Rationing access to care to the medically uninsured: the role of bureaucratic front-line discretion at large healthcare institutions.

Science.gov (United States)

Weiner, Saul J; Laporte, Margaret; Abrams, Richard I; Moswin, Arthur; Warnecke, Richard

2004-04-01

Medically uninsured patients seeking nonemergency care are not guaranteed access to services at most healthcare institutions. They must first register with a clerk who could require a deposit and/or payment on an outstanding debt. This study examines the factors that influence whether nonmedical bureaucratic staff sign in or turn away uninsured patients who cannot meet prepayment requirements. The study was conducted at a for-profit, a not-for-profit, and a public healthcare institution in a metropolitan area. The authors explored the relevant policy environment through interviews with senior administrators and a review of documents pertaining to the management of self-pay patients. Then they examined how policies affecting access were implemented through in-depth, semistructured, audiotaped interviews with 55 front-line clerical personnel. At all 3 institutions, policies were ambiguous about what to do when uninsured patients cannot afford required prepayments. Seventy-one percent of staff reported they do not turn patients away; the remainder stated that on occasion they do. A variety of rationales were provided for how decisions are made. Those with the lowest-level positions were significantly more likely to be sympathetic to indigent patients and less likely to report turning patients away. Consistent with other studies of front-line bureaucracies indicating that low-level personnel who interface with clients make discretionary decisions, particularly when organizations pursue potentially conflicting priorities, this preliminary investigation found that nonmedical personnel play a significant role in decisions affecting access to care for medically indigent patients.

Status of the ELIMED multidisciplinary and medical beam-line at ELI-Beamlines

International Nuclear Information System (INIS)

Romano, F; Cirrone, G A P; Cuttone, G; Schillaci, F; Scuderi, V; Amico, A; Candiano, G; Larosa, G; Leanza, R; Manna, R; Marchese, V; Milluzzo, G; Petringa, G; Pipek, J; Giordanengo, S; Guarachi, L F; Marchetto, F; Sacchi, R; Korn, G; Margarone, D

2017-01-01

Nowadays, one of the biggest challenges consists in using high intensity laser-target interaction to generate high-energy ions for medical purposes, eventually replacing the old paradigm of acceleration characterized by huge and complex machines. In order to investigate the feasibility of using laser-driven ion beams for multidisciplinary application, a dedicated beam transport line will be installed at the ELI-Beamlines facility in Prague (CZ), as a part of the User-oriented ELIMAIA beam-line dedicated to ion acceleration and their potential applications. The beam-line section dedicated to transport and dosimetric endpoints is called ELIMED (ELI-Beamlines MEDical and multidisciplinary applications) and will be developed by the INFN-LNS. (paper)

On-line telemetry: prospective assessment of accuracy in an all-volunteer emergency medical service system.

Science.gov (United States)

Hollander, J E; Delagi, R; Sciammarella, J; Viccellio, P; Ortiz, J; Henry, M C

1995-04-01

To evaluate the need for on-line telemetry control in an all-volunteer, predominantly advanced emergency medical technician (A-EMT) ambulance system. Emergency medical service (EMS) advanced life support (ALS) providers were asked to transmit the ECG rhythms of monitored patients over a six-month period in 1993. The ECG rhythm interpretations of volunteer EMS personnel were compared with those of the on-line medical control physician. All discordant readings were reviewed by a panel of physicians to decide whether the misdiagnosis would have resulted in treatment aberrations had transmission been unavailable. Patients were monitored and rhythms were transmitted in 1,825 cases. 1,642 of 1,825 rhythms were correctly interpreted by the EMS providers (90%; 95% CI 89-91%). The accuracy of the EMS providers was dependent on the patient's rhythm (chi-square, p < 0.00001), the chief complaint (chi-square, p = 0.0001), and the provider's level of training (chi-square, p = 0.02). Correct ECG rhythm interpretations were more common when the out-of-hospital interpretation was sinus rhythm (95%), ventricular fibrillation (87%), paced rhythm (94%), or agonal rhythm (96%). The EMS providers were frequently incorrect when the out-of-hospital rhythm interpretation was atrial fibrillation/flutter (71%), supraventricular tachycardia (46%), ventricular tachycardia (59%), or atrioventricular block (50%). Of the 183 discordant cases, 124 (68%) involved missing a diagnosis of, or incorrectly diagnosing, atrial fibrillation/flutter. Review of the discordant readings identified 11 cases that could have resulted in treatment errors had the rhythms not been transmitted, one of which might have resulted in an adverse outcome. In this all-volunteer, predominantly A-EMT ALS system, patients with a field interpretation of a sinus rhythm do not require ECG rhythm transmission. Field interpretations of atrial fibrillation/flutter, supraventricular tachycardia, ventricular tachycardia, and

Identifying factors affecting destination choice of medical tourists: a ...

African Journals Online (AJOL)

medical tourism”, has emerged as a new source of competitive advantage all over the world. The present study seeks to identify the factors that affect destination choice of medical tourists. Methods: We systematically searched relevant databases ...

Working on reform. How workers' compensation medical care is affected by health care reform.

Science.gov (United States)

Himmelstein, J; Rest, K

1996-01-01

The medical component of workers' compensation programs-now costing over $24 billion annually-and the rest of the nation's medical care system are linked. They share the same patients and providers. They provide similar benefits and services. And they struggle over who should pay for what. Clearly, health care reform and restructuring will have a major impact on the operation and expenditures of the workers' compensation system. For a brief period, during the 1994 national health care reform debate, these two systems were part of the same federal policy development and legislative process. With comprehensive health care reform no longer on the horizon, states now are tackling both workers' compensation and medical system reforms on their own. This paper reviews the major issues federal and state policy makers face as they consider reforms affecting the relationship between workers' compensation and traditional health insurance. What is the relationship of the workers' compensation cost crisis to that in general health care? What strategies are being considered by states involved in reforming the medical component of workers compensation? What are the major policy implications of these strategies?

Affective computing and medical informatics: state of the art in emotion-aware medical applications.

Science.gov (United States)

Luneski, Andrej; Bamidis, Panagiotis D; Hitoglou-Antoniadou, Madga

2008-01-01

The area of affective computing has received significant attention by the research community over the last few years. In this paper we review the underlying principles in the field, in an effort to draw threads for possible future development within medical informatics. The approach is lead by considering the three main affective channels, namely, visual, audio/speech, and physiological in relation to e-health, emotional intelligence and e-learning. A discussion on the importance of past and present applications together with a prediction on future literature output is also provided.

Factors affecting medication-order processing time.

Science.gov (United States)

Beaman, M A; Kotzan, J A

1982-11-01

The factors affecting medication-order processing time at one hospital were studied. The order processing time was determined by directly observing the time to process randomly selected new drug orders on all three work shifts during two one-week periods. An order could list more than one drug for an individual patient. The observer recorded the nature, location, and cost of the drugs ordered, as well as the time to process the order. The time and type of interruptions also were noted. The time to process a drug order was classified as six dependent variables: (1) total time, (2) work time, (3) check time, (4) waiting time I--time from arrival on the dumbwaiter until work was initiated, (5) waiting time II--time between completion of the work and initiation of checking, and (6) waiting time III--time after the check was completed until the order left on the dumbwaiter. The significant predictors of each of the six dependent variables were determined using stepwise multiple regression. The total time to process a prescription order was 58.33 +/- 48.72 minutes; the urgency status of the order was the only significant determinant of total time. Urgency status also significantly predicted the three waiting-time variables. Interruptions and the number of drugs on the order were significant determinants of work time and check time. Each telephone interruption increased the work time by 1.72 minutes. While the results of this study cannot be generalized to other institutions, pharmacy managers can use the method of determining factors that affect medication-order processing time to identify problem areas in their institutions.

Factors affecting the utilisation of electronic medical records system ...

African Journals Online (AJOL)

Malawi Medical Journal 29 (3): September 2017. Electronic medical ... care, as they enable storage of large amounts of data and ... EMRs. This study assessed factors that affect the use of EMRs in Malawi, particularly at Queen Elizabeth and Kamuzu Central ..... paperless hospitals in Norway : A socio-technical perspective.

Out of Our Heads! Four perspectives on the curation of an on-line exhibition of medically themed artwork by UK medical undergraduates

Directory of Open Access Journals (Sweden)

Trevor Thompson

2010-11-01

Full Text Available The Medical School at Bristol University is noted for offering, and in some instances requiring, its students to work creatively with medical themes. Students, artists, educationalists and a web designer have worked to create an on-line exhibition of the resulting creative output. This can be viewed at www.outofourheads.net. This site is a themed repository of poetry, prose, drawings, paintings, cartoons, films, music, dance and rap. Most works come with commentaries that can be as illuminating as the works they describe. The site invites comment and welcomes new postings from anyone connected to medicine. As an alternative to the conventional pedagogical report, and in keeping with the subject matter, in this paper we tell the story of this unique educational enterprise through the narratives of four of its principle architects. The ‘Teacher's Tale’, the ‘Designer's Tale’, the ‘Curator's Tale’ and the ‘Artist's Tale’ offer different, personal, tellings of how the site came to be. Each tale contains hypertext links to notable works on the site some of which have become teaching resources within the institution. This paper is of relevance to anyone who seeks to explore and champion the human insights of this privileged community.

Out of Our Heads! Four perspectives on the curation of an on-line exhibition of medically themed artwork by UK medical undergraduates

Science.gov (United States)

Thompson, Trevor; van de Klee, Danny; Lamont-Robinson, Catherine; Duffin, Will

2010-01-01

The Medical School at Bristol University is noted for offering, and in some instances requiring, its students to work creatively with medical themes. Students, artists, educationalists and a web designer have worked to create an on-line exhibition of the resulting creative output. This can be viewed at www.outofourheads.net. This site is a themed repository of poetry, prose, drawings, paintings, cartoons, films, music, dance and rap. Most works come with commentaries that can be as illuminating as the works they describe. The site invites comment and welcomes new postings from anyone connected to medicine. As an alternative to the conventional pedagogical report, and in keeping with the subject matter, in this paper we tell the story of this unique educational enterprise through the narratives of four of its principle architects. The ‘Teacher's Tale’, the ‘Designer's Tale’, the ‘Curator's Tale’ and the ‘Artist's Tale’ offer different, personal, tellings of how the site came to be. Each tale contains hypertext links to notable works on the site some of which have become teaching resources within the institution. This paper is of relevance to anyone who seeks to explore and champion the human insights of this privileged community. PMID:21321667

Factors affecting future specialty choice among medical students in Kuwait

OpenAIRE

Marwan, Yousef; Al-Fouzan, Rawan; Al-Ajlan, Sarah; Al-Saleh, Mervat

2012-01-01

Background: Choosing a medical specialty can be either a daunting and confusing experience for some medical students and junior doctors or a foregone conclusion to others. The aim of this study is to evaluate factors affecting future specialty choice among medical students in Kuwait University. Methods: A self-administered questionnaire was used to collect data from medical students registered in Kuwait University during the academic year 2011/2012. Chi-square test and logistic regression wer...

Specialty-service lines: salvos in the new medical arms race.

Science.gov (United States)

Berenson, Robert A; Bodenheimer, Thomas; Pham, Hoangmai H

2006-01-01

Hospitals and physicians are developing and marketing discrete and profitable specialty-service lines. Although closely affiliated specialist physicians are central to hospitals' service-line products, other physicians compete directly with hospitals via physician-owned specialty facilities. Specialty-service lines may be provided in a variety of settings, both inside and outside traditional hospital walls. Thus far, the escalating battle between hospitals and physicians for control over specialty services has not affected hospital profitability. However, as the scope of care that can be safely performed in the outpatient arena expands, physician competition for control over specialty services may threaten hospitals' financial health.

Forage production and N2 fixation in mixed cropping of saltbush and shrubby medic grown on a salt affected soil

International Nuclear Information System (INIS)

Kurdali, F.

2008-11-01

Two experiments were conducted to evaluate dry matter, nitrogen yield, N 2 fixation (Ndfa) and soil N uptake in saltbush (Atriplex halimus) and shrubby medic (Medicago arborea) grown either solely or in mixture on a salt affected soil, using 15 N tracer techniques. In a pot experiment, the combined dry matter yield of both species was considerably higher than that of solely grown shrubs. The inclusion of saltbush in the mixed cropping system decreased soil N uptake by shrubby medic and enhanced %Ndfa without affecting amounts of N 2 fixed. Under field conditions, estimated values of %Ndfa via δ 15 N natural abundance were relatively similar to those of the pot experiment using 15 N enrichment method. It can be concluded that the use of mixed cropping system of shrubby medic and saltbush could be a promising bio-saline agricultural approach to utilize salt affected soils in terms of forage yield and N 2 -fixation. (Author)

The effect of family therapy on the changes in the severity of on-line game play and brain activity in adolescents with on-line game addiction

Science.gov (United States)

Han, Doug Hyun; Kim, Sun Mi; Lee, Young Sik; Renshaw, Perry F.

2015-01-01

We evaluated whether a brief 3-week family therapy intervention would change patterns of brain activation in response to affection and gaming cues in adolescents from dysfunctional families who met criteria for on-line game addiction. Fifteen adolescents with on-line game addiction and fifteen adolescents without problematic on-line game play and an intact family structure were recruited. Over 3 weeks, families were asked to carry out homework assignments focused on increasing family cohesion for more than 1 hour/day and 4 days/week. Before therapy, adolescents with on-line game addiction demonstrated decreased activity as measured by functional magnetic resonance imaging (fMRI) within the caudate, middle temporal gyrus, and occipital lobe in response to images depicting parental affection and increased activity of the middle frontal and inferior parietal in response scenes from on-line games, relative to healthy comparison subjects. Improvement in perceived family cohesion following 3 weeks of treatment was associated with an increase in the activity of the caudate nucleus in response to affection stimuli and was inversely correlated with changes in on-line game playing time. With evidence of brain activation changes in response to on-line game playing cues and images depicting parental love, the present findings suggest that family cohesion may be an important factor in the treatment of problematic on-line game playing. PMID:22698763

Facing regulatory challenges of on-line hemodiafiltration.

Science.gov (United States)

Kümmerle, Wolfgang

2011-01-01

On-line hemodiafiltration (on-line HDF) is the result of a vision that triggered multifarious changes in very different areas. Driven by the idea to offer better medical treatment for renal patients, technological innovations were developed and established that also constituted new challenges in the field of regulatory affairs. The existing regulations predominantly addressed the quality and safety of those products needed to perform dialysis treatment which were supplied by industrial manufacturers. However, the complexity of treatment system required for the provision of on-line fluids demanded a holistic approach encompassing all components involved. Hence, focus was placed not only on single products, but much more on their interfacing, and the clinical infrastructure, in particular, had to undergo substantial changes. The overall understanding of the interaction between such factors, quite different in their nature, was crucial to overcome the arising regulatory obstacles. This essay describes the evolution of the on-line HDF procedure from the regulatory point of view. A simplified diagram demonstrates the path taken from the former regulatory understanding to the realization of necessary changes. That achievement was only possible through 'management of preview' and consequent promotion of technical and medical innovations as well as regulatory re-evaluations. Copyright © 2011 S. Karger AG, Basel.

The Imaging and Medical Beam Line at the Australian Synchrotron

Science.gov (United States)

Hausermann, Daniel; Hall, Chris; Maksimenko, Anton; Campbell, Colin

2010-07-01

As a result of the enthusiastic support from the Australian biomedical, medical and clinical communities, the Australian Synchrotron is constructing a world-class facility for medical research, the `Imaging and Medical Beamline'. The IMBL began phased commissioning in late 2008 and is scheduled to commence the first clinical research programs with patients in 2011. It will provide unrivalled x-ray facilities for imaging and radiotherapy for a wide range of research applications in diseases, treatments and understanding of physiological processes. The main clinical research drivers are currently high resolution and sensitivity cardiac and breast imaging, cell tracking applied to regenerative and stem cell medicine and cancer therapies. The beam line has a maximum source to sample distance of 136 m and will deliver a 60 cm by 4 cm x-ray beam1—monochromatic and white—to a three storey satellite building fully equipped for pre-clinical and clinical research. Currently operating with a 1.4 Tesla multi-pole wiggler, it will upgrade to a 4.2 Tesla device which requires the ability to handle up to 21 kW of x-ray power at any point along the beam line. The applications envisaged for this facility include imaging thick objects encompassing materials, humans and animals. Imaging can be performed in the range 15-150 keV. Radiotherapy research typically requires energies between 30 and 120 keV, for both monochromatic and broad beam.

Exploring Factors Affecting Emergency Medical Services Staffs' Decision about Transporting Medical Patients to Medical Facilities.

Science.gov (United States)

Ebrahimian, Abbasali; Seyedin, Hesam; Jamshidi-Orak, Roohangiz; Masoumi, Gholamreza

2014-01-01

Transfer of patients in medical emergency situations is one of the most important missions of emergency medical service (EMS) staffs. So this study was performed to explore affecting factors in EMS staffs' decision during transporting of patients in medical situations to medical facilities. The participants in this qualitative study consisted of 18 EMS staffs working in prehospital care facilities in Tehran, Iran. Data were gathered through semistructured interviews. The data were analyzed using a content analysis approach. The data analysis revealed the following theme: "degree of perceived risk in EMS staffs and their patients." This theme consisted of two main categories: (1) patient's condition' and (2) the context of the EMS mission'. The patent's condition category emerged from "physical health statuses," "socioeconomic statuses," and "cultural background" subcategories. The context of the EMS mission also emerged from two subcategories of "characteristics of the mission" and EMS staffs characteristics'. EMS system managers can consider adequate technical, informational, financial, educational, and emotional supports to facilitate the decision making of their staffs. Also, development of an effective and user-friendly checklist and scoring system was recommended for quick and easy recognition of patients' needs for transportation in a prehospital situation.

A survey of front-line paramedics examining the professional relationship between paramedics and physician medical oversight.

Science.gov (United States)

Foerster, Christopher R; Tavares, Walter; Virkkunen, Ilkka; Kämäräinen, Antti

2018-03-01

Paramedicine is often dependent on physician medical directors and their associated programs for direction and oversight. A positive relationship between paramedics and their oversight physicians promotes safety and quality care while a strained or ineffective one may threaten these goals. The objective of this study was to explore and understand the professional relationship between paramedics and physician medical oversight as viewed by front-line paramedics. All active front-line paramedics from four municipal paramedic services involving three medical oversight groups in Ontario were invited to complete an online survey. Five hundred and four paramedics were invited to participate in the study, with 242 completing the survey (48% response rate); 66% male, 76% primary care paramedics with an average of 13 (SD=9) years of experience. Paramedics had neutral or positive perceptions regarding their autonomy, opportunities to interact with their medical director, and medical director understanding of the prehospital setting. Paramedics perceived medical directives as rigid and ambiguous. A significant amount of respondents reported a perception of having provided suboptimal patient care due to fear of legal or disciplinary consequences. Issues of a lack of support for critical thinking and a lack of trust between paramedics and medical oversight groups were often raised. Paramedic perceptions of physician medical oversight were mixed. Concerning areas identified were perceptions of ambiguous written directives and concerns related to the level of trust and support for critical thinking. These perceptions may have implications for the system of care and should be explored further.

Insurance: Profitability of the Medical Malpractice and General Liability Lines. Report to Congressional Requesters.

Science.gov (United States)

General Accounting Office, Washington, DC.

This report on the profitability of the property/casualty insurance industry and in particular of the medical malpractice insurance line was prepared at the request of Representatives Henry A. Waxman and James J. Florio and Senators Paul Simon, Daniel K. Inouye, Albert Gore, Jr., and Jay D. Rockefeller. Four different estimates of medical…

Factors affecting medication adherence in elderly people

Directory of Open Access Journals (Sweden)

Jin HK

2016-10-01

Full Text Available Hyekyung Jin,1 Yeonhee Kim,2 Sandy Jeong Rhie1,3 1College of Pharmacy, 2Center for Excellence in Teaching & Learning, 3Division of Life and Pharmaceutical Sciences, Ewha Womans University, Seoul, Republic of Korea Background: Little is known about the functional health literacy (FHL associated with medication adherence in elderly patients. The aim of this study was to examine the FHL among older adults and identify influencing factors that can predict medication adherence. Methods: This was a cross-sectional survey. Participants (n=160 aged 65 years and older were selected from outpatient clinics of 3 tertiary care hospitals, 6 community pharmacies, and 2 senior centers between November 1 and 30, 2014. The participants’ FHL was measured using the Korean Functional Health Literacy Test, which consists of 15 items including 8 numeracy and 7 reading comprehension items. Medication adherence was measured by the Adherence to Refills and Medication Scale. Descriptive statistics, chi-square or Fisher’s exact test, and multiple regression analyses were used to analyze the data. Results: The mean score of the total FHL was 7.72±3.51 (range 0–15. The percentage of the total number of correct answers for the reading comprehension subtest and numeracy subtest were 48.1% and 54.4%, respectively. Among 160 participants, 52.5% showed low adherence to medication. The factors affecting medication adherence included the patient’s degree of satisfaction with the service (β=-0.215, P=0.022, sufficient explanation of medication counseling (β=-0.335, P=0.000, education level (β=-0.153, P=0.045, health-related problems (β=-0.239, P=0.004, and dosing frequency (β=0.189, P=0.018. Conclusion: In this study, we found medication adherence of elderly patients was associated with education level, health-related problems, dosing frequency, satisfaction with patient counseling, and explanation of medication, but no association was found with FHL. Pharmacists

Action Intentions: Action Influences Both On-Line Perception and Off-Line Representation

Directory of Open Access Journals (Sweden)

C Kirtley

2014-08-01

Full Text Available Given that one role of vision is to gather information for upcoming tasks, previous studies have investigated whether the preparation for action affects visual behaviour. The current studies aimed to determine if such influences on visual selection would also influence the formation of subsequent memory representations. Two experiments were conducted- in the first, participants' action intentions towards a scene were manipulated by the performance of different grasping postures as they observed the scene. This was followed by a memory test for the objects presented. Participants' eye movements were affected by their action intention, so that performing a power grip led to significantly longer fixation durations on power grip compatible objects. In contrast, memory for the objects and their properties was not affected by the action. Our second study required participants to make the action posture during the recall phase. No effect on eye movements was found, but recall was affected, with a particular advantage for recall of the position of grip-compatible objects. Previous studies have shown that action intentions can affect the on-line perception of objects. The current study suggests this may not extend to off-line representations if they are accessed after the action has been completed or abandoned. However, the recall of information may be affected if gestures are formed during retrieval. Memory representations may not be tailored specifically to an action, but actions can still affect the recall of information.

Exploring Factors Affecting Emergency Medical Services Staffs’ Decision about Transporting Medical Patients to Medical Facilities

Directory of Open Access Journals (Sweden)

Abbasali Ebrahimian

2014-01-01

Full Text Available Transfer of patients in medical emergency situations is one of the most important missions of emergency medical service (EMS staffs. So this study was performed to explore affecting factors in EMS staffs’ decision during transporting of patients in medical situations to medical facilities. The participants in this qualitative study consisted of 18 EMS staffs working in prehospital care facilities in Tehran, Iran. Data were gathered through semistructured interviews. The data were analyzed using a content analysis approach. The data analysis revealed the following theme: “degree of perceived risk in EMS staffs and their patients.” This theme consisted of two main categories: (1 patient’s condition’ and (2 the context of the EMS mission’. The patent’s condition category emerged from “physical health statuses,” “socioeconomic statuses,” and “cultural background” subcategories. The context of the EMS mission also emerged from two subcategories of “characteristics of the mission” and EMS staffs characteristics’. EMS system managers can consider adequate technical, informational, financial, educational, and emotional supports to facilitate the decision making of their staffs. Also, development of an effective and user-friendly checklist and scoring system was recommended for quick and easy recognition of patients’ needs for transportation in a prehospital situation.

Disclosure of personal medical information: differences among parents and affected adults for genetic and nongenetic conditions.

Science.gov (United States)

Johnson, Summer; Kass, Nancy E; Natowicz, Marvin

2005-01-01

Protecting the confidentiality of medical information has been an issue of great interest in the fields of bioethics, public policy, and law. Few empirical studies have addressed patient experiences and attitudes toward disclosure of private medical information in multiple contexts such as health insurance, employment, and the family. Furthermore, it is unclear whether differences exist in experiences and attitudes about privacy between those living with a serious medical condition versus those who have a child with a medical condition. The study sought to determine whether attitudes and experiences related to medical privacy and confidentiality differ between affected adults and parents of affected children. Interviews were conducted with 296 adults and parents of children with sickle cell disease (SCD), cystic fibrosis (CF), or diabetes mellitus (DM). This cross-sectional study collected data regarding their experiences, attitudes, and beliefs concerning medical privacy and confidentiality. Multinomial logistic regression analysis was conducted on quantitative data. Qualitative analysis was conducted on data from open-ended response items. Parents disclose their child's diagnosis to others more often than affected adults disclose their own disease status. Parents are less likely than affected adults to regret their disclosure, to hope others do not find out, to have been pressured to share information, and to be asked about their disease by employers. Affected adults express greater concern about disclosure, a greater prevalence and greater fear of discrimination, and experience greater pressure from family members to disclose. Clinicians and researchers working with these populations should consider these differences in privacy and disclosure. Further study is necessary to examine the implications of these differences in attitudes and experiences concerning insurance, employment, and social interactions among persons with these conditions.

Factors affecting future specialty choice among medical students in Kuwait.

Science.gov (United States)

Al-Fouzan, Rawan; Al-Ajlan, Sarah; Marwan, Yousef; Al-Saleh, Mervat

2012-01-01

Choosing a medical specialty can be either a daunting and confusing experience for some medical students and junior doctors or a foregone conclusion to others. The aim of this study is to evaluate factors affecting future specialty choice among medical students in Kuwait University. A self-administered questionnaire was used to collect data from medical students registered in Kuwait University during the academic year 2011/2012. Chi-square test and logistic regression were used to test the association between deciding a future specialty and students' sociodemographic and academic factors. Of the 422 students approached, 387 (91.7%) decided to participate. A total of 144 (37.2%) students made a decision regarding their choice of future medical specialty. Pediatrics, general surgery, and cardiology were the most desired specialties - 18 (12.5%), 17 (11.8%), and 16 (11.1%) students requested these specialties, respectively. Only 61 (42.4%) of those who selected a future specialty received advice regarding their choice. Looking for a good treatment outcome for patients (66; 45.8%) and a challenging specialty (58; 40.3%) were the most influencing incentives when selecting a future specialty. Students in the clinical phase of their study were 3.014 (95% CI: 1.498-6.065) more likely to report on their decision regarding a future specialty compared to students in the basic medical sciences phase (p=0.002). A variety of factors appeared to inspire medical students in Kuwait to choose a future medical specialty. When identified, these factors can be used by mentors of medical students and directors of residency training programs to motivate students to choose specialties that are limited in Kuwait.

Factors Affecting the Use of Indigenous Publications by Medical and Dental Students in Nigerian Universities

Directory of Open Access Journals (Sweden)

Ahiaoma Ibegwam

2012-06-01

Full Text Available This study examined the indigenous medical publications used by medical and dental students in Nigeria with a view to discovering factors that affects their usage. Data was gathered through a questionnaire survey. The population of the study was 1,264 undergraduate medical and dental students from ten universities in all the geopolitical zones of Nigeria. Data gathered was analysed using SPSS to obtain the summaries of the variables in form of frequency distribution and other descriptive statistics. The findings reveal several factors affecting the usage of indigenous medical publications. In spite of all the inhibitors, 88.2% of the respondents indicated that they need indigenous medical publications for a well-rounded medical education.

[Discussion on logistics management of medical consumables].

Science.gov (United States)

Deng, Sutong; Wang, Miao; Jiang, Xiali

2011-09-01

Management of medical consumables is an important part of modern hospital management. In modern medical behavior, drugs and medical devices act directly on the patient, and are important factors affecting the quality of medical practice. With the increasing use of medical materials, based on practical application, this article proposes the management model of medical consumables, and discusses the essence of medical materials logistics management.

Factors affecting future specialty choice among medical students in Kuwait

Directory of Open Access Journals (Sweden)

Rawan Al-Fouzan

2012-12-01

Full Text Available Background: Choosing a medical specialty can be either a daunting and confusing experience for some medical students and junior doctors or a foregone conclusion to others. The aim of this study is to evaluate factors affecting future specialty choice among medical students in Kuwait University. Methods: A self-administered questionnaire was used to collect data from medical students registered in Kuwait University during the academic year 2011/2012. Chi-square test and logistic regression were used to test the association between deciding a future specialty and students’ sociodemographic and academic factors. Results: Of the 422 students approached, 387 (91.7% decided to participate. A total of 144 (37.2% students made a decision regarding their choice of future medical specialty. Pediatrics, general surgery, and cardiology were the most desired specialties – 18 (12.5%, 17 (11.8%, and 16 (11.1% students requested these specialties, respectively. Only 61 (42.4% of those who selected a future specialty received advice regarding their choice. Looking for a good treatment outcome for patients (66; 45.8% and a challenging specialty (58; 40.3% were the most influencing incentives when selecting a future specialty. Students in the clinical phase of their study were 3.014 (95% CI: 1.498–6.065 more likely to report on their decision regarding a future specialty compared to students in the basic medical sciences phase (p=0.002. Conclusion : A variety of factors appeared to inspire medical students in Kuwait to choose a future medical specialty. When identified, these factors can be used by mentors of medical students and directors of residency training programs to motivate students to choose specialties that are limited in Kuwait.

The research of medical equipment on-line detection system based on Android smartphone

Science.gov (United States)

Jiang, Junjie; Dong, Xinyu; Zhang, Hongjie; Liu, Mengjun

2017-06-01

With the unceasing enhancement of medical level, the expanding scale of medical institutions, medical equipment as an important tool for disease diagnosis, treatment and prevention, used in all levels of medical institutions. The quality and accuracy of the Medical equipment play a key role in the doctor's diagnosis and treatment effect, medical metrology as the important technical foundation is to ensure that the equipment, technology, material components are accurate and the application is safe and reliable. Medical equipment have the feature of variety, large quantity, long using cycle, expensive and multi-site, which bring great difficulty in maintenance, equipment management and verification. Therefore, how to get the medical measurement integrate deeply into the advanced internet technology, information technology and the new measuring method, for real-time monitoring of medical equipment, tracking, positioning, and query is particularly important.

Positive Affect Is Associated With Reduced Fixation in a Realistic Medical Simulation.

Science.gov (United States)

Crane, Monique F; Brouwers, Sue; Forrest, Kirsty; Tan, Suyin; Loveday, Thomas; Wiggins, Mark W; Munday, Chris; David, Leila

2017-08-01

This study extends previous research by exploring the association between mood states (i.e., positive and negative affect) and fixation in practicing anesthetists using a realistic medical simulation. The impact of practitioner emotional states on fixation is a neglected area of research. Emerging evidence is demonstrating the role of positive affect in facilitating problem solving and innovation, with demonstrated implications for practitioner fixation. Twelve practicing anesthetists (4 females; M age = 39 years; SD = 6.71) were involved in a medical simulation. Prior to the simulation, practitioners rated the frequency they had experienced various positive and negative emotions in the previous three days. During the simulation, the patient deteriorated rapidly, and anesthetists were observed for their degree of fixation. After the simulation, practitioners indicated the frequency of these same emotions during the simulation. Nonparametric correlations were used to explore the independent relationships between positive and negative affect and the behavioral measures. Only positive affect impacted the likelihood of fixation. Anesthetists who reported more frequent recent positive affect in the three days prior to the simulation and during the simulation tended to be less fixated as judged by independent raters, identified a decline in patient oxygen saturation more quickly, and more rapidly implemented the necessary intervention (surgical cricothyroidotomy). These findings have some real-world implications for positive affect in patient safety. This research has broad implications for professions where fixation may impair practice. This research suggests that professional training should teach practitioners to identify their emotions and understand the role of these emotions in fixation.

Factors Affecting the Attractiveness of Medical Tourism Destination: An Empirical Study on India- Review Article

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SULTANA, Seyama; HAQUE, Ahasanul; MOMEN, Abdul; YASMIN, Farzana

2014-01-01

Abstract Background In this edge, medical tourism is not a new idea. Medical treatment is one of the essential demands of human beings and it requires high quality and intensive care. Beside western world, few developing countries are playing key roles as medical tourism destinations. India is one of the leading names among these countries. The purpose of the paper is to find the factors influencing the attractiveness of India as a health tourism destination. Methods The study has found the major contributing factors and their relative importance in the attractiveness of the health tourism destination that is India from consumers’ perspectives by conducting survey with an application of structural equation modelling approach. Results In Indian context, medical tourists consider service quality and cost mostly to select any medical destination. In addition they also give value to the destination competitiveness but tourist attitude is less important in comparison with other factors affecting their destination choice. Since the study has used structural equation modelling approach to test the hypothesis and figure out the relative importance of the factors, the fundamental indices such as Normed Chi square(less than 3), RMSEA (less than 0.08) and CFI (more than 0.90) values show the overall model fit of the proposed model. Conclusion In order to transform a country such as India as an attractive and competitive medical tourist destination in this time of globalization, a step should be taken to control cost ensuring the quality of services. PMID:25909055

Factors affecting the attractiveness of medical tourism destination: an empirical study on India- review article.

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Sultana, Seyama; Haque, Ahasanul; Momen, Abdul; Yasmin, Farzana

2014-07-01

In this edge, medical tourism is not a new idea. Medical treatment is one of the essential demands of human beings and it requires high quality and intensive care. Beside western world, few developing countries are playing key roles as medical tourism destinations. India is one of the leading names among these countries. The purpose of the paper is to find the factors influencing the attractiveness of India as a health tourism destination. The study has found the major contributing factors and their relative importance in the attractiveness of the health tourism destination that is India from consumers' perspectives by conducting survey with an application of structural equation modelling approach. In Indian context, medical tourists consider service quality and cost mostly to select any medical destination. In addition they also give value to the destination competitiveness but tourist attitude is less important in comparison with other factors affecting their destination choice. Since the study has used structural equation modelling approach to test the hypothesis and figure out the relative importance of the factors, the fundamental indices such as Normed Chi square(less than 3), RMSEA (less than 0.08) and CFI (more than 0.90) values show the overall model fit of the proposed model. In order to transform a country such as India as an attractive and competitive medical tourist destination in this time of globalization, a step should be taken to control cost ensuring the quality of services.

Survey of Preventable Disaster Deaths at Medical Institutions in Areas Affected by the Great East Japan Earthquake: Retrospective Survey of Medical Institutions in Miyagi Prefecture.

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Yamanouchi, Satoshi; Sasaki, Hiroyuki; Kondo, Hisayoshi; Mase, Tomohiko; Otomo, Yasuhiro; Koido, Yuichi; Kushimoto, Shigeki

2017-10-01

Introduction In 2015, the authors reported the results of a preliminary investigation of preventable disaster deaths (PDDs) at medical institutions in areas affected by the Great East Japan Earthquake (2011). This initial survey considered only disaster base hospitals (DBHs) and hospitals that had experienced at least 20 patient deaths in Miyagi Prefecture (Japan); therefore, hospitals that experienced fewer than 20 patient deaths were not investigated. This was an additional study to the previous survey to better reflect PDD at hospitals across the entire prefecture. Of the 147 hospitals in Miyagi Prefecture, the 14 DBHs and 82 non-DBHs that agreed to participate were included in an on-site survey. A database was created based on the medical records of 1,243 patient deaths that occurred between March 11, 2011 and April 1, 2011, followed by determination of their status as PDDs. A total of 125 cases of PDD were identified among the patients surveyed. The rate of PDD was significantly higher at coastal hospitals than inland hospitals (17.3% versus 6.3%; Pdisaster deaths in non-DBHs were most numerous in facilities with few general beds, especially among patients hospitalized before the disaster in hospitals with fewer than 100 beds. Categorized by area, the most frequent causes of PDD were: insufficient medical resources, disrupted lifelines, delayed medical intervention, and deteriorated environmental conditions in homes and emergency shelters in coastal areas; and were delayed medical intervention and disrupted lifelines in inland areas. Categorized by hospital function, the most frequent causes were: delayed medical intervention, deteriorated environmental conditions in homes and emergency shelters, and insufficient medical resources at DBHs; while those at non-DBHs were disrupted lifelines, insufficient medical resources, delayed medical intervention, and lack of capacity for transport within the area. Preventable disaster death at medical institutions in areas

Impact on Medical Cost, Cumulative Survival, and Cost-Effectiveness of Adding Rituximab to First-Line Chemotherapy for Follicular Lymphoma in Elderly Patients: An Observational Cohort Study Based on SEER-Medicare

International Nuclear Information System (INIS)

Griffiths, R. I.; Gleeson, M. L.; Danese, M. D.; Griffiths, R. I.; Mikhael, J.

2012-01-01

Rituximab improves survival in follicular lymphoma (FL), but is considerably more expensive than conventional chemotherapy. We estimated the total direct medical costs, cumulative survival, and cost-effectiveness of adding rituximab to first-line chemotherapy for FL, based on a single source of data representing routine practice in the elderly. Using surveillance, epidemiology, and end results (SEER) registry data plus Medicare claims, we identified 1,117 FL patients who received first-line CHOP (cyclophosphamide (C), doxorubicin, vincristine (V), and prednisone (P)) or CVP +/− rituximab. Multivariate regression was used to estimate adjusted cumulative cost and survival differences between the two groups over four years after beginning treatment. The median age was 73 years (minimum 66 years), 56% had stage III-IV disease, and 67% received rituximab. Adding rituximab to first-line chemotherapy was associated with higher adjusted incremental total cost ($18,695; 95% Confidence Interval (CI) $9,302-$28,643) and longer adjusted cumulative survival (0.18 years; 95% CI 0.10-0.27) over four years of followup. The expected cost-effectiveness was $102,142 (95% CI $34,531-296,337) per life-year gained. In routine clinical practice, adding rituximab to first-line chemotherapy for elderly patients with FL results in higher direct medical costs to Medicare and longer cumulative survival after four years.

Studies on maize inbred lines susceptibility to herbicides

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Stefanović Lidija

2010-01-01

Full Text Available This paper presents the analysis of results obtained during long- term studies on the response of maize inbred lines to herbicides. Under the agroecological conditions of Zemun Polje the response (reaction of maize inbred lines to herbicides of different classes was investigated. Biological tests were performed and some agronomic, morphological, physiological and biochemical parameters were determined when the response of maize inbred lines to herbicides was estimated. The use of active ingredients of herbicides from triazine, acetanilide, thiocarbamate to new chemical groups (sulfonylurea etc., have been resulted in changes in weed suppression and susceptibility of inbred lines. Obtained results show that effects of herbicides on susceptible maize genotypes can be different: they can slowdown the growth and development and affect the plant height; they can also affect the stages of the tassel and ear development and at the end they can reduced grain yield of the tested inbreds. Numerous studies confirmed the existence of differences in susceptibility level of maize genotypes in relation to herbicides. According to gained results the recommendations for growers are made on the possibility of the application of new herbicides in the hybrid seed production.

New strategies in the assessment of psychological factors affecting medical conditions.

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Sirri, Laura; Fabbri, Stefania; Fava, Giovanni A; Sonino, Nicoletta

2007-12-01

In this article, we examine research that may lead to a better assessment of psychological factors affecting medical conditions. We performed a review of the psychosomatic literature using both Medline and manual searches. We selected papers that were judged to be relevant to new strategies of assessment, with particular reference to the use of the Diagnostic Criteria for Psychosomatic Research. We assessed 8 areas concerned with the assessment of psychological factors in the setting of medical disease: hypochondriasis, disease phobia, persistent somatization, conversion symptoms, illness denial, demoralization, irritable mood, and Type A behavior. A new subclassification of the Diagnostic and Statistical Manual of Mental Disorders (5th ed. [DSM-V]; not yet published) category of psychological factors affecting physical conditions appears to be feasible and may provide the clinician with better tools for identifying psychological distress.

How sequestration cuts affect primary care physicians and graduate medical education.

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Chauhan, Bindiya; Coffin, Janis

2013-01-01

On April 1, 2013, sequestration cuts went into effect impacting Medicare physician payments, graduate medical education, and many other healthcare agencies. The cuts range from 2% to 5%, affecting various departments and organizations. There is already a shortage of primary care physicians in general, not including rural or underserved areas, with limited grants for advanced training. The sequestration cuts negatively impact the future of many primary care physicians and hinder the care many Americans will receive over time.

A Novel Assembly Line Balancing Method Based on PSO Algorithm

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Xiaomei Hu

2014-01-01

Full Text Available Assembly line is widely used in manufacturing system. Assembly line balancing problem is a crucial question during design and management of assembly lines since it directly affects the productivity of the whole manufacturing system. The model of assembly line balancing problem is put forward and a general optimization method is proposed. The key data on assembly line balancing problem is confirmed, and the precedence relations diagram is described. A double objective optimization model based on takt time and smoothness index is built, and balance optimization scheme based on PSO algorithm is proposed. Through the simulation experiments of examples, the feasibility and validity of the assembly line balancing method based on PSO algorithm is proved.

Impact on Medical Cost, Cumulative Survival, and Cost-Effectiveness of Adding Rituximab to First-Line Chemotherapy for Follicular Lymphoma in Elderly Patients: An Observational Cohort Study Based on SEER-Medicare

Directory of Open Access Journals (Sweden)

Robert I. Griffiths

2012-01-01

Full Text Available Rituximab improves survival in follicular lymphoma (FL, but is considerably more expensive than conventional chemotherapy. We estimated the total direct medical costs, cumulative survival, and cost-effectiveness of adding rituximab to first-line chemotherapy for FL, based on a single source of data representing routine practice in the elderly. Using surveillance, epidemiology, and end results (SEER registry data plus Medicare claims, we identified 1,117 FL patients who received first-line CHOP (cyclophosphamide (C, doxorubicin, vincristine (V, and prednisone (P or CVP +/− rituximab. Multivariate regression was used to estimate adjusted cumulative cost and survival differences between the two groups over four years after beginning treatment. The median age was 73 years (minimum 66 years, 56% had stage III-IV disease, and 67% received rituximab. Adding rituximab to first-line chemotherapy was associated with higher adjusted incremental total cost ($18,695; 95% Confidence Interval (CI $9,302–$28,643 and longer adjusted cumulative survival (0.18 years; 95% CI 0.10–0.27 over four years of followup. The expected cost-effectiveness was $102,142 (95% CI $34,531–296,337 per life-year gained. In routine clinical practice, adding rituximab to first-line chemotherapy for elderly patients with FL results in higher direct medical costs to Medicare and longer cumulative survival after four years.

An exploratory study on the elements that might affect medical students’ and residents’ responsibility during clinical training

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Asemani, Omid; Iman, Mohammad Taghi; Moattari, Marzieh; Tabei, Seyed Ziaadin; Sharif, Farkhondeh; Khayyer, Mohammad

2014-01-01

We are now more or less confronting a “challenge of responsibility” among both undergraduate and postgraduate medical students and some recent alumni from medical schools in Iran. This ethical problem calls for urgent etiologic and pathologic investigations into the problem itself and the issues involved. This study aimed to develop a thematic conceptual framework to study factors that might affect medical trainees’ (MTs) observance of responsibility during clinical training. A qualitative descriptive methodology involving fifteen in-depth semi-structured interviews was used to collect the data. Interviews were conducted with both undergraduate and postgraduate MTs as well as clinical experts and experienced nurses. Interviews were audio-recorded and then transcribed. The data was analyzed using thematic content analysis. The framework derived from the data included two main themes, namely “contextual conditions” and “intervening conditions”. Within each theme, participants recurrently described “individual” and “non-individual or system” based factors that played a role in medical trainees’ observance of responsibility. Overall, contextual conditions provide MTs with a “primary or basic responsibility” which is then transformed into a “secondary or observed responsibility” under the influence of intervening conditions. In conclusion three measures were demonstrated to be very important in enhancing Iranian MTs’ observance of responsibility: a) to make and implement stricter and more exact admission policies for medical colleges, b) to improve and revise the education system in its different dimensions such as management, structure, etc. based on regular and systematic evaluations, and c) to establish, apply and sustain higher standards throughout the educational environment. PMID:25512829

Developing a reproducible non-line-of-sight experimental setup for testing wireless medical device coexistence utilizing ZigBee.

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LaSorte, Nickolas J; Rajab, Samer A; Refai, Hazem H

2012-11-01

The integration of heterogeneous wireless technologies is believed to aid revolutionary healthcare delivery in hospitals and residential care. Wireless medical device coexistence is a growing concern given the ubiquity of wireless technology. In spite of this, a consensus standard that addresses risks associated with wireless heterogeneous networks has not been adopted. This paper serves as a starting point by recommending a practice for assessing the coexistence of a wireless medical device in a non-line-of-sight environment utilizing 802.15.4 in a practical, versatile, and reproducible test setup. This paper provides an extensive survey of other coexistence studies concerning 802.15.4 and 802.11 and reports on the authors' coexistence testing inside and outside an anechoic chamber. Results are compared against a non-line-of-sight test setup. Findings relative to co-channel and adjacent channel interference were consistent with results reported in the literature.

Factors affecting smartphone adoption for accessing information in medical settings.

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Tahamtan, Iman; Pajouhanfar, Sara; Sedghi, Shahram; Azad, Mohsen; Roudbari, Masoud

2017-06-01

This study aimed to acquire knowledge about the factors affecting smartphone adoption for accessing information in medical settings in Iranian Hospitals. A qualitative and quantitative approach was used to conduct this study. Semi-structured interviews were conducted with 21 medical residents and interns in 2013 to identify determinant factors for smartphone adoption. Afterwards, nine relationships were hypothesised. We developed a questionnaire to test these hypotheses and to evaluate the importance of each factor. Structural equation modelling was used to analyse the causal relations between model parameters and to accurately identify determinant factors. Eight factors were identified in the qualitative phase of the study, including perceived usefulness, perceived ease of use, training, internal environment, personal experience, social impacts, observability and job related characteristics. Among the studied factors, perceived usefulness, personal experience and job related characteristics were significantly associated with attitude to use a smartphone which accounted for 64% of the variance in attitude. Perceived usefulness had the strongest impact on attitude to use a smartphone. The factors that emerged from interviews were consistent with the Technology Acceptance Model (TAM) and some previous studies. TAM is a reliable model for understanding the factors of smartphone acceptance in medical settings. © 2017 Health Libraries Group.

The Impact of Bar Code Medication Administration Technology on Reported Medication Errors

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Holecek, Andrea

2011-01-01

The use of bar-code medication administration technology is on the rise in acute care facilities in the United States. The technology is purported to decrease medication errors that occur at the point of administration. How significantly this technology affects actual rate and severity of error is unknown. This descriptive, longitudinal research…

A Novel Assembly Line Scheduling Algorithm Based on CE-PSO

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Xiaomei Hu

2015-01-01

Full Text Available With the widespread application of assembly line in enterprises, assembly line scheduling is an important problem in the production since it directly affects the productivity of the whole manufacturing system. The mathematical model of assembly line scheduling problem is put forward and key data are confirmed. A double objective optimization model based on equipment utilization and delivery time loss is built, and optimization solution strategy is described. Based on the idea of solution strategy, assembly line scheduling algorithm based on CE-PSO is proposed to overcome the shortcomings of the standard PSO. Through the simulation experiments of two examples, the validity of the assembly line scheduling algorithm based on CE-PSO is proved.

Factors affecting UK medical students' decision to train in urology: a national survey.

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Jayakumar, Nithish; Ahmed, Kamran; Challacombe, Ben

2016-10-01

Our aim was to understand the specific factors which influence medical students' choice to train in urology, in order to attract the best and the brightest into the specialty during a challenging time for surgical training in the United Kingdom A cross-sectional web-based survey was generated to evaluate: 1) perceptions of urology; 2) attitudes about urology as a career; 3) exposure to urology at medical school; and 4) proficiency in common urological procedures. The survey was sent to all 33 medical schools in the UK and advertised to all medical students. The survey received 488 responses were received from 14 medical schools; 59.8% of respondents did not consider a career in urology. Factors affecting a career choice in urology included: 1) year of study; 2) male gender; 3) favorable perceptions of urology; 4) favorable attitudes about urology as a career; 5) more hours of urology teaching in preclinical years; 6) attendance at urology theatre sessions; 7) confidence in performing urological procedures; and 8) more attempts at male catheterization. The commonest reason for not considering urology was inadequate exposure to urology. Students in Year 3 were more likely to consider urology than final-year students, due to multifactorial reasons. Year of study is a novel factor affecting students' consideration of urology as a career. This paper clearly shows that early and sustained exposure to urology positively correlated with considering a career in urology. Urologists must be more active in promoting the specialty to medical students.

Factors affecting medication adherence in community-managed patients with hypertension based on the principal component analysis: evidence from Xinjiang, China.

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Zhang, Yuji; Li, Xiaoju; Mao, Lu; Zhang, Mei; Li, Ke; Zheng, Yinxia; Cui, Wangfei; Yin, Hongpo; He, Yanli; Jing, Mingxia

2018-01-01

The analysis of factors affecting the nonadherence to antihypertensive medications is important in the control of blood pressure among patients with hypertension. The purpose of this study was to assess the relationship between factors and medication adherence in Xinjiang community-managed patients with hypertension based on the principal component analysis. A total of 1,916 community-managed patients with hypertension, selected randomly through a multi-stage sampling, participated in the survey. Self-designed questionnaires were used to classify the participants as either adherent or nonadherent to their medication regimen. A principal component analysis was used in order to eliminate the correlation between factors. Factors related to nonadherence were analyzed by using a χ 2 -test and a binary logistic regression model. This study extracted nine common factors, with a cumulative variance contribution rate of 63.6%. Further analysis revealed that the following variables were significantly related to nonadherence: severity of disease, community management, diabetes, and taking traditional medications. Community management plays an important role in improving the patients' medication-taking behavior. Regular medication regimen instruction and better community management services through community-level have the potential to reduce nonadherence. Mild hypertensive patients should be monitored by community health care providers.

Relationship between academic performance and affective changes during the first year at medical school.

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Del-Ben, Cristina Marta; Machado, Vanessa Foresto; Madisson, Mariani Mendes; Resende, Tamara Lovatto; Valério, Fernando Passador; Troncon, Luiz Ernesto De Almeida

2013-05-01

Entering medical school may be associated with changes in the students' life, which can affect academic motivation and impair academic performance. This work aimed at measuring longitudinally academic motivation, anxiety, depression and social adjustment in first-year medical students and determining the relationships between these variables and academic performance, as measured mainly by grades on regular exams. Eighty-five first-year medical students (age: 17-25 years) were included after giving informed consent. Beck's Anxiety (BAI) and Beck's Depression (BDI) Inventories, the self-reported Social Adjustment Scale (SAS-SR) and the Academic Motivation Scale (AMS) were applied two months after admission and at the end of the academic year. BAI scores increased throughout the year (7.3 ± 6.6 versus 28.8 ± 6.7; p 0.10). SAS-SR subscales scores remained stable, except for a decreasing pattern for leisure/social life (1.8 ± 0.4 versus 2.1 ± 0.4; p motivation to know (22.2 ± 4.5 versus 19.7 ± 5.5; p academic performance and the global scores for any of the scales except for the SAS-SR subscale for academic life (r = -0.48, p academic year, first-year medical students showed increased anxiety, decreased academic motivation and a maladjusted leisure/social life, which however does not seem to affect academic achievement.

A Medical Student Perspective on Physician-Assisted Suicide.

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Rhee, John Y; Callaghan, Katharine A; Allen, Philip; Stahl, Amanda; Brown, Martin T; Tsoi, Alexandra; McInerney, Grace; Dumitru, Ana-Maria G

2017-09-01

Physician-assisted suicide and euthanasia (PAS/E) has been increasingly discussed and debated in the public arena, including in professional medical organizations. However, the medical student perspective on the debate has essentially been absent. We present a medical student perspective on the PAS/E debate as future doctors and those about to enter the profession. We argue that PAS/E is not in line with the core principles of medicine and that the focus should be rather on providing high-quality end-of-life and palliative care. Copyright © 2017 American College of Chest Physicians. Published by Elsevier Inc. All rights reserved.

Package Design Affects Accuracy Recognition for Medications.

