WorldWideScience

Sample records for aftercare

  1. Episiotomy - aftercare

    Science.gov (United States)

    Perineal laceration - aftercare; Vaginal birth perineal tear - aftercare; Postpartum care - episiotomy - aftercare ... to widen the opening of the vagina. A perineal tear or laceration often forms on its own ...

  2. Skin lesion removal-aftercare

    Science.gov (United States)

    ... aftercare; Nevi - removal aftercare; Scissor excision aftercare; Skin tag removal aftercare; Mole removal aftercare; Skin cancer removal ... to the principles of the Health on the Net Foundation (www.hon.ch). The information provided herein ...

  3. Dislocated shoulder - aftercare

    Science.gov (United States)

    Shoulder dislocation - aftercare; Shoulder subluxation - aftercare; Shoulder reduction - aftercare ... Horn AE, Ufberg JW. Management of common dislocations. In: ... Extremity 6th ed. Philadelphia, PA: ElsevierMosby; 2011:chap 92.

  4. Dislocated shoulder - aftercare

    Science.gov (United States)

    Shoulder dislocation - aftercare; Shoulder subluxation - aftercare; Shoulder reduction - aftercare ... You most likely dislocated your shoulder from a sports injury or accident, such as a fall. You have likely injured (stretched or torn) some of the muscles, ...

  5. Shoulder separation - aftercare

    Science.gov (United States)

    Separated shoulder - aftercare; Acromioclavicular joint separation - aftercare; A/C separation - aftercare ... Shoulder separation is not an injury to the main shoulder joint itself. It is an injury to ...

  6. Benign positional vertigo - aftercare

    Science.gov (United States)

    Vertigo - positional - aftercare; Benign paroxysmal positional vertigo - aftercare; BPPV - aftercare ... Your doctor may have treated your vertigo with the Epley maneuver. ... ear problem that causes BPPV. It usually works quickly. For ...

  7. Dizziness and vertigo - aftercare

    Science.gov (United States)

    Meniere disease - aftercare; Benign positional vertigo - aftercare ... Dizziness can describe two different symptoms: lightheadedness and vertigo. Lightheadedness means you feel like you might faint. ...

  8. Abortion - surgical - aftercare

    Science.gov (United States)

    ... this page: //medlineplus.gov/ency/patientinstructions/000658.htm Abortion - surgical - aftercare To use the sharing features on ... please enable JavaScript. You have had a surgical abortion. This is a procedure that ends pregnancy by ...

  9. Ankle fracture - aftercare

    Science.gov (United States)

    ... page: //medlineplus.gov/ency/patientinstructions/000548.htm Ankle fracture - aftercare To use the sharing features on this ... Sit with your foot elevated higher than your knee at least 4 times a day Apply an ...

  10. Ankle sprain - aftercare

    Science.gov (United States)

    ... this page: //medlineplus.gov/ency/patientinstructions/000574.htm Ankle sprain - aftercare To use the sharing features on this ... help them move in the right ways. An ankle sprain occurs when the ligaments in your ankle are ...

  11. Metatarsal stress fractures - aftercare

    Science.gov (United States)

    ... page: //medlineplus.gov/ency/patientinstructions/000553.htm Metatarsal stress fractures - aftercare To use the sharing features on ... that connect your ankle to your toes. A stress fracture is a break in the bone that ...

  12. Aftercare of malignant thyroid growth

    International Nuclear Information System (INIS)

    The 'standard programme of aftercare for patients with malignant thyroid growths' practised in our department comprises the following measures: - Searching for residual tissues and recurrences in the neck/throat region and for metastases by means of physical examination, scintigraphy, x-ray diagnosis and laboratory tests (including determination of tumour markers); - monitoring and treatment of side effects by thyroidectomy (recurrent paresis, parathyroprival tetany); - prevention, detection and treatment of side effects of high-dosed radio-iodine therapy (on salivary glands and bone marrow) or those of cytostatic treatment (on heart muscle and bone marrow); - monitoring substitutive and suppressive treatment with thyroxines; - psychological guidance and genetic counselling. Corresponding to therapeutic approach, the overall aftercare programme is aimed primarily at papillary and follicular carcinoma and C-cell carcinoma. However, aftercare is hardly effective with anaplastic carcinoma owing to its persistently bad prognosis and its 50% survival time of some three months. (orig./MG)

  13. Aftercare, Emergency Department Visits, and Readmission in Adolescents

    Science.gov (United States)

