studies. The article explains and corrects these misunderstandings one by one...... and concludes with the Kuhnian insight that a scientific discipline without a large number of thoroughly executed case studies is a discipline without systematic production of exemplars, and that a discipline without exemplars is an ineffective one. Social science may be strengthened by the execution of more...

  1. Czech, Slovak science ten years after split

    CERN Multimedia

    2003-01-01

    Ten years after the split of Czechoslovakia Czech and Slovak science are facing the same difficulties: shortage of money for research, poor salaries, obsolete equipment and brain drain, especially of the young, according to a feature in the Daily Lidove Noviny (1 page).

  2. Critical challenges in ERP implementation: A qualitative case study in the Canadian oil and gas industry

    Science.gov (United States)

    Menon, Sreekumar A.

    This exploratory qualitative single-case study examines critical challenges encountered during ERP implementation based on individual perspectives in four project roles: senior leaders, project managers, project team members, and business users, all specifically in Canadian oil and gas industry. Data was collected by interviewing participants belonging to these categories, and by analyzing project documentation about ERP implementation. The organization for the case study was a leading multinational oil and gas company having a substantial presence in the energy sector in Canada. The study results were aligned with the six management questions regarding critical challenges in ERP: (a) circumstances to implement ERP, (b) benefits and process improvements achieved, (c) best practices implemented, (d) critical challenges encountered, (e) strategies and mitigating actions used, and (f) recommendations to improve future ERP implementations. The study results highlight six key findings. First, the study provided valid circumstances for implementing ERP systems. Second, the study underscored the importance of benefits and process improvements in ERP implementation. Third, the study highlighted that adoption of best practices is crucial for ERP Implementation. Fourth, the study found that critical challenges are encountered in ERP Implementation and are significant during ERP implementation. Fifth, the study found that strategies and mitigating actions can overcome challenges in ERP implementation. Finally, the study provided ten major recommendations on how to improve future ERP implementations.

  3. Simultaneous determination of ten compounds in two main ...

    African Journals Online (AJOL)

    Simultaneous determination of ten compounds in two main medicinal plant parts of Tibetan herb, Pterocephalus hookeri (CB Clarke) Höeck, by ultra-high performance liquid chromatography-photodiode array.

  4. Electronic Document Management: A Human Resource Management Case Study

    Directory of Open Access Journals (Sweden)

    Thomas Groenewald

    2004-11-01

    Full Text Available This case study serve as exemplar regarding what can go wrong with the implementation of an electronic document management system. Knowledge agility and knowledge as capital, is outlined against the backdrop of the information society and knowledge economy. The importance of electronic document management and control is sketched thereafter. The literature review is concluded with the impact of human resource management on knowledge agility, which includes references to the learning organisation and complexity theory. The intervention methodology, comprising three phases, follows next. The results of the three phases are presented thereafter. Partial success has been achieved with improving the human efficacy of electronic document management, however the client opted to discontinue the system in use. Opsomming Die gevalle studie dien as voorbeeld van wat kan verkeerd loop met die implementering van ’n elektroniese dokumentbestuur sisteem. Teen die agtergrond van die inligtingsgemeenskap en kennishuishouding word kennissoepelheid en kennis as kapitaal bespreek. Die literatuurstudie word afgesluit met die inpak van menslikehulpbronbestuur op kennissoepelheid, wat ook die verwysings na die leerorganisasie en kompleksietydsteorie insluit. Die metodologie van die intervensie, wat uit drie fases bestaan, volg daarna. Die resultate van die drie fases word vervolgens aangebied. Slegs gedeelte welslae is behaal met die verbetering van die menslike doeltreffendheid ten opsigte van elektroniese dokumentbestuur. Die klient besluit egter om nie voort te gaan om die huidige sisteem te gebruik nie.

  5. Characteristics of Inpatient Hypertension Cases and Factors Associated with Admission Outcomes in Ashanti Region, Ghana: An Analytic Cross-Sectional Study

    Directory of Open Access Journals (Sweden)

    Kenneth Nuamah

    2017-01-01

    Full Text Available Background. Hypertension remains a cause of morbidity and mortality in the Ashanti Region of Ghana. It has been featured in the top ten causes of OPD attendance, admissions, and deaths since 2012. We investigated the sociodemographic characteristics and spatial distribution of inpatient hypertensives and factors associated with their admission outcomes. Methods. A 2014 line list of 1715 inpatient HPT cases aged ≥25 years was used for the cross-sectional analytic study. Accounting for clustering, all analyses were performed using the “svy” command in Stata. Frequencies, Chi-square test, and logistic regression analysis were used in the analysis. Arc view Geographic Information System (ArcGIS was used to map the density of cases by place of residence and reporting hospital. Results. Mean age of cases was 58 (S.D 0.0068. Females constituted 67.6% of the cases. Age, gender, and NHIS status were significantly associated with admission outcomes. Cases were clustered in the regional capital and bordering districts. However, low case densities were recorded in the latter. Conclusion. Increasing NHIS access can potentially impact positively on hypertension admission outcomes. Health educational campaigns targeting men are recommended to address hypertension-related issues.

  6. Case Study: A Picture Worth a Thousand Words? Making a Case for Video Case Studies

    Science.gov (United States)

    Pai, Aditi

    2014-01-01

    A picture, they say, is worth a thousand words. If a mere picture is worth a thousand words, how much more are "moving pictures" or videos worth? The author poses this not merely as a rhetorical question, but because she wishes to make a case for using videos in the traditional case study method. She recommends four main approaches of…

  7. Abused women's experiences of a primary care identification and referral intervention: a case study analysis.

    Science.gov (United States)

    Bradbury-Jones, Caroline; Clark, Maria; Taylor, Julie

    2017-12-01

    The aim of this study was to report the findings of a qualitative case study that investigated abused women's experiences of an identification and referral intervention and to discuss the implications for nurses, specifically those working in primary and community care. Domestic violence and abuse is a significant public health issue globally but it is a hidden problem that is under-reported. In the UK, Identification and Referral to Improve Safety is a primary care-based intervention that has been found to increase referral rates of abused women to support and safety services. This paper reports on the findings of an evaluation study of two sites in England. Qualitative study with a case study design. In line with case study design, the entire evaluation study employed multiple data collection methods. We report on the qualitative interviews with women referred through the programme. The aim was to elicit their experiences of the three aspects of the intervention: identification; referral; safety. Data collection took place March 2016. Ten women took part. Eight had exited the abusive relationship but two remained with the partner who had perpetrated the abuse. Women were overwhelmingly positive about the programme and irrespective of whether they had remained or exited the relationship all reported perceptions of increased safety and improved health. Nurses have an important role to play in identifying domestic violence and abuse and in referral and safety planning. As part of a portfolio of domestic violence and abuse interventions, those that empower women to take control of their safety (such as Identification and Referral to Improve Safety) are important. © 2017 John Wiley & Sons Ltd.

  8. Five misunderstandings about Case-study Research

    DEFF Research Database (Denmark)

    Flyvbjerg, Bent

    This article examines five common misunderstandings about case-study research: (1) Theoretical knowledge is more valuable than practical knowledge; (2) One cannot generalize from a single case, therefore the single case study cannot contribute to scientific development; (3) The case study is most...... useful for generating hypotheses, while other methods aremore suitable for hypotheses testing and theory building; (4) The case study contains a bias toward verification; and (5) It is often difficult to summarize specific case studies. The article explains and corrects these misunderstandings one by one...... and concludes with the Kuhnian insight that a scientific discipline without a large number of thoroughly executed case studies is a discipline without systematic production of exemplars, and that a discipline without  exemplars is an ineffective one. Social science may be strengthened by the execution of more...

  9. Development of a mathematical phantom representing a ten-year-old for use in internal dosimetry calculations

    International Nuclear Information System (INIS)

    Deus, S.F.; Poston, J.W.

    1976-01-01

    A phantom was developed representing a ten-year old child for use as the basis for dosimetric studies. An initial literature survey was made to determine organ mass, shape, and location in a normal ten-year-old child. These data were used to construct a mathematical representation of the child for use in computer calculations of absorbed radiation dose for typical exposure situations following the administration of radiopharmaceuticals

  10. Ten years of experience with transgastric necrosectomy for walled-off necrosis in acute pancreatitis

    DEFF Research Database (Denmark)

    Busse, Malene Just; Ainsworth, Alan Patrick

    2015-01-01

    : Acute pancreatitis with walled-off necrosis has a high mortality rate. Need for additional therapy following necrosectomy was associated with fatal outcome. Endocrine and exocrine insufficiency was often seen at follow-up. FUNDING: none. TRIAL REGISTRATION: The study was approved by the Danish Data....... Ten patients (20%) died during their admission to our department. In total, 18 (45%) patients developed late complications defined as endocrine and/or exocrine malfunction of the pancreas (diabetes (n = 10), exocrine insufficiency (n = 4), both diabetes and exocrine insufficiency (n = 4)). CONCLUSION......INTRODUCTION: The aim of this study was to report our results with open transgastric necrosectomy for walled-off necrosis in acute pancreatitis over a period of ten years. METHODS: Patients operated at the department from 2003 until 2012 were studied retrospectively. RESULTS: A total of 50 patients...

  11. Verification of two simple meteorological models at large travel distances using ten-hour 85Kr measurements

    International Nuclear Information System (INIS)

    Pendergast, M.M.

    1978-01-01

    This report evaluates the wind-rose model and a trajectory model for calculating air concentrations averaged over 10 hours at distances greater than 100 km. Ten-hour averaged 85 Kr air concentrations from 13 sites located withing 143 km of the Savannah River Plant (SRP) were used to evaluate two simple models: a wind-rose model, and a trajectory model. The wind-rose model has previously been shown to estimate annual average concentrations to within a factor of four for travel distances of about 100 km. When 85 Kr concentrations were observed (80 cases), the wind-rose model predicted above background for only 36 percent of the cases, while the trajectory model predicted above background for 56 percent of the cases. The wind-rose model tended to overpredict air concentration by a factor of 4 while the trajectory model tended to underpredict by a factor of 3 for those occasions where observations and calculations were above background

  12. Assessment of clinical residents' needs for ten educational subjects

    Directory of Open Access Journals (Sweden)

    Mansour Razavi

    2002-04-01

    Full Text Available Background Fulfilling the learners' "real needs" will improve medical education. There are subjects that are necessary for any clinical residents not considering their field of specialty. Among the subjects ten seems to be the most important: research methodology and data analysis, computer-based programs, medical recording, cardiopulmonary and cerebral resuscitation, clinical teaching programs, communication skills, clinical ethics, laboratory examinations, reporting special diseases and death certification, and prescription. Purpose This cross-sectional study assessed educational needs of clinical residents for ten educational subjects. Methods A questionnaire prepared by board faculty members consisted of 10 close-ended questions, and one open­ ended question was distributed among 1307 residents from 22 clinical disciplines, who registered for preboard or promotion exam in June 2000. Results Among the subjects three were the most needed: computer-based programs 149 (60%, data collecting system 606 (49%, and clinical ethics 643 (46%. The prescription standard was the least required 177(13%. Conclusion Complementary training courses on these subjects can be an answer to the clinical residents needs. Keywords : research methodology, computer in medicine, cpr, clinical teaching methods, communication in medicine, medical ethics, laboratory ordering, disease coding system, death certificate, prescription writing

  13. Top Ten Concerns for Trustees in 1988.

    Science.gov (United States)

    Meyerson, Joel W.

    1988-01-01

    Ten issues most likely to influence institutions this year include tuition policy and financing, capital renewal and replacement, charitable giving, scientific equipment and laboratories, endowment management and spending policy, research funding, corporate contributions, minority enrollment and hiring, debt financing and debt capacity, and cost…

  14. Dose-specific effects of transcutaneous electrical nerve stimulation (TENS) on experimental pain: a systematic review.

    Science.gov (United States)

    Claydon, Leica S; Chesterton, Linda S; Barlas, Panos; Sim, Julius

    2011-09-01

    To determine the hypoalgesic effects of transcutaneous electrical nerve stimulation (TENS) parameter combinations on experimental models in healthy humans. Searches were performed using the electronic databases Ovid MEDLINE, CINAHL, AMED, and Web of Science (from inception to December 2009). Manual searches of journals and reference lists of retrieved trials were also performed. Randomized controlled trials (RCTs) were included in the review if they compared the hypoalgesic effect of TENS relative with placebo and control, using an experimental pain model in healthy human participants. Two reviewers independently selected the trials, assessed their methodologic quality and extracted data. Forty-three RCTs were eligible for inclusion. A best evidence synthesis revealed: Overall "conflicting" (inconsistent findings in multiple RCTs) evidence of TENS efficacy on experimental pain irrespective of TENS parameters used. Overall intense TENS has "moderate" evidence of efficacy (1 high-quality and 2 low-quality trials). Conventional TENS has overall conflicting evidence of efficacy, this is derived from "strong" evidence of efficacy (generally consistent findings in multiple high-quality RCTs) on pressure pain but strong evidence of inefficacy on other pain models. "Limited" evidence (positive findings from 1 RCT) of hypoalgesia exists for some novel parameters. Low-intensity, low-frequency, local TENS has strong evidence of inefficacy. Inappropriate TENS (using "barely perceptible" intensities) has moderate evidence of inefficacy. The level of hypoalgesic efficacy of TENS is clearly dependent on TENS parameter combination selection (defined in terms of intensity, frequency, and stimulation site) and experimental pain model. Future clinical RCTs may consider these TENS dose responses.

  15. Lateral patellar retinacular release: changes over the last ten years

    Directory of Open Access Journals (Sweden)

    Leonardo Pini Rosalem Marciano da Fonseca

    Full Text Available ABSTRACT Lateral retinacular release is a useful resource in knee surgery that can be used for disorders of the extensor mechanism. For many years, it was indiscriminately used in the treatment of the various patellofemoral joint alterations, with conflicting functional results. This study aimed to analyze the changes that have occurred in the indications and clinical effectiveness of lateral retinacular release by reviewing the relevant literature of the past ten years, comparing it to the classic literature on the subject. It was found that less extensive releases decompress the lateral patellar facet, helping with pain control, while decreasing the risks of medial subluxation. Nowadays, there is clear evidence for its indication in the lateral patellar hypercompression syndrome associated with anterior knee pain, as long as there is no related instability; furthermore, it will normally play an adjuvant role in extensor mechanism alignment surgeries for cases of recurrent patellar instability. The initial results for symptomatic patellofemoral osteoarthritis are promising when lateral release is combined with cartilage debridement; in total knee replacement, it is more commonly used for the correction of valgus deformity in order to improve the components’ congruency. Finally, distinguishing the different patellofemoral joint pathologies is seen as crucial in order to indicate this procedure. Further randomized control trials that compare surgical techniques with long-term results are still needed.

  16. Wie schneiden Sie ab?: Studie über Kontroll- und Prüfungsaktivitäten bei mittelgrossen Unternehmen, Spitälern und Hochschulen in der Schweiz

    OpenAIRE

    Ruud, T F; Isufi, S; Friebe, P; Stebler, W; Seheri, F; Emmenegger, M

    2008-01-01

    Kontroll- und Prüfungsaktivitäten unterstützen den Verwaltungsrat und die Geschäftsleitung bei der Steuerung und Kontrolle des Unternehmens. Bei mittelgrossen Unternehmen ist aufgrund der begrenzten personellen und finanziellen Ressourcen ein effektiver und effizienter Einsatz dieser Aktivitäten unerlässlich. Auch bei Spitälern und Hochschulen gewinnen Kontroll- und Prüfungsaktivitäten infolge erhöhter Wettbewerbsintensität und steigenden Kostendrucks sowie zunehmender Unabhängigkeit diese...

  17. Hobnail hemangioma reclassified as superficial lymphatic malformation: a study of 52 cases.

    Science.gov (United States)

    Trindade, Felicidade; Kutzner, Heinz; Tellechea, Óscar; Requena, Luis; Colmenero, Isabel

    2012-01-01

    Hobnail hemangioma (HH) is currently classified as a benign vascular tumor, although it is not well understood whether this lesion differentiates toward blood or lymphatic endothelial cells. Immunostaining with the endothelial marker Wilms tumor 1 (WT1) helps distinguish between vascular neoplasms and malformations, being positive in the former and negative in the latter. We sought to investigate WT1, human herpesvirus 8 latent nuclear antigen, D2-40, and Ki-67 immunoprofile in HH, to gain further insight into its histogenesis. We evaluated 52 HHs collected in Dermatohistopathologische Gemeinschaftslabor, Friedrichshafen, Germany. Immunohistochemical expression of WT1 was performed in all cases. Ten of 52 lesions were also studied for D2-40 and Ki-67 staining and 12 lesions were stained for human herpesvirus 8 latent nuclear antigen. All 52 HHs were completely negative for WT1 immunostaining. Immunohistochemistry performed in 10 HHs showed diffuse and strong positive staining for D2-40 in 8 lesions and focal positivity in two. All cases tested showed negative staining for Ki-67 and human herpesvirus 8 latent nuclear antigen. There are no limitations. Although the exact histogenesis of HH is unknown, most of the performed immunohistochemical studies support a lymphatic line of differentiation. However, on the basis of the WT1 negativity, we believe that HH is better considered as a lymphatic malformation rather than a lymphatic neoplasm. Copyright © 2011 American Academy of Dermatology, Inc. Published by Mosby, Inc. All rights reserved.

  18. The Effects of Exercise with TENS on Spasticity, Balance, and Gait in Patients with Chronic Stroke: A Randomized Controlled Trial

    OpenAIRE

    Park, Junhyuck; Seo, Dongkwon; Choi, Wonjae; Lee, Seungwon

    2014-01-01

    Background Transcutaneous electrical nerve stimulation (TENS) is a useful modality for pain control. TENS has recently been applied to decrease spasticity. The purpose of this study is to determine whether the addition of TENS to an exercise program reduces spasticity and improves balance and gait in chronic stroke patients. Material/Methods This was a single-blinded, multicenter, randomized controlled trial. Thirty-four ambulatory individuals with chronic stroke participated and were randoml...