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Endestad, Tor; Wortinger, Laura A; Madsen, Steinar; Hortemo, Sigurd

2016-12-01

Our aim was to test if highlighting and placement of substance name on medication package have the potential to reduce patient errors. An unintentional overdose of medication is a large health issue that might be linked to medication package design. In two experiments, placement, background color, and the active ingredient of generic medication packages were manipulated according to best human factors guidelines to reduce causes of labeling-related patient errors. In two experiments, we compared the original packaging with packages where we varied placement of the name, dose, and background of the active ingredient. Age-relevant differences and the effect of color on medication recognition error were tested. In Experiment 1, 59 volunteers (30 elderly and 29 young students), participated. In Experiment 2, 25 volunteers participated. The most common error was the inability to identify that two different packages contained the same active ingredient (young, 41%, and elderly, 68%). This kind of error decreased with the redesigned packages (young, 8%, and elderly, 16%). Confusion errors related to color design were reduced by two thirds in the redesigned packages compared with original generic medications. Prominent placement of substance name and dose with a band of high-contrast color support recognition of the active substance in medications. A simple modification including highlighting and placing the name of the active ingredient in the upper right-hand corner of the package helps users realize that two different packages can contain the same active substance, thus reducing the risk of inadvertent medication overdose. © 2016, Human Factors and Ergonomics Society.

Team Regulation in a Simulated Medical Emergency: An In-Depth Analysis of Cognitive, Metacognitive, and Affective Processes

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Duffy, Melissa C.; Azevedo, Roger; Sun, Ning-Zi; Griscom, Sophia E.; Stead, Victoria; Crelinsten, Linda; Wiseman, Jeffrey; Maniatis, Thomas; Lachapelle, Kevin

2015-01-01

This study examined the nature of cognitive, metacognitive, and affective processes among a medical team experiencing difficulty managing a challenging simulated medical emergency case by conducting in-depth analysis of process data. Medical residents participated in a simulation exercise designed to help trainees to develop medical expertise,…

Words That Fascinate the Listener: Predicting Affective Ratings of On-Line Lectures

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Weninger, Felix; Staudt, Pascal; Schuller, Björn

2013-01-01

In a large scale study on 843 transcripts of Technology, Entertainment and Design (TED) talks, the authors address the relation between word usage and categorical affective ratings of lectures by a large group of internet users. Users rated the lectures by assigning one or more predefined tags which relate to the affective state evoked in the…

Non-medical influences on medical decision-making.

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McKinlay, J B; Potter, D A; Feldman, H A

1996-03-01

The influence of non-medical factors on physicians' decision-making has been documented in many observational studies, but rarely in an experimental setting capable of demonstrating cause and effect. We conducted a controlled factorial experiment to assess the influence of non-medical factors on the diagnostic and treatment decisions made by practitioners of internal medicine in two common medical situations. One hundred and ninety-two white male internists individually viewed professionally produced video scenarios in which the actor-patient, presenting with either chest pain or dyspnea, possessed various balanced combinations of sex, race, age, socioeconomic status, and health insurance coverage. Physician subjects were randomly drawn from lists of internists in private practice, hospital-based practice, and HMO's, at two levels of experience. The most frequent diagnoses for both chest pain and dyspnea were psychogenic origin and cardiac problems. Smoking cessation was the most frequent treatment recommendation for both conditions. Younger patients (all other factors being the same) were significantly more likely to receive the psychogenic diagnosis. Older patients were more likely to receive the cardiac diagnosis for chest pain, particularly if they were insured. HMO-based physicians were more likely to recommend a follow-up visit for chest pain. Several interactions of patient and physician factors were significant in addition to the main effects. The variability in decision-making evidenced by physicians in this experiment was not entirely accounted for by strictly rational Bayesian inference (the common prescriptive model for medical decision-making), in-as-much as non-medical factors significantly affected the decisions that they made. There is a need to supplement idealized medical schemata with considerations of social behavior in any comprehensive theory of medical decision-making.

The performance of select universities of medical sciences based on the components affecting medical education [version 1; referees: 2 approved

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Mehdi Tayebi Arasteh

2018-03-01

Full Text Available Background: Every educational institution requires an evaluation system in order to find out about the quality and desirability of its activities, especially if it is a complex and dynamic environment. The present study was conducted to evaluate the educational performance of schools affiliated to Alborz University of Medical Sciences to help improve their performance. Methods: This descriptive analytical study was conducted in six schools affiliated to Alborz University of Medical Sciences in April 2016-October 2016 and October 2016-April 2017. The evaluation was carried out in two stages: self-assessment by service executives across schools, and external assessment in person by the university’s expert staff. The study tools included the components, criteria and desirable standards of educational performance in ten categories. Data were analyzed in SPSS. Results: The results obtained showed that, in April-October 2016, the highest performance evaluation scores pertained to the "secure testing" and "rules and regulations" components and the lowest to the "packages for reform and innovation in education" and "the school action plan" components. In October 2016-April 2017, the highest scores pertained to "workforce empowerment" and "secure testing" and the lowest to "faculty affairs" and "electronic education management system". Conclusions: Offering a balanced portrayal of the actual performance of schools using the right performance indicators in two consecutive periods can help further motivate the superior schools and encourage the weaker schools to strive harder. Competition among schools to get a higher score in the components affecting medical education helps mobilize them to move toward reform and improvement.

Does an offer for a free on-line continuing medical education (CME) activity increase physician survey response rate? A randomized trial.

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Viera, Anthony J; Edwards, Teresa

2012-03-07

Achieving a high response rate in a physician survey is challenging. Monetary incentives increase response rates but obviously add cost to a survey project. We wondered whether an offer of a free continuing medical education (CME) activity would be effective in improving survey response rate. As part of a survey of a national sample of physicians, we randomized half to an offer for a free on-line CME activity upon completion of a web-based survey and the other half to no such offer. We compared response rates between the groups. A total of 1214 out of 8477 potentially eligible physicians responded to our survey, for an overall response rate of 14.3%. The response rate among the control group (no offer of CME credit) was 16.6%, while among those offered the CME opportunity, the response rate was 12.0% (p offer for a free on-line CME activity did not improve physician survey response rate. On the contrary, the offer for a free CME activity actually appeared to worsen the response rate. © 2011 Viera et al; licensee BioMed Central Ltd.

Does direct-to-consumer advertising affect patients' choice of pain medications?

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Liu, Yifei; Doucette, William R

2008-04-01

In the United States, direct-to-consumer advertising (DTCA) has grown rapidly to promote prescription medications, including analgesics. Few studies in the literature directly examine the association between DTCA and patients' choice of pain medications. This article discusses how DTCA affects such choice from a behavioral perspective, because DTCA-prompted behaviors are important indicators of DTCA's influence. After DTCA exposure, patients may request prescriptions, seek further medication information, and ask about advertised conditions. Patients who suffer from pain may seek more communication with their health care providers because they are cautious about the information quality of DTCA, mainly because of the recall of rofecoxib (Vioxx; Merck, Whitehouse Station, NJ). However, the availability and DTCA of over-the-counter analgesics complicate their treatment choice. Patients could use DTCA as a tool to launch health communication and make an informed treatment choice with the guidance of their health care providers.

Nephrologic Impact of Hurricanes Katrina and Rita in Areas Not Directly Affected.

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Dossabhoy, Neville R; Qadri, Mashood; Beal, Lauren M

2015-01-01

Hurricanes Katrina and Rita resulted in enormous loss of life and disrupted the delivery of health care in areas affected by them. In causing mass movements of patients, natural disasters can overwhelm the resources of nephrology communities in areas not suffering direct damage. The following largely personal account evaluates the impact these hurricanes had upon the nephrology community, patients and health care providers alike, in areas not directly affected by the storms. Mass evacuation of hundreds of dialysis patients to surrounding areas overwhelmed the capacity of local hemodialysis centers. Non-availability of medical records in patients arriving without a supply of their routine medications led to confusion and sub-optimal treatment of conditions such as hypertension and congestive heart failure. Availability of cadaveric organs for transplantation was reduced in the surrounding areas, as the usual lines of communication and transportation were severed for several weeks. All of these issues led to prolong waiting times for patients on the transplant list. The hurricanes severely disrupted usual supply lines of medications to hospitals; certain rare conditions may be seen in higher numbers as a result of the shortages induced. We present the interesting surge in cases of acute kidney injury secondary to use of intravenous immune globulin.

Death, dying and informatics: misrepresenting religion on MedLine.

Science.gov (United States)

Rodríguez Del Pozo, Pablo; Fins, Joseph J

2005-07-01

The globalization of medical science carries for doctors worldwide a correlative duty to deepen their understanding of patients' cultural contexts and religious backgrounds, in order to satisfy each as a unique individual. To become better informed, practitioners may turn to MedLine, but it is unclear whether the information found there is an accurate representation of culture and religion. To test MedLine's representation of this field, we chose the topic of death and dying in the three major monotheistic religions. We searched MedLine using PubMed in order to retrieve and thematically analyze full-length scholarly journal papers or case reports dealing with religious traditions and end-of-life care. Our search consisted of a string of words that included the most common denominations of the three religions, the standard heading terms used by the National Reference Center for Bioethics Literature (NRCBL), and the Medical Subject Headings (MeSH) used by the National Library of Medicine. Eligible articles were limited to English-language papers with an abstract. We found that while a bibliographic search in MedLine on this topic produced instant results and some valuable literature, the aggregate reflected a selection bias. American writers were over-represented given the global prevalence of these religious traditions. Denominationally affiliated authors predominated in representing the Christian traditions. The Islamic tradition was under-represented. MedLine's capability to identify the most current, reliable and accurate information about purely scientific topics should not be assumed to be the same case when considering the interface of religion, culture and end-of-life care.

Influence of Course in Medical Ethics and Law on Career Plans of Medical Students

Science.gov (United States)

Cheng, Shi-Yann; Lin, Lih-Hwa; Kao, Chung-Han; Chan, Tzu-Min

2015-01-01

Background: The significant increase in medical disputes and lawsuits in recent years in Taiwan has severely affected behavior and ecology in medical practice. For this reason, we designed integrated courses on ethics and law and conducted a questionnaire-based career plan study to understand whether these issues influence their specialty…

Factors affecting medication adherence in community-managed patients with hypertension based on the principal component analysis: evidence from Xinjiang, China

Directory of Open Access Journals (Sweden)

Zhang YJ

2018-05-01

Full Text Available Yuji Zhang,* Xiaoju Li,* Lu Mao, Mei Zhang, Ke Li, Yinxia Zheng, Wangfei Cui, Hongpo Yin, Yanli He, Mingxia Jing Department of Public Health, Shihezi University School of Medicine, Shihezi, Xinjiang, China *These authors contributed equally to this work Purpose: The analysis of factors affecting the nonadherence to antihypertensive medications is important in the control of blood pressure among patients with hypertension. The purpose of this study was to assess the relationship between factors and medication adherence in Xinjiang community-managed patients with hypertension based on the principal component analysis.Patients and methods: A total of 1,916 community-managed patients with hypertension, selected randomly through a multi-stage sampling, participated in the survey. Self-designed questionnaires were used to classify the participants as either adherent or nonadherent to their medication regimen. A principal component analysis was used in order to eliminate the correlation between factors. Factors related to nonadherence were analyzed by using a χ2-test and a binary logistic regression model.Results: This study extracted nine common factors, with a cumulative variance contribution rate of 63.6%. Further analysis revealed that the following variables were significantly related to nonadherence: severity of disease, community management, diabetes, and taking traditional medications.Conclusion: Community management plays an important role in improving the patients’ medication-taking behavior. Regular medication regimen instruction and better community management services through community-level have the potential to reduce nonadherence. Mild hypertensive patients should be monitored by community health care providers. Keywords: hypertension, medication adherence, factors, principal component analysis, community management, China

Factors Affecting the Use of Indigenous Publications by Medical and Dental Students in Nigerian Universities

OpenAIRE

Ahiaoma Ibegwam; Oshiotse Andrew Okwilagwe

2012-01-01

This study examined the indigenous medical publications used by medical and dental students in Nigeria with a view to discovering factors that affects their usage. Data was gathered through a questionnaire survey. The population of the study was 1,264 undergraduate medical and dental students from ten universities in all the geopolitical zones of Nigeria. Data gathered was analysed using SPSS to obtain the summaries of the variables in form of frequency distribution and other descriptive stat...

The influence of achievement before, during and after medical school on physician job satisfaction.

Science.gov (United States)

Schmit Jongbloed, Lodewijk J; Schönrock-Adema, Johanna; Borleffs, Jan C C; Stewart, Roy E; Cohen-Schotanus, Janke

2014-10-01

In this longitudinal study, we investigated the relationship between physicians' prior achievements (before, during and after medical school) and job satisfaction, and tested the two lines of reasoning that prior achievements influence job satisfaction positively or negatively, respectively. The participants were graduates who started their medical training in 1982 (n = 147), 1983 (n = 154), 1992 (n = 143) and 1993 (n = 153). We operationalised job satisfaction as satisfaction (on a 10-point scale) with 13 cognitive, affective and instrumental aspects of the participants' jobs. The measures of achievement before, during and after medical school included pre-university grade point average, study progress and a residency position in the specialty of first choice, respectively. We included the effect of curriculum type (problem-based learning versus traditional), gender and years of experience as moderator variables. Higher achievers before and during medical school were more satisfied about their income (β = .152, p job satisfaction. The direction of the influences depended on the job satisfaction aspect in question, which indicates that it is important to distinguish between aspects of job satisfaction. To optimize job satisfaction of high achievers, it is important for graduates to obtain their preferred specialty. Furthermore, it is vital to provide them with enough opportunities for further development.

Death, dying and informatics: misrepresenting religion on MedLine

Directory of Open Access Journals (Sweden)

Fins Joseph J

2005-07-01

Full Text Available Abstract Background The globalization of medical science carries for doctors worldwide a correlative duty to deepen their understanding of patients' cultural contexts and religious backgrounds, in order to satisfy each as a unique individual. To become better informed, practitioners may turn to MedLine, but it is unclear whether the information found there is an accurate representation of culture and religion. To test MedLine's representation of this field, we chose the topic of death and dying in the three major monotheistic religions. Methods We searched MedLine using PubMed in order to retrieve and thematically analyze full-length scholarly journal papers or case reports dealing with religious traditions and end-of-life care. Our search consisted of a string of words that included the most common denominations of the three religions, the standard heading terms used by the National Reference Center for Bioethics Literature (NRCBL, and the Medical Subject Headings (MeSH used by the National Library of Medicine. Eligible articles were limited to English-language papers with an abstract. Results We found that while a bibliographic search in MedLine on this topic produced instant results and some valuable literature, the aggregate reflected a selection bias. American writers were over-represented given the global prevalence of these religious traditions. Denominationally affiliated authors predominated in representing the Christian traditions. The Islamic tradition was under-represented. Conclusion MedLine's capability to identify the most current, reliable and accurate information about purely scientific topics should not be assumed to be the same case when considering the interface of religion, culture and end-of-life care.

LINE FUSION GENES: a database of LINE expression in human genes

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Park Hong-Seog

2006-06-01

Full Text Available Abstract Background Long Interspersed Nuclear Elements (LINEs are the most abundant retrotransposons in humans. About 79% of human genes are estimated to contain at least one segment of LINE per transcription unit. Recent studies have shown that LINE elements can affect protein sequences, splicing patterns and expression of human genes. Description We have developed a database, LINE FUSION GENES, for elucidating LINE expression throughout the human gene database. We searched the 28,171 genes listed in the NCBI database for LINE elements and analyzed their structures and expression patterns. The results show that the mRNA sequences of 1,329 genes were affected by LINE expression. The LINE expression types were classified on the basis of LINEs in the 5' UTR, exon or 3' UTR sequences of the mRNAs. Our database provides further information, such as the tissue distribution and chromosomal location of the genes, and the domain structure that is changed by LINE integration. We have linked all the accession numbers to the NCBI data bank to provide mRNA sequences for subsequent users. Conclusion We believe that our work will interest genome scientists and might help them to gain insight into the implications of LINE expression for human evolution and disease. Availability http://www.primate.or.kr/line

Study of sleep habits and sleep problems among medical students of pravara institute of medical sciences loni, Western maharashtra, India.

Science.gov (United States)

Giri, Pa; Baviskar, Mp; Phalke, Db

2013-01-01

Good quality sleep and adequate amount of sleep are important in order to have better cognitive performance and avoid health problems and psychiatric disorders. The aim of this study was to describe sleep habits and sleep problems in a population of undergraduates, interns and postgraduate students of Pravara Institute of Medical Sciences (Deemed University), Loni, Maharashtra, India. Sleep habits and problems were investigated using a convenience sample of students from Pravara Institute of Medical Sciences (Deemed University), Loni, Maharashtra, India. The study was carried out during Oct. to Dec. 2011 with population consisted of total 150 medical students. A self-administered questionnaire developed based on Epworth Daytime Sleepiness Scale and Pittsburgh Sleep Quality Index was used. Data was analyzed by using Statistical Package of Social Sciences (SPSS) version 16.0. In this study, out of 150 medical students, 26/150 (17.3%) students had abnormal levels of daytime sleepiness while 20/150 (13.3%) were border line. Sleep quality in females was better than the male. Disorders related to poor sleep qualities are significant problems among medical students in our institution. Caffeine and alcohol ingestion affected sleep and there was high level of daytime sleepiness. Sleep difficulties resulted in irritability and affected lifestyle and interpersonal relationships.

On-line monitoring system for I-131 manufacturing labs

International Nuclear Information System (INIS)

Osovizky, A.; Malamud, Y.; Paran, Y.; Tal, N.; Turgeman, S.; Weinstein, M.

1997-01-01

An on-line monitoring and safety system has been installed in a lab for manufacturing 1-131 capsules for nuclear medicine use. Production of up to 100mCi batches is performed in shielded glove boxes. The safety system is based on a unique, 'Medi SMARTS' system (Medical Survey Mapping Automatic Radiation Tracing System), that collects continuously the radiation measurements for processing, display, and storage for future retrieval. Radiation is measured by GM tubes, data is transferred to a data processing unit, and then via a RS-485 communication line to a computer. In addition to the operational advantages and radiation levels storage, the system is being evaluated for the purpose of identifying risky stages in the process. (authors)

User Assessment of "InsuOnLine," a Game to Fight Clinical Inertia in Diabetes: A Pilot Study.

Science.gov (United States)

Diehl, Leandro Arthur; de Souza, Rodrigo Martins; Gordan, Pedro Alejandro; Esteves, Roberto Zonato; Coelho, Izabel Cristina Meister

2015-10-01

We performed a pilot study to assess usability and playability of "InsuOnLine," a serious game for education of primary care physicians on insulin therapy for diabetes mellitus. A multidisciplinary team has designed and developed "InsuOnLine," using Andragogy and Problem-Based Learning principles, with game elements to improve players' motivation. The prototype was tested by four medical doctors and two medical students, using the System Usability Scale (SUS) and a questionnaire to assess playability. These results were used to guide corrections, after which the beta version was retested by 14 medical students and 6 residents. Out of a maximum score of 100 on the SUS, the "InsuOnLine" prototype was rated 88, and some areas for improvement were identified (game instructions, controls). After corrections, the beta version was rated 92.5 on the SUS. Users have found the beta version to be fun, engaging, challenging, relevant, and realistic. Users said that the game has increased their knowledge on diabetes and insulin, that it has made them feel more confident for prescribing insulin, and that it would have impact on how they treated patients with diabetes. Most users said they have learned more from the game than they would have from a lecture. Lessons learned were the need of early piloting, preferably by users with very little or very much gaming experience, on their own computers and free patterns of use. "InsuOnLine" was rated by users as easy to play, fun, and useful for learning. Further studies will assess its educational effectiveness. "InsuOnLine" is a promising tool for large-scale continuing medical education on insulin, helping to fight clinical inertia in diabetes.

Survey of preventable disaster death at medical institutions in areas affected by the Great East Japan Earthquake: a retrospective preliminary investigation of medical institutions in Miyagi Prefecture.

Science.gov (United States)

Yamanouchi, Satoshi; Sasaki, Hiroyuki; Tsuruwa, Miho; Ueki, Yuzuru; Kohayagawa, Yoshitaka; Kondo, Hisayoshi; Otomo, Yasuhiro; Koido, Yuichi; Kushimoto, Shigeki

2015-04-01

The 2011, magnitude (M) 9, Great East Japan Earthquake and massive tsunami caused widespread devastation and left approximately 18,500 people dead or missing. The incidence of preventable disaster death (PDD) during the Great East Japan Earthquake remains to be clarified; the present study investigated PDD at medical institutions in areas affected by the Great East Japan Earthquake in order to improve disaster medical systems. A total of 25 hospitals in Miyagi Prefecture (Japan) that were disaster base hospitals (DBHs), or had at least 20 patient deaths between March 11, 2011 and April 1, 2011, were selected to participate based on the results of a previous study. A database was created using the medical records of all patient deaths (n=868), and PDD was determined from discussion with 10 disaster health care professionals. A total of 102 cases of PDD were identified at the participating hospitals. The rate of PDD was higher at coastal hospitals compared to inland hospitals (62/327, 19.0% vs 40/541, 7.4%; Pdeath at medical institutions in areas affected by the Great East Japan Earthquake occurred mainly at coastal hospitals. Insufficient resources (at GHs), environmental factors (at coastal hospitals), and delayed medical intervention (at all hospitals) constituted the major potential contributing factors. Further investigation of all medical institutions in Miyagi Prefecture, including those with fewer than 20 patient deaths, is required in order to obtain a complete picture of the details of PDD at medical institutions in the disaster area.

[Burnout effect on academic progress of Oncology medical residents].

Science.gov (United States)

González-Ávila, Gabriel; Bello-Villalobos, Herlinda

2014-01-01

In the formative period of the courses taken in medical specializations, new and greater responsibilities are accepted by physicians in personal and academic spheres. The interaction of several factors that encompass the practice of these physicians could surpass their capacity to cope, causing on these professionals a high level of stress and professional exhaustion, which will affect their academic development. The objective of this research was to establish if the occupational stress of these medical residents affects their academic progress. We administered the Spanish version of the Maslach Burnout Inventory (MBI) to 52 residents of three specializations in Oncology (Medical Oncology, Surgical Oncology, and Radio-Oncology). These residents accepted voluntarily at the same time of their third cognitive exam. The prevalence of burnout syndrome was 13.5 %, with a high frequency among medical residents of first degree. Medical Oncology residents showed a higher emotional exhaustion and lower personal fulfillment. Considering the three specializations, the academic progress was higher in the third year, with a significant difference to Surgical Oncology and Medical Oncology (p = 0.026 and 0.015, respectively). No significant difference was found between burnout syndrome, academic progress and sociodemographic characteristics. The presence of burnout syndrome does not affect the academic progress of Oncology medical residents.

Rewiring carbohydrate catabolism differentially affects survival of pancreatic cancer cell lines with diverse metabolic profiles

Science.gov (United States)

Tataranni, Tiziana; Agriesti, Francesca; Ruggieri, Vitalba; Mazzoccoli, Carmela; Simeon, Vittorio; Laurenzana, Ilaria; Scrima, Rosella; Pazienza, Valerio; Capitanio, Nazzareno; Piccoli, Claudia

2017-01-01

An increasing body of evidence suggests that targeting cellular metabolism represents a promising effective approach to treat pancreatic cancer, overcome chemoresistance and ameliorate patient's prognosis and survival. In this study, following whole-genome expression analysis, we selected two pancreatic cancer cell lines, PANC-1 and BXPC-3, hallmarked by distinct metabolic profiles with specific concern to carbohydrate metabolism. Functional comparative analysis showed that BXPC-3 displayed a marked deficit of the mitochondrial respiratory and oxidative phosphorylation activity and a higher production of reactive oxygen species and a reduced NAD+/NADH ratio, indicating their bioenergetic reliance on glycolysis and a different redox homeostasis as compared to PANC-1. Both cell lines were challenged to rewire their metabolism by substituting glucose with galactose as carbon source, a condition inhibiting the glycolytic flux and fostering full oxidation of the sugar carbons. The obtained data strikingly show that the mitochondrial respiration-impaired-BXPC-3 cell line was unable to sustain the metabolic adaptation required by glucose deprivation/substitution, thereby resulting in a G2\\M cell cycle shift, unbalance of the redox homeostasis, apoptosis induction. Conversely, the mitochondrial respiration-competent-PANC-1 cell line did not show clear evidence of cell sufferance. Our findings provide a strong rationale to candidate metabolism as a promising target for cancer therapy. Defining the metabolic features at time of pancreatic cancer diagnosis and likely of other tumors, appears to be crucial to predict the responsiveness to therapeutic approaches or coadjuvant interventions affecting metabolism. PMID:28476035

[Medical equipment product lines in basic pharmacies].

Science.gov (United States)

Macesková, B; Lipská, J

2003-07-01

Medical appliances dispensed in basic type pharmacies for cash or vouchers for medical or orthopedic appliances require expertise of pharmacists and laboratory assistants concerning the assortment, payment, construction of prices, conditions for prescription, ordering, properties, and functions of individual appliances. Using the method of frequency analysis, the analysis of data from five pharmacies within a period of three months (more than 17,000 records) revealed how individual subgroups of medical appliances and their concrete items are represented in both types of dispensation. The method of the semistructured questionnaire (10 respondents) was used to find what problems are encountered in dispensation, and which medical appliances and their subgroups are the sources of the problems. The respondents regard the contemporary level of knowledge concerning medical appliances gained in pregradual studies as insufficient.

Treatment of hepatic encephalopathy by on-line hemodiafiltration: a case series study

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Sugiyama Mitsugi

2010-05-01

Full Text Available Abstract Background It is thought that a good survival rate of patients with acute liver failure can be achieved by establishing an artificial liver support system that reliably compensates liver function until the liver regenerates or a patient undergoes transplantation. We introduced a new artificial liver support system, on-line hemodiafiltration, in patients with acute liver failure. Methods This case series study was conducted from May 2001 to October 2008 at the medical intensive care unit of a tertiary care academic medical center. Seventeen consecutive patients who admitted to our hospital presenting with acute liver failure were treated with artificial liver support including daily on-line hemodiafiltration and plasma exchange. Results After 4.9 ± 0.7 (mean ± SD on-line hemodiafiltration sessions, 16 of 17 (94.1% patients completely recovered from hepatic encephalopathy and maintained consciousness for 16.4 ± 3.4 (7-55 days until discontinuation of artificial liver support (a total of 14.4 ± 2.6 [6-47] on-line hemodiafiltration sessions. Significant correlation was observed between the degree of encephalopathy and number of sessions of on-line HDF required for recovery of consciousness. Of the 16 patients who recovered consciousness, 7 fully recovered and returned to society with no cognitive sequelae, 3 died of complications of acute liver failure except brain edema, and the remaining 6 were candidates for liver transplantation; 2 of them received living-related liver transplantation but 4 died without transplantation after discontinuation of therapy. Conclusions On-line hemodiafiltration was effective in patients with acute liver failure, and consciousness was maintained for the duration of artificial liver support, even in those in whom it was considered that hepatic function was completely abolished.

An image overall complexity evaluation method based on LSD line detection

Science.gov (United States)

Li, Jianan; Duan, Jin; Yang, Xu; Xiao, Bo

2017-04-01

In the artificial world, whether it is the city's traffic roads or engineering buildings contain a lot of linear features. Therefore, the research on the image complexity of linear information has become an important research direction in digital image processing field. This paper, by detecting the straight line information in the image and using the straight line as the parameter index, establishing the quantitative and accurate mathematics relationship. In this paper, we use LSD line detection algorithm which has good straight-line detection effect to detect the straight line, and divide the detected line by the expert consultation strategy. Then we use the neural network to carry on the weight training and get the weight coefficient of the index. The image complexity is calculated by the complexity calculation model. The experimental results show that the proposed method is effective. The number of straight lines in the image, the degree of dispersion, uniformity and so on will affect the complexity of the image.

From Off-line to On-line Handwriting Recognition

NARCIS (Netherlands)

Lallican, P.; Viard-Gaudin, C.; Knerr, S.

2004-01-01

On-line handwriting includes more information on time order of the writing signal and on the dynamics of the writing process than off-line handwriting. Therefore, on-line recognition systems achieve higher recognition rates. This can be concluded from results reported in the literature, and has been

Inhibition of mutant IDH1 decreases D-2-HG levels without affecting tumorigenic properties of chondrosarcoma cell lines.

Science.gov (United States)

Suijker, Johnny; Oosting, Jan; Koornneef, Annemarie; Struys, Eduard A; Salomons, Gajja S; Schaap, Frank G; Waaijer, Cathelijn J F; Wijers-Koster, Pauline M; Briaire-de Bruijn, Inge H; Haazen, Lizette; Riester, Scott M; Dudakovic, Amel; Danen, Erik; Cleton-Jansen, Anne-Marie; van Wijnen, Andre J; Bovée, Judith V M G

2015-05-20

Mutations in isocitrate dehydrogenase 1 (IDH1) and IDH2 are found in a subset of benign and malignant cartilage tumors, gliomas and leukaemias. The mutant enzyme causes the production of D-2-hydroxyglutarate (D-2-HG), affecting CpG island and histone methylation. While mutations in IDH1/2 are early events in benign cartilage tumors, we evaluated whether these mutations play a role in malignant chondrosarcomas. Compared to IDH1/2 wildtype cell lines, chondrosarcoma cell lines harboring an endogenous IDH1 (n=3) or IDH2 mutation (n=2) showed up to a 100-fold increase in intracellular and extracellular D-2-HG levels. Specific inhibition of mutant IDH1 using AGI-5198 decreased levels of D-2-HG in a dose dependent manner. After 72 hours of treatment one out of three mutant IDH1 cell lines showed a moderate decrease in viability , while D-2-HG levels decreased >90%. Likewise, prolonged treatment (up to 20 passages) did not affect proliferation and migration. Furthermore, global gene expression, CpG island methylation as well as histone H3K4, -9, and -27 trimethylation levels remained unchanged. Thus, while IDH1/2 mutations cause enchondroma, malignant progression towards central chondrosarcoma renders chondrosarcoma growth independent of these mutations. Thus, monotherapy based on inhibition of mutant IDH1 appears insufficient for treatment of inoperable or metastasized chondrosarcoma patients.

Metastatic non-small-cell lung cancer: consensus on pathology and molecular tests, first-line, second-line, and third-line therapy: 1st ESMO Consensus Conference in Lung Cancer; Lugano 2010

DEFF Research Database (Denmark)

Felip, E; Gridelli, C; Baas, P

2011-01-01

the conference, the expert panel prepared clinically relevant questions concerning five areas: early and locally advanced non-small-cell lung cancer (NSCLC), first-line metastatic NSCLC, second-/third-line NSCLC, NSCLC pathology and molecular testing, and small-cell lung cancer to be addressed through discussion......The 1st ESMO Consensus Conference on lung cancer was held in Lugano, Switzerland on 21 and 22 May 2010 with the participation of a multidisciplinary panel of leading professionals in pathology and molecular diagnostics, medical oncology, surgical oncology and radiation oncology. Before...... at the Consensus Conference. All relevant scientific literature for each question was reviewed in advance. During the Consensus Conference, the panel developed recommendations for each specific question. The consensus agreement on three of these areas: NSCLC pathology and molecular testing, the treatment of first-line...

Second-line failure and first experience with third-line antiretroviral therapy in Mumbai, India

Directory of Open Access Journals (Sweden)

Samsuddin Khan

2014-07-01

Full Text Available Background: There are limited data on the failure of second-line antiretroviral therapy (ART and the use of third-line ART in people living with HIV in resource-limited settings. Since 2011, the Médecins Sans Frontières (MSF HIV/tuberculosis programme in Mumbai, India, has been providing third-line ART to patients in care. Objective: To describe the experiences and programmatic challenges during management of suspected second-line ART failure and third-line ART therapy for patients living with HIV, including the use of HIV viral load (VL testing. Design: This was a retrospective, observational cohort study of patients with suspected second-line ART treatment failure, who were followed for at least 12 months between January 2011 and March 2014. Results: A total of 47 patients with suspected second-line failure met the inclusion criteria during the study period. Twenty-nine of them (62% responded to enhanced adherence support, had a subsequent undetectable VL after a median duration of 3 months and remained on second-line ART. The other 18 patients had to be initiated on a third-line ART regimen, which consisted of darunavir–ritonavir, raltegravir, and one or more appropriate nucleoside or nucleotide reverse transcriptase inhibitors, based on the results of HIV genotype testing. Of the 13 patients for whom follow-up VL results were available, 11 achieved virological suppression after a median duration of 3 months on third-line ART (interquartile range: 2.5–3.0. No serious treatment-related adverse events were recorded. Conclusions: With intensive counselling and adherence support in those suspected of failing second-line ART, unnecessary switching to more expensive third-line ART can be averted in the majority of cases. However, there is an increasing need for access to third-line ART medications such as darunavir and raltegravir, for which national ART programmes should be prepared. The cost of such medications and inadequate access to VL

Opioid and nicotine receptors affect growth regulation of human lung cancer cell lines

International Nuclear Information System (INIS)

Maneckjee, R.; Minna, J.D.

1990-01-01

Using specific radioactively-labeled ligands, the authors find that lung cancer cell lines of diverse histologic types express multiple, high-affinity membrane receptors for μ, δ, and κ opioid agonists and for nicotine and α-bungarotoxin. These receptors are biologically active because cAMP levels decreased in lung cancer cells after opioid and nicotine application. Nicotine at concentrations found in the blood of smokers had no effect on in vitro lung cancer cell growth, whereas μ, δ, and κ opioid agonists at low concentrations inhibited lung cancer growth in vitro. They also found that lung cancer cells expressed various combinations of immunoreactive opioid peptides (β-endorphin, enkephalin, or dynorphin), suggesting the participation of opioids in a negative autocrine loop or tumor-suppressing system. Due to the almost universal exposure of patients with lung cancer to nicotine, they tested whether nicotine affected the response of lung cancer cell growth to opioids and found that nicotine at concentrations of 100-200 nM partially or totally reversed opioid-induced growth inhibition in 9/14 lung cancer cell lines. These in vitro results for lung cancer cells suggest that opioids could function as part of a tumor suppressor system and that nicotine can function to circumvent this system in the pathogenesis of lung cancer

Opioid and nicotine receptors affect growth regulation of human lung cancer cell lines

Energy Technology Data Exchange (ETDEWEB)

Maneckjee, R.; Minna, J.D. (National Cancer Institute-Navy Medical Oncology Branch, Bethesda, MD (USA) Uniformed Services Univ. of the Health Sciences, Bethesda, MD (USA))

1990-05-01

Using specific radioactively-labeled ligands, the authors find that lung cancer cell lines of diverse histologic types express multiple, high-affinity membrane receptors for {mu}, {delta}, and {kappa} opioid agonists and for nicotine and {alpha}-bungarotoxin. These receptors are biologically active because cAMP levels decreased in lung cancer cells after opioid and nicotine application. Nicotine at concentrations found in the blood of smokers had no effect on in vitro lung cancer cell growth, whereas {mu}, {delta}, and {kappa} opioid agonists at low concentrations inhibited lung cancer growth in vitro. They also found that lung cancer cells expressed various combinations of immunoreactive opioid peptides ({beta}-endorphin, enkephalin, or dynorphin), suggesting the participation of opioids in a negative autocrine loop or tumor-suppressing system. Due to the almost universal exposure of patients with lung cancer to nicotine, they tested whether nicotine affected the response of lung cancer cell growth to opioids and found that nicotine at concentrations of 100-200 nM partially or totally reversed opioid-induced growth inhibition in 9/14 lung cancer cell lines. These in vitro results for lung cancer cells suggest that opioids could function as part of a tumor suppressor system and that nicotine can function to circumvent this system in the pathogenesis of lung cancer.

How do gloves affect cutaneous sensibility in medical practice? Two new applied tests.

Science.gov (United States)

Mylon, Peter; Carré, Matt J; Martin, Nicolas; Lewis, Roger

2017-01-01

In order to quantify the effect of medical gloves on tactile performance, two new Simulated Medical Examination Tactile Tests (SMETT) have been developed to replicate the tactile and haptic ability required in medical examinations: the 'Bumps' test and the 'Princess and the Pea' (P&P) test. A pilot study was carried out using 30-40 subjects for each test in order to investigate the suitability of the tests for medical glove evaluation. Tests were performed with latex and nitrile examination gloves and without gloves. Following the tests, small-scale studies were carried out to investigate the effect of various design parameters, such as material stiffness and tactile exploration method. In the 'Bumps' test, subjects performed significantly better in the ungloved condition, and there were 'almost significant' differences between the gloves, with the thinner latex gloves performing better than the thicker nitrile gloves. Both finger orientation and surface lubrication were found to have a significant effect on results, indicating that these need to be clearly defined in the test procedure. In the 'P&P' test, no significant effect of hand condition was found, suggesting that haptic sensing is less affected by medical gloves than cutaneous sensibility. Other factors such as material stiffness, technique and test orientation had a more significant effect. The SMETT 'Bumps' test has potential as a clinical manual performance evaluation tool and may be used to evaluate the relative effects of different gloves. The SMETT 'P&P' test is a valid measure of haptic or tactile performance, but should not be used in glove evaluation. Both tests could have further applications, such as in the assessment of neurological impairment or aptitude testing for potential surgeons.

Carcass and meat quality traits of Iberian pig as affected by sex and crossbreeding with different Duroc genetic lines

Directory of Open Access Journals (Sweden)

A. Robina

2013-11-01

Full Text Available A total of 144 pigs were used to study the effects of sex (barrows or gilts and terminal sire line (Iberian or three genetic lines of Duroc: Duroc 1, Duroc 2 and Duroc 3 on performance and carcass and meat quality traits. Gilts showed slightly lower average daily gain, shoulder weight and trimming losses, but slightly better primal cuts yields and higher loin weight, while there was no significant effect of sex on meat quality traits or on the fatty acid composition of lard and muscle. There were important differences in performance and in carcass and primal cuts quality traits between pure Iberian pigs and all Iberian × Duroc crossbreeds evaluated, partly due to the lower slaughter weights reached by the formers. The different sire lines showed differences in several traits; Duroc 1 group showed lower backfat thickness and ham and shoulder trimming losses, and higher primal cut yields than Duroc 2 and Duroc 3 groups. Intramuscular fat (IMF content remained unaffected by crossbreeding, but meat color resulted more intense and redder in crosses from the Duroc 1 sire line. The accumulation of fatty acids in lard was not affected by Duroc sire line, while animals of the group Duroc 2 showed higher levels of monounsaturated fatty acid and lower of polyunsaturated ones in IMF. These results highlight the importance of considering not only performance, but also carcass and meat quality traits when deciding the Duroc sire line for crossbreeding in Iberian pig production.

On-line maintenance PSA support at NPP Krsko

International Nuclear Information System (INIS)

Prosen, R.; Vrbanic, I.; Kastelan, M.

2000-01-01

In 1997 Krsko NPP initiated the on-line maintenance (OLM) practice. On-line maintenance constitutes of corrective activities, preventive activities, surveillance activities, tests and inspections, as well as calibrations and modifications, taking place during the normal power operations. The on-line maintenance is a multidisciplinary process consisting of activity specification, planning, and preparation and performing of the OLM activity of interest. The primary role of the PSA group is to assess from the r isk perspective , using the plant-specific NEK PSA model, system unavailability and the impact to the plant operational risk. The intent is to support planning of the on-line maintenance activities from the risk perspective. The risk evaluation of the OLM activities is based on the probability of core damage evaluation for the defined discrete plant configuration states, determined by the OLM activities. Within this application, the optimized, plant-specific PSA model is used on Risk Spectrum platform. To perform the risk assessment of the on-line maintenance activities, first the systems to be affected are defined based on the planned OLM activities. The next important step is the assessment of the planned work schedule. To define the final schedule, the co-ordination and optimizing the planned OLM activities needs activation of all participating departments, supported also from PSA group. The P3 (i.e. Primavera) planning tool system windows are defined for different systems and groups of systems, and the activities are sorted in particular weeks according to these windows. (author)

Joking or decision-making? Affective and instrumental behaviour in doctor-parent-child communication.

OpenAIRE

Tates, K.; Meeuwesen, L.; Bensing, J.; Elbers, E.

2002-01-01

Advocating active child participation in medical encounters is in line with demands for shared decision-making and informed consent. The sparse literature on doctor-child communication, however, conceptualizes children as passive participants and depicts the stereotype of a 'joking' relationship, which is limited mainly to affective behaviour. This descriptive study explores the nature of communication in the doctor-parent-child triad at the general practitioner's surgery. Video-taped observa...

An update on mobile phones interference with medical devices.

Science.gov (United States)

Mahmoud Pashazadeh, Ali; Aghajani, Mahdi; Nabipour, Iraj; Assadi, Majid

2013-10-01

Mobile phones' electromagnetic interference with medical devices is an important issue for the medical safety of patients who are using life-supporting medical devices. This review mainly focuses on mobile phones' interference with implanted medical devices and with medical equipment located in critical areas of hospitals. A close look at the findings reveals that mobile phones may adversely affect the functioning of medical devices, and the specific effect and the degree of interference depend on the applied technology and the separation distance. According to the studies' findings and the authors' recommendations, besides mitigating interference, using mobile phones at a reasonable distance from medical devices and developing technology standards can lead to their effective use in hospital communication systems.

An update on mobile phones interference with medical devices

International Nuclear Information System (INIS)

Pashazadeh, A. M.; Aghajani, M.; Nabipour, I.; Assadi, M.

2013-01-01

Mobile phones' electromagnetic interference with medical devices is an important issue for the medical safety of patients who are using life-supporting medical devices. This review mainly focuses on mobile phones' interference with implanted medical devices and with medical equipment located in critical areas of hospitals. A close look at the findings reveals that mobile phones may adversely affect the functioning of medical devices, and the specific effect and the degree of interference depend on the applied technology and the separation distance. According to the studies' findings and the authors' recommendations, besides mitigating interference, using mobile phones at a reasonable distance from medical devices and developing technology standards can lead to their effective use in hospital communication systems. (authors)

Medication effects on sleep and breathing.

Science.gov (United States)

Seda, Gilbert; Tsai, Sheila; Lee-Chiong, Teofilo

2014-09-01

Sleep respiration is regulated by circadian, endocrine, mechanical and chemical factors, and characterized by diminished ventilatory drive and changes in Pao2 and Paco2 thresholds. Hypoxemia and hypercapnia are more pronounced during rapid eye movement. Breathing is influenced by sleep stage and airway muscle tone. Patient factors include medical comorbidities and body habitus. Medications partially improve obstructive sleep apnea and stabilize periodic breathing at altitude. Potential adverse consequences of medications include precipitation or worsening of disorders. Risk factors for adverse medication effects include aging, medical disorders, and use of multiple medications that affect respiration. Published by Elsevier Inc.

Organization of medical aid and treatment of individuals affected in radiation accidents

International Nuclear Information System (INIS)

Mikhajlov, M.G.; Andreev, E.A.; Bliznakov, V.

1979-01-01

The emergency programme of the medical service for radiation accidents constitutes part of the whole emergency programme of the establishment whose production process is derectly connected with the utilization of ionizing radiation sources. The chief of the establishment health centre also heads the operative radiation accident group. When a radiation accident occurs the medical personnel, according to a previously developed plan, reports at the Health centre. The medical aid is based on the principle of step treatment and evacuation of the affected persons, according to the prescriptions. The first step of the medical evacuation is the health centre; the second - the District hospital, where a team of specialists is formed, all of them previously well trained in the recognition and treatment of radiation sickness. The third step is the specialized clinic for radiation injuries. Persons, who have received irradiation dose of up to 100 rad, or are in a shock state, or have incorporated radioactive substances, are temporarily hospitalized at the health centre. The assistance rended to them consists of: control of shock, asphyxia and bleeding, primary surgical treatment of wounds in cases of complex injuries, deactivation under dosimetric control, attempt for accelerated removal of the radioactive substances, etc. At the District hospital and the specialized clinic the therapeutic measures are conformed to the pathogenetic mechanism and severity of clinical symptoms, and their dynamics. Their aim is first of all to block the earlier radiation effects, to prevent and to treat the haemorrhagic phenomena and infectious complications, to restore the activity of the blood organs, etc. (A.B.)

Cytosolic Cl- Affects the Anticancer Activity of Paclitaxel in the Gastric Cancer Cell Line, MKN28 Cell

Directory of Open Access Journals (Sweden)

Sachie Tanaka

2017-05-01

Full Text Available Background/Aims: Our previous study revealed that cytosolic Cl- affected neurite elongation promoted via assembly of microtubule in rat pheochromocytoma PC12D cells and Cl-–induced blockade of intrinsic GTPase enhanced tubulin polymerization in vitro. Paclitaxel (PTX is a microtubule-targeted chemotherapeutic drug and stabilizes microtubules resulting in mainly blockade of mitosis at the metaphase-anaphase transition and induction of apoptosis. In the present study, we tried to clarify whether the cytosolic Cl- affected PTX ability to inhibit cell growth in the gastric cancer cell line, MKN28. Methods: To clarify the cytosolic Cl- action on PTX-induced cell death and metaphase-anaphase transition in the gastric cancer cell line, MKN28 cell, and PTX-induced tubulin polymerization, we performed cell proliferation assay, cytosolic Cl- concentration measurement, immunofluorescence microscopy, and in vitro tubulin polymerization assay. Results: The decline of cytosolic Cl- weakened the cytotoxic effect of PTX on cell proliferation of MKN28 cells, which could pass through the metaphase-anaphase transition. Moreover, in vitro PTX-induced tubulin polymerization was diminished under the low Cl- condition. Conclusions: Our results strongly suggest that the upregulation of cytosolic Cl- concentration would enhance the antitumor effect of PTX, and that the cytosolic Cl- would be one of the key targets for anti-cancer therapy.

Absolute x-ray dosimetry on a synchrotron medical beam line with a graphite calorimeter.

Science.gov (United States)

Harty, P D; Lye, J E; Ramanathan, G; Butler, D J; Hall, C J; Stevenson, A W; Johnston, P N

2014-05-01

The absolute dose rate of the Imaging and Medical Beamline (IMBL) on the Australian Synchrotron was measured with a graphite calorimeter. The calorimetry results were compared to measurements from the existing free-air chamber, to provide a robust determination of the absolute dose in the synchrotron beam and provide confidence in the first implementation of a graphite calorimeter on a synchrotron medical beam line. The graphite calorimeter has a core which rises in temperature when irradiated by the beam. A collimated x-ray beam from the synchrotron with well-defined edges was used to partially irradiate the core. Two filtration sets were used, one corresponding to an average beam energy of about 80 keV, with dose rate about 50 Gy/s, and the second filtration set corresponding to average beam energy of 90 keV, with dose rate about 20 Gy/s. The temperature rise from this beam was measured by a calibrated thermistor embedded in the core which was then converted to absorbed dose to graphite by multiplying the rise in temperature by the specific heat capacity for graphite and the ratio of cross-sectional areas of the core and beam. Conversion of the measured absorbed dose to graphite to absorbed dose to water was achieved using Monte Carlo calculations with the EGSnrc code. The air kerma measurements from the free-air chamber were converted to absorbed dose to water using the AAPM TG-61 protocol. Absolute measurements of the IMBL dose rate were made using the graphite calorimeter and compared to measurements with the free-air chamber. The measurements were at three different depths in graphite and two different filtrations. The calorimetry measurements at depths in graphite show agreement within 1% with free-air chamber measurements, when converted to absorbed dose to water. The calorimetry at the surface and free-air chamber results show agreement of order 3% when converted to absorbed dose to water. The combined standard uncertainty is 3.9%. The good agreement of

The medical food Souvenaid affects brain phospholipid metabolism in mild Alzheimer's disease: results from a randomized controlled trial.

Science.gov (United States)

Rijpma, Anne; van der Graaf, Marinette; Lansbergen, Marieke M; Meulenbroek, Olga; Cetinyurek-Yavuz, Aysun; Sijben, John W; Heerschap, Arend; Olde Rikkert, Marcel G M

2017-07-26

Synaptic dysfunction contributes to cognitive impairment in Alzheimer's disease and may be countered by increased intake of nutrients that target brain phospholipid metabolism. In this study, we explored whether the medical food Souvenaid affects brain phospholipid metabolism in patients with Alzheimer's disease. Thirty-four drug-naive patients with mild Alzheimer's disease (Mini Mental State Examination score ≥20) were enrolled in this exploratory, double-blind, randomized controlled study. Before and after 4-week intervention with Souvenaid or an isocaloric control product, phosphorus and proton magnetic resonance spectroscopy (MRS) was performed to assess surrogate measures of phospholipid synthesis and breakdown (phosphomonoesters [PME] and phosphodiesters [PDEs]), neural integrity (N-acetyl aspartate), gliosis (myo-inositol), and choline metabolism (choline-containing compounds [tCho]). The main outcome parameters were PME and PDE signal intensities and the PME/PDE ratio. MRS data from 33 patients (60-86 years old; 42% males; Souvenaid arm n = 16; control arm n = 17) were analyzed. PME/PDE and tCho were higher after 4 weeks of Souvenaid compared with control (PME/PDE least squares [LS] mean difference [95% CI] 0.18 [0.06-0.30], p = 0.005; tCho LS mean difference [95% CI] 0.01 [0.00-0.02], p = 0.019). No significant differences were observed in the other MRS outcome parameters. MRS reveals that Souvenaid affects brain phospholipid metabolism in mild Alzheimer's disease, in line with findings in preclinical studies. Netherlands Trial Register, NTR3346 . Registered on 13 March 2012.

POLAND' SYNDROME: An Incidental findings on routine medical ...

African Journals Online (AJOL)

Dr Hamidu

SM is a 20 year, old young man who came for routine medical check for recruitment into a local football club. Born to a 45 ... mimicking a radical mastectomy. A dense ascending line as a result of the absence of the ... centered around reconstructive surgical procedures on the hand. They may however be some functional.

On-line radiation teaching materials using IT technology

International Nuclear Information System (INIS)

Inoue, Hiroyoshi

2005-01-01

We developed the on-line radiation teaching materials using the Internet, in order to provide the teaching support materials of atomic power and radiation educations in on-school study, as well as to create the complementary study system in off-school study. The themes of teaching materials were selected from requests by teachers. In the case of an elementary school, the teaching material 'an environmental problem and atomic power' was created as the aggregate of each content for study without boundary between subjects. The teaching material 'medical treatment and radiation' was created for junior high school students to raise the individual knowledge. In the case of a high school, the teaching material nucleus and radiation' was prepared to supplement the physical study of students. The on-line teaching materials were tried to 300 junior high school and high school students, 68% of students answered that the teaching material is effective to understand atomic power and radiation, though 17% answered they were not effective. Although there are problems to prepare IT learning equipments and learning follow-up system in the material, it is suggested that the on-line teaching materials will provide the novel learning system including debates for the study. This method has no limitation of time and place. (author)

The Effect of Positive Mood on Flexible Processing of Affective Information.