    Carlisle, Corine E.; Mamdani, Muhammad; Schachar, Russell; To, Teresa

    2012-01-01

    Objective: U.S. and Canadian data demonstrate decreasing inpatient days, increasing nonurgent emergency department (ED) visits, and short supply of child psychiatrists. Our study aims to determine whether aftercare reduces ED visits and/or readmission in adolescents with first psychiatric hospitalization. Method: We conducted a population-based…

  14. The Effectiveness of Aftercare for Juvenile and Young Adult Offenders.

    Science.gov (United States)

    James, Chrissy; Asscher, Jessica J; Stams, Geert Jan J M; van der Laan, Peter H

    2016-08-01

    This study examined the New Perspectives Aftercare Program (NPAP) for serious juvenile and young adult offenders in The Netherlands. Participants (n = 127) were randomly assigned to NPAP (n = 66) or existing aftercare services ("treatment as usual" [TAU], n = 61). The aim was to determine whether NPAP was effective in decreasing cognitive distortions and criminal thinking patterns and increasing prosocial skills of the juveniles compared with TAU. No direct intervention effects were found on any of the outcome measures. Moderator analyses, however, showed several interaction effects of ethnicity and coping skills for both NPAP and TAU youths. Furthermore, NPAP dropouts displayed significantly more indirect aggression at posttest compared with youths dropping out from TAU. Possible explanations for the mostly null effects are discussed, including implications for further research, policy, and practice. PMID:25829455

  15. A new economic instrument for financing accelerated landfill aftercare

    OpenAIRE

    Beaven, R.P.; Knox, K.; Gronow, J.R.; Greedy, D; Hjelmar, O.; Scharff, H

    2014-01-01

    The key aspects of landfill operation that remain unresolved are the extended timescale and uncertain funding of the post-closure period. This paper reviews the topic and proposes an economic instrument to resolve the unsustainable nature of the current situation. Unsustainability arises from the sluggish degradation of organic material and also the slow flushing of potential pollutants that is exacerbated by low-permeability capping. A landfill tax or aftercare provision rebate is propose...

  16. Evaluating Alternative Aftercare Models for Ex-Offenders

    OpenAIRE

    Leonard A. Jason; Olson, Bradley D.; Harvey, Ron

    2015-01-01

    This study examined the role played by aftercare following (mainly) inpatient community-based treatment in the outcomes of criminal ex-offenders with substance use disorders. Two hundred and seventy individuals who had been released from the criminal justice system were randomly assigned to either a Therapeutic Community (TC), recovery homes called Oxford Houses (OHs), or usual care settings (UA). The OHs and TCs are residential settings that emphasized socialization and abstinence from drugs...

  17. Implementation and Outcome Evaluation of the Intensive Aftercare Program. Final Report

    Science.gov (United States)

    Wiebush, Richard G.; Wagner, Dennis; McNulty, Betsie; Wang, Yanqing; Le, Thao N.

    2005-01-01

    The Office of Juvenile Justice and Delinquency Prevention?s (OJJDP?s) intensive community based aftercare research and demonstration project known as the Intensive Aftercare Program (IAP) has become widely recognized as one of the most promising recent innovations in juvenile justice. The project has called attention to an area that traditionally…

  18. Addiction Treatment in America: After Money or Aftercare?

    OpenAIRE

    David Miller; Merlene Miller; Kenneth Blum; Badgaiyan, Rajendra D.; Marcelo Febo

    2015-01-01

    There are approximately 14,500 clinics and programs in America that provide treatment for all types of addictive behaviors we call “Reward Deficiency Syndrome (RDS)”. While most of these have good intentions to provide needed help to the victims of RDS, we propose herein that most of their efforts, especially during periods of aftercare, are not based on the existing scientific evidence. We use “aftercare” to refer to any form of program or therapy following primary treatment including 12-Ste...

  19. A randomized controlled study of exposure therapy as aftercare for alcohol use disorder

    DEFF Research Database (Denmark)

    Mellentin, Angelina Isabella; Nielsen, Bent; Nielsen, Anette Søgaard;

    2016-01-01

    exposing individuals to alcohol cues in order to reduce cravings as well as the likelihood of relapse. The aims of the study are: 1) to investigate whether CET aftercare delivered via a smartphone or in group sessions increases the effect of Cognitive Behavioural Treatment in groups of alcohol dependent...... individuals; 2) to investigate whether CET as a smartphone application is as or more effective than CET group therapy, and 3) to investigate whether CET as a smartphone application is more cost-effective than CET group aftercare and Aftercare as Usual. Design and methods The study will be implemented as an...

