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Sample records for advanced medical life

  1. Improving advanced cardiovascular life support skills in medical students: simulation-based education approach

    Directory of Open Access Journals (Sweden)

    Hamidreza Reihani

    2015-01-01

    Full Text Available Objective: In this trial, we intend to assess the effect of simulation-based education approach on advanced cardiovascular life support skills among medical students. Methods: Through convenient sampling method, 40 interns of Mashhad University of Medical Sciences in their emergency medicine rotation (from September to December 2012 participated in this study. Advanced Cardiovascular Life Support (ACLS workshops with pretest and post-test exams were performed. Workshops and checklists for pretest and post-test exams were designed according to the latest American Heart Association (AHA guidelines. Results: The total score of the students increased significantly after workshops (24.6 out of 100 to 78.6 out of 100. This demonstrates 53.9% improvement in the skills after the simulation-based education (P< 0.001. Also the mean score of each station had a significant improvement (P< 0.001. Conclusion: Pretests showed that interns had poor performance in practical clinical matters while their scientific knowledge, such as ECG interpretation was acceptable. The overall results of the study highlights that Simulation based-education approach is highly effective in Improving ACLS skills among medical students.

  2. Hollow fiber membranes for advanced life support systems. [permeable capillaries for medical filtration

    Science.gov (United States)

    Roebelen, G. J., Jr.; Lysaght, M. J.

    1977-01-01

    This paper describes an investigation of the practicability of utilizing hollow fiber membranes in vehicular and portable life support system applications. A preliminary screening of potential advanced life support applications resulted in the selection of five applications for feasibility study and testing. As a result of the feasibility study and testing, three applications, heat rejection, deaeration, and bacteria filtration, were chosen for breadboard development testing. Breadboard hardware has been manufactured and tested, and the physical properties of the three hollow fiber membrane assemblies applicable to use aboard future spacecraft have been characterized.

  3. End-of-life costs of medical care for advanced stage cancer patients

    Directory of Open Access Journals (Sweden)

    Kovačević Aleksandra

    2015-01-01

    Full Text Available Background/Aim. Cancer, one of the leading causes of mortality in the world, imposes a substantial economic burden on each society, including Serbia. The aim of this study was to evaluate the major cancer cost drivers in Serbia. Methods. A retrospective, indepth, bottom-up analysis of two combined databases was performed in order to quantify relevant costs. End-of-life data were obtained from patients with cancer, who deceased within the first year of the established diagnose, including basic demographics, diagnosis, tumour histology, medical resource use and related costs, time and cause of death. All costs were allocated to one of the three categories of cancer health care services: primary care (included home care, hospital outpatient and hospital inpatient care. Results. Exactly 114 patients were analyzed, out of whom a high percent (48.25% had distant metastases at the moment of establishing the diagnosis. Malignant neoplasms of respiratory and intrathoracic organs were leading causes of morbidity. The average costs per patient were significantly different according to the diagnosis, with the highest (13,114.10 EUR and the lowest (4.00 EUR ones observed in the breast cancer and melanoma, respectively. The greatest impact on total costs was observed concerning pharmaceuticals, with 42% of share (monoclonal antibodies amounted to 34% of all medicines and 14% of total costs, followed by oncology medical care (21%, radiation therapy and interventional radiology (11%, surgery (9%, imaging diagnostics (9% and laboratory costs (8%. Conclusion. Cancer treatment incurs high costs, especially for end-of-life pharmaceutical expenses, ensued from medical personnel tendency to improve such patients’ quality of life in spite of nearing the end of life. Reimbursement policy on monoclonal antibodies, in particular at end-stage disease, should rely on cost-effectiveness evidence as well as documented clinical efficiency. [Projekat Ministarstva nauke

  4. [Advance Care Planning and Decisions to limit treatment at the end of life - the view from medical ethics and psychooncology].

    Science.gov (United States)

    Winkler, Eva C; Heußner, Pia

    2016-03-01

    Decisions to limit treatment are important in order to avoid overtreatment at the end of life. They proceed more than half of expected deaths in Europe and the US, but are not always communicated with the patient in advance. One reason for non-involvement is that conversations that prepare patients for end-of-life decisions and work out their preferences do not take place on a regular basis. At the same time there is growing evidence that such communication improves patients' quality of life, reduces anxiety and depression and allows patients to develop a realistic understanding of their situation - which in turn is a prerequisite for shared decision making about limiting treatment.In this paper we define "treatment limitation" and explain the medical ethics perspective. The main focus, however, is on the causes that hinder advanced care planning and conversations about limiting treatment in the care of patients with advanced disease. Finally the evidence for approaches to improve the situation is presented with concrete suggestions for solutions. PMID:26983109

  5. Is Doing More, Doing Better? Basic Versus Advanced Life Support Ambulances for Medical Emergencies

    OpenAIRE

    Sanghavi, Prachi

    2015-01-01

    Deficiencies in the quality of pre-hospital care constitute a serious public health problem that has largely been neglected by the scientific community. Trauma and complications of acute disease produce medical emergencies outside of the hospital setting. Treating patients with these conditions involves an inherent trade-off between providing treatment on-site and reducing time to hospital care. My dissertation compares two models of providing pre-hospital care, and highlights a data-driven a...

  6. Effect of High-Fidelity Simulation on Medical Students' Knowledge about Advanced Life Support: A Randomized Study.

    Directory of Open Access Journals (Sweden)

    Andrea Cortegiani

    Full Text Available High-fidelity simulation (HFS is a learning method which has proven effective in medical education for technical and non-technical skills. However, its effectiveness for knowledge acquisition is less validated. We performed a randomized study with the primary aim of investigating whether HFS, in association with frontal lessons, would improve knowledge about advanced life support (ALS, in comparison to frontal lessons only among medical students. The secondary aims were to evaluate the effect of HFS on knowledge acquisition of different sections of ALS and personal knowledge perception. Participants answered a pre-test questionnaire consisting of a subjective (evaluating personal perception of knowledge and an objective section (measuring level of knowledge containing 100 questions about algorithms, technical skills, team working/early warning scores/communication strategies according to ALS guidelines. All students participated in 3 frontal lessons before being randomized in group S, undergoing a HFS session, and group C, receiving no further interventions. After 10 days from the end of each intervention, both groups answered a questionnaire (post-test with the same subjective section but a different objective one. The overall number of correct answers of the post-test was significantly higher in group S (mean 74.1, SD 11.2 than in group C (mean 65.5, SD 14.3, p = 0.0017, 95% C.I. 3.34 - 13.9. A significantly higher number of correct answers was reported in group S than in group C for questions investigating knowledge of algorithms (p = 0.0001; 95% C.I 2.22-5.99 and team working/early warning scores/communication strategies (p = 0.0060; 95% C.I 1.13-6.53. Students in group S showed a significantly higher score in the post-test subjective section (p = 0.0074. A lower proportion of students in group S confirmed their perception of knowledge compared to group C (p = 0.0079. HFS showed a beneficial effect on knowledge of ALS among medical students

  7. Advanced medical accelerator design

    International Nuclear Information System (INIS)

    This report describes the design of an advanced medical facility dedicated to charged particle radiotherapy and other biomedical applications of relativistic heavy ions. Project status is reviewed and some technical aspects discussed. Clinical standards of reliability are regarded as essential features of this facility. Particular emphasis is therefore placed on the control system and on the use of technology which will maximize operational efficiency. The accelerator will produce a variety of heavy ion beams from helium to argon with intensities sufficient to provide delivered dose rates of several hundred rad/minute over large, uniform fields. The technical components consist of a linac injector with multiple PIG ion sources, a synchrotron and a versatile beam delivery system. An overview is given of both design philosophy and selected accelerator subsystems. Finally, a plan of the facility is described

  8. Flipping the advanced cardiac life support classroom with team-based learning: comparison of cognitive testing performance for medical students at the University of California, Irvine, United State

    OpenAIRE

    Boysen-Osborn, Megan; Anderson, Craig L.; Navarro, Roman; Yanuck, Justin; Strom, Suzanne; McCoy, Christopher E.; Youm, Julie; Ypma-Wong, Mary Frances; Langdorf, Mark I.

    2016-01-01

    Purpose: It aimed to find if written test results improved for advanced cardiac life support (ACLS) taught in flipped classroom/team-based Learning (FC/TBL) vs. lecture-based (LB) control in University of California-Irvine School of Medicine, USA. Methods: Medical students took 2010 ACLS with FC/TBL (2015), compared to 3 classes in LB (2012-14) format. There were 27.5 hours of instruction for FC/TBL model (TBL 10.5, podcasts 9, small-group simulation 8 hours), and 20 (12 lecture, simulation 8...

  9. Advanced Medication Dispenser

    OpenAIRE

    A. I. Alexan; A. R. Osan; Oniga, S.

    2013-01-01

    Medication dispensing is an important activity that can have major implications if done improperly. Dispensing must be done in the correct time interval, at the correct user, with the correct drug and dose. We propose a smart medication dispenser that can satisfy these needs and provide a mechanism for supervision. In order to ensure that the dispensing process is error free, the concept of a new smart medication container is used. A smart medication container is “smart” ...

  10. Advanced Medication Dispenser

    Directory of Open Access Journals (Sweden)

    A.I. Alexan

    2013-12-01

    Full Text Available Medication dispensing is an important activity that can have major implications if done improperly. Dispensing must be done in the correct time interval, at the correct user, with the correct drug and dose. We propose a smart medication dispenser that can satisfy these needs and provide a mechanism for supervision. In order to ensure that the dispensing process is error free, the concept of a new smart medication container is used. A smart medication container is “smart” as it holds the medication dispensing parameters for the drugs it contains: dispensing time and date and name. Based on this information, the actual dispensing is done.

  11. Java advanced medical image toolkit

    International Nuclear Information System (INIS)

    Full text: The Java Advanced Medical Image Toolkit (jAMIT) has been developed at the Center for PET and Department of Nuclear Medicine in an effort to provide a suite of tools that can be utilised in applications required to perform analysis, processing and visualisation of medical images. jAMIT uses Java Advanced Imaging (JAI) to combine the platform independent nature of Java with the speed benefits associated with native code. The object-orientated nature of Java allows the production of an extensible and robust package which is easily maintained. In addition to jAMIT, a Medical Image VO API called Sushi has been developed to provide access to many commonly used image formats. These include DICOM, Analyze, MINC/NetCDF, Trionix, Beat 6.4, Interfile 3.2/3.3 and Odyssey. This allows jAMIT to access data and study information contained in different medical image formats transparently. Additional formats can be added at any time without any modification to the jAMIT package. Tools available in jAMIT include 2D ROI Analysis, Palette Thresholding, Image Groping, Image Transposition, Scaling, Maximum Intensity Projection, Image Fusion, Image Annotation and Format Conversion. Future tools may include 2D Linear and Non-linear Registration, PET SUV Calculation, 3D Rendering and 3D ROI Analysis. Applications currently using JAMIT include Antibody Dosimetry Analysis, Mean Hemispheric Blood Flow Analysis, QuickViewing of PET Studies for Clinical Training, Pharamcodynamic Modelling based on Planar Imaging, and Medical Image Format Conversion. The use of jAMIT and Sushi for scripting and analysis in Matlab v6.1 and Jython is currently being explored. Copyright (2002) The Australian and New Zealand Society of Nuclear Medicine Inc

  12. Advanced Life Support Project Plan

    Science.gov (United States)

    2002-01-01

    Life support systems are an enabling technology and have become integral to the success of living and working in space. As NASA embarks on human exploration and development of space to open the space frontier by exploring, using and enabling the development of space and to expand the human experience into the far reaches of space, it becomes imperative, for considerations of safety, cost, and crew health, to minimize consumables and increase the autonomy of the life support system. Utilizing advanced life support technologies increases this autonomy by reducing mass, power, and volume necessary for human support, thus permitting larger payload allocations for science and exploration. Two basic classes of life support systems must be developed, those directed toward applications on transportation/habitation vehicles (e.g., Space Shuttle, International Space Station (ISS), next generation launch vehicles, crew-tended stations/observatories, planetary transit spacecraft, etc.) and those directed toward applications on the planetary surfaces (e.g., lunar or Martian landing spacecraft, planetary habitats and facilities, etc.). In general, it can be viewed as those systems compatible with microgravity and those compatible with hypogravity environments. Part B of the Appendix defines the technology development 'Roadmap' to be followed in providing the necessary systems for these missions. The purpose of this Project Plan is to define the Project objectives, Project-level requirements, the management organizations responsible for the Project throughout its life cycle, and Project-level resources, schedules and controls.

  13. Flipping the advanced cardiac life support classroom with team-based learning: comparison of cognitive testing performance for medical students at the University of California, Irvine, United State

    Science.gov (United States)

    2016-01-01

    Purpose: It aimed to find if written test results improved for advanced cardiac life support (ACLS) taught in flipped classroom/team-based Learning (FC/TBL) vs. lecture-based (LB) control in University of California-Irvine School of Medicine, USA. Methods: Medical students took 2010 ACLS with FC/TBL (2015), compared to 3 classes in LB (2012-14) format. There were 27.5 hours of instruction for FC/TBL model (TBL 10.5, podcasts 9, small-group simulation 8 hours), and 20 (12 lecture, simulation 8 hours) in LB. TBL covered 13 cardiac cases; LB had none. Seven simulation cases and didactic content were the same by lecture (2012-14) or podcast (2015) as was testing: 50 multiple-choice questions (MCQ), 20 rhythm matchings, and 7 fill-in clinical cases. Results: 354 students took the course (259 [73.1%] in LB in 2012-14, and 95 [26.9%] in FC/TBL in 2015). Two of 3 tests (MCQ and fill-in) improved for FC/TBL. Overall, median scores increased from 93.5% (IQR 90.6, 95.4) to 95.1% (92.8, 96.7, P=0.0001). For the fill-in test: 94.1% for LB (89.6, 97.2) to 96.6% for FC/TBL (92.4, 99.20 P=0.0001). For MC: 88% for LB (84, 92) to 90% for FC/TBL (86, 94, P=0.0002). For the rhythm test: median 100% for both formats. More students failed 1 of 3 tests with LB vs. FC/TBL (24.7% vs. 14.7%), and 2 or 3 components (8.1% vs. 3.2%, P=0.006). Conversely, 82.1% passed all 3 with FC/TBL vs. 67.2% with LB (difference 14.9%, 95% CI 4.8-24.0%). Conclusion: A FC/TBL format for ACLS marginally improved written test results. PMID:26893399

  14. Flipping the advanced cardiac life support classroom with team-based learning: comparison of cognitive testing performance for medical students at the University of California, Irvine, United States

    Directory of Open Access Journals (Sweden)

    Megan Boysen-Osborn

    2016-02-01

    Full Text Available Purpose: It aimed to find if written test results improved for advanced cardiac life support (ACLS taught in flipped classroom/team-based Learning (FC/TBL vs. lecture-based (LB control in University of California-Irvine School of Medicine, USA. Methods: Medical students took 2010 ACLS with FC/TBL (2015, compared to 3 classes in LB (2012-14 format. There were 27.5 hours of instruction for FC/TBL model (TBL 10.5, podcasts 9, small-group simulation 8 hours, and 20 (12 lecture, simulation 8 hours in LB. TBL covered 13 cardiac cases; LB had none. Seven simulation cases and didactic content were the same by lecture (2012-14 or podcast (2015 as was testing: 50 multiple-choice questions (MCQ, 20 rhythm matchings, and 7 fill-in clinical cases. Results: 354 students took the course (259 [73.1%] in LB in 2012-14, and 95 [26.9%] in FC/TBL in 2015. Two of 3 tests (MCQ and fill-in improved for FC/TBL. Overall, median scores increased from 93.5% (IQR 90.6, 95.4 to 95.1% (92.8, 96.7, P=0.0001. For the fill-in test: 94.1% for LB (89.6, 97.2 to 96.6% for FC/TBL (92.4, 99.20 P=0.0001. For MC: 88% for LB (84, 92 to 90% for FC/TBL (86, 94, P=0.0002. For the rhythm test: median 100% for both formats. More students failed 1 of 3 tests with LB vs. FC/TBL (24.7% vs. 14.7%, and 2 or 3 components (8.1% vs. 3.2%, P=0.006. Conversely, 82.1% passed all 3 with FC/TBL vs. 67.2% with LB (difference 14.9%, 95% CI 4.8-24.0%. Conclusion: A FC/TBL format for ACLS marginally improved written test results.

  15. Medical futility and end-of-life care: perspectives from practice. Coping with medical futility.

    Science.gov (United States)

    McCroskey, Diane

    2015-01-01

    Advances in technology a nd medical knowledge have dramatically altered our ability to sustain life in the Intensive Care Unit (ICU). Many things come into play for the nurse when establishing patient goals, respecting patient's wishes, and valuing spiritual and cultural beliefs in end-of-life care. A veteran ICU nurse shares the challenges of caring and how, she copes when medical interventions seem futile. PMID:25898443

  16. Hospice Home Immersion Project: Advancing Medical Education

    OpenAIRE

    Marilyn R. Gugliucci; Himanshu Malhotra; Andrea Gaul

    2015-01-01

    The University of New England College of Osteopathic Medicine (UNECOM) Hospice Immersion project was piloted in 2014 in southern Maine. It was designed and implemented as an experiential medical education learning model whereby medical students were “admitted” into the local Hospice Home to live there for 48 hours. Until this project, palliative and end of life care education at US Medical Schools and specifically UNECOM were accomplished through traditional medical education methods. Th...

  17. Advanced medical video services through context-aware medical networks.

    Science.gov (United States)

    Doukas, Charalampos N; Maglogiannis, Ilias; Pliakas, Thomas

    2007-01-01

    The aim of this paper is to present a framework for advanced medical video delivery services, through network and patient-state awareness. Under this scope a context-aware medical networking platform is described. The developed platform enables proper medical video data coding and transmission according to both a) network availability and/or quality and b) patient status, optimizing thus network performance and telediagnosis. An evaluation platform has been developed based on scalable H.264 coding of medical videos. Corresponding results of video transmission over a WiMax network have proved the effectiveness and efficiency of the platform providing proper video content delivery. PMID:18002643

  18. Advances in medical diagnostic technology

    CERN Document Server

    Lai, Khin Wee; Mohamad Salim, Maheza Irna; Ong, Sang-Bing; Utama, Nugraha Priya; Myint, Yin Mon; Mohd Noor, Norliza; Supriyanto, Eko

    2014-01-01

    This book provides the most recent findings and knowledge in advanced diagnostics technology, covering a wide spectrum including brain activity analysis, breast and lung cancer detection, echocardiography, computer aided skeletal assessment to mitochondrial biology imaging at the cellular level. The authors explored magneto acoustic approaches and tissue elasticity imaging for the purpose of breast cancer detection. Perspectives in fetal echocardiography from an image processing angle are included. Diagnostic imaging in the field of mitochondrial diseases as well as the use of Computer-Aided System (CAD) are also discussed in the book. This book will be useful for students, lecturers or professional researchers in the field of biomedical sciences and image processing.

  19. IOMP - Challenges for advancing medical physic globally

    International Nuclear Information System (INIS)

    IOMP stands for International Organization for Medical Physics. The determinants of health care include; science, research, academia, education, technology, engineering, industry, politics, economic, society, ethics, culture and medicine. However, physics and engineering are the driving forces of progress in health care. Medical Physics is a branch of Applied Physics, pursued by medical physicists, which uses physics principles, methods and techniques in practice and research for the prevention, diagnosis and treatment of human diseases with a specific goal of improving human health and well-being. How can we achieve Health Care improvement through Medical Physics globally? By forming international alliances in the Medical Physics community to develop and implement coherent concepts of • Appropriate University / Hospital Structures • Education & Training and Certification Schemes • Research & Development Platforms • Professional Career Development • International Cooperation within the Science Community IOMP represents ca. 18.000 medical physicists worldwide, it is affiliated to 80 national member organizations, six regional organizations as Members plus Corporate Members. The mission of IOMP is to advance medical physics practice worldwide by disseminating scientific and technical information, fostering the educational and professional development of medical physics and promoting the highest quality medical services for patients. 6 Medical physicists are professionals with education and specialist training in the concepts and techniques of applying physics in medicine. They work in clinical, academic or research institutions. Challenges, Efforts and Achievements of the International Organization for Medical Physics Recognition of the Medical Physics profession by the National Health Authorities. Medical Physicists are essential to ensure adequate and safe use of radiation equipment, Radiation Protection of patients, workers and public in a clinical

  20. [New Act concerning end of life: Impact for medical practice?].

    Science.gov (United States)

    Devalois, Bernard; Puybasset, Louis

    2016-04-01

    New French 2016' Act recognizes 3 new rights for patients at the end of their life: right to dead without futilities, right to have their wishes respected and right to be comfortable in all circumstances. Medical acts must not be continued in an unreasonable way. Futility is defined by useless, disproportionate or without another aim that an artificial life sustaining acts. For patients who cannot tell their wishes, a withdrawing or withholding decision of life sustaining treatments can be taken with a collegiate process. Doctors must always care about patient comfort with palliative care. Artificial hydration and nutrition can be considered as futile. Patients can write advanced directives or design confidence person to attest their wishes if they should be unable to do it. Doctors must respect advanced directives, except in emergency cases or if there are inappropriate. In such cases, the decision not to respect advanced directives must be taken collegially. Sedation is a therapeutic solution to alleviate refractory suffering for patients at the end of life, even if there is a risk to shorten their life, if the aim is to make patient comfortable and if it is the only way to achieve this goal. A specific right to deep and continuous sedation until death is created, only for patients with a short life prognosis (forhours to days). It is an exceptional practice with very strict conditions including a collegiate deliberation including non-medical team members. If they wish, patients at the end of life should be cared at home with comfort treatments if needed. Referent doctor must inform patients about their rights. An initial and continuous formation on this field is required. For every decision, it is important to keep a record in the patient chart. If not, it will be a fault. PMID:27013263

  1. Advanced medical interventions in pleural disease

    Directory of Open Access Journals (Sweden)

    Rahul Bhatnagar

    2016-06-01

    Full Text Available The burden of a number of pleural diseases continues to increase internationally. Although many pleural procedures have historically been the domain of interventional radiologists or thoracic surgeons, in recent years, there has been a marked expansion in the techniques available to the pulmonologist. This has been due in part to both technological advancements and a greater recognition that pleural disease is an important subspecialty of respiratory medicine. This article summarises the important literature relating to a number of advanced pleural interventions, including medical thoracoscopy, the insertion and use of indwelling pleural catheters, pleural manometry, point-of-care thoracic ultrasound, and image-guided closed pleural biopsy. We also aim to inform the reader regarding the latest updates to more established procedures such as chemical pleurodesis, thoracentesis and the management of chest drains, drawing on contemporary data from recent randomised trials. Finally, we shall look to explore the challenges faced by those practicing pleural medicine, especially relating to training, as well as possible future directions for the use and expansion of advanced medical interventions in pleural disease.

  2. End-of-Life Decisions and Advanced Old Age

    Directory of Open Access Journals (Sweden)

    Stoyles

    2014-07-01

    Full Text Available Despite the fact that most people die in advanced old age, little attention is given to cases involving older people in debates about the moral and legal dimensions of end-of-life decision making. The purpose of this paper is to establish some of the ways our discussions should change as we pay attention to important factors influencing end-of-life decisions for people in advanced old age. Focusing on the prevalence of comorbidities and the likelihood that people in advanced old age will experience an extended period of declining function before death, I argue that our debates should be expanded to include greater consideration of how we want to live in the final stages of life. With this, I am arguing against the tendency to think that “end-of-life” decision making concerns only making decisions about when and how it is appropriate to terminate a person’s life. I argue, further, that we should move away from the medicalization of dying.

  3. Should prehospital resuscitative thoracotomy be incorporated in advanced life support after traumatic cardiac arrest?

    Science.gov (United States)

    Chalkias, A; Xanthos, T

    2014-06-01

    The survival of traumatic cardiac arrest patients poses a challenge for Emergency Medical Services initiating advanced life support on-scene, especially with regard to having to decide immediately whether to initiate prehospital emergency thoracotomy. Although the necessity for carrying out the procedure remains a cause for debate, it can be life-saving when performed with the correct indications and approaches. PMID:26816077

  4. End-of-life attitudes in the Intensive Care Unit (ICU) amongst final year medical students at International Medical University, Malaysia

    OpenAIRE

    Sangeetha Poovaneswaran; Anuradha Poovaneswaran; hiruselvi Subramaniam

    2014-01-01

    With recent medical advances and the availability of newer sophisticated technologies, critically ill patients tend to survive longer.1 Thus, decisions to forgo life-sustaining medical treatment generate challenging issues that all doctors must face. The aim of this pilot study was to assess attitudes towards end-of-life care in ICU which included futile therapy (withholding and withdrawing therapy) among final year medical students who had received the same degr...

  5. Advanced Hazmat Life Support (AHLS): A Feasibility Assessment

    International Nuclear Information System (INIS)

    A prospective, descriptive, feasibility study aimed to determine whether an interdisciplinary group of health care experts could design and successfully deliver an international, life support, continuing education program that teaches the medical management of hazardous materials (hazmat) patients. The American Academy of Clinical Toxicology and the University of Arizona College of Medicine, Arizona Emergency Medicine Research Center partnered on July 1, 1998 to develop a two-day Advanced Hazmat Life Support (AHLS) Provider Course. Interdisciplinary expert clinicians designed and then delivered the first AHLS Provider Course in 1999. Prior to this, other courses focused on the management of hazmat incidents and almost exclusively on the prehospital care of hazmat victims by firefighters, hazardous materials technicians, and emergency medical technicians (EMTs), not on the medical management of patients from these incidents. Therefore, AHLS was developed for a broader interdisciplinary group of health care professionals, including both prehospital health care professionals and hospital-based, poison center-based, clinic-based, public health care-based, and other health care professionals. From 1999 through 2006, the AHLS Provider Course has trained 7,142 health care professionals from 48 countries. Of the 7,142 health care professionals worldwide, 43% are paramedics, 24% are physicians, 21% are nurses, 2% are pharmacists, 1% are physician assistants, and 9% are other professionals. Of the professionals trained, 88% are from the United States, 5% from Hong Kong, 2% from Canada, 2% from Australia, 1% from Mexico, and the remainder come from 43 other countries. The Advanced Hazmat Life Support Program is feasible and meets the continuing education needs of health care professionals around the world.(author)

  6. Nanomaterials for Advanced Life Support in Advanced Life Support in Space systems

    Science.gov (United States)

    Allada, Rama Kumar; Moloney, Padraig; Yowell, Leonard

    2006-01-01

    A viewgraph presentation describing nanomaterial research at NASA Johnson Space Center with a focus on advanced life support in space systems is shown. The topics include: 1) Introduction; 2) Research and accomplishments in Carbon Dioxide Removal; 3) Research and Accomplishments in Water Purification; and 4) Next Steps

  7. NASA Advanced Explorations Systems: Advancements in Life Support Systems

    Science.gov (United States)

    Shull, Sarah A.; Schneider, Walter F.

    2016-01-01

    The NASA Advanced Exploration Systems (AES) Life Support Systems (LSS) project strives to develop reliable, energy-efficient, and low-mass spacecraft systems to provide environmental control and life support systems (ECLSS) critical to enabling long duration human missions beyond low Earth orbit (LEO). Highly reliable, closed-loop life support systems are among the capabilities required for the longer duration human space exploration missions assessed by NASA's Habitability Architecture Team (HAT). The LSS project is focused on four areas: architecture and systems engineering for life support systems, environmental monitoring, air revitalization, and wastewater processing and water management. Starting with the international space station (ISS) LSS systems as a point of departure (where applicable), the mission of the LSS project is three-fold: 1. Address discrete LSS technology gaps 2. Improve the reliability of LSS systems 3. Advance LSS systems towards integrated testing on the ISS. This paper summarized the work being done in the four areas listed above to meet these objectives. Details will be given on the following focus areas: Systems Engineering and Architecture- With so many complex systems comprising life support in space, it is important to understand the overall system requirements to define life support system architectures for different space mission classes, ensure that all the components integrate well together and verify that testing is as representative of destination environments as possible. Environmental Monitoring- In an enclosed spacecraft that is constantly operating complex machinery for its own basic functionality as well as science experiments and technology demonstrations, it's possible for the environment to become compromised. While current environmental monitors aboard the ISS will alert crew members and mission control if there is an emergency, long-duration environmental monitoring cannot be done in-orbit as current methodologies

  8. Advanced Life Support System Value Metric

    Science.gov (United States)

    Jones, Harry W.; Rasky, Daniel J. (Technical Monitor)

    1999-01-01

    The NASA Advanced Life Support (ALS) Program is required to provide a performance metric to measure its progress in system development. Extensive discussions within the ALS program have led to the following approach. The Equivalent System Mass (ESM) metric has been traditionally used and provides a good summary of the weight, size, and power cost factors of space life support equipment. But ESM assumes that all the systems being traded off exactly meet a fixed performance requirement, so that the value and benefit (readiness, performance, safety, etc.) of all the different systems designs are considered to be exactly equal. This is too simplistic. Actual system design concepts are selected using many cost and benefit factors and the system specification is defined after many trade-offs. The ALS program needs a multi-parameter metric including both the ESM and a System Value Metric (SVM). The SVM would include safety, maintainability, reliability, performance, use of cross cutting technology, and commercialization potential. Another major factor in system selection is technology readiness level (TRL), a familiar metric in ALS. The overall ALS system metric that is suggested is a benefit/cost ratio, SVM/[ESM + function (TRL)], with appropriate weighting and scaling. The total value is given by SVM. Cost is represented by higher ESM and lower TRL. The paper provides a detailed description and example application of a suggested System Value Metric and an overall ALS system metric.

  9. Advanced Life Support Technologies and Scenarios

    Science.gov (United States)

    Barta, Daniel J.

    2011-01-01

    As NASA looks beyond the International Space Station toward long-duration, deep space missions away from Earth, the current practice of supplying consumables and spares will not be practical nor affordable. New approaches are sought for life support and habitation systems that will reduce dependency on Earth and increase mission sustainability. To reduce launch mass, further closure of Environmental Control and Life Support Systems (ECLSS) beyond the current capability of the ISS will be required. Areas of particular interest include achieving higher degrees of recycling within Atmosphere Revitalization, Water Recovery and Waste Management Systems. NASA is currently investigating advanced carbon dioxide reduction processes that surpass the level of oxygen recovery available from the Sabatier Carbon Dioxide Reduction Assembly (CRA) on the ISS. Improving the efficiency of the recovery of water from spacecraft solid and liquid wastes is possible through use of emerging technologies such as the heat melt compactor and brine dewatering systems. Another significant consumable is that of food. Food production systems based on higher plants may not only contribute significantly to the diet, but also contribute to atmosphere revitalization, water purification and waste utilization. Bioreactors may be potentially utilized for wastewater and solid waste management. The level at which bioregenerative technologies are utilized will depend on their comparative requirements for spacecraft resources including mass, power, volume, heat rejection, crew time and reliability. Planetary protection requirements will need to be considered for missions to other solar system bodies.

  10. Advanced Capabilities Medical Suction Device Project

    Data.gov (United States)

    National Aeronautics and Space Administration — A compact microgravity and hypogravity compatible vacuum device is proposed to provide medical suction and containment of extracted fluids. The proposed aspirator...

  11. Medical Advances in Child Sexual Abuse

    Science.gov (United States)

    Alexander, Randell A.

    2011-01-01

    This volume is the first of a two-part special issue detailing state of the art practice in medical issues around child sexual abuse. The six articles in this issue explore methods for medical history evaluation, the rationale for when sexual examinations should take place, specific hymenal findings that suggest a child has been sexually abused,…

  12. Recent Advances in Medical Treatment for Lymphedema

    OpenAIRE

    Ogawa, Yoshihiro

    2012-01-01

    As medical treatment for lymphedema, combined physical therapy with guidance regarding daily living is recommended. Recently, training has been conducted on a nationwide scale, and this therapy has gradually and commonly been employed. This therapy consists of daily living guidance to prevent edema deterioration, skin care, manual lymph drainage, compression therapy, and exercise therapy. The number of hospitals in which all procedures can be adequately performed is limited. There is no treat...

  13. Critical Limb Ischemia: Advanced Medical Therapy

    OpenAIRE

    Davies, Mark G.

    2012-01-01

    Systemic atherosclerosis and its risk factors are present in the majority of patients with critical limb ischemia. Aggressive medical therapy is an immediate and necessary part of the work-up and management of these patients and will involve a multidisciplinary approach. Risk stratification based on a patient’s current clinical cardiovascular condition is important in determining the most appropriate and safe intervention and will allow both the patient and physician to make an informed decis...

  14. Quality of life of medical students in Tehran University of Medical Sciences.

    OpenAIRE

    Mohammad Heidari; Reza Majdzadeh; Parvin Pasalar; Saharnaz Nedjat

    2014-01-01

    This study aims to investigate the quality of life (QOL) of Tehran University of Medical Sciences' (TUMS) medical students at different educational levels and specify the most important factors related to this quality. A sample of 242 medical students was selected randomly, given their number in three educational levels (basic sciences, physiopathology-stager and intern). The QOL was measured by WHOQOL-BREF. The students obtained average high score in two psychological and environmental healt...

  15. Establishing advanced practice for medical imaging in New Zealand

    International Nuclear Information System (INIS)

    Introduction: This article presents the outcome and recommendations following the second stage of a role development project conducted on behalf of the New Zealand Institute of Medical Radiation Technology (NZIMRT). The study sought to support the development of profiles and criteria that may be used to formulate Advanced Scopes of Practice for the profession. It commenced in 2011, following on from initial research that occurred between 2005 and 2008 investigating role development and a possible career structure for medical radiation technologists (MRTs) in New Zealand (NZ). Methods: The study sought to support the development of profiles and criteria that could be used to develop Advanced Scopes of Practice for the profession through inviting 12 specialist medical imaging groups in NZ to participate in a survey. Results: Findings showed strong agreement on potential profiles and on generic criteria within them; however, there was less agreement on specific skills criteria within specialist areas. Conclusions: The authors recommend that one Advanced Scope of Practice be developed for Medical Imaging, with the establishment of generic and specialist criteria. Systems for approval of the overall criteria package for any individual Advanced Practitioner (AP) profile, audit and continuing professional development requirements need to be established by the Medical Radiation Technologists Board (MRTB) to meet the local needs of clinical departments. It is further recommended that the NZIMRT and MRTB promote and support the need for an AP pathway for medical imaging in NZ

  16. Establishing advanced practice for medical imaging in New Zealand

    Energy Technology Data Exchange (ETDEWEB)

    Yielder, Jill, E-mail: j.yielder@auckland.ac.nz [University of Auckland, Auckland (New Zealand); Young, Adrienne; Park, Shelley; Coleman, Karen [University of Otago, Wellington (New Zealand); University of Auckland, Auckland (New Zealand)

    2014-02-15

    Introduction: This article presents the outcome and recommendations following the second stage of a role development project conducted on behalf of the New Zealand Institute of Medical Radiation Technology (NZIMRT). The study sought to support the development of profiles and criteria that may be used to formulate Advanced Scopes of Practice for the profession. It commenced in 2011, following on from initial research that occurred between 2005 and 2008 investigating role development and a possible career structure for medical radiation technologists (MRTs) in New Zealand (NZ). Methods: The study sought to support the development of profiles and criteria that could be used to develop Advanced Scopes of Practice for the profession through inviting 12 specialist medical imaging groups in NZ to participate in a survey. Results: Findings showed strong agreement on potential profiles and on generic criteria within them; however, there was less agreement on specific skills criteria within specialist areas. Conclusions: The authors recommend that one Advanced Scope of Practice be developed for Medical Imaging, with the establishment of generic and specialist criteria. Systems for approval of the overall criteria package for any individual Advanced Practitioner (AP) profile, audit and continuing professional development requirements need to be established by the Medical Radiation Technologists Board (MRTB) to meet the local needs of clinical departments. It is further recommended that the NZIMRT and MRTB promote and support the need for an AP pathway for medical imaging in NZ.

  17. Astronomy helps advance medical diagnosis techniques

    Science.gov (United States)

    2001-11-01

    Effective treatment of cancer relies on the early detection and removal of cancerous cells. Unfortunately, this is when they are hardest to spot. In the case of breast cancer, now the most prevalent form of cancer in the United Kingdom, cancer cells tend to congregate in the lymph nodes, from where they can rapidly spread throughout the rest of the body. Current medical equipment can give doctors only limited information on tissue health. A surgeon must then perform an exploratory operation to try to identify the diseased tissue. If that is possible, the diseased tissue will be removed. If identification is not possible, the doctor may be forced to take away the whole of the lymphatic system. Such drastic treatment can then cause side effects, such as excessive weight gain, because it throws the patient's hormones out of balance. Now, members of the Science Payloads Technology Division of the Research and Science Support Department, at ESA's science, technology and engineering research centre (ESTEC) in the Netherlands, have developed a new X-ray camera that could make on-the-spot diagnoses and pinpoint cancerous areas to guide surgeons. Importantly, it would be a small device that could be used continuously during operations. "There is no photography involved in the camera we envisage. It will be completely digital, so the surgeon will study the whole lymphatic system and the potentially cancerous parts on his monitor. He then decides which parts he removes," says Dr. Tone Peacock, Head of the Science Payloads Technology Division. The ESA team were trying to find a way to make images using high-energy X-rays because some celestial objects give out large quantities of X-rays but little visible light. To see these, astronomers need to use X-ray cameras. Traditionally, this has been a bit of a blind spot for astronomers. ESA's current X-ray telescope, XMM-Newton, is in orbit now, observing low energy, so-called 'soft' X-rays. European scientists have always wanted to

  18. Improving medical graduates' training in palliative care: advancing education and practice

    Directory of Open Access Journals (Sweden)

    Head BA

    2016-02-01

    Full Text Available Barbara A Head,1 Tara J Schapmire,1 Lori Earnshaw,1 John Chenault,2 Mark Pfeifer,1 Susan Sawning,3 Monica A Shaw,3 1Division of General Internal Medicine, Palliative Care and Medical Education, University of Louisville School of Medicine, 2Kornhouser Health Sciences Library, University of Louisville, 3Undergraduate Medical Education Office, University of Louisville School of Medicine, Louisville, KY, USA Abstract: The needs of an aging population and advancements in the treatment of both chronic and life-threatening diseases have resulted in increased demand for quality palliative care. The doctors of the future will need to be well prepared to provide expert symptom management and address the holistic needs (physical, psychosocial, and spiritual of patients dealing with serious illness and the end of life. Such preparation begins with general medical education. It has been recommended that teaching and clinical experiences in palliative care be integrated throughout the medical school curriculum, yet such education has not become the norm in medical schools across the world. This article explores the current status of undergraduate medical education in palliative care as published in the English literature and makes recommendations for educational improvements which will prepare doctors to address the needs of seriously ill and dying patients. Keywords: medical education, palliative care, end-of-life care

  19. Is advanced life support better than basic life support in prehospital care? A systematic review

    Directory of Open Access Journals (Sweden)

    Ryynänen Olli-Pekka

    2010-11-01

    Full Text Available Abstract Background - Prehospital care is classified into ALS- (advanced life support and BLS- (basic life support levels according to the methods used. ALS-level prehospital care uses invasive methods, such as intravenous fluids, medications and intubation. However, the effectiveness of ALS care compared to BLS has been questionable. Aim - The aim of this systematic review is to compare the effectiveness of ALS- and BLS-level prehospital care. Material and methods - In a systematic review, articles where ALS-level prehospital care was compared to BLS-level or any other treatment were included. The outcome variables were mortality or patient's health-related quality of life or patient's capacity to perform daily activities. Results - We identified 46 articles, mostly retrospective observational studies. The results on the effectiveness of ALS in unselected patient cohorts are contradictory. In cardiac arrest, early cardiopulmonary resuscitation and defibrillation are essential for survival, but prehospital ALS interventions have not improved survival. Prehospital thrombolytic treatment reduces mortality in patients having a myocardial infarction. The majority of research into trauma favours BLS in the case of penetrating trauma and also in cases of short distance to a hospital. In patients with severe head injuries, ALS provided by paramedics and intubation without anaesthesia can even be harmful. If the prehospital care is provided by an experienced physician and by a HEMS organisation (Helicopter Emergency Medical Service, ALS interventions may be beneficial for patients with multiple injuries and severe brain injuries. However, the results are contradictory. Conclusions - ALS seems to improve survival in patients with myocardial infarction and BLS seems to be the proper level of care for patients with penetrating injuries. Some studies indicate a beneficial effect of ALS among patients with blunt head injuries or multiple injuries. There is

  20. A new data architecture for advancing life cycle assessment

    Science.gov (United States)

    IntroductionLife cycle assessment (LCA) has a technical architecture that limits data interoperability, transparency, and automated integration of external data. More advanced information technologies offer promise for increasing the ease with which information can be synthesized...

  1. Asian Medical Students: Quality of Life and Motivation to Learn

    Science.gov (United States)

    Henning, Marcus A.; Hawken, Susan J.; Krageloh, Christian; Zhao, Yipin; Doherty, Iain

    2011-01-01

    Issues linked with the notions of quality of life (QOL) and motivation to learn among Asian medical students have not been well documented. This is true in both the international and the New Zealand contexts. Our paper addresses this lack of research by focusing on the QOL of international and domestic Asian students studying in New Zealand, where…

  2. Early-life medical care and human capital accumulation

    DEFF Research Database (Denmark)

    Daysal, N. Meltem

    2015-01-01

    Ample empirical evidence links adverse conditions during early childhood (the period from conception to age five) to worse health outcomes and lower academic achievement in adulthood. Can early-life medical care and public health interventions ameliorate these effects? Recent research suggests...

  3. Train medical physicist-urgent need for advanced radiotherapy

    International Nuclear Information System (INIS)

    A Japanese advanced charged particle therapy for cancer that places fewer physical burdens on patients is leading the world and stereotactic radiotherapy and intensity-modulated radiotherapy (IMRT) have been implemented also as a high precision radiotherapy. For the further advancement and dissemination of the therapy, training and qualification of medical physicists has become more needed. Cancer professional train course plan has been performed at many universities in Japan partly to train medical physicists. This special issue consists of seven relevant articles from experts of academia. Medical physicists have been qualified by the Japan Radiological Society, but should have national qualification such as to carry out the R and D of therapy equipment. This has been supported by many academia such as the Japanese Society for Therapeutic Radiology and Oncology (JASTRO) but not by the Japan Association of Radiological Technologists (JART). (T. Tanaka)

  4. Developmental life of the medical student: curriculum considerations.

    Science.gov (United States)

    Lipsitt, Don R

    2015-02-01

    Few medical educators would dispute that the emotional development and well being of the medical student is of critical importance in the pathway to physicianhood. It has been suggested that failure to address this aspect of medical education may account for various health problems and levels of impairment during medical school and beyond. Some authors have suggested that the personal development and "professionalization" of the student occurs through modeling, the medical school "culture," and the "hidden curriculum." In recognition of the randomness, incompleteness, or inadequacy of this approach, a number of attempts have been made to address this important but difficult dimension of medical education. However, programs designed to foster self-reflection and appreciation of affect in the physician-patient relationship are often limited as electives or unsupported by faculty and staff and therefore fall short of their objective. The author proposes that a pedagogical framework based on an analogy of life cycle theory (a la Erikson or others) offers a schema within which to consider efforts being made in medical curricula to promote self-awareness, appreciation of affect in oneself and one's patients, and a context in which to minimize the risk of illness and impairment. PMID:25001431

  5. Zone Sonography: The Next Major Advance in Medical Ultrasound

    Directory of Open Access Journals (Sweden)

    M. Ghafoori

    2008-01-01

    Full Text Available There have been dramatic achievements in the ad-vancement of medical ultrasound since its first appli-cation as a diagnostic tool. The advent of real-time imaging, Doppler ultrasound, miniaturization, and a host of specialized adaptations and image quality im-provements have made diagnostic ultrasound a valu-able and reliable tool in the medical theater with ma-jor applications in obstetrics/gynecology, cardiology, abdominal imaging, and vascular imaging. Despite this impressive advancement, however, the data ac-quisition method upon which all conventional ultra-sound systems are based has remained relatively static, with inherent limitations on its ability to de-liver increasing image quality as well as advanced clinical benefits. This paper will explore the current state of the art in ultrasound imaging and discuss a new core technology that has the potential to far ex-ceed the limitations imposed by conventional tech-nology.

  6. Performance of advanced trauma life support procedures in microgravity

    Science.gov (United States)

    Campbell, Mark R.; Billica, Roger D.; Johnston, Smith L 3rd; Muller, Matthew S.

    2002-01-01

    BACKGROUND: Medical operations on the International Space Station will emphasize the stabilization and transport of critically injured personnel and so will need to be capable of advanced trauma life support (ATLS). METHODS: We evaluated the ATLS invasive procedures in the microgravity environment of parabolic flight using a porcine animal model. Included in the procedures evaluated were artificial ventilation, intravenous infusion, laceration closure, tracheostomy, Foley catheter drainage, chest tube insertion, peritoneal lavage, and the use of telemedicine methods for procedural direction. RESULTS: Artificial ventilation was performed and appeared to be unaltered from the 1-G environment. Intravenous infusion, laceration closure, percutaneous dilational tracheostomy, and Foley catheter drainage were achieved without difficulty. Chest tube insertion and drainage were performed with no more difficulty than in the 1-G environment due to the ability to restrain patient, operator and supplies. A Heimlich valve and Sorenson drainage system were both used to provide for chest tube drainage collection with minimal equipment, without the risk of atmospheric contamination, and with the capability to auto-transfuse blood drained from a hemothorax. The use of telemedicine in chest tube insertion was demonstrated to be useful and feasible. Peritoneal lavage using a percutaneous technique, although requiring less training to perform, was found to be dangerous in weightlessness due to the additional pressure of the bowel on the anterior abdominal wall creating a high risk of bowel perforation. CONCLUSIONS: The performance of ATLS procedures in microgravity appears to be feasible with the exception of diagnostic peritoneal lavage. Minor modifications to equipment and techniques are required in microgravity to effect surgical drainage in the presence of altered fluid dynamics, to prevent atmospheric contamination, and to provide for the restraint requirements. A parabolic

  7. Crop Production for Advanced Life Support Systems

    OpenAIRE

    Wheeler, R M; Sager, J C

    2006-01-01

    The use of plants for bioregenerative life support for space missions was first studied by the US Air Force in the 1950s and 1960s. Extensive testing was also conducted from the 1960s through the 1980s by Russian researchers located at the Institute of Biophysics in Krasnoyarsk, Siberia, and the Institute for Biomedical Problems in Moscow. NASA initiated bioregenerative research in the 1960s (e.g., Hydrogenomonas) but this research did not include testing with plants until about 1980, with th...

  8. What do medical students think about their quality of life? A qualitative study

    OpenAIRE

    Tempski Patricia; Bellodi Patricia L; Paro Helena BMS; Enns Sylvia C; Martins Milton A; Schraiber Lilia B

    2012-01-01

    Abstract Background Medical education can affect medical students’ physical and mental health as well as their quality of life. The aim of this study was to assess medical students’ perceptions of their quality of life and its relationship with medical education. Methods First- to sixth-year students from six Brazilian medical schools were interviewed using focus groups to explore what medical student’s lives are like, factors related to increases and decreases of their quality of life during...

  9. Effect of Facebook on the life of Medical University students

    OpenAIRE

    Farooqi, Hassan; Patel, Hamza; Aslam, Hafiz Muhammad; Ansari, Iqra Qamar; Khan, Mariya; Iqbal, Noureen; Rasheed, Hira; Jabbar, Qamar; Khan, Saqib Raza; Khalid, Barira; Nadeem, Anum; Afroz, Raunaq; Shafiq, Sara; Mustafa, Arwa; Asad, Nazia

    2013-01-01

    Background Facebook is a social networking service launched in February 2004, owned and operated by Facebook, Inc. As of June 2012, Facebook reports more than 1 billion active users. Objective of study was to evaluate the effect of Facebook on the social life, health and behavior of medical students. Methodology It was a cross sectional, observational and questionnaire based study conducted in Dow University OF Health Sciences during the period of January 2012 to November 2012. We attempted t...

  10. Medical student debt and major life choices other than specialty

    Directory of Open Access Journals (Sweden)

    James Rohlfing

    2014-11-01

    Full Text Available Background: Median indebtedness at graduation is now more than $170,000 for graduates of US Medical Schools. Debate still exists as to whether higher debt levels influence students to choose high paying non-primary care specialties. Notably, no previous research on the topic has taken into account cost of attendance when constructing a debt model, nor has any research examined the non-career major life decisions that medical students face. Methods: Medical students were surveyed using an anonymous electronic instrument developed for this study. The survey was delivered through a link included in a study email and students were recruited from school wide listservs and through snowball sampling (students were encouraged to share a link to the survey with other medical students. No incentives were offered for survey completion. Results: Responses were recorded from 102 US Allopathic medical schools (n=3,032, with 22 institutions (11 public, 11 private meeting inclusion criteria of 10% student body response proportion (n=1,846. Students with higher debt relative to their peers at their home institution reported higher frequencies of feeling callous towards others, were more likely to choose a specialty with a higher average annual income, were less likely to plan to practice in underserved locations, and were less likely to choose primary care specialties. Students with higher aggregate amounts of medical student loan debt were more likely to report high levels of stress from their educational debt, to delay getting married and to report disagreement that they would choose to become a physician again, if given the opportunity to revisit that choice. Increases in both aggregate and relative debt were associated with delaying having children, delaying buying a house, concerns about managing and paying back educational debt, and worrying that educational debt will influence one's specialty choice. Conclusions: Medical student debt and particularly debt

  11. Hollow fiber membrane systems for advanced life support systems

    Science.gov (United States)

    Roebelen, G. J., Jr.; Lysaght, M. J.

    1976-01-01

    The practicability of utilizing hollow fiber membranes in vehicular and portable life support system applications is described. A preliminary screening of potential advanced life support applications resulted in the selection of five applications for feasibility study and testing. As a result of the feasibility study and testing, three applications, heat rejection, deaeration, and bacteria filtration, were chosen for breadboard development testing; breadboard hardware was manufactured and tested, and the physical properties of the hollow fiber membrane assemblies are characterized.

  12. Physical activity, quality of life and medication in aging: differences between age and gender

    Directory of Open Access Journals (Sweden)

    Lilian Teresa Bucken Gobbi

    2009-04-01

    Full Text Available Studies have shown an inverse relationship between physical activity level (PAL, quality of life (QoL and use of medications in the elderly. The objective of this study was to analyze possible relationships and differences between PAL, QoL and use of medications in the elderly. A total of 192 subjects (≥ 60 years were selected by stratified random sampling according to census sector. The following assessment instruments were used: a Modified Baecke Questionnaire for older adults, b Medical Outcomes Study – 36-Item Short Form Health Survey, and c Sociodemographic and Health Factors Questionnaire. Descriptive statistics and parametric and nonparametric tests were used (p < 0.05. a With respect to chronological age, significant differences between groups were only observed for PAL, with G1 (60-69 years being more active than the other groups. b With respect to gender irrespective of age, analysis showed a difference in QoL and in the number of medications, with men reporting better perceived QoL and using fewer medications. c With respect to gender but considering chronological age, differences in PAL, QoL and medication use were observed between genders for specific age groups. In conclusion, in the elderly a PAL is low, declines even more during advanced age and is higher in men than in women during the first decade of old age, and b men report better perceived QoL and use fewer medications than women.

  13. MAXILLOFACIAL TRAUMA MANAGEMENT IN POLYTRAUMATIZED PATIENTS – THE USE OF ADVANCED TRAUMA LIFE SUPPORT (ATLS PRINCIPLES.

    Directory of Open Access Journals (Sweden)

    Elitsa G. Deliverska

    2013-03-01

    Full Text Available Management of the multiply injured patient requires a co-ordinated multi-disciplinary approach in order to optimise patients’ outcome. A working knowledge of the sort of problems these patients encounter is therefore vital to ensure that life-threatening injuries are recognised and treated in a timely pattern and that more minor associated injuries are not omitted. This article outlines the management of polytraumatized patients using the Advanced Trauma Life Support (ATLS principles and highlights the areas of specific involvement of the engaged medical team. Advanced Trauma Life Support is generally regarded as the gold standard and is founded on a number of well known principles, but strict adherence to protocols may have its drawbacks when facial trauma co-exists. These can arise in the presence of either major or minor facial injuries, and oral and maxillofacial surgeons need to be aware of the potential problems.

  14. Awareness of basic life support among medical, dental, nursing students and doctors

    Directory of Open Access Journals (Sweden)

    Shanta Chandrasekaran

    2010-01-01

    Full Text Available To study the awareness of Basic Life Support (BLS among students, doctors and nurses of medical, dental, homeopathy and nursing colleges. A cross-sectional study was conducted by assessing responses to 20 selected basic questions regarding BLS among students, doctors and nurses of medical, dental, homeopathy and nursing colleges. After excluding the incomplete response forms the data was analysed on 1,054 responders. The results were analysed using an answer key prepared with the use of the Advanced Cardiac Life Support manual. Out of 1,054 responders 345 were medical students, 75 were medical interns, 19 were dental students, 59 were dental interns, 105 were homeopathy interns, 319 were nursing students, 72 were doctors, 29 were dentists, 25 were nursing faculty and six were homeopathy doctors. No one among them had complete knowledge of BLS. Only two out of 1054 (0.19% had secured 80 - 89% marks, 10 out of 1054 (0.95% had secured 70 - 79% marks, 40 of 1054 (4.08% had secured 60 - 69% marks and 105 of 1054 (9.96% had secured 50 - 59% marks. A majority of them, that is, 894 (84.82% had secured less than 50% marks. Awareness of BLS among students, doctors and nurses of medical, dental, homeopathy and nursing colleges is very poor.

  15. Time Dependent Relative Risks in Life Insurance Medical Underwriting.

    Science.gov (United States)

    Kneepkens, Robert F

    2015-01-01

    Introduction .- Life insurance medicine focuses on mortality hazards in specified periods. People are free to insure their lives for shorter or longer terms. Because the chosen terms range from 1 year to a life time, life insurers have to take into account the fact that the predictive value of risk indicators can and will change over time. The time a risk indicator keeps its predictive value, will be dependent on its biological effects, volatility, and treatability. For a given applicant this implies that the relative hazard (RH) calculated for his/her medical condition should be dependent on the term of the insurance. The main objective of this study is to determine if some commonly used risk indicators - previously used to study age dependency of relative risks - have a predictive value that increases with the observation period. (1) Methods .- This population-based cohort study uses NHANES-data files from the Third National Health and Nutrition Examination Survey (NHANES III) and the NHANES Linked Mortality Files 2010. Only participants aged 20 to 69 that were examined in mobile examination centers, without a history of some prevalent high risk diseases were included. The observed mortality was compared to the expected mortality in a Generalized Linear Model (GLM) with Poisson error structure with two reference populations, which both can serve as preferred reference for life insurers: The United States Life Tables 2008 (USLT) and the 2008 Valuation Basic Tables (VBT) based on the insured population of 35 US Life insurers. The time dependency of the RHs of the systolic blood pressure (SBP), aspartate aminotransferase (ASAT), lactate dehydrogenase (LDH), serum albumin and albuminuria, was assessed, with correction for ethnicity, household income, history of diabetes mellitus, BMI and serum cholesterol. To be able to compare the results with the results of the Age Dependency Study (ADS), the same data, risk indicators, statistical analysis method, and the

  16. Quality-of-life assessment in advanced cancer.

    LENUS (Irish Health Repository)

    Donnelly, S

    2000-07-01

    In the past 5 years, quality-of-life (QOL) assessment measures such as the McGill, McMaster, Global Visual Analogue Scale, Assessment of QOL at the End of Life, Life Evaluation Questionnaire, and Hospice QOL Index have been devised specifically for patients with advanced cancer. The developers of these instruments have tried to respond to the changing needs of this specific population, taking into account characteristics including poor performance status, difficulty with longitudinal study, rapidly deteriorating physical condition, and change in relevant issues. Emphasis has been placed on patient report, ease and speed of completion, and the existential domain or meaning of life. Novel techniques in QOL measurement have also been adapted for palliative care, such as judgment analysis in the Schedule for the Evaluation of Individual Quality of Life. It is generally agreed that a single tool will not cover all QOL assessment needs.

  17. Advancing life cycle economics in the Nordic countries

    DEFF Research Database (Denmark)

    Haugbølle, Kim; Hansen, Ernst Jan de Place

    2005-01-01

    Advancing construction and facilities management requires the ability to estimate and evaluate the economic consequences of decisions in a lifetime perspective. A survey of state-of-the-art on life cycle economics in the Nordic countries showed that, despite a number of similarities, no strong co...

  18. Canadian advanced life support capacities and future directions

    Science.gov (United States)

    Bamsey, M.; Graham, T.; Stasiak, M.; Berinstain, A.; Scott, A.; Vuk, T. Rondeau; Dixon, M.

    2009-07-01

    Canada began research on space-relevant biological life support systems in the early 1990s. Since that time Canadian capabilities have grown tremendously, placing Canada among the emerging leaders in biological life support systems. The rapid growth of Canadian expertise has been the result of several factors including a large and technically sophisticated greenhouse sector which successfully operates under challenging climatic conditions, well planned technology transfer strategies between the academic and industrial sectors, and a strong emphasis on international research collaborations. Recent activities such as Canada's contribution of the Higher Plant Compartment of the European Space Agency's MELiSSA Pilot Plant and the remote operation of the Arthur Clarke Mars Greenhouse in the Canadian High Arctic continue to demonstrate Canadian capabilities with direct applicability to advanced life support systems. There is also a significant latent potential within Canadian institutions and organizations with respect to directly applicable advanced life support technologies. These directly applicable research interests include such areas as horticultural management strategies (for candidate crops), growth media, food processing, water management, atmosphere management, energy management, waste management, imaging, environment sensors, thermal control, lighting systems, robotics, command and data handling, communications systems, structures, in-situ resource utilization, space analogues and mission operations. With this background and in collaboration with the Canadian aerospace industry sector, a roadmap for future life support contributions is presented here. This roadmap targets an objective of at least 50% food closure by 2050 (providing greater closure in oxygen, water recycling and carbon dioxide uptake). The Canadian advanced life support community has chosen to focus on lunar surface infrastructure and not low Earth orbit or transit systems (i.e. microgravity

  19. "ATLAS" Advanced Technology Life-cycle Analysis System

    Science.gov (United States)

    Lollar, Louis F.; Mankins, John C.; ONeil, Daniel A.

    2004-01-01

    Making good decisions concerning research and development portfolios-and concerning the best systems concepts to pursue - as early as possible in the life cycle of advanced technologies is a key goal of R&D management This goal depends upon the effective integration of information from a wide variety of sources as well as focused, high-level analyses intended to inform such decisions Life-cycle Analysis System (ATLAS) methodology and tool kit. ATLAS encompasses a wide range of methods and tools. A key foundation for ATLAS is the NASA-created Technology Readiness. The toolkit is largely spreadsheet based (as of August 2003). This product is being funded by the Human and Robotics The presentation provides a summary of the Advanced Technology Level (TRL) systems Technology Program Office, Office of Exploration Systems, NASA Headquarters, Washington D.C. and is being integrated by Dan O Neil of the Advanced Projects Office, NASA/MSFC, Huntsville, AL

  20. 76 FR 48169 - Advancing Regulatory Science for Highly Multiplexed Microbiology/Medical Countermeasure Devices...

    Science.gov (United States)

    2011-08-08

    ... Microbiology/ Medical Countermeasure Devices; Public Meeting AGENCY: Food and Drug Administration, HHS. ACTION... following public meeting: ``Advancing Regulatory Science for Highly Multiplexed Microbiology/Medical... multiplexed microbiology/medical countermeasure (MCM) devices, their clinical application and public...

  1. Medical treatment of advanced non-small cell lung cancer: progress in 2014

    Directory of Open Access Journals (Sweden)

    Yong SONG

    2015-04-01

    Full Text Available Non-small cell lung cancer is the most common pathological type of lung cancer. Along with the rising incidence in recent years, lung cancer has been the leading cause of death due to malignancies both in our country and worldwide. Due to simplistic therapeutic approach for lung cancer decades ago, those patients suffering from advanced lung cancer had short lifetime, and it was difficult to ensure their life quality. In recent years, many molecular targeted drugs, such as Gefitinib, Erlotinib and Crizotinib etc., have been successively applied in clinical use, and they bring about a substantial prolongation of survival life and improvement in life quality of those patients with advanced lung cancer. In 2014, there was a number of important reports concerning the diagnosis and treatment of non-small cell lung cancer in the annual meetings of either American Society of Clinical Oncology or European Society for Medical Oncology. On the basis of the relevant reports delivered in the conferences, it is our attempt to summarize the recent advances in regard to chemotherapy, molecular targeted therapy, measures to treat TKI therapy resistant cases, and immune therapy, followed by a comment regarding recent advances in the treatment of non-small cell lung cancer in 2014. DOI: 10.11855/j.issn.0577-7402.2015.01.03

  2. Simulating advanced life support systems to test integrated control approaches

    Science.gov (United States)

    Kortenkamp, D.; Bell, S.

    Simulations allow for testing of life support control approaches before hardware is designed and built. Simulations also allow for the safe exploration of alternative control strategies during life support operation. As such, they are an important component of any life support research program and testbed. This paper describes a specific advanced life support simulation being created at NASA Johnson Space Center. It is a discrete-event simulation that is dynamic and stochastic. It simulates all major components of an advanced life support system, including crew (with variable ages, weights and genders), biomass production (with scalable plantings of ten different crops), water recovery, air revitalization, food processing, solid waste recycling and energy production. Each component is modeled as a producer of certain resources and a consumer of certain resources. The control system must monitor (via sensors) and control (via actuators) the flow of resources throughout the system to provide life support functionality. The simulation is written in an object-oriented paradigm that makes it portable, extensible and reconfigurable.

  3. Ethics of the allocation of highly advanced medical technologies.

    Science.gov (United States)

    Sass, H M

    1998-03-01

    The disproportionate distribution of financial, educational, social, and medical resources between some rich countries of the northern hemisphere and less fortunate societies creates a moral challenge of global dimension. The development of new forms of highly advanced medical technologies, including neoorgans and xenografts, as well as the promotion of health literacy and predictive and preventive medical services might reduce some problems in allocational justice. Most governments and the World Health Organization (WHO) reject financial and other rewards for living organ donors thus indirectly contributing to the development of black markets. A societal gratuity model supporting and safeguarding a highly regulated market between providers and recipients of organs might provide for better protection of those who provide organs not solely based on altruistic reasons. The moral assessment of global issues in allocation and justice in the distribution of medical technologies must be increased and will have to be based on the principles of self determination and responsibility, solidarity and subsidiarity, and respect for individual values and cultural traditions. PMID:9527289

  4. 1st International Conference on Advancements of Medical Electronics

    CERN Document Server

    Bag, Sandip; Ganguly, Karabi; Sarkar, Indranath; Biswas, Papun

    2015-01-01

    The book is a collection of peer-reviewed scientific papers submitted by active researchers in the 1st International Conference on Advancements of Medical Electronics (ICAME2015). The conference is organized jointly by the Department of Biomedical Engineering and Electronics and Communication Engineering, JIS College of Engineering, West Bengal, India. The primary objective of the conference is to strengthen interdisciplinary research and its applications for the welfare of humanity. A galaxy of academicians, professionals, scientists, statesman and researchers from different parts of the country and abroad got together and shared their knowledge. The book presents research articles of medical image processing & analysis, biomedical instrumentation & measurements, DSP & clinical applications, embedded systems & its applications in healthcare. The book can be referred as a tool for further research.

  5. Globular Clusters as Cradles of Life and Advanced Civilizations

    Science.gov (United States)

    Di Stefano, Rosanne; Ray, Alak

    2016-01-01

    Globular clusters are bound groups of about a million stars and stellar remnants. They are old, largely isolated, and very dense. We consider what each of these special features can mean for the development of life, the evolution of intelligent life, and the long-term survival of technological civilizations. We find that, if they house planets, globular clusters provide ideal environments for advanced civilizations that can survive over long times. We therefore propose methods to search for planets in globular clusters. If planets are found and if our arguments are correct, searches for intelligent life are most likely to succeed when directed toward globular clusters. Globular clusters may be the first places in which distant life is identified in our own or in external galaxies.

  6. Medical futility in children's nursing: making end-of-life decisions.

    LENUS (Irish Health Repository)

    Brien, Irene O

    2012-02-01

    Caring for infants at end of life is challenging and distressing for parents and healthcare professionals, especially in relation to making decisions regarding withholding or withdrawal of treatment. The concept of medical futility must be considered under these circumstances. Parents and healthcare professionals should be involved together in making these difficult decisions. However, for some parents, emotions and guilt often are unbearable and, understandably, parents can be reluctant to make a decision. Despite the recognition of parental autonomy, if parents disagree with a decision made by medical staff, the case will be referred to and solved by the courts. The courts\\' decisions are often based on the best interest of the child. In this article, the authors discuss the concepts of \\'parental autonomy\\' and \\'the child\\'s best interests\\' when determining medical futility for infants or neonates. The role of the nurse when caring for the dying child and their family is multifaceted. While nurses do not have a legitimate role in decision making at the end of life, it is often nurses who, through their advocacy role, inform doctors about parents\\' wishes and it is often nurses who support parents during this difficult time. Furthermore, nurses caring for dying children should be familiar to the family, experienced in end-of-life care and comfortable talking to parents about death and dying and treatment choices. Children\\'s nurses therefore require advanced communication skills and an essential understanding of the ethical and legal knowledge relating to medical futility in end-of-life children\\'s nursing.