  19. A case-control study of autism and mumps-measles-rubella vaccination using the general practice research database: design and methodology

    Directory of Open Access Journals (Sweden)

    Huang Xiangning

    2001-02-01

    Full Text Available Abstract Background An association between mumps-measles-rubella (MMR vaccination and the onset of symptoms typical of autism has recently been suggested. This has led to considerable concern about the safety of the vaccine. Methods A matched case-control study using data derived form the United Kingdom General Practice Research Database. Children with a possible diagnosis of autism will be identified from their electronic health records. All diagnoses will be validated by a detailed review of hospital letters and by using information derived from a parental questionnaire. Ten controls per case will be selected from the database. Conditional logistic regression will be used to assess the association between MMR vaccination and autism. In addition case series analyses will be undertaken to estimate the relative incidence of onset of autism in defined time intervals after vaccination. The study is funded by the United Kingdom Medical Research Council. Discussion Electronic health databases offer tremendous opportunities for evaluating the adverse effects of vaccines. However there is much scope for bias and confounding. The rigorous validation of all diagnoses and the collection of additional information by parental questionnaire in this study are essential to minimise the possibility of misleading results.

  20. Theoretical pluralism in psychoanalytic case studies.

    Science.gov (United States)

    Willemsen, Jochem; Cornelis, Shana; Geerardyn, Filip M; Desmet, Mattias; Meganck, Reitske; Inslegers, Ruth; Cauwe, Joachim M B D

    2015-01-01

    The aim of this study is to provide an overview of the scientific activity of different psychoanalytic schools of thought in terms of the content and production of case studies published on ISI Web of Knowledge. Between March 2013 and November 2013, we contacted all case study authors included in the online archive of psychoanalytic and psychodynamic case studies (www.singlecasearchive.com) to inquire about their psychoanalytic orientation during their work with the patient. The response rate for this study was 45%. It appears that the two oldest psychoanalytic schools, Object-relations psychoanalysis and Ego psychology or "Classical psychoanalysis" dominate the literature of published case studies. However, most authors stated that they feel attached to two or more psychoanalytic schools of thought. This confirms that the theoretical pluralism in psychoanalysis stretches to the field of single case studies. The single case studies of each psychoanalytic school are described separately in terms of methodology, patient, therapist, or treatment features. We conclude that published case studies features are fairly similar across different psychoanalytic schools. The results of this study are not representative of all psychoanalytic schools, as some do not publish their work in ISI ranked journals.

  1. Theoretical pluralism in psychoanalytic case studies

    Science.gov (United States)

    Willemsen, Jochem; Cornelis, Shana; Geerardyn, Filip M.; Desmet, Mattias; Meganck, Reitske; Inslegers, Ruth; Cauwe, Joachim M. B. D.

    2015-01-01

    The aim of this study is to provide an overview of the scientific activity of different psychoanalytic schools of thought in terms of the content and production of case studies published on ISI Web of Knowledge. Between March 2013 and November 2013, we contacted all case study authors included in the online archive of psychoanalytic and psychodynamic case studies (www.singlecasearchive.com) to inquire about their psychoanalytic orientation during their work with the patient. The response rate for this study was 45%. It appears that the two oldest psychoanalytic schools, Object-relations psychoanalysis and Ego psychology or “Classical psychoanalysis” dominate the literature of published case studies. However, most authors stated that they feel attached to two or more psychoanalytic schools of thought. This confirms that the theoretical pluralism in psychoanalysis stretches to the field of single case studies. The single case studies of each psychoanalytic school are described separately in terms of methodology, patient, therapist, or treatment features. We conclude that published case studies features are fairly similar across different psychoanalytic schools. The results of this study are not representative of all psychoanalytic schools, as some do not publish their work in ISI ranked journals. PMID:26483725

  2. Ten-Competence: Life-Long Competence Development and Learning

    NARCIS (Netherlands)

    Koper, Rob; Specht, Marcus

    2006-01-01

    Koper, R., & Specht, M. (2008). Ten-Competence: Life-Long Competence Development and Learning. In M-A. Cicilia (Ed.), Competencies in Organizational e-learning: concepts and tools (pp. 234-252). Hershey: IGI-Global.

  3. Bioremediation case studies: Abstracts. Final report

    International Nuclear Information System (INIS)

    Devine, K.

    1992-03-01

    The report contains abstracts of 132 case studies of bioremediation technology applied to hazardous waste clean-up. It was prepared to compile bioremediation studies in a variety of locations and treating diverse contaminants, most of which were previously undocumented. All data are based on vendor-supplied information and there was no opportunity to independently confirm its accuracy. These 132 case studies, from 10 different biotechnology companies, provide users with reference information about on-going and/or completed field applications and studies. About two-thirds of the cases were at full-scale clean-up level with the remainder at pilot or laboratory scale. In 74 percent of the cases, soil was at least one of the media treated. Soil alone accounts for 46 percent of the cases. Petroleum-related wastes account for the largest contaminant with 82 cases. Thirty-one states are represented in the case studies

  4. Ten colour photometry of twelve Ap-stars

    International Nuclear Information System (INIS)

    Musielok, B.; Lange, D.; Schoeneich, W.; Hildebrandt, G.; Zelwanowa, E.; Hempelmann, A.; Salmanov, G.

    1980-01-01

    Ten-colour photoelectric observations are presented for twelve Ap-stars. Improved ephemeris for seven of them is given. Phase relations between the light curves and line intensity variations are discussed. The problem of the electromagnetic flux conctancy of IOTA Cas is approached from a qualitative point of view. (author)

  5. 451 Case studies Cardiac

    African Journals Online (AJOL)

    Marinda

    Case Studies. 29 ... A case of a 26-year-old ASA I physical status male undergoing septoplasty had an abrupt ... myocardial infarction, severe hypertensive crisis, cerebral .... or no formal management is required in an ASA I patient.8 One.

  6. [Omalizumab: What have we learned after ten years of prescription?].

    Science.gov (United States)

    Pradère, P; Garcia, G; Humbert, M; Aubier, M; Taillé, C

    2016-02-01

    Omalizumab, an anti-immunoglobulin E monoclonal antibody, has now been used for ten years as an add-on therapy for severe adult atopic asthma, poorly controlled by high-doses inhaled steroids and long-acting beta-agonists. This innovative therapy has been the first biotherapy used on a large scale in severe asthma. It has shown clinical benefits, especially in the prevention of severe exacerbation, with a satisfactory safety profile. Despite its cost, it is an interesting alternative to continuous oral steroids, which cause more long-term side effects. After ten-years of prescription of omalizumab, we review here the mechanism of action, the benefits, the main side effects, the cost-effectiveness and also the alternative indications of this interesting molecule. We also consider the practicalities of using omalizumab, particularly the importance a rigorous assessment of its efficacy after 16 weeks of treatment, and possible future therapeutic indications. Omalizumab has proven its efficacy in large randomized studies but also in real life practice in severe allergic asthma. Copyright © 2015 SPLF. Published by Elsevier Masson SAS. All rights reserved.

  7. HYDROGEOLOGICAL RELATIONS ON KARSTIFIED ISLANDS - VIS ISLAND CASE STUDY

    Directory of Open Access Journals (Sweden)

    Josip Terzić

    2004-12-01

    Full Text Available An approach to the hydrogeological investigations on Adriatic islands is presented on the Island of Vis case study. Infiltration, accumulation and discharge of the groundwater occur in karstified rock mass. Hydrogeological relations are mostly a consequence of the geological setting, because of the complete hydrogeologic barrier in Komiža bay, and relative barrier in the area of karst poljes. Significant research was performed in the 1999 – 2000 period aimed of better understanding of hydrogeological relations. These investigations, as well as reinterpretation of some previously known data, included structural geology, hydrogeology, hydrology and hydrochemistry. Approximate rock mass hydraulic conductivity calculation is also shown, as well as level of its usability in such terrain. Based on all these methods, it is possible to conclude that on the Island of Vis there is no saline water present underneath the entire island. There is only a saline water wedge which is formed on the top of relatively impermeable base rock, some few tens of meters under recent sea level. With such a model, and taking in account the hydrological balance, it is possible to conclude that there is possibility of higher amount of groundwater exploitation then it is today (the paper is published in Croatian.

  8. Value of TENS for relief of chronic low back pain with or without radicular pain.

    Science.gov (United States)

    Buchmuller, A; Navez, M; Milletre-Bernardin, M; Pouplin, S; Presles, E; Lantéri-Minet, M; Tardy, B; Laurent, B; Camdessanché, J P

    2012-05-01

    To evaluate the efficacy of transcutaneous electrical neurostimulation (TENS) in patients with chronic low back pain (LBP). Prospective, randomized, multicentre, single-blind study. Twenty-one French pain centres. Two hundred thirty-six consecutive adult patients consulting for chronic LBP, with or without radicular pain (mean age ± standard deviation: 53 ± 13 years; range: 28-86 years). Patients were randomly assigned to receive either active (n = 117) or sham (n = 119) TENS in four 1-h daily treatment sessions for 3 months. The primary outcome measured was improvement of functional status at 6 weeks (Roland-Morris Disability Questionnaire). Secondary outcome measures were improvement of functional status at 3 months, pain relief (weekly visual analogue scale assessments), positive functional repercussions of pain levels on quality of life, a diminution of the use of analgesic and anti-inflammatory medication, satisfaction with the overall treatment strategy and compliance. Functional status did not differ between the groups, whether at 6 weeks or 3 months (p = 0.351 at 6 weeks). A significant improvement between the first and last visual analogue scale assessments was observed in patients with either lumbar pain alone or lumbar and radicular pain treated with active TENS. Other outcome measures did not differ significantly between the two groups. There was no functional benefit of TENS in the treatment of patients with chronic LBP. © 2011 European Federation of International Association for the Study of Pain Chapters.

  9. The use of transcutaneous electrical nerve stimulation (TENS) in a major cancer center for the treatment of severe cancer-related pain and associated disability.

    Science.gov (United States)

    Loh, Jeffrey; Gulati, Amitabh

    2015-06-01

    Cancer pain is difficult to treat, often requiring a multimodal approach. While medication management remains the mainstay for the treatment of cancer pain, medications are often associated with undesired side effects. Transcutaneous electrical nerve stimulation (TENS) provides a potential adjunctive method for treating cancer pain with minimal side effects. Few studies have been performed evaluating the efficacy of TENS on cancer pain. We sought to examine the usefulness of TENS on all cancer patients and to specifically look at the use of TENS as a goal-directed therapy to improve functionality. Retrospective cohort study. Since 2008, patients with chronic cancer pain and on multimodal pain regimens were trialed with TENS. Those patients who showed an improvement in pain symptoms or severity were educated about and provided with a TENS unit for use at home. Pain symptoms and scores were monitored with the visual analog scale (VAS), the numerical rating pain (NRP) scale, and Short-Form McGill Questionnaire at the start of TENS treatment and at 2 months follow-up. TENS proved beneficial in 69.7% of patients over the course of 2 months. In TENS responsive patients, VAS scores decreased by 9.8 on a 0-100 mm scale (P TENS provides a beneficial adjunct for the treatment of cancer pain, especially when utilized as a goal-directed therapy. Wiley Periodicals, Inc.

  10. Reactor dosimetry calibrations in the Big Ten critical assembly

    International Nuclear Information System (INIS)

    Barr, D.W.; Hansen, G.E.

    1977-01-01

    Eleven irradiations of foil packs located in the central region of Big Ten were made for the Interlaboratory Reaction Rate Program. Each irradiation was at a nominal 10 15 fluence and the principal fluence monitor was the National Bureau of Standards' double fission chamber containing 235 U and 238 U deposits and located at the center of Big Ten. Secondary monitors consisted of three external fission chambers and two internal foil sets containing Au, In, and Al. Activities of one set were counted at the LASL and the other at the Hanford Engineering Developement Laboratory. The uncertainty in relative fluence for each irradiation was +-0.3%

  11. CASE STUDY

    African Journals Online (AJOL)

    2011-06-02

    Jun 2, 2011 ... immunosuppression associated with HIV/AIDS puts them at a higher risk of developing oesophageal cancer. 47. CASE STUDY. A 49-year-old man was diagnosed as HIV infected, with a CD4 count of 60 cells/µl. He was started on an antiretroviral treatment regimen comprising zidovudine, lamivudine and ...

  12. Casing study

    Energy Technology Data Exchange (ETDEWEB)

    Roche, P.

    2000-12-01

    An unorthodox method of casing drilling used by Tesco Corporation at a gas well in Wyoming to drill deeper using casings as drillpipe is discussed. The process involves either rotating the casing as drill string or using a downhole mud motor to rotate the bit. In this instance, the surface hole and the production hole were casing-drilled to a record 8,312 feet by rotating the casing. The 8 1/2-inch surface hole was drilled with 7-inch casing to 1,200 feet using a Tesco underreamer and a polycrystalline pilot bit; drilling and cementing was completed in 12 1/2 hours. The 6 1/4-inch production hole was drilled with 4 1/2-inch casing and the bottomhole assembly was retrieved after 191 hours rotating. This case was the first in which the entire well was casing-drilled from surface to TD. Penetration rate compared favorably with conventional methods: 12 1/2 hours for casing-drilling to 18.9 hours for conventional drilling, despite the fact that the casing-drilling technology is still in its infancy. It is suggested that casing-drilling has the potential to eliminate the need for the drillpipe entirely. If these expectations were to be realised, casing-drilling could be one of the most radical drilling changes in the history of the oil and gas industry. 1 photo.

  13. Giant multipole resonances: perspectives after ten years

    International Nuclear Information System (INIS)

    Bertrand, F.E.

    1980-01-01

    Nearly ten years ago evidence was published for the first of the so-called giant multipole resonances, the giant quadrupole resonance. During the ensuing years research in this field has spread to many nuclear physics laboratories throughout the world. The present status of electric giant multipole resonances is reviewed. 24 figures, 1 table

  14. Transcutaneous Electrical Nerve Stimulation (TENS) for the Control of Pain during Rehabilitation Following Total Knee Arthroplasty (TKA): A Randomized, Blinded, Placebo-Controlled Trial

    Science.gov (United States)

    Rakel, Barbara; Zimmerman, M. Bridget; Geasland, Katharine; Embree, Jennie; Clark, Charles R; Noiseux, Nicolas O; Callaghan, John J; Herr, Keela; Walsh, Deirdre; Sluka, Kathleen A

    2014-01-01

    This study evaluated the efficacy of TENS in reducing pain and hyperalgesia and increasing function following total knee arthroplasty (TKA). We hypothesized participants using TENS during rehabilitation exercises would: 1) report significantly lower pain during range-of-motion (ROM) and fast walking but not at rest; 2) have less hyperalgesia; and, 3) have better function than participants receiving Placebo-TENS or Standard Care. We also hypothesized that change in ROM pain would differ based on psychological characteristics (trait anxiety, pain catastrophizing and depression) and treatment group. This prospective, randomized study used intent-to-treat analyses on 317 subjects after primary, unilateral TKA. Assessors, blinded to treatment allocation, measured pain, function (ROM and gait speed), and hyperalgesia (quantitative sensory tests) postoperatively and 6 weeks after surgery. Analgesic intake, anxiety, depression, and pain catastrophizing were also assessed. TENS participants used it 1–2 times/day at 42 mA (on average) and had less pain postoperatively during active knee extension (p=0.019) and fast walking (p=0.006) than Standard Care participants. TENS and Placebo-TENS were not significantly different. TENS participants who scored low on anxiety and pain catastrophizing had a greater reduction in ROM pain at 6 weeks than those scoring high on these factors (p=0.002 and 0.03). Both TENS and Placebo-TENS participants had less postoperative mechanical hyperalgesia (p=0.03 – 0.01) than Standard Care participants. Supplementing pharmacologic analgesia with TENS during rehabilitation exercises reduces movement pain postoperatively but a placebo influence exists and the effect is gone by 6 weeks. Patients with low anxiety and pain catastrophizing may benefit most from TENS. PMID:25270585

  15. A controlled trial of transcutaneous electrical nerve stimulation (TENS) and exercise for chronic low back pain.

    Science.gov (United States)

    Deyo, R A; Walsh, N E; Martin, D C; Schoenfeld, L S; Ramamurthy, S

    1990-06-07

    A number of treatments are widely prescribed for chronic back pain, but few have been rigorously evaluated. We examined the effectiveness of transcutaneous electrical nerve stimulation (TENS), a program of stretching exercises, or a combination of both for low back pain. Patients with chronic low back pain (median duration, 4.1 years) were randomly assigned to receive daily treatment with TENS (n = 36), sham TENS (n = 36), TENS plus a program of exercises (n = 37), or sham TENS plus exercises (n = 36). After one month no clinically or statistically significant treatment effect of TENS was found on any of 11 indicators of outcome measuring pain, function, and back flexion; there was no interactive effect of TENS with exercise. Overall improvement in pain indicators was 47 percent with TENS and 42 percent with sham TENS (P not significant). The 95 percent confidence intervals for group differences excluded a major clinical benefit of TENS for most outcomes. By contrast, after one month patients in the exercise groups had significant improvement in self-rated pain scores, reduction in the frequency of pain, and greater levels of activity as compared with patients in the groups that did not exercise. The mean reported improvement in pain scores was 52 percent in the exercise groups and 37 percent in the nonexercise groups (P = 0.02). Two months after the active intervention, however, most patients had discontinued the exercises, and the initial improvements were gone. We conclude that for patients with chronic low back pain, treatment with TENS is no more effective than treatment with a placebo, and TENS adds no apparent benefit to that of exercise alone.

  16. TOJDE: Electronic Publishing and a Review of Ten Years' Experience in Turkey

    Science.gov (United States)

    Ozarslan, Yasin; Balaban-Sali, Jale; Demiray, Ugur

    2012-01-01

    This review examines "The Turkish Online Journal of Distance Education" (TOJDE) over a ten years period from 2000-2010. The study provides an opportunity to examine publishing activities such as number of published articles, authors, research topics and methods, and analyses of TOJDE's website such as time users stay on site and user…

  17. Ten Things Parents Can Do to Prevent Suicide

    Science.gov (United States)

    ... Ribbon Commands Skip to main content Turn off Animations Turn on Animations Our Sponsors Log in | Register Menu Log in | ... teen at risk for suicide . Spend some time reading these ten ways you can help prevent a ...

