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Sample records for adults current standards

  1. Current concepts in adult aphasia.

    Science.gov (United States)

    McNeil, M R

    1984-01-01

    This paper provides a review of recent research from the areas of speech and language pathology, cognitive psychology, psycholinguistics, neurology, and rehabilitation medicine which is used to refine and extend current definitions of aphasia. Evidence is presented from these diverse disciplines, which supports a multimodality, performance-based, verbal and non-verbal, cortical and subcortical, and cognitively multidimensional view of aphasia. A summary of current practice in the assessment and treatment of adult aphasia is summarized.

  2. Current Cigarette Smoking Among Adults Infographic

    Data.gov (United States)

    U.S. Department of Health & Human Services — Explore the Current Cigarette Smoking Among Adults Infographic which outlines key facts related to current smoking among adults. For accessibility issues contact...

  3. Nuclear standards: current issues and future trends

    International Nuclear Information System (INIS)

    Landis, J.W.

    1985-01-01

    A summary of the important issues that currently face the nuclear standards field is presented and a discussion of how each of these issues is being resolved is given. The economic benefits that properly developed standards produce are listed

  4. A review of the quantum current standard

    International Nuclear Information System (INIS)

    Kaneko, Nobu-Hisa; Nakamura, Shuji; Okazaki, Yuma

    2016-01-01

    The electric current, voltage, and resistance standards are the most important standards related to electricity and magnetism. Of these three standards, only the ampere, which is the unit of electric current, is an International System of Units (SI) base unit. However, even with modern technology, relatively large uncertainty exists regarding the generation and measurement of current. As a result of various innovative techniques based on nanotechnology and novel materials, new types of junctions for quantum current generation and single-electron current sources have recently been proposed. These newly developed methods are also being used to investigate the consistency of the three quantum electrical effects, i.e. the Josephson, quantum Hall, and single-electron tunneling effects, which are also known as ‘the quantum metrology triangle’. This article describes recent research and related developments regarding current standards and quantum-metrology-triangle experiments. (topical review)

  5. Current and future neutron radiography standards

    International Nuclear Information System (INIS)

    Brenizer, J.S.

    1999-01-01

    Only two organizations are actively producing standards which are used in neutron radiology (NR): the American Society of Testing and Materials (ASTM) and the International Organization for Standardization (ISO). Six ASTM standards exist that address the neutron radiography method. Two of the ASTM standards have been extensively used world-wide. ISO has a working group which is developing three standards that also address the neutron radiography method. Two of these are currently making their way through the ISO approval system. No ASTM or ISO standards exist for the neutron radioscopic method. Future ASTM standards will address the neutron radioscopic method and neutron radiologic system characterization. It is expected that similar efforts will be undertaken in ISO. Given the relatively small community providing neutron radiologic services, international cooperation and the need for ISO standards will most likely continue to grow.(author)

  6. Standards for Adult Education ESL Programs

    Science.gov (United States)

    TESOL Press, 2013

    2013-01-01

    What are the components of a quality education ESL program? TESOL's "Standards for Adult Education ESL Programs" answers this question by defining quality components from a national perspective. Using program indicators in eight distinct areas, the standards can be used to review an existing program or as a guide in setting up a new…

  7. Current standard treatment for pediatric glioma patients

    International Nuclear Information System (INIS)

    Sonoda, Yukihiko; Kumabe, Toshihiro; Saito, Ryuta; Kanamori, Masayuki; Yamashita, Yoji; Tominaga, Teiji

    2012-01-01

    In this paper, we selected three representative disorders among pediatric gliomas and reviewed standard treatments for these diseases. The formation of this rare disease is involved with BRAF mutation as well as cerebellar pilocytic astrocytoma. Radical resection is not recommended as initial therapy due to high morbidity. Despite its good tumor control, radiotherapy is not a standard therapy due to neuroendocrine and neurocognitive dysfunction. Several papers have reported the effectiveness of platinum-based chemotherapy, which is a useful for induction therapy. Recent progress in molecular analyses has suggested that some markers might be used for staging ependymoma. While total resection is considered to be strongly correlated with patients' survival, the majority of recurrence occurs in the primary site. Despite many clinical trials, chemotherapeutic agents were not found to be effective for this disease. Since whole brain radiation cannot prevent dissemination, local radiation is recommended for adjuvant therapy. The prognosis of this disease is still dismal, and median survival time is within 1 year. Although clinical trials have been conducted to assess the efficacy of chemotherapy prior to, concomitantly with, or after radiotherapy, an effective regimen has not yet been established. Therefore, only conventional local radiotherapy is the standard regimen for this disease. A new therapeutic approach, such as convection-enhanced drug delivery, would be required for improved outcomes in patients with this disease. (author)

  8. Eddy current standards - Cracks versus notches

    Science.gov (United States)

    Hagemaier, D. J.; Collingwood, M. R.; Nguyen, K. H.

    1992-10-01

    Eddy current tests aimed at evaluating cracks and electron-discharge machined (EDM) notches in 7075-T6 aluminum specimens are described. A comparison of the shape and amplitude of recordings made from both transverse and longitudinal scans of small EDM notches and fatigue cracks showd almost identical results. The signal amplitude and phase angle increased with an increase of EDM notch and crak size. It is concluded that equivalent eddy current results obtained from similar-size surface cracks and notches in aluminum can be used to establish a desired sensitivity level for inspection.

  9. Pharmacotherapy of erectile dysfunction: Current standards

    Directory of Open Access Journals (Sweden)

    Kew-Kim Chew

    2006-01-01

    Full Text Available Pharmacotherapy is currently the therapeutic option of choice for erectile dysfunction. Comprising mainly intracavernosal injection therapy using alprostadil or alprostadil combined with phentolamine and/or papaverine and oral phosphodiesterase-5 inhibitors, it is safe and effective if appropriately prescribed and administered. The medications in current use produce satisfactory erectile responses by enhancing cavernosal vasodilatation mainly through their ability to promote relaxation of the smooth muscle cells in the corpora cavernosa involving the synthesis and activity of nitric oxide via the cyclic guanosine monophosphate and cyclic adenosine monophosphate biochemical pathways. The main side-effects and complications of intracavernosal injections are postinjection pain, prolonged erections, priapism and penile fibrosis. There may be a variety of side-effects with phosphodiesterase-5 inhibition but these are usually inconsequential. Recent serious ill health and the need for ongoing long-acting nitrate therapy or frequent use of short-acting nitrates for angina are absolute contraindications to the use of phosphodiesterase-5 inhibitors. Caution has to be exercised in prescribing phosphodiesterase-5 inhibitors for patients with impaired renal or hepatic functions or receiving multi-drug therapy for any systemic disease. All patients presenting with erectile dysfunction should be investigated and treated for cardiovascular risk factors. They should also be counseled regarding lifestyle factors particularly healthy balanced diet, regular physical exercise and inappropriate social habits.

  10. The development of national standards for adult educators in Namibia

    Science.gov (United States)

    Ellis, Justin; Richardson, Brent H.

    2012-06-01

    Since gaining independence from South Africa in 1990, Namibia has placed considerable emphasis on education, including adult learning. As a means of improving the quality of adult learning, the Namibian Ministry of Education commissioned the development of national standards in 2010 to express competency requirements for adult educators. Particular attention was paid to the views of adult learners who participated through thirty focus groups. The participatory process revealed that the work of an adult educator is more complex and demanding than had previously been appreciated. The required competencies were categorised under four headings: (1) Knowledge as an adult educator, (2) Practice as an adult educator, (3) Relationships as an adult educator and (4) Ethics and professionalism as an adult educator. The Namibia Qualifications Authority, acting under its legislative mandate of setting occupational standards for occupations, jobs, posts and positions, approved the national standards in 2011.

  11. Standard guidelines for electrosurgery with radiofrequency current

    Directory of Open Access Journals (Sweden)

    Mutalik Sharad

    2009-08-01

    Full Text Available Definition: Radiofrequency (RF induces thermal destruction of the targeted tissue by an electrical current at a frequency of 0.5 MHz (RF. As the electrode tip is not heated, there is minimal thermal damage to the surrounding tissues, producing good esthetic results. Therefore, RF ablation is also known as cold ablation or "coblation." Modality: It has three modes of operation: (a Cut, (b cut and coagulate and (c coagulate. Therefore, it can be used for various purposes like incision, ablation, fulguration, shave excision and coagulation. Because of the coagulation facility, hemostasis can be achieved and operation becomes easier and faster. Indications: It is effective in treating various skin conditions like dermatosis papulosa nigra, warts, molluscum contagiosum, colloid milia, acquired junctional, compound and dermal melanocytic nevi, seborrheic keratosis, skin tags, granuloma pyogenicum, verrucous epidermal nevi, xanthelesma, rhinophyma, superficial basal cell carcinoma and telangiectasia. It can also be used for cosmetic indications such as resurfacing, earlobe repair and blepharoplasty. Anesthesia: The procedure is accomplished either under topical anesthesia eutactic mixture of local anesthetics or local injectable anesthesia, under all aseptic precautions. Procedure: While operating, only the tip of the electrode should come in contact with the tissue. Actual contact of the electrode with the tissue should be very brief in order to prevent excessive damage to the deeper tissues. This can be accomplished by moving the electrode quickly. Complications: Complications are uncommon and mainly occur due to an improper technique. The treating physician should be aware of the contraindications of the procedure as listed in these guidelines. Physician qualification: RF surgery may be performed by a dermatologist who has acquired adequate training during post-graduation or through recognized fellowships and workshops dedicated to RF surgery. He

  12. Suicide in older adults: current perspectives

    Science.gov (United States)

    Conejero, Ismael; Olié, Emilie; Courtet, Philippe; Calati, Raffaella

    2018-01-01

    Suicidal behavior in older adults (65 years old and over) is a major public health issue in many countries. Suicide rates increase during the life course and are as high as 48.7/100,000 among older white men in the USA. Specific health conditions and stress factors increase the complexity of the explanatory model for suicide in older adults. A PubMed literature search was performed to identify most recent and representative studies on suicide risk factors in older adults. The aim of our narrative review was to provide a critical evaluation of recent findings concerning specific risk factors for suicidal thoughts and behaviors among older people: psychiatric and neurocognitive disorders, social exclusion, bereavement, cognitive impairment, decision making and cognitive inhibition, physical illnesses, and physical and psychological pain. We also aimed to approach the problem of euthanasia or physician-assisted suicide in older adults. Our main findings emphasize the need to integrate specific stress factors, such as feelings of social disconnectedness, neurocognitive impairment or decision making, as well as chronic physical illnesses and disability in suicide models and in suicide prevention programs in older adults. Furthermore, the chronic care model should be adapted for the treatment of older people with long-term conditions in order to improve the treatment of depressive disorders and the prevention of suicidal thoughts and acts. PMID:29719381

  13. Suicide in older adults: current perspectives

    Directory of Open Access Journals (Sweden)

    Conejero I

    2018-04-01

    Full Text Available Ismael Conejero,1,2 Emilie Olié,1–3 Philippe Courtet,1–3 Raffaella Calati1–3 1Institut National de la Santé Et de la Recherche Médicale (INSERM, University of Montpellier, Neuropsychiatry: Epidemiological and Clinical Research, Montpellier, France; 2Department of Emergency Psychiatry and Post-Acute Care, Lapeyronie Hospital, Center Hospitalier Universitairere (CHU Montpellier, Montpellier, France; 3FondaMental Foundation, Créteil, France Abstract: Suicidal behavior in older adults (65 years old and over is a major public health issue in many countries. Suicide rates increase during the life course and are as high as 48.7/100,000 among older white men in the USA. Specific health conditions and stress factors increase the complexity of the explanatory model for suicide in older adults. A PubMed literature search was performed to identify most recent and representative studies on suicide risk factors in older adults. The aim of our narrative review was to provide a critical evaluation of recent findings concerning specific risk factors for suicidal thoughts and behaviors among older people: psychiatric and neurocognitive disorders, social exclusion, bereavement, cognitive impairment, decision making and cognitive inhibition, physical illnesses, and physical and psychological pain. We also aimed to approach the problem of euthanasia or physician-assisted suicide in older adults. Our main findings emphasize the need to integrate specific stress factors, such as feelings of social disconnectedness, neurocognitive impairment or decision making, as well as chronic physical illnesses and disability in suicide models and in suicide prevention programs in older adults. Furthermore, the chronic care model should be adapted for the treatment of older people with long-term conditions in order to improve the treatment of depressive disorders and the prevention of suicidal thoughts and acts. Keywords: suicide, attempted suicide, older adults, risk

  14. Xpand chest drain: assessing equivalence to current standard ...

    African Journals Online (AJOL)

    leakage from 'open to air' system or breakage of glass bottle (with associated risk to ... and an air-leak detection system. It is connected to a ... need to add water. Xpand chest drain: assessing equivalence to current standard therapy – a randomised controlled trial. CHARL COOPER, M.B. CH.B. TIMOTHY HARDCASTLE ...

  15. UV dose-effect relationships and current protection exposure standards

    International Nuclear Information System (INIS)

    Singh, M.S.; Campbell, G.W.

    1982-04-01

    In this paper we have attempted to quantify the health effects in man of uv-radiation exposure of wavelengths from 240 nm to 320 nm. Exposure to uv in this region could result in the formation of skin cancer or premature aging in man. The induction of cancer by uv radiation results from changes in genetic material. We have used the DNA action spectrum coupled with the uv skin cancer data available in the literature to derive the dose-effect relationships. The results are compared against the current uv protection standards

  16. Adult Current Smoking: Differences in Definitions and Prevalence Estimates—NHIS and NSDUH, 2008

    Science.gov (United States)

    Ryan, Heather; Trosclair, Angela; Gfroerer, Joe

    2012-01-01

    Objectives. To compare prevalence estimates and assess issues related to the measurement of adult cigarette smoking in the National Health Interview Survey (NHIS) and the National Survey on Drug Use and Health (NSDUH). Methods. 2008 data on current cigarette smoking and current daily cigarette smoking among adults ≥18 years were compared. The standard NHIS current smoking definition, which screens for lifetime smoking ≥100 cigarettes, was used. For NSDUH, both the standard current smoking definition, which does not screen, and a modified definition applying the NHIS current smoking definition (i.e., with screen) were used. Results. NSDUH consistently yielded higher current cigarette smoking estimates than NHIS and lower daily smoking estimates. However, with use of the modified NSDUH current smoking definition, a notable number of subpopulation estimates became comparable between surveys. Younger adults and racial/ethnic minorities were most impacted by the lifetime smoking screen, with Hispanics being the most sensitive to differences in smoking variable definitions among all subgroups. Conclusions. Differences in current cigarette smoking definitions appear to have a greater impact on smoking estimates in some sub-populations than others. Survey mode differences may also limit intersurvey comparisons and trend analyses. Investigators are cautioned to use data most appropriate for their specific research questions. PMID:22649464

  17. Adult current smoking: differences in definitions and prevalence estimates--NHIS and NSDUH, 2008.

    Science.gov (United States)

    Ryan, Heather; Trosclair, Angela; Gfroerer, Joe

    2012-01-01

    To compare prevalence estimates and assess issues related to the measurement of adult cigarette smoking in the National Health Interview Survey (NHIS) and the National Survey on Drug Use and Health (NSDUH). 2008 data on current cigarette smoking and current daily cigarette smoking among adults ≥18 years were compared. The standard NHIS current smoking definition, which screens for lifetime smoking ≥100 cigarettes, was used. For NSDUH, both the standard current smoking definition, which does not screen, and a modified definition applying the NHIS current smoking definition (i.e., with screen) were used. NSDUH consistently yielded higher current cigarette smoking estimates than NHIS and lower daily smoking estimates. However, with use of the modified NSDUH current smoking definition, a notable number of subpopulation estimates became comparable between surveys. Younger adults and racial/ethnic minorities were most impacted by the lifetime smoking screen, with Hispanics being the most sensitive to differences in smoking variable definitions among all subgroups. Differences in current cigarette smoking definitions appear to have a greater impact on smoking estimates in some sub-populations than others. Survey mode differences may also limit intersurvey comparisons and trend analyses. Investigators are cautioned to use data most appropriate for their specific research questions.

  18. Adult Current Smoking: Differences in Definitions and Prevalence Estimates—NHIS and NSDUH, 2008

    Directory of Open Access Journals (Sweden)

    Heather Ryan

    2012-01-01

    Full Text Available Objectives. To compare prevalence estimates and assess issues related to the measurement of adult cigarette smoking in the National Health Interview Survey (NHIS and the National Survey on Drug Use and Health (NSDUH. Methods. 2008 data on current cigarette smoking and current daily cigarette smoking among adults ≥18 years were compared. The standard NHIS current smoking definition, which screens for lifetime smoking ≥100 cigarettes, was used. For NSDUH, both the standard current smoking definition, which does not screen, and a modified definition applying the NHIS current smoking definition (i.e., with screen were used. Results. NSDUH consistently yielded higher current cigarette smoking estimates than NHIS and lower daily smoking estimates. However, with use of the modified NSDUH current smoking definition, a notable number of subpopulation estimates became comparable between surveys. Younger adults and racial/ethnic minorities were most impacted by the lifetime smoking screen, with Hispanics being the most sensitive to differences in smoking variable definitions among all subgroups. Conclusions. Differences in current cigarette smoking definitions appear to have a greater impact on smoking estimates in some sub-populations than others. Survey mode differences may also limit intersurvey comparisons and trend analyses. Investigators are cautioned to use data most appropriate for their specific research questions.

  19. International comparison of AC-DC current transfer standards

    Science.gov (United States)

    Heine, G.; Garcocz, M.; Waldmann, W.

    2017-01-01

    The measurements of the international comparison of ac-dc current transfer standards identified as EURAMET.EM-K12 started in June 2012 and were completed in December 2014. Twenty NMIs in the EURAMET region and one NMI in the AFRIMET region took part: BEV (Austria), CMI (Czech Republic), PTB (Germany), METAS (Switzerland), JV (Norway), UME (Turkey), GUM (Poland), IPQ (Portugal), CEM (Spain), INRIM (Italy), SP (Sweden), DANIAmet-MI-Trescal (Denmark), BIM (Bulgaria), MKEH (Hungary), SIQ (Slovenia), LNE (France), NSAI NML (Ireland), VSL (The Netherlands), NPL (United Kingdom), Metrosert (Estonia), NIS (Egypt). The comparison was proposed to link the National Metrology Institutes organised in EURAMET to the key comparison CCEM-K12. The ac-dc current transfer difference of each travelling standard had been measured at its nominal current 10 mA and 5 A at the following frequencies: 10 Hz, 55 Hz, 1 kHz, 10 kHz, 20 kHz, 50 kHz, 100 kHz. The test points were selected to link the results with the equivalent CCEM Key Comparison (CCEM-K12), through five NMIs participating in both EURAMET and CCEM key comparisons (PTB, JV, NPL, SP and BEV). The report shows the degree of equivalence in the EURAMET region and also the degree of equivalence with the corresponding CCEM reference value. Main text To reach the main text of this paper, click on Final Report. Note that this text is that which appears in Appendix B of the BIPM key comparison database kcdb.bipm.org/. The final report has been peer-reviewed and approved for publication by the CCEM, according to the provisions of the CIPM Mutual Recognition Arrangement (CIPM MRA).

  20. STANDARDIZED TERMINOLOGY OF ADULT SPINE DEFORMITY FOR BRAZILIAN PORTUGUESE

    Directory of Open Access Journals (Sweden)

    Raphael de Rezende Pratali

    2015-12-01

    Full Text Available Objective : To develop a consensus for translation of the most relevant terms used in the study of Adult Spinal Deformity, from their original languages into Brazilian Portuguese. Methods : A panel of 12 experts in spine surgery from the five Brazilian regions was constituted. To obtain the standardization of terminology, the Delphi method with an electronic questionnaire was administered to participants about their opinion on the translation of 13 relevant terms chosen by literature review. Each term was considered standard when there was consensus, that is, concordance higher than 80% among participants as to the suggestion to be adopted, and then on the acceptance of the term and its abbreviation in Portuguese. Results : Initially there was consensus (over 80% concordance on the translation of seven terms in the electronic questionnaire. The other six terms that have not reached consensus were discussed at a meeting among the participants, relying on the opinion of a specialized professional in simultaneous translation of orthopedic terms in Portuguese and other professional majored in Portuguese language. It was decided how these terms should be translated and there was a consensus among all participants regarding their acceptance. Finally, there was consensus among the participants, who agreed with the translation and abbreviation of the 13 propose terms, defining its standardization for Brazilian Portuguese. Conclusion : We present a standard terminology used in the study of Adult Spinal Deformity through consensus among experts, seeking uniformity in the use of these terms in Brazilian Portuguese.

  1. Current standards for infection control: audit assures compliance.

    Science.gov (United States)

    Flanagan, Pauline

    Having robust policies and procedures in place for infection control is fundamentally important. However, each organization has to go a step beyond this; evidence has to be provided that these policies and procedures are followed. As of 1 April 2009, with the introduction of the Care Quality Commission and The Health and Social Care Act 2008 Code of Practice for the NHS on the Prevention and Control of Healthcare-Associated Infections and Related Guidance, the assurance of robust infection control measures within any UK provider of health care became an even higher priority. Also, the commissioning of any service by the NHS must provide evidence that the provider has in place robust procedures for infection control. This article demonstrates how the clinical audit team at the Douglas Macmillan Hospice in North Staffordshire, UK, have used audit to assure high rates of compliance with the current national standards for infection control. Prior to the audit, hospice staff had assumed that the rates of compliance for infection control approached 100%. This article shows that a good quality audit tool can be used to identify areas of shortfall in infection control and the effectiveness of putting in place an action plan followed by re-audit.

  2. Current Cigarette Smoking Among Adults - United States, 2016.

    Science.gov (United States)

    Jamal, Ahmed; Phillips, Elyse; Gentzke, Andrea S; Homa, David M; Babb, Stephen D; King, Brian A; Neff, Linda J

    2018-01-19

    The U.S. Surgeon General has concluded that the burden of death and disease from tobacco use in the United States is overwhelmingly caused by cigarettes and other combusted tobacco products (1). Cigarettes are the most commonly used tobacco product among U.S. adults, and about 480,000 U.S. deaths per year are caused by cigarette smoking and secondhand smoke exposure (1). To assess progress toward the Healthy People 2020 target of reducing the proportion of U.S. adults aged ≥18 years who smoke cigarettes to ≤12.0% (objective TU-1.1),* CDC analyzed data from the 2016 National Health Interview Survey (NHIS). In 2016, the prevalence of current cigarette smoking among adults was 15.5%, which was a significant decline from 2005 (20.9%); however, no significant change has occurred since 2015 (15.1%). In 2016, the prevalence of cigarette smoking was higher among adults who were male, aged 25-64 years, American Indian/Alaska Native or multiracial, had a General Education Development (GED) certificate, lived below the federal poverty level, lived in the Midwest or South, were uninsured or insured through Medicaid, had a disability/limitation, were lesbian, gay, or bisexual (LGB), or had serious psychological distress. During 2005-2016, the percentage of ever smokers who quit smoking increased from 50.8% to 59.0%. Proven population-based interventions are critical to reducing the health and economic burden of smoking-related diseases among U.S. adults, particularly among subpopulations with the highest smoking prevalences (1,2).

  3. Current Status of Standardization of Traditional Chinese Medicine in China

    Science.gov (United States)

    Guo, Yi; Li, Gui Lan

    2016-01-01

    As an important component of traditional medicine, Traditional Chinese Medicine (TCM) is widely spread and applied in more than 100 countries across the world. The standardization of TCM is very important for the international application of Chinese medicine. In this paper, we have explained and analyzed the standardization situations of TCM in China with the purpose of providing reference for standardization and international development of TCM. PMID:27110268

  4. Current Status of Standardization of Traditional Chinese Medicine in China

    Directory of Open Access Journals (Sweden)

    Juan Wang

    2016-01-01

    Full Text Available As an important component of traditional medicine, Traditional Chinese Medicine (TCM is widely spread and applied in more than 100 countries across the world. The standardization of TCM is very important for the international application of Chinese medicine. In this paper, we have explained and analyzed the standardization situations of TCM in China with the purpose of providing reference for standardization and international development of TCM.

  5. Current lifestyle of young adults treated for cancer in childhood.

    Science.gov (United States)

    Evans, S E; Radford, M

    1995-05-01

    The aim of this study was to look at the current lifestyle of young adult survivors of childhood cancer between the ages of 16 and 30 years to document their achievements and expose any psychosocial problems. Sixty six young adult survivors were contacted and asked if they and their siblings (16-30 years) would take part in a lifestyle study; 48 patients and 38 sibling controls were interviewed. This took the form of a structured lifestyle questionnaire, a self esteem questionnaire (Oxford Psychologists Press), and an unstructured interview. Fifty five per cent of patients achieved five or more A-C grades at 'O' level/GCSE compared with 62% of siblings and a national average of 30%. Despite that these patients were significantly less likely to go on to higher education than their siblings. The two groups were equally employable and earning similar salaries. There were three cases of known employer prejudice. A slightly higher percentage of patients than siblings had their driving licence. Seventeen patients felt their appearance had changed and eight felt that they had a residual physical mobility problem. Both groups were socially active and equally likely to partake in competitive sports. There was no overall difference in the self esteem of the two groups. In general the survivors of childhood cancer were coping well in their young adult life and achieving the same lifestyle goals as their siblings. However, significant problems have been identified.

  6. Fibrinolysis standards: a review of the current status.

    Science.gov (United States)

    Thelwell, C

    2010-07-01

    Biological standards are used to calibrate measurements of components of the fibrinolytic system, either for assigning potency values to therapeutic products, or to determine levels in human plasma as an indicator of thrombotic risk. Traditionally WHO International Standards are calibrated in International Units based on consensus values from collaborative studies. The International Unit is defined by the response activity of a given amount of the standard in a bioassay, independent of the method used. Assay validity is based on the assumption that both standard and test preparation contain the same analyte, and the response in an assay is a true function of this analyte. This principle is reflected in the diversity of source materials used to prepare fibrinolysis standards, which has depended on the contemporary preparations they were employed to measure. With advancing recombinant technology, and improved analytical techniques, a reference system based on reference materials and associated reference methods has been recommended for future fibrinolysis standards. Careful consideration and scientific judgement must however be applied when deciding on an approach to develop a new standard, with decisions based on the suitability of a standard to serve its purpose, and not just to satisfy a metrological ideal. 2010 The International Association for Biologicals. Published by Elsevier Ltd. All rights reserved.

  7. ANS-10 standards - current status and future direction

    International Nuclear Information System (INIS)

    Poetschat, G.R.

    1988-01-01

    The ANS-10 Standards Subcommittee is sponsored by the Mathematics and Computation Division of the American Nuclear Society (ANS). The scope of ANS-10 activities includes the development of standards that will promote effective utilization of and enhance the reliability of computer programs throughout the nuclear community. The application of ANS-10 standards during the computer program development process creates coding and documentation for the program product that promotes effective use and enhances reliability. The end product is a program package that contains adequate documentation, includes verification and validation results, is easy to use and maintain, and is easy to transfer from one hardware-software system to another

  8. Technical standardization of oil well abandonment: a review of current standards and technologies

    Energy Technology Data Exchange (ETDEWEB)

    Suzart, J. Walter P.; Pessoa, Laudemar; Paiva, Maria [Halliburton Energy Services (HES), Duncan, OK (United States)

    2008-07-01

    The objective of this study is to provide a new methodology for well abandonment. This practice is becoming more and more important because of the increasing number of production fields being abandoned. We strongly recommend a study of cement slurries properties for specific use in temporary and permanent abandonment plugs based on the estimation of the cement slurry hardened when placed in the well. By using specific additives, it is possible to achieve very stable slurries. For example, when permeability is reduced, formation fluid migration can be blocked and chemical reactions between the fluid and the slurry may be inhibited. With this objective, we present a laboratory investigation model and an example of slurry testing recommendation. During the abandonment operation, all records of the well characteristics should be maintained to include the reason for the abandonment, and location of fresh water, brine, and hydrocarbon zones that may exist. This documentation will also allow the analysis of solutions for the problems that originally caused the abandonment of the well. This data could be important for future use by environmental protection commissions to reopen or to drill an adjacent well. Given the high price of oil, it may now be economically feasible to reopen the well, if the reason for abandonment was low productivity. This way, a critical analysis of the current conditions of well and field abandonment in the country is presented. Based on this information, a review of the current standards is suggested. (author)

  9. Estimation of standard liver volume in Chinese adult living donors.

    Science.gov (United States)

    Fu-Gui, L; Lu-Nan, Y; Bo, L; Yong, Z; Tian-Fu, W; Ming-Qing, X; Wen-Tao, W; Zhe-Yu, C

    2009-12-01

    To determine a formula predicting the standard liver volume based on body surface area (BSA) or body weight in Chinese adults. A total of 115 consecutive right-lobe living donors not including the middle hepatic vein underwent right hemi-hepatectomy. No organs were used from prisoners, and no subjects were prisoners. Donor anthropometric data including age, gender, body weight, and body height were recorded prospectively. The weights and volumes of the right lobe liver grafts were measured at the back table. Liver weights and volumes were calculated from the right lobe graft weight and volume obtained at the back table, divided by the proportion of the right lobe on computed tomography. By simple linear regression analysis and stepwise multiple linear regression analysis, we correlated calculated liver volume and body height, body weight, or body surface area. The subjects had a mean age of 35.97 +/- 9.6 years, and a female-to-male ratio of 60:55. The mean volume of the right lobe was 727.47 +/- 136.17 mL, occupying 55.59% +/- 6.70% of the whole liver by computed tomography. The volume of the right lobe was 581.73 +/- 96.137 mL, and the estimated liver volume was 1053.08 +/- 167.56 mL. Females of the same body weight showed a slightly lower liver weight. By simple linear regression analysis and stepwise multiple linear regression analysis, a formula was derived based on body weight. All formulae except the Hong Kong formula overestimated liver volume compared to this formula. The formula of standard liver volume, SLV (mL) = 11.508 x body weight (kg) + 334.024, may be applied to estimate liver volumes in Chinese adults.

  10. Current status of the MPEG-4 standardization effort

    Science.gov (United States)

    Anastassiou, Dimitris

    1994-09-01

    The Moving Pictures Experts Group (MPEG) of the International Standardization Organization has initiated a standardization effort, known as MPEG-4, addressing generic audiovisual coding at very low bit-rates (up to 64 kbits/s) with applications in videotelephony, mobile audiovisual communications, video database retrieval, computer games, video over Internet, remote sensing, etc. This paper gives a survey of the status of MPEG-4, including its planned schedule, and initial ideas about requirements and applications. A significant part of this paper is summarizing an incomplete draft version of a `requirements document' which presents specifications of desirable features on the video, audio, and system level of the forthcoming standard. Very low bit-rate coding algorithms are not described, because no endorsement of any particular algorithm, or class of algorithms, has yet been made by MPEG-4, and several seminars held concurrently with MPEG-4 meetings have not so far provided evidence that such high performance coding schemes are achievable.

  11. Current Tobacco Use Among Adults in the United States: Findings From the National Adult Tobacco Survey

    Science.gov (United States)

    Dube, Shanta R.; Tynan, Michael A.

    2012-01-01

    Objectives. We assessed the prevalence and sociodemographic correlates of tobacco use among US adults. Methods. We used data from the 2009–2010 National Adult Tobacco Survey, a national landline and cell phone survey of adults aged 18 years and older, to estimate current use of any tobacco; cigarettes; cigars, cigarillos, or small cigars; chewing tobacco, snuff, or dip; water pipes; snus; and pipes. We stratified estimates by gender, age, race/ethnicity, education, income, sexual orientation, and US state. Results. National prevalence of current use was 25.2% for any tobacco; 19.5% for cigarettes; 6.6% for cigars, cigarillos, or small cigars; 3.4% for chewing tobacco, snuff, or dip; 1.5% for water pipes; 1.4% for snus; and 1.1% for pipes. Tobacco use was greatest among respondents who were male, younger, of non-Hispanic “other” race/ethnicity, less educated, less wealthy, and lesbian, gay, bisexual, or transgender. Prevalence ranged from 14.1% (Utah) to 37.4% (Kentucky). Conclusions. Tobacco use varies by geography and sociodemographic factors, but remains prevalent among US adults. Evidence-based prevention strategies are needed to decrease tobacco use and the health and economic burden of tobacco-related diseases. PMID:22994278

  12. Adult-onset Still's disease: current challenges and future prospects

    Directory of Open Access Journals (Sweden)

    Siddiqui M

    2016-03-01

    Full Text Available Mariam Siddiqui,1 Michael S Putman,2 Anisha B Dua,11Department of Rheumatology, 2Department of Internal Medicine, The University of Chicago Medical Center, Chicago, IL, USA Abstract: Adult-onset Still's disease (AOSD – a multi-systemic inflammatory condition characterized by high fevers, polyarthritis, an evanescent rash, and pharyngitis – has been a challenging condition to diagnose expediently and treat effectively. Questions remain regarding the underlying pathophysiology and etiology of AOSD. Pathognomonic diagnostic tests and reliable biomarkers remain undiscovered. Over the past decade, important progress has been made. Diagnostic criteria employing glycosylated ferritin have improved specificity. More important, novel biologic therapies have offered important clues to AOSD's underlying pathophysiology. Cytokine-specific biologic therapies have been instrumental in providing more effective treatment for disease refractory to conventional treatment. While IL-1 therapy has demonstrated efficacy in refractory disease, novel therapies targeting IL-6 and IL-18 show great promise and are currently under investigation. Keywords: adult-onset Still's disease, biomarkers, therapeutics

  13. [The costs of new drugs compared to current standard treatment].

    Science.gov (United States)

    Ujeyl, Mariam; Schlegel, Claudia; Gundert-Remy, Ursula

    2013-01-01

    Until AMNOG came into effect Germany had free pricing of new drugs. Our exemplary work investigates the costs of new drugs that were licensed in the two years prior to AMNOG, and compares them to the costs of standard treatment that has been used in pivotal trials. Also, the important components of pharmaceutical prices will be illustrated. We retrospectively analysed the European Public Assessment Reports of proprietary medicinal products that the European Medicinal Agency initially approved in 2009 and 2010 and that were tested against an active control in at least one pivotal trial. If the standard treatment was a generic, the average pharmacy retail price of new drugs was 7.4 times (median 7.1) higher than that of standard treatment. If the standard treatment was an originator drug the average price was 1.4 times (median 1.2) higher than that of the new drug. There was no clear correlation of an increase in costs for new drugs and their "grade of innovation" as rated according to the criteria of Fricke. Our study shows that prices of new drugs must be linked to the evidence of comparative benefit; since German drug pricing is complex, cost saving effects obtained thereby will depend on a range of other rules and decisions. Copyright © 2013. Published by Elsevier GmbH.

  14. Current issues on a standard for surrogate pregnancy procedures

    OpenAIRE

    Ha, Jung-Ok

    2012-01-01

    While Korea does not have any legal statement on surrogacy, treatments are carried out in practice. As a result, every Institutional Review Board (IRB) of each fertility clinic faces an ethical predicament in reviewing each case. There is a need to arrange the institutions' own standards of surrogate pregnancy procedures before the establishment of national or professional regulation. This article examines the legal, social, and medical issues of surrogacy to help IRBs to judge their cases.

  15. Current issues on a standard for surrogate pregnancy procedures.

    Science.gov (United States)

    Ha, Jung-Ok

    2012-12-01

    While Korea does not have any legal statement on surrogacy, treatments are carried out in practice. As a result, every Institutional Review Board (IRB) of each fertility clinic faces an ethical predicament in reviewing each case. There is a need to arrange the institutions' own standards of surrogate pregnancy procedures before the establishment of national or professional regulation. This article examines the legal, social, and medical issues of surrogacy to help IRBs to judge their cases.

  16. Review of Current Standard Model Results in ATLAS

    CERN Document Server

    Brandt, Gerhard; The ATLAS collaboration

    2018-01-01

    This talk highlights results selected from the Standard Model research programme of the ATLAS Collaboration at the Large Hadron Collider. Results using data from $p-p$ collisions at $\\sqrt{s}=7,8$~TeV in LHC Run-1 as well as results using data at $\\sqrt{s}=13$~TeV in LHC Run-2 are covered. The status of cross section measurements from soft QCD processes and jet production as well as photon production are presented. The presentation extends to vector boson production with associated jets. Precision measurements of the production of $W$ and $Z$ bosons, including a first measurement of the mass of the $W$ bosons, $m_W$, are discussed. The programme to measure electroweak processes with di-boson and tri-boson final states is outlined. All presented measurements are compatible with Standard Model descriptions and allow to further constrain it. In addition they allow to probe new physics which would manifest through extra gauge couplings, or Standard Model gauge couplings deviating from their predicted value.

  17. [Standard control for diabetes in older adults based on practice guidelines--the target values of blood glucose, blood pressure and lipids].

    Science.gov (United States)

    Sugimoto, Ken; Rakugi, Hiromi

    2013-11-01

    As for standard controls for life style diseases in older adults, the standard control for hypertension in elderly is defined in detail by the guideline for hypertension, however, that for diabetes or dyslipidemia is not clearly defined by each guideline although each has additional descriptions for elderly. The reports about 'Diabetes in Older Adults' and 'Standards of Medical Care in Diabetes 2013' have been published from American Diabetes Association (ADA), and the standard controls for diabetes might be reviewed in the light of these reports in Japan. Here we would like to consider the standard control and recent trends for diabetes in older adults on the basis of the current practice guidelines.

  18. Current Standards in the Management of Cerebral Metastases

    Directory of Open Access Journals (Sweden)

    Pablo Goetz

    2012-01-01

    Full Text Available The last 30 years have seen major changes in attitude toward patients with cerebral metastases. This paper aims to outline the major landmarks in this transition and the therapeutic strategies currently used. The controversies surrounding control of brain disease are discussed, and two emerging management trends are reviewed: tumor bed radiosurgery and salvage radiation.

  19. Implementation of ISO 9000 Quality Standard into Adult Education

    Directory of Open Access Journals (Sweden)

    Andrej Sotošek

    2000-12-01

    Full Text Available Competition in the field of adult education in Slovenia has become very tough  in the second half of the 1990s. Therefore, educational institutions are forced to use every advantage over the competitors in the educational market. One of them is the quality system in educational process. Such competitive position setting strategic development objectives is also the strategy of UPI - Ljudska univerza Žalec. Through development objectives, relationships with our partners and customers, as well as on the basis of analysis of the position and connections of Slovenia within the European Union and its involvement in international projects we estimated that we should set up a quality system in our institution involving managerial, organisational and professional function. It is important that the system should be comparable and verifiable according to the European standards. We have chosen the Quality System according to ISO 9000 quality standards as the most suitable model. It offers an institutional framework as well as a good basis for an internal and external verification of the efficiency of the system in real life. It also enables corrections to deviations. However, it lacks a stronger stress on internal self-control and self-evaluation, which is emphasised in the model of quality assurance in education developed by a group of experts to order of Ministry of Education and Sport. Both model s can be combined and are mutually compatible. I am convinced of the great importance of self-evaluation in education. Yet, without an appropriate institutional framework and basic external verification the self-evaluation remains on the interna! and subjective level of judgement within an individual educational institution.

  20. Radiation cancer, safety standards and current levels of exposure

    International Nuclear Information System (INIS)

    Mole, R.H.

    1976-01-01

    Cancer can be induced by radiation in any tissue where cancer occurs naturally. The observation that antenatal diagnostic radiography causes a small but definite increase in childhood cancer is as good evidence as could be expected in support of the scientific expectation that there would be no threshold of dose for carcinogenesis. A linear relation between radiation dose and frequency of induced cancer is a necessary assumption for a system of radiological protection but is not necessarily a reasonable basis for realistic assessments of cancer risk. Indeed there are radiobiological and epidemiological reasons to the contrary. If the linear hypothesis is accepted then at the present time in the UK the routine practice of medicine is of about 2 orders of magnitude more important in causing cancer than environmental pollution by discharge of radio-activity. The acceptability of radiation safety standards for occupational exposure may be justified by comparison of radiation cancer risks with risks from fatal accidents in the safer industries. The acceptability of the corresponding standards for members of the public seems to require more public discussion of the concept of negligible risk. Emotional reactions to uncontrolled releases of radio-activity are based at least in part on a failure to appreciate the hypothesis of linearity

  1. Current referral practices and adolescent transition to Adult clinic ...

    African Journals Online (AJOL)

    2016-02-02

    Feb 2, 2016 ... of adolescent transition from child to adult care ... from paediatric to adult clinics. Adolescent ... The fate of older adolescent patients in paediatric clinics is either one of ..... fer depends on physical and psychological factors and.

  2. Connecting the Canon to Current Young Adult Literature

    Science.gov (United States)

    Rybakova, Katie; Roccanti, Rikki

    2016-01-01

    In this article we discuss the respective roles of young adult literature and literary texts in the secondary level English Language Arts classroom and explore the connections that can be made between popular young adult books and the traditional canon. We provide examples showing how young adult literature bestsellers such as "The Book…

  3. Current situation of International Organization for Standardization/Technical Committee 249 international standards of traditional Chinese medicine.

    Science.gov (United States)

    Liu, Yu-Qi; Wang, Yue-Xi; Shi, Nan-Nan; Han, Xue-Jie; Lu, Ai-Ping

    2017-05-01

    To review the current situation and progress of traditional Chinese medicine (TCM) international standards, standard projects and proposals in International Organization for Standardization (ISO)/ technical committee (TC) 249. ISO/TC 249 standards and standard projects on the ISO website were searched and new standard proposals information were collected from ISO/TC 249 National Mirror Committee in China. Then all the available data were summarized in 5 closely related items, including proposed time, proposed country, assigned working group (WG), current stage and classifification. In ISO/TC 249, there were 2 international standards, 18 standard projects and 24 new standard proposals proposed in 2014. These 44 standard subjects increased year by year since 2011. Twenty-nine of them were proposed by China, 15 were assigned to WG 4, 36 were in preliminary and preparatory stage and 8 were categorized into 4 fifields, 7 groups and sub-groups based on International Classifification Standards. A rapid and steady development of international standardization in TCM can be observed in ISO/TC 249.

  4. [Current standards in the treatment of gastric cancer].

    Science.gov (United States)

    Hacker, Ulrich; Lordick, Florian

    2015-08-01

    Endoscopic resection is established in the treatment of early gastric cancer. More advanced gastric cancer requires gastrectomy and D2 lymphadenectomy. Perioperative chemotherapy improves overall survival in locally advanced gastric cancer representing a standard of care. Locally advanced adenocarcinomas of the esophago-gastric junction can alternatively be treated with concurrent radiochemotherapy. In metastatic disease, systemic chemotherapy improves survival, quality of life and symptom control. Trastuzumab plus chemotherapy should be used together with first-line chemotherapy in HER2 positive gastric cancer patients. Second- and third-line therapy is now well established. The anti-VEGFR2 antibody Ramucirumab improves survival in second line treatment both as a monotherapy and in combination with paclitaxel and represents a novel treatment option. © Georg Thieme Verlag KG Stuttgart · New York.

  5. [Current situation of the standardization of acupuncture and moxibustion in Taiwan].

    Science.gov (United States)

    Pan, Li-Jia; Cui, Rui; Zhan, Bi-Yu; Liao, Cai-Yan; Cao, Qi-Hua; Li, Gui-Lan; Guo, Yi

    2012-09-01

    The current situation of the standardization of acupuncture and moxibustion in the Taiwan region is introduced in this paper from the three aspects, named the development state of standard of acupuncture and moxibustion in Taiwan, the implementation of Taiwan district standard and the standardization of acupuncture and moxibustion in Taiwan. At present, the relevant standards of acupuncture and moxibustion in Taiwan just include the standard operation procedure of acupuncture and moxibustion, the reference guideline of the safe operation in the medical service centers of traditional Chinese medicine, and the faculty standard of Chinese medicine hospital, etc. It is concluded that the current situation of the standardization of acupuncture and moxibusiton presented the weak awareness of the standardization of acupuncture and moxibustion in the industry, insufficient enterprise standard, less-quantity of the implemented standards and narrow coverage.

  6. Standardized high current solid targets for cyclotron production of radionuclides

    International Nuclear Information System (INIS)

    Al-Jammaz, Ibrahim

    2000-01-01

    The Cyclotron and Radiopharmaceuticals Department (CRP) is an advanced and modern facility that encompasses two essential components: radioisotope research, and radiopharmaceuticals manufacturing. Radiopharmaceuticals manufacturing program is not only quite unique, but also an essential component of King Faisal Specialist Hospital and Research Center (KFSH and RC) in providing quality patient care for the population of the Kingdom. Accurate diagnosis and therapy with medical imaging equipment requires quality radiopharmaceuticals that are available readily and with reliability. The CRP Department provides that quality and reliability. Research activities of the CRP Department are focused on developing new radiotracers with potential usefulness in biomedical research and clinical applications. Research projects consist of: developing cyclotron targetry for radioisotope production; developing synthesis methods for radiolabeling biomolecules; and developing analytical methods for quality control. The CRP Department operates a semi-commercial radiopharmaceuticals manufacturing program that supplies the diagnostic radioactive products to several hospitals in the Kingdom and neighboring countries. These products for clinical applications are produced according to the international standards of Good Manufacturing Practices of quality and efficacy. At the heart of the radioisotope program is a medium energy cyclotron capable of accelerating a number of particles for transformation of non-radioactive atoms into radionuclides that are the primary sources for research and development activities, and for preparing radiopharmaceuticals. In addition to having the only cyclotron facility in the region, KFSH and RC also has the only Positron Emission Tomography Center (PET) in this part of the world. This combination of cyclotron and the ultra modern PET facility translates into advanced and specialized care for the patients at KFSH and RC

  7. Academy of Nutrition and Dietetics: standards of practice and standards of professional performance for registered dietitian nutritionists (competent, proficient, and expert) in adult weight management.

    Science.gov (United States)

    Jortberg, Bonnie; Myers, Eileen; Gigliotti, Linda; Ivens, Barbara J; Lebre, Monica; Burke March, Susan; Nogueira, Isadora; Nwankwo, Robin; Parkinson, Meredith R; Paulsen, Barbara; Turner, Tonya

    2015-04-01

    Weight management encompasses the inter-relationship of nutrition, physical activity, and health behavior change. Nutrition is key for the prevention and treatment of obesity and chronic disease and maintenance of overall health. Thus, the Weight Management Dietetic Practice Group, with guidance from the Academy of Nutrition and Dietetics Quality Management Committee, has developed Standards of Practice and Standards of Professional Performance for Registered Dietitian Nutritionists (RDNs) in Adult Weight Management as a resource for RDNs working in weight management. This document allows RDNs to assess their current skill levels and to identify areas for further professional development in this expanding practice area. This document describes the current standards for weight management practice for RDNs. The Standards of Practice represent the four steps in the Nutrition Care Process as applied to the care of patients/clients. The Standards of Professional Performance consist of six domains of professionalism: Quality in Practice, Competence and Accountability, Provision of Services, Application of Research, Communication and Application of Knowledge, and Utilization and Management of Resources. Within each standard, specific indicators provide measurable action statements that illustrate how the standard can be applied to practice. The indicators describe three skill levels (competent, proficient, and expert) for RDNs working in weight management. The Standards of Practice and Standards of Professional Performance are complementary resources for the Registered Dietitian Nutritionist in weight management. Copyright © 2015 Academy of Nutrition and Dietetics. Published by Elsevier Inc. All rights reserved.

  8. Adult Cigarette Smoking in the United States: Current Estimates

    Science.gov (United States)

    ... having no disability/limitation (14.4%) By Sexual Orientation 2 Lesbian/gay/bisexual adults were more likely ... YouTube Instagram Listen Watch RSS ABOUT About CDC Jobs Funding LEGAL Policies Privacy FOIA No Fear Act ...

  9. Design and evaluation of a 10-mA DC current reference standard

    CERN Document Server

    Fernqvist, G; Pickering, J; Power, F

    2003-01-01

    A new DC current reference standard has been developed for high- current power converter calibration in the large hadron collider (LHC) project at the European Organization for Nuclear Research (CERN). This standard provides a near ideal 10-mA DC current with long-term drift of one part in 10/sup 6/ per year. The paper describes the requirements and the detailed design and evaluation of the unit. Since similar 10-V standards are commercially available, the paper concentrates on the unique current output capability of this device. (4 refs).

  10. Evaluation of a new 10 mA DC current reference standard

    CERN Document Server

    Fernqvist, G; Power, F

    2002-01-01

    A new DC current reference standard has been developed as a component in a Current calibration hierarchy in the LHC project at CERN. The standard provides 10 mA DC current with an accuracy less than 0.5 ppm, drift less than 2 ppm/year and compliance error less than 0.1 ppm for 0-10 V. The paper gives the results from two years evaluation of a series of 5 units.

  11. Current referral practices and adolescent transition to Adult clinic ...

    African Journals Online (AJOL)

    2016-02-02

    Feb 2, 2016 ... is either one of transfer to adult services, long term retention ... care in the type and level of support, decision-making, ... of Pediatrics (AAP), the American Academy of Family ... cians (ACP) issued a joint statement that defined spe- ... other countries attending Paediatric Association of ..... Diabetes Manage-.

  12. A programmable quantum current standard from the Josephson and the quantum Hall effects

    Energy Technology Data Exchange (ETDEWEB)

    Poirier, W., E-mail: wilfrid.poirier@lne.fr; Lafont, F.; Djordjevic, S.; Schopfer, F.; Devoille, L. [Quantum metrology group, Laboratoire National de métrologie et d' Essais, 29 avenue Roger Hennequin, 78197 Trappes (France)

    2014-01-28

    We propose a way to realize a programmable quantum current standard (PQCS) from the Josephson voltage standard and the quantum Hall resistance standard (QHR) exploiting the multiple connection technique provided by the quantum Hall effect (QHE) and the exactness of the cryogenic current comparator. The PQCS could lead to breakthroughs in electrical metrology like the realization of a programmable quantum current source, a quantum ampere-meter, and a simplified closure of the quantum metrological triangle. Moreover, very accurate universality tests of the QHE could be performed by comparing PQCS based on different QHRs.

  13. Cognitive function in older adults according to current socioeconomic status.

    Science.gov (United States)

    Zhang, Michael; Gale, Shawn D; Erickson, Lance D; Brown, Bruce L; Woody, Parker; Hedges, Dawson W

    2015-01-01

    Cognitive function may be influenced by education, socioeconomic status, sex, and health status. Furthermore, aging interacts with these factors to influence cognition and dementia risk in late life. Factors that may increase or decrease successful cognitive aging are of critical importance, particularly if they are modifiable. The purpose of this study was to determine if economic status in late life is associated with cognition independent of socioeconomic status in early life. Cross-sectional demographic, socioeconomic, and cognitive function data were obtained in 2592 older adults (average age 71.6 years) from the Center for Disease Control's National Health and Nutrition Examination Survey (NHANES) and analyzed with linear regression modeling. Cognitive function, as measured with a test of processing speed, was significantly associated with poverty index scores after adjusting for educational attainment as an estimate of childhood socioeconomic status, ethnic background, age, health status, and sex (P status is independently associated with cognitive function in adults over age 60 years.

  14. Current Status of the IAU Working Group for Numerical Standards of Fundamental Astronomy

    National Research Council Canada - National Science Library

    Luzum, B; Capitaine, N; Fienga, A; Folkner, W; Fukushima, T; Hilton, J; Hohenkerk, C; Krasinsky, G; Petit, G; Pitjeva, E; Soffel, M; Wallace, P

    2007-01-01

    ...) for Numerical Standards of Fundamental Astronomy. The goal of the WG are to update "IAU Current Best Estimates" conforming with IAU Resolutions, the International Earth Rotation and Reference System Service (IERS...

  15. Evaluation of uncertainties in femtoampere current measurement for the number concentration standard of aerosol nanoparticles

    International Nuclear Information System (INIS)

    Sakurai, Hiromu; Ehara, Kensei

    2011-01-01

    We evaluated uncertainties in current measurement by the electrometer at the current level on the order of femtoamperes. The electrometer was the one used in the Faraday-cup aerosol electrometer of the Japanese national standard for number concentration of aerosol nanoparticles in which the accuracy of the absolute current is not required, but the net current which is obtained as the difference in currents under two different conditions must be measured accurately. The evaluation was done experimentally at the current level of 20 fA, which was much smaller than the intervals between the electrometer's calibration points at +1, +0.5, −0.5 and −1 pA. The slope of the response curve for the relationship between the 'true' and measured current, which is crucial in the above measurement, was evaluated locally at many different points within the ±1 pA range for deviation from the slope determined by a linear regression of the calibration data. The sum of the current induced by a flow of charged particles and a bias current from a current-source instrument was measured by the electrometer while the particle current was toggled on and off. The net particle current was obtained as the difference in the measured currents between the toggling, while at the same time the current was estimated from the particle concentration read by a condensation particle counter. The local slope was calculated as the ratio of the measured to estimated currents at each bias current setting. The standard deviation of the local slope values observed at varied bias currents was about 0.003, which was calculated by analysis of variance (ANOVA) for the treatment of the bias current. The combined standard uncertainty of the slope, which was calculated from the uncertainty of the slope by linear regression and the variability of the slope, was calculated to be about 0.004

  16. Child Maltreatment and Adult Living Standards at 50 Years.

    Science.gov (United States)

    Pinto Pereira, Snehal M; Li, Leah; Power, Chris

    2017-01-01

    Child maltreatment (abuse and neglect) has established effects on mental health. Less is known about its influence on adult economic circumstances. We aimed to establish associations of child maltreatment with such outcomes and explore potential pathways. We used 1958 British birth cohort data (N = 8076) to examine associations of child neglect and abuse with adult (50 years) long-term sickness absence, not in employment, education or training (NEET), lacking assets, income-related support, poor qualifications, financial insecurity, manual social class, and social mobility. We assessed mediation of associations by 16-year cognition and mental health. Abuse prevalence varied from 1% (sexual) to 10% (psychological); 16% were neglected. A total of 21% experienced 1 maltreatment type, 10% experienced ≥2 types. Sexual and nonsexual abuse were associated with several outcomes; eg, for sexual abuse, adjusted odds ratio (aOR) of income-related support was 1.75 (95% confidence interval [CI], 1.12-2.72). Associations were little affected by potential mediating factors. Neglect was associated with several adult outcomes (eg, aOR of NEET was 1.43 [95% CI, 1.10-1.85]) and associations were mediated by cognition and mental health (primarily by cognition): percent explained varied between 4% (NEET) to 70% (poor qualifications). In general, the risk of poor outcome increased by number of maltreatment types (eg, aOR for long-term sickness absence increased from 1.0 [reference] to 1.76 [95% CI, 1.32-2.35] to 2.69 [95% CI, 1.96-3.68], respectively, for 0, 1, and ≥2 types of maltreatment. Childhood maltreatment is associated with poor midadulthood socioeconomic outcomes, with accumulating risk for those experiencing multiple types of maltreatment. Cognitive ability and mental health are implicated in the pathway to outcome for neglect but not abuse. Copyright © 2017 by the American Academy of Pediatrics.

  17. Comparison of the Standard of Air Leakage in Current Metal Duct Systems in the World

    Science.gov (United States)

    Di, Yuhui; Wang, Jiqian; Feng, Lu; Li, Xingwu; Hu, Chunlin; Shi, Junshe; Xu, Qingsong; Qiao, Leilei

    2018-01-01

    Based on the requirements of air leakage of metal ducts in Chinese design standards, technical measures and construction standards, this paper compares the development history, the classification of air pressure levels and the air tightness levels of air leakage standards of current Chinese and international metal ducts, sums up the differences, finds shortage by investigating the design and construction status and access to information, and makes recommendations, hoping to help the majority of engineering and technical personnel.

  18. Risk assessment based on current release standards for radioactive surface contamination

    International Nuclear Information System (INIS)

    Chen, S.Y.

    1993-09-01

    Standards for uncontrolled releases of radioactive surface contamination have been in existence in the United States for about two decades. Such standards have been issued by various agencies, including the US Department of Energy. This paper reviews the technical basis of published standards, identifies areas in need of revision, provides risk interpretations based on current technical knowledge and the regulatory environment, and offers suggestions for improvements

  19. Hypercholesterolaemia in children and young adultscurrent ...

    African Journals Online (AJOL)

    to prevent the development or delay the onset of atherosclerosis needs to begin early ... because of hormonal changes and because the growth rate accelerates. Currently ... still believe that a fat baby or a chubby toddler is healthy. In order to.

  20. British Thoracic Society Quality Standards for acute non-invasive ventilation in adults

    Science.gov (United States)

    Davies, Michael; Allen, Martin; Bentley, Andrew; Bourke, Stephen C; Creagh-Brown, Ben; D’Oliveiro, Rachel; Glossop, Alastair; Gray, Alasdair; Jacobs, Phillip; Mahadeva, Ravi; Moses, Rachael; Setchfield, Ian

    2018-01-01

    Introduction The purpose of the quality standards document is to provide healthcare professionals, commissioners, service providers and patients with a guide to standards of care that should be met for the provision of acute non-invasive ventilation in adults together with measurable markers of good practice. Methods Development of British Thoracic Society (BTS) Quality Standards follows the BTS process of quality standard production based on the National Institute for Health and Care Excellence process manual for the development of quality standards. Results 6 quality statements have been developed, each describing a standard of care for the provision of acute non-invasive ventilation in the UK, together with measurable markers of good practice. Conclusion BTS Quality Standards for acute non-invasive ventilation in adults form a key part of the range of supporting materials that the Society produces to assist in the dissemination and implementation of guideline’s recommendations. PMID:29636979

  1. Current Trends in Adult Degree Programs: How Public Universities Respond to the Needs of Adult Learners

    Science.gov (United States)

    Gast, Angela

    2013-01-01

    Although many adult students turn to online degree programs due to their flexibility and convenience, a majority of prospective adult learners prefer to take classes on traditional brick-and-mortar campuses. This chapter examines how public research universities create pathways to degree attainment and boost degree completion rates among adult…

  2. Chronic wound repair and healing in older adults: current status and future research.

    Science.gov (United States)

    Gould, Lisa; Abadir, Peter; Brem, Harold; Carter, Marissa; Conner-Kerr, Teresa; Davidson, Jeff; DiPietro, Luisa; Falanga, Vincent; Fife, Caroline; Gardner, Sue; Grice, Elizabeth; Harmon, John; Hazzard, William R; High, Kevin P; Houghton, Pamela; Jacobson, Nasreen; Kirsner, Robert S; Kovacs, Elizabeth J; Margolis, David; McFarland Horne, Frances; Reed, May J; Sullivan, Dennis H; Thom, Stephen; Tomic-Canic, Marjana; Walston, Jeremy; Whitney, Jo Anne; Williams, John; Zieman, Susan; Schmader, Kenneth

    2015-03-01

    Older adults are more likely to have chronic wounds than younger people, and the effect of chronic wounds on quality of life is particularly profound in this population. Wound healing slows with age, but the basic biology underlying chronic wounds and the influence of age-associated changes on wound healing are poorly understood. Most studies have used in vitro approaches and various animal models, but observed changes translate poorly to human healing conditions. The effect of age and accompanying multimorbidity on the effectiveness of existing and emerging treatment approaches for chronic wounds is also unknown, and older adults tend to be excluded from randomized clinical trials. Poorly defined outcomes and variables; lack of standardization in data collection; and variations in the definition, measurement, and treatment of wounds also hamper clinical studies. The Association of Specialty Professors, in conjunction with the National Institute on Aging and the Wound Healing Society, held a workshop, summarized in this article, to explore the current state of knowledge and research challenges, engage investigators across disciplines, and identify research questions to guide future study of age-associated changes in chronic wound healing. © 2015 by the American Geriatrics Society and the Wound Healing Society.

  3. Chronic Wound Repair and Healing in Older Adults: Current Status and Future Research

    Science.gov (United States)

    Gould, Lisa; Abadir, Peter; Brem, Harold; Carter, Marissa; Conner-Kerr, Teresa; Davidson, Jeff; DiPietro, Luisa; Falanga, Vincent; Fife, Caroline; Gardner, Sue; Grice, Elizabeth; Harmon, John; Hazzard, William R.; High, Kevin P.; Houghton, Pamela; Jacobson, Nasreen; Kirsner, Robert S.; Kovacs, Elizabeth J.; Margolis, David; Horne, Frances McFarland; Reed, May J.; Sullivan, Dennis H.; Thom, Stephen; Tomic-Canic, Marjana; Walston, Jeremy; Whitney, Jo Anne; Williams, John; Zieman, Susan; Schmader, Kenneth

    2015-01-01

    Older adults are more likely to have chronic wounds than younger people, and the effect of chronic wounds on quality of life is particularly profound in this population. Wound healing slows with age, but the basic biology underlying chronic wounds and the influence of age-associated changes on wound healing are poorly understood. Most studies have used in vitro approaches and various animal models, but observed changes translate poorly to human healing conditions. The effect of age and accompanying multimorbidity on the effectiveness of existing and emerging treatment approaches for chronic wounds is also unknown, and older adults tend to be excluded from randomized clinical trials. Poorly defined outcomes and variables; lack of standardization in data collection; and variations in the definition, measurement, and treatment of wounds also hamper clinical studies. The Association of Specialty Professors, in conjunction with the National Institute on Aging and the Wound Healing Society, held a workshop, summarized in this article, to explore the current state of knowledge and research challenges, engage investigators across disciplines, and identify research questions to guide future study of age-associated changes in chronic wound healing. PMID:25753048

  4. Current standards of neuropsychological assessment in epilepsy surgery centers across Europe.

    Science.gov (United States)

    Vogt, Viola Lara; Äikiä, Marja; Del Barrio, Antonio; Boon, Paul; Borbély, Csaba; Bran, Ema; Braun, Kees; Carette, Evelien; Clark, Maria; Cross, Judith Helen; Dimova, Petia; Fabo, Daniel; Foroglou, Nikolaos; Francione, Stefano; Gersamia, Anna; Gil-Nagel, Antonio; Guekht, Alla; Harrison, Sue; Hecimovic, Hrvoje; Heminghyt, Einar; Hirsch, Edouard; Javurkova, Alena; Kälviäinen, Reetta; Kavan, Nicole; Kelemen, Anna; Kimiskidis, Vasilios K; Kirschner, Margarita; Kleitz, Catherine; Kobulashvili, Teia; Kosmidis, Mary H; Kurtish, Selin Yagci; Lesourd, Mathieu; Ljunggren, Sofia; Lossius, Morten Ingvar; Malmgren, Kristina; Mameniskiené, Ruta; Martin-Sanfilippo, Patricia; Marusic, Petr; Miatton, Marijke; Özkara, Çiğdem; Pelle, Federica; Rubboli, Guido; Rudebeck, Sarah; Ryvlin, Philippe; van Schooneveld, Monique; Schmid, Elisabeth; Schmidt, Pia-Magdalena; Seeck, Margitta; Steinhoff, Bernhard J; Shavel-Jessop, Sara; Tarta-Arsene, Oana; Trinka, Eugen; Viggedal, Gerd; Wendling, Anne-Sophie; Witt, Juri-Alexander; Helmstaedter, Christoph

    2017-03-01

    We explored the current practice with respect to the neuropsychological assessment of surgical epilepsy patients in European epilepsy centers, with the aim of harmonizing and establishing common standards. Twenty-six epilepsy centers and members of "E-PILEPSY" (a European pilot network of reference centers in refractory epilepsy and epilepsy surgery), were asked to report the status of neuropsychological assessment in adults and children via two different surveys. There was a consensus among these centers regarding the role of neuropsychology in the presurgical workup. Strong agreement was found on indications (localization, epileptic dysfunctions, adverse drugs effects, and postoperative monitoring) and the domains to be evaluated (memory, attention, executive functions, language, visuospatial skills, intelligence, depression, anxiety, and quality of life). Although 186 different tests are in use throughout these European centers, a core group of tests reflecting a moderate level of agreement could be discerned. Variability exists with regard to indications, protocols, and paradigms for the assessment of hemispheric language dominance. For the tests in use, little published evidence of clinical validity in epilepsy was provided. Participants in the survey reported a need for improvement concerning the validity of the tests, tools for the assessment of everyday functioning and accelerated forgetting, national norms, and test co-normalization. Based on the present survey, we documented a consensus regarding the indications and principles of neuropsychological testing. Despite the variety of tests in use, the survey indicated that there may be a core set of tests chosen based on experience, as well as on published evidence. By combining these findings with the results of an ongoing systematic literature review, we aim for a battery that can be recommended for the use across epilepsy surgical centers in Europe. Wiley Periodicals, Inc. © 2017 International League

  5. 78 FR 33393 - Petition Requesting a Ban or Standard on Adult Portable Bed Rails

    Science.gov (United States)

    2013-06-04

    ... assert that adult portable bed rails currently on the market are responsible for many injuries and deaths among users, particularly the elderly and frail. Petitioners state that many of these deaths result from...

  6. Reasons for current E-cigarette use among U.S. adults

    OpenAIRE

    Patel, Deesha; Davis, Kevin C.; Cox, Shanna; Bradfield, Brian; King, Brian A.; Shafer, Paul; Caraballo, Ralph; Bunnell, Rebecca

    2016-01-01

    E-cigarette use has increased rapidly among U.S. adults. However, reasons for use among adults are unclear. We assessed reasons for e-cigarette use among a national sample of U.S. adults. Data were collected via online surveys among U.S. adults aged 18 or older from April through June 2014. Descriptive and multivariate regression analyses were conducted to assess reasons for e-cigarette use among 2448 current e-cigarette users, by sociodemographic characteristics and product type. Assessed re...

  7. Transresistance calibrations and temperature dependence evaluation of a magnetic bridge current sensor with shunt standards

    International Nuclear Information System (INIS)

    Yamada, T; Kon, S; Tadatsu, T

    2011-01-01

    This paper deals with a magnetic bridge current sensor for dc current measurements and a calibration system developed for the current sensor. The current sensor forms a magnetic bridge structure with a magnetic fluid core. The calibration system has been developed by using standard shunts for a test current range of 1 mA to 100 A and establishing a comparison method with a switching/sampling system. In the calibration system, the transresistances of the current sensor are measured and the uncertainties of the system are estimated for the input test current range. Also, the temperature dependence on the transresistances is investigated for temperatures ranging from −40 to 100 °C

  8. Strategies of bringing drug product marketing applications to meet current regulatory standards.

    Science.gov (United States)

    Wu, Yan; Freed, Anita; Lavrich, David; Raghavachari, Ramesh; Huynh-Ba, Kim; Shah, Ketan; Alasandro, Mark

    2015-08-01

    In the past decade, many guidance documents have been issued through collaboration of global organizations and regulatory authorities. Most of these are applicable to new products, but there is a risk that currently marketed products will not meet the new compliance standards during audits and inspections while companies continue to make changes through the product life cycle for continuous improvement or market demands. This discussion presents different strategies to bringing drug product marketing applications to meet current and emerging standards. It also discusses stability and method designs to meet process validation and global development efforts.

  9. Constraints on Non-Standard Contributions to the Charged-Current Interactions

    CERN Document Server

    Hagiwara, K; Hagiwara, Kaoru; Matsumoto, Seiji

    1998-01-01

    The success of the quantum level predictions of the Standard Model on the $Z$ boson properties, on $\\mw$ and on $\\mt$, which makes use of the muon lifetime as an input, implies a stringent constraint on new physics contributions to the $V-A$ charged-current interactions among leptons. Observed unitarity of the CKM matrix elements then implies constraints on non-standard contributions to the lepton-quark charged-current interactions. By using the recent electroweak data as inputs, we find the 95% CL limits for the corresponding contact interactions: $\\Lambda_{CC,+}^{\\ell\\ell}>7.5$ TeV and the lepton-quark contact interactions.

  10. Reasons for current E-cigarette use among U.S. adults

    Science.gov (United States)

    Patel, Deesha; Davis, Kevin C.; Cox, Shanna; Bradfield, Brian; King, Brian A.; Shafer, Paul; Caraballo, Ralph; Bunnell, Rebecca

    2017-01-01

    E-cigarette use has increased rapidly among U.S. adults. However, reasons for use among adults are unclear. We assessed reasons for e-cigarette use among a national sample of U.S. adults. Data were collected via online surveys among U.S. adults aged 18 or older from April through June 2014. Descriptive and multivariate regression analyses were conducted to assess reasons for e-cigarette use among 2448 current e-cigarette users, by sociodemographic characteristics and product type. Assessed reasons included cessation/health, consideration of others, convenience, cost, curiosity, flavoring, and simulation of conventional cigarettes. Among current e-cigarette users, 93% were also current cigarette smokers. The most common reasons for e-cigarette use were cessation/health (84.5%), consideration of others (71.5%), and convenience (56.7%). The prevalence of citing convenience (adjusted prevalence ratio [aPR] = 1.49) and curiosity (aPR = 1.54) as reasons for e-cigarette use were greater among current cigarette smokers than nonsmokers (P e-cigarette use among adults, and flavorings are more commonly cited by younger adults. Efforts are warranted to provide consumers with accurate information on the health effects of e-cigarettes and to ensure that flavoring and other unregulated features do not promote nicotine addiction, particularly among young adults. PMID:27612572

  11. A New International Standard for "Actions from Waves and Currents on Coastal Structures"

    DEFF Research Database (Denmark)

    Tørum, Alf; Burcharth, Hans F.; Goda, Yoshimi

    2007-01-01

    The International Organization for Standardization (ISO) is going to issue a new standard concerning "Actions from Waves and Currents on Coastal Structures," which becomes the first international standard in coastal engineering. It is composed of a normative part (29 pages), an informative part (80...... pages) and Bibliography ( 17 pages). The normative part describes what is considered as the norm of the matters in concern, while the informative part provides the information on recommended practice. The paper introduces the main points of the normative part and discusses the influence of the new...

  12. Views of surgery program directors on the current ACGME and proposed IOM duty-hour standards.

    Science.gov (United States)

    Willis, Ross E; Coverdill, James E; Mellinger, John D; Collins, J Craig; Potts, John R; Dent, Daniel L

    2009-01-01

    The purpose of this study was to survey the experiences of surgery program directors with the current Accreditation Council for Graduate Medical Education (ACGME) duty-hour standards and views of the Institute of Medicine (IOM) proposed duty-hour recommendations. A total of 118 program directors (47.6% of all surgery programs in the US) responded to the survey. Results showed that the current duty-hour standards have hindered clinical education opportunities by reducing or eliminating rotations on many services, didactic teaching conferences, and clinical bedside teaching opportunities. Additionally, patient safety has been compromised by frequent hand offs of care. Most IOM recommendations were perceived as extremely difficult or impossible to implement, with the exception of the moonlighting recommendation. The results indicated that adopting the IOM recommendations is not feasible given current workforce limitations, and most program directors supported maintaining the current duty-hour standards until such time as there is evidence-based outcomes research to direct change. The conclusion was that the current ACGME duty-hour standards have reduced teaching opportunities and narrowed the scope of training.

  13. Current status of epilepsy treatment and efficacy of standard phenobarbital therapy in rural areas of Northern China.

    Science.gov (United States)

    Yu, Jinbei; Luo, Nan; Wang, Zan; Lin, Weihong

    2017-08-01

    To investigate the current status of epilepsy treatment and the efficacy and adverse effects of phenobarbital therapy in rural areas of Northern China. A total of 2192 patients diagnosed with convulsive epilepsy were recruited from seven different rural regions in Jilin Province, China to investigate the current status of epilepsy treatment, and 1379 of them were enrolled in a standard phenobarbital therapy trial. Patients were selected according to strict inclusion and exclusion criteria, and medical records for all patients were collected and analyzed before the standard treatment was started. Patients were followed up monthly, and efficacy in 1218 patients was analyzed at 1, 3, 6 and 12 months of treatment. More patients had the initial seizure in juveniles than in adults, and 40.72% of the 2192 patients were not receiving any treatment before the treatment trial. The efficacy of phenobarbital increased and adverse effects decreased within the treatment period. Among the 349 patients who were followed up for 12 months from the beginning of the phenobarbital treatment, seizures were decreased by more than 75% in 71.3% of patients using a low-to-medium dose of phenobarbital. Major adverse effects of phenobarbital included mild exhaustion, drowsiness, dizziness and headache. Standardized long-term and regular administration of phenobarbital at a low-to-medium dose can be used as an effective, economic and safe treatment against epilepsy in rural areas.