  7. Advanced lung disease: quality of life and role of palliative care.

    Science.gov (United States)

    Gilbert, Christopher R; Smith, Cecilia M

    2009-02-01

    . Recognition and correction of nocturnal hypoxemia and other sleep disturbances should enhance quality of life in patients with restrictive lung disease; however, there is currently no evidence to support this claim. End-of-life care needs more attention by clinicians in the decision-making and preparatory phase. Physicians need to maintain their focus on quality-of-life issues as medical management shifts from curative therapies to comfort management therapies. Palliative care and hospice appear to be underused in patients with advanced diseases other than cancer. Because the only curative option for some end-stage restrictive lung diseases is lung transplantation, if transplantation is not an option, palliation of symptoms and hospice care may offer patients and families the opportunity to die with dignity and comfort. PMID:19170219

  8. Quality of life of medical students in Tehran University of Medical Sciences.

    Directory of Open Access Journals (Sweden)

    Mohammad Heidari

    2014-05-01

    Full Text Available This study aims to investigate the quality of life (QOL of Tehran University of Medical Sciences' (TUMS medical students at different educational levels and specify the most important factors related to this quality. A sample of 242 medical students was selected randomly, given their number in three educational levels (basic sciences, physiopathology-stager and intern. The QOL was measured by WHOQOL-BREF. The students obtained average high score in two psychological and environmental health domains, and low score in physical health and social relationship domains. As the educational level of students increased their quality of life decreased at all four domains. At social relationship domain, the female students had overall better situation as compared to males (p=0.009. The female and male students had opposite condition at the level of basic sciences and internship, in a way that the female students earned higher marks at basic sciences level and the males at internship level (P= 0.008. The condition of female students in terms of environmental, physical and psychological health became static while their education rose. However, only environmental health of the male students reduced as their education level increased (P= 0.05. The students were of undesirable conditions in two domains of social relationship and physical health. Internship is a specific level in both groups which has a negative impact on the dimensions of quality of life and naturally needs more care for the students. Married status improved the students' QOL and could moderate the undesired effects of internship.

  9. Effectiveness of the "Cancer Home-Life Intervention" on everyday activities and quality of life in people with advanced cancer living at home

    DEFF Research Database (Denmark)

    Brandt, Åse; Pilegaard, Marc Sampedro; Østergaard, Lisa Gregersen;

    2016-01-01

    Background During the past decade an increasing number of people live with advanced cancer mainly due to improved medical treatment. Research has shown that many people with advanced cancer have problems with everyday activities, which have negative impact on their quality of life, and that they...... spend a considerable part of their time at home. Still, research on interventions to support the performance of and participation in everyday activities is only scarcely available. Therefore, the occupational therapy-based “Cancer Home-Life Intervention” consisting of tailored adaptive interventions...... applied in the participant’s home environment was developed. The objective of this study is to examine the effectiveness and cost-effectiveness of the Cancer Home-Life Intervention compared to usual care on the performance of and participation in everyday activities and quality of life in people with...

  10. Tool for Sizing Analysis of the Advanced Life Support System

    Science.gov (United States)

    Yeh, Hue-Hsie Jannivine; Brown, Cheryl B.; Jeng, Frank J.

    2005-01-01

    Advanced Life Support Sizing Analysis Tool (ALSSAT) is a computer model for sizing and analyzing designs of environmental-control and life support systems (ECLSS) for spacecraft and surface habitats involved in the exploration of Mars and Moon. It performs conceptual designs of advanced life support (ALS) subsystems that utilize physicochemical and biological processes to recycle air and water, and process wastes in order to reduce the need of resource resupply. By assuming steady-state operations, ALSSAT is a means of investigating combinations of such subsystems technologies and thereby assisting in determining the most cost-effective technology combination available. In fact, ALSSAT can perform sizing analysis of the ALS subsystems that are operated dynamically or steady in nature. Using the Microsoft Excel spreadsheet software with Visual Basic programming language, ALSSAT has been developed to perform multiple-case trade studies based on the calculated ECLSS mass, volume, power, and Equivalent System Mass, as well as parametric studies by varying the input parameters. ALSSAT s modular format is specifically designed for the ease of future maintenance and upgrades.

  11. Work/Life Satisfaction Policy in ADVANCE Universities: Assessing Levels of Flexibility

    Science.gov (United States)

    Tower, Leslie E.; Dilks, Lisa M.

    2015-01-01

    Work/life satisfaction policies are seen as key to recruiting, retaining, and advancing high quality faculty. This article explores the work/life policies prevalent at NSF ADVANCE institutions (PAID, Catalyst, and IT). We systematically review ADVANCE university websites (N = 124) and rank 9 categories of work/life policy including dual career…

  12. Oxygen Generation from Carbon Dioxide for Advanced Life Support

    Science.gov (United States)

    Bishop, Sean; Duncan, Keith; Hagelin-Weaver, Helena; Neal, Luke; Sanchez, Jose; Paul, Heather L.; Wachsman, Eric

    2007-01-01

    The partial electrochemical reduction of carbon dioxide (CO2) using ceramic oxygen generators (COGs) is well known and widely studied. However, complete reduction of metabolically produced CO2 (into carbon and oxygen) has the potential of reducing oxygen storage weight for life support if the oxygen can be recovered. Recently, the University of Florida devel- oped novel ceramic oxygen generators employing a bilayer elec- trolyte of gadolinia-doped ceria and erbia-stabilized bismuth ox- ide (ESB) for NASA's future exploration of Mars. The results showed that oxygen could be reliably produced from CO2 at temperatures as low as 400 C. The strategy discussed here for advanced life support systems employs a catalytic layer com- bined with a COG cell so that CO2 is reduced all the way to solid carbon and oxygen without carbon buildup on the COG cell and subsequent deactivation.

  13. Barcode of life: Advancing species identification and discovery

    Digital Repository Service at National Institute of Oceanography (India)

    Chandramohan, D.

    and (ii) possess greater range of phylogenetic signal than any other mitochondrial gene. The accumulated evidence now shows that these short DNA sequences can be a distinguishing feature from insects to birds. As a Linnaean binomial is an abbreviated... DNA as a model system. Gene 238, 195-210. 5. Simmons, R.B. and Weller,S.J. 2001. Utility and evolution of cytochrome b in insects.Mol. Phylogenet. Evol. 20, 196-210. Barcode of Life: Advancing Species Identification and Discovery ...

  14. End-of-Life Decisions and Palliative Care in Advanced Heart Failure.

    Science.gov (United States)

    Meyers, Deborah E; Goodlin, Sarah J

    2016-09-01

    Advanced heart failure (HF) therapies are focused on extending life and improving function. In contrast, palliative care is a holistic approach that focuses on symptom alleviation and patients' physical, psychosocial, and spiritual needs. HF clinicians can integrate palliative care strategies by incorporating several important components of planning and decision-making for HF patients. Future care planning (FCP) for HF patients should incorporate the basic tenets of shared decision-making (SDM). These include understanding the patient's perspective and care preferences, articulating what is medically feasible, and integrating these considerations into the overall care plan. Use of defined triggers for FCP can stimulate important patient-caregiver conversations. Guidelines advocate an annual review of HF status and future care preferences. Advance directives are important for any individual with a chronic, life-limiting illness and should be integrated into FCP. Nevertheless, use of advance directives by HF patients is extremely low. Consideration of illness trajectories and risk-scoring tools might facilitate prognostication and delivery of appropriate HF care. Decisions about heart transplantation or left ventricular assist device implantation should include planning for potential complications associated with these therapies. Such decisions also should include a discussion of palliative management, as an alternative to intervention and also as an option for managing symptoms or adverse events after intervention. Palliative care, including FCP and SDM, should be integrated into the course of all patients with advanced HF. Clinicians who provide HF care should acquire the skills necessary for conducting FCP and SDM discussions. PMID:27568873

  15. Advanced robotics for medical rehabilitation current state of the art and recent advances

    CERN Document Server

    Xie, Shane

    2016-01-01

    Focussing on the key technologies in developing robots for a wide range of medical rehabilitation activities – which will include robotics basics, modelling and control, biomechanics modelling, rehabilitation strategies, robot assistance, clinical setup/implementation as well as neural and muscular interfaces for rehabilitation robot control – this book is split into two parts; a review of the current state of the art, and recent advances in robotics for medical rehabilitation. Both parts will include five sections for the five key areas in rehabilitation robotics: (i) the upper limb; (ii) lower limb for gait rehabilitation (iii) hand, finger and wrist; (iv) ankle for strains and sprains; and (v) the use of EEG and EMG to create interfaces between the neurological and muscular functions of the patients and the rehabilitation robots. Each chapter provides a description of the design of the device, the control system used, and the implementation and testing to show how it fulfils the needs of that specific ...

  16. [Attitudes of intellectuals, public life, science. Medical public life and publicity in the 19th century].

    Science.gov (United States)

    Szabó, Katalin

    2011-01-01

    The professional publicity of medical society of the 19th century was assured partly by the medical press partly by different associations. At the end of the century the scientific thinking's accent was put on the prevention, and as a result of this, the physicians' activity focused on informing the public. Contemporary physicians still believed in strong connection between science and everyday life, so they were convinced, that every single individual of the society might and should be addressed. The message this time was mediated mostly by printed media. This program of the medical society attempted to involve the school as well. Anyway, despite some successes, till the end of 19th century health education in schools hasn't been introduced. The oeuvre of Doctor Dubay was an excellent example of this process, since he was also convinced, that media was the possible tool of reaching his professional objectives. His main aim was to raise the level of Hungarian public health. Present article describes Dubay's struggle for using media on behalf of wet nurses, mothers and of their children. PMID:22533251

  17. Geographic Medical History: Advances in Geospatial Technology Present New Potentials in Medical Practice

    Science.gov (United States)

    Faruque, F. S.; Finley, R. W.

    2016-06-01

    Genes, behaviour, and the environment are known to be the major risk factors for common diseases. When the patient visits a physician, typical questions include family history (genes) and lifestyle of the patient (behaviour), but questions concerning environmental risk factors often remain unasked. It is ironic that 25 centuries ago Hippocrates, known as the father of medicine, noted the importance of environmental exposure in medical investigation as documented in his classic work, "Airs, Waters, Places", yet the practice of routinely incorporating environmental risk factors is still not in place. Modern epigenetic studies have found that unhealthy lifestyle and environmental factors can cause changes to our genes that can increase disease risk factors. Therefore, attempting to solve the puzzle of diseases using heredity and lifestyle alone will be incomplete without accounting for the environmental exposures. The primary reason why environmental exposure has not yet been a routine part of the patient's medical history is mostly due to our inability to provide clinicians useful measures of environmental exposures suitable for their clinical practices. This presentation will discuss advances in geospatial technology that show the potential to catalyse a paradigm shift in medical practice and health research by allowing environmental risk factors to be documented as the patient's "Geographic Medical History". In order to accomplish this we need information on: a) relevant spatiotemporal environmental variables, and b) location of the individual in that person's dynamic environment. Common environmental agents that are known to interact with genetic make-up include air pollutants, mold spores, pesticides, etc. Until recently, the other component, location of an individual was limited to a static representation such as residential or workplace location. Now, with the development of mobile technology, changes in an individual's location can be tracked in real time if

  18. What do medical students think about their quality of life? A qualitative study

    Directory of Open Access Journals (Sweden)

    Tempski Patricia

    2012-11-01

    Full Text Available Abstract Background Medical education can affect medical students’ physical and mental health as well as their quality of life. The aim of this study was to assess medical students’ perceptions of their quality of life and its relationship with medical education. Methods First- to sixth-year students from six Brazilian medical schools were interviewed using focus groups to explore what medical student’s lives are like, factors related to increases and decreases of their quality of life during medical school, and how they deal with the difficulties in their training. Results Students reported a variety of difficulties and crises during medical school. Factors that were reported to decrease their quality of life included competition, unprepared teachers, excessive activities, and medical school schedules that demanded exclusive dedication. Contact with pain, death and suffering and harsh social realities influence their quality of life, as well as frustrations with the program and insecurity regarding their professional future. The scarcity of time for studying, leisure activities, relationships, and rest was considered the main factor of influence. Among factors that increase quality of life are good teachers, classes with good didactic approaches, active learning methodologies, contact with patients, and efficient time management. Students also reported that meaningful relationships with family members, friends, or teachers increase their quality of life. Conclusion Quality of teachers, curricula, healthy lifestyles related to eating habits, sleep, and physical activity modify medical students’ quality of life. Lack of time due to medical school obligations was a major impact factor. Students affirm their quality of life is influenced by their medical school experiences, but they also reframe their difficulties, herein represented by their poor quality of life, understood as necessary and inherent to the process of becoming doctors.

  19. Advanced Technologies to Improve Closure of Life Support Systems

    Science.gov (United States)

    Barta, Daniel J.

    2016-01-01

    As NASA looks beyond the International Space Station toward long-duration, deep space missions away from Earth, the current practice of supplying consumables and spares will not be practical nor affordable. New approaches are sought for life support and habitation systems that will reduce dependency on Earth and increase mission sustainability. To reduce launch mass, further closure of Environmental Control and Life Support Systems (ECLSS) beyond the current capability of the ISS will be required. Areas of particular interest include achieving higher degrees of recycling within Atmosphere Revitalization, Water Recovery and Waste Management Systems. NASA is currently investigating advanced carbon dioxide reduction processes that surpass the level of oxygen recovery available from the Sabatier Carbon Dioxide Reduction Assembly (CRA) on the ISS. Candidate technologies will potentially improve the recovery of oxygen from about 50% (for the CRA) to as much as 100% for technologies who's end product is solid carbon. Improving the efficiency of water recycling and recovery can be achieved by the addition of advanced technologies to recover water from brines and solid wastes. Bioregenerative technologies may be utilized for water reclaimation and also for the production of food. Use of higher plants will simultaneously benefit atmosphere revitalization and water recovery through photosynthesis and transpiration. The level at which bioregenerative technologies are utilized will depend on their comparative requirements for spacecraft resources including mass, power, volume, heat rejection, crew time and reliability. Planetary protection requirements will need to be considered for missions to other solar system bodies.

  20. Planner-Based Control of Advanced Life Support Systems

    Science.gov (United States)

    Muscettola, Nicola; Kortenkamp, David; Fry, Chuck; Bell, Scott

    2005-01-01

    The paper describes an approach to the integration of qualitative and quantitative modeling techniques for advanced life support (ALS) systems. Developing reliable control strategies that scale up to fully integrated life support systems requires augmenting quantitative models and control algorithms with the abstractions provided by qualitative, symbolic models and their associated high-level control strategies. This will allow for effective management of the combinatorics due to the integration of a large number of ALS subsystems. By focusing control actions at different levels of detail and reactivity we can use faster: simpler responses at the lowest level and predictive but complex responses at the higher levels of abstraction. In particular, methods from model-based planning and scheduling can provide effective resource management over long time periods. We describe reference implementation of an advanced control system using the IDEA control architecture developed at NASA Ames Research Center. IDEA uses planning/scheduling as the sole reasoning method for predictive and reactive closed loop control. We describe preliminary experiments in planner-based control of ALS carried out on an integrated ALS simulation developed at NASA Johnson Space Center.

  1. New Directions for NASA's Advanced Life Support Program

    Science.gov (United States)

    Barta, Daniel J.

    2006-01-01

    Advanced Life Support (ALS), an element of Human Systems Research and Technology s (HSRT) Life Support and Habitation Program (LSH), has been NASA s primary sponsor of life support research and technology development for the agency. Over its history, ALS sponsored tasks across a diverse set of institutions, including field centers, colleges and universities, industry, and governmental laboratories, resulting in numerous publications and scientific articles, patents and new technologies, as well as education and training for primary, secondary and graduate students, including minority serving institutions. Prior to the Vision for Space Exploration (VSE) announced on January 14th, 2004 by the President, ALS had been focused on research and technology development for long duration exploration missions, emphasizing closed-loop regenerative systems, including both biological and physicochemical. Taking a robust and flexible approach, ALS focused on capabilities to enable visits to multiple potential destinations beyond low Earth orbit. ALS developed requirements, reference missions, and assumptions upon which to structure and focus its development program. The VSE gave NASA a plan for steady human and robotic space exploration based on specific, achievable goals. Recently, the Exploration Systems Architecture Study (ESAS) was chartered by NASA s Administrator to determine the best exploration architecture and strategy to implement the Vision. The study identified key technologies required to enable and significantly enhance the reference exploration missions and to prioritize near-term and far-term technology investments. This technology assessment resulted in a revised Exploration Systems Mission Directorate (ESMD) technology investment plan. A set of new technology development projects were initiated as part of the plan s implementation, replacing tasks previously initiated under HSRT and its sister program, Exploration Systems Research and Technology (ESRT). The

  2. Acquisition of advanced-technology medical instrumentation by developing countries

    International Nuclear Information System (INIS)

    The increasing complexity and cost of new imaging technology makes the purchase of such equipment an undertaking with serious financial and operational consequences. Aside from the basic clinical needs, a number of practical questions must be addressed by the knowledgeable buyer. The natural tendency to avoid used or reconditioned equipment should not prevent the buyer from considering this type of equipment. However, it is essential to obtain the vendor's firm commitment to provide ongoing support of the equipment by making maintenance personnel, spare parts and service contracts available. The complexity of present-day equipment may require significant upgrading of the electrical system in the intended installation site. Air conditioning may be required. Adequate training of physicians and technologists must be provided in order for the equipment to be properly operated so that clinical results are not compromised. This document points out different aspects of acquisition of advanced medical equipment - such as X-ray equipment - that should be taken into consideration in order to avoid problems after its installation. 8 refs

  3. First aid and basic life support: a questionnaire survey of medical schools in the Netherlands.

    NARCIS (Netherlands)

    Tan, E.C.T.H.; Hekkert, K.D.; Vugt, A.B. van; Biert, J.

    2010-01-01

    PURPOSE: Adequate education in first aid and basic life support (BLS) should be considered as an essential aspect of the medical curriculum. The objective of this study was to investigate the current medical training in first aid and BLS at all 8 medical schools in the Netherlands. SUMMARY: An evalu

  4. Advanced Technologies for Space Life Science Payloads on the International Space Station

    Science.gov (United States)

    Hines, John W.; Connolly, John P. (Technical Monitor)

    1997-01-01

    SENSORS 2000! (S2K!) is a specialized, high-performance work group organized to provide advanced engineering and technology support for NASA's Life Sciences spaceflight and ground-based research and development programs. In support of these objectives, S2K! manages NASA's Advanced Technology Development Program for Biosensor and Biotelemetry Systems (ATD-B), with particular emphasis on technologies suitable for Gravitational Biology, Human Health and Performance, and Information Technology and Systems Management. A concurrent objective is to apply and transition ATD-B developed technologies to external, non-NASA humanitarian (medical, clinical, surgical, and emergency) situations and to stimulate partnering and leveraging with other government agencies, academia, and the commercial/industrial sectors. A phased long-term program has been implemented to support science disciplines and programs requiring specific biosensor (i.e., biopotential, biophysical, biochemical, and biological) measurements from humans, animals (mainly primates and rodents), and cells under controlled laboratory and simulated microgravity situations. In addition to the technology programs described above, NASA's Life and Microgravity Sciences and Applications Office has initiated a Technology Infusion process to identify and coordinate the utilization and integration of advanced technologies into its International Space Station Facilities. This project has recently identified a series of technologies, tasks, and products which, if implemented, would significantly increase the science return, decrease costs, and provide improved technological capability. This presentation will review the programs described above and discuss opportunities for collaboration, leveraging, and partnering with NASA.

  5. [Advanced Trauma Life Support. A training concept also for Europe].

    Science.gov (United States)

    Helm, M; Kulla, M; Lampl, L

    2007-11-01

    Advanced Trauma Life Support (ATLS) is a concept for rapid initial assessment and primary management of an injured patient, starting at the time of injury and continuing through initial assessment, lifesaving interventions, re-evaluation, stabilization and, when needed, transfer to a trauma centre. Despite some shortcomings, it is the only standardized concept for emergency room management, which is internationally accepted. Because of its simple and clear structure, it is flexible and can be universally integrated into existing emergency room algorithms under consideration of local, regional as well as national and international peculiarities in the sense of a "common language of trauma". Under these aspects ATLS also seems to be a valid concept for Europe. PMID:17726585

  6. Quality of Life and Motivation to Learn: A Study of Medical Students

    Science.gov (United States)

    Henning, Marcus; Krageloh, Christian; Hawken, Susan; Zhao, Yipin; Doherty, Iain

    2010-01-01

    There is growing literature in the area of medical students' quality of life. As far as we know, no qualitative studies have investigated the links between students' quality of life issues and their motivation to learn. The key question that drove the present study was: Is there a correlation between students' quality of life and their motivation…

  7. Medical Care Use and Expenditures for Children across Stages of the Family Life Cycle.

    Science.gov (United States)

    Cunningham, Peter J.

    1990-01-01

    Investigated differences in use of and expenditures for children's health services across stages of family life cycle and how family characteristics affected medical care use and expenditures for children differently, depending on family life cycle stage. Found variation across family life cycle stages in terms of children's mean number of…

  8. Measuring the Resilience of Advanced Life Support Systems

    Science.gov (United States)

    Bell, Ann Maria; Dearden, Richard; Levri, Julie A.

    2002-01-01

    Despite the central importance of crew safety in designing and operating a life support system, the metric commonly used to evaluate alternative Advanced Life Support (ALS) technologies does not currently provide explicit techniques for measuring safety. The resilience of a system, or the system s ability to meet performance requirements and recover from component-level faults, is fundamentally a dynamic property. This paper motivates the use of computer models as a tool to understand and improve system resilience throughout the design process. Extensive simulation of a hybrid computational model of a water revitalization subsystem (WRS) with probabilistic, component-level faults provides data about off-nominal behavior of the system. The data can then be used to test alternative measures of resilience as predictors of the system s ability to recover from component-level faults. A novel approach to measuring system resilience using a Markov chain model of performance data is also developed. Results emphasize that resilience depends on the complex interaction of faults, controls, and system dynamics, rather than on simple fault probabilities.

  9. System Dynamics in Medical Education: A Tool for Life

    Science.gov (United States)

    Rubin, David M.; Richards, Christopher L.; Keene, Penelope A. C.; Paiker, Janice E.; Gray, A. Rosemary T.; Herron, Robyn F. R.; Russell, Megan J.; Wigdorowitz, Brian

    2012-01-01

    A course in system dynamics has been included in the first year of our university's six-year medical curriculum. System Dynamics is a discipline that facilitates the modelling, simulation and analysis of a wide range of problems in terms of two fundamental concepts viz. rates and levels. Many topics encountered in the medical school curriculum,…

  10. Why I wrote my advance decision to refuse life-prolonging treatment: and why the law on sanctity of life remains problematic.

    Science.gov (United States)

    Gillon, Raanan

    2016-06-01

    This paper, pursuing themes indefatigably defended in this journal and elsewhere by Professors Jenny and Celia Kitzinger, explains what led me to write my own advance decision (AD) to refuse life-prolonging treatment if I become legally incapacitated to make my own healthcare decisions for longer than 3 months and am medically assessed as very unlikely to regain such legal capacity. I attach my Advance Decision to Refuse Life Prolonging Treatment to the online version of this paper for comment advice and possible general interest. I argue that while a Supreme Court judgement in 2013, followed by a Court of Protection judgement in 2015 greatly ameliorate my earlier concerns about excessive judicial emphasis on the sanctity of life, certain current requirements in the Code of Practice to the Mental Capacity Act 2005 and in the Rules of the Court of Protection, especially Practice Direction 9E, concerning permanent vegetative state and minimally conscious state, seem clearly to contradict aspects of that Supreme Court judgement. If the logical implications of those legal requirements were thoroughly implemented medical practice would be substantially and undesirably skewed towards provision of treatments to prolong life that are unwanted, non-beneficial and wasteful of healthcare resources. I urge that these legal requirements are modified to make them consistent with the Supreme Court's judgement in Aintree v James. PMID:27118692

  11. Forensic issues in medical evaluation: competency and end-of-life issues.

    Science.gov (United States)

    Soliman, Sherif; Hall, Ryan C W

    2015-01-01

    Decision-making capacity is a common reason for psychiatric consultation that is likely to become more common as the population ages. Capacity assessments are frequently compromised by misconceptions, such as the belief that incapacity is permanent or that patients with dementia categorically lack capacity. This chapter will review the conceptual framework of decision-making capacity and discuss its application to medical decision-making. We will review selected developments in capacity assessment and recommend an approach to assessing decision-making capacity. We will discuss the unique challenges posed by end-of-life care, including determining capacity, identifying surrogate decision-makers, and working with surrogate decision-makers. We will discuss clinical and legal approaches to incapacity, including advance directives, surrogate decision-makers, and guardians. We will discuss the legal standards based on which surrogates make medical decisions and outline options for resolving disagreements between clinical staff and surrogate decision-makers. We will offer recommendations for approaching decision-making capacity assessments. PMID:25832512

  12. Radio Searches for Signatures of Advanced Extraterrestrial Life

    Science.gov (United States)

    Siemion, Andrew

    Over the last several decades, observational astronomy has produced a flood of discoveries that suggest that the building blocks and circumstances that gave rise to life on Earth may be the rule rather than the exception. It has now been conclusively shown that planets are common and that some 5-15% of FGKM stars host planets existing in their host star's habitable zone. Further, terrestrial biology has demonstrated that life on our own planet can thrive in extraordinarily extreme environments, dramatically extending our notion of what constitutes habitability. The deeper question, yet unanswered, is whether or not life in any form has ever existed in an environment outside of the Earth. As humans, we are drawn to an even more profound question, that of whether or not extraterrestrial life may have evolved a curiosity about the universe similar to our own and the technology with which to explore it. Radio astronomy has long played a prominent role in searches for extraterrestrial intelligence (SETI), beginning with the first suggestions by Cocconi and Morrison (1959) that narrow-band radio signals near 1420 MHz might be effective tracers of advanced technology and early experiments along these lines by Frank Drake in 1961, continuing through to more recent investigations searching for several types of coherent radio signals indicative of technology at a wider range of frequencies. The motivations for radio searches for extraterrestrial intelligence have been throughly discussed in the literature, but the salient arguments are the following: 1. coherent radio emission is commonly produced by advanced technology (judging by Earth’s technological development), 2. electromagnetic radiation can convey information at the maximum velocity currently known to be possible, 3. radio photons are energetically cheap to produce, 4. certain types of coherent radio emissions are easily distinguished from astrophysical background sources, especially within the so

  13. Microbial astronauts: assembling microbial communities for advanced life support systems

    Science.gov (United States)

    Roberts, M. S.; Garland, J. L.; Mills, A. L.

    2004-01-01

    Extension of human habitation into space requires that humans carry with them many of the microorganisms with which they coexist on Earth. The ubiquity of microorganisms in close association with all living things and biogeochemical processes on Earth predicates that they must also play a critical role in maintaining the viability of human life in space. Even though bacterial populations exist as locally adapted ecotypes, the abundance of individuals in microbial species is so large that dispersal is unlikely to be limited by geographical barriers on Earth (i.e., for most environments "everything is everywhere" given enough time). This will not be true for microbial communities in space where local species richness will be relatively low because of sterilization protocols prior to launch and physical barriers between Earth and spacecraft after launch. Although community diversity will be sufficient to sustain ecosystem function at the onset, richness and evenness may decline over time such that biological systems either lose functional potential (e.g., bioreactors may fail to reduce BOD or nitrogen load) or become susceptible to invasion by human-associated microorganisms (pathogens) over time. Research at the John F. Kennedy Space Center has evaluated fundamental properties of microbial diversity and community assembly in prototype bioregenerative systems for NASA Advanced Life Support. Successional trends related to increased niche specialization, including an apparent increase in the proportion of nonculturable types of organisms, have been consistently observed. In addition, the stability of the microbial communities, as defined by their resistance to invasion by human-associated microorganisms, has been correlated to their diversity. Overall, these results reflect the significant challenges ahead for the assembly of stable, functional communities using gnotobiotic approaches, and the need to better define the basic biological principles that define ecosystem

  14. Computing support for advanced medical data analysis and imaging

    CERN Document Server

    Wiślicki, W; Białas, P; Czerwiński, E; Kapłon, Ł; Kochanowski, A; Korcyl, G; Kowal, J; Kowalski, P; Kozik, T; Krzemień, W; Molenda, M; Moskal, P; Niedźwiecki, S; Pałka, M; Pawlik, M; Raczyński, L; Rudy, Z; Salabura, P; Sharma, N G; Silarski, M; Słomski, A; Smyrski, J; Strzelecki, A; Wieczorek, A; Zieliński, M; Zoń, N

    2014-01-01

    We discuss computing issues for data analysis and image reconstruction of PET-TOF medical scanner or other medical scanning devices producing large volumes of data. Service architecture based on the grid and cloud concepts for distributed processing is proposed and critically discussed.

  15. Life sciences: Nuclear medicine, radiation biology, medical physics, 1980-1994. International Atomic Energy Agency Publications

    International Nuclear Information System (INIS)

    The catalogue lists all sales publications of the IAEA dealing with Life Sciences issued during the period 1980-1994. The publications are grouped in the following chapters: Nuclear Medicine (including Radiopharmaceuticals), Radiation Biology and Medical Physics (including Dosimetry)

  16. Life Works: Explore Health and Medical Science Careers | NIH MedlinePlus the Magazine

    Science.gov (United States)

    ... Health Careers Life Works: Explore Health and Medical Science Careers Past Issues / Summer 2011 Table of Contents ... to technicians and therapists. The NIH Office of Science Education has a Web site that lists and ...

  17. Safety Analysis of Soybean Processing for Advanced Life Support

    Science.gov (United States)

    Hentges, Dawn L.

    1999-01-01

    Soybeans (cv. Hoyt) is one of the crops planned for food production within the Advanced Life Support System Integration Testbed (ALSSIT), a proposed habitat simulation for long duration lunar/Mars missions. Soybeans may be processed into a variety of food products, including soymilk, tofu, and tempeh. Due to the closed environmental system and importance of crew health maintenance, food safety is a primary concern on long duration space missions. Identification of the food safety hazards and critical control points associated with the closed ALSSIT system is essential for the development of safe food processing techniques and equipment. A Hazard Analysis Critical Control Point (HACCP) model was developed to reflect proposed production and processing protocols for ALSSIT soybeans. Soybean processing was placed in the type III risk category. During the processing of ALSSIT-grown soybeans, critical control points were identified to control microbiological hazards, particularly mycotoxins, and chemical hazards from antinutrients. Critical limits were suggested at each CCP. Food safety recommendations regarding the hazards and risks associated with growing, harvesting, and processing soybeans; biomass management; and use of multifunctional equipment were made in consideration of the limitations and restraints of the closed ALSSIT.

  18. Advanced Space Suit Portable Life Support Subsystem Packaging Design

    Science.gov (United States)

    Howe, Robert; Diep, Chuong; Barnett, Bob; Thomas, Gretchen; Rouen, Michael; Kobus, Jack

    2006-01-01

    This paper discusses the Portable Life Support Subsystem (PLSS) packaging design work done by the NASA and Hamilton Sundstrand in support of the 3 future space missions; Lunar, Mars and zero-g. The goal is to seek ways to reduce the weight of PLSS packaging, and at the same time, develop a packaging scheme that would make PLSS technology changes less costly than the current packaging methods. This study builds on the results of NASA s in-house 1998 study, which resulted in the "Flex PLSS" concept. For this study the present EMU schematic (low earth orbit) was used so that the work team could concentrate on the packaging. The Flex PLSS packaging is required to: protect, connect, and hold the PLSS and its components together internally and externally while providing access to PLSS components internally for maintenance and for technology change without extensive redesign impact. The goal of this study was two fold: 1. Bring the advanced space suit integrated Flex PLSS concept from its current state of development to a preliminary design level and build a proof of concept mockup of the proposed design, and; 2. "Design" a Design Process, which accommodates both the initial Flex PLSS design and the package modifications, required to accommodate new technology.

  19. Associations of desire for change in sexual life amongst female medical students in North America

    OpenAIRE

    Shindel, AW; Breyer, BN; Smith, JF

    2012-01-01

    We analyzed associations of dissatisfaction with sexual life and desire for change in female medical students. Students enrolled in medical schools in North America between February and July 2008 were invited to participate in an internet-based survey of sexual function. The principle outcome measure was a single item question on sexual life satisfaction and desire for change. Women who reported dissatisfaction and desire for change were classified as 'sexually bothered'. The survey also asse...

  20. Current Advances in the Medical Application of Nanotechnology

    CERN Document Server

    Slevin, Mark

    2012-01-01

    Nanotechnology promises new medical therapies, more rapid and sensitive diagnostic and investigative tools for normal and diseased tissues, and new materials for tissue engineering. This e-book highlights the major current uses, new technologies and future perspectives of nanotechnology in relation to medical applications. Sections in this e-book include nanobiological approaches to imaging, diagnosis and treatment of disease using targeted monoclonal antibodies and siRNA, the medical use of nanomaterials, to nanoelectronic biosensors, and possible future applications of molecular nanotechnolo

  1. Life-Metaphors among Colombian Medical Students: Uncovering Core Values and Educational Implications

    Science.gov (United States)

    Hoffman, Edward; Acosta-Orozco, Catalina; Compton, William C.

    2015-01-01

    The present study utilized metaphor analysis to examine the core values of Colombian medical students. The entire 9th semester medical class of 60 students was invited to respond to a structured questionnaire. It asked participants to state their preferred life-metaphor, whether they had always preferred this metaphor since childhood or…

  2. Medical Diagnosis: A Real Life Application of Logic.

    Science.gov (United States)

    Goldberg, Kenneth P.

    1978-01-01

    This article describes how logic is used as the basis of medical diagnosis, i.e., the presence or absence of certain symptoms implies the presence or absence of certain diseases. This usage is then illustrated with a real example. (MP)

  3. Medical operations and life sciences activities on space station

    Science.gov (United States)

    Johnson, P. C. (Editor); Mason, J. A. (Editor)

    1982-01-01

    Space station health maintenance facilities, habitability, personnel, and research in the medical sciences and in biology are discussed. It is assumed that the space station structure will consist of several modules, each being consistent with Orbiter payload bay limits in size, weight, and center of gravity.

  4. Improving quality of life, emotional states and medical compliance in recipients of kidney transplants

    OpenAIRE

    Jindal, Rahul Mahendra

    2003-01-01

    Quality of Life (QOL) amongst transplant patients has become an issue as a means to optimize the use of scarce resources and improve outcome. The relationship between QOL, medical compliance, psychosocial states and QOL is presented as follows: Patient empowerment: Patient empowerment and compliance with medications in patients who experienced late acute rejection, was assessed using the Long-term Medication Behaviour Scale (LTMBS-scale). We demonstrated a relationship between late acute r...

  5. THE CORRELATION BETWEEN LEARNING ACTIVITY MOTIVATION AND LIFE SENSE ORIENTATION OF MEDICAL INSTITUTE STUDENTS

    OpenAIRE

    Magazeva Elena Anatolevna; Chuvataeva Mayra Kurkutbaevna

    2013-01-01

    In the article the special features of academic motivation of medical institute students in field of “Medical Care” and “Medical preventive Care” are studied.  This study is based on fundamental approaches to the motivation problems and, particularly, academic motivation which was a major precondition for examining its connection with life sense orientation of a personality. The research particularities consist in revealing of academic motivation characteristics of the students and determinat...

  6. Impact of medical intervention on stress and quality of life in patients with cancer

    Directory of Open Access Journals (Sweden)

    Vijay Prasad Barre

    2015-01-01

    Full Text Available Context: Many studies have explored stress and quality of life in (QOL patients with cancer, under several phases of disease and treatment. However, the impact of medical intervention on psychological parameters, such as stress and quality of life focusing on psychological intervention has been sparsely studied. Aims: The main aim of the study was to examine the impact of medical intervention on the level of stress and quality of life of patients with lung, breast, and head and neck cancers. Settings and Design: The study was carried out in hospital settings by following a one-group pre-test-post-test pre-experimental design. Statistical analysis used: The quantitative data were analysed by means of descriptive statistics, paired t-tests, Cohen′s d, and bar graphs accordingly. Results: The effect of medical intervention was medium in case of reduction of overall stress in participants. So far as the components are concerned, the effect was high in case of psychosomatic complaints, medium in case of fear and information deficit, and low in case of everyday life restrictions. The effect of medical intervention in respect of the quality of life was found to be high in case of symptom scale (pain and additional symptoms (constipation; medium in case of functional scale (emotional functioning, cognitive functioning and symptoms scale (nausea, vomiting. In additional symptoms scale the effect of medical intervention was found to be medium in dyspnoea and appetite loss. Conclusions: The findings revealed that though the medical intervention reduced stress and improved the quality of life, it was not instrumental in bringing down the stress to minimal level and enhancing the quality of life to optimum level. Therefore, the findings point to the need of inclusion of psychological intervention along with the medical intervention for minimizing stress and optimizing the quality of life of patients with cancer.

  7. Understanding gender differences in older people's attitudes towards life-prolonging medical technologies

    OpenAIRE

    Arber, S; Vandrevala, T; Daly, T; Hampson, S.

    2008-01-01

    The power of medical technologies to extend the final stages of life has heightened the need to understand what factors influence older people's wish to use such medical technologies. We analyse gender differences in such views, based on audio-recorded interviews with 33 men and 36 women (aged 65-93) in south-east England. Older women were twice as likely as men to Oppose using medical technologies to extend life. More older women voiced 'other-oriented' reasons for their opposition, particul...

  8. Prehospital advanced trauma life support for critical blunt trauma victims.

    Science.gov (United States)

    Cwinn, A A; Pons, P T; Moore, E E; Marx, J A; Honigman, B; Dinerman, N

    1987-04-01

    The ability of paramedics to deliver advanced trauma life support (ATLS) in an expedient fashion for victims of trauma has been strongly challenged. In this study, the records of 114 consecutive victims of blunt trauma who underwent laparotomy or thoracotomy were reviewed. Prehospital care was rendered by paramedics operating under strict protocols. The mean response time (minutes +/- SEM) to the scene was 5.6 +/- 0.27. On-scene time was 13.9 +/- 0.62. The time to return to the hospital was 8.0 +/- 0.4. On-scene time included assessing hazards at the scene, patient extrication, spine immobilization (n = 98), application of oxygen (n = 94), measurement of vital signs (n = 114), splinting of 59 limbs, and the following ATLS procedures: endotracheal intubation (n = 31), IV access (n = 106), ECG monitoring (n = 69), procurement of blood for tests including type and cross (n = 58), and application of a pneumatic antishock garment (PASG) (n = 31). On-scene times were analyzed according to the number of ATLS procedures performed: insertion of one IV line (n = 46), 14.8 +/- 1.03 minutes; two IV lines (n = 28), 13.4 +/- 0.92; one IV line plus intubation (n = 7), 14.0 +/- 2.94; two IV lines plus intubation (n = 9), 17.0 +/- 2.38; and two IV lines plus intubation plus PASG (n = 13), 12.4 +/- 1.36. Of the 161 IV attempts, 94% were completed successfully. Of 36 attempts at endotracheal intubation, 89% were successful.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:3826807

  9. Applying Technology Ranking and Systems Engineering in Advanced Life Support

    Science.gov (United States)

    Jones, Harry; Luna, Bernadette (Technical Monitor)

    2000-01-01

    According to the Advanced Life Support (ALS) Program Plan, the Systems Modeling and Analysis Project (SMAP) has two important tasks: 1) prioritizing investments in ALS Research and Technology Development (R&TD), and 2) guiding the evolution of ALS systems. Investments could be prioritized simply by independently ranking different technologies, but we should also consider a technology's impact on system design. Guiding future ALS systems will require SMAP to consider many aspects of systems engineering. R&TD investments can be prioritized using familiar methods for ranking technology. The first step is gathering data on technology performance, safety, readiness level, and cost. Then the technologies are ranked using metrics or by decision analysis using net present economic value. The R&TD portfolio can be optimized to provide the maximum expected payoff in the face of uncertain future events. But more is needed. The optimum ALS system can not be designed simply by selecting the best technology for each predefined subsystem. Incorporating a new technology, such as food plants, can change the specifications of other subsystems, such as air regeneration. Systems must be designed top-down starting from system objectives, not bottom-up from selected technologies. The familiar top-down systems engineering process includes defining mission objectives, mission design, system specification, technology analysis, preliminary design, and detail design. Technology selection is only one part of systems analysis and engineering, and it is strongly related to the subsystem definitions. ALS systems should be designed using top-down systems engineering. R&TD technology selection should consider how the technology affects ALS system design. Technology ranking is useful but it is only a small part of systems engineering.

  10. A Study on Quality of Work Life among Nurses in a Medical College Hospital in Bangalore

    OpenAIRE

    Naveen Ramesh, Catherine Nisha, Andre Mary Josephine, Seena Thomas, Bobby Joseph

    2013-01-01

    Introduction: Quality of Work Life (QWL) is defined as the extent to which an employee is satisfied with personal and working needs through participating in the workplace while achieving the goals of the organization. Objectives: To assess the quality of life of nurses working in a medical college hospital in Bangalore and the factors associated with it. Methods: Ethical approval from the institution and informed consent from the study participants was obtained and quality of life que...

  11. Advancing Medication Reconciliation in an Outpatient Internal Medicine Clinic through a Pharmacist-Led Educational Initiative

    OpenAIRE

    Sarah M. Westberg, Pharm.D.; Kathrine Beeksma, R.N.

    2010-01-01

    Objectives: To develop and deliver an effective pharmacist-led educational initiative to clinic staff to advance medication reconciliation in the electronic medical record of an outpatient internal medicine clinic.Methods: An educational initiative designed to improve the ability of nursing staff in medication reconciliation was launched in the outpatient internal medicine clinic of a regional healthcare system. The education was provided by the pharmacist to clinic nursing staff, includ...

  12. Promoting medical students’ reflection on competencies to advance a global health equities curriculum

    OpenAIRE

    Mullan, Patricia B; WILLIAMS, Joy; Malani, Preeti N.; RIBA, MICHELLE; Haig, Andrew; Perry, Julie; Kolars, Joseph C; Mangrulkar, Rajesh; Williams, Brent

    2014-01-01

    Background The move to frame medical education in terms of competencies – the extent to which trainees “can do” a professional responsibility - is congruent with calls for accountability in medical education. However, the focus on competencies might be a poor fit with curricula intended to prepare students for responsibilities not emphasized in traditional medical education. This study examines an innovative approach to the use of potential competency expectations related to advancing global ...

  13. [A Medical Devices Management Information System Supporting Full Life-Cycle Process Management].

    Science.gov (United States)

    Tang, Guoping; Hu, Liang

    2015-07-01

    Medical equipments are essential supplies to carry out medical work. How to ensure the safety and reliability of the medical equipments in diagnosis, and reduce procurement and maintenance costs is a topic of concern to everyone. In this paper, product lifecycle management (PLM) and enterprise resource planning (ERP) are cited to establish a lifecycle management information system. Through integrative and analysis of the various stages of the relevant data in life-cycle, it can ensure safety and reliability of medical equipments in the operation and provide the convincing data for meticulous management. PMID:26665958

  14. Alcohol abuse: medical effects of heavy drinking in late life.

    Science.gov (United States)

    Gambert, S R

    1997-06-01

    As many as 15% of community-dwelling older persons are heavy drinkers, but their alcoholism is often hidden from their physicians. Depression, loneliness, and lack of social support are the most frequently cited antecedents to drinking for older alcoholics. Clinically, the same amount of alcohol once consumed with impunity may cause clinical symptoms in late life. Physiologic changes in volume of distribution make older patients susceptible to acute alcohol toxicity, with its CNS effects and metabolic disturbances. Liver disease, nutritional deficiencies, and impotence are consequences of chronic alcohol abuse. PMID:9194788

  15. Medical students` health-related quality of life - a comparative study

    Directory of Open Access Journals (Sweden)

    Latas Milan

    2014-01-01

    Full Text Available Background/Aim. Previous studies on medical students’ subjective perception of health and health-related quality of life (HRQoL showed inconclusive results. Moreover, there are no published studies to compare HRQoL of medical students to non-medical university students. The aim of the study was to assess subjective perception of health-related quality of life (HRQoL in medical students’ sample, to compare it with non-medical university stu-dents and to ascertain predictors of better perception of HRQoL in medical students. Methods. Scores of all domains on the Mental and Physical Component Summary subscales and total score of the Short Form Health Survey (SF-36, used for assessment of HRQoL in samples of 561 medical and 332 non-medical university students were assessed and compared. In addition, linear regression to identify predictors of better perception of mental and physical components of HRQoL and overall HRQoL in the sample of medical students was used. The dependant variables were subscores and total score with the SF- 36, and independent variables were certain sociodemographic and academic characteristics of the students. Results. Medical students had statistically significantly higher scores on the Mental Component Summary and total SF-36 score compared to non-medical students. Linear regression analysis demonstrated that higher scores of Physical Component Summary were associated with age, male sex and the year of studies. The Mental Component Summary were associated with age, male sex, the year of studies and marital status. The total SF-36 score was associated with age, male sex and the year of studies. Conclusion. Medical students perceive their health much better than other university students do, but female, older and second grade medical students have worse perception of their HRQoL. Those points should be potential target areas for specific prevention and treatment in order to achieve better HRQoL.

  16. Advanced techniques in medical image segmentation of the liver

    OpenAIRE

    López Mir, Fernando

    2016-01-01

    [EN] Image segmentation is, along with multimodal and monomodal registration, the operation with the greatest applicability in medical image processing. There are many operations and filters, as much as applications and cases, where the segmentation of an organic tissue is the first step. The case of liver segmentation in radiological images is, after the brain, that on which the highest number of scientific publications can be found. This is due, on the one hand, to the need to continue inno...

  17. Oxygen Generation from Carbon Dioxide for Advanced Life Support

    Science.gov (United States)

    Bishop, s. R.; Duncan, K. L.; Hagelin-Weaver, H. E.; Neal, L.; Paul, H. L.; Wachsman, E. D.

    2007-01-01

    The partial electrochemical reduction of CO2 using ceramic oxygen generators (COGs) is well known and has been studied. Conventional COGs use yttria-stabilized zirconia (YSZ) electrolytes and operate at temperatures greater than 700 C (1, 2). Operating at a lower temperature has the advantage of reducing the mass of the ancillary components such as insulation. Moreover, complete reduction of metabolically produced CO2 (into carbon and oxygen) has the potential of reducing oxygen storage weight if the oxygen can be recovered. Recently, the University of Florida developed ceramic oxygen generators employing a bilayer electrolyte of gadolinia-doped ceria and erbia-stabilized bismuth oxide (ESB) for NASA s future exploration of Mars (3). The results showed that oxygen could be reliably produced from CO2 at temperatures as low as 400 C. These results indicate that this technology could be adapted to CO2 removal from a spacesuit and other applications in which CO2 removal is an issue. This strategy for CO2 removal in advanced life support systems employs a catalytic layer combined with a COG so that the CO2 is reduced completely to solid carbon and oxygen. First, to reduce the COG operating temperature, a thin, bilayer electrolyte was employed. Second, to promote full CO2 reduction while avoiding the problem of carbon deposition on the COG cathode, a catalytic carbon deposition layer was designed and the cathode utilized materials shown to be coke resistant. Third, a composite anode was used consisting of bismuth ruthenate (BRO) and ESB that has been shown to have high performance (4). The inset of figure 1 shows the conceptual design of the tubular COG and the rest of the figure shows schematically the test apparatus. Figure 2 shows the microstructure of a COG tube prior to testing. During testing, current is applied across the cell and initially CuO is reduced to copper metal by electrochemical pumping. Then the oxygen source becomes the CO/CO2. This presentation

  18. [Research advances on medical genetics in China in 2015].

    Science.gov (United States)

    Li, Yuanfeng; Han, Yubo; Cao, Pengbo; Meng, Jinfeng; Li, Haibei; Qin, Geng; Zhang, Feng; Jin, Guangfu; Yang, Yong; Wu, Lingqian; Ping, Jie; Zhou, Gangqiao

    2016-05-01

    Steady progress has been achieved in the medical genetics in China in 2015, as numerous original researches were published in the world's leading journals. Chinese scientists have made significant contributions to various fields of medical genetics, such as pathogenicity of rare diseases, predisposition of common diseases, somatic mutations of cancer, new technologies and methods, disease-related microRNAs (miRNAs), disease-related long non-coding RNAs (lncRNAs), disease-related competing endogenous RNAs (ceRNAs), disease-related RNA splicing and molecular evolution. In these fields, Chinese scientists have gradually formed the tendency, from common variants to rare variants, from single omic analyses to multipleomics integration analyses, from genetic discovery to functional confirmation, from basic research to clinical application. Meanwhile, the findings of Chinese scientists have been drawn great attentions of international peers. This review aims to provide an overall picture of the front in Chinese medical genetics, and highlights the important findings and their research strategy. PMID:27232486

  19. CURRENT SCENARIO: KNOWLEDGE OF BASIC LIFE SUPPORT IN MEDICAL COLLEGE

    Directory of Open Access Journals (Sweden)

    Asmita Chaudhary

    2011-04-01

    Full Text Available A workshop has been conducted on basic skill of Cardio-Pulmonary Resuscitation (CPR among doctors and nursing staff in medical college. Theoretical aspect was explained through power point presentation whereas practical aspect was demonstrated through skill station. The results were analyzed by using an answer key prepared from BLS manual of American Heart Association (AHA. Out of 117 participants only three participants secured 80-90% marks in pretest whereas rest of secured less than 50% marks .Post workshop assessment was done with same question papers showed 70% candidates securing more than 80%. Hence BLS workshop is essential to improve knowledge and skill of CPR. [National J of Med Res 2011; 1(2.000: 80-82

  20. Managing occupations in everyday life for people with advanced cancer at home

    DEFF Research Database (Denmark)

    Peoples, Hanne; Brandt, Åse; Wæhrens, Eva Elisabet Ejlersen;

    Background: People with advanced cancer are increasingly able to live for extended periods of time. Advanced cancer influences the ability to manage occupations in the everyday life. Although studies have showed that people with advanced cancer experience occupational difficulties, there are...... limited research that more specifically explore how these are managed. The objective was to describe and explore how people with advanced cancer manage occupations at home. Material and methods: A qualitative descriptive design was applied. 73 participants were consecutively recruited from a Danish...... “Everyday life under change” and two sub-categories 1) Appling strategies to manage occupations in everyday life and 2) Preserving a meaningful everyday life. Significance: The findings suggest that people with advanced cancer, to a greater extent, should be supported in exploring familiar as well as new...

  1. The environmental control and life support system advanced automation project

    Science.gov (United States)

    Dewberry, Brandon S.

    1991-01-01

    The objective of the ECLSS Advanced Automation project includes reduction of the risk associated with the integration of new, beneficial software techniques. Demonstrations of this software to baseline engineering and test personnel will show the benefits of these techniques. The advanced software will be integrated into ground testing and ground support facilities, familiarizing its usage by key personnel.

  2. Advance directives in dementia research: A medical ethical inquiry

    OpenAIRE

    Jongsma, Karin

    2016-01-01

    markdownabstractDementia is highly prevalent and incurable. The participation of dementia patients in clinical research is indispensable if we want to find an effective treatment for dementia. However, one of the primary challenges in dementia research is the patients’ gradual loss of the capacity to consent. Patients with dementia are characterized by the fact that, at an earlier stage of their life, they were able to give their consent to participation in research. Therefore, the phase when...

  3. 41 CFR 102-36.460 - Do we report excess medical shelf-life items held for national emergency purposes?

    Science.gov (United States)

    2010-07-01

    ... Disposal Requires Special Handling Shelf-Life Items § 102-36.460 Do we report excess medical shelf-life... 41 Public Contracts and Property Management 3 2010-07-01 2010-07-01 false Do we report excess medical shelf-life items held for national emergency purposes? 102-36.460 Section 102-36.460...

  4. 75 FR 42103 - Advancing the Development of Medical Products Used In the Prevention, Diagnosis, and Treatment of...

    Science.gov (United States)

    2010-07-20

    ... HUMAN SERVICES Food and Drug Administration Advancing the Development of Medical Products Used In the... persons on issues related to advancing the development of medical products (drugs, biological products... challenges. To encourage the development of these much needed medical products, section 740 of...

  5. Evaluation of the medication delivery process at LIFE healthcare / by Indren Rama Poovan

    OpenAIRE

    Poovan, Indren Rama

    2007-01-01

    The medication administration process in Life Healthcare is a complex, multidisciplinary process with the potential for error occurring at various stages of the process. The complexity of the process makes it impossible for one solution to be considered as the "magic bullet". Building safety into the process requires interventions at various stages of this process; hence the solutions proposed. The objective of this dissertation was to evaluate nursing medication administrat...

  6. Advancing Medication Reconciliation in an Outpatient Internal Medicine Clinic through a Pharmacist-Led Educational Initiative

    Directory of Open Access Journals (Sweden)

    Sarah M. Westberg, Pharm.D.

    2010-01-01

    Full Text Available Objectives: To develop and deliver an effective pharmacist-led educational initiative to clinic staff to advance medication reconciliation in the electronic medical record of an outpatient internal medicine clinic.Methods: An educational initiative designed to improve the ability of nursing staff in medication reconciliation was launched in the outpatient internal medicine clinic of a regional healthcare system. The education was provided by the pharmacist to clinic nursing staff, including registered nurses, licensed practical nurses, and certified medical assistants. The impact of this training was measured through pre-initiation and post-implementation surveys, competency assessments and an audit. Results: The educational initiative was successfully designed and delivered to clinic nursing staff. Assessment of the initiative found that all nursing staff completing competency assessments successfully passed. Pre-initiation- and post-implementation- survey responses on the self-assessed ability to gather and document accurate medication lists did not show significant changes. Informal observations in the clinic indicated that this initiative changed the culture of the clinic, creating increased awareness of the importance of accurate medications and increased emphasis on medication reconciliation.Conclusions: The expertise of pharmacists can be utilized to educate nursing staff on the skills and abilities necessary to gather and document accurate medication lists. This study did not find measurable changes in the accuracy of medication lists in this clinic. Future research is needed to determine the best methods to train health professionals in medication reconciliation to ensure accurate medication lists in the outpatient setting.

  7. Life science, agriculture and forestry and fishery and health and medical treatment

    International Nuclear Information System (INIS)

    This book gives descriptions of future technology in Korea, by field : Life science, agriculture and forestry and fishery and health and medical treatment. It indicates the purpose of survey, survey system survey outline, characteristic of this survey, how to read the prediction of survey result, the result of survey with the tasks of survey object, field on important survey and development period of realizable prediction, obstacle of realization, propel ways for survey and development, policy tasks, important future technology chronological table, characteristic of respondent, the result of survey : Life science, agriculture and forestry and fishery and health and medical treatment.

  8. WOMEN AND ADVANCEMENT IN NEUROPSYCHOLOGY:REAL-LIFE LESSONS LEARNED

    OpenAIRE

    Hilsabeck, Robin C.; Martin, Eileen M.

    2008-01-01

    The number of women in neuropsychology has been increasing over the past 20 years while the number of women in senior and leadership positions within neuropsychology has not. The field of neuropsychology has much to gain by facilitating the advancement of women into leadership roles, including access to some of the brightest and creative minds in the field. The purpose of this article is to offer practical advice about how to overcome barriers and advance within neuropsychology. Suggestions f...

  9. Advances in intelligent analysis of medical data and decision support systems

    CERN Document Server

    Iantovics, Barna

    2013-01-01

    This volume is a result of the fruitful and vivid discussions during the MedDecSup'2012 International Workshop bringing together a relevant body of knowledge, and new developments in the increasingly important field of medical informatics. This carefully edited book presents new ideas aimed at the development of intelligent processing of various kinds of medical information and the perfection of the contemporary computer systems for medical decision support. The book presents advances of the medical information systems for intelligent archiving, processing, analysis and search-by-content which will improve the quality of the medical services for every patient and of the global healthcare system. The book combines in a synergistic way theoretical developments with the practicability of the approaches developed and presents the last developments and achievements in  medical informatics to a broad range of readers: engineers, mathematicians, physicians, and PhD students.

  10. Advanced ESPI-based medical instruments for otolaryngology

    Science.gov (United States)

    Castracane, James; Conerty, M.; Cacace, Anthony T.; Gardner, Glendon M.; Miller, Mitchell B.; Parnes, Steven M.

    1993-05-01

    Optical fibers have long been used for visual inspection inside the human body for medical diagnoses and treatment. By making use of sophisticated optical interferometric and ultra- small imaging techniques, combined with automated image processing, it is possible to extract significantly increased information for more accurate medical diagnoses. With support from NIH under the SBIR program, we have been developing a range of such instruments. One of these supported by the NIDCD is capable of providing detailed spatial information on the vibratory response of the tympanic membrane (TM). This instrument involves the examination of the TM by means of high speed electronic speckle pattern interferometry (ESPI). This provides a real time view of the vibration patterns of the TM for clinical diagnosis. This Interferometric Otoscope consists of mode conserving fiber optics, miniature diode lasers and high speed solid state detector arrays. We present the current status of the research including holography and ESPI of TM models and excised temporal bone preparations. A second instrument, also developed with support from NIDCD, is for application to the larynx. This system is also ESPI based but will incorporate features for direct vocal cord (VC) examination. By careful examination of the vibratory response of the VC during phonation, the characteristics of the mucosal wave may be examined. Adynamic regions of the cords can signal the start of lesions or cysts. Results of surgery can be evaluated in a quantitative manner. The design of a clinical prototype and preliminary electro-optic experiments on excised larynges and VC models will be presented.

  11. Evaluation of prototype Advanced Life Support (ALS) pack for use by the Health Maintenance Facility (HMF) on Space Station Freedom (SSF)

    Science.gov (United States)

    Krupa, Debra T.; Gosbee, John; Murphy, Linda; Kizzee, Victor D.

    1991-01-01

    The purpose is to evaluate the prototype Advanced Life Support (ALS) Pack which was developed for the Health Maintenance Facility (HMF). This pack will enable the Crew Medical Officer (CMO) to have ready access to advanced life support supplies and equipment for time critical responses to any situation within the Space Station Freedom. The objectives are: (1) to evaluate the design of the pack; and (2) to collect comments for revision to the design of the pack. The in-flight test procedures and other aspects of the KC-135 parabolic test flight to simulate weightlessness are presented.

  12. Life prediction methodology for ceramic components of advanced heat engines. Phase 1: Volume 1, Final report

    Energy Technology Data Exchange (ETDEWEB)

    Cuccio, J.C.; Brehm, P.; Fang, H.T. [Allied-Signal Aerospace Co., Phoenix, AZ (United States). Garrett Engine Div.] [and others

    1995-03-01

    Emphasis of this program is to develop and demonstrate ceramics life prediction methods, including fast fracture, stress rupture, creep, oxidation, and nondestructive evaluation. Significant advancements were made in these methods and their predictive capabilities successfully demonstrated.

  13. Relationship between Immunosuppressive Medications Adherence and Quality of Life and Some Patient Factors in Renal Transplant Patients in Iran

    OpenAIRE

    2014-01-01

    Background & Aim: About organ transplant, immunosuppressive medications adherence is a critical issue, because non-adherence to these medications causes rejection, reduces quality of life and increases treatment cost and mortality rate. Among these, the quality of life is deemed very important to evaluate treatment result and also it can be useful for discovering non adherence. The aim this study was to assess the relationship between medication adherence and quality of life and some patient ...

  14. In-Service Aircraft Engine System Life Monitor Using Advanced Life-Estimating Technique Project

    Data.gov (United States)

    National Aeronautics and Space Administration — It is proposed to develop an accurate in-service aircraft engine life monitor system for the prediction of remaining component and system life for aircraft engines....

  15. Independent contributors to overall quality of life in people with advanced cancer

    OpenAIRE

    M Rodríguez, A; Mayo, N. E.; Gagnon, B.

    2013-01-01

    Background: The definition of health for people with cancer is not focused solely on the physiology of illness and the length of life remaining, but is also concerned with improving the well-being and the quality of the life (QOL) remaining to be lived. This study aimed to identify the constructs most associated with QOL in people with advanced cancer. Methods: Two hundred three persons with recent diagnoses of different advanced cancers were evaluated with 65 variables representing individua...

  16. Advancing Primary Care Use of Electronic Medical Records in Canada

    Directory of Open Access Journals (Sweden)

    Jennifer Zelmer

    2014-10-01

    Full Text Available In 2010, the federal government's Economic Action Plan funded Canada Health Infoway to co-invest with provinces, territories, and health care providers in electronic medical records (EMRs in primary care. The goal is to help improve access to care, quality of health services, and productivity of the health system, as well as to deliver economic benefits. The decision to fund EMRs was consistent with a long-term framework for digital health established in consultation with stakeholders across the country, spurred by analysis demonstrating the economic impact of such investments and data on Canada's low rate of EMR use in primary care compared with other countries. The decision reflected widespread public and stakeholder consensus regarding the importance of such investments. EMR adoption has more than doubled since 2006, with evaluations identifying efficiency and patient care benefits (e.g., reduced time managing laboratory test results and fewer adverse drug events in community-based practices. These benefits are expected to rise further as EMR adoption continues to grow and practices gain more experience with their use.

  17. Frontier of Advanced Accelerator Applications and Medical Treatments Using Nuclear Techniques. Abstract

    International Nuclear Information System (INIS)

    To address the challenges of research-based practice, developing advanced accelerator applications, and medical treatments using nuclear tecniqoes, researchers from Rajamakala University of Technology Lanna, Office of Atoms for Peace, and Chiang Mai University have joined in hosting this conference. Nuclear medicine, amedical specialty, diagnoses and treats diseases in a safe and painless way. Nuclear techniques can determine medical information that may otherwise be unavailable, require surgery, or necessitate more expensive and invasive diagnostic tests. Advance in nuclear techniques also offer the potential to detect abnormalities at earlier stages, leasding to earlier treatment and a more successful prognosis.

  18. Recent advances in chemical evolution and the origins of life

    Science.gov (United States)

    Oro, John; Lazcano, Antonio

    1992-01-01

    Consideration is given to the ideas of Oparin and Haldane who independently suggested more than 60 years ago that the first forms of life were anaerobic, heterotrophic bacteria that emerged as the result of a long period of chemical abiotic synthesis of organic compounds. It is suggested that at least some requirements for life are met in the Galaxy due to the cosmic abundance of carbon, nitrogen, oxygen, and other biogenic elements; the existence of extraterrestrial organic compounds; and the processes of stellar and interstellar planetary formation.

  19. Advanced illumination control algorithm for medical endoscopy applications

    Science.gov (United States)

    Sousa, Ricardo M.; Wäny, Martin; Santos, Pedro; Morgado-Dias, F.

    2015-05-01

    CMOS image sensor manufacturer, AWAIBA, is providing the world's smallest digital camera modules to the world market for minimally invasive surgery and one time use endoscopic equipment. Based on the world's smallest digital camera head and the evaluation board provided to it, the aim of this paper is to demonstrate an advanced fast response dynamic control algorithm of the illumination LED source coupled to the camera head, over the LED drivers embedded on the evaluation board. Cost efficient and small size endoscopic camera modules nowadays embed minimal size image sensors capable of not only adjusting gain and exposure time but also LED illumination with adjustable illumination power. The LED illumination power has to be dynamically adjusted while navigating the endoscope over changing illumination conditions of several orders of magnitude within fractions of the second to guarantee a smooth viewing experience. The algorithm is centered on the pixel analysis of selected ROIs enabling it to dynamically adjust the illumination intensity based on the measured pixel saturation level. The control core was developed in VHDL and tested in a laboratory environment over changing light conditions. The obtained results show that it is capable of achieving correction speeds under 1 s while maintaining a static error below 3% relative to the total number of pixels on the image. The result of this work will allow the integration of millimeter sized high brightness LED sources on minimal form factor cameras enabling its use in endoscopic surgical robotic or micro invasive surgery.

  20. Short report: Chronic medical conditions and life satisfaction in the elderly

    OpenAIRE

    Jelicic, M.; Kempen, GIJM

    1999-01-01

    The aim of this study was to examine the effect of chronic disease on life satisfaction in community dwelling elderly. A total of 5279 research participants, mean age 69.57 (SD = 8.04) yrs, were asked to judge their life satisfaction on the Seven Point Satisfaction Rating Scale. They were also administered a checklist of 18 chronic medical conditions. The results indicate that the more chronic conditions elderly people have, the lower their life satisfaction gets. It is argued that these find...

  1. Teaching Advanced Life Sciences in an Animal Context: Agricultural Science Teacher Voices

    Science.gov (United States)

    Balschweid, Mark; Huerta, Alexandria

    2008-01-01

    The purpose of this qualitative study was to determine agricultural science teacher comfort with a new high school Advanced Life Science: Animal course and determine their perceptions of student impact. The advanced science course is eligible for college credit. The teachers revealed they felt confident of their science background in preparation…

  2. Life disruption, life continuation: contrasting themes in the lives of African-American elders with advanced heart failure.

    Science.gov (United States)

    Hopp, Faith Pratt; Thornton, Nancy; Martin, Lindsey; Zalenski, Robert

    2012-01-01

    This study addresses the need for more information about how urban African-American elders experience advanced heart failure. Participants included 35 African Americans aged 60 and over with advanced heart failure, identified through records from a community hospital in Detroit, Michigan. Four focus groups (n = 13) and 22 individual interviews were conducted. We used thematic analysis to examine qualitative focus groups and interviews. Themes identified included life disruption, which encompassed the sub-themes of living scared, making sense of heart failure, and limiting activities. Resuming life was a contrasting theme involving culturally relevant coping strategies, and included the sub-themes of resiliency, spirituality, and self-care that helped patients regain and maintain a sense of self amid serious illness. Participants faced numerous challenges and invoked a variety of strategies to cope with their illness, and their stories of struggles, hardship, and resilience can serve as a model for others struggling with advanced illness. PMID:22352363

  3. Quality of Life Is More Impaired in Patients Seeking Medical Care for Food Allergy

    NARCIS (Netherlands)

    Le, Thuy-My; Flokstra-de Blok, Bertine M. J.; van Hoffen, Els; Lebens, Ans F. M.; Goossens, Nicole J.; Dubois, Anthony E. J.; Bruijnzeel-Koomen, Carla A. F. M.; Knulst, Andre C.