  18. [10 congenital trigger fingers. Apropos of a case report].

    Science.gov (United States)

    Moutet, F; Lebrun, C; Sartorius, C

    1987-01-01

    Ten congenital triggers fingers have been treated on a 3 years old girl after correction of congenital bilateral club feet. Such a case, without any other congenital malformation seems to be unique in the French literature and only found twice in the English one. This child in spite of a normal growth and good psychomotor development, presents an unusual face, with a mouth a little bit too small, but her karyotype is normal. No trismus and no microstomia were found to enable this case to be classified in a specific syndrome. The right diagnosis may be a non evolutive arthrogryposis of the extremities. Dividing the ten proximal pulleys (A1) let 10 voluminous nodules pass through and allowed full range of motion in nine out of ten fingers. A remaining flexion deformity of the proximal interphalangeal joint needed an anterior arthrolysis, the final result was good.

  19. Risk of intracerebral hemorrhage associated with phenprocoumon exposure: a nested case-control study in a large population-based German database.

    Science.gov (United States)

    Behr, Sigrid; Andersohn, Frank; Garbe, Edeltraut

    2010-07-01

    Intracerebral hemorrhage (ICH) is the most serious complication of oral anticoagulation. This study investigated the risk of ICH for phenprocoumon which is the most widely used oral anticoagulant in Germany. We conducted a nested case-control study in a cohort of 13.4 million insurants of 4 German statutory health insurances (SHIs) who were continuously enrolled for 6 months prior to cohort entry. Cases were patients hospitalized for ICH. Ten controls were matched to each case by SHI, birth year, and sex using incidence density sampling. Rate ratios (RR) of ICH for current phenprocoumon use as compared to non-use were estimated from odds ratios calculated by conditional logistic regression analyses considering multiple risk factors. Analysis of the full cohort revealed a strong increase in incidence of ICH with increasing age. In the nested case-control study including 8138 cases of ICH and 81,373 matched controls, we observed an increased risk of ICH for current phenprocoumon exposure that varied with age. The phenprocoumon-associated risk of ICH was lower in older age groups with RRs from 4.20 (95% confidence interval (CI) 2.44-7.21) for phenprocoumon users less than 55 years of age to 2.43 (95%CI, 1.81-3.27) for those older than 85 years. Our study confirmed known risk factors of ICH. Phenprocoumon exposure was associated with an increased risk of ICH. The interaction of risk for phenprocoumon with age was unexpected and needs further study. (c) 2010 John Wiley & Sons, Ltd.

  20. Modification of the 'ten-day rule'

    International Nuclear Information System (INIS)

    Klempfner, G.

    1985-01-01

    In a 1964 decision the National Health and Medical Research Council recommended that radiological examinations of the lower abdomen and pelvis of women of childbearing age should be confined to the 10-day interval following the onset of menstruation. Recent evidence suggests that the first four weeks from the first day of the last menstrual period is not a critically radiosensitive period and consequently strict adherence to the ten-day rule is no longer indicated

  1. MRI case studies

    International Nuclear Information System (INIS)

    Huggett, S.; Barber, J.

    1989-01-01

    Three case studies are presented to show the value of magnetic resonance imaging used in conjunction with other imaging techniques. In each case MRI proved a vital diagnostic tool and superior to CT in showing firstly the haematoma in a patient with aphasia and right-sided weakness, secondly the size of the disc herniation in a patient with severe leg and ankle pains and thirdly the existence of a metastatic lesion in a patient with a previous history of breast cancer. 11 figs

  2. Ten questions about systems biology

    DEFF Research Database (Denmark)

    Joyner, Michael J; Pedersen, Bente K

    2011-01-01

    to understand how whole animals adapt to the real world. We argue that a lack of fluency in these concepts is a major stumbling block for what has been narrowly defined as 'systems biology' by some of its leading advocates. We also point out that it is a failure of regulation at multiple levels that causes many......In this paper we raise 'ten questions' broadly related to 'omics', the term systems biology, and why the new biology has failed to deliver major therapeutic advances for many common diseases, especially diabetes and cardiovascular disease. We argue that a fundamentally narrow and reductionist...

  3. Ten questions about systems biology

    DEFF Research Database (Denmark)

    Joyner, Michael J; Pedersen, Bente K

    2011-01-01

    In this paper we raise 'ten questions' broadly related to 'omics', the term systems biology, and why the new biology has failed to deliver major therapeutic advances for many common diseases, especially diabetes and cardiovascular disease. We argue that a fundamentally narrow and reductionist...... to understand how whole animals adapt to the real world. We argue that a lack of fluency in these concepts is a major stumbling block for what has been narrowly defined as 'systems biology' by some of its leading advocates. We also point out that it is a failure of regulation at multiple levels that causes many...

  4. Promoting student case creation to enhance instruction of clinical reasoning skills: a pilot feasibility study

    Directory of Open Access Journals (Sweden)

    Chandrasekar H

    2018-04-01

    Full Text Available Hamsika Chandrasekar,1 Neil Gesundheit,2 Andrew B Nevins,3 Peter Pompei,4 Janine Bruce,5 Sylvia Bereknyei Merrell6 1Department of Pediatrics, Boston Children’s Hospital, Boston, MA, USA; 2Department of Medicine, Division of Endocrinology, Stanford University School of Medicine, Stanford, CA, USA; 3Department of Medicine, Division of Infectious Diseases, Stanford University School of Medicine, Stanford, CA, USA; 4Department of Medicine, Division of Primary Care and Population Health, Stanford University School of Medicine, Stanford, CA, USA; 5Department of Pediatrics, Stanford University School of Medicine, Stanford, CA, USA; 6Department of Surgery, Stanford University School of Medicine, Stanford, CA, USA Background: It is a common educational practice for medical students to engage in case-based learning (CBL exercises by working through clinical cases that have been developed by faculty. While such faculty-developed exercises have educational strengths, there are at least two major drawbacks to learning by this method: the number and diversity of cases is often limited; and students decrease their engagement with CBL cases as they grow accustomed to the teaching method. We sought to explore whether student case creation can address both of these limitations. We also compared student case creation to traditional clinical reasoning sessions in regard to tutorial group effectiveness, perceived gains in clinical reasoning, and quality of student–faculty interaction. Methods: Ten first-year medical students participated in a feasibility study wherein they worked in small groups to develop their own patient case around a preassigned diagnosis. Faculty provided feedback on case quality afterwards. Students completed pre- and post-self-assessment surveys. Students and faculty also participated in separate focus groups to compare their case creation experience to traditional CBL sessions. Results: Students reported high levels of team engagement

  5. Qualitative Case Study Guidelines

    Science.gov (United States)

    2013-11-01

    Introduction to Sociological Methods. 2nd ed. New York, McGraw-Hill 14. Denzin , N. K. and Lincoln , Y. S. (2011) The SAGE Handbook of Qualitative...The Art of Science. In: Denzin , N. K. and Lincoln , Y. S. (eds.) Handbook of Qualitative Research. Thousand Oaks, Sage 19. GAO (1990) Case Study...Rinehart & Winston 39. Stake, R. E. (1994) Case Studies. In: Denzin , N. K. and Lincoln , Y. S. (eds.) Handbook of Qualitative Research. Thousand Oaks, Sage

  6. Elliot Lake uranium mine reclamation, the first ten years

    International Nuclear Information System (INIS)

    Payne, R.A.

    2000-01-01

    In 1989, Rio Algom Limited finalized its plans for the closure and subsequent decommissioning of two of its then three operating mines in Elliot Lake as a result of market conditions. These two mines closed in August 1990. These mine closures had significant impacts. The principal mining operations of Rio Algom at that time were still in Elliot Lake and had been the very foundation of the company for about 40 years. The business impact on the Corporation was regarded as possibly severe. The resultant layoff of over 1,500 long-term, highly qualified, skilled and well-paid employees, a devastating blow to the affected employees and their families, would have a significant financial impact on the municipal economy, particularly as this announcement was seen as the first step in the early closure of all four operating mines in the region. At that time there was little precedence for such a high profile mine closure program and consequently the many unknowns relating to the mine decommissioning process, legislative requirements and society's expectations resulted in a perception of a significant yet ill-defined liability. In this atmosphere of understandable company, stakeholder and public concern, Rio Algom Limited embarked on what has turned out to be a long, rigorous, challenging yet ultimately reasonable and rewarding process of progressive reclamation of all its Elliot Lake mines, some ten in total (nine uranium, one copper). Over the past ten years, reclamation of all ten mines has been successfully completed, some $70 m plus has been expended in direct site reclamation works and the workforce has been reduced from over 2,500 to just 4. After ten years, the focus of attention is now on the long-term care, maintenance, monitoring and reporting required for the decommissioned mine sites, and the accomplishment of this in the best interests of all the stakeholders. (author)

  7. Field experiments on seed dispersal by wind in ten umbelliferous species (Apiaceae)

    NARCIS (Netherlands)

    Jongejans, E.; Telenius, A.

    2001-01-01

    This report presents data from experiments on seed dispersal by wind for ten species of the family Apiaceae. Seed shadows were obtained in the field under natural conditions, using wind speeds between four and ten m/s. The flight of individual seeds was followed by eye, and seed shadows were

  8. Radiation therapy of penile cancer: six to ten-year follow-up

    International Nuclear Information System (INIS)

    Grabstald, H.; Kelley, C.D.

    1980-01-01

    Ten patients with penile cancer were treated with radiation therapy between 1968 and 1973. Nine of ten remain free of disease though in 1 patient a new penile primary developed eight years after the radiation therapy and was treated by partial penectomy. One patient died following surgery for ''bleeding ulcer.'' He was free of penile cancer five years after radiation. The most common complication is urethral stricture and skin telangiectasia

  9. Ten Years Back, Five Years Forward: The Data Seal of Approval

    Directory of Open Access Journals (Sweden)

    Ingrid Dillo

    2015-02-01

    Full Text Available If we want to share data, the long-term storage of those data in a trustworthy digital archive is an essential condition. Trust is the basis of storing and sharing data. That trust must be present in the various stakeholders involved. Certification of digital archives can make an important contribution to the confidence of these stakeholders in the digital archives.Ten years ago DANS was assigned the task of developing a Seal of Approval for digital data to ensure that archived data can still be found, understood and used in the future. In 2009 this Data Seal of Approval (DSA was transferred to an international body, the DSA Board, which has managed and further developed the guidelines and the peer review process ever since.The objectives of the DSA are to safeguard data, ensure high quality and guide reliable management of data for the future without requiring implementation of new standards, regulations or heavy investments. The DSA contains 16 guidelines for applying and verifying quality aspects concerning the creation, storage, use and reuse of digital data.Based on feedback from data archives that applied for a DSA and different case studies we have gained some insight into the benefits of DSA. Still, the impact of having the Seal is not easy to measure. Seal holders usually refer to qualitative benefits in the form of increased awareness of the value of their repositories to their communities, funders and publishers.Ten years down the line we can safely state that the Data Seal of Approval has proven its added value. If we try to look five years into the future, what can we expect? There are different developments: a growing interest in DSA among European research infrastructures, the collaboration between DSA and the ISCU World Data System under the umbrella of the RDA (Research Data Alliance and the European Commission is showing a growing interest in certification services.The success of DSA also provides the challenge to further

  10. Effectiveness of complementary pain treatment for women with deep endometriosis through Transcutaneous Electrical Nerve Stimulation (TENS): randomized controlled trial.

    Science.gov (United States)

    Mira, Ticiana A A; Giraldo, Paulo C; Yela, Daniela A; Benetti-Pinto, Cristina L

    2015-11-01

    Evaluate TENS effectiveness as a complementary treatment of chronic pelvic pain and deep dyspareunia in women with deep endometriosis. This randomized controlled trial was performed in a tertiary health care center, including twenty-two women with deep endometriosis undergoing hormone therapy with persistent pelvic pain and/or deep dyspareunia. This study was registered in the Brazilian Record of Clinical Trials (ReBEC), under n RBR-3rndh6. TENS application for 8 weeks followed a randomized allocation into two groups: Group 1 - acupuncture-like TENS (Frequency: 8Hz, pulse duration: 250μs) - VIF (n=11) and Group 2 - self-applied TENS (Frequency: 85Hz, pulse duration: 75μs) (n=11). The intensity applied was "strong, but comfortable". We evaluated patients before and after treatment by the use of the Visual Analogue Scale, Deep Dyspareunia Scale and Endometriosis Quality of Life Questionnaire. We used the Wilcoxon and Mann-Whitney tests to compare before and after treatment conditions. Despite the use of hormone therapy for 1.65±2.08 years, the 22 women with deep endometriosis sustained pelvic pain complaints (VAS=5.95±2.13 and 2.45±2.42, pTENS. Both application types of TENS were effective for improving the evaluated types of pain. Both resources (acupuncture-like TENS and self-applied TENS) demonstrated effectiveness as a complementary treatment of pelvic pain and deep dyspareunia, improving quality of life in women with deep endometriosis regardless of the device used for treatment. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  11. Catalogue of good practice case studies in european towns and cities from 1995 to 2002; Catalogue des bonnes pratiques de villes europeennes de 1995 a 2002

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2002-08-01

    Many towns and cities have already implemented sustainable local energy policies. This has also been the ''raison d'etre of Energie-Cites'', the association of European towns and cities that has been promoting sustainable local energy policies over the last ten years. Energie-Cites has a portfolio of about 400 European good practice case studies in sustainable local energy policies. The 3 to 5 page case studies provide complete information on the action carried out. After general information about the city and a brief introduction to the subject and its general context, the action is presented in detail: local players involved, costs, positive and negative evaluation, prospects and one or more local contacts. (A.L.B.)

  12. Low grade papillary transitional cell carcinoma pelvic recurrence masquerading as high grade invasive carcinoma, ten years after radical cystectomy

    Directory of Open Access Journals (Sweden)

    Mortazavi Amir

    2008-09-01

    Full Text Available Abstract Background Tumor recurrence following radical cystectomy for a low-grade superficial transitional cell carcinoma (TCC is exceedingly uncommon and has not been reported previously. Case presentation We describe a case of a young male presenting with anorexia, weight loss and a large, painful locally destructive pelvic recurrence, ten years after radical cystoprostatectomy. The pathology was consistent with a low-grade urothelial carcinoma. After an unsuccessful treatment with cisplatin-based chemotherapy, the patient underwent a curative intent hemipelvectomy with complete excision of tumor and is disease free at one year follow-up. Conclusion A literature review related to this unusual presentation is reported and a surgical solutions over chemotherapy and radiotherapy is proposed.

  13. Case Study: The Chemistry of Cocaine

    Science.gov (United States)

    Dewprashad, Brahmadeo

    2011-01-01

    This column provides original articles on innovations in case study teaching, assessment of the method, as well as case studies with teaching notes. This month's case study focuses on the chemistry of cocaine to teach a number of core concepts in organic chemistry. It also requires that students read and analyze an original research paper on…

  14. A social work study on the effect of different factors on leadership style: A case study of educational system

    Directory of Open Access Journals (Sweden)

    Hajar Jannesari

    2013-03-01

    Full Text Available Leadership style plays an important role on job satisfaction in educational systems. In this paper, we present a study among 180 school principals in city of Khomeinishahr, located in province of Esfahan, Iran. The study selects a sample of 123 principals and examines ten hypotheses including the effects of personality trait neuroticism, extroversion, resilience, participative, conscientiousness on job satisfaction. The study also investigates the impacts of transformational leadership style, transactional leadership style and Laissez – fair leadership style on job satisfaction. Finally, the study considers the relationship between personality trait neuroticism and transformational leadership style as well as personality trait extraversion and transformational leadership style. The study uses Pearson correlation test and verify that nine out of ten hypotheses have been confirmed and the relationship between Laissez – fair leadership style and job satisfaction is not confirmed.

  15. The role of radionuclide studies in emergency cases

    International Nuclear Information System (INIS)

    Nishimura, Tsunehiko; Hayashida, Kohei; Uehara, Toshiisa

    1982-01-01

    Radionuclide studies have been performed popularly because of its noninvasive and simple method recently. In this study, we applied this technique for the evaluation of emergency cases in cardiovascular diseases. There were 93 cases (1.5%) out of 6163 cases, done during 1981. The subjects were 34 cases of cardiac studies (9 cases of sup(99m)Tc-PYP myocardial imaging, 12 cases of thallium myocardial imaging, 13 cases of cardioangiography), 23 cases of peripheral diseases (12 cases of peripheral angiography, 11 cases of venography), 16 cases of pulmonary imaging, 10 cases of renal studies (6 cases of renal angiography, 9 cases of renal imaging) and 5 cases of brain angiography. These studies were proven to be useful clinically for the evaluation of emergency cases and follow-up studies. In the near future, ''emergency radionuclide studies'' would be benefit for the high-risk patients noninvasively. (author)

  16. Novitäten im Breslauer Stadttheater

    OpenAIRE

    Zduniak, Maria

    2017-01-01

    Am Anfang des 20. Jahrhunderts zählte das Breslauer Stadttheater, obwohl mit nur einer kleinen Orchester-Besetzung ausgestattet, zu den bemerkenswerten europäischen Opernbühnen. Es war aufgeschlossen für musikalische Novitäten. Als Beweis dafür sind u.a. die Breslauer Premieren Salome (1906) von Richard Strauss, L\\'Orfeo (1913) von Claudio Monteverdi und die Uraufführung der Oper Eros und Psyche (1917) von Ludomir Różycki zu nennen.

  17. Frequency of diabetic retinopathy in patients after ten years of diagnosis of type 2 diabetes mellitus

    International Nuclear Information System (INIS)

    Shaikh, M.A.; Yakta, D.E.