  20. Aftercare services for patients with severe mental disorder: A randomized controlled trial

    OpenAIRE

    Majid Barekatain; Mohammad Reza Maracy; Fatemeh Rajabi; Hajar Baratian

    2014-01-01

    Background: Although evidences emphasize on the importance of aftercare programs to achieve continuity of care, different studies have revealed controversial results about the outcome. The objective of this study was to investigate the effect of aftercare program on outcome measures of patients with severe mental disorders. Materials and Methods: Of a total 123 eligible patients with severe mental disorders, 61 patients were randomly assigned to the intervention group and 62 patients to the c...

  1. Addiction Treatment in America: After Money or Aftercare?

    Directory of Open Access Journals (Sweden)

    David Miller

    2015-10-01

    Full Text Available There are approximately 14,500 clinics and programs in America that provide treatment for all types of addictive behaviors we call “Reward Deficiency Syndrome (RDS”. While most of these have good intentions to provide needed help to the victims of RDS, we propose herein that most of their efforts, especially during periods of aftercare, are not based on the existing scientific evidence. We use “aftercare” to refer to any form of program or therapy following primary treatment including 12-Step programs. Very few programs actually provide any evidenced-based treatment approaches during this most vulnerable period in recovery. In this trieste we are suggesting that a hypodopaminergic trait (genetic and/or state (epigenetic is critical in terms of continued motivation to use/abuse of alcohol or other drugs and can lead to relapse. While there is evidence for the approved FDA drugs to treat drug addiction (e.g. alcohol, opiates, nicotine these drugs favor a short-term benefit by blocking dopamine. We argue instead for the utilization of long-term benefits that induce “dopamine homeostasis”, or in simpler terms “normalcy”. We suggest that this could be accomplished through a number of holistic modalities including, but not limited to, dopamine-boosting diets, hyper-oxygenation, heavy metal detoxification, exercise, meditation, yoga, and most importantly, brain neurotransmitter balancing with nutraceuticals such as KB220 variants. We embrace 12-step programs and fellowships but not as a stand-alone modality, especially during aftercare. We also provide some scientific basis for why resting state functional connectivity (rsfMRI is so important and may be the cornerstone in terms of how to treat RDS. We postulate that since drugs, food, smoking, gambling, and even compulsive sexual behavior could reduce rsfMRI then modalities (following required research, that can restore this impaired cross talk between various brain regions (e

  2. Do aftercare mental health services reduce risk of psychiatric rehospitalization for children?

    Science.gov (United States)

    Trask, Emily V; Fawley-King, Kya; Garland, Ann F; Aarons, Gregory A

    2016-05-01

    Appropriate and timely aftercare services are considered critical for children and adolescents with previous psychiatric hospitalization. The purpose of the present study was to investigate the relationship between type and amount of aftercare received and rehospitalization among youths who have been previously hospitalized due to psychiatric illness. The sample consisted of 569 youth ages 6-18 who received services in a large public service system. The sample of youth was 58% female and consisted largely of ethnic minorities (51% Hispanic, 26% White, 16% African American, and 7% were another race/ethnicity). Demographic, diagnostic, and service use data was obtained from billing records. Time-dependent Cox regression models evaluated the impact of aftercare (the primary dependent variable of interest) on risk of rehospitalization. Separate models were analyzed for each type of service and all models were adjusted for race/ethnicity, age, gender, diagnosis, insurance status, and comorbid substance use. Seventy percent of youths with a psychiatric hospitalization received aftercare and 28% were rehospitalized within 6 months of discharge. The total hours of services youths received was significantly related to a smaller likelihood of rehospitalization. Having a diagnosis of schizophrenia was associated with a higher risk of rehospitalization and receiving more days of day treatment was associated with a lower risk of rehospitalization. Given the restrictiveness and cost of hospitalization, mental health practitioners should focus on improving access, engagement, and quality of aftercare services. (PsycINFO Database Record PMID:26147361

  3. Report on Third International Intensive Aftercare Conference in Norrköping, Sweden

    DEFF Research Database (Denmark)

    Jones, Christina; Bäckman, Carl; Egerod, Ingrid;

    2015-01-01

    The third international conference on intensive care unit (ICU) diaries and intensive aftercare took place in Norrköping, Sweden, on 28 November 2013. The conference was organized by Carl Bäckman and colleagues, Vrinnevi Hospital and NOFI, and represented by Sissell Storli. More than 100 clinicians...