  14. Current practice and views of neurologists on the transition from pediatric to adult care.

    Science.gov (United States)

    Oskoui, Maryam; Wolfson, Christina

    2012-12-01

    To describe the current practice and views of neurologists on transitioning patients from pediatric to adult care, a cross-sectional study of all pediatric and adult neurologists in the province of Quebec, Canada, was conducted. The response rate was 73% for pediatric and 49% for adult neurologists. Most pediatric neurologists do not have a patient transition program or policy in place. Although a transfer summary is commonly provided, critical information is often lacking. Nearly half of neurologists believed that patients experience a gap in care during the transition process, and most agreed that the transition process is often poorly coordinated, highlighting patient, family, and health care factors. Current practice does not follow existing consensus statements for transition of care with respect to timing, communication, and preparation, and many pediatric neurologists experience difficulty in finding an appropriate adult health care provider for their patients. Neurologists reported many challenges in the current transition of care process.

  15. Normative functional fitness standards and trends of Portuguese older adults: cross-cultural comparisons.

    Science.gov (United States)

    Marques, Elisa A; Baptista, Fátima; Santos, Rute; Vale, Susana; Santos, Diana A; Silva, Analiza M; Mota, Jorge; Sardinha, Luís B

    2014-01-01

    This cross-sectional study was designed to develop normative functional fitness standards for the Portuguese older adults, to analyze age and gender patterns of decline, to compare the fitness level of Portuguese older adults with that of older adults in other countries, and to evaluate the fitness level of Portuguese older adults relative to recently published criterion fitness standards associated with maintaining physical independence. A sample of 4,712 independent-living older adults, age 65-103 yr, was evaluated using the Senior Fitness Test battery. Age-group normative fitness scores are reported for the 10th, 25th, 50th, 75th, and 90th percentiles. Results indicate that both women and men experience age-related losses in all components of functional fitness, with their rate of decline being greater than that observed in other populations, a trend which may cause Portuguese older adults to be at greater risk for loss of independence in later years. These newly established normative standards make it possible to assess individual fitness level and provide a basis for implementing population-wide health strategies to counteract early loss of independence.

  16. Current National Approach to Healthcare ICT Standardization: Focus on Progress in New Zealand.

    Science.gov (United States)

    Park, Young-Taek; Atalag, Koray

    2015-07-01

    Many countries try to efficiently deliver high quality healthcare services at lower and manageable costs where healthcare information and communication technologies (ICT) standardisation may play an important role. New Zealand provides a good model of healthcare ICT standardisation. The purpose of this study was to review the current healthcare ICT standardisation and progress in New Zealand. This study reviewed the reports regarding the healthcare ICT standardisation in New Zealand. We also investigated relevant websites related with the healthcare ICT standards, most of which were run by the government. Then, we summarised the governance structure, standardisation processes, and their output regarding the current healthcare ICT standards status of New Zealand. New Zealand government bodies have established a set of healthcare ICT standards and clear guidelines and procedures for healthcare ICT standardisation. Government has actively participated in various enactments of healthcare ICT standards from the inception of ideas to their eventual retirement. Great achievements in eHealth have already been realized, and various standards are currently utilised at all levels of healthcare regionally and nationally. Standard clinical terminologies, such as International Classification of Diseases (ICD) and Systematized Nomenclature of Medicine - Clinical Terms (SNOMED-CT) have been adopted and Health Level Seven (HL7) standards are actively used in health information exchanges. The government to New Zealand has well organised ICT institutions, guidelines, and regulations, as well as various programs, such as e-Medications and integrated care services. Local district health boards directly running hospitals have effectively adopted various new ICT standards. They might already be benefiting from improved efficiency resulting from healthcare ICT standardisation.

  17. National BTS bronchiectasis audit 2012: is the quality standard being adhered to in adult secondary care?

    Science.gov (United States)

    Hill, Adam T; Routh, Chris; Welham, Sally

    2014-03-01

    A significant step towards improving care of patients with non-cystic fibrosis bronchiectasis was the creation of the British Thoracic Society (BTS) national guidelines and the quality standard. A BTS bronchiectasis audit was conducted between 1 October and 30 November 2012, in adult patients with bronchiectasis attending secondary care, against the BTS quality standard. Ninety-eight institutions took part, submitting a total of 3147 patient records. The audit highlighted the variable adoption of the quality standard. It will allow the host institutions to benchmark against UK figures and drive quality improvement programmes to promote the quality standard and improve patient care.

  18. Evaluation of 2 new optical biometry devices and comparison with the current gold standard biometer.

    Science.gov (United States)

    Chen, Yen-An; Hirnschall, Nino; Findl, Oliver

    2011-03-01

    To compare 2 new optical biometry devices with the present gold standard biometer. Vienna Institute for Research in Ocular Surgery, Department of Ophthalmology, Hanusch Hospital, Vienna, Austria. Evaluation of diagnostic test or technology. In patients scheduled for cataract surgery, measurements performed with the current gold standard optical biometer (IOLMaster) were compared with those of 2 new optical biometers, the Lenstar LS 900 (optical low-coherence reflectometry [OLCR] device; substudy 1) and the IOLMaster 500 (partial coherence interferometry [PCI] device; substudy 2). The duration of patient data entry and of the actual measurement process and the time from intraocular lens power calculation to printout were calculated. The mean difference in axial length measurements was 0.01 mm ± 0.05 (SD) between the gold standard device and the new OLCR device and 0.01 ± 0.02 mm between the gold standard device and the new PCI device (P=.12 and P gold standard device (mean difference 209 ± 127 seconds), and measurements with the gold standard device took significantly longer than with the new PCI device (mean difference 82 ± 46 seconds) (both P gold standard device. Measurements with the new OLCR device took twice as long as those with the gold standard device. Copyright © 2011 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.

  19. Electromagnetic field standards in Central and Eastern European countries: current state and stipulations for international harmonization.

    Science.gov (United States)

    Gajsek, P; Pakhomov, A G; Klauenberg, B J

    2002-04-01

    Electromagnetic field standards in the West are based on well-established acute biological effects that could be considered as signaling a potentially adverse health effect. The specific absorption rate, which is proportional to the tissue heating (thermal effects), represents the basic restriction of exposure to Radio-Frequency (RF) fields. On the other hand, Eastern European standards are designed to protect from potential non-thermal effects that might be caused by chronic exposure to very low intensities, where a so-called "power load" (a product of field intensity and duration of exposure) represents the basic limitation. Thus, electromagnetic field standards in Eastern European countries differ considerably from those which are proposed by the International Commission of Non-ionizing Radiation Protection and the Standards Coordinating Committee 28 of the Institute of Electrical and Electronics Engineers, Inc. In the present paper, the strategies for development of exposure limit values in electromagnetic fields standards currently in force in Eastern and Central European countries are discussed. Some differences as well as similarities of the national health and safety standards and the main obstacles to harmonization of these standards with those being established by Western national and international organizations and agencies are presented.

  20. Reasons for current E-cigarette use among U.S. adults.

    Science.gov (United States)

    Patel, Deesha; Davis, Kevin C; Cox, Shanna; Bradfield, Brian; King, Brian A; Shafer, Paul; Caraballo, Ralph; Bunnell, Rebecca

    2016-12-01

    E-cigarette use has increased rapidly among U.S. adults. However, reasons for use among adults are unclear. We assessed reasons for e-cigarette use among a national sample of U.S. adults. Data were collected via online surveys among U.S. adults aged 18 or older from April through June 2014. Descriptive and multivariate regression analyses were conducted to assess reasons for e-cigarette use among 2448 current e-cigarette users, by sociodemographic characteristics and product type. Assessed reasons included cessation/health, consideration of others, convenience, cost, curiosity, flavoring, and simulation of conventional cigarettes. Among current e-cigarette users, 93% were also current cigarette smokers. The most common reasons for e-cigarette use were cessation/health (84.5%), consideration of others (71.5%), and convenience (56.7%). The prevalence of citing convenience (adjusted prevalence ratio [aPR]=1.49) and curiosity (aPR=1.54) as reasons for e-cigarette use were greater among current cigarette smokers than nonsmokers (Preason for use was greater among adults aged 18 to 24 (aPR=2.02) than 55 or older (Preason except convenience and curiosity. Cessation- and health-related factors are primary reasons cited for e-cigarette use among adults, and flavorings are more commonly cited by younger adults. Efforts are warranted to provide consumers with accurate information on the health effects of e-cigarettes and to ensure that flavoring and other unregulated features do not promote nicotine addiction, particularly among young adults. Published by Elsevier Inc.

  1. Current state of standardization in the field of dimensional computed tomography

    International Nuclear Information System (INIS)

    Bartscher, Markus; Härtig, Frank; Neuschaefer-Rube, Ulrich; Sato, Osamu

    2014-01-01

    Industrial x-ray computed tomography (CT) is a well-established non-destructive testing (NDT) technology and has been in use for decades. Moreover, CT has also started to become an important technology for dimensional metrology. But the requirements on dimensional CTs, i.e., on performing coordinate measurements with CT, are different from NDT. For dimensional measurements, the position of interfaces or surfaces is of importance, while this is often less critical in NDT. Standardization plays an important role here as it can create trust in new measurement technologies as is the case for dimensional CT. At the international standardization level, the ISO TC 213 WG 10 is working on specifications for dimensional CT. This paper highlights the demands on international standards in the field of dimensional CT and describes the current developments from the viewpoint of representatives of national and international standardization committees. Key aspects of the discussion are the material influence on the length measurement error E and how E can best be measured. A respective study was performed on hole plates as new reference standards for error testing of length measurements incorporating the material influence. We performed corresponding measurement data analysis and present a further elaborated hole plate design. The authors also comment on different approaches currently pursued and give an outlook on upcoming developments as far as they can be foreseen. (paper)

  2. Childhood socioeconomic deprivation, but not current mood, is associated with behavioural disinhibition in adults

    Directory of Open Access Journals (Sweden)

    Tünde Paál

    2015-05-01

    Full Text Available There is evidence to suggest that impulsivity is predicted by socioeconomic background, with people from more deprived backgrounds tending to be more impulsive, and by current mood, with poorer mood associated with greater impulsivity. However, impulsivity is not a unitary construct, and previous research in this area has focused on measures of ‘waiting’ impulsivity rather than behavioural disinhibition. We administered a standard measure of behavioural disinhibition, the stop-signal task, to 58 adult participants from a community sample. We had measured socioeconomic background using participant postcode at age 16, and assigned participants to receive either a neutral or a negative mood induction. We found no effects of mood on behavioural disinhibition, but we found a significant effect of socioeconomic background. Participants who had lived in more deprived postcodes at age 16 showed longer stop-signal reaction times, and hence greater behavioural disinhibition. The pattern was independent of participant age and overall reaction time. Though caution is required inferring causality from correlation, it is possible that that experiencing socioeconomic deprivation in childhood and adolescence may lead to greater behavioural disinhibition in adulthood.

  3. submitter Flavour-changing neutral currents making and breaking the standard model

    CERN Document Server

    Archilli, F; Owen, P; Petridis, K A

    2017-01-01

    The standard model of particle physics is our best description yet of fundamental particles and their interactions, but it is known to be incomplete. As yet undiscovered particles and interactions might exist. One of the most powerful ways to search for new particles is by studying processes known as flavour-changing neutral current decays, whereby a quark changes its flavour without altering its electric charge. One example of such a transition is the decay of a beauty quark into a strange quark. Here we review some intriguing anomalies in these decays, which have revealed potential cracks in the standard model—hinting at the existence of new phenomena.

  4. Analysis of the Current Technical Issues on ASME Code and Standard for Nuclear Mechanical Design(2009)

    International Nuclear Information System (INIS)

    Koo, Gyeong Hoi; Lee, B. S.; Yoo, S. H.

    2009-11-01

    This report describes the analysis on the current revision movement related to the mechanical design issues of the U.S ASME nuclear code and standard. ASME nuclear mechanical design in this report is composed of the nuclear material, primary system, secondary system and high temperature reactor. This report includes the countermeasures based on the ASME Code meeting for current issues of each major field. KAMC(ASME Mirror Committee) of this project is willing to reflect a standpoint of the domestic nuclear industry on ASME nuclear mechanical design and play a technical bridge role for the domestic nuclear industry in ASME Codes application

  5. Current Methods Applied to Biomaterials - Characterization Approaches, Safety Assessment and Biological International Standards.

    Science.gov (United States)

    Oliveira, Justine P R; Ortiz, H Ivan Melendez; Bucio, Emilio; Alves, Patricia Terra; Lima, Mayara Ingrid Sousa; Goulart, Luiz Ricardo; Mathor, Monica B; Varca, Gustavo H C; Lugao, Ademar B

    2018-04-10

    Safety and biocompatibility assessment of biomaterials are themes of constant concern as advanced materials enter the market as well as products manufactured by new techniques emerge. Within this context, this review provides an up-to-date approach on current methods for the characterization and safety assessment of biomaterials and biomedical devices from a physicalchemical to a biological perspective, including a description of the alternative methods in accordance with current and established international standards. Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.org.

  6. Report on the Current Technical Issues on ASME Nuclear Code and Standard

    International Nuclear Information System (INIS)

    Koo, Gyeong Hoi; Lee, B. S.; Yoo, S. H.

    2008-11-01

    This report describes the analysis on the current revision movement related to the mechanical design issues of the U.S ASME nuclear code and standard. ASME nuclear mechanical design in this report is composed of the nuclear material, primary system, secondary system and high temperature reactor. This report includes the countermeasures based on the ASME Code meeting for current issues of each major field. KAMC(ASME Mirror Committee) of this project is willing to reflect a standpoint of the domestic nuclear industry on ASME nuclear mechanical design and play a technical bridge role for the domestic nuclear industry in ASME Codes application

  7. Analysis of the Current Technical Issues on ASME Code and Standard for Nuclear Mechanical Design(2009)

    Energy Technology Data Exchange (ETDEWEB)

    Koo, Gyeong Hoi; Lee, B. S.; Yoo, S. H.

    2009-11-15

    This report describes the analysis on the current revision movement related to the mechanical design issues of the U.S ASME nuclear code and standard. ASME nuclear mechanical design in this report is composed of the nuclear material, primary system, secondary system and high temperature reactor. This report includes the countermeasures based on the ASME Code meeting for current issues of each major field. KAMC(ASME Mirror Committee) of this project is willing to reflect a standpoint of the domestic nuclear industry on ASME nuclear mechanical design and play a technical bridge role for the domestic nuclear industry in ASME Codes application

  8. Comparison of Standard Link Color Visibility Between Young Adults and Elderly Adults

    Science.gov (United States)

    Saito, Daisuke; Saito, Keiichi; Notomi, Kazuhiro; Saito, Masao

    The rapid dissemination of the World Wide Web raises the issue of the Web accessibility, and one of the important things is the combination of a foreground color and a background color. In our previous study, the visibility of web-safe colors on the white background was examined, and the blue used for unvisited standard link color was found high visibility in wide range of ages. Since the usage of the blue and an underline are recommended as a link, in this study, we examined high-visibility background colors to the unvisited standard link color, i.e. blue. One hundred and twenty three background colors to the blue were examined using pair comparison method, and the relationship between the visibility and the color difference was discussed on the uniform color space, CIELAB (L*a*b* color space). As the result, effective background colors to the standard link color were determined on the CIE LAB, that is, L* larger than 68, a* smaller than 50, and b* larger than -50 provided high visibility in wide range of ages.

  9. Standard practice for examination of welds using the alternating current field measurement technique

    CERN Document Server

    American Society for Testing and Materials. Philadelphia

    2007-01-01

    1.1 This practice describes procedures to be followed during alternating current field measurement examination of welds for baseline and service-induced surface breaking discontinuities. 1.2 This practice is intended for use on welds in any metallic material. 1.3 This practice does not establish weld acceptance criteria. 1.4 The values stated in either inch-pound units or SI units are to be regarded separately as standard. The values stated in each system might not be exact equivalents; therefore, each system shall be used independently of the other. 1.5 This standard does not purport to address all of the safety concerns, if any, associated with its use. It is the responsibility of the user of this standard to establish appropriate safety and health practices and determine the applicability of regulatory limitations prior to use.

  10. Measurement of the depth of narrow slotted sections in eddy current reference standards

    Science.gov (United States)

    Kim, Young-Joo; Kim, Young-gil; Ahn, Bongyoung; Yoon, Dong-Jin

    2007-02-01

    The dimensions of the slots in eddy current (EC) reference standards are too narrow to be measured by general depth measurement methods such as the optical (laser) or stylus methods. However, measurement of the dimensions of the machined slots is a prerequisite to using the blocks as references. The present paper suggests a measurement method for the slotted section using an ultrasonic test. The width and depth of the slots measured in our study are roughly 0.1 mm and 0.5 mm, respectively. The time of flight (TOF) of the ultrasonic wave was measured precisely. The ultrasonic velocity in the material of the EC reference standard was calculated with the measured values of the TOF and its thickness. Reflected waves from the tip of the slot and the bottom surface of the EC standard were successfully classified. Using this method we have successfully determined the depth of the slotted section.

  11. Current Standards of Care and Long Term Outcomes for Thalassemia and Sickle Cell Disease.

    Science.gov (United States)

    Chonat, Satheesh; Quinn, Charles T

    2017-01-01

    Thalassemia and sickle cell disease (SCD) are disorders of hemoglobin that affect millions of people worldwide. The carrier states for these diseases arose as common, balanced polymorphisms during human history because they afforded protection against severe forms of malaria. These complex, multisystem diseases are reviewed here with a focus on current standards of clinical management and recent research findings. The importance of a comprehensive, multidisciplinary and lifelong system of care is also emphasized.

  12. Adult Sexual Experiences as a Mediator Between Child Abuse and Current Secretory Immunoglobulin A Levels.

    Science.gov (United States)

    Waldron, Jonathan C; Scarpa, Angela; Kim-Spoon, Jungmeen; Coe, Christopher L

    2016-03-01

    The current study investigated whether a history of child abuse is a predictor of adult immune status, with unwanted adult sexual experiences as a proximal mediator. Participants included 89 young adult women (M(age) = 19.24) who were classified as having experienced no child abuse, child physical abuse, or child sexual abuse, based upon self-reported victimization history before 14 years of age. Participants also reported on unwanted sexual experiences in young adulthood and provided four saliva samples, which were collected over two consecutive days to determine secretory immunoglobulin A (sIgA). Age and negative life events were considered as covariates. The results indicated that adult sexual victimization partially mediated the relationship between child abuse (physical and sexual) and sIgA. Specifically, child abuse experiences predicted more adult sexual victimization experiences, which in turn predicted lower sIgA levels. These findings support long-term health effects of victimization, and suggest that the influence of child abuse on sIgA may be perpetuated through adult victimization. Prevention efforts should aim to empower child maltreatment survivors with skills to prevent adult re-victimization. By thwarting future unwanted sexual experiences in adulthood, individuals will be better protected from the health impairments associated with early abuse experiences. © The Author(s) 2014.

  13. Current status of core and advanced adult gastrointestinal endoscopy training in Canada: Survey of existing accredited programs.

    Science.gov (United States)

    Xiong, Xin; Barkun, Alan N; Waschke, Kevin; Martel, Myriam

    2013-01-01

    To determine the current status of core and advanced adult gastroenterology training in Canada. A survey consisting of 20 questions pertaining to core and advanced endoscopy training was circulated to 14 accredited adult gastroenterology residency program directors. For continuous variables, median and range were analyzed; for categorical variables, percentage and associated 95% CIs were analyzed. All 14 programs responded to the survey. The median number of core trainees was six (range four to 16). The median (range) procedural volumes for gastroscopy, colonoscopy, percutaneous endoscopic gastrostomy and sigmoidoscopy, respectively, were 400 (150 to 1000), 325 (200 to 1500), 15 (zero to 250) and 60 (25 to 300). Eleven of 13 (84.6%) programs used endoscopy simulators in their curriculum. Eight of 14 programs (57%) provided a structured advanced endoscopy training fellowship. The majority (88%) offered training of combined endoscopic retrograde cholangiopancreatography (ERCP) and endoscopic ultrasonography. The median number of positions offered yearly for advanced endoscopy fellowship was one (range one to three). The median (range) procedural volumes for ERCP, endoscopic ultrasonography and endoscopic mucosal resection, respectively, were 325 (200 to 750), 250 (80 to 400) and 20 (10 to 63). None of the current programs offered training in endoscopic submucosal dissection or natural orifice transluminal endoscopic surgery. Most accredited adult Canadian gastroenterology programs met the minimal procedural requirements recommended by the Canadian Association of Gastroenterology during core training. However, a more heterogeneous experience has been observed for advanced training. Additional studies would be required to validate and standardize evaluation tools used during gastroenterology curricula.

  14. Improving Naming Abilities among Healthy Young-Old Adults Using Transcranial Direct Current Stimulation

    Science.gov (United States)

    Lifshitz-Ben-Basat, Adi; Mashal, Nira

    2018-01-01

    Transcranial direct current stimulation (tDCS) is a noninvasive tool to facilitate brain plasticity and enhance language abilities. Our study aims to search for a potential beneficial influence of tDCS on a cognitive linguistic task of naming which found to decline during aging. A group of fifteen healthy old adults (M = 64.93 ± 5.09 years) were…

  15. Current status of multi-detector row helical CT in imaging of adult ...

    African Journals Online (AJOL)

    Current status of multi-detector row helical CT in imaging of adult acquired pancreatic diseases and assessing surgical neoplastic resectability. ... The presence of inflammation, masses, and vascular invasion was evaluated and interpreted images were obtained during each phase. Results were compared with surgery, ...

  16. Effect of temperature on the standard metabolic rates of juvenile and adult Exopalaemon carinicauda

    Science.gov (United States)

    Zhang, Chengsong; Li, Fuhua; Xiang, Jianhai

    2015-03-01

    Ridgetail white prawn ( Exopalaemon carinicauda) are of significant economic importance in China where they are widely cultured. However, there is little information on the basic biology of this species. We evaluated the effect of temperature (16, 19, 22, 25, 28, 31, and 34°C) on the standard metabolic rates (SMRs) of juvenile and adult E. carinicauda in the laboratory under static conditions. The oxygen consumption rate (OCR), ammonia-N excretion rate (AER), and atomic ratio of oxygen consumed to nitrogen consumed (O:N ratio) of juvenile and adult E. carinicauda were significantly influenced by temperature ( P 0.05). The O:N ratio in juveniles was significantly higher than that in the adults over the entire temperature range ( P values. Results from the present study may be used to guide pond culture production of E. carinicauda.

  17. Ion transport and loss in the earth's quiet ring current. I - Data and standard model

    Science.gov (United States)

    Sheldon, R. B.; Hamilton, D. C.

    1993-01-01

    A study of the transport and loss of ions in the earth's quiet time ring current, in which the standard radial diffusion model developed for the high-energy radiation belt particles is compared with the measurements of the lower-energy ring current ions, is presented. The data set provides ionic composition information in an energy range that includes the bulk of the ring current energy density, 1-300 keV/e. Protons are found to dominate the quiet time energy density at all altitudes, peaking near L of about 4 at 60 keV/cu cm, with much smaller contributions from O(+) (1-10 percent), He(+) (1-5 percent), and He(2+) (less than 1 percent). A minimization procedure is used to fit the amplitudes of the standard electric radial diffusion coefficient, yielding 5.8 x 10 exp -11 R(E-squared)/s. Fluctuation ionospheric electric fields are suggested as the source of the additional diffusion detected.

  18. Is it time to reassess current safety standards for glyphosate-based herbicides?

    Science.gov (United States)

    Vandenberg, Laura N; Blumberg, Bruce; Antoniou, Michael N; Benbrook, Charles M; Carroll, Lynn; Colborn, Theo; Everett, Lorne G; Hansen, Michael; Landrigan, Philip J; Lanphear, Bruce P; Mesnage, Robin; Vom Saal, Frederick S; Welshons, Wade V; Myers, John Peterson

    2017-06-01

    Use of glyphosate-based herbicides (GBHs) increased ∼100-fold from 1974 to 2014. Additional increases are expected due to widespread emergence of glyphosate-resistant weeds, increased application of GBHs, and preharvest uses of GBHs as desiccants. Current safety assessments rely heavily on studies conducted over 30 years ago. We have considered information on GBH use, exposures, mechanisms of action, toxicity and epidemiology. Human exposures to glyphosate are rising, and a number of in vitro and in vivo studies challenge the basis for the current safety assessment of glyphosate and GBHs. We conclude that current safety standards for GBHs are outdated and may fail to protect public health or the environment. To improve safety standards, the following are urgently needed: (1) human biomonitoring for glyphosate and its metabolites; (2) prioritisation of glyphosate and GBHs for hazard assessments, including toxicological studies that use state-of-the-art approaches; (3) epidemiological studies, especially of occupationally exposed agricultural workers, pregnant women and their children and (4) evaluations of GBHs in commercially used formulations, recognising that herbicide mixtures likely have effects that are not predicted by studying glyphosate alone. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  19. Lifetime History of Traumatic Brain Injury and Current Disability Among Ohio Adults.

    Science.gov (United States)

    Yi, Honggang; Corrigan, John D; Singichetti, Bhavna; Bogner, Jennifer A; Manchester, Kara; Guo, Jinhong; Yang, Jingzhen

    2017-10-27

    To examine the associations between lifetime history of traumatic brain injury (TBI) with loss of consciousness (LOC) and several types of current disability among adult, noninstitutionalized residents of Ohio. 2014 Ohio Behavioral Risk Factors Surveillance System participants (n = 6998). Statewide population-based survey. Lifetime history of TBI with LOC (number and severity of injury, age of first injury), and number and type of disability (vision, cognition, mobility, self-care, and/or independent living). Of the 6998 participants, 1325 reported lifetime history of TBI with LOC, and 1959 reported currently having one or more disabilities. When weighted, these represented 21.7% and 23.7% of Ohio's noninstitutionalized adult population, respectively. Adults with a history of TBI with LOC showed greater odds of any disability compared with adults with no history (odds ratio = 2.49; 95% confidence interval = 1.97-3.15). The likelihood of having any and each type of disability increased as the number of TBIs or the severity of worst TBI increased, regardless of sustaining first TBI before or after the age of 15 years. Lifetime history of TBI with LOC is significantly associated with disability among Ohio adults. Further research on the natural course of the relation and preventive strategies is warranted.

  20. Aldosterone down-regulates the slowly activated delayed rectifier potassium current in adult guinea pig cardiomyocytes.

    Science.gov (United States)

    Lv, Yankun; Bai, Song; Zhang, Hua; Zhang, Hongxue; Meng, Jing; Li, Li; Xu, Yanfang

    2015-12-01

    There is emerging evidence that the mineralocorticoid hormone aldosterone is associated with arrhythmias in cardiovascular disease. However, the effect of aldosterone on the slowly activated delayed rectifier potassium current (IK s ) remains poorly understood. The present study was designed to investigate the modulation of IK s by aldosterone. Adult guinea pigs were treated with aldosterone for 28 days via osmotic pumps. Standard glass microelectrode recordings and whole-cell patch-clamp techniques were used to record action potentials in papillary muscles and IK s in ventricular cardiomyocytes. The aldosterone-treated animals exhibited a prolongation of the QT interval and action potential duration with a higher incidence of early afterdepolarizations. Patch-clamp recordings showed a significant down-regulation of IK s density in the ventricular myocytes of these treated animals. These aldosterone-induced electrophysiological changes were fully prevented by a combined treatment with spironolactone, a mineralocorticoid receptor (MR) antagonist. In addition, in in vitro cultured ventricular cardiomyocytes, treatment with aldosterone (sustained exposure for 24 h) decreased the IK s density in a concentration-dependent manner. Furthermore, a significant corresponding reduction in the mRNA/protein expression of IKs channel pore and auxiliary subunits, KCNQ1 and KCNE1 was detected in ventricular tissue from the aldosterone-treated animals. Aldosterone down-regulates IK s by inhibiting the expression of KCNQ1 and KCNE1, thus delaying the ventricular repolarization. These results provide new insights into the mechanism underlying K(+) channel remodelling in heart disease and may explain the highly beneficial effects of MR antagonists in HF. © 2015 The British Pharmacological Society.

  1. Including Alternative Resources in State Renewable Portfolio Standards: Current Design and Implementation Experience

    Energy Technology Data Exchange (ETDEWEB)

    Heeter, J.; Bird, L.

    2012-11-01

    Currently, 29 states, the District of Columbia, and Puerto Rico have instituted a renewable portfolio standard (RPS). An RPS sets a minimum threshold for how much renewable energy must be generated in a given year. Each state policy is unique, varying in percentage targets, timetables, and eligible resources. This paper examines state experience with implementing renewable portfolio standards that include energy efficiency, thermal resources, and non-renewable energy and explores compliance experience, costs, and how states evaluate, measure, and verify energy efficiency and convert thermal energy. It aims to gain insights from the experience of states for possible federal clean energy policy as well as to share experience and lessons for state RPS implementation.

  2. ASME nuclear codes and standards: Scope of coverage and current initiatives

    International Nuclear Information System (INIS)

    Eisenberg, G. M.

    1995-01-01

    The objective of this paper is to address the broad scope of coverage of nuclear codes, standards and guides produced and administered by the American Society of Mechanical Engineers (ASME). Background information is provided regarding the evolution of the present activities. Details are provided on current initiatives intended to permit ASME to meet the needs of a changing nuclear industry on a worldwide scale. During the early years of commercial nuclear power, ASME produced a code for the construction of nuclear vessels used in the reactor coolant pressure boundary, containment and auxiliary systems. In response to industry growth, ASME Code coverage soon broadened to include rules for construction of other nuclear components, and inservice inspection of nuclear reactor coolant systems. In the years following this, the scope of ASME nuclear codes, standards and guides has been broadened significantly to include air cleaning activities for nuclear power reactors, operation and maintenance of nuclear power plants, quality assurance programs, cranes for nuclear facilities, qualification of mechanical equipment, and concrete reactor vessels and containments. ASME focuses on globalization of its codes, standards and guides by encouraging and promoting their use in the international community and by actively seeking participation of international members on its technical and supervisory committees and in accreditation activities. Details are provided on current international representation. Initiatives are underway to separate the technical requirements from administrative and enforcement requirements, to convert to hard metric units, to provide for non-U. S. materials, and to provide for translations into non-English languages. ASME activity as an accredited ISO 9000 registrar for suppliers of mechanical equipment is described. Rules are being developed for construction of containment systems for nuclear spent fuel and high-level waste transport packagings. Intensive

  3. Radiotherapy for pediatric brain tumors: Standard of care, current clinical trials, and new directions

    International Nuclear Information System (INIS)

    Kun, Larry E.

    1996-01-01

    Objectives: To review the clinical characteristics of childhood brain tumors, including neurologic signs, neuroimaging and neuropathology. To critically assess indications for therapy relevant to presenting characteristics, age, and disease status. To discuss current management strategies including neurosurgery, radiation therapy, and chemotherapy. To analyze current clinical trials and future directions of clinical research. Brain tumors account for 20% of neoplastic diseases in children. The most common tumors include astrocytoma and malignant gliomas, medulloblastoma and supratentorial PNET's, ependymoma, craniopharyngioma, and intracranial germ cell tumors. Tumor type and clinical course are often correlated with age at presentation and anatomic site. The clinical characteristics and disease extent largely determine the relative merits of available 'standard' and investigational therapeutic approaches. Treatment outcome, including disease control and functional integrity, is dependent upon age at presentation, tumor type, and disease extent. An understanding of the clinical, neuroimaging, and histologic characteristics as they relate to decisions regarding therapy is critical to the radiation oncologist. Appropriate radiation therapy is central to curative therapy for a majority of pediatric brain tumor presentations. Technical advances in neurosurgery provide greater safety for 'gross total resection' in a majority of hemispheric astrocytomas and medulloblastomas. The relative roles of 'standard' radiation therapy and evolving chemotherapy for centrally located astrocytomas (e.g., diencephalic, optic pathway) need to be analyzed in the context of initial and overall disease control, neurotoxicities, and potential modifications in the risk:benefit ratio apparent in the introduction of precision radiation techniques. Modifications in radiation delivery are fundamental to current investigations in medulloblastoma; the rationale for contemporary and projected

  4. Transcranial direct current stimulation over left inferior frontal cortex improves speech fluency in adults who stutter.

    Science.gov (United States)

    Chesters, Jennifer; Möttönen, Riikka; Watkins, Kate E

    2018-04-01

    See Crinion (doi:10.1093/brain/awy075) for a scientific commentary on this article.Stuttering is a neurodevelopmental condition affecting 5% of children, and persisting in 1% of adults. Promoting lasting fluency improvement in adults who stutter is a particular challenge. Novel interventions to improve outcomes are of value, therefore. Previous work in patients with acquired motor and language disorders reported enhanced benefits of behavioural therapies when paired with transcranial direct current stimulation. Here, we report the results of the first trial investigating whether transcranial direct current stimulation can improve speech fluency in adults who stutter. We predicted that applying anodal stimulation to the left inferior frontal cortex during speech production with temporary fluency inducers would result in longer-lasting fluency improvements. Thirty male adults who stutter completed a randomized, double-blind, controlled trial of anodal transcranial direct current stimulation over left inferior frontal cortex. Fifteen participants received 20 min of 1-mA stimulation on five consecutive days while speech fluency was temporarily induced using choral and metronome-timed speech. The other 15 participants received the same speech fluency intervention with sham stimulation. Speech fluency during reading and conversation was assessed at baseline, before and after the stimulation on each day of the 5-day intervention, and at 1 and 6 weeks after the end of the intervention. Anodal stimulation combined with speech fluency training significantly reduced the percentage of disfluent speech measured 1 week after the intervention compared with fluency intervention alone. At 6 weeks after the intervention, this improvement was maintained during reading but not during conversation. Outcome scores at both post-intervention time points on a clinical assessment tool (the Stuttering Severity Instrument, version 4) also showed significant improvement in the group receiving

  5. Standard and biological treatment in large vessel vasculitis: guidelines and current approaches.

    Science.gov (United States)

    Muratore, Francesco; Pipitone, Nicolò; Salvarani, Carlo

    2017-04-01

    Giant cell arteritis and Takayasu arteritis are the two major forms of idiopathic large vessel vasculitis. High doses of glucocorticoids are effective in inducing remission in both conditions, but relapses and recurrences are common, requiring prolonged glucocorticoid treatment with the risk of the related adverse events. Areas covered: In this article, we will review the standard and biological treatment strategies in large vessel vasculitis, and we will focus on the current approaches to these diseases. Expert commentary: The results of treatment trials with conventional immunosuppressive agents such as methotrexate, azathioprine, mycophenolate mofetil, and cyclophosphamide have overall been disappointing. TNF-α blockers are ineffective in giant cell arteritis, while observational evidence and a phase 2 randomized trial support the use of tocilizumab in relapsing giant cell arteritis. Observational evidence strongly supports the use of anti-TNF-α agents and tocilizumab in Takayasu patients with relapsing disease. However biological agents are not curative, and relapses remain common.

  6. Low power fast settling multi-standard current reusing CMOS fractional-N frequency synthesizer

    Institute of Scientific and Technical Information of China (English)

    Lou Wenfeng; Feng Peng; Wang Haiyong; Wu Nanjian

    2012-01-01

    A low power fast settling multi-standard CMOS fractional-N frequency synthesizer is proposed.The current reusing and frequency presetting techniques are adopted to realize the low power fast settling multi-standard fractional-N frequency synthesizer.An auxiliary non-volatile memory (NVM) is embedded to avoid the repetitive calibration process and to save power in practical application.This PLL is implemented in a 0.18μm technology.The frequency range is 0.3 to 2.54 GHz and the settling time is less than 5μs over the entire frequency range.The LC-VCO with the stacked divide-by-2 has a good figure of merit of-193.5 dBc/Hz.The measured phase noise of frequency synthesizer is about -115 dBc/Hz at 1 MHz offset when the carrier frequency is 2.4 GHz and the reference spurs are less than -52 dBc.The whole frequency synthesizer consumes only 4.35 mA @ 1.8 V.

  7. Low power fast settling multi-standard current reusing CMOS fractional-N frequency synthesizer

    International Nuclear Information System (INIS)

    Lou Wenfeng; Feng Peng; Wang Haiyong; Wu Nanjian

    2012-01-01

    A low power fast settling multi-standard CMOS fractional-N frequency synthesizer is proposed. The current reusing and frequency presetting techniques are adopted to realize the low power fast settling multi-standard fractional-N frequency synthesizer. An auxiliary non-volatile memory (NVM) is embedded to avoid the repetitive calibration process and to save power in practical application. This PLL is implemented in a 0.18 μm technology. The frequency range is 0.3 to 2.54 GHz and the settling time is less than 5 μs over the entire frequency range. The LC-VCO with the stacked divide-by-2 has a good figure of merit of −193.5 dBc/Hz. The measured phase noise of frequency synthesizer is about −115 dBc/Hz at 1 MHz offset when the carrier frequency is 2.4 GHz and the reference spurs are less than −52 dBc. The whole frequency synthesizer consumes only 4.35 mA and 1.8 V. (semiconductor integrated circuits)

  8. Modeling of tube current modulation methods in computed tomography dose calculations for adult and pregnant patients

    International Nuclear Information System (INIS)

    Caracappa, Peter F.; Xu, X. George; Gu, Jianwei

    2011-01-01

    The comparatively high dose and increasing frequency of computed tomography (CT) examinations have spurred the development of techniques for reducing radiation dose to imaging patients. Among these is the application of tube current modulation (TCM), which can be applied either longitudinally along the body or rotationally along the body, or both. Existing computational models for calculating dose from CT examinations do not include TCM techniques. Dose calculations using Monte Carlo methods have been previously prepared for constant-current rotational exposures at various positions along the body and for the principle exposure projections for several sets of computational phantoms, including adult male and female and pregnant patients. Dose calculations from CT scans with TCM are prepared by appropriately weighting the existing dose data. Longitudinal TCM doses can be obtained by weighting the dose at the z-axis scan position by the relative tube current at that position. Rotational TCM doses are weighted using the relative organ doses from the principle projections as a function of the current at the rotational angle. Significant dose reductions of 15% to 25% to fetal tissues are found from simulations of longitudinal TCM schemes to pregnant patients of different gestational ages. Weighting factors for each organ in rotational TCM schemes applied to adult male and female patients have also been found. As the application of TCM techniques becomes more prevalent, the need for including TCM in CT dose estimates will necessarily increase. (author)

  9. Factors influencing adult physical health after controlling for current health conditions: evidence from a british cohort.

    Directory of Open Access Journals (Sweden)

    Helen Cheng

    Full Text Available This study explored a longitudinal data set of 6875 British adults examining the effects of parental social status (measured at birth, cognitive ability (at age 11 yrs, personality traits, education and occupational attainment on physical health and functioning (all measured at age 50 yrs, after taking account of current health conditions (number of illness. Correlation analysis showed that parental social class, childhood cognitive ability, education and occupation, and two personality traits (Emotional Stability/Neuroticism, and Conscientiousness were all significantly associated with adult physical health variables. Structural equation modelling showed that health conditions and personality traits were significantly, and inversely, associated with physical health (indicated by good daily physical functioning, relative absence of pain, perceived health, and low level of limitations at work due to physical health. Parental social status, childhood intelligence, educational and occupational attainment were all modestly, but significantly and directly, associated with adult physical health. The effect of childhood intelligence on adult physical health was, in part, mediated through Emotional Stability and Conscientiousness. After controlling for health conditions Emotional Stability was the strongest predictor of physical health. Implications and limitations are discussed.

  10. Air Emissions Damages from Municipal Drinking Water Treatment Under Current and Proposed Regulatory Standards.

    Science.gov (United States)

    Gingerich, Daniel B; Mauter, Meagan S

    2017-09-19

    Water treatment processes present intersectoral and cross-media risk trade-offs that are not presently considered in Safe Drinking Water Act regulatory analyses. This paper develops a method for assessing the air emission implications of common municipal water treatment processes used to comply with recently promulgated and proposed regulatory standards, including concentration limits for, lead and copper, disinfection byproducts, chromium(VI), strontium, and PFOA/PFOS. Life-cycle models of electricity and chemical consumption for individual drinking water unit processes are used to estimate embedded NO x , SO 2 , PM 2.5 , and CO 2 emissions on a cubic meter basis. We estimate air emission damages from currently installed treatment processes at U.S. drinking water facilities to be on the order of $500 million USD annually. Fully complying with six promulgated and proposed rules would increase baseline air emission damages by approximately 50%, with three-quarters of these damages originating from chemical manufacturing. Despite the magnitude of these air emission damages, the net benefit of currently implemented rules remains positive. For some proposed rules, however, the promise of net benefits remains contingent on technology choice.

  11. Standard Operating Procedures for PET/CT: A Practical Approach for Use in Adult Oncology

    International Nuclear Information System (INIS)

    2013-01-01

    of operating procedures for FDG-PET/CT imaging in adult oncology patients. The text is based on consensus and agreement among the authors, following a systematic approach of relying on personal experience and the available scientific evidence on all the subjects included. Due to the evolving nature of PET/CT imaging, which is a rapidly growing technology, this publication will undoubtedly need to be updated on a regular basis. It may well be that each PET/CT centre will have to modify the recommendations provided here to suit its own particular circumstances, according to, inter alia, the type of scanner, patient population, use of intravenous contrast, availability of FDG, professional staff experience, local regulations and preferences of referring physicians. The information provided here is felt to be important in the light of the growing need to standardize and optimize the way PET/CT scans are performed, not only to enable trials using FDG-PET/CT in different institutions to be compared and correlated, but also to allow for more accurate comparisons of scans performed on the same patient at different points in time at a single institution. This is important when assessing the response to cancer therapy, and especially so when this evaluation is performed early and after using novel targeted treatments that very often only produce changes in metabolic activity and not in lesion/tumour size. This is the reason why strictly following a correct imaging protocol is crucial. The reliability of the PET/CT imaging information in cancer patients depends on trustworthy and consistently applied protocols. This issue has current relevance in drug discovery and development, where PET/CT imaging with FDG and other radiotracers is viewed by the pharmaceutical industry as potentially useful for shortening the process of clinical validation of new drugs

  12. Clinical balance assessment: perceptions of commonly-used standardized measures and current practices among physiotherapists in Ontario, Canada.

    Science.gov (United States)

    Sibley, Kathryn M; Straus, Sharon E; Inness, Elizabeth L; Salbach, Nancy M; Jaglal, Susan B

    2013-03-20

    Balance impairment is common in multiple clinical populations, and comprehensive assessment is important for identifying impairments, planning individualized treatment programs, and evaluating change over time. However, little information is available regarding whether clinicians who treat balance are satisfied with existing assessment tools. In 2010 we conducted a cross-sectional survey of balance assessment practices among physiotherapists in Ontario, Canada, and reported on the use of standardized balance measures (Sibley et al. 2011 Physical Therapy; 91: 1583-91). The purpose of this study was to analyse additional survey data and i) evaluate satisfaction with current balance assessment practices and standardized measures among physiotherapists who treat adult or geriatric populations with balance impairment, and ii) identify factors associated with satisfaction. The questionnaire was distributed to 1000 practicing physiotherapists. This analysis focuses on questions in which respondents were asked to rate their general perceptions about balance assessment, the perceived utility of individual standardized balance measures, whether they wanted to improve balance assessment practices, and why. Data were summarized with descriptive statistics and utility of individual measures was compared across clinical practice areas (orthopaedic, neurological, geriatric or general rehabilitation). The questionnaire was completed by 369 respondents, of which 43.4% of respondents agreed that existing standardized measures of balance meet their needs. In ratings of individual measures, the Single Leg Stance test and Berg Balance Scale were perceived as useful for clinical decision-making and evaluating change over time by over 70% of respondents, and the Timed Up-and-Go test was perceived as useful for decision-making by 56.9% of respondents and useful for evaluating change over time by 62.9% of respondents, but there were significant differences across practice groups. Seventy

  13. Early goal-directed nutrition versus standard of care in adult intensive care patients

    DEFF Research Database (Denmark)

    Allingstrup, Matilde Jo; Kondrup, Jens; Wiis, Jørgen

    2017-01-01

    Purpose: We assessed the effects of early goal-directed nutrition (EGDN) vs. standard nutritional care in adult intensive care unit (ICU) patients. Methods: We randomised acutely admitted, mechanically ventilated ICU patients expected to stay longer than 3 days in the ICU. In the EGDN group we...... estimated nutritional requirements by indirect calorimetry and 24-h urinary urea aiming at covering 100% of requirements from the first full trial day using enteral and parenteral nutrition. In the standard of care group we aimed at providing 25 kcal/kg/day by enteral nutrition. If this was not met by day 7......, patients were supplemented with parenteral nutrition. The primary outcome was physical component summary (PCS) score of SF-36 at 6 months. We performed multiple imputation for data of the non-responders. Results: We randomised 203 patients and included 199 in the intention-to-treat analyses; baseline...

  14. Radiotherapy for pediatric brain tumors: Standard of care, current clinical trials and new directions

    International Nuclear Information System (INIS)

    Kun, Larry E.

    1997-01-01

    Objectives: To review the clinical characteristics of childhood brain tumors, including neurologic signs, neuroimaging and neuropathology. To critically assess indications for therapy relevant to presenting characteristics, age, and disease status. To discuss current management strategies including neurosurgery, radiation therapy, and chemotherapy. To analyze current clinical trials and future directions of clinical research. Brain tumors account for 20% of neoplastic diseases in children. The most common tumors include astrocytoma and malignant gliomas, medulloblastoma and supratentorial PNET's, ependymoma, craniopharyngioma, and intracranial germ cell tumors. The clinical characteristics and disease extent largely determine the relative merits of available 'standard' and investigational therapeutic approaches. Treatment outcome, including disease control and functional integrity, is dependent upon tumor type and site, age at presentation, and disease extent. An understanding of the clinical, neuroimaging, and histologic characteristics as they relate to decisions regarding therapy is critical to the radiation oncologist. Appropriate radiation therapy is central to curative therapy for a majority of pediatric brain tumor presentations. Technical advances in neurosurgery provide greater safety for 'gross total resection' in a majority of hemispheric astrocytomas and medulloblastomas. The relative roles of radiation therapy and chemotherapy for centrally located astrocytomas (e.g., diencephalic, optic pathway) need to be analyzed in the context of initial and overall disease control, neurotoxicities, and potential modifications in the risk:benefit ratio apparent in the introduction of 3-dimensional radiation techniques. Modifications in radiation delivery are important components of current investigations in medulloblastoma; the rationale for contemporary cooperative group trials will be presented as well as the background data re surgical, radiotherapeutic, and

  15. Non-destructive testing. The current state of standards and qualification and certification for leak testing

    International Nuclear Information System (INIS)

    Tamura, Yoshikazu

    2011-01-01

    Domestic standards of the leak testing are enacted as one of Japan Industrial Standards. The conformity is advanced between these domestic standards and ISO (International Organization for Standardization) standard. ISO9712 (Non-destructive testing-Qualification and certification of personnel) was revised to include the leak testing of qualification and certification in 2005. The preparation working group of qualification and certification for leak testing is planning start aiming at the system in one and a half years. (author)

  16. Unconditional and Conditional Standards Using Cognitive Function Curves for the Modified Mini-Mental State Exam: Cross-Sectional and Longitudinal Analyses in Older Chinese Adults in Singapore.

    Science.gov (United States)

    Cheung, Yin Bun; Xu, Ying; Feng, Lei; Feng, Liang; Nyunt, Ma Shwe Zin; Chong, Mei Sian; Lim, Wee Shiong; Lee, Tih Shih; Yap, Philip; Yap, Keng Bee; Ng, Tze Pin

    2015-09-01

    The conventional practice of assessing cognitive status and monitoring change over time in older adults using normative values of the Mini-Mental State Exam (MMSE) based on age bands is imprecise. Moreover, population-based normative data on changes in MMSE score over time are scarce and crude because they do not include age- and education-specific norms. This study aims to develop unconditional standards for assessing current cognitive status and conditional standards that take prior MMSE score into account for assessing longitudinal change, with percentile curves as smooth functions of age. Cross-sectional and longitudinal data of a modified version of the MMSE for 2,026 older Chinese adults from the Singapore Longitudinal Aging Study, aged 55-84, in Singapore were used to estimate quantile regression coefficients and create unconditional standards and conditional standards. We presented MMSE percentile curves as a smooth function of age in education strata, for unconditional and conditional standards, based on quantile regression coefficient estimates. We found the 5th and 10th percentiles were more strongly associated with age and education than were higher percentiles. Model diagnostics demonstrated the accuracy of the standards. The development and use of unconditional and conditional standards should facilitate cognitive assessment in clinical practice and deserve further studies. Copyright © 2015 American Association for Geriatric Psychiatry. Published by Elsevier Inc. All rights reserved.

  17. Regional hyperthermia combined with chemotherapy in paediatric, adolescent and young adult patients: current and future perspectives

    International Nuclear Information System (INIS)

    Seifert, Georg; Budach, Volker; Keilholz, Ulrich; Wust, Peter; Eggert, Angelika; Ghadjar, Pirus

    2016-01-01

    Here we evaluate the current status of clinical research on regional hyperthermia (RHT) in combination with chemotherapy or radiation therapy in paediatric oncology. Data were identified in searches of MEDLINE, Current Contents, PubMed, and references from relevant articles using medical subject headings including hyperthermia, cancer, paediatric oncology, children, radiation therapy and chemotherapy. Currently, only two RHT centres exist in Europe which treat children. Clinical RHT research in paediatric oncology has as yet been limited to children with sarcomas and germ cell tumours that respond poorly to or recur after chemotherapy. RHT is a safe and effective treatment delivering local thermic effects, which may also stimulate immunological processes via heat-shock protein reactions. RHT is used chiefly in children and adolescents with sarcomas or germ cell tumours located in the abdomino-pelvic region, chest wall or extremities to improve operability or render the tumour operable. It could potentially be combined with radiation therapy in a post-operative R1 setting where more radical surgery is not possible or combined with chemotherapy instead of radiation therapy in cases where the necessary radiation dose is impossible to achieve or would have mutilating consequences. RHT might also be an option for chemotherapy intensification in the neoadjuvant first-line treatment setting for children and adolescents, as was recently reflected in the promising long-term outcome data in adults with high-risk soft tissue sarcomas (EORTC 62961/ESHO trial). The limited data available indicate that combining RHT with chemotherapy is a promising option to treat germ cell tumours and, potentially, sarcomas. RHT may also be beneficial in first-line therapy in children, adolescents and young adults. The research should focus on optimising necessary technical demands and then initiate several clinical trials incorporating RHT into interdisciplinary treatment of children

  18. Revision of the Euratom basic safety standards directive-current status

    International Nuclear Information System (INIS)

    Mundig, S.

    2011-01-01

    The European Commission is currently developing a revised Euratom Basic Safety Standards (BSS) Directive covering two major objectives: the consolidation of existing Euratom Radiation Protection legislation and the revision of the Euratom BSS. The consolidation will merge the following five Directives into one single Directive: the BSS Directive, the Medical Exposures Directive, the Public Information Directive, the Outside Workers Directive and the Directive on the Control of high-activity sealed radioactive sources and orphan sources. The revision of the Euratom BSS will take account of the latest recommendations by the International Commission on Radiological Protection and shall improve clarity of the requirements where appropriate. It is planned to introduce more binding requirements on natural radiation sources, on criteria for exemption and clearance, and on the cooperation between Member States for emergency planning and response. The provisions for regulatory control of planned exposure situations foresee a graded approach commensurate to the magnitude and likelihood of exposures from a practice. Finally, the new BSS shall take account of recent scientific developments. One additional goal is to achieve greater harmonisation between the Euratom BSS and the international BSS. While the requirements on the protection of workers, apprentices and students remain nearly unchanged, the revised BSS will clarify the roles and responsibilities of services and experts involved in technical and practical aspects of radiation protection, such as the occupational health services, the dosimetry services, the radiation protection expert and the medical physics expert. The requirements in the BSS on individual monitoring of category A workers remain unchanged, but the existing guidance on individual monitoring was revised and updated-the technical recommendations for monitoring individuals occupationally exposed to external radiation are published by the European

  19. Standard procedures for adults in accredited sleep medicine centres in Europe

    DEFF Research Database (Denmark)

    Fischer, Jürgen; Dogas, Zoran; Bassetti, Claudio L

    2012-01-01

    The present paper describes standardized procedures within clinical sleep medicine. As such, it is a continuation of the previously published European guidelines for the accreditation of sleep medicine centres and European guidelines for the certification of professionals in sleep medicine, aimed...... at creating standards of practice in European sleep medicine. It is also part of a broader action plan of the European Sleep Research Society, including the process of accreditation of sleep medicine centres and certification of sleep medicine experts, as well as publishing the Catalogue of Knowledge...... and Skills for sleep medicine experts (physicians, non-medical health care providers, nurses and technologists), which will be a basis for the development of relevant educational curricula. In the current paper, the standard operational procedures sleep medicine centres regarding the diagnostic...

  20. Improved reading measures in adults with dyslexia following transcranial direct current stimulation treatment.

    Science.gov (United States)

    Heth, Inbahl; Lavidor, Michal

    2015-04-01

    To better understand the contribution of the dorsal system to word reading, we explored transcranial direct current stimulation (tDCS) effects when adults with developmental dyslexia received active stimulation over the visual extrastriate area MT/V5, which is dominated by magnocellular input. Stimulation was administered in 5 sessions spread over two weeks, and reading speed and accuracy as well as reading fluency were assessed before, immediately after, and a week after the end of the treatment. A control group of adults with developmental dyslexia matched for age, gender, reading level, vocabulary and block-design WAIS-III sub-tests and reading level was exposed to the same protocol but with sham stimulation. The results revealed that active, but not sham stimulation, significantly improved reading speed and fluency. This finding suggests that the dorsal stream may play a role in efficient retrieval from the orthographic input lexicon in the lexical route. It also underscores the potential of tDCS as an intervention tool for improving reading speed, at least in adults with developmental dyslexia. Copyright © 2015 Elsevier Ltd. All rights reserved.

  1. Diabetes and cardiovascular disease in older adults: current status and future directions.

    Science.gov (United States)

    Halter, Jeffrey B; Musi, Nicolas; McFarland Horne, Frances; Crandall, Jill P; Goldberg, Andrew; Harkless, Lawrence; Hazzard, William R; Huang, Elbert S; Kirkman, M Sue; Plutzky, Jorge; Schmader, Kenneth E; Zieman, Susan; High, Kevin P

    2014-08-01

    The prevalence of diabetes increases with age, driven in part by an absolute increase in incidence among adults aged 65 years and older. Individuals with diabetes are at higher risk for cardiovascular disease, and age strongly predicts cardiovascular complications. Inflammation and oxidative stress appear to play some role in the mechanisms underlying aging, diabetes, cardiovascular disease, and other complications of diabetes. However, the mechanisms underlying the age-associated increase in risk for diabetes and diabetes-related cardiovascular disease remain poorly understood. Moreover, because of the heterogeneity of the older population, a lack of understanding of the biology of aging, and inadequate study of the effects of treatments on traditional complications and geriatric conditions associated with diabetes, no consensus exists on the optimal interventions for older diabetic adults. The Association of Specialty Professors, along with the National Institute on Aging, the National Institute of Diabetes and Digestive and Kidney Diseases, the National Heart, Lung, and Blood Institute, and the American Diabetes Association, held a workshop, summarized in this Perspective, to discuss current knowledge regarding diabetes and cardiovascular disease in older adults, identify gaps, and propose questions to guide future research. © 2014 by the American Diabetes Association. Readers may use this article as long as the work is properly cited, the use is educational and not for profit, and the work is not altered.

  2. Heart transplantation for adults with congenital heart disease: current status and future prospects.

    Science.gov (United States)

    Matsuda, Hikaru; Ichikawa, Hajime; Ueno, Takayoshi; Sawa, Yoshiki

    2017-06-01

    Increased survival rates after corrective or palliative surgery for complex congenital heart disease (CHD) in infancy and childhood are now being coupled with increased numbers of patients who survive to adulthood with various residual lesions or sequelae. These patients are likely to deteriorate in cardiac function or end-organ function, eventually requiring lifesaving treatment including heart transplantation. Although early and late outcomes of heart transplantation have been improving for adult survivors of CHD, outcomes and pretransplant management could still be improved. Survivors of Fontan procedures are a vulnerable cohort, particularly when single ventricle physiology fails, mostly with protein-losing enteropathy and hepatic dysfunction. Therefore, we reviewed single-institution and larger database analyses of adults who underwent heart transplantation for CHD, to enable risk stratification by identifying the indications and outcomes. As the results, despite relatively high early mortality, long-term results were encouraging after heart transplantation. However, further investigations are needed to improve the indication criteria for complex CHD, especially for failed Fontan. In addition, the current system of status criteria and donor heart allocation system in heart transplantation should be arranged as suitable for adults with complex CHD. Furthermore, there is a strong need to develop ventricular assist devices as a bridge to transplantation or destination therapy, especially where right-sided circulatory support is needed.

  3. Current Heavy Alcohol Consumption is Associated with Greater Cognitive Impairment in Older Adults

    Science.gov (United States)

    Woods, Adam J.; Porges, Eric C.; Bryant, Vaughn E.; Seider, Talia; Gongvatana, Assawin; Kahler, Christopher W.; de la Monte, Suzanne; Monti, Peter M.; Cohen, Ronald A.

    2016-01-01

    Background The acute consumption of excessive quantities of alcohol causes well-recognized neurophysiological and cognitive alterations. As people reach advanced age, they are more prone to cognitive decline. To date, the interaction of current heavy alcohol (ETOH) consumption and aging remain unclear. The current paper tested the hypothesis that negative consequences of current heavy alcohol consumption on neurocognitive function are worse with advanced age. Further, we evaluated the relations between lifetime history of alcohol dependence and neurocognitive function Methods Sixty-six participants underwent a comprehensive neurocognitive battery. Current heavy ETOH drinkers were classified using NIAAA criteria (ETOH Heavy, n = 21) based on the Timeline follow-back and a structured clinical interview and compared to non-drinkers, and moderate drinkers (ETOH Low, n = 45). Fifty-three-point-three percent of the total population had a lifetime history of alcohol dependence. Neurocognitive data were grouped and analyzed relative to global and domain scores assessing: global cognitive function, attention/executive function, learning, memory, motor function, verbal function, and speed of processing. Results Heavy current ETOH consumption in older adults was associated with poorer global cognitive function, learning, memory, and motor function (p’sfunction in the same neurocognitive domains, in addition to the attention/executive domain, irrespective of age (p’sfunction. PMID:27658235

  4. Military Housing: Status of the Services' Implementation of the Current Barracks Design Standard

    National Research Council Canada - National Science Library

    1999-01-01

    .... In November 1995, DOD adopted a new barracks construction standard, referred to as the 1+1 design standard, that called for more space and increased privacy in new barracks for service members permanently assigned to an installation...

  5. Geriatric-specific triage criteria are more sensitive than standard adult criteria in identifying need for trauma center care in injured older adults.

    Science.gov (United States)

    Ichwan, Brian; Darbha, Subrahmanyam; Shah, Manish N; Thompson, Laura; Evans, David C; Boulger, Creagh T; Caterino, Jeffrey M

    2015-01-01

    We evaluate the sensitivity of Ohio's 2009 emergency medical services (EMS) geriatric trauma triage criteria compared with the previous adult triage criteria in identifying need for trauma center care among older adults. We studied a retrospective cohort of injured patients aged 16 years or older in the 2006 to 2011 Ohio Trauma Registry. Patients aged 70 years or older were considered geriatric. We identified whether each patient met the geriatric and the adult triage criteria. The outcome measure was need for trauma center care, defined by surrogate markers: Injury Severity Score greater than 15, operating room in fewer than 48 hours, any ICU stay, and inhospital mortality. We calculated sensitivity and specificity of both triage criteria for both age groups. We included 101,577 patients; 33,379 (33%) were geriatric. Overall, 57% of patients met adult criteria and 68% met geriatric criteria. Using Injury Severity Score, for older adults geriatric criteria were more sensitive for need for trauma center care (93%; 95% confidence interval [CI] 92% to 93%) than adult criteria (61%; 95% CI 60% to 62%). Geriatric criteria decreased specificity in older adults from 61% (95% CI 61% to 62%) to 49% (95% CI 48% to 49%). Geriatric criteria in older adults (93% sensitivity, 49% specificity) performed similarly to the adult criteria in younger adults (sensitivity 87% and specificity 44%). Similar patterns were observed for other outcomes. Standard adult EMS triage guidelines provide poor sensitivity in older adults. Ohio's geriatric trauma triage guidelines significantly improve sensitivity in identifying Injury Severity Score and other surrogate markers of the need for trauma center care, with modest decreases in specificity for older adults. Copyright © 2014 American College of Emergency Physicians. Published by Elsevier Inc. All rights reserved.

  6. XBRL Standard for Financial Reporting in Croatia: Current State and Perspectives

    Directory of Open Access Journals (Sweden)

    Gostimir Dejan

    2015-09-01

    Full Text Available Background: Harmonization and standardization is becoming important among regulators and business community. XBRL has entered the global stage as a financial reporting standard. Its mission was to standardize the financial reporting, lower the reporting costs and make the reporting as transparent as possible.

  7. NODC Standard Format Current Meter (Components) (F015) Data (1962-1992) (NODC Accession 0066358)

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — This data set contains time series measurements of ocean currents. These data are obtained from current meter moorings and represent the Eulerian method of current...

  8. A standardized review of smartphone applications to promote balance for older adults.

    Science.gov (United States)

    Reyes, Angelica; Qin, Pei; Brown, Cary A

    2018-03-01

    Balance is one of the risk factors for falls in older adults. The use of smartphone applications (apps) related to health (mHealth) is increasing and, while there is potential for apps to be used as a self-managed balance intervention, many healthcare providers are concerned about the content and credibility of mHealth apps overall. This study evaluates the quality of balance promoting apps and identifies strengths and areas of concern to assist healthcare providers in recommending these resources. Balance apps for the general public, offered on the iPhone Operating System (iOS) and Android platforms, were evaluated using the Mobile Application Rating Scale (MARS). Five iOS apps met the inclusion criteria. The mean scores for each of the domains in MARS were: Engagement (3.32), Information (3.7), Functionality (3.8), and Esthetics (3.8). Overall, one app (UStabilize) received a rating of 4.43 in MARS five-point scale, which was considered "good". Other apps in the review demonstrated acceptable quality. The reviewed balance apps targeted to improve or maintain physical balance were of acceptable quality. Apps address many current issues older adults have to accessing rehabilitation services and, as such, may be particularly useful for this group. Future research should focus on assessing and comparing app efficacy. Development of balance apps for the Android platform is also necessary. Implications for Rehabilitation Given the availability and accessibility of various mHealth apps and the increasing mobile device usage among older adults, mobile apps are a promising avenue for delivering rehabilitation interventions, such as balance training, to older adults. Smartphone apps exist for balance training but overall confidence in health apps within the healthcare community is low and rigorous evaluation is required. A range of apps exist that demonstrate acceptable to good quality and stakeholders should work towards having these apps listed in credible m

  9. Can Transcranial Direct Current Stimulation Improve Cognitive Functioning in Adults with Schizophrenia?

    Science.gov (United States)

    Schretlen, David J; van Steenburgh, Joseph J; Varvaris, Mark; Vannorsdall, Tracy D; Andrejczuk, Megan A; Gordon, Barry

    Cognitive impairment is nearly ubiquitous in schizophrenia. First-degree relatives of persons with schizophrenia often show similar but milder deficits. Current methods for the treatment of schizophrenia are often ineffective in cognitive remediation. Since transcranial direct current stimulation (tDCS) can enhance cognitive functioning in healthy adults, it might provide a viable option to enhance cognition in schizophrenia. We sought to explore whether tDCS can be tolerated by persons with schizophrenia and potentially improve their cognitive functioning. We examined the effects of anodal versus cathodal tDCS on working memory and other cognitive tasks in five outpatients with schizophrenia and six first-degree relatives of persons with schizophrenia. Each participant completed tasks thought to be mediated by the prefrontal cortex during two 30-minute sessions of tDCS to the left and right dorsolateral prefrontal cortex (DLPFC). Anodal stimulation over the left DLPFC improved performance relative to cathodal stimulation on measures of working memory and aspects of verbal fluency relevant to word retrieval. The patient group showed differential changes in novel design production without alteration of overall productivity, suggesting that tDCS might be capable of altering self-monitoring and executive control. All participants tolerated tDCS well. None withdrew from the study or experienced any adverse reaction. We conclude that adults with schizophrenia can tolerate tDCS while engaging in cognitive tasks and that tDCS can alter their performance.

  10. Use of Adult Stem Cells for Cartilage Tissue Engineering: Current Status and Future Developments

    Directory of Open Access Journals (Sweden)

    Catherine Baugé

    2015-01-01

    Full Text Available Due to their low self-repair ability, cartilage defects that result from joint injury, aging, or osteoarthritis, are the most often irreversible and are a major cause of joint pain and chronic disability. So, in recent years, researchers and surgeons have been working hard to elaborate cartilage repair interventions for patients who suffer from cartilage damage. However, current methods do not perfectly restore hyaline cartilage and may lead to the apparition of fibro- or hypertrophic cartilage. In the next years, the development of new strategies using adult stem cells, in scaffolds, with supplementation of culture medium and/or culture in low oxygen tension should improve the quality of neoformed cartilage. Through these solutions, some of the latest technologies start to bring very promising results in repairing cartilage from traumatic injury or chondropathies. This review discusses the current knowledge about the use of adult stem cells in the context of cartilage tissue engineering and presents clinical trials in progress, as well as in the future, especially in the field of bioprinting stem cells.

  11. Outdoor air pollution, exhaled 8-isoprostane and current asthma in adults: the EGEA study.

    Science.gov (United States)

    Havet, Anaïs; Zerimech, Farid; Sanchez, Margaux; Siroux, Valérie; Le Moual, Nicole; Brunekreef, Bert; Stempfelet, Morgane; Künzli, Nino; Jacquemin, Bénédicte; Matran, Régis; Nadif, Rachel

    2018-04-01

    Associations between outdoor air pollution and asthma in adults are still scarce, and the underlying biological mechanisms are poorly understood. Our aim was to study the associations between 1) long-term exposure to outdoor air pollution and current asthma, 2) exhaled 8-isoprostane (8-iso; a biomarker related to oxidative stress) and current asthma, and 3) outdoor air pollution and exhaled 8-iso.Cross-sectional analyses were conducted in 608 adults (39% with current asthma) from the first follow-up of the French case-control and family study on asthma (EGEA; the Epidemiological study of the Genetic and Environmental factors of Asthma). Data on nitrogen dioxide, nitrogen oxides, particulate matter with a diameter ≤10 and ≤2.5 µm (PM 10 and PM 2.5 ), road traffic, and ozone (O 3 ) were from ESCAPE (European Study of Cohorts for Air Pollution Effects) and IFEN (French Institute for the Environment) assessments. Models took account of city and familial dependence.The risk of current asthma increased with traffic intensity (adjusted (a)OR 1.09 (95% CI 1.00-1.18) per 5000 vehicles per day), with O 3 exposure (aOR 2.04 (95% CI 1.27-3.29) per 10 µg·m -3 ) and with exhaled 8-iso concentration (aOR 1.50 (95% CI 1.06-2.12) per 1 pg·mL -1 ). Among participants without asthma, exhaled 8-iso concentration increased with PM 2.5 exposure (adjusted (a)β 0.23 (95% CI 0.005-0.46) per 5 µg·m -3 ), and decreased with O 3 and O 3-summer exposures (aβ -0.20 (95% CI -0.39- -0.01) and aβ -0.52 (95% CI -0.77- -0.26) per 10 µg·m -3 , respectively).Our results add new insights into a potential role of oxidative stress in the associations between outdoor air pollution and asthma in adults. Copyright ©ERS 2018.

  12. The development of national quality performance standards for disposable absorbent products for adult incontinence.

    Science.gov (United States)

    Muller, Nancy; McInnis, Elaine

    2013-09-01

    Disposable absorbent products are widely used in inpatient care settings and in the community to manage adult urinary and fecal incontinence, but few product standards exist to help guide their production or optimal use. Increasing costs and reduced revenues have caused a number of states to evaluate absorbent product use among persons who receive care at home with the assistance of the Medicaid Waiver Program, further increasing concerns about the lack of product performance standards. To address these issues, the National Association For Continence (NAFC) formed a council of experts and key stakeholders with the objective of establishing national, independent quality performance standards for disposable absorbent products provided by states to Waiver Program recipients. The Council consisted of representatives from five purposefully selected states, technical directors from six nonwoven product manufacturers, an officer of the nonwoven manufactures trade association, a delegate from an academic nursing program and professional societies, a family caregiver, and a patient representative. Following a consensus method and guidelines for use, nine specific recommendations were developed, posted for public comment, and further refined. Final recommendations for product performance assessment include: rewet rate (a measure of a product's ability to withstand multiple incontinent episodes between changes), rate of acquisition (a measure of the speed at which urine is drawn away from the skin by a product, product retention capacity (a measure of a product's capacity to hold fluid without rewetting the skin), sizing options, absorbency levels, product safety, closure technology, breathable zones (a measure of the air permeability across a textile-like fabric at a controlled differential pressure), and elasticity. The Council also set values for and recommended four quantifiable parameters, and the testing methodology associated with each, to help consumers and states

  13. Standardizing communication from acute care providers to primary care providers on critically ill adults.

    Science.gov (United States)

    Ellis, Kerri A; Connolly, Ann; Hosseinnezhad, Alireza; Lilly, Craig M

    2015-11-01

    To increase the frequency of communication of patient information between acute and primary care providers. A secondary objective was to determine whether higher rates of communication were associated with lower rates of hospital readmission 30 days after discharge. A validated instrument was used for telephone surveys before and after an intervention designed to increase the frequency of communication among acute care and primary care providers. The communication intervention was implemented in 3 adult intensive care units from 2 campuses of an academic medical center. The frequency of communication among acute care and primary care providers, the perceived usefulness of the intervention, and its association with 30-day readmission rates were assessed for 202 adult intensive care episodes before and 100 episodes after a communication intervention. The frequency of documented communication increased significantly (5/202 or 2% before to 72/100 or 72% after the intervention; P communication was considered useful by every participating primary care provider. Rates of rehospitalization at 30 days were lower for the intervention group than the preintervention group, but the difference was not statistically significant (41/202 or 23% vs 16/88 or 18% of discharged patients; P = .45; power 0.112 at P = .05). The frequency of communication episodes that provide value can be increased through standardized processes. The key aspects of this effective intervention were setting the expectation that communication should occur, documenting when communication has occurred, and reviewing that documentation during multiprofessional rounds. ©2015 American Association of Critical-Care Nurses.