    2010-01-01

    Background: Diabetic retinopathy is one of the most common and serious complications of type 2 diabetes mellitus and a leading cause of blindness not only in Pakistan but also worldwide. So we conducted this study to record the frequency of diabetic retinopathy in known diabetic patients ten years after diagnosis of type 2 diabetes mellitus. Methods: The study was conducted at Liaquat University of Medical and Health Sciences, Jamshoro, Pakistan for a period of 1 year from January 2008 to January 2010. The study group comprised of 200 patients of type 2 diabetes mellitus attending the medical clinic. All patients who were diagnosed as type 2 diabetes mellitus since ten years duration were included in the study. Retinopathy was graded into background, pre proliferative and proliferative retinopathy. Type 2 diabetes was diagnosed using the WHO criteria. Statistical analysis was carried out using the SPSS-11. Results: Diabetic retinopathy was found in 25.5% of the total Type 2 patients after ten years of diagnosis, and of these 4% of patients had proliferative retinopathy. Conclusion: Type 2 diabetic patients should be screened as early as possible to prevent permanent visual loss by timely management of diabetic retinopathy because diabetes is one of most common preventable cause of blindness in the world. (author)

  18. Effects Of Drought Stress on Germination in Fourteen Provenances of Pinus Brutia Ten. Seeds in Turkey

    Directory of Open Access Journals (Sweden)

    Hakan Şevik

    2015-02-01

    Full Text Available Pinus brutia Ten., Red pine, known to be tough drought resistant pine specie, could effectively be used for afforestation of disturbed areas. It is of great interest for the afforestation in arid zones. Appropriate seed sources for the specific areas guarantees reforestation success. Away from its native areas Pinus brutia Ten. is planted for its ornamental value and timber production purposes. Selection of drought resistant provenances can very well increase the survival success. In this study, the effects of water potential on germination were studied in fourteen provenances of Pinus brutia Ten. from Turkey. Water potentials between 0 and -8 bars were obtained using polyethylene glycol 6000 (PEG-6000 solutions. Seeds were kept for 35 day at 20 ± 0.5°C. A decrease in water potential produced a marked reduction in germination percentage and germination value. As a result, significant variations between the provenances were found. It was determined that, under a -8 bar water stress, Isparta-Bucak and Mersin-Silifke, respectively corresponding to 58% and 57% of the control group, were the least water stress affected provenances.

  19. eCompetence Case Studies

    DEFF Research Database (Denmark)

    Jensen, Helle Bækkelund

    2006-01-01

    In this paper we present some details of the processes undertaken in the European eCompetence Initiative. We present two illustrative and representative case studies. The research aims to identify and understand patterns of individual and organisational eCompetence approaches.......In this paper we present some details of the processes undertaken in the European eCompetence Initiative. We present two illustrative and representative case studies. The research aims to identify and understand patterns of individual and organisational eCompetence approaches....

  20. Intrinsic and extrinsic motivation among adolescent ten-pin bowlers in kuala lumpur, malaysia.

    Science.gov (United States)

    Teo, Eng-Wah; Khoo, Selina; Wong, Rebecca; Wee, Eng-Hoe; Lim, Boon-Hooi; Rengasamy, Shabesan Sit

    2015-03-29

    Motivation has long been associated with sports engagement. However, to date no research has been performed to understand the domain of motivation among ten-pin bowlers. The purpose of this study was to investigate different types of motivation (i.e., intrinsic vs. extrinsic) based on self-determination theory from the perspective of gender and the bowler type (competitive vs. casual). A total of 240 bowlers (104 male, 136 female; 152 competitive, 88 casual) with a mean age of 16.61 ± 0.78 years were recruited in Kuala Lumpur. The Sport Motivation Scale, a 28-item self-report questionnaire measuring seven subscales (i.e., intrinsic motivation to know, intrinsic motivation to accomplish, intrinsic motivation to experience stimulation, extrinsic motivation to identify regulation, extrinsic motivation for introjection regulation, extrinsic motivation to external regulation, and amotivation) was administered. Results showed significant differences (t=10.43, df=239, p=0.01) between total scores of intrinsic and extrinsic motivation among ten-pin bowlers. There were significant gender differences with respect to intrinsic motivation to know, intrinsic motivation to accomplish, intrinsic motivation to experience stimulation, and extrinsic motivation to identify regulation. However, no significant bowler type differences were found for either the intrinsic (t=-1.15, df=238, p=0.25) or extrinsic (t=-0.51, df=238, p=0.61) motivation dimensions. In conclusion, our study demonstrated substantial intrinsic motivation for gender effects, but no bowler type effects among adolescent ten-pin bowlers.

  1. Intrinsic and Extrinsic Motivation Among Adolescent Ten-Pin Bowlers in Kuala Lumpur, Malaysia

    Science.gov (United States)

    Teo, Eng-Wah; Khoo, Selina; Wong, Rebecca; Wee, Eng-Hoe; Lim, Boon-Hooi; Rengasamy, Shabesan Sit

    2015-01-01

    Motivation has long been associated with sports engagement. However, to date no research has been performed to understand the domain of motivation among ten-pin bowlers. The purpose of this study was to investigate different types of motivation (i.e., intrinsic vs. extrinsic) based on self-determination theory from the perspective of gender and the bowler type (competitive vs. casual). A total of 240 bowlers (104 male, 136 female; 152 competitive, 88 casual) with a mean age of 16.61 ± 0.78 years were recruited in Kuala Lumpur. The Sport Motivation Scale, a 28-item self-report questionnaire measuring seven subscales (i.e., intrinsic motivation to know, intrinsic motivation to accomplish, intrinsic motivation to experience stimulation, extrinsic motivation to identify regulation, extrinsic motivation for introjection regulation, extrinsic motivation to external regulation, and amotivation) was administered. Results showed significant differences (t=10.43, df=239, p=0.01) between total scores of intrinsic and extrinsic motivation among ten-pin bowlers. There were significant gender differences with respect to intrinsic motivation to know, intrinsic motivation to accomplish, intrinsic motivation to experience stimulation, and extrinsic motivation to identify regulation. However, no significant bowler type differences were found for either the intrinsic (t=−1.15, df=238, p=0.25) or extrinsic (t=−0.51, df=238, p=0.61) motivation dimensions. In conclusion, our study demonstrated substantial intrinsic motivation for gender effects, but no bowler type effects among adolescent ten-pin bowlers. PMID:25964827

  2. Case Study Methodology and Homelessness Research

    Directory of Open Access Journals (Sweden)

    Jill Pable

    2013-10-01

    Full Text Available This paper describes the potential suitability of case study methodology for inquiry with the homeless population. It references a research study that uses case study research method to build theory. This study's topic is the lived experience of destitute individuals who reside in homeless shelters, and explores the homeless shelter built environment's potential influence on resident satisfaction and recovery. Case study methodology may be appropriate because it explores real-life contextual issues that characterize homelessness and can also accommodate the wide range of homeless person demographics that make this group difficult to study in a generalized fashion. Further, case study method accommodates the need within research in this area to understand individualized treatments as a potential solution for homelessness.

  3. Assessing levels of similarity to a "psychodynamic prototype" in psychodynamic psychotherapy with children: a case study approach (preliminary findings

    Directory of Open Access Journals (Sweden)

    Marina Bento Gastaud

    2015-09-01

    Full Text Available Objective:To analyze the degree of similarity to a "psychodynamic prototype" during the first year of two children's once-weekly psychodynamic psychotherapy.Methods: This study used a longitudinal, descriptive, repeated-measures design based on the systematic case study method. Two male school children (here referred to as Walter and Peter and their therapists took part in the study. All sessions were video and audio recorded. Ten sessions from each case were selected for analysis in this preliminary study. Trained examiners (randomly selected in pairs independently and blindly evaluated each session using the Child Psychotherapy Q-Set (CPQ. Experts in psychodynamic therapy and cognitive behavioral therapy from several countries rated each of the 100 CPQ items with regard to how well it characterized a hypothetical ideal session of either treatment modality. A series of paired t tests comparing analogous adherence scores within each session were conducted.Results:There were no significant correlations between time elapsed and adherence to the prototypes. Walter's treatment adhered to both prototypes and Peter's treatment did not adhere to either prototype.Conclusion:Child psychotherapy theory and practice are not absolutely coincident. Real psychotherapy sessions do not necessarily resemble the ideal prototypes.

  4. Assembling a Case Study Tool Kit: 10 Tools for Teaching with Cases

    Science.gov (United States)

    Prud'homme-Généreux, Annie

    2017-01-01

    This column provides original articles on innovations in case study teaching, assessment of the method, as well as case studies with teaching notes. The author shares the strategies and tools that teachers can use to manage a case study classroom effectively.

  5. Ten-a affects the fusion of central complex primordia in Drosophila.

    Directory of Open Access Journals (Sweden)

    Xuebo Cheng

    Full Text Available The central complex of Drosophila melanogaster plays important functions in various behaviors, such as visual and olfactory memory, visual orientation, sleep, and movement control. However little is known about the genes regulating the development of the central complex. Here we report that a mutant gene affecting central complex morphology, cbd (central brain defect, was mapped to ten-a, a type II trans-membrane protein coding gene. Down-regulation of ten-a in pan-neural cells contributed to abnormal morphology of central complex. Over-expression of ten-a by C767-Gal4 was able to partially restore the abnormal central complex morphology in the cbd mutant. Tracking the development of FB primordia revealed that C767-Gal4 labeled interhemispheric junction that separated fan-shaped body precursors at larval stage withdrew to allow the fusion of the precursors. While the C767-Gal4 labeled structure did not withdraw properly and detached from FB primordia, the two fan-shaped body precursors failed to fuse in the cbd mutant. We propose that the withdrawal of C767-Gal4 labeled structure is related to the formation of the fan-shaped body. Our result revealed the function of ten-a in central brain development, and possible cellular mechanism underlying Drosophila fan-shaped body formation.

  6. Changing Course: Ten Years of Tracking Online Education in the United States

    Science.gov (United States)

    Allen, I. Elaine; Seaman, Jeff

    2013-01-01

    "Changing Course: Ten Years of Tracking Online Education" in the United States is the tenth annual report on the state of online learning in U.S. higher education. The survey is designed, administered and analyzed by the Babson Survey Research Group. Data collection is conducted in partnership with the College Board. This year's study, like those…

  7. On misunderstandings in connection with case-studies

    DEFF Research Database (Denmark)

    Flyvbjerg, Bent

    2005-01-01

    This article examines five common misunderstandings about case-study research: (1) Theoretical knowledge is more valuable than practical knowledge; (2) One cannot generalize from a single case, therefore the single case study cannot contribute to scientific development; (3) The case study is most...

  8. Giant vesical calculus in a ten year-old boy - a case report | Saleh ...

    African Journals Online (AJOL)

    This is a case of longstanding urinary tract symptoms in a 10 year old boy in which multi-modality imaging revealed multiple radio-opaque calculi including a giant vesical calculus. He had surgical removal of the stone with no post-op complications. Keywords: Giant, Vesical Calculus, 10 years old ...

  9. Qualitative Case Study Research as Empirical Inquiry

    Science.gov (United States)

    Ellinger, Andrea D.; McWhorter, Rochell

    2016-01-01

    This article introduces the concept of qualitative case study research as empirical inquiry. It defines and distinguishes what a case study is, the purposes, intentions, and types of case studies. It then describes how to determine if a qualitative case study is the preferred approach for conducting research. It overviews the essential steps in…

  10. Assessing the Role of Motivation on Teacher Performance: Case Study in Indonesia

    Directory of Open Access Journals (Sweden)

    Dr. Irwandy

    2014-03-01

    Full Text Available The objective of this study was to assess the role of motivation on teacher performance in Indonesia. This study in an assessment of this aim used deductive approach where a qualitative survey was conducted among students at Universitas Negeri Medan (UNIMED, Indonesia who are assumed to be future teachers. The survey was intended to get their responses on what they feel are the best factors that could motivate them as future teachers among a list of ten motivational factors. In the light of this the study sets to identify the most ranked factors among the ten motivational factors. The analysis from the empirical findings showed that Good Salary was the most ranked factor for both sub groups that made up the sample survey. However, a study from previous researches used in this study showed that different results could be obtained from different groups of already working employees. This study therefore can be seen as an introduction to a more detailed study to be carried by future researchers in the field of teachers’ motivation.

  11. Methodology for the case studies

    NARCIS (Netherlands)

    Smits, M.J.W.; Woltjer, G.B.

    2017-01-01

    This document is about the methodology and selection of the case studies. It is meant as a guideline for the case studies, and together with the other reports in this work package can be a source of inform ation for policy officers, interest groups and researchers evaluating or performing impact

  12. Performable Case Studies in Ethics Education.

    Science.gov (United States)

    Robeson, Richard; King, Nancy M P

    2017-09-12

    Bioethics education often includes the study of short stories, novels, plays, and films, because such materials present case examples that can highlight relevant issues and questions especially vividly for a wide range of students. In addition, creative writing is widely used in the education of health professional students and in continuing education settings for health professionals. There are very few academic or professional disciplines that do not use case studies, but the case study in dialogic form has not been standard practice for thousands of years. Dramatic arts casuistry-the creation and performance of short case studies designed specifically to raise bioethics issues for discussion-represents an application of literature and the medical humanities that is both unique and uniquely valuable. This essay describes the development and history of a course that has been successfully taught to medical students and graduate bioethics students, in which the class researches, writes, and performs a case study designed to elicit reflection and discussion about a topic and set of bioethics issues of current interest to both academic and general audiences. The model is also suited to the presentation and discussion of existing case studies, both live and via on-demand audio.

  13. Effect of conventional TENS on pain and electromyographic activity of masticatory muscles in TMD patients Efeito da TENS convencional sobre a dor e a atividade eletromiográfica dos músculos mastigatórios em pacientes com DTM

    Directory of Open Access Journals (Sweden)

    Delaine Rodrigues

    2004-12-01

    Full Text Available Temporomandibular disorders (TMD are characterized by several signs and symptoms, such as pain and changes in the electrical activity of masticatory muscles. Considering that transcutaneous electrical nerve stimulation (TENS is a resource indicated to promote analgesia, the objective of this study was to evaluate the effect of TENS on pain and electromyographic (EMG activity of the jaw elevator muscles in TMD patients. This study evaluated 35 female volunteers: 19 TMD patients (mean age = 23.04 ± 3.5 and 16 normal subjects (mean age = 23.3 ± 3.0. Transcutaneous electrical nerve stimulation (conventional mode, 150 Hz was applied once to each group for 45 minutes. Surface electromyography (gain of 100 times and 1 kHz sampling frequency and the visual analogue scale (VAS were applied before and immediately after TENS application. Both VAS data and root mean square (RMS values were analyzed using Student's t-test. The TMD group, compared to the control group, showed higher EMG activity of the jaw elevator muscles at rest. No difference was observed between the groups regarding maximum voluntary clenching (MVC. In TMD patients, TENS reduced both pain and EMG activity of the anterior portion of the temporal muscle, increasing the activity of the masseter muscles during MVC. It is possible to conclude that a single TENS application is effective in pain reduction. However, it does not act homogeneously on the features of the electric activity of the muscles evaluated.A desordem temporomandibular (DTM é caracterizada por diversos sinais e sintomas, como dor e alteração do sinal eletromiográfico dos músculos da mastigação. Considerando que a estimulação elétrica nervosa transcutânea (TENS é um recurso indicado para promover analgesia, o objetivo deste trabalho foi avaliar o efeito da TENS na dor e na atividade eletromiográfica (EMG dos músculos elevadores da mandíbula em indivíduos com DTM. Foram selecionados 35 voluntários do sexo

  14. The influence of transcutaneous electrical neurostimulation (TENS) on human cerebral blood flow velocities

    NARCIS (Netherlands)

    ter Laan, Mark; van Dijk, J. Marc C.; Elting, Jan-Willem J.; Fidler, Vaclav; Staal, Michiel J.

    It has been shown that transcutaneous electrical neurostimulation (TENS) reduces sympathetic tone. Spinal cord stimulation (SCS) has proven qualities to improve coronary, peripheral, and cerebral blood circulation. Therefore, we postulate that TENS and SCS affect the autonomic nervous system in

  15. Emotion, Engagement, and Case Studies

    Science.gov (United States)

    Herreid, Clyde Freeman; Terry, David R.; Lemons, Paula; Armstrong, Norris; Brickman, Peggy; Ribbens, Eric

    2014-01-01

    Three college faculty taught large general biology classes using case studies and personal response systems (clickers). Each instructor taught the same eight cases in two different sections, except the questions within the cases differed. In one section the questions were lower order (LO) factual inquiries, and in the other they were largely…

  16. Ten Thousand Years of Solitude

    Energy Technology Data Exchange (ETDEWEB)

    Benford, G. (Los Alamos National Lab., NM (USA) California Univ., Irvine, CA (USA). Dept. of Physics); Kirkwood, C.W. (Los Alamos National Lab., NM (USA) Arizona State Univ., Tempe, AZ (USA). Coll. of Business Administration); Harry, O. (Los Alamos National Lab., NM (USA)); Pasqualetti, M.J. (Los Alamos National Lab., NM (USA) Arizona State Univ., Tempe, AZ (USA))

    1991-03-01

    This report documents the authors work as an expert team advising the US Department of Energy on modes of inadvertent intrusion over the next 10,000 years into the Waste Isolation Pilot Project (WIPP) nuclear waste repository. Credible types of potential future accidental intrusion into the WIPP are estimated as a basis for creating warning markers to prevent inadvertent intrusion. A six-step process is used to structure possible scenarios for such intrusion, and it is concluded that the probability of inadvertent intrusion into the WIPP repository over the next ten thousand years lies between one and twenty-five percent. 3 figs., 5 tabs.

  17. Ten Thousand Years of Solitude?

    International Nuclear Information System (INIS)

    Benford, G.; Pasqualetti, M.J.

    1991-03-01

    This report documents the authors work as an expert team advising the US Department of Energy on modes of inadvertent intrusion over the next 10,000 years into the Waste Isolation Pilot Project (WIPP) nuclear waste repository. Credible types of potential future accidental intrusion into the WIPP are estimated as a basis for creating warning markers to prevent inadvertent intrusion. A six-step process is used to structure possible scenarios for such intrusion, and it is concluded that the probability of inadvertent intrusion into the WIPP repository over the next ten thousand years lies between one and twenty-five percent. 3 figs., 5 tabs

  18. Ten questions on nuclear wastes

    International Nuclear Information System (INIS)

    Guillaumont, R.; Bacher, P.