    2013-01-01

    Background: Food allergy (FA) affects 2-4% of adults, but only a small percentage visit an outpatient clinic for a thorough evaluation. Methods: A matched case-control study was used to compare health-related quality of life (HRQL) of the Dutch general population that did not seek medical care for t

  4. Retention of first aid and basic life support skills in undergraduate medical students

    NARCIS (Netherlands)

    Ruijter, P.A. de; Biersteker, H.A.; Biert, J.; Goor, H. van; Tan, E.C.T.H.

    2014-01-01

    BACKGROUND: Undergraduate medical students follow a compulsory first aid (FA) and basic life support (BLS) course. Retention of BLS seems poor and only little information is provided on the retention of FA skills. This study aims at evaluating 1- and 2-year retention of FA and BLS training in underg

  5. Advancing Literacy: A Review of LIFE 2006-2009

    Science.gov (United States)

    Hanemann, Ulrike

    2009-01-01

    When it became clear that existing literacy efforts would not be enough to enable some countries to reach Education for All (EFA) Goal 4 (a 50 percent improvement in levels of adult literacy), UNESCO launched the Literacy Initiative for Empowerment (LIFE, 2006-2015). 35 countries with literacy rates below 50 percent and/or a population of more…

  6. GEOGRAPHIC MEDICAL HISTORY: ADVANCES IN GEOSPATIAL TECHNOLOGY PRESENT NEW POTENTIALS IN MEDICAL PRACTICE

    OpenAIRE

    Faruque, F. S.; Finley, R W

    2016-01-01

    Genes, behaviour, and the environment are known to be the major risk factors for common diseases. When the patient visits a physician, typical questions include family history (genes) and lifestyle of the patient (behaviour), but questions concerning environmental risk factors often remain unasked. It is ironic that 25 centuries ago Hippocrates, known as the father of medicine, noted the importance of environmental exposure in medical investigation as documented in his classic work, “Airs, Wa...

  7. Nurses' knowledge of advance directives and perceived confidence in end-of-life care: a cross-sectional study in five countries.

    LENUS (Irish Health Repository)

    Coffey, Alice

    2016-01-28

    Nurses\\' knowledge regarding advance directives may affect their administration and completion in end-of-life care. Confidence among nurses is a barrier to the provision of quality end-of-life care. This study investigated nurses\\' knowledge of advance directives and perceived confidence in end-of-life care, in Hong Kong, Ireland, Israel, Italy and the USA using a cross-sectional descriptive design (n = 1089). In all countries, older nurses and those who had more professional experience felt more confident managing patients\\' symptoms at end-of-life and more comfortable stopping preventive medications at end-of-life. Nurses in the USA reported that they have more knowledge and experience of advance directives compared with other countries. In addition, they reported the highest levels of confidence and comfort in dealing with end-of-life care. Although legislation for advance directives does not yet exist in Ireland, nurses reported high levels of confidence in end-of-life care.

  8. Medical student quality-of-life in the clerkships: a scale validation study.

    Science.gov (United States)

    Brannick, Michael T; Horn, Gregory T; Schnaus, Michael J; Wahi, Monika M; Goldin, Steven B

    2015-04-01

    Many aspects of medical school are stressful for students. To empirically assess student reactions to clerkship programs, or to assess efforts to improve such programs, educators must measure the overall well-being of the students reliably and validly. The purpose of the study was to develop and validate a measure designed to achieve these goals. The authors developed a measure of quality of life for medical students by sampling (public domain) items tapping general happiness, fatigue, and anxiety. A quality-of-life scale was developed by factor analyzing responses to the items from students in two different clerkships from 2005 to 2008. Reliability was assessed using Cronbach's alpha. Validity was assessed by factor analysis, convergence with additional theoretically relevant scales, and sensitivity to change over time. The refined nine-item measure is a Likert scaled survey of quality-of-life items comprised of two domains: exhaustion and general happiness. The resulting scale demonstrated good reliability and factorial validity at two time points for each of the two samples. The quality-of-life measure also correlated with measures of depression and the amount of sleep reported during the clerkships. The quality-of-life measure appeared more sensitive to changes over time than did the depression measure. The measure is short and can be easily administered in a survey. The scale appears useful for program evaluation and more generally as an outcome variable in medical educational research. PMID:25831183

  9. Quality of life of medical students in China: a study using the WHOQOL-BREF.

    Directory of Open Access Journals (Sweden)

    Yang Zhang

    Full Text Available OBJECTIVE: The aim of this study was to assess the quality of life (QOL of medical students during their medical education and explore the influencing factors of the QOL of students. METHODS: A cross-sectional study was conducted in June 2011. The study population was composed of 1686 medical students in years 1 to 5 at China Medical University. The Chinese version of WHOQOL-BREF instrument was used to assess the QOL of medical students. The reliability and validity of the questionnaire were assessed by Cronbach's α coefficient and factor analysis respectively. The relationships between QOL and the factors including gender, academic year level, and specialty were examined using t-test or one-way ANOVA followed by Student-Newman-Keuls test. Statistic analysis was performed by SPSS 13.0. RESULTS: The overall Cronbach's α coefficient of the WHOQOL-BREF questionnaire was 0.731. The confirmatory factor analysis provided an acceptable fit to a four-factor model in the medical student sample. The scores of different academic years were significantly different in the psychological health and social relations domains (p<0.05. Third year students had the lowest scores in psychological health and social relations domains. The scores of different specialties had significant differences in psychological health and social relations domains (p<0.05. Students from clinical medicine had the highest scores. Gender, interest in the area of study, confidence in career development, hometown location, and physical exercise were significantly associated with the quality of life of students in some domains (p<0.05. CONCLUSIONS: The WHOQOL-BREF was reliable and valid in the assessment of the QOL of Chinese medical students. In order to cope with the influencing factors of the QOL, medical schools should carry out curriculum innovation and give the necessary support for medical students, especially for 3(rd year students.

  10. The role of advance directives in end-of-life decisions in Austria: survey of intensive care physicians

    Directory of Open Access Journals (Sweden)

    Schopper Andrea

    2010-10-01

    Full Text Available Abstract Background Currently, intensive care medicine strives to define a generally accepted way of dealing with end-of-life decisions, therapy limitation and therapy discontinuation. In 2006 a new advance directive legislation was enacted in Austria. Patients may now document their personal views regarding extension of treatment. The aim of this survey was to explore Austrian intensive care physicians' experiences with and their acceptance of the new advance directive legislation two years after enactment (2008. Methods Under the aegis of the OEGARI (Austrian Society of Anaesthesiology, Resuscitation and Intensive Care an anonymised questionnaire was sent to the medical directors of all intensive care units in Austria. The questions focused on the physicians' experiences regarding advance directives and their level of knowledge about the underlying legislation. Results There were 241 questionnaires sent and 139 were turned, which was a response rate of 58%. About one third of the responders reported having had no experience with advance directives and only 9 directors of intensive care units had dealt with more than 10 advance directives in the previous two years. Life-supporting measures, resuscitation, and mechanical ventilation were the predominantly refused therapies, wishes were mainly expressed concerning pain therapy. Conclusion A response rate of almost 60% proves the great interest of intensive care professionals in making patient-oriented end-of-life decisions. However, as long as patients do not make use of their right of co-determination, the enactment of the new law can be considered only a first important step forward.

  11. Do stressful life events predict medical treatment outcome in first episode of depression?

    DEFF Research Database (Denmark)

    Bock, Camilla; Bukh, Jens Drachmann; Vinberg, Maj;

    2009-01-01

    BACKGROUND: It is unclear whether medical treatment outcome in first episode depression differ for patients with and without stressful life events prior to onset of depression. METHODS: Patients discharged with a diagnosis of a single depressive episode from a psychiatric in- or outpatient hospital...... interview of recent life events (IRLE). Medical treatment history was assessed in detail using standardised procedures (TRAQ). Remission was defined as a score or= 4 on TRAQ following (1) first trial of antidepressant treatment (2) two...... adequate trials of antidepressant treatment. RESULTS: A total of 399 patients participated in the interview and among these 301 patients obtained a SCAN diagnosis of a single depressive episode. A total of 62.8% of the 301 patients experienced at least one moderate to severe stressful life event in a 6...

  12. Conceptualisation of the characteristics of advanced practitioners in the medical radiation professions.

    Science.gov (United States)

    Smith, Tony; Harris, Jillian; Woznitza, Nick; Maresse, Sharon; Sale, Charlotte

    2015-09-01

    Professions grapple with defining advanced practice and the characteristics of advanced practitioners. In nursing and allied health, advanced practice has been defined as 'a state of professional maturity in which the individual demonstrates a level of integrated knowledge, skill and competence that challenges the accepted boundaries of practice and pioneers new developments in health care'. Evolution of advanced practice in Australia has been slower than in the United Kingdom, mainly due to differences in demography, the health system and industrial relations. This article describes a conceptual model of advanced practitioner characteristics in the medical radiation professions, taking into account experiences in other countries and professions. Using the CanMEDS framework, the model includes foundation characteristics of communication, collaboration and professionalism, which are fundamental to advanced clinical practice. Gateway characteristics are: clinical expertise, with high level competency in a particular area of clinical practice; scholarship and teaching, including a masters qualification and knowledge dissemination through educating others; and evidence-based practice, with judgements made on the basis of research findings, including research by the advanced practitioner. The pinnacle of advanced practice is clinical leadership, where the practitioner has a central role in the health care team, with the capacity to influence decision making and advocate for others, including patients. The proposed conceptual model is robust yet adaptable in defining generic characteristics of advanced practitioners, no matter their clinical specialty. The advanced practice roles that evolve to meet future health service demand must focus on the needs of patients, local populations and communities. PMID:26451243

  13. Conceptualisation of the characteristics of advanced practitioners in the medical radiation professions

    International Nuclear Information System (INIS)

    Professions grapple with defining advanced practice and the characteristics of advanced practitioners. In nursing and allied health, advanced practice has been defined as ‘a state of professional maturity in which the individual demonstrates a level of integrated knowledge, skill and competence that challenges the accepted boundaries of practice and pioneers new developments in health care’. Evolution of advanced practice in Australia has been slower than in the United Kingdom, mainly due to differences in demography, the health system and industrial relations. This article describes a conceptual model of advanced practitioner characteristics in the medical radiation professions, taking into account experiences in other countries and professions. Using the CanMEDS framework, the model includes foundation characteristics of communication, collaboration and professionalism, which are fundamental to advanced clinical practice. Gateway characteristics are: clinical expertise, with high level competency in a particular area of clinical practice; scholarship and teaching, including a masters qualification and knowledge dissemination through educating others; and evidence-based practice, with judgements made on the basis of research findings, including research by the advanced practitioner. The pinnacle of advanced practice is clinical leadership, where the practitioner has a central role in the health care team, with the capacity to influence decision making and advocate for others, including patients. The proposed conceptual model is robust yet adaptable in defining generic characteristics of advanced practitioners, no matter their clinical specialty. The advanced practice roles that evolve to meet future health service demand must focus on the needs of patients, local populations and communities

  14. Conceptualisation of the characteristics of advanced practitioners in the medical radiation professions

    Energy Technology Data Exchange (ETDEWEB)

    Smith, Tony [University of Newcastle Department of Rural Health, Taree, New South Wales (Australia); Harris, Jillian [Crown Princess Mary Cancer Centre, Westmead, Sydney, New South Wales (Australia); Woznitza, Nick [Homerton University Hospital and School of Allied Health Professions, Canterbury Christ Church University, Canterbury (Australia); Maresse, Sharon [Department of Imaging and Applied Physics, Curtin University, Perth, Western Australia (Australia); Sale, Charlotte [School of Medical Science, RMIT University, Melbourne, Victoria (Australia); University of Newcastle Department of Rural Health, Taree, New South Wales (Australia)

    2015-09-15

    Professions grapple with defining advanced practice and the characteristics of advanced practitioners. In nursing and allied health, advanced practice has been defined as ‘a state of professional maturity in which the individual demonstrates a level of integrated knowledge, skill and competence that challenges the accepted boundaries of practice and pioneers new developments in health care’. Evolution of advanced practice in Australia has been slower than in the United Kingdom, mainly due to differences in demography, the health system and industrial relations. This article describes a conceptual model of advanced practitioner characteristics in the medical radiation professions, taking into account experiences in other countries and professions. Using the CanMEDS framework, the model includes foundation characteristics of communication, collaboration and professionalism, which are fundamental to advanced clinical practice. Gateway characteristics are: clinical expertise, with high level competency in a particular area of clinical practice; scholarship and teaching, including a masters qualification and knowledge dissemination through educating others; and evidence-based practice, with judgements made on the basis of research findings, including research by the advanced practitioner. The pinnacle of advanced practice is clinical leadership, where the practitioner has a central role in the health care team, with the capacity to influence decision making and advocate for others, including patients. The proposed conceptual model is robust yet adaptable in defining generic characteristics of advanced practitioners, no matter their clinical specialty. The advanced practice roles that evolve to meet future health service demand must focus on the needs of patients, local populations and communities.

  15. End-of-life communication in Korean older adults: With focus on advance care planning and advance directives.

    Science.gov (United States)

    Shin, Dong Wook; Lee, Ji Eun; Cho, BeLong; Yoo, Sang Ho; Kim, SangYun; Yoo, Jun-Hyun

    2016-04-01

    The present article aimed to provide a comprehensive review of current status of end-of-life (EOL) care and sociocultural considerations in Korea, with focus on the EOL communication and use of advance directives (AD) in elderly Koreans. Through literature review, we discuss the current status of EOL care and sociocultural considerations in Korea, and provide a look-ahead. In Korea, patients often receive life-sustaining treatment until the very end of life. Advance care planning is rare, and most do-not-resuscitate decisions are made between the family and physician at the very end of patient's life. Koreans, influenced mainly by Confucian tradition, prefer a natural death and discontinuation of life-sustaining treatment. Although Koreans generally believe that death is natural and unavoidable, they tend not to think about or discuss death, and regard preparation for death as unnecessary. As a result, AD are completed by just 4.7% of the general adult population. This situation can be explained by several sociocultural characteristics including opting for natural death, wish not to burden others, preference for family involvement and trust in doctor, avoidance of talking about death, and filial piety. Patients often receive life-sustaining treatment until the very EOL, advance care planning and the use of AD is not common in Korea. This was related to unique sociocultural characteristics of Korea. A more active role of physicians, development of a more deliberate EOL discussion process, development of culturally appropriate AD and promotion of advance care planning might be required to provide good EOL care in Korea. Geriatr Gerontol Int 2016; 16: 407-415. PMID:26459613

  16. Recent advance in life prediction for HTGR applications

    International Nuclear Information System (INIS)

    Key issues in design methods at high temperatures for an HTGR regime are creep constitutive equations. The life in service of structural components is controlled by creep damage. A creep constitutive equation is then needed to calculate inelastic stress-strain components. The method for life prediction, applicable to this temperature regime, has been investigated. The ductility exhaustion rule in conjunction with the creep constitutive equation is confirmed to be useful from the point of view of methodology. Creep-fatigue damage for Hastelloy XRs was assessed by this method in conjunction with the Miner's rule. It is found that the ductility exhaustion for creep damage has a tendency to estimate creep damage larger than the time faction that is often used conventionally. Creep damage under compressive stress should be evaluated at high temperatures. (Author)

  17. Advances in fatigue life prediction methodology for metallic materials

    Science.gov (United States)

    Newman, J. C., Jr.

    1992-01-01

    The capabilities of a plasticity-induced crack-closure model to predict small- and large-crack growth rates, and in some cases total fatigue life, for four aluminum alloys and three titanium alloys under constant-amplitude, variable-amplitude, and spectrum loading are described. Equations to calculate a cyclic-plastic-zone corrected effective stress-intensity factor range from a cyclic J-integral and crack-closure analysis of large cracks were reviewed. The effective stress-intensity factor range against crack growth rate relations were used in the closure model to predict small- and large-crack growth under variable-amplitude and spectrum loading. Using the closure model and microstructural features, a total fatigue life prediction method is demonstrated for three aluminum alloys under various load histories.

  18. Life prediction of advanced materials for gas turbine application

    Energy Technology Data Exchange (ETDEWEB)

    Zamrik, S.Y.; Ray, A.; Koss, D.A. [Pennsylvania State Univ., University Park, PA (United States)

    1995-10-01

    Most of the studies on the low cycle fatigue life prediction have been reported under isothermal conditions where the deformation of the material is strain dependent. In the development of gas turbines, components such as blades and vanes are exposed to temperature variations in addition to strain cycling. As a result, the deformation process becomes temperature and strain dependent. Therefore, the life of the component becomes sensitive to temperature-strain cycling which produces a process known as {open_quotes}thermomechanical fatigue, or TMF{close_quotes}. The TMF fatigue failure phenomenon has been modeled using conventional fatigue life prediction methods, which are not sufficiently accurate to quantitatively establish an allowable design procedure. To add to the complexity of TMF life prediction, blade and vane substrates are normally coated with aluminide, overlay or thermal barrier type coatings (TBC) where the durability of the component is dominated by the coating/substrate constitutive response and by the fatigue behavior of the coating. A number of issues arise from TMF depending on the type of temperature/strain phase cycle: (1) time-dependent inelastic behavior can significantly affect the stress response. For example, creep relaxation during a tensile or compressive loading at elevated temperatures leads to a progressive increase in the mean stress level under cyclic loading. (2) the mismatch in elastic and thermal expansion properties between the coating and the substrate can lead to significant deviations in the coating stress levels due to changes in the elastic modulii. (3) the {open_quotes}dry{close_quotes} corrosion resistance coatings applied to the substrate may act as primary crack initiation sites. Crack initiation in the coating is a function of the coating composition, its mechanical properties, creep relaxation behavior, thermal strain range and the strain/temperature phase relationship.

  19. Radiation Protection in Medical Physics : Proceedings of the NATO Advanced Study Institute on Radiation Protection in Medical Physics Activities

    CERN Document Server

    Lemoigne, Yves

    2011-01-01

    This book introduces the fundamental aspects of Radiation Protection in Medical Physics and covers three main themes: General Radiation Protection Principles; Radiobiology Principles; Radiation Protection in Hospital Medical Physics. Each of these topics is developed by analysing the underlying physics principles and their implementation, quality and safety aspects, clinical performance and recent advances in the field. Some issues specific to the individual techniques are also treated, e.g. calculation of patient dose as well as that of workers in hospital, optimisation of equipment used, shielding design of radiation facilities, radiation in oncology such as use of brachytherapy in gynecology or interventional procedures. All topics are presented with didactical language and style, making this book an appropriate reference for students and professionals seeking a comprehensive introduction to the field as well as a reliable overview of the most recent developments.

  20. Life cycle assessment of advanced waste water treatment

    DEFF Research Database (Denmark)

    Larsen, Henrik Fred; Hansen, Peter Augusto

    The EU FP6 NEPTUNE project is related to the EU Water Framework Directive and the main goal is to develop new and optimize existing waste water treatment technologies (WWTT) and sludge handling methods for municipal waste water. Besides nutrients, a special focus area is micropollutants (e...... induced impacts as compared to avoided impacts is introduced in the life cycle impact assessment (LCIA) part. Furthermore, as novel approaches, potential ecotoxicity impact from a high number of micropollutants and the potential impact from pathogens (and whole effluent toxicity) are to be included. In...

  1. Encountering Challenges with the EU Regulation on Advance Therapy Medical Products.

    Science.gov (United States)

    Mansnérus, Juli

    2015-12-01

    This article aims at analysing how well the Advanced Therapy Medical Product Regulation (EC) No. 1394/2007 (ATMP Regulation) meets the needs of small and medium-sized enterprises (SMES), academia and public tissue establishments developing advanced therapy medical products (ATMPS). Benefits and shortcomings of the ATMP Regulation are identified, and possible amendments are proposed to accelerate the translation of research into advanced therapies and to facilitate the commercialisation of ATMPS whilst ensuring safety. It was set up as a lex specialis to ensure the free movement of ATMPS within the EU in order to facilitate their access to the internal market and to foster the competitiveness of European pharmaceutical companies, while guaranteeing the highest level protection of public health. Since the adoption of the ATMP Regulation in late 2008, only 5 ATMPS have been granted marketing authorisations thus far. Hence, there is a need to analyse whether the ATMP Regulation meets its objectives. PMID:26665690

  2. Quality of Basic Life Support – A Comparison between Medical Students and Paramedics

    Science.gov (United States)

    Köhler, Thomas; Weiss, Verena; Pfister, Roman; Michels, Guido

    2016-01-01

    Introduction Poor survival rates after cardiac arrest can partly be explained by poor basic life support skills in medical professionals. Aim This study aimed to assess quality of basic life support in medical students and paramedics. Materials and Methods We conducted a prospective observational study with 100 early medical students (group A), 100 late medical students (group B) and 100 paramedics (group C), performing a 20-minute basic life support simulation in teams of two. Average frequency and absolute number of chest compressions per minute (mean (±SD)), chest decompression (millimetres of compression remaining, mean (±SD)), hands-off-time (seconds/minute, mean (±SD)), frequency of switching positions between ventilation and chest compression (per 20 minutes) and rate of sufficient compressions (depth ≥50mm) were assessed as quality parameters of CPR. Results In groups A, B and C the rates of sufficiently deep chest compressions were 56%, 42% and 52%, respectively, without significant differences. Male gender and real-life CPR experience were significantly associated with deeper chest compression. Frequency and number of chest compressions were within recommended goals in at least 96% of all groups. Remaining chest compressions were 6 mm (±2), 6 mm (±2) and 5 mm (±2) with a significant difference between group A and C (p=0.017). Hands-off times were 6s/min (±1), 5s/min (±1) and 4s/min (±1), which was significantly different across all three groups. Conclusion Overall, paramedics tended to show better quality of CPR compared to medical students. Though, chest compression depth as an important quality characteristic of CPR was insufficient in almost 50% of participants, even in well trained paramedics. Therefore, we suggest that an effort should be made to find better ways to educate health care professionals in BLS.

  3. Transition to life--a sendoff to the real world for graduating medical students.

    Science.gov (United States)

    Coates, Wendy C; Spector, Tahlia S; Uijtdehaage, Sebastian

    2012-01-01

    Graduating medical students will enter the workforce, often for the first time. Many have spent the past 20 years as students, receiving financial support from parents, and have not managed real-life issues such as financial planning, real estate, balancing well-being with employment, and integrating into a new community with stressful working conditions. To address a perceived need, we designed an intervention to introduce graduating medical students to financial planning, real estate choices, physician wellness during relocation/internship, and traits of efficient interns. The objectives of this study are to (a) assess baseline experience, knowledge, and comfort of seniors about "real-life" experiences, and (b) assess the efficacy of a 4-hr educational intervention on perceptions of understanding financial planning, real estate choices, intern preparedness, and physician wellness. Acute Care College seniors (classes of 2009 and 2010) attended the intervention after match day and completed a survey to gather demographic data and assess preexisting knowledge and a postintervention survey (1-7 Likert scale). Forty-nine students (45% male; M age = 25.5 years) participated. Prior experiences: 43% no break in education, 51% no full-time job, 38% never signed a rental lease and 94% had not purchased real estate, 90% did not have (or were not aware of having) disability insurance, and 82% had educational debt exceeding $50,000. Following the workshop, students felt more confident in their understanding of life skills topics (real estate, 83%; financial planning, 94%; well-being, 86%). Our workshop assisted in preparing for life after medical school for 98% of the participants. Graduating medical students can gain knowledge about real-life responsibilities and confidence during an educational session prior to starting residency. PMID:22250934

  4. Globular Clusters as Cradles of Life and Advanced Civilizations

    CERN Document Server

    Di Stefano, R

    2016-01-01

    Globular clusters are ancient stellar populations with no star formation or core-collapse supernovae. Several lines of evidence suggest that globular clusters are rich in planets. If so, and if advanced civilizations can develop there, then the distances between these civilizations and other stars would be far smaller than typical distances between stars in the Galactic disk. The relative proximity would facilitate interstellar communication and travel. However, the very proximity that promotes interstellar travel also brings danger, since stellar interactions can destroy planetary systems. However, by modeling globular clusters and their stellar populations, we find that large regions of many globular clusters can be thought of as "sweet spots" where habitable-zone planetary orbits can be stable for long times. We also compute the ambient densities and fluxes in the regions within which habitable-zone planets can survive. Globular clusters are among the best targets for searches for extraterrestrial intellig...

  5. The life aquatic: advances in marine vertebrate genomics.

    Science.gov (United States)

    Kelley, Joanna L; Brown, Anthony P; Therkildsen, Nina Overgaard; Foote, Andrew D

    2016-07-01

    The ocean is hypothesized to be where life on earth originated, and subsequent evolutionary transitions between marine and terrestrial environments have been key events in the origin of contemporary biodiversity. Here, we review how comparative genomic approaches are an increasingly important aspect of understanding evolutionary processes, such as physiological and morphological adaptation to the diverse habitats within the marine environment. In addition, we highlight how population genomics has provided unprecedented resolution for population structuring, speciation and adaptation in marine environments, which can have a low cost of dispersal and few physical barriers to gene flow, and can thus support large populations. Building upon this work, we outline the applications of genomics tools to conservation and their relevance to assessing the wide-ranging impact of fisheries and climate change on marine species. PMID:27376488

  6. Reproducible analyses of microbial food for advanced life support systems

    Science.gov (United States)

    Petersen, Gene R.

    1988-01-01

    The use of yeasts in controlled ecological life support systems (CELSS) for microbial food regeneration in space required the accurate and reproducible analysis of intracellular carbohydrate and protein levels. The reproducible analysis of glycogen was a key element in estimating overall content of edibles in candidate yeast strains. Typical analytical methods for estimating glycogen in Saccharomyces were not found to be entirely aplicable to other candidate strains. Rigorous cell lysis coupled with acid/base fractionation followed by specific enzymatic glycogen analyses were required to obtain accurate results in two strains of Candida. A profile of edible fractions of these strains was then determined. The suitability of yeasts as food sources in CELSS food production processes is discussed.

  7. Advanced Life Support Project: Crop Experiments at Kennedy Space Center

    Science.gov (United States)

    Sager, John C.; Stutte, Gary W.; Wheeler, Raymond M.; Yorio, Neil

    2004-01-01

    Crop production systems provide bioregenerative technologies to complement human crew life support requirements on long duration space missions. Kennedy Space Center has lead NASA's research on crop production systems that produce high value fresh foods, provide atmospheric regeneration, and perform water processing. As the emphasis on early missions to Mars has developed, our research focused on modular, scalable systems for transit missions, which can be developed into larger autonomous, bioregenerative systems for subsequent surface missions. Components of these scalable systems will include development of efficient light generating or collecting technologies, low mass plant growth chambers, and capability to operate in the high energy background radiation and reduced atmospheric pressures of space. These systems will be integrated with air, water, and thermal subsystems in an operational system. Extensive crop testing has been done for both staple and salad crops, but limited data is available on specific cultivar selection and breadboard testing to meet nominal Mars mission profiles of a 500-600 day surface mission. The recent research emphasis at Kennedy Space Center has shifted from staple crops, such as wheat, soybean and rice, toward short cycle salad crops such as lettuce, onion, radish, tomato, pepper, and strawberry. This paper will review the results of crop experiments to support the Exploration Initiative and the ongoing development of supporting technologies, and give an overview of capabilities of the newly opened Space Life Science (SLS) Lab at Kennedy Space Center. The 9662 square m (104,000 square ft) SLS Lab was built by the State of Florida and supports all NASA research that had been performed in Hanger-L. In addition to NASA research, the SLS Lab houses the Florida Space Research Institute (FSRI), responsible for co-managing the facility, and the University of Florida (UF) has established the Space Agriculture and Biotechnology Research and

  8. Life satisfaction and resilience in medical school – a six-year longitudinal, nationwide and comparative study

    Directory of Open Access Journals (Sweden)

    Gronvold Nina T

    2006-09-01

    Full Text Available Abstract Background This study examined the relationship between life satisfaction among medical students and a basic model of personality, stress and coping. Previous studies have shown relatively high levels of distress, such as symptoms of depression and suicidal thoughts in medical undergraduates. However despite the increased focus on positive psychological health and well-being during the past decades, only a few studies have focused on life satisfaction and coping in medical students. This is the first longitudinal study which has identified predictors of sustained high levels of life satisfaction among medical students. Methods This longitudinal, nationwide questionnaire study examined the course of life satisfaction during medical school, compared the level of satisfaction of medical students with that of other university students, and identified resilience factors. T-tests were used to compare means of life satisfaction between and within the population groups. K-means cluster analyses were applied to identify subgroups among the medical students. Analysis of Variance (ANOVA and logistic regression analyses were used to compare the subgroups. Results Life satisfaction decreased during medical school. Medical students were as satisfied as other students in the first year of study, but reported less satisfaction in their graduation year. Medical students who sustained high levels of life satisfaction perceived medical school as interfering less with their social and personal life, and were less likely to use emotion focused coping, such as wishful thinking, than their peers. Conclusion Medical schools should encourage students to spend adequate time on their social and personal lives and emphasise the importance of health-promoting coping strategies.

  9. The art of perception: from the life world to the medical gaze and back again.

    Science.gov (United States)

    Hick, C

    1999-01-01

    Perceptions are often merely regarded as the basic elements of knowledge. They have, however, a complex structure of their own and are far from being elementary. My paper will analyze two basic patterns of perception and some of the resulting medical implications. Most basically, all object perception is characterized by a mixture of knowledge and ignorance (Husserl). Perception essentially perceives with inner and outer horizons, brought about by the kinesthetic activity of the perceiving subject (Sartre). This first layer of perceptual reality, the world of "open" perceptions, is the inescapable background for "every rationality, every value, every existence" (Merleau-Ponty). On an epistemological level a characteristic change of perceptual patterns in medicine was introduced by pathological anatomy (Foucault). The reference of medical perception to the dead body created the new possibility of "absolute" perception, allowing for more precise medical interventions, but at the same time coming into conflict with the open structures of "ordinary," non-scientific perception patterns in everyday life. On the basis of these distinctions, an analysis of the different perceptual patterns in medicine becomes possible. Such an analysis would be the task of a sub-field in medical philosophy that could be called "medical aesthetics" having as its goal an "art of perception" understood as a technique of adequately applying different perceptual patterns in medical practice. PMID:11080980

  10. Advancing Integrated Systems Modelling Framework for Life Cycle Sustainability Assessment

    Directory of Open Access Journals (Sweden)

    Anthony Halog

    2011-02-01

    Full Text Available The need for integrated methodological framework for sustainability assessment has been widely discussed and is urgent due to increasingly complex environmental system problems. These problems have impacts on ecosystems and human well-being which represent a threat to economic performance of countries and corporations. Integrated assessment crosses issues; spans spatial and temporal scales; looks forward and backward; and incorporates multi-stakeholder inputs. This study aims to develop an integrated methodology by capitalizing the complementary strengths of different methods used by industrial ecologists and biophysical economists. The computational methodology proposed here is systems perspective, integrative, and holistic approach for sustainability assessment which attempts to link basic science and technology to policy formulation. The framework adopts life cycle thinking methods—LCA, LCC, and SLCA; stakeholders analysis supported by multi-criteria decision analysis (MCDA; and dynamic system modelling. Following Pareto principle, the critical sustainability criteria, indicators and metrics (i.e., hotspots can be identified and further modelled using system dynamics or agent based modelling and improved by data envelopment analysis (DEA and sustainability network theory (SNT. The framework is being applied to development of biofuel supply chain networks. The framework can provide new ways of integrating knowledge across the divides between social and natural sciences as well as between critical and problem-solving research.

  11. Advanced Life Support Food Subsystem Salad Crop Requirements

    Science.gov (United States)

    Perchonok, Michele H.; Stevens, Irene; Swango, Beverly E.; Toerne, Mary E.; Lane, Helen W. (Technical Monitor)

    2002-01-01

    As the National Aeronautics and Space Administration (NASA) begins to look towards longer duration space flights, the importance of fresh foods and varied menu choices increases. Long duration space missions require development of both a Transit Food System and a Lunar or Planetary Food System. These two systems are intrinsically different since the first one will be utilized in the transit vehicle in microgravity conditions while the second will be used in conditions of partial gravity (hypogravity). The Transit Food System will consist of prepackaged food of extended shelf life. Microgravity imposes significant limitations on the ability of the crew to handle food and allows only for minimal processing. Salad crops will be available for the planetary mission. Supplementing the transit food system with salad crops is also being considered. These crops will include carrots, tomatoes, lettuce, radish, spinach, chard, cabbage, and onion. The crops will be incorporated in the menu along with the prepackaged food. The fresh tasting salad crops will provide variety, texture, and color in the menu. This variety should provide increased psychological benefit. Preliminary studies on spinach, tomatoes, and bok choy have been completed. Sensory and analytical tests, including color and moisture were conducted on the chamber grown crops and compared to store bought spinach, tomatoes, and bok choy. Preliminary studies of the appropriate serving sizes and number of servings per week have also been conducted.

  12. A novel medical image data-based multi-physics simulation platform for computational life sciences

    OpenAIRE

    Neufeld, Esra; Szczerba, Dominik; Chavannes, Nicolas; Kuster, Niels

    2013-01-01

    Simulating and modelling complex biological systems in computational life sciences requires specialized software tools that can perform medical image data-based modelling, jointly visualize the data and computational results, and handle large, complex, realistic and often noisy anatomical models. The required novel solvers must provide the power to model the physics, biology and physiology of living tissue within the full complexity of the human anatomy (e.g. neuronal activity, perfusion and ...

  13. Quality of life of glaucoma patients under medical therapy with different prostaglandins

    Directory of Open Access Journals (Sweden)

    Paletta Guedes RA

    2012-10-01

    Full Text Available Ricardo Augusto Paletta Guedes,1–3 Vanessa Maria Paletta Guedes,1–3, Sirley Maria Freitas,2 Alfredo Chaoubah11Federal University of Juiz de Fora, Juiz de Fora, Minas Gerais, Brazil; 2Paletta Guedes Ophthalmological Center, Juiz de Fora, MG, Brazil; 3Santa Casa de Misericórdia Hospital, Juiz de Fora, Minas Gerais, BrazilPurpose: To assess the quality of life of glaucoma patients under medical therapy with different prostaglandin analogs.Methods: A cross-sectional study of consecutive glaucoma patients was designed. We assessed the patients' quality of life through the Brazilian 25-question version of the National Eye Institute Visual Functioning Questionnaire, comprising 12 subscales (general health, general vision, ocular pain, near vision, distance vision, social function, mental health, role limitations, dependency, driving, color vision, and peripheral vision and a total composite score. Clinical features, including current medical treatment, were obtained from each patient's medical record. Three groups of patients were identified according to the prostaglandin in use: bimatoprost, latanoprost, or travoprost. The main outcome measures were: mean score in each subscale and mean total composite score.Results: The mean total composite score for the whole group was 70.60. The bimatoprost, latanoprost, and travoprost groups had the following mean composite scores, respectively: 56.56, 77.36, and 71.08 (P = 0.001, analysis of variance [ANOVA]. Latanoprost and travoprost results were similar, and both were superior to bimatoprost. Most subscales had similar results. The subscale with the lowest score for all groups was general health. Groups were homogenous and comparable.Conclusion: There is a difference in the quality of life between glaucoma patients using prostaglandin analogs. It seems that bimatoprost users have lower QoL when compared to latanoprost and travoprost users.Keywords: glaucoma, medical treatment, prostaglandin analogs

  14. Quality of life, treatment adherence, and locus of control: multiple family groups for chronic medical illnesses.

    Science.gov (United States)

    López-Larrosa, Silvia

    2013-12-01

    The Multiple Family Groups (MFGs) approach for patients with a chronic medical illness and their families is a structured psychoeducational program that unfolds in six weekly 90-minute sessions. In the MFGs, patients and family members explore new ways to balance illness and nonillness priorities in family life (Steinglass, 1998; Steinglass, 2000 Cuadernos de Terapia Familiar, 44-45, 11; Steinglass, Ostroff, & Steinglass, 2011 Family Process, 50, 393). PMID:24329410

  15. Palliative and end of life care communication as emerging priorities in postgraduate medical education

    OpenAIRE

    des Ordons, Amanda Roze; Ajjawi, Rola; MacDonald, John; Sarti, Aimee; Lockyer, Jocelyn; Hartwick, Michael

    2016-01-01

    Background Reliance on surveys and qualitative studies of trainees to guide postgraduate education about palliative and end of life (EOL) communication may lead to gaps in the curriculum. We aimed to develop a deeper understanding of internal medicine trainees’ educational needs for a palliative and EOL communication curriculum and how these needs could be met. Methods Mixed methods, including a survey and focus groups with trainees, and interviews with clinical faculty and medical educators,...

  16. Relationship among Medical Student Resilience, Educational Environment and Quality of Life.

    Directory of Open Access Journals (Sweden)

    Patricia Tempski

    Full Text Available Resilience is a capacity to face and overcome adversities, with personal transformation and growth. In medical education, it is critical to understand the determinants of a positive, developmental reaction in the face of stressful, emotionally demanding situations. We studied the association among resilience, quality of life (QoL and educational environment perceptions in medical students.We evaluated data from a random sample of 1,350 medical students from 22 Brazilian medical schools. Information from participants included the Wagnild and Young's resilience scale (RS-14, the Dundee Ready Educational Environment Measure (DREEM, the World Health Organization Quality of Life questionnaire - short form (WHOQOL-BREF, the Beck Depression Inventory (BDI and the State-Trait Anxiety Inventory (STAI.Full multiple linear regression models were adjusted for sex, age, year of medical course, presence of a BDI score ≥ 14 and STAI state or anxiety scores ≥ 50. Compared to those with very high resilience levels, individuals with very low resilience had worse QoL, measured by overall (β=-0.89; 95% confidence interval =-1.21 to -0.56 and medical-school related (β=-0.85; 95%CI=-1.25 to -0.45 QoL scores, environment (β=-6.48; 95%CI=-10.01 to -2.95, psychological (β=-22.89; 95%CI=-25.70 to -20.07, social relationships (β=-14.28; 95%CI=-19.07 to -9.49, and physical health (β=-10.74; 95%CI=-14.07 to -7.42 WHOQOL-BREF domain scores. They also had a worse educational environment perception, measured by global DREEM score (β=-31.42; 95%CI=-37.86 to -24.98, learning (β=-7.32; 95%CI=-9.23 to -5.41, teachers (β=-5.37; 95%CI=-7.16 to -3.58, academic self-perception (β=-7.33; 95%CI=-8.53 to -6.12, atmosphere (β=-8.29; 95%CI=-10.13 to -6.44 and social self-perception (β=-3.12; 95%CI=-4.11 to -2.12 DREEM domain scores. We also observed a dose-response pattern across resilience level groups for most measurements.Medical students with higher resilience levels

  17. Care of Patients at the End of Life: Advance Care Planning.

    Science.gov (United States)

    Ackermann, Richard J

    2016-08-01

    Advance directives are legal documents that give instructions about how to provide care when patients develop life-threatening illnesses and can no longer communicate their wishes. Two types of documents are widely used-a living will and a durable power of attorney for health care. Most states also authorize physician orders for life-sustaining treatment. Physicians should encourage patients, particularly those with severe chronic or terminal conditions, to prepare advance directives. Medicare now reimburses billing codes for advance care consultations. Directions regarding cardiopulmonary resuscitation and artificial ventilation often are included in advance care plans, and use of artificial nutrition and hydration (ANH) also should be addressed, particularly for patients with advanced dementia. Evidence shows that in such patients, ANH does not prolong survival, increase comfort, or improve quality of life. Given the lack of benefit, physicians should recommend against use of ANH for patients with dementia. Finally, physicians should encourage use of hospice services by patients whose life expectancy is 6 months or less. Although Medicare and most other health care insurers cover hospice care, and despite evidence that patient and family satisfaction increase when hospice services are used, many patients do not use these services. PMID:27490070

  18. A survey of basic life support awareness among final year undergraduate medical, dental, and nursing students

    Directory of Open Access Journals (Sweden)

    H T Srinivas

    2014-01-01

    Full Text Available Context: Cardiac arrest or respiratory arrest is the most common emergency which results in grave consequences and mortality and can be easily prevented by simple maneuvers and skills with the knowledge of basic life support (BLS, thus ensuring the survival of the patient. This study aims to assess the awareness of BLS and cardiopulmonary resuscitation (CPR among the medical, dental, and nursing students. Aims: To assess the awareness of BLS among medical, dental, and nursing undergraduate students. Settings and Design: The study was carried out on undergraduate students randomly chosen from medical college, dental college, and nursing institute using response to a structured questionnaire. Materials and Methods: A cross-sectional study was conducted in Mysore during April-May 2012 among medical, dental, and nursing student. A questionnaire was given interrogating them regarding various aspects of awareness and skills involved in BLS. The results were analyzed using an answer key employing appropriate statistical tools. Statistical Analysis Used: The data was analyzed using software version Statistical Package for Social Sciences (SPSS 12.0. Demographic data were analyzed using analysis of variance. Unpaired t-test and Chi-square tests were used where appropriate. Sample size of 500 was determined. Standard tests of significance were applied to determine the P < 0.05 was considered significant. Results: More than half of the medical students had fair knowledge of the basics in BLS. Poorer number of students had a general idea about the skills and techniques used in BLS. Response during an emergency real life situation was disappointingly low among the respondents and it was found that the students considerably lagged behind in the knowledge of cognitive and practical skills of BLS. Conclusions: We conclude that awareness regarding BLS among the study groups was varied and was generally poor, which calls for standardizing training in BLS and

  19. Process control integration requirements for advanced life support systems applicable to manned space missions

    Science.gov (United States)

    Spurlock, Paul; Spurlock, Jack M.; Evanich, Peggy L.

    1991-01-01

    An overview of recent developments in process-control technology which might have applications in future advanced life support systems for long-duration space operations is presented. Consideration is given to design criteria related to control system selection and optimization, and process-control interfacing methodology. Attention is also given to current life support system process control strategies, innovative sensors, instrumentation and control, and innovations in process supervision.

  20. The Advanced Microwave Sounding Unit-A: Antenna Number 2 Bearing Assembly Life Test

    Science.gov (United States)

    Powers, Charles E.

    1997-01-01

    Four bearing assemblies, lubricated with Apiezon C oil with 5% lead naphthenate (PbNp), were life tested in support of the Advanced Microwave Sounding Unit-A (AMSU-A). These assemblies were tested continuously for five to six years using the scanning pattern of the flight instrument. A post-life-test analysis was performed on two of the assemblies to evaluate the lubricant behavior and wear in the bearings.

  1. Preparation and Characterization of an Advanced Medical Device for Bone Regeneration

    OpenAIRE

    Dorati, Rossella; Colonna, Claudia; Genta, Ida; Bruni, Giovanna; Visai, Livia; Conti, Bice

    2013-01-01

    Tridimensional scaffolds can promote bone regeneration as a framework supporting the migration of cells from the surrounding tissue into the damaged tissue and as delivery systems for the controlled or prolonged release of cells, genes, and growth factors. The goal of the work was to obtain an advanced medical device for bone regeneration through coating a decellularized and deproteinized bone matrix of bovine origin with a biodegradable, biocompatible polymer, to improve the cell engraftment...

  2. [Life and medical missionary activities of Esther K. Pak (1877-1910)].

    Science.gov (United States)

    Lee, Bang Weon

    2007-12-01

    Esther K. Pak (1876-1910) is believed as the first medical doctor in Korea. Esther's life can be largely reviewed in three parts: school-hood at EwhaHaktang (currently Ewha Womans University), Education in the United States, and medical missionary work after coming back to Korea from the United States. The foreign Methodist missionaries was able to enter Korea after opening of its ports and establishing its diplomatic relationship with the United States. Esther met modern sciences and Christianity at EwhaHaktang, which was founded by those missionaries. She could dream of being an American-style medical doctor in the future, while she assisted medical missionaries at PoKuNyoKwan in EwhaHaktang. She could get substantial academic help from those missionaries. With the support of Dr. Rosetta Sherwood Hall, who first introduced the world of medial science to Esther in a real sense, Esther went to the United States to study the field in 1894. While learning it, she suffered from academic frustration, economic difficulty, her husband's death and so on, but she eventually got over those adversities and completed the four years of academic courses to become a medical doctor. Her religious faith and will to help Koreans as a doctor encouraged her to finish what she had originally planned. Esther came back to Korea in 1900 and began to work earnestly as a medical missionary delegated from Woman's Foreign Missionary Society. At PoKuNyoKwan in Seoul and Woman's Hospital in Pyongyang, She performed medical work and enlightenment campaign against the superstitious healing conduct. Esther also took part in the circuit missionary performances. She devoted herself for evangelical work at Bible Institute as well. Esther's activity made people understand the effectiveness of education. She helped people to recognize education for woman, occidental medical treatment and Christianity in a positive way. On April 28, 1909, based on these excellent performances for the social development

  3. Quality of life assessment in advanced cancer patients treated at home, an inpatient unit, and a day care center

    Directory of Open Access Journals (Sweden)

    Leppert W

    2014-05-01

    Full Text Available Wojciech Leppert,1 Mikolaj Majkowicz,2 Maria Forycka,1 Eleonora Mess,3 Agata Zdun-Ryzewska2 1Department of Palliative Medicine, Poznan University of Medical Sciences, Poznan, Poland; 2Department of Quality of Life Research, Gdansk Medical University, Gdansk, Poland; 3Palliative Care Nursing Department, Wroclaw Medical University, Wroclaw, Poland Aim of the study: To assess quality of life (QoL in cancer patients treated at home, at an in-patient palliative care unit (PCU, and at a day care center (DCC. Patients and methods: QoL was assessed in advanced cancer patients at baseline and after 7 days of symptomatic treatment using the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Core 15-Palliative Care (EORTC QLQ-C15-PAL, the Edmonton Symptom Assessment System (ESAS, and the Karnofsky Performance Status (KPS scale. Results: A total of 129 patients completed the study, with 51 patients treated at home, 51 patients treated at the PCU, and 27 patients at DCC. In the EORTC QLQ-C15-PAL, improvement in functional and symptom scales was observed except in physical functioning and fatigue levels; patients at DCC had a better physical functioning, global QoL, appetite, and fatigue levels. In the ESAS, improvement in all items was found except for drowsiness levels, which was stable in patients treated at DCC and deteriorated in home and PCU patients. Higher activity, better appetite and well-being, and less drowsiness were observed in patients treated at DCC. KPS was better in DCC patients compared to those treated at home and at the PCU; the latter group deteriorated. Conclusions: QoL improved in all patient groups, with better results in DCC patients and similar scores in those staying at home and at the PCU. Along with clinical assessment, baseline age, KPS, physical and emotional functioning may be considered when assigning patients to care at a DCC, PCU, or at home. Keywords: oncology, patient care

  4. A study of the Life Quality of Students at a University of Medical Sciences in the Northeast of Iran

    OpenAIRE

    Mohammad Amiri; Mehdi Raei; Reza Chaman; Ali Khamseh; Nazi Rezaee; Jila Manouchehri Moghaddam; Hosein Rohani; Mohammadreza Khatibi

    2014-01-01

    Introduction: Quality of life is an important index in assessing the personal health, making decisions and passing judgments on the general health status of the society, and finding major problems people have in different arenas of life. This study aimed at determining the quality of life among students of Shahroud University of Medical Sciences. Methods: This applied cross-sectional research was carried out in 2011. The data collection instrument was the 26-item quality of life questionna...

  5. Study calls for safeguards against misuse of advances in life sciences

    OpenAIRE

    Micale, Barbara L.

    2006-01-01

    Vigilance among the world's scientists, an expanded view of bioterrorism threats, and a stronger public health infrastructure are needed to reduce the growing risk that new advances in the life sciences and related technologies will be used to create novel biological weapons or misused by careless individuals, says a new report from the National Research Council and Institute of Medicine.

  6. Advanced Life Support in Obstetrics (ALSO) and postpartum hemorrhage: A prospective intervention study in Tanzania

    DEFF Research Database (Denmark)

    Sorensen, Bjarke Lund; Rasch, Vibeke; Massawe, Siriel;

    2011-01-01

    Objective. To evaluate the impact of Advanced Life Support in Obstetrics (ALSO) training on staff performance and the incidences of postpartum hemorrhage (PPH) at a regional hospital in Tanzania. Design. Prospective intervention study. Setting. A regional, referral hospital. Population. A total of...

  7. Long-term intended and unintended experiences after Advanced Life Support training

    DEFF Research Database (Denmark)

    Rasmussen, M.B.; Dieckmann, Peter; Issenberg, Berry; Ostergaard, Doris; Søreide, Eldar; Ringsted, Charlotte Vibeke

    2012-01-01

    Highly structured simulation-based training (SBT) on managing emergency situations can have a significant effect on immediate satisfaction and learning. However, there are some indications of problems when applying learned skills to practice. The aim of this study was to identify long-term intended...... and unintended learner reactions, experiences and reflections after attending a simulation based Advanced Life Support (ALS) course....

  8. The influences of patient's satisfaction with medical service delivery, assessment of medical service, and trust in health delivery system on patient's life satisfaction in China

    OpenAIRE

    Tang Liyang

    2012-01-01

    Abstract Background Patient’s satisfaction with medical service delivery/assessment of medical service/trust in health delivery system may have significant influence on patient’s life satisfaction in China’s health delivery system/in various kinds of hospitals. The aim of this study was to test whether and to what extent patient’s satisfaction with medical service delivery/patient’s assessments of various major aspects of medical service/various major aspects of patient’s trust in health deli...

  9. Newly graduated doctors' competence in managing cardiopulmonary arrests assessed using a standardized Advanced Life Support (ALS) assessment

    DEFF Research Database (Denmark)

    Jensen, Marianne Lidang; Hesselfeldt, R.; Rasmussen, M.B.;

    2008-01-01

    Aim of the study: Several studies using a variety of assessment approaches have demonstrated that young doctors possess insufficient resuscitation competence. The aims of this study were to assess newly graduated doctors’ resuscitation competence against an internationally recognised standard and...... to study whether teaching site affects their resuscitation competence. Materials and methods: The entire cohort of medical students from Copenhagen University expected to graduate in June 2006 was invited to participate in the study. Participants’ ALS- competence was assessed using the Advanced Life...... resuscitation teaching issued by the university. Results: Participation was accepted by 154/240 (64%) graduates. Only 23% of the participants met the ALS pass criteria. They primarily lacked skills in managing cardiopulmonary arrest. There were significant differences in ALS-competence between teaching sites....

  10. 41 CFR 102-36.465 - May we transfer or exchange excess medical shelf-life items with other federal agencies?

    Science.gov (United States)

    2010-07-01

    ... exchange excess medical shelf-life items with other federal agencies? 102-36.465 Section 102-36.465 Public... Disposal Requires Special Handling Shelf-Life Items § 102-36.465 May we transfer or exchange excess medical shelf-life items with other federal agencies? Yes, you may transfer or exchange excess medical...

  11. Survey of the incidence and effect of major life events on graduate medical education trainees

    Directory of Open Access Journals (Sweden)

    Lars J. Grimm

    2015-06-01

    Full Text Available Purpose: This study aims to assess the incidence of major life events during graduate medical education (GME training and to establish any associations with modifiable activities and career planning. Methods: The authors surveyed graduating GME trainees from their parent institution in June 2013. Demographic information (clinical department, gender, training duration and major life events (marriage, children, death/illness, home purchase, legal troubles, property loss were surveyed. Respondents were queried about the relationship between life events and career planning. A multivariable logistic regression model tested for associations. Results: A total of 53.2% (166/312 of graduates responded to the survey. 50% (83/166 of respondents were female. Major life events occurred in 96.4% (160/166 of respondents. Male trainees were more likely (56.1% [46/82] vs. 30.1% [25/83] to have a child during training (p=0.01. A total of 41.6% (69/166 of responders consciously engaged or avoided activities during GME training, while 31.9% (53/166 of responders reported that life events influenced their career plans. Trainees in lifestyle residencies (p=0.02, those who experienced the death or illness of a close associate (p=0.01, and those with legal troubles (p=0.04 were significantly more likely to consciously control life events. Conclusion: Major life events are very common and changed career plans in nearly a third of GME trainees. Furthermore, many trainees consciously avoided activities due to their responsibilities during training. GME training programs should closely assess the institutional support systems available to trainees during this difficult time.

  12. Quality of life assessment in advanced cancer patients treated at home, an inpatient unit, and a day care center

    OpenAIRE

    Leppert, Wojciech

    2014-01-01

    Wojciech Leppert,1 Mikolaj Majkowicz,2 Maria Forycka,1 Eleonora Mess,3 Agata Zdun-Ryzewska2 1Department of Palliative Medicine, Poznan University of Medical Sciences, Poznan, Poland; 2Department of Quality of Life Research, Gdansk Medical University, Gdansk, Poland; 3Palliative Care Nursing Department, Wroclaw Medical University, Wroclaw, Poland Aim of the study: To assess quality of life (QoL) in cancer patients treated at home, at an in-patient palliative care unit (PCU), and at a day care...

  13. Preliminary Study for Conceptual Design of Advanced Long Life Small Modular Fast Reactor

    Energy Technology Data Exchange (ETDEWEB)

    Tak, Taewoo; Choe, Jiwon; Jeong, Yongjin; Lee, Deokjung [Ulsan National Institute of Science and Technology, Ulsan (Korea, Republic of); Kim, T. K. [Argonne National Laboratory, Argonne (United States)

    2015-05-15

    As one of the non-water coolant Small-Modular Reactor (SMR) core concepts for use in the mid- to long-term, ANL has proposed a 100 MWe Advanced sodium-cooled Fast Reactor core concept (AFR-100) targeting a small grid, transportable from pre-licensed factories to the remote plant site for affordable supply. Various breed-and-burn core concepts have been proposed to extend the reactor cycle length, which includes CANDLE with a cigar-type depletion strategy, TerraPower reactors with fuel shuffling for effective breeding, et al. UNIST has also proposed an ultra-long cycle fast reactor (UCFR) core concept having the power rating of 1000 MWe. By adopting the breed-and-burn strategies, the UCFR core can maintain criticality for a targeting reactor lifetime of 60 years without refueling. The objective of this project is to develop an advanced long-life SMR core concept by adopting both the small modular design features of the AFR-100 and the long-life breed-and-burn concept of the UCFR. A conceptual design of long life small modular fast reactor is under development by adopting both the small modular design features of the AFR-100 and the long-life breed-and-burn concept of the UCFR. The feasibility of the long-life fast reactor concepts was reviewed to obtain the core design guidelines and the reactor design requirements of long life small modular fast reactor were proposed in this study.

  14. Preliminary Study for Conceptual Design of Advanced Long Life Small Modular Fast Reactor

    International Nuclear Information System (INIS)

    As one of the non-water coolant Small-Modular Reactor (SMR) core concepts for use in the mid- to long-term, ANL has proposed a 100 MWe Advanced sodium-cooled Fast Reactor core concept (AFR-100) targeting a small grid, transportable from pre-licensed factories to the remote plant site for affordable supply. Various breed-and-burn core concepts have been proposed to extend the reactor cycle length, which includes CANDLE with a cigar-type depletion strategy, TerraPower reactors with fuel shuffling for effective breeding, et al. UNIST has also proposed an ultra-long cycle fast reactor (UCFR) core concept having the power rating of 1000 MWe. By adopting the breed-and-burn strategies, the UCFR core can maintain criticality for a targeting reactor lifetime of 60 years without refueling. The objective of this project is to develop an advanced long-life SMR core concept by adopting both the small modular design features of the AFR-100 and the long-life breed-and-burn concept of the UCFR. A conceptual design of long life small modular fast reactor is under development by adopting both the small modular design features of the AFR-100 and the long-life breed-and-burn concept of the UCFR. The feasibility of the long-life fast reactor concepts was reviewed to obtain the core design guidelines and the reactor design requirements of long life small modular fast reactor were proposed in this study

  15. End-of-Life Care for Undocumented Immigrants With Advanced Cancer: Documenting the Undocumented.

    Science.gov (United States)

    Jaramillo, Sylvia; Hui, David

    2016-04-01

    There are approximately 11.1 million undocumented immigrants in the United States, with a majority being Latino. Cancer is now the leading cause of death in Latinos. There is little research guiding providers on how to deliver optimal end-of-life care in this population. We describe a case of an undocumented Latino patient with advanced cancer, and provide a review of the literature on end-of-life care in undocumented immigrants. Our patient encountered many challenges as he navigated through the healthcare system in the last months of life. These included delayed diagnosis, limited social support, financial issues, fear of deportation, and language and cultural barriers, which resulted in significant physical and psychological distress. Within the undocumented patient population, there is often a lack of advance care planning, prognostic understanding, mistrust, religious practices, and cultural beliefs that may affect decision making. Given the growing number of undocumented immigrants in the United States, it is important for clinicians and policy makers to have a better understanding of the issues surrounding end-of-life care for undocumented immigrants, and work together to improve the quality of life and quality of end-of-life care for these disadvantaged individuals. PMID:26681362

  16. Ethical framework for medication discontinuation in nursing home residents with limited life expectancy.

    Science.gov (United States)

    Tjia, Jennifer; Givens, Jane

    2012-05-01

    A recent editorial by health economist Victor Fuchs summarized the current challenges with health care delivery in this way: “Most physicians want to deliver ‘appropriate’ care. Most want to practice ‘ethically’, but it is difficult to know what is ‘appropriate’ and what is ‘ethical’. This characterization is particularly true for medication use and deprescribing in elderly NH residents with limited life expectancy. Medical ethics sets 4 key principles (beneficence, nonmaleficence, patient autonomy, and justice) to guide practice. However, decisional conflicts will continue between providers and patients, and physicians will continue to struggle with the dilemma of balancing the primacy of patient welfare, values, and beliefs against the desire for promising, but often minimally beneficial and harmful, medications that threaten limited clinical resources. Despite these challenges, physicians should be able to perform systematic medication reviews and monitor discontinuation trials in their NH patients for whom this is consistent with their goals of care. PMID:22500542

  17. The Basic Life Support Training and Its Importance for Medical University Staff

    Directory of Open Access Journals (Sweden)

    Afrooz Habibi

    2015-06-01

    Full Text Available Background The survival rate of a cardiac arrest victim increases with basic life support (BLS as the first level of medical care. The purpose of this study was to compare BLS knowledge and skills of medical university staff before and after training course. Methods Thirty eight medical university staff participated in a BSL training course. The course included the assessment of participant’s knowledge by a pretest questionnaire, a lecture, hands-on training in BLS skills, a post-test questionnaire and an interview to evaluate their attitudes. Data were analyzed by the SPSS software version 19, using t-test, one-way ANOVA and chi square tests. P value less than 0.05 was considered statistically significant. Results Our results demonstrated that the mean knowledge score was 6.00 ± 2.09 vs. 8.26 ± 2.10 in pre- and post- education, respectively. A significant mean gain score (2.26 from the pre-test scores to post-test scores was statistically observed (P0.05 whereas, there were the significant differences between trainees’ gain scores and, education and career fields(p< 0.05. Our result also presents that staff attitudes toward the training were positive. Conclusion The present research shows the BLS training had a positive impact on the knowledge and attitudes among university staff. BLS training is extremely useful for medical university staf

  18. Development of advanced techniques for life management and inspection of advanced heavy water reactor (AWHR) coolant channel components

    International Nuclear Information System (INIS)

    Operating life of pressure tubes of Pressurized Heavy Water Reactor (PHWR) is limited due to the presence of various issues associated with the material like hydrogen pick up, delayed hydride cracking, axial elongation and increase in diameter due to irradiation creep and growth. Periodic monitoring of the health of the pressure tube under in-situ conditions is essential to ensure the safe operation of the reactor. New designs of reactor call for innovative design philosophy, modification in fabrication route of pressure tube, development of reactor specific tools, both analytical and hardware for assessing the fitness for service of the pressure tube. Feedback from existing reactors has enhanced the understanding about life limiting parameters. This paper gives an insight into the life limiting issues associated with pressure tube and the efforts pursued for development of life management techniques for coolant channel of Advanced Heavy Water Reactor (AHWR) designed in India. The tools and techniques for in-situ property/hydrogen measurement, pulsed eddy current technique for zirconium alloy in-homogeneity characterization, horizontal shear wave EMAT system for dissimilar metal weld inspection, sliver sampling of vertical channel etc. are elaborated in the paper. (author)

  19. The Effect of Life Skills Training on Emotional Intelligence of the Medical Sciences Students in Iran

    Directory of Open Access Journals (Sweden)

    Hamideh A Lolaty

    2012-01-01

    Full Text Available Background: Emotional intelligence has a major role in mental health and life skills training, and could be viewed as a bridge relating to emotional intelligence and mental health. Aim: The present study is aimed at determining the effect of life skills training on the emotional intelligence among the first year students of Mazandaran University of Medical Sciences. Materials and Methods: In this experimental study, the subjects were selected by random sampling and allocated into two groups: Case group (n=20 and control group (n=19; they matched for gender, experience of stressful life events in the past six months, level of interest in the field of study, and level of emotional intelligence. The two groups responded to Bar-on Emotional Quotient Inventory before starting the experiment. Subsequently, the case group underwent life skills training. After the training, Bar-on Emotional Quotient Inventory was responded by the case and control groups again. The data was analyzed using descriptive statistics including Chi-square test, paired and independent t-tests, using SPSS software version 15. Results and Conclusion: In the case group, the scores of emotional intelligence after life skills training were significantly improved (t=11.703 df=19 P=0.001, while no significant difference was observed in the control group (t=0.683 df =18 P=0.503. By performing programs such as life skills training, the levels of emotional intelligence of the students could be increased, which itself could lead to academic success, reduced substance abuse, and increased stress tolerance in the students.

  20. Long-Term Care Benefits May Reduce End-of-Life Medical Care Costs

    Science.gov (United States)

    Evered, Sharrilyn R.; Center, Bruce A.

    2014-01-01

    Abstract This study explores whether personal care services for functionally dependent or cognitively impaired individuals paid for by a long-term care (LTC) insurance policy can reduce health care utilization and costs at the end of life. This retrospective study uses propensity score matching methodology, hierarchical multiple regression, and Poisson regression to compare 830 decedents who utilized benefits from a voluntary LTC insurance plan (“claimants”) to 6860 decedents who never purchased coverage but were similar to claimants on 17 variables, including age, sex, frailty, burden of illness markers, and propensity to have needed LTC services. Claimants using LTC benefits experienced significantly lower health care costs at end of life, including 14% lower total medical costs, 13% lower pharmacy costs, 35% lower inpatient admission costs, and 16% lower outpatient visit costs. They also experienced 8% fewer inpatient admissions and 10% fewer inpatient days. The presence of dementia at the end of life moderated these effects. This study suggests that use of insurance-based LTC services measurably reduces health care expenditures at the end of life. (Population Health Management 2014;17:332–339) PMID:24784144

  1. Recent PLiM advances for current operation and long life

    International Nuclear Information System (INIS)

    While plant aging is inevitable, continuous improvements can be applied at various stages of the plant design and operations life cycle to ensure predictable, reliable and graceful 'aging' behaviour. Comprehensive and integrated Plant Life Management (PLiM) programs and associated technologies are key management tools for identifying these improvements. PLiM technology has grown and advanced to be applicable to new plants as well as older ones, although the purposes and key outcomes vary. The key impetus is the drive for high equipment reliability. For older plants, PLiM techniques are often used to ensure design life is successfully and reliably attained and to provide prognosis for life extension, including technical and cost inputs to life extension business cases. For new plants, PLiM is helping utilities develop effective plant programs in preventive maintenance, surveillance and inspection, both for active and passive components, and to start building Life Cycle Management plans for the most important Structures, Systems and Components. For new designs, the objective is to understand potential aging degradation for both passive and active components, incorporate operating experience, and ensure design margins and measures taken to assure component reliability, can be achieved. This is important to demonstrate that the design has been improved for high capacity factors and longer design life. Atomic Energy of Canada Ltd. (AECL) has worked with many CANDU utilities on Plant Life Management over the last 10 years. However, several recent applications and developments have led to further advances in PLiM technology. These include the increased focus on the effectiveness of maintenance programs to deal with aging, both long and short term, that is driving the nuclear industry to better understand the overall system maintenance strategy. (author)

  2. Advanced biosensing methodologies developed for evaluating performance quality and safety of emerging biophotonics technologies and medical devices (Conference Presentation)

    Science.gov (United States)

    Ilev, Ilko K.; Walker, Bennett; Calhoun, William; Hassan, Moinuddin

    2016-03-01

    Biophotonics is an emerging field in modern biomedical technology that has opened up new horizons for transfer of state-of-the-art techniques from the areas of lasers, fiber optics and biomedical optics to the life sciences and medicine. This field continues to vastly expand with advanced developments across the entire spectrum of biomedical applications ranging from fundamental "bench" laboratory studies to clinical patient "bedside" diagnostics and therapeutics. However, in order to translate these technologies to clinical device applications, the scientific and industrial community, and FDA are facing the requirement for a thorough evaluation and review of laser radiation safety and efficacy concerns. In many cases, however, the review process is complicated due the lack of effective means and standard test methods to precisely analyze safety and effectiveness of some of the newly developed biophotonics techniques and devices. There is, therefore, an immediate public health need for new test protocols, guidance documents and standard test methods to precisely evaluate fundamental characteristics, performance quality and safety of these technologies and devices. Here, we will overview our recent developments of novel test methodologies for safety and efficacy evaluation of some emerging biophotonics technologies and medical devices. These methodologies are based on integrating the advanced features of state-of-the-art optical sensor technologies and approaches such as high-resolution fiber-optic sensing, confocal and optical coherence tomography imaging, and infrared spectroscopy. The presentation will also illustrate some methodologies developed and implemented for testing intraocular lens implants, biochemical contaminations of medical devices, ultrahigh-resolution nanoscopy, and femtosecond laser therapeutics.