  14. Prehospital Care for the Adult and Pediatric Seizure Patient: Current Evidence Based Recommendations

    Directory of Open Access Journals (Sweden)

    Eric C. Silverman

    2017-04-01

    Full Text Available Introduction: We sought to develop evidence-based recommendations for the prehospital evaluation and treatment of adult and pediatric patients with a seizure and to compare these recommendations against the current protocol used by the 33 emergency medical services (EMS agencies in California. Methods: We performed a review of the evidence in the prehospital treatment of patients with a seizure, and then compared the seizure protocols of each of the 33 EMS agencies for consistency with these recommendations. We analyzed the type and route of medication administered, number of additional rescue doses permitted, and requirements for glucose testing prior to medication. The treatment for eclampsia and seizures in pediatric patients were analyzed separately. Results: Protocols across EMS Agencies in California varied widely. We identified multiple drugs, dosages, routes of administration, re-dosing instructions, and requirement for blood glucose testing prior to medication delivery. Blood glucose testing prior to benzodiazepine administration is required by 61% (20/33 of agencies for adult patients and 76% (25/33 for pediatric patients. All agencies have protocols for giving intramuscular benzodiazepines and 76% (25/33 have protocols for intranasal benzodiazepines. Intramuscular midazolam dosages ranged from 2 to 10 mg per single adult dose, 2 to 8 mg per single pediatric dose, and 0.1 to 0.2 mg/kg as a weight-based dose. Intranasal midazolam dosages ranged from 2 to 10 mg per single adult or pediatric dose, and 0.1 to 0.2 mg/kg as a weight-based dose. Intravenous/intrasosseous midazolam dosages ranged from 1 to 6 mg per single adult dose, 1 to 5 mg per single pediatric dose, and 0.05 to 0.1 mg/kg as a weight-based dose. Eclampsia is specifically addressed by 85% (28/33 of agencies. Forty-two percent (14/33 have a protocol for administering magnesium sulfate, with intravenous dosages ranging from 2 to 6 mg, and 58% (19/33 allow benzodiazepines to be

  15. NODC Standard Product: Ocean current drifter data (2 disc set) (NODC Accession 0098060)

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — These CD-ROMs hold over 4 million surface current observations, almost all obtained by the ship drift method. Date, data source, position, and current direction and...

  16. Delivery of care consistent with the psychosocial standards in pediatric cancer: Current practices in the United States.

    Science.gov (United States)

    Scialla, Michele A; Canter, Kimberly S; Chen, Fang Fang; Kolb, E Anders; Sandler, Eric; Wiener, Lori; Kazak, Anne E

    2018-03-01

    With published evidence-based Standards for Psychosocial Care for Children with Cancer and their Families, it is important to know the current status of their implementation. This paper presents data on delivery of psychosocial care related to the Standards in the United States. Pediatric oncologists, psychosocial leaders, and administrators in pediatric oncology from 144 programs completed an online survey. Participants reported on the extent to which psychosocial care consistent with the Standards was implemented and was comprehensive and state of the art. They also reported on specific practices and services for each Standard and the extent to which psychosocial care was integrated into broader medical care. Participants indicated that psychosocial care consistent with the Standards was usually or always provided at their center for most of the Standards. However, only half of the oncologists (55.6%) and psychosocial leaders (45.6%) agreed or strongly agreed that their psychosocial care was comprehensive and state of the art. Types of psychosocial care provided included evidence-based and less established approaches but were most often provided when problems were identified, rather than proactively. The perception of state of the art care was associated with practices indicative of integrated psychosocial care and the extent to which the Standards are currently implemented. Many oncologists and psychosocial leaders perceive that the delivery of psychosocial care at their center is consistent with the Standards. However, care is quite variable, with evidence for the value of more integrated models of psychosocial services. © 2017 Wiley Periodicals, Inc.

  17. Current Heavy Alcohol Consumption is Associated with Greater Cognitive Impairment in Older Adults.

    Science.gov (United States)

    Woods, Adam J; Porges, Eric C; Bryant, Vaughn E; Seider, Talia; Gongvatana, Assawin; Kahler, Christopher W; de la Monte, Suzanne; Monti, Peter M; Cohen, Ronald A

    2016-11-01

    The acute consumption of excessive quantities of alcohol causes well-recognized neurophysiological and cognitive alterations. As people reach advanced age, they are more prone to cognitive decline. To date, the interaction of current heavy alcohol (ethanol [EtOH]) consumption and aging remains unclear. This study tested the hypothesis that negative consequences of current heavy alcohol consumption on neurocognitive function are worse with advanced age. Further, we evaluated the relations between lifetime history of alcohol dependence and neurocognitive function METHODS: Sixty-six participants underwent a comprehensive neurocognitive battery. Current heavy EtOH drinkers were classified using National Institute on Alcohol Abuse and Alcoholism criteria (EtOH heavy, n = 21) based on the Timeline follow-back and a structured clinical interview and compared to nondrinkers, and moderate drinkers (EtOH low, n = 45). Of the total population, 53.3% had a lifetime history of alcohol dependence. Neurocognitive data were grouped and analyzed relative to global and domain scores assessing: global cognitive function, attention/executive function, learning, memory, motor function, verbal function, and speed of processing. Heavy current EtOH consumption in older adults was associated with poorer global cognitive function, learning, memory, and motor function (ps alcohol dependence was associated with poorer function in the same neurocognitive domains, in addition to the attention/executive domain, irrespective of age (ps alcohol consumption is associated with significant impairment in a number of neurocognitive domains, history of alcohol dependence, even in the absence of heavy current alcohol use, is associated with lasting negative consequences for neurocognitive function. Copyright © 2016 by the Research Society on Alcoholism.

  18. Lifelong education for older adults in Malta: Current trends and future visions

    Science.gov (United States)

    Formosa, Marvin

    2012-04-01

    With European demographic developments causing a decline of the available workforce in the foreseeable future and the unsustainability of dominant pay-as-you-go pension systems (where contributions from the current workforce sustain pensioners), governments need to come up with strategies to deal with this upcoming challenge and to adjust their policies. Based on a study carried out between September 2009 and May 2010, this article evaluates the policies guiding late-life education in Malta, as well as the local plethora of learning opportunities for older adult education, and participation rates. The Maltese government is committed to supporting the inclusion of older persons (aged 60+) in lifelong education policies and programmes, to the extent that local studies have uncovered a recent rise in the overall participation of older adults in formal, non-formal and informal areas of learning. While the present and future prospects for late-life education in Malta seem promising, a critical scrutiny of present ideologies and trends finds the field to be no more than seductive rhetoric. Though the coordination of late-life education in Malta does result in various social benefits to older learners and Maltese society in general, it also occurs within five intersecting lines of inequality - namely an economic rationale, elitism, gender bias, the urban-rural divide and third ageism. This article ends by proposing policy recommendations for the future of late-life education.

  19. A survey of current and anticipated use of standard and specialist equipment by UK optometrists.

    Science.gov (United States)

    Dabasia, Priya L; Edgar, David F; Garway-Heath, David F; Lawrenson, John G

    2014-09-01

    To investigate current and anticipated use of equipment and information technology (IT) in community optometric practice in the UK, and to elicit optometrists' views on adoption of specialist equipment and IT. An anonymous online questionnaire was developed, covering use of standard and specialist diagnostic equipment, and IT. The survey was distributed to a random sample of 1300 UK College of Optometrists members. Four hundred and thirty-two responses were received (response rate = 35%). Enhanced (locally commissioned) or additional/separately contracted services were provided by 73% of respondents. Services included glaucoma repeat measures (30% of respondents), glaucoma referral refinement (22%), fast-track referral for wet age-related macular degeneration (48%), and direct cataract referral (40%). Most respondents (88%) reported using non-contact/pneumo tonometry for intra-ocular pressure measurement, with 81% using Goldmann or Perkins tonometry. The most widely used item of specialist equipment was the fundus camera (74% of respondents). Optical Coherence Tomography (OCT) was used by 15% of respondents, up from 2% in 2007. Notably, 43% of those anticipating purchasing specialist equipment in the next 12 months planned to buy an OCT. 'Paperless' records were used by 39% of respondents, and almost 80% of practices used an electronic patient record/practice management system. Variations in responses between parts of the UK reflect differences in the provision of the General Ophthalmic Services contract or community enhanced services. There was general agreement that specialised equipment enhances clinical care, permits increased involvement in enhanced services, promotes the practice and can be used as a defence in clinico-legal cases, but initial costs and ongoing maintenance can be a financial burden. Respondents generally agreed that IT facilitates administrative flow and secure exchange of health information, and promotes a state-of-the-art practice image

  20. Standardization of the Czech version of the Snyder´s Adult dispositional hope scale

    Directory of Open Access Journals (Sweden)

    Marie Ocisková

    2016-01-01

    Full Text Available Hope is one of important factors affecting the psychological state of individuals. It influences well-being and self-esteem, academic and athletic performance, and even the probability of repeated incarceration of offenders. It also predicts the efficacy of the systematic psychotherapy of mental disorders, as well as the supportive psychotherapy in patients with oncologic illnesses. Hope has a central position in positive and clinical psychology. The aim of the presented work was to translate the adult dispositional hope scale into Czech, verify its psychometric properties and develop the norms for interpreting the resulting scores. The scale could be helpful both in mental health research and practice. 394 healthy adults participated in the study. The average age of the probands was 27.1 + 11.7 years. There were more women (n = 303; i.e. 76.9 % than men. The most common level of education was secondary (n = 309; 78.4 %. The participants were mainly students (n = 273; 69.3 % or employees and self-employed individuals (n = 113; 28.7 %. Most of them were single (n = 300; 76.1 % or married (n = 84; 21.3 %. The Adult Dispositional Hope Scale consists of 12 items. Four items measure pathways thinking (i.e. the ability to find ways to achieve one's goals and four items assess agency (i.e. goal-directed energy. The remaining four items are fillers that are not interpreted. Apart from this scale, all participants completed a demographic questionnaire and the second version of the Beck Depression Inventory. The statistical analyses consisted of the Cronbach's alpha and Spearman-Brown coefficient analysis, the exploratory and confirmatory factor analysis, the correlation between the standardized scale and the Beck Depression Inventory-II, and finally the creation of the norms based on the stens. The overall rate of hope was not statistically significantly associated with the subjects' age (Spearman r = -0.06, non-significant, nor with their sex (Mann

  1. A standardized procedure for eddy-current testing of stainless steel, thin-walled nuclear fuel element cladding tubes

    International Nuclear Information System (INIS)

    Barat, P.; Raj, B.; Bhattacharya, D.K.

    1982-01-01

    Thin-walled nuclear fuel cladding tubes made of AISI 316 stainless steel have been examined by eddy-current testing. Standardization of the procedures has required investigations on optimizing the test frequency, finding a method to locate a defect with respect to the probe reference end, and the use of standard defects and sequential metallography of natural defects detected by eddy-current testing, to understand the influence of the nature of defects on the impedance output signals. Test frequency and method of locating the defect were optimized by the use of standard defects made by machining in reference cladding tubes. Subsequent metallography of natural defects detected by eddy-current testing revealed mainly clusters of inclusions but also other types of defects. The effect of the distribution of inclusions along the length of the tube on the impedance output is discussed. (author)

  2. Standardized procedure for eddy-current testing of stainless steel, thin-walled nuclear fuel element cladding tubes

    Energy Technology Data Exchange (ETDEWEB)

    Barat, P; Raj, B; Bhattacharya, D K [Reactor Research Centre, Kalpakkam (India)

    1982-10-01

    Thin-walled nuclear fuel cladding tubes made of AISI 316 stainless steel have been examined by eddy-current testing. Standardization of the procedures has required investigations on optimizing the test frequency, finding a method to locate a defect with respect to the probe reference end, and the use of standard defects and sequential metallography of natural defects detected by eddy-current testing, to understand the influence of the nature of defects on the impedance output signals. Test frequency and method of locating the defect were optimized by the use of standard defects made by machining in reference cladding tubes. Subsequent metallography of natural defects detected by eddy-current testing revealed mainly clusters of inclusions but also other types of defects. The effect of the distribution of inclusions along the length of the tube on the impedance output is discussed.

  3. Do current national and international guidelines have specific recommendations for older adults with bipolar disorder?

    DEFF Research Database (Denmark)

    Dols, Annemiek; Kessing, Lars Vedel; Strejilevich, Sergio A

    2016-01-01

    a variety of sources have become available in recent years. It is expected that at least some of this emerging information on OABD would be incorporated into treatment guidelines available to clinicians around the world. METHODS: The International Society of Bipolar Disorders OABD task force compiled...... and compared recommendations from current national and international guidelines that specifically address geriatric or older individuals with BD (from year 2005 onwards). RESULTS: There were 34 guidelines, representing six continents and 19 countries. The majority of guidelines had no separate section on OABD....... General principles for treating OABD with medication are recommended to be similar to those for younger adults, with special caution for side effects due to somatic comorbidity and concomitant medications. Therapeutic lithium serum levels are suggested to be lower but recommendations are very general...

  4. STATEWIDE DATA STANDARDS TO SUPPORT CURRENT AND FUTURE STRATEGIC PUBLIC TRANSIT INVESTMENT

    Science.gov (United States)

    2018-04-01

    Significant progress has been made in recent years in reporting and using public transit service data. With the creation and widespread use of the General Transit Feed Specification (GTFS) data standard, there has been a significant increase in the f...

  5. Age of First Use as a Predictor of Current Alcohol and Marijuana Use among College-Bound Emerging Adults

    Science.gov (United States)

    Bergen-Cico, Dessa K.; Lape, Megan E.

    2013-01-01

    Background: Alcohol and marijuana are the most commonly used psychoactive substances; however, the sequencing and relationship between age of first use and continued current problematic use among college-bound emerging adults is not well understood. Methods: This is a cross-sectional study of current and historical alcohol and marijuana use among…

  6. Current active and passive smoking among adults living with same sex partners in Spain.

    Science.gov (United States)

    Perales, Jaime; Checa, Irene; Espejo, Begoña

    2017-05-19

    To assess the association between current active and passive tobacco smoking and living with a same-sex partner in Spain. We analysed data from two cross-sectional national surveys of the Spanish population 15 years and older (2011-Encuesta Nacional de Salud en España and 2014-Encuesta Europea de Salud en España). Analyses included only people living with their partner. Associations were calculated using multiple logistic regressions adjusting for gender, social class and age. Current active and passive smoking were significantly associated with living with same sex partners (odds ratio: 2.71 and 2.88), and particularly strong among women. Spanish adults living with same-sex partners are at higher risk of active and passive smoking. This risk varies by gender. Spanish national surveys should include items on sexual orientation for improved data on health disparities. Copyright © 2017 SESPAS. Publicado por Elsevier España, S.L.U. All rights reserved.

  7. Angular on-line tube current modulation in multidetector CT examinations of children and adults: The influence of different scanning parameters on dose reduction

    International Nuclear Information System (INIS)

    Papadakis, Antonios E.; Perisinakis, Kostas; Damilakis, John

    2007-01-01

    The purpose of this study was to assess the potential of angular on-line tube current modulation on dose reduction in pediatric and adult patients undergoing multidetector computed tomography (MDCT) examinations. Five physical anthropomorphic phantoms that simulate the average individual as neonate, 1-year-old, 5-year-old, 10-year-old, and adult were employed in the current study. Phantoms were scanned with the use of on-line tube current modulation (TCM). Percent dose reduction (%DR) factors achieved by applying TCM, were determined for standard protocols used for head and neck, shoulder, thorax, thorax and abdomen, abdomen, abdomen and pelvis, pelvis, and whole body examinations. A preliminary study on the application of TCM in MDCT examinations of adult patients was performed to validate the results obtained in anthropomorphic phantoms. Dose reduction was estimated as the percentage difference of the modulated milliamperes for each scan and the preset milliamperes prescribed by the scan protocol. The dose reduction in children was found to be much lower than the corresponding reduction achieved for adults. For helical scans the %DR factors, ranged between 1.6% and 7.4% for the neonate, 2.9% and 8.7% for the 1-year old, 2% and 6% for the 5-year-old, 5% and 10.9% for the 10-year-old, and 10.4% and 20.7% for the adult individual. For sequential scans the corresponding %DR factors ranged between 1.3% and 6.7%, 4.5% and 11%, 4.2% and 6.6%, 6.4% and 12.3%, and 8.9% and 23.3%, respectively. Broader beam collimations are associated with decreased %DR factors, when other scanning parameters are held constant. TCM did not impair image noise. In adult patients, the %DR values were found to be in good agreement with the corresponding results obtained in the anthropomorphic adult phantom. In conclusion, on-line TCM may be considered as a valuable tool for reducing dose in routine CT examinations of pediatric and adult patients. However, the dose reduction achieved with TCM

  8. THE CURRENT STATE OF APPLICATION OF INTERNATIONAL FINANCIAL REPORTING STANDARDS IN UKRAINE.

    Directory of Open Access Journals (Sweden)

    B. Zasadnyi

    2016-09-01

    Full Text Available The article analyzed the process of reforming the system of accounting and reporting in Ukraine in accordance with International Financial Reporting Standards. The main results of the tasks of the Strategy of application IFRS in Ukraine approved by the Cabinet of Ministers of Ukraine in 2007 are identified. The results of analysis showed that only 1% of the total number of enterprises form the financial statements in accordance with IFRS, the others apply national standards of accounting. The proportion of small enterprises is 95% that do not have the financial capacity, qualified staff and the necessary motivation for the formation of financial statements in accordance with IFRS. As a result, one of the main objectives of the reform of the accounting and reporting is to improve the legislation on accounting for small enterprises and develop national accounting standards of the simplified procedure for accounting of assets, liabilities, equity and financial results of the calculation for small enterprises.

  9. Implementing the psychosocial standards in pediatric cancer: Current staffing and services available.

    Science.gov (United States)

    Scialla, Michele A; Canter, Kimberly S; Chen, Fang Fang; Kolb, E Anders; Sandler, Eric; Wiener, Lori; Kazak, Anne E

    2017-11-01

    Fifteen evidence-based Standards for Psychosocial Care for Children with Cancer and Their Families (Standards) were published in 2015. The Standards cover a broad range of topics and circumstances and require qualified multidisciplinary staff to be implemented. This paper presents data on the availability of psychosocial staff and existing practices at pediatric oncology programs in the United States, providing data that can be used to advocate for expanded services and prepare for implementation of the Standards. Up to three healthcare professionals from 144 programs (72% response rate) participated in an online survey conducted June-December 2016. There were 99 pediatric oncologists with clinical leadership responsibility (Medical Director/Clinical Director), 132 psychosocial leaders in pediatric oncology (Director of Psychosocial Services/Manager/most senior staff member), and 58 administrators in pediatric oncology (Administrative Director/Business Administrator/Director of Operations). The primary outcomes were number and type of psychosocial staff, psychosocial practices, and identified challenges in the delivery of psychosocial care. Over 90% of programs have social workers and child life specialists who provide care to children with cancer and their families. Fewer programs have psychologists (60%), neuropsychologists (31%), or psychiatrists (19%). Challenges in psychosocial care are primarily based on pragmatic issues related to funding and reimbursement. Most participating pediatric oncology programs appear to have at least the basic level of staffing necessary to implement of some of the Standards. However, the lack of a more comprehensive multidisciplinary team is a likely barrier in the implementation of the full set of Standards. © 2017 Wiley Periodicals, Inc.

  10. Historical Development of NATO Stanag 6001 Language Standards and Common European Framework (CEF) and the Comparison of Their Current Status

    Science.gov (United States)

    Solak, Ekrem

    2011-01-01

    The aim of the article is to shed light on the historical development of language studies in military and social context and to compare the current status of NATO Stanag (Standard Agreement) 6001 language scale with Common European Framework (CEF). Language studies in military context date back to World War II and the emergence of Army Specialized…

  11. Management of hypercalcaemic crisis in adults: Current role of renal replacement therapy.

    Science.gov (United States)

    Bentata, Yassamine; El Maghraoui, H; Benabdelhak, M; Haddiya, I

    2018-06-01

    Neoplasms and hematologic diseases are the predominant etiologies of hypercalcemic crisis in adults and the immediate treatment is mainly medical and symptomatic. The use of renal replacement therapy (RRT) is often necessary to correct the hypercalcemia, uremia and electrolyte disturbances related to Acute Kidney Injury (AKI). The aim of this work was to determine the etiologies and the place of RRT in treating patients with hypercalcaemic crisis. We conducted a retrospective study for 36months at the Nephrology Unit, University Hospital, Oujda, eastern of Morocco. We included all adult patients diagnosed with hypercalcemic crisis that was defined as corrected total serum calcium of >3.5mmol/l. 12 patients were collected. All patients were female and 5 patients were elderly (≥65years). Three patients had a serum calcium value of >4mmol/l and the highest calcium value was 5.8mmol/l. Electrocardiographic abnormalities were observed in 8 cases. AKI was observed in 8 cases. Three patients had chronic kidney disease on hemodialysis. Neoplasm was noted in 9 cases. All patients received venous rehydration, glucocorticoids and biphosphonates. The use of RRT with low calcium dialysate was performed in 11 cases. Three patients died during the first 24h of hospitalization. RRT must play its full role as first line treatment of hypercalcemia crisis. Improvements in hemodialysis techniques and the use of low calcium or calcium-free dialysates currently allows this therapeutic measure to be prescribed safely, and the benefit-risk balance is positive for the great benefit provided by dialysis. Copyright © 2018 Elsevier Inc. All rights reserved.

  12. Sulfur Dioxide (SO2) Primary Standards Documents from Current Review - Federal Register Notices

    Science.gov (United States)

    EPA develops and publishes a notice of proposed rulemaking regarding the review of the SO2 national ambient air quality standards (NAAQS). A public comment period follows. Taking into account comments received on the proposed rule, EPA issues a final rule.

  13. Standard Terminology for Phenotypic Variations: The Elements of Morphology Project, Its Current Progress, and Future Directions

    NARCIS (Netherlands)

    Carey, John C.; Allanson, Judith E.; Hennekam, Raoul C. M.; Biesecker, Leslie G.

    2012-01-01

    In 2005, the authors of this article formed an international working group to develop standardized definitions and terms to describe the physical variations used in human phenotypic analyses. This project, which came to be known as the Elements of Morphology, resulted in six articles proposing

  14. Risk Perceptions of Little Cigar and Cigarillo Smoking Among Adult Current Cigarette Smokers.

    Science.gov (United States)

    Sterling, Kymberle L; Majeed, Ban A; Nyman, Amy; Eriksen, Michael

    2017-11-01

    Few studies have examined the perceptions of risk of little cigar and cigarillo (LCC) smoking among cigarette smokers, which is important for expanding regulatory policies and developing prevention programs. We examined current cigarette smokers' perceived harm of LCC smoking, and determined whether these perceptions were associated with susceptibility and intention to continue smoking LCCs. Data were from the 2014 Tobacco Products and Risk Perceptions Survey of a probability sample of 5717 US adults. Data were analyzed for a subsample of 1191 current cigarette smokers who were stratified into three groups: (1) dual current cigarette smokers who had ever used LCCs, (2) current smokers susceptible to LCC smoking, and (3) current smokers who were not susceptible to LCC smoking. Overall, 47.2% of participants were dual smokers, 12.7% were susceptible to LCC smoking, and 40.1% were not susceptible. Perceptions of risk of LCCs varied across the groups. Dual smokers were more likely to perceive that daily LCC smoking is "very risky" (OR = 1.64, 95% CI = 1.08, 2.41) while occasional LCC smoking is only "somewhat risky" (OR = 1.71, 95% CI = 1.02, 2.87). Of the dual smokers, 20.7% intended to continue smoking LCCs in the future. Perceptions of addiction and risk of daily LCC smoking significantly predicted intention to continue LCC smoking. Addiction perceptions also significantly predicted susceptibility to initiate LCC smoking. Perceptions about harms from and addiction to LCCs could predict future LCC smoking. Health communication campaigns need to address the harms of LCCs. Our data suggest that perceptions of risk about the addictiveness of LCCs and frequency of use are important determinants of the LCC smoking susceptibility among some cigarette smokers and intended continued use among cigarette smokers with a history of LCC use. Health communication campaigns should address misperceptions related to LCCs. © The Author 2016. Published by Oxford University Press on

  15. HYDROXYCARBAMINE: FROM AN OLD DRUG USED IN MALIGNANT HEMOPATHIES TO A CURRENT STANDARD IN SICKLE CELL DISEASE

    Directory of Open Access Journals (Sweden)

    Giovanna Cannas

    2017-02-01

    Full Text Available While hydroxycarbamine (hydroxyurea, HU has less and less indications in malignant hemopathies, it represents the only widely used drug which modifies sickle cell disease pathogenesis. Clinical experience with HU for patients with sickle cell disease has been accumulated over the past 25 years in Western countries. The review of the literature provides increasing support of safety and efficacy in both children and adults for reducing acute vaso-occlusive events including pain episodes and acute chest syndrome. HU has become the standard-of-care for sickle cell anemia, but remains underused. Barriers to its use should be identified and overcome.

  16. De-standardization of family-life trajectories of young adults: a cross-national comparison using sequence analysis

    NARCIS (Netherlands)

    Elzinga, C.; Liefbroer, A.C.

    2007-01-01

    We introduce a number of new methods based on sequence analysis to test hypotheses on the de-standardization of family-life trajectories in early adulthood, using Fertility and Family Survey data on 19 countries. Across cohorts, family-life trajectories of young adults have not become more

  17. De-standardization of family-life trajectories of young adults: A cross-national comparison using sequence analyses

    NARCIS (Netherlands)

    Elzinga, C.H.; Liefbroer, A.C.

    2007-01-01

    We introduce a number of new methods based on sequence analysis to test hypotheses on the de-standardization of family-life trajectories in early adulthood, using Fertility and Family Survey data on 19 countries. Across cohorts, family-life trajectories of young adults have not become more

  18. Comparison of current practices of cardiopulmonary perfusion technology in Iran with American Society of Extracorporeal Technology's standards.

    Science.gov (United States)

    Faravan, Amir; Mohammadi, Nooredin; Alizadeh Ghavidel, Alireza; Toutounchi, Mohammad Zia; Ghanbari, Ameneh; Mazloomi, Mehran

    2016-01-01

    Standards have a significant role in showing the minimum level of optimal optimum and the expected performance. Since the perfusion technology staffs play an the leading role in providing the quality services to the patients undergoing open heart surgery with cardiopulmonary bypass machine, this study aimed to assess the standards on how Iranian perfusion technology staffs evaluate and manage the patients during the cardiopulmonary bypass process and compare their practice with the recommended standards by American Society of Extracorporeal Technology. In this descriptive study, data was collected from 48 Iranian public hospitals and educational health centers through a researcher-created questionnaire. The data collection questionnaire assessed the standards which are recommended by American Society of Extracorporeal Technology. Findings showed that appropriate measurements were carried out by the perfusion technology staffs to prevent the hemodilution and avoid the blood transfusion and unnecessary blood products, determine the initial dose of heparin based on one of the proposed methods, monitor the anticoagulants based on ACT measurement, and determine the additional doses of heparin during the cardiopulmonary bypass based on ACT or protamine titration. It was done only in 4.2% of hospitals and health centers. Current practices of cardiopulmonary perfusion technology in Iran are inappropriate based on the standards of American Society of Cardiovascular Perfusion. This represents the necessity of authorities' attention to the validation programs and development of the caring standards on one hand and continuous assessment of using these standards on the other hand.

  19. Dengue: Moving from Current Standard of Care to State-of-the-Art Treatment.

    Science.gov (United States)

    Gan, Victor C

    Treatment of dengue remains supportive in the absence of targeted antiviral therapy or approved vaccines. Responsive fluid management is key to preventing progression to shock or other severe manifestations. The dynamic natural history of dengue infection and its influence on hemodynamic homeostasis needs to be carefully considered in the planning of individualized therapy. Though largely self-limiting, the sheer burden of dengue disease on the global population will result in atypical manifestations especially in children, older adults, and comorbid patients. Management of these has not yet been systematized. The failure of recent randomized controlled trials to show utility for antiviral and immunomodulatory agents in dengue is disappointing. Vaccine candidates hold promise, but growing outbreaks require more robust, evidence-based management guidelines to inform clinicians, especially in novel epidemic situations.

  20. Radiotherapy for pediatric brain tumors: Standards of care, current clinical trials, and new directions

    International Nuclear Information System (INIS)

    Goldwein, Joel W.

    1995-01-01

    The objectives of the course are to evaluate the role of radiation therapy in the treatment of pediatric brain tumors. Areas where the role is evolving will be identified, and the results of clinical trials which been mounted to clarify radiotherapy's role will be reviewed. Brain tumors are the second most common malignancy of childhood after leukemias and lymphomas. However, they remain the most common group of childhood tumors to require radiation therapy. Therefore, a thorough understanding of these tumors, and the appropriate role of surgery, radiation and chemotherapy is critical. Issues surrounding the management of sequelae are no less important. The role of radiotherapy for the treatment of these tumors is far different from that for adults. These differences relate to the profound potential for sequelae from therapy, the higher overall cure rates, and the utility of multimodality therapies. In addition, the rarity of childhood brain tumors compared with adults' makes them more difficult to study. In this session, the following issues will be reviewed; 1. Incidence of pediatric brain tumors, 2. General issues regarding symptoms, diagnosis, diagnostic tests and evaluation, 3. Importance of a team approach, 4. General issues regarding treatment sequelae, 5. Specific tumor types/entities; a. Cerebellar Astrocytomas b. Benign and malignant Gliomas including brainstem and chiasmatic lesions c. Primitive Neuroectodermal Tumors (PNET) and Medulloblastoma d. Ependymomas e. Craniopharyngiomas f. Germ cell tumors g. Miscellaneous and rare pediatric brain tumors 6. Management of sequelae 7. New and future directions a. Treatment of infants b. The expanding role of chemotherapy c. Advances in radiotherapy. The attendees will complete the course with a better understanding of the role that radiation therapy plays in the treatment of pediatric brain tumors. They will be knowledgeable in the foundation for that role, and the changes which are likely to take place in the

  1. Current applications and future directions for the CDISC Operational Data Model standard: A methodological review.

    Science.gov (United States)

    Hume, Sam; Aerts, Jozef; Sarnikar, Surendra; Huser, Vojtech

    2016-04-01

    In order to further advance research and development on the Clinical Data Interchange Standards Consortium (CDISC) Operational Data Model (ODM) standard, the existing research must be well understood. This paper presents a methodological review of the ODM literature. Specifically, it develops a classification schema to categorize the ODM literature according to how the standard has been applied within the clinical research data lifecycle. This paper suggests areas for future research and development that address ODM's limitations and capitalize on its strengths to support new trends in clinical research informatics. A systematic scan of the following databases was performed: (1) ABI/Inform, (2) ACM Digital, (3) AIS eLibrary, (4) Europe Central PubMed, (5) Google Scholar, (5) IEEE Xplore, (7) PubMed, and (8) ScienceDirect. A Web of Science citation analysis was also performed. The search term used on all databases was "CDISC ODM." The two primary inclusion criteria were: (1) the research must examine the use of ODM as an information system solution component, or (2) the research must critically evaluate ODM against a stated solution usage scenario. Out of 2686 articles identified, 266 were included in a title level review, resulting in 183 articles. An abstract review followed, resulting in 121 remaining articles; and after a full text scan 69 articles met the inclusion criteria. As the demand for interoperability has increased, ODM has shown remarkable flexibility and has been extended to cover a broad range of data and metadata requirements that reach well beyond ODM's original use cases. This flexibility has yielded research literature that covers a diverse array of topic areas. A classification schema reflecting the use of ODM within the clinical research data lifecycle was created to provide a categorized and consolidated view of the ODM literature. The elements of the framework include: (1) EDC (Electronic Data Capture) and EHR (Electronic Health Record

  2. Recruitment Issues and Strategies for Adults Who Are Not Currently Participating in Literacy and Adult Basic Education (ABE) Programs.

    Science.gov (United States)

    Kohring, Aaron

    Adult basic education (ABE) and literacy programs have used many different strategies and tools to recruit new students. A small sampling of Tennessee ABE programs shows the more effective recruitment strategies are word-of-mouth referrals; newspaper advertisements and articles; fliers; brochures; posters, radio messages, and public service…

  3. Transcranial direct current stimulation of the primary motor cortex improves word-retrieval in older adults.

    Directory of Open Access Journals (Sweden)

    Marcus eMeinzer

    2014-09-01

    Full Text Available Language facilitation by transcranial direct current stimulation (tDCS in healthy individuals has generated hope that tDCS may also allow improving language impairment after stroke (aphasia. However, current stimulation protocols have yielded variable results and may require identification of residual language cortex using functional magnetic resonance imaging (fMRI, which complicates incorporation into clinical practice. Based on previous behavioral studies that demonstrated improved language processing by motor system pre-activation, the present study assessed whether tDCS administered to the primary motor cortex (M1 can enhance language functions.This proof-of-concept study employed a sham-tDCS controlled, cross-over, within-subject design and assessed the impact of unilateral excitatory (anodal and bihemispheric (dual tDCS in eighteen healthy older adults during semantic word-retrieval and motor speech tasks. Simultaneous fMRI scrutinized the neural mechanisms underlying tDCS effects.Both active tDCS conditions significantly improved word-retrieval compared to sham-tDCS. The direct comparison of activity elicited by word-retrieval vs. motor-speech trials revealed bilateral frontal activity increases during both anodal- and dual-tDCS compared to sham-tDCS. This effect was driven by more pronounced deactivation of frontal regions during the motor-speech task, while activity during word-retrieval trials was unaffected by the stimulation. No effects were found in M1 and secondary motor regions.Our results show that tDCS administered to M1 can improve word-retrieval in healthy individuals, thereby providing a rationale to explore whether M1-tDCS may offer a novel approach to improve language functions in aphasia. fMRI revealed neural facilitation specifically during motor speech trials, which may have reduced switching costs between the overlapping neural systems for lexical retrieval and speech processing, thereby resulting in improved

  4. The Association of Current Violence from Adult Family Members with Adolescent Bullying Involvement and Suicidal Feelings

    Science.gov (United States)

    Shimodera, Shinji; Koike, Shinsuke; Usami, Satoshi; Toriyama, Rie; Kanata, Sho; Sasaki, Tsukasa; Kasai, Kiyoto; Okazaki, Yuji; Nishida, Atsushi

    2016-01-01

    Although several studies have reported that child physical abuse increased the risk for bullying involvement, the effect of current violence from adult family members (CVA) on bullying involvement and suicidal feelings among adolescents has not been sufficiently examined. This study investigated the association of CVA with adolescent bullying involvement and the interaction effect of CVA and bullying involvement on suicidal feelings. This cross-sectional study used data from a school-based survey with a general population of adolescents (grades 7 to 12). Data were collected using a self-report questionnaire completed by 17,530 students. Logistic regression analyses were performed to explore the association of CVA with adolescent bullying involvement and suicidal feelings. The overall response rate was 90.2%. The odds of students being characterized as bullies, victims, and bully-victims were higher among adolescents with CVA than without CVA (odds ratios (OR) = 2.9, 95% confidence interval (CI), [2.3–3.7], 4.6 [3.6–5.8], and 5.8 [4.4–7.6], respectively). Both CVA (OR = 3.4 [95% CI 2.7–4.3]) and bullying (bullies, victims, and bully-victims; OR = 2.0 [95% CI 1.6–2.6], 4.0 [3.1–5.1], 4.1 [3.0–5.6], respectively), were associated with increased odds of current suicidal feelings after adjusting for confounding factors. Furthermore, positive additive effects of CVA and all three types of bullying involvement on suicidal feelings were found. For example, bully-victims with CVA had about 19-fold higher odds of suicidal feelings compared with uninvolved adolescents without CVA. This study, although correlational, suggested that CVA avoidance might prevent bullying involvement and suicidal feelings in adolescents. PMID:27711150

  5. Current physical activity improves balance control during sensory conflicting conditions in older adults.

    Science.gov (United States)

    Buatois, S; Gauchard, G C; Aubry, C; Benetos, A; Perrin, P

    2007-01-01

    Aging process is characterized by difficulties in ensuring balance control, especially in conditions of reduced or conflicting sensory information, leading to an increased risk of falling. Conversely, the practise of physical activities (PA) has been recognized as a good approach to improve the quality of balance control. This study aimed to investigate the influence of current and/or past PA on balance-related neurosensorial organization in older adults on the maintenance of the upright stance, especially during sensory conflicting situations. Postural control was evaluated by means of the Sensory Organization Test on 130 healthy noninstitutionalized volunteers aged over 65, split into four groups according to the presence or absence of PA before or after retirement. Subjects who practised PA for a long time (Gr1) and subjects who started PA after retirement (Gr2) displayed the best postural performances and better managed sensory conflicting situations compared to subjects who had stopped PA for many years (Gr3) and subjects who had never practised PA (Gr4). Multiple regression analyses revealed that current PA was the major determinant for postural parameters during sensorial conflict compared to age, gender, body mass index and past PA. Regular PA, even when started late in life, allows appropriate reorganization of the different components of postural control during sensory conflicting situations. Indeed, active subjects were more able to compensate for suppressed or perturbed sensory information by an increased usage of another referential and so to correct their posture by adopting a more appropriate balance strategy. Thus, PA counteracts the age-related decline of postural control and could consequently reduce the risk of falling.

  6. Transcranial direct current stimulation of the primary motor cortex improves word-retrieval in older adults.

    Science.gov (United States)

    Meinzer, Marcus; Lindenberg, Robert; Sieg, Mira M; Nachtigall, Laura; Ulm, Lena; Flöel, Agnes

    2014-01-01

    Language facilitation by transcranial direct current stimulation (tDCS) in healthy individuals has generated hope that tDCS may also allow improving language impairment after stroke (aphasia). However, current stimulation protocols have yielded variable results and may require identification of residual language cortex using functional magnetic resonance imaging (fMRI), which complicates incorporation into clinical practice. Based on previous behavioral studies that demonstrated improved language processing by motor system pre-activation, the present study assessed whether tDCS administered to the primary motor cortex (M1) can enhance language functions. This proof-of-concept study employed a sham-tDCS controlled, cross-over, within-subject design and assessed the impact of unilateral excitatory (anodal) and bihemispheric (dual) tDCS in 18 healthy older adults during semantic word-retrieval and motor speech tasks. Simultaneous fMRI scrutinized the neural mechanisms underlying tDCS effects. Both active tDCS conditions significantly improved word-retrieval compared to sham-tDCS. The direct comparison of activity elicited by word-retrieval vs. motor-speech trials revealed bilateral frontal activity increases during both anodal- and dual-tDCS compared to sham-tDCS. This effect was driven by more pronounced deactivation of frontal regions during the motor-speech task, while activity during word-retrieval trials was unaffected by the stimulation. No effects were found in M1 and secondary motor regions. Our results show that tDCS administered to M1 can improve word-retrieval in healthy individuals, thereby providing a rationale to explore whether M1-tDCS may offer a novel approach to improve language functions in aphasia. Functional magnetic resonance imaging revealed neural facilitation specifically during motor speech trials, which may have reduced switching costs between the overlapping neural systems for lexical retrieval and speech processing, thereby resulting in

  7. The Association of Current Violence from Adult Family Members with Adolescent Bullying Involvement and Suicidal Feelings.

    Science.gov (United States)

    Fujikawa, Shinya; Ando, Shuntaro; Shimodera, Shinji; Koike, Shinsuke; Usami, Satoshi; Toriyama, Rie; Kanata, Sho; Sasaki, Tsukasa; Kasai, Kiyoto; Okazaki, Yuji; Nishida, Atsushi

    2016-01-01

    Although several studies have reported that child physical abuse increased the risk for bullying involvement, the effect of current violence from adult family members (CVA) on bullying involvement and suicidal feelings among adolescents has not been sufficiently examined. This study investigated the association of CVA with adolescent bullying involvement and the interaction effect of CVA and bullying involvement on suicidal feelings. This cross-sectional study used data from a school-based survey with a general population of adolescents (grades 7 to 12). Data were collected using a self-report questionnaire completed by 17,530 students. Logistic regression analyses were performed to explore the association of CVA with adolescent bullying involvement and suicidal feelings. The overall response rate was 90.2%. The odds of students being characterized as bullies, victims, and bully-victims were higher among adolescents with CVA than without CVA (odds ratios (OR) = 2.9, 95% confidence interval (CI), [2.3-3.7], 4.6 [3.6-5.8], and 5.8 [4.4-7.6], respectively). Both CVA (OR = 3.4 [95% CI 2.7-4.3]) and bullying (bullies, victims, and bully-victims; OR = 2.0 [95% CI 1.6-2.6], 4.0 [3.1-5.1], 4.1 [3.0-5.6], respectively), were associated with increased odds of current suicidal feelings after adjusting for confounding factors. Furthermore, positive additive effects of CVA and all three types of bullying involvement on suicidal feelings were found. For example, bully-victims with CVA had about 19-fold higher odds of suicidal feelings compared with uninvolved adolescents without CVA. This study, although correlational, suggested that CVA avoidance might prevent bullying involvement and suicidal feelings in adolescents.

  8. Standardization of calibration of clinic dosemeters using electric currents and charges

    International Nuclear Information System (INIS)

    Peres, Marcos Antonio de Lima

    1999-09-01

    Clinical dosimeters used in radiotherapy are calibrated in Latin American countries, including Brazil, as a complete 'system, i.e., ionization chamber and electrometer together. Some countries, as European ones, and USA calibrate them by component, i.e., ionisation chamber apart from electrometer. This method is more advantageous than the previous one, since it makes possible the automation of the calibration process, allowing the acquisition of data related to the chamber and the electrometer measurements independently, as well as the substitution of one of the components, in case of failure. This work proposes a method for standardisation of low intensity electric charge and currents in order to implement electric calibration of electrometers. This will make possible the implementation of a by components calibration technique, by components, of clinical dosimeters in Brazil. The results obtained with the calibration by components prove that the proposed method of standardisation of low electric charges and currents is viable. The difficulties found for the generation and measurement of low intensity electric charges and currents and the procedures adopted for the calibration by components are presented. Additionally, a current source was built to yield reference electric charges that will make possible the quality control clinical dosimeters. This source will also allow the user to identify the defective components of the dosimeters, through a simple verification test. (author)

  9. The current status of prophylactic replacement therapy in children and adults with haemophilia.

    Science.gov (United States)

    Ljung, Rolf; Gretenkort Andersson, Nadine

    2015-06-01

    Initiating prophylactic treatment at an early age is considered to be the optimal form of therapy for a child with haemophilia A or B. The pioneering long term experiences of prophylactic treatment from Sweden and The Netherlands demonstrated the benefit of prophylaxis in retrospective and observational studies. Decades later, these benefits were confirmed in a randomized controlled study in USA. We review the current status of prophylactic replacement therapy of haemophilia in children, adolescents, adults and the elderly. Prophylaxis should begin at an early age and there are arguments for continuing it into adulthood. The dose of prophylaxis is dependent on the goal of treatment, economic resources and venous access and should be tailored individually. Starting the first exposures to clotting factor concentrates as prophylactic treatment, instead of on-demand in response to a bleed, may decrease the frequency of inhibitors in patients with haemophilia A. Novel longer-acting products are being introduced that could be helpful for patients with difficult venous access and enable higher trough levels. © 2015 John Wiley & Sons Ltd.

  10. Labeling programs and efficiency standards to control the energy consumption of household appliances: current situation, main results and recommendations

    Energy Technology Data Exchange (ETDEWEB)

    Menanteau, Ph.

    2000-09-01

    To control the rise in electricity consumption for specific uses, the industrialized countries started by introducing special programs aimed at improving energy efficiency. Among the different instruments available, labeling programs and minimum energy performance standards (MEPS) have proved to be very effective. The first part of this document presents the current situation, the main results and recommendations concerning the labeling programs and efficiency standards to control the energy consumption of household appliances. This analyze is done for each country in details providing the name of the program or measure, the date of implementation, the objective and the main characteristics of the program, the impacts and evaluation. (A.L.B.)

  11. Including alternative resources in state renewable portfolio standards: Current design and implementation experience

    International Nuclear Information System (INIS)

    Heeter, Jenny; Bird, Lori

    2013-01-01

    As of October 2012, 29 states, the District of Columbia, and Puerto Rico have instituted a renewable portfolio standard (RPS). Each state policy is unique, varying in percentage targets, timetables, and eligible resources. Increasingly, new RPS polices have included alternative resources. Alternative resources have included energy efficiency, thermal resources, and, to a lesser extent, non-renewables. This paper examines state experience with implementing renewable portfolio standards that include energy efficiency, thermal resources, and non-renewable energy and explores compliance experience, costs, and how states evaluate, measure, and verify energy efficiency and convert thermal energy. It aims to gain insights from the experience of states for possible federal clean energy policy as well as to share experience and lessons for state RPS implementation. - Highlights: • Increasingly, new RPS policies have included alternative resources. • Nearly all states provide a separate tier or cap on the quantity of eligible alternative resources. • Where allowed, non-renewables and energy efficiency are being heavily utilized

  12. The Social and Consumer Standards and Guarantees in Ukraine: the Current Structural and Dynamic Characteristics

    Directory of Open Access Journals (Sweden)

    Kolesov Oleksandr S.

    2017-04-01

    Full Text Available The article attempts to generalize the theoretical approaches to the social guarantees and standards as economic categories. The classification of social guarantees is provided. The dynamic parameters for development of the social and consumer standards adopted in Ukraine were considered. An evaluation of the real poverty level under the system of criteria was carried out. The inconsistency of methods for the poverty evaluation adopted by the Ministry of Social Policy of Ukraine and contradiction of its individual indicators has been indicated. The structural characteristics of the population’s income have been determined. The relevance of the existing social guarantees to their real value in today’s economic conditions have been analyzed. Tendencies of falling of the welfare level of population, resulting in a decline in the consumer demand and a narrowing of the domestic market for goods and services, have been identified. The need to take measures to stimulate small businesses, to overcome corruption, and to deregulate the economy has been indicated.

  13. Effects of ionizing radiation on plants and animals at levels implied by current radiation protection standards

    International Nuclear Information System (INIS)

    1992-01-01

    The 1977 Recommendations of the International Commission on Radiological Protection stated that the commission believes that if man is adequately protected from radiation, other organisms are also likely to be sufficiently protected. The present report examines this statement by considering the effects of ionizing radiation on animals and plants in both terrestrial and aquatic ecosystems. The conclusions are that chronic dose rates of IMGy.d -1 or less are unlikely to cause measurable deleterious effects in terrestrial populations, and that in the aquatic environment limiting chronic dose rates to 10MGy.d -1 to the maximally exposed individuals would provide adequate protection for the population. Thus specific radiation protection standards for non-human organisms are not needed. 193 refs, 2 figs, 7 tabs

  14. Current medical treatment of lower urinary tract symptoms/BPH: do we have a standard?

    Science.gov (United States)

    Silva, João; Silva, Carlos Martins; Cruz, Francisco

    2014-01-01

    The pharmacological treatment of lower urinary tract symptoms (LUTS) in patients with benign prostatic hyperplasia (BPH) is based on alpha-blockers and 5α-reductase inhibitors isolated or in combination. Silodosin, an alpha-1A specific alpha-blocker is the only innovation in these groups of agents. This classical paradigm is being challenged by antimuscarinics, 5-phosphodiesterase inhibitors (PDE5i) and β3-adrenoreceptor agonists. Silodosin is effective in reducing BPH/LUTS, including nocturia and shows little cardiovascular adverse events. Antimuscarinic drugs isolated or in combination with alpha-blockers improve storage symptoms without any harmful effect to the voiding function. PDE5i alone improve BPH/LUTS. Combination of PDE5i with alpha-blockers provides better symptomatic control than alpha-blockers alone. A recent head-to-head comparison of tadalafil 5 mg/day with tamsulosin 0.4 mg/day showed that these agents provided the same improvement in BPH/LUTS and, surprisingly, the same improvement in the urinary flow. In fact, previous studies with tadalafil had not shown any effect of tadalafil on flow. In addition, tadalafil but not tamsulosin improved sexual function. Mirabegron, the first β3-adrenoreceptor agonist, while improving BPH/LUTS in men with bladder outlet obstruction, do not decrease urinary flow or detrusor pressure. The standard medical treatment for BPH/LUTS is still based on alpha-blockers, 5ARIs or its combination. In the future, it is expected that BPH/LUTS treatment will become individualized, according to the type of symptoms, presence of sexual dysfunction and risk of BPH progression. This will challenge our concept of standard treatment for BPH/LUTS.

  15. Online purchases of an expanded range of condom sizes in comparison to current dimensional requirements allowable by US national standards.

    Science.gov (United States)

    Cecil, Michael; Warner, Lee; Siegler, Aaron J

    2013-11-01

    Across studies, 35-50% of men describe condoms as fitting poorly. Rates of condom use may be inhibited in part due to the inaccessibility of appropriately sized condoms. As regulated medical devices, condom sizes conform to national standards such as those developed by the American Society for Testing and Materials (ASTM) or international standards such as those developed by the International Organisation for Standardisation (ISO). We describe the initial online sales experience of an expanded range of condom sizes and assess uptake in relation to the current required standard dimensions of condoms. Data regarding the initial 1000 sales of an expanded range of condom sizes in the United Kingdom were collected from late 2011 through to early 2012. Ninety-five condom sizes, comprising 14 lengths (83-238mm) and 12 widths (41-69mm), were available. For the first 1000 condom six-pack units that were sold, a total of 83 of the 95 unique sizes were purchased, including all 14 lengths and 12 widths, and both the smallest and largest condoms. Initial condom purchases were made by 572 individuals from 26 countries. Only 13.4% of consumer sales were in the ASTM's allowable range of sizes. These initial sales data suggest consumer interest in an expanded choice of condom sizes that fall outside the range currently allowable by national and international standards organisations.

  16. International pressure vessels and piping codes and standards. Volume 2: Current perspectives; PVP-Volume 313-2

    International Nuclear Information System (INIS)

    Rao, K.R.; Asada, Yasuhide; Adams, T.M.

    1995-01-01

    The topics in this volume include: (1) Recent or imminent changes to Section 3 design sections; (2) Select perspectives of ASME Codes -- Section 3; (3) Select perspectives of Boiler and Pressure Vessel Codes -- an international outlook; (4) Select perspectives of Boiler and Pressure Vessel Codes -- ASME Code Sections 3, 8 and 11; (5) Codes and Standards Perspectives for Analysis; (6) Selected design perspectives on flow-accelerated corrosion and pressure vessel design and qualification; (7) Select Codes and Standards perspectives for design and operability; (8) Codes and Standards perspectives for operability; (9) What's new in the ASME Boiler and Pressure Vessel Code?; (10) A look at ongoing activities of ASME Sections 2 and 3; (11) A look at current activities of ASME Section 11; (12) A look at current activities of ASME Codes and Standards; (13) Simplified design methodology and design allowable stresses -- 1 and 2; (14) Introduction to Power Boilers, Section 1 of the ASME Code -- Part 1 and 2. Separate abstracts were prepared for most of the individual papers

  17. Imaging in syndrome complex diabetes mellitus. Current standards and future perspectives

    International Nuclear Information System (INIS)

    Hetterich, H.; Schafnitzel, A.; Bamberg, F.

    2015-01-01

    Diabetes mellitus is a highly prevalent multisystemic disorder with numerous potential complications and substantial socioeconomic consequences. In many cases, the patient history, physical examination and laboratory tests are not sufficient for a comprehensive evaluation of complicating disorders. Imaging modalities, such as sonography, computed tomography (CT) and magnetic resonance imaging (MRI) are of major significance in the evaluation of complicating disorders of diabetes according to current guidelines. Examples include assessment of coronary artery disease, peripheral artery disease, stroke and diabetic foot syndrome. Technical developments allow a substantial reduction in radiation dose and scan time in CT and MRI, respectively and could therefore justify a broader application in this patient population. In the future CT and MRI could also be used for the early detection of diabetic complications. Furthermore, they could also be used for risk stratification, e.g. measurement of hepatic fat content and evaluation of atherosclerosis in whole body MRI. Prior to widespread application of advanced imaging techniques in this patient population, improved outcomes with respect to survival, quality of life and cost-effectiveness need to be demonstrated. Diagnostic imaging modalities for the evaluation of the syndrome complex of diabetic disorders should be used according to the current guidelines but the use is predicted to increase given the high potential in this population. (orig.) [de

  18. Sexuality Education and Implications for Quality of Care for Individuals with Adult Onset Disability: A Review of Current Literature

    Science.gov (United States)

    Eglseder, Kate; Webb, Sheridan

    2017-01-01

    Purpose: To investigate the need for sexuality education for individuals with adult onset physical disabilities as it relates to quality of life and to identify current trends in the provision of sexuality education by health care providers relating to quality of care. Data Sources: Literature review from January 1986 to December 2016. Study…

  19. Current practices related to family presence during acute deterioration in adult emergency department patients.

    Science.gov (United States)

    Youngson, Megan J; Currey, Judy; Considine, Julie

    2017-11-01

    To explore the characteristics of and interactions between clinicians, patients and family members during management of the deteriorating adult patient in the emergency department. Previous research into family presence during resuscitation has identified many positive outcomes when families are included. However, over the last three decades the epidemiology of acute clinical deterioration has changed, with a decrease in in-hospital cardiac arrests and an increase in acute clinical deterioration. Despite the decrease in cardiac arrests, research related to family presence continues to focus on care during resuscitation rather than care during acute deterioration. Descriptive exploratory study using nonparticipatory observation. Five clinical deterioration episodes were observed within a 50-bed, urban, Australian emergency department. Field notes were taken using a semistructured tool to allow for thematic analysis. Presence, roles and engagement describe the interactions between clinicians, family members and patients while family are present during a patient's episode of deterioration. Presence was classified as no presence, physical presence and therapeutic presence. Clinicians and family members moved through primary, secondary and tertiary roles during patients' deterioration episode. Engagement was observed to be superficial or deep. There was a complex interplay between presence, roles and engagement with each influencing which form the other could take. Current practices of managing family during episodes of acute deterioration are complex and multifaceted. There is fluid interplay between presence, roles and engagement during a patient's episode of deterioration. This study will contribute to best practice, provide a strong foundation for clinician education and present opportunities for future research. © 2017 John Wiley & Sons Ltd.

  20. Composite Reliability and Standard Errors of Measurement for a Seven-Subtest Short Form of the Wechsler Adult Intelligence Scale-Revised.

    Science.gov (United States)

    Schretlen, David; And Others

    1994-01-01

    Composite reliability and standard errors of measurement were computed for prorated Verbal, Performance, and Full-Scale intelligence quotient (IQ) scores from a seven-subtest short form of the Wechsler Adult Intelligence Scale-Revised. Results with 1,880 adults (standardization sample) indicate that this form is as reliable as the complete test.…

  1. Wireless networking for the dental office: current wireless standards and security protocols.

    Science.gov (United States)

    Mupparapu, Muralidhar; Arora, Sarika

    2004-11-15

    Digital radiography has gained immense popularity in dentistry today in spite of the early difficulty for the profession to embrace the technology. The transition from film to digital has been happening at a faster pace in the fields of Orthodontics, Oral Surgery, Endodontics, Periodontics, and other specialties where the radiographic images (periapical, bitewing, panoramic, cephalometric, and skull radiographs) are being acquired digitally, stored within a server locally, and eventually accessed for diagnostic purposes, along with the rest of the patient data via the patient management software (PMS). A review of the literature shows the diagnostic performance of digital radiography is at least comparable to or even better than that of conventional radiography. Similarly, other digital diagnostic tools like caries detectors, cephalometric analysis software, and digital scanners were used for many years for the diagnosis and treatment planning purposes. The introduction of wireless charged-coupled device (CCD) sensors in early 2004 (Schick Technologies, Long Island City, NY) has moved digital radiography a step further into the wireless era. As with any emerging technology, there are concerns that should be looked into before adapting to the wireless environment. Foremost is the network security involved in the installation and usage of these wireless networks. This article deals with the existing standards and choices in wireless technologies that are available for implementation within a contemporary dental office. The network security protocols that protect the patient data and boost the efficiency of modern day dental clinics are enumerated.

  2. Limiting the costs of renewable portfolio standards: A review and critique of current methods

    International Nuclear Information System (INIS)

    Stockmayer, Gabriella; Finch, Vanessa; Komor, Paul; Mignogna, Rich

    2012-01-01

    Over half of U.S. states have renewable portfolio standards (RPSs) mandating that a minimum percentage of electricity sold derives from renewable sources. State RPSs vary widely in how they attempt to control or limit the costs of these RPSs. Approaches utilized include alternative compliance payments, direct rate caps, and cost caps on resource acquisitions, while some states employ no specific limitation at all. This paper describes how states attempt to control RPS costs and discusses the strengths and weaknesses of these various cost controls. There is no one best method; however the experience to date suggests that the most important factors in implementing an effective mechanism to curtail costs are clarity of the rule, consistency in application, and transparency for customers. - Highlights: ▶ We review states' RPS statutes and regulations for mechanisms that attempt to control overall compliance costs. ▶ We categorize the major cost curtailment mechanisms. ▶ For each mechanism, we describe policy designs that are or could be implemented by states. ▶ We identify strengths and weaknesses of the various designs for consideration by policymakers.

  3. Chest Fat Quantification via CT Based on Standardized Anatomy Space in Adult Lung Transplant Candidates.

    Directory of Open Access Journals (Sweden)

    Yubing Tong

    Full Text Available Overweight and underweight conditions are considered relative contraindications to lung transplantation due to their association with excess mortality. Yet, recent work suggests that body mass index (BMI does not accurately reflect adipose tissue mass in adults with advanced lung diseases. Alternative and more accurate measures of adiposity are needed. Chest fat estimation by routine computed tomography (CT imaging may therefore be important for identifying high-risk lung transplant candidates. In this paper, an approach to chest fat quantification and quality assessment based on a recently formulated concept of standardized anatomic space (SAS is presented. The goal of the paper is to seek answers to several key questions related to chest fat quantity and quality assessment based on a single slice CT (whether in the chest, abdomen, or thigh versus a volumetric CT, which have not been addressed in the literature.Unenhanced chest CT image data sets from 40 adult lung transplant candidates (age 58 ± 12 yrs and BMI 26.4 ± 4.3 kg/m2, 16 with chronic obstructive pulmonary disease (COPD, 16 with idiopathic pulmonary fibrosis (IPF, and the remainder with other conditions were analyzed together with a single slice acquired for each patient at the L5 vertebral level and mid-thigh level. The thoracic body region and the interface between subcutaneous adipose tissue (SAT and visceral adipose tissue (VAT in the chest were consistently defined in all patients and delineated using Live Wire tools. The SAT and VAT components of chest were then segmented guided by this interface. The SAS approach was used to identify the corresponding anatomic slices in each chest CT study, and SAT and VAT areas in each slice as well as their whole volumes were quantified. Similarly, the SAT and VAT components were segmented in the abdomen and thigh slices. Key parameters of the attenuation (Hounsfield unit (HU distributions were determined from each chest slice and from the

  4. Radiotherapy in the management of non-metastatic prostate cancer: Current standards and future opportunities

    International Nuclear Information System (INIS)

    Forman, Jeffrey D.

    1997-01-01

    Objectives: The intent of this course is to review issues involved in the management of non-metastatic prostate cancer and to clarify the role of external beam radiotherapy, the use of neo-adjuvant and adjuvant hormonal therapy in conjunction with the radiation, the management of patients with regional metastases and recurrent disease following surgery and radiation. At the end of this course, participants should be able to fluently discuss management issues and strategies across the entire spectrum of non-metastatic prostate cancer. - Pre-treatment prognostic factors including clinical stage, grade, and pre-treatment PSA, will be presented and their relative value in determining therapeutic strategies will be discussed. Strategies to be discussed include standard dose radiation, escalated dose radiation, particle radiation and the use of adjuvant and neo-adjuvant hormonal therapy. - The process of simulation and field design will be presented, the value of CT-based treatment planning, beams-eye view design and the relative value of three-dimensional treatment planning will be discussed. - The significance of prostate and patient movement and strategies for dealing with this will also be presented so that what constitutes an adequate simulation and margin of treatment can be clarified. - The management of newly diagnosed patients, covering the range of low stage/low grade to locally advanced prostate cancer will be discussed. - The relative value of increasing dose, the relative value of using neo-adjuvant and/or adjuvant hormone therapy and the indications for escalated dose will be presented. - Strategies for managing post-prostatectomy patients will be reviewed. Data on adjuvant and therapeutic irradiation for biochemical failure will be presented and a strategy for management will be discussed. - How to deal with patients with residual disease post radiation will be discussed and the relative value of cryotherapy, salvage prostatectomy or hormonal therapy will

  5. Association between current asthma and secondhand smoke exposure in vehicles among adults living in four US states.

    Science.gov (United States)

    Nguyen, Kimberly H; King, Brian A; Dube, Shanta R

    2015-07-01

    Many states have implemented laws prohibiting tobacco smoking in indoor public places. However, private settings remain a major source of secondhand smoke (SHS) exposure for many people. We assessed the association between current asthma and SHS exposure in vehicles among adult never-smokers in Indiana, Kentucky, Louisiana and Mississippi. Data came from the 2011 Behavioral Risk Factor Surveillance System, a state-based telephone survey of US adults aged ≥18 years. Analyses were restricted to states (n=4) that administered an optional SHS module. Prevalence of self-reported asthma and past 7-day SHS exposure in vehicles was calculated by demographics, voluntary smoke-free vehicle rules and SHS exposure in homes, public places and workplaces. Logistic regression was used to assess the adjusted association between asthma and SHS exposure in vehicles. Among 17 863 never-smoking adults, 7.4% reported having current asthma, whereas 12.3% reported past 7-day SHS exposure in vehicles. Among adults with asthma, SHS exposure in vehicles was lower among those with voluntary smoke-free rules compared with those without voluntary smoke-free rules (9.5% vs 56.7%, psmoke-free rules in vehicles, especially among adults with asthma. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  6. Proposal on ''standardized high current solid targets for cyclotron production of diagnostic and therapeutic radionuclides''

    International Nuclear Information System (INIS)

    Suparman, Ibon

    2000-01-01

    The Center for the Development of Radioisotopes and Radiopharmaceuticals - National Nuclear Energy Agency (P2RR-BATAN) has one Cyclotron type CS-30 with maximum 30 MeV proton energy. It is used since 1990 for 201 Tl production. The main use of 201 Tl in Indonesia is for diagnosis and assessment of myocardial ischaemia, especially diagnosis of coronary artery disease, viability of the heart muscle and forecasting the outcome for patients with coronary disease. The Cyclotron facility is supported with a solid target station, two hot cells and the chemical equipment for electroplating. The yield of 201 Tl production currently achieved around 40-50%. The irradiation technique and chemical separation should be improved. We are also very interested in the development of the production of 103 Pd via 103 Rh (p,n) 103 Pd reaction. The objective of this proposal will support the main program of the National Nuclear Energy Agency (BATAN) in enhancement of health care and in providing Cyclotron produced radiopharmaceuticals for hospitals

  7. Treatment Options for Paediatric Anaplastic Large Cell Lymphoma (ALCL: Current Standard and beyond

    Directory of Open Access Journals (Sweden)

    Nina Prokoph

    2018-03-01

    Full Text Available Anaplastic Lymphoma Kinase (ALK-positive Anaplastic Large Cell Lymphoma (ALCL, remains one of the most curable cancers in the paediatric setting; multi-agent chemotherapy cures approximately 65–90% of patients. Over the last two decades, major efforts have focused on improving the survival rate by intensification of combination chemotherapy regimens and employing stem cell transplantation for chemotherapy-resistant patients. More recently, several new and ‘renewed’ agents have offered the opportunity for a change in the paradigm for the management of both chemo-sensitive and chemo-resistant forms of ALCL. The development of ALK inhibitors following the identification of the EML4-ALK fusion gene in Non-Small Cell Lung Cancer (NSCLC has opened new possibilities for ALK-positive ALCL. The uniform expression of CD30 on the cell surface of ALCL has given the opportunity for anti-CD30 antibody therapy. The re-evaluation of vinblastine, which has shown remarkable activity as a single agent even in the face of relapsed disease, has led to the consideration of a revised approach to frontline therapy. The advent of immune therapies such as checkpoint inhibition has provided another option for the treatment of ALCL. In fact, the number of potential new agents now presents a real challenge to the clinical community that must prioritise those thought to offer the most promise for the future. In this review, we will focus on the current status of paediatric ALCL therapy, explore how new and ‘renewed’ agents are re-shaping the therapeutic landscape for ALCL, and identify the strategies being employed in the next generation of clinical trials.

  8. Future directions for ICT in aphasia therapy for older adults: enhancing current practices through interdisciplinary perspectives

    OpenAIRE

    Kötteritzsch, Anna; Gerling, Kathrin

    2015-01-01

    Growing numbers of older adults requiring aphasia therapy create challenges for the health care system. Information and communication technology (ICT) has the potential to provide computer-mediated, self-administered aphasia therapy that complements conventional therapy. We explore overlaps in ICT for older adults and aphasia therapy applications with the goal of integrating innovative ICT in aphasia therapy. Based on a case study, we explain how results of different disciplines developing IC...

  9. Quantification of the islet product: presentation of a standardized current good manufacturing practices compliant system with minimal variability.

    Science.gov (United States)

    Friberg, Andrew S; Brandhorst, Heide; Buchwald, Peter; Goto, Masafumi; Ricordi, Camillo; Brandhorst, Daniel; Korsgren, Olle

    2011-03-27

    Accurate islet quantification has proven difficult to standardize in a good manufacturing practices (GMP) approved manner. The influence of assessment variables from both manual and computer-assisted digital image analysis (DIA) methods were compared using calibrated, standardized microspheres or islets alone. Additionally, a mixture of microspheres and exocrine tissue was used to evaluate the variability of both the current, internationally recognized, manual method and a novel GMP-friendly purity- and volume-based method (PV) evaluated by DIA in a semiclosed, culture bag system. Computer-assisted DIA recorded known microsphere size distribution and quantities accurately. By using DIA to evaluate islets, the interindividual manually evaluated percent coefficients of variation (CV%; n=14) were reduced by almost half for both islet equivalents (IEs; 31% vs. 17%, P=0.002) and purity (20% vs. 13%, P=0.033). The microsphere pool mixed with exocrine tissue did not differ from expected IE with either method. However, manual IE resulted in a total CV% of 44.3% and a range spanning 258 k IE, whereas PV resulted in CV% of 10.7% and range of 60 k IE. Purity CV% for each method were similar approximating 10.5% and differed from expected by +7% for the manual method and +3% for PV. The variability of standard counting methods for islet samples and clinical quantities of microspheres mixed with exocrine tissue were reduced with DIA. They were reduced even further by use of a semiclosed bag system compared with standard manual counting, thereby facilitating the standardization of islet evaluation according to GMP standards.

  10. Current perspectives on Internet delivered cognitive behavioral therapy for adults with anxiety and related disorders

    Directory of Open Access Journals (Sweden)

    Mewton L

    2014-01-01

    Full Text Available Louise Mewton, Jessica Smith, Pieter Rossouw, Gavin Andrews Clinical Research Unit for Anxiety and Depression, St Vincent’s Hospital, Sydney, NSW, Australia Abstract: The aim of the current review is to provide a summary of research into Internet-delivered cognitive behavioral therapy (iCBT for anxiety disorders. We include 37 randomized controlled trials that examined the efficacy of iCBT programs in adults (aged over 18 years, as compared with waiting list or active control. The included studies were identified from Medline searches and from reference lists, and only published data were included. Several trials of iCBT for generalized anxiety disorder, panic disorder, and social phobia were identified. Two trials of iCBT for obsessive-compulsive disorder were identified, whilst one trial each was identified for hypochondriasis, specific phobia (spiders, and post-traumatic stress disorder. Finally, there were five trials that focused on transdiagnostic therapy for either a range of comorbid anxiety disorders or comorbid anxiety and depression. Between-group effect sizes were moderate to large for all disorders, and ranged from 0.30 to 2.53. iCBT was found to be commensurate with face-to-face cognitive behavioral therapy whether delivered individually or in group format. Guidance may not be necessary for iCBT to be effective for immediate gains, but may be more important in longer-term maintenance of symptom improvement and maximizing patient adherence. The clinical experience of the individual providing guidance does not appear to impact treatment outcomes. Future research needs to focus on the optimal level of guidance required to generate maximum patient benefits, whilst balancing the efficient use of clinician time and resources. Evidence-based contraindications to iCBT should also be developed so that the choice of treatment modality accurately reflects patients’ needs. Further research should be conducted into the effective elements of

  11. A Summary of Proposed Changes to the Current ICARTT Format Standards and their Implications to Future Airborne Studies

    Science.gov (United States)

    Northup, E. A.; Kusterer, J.; Quam, B.; Chen, G.; Early, A. B.; Beach, A. L., III

    2015-12-01

    The current ICARTT file format standards were developed for the purpose of fulfilling the data management needs for the International Consortium for Atmospheric Research on Transport and Transformation (ICARTT) campaign in 2004. The goal of the ICARTT file format was to establish a common and simple to use data file format to promote data exchange and collaboration among science teams with similar science objectives. ICARTT has been the NASA standard since 2010, and is widely used by NOAA, NSF, and international partners (DLR, FAAM). Despite its level of acceptance, there are a number of issues with the current ICARTT format, especially concerning the machine readability. To enhance usability, the ICARTT Refresh Earth Science Data Systems Working Group (ESDSWG) was established to enable a platform for atmospheric science data producers, users (e.g. modelers) and data managers to collaborate on developing criteria for this file format. Ultimately, this is a cross agency effort to improve and aggregate the metadata records being produced. After conducting a survey to identify deficiencies in the current format, we determined which are considered most important to the various communities. Numerous recommendations were made to improve upon the file format while maintaining backward compatibility. The recommendations made to date and their advantages and limitations will be discussed.

  12. Assessment and monitoring of treatment response in adult ADHD patients: current perspectives

    Directory of Open Access Journals (Sweden)

    Ramsay JR

    2017-01-01

    Full Text Available J Russell Ramsay Adult ADHD Treatment & Research Program, Perelman School of Medicine, University of Pennsylvania Philadelphia, PA, USA Abstract: Attention-deficit/hyperactivity disorder (ADHD is a neurodevelopmental syndrome that emerges in childhood or early adolescence and persists into adulthood for a majority of individuals. There are many other adults with ADHD who may not seek out evaluation and treatment until adulthood, having been able to “get by” before struggling with inattention, hyperactivity, and/or impulsivity in adulthood, in addition to facing the associated features of disorganization, poor time management, and procrastination among many others. A lifetime diagnosis of ADHD is associated with a wide range of life impairments, which makes a comprehensive and accurate diagnostic assessment essential in order to obtain appropriate treatment. Moreover, while there are effective medical and psychosocial treatments for ADHD, it is important to be able to track treatment response in order to evaluate whether adjustments in specific interventions are needed or referrals for adjunctive treatments and supports are indicated to facilitate optimal therapeutic outcomes. The goal of this article is to provide a clinically useful review of the various measures that practicing clinicians can use to aid in the diagnostic assessment and monitoring of psychosocial and medical treatment of ADHD in adult patients. This review includes various structured interviews, screening scales, adult ADHD symptom inventories, measures of associated features of ADHD, as well as ratings of impairment and functioning which can be adapted to clinicians’ practice needs in order to track treatment progress and optimize treatments for adults with ADHD. Keywords: adult attention-deficit/hyperactivity disorder, adult ADHD, pharmacotherapy, psychosocial treatment, symptoms, functional impairments, executive functions

  13. Evaluation of current operating standards for chlorine dioxide in disinfection of dump tank and flume for fresh tomatoes.

    Science.gov (United States)

    Tomás-Callejas, Alejandro; López-Velasco, Gabriela; Valadez, Angela M; Sbodio, Adrian; Artés-Hernández, Francisco; Danyluk, Michelle D; Suslow, Trevor V

    2012-02-01

    Standard postharvest unit operations that rely on copious water contact, such as fruit unloading and washing, approach the criteria for a true critical control point in fresh tomato production. Performance data for approved sanitizers that reflect commercial systems are needed to set standards for audit compliance. This study was conducted to evaluate the efficacy of chlorine dioxide (ClO(2)) for water disinfection as an objective assessment of recent industry-adopted standards for dump tank and flume management in fresh tomato packing operations. On-site assessments were conducted during eight temporally distinct shifts in two Florida packinghouses and one California packinghouse. Microbiological analyses of incoming and washed fruit and dump and flume system water were evaluated. Water temperature, pH, turbidity, conductivity, and oxidation-reduction potential (ORP) were monitored. Reduction in populations of mesophilic and coliform bacteria on fruit was not significant, and populations were significantly higher (P Turbidity and conductivity increased with loads of incoming tomatoes. Water temperature varied during daily operations, but pH and ORP mostly remained constant. The industry standard positive temperature differential of 5.5°C between water and fruit pulp was not maintained in tanks during the full daily operation. ORP values were significantly higher in the flume than in the dump tank. A positive correlation was found between ORP and temperature, and negative correlations were found between ORP and turbidity, total mesophilic bacteria, and coliforms. This study provides in-plant data indicating that ClO(2) can be an effective sanitizer in flume and spray-wash systems, but current operational limitations restrict its performance in dump tanks. Under current conditions, ClO(2) alone is unlikely to allow the fresh tomato industry to meet its microbiological quality goals under typical commercial conditions.