    2004-01-01

    The authors give explanations and answers to ten issues related to nuclear wastes: when a radioactive material becomes a waste, how radioactive wastes are classified and particularly nuclear wastes in France, what are the risks associated with radioactive wastes, whether the present management of radioactive wastes is well controlled in France, which wastes are raising actual problems and what are the solutions, whether amounts and radio-toxicity of wastes can be reduced, whether all long life radionuclides or part of them can be transmuted, whether geologic storage of final wastes is inescapable, whether radioactive material can be warehoused over long durations, and how the information on radioactive waste management is organised

  19. Ten-year study of postoperative complications following dental extractions in patients with inherited bleeding disorders.

    Science.gov (United States)

    Hsieh, J-T; Klein, K; Batstone, M

    2017-09-01

    Dental extractions challenge the body's haemostatic mechanism. Postoperative bleeding from dental extraction can be prolonged, or even life threatening in patients with inherited bleeding disorders. Pre- and postoperative clotting factor replacements or systemic desmopressin (ddAVP) have been advocated at our institution to prevent bleeding complications in these patients. This study aimed to assess the postoperative bleeding rate in patients with inherited bleeding disorders that underwent dental extractions at our institution between 2003 and 2012. Patients with inherited bleeding disorders such as haemophilia A, haemophilia B, and von Willebrand's disease were included. Retrospective chart review was conducted. The result showed 53 extraction events occurred in 45 patients over the 10-year period. Ten out of 53 extraction events (18.9%) had postoperative bleeding requiring further factor replacement or ddAVP. Postoperative bleeding in one patient with mild haemophilia A was complicated by the development of inhibitors. Type and severity of bleeding disorder, bone removal, and use of a local haemostatic agent did not have any significant effect on postoperative bleeding. Despite the use of perioperative factors and desmopressin, the postoperative bleeding rates remain high for patients with inherited bleeding disorders. More studies are required to assess the safety and effectiveness of using local haemostatic control to achieve haemostasis following extractions. Crown Copyright © 2017. Published by Elsevier Ltd. All rights reserved.

  20. Ten recommendations for software engineering in research.

    Science.gov (United States)

    Hastings, Janna; Haug, Kenneth; Steinbeck, Christoph

    2014-01-01

    Research in the context of data-driven science requires a backbone of well-written software, but scientific researchers are typically not trained at length in software engineering, the principles for creating better software products. To address this gap, in particular for young researchers new to programming, we give ten recommendations to ensure the usability, sustainability and practicality of research software.

  1. Ten new withanolides from Physalis peruviana.

    Science.gov (United States)

    Fang, Sheng-Tao; Liu, Ji-Kai; Li, Bo

    2012-01-01

    Ten new withanolides, including four perulactone-type withanolides, perulactones E-H (1-4), three 28-hydroxy-withanolides, withaperuvins I-K (5-7), and three other withanolides, withaperuvins L-N (8-10), together with six known compounds (11-16) were isolated from the aerial parts of Physalis peruviana. The structures of these compounds were elucidated on the basis of extensive spectroscopic analyses (1D and 2D NMR, IR, HR-MS) and chemical methods. Copyright © 2011 Elsevier Inc. All rights reserved.

  2. Using Correspondence Analysis in Multiple Case Studies

    NARCIS (Netherlands)

    Kienstra, Natascha; van der Heijden, Peter G.M.

    2015-01-01

    In qualitative research of multiple case studies, Miles and Huberman proposed to summarize the separate cases in a so-called meta-matrix that consists of cases by variables. Yin discusses cross-case synthesis to study this matrix. We propose correspondence analysis (CA) as a useful tool to study

  3. Using correspondence analysis in multiple case studies

    NARCIS (Netherlands)

    Kienstra, N.H.H.; van der Heijden, P.G.M.

    2015-01-01

    In qualitative research of multiple case studies, Miles and Huberman proposed to summarize the separate cases in a so-called meta-matrix that consists of cases by variables. Yin discusses cross-case synthesis to study this matrix. We propose correspondence analysis (CA) as a useful tool to study

  4. Family structure and risk factors for schizophrenia: case-sibling study

    Directory of Open Access Journals (Sweden)

    Lönnqvist Jouko

    2004-11-01

    Full Text Available Abstract Background Several family structure-related factors, such as birth order, family size, parental age, and age differences to siblings, have been suggested as risk factors for schizophrenia. We examined how family-structure-related variables modified the risk of schizophrenia in Finnish families with at least one child with schizophrenia born from 1950 to 1976. Methods We used case-sibling design, a variant of the matched case-control design in the analysis. Patients hospitalized for schizophrenia between 1969 and 1996 were identified from the Finnish Hospital Discharge Register, and their families from the Population Register Center. Only families with at least two children (7914 sibships and 21059 individuals were included in the analysis. Conditional logistic regression with sex, birth cohort, maternal schizophrenia status, and several family-related variables as explanatory variables was used in the case-sibling design. The effect of variables with the same value in each sibship was analyzed using ordinary logistic regression. Results Having a sibling who was less than five years older (OR 1.46, 95% CI 1.29–1.66, or being the firstborn (first born vs. second born 1.62, 1.87–1.4 predicted an elevated risk, but having siblings who were more than ten years older predicted a lower risk (0.66, 0.56–0.79. Conclusions Several family-structure-related variables were identified as risk factors for schizophrenia. The underlying causative mechanisms are likely to be variable.

  5. A STUDY OF EPIDEMIOLOGY OF SPINE INJURY IN FALL FROM HEIGHT

    Directory of Open Access Journals (Sweden)

    Amel Antony

    2016-09-01

    Full Text Available BACKGROUND This study puts in a sincere effort to study the spinal cord injuries in cases of fall from height. This study is intended to help the fellow radiologists to identify and thus help the individuals to cut down the progression of the disease. Identifying the spinal trauma and its clinic - epidemiological aspects will help further the practicing clinicians. The study can also help in formulation of preventive measures and putting forward management protocols in cases of spinal injury. METHODS This study was done in the Department of Radiology, Travancore Medical College, Kollam. This study was done from June 2104 to march 2016. Thirty two cases were identified and were taken up for the study. INCLUSION CRITERIA Spinal injuries following fall from height. EXCLUSION CRITERIA 1. Other spinal pathologies were not considered for the study. 2. Diabetic patients were excluded. RESULTS In the present study male sex amounted to ninety percent which amounted to twenty nine cases of spinal injury followed by female sex which amounted to ten percent which amounted to three cases. The age wise distribution of cases showed that age group of twenty to forty years showed maximum number of cases which amounted to sixteen admissions followed by age group of forty to sixty years which amounted to seven cases followed by age group of zero to twenty years which amounted to five cases, followed by age group of more than sixty years which amounted to four cases. Based on approximate height from which the fall occurred seventeen cases fell from the height of more than twenty feet, followed by nine cases which fell from the height of ten to twenty feet and six cases fell from the height of less than ten feet. The CT scan showed that eighteen cases had displaced spinal fractures followed by forteen cases which had undisplaced spinal fractures. Cord injury was seen in six cases. Based on the level of spine injury twenty six cases had lumbar spine injury, eleven

  6. Teaching Business French through Case Studies: Presentation of a Marketing Case.

    Science.gov (United States)

    Federico, Salvatore; Moore, Catherine

    The use of case studies as a means for teaching business French is discussed. The approach is advocated because of the realism of case studies, which are based on actual occurrences. Characteristics of a good case are noted: it tells a story, focuses on interest-arousing issues, is set in the past 10 years, permits empathy with the main…

  7. Case Study: Puttin' on the Ritz: How to Put Science into Cases

    Science.gov (United States)

    Herreid, Clyde Freeman

    2017-01-01

    There are multiple ways to put science into a case. This column provides original articles on innovations in case study teaching, assessment of the method, as well as case studies with teaching notes. This month's issue discusses different ways of presenting science in case studies.

  8. Time in powers of ten natural phenomena and their timescales

    CERN Document Server

    't Hooft, Gerard

    2014-01-01

    In this richly illustrated book, Nobel Laureate Gerard 't Hooft and Theoretical Physicist Stefan Vandoren describe the enormous diversity of natural phenomena that take place at different time scales. In the tradition of the bestseller Powers of Ten , the authors zoom in and out in time, each step with a factor of ten. Starting from one second, time scales are enlarged until processes are reached that take much longer than the age of the universe. After the largest possible eternities, the reader is treated to the shortest and fastest phenomena known. Then the authors increase with powers of t

  9. Case Study Observational Research: A Framework for Conducting Case Study Research Where Observation Data Are the Focus.

    Science.gov (United States)

    Morgan, Sonya J; Pullon, Susan R H; Macdonald, Lindsay M; McKinlay, Eileen M; Gray, Ben V

    2017-06-01

    Case study research is a comprehensive method that incorporates multiple sources of data to provide detailed accounts of complex research phenomena in real-life contexts. However, current models of case study research do not particularly distinguish the unique contribution observation data can make. Observation methods have the potential to reach beyond other methods that rely largely or solely on self-report. This article describes the distinctive characteristics of case study observational research, a modified form of Yin's 2014 model of case study research the authors used in a study exploring interprofessional collaboration in primary care. In this approach, observation data are positioned as the central component of the research design. Case study observational research offers a promising approach for researchers in a wide range of health care settings seeking more complete understandings of complex topics, where contextual influences are of primary concern. Future research is needed to refine and evaluate the approach.

  10. Stakeholders’ Views on Factors Influencing Nutrition Policy: a Qualitative Study Across Ten European Countries

    Directory of Open Access Journals (Sweden)

    Jeruszka-Bielak Marta

    2015-12-01

    Full Text Available The objective was to identify the main factors influencing micronutrient policies in the opinion of policy actors in ten European countries. Study was carried out during Jan-Nov 2010 in European countries: the Czech Republic, Denmark, England, Germany, Greece, Italy, the Netherlands, Norway, Poland and Spain. Semi-structured qualitative interviews were conducted with representatives of stakeholders involved in the vitamin D, folate and iodine policy making process. Fifty eight key informants representing mainly scientific advisory bodies (n=24 and governmental organisations (n=19 participated in the study. The remaining interviewees represented non-governmental organisations (n=6, industry (n=4 or were independent academic or health professional experts (n=5. Data were analysed by theoretical interpretative thematic analysis. Insights from interviewees on the development of micronutrient policies were grouped using the Public Health Nutrition Policy-making model. The main factors influencing the micronutrient policies were: systematic monitoring of nutrition and health, causal relationships between consumers’ diet-related behaviours and health outcomes, scientific recommendations from national bodies (Science area; scientific recommendations from international authorities and experiences of other countries, EU legislation, cultural factors (Wider context and political environment, national capacity to deal with the problem, national legislation, economics, stakeholder engagement, relationships between stakeholders (Policy and institutions area. The spectrum and weight of the factors influencing nutritional policy depends on nutrient, country and degree of its “advanced status” within nutrition policy, political environment, culture and socio-economic conditions as well as the point of view (who is expressing the opinion.

  11. Beyond Clinical Case Studies in Psychoanalysis: A Review of Psychoanalytic Empirical Single Case Studies Published in ISI-Ranked Journals

    Science.gov (United States)

    Meganck, Reitske; Inslegers, Ruth; Krivzov, Juri; Notaerts, Liza

    2017-01-01

    Single case studies are at the origin of both theory development and research in the field of psychoanalysis and psychotherapy. While clinical case studies are the hallmark of psychoanalytic theory and practice, their scientific value has been strongly criticized. To address problems with the subjective bias of retrospective therapist reports and uncontrollability of clinical case studies, systematic approaches to investigate psychotherapy process and outcome at the level of the single case have been developed. Such empirical case studies are also able to bridge the famous gap between academic research and clinical practice as they provide clinically relevant insights into how psychotherapy works. This study presents a review of psychoanalytic empirical case studies published in ISI-ranked journals and maps the characteristics of the study, therapist, patient en therapies that are investigated. Empirical case studies increased in quantity and quality (amount of information and systematization) over time. While future studies could pay more attention to providing contextual information on therapist characteristics and informed consent considerations, the available literature provides a basis to conduct meta-studies of single cases and as such contribute to knowledge aggregation. PMID:29046660

  12. Ten-year statistics of the electric power supply. Status and tendencies

    International Nuclear Information System (INIS)

    2001-12-01

    The ten-year statistics of the electric power supply in Denmark for 1991-2000 presents in tables and figures the trend of the electric power supply sector during the last ten years. The tables and figures present information on total energy consumption, combined heat and power generation, fuel consumption and the environment, the technical systems, economy and pricing, organization of the electricity supply, and information on electricity prices and taxes for households and industry in various countries. (LN)

  13. Warfarin-induced toxic epidermal necrolysis in combination therapy of Henoch-Schönlein purpura nephritis: a case report.

    Science.gov (United States)

    Kasahara, Katsuaki; Gotoh, Yoshimitsu; Kuroyanagi, Yoshiyuki; Nagano, China

    2017-07-14

    Toxic epidermal necrolysis (TEN) is a rare life-threatening condition almost exclusively attributed to drugs. The main etiologic factors for TEN are sulphonamides, anticonvulsants, and antibiotics; however, there are no published reports of warfarin causing TEN. We present the case of a 3-year-old patient who developed TEN while receiving treatment for Henoch-Schönlein purpura nephritis (HSPN). With multiple-drug therapy comprising prednisolone, mizoribine, dipyridamole, and warfarin, it is difficult to detect which drug is the causative agent. While in most cases, diagnosis of the causative drug is based on clinical history without a lymphocyte transformation test (LTT), we performed the test three times and identified the causative drug as warfarin at the late phase. We continued HSPN treatment without warfarin, and results showed good renal function without life-threatening complications. To our knowledge, this is the first report about TEN caused by warfarin. Repeated LTTs could be useful for identifying TEN-causative drugs even in the late phase.

  14. Implementing maternal death surveillance and response: a review of lessons from country case studies.

    Science.gov (United States)

    Smith, Helen; Ameh, Charles; Roos, Natalie; Mathai, Matthews; Broek, Nynke van den

    2017-07-17

    Maternal Death Surveillance and Response (MDSR) implementation is monitored globally, but not much is known about what works well, where and why in scaling up. We reviewed a series of country case studies in order to determine whether and to what extent these countries have implemented the four essential components of MDSR and identify lessons for improving implementation. A secondary analysis of ten case studies from countries at different stages of MDSR implementation, using a policy analysis framework to draw out lessons learnt and opportunities for improvement. We identify the consistent drivers of success in countries with well-established systems for MDSR, and common barriers in countries were Maternal Death Review (MDR) systems have been less successful. MDR is accepted and ongoing at subnational level in many countries, but it is not adequately institutionalised and the shift from facility based MDR to continuous MDSR that informs the wider health system still needs to be made. Our secondary analysis of country experiences highlights the need for a) social and team processes at facility level, for example the existence of a 'no shame, no blame' culture, and the ability to reflect on practice and manage change as a team for recommendations to be acted upon, b) health system inputs including adequate funding and reliable health information systems to enable identification and analysis of cases c) national level coordination of dissemination, and monitoring implementation of recommendations at all levels and d) mandatory notification of maternal deaths (and enforcement of this) and a professional requirement to participate in MDRs. Case studies from countries with established MDSR systems can provide valuable guidance on ways to set up the processes and overcome some of the barriers; but the challenge, as with many health system interventions, is to find a way to provide catalytic assistance and strengthen capacity for MDSR such that this becomes embedded in

  15. Newly blind persons using virtual environment system in a traditional orientation and mobility rehabilitation program: a case study.

    Science.gov (United States)

    Lahav, Orly; Schloerb, David W; Srinivasan, Mandayam A

    2012-09-01

    This paper presents a virtual reality system (the BlindAid) developed for orientation and mobility training of people who are newly blind. The BlindAid allows users to interact with different virtual structures and objects via auditory and haptic feedback. This case study aims to examine if and how the BlindAid, in conjunction with a traditional rehabilitation programme, can help people who are newly blind develop new orientation and mobility methods. Follow-up research based on this study, with a large experiment and control group, could contribute to the area of orientation and mobility rehabilitation training for the newly blind. The case study research focused on A., a woman who is newly blind, for 17 virtual sessions spanning ten weeks, during the 12 weeks of her traditional orientation and mobility rehabilitation programme. The research was implemented by using virtual environment (VE) exploration and orientation tasks in VE and physical spaces. The research methodology used both qualitative and quantitative methods, including interviews, questionnaire, videotape recording, and user computer logs. The results of this study helped elucidate several issues concerning the contribution of the BlindAid system to the exploration strategies and learning processes experienced by the participant in her encounters with familiar and unfamiliar physical surroundings. [Box: see text].

  16. Ten years of born and infeld electrodynamics investigations

    Energy Technology Data Exchange (ETDEWEB)

    Vellozo, Sergio O. [Instituto Militar de Engenharia (IME), Rio de Janeiro, RJ (Brazil); Helayel Neto, Jose Abdala [Centro Brasileiro de Pesquisas Fisicas (CBPF), Rio de Janeiro, RJ (Brazil); Assis, Leonardo P. G. De [Stanford University (United States); Gaete, Patricio [U.S.M. (Chile)

    2013-07-01

    Full text: In this year, our group celebrates ten years of incursions in four-dimensional (3+1) Born and Infeld Electrodynamics (BIE). As is well known, BIE is a classical and nonlinear theory and it predicts a maximum finite value for the electric field, preventing the occurrence of classical singularities. It gives also finite energy for a point-like electric charge. In this period, our main effort was on BIE magnetic sector and the most significant results were: 1. the finite and well behaved magnetostatic field solution for a point-like electric charge at rest, 2. the intrinsic angular momentum (spin) as a self interaction among electric and magnetic field, 3. the cohesive resultant force, using the same natural and simple mechanism, giving stability to the electric charge. Another BIE incursion line stands for three-dimensional (2+1). We investigated the consequences of the space-time dimensionality on the existence of magnetostatic fields generated by electric charges at rest in an inertial frame, which were present in our four-dimensional version. A magnetostatic field associated with an electric charge at rest does not appear in this case. Interestingly, the addition of the topological term (Chern-Simons) to BIE yields the appearance of the magnetostatic field. Finally, we are looking for the hydrogen-like atom spectrum under the BI electrostatic potential, as well the muonic atom spectrum. (author)

  17. Institutionalizing Blended Learning into Joint Training: A Case Study and Ten Recommendations

    Science.gov (United States)

    2014-12-01

    mail.mil pbockelman@mesh.dsci.com ABSTRACT In 2011, the Joint Staff J7 (Joint Training) directorate initiated the Continuum of eLearning project in...Orlando, FL. 14. ABSTRACT In 2011, the Joint Staff J7 (Joint Training) directorate initiated the Continuum of eLearning project in order to integrate...dispersed organizations still poses significant challenges. The Joint Staff J7, Deputy Director for Joint Training initiated the Continuum of eLearning

  18. HYDROGEOLOGIC CASE STUDIES

    Science.gov (United States)

    Hydrogeology is the foundation of subsurface site characterization for evaluations of monitored natural attenuation (MNA). Three case studies are presented. Examples of the potentially detrimental effects of drilling additives on ground-water samples from monitoring wells are d...