Science.gov (United States)

Grol, Maud; De Raedt, Rudi

2017-07-17

Recent efforts have been made to understand the cognitive mechanisms underlying psychological resilience. Cognitive flexibility in the context of affective information has been related to individual differences in resilience. However, it is unclear whether flexible affective processing is sensitive to mood fluctuations. Furthermore, it remains to be investigated how effects on flexible affective processing interact with the affective valence of information that is presented. To fill this gap, we tested the effects of positive mood and individual differences in self-reported resilience on affective flexibility, using a task switching paradigm (N = 80). The main findings showed that positive mood was related to lower task switching costs, reflecting increased flexibility, in line with previous findings. In line with this effect of positive mood, we showed that greater resilience levels, specifically levels of acceptance of self and life, also facilitated task set switching in the context of affective information. However, the effects of resilience on affective flexibility seem more complex. Resilience tended to relate to more efficient task switching when negative information was preceded by positive information, possibly because the presentation of positive information, as well as positive mood, can facilitate task set switching. Positive mood also influenced costs associated with switching affective valence of the presented information. This latter effect was indicative of a reduced impact of no longer relevant negative information and more impact of no longer relevant positive information. Future research should confirm these effects of individual differences in resilience on affective flexibility, considering the affective valence of the presented information. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

Quantitative Analysis of Contributing Factors Affecting Patient Satisfaction in Family Medicine Service Clinics at Brooke Army Medical Center

Science.gov (United States)

2008-06-06

Predictors of patient satisfaction for Brooke Army Medical Center Family Medicine Service primary care clinics was performed. Data was obtained from...Factors Affecting Patient Satisfaction in Family Medicine Service Clinics at Brooke Army Medical Center Presented to MAJ Eric Schmacker, Ph.D. In...study. All patients ’ medical information was protected at all times and under no circumstances will be discussed or released to any outside agency

Risk Analysis Method Based on FMEA for Transmission Line in Lightning Hazards

Directory of Open Access Journals (Sweden)

You-Yuan WANG

2014-05-01

Full Text Available Failure rate of transmission line and reliability of power system are significantly affected by Lightning meteorological factor. In view of the complexity and variability of Lightning meteorological factors, this paper presents lightning trip-out rate model of transmission line in considering distribution of ground flash density and lightning day hours. Meanwhile, presents a failure rate model of transmission line in different condition, and a risk analysis method for transmission line considering multiple risk factors based on risk quantification. This method takes Lightning meteorological factor as the main evaluation standard, and establishes risk degree evaluation system for transmission line including another five evaluation standard. Put forward the risk indicators by quantify the risk factors based on experience date of transmission line in service. Based on the risk indexes comprehensive evaluation is conducted, and the evaluation result closer to practice is achieved, providing basis for transmission line risk warning and maintenance strategy. Through the risk analysis for 220 kV transmission line in a certain power supply bureau, the effectiveness of the proposed method is validated.

Current status on image processing in medical fields in Japan

International Nuclear Information System (INIS)

Atsumi, Kazuhiko

1979-01-01

Information on medical images are classified in the two patterns. 1) off-line images on films-x-ray films, cell image, chromosome image etc. 2) on-line images detected through sensors, RI image, ultrasonic image, thermogram etc. These images are divided into three characteristic, two dimensional three dimensional and dynamic images. The research on medical image processing have been reported in several meeting in Japan and many fields on images have been studied on RI, thermogram, x-ray film, x-ray-TV image, cancer cell, blood cell, bacteria, chromosome, ultrasonics, and vascular image. Processing on TI image useful and easy because of their digital displays. Software on smoothing, restoration (iterative approximation), fourier transformation, differentiation and subtration. Image on stomach and chest x-ray films have been processed automatically utilizing computer system. Computed Tomography apparatuses have been already developed in Japan and automated screening instruments on cancer cells and recently on blood cells classification have been also developed. Acoustical holography imaging and moire topography have been also studied in Japan. (author)

Does common prescription medication affect the rate of orthodontic tooth movement? A systematic review.

Science.gov (United States)

Makrygiannakis, Militiadis A; Kaklamanos, Eleftherios G; Athanasiou, Athanasios E

2018-03-06

As the taking of any medication may theoretically affect the complex pathways responsible for periodontal tissue homeostasis and the events leading to orthodontic tooth movement, it is considered important for the orthodontist to be able to identify prospective patients' history and patterns of pharmaceutical consumption. To systematically investigate and appraise the quality of the available evidence regarding the effect of commonly prescribed medications on the rate of orthodontic tooth movement. Search without restrictions in eight databases and hand searching until June 2017. Controlled studies investigating the effect of commonly prescribed medications with emphasis on the rate of orthodontic tooth movement. Following study retrieval and selection, relevant data was extracted and the risk of bias was assessed using the SYRCLE's Risk of Bias Tool. Twenty-seven animal studies, involving various pharmacologic and orthodontic interventions, were finally identified. Most studies were assessed to be at unclear or high risk of bias. The rate of orthodontic tooth movement was shown to increase after the administration of diazepam, Vitamin C and pantoprazole, while simvastatin, atorvastatin, calcium compounds, strontium ranelate, propranolol, losartan, famotidine, cetirizine, and metformin decreased the rate of orthodontic tooth movement. No interference with the rate of orthodontic tooth movement was reported for phenytoin, phenobarbital and zinc compounds, whereas, inconsistent or conflicting effects were noted after the administration of L-thyroxine, lithium compounds, fluoxetine and insulin. The quality of the available evidence was considered at best as low. Commonly prescribed medications may exhibit variable effects on the rate of orthodontic tooth movement. Although the quality of evidence was considered at best as low, raising reservations about the strength of the relevant recommendations, the clinician should be capable of identifying patients taking

Concept of radiological, medical and social protection of the population of Russia affected by accidental exposure

International Nuclear Information System (INIS)

Osechinski, I.V.; Ivanov, E.V.; Ramzaev, P.V.; Balonov, M.I.; Tsyb, A.F.

1997-01-01

Main principles of population radiation protection from various accidental exposure, including the Chernobyl accident, have been implemented in officially approved Concept ''On radiological, medical, social protection and rehabilitation of the Russian Federation population affected by accidental radiation exposure''. The concept includes basic principles of radiation protection, designation of regional radionuclide contaminated territories, records and registers of exposed persons, health protection and rehabilitation, socio-economic and legal aspects

A review on high-resolution CMOS delay lines: towards sub-picosecond jitter performance.

Science.gov (United States)

Abdulrazzaq, Bilal I; Abdul Halin, Izhal; Kawahito, Shoji; Sidek, Roslina M; Shafie, Suhaidi; Yunus, Nurul Amziah Md

2016-01-01

A review on CMOS delay lines with a focus on the most frequently used techniques for high-resolution delay step is presented. The primary types, specifications, delay circuits, and operating principles are presented. The delay circuits reported in this paper are used for delaying digital inputs and clock signals. The most common analog and digitally-controlled delay elements topologies are presented, focusing on the main delay-tuning strategies. IC variables, namely, process, supply voltage, temperature, and noise sources that affect delay resolution through timing jitter are discussed. The design specifications of these delay elements are also discussed and compared for the common delay line circuits. As a result, the main findings of this paper are highlighting and discussing the followings: the most efficient high-resolution delay line techniques, the trade-off challenge found between CMOS delay lines designed using either analog or digitally-controlled delay elements, the trade-off challenge between delay resolution and delay range and the proposed solutions for this challenge, and how CMOS technology scaling can affect the performance of CMOS delay lines. Moreover, the current trends and efforts used in order to generate output delayed signal with low jitter in the sub-picosecond range are presented.

On-line fouling monitor for heat exchangers

International Nuclear Information System (INIS)

Tsou, J.L.

1995-01-01

Biological and/or chemical fouling in utility service water system heat exchangers adversely affects operation and maintenance costs, and reduced heat transfer capability can force a power deaerating or even a plant shut down. In addition, service water heat exchanger performance is a safety issue for nuclear power plants, and the issue was highlighted by NRC in Generic Letter 89-13. Heat transfer losses due to fouling are difficult to measure and, usually, quantitative assessment of the impact of fouling is impossible. Plant operators typically measure inlet and outlet water temperatures and flow rates and then perform complex calculations for heat exchanger fouling resistance or ''cleanliness''. These direct estimates are often imprecise due to inadequate instrumentation. Electric Power Research Institute developed and patented an on-line condenser fouling monitor. This monitor may be installed in any location within the condenser; does not interfere with routine plant operations, including on-line mechanical and chemical treatment methods; and provides continuous, real-time readings of the heat transfer efficiency of the instrumented tube. This instrument can be modified to perform on-line monitoring of service water heat exchangers. This paper discusses the design, construction of the new monitor, and algorithm used to calculate service water heat exchanger fouling

Families of Children With Medical Complexity: A View From the Front Lines.

Science.gov (United States)

Allshouse, Carolyn; Comeau, Meg; Rodgers, Rylin; Wells, Nora

2018-03-01

This article, written by a group of experienced parents of children with medical complexity (CMC), provides an overview of the demands of managing care from their unique perspective. The article articulates why attention to understanding the challenges that families of CMC face with a fragmented health care system, inadequate health insurance coverage, deficits in the delivery of medical care, and problems accessing other critical services (as well as lack of support for children and adolescents in developing and exercising self-management skills) are vital to efforts to improve the current system and positively impact the life course of vulnerable populations. The authors discuss the financial and intangible costs experienced by families of CMC and other stakeholders (including providers, payers, and others), as well as the benefits that can result when effective, flexible, comanaged team-based care coordination is provided within the environment that is the most natural locus of care for the family. The authors detail the role of policy strategies that provide protections for CMC and the importance of family-led advocacy and support organizations in helping families "on the front lines." Throughout the article, the case is made that families authentically involved at every level of health care systems are critical partners in designing policies and systems that will improve care for CMC. The experiences of families of CMC should inform and guide efforts to improve systems of care, thus positively impacting the life course of this vulnerable population. Copyright © 2018 by the American Academy of Pediatrics.

Does reporting of plain chest radiographs affect the immediate management of patients admitted to a medical assessment unit?

International Nuclear Information System (INIS)

Grosvenor, L.J.; Verma, R.; O'Brien, R.; Entwisle, J.J.; Finlay, D.

2003-01-01

AIM: The purpose of our study was to investigate whether reporting of plain chest radiographs affects immediate management of patients admitted to a medical assessment unit. MATERIALS AND METHODS: During a 3 month period we prospectively evaluated 200 patients who had a plain chest radiograph on admission. After the post on-call ward round, an independent medical specialist registrar reviewed the notes, retrieving relevant clinical details. The plain chest films were reported independently by a trainee radiologist and consultant, reaching a consensus report. RESULTS: There was 93% agreement between trainee and consultant radiologists (95% CI=89-96%). Seventy percent had documented reports by the on-call medical team. There was disagreement between radiology and medical reports in 49% of reported films (95% CI=40-57%). The radiologist's report led to a direct change in the immediate management of 22 patients (11%). CONCLUSION: Only 70% of films had documented reports in the clinical notes despite this being a legal requirement. Radiology reporting does cause a direct change in patient management. Chest radiographs of patients admitted to a medical admissions unit should be reported by a radiologist with the minimum of delay

Use of a computerized medication shared decision making tool in community mental health settings: impact on psychotropic medication adherence.

Science.gov (United States)

Stein, Bradley D; Kogan, Jane N; Mihalyo, Mark J; Schuster, James; Deegan, Patricia E; Sorbero, Mark J; Drake, Robert E

2013-04-01

Healthcare reform emphasizes patient-centered care and shared decision-making. This study examined the impact on psychotropic adherence of a decision support center and computerized tool designed to empower and activate consumers prior to an outpatient medication management visit. Administrative data were used to identify 1,122 Medicaid-enrolled adults receiving psychotropic medication from community mental health centers over a two-year period from community mental health centers. Multivariate linear regression models were used to examine if tool users had higher rates of 180-day medication adherence than non-users. Older clients, Caucasian clients, those without recent hospitalizations, and those who were Medicaid-eligible due to disability had higher rates of 180-day medication adherence. After controlling for sociodemographics, clinical characteristics, baseline adherence, and secular changes over time, using the computerized tool did not affect adherence to psychotropic medications. The computerized decision tool did not affect medication adherence among clients in outpatient mental health clinics. Additional research should clarify the impact of decision-making tools on other important outcomes such as engagement, patient-prescriber communication, quality of care, self-management, and long-term clinical and functional outcomes.

Factors Affecting Physician Satisfaction and Wisconsin Medical Society Strategies to Drive Change.

Science.gov (United States)

Coleman, Michele; Dexter, Donn; Nankivil, Nancy

2015-08-01

Physicians' dissatisfaction in their work is increasing, which is affecting the stability of health care in America. The Wisconsin Medical Society (Society) surveyed 1016 Wisconsin physicians to determine the source of their dissatisfaction. The survey results indicate Wisconsin physicians are satisfied when it comes to practice environment, work-life balance, and income. In addition, they are extremely satisfied when it comes to rating their ability to provide high quality care, and they have identified some benefits related to the adoption of electronic health records. However, they are feeling burned out, very unsatisfied with the amount of time spent in direct patient care compared to indirect patient care, and that they are spending too much time on administrative and data entry tasks. In terms of future workforce, many physicians are either unsure or would not recommend the profession to a prospective medical student. Electronic health records serve as both a satisfier and dissatisfier and as a potential driver for future physician satisfaction interventions. Changes at the institutional, organizational, and individual levels potentially could address the identified dissatisfiers and build upon the satisfiers. The Society identifies 12 strategies to improve upon the physician experience.

Gamma irradiation on canola seeds affects herbivore-plant and host-parasitoid interactions

International Nuclear Information System (INIS)

Akandeh, M.; Kocheili, F.; Rasekh, A.; Soufbaf, M.

2017-01-01

As an agricultural modernization, gamma irradiation is an important method for enhancing crop yield and quality. Nevertheless, its use can alter other plant traits such as nutrition and resistance to different biotic/abiotic stresses that consequently affect plant-insect interactions. A tritrophic system was utilized based on two canola mutant lines produced through gamma irradiation (RGS 8-1 and Talaye 8-3). Plutella xylostella (L.), as a worldwide pest of Brassicaceae and Cotesia vestalis (Holiday) as a key biocontrol agent of P. xylostella were examined for the potential indirect effects of canola seed irradiation on the experimental insects' performance when acting on the respective mutant lines. This study showed that physical mutation did not affect plant nitrogen and herbivore-damaged total phenolics; however, phenolic compounds showed greater concentration in damaged leaves than undamaged leaves of both mutant and control plants. The relative growth rate and pupal weight of P. xylostella reared on RGS 8-1 were significantly higher than those reared on the control RGS. There was no significant difference by performance parameters of the parasitoid, C. vestalis, including total pre-oviposition period, adult longevity, adult fresh body weight of males and females, pupal weight, forewing area, and total longevity of both sexes on tested canola cultivars in comparison with their mutant lines. Life table parameters of C. vestalis on mutant lines of both cultivars, RGS and Talaye, were not significantly different from their control treatments. Comprehensive studies should be conducted to find out the mechanisms under which gamma rays affect plant-insect interactions. (author)

Gamma irradiation on canola seeds affects herbivore-plant and host-parasitoid interactions

Energy Technology Data Exchange (ETDEWEB)

Akandeh, M.; Kocheili, F.; Rasekh, A. [Dept. of Entomology, Shahid Chamran Univ of Ahvaz (Iran, Islamic Republic of); Soufbaf, M., E-mail: msoufbaf@nrcam.org [Agricultural, Medical and Industrial Research School, Karaj (Iran, Islamic Republic of)

2017-06-15

As an agricultural modernization, gamma irradiation is an important method for enhancing crop yield and quality. Nevertheless, its use can alter other plant traits such as nutrition and resistance to different biotic/abiotic stresses that consequently affect plant-insect interactions. A tritrophic system was utilized based on two canola mutant lines produced through gamma irradiation (RGS 8-1 and Talaye 8-3). Plutella xylostella (L.), as a worldwide pest of Brassicaceae and Cotesia vestalis (Holiday) as a key biocontrol agent of P. xylostella were examined for the potential indirect effects of canola seed irradiation on the experimental insects' performance when acting on the respective mutant lines. This study showed that physical mutation did not affect plant nitrogen and herbivore-damaged total phenolics; however, phenolic compounds showed greater concentration in damaged leaves than undamaged leaves of both mutant and control plants. The relative growth rate and pupal weight of P. xylostella reared on RGS 8-1 were significantly higher than those reared on the control RGS. There was no significant difference by performance parameters of the parasitoid, C. vestalis, including total pre-oviposition period, adult longevity, adult fresh body weight of males and females, pupal weight, forewing area, and total longevity of both sexes on tested canola cultivars in comparison with their mutant lines. Life table parameters of C. vestalis on mutant lines of both cultivars, RGS and Talaye, were not significantly different from their control treatments. Comprehensive studies should be conducted to find out the mechanisms under which gamma rays affect plant-insect interactions. (author)

An investigation of the parameters affecting continuous on-line neutron activation analysis and its application to process control

International Nuclear Information System (INIS)

Boswell, C.

1977-03-01

A system analysis was made and a description was given of on-line continuous activation analysis. The suitability of the various languages available on the Burroughs B6700 computer for simulation of such systems was assessed. A programme was written in the selected languages to incorporate facilities for specifying the geometry of both activation and detector cells and of the delay line linking the two

Research on Energy-Saving Operation Strategy for Multiple Trains on the Urban Subway Line

Directory of Open Access Journals (Sweden)

Jianqiang Liu

2017-12-01

Full Text Available Energy consumption for multiple trains on the urban subway line is predominantly affected by the operation strategy. This paper proposed an energy-saving operation strategy for multiple trains, which is suitable for various line conditions and complex train schedules. The model and operation modes of the strategy are illustrated in detail, aiming to take full use of regenerative braking energy in complex multi-train systems with different departure intervals and dwell times. The computing method is proposed by means of the heuristic algorithm to obtain the optimum operation curve for each train. The simulation result based on a real urban subway line is provided to verify the correctness and effectiveness of the proposed energy-saving operation strategy.

On-Line Resources for Teaching an Introductory Social Justice Course

OpenAIRE

Jacqueline Keil

2007-01-01

It is often difficult to interest students in a course in social justice using just textbooks. It is now possible to use free, on-line resources that positively affect student interest, comprehension, and participation in a course. Such a course is described. Links to suggested materials are provided.

Quantum Walks on the Line with Phase Parameters

Science.gov (United States)

Villagra, Marcos; Nakanishi, Masaki; Yamashita, Shigeru; Nakashima, Yasuhiko

In this paper, a study on discrete-time coined quantum walks on the line is presented. Clear mathematical foundations are still lacking for this quantum walk model. As a step toward this objective, the following question is being addressed: Given a graph, what is the probability that a quantum walk arrives at a given vertex after some number of steps? This is a very natural question, and for random walks it can be answered by several different combinatorial arguments. For quantum walks this is a highly non-trivial task. Furthermore, this was only achieved before for one specific coin operator (Hadamard operator) for walks on the line. Even considering only walks on lines, generalizing these computations to a general SU(2) coin operator is a complex task. The main contribution is a closed-form formula for the amplitudes of the state of the walk (which includes the question above) for a general symmetric SU(2) operator for walks on the line. To this end, a coin operator with parameters that alters the phase of the state of the walk is defined. Then, closed-form solutions are computed by means of Fourier analysis and asymptotic approximation methods. We also present some basic properties of the walk which can be deducted using weak convergence theorems for quantum walks. In particular, the support of the induced probability distribution of the walk is calculated. Then, it is shown how changing the parameters in the coin operator affects the resulting probability distribution.

Doctor shopping for medications used in the treatment of attention deficit hyperactivity disorder: shoppers often pay in cash and cross state lines.

Science.gov (United States)

Cepeda, M Soledad; Fife, Daniel; Berwaerts, Joris; Friedman, Andrew; Yuan, Yingli; Mastrogiovanni, Greg

2015-05-01

Doctor shopping, defined by filling overlapping prescriptions from more than one prescriber at more than two pharmacies, is a way to obtain scheduled medications for diversion or abuse. Little is known about how far attention deficit hyperactivity disorder (ADHD) medication shoppers travel, how often they cross state lines to fill their ADHD prescriptions and how often they pay for their medication in cash, i.e. entirely out of pocket. We sought to describe the pattern of doctor shopping for ADHD medications: how far shoppers travel, how often they cross state lines to fill their prescriptions, and how often they pay in cash. Retrospective cohort study using LRx, a large US retail prescription database. We included subjects with any ADHD medication dispensed between 2011 and 2012. Subjects were followed for 18 months. Of a total of 4 402 464 subjects exposed to ADHD medications, 0.4% developed shopping behavior. Women were more likely to become shoppers. Shoppers travelled a median of 91.9 miles and non-shoppers 0.2 miles to fill their ADHD prescriptions. Almost 28% of the shoppers filled prescriptions in >1 state compared with 4.3% of non-shoppers. Of the shoppers, 27.3% paid at least one prescription in cash compared to 14.4% of the non-shoppers. Shoppers travelled larger distances, visited more states and paid in cash for ADHD medications more often than non-shoppers. Data sharing among prescriptions monitoring programs can improve their effectiveness and drug utilization studies should take account of cash purchases.

Dissociable attentional and affective circuits in medication-naïve children with attention-deficit/hyperactivity disorder.

Science.gov (United States)

Posner, Jonathan; Rauh, Virginia; Gruber, Allison; Gat, Inbal; Wang, Zhishun; Peterson, Bradley S

2013-07-30

Current neurocognitive models of attention-deficit/hyperactivity disorder (ADHD) suggest that neural circuits involving both attentional and affective processing make independent contributions to the phenomenology of the disorder. However, a clear dissociation of attentional and affective circuits and their behavioral correlates has yet to be shown in medication-naïve children with ADHD. Using resting-state functional connectivity MRI (rs-fcMRI) in a cohort of medication naïve children with (N=22) and without (N=20) ADHD, we demonstrate that children with ADHD have reduced connectivity in two neural circuits: one underlying executive attention (EA) and the other emotional regulation (ER). We also demonstrate a double dissociation between these two neural circuits and their behavioral correlates such that reduced connectivity in the EA circuit correlates with executive attention deficits but not with emotional lability, while on the other hand, reduced connectivity in the ER circuit correlates with emotional lability but not with executive attention deficits. These findings suggest potential avenues for future research such as examining treatment effects on these two neural circuits as well as the potential prognostic and developmental significance of disturbances in one circuit vs the other. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

On-Line Resources for Teaching an Introductory Social Justice Course

Directory of Open Access Journals (Sweden)

Jacqueline Keil

2007-05-01

Full Text Available It is often difficult to interest students in a course in social justice using just textbooks. It is now possible to use free, on-line resources that positively affect student interest, comprehension, and participation in a course. Such a course is described. Links to suggested materials are provided.

China's Bilateral Currency Swap Lines

OpenAIRE

Zhitao, Lin; Wenjie, Zhan; Cheung, Yin-Wong

2016-01-01

We study the determinants of China’s bilateral local currency swap lines that were established since the recent global finance crisis. It is found that economic factors, political considerations, and institutional characteristics including trade intensity, economic size, strategic partnership, free trade agreement, corruption, and stability affect the decision of signing a swap line agreement. Once a swap line agreement decision is made, the size of the swap line is then mainly affected by tr...

Altering graphene line defect properties using chemistry

Science.gov (United States)

Vasudevan, Smitha; White, Carter; Gunlycke, Daniel

2012-02-01

First-principles calculations are presented of a fundamental topological line defect in graphene that was observed and reported in Nature Nanotech. 5, 326 (2010). These calculations show that atoms and smaller molecules can bind covalently to the surface in the vicinity of the graphene line defect. It is also shown that the chemistry at the line defect has a strong effect on its electronic and magnetic properties, e.g. the ferromagnetically aligned moments along the line defect can be quenched by some adsorbates. The strong effect of the adsorbates on the line defect properties can be understood by examining how these adsorbates affect the boundary-localized states in the vicinity of the Fermi level. We also expect that the line defect chemistry will significantly affect the scattering properties of incident low-energy particles approaching it from graphene.

[Effects of ezrin silencing on pancreatic cancer cell line Panc-1].

Science.gov (United States)

Meng, Yun-xiao; Yu, Shuang-ni; Lu, Zhao-hui; Chen, Jie

2012-12-01

To explore the effects of ezrin silencing on pancreatic cancer cell line Panc-1. Pancreatic cancer cell line Panc-1 was transfected with ezrin silencing plasmid. The proliferation and the cell cycle status were determined by CCK-8 assay and flow cytometry analysis, respectively. Cellular membrane protrusions/microvilli formation were visualized by scanning election microscopy. Colony formation assay was used to determine the cell anchor-independent growth ability in vitro. Trans-filter migration and invasion assays were performed with 8 µm pore inserts in a 24-well BioCoat chamber with/without Matrigel. Ezrin silencing decreased cellular protrusions/microvilli formation, anchorage-independent growth, cell migration and invasion, but had no effects on cell proliferation in vitro and cell cycle, in pancreatic cancer cell line Panc-1. Ezrin expression affects the cellular protrusions/microvilli formation, anchorage-independent growth, cell migration and invasion in pancreatic cancer cell line Panc-1.

The Influence of Physical Fatigue on Work on a Production Line

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Kołodziej Sabina

2017-09-01

Full Text Available The purpose of this study is to determine the factors having impacts on the physical fatigue of employees and to analyse its influence on work on a production line. In order to carry out these objectives, a comprehensive research was conducted in a medium enterprise producing processed fruit and vegetable products. Air temperature and humidity tests, employee survey, production line productivity measurements, and other observations were performed. Large variations in temperature and humidity were observed during the analysed period. Analysing the survey results, attention was paid to the declared length of sleeping of employees after each shift, the time when they feel fatigue and the factors that, according to respondents, have the greatest impact on the work performed. Attempts were made to determine the wellbeing of employees and to indicate the disturbing symptoms. Special attention was paid to the negative phenomena felt by respondents. The main factors affecting the physical fatigue of employees were identified and described. We sought to explain the impacts of physical fatigue on work on the production line. Improvements, which should help to reduce fatigue and improve working conditions, have been proposed. The analysis provided interesting information that could be used in various food manufacturing companies.

Research on the Influence of Perceived Risk in Consumer On-line Purchasing Decision

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Hong, Zhao; Yi, Li

Perceived risk is an important factor that affects consumer's on-line shopping purchasing decision, through the perceived theories the consumer can know clearly which step owns higher risk in the whole shopping process, then learn how to prevent it, this process also strengthen the consumer confidence, thus lowering to know that the risk adjudicate to the feeling, so the essay has important and realistic meaning for further expand the electronic commerce. At first, investigate, collect, tidy up, analyze the questionnaire information, and thus get the primary data. Finally try to find out the influence of perceived risk to each stage of purchasing decision during consumer on-line shopping process with data and personal analytical. The paper is a complement to the local and existing perceived theories. The result of the study manifests that, the order of main perceived risks which felt by consumer during on-line shopping process are as follow: financial risk, the performance risk and service risk.

Walking a fine line: managing the tensions associated with medication non-adherence in an acute inpatient psychiatric setting.

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Wijnveld, Anne-Marie; Crowe, Marie

2010-05-01

The aim of this study was to use a phenomenological methodology to examine mental health nurses' experiences of administering medications to patients who were non-adherent in an acute inpatient service. There is a large body of literature focused on exploring the issue of non-adherence to prescribed medication, but there is very little examining this from mental health nurses' perspectives. Many of the medications prescribed for patients diagnosed with a psychiatric disorder have serious side effects and limited efficacy. Mental health nurses in acute inpatient environments are regularly confronted with the difficulties inherent in the conflicting roles associated with the need to maintain therapeutic relationships and the expectation that they ensure patients take their medications. This is a qualitative study exploring mental health nurses' descriptions of managing medication adherence in an acute inpatient unit. The interpretive phenomenological methodology of Van Manen (Researching Lived Experience: Human Science for an Action Sensitive Pedagogy, 1990) was used in this study to capture the experiences of a group of nurses. This research process involves a dynamic interplay between the following six research activities: (1) turning to the nature of the lived experience; (2) investigating the experience as we live it; (3) reflecting on essential themes; (4) a description of the phenomenon through the art of writing and rewriting; (5) maintaining a strong and oriented pedagogical relation to the phenomenon; and (6) balancing the research context by considering parts and whole. Four themes emerged from the existential analysis that described the mental health nurses' experiences: doing the job for doctors (relationality); stopping and listening (temporality); stepping in (corporeality); and walking a fine line (spatiality). It is proposed that models of therapeutic interventions offering alternative or conjunctive treatment to medications could be incorporated into

On-line case discussion assessment in ultrasound: The effect on student centred and inter-professional learning

International Nuclear Information System (INIS)

Harrison, G.; Mulloy, B.; Harris, A.; Flinton, D.

2012-01-01

In 2009 an asynchronous on-line case discussion assessment was introduced, to replace an existing traditional case study assessment, within the Medical Ultrasound Programmes at City University London, to help extend collaborative, inter-professional student-led learning skills. Two clinical modules were used to develop the on-line learning method with associated assessments. Students selected and led a clinical case from their department, uploaded anonymised images and case details with questions, to encourage interaction from other colleagues. Thirty students participated in the on-line case discussions. The assessment was evaluated via informal feedback, end of module feedback and an on-line questionnaire. Some students completed two modules, using the on-line discussion, others were involved in only one module, of which 21 out of 26 students completed end of module feedback for the 1st module and 18 out of 20 students completed feedback from the 2nd module. Twelve students out of 30 completed the on-line questionnaire. Feedback suggested that the on-line case discussions were a good learning tool, providing a wide range of cases for students to participate in or read and learn from each other. All students found the cases interesting, engaging and useful, but time consuming. Despite the small numbers involved, useful feedback was provided to assist further development of the assessment, particularly in relation to the number of cases being assessed and length of availability. On-line case discussions are an innovative, engaging method to encourage self directed, collaborative learning which could be utilised in the health care setting to share interesting cases, promote inter-professional and self-directed learning.

On line local measurement of thermal neutron flux on BNCT patient using SPND

International Nuclear Information System (INIS)

Miller, M.E.; Sztejnberg Goncalves-Carralves, M.L.; Gonzalez, S.J.

2006-01-01

The first on-line neutron flux measurement on a patient using a self-powered neutron detector (SPND) was assessed during the fourth clinical trial of the Boron Neutron Capture Therapy (BNCT) Project carried out at the National Atomic Energy Commission of Argentina (CNEA) and the medical center Angel H. Roffo. The SPND was specially developed and assembled for BNCT by CNEA. Its small size, 1 cm sensible length and 1.9 mm diameter, allowed performing a localized measurement. Since the treated tumors were cutaneous melanomas of nodular type, the SPND was located on the patient's skin. The patient was exposed to three different and consecutive fields and in each of them the SPND was used to measure local thermal neutron fluxes at selected dosimetric reference points. The values of the measured fluxes agreed with the ones estimated by calculation. This trial also demonstrated the usefulness of the SPND for assessing flux on-line. (author)

Derivation of Huntington Disease affected Genea046 human embryonic stem cell line

Directory of Open Access Journals (Sweden)

Biljana Dumevska

2016-03-01

Full Text Available The Genea046 human embryonic stem cell line was derived from a donated, fully commercially consented ART blastocyst, carrying HTT gene CAG expansion of 45 repeats, indicative of Huntington Disease. Following ICM outgrowth on inactivated human feeders, karyotype was confirmed as 46, XX by CGH and STR analysis demonstrated a female Allele pattern. The hESC line had pluripotent cell morphology, 85% of cells expressed Nanog, 92% Oct4, 75% Tra1–60 and 99% SSEA4 and demonstrated Alkaline Phosphatase activity. The cell line was negative for Mycoplasma and visible contamination.

Analysis on factors affecting consumers decision on purchasing simple-type houses

Science.gov (United States)

Rumintang, A.; Sholichin, I.

2018-01-01

In line with the increase of the population and the need of comfortable houses, as affected by modernization era, the house demand is getting higher. Hence, conducting a research on consumers need and want in buying a house should be seriously attempted to succeed marketing activity. Using an analysis consumers’ behavior, the researcher will know few affecting factors related to consumers’ satisfaction in buying a house. Among other, the factors in question include: house price, house condition, facilities, location and accessability. The sample of this research was drawn from the residents of Graha Asri Housing, Taman Bulang Permai, and Sukodono Permai. Based on the analysis and discussion, some conclusions are made as follow: the factors and variables affecting the consumers’ decision on each choice of house is different and also the same variables on three sources of data include housing atmosphere, cleaning service, ease of access to shopping center, health clinics or hospitals, tourism spot, schools, and the bus station.

Identification of Bodies by Unique Serial Numbers on Implanted Medical Devices.

Science.gov (United States)

Blessing, Melissa M; Lin, Peter T

2018-05-01

Visual identification is the most common identification method used by medical examiners but is not always possible. Alternative methods include X-ray, fingerprint, or DNA comparison, but these methods require additional resources. Comparison of serial numbers on implanted medical devices is a rapid and definitive method of identification. To assess the practicality of using this method, we reviewed 608 consecutive forensic autopsies performed at a regional medical examiner office. Of these, 56 cases required an alternative method of identification due to decomposition (n = 35), gunshot wound (n = 9), blunt trauma (n = 6), or charring (n = 6). Of these 56 cases, eight (14.3%) were known to have an implanted medical device. Of these eight cases, five (63%) could be positively identified by comparing serial numbers. If an implanted medical device is known to be present, and medical records are available, identification by medical device serial number should be a first-line method. © 2017 American Academy of Forensic Sciences.

Social Media Etiquette for the Modern Medical Student: A Narrative Review

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Brittany Harrison

2014-06-01

Full Text Available Most medical students worldwide are using some form of social media platform to supplement their learning via file sharing and to stay up-to-date on medical events. Often, social media may blur the line between socialization and educational use, so it is important to be aware of how one is utilizing social media and how to remain professional. Research has yielded some troublesome themes of misconduct: drunken behaviour, violations of confidentiality and defamation of institutions. Because there is no universal policy to monitor online professionalism, there exists the potential for indiscretions to occur. It has been reported that misdemeanours can affect future residency placements and employment for medical students. Accordingly, studies suggest that educators need to recognize this new era of professionalism and adapt policies and reprimands to meet modern outlets where professionalism may be violated.

Analysis of Factors Affecting Patients’ Compliance to Topical Antiglaucoma Medications in Egypt as a Developing Country Model

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Nahla B. Abu Hussein

2015-01-01

Full Text Available Purpose. To study factors affecting patients’ compliance to antiglaucoma medications in Egypt where there are unique factors as a developing country. Patients and Methods. A cross-sectional descriptive study on 440 Egyptian patients with open angle glaucoma (OAG recruited for over two years. The patients were thoroughly interviewed about their age, education level, duration of glaucoma, difficulty in instilling the drops, medication regimens, a family history of glaucoma, knowledge of the disease, and the presence of medical insurance. Results. 236 (53.6% were noncompliant compared to 204 (46.4% who were compliant. Females had a tendency for higher compliance (p=0.061. Patient age above 50 years and low level of education and negative family history of glaucoma were factors significantly associated with poor compliance (p<0.0001. Polytherapy and lack of medical insurance could be contributing factors. Conclusion. Egyptian patients have a high rate of noncompliance compared to the average in literature. Great effort is needed in educating patients about the importance of medications and the risk and the prognosis of this disease. Economic factors must also be taken into consideration in developing countries with large number of poor patients. We recommend simplifying drug regimens, incorporating electronic dose monitors, and creating reminders for follow-up visits of glaucoma patients.

Factors affecting nursing students' intention to report medication errors: An application of the theory of planned behavior.

Science.gov (United States)

Ben Natan, Merav; Sharon, Ira; Mahajna, Marlen; Mahajna, Sara

2017-11-01

Medication errors are common among nursing students. Nonetheless, these errors are often underreported. To examine factors related to nursing students' intention to report medication errors, using the Theory of Planned Behavior, and to examine whether the theory is useful in predicting students' intention to report errors. This study has a descriptive cross-sectional design. Study population was recruited in a university and a large nursing school in central and northern Israel. A convenience sample of 250 nursing students took part in the study. The students completed a self-report questionnaire, based on the Theory of Planned Behavior. The findings indicate that students' intention to report medication errors was high. The Theory of Planned Behavior constructs explained 38% of variance in students' intention to report medication errors. The constructs of behavioral beliefs, subjective norms, and perceived behavioral control were found as affecting this intention, while the most significant factor was behavioral beliefs. The findings also reveal that students' fear of the reaction to disclosure of the error from superiors and colleagues may impede them from reporting the error. Understanding factors related to reporting medication errors is crucial to designing interventions that foster error reporting. Copyright © 2017 Elsevier Ltd. All rights reserved.

Current trends in medical ethics education in Japanese medical schools.

Science.gov (United States)

Kurosu, Mitsuyasu

2012-09-01

The Japanese medical education program has radically improved during the last 10 years. In 1999, the Task Force Committee on Innovation of Medical Education for the 21st Century proposed a tutorial education system, a core curriculum, and a medical student evaluation system for clinical clerkship. In 2001, the Model Core Curriculum of medical education was instituted, in which medical ethics became part of the core material. Since 2005, a nationwide medical student evaluation system has been applied for entrance to clinical clerkship. Within the Japan Society for Medical Education, the Working Group of Medical Ethics proposed a medical ethics education curriculum in 2001. In line with this, the Japanese Association for Philosophical and Ethical Research in Medicine has begun to address the standardization of the curriculum of medical ethics. A medical philosophy curriculum should also be included in considering illness, health, life, death, the body, and human welfare.

Factors that affect general practice as a choice of medical speciality: implications for policy development.

Science.gov (United States)

Vohra, Amit; Ladyshewsky, Richard; Trumble, Stephen

2017-11-28

Objective This article critically appraises the range of personal, professional and social factors that affect the choice of speciality across medical students, prevocational doctors, general practice registrars and general practitioners. Methods This qualitative study applied constructs from the fields of decision theory and career theory to better understand the complex nature of choosing a speciality. In all, 47 in-depth interviews were conducted with participants at different stages of their career cycle. The data was codified and analysed using NVivo to identify key factors that influenced speciality choice. Results The research identified 77 individual findings influencing general practice as a choice of medical speciality. These were distilled into a matrix to show that factors such as money, prestige and peer interaction did not have a compelling effect, whereas clinical and academic role models, flexibility, work-life balance, scope of practice, connection with patients, training environment and practical opportunities did. Conclusion The findings indicate that the decision in relation to the choice of medical speciality is a complex cognitive process that is undertaken within a personal, social and professional context particular to each individual. What is known about the topic? Current literature aims to quantify changes in attitudes towards choice of speciality or the effect of particular variables in isolation while ignoring the complexity of this decision process and how the numerous variables compare with each other. What does this paper add? The present study is the first intergenerational research on this topic in the Australian context and the paper dismisses the role of prestige and remuneration as key drivers of choice in picking general practice as a speciality, noting that money is merely a 'hygiene factor'. What are the implications for policy makers? A policy framework outlining 10 key principles is presented to assist policy makers seeking

Gender Disparities in Faculty Rank: Factors that Affect Advancement of Women Scientists at Academic Medical Centers

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Cristina M. López

2018-04-01

Full Text Available While a significant portion of women within academic science are employed within medical schools, women faculty in these academic medical centers are disproportionately represented in lower faculty ranks. The medical school setting is a critical case for both understanding and advancing women in basic sciences. This study highlights the findings from focus groups conducted with women faculty across Assistant, Associate, and Full Professor ranks (n = 35 in which they discussed barriers and facilitators for advancement of women basic scientists at an academic medical center. Qualitative analysis demonstrated several emergent themes that affect women’s advancement, including gendered expectation norms (e.g., good citizenship, volunteerism, work-life balance, mentorship/sponsorship, adoption of a team science approach, tenure process milestones, soft money research infrastructure, institution specific policies (or lack thereof, and operating within an MD-biased culture. These findings are compared with the extant literature of women scientists in STEM institutions. Factors that emerged from these focus groups highlight the need for evidence-based interventions in the often overlooked STEM arena of academic medical centers.

On the Intermediate Line Region in AGNs

Energy Technology Data Exchange (ETDEWEB)

Adhikari, Tek P.; Różańska, Agata; Hryniewicz, Krzysztof [Nicolaus Copernicus Astronomical Center, Polish Academy of Sciences, Warsaw (Poland); Czerny, Bozena [Nicolaus Copernicus Astronomical Center, Polish Academy of Sciences, Warsaw (Poland); Center for Theoretical Physics, Polish Academy of Sciences, Warsaw (Poland); Ferland, Gary J., E-mail: tek@camk.edu.pl [Department of Physics and Astronomy, The University of Kentucky, Lexington, KY (United States)

2017-09-29

In this paper we explore the intermediate line region (ILR) by using the photoionisation simulations of the gas clouds present at different radial distances from the center, corresponding to the locations from BLR out to NLR in four types of AGNs. We let for the presence of dust whenever conditions allow for dust existence. All spectral shapes are taken from the recent multi-wavelength campaigns. The cloud density decreases with distance as a power law. We found that the slope of the power law density profile does not affect the line emissivity radial profiles of major emission lines: Hβ, He II, Mg II, C III, and O III. When the density of the cloud at the sublimation radius is as high as 10{sup 11.5} cm{sup −3}, the ILR should clearly be seen in the observations independently of the shape of the illuminating radiation. Moreover, our result is valid for low ionization nuclear emission regions of active galaxies.

Factors affecting the delivery of community pharmacist-led medication reviews: evidence from the MedsCheck annual service in Ontario

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Petros Pechlivanoglou

2016-11-01

Full Text Available Abstract Background Medication reviews have become part of pharmacy practice across developed countries. This study aimed to identify factors affecting the likelihood of eligible Ontario seniors receiving a pharmacy-led medication review called MedsCheck annual (MCA. Methods We designed a cohort study using a random sample of pharmacy claims for MCA-eligible Ontario seniors using linked administrative data from April 2012 to March 2013. Guided by a conceptual framework, we constructed a generalized-estimating-equations model to estimate the effect of patient, pharmacy and community factors on the likelihood of receiving MCA. Results Of the 2,878,958 eligible claim-dates, 65,605 included an MCA. Compared to eligible individuals who did not receive an MCA, recipients were more likely to have a prior MCA (OR = 3.03, receive a new medication on the claim-date (OR = 1.78, be hypertensive (OR = 1.18 or have a recent hospitalization (OR = 1.07. MCA recipients had fewer medications (e.g., OR = 0.44 for ≥12 medications versus 0–4 medications, and were less likely to receive an MCA in a rural (OR = 0.74 or high-volume pharmacy (OR = 0.65. Conclusions The most important determinant of receiving an MCA was having had a prior MCA. Overall, MCA recipients were healthier, younger, urban-dwelling, and taking fewer medications than non-recipients. Policies regarding current and future medication review programs may need to evolve to ensure that those at greatest need receive timely and comprehensive medication reviews.

On-line biomedical databases-the best source for quick search of the scientific information in the biomedicine.

Science.gov (United States)

Masic, Izet; Milinovic, Katarina

2012-06-01

Most of medical journals now has it's electronic version, available over public networks. Although there are parallel printed and electronic versions, and one other form need not to be simultaneously published. Electronic version of a journal can be published a few weeks before the printed form and must not has identical content. Electronic form of a journals may have an extension that does not contain a printed form, such as animation, 3D display, etc., or may have available fulltext, mostly in PDF or XML format, or just the contents or a summary. Access to a full text is usually not free and can be achieved only if the institution (library or host) enters into an agreement on access. Many medical journals, however, provide free access for some articles, or after a certain time (after 6 months or a year) to complete content. The search for such journals provide the network archive as High Wire Press, Free Medical Journals.com. It is necessary to allocate PubMed and PubMed Central, the first public digital archives unlimited collect journals of available medical literature, which operates in the system of the National Library of Medicine in Bethesda (USA). There are so called on- line medical journals published only in electronic form. It could be searched over on-line databases. In this paper authors shortly described about 30 data bases and short instructions how to make access and search the published papers in indexed medical journals.

Derivation of NEM2 affected human embryonic stem cell line Genea079

Directory of Open Access Journals (Sweden)

Biljana Dumevska

2016-03-01

Full Text Available The Genea079 human embryonic stem cell line was derived from a donated, fully commercially consented ART blastocyst, carrying compound heterozygous mutations in the NEB gene, exon 55 deletion & c.15110dupA, indicative of Nemaline Myopathy Type 2 (NEM2. Following ICM outgrowth on inactivated human feeders, karyotype was confirmed as 46, XY and STR analysis demonstrated a male Allele pattern. The hESC line had pluripotent cell morphology, 86% of cells expressed Nanog, 95% Oct4, 54% Tra1-60 and 98% SSEA4 and gave a PluriTest Pluripotency score of 30.25, Novelty of 1.21. The cell line was negative for Mycoplasma and visible contamination.

Medical service plans in academic medical centers.

Science.gov (United States)

Siegel, B

1978-10-01

Medical service plans are of major importance to academic medical centers and are becoming increasingly so each year as evidenced by growing dependence of medical schools on resulting funds. How these funds are generated and used varies among schools. The procedures may affect the governance of the institution, modifying the authority of the central administration or the clinical departments. Recent developments in federal legislation, such as health maintenance organizations and amendments (Section 227) to the Social Security Act, and the future development of national health insurance will certainly have an effect on how academic medical centers organize their clinical activities. How successfully various medical schools deal with the dynamic problem may well determine their future survival.

Electric Power Lines : Questions and Answers on Research into Health Effects.

Energy Technology Data Exchange (ETDEWEB)

United States. Bonneville Power Administration.

1995-06-01

Most people know that electric power lines, like the wiring in our homes, can cause serious electric shocks if we`re not careful. Many people also want to know whether the EMF (electric and magnetic fields) produced by power lines and other electrical devices affect our health. Although no adverse health effects of electric power EMF have been confirmed, there is continued scientific uncertainty about this issue. Research on EMF is ongoing throughout the world. The purpose of this booklet is to answer some common questions that the BPA (Bonneville Power Administration) receives about the possible effects of power lines on health. First, some basic electrical terms are defined, and electric and magnetic fields are debed. Next, answers are given to several questions about recent scientific studies. Some important information about electrical safety follows. We then describe how BPA is addressing public concerns about potential health effects of power lines. The last section tells you how to obtain more detailed information about the health and safety issues summarized in this booklet.

Ion source and injection line for high intensity medical cyclotron

Science.gov (United States)

Jia, XianLu; Guan, Fengping; Yao, Hongjuan; Zhang, TianJue; Yang, Jianjun; Song, Guofang; Ge, Tao; Qin, Jiuchang

2014-02-01

A 14 MeV high intensity compact cyclotron, CYCIAE-14, was built at China Institute of Atomic Energy (CIAE). An injection system based on the external H- ion source was used on CYCIAE-14 so as to provide high intensity beam, while most positron emission tomography cyclotrons adopt internal ion source. A beam intensity of 100 μA/14 MeV was extracted from the cyclotron with a small multi-cusp H- ion source (CIAE-CH-I type) and a short injection line, which the H- ion source of 3 mA/25 keV H- beam with emittance of 0.3π mm mrad and the injection line of with only 1.2 m from the extraction of ion source to the medial plane of the cyclotron. To increase the extracted beam intensity of the cyclotron, a new ion source (CIAE-CH-II type) of 9.1 mA was used, with maximum of 500 μA was achieved from the cyclotron. The design and test results of the ion source and injection line optimized for high intensity acceleration will be given in this paper.

Using evidence to improve satisfaction with medication side-effects education on a neuro-medical surgical unit.

Science.gov (United States)

Ahrens, Susan L; Wirges, Ashley M

2013-10-01

Patient satisfaction is viewed as a significant indicator of quality of care. More specifically, improving patient satisfaction related to communication about medications and potential side effects can improve healthcare outcomes. Patient satisfaction scores related to medication side effects on a neuro-medical surgical unit were monitored following a quality improvement program. These patients frequently experience cognitive impairment and functional difficulties that can affect the way they understand and handle medications. The purpose of this quality improvement practice change was to (a) develop an educational approach for post acute neurosurgical patients and (b) evaluate whether the use of the approach is successful in improving patient satisfaction scores related to medication education on side effects. The quality improvement program interventions included (a) patient informational handouts inserted into admission folders, (b) nurse education about the importance of providing education on side effects to patient and discussion of their involvement with the program, (c) unit flyers with nurse education, and (d) various communications with bedside nurses through personal work mail and emails. The primary focus was for nurses to employ the "teach back" method to review and reinforce the medication side-effect teaching with patients. Evaluation of the data showed an increase in patient satisfaction after the implementation of the "Always Ask" program.

Core on-line monitoring and computerized procedures systems

International Nuclear Information System (INIS)

Gangloff, W.C.

1986-01-01

The availability of operating nuclear power plants has been affected significantly by the difficulty people have in coping with the complexity of the plants and the operating procedures. Two ways to use modern computer technology to ease the burden of coping are discussed in this paper, an on-line core monitoring system with predictive capability and a computerized procedures system using live plant data. These systems reduce human errors by presenting information rather than simply data, using the computer to manipulate the data, but leaving the decisions to the plant operator

Incorrect strain information for mouse cell lines: sequential influence of misidentification on sublines.

Science.gov (United States)

Uchio-Yamada, Kozue; Kasai, Fumio; Ozawa, Midori; Kohara, Arihiro

2017-03-01

Misidentification or cross-contamination of cell lines can cause serious issues. Human cell lines have been authenticated by short tandem repeat profiling; however, mouse cell lines have not been adequately assessed. In this study, mouse cell lines registered with the JCRB cell bank were examined by simple sequence length polymorphism (SSLP) analysis to identify their strains. Based on comparisons with 7 major inbred strains, our results revealed their strains in 80 of 90 cell lines. However, 12 of the 80 cell lines (15%) were found to differ from registered information. Of them, 4 cell lines originated from the same mouse, which had been generated through mating between two different inbred strains. The genotype of the mouse sample had not been examined after the backcross, leading to strain misidentification in those cell lines. Although 8 other cell lines had been established as sublines of a BALB/c cell line, their SSLP profiles are similar to a Swiss cell line. This affects differences in genotypes between inbred and outbred strains. Because the use of inbred samples and interbreeding between strains are not involved in human materials, our results suggest that the cause and influence of misidentification in mouse cell lines are different from those in human.

Psychiatric framing affects positive but not negative schizotypy scores in psychology and medical students.

Science.gov (United States)

Mohr, Christine; Schofield, Kerry; Leonards, Ute; Wilson, Marc S; Grimshaw, Gina M

2018-08-01

When testing risk for psychosis, we regularly rely on self-report questionnaires. Yet, the more that people know about this condition, the more they might respond defensively, in particular with regard to the more salient positive symptom dimension. In two studies, we investigated whether framing provided by questionnaire instructions might modulate responses on self-reported positive and negative schizotypy. The O-LIFE (UK study) or SPQ (New Zealand study) questionnaire was framed in either a "psychiatric", "creativity", or "personality" (NZ only) context. We tested psychology students (without taught knowledge about psychosis) and medical students (with taught knowledge about psychosis; UK only). We observed framing effects in psychology students in both studies: positive schizotypy scores were lower after the psychiatric compared to the creativity instruction. However, schizotypy scores did not differ between the creativity and personality framing conditions, suggesting that the low scores with psychiatric framing reflect defensive responding. The same framing effect was also observed in medical students, despite their lower positive schizotypy scores overall. Negative schizotypy scores were not affected by framing in either study. These results highlight the need to reduce response biases when studying schizotypy, because these might blur schizotypy-behaviour relationships. Copyright © 2018 Elsevier B.V. All rights reserved.

Miniaturized Printed Inverted-F Antenna for Internet of Things: A Design on PCB with a Meandering Line and Shorting Strip

Directory of Open Access Journals (Sweden)

Cheuk Yin Cheung

2018-01-01

Full Text Available This paper focuses on a printed inverted-F antenna (PIFA with meandering line and meandering shorting strip under 2.4 GHz industrial, scientific, and medical (ISM band for Internet of things (IoT applications. Bluetooth Low Energy (BLE technology is one of potential platforms and technologies for IoT applications under ISM band. Printed circuit board (PCB antenna commonly used in commercial and medical applications because of its small size, low profile, and low cost compared to low temperature cofired ceramic (LTCC technology. The proposed structure of PIFA is implemented on PCB to gain all these advantages. Replacing conventional PCB line in PIFA by the meandering line and meandering shorting strip improves the efficiency of the PIFA as well as the bandwidth. As a case study, design and measurement results of the proposed PIFA are presented.