  3. Quality of life of patients with locally advanced rectal cancer: anterior rectal resection with colorectal anastomosis versus abdominoperineal excision

    Directory of Open Access Journals (Sweden)

    Maria-Gabriela Aniţei

    2013-09-01

    Full Text Available BACKGROUND: Despite advances in neoadjuvant treatment, rectal resection remains the gold-standard treatment for rectal cancer. AIM: The aim of this study was to assess the benefits of anal sphincter preservation and to compare the quality of life in terms of functional outcome in long term survivors who underwent low (or ultra low anterior resection with total mesorectal excision to patients with abdominoperineal excision for locally advanced rectal cancer with neoadjuvant therapy. MATERIAL AND METHODS: We retrospectively analyzed the medical records of 319 patients who underwent surgery for rectal cancer from 2006 to 2011. Quality of life in 69 eligible patients with preoperative treatment and rectal resection with total mesorectal excision was assessed using the EORTC QLQ C 30 and EORTC QLQ CR29 questionnaires. We evaluated the overall status of quality of life and functional status of these patients symptoms scale. High score for functional scores shows better function whereas high symptom score shows more problems. Results were compared for patients with anal sphincter preservation (SP, 20 patients versus abdominoperineal excision (APE, 49 patients using t-Student test for independent samples. RESULTS: The median follow up in 69 patients was 32 months (range 11-74 months, 32±2,3SD. Quality of life for our group is significantly higher than the reference EORTC population (P < 0.001. Physical functioning (P = 0.050, cognitive functioning (P = 0.039, emotional functioning (P = 0.006, physical and social functioning (P = 0.005, constipation (P = 0.018, body image (P = 0.003, abdominal pain (P = 0.004, embarrassment (P = 0.003 were significantly better for patients with SP. There was no significant differences in the general symptoms of the radiochemotherapy treatment (mouth dryness, hair loss, flavor. Most of the symptom scales like sexual interest, impotence, dyspareunia, diarrhoea did not differ. APE patients suffered more from anxiety (P = 0

  4. 76 FR 52377 - Colorado Wyoming Reserve Co., Grant Life Sciences, Inc., NOXSO Corp., Omni Medical Holdings, Inc...

    Science.gov (United States)

    2011-08-22

    ... From the Federal Register Online via the Government Publishing Office SECURITIES AND EXCHANGE COMMISSION Colorado Wyoming Reserve Co., Grant Life Sciences, Inc., NOXSO Corp., Omni Medical Holdings, Inc... accurate information concerning the securities of Grant Life Sciences, Inc. because it has not filed...

  5. Palliative home care intervention to improve the quality of life of women with advanced breast cancer

    International Nuclear Information System (INIS)

    The quality of life is affected frequently observed in women with advanced breast cancer and is considered a leading indicator of effectiveness of palliative care. A descriptive, quasi-experimental study is presented ex-ante / ex-post, by applying open-ended interviews to explore the effects on the processes of adaptation of each patient and a self-administrable scale identified specific dimensions of quality of life, satisfaction with care and overall quality of life. The intervention was performed palliative home care to 52 women, according to the damages identified in the baseline diagnosis. The overall strategy included four steps: clinical and socio-demographic characterization of women; identification of the effects on the processes of adaptation by the theoretical model of Roy and dimensions of quality of life frequently affected, to design individually oriented actions on the drive shaft of Nursing Interventions Classification and evaluation of results intervention. The dimensions achieved higher frequency of involvement were: behavior, physical symptoms, pain interference and leisure activities, social life and family. Data were analyzed with qualitative methodologies and uni and multivariate statistical processing. After the intervention favorable changes in adaptive processes and dimensions of quality of life were observed; well as in the assessment of overall satisfaction with life. It was interesting that the dimensions of satisfaction assessed at the end of the intervention obtained an unfavorable assessment, outcome associated with sociodemographic variables. (author)

  6. The use of the pectoralis major flap for advanced and recurrent head and neck malignancy in the medically compromised patient.

    Science.gov (United States)

    Avery, C M E; Crank, S T; Neal, C P; Hayter, J P; Elton, C

    2010-11-01

    A retrospective review of seventy-one PPM flaps used between 1996 and 2010 primarily for oral and oropharyngeal squamous cell carcinoma presenting as either advanced stage IV primary disease (41/43), extensive recurrent (10) or metastatic (9) neck disease. The PPM flap was most commonly used following resection of the mandible (23) or the tongue/oropharynx (19). When the PPM flap was the preferred reconstruction option (54) the main indication, in addition to advanced disease, was significant medical co-morbidity (23). The majority of PPM flaps (75%) were used in the latter half of the series for an increasing number of patients in poor health with advanced disease. There was no evidence of an increase in age, ASA grade or extent of disease during this period. Approximately one quarter (17) of the flaps were used after failure of a free flap, most commonly a DCIA (7) or radial (6) flap. The 30day mortality in this group of compromised patients undergoing major surgery for advanced disease was 7% (5/71). The overwhelming majority had significant co-morbidity (94% grade 2 or higher with 63% ASA grade 3) and 90% had already undergone previous major surgery and/or radiotherapy. The 1-year, 3-year and 5-year overall survival rates were 65.5%, 39.1% and 11.0% respectively with cancer-specific survival rates of 82.0%, 65.5% and 65.5%. The majority died of disease related to the underlying co-morbidity. We recommend an aggressive approach to the surgical resection of advanced and recurrent disease but a pragmatic approach to reconstruction. The PPM major flap is reliable for reconstruction of defects of the mandible, tongue and oropharynx with a complete flap failure rate of 2.8%. Lateral defects of the mandible were managed without a plate and with an acceptable outcome in the context of limited life expectancy. This is the largest study of the use of the PPM flap for this type of patient group. The flap retains a major role in the management of advanced primary or

  7. Doing the right thing: a geriatrician's perspective on medical care for the person with advanced dementia.

    Science.gov (United States)

    Gillick, Muriel R

    2012-01-01

    Developing a reasonable approach to the medical care of older people with dementia will be essential in the coming decades. Physicians are the locus of decision making for persons with dementia. It is the responsibility of the physician to assure that the surrogate understands the nature and trajectory of the disease and then to elicit the desired goal of care. Physicians need to ascertain whether any advance directives are available, and if so, whether they apply to the situation of advanced dementia. Finally, physicians should help surrogates understand how the goals of care are best translated into practice. When the goal is comfort, this is achieved by assuring dignity, minimizing suffering, and promoting caring. In general, comfort should be the default goal of care, best implemented through palliative care or hospice. PMID:22458462

  8. Predictors of Life Skills Level of Students in Zahedan University of Medical Sciences in Southeast of Iran

    OpenAIRE

    Hossein Ansari; Mahmood Khorram; Ali Soleimaninejad; Alireza Ansari-Moghaddam

    2016-01-01

    Background and aims: Life skills involve a big class of socio-psychological and interpersonal skills which help a person to take conscious decisions, communicate effectively and improve self-management skills. Preparing a plan for all the above mentioned programs, need awareness about life skills level of different groups such as students in universities. Present study was aimed to reveal the predictors of life skills level of Students in Zahedan University of Medical Sciences in southeast of...

  9. The impact of a simulated intervention on attitudes of undergraduate nursing and medical students towards end of life care provision

    OpenAIRE

    Lewis, Claire; Reid, Joanne; McLernon, Zara; Ingham, Rory; Traynor, Mary

    2016-01-01

    Background: The concerns of undergraduate nursing and medical students’ regarding end of life care are well documented. Many report feelings of emotional distress, anxiety and a lack of preparation to provide care to patients at end of life and their families. Evidence suggests that increased exposure to patients who are dying and their families can improve attitudes toward end of life care. In the absence of such clinical exposure, simulation provides experiential learning with outcomes comp...

  10. Retention of first aid and basic life support skills in undergraduate medical students

    Science.gov (United States)

    de Ruijter, Pim A.; Biersteker, Heleen A.; Biert, Jan; van Goor, Harry; Tan, Edward C.

    2014-01-01

    Background Undergraduate medical students follow a compulsory first aid (FA) and basic life support (BLS) course. Retention of BLS seems poor and only little information is provided on the retention of FA skills. This study aims at evaluating 1- and 2-year retention of FA and BLS training in undergraduate medical students. Methods One hundred and twenty students were randomly selected from first year (n=349) medical students who successfully followed a compulsory FA and BLS course. From these 120 students, 94 (78%) and 69 (58%) participated in retention tests of FA and BLS skills after 1 and 2 years, respectively. The assessment consisted of two FA stations and one BLS station. Results After 1 year, only 2% passed both FA and BLS stations and 68% failed both FA and BLS stations. After 2 years, 5% passed and 50% failed both FA and BLS stations. Despite the high failure rate at the stations, 90% adequately checked vital signs and started cardiopulmonary resuscitation appropriately. Conclusions The long-term retention of FA and BLS skills after a compulsory course in the first year is poor. Adequate check of vital signs and commencing cardiopulmonary resuscitation retained longer. PMID:25382803

  11. Retention of first aid and basic life support skills in undergraduate medical students

    Directory of Open Access Journals (Sweden)

    Pim A. de Ruijter

    2014-11-01

    Full Text Available Background: Undergraduate medical students follow a compulsory first aid (FA and basic life support (BLS course. Retention of BLS seems poor and only little information is provided on the retention of FA skills. This study aims at evaluating 1- and 2-year retention of FA and BLS training in undergraduate medical students. Methods: One hundred and twenty students were randomly selected from first year (n=349 medical students who successfully followed a compulsory FA and BLS course. From these 120 students, 94 (78% and 69 (58% participated in retention tests of FA and BLS skills after 1 and 2 years, respectively. The assessment consisted of two FA stations and one BLS station. Results: After 1 year, only 2% passed both FA and BLS stations and 68% failed both FA and BLS stations. After 2 years, 5% passed and 50% failed both FA and BLS stations. Despite the high failure rate at the stations, 90% adequately checked vital signs and started cardiopulmonary resuscitation appropriately. Conclusions: The long-term retention of FA and BLS skills after a compulsory course in the first year is poor. Adequate check of vital signs and commencing cardiopulmonary resuscitation retained longer.

  12. Improving end of life care: an information systems approach to reducing medical errors.

    Science.gov (United States)

    Tamang, S; Kopec, D; Shagas, G; Levy, K

    2005-01-01

    Chronic and terminally ill patients are disproportionately affected by medical errors. In addition, the elderly suffer more preventable adverse events than younger patients. Targeting system wide "error-reducing" reforms to vulnerable populations can significantly reduce the incidence and prevalence of human error in medical practice. Recent developments in health informatics, particularly the application of artificial intelligence (AI) techniques such as data mining, neural networks, and case-based reasoning (CBR), presents tremendous opportunities for mitigating error in disease diagnosis and patient management. Additionally, the ubiquity of the Internet creates the possibility of an almost ideal network for the dissemination of medical information. We explore the capacity and limitations of web-based palliative information systems (IS) to transform the delivery of care, streamline processes and improve the efficiency and appropriateness of medical treatment. As a result, medical error(s) that occur with patients dealing with severe, chronic illness and the frail elderly can be reduced.The palliative model grew out of the need for pain relief and comfort measures for patients diagnosed with cancer. Applied definitions of palliative care extend this convention, but there is no widely accepted definition. This research will discuss the development life cycle of two palliative information systems: the CONFER QOLP management information system (MIS), currently used by a community-based palliative care program in Brooklyn, New York, and the CAREN case-based reasoning prototype. CONFER is a web platform based on the idea of "eCare". CONFER uses XML (extensible mark-up language), a W3C-endorced standard mark up to define systems data. The second system, CAREN, is a CBR prototype designed for palliative care patients in the cancer trajectory. CBR is a technique, which tries to exploit the similarities of two situations and match decision-making to the best

  13. Analysis of edible oil processing options for the BIO-Plex advanced life support system

    Science.gov (United States)

    Greenwalt, C. J.; Hunter, J.

    2000-01-01

    Edible oil is a critical component of the proposed plant-based Advanced Life Support (ALS) diet. Soybean, peanut, and single-cell oil are the oil source options to date. In terrestrial manufacture, oil is ordinarily extracted with hexane, an organic solvent. However, exposed solvents are not permitted in the spacecraft environment or in enclosed human tests by National Aeronautics and Space Administration due to their potential danger and handling difficulty. As a result, alternative oil-processing methods will need to be utilized. Preparation and recovery options include traditional dehulling, crushing, conditioning, and flaking, extrusion, pressing, water extraction, and supercritical extraction. These processing options were evaluated on criteria appropriate to the Advanced Life Support System and BIO-Plex application including: product quality, product stability, waste production, risk, energy needs, labor requirements, utilization of nonrenewable resources, usefulness of by-products, and versatility and mass of equipment to determine the most appropriate ALS edible oil-processing operation.

  14. Measuring social support in patients with advanced medical illnesses: An analysis of the Duke–UNC Functional Social Support Questionnaire

    Science.gov (United States)

    SARACINO, REBECCA; KOLVA, ELISSA; ROSENFELD, BARRY; BREITBART, WILLIAM

    2016-01-01

    Objective To date, no measure of social support has been developed specifically for either palliative care or oncology settings. The present study examined the psychometric properties of the Duke–University of North Carolina Functional Social Support Questionnaire (DUFSS) in order to (1) assess the adequacy of the scale in the context of severe medical illness and (2) evaluate whether a brief subset of items might generate roughly comparable utility. Method The 14-item DUFSS was administered to 1,362 individuals with advanced cancer or AIDS. Classical test theory (CTT) and item response theory (IRT) analyses were utilized to develop an abbreviated version of the DUFSS that maintained adequate reliability and validity and might increase the feasibility of its administration in a palliative care setting. The reliability and concurrent validity of the DUFSS-5 were evaluated in a separate validation sample of patients with advanced cancer. Results Analyses generated a five-item version of the DUFSS (the DUFSS-5) that collapsed response levels into only three options, instead of five. Correlations between the DUFSS-5 and measures of depression, quality of life, and desire for hastened death, as well as regression models testing the main-effect and buffering models of social support, provided support for the utility of the DUFSS-5. Significance of results Both the DUFSS and the abbreviated DUFSS-5 appear to have adequate reliability and validity in this setting. Moreover, the DUFSS-5 represents a potentially important option for healthcare researchers, particularly for those working in palliative care settings where issues of patient burden are paramount. Such analyses are critical for advancing the development and refinement of psychosocial measures, but have often been neglected. PMID:25201170

  15. Quality of life among advanced breast cancer patients with and without distant metastasis

    OpenAIRE

    Wyatt, G.; Sikorskii, A.; TAMKUS, D.; You, M

    2012-01-01

    This study presents the results of a secondary analysis of data collected during a trial of reflexology that aimed to improve health-related quality of life (HRQOL) among women with advanced breast cancer in treatment. A comparison of HRQOL (functioning, symptoms, spirituality) of those with (n = 298) and without (n = 87) distant metastasis is presented. Following the intake interview, 385 women were randomised to reflexology, lay foot manipulation or conventional care control, and were inter...

  16. Development of a preprototype Advanced Extravehicular Mobility Unit (AEMU) regenerable life support subsystem - A progress report

    Science.gov (United States)

    Allen, Norman C.; Lawson, B. Michael

    1989-01-01

    Regenerable life support (RLS) technologies are being developed for use in the Advanced Extravehicle Mobility Unit (AEMU) aboard Space Station Freedom. This report describes the requirements that these RLS technologies must satisfy in the Space Station application and the significant features of the technologies now being evaluated. Who is developing the equipment and how the subsystems will be integrated are addressed. An overview of the planned test program schedule is given.

  17. Level of Knowledge of specialist cardiologists and anesthesiologists in Basic and Advanced Life Support

    OpenAIRE

    Maria Vachla; Dimitris Barouxis; Evagelos Kotsiomitis; Lila Papadimitriou Lila; Evagelia Kouskouni Evagelia; Georgios Triantis

    2013-01-01

    Health professionals often witness in-hospital episodes of cardiac arrest. The quality of the Cardiopulmonary Resuscitation (CPR) depends on the level of theoretical background and practical skills. Purpose: The aim of the present study was to investigate the level of theoretical knowledge of skilled cardiologists and anesthesiologists in the Basic and Advanced Life Support (BLS/ ALS). Material - method: In this study, sample included 240 cardiologists and anesthesiologists, chosen randomly f...

  18. Advancing Competency-Based Medical Education: A Charter for Clinician-Educators.

    Science.gov (United States)

    Carraccio, Carol; Englander, Robert; Van Melle, Elaine; Ten Cate, Olle; Lockyer, Jocelyn; Chan, Ming-Ka; Frank, Jason R; Snell, Linda S

    2016-05-01

    The International Competency-Based Medical Education (ICBME) Collaborators have been working since 2009 to promote understanding of competency-based medical education (CBME) and accelerate its uptake worldwide. This article presents a charter, supported by a literature-based rationale, which is meant to provide a shared mental model of CBME that will serve as a path forward in its widespread implementation.At a 2013 summit, the ICBME Collaborators laid the groundwork for this charter. Here, the fundamental principles of CBME and professional responsibilities of medical educators in its implementation process are described. The authors outline three fundamental principles: (1) Medical education must be based on the health needs of the populations served; (2) the primary focus of education and training should be the desired outcomes for learners rather than the structure and process of the educational system; and (3) the formation of a physician should be seamless across the continuum of education, training, and practice.Building on these principles, medical educators must demonstrate commitment to teaching, assessing, and role modeling the range of identified competencies. In the clinical setting, they must provide supervision that balances patient safety with the professional development of learners, being transparent with stakeholders about level of supervision needed. They must use effective and efficient assessment strategies and tools for basing transition decisions on competence rather than time in training, empowering learners to be active participants in their learning and assessment. Finally, advancing CBME requires program evaluation and research, faculty development, and a collaborative approach to realize its full potential. PMID:26675189

  19. Life-Cycle Assessment of Advanced Nutrient Removal Technologies for Wastewater Treatment.

    Science.gov (United States)

    Rahman, Sheikh M; Eckelman, Matthew J; Onnis-Hayden, Annalisa; Gu, April Z

    2016-03-15

    Advanced nutrient removal processes, while improving the water quality of the receiving water body, can also produce indirect environmental and health impacts associated with increases in usage of energy, chemicals, and other material resources. The present study evaluated three levels of treatment for nutrient removal (N and P) using 27 representative treatment process configurations. Impacts were assessed across multiple environmental and health impacts using life-cycle assessment (LCA) following the Tool for the Reduction and Assessment of Chemical and Other Environmental Impacts (TRACI) impact-assessment method. Results show that advanced technologies that achieve high-level nutrient removal significantly decreased local eutrophication potential, while chemicals and electricity use for these advanced treatments, particularly multistage enhanced tertiary processes and reverse osmosis, simultaneously increased eutrophication indirectly and contributed to other potential environmental and health impacts including human and ecotoxicity, global warming potential, ozone depletion, and acidification. Average eutrophication potential can be reduced by about 70% when Level 2 (TN = 3 mg/L; TP = 0.1 mg/L) treatments are employed instead of Level 1 (TN = 8 mg/L; TP = 1 mg/L), but the implementation of more advanced tertiary processes for Level 3 (TN = 1 mg/L; TP = 0.01 mg/L) treatment may only lead to an additional 15% net reduction in life-cycle eutrophication potential. PMID:26871301

  20. Advanced Launch Technology Life Cycle Analysis Using the Architectural Comparison Tool (ACT)

    Science.gov (United States)

    McCleskey, Carey M.

    2015-01-01

    Life cycle technology impact comparisons for nanolauncher technology concepts were performed using an Affordability Comparison Tool (ACT) prototype. Examined are cost drivers and whether technology investments can dramatically affect the life cycle characteristics. Primary among the selected applications was the prospect of improving nanolauncher systems. As a result, findings and conclusions are documented for ways of creating more productive and affordable nanolauncher systems; e.g., an Express Lane-Flex Lane concept is forwarded, and the beneficial effect of incorporating advanced integrated avionics is explored. Also, a Functional Systems Breakdown Structure (F-SBS) was developed to derive consistent definitions of the flight and ground systems for both system performance and life cycle analysis. Further, a comprehensive catalog of ground segment functions was created.

  1. Advances in the physics of radiation oncology - 50 years of contributions by US Medical Physicists

    International Nuclear Information System (INIS)

    Medical Physicists have a long standing record in the advancement of the discipline of Radiation Oncology, not only in the United States but world-wide, going back to the pre-world war II era. In the United States the contributions of Failla and Quimby, first at Memorial Hospital and then at Columbia University in New York, laid the foundation for the Profession of Medical Physics in the US. Radiation Therapy first used low and high kilovoltage machines for external beam therapy. Radium (Parker) and radon seeds (Quimby) were used for brachytherapy. Subsequently, clinical Van-de-Graaff machines (Trump and Wright) and the Betatron (Kerst, Adams and Skaggs) provided the required photon beams and also made available clinically useful electron beams. The work of John Laughlin, Larry Lanzl, Jacques Ovadia together with Gail Adams and Lester Skaggs, needs to be recognized for their pioneering efforts. With the introduction of Cobalt-60 Teletherapy (Harold Johns and the Canadian Group, Gilbert Fletcher and the MD Anderson Group) and Linear Accelerators (Henry Kaplan and the Stanford Group, and Varian), in the late 1950s ∼ 1960, there was even a greater need for the strong participation of medical physicists, as a useful technical resource to the physicians

  2. The Chinese community patient’s life satisfaction, assessment of community medical service, and trust in community health delivery system

    Directory of Open Access Journals (Sweden)

    Tang Liyang

    2013-02-01

    Full Text Available Abstract Background Although the Chinese government put a lot of effort into promoting the community patient’s life satisfaction, there still lacked the holistic and systematic approaches to promote the community patient’s life satisfaction in various regions of China. On the basis of the literature, it was found that both the community patient’s assessment of community medical service and trust in community health delivery system were important considerations when the community patient comprehensively evaluated community medical service to generate life satisfaction. So this study was set up to test whether and to what extent the community patient’s assessments of various major aspects of community medical service/various major aspects of the community patient’s trust in community health delivery system influenced life satisfaction in whole China/in various regions of China. Methods In order to explore the situation of China’s community health delivery system before 2009 and provide a reference for China’s community health delivery system reform, the data that could comprehensively and accurately reflect the community patient’s life satisfaction, assessment of community medical service, and trust in community health delivery system in various regions of China was needed, so this study collaborated with the National Bureau of Statistics of China to carry out a large-scale 2008 national community resident household survey (N = 3,306 for the first time in China. And the specified ordered probit models were established to analyze the dataset from this household survey. Results Among major aspects of community medical service, the medical cost (particularly in developed regions, the doctor-patient communication (particularly in developed regions, the medical facility and hospital environment (particularly in developed regions, and the medical treatment process (particularly in underdeveloped regions were all key considerations (p

  3. Exploring the relationship between the engineering and physical sciences and the health and life sciences by advanced bibliometric methods.

    Directory of Open Access Journals (Sweden)

    Ludo Waltman

    Full Text Available We investigate the extent to which advances in the health and life sciences (HLS are dependent on research in the engineering and physical sciences (EPS, particularly physics, chemistry, mathematics, and engineering. The analysis combines two different bibliometric approaches. The first approach to analyze the 'EPS-HLS interface' is based on term map visualizations of HLS research fields. We consider 16 clinical fields and five life science fields. On the basis of expert judgment, EPS research in these fields is studied by identifying EPS-related terms in the term maps. In the second approach, a large-scale citation-based network analysis is applied to publications from all fields of science. We work with about 22,000 clusters of publications, each representing a topic in the scientific literature. Citation relations are used to identify topics at the EPS-HLS interface. The two approaches complement each other. The advantages of working with textual data compensate for the limitations of working with citation relations and the other way around. An important advantage of working with textual data is in the in-depth qualitative insights it provides. Working with citation relations, on the other hand, yields many relevant quantitative statistics. We find that EPS research contributes to HLS developments mainly in the following five ways: new materials and their properties; chemical methods for analysis and molecular synthesis; imaging of parts of the body as well as of biomaterial surfaces; medical engineering mainly related to imaging, radiation therapy, signal processing technology, and other medical instrumentation; mathematical and statistical methods for data analysis. In our analysis, about 10% of all EPS and HLS publications are classified as being at the EPS-HLS interface. This percentage has remained more or less constant during the past decade.

  4. Professional identity formation in the transition from medical school to working life

    DEFF Research Database (Denmark)

    de Lasson, Lydia; Just, Eva; Stegeager, Nikolaj W.M.;

    2016-01-01

    background as health professionals combined with coaching educations. Data was obtained through observations, open-ended questionnaires and interviews. A generic thematic analysis was applied. Results Forty-five doctors participated in six coaching groups. The three main themes emerging in the sessions were......: Adoption to medical culture, career planning, and work/life-balance. The junior doctors found the coaching intervention highly useful in order to cope with these challenges. Furthermore, the group was a forum where the junior doctors could share thoughts and feelings with colleagues without being afraid...... that this would endanger their professional career. Many found new ways to respond to everyday challenges mainly through a new awareness of patterns of thinking and feeling. Conclusions The participants found that the group-coaching course supported their professional identity formation (thinking...

  5. Calendar Life Studies of Advanced Technology Development Program Gen 1 Lithium Ion Batteries

    Energy Technology Data Exchange (ETDEWEB)

    Wright, Randy Ben; Motloch, Chester George

    2001-03-01

    This report presents the test results of a special calendar-life test conducted on 18650-size, prototype, lithium-ion battery cells developed to establish a baseline chemistry and performance for the Advanced Technology Development Program. As part of electrical performance testing, a new calendar-life test protocol was used. The test consisted of a once-per-day discharge and charge pulse designed to have minimal impact on the cell yet establish the performance of the cell over a period of time such that the calendar life of the cell could be determined. The calendar life test matrix included two states of charge (i.e., 60 and 80%) and four temperatures (40, 50, 60, and 70°C). Discharge and regen resistances were calculated from the test data. Results indicate that both discharge and regen resistance increased nonlinearly as a function of the test time. The magnitude of the discharge and regen resistance depended on the temperature and state of charge at which the test was conducted. The calculated discharge and regen resistances were then used to develop empirical models that may be useful to predict the calendar life or the cells.

  6. Calendar Life Studies of Advanced Technology Development Program Gen 1 Lithium Ion Batteries

    International Nuclear Information System (INIS)

    This report presents the test results of a special calendar-life test conducted on 18650-size, prototype, lithium-ion battery cells developed to establish a baseline chemistry and performance for the Advanced Technology Development Program. As part of electrical performance testing, a new calendar-life test protocol was used. The test consisted of a once-per-day discharge and charge pulse designed to have minimal impact on the cell yet establish the performance of the cell over a period of time such that the calendar life of the cell could be determined. The calendar life test matrix included two states of charge (i.e., 60 and 80%) and four temperatures (40, 50, 60, and 70 C). Discharge and regen resistances were calculated from the test data. Results indicate that both discharge and regen resistance increased nonlinearly as a function of the test time. The magnitude of the discharge and regen resistance depended on the temperature and state of charge at which the test was conducted. The calculated discharge and regen resistances were then used to develop empirical models that may be useful to predict the calendar life or the cells

  7. Cycle Life Studies of Advanced Technology Development Program Gen 1 Lithium Ion Batteries

    International Nuclear Information System (INIS)

    This report presents the test results of a special calendar-life test conducted on 18650-size, prototype, lithium-ion battery cells developed to establish a baseline chemistry and performance for the Advanced Technology Development Program. As part of electrical performance testing, a new calendar-life test protocol was used. The test consisted of a once-per-day discharge and charge pulse designed to have minimal impact on the cell yet establish the performance of the cell over a period of time such that the calendar life of the cell could be determined. The calendar life test matrix included two states of charge (i.e., 60 and 80%) and four temperatures (40, 50, 60, and 70 C). Discharge and regen resistances were calculated from the test data. Results indicate that both discharge and regen resistance increased nonlinearly as a function of the test time. The magnitude of the discharge and regen resistance depended on the temperature and state of charge at which the test was conducted. The calculated discharge and regen resistances were then used to develop empirical models that may be useful to predict the calendar life or the cells

  8. The environmental control and life support system advanced automation project. Phase 1: Application evaluation

    Science.gov (United States)

    Dewberry, Brandon S.

    1990-01-01

    The Environmental Control and Life Support System (ECLSS) is a Freedom Station distributed system with inherent applicability to advanced automation primarily due to the comparatively large reaction times of its subsystem processes. This allows longer contemplation times in which to form a more intelligent control strategy and to detect or prevent faults. The objective of the ECLSS Advanced Automation Project is to reduce the flight and ground manpower needed to support the initial and evolutionary ECLS system. The approach is to search out and make apparent those processes in the baseline system which are in need of more automatic control and fault detection strategies, to influence the ECLSS design by suggesting software hooks and hardware scars which will allow easy adaptation to advanced algorithms, and to develop complex software prototypes which fit into the ECLSS software architecture and will be shown in an ECLSS hardware testbed to increase the autonomy of the system. Covered here are the preliminary investigation and evaluation process, aimed at searching the ECLSS for candidate functions for automation and providing a software hooks and hardware scars analysis. This analysis shows changes needed in the baselined system for easy accommodation of knowledge-based or other complex implementations which, when integrated in flight or ground sustaining engineering architectures, will produce a more autonomous and fault tolerant Environmental Control and Life Support System.

  9. Experimental Creep Life Assessment for the Advanced Stirling Convertor Heater Head

    Science.gov (United States)

    Krause, David L.; Kalluri, Sreeramesh; Shah, Ashwin R.; Korovaichuk, Igor

    2010-01-01

    The United States Department of Energy is planning to develop the Advanced Stirling Radioisotope Generator (ASRG) for the National Aeronautics and Space Administration (NASA) for potential use on future space missions. The ASRG provides substantial efficiency and specific power improvements over radioisotope power systems of heritage designs. The ASRG would use General Purpose Heat Source modules as energy sources and the free-piston Advanced Stirling Convertor (ASC) to convert heat into electrical energy. Lockheed Martin Corporation of Valley Forge, Pennsylvania, is integrating the ASRG systems, and Sunpower, Inc., of Athens, Ohio, is designing and building the ASC. NASA Glenn Research Center of Cleveland, Ohio, manages the Sunpower contract and provides technology development in several areas for the ASC. One area is reliability assessment for the ASC heater head, a critical pressure vessel within which heat is converted into mechanical oscillation of a displacer piston. For high system efficiency, the ASC heater head operates at very high temperature (850 C) and therefore is fabricated from an advanced heat-resistant nickel-based superalloy Microcast MarM-247. Since use of MarM-247 in a thin-walled pressure vessel is atypical, much effort is required to assure that the system will operate reliably for its design life of 17 years. One life-limiting structural response for this application is creep; creep deformation is the accumulation of time-dependent inelastic strain under sustained loading over time. If allowed to progress, the deformation eventually results in creep rupture. Since creep material properties are not available in the open literature, a detailed creep life assessment of the ASC heater head effort is underway. This paper presents an overview of that creep life assessment approach, including the reliability-based creep criteria developed from coupon testing, and the associated heater head deterministic and probabilistic analyses. The approach also

  10. Life Cycle Assessment as a tool for green Chemistry: Application to different advanced oxidation processes for wastewater treatment

    Energy Technology Data Exchange (ETDEWEB)

    Munoz Ortiz, I.; Domenech Antunez, X.; Malato Rodriguez, S.

    2006-07-01

    The development of chemistry during the twentieth century has changed our lives. In fact, chemistry and chemicals surrounds US in our daily activities, due to the huge supply of products aimed at improving our quality of life. Chemistry has resulted in the medical revolution of the past century, in which drugs as antibiotics have been used to cure diseases that affected mankind for centuries. These advances have led to the rise in the average life expectancy from 47 in 1900, to 75 years in the 1990s (Breslow 1997). On the other hand, the world's food supply has seen an explosive expansion because of the development of pesticides as well as fertilisers that protect crops and improve their productivity. Other common chemicals are those related to hygiene, such as soaps, detergents, disinfectants, toothpaste, etc. Therefore, there is practically no facet in material life-transportation communication, clothing, shelter, office- in which chemistry does not play an important role, either to supply consumer products or to improve services addressed to society in general (Domenech 2005). In spite of all these clear benefits, the chemical industry is often viewed by the general public as causing more harm than good (Lancaster 2002). A major reason for this is that the industry is perceived as being polluting and causing significant environmental damage. Indeed, the manufacture, use and disposal of chemicals consume large amounts of resources, and originates emissions of pollutants to all environmental compartments, not to mention the numerous accidents and disasters in which the chemical industry has been involved in the recent past. (Author)

  11. Knowledge, attitude and practice of basic life support among junior doctors and students in a tertiary care medical institute

    OpenAIRE

    Md. Yunus; Animesh Mishra; Habib M. R. Karim; Vandana Raphael; Ghazal Ahmed; Catherine E. Myrthong

    2015-01-01

    Background: Basic life support (BLS) is an integral part of health care. However, teaching of BLS is not yet a part of protocolized curriculum and uniform throughout. The present study is designed to assess the knowledge, attitude and practice of BLS and compare it among trained and untrained medical students and junior doctors in a medical institute. Methods: After approval from Institute Ethical Committee and informed consent from the participant, the present study was conducted among t...

  12. Adult patients with pulmonary arterial hypertension due to congenital heart disease: a review on advanced medical treatment with bosentan

    Directory of Open Access Journals (Sweden)

    Mark J Schuuring

    2010-08-01

    Full Text Available Mark J Schuuring1,2, Jeroen C Vis1,2, Marielle G Duffels1, Berto J Bouma1, Barbara JM Mulder1,21Department of Cardiology, Academic Medical Centre, Amsterdam, The Netherlands; 2Interuniversity Cardiology Institute of The Netherlands, Utrecht, The NetherlandsAbstract: Pulmonary arterial hypertension (PAH is a progressive disease with poor survival outcome. PAH is classified by the 2009 updated clinical classification of pulmonary hypertension and a major subgroup is PAH due to congenital heart disease (CHD with systemic-to-pulmonary shunt. CHD-PAH is a result of systemic-to-pulmonary shunting and chronic increased flow that ultimately results in adaptations of pulmonary vasculature and endothelial dysfunction. The advanced stage is called Eisenmenger syndrome which forms a small percentage (1% of all CHD patients. Therapies targeted on PAH symptoms are called primary therapy for PAH, but most CHD-PAH patients progress to advanced therapy which is directed at the PAH itself. In CHD-PAH, advanced therapies are extensively investigated for all three major pathways: endothelin-1 receptor antagonists such as bosentan, prostanoids such as epoprostenol and phosphodiesterase 5 inhibitors such as sildenafil. Endpoints in most trials were catheterization hemodynamics, World Health Organization functional class, six-minute walking distance and patient-focused outcomes, based on quality of life questionnaires and Borg dyspnea index. The BREATHE-5 and EARLY study were two important randomized controlled trials showing efficacy of bosentan at short follow-up. Moreover in patients with Eisenmenger syndrome, one recent survival retrospective study with majority of patients on bosentan showed strong survival benefit over conservative therapy. A diversity of prospective cohort and retrospective studies were performed but all with limited data, due to small numbers and heterogeneity of underlying CHD diagnoses. Further larger studies are needed to determine optimal

  13. [Discussion on Quality Evaluation Method of Medical Device During Life-Cycle in Operation Based on the Analytic Hierarchy Process].

    Science.gov (United States)

    Zheng, Caixian; Zheng, Kun; Shen, Yunming; Wu, Yunyun

    2016-01-01

    The content related to the quality during life-cycle in operation of medical device includes daily use, repair volume, preventive maintenance, quality control and adverse event monitoring. In view of this, the article aims at discussion on the quality evaluation method of medical devices during their life cycle in operation based on the Analytic Hierarchy Process (AHP). The presented method is proved to be effective by evaluating patient monitors as example. The method presented in can promote and guide the device quality control work, and it can provide valuable inputs to decisions about purchase of new device. PMID:27197489

  14. Targeted medical therapy of biliary tract cancer: Recent advances and future perspectives

    Institute of Scientific and Technical Information of China (English)

    2008-01-01

    The limited efficacy of cytotoxic therapy for advanced biliary tract and gallbladder cancers emphasizes the need for novel and more effective medical treatment options. A better understanding of the specific biological features of these neoplasms led to the development of new targeted therapies, which take the abundant expression of several growth factors and cognate tyrosine kinase receptors into account. This review will briefly summarize the status and future perspectives of antiangiogenic and growth factor receptor-based pharmacological approaches for the treatment of biliary tract and gallbladder cancers. In view of multiple novel targeted approaches, the rationale for innovative therapies, such as combinations of growth factor (receptor)-targeting agents with cytotoxic drugs or with other novel anticancer drugs will be highlighted.

  15. Available evidence and new biological perspectives on medical treatment of advanced thymic epithelial tumors.

    Science.gov (United States)

    Serpico, D; Trama, A; Haspinger, E R; Agustoni, F; Botta, L; Berardi, R; Palmieri, G; Zucali, P; Gallucci, R; Broggini, M; Gatta, G; Pastorino, U; Pelosi, G; de Braud, F; Garassino, M C

    2015-05-01

    Thymic epithelial tumors (TETs) are rare primary mediastinal tumors arising from thymic epithelium. Their rarity and complexity hinder investigations of their causes and therapy development. Here, we summarize the existing knowledge regarding medical treatment of these tumors, and thoroughly review the known genetic aberrations associated with TETs and the present status of potential biological treatments. Epidermal growth factor receptor (EGFR), stem-cell factor receptor, insulin-like growth factor-1 receptor (IGF1R), and vascular endothelial growth factors (VEGF-A, VEGF-B, and VEGF-2) are overexpressed in TETs. EGFR overexpression in TETs is associated with higher stage, and IGF1R overexpression has poor prognostic value. Data indicate that anti-IGF1R monoclonal antibodies, and inhibitors of angiogenesis, somatostatin receptors, histone deacetylase, mammalian target of rapamycin, and cyclin-dependent kinases may be active against TETs. Continued investigations in this field could lead to advancement of targeted and biological therapies for TETs. PMID:25411417

  16. ERCC1, toxicity and quality of life in advanced NSCLC patients randomized in a large multicentre phase III trial

    DEFF Research Database (Denmark)

    Vilmar, Adam Christian; Santoni-Rugiu, Eric; Sørensen, Jens Benn

    2010-01-01

    Excision repair cross complementation group 1 (ERCC1) is a promising biomarker in advanced non-small cell lung cancer (NSCLC). However, current evidence regarding the impact of ERCC1 on toxicity and quality of life (QOL) is limited.......Excision repair cross complementation group 1 (ERCC1) is a promising biomarker in advanced non-small cell lung cancer (NSCLC). However, current evidence regarding the impact of ERCC1 on toxicity and quality of life (QOL) is limited....

  17. The Chinese community patient’s life satisfaction, assessment of community medical service, and trust in community health delivery system

    OpenAIRE

    Tang Liyang

    2013-01-01

    Abstract Background Although the Chinese government put a lot of effort into promoting the community patient’s life satisfaction, there still lacked the holistic and systematic approaches to promote the community patient’s life satisfaction in various regions of China. On the basis of the literature, it was found that both the community patient’s assessment of community medical service and trust in community health delivery system were important considerations when the community patient compr...

  18. Physical sciences and engineering advances in life sciences and oncology a WTEC global assessment

    CERN Document Server

    Fletcher, Daniel; Gerecht, Sharon; Levine, Ross; Mallick, Parag; McCarty, Owen; Munn, Lance; Reinhart-King, Cynthia

    2016-01-01

    This book presents an Assessment of Physical Sciences and Engineering Advances in Life Sciences and Oncology (APHELION) by a panel of experts. It covers the status and trends of applying physical sciences and engineering principles to oncology research in leading laboratories and organizations in Europe and Asia. The book elaborates on the six topics identified by the panel that have the greatest potential to advance understanding and treatment of cancer, each covered by a chapter in the book. The study was sponsored by the National Cancer Institute (NCI) at the National Institute of Health (NIH), the National Science Foundation (NSF) and the National Institute of Biomedical Imaging and Bioengineering at the NIH in the US under a cooperative agreement with the World Technology Evaluation Center (WTEC).

  19. Life-threatening coagulopathy and hypofibrinogenaemia induced by tigecycline in a patient with advanced liver cirrhosis.

    Science.gov (United States)

    Rossitto, Giacomo; Piano, Salvatore; Rosi, Silvia; Simioni, Paolo; Angeli, Paolo

    2014-06-01

    Bacterial infections because of multidrug-resistant (MDR) bacteria are spreading worldwide. In patients with advanced liver cirrhosis, healthcare-acquired and hospital-acquired infections are common and are frequently sustained by MDR bacteria. In these settings, tigecycline, a new antibiotic, has been shown to be useful in the treatment of MDR bacteria, and it has been proposed for the treatment of hospital-acquired infections in patients with cirrhosis. Nevertheless, poor data exist on the safety profile of tigecycline in patients with cirrhosis. Here, an experience is reported in a female patient with advanced liver cirrhosis, who developed sepsis by an MDR Stenotrophomonas maltophilia and was treated with tigecycline. She experienced life-threatening side effects consisting of severe coagulopathy with hypofibrinogenaemia and subsequent gastrointestinal haemorrhage. The side effect disappeared after the withdrawal of tigecycline. Therefore, a strict monitoring of coagulation parameters in patients with cirrhosis treated with tigecycline is recommended. PMID:24667348

  20. The "Conflicted Dying": The Active Search for Life Extension in Advanced Cancer Through Biomedical Treatment.

    Science.gov (United States)

    Mohammed, Shan; Peter, Elizabeth; Gastaldo, Denise; Howell, Doris

    2016-03-01

    Using a poststructural perspective, we examine the subjectivities that are produced when advanced cancer patients seek life extension through biomedical treatments. Seven case studies were developed that included 20 interviews with patients, family, nurses, and physicians recruited from a tertiary hospital in Canada, 30 documents, and 5 hours of participant observation. We identify seven types of subjectivity: (a) the Desperate Subject, (b) the Cancer Expert Subject, (c) the Proactive Subject, (d) the Productive Subject, (e) the Mistrusting Subject, (f) the Model Patient Subject, and (g) the Suffering Subject. We characterize the "conflicted dying," a contemporary figure who holds multiple perspectives about seeking curative treatment despite the acknowledgment of death. Using active strategies to gain access to treatment, this figure resists traditional arrangements of power/knowledge established by health care providers. We suggest that the search for life extension is a process of shaping the self to fit certain aesthetical traits associated with surviving cancer. PMID:25711844

  1. Advancing Life Projects: South African Students Explain Why They Come to FET Colleges

    Directory of Open Access Journals (Sweden)

    Lesley Powell

    2014-10-01

    Full Text Available Vocational Education and Training (VET policy in South Africa is based on a narrow set of assumptions regarding the identity of learners and the reasons that they are in public further education and training (FET colleges. These assumptions reflect an international orthodoxy about the centrality of employability that is located within what Giddens (1994 has described as 'productivism', a view that reduces life to the economic sphere. Through exploring the stories of a group of South African public FET college learners' regarding their reasons for choosing FET colleges, this paper shows that VET is valued by these students for a range of reasons. These include preparation for the world of work, but also a desire to improve their ability to contribute to their communities and families; raise their self-esteem; and expand their future life possibilities. Thus, the paper advances the largely hitherto theoretical critique of productivist VET accounts by offering empirical evidence of counter-narratives.

  2. Performance and life evaluation of advanced battery technologies for electric vehicle applications

    Science.gov (United States)

    Deluca, W. H.; Gillie, K. R.; Kulaga, J. E.; Smaga, J. A.; Tummillo, A. F.; Webster, C. E.

    Advanced battery technology evaluations are performed under simulated electric vehicle (EV) operating conditions at the Argonne Analysis and Diagnostic Laboratory (ADL). The ADL provides a common basis for both performance characterization and life evaluation with unbiased application of tests and analyses. This paper summarizes the performance characterizations and life evaluations conducted in 1990 on nine single cells and fifteen 3- to 360-cell modules that encompass six technologies: (Na/S, Zn/Br, Ni/Fe, Ni/Cd, Ni-metal hydride, and lead-acid). These evaluations were performed for the Department of Energy and Electric Power Research Institute. The results provide battery users, developers, and program managers an interim measure of the progress being made in battery R and D programs, a comparison of battery technologies, and a source of basic data for modelling and continuing R and D.

  3. Award-Winning CARES/Life Ceramics Durability Evaluation Software Is Making Advanced Technology Accessible

    Science.gov (United States)

    1997-01-01

    Products made from advanced ceramics show great promise for revolutionizing aerospace and terrestrial propulsion and power generation. However, ceramic components are difficult to design because brittle materials in general have widely varying strength values. The CARES/Life software developed at the NASA Lewis Research Center eases this by providing a tool that uses probabilistic reliability analysis techniques to optimize the design and manufacture of brittle material components. CARES/Life is an integrated package that predicts the probability of a monolithic ceramic component's failure as a function of its time in service. It couples commercial finite element programs--which resolve a component's temperature and stress distribution - with reliability evaluation and fracture mechanics routines for modeling strength - limiting defects. These routines are based on calculations of the probabilistic nature of the brittle material's strength.

  4. Environmental control and life support system requirements and technology needs for advanced manned space missions

    Science.gov (United States)

    Powell, Ferolyn T.; Sedej, Melaine; Lin, Chin

    1987-01-01

    NASA has completed an environmental control and life support system (ECLSS) technology R&D plan for advanced missions which gave attention to the drivers (crew size, mission duration, etc.) of a range of manned missions under consideration. Key planning guidelines encompassed a time horizon greater than 50 years, funding resource requirements, an evolutionary approach to goal definition, and the funding of more than one approach to satisfy a given perceived requirement. Attention was given to the ECLSS requirements of transportation and service vehicles, platforms, bases and settlements, ECLSS functions and average load requirements, unique drivers for various missions, and potentially exploitable commonalities among vehicles and habitats.

  5. Activity and meaning-making in everyday life of people with advanced cancer

    DEFF Research Database (Denmark)

    la Cour, Karen; Johannessen, Helle; Josephsson, Staffan

    2009-01-01

    narrative of “being healthy although ill” provided an arena for exploring the contrast between simultaneously feeling well and severely ill. Further emplotment of activities in “routines and continuity” was identified as a means to provide a safe, familiar framework stimulating participants’ everyday agency......Objective: This study aims to explore and understand how people with advanced cancer create meaning and handle everyday life through activity. Methods: A purposive sample of seven participants was recruited from a larger study. Data were collected through qualitative interviews and participant...... in creating meaning in the remains of their lives....

  6. Fluctuating functions related to quality of life in advanced Parkinson disease: effects of duodenal levodopa infusion

    DEFF Research Database (Denmark)

    Isacson, D; Bingefors, K; Sønbø Kristiansen, Ivar

    2008-01-01

    OBJECTIVE: To assess fluctuations in quality of life (QoL) and motor performance in patients with advanced Parkinson disease (PD) treated with continuous daytime duodenal levodopa/carbidopa infusion or conventional therapy. METHODS: Of 18 patients completing a 6-week trial (DIREQT), 12 were...... significantly more favourable outcomes compared with conventional treatment for satisfaction with overall functioning, 'off' time and ability to walk, with improved outcomes with PDQ-39. CONCLUSIONS: Relative to conventional treatment, infusion therapy may stabilize and significantly improve motor function and...

  7. Assessment of Advanced Life Support competence when combining different test methods--reliability and validity

    DEFF Research Database (Denmark)

    Ringsted, C; Lippert, F; Hesselfeldt, R;

    2007-01-01

    Summary Robust assessment of Advanced Life Support (ALS) competence is paramount to the credibility of ALS-provider certification and for estimating the learning outcome and retention of ALS competence following the courses. The Euro- pean Resuscitation Council (ERC) provides two sets of MCQs and...... Correlation Coefficients between 0.766 and 0.977. Inter-rater agreements on pass/fail decisions were not perfect. The one MCQ test was significantly more difficult than the other. There were no significant differences between CASTests....

  8. Evaluating the Effects of Medical Explorers a Case Study Curriculum on Critical Thinking, Attitude Toward Life Science, and Motivational Learning Strategies in Rural High School Students

    Science.gov (United States)

    Brand, Lance G.

    2011-12-01

    The purpose of this study was three-fold: to measure the ability of the Medical Explorers case-based curriculum to improve higher order thinking skills; to evaluate the impact of the Medical Explorers case-based curriculum to help students be self directed learners; and to investigate the impact of the Medical Explorers case-based curriculum to improve student attitudes of the life sciences. The target population for this study was secondary students enrolled in advanced life science programs. The resulting sample (n = 71) consisted of 36 students in the case-based experimental group and 35 students in the control group. Furthermore, this study employed an experimental, pretest-posttest control group research design. The treatment consisted of two instructional strategies: case-based learning and teacher-guided learning. Analysis of covariance indicated no treatment effect on critical thinking ability or Motivation and Self-regulation of Learning. However, the Medical Explorers case-based curriculum did show a treatment effect on student attitudes toward the life sciences. These results seem to indicate that case-based curriculum has a positive impact on students' perspectives and attitudes about the study of life science as well as their interest in life science based careers. Such outcomes are also a good indicator that students enjoy and perceive the value to use of case studies in science, and because they see value in the work that they do they open up their minds to true learning and integration. Of additional interest was the observationthat on average eleventh graders showed consistently stronger gains in critical thinking, motivation and self-regulation of learning strategies, and attitudes toward the life sciences as compared to twelfth grade students. In fact, twelfth grade students showed a pre to post loss on the Watson-Glaser and the MSLQ scores while eleventh grade students showed positive gains on each of these instruments. This decline in twelfth

  9. Crop Production for Advanced Life Support Systems - Observations From the Kennedy Space Center Breadboard Project

    Science.gov (United States)

    Wheeler, R. M.; Sager, J. C.; Prince, R. P.; Knott, W. M.; Mackowiak, C. L.; Stutte, G. W.; Yorio, N. C.; Ruffe, L. M.; Peterson, B. V.; Goins, G. D.

    2003-01-01

    The use of plants for bioregenerative life support for space missions was first studied by the US Air Force in the 1950s and 1960s. Extensive testing was also conducted from the 1960s through the 1980s by Russian researchers located at the Institute of Biophysics in Krasnoyarsk, Siberia, and the Institute for Biomedical Problems in Moscow. NASA initiated bioregenerative research in the 1960s (e.g., Hydrogenomonas) but this research did not include testing with plants until about 1980, with the start of the Controlled Ecological Life Support System (CELSS) Program. The NASA CELSS research was carried out at universities, private corporations, and NASA field centers, including Kennedy Space Center (KSC). The project at KSC began in 1985 and was called the CELSS Breadboard Project to indicate the capability for plugging in and testing various life support technologies; this name has since been dropped but bioregenerative testing at KSC has continued to the present under the NASA s Advanced Life Support (ALS) Program. A primary objective of the KSC testing was to conduct pre-integration tests with plants (crops) in a large, atmospherically closed test chamber called the Biomass Production Chamber (BPC). Test protocols for the BPC were based on observations and growing procedures developed by university investigators, as well as procedures developed in plant growth chamber studies at KSC. Growth chamber studies to support BPC testing focused on plant responses to different carbon dioxide (CO2) concentrations, different spectral qualities from various electric lamps, and nutrient film hydroponic culture techniques.

  10. Building Irish families through surrogacy: medical and judicial issues for the advanced reproductive technologies.

    LENUS (Irish Health Repository)

    Sills, Eric Scott

    2008-01-01

    Surrogacy involves one woman (surrogate mother) carrying a child for another person\\/s (commissioning person\\/couple), based on a mutual agreement requiring the child to be handed over to the commissioning person\\/couple following birth. Reasons for seeking surrogacy include situations where a woman has non-functional or absent reproductive organs, or as a remedy for recurrent pregnancy loss. Additionally, surrogacy may find application in any medical context where pregnancy is contraindicated, or where a couple consisting of two males seek to become parents through oocyte donation. Gestational surrogacy is one of the main issues at the forefront of bioethics and the advanced reproductive technologies, representing an important challenge to medical law. This analysis reviews the history of surrogacy and clinical and legal issues pertaining to this branch of reproductive medicine. Interestingly, the Medical Council of Ireland does not acknowledge surrogacy in its current practice guidelines, nor is there specific legislation addressing surrogacy in Ireland at present. We therefore have developed a contract-based model for surrogacy in which, courts in Ireland may consider when confronted with a surrogacy dispute, and formulated a system to resolve any potential dispute arising from a surrogacy arrangement. While the 2005 report by the Commission on Assisted Human Reproduction (CAHR) is an expert opinion guiding the Oireachtas\\' development of specific legislation governing assisted human reproduction and surrogacy, our report represents independent scholarship on the contractual elements of surrogacy with particular focus on how Irish courts might decide on surrogacy matters in a modern day Ireland. This joint medico-legal collaborative also reviews the contract for services arrangement between the commissioning person\\/s and the surrogate, and the extent to which the contract may be enforced.

  11. Building Irish families through surrogacy: medical and judicial issues for the advanced reproductive technologies

    Directory of Open Access Journals (Sweden)

    Healy Clifford M

    2008-11-01

    Full Text Available Abstract Surrogacy involves one woman (surrogate mother carrying a child for another person/s (commissioning person/couple, based on a mutual agreement requiring the child to be handed over to the commissioning person/couple following birth. Reasons for seeking surrogacy include situations where a woman has non-functional or absent reproductive organs, or as a remedy for recurrent pregnancy loss. Additionally, surrogacy may find application in any medical context where pregnancy is contraindicated, or where a couple consisting of two males seek to become parents through oocyte donation. Gestational surrogacy is one of the main issues at the forefront of bioethics and the advanced reproductive technologies, representing an important challenge to medical law. This analysis reviews the history of surrogacy and clinical and legal issues pertaining to this branch of reproductive medicine. Interestingly, the Medical Council of Ireland does not acknowledge surrogacy in its current practice guidelines, nor is there specific legislation addressing surrogacy in Ireland at present. We therefore have developed a contract-based model for surrogacy in which, courts in Ireland may consider when confronted with a surrogacy dispute, and formulated a system to resolve any potential dispute arising from a surrogacy arrangement. While the 2005 report by the Commission on Assisted Human Reproduction (CAHR is an expert opinion guiding the Oireachtas' development of specific legislation governing assisted human reproduction and surrogacy, our report represents independent scholarship on the contractual elements of surrogacy with particular focus on how Irish courts might decide on surrogacy matters in a modern day Ireland. This joint medico-legal collaborative also reviews the contract for services arrangement between the commissioning person/s and the surrogate, and the extent to which the contract may be enforced.

  12. Building Irish families through surrogacy: medical and judicial issues for the advanced reproductive technologies.

    Science.gov (United States)

    Sills, Eric Scott; Healy, Clifford M

    2008-01-01

    Surrogacy involves one woman (surrogate mother) carrying a child for another person/s (commissioning person/couple), based on a mutual agreement requiring the child to be handed over to the commissioning person/couple following birth. Reasons for seeking surrogacy include situations where a woman has non-functional or absent reproductive organs, or as a remedy for recurrent pregnancy loss. Additionally, surrogacy may find application in any medical context where pregnancy is contraindicated, or where a couple consisting of two males seek to become parents through oocyte donation. Gestational surrogacy is one of the main issues at the forefront of bioethics and the advanced reproductive technologies, representing an important challenge to medical law. This analysis reviews the history of surrogacy and clinical and legal issues pertaining to this branch of reproductive medicine. Interestingly, the Medical Council of Ireland does not acknowledge surrogacy in its current practice guidelines, nor is there specific legislation addressing surrogacy in Ireland at present. We therefore have developed a contract-based model for surrogacy in which, courts in Ireland may consider when confronted with a surrogacy dispute, and formulated a system to resolve any potential dispute arising from a surrogacy arrangement. While the 2005 report by the Commission on Assisted Human Reproduction (CAHR) is an expert opinion guiding the Oireachtas' development of specific legislation governing assisted human reproduction and surrogacy, our report represents independent scholarship on the contractual elements of surrogacy with particular focus on how Irish courts might decide on surrogacy matters in a modern day Ireland. This joint medico-legal collaborative also reviews the contract for services arrangement between the commissioning person/s and the surrogate, and the extent to which the contract may be enforced. PMID:18983640

  13. Training medics for the combat environment of tomorrow.

    Science.gov (United States)

    Ekblad, G S

    1990-05-01

    Advanced training for medics and corpsmen in the field would help prevent deaths and disabilities. Courses in Basic Trauma Life Support (BTLS) and Advanced Trauma Life Support (ATLS) can be used as a format for standardizing the approach to the injured patient. It can be integrated into the military setting along with the basic survival skills needed by the unit's medical provider. PMID:2114591

  14. Advanced life support provider course in Italy: A 5-year nationwide study to identify the determinants of course success

    NARCIS (Netherlands)

    F. Semeraro; A. Scapigliati; G. Tammaro; U. Olcese; E.L. Cerchiari; G. Ristagno

    2015-01-01

    INTRODUCTION: The advanced life support (ALS) provider course is the gold standard for teaching and assessing competence in advanced resuscitation. Outcomes over a 5-year period of European Resuscitation (ERC)/IRC ALS provider courses in Italy were investigated, and the factors associated with cours

  15. Measuring quality of life: impact of chemotherapy for advanced colorectal cancer. Experience from two recent large phase III trials.

    OpenAIRE

    Anderson, H; Palmer, M. K.

    1998-01-01

    When assessing the value of a particular treatment, it is important to consider the impact it may have on the quality of life of those being treated. This is particularly so for cancer patients, whose life expectancy may be short. Patients with advanced colorectal cancer who participated in two international comparative studies of raltitrexed ('Tomudex') vs standard 5-fluorouracil (5-FU) plus leucovorin (LV) completed previously validated quality-of-life questionnaires (EORTC questionnaire, E...

  16. Paul Scherrer Institut annual report 1994. Annex II: PSI life sciences and institute for medical radiobiology newsletter 1994

    International Nuclear Information System (INIS)

    This annex reports on the PSI life science division's progress achieved during 1994 in the fields of radiation medicine, radiopharmacy, magnetic resonance imaging, radiation hygiene, positron emission tomography (PET) and medical radiology. A bibliography of the department's publications is included. figs., tabs., refs

  17. Paul Scherrer Institut annual report 1994. Annex II: PSI life sciences and institute for medical radiobiology newsletter 1994

    Energy Technology Data Exchange (ETDEWEB)

    Reist, H.W. [ed.] [Paul Scherrer Inst. (PSI), Villigen (Switzerland)

    1995-10-01

    This annex reports on the PSI life science division`s progress achieved during 1994 in the fields of radiation medicine, radiopharmacy, magnetic resonance imaging, radiation hygiene, positron emission tomography (PET) and medical radiology. A bibliography of the department`s publications is included. figs., tabs., refs.

  18. Refusal of Medical Blood Transfusions Among Jehovah's Witnesses: Emotion Regulation of the Dissonance of Saving and Sacrificing Life.

    Science.gov (United States)

    Ringnes, Hege Kristin; Hegstad, Harald

    2016-10-01

    This study focuses on the requirement of JWs to refuse medical blood transfusions. We identified a life-death cognitive dissonance among JWs, with the opposing cognitions of being willing to sacrifice life by religious standards, while being unwilling to do so. Using a theory that connects cognitive dissonance with the need to regulate difficult emotions to analyze our qualitative data material, we identified two sets of dissonance reduction strategies among the JWs. Set 1 was tied to the individual-group: selective focus on eternal life, a non-blood support and control system, and increased individualization of treatment choices. Set 2 was in the religion versus medicine intersection: denial of risk combined with optimism, perception of blood as dangerous, and use of medical language to underscore religious doctrine. PMID:27094707

  19. The Environmental Control and Life Support System (ECLSS) advanced automation project

    Science.gov (United States)

    Dewberry, Brandon S.; Carnes, Ray

    1990-01-01

    The objective of the environmental control and life support system (ECLSS) Advanced Automation Project is to influence the design of the initial and evolutionary Space Station Freedom Program (SSFP) ECLSS toward a man-made closed environment in which minimal flight and ground manpower is needed. Another objective includes capturing ECLSS design and development knowledge future missions. Our approach has been to (1) analyze the SSFP ECLSS, (2) envision as our goal a fully automated evolutionary environmental control system - an augmentation of the baseline, and (3) document the advanced software systems, hooks, and scars which will be necessary to achieve this goal. From this analysis, prototype software is being developed, and will be tested using air and water recovery simulations and hardware subsystems. In addition, the advanced software is being designed, developed, and tested using automation software management plan and lifecycle tools. Automated knowledge acquisition, engineering, verification and testing tools are being used to develop the software. In this way, we can capture ECLSS development knowledge for future use develop more robust and complex software, provide feedback to the knowledge based system tool community, and ensure proper visibility of our efforts.

  20. Quality of life among advanced breast cancer patients with and without distant metastasis.

    Science.gov (United States)

    Wyatt, G; Sikorskii, A; Tamkus, D; You, M

    2013-03-01

    This study presents the results of a secondary analysis of data collected during a trial of reflexology that aimed to improve health-related quality of life (HRQOL) among women with advanced breast cancer in treatment. A comparison of HRQOL (functioning, symptoms, spirituality) of those with (n = 298) and without (n = 87) distant metastasis is presented. Following the intake interview, 385 women were randomised to reflexology, lay foot manipulation or conventional care control, and were interviewed again at weeks 5 and 11. Those with distant metastasis were older, had fewer comorbid conditions, and a smaller proportion were employed. Longitudinal analysis of HRQOL at intake, 5 and 11 weeks revealed that those with distant metastasis had lower functioning and more pain; however, no differences were found on fatigue, nausea, shortness of breath, sleep quality, anxiety, depressive symptoms or spirituality. Despite advanced disease, 56% of all women in this study were below the clinical screening cut-off for depressive symptoms. These findings may indicate that patients with advanced breast cancer have adapted emotionally and spiritually; however, the management of physical symptoms remains a priority. PMID:23252474

  1. A novel medical image data-based multi-physics simulation platform for computational life sciences.

    Science.gov (United States)

    Neufeld, Esra; Szczerba, Dominik; Chavannes, Nicolas; Kuster, Niels

    2013-04-01

    Simulating and modelling complex biological systems in computational life sciences requires specialized software tools that can perform medical image data-based modelling, jointly visualize the data and computational results, and handle large, complex, realistic and often noisy anatomical models. The required novel solvers must provide the power to model the physics, biology and physiology of living tissue within the full complexity of the human anatomy (e.g. neuronal activity, perfusion and ultrasound propagation). A multi-physics simulation platform satisfying these requirements has been developed for applications including device development and optimization, safety assessment, basic research, and treatment planning. This simulation platform consists of detailed, parametrized anatomical models, a segmentation and meshing tool, a wide range of solvers and optimizers, a framework for the rapid development of specialized and parallelized finite element method solvers, a visualization toolkit-based visualization engine, a Python scripting interface for customized applications, a coupling framework, and more. Core components are cross-platform compatible and use open formats. Several examples of applications are presented: hyperthermia cancer treatment planning, tumour growth modelling, evaluating the magneto-haemodynamic effect as a biomarker and physics-based morphing of anatomical models. PMID:24427518

  2. HEALTH SURVEY AND LIFE HABITS OF NURSES WHO WORK AT THE MEDICAL FACULTY HOSPITAL AT AIBU

    Directory of Open Access Journals (Sweden)

    Fatih DENIZ

    2005-04-01

    Full Text Available Objectives: Nursing is an occupation needed renunciation, patience and physical endurance. Nurses have to prevent their physical and mental health, because they can be more beneficial to patients. A cross-sectional study was conducted on AIBU Duzce Medical School Nurses to determine health problems and nutritional habits. Materials and Methods: The questionnaires forms filled by 79 nurses(%86 and analysed the data using an statistical package programme. Results: Mean age of the study group was 23.5 ± 0.2(Standard Erroryears. The answer to ‘Do you satisfied in your life?’question was reported ‘fair’ in 39.7% of the group. 65.7% reported no physical activity. Skipped meals were 80.9%. The most frequent health problems were reported as low back pain (52.9%, back pain (48.5%, stomach pain (48.5%, shoulder pain (38.2% and neck pain (38.2%. Twenty-six and half percent of the group were not immunized against to Hepatitis B. Conclusion: Occupational health and safety unit must be established in workplace. Training about occupational risks and stress management must be given to nurses. [TAF Prev Med Bull 2005; 4(2.000: 55-65

  3. Palliative and end of life care communication as emerging priorities in postgraduate medical education

    Science.gov (United States)

    des Ordons, Amanda Roze; Ajjawi, Rola; Macdonald, John; Sarti, Aimee; Lockyer, Jocelyn; Hartwick, Michael

    2016-01-01

    Background Reliance on surveys and qualitative studies of trainees to guide postgraduate education about palliative and end of life (EOL) communication may lead to gaps in the curriculum. We aimed to develop a deeper understanding of internal medicine trainees’ educational needs for a palliative and EOL communication curriculum and how these needs could be met. Methods Mixed methods, including a survey and focus groups with trainees, and interviews with clinical faculty and medical educators, were applied to develop a broader perspective on current experiences and needs for further education. Quantitative descriptive and thematic analyses were conducted. Results Surveyed trainees were least confident and least satisfied with teaching in counseling about the emotional impact of emergencies and discussing organ donation. Direct observation with feedback, small group discussion, and viewing videos of personal consultations were perceived as effective, yet infrequently identified as instructional methods. Focus groups and interviews identified goals of care conversations as the highest educational priority, with education adapted to learner needs and accompanied by feedback and concurrent clinical and organizational support. Conclusions Our work expands on previous research describing needs for postgraduate education in palliative and EOL communication to include the importance of support, culture change, and faculty development, and provides insight into why such needs exist. PMID:27103952

  4. Planning a pharmacy-led medical mission trip, part 3: development and implementation of an elective medical missions advanced pharmacy practice experience (APPE) rotation.