  14. The Stressors and Coping Strategies of Older Adults With Persistent Atrial Fibrillation Prior to and Following Direct Current Cardioversion.

    Science.gov (United States)

    Rush, Kathy L; Hatt, Linda; Shay, Matt; Gorman, Nicole; Laberge, Carol G; Reid, R Colin; Wilson, Ryan

    2017-09-01

    The purpose of this study was to explore the stressors and coping strategies of older adults with persistent atrial fibrillation (AF) before and after direct current cardioversion. The study used a qualitative descriptive design. Sixteen patients were recruited through an AF clinic to participate in individual interviews prior to the cardioversion and at 6 and 12 weeks post procedure. Pre-cardioversion, older adults experienced symptom and health care-related stressors superimposed on existing non-AF stressors. They used a range of emotion and problem-focused coping. Non-AF stressors increased post procedure at the same time that participants perceived less need for coping strategies with a return to regular rhythm. There was a shift from AF to non-AF related stressors following the cardioversion but a decrease in coping strategies. Older adults with AF should be encouraged to maintain use of coping strategies to manage ongoing stress and reduce the risk of AF recurrence.

  15. Pituitary adenylate cyclase activating polypeptide reduces A-type K+ currents and caspase activity in cultured adult mouse olfactory neurons.

    Science.gov (United States)

    Han, P; Lucero, M T

    2005-01-01

    Pituitary adenylate cyclase activating polypeptide has been shown to reduce apoptosis in neonatal cerebellar and olfactory receptor neurons, however the underlying mechanisms have not been elucidated. In addition, the neuroprotective effects of pituitary adenylate cyclase activating polypeptide have not been examined in adult tissues. To study the effects of pituitary adenylate cyclase activating polypeptide on neurons in apoptosis, we measured caspase activation in adult olfactory receptor neurons in vitro. Interestingly, we found that the protective effects of pituitary adenylate cyclase activating polypeptide were related to the absence of a 4-aminopyridine (IC50=144 microM) sensitive rapidly inactivating potassium current often referred to as A-type current. In the presence of 40 nM pituitary adenylate cyclase activating polypeptide 38, both A-type current and activated caspases were significantly reduced. A-type current reduction by pituitary adenylate cyclase activating polypeptide was blocked by inhibiting the phospholipase C pathway, but not the adenylyl cyclase pathway. Our observation that 5 mM 4-aminopyridine mimicked the caspase inhibiting effects of pituitary adenylate cyclase activating polypeptide indicates that A-type current is involved in apoptosis. This work contributes to our growing understanding that potassium currents are involved with the activation of caspases to affect the balance between cell life and death.

  16. Effects of transcranial direct current stimulation on the control of finger force during dexterous manipulation in healthy older adults.

    Directory of Open Access Journals (Sweden)

    Pranav J Parikh

    Full Text Available The contribution of poor finger force control to age-related decline in manual dexterity is above and beyond ubiquitous behavioral slowing. Altered control of the finger forces can impart unwanted torque on the object affecting its orientation, thus impairing manual performance. Anodal transcranial direct current stimulation (tDCS over primary motor cortex (M1 has been shown to improve the performance speed on manual tasks in older adults. However, the effects of anodal tDCS over M1 on the finger force control during object manipulation in older adults remain to be fully explored. Here we determined the effects of anodal tDCS over M1 on the control of grip force in older adults while they manipulated an object with an uncertain mechanical property. Eight healthy older adults were instructed to grip and lift an object whose contact surfaces were unexpectedly made more or less slippery across trials using acetate and sandpaper surfaces, respectively. Subjects performed this task before and after receiving anodal or sham tDCS over M1 on two separate sessions using a cross-over design. We found that older adults used significantly lower grip force following anodal tDCS compared to sham tDCS. Friction measured at the finger-object interface remained invariant after anodal and sham tDCS. These findings suggest that anodal tDCS over M1 improved the control of grip force during object manipulation in healthy older adults. Although the cortical networks for representing objects and manipulative actions are complex, the reduction in grip force following anodal tDCS over M1 might be due to a cortical excitation yielding improved processing of object-specific sensory information and its integration with the motor commands for production of manipulative forces. Our findings indicate that tDCS has a potential to improve the control of finger force during dexterous manipulation in older adults.

  17. Age standardization in mapping adult overweight and obesity trends in the WHO European Region

    NARCIS (Netherlands)

    Doak, C M; Wijnhoven, T.M.A.; Schokker, D F; Visscher, T L S; Seidell, J C

    2012-01-01

    This study aims to improve comparability of available data within the World Health Organization (WHO) European Region taking into account differences related to the aging of the population. Surveys were included if they were conducted on adults aged 25-64 years between 1985 and 2010 in the WHO

  18. Standard methods for maintaining adult Apis mellifera in cages under in vitro laboratory conditions

    NARCIS (Netherlands)

    Williams, G.R.; Alaux, C.; Costa, C.; Csaki, C.; Steen, van der J.J.M.

    2013-01-01

    Adult honey bees are maintained in vitro in laboratory cages for a variety of purposes. For example, researchers may wish to perform experiments on honey bees caged individually or in groups to study aspects of parasitology, toxicology, or physiology under highly controlled conditions, or they may

  19. Standardized multidisciplinary evaluation yields significant previously undiagnosed morbidity in adult women with Turner syndrome

    NARCIS (Netherlands)

    Freriks, K.; Timmermans, J.; Beerendonk, C.C.M.; Verhaak, C.M.; Netea-Maier, R.T.; Otten, B.J.; Braat, D.D.M.; Smeets, D.F.C.M.; Kunst, D.; Hermus, A.R.M.M.; Timmers, H.J.L.M.

    2011-01-01

    CONTEXT: Besides short stature and gonadal dysgenesis, Turner syndrome (TS) is associated with various abnormalities. Adults with TS have a reduced life expectancy, mainly related to structural abnormalities of the heart and aorta, and an increased risk of atherosclerosis. OBJECTIVE: Our objective

  20. Mobile health in adults with congenital heart disease: Current use and future needs

    NARCIS (Netherlands)

    Schuuring, M.J.; A. Backx (Ad); Zwart, R.; Veelenturf, A.H.; D. Robbers-Visser (Daniëlle); M. Groenink (Maarten); A. Abu-Hanna (Ameen); N. Bruining (Nico); M.P. Schijven; B.J.M. Mulder (Barbara); B.J. Bouma (Berto)

    2016-01-01

    textabstractObjective Many adults with congenital heart disease (CHD) are affected lifelong by cardiac events, particularly arrhythmias and heart failure. Despite the care provided, the cardiac event rate remains high. Mobile health (mHealth) brings opportunities to enhance daily monitoring and

  1. Current issues around the pharmacotherapy of ADHD in children and adults

    NARCIS (Netherlands)

    Meijer, W.M.; Faber, A.; Ban, van den E.; Tobi, H.

    2009-01-01

    Background New drugs and new formulations enter the growing market for ADHD medication. The growing awareness of possible persistence of ADHD impairment beyond childhood and adolescence resulting in increased pharmacotherapy of ADHD in adults, is also a good reason for making an inventory of the

  2. Gene regulation in adult neural stem cells : Current challenges and possible applications

    NARCIS (Netherlands)

    Encinas, J.M.; Fitzsimons, C.P.

    2017-01-01

    Adult neural stem and progenitor cells (NSPCs) offer a unique opportunity for neural regeneration and niche modification in physiopathological conditions, harnessing the capability to modify from neuronal circuits to glial scar. Findings exposing the vast plasticity and potential of NSPCs have

  3. Optimal dosages for melatonin supplementation therapy in older adults: a systematic review of current literature

    NARCIS (Netherlands)

    Vural, Esmée M. S.; van Munster, Barbara C.; de Rooij, Sophia E.

    2014-01-01

    Melatonin is a hormone that regulates circadian rhythm, and its levels decline with age. As melatonin levels decrease, older adults are prone to develop disorders related to an altered circadian rhythm. The effective dose of melatonin supplementation in these disorders remains unclear. Our objective

  4. Assessment and monitoring of treatment response in adult ADHD patients: current perspectives.

    Science.gov (United States)

    Ramsay, J Russell

    2017-01-01

    Attention-deficit/hyperactivity disorder (ADHD) is a neurodevelopmental syndrome that emerges in childhood or early adolescence and persists into adulthood for a majority of individuals. There are many other adults with ADHD who may not seek out evaluation and treatment until adulthood, having been able to "get by" before struggling with inattention, hyperactivity, and/or impulsivity in adulthood, in addition to facing the associated features of disorganization, poor time management, and procrastination among many others. A lifetime diagnosis of ADHD is associated with a wide range of life impairments, which makes a comprehensive and accurate diagnostic assessment essential in order to obtain appropriate treatment. Moreover, while there are effective medical and psychosocial treatments for ADHD, it is important to be able to track treatment response in order to evaluate whether adjustments in specific interventions are needed or referrals for adjunctive treatments and supports are indicated to facilitate optimal therapeutic outcomes. The goal of this article is to provide a clinically useful review of the various measures that practicing clinicians can use to aid in the diagnostic assessment and monitoring of psychosocial and medical treatment of ADHD in adult patients. This review includes various structured interviews, screening scales, adult ADHD symptom inventories, measures of associated features of ADHD, as well as ratings of impairment and functioning which can be adapted to clinicians' practice needs in order to track treatment progress and optimize treatments for adults with ADHD.

  5. Nurse specialists in adult congenital heart disease: The current status in Europe

    NARCIS (Netherlands)

    Moons, P.; Scholte op Reimer, W.; De Geest, S.; Fridlund, B.; Heikkila, J.; Jaarsma, Trijntje (Tiny); Martensson, J.; Smith, K; Stewart, S.; Stromberg, A; Thompson, D.R.

    2006-01-01

    Aim: Recommendations for the management of adults with congenital heart disease indicate that specialist referral centres should employ nurse specialists who are trained and educated in the care for these patients. We surveyed the involvement, education and activities of nurse specialists in the

  6. The emergence of international food safety standards and guidelines: understanding the current landscape through a historical approach.

    Science.gov (United States)

    Ramsingh, Brigit

    2014-07-01

    Following the Second World War, the Food and Agriculture Organization (FAO) and the World Health Organization (WHO) teamed up to construct an International Codex Alimentarius (or 'food code') which emerged in 1963. The Codex Committee on Food Hygiene (CCFH) was charged with the task of developing microbial hygiene standards, although it found itself embroiled in debate with the WHO over the nature these standards should take. The WHO was increasingly relying upon the input of biometricians and especially the International Commission on Microbial Specifications for Foods (ICMSF) which had developed statistical sampling plans for determining the microbial counts in the final end products. The CCFH, however, was initially more focused on a qualitative approach which looked at the entire food production system and developed codes of practice as well as more descriptive end-product specifications which the WHO argued were 'not scientifically correct'. Drawing upon historical archival material (correspondence and reports) from the WHO and FAO, this article examines this debate over microbial hygiene standards and suggests that there are many lessons from history which could shed light upon current debates and efforts in international food safety management systems and approaches.

  7. Comparison of SAR and induced current densities in adults and children exposed to electromagnetic fields from electronic article surveillance devices

    Energy Technology Data Exchange (ETDEWEB)

    Martinez-Burdalo, M; Sanchis, A; Martin, A; Villar, R [Consejo Superior de Investigaciones Cientificas (CSIC), Instituto de Fisica Aplicada, C/Serrano 144, 28006 Madrid (Spain)], E-mail: mercedes@iec.csic.es

    2010-02-21

    Electronic article surveillance (EAS) devices are widely used in most stores as anti-theft systems. In this work, the compliance with international guidelines in the human exposure to these devices is analysed by using the finite-difference time-domain (FDTD) method. Two sets of high resolution numerical phantoms of different size (REMCOM/Hershey and Virtual Family), simulating adult and child bodies, are exposed to a 10 MHz pass-by panel-type EAS consisting of two overlapping current-carrying coils. Two different relative positions between the EAS and the body (frontal and lateral exposures), which imply the exposure of different parts of the body at different distances, have been considered. In all cases, induced current densities in tissues of the central nervous system and specific absorption rates (SARs) are calculated to be compared with the limits from the guidelines. Results show that induced current densities are lower in the case of adult models as compared with those of children in both lateral and frontal exposures. Maximum SAR values calculated in lateral exposure are significantly lower than those calculated in frontal exposure, where the EAS-body distance is shorter. Nevertheless, in all studied cases, with an EAS driving current of 4 A rms, maximum induced current and SAR values are below basic restrictions.

  8. Comparison of SAR and induced current densities in adults and children exposed to electromagnetic fields from electronic article surveillance devices

    International Nuclear Information System (INIS)

    Martinez-Burdalo, M; Sanchis, A; Martin, A; Villar, R

    2010-01-01

    Electronic article surveillance (EAS) devices are widely used in most stores as anti-theft systems. In this work, the compliance with international guidelines in the human exposure to these devices is analysed by using the finite-difference time-domain (FDTD) method. Two sets of high resolution numerical phantoms of different size (REMCOM/Hershey and Virtual Family), simulating adult and child bodies, are exposed to a 10 MHz pass-by panel-type EAS consisting of two overlapping current-carrying coils. Two different relative positions between the EAS and the body (frontal and lateral exposures), which imply the exposure of different parts of the body at different distances, have been considered. In all cases, induced current densities in tissues of the central nervous system and specific absorption rates (SARs) are calculated to be compared with the limits from the guidelines. Results show that induced current densities are lower in the case of adult models as compared with those of children in both lateral and frontal exposures. Maximum SAR values calculated in lateral exposure are significantly lower than those calculated in frontal exposure, where the EAS-body distance is shorter. Nevertheless, in all studied cases, with an EAS driving current of 4 A rms, maximum induced current and SAR values are below basic restrictions.

  9. Comparison of SAR and induced current densities in adults and children exposed to electromagnetic fields from electronic article surveillance devices

    Science.gov (United States)

    Martínez-Búrdalo, M.; Sanchis, A.; Martín, A.; Villar, R.

    2010-02-01

    Electronic article surveillance (EAS) devices are widely used in most stores as anti-theft systems. In this work, the compliance with international guidelines in the human exposure to these devices is analysed by using the finite-difference time-domain (FDTD) method. Two sets of high resolution numerical phantoms of different size (REMCOM/Hershey and Virtual Family), simulating adult and child bodies, are exposed to a 10 MHz pass-by panel-type EAS consisting of two overlapping current-carrying coils. Two different relative positions between the EAS and the body (frontal and lateral exposures), which imply the exposure of different parts of the body at different distances, have been considered. In all cases, induced current densities in tissues of the central nervous system and specific absorption rates (SARs) are calculated to be compared with the limits from the guidelines. Results show that induced current densities are lower in the case of adult models as compared with those of children in both lateral and frontal exposures. Maximum SAR values calculated in lateral exposure are significantly lower than those calculated in frontal exposure, where the EAS-body distance is shorter. Nevertheless, in all studied cases, with an EAS driving current of 4 A rms, maximum induced current and SAR values are below basic restrictions.

  10. 2010 Canadian Cardiovascular Society/Canadian Heart Rhythm Society Training Standards and Maintenance of Competency in Adult Clinical Cardiac Electrophysiology.

    Science.gov (United States)

    Green, Martin S; Guerra, Peter G; Krahn, Andrew D

    2011-01-01

    The last guidelines on training for adult cardiac electrophysiology (EP) were published by the Canadian Cardiovascular Society in 1996. Since then, substantial changes in the knowledge and practice of EP have mandated a review of the previous guidelines by the Canadian Heart Rhythm Society, an affiliate of the Canadian Cardiovascular Society. Novel tools and techniques also now allow electrophysiologists to map and ablate increasingly complex arrhythmias previously managed with pharmacologic or device therapy. Furthermore, no formal attempt had previously been made to standardize EP training across the country. The 2010 Canadian Cardiovascular Society/Canadian Heart Rhythm Society Training Standards and Maintenance of Competency in Adult Clinical Cardiac Electrophysiology represent a consensus arrived at by panel members from both societies, as well as EP program directors across Canada and other select contributors. In describing program requirements, the technical and cognitive skills that must be acquired to meet training standards, as well as the minimum number of procedures needed in order to acquire these skills, the new guidelines provide EP program directors and committee members with a template to develop an appropriate curriculum for EP training for cardiology fellows here in Canada. Copyright © 2011 Canadian Cardiovascular Society. Published by Elsevier Inc. All rights reserved.

  11. Comparison of two standardized methods of methacholine inhalation challenge in young adults

    DEFF Research Database (Denmark)

    Siersted, H C; Walker, C M; O'Shaughnessy, A D

    2000-01-01

    In the European Community Respiratory Health Study (ECRHS), airway responsiveness to methacholine was determined using the Mefar dosimeter protocol. Elsewhere, the 2-min tidal breathing method has become the preferred standardized method. The relationship between measurements of responsiveness by...

  12. Adult Nutrient Intakes from Current National Dietary Surveys of European Populations

    Directory of Open Access Journals (Sweden)

    Holly L. Rippin

    2017-11-01

    Full Text Available The World Health Organization (WHO encourages countries to undertake national dietary survey (NDS but implementation and reporting is inconsistent. This paper provides an up-to-date review of adult macro and micronutrient intakes in European populations as reported by NDS. It uses WHO Recommended Nutrient Intakes (RNIs to assess intake adequacy and highlight areas of concern. NDS information was gathered primarily by internet searches and contacting survey authors and nutrition experts. Survey characteristics and adult intakes by gender/age group were extracted for selected nutrients and weighted means calculated by region. Of the 53 WHO Europe countries, over a third (n = 19, mainly Central & Eastern European countries (CEEC, had no identifiable NDS. Energy and nutrient intakes were extracted for 21 (40% countries but differences in age group, methodology, under-reporting and nutrient composition databases hindered inter-country comparisons. No country met more than 39% WHO RNIs in all age/gender groups; macronutrient RNI achievement was poorer than micronutrient. Overall RNI attainment was slightly worse in CEEC and lower in women and female elderly. Only 40% countries provided adult energy and nutrient intakes. The main gaps lie in CEEC, where unknown nutrient deficiencies may occur. WHO RNI attainment was universally poor for macronutrients, especially for women, the female elderly and CEEC. All countries could be encouraged to report a uniform nutrient set and sub-analyses of nationally representative nutrient intakes.

  13. Group Independent Component Analysis (gICA) and Current Source Density (CSD) in the study of EEG in ADHD adults.

    Science.gov (United States)

    Ponomarev, Valery A; Mueller, Andreas; Candrian, Gian; Grin-Yatsenko, Vera A; Kropotov, Juri D

    2014-01-01

    To investigate the performance of the spectral analysis of resting EEG, Current Source Density (CSD) and group independent components (gIC) in diagnosing ADHD adults. Power spectra of resting EEG, CSD and gIC (19 channels, linked ears reference, eyes open/closed) from 96 ADHD and 376 healthy adults were compared between eyes open and eyes closed conditions, and between groups of subjects. Pattern of differences in gIC and CSD spectral power between conditions was approximately similar, whereas it was more widely spatially distributed for EEG. Size effect (Cohen's d) of differences in gIC and CSD spectral power between groups of subjects was considerably greater than in the case of EEG. Significant reduction of gIC and CSD spectral power depending on conditions was found in ADHD patients. Reducing power in a wide frequency range in the fronto-central areas is a common phenomenon regardless of whether the eyes were open or closed. Spectral power of local EEG activity isolated by gICA or CSD in the fronto-central areas may be a suitable marker for discrimination of ADHD and healthy adults. Spectral analysis of gIC and CSD provides better sensitivity to discriminate ADHD and healthy adults. Copyright © 2013 International Federation of Clinical Neurophysiology. Published by Elsevier Ireland Ltd. All rights reserved.

  14. Adult subependymal neural precursors, but not differentiated cells, undergo rapid cathodal migration in the presence of direct current electric fields.

    Directory of Open Access Journals (Sweden)

    Robart Babona-Pilipos

    Full Text Available BACKGROUND: The existence of neural stem and progenitor cells (together termed neural precursor cells in the adult mammalian brain has sparked great interest in utilizing these cells for regenerative medicine strategies. Endogenous neural precursors within the adult forebrain subependyma can be activated following injury, resulting in their proliferation and migration toward lesion sites where they differentiate into neural cells. The administration of growth factors and immunomodulatory agents following injury augments this activation and has been shown to result in behavioural functional recovery following stroke. METHODS AND FINDINGS: With the goal of enhancing neural precursor migration to facilitate the repair process we report that externally applied direct current electric fields induce rapid and directed cathodal migration of pure populations of undifferentiated adult subependyma-derived neural precursors. Using time-lapse imaging microscopy in vitro we performed an extensive single-cell kinematic analysis demonstrating that this galvanotactic phenomenon is a feature of undifferentiated precursors, and not differentiated phenotypes. Moreover, we have shown that the migratory response of the neural precursors is a direct effect of the electric field and not due to chemotactic gradients. We also identified that epidermal growth factor receptor (EGFR signaling plays a role in the galvanotactic response as blocking EGFR significantly attenuates the migratory behaviour. CONCLUSIONS: These findings suggest direct current electric fields may be implemented in endogenous repair paradigms to promote migration and tissue repair following neurotrauma.

  15. Prevalence and correlates of DSM-IV-TR major depressive disorder, self-reported diagnosed depression and current depressive symptoms among adults in Germany.

    Science.gov (United States)

    Maske, Ulrike E; Buttery, Amanda K; Beesdo-Baum, Katja; Riedel-Heller, Steffi; Hapke, Ulfert; Busch, Markus A

    2016-01-15

    While standardized diagnostic interviews using established criteria are the gold standard for assessing depression, less time consuming measures of depression and depressive symptoms are commonly used in large population health surveys. We examine the prevalence and health-related correlates of three depression measures among adults aged 18-79 years in Germany. Using cross-sectional data from the national German Health Interview and Examination Survey for Adults (DEGS1) (n=7987) and its mental health module (DEGS1-MH) (n=4483), we analysed prevalence and socio-demographic and health-related correlates of (a) major depressive disorder (MDD) established by Composite International Diagnostic Interview (CIDI) using DSM-IV-TR criteria (CIDI-MDD) in the last 12 months, (b) self-reported physician or psychotherapist diagnosed depression in the last 12 months, and (c) current depressive symptoms in the last two weeks (PHQ-9, score ≥10). Prevalence of 12-month CIDI-MDD was 4.2% in men and 9.9% in women. Prevalence of 12-month self-reported health professional-diagnosed depression was 3.8% and 8.1% and of current depressive symptoms 6.1% and 10.2% in men and women, respectively. Case-overlap between measures was only moderate (32-45%). In adjusted multivariable analyses, depression according to all three measures was associated with lower self-rated health, lower physical and social functioning, higher somatic comorbidity (except for women with 12-month CIDI-MDD), more sick leave and higher health service utilization. Persons with severe depression may be underrepresented. Associations between CIDI-MDD and correlates and overlap with other measures may be underestimated due to time lag between DEGS1 and DEGS1-MH. Prevalence and identified cases varied between these three depression measures, but all measures were consistently associated with a wide range of adverse health outcomes. Copyright © 2015 Elsevier B.V. All rights reserved.

  16. Are childhood abuse and neglect related to age of first homelessness episode among currently homeless adults?

    Science.gov (United States)

    Mar, Marissa Y; Linden, Isabelle A; Torchalla, Iris; Li, Kathy; Krausz, Michael

    2014-01-01

    This study investigates 500 homeless adults and the associations between childhood maltreatment types and the age of first reported homelessness episode. Those first experiencing homelessness in youth (age 24 years or younger; 46%) were compared with those first experiencing homelessness at a later age (older than age 24 years). In individual models, physical abuse, emotional abuse, and emotional neglect were associated with first experiencing homelessness during youth (p homeless during youth (p homeless earlier in life and support the need for early interventions with at-risk families.

  17. Prognostic Modeling in Pathologic N1 Breast Cancer Without Elective Nodal Irradiation After Current Standard Systemic Management.

    Science.gov (United States)

    Yu, Jeong Il; Park, Won; Choi, Doo Ho; Huh, Seung Jae; Nam, Seok Jin; Kim, Seok Won; Lee, Jeong Eon; Kil, Won Ho; Im, Young-Hyuck; Ahn, Jin Seok; Park, Yeon Hee; Cho, Eun Yoon

    2015-08-01

    This study was conducted to establish a prognostic model in patients with pathologic N1 (pN1) breast cancer who have not undergone elective nodal irradiation (ENI) under the current standard management and to suggest possible indications for ENI. We performed a retrospective study with patients with pN1 breast cancer who received the standard local and preferred adjuvant chemotherapy treatment without neoadjuvant chemotherapy and ENI from January 2005 to June 2011. Most of the indicated patients received endocrine and trastuzumab therapy. In 735 enrolled patients, the median follow-up period was 58.4 months (range, 7.2-111.3 months). Overall, 55 recurrences (7.4%) developed, and locoregional recurrence was present in 27 patients (3.8%). Recurrence-free survival was significantly related to lymphovascular invasion (P = .04, hazard ratio [HR], 1.83; 95% confidence interval [CI], 1.03-2.88), histologic grade (P = .03, HR, 2.57; 95% CI, 1.05-6.26), and nonluminal A subtype (P = .02, HR, 3.04; 95% CI, 1.23-7.49) in multivariate analysis. The prognostic model was established by these 3 prognostic factors. Recurrence-free survival was less than 90% at 5 years in cases with 2 or 3 factors. The prognostic model has stratified risk groups in pN1 breast cancer without ENI. Patients with 2 or more factors should be considered for ENI. Copyright © 2015 Elsevier Inc. All rights reserved.

  18. Utilization study of antidiabetic agents in a teaching hospital of Sikkim and adherence to current standard treatment guidelines.

    Science.gov (United States)

    Satpathy, Sushrut Varun; Datta, Supratim; Upreti, Binu

    2016-01-01

    Diabetes has gradually emerged as one of the most serious public health problems in our country. This underlines the need for timely disease detection and decisive therapeutic intervention. This prospective cross-sectional observational study aims at analyzing the utilization pattern of antidiabetic agents in a remote North-East Indian tertiary care teaching hospital in the perspective of current standard treatment guidelines. Diabetic patients receiving antidiabetic medication, both as outpatients and inpatients in our hospital over a period of 12 months (May 2013-May 2014), were included in this study. The data obtained were sorted and analyzed on the basis of gender, type of therapy, and hospital setting. A total of 310 patients were included in the study. Metformin was the single most frequently prescribed antidiabetic agent (66.8%) followed by the sulfonylureas group (37.4%). Insulin was prescribed in 23.2% of the patients. Combination antidiabetic drug therapy (65.1%) was used more frequently than monotherapy (34.8%). The use of biguanides (P standard treatment guidelines. Increased use of generic drugs is an area with scope for improvement.

  19. The effect of activity history and current activity on static and dynamic postural balance in older adults.

    Science.gov (United States)

    Bulbulian, R; Hargan, M L

    2000-01-01

    The purpose of this study was to investigate the effects of former athleticism and current activity status on static and dynamic postural balance in older adults. Fifty-six subjects participated in four study groups including former athletes, currently active (AA; n = 15; 69.1+/-4.4 years.; 77.8+/-9.8 kg), former athletes, currently inactive (AI; n = 12; 66.7 years.; 87.2+/-15.1 kg), controls currently active (CA; n = 14; 68.6 +/- 4.5 years.; 73.9+/-15 kg), and controls currently inactive (CI; n = 15; 72.8+/-4.8 years; 81.1+/-14.8). All subjects were tested for height, weight, flexibility, thigh circumference, and static (sharpened Romberg/unipedal stance), and dynamic (step length and width) balance tests. The sharpened Romberg (eyes open) test showed that AA (60.0+/-0 s) and CA (59.4+/- 0.5 s) balanced significantly longer than AI (41.5+/-7.2 s), and CI (41.8+/-6.1 s) (punipedal (eyes open) test balance scores for AA, CA, AI, and CI were respectively 40.0+/-4.5, 55.1+/- 3.4, 33.0+/-7.1, and 27.5+/-6.1 s, with CA significantly better than CI (ptest results for relative group comparisons were similar. Overall, two-way analysis of variance showed a significant activity main effect for all dependent variables measured (p<0.05). The results indicated that current activity status plays a key role on balance performance in older adults. Furthermore, former athletic activity history provides no protection for the age related onset of postural imbalance.

  20. Achieving transparency in carbon labelling for construction materials – Lessons from current assessment standards and carbon labels

    International Nuclear Information System (INIS)

    Wu, Peng; Low, Sui Pheng; Xia, Bo; Zuo, Jian

    2014-01-01

    Highlights: • The evolution of international GHG standards is reviewed. • The evolution of international carbon labelling schemes is reviewed. • The transparency requirements in carbon labelling schemes are revealed. • Key recommendations are provided to improve transparency in carbon labelling. - Abstract: The construction industry is one of the largest sources of carbon emissions. Manufacturing of raw materials, such as cement, steel and aluminium, is energy intensive and has considerable impact on carbon emissions level. Due to the rising recognition of global climate change, the industry is under pressure to reduce carbon emissions. Carbon labelling schemes are therefore developed as meaningful yardsticks to measure and compare carbon emissions. Carbon labelling schemes can help switch consumer-purchasing habits to low-carbon alternatives. However, such switch is dependent on a transparent scheme. The principle of transparency is highlighted in all international greenhouse gas (GHG) standards, including the newly published ISO 14067: Carbon footprint of products – requirements and guidelines for quantification and communication. However, there are few studies which systematically investigate the transparency requirements in carbon labelling schemes. A comparison of five established carbon labelling schemes, namely the Singapore Green Labelling Scheme, the CarbonFree (the U.S.), the CO 2 Measured Label and the Reducing CO 2 Label (UK), the CarbonCounted (Canada), and the Hong Kong Carbon Labelling Scheme is therefore conducted to identify and investigate the transparency requirements. The results suggest that the design of current carbon labels have transparency issues relating but not limited to the use of a single sign to represent the comprehensiveness of the carbon footprint. These transparency issues are partially caused by the flexibility given to select system boundary in the life cycle assessment (LCA) methodology to measure GHG emissions. The

  1. Does SMS Text Messaging Help or Harm Adults' Knowledge of Standard Spelling?

    Science.gov (United States)

    Powell, D.; Dixon, M.

    2011-01-01

    The recent increase in short messaging system (SMS) text messaging, often using abbreviated, non-conventional "textisms" (e.g. "2nite"), in school-aged children has raised fears of negative consequences of such technology for literacy. The current research used a paradigm developed by Dixon and Kaminska, who showed that exposure to phonetically…

  2. Mixed methods research in tobacco control with youth and young adults: A methodological review of current strategies.

    Directory of Open Access Journals (Sweden)

    Craig S Fryer

    Full Text Available Tobacco use among young people is a complex and serious global dilemma that demands innovative and diverse research approaches. The purpose of this methodological review was to examine the current use of mixed methods research in tobacco control with youth and young adult populations and to develop practical recommendations for tobacco control researchers interested in this methodology.Using PubMed, we searched five peer-reviewed journals that publish tobacco control empirical literature for the use of mixed methods research to study young populations, age 12-25 years. Our team analyzed the features of each article in terms of tobacco control topic, population, youth engagement strategies, and several essential elements of mixed methods research.We identified 23 mixed methods studies published by authors from five different countries reported between 2004 and 2015. These 23 articles examined various topics that included tobacco use behavior, tobacco marketing and branding, and cessation among youth and young adults. The most common mixed methods approach was variations of the concurrent design in which the qualitative and quantitative strands were administered at the same time and given equal priority. This review documented several innovative applications of mixed methods research as well as challenges in the reporting of the complex research designs.The use of mixed methods research in tobacco control has great potential for advancing the understanding of complex behavioral and sociocultural issues for all groups, especially youth and young adults.

  3. The effect of transcranial direct current stimulation on contrast sensitivity and visual evoked potential amplitude in adults with amblyopia.

    Science.gov (United States)

    Ding, Zhaofeng; Li, Jinrong; Spiegel, Daniel P; Chen, Zidong; Chan, Lily; Luo, Guangwei; Yuan, Junpeng; Deng, Daming; Yu, Minbin; Thompson, Benjamin

    2016-01-14

    Amblyopia is a neurodevelopmental disorder of vision that occurs when the visual cortex receives decorrelated inputs from the two eyes during an early critical period of development. Amblyopic eyes are subject to suppression from the fellow eye, generate weaker visual evoked potentials (VEPs) than fellow eyes and have multiple visual deficits including impairments in visual acuity and contrast sensitivity. Primate models and human psychophysics indicate that stronger suppression is associated with greater deficits in amblyopic eye contrast sensitivity and visual acuity. We tested whether transcranial direct current stimulation (tDCS) of the visual cortex would modulate VEP amplitude and contrast sensitivity in adults with amblyopia. tDCS can transiently alter cortical excitability and may influence suppressive neural interactions. Twenty-one patients with amblyopia and twenty-seven controls completed separate sessions of anodal (a-), cathodal (c-) and sham (s-) visual cortex tDCS. A-tDCS transiently and significantly increased VEP amplitudes for amblyopic, fellow and control eyes and contrast sensitivity for amblyopic and control eyes. C-tDCS decreased VEP amplitude and contrast sensitivity and s-tDCS had no effect. These results suggest that tDCS can modulate visual cortex responses to information from adult amblyopic eyes and provide a foundation for future clinical studies of tDCS in adults with amblyopia.

  4. Mixed methods research in tobacco control with youth and young adults: A methodological review of current strategies.

    Science.gov (United States)

    Fryer, Craig S; Seaman, Elizabeth L; Clark, Rachael S; Plano Clark, Vicki L

    2017-01-01

    Tobacco use among young people is a complex and serious global dilemma that demands innovative and diverse research approaches. The purpose of this methodological review was to examine the current use of mixed methods research in tobacco control with youth and young adult populations and to develop practical recommendations for tobacco control researchers interested in this methodology. Using PubMed, we searched five peer-reviewed journals that publish tobacco control empirical literature for the use of mixed methods research to study young populations, age 12-25 years. Our team analyzed the features of each article in terms of tobacco control topic, population, youth engagement strategies, and several essential elements of mixed methods research. We identified 23 mixed methods studies published by authors from five different countries reported between 2004 and 2015. These 23 articles examined various topics that included tobacco use behavior, tobacco marketing and branding, and cessation among youth and young adults. The most common mixed methods approach was variations of the concurrent design in which the qualitative and quantitative strands were administered at the same time and given equal priority. This review documented several innovative applications of mixed methods research as well as challenges in the reporting of the complex research designs. The use of mixed methods research in tobacco control has great potential for advancing the understanding of complex behavioral and sociocultural issues for all groups, especially youth and young adults.

  5. Current Trends in the Monitoring and Treatment of Diabetic Retinopathy in Young Adults

    Directory of Open Access Journals (Sweden)

    Dorota Raczyńska

    2014-01-01

    Full Text Available The diagnosis and treatment of diabetic retinopathy (DR in young adults have significantly improved in recent years. Research methods have widened significantly, for example, by introducing spectral optical tomography of the eye. Invasive diagnostics, for example, fluorescein angiography, are done less frequently. The early introduction of an insulin pump to improve the administration of insulin is likely to delay the development of diabetic retinopathy, which is particularly important for young patients with type 1 diabetes mellitus (T1DM. The first years of diabetes occurring during childhood and youth are the most appropriate to introduce proper therapeutic intervention before any irreversible changes in the eyes appear. The treatment of DR includes increased metabolic control, laserotherapy, pharmacological treatment (antiangiogenic and anti-inflammatory treatment, enzymatic vitreolysis, and intravitreal injections, and surgery. This paper summarizes the up-to-date developments in the diagnostics and treatment of DR. In the literature search, authors used online databases, PubMed, and clinitrials.gov and browsed through individual ophthalmology journals, books, and leading pharmaceutical company websites.

  6. Current self-reported symptoms of attention deficit/hyperactivity disorder are associated with total brain volume in healthy adults.

    Directory of Open Access Journals (Sweden)

    Martine Hoogman

    Full Text Available BACKGROUND: Reduced total brain volume is a consistent finding in children with Attention Deficit/Hyperactivity Disorder (ADHD. In order to get a better understanding of the neurobiology of ADHD, we take the first step in studying the dimensionality of current self-reported adult ADHD symptoms, by looking at its relation with total brain volume. METHODOLOGY/PRINCIPAL FINDINGS: In a sample of 652 highly educated adults, the association between total brain volume, assessed with magnetic resonance imaging, and current number of self-reported ADHD symptoms was studied. The results showed an association between these self-reported ADHD symptoms and total brain volume. Post-hoc analysis revealed that the symptom domain of inattention had the strongest association with total brain volume. In addition, the threshold for impairment coincides with the threshold for brain volume reduction. CONCLUSIONS/SIGNIFICANCE: This finding improves our understanding of the biological substrates of self-reported ADHD symptoms, and suggests total brain volume as a target intermediate phenotype for future gene-finding in ADHD.

  7. Current standard rules of combined anteversion prevent prosthetic impingement but ignore osseous contact in total hip arthroplasty.

    Science.gov (United States)

    Weber, Markus; Woerner, Michael; Craiovan, Benjamin; Voellner, Florian; Worlicek, Michael; Springorum, Hans-Robert; Grifka, Joachim; Renkawitz, Tobias

    2016-12-01

    In this prospective study of 135 patients undergoing cementless total hip arthroplasty (THA) we asked whether six current definitions of combined anteversion prevent impingement and increase postoperative patient individual impingement-free range-of-motion (ROM). Implant position was measured by an independent, external institute on 3D-CT performed six weeks post-operatively. Post-operative ROM was calculated using a CT-based algorithm detecting osseous and/or prosthetic impingement by virtual hip movement. Additionally, clinical ROM was evaluated pre-operatively and one-year post-operatively by a blinded observer. Combined component position of cup and stem according to the definitions of Ranawat, Widmer, Dorr, Hisatome and Yoshimine inhibited prosthetic impingement in over 90 %, while combined osseous and prosthetic impingement still occurred in over 40 % of the cases. The recommendations by Jolles, Widmer, Dorr, Yoshimine and Hisatome enabled higher flexion (p ≤ 0.001) and internal rotation (p ≤ 0.006). Clinically, anteversion rules of Widmer and Yoshimine provided one-year post-operatively statistically but not clinically relevant higher internal rotation (p ≤0.034). Standard rules of combined anteversion detect prosthetic but fail to prevent combined osseous and prosthetic impingement in THA. Future models will have to account for the patient-individual anatomic situation to ensure impingement-free ROM.

  8. The relationship of religious involvement indicators and social support to current and past suicidality among depressed older adults.

    Science.gov (United States)

    Rushing, Nicole C; Corsentino, Elizabeth; Hames, Jennifer L; Sachs-Ericsson, Natalie; Steffens, David C

    2013-01-01

    Elderly people, particularly those with major depression, are at the highest risk for suicide than any other age group. Religious involvement is associated with a range of health outcomes including lower odds of death by suicide. However, not much is known about the effects of religious involvement on suicidal ideation in the elderly or which aspects of religiosity are beneficial. This study examined the relative influence of various conceptualizations of religious involvement, above and beyond the protective effects of social support, on current and past suicidality among depressed older adults. Participants were 248 depressed patients, 59 years and older, enrolled in the Neurocognitive Outcomes of Depression in the Elderly study. A psychiatrist assessed current suicidal ideation using the suicidal thoughts item from the Montgomery-Asberg Depression Rating Scale. Past history of suicide attempts, four religious involvement indicators, social support indicators, and control variables were assessed via self-report. Church attendance, above and beyond importance of religion, private religious practices, and social support, was associated with less suicidal ideation; perceived social support partially mediated this relationship. Current religious practices were not predictive of retrospective reports of past suicide attempts. Church attendance, rather than other religious involvement indicators, has the strongest relationship to current suicidal ideation. Clinicians should consider public religious activity patterns and perceived social support when assessing for other known risk and protective factors for suicide and in developing treatment plans.

  9. Contact and perspective taking improve humanness standards and perceptions of humanness of older adults and people with dementia: a cross-sectional survey study.

    Science.gov (United States)

    Miron, Anca M; McFadden, Susan H; Hermus, Nathan J; Buelow, Jennifer; Nazario, Amanda S; Seelman, Katarena

    2017-10-01

    No empirical work has systematically explored perceptions of humanness of people with dementia and of older adults and the variables that could improve these perceptions. We thus investigated the role of contact and perspective taking in improving perceptions of humanness of these social groups. To do so, we developed a new concept, humanness standards, defined as the amount of evidence of ability impairment needed to conclude that elderly people and those with dementia have lost personhood. We used a cross-sectional survey design (n = 619) to assess participants' humanness standards and perceptions of uniquely human characteristics and human nature characteristics of two social groups (people with dementia and older adults). Half the participants (n = 311) completed a survey about people with dementia and half (n = 308) assessed older adults. People with dementia were perceived as possessing humanness characteristics to a lesser extent than were older adults. For both groups, contact predicted enhanced perceptions of humanness characteristics. Participants' degree of contact with individuals with dementia also predicted humanness standards, but only under low perspective-taking conditions. As predicted, for older adults, participants set the highest humanness impairment thresholds in the high contact/high perspective-taking condition. We conclude that while social programs that bring persons with dementia and other individuals in contact could change humanness standards and perceptions of humanness characteristics of people with dementia, in the case of elderly adults, the contact must be supplemented by variables that facilitate taking the perspective of the person.

  10. Fructose intake at current levels in the United States may cause gastrointestinal distress in normal adults.

    Science.gov (United States)

    Beyer, Peter L; Caviar, Elena M; McCallum, Richard W

    2005-10-01

    Fructose intake has increased considerably in the United States, primarily as a result of increased consumption of high-fructose corn syrup, fruits and juices, and crystalline fructose. The purpose was to determine how often fructose, in amounts commonly consumed, would result in malabsorption and/or symptoms in healthy persons. Fructose absorption was measured using 3-hour breath hydrogen tests and symptom scores were used to rate subjective responses for gas, borborygmus, abdominal pain, and loose stools. The study included 15 normal, free-living volunteers from a medical center community and was performed in a gastrointestinal specialty clinic. Subjects consumed 25- and 50-g doses of crystalline fructose with water after an overnight fast on separate test days. Mean peak breath hydrogen, time of peak, area under the curve (AUC) for breath hydrogen and gastrointestinal symptoms were measured during a 3-hour period after subjects consumed both 25- and 50-g doses of fructose. Differences in mean breath hydrogen, AUC, and symptom scores between doses were analyzed using paired t tests. Correlations among peak breath hydrogen, AUC, and symptoms were also evaluated. More than half of the 15 adults tested showed evidence of fructose malabsorption after 25 g fructose and greater than two thirds showed malabsorption after 50 g fructose. AUC, representing overall breath hydrogen response, was significantly greater after the 50-g dose. Overall symptom scores were significantly greater than baseline after each dose, but scores were only marginally greater after 50 g than 25 g. Peak hydrogen levels and AUC were highly correlated, but neither was significantly related to symptoms. Fructose, in amounts commonly consumed, may result in mild gastrointestinal distress in normal people. Additional study is warranted to evaluate the response to fructose-glucose mixtures (as in high-fructose corn syrup) and fructose taken with food in both normal people and those with

  11. What is the standard approach to assessment of an unprovoked seizure in an adult?: HONG KONG.

    Science.gov (United States)

    Kwan, Patrick

    2012-12-01

    Since Hong Kong is highly urbanized and acute public hospitals have been established across the city, most patients with unprovoked seizures not already receiving antiepileptic drug (AED) therapy, particularly convulsive seizures, will be admitted as emergency for assessment. A thorough history is taken from the patient and any witnesses to the seizure. This includes the circumstance of the seizures, detailed symptoms and signs experienced by the patient and witnessed by others before, during, and after the seizure, any potential precipitating factors, history of previous seizures (that the patient might have overlooked), and history of previous brain insults that might have increased the risk of epilepsy later in life, including gestational and birth history, history of childhood febrile seizure, significant head trauma, any family history of epilepsy or seizures, comorbidities, current medications, drug and alcohol abuse, and social history including employment, driving, and living circumstances. A detailed physical and neurologic examination is performed.

  12. Sarcopenia: An Undiagnosed Condition in Older Adults. Current Consensus Definition: Prevalence, Etiology, and Consequences

    Science.gov (United States)

    2012-01-01

    Sarcopenia, the age associated loss of skeletal muscle mass and function, has considerable societal consequences for the development of frailty, disability and health care planning. A group of geriatricians and scientists from academia and industry met in Rome, Italy on November 18, 2009 to arrive at a consensus definition of sarcopenia. The current consensus definition was approved unanimously by the meeting participants and is as follows: Sarcopenia is defined as the age-associated loss of skeletal muscle mass and function. The causes of sarcopenia are multi-factorial and can include disuse, altered endocrine function, chronic diseases, inflammation, insulin resistance, and nutritional deficiencies. While cachexia may be a component of sarcopenia, the two conditions are not the same. The diagnosis of sarcopenia should be considered in all older patients who present with observed declines in physical function, strength, or overall health. Sarcopenia should specifically be considered in patients who are bedridden, cannot independently rise from a chair, or who have a measured gait speed less that 1.0 m·s−1. Patients who meet these criteria should further undergo body composition assessment using dual energy x-ray absorptiometry (DXA) with sarcopenia being defined using currently validated definitions. A diagnosis of sarcopenia is consistent with a gait speed of less than 1 m·s−1 and an objectively measured low muscle mass (eg: appendicular mass relative to ht2 that is ≤ 7.23 kg/ m2 in men ≤ 5.67 kg/ m2 in men). Sarcopenia is a highly prevalent condition in older persons that leads to disability, hospitalization and death. PMID:21527165

  13. Na+ currents in vestibular type I and type II hair cells of the embryo and adult chicken.

    Science.gov (United States)

    Masetto, S; Bosica, M; Correia, M J; Ottersen, O P; Zucca, G; Perin, P; Valli, P

    2003-08-01

    In birds, type I and type II hair cells differentiate before birth. Here we describe that chick hair cells, from the semicircular canals, begin expressing a voltage-dependent Na current (INa) from embryonic day 14 (E14) and continue to express the current up to hatching (E21). During this period, INa was present in most (31/43) type I hair cells irrespective of their position in the crista, in most type II hair cells located far from the planum semilunatum (48/63), but only occasionally in type II hair cells close to the planum semilunatum (2/35). INa activated close to -60 mV, showed fast time- and voltage-dependent activation and inactivation, and was completely, and reversibly, blocked by submicromolar concentrations of tetrodotoxin (Kd = 17 nM). One peculiar property of INa concerns its steady-state inactivation, which is complete at -60 mV (half-inactivating voltage = -96 mV). INa was found in type I and type II hair cells from the adult chicken as well, where it had similar, although possibly not identical, properties and regional distribution. Current-clamp experiments showed that INa could contribute to the voltage response provided that the cell membrane was depolarized from holding potentials more negative than -80 mV. When recruited, INa produced a significant acceleration of the cell membrane depolarization, which occasionally elicited a large rapid depolarization followed by a rapid repolarization (action-potential-like response). Possible physiological roles for INa in the embryo and adult chicken are discussed.

  14. First Results of the “Carbonaceous Aerosol in Rome and Environs (CARE” Experiment: Beyond Current Standards for PM10

    Directory of Open Access Journals (Sweden)

    Francesca Costabile

    2017-12-01

    future research directions. First, we found that BC and EC mass concentration in Rome are larger than those measured in similar urban areas across Europe (the urban background mass concentration of eBC in Rome in winter being on average 2.6 ± 2.5 μ g · m − 3 , mean eBC at the peak level hour being 5.2 (95% CI = 5.0–5.5 μ g · m − 3 . Then, we discussed significant variations of carbonaceous aerosol properties occurring with time scales of minutes, and questioned on the data averaging period used in current air quality standard for PM 10 (24-h. Third, we showed that the oxidative potential induced by aerosol depends on particle size and composition, the effects of toxicity being higher with lower mass concentrations and smaller particle size. Albeit this is a preliminary analysis, findings reinforce the need for an urgent update of existing air quality standards for PM 10 and PM 2.5 with regard to particle composition and size distribution, and data averaging period. Our results reinforce existing concerns about the toxicity of carbonaceous aerosols, support the existing evidence indicating that particle size distribution and composition may play a role in the generation of this toxicity, and remark the need to consider a shorter averaging period (<1 h in these new standards.

  15. Zero new HIV infections: Mission impossible with current perceptions of young adults in Vhembe District regarding condom use

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    Azwihangwisi H. Mavhandu-Mudzusi

    2016-05-01

    Full Text Available Background: Millennium Development Goal (MDG number 6, target 6A focuses on halting and reversing the spread of HIV by 2015. South Africa is amongst the 189 countries that are involved in trying to meet the MDGs. In order to try and achieve this goal, South Africa, through its HIV and AIDS, STI and TB strategic plans has adopted the United Nations vision of ‘Zeros’, which include zero new HIV infections by the year 2015. One of the key interventions for achieving this is improvement in access to condoms. Aim: This article reports on perceptions of Vhembe District young adults regarding condom use. Setting: This study was conducted in one of the rural clinics in Vhembe District of the Limpopo Province: South Africa. Methods: A quantitative, cross-sectional design approach was followed. Data were collected using structured questionnaires administered to 372 young adults who came for healthcare services at one of the clinics in Vhembe District. Results: The findings indicated that there is a relationship between positive perceptions toward condom use and actual condom use. People who have positive attitudes toward condoms are also more likely to use them. In contrast, people with a negative attitude towards condoms are less likely to use them during sexual intercourse. Negative attitudes of health care providers were found to be a barrier that prevents sexually active individuals to access condoms in primary health care facilities. Conclusion: With current peceptions towards condom use, Zero new HIV infection will never be achieved. The researcher recommends development of strategies for promoting access and correct use of condoms. Keywords: Condom use, perception, young adults

  16. [E-Cigarettes on Everyone's Lips - Current Representative Data on Use Among Adolescents and Adults].

    Science.gov (United States)

    Schneider, Sven; Görig, Tatiana; Schilling, Laura; Diehl, Katharina

    2017-11-01

    Background  International data suggest an increase in e-cigarette use. However, there are still significant deficits in the reporting of its current prevalence. The present study reports representative data on e-cigarette use that make it possible to differentiate users both by the nicotine content of the e-cigarette liquids being used and by their smoking status. Methods and material  The underlying data are taken from the National Cancer Aid Monitoring (NCAM). In its first wave, 3000 persons aged between 14 and 45 were interviewed by telephone. Point estimates, confidence intervals and determinants of use will be presented. Results  Overall, 20 % of respondents had used an e-cigarette before, of which 80 % used liquids containing nicotine. Men, younger persons, persons with a migrant background and persons with a lower education level were more likely to have used an e-cigarette before than their respective reference groups. Half of all ever users of e-cigarettes also smoked tobacco cigarettes, while roughly one third had never used tobacco products before. Conclusions  For the first time, a representative study was conducted combining questions on the use of e-cigarettes with questions on smoking tobacco cigarettes and the nicotine content of the liquids being used. Target groups for future prevention measures are adolescents, as they had the highest prevalence of e-cigarette use, as well as non-smokers, since one third of e-cigarette users had never used a tobacco product before. Both groups also seem to be relevant target groups for which the introduction to e-cigarettes should be prevented. © Georg Thieme Verlag KG Stuttgart · New York.

  17. Measuring outcomes in adult spinal deformity surgery: a systematic review to identify current strengths, weaknesses and gaps in patient-reported outcome measures.

    Science.gov (United States)

    Faraj, Sayf S A; van Hooff, Miranda L; Holewijn, Roderick M; Polly, David W; Haanstra, Tsjitske M; de Kleuver, Marinus

    2017-08-01

    Adult spinal deformity (ASD) causes severe disability, reduces overall quality of life, and results in a substantial societal burden of disease. As healthcare is becoming more value based, and to facilitate global benchmarking, it is critical to identify and standardize patient-reported outcome measures (PROMs). This study aims to identify the current strengths, weaknesses, and gaps in PROMs used for ASD. Studies were included following a systematic search in multiple bibliographic databases between 2000 and 2015. PROMs were extracted and linked to the outcome domains of WHO's International Classification of Functioning and Health (ICF) framework. Subsequently, the clinimetric quality of identified PROMs was evaluated. The literature search identified 144 papers that met the inclusion criteria, and nine frequently used PROMs were identified. These covered 29 ICF outcome domains, which could be grouped into three of the four main ICF chapters: body function (n = 7), activity and participation (n = 19), environmental factors (n = 3), and body structure (n = 0). A low quantity (n = 3) of papers was identified that studied the clinimetric quality of PROMs. The Scoliosis Research Society (SRS)-22 has the highest level of clinimetric quality for ASD. Outcome domains related to mobility and pain were well represented. We identified a gap in current outcome measures regarding neurological and pulmonary function. In addition, no outcome domains were measured in the ICF chapter body structure. These results will serve as a foundation for the process of seeking international consensus on a standard set of outcome domains, accompanied PROMs and contributing factors to be used in future clinical trials and spine registries.

  18. Young adult sexual health: current and prior sexual behaviors among non-Hispanic white U.S. college students

    Science.gov (United States)

    Higgins, Jenny A.; Trussell, James; Moore, Nelwyn B.; Davidson, J. Kenneth

    2013-01-01

    Objective Less is known about the sexual health of young adults compared to adolescents, despite 20-24 year olds' greater risk of unintended pregnancy and sexually transmitted infections. This paper provides information on college students' prior and current sexual practices, including oral sex, vaginal intercourse, anal intercourse, and masturbation. Methods We analyzed data from a cross-sectional sexuality survey of students from two university campuses in the USA, one Midwestern and one Southwestern (N=1504). The sample consisted of non-Hispanic white, never-married students who identified as heterosexual. Results Of 16 possible combinations of four sexual activities (solitary masturbation, oral sex, vaginal intercourse, and anal intercourse), only four contained more than 5% of respondents: masturbation, oral sex, and vaginal intercourse (37%); oral sex and vaginal intercourse only (20%); all four (14%); and none (8%). Twenty percent had ever engaged in anal intercourse. Women were significantly less likely than men to have ever masturbated (48% versus 92%). Analyses exhibited several sexual health challenges, including lack of verbal sexual consent, alcohol use proximal to sex, and lack of contraceptive use. Conclusions Although few young adults are substituting it for vaginal intercourse, anal intercourse is increasingly common, and safer sex efforts should encourage condom use during both sexual activities. Masturbation should be encouraged as an alternative to higher risk sexual practices and an essential aspect of sexual well-being. Finally, practitioners should continue to address specific threats to college students' sexual health, including alcohol use and nonverbal consent. PMID:20152094

  19. Young adult sexual health: current and prior sexual behaviours among non-Hispanic white US college students.

    Science.gov (United States)

    Higgins, Jenny A; Trussell, James; Moore, Nelwyn B; Davidson, J Kenneth

    2010-03-01

    Less is known about the sexual health of young adults than about adolescents, despite 20 to 24-year-olds' greater risk of unintended pregnancy and sexually transmissible infections. This paper provides information on college students' prior and current sexual practices including oral sex, vaginal intercourse, anal intercourse and masturbation. We analysed data from a cross-sectional sexuality survey of students from two university campuses in the USA, one Mid-western and one South-western (n = 1504). The sample consisted of non-Hispanic white, never-married students who identified as heterosexual. Of 16 possible combinations of four sexual activities (solitary masturbation, oral sex, vaginal intercourse and anal intercourse), only four contained more than 5% of respondents: masturbation, oral sex and vaginal intercourse (37%); oral sex and vaginal intercourse only (20%); all four (14%); and none (8%). Twenty percent had ever engaged in anal intercourse. Women were significantly less likely than men to have ever masturbated (48 v. 92%). Analyses exhibited several sexual health challenges, including lack of verbal sexual consent, alcohol use proximal to sex and lack of contraceptive use. Although few young adults are substituting it for vaginal intercourse, anal intercourse is increasingly common and safer sex efforts should encourage condom use during both sexual activities. Masturbation should be encouraged as an alternative to higher risk sexual practices and an essential aspect of sexual well being. Finally, practitioners should continue to address specific threats to college students' sexual health, including alcohol use and non-verbal consent.

  20. Diagnosing acute and prevalent HIV-1 infection in young African adults seeking care for fever: a systematic review and audit of current practice.

    Science.gov (United States)

    Prins, Henrieke A B; Mugo, Peter; Wahome, Elizabeth; Mwashigadi, Grace; Thiong'o, Alexander; Smith, Adrian; Sanders, Eduard J; Graham, Susan M

    2014-06-01

    Fever is a common complaint in HIV-1 infected adults and may be a presenting sign of acute HIV-1 infection (AHI). We investigated the extent to which HIV-1 infection was considered in the diagnostic evaluation of febrile adults in sub-Saharan Africa (SSA) through a systematic review of published literature and guidelines in the period 2003-2014. We also performed a detailed audit of current practice for the evaluation of febrile young adults in coastal Kenya. Our review identified 43 studies investigating the aetiology of fever in adult outpatients in SSA. While the guidelines identified recommend testing for HIV-1 infection, none mentioned AHI. In our audit of current practice at nine health facilities, only 189 out of 1173 (16.1%) patients, aged 18-29 years, were tested for HIV-1. In a detailed record review, only 2 out of 39 (5.1%) young adults seeking care for fever were tested for HIV-1, and the possibility of AHI was not mentioned. Available literature on adult outpatients presenting with fever is heavily focused on diagnosing malaria and guidelines are poorly defined in terms of evaluating aetiologies other than malaria. Current practice in coastal Kenya shows poor uptake of provider-initiated HIV-1 testing and AHI is not currently considered in the differential diagnosis. © The Author 2014. Published by Oxford University Press on behalf of Royal Society of Tropical Medicine and Hygiene.

  1. Ambulatory Blood Pressure Monitoring (ABPM) as the reference standard for diagnosis of hypertension and assessment of vascular risk in adults.

    Science.gov (United States)

    Hermida, Ramón C; Smolensky, Michael H; Ayala, Diana E; Portaluppi, Francesco

    2015-01-01

    New information has become available since the ISC, AAMCC, and SECAC released their first extensive guidedelines to improve the diagnosis and treatment of adult arterial hypertension. A critical assessment of evidence and a comparison of what international guidelines now propose are the basis for the following statements, which update the recommendations first issued in 2013. Office blood pressure (BP) measurements should no longer be considered to be the "gold standard" for the diagnosis of hypertension and assessment of cardiovascular risk. Relying on office BP, even when supplemented with at-home wake-time self-measurements, to identify high-risk individuals, disregarding circadian BP patterning and asleep BP level, leads to potential misclassification of 50% of all evaluated persons. Accordingly, ambulatory BP monitoring is the recommended reference standard for the diagnosis of true hypertension and accurate assessment of cardiovascular risk in all adults ≥18 yrs of age, regardless of whether office BP is normal or elevated. Asleep systolic BP mean is the most significant independent predictor of cardiovascular events. The sleep-time relative SBP decline adds prognostic value to the statistical model that already includes the asleep systolic BP mean and corrected for relevant confounding variables. Accordingly, the asleep systolic BP mean is the recommended protocol to diagnose hypertension, assess cardiovascular risk, and predict cardiovascular event-free interval. In men, and in the absence of compelling clinical conditions, reference thresholds for diagnosing hypertension are 120/70 mmHg for the asleep systolic/diastolic BP means derived from ambulatory BP monitoring. However, in women, in the absence of complicating co-morbidities, the same thresholds are lower by 10/5 mmHg, i.e., 110/65 mmHg for the asleep means. In high-risk patients, including those diagnosed with diabetes or chronic kidney disease, and/or those having experienced past

  2. Do current national and international guidelines have specific recommendations for older adults with bipolar disorder? A brief report.

    Science.gov (United States)

    Dols, Annemiek; Kessing, Lars Vedel; Strejilevich, Sergio A; Rej, Soham; Tsai, Shang-Ying; Gildengers, Ariel G; Almeida, Osvaldo P; Shulman, Kenneth I; Sajatovic, Martha

    2016-12-01

    Older adults with bipolar disorder (OABD) are a growing segment of patients with bipolar disorder (BD) for which specific guidelines are warranted. Although, OABD are frequently excluded from randomized controlled trials due to their age or somatic comorbidity, more treatment data from a variety of sources have become available in recent years. It is expected that at least some of this emerging information on OABD would be incorporated into treatment guidelines available to clinicians around the world. The International Society of Bipolar Disorders OABD task force compiled and compared recommendations from current national and international guidelines that specifically address geriatric or older individuals with BD (from year 2005 onwards). There were 34 guidelines, representing six continents and 19 countries. The majority of guidelines had no separate section on OABD. General principles for treating OABD with medication are recommended to be similar to those for younger adults, with special caution for side effects due to somatic comorbidity and concomitant medications. Therapeutic lithium serum levels are suggested to be lower but recommendations are very general and mostly not informed by specific research evidence. There is a lack of emphasis of OABD-specific issues in existing guidelines. Given the substantial clinical heterogeneity in BD across the life span, along with the rapidly expanding population of older individuals worldwide, and limited mental health workforce with geriatric expertise, it is critical that additional effort and resources be devoted to studying treatment interventions specific to OABD and that treatment guidelines reflect research findings. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

  3. Screening for Diabetic Retinopathy in Adults with Learning Disability: Current Uptake and Adjustments to Facilitate Equality of Access

    Science.gov (United States)

    Pilling, Rachel F.

    2015-01-01

    Equality of access to health care for adults with learning disability has been in the spotlight in the UK in recent years due to publication of several reports. Adults with learning disability are thought to account for a significant proportion of the diabetic population in the UK. A list of adults known to the learning disability health…

  4. Evaluation of the Mating Competitiveness of the Adult Oriental Fruit Fly Reared as Larvae in Liquid vs. Those Raised on Standard Wheat-based Diets

    Science.gov (United States)

    Three strains (standard lab, DTWP pupal color sexing strain and wild strain) of adult oriental fruit flies, which were reared as larvae on a liquid diet, mill feed diet (Tanaka’s diet), or natural host fruit diet, were evaluated for mating competitiveness in both indoor and outdoor Boller’s mating c...

  5. Making Sense of Varying Standards of Care: The Experiences of Staff Working in Residential Care Environments for Adults with Learning Disabilities

    Science.gov (United States)

    Hutchison, Andrew; Kroese, Biza Stenfert

    2016-01-01

    Research evidence reveals that adults with learning disabilities who live in residential care facilities are being exposed to considerable variation in the standards of care they receive. High profile cases of substandard care have also raised concerns regarding the appropriateness of existing care provisions and practices. While attempts have…

  6. Measuring outcomes in adult spinal deformity surgery: a systematic review to identify current strengths, weaknesses and gaps in patient-reported outcome measures

    NARCIS (Netherlands)

    Faraj, S.S.; Hooff, M.L. Van; Holewijn, R.M.; Polly, D.W.; Haanstra, T.M.; Kleuver, M. de

    2017-01-01

    PURPOSE: Adult spinal deformity (ASD) causes severe disability, reduces overall quality of life, and results in a substantial societal burden of disease. As healthcare is becoming more value based, and to facilitate global benchmarking, it is critical to identify and standardize patient-reported

  7. Dietary Intakes and Eating Habits of College Athletes: Are Female College Athletes Following the Current Sports Nutrition Standards?

    Science.gov (United States)

    Shriver, Lenka H.; Betts, Nancy M.; Wollenberg, Gena

    2013-01-01

    Objective: The objective of this study was to assess dietary intakes and eating habits of female college athletes and compared them with the minimum sports nutrition standards. Participants: Data were obtained from 52 female college athletes from a National Collegiate Athletic Association (NCAA) Division I university between January 2009 and May…

  8. Validation of the RisingSun RS-651 Blood Pressure Monitor Based on Auscultation in Adults According to the ANSI/AAMI/ISO 81060-2:2013 Standard.

    Science.gov (United States)

    She, Jin; Guan, Xizhou; Liu, Yanyong; Xiang, Haiyan

    2016-12-01

    This study validated the RisingSun RS-651 blood pressure (BP) monitor based on auscultation in adults according to the American National Standards Institute/Association for the Advancement of Medical Instrumentation/International Organization for Standardization (ANSI/AAMI/ISO) 81060-2:2013 standard. The RS-651 device was evaluated in a study of 97 participants. The same arm simultaneous method, as defined in the ANSI/AAMI/ISO standard, was used. The mean differences±standard deviation for criterion 1 were 0.8±2.3 mm Hg for systolic BP (SBP) and -0.1±2.9 mm Hg for diastolic BP (DBP). Analysis for criterion 2 resulted in values of 0.8±1.5 mm Hg for SBP and -0.1±2.1 mm Hg for DBP. All of the data fulfilled the ANSI/AAMI/ISO 81060-2:2013 standard requirements to pass the validation. The RisingSun RS-651 device can be recommended for both clinical and self/home use in adults according to the ANSI/AAMI/ISO 81060-2:2013 standard. © 2016 The Authors. The Journal of Clinical Hypertension Published by Wiley Periodicals, Inc.

  9. Current global standards for chemical protective clothing: how to choose the right protection for the right job?

    Science.gov (United States)

    VAN WELY, Eric

    2017-01-01

    The first standards for chemical protective clothing (CPC) emerged mid to late 1980’s and have evolved since as most standards are revisited every 5 yr. Over the past years, we have also seen a strengthening of the chemical and worker protection legislation around the globe (various forms of REACH) but also protection of workers. The most prevalent standards originate under the auspices of the International Standards Organisation (ISO), European Committee for Standardisation (CEN) or under various US standards organisations (e.g. NFPA, ASTM). Protective clothing against hazardous materials is required in many of the professional and non-professional activities of everyday life. Effective and adequate protection is important in many scenarios from household (e.g. cleaning agents, peroxides, acids and bases, paints), to agricultural (e.g. fuel, pesticides), to medical (e.g. pharmaceuticals and active ingredients), to industrial production (e.g. petro-chemicals, chemicals, paints, adhesive and coatings) but also manufacturing of many products (e.g. light bulbs, cars, semi-conductors), during various emergency activities (e.g. boat, rail or road accidents as well as fire-fighting in an urban and industrial setting), and finally, military operations or response to incidents of terrorism. Nevertheless, CPC must remain the last line of defence whenever possible through a preference for less hazardous chemicals, less dangerous processes and handling operations, and by engineering controls to reduce and minimise human contact with the chemicals. This article provides information about the selection, use, care and maintenance (SUCAM) of protective clothing against chemical and microbiological hazards. PMID:29046493

  10. Battery powered thought: enhancement of attention, learning, and memory in healthy adults using transcranial direct current stimulation.

    Science.gov (United States)

    Coffman, Brian A; Clark, Vincent P; Parasuraman, Raja

    2014-01-15

    This article reviews studies demonstrating enhancement with transcranial direct current stimulation (tDCS) of attention, learning, and memory processes in healthy adults. Given that these are fundamental cognitive functions, they may also mediate stimulation effects on other higher-order processes such as decision-making and problem solving. Although tDCS research is still young, there have been a variety of methods used and cognitive processes tested. While these different methods have resulted in seemingly contradictory results among studies, many consistent and noteworthy effects of tDCS on attention, learning, and memory have been reported. The literature suggests that although tDCS as typically applied may not be as useful for localization of function in the brain as some other methods of brain stimulation, tDCS may be particularly well-suited for practical applications involving the enhancement of attention, learning, and memory, in both healthy subjects and in clinical populations. © 2013 Elsevier Inc. All rights reserved.

  11. Current understanding of treatment and management protocol for adult diabetic in-patients at a tertiary care hospital

    International Nuclear Information System (INIS)

    Waki, N.; Memon, A.; Khan, M.O.; Masood, S.; Rouf, M.; Mirza, R.

    2012-01-01

    Objective: To assess the current understanding of treatment and management protocols for adult diabetic in-patients at a tertiary care hospital. Methods: This cross-sectional study, conducted at the Civil Hospital Karachi from July to September 2009, involved 450 participants, who were interviewed through a well-structured questionnaire regarding the patient's demography, clinical features, past medical history, type of diabetes mellitus, duration, associated complications, and also involved patient notes for laboratory tests and management. SPSSv15.0 was used for descriptive analysis. Results: The study population of 450 diabetics had 144 (32%) males and 306 (68%) females. Of the total, 435 (96.7%) patients had type 2 diabetes. There were 231 (51%) patients using insulin, 168 (37.3%) oral hypoglycaemic drugs, and 51 (11.3%) using both. Among patients using insulin, regular insulin usage stood at 30% followed by a combination of regular insulin and NPH (26.7%) and NPH alone at 6%. The most popular drug used was metformin (27.3%) and the least used drug was glitazones (4%). In the study population, 73.3% patients controlled their diabetes with diet, and 24.7% with regular exercise. Conclusion: Majority of the study population had type 2 diabetes with a female preponderance. Insulin was prescribed for half the patients. Metformin was the most frequently used oral hypoglycaemic drug. (author)

  12. Developing standardised treatment for adults with myositis and different phenotypes: an international survey of current prescribing preferences.

    Science.gov (United States)

    Tansley, Sarah; Shaddick, Gavin; Christopher-Stine, Lisa; Sharp, Charlotte; Dourmishev, Lyubomir; Maurer, Britta; Chinoy, Hector; McHugh, Neil

    2016-01-01

    The evidence base for treatment of the idiopathic inflammatory myopathies is extremely limited. The rarity and heterogeneity of these diseases has hampered the development of good quality clinical trials and while a range of immunomodulatory treatments are commonly used in clinical practice, as yet there are no clear guidelines directing their use. We aimed to establish current prescribing regimens used to treat adults with myositis internationally. An electronic survey based on different clinical scenarios was distributed internationally to clinicians involved in the treatment of patients with myositis. Participants were asked to select their first-line treatment preferences in each situation. A multinomial regression analysis was used to assess the influence of clinical scenario, respondent expertise and country of origin on first-line treatment choice. 107 survey responses were received. 57% of respondents considered themselves an expert in myositis and the majority of respondents were rheumatologists although responses from other specialities were also received. Pharmacological treatment with steroids and additional immunotherapy was the preference in most scenarios. First-line immunosuppressant choice was significantly influenced by the clinical scenario, the expertise of the treating physician and country of practice. Azathioprine, methotrexate and mycophenolate mofetil were the most commonly chosen agents. In the absence of available evidence, clinical experience and expert consensus often forms the basis of treatment guidelines. These results suggest that an international consensus approach would be possible in myositis and would overcome an urgent, yet unmet need for patients suffering with this difficult disease.

  13. Voltage clamp methods for the study of membrane currents and SR Ca2+ release in adult skeletal muscle fibres

    Science.gov (United States)

    Hernández-Ochoa, Erick O.; Schneider, Martin F.