Effects of mercury on behavior and performance of northern two-lined salamanders (Eurycea bislineata)

Energy Technology Data Exchange (ETDEWEB)

Burke, John N; Bergeron, Christine M; Todd, Brian D [Wildlife Ecotoxicology and Physiological Ecology Program, Department of Fisheries and Wildlife Sciences, Virginia Polytechnic Institute and State University, 100 Cheatham Hall, Blacksburg, VA 24061 (United States); Hopkins, William A., E-mail: hopkinsw@vt.ed [Wildlife Ecotoxicology and Physiological Ecology Program, Department of Fisheries and Wildlife Sciences, Virginia Polytechnic Institute and State University, 100 Cheatham Hall, Blacksburg, VA 24061 (United States)

2010-12-15

Mercury (Hg) causes a range of deleterious effects in wildlife, but little is known about its effects on amphibians. Our objective was to determine whether Hg affects performance and behavior in two-lined salamanders (Eurycea bislineata). We collected salamanders from Hg-contaminated and reference sites and assessed speed, responsiveness, and prey capture ability. Mercury concentrations were >17x higher in salamanders from the contaminated sites and were among the highest documented in amphibians. In the first, but not in the second, locomotion trial, we found a significant effect of Hg on speed and responsiveness. In the prey capture experiment, reference salamanders ate approximately twice as many prey items as the contaminated salamanders. Together, our results suggest that sublethal Hg concentrations may negatively affect salamanders by reducing their ability to successfully execute tasks critical to survival. Future work is warranted to determine whether Hg has other sublethal effects on salamanders and whether other amphibians are similarly affected. - Mercury contamination may alter behavior and performance in the northern two-lined salamander (Eurycea bislineata).

Effects of mercury on behavior and performance of northern two-lined salamanders (Eurycea bislineata)

International Nuclear Information System (INIS)

Burke, John N.; Bergeron, Christine M.; Todd, Brian D.; Hopkins, William A.

2010-01-01

Mercury (Hg) causes a range of deleterious effects in wildlife, but little is known about its effects on amphibians. Our objective was to determine whether Hg affects performance and behavior in two-lined salamanders (Eurycea bislineata). We collected salamanders from Hg-contaminated and reference sites and assessed speed, responsiveness, and prey capture ability. Mercury concentrations were >17x higher in salamanders from the contaminated sites and were among the highest documented in amphibians. In the first, but not in the second, locomotion trial, we found a significant effect of Hg on speed and responsiveness. In the prey capture experiment, reference salamanders ate approximately twice as many prey items as the contaminated salamanders. Together, our results suggest that sublethal Hg concentrations may negatively affect salamanders by reducing their ability to successfully execute tasks critical to survival. Future work is warranted to determine whether Hg has other sublethal effects on salamanders and whether other amphibians are similarly affected. - Mercury contamination may alter behavior and performance in the northern two-lined salamander (Eurycea bislineata).

Development of a medical informatics data warehouse.

Science.gov (United States)

Wu, Cai

2006-01-01

This project built a medical informatics data warehouse (MedInfo DDW) in an Oracle database to analyze medical information which has been collected through Baylor Family Medicine Clinic (FCM) Logician application. The MedInfo DDW used Star Schema with dimensional model, FCM database as operational data store (ODS); the data from on-line transaction processing (OLTP) were extracted and transferred to a knowledge based data warehouse through SQLLoad, and the patient information was analyzed by using on-line analytic processing (OLAP) in Crystal Report.

Effects of Surrounding Information and Line Length on Text Comprehension from the Web

Directory of Open Access Journals (Sweden)

Jess McMullin

2002-02-01

Full Text Available The World Wide Web (Web is becoming a popular medium for transmission of information and online learning. We need to understand how people comprehend information from the Web to design Web sites that maximize the acquisition of information. We examined two features of Web page design that are easily modified by developers, namely line length and the amount of surrounding information, or whitespace. Undergraduate university student participants read text and answered comprehension questions on the Web. Comprehension was affected by whitespace; participants had better comprehension for information surrounded by whitespace than for information surrounded by meaningless information. Participants were not affected by line length. These findings demonstrate that reading from the Web is not the same as reading print and have implications for instructional Web design.

Scientific writing: a randomized controlled trial comparing standard and on-line instruction

OpenAIRE

Phadtare, Amruta; Bahmani, Anu; Shah, Anand; Pietrobon, Ricardo

2009-01-01

Abstract Background Writing plays a central role in the communication of scientific ideas and is therefore a key aspect in researcher education, ultimately determining the success and long-term sustainability of their careers. Despite the growing popularity of e-learning, we are not aware of any existing study comparing on-line vs. traditional classroom-based methods for teaching scientific writing. Methods Forty eight participants from a medical, nursing and physiotherapy background from US ...

MARGINALIZING TRANS MEDICAL EXPENSES: LINE-DRAWING EXERCISES IN TAX

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Samuel Singer

2013-10-01

Full Text Available This article explores the treatment of trans medical expenses under American and Canadian tax laws. In both tax systems, medical expenses are deemed worthy of tax relief, while many cosmetic procedures are excluded. This article argues that tax administrators and the judiciary are influenced by social stigma when they employ the distinction between cosmetic and medical expenses to exclude or allow trans medical expenses. In the American context, this article focuses on the Internal Revenue Service’s reasons for deeming a trans woman’s gender dysphoria-related medical expenses to be ineligible for the medical deduction. It then turns to the taxpayer’s subsequent appeal to the U.S. Tax Court in O’Donnabhain v. Commissioner, 134 TC no. 4, and the Court’s determination that, while the taxpayer’s sex reassignment surgery and hormone therapy were eligible expenses, her breast augmentation was not deductible. The article follows by outlining the Canadian medical expense tax credit to determine how similar trans medical expenses might be treated in light of a budget amendment in 2010 prohibiting claims for most cosmetic procedures. The article concludes that in both the American and Canadian context, trans people are held to a higher standard than required under each respective tax statute, with their gender dysphoria-related medical expenses needing to be documented as “medically necessary” to avoid categorization as ineligible cosmetic expenses.   Le présent article examine le traitement des frais médicaux liés à la dysphorie sexuelle en vertu des lois fiscales américaines et canadiennes. Dans les deux régimes fiscaux, les frais médicaux sont considérés comme admissibles à un allègement fiscal, tandis que plusieurs interventions esthétiques sont exclues. Le présent article fait valoir que les administrateurs fiscaux et la magistrature sont influencés par les stigmates sociaux lorsqu’ils ont recours à la distinction

The medical food Souvenaid affects brain phospholipid metabolism in mild Alzheimer's disease: results from a randomized controlled trial

NARCIS (Netherlands)

Rijpma, A.; Graaf, M. van der; Lansbergen, M.M.; Meulenbroek, O.V.; Cetinyurek-Yavuz, A.; Sijben, J.W.; Heerschap, A.; Olde Rikkert, M.G.M.

2017-01-01

BACKGROUND: Synaptic dysfunction contributes to cognitive impairment in Alzheimer's disease and may be countered by increased intake of nutrients that target brain phospholipid metabolism. In this study, we explored whether the medical food Souvenaid affects brain phospholipid metabolism in patients

First on-line survey of an international multidisciplinary working group (MightyMedic) on current practice in diagnosis, therapy and follow-up of dyslipidemias.

Science.gov (United States)

Stefanutti, C; D'Alessandri, G; Petta, A; Harada-Shiba, M; Julius, U; Soran, H; Moriarty, P M; Romeo, S; Drogari, E; Jaeger, B R

2015-05-01

The MightyMedic (Multidisciplinary International Group for Hemapheresis TherapY and MEtabolic DIsturbances Contrast) Working Group has been founded in 2013. The leading idea was to establish an international network of interdisciplinary nature aimed at working to cross national borders research projects, clinical trials, educational initiatives (meetings, workshops, summer schools) in the field of metabolic diseases, namely hyperlipidemias, and diabetes, preventive cardiology, and atherosclerosis. Therapeutic apheresis, its indications and techniques, is a parallel field of investigation. The first on-line survey of the Group has been completed in the first half of 2014. The survey included # 24 Centers in Italy, Germany, Greece, UK, Sweden, Japan and USA. Relevant data have been collected on current practice in diagnosis, therapy and follow-up of dyslipidemias. 240 subjects with hyperlipidemia and treated with lipoprotein apheresis have been reported in the survey, but a large percentage of patients (35%) who could benefit from this therapeutic option are still treated by conventional drug approach. Genetic molecular diagnosis is performed in only 33% of patients while Lipoprotein(a) (Lp(a)) is included in cardiovascular disease risk assessment in 71% of participating Centers. New detailed investigations and prospective multicenter studies are needed to evaluate changes induced by the impact of updated indications and strategies, as well as new treatment options, targeting standardization of therapeutic and diagnostic approaches. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

The role of Patient Health Engagement Model (PHE-model in affecting patient activation and medication adherence: A structural equation model.

Directory of Open Access Journals (Sweden)

Guendalina Graffigna

Full Text Available Increasing bodies of scientific research today examines the factors and interventions affecting patients' ability to self-manage and adhere to treatment. Patient activation is considered the most reliable indicator of patients' ability to manage health autonomously. Only a few studies have tried to assess the role of psychosocial factors in promoting patient activation. A more systematic modeling of the psychosocial factors explaining the variance of patient activation is needed.To test the hypothesized effect of patient activation on medication adherence; to test the the hypothesized effects of positive emotions and of the quality of the patient/doctor relationship on patient activation; and to test the hypothesized mediating effect of Patient Health Engagement (PHE-model in this pathway.This cross-sectional study involved 352 Italian-speaking adult chronic patients. The survey included measures of i patient activation (Patient Activation Measure 13 -short form; ii Patient Health Engagement model (Patient Health Engagement Scale; iii patient adherence (4 item-Morinsky Medication Adherence Scale; iv the quality of the patients' emotional feelings (Manikin Self Assessment Scale; v the quality of the patient/doctor relationship (Health Care Climate Questionnaire. Structural equation modeling was used to test the hypotheses proposed.According to the theoretical model we hypothesized, research results confirmed that patients' activation significantly affects their reported medication adherence. Moreover, psychosocial factors, such as the patients' quality of the emotional feelings and the quality of the patient/doctor relationship were demonstrated to be factors affecting the level of patient activation. Finally, the mediation effect of the Patient Health Engagement model was confirmed by the analysis.Consistently with the results of previous studies, these findings demonstrate that the Patient Health Engagement Model is a critical factor in

The role of Patient Health Engagement Model (PHE-model) in affecting patient activation and medication adherence: A structural equation model.

Science.gov (United States)

Graffigna, Guendalina; Barello, Serena; Bonanomi, Andrea

2017-01-01

Increasing bodies of scientific research today examines the factors and interventions affecting patients' ability to self-manage and adhere to treatment. Patient activation is considered the most reliable indicator of patients' ability to manage health autonomously. Only a few studies have tried to assess the role of psychosocial factors in promoting patient activation. A more systematic modeling of the psychosocial factors explaining the variance of patient activation is needed. To test the hypothesized effect of patient activation on medication adherence; to test the the hypothesized effects of positive emotions and of the quality of the patient/doctor relationship on patient activation; and to test the hypothesized mediating effect of Patient Health Engagement (PHE-model) in this pathway. This cross-sectional study involved 352 Italian-speaking adult chronic patients. The survey included measures of i) patient activation (Patient Activation Measure 13 -short form); ii) Patient Health Engagement model (Patient Health Engagement Scale); iii) patient adherence (4 item-Morinsky Medication Adherence Scale); iv) the quality of the patients' emotional feelings (Manikin Self Assessment Scale); v) the quality of the patient/doctor relationship (Health Care Climate Questionnaire). Structural equation modeling was used to test the hypotheses proposed. According to the theoretical model we hypothesized, research results confirmed that patients' activation significantly affects their reported medication adherence. Moreover, psychosocial factors, such as the patients' quality of the emotional feelings and the quality of the patient/doctor relationship were demonstrated to be factors affecting the level of patient activation. Finally, the mediation effect of the Patient Health Engagement model was confirmed by the analysis. Consistently with the results of previous studies, these findings demonstrate that the Patient Health Engagement Model is a critical factor in enhancing

Perceived adherence barriers among patients failing second-line antiretroviral therapy in Khayelitsha, South Africa

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W Barnett

2013-11-01

Full Text Available Background. The recent scale-up of antiretroviral therapy (ART coverage in resource-limited settings has greatly improved access to treatment. However, increasing numbers of patients are failing first- and second-line ART. Objective. To examine factors affecting adherence to second-line ART from the perspective of clinic staff and patients, assessing both individual and structural perceived barriers. Methods. Research was conducted at a large primary care tuberculosis (TB/HIV clinic in Khayelitsha, a peri-urban township in Cape Town, South Africa. Participants were drawn from a Médecins Sans Frontières-run programme to support patients failing second-line ART. A qualitative research approach was used, combining multiple methodologies including key informant interviews with staff (n=11, in-depth interviews with patients (n=10 and a Photovoice workshop (n=11. Responses and photographs were coded by content; data were transformed into variables and analysed accordingly. Results. Staff identified drinking, non-disclosure, not using condoms and pill fatigue as barriers to ART adherence, while patients identified side-effects, not using condoms and a lack of understanding concerning medication timing. With respect to service delivery, staff identified a need for continued counselling and educational support following ART initiation. Patients were concerned about missing medical records and poor staff attitudes in the clinic. Conclusion. These findings identify discrepancies between provider and patient perceptions of barriers to, and facilitators of adherence, as well as of service delivery solutions. This highlights the need for on-going counselling and education following ART initiation, improved quality of counselling, and improved methods to identify and address specific barriers concerning medication adherence.

Study on personality dimension negative emotionality affecting academic achievement among Malaysian medical students studying in Malaysia and overseas

Directory of Open Access Journals (Sweden)

Bhagat V

2016-06-01

Full Text Available Vidya Bhagat,1 Mainul Haque,2 Nordin Bin Simbak,1 Kamarudin Jaalam3 1Faculty of Medicine, Universiti Sultan Zainal Abidin, Jalan Sultan Mahmud, Kuala Terengganu, Malaysia; 2Faculty of Medicine and Defense Health, National Defence University of Malaysia, Kuala Lumpur, Malaysia; 3USM-KLE International Medical Program, Belgaum, Karnataka, India Abstract: Personality dimension negative emotionality is known to be associated with academic achievement. The present study focuses on the influence of negative emotionality (neuroticism on the medical students’ academic achievements. The main objective of this study was to ascertain the negative emotionality scores among the first year Malaysian medical students studying in Malaysia and India, further to find out the association between negative emotionality and their academic achievements. The current study sample includes 60 first year Malaysian medical students from Universiti Sultan Zainal Abidin, Malaysia, and USM-KLE IMP, Belgaum, India. They were selected by convenient sampling technique. The Medico-Psychological questionnaire was used to find out the negative emotionality scores among the students and these scores were compared with academic scores. The data were analyzed using SPSS- 20. Thus, the study result goes with the prediction that there is a significant correlation between academic achievement and negative emotionality. We concluded that negative emotionality has a negative impact on medical student’s academic achievement regardless of the fact whether they study in their own country or overseas. Keywords: academic achievement, negative emotionality, Malay, medical students, Malaysia

Job sharing at a children's hospital: evaluation by medical staff.

Science.gov (United States)

Valentine, J P; Martin, C J

1996-01-13

To evaluate job sharing for registrars at Princess Margaret Hospital for Children, Perth, by seeking responses from members of the relevant medical teams. A questionnaire was sent to all 126 medical staff within the hospital (and three managers in medical administration) asking their views on job sharing for registrars. Whether job sharing should continue, who should do it, at what stage of training, and the effects on patient care. Among the 77 respondents (60%) there was broad support for the continuation of job sharing at the hospital: only 5 of 37 consultants and 2 of 19 non-job sharing registrars rejected the idea (with a further 4 consultants uncertain). 43% Of the consultants who had worked with job sharing registrars thought continuity of care was adversely affected. The committee for physician training of the Royal Australasian College of Physicians emphasises that advanced training should be flexible, with a wide range of opportunities for individuals to plan an appropriate training programme in line with their personal goals. This study has shown that job sharing for registrars at Princess Margaret Hospital for Children allows this choice. Action on concerns over any adverse effects on patient care should resolve any persisting disquiet.

An analytical look at the effects of compression on medical images

OpenAIRE

Persons, Kenneth; Palisson, Patrice; Manduca, Armando; Erickson, Bradley J.; Savcenko, Vladimir

1997-01-01

This article will take an analytical look at how lossy Joint Photographic Experts Group (JPEG) and wavelet image compression techniques affect medical image content. It begins with a brief explanation of how the JPEG and wavelet algorithms work, and describes in general terms what effect they can have on image quality (removal of noise, blurring, and artifacts). It then focuses more specifically on medical image diagnostic content and explains why subtle pathologies, that may be difficult for...

Purity, adulteration and price of drugs bought on-line versus off-line in the Netherlands.

Science.gov (United States)

van der Gouwe, Daan; Brunt, Tibor M; van Laar, Margriet; van der Pol, Peggy

2017-04-01

On-line drug markets flourish and consumers have high expectations of on-line quality and drug value. The aim of this study was to (i) describe on-line drug purchases and (ii) compare on-line with off-line purchased drugs regarding purity, adulteration and price. Comparison of laboratory analyses of 32 663 drug consumer samples (stimulants and hallucinogens) purchased between January 2013 and January 2016, 928 of which were bought on-line. The Netherlands. Primary outcome measures were (i) the percentage of samples purchased on-line and (ii) the chemical purity of powders (or dosage per tablet); adulteration; and the price per gram, blotter or tablet of drugs bought on-line compared with drugs bought off-line. The proportion of drug samples purchased on-line increased from 1.4% in 2013 to 4.1% in 2015. The frequency varied widely, from a maximum of 6% for controlled, traditional substances [ecstasy tablets, 3,4-methylenedioxy-methamphetamine (MDMA) powder, amphetamine powder, cocaine powder, 4-bromo-2,5-dimethoxyphenethylamine (2C-B) and lysergic acid diethylamide (LSD)] to more than a third for new psychoactive substances (NPS) [4-fluoroamphetamine (4-FA), 5/6-(2-aminopropyl)benzofuran (5/6-APB) and methoxetamine (MXE)]. There were no large differences in drug purity, yet small but statistically significant differences were found for 4-FA (on-line 59% versus off-line 52% purity for 4-FA on average, P = 0.001), MDMA powders (45 versus 61% purity for MDMA, P = 0.02), 2C-B tablets (21 versus 10 mg 2C-B/tablet dosage, P = 0.49) and ecstasy tablets (131 versus 121 mg MDMA/tablet dosage, P = 0.05). The proportion of adulterated samples purchased on-line and off-line did not differ, except for 4-FA powder, being less adulterated on-line (χ 2  = 8.3; P < 0.02). Drug prices were mainly higher on-line, ranging for various drugs from 10 to 23% higher than that of drugs purchased off-line (six of 10 substances: P < 0.05). Dutch drug users increasingly

Encouragers and discouragers affecting medical graduates' choice of regional and rural practice locations.

Science.gov (United States)

McKillop, Ann; Webster, Craig; Bennett, Win; O'Connor, Barbara; Bagg, Warwick

2017-12-01

Access to health care as near to where people live as possible is desirable. However, not enough medical graduates choose to work in rural and regional areas, especially in general practice. The career decisions of recent medical graduates are known to be affected by a variety of professional, societal and personal factors. Internationally, medical programmes have exposed students to regional and rural experiences partly to encourage them to seek employment in these areas after graduation. As such, the Pūkawakawa Programme is a year-long regional and rural experience for selected Year 5 students from the University of Auckland‘s Medical Programme in New Zealand in partnership with the Northland District Health Board and two Primary Health Organisations. A lack of clarity about the drivers of rural and regional career decisions underpinned this study, which aimed to explore the barriers and encouragers for students of the programme to return as resident medical officers to the regional hospital where they had gained clinical experience. A mixed-method, descriptive design was used, including a short survey, followed by participation in a focus-group discussion or a one-on-one interview. Survey data were summarised in tabular form and inductive, thematic analysis was applied to transcripts of focus groups and interviews. Nineteen doctors in their first or second year following graduation participated: 15 who had returned to the hospital where they had clinical experience in the programme and four who were employed elsewhere. 'A match of personal goals and intended career intentions' was the reason most frequently selected for junior doctors’ choice of early career employment. Other frequently selected reasons were lifestyle, friends and family close by, and the reputation and experience of the Pūkawakawa Programme. Qualitative data revealed that the learning experience, the unique design of the curriculum and associated support from clinicians were identified as

Power lines, roads, and avian nest survival: effects on predator identity and predation intensity.

Science.gov (United States)

DeGregorio, Brett A; Weatherhead, Patrick J; Sperry, Jinelle H

2014-05-01

1 Anthropogenic alteration of landscapes can affect avian nest success by influencing the abundance, distribution, and behavior of predators. Understanding avian nest predation risk necessitates understanding how landscapes affect predator distribution and behavior. 2 From a sample of 463 nests of 17 songbird species, we evaluated how landscape features (distance to forest edge, unpaved roads, and power lines) influenced daily nest survival. We also used video cameras to identify nest predators at 137 nest predation events and evaluated how landscape features influenced predator identity. Finally, we determined the abundance and distribution of several of the principal predators using surveys and radiotelemetry. 3 Distance to power lines was the best predictor of predator identity: predation by brown-headed cowbirds (Molothrus ater), corvids (Corvus sp. and Cyanocitta cristata), racers (Coluber constrictor), and coachwhips (Masticophis flagellum) increased with proximity to power lines, whereas predation by rat snakes (Elaphe obsoleta) and raptors decreased. In some cases, predator density may reliably indicate nest predation risk because racers, corvids, and cowbirds frequently used power line right-of-ways. 4 Of five bird species with enough nests to analyze individually, daily nest survival of only indigo buntings (Passerina cyanea) decreased with proximity to power lines, despite predation by most predators at our site being positively associated with power lines. For all nesting species combined, distance to unpaved road was the model that most influenced daily nest survival. This pattern is likely a consequence of rat snakes, the locally dominant nest predator (28% of predation events), rarely using power lines and associated areas. Instead, rat snakes were frequently associated with road edges, indicating that not all edges are functionally similar. 5 Our results suggest that interactions between predators and landscape features are likely to be specific to

Perceptions on gender awareness and considerations in career choices of medical students in a medical school in Taiwan.

Science.gov (United States)

Chung, Yueh-Chin; Lin, Ching-Yi; Huang, Chien-Ning; Yang, Jen-Hung

2013-11-01

The trend of medical career choice in the younger generation has resulted in deficiency of manpower in the four major disciplines of internal medicine, surgery, obstetrics/gynecology, and pediatrics, which will threaten people's health care in Taiwan. However, perceptions of gender awareness and factors affecting the career choices of medical students have not been investigated systemically in Taiwan. To explore the perceptions on gender awareness and considerations in career choices, we recruited 280 1(st)- and 7(th)-year male and female medical students at a Medical University for the study. A modified Nijmegen questionnaire using a 5-point Likert scale containing medical curricula (18 items), gender awareness (13 items), and career inclination (9 items) was adopted as the investigation tool in our study. The response rate was 75% (224/280). With regard to gender, the 1(st)-year male students had greater confidence in being a physician than the female students (p gender was more prominent in the 7(th)-year than in the 1(st)-year students (p gender and "female physicians are more empathetic and provide more communications than male physicians". Factors influencing career choices of medical students, including "personal interests/talents" and "academic achievement of the specialty," were not significantly different by gender. Factors included "training and learning environments of the specialty", "risk of lawsuit", and "economic incentive" were more appreciated by the senior than the junior students (p gender or seniority. The 7(th)-year students had experiences in clinical medicine and had different considerations in career choice in comparison to the 1(st)-year students, and gender played a role in senior students. In addition, the senior rather than the junior students regarded "training and learning environments", "risk of lawsuit", and "economic incentive" as more important factors affecting the career choices, and male students paid more attention to these

The effect of regular medication on the outcome of paracetamol poisoning

DEFF Research Database (Denmark)

Schmidt, L E; Dalhoff, K

2002-01-01

BACKGROUND: Patients admitted with paracetamol overdose frequently receive one or more types of regular medication that may affect the outcome of the paracetamol intoxication. AIM: To describe the use of regular medication in patients with paracetamol poisoning and to evaluate its effects...... on morbidity and mortality. METHODS: Seven hundred and thirty-seven consecutive patients admitted with paracetamol poisoning were studied and the use of regular medication was recorded. The relative risk of hepatic encephalopathy, death or liver transplantation, severe hepatic dysfunction and severe...... hepatocellular injury was evaluated by multivariate analysis. RESULTS: Regular medication was received by 332 patients (45%). Medication with benzodiazepines (105 cases), antidepressants (100 cases), neuroleptics (75 cases), paracetamol (58 cases), oral contraceptives (51 cases), beta-agonists (40 cases), opioid...

Study on personality dimension negative emotionality affecting academic achievement among Malaysian medical students studying in Malaysia and overseas

Science.gov (United States)

Bhagat, Vidya; Haque, Mainul; Simbak, Nordin Bin; Jaalam, Kamarudin

2016-01-01

Personality dimension negative emotionality is known to be associated with academic achievement. The present study focuses on the influence of negative emotionality (neuroticism) on the medical students’ academic achievements. The main objective of this study was to ascertain the negative emotionality scores among the first year Malaysian medical students studying in Malaysia and India, further to find out the association between negative emotionality and their academic achievements. The current study sample includes 60 first year Malaysian medical students from Universiti Sultan Zainal Abidin, Malaysia, and USM-KLE IMP, Belgaum, India. They were selected by convenient sampling technique. The Medico-Psychological questionnaire was used to find out the negative emotionality scores among the students and these scores were compared with academic scores. The data were analyzed using SPSS- 20. Thus, the study result goes with the prediction that there is a significant correlation between academic achievement and negative emotionality. We concluded that negative emotionality has a negative impact on medical student’s academic achievement regardless of the fact whether they study in their own country or overseas. PMID:27354836

White thrombus formation in blood tubing lines in a chronic hemodialysis unit.

Science.gov (United States)

Watnick, Suzanne; Stooksbury, Michael; Winter, Rolf; Riscoe, Michael; Cohen, David M

2008-03-01

Previous reports have described white particulate matter in banked blood components, but no prior public reports describe such matter in blood tubing during the course of routine in-center hemodialysis. This report describes the events, investigations, and preliminary conclusions associated with the spontaneous formation of adherent white thrombus in the venous and arterial blood lines during routine in-center hemodialysis treatments. Design setting, participants, & measurements: This investigation occurred at the Portland Veterans Administration Medical Center (PVAMC) Hemodialysis Unit from October 2006 through April 2007. Sixty-eight variables regarding demographics, medical history and dialysis treatments were collected on our 34 chronic hemodialysis outpatients. Over a 5-wk interval, 62% (21 of 34) of the chronic hemodialysis patients unexpectedly developed a white precipitate adhering to the lumenal surface of their dialysis blood tubing, with 73 of 580 chronic dialysis treatments exhibiting the phenomenon. Microscopic and biochemical analyses were consistent with white thrombus, formed by an aggregation of platelets and fibrin. An alert was issued and other in-center hemodialysis units noted similar findings. This was remedied by the removal of specific tubing. Both patient-specific and tubing-specific factors may have been operative. Although patient safety was not adversely affected, assessment of clinical and manufacturing variables potentially affecting platelet activation is warranted.

Medical supply on contingency military operations: experience from Operation GRITROCK.

Science.gov (United States)

Robinson, J P; Reeves, P

2015-01-01

Medical supply during military operations has the ability to affect the efficacy of the operation being undertaken, either negatively or positively. An appropriately-managed maritime platform with a robust medical supply chain during transit and on arrival in theatre is the main aim. A secure supply chain will reduce any implications that logistics may have with regard to capability, and negate the effects of deficiencies of short shelf life items occurring over time and during use in high tempo operations.

Identification of factors which affect the tendency towards and attitudes of emergency unit nurses to make medical errors.

Science.gov (United States)

Kiymaz, Dilek; Koç, Zeliha

2018-03-01

To determine individual and professional factors affecting the tendency of emergency unit nurses to make medical errors and their attitudes towards these errors in Turkey. Compared with other units, the emergency unit is an environment where there is an increased tendency for making medical errors due to its intensive and rapid pace, noise and complex and dynamic structure. A descriptive cross-sectional study. The study was carried out from 25 July 2014-16 September 2015 with the participation of 284 nurses who volunteered to take part in the study. Data were gathered using the data collection survey for nurses, the Medical Error Tendency Scale and the Medical Error Attitude Scale. It was determined that 40.1% of the nurses previously witnessed medical errors, 19.4% made a medical error in the last year, 17.6% of medical errors were caused by medication errors where the wrong medication was administered in the wrong dose, and none of the nurses filled out a case report form about the medical errors they made. Regarding the factors that caused medical errors in the emergency unit, 91.2% of the nurses stated excessive workload as a cause; 85.1% stated an insufficient number of nurses; and 75.4% stated fatigue, exhaustion and burnout. The study showed that nurses who loved their job were satisfied with their unit and who always worked during day shifts had a lower medical error tendency. It is suggested to consider the following actions: increase awareness about medical errors, organise training to reduce errors in medication administration, develop procedures and protocols specific to the emergency unit health care and create an environment which is not punitive wherein nurses can safely report medical errors. © 2017 John Wiley & Sons Ltd.

Medical students' learning orientation regarding interracial interactions affects preparedness to care for minority patients: a report from Medical Student CHANGES.

Science.gov (United States)

Burgess, Diana J; Burke, Sara E; Cunningham, Brooke A; Dovidio, John F; Hardeman, Rachel R; Hou, Yuefeng; Nelson, David B; Perry, Sylvia P; Phelan, Sean M; Yeazel, Mark W; van Ryn, Michelle

2016-09-29

There is a paucity of evidence on how to train medical students to provide equitable, high quality care to racial and ethnic minority patients. We test the hypothesis that medical schools' ability to foster a learning orientation toward interracial interactions (i.e., that students can improve their ability to successfully interact with people of another race and learn from their mistakes), will contribute to white medical students' readiness to care for racial minority patients. We then test the hypothesis that white medical students who perceive their medical school environment as supporting a learning orientation will benefit more from disparities training. Prospective observational study involving web-based questionnaires administered during first (2010) and last (2014) semesters of medical school to 2394 white medical students from a stratified, random sample of 49 U.S. medical schools. Analysis used data from students' last semester to build mixed effects hierarchical models in order to assess the effects of medical school interracial learning orientation, calculated at both the school and individual (student) level, on key dependent measures. School differences in learning orientation explained part of the school difference in readiness to care for minority patients. However, individual differences in learning orientation accounted for individual differences in readiness, even after controlling for school-level learning orientation. Individual differences in learning orientation significantly moderated the effect of disparities training on white students' readiness to care for minority patients. Specifically, white medical students who perceived a high level of learning orientation in their medical schools regarding interracial interactions benefited more from training to address disparities. Coursework aimed at reducing healthcare disparities and improving the care of racial minority patients was only effective when white medical students perceived their

Influence of damage and basal friction on the grounding line dynamics

Science.gov (United States)

Brondex, Julien; Gagliardini, Olivier; Gillet-Chaulet, Fabien; Durand, Gael

2016-04-01

The understanding of grounding line dynamics is a major issue in the prediction of future sea level rise due to ice released from polar ice sheets into the ocean. This dynamics is complex and significantly affected by several physical processes not always adequately accounted for in current ice flow models. Among those processes, our study focuses on ice damage and evolving basal friction conditions. Softening of the ice due to damaging processes is known to have a strong impact on its rheology by reducing its viscosity and therefore promoting flow acceleration. Damage creates where shear stresses are high enough which is usually the case at shear margins and in the vicinity of pinning points in contact with ice-shelves. Those areas are known to have a buttressing effect on ice shelves contributing to stabilize the grounding line. We aim at evaluating the extent to which this stabilizing effect is hampered by damaging processes. Several friction laws have been proposed by various author to model the contact between grounded-ice and bedrock. Among them, Coulomb-type friction laws enable to account for reduced friction related to low effective pressure (the ice pressure minus the water pressure). Combining such a friction law to a parametrization of the effective pressure accounting for the fact that the area upstream the grounded line is connected to the ocean, is expected to have a significant impact on the grounding line dynamics. Using the finite-element code Elmer/Ice within which both the Coulomb-type friction law, the effective pressure parametrization and the damage model have been implemented, the goal of this study is to investigate the sensitivity of the grounding line dynamics to damage and to an evolving basal friction. The relative importance between those two processes on the grounding line dynamics is addressed as well.

Applying TPM on Production Line of Huanwei

Directory of Open Access Journals (Sweden)

Zhai Yunkai

2017-01-01

The study based on the study and analysis of the TPM theory, based on my practice in the SMT2 production line of Victoria Electronics of Huanwei. Then it studied the promotion and implementation steps of TPM on SMT2 line. And it also introduced the improvement instance of SMT2 line. By contrasting the utilization of equipment on SMT2 line before and after the comprehensive of TPM, the necessity of implementing TPM is derived. For how to apply TPM on the production lines, and how to improve equipment comprehensive utilization, finish the order on time, provide high quality products to our customers, these are the main part of production line equipment management work. This article provides the reference for how to promote TPM on other production lines.

The effect of privatisation on front line employees in a service organisation

Directory of Open Access Journals (Sweden)

FW Struwig

2004-07-01

Full Text Available A government organisation in the water supply business was faced with the challenge of changing their traditional way of doing business to operate as a profit driven entity. This research focuses on how privatisation has affected front-line service employees. Both the front-line service employees and management were interviewed and included as cases to investigate changes that have occurred as a result of privatisation. These cases revealed that after privatisation front line service employees have received better training, appreciated a better system of communication, experienced a higher degree of empowerment and enjoyed an organisational culture that is more customer focused. The research, however, indicated lower levels of motivation, that employees do not appreciate an improvement in their reward system neither do they get feedback regarding their achievements and that they experience little job security.

Checklist Usage as a Guidance on Read-Back Reducing the Potential Risk of Medication Error

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Ida Bagus N. Maharjana

2014-06-01

Full Text Available Hospital as a last line of health services shall provide quality service and oriented on patient safety, one responsibility in preventing medication errors. Effective collaboration and communication between the profession needed to achieve patient safety. Read-back is one way of doing effective communication. Before-after study with PDCA TQM approach. The samples were on the medication chart patient medical rd rd records in the 3 week of May (before and the 3 week in July (after 2013. Treatment using the check list, asked for time 2 minutes to read-back by the doctors and nurses after the visit together. Obtained 57 samples (before and 64 samples (after. Before charging 45.54% incomplete medication chart on patient medical records that have the potential risk of medication error to 10.17% after treatment with a read back check list for 10 weeks, with 77.78% based on the achievement of the PDCA TQM approach. Checklist usage as a guidance on Read-back as an effective communication can reduce charging incompleteness drug records on medical records that have the potential risk of medication errors, 45.54% to 10.17%.

The number of pickers and stock-keeping unit arrangement on a uni-directional picking line

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Hagspihl, Robert

2014-10-01

Full Text Available The order picking process is often the single largest expense in a distribution centre (DC. The DC considered in this paper uses a picking line configuration to perform order picking. The number of pickers in a picking line, and the initial arrangement of stock-keeping units (SKUs, are two important factors that affect the total completion time of the picking lines. In this paper, the picking line configuration is simulated with an agent-based approach to describe the behaviour of an individual picker. The simulation is then used to analyse the effect of the number of pickers and the SKU arrangement. Verification and validation of this model shows that the model represents the real-world picking line to a satisfactory degree. Marginal analysis (MA was chosen to determine a ‘good’ number of pickers by means of the simulation model. A look-up table is presented to provide decision support for the choice of a ‘good’ number of pickers to improve completion times of the picking line, for the properties of a specific picking line. The initial SKU arrangement on a picking line is shown to be a factor that can affect the level of picker congestion and the total completion time. The greedy ranking and partitioning (GRP and organ pipe arrangement (OPA techniques from the literature, as well as the historical SKU arrangements used by the retailer under consideration, were compared with the proposed classroom discipline heuristic (CDH for SKU arrangement. It was found that the CDH provides an more even spread of SKUs that are picked most frequently, thus decreasing congestion and total completion time.

An Experimental Evaluation of the Weathering Effects on Mine Shaft Lining Materials

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W. Yang

2017-01-01

Full Text Available Many shaft collapses are related to the deterioration and failure of the masonry shaft lining materials. In modern mine shaft, concrete is widely used to provide support. To analyse shafts stability, the properties of the lining need to be well defined. The behaviour of masonry and concrete can be considerably affected by long-term exposure to harsh mine water. This paper presents a study which focuses on the weathering effects of mine water on lining materials (brick, mortar, and concrete. To reproduce the weathering process, samples were placed into solutions of potable water, artificial mine water, and a more aggressive mine-water solution for just less than one year. Four phases of laboratory tests were conducted throughout the time period to assess the degradation of mechanical properties of the lining materials. Particular attention is given to the degradation of material strength and stiffness. Results indicate that the harsh acidic mine water has pronounced detrimental effects on the strength and stiffness of mortar. The weathering process is shown to have the most significant effect on the stiffness of concrete and mortar. It is also shown that the use of mass loss as an index for evaluation of mechanical properties may not be appropriate.

Robust Control Methods for On-Line Statistical Learning

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Capobianco Enrico

2001-01-01

Full Text Available The issue of controlling that data processing in an experiment results not affected by the presence of outliers is relevant for statistical control and learning studies. Learning schemes should thus be tested for their capacity of handling outliers in the observed training set so to achieve reliable estimates with respect to the crucial bias and variance aspects. We describe possible ways of endowing neural networks with statistically robust properties by defining feasible error criteria. It is convenient to cast neural nets in state space representations and apply both Kalman filter and stochastic approximation procedures in order to suggest statistically robustified solutions for on-line learning.

Metabolite Depletion Affects Flux Profiling of Cell Lines

DEFF Research Database (Denmark)

Nilsson, A.; Haanstra, J. R.; Teusink, B.

2018-01-01

Quantifying the rate of consumption and release of metabolites (i.e., flux profiling) has become integral to the study of cancer. The fluxes as well as the growth of the cells may be affected by metabolite depletion during cultivation.......Quantifying the rate of consumption and release of metabolites (i.e., flux profiling) has become integral to the study of cancer. The fluxes as well as the growth of the cells may be affected by metabolite depletion during cultivation....

The Impact of Baccalaureate Medical Humanities on Subsequent Medical Training and Practice: A Physician-Educator's Perspective.

Science.gov (United States)

Barron, Lauren

2017-12-01

This reflective essay is an attempt to organize trends in feedback I have observed during ten years of coursework, conversations, and correspondence with former students associated with the Medical Humanities Program at Baylor University. Over the years, recurrent themes arise when speaking with alumni about whether and how their medical humanities experience intersects with their current training. I have identified five particular domains in which baccalaureate medical humanities training affects students' subsequent healthcare professions training and practice: context and complementarity, clinical relevance, reflective practice, professional preparedness and vocational calling. I created an instrument of open-ended questions for each of these categories and posted it to social media with an invitation for alumni to respond. This informal survey was conceived as an exploratory exercise with the intent to help generate a foundation for more formal qualitative research in these five domains. In this essay, I offer my own reflections together with those of former students on the impact of baccalaureate-level medical humanities training in order to illustrate the benefits in each domain for subsequent healthcare training and practice. The need for qualitative research that explores the impact of baccalaureate medical humanities merits collaboration between multiple centers of investigation across many disciplines, and across the divide between premedical and medical educators.

Influence of visualization on consumption during on-line shopping

OpenAIRE

Hictaler, Urška

2013-01-01

This diploma work studies the influence of visualization on consumption during on-line shopping. The first part of the thesis starts with key areas of visualization, consumption and on-line shopping. Visualization, areas of use, human perception and ways of product presentation in on-line shops are defined discussed first. Next, consumption, consumers and factors that influence their decisions and satisfaction are defined. The last topic in the first part of the thesis discusses on-line shopp...

FACTORS AFFECTING THE DEVELOPMENT OF MEDICAL TOURISM IN PUBLIC HOSPITALS

OpenAIRE

YİĞİT, Vahit

2016-01-01

Medical tourism is a burgeoning industry in the world. Nowadays, over 50countries have been identified medical tourism as a national industry. AlthoughAsian countries where India, Thailand, Singapore and Malaysia popular medicaltourism destination, medical tourism in Turkey has not reached the desiredlevel and and could not get enough share of the medical tourism market. The aimof this study is to determine the factors influencing the development ofmedical tourism in Turkey. This research was...

Moral fictions and medical ethics.

Science.gov (United States)

Miller, Franklin G; Truog, Robert D; Brock, Dan W

2010-11-01

Conventional medical ethics and the law draw a bright line distinguishing the permitted practice of withdrawing life-sustaining treatment from the forbidden practice of active euthanasia by means of a lethal injection. When clinicians justifiably withdraw life-sustaining treatment, they allow patients to die but do not cause, intend, or have moral responsibility for, the patient's death. In contrast, physicians unjustifiably kill patients whenever they intentionally administer a lethal dose of medication. We argue that the differential moral assessment of these two practices is based on a series of moral fictions - motivated false beliefs that erroneously characterize withdrawing life-sustaining treatment in order to bring accepted end-of-life practices in line with the prevailing moral norm that doctors must never kill patients. When these moral fictions are exposed, it becomes apparent that conventional medical ethics relating to end-of-life decisions is radically mistaken. © 2009 Blackwell Publishing Ltd.

Non-evidence-based policy: how effective is China's new cooperative medical scheme in reducing medical impoverishment?

Science.gov (United States)

Yip, Winnie; Hsiao, William C

2009-01-01

In recent years, many lower to middle income countries have looked to insurance as a means to protect their populations from medical impoverishment. In 2003, the Chinese government initiated the New Cooperative Medical System (NCMS), a government-run voluntary insurance program for its rural population. The prevailing model of NCMS combines medical savings accounts with high-deductible catastrophic hospital insurance (MSA/Catastrophic). To assess the effectiveness of this approach in reducing medical impoverishment, we used household survey data from 2006 linked to claims records of health expenditures to simulate the effect of MSA/Catastrophic on reducing the share of individuals falling below the poverty line (headcount), and the amount by which household resources fall short of the poverty line (poverty gap) due to medical expenses. We compared the effects of MSA/Catastrophic to Rural Mutual Health Care (RMHC), an experimental model that provides first dollar coverage for primary care, hospital services and drugs with a similar premium but a lower ceiling. Our results show that RMHC is more effective at reducing medical impoverishment than NCMS. Under the internationally accepted poverty line of US$1.08 per person per day, the MSA/Catastrophic models would reduce the poverty headcount by 3.5-3.9% and the average poverty gap by 11.8-16.4%, compared with reductions of 6.1-6.8% and 15-18.5% under the RMHC model. The primary reason for this is that NCMS does not address a major cause of medical impoverishment: expensive outpatient services for chronic conditions. As such, health policymakers need first to examine the disease profile and health expenditure pattern of a population before they can direct resources to where they will be most effective. As chronic diseases impose a growing share of the burden on the population in developing countries, it is not necessarily true that insurance coverage focusing on expensive hospital care alone is the most effective at

Factors affecting attitudes towards medical abortion in Lithuania

DEFF Research Database (Denmark)

Lazarus, Jeff; Nielsen, Stine; Jakubcionyte, Rita

2006-01-01

Surgical abortion in Lithuania is governed by a 1994 ministerial decree that made it legal for any woman 16 or older. This article seeks to determine the key demographic factors in Lithuanian attitudes towards medical abortion, which is currently not legal.......Surgical abortion in Lithuania is governed by a 1994 ministerial decree that made it legal for any woman 16 or older. This article seeks to determine the key demographic factors in Lithuanian attitudes towards medical abortion, which is currently not legal....

Searching for Silver Linings: Is Perceived Medical Discrimination Weaker in Segregated Areas?

Science.gov (United States)

Gibbons, Joseph; Yang, Tse-Chuan

2018-03-01

An ongoing obstacle in dealing with minority health disparities is discriminatory behavior from healthcare practitioners, also known as medical discrimination. It is not clear, however, if the effects of medical discriminations onto health are constant across space. For example, there is evidence to suspect minorities in racially segregated neighborhoods suffer less from discrimination compared to those living elsewhere. To determine the presence of spatial heterogeneity underlying medical discrimination, we implement logistic geographically weighted regression (GWR) using individual data in the city of Philadelphia from the 2006 and 2008 Public Health Management Corporation's Southeastern Pennsylvania Household Health Surveys. Evaluating the potential role residential segregation has in offsetting medical discrimination, we compare the GWR results to tract data from the 2005-2009 American Community Survey. Through this comparison, we find that the effects of medical discrimination on self-rated health are weaker in magnitude in areas that are mostly minority. However, evidence of direct health benefits for minorities in segregated communities is inconclusive. Thus, while we cannot say living in segregated neighborhoods leads to better minority health, the sting of medical discrimination can be weaker in these places. These results emphasize the importance of local variation, even within a city like Philadelphia, challenging the aspatial one-model-fits-all approach normally found in population studies.

[The global medical record + (DMG+), tool for prevention in first line care].

Science.gov (United States)

Schetgen, M

2012-09-01

The "global medical record +" can be offered to all 45 to 75 year-old patients in the form of a prevention module within the global medical record and which the general practitioner and the patient will regularly update. It will include in particular an assessment of cardiovascular risk, cervical, breast and colon cancer screening, a check of main adult vaccinations, as well as a primary prevention section focused on smoking, alcohol consumption and various hygiene and dietary measures. The inclusion of this module in a computerized medical record will make it more efficient and will lighten the practitioner's workload.

[Medical intern or locum doctor--does job position affect learning?].

Science.gov (United States)

Mars, Nina; Kalske, Jaakko; Halttunen-Nieminen, Mervi; Pitkäranta, Anne

2015-01-01

At the University of Helsinki, the licentiate degree in medicine involves internships that can be conducted as a medical intern or locum doctor. The students and their supervisors fill out a feedback form, which helps in assessing the students' improvement in various areas. Based on the feedback form between 2008 and 2013, students having worked as locum doctor rated better improvement in their diagnostic skills, writing medical records, interacting with the patient, and operating in the work community. Supervisor evaluations did not show a similar clear difference between the job positions.

Experimental study on distributed optical fiber-based approach monitoring saturation line in levee engineering

Science.gov (United States)

Su, Huaizhi; Li, Hao; Kang, Yeyuan; Wen, Zhiping

2018-02-01

Seepage is one of key factors which affect the levee engineering safety. The seepage danger without timely detection and rapid response may likely lead to severe accidents such as seepage failure, slope instability, and even levee break. More than 90 percent of levee break events are caused by the seepage. It is very important for seepage behavior identification to determine accurately saturation line in levee engineering. Furthermore, the location of saturation line has a major impact on slope stability in levee engineering. Considering the structure characteristics and service condition of levee engineering, the distributed optical fiber sensing technology is introduced to implement the real-time observation of saturation line in levee engineering. The distributed optical fiber temperature sensor system (DTS)-based monitoring principle of saturation line in levee engineering is investigated. An experimental platform, which consists of DTS, heating system, water-supply system, auxiliary analysis system and levee model, is designed and constructed. The monitoring experiment of saturation line in levee model is implemented on this platform. According to the experimental results, the numerical relationship between moisture content and thermal conductivity in porous medium is identified. A line heat source-based distributed optical fiber method obtaining the thermal conductivity in porous medium is developed. A DTS-based approach is proposed to monitor the saturation line in levee engineering. The embedment pattern of optical fiber for monitoring saturation line is presented.

Analysing the Unequal Effects of Positive and Negative Information on the Behaviour of Users of a Taiwanese On-Line Bulletin Board.

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Shu-Li Cheng

Full Text Available The impact of social influence causes people to adopt the behaviour of others when interacting with other individuals. The effects of social influence can be direct or indirect. Direct social influence is the result of an individual directly influencing the opinion of another, while indirect social influence is a process taking place when an individual's opinion and behaviour is affected by the availability of information about others' actions. Such indirect effect may exhibit a more significant impact in the on-line community because the internet records not only positive but also negative information, for example on-line written text comments. This study focuses on indirect social influence and examines the effect of preceding information on subsequent users' opinions by fitting statistical models to data collected from an on-line bulletin board. Specifically, the different impacts of information on approval and disapproval comments on subsequent opinions were investigated. Although in an anonymous situation where social influence is assumed to be at minimum, our results demonstrate the tendency of on-line users to adopt both positive and negative information to conform to the neighbouring trend when expressing opinions. Moreover, our results suggest unequal effects of the local approval and disapproval comments in affecting the likelihood of expressing opinions. The impact of neighbouring disapproval densities was stronger than that of neighbouring approval densities on inducing subsequent disapproval relative to approval comments. However, our results suggest no effects of global social influence on subsequent opinion expression.

Radiative effect of black carbon aerosol on a squall line case in North China

Science.gov (United States)

Fu, Shizuo; Deng, Xin; Li, Zhe; Xue, Huiwen

2017-11-01

The radiative effect of black carbon aerosol (BC) on a squall line case in north China is studied with the Weather Research and Forecasting model. Before the initiation of the squall line, the surface-emitted BC is mixed only in the boundary layer (BL). BC is then transported from the BL into the free troposphere by the updrafts in the squall line system. Once distributed in the atmosphere, BC absorbs solar radiation and heats the surrounding air. The maximum increase of temperature is 0.05 K for the moderately polluted case bc2 and 0.37 K for the heavily polluted case bc20. In case bc2, where the BC concentration is not very high, the solar flux reaching the surface, the sensible heat flux, and the latent heat flux are not significantly affected by BC. In case bc20, the solar flux reaching the surface, the sensible heat flux, and the latent heat flux are reduced by up to 80, 30, and 21 W m- 2, respectively. The reduced surface evaporation leads to a reduced vapor amount at the early stage. After some time, the heating effect causes a large-scale convergence and brings slightly more vapor into the domain. The effect of BC on the cold pool strength and low-level wind shear is small and hence does not significantly affect the triggering of new convections. In addition, our results show that the effect of BC is negligible on the strength and rain rate of the squall line case.

Linear scleroderma following Blaschko′s lines

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Mukhopadhyay Amiya

2005-01-01

Full Text Available Blaschko′s lines form a pattern, which many diseases are found to follow, but linear scleroderma following Blaschko′s lines is a controversial entity rarely reported in the literature. A 24-year-old man presented with multiple linear, atrophic, hyperpigmented lesions punctuated by areas of depigmentations on the left half of the trunk distributed on the anterior, lateral and posterior aspects. The lesions were distributed in a typical S-shaped line. Antinuclear antibody and antihistone antibody tests were negative. Histopathological examination of the skin from the affected area showed features suggestive of scleroderma. Here, we present a case of linear scleroderma following Blaschko′s lines in a male patient - an entity reported only three times so far.

Real-time on-line space research laboratory environment monitoring with off-line trend and prediction analysis

Science.gov (United States)

Jules, Kenol; Lin, Paul P.

2007-06-01

With the International Space Station currently operational, a significant amount of acceleration data is being down-linked, processed and analyzed daily on the ground on a continuous basis for the space station reduced gravity environment characterization, the vehicle design requirements verification and science data collection. To help understand the impact of the unique spacecraft environment on the science data, an artificial intelligence monitoring system was developed, which detects in near real time any change in the reduced gravity environment susceptible to affect the on-going experiments. Using a dynamic graphical display, the monitoring system allows science teams, at any time and any location, to see the active vibration disturbances, such as pumps, fans, compressor, crew exercise, re-boost and extra-vehicular activities that might impact the reduced gravity environment the experiments are exposed to. The monitoring system can detect both known and unknown vibratory disturbance activities. It can also perform trend analysis and prediction by analyzing past data over many increments (an increment usually lasts 6 months) collected onboard the station for selected disturbances. This feature can be used to monitor the health of onboard mechanical systems to detect and prevent potential systems failures. The monitoring system has two operating modes: online and offline. Both near real-time on-line vibratory disturbance detection and off-line detection and trend analysis are discussed in this paper.

On-Line Voltage Stability Assessment based on PMU Measurements

DEFF Research Database (Denmark)

Garcia-Valle, Rodrigo; P. Da Silva, Luiz C.; Nielsen, Arne Hejde

2009-01-01

This paper presents a method for on-line monitoring of risk voltage collapse based on synchronised phasor measurement. As there is no room for intensive computation and analysis in real-time, the method is based on the combination of off-line computation and on-line monitoring, which are correlat...