  4. Computerized tomography and its significance in the diagnosis, staging and aftercare of the cervical cancer

    International Nuclear Information System (INIS)

    Computerized tomography (CT) is studied for its clinical value using follow-up assessment of the computer tomograms of 181 patients while considering clinical findings. The results of the study show CT application to have great benefits - in particular in tumour aftercare - if clinical examination is accompanied by posttherapy basic diagnosis and by a comparison of initial and comparative findings. (orig./HSA)

  5. Improved methodology to assess modification and completion of landfill gas management in the aftercare period.

    Science.gov (United States)

    Morris, Jeremy W F; Crest, Marion; Barlaz, Morton A; Spokas, Kurt A; Kerman, Anna; Yuan, Lei

    2012-12-01

    Municipal solid waste landfills represent the dominant option for waste disposal in many parts of the world. While some countries have greatly reduced their reliance on landfills, there remain thousands of landfills that require aftercare. The development of cost-effective strategies for landfill aftercare is in society's interest to protect human health and the environment and to prevent the emergence of landfills with exhausted aftercare funding. The Evaluation of Post-Closure Care (EPCC) methodology is a performance-based approach in which landfill performance is assessed in four modules including leachate, gas, groundwater, and final cover. In the methodology, the objective is to evaluate landfill performance to determine when aftercare monitoring and maintenance can be reduced or possibly eliminated. This study presents an improved gas module for the methodology. While the original version of the module focused narrowly on regulatory requirements for control of methane migration, the improved gas module also considers best available control technology for landfill gas in terms of greenhouse gas emissions, air quality, and emissions of odoriferous compounds. The improved module emphasizes the reduction or elimination of fugitive methane by considering the methane oxidation capacity of the cover system. The module also allows for the installation of biologically active covers or other features designed to enhance methane oxidation. A methane emissions model, CALMIM, was used to assist with an assessment of the methane oxidation capacity of landfill covers. PMID:22884579

  6. Motivation for Treatment Among Women Offenders in Prison-Based Treatment and Longitudinal Outcomes Among Those Who Participate in Community Aftercare

    OpenAIRE

    GRELLA, CHRISTINE E.; Rodriguez, Luz

    2011-01-01

    Participation in aftercare may reduce risk of recidivism among women offenders with substance use problems following their release to the community. This study examines motivation to participate in aftercare among women offenders and whether their participation in both in-custody and aftercare treatment reduces their risk of recidivism. Surveys were conducted with women (N = 1,158) in prison-based substance abuse treatment programs. Return-to-prison was examined among participants in communit...

  7. Aftercare of inward foreign direct investment: A case study of South Africa

    OpenAIRE

    Benjamin Manasoe; Ronald Mears

    2011-01-01

    Attraction of new inward foreign direct investment (FDI) globally, especially in the developing countries, is problematic. Economic development practitioners have recently started to prioritise the retention and growing of existing investments to enhance their economic development agenda. The purpose of this paper is to analyse and investigate the relationship between inward FDI and investment aftercare in South Africa (SA). Only a few studies have been carried out on the topic at the global ...

  8. Improved methodology to assess modification and completion of landfill gas management in the aftercare period

    International Nuclear Information System (INIS)

    Highlights: ► Performance-based evaluation of landfill gas control system. ► Analytical framework to evaluate transition from active to passive gas control. ► Focus on cover oxidation as an alternative means of passive gas control. ► Integrates research on long-term landfill behavior with practical guidance. - Abstract: Municipal solid waste landfills represent the dominant option for waste disposal in many parts of the world. While some countries have greatly reduced their reliance on landfills, there remain thousands of landfills that require aftercare. The development of cost-effective strategies for landfill aftercare is in society’s interest to protect human health and the environment and to prevent the emergence of landfills with exhausted aftercare funding. The Evaluation of Post-Closure Care (EPCC) methodology is a performance-based approach in which landfill performance is assessed in four modules including leachate, gas, groundwater, and final cover. In the methodology, the objective is to evaluate landfill performance to determine when aftercare monitoring and maintenance can be reduced or possibly eliminated. This study presents an improved gas module for the methodology. While the original version of the module focused narrowly on regulatory requirements for control of methane migration, the improved gas module also considers best available control technology for landfill gas in terms of greenhouse gas emissions, air quality, and emissions of odoriferous compounds. The improved module emphasizes the reduction or elimination of fugitive methane by considering the methane oxidation capacity of the cover system. The module also allows for the installation of biologically active covers or other features designed to enhance methane oxidation. A methane emissions model, CALMIM, was used to assist with an assessment of the methane oxidation capacity of landfill covers.