    2012-01-01

    Skeletal muscle excitation-contraction (E-C)1 coupling is a process composed of multiple sequential stages, by which an action potential triggers sarcoplasmic reticulum (SR)2 Ca2+ release and subsequent contractile activation. The various steps in the E-C coupling process in skeletal muscle can be studied using different techniques. The simultaneous recordings of sarcolemmal electrical signals and the accompanying elevation in myoplasmic Ca2+, due to depolarization-initiated SR Ca2+ release in skeletal muscle fibres, have been useful to obtain a better understanding of muscle function. In studying the origin and mechanism of voltage dependency of E-C coupling a variety of different techniques have been used to control the voltage in adult skeletal fibres. Pioneering work in muscles isolated from amphibians or crustaceans used microelectrodes or ‘high resistance gap’ techniques to manipulate the voltage in the muscle fibres. The development of the patch clamp technique and its variant, the whole-cell clamp configuration that facilitates the manipulation of the intracellular environment, allowed the use of the voltage clamp techniques in different cell types, including skeletal muscle fibres. The aim of this article is to present an historical perspective of the voltage clamp methods used to study skeletal muscle E-C coupling as well as to describe the current status of using the whole-cell patch clamp technique in studies in which the electrical and Ca2+ signalling properties of mouse skeletal muscle membranes are being investigated. PMID:22306655

  14. Prevalence, correlates, and trends in tobacco use and cessation among current, former, and never adult marijuana users with a history of tobacco use, 2005-2014.

    Science.gov (United States)

    Schauer, Gillian L; King, Brian A; McAfee, Timothy A

    2017-10-01

    Approximately 70% of current (past 30-day) adult marijuana users are current tobacco users, which may complicate tobacco cessation. We assessed prevalence and trends in tobacco cessation among adult ever tobacco users, by marijuana use status. Data came from the National Survey on Drug Use and Health, a cross-sectional, nationally representative, household survey of U.S. civilians. Analyses included current, former, and never marijuana users aged≥18 reporting ever tobacco use (cigarette, cigar, chew/snuff). We computed weighted estimates (2013-2014) of current tobacco use, recent tobacco cessation (quit 30days to 12months), and sustained tobacco cessation (quit>12months) and adjusted trends in tobacco use and cessation (2005-2014) by marijuana use status. We also assessed the association between marijuana and tobacco use status. In 2013-2014, among current adult marijuana users reporting ever tobacco use, 69.1% were current tobacco users (vs. 38.5% of former marijuana users, pusers, pusers, pusers, pusers, pusers, pusers who ever used tobacco had double the prevalence (vs. never-marijuana users) of current tobacco use, and significantly lower sustained abstinence. Interventions addressing tobacco cessation in the context of use of marijuana and other substances may be warranted. Copyright © 2017 Elsevier Ltd. All rights reserved.

  15. A prospective study of the substance use and mental health outcomes of young adult former and current cannabis users.

    Science.gov (United States)

    Silins, Edmund; Swift, Wendy; Slade, Tim; Toson, Barbara; Rodgers, Bryan; Hutchinson, Delyse M

    2017-09-01

    The extent to which young adult former cannabis users fare better than infrequent users is unclear. We investigated the association between cannabis use status at age 23 and substance use and mental health outcomes at age 27. Data were from the 20+ year cohort of the PATH Through Life Study. Lifetime cannabis users (n = 1410) at age 23 were classified as former/occasional/regular users. Multivariable logistic regression was used to estimate the association between cannabis use status at age 23 and six outcomes assessed at age 27. Compared with occasional cannabis users: (i) former users had odds of subsequent tobacco use [odds ratio (OR) = 0.67, 95% confidence interval (CI) 0.52-0.85], illicit drug use (cannabis, OR = 0.22, 95% CI 0.17-0.28; other illicit drugs, OR = 0.29, 95% CI 0.22-0.39) and mental health impairment (OR = 0.71, 95% CI 0.55-0.92) that were 29-78% lower; and (ii) regular users had odds of subsequent frequent alcohol use (OR = 2.34, 95% CI 0.67-1.34), tobacco use (OR = 3.67, 95% CI 2.54-5.30), cannabis use (OR = 11.73, 95% CI 6.81-20.21) and dependence symptoms (OR = 12.60, 95% CI 8.38-18.94), and other illicit drug use (OR = 2.95, 95% CI 2.07-4.21) that were 2-13 times greater. Associations attenuated after covariate adjustment, and most remained significant. Clear associations exist between cannabis use status in young adulthood and subsequent mental health and substance use. While early intervention remains important to prevent regular cannabis use and the associated harms, experimentation with cannabis use in the years leading into young adulthood may not necessarily determine an immutable pathway to mental health problems and illicit substance use. [Silins E, Swift W, Slade T, Toson B, Rodgers B, Hutchinson DM. A prospective study of the substance use and mental health outcomes of young adult former and current cannabis users. Drug Alcohol Rev 2017;00:000-000]. © 2017 Australasian Professional Society on Alcohol and other

  16. Adult Dental Health Survey 2009: relationships between dental attendance patterns, oral health behaviour and the current barriers to dental care.

    Science.gov (United States)

    Hill, K B; Chadwick, B; Freeman, R; O'Sullivan, I; Murray, J J

    2013-01-01

    The importance of understanding barriers to dental attendance of adults in the UK was acknowledged in the first Adult Dental Health Survey in 1968 and has been investigated in all subsequent ADH surveys. In 1968, approximately 40% of dentate adults said they attended for a regular check-up; by 2009 this was 61%. Attendance patterns were associated with greater frequency of toothbrushing, use of additional dental hygiene products, lower plaque and calculus levels. Just under three-fifths of adults said they had tried to make an NHS dental appointment in the previous five years. The vast majority (92%) successfully received and attended an appointment, while a further 1% received an appointment but did not attend. The remaining 7% of adults were unable to make an appointment with an NHS dentist. The majority of adults were positive about their last visit to the dentist, with 80% of adults giving no negative feedback about their last dentist visit. Cost and anxiety were important barriers to care. Twenty-six percent of adults said the type of treatment they had opted for in the past had been affected by the cost and 19% said they had delayed dental treatment for the same reason. The 2009 survey data demonstrated a relationship between dental anxiety and dental attendance. Adults with extreme dental anxiety were more likely to attend only when they had trouble with their teeth (22%) than for a regular check-up.

  17. [Current status on prevalence, treatment and management of hypertension among Chinese adults in the National Demonstration Areas for Comprehensive Prevention and Control of Non-communicable Diseases].

    Science.gov (United States)

    Jin, R R; Zhang, J; Li, J L; Li, J J; Ma, S; Bian, F; Deng, G J; Su, X W; Shen, Z Z; Wang, Y P; Jiang, Y

    2018-04-10

    Objective: To investigate the current status of prevalence, treatment, and management on hypertension among Chinese adults from the National Demonstration Areas for Comprehensive Prevention and Control of Non-communicable Diseases. Methods: We selected a total of 4 000 residents aged ≥18 years for this questionnaire-based survey by multi-stage clustering sampling in 10 National Demonstration Areas between November and December, 2016. Results: There were 3 891 effective questionnaires. The self-reported prevalence of hypertension among aged ≥35 years was 31.47% (1 011/3 213). For the past two weeks, the self-reported treatment of hypertension was 86.75%(877/1 011), with the rates of guidance as 56.87% (575/1 011) on physical activity, 40.95% (414/1 011) on diet, 38.33% (385/1 011) on weight management, and 22.75% (228/1 011) on smoking cessation. For the past 12 months, 74.68% (755/1 011) of the residents aged ≥35 years were under the proper management and 62.12% (628/1 011) of them were under the standardized management programs. The follow-up program lasted for 4 ( P(25) - P(75) : 4-12) times per year, with 15 ( P(25) - P(75) : 10-20) minutes per each visit. Hypertensive patients would mainly visit the outpatient clinics (53.51%), followed by home visits (22.91%) and telephone calls (13.64%). Rate of satisfaction on management services was 94.83% (716/755) from the hypertensive patients. Multivariate analysis showed that the rate of self-reported treatment ( OR =1.986, 95% CI : 1.222-3.228) and self-reported standardized management ( OR =2.204, 95% CI : 1.519-3.199) on hypertension were higher in the Demonstration Areas with higher implementation scores of self-reported non-communicable diseases management. Conclusions: Prevention and management on hypertension in the Demonstration Areas had met the requirement set for the Demonstration Areas during the "12th Five-Year Plan" . Projects on setting up the National Non-communicable Diseases Demonstration Areas

  18. Financing Adult Education: How Adequate Are Current Sources in Facilitating Access and Participation in Centres in Murang'a South Sub-County, Murang'a County, Kenya?

    Science.gov (United States)

    Maina, Ndonga James; Orodho, John Aluko

    2016-01-01

    The thrust of this study was to examine the level of adequacy of current sources in facilitating access and participation in adult education centres in Murang'a South Sub-County, Murang'a County, Kenya. The study adopted the descriptive survey design. Combinations of purposive and stratified random sampling techniques were used to select 82…

  19. Employment and Adults Who Are Deaf or Hard of Hearing: Current Status and Experiences of Barriers, Accommodations, and Stress in the Workplace

    Science.gov (United States)

    Punch, Renée

    2016-01-01

    In an integrative review of the literature covering the period 2004-2016, the author presents a current picture of the situation of people who are deaf or hard of hearing (DHH) relative to employment and careers--particularly the barriers, facilitators, and stress levels experienced by working DHH adults. First, an overview is provided of findings…

  20. Determining the normal range for IGF-I, IGFBP-3, and ALS: new reference data based on current internal standards.

    Science.gov (United States)

    Ertl, Diana-Alexandra; Gleiss, Andreas; Sagmeister, Susanne; Haeusler, Gabriele

    2014-09-01

    The measurement of insulin-like growth factors (IGF-I) and insulin-like growth factor-binding protein (IGFBP-3) often serves as first-line testing in children with growth disorders. The role of acid-labile subunit (ALS) as a screening parameter for homozygous or heterozygous mutations of the ALS gene still has to be determined. IGF-I, IGFBP-3, and ALS were measured in 252 samples from children and adolescents. Reference curves were fitted using generalized additive model for location, scale and shape (GAMLSS) models and SD-Scores were calculated. Bootstrap analysis was used to quantify the uncertainty of the estimated percentiles. Bland-Altman plots were used to investigate the discrepancy between our newly estimated standard deviation scores (SDS) and SDS calculated on the basis of previous reference data. We present reference data for enzyme-linked immunosorbent assay (ELISA) measurements based on recommended internal standard for IGF-I, IGFBP-3, and ALS suitable for calculation of SD-scores. The Bland-Altman plot shows a rough agreement between the previous SDS calculation and our new one only for SDS around 1; for SDS at -2, an average difference of 0.83 SD was noticed. Our IGF-I reference values for the interval of interest in diagnosing growth hormone deficiency (GHD) (prepubertal age) are solid as proved by bootstrap analysis. The difference in calculated SD scores by using data provided previously highlights the importance of using labor and method specific reference data.

  1. Job stress is associated with migraine in current workers: the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil).

    Science.gov (United States)

    Santos, I S; Griep, R H; Alves, M G M; Goulart, A C; Lotufo, P A; Barreto, S M; Chor, D; Benseñor, I M

    2014-10-01

    Migraine is an important source of social burden and work-related costs. Studies addressing the association of migraine with job stress are rare. The aim of this paper was to study the association of job stress components and migraine using structured, validated questionnaires that were part of the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil). The ELSA-Brasil is a multicentre cohort of 15,105 civil servants (12,096 current workers) in Brazil. Job strain was assessed using the 17-item Brazilian version of the Swedish Demand-Control-Support Questionnaire. Headache episodes in the preceding 12 months were assessed using a questionnaire based on the International Headache Society criteria. We analysed the association between job stress domains and migraine in men and women using adjusted logistic regression and interaction models. We included 3113 individuals without headache and 3259 migraineurs. Low job control [odds ratio (OR) 1.30; 95% confidence interval (95% CI) 1.10-1.53], high job demands (OR 1.37; 95% CI 1.18-1.59) and low social support (OR 1.49; 95% CI 1.29-1.71) were associated with migraine. Job control was more strongly associated with migraine in women (p for interaction = 0.02). High-strain (high demand and low control) jobs were associated with migraine in both men (OR 1.48; 95% CI 1.11-1.97) and women (OR 1.51; 95% CI 1.17-1.95). We observed a strong association between high-strain jobs and migraine. Job control was a stronger migraine-related factor for women. Low social support was associated with migraine in both sexes. © 2014 European Pain Federation - EFIC®

  2. Systemic Right Ventricle in Adults With Congenital Heart Disease: Anatomic and Phenotypic Spectrum and Current Approach to Management.

    Science.gov (United States)

    Brida, Margarita; Diller, Gerhard-Paul; Gatzoulis, Michael A

    2018-01-30

    The systemic right ventricle (SRV) is commonly encountered in congenital heart disease representing a distinctly different model in terms of its anatomic spectrum, adaptation, clinical phenotype, and variable, but overall guarded prognosis. The most common clinical scenarios where an SRV is encountered are complete transposition of the great arteries with previous atrial switch repair, congenitally corrected transposition of the great arteries, double inlet right ventricle mostly with previous Fontan palliation, and hypoplastic left heart syndrome palliated with the Norwood-Fontan protocol. The reasons for the guarded prognosis of the SRV in comparison with the systemic left ventricle are multifactorial, including distinct fibromuscular architecture, shape and function, coronary artery supply mismatch, intrinsic abnormalities of the tricuspid valve, intrinsic or acquired conduction abnormalities, and varied SRV adaptation to pressure or volume overload. Management of the SRV remains an ongoing challenge because SRV dysfunction has implications on short- and long-term outcomes for all patients irrespective of underlying cardiac morphology. SRV dysfunction can be subclinical, underscoring the need for tertiary follow-up and timely management of target hemodynamic lesions. Catheter interventions and surgery have an established role in selected patients. Cardiac resynchronization therapy is increasingly used, whereas pharmacological therapy is largely empirical. Mechanical assist device and heart transplantation remain options in end-stage heart failure when other management strategies have been exhausted. The present report focuses on the SRV with its pathological subtypes, pathophysiology, clinical features, current management strategies, and long-term sequelae. Although our article touches on issues applicable to neonates and children, its main focus is on adults with SRV. © 2018 American Heart Association, Inc.

  3. Paralympic sports medicine--current evidence in winter sport: considerations in the development of equipment standards for paralympic athletes.

    Science.gov (United States)

    Burkett, Brendan

    2012-01-01

    To highlight and discuss the considerations for the future development of equipment standards for Winter Paralympic sports. Literature searches were performed (in English) during May 2011 using the key words "technology, winter sport, Olympic, and Paralympic" in the computerized databases PubMed, PsycINFO, Science Direct, and Google Scholar. In addition, personal scientific observations were made at several Winter Paralympic Games. The retrieved articles were screened and assessed for relevance to the biological, biomechanical, and sport medicine aspects of equipment. There are 3 key areas in which technology has influenced sports performance in Paralympic winter sports, namely, specialized prostheses, crutch skis or outriggers (in lieu of poles), and sport-specific wheelchairs (such as the sit-ski). From a sport medicine perspective, a crucial factor not considered in the standard laboratory test of mechanical efficiency is the influence of the human-equipment connection, such as the stump-to-prosthesis interface or the required human-to-wheelchair control. This connectivity is critical to the effective operation of the assistive device. When assessing the efficiency of this equipment, the not-so-obvious, holistic, compensatory factors need to be considered. Assistive equipment is fundamental for a person with a disability to participate and compete in winter sport activities. Although there have been improvements in the mechanical function of some assistive devices, the key issue is matching the residual function of the person with the assistive equipment. Equitable access to this technology will also ensure that the fundamental spirit of fair play that underpins the Paralympic Games is maintained.

  4. Validation of a smartphone auscultatory blood pressure kit Accutension XYZ-110 in adults according to the ANSI/AAMI/ISO 81060-2: 2013 standard.

    Science.gov (United States)

    Chu, Guang; Zhang, Zhi; Xu, Mengdan; Huang, Daini; Dai, Qiuyan

    2017-10-01

    The aim of this study was to validate the accuracy of the Accutension XYZ-110 blood pressure (BP) kit according to the American National Standards Institute/Association for the Advancement of Medical Instrumentation/International Organization for Standardization (ANSI/AAMI/ISO) 81060-2:2013 standard. Systolic blood pressure (SBP) and diastolic blood pressure (DBP) were measured simultaneously on the same arm in 85 Chinese adults (female : male=48 : 37) with a mean age of 43.2 years using the mercury sphygmomanometer (two observers) and the Accutension XYZ-110 device (one supervisor). The ANSI/AAMI/ISO 81060-2:2013 standard for the validation of BP-measuring devices in adults was followed precisely. A total of 255 comparison pairs were obtained for analysis. The mean device-observer difference in the 255 separate BP data pairs was 2.45±2.24 mmHg for SBP and 0.69±2.09 mmHg for DBP. The data were in accordance with the criterion 1 of the ANSI/AAMI/ISO 81060-2:2013 standard requirements (≤5±8 mmHg). In addition, the mean device-observer difference of the 85 participants was 2.45±1.47 mmHg for SBP and 0.69±1.36 mmHg for DBP. The device accuracy also fulfilled the criterion 2 with the SD of less than or equal to 6.47 for SBP and less than or equal to 6.90 mmHg for DBP. The Accutension XYZ-110 BP kit fulfilled the requirements of the ANSI/AAMI/ISO 81060-2:2013 standard, and hence could be recommended for both clinical and self/home BP measurement in adults.

  5. A Summary of Proposed Changes to the Current ICARTT Format Standards and their Implications to Future Airborne Studies

    Science.gov (United States)

    Northup, Emily; Benson Early, Amanda; Beach, Aubrey; Wang, Dali; Kusterer, John; Quam, Brandi; Chen, Gao

    2015-01-01

    The Atmospheric Science Data Center (ASDC) at NASA Langley Research Center is responsible for the ingest, archive, and distribution of NASA Earth Science data in the areas of radiation budget, clouds, aerosols, and tropospheric chemistry. The ASDC specializes in atmospheric data that is important to understanding the causes and processes of global climate change and the consequences of human activities on the climate. The ASDC currently supports more than 44 projects and has over 1,700 archived data sets, which increase daily. ASDC customers include scientists, researchers, federal, state, and local governments, academia, industry, and application users, the remote sensing community, and the general public.

  6. Long-Term Visual Training Increases Visual Acuity and Long-Term Monocular Deprivation Promotes Ocular Dominance Plasticity in Adult Standard Cage-Raised Mice

    OpenAIRE

    Hosang, Leon; Yusifov, Rashad; Löwel, Siegrid

    2018-01-01

    Abstract For routine behavioral tasks, mice predominantly rely on olfactory cues and tactile information. In contrast, their visual capabilities appear rather restricted, raising the question whether they can improve if vision gets more behaviorally relevant. We therefore performed long-term training using the visual water task (VWT): adult standard cage (SC)-raised mice were trained to swim toward a rewarded grating stimulus so that using visual information avoided excessive swimming toward ...

  7. Current Explorations of Adult Learner: Implications for Mentoring and More. Adult Higher Education Alliance Annual Conference Proceedings (36th, Orlando, Florida, March 10-11, 2016)

    Science.gov (United States)

    Elufiede, Kemi, Ed.; Flynn, Bonnie, Ed.

    2016-01-01

    The 36th Annual Adult Higher Education Alliance (AHEA) Conference was held on March 10-11, 2016 in Orlando, Florida, on the campus of the University of Central Florida. There were 48 presentations from scholars and practitioners from 20 states who participated in the conference. The contributions to these proceedings represent the best of the…

  8. Creating a standardized process to offer the standard of care: continuous process improvement methodology is associated with increased rates of sperm cryopreservation among adolescent and young adult males with cancer.

    Science.gov (United States)

    Shnorhavorian, Margarett; Kroon, Leah; Jeffries, Howard; Johnson, Rebecca

    2012-11-01

    There is limited literature on strategies to overcome the barriers to sperm banking among adolescent and young adult (AYA) males with cancer. By standardizing our process for offering sperm banking to AYA males before cancer treatment, we aimed to improve rates of sperm banking at our institution. Continuous process improvement is a technique that has recently been applied to improve health care delivery. We used continuous process improvement methodologies to create a standard process for fertility preservation for AYA males with cancer at our institution. We compared rates of sperm banking before and after standardization. In the 12-month period after implementation of a standardized process, 90% of patients were offered sperm banking. We demonstrated an 8-fold increase in the proportion of AYA males' sperm banking, and a 5-fold increase in the rate of sperm banking at our institution. Implementation of a standardized process for sperm banking for AYA males with cancer was associated with increased rates of sperm banking at our institution. This study supports the role of standardized health care in decreasing barriers to sperm banking.

  9. Imaging in syndrome complex diabetes mellitus. Current standards and future perspectives; Bildgebung im Syndromkomplex Diabetes mellitus. Stellenwert und Chancen

    Energy Technology Data Exchange (ETDEWEB)

    Hetterich, H.; Schafnitzel, A. [Klinikum der Ludwig-Maximilians-Universitaet, Campus Grosshadern, Institut fuer Klinische Radiologie, Muenchen (Germany); Bamberg, F. [Eberhard-Karls-Universitaet, Abteilung fuer Diagnostische und Interventionelle Radiologie, Tuebingen (Germany)

    2015-04-01

    Diabetes mellitus is a highly prevalent multisystemic disorder with numerous potential complications and substantial socioeconomic consequences. In many cases, the patient history, physical examination and laboratory tests are not sufficient for a comprehensive evaluation of complicating disorders. Imaging modalities, such as sonography, computed tomography (CT) and magnetic resonance imaging (MRI) are of major significance in the evaluation of complicating disorders of diabetes according to current guidelines. Examples include assessment of coronary artery disease, peripheral artery disease, stroke and diabetic foot syndrome. Technical developments allow a substantial reduction in radiation dose and scan time in CT and MRI, respectively and could therefore justify a broader application in this patient population. In the future CT and MRI could also be used for the early detection of diabetic complications. Furthermore, they could also be used for risk stratification, e.g. measurement of hepatic fat content and evaluation of atherosclerosis in whole body MRI. Prior to widespread application of advanced imaging techniques in this patient population, improved outcomes with respect to survival, quality of life and cost-effectiveness need to be demonstrated. Diagnostic imaging modalities for the evaluation of the syndrome complex of diabetic disorders should be used according to the current guidelines but the use is predicted to increase given the high potential in this population. (orig.) [German] Diabetes mellitus ist eine hochpraevalente Multisystemerkrankung mit zahlreichen Komplikationen und bedeutenden soziooekonomischen Konsequenzen. Die Folgeerkrankungen koennen oft nicht abschliessend mittels Anamnese, koerperlicher Untersuchung und laborchemischen Verfahren evaluiert werden. Radiologische Verfahren wie die Sonographie, Computertomographie (CT) und Magnetresonanztomographie (MRT) haben gemaess verschiedener Leitlinien einen festen Stellenwert bei der

  10. Current Understanding on the Role of Standard and Immunoproteasomes in Inflammatory/Immunological Pathways of Multiple Sclerosis

    Directory of Open Access Journals (Sweden)

    Elena Bellavista

    2014-01-01

    Full Text Available The ubiquitin-proteasome system is the major intracellular molecular machinery for protein degradation and maintenance of protein homeostasis in most human cells. As ubiquitin-proteasome system plays a critical role in the regulation of the immune system, it might also influence the development and progression of multiple sclerosis (MS. Both ex vivo analyses and animal models suggest that activity and composition of ubiquitin-proteasome system are altered in MS. Proteasome isoforms endowed of immunosubunits may affect the functionality of different cell types such as CD8+ and CD4+ T cells and B cells as well as neurons during MS development. Furthermore, the study of proteasome-related biomarkers, such as proteasome antibodies and circulating proteasomes, may represent a field of interest in MS. Proteasome inhibitors are already used as treatment for cancer and the recent development of inhibitors selective for immunoproteasome subunits may soon represent novel therapeutic approaches to the different forms of MS. In this review we describe the current knowledge on the potential role of proteasomes in MS and discuss the pro et contra of possible therapies for MS targeting proteasome isoforms.

  11. ['Gold standard', not 'golden standard'

    NARCIS (Netherlands)

    Claassen, J.A.H.R.

    2005-01-01

    In medical literature, both 'gold standard' and 'golden standard' are employed to describe a reference test used for comparison with a novel method. The term 'gold standard' in its current sense in medical research was coined by Rudd in 1979, in reference to the monetary gold standard. In the same

  12. Effects of arginine vasotocin and mesotocin on the activation and development of amiloride-blockable short-circuit current across larval, adult, and cultured larval bullfrog skins.

    Science.gov (United States)

    Takada, Makoto; Fujimaki-Aoba, Kayo; Hokari, Shigeru

    2010-03-01

    Amphibian skin has osmoregulatory functions, with Na(+) crossing from outside to inside. Na(+) transport can be measured as the short-circuit current (SCC). We investigated the short-term and long-term effects of arginine vasotocin (AVT) and mesotocin (MT) (which modulate Na(+) transport) on the activation and development of an amiloride-blockable SCC (adult-type feature) in larval, adult, and corticoid-cultured larval bullfrog skins. We found: (1) AVT-receptor (AVT-R) and MT-receptor (MT-R) mRNAs could be detected in both larval and adult skins, (2) in the short term (within 60 min), the larval SCC (amiloride-stimulated SCC) was increased by AVT, forskolin, and MT, suggesting that AVT and MT did not activate the inactive ENaC (epithelial sodium channel) protein thought to be expressed in larval skin, (3) in the short term (within 90 min), AVT, forskolin, and MT stimulated the adult SCC (amiloride-blockable SCC), (4) AVT and MT increased both the larval and adult SCC via receptors insensitive to OPC-21268 (an antagonist of the V(1)-type receptor), OPC-31260 (an antagonist of the V(2)-type receptor), and ([d(CH(2))(5),Tyr(Me)(2),Thr(4),Orn(8),des-Gly-NH (2) (9) ]VT) (an antagonist of the oxytocin receptor), (5) culturing EDTA-treated larval skin with corticoids supplemented with AVT (1 microM) or MT (1 microM) for 2 weeks (long-term effects of AVT and MT) did not alter the corticoid-induced development of an amiloride-blockable SCC (adult-type feature). AVT and MT thus have the potential to stimulate SCC though channels that are already expressed, but they may not influence the development of the amiloride-blockable SCC (an adult-type feature) in larval skin.

  13. Current and Potential Support for Chronic Disease Management in the United States: The Perspective of Family and Friends of Chronically Ill Adults

    Science.gov (United States)

    Rosland, Ann-Marie; Heisler, Michele; Janevic, Mary; Connell, Cathleen; Langa, Kenneth M.; Kerr, Eve A.; Piette, John D.

    2013-01-01

    Objectives Family members and friends can be an important source of self-management support for older adults with chronic diseases. We characterized the U.S. population of potential and current “disease management supporters” for people with chronic illness who are ADL-independent, the help that supporters could provide, and barriers to increasing support. Methods Nationally-representative survey of U.S. adults (N=1,722). Results 44% of respondents (representing 100 million US adults) help a family member or friend with chronic disease management; another 9% (representing 21 million US adults) are willing to start. Most are willing to assist with key tasks such as medication use and communicating with providers, although they feel constrained by privacy concerns and a lack of patient health information. Discussion The majority of U.S. adults already help or would be willing to help one of their family members or friends with chronic illness care. Supporters' specific concerns could be addressed through innovative programs. PMID:23795624

  14. Routine Immunization of Adults in Canada: Review of the Epidemiology of Vaccine-Preventable Diseases and Current Recommendations for Primary Prevention

    Directory of Open Access Journals (Sweden)

    Michael D Parkins

    2009-01-01

    Full Text Available Vaccination is one of the greatest achievements in public health of the 20th century. However, the success of vaccine uptake and adherence to immunization guidelines seen in pediatric populations has not been observed among adult Canadians. As a result of the disparity in susceptibility to vaccine-preventable disease, there has been an increasing shift of vaccine-preventable childhood diseases into adult populations. Accordingly, morbidity and mortality due to vaccine-preventable illnesses now occur disproportionately in adults. All Canadians, irrespective of age, should have immunity to measles, mumps, rubella, tetanus, diphtheria, pertussis and varicella. All adult Canadians with significant medical comorbidities or those older than 65 years of age should receive the pneumococcal polysaccharide vaccine and yearly trivalent inactivate influenza vaccines. The present review summarizes the burden of illness of these vaccine-preventable diseases in the Canadian adult population and reviews the current immunization recommendations. Vaccination of all Canadians to these common agents remains a vital tool to decrease individual morbidity and mortality and reduce the overall burden of preventable disease in Canada.

  15. Determination of metal impurities in MOX powder by direct current arc atomic emission spectroscopy. Application of standard addition method for direct analysis of powder sample

    International Nuclear Information System (INIS)

    Furuse, Takahiro; Taguchi, Shigeo; Kuno, Takehiko; Surugaya, Naoki

    2016-12-01

    Metal impurities in MOX powder obtained from uranium and plutonium recovered from reprocessing process of spent nuclear fuel have to be determined for its characterization. Direct current arc atomic emission spectroscopy (DCA-AES) is one of the useful methods for direct analysis of powder sample without dissolving the analyte into aqueous solution. However, the selection of standard material, which can overcome concerns such as matrix matching, is quite important to create adequate calibration curves for DCA-AES. In this study, we apply standard addition method using the certified U_3O_8 containing known amounts of metal impurities to avoid the matrix problems. The proposed method provides good results for determination of Fe, Cr and Ni contained in MOX samples at a significant quantity level. (author)

  16. Inflammation-induced increase in nicotinic acetylcholine receptor current in cutaneous nociceptive DRG neurons from the adult rat.

    Science.gov (United States)

    Zhang, X-L; Albers, K M; Gold, M S

    2015-01-22

    The goals of the present study were to determine (1) the properties of the nicotinic acetylcholine receptor (nAChR) currents in rat cutaneous dorsal root ganglion (DRG) neurons; (2) the impact of nAChR activation on the excitability of cutaneous DRG neurons; and (3) the impact of inflammation on the density and distribution of nAChR currents among cutaneous DRG neurons. Whole-cell patch-clamp techniques were used to study retrogradely labeled DRG neurons from naïve and complete Freund's adjuvant inflamed rats. Nicotine-evoked currents were detectable in ∼70% of the cutaneous DRG neurons, where only one of two current types, fast or slow currents based on rates of activation and inactivation, was present in each neuron. The biophysical and pharmacological properties of the fast current were consistent with nAChRs containing an α7 subunit while those of the slow current were consistent with nAChRs containing α3/β4 subunits. The majority of small diameter neurons with fast current were IB4- while the majority of small diameter neurons with slow current were IB4+. Preincubation with nicotine (1 μM) produced a transient (1 min) depolarization and increase in the excitability of neurons with fast current and a decrease in the amplitude of capsaicin-evoked current in neurons with slow current. Inflammation increased the current density of both slow and fast currents in small diameter neurons and increased the percentage of neurons with the fast current. With the relatively selective distribution of nAChR currents in putative nociceptive cutaneous DRG neurons, our results suggest that the role of these receptors in inflammatory hyperalgesia is likely to be complex and dependent on the concentration and timing of acetylcholine release in the periphery. Copyright © 2014 IBRO. Published by Elsevier Ltd. All rights reserved.

  17. The application of strength and power related field tests in older adults : criteria, current status and a future perspective

    NARCIS (Netherlands)

    Regterschot, G. Ruben H.; Morat, Tobias; Folkersma, Marjanne; Zijlstra, Wiebren

    2015-01-01

    Leg muscle strength (LMS) and leg muscle power (LMP) are determinants of aspects of functional status and important parameters for measuring intervention effects in older adults. Field tests are often used for the evaluation of LMS and LMP in older persons. However, criteria important for the

  18. Assessing asthma control and associated risk factors among persons with current asthma - findings from the child and adult Asthma Call-back Survey.

    Science.gov (United States)

    Zahran, Hatice S; Bailey, Cathy M; Qin, Xiaoting; Moorman, Jeanne E

    2015-04-01

    Monitoring the level of asthma control is important in determining the effectiveness of current treatment which may decrease the frequency and intensity of symptoms and functional limitations. Uncontrolled asthma has been associated with decreased quality of life and increased health care use. The objectives of this study were to assess the level of asthma control and identify related risk factors among persons with current asthma. Using the 2006 to 2010 BRFSS child and adult Asthma Call-back Survey, asthma control was classified as well-controlled or uncontrolled (not-well-controlled or very-poorly-controlled) using three impairment measures: daytime symptoms, night-time symptoms, and taking short-acting β2-agonists for symptom control. Multivariate logistic regression identified predictors of asthma control. Fifty percent of adults and 38.4% of children with current asthma had uncontrolled asthma. About 63% of children and 53% of adults with uncontrolled asthma were on long-term asthma control medications. Among children, uncontrolled asthma was significantly associated with being younger than 5 years, having annual household income asthma (low educational attainment, low income, cigarette smoking, and co-morbid conditions including obesity and depression) could improve asthma control.

  19. Comparison of standardized uptake values measured on 18F-NaF PET/CT scans using three different tube current intensities

    OpenAIRE

    Agnes Araujo Valadares; Paulo Schiavom Duarte; Eduardo Bechtloff Woellner; George Barberio Coura-Filho; Marcelo Tatit Sapienza; Carlos Alberto Buchpiguel

    2015-01-01

    Objective: To analyze standardized uptake values (SUVs) using three different tube current intensities for attenuation correction on 18FNaF PET/CT scans. Materials and Methods: A total of 254 18F-NaF PET/CT studies were analyzed using 10, 20 and 30 mAs. The SUVs were calculated in volumes of interest (VOIs) drawn on three skeletal regions, namely, right proximal humeral diaphysis (RH), right proximal femoral diaphysis (RF), and first lumbar vertebra (LV1) in a total of 712 VOIs. The analyses ...

  20. Dual Energy X-Ray Absorptiometry Compared with Anthropometry in Relation to Cardio-Metabolic Risk Factors in a Young Adult Population: Is the 'Gold Standard' Tarnished?

    Science.gov (United States)

    Demmer, Denise L; Beilin, Lawrence J; Hands, Beth; Burrows, Sally; Pennell, Craig E; Lye, Stephen J; Mountain, Jennifer A; Mori, Trevor A

    2016-01-01

    Assessment of adiposity using dual energy x-ray absorptiometry (DXA) has been considered more advantageous in comparison to anthropometry for predicting cardio-metabolic risk in the older population, by virtue of its ability to distinguish total and regional fat. Nonetheless, there is increasing uncertainty regarding the relative superiority of DXA and little comparative data exist in young adults. This study aimed to identify which measure of adiposity determined by either DXA or anthropometry is optimal within a range of cardio-metabolic risk factors in young adults. 1138 adults aged 20 years were assessed by DXA and standard anthropometry from the Western Australian Pregnancy Cohort (Raine) Study. Cross-sectional linear regression analyses were performed. Waist to height ratio was superior to any DXA measure with HDL-C. BMI was the superior model in relation to blood pressure than any DXA measure. Midriff fat mass (DXA) and waist circumference were comparable in relation to glucose. For all the other cardio-metabolic variables, anthropometric and DXA measures were comparable. DXA midriff fat mass compared with BMI or waist hip ratio was the superior measure for triglycerides, insulin and HOMA-IR. Although midriff fat mass (measured by DXA) was the superior measure with insulin sensitivity and triglycerides, the anthropometric measures were better or equal with various DXA measures for majority of the cardio-metabolic risk factors. Our findings suggest, clinical anthropometry is generally as useful as DXA in the evaluation of the individual cardio-metabolic risk factors in young adults.

  1. Validation of five minimally obstructive methods to estimate physical activity energy expenditure in young adults in semi-standardized settings

    DEFF Research Database (Denmark)

    Schneller, Mikkel Bo; Pedersen, Mogens Theisen; Gupta, Nidhi

    2015-01-01

    We compared the accuracy of five objective methods, including two newly developed methods combining accelerometry and activity type recognition (Acti4), against indirect calorimetry, to estimate total energy expenditure (EE) of different activities in semi-standardized settings. Fourteen particip...

  2. Anodal Transcranial Direct Current Stimulation Shows Minimal, Measure-Specific Effects on Dynamic Postural Control in Young and Older Adults: A Double Blind, Sham-Controlled Study.

    Science.gov (United States)

    Craig, Chesney E; Doumas, Michail

    2017-01-01

    We investigated whether stimulating the cerebellum and primary motor cortex (M1) using transcranial direct current stimulation (tDCS) could affect postural control in young and older adults. tDCS was employed using a double-blind, sham-controlled design, in which young (aged 18-35) and older adults (aged 65+) were assessed over three sessions, one for each stimulatory condition-M1, cerebellar and sham. The effect of tDCS on postural control was assessed using a sway-referencing paradigm, which induced platform rotations in proportion to the participant's body sway, thus assessing sensory reweighting processes. Task difficulty was manipulated so that young adults experienced a support surface that was twice as compliant as that of older adults, in order to minimise baseline age differences in postural sway. Effects of tDCS on postural control were assessed during, immediately after and 30 minutes after tDCS. Additionally, the effect of tDCS on corticospinal excitability was measured by evaluating motor evoked potentials using transcranial magnetic stimulation immediately after and 30 minutes after tDCS. Minimal effects of tDCS on postural control were found in the eyes open condition only, and this was dependent on the measure assessed and age group. For young adults, stimulation had only offline effects, as cerebellar stimulation showed higher mean power frequency (MPF) of sway 30 minutes after stimulation. For older adults, both stimulation conditions delayed the increase in sway amplitude witnessed between blocks one and two until stimulation was no longer active. In conclusion, despite tDCS' growing popularity, we would caution researchers to consider carefully the type of measures assessed and the groups targeted in tDCS studies of postural control.

  3. Gender Dysphoria in Adults.

    Science.gov (United States)

    Zucker, Kenneth J; Lawrence, Anne A; Kreukels, Baudewijntje P C

    2016-01-01

    Gender dysphoria (GD), a term that denotes persistent discomfort with one's biologic sex or assigned gender, replaced the diagnosis of gender identity disorder in the Diagnostic and Statistical Manual of Mental Disorders in 2013. Subtypes of GD in adults, defined by sexual orientation and age of onset, have been described; these display different developmental trajectories and prognoses. Prevalence studies conclude that fewer than 1 in 10,000 adult natal males and 1 in 30,000 adult natal females experience GD, but such estimates vary widely. GD in adults is associated with an elevated prevalence of comorbid psychopathology, especially mood disorders, anxiety disorders, and suicidality. Causal mechanisms in GD are incompletely understood, but genetic, neurodevelopmental, and psychosocial factors probably all contribute. Treatment of GD in adults, although largely standardized, is likely to evolve in response to the increasing diversity of persons seeking treatment, demands for greater client autonomy, and improved understanding of the benefits and limitations of current treatment modalities.

  4. Efficacy of standardized extract of Hibiscus sabdariffa L. (Malvaceae) in improving iron status of adults in malaria endemic area: A randomized controlled trial.

    Science.gov (United States)

    Peter, Emanuel L; Rumisha, Susan F; Mashoto, Kijakazi O; Minzi, Omary Ms; Mfinanga, Sayoki

    2017-09-14

    Indigenous community of Mkuranga district have been using aqueous extract of H. sabdariffa L. for treating anemia. However, there have been neither safety nor efficacy studies to validate this medicinal product in anemia. The purpose of this study was to establish efficacy and safety of standardized aqueous extract of H. sabdariffa L. in anemic adults. This was a randomized controlled clinical trial in which 130 adults' men and women aged 18-50 years were involved after meeting the inclusion criteria. Initially, standardized aqueous extract of H. sabdariffa L. was prepared using optimized extraction parameters. Stratified randomization was used to randomize participants into four fixed dose groups. The first group received oral dose of 1000ml while the 2nd group was randomized to receive 1500ml orally. The last two groups were given a dose of 2000ml of extract and 200mg ferrous sulphate tablet respectively. Primary endpoint was the actual change of iron status indicators at the end of 30 days follow up period as compared to those recorded at baseline. Adverse effects were assessed at every 10th day scheduled visit. In all arms, HB and hematopoietic parameters were measured using HemoCue hemoglobinometer® (HemoCue, Ängelholm, Sweden) and hematology analyzer® respectively at the trial site. Follow up was done for 30 days. A total of 82 participants were included for analysis. A standardized aqueous extract of H. sabdariffa L. did not improve iron status in anemic adults in malaria endemic region (P>0.005). However, there was evidence to support the safety of the extract for human consumptions as herbal supplement. Iron and organic acids contents of H. sabdariffa L. extract showed the potential of improving hematopoietic parameters. Studies with bigger sample size are therefore needed to establish the efficacy of the extract when concurrently used with malaria chemoprophylaxis in malaria endemic areas. Copyright © 2017 Elsevier Ireland Ltd. All rights reserved.

  5. Patient-reported outcomes in adults with congenital heart disease: Inter-country variation, standard of living and healthcare system factors.

    Science.gov (United States)

    Moons, Philip; Kovacs, Adrienne H; Luyckx, Koen; Thomet, Corina; Budts, Werner; Enomoto, Junko; Sluman, Maayke A; Yang, Hsiao-Ling; Jackson, Jamie L; Khairy, Paul; Cook, Stephen C; Subramanyan, Raghavan; Alday, Luis; Eriksen, Katrine; Dellborg, Mikael; Berghammer, Malin; Johansson, Bengt; Mackie, Andrew S; Menahem, Samuel; Caruana, Maryanne; Veldtman, Gruschen; Soufi, Alexandra; Fernandes, Susan M; White, Kamila; Callus, Edward; Kutty, Shelby; Van Bulck, Liesbet; Apers, Silke

    2018-01-15

    Geographical differences in patient-reported outcomes (PROs) of adults with congenital heart disease (ConHD) have been observed, but are poorly understood. We aimed to: (1) investigate inter-country variation in PROs in adults with ConHD; (2) identify patient-related predictors of PROs; and (3) explore standard of living and healthcare system characteristics as predictors of PROs. Assessment of Patterns of Patient-Reported Outcomes in Adults with Congenital Heart disease - International Study (APPROACH-IS) was a cross-sectional, observational study, in which 4028 patients from 15 countries in 5 continents were enrolled. Self-report questionnaires were administered: patient-reported health (12-item Short Form Health Survey; EuroQOL-5D Visual Analog Scale); psychological functioning (Hospital Anxiety and Depression Scale); health behaviors (Health Behavior Scale-Congenital Heart Disease) and quality of life (Linear Analog Scale for quality of life; Satisfaction With Life Scale). A composite PRO score was calculated. Standard of living was expressed as Gross Domestic Product per capita and Human Development Index. Healthcare systems were operationalized as the total health expenditure per capita and the overall health system performance. Substantial inter-country variation in PROs was observed, with Switzerland having the highest composite PRO score (81.0) and India the lowest (71.3). Functional class, age, and unemployment status were patient-related factors that independently and consistently predicted PROs. Standard of living and healthcare system characteristics predicted PROs above and beyond patient characteristics. This international collaboration allowed us to determine that PROs in ConHD vary as a function of patient-related factors as well as the countries in which patients live. Copyright © 2017 Elsevier B.V. All rights reserved.

  6. The Process of Cessation Among Current Tobacco Smokers: A Cross-Sectional Data Analysis From 21 Countries, Global Adult Tobacco Survey, 2009–2013

    Science.gov (United States)

    Palipudi, Krishna M.; Nelson-Blutcher, Glenda; Murty, Komanduri S.; Asma, Samira

    2015-01-01

    We analyzed data from the Global Adult Tobacco Survey (GATS) from 21 countries to categorize smokers by stages of cessation and highlight interventions that could be tailored to each stage. GATS is a nationally representative household survey that measures tobacco use and other key indicators by using a standardized protocol. The distribution of smokers into precontemplation, contemplation, and preparation stages varied by country. Using the stages of change model, each country can design and implement effective interventions suitable to its cultural, social, and economic situations to help smokers advance successfully through the stages of cessation. PMID:26378897

  7. The Process of Cessation Among Current Tobacco Smokers: A Cross-Sectional Data Analysis From 21 Countries, Global Adult Tobacco Survey, 2009-2013.

    Science.gov (United States)

    Mbulo, Lazarous; Palipudi, Krishna M; Nelson-Blutcher, Glenda; Murty, Komanduri S; Asma, Samira

    2015-09-17

    We analyzed data from the Global Adult Tobacco Survey (GATS) from 21 countries to categorize smokers by stages of cessation and highlight interventions that could be tailored to each stage. GATS is a nationally representative household survey that measures tobacco use and other key indicators by using a standardized protocol. The distribution of smokers into precontemplation, contemplation, and preparation stages varied by country. Using the stages of change model, each country can design and implement effective interventions suitable to its cultural, social, and economic situations to help smokers advance successfully through the stages of cessation.

  8. Open radical cystectomy in England: the current standard of care - an analysis of the British Association of Urological Surgeons (BAUS) cystectomy audit and Hospital Episodes Statistics (HES) data.

    Science.gov (United States)

    Jefferies, Edward R; Cresswell, Joanne; McGrath, John S; Miller, Catherine; Hounsome, Luke; Fowler, Sarah; Rowe, Edward W

    2018-01-23

    To establish the current standard for open radical cystectomy (ORC) in England, as data entry by surgeons performing RC to the British Association of Urological Surgeons (BAUS) database was mandated in 2013 and combining this with Hospital Episodes Statistics (HES) data has allowed comprehensive outcome analysis for the first time. All patients were included in this analysis if they were uploaded to the BAUS data registry and reported to have been performed in the 2 years between 1 January 2014 and 31 December 2015 in England (from mandate onwards) and had been documented as being performed in an open fashion (not laparoscopic, robot assisted or the technique field left blank). The HES data were accessed via the HES website. Office of Population Censuses and Surveys Classification of Surgical Operations and Procedures version 4 (OPCS-4) Code M34 was searched during the same 2-year time frame (not including M34.4 for simple cystectomy or with additional minimal access codes Y75.1-9 documenting a laparoscopic or robotic approach was used) to assess data capture. A total of 2 537 ORCs were recorded in the BAUS registry and 3 043 in the HES data. This indicates a capture rate of 83.4% of all cases. The median operative time was 5 h, harvesting a median of 11-20 lymph nodes, with a median blood loss of 500-1 000 mL, and a transfusion rate of 21.8%. The median length of stay was 11 days, with a 30-day mortality rate of 1.58%. This is the largest, contemporary cohort of ORCs in England, encompassing >80% of all performed operations. We now know the current standard for ORC in England. This provides the basis for individual surgeons and units to compare their outcomes and a standard with which future techniques and modifications can be compared. © 2018 The Authors BJU International © 2018 BJU International Published by John Wiley & Sons Ltd.

  9. Associations between self-reported lifetime history of traumatic brain injuries and current disability assessment in a population sample of Canadian adults.

    Science.gov (United States)

    Ilie, Gabriela; Adlaf, Edward M; Mann, Robert E; Ialomiteanu, Anca; Hamilton, Hayley; Rehm, Jürgen; Asbridge, Mark; Cusimano, Michael D

    2018-01-01

    This study describes the association between history of lifetime traumatic brain injury (TBI) and current disabling functional restrictions among Ontario adults. A two-stage rolling cross-sectional sample of 6,048 adults aged 18 to 93 were interviewed by computer assisted telephone interviewing between 2011-2013 regarding their mental health and substance use in Ontario, Canada. TBI criteria were defined by loss of consciousness for minimum five minutes or at least one overnight hospitalization. Dimensions of functionality restrictions in the last 30 days were measured with the WHO Disability Assessment Schedule (WHODAS). The estimated mean for global disability in this sample of Ontario adults was 2.75 (SD = 5.4, range 0-40). The estimated means of global disability for individuals who reported a history of lifetime TBI was 4.16 (SD = 7.12) and compared with 2.46 (SD = 4.98) for individuals who never had a TBI (p history of lifetime TBI had greater odds of global and item disability including restricted cognition, decreased self-care, difficulties with social relationships, fewer life activities and reduced participation in society compared to adults without a history of TBI (p history of lifetime TBI with self-reported disability within the past 30 days provide evidence that careful consideration, planning and understanding of short and long term health needs of TBI survivors are critical.

  10. Anodal Direct Current Stimulation of the Cerebellum Reduces Cerebellar Brain Inhibition but Does Not Influence Afferent Input from the Hand or Face in Healthy Adults.

    Science.gov (United States)

    Doeltgen, Sebastian H; Young, Jessica; Bradnam, Lynley V

    2016-08-01

    The cerebellum controls descending motor commands by outputs to primary motor cortex (M1) and the brainstem in response to sensory feedback. The cerebellum may also modulate afferent input en route to M1 and the brainstem. The objective of this study is to determine if anodal transcranial direct current stimulation (tDCS) to the cerebellum influences cerebellar brain inhibition (CBI), short afferent inhibition (SAI) and trigeminal reflexes (TRs) in healthy adults. Data from two studies evaluating effects of cerebellar anodal and sham tDCS are presented. The first study used a twin coil transcranial magnetic stimulation (TMS) protocol to investigate CBI and combined TMS and cutaneous stimulation of the digit to assess SAI. The second study evaluated effects on trigemino-cervical and trigemino-masseter reflexes using peripheral nerve stimulation of the face. Fourteen right-handed healthy adults participated in experiment 1. CBI was observed at baseline and was reduced by anodal cerebellar DCS only (P < 0.01). There was SAI at interstimulus intervals of 25 and 30 ms at baseline (both P < 0.0001), but cerebellar tDCS had no effect. Thirteen right-handed healthy adults participated in experiment 2. Inhibitory reflexes were evoked in the ipsilateral masseter and sternocleidomastoid muscles. There was no effect of cerebellar DCS on either reflex. Anodal DCS reduced CBI but did not change SAI or TRs in healthy adults. These results require confirmation in individuals with neurological impairment.

  11. The U.S. Forest Service's analysis of cumulative effects to wildlife: A study of legal standards, current practice, and ongoing challenges on a National Forest

    International Nuclear Information System (INIS)

    Schultz, Courtney A.

    2012-01-01

    Cumulative effects analysis (CEA) allows natural resource managers to understand the status of resources in historical context, learn from past management actions, and adapt future activities accordingly. U.S. federal agencies are required to complete CEA as part of environmental impact assessment under the National Environmental Policy Act (NEPA). Past research on CEA as part of NEPA has identified significant deficiencies in CEA practice, suggested methodologies for handling difficult aspects of CEA, and analyzed the rise in litigation over CEA in U.S. courts. This article provides a review of the literature and legal standards related to CEA as it is done under NEPA and then examines current practice on a U.S. National Forest, utilizing qualitative methods in order to provide a detailed understanding of current approaches to CEA. Research objectives were to understand current practice, investigate ongoing challenges, and identify impediments to improvement. Methods included a systematic review of a set of NEPA documents and semi-structured interviews with practitioners, scientists, and members of the public. Findings indicate that the primary challenges associated with CEA include: issues of both geographic and temporal scale of analysis, confusion over the purpose of the requirement, the lack of monitoring data, and problems coordinating and disseminating data. Improved monitoring strategies and programmatic analyses could support improved CEA practice.

  12. Risk Factors for Falls in Older Adults with Lower Extremity Arthritis: A Conceptual Framework of Current Knowledge and Future Directions

    Science.gov (United States)

    Gyurcsik, Nancy C.

    2012-01-01

    ABSTRACT Purpose: As the numbers of Canadians aged 65 years and over increases over the next 20 years, the prevalence of chronic conditions, including arthritis, will rise as will the number of falls. Although known fall-risk factors are associated with hip and knee osteoarthritis (OA), minimal research has evaluated fall and fracture risk and/or rates in this population. Thus, the purpose was to summarize research on fall and fracture risk in older adults with hip or knee OA and to develop a conceptual framework of fall-risk screening and assessment. Method: The International Classification of Functioning, Disability and Health, clinical practice guidelines for fall-risk screening, and a selected literature review were used. Results: Gaps exist in our knowledge of fall and fracture risk for this population. Muscle performance, balance, and mobility impairments have been identified, but little is known about whether personal and environmental contextual factors impact fall and fracture risk. Physical activity may help to prevent falls, but non-adherence is a problem. Conclusion: A need exists to assess fall risk in older adults with hip and knee OA. Promoting regular physical activity by focusing on disease- and activity-specific personal contextual factors may help direct treatment planning. PMID:23729967

  13. The effectiveness of virtual reality interventions in improving balance in adults with impaired balance compared with standard or no treatment: a systematic review and meta-analysis.

    Science.gov (United States)

    Booth, Vicky; Masud, Tahir; Connell, Louise; Bath-Hextall, Fiona

    2014-05-01

    To evaluate whether virtual reality interventions, including interactive gaming systems, are effective at improving balance in adults with impaired balance. Systematic review and meta-analysis of randomized control trials. Studies were identified from electronic databases (CENTRAL, MEDLINE, EMBASE, AMED, CINAHL, PyschINFO, PyschBITE, OTseeker, Ei Compendex, and Inspec) searched to November 2011, and repeated in November 2012. Two reviewers selected studies meeting inclusion criteria and quality of included studies assessed using a Joanna Briggs Institute appraisal tool. Data was pooled and a meta-analysis completed. The systematic review was reported following guidance of the PRISMA statement. A total of 251 articles were screened. Eight randomized control trials were included. These studies presented the results of 239 participants, with various aetiologies, and used a variety of virtual reality systems. The number of falls was documented in only one included study. Meta-analysis was completed on data from the Berg Balance Scale, walking speed, 30 second sit-to-stand test, and Timed Up and Go Test, and favoured standard therapy when compared with standard plus virtual reality interventions. There was a notable inconsistency in the outcome measures, experimental, and control interventions used within the included studies. The pooled results of the studies showed no significant difference. Therefore this review cannot support nor refute the use of virtual reality interventions, rather than conventional physiotherapy, to improve balance in adults with impaired balance.

  14. Childhood trauma, parental death, and their co-occurrence in relation to current suicidality risk in adults: a nationwide community sample of Korea.

    Science.gov (United States)

    Jeon, Hong Jin; Lee, Christina; Fava, Maurizio; Mischoulon, David; Shim, Eun-Jung; Heo, Jung-Yoon; Choi, Hong; Park, Jae-Hyun

    2014-12-01

    Although previous studies have suggested that childhood trauma and parental death are strongly associated with suicidality in adulthood, it is still unclear how these factors interact within the same population. A total of 1396 adults were recruited through nationwide multistage probability sampling in South Korea. Subjects were evaluated through face-to-face interviews using the Suicidality Module of the Mini-International Neuropsychiatric Interview and the Early Trauma Inventory Self Report-Short Form. Among the 1396 adults, the group that experienced both childhood trauma and parental death had the highest current suicidality risks (F = 12.16, p suicide attempt (χ2 = 35.81, p suicidality risk and lifetime suicide attempt were significantly associated with concurrent childhood trauma and parental death (odds ratio, 3.64; 95% confidence interval, 1.99-6.65) as well as with only childhood trauma (odds ratio, 1.95; 95% confidence interval, 1.33-2.87), after adjusting for age, sex, education, marital status, household monthly income, and living area. Emotional abuse was the only type of childhood trauma significantly associated with higher current suicidality scores in those who experienced childhood parental death than in those who did not (F = 3.26, p = 0.041). Current suicidality risk and lifetime suicide attempt are associated with experiencing both parental death and trauma, especially emotional abuse, in childhood, whereas experiencing only childhood parental death is associated with neither.

  15. Energy retrofit of an office building by substitution of the generation system: performance evaluation via dynamic simulation versus current technical standards

    International Nuclear Information System (INIS)

    Testi, D; Schito, E; Grassi, W; Menchetti, E

    2014-01-01

    Constructions built in Italy before 1945 (about 30% of the total built stock) feature low energy efficiency. Retrofit actions in this field can lead to valuable energetic and economic savings. In this work, we ran a dynamic simulation of a historical building of the University of Pisa during the heating season. We firstly evaluated the energy requirements of the building and the performance of the existing natural gas boiler, validated with past billings of natural gas. We also verified the energetic savings obtainable by the substitution of the boiler with an air-to-water electrically-driven modulating heat pump, simulated through a cycle-based model, evaluating the main economic metrics. The cycle-based model of the heat pump, validated with manufacturers' data available only at specified temperature and load conditions, can provide more accurate results than the simplified models adopted by current technical standards, thus increasing the effectiveness of energy audits

  16. Restricted versus continued standard caloric intake during the management of refeeding syndrome in critically ill adults: a randomised, parallel-group, multicentre, single-blind controlled trial.

    Science.gov (United States)

    Doig, Gordon S; Simpson, Fiona; Heighes, Philippa T; Bellomo, Rinaldo; Chesher, Douglas; Caterson, Ian D; Reade, Michael C; Harrigan, Peter W J

    2015-12-01

    Equipoise exists regarding the benefits of restricting caloric intake during electrolyte replacement for refeeding syndrome, with half of intensive care specialists choosing to continue normal caloric intake. We aimed to assess whether energy restriction affects the duration of critical illness, and other measures of morbidity, compared with standard care. We did a randomised, multicentre, single-blind clinical trial in 13 hospital intensive care units (ICUs) in Australia (11 sites) and New Zealand (two sites). Adult critically ill patients who developed refeeding syndrome within 72 h of commencing nutritional support in the ICU were enrolled and allocated to receive continued standard nutritional support or protocolised caloric restriction. 1:1 computer-based randomisation was done in blocks of variable size, stratified by enrolment serum phosphate concentration (>0·32 mmol/L vs ≤0·32 mmol/L) and body-mass index (BMI; >18 kg/m(2)vs ≤18 kg/m(2)). The primary outcome was the number of days alive after ICU discharge, with 60 day follow-up, in a modified intention-to-treat population of all randomly allocated patients except those mistakenly enrolled. Days alive after ICU discharge was a composite outcome based on ICU length of stay, overall survival time, and mortality. The Refeeding Syndrome Trial was registered with the Australian and New Zealand Clinical Trials Registry (ANZCTR number 12609001043224). Between Dec 3, 2010, and Aug 13, 2014, we enrolled 339 adult critically ill patients: 170 were randomly allocated to continued standard nutritional support and 169 to protocolised caloric restriction. During the 60 day follow-up, the mean number of days alive after ICU discharge in 165 assessable patients in the standard care group was 39·9 (95% CI 36·4-43·7) compared with 44·8 (95% CI 40·9-49·1) in 166 assessable patients in the caloric restriction group (difference 4·9 days, 95% CI -2·3 to 13·6, p=0·19). Nevertheless, protocolised caloric

  17. Long-Term Visual Training Increases Visual Acuity and Long-Term Monocular Deprivation Promotes Ocular Dominance Plasticity in Adult Standard Cage-Raised Mice.

    Science.gov (United States)

    Hosang, Leon; Yusifov, Rashad; Löwel, Siegrid

    2018-01-01

    For routine behavioral tasks, mice predominantly rely on olfactory cues and tactile information. In contrast, their visual capabilities appear rather restricted, raising the question whether they can improve if vision gets more behaviorally relevant. We therefore performed long-term training using the visual water task (VWT): adult standard cage (SC)-raised mice were trained to swim toward a rewarded grating stimulus so that using visual information avoided excessive swimming toward nonrewarded stimuli. Indeed, and in contrast to old mice raised in a generally enriched environment (Greifzu et al., 2016), long-term VWT training increased visual acuity (VA) on average by more than 30% to 0.82 cycles per degree (cyc/deg). In an individual animal, VA even increased to 1.49 cyc/deg, i.e., beyond the rat range of VAs. Since visual experience enhances the spatial frequency threshold of the optomotor (OPT) reflex of the open eye after monocular deprivation (MD), we also quantified monocular vision after VWT training. Monocular VA did not increase reliably, and eye reopening did not initiate a decline to pre-MD values as observed by optomotry; VA values rather increased by continued VWT training. Thus, optomotry and VWT measure different parameters of mouse spatial vision. Finally, we tested whether long-term MD induced ocular dominance (OD) plasticity in the visual cortex of adult [postnatal day (P)162-P182] SC-raised mice. This was indeed the case: 40-50 days of MD induced OD shifts toward the open eye in both VWT-trained and, surprisingly, also in age-matched mice without VWT training. These data indicate that (1) long-term VWT training increases adult mouse VA, and (2) long-term MD induces OD shifts also in adult SC-raised mice.

  18. Dual Energy X-Ray Absorptiometry Compared with Anthropometry in Relation to Cardio-Metabolic Risk Factors in a Young Adult Population: Is the 'Gold Standard' Tarnished?

    Directory of Open Access Journals (Sweden)

    Denise L Demmer

    Full Text Available Assessment of adiposity using dual energy x-ray absorptiometry (DXA has been considered more advantageous in comparison to anthropometry for predicting cardio-metabolic risk in the older population, by virtue of its ability to distinguish total and regional fat. Nonetheless, there is increasing uncertainty regarding the relative superiority of DXA and little comparative data exist in young adults. This study aimed to identify which measure of adiposity determined by either DXA or anthropometry is optimal within a range of cardio-metabolic risk factors in young adults.1138 adults aged 20 years were assessed by DXA and standard anthropometry from the Western Australian Pregnancy Cohort (Raine Study. Cross-sectional linear regression analyses were performed. Waist to height ratio was superior to any DXA measure with HDL-C. BMI was the superior model in relation to blood pressure than any DXA measure. Midriff fat mass (DXA and waist circumference were comparable in relation to glucose. For all the other cardio-metabolic variables, anthropometric and DXA measures were comparable. DXA midriff fat mass compared with BMI or waist hip ratio was the superior measure for triglycerides, insulin and HOMA-IR.Although midriff fat mass (measured by DXA was the superior measure with insulin sensitivity and triglycerides, the anthropometric measures were better or equal with various DXA measures for majority of the cardio-metabolic risk factors. Our findings suggest, clinical anthropometry is generally as useful as DXA in the evaluation of the individual cardio-metabolic risk factors in young adults.

  19. Increased height standard deviation scores in response to growth hormone therapy to near-adult height in older children with delayed skeletal maturation: results from the ANSWER Program.

    Science.gov (United States)

    Ross, Judith L; Lee, Peter A; Gut, Robert; Germak, John

    2015-01-01

    A primary goal of recombinant human growth hormone therapy (GHT) in children is attaining normal adult height. In this study, children with growth hormone deficiency (GHD) (including isolated idiopathic growth hormone deficiency [IGHD] and multiple pituitary hormone deficiency [MPHD]), idiopathic short stature (ISS), and Turner syndrome (TS) were evaluated for near-adult height (NAH) and percent achieving NAH within the normal range after approximately 4 years of GHT. Data from the American Norditropin® Web-Enabled Research (ANSWER) Program were analyzed for NAH from age at treatment start (ATS) (i.e., referral age as defined by age at enrollment in the study) to last clinic visit using one of the following two criteria: 1) age ≥18 years, or 2) if male: ≥16 years and height velocity (HV) standard deviation score (HSDS) ≤ -2, and either GHD (n = 201), ISS (n = 19), or TS (n = 41). The main outcome measures included HSDS and corrected HSDS (HSDS-target HSDS) in response to GH treatment, and correlation of ATS with NAH HSDS. Mean (± SD) chronological and bone ages at baseline were 14.0 ± 2.1 years and 11.7 ± 2.0 years, respectively, and mean GHT duration was 4.0 ± 1.6 years. Mean HSDS (baseline to NAH; GHD: -2.7 to -1.0; ISS: -2.8 to -1.4; TS: -3.0 to -1.8) and mean corrected HSDS (baseline to NAH; GHD: -2.1 to -0.3; ISS: -2.1 to -0.6; TS: -1.8 to -0.6) increased across diagnostic indications. Percentages of patients reaching near-adult HSDS > -2 were GHD: 87.6%; ISS: 78.9%; TS: 65.8%. Significant negative correlations were found between ATS and NAH HSDS when analyzed by sex. Despite a relatively advanced childhood age, the majority of GH-treated patients attained mean near-adult HSDS within the normal range (HSDS > -2). Negative correlations of ATS with near-adult HSDS indicate that an earlier age at treatment start would likely have resulted in greater adult height achieved in both male and female patients.

  20. Primary Radiation Damage in Materials. Review of Current Understanding and Proposed New Standard Displacement Damage Model to Incorporate in Cascade Defect Production Efficiency and Mixing Effects

    International Nuclear Information System (INIS)

    Nordlund, Kai; Sand, Andrea E.; Granberg, Fredric; Zinkle, Steven J.; Stoller, Roger; Averback, Robert S.; Suzudo, Tomoaki; Malerba, Lorenzo; Banhart, Florian; Weber, William J.; Willaime, Francois; Dudarev, Sergei; Simeone, David

    2015-01-01

    Under the auspices of the NEA Nuclear Science Committee (NSC), the Working Party on Multi-scale Modelling of Fuels and Structural Materials for Nuclear Systems (WPMM) was established in 2008 to assess the scientific and engineering aspects of fuels and structural materials, aiming at evaluating multi-scale models and simulations as validated predictive tools for the design of nuclear systems, fuel fabrication and performance. The WPMM's objective is to promote the exchange of information on models and simulations of nuclear materials, theoretical and computational methods, experimental validation, and related topics. It also provides member countries with up-to-date information, shared data, models and expertise. The WPMM Expert Group on Primary Radiation Damage (PRD) was established in 2009 to determine the limitations of the NRT-dpa standard, in the light of both atomistic simulations and known experimental discrepancies, to revisit the NRT-dpa standard and to examine the possibility of proposing a new improved standard of primary damage characteristics. This report reviews the current understanding of primary radiation damage from neutrons, ions and electrons (excluding photons, atomic clusters and more exotic particles), with emphasis on the range of validity of the 'displacement per atom' (dpa) concept in all major classes of materials with the exception of organics. The report also introduces an 'athermal recombination-corrected dpa' (arc-dpa) relation that uses a relatively simple functional to address the well-known issue that 'displacement per atom' (dpa) overestimates damage production in metals under energetic displacement cascade conditions, as well as a 'replacements-per-atom' (rpa) equation, also using a relatively simple functional, that accounts for the fact that dpa is understood to severely underestimate actual atom relocation (ion beam mixing) in metals. (authors)

  1. How to use current practice, risk analysis and standards to define hospital-wide policies on the safe use of infusion technology.

    Science.gov (United States)

    Timmerman, Annemoon M; Oliveira-Martens, Suzanne M; Snijder, Roland A; Nieman, Anders K; Egberts, Toine C

    2015-08-01

    Infusion therapy is widely used in hospitals. It is well known that medication errors constitute one of the highest risks to patient safety, leading to numerous adverse events concerning incorrect application of infusion technology. Both clinical practice and in vitro studies show that infusion of multiple medications via one access point induces unwanted phenomena such as backflow and an incorrect system response to interventions. Within the Metrology for Drug Delivery project, we addressed the role of infusion devices in drug delivery. We surveyed current practices for application in hospitals to provide input to standards and quality norms for the materials used in infusion technology. Furthermore, we organized meetings with clinicians and other relevant stakeholders to set up a risk analysis-based infusion policy, accompanied by easy to access operating procedures on infusion technology. It was found difficult to establish clear-cut infusion safety guidelines based on quantitative data because of the many different application areas and stakeholders. However, both the expert team and the survey indicated the value of multidisciplinary qualitative discussion for defining best practices. We advise to incorporate specific requirements on infusion devices in protocols and standards, adjusted to specific applications, to ensure safe use of infusion technology.

  2. [Current state of training in pharmacy education using a problem-based learning/tutorial model with simulated patients and standardized patients at National University Corporation].

    Science.gov (United States)

    Irie, Tetsumi; Nitta, Atsumi; Akaike, Akinori

    2012-01-01

    Simulated/standardized patient-based (SP) education and problem-based learning (PBL) tutorial education become a powerful tool to heighten the pharmacy students' will to learn in order to cultivate the responsibility to contribute to public health and welfare as a clinical professional and to facilitate students' competences to solve problems by themselves. What this program is trying to do is: 1) to establish the system to train, educate and supply SP who are effective in the training and education of pharmacy students in close cooperation with the medical schools and their affiliated hospitals; 2) to improve the quality of the current PBL tutorial education and thereby establish it as an advanced education program in the education of senior students. We carried out the questionnaire to National University Corporation which establishes a school of pharmacy, as to the training and education of SP. The analysis of the answers to the questionnaire revealed the present status of SP in the Pharmaceutical Objective Structured Clinical Examination (OSCE) in the Pharmaceutical Common Achievement Test, and the existence of the problems on how to standardize SP as well as how to cover such expenses. Furthermore, the activity of the first year consisted of the exchange and sharing of information regarding the existing method of training and education of SP and PBL tutorial education and the identification of the problems to be solved in order to improve the quality of the educational program.

  3. Current tobacco use and its associated factors among adults in Georgia: findings from Non-Communicable Disease Risk Factors STEPS Survey Georgia 2016

    Directory of Open Access Journals (Sweden)

    Nino Maglaklelidze

    2018-03-01

    Full Text Available Background Tobacco surveys of past decades show that tobacco use prevalence is high in Georgia; According to nationwide Noncommunicable Diseases (NCDC Risk Factors STEPS Survey 2010 30% of adult population are current tobacco users. Another Nationwide Tobacco Survey 2014 reported 28% of tobacco use prevalence among Georgian adults. However, there has been relatively little progress in systematic study of the factors associated with this high tobacco use. The current study aimed to assess the prevalence of tobacco use and its associated sociodemographic, behavioral and environmental factors in Georgia. Methods The current study in Georgia was a population-based STEPS survey of adults aged 18-69. A multi-stage cluster sample design was used to produce representative data for that age range in Georgia. The. A total of 5554 adults participated in the survey. The overall response rate was 75.7%. We assessed sociodemographics, behavioral and other health-related factors. Results The prevalence of current overall tobacco use was 31.1% (95 % CI: 29.0-33.1 which comprised of smoked tobacco use, smoked cigarettes and use of smokeless tobacco, 31.0% (95% 28.9-33.0 smoked tobacco, 29.9 (95% CI: 27.9-32.0 smoked cigarettes and 0.3 (95% CI: 0.0-0.6 use of smokeless tobacco. Smoking prevalence was significantly higher in men 57.1% (95% CI: 53.7-60.4 compared to women 7.1% (95% CI: 5.9-8.4, especially in younger age groups and with other substance abuse history (predominantly alcohol. Conclusions Despite of some efforts in the field of tobacco control, tobacco use (particularly smoking was high in Georgia. Males, younger age groups, and population with addictions to other substances (especially alcohol should be the primary target of behavioral interventions; The stricter implementation of tobacco control measures, including comprehensive ban of tobacco marketing and smoking in public places, improved health warnings on tobacco packages and anti

  4. Current manufactured cigarette smoking and roll-your-own cigarette smoking in Thailand: findings from the 2009 Global Adult Tobacco Survey.

    Science.gov (United States)

    Benjakul, Sarunya; Termsirikulchai, Lakkhana; Hsia, Jason; Kengganpanich, Mondha; Puckcharern, Hataichanok; Touchchai, Chitrlada; Lohtongmongkol, Areerat; Andes, Linda; Asma, Samira

    2013-03-27

    Current smoking prevalence in Thailand decreased from 1991 to 2004 and since that time the prevalence has remained flat. It has been suggested that one of the reasons that the prevalence of current smoking in Thailand has stopped decreasing is due to the use of RYO cigarettes. The aim of this study was to examine characteristics of users of manufactured and RYO cigarettes and dual users in Thailand, in order to determine whether there are differences in the characteristics of users of the different products. The 2009 Global Adult Tobacco Survey (GATS Thailand) provides detailed information on current smoking patterns. GATS Thailand used a nationally and regionally representative probability sample of 20,566 adults (ages 15 years and above) who were chosen through stratified three-stage cluster sampling and then interviewed face-to-face. The prevalence of current smoking among Thai adults was 45.6% for men and 3.1% for women. In all, 18.4% of men and 1.0% of women were current users of manufactured cigarettes only, while 15.8% of men and 1.7% of women were current users of RYO cigarettes only. 11.2% of men and 0.1% of women used both RYO and manufactured cigarettes. Users of manufactured cigarettes were younger and users of RYO were older. RYO smokers were more likely to live in rural areas. Smokers of manufactured cigarettes appeared to be more knowledgeable about the health risks of tobacco use. However, the difference was confounded with age and education; when demographic variables were controlled, the knowledge differences no longer remained. Smokers of manufactured cigarettes were more likely than dual users and those who used only RYO to report that they were planning on quitting in the next month. Users of RYO only appeared to be more addicted than the other two groups as measured by time to first cigarette. There appears to be a need for product targeted cessation and prevention efforts that are directed toward specific population subgroups in Thailand and

  5. A Method for the Automatic Exposure Control in Pediatric Abdominal CT: Application to the Standard Deviation Value and Tube Current Methods by Using Patient's Age and Body Size.