  19. THE ABUSE OF DOMINANT POSITION - RESTRICTING COMPETITION PRACTICE. CASE STUDY: ENI

    Directory of Open Access Journals (Sweden)

    BERINDE Mihai

    2013-07-01

    Full Text Available The abuse of dominant position along with cartel, merger and state aid are practices restricting competition strictly regulated at EU level. These practices can have a disastrous effect on the internal market harming both competition especially consumers. These practices can have a disastrous effect on the domestic market harming both competition and especially consumers. This paper aims to analyze how the abuse of a dominant position is regulated in the European Union. The research methodology used is the study of literature, analysis of legislation, case study, and the collection and interpretation of statistical data. The Competition Law at European level is harmonized among European Union member states. The competition authorities of the EU Member States work together to detect and sanction the practice that is restrictive for competition. Improving legislation that regulates the abuse of dominant position has been an ongoing concern of competition authorities, which is why the EU currently enjoys a very well established procedure. The procedure governing the abuse of dominant position consists of a series of steps that must be taken gradually to have the desired result, i.e. restoring fair competition on a given market. The case study presented in this paper is indicative and shows very clearly the next steps for referral to an abuse of dominant position, with special reference to the outcome arising when applying the procedure correctly. The analysis of statistical data regarding the number of investigations opened and the number of decisions made by competition authorities on abuse of dominant position is relevant, outlining the evolution of the work performed by competition authorities. Throughout the period of ten years analyzed (January 2004 - February 2013 there were 1583 cases of violation of antitrust laws at European level. The percentage of investigations opened by the competition authorities of the Member States is 86%, much

  20. Increasing pressure does not benefit lie detection : A reply to Ten Brinke et al.

    NARCIS (Netherlands)

    Verschuere, B.; Meijer, E.; Vrij, A.

    2016-01-01

    When passively attending to suspects, observers are poor at distinguishing lies from truths. Deception research has therefore shifted to examining interview styles aimed at eliciting and enhancing deception cues. Based upon a literature review and three empirical studies, ten Brinke, L., Khambatta,

  1. Ten-year statistics of the electric power supply. Status and tendencies

    International Nuclear Information System (INIS)

    2000-12-01

    The ten-year statistics of the electric power supply in Denmark for 1990-1999 presents in tables and figures the trend of the electric power supply sector during the last ten years. The tables and figures present information on total energy consumption, combined heat and power generation, fuel consumption and the environment, the technical systems, economy and pricing, organization of the electricity supply, auto-production of electricity and information on electricity prices and taxes for households and industry in various countries. (LN)

  2. The short-term effects of TENS plus therapeutic ultrasound combinations in chronic neck pain.

    Science.gov (United States)

    Sayilir, Selcuk

    2018-05-01

    To investigate the effects of TENS plus therapeutic ultrasound combinations on symptom relief, physical functionality, perceived stress levels, daytime sleepiness and neck mobility in patients with chronic neck pain (CNP). A total of 64 patients were divided into two groups as the TENS plus ultrasound group (n = 39) and the control CNP group (n = 25). The therapy comprised TENS and therapeutic ultrasound applications for 10 sessions. The control subjects were discouraged from using analgesics but were allowed to use paracetamol daily, if necessary. The Neck Disability Index (NDI), Epworth Sleepiness Scale (ESS), Perceived Stress Scale (PSS), visual analog scale (VAS) and tragus-wall/chin-manubrium distances were recorded at the baseline and after therapy. Significant improvements were detected in the TENS plus ultrasound group compared to the control CNP subjects in respect of VAS, PSS and NDI scores after the TENS plus therapeutic ultrasound therapies (all p stress levels and improving functionality in the short-term of CNP. Copyright © 2018 Elsevier Ltd. All rights reserved.

  3. French experience in operating pressurized water reactor power stations. Ten years' operation of the Ardennes power station

    International Nuclear Information System (INIS)

    Teste du Bailler, A.; Vedrinne, J.F.

    1978-01-01

    In the paper the experience gained over ten years' operation of the Ardennes (Chooz) nuclear power station is summarized from the point of view of monitoring and control equipment. The reactor was the first pressurized water reactor to be installed in France; it is operated jointly by France and Belgium. The equipment, which in many cases consists of prototypes, was developed for industrial use and with the experience that has now been gained it is possible to evaluate its qualities and defects, the constraints which it imposes and the action that has to be taken in the future. (author)

  4. Inducible displacement of cemented tibial components ten years after total knee arthroplasty.

    Science.gov (United States)

    Lam Tin Cheung, K; Lanting, B A; McCalden, R W; Yuan, X; MacDonald, S J; Naudie, D D; Teeter, M G

    2018-02-01

    The aim of this study was to evaluate the long-term inducible displacement of cemented tibial components ten years after total knee arthroplasty (TKA). A total of 15 patients from a previously reported prospective trial of fixation using radiostereometric analysis (RSA) were examined at a mean of 11 years (10 to 11) postoperatively. Longitudinal supine RSA examinations were acquired at one week, one year, and two years postoperatively and at final follow-up. Weight-bearing RSA examinations were also undertaken with the operated lower limb in neutral and in maximum internal rotation positions. Maximum total point motion (MTPM) was calculated for the longitudinal and inducible displacement examinations (supine versus standing, standing versus internal rotation, and supine versus standing with internal rotation). All patients showed some inducible displacement. Two patients with radiolucent lines had greater mean standing-supine MTPM displacement (1.35; sd 0.38) compared with the remaining patients (0.68; sd 0.36). These two patients also had a greater mean longitudinal MTPM at ten years (0.64; sd 0.50) compared with the remaining patients (0.39; sd 0.13 mm). Small inducible displacements in well-fixed cemented tibial components were seen ten years postoperatively, of a similar magnitude to that which has been reported for well-fixed components one to two years postoperatively. Greater displacements were found in components with radiolucent lines. Cite this article: Bone Joint J 2018;100-B:170-5. ©2018 The British Editorial Society of Bone & Joint Surgery.

  5. Objectivist case study research

    DEFF Research Database (Denmark)

    Ridder, Hanne Mette Ochsner; Fachner, Jörg

    2016-01-01

    be achieved through the use of objectivist case study research. The strength of the case study design is that it allows for uncovering or suggesting causal relationships in real-life settings through an intensive and rich collection of data. According to Hilliard (1993), the opposite applies for extensive......In order to comprehend the impact of music therapy or music therapy processes, a researcher might look for an approach where the topic under investigation can be understood within a broader context. This calls for a rich inclusion of data and consequently a limited number of participants and may...... designs, in which a small amount of data is gathered on a large number of subjects. With the richness of data, the intensive design is ―the primary pragmatic reason for engaging in single-case or small N research‖ (p. 374) and for working from an idiographic rather than a nomothetic perspective....

  6. Methodology Series Module 2: Case-control Studies.

    Science.gov (United States)

    Setia, Maninder Singh

    2016-01-01

    Case-Control study design is a type of observational study. In this design, participants are selected for the study based on their outcome status. Thus, some participants have the outcome of interest (referred to as cases), whereas others do not have the outcome of interest (referred to as controls). The investigator then assesses the exposure in both these groups. The investigator should define the cases as specifically as possible. Sometimes, definition of a disease may be based on multiple criteria; thus, all these points should be explicitly stated in case definition. An important aspect of selecting a control is that they should be from the same 'study base' as that of the cases. We can select controls from a variety of groups. Some of them are: General population; relatives or friends; and hospital patients. Matching is often used in case-control control studies to ensure that the cases and controls are similar in certain characteristics, and it is a useful technique to increase the efficiency of the study. Case-Control studies can usually be conducted relatively faster and are inexpensive - particularly when compared with cohort studies (prospective). It is useful to study rare outcomes and outcomes with long latent periods. This design is not very useful to study rare exposures. Furthermore, they may also be prone to certain biases - selection bias and recall bias.

  7. Ten questions about radiant heating and cooling systems

    DEFF Research Database (Denmark)

    Rhee, Kyu-Nam; Olesen, Bjarne W.; Kim, Kwang Woo

    2017-01-01

    to extend the applicability of the RHC system are providing the continuous impetus for research on RHC systems. This paper summarizes the important issues involved in the research on RHC system, whereby ten questions and answers concerning the RHC system are discussed, which will help researchers to conduct...

  8. Catalog of NASA-Related Case Studies

    Data.gov (United States)

    National Aeronautics and Space Administration — The OCKO has developed over 50 case studies to enhance learning at workshops, training, retreats and conferences. Case studies make mission knowledge attractive and...

  9. Genetic diversity and gene differentiation among ten species of Zingiberaceae from Eastern India.

    Science.gov (United States)

    Mohanty, Sujata; Panda, Manoj Kumar; Acharya, Laxmikanta; Nayak, Sanghamitra

    2014-08-01

    In the present study, genetic fingerprints of ten species of Zingiberaceae from eastern India were developed using PCR-based markers. 19 RAPD (Rapid Amplified polymorphic DNA), 8 ISSR (Inter Simple Sequence Repeats) and 8 SSR (Simple Sequence Repeats) primers were used to elucidate genetic diversity important for utilization, management and conservation. These primers produced 789 loci, out of which 773 loci were polymorphic (including 220 unique loci) and 16 monomorphic loci. Highest number of bands amplified (263) in Curcuma caesia whereas lowest (209) in Zingiber cassumunar. Though all the markers discriminated the species effectively, analysis of combined data of all markers resulted in better distinction of individual species. Highest number of loci was amplified with SSR primers with resolving power in a range of 17.4-39. Dendrogram based on three molecular data using unweighted pair group method with arithmetic mean classified all the species into two clusters. Mantle matrix correspondence test revealed high matrix correlation in all the cases. Correlation values for RAPD, ISSR and SSR were 0.797, 0.84 and 0.8, respectively, with combined data. In both the genera wild and cultivated species were completely separated from each other at genomic level. It also revealed distinct genetic identity between species of Curcuma and Zingiber. High genetic diversity documented in the present study provides a baseline data for optimization of conservation and breeding programme of the studied zingiberacious species.

  10. The General Factor of Personality: Ten Years After

    Directory of Open Access Journals (Sweden)

    Janek Musek

    2017-05-01

    Full Text Available According to the empirical and theoretical research in past ten years, the General Factor of Personality (GFP was interpreted as the highest-order (most general personality dimension, which occupies the apex of the structural hierarchy of personality traits. Thus, the GFP is the central concept in the new structural paradigm of personality (the Pyramidal Model of Personality. In the majority of the studies, the GFP was conceptualized as a general factor with substantial psychological (cognitive and behavioural content reflecting the general social and personal adjustment or effectiveness. The alternative explanations of the GFP emphasize the role of the semantic factors, response styles and other biases. This study reviews the main results of the GFP research including the nature, the biological bases, the strength and cultural universality of GFP, its relations to intelligence and other prominent psychological variables, and its predictive power and practical importance.

  11. Case Study: Let's Get Personal--Putting Personality into Your Cases

    Science.gov (United States)

    Herreid, Clyde Freeman

    2017-01-01

    In this case study, the subject for discussion is the need to use teaching notes in order to add personality to case studies. Personality, it is said, is more important than policy, than demographics, than finances, or amorous peccadillos. Personality is essential. It is the interaction of people that capture our interest, yet, the question is…

  12. Case Study of 'moral injury' : Format Dutch Case Studies Project

    NARCIS (Netherlands)

    Korver, Sjaak; Walton, Martin N.; van Loenen, Guus

    2017-01-01

    The case study ‘Moral Injury’ traces care provided by a chaplain in a mental health institution to a former military marksman named Hans. Hans was in care at a specialized unit for military veterans with traumas. He sought contact with a chaplain “to set things right with God” and wanted the

  13. Beyond case studies: Quantitative effects of recycling, incentive, and diversion program choices

    Energy Technology Data Exchange (ETDEWEB)

    Skumatz, L.A. [Skumatz Economic Research Associates, Seattle, WA (United States)

    1997-12-31

    Communities, facing tight budgets, volatile markets, and the recycling backlash are turning their attention to making their programs more efficient and effective. Unfortunately, communities have very little quantitative information available to help them improve their programs. This is despite the fact that the majority of recycling programs have been running for over 6 years. Further, the author found that there are many thousands of curbside and dropoff recycling programs across the nation, as well as thousands of yard waste and variable rate programs. Still, with all these years of operating experience across the nation, at conferences, when planners ask about the likely impacts of possible program improvements, the answers usually begin, ``well, the City of [fill in the blank] made that change and found...``. Answers like this are seldom transferable to other communities. Similarly, most published information also relies on one or a few (less than ten) case studies, and published case studies usually describe programs that are outstanding in some way, making the information even less transferable. This type of information is wholly inadequate to derive information that is transferable to any other community. Can one really expect information from the City of San Jose, California, to transfer directly to the Village of Hartland, Wisconsin? That is the level of information that has been available thus far to planners. This study uses specially collected data from over 500 communities across North America as the basis for a statistical analysis of those programmatic and socio-demographic factors that contribute most to higher levels of recycling diversion. The work is unique in that it provides the first reliable quantitative information for use by community program planners in analyzing impacts of alternative programs and their cost-effectiveness to design sustainable, appropriate programs to improve diversion.

  14. Optical spectroscopy of ten extragalactic radiosources

    International Nuclear Information System (INIS)

    Rawlings, S.; Riley, J.M.; Saunders, R.

    1989-01-01

    We present optical spectroscopy of ten objects associated with extra-galactic radiosources, using the University of Hawaii 2.2-m telescope. Redshifts are measured for four radiogalaxies (B20217 + 36A + B, 3C73, 0648 + 19A, 0648 + 19B) and for a galaxy which is probably associated with a double radio-source with highly unusual properties (0951 + 37); existing redshifts are confirmed for two radiogalaxies (4C39.04, 4C40.08); and a tentative redshift of z=2.87 measured for the quasar 3C82. (author)

  15. Ten essential skills for electrical engineers

    CERN Document Server

    Dorr, Barry

    2014-01-01

    Engineers know that, as in any other discipline, getting a good job requires practical, up-to-date skills. An engineering degree provides a broad set of fundamentals. Ten Essential Skills applies those fundamentals to practical tasks required by employers. Written in a user-friendly, no-nonsense format, the book reviews practical skills using the latest tools and techniques, and features a companion website with interview practice problems and advanced material for readers wishing to pursue additional skills. With this book, aspiring and current engineers may approach job interviews confident

  16. Survival of the Scandinavian total ankle replacement (STAR): results of ten to nineteen years follow-up.

    Science.gov (United States)

    Frigg, Arno; Germann, Ursula; Huber, Martin; Horisberger, Monika

    2017-10-01

    The purpose of this study was to evaluate survival and clinical outcome of the Scandinavian total ankle replacement (STAR) prosthesis after a minimum of ten years up to a maximum of 19 years. Fifty STAR prostheses in 46 patients with end stage ankle osteoarthritis operated between 1996 and 2006 by the same surgeon (MH) were included. Minimal follow-up was ten years (median 14.6 years, 95% confidence interval [CI] 12.9-16.4). Clinical (Kofoed score) and radiological assessments were taken before the operation and at one, ten (+2), and 16 (±3) years after implantation. The primary endpoint was defined as exchange of the whole prosthesis or conversion to arthrodesis (def. 1), exchange of at least one metallic component (def. 2), or exchange of any component including the inlay (due to breakage or wear) (def. 3). Survival was estimated according to Kaplan-Meier. Further reoperations related to STAR were also recorded. The ten year survival rate was (def. 1) 94% (CI 82-98%), (def. 2) 90% (CI, 77-96%), and (def. 3) 78% (CI 64-87%). The 19-year survival rate was (def. 1) 91% (CI 78-97%), (def. 2) 75% (CI 53-88%), and (def. 3) 55% (CI 34-71%). Considering any re-operations related to STAR, 52% (26/50) of prostheses were affected by re-operations. Mean pre-operative Kofoed score was 49, which improved to 84 after one year (n = 50), to 90 after ten years (n = 46), and to 89 after 16 years (n = 28). The survival rate for def. 1 and 2 was high. However, re-operations occurred in 52% of all STAR prosthesis. Retrospective cohort study, evidence Level 4.

  17. [Mobbing: ten-year evaluation experience in a University Hospital].