    Science.gov (United States)

    Brown, Dana A; Ferrill, Mary J

    2012-01-01

    With an increasing number of new pharmacy schools/colleges and expansion of existing ones, pharmacy schools/colleges are often in need of elective rotation experiences as part of the final year advanced pharmacy practice experience (APPE) program. Offering a medical missions elective APPE in either a domestic or international setting is a unique opportunity to expose pharmacy students to direct patient care. APPE students can be involved in triaging patients, compounding and dispensing medications, and providing patient education. As part of this APPE, pharmacy students are expected to complete projects such as formulary development, case presentations, book club discussions, journal reflections, manuscript preparations, and trip logistics planning. An elective APPE focused on medical missions facilitates the learning process and promotes the emergence of team leaders and leadership skills in general. PMID:22739719

  5. Next Generation Life Support Project: Development of Advanced Technologies for Human Exploration Missions

    Science.gov (United States)

    Barta, Daniel J.

    2012-01-01

    Next Generation Life Support (NGLS) is one of several technology development projects sponsored by the National Aeronautics and Space Administration s Game Changing Development Program. NGLS is developing life support technologies (including water recovery, and space suit life support technologies) needed for humans to live and work productively in space. NGLS has three project tasks: Variable Oxygen Regulator (VOR), Rapid Cycle Amine (RCA) swing bed, and Alternative Water Processing. The selected technologies within each of these areas are focused on increasing affordability, reliability, and vehicle self sufficiency while decreasing mass and enabling long duration exploration. The RCA and VOR tasks are directed at key technology needs for the Portable Life Support System (PLSS) for an Exploration Extravehicular Mobility Unit (EMU), with focus on prototyping and integrated testing. The focus of the Rapid Cycle Amine (RCA) swing-bed ventilation task is to provide integrated carbon dioxide removal and humidity control that can be regenerated in real time during an EVA. The Variable Oxygen Regulator technology will significantly increase the number of pressure settings available to the space suit. Current spacesuit pressure regulators are limited to only two settings while the adjustability of the advanced regulator will be nearly continuous. The Alternative Water Processor efforts will result in the development of a system capable of recycling wastewater from sources expected in future exploration missions, including hygiene and laundry water, based on natural biological processes and membrane-based post treatment. The technologies will support a capability-driven architecture for extending human presence beyond low Earth orbit to potential destinations such as the Moon, near Earth asteroids and Mars.

  6. Advanced medical countermeasures for radiological accidents and nuclear disasters: prevention, prophylaxis, treatment and pre- and post-exposure management.

    Science.gov (United States)

    Popov, Dmitri; Maliev, Slava; Jones, Jeffrey

    Countermeasures against nuclear terrorism to prevent or limit the number of irradiated human population or radiation intoxications include early identification of the nuclear terrorism event and all persons which exposed by radiation, decontamination program and procedures, radiation control, and medical countermeasures which include medical diagnosis,differential diagnosis of Acute Radiation Syndromes by Immune Enzyme Assay , pre-exposure vaccination with Human Antiradiation Vaccine, post-exposure specific treatment - de-intoxication with Radiation Antidote IgG (blocking Antiradiation Antibodies). Our Advanced Medical Technology elaborated as a part of effective countermeasure include Plan of Action.Countermeasures against nuclear terrorism to prevent or limit the number of high level of lethality and severe forms of radiation illness or intoxications include A.early identification of the nuclear terrorism event and persons exposed,b. appropriate decontamination, c. radiation control, and d.medical countermeasures and medical management of ARS. Medical countermeasures, which include medical interventions such as active immuneprophylaxis with Human Antiradiation Vaccine , passive immune-prophylaxis with Antiradiation Antitoxins immune-globulins IgG , and chemoprophylaxis - post-exposure antioxidants prophylaxis and antibioticprophylaxis. Medical countermeasures with Antiradiation Vaccine should be initiated before an exposure (if individuals are identified as being at high risk for exposure)but after a confirmed exposure event Antiradiation Vaccine not effective and Antiradiation Antidot IgG must be applyed for treatment of Acute Radiation Syndromes.

  7. Evaluation of environmental impacts of cellulosic ethanol using life cycle assessment with technological advances over time

    International Nuclear Information System (INIS)

    Life Cycle Assessment (LCA) has been used in quantifying the environmental impacts of materials, processes, products, or systems across their entire lifespan from creation to disposal. To evaluate the environmental impact of advancing technology, Life Cycle Assessment with Technological Advances over Time (LCA-TAT) incorporates technology improvements within the traditional LCA framework. In this paper, the LCA-TAT is applied to quantify the environmental impacts of ethanol production using cellulosic biomass as a feedstock through the simultaneous saccharification and co-fermentation (SSCF) process as it improves over time. The data for the SSCF process are taken from the Aspen Plus® simulation developed by the National Renewable Energy Lab (NREL). The Environmental Fate and Risk Assessment Tool (EFRAT) is used to calculate the fugitive emissions and SimaPro 7.1 software is used to quantify the environmental impacts of processes. The impact indicators of the processes are calculated using the Eco-indicator 95 method; impact categories analyzed include ozone layer depletion, heavy metals, carcinogens, summer smog, winter smog, pesticides, greenhouse effect, acidification, and eutrophication. Based on the LCA-TAT results, it is found that removal of the continuous ion exchange step within the pretreatment area increases the environmental impact of the process. The main contributor to the increase in the environmental impact of the process is the heavy metal indicator. In addition, a sensitivity analysis is performed to identify major inputs and outputs that affect environmental impacts of the overall process. Based on this analysis it is observed that an increase in waste production and acid use have the greatest effect on the environmental impacts of the SSCF process. Comparing economic analysis with projected technological advances performed by NREL, the improvement in environmental impact was not matched by a concomitant improvement in economic performance. In

  8. Effects of LifeSkills Training on Medical Students' Performance in Dealing with Complex Clinical Cases

    Science.gov (United States)

    Campo, Ana E.; Williams, Virginia; Williams, Redford B.; Segundo, Marisol A.; Lydston, David; Weiss, Stephen M.'

    2008-01-01

    Objective: Sound clinical judgment is the cornerstone of medical practice and begins early during medical education. The authors consider the effect of personality characteristics (hostility, anger, cynicism) on clinical judgment and whether a brief intervention can affect this process. Methods: Two sophomore medical classes (experimental,…

  9. Advancing science diplomacy: Indonesia and the US Naval Medical Research Unit.

    Science.gov (United States)

    Smith, Frank L

    2014-12-01

    Science diplomacy supposedly builds international cooperation through scientific and technical exchange. In practice, however, there are important but often overlooked instances where it might create conflict instead--as with accusations of espionage surrounding the US Naval Medical Research Unit 2 (NAMRU-2) in Indonesia. Did American science diplomacy backfire in Indonesia and, if so, why? Most literature fails to anticipate this possibility, let alone explain it, since science diplomacy is rarely subject to critical analysis. Rather than shun politics or, similarly, simply blame the demise of NAMRU-2 on the military or avian influenza, I consider both the successes and failures of this research unit in the context of Indonesia's transition to democracy and America's legacy from the Cold War. Based on this history, I propose that the effects of science diplomacy depend on strategic communication and exchange, as well as elite influence and material incentives. Therefore, by challenging the conventional wisdom about science diplomacy, NAMRU-2 can help advance the theory and practice of this potentially useful tool of statecraft. PMID:25608440

  10. Development Status of the Advanced Life Support On-Line Project Information System

    Science.gov (United States)

    Levri, Julie A.; Hogan, John A.; Cavazzoni, Jim; Brodbeck, Christina; Morrow, Rich; Ho, Michael; Kaehms, Bob; Whitaker, Dawn R.

    2005-01-01

    The Advanced Life Support Program has recently accelerated an effort to develop an On-line Project Information System (OPIS) for research project and technology development data centralization and sharing. The core functionality of OPIS will launch in October of 2005. This paper presents the current OPIS development status. OPIS core functionality involves a Web-based annual solicitation of project and technology data directly from ALS Principal Investigators (PIS) through customized data collection forms. Data provided by PIs will be reviewed by a Technical Task Monitor (TTM) before posting the information to OPIS for ALS Community viewing via the Web. The data will be stored in an object-oriented relational database (created in MySQL(R)) located on a secure server at NASA ARC. Upon launch, OPIS can be utilized by Managers to identify research and technology development gaps and to assess task performance. Analysts can employ OPIS to obtain.

  11. Solid Waste Management Requirements Definition for Advanced Life Support Missions: Results

    Science.gov (United States)

    Alazraki, Michael P.; Hogan, John; Levri, Julie; Fisher, John; Drysdale, Alan

    2002-01-01

    Prior to determining what Solid Waste Management (SWM) technologies should be researched and developed by the Advanced Life Support (ALS) Project for future missions, there is a need to define SWM requirements. Because future waste streams will be highly mission-dependent, missions need to be defined prior to developing SWM requirements. The SWM Working Group has used the mission architecture outlined in the System Integration, Modeling and Analysis (SIMA) Element Reference Missions Document (RMD) as a starting point in the requirement development process. The missions examined include the International Space Station (ISS), a Mars Dual Lander mission, and a Mars Base. The SWM Element has also identified common SWM functionalities needed for future missions. These functionalities include: acceptance, transport, processing, storage, monitoring and control, and disposal. Requirements in each of these six areas are currently being developed for the selected missions. This paper reviews the results of this ongoing effort and identifies mission-dependent resource recovery requirements.

  12. A Simulation Study Comparing Incineration and Composting in a Mars-Based Advanced Life Support System

    Science.gov (United States)

    Hogan, John; Kang, Sukwon; Cavazzoni, Jim; Levri, Julie; Finn, Cory; Luna, Bernadette (Technical Monitor)

    2000-01-01

    The objective of this study is to compare incineration and composting in a Mars-based advanced life support (ALS) system. The variables explored include waste pre-processing requirements, reactor sizing and buffer capacities. The study incorporates detailed mathematical models of biomass production and waste processing into an existing dynamic ALS system model. The ALS system and incineration models (written in MATLAB/SIMULINK(c)) were developed at the NASA Ames Research Center. The composting process is modeled using first order kinetics, with different degradation rates for individual waste components (carbohydrates, proteins, fats, cellulose and lignin). The biomass waste streams are generated using modified "Eneray Cascade" crop models, which use light- and dark-cycle temperatures, irradiance, photoperiod, [CO2], planting density, and relative humidity as model inputs. The study also includes an evaluation of equivalent system mass (ESM).

  13. Advanced Spacesuit Portable Life Support System Packaging Concept Mock-Up Design & Development

    Science.gov (United States)

    O''Connell, Mary K.; Slade, Howard G.; Stinson, Richard G.

    1998-01-01

    A concentrated development effort was begun at NASA Johnson Space Center to create an advanced Portable Life Support System (PLSS) packaging concept. Ease of maintenance, technological flexibility, low weight, and minimal volume are targeted in the design of future micro-gravity and planetary PLSS configurations. Three main design concepts emerged from conceptual design techniques and were carried forth into detailed design, then full scale mock-up creation. "Foam", "Motherboard", and "LEGOtm" packaging design concepts are described in detail. Results of the evaluation process targeted maintenance, robustness, mass properties, and flexibility as key aspects to a new PLSS packaging configuration. The various design tools used to evolve concepts into high fidelity mock ups revealed that no single tool was all encompassing, several combinations were complimentary, the devil is in the details, and, despite efforts, many lessons were learned only after working with hardware.

  14. Health-related quality of life and depression among medical sales representatives in Pakistan.

    Science.gov (United States)

    Atif, Muhammad; Bashir, Arslan; Saleem, Quratulain; Hussain, Rabia; Scahill, Shane; Babar, Zaheer-Ud-Din

    2016-01-01

    Pharmaceutical companies have been known to pose stress and mental harassment on medical sales representatives (MSRs) in-order to increase pharmaceutical sales. This cross sectional descriptive study, conducted during November and December 2014 in the Lahore and Bahawalpur districts of Punjab, Pakistan, evaluates the Health-Related Quality of Life (HRQoL) and extent of depression among MSRs in Pakistan. The significant predictors of HRQoL and depression among the MSRs were also determined. Using a convenience sampling technique, all consenting MSRs (N = 318) of pharmaceutical companies were asked to self-complete the Short Form-36 (SF-36v2) Health Survey and Stanford Personal Health Questionnaire (PHQ-8). The standard scoring scheme for the SF36v2 and PHQ-8 questionnaires was used. The PHQ-8 scores showed that 16.4 % (n = 52) and 2.5 % of respondents were suffering from major depression and severe major depression, respectively. Being depressed and having difficulty in achieving sales targets were the factors independently associated with lower physical health. Similarly, depression, insufficient time for the family and monthly income less than 36,000 Pakistan Rupees were significant predictors of lower mental health. The factors associated with depression included insufficient time for the family and unsatisfactory behavior of the managers. Compromised mental health and the prevalence of depression among the MSRs suggest pharmaceutical companies need to devise health management strategies and interventions to ensure effective prevention and management of mental health problems among Pakistani MSRs. PMID:27462496

  15. Impact of Duodopa on Quality of Life in Advanced Parkinson's Disease: A UK Case Series

    Directory of Open Access Journals (Sweden)

    T. Foltynie

    2013-01-01

    Full Text Available Treatment options in advanced Parkinson’s disease (PD include subcutaneous apomorphine, pallidal or subthalamic nucleus Deep Brain Stimulation (DBS, or levodopa/carbidopa intestinal gel (LCIG/Duodopa. In this study, we describe the outcome of 12 PD patients with PD related complications started on LCIG, with respect to their quality of life measured by a disease specific validated scale—the PDQ39, together with diaries recording time spent “On,” “Off,” “Dyskinetic,” or “Asleep.” At the time of latest follow up, improvements were observed in both the PDQ39 Summary index as well as diary reports of PD symptom control following introduction of LCIG, supporting its use in well selected patients. The use of a trial period of LCIG via naso-jejunal administration allows objective evaluation of improvement in PD symptom control in advance of the placement of the more invasive percutaneous jejunostomy procedure. The decision to embark on LCIG, apomorphine or DBS should be supported by input from centres with experience of all 3 approaches. Since LCIG is an expensive option, development of the most appropriate future commissioning of this therapy in the absence of Class 1 evidence requires careful scrutiny of the outcomes of its use in a broad range of published series.

  16. Study for requirement of advanced long life small modular fast reactor

    Energy Technology Data Exchange (ETDEWEB)

    Tak, Taewoo, E-mail: ttwispy@unist.ac.kr; Choe, Jiwon, E-mail: chi91023@unist.ac.kr; Jeong, Yongjin, E-mail: yjjeong09@unist.ac.kr; Lee, Deokjung, E-mail: deokjung@unist.ac.kr [Ulsan National Institute of Science and Technology, 50, UNIST-gil, Eonyang-eup, Ulju-gun, Ulsan, 689-798 (Korea, Republic of); Kim, T. K., E-mail: tkkim@anl.gov [Argonne National Laboratory, 9700 South Cass Avenue, Argonne, IL 60564 (United States)

    2016-01-22

    To develop an advanced long-life SMR core concept, the feasibility of the long-life breed-and-burn core concept has been assessed and the preliminary selection on the reactor design requirement such as fuel form, coolant material has been performed. With the simplified cigar-type geometry of 8m-tall CANDLE reactor concept, it has demonstrated the strengths of breed-and-burn strategy. There is a saturation region in the graph for the multiplication factors, which means that a steady breeding is being proceeded along the axial direction. The propagation behavior of the CANDLE core can be also confirmed through the evolution of the axial power profile. Coolant material is expected to have low melting point, density, viscosity and absorption cross section and a high boiling point, specific heat, and thermal conductivity. In this respect, sodium is preferable material for a coolant of this nuclear power plant system. The metallic fuel has harder spectrum compared to the oxide and carbide fuel, which is favorable to increase the breeding and extend the cycle length.

  17. Study for requirement of advanced long life small modular fast reactor

    Science.gov (United States)

    Tak, Taewoo; Choe, Jiwon; Jeong, Yongjin; Lee, Deokjung; Kim, T. K.

    2016-01-01

    To develop an advanced long-life SMR core concept, the feasibility of the long-life breed-and-burn core concept has been assessed and the preliminary selection on the reactor design requirement such as fuel form, coolant material has been performed. With the simplified cigar-type geometry of 8m-tall CANDLE reactor concept, it has demonstrated the strengths of breed-and-burn strategy. There is a saturation region in the graph for the multiplication factors, which means that a steady breeding is being proceeded along the axial direction. The propagation behavior of the CANDLE core can be also confirmed through the evolution of the axial power profile. Coolant material is expected to have low melting point, density, viscosity and absorption cross section and a high boiling point, specific heat, and thermal conductivity. In this respect, sodium is preferable material for a coolant of this nuclear power plant system. The metallic fuel has harder spectrum compared to the oxide and carbide fuel, which is favorable to increase the breeding and extend the cycle length.

  18. Hydroponics Database and Handbook for the Advanced Life Support Test Bed

    Science.gov (United States)

    Nash, Allen J.

    1999-01-01

    During the summer 1998, I did student assistance to Dr. Daniel J. Barta, chief plant growth expert at Johnson Space Center - NASA. We established the preliminary stages of a hydroponic crop growth database for the Advanced Life Support Systems Integration Test Bed, otherwise referred to as BIO-Plex (Biological Planetary Life Support Systems Test Complex). The database summarizes information from published technical papers by plant growth experts, and it includes bibliographical, environmental and harvest information based on plant growth under varying environmental conditions. I collected 84 lettuce entries, 14 soybean, 49 sweet potato, 16 wheat, 237 white potato, and 26 mix crop entries. The list will grow with the publication of new research. This database will be integrated with a search and systems analysis computer program that will cross-reference multiple parameters to determine optimum edible yield under varying parameters. Also, we have made preliminary effort to put together a crop handbook for BIO-Plex plant growth management. It will be a collection of information obtained from experts who provided recommendations on a particular crop's growing conditions. It includes bibliographic, environmental, nutrient solution, potential yield, harvest nutritional, and propagation procedure information. This handbook will stand as the baseline growth conditions for the first set of experiments in the BIO-Plex facility.

  19. Advanced condition monitoring techniques and plant life extension studies at EBR-2

    International Nuclear Information System (INIS)

    Numerous advanced techniques have been evaluated and tested at EBR-2 as part of a plant-life extension program for detection of degradation and other abnormalities in plant systems. Two techniques have been determined to be of considerable assistance in planning for the extended-life operation of EBR-2. The first, a computer-based pattern-recognition system (System State Analyzer or SSA) is used for surveillance of the primary system instrumentation, primary sodium pumps and plant heat balances. This surveillance has indicated that the SSA can detect instrumentation degradation and system performance degradation over varying time intervals and can be used to provide derived signal values to replace signals from failed sensors. The second technique, also a computer-based pattern-recognition system (Sequential Probability Ratio Test or SPRT) is used to validate signals and to detect incipient failures in sensors and components or systems. It is being used on the failed fuel detection system and is experimentally used on the primary coolant pumps. Both techniques are described and experience with their operation presented

  20. Study for requirement of advanced long life small modular fast reactor

    International Nuclear Information System (INIS)

    To develop an advanced long-life SMR core concept, the feasibility of the long-life breed-and-burn core concept has been assessed and the preliminary selection on the reactor design requirement such as fuel form, coolant material has been performed. With the simplified cigar-type geometry of 8m-tall CANDLE reactor concept, it has demonstrated the strengths of breed-and-burn strategy. There is a saturation region in the graph for the multiplication factors, which means that a steady breeding is being proceeded along the axial direction. The propagation behavior of the CANDLE core can be also confirmed through the evolution of the axial power profile. Coolant material is expected to have low melting point, density, viscosity and absorption cross section and a high boiling point, specific heat, and thermal conductivity. In this respect, sodium is preferable material for a coolant of this nuclear power plant system. The metallic fuel has harder spectrum compared to the oxide and carbide fuel, which is favorable to increase the breeding and extend the cycle length

  1. Requirements Development Issues for Advanced Life Support Systems: Solid Waste Management

    Science.gov (United States)

    Levri, Julie A.; Fisher, John W.; Alazraki, Michael P.; Hogan, John A.

    2002-01-01

    Long duration missions pose substantial new challenges for solid waste management in Advanced Life Support (ALS) systems. These possibly include storing large volumes of waste material in a safe manner, rendering wastes stable or sterilized for extended periods of time, and/or processing wastes for recovery of vital resources. This is further complicated because future missions remain ill-defined with respect to waste stream quantity, composition and generation schedule. Without definitive knowledge of this information, development of requirements is hampered. Additionally, even if waste streams were well characterized, other operational and processing needs require clarification (e.g. resource recovery requirements, planetary protection constraints). Therefore, the development of solid waste management (SWM) subsystem requirements for long duration space missions is an inherently uncertain, complex and iterative process. The intent of this paper is to address some of the difficulties in writing requirements for missions that are not completely defined. This paper discusses an approach and motivation for ALS SWM requirements development, the characteristics of effective requirements, and the presence of those characteristics in requirements that are developed for uncertain missions. Associated drivers for life support system technological capability are also presented. A general means of requirements forecasting is discussed, including successive modification of requirements and the need to consider requirements integration among subsystems.

  2. Axisymmetric whole pin life modelling of advanced gas-cooled reactor nuclear fuel

    International Nuclear Information System (INIS)

    Thermo-mechanical contributions to pellet–clad interaction (PCI) in advanced gas-cooled reactors (AGRs) are modelled in the ABAQUS finite element (FE) code. User supplied sub-routines permit the modelling of the non-linear behaviour of AGR fuel through life. Through utilisation of ABAQUS’s well-developed pre- and post-processing ability, the behaviour of the axially constrained steel clad fuel was modelled. The 2D axisymmetric model includes thermo-mechanical behaviour of the fuel with time and condition dependent material properties. Pellet cladding gap dynamics and thermal behaviour are also modelled. The model treats heat up as a fully coupled temperature-displacement study. Dwell time and direct power cycling was applied to model the impact of online refuelling, a key feature of the AGR. The model includes the visco-plastic behaviour of the fuel under the stress and irradiation conditions within an AGR core and a non-linear heat transfer model. A multiscale fission gas release model is applied to compute pin pressure; this model is coupled to the PCI gap model through an explicit fission gas inventory code. Whole pin, whole life, models are able to show the impact of the fuel on all segments of cladding including weld end caps and cladding pellet locking mechanisms (unique to AGR fuel). The development of this model in a commercial FE package shows that the development of a potentially verified and future-proof fuel performance code can be created and used

  3. Development Approach of the Advanced Life Support On-line Project Information System

    Science.gov (United States)

    Levri, Julie A.; Hogan, John A.; Morrow, Rich; Ho, Michael C.; Kaehms, Bob; Cavazzoni, Jim; Brodbeck, Christina A.; Whitaker, Dawn R.

    2005-01-01

    The Advanced Life Support (ALS) Program has recently accelerated an effort to develop an On-line Project Information System (OPIS) for research project and technology development data centralization and sharing. There has been significant advancement in the On-line Project Information System (OPIS) over the past year (Hogan et al, 2004). This paper presents the resultant OPIS development approach. OPIS is being built as an application framework consisting of an uderlying Linux/Apache/MySQL/PHP (LAMP) stack, and supporting class libraries that provides database abstraction and automatic code generation, simplifying the ongoing development and maintenance process. Such a development approach allows for quick adaptation to serve multiple Programs, although initial deployment is for an ALS module. OPIS core functionality will involve a Web-based annual solicitation of project and technology data directly from ALS Principal Investigators (PIs) through customized data collection forms. Data provided by PIs will be reviewed by a Technical Task Monitor (TTM) before posting the information to OPIS for ALS Community viewing via the Web. Such Annual Reports will be permanent, citable references within OPIS. OPlS core functionality will also include Project Home Sites, which will allow PIS to provide updated technology information to the Community in between Annual Report updates. All data will be stored in an object-oriented relational database, created in MySQL(Reistered Trademark) and located on a secure server at NASA Ames Research Center (ARC). Upon launch, OPlS can be utilized by Managers to identify research and technology development (R&TD) gaps and to assess task performance. Analysts can employ OPlS to obtain the current, comprehensive, accurate information about advanced technologies that is required to perform trade studies of various life support system options. ALS researchers and technology developers can use OPlS to achieve an improved understanding of the NASA

  4. Health-Related Quality of Life after surgery for primary advanced rectal cancer and recurrent rectal cancer

    DEFF Research Database (Denmark)

    Thaysen, Henriette Vind; Jess, Per; Laurberg, Søren

    2012-01-01

    Aim: A review of the literature was undertaken to provide an overview of Health-related quality of life (HRQoL) after surgery for primary advanced or recurrent rectal cancer and to outline proposals for future HRQoL studies in this area. Method: A systematic literature search was undertaken. Only...... studies concerning surgery for primary advanced or recurrent rectal cancer and describing methods used for measuring HRQoL were considered. Results Seven studies were identified including two prospective longitudinal, three cross-sectional and two based on qualitative data. Global quality of life...... time of impaired HRQoL and also if this is different after surgery for locally advanced or recurrent disease than after total mesorectal excision used for earlier tumours.. Conclusion Several aspects of HRQoL are impaired for a variable time after treatment for locally advanced or recurrence of rectal...

  5. Weighing environmental advantages and disadvantages of advanced wastewater treatment of micro-pollutants using environmental life cycle assessment

    DEFF Research Database (Denmark)

    Wenzel, Henrik; Larsen, Henrik Fred; Clauson-Kaas, Jes;

    2008-01-01

    Much research and development effort is directed towards advances in municipal wastewater treatment aiming at reducing the effluent content of micro-pollutants and pathogens. The objective is to further reduce the eco-toxicity, hormone effects and pathogenic effects of the effluent. Such further......-off was investigated using Life Cycle Assessment (LCA) methodology and based on a literature review of advanced treatment performance. The LCA evaluation comprised sand filtration, ozonation and MBRs and assessed the effect of extending existing tertiary treatment with these technologies on a variety of micro-pollutants......; life cycle assessment; MBR; micro-pollutants; ozonation; sand filtration....

  6. Awareness about basic life support and emergency medical services and its associated factors among students in a tertiary care hospital in South India

    Directory of Open Access Journals (Sweden)

    Akshatha Rao Aroor

    2014-01-01

    Full Text Available Background: The knowledge and skills about the basic life support (BLS and the advanced life support are the most important determining factors of the cardiopulmonary resuscitation (CPR success rates. Objectives: To determine the level of awareness on BLS and skills among undergraduate and postgraduate students of medical and dental profession, as well as nursing students and interns in a tertiary care hospital. Materials and Methods: This descriptive cross-sectional study was conducted in a tertiary care hospital in South India. The awareness level on BLS and factors associated which include age, sex, level of training (undergraduate, internship, and postgraduate groups, course of study (nursing, dental, and medical groups, and previous exposure to BLS were assessed by using a structured questionnaire. The association of these variables with awareness level was assessed by independent t test, analysis of variance, and linear regression analysis. Results: Among 520 study subjects, 229 were students, 171 were interns, and 120 were postgraduate students. The overall mean score of awareness was 4.16 ± 1.40 (score range: 0-10. Age, sex, level of training, course of study, and previous exposure to BLS were significantly associated with awareness level in univariate analysis (P < 0.05. Linear regression model also showed that all the above variables were significantly associated with awareness level (P < 0.05. About 322 (61.9% subjects attributed lack of awareness about BLS to lack of available professional training. About 479 (92.1% responded that BLS training should be a part of medical curriculum. Conclusion: Awareness level on BLS is below average indicating the importance of professional training at all levels in a tertiary care health institution.

  7. Life imitating art: Depictions of the hidden curriculum in medical television programs

    OpenAIRE

    Stanek, Agatha; Clarkin, Chantalle; Bould, M. Dylan; Writer, Hilary; Doja, Asif

    2015-01-01

    Background The hidden curriculum represents influences occurring within the culture of medicine that indirectly alter medical professionals’ interactions, beliefs and clinical practices throughout their training. One approach to increase medical student awareness of the hidden curriculum is to provide them with readily available examples of how it is enacted in medicine; as such the purpose of this study was to examine depictions of the hidden curriculum in popular medical television programs...

  8. Quality of life of breast cancer patients medicated with anti-estrogens, 2 years after acupuncture treatment: a qualitative study

    OpenAIRE

    Jill Hervik; Odd Mjåland

    2010-01-01

    Jill Hervik1, Odd Mjåland21Pain Clinic, Vestfold Hospital, Tønsberg, Norway; 2Department of Abdominal Surgery, Sørlandet Sykehus, Kristiansand, NorwayObjective: The aim of this study was to examine the quality of life of breast cancer patients medicated with estrogen antagonists, 2 years after having acupuncture treatment for hot flashes.Methods and materials: Our sample was taken from women who had recently participated in a randomized controlled trial investi...

  9. Relationship Between Low Back Pain With Quality of Life, Depression, Anxiety and Stress Among Emergency Medical Technicians

    OpenAIRE

    Rahimi, Abolfazl; Vazini, Hossein; Alhani, Fatemeh; Anoosheh, Monireh

    2015-01-01

    Background: Musculoskeletal disorders have become increasingly common among healthcare providers. They have become the most common cause of work-related disabilities among nurses. Objectives: The current cross-sectional study aimed to measure the prevalence of back pains among emergency medical technicians (EMTs), and association of back pain with quality of life, depression, anxiety and stress. Materials and Methods: One hundred and eighty registered nurses working as EMTs at the Hamadan Eme...

  10. The making of an endocrinologist in India: Life and times at Institute of Post Graduate Medical Education and Research Calcutta

    OpenAIRE

    Deep Dutta

    2015-01-01

    Endocrinology is relatively one of the newer super-specialties of internal medicine. Following higher secondary schooling, it takes anywhere between 13 and 18 years to become a super-specialist in India, which holds true for endocrinology also. This article intends to highlight the life and the journey of making an endocrinologist in India, through personal experiences, focusing on Institute of Post Graduate Medical Education and Research (IPGMER) Calcutta, the largest super-specialty teachin...

  11. Nurses' experiences of pain management for people with advanced dementia approaching the end of life: a qualitative study

    OpenAIRE

    De Witt Jansen, Bannin; Brazil, Kevin; Passmore, Peter; Buchanan, Hilary; Maxwell, Doreen; McIlfatrick, Sonja J; Morgan, Sharon M; Watson, Max; Parsons, Carole

    2016-01-01

    AIMS AND OBJECTIVES: To explore hospice, acute care and nursing home nurses' experiences of pain management for people with advanced dementia in the final month of life. To identify the challenges, facilitators and practice areas requiring further support.BACKGROUND: Pain management in end-stage dementia is a fundamental aspect of end of life care; however, it is unclear what challenges and facilitators nurses experience in practice, whether these differ across care settings, and whether trai...

  12. Exploring the relationship between the Engineering and Physical Sciences and the Health and Life Sciences by advanced bibliometric methods

    OpenAIRE

    Waltman, Ludo; van Raan, Anthony F. J.; Smart, Sue

    2014-01-01

    We investigate the extent to which advances in the health and life sciences (HLS) are dependent on research in the engineering and physical sciences (EPS), particularly physics, chemistry, mathematics, and engineering. The analysis combines two different bibliometric approaches. The first approach to analyze the ‘EPS-HLS interface’ is based on term map visualizations of HLS research fields. We consider 16 clinical fields and five life science fields. On the basis of expert judgment, EPS resea...

  13. Invited Commentary: Integrating a Life-Course Perspective and Social Theory to Advance Research on Residential Segregation and Health

    OpenAIRE

    Osypuk, Theresa L.

    2013-01-01

    Research on racial residential segregation and health typically uses multilevel, population-based, slice-in-time data. Although research using this approach, including that by Kershaw et al. (Am J Epidemiol. 2013;177(4):299–309), has been valuable, I argue that to advance our understanding of how residential segregation influences health and health disparities, it is critical to incorporate a life-course perspective and integrate social theory. Applying a life-course perspective would entail ...

  14. A study of the Life Quality of Students at a University of Medical Sciences in the Northeast of Iran

    Directory of Open Access Journals (Sweden)

    Mohammad Amiri

    2014-01-01

    Full Text Available Introduction: Quality of life is an important index in assessing the personal health, making decisions and passing judgments on the general health status of the society, and finding major problems people have in different arenas of life. This study aimed at determining the quality of life among students of Shahroud University of Medical Sciences. Methods: This applied cross-sectional research was carried out in 2011. The data collection instrument was the 26-item quality of life questionnaire by WHO. The collected data were analyzed through chi square test with SPSS. Results: The average age of the participants was 20.8±2.3. 79.2% of the participants were females. 22.7% of the participants were indigenous students. In studying the students’ quality of life in the four areas of health, physical health (14.2±2.4 showed the highest score, followed by social health (14.1±3.2, mental health (13.1±2.8 and environmental health (12.7±2.5. No significant relationships were observed between quality of life and gender, level of education, marital status, place of residence, economic activities, the size of family, birth order, and the life status (dead/alive of the parents (P>0.05. However the relationships between quality of life and being indigenous (P=0.049, family’s income (P=0.02 and main field of study (P=0.02 were significant. Conclusion: In addition to admitting indigenous students, setting up counseling clinics in campuses and dormitories and offering training and explanatory courses on living in university environments, improving the facilities and sports and recreational programs can promote the health level of students and enhance their life quality.

  15. Conceptualisation of the characteristics of advanced practitioners in the medical radiation professions

    OpenAIRE

    Smith, Tony; Harris, Jillian; Woznitza, Nick; Maresse, Sharon; Sale, Charlotte

    2015-01-01

    Professions grapple with defining advanced practice and the characteristics of advanced practitioners. In nursing and allied health, advanced practice has been defined as ‘a state of professional maturity in which the individual demonstrates a level of integrated knowledge, skill and competence that challenges the accepted boundaries of practice and pioneers new developments in health care’. Evolution of advanced practice in Australia has been slower than in the United Kingdom, mainly due to ...

  16. Quality of Life of Persons with Medical Illnesses: Counseling's Holistic Contribution.

    Science.gov (United States)

    Roberts, Shirley A.; Kiselica, Mark S.; Fredickson, Susan A.

    2002-01-01

    Presents a rationale for the addition of psychological counseling in the treatment of persons with medical illnesses. Empirical data on the mind-body connection are presented, and the Medical Crisis Counseling model is outlined as an example of an effective intervention. Discusses issues and counseling techniques related to the model within the…

  17. End-of-Life Decisions about Withholding or Withdrawing Therapy: Medical, Ethical, and Religio-Cultural Considerations

    Science.gov (United States)

    Manalo, Maria Fidelis C

    2013-01-01

    Towards the end of life, physicians face dilemmas of discontinuing life-sustaining treatments or interventions. In some circumstances, these treatments are no longer of benefit, while in others the patient or family no longer want them. The physician plays an essential role in clarifying the goals of medical treatment, defining the care plan, initiating discussions about life-sustaining therapy, educating patients and families, helping them deliberate, making recommendations, and implementing the treatment plan. Communication is key. It should be clarified that when inevitable death is imminent, it is legitimate to refuse or limit forms of treatment that would only secure a precarious and burdensome prolongation of life, for as long as basic humane, compassionate care is not interrupted. Agreement to DNR status does not preclude supportive measures that keep patients free from pain and suffering as possible. Acceptable clinical practice on withdrawing or withholding treatment is based on an understanding of the medical, ethical, cultural, and religious issues. There is a need to individualize care option discussions to illness status, and patient and family preferences, beliefs, values, and cultures. The process of shared decision making between the patient, the family, and the clinicians should continue as goals evolve and change over time. PMID:25278756

  18. Objective Structured Clinical Examination (OSCE)-based Assessment of the Advanced Trauma Life Support (ATLS) Course in Iran

    Science.gov (United States)

    Abbasi, Hamid Reza; Amini, Mitra; Bolandparvaz, Shahram; Paydar, Shahram; Ali, Jameel; Sefidbakht, Sepideh

    2016-01-01

    Objective: To evaluate the effect of advance trauma life support (ATLS®) training on general surgery residents clinical reasoning skills using the national boards-style objective structured clinical examination (OSCE). Methods: This cross-sectional single-center study was conducted in Shiraz University of Medical Sciences including 51 surgery residents that participated in a mandatory national board style OSCE between May 2014 and May 2015. OSCE scores of two groups of general surgery residents including 23 ATLS® trained and 28 non-ATLS® trained were compared using Mann-Whitney U test. The exam was graded out of 20 points and the passing score was ≥14 including 40% trauma cases. Results: There were 8(15.7%) women and 43(84.3%) men among the participants with mean age of 31.12 ± 2.69 and 33.67 ± 4.39 years in women and men respectively. Overall 7 (87.5%) women and 34 (79.07%) men passed the OSCE. The trauma section OSCE score was significantly higher in the ATLS® trained participants when compared to non-ATLS®(7.79 ± 0.81vs.6.90 ± 1.00; p=0.001). In addition, the total score was also significantly higher in ATLS® trained residents (16.07 ± 1.41 vs. 14.60 ± 1.40; p=0.001). There was no association between gender and ATLS® score (p=0.245) or passing the OSCE (p=0.503). Conclusion: ATLS® training is associated with improved overall OSCE scores of general surgery residents completing the board examinations suggesting a positive transfer of ATLS learned skills to management of simulated surgical patients including trauma cases.

  19. How to be a patient in a palliative life experience? A qualitative study to enhance knowledge about coping abilities in advanced cancer patients

    DEFF Research Database (Denmark)

    Thomsen, Thora Grothe; Hansen, Susan Maybritt Rydahl; Wagner, Lis

    2011-01-01

    's own life" was identified as a central tendency in coping with advanced cancer. It involved a pattern of four life conditions: alleviation from a life-threatening illness, carry on a normal life, live with powerlessness, and find courage and strength, which were characterized by a series of limitations...

  20. The Quality-of-Life Effects of Neoadjuvant Chemoradiation in Locally Advanced Rectal Cancer

    Energy Technology Data Exchange (ETDEWEB)

    Herman, Joseph M., E-mail: jherma15@jhmi.edu [Department of Radiation Oncology, Johns Hopkins University School of Medicine, Baltimore, Maryland (United States); Narang, Amol K. [Department of Radiation Oncology, Johns Hopkins University School of Medicine, Baltimore, Maryland (United States); Griffith, Kent A. [Department of Biostatistics, University of Michigan School of Medicine, Ann Arbor, Michigan (United States); Zalupski, Mark M. [Department of Hematology Oncology, University of Michigan School of Medicine, Ann Arbor, Michigan (United States); Reese, Jennifer B. [Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland (United States); Gearhart, Susan L. [Department of Medical Oncology, Johns Hopkins University School of Medicine, Baltimore, Maryland (United States); Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland (United States); Azad, Nolifer S. [Department of Medical Oncology, Johns Hopkins University School of Medicine, Baltimore, Maryland (United States); Chan, June; Olsen, Leah [Department of Radiation Oncology, University of Michigan School of Medicine, Ann Arbor, Michigan (United States); Efron, Jonathan E. [Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland (United States); Lawrence, Theodore S.; Ben-Josef, Edgar [Department of Radiation Oncology, University of Michigan School of Medicine, Ann Arbor, Michigan (United States)

    2013-01-01

    Purpose: Existing studies that examine the effect of neoadjuvant chemoradiation (CRT) for locally advanced rectal cancer on patient quality of life (QOL) are limited. Our goals were to prospectively explore acute changes in patient-reported QOL endpoints during and after treatment and to establish a distribution of scores that could be used for comparison as new treatment modalities emerge. Methods and Materials: Fifty patients with locally advanced rectal cancer were prospectively enrolled at 2 institutions. Validated cancer-specific European Organization for Research and Treatment of Cancer (EORTC QLQ-CR30) and colorectal cancer-specific (EORTC QLQ-CR38 and EORTC QLQ-CR 29) QOL questionnaires were administered to patients 1 month before they began CRT, at week 4 of CRT, and 1 month after they had finished CRT. The questionnaires included multiple symptom scales, functional domains, and a composite global QOL score. Additionally, a toxicity scale was completed by providers 1 month before the beginning of CRT, weekly during treatment, and 1 month after the end of CRT. Results: Global QOL showed a statistically significant and borderline clinically significant decrease during CRT (-9.50, P=.0024) but returned to baseline 1 month after the end of treatment (-0.33, P=.9205). Symptoms during treatment were mostly gastrointestinal (nausea/vomiting +9.94, P<.0001; and diarrhea +16.67, P=.0022), urinary (dysuria +13.33, P<.0001; and frequency +11.82, P=.0006) or fatigue (+16.22, P<.0001). These symptoms returned to baseline after therapy. However, sexual enjoyment (P=.0236) and sexual function (P=.0047) remained persistently diminished after therapy. Conclusions: Rectal cancer patients undergoing neoadjuvant CRT may experience a reduction in global QOL along with significant gastrointestinal and genitourinary symptoms during treatment. Moreover, provider-rated toxicity scales may not fully capture this decrease in patient-reported QOL. Although most symptoms are transient

  1. Prehospital advanced trauma life support for critical penetrating wounds to the thorax and abdomen.

    Science.gov (United States)

    Pons, P T; Honigman, B; Moore, E E; Rosen, P; Antuna, B; Dernocoeur, J

    1985-09-01

    The role of advanced trauma life support (ATLS) in the prehospital care of the critically injured is highly controversial. This study analyzes the efficacy of ATLS in the management of critical penetrating wounds of the thorax and abdomen. In the 2 1/2-year period ending July 1984, 203 consecutive patients underwent emergency laparotomy or thoracotomy for gunshot and stab wounds. All patients were treated in the field by advanced paramedics (EMT-P). For gunshot wounds the mean time (+/- S.E.M.) responding to the scene was 4.5 (+/- 0.29) minutes, on the scene 10.1 (+/- 0.41) minutes, and returning to the hospital 6.4 (+/- 0.32) minutes. For stab wounds the mean time responding to the scene was 4.8 (+/- 0.21) minutes, on the scene 9.5 (+/- 0.37) minutes, and returning to the hospital 5.7 (+ 0.30) minutes. The number of intravenous lines started averaged 1.8 per patient. Eighty-one patients had PASG applied and 28 patients underwent endotracheal intubation (21 orally, seven nasally). Thirty-three patients had no obtainable blood pressure, of whom six survived (18%). One hundred sixty (94%) of the remaining 170 patients who had any initial blood pressure survived. One hundred nine (55%) patients had an increase in BP greater than or equal to 10 mm Hg (average, 35.6 mm Hg), 64 (32%) had no significant change, and 25 (13%) had a fall greater than or equal to 10 mm Hg (average, 24.2 mm Hg) from the field to the emergency department. Twenty (80%) of the 25 patients with a fall in blood pressure survived.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:4032506

  2. Effect of Intermittent Androgen Blockade on the Quality of Life of Patients with Advanced Prostate Carcinoma

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    OBJECTIVE To investigate the effect of intermittent androgen blockade (IAB) on the quality of life (QOL) of patients with advanced prostatic carcinoma (APC).METHODS Investigations on the QOL of 51 APC patients receiving IAB treatment, totaling 3 times, i.e. 6 months before and after, and 12 months after treatment, were perform using the EORTC QLQ-C30 measuring scale and QLQ-PR25 scale.RESULTS Although IAB became an economic burden for the families, it was lessened during the intermission (P<0.05). The overall health status significantly improved 6 months after IAB treatment (P<0.01), especially during the intermission (P<0.05), with a total or local easement of pain (P<0.01) and an improvement of urinary function (P<0.01). Although there was impairment,to various degrees, in many functions of the patients on the 6th month of treatment, such as the physical function (P<0.05), role function (P<0.05), the emotional (P<0.01) and the social functions (P<0.01), with an enhancement of fatigue (P<0.01), these functions gradually recovered by the 12th month as the intermission started. Treatment-related symptoms such as flushing and mammary swelling significantly emerged on the 6th treatment month (P<0.01), and lessened on the 12th (P<0.01). During the treatment period,therewas an notable drop in sexual interest (P<0.01), with a deprivation of sex life, but revived to various degrees during the intermission (P<0.01).CONCLUSION Although IAB treatment of APC patients did impair the physiologic and psychologic status of patients to varying degrees, these were improved and restored during the intermission.

  3. Balancing Act: A View of Benefits and Work-Life Balance through the Eyes of Advancement Professionals

    Science.gov (United States)

    Collins, Mary Ellen

    2011-01-01

    People who choose careers in advancement know they're not entering a 9-to-5, 40-hours-a-week profession. Staffers juggle personal lives with their commitment to stressful jobs that involve travel, long hours, weekend events, and deadlines. Work-life balance means different things to different people, but flexibility seems to be a priority for…

  4. Do self-report and medical record comorbidity data predict longitudinal functional capacity and quality of life health outcomes similarly?

    Directory of Open Access Journals (Sweden)

    Olomu Adesuwa B

    2012-11-01

    Full Text Available Abstract Background The search for a reliable, valid and cost-effective comorbidity risk adjustment method for outcomes research continues to be a challenge. The most widely used tool, the Charlson Comorbidity Index (CCI is limited due to frequent missing data in medical records and administrative data. Patient self-report data has the potential to be more complete but has not been widely used. The purpose of this study was to evaluate the performance of the Self-Administered Comorbidity Questionnaire (SCQ to predict functional capacity, quality of life (QOL health outcomes compared to CCI medical records data. Method An SCQ-score was generated from patient interview, and the CCI score was generated by medical record review for 525 patients hospitalized for Acute Coronary Syndrome (ACS at baseline, three months and eight months post-discharge. Linear regression models assessed the extent to which there were differences in the ability of comorbidity measures to predict functional capacity (Activity Status Index [ASI] scores and quality of life (EuroQOL 5D [EQ5D] scores. Results The CCI (R2 = 0.245; p = 0.132 did not predict quality of life scores while the SCQ self-report method (R2 = 0.265; p 2 = 0.370; p 2 = 0.358; p Conclusions Although our model R-squares were fairly low, these results show that the self-report SCQ index is a good alternative method to predict QOL health outcomes when compared to a CCI medical record score. Both measures predicted physical functioning similarly. This suggests that patient self-reported comorbidity data can be used for predicting physical functional capacity and QOL and can serve as a reliable risk adjustment measure. Self-report comorbidity data may provide a cost-effective alternative method for risk adjustment in clinical research, health policy and organizational improvement analyses. Trial registration Clinical Trials.gov NCT00416026

  5. The Study of Life Change Unit as Stressor Agents among Tehran University of Medical Sciences Hospitals' Employees

    Directory of Open Access Journals (Sweden)

    Hossein Dargahi

    2010-08-01

    Full Text Available Life crises as stressor agents can disrupt the best stress management regime. Different life crises have different impacts. A standard scale to rate change and its related stress impact has been developed commonly referred to as LCU (Life Change Unit Rating. This allocates a number of Life Crisis Units or Life Change Units (LCUs to different event and then evaluates them and takes action accordingly. This idea behind this approach of is to rundown the LCU table, totaling the LCUs for life crisis that have occurred in the previous one year. A Cross - sectional, descriptive and analytical study was conducted among 900 Tehran University of Medical Sciences (TUMS Employees by a Holms and Rahe LCU questionnaire at 15 hospitals. The respondents were asked to determine their demographic information, list of stress symptoms which suffered from these diseases in the previous one year and finally, responded to 45 Life Change Unit as stressful life events and the value of each in "stress units" which occurred in the previous one year. The results showed that there is significant correlation between the employees LCU rating by sex, educational degree and size of hospital. Also we found that there are significant correlations between the employees stress symptoms with their LCU rating. Totally, 40% of the employees have less than 150 LCU rating (normal range and 60% of them have 150-300 or more than 300 LCU rating (abnormal range. In conclusion most of TUMS hospitals' employees who had stress symptoms have more LCU rating. One third of these employees are not in danger of suffering the illness effect, while two third of them are in danger.

  6. Quality of life of breast cancer patients medicated with anti-estrogens, 2 years after acupuncture treatment: a qualitative study

    Directory of Open Access Journals (Sweden)

    Jill Hervik

    2010-09-01

    Full Text Available Jill Hervik1, Odd Mjåland21Pain Clinic, Vestfold Hospital, Tønsberg, Norway; 2Department of Abdominal Surgery, Sørlandet Sykehus, Kristiansand, NorwayObjective: The aim of this study was to examine the quality of life of breast cancer patients medicated with estrogen antagonists, 2 years after having acupuncture treatment for hot flashes.Methods and materials: Our sample was taken from women who had recently participated in a randomized controlled trial investigating the effects of acupuncture on hot flashes, a side effect of estrogen-antagonist treatment. Forty-one women from the true acupuncture treatment group and 41 women from the control group (sham acupuncture, who had 2 years previously received a course of 15 acupuncture treatments over a period of 10 weeks, were asked to answer an open question. The question, “Would you like to share your thoughts and experiences related to your breast cancer diagnosis, treatments or anything else?” was by being open, broad, and nonspecific, intended to stimulate subjective information, which was not included in the original, or future quantitative studies. Qualitative data were analyzed using systematic text condensation.Results: Most women were troubled by two or more side effects due to anti-estrogen medication, negatively affecting their life quality. Symptoms included hot flashes, sleep problems, muscle and joint pain, arm edema, fatigue, weight gain, depression, and lack of sexual desire. Women previously treated with sham acupuncture complained that hot flashes were still problematic, whilst those previously treated with traditional Chinese acupuncture found them less of a problem and generally had a more positive outlook on life. These results compare favorably with the findings from our original study that measured quantitatively health related quality of life.Conclusion: Side effects due to anti-estrogen treatment seriously affect the quality of life of breast cancer operated patients

  7. ADVANCEMENT IN MEDICAL TREATMENT OF PATIENTS WITH ACUTE RESPIRATORY VIRAL INFECTIONS

    Directory of Open Access Journals (Sweden)

    Kopcha V.S.

    2015-05-01

    Full Text Available Introduction. Acute respiratory viral infections are the special group of diseases, which in the structure of infectious pathology firmly occupies one of leading places. The problem of morbidity belongs to the number of leading medical problems not only in Ukraine but also in the whole world. In addition, there is a greater risk of epidemic flashes of acute respiratory infections in the conditions of megapolis with the expressed processes of migration and accumulation of people. Purpose of test – to promote efficiency of patients treatment with acute respiratory viral infections by complex application of preparation «Extralact» on a background traditional (base therapy without the use of other antiviral preparations, thoroughly to probe influence on clinical motion of the indicated illnesses, endogenous intoxication and immune status of organism. Patients & methods. Under a supervision was 60 patients (22 men and 38 women of young and middle age (hesitated from 18 to 58, which treated oneself concerning ARVI. Determined the indexes of Extralact efficiency: general duration of disease; frequency of development of complications; dynamics of clinical displays; dynamics of laboratory indexes, indexes of endogenous intoxication, and immunological indexes. Patients were randomised on 2 groups: a I group (30 persons – 50,0 % got treatment of base therapy preparations; the II group (30 patients – 50,0 % on a background base therapy got preparation «Extralact» for 2 capsules 3 times per days during 5 days. Results & discussion. Based on the examination of 60 patients with ARVI established following. Addition of base therapy of such patients of extralact in a dose 2 caps. 3 times daily during 5 days was accompanied by a significant advantage compared with only basic therapy on several grounds: the greater the number of patients advancing recovery up to 7 days, most regressed cough, relatively less there were complications. After 5 days of

  8. Making Medical Decisions for a Loved One at the End of Life

    Science.gov (United States)

    ... Must Decide for Someone Else When making medical decisions for someone else, it is important to remember ... is no specific information, you can make a decision in many states if you can determine what ...

  9. Recycling of Na in advanced life support: strategies based on crop production systems.

    Science.gov (United States)

    Guntur, S V; Mackowiak, C; Wheeler, R M

    1999-01-01

    Sodium is an essential dietary requirement in human nutrition, but seldom holds much importance as a nutritional element for crop plants. In Advanced Life Support (ALS) systems, recycling of gases, nutrients, and water loops is required to improve system closure. If plants are to play a significant role in recycling of human wastes, Na will need to accumulate in edible tissues for return to the crew diet. If crops fail to accumulate the incoming Na into edible tissues, Na could become a threat to the hydroponic food production system by increasing the nutrient solution salinity. Vegetable crops of Chenopodiaceae such as spinach, table beet, and chard may have a high potential to supply Na to the human diet, as Na can substitute for K to a large extent in metabolic processes of these crops. Various strategies are outlined that include both genetic and environmental management aspects to optimize the Na recovery from waste streams and their resupply through the human diet in ALS. PMID:11542242

  10. Nile tilapia Oreochromis niloticus as a food source in advanced life support systems: Initial considerations

    Science.gov (United States)

    Gonzales, John M.; Brown, Paul B.

    2006-01-01

    Maintenance of crew health is of paramount importance for long duration space missions. Weight loss, bone and calcium loss, increased exposure to radiation and oxidative stress are critical concerns that need to be alleviated. Tilapia are currently under evaluation as a source of food and their contribution to reducing waste in advanced life support systems (ALSS). The nutritional composition of tilapia whole bodies, fillet, and carcass residues were quantitatively determined. Carbon and nitrogen free-extract percentages were similar among whole body (53.76% and 6.96%, respectively), fillets (47.06% and 6.75%, respectively), and carcass (56.36% and 7.04%, respectively) whereas percentages of N, S, and protein were highest in fillet (13.34, 1.34, and 83.37%, respectively) than whole body (9.27, 0.62, and 57.97%, respectively) and carcass (7.70, 0.39, and 48.15%, respectively). Whole body and fillet meet and/or exceeded current nutritional recommendations for protein, vitamin D, ascorbic acid, and selenium for international space station missions. Whole body appears to be a better source of lipids and n-3 fatty acids, calcium, and phosphorous than fillet. Consuming whole fish appears to optimize equivalent system mass compared to consumption of fillets. Additional research is needed to determine nutritional composition of tilapia whole body, fillet, and carcass when fed waste residues possibly encountered in an ALSS.

  11. Mission simulation as an approach to develop requirements for automation in Advanced Life Support Systems

    Science.gov (United States)

    Erickson, J. D.; Eckelkamp, R. E.; Barta, D. J.; Dragg, J.; Henninger, D. L. (Principal Investigator)

    1996-01-01

    This paper examines mission simulation as an approach to develop requirements for automation and robotics for Advanced Life Support Systems (ALSS). The focus is on requirements and applications for command and control, control and monitoring, situation assessment and response, diagnosis and recovery, adaptive planning and scheduling, and other automation applications in addition to mechanized equipment and robotics applications to reduce the excessive human labor requirements to operate and maintain an ALSS. Based on principles of systems engineering, an approach is proposed to assess requirements for automation and robotics using mission simulation tools. First, the story of a simulated mission is defined in terms of processes with attendant types of resources needed, including options for use of automation and robotic systems. Next, systems dynamics models are used in simulation to reveal the implications for selected resource allocation schemes in terms of resources required to complete operational tasks. The simulations not only help establish ALSS design criteria, but also may offer guidance to ALSS research efforts by identifying gaps in knowledge about procedures and/or biophysical processes. Simulations of a planned one-year mission with 4 crewmembers in a Human Rated Test Facility are presented as an approach to evaluation of mission feasibility and definition of automation and robotics requirements.

  12. 76 FR 71982 - Advancing Regulatory Science for Highly Multiplexed Microbiology/Medical Countermeasure Devices...

    Science.gov (United States)

    2011-11-21

    ... Regulatory Science for Highly Multiplexed Microbiology/ Medical Countermeasure Devices'' that published in the Federal Register of August 8, 2011 (76 FR 48169). In the notice, FDA requested public comments... Microbiology/ Medical Countermeasure Devices; Public Meeting; Reopening of Comment Period AGENCY: Food and...

  13. Advanced signal processing theory and implementation for sonar, radar, and non-invasive medical diagnostic systems

    CERN Document Server

    Stergiopoulos, Stergios

    2009-01-01

    Integrates topics of signal processing from sonar, radar, and medical system technologies by identifying their concept similarities. This book covers non-invasive medical diagnostic system applications, including intracranial ultrasound, a technology that attempts to address non-invasive detection on brain injuries and stroke.

  14. The impact of Implementation of New Systems of Finance (accrual accounting) at Ministry of Health and Medical Education on the components of quality of work life in Shiraz University of Medical Sciences: Perspectives of managers and financial analysts

    OpenAIRE

    Mohammad Namazi; Mohammad Hadi Maher; Zohreh Karim

    2014-01-01

    Introduction: The main objective of this research was to investigate the viewpoints of managers and finance experts of medical sciences on the impact of implementation of the modern financial system (accrual accounting) on the components of their quality of work life. Method: To achieve this goa Walton’s theory (1973) quality of life,was employed, totally 66 people from universities of medical sciences of all over Iran were selected ,and nine hypotheses were compiled and tested via a...

  15. Medical Informatics For Medical Students And Medical Practitioners

    Directory of Open Access Journals (Sweden)

    Jai MOHAN

    2010-06-01

    Full Text Available The importance of incorporating medical (or healthinformatics into the education of medical students andmedical practitioners is being increasingly recognised.The advances in information and communicationtechnology and the pervasion of the Internet intoeveryday life have important implications forhealthcare services and medical education.Students and practitioners should learn to utilisebiomedical information for problem solving anddecision making based on evidence. The extensiveintroduction of electronic health information systemsinto hospitals and clinics and at the enterprise level inMalaysia and elsewhere is driving a demand for healthprofessionals who have at least basic skills in andappreciation of the use of these technologies.The essential clinical informatics skills have beenidentified and should be incorporated into theundergraduate medical curriculum. It is recommendedthat these be introduced in stages and integrated intoexisting programmes rather than taught as a separatemodule. At the same time, medical schools shouldsupport the integration of e-learning in the educationalprocess in view of the numerous potential benefits.

  16. Axisymmetric whole pin life modelling of advanced gas-cooled reactor nuclear fuel

    Science.gov (United States)

    Mella, R.; Wenman, M. R.

    2013-06-01

    Thermo-mechanical contributions to pellet-clad interaction (PCI) in advanced gas-cooled reactors (AGRs) are modelled in the ABAQUS finite element (FE) code. User supplied sub-routines permit the modelling of the non-linear behaviour of AGR fuel through life. Through utilisation of ABAQUS's well-developed pre- and post-processing ability, the behaviour of the axially constrained steel clad fuel was modelled. The 2D axisymmetric model includes thermo-mechanical behaviour of the fuel with time and condition dependent material properties. Pellet cladding gap dynamics and thermal behaviour are also modelled. The model treats heat up as a fully coupled temperature-displacement study. Dwell time and direct power cycling was applied to model the impact of online refuelling, a key feature of the AGR. The model includes the visco-plastic behaviour of the fuel under the stress and irradiation conditions within an AGR core and a non-linear heat transfer model. A multiscale fission gas release model is applied to compute pin pressure; this model is coupled to the PCI gap model through an explicit fission gas inventory code. Whole pin, whole life, models are able to show the impact of the fuel on all segments of cladding including weld end caps and cladding pellet locking mechanisms (unique to AGR fuel). The development of this model in a commercial FE package shows that the development of a potentially verified and future-proof fuel performance code can be created and used. The usability of a FE based fuel performance code would be an enhancement over past codes. Pre- and post-processors have lowered the entry barrier for the development of a fuel performance model to permit the ability to model complicated systems. Typical runtimes for a 5 year axisymmetric model takes less than one hour on a single core workstation. The current model has implemented: Non-linear fuel thermal behaviour, including a complex description of heat flow in the fuel. Coupled with a variety of

  17. Impact of continuous glucose monitoring on quality of life, treatment satisfaction, and use of medical care resources

    DEFF Research Database (Denmark)

    Hommel, E; Olsen, B; Battelino, T;

    2014-01-01

    To investigate the impact of continuous glucose monitoring (CGM) on health-related quality of life (HRQOL), treatment satisfaction (TS) medical resource use, and indirect costs in the SWITCH study. SWITCH was a multicentre, randomized, crossover study. Patients with type 1 diabetes (n = 153) using...... longer during the sensor-On arm. Regarding indirect costs, children with >70 % sensor usage missed fewer school days, compared with the sensor-Off arm (P = 0.0046) but there was no significant difference in the adults days of work off. The addition of CGM to CSII resulted in better metabolic control...... without imposing an additional burden on the patient or increased medical resource use, and offered the potential for cost offsets....

  18. Advance Directives for End-of-Life Care and the Role of Health Education Specialists: Applying the Theory of Reasoned Action

    Science.gov (United States)

    Tremethick, Mary Jane; Johnson, Maureen K.; Carter, Mary R.

    2011-01-01

    Quality end-of-life care is subjective and based on individual values and beliefs. An advance directive provides a legal means of communicating these values and beliefs, as well as preferences in regards to end-of-life care when an individual is no longer able to make his or her desires known. In many nations, advance directives are underused…

  19. The CELSS Antarctic Analog Project: An Advanced Life Support Testbed at the Amundsen-Scott South Pole Station, Antarctica

    Science.gov (United States)

    Straight, Christian L.; Bubenheim, David L.; Bates, Maynard E.; Flynn, Michael T.

    1994-01-01

    CELSS Antarctic Analog Project (CAAP) represents a logical solution to the multiple objectives of both the NASA and the National Science Foundation (NSF). CAAP will result in direct transfer of proven technologies and systems, proven under the most rigorous of conditions, to the NSF and to society at large. This project goes beyond, as it must, the generally accepted scope of CELSS and life support systems including the issues of power generation, human dynamics, community systems, and training. CAAP provides a vivid and starkly realistic testbed of Controlled Ecological Life Support System (CELSS) and life support systems and methods. CAAP will also be critical in the development and validation of performance parameters for future advanced life support systems.

  20. Advance directives and nursing home stays associated with less aggressive end-of-life care for patients with severe dementia.

    Science.gov (United States)

    Nicholas, Lauren H; Bynum, Julie P W; Iwashyna, Theodore J; Weir, David R; Langa, Kenneth M

    2014-04-01

    The number of older adults with cognitive impairment is increasing, and such adults often require a surrogate to make decisions about health care. However, little is known about the aggressiveness of end-of-life care for these people, especially those who reside in the community. We found that cognitive impairment is common among older adults approaching the end of life, whether they live in the community or in a nursing home, and that nearly 30 percent of patients with severe dementia remained in the community until death. Among those patients, having an advance directive in the form of a living will was associated with significantly less aggressive care at the end of life, compared to similar patients without an advance directive-as measured by Medicare spending ($11,461 less per patient), likelihood of in-hospital death (17.9 percentage points lower), and use of the intensive care unit (9.4 percentage points lower). In contrast, advance directives were not associated with differences in care for people with normal cognition or mild dementia, whether they resided in the community or in a nursing home. Timely advance care planning after a diagnosis of cognitive impairment may be particularly important for older adults who reside in the community. PMID:24711329

  1. The characteristics of advanced cancer patients followed at home, but admitted to the hospital for the last days of life.

    Science.gov (United States)

    Mercadante, Sebastiano; Masedu, Francesco; Valenti, Marco; Mercadante, Alessandro; Aielli, Federica

    2016-08-01

    Information regarding advanced cancer patients followed at home who are admitted to the hospital in the last days of life are lacking. The aim of this study was to assess the characteristics of patients who were hospitalized in the last days of life after being assisted by a home palliative care team. The secondary outcome was to identify possible risk factors for hospitalization. The charts were analyzed of a consecutive sample of advanced cancer patients admitted to hospital wards in the last days of life after being followed at home by a palliative care team. Of 550 consecutive patients followed at home, 138 (25.1 %) were admitted to the hospital. Younger patients were more likely to die in the hospital. In a logistic risk analysis adjusted for age, patients with lung and head-neck cancer were more likely to die in the hospital. Patients having a female relative or a female consort as a caregiver were more likely to die at home. CAGE-positive patients (7.25 %), and patients with a shorter period of home assistance were more likely transported to hospital before dying (p = 0.00 and p risk factors of hospitalization at the end of life for advanced cancer patients followed at home. PMID:26895033

  2. The Quality-of-Life Effects of Neoadjuvant Chemoradiation in Locally Advanced Rectal Cancer

    International Nuclear Information System (INIS)

    Purpose: Existing studies that examine the effect of neoadjuvant chemoradiation (CRT) for locally advanced rectal cancer on patient quality of life (QOL) are limited. Our goals were to prospectively explore acute changes in patient-reported QOL endpoints during and after treatment and to establish a distribution of scores that could be used for comparison as new treatment modalities emerge. Methods and Materials: Fifty patients with locally advanced rectal cancer were prospectively enrolled at 2 institutions. Validated cancer-specific European Organization for Research and Treatment of Cancer (EORTC QLQ-CR30) and colorectal cancer-specific (EORTC QLQ-CR38 and EORTC QLQ-CR 29) QOL questionnaires were administered to patients 1 month before they began CRT, at week 4 of CRT, and 1 month after they had finished CRT. The questionnaires included multiple symptom scales, functional domains, and a composite global QOL score. Additionally, a toxicity scale was completed by providers 1 month before the beginning of CRT, weekly during treatment, and 1 month after the end of CRT. Results: Global QOL showed a statistically significant and borderline clinically significant decrease during CRT (−9.50, P=.0024) but returned to baseline 1 month after the end of treatment (−0.33, P=.9205). Symptoms during treatment were mostly gastrointestinal (nausea/vomiting +9.94, P<.0001; and diarrhea +16.67, P=.0022), urinary (dysuria +13.33, P<.0001; and frequency +11.82, P=.0006) or fatigue (+16.22, P<.0001). These symptoms returned to baseline after therapy. However, sexual enjoyment (P=.0236) and sexual function (P=.0047) remained persistently diminished after therapy. Conclusions: Rectal cancer patients undergoing neoadjuvant CRT may experience a reduction in global QOL along with significant gastrointestinal and genitourinary symptoms during treatment. Moreover, provider-rated toxicity scales may not fully capture this decrease in patient-reported QOL. Although most symptoms are

  3. Measuring the Effects of Medication Use on Health-Related Quality of Life in Patients with Rheumatoid Arthritis: A Review

    OpenAIRE

    Michael B. Nichol; Ann S. M. Harada

    1999-01-01

    As the treatment of rheumatoid arthritis (RA) moves towards earlier and more consistently maintained therapy, often with highly toxic medications, the importance of assessing patients' health-related quality of life (HR-QOL) is of increasing concern to healthcare providers, insurers and policy-makers. As the course of RA can extend 20 years or more, and as patient involvement in their care and evaluation increases, the goal of therapy should be to work towards the HR-QOL desired by the patien...