    Science.gov (United States)

    Furuya, Ken; Akiyama, Shinji; Nambu, Atushi; Suzuki, Yutaka; Hasebe, Yuusuke

    2017-01-01

    We aimed to apply the pediatric abdominal CT protocol of Donnelly et al. in the United States to the pediatric abdominal CT-AEC. Examining CT images of 100 children, we found that the sectional area of the hepatic portal region (y) was strongly correlated with the body weight (x) as follows: y=7.14x + 84.39 (correlation coefficient=0.9574). We scanned an elliptical cone phantom that simulates the human body using a pediatric abdominal CT scanning method of Donnelly et al. in, and measured SD values. We further scanned the same phantom under the settings for adult CT-AEC scan and obtained the relationship between the sectional areas (y) and the SD values. Using these results, we obtained the following preset noise factors for CT-AEC at each body weight range: 6.90 at 4.5-8.9 kg, 8.40 at 9.0-17.9 kg, 8.68 at 18.0-26.9 kg, 9.89 at 27.0-35.9 kg, 12.22 at 36.0-45.0 kg, 13.52 at 45.1-70.0 kg, 15.29 at more than 70 kg. From the relation between age, weight and the distance of liver and tuber ischiadicum of 500 children, we obtained the CTDI vol values and DLP values under the scanning protocol of Donnelly et al. Almost all of DRL from these values turned out to be smaller than the DRL data of IAEA and various countries. Thus, by setting the maximum current values of CT-AEC to be the Donnelly et al.'s age-wise current values, and using our weight-wise noise factors, we think we can perform pediatric abdominal CT-AEC scans that are consistent with the same radiation safety and the image quality as those proposed by Donnelly et al.

  6. Flavor changing neutral currents, CP violation, and implications for some rare decays in a SU(4)L x U(1)X extension of the standard model

    International Nuclear Information System (INIS)

    Jaramillo, Alejandro; Sanchez, Luis A.

    2011-01-01

    Extensions of the standard model with gauge symmetry SU(3) c x SU(4) L x U(1) X (3-4-1 extensions) where anomaly cancellation takes place between the fermion families (three-family models) predict the existence of two new heavy neutral gauge bosons which transmit flavor changing neutral currents at tree level. In this work, in the context of a three-family 3-4-1 extension which does not contain particles with exotic electric charges, we study the constraints coming from neutral meson mixing on the parameters of the extension associated to tree-level flavor changing neutral current effects. Taking into account experimental measurements of observables related to K and B meson mixing and including new CP-violating phases, we study the resulting bounds for angles and phases in the mixing matrix for the down-quark sector, as well as the implications of these bounds for the modifications in the amplitudes of the clean rare decays K + →π + νν, K L →π 0 νν, K L →π 0 l + l - (l=e, μ) and B d/s →μ + μ - .

  7. Comparison of standardized uptake values measured on {sup 18}F-NaF PET/CT scans using three different tube current intensities

    Energy Technology Data Exchange (ETDEWEB)

    Valadares, Agnes Araujo; Woellner, Eduardo Bechtloff; Sapienza, Marcelo Tatit; Buchpiguel, Carlos Alberto, E-mail: agnesvaladares@me.com [Universidade de Sao Paulo (HC/FMUSP), Sao Paulo, SP (Brazil). Fac. de Medicina. Hospital das Clinicas; Duarte, Paulo Schiavom; Coura-Filho, George Barberio [Instituto do Cancer do Estado de Sao Paulo Octavio Frias de Oliveira (ICESP), Sao Paulo, SP (Brazil)

    2015-01-15

    Objective: to analyze standardized uptake values (SUVs) using three different tube current intensities for attenuation correction on {sup 18}FNaF PET/CT scans. Materials and methods: a total of 254 {sup 18}F-NaF PET/CT studies were analyzed using 10, 20 and 30 mAs. The SUVs were calculated in volumes of interest (VOIs) drawn on three skeletal regions, namely, right proximal humeral diaphysis (RH), right proximal femoral diaphysis (RF), and first lumbar vertebra (LV1) in a total of 712 VOIs. The analyses covered 675 regions classified as normal (236 RH, 232 RF, and 207 LV1). Results: mean SUV for each skeletal region was 3.8, 5.4 and 14.4 for RH, RF, and LV1, respectively. As the studies were grouped according to mAs value, the mean SUV values were 3.8, 3.9 and 3.7 for 10, 20 and 30 mAs, respectively, in the RH region; 5.4, 5.5 and 5.4 for 10, 20 and 30 mAs, respectively, in the RF region; 13.8, 14.9 and 14.5 for 10, 20 and 30 mAs, respectively, in the LV1 region. Conclusion: the three tube current values yielded similar results for SUV calculation. (author)

  8. Comparison of standardized uptake values measured on 18F-NaF PET/CT scans using three different tube current intensities

    International Nuclear Information System (INIS)

    Valadares, Agnes Araujo; Woellner, Eduardo Bechtloff; Sapienza, Marcelo Tatit; Buchpiguel, Carlos Alberto

    2015-01-01

    Objective: to analyze standardized uptake values (SUVs) using three different tube current intensities for attenuation correction on 18 FNaF PET/CT scans. Materials and methods: a total of 254 18 F-NaF PET/CT studies were analyzed using 10, 20 and 30 mAs. The SUVs were calculated in volumes of interest (VOIs) drawn on three skeletal regions, namely, right proximal humeral diaphysis (RH), right proximal femoral diaphysis (RF), and first lumbar vertebra (LV1) in a total of 712 VOIs. The analyses covered 675 regions classified as normal (236 RH, 232 RF, and 207 LV1). Results: mean SUV for each skeletal region was 3.8, 5.4 and 14.4 for RH, RF, and LV1, respectively. As the studies were grouped according to mAs value, the mean SUV values were 3.8, 3.9 and 3.7 for 10, 20 and 30 mAs, respectively, in the RH region; 5.4, 5.5 and 5.4 for 10, 20 and 30 mAs, respectively, in the RF region; 13.8, 14.9 and 14.5 for 10, 20 and 30 mAs, respectively, in the LV1 region. Conclusion: the three tube current values yielded similar results for SUV calculation. (author)

  9. Comparison of standardized uptake values measured on F-NaF PET/CT scans using three different tube current intensities.

    Science.gov (United States)

    Valadares, Agnes Araujo; Duarte, Paulo Schiavom; Woellner, Eduardo Bechtloff; Coura-Filho, George Barberio; Sapienza, Marcelo Tatit; Buchpiguel, Carlos Alberto

    2015-01-01

    To analyze standardized uptake values (SUVs) using three different tube current intensities for attenuation correction on (18)FNaF PET/CT scans. A total of 254 (18)F-NaF PET/CT studies were analyzed using 10, 20 and 30 mAs. The SUVs were calculated in volumes of interest (VOIs) drawn on three skeletal regions, namely, right proximal humeral diaphysis (RH), right proximal femoral diaphysis (RF), and first lumbar vertebra (LV1) in a total of 712 VOIs. The analyses covered 675 regions classified as normal (236 RH, 232 RF, and 207 LV1). Mean SUV for each skeletal region was 3.8, 5.4 and 14.4 for RH, RF, and LV1, respectively. As the studies were grouped according to mAs value, the mean SUV values were 3.8, 3.9 and 3.7 for 10, 20 and 30 mAs, respectively, in the RH region; 5.4, 5.5 and 5.4 for 10, 20 and 30 mAs, respectively, in the RF region; 13.8, 14.9 and 14.5 for 10, 20 and 30 mAs, respectively, in the LV1 region. The three tube current values yielded similar results for SUV calculation.

  10. A wideband current-commutating passive mixer for multi-standard receivers in a 0.18 μm CMOS

    International Nuclear Information System (INIS)

    Bao Kuan; Fan Xiangning; Li Wei; Wang Zhigong

    2013-01-01

    This paper reports a wideband passive mixer for direct conversion multi-standard receivers. A brief comparison between current-commutating passive mixers and active mixers is presented. The effect of source and load impedance on the linearity of a mixer is analyzed. Specially, the impact of the input impedance of the transimpedance amplifier (TIA), which acts as the load impedance of a mixer, is investigated in detail. The analysis is verified by a passive mixer implemented with 0.18 μm CMOS technology. The circuit is inductorless and can operate over a broad frequency range. On wafer measurements show that, with radio frequency (RF) ranges from 700 MHz to 2.3 GHz, the mixer achieves 21 dB of conversion voltage gain with a −1 dB intermediate frequency (IF) bandwidth of 10 MHz. The measured IIP3 is 9 dBm and the measured double-sideband noise figure (NF) is 10.6 dB at 10 MHz output. The chip occupies an area of 0.19 mm 2 and drains a current of 5.5 mA from a 1.8 V supply. (semiconductor integrated circuits)

  11. Greater dietary acculturation (dietary change) is associated with poorer current self-rated health among African immigrant adults.

    Science.gov (United States)

    Okafor, Maria-Theresa C; Carter-Pokras, Olivia D; Zhan, Min

    2014-01-01

    Investigate the relationship between dietary acculturation and current self-rated health (SRH) among African immigrants, by country or region of origin. Cross-sectional, mixed-methods design using baseline data from longitudinal study of immigrants granted legal permanent residence May to November, 2003, and interviewed June, 2003 to June, 2004. 2003 New Immigrant Survey. African immigrants from a nationally representative sample (n = 763) averaged 34.7 years of age and 5.5 years' US residency; 56.6% were male, 54.1% were married, 26.1% were Ethiopian, and 22.5% were Nigerian. Current SRH (dependent variable) was measured using 5-point Likert scale questions; dietary acculturation (independent variable) was assessed using a quantitative dietary change scale. Multivariate logistic regression tested the relationship of dietary acculturation with current SRH (α = .05; P food/beverages consumed pre-/post-migration. African immigrants reporting moderate dietary change since arrival in the US had higher odds of poorer SRH status than immigrants reporting low dietary change (odds ratio, 1.903; 95% confidence interval, 1.143-3.170; P = .01). Among most dietary change groups, there was an increase in fast food consumption and decrease in fruit and vegetable consumption. Nutrition educators and public health practitioners should develop targeted nutrition education for African immigrants who are older, less educated, and at increased health risk. Copyright © 2014 Society for Nutrition Education and Behavior. Published by Elsevier Inc. All rights reserved.

  12. Current and former marijuana use: preliminary findings of a longitudinal study of effects on IQ in young adults.

    Science.gov (United States)

    Fried, Peter; Watkinson, Barbara; James, Deborah; Gray, Robert

    2002-04-02

    Assessing marijuana's impact on intelligence quotient (IQ) has been hampered by a lack of evaluation of subjects before they begin to use this substance. Using data from a group of young people whom we have been following since birth, we examined IQ scores before, during and after cessation of regular marijuana use to determine any impact of the drug on this measure of cognitive function. We determined marijuana use for seventy 17- to 20-year-olds through self-reporting and urinalysis. IQ difference scores were calculated by subtracting each person's IQ score at 9-12 years (before initiation of drug use) from his or her score at 17-20 years. We then compared the difference in IQ scores of current heavy users (at least 5 joints per week), current light users (less than 5 joints per week), former users (who had not smoked regularly for at least 3 months) and non-users (who never smoked more than once per week and no smoking in the past two weeks). Current marijuana use was significantly correlated (p marijuana use had a negative effect on global IQ score only in subjects who smoked 5 or more joints per week. A negative effect was not observed among subjects who had previously been heavy users but were no longer using the substance. We conclude that marijuana does not have a long-term negative impact on global intelligence. Whether the absence of a residual marijuana effect would also be evident in more specific cognitive domains such as memory and attention remains to be ascertained.

  13. Assessing informed consent in an opioid relapse prevention study with adults under current or recent criminal justice supervision.

    Science.gov (United States)

    Allen, Ashleigh A; Chen, Donna T; Bonnie, Richard J; Ko, Tomohiro M; Suratt, Colleen E; Lee, Joshua D; Friedmann, Peter D; Gordon, Michael; McDonald, Ryan; Murphy, Sean M; Boney, Tamara Y; Nunes, Edward V; O'Brien, Charles P

    2017-10-01

    Concerns persist that individuals with substance use disorders who are under community criminal justice supervision experience circumstances that might compromise their provision of valid, informed consent for research participation. These concerns include the possibilities that desire to obtain access to treatment might lead individuals to ignore important information about research participation, including information about risks, or that cognitive impairment associated with substance use might interfere with attending to important information. We report results from a consent quiz (CQ) administered in a multisite randomized clinical trial of long-acting naltrexone to prevent relapse to opioid use disorder among adults under community criminal justice supervision-a treatment option difficult to access by this population of individuals. Participants were required to answer all 11 items correctly before randomization. On average, participants answered 9.8 items correctly (89%) at baseline first attempt (n=306). At week 21 (n=212), participants scored 87% (9.5 items correct) without review. Performance was equivalent to, or better than, published results from other populations on a basic consent quiz instrument across multiple content domains. The consent quiz is an efficient method to screen for adequate knowledge of consent information as part of the informed consent process. Clinical researchers who are concerned about these issues should consider using a consent quiz with corrected feedback to enhance the informed consent process. Overall, while primarily useful as an educational tool, employing a CQ as part of the gateway to participation in research may be particularly important as the field continues to advance and tests novel experimental treatments with significant risks and uncertain potential for benefit. Copyright © 2017. Published by Elsevier Inc.

  14. Clinical Interventions for Hyperacusis in Adults: A Scoping Review to Assess the Current Position and Determine Priorities for Research

    Directory of Open Access Journals (Sweden)

    Kathryn Fackrell

    2017-01-01

    Full Text Available Background. There is no universally accepted definition for hyperacusis, but in general it is characterised by decreased sound tolerance to ordinary environmental sounds. Despite hyperacusis being prevalent and having significant clinical implications, much remains unknown about current management strategies. Purpose. To establish the current position of research on hyperacusis and identify research gaps to direct future research. Design and Sample. Using an established methodological framework, electronic and manual searches of databases and journals identified 43 records that met our inclusion criteria. Incorporating content and thematic analysis approaches, the definitions of hyperacusis, management strategies, and outcome measures were catalogued. Results. Only 67% of the studies provided a definition of hyperacusis, such as “reduced tolerance” or “oversensitivity to sound.” Assessments and outcome measures included Loudness Discomfort Levels, the Hyperacusis Questionnaire, and Tinnitus Retraining Therapy (TRT interview. Management strategies reported were Cognitive Behavioural Therapy, TRT, devices, pharmacological therapy, and surgery. Conclusions. Management strategies were typically evaluated in patients reporting hyperacusis as a secondary complaint or as part of a symptom set. As such the outcomes reported only provided an indication of their effectiveness for hyperacusis. Randomised Controlled Trials are needed to evaluate the effectiveness of management strategies for patients experiencing hyperacusis.

  15. Immunogenicity and safety of high-dose trivalent inactivated influenza vaccine compared to standard-dose vaccine in children and young adults with cancer or HIV infection.

    Science.gov (United States)

    Hakim, Hana; Allison, Kim J; Van de Velde, Lee-Ann; Tang, Li; Sun, Yilun; Flynn, Patricia M; McCullers, Jonathan A

    2016-06-08

    Approaches to improve the immune response of immunocompromised patients to influenza vaccination are needed. Children and young adults (3-21 years) with cancer or HIV infection were randomized to receive 2 doses of high-dose (HD) trivalent influenza vaccine (TIV) or of standard-dose (SD) TIV. Hemagglutination inhibition (HAI) antibody titers were measured against H1, H3, and B antigens after each dose and 9 months later. Seroconversion was defined as ≥4-fold rise in HAI titer comparing pre- and post-vaccine sera. Seroprotection was defined as a post-vaccine HAI titer ≥1:40. Reactogenicity events (RE) were solicited using a structured questionnaire 7 and 14 days after each dose of vaccine, and adverse events by medical record review for 21 days after each dose of vaccine. Eighty-five participants were enrolled in the study; 27 with leukemia, 17 with solid tumor (ST), and 41 with HIV. Recipients of HD TIV had significantly greater fold increase in HAI titers to B antigen in leukemia group and to H1 antigen in ST group compared to SD TIV recipients. This increase was not documented in HIV group. There were no differences in seroconversion or seroprotection between HD TIV and SD TIV in all groups. There was no difference in the percentage of solicited RE in recipients of HD TIV (54% after dose 1 and 38% after dose 2) compared to SD TIV (40% after dose 1 and 20% after dose 2, p=0.27 and 0.09 after dose 1 and 2, respectively). HD TIV was more immunogenic than SD TIV in children and young adults with leukemia or ST, but not with HIV. HD TIV was safe and well-tolerated in children and young adults with leukemia, ST, or HIV. Copyright © 2016 Elsevier Ltd. All rights reserved.

  16. Postprandial Glycemic and Insulinemic Responses to Common Breakfast Beverages Consumed with a Standard Meal in Adults Who Are Overweight and Obese

    Directory of Open Access Journals (Sweden)

    Jia Li

    2017-01-01

    Full Text Available Breakfast beverages with different nutrient compositions may affect postprandial glycemic control differently. We assessed the effects of consuming (1 common breakfast beverages (water, sugar-sweetened coffee, reduced-energy orange juice (OJ, and low-fat milk (LFM; and (2 fat-free, low-fat, and whole milk with breakfast on postprandial plasma glucose and insulin responses in adults who were overweight/obese. Forty-six subjects (33F/13M, body mass index: 32.5 ± 0.7 kg/m2, age: 50 ± 1 years, mean ± SEMs consumed a standard sandwich with one of the six beverages on separate mornings in randomized order. The test beverages (except water each contained 12 g digestible carbohydrate. Plasma glucose and insulin concentrations were measured from blood obtained pre- and post-meal at 30-min intervals for 4 h and incremental areas under the curve (AUC were computed. We found (1 among different beverage types, glucose AUC was higher for coffee versus water, OJ, and LFM. Insulin AUC was higher for coffee and LFM versus OJ and water; (2 Glucose AUCs were not different among water and milks while insulin AUC was higher for milks versus water. In conclusion, consumption of water, reduced-energy OJ, or milk (irrespective of fat content with a meal may be preferable to consuming sugar-sweetened coffee for glucose control in middle-aged adults who are overweight and obese.

  17. Postprandial Glycemic and Insulinemic Responses to Common Breakfast Beverages Consumed with a Standard Meal in Adults Who Are Overweight and Obese.

    Science.gov (United States)

    Li, Jia; Janle, Elsa; Campbell, Wayne W

    2017-01-04

    Breakfast beverages with different nutrient compositions may affect postprandial glycemic control differently. We assessed the effects of consuming (1) common breakfast beverages (water, sugar-sweetened coffee, reduced-energy orange juice (OJ), and low-fat milk (LFM)); and (2) fat-free, low-fat, and whole milk with breakfast on postprandial plasma glucose and insulin responses in adults who were overweight/obese. Forty-six subjects (33F/13M, body mass index: 32.5 ± 0.7 kg/m², age: 50 ± 1 years, mean ± SEMs) consumed a standard sandwich with one of the six beverages on separate mornings in randomized order. The test beverages (except water) each contained 12 g digestible carbohydrate. Plasma glucose and insulin concentrations were measured from blood obtained pre- and post-meal at 30-min intervals for 4 h and incremental areas under the curve (AUC) were computed. We found (1) among different beverage types, glucose AUC was higher for coffee versus water, OJ, and LFM. Insulin AUC was higher for coffee and LFM versus OJ and water; (2) Glucose AUCs were not different among water and milks while insulin AUC was higher for milks versus water. In conclusion, consumption of water, reduced-energy OJ, or milk (irrespective of fat content) with a meal may be preferable to consuming sugar-sweetened coffee for glucose control in middle-aged adults who are overweight and obese.

  18. Annual research review: Current limitations and future directions in MRI studies of child- and adult-onset developmental psychopathologies.

    Science.gov (United States)

    Horga, Guillermo; Kaur, Tejal; Peterson, Bradley S

    2014-06-01

    The widespread use of Magnetic Resonance Imaging (MRI) in the study of child- and adult-onset developmental psychopathologies has generated many investigations that have measured brain structure and function in vivo throughout development, often generating great excitement over our ability to visualize the living, developing brain using the attractive, even seductive images that these studies produce. Often lost in this excitement is the recognition that brain imaging generally, and MRI in particular, is simply a technology, one that does not fundamentally differ from any other technology, be it a blood test, a genotyping assay, a biochemical assay, or behavioral test. No technology alone can generate valid scientific findings. Rather, it is only technology coupled with a strong experimental design that can generate valid and reproducible findings that lead to new insights into the mechanisms of disease and therapeutic response. In this review we discuss selected studies to illustrate the most common and important limitations of MRI study designs as most commonly implemented thus far, as well as the misunderstanding that the interpretations of findings from those studies can create for our theories of developmental psychopathologies. Common limitations of MRI study designs are in large part responsible thus far for the generally poor reproducibility of findings across studies, poor generalizability to the larger population, failure to identify developmental trajectories, inability to distinguish causes from effects of illness, and poor ability to infer causal mechanisms in most MRI studies of developmental psychopathologies. For each of these limitations in study design and the difficulties they entail for the interpretation of findings, we discuss various approaches that numerous laboratories are now taking to address those difficulties, which have in common the yoking of brain imaging technologies to studies with inherently stronger designs that permit more valid

  19. Awareness and Current Use of Electronic Cigarettes in Indonesia, Malaysia, Qatar, and Greece: Findings From 2011–2013 Global Adult Tobacco Surveys

    Science.gov (United States)

    Palipudi, Krishna Mohan; Mbulo, Lazarous; Morton, Jeremy; Mbulo, Lazarous; Bunnell, Rebecca; Blutcher-Nelson, Glenda; Kosen, Soewarta; Tee, Guat Hiong; Abdalla, Amani Mohamed Elkhatim; Al Mutawa, Kholood Ateeq; Barbouni, Anastasia; Antoniadou, Eleni; Fouad, Heba; Khoury, Rula N.; Rarick, James; Sinha, Dhirendra N.; Asma, Samira

    2016-01-01

    Introduction Increases in electronic cigarette (e-cigarette) awareness and current use have been documented in high income countries but less is known about middle and low income countries. Methods Nationally representative household survey data from the first four Global Adult Tobacco Surveys to assess e-cigarettes were analyzed, including Indonesia (2011), Malaysia (2011), Qatar (2013), and Greece (2013). Correlates of e-cigarette awareness and current use were calculated. Sample sizes for Greece and Qatar allowed for further analysis of e-cigarette users. Results Awareness of e-cigarettes was 10.9% in Indonesia, 21.0% in Malaysia, 49.0% in Qatar, and 88.5% in Greece. In all four countries, awareness was higher among male, younger, more educated, and wealthier respondents. Current e-cigarette use among those aware of e-cigarettes was 3.9% in Malaysia, 2.5% in Indonesia, 2.2% in Greece and 1.8% in Qatar. Across these four countries, an estimated 818 500 people are currently using e-cigarettes. Among current e-cigarette users, 64.4% in Greece and 84.1% in Qatar also smoked cigarettes, and, 10.6% in Greece and 6.0% in Qatar were never-smokers. Conclusions E-cigarette awareness and use was evident in all four countries. Ongoing surveillance and monitoring of awareness and use of e-cigarettes in these and other countries could help inform tobacco control policies and public health interventions. Future surveillance should monitor use of e-cigarettes among current smokers and uptake among never-smokers and relapsing former smokers. PMID:25895951

  20. Awareness and Current Use of Electronic Cigarettes in Indonesia, Malaysia, Qatar, and Greece: Findings From 2011-2013 Global Adult Tobacco Surveys.

    Science.gov (United States)

    Palipudi, Krishna Mohan; Mbulo, Lazarous; Morton, Jeremy; Mbulo, Lazarous; Bunnell, Rebecca; Blutcher-Nelson, Glenda; Kosen, Soewarta; Tee, Guat Hiong; Abdalla, Amani Mohamed Elkhatim; Mutawa, Kholood Ateeq Al; Barbouni, Anastasia; Antoniadou, Eleni; Fouad, Heba; Khoury, Rula N; Rarick, James; Sinha, Dhirendra N; Asma, Samira

    2016-04-01

    Increases in electronic cigarette (e-cigarette) awareness and current use have been documented in high income countries but less is known about middle and low income countries. Nationally representative household survey data from the first four Global Adult Tobacco Surveys to assess e-cigarettes were analyzed, including Indonesia (2011), Malaysia (2011), Qatar (2013), and Greece (2013). Correlates of e-cigarette awareness and current use were calculated. Sample sizes for Greece and Qatar allowed for further analysis of e-cigarette users. Awareness of e-cigarettes was 10.9% in Indonesia, 21.0% in Malaysia, 49.0% in Qatar, and 88.5% in Greece. In all four countries, awareness was higher among male, younger, more educated, and wealthier respondents. Current e-cigarette use among those aware of e-cigarettes was 3.9% in Malaysia, 2.5% in Indonesia, 2.2% in Greece and 1.8% in Qatar. Across these four countries, an estimated 818 500 people are currently using e-cigarettes. Among current e-cigarette users, 64.4% in Greece and 84.1% in Qatar also smoked cigarettes, and, 10.6% in Greece and 6.0% in Qatar were never-smokers. E-cigarette awareness and use was evident in all four countries. Ongoing surveillance and monitoring of awareness and use of e-cigarettes in these and other countries could help inform tobacco control policies and public health interventions. Future surveillance should monitor use of e-cigarettes among current smokers and uptake among never-smokers and relapsing former smokers. © The Author 2015. Published by Oxford University Press on behalf of the Society for Research on Nicotine and Tobacco. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  1. Differential behavioral and physiological effects of anodal transcranial direct current stimulation in healthy adults of younger and older age

    Science.gov (United States)

    Heise, Kirstin-Friederike; Niehoff, Martina; Feldheim, J.-F.; Liuzzi, Gianpiero; Gerloff, Christian; Hummel, Friedhelm C.

    2014-01-01

    Changes in γ-aminobutyric acid (GABA) mediated synaptic transmission have been associated with age-related motor and cognitive functional decline. Since anodal transcranial direct current stimulation (atDCS) has been suggested to target cortical GABAergic inhibitory interneurons, its potential for the treatment of deficient inhibitory activity and functional decline is being increasingly discussed. Therefore, after-effects of a single session of atDCS on resting-state and event-related short-interval intracortical inhibition (SICI) as evaluated with double-pulse TMS and dexterous manual performance were examined using a sham-controlled cross-over design in a sample of older and younger participants. The atDCS effect on resting-state inhibition differed in direction, magnitude, and timing, i.e., late relative release of inhibition in the younger and early relative increase in inhibition in the older. More pronounced release of event-related inhibition after atDCS was exclusively seen in the older. Event-related modulation of inhibition prior to stimulation predicted the magnitude of atDCS-induced effects on resting-state inhibition. Specifically, older participants with high modulatory capacity showed a disinhibitory effect comparable to the younger. Beneficial effects on behavior were mainly seen in the older and in tasks requiring higher dexterity, no clear association with physiological changes was found. Differential effects of atDCS on SICI, discussed to reflect GABAergic inhibition at the level of the primary motor cortex, might be distinct in older and younger participants depending on the functional integrity of the underlying neural network. Older participants with preserved modulatory capacity, i.e., a physiologically “young” motor network, were more likely to show a disinhibitory effect of atDCS. These results favor individually tailored application of tDCS with respect to specific target groups. PMID:25071555

  2. Differential effects of bihemispheric and unihemispheric transcranial direct current stimulation in young and elderly adults in verbal learning.

    Science.gov (United States)

    Fiori, Valentina; Nitsche, Michael; Iasevoli, Luigi; Cucuzza, Gabriella; Caltagirone, Carlo; Marangolo, Paola

    2017-03-15

    For the past few years, the potential of transcranial direct current stimulation (tDCS) for the treatment of several pathologies has been investigated. In the language domain, several studies, in healthy and brain-damaged populations, have already shown that tDCS is effective in enhancing naming, repetition and semantic word generation. In those studies, different tDCS electrode configurations have been tested, however, a direct comparison between different montages in verbal learning has never been conducted. In this study, we aimed to explore the impact of bihemispheric and unihemispheric tDCS on verbal learning task performance in two groups (young vs. elderly). Fifteen healthy volunteers participated per group. Each participant received three stimulation conditions: unihemispheric anodal tDCS over the left temporal area, bihemispheric tDCS over the left (anodal) and right (cathodal) temporal areas and a sham condition. During active stimulation, tDCS (20min, 2mA) was applied while each participant learned twenty pseudowords (arbitrarily assigned to corresponding pictures). No significant differences were found between the three conditions for the young group with regard to accuracy and vocal reaction times. In contrast, in the elderly group, real stimulation improved performance compared to sham but bihemispheric tDCS was more efficient than unilateral stimulation. These results suggest that bihemispheric stimulation is more effective in improving language learning but this effect is age-dependent. The hypothesis is advanced that cortical changes in the course of aging might differentially impact on tDCS efficacy on behavioral performance. These data may also have implications for treatment of stroke patients with language impairment. Copyright © 2017 Elsevier B.V. All rights reserved.

  3. The mediating sex-specific effect of psychological distress on the relationship between adverse childhood experiences and current smoking among adults.

    Science.gov (United States)

    Strine, Tara W; Edwards, Valerie J; Dube, Shanta R; Wagenfeld, Morton; Dhingra, Satvinder; Prehn, Angela Witt; Rasmussen, Sandra; McKnight-Eily, Lela; Croft, Janet B

    2012-07-13

    Research suggests that ACEs have a long-term impact on the behavioral, emotional, and cognitive development of children. These disruptions can lead to adoption of unhealthy coping behaviors throughout the lifespan. The present study sought to examine psychological distress as a potential mediator of sex-specific associations between adverse childhood experiences (ACEs) and adult smoking. Data from 7,210 Kaiser-Permanente members in San Diego California collected between April and October 1997 were used. Among women, psychological distress mediated a significant portion of the association between ACEs and smoking (21% for emotional abuse, 16% for physical abuse, 15% for physical neglect, 10% for parental separation or divorce). Among men, the associations between ACEs and smoking were not significant. These findings suggest that for women, current smoking cessation strategies may benefit from understanding the potential role of childhood trauma.

  4. The mediating sex-specific effect of psychological distress on the relationship between adverse childhood experiences and current smoking among adults

    Directory of Open Access Journals (Sweden)

    Strine Tara W

    2012-07-01

    Full Text Available Abstract Background Research suggests that ACEs have a long-term impact on the behavioral, emotional, and cognitive development of children. These disruptions can lead to adoption of unhealthy coping behaviors throughout the lifespan. The present study sought to examine psychological distress as a potential mediator of sex-specific associations between adverse childhood experiences (ACEs and adult smoking. Method Data from 7,210 Kaiser-Permanente members in San Diego California collected between April and October 1997 were used. Results Among women, psychological distress mediated a significant portion of the association between ACEs and smoking (21% for emotional abuse, 16% for physical abuse, 15% for physical neglect, 10% for parental separation or divorce. Among men, the associations between ACEs and smoking were not significant. Conclusions These findings suggest that for women, current smoking cessation strategies may benefit from understanding the potential role of childhood trauma.

  5. Receipt of evidence-based brief cessation interventions by health professionals and use of cessation assisted treatments among current adult cigarette-only smokers: National Adult Tobacco Survey, 2009–2010

    Directory of Open Access Journals (Sweden)

    Judy Kruger

    2016-02-01

    Full Text Available Abstract Background Helping tobacco smokers to quit during a medical visit is a clinical and public health priority. Research suggests that most health professionals engage their patients in at least some of the ‘5 A’s’ of the brief cessation intervention recommended in the U.S. Public Health Service Clinical Practice Guideline, but information on the extent to which patients act on this intervention is uncertain. We assessed current cigarette-only smokers’ self-reported receipt of the 5 A’s to determine the odds of using optimal cessation assisted treatments (a combination of counseling and medication. Methods Data came from the 2009–2010 National Adult Tobacco Survey (NATS, a nationally representative landline and mobile phone survey of adults aged ≥18 years. Among current cigarette-only smokers who visited a health professional in the past 12 months, we assessed patients’ self-reported receipt of the 5 A’s, use of the combination of counseling and medication for smoking cessation, and use of other cessation treatments. We used logistic regression to examine whether receipt of the 5 A’s during a recent clinic visit was associated with use of cessation treatments (counseling, medication, or a combination of counseling and medication among current cigarette-only smokers. Results In this large sample (N = 10,801 of current cigarette-only smokers who visited a health professional in the past 12 months, 6.3 % reported use of both counseling and medication for smoking cessation within the past year. Other assisted cessation treatments used to quit were: medication (19.6 %; class or program (3.8 %; one-on-one counseling (3.7 %; and telephone quitline (2.6 %. Current cigarette-only smokers who reported receiving all 5 A’s during a recent clinic visit were more likely to use counseling (odds ratio [OR]: 11.2, 95 % confidence interval [CI]: 7.1–17.5, medication (OR: 6.2, 95 % CI: 4.3–9.0, or a combination of

  6. Restrictions on the use of e-cigarettes in public and private places-current practice and support among adults in Great Britain.

    Science.gov (United States)

    Brose, Leonie S; McNeill, Ann; Arnott, Deborah; Cheeseman, Hazel

    2017-08-01

    Debates around policies regulating e-cigarette use make it important to obtain an overview of current practice, people's attitudes and correlates of policy support. Aims were to assess (i) current practices for e-cigarette use in homes and workplaces; (ii) characteristics associated with allowing e-cigarette use in the home; and (iii) level of, and characteristics associated with, support for extending smoke-free legislation to include e-cigarettes. Online survey in 2016, n = 11 389 adults in Great Britain. Descriptives for all measures; multivariable logistic regressions assessed correlates of allowing e-cigarette use and support for extension of legislation. Most (79%) reporting on workplace policies reported some level of restrictions on e-cigarette use. Small majorities would not allow e-cigarette use in their home (58%) and supported an extension of smoke-free legislation (52%; 21% opposed). Allowing use was less likely and supporting an extension more likely among men, respondents from a higher socio-economic status, ex-smokers, never-smokers, non-users of e-cigarettes and respondents with increased perceived harm of e-cigarettes or nicotine (all P e-cigarette use. Over half of adults would not allow use of e-cigarettes in their home and support prohibiting the use of e-cigarettes in smoke-free places. Adjusting for socio-demographics, more restrictive attitudes are more common among never-smokers, never-users and those with increased perception of relative harms of e-cigarettes or nicotine as cause of smoking-related illness. © The Author 2017. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved.

  7. Synergistic effect of combined transcranial direct current stimulation/constraint-induced movement therapy in children and young adults with hemiparesis: study protocol.

    Science.gov (United States)

    Gillick, Bernadette; Menk, Jeremiah; Mueller, Bryon; Meekins, Gregg; Krach, Linda E; Feyma, Timothy; Rudser, Kyle

    2015-11-12

    Perinatal stroke occurs in more than 1 in 2,500 live births and resultant congenital hemiparesis necessitates investigation into interventions which may improve long-term function and decreased burden of care beyond current therapies ( http://www.cdc.gov/ncbddd/cp/data.html ). Constraint-Induced Movement Therapy (CIMT) is recognized as an effective hemiparesis rehabilitation intervention. Transcranial direct current stimulation as an adjunct treatment to CIMT may potentiate neuroplastic responses and improve motor function. The methodology of a clinical trial in children designed as a placebo-controlled, serial -session, non-invasive brain stimulation trial incorporating CIMT is described here. The primary hypotheses are 1) that no serious adverse events will occur in children receiving non-invasive brain stimulation and 2) that children in the stimulation intervention group will show significant improvements in hand motor function compared to children in the placebo stimulation control group. A randomized, controlled, double-blinded clinical trial. Twenty children and/or young adults (ages 8-21) with congenital hemiparesis, will be enrolled. The intervention group will receive ten 2-hour sessions of transcranial direct current stimulation combined with constraint-induced movement therapy and the control group will receive sham stimulation with CIMT. The primary outcome measure is safety assessment of transcranial direct current stimulation by physician evaluation, vital sign monitoring and symptom reports. Additionally, hand function will be evaluated using the Assisting Hand Assessment, grip strength and assessment of goals using the Canadian Occupational Performance Measure. Neuroimaging will confirm diagnoses, corticospinal tract integrity and cortical activation. Motor cortical excitability will also be examined using transcranial magnetic stimulation techniques. Combining non-invasive brain stimulation and CIMT interventions has the potential to improve motor

  8. Time Well Spent: Making Choices and Setting Priorities in Adult Numeracy Instruction

    Science.gov (United States)

    Braaten, Melissa

    2017-01-01

    In her Forum piece, "What's an Adult Numeracy Teacher to Teach? Negotiating the Complexity of Adult Numeracy Instruction," Lynda Ginsburg set the stage of the current problem (poor numeracy levels in American adults) and the bevy of standards, legislation, and new exams that have recently been developed to address it. Ginsburg also…

  9. Comparative long-term results of mitral valve repair in adults with chronic rheumatic disease and degenerative disease: is repair for "burnt-out" rheumatic disease still inferior to repair for degenerative disease in the current era?

    Science.gov (United States)

    Dillon, Jeswant; Yakub, Mohd Azhari; Kong, Pau Kiew; Ramli, Mohd Faizal; Jaffar, Norfazlina; Gaffar, Intan Fariza

    2015-03-01

    Mitral valve repair is perceived to be of limited durability for advanced rheumatic disease in adults. We aim to examine the long-term outcomes of repair for rheumatic disease, identify predictors of durability, and compare with repair for degenerative disease. Rheumatic and degenerative mitral valve repairs in patients aged 40 years or more were prospectively analyzed. The primary outcomes investigated were mortality, freedom from reoperation, and valve failure. Logistic regression analysis was performed to define predictors of poor outcome. Between 1997 and 2011, 253 rheumatic and 148 degenerative mitral valves were repaired. The age of patients in both groups was similar, with a mean of 54.1 ± 8.4 years versus 55.6 ± 7.3 years (P = .49). Freedom from reoperation for rheumatic valves at 5 and 10 years was 98.4%, comparable to 95.3% (P = .12) for degenerative valves. Freedom from valve failure at 5 and 10 years was 91.4% and 81.5% for rheumatic repairs and 82.5% and 75.4% for degenerative repairs, respectively (P = .15). The presence of residual mitral regurgitation greater than 2+ before discharge was the only significant independent predictor of reoperation, whereas residual mitral regurgitation greater than 2+ and leaflet procedures were significant risk factors for valve failure. The durability of rheumatic mitral valve repair in the current era has improved and is comparable to the outstanding durability of repairs for degenerative disease, even in the adult rheumatic population. Modifications of standard repair techniques, adherence to the importance of good leaflet coaptation, and strict quality control with stringent use of intraoperative transesophageal echocardiography have all contributed to the improved long-term results. Copyright © 2015 The American Association for Thoracic Surgery. Published by Elsevier Inc. All rights reserved.

  10. Current Age, Age at First Sex, Age at First Homelessness, and HIV Risk Perceptions Predict Sexual Risk Behaviors among Sexually Active Homeless Adults

    Directory of Open Access Journals (Sweden)

    Diane Santa Maria

    2018-01-01

    Full Text Available While HIV disproportionately impacts homeless individuals, little is known about the prevalence of HIV risk behaviors in the southwest and how age factors and HIV risk perceptions influence sexual risk behaviors. We conducted a secondary data analysis (n = 460 on sexually active homeless adults from a cross-sectional study of participants (n = 610 recruited from homeless service locations, such as shelters and drop-in centers, in an understudied region of the southwest. Covariate-adjusted logistic regressions were used to assess the impact of age at homelessness onset, current age, age at first sex, and HIV risk perceptions on having condomless sex, new sexual partner(s, and multiple sexual partners (≥4 sexual partners in the past 12 months. Individuals who first experienced homelessness by age 24 were significantly more likely to report condomless sex and multiple sexual partners in the past year than those who had a later onset of their first episode of homelessness. Individuals who were currently 24 years or younger were more likely to have had condomless sex, new sexual partners, and multiple sexual partners in the past 12 months than those who were 25 years or older. Those who had low perceived HIV risk had lower odds of all three sexual risk behaviors. Social service and healthcare providers should consider a younger age at homelessness onset when targeting HIV prevention services to youth experiencing homelessness.

  11. NODC Standard Product: Texas-Louisiana Shelf Circulation and Transport Processes Study: Current Meter, Meteorological Buoy, XBT/XSV/XCP/CTD/IES (NODC Accession 9700319)

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — This package contains current direction/velocity, water temperature, air temperature, salinity, and other data which were collected using current meter, CTD casts,...

  12. High Seroprotection Rate Induced by Intradermal Administration of a Recombinant Hepatitis B Vaccine in Young Healthy Adults: Comparison with Standard Intramuscular Vaccination

    International Nuclear Information System (INIS)

    Ghabouli, Mohammad J.; Sabouri, Amir Hossein; Shoeibi, Naser; Naghibzadeh Bajestan, Sepideh; Baradaran, H.

    2004-01-01

    Intradermal (ID) vaccination has been proposed as a cost-saving alternative for administration of Hepatitis B (HB) vaccine to implement of mass vaccination of high-risk groups, particularly in developing countries. Therefore, the effectiveness of ID vaccination needs to be evaluated and verified in different ethnic backgrounds. The present study is a randomized trail using a recombinant vaccine (Heberbiovac) to compare immunogenecity and safety of an intradermal low-dose (4 μg) with standard dose (20 μg) of intramuscular (IM) vaccination in healthy Iranian population. Participants were 143 healthy Iranian medical and nursing students randomly allocated to ID or IM vaccination group. The vaccine was inoculated at 0, 1 and 6 months intervals. Serum samples were collected 1 month after the last vaccination and the anti-HBs response was determined using ELISA. The overall seroprotection rate (anti-HBs level ≥ 10IU/L) was 97.3% for ID vaccination group, which was not different from that of IM vaccination group (98.55%)(p= 0.99). Similarly, geometric mean titers (GMT) of anti-HBs were not significantly different between ID (1164.1IU/L) and IM (1071.8IU/L) vaccination groups (p= 0.4). There was no significant difference in seroprotection rate and GMT of anti-HBs between sexes. Although induration and hyperpigmentation at the site of injection were more frequently observed in ID vaccination group, no other clinically adverse effects were observed in both vaccination groups. We conclude that the ID route, which would require one-fifth of the standard dose, would be suitable for use in certain groups such as high-risk adults when the cost of vaccine is the inhibiting factor for mass vaccination

  13. Arrhythmias and sudden death among older children and young adults following tetralogy of Fallot repair in the current era: are previously reported risk factors still applicable?

    Science.gov (United States)

    Arya, Swati; Kovach, Julie; Singh, Harinder; Karpawich, Peter P

    2014-01-01

    Young adult patients (pts) with repaired tetralogy of Fallot (TOF) remain at risk for arrhythmias (Ar) and sudden cardiac death (SCD). Based on past studies with earlier pt subsets, Ar/SCD events were associated with right ventricular (RV) systolic pressures >60 mm Hg, outflow tract gradients >20 mm Hg, and QRS duration >180 ms. However, there are limited recent studies to evaluate these risk factors in the current patient generation. Patients with TOF followed over the past 50 years were grouped by presence of any arrhythmias (group 1), absence of arrhythmias (group 2), and presence of SCD or significant ventricular arrhythmias (group 3) and correlated with current pt age, gender, age at repair, repair types, echocardiogram, cardiac magnetic resonance imaging, electrocardiogram/Holter, hemodynamics, and electrophysiology findings. Of 109 pts, 52 were male aged 17-58 years. Of these, 59 (54%) had Ar, two of whom had SCD. These 59 pts were chronologically older at the time of analysis, with repair at an older age and wider QRS duration (78-240, mean 158 ms) when compared with those without Ar. However, there was no correlation with surgical era, surgical repair, gender, RV pressure >60 mm Hg, right ventricular outflow tract gradient >20 mm Hg, or RV end-diastolic volume on CMRI. Ar/SCD risk continues to correlate with repair age and advancing pt age. QRS duration is longer in these patients but at a shorter interval (mean 158 ms) and less RV pressure (mean 43 mm Hg) than previously reported. In the current TOF patient generation, neither surgical era, type of repair, RV outflow gradient nor RV volume correlate with Ar/SCD. Electrophysiologic testing to verify and identify arrhythmias remains clinically effective. © 2013 Wiley Periodicals, Inc.

  14. Prevalence of psychological trauma and association with current health and functioning in a sample of HIV-infected and HIV-uninfected Tanzanian adults.

    Directory of Open Access Journals (Sweden)

    Brian W Pence

    Full Text Available In high income nations, traumatic life experiences such as childhood sexual abuse are much more common in people living with HIV/AIDS (PLWHA than the general population, and trauma is associated with worse current health and functioning. Virtually no data exist on the prevalence or consequences of trauma for PLWHA in low income nations.We recruited four cohorts of Tanzanian patients in established medical care for HIV infection (n = 228, individuals newly testing positive for HIV (n = 267, individuals testing negative for HIV at the same sites (n = 182, and a random sample of community-dwelling adults (n = 249. We assessed lifetime prevalence of traumatic experiences, recent stressful life events, and current mental health and health-related physical functioning. Those with established HIV infection reported a greater number of childhood and lifetime traumatic experiences (2.1 and 3.0 respectively than the community cohort (1.8 and 2.3. Those with established HIV infection reported greater post-traumatic stress disorder (PTSD symptomatology and worse current health-related physical functioning. Each additional lifetime traumatic experience was associated with increased PTSD symptomatology and worse functioning.This study is the first to our knowledge in an HIV population from a low income nation to report the prevalence of a range of potentially traumatic life experiences compared to a matched community sample and to show that trauma history is associated with poorer health-related physical functioning. Our findings underscore the importance of considering psychosocial characteristics when planning to meet the health needs of PLWHA in low income countries.

  15. Prevalence of psychological trauma and association with current health and functioning in a sample of HIV-infected and HIV-uninfected Tanzanian adults.

    Science.gov (United States)

    Pence, Brian W; Shirey, Kristen; Whetten, Kathryn; Agala, Bernard; Itemba, Dafrosa; Adams, Julie; Whetten, Rachel; Yao, Jia; Shao, John

    2012-01-01

    In high income nations, traumatic life experiences such as childhood sexual abuse are much more common in people living with HIV/AIDS (PLWHA) than the general population, and trauma is associated with worse current health and functioning. Virtually no data exist on the prevalence or consequences of trauma for PLWHA in low income nations. We recruited four cohorts of Tanzanian patients in established medical care for HIV infection (n = 228), individuals newly testing positive for HIV (n = 267), individuals testing negative for HIV at the same sites (n = 182), and a random sample of community-dwelling adults (n = 249). We assessed lifetime prevalence of traumatic experiences, recent stressful life events, and current mental health and health-related physical functioning. Those with established HIV infection reported a greater number of childhood and lifetime traumatic experiences (2.1 and 3.0 respectively) than the community cohort (1.8 and 2.3). Those with established HIV infection reported greater post-traumatic stress disorder (PTSD) symptomatology and worse current health-related physical functioning. Each additional lifetime traumatic experience was associated with increased PTSD symptomatology and worse functioning. This study is the first to our knowledge in an HIV population from a low income nation to report the prevalence of a range of potentially traumatic life experiences compared to a matched community sample and to show that trauma history is associated with poorer health-related physical functioning. Our findings underscore the importance of considering psychosocial characteristics when planning to meet the health needs of PLWHA in low income countries.

  16. Current wheeze, asthma, respiratory infections, and rhinitis among adults in relation to inspection data and indoor measurements in single-family houses in Sweden-The BETSI study.

    Science.gov (United States)

    Wang, J; Engvall, K; Smedje, G; Nilsson, H; Norbäck, D

    2017-07-01

    In the Swedish Building Energy, Technical Status and Indoor environment study, a total of 1160 adults from 605 single-family houses answered a questionnaire on respiratory health. Building inspectors investigated the homes and measured temperature, air humidity, air exchange rate, and wood moisture content (in attic and crawl space). Moisture load was calculated as the difference between indoor and outdoor absolute humidity. Totally, 7.3% were smokers, 8.7% had doctor' diagnosed asthma, 11.2% current wheeze, and 9.5% current asthma symptoms. Totally, 50.3% had respiratory infections and 26.0% rhinitis. The mean air exchange rate was 0.36/h, and the mean moisture load 1.70 g/m 3 . Damp foundation (OR=1.79, 95% CI 1.16-2.78) was positively associated while floor constructions with crawl space (OR=0.49, 95% CI 0.29-0.84) was negatively associated with wheeze. Concrete slabs with overlying insulation (OR=2.21, 95% CI 1.24-3.92) and brick façade (OR=1.71, 95% CI 1.07-2.73) were associated with rhinitis. Moisture load was associated with respiratory infections (OR=1.21 per 1 g/m 3 , 95% CI 1.04-1.40) and rhinitis (OR=1.36 per 1 g/m 3 , 95% CI 1.02-1.83). Air exchange rate was associated with current asthma symptoms (OR=0.85 per 0.1/h, 95% CI 0.73-0.99). Living in homes with damp foundation, concrete slabs with overlying insulation, brick façade, low ventilation flow, and high moisture load are risk factors for asthma, rhinitis, and respiratory infections. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  17. Effects of transcranial direct current stimulation (tDCS) on multiscale complexity of dual-task postural control in older adults.

    Science.gov (United States)

    Zhou, Diange; Zhou, Junhong; Chen, Hu; Manor, Brad; Lin, Jianhao; Zhang, Jue

    2015-08-01

    Transcranial direct current stimulation (tDCS) targeting the prefrontal cortex reduces the size and speed of standing postural sway in younger adults, particularly when performing a cognitive dual task. Here, we hypothesized that tDCS would alter the complex dynamics of postural sway as quantified by multiscale entropy (MSE). Twenty healthy older adults completed two study visits. Center-of-pressure (COP) fluctuations were recorded during single-task (i.e., quiet standing) and dual-task (i.e., standing while performing serial subtractions) conditions, both before and after a 20-min session of real or sham tDCS. MSE was used to estimate COP complexity within each condition. The percentage change in complexity from single- to dual-task conditions (i.e., dual-task cost) was also calculated. Before tDCS, COP complexity was lower (p = 0.04) in the dual-task condition as compared to the single-task condition. Neither real nor sham tDCS altered complexity in the single-task condition. As compared to sham tDCS, real tDCS increased complexity in the dual-task condition (p = 0.02) and induced a trend toward improved serial subtraction performance (p = 0.09). Moreover, those subjects with lower dual-task COP complexity at baseline exhibited greater percentage increases in complexity following real tDCS (R = -0.39, p = 0.05). Real tDCS also reduced the dual-task cost to complexity (p = 0.02), while sham stimulation had no effect. A single session of tDCS targeting the prefrontal cortex increased standing postural sway complexity with concurrent non-postural cognitive task. This form of noninvasive brain stimulation may be a safe strategy to acutely improve postural control by enhancing the system's capacity to adapt to stressors.

  18. Self-reported volitional control in adolescents and young adults from a community cohort: Associations with current, past and future mental disorders.

    Science.gov (United States)

    Asselmann, Eva; Hilbert, Kevin; Hoyer, Jana; Wittchen, Hans-Ulrich; Lieb, Roselind; Bühringer, Gerhard; Beesdo-Baum, Katja

    2017-11-21

    Alterations in volitional control have been found for various mental disorders. However, it remains unclear to which degree such alterations vary by type of psychopathology and constitute preceding vulnerabilities or correlates of mental disorders. DSM-IV mental disorders were assessed among adolescents and young adults from the community at baseline (age 14-24) and in up to 3 follow-up assessments over 10 years (n = 2515) using a standardized diagnostic interview (DIA-X/M-CIDI). Self-reported volitional control was assessed at second follow-up (T2) when subjects were aged 17-28 using the German version of the Short Form of the Volitional Components Inventory. Linear regressions adjusted for sex, age and lifetime disorders revealed that anxiety and affective disorders were associated with widespread alterations in self-reported volitional control (lower self regulation, higher self inhibition and volitional inhibition), while substance use disorders were specifically associated with higher volitional inhibition. Logistic regressions adjusted for sex, age and prior lifetime psychopathology revealed that lower self-reported volitional control at T2 predicted incident panic, social phobia and substance use at T3 (follow-up interval M = 4.8 years). Findings point toward at least partly disorder-specific alterations in volitional control in mental disorders, which might be antecedent vulnerability factors and thus useful to guide early recognition and prevention. Copyright © 2017. Published by Elsevier B.V.

  19. Proportion of U.S. Civilian Population Ineligible for U.S. Air Force Enlistment Based on Current and Previous Weight Standards

    National Research Council Canada - National Science Library

    D'Mello, Tiffany A; Yamane, Grover K

    2007-01-01

    .... Until recently, gender-specific weight standards based on height were in place. However, in June 2006 the USAF implemented a new set of height-weight limits utilizing body mass index (BMI) criteria...

  20. Training Standardization

    International Nuclear Information System (INIS)

    Agnihotri, Newal

    2003-01-01

    The article describes the benefits of and required process and recommendations for implementing the standardization of training in the nuclear power industry in the United States and abroad. Current Information and Communication Technologies (ICT) enable training standardization in the nuclear power industry. The delivery of training through the Internet, Intranet and video over IP will facilitate this standardization and bring multiple benefits to the nuclear power industry worldwide. As the amount of available qualified and experienced professionals decreases because of retirements and fewer nuclear engineering institutions, standardized training will help increase the number of available professionals in the industry. Technology will make it possible to use the experience of retired professionals who may be interested in working part-time from a remote location. Well-planned standardized training will prevent a fragmented approach among utilities, and it will save the industry considerable resources in the long run. It will also ensure cost-effective and safe nuclear power plant operation

  1. Long-Term Effects of Repeated Prefrontal Cortex Transcranial Direct Current Stimulation (tDCS) on Food Craving in Normal and Overweight Young Adults.

    Science.gov (United States)

    Ljubisavljevic, M; Maxood, K; Bjekic, J; Oommen, J; Nagelkerke, N

    The dorsolateral prefrontal cortex (DLPFC) plays an important role in the regulation of food intake. Several previous studies demonstrated that a single session of transcranial direct current stimulation (tDCS) of the DLPFC reduces food craving and caloric intake. We hypothesized that repeated tDCS of the right DLPFC cortex may exert long-term changes in food craving in young, healthy adults and that these changes may differ between normal and overweight subjects. Thirty healthy individuals who reported frequent food cravings without a prior history of eating disorders were initially recruited. Subjects were randomized into an ACTIVE group who received 5 days of real tDCS (20 minutes, anode right-cathode left montage, 2 mA with current density kept at 0.06 mA/cm2, 1 min ramp-up/ramp-down), and a SHAM group, who received one day of real tDCS, on the first day (same parameters), followed by 4 days of sham tDCS. Food craving intensity was examined by Food Craving Questionnaires State and Trait and Food Craving Inventory before, during, (5-days) and one month (30-days) after tDCS. Single session of tDCS significantly reduced the intensity of current food craving (FCQ-S). Five days of active tDCS significantly reduced habitual experiences of food craving (FCQ-T), when compared to baseline pre-stimulation levels. Furthermore, both current (FCQ-S) and habitual craving (FCQ-T) were significantly reduced 30 days after active tDCS, while sham tDCS, i.e. a single tDCS session did not have significant effects. Also, active tDCS significantly decreased craving for fast food and sweets, and to a lesser degree for fat, while it did not have significant effects on craving for carbohydrates (FCI). There were no significant differences between individual FCQ-T subscales (craving dimensions) after 5 or 30 days of either sham or active tDCS. Changes in craving were not significantly associated with the initial weight, or with weight changes 30 days after the stimulation in the

  2. Urinary growth hormone level and insulin-like growth factor-1 standard deviation score (IGF-SDS) can discriminate adult patients with severe growth hormone deficiency.

    Science.gov (United States)

    Hirohata, Toshio; Saito, Nobuhito; Takano, Koji; Yamada, So; Son, Jae-Hyun; Yamada, Shoko M; Nakaguchi, Hiroshi; Hoya, Katsumi; Murakami, Mineko; Mizutani, Akiko; Okinaga, Hiroko; Matsuno, Akira

    2013-01-01

    Adult growth hormone (GH) deficiency (AGHD) in Japan is diagnosed based on peak GH concentrations during GH provocative tests such as GHRP-2 stimulation test. In this study, we aimed to evaluate the ability of serum insulin-like growth factor-1 (sIGF-1) and urinary GH (uGH) at the time of awakening to diagnose AGHD. Fifty-nine patients with pituitary disease (32 men and 27 women; age 20-85 y (57.5 ± 15.5, mean ± SD) underwent GHRP-2 stimulation and sIGF-1 testing. Thirty-six and 23 patients were diagnosed with and without severe AGHD, respectively based on a peak GH response of standard deviation score (IGF-1 SDS) based on age and sex. We determined whether uGH levels in urine samples from 42 of the 59 patients at awakening were above or below the sensitivity limit. We evaluated IGF-1 SDS and uGH levels in a control group of 15 healthy volunteers. Values for IGF-1 SDS were significantly lower in patients with, than without (-2.07 ± 1.77 vs.-0.03 ± 0.92, mean ± SD; p -1.4. IGF-1 SDS discriminated AGHD more effectively in patients aged ≤60 years. The χ2 test revealed a statistical relationship between uGH and AGHD (test statistic: 7.0104 ≥ χ2 (1; 0.01) = 6.6349). When IGF-1 SDS is < -1.4 or uGH is below the sensitivity limit, AGHD can be detected with high sensitivity.

  3. Relationships between self-reported lifetime physical activity, estimates of current physical fitness, and aBMD in adult premenopausal women.

    Science.gov (United States)

    Greenway, Kathleen G; Walkley, Jeff W; Rich, Peter A

    2015-01-01

    Osteoporosis is common, and physical activity is important in its prevention and treatment. Of the categories of historical physical activity (PA) examined, we found that weight-bearing and very hard physical activity had the strongest relationships with areal bone mineral density (aBMD) throughout growth and into adulthood, while for measures of strength, only grip strength proved to be an independent predictor of aBMD. To examine relationships between aBMD (total body, lumbar spine, proximal femur, tibial shaft, distal radius) and estimates of historical PA, current strength, and cardiovascular fitness in adult premenopausal women. One hundred fifty-two adult premenopausal women (40 ± 9.6 years) undertook aBMD (dual-energy X-ray absorptiometry (DXA)) and completed surveys to estimate historical physical activity representative of three decades (Kriska et al. [1]), while subsets underwent functional tests of isokinetic strength (hamstrings and quadriceps), grip strength (hand dynamometer), and maximum oxygen uptake (MaxV02; cycle ergometer). Historical PA was characterized by demand (metabolic equivalents, PA > 3 METS; PA > 7 METS) and type (weight-bearing; high impact). Significant positive independent predictors varied by decade and site, with weight-bearing exercise and PA > 3 METS significant for the tibial shaft (10-19 decade) and only PA > 7 METS significant for the final two decades (20-29 and 30-39 years; total body and total hip). A significant negative correlation between high impact activity and tibial shaft aBMD appeared for the final decade. For strength measures, only grip strength was an independent predictor (total body, total hip), while MaxV02 provided a significant independent prediction for the tibial shaft. Past PA > 7 METS was positively associated with aBMD, and such activity should probably constitute a relatively high proportion of all weekly PA to positively affect aBMD. The findings warrant more detailed investigations in a prospective

  4. NODC Standard Format Coastal Ocean Wave and Current (F181) Data from the Atlantic Remote Sensing Land/Ocean Experiment (ARSLOE) (1980) (NODC Accession 0014202)

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — This data set contains time series coastal ocean wave and current data collected during the Atlantic Remote Sensing Land/Ocean Experiment (ARSLOE). ARSLOE was...

  5. Patient-reported outcomes in adults with congenital heart disease: Inter-country variation, standard of living and healthcare system factors

    NARCIS (Netherlands)

    Moons, Philip; Kovacs, Adrienne H.; Luyckx, Koen; Thomet, Corina; Budts, Werner; Enomoto, Junko; Sluman, Maayke A.; Yang, Hsiao-Ling; Jackson, Jamie L.; Khairy, Paul; Cook, Stephen C.; Subramanyan, Raghavan; Alday, Luis; Eriksen, Katrine; Dellborg, Mikael; Berghammer, Malin; Johansson, Bengt; Mackie, Andrew S.; Menahem, Samuel; Caruana, Maryanne; Veldtman, Gruschen; Soufi, Alexandra; Fernandes, Susan M.; White, Kamila; Callus, Edward; Kutty, Shelby; van Bulck, Liesbet; Apers, Silke

    2018-01-01

    Aims: Geographical differences in patient-reported outcomes (PROs) of adults with congenital heart disease (ConHD) have been observed, but are poorly understood. We aimed to: (1) investigate inter-country variation in PROs in adults with ConHD; (2) identify patient-related predictors of PROs; and

  6. Pediatric Provider's Perspectives on the Transition to Adult Health Care for Youth with Autism Spectrum Disorder: Current Strategies and Promising New Directions

    Science.gov (United States)

    Kuhlthau, Karen A.; Warfield, Marji E.; Hurson, Jill; Delahaye, Jennifer; Crossman, Morgan K.

    2015-01-01

    Few youth with autism spectrum disorder (ASD) nationally report receiving services to help them transition from the pediatric health care system to the adult health care system. For example, only one-fifth (21.1%) of youth with ASD receive any transition planning services. To better understand why the transition from pediatric to adult health care…

  7. Relationship between spending on electronic cigarettes, 30-day use, and disease symptoms among current adult cigarette smokers in the U.S.

    Directory of Open Access Journals (Sweden)

    Tingting Yao

    Full Text Available To examine the relationship between spending on electronic cigarettes (e-cigarettes and disease symptoms compared with the relationship between 30-day e-cigarette use and disease symptoms among adult cigarette smokers in the U.S.We analyzed data from the Tobacco and Attitudes Beliefs Survey which included 533 respondents aged 24+ who were current cigarette smokers and e-cigarette ever users. Fifteen self-reported disease symptoms were included as outcome variables. Separate multivariable logistic regression models were estimated for each disease symptom with total spending on e-cigarettes in the past 30 days and with reported 30-day e-cigarette use. All models controlled for cigarettes smoked per day (CPD and sociodemographic characteristics.We found that those who spent more on e-cigarettes were more likely to report chest pain (AOR = 1.25, 95% CI 1.02-1.52, to notice blood when brushing their teeth (AOR = 1.23, 95% CI 1.02-1.49, to have sores or ulcers in their mouth (AOR = 1.36, 95% CI 1.08-1.72, and to have more than one cold (AOR = 1.36, 95% CI 1.05-1.78 than those with no spending on e-cigarettes in the past 30 days in an adjusted analysis. After controlling for CPD and other covariates, there were no significant relationships between 30-day e-cigarette use and symptoms. Even after controlling for CPD, e-cigarette expenditures or use was associated with greater odds of wheezing and shortness of breath.E-cigarette expenditures might be a more useful measure of intensity of e-cigarette use. The additional health effect of e-cigarette use or expenditures among smokers independent of the effect of CPD suggests that e-cigarette use adds adverse health effects even among cigarette smokers.

  8. Relationship between spending on electronic cigarettes, 30-day use, and disease symptoms among current adult cigarette smokers in the U.S.

    Science.gov (United States)

    Yao, Tingting; Max, Wendy; Sung, Hai-Yen; Glantz, Stanton A; Goldberg, Rachel L; Wang, Julie B; Wang, Yingning; Lightwood, James; Cataldo, Janine

    2017-01-01

    To examine the relationship between spending on electronic cigarettes (e-cigarettes) and disease symptoms compared with the relationship between 30-day e-cigarette use and disease symptoms among adult cigarette smokers in the U.S. We analyzed data from the Tobacco and Attitudes Beliefs Survey which included 533 respondents aged 24+ who were current cigarette smokers and e-cigarette ever users. Fifteen self-reported disease symptoms were included as outcome variables. Separate multivariable logistic regression models were estimated for each disease symptom with total spending on e-cigarettes in the past 30 days and with reported 30-day e-cigarette use. All models controlled for cigarettes smoked per day (CPD) and sociodemographic characteristics. We found that those who spent more on e-cigarettes were more likely to report chest pain (AOR = 1.25, 95% CI 1.02-1.52), to notice blood when brushing their teeth (AOR = 1.23, 95% CI 1.02-1.49), to have sores or ulcers in their mouth (AOR = 1.36, 95% CI 1.08-1.72), and to have more than one cold (AOR = 1.36, 95% CI 1.05-1.78) than those with no spending on e-cigarettes in the past 30 days in an adjusted analysis. After controlling for CPD and other covariates, there were no significant relationships between 30-day e-cigarette use and symptoms. Even after controlling for CPD, e-cigarette expenditures or use was associated with greater odds of wheezing and shortness of breath. E-cigarette expenditures might be a more useful measure of intensity of e-cigarette use. The additional health effect of e-cigarette use or expenditures among smokers independent of the effect of CPD suggests that e-cigarette use adds adverse health effects even among cigarette smokers.

  9. Osmotic Edema Rapidly Increases Neuronal Excitability Through Activation of NMDA Receptor-Dependent Slow Inward Currents in Juvenile and Adult Hippocampus

    Directory of Open Access Journals (Sweden)

    Kelli Lauderdale

    2015-09-01

    Full Text Available Cellular edema (cell swelling is a principal component of numerous brain disorders including ischemia, cortical spreading depression, hyponatremia, and epilepsy. Cellular edema increases seizure-like activity in vitro and in vivo, largely through nonsynaptic mechanisms attributable to reduction of the extracellular space. However, the types of excitability changes occurring in individual neurons during the acute phase of cell volume increase remain unclear. Using whole-cell patch clamp techniques, we report that one of the first effects of osmotic edema on excitability of CA1 pyramidal cells is the generation of slow inward currents (SICs, which initiate after approximately 1 min. Frequency of SICs increased as osmolarity decreased in a dose-dependent manner. Imaging of real-time volume changes in astrocytes revealed that neuronal SICs occurred while astrocytes were still in the process of swelling. SICs evoked by cell swelling were mainly nonsynaptic in origin and NMDA receptor-dependent. To better understand the relationship between SICs and changes in neuronal excitability, recordings were performed in increasingly physiological conditions. In the absence of any added pharmacological reagents or imposed voltage clamp, osmotic edema induced excitatory postsynaptic potentials and burst firing over the same timecourse as SICs. Like SICs, action potentials were blocked by NMDAR antagonists. Effects were more pronounced in adult (8–20 weeks old compared with juvenile (P15–P21 mice. Together, our results indicate that cell swelling triggered by reduced osmolarity rapidly increases neuronal excitability through activation of NMDA receptors. Our findings have important implications for understanding nonsynaptic mechanisms of epilepsy in relation to cell swelling and reduction of the extracellular space.

  10. The effectiveness of virtual reality interventions in improving balance in adults with impaired balance compared to standard or no treatment: A systematic review.

    Science.gov (United States)

    Booth, Vicky; Masud, Tahir; Bath-Hextall, Fiona

    Balance impairment can result in falls and reduced activities of daily living and function. Virtual reality and interactive gaming systems provide a novel and potentially environmentally flexible treatment option to improve postural stability and reduce falls in balance impaired populations. There are no existing systematic reviews in this topic area. To search, critically appraise and synthesise the best available evidence on whether virtual reality interventions, including interactive gaming systems, are effective at improving balance in adults with impaired balance. Adults with impaired, altered or reduced balance identified either through reduced balance outcome measure score or increased risk or incidence of falls.Types of interventions:Any virtual reality or interactive gaming systems used within a rehabilitative setting.The primary outcome was an objective measure of balance (i.e. balance outcome measure such as Berg Balance Score) or number and/or incidence of falls. Secondary outcome measures of interest included any adverse effects experienced, an outcome measure indicating functional balance (i.e. walking speed), quality of life (through use of an objective measure i.e. EuroQOL), and number of days in hospital due to falls.Types of studies:Randomised controlled trials (RCT). A three-stage strategy searched the following electronic databases: The Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, EMBASE, AMED, CINAHL, PsycINFO, PsycBITE, OTseeker, Ei Compendex, Inspec, Current Controlled Trials, and the National Institute of Health Clinical Trials Database. The methodological quality of each included study was independently assessed using the Joanna Briggs Institute Meta Analysis of Statistics Assessment and Review Instrument (JBI-MAStARI) to systematically comment on influence of bias. Data was individually extracted from the included studies using the standardised JBI data extraction tool from JBI-MAStARI. Data was analysed using Review

  11. Effect of square stepping exercise for older adults to prevent fall and injury related to fall: systematic review and meta-analysis of current evidences

    OpenAIRE

    Fisseha, Berihu; Janakiraman, Balamurugan; Yitayeh, Asmare; Ravichandran, Hariharasudhan

    2017-01-01

    Falls and fall related injuries become an emerging health problem among older adults. As a result a review of the recent evidences is needed to design a prevention strategy. The aim of this review was to determine the effect of square stepping exercise (SSE) for fall down injury among older adults compared with walking training or other exercises. An electronic database search for relevant randomized control trials published in English from 2005 to 2016 was conducted. Articles with outcome me...

  12. Towards a standard design model for quad-rotors: A review of current models, their accuracy and a novel simplified model

    Science.gov (United States)

    Amezquita-Brooks, Luis; Liceaga-Castro, Eduardo; Gonzalez-Sanchez, Mario; Garcia-Salazar, Octavio; Martinez-Vazquez, Daniel

    2017-11-01

    Applications based on quad-rotor-vehicles (QRV) are becoming increasingly wide-spread. Many of these applications require accurate mathematical representations for control design, simulation and estimation. However, there is no consensus on a standardized model for these purposes. In this article a review of the most common elements included in QRV models reported in the literature is presented. This survey shows that some elements are recurrent for typical non-aerobatic QRV applications; in particular, for control design and high-performance simulation. By synthesising the common features of the reviewed models a standard generic model SGM is proposed. The SGM is cast as a typical state-space model without memory-less transformations, a structure which is useful for simulation and controller design. The survey also shows that many QRV applications use simplified representations, which may be considered simplifications of the SGM here proposed. In order to assess the effectiveness of the simplified models, a comprehensive comparison based on digital simulations is presented. With this comparison, it is possible to determine the accuracy of each model under particular operating ranges. Such information is useful for the selection of a model according to a particular application. In addition to the models found in the literature, in this article a novel simplified model is derived. The main characteristics of this model are that its inner dynamics are linear, it has low complexity and it has a high level of accuracy in all the studied operating ranges, a characteristic found only in more complex representations. To complement the article the main elements of the SGM are evaluated with the aid of experimental data and the computational complexity of all surveyed models is briefly analysed. Finally, the article presents a discussion on how the structural characteristics of the models are useful to suggest particular QRV control structures.

  13. Current and proposed revisions, changes, and modifications to American codes and standards to address packaging, handling, and transportation of radioactive materials and how they relate to comparable international regulations

    International Nuclear Information System (INIS)

    Borter, W.H.; Froehlich, C.H.