Scientific writing: a randomized controlled trial comparing standard and on-line instruction

Directory of Open Access Journals (Sweden)

Phadtare Amruta

2009-05-01

Full Text Available Abstract Background Writing plays a central role in the communication of scientific ideas and is therefore a key aspect in researcher education, ultimately determining the success and long-term sustainability of their careers. Despite the growing popularity of e-learning, we are not aware of any existing study comparing on-line vs. traditional classroom-based methods for teaching scientific writing. Methods Forty eight participants from a medical, nursing and physiotherapy background from US and Brazil were randomly assigned to two groups (n = 24 per group: An on-line writing workshop group (on-line group, in which participants used virtual communication, google docs and standard writing templates, and a standard writing guidance training (standard group where participants received standard instruction without the aid of virtual communication and writing templates. Two outcomes, manuscript quality was assessed using the scores obtained in Six subgroup analysis scale as the primary outcome measure, and satisfaction scores with Likert scale were evaluated. To control for observer variability, inter-observer reliability was assessed using Fleiss's kappa. A post-hoc analysis comparing rates of communication between mentors and participants was performed. Nonparametric tests were used to assess intervention efficacy. Results Excellent inter-observer reliability among three reviewers was found, with an Intraclass Correlation Coefficient (ICC agreement = 0.931882 and ICC consistency = 0.932485. On-line group had better overall manuscript quality (p = 0.0017, SSQSavg score 75.3 ± 14.21, ranging from 37 to 94 compared to the standard group (47.27 ± 14.64, ranging from 20 to 72. Participant satisfaction was higher in the on-line group (4.3 ± 0.73 compared to the standard group (3.09 ± 1.11 (p = 0.001. The standard group also had fewer communication events compared to the on-line group (0.91 ± 0.81 vs. 2.05 ± 1.23; p = 0.0219. Conclusion Our protocol

Managing Complexity: Exploring Decision Making on Medication by Young Adults with ADHD.

Science.gov (United States)

Druedahl, Louise C; Kälvemark Sporrong, Sofia

2018-04-19

Attention-deficit hyperactivity disorder (ADHD) causes difficulties with hyperactivity, impulsivity and inattention. Treatment of ADHD includes both medication and non-pharmacological options. Knowledge of treatment preferences by young adults with ADHD is sparse. The objective of this study was to explore the beliefs and experiences of young adults with ADHD related to their medication treatment decisions. Data were collected in Denmark in 2016 through a focus group and individual in-depth interviews. Conventional content analysis was used. Ten young adults with ADHD (22-to 29-year-old) participated. Three major themes were identified: (1) the patient’s right to choose concerning ADHD medicine; (2) the patient’s decision of whether or not to treat ADHD with medication; and (3) factors affecting the patient’s decision on whether to take ADHD medication or not. The latter theme contained 15 factors, which were distributed across three levels: individual, between-individuals, and societal. The dominant factors were increasing quality of life and improving oneself e.g., improving social skills. For counselling at the pharmacy and by prescribers, it is important to be aware of the different factors that affect young adult patients’ decisions on whether to take ADHD medication or not. This knowledge will aid to understand reasons for non-adherence and to determine appropriate treatment for the individual patient.

What do patients think of medical students during their hospitalization? One institution's experience.

Science.gov (United States)

Mora-Pinzon, Maria; Lal, Ankita; Edquist, Sarah; Francescatti, Amanda; Hughes, Tasha; Hayden, Dana; Brand, Marc; Saclarides, Theodore

2013-12-01

Multiple studies have shown patients have a positive attitude toward medical students in outpatient facilities, but it is unknown whether these results can be extrapolated to inpatients. The purpose of this study is to describe the patients' attitude toward medical students in the inpatient facility and factors that may affect it. A 43-item questionnaire was provided to patients of the general surgery department; it gathered demographics, clinical condition, and patients' opinions regarding the medical students' involvement in their care. Eighty-four patients completed the questionnaire. Forty-three per cent were males and the average age was 56 years old (range, 26 to 86 years). Sixty-one patients (72.6%) felt that having medical students enhanced the care provided. Patients' attitudes toward students were as follows: seven patients (8.3%) refused medical students, 40 (47.6%) accepted a limited involvement, and 37 (44%) offered no objections. Patients who refused medical students or preferred a limited involvement were more likely to 1) consider their health as good or excellent; 2) feel that the rounds were too early; and 3) feel that the residents did not spend enough time with them. More patients prefer that medical students have a limited involvement, especially when referring to minor procedures (e.g., nasogastric tube, intravenous line). Better more thorough communication with patients positively affects their attitudes toward students. More studies are required to confirm these results and to analyze other factors that may improve the patients' attitudes toward medical students.

INIS retrieval service, towards on-line

International Nuclear Information System (INIS)

Ebinuma, Yukio; Komatsubara, Yasutoshi

1983-01-01

Japan Atomic Energy Research Institute executes the retrieval service of INIS atomic energy information by batch system in cooperation with Genshiryoku Kozaikai. This service is very popular to the users in whole Japan, but the demand of on-line service has increased recently. Therefore, it was decided to begin the INIS on-line service from January, 1984, through the on-line information retrieval system of the Japan Information Center of Science and Technology. It is expected that when the operation will be started, the utilization of INIS atomic energy information in Japan will drastically increase. Also Japan Atomic Energy Research Institute has carried out the retrieval service by on-line system for those in the institute besides the batch system, accordingly, at this opportunity, the state of utilization of both systems and their distinction to use effectively, and the operation and the method of utilization of the on-line information retrieval system of JICST are explained. In the on-line system, the users are accessible to the data base themselves, and immediate information retrieval is possible, while in the batch system, the related information can be retrieved without fail, and the troublesome operation of equipment is not necessary. (Kako, I.)

A new technique for on-line and off-line high speed computation

International Nuclear Information System (INIS)

Hartouni, E.P.; Jensen, D.A.; Klima, B.; Kreisler, M.N.; Rabin, M.S.Z.; Uribe, J.; Gottschalk, E.; Gara, A.; Knapp, B.C.

1989-01-01

A new technique for both on-line and off-line computation has been developed. With this technique, a reconstruction analysis in Elementary Particle Physics, otherwise prohibitively long, has been accomplished. It will be used on-line in an upcoming Fermilab experiment to reconstruct more than 100,000 events per second and to trigger on the basis of that information. The technique delivers 40 Giga operations per second, has a bandwidth on the order of Gigabytes per second and has a modest cost. An overview of the program, details of the system, and performance measurements are presented in this paper

The impact of an automated dose-dispensing scheme on user compliance, medication understanding, and medication stockpiles

DEFF Research Database (Denmark)

Larsen, Anna Bira; Haugbølle, Lotte Stig

2007-01-01

the assumed user benefits. Neither Danish nor international studies dealt with users' perspective on ADD in general or with respect to the pinpointed benefits, and thus exploration was needed. OBJECTIVES: The objective of this article is to respond to the following research question: How does ADD affect users......' handling and consumption of medication in terms of compliance behavior, and how does the assumption of user benefits made by health professionals and legislators measure up to users' experiences with ADD? METHODS: The results built on a secondary analysis of 9 qualitative interviews with a varied selection...... understanding, nor does it automatically eliminate stockpiles of old medication in users' homes. The gap between the perspectives of users and health professionals makes a compelling case for considering users' voices in the development and implementation of future health technologies....

Individual and crossover effects of stress on adjustment in medical student marriages.

Science.gov (United States)

Katz, J; Monnier, J; Libet, J; Shaw, D; Beach, S R

2000-07-01

High-stress individuals may benefit from social support, although their support providers may be adversely affected via stress crossover effects. Individual and crossover effects of perceived stress within medical student marriages (n = 30) were investigated. Perceived spousal support was positively associated with individuals' own marital and emotional adjustment, attenuating stress effects. With regard to crossover effects, medical students' perceived stress was significantly associated with their spouses' emotional adjustment. Further, medical students' own emotional adjustment fully mediated this crossover effect. Results suggest that the contagion of negative affect may serve as a key mechanism through which stress crossover effects operate in marriage.

Impact of SSSC on Measured Impedance in Single Phase to Ground Fault Condition on 220 kV Transmission Line

Directory of Open Access Journals (Sweden)

Mohamed ZELLAGUI

2012-08-01

Full Text Available This paper presents and compares the impact of SSSC on measured impedance for single phase to ground fault condition. The presence of Static Synchronous SSSC on a transmission line has a great influence on the ZRelay in distance protection. The protection of the high voltage 220 kV single circuit transmission line in eastern Algerian electrical transmission networks is affected in the case with resistance fault RF. The paper investigate the effect of Static Synchronous Series Compensator (SSSC on the measured impedance (Relay taking into account the distance fault point (n and fault resistance (RF. The resultants simulation is performed in MATLAB software environment.

Research for the Influence of Distribution Network Line Reclosing Current on Line Protection

Directory of Open Access Journals (Sweden)

Yu Kansheng

2016-01-01

Full Text Available According to the distribution network line structure and reclosing control strategy, the system simulation model of distribution network lines has established based on the real-time digital simulation RTDS. Based on this, distribution network switching impulse current characteristic has researched with different capacity, different distribution and different load power factor under the different voltage switching angles. The results of the study provide a scientific basis for distribution network line protection setting, in order to further lay the foundation for improvement the validity and reliability of distribution network line protection action.

Qualitative study of patients’ decision-making when accepting second-line treatment after failure of first-line chemotherapy

Science.gov (United States)

Roch, Benoît; Roth, Caroline; Mérel, Jean-Pierre

2018-01-01

Objective Treatment failures in advanced lung cancer are frequent events affecting patients during or after first-line chemotherapy. International guidelines recommend second-line chemotherapy. However, around one half of patients who experience disease progression enter a systemic second-line therapy. In the herein qualitative study, we investigated patients' thoughts and attitudes determining the decision to undergo a second-line chemotherapy. Methods Thirty-three purposively selected patients who recently accepted second-line or palliative chemotherapy were invited to participate in this survey consisting of semi-structured in-depth interviews. Grounded theory was applied to investigate participants’ perceptions of the context that have surrounded their decision to undergo palliative chemotherapy. Results For most patients, tumor burden and reduced quality of life in relation with lung cancer itself were major drivers of the decision-making process. There was a balance between two different attitudes: making a decision to undergo a new line of chemotherapy or starting a psychological process in order to accept end of life. Choosing between these two attitudes allowed the patient to keep the matter of palliative care at a distance. Even in case of low chance of success, many patients who worried about their life partner's future would accept a new chemotherapy line. Some patients experienced ambivalent thoughts regarding social network, particularly about their family as daily function impairment required an increased need for relative's support. The initial "Worrying about others" thoughts left place to in an increasing self-need of care as those provided by relatives; this phenomenon might increase patients' self- perception of being a burden for others. Confidence previously established with formal caregiver support was another major decision driver: some patients with sustained confidence in their medical staff may have privileged this formal support rather

On-line monitoring of methane in sewer air.

Science.gov (United States)

Liu, Yiwen; Sharma, Keshab R; Murthy, Sudhir; Johnson, Ian; Evans, Ted; Yuan, Zhiguo

2014-10-16

Methane is a highly potent greenhouse gas and contributes significantly to climate change. Recent studies have shown significant methane production in sewers. The studies conducted so far have relied on manual sampling followed by off-line laboratory-based chromatography analysis. These methods are labor-intensive when measuring methane emissions from a large number of sewers, and do not capture the dynamic variations in methane production. In this study, we investigated the suitability of infrared spectroscopy-based on-line methane sensors for measuring methane in humid and condensing sewer air. Two such sensors were comprehensively tested in the laboratory. Both sensors displayed high linearity (R(2) > 0.999), with a detection limit of 0.023% and 0.110% by volume, respectively. Both sensors were robust against ambient temperature variations in the range of 5 to 35°C. While one sensor was robust against humidity variations, the other was found to be significantly affected by humidity. However, the problem was solved by equipping the sensor with a heating unit to increase the sensor surface temperature to 35°C. Field studies at three sites confirmed the performance and accuracy of the sensors when applied to actual sewer conditions, and revealed substantial and highly dynamic methane concentrations in sewer air.

Plasmodium species differentiation by non-expert on-line volunteers for remote malaria field diagnosis.

Science.gov (United States)

Ortiz-Ruiz, Alejandra; Postigo, María; Gil-Casanova, Sara; Cuadrado, Daniel; Bautista, José M; Rubio, José Miguel; Luengo-Oroz, Miguel; Linares, María

2018-01-30

Routine field diagnosis of malaria is a considerable challenge in rural and low resources endemic areas mainly due to lack of personnel, training and sample processing capacity. In addition, differential diagnosis of Plasmodium species has a high level of misdiagnosis. Real time remote microscopical diagnosis through on-line crowdsourcing platforms could be converted into an agile network to support diagnosis-based treatment and malaria control in low resources areas. This study explores whether accurate Plasmodium species identification-a critical step during the diagnosis protocol in order to choose the appropriate medication-is possible through the information provided by non-trained on-line volunteers. 88 volunteers have performed a series of questionnaires over 110 images to differentiate species (Plasmodium falciparum, Plasmodium ovale, Plasmodium vivax, Plasmodium malariae, Plasmodium knowlesi) and parasite staging from thin blood smear images digitalized with a smartphone camera adapted to the ocular of a conventional light microscope. Visual cues evaluated in the surveys include texture and colour, parasite shape and red blood size. On-line volunteers are able to discriminate Plasmodium species (P. falciparum, P. malariae, P. vivax, P. ovale, P. knowlesi) and stages in thin-blood smears according to visual cues observed on digitalized images of parasitized red blood cells. Friendly textual descriptions of the visual cues and specialized malaria terminology is key for volunteers learning and efficiency. On-line volunteers with short-training are able to differentiate malaria parasite species and parasite stages from digitalized thin smears based on simple visual cues (shape, size, texture and colour). While the accuracy of a single on-line expert is far from perfect, a single parasite classification obtained by combining the opinions of multiple on-line volunteers over the same smear, could improve accuracy and reliability of Plasmodium species

The new vertical neutron beam line at the CERN n-TOF facility design and outlook on the performance

Energy Technology Data Exchange (ETDEWEB)

Weiß, C., E-mail: christina.weiss@cern.ch [European Organization for Nuclear Research (CERN), Geneva (Switzerland); Chiaveri, E.; Girod, S.; Vlachoudis, V.; Aberle, O. [European Organization for Nuclear Research (CERN), Geneva (Switzerland); Barros, S. [Instituto Tecnológico e Nuclear, Instituto Superior Técnico, Universidade Técnica de Lisboa, Lisboa (Portugal); Bergström, I. [European Organization for Nuclear Research (CERN), Geneva (Switzerland); Berthoumieux, E. [Commissariat à l’Énergie Atomique (CEA) Saclay – Irfu, Gif-sur-Yvette (France); Calviani, M. [European Organization for Nuclear Research (CERN), Geneva (Switzerland); Guerrero, C.; Sabaté-Gilarte, M. [Universidad de Sevilla (Spain); European Organization for Nuclear Research (CERN), Geneva (Switzerland); Tsinganis, A. [European Organization for Nuclear Research (CERN), Geneva (Switzerland); National Technical University of Athens (NTUA) (Greece); Andrzejewski, J. [Uniwersytet Łódzki, Lodz (Poland); Audouin, L. [Centre National de la Recherche Scientifique/IN2P3 – IPN, Orsay (France); Bacak, M. [Atominstitut, Technische Universität Wien (Austria); Balibrea-Correa, J. [Centro de Investigaciones Energeticas Medioambientales y Tecnológicas (CIEMAT), Madrid (Spain); Barbagallo, M. [Istituto Nazionale di Fisica Nucleare, Bari (Italy); Bécares, V. [Centro de Investigaciones Energeticas Medioambientales y Tecnológicas (CIEMAT), Madrid (Spain); and others

2015-11-01

At the neutron time-of-flight facility n-TOF at CERN a new vertical beam line was constructed in 2014, in order to extend the experimental possibilities at this facility to an even wider range of challenging cross-section measurements of interest in astrophysics, nuclear technology and medical physics. The design of the beam line and the experimental hall was based on FLUKA Monte Carlo simulations, aiming at maximizing the neutron flux, reducing the beam halo and minimizing the background from neutrons interacting with the collimator or back-scattered in the beam dump. The present paper gives an overview on the design of the beam line and the relevant elements and provides an outlook on the expected performance regarding the neutron beam intensity, shape and energy resolution, as well as the neutron and photon backgrounds.

Private primary care physicians' perspectives on factors affecting the adoption of electronic medical records: a qualitative pre-implementation study.

Science.gov (United States)

Or, Calvin; Wong, Katie; Tong, Ellen; Sek, Antonio

2014-01-01

Use of electronic medical records (EMR) has the potential to offer quality and safety benefits, but without the adoption of the technology, the benefits will not be realized. This study aimed to identify the factors perceived as relevant by private physicians when considering EMR adoption. A qualitative pre-implementation study was conducted using semi-structured, face to face interviews to explore the perspectives of physicians (n=16) operating in private clinics on the factors affecting their adoption of EMR. A multilevel, work system approach and the immersion/crystallization data analysis technique guided the researchers in examining the data, identifying patterns and key themes, and extracting representative quotes to illustrate these themes. The major factors associated with EMR adoption, which relate to the five categories of a work system, were system usefulness; user interface design; technical support; cost; system reliability; the privacy, confidentiality, and security of patient information; physical space in the clinic; data migration process; adverse work-related factors; and the computer and systems skills of physicians. Pre-implementation identification of factors important to adoption can allow system developers to focus proactively on these factors when developing the system and its implementation strategies, to maximize the likelihood of successful introduction.

The influence of printing substrate on macro non-uniformity and line reproduction quality of imprints printed with electrophotographic process

Directory of Open Access Journals (Sweden)

Đorđe Vujčić

2016-12-01

Full Text Available Print quality is very important for every printing technique. It depends on many different quality attributes. This research included analysis of macro non-uniformities and line reproduction. 16 different paper substrates printed by electrophotographic process were analyzed. They were separated in two groups: coated and uncoated papers. Analysis of macro non-uniformity showed that print mottle has lower values when printed on coated papers than on uncoated papers. Line reproduction analysis showed that the toner spreaded, during melting and fixation, on line edges for both types of paper. According to these results it can be concluded that paper substrate affects the macro non-uniformity and line reproduction, thus overall print quality.

Response analysis on nonuniform transmission line

Directory of Open Access Journals (Sweden)

Cvetković Zlata

2005-01-01

Full Text Available Transients on a loss less exponential transmission line with a pure resistance load are presented in this paper. The approach is based on the two-port presentation of the transmission line. Using Picard-Carson's method the transmission line equations are solved. The relationship between source voltage and the load voltage in s-domain is derived. All the results are plotted using program package Mathematica 3.0.

Can Opening ‘Ethics Files’ on Medical Staff Improve Patients’ Care?

Institute of Scientific and Technical Information of China (English)

2007-01-01

Healthcare workers in Shanghai are walking the line after recent news that regulations issued by local health authorities will soon enforce the opening of an “ethics file” for each of the city’s 140,000 medical workers. According to the regulations, once

On-line adaptive line frequency noise cancellation from a nuclear power measuring channel

Directory of Open Access Journals (Sweden)

Qadir Javed

2011-01-01

Full Text Available On-line software for adaptively canceling 50 Hz line frequency noise has been designed and tested at Pakistan Research Reactor 1. Line frequency noise causes much problem in weak signals acquisition. Sometimes this noise is so dominant that original signal is totally corrupted. Although notch filter can be used for eliminating this noise, but if signal of interest is in close vicinity of 50 Hz, then original signal is also attenuated and hence overall performance is degraded. Adaptive noise removal is a technique which could be employed for removing line frequency without degrading the desired signal. In this paper line frequency noise has been eliminated on-line from a nuclear power measuring channel. The adaptive LMS algorithm has been used to cancel 50 Hz noise. The algorithm has been implemented in labVIEW with NI 6024 data acquisition card. The quality of the acquired signal has been improved much as can be seen in experimental results.

Decision-making in a bisexual line and a thelytokous Wolbachia-infected line of Trichogramma dendrolimi Matsumura (Hymenoptera: Trichogrammatidae) regarding behavior toward their hosts.

Science.gov (United States)

Liu, Quan-Quan; Zhang, Tong-Shu; Li, Chun-Xue; Gu, Jun-Wen; Hou, Jie-Bin; Dong, Hui

2018-07-01

The use of thelytokous Wolbachia-infected Trichogramma (parasitic wasps) has long been considered as a way to enhance the efficacy of biocontrol. However, Wolbachia can affect the host physiology. We compared decision-making between bisexual and thelytokous Wolbachia-infected lines of Trichogramma dendrolimi Matsumura regarding behavior toward fresh and old eggs of Corcyra cephalonica at 25 ± 1 °C and 70 ± 5% relative humidity. The behavioral patterns and sequences of the two lines were basically the same. The durations of various behavioral patterns and values of fitness indicators of the bisexual line on fresh eggs were generally significantly shorter and better, respectively, than on old eggs, whereas the thelytokous line behaved similarly toward the two types of eggs, and differences in most fitness indicators between fresh and old eggs were not significant. On fresh eggs, the durations of various behaviors in the bisexual line were generally significantly shorter than in the thelytokous line and the fitness indicators were generally significantly better. Wolbachia affected the fitness of T. dendrolimi negatively. The potential of the thelytokous line as a biocontrol agent would not be as good as that of the bisexual line when decision-making only is considered. Therefore, further evaluations need to be carried out before the thelytokous line can be used in practical biocontrol. © 2018 Society of Chemical Industry. © 2018 Society of Chemical Industry.

The Effect of Medical Marijuana Laws on Crime: Evidence from State Panel Data, 1990-2006

OpenAIRE

Morris, Robert G.; TenEyck, Michael; Barnes, J. C.; Kovandzic, Tomislav V.

2014-01-01

Background Debate has surrounded the legalization of marijuana for medical purposes for decades. Some have argued medical marijuana legalization (MML) poses a threat to public health and safety, perhaps also affecting crime rates. In recent years, some U.S. states have legalized marijuana for medical purposes, reigniting political and public interest in the impact of marijuana legalization on a range of outcomes. Methods Relying on U.S. state panel data, we analyzed the association between st...

[Applications and prospects of on-line near infrared spectroscopy technology in manufacturing of Chinese materia medica].

Science.gov (United States)

Li, Yang; Wu, Zhi-Sheng; Pan, Xiao-Ning; Shi, Xin-Yuan; Guo, Ming-Ye; Xu, Bing; Qiao, Yan-Jiang

2014-10-01

The quality of Chinese materia medica (CMM) is affected by every process in CMM manufacturing. According to multi-unit complex features in the production of CMM, on-line near infrared spectroscopy (NIR) is used as an evaluating technology with its rapid, non-destructive and non-pollution etc. advantages. With the research in institutions, the on-line NIR applied in process analysis and control of CMM was described systematically, and the on-line NIR platform building was used as an example to clarify the feasibility of on-line NIR technology in CMM manufacturing process. Then, from the point of application by pharmaceutical companies, the current on-line NIR research on CMM and its production in pharmaceutical companies was relatively comprehensively summarized. Meanwhile, the types of CMM productions were classified in accordance with two formulations (liquid and solid dosage formulations). The different production processes (extraction, concentration and alcohol precipitation, etc. ) were used as liquid formulation diacritical points; the different types (tablets, capsules and plasters, etc.) were used as solid dosage formulation diacritical points, and the reliability of on-line NIR used in the whole process in CMM production was proved in according to the summary of literatures in recent 10 years, which could support the modernization of CMM production.

Crosstalk between EGFR and integrin affects invasion and proliferation of gastric cancer cell line, SGC7901

Directory of Open Access Journals (Sweden)

Dan L

2012-10-01

Full Text Available Li Dan,1,* Ding Jian,2,* Lin Na,1 Wang Xiaozhong,1 1Digestive Department, the Union Hospital of Fujian Medical University, Fujian, People’s Republic of China; 2Digestive Department, the First Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian, People’s Republic of China*These authors contributed equally to this workBackground/objective: To investigate the crosstalk between epidermal growth factor receptor (EGFR and integrin-mediated signal transduction pathways in human gastric adenocarcinoma cells.Methods: EGF was used as a ligand of EGFR to stimulate the gastric adenocarcinoma cell, SGC7901. Signal molecules downstream of the integrin, FAK(Y397 and p130cas(Y410 phosphorylation, were measured by immunoprecipitation and western blot. Fibronectin (Fn was used as a ligand of integrin to stimulate the same cell line. Signal molecules downstream of EGFR and extracellular signal-regulated kinase (ERK general phosphorylation were also measured. Focal adhesion kinase (FAK small-interfering RNA was designed and transfected into SGC7901 cells to decrease the expression of FAK. Modified Boyden chambers and MTT assay were used to examine the effect of FAK inhibition on the invasiveness and proliferation of SGC7901.Results: EGF activated FAK(Y397 and p130cas(Y410 phosphorylation, while Fn activated ERK general phosphorylation. Inhibition of FAK expression decreased p130cas(Y410 phosphorylation activated by EGF and ERK general phosphorylation activated by Fn, also decreased the invasiveness and proliferation of SGC7901 cells activated by EGF or Fn.Conclusion: There is crosstalk between EGFR and integrin signal transduction. FAK may be a key cross point of the two signal pathways and acts as a potential target for human gastric cancer therapy.Keywords: gastric adenocarcinoma, epidermal growth factor receptor, integrin, focal adhesion kinase, crosstalk

Enacting Pedagogy in Curricula: On the Vital Role of Governance in Medical Education.

Science.gov (United States)

Casiro, Oscar; Regehr, Glenn

2018-02-01

Managing curricula and curricular change involves both a complex set of decisions and effective enactment of those decisions. The means by which decisions are made, implemented, and monitored constitute the governance of a program. Thus, effective academic governance is critical to effective curriculum delivery. Medical educators and medical education researchers have been invested heavily in issues of educational content, pedagogy, and design. However, relatively little consideration has been paid to the governance processes that ensure fidelity of implementation and ongoing refinements that will bring curricular practices increasingly in line with the pedagogical intent. In this article, the authors reflect on the importance of governance in medical schools and argue that, in an age of rapid advances in knowledge and medical practices, educational renewal will be inhibited if discussions of content and pedagogy are not complemented by consideration of a governance framework capable of enabling change. They explore the unique properties of medical curricula that complicate academic governance, review the definition and properties of good governance, offer mechanisms to evaluate the extent to which governance is operating effectively within a medical program, and put forward a potential research agenda for increasing the collective understanding of effective governance in medical education.

An inventory of publications on electronic medical records revisited.

Science.gov (United States)

Moorman, P W; Schuemie, M J; van der Lei, J

2009-01-01

In this short review we provide an update of our earlier inventories of publications indexed in MedLine with the MeSH term 'Medical Records Systems, Computerized'. We retrieved and analyzed all references to English articles published before January 1, 2008, and indexed in PubMed with the MeSH term 'Medical Records Systems, Computerized'. We retrieved a total of 11,924 publications, of which 3937 (33%) appeared in a journal with an impact factor. Since 2002 the number of yearly publications, and the number of journals in which those publications appeared, increased. A cluster analysis revealed three clusters: an organizational issues cluster, a technically oriented cluster and a cluster about order-entry and research. Although our previous inventory in 2003 suggested a constant yearly production of publications on electronic medical records since 1998, the current inventory shows another rise in production since 2002. In addition, many new journals and countries have shown interest during the last five years. In the last 15 years, interest in organizational issues remained fairly constant, order entry and research with systems gained attention, while interest in technical issues relatively decreased.

Line-on-line organic-organic heteroepitaxy of quaterrylene on hexa-peri-hexabenzocoronene on Au(111).

Science.gov (United States)

Kasemann, Daniel; Wagner, Christian; Forker, Roman; Dienel, Thomas; Müllen, Klaus; Fritz, Torsten

2009-11-03

In a recent paper, we discussed the optical properties of a heterostructure consisting of a highly ordered monolayer of quaterrylene (QT), electronically decoupled from the gold substrate by a predeposited epitaxial monolayer of hexa-peri-hexabenzocoronene (HBC). Here we now present the detailed structural investigation of this organic double-layer system. We show that the structure of the heterosystem can be identified as line-on-line coincidence (lol), a new type of epitaxy discovered by us previously for the system 3,4,9,10-perylenetetracarboxylic dianhydride (PTCDA) on HBC on highly oriented pyrolytic graphite (HOPG). Additionally, we provide evidence on the basis of advanced potential energy calculations that indeed energetic gain drives this lol growth mode.

A Quantitative Analysis of the Effect of Simulation on Medication Administration in Nursing Students

Science.gov (United States)

Scudmore, Casey

2013-01-01

Medication errors are a leading cause of injury and death in health care, and nurses are the last line of defense for patient safety. Nursing educators must develop curriculum to effectively teach nursing students to prevent medication errors and protect the public. The purpose of this quantitative, quasi-experimental study was to determine if…

Stroke and TIA survivors’ cognitive beliefs and affective responses regarding treatment and future stroke risk differentially predict medication adherence and categorised stroke risk

OpenAIRE

Phillips, L. Alison; Diefenbach, Michael A.; Abrams, Jessica; Horowitz, Carol R.

2014-01-01

Cognitive beliefs and affective responses to illness and treatment are known to independently predict health behaviours. The purpose of the current study is to assess the relative importance of four psychological domains – specifically, affective illness, cognitive illness, affective treatment and cognitive treatment – for predicting stroke and transient ischemic attack (TIA) survivors’ adherence to stroke prevention medications as well as their objective, categorised stroke risk. We assessed...

[Knowledge and attitudes of medical students on decriminalized induced abortion].

Science.gov (United States)

Quintero-Roa, Eliana M; Ochoa-Vera, Miguel E

2015-12-01

Objective To explore if the academic exposure to legal abortion affects the knowledge and attitudes of medical students. Method To asses this relationship, both qualitative and quantitative approaches were performed. We analyzed a medical student cohort enrolled in gynecology and obstetrics at two accredited universities in Bucaramanga, Colombia during the second half of 2011. Students were invited to participate in two anonymous surveys. One survey was conducted in the first three weeks of the semester, and the second was done in the last three weeks. A quantitative approach was taken by a group interview of two random groups of participants. One group was composed of medical students of gynecology and obstetrics (fourth year of medicine), and the other group was composed of medical students in their last year (internal medical students). Results The items pregnancy with risk to the mother´s life, or affected by a non-viable fetal malformation, or result of rape were recognized and accepted. 46% of the participants changed their attitude about legal abortion at the end of the semester. Three out of every four participants changed their attitude to accept the decriminalized conditions, while one out of every four people had the opposite change of opinion. Medical student´s don´t believe that general practitioners are trained to advice patients in these cases. Conclusions Educating and training general practitioners in issues related to legal abortion may decrease the risk of inadequate medical assessment in cases of legal abortion.

Life on the front lines.

Science.gov (United States)

Hern, W M

1993-01-01

A physician who owns and operates an abortion clinic in Boulder, Colorado, in the US relates how he came to offer this procedure to women and how this choice has affected his life. The physician had worked as a medical student at a Schweitzer-inspired hospital in the Peruvian Amazon in 1964 and later as a Peace Corps physician in Brazil. He performed his first abortion in 1970, in Washington, D. C., for a 17-year-old high school student whose future plans would have been derailed by her pregnancy. At that time, the physician was working to change the federal government's restrictions on abortion funding and he began to correspond with abortion rights groups and heard the Supreme Court arguments in the landmark abortion cases. As part-time medical director of a family planning training program in the Rocky Mountain region, part of his job was to provide information about new abortion techniques. In 1973, he was asked to help start an abortion clinic in Boulder, and he accepted the position of medical director reporting to an executive director. He had to struggle to acquire privileges at Boulder Community Hospital in order to admit patients with complications. In addition, a "Fight the Abortion Clinic Committee" tried to have the clinic closed by the Colorado Board of Health. Further obstacles were placed by members of the Boulder County Medical Society who formed another committee with the intent of closing the clinic. After a tour of the clinic, the committee chairman declared that the clinic met the highest standards of medical care, so that effort was ended. In November 1973, antiabortion groups began to picket the clinic and the physician began to receive threatening phone calls at home. He purchased a rifle and kept it by his bed. In the summer of 1974, he participated in a debate on Denver television. He had to be secreted out a back door after a subsequent debate. The same summer, the Denver chapter of the National Organization for Women held a rally to

Desenvolvimento de um curso on-line sobre o tema administração de medicamentos Desarrollo de un curso via electrónica sobre la administración de medicamentos Development of a on-line course about administration of medication

Directory of Open Access Journals (Sweden)

Silvia Helena De Bortoli Cassiani

2003-09-01

Full Text Available O estudo descreveu o desenvolvimento de um curso on-line sobre o processo da administração de medicamentos - vias. Para tanto se utilizou o World Wide Web Course Tools (WebCT, que é um software que fornece várias ferramentas a supervisores e acesso a estudantes providos de uma senha a diversos ambientes. O material do curso foi subdivido em oito tópicos ilustrados: administração de medicamentos por via oral, sublingual, via parenteral, intradérmica, subcutânea, intramuscular, endovenosa e aplicação tópica e instilação, além das questões para avaliação de conhecimentos. Uma amostra de alunos de graduação da Escola de Enfermagem de Ribeirão Preto - USP avaliou positivamente o curso. Pretende-se agora inseri-lo em disciplina curricular do ensino de graduação, como um recurso adicional à aprendizagem dos alunos.El estudio describe el desarrollo de un curso via internet sobre el proceso de administración de medicamentos - vias. Para tal fin se utilizó el World Wide Web Course Tools (WebCT, que es un software que proporciona varias herramientas a supervisores y acceso a estudiantes, provistos de una clave, a diversos ambientes. El material del curso fue subdividido en ocho tópicos ilustrados: administración de medicamentos por via oral, sub-lingual, via parenteral, intradérmica, subcutánea, intramuscular, endovenosa y aplicación tópica e instilación, contiene además preguntas para la evaluación de conocimientos. Una muestra de alumnos del pre grado de la Escuela de Enfermería de Ribeirão Preto - USP evaluó positivamente el curso. Ahora se pretende incluirlo en la disciplina curricular del pre grado, como un recurso adicional para el aprendizaje de los alumnos.The study describes the development of an on-line course on medication administration. The World Wide Web Course Tools (WebCT that was used is software that provides various tools for supervisors and access to a number of environments for students who have a

The inclusion of Duroc breed in maternal line affects pork quality and fatty acid profile.

Science.gov (United States)

Alonso, Verónica; Muela, Erica; Gutiérrez, Beatriz; Calanche, Juan Benito; Roncalés, Pedro; Beltrán, José A

2015-09-01

The aim of this study was to evaluate the effect of including different percentages of Duroc (D) breed in maternal line [Landrace (LR) × Large White (LW); LR × (LW × D); LR × D] and gender on meat quality and intramuscular (IMF) and subcutaneous (SCF) fatty acid composition. No significant differences were found among dam lines in ultimate pH, L* values and drip and cooking losses. There were higher percentages of saturated fatty acids in LR × D and LR × (LW × D) lines and higher percentages of polyunsaturated fatty acids in LR × LW line in IMF and SCF. Also, LR × D line produced pork with a lower Warner-Bratzler shear force values and higher IMF content and potential of lipid oxidation. Furthermore, the L*, a* and b* values and drip loss were greater in pork from entire males than females. The IMF and SCF of females were more monounsaturated and less polyunsaturated than those from entire males. Copyright © 2015 Elsevier Ltd. All rights reserved.

Moving contact lines on vibrating surfaces

Science.gov (United States)

Solomenko, Zlatko; Spelt, Peter; Scott, Julian

2017-11-01

Large-scale simulations of flows with moving contact lines for realistic conditions generally requires a subgrid scale model (analyses based on matched asymptotics) to account for the unresolved part of the flow, given the large range of length scales involved near contact lines. Existing models for the interface shape in the contact-line region are primarily for steady flows on homogeneous substrates, with encouraging results in 3D simulations. Introduction of complexities would require further investigation of the contact-line region, however. Here we study flows with moving contact lines on planar substrates subject to vibrations, with applications in controlling wetting/dewetting. The challenge here is to determine the change in interface shape near contact lines due to vibrations. To develop further insight, 2D direct numerical simulations (wherein the flow is resolved down to an imposed slip length) have been performed to enable comparison with asymptotic theory, which is also developed further. Perspectives will also be presented on the final objective of the work, which is to develop a subgrid scale model that can be utilized in large-scale simulations. The authors gratefully acknowledge the ANR for financial support (ANR-15-CE08-0031) and the meso-centre FLMSN for use of computational resources. This work was Granted access to the HPC resources of CINES under the allocation A0012B06893 made by GENCI.

Medical professionalism from a socio-cultural perspective: Evaluating medical residents communicative attitudes during the medical encounter in Malaysia

OpenAIRE

K Ganasegeran; SAR Al-Dubai

2014-01-01

Context: The practice of medicine requires good communication skills to foster excellent rapport in doctor patient relationship. Reports on communication skills learning attitude among medical professionals are key essentials toward improving patient safety and quality of care. Aims: We aimed to determine factors affecting communication skills learning attitudes among medical residents in Malaysia. Settings and Design: Cross-sectional survey, in a Malaysian public health hospital. Materials a...

Clouds and silver linings: positive experiences associated with primary affective disorders.

Science.gov (United States)

Jamison, K R; Gerner, R H; Hammen, C; Padesky, C

1980-02-01

Clinical psychiatry has focused almost entirely on the psychopathology of the affective disorders. The authors studied responses of 61 patients (35 bipolar. 26 unipolar) to questions about perceived short- and long-term benefits (increased sensitivity, sexuality, productivity, creativity, and social outgoingness) they attributed to their affective illness. Bipolar patients strongly indicated positive experiences associated with manic-depressive illness; few unipolar patients perceived their disorder in such a way. Significant sex differences emerged in the attributions made by bipolar patients.

[Monitoring medication errors in personalised dispensing using the Sentinel Surveillance System method].

Science.gov (United States)

Pérez-Cebrián, M; Font-Noguera, I; Doménech-Moral, L; Bosó-Ribelles, V; Romero-Boyero, P; Poveda-Andrés, J L

2011-01-01

To assess the efficacy of a new quality control strategy based on daily randomised sampling and monitoring a Sentinel Surveillance System (SSS) medication cart, in order to identify medication errors and their origin at different levels of the process. Prospective quality control study with one year follow-up. A SSS medication cart was randomly selected once a week and double-checked before dispensing medication. Medication errors were recorded before it was taken to the relevant hospital ward. Information concerning complaints after receiving medication and 24-hour monitoring were also noted. Type and origin error data were assessed by a Unit Dose Quality Control Group, which proposed relevant improvement measures. Thirty-four SSS carts were assessed, including 5130 medication lines and 9952 dispensed doses, corresponding to 753 patients. Ninety erroneous lines (1.8%) and 142 mistaken doses (1.4%) were identified at the Pharmacy Department. The most frequent error was dose duplication (38%) and its main cause inappropriate management and forgetfulness (69%). Fifty medication complaints (6.6% of patients) were mainly due to new treatment at admission (52%), and 41 (0.8% of all medication lines), did not completely match the prescription (0.6% lines) as recorded by the Pharmacy Department. Thirty-seven (4.9% of patients) medication complaints due to changes at admission and 32 matching errors (0.6% medication lines) were recorded. The main cause also was inappropriate management and forgetfulness (24%). The simultaneous recording of incidences due to complaints and new medication coincided in 33.3%. In addition, 433 (4.3%) of dispensed doses were returned to the Pharmacy Department. After the Unit Dose Quality Control Group conducted their feedback analysis, 64 improvement measures for Pharmacy Department nurses, 37 for pharmacists, and 24 for the hospital ward were introduced. The SSS programme has proven to be useful as a quality control strategy to identify Unit

Issues for Bringing Electron Beam Irradiators On-Line

International Nuclear Information System (INIS)

Kaye, R.J.; Turman, B.N.

1999-01-01

Irradiation of red meat and poultry has been approved by the U.S. FDA, and the U.S. Department of Agriculture's rule for processing red meat is out for comment. Looking beyond the current issues of packaging materials, labeling, and consumer acceptance, this paper reviews the next step of implementation and how to remove, or at least reduce, the barriers to utilization. Polls of the user community identified their requirements for electron beam or x-ray processing of meat or poultry and their concerns about implementation for on-line processing. These needs and issues are compared to the capabilities of the accelerator industry. The critical issues of beam utilization and dose uniformity, factors affecting floor space requirements, and treatment costs are examined

Issues for Bringing Electron Beam Irradiators On-Line

Energy Technology Data Exchange (ETDEWEB)

Kaye, R.J.; Turman, B.N.

1999-04-20

Irradiation of red meat and poultry has been approved by the U.S. FDA, and the U.S. Department of Agriculture's rule for processing red meat is out for comment. Looking beyond the current issues of packaging materials, labeling, and consumer acceptance, this paper reviews the next step of implementation and how to remove, or at least reduce, the barriers to utilization. Polls of the user community identified their requirements for electron beam or x-ray processing of meat or poultry and their concerns about implementation for on-line processing. These needs and issues are compared to the capabilities of the accelerator industry. The critical issues of beam utilization and dose uniformity, factors affecting floor space requirements, and treatment costs are examined.

Survey of transmission line corridors. [Data on delays in transmission line construction

Energy Technology Data Exchange (ETDEWEB)

1979-01-05

The intent of this study is to determine the extent of delays experienced in planning and constructing transmission lines in the continental United States. The reasons for the delays are identified for each line studied and their effect on the total electrical system is sought. Data was collected for 136 different lines either recently built or currently under study. Statistics were developed for each line in several categories and comparisons of lines delayed were made by company, area served and generation capacity. From the study presented here it was found that: right-of-way acquisition procedures including condemnation and easement negotiation practices delay more projects than local, state and federal regulatory requirements combined; load growth reductions particularly in the east have reduced the impact of regulatory delays; the south, southeast and southwestern areas of the country experience fewer delays in constructing transmission lines than the more populated states, and the cost for corridor delays was responded to for only 17 of the 142 projects surveyed. By far the most costly delay is the expense of condemning land for transmission right-of-way.

On-line atomic data access

Energy Technology Data Exchange (ETDEWEB)

Schultz, D.R. [Oak Ridge National Lab., TN (United States); Nash, J.K. [Lawrence Livermore National Lab., CA (United States)

1996-04-01

The need for atomic data is one which continues to expand in a wide variety of applications including fusion energy, astrophysics, laser- produced plasma research, and plasma processing. Modern computer database and communications technology nables this data to be placed on-line and obtained by users of the Internet. Presented here is a summary of the observations and conclusions regarding such on-line atomic data access derived from a forum held at the Tenth APS Topical Conference on Atomic Processes in Plasmas.

My Retina Tracker™: An On-line International Registry for People Affected with Inherited Orphan Retinal Degenerative Diseases and their Genetic Relatives - A New Resource.

Science.gov (United States)

Fisher, Joan K; Bromley, Russell L; Mansfield, Brian C

2016-01-01

My Retina Tracker™ is a new on-line registry for people affected with inherited orphan retinal degenerative diseases, and their unaffected, genetic relatives. Created and supported by the Foundation Fighting Blindness, it is an international resource designed to capture the disease from the perspective of the registry participant and their retinal health care providers. The registry operates under an Institutional Review Board (IRB)-approved protocol and allows sharing of de-identified data with participants, researchers and clinicians. All participants sign an informed consent that includes selecting which data they wish to share. There is no minimum age of participation. Guardians must sign on behalf of minors, and children between the ages of 12 to 17 also sign an informed assent. Participants may compare their disease to others in the registry using graphical interpretations of the aggregate registry data. Researchers and clinicians have two levels of access. The first provides an interface to interrogate all data fields registrants have agreed to share based on their answers in the IRB informed consent. The second provides a route to contact people in the registry who may be eligible for studies or trials, through the Foundation.

Effects of learning climate and registered nurse staffing on medication errors.

Science.gov (United States)

Chang, YunKyung; Mark, Barbara

2011-01-01

Despite increasing recognition of the significance of learning from errors, little is known about how learning climate contributes to error reduction. The purpose of this study was to investigate whether learning climate moderates the relationship between error-producing conditions and medication errors. A cross-sectional descriptive study was done using data from 279 nursing units in 146 randomly selected hospitals in the United States. Error-producing conditions included work environment factors (work dynamics and nurse mix), team factors (communication with physicians and nurses' expertise), personal factors (nurses' education and experience), patient factors (age, health status, and previous hospitalization), and medication-related support services. Poisson models with random effects were used with the nursing unit as the unit of analysis. A significant negative relationship was found between learning climate and medication errors. It also moderated the relationship between nurse mix and medication errors: When learning climate was negative, having more registered nurses was associated with fewer medication errors. However, no relationship was found between nurse mix and medication errors at either positive or average levels of learning climate. Learning climate did not moderate the relationship between work dynamics and medication errors. The way nurse mix affects medication errors depends on the level of learning climate. Nursing units with fewer registered nurses and frequent medication errors should examine their learning climate. Future research should be focused on the role of learning climate as related to the relationships between nurse mix and medication errors.

Effects of main actor, outcome and affect on biased braking speed judgments

Directory of Open Access Journals (Sweden)

Ola Svenson

2012-05-01

Full Text Available Subjects who judged speed in a driving scenario overestimated how fast they could decelerate when speeding compared to when keeping within the speed limit (Svenson, 2009. The purpose of the present studies were to replicate studies conducted in Europe with subjects in the U.S., to study the influence of speed unit (kph vs. mph, affective reactions to outcome (collision and identity of main actor (driver on braking speed judgments. The results replicated the European findings and the outcome affective factor (passing a line/killing a child and the actor factor (subject/driver in general had significant effects on judgments of braking speed. The results were related to psychological theory and applied implications were discussed.

The structure of affective action representations: temporal binding of affective response codes.

Science.gov (United States)

Eder, Andreas B; Müsseler, Jochen; Hommel, Bernhard

2012-01-01

Two experiments examined the hypothesis that preparing an action with a specific affective connotation involves the binding of this action to an affective code reflecting this connotation. This integration into an action plan should lead to a temporary occupation of the affective code, which should impair the concurrent representation of affectively congruent events, such as the planning of another action with the same valence. This hypothesis was tested with a dual-task setup that required a speeded choice between approach- and avoidance-type lever movements after having planned and before having executed an evaluative button press. In line with the code-occupation hypothesis, slower lever movements were observed when the lever movement was affectively compatible with the prepared evaluative button press than when the two actions were affectively incompatible. Lever movements related to approach and avoidance and evaluative button presses thus seem to share a code that represents affective meaning. A model of affective action control that is based on the theory of event coding is discussed.

Radecs 99: medical environments - first approach

International Nuclear Information System (INIS)

Meyroneinc, S.; Ferrand, R.

1999-01-01

1999 is the first year when the medical subject is specifically named during a session of the RADECS conference. This initiative aims at identifying from a group of correspondents, the problems and needs linked to the irradiation of electronic systems in the medical area. A survey shows that the main needs of the medical community are: -) centralization of all the information on the subject, -) gathering of all the experience by a RADECS expert, -) the setting of a hot line dedicated to help medical staff choosing the equipment best adapted to their particular situation, and -) the setting of a certification concerning the resistance to radiation of medical equipment likely to be used under radiation (drugs injectors, respirators...)

Computational nanometrology of line-edge roughness: noise effects, cross-line correlations and the role of etch transfer

Science.gov (United States)

Constantoudis, Vassilios; Papavieros, George; Lorusso, Gian; Rutigliani, Vito; Van Roey, Frieda; Gogolides, Evangelos

2018-03-01

The aim of this paper is to investigate the role of etch transfer in two challenges of LER metrology raised by recent evolutions in lithography: the effects of SEM noise and the cross-line and edge correlations. The first comes from the ongoing scaling down of linewidths, which dictates SEM imaging with less scanning frames to reduce specimen damage and hence with more noise. During the last decade, it has been shown that image noise can be an important budget of the measured LER while systematically affects and alter the PSD curve of LER at high frequencies. A recent method for unbiased LER measurement is based on the systematic Fourier or correlation analysis to decompose the effects of noise from true LER (Fourier-Correlation filtering method). The success of the method depends on the PSD and HHCF curve. Previous experimental and model works have revealed that etch transfer affects the PSD of LER reducing its high frequency values. In this work, we estimate the noise contribution to the biased LER through PSD flat floor at high frequencies and relate it with the differences between the PSDs of lithography and etched LER. Based on this comparison, we propose an improvement of the PSD/HHCF-based method for noise-free LER measurement to include the missed high frequency real LER. The second issue is related with the increased density of lithographic patterns and the special characteristics of DSA and MP lithography patterns exhibits. In a previous work, we presented an enlarged LER characterization methodology for such patterns, which includes updated versions of the old metrics along with new metrics defined and developed to capture cross-edge and cross-line correlations. The fundamental concept has been the Line Center Roughness (LCR), the edge c-factor and the line c-factor correlation function and length quantifying the line fluctuations and the extent of cross-edge and cross-line correlations. In this work, we focus on the role of etch steps on cross-edge and

Electronic transport of bilayer graphene with asymmetry line defects

International Nuclear Information System (INIS)

Zhao Xiao-Ming; Chen Chan; Liang Ying; Kou Su-Peng; Wu Ya-Jie

2016-01-01

In this paper, we study the quantum properties of a bilayer graphene with (asymmetry) line defects. The localized states are found around the line defects. Thus, the line defects on one certain layer of the bilayer graphene can lead to an electric transport channel. By adding a bias potential along the direction of the line defects, we calculate the electric conductivity of bilayer graphene with line defects using the Landauer–Büttiker theory, and show that the channel affects the electric conductivity remarkably by comparing the results with those in a perfect bilayer graphene. This one-dimensional line electric channel has the potential to be applied in nanotechnology engineering. (paper)

Comparison of stress among medical and not medical personnel in health care

Directory of Open Access Journals (Sweden)

Anita Mujakić

2014-09-01

Full Text Available Research Question (RQ: Does the opinion of the medical and non - medical staff varies on (1 the level of stress depending on seniority, (2 the staircase of stress in relation to education, and (3 how motivation affects the level of stress. Purpose: The purpose of the study is to determine whether in health care and higher education contribute to increased job stress. Also, we wanted to know whether they are more motivated workers are less exposed to occupational stress and / or employees with higher seniority also more exposed to stress. Method: We did quantitative research in public health institute. Overview of theoretical principles based on domestic and foreign professional literature. Articles and expert input was obtained in electronic databases ProQuest Online Information Service, Ebsco and SpringerLink. Statistical part of the study, we calculated the statistical program where we used the Mann - Whitney U- statistics and Wilcox W-statistics. Results: The results indicate that there is a statistical difference in understanding the importance of seniority and education on occupational stress among medical and non - medical sector. Employees in the medical sector more statistically argue that education and working life affect the career stress. We rejected our second hypothesis, which says that there is a difference between the two sectors regarding the impact of motivation on occupational stress. Both sectors they consider to be less motivated workers exposed to occupational stress. Organization: The survey can further highlight the risks that may be possible due to congestion and occupational stress. Society: positive influence on the social understanding of diversity obtained service of a single profession and thus routing problem in a disproportionate burden of healthcare workers. Healthcare professionals who work under less stress effectively and positively affect the quality of services rendered. Originality: This kind of research by

Study of electric and magnetic fields on transmission lines using a computer simulation program

International Nuclear Information System (INIS)

Robelo Mojica, Nelson

2011-01-01

A study was conducted to determine and reduce levels of electric and magnetic fields with different configurations used by the Instituto Costarricense de Electricidad in power transmission lines in Costa Rica. The computer simulation program PLS-CADD with EPRI algorithm has been used to obtain field values close to those actual to lines easements that have worked to date. Different configurations have been compared on equal terms and the lowest levels of electric and magnetic fields are determined. The most appropriate configuration of the tower has been obtained and therefore has decreased exposure to electromagnetic fields people, without affecting the energy demand of the population. (author) [es

DOE-EPRI On-Line Monitoring Implementation Guidelines

International Nuclear Information System (INIS)

E. Davis, R. Bickford

2003-01-01

Industry and EPRI experience at several plants has shown on-line monitoring to be very effective in identifying out-of-calibration instrument channels or indications of equipment-degradation problems. The EPRI implementation project for on-line monitoring has demonstrated the feasibility of on-line monitoring at several participating nuclear plants. The results have been very encouraging, and substantial progress is anticipated in the coming years

Pink-line syndrome

Digital Repository Service at National Institute of Oceanography (India)

Ravindran J.; Raghukumar, C.; Manikandan, B.