  4. Next-Generation Evaporative Cooling Systems for the Advanced Extravehicular Mobility Unit Portable Life Support System

    Science.gov (United States)

    Makinen, Janice V.; Anchondo, Ian; Bue, Grant C.; Campbell, Colin; Colunga, Aaron

    2012-01-01

    The development of the Advanced Extravehicular Mobility Unit (AEMU) Portable Life Support System (PLSS) is currently underway at NASA Johnson Space Center. The AEMU PLSS features two new evaporative cooling systems, the Reduced Volume Prototype Spacesuit Water Membrane Evaporator (RVP SWME), and the Auxiliary Cooling Loop (ACL). The RVP SWME is the third generation of hollow fiber SWME hardware, and like its predecessors, RVP SWME provides nominal crewmember and electronics cooling by flowing water through porous hollow fibers. Water vapor escapes through the hollow fiber pores, thereby cooling the liquid water that remains inside of the fibers. This cooled water is then recirculated to remove heat from the crewmember and PLSS electronics. Major design improvements, including a 36% reduction in volume, reduced weight, and more flight like back-pressure valve, facilitate the packaging of RVP SWME in the AEMU PLSS envelope. In addition to the RVP SWME, the Auxiliary Cooling Loop (ACL), was developed for contingency crewmember cooling. The ACL is a completely redundant, independent cooling system that consists of a small evaporative cooler--the Mini Membrane Evaporator (Mini-ME), independent pump, independent feed-water assembly and independent Liquid Cooling Garment (LCG). The Mini-ME utilizes the same hollow fiber technology featured in the RVP SWME, but is only 25% of the size of RVP SWME, providing only the necessary crewmember cooling in a contingency situation. The ACL provides a number of benefits when compared with the current EMU PLSS contingency cooling technology; contingency crewmember cooling can be provided for a longer period of time, more contingency situations can be accounted for, no reliance on a Secondary Oxygen Vessel (SOV) for contingency cooling--thereby allowing a SOV reduction in size and pressure, and the ACL can be recharged-allowing the AEMU PLSS to be reused, even after a contingency event. The development of these evaporative cooling

  5. Architecture and Functionality of the Advanced Life Support On-Line Project Information System

    Science.gov (United States)

    Hogan, John A.; Levri, Julie A.; Morrow, Rich; Cavazzoni, Jim; Rodriguez, Luis F.; Riano, Rebecca; Whitaker, Dawn R.

    2004-01-01

    An ongoing effort is underway at NASA Ames Research Center (ARC) to develop an On-line Project Information System (OPIS) for the Advanced Life Support (ALS) Program. The objective of this three-year project is to develop, test, revise and deploy OPIS to enhance the quality of decision-making metrics and attainment of Program goals through improved knowledge sharing. OPIS will centrally locate detailed project information solicited from investigators on an annual basis and make it readily accessible by the ALS Community via a Web-accessible interface. The data will be stored in an object-oriented relational database (created in MySQL) located on a secure server at NASA ARC. OPE will simultaneously serve several functions, including being an research and technology development (R&TD) status information hub that can potentially serve as the primary annual reporting mechanism for ALS-funded projects. Using OPIS, ALS managers and element leads will be able to carry out informed R&TD investment decisions, and allow analysts to perform accurate systems evaluations. Additionally, the range and specificity of information solicited will serve to educate technology developers of programmatic needs. OPIS will collect comprehensive information from all ALS projects as well as highly detailed information specific to technology development in each ALS area (Waste, Water, Air, Biomass, Food, Thermal, Controls and Systems Analysis). Because the scope of needed information can vary dramatically between areas, element-specific technology information is being compiled with the aid of multiple specialized working groups. This paper presents the current development status in terms of the architecture and functionality of OPIS. Possible implementation approaches for OPIS are also discussed.

  6. Architecture and Functionality of the Advanced Life Support On-Line Project Information System (OPIS)

    Science.gov (United States)

    Hogan, John A.; Levri, Julie A.; Morrow, Rich; Cavazzoni, Jim; Rodriquez, Luis F.; Riano, Rebecca; Whitaker, Dawn R.

    2004-01-01

    An ongoing effort is underway at NASA Amcs Research Center (ARC) tu develop an On-line Project Information System (OPIS) for the Advanced Life Support (ALS) Program. The objective of this three-year project is to develop, test, revise and deploy OPIS to enhance the quality of decision-making metrics and attainment of Program goals through improved knowledge sharing. OPIS will centrally locate detailed project information solicited from investigators on an annual basis and make it readily accessible by the ALS Community via a web-accessible interface. The data will be stored in an object-oriented relational database (created in MySQL(Trademark) located on a secure server at NASA ARC. OPE will simultaneously serve several functions, including being an R&TD status information hub that can potentially serve as the primary annual reporting mechanism. Using OPIS, ALS managers and element leads will be able to carry out informed research and technology development investment decisions, and allow analysts to perform accurate systems evaluations. Additionally, the range and specificity of information solicited will serve to educate technology developers of programmatic needs. OPIS will collect comprehensive information from all ALS projects as well as highly detailed information specific to technology development in each ALS area (Waste, Water, Air, Biomass, Food, Thermal, and Control). Because the scope of needed information can vary dramatically between areas, element-specific technology information is being compiled with the aid of multiple specialized working groups. This paper presents the current development status in terms of the architecture and functionality of OPIS. Possible implementation approaches for OPIS are also discussed.

  7. Astrobiology Sample Analysis Program (ASAP) for Advanced Life Detection Instrumentation Development and Calibration

    Science.gov (United States)

    Glavin, Daniel; Brinkerhoff, Will; Dworkin, Jason; Eigenbrode, Jennifer; Franz, Heather; Mahaffy, Paul; Stern, Jen; Blake, Daid; Sandford, Scott; Fries, marc; Steele, Andrew; Amashukeli, Xenia; Fisher, Anita; Grunthaner, Frank; Aubrey, Andrew; Bada, Jeff; Chiesl, Tom; Stockton, Amanda; Mathies, Rich

    2008-01-01

    Scientific ground-truth measurements for near-term Mars missions, such as the 2009 Mars Science Laboratory (MSL) mission, are essential for validating current in situ flight instrumentation and for the development of advanced instrumentation technologies for life-detection missions over the next decade. The NASA Astrobiology Institute (NAI) has recently funded a consortium of researchers called the Astrobiology Sample Analysis Program (ASAP) to analyze an identical set of homogenized martian analog materials in a "round-robin" style using both state-of-the-art laboratory techniques as well as in-situ flight instrumentation including the SAM gas chromatograph mass spectrometer and CHEMIN X-ray diffraction/fluorescence instruments on MSL and the Urey and MOMA organic analyzer instruments under development for the 2013 ExoMars missions. The analog samples studied included an Atacama Desert soil from Chile, the Murchison meteorite, a gypsum sample from the 2007 AMASE Mars analog site, jarosite from Panoche Valley, CA, a hydrothermal sample from Rio Tinto, Spain, and a "blind" sample collected during the 2007 MSL slow-motion field test in New Mexico. Each sample was distributed to the team for analysis to: (1) determine the nature and inventory of organic compounds, (2) measure the bulk carbon and nitrogen isotopic composition, (3) investigate elemental abundances, mineralogy and matrix, and (4) search for biological activity. The experimental results obtained from the ASAP Mars analog research consortium will be used to build a framework for understanding the biogeochemistry of martian analogs, help calibrate current spaceflight instrumentation, and enhance the scientific return from upcoming missions.

  8. Advanced life events (ALEs) that impede aging-in-place among seniors.

    Science.gov (United States)

    Lindquist, Lee A; Ramirez-Zohfeld, Vanessa; Sunkara, Priya; Forcucci, Chris; Campbell, Dianne; Mitzen, Phyllis; Cameron, Kenzie A

    2016-01-01

    Despite the wishes of many seniors to age-in-place in their own homes, critical events occur that impede their ability to do so. A gap exists as to what these advanced life events (ALEs) entail and the planning that older adults perceive is necessary. The purpose of this study was to identify seniors' perceptions and planning toward ALEs that may impact their ability to remain in their own home. We conducted focus groups with 68 seniors, age ≥65 years (mean age 73.8 years), living in the community (rural, urban, and suburban), using open-ended questions about perceptions of future heath events, needs, and planning. Three investigators coded transcriptions using constant comparative analysis to identify emerging themes, with disagreements resolved via consensus. Subjects identified five ALEs that impacted their ability to remain at home: (1) Hospitalizations, (2) Falls, (3) Dementia, (4) Spousal Loss, and (5) Home Upkeep Issues. While recognizing that ALEs frequently occur, many subjects reported a lack of planning for ALEs and perceived that these ALEs would not happen to them. Themes for the rationale behind the lack of planning emerged as: uncertainty in future, being too healthy/too sick, offspring influences, denial/procrastination, pride, feeling overwhelmed, and financial concerns. Subjects expressed reliance on offspring for navigating future ALEs, although many had not communicated their needs with their offspring. Overcoming the reasons for not planning for ALEs is crucial, as being prepared for future home needs provides seniors a voice in their care while engaging key supporters (e.g., offspring). PMID:26952382

  9. Level of Knowledge of specialist cardiologists and anesthesiologists in Basic and Advanced Life Support

    Directory of Open Access Journals (Sweden)

    Maria Vachla

    2013-01-01

    Full Text Available Health professionals often witness in-hospital episodes of cardiac arrest. The quality of the Cardiopulmonary Resuscitation (CPR depends on the level of theoretical background and practical skills. Purpose: The aim of the present study was to investigate the level of theoretical knowledge of skilled cardiologists and anesthesiologists in the Basic and Advanced Life Support (BLS/ ALS. Material - method: In this study, sample included 240 cardiologists and anesthesiologists, chosen randomly from employers of 17 General Public Hospitals of Athens. For data collection, a questionnaire with 16 theoretical questions was designed, based on the guidelines of the European Resuscitation Council (ERC 2005. Significance level was set at p=≤0,05. The analysis was performed with the Statistical Package IBM SPSS Statistics 19. Results: No statistically significant difference was observed between specialists cardiologists and anesthesiologists in overall performance in theoretical knowledge on the BLS and ALS. Additionally, no statistical significance was observed between the two separate groups of theoretical background. Statistically significant difference was observed among those who had participated in a training seminar in BLS and ALS and those who had not participated (p<0,001. Also, there was statistical significance between the follow-up seminar in BLS/ ALS and specialty for the right answer to the question "which is the right ratio of chest compressions and ventilation", (p<0,001. Conclusions: The level of background knowledge of specialist cardiologists and anesthesiologists in the algorithms of BLS and ALS seem to correlate to the attendance of a training course.

  10. How does the quality of life and the underlying biochemical indicators correlate with the performance in academic examinations in a group of medical students of Sri Lanka?

    OpenAIRE

    Hettiarachchi, Manjula; Lakmal Fonseka, Chathuranga; Gunasekara, Priyanka; Jayasinghe, Prasanjanie; Maduranga, Dasun

    2014-01-01

    Background: Individual variation of examination performance depends on many modifiable and non-modifiable factors, including pre-examination anxiety. Medical students’ quality of life (QoL) and certain biochemical changes occurring while they are preparing for examinations has not been explored.Purpose: We hypothesize that these parameters would determine the examination performance among medical students.Methods: Fourth-year medical students (n=78) from the University of Ruhuna, Sri Lanka, w...

  11. Administering anticipatory medications in end-of-life care: A qualitative study of nursing practice in the community and in nursing homes

    OpenAIRE

    Wilson, Eleanor; Morbey, Hazel; Brown, Jayne; Payne, Sheila; Seale, Clive; Seymour, Jane

    2015-01-01

    Background: In the United Kingdom, an approach to improving end-of-life care has been the introduction of ‘just in case’ or ‘anticipatory’ medications. Nurses are often responsible for deciding when to use anticipatory medications, but little is known about their experiences. Aim: To examine nurses’ decisions, aims and concerns when using anticipatory medications. Design: An ethnographic study in two UK regions, using observations and interviews with nurses working in community and nurs...

  12. Comparison of peer-led versus professional-led training in basic life support for medical students

    Directory of Open Access Journals (Sweden)

    Fujiwara T

    2011-07-01

    Full Text Available Takashi Fujiwara1, Mai Nishimura2, Ryoko Honda3, Takashi Nishiyama4, Masahiro Nomoto5, Naoto Kobayashi6, Masayuki Ikeda71Division of Educational Training, Kurashiki Central Hospital, Kurashiki, Japan, 2Sixth-year medical student, 3Department of Anaesthesiology and Resuscitology, 4Department of Emergency Medicine, 5Department of Therapeutics, 6Medical Education Center, Ehime University School of Medicine, Ehime, Japan, 7Graduate School of Biomedical Sciences, Nagasaki University School of Medicine, Nagasaki, JapanBackground: The effect of peer-led training in basic life support (BLS in the education of medical students has not been assessed.Subjects and methods: This study was a randomized controlled trial with a blinded outcome assessor. A total of 74 fourth-year medical students at Ehime University School of Medicine, Japan were randomly assigned to BLS training conducted by either a senior medical student (peer-led group or a health professional (professional-led group. The primary outcome measure was the percentage of chest compressions with adequate depth (38–51 mm by means of a training mannequin evaluated 20 weeks after BLS training. Secondary outcome measures were compression depth, compression rate, proportion of participants who could ensure adequate compression depth (38–51 mm and adequate compression rate (90–110/minute, and retention of BLS knowledge as assessed by 22-point questionnaire.Results: Percentage chest compressions with adequate depth (mean ± SD was 54.5% ± 31.8% in the peer-led group and 52.4% ± 35.6% in the professional-led group. The 95% confidence interval (CI of difference of the means was –18.7% to 22.8%. The proportion of participants who could ensure an adequate mean compression rate was 17/23 (73.9% in the peer-led group but only 8/22 (36.4% in the professional-led group (P = 0.011. On the 22-point questionnaire administered 20 weeks after training, the peer-led group scored 17.2 ± 2.3 whereas the

  13. Quality of life assessment in advanced cancer patients treated at home, an inpatient unit, and a day care center

    OpenAIRE

    Leppert, Wojciech; Majkowicz, Mikolaj; Forycka, Maria; Mess, Eleonora; Zdun-Ryzewska, Agata

    2014-01-01

    Aim of the study To assess quality of life (QoL) in cancer patients treated at home, at an in-patient palliative care unit (PCU), and at a day care center (DCC). Patients and methods QoL was assessed in advanced cancer patients at baseline and after 7 days of symptomatic treatment using the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Core 15-Palliative Care (EORTC QLQ-C15-PAL), the Edmonton Symptom Assessment System (ESAS), and the Karnofsky Perfor...

  14. A randomised trial of lung sealant versus medical therapy for advanced emphysema

    OpenAIRE

    Come, Carolyn E.; Kramer, Mordechai R.; Dransfield, Mark T.; Abu-Hijleh, Muhanned; Berkowitz, David; Bezzi, Michela; Bhatt, Surya P; Boyd, Michael B.; Cases, Enrique; Chen, Alexander C.; Christopher B. Cooper; Flandes, Javier; Gildea, Thomas; Gotfried, Mark; Hogarth, D. Kyle

    2015-01-01

    Uncontrolled pilot studies demonstrated promising results of endoscopic lung volume reduction using emphysematous lung sealant (ELS) in patients with advanced, upper lobe predominant emphysema. We aimed to evaluate the safety and efficacy of ELS in a randomised controlled setting.

  15. Balancing Work and Life Promotes Job Satisfaction – Generational Gap among Medical Doctors

    OpenAIRE

    Perumal, Kala Premarani

    2013-01-01

    The profession of a doctor is considered to be one of the noblest professions. Doctors in general work around the clock in their deed of saving human lives and relieving them of physical ailments. However, on their personal front, most of them do not find them to fulfil their personal obligations. A work-life balance, which is nothing but the art of balancing personal and professional lives, is important for any individual to have fulfilment and satisfaction in life. This research intended to...

  16. Advance of the National Program of Radiological Protection and Safety for medical diagnostic with X-rays

    International Nuclear Information System (INIS)

    The National Program of Radiological Protection and Safety for medical diagnostic with X-ray (Programa Nacional de Proteccion y Seguridad Radiologica para diagnostico medico con rayos X) was initiated in the General Direction of Environmental Health (Direccion General de Salud Ambiental) in 1995. Task coordinated with different dependences of the Public Sector in collaboration between the Secretary of Health (Secretaria de Salud), the National Commission of Nuclear Safety and Safeguards (Comision Nacional de Seguridad Nuclear y Salvaguardias) and, the National Institute of Nuclear Research (Instituto Nacional de Investigaciones Nucleares). The surveillance to the fulfilment of the standardization in matter of Radiological Protection and Safety in the medical diagnostic with X-rays has been obtained for an important advance in the Public sector and it has been arousing interest in the Private sector. (Author)

  17. Women in the C-Suite: A Study of How Succession Planning May Best Be Utilized for Career Advancement of Medical College Executives

    Science.gov (United States)

    Mack, Yvette E.

    2010-01-01

    This study evaluated and analyzed medical school executives' perceptions of the low level of advancement of women into the healthcare c-suite. As well, medical school executives' recommendations for increasing the number of women entering and experiencing sustained success in executive positions were assessed. Related to these observations were…

  18. Electromagnetic compatibility of WLAN adapters with life-supporting medical devices.

    Science.gov (United States)

    Calcagnini, G; Mattei, E; Censi, F; Triventi, M; Lo Sterzo, R; Marchetta, E; Bartolini, P

    2011-05-01

    This paper investigates the electromagnetic compatibility of 45 critical care medical devices (infusion pumps, defibrillators, monitors, lung ventilators, anesthesia machines and external pacemakers) with various types of wireless local area network (WLAN, IEEE 802.11 b/g, 2.45 GHz, 100 mW) adapters. Interference is evaluated by performing ad-hoc tests according to the ANSI C63.18 recommended practice. The behavior of the devices during the tests was monitored using patient simulators/device testers specific for each device class. Electromagnetic interference cases were observed in three of 45 devices at a maximum distance of 5 cm. In two cases the interference caused malfunctions that may have clinical consequences for the patient. The authors' findings show that the use of these wireless local area network adapters can be considered reasonably safe, although interference may occur if they are operated at very close distance (<10 cm) to the medical devices. PMID:21451319

  19. Gaps in the knowledge about advancements in rabies vaccines among the undergraduate medical students.

    Science.gov (United States)

    Laskar, Ananya Ray; Singh, Megha Chandra; Saha, S S

    2010-12-01

    Enormous developments have taken place during the past few years in the field of Rabies prevention and control particularly rabies vaccines. Intra-dermal Rabies Vaccination (IDRV) has already emerged as a safe, ethical and cost-effective replacement. However appropriate dissemination of knowledge and implementation by medical fraternity is imperative for effective prevention and control of this fatal disease. Gaps were found in the knowledge of medical students regarding the newer rabies vaccines. This can be resolved to great extent by updating the undergraduate curriculum with the current control strategies used in this field. PMID:22471199

  20. Life in the Medical Career: Perception of Pre-University Students

    OpenAIRE

    Somsubhra De; Ankur Barua; Alpana Chhetri

    2012-01-01

    Objectives: Pre-University students have to decide their career pathway. In this study the primary objective was to find out the perception of students keen on pursuing medical career. Our secondary objective was to find out the parents’ response to their decision according to them.Material and Methods: Fifty one students from two colleges were given questionnaire survey. They were from the same Pre-University institution but their colleges were located in East and Peninsula Malaysia. They fu...

  1. HEALTH SURVEY AND LIFE HABITS OF NURSES WHO WORK AT THE MEDICAL FACULTY HOSPITAL AT AIBU

    OpenAIRE

    Deniz, Fatih; Alcelik, Aytekin; Nuray YESILDAL; Atilla Senih MAYDA; Berna AYAKTA SERIFI

    2005-01-01

    Objectives: Nursing is an occupation needed renunciation, patience and physical endurance. Nurses have to prevent their physical and mental health, because they can be more beneficial to patients. A cross-sectional study was conducted on AIBU Duzce Medical School Nurses to determine health problems and nutritional habits. Materials and Methods: The questionnaires forms filled by 79 nurses(%86) and analysed the data using an statistical package programme. Results: Mean age of the study group w...

  2. Attitudes on end-of-life care and advance care planning in the lesbian and gay community.

    Science.gov (United States)

    Stein, G L; Bonuck, K A

    2001-01-01

    Gay men and lesbians have special interests in documenting their preferences regarding advance care planning and end-of-life care. A 64-item survey instrument was developed to ascertain the preferences of this community regarding approaches to end-of-life care, viewpoints on physician-assisted suicide (PAS) and euthanasia, and practices regarding advance care planning. The survey was completed by 575 participants recruited through community-based health care and social service organizations serving the lesbian and gay community, primarily in the New York metropolitan area. Respondents represent a diverse group of women (36%) and men (63%) from various age, racial/ethnic, and religious/spiritual backgrounds; 10% were human immunodeficiency virus (HIV)-positive. Respondents' perspectives on end-of-life care are generally consistent with findings from other attitudinal studies of U.S. adults: a majority supported legalization of PAS and preferred a palliative approach to end-of-life care. However, the gay community sample revealed even stronger support for assisted suicide and palliative care. Although respondents completed advance directives at a higher rate than adults generally, the legal importance for gay men and lesbians to execute directives should encourage health care providers and community organizations to assume a larger educational role on advance care planning. Results confirm other reports on the need to address provider communication skills. It is speculated that the HIV epidemic was a major influence behind these results because of the overwhelming personal impact of the epidemic on most gay men and lesbians during the past two decades. PMID:11441626

  3. A study of the relationships between perceived pain, social support, coping and quality of life in patients with advanced cancer

    OpenAIRE

    Wright, Shelagh

    1999-01-01

    The aim of the study was to assess the implications of perceived pain and social support for coping ability, levels of distress and quality of life in a group of patients with advanced cancer. A total of 98 patients who were undergoing palliative treatment and/or care and were aware of their cancer diagnosis, but not necessarily of their prognosis, consented verbally to participate. A questionnaire was administered to each participant comprised of scales to measure perceived pain intensity an...

  4. Toward Optimal End-of-Life Care for Patients with Advanced Chronic Obstructive Pulmonary Disease: Insights from a Multicentre Study

    OpenAIRE

    Rocker, Graeme M; Dodek, Peter M; Heyland, Daren K; for the Canadian Researchers at the End of Life Network

    2008-01-01

    BACKGROUND: Understanding patients’ needs and perspectives is fundamental to improving end-of-life (EOL) care. However, little is known of what quality care means to patients who have advanced lung disease.OBJECTIVES: To describe ratings of importance and satisfaction with elements of EOL care, informational needs, decision-making preferences, obstacles to a preferred location of death, clinical outcomes, and health care use before and during an index hospital admission for patients who have ...

  5. Fertility history and use of antidepressant medication in late mid-life: a register-based analysis of Norwegian women and men

    OpenAIRE

    KRAVDAL, ØYSTEIN; Grundy, Emily; Skirbekk, Vegard

    2015-01-01

    Objectives: Life course influences on later life depression may include parenting trajectories. We investigate associations between number and timing of births and use of antidepressant medication in late mid-life using data on the whole Norwegian population. Methods: We estimated logistic regression models to analyse variations in the purchase of antidepressants between 2004 and 2008 by timing of births and number of children among women and men aged 45–73, using Norwegian population reg...

  6. Data Mining and Domain Knowledge: An Exploration of Methods to Advance Medical Research

    Science.gov (United States)

    Engle, Kelley M.

    2013-01-01

    Researchers in the medical domain consider the double-blind placebo controlled clinical trial the gold standard. The data for these clinical trials are collected for a specifically defined hypothesis and there is very little in the realm of secondary data analyses conducted. The underlying purpose of this work is to demonstrate the value and…

  7. Medical undergraduates and pathological internet use: Interplay of stressful life events and resilience

    OpenAIRE

    Amrita Chakraborti; Prasenjit Ray; Mehboob U Islam; Asim Kumar Mallick

    2016-01-01

    Background: Being in the age of technological advancement, the human mind is under constant risk of being engulfed by social media leading to pathological internet use. Cyberworld serves as a buffer under stress by means of satisfying various needs of an individual in the form of entertainment, access to information, gaining recognition and maintaining relationships. Conversely, the morbid preoccupation of the internet was found to be averted by positive coping resilience and sense of self-ef...

  8. DOES URINARY DIVERSION IMPROVE THE QUALITY OF LIFE IN OBSTRUCTIVE UROPATHY SECONDARY TO ADVANCED PELVIC MALIGNANCY?

    Directory of Open Access Journals (Sweden)

    Shivashankarappa

    2016-02-01

    Full Text Available INTRODUCTION The incidence of patients presenting with advanced pelvic malignancy with obstructive uropathy is high in our country. Relentless progress of the malignancy will cause deterioration of renal function, aggravation of pain, infection, deterioration of Quality of Life (QOL, uremia and death. Decreased renal function is considered as a contraindication for palliative chemo and radiotherapy. However urinary diversion in these patients will lead to improvement in renal function and may help in administration of palliative therapy and thus, improve the quality of life of these patients. MATERIALS AND METHODS The present study includes the obstructive uropathy patients secondary to pelvic malignancy referred to our institution for urinary diversion between Jan 2010 to Dec 2014. Total 40 patients were included, of which, 25 patients underwent PCN, 9 patients retrograde DJ stenting, 4 patients refused the treatment, 2 patients were not fit for any intervention due to coagulopathy & comorbid conditions. Of 34 treated patients, 30 were female patients and 4 were male patients. All the patients were explained about the procedure and proper consent taken. Laboratory investigations like CBC, coagulation profile, LFT, routine urine analysis, urine C&S and serum electrolytes were carried out. Haemodialysis was done for 10 patients whose serum creatinine was >6mg% & potassium >6meq. USG guided PCN insertion was done in 8 patients, and in those who failed in this procedure, fluoroscopic C-ARM guided PCN insertion done in 17 patients. Post operatively RFT and serum electrolytes were assessed on 3, 7, 15, & 30th day. PCN catheter was changed once in 3 months. RESULTS 8 patients succeeded in USG guided PCN insertion and 17 patients who failed USG PCN insertion, was done under C–Arm guidance. 3 patients received blood transfusion. No deaths were seen during or post procedure in the hospital. Renal functions improved and normalised in most of the

  9. Quality of life of diabetic patients with medical or surgical treatment

    Directory of Open Access Journals (Sweden)

    S. Weiner

    2013-01-01

    Full Text Available Introduction: In general, most of the studies agree in that the quality of life (QoL of patients with diabetes is worse than that of the general population. Furthermore, these same studies have also described very positive effects on quality of life after bariatric surgery. The aim of this study was to analyze whether the impact on quality of life of diabetic patients after being submitted to bariatric surgery is the one supposed to be. Methods: We prospectively analyzed our data on 524 diabetic patients submitted to bariatric surgery between 2001 and 2005. All the patients filled up three QoL questionnaires before the surgery and at 1, 3, 6, and 12 months after the surgery. The answers were gathered from an annual database. All patients were submitted to adjustable gastric band surgery, Y-Roux gastric bypass, or BPD-Scopinaro. Results: We obtained complete data on 89 patients that were included into the study. One year after the surgery, the QoL had significantly improved independent of disease remission and weight loss. Diabetes got improved in all the cases. The improvement on the quality of life was higher in the patients with total remission of the disease than in those only improving their health status, although it was lower than that of those patients without diabetes before the surgery. Conclusions: After a literature review and with our own prospective data, we may conclude that the benefits obtained by diabetic patients from bariatric surgery are mainly due to improvement of their diabetes, irrespective of their initial BMI and the BMI decrease after the intervention. Further studies are needed to investigate the results of the QoL test in diabetics with low BMI after bariatric surgery and in the long run.

  10. End of Life Care and the Chaplain's Role on the Medical Team

    OpenAIRE

    Lahaj, Mary

    2012-01-01

    This article depicts a chaplain’s role in various learning and teaching situations, including end-of-life care and cases requiring cultural competency and gender preferences. The cases exemplify and underscore the difference between the role of a chaplain and the imam, as well as the necessity to have imams and both male and female chaplains in the hospital. It also describes the training, education, pastoral formation, pastoral identity, and roots of pastoral care in the Islamic tradition. T...

  11. Basic and Advanced Bayesian Structural Equation Modeling With Applications in the Medical and Behavioral Sciences

    CERN Document Server

    Lee, Sik-Yum

    2012-01-01

    This book provides clear instructions to researchers on how to apply Structural Equation Models (SEMs) for analyzing the inter relationships between observed and latent variables. Basic and Advanced Bayesian Structural Equation Modeling introduces basic and advanced SEMs for analyzing various kinds of complex data, such as ordered and unordered categorical data, multilevel data, mixture data, longitudinal data, highly non-normal data, as well as some of their combinations. In addition, Bayesian semiparametric SEMs to capture the true distribution of explanatory latent variables are introduce

  12. Medical students' perception of inpatients' anxiety, self-esteem, purpose-in-life and health locus of control as compared with nursing practitioners'.

    Directory of Open Access Journals (Sweden)

    Nagata H

    1999-06-01

    Full Text Available Medical students (fourth-year: n = 67; fifth-year: n = 63 estimated inpatients' feelings of anxiety, self-esteem, purpose-in-life, and multidimensional health locus of control. Their ratings were compared both with the ratings given by the 121 inpatients themselves and with those given by nursing practitioners (nurses and nursing students. Findings showed that the medical students overestimated inpatients' anxiety, while they underestimated the inpatients' purpose-in-life and internal health locus of control. Hence they underestimated, as did the nursing practitioners, the inpatients' positive emotional states and their positive attitude toward their own lives. Fifth-year medical students, with clinical experience, rated the inpatients' score of chance health locus of control higher than did the fourth-year medical students, who had no clinical experience. These findings indicate that medical students, like nursing practitioners, are inclined to pay more attention to inpatients' weaknesses than to their strengths.

  13. Medication adherence and quality of life among the elderly with diabetic retinopathy

    Directory of Open Access Journals (Sweden)

    Fernanda Freire Jannuzzi

    2014-12-01

    Full Text Available METHOD: one hundred (n=100 elderly outpatients with diabetic retinopathy taking antihypertensives and/or oral antidiabetics/insulin were interviewed. Adherence was evaluated by the adherence proportion and its association with the care taken in administrating medications and by the Morisky Scale. The National Eye Institute Visual Functioning Questionnaire (NEI VFQ-25 was used to evaluate HRQoL.RESULTS: most (58% reported the use of 80% or more of the prescribed dose and care in utilizing the medication. The item "stopping the drug when experiencing an adverse event", from the Morisky Scale, explained 12.8% and 13.5% of the variability of adherence proportion to antihypertensives and oral antidiabetics/insulin, respectively.CONCLUSION: there was better HRQoL in the Color Vision, Driving and Social Functioning domains of the NEI VFQ-25. Individuals with lower scores on the NEI VFQ-25 and higher scores on the Morisky Scale presented greater chance to be nonadherent to the pharmacological treatment of diabetes and hypertension.

  14. An advanced PC-PLC-based SCADA system for a commercial medical cyclotron

    International Nuclear Information System (INIS)

    A novel SCADA system is developed for the 30 MeV H- ion commercial medical cyclotron (model: Cyclone-30) operating at proton beam currents up to 850 μA, at the national medical cyclotron, Sydney Australia. Cyclone-30 control system at NMC consists of two PLCs and a PC. The NMC SCADA system is based on a IBM compatible PC and FIX DMACS software package running on Windows 3.1 platform. This system is custom built for the Cyclone-30 at NMC. High-quality graphic screens are designed to suit the cyclotron at NMC keeping up to date with all the system upgrades. This system is designed to completely replace the existing man-machine interface with many new functions. This paper describes the important components of the system including system architecture and software development. (orig.)

  15. Using System Mass (SM), Equivalent Mass (EM), Equivalent System Mass (ESM) or Life Cycle Mass (LCM) in Advanced Life Support (ALS) Reporting

    Science.gov (United States)

    Jones, Harry

    2003-01-01

    The Advanced Life Support (ALS) has used a single number, Equivalent System Mass (ESM), for both reporting progress and technology selection. ESM is the launch mass required to provide a space system. ESM indicates launch cost. ESM alone is inadequate for technology selection, which should include other metrics such as Technology Readiness Level (TRL) and Life Cycle Cost (LCC) and also consider perfom.arxe 2nd risk. ESM has proven difficult to implement as a reporting metric, partly because it includes non-mass technology selection factors. Since it will not be used exclusively for technology selection, a new reporting metric can be made easier to compute and explain. Systems design trades-off performance, cost, and risk, but a risk weighted cost/benefit metric would be too complex to report. Since life support has fixed requirements, different systems usually have roughly equal performance. Risk is important since failure can harm the crew, but it is difficult to treat simply. Cost is not easy to estimate, but preliminary space system cost estimates are usually based on mass, which is better estimated than cost. Amass-based cost estimate, similar to ESM, would be a good single reporting metric. The paper defines and compares four mass-based cost estimates, Equivalent Mass (EM), Equivalent System Mass (ESM), Life Cycle Mass (LCM), and System Mass (SM). EM is traditional in life support and includes mass, volume, power, cooling and logistics. ESM is the specifically defined ALS metric, which adds crew time and possibly other cost factors to EM. LCM is a new metric, a mass-based estimate of LCC measured in mass units. SM includes only the factors of EM that are originally measured in mass, the hardware and logistics mass. All four mass-based metrics usually give similar comparisons. SM is by far the simplest to compute and easiest to explain.

  16. Sustainable and responsible preventive medicine : Conceptualising ethical dilemmas arising from clinical implementation of advancing medical technology

    OpenAIRE

    Getz, Linn

    2006-01-01

    Background and setting Health care has become one of the most expansive activities in contemporary societies, and technology is one of its most influential factors. The modern medical-technological enterprise is however facing unprecedented practical, ethical and epistemic challenges. This thesis arises from a well-founded concern that medicine in general, and individually targeted preventive medicine in particular, may be about to become technified and dehumanised to an extent where its inte...

  17. Building Irish families through surrogacy: medical and judicial issues for the advanced reproductive technologies

    OpenAIRE

    Healy Clifford M; Sills Eric

    2008-01-01

    Abstract Surrogacy involves one woman (surrogate mother) carrying a child for another person/s (commissioning person/couple), based on a mutual agreement requiring the child to be handed over to the commissioning person/couple following birth. Reasons for seeking surrogacy include situations where a woman has non-functional or absent reproductive organs, or as a remedy for recurrent pregnancy loss. Additionally, surrogacy may find application in any medical context where pregnancy is contrain...

  18. Quality of Life Assessment:an Outcome Estimation of Chinese Medical Treatment

    Institute of Scientific and Technical Information of China (English)

    赵利; 陈金泉

    2003-01-01

    @@ At present, quality of life (QOL) has become a relevant measure of efficacy in clinical trials. Its use is spreading, and its importance is growing as a valid indicator of effectiveness of a treatment(1). In 1985, QOL, recommended by Food and Drug Administration (FDA), is one of the primary efficacy parameters as a basis for approval of anticancer drugs. Some scholars in China are also interested in establishing a related parameter for measuring efficacy of new drugs in view of QOL(2). Without question, to improve QOL is one of the main goals in health care and social work.

  19. Religious affiliation, quality of life and academic performance: New Zealand medical students.

    Science.gov (United States)

    Henning, Marcus A; Krägeloh, Christian; Thompson, Andrea; Sisley, Richard; Doherty, Iain; Hawken, Susan J

    2015-02-01

    The present study investigated the connections between religious affiliation, quality of life (QOL) and measures of academic performance. Participants (n = 275) were recruited from the School of Medicine within a New Zealand university. Religious affiliation was classified according to three subcategories: Christian (n = 104), Eastern religion (n = 34) and non-religious (n = 117). The participants completed the World Health Organisation quality of life questionnaire (WHOQOL-BREF) and the World Health Organisation Spiritual, Religiousness, and Personal Beliefs questionnaire immediately before their lecture time. The main findings of the study indicated that participants from different religious affiliations expressed different spiritual QOL perceptions. However, these different expressions did not translate into their perceptions related to hours of study and academic achievement. In addition, the QOL measures did not relate to academic achievement estimation but did predict hours of study. Greater hours of study were related to greater physical health but lower psychological health and poorer engagement in developing social relationships. Data from a small focus group (n = 4) revealed that these students believed that having a belief system assisted them when coping with the academic learning environment, although little difference could be found between external religious orientations and internal belief systems. PMID:24005316

  20. A retrospective quality of life analysis using the lung cancer symptom scale in patients treated with palliative radiotherapy for advanced nonsmall cell lung cancer

    International Nuclear Information System (INIS)

    Purpose: To measure symptom palliation in patients treated with radiation therapy for advanced nonsmall cell lung cancer (NSCLC). Methods and Materials: Five hundred thirty patients with NSCLC were treated at the Medical College of Virginia between 1988 and 1993. Sixty-three patients with the least favorable prognostic features received palliative radiation to 30 Gy in 10 or 12 fractions for symptoms related to the presence of intrathoracic tumor. The observer portion of the Lung Cancer Symptom Scale (LCSS) was employed in a retrospective chart review, scoring measures of appetite, fatigue, cough, dyspnea, hemoptysis, and pain. Results: In 54 evaluable patients, median survival was 4 months and was independent of age, stage, performance status, or histology. Ninety-six percent of the patients had at least one LCSS symptom at presentation. Fatigue was unaffected by therapy. Improvements in appetite (p = 0.68) and pain (p = 0.61) were not statistically significant. There was, however, a statistically significant reduction in cough (p = 0.01), hemoptysis (p = 0.001), and dyspnea (p 0.0003). Self-limiting acute side effects included transient esophagitis in 37% of patients, though no severe toxicities were noted. Conclusions: These results suggest symptomatic benefit from radiotherapy even in those NSCLC patients with advanced disease and a limited life expectancy. Treatment should be given to patients whose symptoms are most amenable to palliation. A site-specific quality of life instrument such as the LCSS should be included within any future clinical trial of NSCLC management so that symptom control may be scored as a treatment outcome in addition to disease-free survival

  1. Mandatory HIV Screening Policy & Everyday Life: A Look Inside the Canadian Immigration Medical Examination

    Directory of Open Access Journals (Sweden)

    LAURA BISAILLON

    2011-11-01

    Full Text Available Findings that detail the social organization of day-to-day practices associated with the Canadian government policy of mandatory HIV testing of permanent residence applicants to Canada are reported. Institutional ethnography was used to investigate interactions between HIV-positive applicants and immigration physicians during the immigration medical examination. A composite narrative recounts details of a woman applicant's discovery through immigration testing that she was living with HIV. Mandatory HIV testing gives rise to serious difficulties for applicants to Canada living with HIV. Applicant, physician and federal state employee work practices associated with mandatory HIV testing are analysed. These practices contribute to the ideological work of the Canadian state, where interest bounds up in the examination serve the state and not the applicant. Findings should be useful for Canadian immigration policy makers who wish to develop constructive and functional strategies to address issues that matter in people's lives

  2. [Medical castration in the treatment of locally advanced or metastatic prostate cancer: an update].

    Science.gov (United States)

    Drouin, S-J; Rouprêt, M; Davin, J-L; Soulié, M

    2009-04-01

    Indications for hormonotherapy in prostate cancer are in deep mutation and are constantly evolving. Used initially (1941) in metastatic stages, hormone therapy is used nowadays in locally advanced prostate cancer and aggressive localized disease. Its prescription in association with radiotherapy or surgery has provided a benefit regarding survival free progression. The place of hormone therapy in localized prostate cancer is not well defined and the debate is still ongoing, especially in case of biochemical recurrence after irradiation or radical prostatectomy and even in neoadjuvant cases. Additional and further studies are ongoing and are strongly needed to establish new guidelines. Nevertheless, hormone therapy is not restricted any more to palliative cases and is part of the current therapeutic arsenal of the urologist for high risk localized and/or locally advanced prostate cancers. PMID:19465332

  3. 攀登医学生命树观看人生%Watching human lire from top of medical life tree

    Institute of Scientific and Technical Information of China (English)

    姚树印

    2009-01-01

    以关于人身心的全方位的医学科研管理学为理论基础,在认同自然抗病力假说的前提下,对笔者提出的以神为根、以人为本、以物为枝叶的医学生命树哲学猜想的特定概念,特别是关于神的概念,做出了自我认知的诠释.通过分析、综合,归纳、演绎,推理、判断,从中医、中西医结合的原则与现代生物-心理-社会医学模式相整合,义通过四川汶川大地震的突发自然暴力事件中所显示出医学与生命的关系,力求印证这个哲学猜想的理论价值和现实意义.%All-round Medical science research management is based on the hypothesis that human body has nature resistance to diseases.Under this principle,the author put forward and annotated a specific concept about philosophical guess:medical and life tree consists in spirit-guided,human-oriented and matter-based.Especially,the idea on the supernatural was originally explained by the author.The relationship between the medicine and life was proposed using the strategy of analysis,synthesis,inducing,deducing,discursiveness and judgment,combining Traditional Chinese Medicine(TCM)with western medicine,as well as following the integrated modern biology-mentality-society medicinal mode.Wenchuan's earthquake of Sichuan province shaked all over the world.It also showed that the relation between the medicine and life,which confirmed that philosophical hypothesis(i.e.life tree)is theoretical value and practical significance in both theory and reality perspective.

  4. Advanced support systems development and supporting technologies for Controlled Ecological Life Support Systems (CELSS)

    Science.gov (United States)

    Simon, William E.; Li, Ku-Yen; Yaws, Carl L.; Mei, Harry T.; Nguyen, Vinh D.; Chu, Hsing-Wei

    1994-01-01

    A methyl acetate reactor was developed to perform a subscale kinetic investigation in the design and optimization of a full-scale metabolic simulator for long term testing of life support systems. Other tasks in support of the closed ecological life support system test program included: (1) heating, ventilation and air conditioning analysis of a variable pressure growth chamber, (2) experimental design for statistical analysis of plant crops, (3) resource recovery for closed life support systems, and (4) development of data acquisition software for automating an environmental growth chamber.

  5. Recent developments of ion sources for life-science studies at the Heavy Ion Medical Accelerator in Chiba (invited)

    International Nuclear Information System (INIS)

    With about 1000-h of relativistic high-energy ion beams provided by Heavy Ion Medical Accelerator in Chiba, about 70 users are performing various biology experiments every year. A rich variety of ion species from hydrogen to xenon ions with a dose rate of several Gy/min is available. Carbon, iron, silicon, helium, neon, argon, hydrogen, and oxygen ions were utilized between 2012 and 2014. Presently, three electron cyclotron resonance ion sources (ECRISs) and one Penning ion source are available. Especially, the two frequency heating techniques have improved the performance of an 18 GHz ECRIS. The results have satisfied most requirements for life-science studies. In addition, this improved performance has realized a feasible solution for similar biology experiments with a hospital-specified accelerator complex

  6. Recent developments of ion sources for life-science studies at the Heavy Ion Medical Accelerator in Chiba (invited)

    Science.gov (United States)

    Kitagawa, A.; Drentje, A. G.; Fujita, T.; Muramatsu, M.; Fukushima, K.; Shiraishi, N.; Suzuki, T.; Takahashi, K.; Takasugi, W.; Biri, S.; Rácz, R.; Kato, Y.; Uchida, T.; Yoshida, Y.

    2016-02-01

    With about 1000-h of relativistic high-energy ion beams provided by Heavy Ion Medical Accelerator in Chiba, about 70 users are performing various biology experiments every year. A rich variety of ion species from hydrogen to xenon ions with a dose rate of several Gy/min is available. Carbon, iron, silicon, helium, neon, argon, hydrogen, and oxygen ions were utilized between 2012 and 2014. Presently, three electron cyclotron resonance ion sources (ECRISs) and one Penning ion source are available. Especially, the two frequency heating techniques have improved the performance of an 18 GHz ECRIS. The results have satisfied most requirements for life-science studies. In addition, this improved performance has realized a feasible solution for similar biology experiments with a hospital-specified accelerator complex.

  7. Recent developments of ion sources for life-science studies at the Heavy Ion Medical Accelerator in Chiba (invited)

    Energy Technology Data Exchange (ETDEWEB)

    Kitagawa, A.; Drentje, A. G.; Fujita, T.; Muramatsu, M. [National Institute of Radiological Sciences, 4-9-1 Anagawa, Inage, Chiba 263-8555 (Japan); Fukushima, K.; Shiraishi, N.; Suzuki, T.; Takahashi, K.; Takasugi, W. [Accelerator Engineering Corporation, Chiba (Japan); Biri, S.; Rácz, R. [Institute for Nuclear Research (Atomki), Hungarian Academy of Sciences, Bem tér 18/C, H-4026 Debrecen (Hungary); Kato, Y. [Graduate School of Engineering, Osaka University, Osaka (Japan); Uchida, T.; Yoshida, Y. [Bio-Nano Electronics Research Centre, Toyo University, Kawagoe (Japan)

    2016-02-15

    With about 1000-h of relativistic high-energy ion beams provided by Heavy Ion Medical Accelerator in Chiba, about 70 users are performing various biology experiments every year. A rich variety of ion species from hydrogen to xenon ions with a dose rate of several Gy/min is available. Carbon, iron, silicon, helium, neon, argon, hydrogen, and oxygen ions were utilized between 2012 and 2014. Presently, three electron cyclotron resonance ion sources (ECRISs) and one Penning ion source are available. Especially, the two frequency heating techniques have improved the performance of an 18 GHz ECRIS. The results have satisfied most requirements for life-science studies. In addition, this improved performance has realized a feasible solution for similar biology experiments with a hospital-specified accelerator complex.

  8. Advanced SiC-Matrix Composites with Improved Oxidation Resistance and Life Project

    Data.gov (United States)

    National Aeronautics and Space Administration — The objective of this proposed effort is to demonstrate the promise of advanced C/SiC and SiC/SiC composites having improved environmental durability and longer...

  9. Change in quality of life after medical and surgical treatment of graves′ ophthalmopathy

    Directory of Open Access Journals (Sweden)

    Mohsen Bahmani Kashkouli

    2011-01-01

    Full Text Available Purpose : To assess the changes in quality of life (QOL of patients after treatment of their Graves′ ophthalmopathy (GO. Materials and Methods : In this prospective, cross-sectional study, the GO-QOL questionnaire was completed by 67 subjects before and at least 6 months after steroid treatment (61 subjects, group 1 or optic neuropathy orbital decompression (6 subjects, group 2. Visual, psychosocial, education and counseling scores (higher score = better health, GO severity and clinical activity scores and minimal clinically important difference (MCID were recorded and analyzed for correlation and statistical significance. A P-value 0.05. There was no significant effect of duration of thyroid disease and GO and severity and activity of GO on QOL scores either before or after treatment (P > 0.05, all cases. Conclusion : Steroid treatment and orbital decompression significantly improve the QOL in GO. Duration, severity and activity of GO did not have a significant impact on the QOL.

  10. End‐of‐life decisions in medical practice: a survey of doctors in Victoria (Australia)

    Science.gov (United States)

    Neil, D A; Coady, C A J; Thompson, J; Kuhse, H

    2007-01-01

    Objectives To discover the current state of opinion and practice among doctors in Victoria, Australia, regarding end‐of‐life decisions and the legalisation of voluntary euthanasia. Longitudinal comparison with similar 1987 and 1993 studies. Design and participants Cross‐sectional postal survey of doctors in Victoria. Results 53% of doctors in Victoria support the legalisation of voluntary euthanasia. Of doctors who have experienced requests from patients to hasten death, 35% have administered drugs with the intention of hastening death. There is substantial disagreement among doctors concerning the definition of euthanasia. Conclusions Disagreement among doctors concerning the meaning of the term euthanasia may contribute to misunderstanding in the debate over voluntary euthanasia. Among doctors in Victoria, support for the legalisation of voluntary euthanasia appears to have weakened slightly over the past 17 years. Opinion on this issue is sharply polarised. PMID:18055904

  11. Advanced, Long-Life Cryocooler Technology for Zero-Boil-Off Cryogen Storage Project

    Data.gov (United States)

    National Aeronautics and Space Administration — Long-life, high-capacity cryocoolers are a critical need for future space systems utilizing stored cryogens. The cooling requirements for planetary and...

  12. Advanced Energy Storage Life and Health Prognostics (INL) FY 2012 Annual Progress Report

    Energy Technology Data Exchange (ETDEWEB)

    Jon P. Christophersen

    2012-10-01

    The objective of this work is to develop methodologies that will accurately estimate state-of-health (SOH) and remaining useful life (RUL) of electrochemical energy storage devices using both offline and online (i.e., in-situ) techniques through: · A statistically robust offline battery calendar life estimator tool based on both testing and simulation, and · Novel onboard sensor technology for improved online battery diagnostics and prognostics.

  13. Nurses and Psychologists Advancing the Patient-Centered Medical Home Model.

    Science.gov (United States)

    Corso, Kent A; Gage, Donna

    2016-01-01

    As America experiences the largest health care revolution of the past 50 years, clinicians and administrators are refocusing their attention on the goals of the Quadruple Aim. Motivation and capabilities among stakeholders vary as practical tools and an adequate workforce remain elusive. At the same time, the patient-centered medical home (PCMH) model is spreading rapidly but demonstrating variable results. Positive PCMH outcomes seem to reflect high-quality teamwork. A primary care physician shortage is looming, and increasing numbers of health professionals are being pushed into the PCMH, mandated to provide "integrated" care. Even now, the majority of our Graduate Medical Education programs do not train clinicians in team-based workflow models and interaction skills. Consequently, PCMH teams will only optimize and realize the model's true potential if they learn to coordinate, communicate, and collaborate effectively. This means all PCMH staff members achieve solid teamwork skills and work at the top of their license. The authors discuss resources for improving coordination, communication, and collaboration among members of PCMH teams, and strategies for including other professionals. PMID:27259123

  14. Love and the Value of Life in Health Care: A Narrative Medicine Case Study in Medical Education.

    Science.gov (United States)

    Pentiado, Jorge Alberto Martins; De Almeida, Helcia Oliveira; Amorim, Fábio Ferreira; Facioli, Adriano Machado; Trindade, Eliana Mendonça Vilar; De Almeida, Karlo Jozefo Quadros

    2016-01-01

    This case study is an example of narrative medicine applied to promote self-awareness and develop humanistic contents in medical education. The impact and the human appeal of the narrative lie in the maturity and empathy shown by a student when reporting his dramatic experience during the care given to a newborn (with Patau syndrome and multiple malformations diagnosed at birth) and to her mother. The narrative approach helped the student to be successful in bringing out the meaning behind the story and to position himself from the mother's and newborn's perspective. The student's introspection changed a seemingly scary interaction into a positive experience, overcoming many initial negative emotions, such as fear, disappointment, horror, hopelessness, and insecurity in the face of the unexpected. It is uplifting how the student was strengthened by the power of maternal love to the point of overcoming any remaining feelings of eugenics or rejection. Other important lessons emerging from the case study were the art of listening and the value of silence. This narrative shows how the development of narrative competence can help establish a good physician-patient relationship, because the physician or the student with such competence usually confirms the patient's value and demonstrates concern for them, focusing on what they say and allowing genuine contact to be established, which is necessary for effective therapeutic alliance. The student's interpretations of the meaning of love and value of life inspired him on his reframing process of a medical practice marked by vicarious suffering. PMID:26901271

  15. Advancing LGBT Health at an Academic Medical Center: A Case Study.

    Science.gov (United States)

    Yehia, Baligh R; Calder, Daniel; Flesch, Judd D; Hirsh, Rebecca L; Higginbotham, Eve; Tkacs, Nancy; Crawford, Beverley; Fishman, Neil

    2015-12-01

    Academic health centers are strategically positioned to impact the health of lesbian, gay, bisexual and transgender (LGBT) populations by advancing science, educating future generations of providers, and delivering integrated care that addresses the unique health needs of the LGBT community. This report describes the early experiences of the Penn Medicine Program for LGBT Health, highlighting the favorable environment that led to its creation, the mission and structure of the Program, strategic planning process used to set priorities and establish collaborations, and the reception and early successes of the Program. PMID:26788778

  16. RTOG's first quality of life study--RTOG 90-20: a phase II trial of external beam radiation with etanidazole for locally advanced prostate cancer

    International Nuclear Information System (INIS)

    Purpose: To assess institutional and patient compliance with quality of life (QL) instruments in RTOG clinical trials. To assess feasibility of using the Functional Assessment Cancer Therapy (FACT), Sexual Adjustment Questionnaire (SAQ), and Changes in Urinary Function (CUF) QL instruments in a prostate clinical trial and to compare patient self-report of symptoms to medical professional ratings of the same symptoms using the RTOG acute toxicity rating scales. Methods and Materials: Three self-assessment QL instruments, the FACT, the SAQ, and CUF, were to be administered to patients on a Phase II locally advanced prostate trial at specified time points. Specific instructions for both data managers and for patients on when, how, and why to fill out the questionnaires were included. Results: Sixty-seven percent (24 out of 36) of patients accrued to RTOG 90-20 completed both the initial FACT and SAQ. Eighty-five percent completed FACT at end of RT and 73% at 3 months. Eighty-one percent completed SAQ at end of treatment, while 69% completed this form at 3 months. Compliance drops off thereafter. Seventy-five percent of patients who had their symptom of dysuria rated by a medical professional as 0 on the RTOG toxicity rating scale self-reported the same. Only 56% of patient self-reports on FACT regarding diarrhea were in agreement with the medical professional's RTOG rating of 0 toxicity. The measures were determined to be in moderate agreement when the patient evaluated a symptom as a 1 on the FACT and the medical professional rated the same symptom as a 0 on the RTOG toxicity rating scale. There was moderate agreement in 13% of patients with dysuria and 31% of patients with diarrhea. Low agreement occurred when the patient evaluated a symptom as a 2 or 3 on the FACT and the medical professional rated the same symptom as a 0 on the RTOG scale. Low agreement occurred in 13% of both patients reporting dysuria and diarrhea. Differences between how medical professionals

  17. Chronic migraine with medication overuse: association between disability and quality of life measures, and impact of disease on patients' lives.

    Science.gov (United States)

    Raggi, Alberto; Schiavolin, Silvia; Leonardi, Matilde; Giovannetti, Ambra Mara; Bussone, Gennaro; Curone, Marcella; Di Fiore, Paola; Grazzi, Licia; Usai, Susanna; D'Amico, Domenico

    2015-01-15

    Patients with chronic migraine with medication overuse (CM-MO) have decreased quality of life (QoL) and increased disability: the degree to which these outcomes are connected to disease severity and the pattern of MO towards disease severity are unclear. Patients under withdrawal were administered the Migraine Disability Assessment (MIDAS), the WHO Disability Assessment Schedule (WHODAS), and the Migraine-Specific Quality of Life Questionnaire (MSQ). They overused NSAIDs, triptans, NSAIDs and triptans, and other drugs (ergotamine, caffeine, opioids/barbiturates). We calculated the correlations between MIDAS, WHODAS, and MSQ; compared WHODAS to normative scores; compared MIDAS, WHODAS, and MSQ in patients with different CM-MO severity; and run a logistic regression to predict CM-MO severity based on overused drugs. One hundred ninety-four patients were enrolled: correlations between WHODAS, MSQ, and MIDAS were moderate; wide differences on WHODAS against normative were found; and no trend was found across severity groups. Compared to triptans overusers, patients overusing NSAID and other drugs had higher odds of severe CM-MO. Coupling different disability measures with QoL assessment offered different insights on the lived experience of CM-MO. Future studies are needed to clarify the relationship between overused drugs and CM-MO severity: we added evidence that NSAIDs do not have protective effect in high-frequency CM-MO. PMID:25434715

  18. The Effect of Diabetes Medication on Cognitive Function: Evidence from the PATH Through Life Study

    Directory of Open Access Journals (Sweden)

    Pushpani M. Herath

    2016-01-01

    Full Text Available Objective. To examine the effect of diabetes treatment on change of measures of specific cognitive domains over 4 years. Research Design and Methods. The sample was drawn from a population-based cohort study in Australia (the PATH Through Life Study and comprised 1814 individuals aged 65–69 years at first measurement, of whom 211 were diagnosed with diabetes. Cognitive function was measured using 10 neuropsychological tests. The effect of type of diabetes treatment (diet, oral hypoglycemic agents, and insulin on measures of specific cognitive domains was assessed using Generalized Linear Models adjusted for age, sex, education, smoking, physical activity level, BMI, and hypertension. Results. Comparison of cognitive function between diabetes treatment groups showed no significant effect of type of pharmacological treatment on cognitive function compared to diet only group or no diabetes group. Of those on oral hypoglycaemic treatment only, participants who used metformin alone had better cognitive function at baseline for the domains of verbal learning, working memory, and executive function compared to participants on other forms of diabetic treatment. Conclusion. This study did not observe significant effect from type of pharmacological treatment for diabetes on cognitive function except that participants who only used metformin showed significant protective effect from metformin on domain of verbal learning, working memory, and executive function.

  19. Final report of the group research. Advanced Technology for Medical Imaging Research. 1996-2000 FY

    International Nuclear Information System (INIS)

    This report involves the organization of the research groups (4 units of radiopharmaceutical chemistry, radiotracer and radiopharmacology, clinical imaging, and molecular informative research), 5 research reports and 38 published research papers. The research reports concern Fundamental researches on the availability and production of PET radiopharmaceuticals using the National Institute of Radiological Sciences (NIRS) cyclotron, Design and evaluation of in vivo radiopharmaceuticals for PET measurement (kinetics and metabolism in small animals and primates), Fundamental studies on development of technique radiation measurement, Clinical application of medical imaging technology in the fields of neuroscience, cardiovascular, cancer diagnosis and others, and A study to establish and evaluate a lung cancer screening system using spiral CT units which is in pilot-progress in Kanto and Kansai regions. (N.I.)

  20. An ethnographic study of strategies to support discussions with family members on end-of-life care for people with advanced dementia in nursing homes

    OpenAIRE

    Saini, Geena; Sampson, Elizabeth L.; Davis, Sarah; Kupeli, Nuriye; Harrington, Jane; Leavey, Gerard; Nazareth, Irwin; Jones, Louise; Moore, Kirsten J.

    2016-01-01

    Background Most people with advanced dementia die in nursing homes where families may have to make decisions as death approaches. Discussions about end-of-life care between families and nursing home staff are uncommon, despite a range of potential benefits. In this study we aimed to examine practices relating to end-of-life discussions with family members of people with advanced dementia residing in nursing homes and to explore strategies for improving practice. Methods An ethnographic study ...

  1. Advanced life-cycle management for an increased steam generator performance

    International Nuclear Information System (INIS)

    High steam generators performance is a prerequisite for high plant availability and possible life time extension. During operation, the performance is reduced by fouling of the heating tubes and by corrosion, resulting on a reduction of the heat-exchange area. Such steam generator degradation problems arise from mechanical degradation and a continuous ingress of non-volatile contaminants, i.e. corrosion products and salt impurities accumulated in the steam generators. In addition, the tube scales in general affect the steam generator thermal performance, which ultimately cause a reduction of power output. AREVA applied an integrated service for utilities to evaluate all operational parameters influencing the steam generator performance. The evaluation is assisted by a systematic approach to evaluate the major steam generator operational data. The different data are structured and indexed in a Cleanling-Matrix. The result of this matrix is a quantified, dimensionless figure, given as the Fouling Index. The Fouling Index allows to monitor the condition of steam generators, compare it to other plants and, in combination with a life-time management applied at several German utilities, it allows verified statements on the past operation. Based on these data, an extrapolation of the potential additional life-time of the component is possible. As such, the Fouling Index is a valuable tool concerning life-time extension considerations. The application of the cleanliness criteria in combination with operational data with respect to life-time monitoring and improvements of steam generator performance are presented. (author)

  2. Clinical observation on scores of anxiety, depression and quality of life for advanced gastrointestinal carcinoma patients with palliation intervention therapy

    International Nuclear Information System (INIS)

    Objective: To evaluate the influence of palliative intervention therapy on advanced gastrointestinal carcinoma patients with depression and anxiety before and after the treatment. Methods: 56 advanced gastrointestinal carcinoma patients were selected and treated with intra-arterial perfusion chemotherapy or intra-arterial perfusion chemotherapy with embolization. Curative effects were assessed with the SDS, SAS and FACT-G before and after the treatment. In addition, all patients took self-assessment with SCL-90, comparing with the Chinese norms. Results: SCL-90 scores including the somatization agent, depression agent, and anxiety agent scores of the advanced gastrointestinal carcinoma were higher than those of Chinese norms, with significant difference (P<0.05). After palliative intervention therapy, the scores of SDS and SAS were lower than those before the palliative intervention therapy with significant difference (P< 0.05); and furthermore with an obvious improvement in the scores of FACT-G (P<0.05). Conclusion: Palliative intervention therapy for advanced gastrointestinal carcinoma patients can improve the complaints of depression anxiety and quality of life. (authors)

  3. Assessing Quality of Life and Medical Care in Chronic Angina: An Internet Survey

    Science.gov (United States)

    2016-01-01

    Background Angina is a clinical syndrome whose recognition relies heavily on self-report, so its identification can be challenging. Most data come from cohorts identified by physicians and nurses at the point of care; however, current widespread access to the Internet makes identification of community cohorts feasible and offers a complementary picture of angina. Objective To describe a population self-identified as experiencing chronic angina by use of an Internet survey. Methods Using email and an Internet portal, we invited individuals with a diagnosis of angina and recent symptoms to complete an Internet survey on treatment and quality of life (QOL). In total, 1147 surveys were received. The main analysis was further limited to those reporting a definite coronary heart disease (CHD) history (N=646, 56% of overall). Results Overall, about 15% reported daily angina and 40% weekly angina. Those with more frequent angina were younger, more often depressed, and reported a shorter time since diagnosis. They also had substantially worse treatment satisfaction, physical function, and overall QOL. Fewer than 40% were on ≥ 2 anti-anginals, even with daily angina. The subjects without a history of definite CHD had unexpectedly low use of antianginal and evidence-based medicines, suggesting either a lack of specificity in the use of self-reported angina to identify patients with CHD or lack of access to care. Conclusions Use of inexpensive electronic tools can identify community-based angina cohorts for clinical research. Limitation to subjects with a definite history of CHD lends diagnostic face validity to the approach; however, other symptomatic individuals are also identified. PMID:27125492

  4. Effect of standard medication on quality of life of patients with atopic dermatitis.

    Science.gov (United States)

    Kawashima, Makoto; Harada, Shotaro

    2007-01-01

    Patients with atopic dermatitis present with debilitating symptoms, including pruritus and subsequent excoriation, which significantly reduces their quality of life (QOL). At present, the standard therapy for atopic dermatitis constitutes a topical steroid and/or a topical immunomodulator, an emollient and an oral antihistamine, although few studies have reported the effect of this treatment regimen on QOL. The current study aimed to verify the efficacy of the standard therapy for both clinical symptom severity and patient QOL, assessed using the validated Skindex-16 questionnaire. Atopic dermatitis patients receiving the standard therapy (n=771) were enrolled in the current phase IV, multicenter, 12-week, open-label study. The Rajka and Langeland scale (used to rate the severity of atopic dermatitis symptoms) and the Skindex-16 QOL questionnaire were completed at weeks 0 (baseline), 4 and 12. Of 415 patients completing the questionnaire at all time points (per-protocol population), 95.2% were prescribed the antihistamine fexofenadine HCl 60 mg. There were significant improvements in symptoms, emotions and functioning scale scores at weeks 4 and 12 compared with baseline (PSkindex-16, improved over the treatment period (score decreased by >or=1 and >or=2 in 75.2% and 50.9% of patients, respectively). Significant (P<0.005) improvements from baseline in global scores were also observed at weeks 4 and 12, and for week 12 compared with week 4. Severity scores improved significantly (P<0.005) from weeks 0-4 and from weeks 4-12. The standard therapy was generally well tolerated with only mild adverse events reported (0.5%). These data suggest that patients with atopic dermatitis and associated pruritus experience significant improvements in both symptom severity and QOL when receiving standard therapy. PMID:17204095

  5. Correlation between perception of quality of life and social/demographic/medical variables as well as anti-health behaviours among alcohol-dependent individuals

    OpenAIRE

    Marta Makara-Studzińska; Agnieszka J. Kowalska; Danuta Podstawka; Aneta Pyłypczuk; Zbigniew Śliwiński

    2013-01-01

    Introduction: The level of life quality of people with alcohol dependence is significantly influenced by socio-demographic factors such as: gender, marital status and having a family. Additionally promoting anti-health behaviors such as smoking or using psychoactive substances among those with alcohol dependence also reduces the quality of life in this population. Aim of the research: The purpose of this project was to determine the impact of selected psycho-social and medical factors ...

  6. Self-awareness of depression and life events in three groups of patients: Psychotic depression, obsessive–compulsive disorder and chronic medical illness in North India

    OpenAIRE

    Gupta, Anjali; Bahadur, Indu; Gupta, K.R.; Bhugra, Dinesh

    2006-01-01

    Background: Depression is a common experience across cultures although not all languages have words describing depression. Aim: To identify patients' perception and awareness of depression as an illness. Methods: Sixty psychiatric patients (each with depression or obsessive–compulsive disorder [OCD]) were compared with 30 medical patients with chronic physical illness and assessed on levels of awareness of depression in relation to life events. Results: Life events were more in patients with ...

  7. Persistent recurring wheezing in the fifth year of life after laboratory-confirmed, medically attended respiratory syncytial virus infection in infancy

    OpenAIRE

    Escobar, Gabriel J; Masaquel, Anthony S; Li, Sherian X; Walsh, Eileen M.; Kipnis, Patricia

    2013-01-01

    Background Respiratory syncytial virus (RSV) infection in infancy is associated with subsequent recurrent wheezing. Methods A retrospective cohort study examined children born at ≥32 weeks gestation between 1996–2004. All children were enrolled in an integrated health care delivery system in Northern California and were followed through the fifth year of life. The primary endpoint was recurrent wheezing in the fifth year of life and its association with laboratory-confirmed, medically-attende...