    2004-01-01

    This paper addresses current and proposed revisions, additions, and modifications to American Society of Mechanical Engineers (ASME) Boiler and Pressure Vessel Code (BPVC) (i.e., ''ASMEthe Code'') Section III, Division 3 and American National Standards Institute (ANSI)/ASME N14.6. It provides insight into the ongoing processes of the associated committees and highlights important revisions, changes, and modifications to this Code and Standard. The ASME Code has developed and issued Division 3 to address items associated with the transportation and storage of radioactive materials. It currently only addresses ''General Requirements'' in Subsections WA and ''Class TP (Type B) Containments'' (Transportation Packages) in Subsection WB, but is in the process of adding a new Subsection WC to address ''Class SC'' (Storage Containments). ANSI/ASME Standard N14.6 which interacts with components constructed to Division 3 by addressinges special lifting devices for radioactive material shipping containers. This Standard is in the process of a complete re-write. This Code and Standard can be classified as ''dynamic'' in that their committees meet at least four times a year to evaluate proposed modifications and additions that reflect current safety practices in the nuclear industry. These evaluations include the possible addition of new materials, fabrication processes, examination methods, and testing requirements. An overview of this ongoing process is presented in this paper along with highlights of the more important proposed revisions, changes, and modifications and how they relate to United States (US) and international regulations and guidance like International Atomic Energy Agency (IAEA) Requirement No. TS-R-1

  14. Superallowed 0+→0+ nuclear β decays: A critical survey with tests of the conserved vector current hypothesis and the standard model

    International Nuclear Information System (INIS)

    Hardy, J.C.; Towner, I.S.

    2005-01-01

    A complete and critical survey is presented of all half-life, decay-energy, and branching-ratio measurements related to 20 superallowed 0 + →0 + decays; no measurements are ignored, although some are rejected for cause and others updated. A new calculation of the statistical rate function f is described and experimental ft values determined. The associated theoretical corrections needed to convert these results into 'corrected' Ft values are discussed, and careful attention is paid to the origin and magnitude of their uncertainties. As an exacting confirmation of the conserved vector current hypothesis, the corrected Ft values are seen to be constant to three parts in 10 4 . These data are also used to set a new limit on any possible scalar interaction (assuming maximum parity violation) of C S /C V =-(0.00005±0.00130). The average Ft value obtained from the survey, when combined with the muon lifetime, yields the up-down quark-mixing element of the Cabibbo-Kobayashi-Maskawa (CKM) matrix, V ud =0.9738±0.0004, and the unitarity test on the top row of the matrix becomes vertical bar V ud vertical bar 2 + vertical bar V us vertical bar 2 + vertical bar V ub vertical bar 2 =0.9966±0.0014 using the Particle Data Group's currently recommended values for V us and V ub . If V us comes instead from two recent results on K e3 decay, the unitarity sum becomes 0.9996(11). Either result can be expressed in terms of the possible existence of right-hand currents. Finally, we discuss the priorities for future theoretical and experimental work with the goal of making the CKM unitarity test more definitive

  15. Online and offline effects of cerebellar transcranial direct current stimulation on motor learning in healthy older adults: a randomized double-blind sham-controlled study.

    Science.gov (United States)

    Samaei, Afshin; Ehsani, Fatemeh; Zoghi, Maryam; Hafez Yosephi, Mohaddese; Jaberzadeh, Shapour

    2017-05-01

    The aim of this randomized double blinded sham-controlled study was to determine the effect of cerebellar anodal transcranial direct current stimulation (a-tDCS) on online and offline motor learning in healthy older individuals. Thirty participants were randomly assigned in experimental (n = 15) or sham tDCS (n = 15) groups. Participants in experimental group received 2 mA cerebellar a-tDCS for 20 min. However, the tDCS was turned off after 30 seconds in sham group. Response time (RT) and error rate (ER) in serial RT test were assessed before, during 35 minutes and 48 h after the intervention. Reduction of RT and ER following the intervention session was considered as short-term (35 min post intervention) and long-term offline learning (48 h post intervention), respectively. Online RT and ER reduction were similar in both groups (P > 0.05). RT was significantly reduced 48 hours post intervention in cerebellar a-tDCS group (P = 0.03). Moreover, RT was significantly increased after 35 minutes and 48 hours in sham tDCS group (P = 0.03, P = 0.007), which indicates a lack of short-term and long-term offline learning in older adults. A-tDCS on cerebellar region produced more short-term and long-term offline improvement in RT (P = 0.014, P = 0.01) compared to sham tDCS. In addition, online, short-term and long-term (48 h) offline error reduced in cerebellar a-tDCS as compared to sham-control group, although this reduction was not significant (P > 0.05). A deficit suggests that a direct comparison to a younger group was made. The findings suggested that cerebellar a-tDCS might be useful for improvement of offline motor learning in older individuals. © 2017 Federation of European Neuroscience Societies and John Wiley & Sons Ltd.

  16. Malaysian NDT standards

    International Nuclear Information System (INIS)

    Khazali Mohd Zin

    2001-01-01

    In order to become a developed country, Malaysia needs to develop her own national standards. It has been projected that by the year 2020, Malaysia requires about 8,000 standards (Department of Standard Malaysia). Currently more than 2,000 Malaysian Standards have been gazette by the government which considerably too low before tire year 2020. NDT standards have been identified by the standard working group as one of the areas to promote our national standards. In this paper the author describes the steps taken to establish the Malaysian very own NDT standards. The project starts with the establishment of radiographic standards. (Author)

  17. Instant standard concept for data standards development

    NARCIS (Netherlands)

    Folmer, Erwin Johan Albert; Kulcsor, Istvan Zsolt; Roes, Jasper

    2013-01-01

    This paper presents the current results of an ongoing research about a new data standards development concept. The concept is called Instant Standard referring to the pressure that is generated by shrinking the length of the standardization process. Based on this concept it is estimated that the

  18. Association between a dietary quality index based on the food standard agency nutrient profiling system and cardiovascular disease risk among French adults.

    Science.gov (United States)

    Adriouch, Solia; Julia, Chantal; Kesse-Guyot, Emmanuelle; Ducrot, Pauline; Péneau, Sandrine; Méjean, Caroline; Assmann, Karen E; Deschasaux, Mélanie; Hercberg, Serge; Touvier, Mathilde; Fezeu, Léopold K

    2017-05-01

    In France, the implementation of a front-of-pack (FOP) nutrition label-the 5-Colour Nutrition Label (5-CNL) is currently under consideration as a strategic tool to allow consumers making healthier food choices. This FOP label is based on the British Food Standards Agency Nutrient Profiling System (FSA-NPS), reflecting the overall nutritional quality of foods. At the individual level, an energy-weighted mean of all FSA-NPS scores of foods usually consumed has been elaborated (FSA-NPS DI). Our objective was to investigate the prospective association between the FSA-NPS DI and cardiovascular disease (CVD) risk. 75,801 participants to the NutriNet-Santé cohort, who completed at least three 24h dietary records during the first 2y of the follow-up, were followed between 2009 and 2016. Multivariable Cox proportional hazards models were used to characterize the associations between FSA-NPS DI and the incidence of CVDs. 509 major cardiovascular events were diagnosed (262 coronary heart diseases and 247 strokes). A higher FSA-NPS DI, characterizing lower dietary quality, was associated with increased CVD risk (HR for a 1-point increment =1.08 (1.03-1.13); HR Q4vs.Q1 =1.40 (1.06-1.84), P trend Q4-Q1 =0.01). This association tended to be stronger in overweight subjects (HR for a 1-point increment =1.12 (1.04-1.19); P interaction =0.003). These results suggest that lower dietary quality, as reflected by a higher FSA-NPS DI, may be associated with a significant increase in cardiovascular risk, especially in at-risk individuals (overweight population). They support the public health relevance of developing a front-of-pack nutrition label based on this score. Copyright © 2017 Elsevier B.V. All rights reserved.

  19. RESULTS OF TESTS OF LIGHTNING-RODS WITH UNIVERSAL CLAMPS BY THE APERIODIC IMPULSES OF CURRENT OF ARTIFICIAL LIGHTNING WITH THE PEAK-TEMPORAL PARAMETERS RATIONED ON FOREIGN STANDARDS

    Directory of Open Access Journals (Sweden)

    M.I. Baranov

    2015-06-01

    Full Text Available Purpose. Test in obedience to the requirements of row of operating foreign standards of round metallic lightning-rods with the flat metallic universal clamps of the special type on firmness to direct action of аperiodic impulses of current of temporal form 10/350 μs by amplitude of 50 кА (N− class and 100 кА (H− class. Methodology. The order of leadthrough of these tests is certain the followings normative documents: International IEC 62305-1: 2010, Russian national GOST R IEC 62305-1-2010 and German national DIN EN 50164-1:2008 Standards. Results. Conducted on a powerful high-voltage pulsed current of artificial linear lightning with the peak-temporal parameters and admittances of test rationed on the indicated foreign standards rationed that all of the lightning-rods tested in collection with universal clamps, isolating holders and ceramic elements of roof of technical building were survive electrodynamics and electrothermal action of in-use single short blow of an artificial storm digit. Originality. First in domestic practice the similar model tests of lightning-rods are conducted with universal clamps, executed from different explorer materials, on firmness to flowing to on by it the indicated large impulsive currents of artificial lightning. Practical value. Real firmness to lightning of round copper and zincked steel lightning-rods is certain with the flat copper, zincked steel and non-rusting steel universal clamps of the special execution.

  20. Fluorine--a current literature review. An NRC and ATSDR based review of safety standards for exposure to fluorine and fluorides.

    Science.gov (United States)

    Prystupa, Jeff

    2011-02-01

    A review of the literature of the element fluorine and its bonded-form, fluoride, was undertaken. Generally regarded as safe, an expanding body of literature reveals that fluoride's toxicity has been unappreciated, un-scrutinized, and hidden for over 70 years. The context for the literature search and review was an environmental climate-change study, which demonstrated widespread fluoride contamination by smokestack emissions from coal-fired electricity-generating plants. The objective of this review is to educate and inform regarding the ubiquitous presence and harmful nature of this now ever-present corrosive and reactive toxin. Methods include examination of national health agency reviews, primarily the National Research Council (NRC), Agency for Toxic Substances & Disease Registry (ATSDR), standard medical toxicology references, text books, as well as reports and documents from both private and public research as well as consumer-based NGOs. Study criteria were chosen for relevancy to the subject of the toxicity of fluoride. Fluoride is the extreme electron scavenger, the most corrosive of all elements, as well as the most-reactive. Fluoride appears to attack living tissues, via several mechanisms. Fluoride renders strong evidence that it is a non-biological chemical, demonstrating no observed beneficial function or role in organic chemistry, beyond use as a pesticide or insecticide. Fluorine has a strong role to play in industry, having been utilized extensively in metals, plastics, paints, aluminium, steel, and uranium production. Due to its insatiable appetite for calcium, fluorine and fluorides likely represent a form of chemistry that is incompatible with biological tissues and organ system functions. Based on an analysis of the affects of fluoride demonstrated consistently in the literature, safe levels have not been determined nor standardized. Mounting evidence presents conflicting value to its presence in biological settings and applications. Evidence

  1. [Current status of the standardization of air impulse tonometers and their evaluation--as an example: the Non-Contact Tonometer II].

    Science.gov (United States)

    Jessen, K; Hoffmann, F

    1983-10-01

    The standard values and tolerances used in the assessment of the clinical efficiency of different types of tonometers are once again demonstrated. Investigations carried out in accordance with the existing test plan for comparative clinical measurements using two non-contact tonometers II (NCT II) and a calibrated applanation tonometer as a reference instrument in 155 patient eyes showed that both the regression equation and the scattering of the individual values around the regression curve satisfy the conditions of clinical assessment criteria. Of the individual values, 2.6% are outside the 95% limits. Following a brief illustration of the measuring principle of the NCT II, a test procedure is described for this type of tonometer. It consists of a torsion balance mounted on a cross-sliding carriage with a small mirror 2.5 mm in diameter and a control balance. A lens equipped with a centering cross is used for adjustment to the nominal distances of 11 mm between the nozzle and the cornea. This test procedure makes it possible to determine whether the digital display of any particular NTC II deviates from the nominal value by not more than +/- 1 digit in the range between "12" and "30" and by not more than +/- 2 digits between "31" and "50".

  2. 3D mathematical modeling of glioblastoma suggests that transdifferentiated vascular endothelial cells mediate resistance to current standard-of-care therapy

    Science.gov (United States)

    Yan, Huaming; Romero-López, Mónica; Benitez, Lesly I.; Di, Kaijun; Frieboes, Hermann B.; Hughes, Christopher C. W.; Bota, Daniela A.; Lowengrub, John S.

    2017-01-01

    Glioblastoma (GBM), the most aggressive brain tumor in human patients, is decidedly heterogeneous and highly vascularized. Glioma stem/initiating cells (GSC) are found to play a crucial role by increasing cancer aggressiveness and promoting resistance to therapy. Recently, crosstalk between GSC and vascular endothelial cells has been shown to significantly promote GSC self-renewal and tumor progression. Further, GSC also transdifferentiate into bona-fide vascular endothelial cells (GEC), which inherit mutations present in GSC and are resistant to traditional anti-angiogenic therapies. Here we use 3D mathematical modeling to investigate GBM progression and response to therapy. The model predicted that GSC drive invasive fingering and that GEC spontaneously form a network within the hypoxic core, consistent with published experimental findings. Standard-of-care treatments using DNA-targeted therapy (radiation/chemo) together with anti-angiogenic therapies, reduced GBM tumor size but increased invasiveness. Anti-GEC treatments blocked the GEC support of GSC and reduced tumor size but led to increased invasiveness. Anti-GSC therapies that promote differentiation or disturb the stem cell niche effectively reduced tumor invasiveness and size, but were ultimately limited in reducing tumor size because GEC maintain GSC. Our study suggests that a combinatorial regimen targeting the vasculature, GSC, and GEC, using drugs already approved by the FDA, can reduce both tumor size and invasiveness and could lead to tumor eradication. PMID:28536277

  3. Caracterização da normalidade do P300 em adultos jovens Standard characterization of P300 in young adults

    Directory of Open Access Journals (Sweden)

    Cíntia Santos Silva Machado

    2009-01-01

    Full Text Available OBJETIVO: Comparar com a literatura os valores de latência e amplitude de P300 em adultos jovens brasileiros saudáveis a fim de estabelecer um padrão normativo para futuros estudos, e verificar se os valores encontrados na amostra possuem correlação com o sexo, situação proposta na metodologia do exame e fases do ciclo menstrual. MÉTODOS: A amostra constou de 22 indivíduos saudáveis, sem queixa de desatenção, sem problemas neurológicos e auditivos, de 18 a 30 anos de idade. Todos os indivíduos foram submetidos à avaliação audiológica básica a fim de excluir aqueles com perda de audição. As respostas do P300 foram obtidas com equipamento AMPLAID MK22, de dois canais e em ambiente silencioso. RESULTADOS: Os resultados de latência encontrados na amostra, depois de comparados à literatura, enquadraram-se melhor nos intervalos de latência entre 220 e 380 ms. Somente os valores de amplitude foram influenciados pelas variáveis sexo e fase do ciclo menstrual. CONCLUSÃO: Os valores de latência da amostra não sofreram influência da variável sexo, ciclo menstrual e situação, e aproximaram-se com mais fidedignidade aos valores de intervalos de latência entre 220 e 380 ms. Contudo, os intervalos para a amplitude sofreram influência das variáveis sexo e ciclo menstrual, mas não se enquadraram adequadamente aos valores de intervalo encontrados na literatura.PURPOSE: To compare the values of latency and amplitude of P300 of healthy Brazilian young adults with the data available on the literature, in order to establish a normative standard for future studies. In addition, the aim was also to verify if the values found in the sample were correlated to gender, situation proposed in the methodology of the examination, and phase of menstrual cycle. METHODS: The sample consisted of 22 healthy individuals, without any attention complaints, neurological or auditory disorders, and with ages ranging from 18 to 30 years. All subjects

  4. CALCULATION AND EXPERIMENTAL ESTIMATION OF RESULTS OF ELECTRO-THERMAL ACTION OF RATIONED BY THE INTERNATIONAL STANDARD IEC 62305-1-2010 IMPULSE CURRENT OF SHORT BLOW OF ARTIFICIAL LIGHTNING ON THE THIN-WALLED COVERAGE FROM STAINLESS STEEL

    Directory of Open Access Journals (Sweden)

    M. I. Baranov

    2017-03-01

    Full Text Available Purpose. Calculation and experimental researches of electro-thermal resistibility of the pre-production thin-walled sheet models of outward roof of height technical buildings from stainless steel are easily soiled 12Х18Н10Т to direct action on them rationed by the International Standard IEC 62305-1-2010 aperiodic impulse of current of short bow of artificial lightning of temporal form 10/350 μs with the proper admittances on his peak-temporal parameters (PTP. Methodology. Electrophysics bases of technique of high voltage and large impulsive currents (LIC, and also scientific and technical bases of planning of high-voltage impulsive devices and measuring methods in them LIC with followings below extreme PTP: amplitude of impulse of current of ImL=200 кА (with admittance ±10 %; integral of action of impulse of current of JL=10·106 A2·s (with admittance ±35 %; %; duration of wavefront current of T1=10 μs (with admittance ±20 %; time, proper amplitude of impulse of current of ImL, tmL≤24 μs (with admittance ±20 %; duration of flowing of impulse of current of T2=350 μs (with admittance ±10 %. Results. The results of evaluation calculation and experimental researches of electro-thermal resistibility of the indicated pre-production sheet models are resulted measuring in the plan of 0,5 x 0,5 m from stainless steel are easily soiled the 12Х18Н10Т thickness of 1 mm to action on them of aperiodic impulse of current of short blow of artificial lightning with rationed PTP on the requirements of the International Standard IEC 62305-1-2010. In high current experiments amplitude of ImL of the aperiodic rationed impulse of current of artificial lightning of temporal form of T1/T2=15 μs/315 μs changed in the range of (100-184 кА. The integral of action of JL of impulse of current for I-IV of levels of protection of lightning of technical objects (TO numeral made from 2,32·106 А2·s to 7,88·106 А2·s, and the flowing through the

  5. Predictors of AIDS-preventive behavioral intentions among adult heterosexuals at risk for HIV-infection : Extending current models and measures

    NARCIS (Netherlands)

    Buunk, BP; Bakker, AB; Siero, FW; van den Eijnden, RJJM; Yzer, MC

    This study examined the predictors of the intention to use condoms with new sexual partners. A sample of heterosexual adult females and males (n = 711) was recruited through various channels. A substantial part of the sample had engaged in risky sexual behavior. Predictors were based on various

  6. Strength and balance training for adults with peripheral neuropathy and high risk of fall: current evidence and implications for future research.

    Science.gov (United States)

    Tofthagen, Cindy; Visovsky, Constance; Berry, Donna L

    2012-09-01

    To evaluate the evidence for strength- and balance-training programs in patients at high risk for falls, discuss how results of existing studies might guide clinical practice, and discuss directions for additional research. A search of PubMed and CINAHL® databases was conducted in June 2011 using the terms strength, balance training, falls, elderly, and neuropathy. Only clinical trials conducted using specific strength- or balance-training exercises that included community-dwelling adults and examined falls, fall risk, balance, and/or strength as outcome measures were included in this review. One matched case-control study and two randomized, controlled studies evaluating strength and balance training in patients with diabetes-related peripheral neuropathy were identified. Eleven studies evaluating strength and balance programs in community-dwelling adults at high risk for falls were identified. The findings from the reviewed studies provide substantial evidence to support the use of strength and balance training for older adults at risk for falls, and detail early evidence to support strength and balance training for individuals with peripheral neuropathy. The evidence demonstrates that strength and balance training is safe and effective at reducing falls and improving lower extremity strength and balance in adults aged 50 years and older at high risk for falls, including patients with diabetic peripheral neuropathy. Future studies should evaluate the effects of strength and balance training in patients with cancer, particularly individuals with chemotherapy-induced peripheral neuropathy.

  7. EXPERIMENTAL RESEARCHES OF ELECTRO-THERMAL RESISTIBILITY OF SEND-OFFS AND CABLES TO ACTION RATIONED ON THE INTERNATIONAL STANDARD OF IEC 62305-1-2010 OF APERIODIC IMPULSE OF CURRENT OF ARTIFICIAL LIGHTNING

    Directory of Open Access Journals (Sweden)

    M.I. Baranov

    2016-03-01

    Full Text Available Purpose. Experimental researches of electro-thermal resistibility of cable-explorer products, applied in the power electric circuits of objects of electric-power industry, to action on its copper and aluminum parts bearings a current rationed on the International Standard of IEC 62305-1-2010 aperiodic impulse 10/350 μs of current of artificial lightning. Methodology. Electrophysics bases of technique of high tensions and high pulsed currents (HPC, and also scientific and technical bases of planning of devices of high-voltage impulsive technique and measuring HPC in them. Results. Experimental a way the quantitative levels of maximal values maximum of possible and critical closenesses of aperiodic impulse 10/350 μs of current of artificial lightning with rationed on the international standard of IEC 62305-1-2010 peak-temporal parameters and admittances on them in copper (aluminum parts bearings a current of send-offs and cables with a polyethylene (PET and polyvinylchloride (PVCH isolation. Originality. First in world practice on the unique powerful high-voltage generator of HPC of artificial lightning experimental researches of resistibility to lightning of pre-production models of send-offs (cables are conducted with copper (aluminum tendons, PET and PVCH by an isolation, in-use in power electric circuits of electric-power industry objects. Practical value. The use in practice of protecting from lightning of the got results will allow substantially to promote functional and fire-prevention safety of engineering communications of objects of industrial electroenergy in the conditions of action on them of short shots of linear lightning.

  8. Health Literacy and Older Adults

    Science.gov (United States)

    Chesser, Amy K.; Keene Woods, Nikki; Smothers, Kyle; Rogers, Nicole

    2016-01-01

    Objective: The objective of this review was to assess published literature relating to health literacy and older adults. Method: The current review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta Analyses. Results: Eight articles met inclusion criteria. All studies were conducted in urban settings in the United States. Study sample size ranged from 33 to 3,000 participants. Two studies evaluated health-related outcomes and reported significant associations between low health literacy and poorer health outcomes. Two other studies investigated the impact of health literacy on medication management, reporting mixed findings. Discussion: The findings of this review highlight the importance of working to improve health care strategies for older adults with low health literacy and highlight the need for a standardized and validated clinical health literacy screening tool for older adults. PMID:28138488

  9. Perceived Comfort and Blinding Efficacy in Randomised Sham-Controlled Transcranial Direct Current Stimulation (tDCS Trials at 2 mA in Young and Older Healthy Adults.

    Directory of Open Access Journals (Sweden)

    Denise Wallace

    Full Text Available tDCS studies typically find that: lowest levels of comfort occur at stimulation-onset; young adult participants experience less comfort than older participants; and participants' blinding seems effective at low current strengths. At 2 mA conflicting results have been reported, questioning the effectiveness of blinding in sham-controlled paradigms using higher current strengths. Investigator blinding is rarely reported.Using a protocol with 30 min of 2 mA stimulation we sought to: (a investigate the level of perceived comfort in young and older adults, ranging in age from 19 to 29 years and 63 to 76 years, respectively; (b test investigator and participant blinding; (c assess comfort over a longer stimulation duration; (d add to the literature on protocols using 2 mA current strength.A two-session experiment was conducted where sham and active stimulation were administered to the frontal cortex at the F8/FP1 sites in a within-subjects manner. Levels of perceived comfort were measured, using a visual analogue scale, at the start and end of stimulation in young and older adults. Post-stimulation, participants and investigators judged whether or not active stimulation was used.Comfort scores were lower at stimulation onset in both age groups. Older adults reported: (i more comfort than young participants overall; (ii comparable levels of comfort in sham and active stimulation; (iii significantly more comfort than the young participants during active stimulation. Stimulation mode was correctly identified above chance in the second of the two sessions; 65% of all participants correctly identified the stimulation mode, resulting in a statistical trend. Similarly, the experimenter correctly identified stimulation mode significantly above chance, with 62% of all investigator judgements correct across 120 judgements.Using 2 mA current strength over 30 minutes, tDCS stimulation comfort is lower at stimulation onset in young and older adults and, overall

  10. Adult Appeal.

    Science.gov (United States)

    Stinehart, Kathleen; Kornegay, Jane G.

    1997-01-01

    To reach older, nontraditional students and alumni, alumni associations must offer a different type of programming Suggestions include ignoring class years of alumni, bringing current and former adult students together, emphasizing career connections, supporting networking, featuring a college speaker to satisfy lifelong learners' hunger for…

  11. Are informal carers and community care workers effective in managing malnutrition in the older adult community? A systematic review of current evidence.

    Science.gov (United States)

    Marshall, S; Bauer, J; Capra, S; Isenring, E

    2013-01-01

    Enhancing the effectiveness of the community and aged care workforce to prevent malnutrition and functional decline is important in reducing hospital and aged care facility demand. To investigate the impact of nutrition-related interventions delivered to or by informal carers and non-clinical community care workers on malnutrition-related health outcomes of community-dwelling older adults (≥65 years). Intervention studies were searched for using six electronic databases for English-language publications from January 1980 to 30 May 2012. Nine studies were eligible for inclusion. The strength and quality of the evidence was moderate (six studies with level II intervention evidence, five with positive quality). Types of interventions used were highly varied. The majority of interventions were delivered to informal carers (6 studies), with three of these studies also involving older adult care recipients. Five interventions were targeted at identifying, preventing and/or treating malnutrition specifically (two positive quality, three neutral quality, n=2368). As a result of these interventions, nutritional status improved or stabilized (two positive quality, two neutral quality, n=2333). No study reported an improvement in functional status but two successfully prevented further decline in their participants (two neutral quality, n=1097). Interventions targeted at identifying, preventing and/or treating malnutrition were able to improve or prevent decline in nutritional and functional status, without increasing informal carer burden. The findings of this review support the involvement of non-clinical community care workers and informal carers as part of the nutritional care team for community-dwelling older adults.

  12. Postprandial Glycemic and Insulinemic Responses to Common Breakfast Beverages Consumed with a Standard Meal in Adults Who Are Overweight and Obese

    OpenAIRE

    Jia Li; Elsa Janle; Wayne W. Campbell

    2017-01-01

    Breakfast beverages with different nutrient compositions may affect postprandial glycemic control differently. We assessed the effects of consuming (1) common breakfast beverages (water, sugar-sweetened coffee, reduced-energy orange juice (OJ), and low-fat milk (LFM)); and (2) fat-free, low-fat, and whole milk with breakfast on postprandial plasma glucose and insulin responses in adults who were overweight/obese. Forty-six subjects (33F/13M, body mass index: 32.5 ? 0.7 kg/m2, age: 50 ? 1 year...

  13. Environmental radiation standards

    International Nuclear Information System (INIS)

    Kocher, D.C.

    1987-01-01

    This document contains an outline of an oral presentation on environmental radiation standards presented to the American Nuclear Societies' Topical Conference on Population Exposure from the Nuclear Fuel Cycle. The paper contains several definitions, a summary of current radiation exposure limits; and numerous proposed changes to current standards. 7 figs

  14. Evidence-based guideline update: determining brain death in adults: report of the Quality Standards Subcommittee of the American Academy of Neurology.

    Science.gov (United States)

    Wijdicks, Eelco F M; Varelas, Panayiotis N; Gronseth, Gary S; Greer, David M

    2010-06-08

    To provide an update of the 1995 American Academy of Neurology guideline with regard to the following questions: Are there patients who fulfill the clinical criteria of brain death who recover neurologic function? What is an adequate observation period to ensure that cessation of neurologic function is permanent? Are complex motor movements that falsely suggest retained brain function sometimes observed in brain death? What is the comparative safety of techniques for determining apnea? Are there new ancillary tests that accurately identify patients with brain death? A systematic literature search was conducted and included a review of MEDLINE and EMBASE from January 1996 to May 2009. Studies were limited to adults. In adults, there are no published reports of recovery of neurologic function after a diagnosis of brain death using the criteria reviewed in the 1995 American Academy of Neurology practice parameter. Complex-spontaneous motor movements and false-positive triggering of the ventilator may occur in patients who are brain dead. There is insufficient evidence to determine the minimally acceptable observation period to ensure that neurologic functions have ceased irreversibly. Apneic oxygenation diffusion to determine apnea is safe, but there is insufficient evidence to determine the comparative safety of techniques used for apnea testing. There is insufficient evidence to determine if newer ancillary tests accurately confirm the cessation of function of the entire brain.

  15. Effect of square stepping exercise for older adults to prevent fall and injury related to fall: systematic review and meta-analysis of current evidences.

    Science.gov (United States)

    Fisseha, Berihu; Janakiraman, Balamurugan; Yitayeh, Asmare; Ravichandran, Hariharasudhan

    2017-02-01

    Falls and fall related injuries become an emerging health problem among older adults. As a result a review of the recent evidences is needed to design a prevention strategy. The aim of this review was to determine the effect of square stepping exercise (SSE) for fall down injury among older adults compared with walking training or other exercises. An electronic database search for relevant randomized control trials published in English from 2005 to 2016 was conducted. Articles with outcome measures of functional reach, perceived health status, fear of fall were included. Quality of the included articles was rated using Physiotherapy Evidence Database (PEDro) scale and the pooled effect of SSE was obtained by Review Manager (RevMan5) software. Significant effect of SSE was detected over walking or no treatment to improve balance as well to prevent fear of fall and improve perceived health status. The results of this systematic review proposed that SSE significantly better than walking or no treatment to prevent fall, prevent fear of fall and improve perceived health status.

  16. Quality of Survival and Growth in Children and Young Adults in the PNET4 European Controlled Trial of Hyperfractionated Versus Conventional Radiation Therapy for Standard-Risk Medulloblastoma

    International Nuclear Information System (INIS)

    Kennedy, Colin; Bull, Kim; Chevignard, Mathilde; Culliford, David; Dörr, Helmuth G.; Doz, François; Kortmann, Rolf-Dieter; Lannering, Birgitta; Massimino, Maura; Navajas Gutiérrez, Aurora; Rutkowski, Stefan; Spoudeas, Helen A.; Calaminus, Gabriele

    2014-01-01

    Purpose: To compare quality of survival in “standard-risk” medulloblastoma after hyperfractionated radiation therapy of the central nervous system with that after standard radiation therapy, combined with a chemotherapy regimen common to both treatment arms, in the PNET4 randomised controlled trial. Methods and Materials: Participants in the PNET4 trial and their parents/caregivers in 7 participating anonymized countries completed standardized questionnaires in their own language on executive function, health status, behavior, health-related quality of life, and medical, educational, employment, and social information. Pre- and postoperative neurologic status and serial heights and weights were also recorded. Results: Data were provided by 151 of 244 eligible survivors (62%) at a median age at assessment of 15.2 years and median interval from diagnosis of 5.8 years. Compared with standard radiation therapy, hyperfractionated radiation therapy was associated with lower (ie, better) z-scores for executive function in all participants (mean intergroup difference 0.48 SDs, 95% confidence interval 0.16-0.81, P=.004), but health status, behavioral difficulties, and health-related quality of life z-scores were similar in the 2 treatment arms. Data on hearing impairment were equivocal. Hyperfractionated radiation therapy was also associated with greater decrement in height z-scores (mean intergroup difference 0.43 SDs, 95% confidence interval 0.10-0.76, P=.011). Conclusions: Hyperfractionated radiation therapy was associated with better executive function and worse growth but without accompanying change in health status, behavior, or quality of life

  17. Quality of Survival and Growth in Children and Young Adults in the PNET4 European Controlled Trial of Hyperfractionated Versus Conventional Radiation Therapy for Standard-Risk Medulloblastoma

    Energy Technology Data Exchange (ETDEWEB)

    Kennedy, Colin, E-mail: crk1@soton.ac.uk [University of Southampton Faculty of Medicine and University Hospital Southampton National Health Service Foundation Trust, Southampton (United Kingdom); Bull, Kim [University of Southampton Faculty of Medicine and University Hospital Southampton National Health Service Foundation Trust, Southampton (United Kingdom); Chevignard, Mathilde [Hôpitaux de Saint Maurice, Saint Maurice (France); Neurophysiology, University of Pierre et Marie-Curie Paris 6, Paris (France); Culliford, David [University of Southampton Faculty of Medicine and University Hospital Southampton National Health Service Foundation Trust, Southampton (United Kingdom); Dörr, Helmuth G. [Kinder- und Jugendklinik der Universität Erlangen, Erlangen (Germany); Doz, François [Institut Curie and University Paris Descartes, Sorbonne Paris Cité (France); Kortmann, Rolf-Dieter [Department of Radiation Therapy, University of Leipzig, Leipzig (Germany); Lannering, Birgitta [Department of Pediatrics, The Sahlgren Academy, University of Gothenburg, Gothenburg (Sweden); Massimino, Maura [Fondazione Istituto di Ricovero e Cura a Carattere Scientifico IRCCS Istituto Nazionale dei Tumori, Milan (Italy); Navajas Gutiérrez, Aurora [Hospital Universitario Cruces, Baracaldo-Vizcaya (Spain); Rutkowski, Stefan [University Medical Center Hamburg-Eppendorf, Hamburg (Germany); Spoudeas, Helen A. [Center for Pediatric Endocrinology, University College London, London (United Kingdom); Calaminus, Gabriele [Pediatric Oncology, University of Muenster, Muenster (Germany)

    2014-02-01

    Purpose: To compare quality of survival in “standard-risk” medulloblastoma after hyperfractionated radiation therapy of the central nervous system with that after standard radiation therapy, combined with a chemotherapy regimen common to both treatment arms, in the PNET4 randomised controlled trial. Methods and Materials: Participants in the PNET4 trial and their parents/caregivers in 7 participating anonymized countries completed standardized questionnaires in their own language on executive function, health status, behavior, health-related quality of life, and medical, educational, employment, and social information. Pre- and postoperative neurologic status and serial heights and weights were also recorded. Results: Data were provided by 151 of 244 eligible survivors (62%) at a median age at assessment of 15.2 years and median interval from diagnosis of 5.8 years. Compared with standard radiation therapy, hyperfractionated radiation therapy was associated with lower (ie, better) z-scores for executive function in all participants (mean intergroup difference 0.48 SDs, 95% confidence interval 0.16-0.81, P=.004), but health status, behavioral difficulties, and health-related quality of life z-scores were similar in the 2 treatment arms. Data on hearing impairment were equivocal. Hyperfractionated radiation therapy was also associated with greater decrement in height z-scores (mean intergroup difference 0.43 SDs, 95% confidence interval 0.10-0.76, P=.011). Conclusions: Hyperfractionated radiation therapy was associated with better executive function and worse growth but without accompanying change in health status, behavior, or quality of life.

  18. Quality of survival and growth in children and young adults in the PNET4 European controlled trial of hyperfractionated versus conventional radiation therapy for standard-risk medulloblastoma.

    Science.gov (United States)

    Kennedy, Colin; Bull, Kim; Chevignard, Mathilde; Culliford, David; Dörr, Helmuth G; Doz, François; Kortmann, Rolf-Dieter; Lannering, Birgitta; Massimino, Maura; Navajas Gutiérrez, Aurora; Rutkowski, Stefan; Spoudeas, Helen A; Calaminus, Gabriele

    2014-02-01

    To compare quality of survival in "standard-risk" medulloblastoma after hyperfractionated radiation therapy of the central nervous system with that after standard radiation therapy, combined with a chemotherapy regimen common to both treatment arms, in the PNET4 randomised controlled trial. Participants in the PNET4 trial and their parents/caregivers in 7 participating anonymized countries completed standardized questionnaires in their own language on executive function, health status, behavior, health-related quality of life, and medical, educational, employment, and social information. Pre- and postoperative neurologic status and serial heights and weights were also recorded. Data were provided by 151 of 244 eligible survivors (62%) at a median age at assessment of 15.2 years and median interval from diagnosis of 5.8 years. Compared with standard radiation therapy, hyperfractionated radiation therapy was associated with lower (ie, better) z-scores for executive function in all participants (mean intergroup difference 0.48 SDs, 95% confidence interval 0.16-0.81, P=.004), but health status, behavioral difficulties, and health-related quality of life z-scores were similar in the 2 treatment arms. Data on hearing impairment were equivocal. Hyperfractionated radiation therapy was also associated with greater decrement in height z-scores (mean intergroup difference 0.43 SDs, 95% confidence interval 0.10-0.76, P=.011). Hyperfractionated radiation therapy was associated with better executive function and worse growth but without accompanying change in health status, behavior, or quality of life. Copyright © 2014 Elsevier Inc. All rights reserved.

  19. Standardization of terminology, definitions and outcome criteria in immune thrombocytopenic purpura of adults and children: report from an international working group.

    Science.gov (United States)

    Rodeghiero, Francesco; Stasi, Roberto; Gernsheimer, Terry; Michel, Marc; Provan, Drew; Arnold, Donald M; Bussel, James B; Cines, Douglas B; Chong, Beng H; Cooper, Nichola; Godeau, Bertrand; Lechner, Klaus; Mazzucconi, Maria Gabriella; McMillan, Robert; Sanz, Miguel A; Imbach, Paul; Blanchette, Victor; Kühne, Thomas; Ruggeri, Marco; George, James N

    2009-03-12

    Diagnosis and management of immune thrombocytopenic purpura (ITP) remain largely dependent on clinical expertise and observations more than on evidence derived from clinical trials of high scientific quality. One major obstacle to the implementation of such studies and in producing reliable meta-analyses of existing data is a lack of consensus on standardized critical definitions, outcome criteria, and terminology. Moreover, the demand for comparative clinical trials has dramatically increased since the introduction of new classes of therapeutic agents, such as thrombopoietin receptor agonists, and innovative treatment modalities, such as anti-CD 20 antibodies. To overcome the present heterogeneity, an International Working Group of recognized expert clinicians convened a 2-day structured meeting (the Vicenza Consensus Conference) to define standard terminology and definitions for primary ITP and its different phases and criteria for the grading of severity, and clinically meaningful outcomes and response. These consensus criteria and definitions could be used by investigational clinical trials or cohort studies. Adoption of these recommendations would serve to improve communication among investigators, to enhance comparability among clinical trials, to facilitate meta-analyses and development of therapeutic guidelines, and to provide a standardized framework for regulatory agencies.

  20. Probiotic-enriched foods and dietary supplement containing SYNBIO positively affects bowel habits in healthy adults: an assessment using standard statistical analysis and Support Vector Machines.

    Science.gov (United States)

    Silvi, Stefania; Verdenelli, M Cristina; Cecchini, Cinzia; Coman, M Magdalena; Bernabei, M Simonetta; Rosati, Jessica; De Leone, Renato; Orpianesi, Carla; Cresci, Alberto

    2014-12-01

    A randomised, double-blind, placebo-controlled, parallel group study assessed in healthy adults how daily consumption of the probiotic combination SYNBIO®, administered in probiotic-enriched foods or in a dietary supplement, affected bowel habits. Primary and secondary outcomes gave the overall assessment of bowel well-being, while a Psychological General Well-Being Index compiled by participants estimated the health-related quality of life as well as the gastrointestinal tolerance determined with the Gastrointestinal Symptom Rating Scale. Support Vector Machine models for classification problems were used to validate the total outcomes on bowel well-being. SYNBIO® consumption improved bowel habits of volunteers consuming the probiotic foods or capsules, while the same effects were not registered in the control groups. The recovery of probiotic bacteria from the faeces of a cohort of 100 subjects for each supplemented group showed the persistence of strains in the gastrointestinal tract.

  1. Topical petrolatum gel alone versus topical silver sulfadiazine with standard gauze dressings for the treatment of superficial partial thickness burns in adults: a randomized controlled trial.

    Science.gov (United States)

    Genuino, Glenn Angelo S; Baluyut-Angeles, Kathrina Victoria; Espiritu, Andre Paolo T; Lapitan, Marie Carmela M; Buckley, Brian S

    2014-11-01

    Non-extensive superficial partial thickness burns constitute a major proportion of burns. Conventional treatment involves regular changing of absorptive dressings including the application of a topical antimicrobial, commonly silver sulfadiazine. A systematic review has found insufficient evidence to support or refute such antimicrobial prophylaxis. Another review compared silver sulfadiazine dressings with other occlusive and non-antimicrobial dressings and found insufficient evidence to guide practice. Other research has suggested that dressings with petrolatum gel are as effective as silver sulfadiazine. Single-center, randomized, controlled parallel group trial comparing conventional silver sulfadiazine dressings with treatment with petrolatum gel alone. Consenting adults 18-45 years old with superficial partial thickness burns≤10% total body surface area seen within 24h of the injury were randomized to daily dressing either with petrolatum gel without top dressings or conventional silver sulfadiazine treatment with gauze dressings. Primary outcomes were blinded assessment of time to complete re-epithelialization, wound infection or allergic contact dermatitis. Secondary outcomes included assessment of ease, time and pain of dressing changes. 26 patients were randomized to petrolatum and 24 to silver sulfadiazine dressings. Follow up data available for 19 in each group. Mean time to re-epithelialization was 6.2 days (SD 2.8) in the petrolatum group and 7.8 days (SD 2.1) in the silver sulfadiazine group (p=0.050). No wound infection or dermatitis was observed in either group. Scores for adherence to wound, ease of dressing removal and time required to change dressings were significantly better in the petrolatum treatment arm (ptreatment of minor superficial partial thickness burns in adults. Copyright © 2014 Elsevier Ltd and ISBI. All rights reserved.

  2. DOE technical standards list: Department of Energy standards index

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1999-05-01

    This Department of Energy (DOE) technical standards list (TSL) has been prepared by the Office of Nuclear Safety Policy and Standards (EH-31) on the basis of currently available technical information. Periodic updates of this TSL will be issued as additional information is received on standardization documents being issued, adopted, or canceled by DOE. This document was prepared for use by personnel involved in the selection and use of DOE technical standards and other Government and non-Government standards. This TSL provides listings of current DOE technical standards, non-Government standards that have been adopted by DOE, other standards-related documents in which DOE has a recorded interest, and canceled DOE technical standards. Information on new DOE technical standards projects, technical standards released for coordination, recently published DOE technical standards, and activities of non-Government standards bodies that may be of interest to DOE is published monthly in Standards Actions.

  3. Effects of standard training in the use of closed-circuit televisions in visually impaired adults: design of a training protocol and a randomized controlled trial

    Directory of Open Access Journals (Sweden)

    van Rens Ger HMB

    2010-03-01

    Full Text Available Abstract Background Reading problems are frequently reported by visually impaired persons. A closed-circuit television (CCTV can be helpful to maintain reading ability, however, it is difficult to learn how to use this device. In the Netherlands, an evidence-based rehabilitation program in the use of CCTVs was lacking. Therefore, a standard training protocol needed to be developed and tested in a randomized controlled trial (RCT to provide an evidence-based training program in the use of this device. Methods/Design To develop a standard training program, information was collected by studying literature, observing training in the use of CCTVs, discussing the content of the training program with professionals and organizing focus and discussion groups. The effectiveness of the program was evaluated in an RCT, to obtain an evidence-based training program. Dutch patients (n = 122 were randomized into a treatment group: normal instructions from the supplier combined with training in the use of CCTVs, or into a control group: instructions from the supplier only. The effect of the training program was evaluated in terms of: change in reading ability (reading speed and reading comprehension, patients' skills to operate the CCTV, perceived (vision-related quality of life and tasks performed in daily living. Discussion The development of the CCTV training protocol and the design of the RCT in the present study may serve as an example to obtain an evidence-based training program. The training program was adjusted to the needs and learning abilities of individual patients, however, for scientific reasons it might have been preferable to standardize the protocol further, in order to gain more comparable results. Trial registration http://www.trialregister.nl, identifier: NTR1031

  4. Intra-arterial thrombolysis vs. standard treatment or intravenous thrombolysis in adults with acute ischemic stroke: a systematic review and meta-analysis.

    Science.gov (United States)

    Nam, Julian; Jing, He; O'Reilly, Daria

    2015-01-01

    Recent evidence has suggested that intra-arterial thrombolysis may provide benefit beyond intravenous thrombolysis in ischemic stroke patients. Previous meta-analyses have only compared intra-arterial thrombolysis with standard treatment without thrombolysis. The objective was to review the benefits and harms of intra-arterial thrombolysis in ischemic stroke patients. We undertook a meta-analysis of randomized controlled trials comparing the efficacy and safety of intra-arterial thrombolysis with either standard treatment or intravenous thrombolysis following acute ischemic stroke. Primary outcomes included poor functional outcomes (modified Rankin Scale 3-6), mortality, and symptomatic intracranial hemorrhage. Study quality was assessed, and outcomes were stratified by comparison treatment received. Four trials (n = 351) comparing intra-arterial thrombolysis with standard treatment were identified. Intra-arterial thrombolysis reduced the risk of poor functional outcomes (modified Rankin Scale 3-6) [relative risk (RR) = 0·80; 95% confidence interval = 0·67-0·95; P = 0·01]. Mortality was not increased (RR = 0·82; 95% confidence interval = 0·56-1·21; P = 0·32); however, risk of symptomatic intracranial hemorrhage was nearly four times more likely (RR = 3·90; 95% confidence interval = 1·41-10·76; P = 0·006). Two trials (n = 81) comparing intra-arterial thrombolysis with intravenous thrombolysis were identified. Intra-arterial thrombolysis was not found to reduce poor functional outcomes (modified Rankin Scale 3-6) (RR = 0·68; 95% confidence interval = 0·46-1·00; P = 0·05). Mortality was not increased (RR = 1·12; 95% confidence interval = 0·47-2·68; P = 0·79); neither was symptomatic intracranial hemorrhage (RR = 1·13; 95% confidence interval = 0·32-3·99; P = 0·85). Differences in time from symptom onset-to-treatment and type of thrombolytic administered were found

  5. Improving Access to Standardized Fertility Preservation Information for Older Adolescents and Young Adults with Cancer: Using a User-Centered Approach with Young Adult Patients, Survivors, and Partners to Refine Fertility Knowledge Transfer.

    Science.gov (United States)

    Tam, Seline; Puri, Natasha; Stephens, Derek; Mitchell, Laura; Giuliani, Meredith; Papadakos, Janet; Gupta, Abha A

    2016-09-27

    Adolescent and young adult (AYA) cancer patients under 40 should be made aware of their fertility risks and preservation options throughout their care. However, discussions on fertility preservation (FP) do not routinely occur. With a dearth of FP resources, oncology providers may lack knowledge around FP. Thus, informational needs can be unmet, leading to anxiety and distress in patients. Provision of pertinent and timely information can help patients cope better with their diagnosis. FP pamphlets were developed for men and women with cancer. A cross-sectional in-house survey, using convenience sampling, evaluated the pamphlets' effectiveness and measured ease of understanding, acceptability, and perceived utility. Patients and partners were also asked to provide recommendations and complete the Short Test of Functional Health Literacy in Adults (S-TOFHLA) measuring health literacy level. This helps determine if health literacy influences perception of pamphlet effectiveness. All participants (n = 56) reviewed both pamphlets. Fifty-four participants (96 %) found the pamphlet for men useful, while 29 participants (52 %) improved their male fertility knowledge. The pamphlet for women was useful for 52 participants (93 %) and improved knowledge in 35 (63 %) of them. Although the majority of participants had adequate health literacy (98 %), there was insufficient sample diversity to determine if health literacy influenced the pamphlet's effectiveness. Participants indicated preference in receiving verbal (73 %) and written (66 %) information over watching videos or in-class education. They recommended including fertility clinics, financial resources, and statistics in the brochures. These FP pamphlets were concluded as effective in supporting patients in making FP decisions.

  6. Department of Energy Standards Index

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1995-08-01

    This TSL, intended for use in selecting and using DOE technical standards and other Government and non-Government standards, provides listing of current and inactive DOE technical standards, non-Government standards adopted by DOE, other Government documents in which DOE has a recorded interest, and cancelled DOE technical standards.

  7. Abdominal pain endpoints currently recommended by the FDA and EMA for adult patients with irritable bowel syndrome may not be reliable in children.

    Science.gov (United States)

    Saps, M; Lavigne, J V

    2015-06-01

    The Food and Drug Administration (FDA) recommended ≥30% decrease on patient-reported outcomes for pain be considered clinically significant in clinical trials for adults with irritable bowel syndrome. This percent change approach may not be appropriate for children. We compared three alternate approaches to determining clinically significant reductions in pain among children. 80 children with functional abdominal pain participated in a study of the efficacy of amitriptyline. Endpoints included patient-reported estimates of feeling better, and pain Visual Analog Scale (VAS). The minimum clinically important difference in pain report was calculated as (i) mean change in VAS score for children reporting being 'better'; (ii) percent changes in pain (≥30% and ≥50%) on the VAS; and (iii) statistically reliable changes on the VAS for 68% and 95% confidence intervals. There was poor agreement between the three approaches. 43.6% of the children who met the FDA ≥30% criterion for clinically significant change did not achieve a reliable level of improvement (95% confidence interval). Children's self-reported ratings of being better may not be statistically reliable. A combined approach in which children must report improvement as better and achieve a statistically significant change may be more appropriate for outcomes in clinical trials. © 2015 John Wiley & Sons Ltd.

  8. DOE technical standards list. Department of Energy standards index

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1995-08-01

    This document was prepared for use by personnel involved in the selection and use of DOE technical standards and other Government and non-Government standards. This TSL provides listing of current DOE technical standards, non-Government standards that have been adopted by DOE, other Government documents in which DOE has a recorded interest, and canceled DOE technical standards. Information on new DOE technical standards projects, technical standards released for coordination, recently published DOE technical standards, and activities of non-Government standards bodies that may be of interest to DOE is published monthly in Standards Actions.

  9. Cumulative meta-analysis of the relationship between useful field of view and driving performance in older adults: current and future implications.

    Science.gov (United States)

    Clay, Olivio J; Wadley, Virginia G; Edwards, Jerri D; Roth, David L; Roenker, Daniel L; Ball, Karlene K

    2005-08-01

    Driving is a complex behavior that requires the utilization of a wide range of individual abilities. Identifying assessments that not only capture individual differences, but also are related to older adults' driving performance would be beneficial. This investigation examines the relationship between the Useful Field of View (UFOV) assessment and objective measures of retrospective or concurrent driving performance, including state-recorded accidents, on-road driving, and driving simulator performance. The PubMed and PsycINFO databases were searched to retrieve eight studies that reported bivariate relationships between UFOV and these objective driving measures. Cumulative meta-analysis techniques were used to combine the effect sizes in an attempt to determine whether the strength of the relationship was stable across studies and to assess whether a sufficient number of studies have been conducted to validate the relationship between UFOV and driving performance. A within-group homogeneity of effect sizes test revealed that the samples could be thought of as being drawn from the same population, Q [7] = 11.29, p (one-tailed) = 0.13. Therefore, the effect sizes of eight studies were combined for the present cumulative meta-analysis. The weighted mean effect size across the studies revealed a large effect (Cohen's d = 0.945), with poorer UFOV performance associated with negative driving outcomes. This relationship was robust across multiple indices of driving performance and several research laboratories. This convergence of evidence across numerous studies using different methodologies confirms the importance of the UFOV assessment as a valid and reliable index of driving performance and safety. Recent prospective studies have confirmed a relationship between UFOV performance and future crashes, further supporting the use of this instrument as a potential screening measure for at-risk older drivers.

  10. Role of food preoccupation and current dieting in the associations of parental feeding practices to emotional eating in young adults: A moderated mediation study.

    Science.gov (United States)

    Williams, Natalie A; Dev, Dipti A; Hankey, Maren; Blitch, Kimberly

    2017-04-01

    Parental feeding practices reflecting coercive control are related to children's later eating behaviors, but the mechanisms underlying these effects remain poorly understood. This study examined the relationships between recalled childhood experiences of parental pressure to eat and restriction and current food preoccupation, dieting, and emotional eating in a racially diverse sample of college students (N = 711). Results revealed that parental restriction, but not pressure to eat, was associated with more emotional eating (r = 0.18, p Food preoccupation mediated the association between restriction and emotional eating (95% CI [3.6495-7.2231]); however, a moderated mediation model revealed that the strength of the indirect effect of restrictive feeding on emotional eating through food preoccupation was significantly different for dieters and non-dieters (index of moderated mediation = 1.79, Boot SE = 0.79; 95% bias-corrected bootstrap CI [-3.5490 to -0.4515]). These findings provide unique insight into the mechanisms linking parental feeding practices with emotional eating in young adulthood. Future studies attempting to clarify the processes through which child feeding practices impact later eating behaviors should consider the role of current dieting. Copyright © 2017 Elsevier Ltd. All rights reserved.

  11. Standardized screening for periodontitis as an integral part of multidisciplinary management of adults with type 2 diabetes: an observational cross-sectional study of cohorts in the USA and UK.

    Science.gov (United States)

    Pumerantz, Andrew S; Bissett, Susan M; Dong, Fanglong; Ochoa, Cesar; Wassall, Rebecca R; Davila, Heidi; Barbee, Melanie; Nguyen, John; Vila, Pamela; Preshaw, Philip M

    2017-01-01

    To determine prevalence and factors predictive of periodontitis by using a standardized assessment model in adults with type 2 diabetes. We performed an observational cross-sectional study to determine the burden of periodontitis in adults with type 2 diabetes attending urban, ambulatory referral centers in the USA and UK. Full-mouth probing was performed and periodontitis was diagnosed based on either a low (≥5 mm at ≥1 site) or high pocket probing-depth threshold (≥6 mm at ≥1 site). Results were stratified into a five-stage schema and integrated with other clinical variables into the novel Diabetes Cross-Disciplinary Index to function as a balanced health scorecard. Corresponding demographic and routinely collected health data were obtained and comparisons were made between patients with and without periodontitis. Multivariable logistic regression was performed to identify factors predictive of the presence or absence of periodontitis. Between our two cohorts, 253 patients were screened. Caucasians comprised >90% and Hispanic Americans >75% of the UK and US cohorts, respectively. Males and females were equally distributed; mean age was 53.6±11 years; and 17 (6.7%) were edentulous. Of the 236 dentate patients, 128 (54.2%) had periodontitis by low threshold and 57 (24.2%) by high threshold. Just 17 (7.2%) were periodontally healthy. No significant differences in age, HbA1c, blood pressure, body mass index, low-density lipoprotein cholesterol, or smoking status (all p>0.05) were identified between those with or without periodontitis (regardless of threshold) and none was found to be a significant predictor of disease. Periodontitis is frequent in adults with type 2 diabetes and all should be screened. Periodontal health status can be visualized with other comorbidities and complications using a novel balanced scorecard that could facilitate patient-clinician communication, shared decision-making, and prioritization of individual healthcare needs.

  12. Iodine intake by adult residents of a farming area in Iwate Prefecture, Japan, and the accuracy of estimated iodine intake calculated using the Standard Tables of Food Composition in Japan.

    Science.gov (United States)

    Nakatsuka, Haruo; Chiba, Keiko; Watanabe, Takao; Sawatari, Hideyuki; Seki, Takako

    2016-11-01

    Iodine intake by adults in farming districts in Northeastern Japan was evaluated by two methods: (1) government-approved food composition tables based calculation and (2) instrumental measurement. The correlation between these two values and a regression model for the calibration of calculated values was presented. Iodine intake was calculated, using the values in the Japan Standard Tables of Food Composition (FCT), through the analysis of duplicate samples of complete 24-h food consumption for 90 adult subjects. In cases where the value for iodine content was not available in the FCT, it was assumed to be zero for that food item (calculated values). Iodine content was also measured by ICP-MS (measured values). Calculated and measured values rendered geometric means (GM) of 336 and 279 μg/day, respectively. There was no statistically significant (p > 0.05) difference between calculated and measured values. The correlation coefficient was 0.646 (p GM, calculated) and 279 μg/day (GM, measured). Both values correlated so well, with a correlation coefficient of 0.646, that a regression model (Y = 130.8 + 1.9479X, where X and Y are measured and calculated values, respectively) could be used to calibrate calculated values.

  13. The positive impact of general vitamin D food fortification policy on vitamin D status in a representative adult Finnish population: evidence from an 11-y follow-up based on standardized 25-hydroxyvitamin D data.

    Science.gov (United States)

    Jääskeläinen, Tuija; Itkonen, Suvi T; Lundqvist, Annamari; Erkkola, Maijaliisa; Koskela, Tapani; Lakkala, Kaisa; Dowling, Kirsten G; Hull, George Lj; Kröger, Heikki; Karppinen, Jaro; Kyllönen, Eero; Härkänen, Tommi; Cashman, Kevin D; Männistö, Satu; Lamberg-Allardt, Christel

    2017-06-01

    Background: A systematic vitamin D fortification of fluid milk products and fat spreads was started in 2003 in Finland to improve vitamin D status. Objective: We investigated the effects of the vitamin D fortification policy on vitamin D status in Finland between 2000 and 2011. Design: Serum 25-hydroxyvitamin D [S-25(OH)D] concentrations of a nationally representative sample comprising 6134 and 4051 adults aged ≥30 y from the Health 2000 and Health 2011 surveys, respectively, were standardized according to the Vitamin D Standardization Program with the use of liquid chromatography-tandem mass spectrometry. Linear and logistic regression models were used to assess the change in S-25(OH)D concentrations. Results: Between 2000 and 2011, the mean S-25(OH)D increased from 48 nmol/L (95% CI: 47, 48 nmol/L) to 65 nmol/L (95% CI: 65, 66 nmol/L) ( P vitamin D supplement users increased from 11% to 41% ( P 50 nmol/L in 2011. Conclusions: The vitamin D status of the Finnish adult population has improved considerably during the time period studied. The increase is mainly explained by food fortification, especially of fluid milk products, and augmented vitamin D supplement use. Other factors, such as the difference in the ultraviolet radiation index between 2000 and 2011, may partly explain the results. When consuming vitamin D sources based on the nutritional recommendations, vitamin D status is sufficient [S-25(OH)D ≥50 nmol/L], and supplementation is generally not needed. © 2017 American Society for Nutrition.

  14. Evidence-Based Practice Standard Care for Acute Pain Management in Adults With Sickle Cell Disease in an Urgent Care Center.

    Science.gov (United States)

    Kim, Sunghee; Brathwaite, Ron; Kim, Ook

    Vaso-occlusive episodes (VOEs) with sickle cell disease (SCD) require opioid treatment. Despite evidence to support rapid pain management within 30 minutes, care for these patients does not consistently meet this benchmark. This quality improvement study sought to decrease the first analgesic administration time, increase patient satisfaction, and expedite patient flow. A prospective pre-/postevaluation design was used to evaluate outcomes with patients 18 years or older with VOEs in an urgent care (UC) center after implementation of evidence-based practice standard care (EBPSC). A pre- and postevaluation survey of SCD patients' satisfaction with care and analogous surveys of the UC team to assess awareness of EBPSC were used. A retrospective review of the electronic medical records of patients with VOEs compared mean waiting time from triage to the first analgesic administration and the mean length of stay (LOS) over 6 months. Implementing EBPSC decreased the mean time of the first analgesic administration (P = .001), significantly increased patient satisfaction (P = .002), and decreased the mean LOS (P = .010). Implementing EBPSC is a crucial step for improving the management of VOEs and creating a positive patient experience. The intervention enhances the quality of care for the SCD population in a UC center.

  15. Serological diagnosis of toxoplasmosis and standardization.

    Science.gov (United States)

    Zhang, Kuo; Lin, Guigao; Han, Yanxi; Li, Jinming

    2016-10-01

    Humans can be infected by the intracellular parasite Toxoplasma gondii, which causes toxoplasmosis, a common parasitic disease. Although the infection is generally asymptomatic for most adults, severe complications may occur in some individuals, especially women in early pregnancy. Serologic diagnosis is used as a routine practice to determine the immune status for infection by T. gondii. In this review, we attempt to provide an overview of the serological diagnosis of toxoplasmosis, including diagnostic strategy, current problems in detection with specific antibodies, and the standardization of T. gondii serological detection. Copyright © 2016 Elsevier B.V. All rights reserved.

  16. What is the comparative effectiveness of current standard treatment, against an individually tailored behavioural programme delivered either on the Internet or face-to-face for people with acute whiplash associated disorder? A randomized controlled trial.

    Science.gov (United States)

    Bring, Annika; Åsenlöf, Pernilla; Söderlund, Anne

    2016-05-01

    To investigate the comparative effectiveness of current standard treatment, against an individually tailored behavioural programme delivered via the Internet or face-to-face for people with acute whiplash associated disorders. A multicentre, randomized, three-group design, with concealed allocation. A total of 55 participants (37 female), age 18-65, with acute Whiplash Associated Disorder (Grade I-II), recruited at two emergency clinics in Sweden. Before randomization all participants received standard self-care instructions. The Internet and face-to-face groups followed a seven-week behavioural programme involving individual tailoring, via email (Internet group), or in sessions at a physical therapy unit (face-to-face group). The control group only received the self-care instructions. Pain-related disability, pain intensity, self-efficacy in daily activities, catastrophizing and fear of movement/(re)injury. Assessments were performed at baseline (2-4 weeks postinjury) and at three, six and 12 months postintervention. Both the Internet (n = 16) and face-to-face (n = 14) group showed a larger decrease in pain-related disability than the control group (n = 16); -12 and -11, respectively, compared with -5 in the control group at 12-months follow-up. Significant differences between the groups in overall treatment effect were shown in all outcomes except pain intensity. All groups improved significantly over time in all outcomes, except for fear of movement/(re)injury and catastrophizing in the control group. An individually tailored behavioural programme improved biopsychosocial factors in patients with whiplash associated disorders up to 12 months after treatment. Internet-delivered intervention was as effective as clinic-based face-to-face therapy sessions. © The Author(s) 2015.

  17. Expression and function of a CP339,818-sensitive K+ current in a subpopulation of putative nociceptive neurons from adult mouse trigeminal ganglia

    Science.gov (United States)

    Sforna, Luigi; D'Adamo, Maria Cristina; Servettini, Ilenio; Guglielmi, Luca; Pessia, Mauro; Franciolini, Fabio

    2015-01-01

    Trigeminal ganglion (TG) neurons are functionally and morphologically heterogeneous, and the molecular basis of this heterogeneity is still not fully understood. Here we describe experiments showing that a subpopulation of neurons expresses a delayed-rectifying K+ current (IDRK) with a characteristically high (nanomolar) sensitivity to the dihydroquinoline CP339,818 (CP). Although submicromolar CP has previously been shown to selectively block Kv1.3 and Kv1.4 channels, the CP-sensitive IDRK found in TG neurons could not be associated with either of these two K+ channels. It could neither be associated with Kv2.1 channels homomeric or heteromerically associated with the Kv9.2, Kv9.3, or Kv6.4 subunits, whose block by CP, tested using two-electrode voltage-clamp recordings from Xenopus oocytes, resulted in the low micromolar range, nor to the Kv7 subfamily, given the lack of blocking efficacy of 3 μM XE991. Within the group of multiple-firing neurons considered in this study, the CP-sensitive IDRK was preferentially expressed in a subpopulation showing several nociceptive markers, such as small membrane capacitance, sensitivity to capsaicin, and slow afterhyperpolarization (AHP); in these neurons the CP-sensitive IDRK controls the membrane resting potential, the firing frequency, and the AHP duration. A biophysical study of the CP-sensitive IDRK indicated the presence of two kinetically distinct components: a fast deactivating component having a relatively depolarized steady-state inactivation (IDRKf) and a slow deactivating component with a more hyperpolarized V1/2 for steady-state inactivation (IDRKs). PMID:25652918

  18. Measurement of muscle thickness of the serratus anterior and lower trapezius using ultrasound imaging in competitive recreational adult swimmers, with and without current shoulder pain.

    Science.gov (United States)

    McKenna, Leanda J; de Ronde, Mandy; Le, Minyang; Burke, William; Graves, Anna; Williams, Sian A

    2018-02-01

    To compare serratus anterior and lower trapezius muscle thickness between swimmers with and without current shoulder pain, and between sides when measured by real-time ultrasound imaging. A single blinded age and gender-matched case-control study with 26 symptomatic and 26 asymptomatic recreational swimmers. Muscle thickness of serratus anterior and lower trapezius were measured using previously validated real-time ultrasound imaging protocols. Serratus anterior thickness was measured in side lying with 90° of glenohumeral flexion at rest and during a scapular protraction contraction. Lower trapezius thickness was measured in prone with 145° of glenohumeral abduction whilst at rest and when holding the weight of the arm. There was no statistically significant difference between the muscle thickness of serratus anterior and lower trapezius between the symptomatic shoulder and the dominance-matched shoulder in the asymptomatic group of swimmers. There was also no significant difference in muscle thickness between the symptomatic side and asymptomatic side within the symptomatic group. There appears to be no difference in serratus anterior and lower trapezius thickness between swimmers who have mild to moderate shoulder pain, who continue to swim and those who do not have shoulder pain. When imaging the serratus anterior and lower trapezius in swimmers with mild shoulder pain, clinicians should expect no differences between sides. If muscle thickness differences between sides are detected in recreational swimmers, this may indicate that the swimmer is participating in other asymmetrical activities or has a higher level of shoulder pain. Copyright © 2017 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.

  19. The relationship between cadaver, living and forensic stature: A review of current knowledge and a test using a sample of adult Portuguese males.

    Science.gov (United States)

    Cardoso, Hugo F V; Marinho, Luísa; Albanese, John

    2016-01-01

    The use of cadaver length and forensic stature as a proxy for living standing height has not been scrutinized in detail. In this paper we present a brief review of the current knowledge on the relationship between cadaver, living and forensic stature; assess the magnitude and nature of the differences between these three measures of stature; and investigate the potential impact of these differences in forensic contexts. The study uses a sample of 84 males who were autopsied in 2008 at the National Institute of Legal Medicine and Forensic Sciences (Porto, Portugal), where stature data were collected from three different sources: cadaver stature was obtained from the corpse prior to autopsy, living stature was obtained from military conscription records and forensic stature was obtained from national citizenship identification card records. Descriptive statistics, ANOVA and linear regression are used to analyze the data. The results show that cadaver stature is the highest measure, followed by forensic and by living stature, and the difference between cadaver and living stature is greater than expected (4.3cm). Results also show considerable individual variation in the differences between the three measures of stature and that differences decrease with stature, although only slightly. This study has shown that the difference between cadaver and living stature is greater than previously thought and suggests that previously reported correction factors are a minimum rather than a mean correction. Forensic stature is likely to be incorrectly estimated and can jeopardize identification if methods estimate living rather than forensic stature. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  20. The Genomic Standards Consortium

    DEFF Research Database (Denmark)

    Field, Dawn; Amaral-Zettler, Linda; Cochrane, Guy

    2011-01-01

    Standards Consortium (GSC), an open-membership organization that drives community-based standardization activities, Here we provide a short history of the GSC, provide an overview of its range of current activities, and make a call for the scientific community to join forces to improve the quality...

  1. Decommissioning standards

    International Nuclear Information System (INIS)

    Crofford, W.N.

    1980-01-01

    EPA has agreed to establish a series of environmental standards for the safe disposal of radioactive waste through participation in the Interagency Review Group on Nuclear Waste Management (IRG). One of the standards required under the IRG is the standard for decommissioning of radioactive contaminated sites, facilities, and materials. This standard is to be proposed by December 1980 and promulgated by December 1981. Several considerations are important in establishing these standards. This study includes discussions of some of these considerations and attempts to evaluate their relative importance. Items covered include: the form of the standards, timing for decommissioning, occupational radiation protection, costs and financial provisions. 4 refs

  2. Survey on current status of laboratory test method and experimental consideration for establishing standardized procedure of material containing bentonite. Report of collaboration research between JAEA and CRIEPI (Joint research)

    International Nuclear Information System (INIS)

    Tanai, Kenji; Kikuchi, Hirohito; Nakamura, Kunihiko; Tanaka, Yukihisa; Hironaga, Michihiko

    2010-08-01

    In the current concept of repository for radioactive waste disposal, compacted bentonite as well as bentonite based material will be used as an engineered barrier mainly for inhibiting migration of radioactive nuclides. In most cases, properties of bentonite, such as low permeability etc., are obtained by laboratory tests. However, results of laboratory tests of bentonite often vary considerably even if index parameter, such as effective clay density, is constant. One of the causes of the variability is considered to be lack of standardized method of laboratory test for bentonite. Thus standardization of laboratory test methods for bentonite is needed. So, investigation for establishing standardized laboratory test method of bentonite is conducted based on the results of survey on current status of laboratory test method for bentonite. In particular, the literature survey as well as laboratory tests were conducted to find factors affecting the results of laboratory tests for bentonite and to estimate their degree of influence. The following conclusions are obtained through this study. (1) Hydraulic conductivity test. According to the results of literature survey, it is revealed that constant pressure permeability test and consolidation test are currently used for measuring hydraulic conductivity of bentonite and that (a) hydraulic gradient, (b) local seepage flow between lateral surface of the specimen and lateral wall of the container, (c) water pressure which is applied to the specimen, (d) degree of saturation and (e) size of the specimen possibly affect the results of the constant pressure permeability test, while (f) friction between lateral surface of the specimen and lateral wall of the container accompanied by deformation of the specimen, (g) consolidation pressure together with factors (d), (e) affect the results of the consolidation test. Literature which describes that factors (a), (b) and (e) affect the results of the constant pressure permeability test

  3. Accounting standards

    NARCIS (Netherlands)

    Stellinga, B.; Mügge, D.

    2014-01-01

    The European and global regulation of accounting standards have witnessed remarkable changes over the past twenty years. In the early 1990s, EU accounting practices were fragmented along national lines and US accounting standards were the de facto global standards. Since 2005, all EU listed

  4. Standardization Documents

    Science.gov (United States)

    2011-08-01

    Specifications and Standards; Guide Specifications; CIDs; and NGSs . Learn. Perform. Succeed. STANDARDIZATION DOCUMENTS Federal Specifications Commercial...national or international standardization document developed by a private sector association, organization, or technical society that plans ...Maintain lessons learned • Examples: Guidance for application of a technology; Lists of options Learn. Perform. Succeed. DEFENSE HANDBOOK

  5. DOE technical standards list: Department of Energy standards index

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1997-06-01

    This technical standards list (TSL) was prepared for use by personnel involved in the selection and use of US DOE technical standards and other government and non-government standards. This TSL provides listings of current DOE technical standards, non-government standards that have been adopted by DOE, other government documents in which DOE has a recorded interest, and cancelled DOE technical standards. Standards are indexed by type in the appendices to this document. Definitions of and general guidance for the use of standards are also provided.

  6. PIAAC Technical Standards and Guidelines

    Science.gov (United States)

    OECD Publishing, 2014

    2014-01-01

    The Programme for International Assessment of Adult Competencies (PIAAC) will establish technical standards and guidelines to ensure that the survey design and implementation processes of PIAAC yield high-quality and internationally comparable data. This document provides a revised version of the technical standards and guidelines originally…

  7. Clinical grade adult stem cell banking.

    Science.gov (United States)

    Thirumala, Sreedhar; Goebel, W Scott; Woods, Erik J

    2009-07-01

    There has been a great deal of scientific interest recently generated by the potential therapeutic applications of adult stem cells in human care but there are several challenges regarding quality and safety in clinical applications and a number of these challenges relate to the processing and banking of these cells ex-vivo. As the number of clinical trials and the variety of adult cells used in regenerative therapy increases, safety remains a primary concern. This has inspired many nations to formulate guidelines and standards for the quality of stem cell collection, processing, testing, banking, packaging and distribution. Clinically applicable cryopreservation and banking of adult stem cells offers unique opportunities to advance the potential uses and widespread implementation of these cells in clinical applications. Most current cryopreservation protocols include animal serum proteins and potentially toxic cryoprotectant additives (CPAs) that prevent direct use of these cells in human therapeutic applications. Long term cryopreservation of adult stem cells under good manufacturing conditions using animal product free solutions is critical to the widespread clinical implementation of ex-vivo adult stem cell therapies. Furthermore, to avoid any potential cryoprotectant related complications, reduced CPA concentrations and efficient post-thaw washing to remove CPA are also desirable. The present review focuses on the current strategies and important aspects of adult stem cell banking for clinical applications. These include current good manufacturing practices (cGMPs), animal protein free freezing solutions, cryoprotectants, freezing & thawing protocols, viability assays, packaging and distribution. The importance and benefits of banking clinical grade adult stem cells are also discussed.