, a physiological crisis in the scleractinian coral Porites lutea. Marine biology 149: 347-356 7. Ravindran J, Raghukumar C (2006a) Histological observations on the scleractinian coral Porites lutea affected by pink-line syndrome. Current science... handbook: guidelines for assessment and monitoring. Currie Communications, Melbourne, Australia, 94p+App 10. Vargas-Angel B, Wheeler B (2009) Coral health and disease assessment in the US Pacific territories and affiliated states. Proc. 11th Coral Reef...

Impact of interventions for patients refusing emergency medical services transport.

Science.gov (United States)

Alicandro, J; Hollander, J E; Henry, M C; Sciammarella, J; Stapleton, E; Gentile, D

1995-06-01

To evaluate the effect of a documentation checklist and on-line medical control contact on ambulance transport of out-of-hospital patients refusing medical assistance. Consecutive patients served by four suburban ambulance services who initially refused emergency medical services (EMS) transport to the hospital were prospectively enrolled. In phase 1 (control phase), all patients who initially refused medical attention or transport had an identifying data card completed. In phase 2 (documentation phase), out-of-hospital providers completed a similar data card that contained a checklist of high-risk criteria for a poor outcome if not transported. In phase 3 (intervention phase), a data card similar to that used in phase 2 was completed, and on-line medical control was contacted for all patients with high-risk criteria who refused transport. The primary endpoint was the percentage of patients transported to the hospital. A total of 361 patients were enrolled. Transport rate varied by phase: control, 17 of 144 (12%); documentation, 11 of 150 (7%); and intervention, 12 of 67 (18%) (chi-square, p = 0.023). Transport of high-risk patients improved with each intervention: control, two of 60 (3%); documentation, seven of 70 (10%); and intervention, 12 of 34 (35%) (chi-square, p = 0.00003). Transport of patients without high-risk criteria decreased with each intervention: control, 15 of 84 (18%); documentation, four of 80 (5%); and intervention, 0 of 33 (0%) (p = 0.0025). Of the 28 patients for whom medical control was contacted, 12 (43%) were transported to the hospital, and only three of these 12 patients (25%) were released from the ED. Contact with on-line medical control increased the likelihood of transport of high-risk patients who initially refused medical assistance. The appropriateness of the decreased transport rate of patients not meeting high-risk criteria needs further evaluation.

[Impact of the Core Training Law on preventive medicine and public health training and other common medical specialties].

Science.gov (United States)

Latasa, Pello; Gil-Borrelli, Christian; Aguilera, José Antonio; Reques, Laura; Barreales, Saúl; Ojeda, Elena; Alemán, Guadalupe; Iniesta, Carlos; Gullón, Pedro

2016-01-01

The purpose of the Core Training Law (CTL) is to amend specialised medical training to include 24 months of common training. The aim of this study is to assess its potential impact on the Preventive Medicine and Public Health (PM&PH) training programme and other medical specialties. The programmes of the 21 common medical specialties were analysed and the recommended training periods for each specialty collected, before the information was agreed upon by three observers. The training impact was calculated as the percentage of months that should be amended per specialty to adapt to the common training schedule. The Preventive Medicine and Public Health training programme is the specialty most affected by the Core Training Law (100%, 24 months). Intensive medicine (0%, 0 months) and medical oncology (17%, 4 months) is the least affected. The CTL affects the common medical specialties in different ways and requires a complete reorganisation of the activities and competencies of PM&PH professionals. Copyright © 2016 SESPAS. Published by Elsevier Espana. All rights reserved.

On-line monitoring for calibration reduction

International Nuclear Information System (INIS)

Hoffmann, Mario; Gran, Frauke Schmitt; Thunem, Harald P-J.

2004-04-01

On-Line Monitoring (OLM) of a channel's calibration state evaluates instrument channel performance by assessing its consistency with other plant indications. Industry and experience at several plants has shown this overall approach to be very effective in identifying instrument channels that are exhibiting degrading or inconsistent performance characteristics. The Halden Reactor Project has developed the signal validation system PEANO, which can be used to assist with the tasks of OLM. To further enhance the PEANO System for use as a calibration reduction tool, the following two additional modules have been developed; HRP Prox, which performs pre-processing and statistical analysis of signal data, Batch Monitoring Module (BMM), which is an off-line batch monitoring and reporting suite. The purpose and functionality of the HRP Prox and BMM modules are discussed in this report, as well as the improvements made to the PEANO Server to support these new modules. The Halden Reactor Project has established a Halden On-Line Monitoring User Group (HOLMUG), devoted to the discussion and implementation of on-line monitoring techniques in power plants. It is formed by utilities, vendors, regulatory bodies and research institutes that meet regularly to discuss implementation aspects of on-line monitoring, technical specification changes, cost-benefit analysis and regulatory issues. (Author)

?Best care on home ground? versus ?elitist healthcare?: concerns and competing expectations for medical tourism development in Barbados

OpenAIRE

Johnston, Rory; Adams, Krystyna; Bishop, Lisa; Crooks, Valorie A; Snyder, Jeremy

2015-01-01

Introduction Many countries have demonstrated interest in expanding their medical tourism sectors because of its potential economic and health system benefits. However, medical tourism poses challenges to the equitable distribution of health resources between international and local patients and private and public medical facilities. Currently, very little is known about how medical tourism is perceived among front line workers and users of health systems in medical tourism ?destinations?. Ba...

On-line signal trend identification

International Nuclear Information System (INIS)

Tambouratzis, T.; Antonopoulos-Domis, M.

2004-01-01

An artificial neural network, based on the self-organizing map, is proposed for on-line signal trend identification. Trends are categorized at each incoming signal as steady-state, increasing and decreasing, while they are further classified according to characteristics such signal shape and rate of change. Tests with model-generated signals illustrate the ability of the self-organizing map to accurately and reliably perform on-line trend identification in terms of both detection and classification. The proposed methodology has been found robust to the presence of white noise

Vertical integration in medical school: effect on the transition to postgraduate training.

Science.gov (United States)

Wijnen-Meijer, Marjo; ten Cate, Olle Th J; van der Schaaf, Marieke; Borleffs, Jan C C

2010-03-01

Recently, many medical schools' curricula have been revised so that they represent vertically integrated (VI) curricula. Important changes include: the provision of earlier clinical experience; longer clerkships, and the fostering of increasing levels of responsibility. One of the aims of vertical integration is to facilitate the transition to postgraduate training. The purpose of the present study is to determine whether a VI curriculum at medical school affects the transition to postgraduate training in a positive way. We carried out a questionnaire study among graduates of six medical schools in the Netherlands, who had followed either a VI or a non-VI curriculum. Items in the questionnaire focused on preparedness for work and postgraduate training, the time and number of applications required to be admitted to residency, and the process of making career choices. In comparison with those who have followed non-VI programmes, graduates of VI curricula appear to make definitive career choices earlier, need less time and fewer applications to obtain residency positions and feel more prepared for work and postgraduate training. The curriculum at medical school affects the transition to postgraduate training. Additional research is required to determine which components of the curriculum cause this effect and to specify under which conditions this effect occurs.

The effectiveness of streaming video on medical student learning: a case study.

Science.gov (United States)

Bridge, Patrick D; Jackson, Matt; Robinson, Leah

2009-08-19

Information technology helps meet today's medical students' needs by providing multiple curriculum delivery methods. Video streaming is an e-learning technology that uses the Internet to deliver curriculum while giving the student control of the content's delivery. There have been few studies conducted on the effectiveness of streaming video in medical schools. A 5-year retrospective study was conducted using three groups of students (n = 1736) to determine if the availability of streaming video in Years 1-2 of the basic science curriculum affected overall Step 1 scores for first-time test-takers. The results demonstrated a positive effect on program outcomes as streaming video became more readily available to students. Based on these findings, streaming video technology seems to be a viable tool to complement in-class delivery methods, to accommodate the needs of medical students, and to provide options for meeting the challenges of delivering the undergraduate medical curriculum. Further studies need to be conducted to continue validating the effectiveness of streaming video technology.

Sport Management Taught On-Line: A Discussion

Directory of Open Access Journals (Sweden)

William F. Stier Jr

2009-01-01

Full Text Available An introduction to the world of on-line courses (distance education/learning is presented. In addition, the world of on-line learning, as it pertains to sport management, is examined within the framework of (a pedagogy, (b finances,(c assessment, and (d choosing to transition from the traditional classroom to on-line learning. Pertinent points relative to each of the four categories are presented from the literature. In an effort to stimulate thought and discussion to the subject of on-line learning for sport management programs/courses the authors provide their reactions to the literature points by presenting their comments/reactions from a sport management perspective. Sport management professors and administrators are encouraged to critically examine the feasibility of such on-line courses (distance education/learning within their own curricula while maintaining an appropriate framework revolving around sound theoretical instructional strategies, methods as well as appropriate use of instructional tools, including but not limited to, computersand the WWW.

Medical tourism's impacts on health worker migration in the Caribbean: five examples and their implications for global justice

OpenAIRE

Snyder, Jeremy; Crooks, Valorie A.; Johnston, Rory; Adams, Krystyna; Whitmore, Rebecca

2015-01-01

Medical tourism is a practice where individuals cross international borders in order to access medical care. This practice can impact the global distribution of health workers by potentially reducing the emigration of health workers from destination countries for medical tourists and affecting the internal distribution of these workers. Little has been said, however, about the impacts of medical tourism on the immigration of health workers to medical tourism destinations. We discuss five patt...

Optimization of antibody immobilization for on-line or off-line immunoaffinity chromatography

DEFF Research Database (Denmark)

Beyer, Natascha Helena; Schou, Christian; Højrup, Peter

2009-01-01

-POROS. Protein G-based matrices are very stable showing essentially no decline in performance after 50 application-wash-elution-reequilibration cycles and being easily prepared within 2-3 h of working time with a typical antibody coupling yield of above 80%. In off-line applications where constant flow....... A systematic study was conducted to determine the most versatile antibody immobilization method for use in on-line and off-line IA chromatography applications using commonly accessible immobilization methods. Four chemistries were examined using polyclonal and monoclonal antibodies and antibody fragments. We...

Perceptions on gender awareness and considerations in career choices of medical students in a medical school in Taiwan

Directory of Open Access Journals (Sweden)

Yueh-Chin Chung

2013-11-01

Full Text Available The trend of medical career choice in the younger generation has resulted in deficiency of manpower in the four major disciplines of internal medicine, surgery, obstetrics/gynecology, and pediatrics, which will threaten people's health care in Taiwan. However, perceptions of gender awareness and factors affecting the career choices of medical students have not been investigated systemically in Taiwan. To explore the perceptions on gender awareness and considerations in career choices, we recruited 280 1st- and 7th-year male and female medical students at a Medical University for the study. A modified Nijmegen questionnaire using a 5-point Likert scale containing medical curricula (18 items, gender awareness (13 items, and career inclination (9 items was adopted as the investigation tool in our study. The response rate was 75% (224/280. With regard to gender, the 1st-year male students had greater confidence in being a physician than the female students (p < 0.05, and female students subjectively suggested an advantage to communicate with patients or colleagues (p < 0.05. Faculty attitude in treating students differently by gender was more prominent in the 7th-year than in the 1st-year students (p < 0.001, and they felt male preceptors typically were more enthusiastic to teach and to rank higher grades to female than to male students; however, this was not observed among female preceptors. Both male and female students showed a low level of agreement that clinical skills and performance of a physician were significantly different by gender and “female physicians are more empathetic and provide more communications than male physicians”. Factors influencing career choices of medical students, including “personal interests/talents” and “academic achievement of the specialty,” were not significantly different by gender. Factors included “training and learning environments of the specialty”, “risk of lawsuit”, and �

The Health Experts onLine at Portsmouth (HELP) system: One-year review of adult and Pediatric Asynchronous Telehealth Consultations.

Science.gov (United States)

Lin, Andrew H; Cole, Jacob H; Chin, John C; Mahnke, Chirstopher Becket

2016-01-01

The Health Experts onLine at Portsmouth teleconsultation system is designed to connect health providers in the Navy Medicine East Region to specialists at Naval Medical Center Portsmouth. A review of the first year of the Health Experts onLine at Portsmouth system was performed. Data on each teleconsultation were extracted from the Health Experts onLine at Portsmouth system database and analyzed. From June 2014 to May 2015 there have been 585 teleconsultations. Providers stationed on 36 ships/submarines and at 28 remote military treatment facilities have utilized the Health Experts onLine at Portsmouth system. Over 280 specialists in 34 different specialties were consulted. The median time to first response from a specialist was 6 h and 8 min, with 75% of all consults being addressed within 24 h. Eighteen medevacs were recommended. Thirty-nine potential medevacs were prevented, and 100 potential civilian network deferrals were prevented, resulting in an estimated savings of over US$580,000. Based on the 1-year metrics, Health Experts onLine at Portsmouth has provided improved access and quality of care to service members and their families throughout the Navy Medicine East Region. It has helped avoid over US$580,000 in unnecessary cost burden. Further review at the 2-year time interval will demonstrate the continued growth and effectiveness of the Health Experts onLine at Portsmouth system.

Effect of capping agents on the cytotoxicity of silver nanoparticles in human normal and cancer skin cell lines

Energy Technology Data Exchange (ETDEWEB)

Netchareonsirisuk, Ponsawan [Chulalongkorn University, Program in Biotechnology, Faculty of Science (Thailand); Puthong, Songchan [Chulalongkorn University, Antibody Production Research Unit, Institute of Biotechnology and Genetic Engineering (Thailand); Dubas, Stephan [Chulalongkorn University, Petroleum and Petrochemical College (Thailand); Palaga, Tanapat [Chulalongkorn University, Department of Microbiology, Faculty of Science (Thailand); Komolpis, Kittinan, E-mail: kittinan.k@chula.ac.th [Chulalongkorn University, Antibody Production Research Unit, Institute of Biotechnology and Genetic Engineering (Thailand)

2016-11-15

Silver nanoparticles (AgNPs) are among the most widely used nanomaterials in medical and consumer products. However, safety in the uses of AgNPs is still controversial. The toxicity of AgNPs toward various cell types has been reported to depend on the surface properties of the nanoparticles. In this study, the effect of AgNPs with the average size of 5–15 nm on the viability of the CCD-986SK human normal skin fibroblast cell line and A375 human malignant melanoma cell line was evaluated. Comparative toxicity studies, based on MTT assay, were performed by using either sodium alginate or poly (4-styrenesulfonic acid-co-maleic acid) sodium salt (PSSMA) as capping agent in the nanoparticle preparation. The cytotoxicity tests revealed that AgNO{sub 3} alone was highly toxic to both cell types while both alginate and PSSMA alone were not toxic. AgNPs capped with alginate were selectively toxic to the cancer cell line but not to the normal cell line while AgNPs capped with PSSMA were toxic to both cancer and normal cell lines. Judging from the 50 % inhibition concentration (IC{sub 50}), it was found that the cancer cell line was more sensitive to AgNPs than the normal cell line. Study on the mode of cell death by annexin V and propidium iodide staining revealed that AgNPs induced more apoptotic cell death (84–90 %) than necrosis (8–12 %) in the skin cancer cell line. These results suggest that the toxicity of AgNPs depended on the type of capping agent and the type of cell line.

Weight loss on stimulant medication: how does it affect body composition and bone metabolism? – A prospective longitudinal study

Directory of Open Access Journals (Sweden)

Poulton Alison

2012-12-01

Full Text Available Abstract Objective Children treated with stimulant medication for attention deficit hyperactivity disorder (ADHD often lose weight. It is important to understand the implications of this during growth. This prospective study was designed to quantify the changes in body composition and markers of bone metabolism on starting treatment. Methods 34 children (29 boys aged 4.7 to 9.1 years newly diagnosed with ADHD were treated with dexamphetamine or methylphenidate, titrating the dose to optimise the therapeutic response. Medication was continued for as long as clinically indicated. Body composition and bone density (dual-energy X-ray absorptiometry were measured at baseline, 6 months and 3 years; changes were analysed in Z-scores based on data from 241 healthy, local children. Markers of bone turnover were measured at baseline, 3 months and 3 years. Results Fat loss of 1.4±0.96kg (total fat 5.7±3.6 to 4.3±3.1kg, p Conclusions Stimulant medication was associated with early fat loss and reduced bone turnover. Lean tissue including bone increased more slowly over 3 years of continuous treatment than would be expected for growth in height. There was long-term improvement in the proportion of central fat for height. This study shows that relatively minor reductions in weight on stimulant medication can be associated with long-term changes in body composition. Further study is required to determine the effects of these changes on adult health.

Factors affecting medical waste management in lowlevel health ...

African Journals Online (AJOL)

African Journal of Environmental Science and Technology ... evaluation of medical waste management systems was conducted in the low-level health ... In Ilala, 70% of the health facilities burn wastes in poorly designed incinerators, open pit ...

The medical food Souvenaid affects brain phospholipid metabolism in mild Alzheimer's disease: results from a randomized controlled trial

OpenAIRE

Rijpma, A.; Graaf, M. van der; Lansbergen, M.M.; Meulenbroek, O.V.; Cetinyurek-Yavuz, A.; Sijben, J.W.; Heerschap, A.; Olde Rikkert, M.G.M.

2017-01-01

Background Synaptic dysfunction contributes to cognitive impairment in Alzheimer?s disease and may be countered by increased intake of nutrients that target brain phospholipid metabolism. In this study, we explored whether the medical food Souvenaid affects brain phospholipid metabolism in patients with Alzheimer?s disease. Methods Thirty-four drug-naive patients with mild Alzheimer?s disease (Mini Mental State Examination score ?20) were enrolled in this exploratory, double-blind, randomized...

Toxicity evaluation of ZnO nanostructures on L929 fibroblast cell line using MTS assay

Energy Technology Data Exchange (ETDEWEB)

Bakhori, Siti Khadijah Mohd; Mahmud, Shahrom; Ann, Ling Chuo [Nano-optoelectronics Research and Technology Laboratory (NOR.), School of Physics, Universiti Sains Malaysia, 11800, USM, Pulau Pinang (Malaysia); Mohamed, Azman Seeni; Saifuddin, Siti Nazmin [Integrative Medicine Cluster, Advanced Medical and Dental Institute, Universiti Sains Malaysia, Bandar Putra Bertam, 13200 Kepala Batas, Pulau Pinang (Malaysia); Masudi, Sam’an Malik; Mohamad, Dasmawati [Craniofacial Science Laboratory, School of Dentistry, Health Campus, Universiti Sains Malaysia, 16150 Kubang Kerian, Kelantan (Malaysia)

2015-04-24

ZnO has wide applications in medical and dentistry apart from being used as optoelectronic devices such as solar cells, photodetectors, sensors and light emitting diodes (LEDs). Therefore, the toxicity evaluation is important to know the toxicity level on normal cell line. The toxicity of two grades ZnO nanostructures, ZnO-4 and ZnO-8 have been carried out using cytotoxicity test of MTS assay on L929 rat fibroblast cell line. Prior to that, ZnO-4 and ZnO-8 were characterized for its morphology, structure and optical properties using FESEM, X-ray diffraction, and Photoluminescence respectively. The two groups revealed difference in morphology and exhibit slightly shifted of near band edge emission of Photoluminescence other than having a similar calculated crystallite size of nanostructures. The viability of cells after 72h were obtained and the statistical significance value was calculated using SPSS v20. The p value is more than 0.05 between untreated and treated cell with ZnO. This insignificant value of p>0.05 can be summarized as a non-toxic level of ZnO-4 and ZnO-8 on the L929 cell line.

Toxicity evaluation of ZnO nanostructures on L929 fibroblast cell line using MTS assay

International Nuclear Information System (INIS)

Bakhori, Siti Khadijah Mohd; Mahmud, Shahrom; Ann, Ling Chuo; Mohamed, Azman Seeni; Saifuddin, Siti Nazmin; Masudi, Sam’an Malik; Mohamad, Dasmawati

2015-01-01

ZnO has wide applications in medical and dentistry apart from being used as optoelectronic devices such as solar cells, photodetectors, sensors and light emitting diodes (LEDs). Therefore, the toxicity evaluation is important to know the toxicity level on normal cell line. The toxicity of two grades ZnO nanostructures, ZnO-4 and ZnO-8 have been carried out using cytotoxicity test of MTS assay on L929 rat fibroblast cell line. Prior to that, ZnO-4 and ZnO-8 were characterized for its morphology, structure and optical properties using FESEM, X-ray diffraction, and Photoluminescence respectively. The two groups revealed difference in morphology and exhibit slightly shifted of near band edge emission of Photoluminescence other than having a similar calculated crystallite size of nanostructures. The viability of cells after 72h were obtained and the statistical significance value was calculated using SPSS v20. The p value is more than 0.05 between untreated and treated cell with ZnO. This insignificant value of p>0.05 can be summarized as a non-toxic level of ZnO-4 and ZnO-8 on the L929 cell line

Social factors affecting education quality of Iranian medical & dental students.

Science.gov (United States)

Zafarmand, A Hamid; Sabour, Siamak

2014-09-01

Positive social behavior of student is an important factor in the integrity of educational quality. Unbalanced behavior can disrupt the progress of students in learning. The present study evaluates the effect of social factors on education quality of dental and medical students. This descriptive cross-sectional study was conducted on 227 randomly selected students (109 dental and 118 medical). The questionnaire contained three domains of cultural collectivism, self-concept, and social adjustment adapted from California Test of Personality. It also included demographic questions like; field of study, gender and home city of residence. Data was analyzed using SPSS (version#19) software. Pearsons' correlation coefficient and independent t-test were used at the P-value of 0.05. Generally, girl students showed higher cultural collectivism (P=0.028) and social adjustment (P=0.04). On the contrary, boys were better in self-concept behavior (P=0.34). Home city of residence evidenced with no significant effect on any aspects of social attitudes of subjects. Pearsons' correlation coefficient test showed a weak correlation between cultural collectivism and self-concept (r=0.134, P=0.04) and between cultural collectivism and social adjustment, as well. (r=0.252, P=0.001) Independent t-test showed a significant difference between male and female students concerning cultural collectivism and social adjustment. Reliability of cultural collectivism, self-concept and social adjustment scales ranged from very good to moderate, α=0.83, α=0.63, and α=0.54 respectively. The results of this study indicated that female students show better cultural collectivism and social adjustment skills. It also proved that home city of residence has no significant effect upon social behavior of either medical or dental students.

The Effects of Medication on Activity and Rehabilitation of Older People – Opportunities and Risks

Directory of Open Access Journals (Sweden)

Clare L Clarke

2017-06-01

Full Text Available Multiple medication use, or polypharmacy, is common in people undergoing rehabilitation. Polypharmacy is also common in older people, where it has the potential to impact on habitual physical activity. Despite this, the interactions between medication, disease, activity, and rehabilitation outcomes are insufficiently researched. In this review, we consider common classes of medications that can affect physical activity levels and outcomes of rehabilitation. We consider medications that improve disease processes and improve limiting symptoms (eg, breathlessness in heart failure and lung disease, pain in arthritis, unwanted side effects of medications (eg, central slowing caused by opioids and hypnotics, and also medication classes that might have the ability to improve activity and rehabilitation outcomes via beneficial effects on neuromuscular function (eg, angiotensin-converting enzyme inhibitors. We conclude by giving practical advice on how to review and optimise medication use to support habitual physical activity and ensure the best results from rehabilitation.

Mycoplasma orale infection affects K+ and Cl- currents in the HSG salivary gland cell line.

Science.gov (United States)

Izutsu, K T; Fatherazi, S; Belton, C M; Oda, D; Cartwright, F D; Kenny, G E

1996-06-01

The relations between K+ channel and Cl- channel currents and mycoplasma infection status were studied longitudinally in HSG cells, a human submandibular gland cell line. The K+ channel currents were disrupted by the occurrence of mycoplasma infection: muscarinic activation of K+ channels and K+ channel expression as estimated by ionomycin- or hypotonically induced K+ current responses were all decreased. Similar decreases in ionomycin- and hypotonically induced responses were observed for Cl- channels, but only the latter decrease was statistically significant. Also, Cl- currents could be elicited more frequently than K+ currents (63% of cases versus 0%) in infected cells when tested by exposure to hypotonic media, indicating that mycoplasma infection affects K+ channels relatively more than Cl- channels. These changes occurred in the originally infected cells, were ameliorated when the infection was cleared with sparfloxacin, and recurred when the cells were reinfected. Such changes would be expected to result in hyposecretion of salivary fluid if they occurred in vivo.

Factors that affect medical students' performance in Anatomy in the ...

African Journals Online (AJOL)

Background: Much attention has been drawn to the area of medical education in contemporary times with the aim of developing effective teaching strategies in our medical schools. Objectives: To identify the problems encountered by students in the study of Anatomy and suggest ways of enhancing their performance in the ...

A Study of Factors Influencing Brain Drain among Medical ...

African Journals Online (AJOL)

This economic situation deeply affected the medical groups that migration became the chorus of the medical personnel. ... purposively selected medical personnel, to ferret the causes of immigration and the corresponding effect on the provision of medical services and development of future medical personnel in the country.

Postgraduation retention of medical students from Otago and Auckland medical programmes.

Science.gov (United States)

Shelker, William; Poole, Phillippa; Bagg, Warwick; Wood, Ian; Glue, Paul

2014-01-24

Auckland and Otago medical programmes have different methods for selecting students. This study compared postgraduate retention in New Zealand (NZ) of medical graduates from the two medical programmes, to assess whether different selection methods influenced retention. Other variables assessed included entrance category and age at graduation. Anonymised databases were created of all graduates from the Otago Faculty of Medicine (1999-2011) and the Auckland medical programme (2000-2012). Demographic and entry category data were recorded. Retention was defined as presence on the NZ Medical Register in December 2012. Risk differences (RD) were calculated to compare retention between the two medical programmes using the Mantel-Haenszel method. The influence of medical programme entrance category on retention was also tested. The influence of covariates on retaining graduates on the register was evaluated using a multiple logistic regression model. The postgraduate retention of graduates of the two medical programmes over 13 years was identical (Auckland 74.9%, Otago 73.6%, P=0.48). Retention of graduate and non-graduate entry students from both medical programmes was similar by 6 years after graduation. Age during medical school did not affect retention. University of attendance had no effect on postgraduation retention of students on the NZ Medical Register, suggesting that retention is not influenced by the different student selection methods at each programme. The data presented shows that New Zealand graduates regardless of programme completed show a similar profile in terms of retention.

A Bayesian-Based System to Assess Wave-Driven Flooding Hazards on Coral Reef-Lined Coasts

Science.gov (United States)

Pearson, S. G.; Storlazzi, C. D.; van Dongeren, A. R.; Tissier, M. F. S.; Reniers, A. J. H. M.

2017-12-01

Many low-elevation, coral reef-lined, tropical coasts are vulnerable to the effects of climate change, sea level rise, and wave-induced flooding. The considerable morphological diversity of these coasts and the variability of the hydrodynamic forcing that they are exposed to make predicting wave-induced flooding a challenge. A process-based wave-resolving hydrodynamic model (XBeach Non-Hydrostatic, "XBNH") was used to create a large synthetic database for use in a "Bayesian Estimator for Wave Attack in Reef Environments" (BEWARE), relating incident hydrodynamics and coral reef geomorphology to coastal flooding hazards on reef-lined coasts. Building on previous work, BEWARE improves system understanding of reef hydrodynamics by examining the intrinsic reef and extrinsic forcing factors controlling runup and flooding on reef-lined coasts. The Bayesian estimator has high predictive skill for the XBNH model outputs that are flooding indicators, and was validated for a number of available field cases. It was found that, in order to accurately predict flooding hazards, water depth over the reef flat, incident wave conditions, and reef flat width are the most essential factors, whereas other factors such as beach slope and bed friction due to the presence or absence of corals are less important. BEWARE is a potentially powerful tool for use in early warning systems or risk assessment studies, and can be used to make projections about how wave-induced flooding on coral reef-lined coasts may change due to climate change.Plain Language SummaryLow-lying tropical coasts fronted by coral reefs are threatened by the effects of climate change, sea level rise, and flooding caused by waves. However, the reefs on these coasts differ widely in their shape, size, and physical characteristics; the wave and water level conditions affecting these coastlines also vary in space and time. These factors make it difficult to predict flooding caused by waves along coral reef-lined coasts. We

Gastrointestinal medications and breastfeeding.

Science.gov (United States)

Hagemann, T M

1998-09-01

Medications used to treat gastrointestinal symptoms are increasingly being used as more have been gained nonprescription status. Most of the gastrointestinal medications, such as laxatives, antacids, and antidiarrheal agents, are used short term. Women who breastfeed should be aware of the risks of taking any medications, whether prescription or nonprescription. There is little information describing transfer into breast milk for many of these products. Cimetidine, atropine, cascara, cisapride, loperamide, magnesium sulfate, and senna are the only products identified by the AAP as compatible with breast feeding. Metoclopramide is listed by the AAP as a drug whose effect on nursing infants is unknown but may be of potential concern, although studies published to date have not reported any adverse effects. The safest laxatives and antidiarrheals are those that are not absorbed and should be considered first-line therapy for conditions of constipation or loose stools. Famotidine and nizatidine are excreted into breast milk to a lesser extent than cimetidine or ranitidine and may be the preferred histamine antagonists. Despite the limited data on the use of cisapride in nursing women, it is considered safe by the AAP and may be preferred over metoclopramide for first-line prescription treatment of heartburn. Although most of these agents appear safe in the nursing infant, caretakers should be aware of the potential adverse reactions that may occur in infants whose mothers require these products.

ON THE ANTI-CORRELATION BETWEEN SPECTRAL LINE BROADENING AND INTENSITY IN CORONAL STRUCTURES OBSERVED WITH EIS

International Nuclear Information System (INIS)

Scott, J. T.; Martens, P. C. H.

2011-01-01

The advance in spectral resolution of the Extreme Ultraviolet Imaging (EIS) spectrometer on board Hinode has allowed for more detailed analysis of coronal spectral lines. Large line broadening and blueshifted velocities have been found in the periphery of active region (AR) cores and near the footpoints of coronal loops. This line broadening is yet to be understood. We study the correlation of intensity and line width for entire ARs and sub-regions selected to include coronal features. The results show that although a slight positive correlation can be found when considering whole images, many sub-regions have a negative correlation between intensity and line width. Sections of a coronal loop display some of the largest anti-correlations found for this study with the increased line broadening occurring directly adjacent to the footpoint section of the loop structure, not at the footpoint itself. The broadened lines may be due to a second Doppler-shifted component that is separate from the main emitting feature such as a coronal loop, but related in their excitation. The small size of these features forces the considerations of investigator and instrumental effects. Preliminary analyses are shown that indicate the possibility of a point-spread function that is not azimuthally symmetric and may affect velocity and line profile measurements.

Research on cotton anther development of three male-sterile lines

International Nuclear Information System (INIS)

Dou Liping; Tang Canming; Yue Jieyu; Wang Qingya

2009-01-01

Pollens of Sumian 22 were irradiated by 60 Co γ-rays at a dose of 20Gy, then fertilized to pistil and harvested seed. Three male-sterile lines were selected from M 1 plants, their anther observed by paraffin slice technique. Although there were some different characteristics during the abortion anther development, the abortion was consistent: the abortion stage from the development periods of pollen mother cells to microspore, pollen mother cells, tapetum, middle layer cells and the shape of anther were affected, the results contained micronucleus and double nucleus, cytoplasm expansion during the period of meiosis, tapetum and middle layer cells and so on were abnormal. (authors)

GERD: Can Certain Medications Increase Severity?

Science.gov (United States)

... increase severity? I've heard that some medications can aggravate the symptoms of GERD. Can you tell me more? Answers from Michael F. Picco, M.D. Certain medications and dietary supplements can irritate the lining of your esophagus, causing heartburn ...

On-line moisture analysis

CERN Document Server

Cutmore, N G

2002-01-01

Measurement of the moisture content of iron ore has become a key issue for controlling moisture additions for dust suppression. In most cases moisture content is still determined by manual or automatic sampling of the ore stream, followed by conventional laboratory analysis by oven drying. Although this procedure enables the moisture content to be routinely monitored, it is too slow for control purposes. This has generated renewed interest in on-line techniques for the accurate and rapid measurement of moisture in iron ore on conveyors. Microwave transmission techniques have emerged over the past 40 years as the dominant technology for on-line measurement of moisture in bulk materials, including iron ores. Alternative technologies have their limitations. Infra-red analysers are used in a variety of process industries, but rely on the measurement of absorption by moisture in a very thin surface layer. Consequently such probes may be compromised by particle size effects and biased presentation of the bulk mater...

Effects of Power Lines on Area Use and Behaviour of Semi-Domestic Reindeer in Enclosures

International Nuclear Information System (INIS)

Flydal, K.; Reimers, E.; Johansen, F.; Colman, J.E.; Korslund, L.; Colman, J.E.

2009-01-01

We conducted large-scale, replicated experiments to test the effects of two parallel power lines on area use, behaviour, and activity of semidomestic reindeer in enclosures. Yearling female reindeer were released into four 50 x 400 m enclosures; two treatment enclosures with power lines and two control enclosures. Reindeer from two herds, one from Kautokeino (domestic tame) and one from Vaga, (domestic wild) were tested separately and compared. Individual location within the enclosures was not affected by the power lines. Effects on restless behaviour were ambiguous, with slightly more restless behaviour in the treatment enclosures for the domestic tame reindeer, while the domestic wild reindeer maintained a stable level in the treatment enclosures, increasing with time in the control enclosures. Activity changes were slightly more common among animals within treatment enclosures for both herds, with no indication of habituation during the experiment. The domestic wild reindeer had more than three times the amount of restless behaviour than the domestic tame reindeer. Our study indicates that for reindeer in enclosures, the disturbance from a power line construction is negligible. This suggests that power lines are a minor disturbing factor compared to human handling when using fenced in areas like grazing gardens in reindeer husbandry.

Germ-line gene therapy and the medical imperative.

Science.gov (United States)

Munson, Ronald; Davis, Lawrence H

1992-06-01

Somatic cell gene therapy has yielded promising results. If germ cell gene therapy can be developed, the promise is even greater: hundreds of genetic diseases might be virtually eliminated. But some claim the procedure is morally unacceptable. We thoroughly and sympathetically examine several possible reasons for this claim but find them inadequate. There is no moral reason, then, not to develop and employ germ-line gene therapy. Taking the offensive, we argue next that medicine has a prima facie moral obligation to do so.

Shaping the spectra of the line-to-line voltage using signal injection in the common mode voltage

DEFF Research Database (Denmark)

Mathe, Laszlo; Rasmussen, Peter Omand; Pedersen, John Kim

2009-01-01

A drawback of Pulse Width Modulation in electrical drives is the high harmonic content of the line to line voltages, which gives rise to Electro-Magnetic Interference and acoustic noise. By injection of a signal into the common mode voltage, the fundamental is not affected, but new frequency...

Suberoylanilide hydroxamic acid affects γH2AX expression in osteosarcoma, atypical teratoid rhabdoid tumor and normal tissue cell lines after irradiation

International Nuclear Information System (INIS)

Blattmann, C.; Oertel, S.; Thiemann, M.; Weber, K.J.; Schmezer, P.; Zelezny, O.; Lopez Perez, R.; Kulozik, A.E.; Debus, J.; Ehemann, V.

2012-01-01

Osteosarcoma and atypical teratoid rhabdoid tumors are tumor entities with varying response to common standard therapy protocols. Histone acetylation affects chromatin structure and gene expression which are considered to influence radiation sensitivity. The aim of this study was to investigate the effect of the combination therapy with the histone deacetylase inhibitor suberoylanilide hydroxamic acid (SAHA) and irradiation on atypical teratoid rhabdoid tumors and osteosarcoma compared to normal tissue cell lines. Clonogenic assay was used to determine cell survival. DNA double-strand breaks (DSB) were examined by pulsed-field electrophoresis (PFGE) as well as by γH2AX immunostaining involving flow cytometry, fluorescence microscopy, and immunoblot analysis. SAHA lead to an increased radiosensitivity in tumor but not in normal tissue cell lines. γH2AX expression as an indicator for DSB was significantly increased when SAHA was applied 24 h before irradiation to the sarcoma cell cultures. In contrast, γH2AX expression in the normal tissue cell lines was significantly reduced when irradiation was combined with SAHA. Analysis of initial DNA fragmentation and fragment rejoining by PFGE, however, did not reveal differences in response to the SAHA pretreatment for either cell type. SAHA increases radiosensitivity in tumor but not normal tissue cell lines. The increased H2AX phosphorylation status of the SAHA-treated tumor cells post irradiation likely reflects its delayed dephosphorylation within the DNA damage signal decay rather than chromatin acetylation-dependent differences in the overall efficacy of DSB induction and rejoining. The results support the hypothesis that combining SAHA with irradiation may provide a promising strategy in the treatment of solid tumors. (orig.)

On line performance monitoring for predictive maintenance [Paper No.: VIA - 2

International Nuclear Information System (INIS)

Gupta, R.K.; Chandra, Rajesh

1981-01-01

There will always be progressive deterioration in the performance of dynamic equipment due to normal inevitable wear, malfunctions, failures and other reasons. In most cases it is possible to monitor some parameters of a system which would get progressively affected with the deterioration in the health of the system. By on-line monitoring of such predetermined parameters, compared with preset base data generated for a healthy system earlier, would prove very helpful in avoiding breakdowns and in proper planning of preventive and predictive maintenance. With increasing use of on-line computerised controls the generation of design base data and also the in-built self checking feature of monitoring the equipment health can be achieved by incorporating suitable software. This type of system will be helpful in: (a) predicting the life of component, (b) prewarning the operator about impending malfunctions, (c) establishing a maintenance schedule and spare inventory, and (d) analysing the failures. This type of centralised predictive maintenance is increasingly becoming important where: (a) the number of equipments are large, (b) the operation of equipment is critical from safety criteria, and (c) the minimum safety margin in the performance of the component is to be maintained. Keeping this in mind, the Fuel Handling System of Narora Atomic Power Project and the future power plants having computerised controls will have facility for on-line performance monitoring for predictive maintenance. The paper also describes methodology of the technique in detail, with a few representative cases. (author)

A biocompatible micro cell culture chamber (mu CCC) for the culturing and on-line monitoring of eukaryote cells

DEFF Research Database (Denmark)

Stangegaard, Michael; Petronis, Sarunas; Jørgensen, Anders Michael

2006-01-01

culture chip compared to cell culture flasks. The cell culture chip could without further modification support cell growth of two other cell lines. Light coming from the microscope lamp during optical recordings of the cells was the only external factor identified, that could have a negative effect...... on cell survival. Low grade light exposure was however compatible with optical recordings as well as cell viability. These results strongly indicate that a cell culture chip could be constructed that allowed for on-line optical recording of cellular events without affecting the cell culturing condition...

A biocompatible micro cell culture chamber (microCCC) for the culturing and on-line monitoring of eukaryote cells

DEFF Research Database (Denmark)

Stangegaard, Michael; Petronis, Sarunas; Jørgensen, A M

2006-01-01

culture chip compared to cell culture flasks. The cell culture chip could without further modification support cell growth of two other cell lines. Light coming from the microscope lamp during optical recordings of the cells was the only external factor identified, that could have a negative effect...... on cell survival. Low grade light exposure was however compatible with optical recordings as well as cell viability. These results strongly indicate that a cell culture chip could be constructed that allowed for on-line optical recording of cellular events without affecting the cell culturing condition...

A Viewpoint on Medical Education in Iran

Directory of Open Access Journals (Sweden)

Mozafar Khazaei

2013-08-01

Full Text Available One of the unique characteristics of medical universities compared to other higher education centers in Iran is existence of medical education development centers. These centers have made an attempt to enhance the quality of medical education by regular and constant activity in various domains of educational planning and policymaking, and empowerment of the faculty members, students and personnel. Numerous studies published in Persian and English journals are one of the achievements of these centers. Also, several Persian and English scientific journals are being published by these centers among which the role of the few English languages journals of these centers is remarkably significant. Since these journals attract more audience, especially from abroad, it is necessary to pay special heed to the quality of their published articles. Avoiding the publication of such articles as “analysis of awareness and attitude” and turning to innovative intervention studies in medical education (1 have been highlighted by the authorities of medical education. During the past 30 years, the planners and medical sciences teachers have made to keep up with global developments in medicine. However, medical education in Iran has encountered numerous challenges, some of which have been referred to in the literature such as incompatibility of education with the real needs of the society, necessity of revising the syllabi and scientific resources, and weakness of clinical education (2, 3. One of the challenges highlighted in the recent years is the decreasing trend in medical students’ motivation and their academic failure. Various studies have investigated the factors affecting the students’ academic failure (4, 5, but few studies have analyzed the practical and scientific solutions to decrease and prevent it. Accepting undergraduate students in Iranian universities is state-based and the fact that universities have no role in the selection and acceptance

Making the most of on-line recruiting.

Science.gov (United States)

Cappelli, P

2001-03-01

Ninety percent of large U.S. companies are already recruiting via the Internet. By simply logging on to the Web, company recruiters can locate vast numbers of qualified candidates for jobs at every level, screen them in minutes, and contact the most promising ones immediately. The payoffs can be enormous: it costs substantially less to hire someone on-line, and the time saved is equally great. In this article, Peter Cappelli examines some of the emerging service providers and technologies--matchmakers, job boards, hiring management systems software, and applicant-screening mechanisms that test skills and record interests. He also looks at some of the strategies companies are adopting as they enter on-line labor markets. Recruiting needs to be refashioned to resemble marketing, he stresses. Accordingly, smart companies are designing Web pages, and even product ads, with potential recruits in mind. They're giving line managers authority to hire so that candidates in cyberspace aren't lost. They're building internal on-line job networks to retain talent. Integrating recruiting efforts with overall marketing campaigns, especially through coordination and identification with the company's brand, is the most important thing companies can do to ensure success in on-line hiring. Along the way, Cappelli sounds two cautionary notes. First, a human touch, not electronic contact, is vital in the last steps of a successful hiring process. Second, companies must make sure that on-line testing and hiring criteria do not discriminate against women, disabled people, workers over 40, or members of minority groups. When competition for talent is fierce, companies that master the art and science of on-line recruiting will be the ones that attract and keep the best people.

An algorithm for on-line price discrimination

NARCIS (Netherlands)

D.D.B. van Bragt; D.J.A. Somefun (Koye); E. Kutschinski; J.A. La Poutré (Han)

2002-01-01

textabstractThe combination of on-line dynamic pricing with price discrimination can be very beneficial for firms operating on the Internet. We therefore develop an on-line dynamic pricing algorithm that can adjust the price schedule for a good or service on behalf of a firm. This algorithm (a

Simultaneous influence of Stark effect and excessive line broadening on the Hα line

Science.gov (United States)

Cvetanović, Nikola; Ivković, Saša S.; Obradović, Bratislav M.; Kuraica, Milorad M.

2017-12-01

The aim of this paper is to study the combined influence of the Stark effect and the excessive Doppler broadening on the Balmer alpha line in hydrogen discharges. Since this line is a good candidate for measuring electric field in various types of discharges with different gas compositions, a simple method for field measurement based on polarization spectroscopy is developed, that includes all the excitation mechanisms. To simultaneously test the flexibility of the fitting procedure and investigate the excessive broadening, we applied the fitting procedure on line profiles obtained at a range of conditions from two different discharges. The range of pressures and voltages was examined in an abnormal glow and in dielectric barrier discharge operating with hydrogen gas. The model fitting function was able to respond and follow the change in the line profile caused by the change of conditions. This procedure can therefore be recommended for electric field measurement. Contribution to the "Topical Issue: Physics of Ionized Gases (SPIG 2016)", edited by Goran Poparic, Bratislav Obradovic, Dragana Maric and Aleksandar Milosavljevic.

Taking note of the perceived value and impact of medical student chart documentation on education and patient care.

Science.gov (United States)

Friedman, Erica; Sainte, Michelle; Fallar, Robert

2010-09-01

To determine the extent of restrictions to medical student documentation in patients' records and the opinions of medical education leaders about such restrictions' impact on medical student education and patient care. Education deans (n = 126) of medical schools in the United States and Canada were surveyed to determine policies regarding placement of medical student notes in the patient record, the value of medical students' documentation in the medical record, and the use of electronic medical records (EMRs) for patient notes. The instrument was a 23-item anonymous Web survey. Seventy-nine deans responded. Over 90% believed student notes belong in medical records, but only 42% had a policy regarding this. Ninety-three percent indicated that without student notes, student education would be negatively affected. Fewer (56%) indicated that patient care would be negatively affected. Most thought limiting students' notes would negatively affect several other issues: feeling a part of the team (96%), preparation for internship (95%), and students' sense of involvement (94%). Half (52%) reported that fourth-year students could place notes in paper charts at "all" affiliated hospitals, and 6% reported that fourth-year students could do so at "no" hospitals. Although students' ability to enter notes in patients' records is believed to be important for student education, only about half of all hospitals allow all students' notes in the EMR. Policies regarding placement of student notes should be implemented to ensure students' competency in note writing and their value as members of the patient care team.

A model of user engagement in medical device development.

Science.gov (United States)

Grocott, Patricia; Weir, Heather; Ram, Mala Bridgelal

2007-01-01

The purpose of this paper is to address three topical themes: user involvement in health services research; determining the value of new medical technologies in patient care pathways, furthering knowledge related to quality in health and social care; and knowledge exchange between manufacturers, health service supply chain networks and device users. The model is being validated in a case study in progress. The latter is a "proving ground" study for a translational research company. Medical devices play a pivotal role in the management of chronic diseases, across all care settings. Failure to engage users in device development inevitably affects the quality of clinical outcomes. A model of user engagement is presented, turning unmet needs for medical devices into viable commercial propositions. A case study investigating the perceptions of individuals with Epidermolysis Bullosa (EB), their lay and professional carers into unmet needs. EB is an inherited condition affecting the skin and mucosal linings that leads to blistering and wounds. Qualitative data are being collected to generate understanding of unmet needs and wound care products. These needs are being translated into new design concepts and prototypes. Prototypes will be evaluated in an n = 1 experimental design, generating quantitative outcomes data. There are generalisations from the case study, and the model outlined. New products for managing EB wounds can logically benefit other groups. The model is transferable to other clinical problems, which can benefit from research and technological advances that are integral to clinical needs and care.

The effective factors on library anxiety of students in Isfahan University of Medical Sciences and Shiraz University of Medical Sciences.

Science.gov (United States)

Ashrafi-Rizi, Hasan; Sajad, Maryam Sadat; Rahmani, Sedigheh; Bahrami, Susan; Papi, Ahmad

2014-01-01

The efficient use of libraries can be an important factor in determining the educational quality of Universities. Therefore, investigation and identification of factors affecting library anxiety becomes increasingly necessary. The purpose of this research is to determine the factors effecting library anxiety of students in Isfahan University of Medical Sciences and Shiraz University of Medical Sciences. This was an applied survey research using Bostick's Library Anxiety questionnaire as data gathering tool. The statistical population consisted of all students of Isfahan University of Medical Sciences and Shiraz University of Medical Sciences (15011 students) with the sample size of 375 using stratified random sampling. The validity of data gathering tool was confirmed by experts in the library and information science and its reliability was determined by Cronbach's alpha (r = 0.92). Descriptive statistics (frequency, percentage, mean and standard deviation) and inferential statistics (t-test and ANOVA) were used for data analysis using SPSS 18 software. Findings showed that the mean of library anxiety score was 2.68 and 2.66 for students of Isfahan University of Medical Sciences and Shiraz University of Medical Sciences respectively which is above average (2.5). Furthermore, age and gender had no meaningful effect on the library anxiety of students of Isfahan University of Medical Sciences, but gender had a meaningful effect on library anxiety of students of Shiraz University of Medical Sciences while age had no such effect. The results showed that the mean of factors effecting library anxiety in students of Isfahan University of Medical Sciences and students of Shiraz University of Medical Sciences is higher than average and therefore not satisfactory and only factors relating to feeling comfortable in the library is lower than average and somewhat satisfactory.

Effect of open rhinoplasty on the smile line.

Science.gov (United States)

Tabrizi, Reza; Mirmohamadsadeghi, Hoori; Daneshjoo, Danadokht; Zare, Samira

2012-05-01

Open rhinoplasty is an esthetic surgical technique that is becoming increasingly popular, and can affect the nose and upper lip compartments. The aim of this study was to evaluate the effect of open rhinoplasty on tooth show and the smile line. The study participants were 61 patients with a mean age of 24.3 years (range, 17.2 to 39.6 years). The surgical procedure consisted of an esthetic open rhinoplasty without alar resection. Analysis of tooth show was limited to pre- and postoperative (at 12 months) tooth show measurements at rest and the maximum smile with a ruler (when participants held their heads naturally). Statistical analyses were performed with SPSS 13.0, and paired-sample t tests were used to compare tooth show means before and after the operation. Analysis of the rest position showed no statistically significant change in tooth show (P = .15), but analysis of participants' maximum smile data showed a statistically significant increase in tooth show after surgery (P smile, especially in subjects with high smile lines. This study shows that the nasolabial compartment is a single unit and any change in 1 part may influence the other parts. Further studies should be conducted to investigate these interactions. Copyright © 2012 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

A Distributed System for Learning Programming On-Line

Science.gov (United States)

Verdu, Elena; Regueras, Luisa M.; Verdu, Maria J.; Leal, Jose P.; de Castro, Juan P.; Queiros, Ricardo

2012-01-01

Several Web-based on-line judges or on-line programming trainers have been developed in order to allow students to train their programming skills. However, their pedagogical functionalities in the learning of programming have not been clearly defined. EduJudge is a project which aims to integrate the "UVA On-line Judge", an existing…

The ethics of medical tourism: from the United Kingdom to India seeking medical care.

Science.gov (United States)

Meghani, Zahra

2013-01-01

Is the practice of UK patients traveling to India as medical tourists morally justified? This article addresses that question by examining three ethically relevant issues. First, the key factor motivating citizens of the United Kingdom to seek medical treatment in India is identified and analyzed. Second, the life prospects of the majority of the citizens of the two nations are compared to determine whether the United Kingdom is morally warranted in relying on India to meet the medical needs of its citizens. Third, as neoliberal reforms are justified on the grounds that they will help the indigent populations affected by them, the impact of medical tourism--a neoliberal initiative--on India's socially and economically marginalized groups is scrutinized.

Comparison of On-Line Maintenance Support Tools

International Nuclear Information System (INIS)

Simic, Z.; Follen, S. M.; Mikulicic, V.

1998-01-01

Modeling approach to on-line risk monitoring is today in a rapid developing phase. For that reason number of different solutions are available. This paper will attempt to present existing approaches to address on-line risk modeling problem Starting with description of on-line risk monitoring issues in general, then following by presentation of existing software tools (EPRI's Safety Monitor, Equipment Out of Service Monitor, and ORAM-SENTINEL) the current state of the art in this area will be demonstrated. Finally, conclusions and ideas will be outlined. (author)

APOBEC3DE Inhibits LINE-1 Retrotransposition by Interacting with ORF1p and Influencing LINE Reverse Transcriptase Activity.

Directory of Open Access Journals (Sweden)

Weizi Liang

Full Text Available Human long interspersed elements 1 (LINE-1 or L1 is the only autonomous non-LTR retroelement in humans and has been associated with genome instability, inherited genetic diseases, and the development of cancer. Certain human APOBEC3 family proteins are known to have LINE-1 restriction activity. The mechanisms by which APOBEC3 affects LINE-1 retrotransposition are not all well characterized; here, we confirm that both A3B and A3DE have a strong ability to inhibit LINE-1 retrotransposition. A3DE interacts with LINE-1 ORF1p to target LINE-1 ribonucleoprotein particles in an RNA-dependent manner. Moreover, A3DE binds to LINE-1 RNA and ORF1 protein in cell culture system. Fluorescence microscopy demonstrated that A3DE co-localizes with ORF1p in cytoplasm. Furthermore, A3DE inhibits LINE-1 reverse transcriptase activity in LINE-1 ribonucleoprotein particles in a cytidine deaminase-independent manner. In contrast, A3B has less inhibitory effects on LINE-1 reverse transcriptase activity despite its strong inhibition of LINE-1 retrotransposition. This study demonstrates that different A3 proteins have been evolved to inhibit LINE-1 activity through distinct mechanisms.