  8. Advances in the medical management of the severe cutaneous radiation syndrome

    International Nuclear Information System (INIS)

    The cutaneous radiation syndrome is a dose dependant complex pathological syndrome which follows a brief localized exposure and characterized by erythema, swelling, moist desquamation, ulceration and necrosis (25-30 Gy). Highly penetrating gamma radiation induces severe dose dependent lesions involving skin, subcutaneous tissue, muscle, vessels, nerves and occasionally, bony structures. The classical treatment of this syndrome includes the debridement of devitalized tissues, the application of bacteriostatic agents coated in non-adherent dressings, opiate-based drugs and in some cases the use of non-steroidal anti-inflammatory drugs. For ulceration and necrosis treatment, the classical surgery is ulcerectomy, necrectomy and amputation for the distal extremity injuries. For the profound et large necrosis, the lesion should be excised and the wound bed covered with a good quality, full-thickness skin graft. Unfortunately the delayed of appearance of this syndrome results often in non specialized medical treatment. Furthermore, because of the chronic evolution (months or years) the management of the cutaneous radiation syndrome has not been considered as a priority for the medical management. Recent accident like the Georgian accident demonstrated that new techniques such as artificial skin graft could change significantly patient prognosis. This technique is routinely used for thermal burn in specialized burn units. We realized the first application of this methodology in the field of radiopathology. An important factor of this technique is that in the case of recurrence of radionecrosis. Often observed, using this technique further grafting may be employed. However the success of this procedure depends on an effective control of the infection. These has sadly been illustrated in the last accident case in Peru where it was impossible to perform the artificial skin graft due to the persistence of a non-eradicated local infection. Whether this particular approach has a

  9. Experience with using second life for medical education in a family and community medicine education unit

    Directory of Open Access Journals (Sweden)

    Melús-Palazón Elena

    2012-05-01

    Full Text Available Abstract Background The application of new technologies to the education of health professionals is both a challenge and a necessity. Virtual worlds are increasingly being explored as a support for education. Aim: The aim of this work is to study the suitability of Second Life (SL as an educational tool for primary healthcare professionals. Methods Design: Qualitative study of accredited clinical sessions in SL included in a continuing professional development (CPD programme for primary healthcare professionals. Location: Zaragoza I Zone Family and Community Medicine Education Unit (EU and 9 health centres operated by the Aragonese Health Service, Aragon, Spain. Method: The EU held two training workshops in SL for 16 healthcare professionals from 9 health centres by means of two workshops, and requested them to facilitate clinical sessions in SL. Attendance was open to all personnel from the EU and the 9 health centres. After a trail period of clinical sessions held at 5 health centres between May and November 2010, the CPD-accredited clinical sessions were held at 9 health centres between February and April 2011. Participants: 76 healthcare professionals attended the CPD-accredited clinical sessions in SL. Main measurements: Questionnaire on completion of the clinical sessions. Results Response rate: 42-100%. Questionnaire completed by each health centre on completion of the CPD-accredited clinical sessions: Access to SL: 2 centres were unable to gain access. Sound problems: 0% (0/9. Image problems: 0% (0/9. Voice/text chat: used in 100% (10/9; 0 incidents. Questionnaire completed by participants in the CPD-accredited clinical sessions: Preference for SL as a tool: 100% (76/76. Strengths of this method: 74% (56/76 considered it eliminated the need to travel; 68% (52/76 believed it made more effective use of educational resources; and 47% (36/76 considered it improved accessibility. Weaknesses: 91% (69/76 experienced technical problems, while; 9

  10. Alternative Metrics for Evaluating the Resilence of Advanced Life Support Systems

    Science.gov (United States)

    Bell, Ann Maria; Dearden, Richard; Levri, Julie A.

    2002-01-01

    Ensuring the safety of the crew is a key performance requirement of a life support system. However, a number of conceptual and practical difficulties arise when devising metrics to concretely measure the ability of a life support system to maintain critical functions in the presence of anticipated and unanticipated faults. Resilience is a dynamic property of a life support system that depends on the complex interactions between faults, controls and system hardware. We review some of the approaches to understanding the robustness or resilience of complex systems being developed in diverse fields such as ecology, software engineering and cell biology and discuss their applicability to regenerative life support systems. We also consider how approaches to measuring resilience vary depending on system design choices such as the definition and choice of the nominal operating regime. Finally, we explore data collection and implementation issues such as the key differences between the instantaneous or conditional and average or overall measures of resilience. Extensive simulation of a hybrid computational model of a water revitalization subsystem (WRS) with probabilistic, component-level faults provides data about off-nominal behavior of the system. The data are used to consider alternative measures of resilience as predictors of the system's ability to recover from component-level faults.

  11. Alkali metal pool boiler life tests for a 25 kWe advanced Stirling conversion system

    Science.gov (United States)

    Anderson, W. G.; Rosenfeld, J. H.; Noble, J.

    The overall operating temperature and efficiency of solar-powered Stirling engines can be improved by adding an alkali metal pool boiler heat transport system to supply heat more uniformly to the heater head tubes. One issue with liquid metal pool boilers is unstable boiling. Stable boiling is obtained with an enhanced boiling surface containing nucleation sites that promote continuous boiling. Over longer time periods, it is possible that the boiling behavior of the system will change. An 800-h life test was conducted to verify that pool boiling with the chosen fluid/surface combination remains stable as the system ages. The apparatus uses NaK boiling on a - 100 + 140 stainless steel sintered porous layer, with the addition of a small amount of xenon. Pool boiling remained stable to the end of life test. The pool boiler life test included a total of 82 cold starts, to simulate startup each morning, and 60 warm restarts, to simulate cloud cover transients. The behavior of the cold and warm starts showed no significant changes during the life test. In the experiments, the fluid/surface combination provided stable, high-performance boiling at the operating temperature of 700 C. Based on these experiments, a pool boiler was designed for a full-scale 25-kWe Stirling system.

  12. Long-Term Effects of Maternal Medication on Global Quality of Life Measured with SEQOL. Results from the Copenhagen Perinatal Birth Cohort 1959�61

    Directory of Open Access Journals (Sweden)

    Soren Ventegodt

    2003-01-01

    Full Text Available The Copenhagen Perinatal Birth Cohort 1959�61 is a prospective longitudinal perinatal study that included all deliveries (over 20 weeks gestation, birthweight over 250 g that took place at the University Hospital (Rigshospitalet in Copenhagen, Denmark during the period of September 21, 1959 to December 21, 1961 and used in this follow-up study to investigate the connection between maternal medication during pregnancy and the quality of life of the child 31 to 33 years later. The latest follow-up study from the cohort was performed in 1993 and 7,222 of the surviving children were identified (now aged between 31 and 33 years and contacted with a nonanonymous questionnaire on several aspects of quality of life issues.There were 4,626 usable responses (f = 2,489, m = 2,131 corresponding to a response rate of 64.1%. Of the 12 groups of medication taking during pregnancy we found, before controlling (using multiple linear regression, that analgesics, chemotherapy, and psychopharmacologica showed links with the quality of life in the child 31 to 33 years later. Barbiturate use (95% was phenemal showed significant connection to quality of life. After controlling for social and pregnancy factors there was no correlation between quality of life and medication taken by the mother during pregnancy. From this study it is concluded the fetal exposure to the drugs examined showed no measurable long-term effects on quality of life.

  13. Organ function and quality of life after transoral laser microsurgery and adjuvant radiotherapy for locally advanced laryngeal cancer

    Energy Technology Data Exchange (ETDEWEB)

    Olthoff, Arno; Hess, Clemens F. [Dept. of Phoniatrics and Pedaudiology, Univ. of Goettingen (Germany); Ewen, Andreas; Wolff, Hendrik Andreas; Hermann, Robert Michael; Vorwerk, Hilke; Hille, Andrea; Christiansen, Hans [Dept. of Radiotherapy, Univ. of Goettingen (Germany); Roedel, Ralph; Steiner, Wolfgang [Dept. of Otorhinolaryngology, Univ. of Goettingen (Germany); Pradier, Olivier [Dept. of Cancerology, CHU Morvan, Brest (France)

    2009-05-15

    Background and purpose: transoral laser microsurgery (TLM) and adjuvant radiotherapy are an established therapy regimen for locally advanced laryngeal cancer at our institution. Aim of the present study was to assess value of quality of life (QoL) data with special regard to organ function under consideration of treatment efficacy in patients with locally advanced laryngeal cancer treated with larynx-preserving TLM and adjuvant radiotherapy. Patients and methods: from 1994 to 2006, 39 patients (ten UICC stage III, 29 UICC stage IVA/B) with locally advanced laryngeal carcinomas were treated with TLM and adjuvant radiotherapy. Data concerning treatment efficacy, QoL (using the VHI [Voice Handicap Index], the EORTC QLQ-C30 and QLQ-H and N35 questionnaires) and organ function (respiration, deglutition, voice quality) were obtained for ten patients still alive after long-term follow-up. Correlations were determined using the Spearman rank test. Results: after a median follow-up of 80.8 months, the 5-year overall survival rate was 46.8% and the locoregional control rate 76.5%, respectively. The larynx preservation rate was 89.7% for all patients and 100% for patients still alive after follow-up. Despite some verifiable problems in respiration, speech and swallowing, patients showed a subjectively good QoL. Conclusion: TLM and adjuvant radiotherapy is a curative option for patients with locally advanced laryngeal cancer and an alternative to radical surgery. Even if functional deficits are unavoidable in the treatment of locally advanced laryngeal carcinomas, larynx preservation is associated with a subjectively good QoL. (orig.)

  14. Effect of integrated Chinese medical treatment on the survival time of patients with advanced non-small-cell lung cancer: a clinical study

    Institute of Scientific and Technical Information of China (English)

    刘苓霜

    2014-01-01

    Objective To observe clinical effect of integrated Chinese medical(CM)treatment(as maintenance therapy)on the progression-free survival(PFS)and overall survival(OS)in patients with advanced non-small-cell lung cancer(NSCLC)after first-line chemotherapy.Methods The study was a prospective,randomized,controlled clinical trial.Totally 69 non-progressive advanced NSCLC patients treated with first-line chemotherapy were

  15. Application of NASA's Advanced Life Support Technologies for Waste Treatment, Water Purification and Recycle, and Food Production in Polar Regions

    Science.gov (United States)

    Bubenheim, David L.; Lewis, Carol E.; Covington, M. Alan (Technical Monitor)

    1995-01-01

    NASA's advanced life support technologies are being combined with Arctic science and engineering knowledge to address the unique needs of the remote communities of Alaska through the Advanced Life Systems for Extreme Environments (ALSEE) project. ALSEE is a collaborative effort involving NASA, the State of Alaska, the University of Alaska, the North Slope Borough of Alaska, and the National Science Foundation (NSF). The focus is a major issue in the state of Alaska and other areas of the Circumpolar North, the health and welfare of its people, their lives and the subsistence lifestyle in remote communities, economic opportunity, and care for the environment. The project primarily provides treatment and reduction of waste, purification and recycling of water. and production of food. A testbed is being established to demonstrate the technologies which will enable safe, healthy, and autonomous function of remote communities and to establish the base for commercial development of the resulting technology into new industries. The challenge is to implement the technological capabilities in a manner compatible with the social and economic structures of the native communities, the state, and the commercial sector. Additional information is contained in the original extended abstract.

  16. Life prediction methodology for ceramic components of advanced heat engines. Phase 1: Volume 2, Appendices

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1995-03-01

    This volume presents the following appendices: ceramic test specimen drawings and schematics, mixed-mode and biaxial stress fracture of structural ceramics for advanced vehicular heat engines (U. Utah), mode I/mode II fracture toughness and tension/torsion fracture strength of NT154 Si nitride (Brown U.), summary of strength test results and fractography, fractography photographs, derivations of statistical models, Weibull strength plots for fast fracture test specimens, and size functions.

  17. Advances in Modeling Concrete Service Life : Proceedings of 4th International RILEM PhD Workshop

    CERN Document Server

    Gulikers, Joost

    2012-01-01

    In this book, a critical analysis is made on service life models related to reinforcement corrosion. The contributors are on the frontier of knowledge in the field of durability of reinforced concrete. Topics covered in the book include: causes and mechanisms of deterioration, transport mechanisms in concrete, numerical modeling of concrete behavior, durability modeling and prediction, reliability approach to structural design for durability, structural behavior following degradation of concrete structures, deterioration and repair of concrete structures, and corrosion measurement techniques.

  18. [Advances in psychosocial interventions on quality of life of cancer survivors].

    Science.gov (United States)

    Chen, Xuefen; Wang, Jiwei; Gong, Xiaohuan; Yu, Jinming

    2015-02-01

    In recent years, there has been increasing recognition of the importance of psychosocial interventions' studies on quality of life in cancer survivors because of improving cancer survival rate. This paper was an integrative literatures review of various psychosocial interventions including cognitive behavioral therapy, group-based supportive therapy, counseling or psychotherapy, education or psychoeducation and music therapy et al, and analyzing the complexity of psychosocial interventions' RCTs in oncology and the current characteristic of these studies in China. PMID:26081409

  19. Disability in activities of daily living, depression, and quality of life among older medical ICU survivors: a prospective cohort study

    Directory of Open Access Journals (Sweden)

    Pisani Margaret A

    2011-02-01

    Full Text Available Abstract Background Accurate measurement of quality of life in older ICU survivors is difficult but critical for understanding the long-term impact of our treatments. Activities of daily living (ADLs are important components of functional status and more easily measured than quality of life (QOL. We sought to determine the cross-sectional associations between disability in ADLs and QOL as measured by version one of the Short Form 12-item Health Survey (SF-12 at both one month and one year post-ICU discharge. Methods Data was prospectively collected on 309 patients over age 60 admitted to the Yale-New Haven Hospital Medical ICU between 2002 and 2004. Among survivors an assessment of ADL's and QOL was performed at one month and one-year post-ICU discharge. The SF-12 was scored using the version one norm based scoring with 1990 population norms. Multivariable regression was used to adjust the association between ADLs and QOL for important covariates. Results Our analysis of SF-12 data from 110 patients at one month post-ICU discharge showed that depression and ADL disability were associated with decreased QOL. Our model accounted for 17% of variability in SF12 physical scores (PCS and 20% of variability in SF12 mental scores (MCS. The mean PCS of 37 was significantly lower than the population mean whereas the mean MCS score of 51 was similar to the population mean. At one year mean PCS scores improved and ADL disability was no longer significantly associated with QOL. Mortality was 17% (53 patients at ICU discharge, 26% (79 patients at hospital discharge, 33% (105 patients at one month post ICU admission, and was 45% (138 patients at one year post ICU discharge. Conclusions In our population of older ICU survivors, disability in ADLs was associated with reduced QOL as measured by the SF-12 at one month but not at one year. Although better markers of QOL in ICU survivors are needed, ADLs are a readily observable outcome. In the meantime, clinicians

  20. Impact of hypoglycemia on patients with type 2 diabetes mellitus and their quality of life, work productivity, and medication adherence

    Directory of Open Access Journals (Sweden)

    Lopez JMS

    2014-05-01

    Full Text Available Janice MS Lopez,1 Kathy Annunziata,2 Robert A Bailey,1 Marcia FT Rupnow,1 Donald E Morisky31Janssen Scientific Affairs, LLC, Raritan, NJ, 2Kantar Health, Princeton, NJ, 3University of California at Los Angeles Fielding School of Public Health, Los Angeles, CA, USABackground: The purpose of this study was to determine the characteristics of adults with type 2 diabetes mellitus (T2DM that correlate with greater risk of hypoglycemia and determine the impact of hypoglycemia on health-related quality of life, work productivity, and medication adherence from a patient perspective.Methods: Data from a large web-based survey were retrospectively analyzed. Adults with a diagnosis of T2DM taking antihyperglycemic agents were included in the analysis. Participants with knowledge of their hypoglycemic history were divided into three groups: those experiencing recent hypoglycemia (previous 3 months, those experiencing nonrecent hypoglycemia, and those never experiencing hypoglycemia.Results: Of the participants with T2DM taking antihyperglycemic agents who were knowledgeable of their hypoglycemia history, 55.7% had ever experienced hypoglycemia. Of those, 52.7% had recent hypoglycemia. Compared with those who never experienced hypoglycemia, those who experienced hypoglycemia tended to: be younger; be more aware of their glycated hemoglobin (HbA1c levels; have higher HbA1c levels; have a higher body mass index; have higher Charlson Comorbidity Index scores; be on insulin, sulfonylureas, and/or glucagon-like peptide-1 agonists; and be less adherent to their antihyperglycemic agents. Hypoglycemia interfered with social activities, caused more missed work (absenteeism, more impairment while at work (presenteeism, and decreased overall work productivity compared with patients who had never experienced hypoglycemia. Overall health-related quality of life, as determined by the Short Form-36 health questionnaire, was negatively impacted by hypoglycemia. Both

  1. Advanced maintenance strategies for power plant operators--introducing inter-plant life cycle management

    International Nuclear Information System (INIS)

    One of the most important goals of competing power plant operators is to ensure safe operation of their plants, characterized by maximum availability throughout the entire life cycle and minimized specific generating costs. One parameter crucial to the total price of electricity--and one that can be actively influenced by the power plant operators--is maintenance. Up to 30% of all electricity generating costs accrue from maintenance. In the past years maintenance measures have been optimized particularly by the application and continuing development of testing and diagnostic techniques, by the increased level of system and component automation as well as more efficient organization structures. Despite the considerable success of these efforts, the potential for further cost reductions is still far from exhausted. But the risks connected to reliability, availability and safety need to be analyzed in greater detail in order to ensure the sustainability of the savings already achieved as well as those yet to be realized. The systematic application of condition-based maintenance and the implementation of structured life cycle management are essential requirements. An inter-plant approach is recommended to make a quick implementation of maintenance optimization potentials possible. Plant-specific improvement potentials can be established with the help of a best-practice comparison, and measures and priorities can be defined for realizing them. Creating an inter-plant database will allow experience and findings to be analyzed quickly and efficiently by experts and made available to all participants on a neutral platform. Despite--or maybe owing to--the increasingly competitive marketplace, a sustained reduction in the maintenance costs of power plant operators can only be achieved through a structured, inter-plant exchange of experience. The ZES offers the industry a suitable platform for cooperation with its 'Condition-Based Maintenance' research focus. The introduction

  2. Uncertainties in Life Cycle Greenhouse Gas Emissions from Advanced Biomass Feedstock Logistics Supply Chains in Kansas

    Directory of Open Access Journals (Sweden)

    Long Nguyen

    2014-11-01

    Full Text Available To meet Energy Independence and Security Act (EISA cellulosic biofuel mandates, the United States will require an annual domestic supply of about 242 million Mg of biomass by 2022. To improve the feedstock logistics of lignocellulosic biofuels in order to access available biomass resources from areas with varying yields, commodity systems have been proposed and designed to deliver quality-controlled biomass feedstocks at preprocessing “depots”. Preprocessing depots densify and stabilize the biomass prior to long-distance transport and delivery to centralized biorefineries. The logistics of biomass commodity supply chains could introduce spatially variable environmental impacts into the biofuel life cycle due to needing to harvest, move, and preprocess biomass from multiple distances that have variable spatial density. This study examines the uncertainty in greenhouse gas (GHG emissions of corn stover logistics within a bio-ethanol supply chain in the state of Kansas, where sustainable biomass supply varies spatially. Two scenarios were evaluated each having a different number of depots of varying capacity and location within Kansas relative to a central commodity-receiving biorefinery to test GHG emissions uncertainty. The first scenario sited four preprocessing depots evenly across the state of Kansas but within the vicinity of counties having high biomass supply density. The second scenario located five depots based on the shortest depot-to-biorefinery rail distance and biomass availability. The logistics supply chain consists of corn stover harvest, collection and storage, feedstock transport from field to biomass preprocessing depot, preprocessing depot operations, and commodity transport from the biomass preprocessing depot to the biorefinery. Monte Carlo simulation was used to estimate the spatial uncertainty in the feedstock logistics gate-to-gate sequence. Within the logistics supply chain GHG emissions are most sensitive to the

  3. Milk Intake in Early Life and Risk of Advanced Prostate Cancer

    OpenAIRE

    Torfadottir, Johanna E.; Steingrimsdottir, Laufey; Mucci, Lorelei; Aspelund, Thor; Kasperzyk, Julie L.; Olafsson, Orn; Fall, Katja; Tryggvadottir, Laufey; Harris, Tamara B; Launer, Lenore; Jonsson, Eirikur; Tulinius, Hrafn; Stampfer, Meir; Adami, Hans-Olov; Gudnason, Vilmundur

    2011-01-01

    The authors investigated whether early-life residency in certain areas of Iceland marked by distinct differences in milk intake was associated with risk of prostate cancer in a population-based cohort of 8,894 men born between 1907 and 1935. Through linkage to cancer and mortality registers, the men were followed for prostate cancer diagnosis and mortality from study entry (in waves from 1967 to 1987) through 2009. In 2002–2006, a subgroup of 2,268 participants reported their milk intake in e...

  4. Health-related quality of life in nonsplenectomized immune thrombocytopenia patients receiving romiplostim or medical standard of care.

    Science.gov (United States)

    Kuter, David J; Mathias, Susan D; Rummel, Mathias; Mandanas, Romeo; Giagounidis, Aristoteles A; Wang, Xuena; Deuson, Robert R

    2012-05-01

    Immune thrombocytopenia (ITP) is an autoimmune disorder characterized by platelet destruction and insufficient platelet production. The resulting thrombocytopenia reduces patient health-related quality of life (HRQOL). In a randomized, open-label, 52-week study of non-splenectomized ITP patients treated with romiplostim or medical standard of care (SOC), patients completed the 10-scale ITP-patient assessment questionnaire (PAQ) at the start of the study and after 12, 24, 36, 48,and 52 weeks of treatment. HRQOL changes were examined for all patients in both treatment groups and by responder status, splenectomy status, and after the use of rituximab. Patients in both groups showed marked increases in all HRQOL scales over 52 weeks of treatment.These change scores exceeded the minimally important difference values (a measure of clinical relevance) for most of these scales,especially in responders to treatment. Compared with baseline,patients receiving romiplostim showed statistically significant improvements compared to SOC over 52 weeks for the ITP-PAQ scales of Symptoms, Bother, Activity, Psychological Health, Fear, Overall QOL,and Social QOL. Overall, treatment of ITP was associated with improvement in HRQOL. Patients receiving romiplostim had greater HRQOL improvements than those receiving SOC, but the magnitude ofthe difference is of uncertain clinical benefit. PMID:22460421

  5. The making of an endocrinologist in India: Life and times at Institute of Post Graduate Medical Education and Research Calcutta

    Directory of Open Access Journals (Sweden)

    Deep Dutta

    2015-01-01

    Full Text Available Endocrinology is relatively one of the newer super-specialties of internal medicine. Following higher secondary schooling, it takes anywhere between 13 and 18 years to become a super-specialist in India, which holds true for endocrinology also. This article intends to highlight the life and the journey of making an endocrinologist in India, through personal experiences, focusing on Institute of Post Graduate Medical Education and Research (IPGMER Calcutta, the largest super-specialty teaching hospital and research institute of Eastern India. In general, there is lack of adequate exposure to endocrinology during the Bachelor of Medicine, Bachelor of Surgery and MD Internal Medicine Training in India. Pre-Doctorate of Medicine (DM senior residency goes a long way in developing an orientation for endocrinology. Endocrinology DM entrance examinations are usually a rigorous intimidating affair. Endocrinology training at IPGMER was a heady mix of managing huge number of patients with diverse endocrinopathies, laboratory work, academic presentations, and clinical research. The support and back up provided by the entire faculty enhanced the learning process. As I look back, the 3 years of DM residency flew by like the wink of the eye. The journey of endocrinology is the journey of a lifetime.

  6. Life Cycle Assessment of Environmental and Economic Impacts of Advanced Vehicles

    Directory of Open Access Journals (Sweden)

    Zach C. Winfield

    2012-03-01

    Full Text Available Many advanced vehicle technologies, including electric vehicles (EVs, hybrid electric vehicles (HEVs, and fuel cell vehicles (FCVs, are gaining attention throughout the World due to their capability to improve fuel efficiencies and emissions. When evaluating the operational successes of these new fuel-efficient vehicles, it is essential to consider energy usage and greenhouse gas (GHG emissions throughout the entire lifetimes of the vehicles, which are comprised of two independent cycles: a fuel cycle and a vehicle cycle. This paper intends to contribute to the assessment of the environmental impacts from the alternative technologies throughout the lifetimes of various advanced vehicles through objective comparisons. The methodology was applied to six commercial vehicles that are available in the U.S. and that have similar dimensions and performances. We also investigated the shifts in energy consumption and emissions through the use of electricity and drivers’ behavior regarding the frequencies of battery recharging for EVs and plug-in hybrid electric vehicles (PHEVs. This study thus gives insight into the impacts of the electricity grid on the total energy cycle of a vehicle lifetime. In addition, the total ownership costs of the selected vehicles were examined, including considerations of the fluctuating gasoline prices. The cost analysis provides a resource for drivers to identify optimal choices for their driving circumstances.

  7. Life prediction methodology for ceramic components of advanced vehicular heat engines: Volume 1. Final report

    Energy Technology Data Exchange (ETDEWEB)

    Khandelwal, P.K.; Provenzano, N.J.; Schneider, W.E. [Allison Engine Co., Indianapolis, IN (United States)

    1996-02-01

    One of the major challenges involved in the use of ceramic materials is ensuring adequate strength and durability. This activity has developed methodology which can be used during the design phase to predict the structural behavior of ceramic components. The effort involved the characterization of injection molded and hot isostatic pressed (HIPed) PY-6 silicon nitride, the development of nondestructive evaluation (NDE) technology, and the development of analytical life prediction methodology. Four failure modes are addressed: fast fracture, slow crack growth, creep, and oxidation. The techniques deal with failures initiating at the surface as well as internal to the component. The life prediction methodology for fast fracture and slow crack growth have been verified using a variety of confirmatory tests. The verification tests were conducted at room and elevated temperatures up to a maximum of 1371 {degrees}C. The tests involved (1) flat circular disks subjected to bending stresses and (2) high speed rotating spin disks. Reasonable correlation was achieved for a variety of test conditions and failure mechanisms. The predictions associated with surface failures proved to be optimistic, requiring re-evaluation of the components` initial fast fracture strengths. Correlation was achieved for the spin disks which failed in fast fracture from internal flaws. Time dependent elevated temperature slow crack growth spin disk failures were also successfully predicted.

  8. Ethical Issues Surrounding End-of-Life Care: A Narrative Review.

    Science.gov (United States)

    Karnik, Sameera; Kanekar, Amar

    2016-01-01

    End-of-life care decision making carries paramount importance due to the advancements in medical sciences. Since medical science has evolved over the time and now has a potentiality to reshape the circumstances during death and in turn prolong lives, various ethical issues surround end-of-life care. The purpose of this narrative review is to discuss issues such as autonomous decision making, importance of advance directives, rationing of care in futile treatments and costs involved in providing end-of-life care. Even though much progress has been made in this area continued advancement in medical science demands further research into this topic. PMID:27417612

  9. Correlation between perception of quality of life and social/demographic/medical variables as well as anti-health behaviours among alcohol-dependent individuals

    Directory of Open Access Journals (Sweden)

    Marta Makara-Studzińska

    2013-10-01

    Full Text Available Introduction: The level of life quality of people with alcohol dependence is significantly influenced by socio-demographic factors such as: gender, marital status and having a family. Additionally promoting anti-health behaviors such as smoking or using psychoactive substances among those with alcohol dependence also reduces the quality of life in this population. Aim of the research: The purpose of this project was to determine the impact of selected psycho-social and medical factors on the quality of life in alcohol-dependent patients in relation to the duration of abstinence. Study data served to determine whether there is a correlation between the presence of selected psycho-social and medical factors and a patient’s subjective perception of his/her quality of life. Material and methods: The study involved alcohol-dependent patients undergoing treatment in the Residential Alcohol Addiction Therapy Department of the Neuropsychiatric Hospital in Lublin. In the first stage of the study, the severity of the alcohol problem was assessed with the MAST and CAGE tests and quality of life was assessed with the SF-36 questionnaire. An Original Socio-Demographic Questionnaire was also used. In the second stage of the study, the SF-36 scale was used to evaluate the quality of life. The Original Socio-Demographic Questionnaire was also used. Results : The socio-economic factors that had a statistically significant impact on the quality of life of the alcohol-dependent individuals comprised sex, marital status and having a family. Marital status was shown to be one of the most important family-related factors significantly influencing the quality of life. Having a family was not a factor associated with subjective improvement of the quality of life during abstinence for alcohol-dependent individuals. Awareness of socio-economic and medical factors influencing quality of life in individuals addicted to alcohol and gambling is an important

  10. Environmental control and life support technologies for advanced manned space missions

    Science.gov (United States)

    Powell, F. T.; Wynveen, R. A.; Lin, C.

    1986-01-01

    Regenerative environmental control and life support system (ECLSS) technologies are found by the present evaluation to have reached a degree of maturity that recommends their application to long duration manned missions. The missions for which regenerative ECLSSs are attractive in virtue of the need to avoid expendables and resupply requirements have been identified as that of the long duration LEO Space Station, long duration stays at GEO, a permanently manned lunar base (or colony), manned platforms located at the earth-moon libration points L4 or L5, a Mars mission, deep space exploration, and asteroid exploration. A comparison is made between nonregenerative and regenerative ECLSSs in the cases of 10 essential functions.

  11. Life cycle assessment of advanced bioethanol production from pulp and paper sludge.

    Science.gov (United States)

    Sebastião, Diogo; Gonçalves, Margarida S; Marques, Susana; Fonseca, César; Gírio, Francisco; Oliveira, Ana C; Matos, Cristina T

    2016-05-01

    This work evaluates the environmental performance of using pulp and paper sludge as feedstock for the production of second generation ethanol. An ethanol plant for converting 5400 tons of dry sludge/year was modelled and evaluated using a cradle-to-gate life cycle assessment approach. The sludge is a burden for pulp and paper mills that is mainly disposed in landfilling. The studied system allows for the valorisation of the waste, which due to its high polysaccharide content is a valuable feedstock for bioethanol production. Eleven impact categories were analysed and the results showed that enzymatic hydrolysis and neutralisation of the CaCO3 are the environmental hotspots of the system contributing up to 85% to the overall impacts. Two optimisation scenarios were evaluated: (1) using a reduced HCl amount in the neutralisation stage and (2) co-fermentation of xylose and glucose, for maximal ethanol yield. Both scenarios displayed significant environmental impact improvements. PMID:26926202

  12. Human Engineering Operations and Habitability Assessment: A Process for Advanced Life Support Ground Facility Testbeds

    Science.gov (United States)

    Connolly, Janis H.; Arch, M.; Elfezouaty, Eileen Schultz; Novak, Jennifer Blume; Bond, Robert L. (Technical Monitor)

    1999-01-01

    Design and Human Engineering (HE) processes strive to ensure that the human-machine interface is designed for optimal performance throughout the system life cycle. Each component can be tested and assessed independently to assure optimal performance, but it is not until full integration that the system and the inherent interactions between the system components can be assessed as a whole. HE processes (which are defining/app lying requirements for human interaction with missions/systems) are included in space flight activities, but also need to be included in ground activities and specifically, ground facility testbeds such as Bio-Plex. A unique aspect of the Bio-Plex Facility is the integral issue of Habitability which includes qualities of the environment that allow humans to work and live. HE is a process by which Habitability and system performance can be assessed.

  13. Intelligent Human Machine Interface Design for Advanced Product Life Cycle Management Systems

    CERN Document Server

    Ahmed, Zeeshan

    2010-01-01

    Designing and implementing an intelligent and user friendly human machine interface for any kind of software or hardware oriented application is always be a challenging task for the designers and developers because it is very difficult to understand the psychology of the user, nature of the work and best suit of the environment. This research paper is basically about to propose an intelligent, flexible and user friendly machine interface for Product Life Cycle Management products or PDM Systems since studies show that usability and human computer interaction issues are a major cause of acceptance problems introducing or using such systems. Going into details of the proposition, we present prototype implementations about theme based on design requirements, designed designs and technologies involved for the development of human machine interface.

  14. Bioregenerative technologies for waste processing and resource recovery in advanced space life support system

    Science.gov (United States)

    Chamberland, Dennis

    1991-01-01

    The Controlled Ecological Life Support System (CELSS) for producing oxygen, water, and food in space will require an interactive facility to process and return wastes as resources to the system. This paper examines the bioregenerative techologies for waste processing and resource recovery considered for a CELSS Resource Recovery system. The components of this system consist of a series of biological reactors to treat the liquid and solid material fractions, in which the aerobic and anaerobic reactors are combined in a block called the Combined Reactor Equipment (CORE) block. The CORE block accepts the human wastes, kitchen wastes, inedible refractory plant materials, grey waters from the CELLS system, and aquaculture solids and processes these materials in either aerobic or anaerobic reactors depending on the desired product and the rates required by the integrated system.

  15. Spacesuit Water Membrane Evaporator; An Enhanced Evaporative Cooling Systems for the Advanced Extravehicular Mobility Unit Portable Life Support System

    Science.gov (United States)

    Bue, Grant C.; Makinen, Janice V.; Miller, Sean.; Campbell, Colin; Lynch, Bill; Vogel, Matt; Craft, Jesse; Petty, Brian

    2014-01-01

    Spacesuit Water Membrane Evaporator - Baseline heat rejection technology for the Portable Life Support System of the Advanced EMU center dot Replaces sublimator in the current EMU center dot Contamination insensitive center dot Can work with Lithium Chloride Absorber Radiator in Spacesuit Evaporator Absorber Radiator (SEAR) to reject heat and reuse evaporated water The Spacesuit Water Membrane Evaporator (SWME) is being developed to replace the sublimator for future generation spacesuits. Water in LCVG absorbs body heat while circulating center dot Warm water pumped through SWME center dot SWME evaporates water vapor, while maintaining liquid water - Cools water center dot Cooled water is then recirculated through LCVG. center dot LCVG water lost due to evaporation (cooling) is replaced from feedwater The Independent TCV Manifold reduces design complexity and manufacturing difficulty of the SWME End Cap. center dot The offset motor for the new BPV reduces the volume profile of the SWME by laying the motor flat on the End Cap alongside the TCV.

  16. Global faculty development: lessons learned from the Foundation for Advancement of International Medical Education and Research (FAIMER) initiatives.

    Science.gov (United States)

    Burdick, William P

    2014-08-01

    Foundation for Advancement of International Medical Education and Research (FAIMER) faculty development programs have operated since 2001 and are designed to overcome many of the challenges inherent in global health collaborations, including alignment with local needs, avoiding persistent dependency, and development of trust. FAIMER fellowship programs, developed for midcareer faculty members in all health professions from around the world, share goals of strengthening knowledge and skills in education leadership, education methods, and project management and evaluation. Building community is another explicit goal that allows participants to support and learn from each other.The author recommends several practices for successful international collaborations based on 13 years of experience with FAIMER fellowships. These include using authentic education projects to maintain alignment with local needs and apply newly acquired knowledge and skills, teaching leadership across cultures with careful communication and adaptation of concepts to local environments, cultivating a strong field of health professions education to promote diffusion of ideas and advocate for policy change, intentionally promoting field development and leadership to reduce dependency, giving generously of time and resources, learning from others as much as teaching others, and recognizing that effective partnerships revolve around personal relationships to build trust. These strategies have enabled the FAIMER fellowship programs to stay aligned with local needs, reduce dependency, and maintain trust. PMID:24918762

  17. Social workers' roles in addressing the complex end-of-life care needs of elders with advanced chronic disease.

    Science.gov (United States)

    Kramer, Betty J

    2013-01-01

    This study examined social workers' roles in caring for low-income elders with advanced chronic disease in an innovative, community-based managed care program, from the perspective of elders, family, team members, and social workers. The results are drawn from a larger longitudinal, multimethod case study. Sources of data include survey reports of needs addressed by social workers for 120 deceased elders, five focus groups with interdisciplinary team members, and in-depth interviews with 14 elders and 10 of their family caregivers. A thematic conceptual matrix was developed to detail 32 distinctive social work roles that address divergent needs of elders, family, and team members. Distinctive perceptions of social workers' roles were identified for the different stakeholder groups (i.e., elders, family caregivers, team members, and social workers). Findings from this study may inform supervisors and educators regarding training needs of those preparing to enter the rapidly growing workforce of gerontological social workers who may be called upon to care for elders at the end of life. Training is particularly warranted to help social workers gain the skills needed to more successfully treat symptom management, depression, anxiety, agitation, grief, funeral planning, and spiritual needs that are common to the end of life. PMID:24295099

  18. Symptom burden and quality of life in advanced head and neck cancer patients: AIIMS study of 100 patients

    Directory of Open Access Journals (Sweden)

    Ajeet Kumar Gandhi

    2014-01-01

    Full Text Available Aim: Head and neck cancers (HNCa are the most common cancers among males in India and 70-80% present in advanced stage. The study aims to assess symptom burden and quality of life (QOL in advanced incurable HNCa patients at presentation. Materials and Methods: One hundred patients were asked to fill EORTC QLQ-C15-PAL questionnaire, which consisted of Global QOL, physical functioning (PF, emotional functioning (EF, fatigue (FA, nausea-vomiting (NV, pain (PA, dyspnea (DY, sleep (SL, appetite (AP, and constipation (CO. Additional questions pertaining to swallowing (SW, hoarseness (HO, cough (CG, weight loss (WL, using pain killers (PK, taste (TA, bleeding (BL, hearing (HE, pain in neck lump (PALMP, opening mouth (OM, and oral secretions (OS were asked based on a modified EORTC-HN35 questionnaire. Scoring was according to EORTC scoring manual. Mean, median and range were calculated for each item for the entire cohort. Results: The female:male ratio was 17:83.42% of them were ≥60 years of age. Sixty-six patients had T4, 25 had T3, 36 had N2, and 33 had N3 disease. Median QOL was 50 (range 0-83.33 and PF was 77.78 (0-100. Median score for EF and FA was 50. Median score for PA, PK, and SL was 66.67 while that for AP was 33.33. Median value for SW, HO, WL, BL, PALMP, OM, and OS was 33.33 (100-0 while TA, CG, NV, DY, and HE had a median score of 0.00. Conclusion: Advanced HNCa has a significant burden of symptoms. These results would help in giving patients better symptom directed therapies and improve their QOL.

  19. Is it safe? Talking to teens with HIV/AIDS about death and dying: a 3-month evaluation of Family Centered Advance Care (FACE planning – anxiety, depression, quality of life

    Directory of Open Access Journals (Sweden)

    Maureen E Lyon

    2010-02-01

    Full Text Available Maureen E Lyon1, Patricia A Garvie2, Linda Briggs3, Jianping He4, Robert Malow5, Lawrence J D’Angelo1, Robert McCarter41Children’s National Medical Center and George Washington School of Medicine and Health Sciences, Washington, District of Columbia; 2St Jude Children’s Research Hospital, Memphis, Tennessee; 3Gundersen Lutheran Medical Foundation, Inc., Madison, Wisconsin; 4Children’s Research Institute, Washington, District of Columbia; 5Florida International University, Miami, FloridaPurpose: To determine the safety of engaging HIV-positive (HIV+ adolescents in a Family Centered Advance Care (FACE planning intervention.Patients and methods: We conducted a 2-armed, randomized controlled clinical trial in 2 hospital-based outpatient clinics from 2006–2008 with HIV+ adolescents and their surrogates (n = 76. Three 60–90 minutes sessions were conducted weekly. FACE intervention groups received: Lyon FCACP Survey©, the Respecting Choices® interview, and completion of The Five Wishes©. The Healthy Living Control (HLC received: Developmental History, Healthy Tips, Future Planning (vocational, school or vocational rehabilitation. Three-month post-intervention outcomes were: completion of advance directive (Five Wishes©; psychological adjustment (Beck Depression, Anxiety Inventories; quality of life (PedsQL™; and HIV symptoms (General Health Self-Assessment.Results: Adolescents had a mean age, 16 years; 40% male; 92% African-American; 68% with perinatally acquired HIV, 29% had AIDS diagnosis. FACE participants completed advance directives more than controls, using time matched comparison (P < 0.001. Neither anxiety, nor depression, increased at clinically or statistically significant levels post-intervention. FACE adolescents maintained quality of life. FACE families perceived their adolescents as worsening in their school (P = 0.018 and emotional (P = 0.029 quality of life at 3 months, compared with controls.Conclusions: Participating

  20. Life Stress and the Long-Term Treatment Course of Recurrent Depression: III. Nonsevere Life Events Predict Recurrence for Medicated Patients over 3 Years

    Science.gov (United States)

    Monroe, Scott M.; Torres, Leandro D.; Guillaumot, Julien; Harkness, Kate L.; Roberts, John E.; Frank, Ellen; Kupfer, David

    2006-01-01

    Research has consistently documented the significance of severe life events for onset of major depression. Theory, however, suggests other forms of stress are relevant for depression's recurrence. Nonsevere life events were tested in relation to depression for 126 patients with recurrent depression in a 3-year randomized maintenance protocol. Life…

  1. Ototoxic Medications (Medication Effects)

    Science.gov (United States)

    ... effects of the medications on your hearing and balance systems. The team will discuss with you how these side effects will affect your quality of life. What are the effects I may notice from ... speech is affected. Balance problems can also occur as a result of ...

  2. Advanced anaerobic bioconversion of lignocellulosic waste for the melissa life support system

    Science.gov (United States)

    Lissens, G.; Verstraete, W.; Albrecht, T.; Brunner, G.; Creuly, C.; Dussap, G.; Kube, J.; Maerkl, H.; Lasseur, C.

    The feasibility of nearly-complete conversion of lignocellulosic waste (70% food crops, 20% faecal matter and 10% green algae) into biogas was investigated in the context of the MELiSSA loop (Micro-Ecological Life Support System Alternative). The treatment comprised a series of processes, i.e. a mesophilic laboratory scale CSTR (continuously stirred tank reactor), an upflow biofilm reactor, a fiber liquefaction reactor employing the rumen bacterium Fibrobacter succinogenes and a hydrothermolysis system in near-critical water. By the one-stage CSTR, a biogas yield of 75% with a specific biogas production of 0.37 l biogas g-1 VSS (volatile suspended solids) added at a RT (hydraulic retention time) of 20-25 d was obtained. Biogas yields could not be increased considerably at higher RT, indicating the depletion of readily available substrate after 25 d. The solids present in the CSTR-effluent were subsequently treated in two ways. Hydrothermal treatment (T ˜ 310-350C, p ˜ 240 bar) resulted in effective carbon liquefaction (50-60% without and 83% with carbon dioxide saturation) and complete sanitation of the residue. Application of the cellulolytic Fibrobacter succinogenes converted remaining cellulose contained in the CSTR-effluent into acetate and propionate mainly. Subsequent anaerobic digestion of the hydrothermolysis and the Fibrobacter hydrolysates allowed conversion of 48-60% and 30%, respectively. Thus, the total process yielded biogas corresponding with conversions up to 90% of the original organic matter. It appears that particularly mesophilic digestion in conjunction with hydrothermolysis offers interesting features for (nearly) the MELiSSA system. The described additional technologies show that complete and hygienic carbon and energy recovery from human waste within MELiSSA is technically feasible, provided that the extra energy needed for the thermal treatment is guaranteed.

  3. The Giant Snail Achatina fulica as a Candidate Species for Advanced Bioregenerative Life Support Systems

    Science.gov (United States)

    Verbitskaya, Olga; Manukovsky, Nickolay; Kovalev, Vladimir

    Maintenance of crew health is of paramount importance for long duration space missions. Weight loss, bone and calcium loss, increased exposure to radiation and oxidative stress are critical concerns that need to be alleviated. Rational nutrition is a resource for mitigating the influence of unfavorable conditions. The insufficiency of vegetarian diet has been examined by the Japanese, Chinese and U.S. developers of bioregenerative life support systems (BLSS). Hence, inclusion of animals such as silkworm in BLSS looks justified. The giant snail is currently under studying as a source of animal food and a species of reducing waste in BLSS. An experimental system to conduct cultivation of giant snail was developed. It was established that there are some reasons to use the giant snails in BLSS. It could be a source of delicious meat. A. fulica is capable of consuming a wide range of feedstuffs including plant residues. Cultivation of snail in the limited volume does not demand the big expenditures of labor. The production of crude edible biomass and protein of A. fulica was 60±15 g and 7±1.8 g respectively per 1 kg of consumed forage (fresh salad leaves, root and leafy tops of carrot). To satisfy daily animal protein needs (30-35 g) a crewman has to consume 260-300 g of snail meat. To produce such amount of snail protein it takes to use 4.3-5.0 kg of plant forage daily. The nutritional composition of A. fulica whole bodies (without shell) and a meal prepared in various ways was quantitatively determined. Protein, carbohydrate, fat acid and ash content percentages were different among samples prepared in various ways. The protein content was highest (68 %) in the dry sample washed with CH3 COOH solution. Taking into consideration the experimental results a conceptual configuration of BLSS with inclusion of giant snail was developed and mass flow rates between compartments were calculated. Keywords: animal food; protein; giant snail; BLSS; conceptual configuration.

  4. Self-reported health-related quality of life is an independent predictor of chemotherapy treatment benefit and toxicity in women with advanced breast cancer

    OpenAIRE

    Lee, C. K.; Stockler, M R; Coates, A. S.; Gebski, V.; Lord, S J; Simes, R J

    2010-01-01

    Background: Baseline health-related quality of life (QL) is associated with survival in advanced breast cancer. We sought to identify patients who were less likely to respond to chemotherapy and at greater risk of toxicity on the basis of their QL. Methods: We used data from three advanced breast cancer trials in which patients (n=378) were treated with cyclophosphamide, methotrexate and 5-fluouracil. Patients self-rated their QL using LASA scales for physical well-being (PWB), mood, pain, na...

  5. They know! - do they? A qualitative study of residents and relatives views on advance care planning, end-of-life care, and decision-making in nursing homes.

    OpenAIRE

    Bollig, Georg; Gjengedal, Eva; Rosland, Jan Henrik

    2015-01-01

    Background: Residents living in long-term care facilities are a vulnerable population. For many residents, a nursing home is their place of death. Palliative care and end-of-life decisions are important components of their care provision. Aim: To study the views of cognitively able residents and relatives on advance care planning, end-of-life care, and decision-making in nursing homes. Design: A qualitative study with in-depth interviews with nursing home residents and focus group inter...

  6. Advancing Innovation Through Collaboration: Implementation of the NASA Space Life Sciences Strategy

    Science.gov (United States)

    Davis, Jeffrey R.; Richard, Elizabeth E.

    2010-01-01

    On October 18, 2010, the NASA Human Health and Performance center (NHHPC) was opened to enable collaboration among government, academic and industry members. Membership rapidly grew to 90 members (http://nhhpc.nasa.gov ) and members began identifying collaborative projects as detailed in this article. In addition, a first workshop in open collaboration and innovation was conducted on January 19, 2011 by the NHHPC resulting in additional challenges and projects for further development. This first workshop was a result of the SLSD successes in running open innovation challenges over the past two years. In 2008, the NASA Johnson Space Center, Space Life Sciences Directorate (SLSD) began pilot projects in open innovation (crowd sourcing) to determine if these new internet-based platforms could indeed find solutions to difficult technical problems. From 2008 to 2010, the SLSD issued 34 challenges, 14 externally and 20 internally. The 14 external challenges were conducted through three different vendors: InnoCentive, Yet2.com and TopCoder. The 20 internal challenges were conducted using the InnoCentive platform, customized to NASA use, and promoted as NASA@Work. The results from the 34 challenges involved not only technical solutions that were reported previously at the 61st IAC, but also the formation of new collaborative relationships. For example, the TopCoder pilot was expanded by the NASA Space Operations Mission Directorate to the NASA Tournament Lab in collaboration with Harvard Business School and TopCoder. Building on these initial successes, the NHHPC workshop in January of 2011, and ongoing NHHPC member discussions, several important collaborations have been developed: (1) Space Act Agreement between NASA and GE for collaborative projects (2) NASA and academia for a Visual Impairment / Intracranial Hypertension summit (February 2011) (3) NASA and the DoD through the Defense Venture Catalyst Initiative (DeVenCI) for a technical needs workshop (June 2011) (4

  7. Satisfaction, adherence and health-related quality of life with transdermal buprenorphine compared with oral opioid medications in the usual care of osteoarthritis pain

    OpenAIRE

    Conaghan, Philip G; Serpell, Michael; McSkimming, Paula; Junor, Rod; Dickerson, Sara

    2016-01-01

    Background: Osteoarthritis (OA) causes substantial pain and reduced health-related quality of life (HRQL). Although opioid analgesics are commonly used, the relative benefits of different opioids are poorly studied. Transdermal buprenorphine (TDB) offers an alternative to oral opioids for the treatment of moderate-to-severe chronic pain. This observational study of people with OA pain assessed satisfaction, HRQL and medication adherence. Methods: Patients in the UK with self-repor...

  8. Satisfaction, adherence and health-related quality of life with transdermal buprenorphine compared with oral opioid medications in the usual care of osteoarthritis pain

    OpenAIRE

    Conaghan, Philip G.; Serpell, Michael; McSkimming, Paula; Junor, Rod; Dickerson, Sara

    2016-01-01

    Background Osteoarthritis (OA) causes substantial pain and reduced health-related quality of life (HRQL). Although opioid analgesics are commonly used, the relative benefits of different opioids are poorly studied. Transdermal buprenorphine (TDB) offers an alternative to oral opioids for the treatment of moderate-to-severe chronic pain. This observational study of people with OA pain assessed satisfaction, HRQL and medication adherence. Methods Patients in the UK with self-reported knee and/o...

  9. Is there an association between immunosuppressant therapy medication adherence and depression, quality of life, and personality traits in the kidney and liver transplant population?

    OpenAIRE

    Gorevski E; Succop P; Sachdeva J; Cavanaugh TM; Volek P; Heaton P; Chisholm-Burns M; Martin-Boone JE

    2013-01-01

    Elizabeth Gorevski,1 Paul Succop,1 Jyoti Sachdeva,1 Teresa M Cavanaugh,1 Paul Volek,1 Pamela Heaton,1 Marie Chisholm-Burns,2 Jill E Martin-Boone1 1University of Cincinnati, Cincinnati, OH, USA, 2University of Tennessee College of Pharmacy, Memphis, TN, USA Objectives: To measure the association of transplant patients' personality, depression, and quality of life with medication adherence in kidney and liver transplant recipients. Methods: A cross-sectional study of liver and kidney t...

  10. Advance directives in action in a regional palliative care service: "road testing" the provisions of the Medical Treatment Act 1988 (VIC).

    Science.gov (United States)

    Brown, Margaret; Fisher, John W; Brumley, David J; Ashby, Michael A; Milliken, Jan

    2005-11-01

    In order to explore the usefulness and acceptability of the provisions of the Medical Treatment Act 1988 (Vic) for palliative care patients in a rural region in Victoria, Australia, between July and December 2004 patients were given information explaining the Act and the opportunity to discuss it with the research officer. Grounded theory methodology was used to evaluate client responses. Findings suggested that palliative care patients are willing to engage in advance care planning but they have to be well enough and need skilled, practical, face-to-face assistance to complete the required legal forms. Written materials alone are not adequate, but provide the opportunity for medical staff to have conversations about death and dying. Doctors and nurses should understand the provisions of the Act to assist patients and families. It is recommended that advance care planning, appropriate to the jurisdiction, be an integral part of the palliative care assessment process. PMID:16304759

  11. Quality of life and life circumstances in German myasthenia gravis patients

    OpenAIRE

    Pöhlau Dieter; Klewer Jörg; Wiesmeth Susanne; Twork Sabine; Kugler Joachim

    2010-01-01

    Abstract Background Myasthenia gravis (MG) is a chronic neuromuscular disease. Advances in medical therapy have continuously increased the life expectancy of MG patients, without definitively curing the disease. To analyze life circumstances and quality of life (QoL), a large German MG cohort was investigated. Methods and Sample In cooperation with the German Myasthenia Association, 2,150 patients with confirmed MG were asked to respond to a mailed questionnaire. The standardized questions re...

  12. Management practices for end-of-life cathode ray tube glass: Review of advances in recycling and best available technologies.

    Science.gov (United States)

    Iniaghe, Paschal O; Adie, Gilbert U

    2015-11-01

    Cathode ray tubes are image display units found in computer monitors and televisions. In recent years, cathode ray tubes have been generated as waste owing to the introduction of newer and advanced technologies in image displays, such as liquid crystal displays and high definition televisions, among others. Generation and subsequent disposal of end-of-life cathode ray tubes presents a challenge owing to increasing volumes and high lead content embedded in the funnel and neck sections of the glass. Disposal in landfills and open dumping are anti-environmental practices considering the large-scale contamination of environmental media by the potential of toxic metals leaching from glass. Mitigating such environmental contamination will require sound management strategies that are environmentally friendly and economically feasible. This review covers existing and emerging management practices for end-of-life cathode ray tubes. An in-depth analysis of available technologies (glass smelting, detoxification of cathode ray tube glass, lead extraction from cathode ray tube glass) revealed that most of the techniques are environmentally friendly, but are largely confined to either laboratory scale, or are often limited owing to high cost to mount, or generate secondary pollutants, while a closed-looped method is antiquated. However, recycling in cementitious systems (cement mortar and concrete) gives an added advantage in terms of quantity of recyclable cathode ray tube glass at a given time, with minimal environmental and economic implications. With significant quantity of waste cathode ray tube glass being generated globally, cementitious systems could be economically and environmentally acceptable as a sound management practice for cathode ray tube glass, where other technologies may not be applicable. PMID:26463115

  13. Impact of advanced cardiac life support training program on the outcome of cardiopulmonary resuscitation in a tertiary care hospital

    Directory of Open Access Journals (Sweden)

    Kanwalpreet Sodhi

    2011-01-01

    Full Text Available Background: Guidelines on performing cardiopulmonary resuscitation (CPR have been published from time to time, and formal training programs are conducted based on these guidelines. Very few data are available in world literature highlighting the impact of these trainings on CPR outcome. Aim: The aim of our study was to evaluate the impact of the American Heart Association (AHA-certified basic life support (BLS and advanced cardiac life support (ACLS provider course on the outcomes of CPR in our hospital. Materials and Methods : An AHA-certified BLS and ACLS provider training programme was conducted in our hospital in the first week of October 2009, in which all doctors in the code blue team and intensive care units were given training. The retrospective study was performed over an 18-month period. All in-hospital adult cardiac arrest victims in the pre-BLS/ACLS training period (January 2009 to September 2009 and the post-BLS/ACLS training period (October 2009 to June 2010 were included in the study. We compared the outcomes of CPR between these two study periods. Results: There were a total of 627 in-hospital cardiac arrests, 284 during the pre-BLS/ACLS training period and 343 during the post-BLS/ACLS training period. In the pre-BLS/ACLS training period, 52 patients (18.3% had return of spontaneous circulation, compared with 97 patients (28.3% in the post-BLS/ACLS training period (P < 0.005. Survival to hospital discharge was also significantly higher in the post-BLS/ACLS training period (67 patients, 69.1% than in the pre-BLS/ACLS training period (12 patients, 23.1% (P < 0.0001. Conclusion : Formal certified BLS and ACLS training of healthcare professionals leads to definitive improvement in the outcome of CPR.

  14. THE RELATIONSHIP OF MEDICAL AND SOCIAL PREDICTORS OF DISADAPTATION AND INDICATORS OF THE QUALITY OF LIFE AMONG FORMER ATHLETES DEPENDING ON THE LEVEL OF PHYSICAL ACTIVITY

    Directory of Open Access Journals (Sweden)

    Irina Victorovna Fedotova

    2015-12-01

    Full Text Available Negative aspects of post-professional adaptation and indicators of quality of life among former athletes with various level of physical activity are analysed in the work. We conducted a survey of 456 former athletes of high qualification categories of cyclic and acyclic sports. A special author’s questionnaire to study the basic medical and social factors of disadaptive disorders among former athletes was used. According to the results of the survey we formed two groups depending on the level of physical activity. Quality of life was studied using a questionnaire MOS SF-36. There were significant correlations between predictors of medical and social disadaptation and the level of quality of life, depending on the mode of the physical activity among former athletes. Timely evaluation of the social dimension of disadaptation and level of quality of life allows you to create a system of medico-social monitoring and to provide a successful adaptation to the completion of the sports career. The necessity of maintaining a high level of athletes’ physical activity at an early post-sport period with a gradual decrease in stress after the cessation of intensive training and competitive activity is established.

  15. The impact of quality assurance in medical radiology in raising the quality of life and the role of medical physicist in this process

    International Nuclear Information System (INIS)

    The goal on establishing quality assurance programmes in diagnostic radiology at the European level is to provide explanations on regulations, which had been developed by International Organizations on the level of the existing knowledge on the use of ionizing radiation for medical diagnosis. Since it is well known that diagnostic radiological users often produce poor quality images and are applying to patients unnecessary high radiation exposure the criteria for performance characteristics related to good imaging quality and patient exposure had been established. The correct application of the principles of quality assurance and quality control in relation to patient exposure needs to be standardised on a general European level, since radiographs should be generally comparable. The implementation of quality assurance programmes and quality control methods could lead to more accurate diagnosis and better informed decisions regarding treatment. The role and responsibility of medical physicists in the process of image production, radiation exposure and quality assurance in diagnostic radiology is now implemented in this Directive. The tasks of the medical physicist in this process had been identified and explained. (author)

  16. Quality of life assessment with different radiotherapy schedules in palliative management of advanced carcinoma esophagus: A prospective randomized study

    Directory of Open Access Journals (Sweden)

    Shaveta Mehta

    2008-01-01

    Full Text Available Aim: To investigate the quality of life (QOL of patients with advanced carcinoma esophagus treated with different palliative radiation schedules. Methods: Sixty-two consecutive patients with inoperable, non-metastatic carcinoma of the esophagus were randomly allocated to Arm-A (external radiotherapy 30 Gy/10 fractions + brachytherapy 12 Gy/two sessions, Arm-B (external radiotherapy 30 Gy /10 fractions and Arm-C (external radiotherapy 20Gy /five fractions. The QOL was assessed using the European Organization for Research and Treatment of Cancer questionnaire at presentation, after treatment and at 3 months follow-up. Results: The mean QOL score improved, in arm-A from 38 to 52 after treatment and 56 at 3 months, in arm-B from 30 to 44 after treatment and 55 at 3 months and in arm-C from 24 to 40 after treatment but decreased to 37 at 3 months. Improvement in dysphagia scores at the first follow-up was 46.1% in arm-A, 25.0% in arm-B and 22.6% in arm-C. The difference was maintained at 3 months, with maximum improvement in arm-A (57.6%. No significant differences were found between the three arms with regard to complications and additional procedures needed for relief of dysphagia. Conclusion: In comparison with external radiotherapy alone, external radiotherapy with intraluminal brachytherapy has shown a trend toward better QOL and consistent dysphagia relief without significant difference in adverse effects.

  17. A census of fishes and everything they eat: How the census of marine life advanced fisheries science

    Science.gov (United States)

    O'Dor, Ron; Boustany, Andre M.; Chittenden, Cedar M.; Costello, Mark J.; Moustahfid, Hassan; Payne, John; Steinke, Dirk; Stokesbury, Michael J. W.; Vanden Berghe, Edward

    2012-01-01

    The Census of Marine Life was a 10-year, international research effort to explore poorly known ocean habitats and conduct large-scale experimentation with new technology. The goal of Census 2010 in its mission statement was to describe what did live in the oceans, what does live in the oceans, and what will live in the ocean. Many of the findings and techniques from census research may prove valuable in making a transition, which many governments have publicly endorsed, from single-species fisheries management to more holistic ecosystem management. Census researchers sampled continental margins, mid-Atlantic ridges, ocean floor vents and seeps, and abyssal plains and polar seas and organized massive amounts of past and new information in a public online database called the Ocean Biogeographic Information System (www.iobis.org). The census described and categorized seamount biology worldwide for its vulnerability to fishing, advanced large-scale animal tracking with acoustic arrays and satellite archival tags, and accelerated species identification, including nearshore, coral reef, and zooplankton sampling using genetic barcoding and pyrotag sequencing for microbes and helped to launch the exciting new field of marine environmental history. Above all, the census showed the value of investing in large-scale, collaborative projects and sharing results publicly.

  18. Ethical Issues Surrounding End-of-Life Care: A Narrative Review

    OpenAIRE

    Sameera Karnik; Amar Kanekar

    2016-01-01

    End-of-life care decision making carries paramount importance due to the advancements in medical sciences. Since medical science has evolved over the time and now has a potentiality to reshape the circumstances during death and in turn prolong lives, various ethical issues surround end-of-life care. The purpose of this narrative review is to discuss issues such as autonomous decision making, importance of advance directives, rationing of care in futile treatments and costs involved in providi...

  19. Paul Scherrer Institut annual report 1995. Annex II: PSI life sciences and institute for medical radiobiology newsletter 1995

    International Nuclear Information System (INIS)

    The newsletter presents the 1995 progress report of PSI F2-Department and of the Institute for Medical Radiobiology in the fields of radiation medicine, radiopharmacy and radiation hygiene. figs., tabs., refs

  20. Paul Scherrer Institut annual report 1995. Annex II: PSI life sciences and institute for medical radiobiology newsletter 1995

    Energy Technology Data Exchange (ETDEWEB)

    Blaeuenstein, P.; Gschwend, B. [eds.

    1996-09-01

    The newsletter presents the 1995 progress report of PSI F2-Department and of the Institute for Medical Radiobiology in the fields of radiation medicine, radiopharmacy and radiation hygiene. figs., tabs., refs.

  1. Paul Scherrer Institut annual report 1996. Annex II: PSI life sciences and Institute for Medical Radiobiology Newsletter 1996

    International Nuclear Information System (INIS)

    This annex to the PSI Annual Report 1996 reports on the progress achieved by the PSI Department II during 1996 in the fields of radiation medicine, radiopharmacy, radiation hygiene, positron emission tomography and medical radiobiology. figs., tab., refs

  2. Advancing the Integration of Population Medicine into Medical Curricula at The Warren Alpert Medical School of Brown University: A New Master's Degree Program.

    Science.gov (United States)

    Mello, Michael J; Feller, Edward; George, Paul; Borkan, Jeffrey

    2015-09-01

    Additional knowledge, attitudes and skills are required for the next generation of medical students as they expand the traditional focus on individual patients to include population-based health and scholarly investigation. The Warren Alpert Medical School of Brown University (AMS) is initiating a master's degree program as a key component of the new Primary Care-Population Medicine program at AMS leading to both a Doctorate in Medicine (MD) and Master of Science in Population Medicine (ScM) degrees in four years. The ScM is composed of a series of nine courses, integrated into the four-year MD curriculum, as well as a thesis. Additional attention will be given to leadership and quality improvement training. The goal is to produce graduates competent in the care of individual patients, panels, communities, and populations. PMID:26324971

  3. Proceedings of DAE-BRNS life sciences symposium 2011 on advances in molecular and cell biology of stress response

    International Nuclear Information System (INIS)

    This series of symposia in life sciences was initiated for the purpose of facilitating strong interactions among the national research fraternity working in the areas of bio-medical and agricultural sciences of relevance and interest for the Department of Atomic Energy, Government of India. Dedicated research efforts in the Bhabha Atomic Research Centre and other DAE institutions for nearly four decades have not only resulted in the development of technologies and products to improve the quality of human life, but have made impactful contributions in several contemporary areas in basic biological sciences. It is natural that keep visiting certain themes more than once. Biology of stress response is one such theme. The first symposium in the series was devoted to this field. And six years is long enough a time for catching up with the new developments. Stress to a system at equilibrium induces homeostatic mechanisms that ameliorate the stress. Entire living world, from microbes to man, have evolved such response mechanisms. Often a given battery of responsive genes may take care of more than one stresses and there may also be some redundancy in signalling or effector pathways to a response. Oxidative stress in one of the most common stresses that most living systems have to endure. Such a stress could be induced by a wide variety of insults including ionizing radiation, visible light, antibiotics, xenobiotics, metal ions, environmental pollutants, carcinogens, infectious agents etc. It may contribute to some inflammatory and autoimmune diseases. It also plays an important role in killing of intracellular pathogens. In recent years mechanistic details of body's antioxidant defences are being increasingly revealed. Even more interesting are the new findings that suggest that prooxidants may induce an adaptive response to help cells survive against death induced by higher levels of reactive oxygen species (ROS). The role of prosurvival transcription factors like NRF-2

  4. The social life of the dead: The role of post-mortem examinations in medical student socialisation.

    Science.gov (United States)

    Goodwin, Dawn; Machin, Laura; Taylor, Adam

    2016-07-01

    Dissection has held a privileged position in medical education although the professional values it inculcates have been subject to intense debate. Claims vary from it generating a dehumanising level of emotional detachment, to promotion of rational and dispassionate decision-making, even to being a positive vehicle for ethical education. Social scientists have positioned dissection as a critical experience in the emotional socialisation of medical students. However, curricular revision has provoked debate about the style and quantity of anatomy teaching thus threatening this 'rite of passage' of medical students. Consequently, some UK medical schools do not employ dissection at all. In its place, observation of post-mortem examinations - a long established, if underutilised, practice - has re-emerged in an attempt to recoup aspects of anatomical knowledge that are arguably lost when dissection is omitted. Bodies for post-mortem examinations and bodies for dissection, however, have striking differences, meaning that post-mortem examinations and dissection cannot be considered comparable opportunities to learn anatomy. In this article, we explore the distinctions between dissection and post-mortem examinations. In particular, we focus on the absence of a discourse of consent, concerns about bodily integrity, how the body's shifting ontology, between object and person, disrupts students' attempts to distance themselves, and how the observation of post-mortem examinations features in the emotional socialisation of medical students. PMID:27261534

  5. Health-promoting lifestyle and quality of life among undergraduate students at school of health, Isfahan university of medical sciences

    OpenAIRE

    Tol, Azar; Tavassoli, Elaheh; Shariferad, Gholam Reza; Shojaeezadeh, Davoud

    2013-01-01

    Background: Health promoting lifestyle (HPL) focuses on life promotion through lifestyle which consists of six aspects of “physical activity”, “nutrition”, “health responsibility”, “spiritual growth”, “interpersonal relations” and “stress management”. This lifestyle promotes health and welfare and induces satisfaction, self-persuasion and self-improvement. Considering the importance of the way a new behavior affects “life quality” as a motivational factor for starting and continuing that beha...