    Science.gov (United States)

    Monaco, Edoardo; Girardi, Paolo; Falaschi, Paolo; Ferracuti, Stefano; Martocchia, Antonio; Battaglia, Valentina; Capitanelli, Ilaria; Catarinozzi, Elena; Piccari, Ines; Rossi, Marina; Prestigiacomo, Claudio

    2017-11-01

    Bullying is a manifestation of occupational stress and can therefore be considered as a real "organizational pathology." Include the activities of the surgery dedicated to Mobbing, Unit of Occupational Medicine Sant'Andrea Hospital, which began operations in June 2001. In over ten years of operation (July 2012), the sample, consisting of 50.7% for men and 49.3% women, is heterogeneous in age. The schooling of the sample is medium-high as more than 82% have higher education level. The business sector is the service sector accounted for most (84%) than in industry (9%) and agriculture (2%). Of the 1545 patients seen, 1320 completed the diagnostic path, while 225 have stopped. 814 users have been certified for compatibility bullying (63% of cases) with a net reduction of the awards from 2007 onwards. Considerations are expressed about the possible intervention strategies: the presence of dedicated experts at the counters of listening and professionals as the trusted advisor, to which workers in distress can call on for advice and guidance on how to defend itself from, in accordance with the implemented for years at the Ministry of Health, the establishment of such figures as the manager rehability that in other European countries, are scheduled for some time in work organization. Copyright© by Aracne Editrice, Roma, Italy.

  18. Educational virtual environments: A ten-year review of empirical research (1999-2009)

    DEFF Research Database (Denmark)

    Mikropoulos, Tassos; Natsis, Antonios

    2011-01-01

    This study is a ten-year critical review of empirical research on the educational applications of Virtual Reality (VR). Results show that although the majority of the 53 reviewed articles refer to science and mathematics, researchers from social sciences also seem to appreciate the educational...... value of VR and incorporate their learning goals in Educational Virtual Environments (EVEs). Although VR supports multisensory interaction channels, visual representations predominate. Few are the studies that incorporate intuitive interactivity, indicating a research trend in this direction. Few...

  19. Schematic representation of case study research designs.

    Science.gov (United States)

    Rosenberg, John P; Yates, Patsy M

    2007-11-01

    The paper is a report of a study to demonstrate how the use of schematics can provide procedural clarity and promote rigour in the conduct of case study research. Case study research is a methodologically flexible approach to research design that focuses on a particular case - whether an individual, a collective or a phenomenon of interest. It is known as the 'study of the particular' for its thorough investigation of particular, real-life situations and is gaining increased attention in nursing and social research. However, the methodological flexibility it offers can leave the novice researcher uncertain of suitable procedural steps required to ensure methodological rigour. This article provides a real example of a case study research design that utilizes schematic representation drawn from a doctoral study of the integration of health promotion principles and practices into a palliative care organization. The issues discussed are: (1) the definition and application of case study research design; (2) the application of schematics in research; (3) the procedural steps and their contribution to the maintenance of rigour; and (4) the benefits and risks of schematics in case study research. The inclusion of visual representations of design with accompanying explanatory text is recommended in reporting case study research methods.

  20. HIV and childhood disability: a case-controlled study at a paediatric antiretroviral therapy centre in Lilongwe, Malawi.

    Directory of Open Access Journals (Sweden)

    Akash Devendra

    Full Text Available BACKGROUND: As paediatric antiretroviral therapy (ART is rapidly scaled up in Southern Africa, Human Immunodeficiency Virus (HIV infection is becoming a chronic illness. Children growing up with HIV may begin to encounter disabilities. The relationship between HIV, disability and the need for rehabilitation has added an additional element that needs to be addressed by paediatric HIV treatment programmes. STUDY OBJECTIVES: 1 Estimate the prevalence of disabilities in HIV-infected and HIV-uninfected children in Lilongwe, Malawi. 2 Examine types of disability and associated clinical and socio-demographic factors. 3 Identify needs, opportunities and barriers for rehabilitation in Malawi. METHODS: A case-controlled study of 296 HIV-infected children aged 2-9 years attending an ART centre in Lilongwe (cases and their uninfected siblings (controls was conducted. Disability was assessed using the WHO Ten Question Screen (TQS. Socio-demographic and clinical data were collected using a parent-proxy questionnaire and medical records. RESULTS: Of 296 case and control pairs recruited, 33% (98 versus 7% (20 screened positive for a disability (OR 8.4, 4.4-15.7 respectively. Of these 98 HIV-infected cases, 6%, 36%, 33%, 53%, 46% and 6% had a vision, hearing; physical, learning/comprehension, speech or seizure-related disability respectively and 51% had multiple coexisting disabilities. HIV-infected cases with a disability were more likely to be WHO stage III or IV at enrolment (71% vs. 52%, OR 2.7, 1.5-4.2, to have had TB (58% vs. 39%, OR 2.3, 1.4-3.8 and to have below-average school grades (18% vs. 2%, OR 11.1, 2.2-54.6 than those without. Sixty-seven percent of cases with a disability had never attended any rehabilitative service. Twenty-nine percent of caregivers reported facing stigma and discrimination because of the child's disability. CONCLUSION: This study reveals the magnitude of disability among HIV-infected children and the large unmet need for

  1. Students' Constitutional Right to a Sound Basic Education: New York State's Unfinished Agenda. Part 1. A Roadmap to Constitutional Compliance Ten Years after "CFE v. State"

    Science.gov (United States)

    Rebell, Michael A.; Wolff, Jessica R.

    2016-01-01

    Ten years have passed since New York's highest court ruled in the landmark school-funding and educational-rights case, "Campaign for Fiscal Equity (CFE) v. State of New York," that the state was violating students' constitutional right to the "opportunity for a sound basic education" and ordered significant reforms of the…

  2. A case report of Halzon syndrome

    Directory of Open Access Journals (Sweden)

    Montazeri A

    1997-07-01

    Full Text Available Report of two cases from Halzon syndrome (Tabriz-1996-97. One mother and her daughter ten minutes after eating from raw or half-ripe sheep gut (bowel, showed clinical demonstration of Halzon syndrome. Clinical aspects included: nasal, ear, frontal, and throat pruritis; oral and nasal discharge, caugh, headache, vertigo and mucoid sputum. One day after beginning of this signs and symptoms, some small white worms in 4-6 mm size, discharge from nose and mouth of patients. These worms in laboratory study, were diagnosed as nymph of linguatula serrata

  3. A prospective randomized controlled study of VAX-D and TENS for the treatment of chronic low back pain.

    Science.gov (United States)

    Sherry, E; Kitchener, P; Smart, R

    2001-10-01

    Low back pain is one of the most significant medical and socioeconomic problems in modern society. International guidelines call for evidence-based management for the pain and disability associated with musculoskeletal disorders. The purpose of this randomized controlled trial is to address the question of efficacy and appropriateness of vertebral axial decompression (VAX-D) therapy, a new technology that has been shown in clinical research to create negative intradiscal pressures, and has been shown to be effective in treating patients presenting with chronic low back pain (> 3 months duration) with associated leg pain. Successful outcome was defined as a 50% reduction in pain utilizing a 10 cm Visual Analog Pain Scale and an improvement in the level of functioning as measured by patient-nominated disability ratings. Patients were randomly assigned to VAX-D or to TENS which was used as a control treatment or placebo. The TENS treatment demonstrated a success rate of 0%, while VAX-D demonstrated a success rate of 68.4% (p pain and improvement in functional outcome was obtained in patients with chronic low back pain treated with VAX-D.

  4. Solving Business Problems Together Case: A Master's Degree Programme in Finland

    Directory of Open Access Journals (Sweden)

    Maria Jakubik

    2017-08-01

    Full Text Available This descriptive, single, intrinsic case study seeks to answer the following questions: Why should business practitioners and educators work together in solving business problems? How are the business problems of companies handled in a master's degree programme in Finland? The case study is based on multiple sources of documents collected and developed during the ten years of the programme. It demonstrates that solving authentic business problems in a learning community of business practitioners, i.e. students, as well as educators, i.e. teachers and thesis advisors, leads to solutions that satisfy practitioners, educators, and the business community. This case is an example of how solving business problems together contributes to the better performance of businesses and a better society in Finland.

  5. Fulfilling the atomic promise: Ten years history gives pointers for the future

    International Nuclear Information System (INIS)

    1967-01-01

    Ten years is a short period in human history, and a short period in the life of an international organization. Nevertheless the ten years now completed by the International Atomic Energy Agency has seen much work accomplished and has brought greater realization than ever before of the promise held out by the atom for peaceful benefits leading to the promotion of peace, health and prosperity throughout the world

  6. Peace Corps Water/Sanitation Case Studies and Analyses. Appropriate Technologies for Development. Case Study CS-4.

    Science.gov (United States)

    Talbert, Diana E., Comp.

    This document provides an overview of Peace Corps water and sanitation activities, five case studies (Thailand, Yemen, Paraguay, Sierra Leone, and Togo), programming guidelines, and training information. Each case study includes: (1) background information on the country's geography, population, and economics; (2) information on the country's…

  7. Herbal does not mean innocuous: ten cases of severe hepatotoxicity associated with dietary supplements from Herbalife products.

    Science.gov (United States)

    Schoepfer, Alain M; Engel, Antoinette; Fattinger, Karin; Marbet, Urs A; Criblez, Dominique; Reichen, Juerg; Zimmermann, Arthur; Oneta, Carl M

    2007-10-01

    Herbal agents are popular and perceived as safe because they are supposedly 'natural'. We report 10 cases of toxic hepatitis implicating Herbalife products. To determine the prevalence and outcome of hepatotoxicity due to Herbalife products. A questionnaire was sent to all public Swiss hospitals. Reported cases were subjected to causality assessment using the CIOMS criteria. Twelve cases of toxic hepatitis implicating Herbalife preparations (1998-2004) were retrieved, 10 sufficiently documented to permit causality analysis. Median age of patients was 51 years (range 30-69) and latency to onset was 5 months (0.5-144). Liver biopsy (7/10) showed hepatic necrosis, marked lymphocytic/eosinophilic infiltration and cholestasis in five patients. One patient with fulminant liver failure was successfully transplanted; the explant showed giant cell hepatitis. Sinusoidal obstruction syndrome was observed in one case. Three patients without liver biopsy presented with hepatocellular (2) or mixed (1) liver injury. Causality assessment of adverse drug reaction was classified as certain in two, probable in seven and possible in one case(s), respectively. We present a case series of toxic hepatitis implicating Herbalife products. Liver toxicity may be severe. A more detailed declaration of components and pro-active role of regulatory agencies would be desirable.

  8. Sequentially allocated clinical trial of rhythmic stabilization exercises and TENS in women with chronic low back pain.

    Science.gov (United States)

    Kofotolis, Nikolaos D; Vlachopoulos, Symeon P; Kellis, Eleftherios

    2008-02-01

    To examine the effectiveness of rhythmic stabilization exercises and transcutaneous electrical nerve stimulation (TENS) and their combination in treating women with chronic low back pain. Sequentially allocated, single-blinded and controlled study, with a two-month follow-up. The data were collected in a patient rehabilitation setting. A total of 92 women (34-46 years old) with chronic low back pain were studied. Sequential allocation was undertaken into four groups: ;rhythmic stabilization' (n=23), ;rhythmic stabilization - TENS' (n=23), TENS (n=23), and a placebo group (n = 23). Each programme lasted for four weeks. All outcome measures were assessed prior to, immediately after, four weeks and eight weeks post intervention. Data were obtained on functional disability, pain intensity, trunk extension range of motion, dynamic endurance of trunk flexion and static endurance of trunk extension. A total of 88 patients provided two-month follow-up data. The ;rhythmic stabilization' and the ;rhythmic stabilization - TENS' groups displayed statistically significant (Ppain intensity (ranging from 21.2 to 42.8%), trunk extension range of motion (ranging from 6.5 to 25.5%), dynamic endurance of trunk flexion and static endurance of trunk extension (ranging from 13.5 to 74.3%) compared with the remaining groups. The rhythmic stabilization programmes resulted in more gains in women with chronic low back pain regarding the present outcome variables compared with the other groups; therefore, its application in female chronic low back pain patients aged 34-46 years is recommended.

  9. Five case studies of multifamily weatherization programs

    Energy Technology Data Exchange (ETDEWEB)

    Kinney, L; Wilson, T.; Lewis, G. [Synertech Systems Corp. (United States); MacDonald, M. [Oak Ridge National Lab., TN (United States)

    1997-12-31

    The multifamily case studies that are the subject of this report were conducted to provide a better understanding of the approach taken by program operators in weatherizing large buildings. Because of significant variations in building construction and energy systems across the country, five states were selected based on their high level of multifamily weatherization. This report summarizes findings from case studies conducted by multifamily weatherization operations in five cities. The case studies were conducted between January and November 1994. Each of the case studies involved extensive interviews with the staff of weatherization subgrantees conducting multifamily weatherization, the inspection of 4 to 12 buildings weatherized between 1991 and 1993, and the analysis of savings and costs. The case studies focused on innovative techniques which appear to work well.

  10. Do nurses really care? Confirming the stereotype with a case control study.

    Science.gov (United States)

    Williams, Geraint; Dean, Phil; Williams, Elisabeth

    In their definition of modern nursing, the Royal College of Nursing emphasizes the importance of caring. However, there is little other than anecdotal evidence that female qualified staff nurses are more caring and compassionate than average individuals. A study was carried out to test, under scientific conditions with a case control study, the hypothesis that staff nurses are no more caring than average female individuals. Using the ten-item personality inventory (TIPI) questionnaire, a statistical comparison was made between 174 volunteer female staff nurses and data for 760 adult female controls extracted from the TIPI instrument's original validation study. The questionnaire measures each of the five major facets of personality: openness, extroversion, conscientiousness, agreeableness and neuroticism. Agreeableness, which is a tendency to be compassionate, considerate and cooperative, was used as a proxy measure for 'caring'. Data were analysed using unpaired Student's t-tests. Female staff nurses recorded significantly higher scores than female controls concerning the personality traits extroversion, agreeableness, conscientiousness and emotional stability (Pnurses are significantly more caring, conscientious and resilient individuals. The personality traits found in female staff nurses complement their profession and to some extent justify the caring, compassionate nurse stereotype. Whether career nursing self-selects these qualities or to what extent nursing staff develop aspects of their personality as a product of experience is a subject for debate.

  11. Summary of case studies for cooperation mechanisms

    DEFF Research Database (Denmark)

    Longa, Francesco Dalla; Klinge Jacobsen, Henrik; Hansen, Lise-Lotte Pade

    2012-01-01

    This document is a summary report highlighting the main aspect analyzed in the RES4LESS case studies. The document starts with an introductory chapter where the background that led to the selection of the case studies is outlined. In the following three chapters the case studies are presented, hi...

  12. A Qualitative Case Study of Smartphone-Connected Hearing Aids: Influences on Patients, Clinicians, and Patient-Clinician Interactions.

    Science.gov (United States)

    Ng, Stella L; Phelan, Shanon; Leonard, MaryAnn; Galster, Jason

    2017-06-01

    Innovations in hearing aid technology influence clinicians and individuals who use hearing aids. Little research, to date, explains the innovation adoption experiences and perspectives of clinicians and patients, which matter to a field like audiology, wherein technology innovation is constant. By understanding clinician and patient experiences with such innovations, the field of audiology may develop technologies and ways of practicing in a manner more responsive to patients' needs, and attentive to society's influence. The authors aimed to understand how new innovations influence clinician and patient experiences, through a study focusing on connected hearing aids. "Connected" refers to the wireless functional connection of hearing aids with everyday technologies like mobile phones and tablets. The authors used a qualitative collective case study methodology, borrowing from constructivist grounded theory for data collection and analysis methods. Specifically, the authors designed a collective case study of a connected hearing aid and smartphone application, composed of two cases of experience with the innovation: the case of clinician experiences, and the case of patient experiences. The qualitative sampling methods employed were case sampling, purposive within-case sampling, and theoretical sampling, and culminated in a total collective case n = 19 (clinician case n = 8; patient case n = 11). These data were triangulated with a supplementary sample of ten documents: relevant news and popular media collected during the study time frame. The authors conducted interviews with the patients and clinicians, and analyzed the interview and document data using the constant comparative method. The authors compared their two cases by looking at trends within, between, and across cases. The clinician case highlighted clinicians' heuristic-based candidacy judgments in response to the adoption of the connected hearing aids into their practice. The patient case revealed

  13. Implementing Product Platforms: A Case Study

    DEFF Research Database (Denmark)

    Nielsen, Ole Fiil; Mortensen, Niels Henrik

    2006-01-01

    The paper describes a case study dealing with the process of creating and implementing a product platform. The paper espessially deals with the fact that to obtain the benefits of platforms a permanent change in behaviour in product development must be ensured. This change in behaviour requires...... acceptance and approval from the organisation in general and the commitment from management to enforce agreed-upon decisions. The case study itself was performed in the Danish company LEGO Group. The case study had two objectives: To create a technical architecture and align this architecture...

  14. Quantum golden field theory - Ten theorems and various conjectures

    International Nuclear Information System (INIS)

    El Naschie, M.S.

    2008-01-01

    Ten theorems and few conjectures related to quantum field theory as applied to high energy physics are presented. The work connects classical quantum field theory with the golden mean renormalization groups of non-linear dynamics and E-Infinity theory

  15. [THE TEN MOST CITED ARTICLES OF THE JOURNAL "NUTRICION HOSPITALARIA"].

    Science.gov (United States)

    Franco-López, Ángeles; González-Gallego, Javier; Sanz-Valero, Javier; Tuñón, María Jesús; García-De-Lorenzo, Abelardo; Culebras, Jesús M

    2015-12-01

    After 36 years of continued publication of the journal Nutrición Hospitalaria, a list with the ten most cited articles published in it is elaborated. The top ten most cited articles in the world literature and stratification according to language, English or Spanish, subject, or period of time published are also analyzed. Nutr Hosp is the most important Ibero latin American nutrition journal. Nutr Hosp published 369 items in 2014 gaining the fourth position among all the world's journals devoted to nutrition. Article publication in English, or simultaneously in Spanish and English and Open Access policy probably benefit the number of citations. Copyright AULA MEDICA EDICIONES 2014. Published by AULA MEDICA. All rights reserved.

  16. An Investigation of the Effects of Different Pulse Patterns of Transcutaneous Electrical Nerve Stimulation (TENS) on Perceptual Embodiment of a Rubber Hand in Healthy Human Participants With Intact Limbs.