Herding: a new phenomenon affecting medical decision-making in multiple sclerosis care? Lessons learned from DIScUTIR MS

Directory of Open Access Journals (Sweden)

Saposnik G

2017-01-01

Full Text Available Gustavo Saposnik,1–3 Jorge Maurino,4 Angel P Sempere,5 Christian C Ruff,2 Philippe N Tobler2 1Division of Neurology, Department of Medicine, St Michael’s Hospital, University of Toronto, Toronto, ON, Canada; 2Laboratory for Social and Neural Systems Research, Department of Economics, University of Zurich, Zurich, Switzerland; 3Li Ka Shing Knowledge Institute, St Michael’s Hospital, University of Toronto, Toronto, ON, Canada; 4Neuroscience Area, Medical Department, Roche Farma, Madrid, 5Department of Neurology, Hospital General Universitario de Alicante, Alicante, Spain Purpose: Herding is a phenomenon by which individuals follow the behavior of others rather than deciding independently on the basis of their own private information. A herding-like phenomenon can occur in multiple sclerosis (MS when a neurologist follows a therapeutic recommendation by a colleague even though it is not supported by best practice clinical guidelines. Limited information is currently available on the role of herding in medical care. The objective of this study was to determine the prevalence (and its associated factors of herding in the management of MS.Methods: We conducted a study among neurologists with expertise in MS care throughout Spain. Participants answered questions regarding the management of 20 case scenarios commonly encountered in clinical practice and completed 3 surveys and 4 experimental paradigms based on behavioral economics. The herding experiment consisted of a case scenario of a 40-year-old woman who has been stable for 3 years on subcutaneous interferon and developed a self-limited neurological event. There were no new magnetic resonance imaging (MRI lesions. Her neurological examination and disability scores were unchanged. She was advised by an MS neurologist to switch from interferon to fingolimod against best practice guidelines. Multivariable logistic regression analysis was conducted to evaluate factors associated with herding

Optimization of Rear Local Al-Contacts on High Efficiency Commercial PERC Solar Cells with Dot and Line Openings

Directory of Open Access Journals (Sweden)

Peisheng Liu

2014-01-01

Full Text Available Crystalline silicon PERCs with dot or line openings on rear surface were studied here. By measuring the minor carrier lifetimes of the PERCs with dot and line openings, passivation effects of rear surface with dot and line openings were discussed. The performance affected by dot and line openings was analyzed in detail by testing the open-circuit voltages, short-circuit current densities, fill factors, and conversion efficiencies of the PERCs. The results show that the wider space resulted in better minor carrier lifetimes on the rear surface. And the cells with a line opening space of 0.5 mm had an average of 0.22% improvement of conversion efficiency, compared with the cells with full-area Al-BSF. On the other hand, the dot opening PERCs exhibited only a conversion efficiency of 17.4%, although there had been good rear surface reflectivity. The bad Al-Si alloy layer and large hollow densities in dot Al-contacts resulted in bad performance of the PERCs with dot openings.

Implementation and Test of On-line Embedded Grid Impedance Estimation for PV-inverters

DEFF Research Database (Denmark)

Asiminoaei, Lucian; Teodorescu, Remus; Blaabjerg, Frede

2004-01-01

to evaluate the grid impedance directly by the PV-inverter, providing a fast and low cost implementation. This principle theoretically provides a correct result of the grid impedance but when using it into the context of PV integration, different implementation issues strongly affect the quality...... of the results. This paper presents a new impedance estimation method including typical implementation problems encountered and it also presents adopted solutions for on-line grid impedance measurement. Practical tests on an existing PV-inverter validate the chosen solutions....

Engaging Frontline Staff in Central Line-Associated Bloodstream Infection Prevention Practice in the Wake of Superstorm Sandy.

Science.gov (United States)

Rosenberg, Rebecca E; Devins, Lea; Geraghty, Gail; Bock, Steven; Dugan, Christina A; Transou, Marjorie; Phillips, Michael; Lighter-Fisher, Jennifer

2015-10-01

Central venous catheters are crucial devices in the care of hospitalized children, both in and out of critical care units, but the concomitant risk of central line-associated bloodstream infection (CLABSI) affects 15,000 Americans annually. In 2012, CLABSI rates varied among units from 6.8/1,000 to 1.0/1,000 in a 109-bed children's service within NYU Langone Medical Center (NYULMC; New York City), a 1,069-bed tertiary care academic medical center. In response to variation in central line-related practices and infection prevention rates, a CLABSI Prevention Core Team began an effort to standardize central venous catheter (CVC) care across all pediatric units (ICU and non-ICU). Momentum in this quality improvement (QI) work was interrupted when Superstorm Sandy shuttered the flagship hospital, but the relatively decreased clinical load provided a "downtime" opportunity to address CLABSI prevention. The first phase of the collaborative effort, Booster 1, Planning/Initial Phase: Development of a Pediatric Central Venous Catheter Working Group, was followed by Booster 2, Maintenance/Sustaining Phase: Transitioning for Sustainability and Adopting Model for Improvement. Data in the subsequent 21 months after the temporary closure of the facility (January 2013-September 2014) showed an increase in maintenance bundle reliability. The inpatient CLABSI rate for patients<18 years decreased from an annual rate of 2.7/1,000 line days (2012) to 0.6/1,000 line days (2013) to 0.5/1,000 line days as of August 2014. There was a decrease in pediatric CLABSI events and no significant change in line days. Key elements contributing to initial success with evolving QI capacity and resources were likely multi-factorial, including staff and leadership engagement, culture change, consistent guidelines, and accountability by individuals and by our multidisciplinary core team.

Development of a fast multi-line x-ray CT detector for NDT

International Nuclear Information System (INIS)

Hofmann, T.; Nachtrab, F.; Schlechter, T.; Mühlbauer, J.; Schröpfer, S.; Firsching, M.; Uhlmann, N.; Neubauer, H.; Ernst, J.; Schweiger, T.; Oberst, M.; Meyer, A.

2015-01-01

Typical X-ray detectors for non-destructive testing (NDT) are line detectors or area detectors, like e.g. flat panel detectors. Multi-line detectors are currently only available in medical Computed Tomography (CT) scanners. Compared to flat panel detectors, line and multi-line detectors can achieve much higher frame rates. This allows time-resolved 3D CT scans of an object under investigation. Also, an improved image quality can be achieved due to reduced scattered radiation from object and detector themselves. Another benefit of line and multi-line detectors is that very wide detectors can be assembled easily, while flat panel detectors are usually limited to an imaging field with a size of approx. 40 × 40 cm 2 at maximum. The big disadvantage of line detectors is the limited number of object slices that can be scanned simultaneously. This leads to long scan times for large objects. Volume scans with a multi-line detector are much faster, but with almost similar image quality. Due to the promising properties of multi-line detectors their application outside of medical CT would also be very interesting for NDT. However, medical CT multi-line detectors are optimized for the scanning of human bodies. Many non-medical applications require higher spatial resolutions and/or higher X-ray energies. For those non-medical applications we are developing a fast multi-line X-ray detector.In the scope of this work, we present the current state of the development of the novel detector, which includes several outstanding properties like an adjustable curved design for variable focus-detector-distances, conserving nearly uniform perpendicular irradiation over the entire detector width. Basis of the detector is a specifically designed, radiation hard CMOS imaging sensor with a pixel pitch of 200 μ m. Each pixel has an automatic in-pixel gain adjustment, which allows for both: a very high sensitivity and a wide dynamic range. The final detector is planned to have 256 lines of

Automatic Delineation of On-Line Head-And-Neck Computed Tomography Images: Toward On-Line Adaptive Radiotherapy

International Nuclear Information System (INIS)

Zhang Tiezhi; Chi Yuwei; Meldolesi, Elisa; Yan Di

2007-01-01

Purpose: To develop and validate a fully automatic region-of-interest (ROI) delineation method for on-line adaptive radiotherapy. Methods and Materials: On-line adaptive radiotherapy requires a robust and automatic image segmentation method to delineate ROIs in on-line volumetric images. We have implemented an atlas-based image segmentation method to automatically delineate ROIs of head-and-neck helical computed tomography images. A total of 32 daily computed tomography images from 7 head-and-neck patients were delineated using this automatic image segmentation method. Manually drawn contours on the daily images were used as references in the evaluation of automatically delineated ROIs. Two methods were used in quantitative validation: (1) the dice similarity coefficient index, which indicates the overlapping ratio between the manually and automatically delineated ROIs; and (2) the distance transformation, which yields the distances between the manually and automatically delineated ROI surfaces. Results: Automatic segmentation showed agreement with manual contouring. For most ROIs, the dice similarity coefficient indexes were approximately 0.8. Similarly, the distance transformation evaluation results showed that the distances between the manually and automatically delineated ROI surfaces were mostly within 3 mm. The distances between two surfaces had a mean of 1 mm and standard deviation of <2 mm in most ROIs. Conclusion: With atlas-based image segmentation, it is feasible to automatically delineate ROIs on the head-and-neck helical computed tomography images in on-line adaptive treatments

Handbook of medical and healthcare technologies

CERN Document Server

Furht, Borko

2013-01-01

This book equips readers to understand a complex range of healthcare products that are used to diagnose, monitor, and treat diseases or medical conditions affecting humans. The first part of the book presents medical technologies such as medical information retrieval, tissue engineering techniques, 3D medical imaging, nanotechnology innovations in medicine, medical wireless sensor networks, and knowledge mining techniques in medicine. The second half of the book focuses on healthcare technologies including prediction hospital readmission risk, modeling e-health framework, personal Web in healt

Herding: a new phenomenon affecting medical decision-making in multiple sclerosis care? Lessons learned from DIScUTIR MS.

Science.gov (United States)

Saposnik, Gustavo; Maurino, Jorge; Sempere, Angel P; Ruff, Christian C; Tobler, Philippe N

2017-01-01

Herding is a phenomenon by which individuals follow the behavior of others rather than deciding independently on the basis of their own private information. A herding-like phenomenon can occur in multiple sclerosis (MS) when a neurologist follows a therapeutic recommendation by a colleague even though it is not supported by best practice clinical guidelines. Limited information is currently available on the role of herding in medical care. The objective of this study was to determine the prevalence (and its associated factors) of herding in the management of MS. We conducted a study among neurologists with expertise in MS care throughout Spain. Participants answered questions regarding the management of 20 case scenarios commonly encountered in clinical practice and completed 3 surveys and 4 experimental paradigms based on behavioral economics. The herding experiment consisted of a case scenario of a 40-year-old woman who has been stable for 3 years on subcutaneous interferon and developed a self-limited neurological event. There were no new magnetic resonance imaging (MRI) lesions. Her neurological examination and disability scores were unchanged. She was advised by an MS neurologist to switch from interferon to fingolimod against best practice guidelines. Multivariable logistic regression analysis was conducted to evaluate factors associated with herding. Out of 161 neurologists who were invited to participate, 96 completed the study (response rate: 60%). Herding was present in 75 (78.1%), having a similar prevalence in MS experts and general neurologists (68.8% vs 82.8%; P =0.12). In multivariate analyses, the number of MS patients seen per week was positively associated with herding (odds ratio [OR] 1.08, 95% CI 1.01-1.14). Conversely, physician's age, gender, years of practice, setting of practice, or risk preferences were not associated with herding. Herding was a common phenomenon affecting nearly 8 out of 10 neurologists caring for MS patients. Herding may

Final year medical students' views on simulation-based teaching: a comparison with the Best Evidence Medical Education Systematic Review.

Science.gov (United States)

Paskins, Zoë; Peile, Ed

2010-01-01

Simulation is being increasingly used in medical education. The aim of this study was to explore in more depth the features of simulation-based teaching that undergraduate medical students value using the Best Evidence Medical Education (BEME) Systematic Review features that lead to effective learning as a framework. Thematic analysis of four semi-structured focus groups with final year medical students who had been taught acute care skills using a medium-fidelity whole-body simulator manikin (SimMan). Twelve key themes were identified, namely, feedback, integration into curriculum, learning style, learning environment, realism, teamwork, communication skills, confidence/increased self-efficacy, anxiety, performance, perceptions of foundation year 1 (FY1) and SimMan as a resource. Each theme is described with supporting quotes. Six of the ten features listed in the BEME review appeared to be of particular value to the medical students. This study provides a richer understanding of these features. In addition, new insights into the effect of simulation on confidence, anxiety and self-efficacy are discussed which may be affected by the 'performance' nature of simulation role-play. Students also contribute critical thought about the use of SimMan as a resource and provide novel ideas for reducing 'downtime'.

Raptor nest management on power lines

Energy Technology Data Exchange (ETDEWEB)

Harness, R.E. [EDM International Inc., Fort Collins, CO (United States)

2005-07-01

Many utilities in South Africa are now implementing labor-intensive methods to combat raptor nesting on power transmission lines. Methods have typically included direct nest removal and trimming of nest materials. However, the process is often unsuccessful, and utilities are now learning to accommodate the raptor nests. This paper argued that managing nests on utility structures has solved many operational problems and has resulted in positive publicity for many line operators. Nest management options included the use of stick deflectors to prevent nest material from accumulating during initial nest construction, as well as encouraging raptors to shift their efforts to a more suitable location. Raptors will often accept alternative nesting platforms, and taller, surrogate nesting poles can be placed next to distribution line structures. Elevated platforms can also be placed on problematic distribution structures, but may result in birds coming into contact with unprotected equipment. It was concluded that a successful nest management program includes plans to make nearby lines safe for raptors and to prevent their electrocution. Providing nests with bird-friendly utility configurations can result in electric facilities enhancing wild raptor populations without impacting power reliability. 14 refs., 9 figs.

Diffusion effects on the line intensities of He I and He II in the solar transition region

International Nuclear Information System (INIS)

Shine, R.; Gerola, H.; Linsky, J.L.

1975-01-01

A heuristic treatment of diffusion in the solar chromosphere-corona transition region is developed. Diffusion becomes increasingly important with steeper temperature gradients, in active and quiet regions relative to coronal holes, and with increasing excitation potential. Numerical calculations are made for the resonance lines of He i and He ii and show that diffusion can enhance these lines. Thus the helium lines may appear relatively weak in coronal holes due to a weakening of the enhancement mechanism. Most transition region lines will be less affected by diffusion than He i or He ii

All-trans retinoic acid inhibits KIT activity and induces apoptosis in gastrointestinal stromal tumor GIST-T1 cell line by affecting on the expression of survivin and Bax protein

Directory of Open Access Journals (Sweden)

Taguchi Takahiro

2010-12-01

Full Text Available Abstract Background Imatinib, a selective tyrosine kinase inhibitor, has been used as a standard first-line therapy for irresectable and metastasized gastrointestinal stromal tumor (GIST patients. Unfortunately, most patients responding to imatinib will eventually exhibit imatinib-resistance, the cause of which is not fully understood. The serious clinical problem of imatinib-resistance demands alternative therapeutic strategy. This study was conducted to investigate the effect of all-trans retinoic acid (ATRA on GIST cell lines. Methods Cell proliferation was determined by trypan blue dye exclusion test. Western blot analysis was performed to test the expression of activated KIT, its downstream proteins, and apoptosis associated proteins. The cytotoxic interactions of imatinib with ATRA were evaluated using the isobologram of Steel and Peckham. Results and conclusion In this work, for the first time we have demonstrated that ATRA affected on cell proliferation of GIST-T1 and GIST-882 cell line through inhibition of cell growth in a dose dependent manner and induced apoptosis. High dose of ATRA induced morphologic change in GIST-T1 cells, rounded-up cells, and activated the caspase-3 protein. In further examination, we found that the ATRA-induced apoptosis in GIST-T1 cells was accompanied by the down-regulated expression of survivin and up-regulated expression of Bax protein. Moreover, ATRA suppressed the activity of KIT protein in GIST-T1 cells and its downstream signal, AKT activity, but not MAPK activity. We also have demonstrated that combination of ATRA with imatinib showed additive effect by isobologram, suggesting that the combination of ATRA and imatinib may be a novel potential therapeutic option for GIST treatment. Furthermore, the scracht assay result suggested that ATRA was a potential reagent to prevent the invasion or metastasis of GIST cells.

Portrayal of medical decision making around medical interventions life-saving encounters on three medical television shows.

Science.gov (United States)

Schwei, Rebecca J; Jacobs, Elizabeth A; Wingert, Katherine; Montague, Enid

2015-07-01

Previous literature has shown that patients obtain information about the medical system from television shows. Additionally, shared decision making is regularly cited as the ideal way to make decisions during a medical encounter. Little information exists surrounding the characteristics of medical decision-making, such as who makes the decision, on medical television shows. We evaluate the characteristics of medical decisions in lifesaving encounters on medical television shows and evaluate if these characteristics were different on staged and reality television shows. We coded type of medical intervention, patient's ability to participate in decision, presence of patient advocate during decision, final decision maker, decision to use intervention, and controversy surrounding decision on three television shows. Frequencies by show were calculated and differences across the three television shows and between staged (ER) and reality ( BostonMed and Hopkins ) television shows were assessed with chi-square tests. The final data set included 37 episodes, 137 patients and 593 interventions. On ER, providers were significantly more likely to make the decision about the medical intervention without informing the patient when a patient was capable of making a decision compared to BostonMed or Hopkins (ptelevision shows we analyzed. It is possible that what patients see on television influences their expectations surrounding the decision making process and the use of medical interventions in everyday healthcare encounters.

Effects of Medications on Voice

Science.gov (United States)

... ENTCareers Marketplace Find an ENT Doctor Near You Effects of Medications on Voice Effects of Medications on Voice Patient Health Information News ... replacement therapy post-menopause may have a variable effect. An inadequate level of thyroid replacement medication in ...

Possible mechanisms by which electric fields from power lines might affect airborne particles harmful to health

International Nuclear Information System (INIS)

Swanson, J.; Jeffers, D.

1999-01-01

Power lines produce alternating electric fields and modify static electric fields in their vicinity. These electric fields, if large enough, can alter the concentration or transport of airborne particles (including particles harmful to health), for example by causing deposition of charged particles, polarisation of neutral particles, or by production of ions. It has been suggested that this could lead to adverse health effects being associated with power lines. Theoretical considerations and experimental evidence relevant to eight separate postulated mechanisms involving power lines and airborne particles are examined. On theoretical grounds, none should lead to any adverse health effect, primarily because the effects produced are very small and are swamped by air currents or by gravity, and because people spend limited time in the relevant conditions. The experimental evidence also weighs against any adverse health effects. Further, even if significant health effects were produced, they would be different from those suggested by existing epidemiology concerning power lines. (author)

Using Learner-Centered, Simulation-Based Training to Improve Medical Students’ Procedural Skills

Directory of Open Access Journals (Sweden)

Serkan Toy

2017-03-01

Full Text Available Purpose: To evaluate the effectiveness of a learner-centered, simulation-based training developed to help medical students improve their procedural skills in intubation, arterial line placement, lumbar puncture, and central line insertion. Method: The study participants were second and third year medical students. Anesthesiology residents provided the training and evaluated students’ procedural skills. Two residents were present at each station to train the medical students who rotated through all 4 stations. Pre/posttraining assessment of confidence, knowledge, and procedural skills was done using a survey, a multiple-choice test, and procedural checklists, respectively. Results: In total, 24 students were trained in six 4-hour sessions. Students reported feeling significantly more confident, after training, in performing all 4 procedures on a real patient ( P < .001. Paired-samples t tests indicated statistically significant improvement in knowledge scores for intubation, t (23 = −2.92, P < .001, and arterial line placement, t (23 = −2.75, P < .001. Procedural performance scores for intubation ( t (23 = −17.29, P < .001, arterial line placement ( t (23 = −19.75, P < .001, lumbar puncture ( t (23 = −16.27, P < .001, and central line placement ( t (23 = −17.25, P < .001 showed significant improvement. Intraclass correlation coefficients indicated high reliability in checklist scores for all procedures. Conclusions: The simulation sessions allowed each medical student to receive individual attention from 2 residents for each procedure. Students’ written comments indicated that this training modality was well received. Results showed that medical students improved their self-confidence, knowledge, and skills in the aforementioned procedures.

Educational On-Line Gaming Propensity

DEFF Research Database (Denmark)

Sudzina, Frantisek; Razmerita, Liana; Kirchner, Kathrin

2014-01-01

Educational on-line games are promising for new generations of students who are grown up digital. Th e new generations of students are technology savvy and spend lots of time on the web and on social networks. Based on an exploratory study, this article investigates the factors that infl uence...... students’ willingness to participate in serious games for teaching/learning. Th is study investigates the relationship between students’ behavior on Facebook, Facebook games, and their attitude toward educational on-line games. Th e results of the study reveal that the early adopters of educational games...... are likely to be students, who are young, have only a few Facebook connections, who currently play Facebook game(s). Furthermore, the study emphasizes that there may be differences between students coming from various countries....

Does students' exposure to gender discrimination and sexual harassment in medical school affect specialty choice and residency program selection?

Science.gov (United States)

Stratton, Terry D; McLaughlin, Margaret A; Witte, Florence M; Fosson, Sue E; Nora, Lois Margaret

2005-04-01

To examine the role of gender discrimination and sexual harassment in medical students' choice of specialty and residency program. Anonymous, self-administered questionnaires were distributed in 1997 to fourth-year students enrolled in 14 public and private U.S. medical schools. In addition to reporting the frequency of gender discrimination and sexual harassment encountered during preclinical coursework, core clerkships, elective clerkships, and residency selection, students assessed the impact of these exposures (none, a little, some, quite a bit, the deciding factor) on their specialty choices and rankings of residency programs. A total of 1,314 (69%) useable questionnaires were returned. Large percentages of men (83.2%) and women (92.8%) experienced, observed, or heard about at least one incident of gender discrimination and sexual harassment during medical school, although more women reported such behavior across all training contexts. Compared with men, significantly (p harassment influenced their specialty choices (45.3% versus 16.4%) and residency rankings (25.3% versus 10.9%). Across all specialties, more women than men experienced gender discrimination and sexual harassment during residency selection, with one exception: a larger percentage of men choosing obstetrics and gynecology experienced such behavior. Among women, those choosing general surgery were most likely to experience gender discrimination and sexual harassment during residency selection. Interestingly, correlations between exposure to gender discrimination and sexual harassment and self-assessed impact on career decisions tended to be larger for men, suggesting that although fewer men are generally affected, they may weigh such experiences more heavily in their choice of specialty and residency program. This study suggests that exposure to gender discrimination and sexual harassment during undergraduate education may influence some medical students' choice of specialty and, to a lesser

Effect of two Howard Hughes Medical Institute research training programs for medical students on the likelihood of pursuing research careers.

Science.gov (United States)

Fang, Di; Meyer, Roger E

2003-12-01

To assess the effect of Howard Hughes Medical Institute's (HHMI) two one-year research training programs for medical students on the awardees' research careers. Awardees of the HHMI Cloister Program who graduated between 1987 and 1995 and awardees of the HHMI Medical Fellows Program who graduated between 1991 and 1995 were compared with unsuccessful applicants to the programs and MD-PhD students who graduated during the same periods. Logistic regression analyses were conducted to assess research career outcomes while controlling for academic and demographic variables that could affect selection to the programs. Participation in both HHMI programs increased the likelihood of receiving National Institutes of Health postdoctoral support. Participation in the Cloister Program also increased the likelihood of receiving a faculty appointment with research responsibility at a medical school. In addition, awardees of the Medical Fellows Program were not significantly less likely than Medical Scientist Training Program (MSTP) and non-MSTP MD-PhD program participants to receive a National Institutes of Health postdoctoral award, and awardees of the Cloister Program were not significantly less likely than non-MSTP MD-PhD students to receive a faculty appointment with research responsibility. Women and underrepresented minority students were proportionally represented among awardees of the two HHMI programs whereas they were relatively underrepresented in MD-PhD programs. The one-year intensive research training supported by the HHMI training programs appears to provide an effective imprinting experience on medical students' research careers and to be an attractive strategy for training physician-scientists.

A pilot study of gestational diabetes mellitus not controlled by diet alone: First-line medical treatment with myoinositol may limit the need for insulin.

Science.gov (United States)

Lubin, V; Shojai, R; Darmon, P; Cosson, E

2016-06-01

This study assessed whether myoinositol might be a first-line medical treatment for gestational diabetes mellitus (GDM). For 12 months, women with GDM not controlled by diet (n=32) were prospectively treated with myoinositol 1200mg and folic acid 400μg/day, while consecutive women (n=28) with insulin-requiring GDM treated during the previous year at our centre constituted the control group. Baseline characteristics and care were similar in both groups. Insulin was required in eight women (25%) in the myoinositol group who, compared with the 24 who did not need insulin, were older (37±5 vs. 32±5 years, respectively; P=0.018) and had a larger percentage of high self-monitored glucose values (45±8% vs. 32±14%; P<0.0001) during the week prior to the introduction of myoinositol treatment. All of the women had similar pregnancy outcomes regardless of their GDM management, although less labour induction was required in the myoinositol group (OR: 0.22 [0.07-0.65]), which had no side effects. This pilot study suggests that myoinositol may be a safe first-line medical treatment for uncontrolled GDM. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

Consensus statement on an updated core communication curriculum for UK undergraduate medical education.

Science.gov (United States)

Noble, Lorraine M; Scott-Smith, Wesley; O'Neill, Bernadette; Salisbury, Helen

2018-04-22

Clinical communication is a core component of undergraduate medical training. A consensus statement on the essential elements of the communication curriculum was co-produced in 2008 by the communication leads of UK medical schools. This paper discusses the relational, contextual and technological changes which have affected clinical communication since then and presents an updated curriculum for communication in undergraduate medicine. The consensus was developed through an iterative consultation process with the communication leads who represent their medical schools on the UK Council of Clinical Communication in Undergraduate Medical Education. The updated curriculum defines the underpinning values, core components and skills required within the context of contemporary medical care. It incorporates the evolving relational issues associated with the more prominent role of the patient in the consultation, reflected through legal precedent and changing societal expectations. The impact on clinical communication of the increased focus on patient safety, the professional duty of candour and digital medicine are discussed. Changes in the way medicine is practised should lead rapidly to adjustments to the content of curricula. The updated curriculum provides a model of best practice to help medical schools develop their teaching and argue for resources. Copyright © 2018 Elsevier B.V. All rights reserved.

Coping on the Front-line

DEFF Research Database (Denmark)

Sanden, Guro Refsum; Lønsmann, Dorte

language boundaries in their everyday work. Despite official English language policies in the three companies, our findings show that employees face a number of different language boundaries, and that ad hoc and informal solutions in many cases are vital for successful cross-language communication. Drawing......This article investigates how front-line employees respond to English language policies implemented by the management of three multinational corporations (MNCs) headquartered in Scandinavia. Based on interview and document data the article examines the ways in which front-line employees cross...

Effect of freezing extender composition and male line on semen traits and reproductive performance in rabbits.

Science.gov (United States)

Viudes-de-Castro, M P; Lavara, R; Safaa, H M; Marco-Jiménez, F; Mehaisen, G M K; Vicente, J S

2014-05-01

This study was conducted to elucidate the effect of different freezing extenders on two lines selected for hyperprolificacy and longevity (H and LP, respectively). In extender A, dimethyl sulphoxide (Me2SO) and sucrose were used as cryoprotectants. In extenders B and C, the sucrose was replaced by 20% egg yolk, and in extender C the Me2SO was substituted by acetamide. Semen was packaged in 0.25 ml plastic straws and cooled at 5°C for 45 min, and then was frozen in liquid nitrogen vapour for 10 min before being plunged into the liquid nitrogen. Thawing was carried out by immersing the straws in a water bath at 50°C for 10 s. Frozen-thawed semen characteristics and reproductive parameters were affected by freezing. Extender C showed significantly lower post-thawing quality traits than any of the three extenders. Acrosome integrity was significantly improved when Me2SO was used as cryoprotectant. Sucrose replacement by 20% egg yolk had no effect on acrosome integrity but provided significantly lower sperm motility and viability. Freezing extender affected fertility rate, total born, number of implantation sites and gestational losses, obtaining better results when extender A was used. The acrosomal integrity after frozen-thawed process showed a significant correlation with fertility at 12th day and also at birth, indicating that an increase in acrosomal integrity leads to an increase in both fertilities (12th day and at birth). A positive correlation between motility of semen and implantation sites was found. The post-thawing quality traits of semen were not affected by the genetic line, although LP line showed higher total born and lower foetal and gestational losses. The findings of this study suggest that freezing extender composition has a significant effect on the success of rabbit sperm for preservation, and when Me2SO was used as permeable cryoprotectant sucrose provided better protection compared with egg yolk and improved reproductive traits, and, on the

Shawnee Mission's On-Line Cataloging System

Directory of Open Access Journals (Sweden)

Ellen Wasby Miller

1971-03-01

Full Text Available An on-line cataloging pilot project for two elementary schools is discussed. The system components are 2740 terminals, upper-lower-case input, IBM's FASTER generalized software package, and usual cards/labels output. Reasons for choosing FASTER, software and hardware features, operating procedures, system performance and costs are detailed. Future expansion to cataloging 100,000 annual K-12 acquisitions, on-line circulation, retrospective conversion, and union book catalogs is set forth.

On-line and off-line data analysis for the EUSO-TA experiment

International Nuclear Information System (INIS)

Piotrowski, Lech Wiktor; Casolino, Marco; Conti, Livio; Ebisuzaki, Toshikazu; Fornaro, Claudio; Kawasaki, Yoshiya; Hachisu, Yusuke; Ohmori, Hitoshi; De Santis, Cristian; Shinozaki, Kenji; Takizawa, Yoshiyuki; Uehara, Yoshihiro

2015-01-01

We show the principles of the communication protocol, on-line calibration, off-line data format as well as basic visualisation and data analysis software implemented for the EUSO-TA on-ground experiment, being the first step towards implementation in a future space based mission. EUSO-TA is an on-ground detector for measuring UV (290–430 nm) light from extensive air showers induced by cosmic rays. It is a prototype experiment for the JEM-EUSO space-borne mission, built according to the same constraints of low mass, low power consumption and thus low computing power. Nevertheless, it needs to process a huge amount of data in short time, taking 2.5μs exposures for 2304 channels. The low processing power and high time resolution require an efficient communication protocol and simple yet powerful algorithms for on-line analysis. The off-line data format is designed for storing a huge amount of data, at the same time allowing easy access, analysis and sharing. Its structure is scalable and adjustable to different experimental designs. It is independent of the data origin, whether it is hardware or a Monte-Carlo simulator. Use of object-oriented techniques and the ROOT framework allows rapid development of dedicated analysis software, such as a Python based quick-view program described herein. Basic capabilities of the software, such as display of the focal surface, light curves and calibration data are shown in this paper

On-line and off-line data analysis for the EUSO-TA experiment

Energy Technology Data Exchange (ETDEWEB)

Piotrowski, Lech Wiktor, E-mail: lech.piotrowski@riken.jp [RIKEN, Wako (Japan); Casolino, Marco [RIKEN, Wako (Japan); INFN and Univ. Rome Tor Vergata, Rome (Italy); Conti, Livio [International Telematic University UNINETTUNO, Rome (Italy); Ebisuzaki, Toshikazu [RIKEN, Wako (Japan); Fornaro, Claudio [International Telematic University UNINETTUNO, Rome (Italy); Kawasaki, Yoshiya; Hachisu, Yusuke; Ohmori, Hitoshi [RIKEN, Wako (Japan); De Santis, Cristian [INFN and Univ. Rome Tor Vergata, Rome (Italy); Shinozaki, Kenji [Institute for Astronomy and Astrophysics, Kepler Center, University of Tübingen, Sand 6, D-72076 Tübingen (Germany); RIKEN, Wako (Japan); Takizawa, Yoshiyuki; Uehara, Yoshihiro [RIKEN, Wako (Japan)

2015-02-11

We show the principles of the communication protocol, on-line calibration, off-line data format as well as basic visualisation and data analysis software implemented for the EUSO-TA on-ground experiment, being the first step towards implementation in a future space based mission. EUSO-TA is an on-ground detector for measuring UV (290–430 nm) light from extensive air showers induced by cosmic rays. It is a prototype experiment for the JEM-EUSO space-borne mission, built according to the same constraints of low mass, low power consumption and thus low computing power. Nevertheless, it needs to process a huge amount of data in short time, taking 2.5μs exposures for 2304 channels. The low processing power and high time resolution require an efficient communication protocol and simple yet powerful algorithms for on-line analysis. The off-line data format is designed for storing a huge amount of data, at the same time allowing easy access, analysis and sharing. Its structure is scalable and adjustable to different experimental designs. It is independent of the data origin, whether it is hardware or a Monte-Carlo simulator. Use of object-oriented techniques and the ROOT framework allows rapid development of dedicated analysis software, such as a Python based quick-view program described herein. Basic capabilities of the software, such as display of the focal surface, light curves and calibration data are shown in this paper.

“Best Care on Home Ground” Versus “Elitist Healthcare”: Concerns and Competing Expectations for Medical Tourism Development in Barbados

OpenAIRE

Johnston, Rory; Adams, Krystyna; Snyder, Jeremy

2015-01-01

Introduction Many countries have demonstrated interest in expanding their medical tourism sectors because of its potential economic and health system benefits. However, medical tourism poses challenges to the equitable distribution of health resources between international and local patients and private and public medical facilities. Currently, very little is known about how medical tourism is perceived among front line workers and users of health systems in medical tourism ‘destinations’....

Recent Progress in the Medical Therapy of Pituitary Tumors

Directory of Open Access Journals (Sweden)

Fabienne Langlois

2017-05-01

Full Text Available Management of pituitary tumors is multidisciplinary, with medical therapy playing an increasingly important role. With the exception of prolactin-secreting tumors, surgery is still considered the first-line treatment for the majority of pituitary adenomas. However, medical/pharmacological therapy plays an important role in controlling hormone-producing pituitary adenomas, especially for patients with acromegaly and Cushing disease (CD. In the case of non-functioning pituitary adenomas (NFAs, pharmacological therapy plays a minor role, the main objective of which is to reduce tumor growth, but this role requires further studies. For pituitary carcinomas and atypical adenomas, medical therapy, including chemotherapy, acts as an adjuvant to surgery and radiation therapy, which is often required to control these aggressive tumors. In the last decade, knowledge about the pathophysiological mechanisms of various pituitary adenomas has increased, thus novel medical therapies that target specific pathways implicated in tumor synthesis and hormonal over secretion are now available. Advancement in patient selection and determination of prognostic factors has also helped to individualize therapy for patients with pituitary tumors. Improvements in biochemical and “tumor mass” disease control can positively affect patient quality of life, comorbidities and overall survival. In this review, the medical armamentarium for treating CD, acromegaly, prolactinomas, NFA, and carcinomas/aggressive atypical adenomas will be presented. Pharmacological therapies, including doses, mode of administration, efficacy, adverse effects, and use in special circumstances are provided. Medical therapies currently under clinical investigation are also briefly discussed.

Why do People Stop Playing On-Line Games?

DEFF Research Database (Denmark)

Sudzina, Frantisek; Razmerita, Liana

2012-01-01

The recent initial public offering of shares of Zynga, probably the most important on-line game provider, drew interest of potential investors but also of general public to their business model. What the most interested people learned so far is that if Zynga had not changed their accounting...... practice, they would be in red numbers for several months already. This is most likely caused by people stopping to play their games. This paper provides an estimate of what proportion of people, who played on-line games, already stopped playing them. Additionally, it analyzed the reasons why people...... stopped playing on-line games. It also compares Facebook and other on-line games....

Pressurized capillary electrochromatographic analysis of water-soluble vitamins by combining with on-line concentration technique.

Science.gov (United States)

Jia, Li; Liu, Yaling; Du, Yanyan; Xing, Da

2007-06-22

A pressurized capillary electrochromatography (pCEC) system was developed for the separation of water-soluble vitamins, in which UV absorbance was used as the detection method and a monolithic silica-ODS column as the separation column. The parameters (type and content of organic solvent in the mobile phase, type and concentration of electrolyte, pH of the electrolyte buffer, applied voltage and flow rate) affecting the separation resolution were evaluated. The combination of two on-line concentration techniques, namely, solvent gradient zone sharpening effect and field-enhanced sample stacking, was utilized to improve detection sensitivity, which proved to be beneficial to enhance the detection sensitivity by enabling the injection of large volumes of samples. Coupling electrokinetic injection with the on-line concentration techniques was much more beneficial for the concentration of positively charged vitamins. Comparing with the conventional injection mode, the enhancement in the detection sensitivities of water-soluble vitamins using the on-line concentration technique is in the range of 3 to 35-fold. The developed pCEC method was applied to evaluate water-soluble vitamins in corns.

A Contrastive Study of Potential and Practical Errors in On-line Translation Due to Linguistic Differences in Chinese, English and Japanese

OpenAIRE

Seta, Yukito; Jiang, Fan

2011-01-01

Nowadays, some students in China often use on-line translators when they have to write papers, especially the abstract in English or in Japanese. However, the morphological and syntactic differences in Chinese, English and Japanese frequently lead to problems in translation. The present paper aims at exploring the major morphological and syntactic differences among the three languages and demonstrating how these major differences affect translation rendered by on-line translators. Totally, 8 ...

Art-making in a family medicine clerkship: how does it affect medical student empathy?

Science.gov (United States)

Potash, Jordan S; Chen, Julie Y; Lam, Cindy L K; Chau, Vivian T W

2014-11-28

To provide patient-centred holistic care, doctors must possess good interpersonal and empathic skills. Medical schools traditionally adopt a skills-based approach to such training but creative engagement with the arts has also been effective. A novel arts-based approach may help medical students develop empathic understanding of patients and thus contribute to medical students' transformative process into compassionate doctors. This study aimed to evaluate the impact of an arts-making workshop on medical student empathy. This was a mixed-method quantitative-qualitative study. In the 2011-12 academic year, all 161 third year medical students at the University of Hong Kong were randomly allocated into either an arts-making workshop or a problem-solving workshop during the Family Medicine clerkship according to a centrally-set timetable. Students in the arts-making workshop wrote a poem, created artwork and completed a reflective essay while students in the conventional workshop problem-solved clinical cases and wrote a case commentary. All students who agreed to participate in the study completed a measure of empathy for medical students, the Jefferson Scale of Empathy (JSE) (student version), at the start and end of the clerkship. Quantitative data analysis: Paired t-test and repeated measures ANOVA was used to compare the change within and between groups respectively. Qualitative data analysis: Two researchers independently chose representational narratives based on criteria adapted from art therapy. The final 20 works were agreed upon by consensus and thematically analysed using a grounded theory approach. The level of empathy declined in both groups over time, but with no statistically significant differences between groups. For JSE items relating to emotional influence on medical decision making, participants in the arts-making workshop changed more than those in the problem-solving workshop. From the qualitative data, students perceived benefits in arts

Assessment of medical students' attitudes on social media use in medicine: a cross-sectional study.

Science.gov (United States)

Avcı, Kadriye; Çelikden, Sevda Gerek; Eren, Semih; Aydenizöz, Doğukan

2015-02-15

Social media has created a revolution in health services. Information available on the Internet and via social media is now being used as reference guides for sensitive health issues by nonprofessionals, physicians, and medical students. When used by physicians and medical students, social media has the potential to raise issues such as the blurring of the line between professional and private lives, patient relations, and medical ethics. The aim of this cross-sectional study was to evaluate the use of social media and attitudes toward its use in medicine among medical students. Medical students from Afyon Kocatepe University, Faculty of Medicine (Afyonkarahisar, Turkey) were asked to participate in a survey consisting of two sections, the first containing questions assessing the frequency of social media use and the second regarding attitudes toward the use of social media in medicine. Survey responses indicated that 93.4% of medical students used social media and 89.3% used social media for professional purposes. Factor analysis showed that attitudes toward social media are based on five factors: professional usefulness, popularity, ethics, barriers, and innovativeness. A structural equation model revealed the highest positive correlation between usefulness and innovativeness; ethics had a low but positive correlation with other factors. Although social media is being used extensively by medical students, they appear unaware of possible ethical issues. Therefore, social media guidelines should be developed.

Photosensitizing medication use and risk of skin cancer

DEFF Research Database (Denmark)

Kaae, Jeanette; Boyd, Heather A; Hansen, Anne

2010-01-01

Many commonly used medications, including both medications for long-term (daily) use and short-term use (treatment courses of finite duration), have photosensitizing properties. Whether use of these medications affects skin cancer risk, however, is unclear.......Many commonly used medications, including both medications for long-term (daily) use and short-term use (treatment courses of finite duration), have photosensitizing properties. Whether use of these medications affects skin cancer risk, however, is unclear....

The influence of achievement before, during and after medical school on physician job satisfaction

NARCIS (Netherlands)

Schmit Jongbloed, Lodewijk J.; Schonrock-Adema, Johanna; Borleffs, Jan C. C.; Stewart, Roy E.; Cohen-Schotanus, Janke

2014-01-01

In this longitudinal study, we investigated the relationship between physicians' prior achievements (before, during and after medical school) and job satisfaction, and tested the two lines of reasoning that prior achievements influence job satisfaction positively or negatively, respectively. The

NEA activities on medical isotope supply issues

International Nuclear Information System (INIS)

Westmacott, C.; Vance, R.

2009-01-01

Medical radioisotopes play a vital role in modern medical practices. One of their principal uses is for nuclear diagnostic imaging techniques. These techniques are powerful and non-invasive, allowing the identification of common diseases such as heart conditions and cancer at an early stage, tracking disease progression and providing predictive information about likely success of a therapy. Such techniques enable precise and accurate management of the disease and may significantly assist in the medical decision-making process, for example removing the need for surgical intervention to obtain diagnostic information. Every year, 46 million people are estimated to benefit globally from such nuclear medicine testing. However, over the last few years there have been a number of supply shortages of Molybdenum-99 (Mo-99) and its decay product, Technetium-99m (Tc-99m), the most widely used medical radioisotope. These isotopes decay within a matter of days; therefore they must be produced continually in order to meet demand. Most recently, the unexpected extended shutdown of Canada's NRU research reactor - which produces approximately 35 percent of world Mo-99 supply - has compounded existing concerns regarding the supply reliability of these medical radioisotopes. Currently, five reactors between 42 and 52 years old produce over 95 percent of the world's supply of Mo-99 and face challenges in maintaining a continuous supply to the health community. As outlined above, disruptions in this supply chain have affected the availability of vital medical testing for millions of patients around the world. On 29-30 January 2009, the NEA hosted a workshop on Security of Supply of Medical Radioisotopes at the request of the Government of Canada. The workshop assembled an international group of experts to identify challenges faced in providing a reliable supply of Mo-99 and Tc-99m and measures that should be taken to ensure such reliability. Workshop participants discussed a wide

MICROLENSING OF QUASAR BROAD EMISSION LINES: CONSTRAINTS ON BROAD LINE REGION SIZE

Energy Technology Data Exchange (ETDEWEB)

Guerras, E.; Mediavilla, E. [Instituto de Astrofisica de Canarias, Via Lactea S/N, La Laguna E-38200, Tenerife (Spain); Jimenez-Vicente, J. [Departamento de Fisica Teorica y del Cosmos, Universidad de Granada, Campus de Fuentenueva, E-18071 Granada (Spain); Kochanek, C. S. [Department of Astronomy and the Center for Cosmology and Astroparticle Physics, The Ohio State University, 4055 McPherson Lab, 140 West 18th Avenue, Columbus, OH 43221 (United States); Munoz, J. A. [Departamento de Astronomia y Astrofisica, Universidad de Valencia, E-46100 Burjassot, Valencia (Spain); Falco, E. [Center for Astrophysics, 60 Garden Street, Cambridge, MA 02138 (United States); Motta, V. [Departamento de Fisica y Astronomia, Universidad de Valparaiso, Avda. Gran Bretana 1111, Valparaiso (Chile)

2013-02-20

We measure the differential microlensing of the broad emission lines between 18 quasar image pairs in 16 gravitational lenses. We find that the broad emission lines are in general weakly microlensed. The results show, at a modest level of confidence (1.8{sigma}), that high ionization lines such as C IV are more strongly microlensed than low ionization lines such as H{beta}, indicating that the high ionization line emission regions are more compact. If we statistically model the distribution of microlensing magnifications, we obtain estimates for the broad line region size of r{sub s} = 24{sup +22} {sub -15} and r{sub s} = 55{sup +150} {sub -35} lt-day (90% confidence) for the high and low ionization lines, respectively. When the samples are divided into higher and lower luminosity quasars, we find that the line emission regions of more luminous quasars are larger, with a slope consistent with the expected scaling from photoionization models. Our estimates also agree well with the results from local reveberation mapping studies.

An evaluation related to the effect of strategic facility management on choice of medical tourism destination

Directory of Open Access Journals (Sweden)

Tarcan Ertugrul

2015-01-01

Full Text Available This study based on literature review aims to evaluate and emphasize the affect of the strategic facility management (SFM on choice of medical tourism destination. Medical Tourism, which ranges from the health care services involving a cure to the wellness services involving no specific health trouble to pleasure and amusement services, is one of the most growing sectors in the world. Cost and quality of medical services are among the main reasons for the choice of destination. Strategic facility management has a positive correlation on the levels of quality, cost and customer satisfaction. Thus medical tourism and destination managers should take into account of the potential advantages of value creation offered through SFM in order to be chosen by customers (stakeholders.

49 CFR 192.705 - Transmission lines: Patrolling.

Science.gov (United States)

2010-10-01

... adjacent to the transmission line right-of-way for indications of leaks, construction activity, and other factors affecting safety and operation. (b) The frequency of patrols is determined by the size of the line, the operating pressures, the class location, terrain, weather, and other relevant factors, but...

Bird nesting on an Athabasca power line structure

International Nuclear Information System (INIS)

Stedwill, R.J.

1989-01-01

SaskPower has recently completed its 400 km Athabasca power line, and is evaluating the predicted environmental impact of the line on the resident population of bald eagles and other raptors. During construction of the line, five major types of impact associated with the line were addressed. Minor route adjustments were made to by-pass nests of bald eagles and osprey to minimize impact of construction on breeding. The proximity of the power line to cliff faces and the north shore of lake Athabasca was maximized, and frequency of stream crossings and proximity to rapids were minimized. Route adjustments were made to ensure that the line was at least 1.6 km from bald eagle nest sites. As structures of the main 115 kV power line allow a minimum separation between conductors and grounded spars of 1.6 m, and between conductors of 4.6 m, electrocution was not considered to be a significant risk. However, on the 25 kV power line in regions of known bald eagle activity and in close proximity to bodies of water, provision was made for special structures to allow birds to perch without danger of electrocution. It was concluded that the resident population of raptors will probably be enhanced, particularly in areas not previously utilized. 8 refs., 5 figs

Trends in on-line data processing

International Nuclear Information System (INIS)

Masetti, M.

1981-01-01

The developement of integrated circuits has been characterized by an exponential growth of gates on a single chip that will still continue in the coming years. In parallel the price per bit is dropping down with more or less the same law. As a consequence of this a few statements can be made: The present 16-bit minicomputer in a small configuration is going to be substituted by a 16-bit microcomputer, and the 16-bit microcomputer in a powerful configuration by a 32-bit midi having also a virtual memory facility. Fully programmable or microcoded powerful devices like the LASS hardware processor or MICE, will allow an efficient on-line filter. Higher computing speed can be achieved by a multiprocessor configuration which can be insensitive to hardware failures. Therefore we are moving towards an integrated on-line computing system with much higher computing power than now and the present distinction between on-line and off-line will no longer be so sharp. As more processing can be performed on-line, fast high quality feed-back can be provided for the experiment. In the years to come the trend towards more processing power, at a lower price, and assembled in the same hardware volume will continue for at least five years; at the same time the future large high-energy physics experiments at LEP will be carried out within a wide international collaboration. In this environment methods must be found for a large fraction of the work to be distributed amongst the collaborators. To accomplish this aim it is necessary to introduce common standard practices concerning both hardware and software, in such a way that the seperate parts, developed by the collaborators, will be plug-compatible. (orig.)

Line lessons: Enbridge's Northern Line provides valuable information

Energy Technology Data Exchange (ETDEWEB)

Ross, E.

2000-02-01

Experiences gained from the 14-year old Norman Wells crude oil pipeline in the Northwest Territories may provide operators with valuable insights in natural gas pipeline developments in northern Canada. The Norman Wells line is the first and only long-distance pipeline in North America buried in permafrost and has proven to be a veritable laboratory on pipeline behaviour in extremely cold climates which also happen to be discontinuous at the same time. The line was built by Enbridge with a 'limit state' design, i e. it was built to move within the permafrost within certain limits, the amount of movement depending upon the area in which the line was built. This technology, which is still cutting edge, allows the pipeline to react to the freeze-thaw cycle without being affected by the heaving and resettling. The knowledge gained from the Norman Wells Line has come in very useful in the more recent AltaGas Services project transporting natural gas from a nearby well into the the town of Inuvik. Enbridge also contributed to the development of various pipeline inspection tools such as the 'Geopig' which travels within the pipeline and can pinpoint the location of problems practically within a matter of inches, and the 'Rolligon' an amphibious vehicle with five-foot diameter rubber tires that displaces only two pounds per square inch, leaving barely a track as it travels along the right-of-way during times other than winter.

On-line spectroscopy with thermal atomic beams

International Nuclear Information System (INIS)

Thibault, C.; Guimbal, P.; Klapisch, R.; Saint Simon, M. de; Serre, J.M.; Touchard, F.; Duong, H.T.; Jacquinot, P.; Juncar, P.

1981-01-01

On-line high resolution laser spectroscopy experiments have been performed in which the light from a cw tunable dye laser interacts at right angles with a thermal atomic beam. sup(76-98)Rb, sup(118-145)Cs and sup(208-213)Fr have been studied using the ionic beam delivered by the ISOLDE on-line mass separator at CERN while sup(20-31)Na and sup(38-47)K have been studied by setting the apparaturs directly on-line with the PS 20 GeV proton beam. The principle of the method is briefly explained and some results concerning nuclear structure are given. (orig.)

Affect of Presenilin Mutations on APP Cleavage; Insights into the Pathogenesis of FAD

Directory of Open Access Journals (Sweden)

Nuomin eLi

2016-03-01

Full Text Available Alzheimer disease (AD is characterized by progressive memory loss, reduction in cognitive functions, and damage to the brain. The β-amyloid precursor protein can be sequentially cleaved by β- secretase and γ-secretase. Mutations in the presenilin1（PS1） are the most common cause of Familial Alzheimer’s disease ( FAD. PS1 mutations can alter the activity of γ-secretase on the cleavage of the β-amyloid precursor protein, causing increased Aβ production. Previous studies show that the βAPP-C-terminal fragment is first cleaved by β-scretase, primarily generating long fragments of Aβ48 and Aβ49, followed by the stepwise cleavage of every three amino acid residues at the C terminus, resulting in Aβ48-, 45-, 42 line and Aβ49-, 46-, 43-, 40 line. Here, we used LC-MS/MS to analyze unique peptides IAT, VVIA, ITL，TVI，IVI through sequential cleavage, combined with ELISA to test the level of Aβ42 and Aβ40 for validation. The results show that most FAD mutant PS1 can alter the level of Aβ42 and Aβ40 monitored by the Aβ42/Aβ40 ratio. Among them, 6 mutants (I143T, H163P, S170F, Q223R, M233V and G384A affect the Aβ42/40 ratio through both Aβ49-40 and Aβ48-38 lines; L166P through decreasing the Aβ49-40 line, 6 mutants (I143V, M146V, G217A, E280A, L381V and L392V through increasing the Aβ48-42 line. More importantly, we found some mutations can affect the γ-secretase cleavage preference of α-CTF and β-CTF. In conclusion, we found that the FAD PS1 mutations mainly increase the generation of Aβ42 by decreasing the cleavage of Aβ42-Aβ38 and Aβ43-Aβ40.