  6. Quality of Life, Stress, and Mental Health in Parents of Children with Parentally Diagnosed Food Allergy Compared to Medically Diagnosed and Healthy Controls

    Directory of Open Access Journals (Sweden)

    Gurkiran Birdi

    2016-01-01

    Full Text Available Background. Food allergy is related to poorer quality of life (QoL and mental health of caregivers. Many parents diagnose food allergy in their child without seeking medical care and there is limited research on this group. This study investigated parental QoL and mental health in parents of children with parent-diagnosed food allergy (PA, medically diagnosed food allergy (MA, and a control group with no allergy (NA. Methods. One hundred and fifty parents from a general population completed validated measures of QoL, anxiety, depression, and stress. Results. Parents of children with food allergy (PA or MA reported higher stress, anxiety, and depression than the control group (all p<0.05. Parents of children with MA reported poorer food allergy related QoL compared to parents of children with PA (p<0.05; parents of children with PA reported poorer general QoL compared to parents of children with MA (p<0.05. Conclusion. Parents of children with food allergy have significantly poorer mental health compared to healthy controls, irrespective of whether food allergy is medically diagnosed or not. It is important to encourage parents to have their child medically tested for food allergy and to recognise and refer for psychological support where needed.

  7. Decay in chest compression quality due to fatigue is rare during prolonged advanced life support in a manikin model

    Directory of Open Access Journals (Sweden)

    Bjørshol Conrad A

    2011-08-01

    Full Text Available Abstract Background The aim of this study was to measure chest compression decay during simulated advanced life support (ALS in a cardiac arrest manikin model. Methods 19 paramedic teams, each consisting of three paramedics, performed ALS for 12 minutes with the same paramedic providing all chest compressions. The patient was a resuscitation manikin found in ventricular fibrillation (VF. The first shock terminated the VF and the patient remained in pulseless electrical activity (PEA throughout the scenario. Average chest compression depth and rate was measured each minute for 12 minutes and divided into three groups based on chest compression quality; good (compression depth ≥ 40 mm, compression rate 100-120/minute for each minute of CPR, bad (initial compression depth 120/minute or decay (change from good to bad during the 12 minutes. Changes in no-flow ratio (NFR, defined as the time without chest compressions divided by the total time of the ALS scenario over time was also measured. Results Based on compression depth, 5 (26%, 9 (47% and 5 (26% were good, bad and with decay, respectively. Only one paramedic experienced decay within the first two minutes. Based on compression rate, 6 (32%, 6 (32% and 7 (37% were good, bad and with decay, respectively. NFR was 22% in both the 1-3 and 4-6 minute periods, respectively, but decreased to 14% in the 7-9 minute period (P = 0.002 and to 10% in the 10-12 minute period (P Conclusions In this simulated cardiac arrest manikin study, only half of the providers achieved guideline recommended compression depth during prolonged ALS. Large inter-individual differences in chest compression quality were already present from the initiation of CPR. Chest compression decay and thereby fatigue within the first two minutes was rare.

  8. Spacesuit Water Membrane Evaporator; An Enhanced Evaporative Cooling System for the Advanced Extravehicular Mobility Unit Portable Life Support System

    Science.gov (United States)

    Bue, Grant C.; Makinen, Janice V.; Miller, Sean; Campbell, Colin; Lynch, Bill; Vogel, Matt; Craft, Jesse; Wilkes, Robert; Kuehnel, Eric

    2014-01-01

    Development of the Advanced Extravehicular Mobility Unit (AEMU) portable life support subsystem (PLSS) is currently under way at NASA Johnson Space Center. The AEMU PLSS features a new evaporative cooling system, the Generation 4 Spacesuit Water Membrane Evaporator (Gen4 SWME). The SWME offers several advantages when compared with prior crewmember cooling technologies, including the ability to reject heat at increased atmospheric pressures, reduced loop infrastructure, and higher tolerance to fouling. Like its predecessors, Gen4 SWME provides nominal crew member and electronics cooling by flowing water through porous hollow fibers. Water vapor escapes through the hollow fiber pores, thereby cooling the liquid water that remains inside of the fibers. This cooled water is then recirculated to remove heat from the crew member and PLSS electronics. Test results from the backup cooling system which is based on a similar design and the subject of a companion paper, suggested that further volume reductions could be achieved through fiber density optimization. Testing was performed with four fiber bundle configurations ranging from 35,850 fibers to 41,180 fibers. The optimal configuration reduced the Gen4 SWME envelope volume by 15% from that of Gen3 while dramatically increasing the performance margin of the system. A rectangular block design was chosen over the Gen3 cylindrical design, for packaging configurations within the AEMU PLSS envelope. Several important innovations were made in the redesign of the backpressure valve which is used to control evaporation. A twin-port pivot concept was selected from among three low profile valve designs for superior robustness, control and packaging. The backpressure valve motor, the thermal control valve, delta pressure sensors and temperature sensors were incorporated into the manifold endcaps, also for packaging considerations. Flight-like materials including a titanium housing were used for all components. Performance testing

  9. Effectiveness of beneficial plant-microbe interactions under hypobaric and hypoxic conditions in an advanced life support system

    Science.gov (United States)

    MacIntyre, Olathe; Stasiak, Michael; Cottenie, Karl; Trevors, Jack; Dixon, Mike

    An assembled microbial community in the hydroponics solution of an advanced life support system may improve plant performance and productivity in three ways: (1) exclusion of plant pathogens from the initial community, (2) resistance to infection, and (3) plant-growth promotion. However, the plant production area is likely to have a hypobaric (low pressure) and hypoxic (low oxygen) atmosphere to reduce structural mass and atmosphere leakage, and these conditions may alter plant-microbe interactions. Plant performance and productivity of radish (Raphanus sativus L. cv. Cherry Bomb II) grown under hypobaric and hypoxic conditions were investigated at the University of Guelph's Controlled Environment Systems Research Facility. Changes in the microbial communities that routinely colonized the re-circulated nutrient solution, roots, and leaves of radishes in these experiments were quantified in terms of similarity in community composition, abundance of bacteria, and community diversity before and after exposure to hypobaric and hypoxic conditions relative to communities maintained at ambient growth conditions. The microbial succession was affected by extreme hypoxia (2 kPa oxygen partial pressure) while hypobaria as low as 10 kPa total pressure had little effect on microbial ecology. There were no correlations found between the physiological profile of these unintentional microbial communities and radish growth. The effects of hypobaric and hypoxic conditions on specific plant-microbe interactions need to be determined before beneficial gnotobiotic communities can be developed for use in space. The bacterial strains Tal 629 of Bradyrhizobium japonicum and WCS417 of Pseudomonas fluorescens, and the plant pathogen Fusarium oxysporum f. sp. raphani will be used in future experiments. B. japonicum Tal 629 promotes radish growth in hydroponics systems and P. fluorescens WCS417 induces systemic resistance to fusarium wilt (F. oxysporum f. sp. raphani) in radish under ambient

  10. Isotope-based medical research in the post genome era: Gene-orchestrated life functions in medicine seen and affected by isotopes. Workshop report

    International Nuclear Information System (INIS)

    The US Department of Energy (DOE) and the National Institutes of Health (NIH) conducted a workshop on Isotope-Based Medical Research in the Post Genome Era at NIH, Bethesda, Maryland, November 12--14, 1997. The workshop aimed at identifying the role of stable and radioisotopes for advanced diagnosis and therapy of a wide range of illnesses using the new information that comes from the human genome program. In this sense, the agenda addressed the challenge of functional genomics in humans. The workshop addressed: functional genomics in clinical medicine; new diagnostic potentials; new therapy potentials; challenge to tracer- and effector-pharmaceutical chemistry; and project plans for joint ventures

  11. Isotope-based medical research in the post genome era: Gene-orchestrated life functions in medicine seen and affected by isotopes. Workshop report

    Energy Technology Data Exchange (ETDEWEB)

    Feinendegen, L.E.

    1997-12-31

    The US Department of Energy (DOE) and the National Institutes of Health (NIH) conducted a workshop on Isotope-Based Medical Research in the Post Genome Era at NIH, Bethesda, Maryland, November 12--14, 1997. The workshop aimed at identifying the role of stable and radioisotopes for advanced diagnosis and therapy of a wide range of illnesses using the new information that comes from the human genome program. In this sense, the agenda addressed the challenge of functional genomics in humans. The workshop addressed: functional genomics in clinical medicine; new diagnostic potentials; new therapy potentials; challenge to tracer- and effector-pharmaceutical chemistry; and project plans for joint ventures.

  12. Quality of life as predictor of survival: A prospective study on patients treated with combined surgery and radiotherapy for advanced oral and oropharyngeal cancer

    International Nuclear Information System (INIS)

    Background and purpose: The relation between health-related quality of life (HRQOL) and survival was investigated at baseline and 6 months in 80 patients with advanced oral or oropharyngeal cancer after microvascular reconstructive surgery and (almost all) adjuvant radiotherapy. Materials and methods: Multivariate Cox regression analyses of overall and disease-specific survival were performed including sociodemographic (age, gender, marital status, comorbidity), and clinical (tumor stage and site, radical surgical, metastasis, radiotherapy) parameters, and HRQOL (EORTC QLQ-C30 global quality of life scale). Results: Before treatment, younger age and having a partner were predictors of disease-specific survival; younger age predicted overall survival. At 6 months post-treatment, disease-specific and overall survival was predicted by (deterioration of) global quality of life solely. Global health-related quality of life after treatment was mainly influenced by emotional functioning. Conclusion: Deterioration of global quality of life after treatment is an independent predictor of survival in patients with advanced oral or oropharyngeal cancer.

  13. 人生回顾对晚期癌症患者生存质量的影响%Effect of a life review program on the quality of life among patients with advanced cancer at home

    Institute of Scientific and Technical Information of China (English)

    肖惠敏; 邝惠容; 彭美慈; 莫孙淑冰

    2012-01-01

    目的 探讨人生回顾对晚期癌症患者生存质量的影响.方法 选择晚期癌症患者80例,随机分成两组,试验组接受人生回顾干预,对照组接受常规照顾.在干预前后分别测量两组的生存质量,通过半结构访谈收集其对人生回顾的感受.结果 干预后两组在整体生存质量、支持、负面情绪、疏离感、存在困扰及生活价值等方面比较,差异均有统计学意义(P<0.05).参与者对人生回顾干预的感受包括:接受独特的人生、情绪上的解脱、获得生命意义感、留下个人精神遗产.结论 人生回顾是促进晚期癌症患者心理、精神健康的有效措施.%Objective To evaluate the effect of a life review program on the quality of life among patients with advanced cancer at home. Method Eighty patients with advanced cancer at home were randomly divided into two groups. The 40 patients in the experimental group received a life review program,while the 40 patients in the control group received routine home care. The patients' were investigated with the scale of Quality of Life(QOL) for cancer patients before and after intervention. Their perceptions of the life review program were collected through individual semi-structured interviews after intervention. Results The patients in the experimental group demonstrated a significant improvement in overall QOL,support and value of life,and a significant reduction in negative emotions, sense of alienation, and existential distress. The four categories identified in the qualitative analysis were:accepting one's unique life,feelings of emotional relief,bolstering a sense of meaning in life,and leaving a personal legacy. Conclusion The life review program is an effective intervention to improve the psycho-spiritual well of patients with advanced cancer.

  14. How to Evaluate Health-Related Quality of Life and Its Association with Medication Adherence in Pulmonary Tuberculosis – Designing a Prospective Observational Study in South Africa

    Science.gov (United States)

    Kastien-Hilka, Tanja; Rosenkranz, Bernd; Bennett, Bryan; Sinanovic, Edina; Schwenkglenks, Matthias

    2016-01-01

    Introduction: Health-related quality of life (HRQOL) has become an important measure to identify and shape effective and patient-relevant healthcare interventions innovations through outcomes. Adherence to tuberculosis (TB) treatment is a public health concern. The main objective of this research is to develop a study design for evaluation of HRQOL and its association with medication adherence in TB in South Africa. Methodology: A conceptual framework for HRQOL in TB has been developed to identify Patient-Reported Outcomes and Quality of Life Database (PROQOLID), (n.d.) measures for HRQOL and adherence and to generate an endpoint model. Two generic (SF-12 and EQ-5D-5L), one disease-specific (St. George’s Respiratory Questionnaire) and one condition-specific (Hospital Anxiety and Depression Scale) measure for HRQOL and Morisky Medication Adherence Scale for adherence assessment were identified. All measures are applied in a longitudinal multi-center study at five data collection time points during standard TB treatment. Statistical analysis includes multivariable analysis. Change over time in the physical component score of SF-12 is defined as primary endpoint. Sample size estimation based thereupon has led to a recruitment target of 96 patients. This study is on-going. Discussion: This is the first longitudinal study in South Africa which evaluates HRQOL and its association with medication adherence in TB in a comprehensive manner. Results will help to improve current treatment programs and medication adherence and will support the identification of sustainable health innovations in TB, determining the value of new products, and supporting decision making with regard to health policy and pricing. PMID:27303294

  15. Oxygen in human health from life to death – An approach to teaching redox biology and signaling to graduate and medical students

    Directory of Open Access Journals (Sweden)

    Margaret M. Briehl

    2015-08-01

    Full Text Available In the absence of oxygen human life is measured in minutes. In the presence of oxygen, normal metabolism generates reactive species (ROS that have the potential to cause cell injury contributing to human aging and disease. Between these extremes, organisms have developed means for sensing oxygen and ROS and regulating their cellular processes in response. Redox signaling contributes to the control of cell proliferation and death. Aberrant redox signaling underlies many human diseases. The attributes acquired by altered redox homeostasis in cancer cells illustrate this particularly well. This teaching review and the accompanying illustrations provide an introduction to redox biology and signaling aimed at instructors of graduate and medical students.

  16. Should a patient with a life threatening illness be informed of the diagnosis? A survey of physicians and medical students in Calicut

    Directory of Open Access Journals (Sweden)

    Purakkal Divya

    2004-01-01

    Full Text Available AIM: To ascertain how doctors and under graduate medical students in a teaching hospital felt about revealing and knowing the diagnosis of a life threatening illness. MATERIALS AND METHODS: 850 respondents (200 pre clinical students, 300 clinical students, 100 interns, 150 postgraduate registrars and 100 faculty were interviewed with the help of a set questionnaire. RESULTS: 70% of pre clinical students, 85% of clinical students and 89% of doctors stated that the diagnosis should be revealed. Women preclinical students, (60%, were significantly less in favour of the diagnosis being revealed than other groups. 81% of pre - clinical students, 89% of clinical students, 94% of postgraduates and 95% of faculty would want to know the diagnosis if they themselves were to develop a life threatening illness.

  17. A qualidade de vida de jovens portadores de espinha bífida do Children's National Medical Center – Washington DC The quality of life of adolescents with spina bifida at the Children's National Medical Center – Washington DC

    Directory of Open Access Journals (Sweden)

    Ana Helena Rotta Soares

    2006-09-01

    Full Text Available O presente artigo tem como objetivo explorar a qualidade de vida de jovens portadores de espinha bífida atendidos no Children's National Medical Center em Washington DC. A pesquisa baseia-se em uma perspectiva qualitativa que utiliza como referencial teórico central a "Teoria do estigma" e as discussões conceituais sobre as dimensões de qualidade de vida. Foram entrevistados 15 jovens do serviço acima citado, sendo que 8 deles participaram de um grupo focal construído através das questões levantadas durante entrevistas. Os discursos dos jovens em questão refletem a necessidade de categorias mais englobantes que não remetam a uma pulverização da experiência de vida. Evidenciou-se uma estrutura de desigualdade nas interações entre saudáveis e deficientes, e reproduzida pelos próprios jovens. Os resultados demonstram que o estigma se encontra presente em todas as dimensões da vida dos sujeitos, interferindo na inserção social, construção subjetiva do jovem e sua auto-estima, reforçando o papel do portador de deficiência como uma "não-pessoa". Embora a categoria sexualidade não seja priorizada em outros instrumentos para esta população, o tema se faz presente e central na discussão da experiência da vida dos mesmos.The present article explores the quality of life of adolescents with spina bifida at the Children's National Medical Center in Washington DC. The research is based on a qualitative perspective that utilizes the "Theory of stigma" as the central theoretical framework, in addition to the discussions of the concept of quality of life and its dimensions. Fifteen adolescents were interviewed at the above institution, eight of which then participated in a focal group structured through issues that emerged during this previous phase. The discourses reflected the need for more encompassing categories for quality of life that do not pulverize the life experience. The adolescent's discourses demonstrate an inequality

  18. Medical Ethics

    Science.gov (United States)

    ... have an ethical aspect. For example, there are ethical issues relating to End of life care: Should a patient receive nutrition? What about advance directives and resuscitation orders? Abortion: When does life begin? Is it ethical to terminate a pregnancy with a birth defect? ...

  19. Medication beliefs among patients with inflammatory bowel disease who report low quality of life: a qualitative study

    Directory of Open Access Journals (Sweden)

    Hungin APS

    2007-06-01

    Full Text Available Abstract Background Non-adherence to drug therapy is common in Inflammatory Bowel Disease (IBD. Patients' beliefs about treatment have an important influence on adherence. An in-depth understanding of this area is, therefore, important for patient-centred care. The aim of the study was to assess patients' perspectives and beliefs about their medication and to determine how this relates to medicine taking and other related health behaviour as part of a larger qualitative study on health care related behaviour in patients with IBD. Methods Individual semi-structured interviews and focus groups. An iterative approach following principles of grounded theory was applied to data collection and analysis. Results Main emerging themes were: balance of perceived necessity versus concerns, perceived impact of symptoms and willingness to self-manage medication. There was a clear distinction made between steroids and other preparations. Concerns included the fear of both short and long-term side-effects (mainly steroids, uncertainties about drug interactions and development of long-term immunity. Adapting to and accepting medication use was linked to acceptance of IBD. Conclusion A concordant approach including flexible and pro-active support as well as accurate information is important in assisting patients with IBD to self-manage their medication effectively. Health professionals should be aware that attitudes to medicine taking and other related behaviours may be medicine specific and change over time.

  20. Final Report for The University of Texas at Arlington Optical Medical Imaging Section of Advanced Imaging Research Center

    Energy Technology Data Exchange (ETDEWEB)

    Khosrow Behbehani

    2013-02-26

    The goal of this project was to create state-of-the-art optical medical imaging laboratories for the Biomedical Engineering faculty and student researchers of the University of Texas at Arlington (UTA) on the campus of the University of Texas Southwestern Medical Center (UTSW). This has been successfully achieved. These laboratories provide an unprecedented opportunity for the bioengineers (from UTA) to bring about new breakthroughs in medical imaging using optics. Specifically, three major laboratories have been successfully established and state-of-the-art scientific instruments have been placed in the labs. As a result of this grant, numerous journal and conference publications have been generated, patents for new inventions have been filed and received, and many additional grants for the continuation of the research has been received.

  1. Love and the Value of Life in Health Care: A Narrative Medicine Case Study in Medical Education

    OpenAIRE

    Pentiado, Jorge Alberto Martins; de Almeida, Helcia Oliveira; Amorim, Fábio Ferreira; Facioli, Adriano Machado; Trindade, Eliana Mendonça Vilar; de Almeida, Karlo Jozefo Quadros

    2016-01-01

    This case study is an example of narrative medicine applied to promote self-awareness and develop humanistic contents in medical education. The impact and the human appeal of the narrative lie in the maturity and empathy shown by a student when reporting his dramatic experience during the care given to a newborn (with Patau syndrome and multiple malformations diagnosed at birth) and to her mother. The narrative approach helped the student to be successful in bringing out the meaning behind th...

  2. Medication beliefs among patients with inflammatory bowel disease who report low quality of life: a qualitative study

    OpenAIRE

    Hungin APS; Rubin Gregory P; Hall Nicola J; Dougall Audrey

    2007-01-01

    Abstract Background Non-adherence to drug therapy is common in Inflammatory Bowel Disease (IBD). Patients' beliefs about treatment have an important influence on adherence. An in-depth understanding of this area is, therefore, important for patient-centred care. The aim of the study was to assess patients' perspectives and beliefs about their medication and to determine how this relates to medicine taking and other related health behaviour as part of a larger qualitative study on health care ...

  3. Effects of live music therapy sessions on quality of life indicators, medications administered and hospital length of stay for patients undergoing elective surgical procedures for brain.

    Science.gov (United States)

    Walworth, Darcy; Rumana, Christopher S; Nguyen, Judy; Jarred, Jennifer

    2008-01-01

    The physiological and psychological stress that brain tumor patients undergo during the entire surgical experience can considerably affect several aspects of their hospitalization. The purpose of this study was to examine the effects of live music therapy on quality of life indicators, amount of medications administered and length of stay for persons receiving elective surgical procedures of the brain. Subjects (N = 27) were patients admitted for some type of surgical procedure of the brain. Subjects were randomly assigned to either the control group receiving no music intervention (n = 13) or the experimental group receiving pre and postoperative live music therapy sessions (n = 14). Anxiety, mood, pain, perception of hospitalization or procedure, relaxation, and stress were measured using a self-report Visual Analog Scale (VAS) for each of the variables. The documented administration of postoperative pain medications; the frequency, dosage, type, and how it was given was also compared between groups. Experimental subjects live and interactive music therapy sessions, including a pre-operative session and continuing with daily sessions until the patient was discharged home. Control subjects received routine hospital care without any music therapy intervention. Differences in experimental pretest and posttest scores were analyzed using a Wilcoxon Matched-Pairs Signed-Rank test. Results indicated statistically significant differences for 4 of the 6 quality of life measures: anxiety (p = .03), perception of hospitalization (p = .03), relaxation (p = .001), and stress (p = .001). No statistically significant differences were found for mood (p > .05) or pain (p > .05) levels. Administration amounts of nausea and pain medications were compared with a Two-Way ANOVA with One Repeated Measure resulting in no significant differences between groups and medications, F(1, 51) = 0.03; p > .05. Results indicate no significant differences between groups for length of stay (t = .97

  4. 医学生生命质量影响因素分析%On the Influencing Factors on Quality of Life in Medical Students

    Institute of Scientific and Technical Information of China (English)

    韩爱侠; 王锋; 吴秋云; 朱元业; 杨广平

    2012-01-01

    Objective: To investigate the influencing factors of quality of life (QOL) in medical students, and to provide basis for their activities on life education. Methods: By investigation through random cluster sam piing in the medical students, the World Health Organization Quality of Life-100 and influencing factors question naire survey. Then we analyzed the results through the multiple stepwise regression analysis method. Results: The multiple stepwise regression analysis indicated that the following things, such as gender, grade, Jiving expenses, major interest, leadership in student union or social association, reward or commendation, physical exercise, were significant influential factors of QOL among the medical students. Conclusion: The influencing factors of QOL in medical students are comparatively integrated, so effective measures should be taken to improve the QOL of these students.%目的了解医学生生命质量影响因素,为开展有针对性的生命教育活动提供依据。方法采用分层随机整群抽样方法,用世界卫生组织生存质量测定量表中文版及自行设计的影响因素调查表对医学生进行调查、采用多元逐步回归方法对调查结果进行分析。结果多元逐步回归分析结果显示,影响医学生生命质量的因素为性别、年级、生活费、专业兴趣、担任学生干部或参加社团、获过奖励或表彰、体育锻炼。结论医学生生命质量影响因素较为综合,应采取有效措施改善其生命质量。

  5. Assessment of quality of life in patients with advanced non-small cell lung carcinoma treated with a combination of carboplatin and paclitaxel

    Directory of Open Access Journals (Sweden)

    Camila Uanne Resende Avelino

    2015-04-01

    Full Text Available OBJECTIVE: Non-small cell lung carcinoma (NSCLC is the most common type of lung cancer. Most patients are diagnosed at an advanced stage, palliative chemotherapy therefore being the only treatment option. This study was aimed at evaluating the health-related quality of life (HRQoL of advanced-stage NSCLC patients receiving palliative chemotherapy with carboplatin and paclitaxel. METHODS: This was a multiple case study of advanced-stage NSCLC outpatients receiving chemotherapy at a public hospital in Rio de Janeiro, Brazil. The European Organization for Research and Treatment of Cancer Core Quality of Life Questionnaire was used in conjunction with its supplemental lung cancer-specific module in order to assess HRQoL. RESULTS: Physical and cognitive functioning scale scores differed significantly among chemotherapy cycles, indicating improved and worsened HRQoL, respectively. The differences regarding the scores for pain, loss of appetite, chest pain, and arm/shoulder pain indicated improved HRQoL. CONCLUSIONS: Chemotherapy was found to improve certain aspects of HRQoL in patients with advanced-stage NSCLC.

  6. Quality of life and management project for patients with advanced lung cancer%晚期肺癌生活质量与治疗方案选择

    Institute of Scientific and Technical Information of China (English)

    2002-01-01

    Compared with best supportive care,chemotherapy can prolong survival and improve quality of life,and symptoms associated with society activities and disease.Chemotherapy can improve quality of life of patients with effective treatment and stable treatment. Treatment benefit was often underestimated using clinical relief rate,so which should not chosen as index for evaluating effect of palliative treatment. So for patients with poor status ,and objective of relieving symptoms,short term,low dose chemotherapy should be suggested due to its characteristic of low cost,short inhospitalization time,and favorable improvement of quality of life. For patients with good condition in limited advanced stage,radical treatment is objective,and hence single chemotherapy of standard dose or chemotherapy combining radiotherapy should be suggested.

  7. Saúde e qualidade de vida de médicos residentes Health and quality of life of medical residents

    Directory of Open Access Journals (Sweden)

    Luciano Garcia Lourenção

    2010-01-01

    Full Text Available OBJETIVO: Discutir sobre saúde e qualidade de vida de médicos residentes. MÉTODOS: Estudo de revisão bibliográfica no qual se realizou a análise de conteúdo do assunto enfocado. A fonte de busca foi a Biblioteca Virtual em Saúde (BVS, por meio da BIREME (Centro Latino-Americano e do Caribe de Informação em Ciências da Saúde, nas Bases Eletrônicas Medline (Medical Literature Analysis and Retrietal System On-Line, Lilacs (Literatura Latino-Americana e do Caribe em Ciências da Saúde, SciELO (Scientific Eletronic Library On Line e pelo endereço eletrônico scholar.google.com.br. Os descritores utilizados foram: qualidade de vida, estresse, internato e residência. Realizou-se o ordenamento e a análise da bibliografia científica, de modo a avaliar e discutir aspectos apresentados nos estudos com relação à temática, considerando a distribuição das publicações segundo país de origem, o período de publicação, a fonte e o título, o foco de estudo e as principais conclusões. RESULTADOS: As publicações analisadas abordam aspectos importantes como incidências elevadas de Burnout, estresse, depressão, fadiga e sono entre os residentes; dificuldade de enfrentamento; relação entre carga horária de trabalho e qualidade de vida; necessidade de melhorias na legislação da residência médica para melhorar as condições de trabalho e aprendizado. CONCLUSÃO: A implementação de programas de assistência aos residentes produz melhorias na qualidade da capacitação profissional e na qualidade de vida pessoal, melhorando o relacionamento com os pacientes. Apesar de estressante, a residência médica é uma experiência enriquecedora, que propicia o desenvolvimento profissional e pessoal dos jovens médicos.OBJECTIVE: This article highlights the relationship between health and quality of life among the resident medical staff. METHODS: A review was carried out to analyze the content of the relationship under study. Sources for

  8. Can the Tools of Activity Theory Help Us in Advancing Understanding and Organisational Change in Undergraduate Medical Education?

    Science.gov (United States)

    Reid, Anne-Marie; Ledger, Alison; Kilminster, Sue; Fuller, Richard

    2015-01-01

    Continued changes to healthcare delivery in the UK, and an increasing focus on patient safety and quality improvement, require a radical rethink on how we enable graduates to begin work in challenging, complex environments. Professional regulatory bodies now require undergraduate medical schools to implement an "assistantship" period in…

  9. Development and pilot evaluation of user acceptance of advanced mass-gathering emergency medical services PDA support systems.

    Science.gov (United States)

    Chang, Polun; Hsu, Yueh-Shuang; Tzeng, Yuann-Mei; Hou, I-Ching; Sang, Yiing-Yiing

    2004-01-01

    The support systems for the Emergency Medical Services (EMS) in the mass gatherings, such as the local marathon or the large international baseball games, had been underdeveloped. The purposes for this study were to develop triage-based EMS Personal Digital Assistant (PDA) support systems for the mass-gatherings and to evaluate users' perceived ease of use and usefulness of the systems in terms of Davis' Technology Acceptance Model (TAM). The systems were developed based on an established intelligent triage PDA support system and two other forms-the general EMS form from the Taipei EMT and the customer-made Mass Gathering Medical form used by a medical center. 23 nurses and 6 physicians in the medical center, who had ever served in the mass gatherings, were invited to examine the new systems and answered the TAM questionnaire. The results showed that the PDA systems included as many 450 information items inside 42 screens under 6 categories and the great potential of using triage-based PDA systems in the mass gatherings. Overall, most of the subjects agreed with that the systems were easy to use and useful for the mass gatherings, and they were willing to accept the systems. PMID:15361049

  10. Is there an association between immunosuppressant therapy medication adherence and depression, quality of life, and personality traits in the kidney and liver transplant population?

    Directory of Open Access Journals (Sweden)

    Gorevski E

    2013-04-01

    Full Text Available Elizabeth Gorevski,1 Paul Succop,1 Jyoti Sachdeva,1 Teresa M Cavanaugh,1 Paul Volek,1 Pamela Heaton,1 Marie Chisholm-Burns,2 Jill E Martin-Boone1 1University of Cincinnati, Cincinnati, OH, USA, 2University of Tennessee College of Pharmacy, Memphis, TN, USA Objectives: To measure the association of transplant patients' personality, depression, and quality of life with medication adherence in kidney and liver transplant recipients. Methods: A cross-sectional study of liver and kidney transplant recipients greater than 1 year post-transplant was conducted. Patients’ adherence with medications was assessed using the Immunosuppressive Therapy Adherence Scale. Personality and depression were assessed using the NEO Five-Factor Inventory Scale and Patient Health Questionnaire 9, respectively. Quality of life was assessed using the Short Form-36, and functional status was determined using the Karnofsky Performance Status Scale. Results: A total of 86 kidney and 50 liver transplant patients completed the surveys. Logistic regression analysis demonstrated an association between depression and adherence with immunosuppressive medications in kidney transplant recipients. Kidney transplant patients who exhibited “low openness” scores were 91% more likely to be nonadherent. Kidney transplant patients’ physical functional status was strongly associated with nonadherence, and for each point increase in functionality the patients adherence increased by 4%. In the liver sample, age was associated with adherence. For every year increase in age, adherence increased by 7%. Conclusion: The presence of low openness as a personality trait, poor physical functional status, and depression were associated with adherence in the kidney transplant population. In the liver transplant population, younger age was associated with nonadherence. Keywords: adherence, transplant, liver, kidney

  11. Effect of music intervention on quality of life in advanced cancer patients during chemotherapy%音乐干预对晚期肿瘤患者化疗期间生活质量的影响

    Institute of Scientific and Technical Information of China (English)

    李春梅; 谭华凤; 刘艳华

    2011-01-01

    Objective To explore the effect of music therapy on reducing chemotherapy toxicity, improving the quality of life of the patients with advanced cancer patients during chemotherapy.Methods According to psychological law characteristics of patients, we design a music system, including: morning nursing "A" song, analgesia "B", dine "C" song, sleep "D" song. 100 advanced cancer patients from the affiliated hospital of guangdong medical college, between June 2009 and June 2010, were enrolled in this study. They were randomly divided into two groups according to numerical table. The control group (50 patients) received routine nursing, while the experimental group (50 patients) received music therapy intervention during each chemotherapy process or break. The effects were evaluated from two aspects: the side effects of chemotherapy and the changes of blood-routine after chemotherapy.Results The experimental group feel cheerfulness, tranquil at every time after chemotherapy and the degree of adverse reaction is light, than the control group, and there were significant differences between them (P.05), and the SANS scores were significantly different between the two groups(P.05);治疗后两组SANS评分比较差异有统计学意义(P<0.05).结论 在患者化疗期间实施音乐干预可减轻化疗副作用,稳定患者血象,减轻患者心理恐惧,直接提高患者生存质量.

  12. Medical evaluations on the KC-135 1991 flight report summary

    Science.gov (United States)

    Lloyd, Charles W.

    1993-01-01

    The medical investigations completed on the KC-135 during FY 1991 in support of the development of the Health Maintenance Facility and Medical Operations are presented. The experiments consisted of medical and engineering evaluations of medical hardware and procedures and were conducted by medical and engineering personnel. The hardware evaluated included prototypes of a crew medical restraint system and advanced life support pack, a shuttle orbiter medical system, an airway medical accessory kit, a supplementary extended duration orbiter medical kit, and a surgical overhead canopy. The evaluations will be used to design flight hardware and identify hardware-specific training requirements. The following procedures were evaluated: transport of an ill or injured crewmember at man-tended capability, surgical technique in microgravity, transfer of liquids in microgravity, advanced cardiac life support using man-tended capability Health Maintenance Facility hardware, medical transport using a model of the assured crew return vehicle, and evaluation of delivery mechanisms for aerosolized medications in microgravity. The results of these evaluation flights allow for a better understanding of the types of procedures that can be performed in a microgravity environment.

  13. Impact of childlessness on life and attitudes towards continuation of medically assisted reproduction and/or adoption

    DEFF Research Database (Denmark)

    Petersen, Gitte Lindved; Blenstrup, Lene Tølbøll; Peterson, Brennan D.;

    2015-01-01

    Infertility and fertility treatment have the potential to impact and disrupt a couple’s overall life. In order to study the associations between the impact of childlessness on one’s life, and men and women’s attitudes towards fertility treatment continuation and/or adoption, we analysed data from a...... one-year follow-up questionnaire in a prospective, longitudinal cohort study of consecutive couples initiating fertility treatment in Denmark. The study comprised 302 couples with no children at baseline and no joint children at one-year follow-up. In total, 71.9% of women and 72.5% of men reported...... that they wished to continue fertility treatment, while 20.2% of women and 19.2% of men reported that they wished to pursue adoption. The attitudes of nearly 8 in 10 couples were congruent towards further fertility treatments, while nearly 7 in 10 couples were congruent in their attitudes to pursuing...

  14. Recent advances on tea polyphenols

    OpenAIRE

    Kanwar, Jyoti; Taskeen, Mujtaba; Mohammad, Imthiyaz; HUO, CONGDE; CHAN, TAK HANG; Dou, Qing Ping

    2012-01-01

    Over the past decade many scientific and medical studies have focused on green tea for its long-purported health benefits. There is convincing evidence that tea is a cup of life. It has multiple preventive and therapeutic effects. This review thus focuses on the recent advances of tea polyphenols and their applications in the prevention and treatment of human cancers. Of the various polyphenols in tea, (−)-Epigallocatechin-3-gallate (EGCG) is the most abundant, and active compound studied in ...

  15. Parental refusal of life-saving treatments for adolescents: Chinese familism in medical decision-making re-visited.

    Science.gov (United States)

    Hui, Edwin

    2008-06-01

    This paper reports two cases in Hong Kong involving two native Chinese adolescent cancer patients (APs) who were denied their rights to consent to necessary treatments refused by their parents, resulting in serious harm. We argue that the dynamics of the 'AP-physician-family-relationship' and the dominant role Chinese families play in medical decision-making (MDM) are best understood in terms of the tendency to hierarchy and parental authoritarianism in traditional Confucianism. This ethic has been confirmed and endorsed by various Chinese writers from Mainland China and Hong Kong. Rather than giving an unqualified endorsement to this ethic, based more on cultural sentimentalism than rational moral reasoning, we warn that a strong familism in MDM, which deprives 'weak' family members of rights, represents the less desirable elements of this tradition, against which healthcare professionals working in this cultural milieu need to safeguard. Specifically for APs, we suggest that parental authority and family integrity should be re-interpreted in terms of parental responsibility and the enhancement of children's interests respectively, as done in the West. This implies that when parents refuse to consent to necessary treatment and deny their adolescent children's right to consent, doctors, as the only remaining advocates of the APs' interest, have the duty to inform the state, which can override parental refusal to enable the doctors to fulfill their professional and moral obligations. In so doing the state exercises its 'parens patriae' power to defend the defenseless in society and the integrity of the medical profession. PMID:18447864

  16. Knowledge, attitude and practice of basic life support among junior doctors and students in a tertiary care medical institute

    Directory of Open Access Journals (Sweden)

    Md. Yunus

    2015-12-01

    Results: Only 16.41% of all participants and 52% of doctors have received class and/or hands on training. The untrained participants have scored poorly as compared to trained participants in theoretical knowledge and practice of BLS (24.36 % and 53.45% versus 9.25 % and 24.07% respectively. The mean score for both theoretical knowledge and practice of BLS for trained students was higher than that of the untrained participants and the statistical difference was highly significant - p<0.0001. Most of the participants of both trained and untrained group were having very good attitude towards BLS. Conclusions: Knowledge and practice skills of BLS/CPR are poor in medical and nursing students. A significant portion of trainees do not acquire adequate knowledge in a single session of training. An organised curriculum for BLS and its protocolized training is the need of the hour in medical education. [Int J Res Med Sci 2015; 3(12.000: 3644-3650

  17. Application of advanced validation concepts to oxide fuel performance codes: LIFE-4 fast-reactor and FRAPCON thermal-reactor fuel performance codes

    International Nuclear Information System (INIS)

    Highlights: ► The application of advanced validation techniques (sensitivity, calibration and prediction) to nuclear performance codes FRAPCON and LIFE-4 is the focus of the paper. ► A sensitivity ranking methodology narrows down the number of selected modeling parameters from 61 to 24 for FRAPCON and from 69 to 35 for LIFE-4. ► Fuel creep, fuel thermal conductivity, fission gas transport/release, crack/boundary, and fuel gap conductivity models of LIFE-4 are identified for improvements. ► FRAPCON sensitivity results indicated the importance of the fuel thermal conduction and the fission gas release models. -- Abstract: Evolving nuclear energy programs expect to use enhanced modeling and simulation (M and S) capabilities, using multiscale, multiphysics modeling approaches, to reduce both cost and time from the design through the licensing phases. Interest in the development of the multiscale, multiphysics approach has increased in the last decade because of the need for predictive tools for complex interacting processes as a means of eliminating the limited use of empirically based model development. Complex interacting processes cannot be predicted by analyzing each individual component in isolation. In most cases, the mathematical models of complex processes and their boundary conditions are nonlinear. As a result, the solutions of these mathematical models often require high-performance computing capabilities and resources. The use of multiscale, multiphysics (MS/MP) models in conjunction with high-performance computational software and hardware introduces challenges in validating these predictive tools—traditional methodologies will have to be modified to address these challenges. The advanced MS/MP codes for nuclear fuels and reactors are being developed within the Nuclear Energy Advanced Modeling and Simulation (NEAMS) program of the US Department of Energy (DOE) – Nuclear Energy (NE). This paper does not directly address challenges in calibration

  18. Investigation of quality of life in the treatment of locally advanced and recurrent oropharyngeal cancer: State-of the-art

    Directory of Open Access Journals (Sweden)

    D. V. Sikorsky

    2015-01-01

    Full Text Available Postsurgical survival is considered to be indicators of treatment efficiency in most cases. However, the sociomedical rehabilitation of patients in this group is no less important; not only life expectancy, but also functional rehabilitation and quality of life are in the lead in patients with Stage III–IVA due to their low 2-year and much lower 5-year survival. The main efficiency criterion is patients, quality of life as compared to antitumor treatment programs in the absence of differences in survival.As the only chance of cure or life prolongation in most cases, multicomponent surgery for locally advanced and recurrent oropharyngeal cancer may be refused by a patient for fear of being lost to society. Identification of surgical treatment-induced changes in quality of life in patients may be used as a criterion for assessing the performed operations.The body's changes in a patient with otopharyngeal cancer are associated with impairment of basic physiological functions (deglutition, mastication, and breathing, sensitivity (taste, olfaction, and hearing, and individual characteristics of a human being (for example, appearance and voice. The quality of life is integral characteristics of the physical, psychological, emotional, and social functioning of a patient, which is based on his subjective perception. The methods for studying the quality of life include first of all questionnaires that are classified as general and special ones.The general questionnaires are intended to assess the quality of life of both healthy individuals and patients regardless of their disease; the special questionnaires are used to study that in certain categories and groups of patients. The general questionnaires allow the comparison of patients with a population of healthy people. Account must be also taken of the fact that the quality of life varies with age and comorbidities. A great deal of procedures for measuring the quality of life in different groups of

  19. Lifetime health effects and medical costs of integrated stroke services - a non-randomized controlled cluster-trial based life table approach

    Directory of Open Access Journals (Sweden)

    Dirks Maaike

    2010-11-01

    Full Text Available Abstract Background Economic evaluation of stroke services indicates that such services may lead to improved quality of life at affordable cost. The present study assesses lifetime health impact and cost consequences of stroke in an integrated service setting. Methods The EDISSE study is a prospective non-randomized controlled cluster trial that compared stroke services (n = 151 patients to usual care (n = 187 patients. Health status and cost trial-data were entered in multi-dimensional stroke life-tables. The tables distinguish four levels of disability which are defined by the modified Rankin scale. Quality-of-life scores (EuroQoL-5D, transition and survival probabilities are based on concurrent Dutch follow-up studies. Outcomes are quality-adjusted life years lived and lifetime medical cost by disability category. An economic analysis compares outcomes from a successful stroke service to usual care, by bootstrapping individual costs and effects data from patients in each arm. Results Lifetime costs and QALYs after stroke depend on age-of-onset of first-ever stroke. Lifetime QALYs after stroke are 2.42 (90% CI - 0.49 - 2.75 for male patients in usual care and 2.75 (-0.61; 6.26 for females. Lifetime costs for men in the usual care setting are €39,335 (15,951; 79,837 and €42,944 (14,081; 95,944 for women. A comparison with the stroke service results in an ICER of €11,685 saved per QALY gained (€14,211 and €7,745 for men and women respectively. This stroke service is with 90% certainty cost-effective. Conclusions Our analysis shows the potential of large health benefits and cost savings of stroke services, taking a lifetime perspective, also in other European settings.

  20. Phase contrast medical imaging with compact X-ray sources at the Munich-Centre for Advance Photonics (MAP)

    Energy Technology Data Exchange (ETDEWEB)

    Coan, P. [European Synchrotron Radiation Facility, Grenoble (France); Munich-Centre for Advance Photonics, Munich (Germany)], E-mail: paola.coan@esrf.fr; Gruener, F. [Munich-Centre for Advance Photonics, Munich (Germany); Department of Physics, Ludwig-Maximilians-Universitaet Munich, Garching (Germany); Glaser, C.; Schneider, T. [Munich-Centre for Advance Photonics, Munich (Germany); Institut of Clinical Radiology, Klinikum Ludwig-Maximilians-Universitaet, Munich (Germany); Bravin, A. [European Synchrotron Radiation Facility, Grenoble (France); Munich-Centre for Advance Photonics, Munich (Germany); Reiser, M. [Munich-Centre for Advance Photonics, Munich (Germany); Institut of Clinical Radiology, Klinikum Ludwig-Maximilians-Universitaet, Munich (Germany); Habs, D. [Munich-Centre for Advance Photonics, Munich (Germany); Department of Physics, Ludwig-Maximilians-Universitaet Munich, Garching (Germany)

    2009-09-01

    In this paper, the excellence cluster 'Munich-Centre for Advance Photonics' (MAP) is presented. One of the aims of the project is the development of innovative X-ray-based diagnostics imaging techniques to be implemented at an ultra-compact high-energy and high-brilliance X-ray source. The basis of the project and the developments towards the clinical application of phase contrast imaging applied to mammography and cartilage studies will be presented and discussed.

  1. The Break-Even Point: When Medical Advances Are Less Important Than Improving the Fidelity With Which They Are Delivered

    OpenAIRE

    Woolf, Steven H.; Johnson, Robert E.

    2005-01-01

    Society invests billions of dollars in the development of new drugs and technologies but comparatively little in the fidelity of health care, that is, improving systems to ensure the delivery of care to all patients in need. Using mathematical arguments and a nomogram, we demonstrate that technological advances must yield dramatic, often unrealistic increases in efficacy to do more good than could be accomplished by improving fidelity. In 2 examples (the development of anti-platelet agents an...

  2. [QUALITY OF LIFE IN CARERS OF PATIENTS WITH MULTIPLE SCLEROSIS TAKING A DISEASE-MODIFYING MEDICATION: A PILOT STUDY].

    Science.gov (United States)

    Gigineishvili, D; Kiziria, M; Tsiskaridze, A; Shakarishvili, R

    2016-04-01

    A chronic physical disease not only has direct consequences for the chronically ill person but can also distort the life of the healthy family member. The aim of our study was to measure the health-related quality of life (QOL) in people caring for patients with relapsing-remitting form of multiple sclerosis (MS) and currently treated with disease-modifying drugs. Eligible patients were selected via Sarajishvili Institute of Neurology database for MS. 25 carers (mean age 40.7; 56% women, 56% partners) and 25 sex and age-matched controls completed 36-item Short Form Health Survey (SF-36), version 2. Carers also completed the Beck depression Inventory (BDI-II). Compared to carers, patients were found to have a lower QOL (P<0.05 for five dimensions). However, no significant difference was observed in SF-36 domains scores between carers and controls except general health score which was lower in carers (63.3 vs 75.6, p=0.016). A strong negative correlation was found between BDI and all SF-36 dimension scores of carers. The association remains unchanged even adjusted to carers other independent variables. Last year relapse rate was the only clinical variable correlated with carers QOL dimensions. Our pilot study demonstrated that QOL in carers of patients with relapsing-remitting MS receiving disease-modifying treatment is minimally affected. Further study with large sample size is warranted. PMID:27249435

  3. Using Technology Readiness Level (TRL), Life Cycle Cost (LCC), and Other Metrics to Supplement Equivalent System Mass (ESM) in Advanced Life Support (ALS)

    Science.gov (United States)

    Jones, Harry

    2003-01-01

    The ALS project plan goals are reducing cost, improving performance, and achieving flight readiness. ALS selects projects to advance the mission readiness of low cost, high performance technologies. The role of metrics is to help select good projects and report progress. The Equivalent Mass (EM) of a system is the sum of the estimated mass of the hardware, of its required materials and spares, and of the pressurized volume, power supply, and cooling system needed to support the hardware in space. EM is the total payload launch mass needed to provide and support a system. EM is directly proportional to the launch cost.

  4. Advance Directives And Nursing Home Stays Associated With Less Aggressive End-Of-Life Care For Severe Dementia Patients

    OpenAIRE

    Nicholas, Lauren Hersch; Bynum, Julie P. W.; Weir, David R.; Iwashyna, Theodore J.; Langa, Kenneth M.

    2014-01-01

    The number of older adults with cognitive impairment is increasing, and such adults often require a surrogate to make decisions about health care. However, little is known about the aggressiveness of end-of-life care for these people, especially those who reside in the community. We found that cognitive impairment is common among older adults approaching the end of life, whether they live in the community or a nursing home, and that nearly 30 percent of patients with severe dementia remained ...

  5. Routine administration of standardized questionnaires that assess aspects of patients quality of life in medical oncology clinics: A systematic review

    International Nuclear Information System (INIS)

    Purpose: Increasing interest in the Quality of Life outcomes in cancer patients led to increase implementation of their use in routine clinical practice. The aim of this systemic review is to review the scientific evidence behind recommending the use of quality of life (QoL) scales routinely in outpatient evaluation. Methods: Systematic review for all published randomized controlled trials in English language between January 1, 1990 till December 31, 2012. Out of 487 articles (476 identified by electronic search + 11 articles identified by manual search), six trials satisfied the eligibility criteria: (1) the study was a randomized controlled trial (RCT) with randomization of patients or health care providers; (2) the findings of the administered questionnaire or scale (the intervention) were given to health care provider, and compared to standard care with no questionnaire administered (the control); (3) study was conducted in outpatient oncology clinics; and (4) an outcome was measured that related to (i) QoL improvement, (ii) reduction in morbidity, (iii) reduction in stress for the patients, (iv) improvement in communication between patients and health care provider, or (v) improved patient satisfaction. Assessment for the quality of the study was done using the GRADE methodology. Results: Serious methodological issues were affecting most of the trials. Overall the evaluation of the quality of the evidence from these identified trials suggests that there is a weak recommendation to use QoL scales in routine oncology practice to improve communication between physicians and patients. Conclusion: The routine use of such tools in the outpatient settings at improving the patient outcome or satisfaction cannot be recommended based on the available evidence. The potential harm with the excess use of resources needed to implement, collect, store, analyse, and present such data to health care providers should be also considered. Further research and better designed

  6. Development and Qualification of Advancements in Submersible Transfer Pump Performance and Life, and Implications for Advancing and Supporting Processing Options - 13343

    International Nuclear Information System (INIS)

    From the 1950's through the 1990's, relatively inexpensive, 'off-the-shelf' type, vertical turbine pumps (VTP) were used to transfer Hanford waste. The technology of those pumps was rooted primarily in the mining and agricultural (irrigation) industries. HNF-3218, Double Shell Tank (DST) Transfer Pump History and Reliability Report, 1998, provides a summary of Hanford DST pump history to that date. Such pumps operated in the Hanford radioactive waste environment for an average of only 400 hours before failure. However, at that time, operating life was not a driving criteria within the Department of Energy (DOE) complex, as the failure of transfer pumps represented a relatively low replacement and disposal cost. The Environmental Protection Agency (EPA) issuance of the 'Debris Rule' in 1992, which mandated that mixed radioactive waste contaminated equipment be decontaminated to a 'low level waste' category prior to burial, elevated the significance of transfer pump reliability and decontamination capability as life-cycle cost criteria. Minimizing the frequency of transfer pump failures and design for decontamination became significantly important and served to drive the need toward specific, designed for application pumps to meet this challenge. To this end, Washington River Protection Solutions (WRPS) and the supplier, Curtiss-Wright EMD (EMD), have recently collaborated on an intense program to further transfer pump technology and performance. (authors)

  7. Is the advanced trauma life support simulation exam more stressful for the surgeon than emergency department trauma care? O stress afeta cirurgiões durante o aprendizado tanto quanto na sua carreira profissional?

    OpenAIRE

    Ana Paula Quilici; Renato Sergio Pogetti; Belchor Fontes; Luis Fernando Correa Zantut; Eliana Torrea Chaves; Dario Birolini

    2005-01-01

    BACKGROUND: Stress affects surgeons both during training and during professional activity. OBJECTIVE: To compare stress levels affecting surgical residents during the simulated initial assessment and management in the Advanced Trauma Life Support practical exam vs initial assessment and management of trauma patients in the emergency room. METHOD: Eighteen surgical residents were evaluated under basal conditions, during the Advanced Trauma Life Support simulation, and during emergency room ini...

  8. Life sciences

    Energy Technology Data Exchange (ETDEWEB)

    Day, L. (ed.)

    1991-04-01

    This document is the 1989--1990 Annual Report for the Life Sciences Divisions of the University of California/Lawrence Berkeley Laboratory. Specific progress reports are included for the Cell and Molecular Biology Division, the Research Medicine and Radiation Biophysics Division (including the Advanced Light Source Life Sciences Center), and the Chemical Biodynamics Division. 450 refs., 46 figs. (MHB)

  9. Life sciences

    International Nuclear Information System (INIS)

    This document is the 1989--1990 Annual Report for the Life Sciences Divisions of the University of California/Lawrence Berkeley Laboratory. Specific progress reports are included for the Cell and Molecular Biology Division, the Research Medicine and Radiation Biophysics Division (including the Advanced Light Source Life Sciences Center), and the Chemical Biodynamics Division. 450 refs., 46 figs

  10. A STUDY OF RISK FACTOR SCORE OF LIFE-STYLE DISEASES AMONG THE STAFF OF A PRIVATE MEDICAL COLLEGE OF JAIPUR

    Directory of Open Access Journals (Sweden)

    Anjali

    2014-09-01

    Full Text Available BACKGROUND: With the changing lifestyles and dietary habits, the health of the world is now dominated by non-communicable diseases such as diabetes, obesity, cardiovascular diseases and cancer. These are commonly linked to risk factors associated with the life style of an individual like tobacco use, unhealthy diet, physical inactivity, obesity, high blood pressure. These diseases can be modified by just adopting healthy lifestyle habits. STUDY OBJECTIVE: To assess the risk factors score (tobacco, alcohol, diet, physical activity, BMI, blood pressure, etc. of non-communicable diseases in the staff of a private medical college of Jaipur. STUDY DESIGN: Hospital-based Cross-sectional study. SETTING: A private medical college of Jaipur district. Sample Population: Staff members including all the doctors, nurses, laboratory technicians and class three workers were interviewed using the pre-designed schedule. DURATION OF STUDY: 2 months (July – September, 2010. RESULTS: Of all the risk factors the maximum (i.e. 37 respondents (20.5% had 4 risk factors. In the 40-49 yrs age group majority of respondents (i.e. 18 and 18 had the risk factor score of 4 and 5, in 50-59 years, majority (i.e. 12 respondents had 4 and in ≥60 yrs majority (i.e. 8 respondents had 7 risk factors.

  11. A cross-sectional study on awareness and perception about basic life support/cardio-pulmonary resuscitation among undergraduate medical students from coastal South India

    Directory of Open Access Journals (Sweden)

    HN Harsha Kumar

    2013-07-01

    Full Text Available Background: Basic Life Support (BLS/Cardiopulmonary Resuscitation (CPR is an important part of emergency medical care. This study is done among medical undergraduate students, to know their knowledge and perceptions about BLS, as they are going to face such situations in future, as doctors. Materials and Methods: A questionnaire-based study was conducted among 377 medical undergraduate students. The questionnaire included the following parts: (1 Basic characteristics of the study participants, (2 Knowledge about BLS/CPR, (3 Perceptions about BLS/CPR. The components of knowledge and perception based questions were scored. The data was analyzed using SPSS version 12. Results were expressed as proportions in appropriate tables and graphs. Student's Independent 't' test was used to compare means between students who had undergone previous training if any and those who had no such training. Results: Out of 377 students, majority (84.6% had heard of BLS/CPR. Some of them (30.6% could give the correct order of performing CPR as per the AHA guidelines (Year 2010. Few (18.9% had undergone prior training in BLS, whereas, only 17.7% had been in a situation that needed BLS/CPR. Nearly half (50.2% were not confident of performing BLS/CPR. Comparison of the students revealed that students who had training had higher mean scores for 'response to a situation needing BLS/CPR' and 'signs of successful resuscitation', though there was little difference in their knowledge of 'indications for BLS/CPR. Overall perception was not favourable and the students were not confident of performing BLS/CPR. Conclusions: The students need to be taught and trained in the CPR/BLS early in the curriculum to improve their knowledge. Repeated training would increase their confidence.

  12. Results of the Workshop on Two-Phase Flow, Fluid Stability and Dynamics: Issues in Power, Propulsion, and Advanced Life Support Systems

    Science.gov (United States)

    McQuillen, John; Rame, Enrique; Kassemi, Mohammad; Singh, Bhim; Motil, Brian

    2003-01-01

    The Two-phase Flow, Fluid Stability and Dynamics Workshop was held on May 15, 2003 in Cleveland, Ohio to define a coherent scientific research plan and roadmap that addresses the multiphase fluid problems associated with NASA s technology development program. The workshop participants, from academia, industry and government, prioritized various multiphase issues and generated a research plan and roadmap to resolve them. This report presents a prioritization of the various multiphase flow and fluid stability phenomena related primarily to power, propulsion, fluid and thermal management and advanced life support; and a plan to address these issues in a logical and timely fashion using analysis, ground-based and space-flight experiments.

  13. Preferences for end-of-life care among community-dwelling older adults and patients with advanced cancer: A discrete choice experiment.

    Science.gov (United States)

    Finkelstein, Eric A; Bilger, Marcel; Flynn, Terry N; Malhotra, Chetna

    2015-11-01

    Singapore is in the midst of several healthcare reforms in efforts to finance and deliver health services for a rapidly aging population. The primary focus of these reforms is to make healthcare services, including those at the end of life (EOL), affordable. Given the increasingly high health care costs at the EOL, policy makers need to consider how best to allocate resources. One strategy is to allocate resources based on the preferences of sub-populations most likely to be affected. This paper thus aims to quantify preferences for EOL care both among community dwelling older adults (CDOAs) and among patients with a life-limiting illness. A discrete choice experiment was administered to CDOAs and advanced cancer patients in Singapore and willingness to pay (WTP) for specific EOL improvements was estimated. We find that patients have a higher WTP for nearly all EOL attributes compared with CDOAs. We also show that, for both groups, moderate life extension is not the most important consideration; WTP for one additional life year is lower than common thresholds for cost-effectiveness. Irrespective of whose preference are considered, the results highlight the importance of pain management and supporting home deaths at the EOL, perhaps at the expense of public funding for costly but only marginally effective treatments. PMID:26421597

  14. Weighing environmental advantages and disadvantages of advanced wastewater treatment of micro-pollutants using environmental life cycle assessment

    DEFF Research Database (Denmark)

    Wenzel, Henrik; Larsen, Henrik Fred; Clauson-Kaas, Jes;

    2007-01-01

    Much research and development effort is directed towards advances in municipal wastewater treatment aiming at reducing the effluent content of micro-pollutants and pathogens. The objective is to further reduce the eco-toxicity, hormone effects and pathogenic effects of the effluent. Such further...... micro-pollutants being: heavy metals (Cd, Pb, Ni), endocrine disruptors (E2 and EE2), PAH, DEHP, and detergents (LAS & NPE). It was found, in some of the studied scenarios, that more environmental impact may be induced than removed by the advanced treatment. The study showed that for the 3 technologies...

  15. Weighing environmental advantages and disadvantages of advanced wastewater treatment of micro-pollutants using environmental life cycle assessment

    DEFF Research Database (Denmark)

    Wenzel, Henrik; Larsen, Henrik Fred; Clauson-Kaas, Jes;

    2008-01-01

    Much research and development effort is directed towards advances in municipal wastewater treatment aiming at reducing the effluent content of micro-pollutants and pathogens. The objective is to further reduce the eco-toxicity, hormone effects and pathogenic effects of the effluent. Such further...... micro-pollutants being: heavy metals (Cd, Pb, Ni), endocrine disruptors (E2 and EE2), PAH, DEHP, and detergents (LAS & NPE). It was found, in some of the studied scenarios, that more environmental impact may be induced than removed by the advanced treatment. The study showed that for the 3 technologies...

  16. Advanced diagnostic approaches and current medical management of insulinomas and adrenocortical disease in ferrets (Mustela putorius furo).

    Science.gov (United States)

    Chen, Sue

    2010-09-01

    Endocrine neoplasia is the most common tumor type in domestic ferrets, especially in middle-aged to older ferrets. Islet cell tumors and adrenocortical tumors constitute the major types of endocrine neoplasms. Insulinoma is a tumor that produces and releases excessive amounts of insulin. Evaluation of fasted blood glucose levels provides a quick diagnostic assessment for the detection of insulinomas. Use of glucocorticoids, diazoxide, and diet modification are some of the medical treatment options for insulinomas. Adrenocortical neoplasia in ferrets usually overproduces one or more sex hormones. Sex hormones which can result in progressive alopecia, vulvar swelling in females, and prostagomegaly in males. Abdominal ultrasonography and sex hormone assays can be used to diagnose adrenocortical neoplasms. Drugs such as leuprolide acetate, deslorelin acetate, and the hormone melatonin can be used to treat adrenocortical neoplasms in ferrets when surgery is not an option. PMID:20682429

  17. Atención médica al final de la vida: Conceptos Medical care at the end of life: Concepts

    Directory of Open Access Journals (Sweden)

    M. Gómez-Sancho

    2010-04-01

    Full Text Available Hay una gran confusión terminológica en cuanto se refiere al final de la vida de los pacientes. Como quiera que es un asunto de un permanente debate, con mucha frecuencia la discusión se ve entorpecida por la interpretación que los diversos interlocutores hacen de algunos conceptos. Por este motivo, desde la Organización Médica Colegial se ha elaborado un pequeño documento en el que se clarifica el significado de las palabras que aluden a situaciones relacionadas con el final de la vida.There is great confusion as regards the therm "end of life" of patients. The subject is continuosly under debate, with the arguments often being obstructed by how various interlocutors interpret some concepts. For this reason the Medical Colleges Organisation has prepared a short document in which it clarifies the significance of these words that allude to situations associated with the end of life.

  18. Health and Quality of Life

    DEFF Research Database (Denmark)

    Gimmler, Antje; Lenk, Christian (ed.); Aumüller, Gerhard (ed.)

    How could one define health and disease? On what presuppositions, and oughtwe look for such definitions? Does quality of life inherit a subjective orobjective evaluation? Are health and quality of life culture dependentconcepts? Under the conditions of technologically advanced medicine and...... thecommon tendency towards a hedonistic lifestyle such questions come intofocus. Hence, one question is of special relevance: which role does healthplay in our quality of life? The contributions of this interdisciplinaryvolume aim at the clarification of the various concepts in use.Internationally well......-known scholars and scientists such as AlfredMusschenga, Alfons Labisch, Lennart Nordenfelt, Peter Janich, Henrik Wulffand several others outline the framework for a more comprehensive anddemanding concept of health and quality of life including philosophical andcultural aspects as well as medical and...

  19. The association of quality of life with potentially remediable disruptions of circadian sleep/activity rhythms in patients with advanced lung cancer

    Directory of Open Access Journals (Sweden)

    Braun Donald P

    2011-05-01

    Full Text Available Abstract Background Cancer patients routinely develop symptoms consistent with profound circadian disruption, which causes circadian disruption diminished quality of life. This study was initiated to determine the relationship between the severity of potentially remediable cancer-associated circadian disruption and quality of life among patients with advanced lung cancer. Methods We concurrently investigated the relationship between the circadian rhythms of 84 advanced lung cancer patients and their quality of life outcomes as measured by the EORTC QLQ C30 and Ferrans and Powers QLI. The robustness and stability of activity/sleep circadian daily rhythms were measured by actigraphy. Fifty three of the patients in the study were starting their definitive therapy following diagnosis and thirty one patients were beginning second-line therapy. Among the patients who failed prior therapy, the median time between completing definitive therapy and baseline actigraphy was 4.3 months, (interquartile range 2.1 to 9.8 months. Results We found that circadian disruption is universal and severe among these patients compared to non-cancer-bearing individuals. We found that each of these patient's EORTC QLQ C30 domain scores revealed a compromised capacity to perform the routine activities of daily life. The severity of several, but not all, EORTC QLQ C30 symptom items correlate strongly with the degree of individual circadian disruption. In addition, the scores of all four Ferrans/Powers QLI domains correlate strongly with the degree of circadian disruption. Although Ferrans/Powers QLI domain scores show that cancer and its treatment spared these patients' emotional and psychological health, the QLI Health/Function domain score revealed high levels of patients' dissatisfaction with their health which is much worse when circadian disruption is severe. Circadian disruption selectively affects specific Quality of Life domains, such as the Ferrans/Powers Health

  20. How does the quality of life and the underlying biochemical indicators correlate with the performance in academic examinations in a group of medical students of Sri Lanka?

    Directory of Open Access Journals (Sweden)

    Manjula Hettiarachchi

    2014-02-01

    Full Text Available Background: Individual variation of examination performance depends on many modifiable and non-modifiable factors, including pre-examination anxiety. Medical students’ quality of life (QoL and certain biochemical changes occurring while they are preparing for examinations has not been explored. Purpose: We hypothesize that these parameters would determine the examination performance among medical students. Methods: Fourth-year medical students (n=78 from the University of Ruhuna, Sri Lanka, were invited. Their pre- and post-exam status of QoL, using the World Health Organization Quality of Life (WHOQOL-BREF questionnaire, and the level of biochemical marker levels (i.e., serum levels of thyroid profile including thyroglobulin, cortisol and ferritin were assessed. Differences between the scores of QoL and serum parameters were compared with their performance at the examination. Results: The mean QoL score was significantly lower at pre-exam (56.19±8.1 when compared with post-exam (61.7±7.1 levels (p<0.001. The median serum TSH level prior to the exam (0.9 mIU/L; interquartile range 0.74–1.4 mIU/L was significantly lower (p=0.001 when compared with the level after the exam (median of 2.7 mIU/L; IQR 1.90–3.60. The mean±SD fT4 level was significantly higher before the exam (19.48±0.4 pmol/L at study entry vs. 17.43±0.3 pmol/L after the exam; p<0.001. Median serum ferritin (SF level prior to the exam (43.15 (23.5–63.3 µg/L was significantly lower (p≤0.001 when compared with after-exam status (72.36 (49.9–94.9 µg/L. However, there was no difference in mean serum cortisol levels (16.51±0.7 at pre-exam and 15.88±0.7 at post-exam, respectively; p=0.41. Conclusions: Students had higher fT4 and low ferritin levels on pre-exam biochemical assessment. It was evident that students who perform better at the examination had significantly higher QoL scores at each domain tested through the questionnaire (Physical health, Psychological