    Science.gov (United States)

    Mulvey, Matthew R; Fawkner, Helen J; Johnson, Mark I

    2015-12-01

    The aim of this study was to investigate the strength of perceptual embodiment achieved during an adapted version of the rubber hand illusion (RHI) in response to a series of modified transcutaneous electrical nerve stimulation (TENS) pulse patterns with dynamic temporal and spatial characteristics which are more akin to the mechanical brush stroke in the original RHI. A repeated-measures counterbalanced experimental study was conducted where each participant was exposed to four TENS interventions: continuous pattern TENS; burst pattern TENS (fixed frequency of 2 bursts per second of 100 pulses per second); amplitude-modulated pattern TENS (intensity increasing from zero to a preset level, then back to zero again in a cyclical fashion); and sham (no current) TENS. Participants rated the intensity of the RHI using a three-item numerical rating scale (each item was ranked from 0 to 10). Friedman's analysis of ranks (one-factor repeated measure) was used to test the differences in perceptual embodiment between TENS innervations; alpha was set at p ≤ 0.05. There were statistically significant differences in the intensity of misattribution and perceptual embodiment between sham and active TENS interventions, but no significant differences between the three active TENS conditions (amplitude-modulated TENS, burst TENS, and continuous TENS). Amplitude-modulated and burst TENS produced significantly higher intensity scores for misattribution sensation and perceptual embodiment compared with sham (no current) TENS, whereas continuous TENS did not. The findings provide tentative, but not definitive, evidence that TENS parameters with dynamic spatial and temporal characteristics may produce more intense misattribution sensations and intense perceptual embodiment than parameters with static characteristics (e.g., continuous pulse patterns). © 2015 International Neuromodulation Society.

  17. Ten Indicators of Vitality in Smaller Academic Libraries

    Science.gov (United States)

    Pappas, David

    2009-01-01

    This paper provides a means of quickly ascertaining the relative health of smaller academic libraries by presenting a top ten list of vitality indicators. The list is based on an observational convenience sampling of thirty smaller academic libraries across the United States. The indicators making the list were those which appeared most often in…

  18. Ten Strengths of How Teachers Do Cooperative Learning

    Science.gov (United States)

    Jaocbs, George M.

    2016-01-01

    Cooperative learning involves students in working together with peers to learn, to develop learning skills and to enjoy the learning process. This paper examines ten areas in which the author believes he and other teachers do cooperative learning well. These areas are: (1) keeping group size small, usually four or fewer; (2) encouraging students…

  19. Unified SU(4) color models in ten dimensions

    International Nuclear Information System (INIS)

    Hanlon, B.E.; Joshi, G.C.

    1992-01-01

    Some aspects of constructing unified models with SU(4) as the color group via a unifying group defined in ten dimensions are examined. Four dimensional theories are recovered using the Coset Space Dimensional Reduction scheme. Candidate models are considered in order to highlight some of the difficulties in constructing realistic four dimensional theories. 30 refs

  20. Chinese Junior High School Students' Perceptions of Geographic Fieldwork: A Case Study

    Science.gov (United States)

    Yang, Daihu; Wang, Ziying; Xu, Di; Wang, Chuanbing; Deng, Zhengzheng

    2013-01-01

    After nearly ten years of implementation of the first junior high school geography standards, Chinese geography educators have been increasingly incorporating fieldwork into their geography teaching. This study examined student perceptions of fieldwork from an international perspective by reviewing student fieldwork reports and administering a…

  1. Location of existing Case Studies on Open Education

    OpenAIRE

    Burke, Siobhan

    2014-01-01

    Members of the Open Education Special Interest Group have collected a selection of short case studies on Open Education. View all of the case studies at http://repository.alt.ac.uk/view/divisions/CaseStudies/ Location of existing Case Studies on Open Education: The following lists aims to capture and amalgamate the various different case study sources which have been created and developed within the UK around experiences of Open Educational Resources.

  2. Simplification of the helical TEN2 laser

    Science.gov (United States)

    Krahn, K.-H.

    1980-04-01

    The observation that the helical TEN2 laser can effectively be simplified by giving up the use of decoupling elements as well as by abolishing the segmentation of the electrode structure is examined. Although, as a consequence of this simplification, the operating pressure range was slightly decreased, the output power could be improved by roughly 30%, a result which is attributed to the new electrode geometry exhibiting lower inductance and lower damping losses.

  3. Antimicrobial activity of Verbascum macrurum Ten. (Scrophulariaceae).

    Science.gov (United States)

    Guarino, C

    2002-01-01

    The Author presents the results regarding the antibacterial action of extracts of Verbascum macrurum Ten.. The leaves of this species, gathered on the slopes of Mt. Matese, were ground and four extracts were made as follows: with dicholoromethane, ethonol and water (70:30 v/v), water and methanol. The antibacterial activity of each of the samples was tested and it is demonstrated that the extract with the ethanol/water was the most activity one.

  4. national Case study

    African Journals Online (AJOL)

    This national case study reports on the development of a national network, ... system under the new policy), tends to be limited by content on problems and ... 20 credit programme; and within two Post Graduate Certificate of Education contexts, ...... descriptive with an issues focus (empirical) towards awareness production to.

  5. Writing case studies in information systems research

    NARCIS (Netherlands)

    van der Blonk, H.C.

    Case study research can be reported in different ways. This paper explores the various ways in which researchers may choose to write down their case studies and then introduces a subsequent typology of writing case studies. The typology is based on a 2 x 2 matrix, resulting in four forms of writing

  6. Climate variability as a threat for countries progressing towards malaria elimination: The case study of Peru

    Science.gov (United States)

    Mousam, Aneela; Maggioni, Viviana; Quispe, Antonio; Aquila, Valentina

    2015-04-01

    Malaria cases reported by the Peruvian Ministry of Health demonstrate a 61% reduction of malaria in the last decade (2001- 2010). However, during the years 2011-14 malaria increased by ~2.7 folds in Peru and ~5 folds in Loreto, an Amazonian department that continues contributing over 90% of the malaria cases in Peru. Past studies have indicated that there is a strong association between climate variability and malaria rates. The purpose of this study is to test the hypothesis that climate variables have played a key role in the recent increase of malaria cases in Peru. Climate data, such as precipitation, temperature, humidity and surface pressure simulated by the NASA MERRA model during a 10-year ling time series (2004-2013) are used to verify this hypothesis. Preliminary data analyses show large deviations from the 10-year mean (i.e., climatological anomalies) in humidity, surface pressure, and temperature during 2010 up to four times larger than previous and subsequent years. An increase of 8% in precipitation yearly averages is observed in 2010, which also corresponds with the following reverse of the downward trend of malaria incidence, particularly in Loreto. The sudden amplification of climatological anomalies in 2010 could have set the environmental conditions that caused the re-emergence of malaria in 2011. Investigation is underway to link weekly malaria data from different districts in Peru to the climate conditions at those locations during the past ten years. This will be crucial in understanding why some countries, despite all necessary efforts, are unable to completely eliminate malaria.

  7. Ten steps to successful poster presentation.

    Science.gov (United States)

    Hardicre, Jayne; Devitt, Patric; Coad, Jane

    Receiving a letter confirming acceptance for you to present a poster at a conference can evoke mixed emotions. Joy, panic, fear and dread are among the many possible emotions and this is not exclusive to first time presenters. Developing an effective poster presentation is a skill that you can learn and can provide a rewarding way to present your work in a manner less intimidating than oral presentation (Shelledy, 2004). The key to successful poster presentation is meticulous, timely, well informed preparation. This article outlines ten steps to help guide you through the process to maximize your success.

  8. Audits reveal ten common environmental problems

    International Nuclear Information System (INIS)

    Buys, M.W.

    1992-01-01

    The old saying that open-quotes an ounce of prevention is worth a pound of cureclose quotes rings particularly true in environmental matters in the 1990s. Environmental problems can potentially lead to expensive fines, costly cleanups, negative public relations, and even criminal sanctions against members of the corporation. A recurring pattern of problems has been noted during the performance of environmental disposition, acquisition, and compliance assessments of many different operators in most of the producing states. The ten most common problems found in oilfield audits are discussed here in an effort to enhance the awareness of operators

  9. Ten financial management principles for survival.

    Science.gov (United States)

    Cleverley, W O

    1988-03-01

    Financial insolvency is the primary cause of hospital failure. Managers may analyze a hospital's financial statements to anticipate and prevent fiscal problems. Ten measures of fiscal status may be used to evaluate the following: operating profitability nonoperating income equity growth liquidity debt capacity age of facilities revenue generation replacement funds receivables survivability Based on data from the Financial Analysis Service, Catholic hospitals are doing better than other U.S. hospitals in some areas of financial preparedness. In most areas, however, all hospitals suffer by comparison with manufacturers. The 10 principles of solvent and successful operations can help hospitals improve financial resiliency.

  10. Sclerotherapy of Plummer's disease - A critical ten year review

    International Nuclear Information System (INIS)

    Sandrock, D.; Humplik, B.I.; Munz, D.L.

    2002-01-01

    Aim: Since ten years sclerotherapy with ethanol is proposed for the treatment of Plummer's disease (unifocal autonomy). Hence, it was the aim of this study to evaluate critically all the sclerotherapies performed in our institution. Special attention should be given to the long-term results. Material and Methods: In the study enrolled were 47 consecutive patients with Plummer's disease, who were referred to sclerotherapy with ethanol since 1991 (10 men, 37 women, aged 24-79 years). The diagnosis of unifocal autonomy was proven in all patients by scintigraphy under TSH-suppressed conditions. 31 patients had latent, 16 manifest hyperthyroidism, 12 of these under antithyroid medication. All patients received ultrasound guided infiltrations of 0.5-2 ml 96 % ethanol into the autonomy. The procedure was repeated at intervals (individually between 1 week and 3 months) until there was A) sufficient success, B) partial success or C) the patient refused further infiltrations. Results: Overall, 407 infiltrations were performed. The number of infiltrations per patient reached from 1 to 63 (mean 7). The side effects included 2 cases of a (transient) paresis of the recurrent nerve and pain/discomfort in 32 %. The therapy was finished successfully (group A; normal TSH, normalisation of the scintigraphic pattern) in 17 patients, partially successfully (group B; change from manifest to latent hyperthyroidism and/or TSH > 0.1 mU/l, scintigram not completely normalized) in 12 patients, and without success (group C) in 16 patients - 2 changed to surgery, 4 to radioiodine therapy, 3 continued antithyroid medication and 4 refused therapy without further comments. Excluding 2 patients from group B (with 35 and 61 infiltrations, respectively) there was no significant difference between A, B, and C in the parameters uptake under suppression, volume of the autonomy, laboratory values, number of infiltrations, age or sex. Conclusion: The sclerotherapy with ethanol, consequently performed, is

  11. The Danish National Case Study Report

    DEFF Research Database (Denmark)

    Brodersen, Søsser; Jørgensen, Michael Søgaard

    Three case studies from Danish science shops within the environmental field are analysed with respect to societal background, interaction between the involved actors and the societal impact of the co-operation. The report is one of the seven national case study reports from the EU...

  12. Using Case Studies in Calculus-based Physics

    Science.gov (United States)

    Katz, Debora M.

    2006-12-01

    Do your students believe that the physics only works in your classroom or laboratory? Or do they see that physics underlies their everyday experience? Case studies in physics help students connect physics principles to their everyday experience. For decades, case studies have been used to teach law, medicine and biology, but they are rarely used in physics. I am working on a calculus-based physics textbook for scientists and engineers. Case studies are woven into each chapter. Stop by and get a case study to test out in your classroom. I would love to get your feedback.

  13. Modalities of Generalization Through Single Case Studies.

    Science.gov (United States)

    Zittoun, Tania

    2017-06-01

    The value of case studies for theory building is still doubted in psychology. The paper argues for the importance of case studies and the possibility of generalizing from these for a specific sociocultural understanding of human development. The paper first clarifies the notion of abduction within case studies, drawing on pragmatists James and Peirce and expanding it with the work of Lewin, and argues that it is the core mechanism that allows generalization from case studies. The second section presents the possibility of generalizing from individual single case studies, for which not only the subjective perspective, but also the dynamics by which the social and cultural environment guide and enable the person's development, have to be accounted for. The third section elaborates the question of institutional case studies, where the challenge is to account both for institutional dynamics, and for persons' trajectories within; this is exemplified with an ongoing study on the process of obtaining citizenship in Switzerland. The paper briefly concludes by highlighting two possible implications of the paper, one concerning the process of theoretical reasoning, the other, the fact that sociocultural psychology could itself be seen as an institution in-the-making.

  14. Top Ten Challenges Facing the Next Secretary of Homeland Security

    National Research Council Canada - National Science Library

    2008-01-01

    In an effort to assist with the first Presidential administration transition of the Department of Homeland Security, the Homeland Security Advisory Council has identified ten key challenges that will...

  15. Effects of transcutaneous electrical nerve stimulation (TENS) on memory in elderly with mild cognitive impairment.

    NARCIS (Netherlands)

    Luijpen, M.W.; Swaab, D.F.; Sergeant, J.A.; Dijk, K.R.A.; Scherder, E.J.

    2005-01-01

    In previous studies, transcutaneous electrical nerve stimulation (TENS) was shown to have a positive effect on memory in Alzheimer's disease (AD) patients. Moreover, the reported effects appeared to be more beneficial in early stages of Alzheimer's disease compared to later stage intervention. Based

  16. Effects of transcutaneous electrical nerve stimulation (TENS) on memory in elderly with mild cognitive impairment

    NARCIS (Netherlands)

    Luijpen, MW; Swaab, DF; Sergeant, JA; van Dijk, KRA; Scherder, EJA

    2005-01-01

    In previous studies, transcutaneous electrical nerve stimulation (TENS) was shown to have a positive effect on memory in Alzheimer's disease (AD) patients. Moreover, the reported effects appeared to be more beneficial in early stages of Alzheimer's disease compared to later stage intervention. Based

  17. Implementation of case studies in undergraduate didactic nursing courses: a qualitative study.

    Science.gov (United States)

    Dutra, Danette K

    2013-07-04

    The implementation of unfolding scenario-based case studies in the didactic classroom is associated with learner-centered education. The utilization of learner-centered pedagogies, such as case studies, removes the focus from the instructor and instead places it on the student. Learner-centered pedagogies are believed to improve students' levels of cognition. The purpose of this study was to examine how nurse educators are implementing the pedagogies of case studies in their undergraduate didactic courses. The goal was to examine, document, report, and, ultimately, implement the strategies. Purposeful sampling was utilized in this qualitative, multisite-designed study. For each of the four participants, three separate site visits were completed. Observations and post-observational interviews took place at each site visit. Transcribed data from interviews, observations, and course documents were imported into the computer program Nvivo8. Repetitive comparative analysis was utilized to complete the data coding process. The guiding research question of this study sought to investigate the implementation strategies of case studies in didactic nursing courses. The implementation of case studies by the participants reflected two primary patterns: Formal Implementation (FI) and Informal Implementation (II) of case studies. The FI of case studies was further divided into two subcategories: Formal Implementation of case studies used Inside the Classroom setting (FIIC) and Formal Implementation of cases studies used Outside of the Classroom (FIOC). Results of this investigation have led to an increased understanding of implementation strategies of unfolding scenario-based case studies in undergraduate nursing didactic courses. Data collected were rich in the description of specific methodologies for utilization of case studies and may serve as a resource for faculty in development of creative strategies to enhance the didactic classroom experience.

  18. Supersymmetric Yang-Mills theory on conformal supergravity backgrounds in ten dimensions

    Energy Technology Data Exchange (ETDEWEB)

    Medeiros, Paul de; Figueroa-O’Farrill, José [Maxwell Institute and School of Mathematics, The University of Edinburgh,James Clerk Maxwell Building, Peter Guthrie Tait Road, Edinburgh EH9 3FD (United Kingdom)

    2016-03-14

    We consider bosonic supersymmetric backgrounds of ten-dimensional conformal supergravity. Up to local conformal isometry, we classify the maximally supersymmetric backgrounds, determine their conformal symmetry superalgebras and show how they arise as near-horizon geometries of certain half-BPS backgrounds or as a plane-wave limit thereof. We then show how to define Yang-Mills theory with rigid supersymmetry on any supersymmetric conformal supergravity background and, in particular, on the maximally supersymmetric backgrounds. We conclude by commenting on a striking resemblance between the supersymmetric backgrounds of ten-dimensional conformal supergravity and those of eleven-dimensional Poincaré supergravity.

  19. Research on the localization method of protecting traditional village landscape: a case study on Tangyin

    Directory of Open Access Journals (Sweden)

    W. Li

    2015-08-01

    Full Text Available China has over 271 million villages and less than the number in ten years ago in which there are 363 million villages. New rural construction indeed do some good for common villages but still destroy hundreds and thousands traditional village which contain great cultural, science, artistic values. In addition, traditional villages can't meet the increasing needs in more convenient and comfortable living conditions. Increasing population also makes traditional villages out of control in construction. With the background of this, we have to set up in traditional village protection. This article put forward an idea in protection which make use of landscape localization to pursue the sustainable development and vernacular landscape protection. Tangyin Town is a famous trade center in history and left many cultural heritage, especially historical buildings. Take Tangyin as a case study to apply the localization method which could guide other similar villages to achieve same goals.

  20. Is there a role for TENS application in the control of diabetes mellitus in insulin-dependent patients?

    Science.gov (United States)

    Khan, Mueen Ullah

    2012-11-01

    An 80-year-old man with insulin-dependent diabetes mellitus presented to the hospital with low back pain. He was initially managed with non-steroidal anti-inflammatory drugs, tramadol and epidural steroid injection. Transcutaneous electrical nerve stimulation (TENS), applied on the back and buttocks, was subsequently advised. Initially, TENS was applied once every 24 hours. On improvement of pain symptoms, it was increased to thrice every 24 hours. The patient then complained of symptoms of hypoglycaemia (blood sugar level TENS resulted in raised blood sugar level. When TENS was restarted, the same hypoglycaemic response was noted. The insulin dosage was adjusted to half of the patient's routine daily requirement with continued application of TENS. This incidental finding has alerted us to hypoglycaemic episodes following TENS application, which may be due to effective pain control, decreased sympathetic stimulation, enhanced insulin sensitivity or altered muscle metabolism due to electrical stimulation.