Effect of small-scale biomass gasification at the state of refractory lining the fixed bed reactor

Energy Technology Data Exchange (ETDEWEB)

Janša, Jan, E-mail: jan.jansa@vsb.cz; Peer, Vaclav, E-mail: vaclav.peer@vsb.cz; Pavloková, Petra, E-mail: petra.pavlokova@vsb.cz [VŠB – Technical University of Ostrava, Energy Research Center, 708 33 Ostrava (Czech Republic)

2016-06-30

The article deals with the influence of biomass gasification on the condition of the refractory lining of a fixed bed reactor. The refractory lining of the gasifier is one part of the device, which significantly affects the operational reliability and durability. After removing the refractory lining of the gasifier from the experimental reactor, there was done an assessment how gasification of different kinds of biomass reflected on its condition in terms of the main factors affecting its life. Gasification of biomass is reflected on the lining, especially through sticking at the bottom of the reactor. Measures for prolonging the life of lining consist in the reduction of temperature in the reactor, in this case, in order to avoid ash fusion biomass which it is difficult for this type of gasifier.

Algorithms for the on-line travelling salesman

NARCIS (Netherlands)

Ausiello, G.; Feuerstein, E.; Leonardi, S.; Stougie, L.; Talamo, M.

1999-01-01

In this paper the problem of efficiently serving a sequence of requests presented in an on-line fashion located at points of a metric space is considered. We call this problem the On-Line Travelling Salesman Problem (OLTSP). It has a variety of relevant applications in logistics and robotics. We

The ethics of germ line gene manipulation--a five dimensional debate.

Science.gov (United States)

Carter, Lucy

2002-10-01

Contributors to the debate surrounding the ethics of germ line gene manipulation have by and large concentrated their efforts on discussions of the potential risks that are associated with the use of this technology. Many international advisory committees have ruled out the acceptability of germ line gene manipulation at least for the time being. The purpose of this work is to generate much needed discussion on the many other ethical issues concerning the implementation of not only germ line gene manipulation but also other related biotechnologies. In this paper I systematically investigate and analyse the most salient issues put forward by proponents and opponents alike. I argue that if germ line manipulation proves to be a safe and effective procedure, then the principle of beneficence imposes on the medical profession a moral duty to pursue the technology.

Medics on the Move South Africa: Access to Medical Words

OpenAIRE

Kris Van de Poel; Christine Fourie; Karen Seberechts

2013-01-01

South African medical students who are Cuban-trained and therefore Spanish- speaking, on their return to South Africa need to learn medical vocabulary, terminology, and appropriate interactional discourse in the two major languages of English and Afrikaans, in order to be able to practise professional medicine effectively and efficiently. Indeed, their language problems are further compounded by differences in medical equipment and in medical practices between Cuba and South Africa. To meet t...

Reactions to perceived fairness: The impact of mortality salience and self-esteem on ratings of negative affect

NARCIS (Netherlands)

Bos, K. van den

2001-01-01

In correspondence with terror management theory, the findings of two experiments show that reminders of death lead to stronger effects of perceived fairness on ratings of negative affect. Furthermore, in line with the theory''s self-esteem mechanism, results of Experiment 1 suggest that state

Factors Affecting Job Satisfaction among the Faculty Members at Guilan University of Medical Sciences

Directory of Open Access Journals (Sweden)

Fardin Mehrabian

2013-08-01

Full Text Available Introduction: Job satisfaction plays a pivotal role in the performance of university faculty members. Identification of the factors influencing job satisfaction can be useful in advancing the educational and research objectives of the university. The aim of the present study was to analyze the factors influencing job satisfaction among the faculty members of Guilan University of medical sciences. Methods: This study was a descriptive cross-sectional research that was conducted in 2012. The statistical population of the research included 139 faculty members at faculties of Guilan University of Medical Sciences selected using stratified random sampling. The instrument of data collection was a questionnaire consisting of two sections; the first section contained 10 questions about demographic information and the second section comprised of 19 questions which was designed based on Herzberg's two-factor theory. The questionnaire was scored according to 5-point Likert scale. Data were analyzed by SPSS 18 software and descriptive statistics indices of frequency, mean, standard deviation and Pearson correlation coefficient reported.Results: 66.2% of the faculty members were male, 62.6% were clinical faculty members and 37.4% basic sciences faculty members. The most important factors affecting the faculty members’ job satisfaction were job security (4.14±0.96, friendly relationship with colleagues (4.01±0.81, and technology and technical knowledge (3.99±0.87. The most important motivational factors influencing job satisfaction were interest in job (4.24+0.71, achievement (3.99±0.87 and equal opportunities for career promotion (3.95±0.99.Conclusion: stability and job satisfaction, creating friendly working environment, proper environmental conditions, professor’s welfare and providing spiritual and material incentives are factors that influence the professor’s job satisfaction.

On line routing per mobile phone

DEFF Research Database (Denmark)

Bieding, Thomas; Görtz, Simon; Klose, Andreas

2009-01-01

On-line routing is concerned with building vehicle routes in an ongoing fashion in such a way that customer requests arriving dynamically in time are efficiently and effectively served. An indispensable prerequisite for applying on-line routing methods is mobile communication technology....... Additionally it is of utmost importance that the employed communication system is suitable integrated with the firm’s enterprise application system and business processes. On basis of a case study, we describe in this paper a system that is cheap and easy to implement due to the use of simple mobile phones...

Strengthening weak ties through on-line gaming

DEFF Research Database (Denmark)

Sudzina, Frantisek; Razmerita, Liana Virginia; Kirchner, Kathrin

On-line gaming became widespread in the last couple of years. The aim of the research presented in the paper is to figure out to what extent does game playing helps to strengthen weak ties and what additional factors influence this process. The approach is rather exploratory – some factors...... are grounded in theory, some are new. These factors are age, gender, place of origin, number of their Facebook connections (friends in Facebook terminology), the amount of time they are on Facebook, the amount of time they keep the Facebook site open, the amount of time they play on-line games, and the reasons...... for starting to play on-line games. Regarding the latter, we chose to focus only on escapist reasons....

Does the Cultural Formulation Interview for the fifth revision of the diagnostic and statistical manual of mental disorders (DSM-5) affect medical communication? A qualitative exploratory study from the New York site.

Science.gov (United States)

Aggarwal, Neil K; Desilva, Ravi; Nicasio, Andel V; Boiler, Marit; Lewis-Fernández, Roberto

2015-01-01

Cross-cultural mental health researchers often analyze patient explanatory models of illness to optimize service provision. The Cultural Formulation Interview (CFI) is a cross-cultural assessment tool released in May 2013 with DSM-5 to revise shortcomings from the DSM-IV Outline for Cultural Formulation (OCF). The CFI field trial took place in 6 countries, 14 sites, and with 321 patients to explore its feasibility, acceptability, and clinical utility with patients and clinicians. We sought to analyze if and how CFI feasibility, acceptability, and clinical utility were related to patient-clinician communication. We report data from the New York site which enrolled 7 clinicians and 32 patients in 32 patient-clinician dyads. We undertook a data analysis independent of the parent field trial by conducting content analyses of debriefing interviews with all participants (n = 64) based on codebooks derived from frameworks for medical communication and implementation outcomes. Three coders created codebooks, coded independently, established inter-rater coding reliability, and analyzed if the CFI affects medical communication with respect to feasibility, acceptability, and clinical utility. Despite racial, ethnical, cultural, and professional differences within our group of patients and clinicians, we found that promoting satisfaction through the interview, eliciting data, eliciting the patient's perspective, and perceiving data at multiple levels were common codes that explained how the CFI affected medical communication. We also found that all but two codes fell under the implementation outcome of clinical utility, two fell under acceptability, and none fell under feasibility. Our study offers new directions for research on how a cultural interview affects patient-clinician communication. Future research can analyze how the CFI and other cultural interviews impact medical communication in clinical settings with subsequent effects on outcomes such as medication adherence

Comparisons on Genetic Diversity among the Isonuclear-Alloplasmic Male Sterile Lines and Their Maintainer Lines in Rice

Directory of Open Access Journals (Sweden)

Jin-quan LI

2007-06-01

Full Text Available Four sets of rice isonuclear-alloplasmic lines including 16 male sterile lines and their maintainer lines were analyzed by using 91 pairs of SSR primers to study the genetic diversity of nuclear genome and their relative relationships. A total of 169 alleles were detected in the 16 lines, with a frequency of polymorphic loci of 53.85% and an average number of alleles per locus of 1.8, and the average gene diversity was 0.228. Four sets of the isonuclear-alloplasmic male sterile lines shared 146 identical alleles, corresponding to 86.39% of the total alleles; meanwhile, there are 23 different alleles among the tested materials, being 13.61% of the total alleles. On average, 78.70% identical alleles and 21.30% different alleles of the total alleles were detected between the isonuclear-alloplasmic male sterile lines and their maintainer lines. There were 53.85% identical alleles and 46.15% different alleles of the total alleles among the homozygous allonucleus male sterile lines. The fingerprints were established for some male sterile lines and maintainer lines. All the materials tested were divided into three groups at the 0.2 genetic distance based on the cluster analysis. Eight lines of Huanong A and Huayu A (including Huanong B and Huayu B were in the first group, four lines of Kezhen A (including Kezhen B in the second group, and four lines of Zhenshan 97A (including Zhenshan 97B in the third group. For the isonuclear-alloplasmic male sterile lines, the similarity coefficient between Y (Yegong type and WA (wild abortive type or between CW (Raoping wild rice and WA type reached 87–98%.

Optimization of X-ray phase-contrast imaging based on in-line holography

International Nuclear Information System (INIS)

Wu Xizeng; Liu Hong; Yan Aimin

2005-01-01

This paper introduces a newly conceived formalism for clinical in-line phase-contrast X-ray imaging. The new formalism applies not only to ideal 'thin' objects analyzed in previous studies, but also applies to the real-world tissues used in actual clinical practice. Moreover we have identified the four clinically important factors that affect phase-contrast characteristics. These factors are: (1) body part attenuation (2) the spatial coherence of incident X-rays from an X-ray tube (3) the polychromatic nature of the X-ray source and (4) radiation dose to patients for clinical applications. Techniques of phase image-reconstruction based on the new X-ray in-line holography theory are discussed. Numerical simulations are described which were used to validate the theory. The design parameters of an optimal clinical phase-contrast mammographic imaging system which were determined based on the new theory, and validated in the simulations, are presented. The theory, image reconstruction algorithms, and numerical simulation techniques presented in this paper can be applied widely to clinical diagnostic X-ray imaging applications

Magnetic field line random walk in two-dimensional dynamical turbulence

Science.gov (United States)

Wang, J. F.; Qin, G.; Ma, Q. M.; Song, T.; Yuan, S. B.

2017-08-01

The field line random walk (FLRW) of magnetic turbulence is one of the important topics in plasma physics and astrophysics. In this article, by using the field line tracing method, the mean square displacement (MSD) of FLRW is calculated on all possible length scales for pure two-dimensional turbulence with the damping dynamical model. We demonstrate that in order to describe FLRW with the damping dynamical model, a new dimensionless quantity R is needed to be introduced. On different length scales, dimensionless MSD shows different relationships with the dimensionless quantity R. Although the temporal effect affects the MSD of FLRW and even changes regimes of FLRW, it does not affect the relationship between the dimensionless MSD and dimensionless quantity R on all possible length scales.

Workshop on Radio Recombination Lines

CERN Document Server

1980-01-01

Since their first detection 15 years ago, radio recombination lines from several elements have been observed in a wide variety of objects including HII regions, planetary nebulae, molecular clouds, the diffuse interstellar medium, and recently, other galaxies. The observations span almost the entire range from 0.1 to 100 GHz, and employ both single­ djsh and aperture synthesis techniques. The theory of radio recombination lines has also advanced strongly, to the point where it is perhaps one of the best-understood in astro­ physics. In a parallel development, it has become possible over the last decade to study these same highly-excited atoms in the laboratory; this work provides further confirmation of the theoretical framework. However there has been continuing controversy over the astrophysical interpre­ tation of radio recombination line observations, especially regarding the role of stimulated emission. A workshop was held in Ottawa on 24-25 August, 1979, bringing together many of the active scientist...

Influence of Genotype Lines, Age at Slaughter and Sexes on the Composition of Rabbit Meat

Directory of Open Access Journals (Sweden)

Tomaž Polak

2006-01-01

Full Text Available Chemical composition (water, proteins, ash, intramuscular fat, cholesterol, fatty acid composition, sensory characteristics and instrumental profiles (colour and texture of lean rabbit meat were investigated. It originated from animals of three different lines of SIKA genotype (A – mother line, C – father line, AC – hybrid of mother and father lines, two animal ages at slaughter (93 and 105 days and both sexes. Rabbits were fed a commercial diet ad libitum. The boneless muscles of the back (longissimus lumborum including muscles of abdominal wall and hind legs were sampled from thirty-six animals. On the average rabbit meat contains 71.5 % of water, 22.0 % of proteins, 1.17 % of ash, 5.4 % of intramuscular fat, 67.6 mg of cholesterol per 100 g of fresh meat, and as for fatty acid composition, 34.1 % belong to monounsaturated, 25.1 % to polyunsaturated and 40.9 % to saturated fatty acids. The P/S mass ratio (0.62, the atherogenic index (0.70, the n-6/n-3 ratio (8.1 and the cholesterol content show that the rabbit meat can and should be included into a balanced human diet. Meat of female rabbits contains more intramuscular fat and cholesterol compared to the male ones (5.7 vs. 5.2 g of intramuscular fat/100 g; p0.05; 71.5 vs. 63.7 mg of cholesterol/100 g, respectively; p0.01. Genotype line does not affect either the fatty acid profile or the content of cholesterol, but it has a significant impact on intramuscular fat (A line 5.0 g/100 g; AC line 5.9 g/100 g; C line 5.4 g/100 g; p0.05 as well as on cutting values across the fibres (Instron apparatus; A line 43 N; AC line 38 N; C line 42 N; p0.05. Meat of 105-day-old rabbits contains more intramuscular fat (5.7 vs. 5.2 g/100 g; respectively; p0.05 and shows darker and redder colour (both sensorially evaluated colour as well as instrumentally measured L* and a* values; p0.01 compared to the 93-day-old ones.

On-line monitoring for calibration reduction

International Nuclear Information System (INIS)

Hoffmann, M.

2005-09-01

On-Line Monitoring evaluates instrument channel performance by assessing its consistency with other plant indications. Elimination or reduction of unnecessary field calibrations can reduce associated labour costs, reduce personnel radiation exposure, and reduce the potential for calibration errors. On-line calibration monitoring is an important technique to implement a state-based maintenance approach and reduce unnecessary field calibrations. In this report we will look at how the concept is currently applied in the industry and what the arising needs are as it becomes more commonplace. We will also look at the PEANO System, a tool developed by the Halden Project to perform signal validation and on-line calibration monitoring. Some issues will be identified that are being addressed in the further development of these tools to better serve the future needs of the industry in this area. An outline for how to improve these points and which aspects should be taken into account is described in detail. (Author)

Primary Salvage Survey of the Interference of Radiowaves Emitted by Smartphones on Medical Equipment.

Science.gov (United States)

Takao, Hiroyuki; Yeh, Yu Chih; Arita, Hiroyuki; Obatake, Takumi; Sakano, Teppei; Kurihara, Minoru; Matsuki, Akira; Ishibashi, Toshihiro; Murayama, Yuichi

2016-10-01

Use of mobile phones has become a standard reality of everyday living for many people worldwide, including medical professionals, as data sharing has drastically helped to improve quality of care. This increase in the use of mobile phones within hospitals and medical facilities has raised concern regarding the influence of radio waves on medical equipment. Although comprehensive studies have examined the effects of electromagnetic interference from 2G wireless communication and personal digital cellular systems on medical equipment, similar studies on more recent wireless technologies such as Long Term Evolution, wideband code division multiple access, and high-speed uplink access have yet to be published. Numerous tests targeting current wireless technologies were conducted between December 2012 and March 2013 in an anechoic chamber, shielded from external radio signals, with a dipole antenna to assess the effects of smartphone interference on several types of medical equipment. The interference produced by electromagnetic waves across five frequency bands from four telecommunication standards was assessed on 49 components from 22 pieces of medical equipment. Of the 22 pieces of medical equipment tested, 13 experienced interference at maximum transmission power. In contrast, at minimum transmission power, the maximum interference distance varied from 2 to 5 cm for different wireless devices. Four machines were affected at the minimum transmission power, and the maximum interference distance at the maximum transmission power was 38 cm. Results show that the interference from smartphones on medical equipment is very controllable.

A Pilot Directional Protection for HVDC Transmission Line Based on Relative Entropy of Wavelet Energy

Directory of Open Access Journals (Sweden)

Sheng Lin

2015-07-01

Full Text Available On the basis of analyzing high-voltage direct current (HVDC transmission system and its fault superimposed circuit, the direction of the fault components of the voltage and the current measured at one end of transmission line is certified to be different for internal faults and external faults. As an estimate of the differences between two signals, relative entropy is an effective parameter for recognizing transient signals in HVDC transmission lines. In this paper, the relative entropy of wavelet energy is applied to distinguish internal fault from external fault. For internal faults, the directions of fault components of voltage and current are opposite at the two ends of the transmission line, indicating a huge difference of wavelet energy relative entropy; for external faults, the directions are identical, indicating a small difference. The simulation results based on PSCAD/EMTDC show that the proposed pilot protection system acts accurately for faults under different conditions, and its performance is not affected by fault type, fault location, fault resistance and noise.

A study of clinicians' views on medical gloves and their effect on manual performance.

Science.gov (United States)

Mylon, Peter; Lewis, Roger; Carré, Matt J; Martin, Nicolas; Brown, Steven

2014-01-01

The effect of gloves on practitioners' performance has not been a major factor in their design. To determine the critical elements of performance and design appropriate tests, data from clinicians were needed. Semistructured interviews were carried out with medical practitioners from various disciplines, in which they were asked about their glove use, their views on gloves, medical tasks requiring the highest manual performance or most affected by gloves, and what the main issues with glove use were. Many participants expressed a preference for latex over nitrile, with glove fit being the main reason given. Satisfaction with surgical gloves (generally latex) was high but less so with examination gloves, which were generally nitrile. Tactile sensation, comfort, and donning were also seen as major issues with glove use. A number of tasks were identified for possible development as tests. Performance in medical practice needs to be clearly defined, separating perceived and measured performance, and understanding the effect of glove material, fit, and thickness. Development of new glove performance tests based on the tasks identified is an important part of this. Copyright © 2014 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Mosby, Inc. All rights reserved.

Sex-Specific Effect of Recalled Parenting on Affective and Cognitive Empathy in Adulthood.

Science.gov (United States)

Lyons, Minna T; Brewer, Gayle; Bethell, Emily J

2017-01-01

Previous research has demonstrated the influence of parenting on the development of children's empathy. However, few studies have considered the impact of parents on empathy in adulthood, specific components of empathy, or the importance of parent and child biological sex. In the present study, 226 participants (71 men) completed online versions of the Parental Bonding Instrument (Parker et al. British Journal of Medical Psychology, 52, 1-10 1979), Empathy Quotient (Baron-Cohen and Wheelwright Journal of Autism and Developmental Disorders, 34, 163-175 2004), and Interpersonal Reactivity Index (Davis JSAS Catalog of Selected Documents in Psychology, 10, 85 1980). Paternal care and overprotection influenced affective empathy in men, whilst maternal overprotection predicted affective empathy in women. Further, maternal care related to cognitive empathy in men, whilst none of the parental care variables related to cognitive empathy in women. Findings are discussed in relation to sex differences in childhood parenting experiences on adult cognitive and affective empathy.

The effect of illustrations on patient comprehension of medication instruction labels

OpenAIRE

Hwang, Stephen W; Tram, Carolyn QN; Knarr, Nadia

2005-01-01

Abstract Background Labels with special instructions regarding how a prescription medication should be taken or its possible side effects are often applied to pill bottles. The goal of this study was to determine whether the addition of illustrations to these labels affects patient comprehension. Methods Study participants (N = 130) were enrolled by approaching patients at three family practice clinics in Toronto, Canada. Participants were asked to interpret two sets of medication instruction...

Effects of γ-radiation on cell growth, cell cycle and promoter methylation of 22 cell cycle genes in the 1321NI astrocytoma cell line.

Science.gov (United States)

Alghamian, Yaman; Abou Alchamat, Ghalia; Murad, Hossam; Madania, Ammar

2017-09-01

DNA damage caused by radiation initiates biological responses affecting cell fate. DNA methylation regulates gene expression and modulates DNA damage pathways. Alterations in the methylation profiles of cell cycle regulating genes may control cell response to radiation. In this study we investigated the effect of ionizing radiation on the methylation levels of 22 cell cycle regulating genes in correlation with gene expression in 1321NI astrocytoma cell line. 1321NI cells were irradiated with 2, 5 or 10Gy doses then analyzed after 24, 48 and 72h for cell viability using MTT (3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazoliu bromide) assay. Flow cytometry were used to study the effect of 10Gy irradiation on cell cycle. EpiTect Methyl II PCR Array was used to identify differentially methylated genes in irradiated cells. Changes in gene expression was determined by qPCR. Azacytidine treatment was used to determine whether DNA methylation affectes gene expression. Our results showed that irradiation decreased cell viability and caused cell cycle arrest at G2/M. Out of 22 genes tested, only CCNF and RAD9A showed some increase in DNA methylation (3.59% and 3.62%, respectively) after 10Gy irradiation, and this increase coincided with downregulation of both genes (by 4 and 2 fold, respectively). with azacytidine confirmed that expression of CCNF and RAD9A genes was regulated by methylation. 1321NI cell line is highly radioresistant and that irradiation of these cells with a 10Gy dose increases DNA methylation of CCNF and RAD9A genes. This dose down-regulates these genes, favoring G2/M arrest. Copyright © 2017 Medical University of Bialystok. Published by Elsevier B.V. All rights reserved.

On-line analysis of water contamination by organic compounds; On-line-Analytik der Wasserverschmutzung durch organische Substanzen

Energy Technology Data Exchange (ETDEWEB)

Wagt, R. van der; Vos, F. de [Skalar Analytical (Netherlands); Babichenko, S.; Poryvkina, L. [Institute of Ecology, Tallinn (Estonia)

1999-08-01

In many environmental applications decomposing the mixture of substances in the water into its various chemical ingredients, for subsequent analysis, is a very complicated task. The most productive approach to on-line diagnosis is to treat the object as an integral spectroscopic sample, characterized by certain specific Spectral Fluorescent Signatures (SFS). The SFS are recorded as a matrix of fluorescent intensity of organic compounds in water, in co-ordinates of excitation and emission spectra, providing a three-dimensional spectrum. Spectral windows of SFS are defined by fluorescent characteristics of basic groups of organic substances in the water sample. The novel Skalar Fluo Imager, based on this principle, is intended for the analysis of organic compounds in natural, domestic, and technological waters in an on-line mode. (orig.) [German] In vielen Umweltschutzanwendungen stellt die Auftrennung eines Substanzgemisches zum Zweck der Analyse eine sehr komplizierte Aufgabe dar. Ein erfolgversprechender Ansatz fuer eine on-line-Diagnostik besteht darin, das Objekt als integrale Spektroskopieprobe zu betrachten, die durch bestimmte spezifische Spektral-Fluoreszenz-Signaturen (SFS) charakterisiert wird. Diese werden als Fluoreszenz-Intensitaets-Matrix organischer Verbindungen in Wasser dargestellt, mit Anregungs- und Emissionsspektren als weiteren Koordinaten, wodurch ein dreidimensionales Spektrum entsteht. Spektrale Fenster der SFS sind definiert als Fluoreszenzcharakteristika von Funktionsgruppen organischer Substanzen in der Wasserprobe. Der auf diesem Prinzip basierende Skalar Fluo Imager ist fuer die on-line-Analyse organischer Bestandteile in natuerlichen, Haus- und technischen Waessern gedacht. (orig.)

Robust on-line monitoring of biogas processes; Robusta maettekniker on-line foer optimerad biogasproduktion

Energy Technology Data Exchange (ETDEWEB)

Nordberg, Aake; Hansson, Mikael; Kanerot, Mija; Krozer, Anatol; Loefving, Bjoern; Sahlin, Eskil

2010-03-15

Although demand for biomethane in Sweden is higher than ever, many Swedish codigestion plants are presently operated below their designed capacity. Efforts must be taken to increase the loading rate and guarantee stable operation and high availability of the plants. There are currently no commercial systems for on-line monitoring, and due to the characteristics of the material, including corrosion and tearing, robust applications have to be developed. The objective of this project was to identify and study different monitoring technologies with potential for on-line monitoring of both substrate mixtures and anaerobic digester content. Based on the prerequisites and demands at Boraas Energi och Miljoe AB's (BEMAB, the municipal energy and waste utility in the city of Boraas, Sweden) biogas plant, the extent of the problems, measurement variables and possible ways of managing these issues have been identified and prioritized. The substrate mixtures in question have a high viscosity and are inhomogeneous with variation in composition, which calls for further homogenization, dilution and filtration to achieve high precision in the necessary analyses. Studies of using different mixers and mills showed that the particle size (800 mum) needed for on-line COD measurement could not be achieved. The problem of homogenization can be avoided if indirect measurement methods are used. Laboratory tests with NIR (near-infra red spectroscopy) showed that VS can be predicted (R2=0,78) in the interval of 2-9% VS. Furthermore, impedance can give a measurement of soluble components. However, impedance is not sensitive enough to give a good measurement of total TS. Microwave technology was installed at the production plant and showed a faster response to changes in TS than the existing TS-sensor. However, due to technical problems, the evaluation only could be done during a limited period of ten days. BEMAB will continue the measurements and evaluation of the instrument. The

Research on Line Patrol Strategy of 110kV Transmission Line after Lightning Strike

Directory of Open Access Journals (Sweden)

Li Mingjun

2016-01-01

Full Text Available Lightning faults occupy in the majority of instantaneous fault and reclosing can usually be successful, so power supply can be restored without immediate patrol in many cases. Firstly, this paper introduces the lightning fault positioning and identifying method. Then test electrical performance of insulators after lightning strike from 110kV lines. Data shows that lightning strike has little effect on the electric performance of insulator. Finally, illustrating disposal process of the 110 kV transmission line after lightning fault, certifying that the power supply reliability be ensured without line patrol.

Polyphenolic Profile and Targeted Bioactivity of Methanolic Extracts from Mediterranean Ethnomedicinal Plants on Human Cancer Cell Lines

Directory of Open Access Journals (Sweden)

Antonino Pollio

2016-03-01

Full Text Available The methanol extracts of the aerial part of four ethnomedicinal plants of Mediterranean region, two non-seed vascular plants, Equisetum hyemale L. and Phyllitis scolopendrium (L. Newman, and two Spermatophyta, Juniperus communis L. (J. communis and Cotinus coggygria Scop. (C. coggygria, were screened against four human cells lines (A549, MCF7, TK6 and U937. Only the extracts of J. communis and C. coggygria showed marked cytotoxic effects, affecting both cell morphology and growth. A dose-dependent effect of these two extracts was also observed on the cell cycle distribution. Incubation of all the cell lines in a medium containing J. communis extract determined a remarkable accumulation of cells in the G2/M phase, whereas the C. coggygria extract induced a significant increase in the percentage of G1 cells. The novelty of our findings stands on the observation that the two extracts, consistently, elicited coherent effects on the cell cycle in four cell lines, independently from their phenotype, as two of them have epithelial origin and grow adherent and two are lymphoblastoid and grow in suspension. Even the expression profiles of several proteins regulating cell cycle progression and cell death were affected by both extracts. LC-MS investigation of methanol extract of C. coggygria led to the identification of twelve flavonoids (compounds 1–11, 19 and eight polyphenols derivatives (12–18, 20, while in J. communis extract, eight flavonoids (21–28, a α-ionone glycoside (29 and a lignin (30 were found. Although many of these compounds have interesting individual biological activities, their natural blends seem to exert specific effects on the proliferation of cell lines either growing adherent or in suspension, suggesting potential use in fighting cancer.

The Power Behind the Controversy: Understanding Local Policy Elites' Perceptions on the Benefits and Risks Associated with High Voltage Power Line Installation in the State of Arkansas

Science.gov (United States)

Moyer, Rachael M.

Following a proposal for the installation of high voltage power lines in northwest Arkansas, a controversial policy debate emerged. Proponents of the transmission line argue that such an installation is inevitable and necessary to efficiently and reliably support the identified electric load in the region. Opponents claim that the lines will degrade the natural environment and hamper the tourism-based local economy in affected regions, notably in Ozark Mountain areas. This study seeks to understand how local policy elites perceive the benefits and risks associated with proposed transmission lines, which is a critical step in comprehending the formation and changes of related government policies. First, based upon the dual process theory of judgment, this study systematically investigates the triadic relationships between (a) more profound personal value predispositions, (b) affects and feelings, and (c) perceived benefits and risks related to the proposed installation of high voltage power lines among local policy elites in the state of Arkansas. Next, this study focuses more specifically on the role of value predispositions, specific emotional dimensions of affect heuristics, and perceptions pertaining to high voltage power line risks and benefits. Using original data collected from a statewide Internet survey of 420 local leaders and key policymakers about their opinions on the related issues, other factors claimed by previous literature, including trust, knowledge level, and demographic characteristics are considered. Analytical results suggest that grid-group cultural predispositions, as deeply held core values within local policy elites' individual belief systems, both directly and indirectly -- through affective feelings -- shape perceived utility associated with the installation of high voltage power lines. Recognizing that risk perceptions factor into policy decisions, some practical considerations for better designing policy addressing controversial issues

Considerations in applying on-line IC techniques to BWR's

International Nuclear Information System (INIS)

Kaleda, R.J.

1992-01-01

Ion-Chromatography (IC) has moved from its traditional role as a laboratory analytical tool to a real time, dynamic, on-line measurement device to follow ppb and sub-ppb concentrations of deleterious impurities in nuclear power plants. Electric Power Research Institute (EPRI), individual utilities, and industry all have played significant roles in effecting the transition. This paper highlights considerations and the evolution in current on-line Ion Chromatography systems. The first applications of on-line techniques were demonstrated by General Electric (GE) under EPRI sponsorship at Rancho Seco (1980), Calvert Cliffs, and McGuire nuclear units. The primary use was for diagnostic purposes. Today the on-line IC applications have been expanded to include process control and routine plant monitoring. Current on-line IC's are innovative in design, promote operational simplicity, are modular for simplified maintenance and repair, and use field-proven components which enhance reliability. Conductivity detection with electronic or chemical suppression and spectrometric detection techniques are intermixed in applications. Remote multi-point sample systems have addressed memory effects. Early applications measured ionic species in the part per billion range. Today reliable part per trillion measurements are common for on-line systems. Current systems are meeting the challenge of EPRI guideline requirements. Today's on-line IC's, with programmed sampling systems, monitor fluid streams throughout a power plant, supplying data that can be trended, stored and retrieved easily. The on-line IC has come of age. Many technical challenges were overcome to achieve today's IC

Stress and its risk factors in medical students: An observational study from a medical college in India

OpenAIRE

Madhumita Nandi; Avijit Hazra; Sumantra Sarkar; Rakesh Mondal; Malay Kumar Ghosal

2012-01-01

Objectives: Stress in medical students is well established. It may affect academic performance and lead to anxiety, depression, substance abuse, and burnouts. There is limited data on stress in Indian medical students. We conducted an analytical observational study to assess the magnitude of stress and identify possible "stressors" in medical students of a teaching hospital in Kolkata. Materials And Methods: This questionnaire-based study was conducted in the Institute of Post Graduate Medica...

Underreporting of side effects of standard first-line ART in the routine ...

African Journals Online (AJOL)

Malawi Medical Journal; 23(4): 116-118 December 2011. Side effects of standard first line in ART 116. Underreporting of side effects of standard first-line. ART in the routine setting in Blantyre, Malawi. Abstract. Introduction. In the Malawi ART programme, 92% of 250,000 patients are using the standard first-line regime of ...

Mentoring Narratives ON-LINE:Teaching the Principalship

Directory of Open Access Journals (Sweden)

Allison I. Griffith

2002-05-01

Full Text Available The need to develop new models for preparation of school administrators has been a prominent concern in educational discourse in the last decade. Having been criticized for the inadequate preparation of the school leadership cadre, academic departments responsible for training future school administrators have had to revisit their approaches and to reframe their teaching philosophies to ensure the readiness of their graduates for the challenges and complexities of school leadership. This article reports on the new model of principals' training that has been used in York University's Principals' Qualification Program (PQP from the late 1990s onward. One component of the program brings traditional case methodology into a computer-mediated/on-line environment. The on-line cases are narratives from the everyday lives of the Ontario school administrators who serve as mentors in the on-line environment. Situating our discussion within the context of the rapidly changing educational landscape of Ontario, we focus on the PQP model to explore experientially generated case narratives as one method for teaching and learning the work of the local school administrator. We focus particularly on the teaching and learning embedded in computer-mediated or on-line case narratives used in training teachers for school leadership. We argue that the complexities of school leadership—the social, cultural, relational, ethical and moral context of school leadership—can be taught effectively through the reflective processes of on-line case narratives. We seek to contribute to the ongoing dialogue on the potential of new pedagogies and new technologies to help prepare the competent and responsible leaders for tomorrow's schools.

The landscape of research on smartphone medical apps: Coherent taxonomy, motivations, open challenges and recommendations.

Science.gov (United States)

Hussain, Muzammil; Al-Haiqi, Ahmed; Zaidan, A A; Zaidan, B B; Kiah, M L M; Anuar, Nor Badrul; Abdulnabi, Mohamed

2015-12-01

To survey researchers' efforts in response to the new and disruptive technology of smartphone medical apps, mapping the research landscape form the literature into a coherent taxonomy, and finding out basic characteristics of this emerging field represented on: motivation of using smartphone apps in medicine and healthcare, open challenges that hinder the utility, and the recommendations to improve the acceptance and use of medical apps in the literature. We performed a focused search for every article on (1) smartphone (2) medical or health-related (3) app, in four major databases: MEDLINE, Web of Science, ScienceDirect, and IEEE Xplore. Those databases are deemed broad enough to cover both medical and technical literature. The final set included 133 articles. Most articles (68/133) are reviews and surveys that refer to actual apps or the literature to describe medical apps for a specific specialty, disease, or purpose; or to provide a general overview of the technology. Another group (43/133) carried various studies, from evaluation of apps to exploration of desired features when developing them. Few researchers (17/133) presented actual attempts to develop medical apps, or shared their experiences in doing so. The smallest portion (5/133) proposed general frameworks addressing the production or operation of apps. Since 2010, researchers followed the trend of medical apps in several ways, though leaving areas or aspect for further attention. Regardless of their category, articles focus on the challenges that hinder the full utility of medical apps and do recommend mitigations to them. Research on smartphone medical apps is active and various. We hope that this survey contribute to the understanding of the available options and gaps for other researchers to join this line of research. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Packings of a charged line on a sphere.

Science.gov (United States)

Alben, Silas

2008-12-01

We find equilibrium configurations of open and closed lines of charge on a sphere, and track them with respect to varying sphere radius. Closed lines transition from a circle to a spiral-like shape through two low-wave-number bifurcations-"baseball seam" and "twist"-which minimize Coulomb energy. The spiral shape is the unique stable equilibrium of the closed line. Other unstable equilibria arise through tip-splitting events. An open line transitions smoothly from an arc of a great circle to a spiral as the sphere radius decreases. Under repulsive potentials with faster-than-Coulomb power-law decay, the spiral is tighter in initial stages of sphere shrinkage, but at later stages of shrinkage the equilibria for all repulsive potentials converge on a spiral with uniform spacing between turns. Multiple stable equilibria of the open line are observed.

Improving perception, attitude and interest in medical leadership and management – a novel model proposed by medical students

Directory of Open Access Journals (Sweden)

Shah OA

2018-05-01

Full Text Available Owais Ali Shah, Mohammed Khalid Aslami, Amir-Humza Tahir SulemanFaculty of Medicine, St. George’s Hospital Medical School, London, UKAfter reading the article by Rouhani et al1 with great interest, we agree that the level of medical leadership and management (MLM training in the UK medical schools could be improved massively. As fellow medical students, we would like to offer our perspective on how universities can better implement MLM teaching into curricula to effectively mould future clinician leaders within an ever-expanding National Health Service. As reported, the General Medical Council provides curriculum guidance for medical schools based on the skills identified in the Medical Leadership Competency Framework (MLCF.1 In line with the findings of the authors, a study showed that only 56% of the responding universities incorporate MLCF into their curriculum, and remarkably, 81.9% of students were unaware of the MLCF.2 This can lead to a lack of insight and awareness into MLM among medical students possibly leading to reluctance in pursuing MLM roles in the future.View the original paper by Rouhani and colleagues.

Laser based thermo-conductometry as an approach to determine ribbon solid fraction off-line and in-line.

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Wiedey, Raphael; Šibanc, Rok; Kleinebudde, Peter

2018-06-06

Ribbon solid fraction is one of the most important quality attributes during roll compaction/dry granulation. Accurate and precise determination is challenging and no in-line measurement tool has been generally accepted, yet. In this study, a new analytical tool with potential off-line as well as in-line applicability is described. It is based on the thermo-conductivity of the compacted material, which is known to depend on the solid fraction. A laser diode was used to punctually heat the ribbon and the heat propagation monitored by infrared thermography. After performing a Gaussian fit of the transverse ribbon profile, the scale parameter σ showed correlation to ribbon solid fraction in off-line as well as in-line studies. Accurate predictions of the solid fraction were possible for a relevant range of process settings. Drug stability was not affected, as could be demonstrated for the model drug nifedipine. The application of this technique was limited when using certain fillers and working at higher roll speeds. This study showed the potentials of this new technique and is a starting point for additional work that has to be done to overcome these challenges. Copyright © 2018 Elsevier B.V. All rights reserved.

Radiologic analysis of the medical collateral ligament rupture

International Nuclear Information System (INIS)

Cho, Chung Che; Lee, Chang Jun; Kim, Kun Sang; Park, Soo Soung

1979-01-01

The medical collateral ligament rupture is the most common injury involving the knee joint ligaments. The ruptured medical collateral ligaments of 73 cases with clinical and surgical confirmations were radiologically analyzed. The results were obtained as follows: 1. The most risky age for tearing of the medical collateral ligament was third to fifth decades (50 cases of male and 23 of females). 2. The most common cause of the medical collateral ligament rupture was traffic accident (82.2%). 3. The mean distance of medial knee joint space was 7.9 ± 2.0 mm on the normal side and 13.7 ± 4.2 mm on the affected side. 4. The mean degree of knee joint space was 10.1 ± 2.5 on the normal side and 14.7 ± 3.8 on the affected side. 5. The fibula was the bone fractured most frequently in association with the medial collateral ligament rupture (30.6%).

Does the Cultural Formulation Interview (CFI) for the Fifth Revision of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) affect medical communication? A qualitative exploratory study from the New York site

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Aggarwal, Neil K.; DeSilva, Ravi; Nicasio, Andel V.; Boiler, Marit; Lewis-Fernández, Roberto

2014-01-01

Objectives Cross-cultural mental health researchers often analyze patient explanatory models of illness to optimize service provision. The Cultural Formulation Interview (CFI) is a cross-cultural assessment tool released in May 2013 with DSM-5 to revise shortcomings from the DSM-IV Outline for Cultural Formulation (OCF). The CFI field trial took place in 6 countries, 14 sites, and with 321 patients to explore its feasibility, acceptability, and clinical utility with patients and clinicians. We sought to analyze if and how CFI feasibility, acceptability, and clinical utility were related to patient-clinician communication. Design We report data from the New York site which enrolled 7 clinicians and 32 patients in 32 patient-clinician dyads. We undertook a data analysis independent of the parent field trial by conducting content analyses of debriefing interviews with all participants (n=64) based on codebooks derived from frameworks for medical communication and implementation outcomes. Three coders created codebooks, coded independently, established inter-rater coding reliability, and analyzed if the CFI affects medical communication with respect to feasibility, acceptability, and clinical utility. Results Despite racial, ethnic, cultural, and professional differences within our group of patients and clinicians, we found that promoting satisfaction through the interview, eliciting data, eliciting the patient’s perspective, and perceiving data at multiple levels were common codes that explained how the CFI affected medical communication. We also found that all but 2 codes fell under the implementation outcome of clinical utility, 2 fell under acceptability, and none fell under feasibility. Conclusion Our study offers new directions for research on how a cultural interview affects patient-clinician communication. Future research can analyze how the CFI and other cultural interviews impact medical communication in clinical settings with subsequent effects on outcomes

[An approach regarding the use of medication in biology textbooks as a strategy for health promotion].

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Corrêa, Anderson Domingues; Caminha, Juliana dos Reis; de Souza, Cristina Alves Magalhães; Alves, Luiz Anastacio

2013-10-01

The inappropriate use of medication represents a major threat to public health and drugs rank first among the agents causing intoxication in Brazil, ahead of poisons for rodents and insects, illegal drugs, pesticides, cleaning products and spoiled food. The National Curriculum of Secondary Education Parameters (PCN+) give major emphasis to health, since the reference to Drugs is mentioned repeatedly in the text. The scope of this research was to study the approaches to drug use in textbooks. For this purpose, eleven biology textbooks were analyzed, namely six single volumes and five with three volumes each, i.e. a total of twenty-one volumes. The rational use of medication should be considered an important topic for the promotion of health which affects all sectors of society and should be emphasized in basic education. In line with this idea and based on the results obtained, it is suggested that the textbooks analyzed should be adapted to the new legislation and content that addresses Rational Drug Use, thus meeting the recommendations of PCN+. In this context, the books should concisely address the following topics: self-medication, adherence to drug treatment, advertisements and reports on drugs, among others.

A methodology for on-line fatigue life monitoring of Indian nuclear power plant components

International Nuclear Information System (INIS)

Mukhopadhyay, N.K.; Dutta, B.K.; Kushawaha, H.S.

1992-01-01

Fatigue is one of the most important aging effects of nuclear power plant components. Information about accumulation of fatigue helps in assessing structural degradation of the components. This assists in-service inspection and maintenance and may also support future life extension program of a plant. In the present report a methodology is being proposed for monitoring on line fatigue life of nuclear power plant components using available plant instrumentations. Major factors affecting fatigue life of a nuclear power plant components are the fluctuations of temperature, pressure and flow rate. Green's function technique is used in on line fatigue monitoring as computation time is much less than finite element method. A code has been developed which computes temperature and stress Green's functions in 2-D and axisymmetric structure by finite element method due to unit change in various fluid parameters. A post processor has also been developed which computes the temperature and stress responses using corresponding Green's functions and actual fluctuation in fluid parameters. In this post processor, the multiple site problem is solved by superimposing single site Green's function technique. It is also shown that Green's function technique is best suited for on line fatigue life monitoring of nuclear power plant components. (author). 6 refs., 43 figs

Basic Stand Alone Medicare DME Line Items PUF

Data.gov (United States)

U.S. Department of Health & Human Services — This release contains the Basic Stand Alone (BSA) Durable Medical Equipment (DME) Line Items Public Use Files (PUF) with information from Medicare DME claims. The...

[Differences between generations: relevant for medical education in the Netherlands].

Science.gov (United States)

Busari, Jamiu O; Scheele, Fedde

2015-01-01

Provision of care is increasingly being tailored to patients' wishes, which means that insight into the ideas, norms and values of the care-consumer are required. This approach is also beginning to filter through into medical education. We can differentiate generations on the basis of shared opinions, because groups with shared experiences usually share the same values. This is a useful line of approach if we wish to serve different generations of consumers better. At the moment there are four different generations influencing the setup and division of the healthcare services and relevant to medical education in the coming decades. Future education methods will have to be in line with the wishes of the generation from which new doctors come. In order to achieve better care for patients it is important to give 'thinking in generations' more attention in medical education.

Etnografia on e off-line: cibercafés em Trinidad

Directory of Open Access Journals (Sweden)

Daniel Miller

2004-06-01

Full Text Available O presente artigo questiona pressupostos sobre a distinção, comum na pesquisa de Internet, entre on-line e off-line. Várias pesquisas presumiram a "virtualidade", bem como uma forte divisão entre o on-line e o off-line como sendo um dado e um ponto de partida metodológico e analítico em pesquisa. Argumentamos que quando se aborda o uso de fato da Internet a partir de uma abordagem etnográfica, uma tal distinção se revela como um feito social altamente contingente: alguns atores empregam grandes habilidades para estabelecer uma distinção clara entre on-line e off-line em suas práticas de Internet; em outros, tal distinção não tem sentido, ou não é desejável, e tais distinções não são de fato estabelecidas. Utilizamos uma comparação entre cibercafés em Trinidad para demonstrar essa variabilidade e a ampla gama de diferentes relações on-line/off-line que são realmente observadas. Nós relacionamos esse material com a questão mais geral de se estabelecer "contextos" na pesquisa etnográfica.This article interrogates assumptions about the on-line/off-line distinction in internet research. Much research has presumed "virtuality" and a strong division between the on-line and the off-line as a methodological and analytical given and starting point for research. We argue that when actual internet use is approached from an ethnographic perspective, this distinction turns out to be a highly contingent social accomplishment: some actors deploy great skill to establish a sharp on-line/off-line distinction in their internet practices; for others, it is meaningless or undesirable and the distinctions is not established in reality. A comparison of cybercafes in Trinidad is used to demonstrate this variability and the wide range of different on-line/off-line relationships that are in fact observed. We relate this material to the overall issue of establishing "contexts" in ethnographic research.

Network Meta-analysis for Clinical Practice Guidelines: A Case Study on First-Line Medical Therapies for Primary Open-Angle Glaucoma

Science.gov (United States)

Rouse, Benjamin; Cipriani, Andrea; Shi, Qiyuan; Coleman, Anne L.; Dickersin, Kay; Li, Tianjing

2016-01-01

Background Network meta-analysis compares multiple treatment options for the same condition and may be useful for developing clinical practice guidelines. Purpose To compare treatment recommendations for first-line medical therapy for primary open angle-glaucoma (POAG) from major updates of American Academy of Ophthalmology (AAO) guidelines with the evidence available at the time, using network meta-analysis. Data Sources MEDLINE, Embase, and the Cochrane Library were searched on 11 March 2014 for randomized, controlled trials (RCTs) of glaucoma monotherapies compared with placebo, vehicle, or no treatment or other monotherapies. The AAO Web site was searched in August 2014 to identify AAO POAG guidelines. Study Selection Eligible RCTs were selected by 2 independent reviewers, and guidelines were selected by 1 person. Data Extraction One person abstracted recommendations from guidelines and a second person verified. Two people independently abstracted data from included RCTs. Data Synthesis Guidelines were grouped together on the basis of literature search dates, and RCTs that existed at 1991, 1995, 1999, 2004, and 2009 were analyzed. The outcome of interest was intraocular pressure (IOP) at 3 months. Only the latest guideline made a specific recommendation: prostaglandins. Network meta-analyses showed that all treatments were superior to placebo in decreasing IOP at 3 months. The mean reductions (95% credible intervals [CrIs]) for the highest-ranking class compared with placebo were as follows: 1991: β-blockers, 4.01 (CrI, 0.48 to 7.43); 1995: α2-adrenergic agonists, 5.64 (CrI, 1.73 to 9.50); 1999: prostaglandins, 5.43 (CrI, 3.38 to 7.38); 2004: prostaglandins, 4.75 (CrI, 3.11 to 6.44); 2009: prostaglandins, 4.58 (CrI, 2.94 to 6.24). Limitation When comparisons are informed by a small number of studies, the treatment effects and rankings may not be stable. Conclusion For timely recommendations when multiple treatment options are available, guidelines developers

Plants Regeneration Derived From Various on Peanut on Mutant Lines

International Nuclear Information System (INIS)

Dewi, Kumala; Masrizal; Mugiono

1998-01-01

The study of calli, greenspot formation and shoot regeneration on peanut mutant lines has ben conducted by MS media. Three explants derived from shoot tips, embryo and seeding root of two mutant lines a/20/3 and D/25/3/2 were used in this experiment. the explants were cultured on modified MS media enriched by vitamins, growth regulation, amino acids for fourth teen calli were transferred on regeneration media. The ability of calli formation and plant regeneration of each explant and genotypes of plants was varied. Greenspot and shoot formation were observed seventh days after the calli transferred on regeneration media. It is shown that the ability of calli, greenspot and shoot formation of each explants and genotypes was varied. the high ability of calli, greenspot and shoot formation were found in explant derived from shoot tip and embryo. Seedling root explant has lower ability in calli formation, while greenspot and shoot was formatted. The ability of calli, greenspot and shoot formation on A/20/3 mutant line was better than D/25/3/2 mutant line. (author)

Long-distance pulse propagation on high-frequency dissipative nonlinear transmission lines/resonant tunneling diode line cascaded maps

International Nuclear Information System (INIS)

Klofai, Yerima; Essimbi, B Z; Jaeger, D

2011-01-01

Pulse propagation on high-frequency dissipative nonlinear transmission lines (NLTLs)/resonant tunneling diode line cascaded maps is investigated for long-distance propagation of short pulses. Applying perturbative analysis, we show that the dynamics of each line is reduced to an expanded Korteweg-de Vries-Burgers equation. Moreover, it is found by computer experiments that the soliton developed in NLTLs experiences an exponential amplitude decay on the one hand and an exponential amplitude growth on the other. As a result, the behavior of a pulse in special electrical networks made of concatenated pieces of lines is closely similar to the transmission of information in optical/electrical communication systems.

Long-distance pulse propagation on high-frequency dissipative nonlinear transmission lines/resonant tunneling diode line cascaded maps

Energy Technology Data Exchange (ETDEWEB)

Klofai, Yerima [Department of Physics, Higher Teacher Training College, University of Maroua, PO Box 46 Maroua (Cameroon); Essimbi, B Z [Department of Physics, Faculty of Science, University of Yaounde 1, PO Box 812 Yaounde (Cameroon); Jaeger, D, E-mail: bessimb@yahoo.fr [ZHO, Optoelectronik, Universitaet Duisburg-Essen, D-47048 Duisburg (Germany)

2011-10-15

Pulse propagation on high-frequency dissipative nonlinear transmission lines (NLTLs)/resonant tunneling diode line cascaded maps is investigated for long-distance propagation of short pulses. Applying perturbative analysis, we show that the dynamics of each line is reduced to an expanded Korteweg-de Vries-Burgers equation. Moreover, it is found by computer experiments that the soliton developed in NLTLs experiences an exponential amplitude decay on the one hand and an exponential amplitude growth on the other. As a result, the behavior of a pulse in special electrical networks made of concatenated pieces of lines is closely similar to the transmission of information in optical/electrical communication systems.

Influence of awareness and availability of medical alternatives on parents seeking paediatric emergency care.

Science.gov (United States)

Ellbrant, Julia A; Åkeson, S Jonas; Karlsland Åkeson, Pia M

2018-06-01

Direct seeking of care at paediatric emergency departments may result from an inadequate awareness or a short supply of medical alternatives. We therefore evaluated the care-seeking patterns, availability of medical options and initial medical assessments - with overall reference to socioeconomic status - of parents at an urban paediatric emergency department in a Scandinavian country providing free paediatric healthcare. The parents of children assessed by paediatric emergency department physicians at a Swedish university hospital over a 25-day winter period completed a questionnaire on recent medical contacts and their reasons for attendance. Additional information was obtained from ledgers, patient records and population demographics. In total, 657 of 713 eligible patients (92%) were included. Seventy-nine per cent of their parents either failed to or managed to establish medical contact before the emergency department visit, whereas 21% sought care with no attempt at recent medical contact. Visits with a failed telephone or primary care contact (18%) were more common outside office hours ( p=0.014) and were scored as less urgent ( p=0.014). A perceived emergency was the main reason for no attempt at medical contact before the visit. Direct emergency department care-seeking was more common from the city district with the lowest socioeconomic status ( p=0.027). Although most parents in this Swedish study tried to seek medical advice before attending a paediatric emergency department, perceived emergency, a short supply of telephone health line or primary care facilities and lower socioeconomic status contributed to direct care-seeking by almost 40% of parents. Pre-hospital awareness and the availability of medical alternatives with an emphasis on major differences in socioeconomic status should therefore be considered to further optimize care-seeking in paediatric emergency departments.