  8. Standard NIM instrumentation system

    International Nuclear Information System (INIS)

    1990-05-01

    NIM is a standard modular instrumentation system that is in wide use throughout the world. As the NIM system developed and accommodations were made to a dynamic instrumentation field and a rapidly advancing technology, additions, revisions and clarifications were made. These were incorporated into the standard in the form of addenda and errata. This standard is a revision of the NIM document, AEC Report TID-20893 (Rev. 4) dated July 1974. It includes all the addenda and errata items that were previously issued as well as numerous additional items to make the standard current with modern technology and manufacturing practice

  9. Becoming adult educators in Denmark

    DEFF Research Database (Denmark)

    Milana, Marcella; Søgaard Lund, Lise

    2009-01-01

    In this paper we present an analysis of identity-construction processes among adult educators in Denmark and we address the question how adult educators develop professionalism, not least by taking advantage of existing opportunity structures for current and prospective adult educators. A between......-cases analysis of fifteen narrative interviews explores the professional pathways towards adult education, the perceived images of a (professional) adult educator, processes of identification with concrete or imaginary communities, and motivation for adult educator to enrol in current opportunity structures...

  10. Current asthma deaths among adults in Japan

    Directory of Open Access Journals (Sweden)

    Tsugio Nakazawa

    2004-01-01

    Full Text Available Recent asthma deaths were examined from yearly reports of the Ministry of Health, Labor and Welfare of Japan and from reports published by the Japan Asthma Death Investigation Committee on 811 deaths over the period 1992–2000. The rate and number of recent asthma deaths in Japan have been decreasing rapidly. Most asthma deaths were of patients aged 70–90 years and there has been a marked trend for increased asthma deaths in the elderly. As for the circumstances surrounding the deaths, sudden death, unstable sudden aggravation and intermittent aggravation were mainly noted. Respiratory infections, fatigue and stress were the major courses of fatal attacks contributing to deaths due to asthma. Many of the patients who died from asthma had been diagnosed as having as moderate to severe asthma and many had non-atopic asthma. There are some reports that suggest that the recent decrease in asthma deaths in Japan is correlated with the use of inhaled cortico- steroids.

  11. Communications standards

    CERN Document Server

    Stokes, A V

    1986-01-01

    Communications Standards deals with the standardization of computer communication networks. This book examines the types of local area networks (LANs) that have been developed and looks at some of the relevant protocols in more detail. The work of Project 802 is briefly discussed, along with a protocol which has developed from one of the LAN standards and is now a de facto standard in one particular area, namely the Manufacturing Automation Protocol (MAP). Factors that affect the usage of networks, such as network management and security, are also considered. This book is divided into three se

  12. Rethinking wood dust safety standards

    OpenAIRE

    Ratnasingam, Jega; Wai, Lim Tau; Ramasamy, Geetha; Ioras, Florin; Tadin, Ishak; Universiti Putra Malaysia; Buckinghamshire New University; Centre for Occupational Safety and Health Singapore

    2015-01-01

    The current universal work safety and health standards pertaining to wood dust in factories lack the localisation required. As a study has shown, there is a urgent need to reevaluate the current guidelines and practices.

  13. Requirements of quality standards

    International Nuclear Information System (INIS)

    Mueller, J.

    1977-01-01

    The lecture traces the development of nuclear standards, codes, and Federal regulations on quality assurance (QA) for nuclear power plants and associated facilities. The technical evolution of the last twelve years, especially in the area of nuclear technology, led to different activities and regulatory initiatives, and the present result is: several nations have their own homemade standards. The lecture discusses the former and especially current activities in standard development, and gives a description of the requirements of QA-standards used in USA and Europe, especially Western Germany. Furthermore the lecture attempts to give a comparison and an evaluation of the international quality standards from the author's viewpoint. Finally the lecture presents an outlook for the future international implications of QA-standards. There is an urgent need within the nuclear industry for simplification and standardization of QA-standards. The relationship between the various standards, and the applicability of the standards need clarification and a better transparancy. To point out these problems is the purpose of the lecture. (orig.) [de

  14. Weak currents

    International Nuclear Information System (INIS)

    Leite Lopes, J.

    1976-01-01

    A survey of the fundamental ideas on weak currents such as CVC and PCAC and a presentation of the Cabibbo current and the neutral weak currents according to the Salam-Weinberg model and the Glashow-Iliopoulos-Miami model are given [fr

  15. Spin current

    CERN Document Server

    Valenzuela, Sergio O; Saitoh, Eiji; Kimura, Takashi

    2012-01-01

    In a new branch of physics and technology called spin-electronics or spintronics, the flow of electrical charge (usual current) as well as the flow of electron spin, the so-called 'spin current', are manipulated and controlled together. This book provides an introduction and guide to the new physics and application of spin current.

  16. Effluent standards

    Energy Technology Data Exchange (ETDEWEB)

    Geisler, G C [Pennsylvania State University (United States)

    1974-07-01

    At the conference there was a considerable interest in research reactor standards and effluent standards in particular. On the program, this is demonstrated by the panel discussion on effluents, the paper on argon 41 measured by Sims, and the summary paper by Ringle, et al. on the activities of ANS research reactor standards committee (ANS-15). As a result, a meeting was organized to discuss the proposed ANS standard on research reactor effluents (15.9). This was held on Tuesday evening, was attended by members of the ANS-15 committee who were present at the conference, participants in the panel discussion on the subject, and others interested. Out of this meeting came a number of excellent suggestions for changes which will increase the utility of the standard, and a strong recommendation that the effluent standard (15.9) be combined with the effluent monitoring standard. It is expected that these suggestions and recommendations will be incorporated and a revised draft issued for comment early this summer. (author)

  17. Nuclear standards

    International Nuclear Information System (INIS)

    Fichtner, N.; Becker, K.; Bashir, M.

    1981-01-01

    This compilation of all nuclear standards available to the authors by mid 1980 represents the third, carefully revised edition of a catalogue which was first published in 1975 as EUR 5362. In this third edition several changes have been made. The title has been condensed. The information has again been carefully up-dated, covering all changes regarding status, withdrawal of old standards, new projects, amendments, revisions, splitting of standards into several parts, combination of several standards into one, etc., as available to the authors by mid 1980. The speed with which information travels varies and requires in many cases rather tedious and cumbersome inquiries. Also, the classification scheme has been revised with the goal of better adjustment to changing situations and priorities. Whenever it turned out to be difficult to attribute a standard to a single subject category, multiple listings in all relevant categories have been made. As in previous editions, within the subcategories the standards are arranged by organization (in Categorie 2.1 by country) alphabetically and in ascending numerical order. It covers all relevant areas of power reactors, the fuel cycle, radiation protection, etc., from the basic laws and governmental regulations, regulatory guides, etc., all the way to voluntary industrial standards and codes of pratice. (orig./HP)

  18. Testing the standard model

    International Nuclear Information System (INIS)

    Gordon, H.; Marciano, W.; Williams, H.H.

    1982-01-01

    We summarize here the results of the standard model group which has studied the ways in which different facilities may be used to test in detail what we now call the standard model, that is SU/sub c/(3) x SU(2) x U(1). The topics considered are: W +- , Z 0 mass, width; sin 2 theta/sub W/ and neutral current couplings; W + W - , Wγ; Higgs; QCD; toponium and naked quarks; glueballs; mixing angles; and heavy ions

  19. Standardization of depression measurement

    DEFF Research Database (Denmark)

    Wahl, Inka; Löwe, Bernd; Bjørner, Jakob

    2014-01-01

    OBJECTIVES: To provide a standardized metric for the assessment of depression severity to enable comparability among results of established depression measures. STUDY DESIGN AND SETTING: A common metric for 11 depression questionnaires was developed applying item response theory (IRT) methods. Data...... of 33,844 adults were used for secondary analysis including routine assessments of 23,817 in- and outpatients with mental and/or medical conditions (46% with depressive disorders) and a general population sample of 10,027 randomly selected participants from three representative German household surveys....... RESULTS: A standardized metric for depression severity was defined by 143 items, and scores were normed to a general population mean of 50 (standard deviation = 10) for easy interpretability. It covers the entire range of depression severity assessed by established instruments. The metric allows...

  20. Current status of quantum electrical metrology

    International Nuclear Information System (INIS)

    Urano, Chiharu; Kaneko, Nobuhisa; Kiryu, Shogo

    2005-01-01

    Physical background, current status of proof systems and researches of the next generation standards of Josephson voltage and Quantized Hall Resistance (QHR) standard system are described. Josephson effect, the principle and theory of quantized hall effect, usual voltage standard system, standard feed of direct current resistance, and researches of voltage standard and direct current resistance standard are explained. The current-voltage of Josephson element in the usual voltage standard proof system and bias method, outline of typical Josephson voltage standard proof system and GaAs/AlGaAs heterostructure used as resistance standard are stated. Cryogenic Current Comparator (CCC) and Direct Current Comparator (DCC) proofread usual resistor. New Quantum Hall Array Resistance Standard (QHARS) is studied by BNM-LNE group in French, and the other new AC Quantized Hall Resistance (AC-QHR) by the European ACQHE Project. (S.Y.)

  1. ISO radiation sterilization standards

    International Nuclear Information System (INIS)

    Lambert, Byron J.; Hansen, Joyce M.

    1998-01-01

    This presentation provides an overview of the current status of the ISO radiation sterilization standards. The ISO standards are voluntary standards which detail both the validation and routine control of the sterilization process. ISO 11137 was approved in 1994 and published in 1995. When reviewing the standard you will note that less than 20% of the standard is devoted to requirements and the remainder is guidance on how to comply with the requirements. Future standards developments in radiation sterilization are being focused on providing additional guidance. The guidance that is currently provided in informative annexes of ISO 11137 includes: device/packaging materials, dose setting methods, and dosimeters and dose measurement, currently, there are four Technical Reports being developed to provide additional guidance: 1. AAMI Draft TIR, 'Radiation Sterilization Material Qualification' 2. ISO TR 13409-1996, 'Sterilization of health care products - Radiation sterilization - Substantiation of 25 kGy as a sterilization dose for small or infrequent production batches' 3. ISO Draft TR, 'Sterilization of health care products - Radiation sterilization Selection of a sterilization dose for a single production batch' 4. ISO Draft TR, 'Sterilization of health care products - Radiation sterilization-Product Families, Plans for Sampling and Frequency of Dose Audits'

  2. MATE standardization

    Science.gov (United States)

    Farmer, R. E.

    1982-11-01

    The MATE (Modular Automatic Test Equipment) program was developed to combat the proliferation of unique, expensive ATE within the Air Force. MATE incorporates a standard management approach and a standard architecture designed to implement a cradle-to-grave approach to the acquisition of ATE and to significantly reduce the life cycle cost of weapons systems support. These standards are detailed in the MATE Guides. The MATE Guides assist both the Air Force and Industry in implementing the MATE concept, and provide the necessary tools and guidance required for successful acquisition of ATE. The guides also provide the necessary specifications for industry to build MATE-qualifiable equipment. The MATE architecture provides standards for all key interfaces of an ATE system. The MATE approach to the acquisition and management of ATE has been jointly endorsed by the commanders of Air Force Systems Command and Air Force Logistics Command as the way of doing business in the future.

  3. International radiofrequency standards

    International Nuclear Information System (INIS)

    Lincoln, J.

    2001-01-01

    Of the various radiofrequency standards in use around the world, many are based on or similar to the Guidelines published by ICNIRP (The International Commission on Non-ionising Radiation Protection). This organisation is a working group operating in co-operation with the Environmental Health division of the World Health Organisation (WHO). This paper presents a very brief overview of current international standards, beginning with a summary of the salient points of the ICNIRP Guidelines. It should be remembered that these are guidelines only and do not exist as a separate standard. Copyright (2001) Australasian Radiation Protection Society Inc

  4. Adult Strabismus

    Science.gov (United States)

    ... Conditions Frequently Asked Questions Español Condiciones Chinese Conditions Adult Strabismus En Español Read in Chinese Can anything be done for adults with strabismus (misaligned eyes)? Yes. Adults can benefit ...

  5. 试论现行财务会计与报表的缺陷及改进--从企业会计准则(基本准则)的缺陷谈起%On the Defects and Improvement of Current Financial Accounting and Reporting---from the defects of the enterprise accounting standards (basic standards)

    Institute of Scientific and Technical Information of China (English)

    曹苏铁

    2016-01-01

    China's current enterprise accounting standards - Basic Standards in accounting and accounting elements of the division, the statement of accounting measurement, as well as the understanding and use of the accrual basis, all exist obvious defects. This paper analyzes the defects of the above mentioned defects, and puts forward care his own opinion 1. Do not put“sustainable management”set a foundation for enterprise accounting; 2. The profit should not be included in the accounting elements as the basic classification of accounting; 3. Enterprises in the initial measurement of the accounting elements shall, in general, use the fair value, and surviving measurement is usually follow the historical cost principle; 4. Responsibilities occurred receipt and payment system and implementation system is not “either/or” antagonistic relationship; 5. The traditional income statement can be adapted as income and expenditure.%我国现行企业会计准则—基本准则在会计假设和会计要素划分,对会计计量的表述,以及对权责发生制的理解与运用方面存在着明显的缺陷.本文逐一分析了上述缺陷条款的不妥当之处,并提出了自己的见解:1.不能把“持续经营”设定为企业会计核算的基础;2.利润不应当作为会计的基本分类列入会计要素;3.企业在对会计要素进行初始计量时一般采用公允价值,而存续计量则通常遵照历史成本原则;4.权责发生制与收付实现制不是“非此即彼”的对立关系;5.传统利润表可以改编为新的收入支出表.

  6. Standard Model physics

    CERN Multimedia

    Altarelli, Guido

    1999-01-01

    Introduction structure of gauge theories. The QEDand QCD examples. Chiral theories. The electroweak theory. Spontaneous symmetry breaking. The Higgs mechanism Gauge boson and fermion masses. Yukawa coupling. Charges current couplings. The Cabibo-Kobayashi-Maskawa matrix and CP violation. Neutral current couplings. The Glasow-Iliopoulos-Maiani mechanism. Gauge boson and Higgs coupling. Radiative corrections and loops. Cancellation of the chiral anomaly. Limits on the Higgs comparaison. Problems of the Standard Model. Outlook.

  7. Measurement system of high voltage and high current measurements at INMETRO - Brazilian Institute for Metrology, Standardization and Industrial Quality; Sistema de medicao de alta tensao e alta corrente do INMETRO - Brasil

    Energy Technology Data Exchange (ETDEWEB)

    Vitorio, Patricia Cals de O.; Franca, Ademir Martins de; Soares, Marco Aurelio; Pereira, Luiz Napoleao; Costa, Danielli Guimaraes; Moreira, Giselle Cobica; Nascimento, Paulo Roberto Mesquita [Instituto Nacional de Metrologia, Normalizacao e Qualidade Industrial (DIMCI/INMETRO), Duque de Caxias, RJ (Brazil). Diretoria de Metrologia Cientifica e Industrial], E-mail: latra@inmetro.gov.br

    2009-07-01

    This work presents the basic characteristics and uncertainties of the calibration equipment in high voltage and high current available at the INMETRO: system of measurement in alternating high voltage up to 200 kV, system of measurement in alternating current up to 2 k A, and system of measurement in continuous high voltage up to 150 kV.

  8. Field-parallel Acceleration: Comment on the Paper “Electric Currents on the Flare Ribbons: Observations and Standard Model” by Janvier et al. (2014, ApJ, 788, 60)

    Energy Technology Data Exchange (ETDEWEB)

    Haerendel, G. [Max Planck Institute for Extraterrestrial Physics, Garching (Germany)

    2017-10-01

    It is proposed that the coincidence of higher brightness and upward electric current observed by Janvier et al. during a flare indicates electron acceleration by field-parallel potential drops sustained by extremely strong field-aligned currents of order 10{sup 4} A m{sup −2}. A few consequences are discussed here.

  9. Report on the 1st research co-ordination meeting of the co-ordinated research project on standardized high current solid targets for cyclotron production of diagnostic and therapeutic radionuclides

    International Nuclear Information System (INIS)

    2000-01-01

    of deposition of the oxide on the metal target plate, 2) the stability of the oxide layer during storage and irradiation, 3) the thermal characteristics of the oxide layer especially during irradiation, 4) methods of radioiodine recovery such as dry distillation, and 5) reprocessing of the targets. For the electrodeposited tellurium targets, the improvement of the existing deposition method and the presently used recovery process (wet chemistry) will be done. (ii) to prepare a target for the production of Thallium-201 which will withstand high beam currents in the range of 100 μA or more This will be accomplished through the transfer of the technology available on the electrodeposition of Thallium onto copper plates to produce a smooth, stable surface. The techniques will include the preparation of the targets before irradiation, extraction of the desired radioisotope, and the processing and recovery of the enriched materials after irradiation. Furthermore, a standard procedure for the preparation of trivalent Tl-201 ( 201 Tl + ) suitable for polypeptide labelling can be developed. (iii) to prepare a target for the production of Pd-103 from Rhodium. This will be accomplished by transferring the existing technology for the electrodeposition of Rh onto metal plates. The chemical removal of Rh will also be investigated as an integral goal of the CRP. Attempts will be made to investigate the production and quality control methods for the preparation of sealed sources for the treatment of prostate cancer

  10. Influenza among adults in Latin America, current status, and future directions: a consensus statement La gripe en adultos en América Latina, situación actual y tendencias futuras: una declaración de consenso

    Directory of Open Access Journals (Sweden)

    Pablo E. Bonvehí

    2012-06-01

    Full Text Available In Latin America, adult influenza is a serious disease that exacts a heavy burden in terms of morbidity, mortality, and cost. Although much has been written about the disease itself, relatively little information has been compiled on what could be done to reduce its impact across the region, particularly from the perspective of clinicians with firsthand experience in confronting its effects. To fill this data gap, in 2011, the Pan American Health and Education Foundation (PAHEF and the U.S.-based nonprofit Fighting Infectious Diseases in Emerging Countries (FIDEC organized a conference and convened a panel of Latin American scientistclinicians with experience and expertise in adult influenza in the region tol discuss the major issues related to the disease and 2 develop and produce a consensus statement summarizing its impact as well as current efforts to diagnose, prevent, and treat it. The consensus panel concluded a more concerted and better-coordinated effort was needed to reduce the adverse impact of seasonal influenza and future pandemics, including more surveillance, more active involvement by both governmental and nongovernmental organizations, and a much greater effort to vaccinate more adults, especially those at high risk of contracting the disease. In addition, a new approach for diagnosing influenza was recommended.En América Latina, la gripe en adultos es una enfermedad grave que impone una carga importante en cuanto a la morbilidad, la mortalidad y el costo. Aunque se ha escrito mucho acerca de la enfermedad en sí, se ha recopilado relativamente escasa información sobre lo que podría hacerse para reducir su repercusión en la región, en particular desde la perspectiva de los médicos con experiencia directa en afrontar sus efectos. Para compensar esta falta de información, en 2011 la Fundación Panamericana de la Salud y Educación (PAHEF y la organización sin fines de lucro establecida en los Estados Unidos Fighting

  11. Older adults' engagement with a video game training program.

    Science.gov (United States)

    Belchior, Patrícia; Marsiske, Michael; Sisco, Shannon; Yam, Anna; Mann, William

    2012-12-19

    The current study investigated older adults' level of engagement with a video game training program. Engagement was measured using the concept of Flow (Csikszentmihalyi, 1975). Forty-five older adults were randomized to receive practice with an action game ( Medal of Honor ), a puzzle-like game ( Tetris ), or a gold-standard Useful Field of View (UFOV) training program. Both Medal of Honor and Tetris participants reported significantly higher Flow ratings at the conclusion, relative to the onset of training. Participants are more engaged in games that can be adjusted to their skill levels and that provide incremental levels of difficulty. This finding was consistent with the Flow theory (Csikszentmihalyi, 1975).

  12. Service Providers' Perceptions of Active Ageing among Older Adults with Lifelong Intellectual Disabilities

    Science.gov (United States)

    Buys, L.; Aird, R.; Miller, E.

    2012-01-01

    Background: Considerable attention is currently being directed towards both active ageing and the revising of standards for disability services within Australia and internationally. Yet, to date, no consideration appears to have been given to ways to promote active ageing among older adults with intellectual disabilities (IDs). Methods:…

  13. Frequency standards

    CERN Document Server

    Riehle, Fritz

    2006-01-01

    Of all measurement units, frequency is the one that may be determined with the highest degree of accuracy. It equally allows precise measurements of other physical and technical quantities, whenever they can be measured in terms of frequency.This volume covers the central methods and techniques relevant for frequency standards developed in physics, electronics, quantum electronics, and statistics. After a review of the basic principles, the book looks at the realisation of commonly used components. It then continues with the description and characterisation of important frequency standards

  14. Current limiters

    Energy Technology Data Exchange (ETDEWEB)

    Loescher, D.H. [Sandia National Labs., Albuquerque, NM (United States). Systems Surety Assessment Dept.; Noren, K. [Univ. of Idaho, Moscow, ID (United States). Dept. of Electrical Engineering

    1996-09-01

    The current that flows between the electrical test equipment and the nuclear explosive must be limited to safe levels during electrical tests conducted on nuclear explosives at the DOE Pantex facility. The safest way to limit the current is to use batteries that can provide only acceptably low current into a short circuit; unfortunately this is not always possible. When it is not possible, current limiters, along with other design features, are used to limit the current. Three types of current limiters, the fuse blower, the resistor limiter, and the MOSFET-pass-transistor limiters, are used extensively in Pantex test equipment. Detailed failure mode and effects analyses were conducted on these limiters. Two other types of limiters were also analyzed. It was found that there is no best type of limiter that should be used in all applications. The fuse blower has advantages when many circuits must be monitored, a low insertion voltage drop is important, and size and weight must be kept low. However, this limiter has many failure modes that can lead to the loss of over current protection. The resistor limiter is simple and inexpensive, but is normally usable only on circuits for which the nominal current is less than a few tens of milliamperes. The MOSFET limiter can be used on high current circuits, but it has a number of single point failure modes that can lead to a loss of protective action. Because bad component placement or poor wire routing can defeat any limiter, placement and routing must be designed carefully and documented thoroughly.

  15. Current standardisation for nanotechnology

    International Nuclear Information System (INIS)

    Bard, Delphine; Mark, David; Moehlmann, Carsten

    2009-01-01

    Standardisation and standards provide an important mechanism to support both innovation and the application of regulations. There is currently no specific regulation for any nanomaterials. Health, safety and environmental protection aspects associated with nanomaterials are however in principle covered to different levels by current EU regulatory framework. There are a number of national, European and international organisations developing standards associated with the development, description and use of nanomaterials as well as the protection of human health and the environment from the production and use of chemicals and consumer products, including nanomaterials. These organisations have also established specific committees on nanotechnology. This paper outlines the different relevant regulations and standards. This paper will mainly be focused on a European health and safety perspective.

  16. [Adult phenylketonuria].

    Science.gov (United States)

    Sumánszki, Csaba; Barta, András Gellért; Reismann, Péter

    2017-11-01

    Starting from 1975 phenylketonuria is part of the newborn screening program in Hungary. Since then a generation, treated with special diet and medical foods right after neonatal diagnosis has reached adulthood. Thanks to early treatment initiation, children with phenylketonuria are able to lead life to the full. Consequently, phenylketonuria is no longer considered a pediatric disease. Follow up of adult patients with phenylketonuria is performed in internal medicine centers specialized in metabolic diseases. The outcome of the lifelong special treatment, and the particularities of phenylketonuria in adulthood are yet to be determined. The aim of our review is to present recent findings in phenylketonuria focusing mainly on the adult care. After long time the first international guidelines appeared, new therapies were put in use, and these current developments are expected to be implemented in daily practice in the near future. New challenges must be met such as maternal phenylketonuria, long term effects of dietotherapy and the sequelae of untreated phenylketonuria in adulthood. Orv Hetil. 2017; 158(46): 1857-1863.

  17. Relevant Standards

    Indian Academy of Sciences (India)

    .86: Ethernet over LAPS. Standard in China and India. G.7041: Generic Framing Procedure (GFP). Supports Ethernet as well as other data formats (e.g., Fibre Channel); Protocol of ... IEEE 802.3x for flow control of incoming Ethernet data ...

  18. Achieving Standardization

    DEFF Research Database (Denmark)

    Henningsson, Stefan

    2014-01-01

    International e-Customs is going through a standardization process. Driven by the need to increase control in the trade process to address security challenges stemming from threats of terrorists, diseases, and counterfeit products, and to lower the administrative burdens on traders to stay...

  19. Achieving Standardization

    DEFF Research Database (Denmark)

    Henningsson, Stefan

    2016-01-01

    International e-Customs is going through a standardization process. Driven by the need to increase control in the trade process to address security challenges stemming from threats of terrorists, diseases, and counterfeit products, and to lower the administrative burdens on traders to stay...

  20. Standard Fortran

    International Nuclear Information System (INIS)

    Marshall, N.H.

    1981-01-01

    Because of its vast software investment in Fortran programs, the nuclear community has an inherent interest in the evolution of Fortran. This paper reviews the impact of the new Fortran 77 standard and discusses the projected changes which can be expected in the future

  1. Spin current

    CERN Document Server

    Valenzuela, Sergio O; Saitoh, Eiji; Kimura, Takashi

    2017-01-01

    Since the discovery of the giant magnetoresistance effect in magnetic multilayers in 1988, a new branch of physics and technology, called spin-electronics or spintronics, has emerged, where the flow of electrical charge as well as the flow of electron spin, the so-called “spin current,” are manipulated and controlled together. The physics of magnetism and the application of spin current have progressed in tandem with the nanofabrication technology of magnets and the engineering of interfaces and thin films. This book aims to provide an introduction and guide to the new physics and applications of spin current, with an emphasis on the interaction between spin and charge currents in magnetic nanostructures.

  2. Status of conversion of NE standards to national consensus standards

    International Nuclear Information System (INIS)

    Jennings, S.D.

    1990-06-01

    One major goal of the Nuclear Standards Program is to convert existing NE standards into national consensus standards (where possible). This means that an NE standard in the same subject area using the national consensus process. This report is a summary of the activities that have evolved to effect conversion of NE standards to national consensus standards, and the status of current conversion activities. In some cases, all requirements in an NE standard will not be incorporated into the published national consensus standard because these requirements may be considered too restrictive or too specific for broader application by the nuclear industry. If these requirements are considered necessary for nuclear reactor program applications, the program standard will be revised and issued as a supplement to the national consensus standard. The supplemental program standard will contain only those necessary requirements not reflected by the national consensus standard. Therefore, while complete conversion of program standards may not always be realized, the standards policy has been fully supported in attempting to make maximum use of the national consensus standard. 1 tab

  3. Chronic Lymphocytic Leukemia: Current Concepts.

    Science.gov (United States)

    Yu, Eun-Mi; Kittai, Adam; Tabbara, Imad A

    2015-10-01

    Chronic lymphocytic leukemia (CLL) is the most common type of leukemia in adults, and while in early, asymptomatic stages treatment is not indicated, the threat to the quality of life and increased mortality of patients posed by more advanced-stage disease necessitate therapeutic intervention. Guidelines of when and how to treat are not well-established because CLL is a disease of the elderly and it is important to balance preservation of functional status and control of the disease. Advances in molecular and genetic profiling has led to the ability to identify sub-groups of patients with CLL whose disease may respond to selected therapy. This review discusses current standard therapies in the major sub-groups of CLL based on age and functional status, in both the front-line and relapsed/refractory settings. It also provides a concise review of novel agents that have shown considerable efficacy in CLL. Copyright© 2015 International Institute of Anticancer Research (Dr. John G. Delinassios), All rights reserved.

  4. Nurse health and lifestyle modification versus standard care in 40 to 70 year old regional adults: study protocol of the Management to Optimise Diabetes and mEtabolic syndrome Risk reduction via Nurse-led intervention (MODERN) randomized controlled trial.

    Science.gov (United States)

    Carrington, Melinda J; Zimmet, Paul

    2017-12-06

    Metabolic syndrome (MetS), the clustering of multiple leading risk factors, predisposes individuals to increased risk for developing type 2 diabetes and/or cardiovascular disease (CVD). Cardio-metabolic disease risk increases with greater remoteness where specialist services are scarce. Nurse-led interventions are effective for the management of chronic disease. The aim of this clinical trial is to determine whether a nurse-implemented health and lifestyle modification program is more beneficial than standard care to reduce cardio-metabolic abnormalities and future risk of CVD and diabetes in individuals with MetS. MODERN is a multi-centre, open, parallel group randomized controlled trial in regional Victoria, Australia. Participants were self-selected and individuals aged 40 to 70 years with MetS who had no evidence of CVD or other chronic disease were recruited. Those attending a screening visit with any 3 or more risk factors of central obesity, dyslipidemia (high triglycerides or low high density lipoprotein cholesterol) elevated blood pressure and dysglycemia were randomized to either nurse-led health and lifestyle modification (intervention) or standard care (control). The intervention included risk factor management, health education, care planning and scheduled follow-up commensurate with level of risk. The primary cardio-metabolic end-point was achievement of risk factor thresholds to eliminate MetS or minimal clinically meaningful changes for at least 3 risk factors that characterise MetS over 2 year follow-up. Pre-specified secondary endpoints to evaluate between group variations in cardio-metabolic risk, general health and lifestyle behaviours and new onset CVD and type 2 diabetes will be evaluated. Key outcomes will be measured at baseline, 12 and 24 months via questionnaires, physical examinations, pathology and other diagnostic tests. Health economic analyses will be undertaken to establish the cost-effectiveness of the intervention. The MODERN

  5. Professionalism Prevails in Adult Education ESL Classrooms

    Science.gov (United States)

    Brown, Megan C.; Bywater, Kathleen

    2010-01-01

    The purpose of this report is to explore the issue of professionalism of adult education ESL educators and uncover any inequities. The arc of this exploration describes the history of adult education, the current state of adult education ESL professionals, and the direction in which ESL adult educators appear to be heading. The results illustrate…

  6. Neutral currents

    International Nuclear Information System (INIS)

    Paschos, E.A.

    1977-01-01

    It is stated that over the past few years considerable progress has been made in the field of weak interactions. The existence of neutral currents involving leptons and hadrons has been established and some of the questions concerning their detailed structure have been answered. This imposes constraints on the gauge theories and has eliminated large classes of models. New questions have also been raised, one of which concerns the conservation laws obeyed by neutral currents. The wide range of investigations is impressive and is expected to continue with new results from particle, nuclear, and atomic physics. Headings include - various aspects of a gauge theory (choice of group, the symmetry breaking scheme, representation assignments for fermion fields); space-time structure; isospin structure; leptonic neutral currents; and atomic experiments. (U.K.)

  7. Neutral currents

    International Nuclear Information System (INIS)

    Aubert, B.

    1994-11-01

    The evidence for the existence of weak neutral current has been a very controverted topics in the early 1970's, as well as the muon did in the 1930's. The history is very rich considering the evolution of the experimental techniques in high energy particle physics. The history of the discovery and the study of weak neutral current is reviewed. Later the quest of the intermediate vector boson continues with the decision of the community to build a large proton antiproton collider. (K.A.). 14 refs., 1 fig

  8. Developmental dyslexia in adults: behavioural manifestations and cognitive correlates.

    Science.gov (United States)

    Nergård-Nilssen, Trude; Hulme, Charles

    2014-08-01

    This paper explores the nature of residual literacy and cognitive deficits in self-reported dyslexic Norwegian adults. The performance of 26 self-reported dyslexic adults was compared with that of a comparison group of 47 adults with no history of reading or spelling difficulties. Participants completed standardized and experimental measures tapping literacy skills, working memory, phonological awareness and rapid naming. Spelling problems were the most prominent marker of dyslexia in adults, followed by text reading fluency and nonword decoding. Working memory and phoneme awareness explained unique variance in spelling, whereas rapid automatized naming explained unique variance in reading fluency and nonword reading. The moderate to strong correlations between self-reported history, self-rating of current literacy skills and outcomes on literacy tests indicate that adults estimated their literacy skills fairly well. Results suggest that spelling impairments, more strongly than reading impairments, make adults perceive themselves as being dyslexic. A combination of three literacy and three cognitive tests predicted group membership with 90.4% accuracy. It appears that weaknesses in phoneme awareness, rapid automatized naming and working memory are strong and persistent correlates of literacy problems even in adults learning a relatively transparent orthography. Copyright © 2014 John Wiley & Sons, Ltd.

  9. Current algebra

    International Nuclear Information System (INIS)

    Jacob, M.

    1967-01-01

    The first three chapters of these lecture notes are devoted to generalities concerning current algebra. The weak currents are defined, and their main properties given (V-A hypothesis, conserved vector current, selection rules, partially conserved axial current,...). The SU (3) x SU (3) algebra of Gell-Mann is introduced, and the general properties of the non-leptonic weak Hamiltonian are discussed. Chapters 4 to 9 are devoted to some important applications of the algebra. First one proves the Adler- Weisberger formula, in two different ways, by either the infinite momentum frame, or the near-by singularities method. In the others chapters, the latter method is the only one used. The following topics are successively dealt with: semi leptonic decays of K mesons and hyperons, Kroll- Ruderman theorem, non leptonic decays of K mesons and hyperons ( ΔI = 1/2 rule), low energy theorems concerning processes with emission (or absorption) of a pion or a photon, super-convergence sum rules, and finally, neutrino reactions. (author) [fr

  10. Current Titles

    Energy Technology Data Exchange (ETDEWEB)

    Various

    2006-06-01

    This booklet is published for those interested in current research being conducted at the National Center for Electron Microscopy. The NCEM is a DOE-designated national user facility and is available at no charge to qualified researchers. Access is controlled by an external steering committee. Interested researchers may contact Jane Cavlina, Administrator, at 510/486-6036.

  11. Current scenario

    Indian Academy of Sciences (India)

    First page Back Continue Last page Overview Graphics. Current scenario. India , like other parts of the world, is also facing the problem of increase in the incidence of drug resistance in tuberculosis. Multi-drug resistance (MDR, resistance to RIF & INH) and extensively drug resistant strains (X-DR, resistance to RIF, INH, FQs ...

  12. Partial Thickness Rotator Cuff Tears: Current Concepts

    Science.gov (United States)

    Matthewson, Graeme; Beach, Cara J.; Nelson, Atiba A.; Woodmass, Jarret M.; Ono, Yohei; Boorman, Richard S.; Lo, Ian K. Y.; Thornton, Gail M.

    2015-01-01

    Partial thickness rotator cuff tears are a common cause of pain in the adult shoulder. Despite their high prevalence, the diagnosis and treatment of partial thickness rotator cuff tears remains controversial. While recent studies have helped to elucidate the anatomy and natural history of disease progression, the optimal treatment, both nonoperative and operative, is unclear. Although the advent of arthroscopy has improved the accuracy of the diagnosis of partial thickness rotator cuff tears, the number of surgical techniques used to repair these tears has also increased. While multiple repair techniques have been described, there is currently no significant clinical evidence supporting more complex surgical techniques over standard rotator cuff repair. Further research is required to determine the clinical indications for surgical and nonsurgical management, when formal rotator cuff repair is specifically indicated and when biologic adjunctive therapy may be utilized. PMID:26171251

  13. Partial Thickness Rotator Cuff Tears: Current Concepts

    Directory of Open Access Journals (Sweden)

    Graeme Matthewson

    2015-01-01

    Full Text Available Partial thickness rotator cuff tears are a common cause of pain in the adult shoulder. Despite their high prevalence, the diagnosis and treatment of partial thickness rotator cuff tears remains controversial. While recent studies have helped to elucidate the anatomy and natural history of disease progression, the optimal treatment, both nonoperative and operative, is unclear. Although the advent of arthroscopy has improved the accuracy of the diagnosis of partial thickness rotator cuff tears, the number of surgical techniques used to repair these tears has also increased. While multiple repair techniques have been described, there is currently no significant clinical evidence supporting more complex surgical techniques over standard rotator cuff repair. Further research is required to determine the clinical indications for surgical and nonsurgical management, when formal rotator cuff repair is specifically indicated and when biologic adjunctive therapy may be utilized.

  14. Environmental radiation standards and risk limitation

    International Nuclear Information System (INIS)

    Kocher, D.C.

    1987-01-01

    The Environmental Protection Agency and Nuclear Regulatory Commission have established environmental radiation standards for specific practices which correspond to limits on risk to the public that vary by several orders of magnitude and often are much less than radiation risks that are essentially unregulated, e.g., risks from radon in homes. This paper discusses a proposed framework for environmental radiation standards that would improve the correspondence with limitation of risk. This framework includes the use of limits on annual effective dose equivalent averaged over a lifetime, rather than limits on dose equivalent to whole body or any organ for each year of exposure, and consideration of exposures of younger age groups as well as adults; limits on annual effective dose equivalent averaged over a lifetime no lower than 0.25 mSv (25 mrem) per practice; maintenance of all exposures as low as reasonably achievable (ALARA); and establishment of a generally applicable de minimis dose for public exposures. Implications of the proposed regulatory framework for the current system of standards for limiting public exposures are discussed. 20 refs

  15. Adult Scoliosis

    Science.gov (United States)

    ... For Parents For Adolescents For Adults Scoliosis Kyphosis Spondylolysis Other Spine Deformities & Conditions Conditions of the Aging ... For Parents For Adolescents For Adults Scoliosis Kyphosis Spondylolysis Other Spine Deformities & Conditions Conditions of the Aging ...

  16. Comparison of a standardized procedure with current laboratory practices for the detection of lupus anticoagulant in France. Working Group on Hemostasis of the Société Française de Biologie Clinique.

    Science.gov (United States)

    1993-11-15

    A multicenter study involving 13 laboratories was designed to compare a common procedure for screening lupus anticoagulants (LA) to the different practices currently in use in these laboratories. The common procedure combined 3 phospholipid-dependent assays, including mixing studies and a phospholipid neutralizing test. Due to the heterogeneity of LA expression, an abnormal result in at least one of the tests was sufficient to classify a sample as positive for LA. Consecutive samples referred for LA diagnosis were evaluated in parallel by each participant and the data found using the common procedure were analyzed independently according to mutually agreed cut-offs and criteria for sample classification. Within a period of 3 months, 535 samples were included, of which 147 were judged LA positive, 29 undetermined and 359 negative by the respective laboratories using their current practice. When using the common procedure, 149 plasmas were said to be positive, 38 undetermined and 348 negative. Absolute concordance occurred for 81% of the specimen population and absolute discordance (positive versus negative) for 7%. The level of agreement between the common procedure and the current practices, assessed by kappa indexes, indicated noticeable variations in the rates of detection from laboratory to laboratory. Among the different tests used in the common procedure, regular APTT was the least sensitive (about 50% detection) but none of the other tests alone recognized more than 73% of specimens from the LA positive population. This yield increased to about 90% with any combination of 2 sensitive tests.(ABSTRACT TRUNCATED AT 250 WORDS)

  17. Time and Standards - An Overview

    National Research Council Canada - National Science Library

    Guinot, Bernard

    2000-01-01

    ...? This paper attempts to answer this question. After recalling current performances of time and frequency standards and their use in establishing time scales, the author considers their limitations in astronomical observations and studies...

  18. Adult medulloblastoma

    OpenAIRE

    Rege S.V.; Patil Harshad; Narayan Sharadendu

    2016-01-01

    Medulloblastoma is a highly malignant central nervous system (CNS) tumor that arises from the cerebellum. It is the most common primary malignant intracranial childhood neoplasm. In adults, medulloblastoma are much less common, accounting for < 1% of all adult brain tumors. Herein, author has described a rare case of cerebellar medulloblastoma in adult.

  19. Omega-6/omega-3 fatty acid intake of children and older adults in the U.S.: dietary intake in comparison to current dietary recommendations and the Healthy Eating Index.

    Science.gov (United States)

    Sheppard, Kelly W; Cheatham, Carol L

    2018-03-09

    Omega-6 and omega-3 fatty acids (FAs) and their ratio have been shown to affect cognitive function in children and older adults. With these analyses, we aimed to describe omega-6 and omega-3 FA intake among children and older adults in light of FA intake recommendations and with consideration of overall diet. Data were merged from two cross-sectional studies with 219 children 7 to 12 years old and one longitudinal study with 133 adults 65 to 79 years old. Demographic data, anthropometric data, and Healthy Eating Index scores were used to study relations among the omega-6 to omega-3 FA ratio and age, education, body mass index, and diet quality. FA intake, demographic, and anthropometric data were examined using partial correlations, t-tests, and analysis of variance. Most children and adults consumed at least the recommended amount of alpha-linolenic acid (LNA; omega-3) for their age and gender without consuming high amounts of linoleic acid (LA; omega-6), but did not consume sufficient eicosapentaenoic acid (EPA; omega-) and docosahexaenoic acid (DHA; omega-3). The average omega-6 to omega-3 ratios in both groups were lower than previously reported. Eating lower ratios was associated with healthier diets and consuming adequate amounts of several other nutrients. No demographic or anthropometric variables were related to FA intake in children. Adults with a college degree had significantly lower ratios than those without a college degree. American children and older adults are able to consume more balanced omega-6 to omega-3 ratios than has been indicated by commodity data. However, very few American children met even the lowest recommendations for EPA and DHA intake. Research is needed to clarify recommendations for the optimal ratio across development, which may aid in increasing EPA and DHA intake and improving health outcomes in the United States. ClinicalTrials.gov NCT02199808 13 July 2014, NCT01823419 (retrospectively registered) 20 March 2013, and NCT

  20. Current awareness.

    Science.gov (United States)

    Compagno, C; Brambilla, L; Capitanio, D; Boschi, F; Ranzi, B M; Porro, D

    2001-05-01

    In order to keep subscribers up-to-date with the latest developments in their field, this current awareness service is provided by John Wiley & Sons and contains newly-published material on yeasts. Each bibliography is divided into 10 sections. 1 Books, Reviews & Symposia; 2 General; 3 Biochemistry; 4 Biotechnology; 5 Cell Biology; 6 Gene Expression; 7 Genetics; 8 Physiology; 9 Medical Mycology; 10 Recombinant DNA Technology. Within each section, articles are listed in alphabetical order with respect to author. If, in the preceding period, no publications are located relevant to any one of these headings, that section will be omitted. (4 weeks journals - search completed 7th Mar. 2001)

  1. Current titles

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1995-07-01

    This booklet is published for those interested in current research being conducted at the National Center for Electron Microscopy. The NCEM is a DOE-designated national user facility and is available at no charge to qualified researchers. Access is controlled by an external steering committee. Interested researchers may contact Gretchen Hermes at (510) 486-5006 or address below for a User`s Guide. Copies of available papers can be ordered from: Theda Crawford National Center for Electron Microscopy, Lawrence Berkeley Laboratory, One Cyclotron Rd., MS72, Berkeley, California, USA 94720.

  2. Standardization of the bakery goods

    OpenAIRE

    Elżbieta Goryńska-Goldmann

    2010-01-01

    The article presents selected aspects of the standardization, highly valued factor that stimulates the economic development of the country. The attention was paid to the purpose of the standardization, basic normative documents and standardizing activity. Different proposals for the classification of bread applied in practice or appearing in scientific studies were presented. It was emphasised that currently legal mess exists in Poland, in terms of use of the bread classification. The necessi...

  3. Standards development status. Summary report

    International Nuclear Information System (INIS)

    1981-12-01

    The Standards Development Status Summary Report is designed for scheduling, monitoring, and controlling the process by which Regulatory Standards, Guides, Reports, Petitions, and Environmental Statements are written. It is a summary of the current schedule plans for development of the above products

  4. Current ornithology

    CERN Document Server

    1983-01-01

    The appearance of the first volume of a projected series is the occasion for comment on scope, aims, and genesis of the work. The scope of Current Ornithology is all of the biology of birds. Ornithology, as a whole-organism science, is concerned with birds at every level of bi­ ological organization, from the molecular to the community, at least from the Jurassic to the present time, and over every scholarly discipline in which bird biology is done; to say this is merely to expand a dic­ tionary definition of "ornithology. " The aim of the work, to be realized over several volumes, is to present reviews or position statements con­ cerning the active fields of ornithological research. The reviews will be relatively short, and often will be done from the viewpoint of a readily­ identified group or school. Such a work could have come into being at any time within the past fifty years, but that Current Ornithology appears now is a result of events that are only seven to eight years old. One important event wa...

  5. Adult ESL Education in the US

    Science.gov (United States)

    Eyring, Janet L.

    2014-01-01

    This article discusses the state of the art in the field of "adult ESL" in the US. It identifies the size, characteristics, and settings of adult education and discusses relevant professional standards, assessment procedures, and teacher preparation. Three approaches to noncredit adult ESL education will be presented (Functional…

  6. Intra-rater reproducibility and validity of Nintendo Wii Balance Tests in community-dwelling Older Adults

    DEFF Research Database (Denmark)

    Jørgensen, Martin; Læssøe, Uffe; Hendriksen, C

    2014-01-01

    The aims of the current study were to examine the intrarater intersession reproducibility of the Nintendo Wii agility and stillness tests and explore the concurrent validity in relation to gold-standard force-plate analysis. Within-day intersession reproducibility was examined in 30 older adults ...

  7. Craniospinal radiotherapy in adult medulloblastoma

    International Nuclear Information System (INIS)

    Selek, U.; Zorlu, F.; Hurmuz, P.; Cengiz, M.; Gurkaynak, M.; Turker, A.; Soylemezoglu, F.

    2007-01-01

    Purpose: To evaluate the outcome and prognostic factors of adult patients with medulloblastoma. Patients and Methods: 26 adult medulloblastoma patients with a median age of 27 were subjected to craniospinal radiotherapy. A dose of 30.6 Gy with 1.8 Gy/fraction/day was prescribed to M0 patients, while 36 Gy were to be applied in patients with positive cerebrospinal liquor findings. The posterior fossa was boosted to 54 Gy. While 20 patients underwent external-beam radiotherapy alone, only six received sequential adjuvant chemotherapy. Results: Male/female ratio was 1.2. Preradiotherapy Karnofsky performance status was recorded as median 100%. 50% were classified as poor risk (n = 10, subtotal resection; n = 3, M+). The median follow-up time was 46.5 months. The 5-year actuarial survival rates for recurrence-free, distant metastasis-free, disease-free, and overall survival were 82.5%, 90.8%, 73.5%, and 89.7%, respectively. Patient characteristics, treatment factors and tumor characteristics failed to show any significance in univariate analysis. Grade 3 or 4 late morbidities were not observed. Conclusion: Yet, the current standard of care seems to remain craniospinal irradiation after maximal surgical resection of the primary neoplasm without clear indications for adjuvant chemotherapy. (orig.)

  8. The Satisfaction of the Right of Justice under the Colombian Peace Process. A Look at Developments in the Field of Criminal Responsibility in the Context of a Peace Process and Current International Standards

    Directory of Open Access Journals (Sweden)

    Beatriz Eugenia Suárez López

    2014-07-01

    Full Text Available With the purpose of comparing the peace agreements that were carried out in Colombia during the decades of the 80s and 90s and the current negotiation process that is taking place in Havana with the farc, the article identifies the lessons of the peace processes selected and discusses their relevance to the negotiation in progress. In particular, the article explicates how the right to justice of the victims, and the amnesties and pardons to members of illegal armed groups, were addressed in the past. Furthermore, the article examines the Legislative Act 1 of 2012, which establishes the so-called ‘Legal Framework for Peace’. Thus, it highlights the possible consequences in regards to international responsibility of the Colombian State and of the perpetrators of international crimes.

  9. Cross-sectional imaging of adult crystal and inflammatory arthropathies

    International Nuclear Information System (INIS)

    Soldatos, Theodoros; Pezeshk, Parham; Ezzati, Fatemeh; Karp, David R.; Taurog, Joel D.; Chhabra, Avneesh

    2016-01-01

    This article highlights the key aspects and current perspectives of the role of cross-sectional imaging in adult crystal and inflammatory arthropathies in adults, briefly discussing CT, and particularly focusing on MRI and US imaging as it supplements the conventional radiography. The role of conventional and advanced MR imaging techniques and imaging findings in this domain is discussed and illustrated with case examples. All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. This article contains images and data, which were collected from patients as a part of a retrospective IRB from the institutional teaching files and informed consent was waived. (orig.)

  10. IAEA Safety Standards

    International Nuclear Information System (INIS)

    2016-09-01

    The IAEA Safety Standards Series comprises publications of a regulatory nature covering nuclear safety, radiation protection, radioactive waste management, the transport of radioactive material, the safety of nuclear fuel cycle facilities and management systems. These publications are issued under the terms of Article III of the IAEA’s Statute, which authorizes the IAEA to establish “standards of safety for protection of health and minimization of danger to life and property”. Safety standards are categorized into: • Safety Fundamentals, stating the basic objective, concepts and principles of safety; • Safety Requirements, establishing the requirements that must be fulfilled to ensure safety; and • Safety Guides, recommending measures for complying with these requirements for safety. For numbering purposes, the IAEA Safety Standards Series is subdivided into General Safety Requirements and General Safety Guides (GSR and GSG), which are applicable to all types of facilities and activities, and Specific Safety Requirements and Specific Safety Guides (SSR and SSG), which are for application in particular thematic areas. This booklet lists all current IAEA Safety Standards, including those forthcoming

  11. radioactive waste disposal standards abroad

    International Nuclear Information System (INIS)

    Lu Yan; Xin Pingping; Wu Jian; Zhang Xue

    2012-01-01

    With the world focus on human health and environmental protection, the problem of radioactive waste disposal has gradually become a global issue, and the focus of attention of public. The safety of radioactive waste disposal, is not only related to human health and environmental safety, but also an important factor of affecting the sustainable development of nuclear energy. In recent years the formulation of the radioactive waste disposal standards has been generally paid attention to at home and abroad, and it has made great progress. In China, radioactive waste management standards are being improved, and there are many new standards need to be developed. The revised task of implement standards is very arduous, and there are many areas for improvement about methods and procedures of the preparation of standards. This paper studies the current situation of radioactive waste disposal standards of the International Atomic Energy Agency, USA, France, Britain, Russia, Japan, and give some corresponding recommendations of our radioactive waste disposal standards. (authors)

  12. Who Recognises Technical Standards in TTIP?

    NARCIS (Netherlands)

    K.P. Purnhagen (Kai)

    2017-01-01

    textabstractCurrent political discussions on the relationship of technical standards to the Transatlantic, Trade and Investment Partnership (TTIP) concern the question whether TTIP can provide a transatlantic level playing field for technical standards, and whether this will negatively affect

  13. Who recognises technical standards in TTIP?

    NARCIS (Netherlands)

    Purnhagen, K.

    2018-01-01

    Current political discussions on the relationship of technical standards to the Transatlantic, Trade and Investment Partnership (TTIP) concern the question whether TTIP can provide a transatlantic level playing field for technical standards, and whether this will negatively affect technical

  14. Optimization and standardization of pavement management processes.

    Science.gov (United States)

    2004-08-01

    This report addresses issues related to optimization and standardization of current pavement management processes in Kentucky. Historical pavement management records were analyzed, which indicates that standardization is necessary in future pavement ...

  15. Age differences in big five behavior averages and variabilities across the adult life span: moving beyond retrospective, global summary accounts of personality.

    Science.gov (United States)

    Noftle, Erik E; Fleeson, William

    2010-03-01

    In 3 intensive cross-sectional studies, age differences in behavior averages and variabilities were examined. Three questions were posed: Does variability differ among age groups? Does the sizable variability in young adulthood persist throughout the life span? Do past conclusions about trait development, based on trait questionnaires, hold up when actual behavior is examined? Three groups participated: young adults (18-23 years), middle-aged adults (35-55 years), and older adults (65-81 years). In 2 experience-sampling studies, participants reported their current behavior multiple times per day for 1- or 2-week spans. In a 3rd study, participants interacted in standardized laboratory activities on 8 occasions. First, results revealed a sizable amount of intraindividual variability in behavior for all adult groups, with average within-person standard deviations ranging from about half a point to well over 1 point on 6-point scales. Second, older adults were most variable in Openness, whereas young adults were most variable in Agreeableness and Emotional Stability. Third, most specific patterns of maturation-related age differences in actual behavior were more greatly pronounced and differently patterned than those revealed by the trait questionnaire method. When participants interacted in standardized situations, personality differences between young adults and middle-aged adults were larger, and older adults exhibited a more positive personality profile than they exhibited in their everyday lives.

  16. Compliance with Adult Congenital Heart Disease Guidelines: Are We Following the Recommendations?

    Science.gov (United States)

    Gerardin, Jennifer F; Menk, Jeremiah S; Pyles, Lee A; Martin, Cindy M; Lohr, Jamie L

    2016-05-01

    As the adult congenital heart disease population increases, poor transition from pediatric to adult care can lead to suboptimal quality of care and an increase in individual and institutional costs. In 2008, the American College of Cardiology and American Heart Association updated the adult congenital heart disease practice guidelines and in 2011, the American Heart Association recommended transition guidelines to standardize and encourage appropriate timing of transition to adult cardiac services. The objective of this study was to evaluate if patient age or complexity of congenital heart disease influences pediatric cardiologists' decision to transfer care to adult providers and to evaluate the compliance of different types of cardiology providers with current adult congenital heart disease treatment guidelines. A single-center retrospective review of 991 adult congenital heart disease patients identified by ICD-9 code from 2010 to 2012. Academic and community outpatient cardiology clinics. Nine hundred ninety-one patients who are 18 years and older with congenital heart disease. None. The compliance with health maintenance and transfer of care recommendations in the outpatient setting. For patients seen by pediatric cardiologists, only 20% had transfer of care discussions documented, most often in younger simple patients. Significant differences in compliance with preventative health guidelines were found between cardiology provider types. Even though a significant number of adults with congenital heart disease are lost to appropriate follow-up in their third and fourth decades of life, pediatric cardiologists discussed transfer of care with moderate and complex congenital heart disease patients less frequently. Appropriate transfer of adults with congenital heart disease to an adult congenital cardiologist provides an opportunity to reinforce the importance of regular follow-up in adulthood and may improve outcomes as adult congenital cardiologists followed the

  17. Record productions establish RF-driven sources as the standard for generating high-duty-factor, high-current H- beams for accelerators (Winner of the ICIS 2017 Brightness Award)

    Science.gov (United States)

    Stockli, Martin P.; Welton, Robert F.; Han, Baoxi

    2018-05-01

    The Spallation Neutron Source operates reliably at 1.2 MW and will gradually ramp to 1.4 MW. This paper briefly recalls some of the struggles when the unprecedented project was started and ramped to 1 MW over a 3½ year period. This was challenging, especially for the H- ion source and the low-energy beam transport system, which make up the H- injector. It took several more years to push the H- injector to the 1.4 MW requirements, and even longer to reach close to 100% injector availability. An additional breakthrough was the carefully staged, successful extension of the H- source service cycle so that disruptive source changes became rare events. More than 7 A.h of extracted H- ions have been demonstrated with a single source without maintenance, more than twice the single-source quantity of ions produced by any other high-current H- accelerator facility. Achieving the 1.4 MW requirements with close to 100% availability and record-breaking source service cycles were the basis for the 2017 Brightness Award.

  18. Clinical Interviewing with Older Adults

    Science.gov (United States)

    Mohlman, Jan; Sirota, Karen Gainer; Papp, Laszlo A.; Staples, Alison M.; King, Arlene; Gorenstein, Ethan E.

    2012-01-01

    Over the next few decades the older adult population will increase dramatically, and prevalence rates of psychiatric disorders are also expected to increase in the elderly cohort. These demographic projections highlight the need for diagnostic instruments and methods that are specifically tailored to older adults. The current paper discusses the…

  19. Standardization of the bakery goods

    Directory of Open Access Journals (Sweden)

    Elżbieta Goryńska-Goldmann

    2010-01-01

    Full Text Available The article presents selected aspects of the standardization, highly valued factor that stimulates the economic development of the country. The attention was paid to the purpose of the standardization, basic normative documents and standardizing activity. Different proposals for the classification of bread applied in practice or appearing in scientific studies were presented. It was emphasised that currently legal mess exists in Poland, in terms of use of the bread classification. The necessity of legal regulations of this issue by standard regulations was pointed out.

  20. The Dynamics of Standardization

    DEFF Research Database (Denmark)

    Brunsson, Nils; Rasche, Andreas; Seidl, David

    2012-01-01

    This paper suggests that when the phenomenon of standards and standardization is examined from the perspective of organization studies, three aspects stand out: the standardization of organizations, standardization by organizations and standardization as (a form of) organization. Following a comp...

  1. Clopidogrel Resistance: Current Issues

    Directory of Open Access Journals (Sweden)

    NS Neki

    2016-05-01

    Full Text Available Antiplatelet agents are mainly used in the prevention and management of atherothrombotic complications. Dual antiplatelet therapy, combining aspirin and clopidogrel, is the standard care for patients having acute coronary syndromes or undergoing percutaneous coronary intervention according to the current ACC/AHA and ESC guidelines. But in spite of administration of dual antiplatelet therapy, some patients develop recurrent cardiovascular ischemic events especially stent thrombosis which is a serious clinical problem. Antiplatelet response to clopidogrel varies widely among patients based on ex vivo platelet function measurements. Clopidogrel is an effective inhibitor of platelet activation and aggregation due to its selective and irreversible blockade of the P2Y12 receptor. Patients who display little attenuation of platelet reactivity with clopidogrel therapy are labeled as low or nonresponders or clopidogrel resistant. The mechanism of clopidogrel resistance remains incompletely defined but there are certain clinical, cellular and genetic factors including polymorphisms responsible for therapeutic failure. Currently there is no standardized or widely accepted definition of clopidogrel resistance. The future may soon be realised in the routine measurement of platelet activity in the same way that blood pressure, cholesterol and blood sugar are followed to help guide the therapy, thus improving the care for millions of people. This review focuses on the methods used to identify patients with clopidogrel resistance, the underlying mechanisms, metabolism, clinical significance and current therapeutic strategies to overcome clopidogrel resistance. J Enam Med Col 2016; 6(1: 38-46

  2. Adult Education and Adult Learning

    DEFF Research Database (Denmark)

    Illeris, Knud

    Kort beskrivelse Bogen, 'Adult Education og Adult Learning', giver et fyldestgørende overblik over forståelsen af voksenuddannelse og læring. Abstract I "Adult Education and Adult Learning' ser Knud Illeris på voksenuddannelse fra to perspektiver. På den ene side beskrives de aktuelle udfordringer...... Rubinson, Professor of Education, University of British Colombia, Vancouver skrev: "Illeris viser et fantastisk overblik over nøgleproblematikkerne når vi taler voksenuddannelse og læring. Han har en evne til fremvise komplekse emner og sammenhænge, som selv menigmand let kan forstå."...

  3. Immunizing Adults

    Centers for Disease Control (CDC) Podcasts

    Vaccines aren’t just for kids; adults also need to get immunized. Overall, far too many people 19 years and older aren’t getting the vaccines they need and remain unprotected. In this podcast, Dr. Walter Williams discuss the importance of adults being fully vaccinated.

  4. Effectiveness of individual placement and support supported employment for young adults.

    Science.gov (United States)

    Bond, Gary R; Drake, Robert E; Campbell, Kikuko

    2016-08-01

    The individual placement and support (IPS) model of supported employment was first developed in community mental health centres for adults with severe mental illness. While IPS is an established evidence-based practice in this broad population, evidence on its effectiveness focused specifically on young adults has been limited. The current study aimed to address this gap. To investigate the effects of IPS on young adults, the authors conducted a secondary analysis on a pooled sample of 109 unemployed young adults (under age 30) from four randomized controlled trials employing a common research protocol that included a standardized measurement battery and rigorous fidelity monitoring. Researchers assessed these participants over 18 months on nine competitive employment outcome measures. On all measures, the IPS group had significantly better employment outcomes. Overall, 40 (82%) of IPS participants obtained employment during follow-up compared with 25 (42%) of control participants, χ(2) = 17.9, P < .001. IPS participants averaged 25.0 weeks of employment, compared with 7.0 weeks for control participants, t = 4.50, P < .001. The current analysis supports a small number of previous studies in showing that IPS is highly effective in helping young adults with severe mental illness to attain competitive employment. When young adults acquire competitive jobs and initiate a path towards normal adult roles, they may avoid the cycle of disability and psychiatric patient roles that are demeaning and demoralizing. © 2014 Wiley Publishing Asia Pty Ltd.

  5. Adult education

    DEFF Research Database (Denmark)

    Rasmussen, Palle; Larson, Anne; Cort, Pia

    education works well, serving relevant needs of citizens as well as the labour market and contributes to social justice. Thus policy intervention is not needed and the workings of adult education are more or less invisible (2) the Danish system of adult education confronts problems of quality......When the first round of results from the PIAAC survey was published in 2013, the media coverage in Denmark was limited and quickly focused on how to enhance learning in primary school (Cort & Larson, 2015). What could have led to an increased focus on adult education and training, thus, instead...... revealed how the interest in adult education and training was being overshadowed by a dominant focus on primary education. This apparent lack of interest for adult education and training is not a given in the international context and perhaps especially in Denmark. In the 1970’s, both UNESCO and the OECD...

  6. Validity of ultrasonography and measures of adult shoulder function and reliability of ultrasonography in detecting shoulder synovitis in patients with rheumatoid arthritis using magnetic resonance imaging as a gold standard.

    LENUS (Irish Health Repository)

    Bruyn, G A W

    2010-08-01

    To assess the intra- and interobserver reproducibility of musculoskeletal ultrasonography (US) in detecting inflammatory shoulder changes in patients with rheumatoid arthritis, and to determine the agreement between US and the Shoulder Pain and Disability Index (SPADI) and the Disabilities of the Arm, Shoulder, and Hand (DASH) questionnaire, using magnetic resonance imaging (MRI) as a gold standard.

  7. Student/Pupil Accounting: Standard Terminology and Guide for Managing Student Data in Elementary and Secondary Schools, Community/Junior Colleges, and Adult Education. State Educational Records and Reports Series: Handbook V. Revised.

    Science.gov (United States)

    Putnam, John F.

    This handbook's fundamental purpose is to provide terms and definitions for the data and information educators use in student services. It identifies concepts used in decisionmaking, provides standardized terms and definitions, classifies the terms, provides guidelines for developing and managing student records, and recommends the development of…

  8. Brief Report: Relationship Between ADOS-2, Module 4 Calibrated Severity Scores (CSS) and Social and Non-Social Standardized Assessment Measures in Adult Males with Autism Spectrum Disorder (ASD)

    Science.gov (United States)

    Morrier, Michael J.; Ousley, Opal Y.; Caceres-Gamundi, Gabriella A.; Segall, Matthew J.; Cubells, Joseph F.; Young, Larry J.; Andari, Elissar

    2017-01-01

    The ADOS-2 Modules 1-3 now include a standardized calibrated severity score (CSS) from 1 to 10 based on the overall total raw score. Subsequent research published CSS for Module 4 (Hus, Lord, "Journal of Autism and Developmental Disorders" 44(8):1996-2012, 2014); however more research is needed to examine the psychometric properties of…

  9. QuickStats: Percentage* of Adults Aged ≥18 Years Who Currently Use E-Cigarettes,† by Sex and Age Group - National Health Interview Survey,§ 2016.

    Science.gov (United States)

    2018-01-05

    In 2016, 3.8% of men and 2.6% of women aged ≥18 years currently used e-cigarettes. Among men, current e-cigarette use decreased with advancing age, from 7.1% among men aged 18-24 years to 4.8% among men aged 25-49 years, 2.6% among men 50-64 years, and 1.1% among men aged ≥65 years. Among women, current e-cigarette use increased between ages 18-24 years (2.3%) and 25-49 years (3.3%) and decreased between ages 50-64 years (3.0%) and ≥65 years (0.9%). A greater percentage of men aged 18-24 years and 25-49 years currently used e-cigarettes compared with women in the same age groups.

  10. Hazard Communication Standard

    International Nuclear Information System (INIS)

    Sichak, S.

    1991-01-01

    The current rate of technological advances has brought with it an overwhelming increase in the usage of chemicals in the workplace and in the home. Coupled to this increase has been a heightened awareness in the potential for acute and chronic injuries attributable to chemical insults. The Hazard Communication Standard has been introduced with the desired goal of reducing workplace exposures to hazardous substances and thereby achieving a corresponding reduction in adverse health effects. It was created and proclaimed by the US Department of Labor and regulated by the Occupational Safety and Health Administration. 1 tab

  11. Adult neurology training during child neurology residency.

    Science.gov (United States)

    Schor, Nina F

    2012-08-21

    As it is currently configured, completion of child neurology residency requires performance of 12 months of training in adult neurology. Exploration of whether or not this duration of training in adult neurology is appropriate for what child neurology is today must take into account the initial reasons for this requirement and the goals of adult neurology training during child neurology residency.

  12. Teleradiology - current status

    International Nuclear Information System (INIS)

    Baltadjiev, D.; Charakchiev

    2000-01-01

    Tele-radiology is a term becoming increasingly popular in the medical literature. Nevertheless, terminological definitions in this particular field are still rather vague. The scope of applications extend from simple image presenting via analogue telephone lines to transmission of 3-D medical images through a satellite. It is a matter of standards highly differing in terms of data transmission rates, safety, technical demands on the systems and the like. In this article new information technologies, technical aspects, as well as some major applications of tele-radiology are discussed. The current status of tele-medicine/tele-radiology in this country is likewise briefly outlined

  13. The German radiation protection standards

    International Nuclear Information System (INIS)

    Becker, Klaus; Neider, Rudolf

    1977-01-01

    The German Standards Institute (DIN Deutsches Institut fuer Normung, Berlin) is engaged in health physics standards development in the following committees. The Nuclear Standards Committee (NKe), which deals mainly with nuclear science and technology, the fuel cycle, and radiation protection techniques. The Radiology Standards Committee (FNR), whose responsibilities are traditionally the principles of radiation protection and dosimetry, applied medical dosimetry, and medical health physics. The German Electrotechnical Commission (DKE), which is concerned mostly with instrumentation standards. The Material Testing Committee (FNM), which is responsible for radiation protection in nonmedical radiography. The current body of over one hundred standards and draft standards was established to supplement the Federal German radiation protection legislation, because voluntary standards can deal in more detail with the specific practical problems. The number of standards is steadily expanding due to the vigorous efforts of about thirty working groups, consisting of essentially all leading German experts of this field. Work is supported by the industry and the Federal Government. A review of the present status and future plans, and of the international aspects with regard to European and world (ISO, etc.) standards will be presented

  14. Transgender youth: current concepts

    Science.gov (United States)

    2016-01-01

    In many countries throughout the world, increasing numbers of gender nonconforming/transgender youth are seeking medical services to enable the development of physical characteristics consistent with their experienced gender. Such medical services include use of agents to block endogenous puberty at Tanner stage II with subsequent use of cross-sex hormones, and are based on longitudinal studies demonstrating that those individuals who were first identified as gender dysphoric in early or middle childhood and continue to meet the mental health criteria for being transgender at early puberty are likely to be transgender as adults. This review addresses terms and definitions applicable to gender nonconforming youth, studies that shed light on the biologic determinants of gender identity, current clinical practice guidelines for transgender youth, challenges to optimal care, and priorities for research. PMID:28164070

  15. Transgender youth: current concepts

    Directory of Open Access Journals (Sweden)

    Stephen M. Rosenthal

    2016-12-01

    Full Text Available In many countries throughout the world, increasing numbers of gender nonconforming/transgender youth are seeking medical services to enable the development of physical characteristics consistent with their experienced gender. Such medical services include use of agents to block endogenous puberty at Tanner stage II with subsequent use of cross-sex hormones, and are based on longitudinal studies demonstrating that those individuals who were first identified as gender dysphoric in early or middle childhood and continue to meet the mental health criteria for being transgender at early puberty are likely to be transgender as adults. This review addresses terms and definitions applicable to gender nonconforming youth, studies that shed light on the biologic determinants of gender identity, current clinical practice guidelines for transgender youth, challenges to optimal care, and priorities for research.

  16. Dehydration in the Older Adult.

    Science.gov (United States)

    Miller, Hayley J

    2015-09-01

    Dehydration affects 20% to 30% of older adults. It has a greater negative outcome in this population than in younger adults and increases mortality, morbidity, and disability. Dehydration is often caused by water deprivation in older adults, although excess water loss may also be a cause. Traditional markers for dehydration do not take into consideration many of the physiological differences present in older adults. Clinical assessment of dehydration in older adults poses different findings, yet is not always diagnostic. Treatment of dehydration should focus on prevention and early diagnosis before it negatively effects health and gives rise to comorbidities. The current article discusses what has most thoroughly been studied; the best strategies and assessment tools for evaluation, diagnosis, and treatment of dehydration in older adults; and what needs to be researched further. [Journal of Gerontological Nursing, 41(9), 8-13.]. Copyright 2015, SLACK Incorporated.

  17. Hg(+) Frequency Standards

    Science.gov (United States)

    Prestage, John D.; Tjoelker, Robert L.; Maleki, Lute

    2000-01-01

    In this paper we review the development of Hg(+) microwave frequency standards for use in high reliability and continuous operation applications. In recent work we have demonstrated short-term frequency stability of 3 x 10(exp -14)/nu(sub tau) when a cryogenic oscillator of stability 2-3 x 10(exp 15) was used a the local oscillator. The trapped ion frequency standard employs a Hg-202 discharge lamp to optically pump the trapped Hg(+)-199 clock ions and a helium buffer gas to cool the ions to near room temperature. We describe a small Hg(+) ion trap based frequency standard with an extended linear ion trap (LITE) architecture which separates the optical state selection region from the clock resonance region. This separation allows the use of novel trap configurations in the resonance region since no optical pumping is carried out there. A method for measuring the size of an ion cloud inside a linear trap with a 12-rod trap is currently being investigated. At approx. 10(exp -12), the 2nd order Doppler shift for trapped mercury ion frequency standards is one of the largest frequency offsets and its measurement to the 1% level would represent an advance in insuring the very long-term stability of these standards to the 10(exp -14) or better level. Finally, we describe atomic clock comparison experiments that can probe for a time variation of the fine structure constant, alpha = e(exp 2)/2(pi)hc, at the level of 10(exp -20)/year as predicted in some Grand Unified String Theories.

  18. Adult teachers

    DEFF Research Database (Denmark)

    Larsen, Lea Lund

    2011-01-01

    In this paper I examine the research into the process of adult teachers’ practice-based learning as a part of an on-going project titled “Competence development through practice-based learning – a study of adult teacher’s learning processes”. The project relies on the notion of the adult teacher...... as a 'reflective practitioner’, who develops 'the language of practice’, through experience and learns when she is exposed to 'disjuncture’. Research done on continuing professional development and the inquiries done in the field of teacher thinking and within this the research on novices becoming expert...

  19. Internet use, misuse, and addiction in adolescents: current issues and challenges.

    Science.gov (United States)

    Greydanus, Donald E; Greydanus, Megan M

    2012-01-01

    The Internet has revolutionized education and social communication in the 21st century. This article reviews the growing literature identifying a number of adolescents and young adults with a pathologically excessive Internet use leading to many potential consequences. Current research dilemmas in this area include that Internet addiction is a broad topic with no standard definition and no standard measurement tools. Management of youth with identified problematic Internet use or misuse centers on behavioral therapy and treatment of comorbidities. Pharmacologic approaches are limited at this time but are undergoing research, such as use of opioid antagonists and antidepressants in adults with pathological gambling. Efforts should be expanded on not only the education of all adolescents regarding the benefits but also the potential negative consequences of Internet use. It is vital that we do this for Generation Z, whereas Generation ALPHA will soon benefit or suffer from our efforts in this regard today.

  20. The effects of body posture, anatomy, age and pregnancy on the calculation of induced current densities at 50 Hz

    International Nuclear Information System (INIS)

    Dimbylow, P.; Findlay, R.

    2010-01-01

    This paper presents calculations of the induced current density in the body at 50 Hz from applied electric and magnetic fields. An extensive ensemble of 25 voxel models has been used to investigate the effects of body posture, anatomy, age and pregnancy. This set includes six adult models, eight child models and seven pregnant female models at various stages of gestation. The four postures investigated in the HPA adult model, NORMAN, were the standard position with the arms at the side, with the arms vertically above the head, the arms horizontally to the side and sitting. (authors)