  9. A bio-psycho-social exercise program (RÜCKGEWINN for chronic low back pain in rehabilitation aftercare - Study protocol for a randomised controlled trial

    Directory of Open Access Journals (Sweden)

    Pfeifer Klaus

    2010-11-01

    Full Text Available Abstract Background There is strong, internationally confirmed evidence for the short-term effectiveness of multimodal interdisciplinary specific treatment programs for chronic back pain. However, the verification of long-term sustainability of achieved effects is missing so far. For long-term improvement of pain and functional ability high intervention intensity or high volume seems to be necessary (> 100 therapy hours. Especially in chronic back pain rehabilitation, purposefully refined aftercare treatments offer the possibility to intensify positive effects or to increase their sustainability. However, quality assured goal-conscious specific aftercare programs for the rehabilitation of chronic back pain are absent. Methods/Design This study aims to examine the efficacy of a specially developed bio-psycho-social chronic back pain specific aftercare intervention (RÜCKGEWINN in comparison to the current usual aftercare (IRENA and a control group that is given an educational booklet addressing pain-conditioned functional ability and back pain episodes. Overall rehabilitation effects as well as predictors for compliance to the aftercare programs are analysed. Therefore, a multicenter prospective 3-armed randomised controlled trial is conducted. 456 participants will be consecutively enrolled in inpatient and outpatient rehabilitation and assigned to either one of the three study arms. Outcomes are measured before and after rehabilitation. Aftercare programs are assessed at ten month follow up after dismissal form rehabilitation. Discussion Special methodological and logistic challenges are to be mastered in this trial, which accrue from the interconnection of aftercare interventions to their residential district and the fact that the proportion of patients who take part in aftercare programs is low. The usability of the aftercare program is based on the transference into the routine care and is also reinforced by developed manuals with structured

  10. Aftercare services for patients with severe mental disorder: A randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Majid Barekatain

    2014-01-01

    Full Text Available Background: Although evidences emphasize on the importance of aftercare programs to achieve continuity of care, different studies have revealed controversial results about the outcome. The objective of this study was to investigate the effect of aftercare program on outcome measures of patients with severe mental disorders. Materials and Methods: Of a total 123 eligible patients with severe mental disorders, 61 patients were randomly assigned to the intervention group and 62 patients to the control group. The interventions included follow-up phone calls, home visits, and psychoeducation for families. Assessments were performed on hospital admission, discharge and the following 3 rd , 6 th and 12 th month. Young Mania Rating Scale (YMRS, Hamilton Depression Rating Scale (HDRS, Positive and Negative Syndrome Scale (PANSS, Global Assessment of Functioning (GAF, Clinical Global Impression (CGI, and the World Health Organization Quality of Life Questionnaire (WHO-QOL were used. Data were analyzed through Chi square, t-test, Mann-Whitney-U, and Repeated Measures Analysis of Co-Variance. Results: Mean of the HDRS scores revealed significant difference between the two groups when HDRS scores on the admission day were controlled (P = 0.028. The level of functioning was significantly different between the two groups based on the sequential assessments of GAF (P = 0.040. One year after the onset of trial, the number of psychiatric readmissions were significantly different between the two groups (P = 0.036. Conclusion: Readmission rates could be reduced by aftercare services, through the first year, after discharge of patients with severe mental disorders. On the other hand, higher levels of functioning would be expected after one year.

  11. Identifying Aftercare Supports for Out-of-Home Transitions: A Descriptive Analysis of Youth Perceptions and Preparedness

    Science.gov (United States)

    Trout, Alexandra L.; Huscroft-D'Angelo, Jacqueline; Epstein, Michael H.; Kavan, Jane

    2014-01-01

    Youth served in residential care often demonstrate significant educational and behavioral gains during treatment; however, struggles evidenced during the reunification and reintegration process underscore the importance of continued aftercare services and supports. While these needs have been widely noted in the literature, little is known about…

  12. [Modern information and communication technology in medical rehabilitation. Enhanced sustainability through Internet-delivered aftercare].

    Science.gov (United States)

    Kordy, H; Theis, F; Wolf, M

    2011-04-01

    Internet and mobile phones open new avenues for the optimization of health services in medical rehabilitation. Various models of Internet-delivered aftercare after psychosomatic inpatient treatment have shown promising results. The focus of this report is on the experience in translating one of the promising models, the Internet-Bridge ("Internet-Brücke"), to every day health care. Effectiveness was estimated through comparison of 254 patients who were treated in a hospital specialized in psychosomatic medicine and who participated in the Internet-Bridge as well as in the 1-year follow-up in the frame of standard quality assurance between 2003-2010 with 364 patients of the same hospital who also participated in the 1-year follow-up, but did not utilize the aftercare. Sustainable, reliable, and clinically significant improvements were more frequent in participants of the Internet-Bridge, especially with regard to psychological well-being, social problems, and psychosocial competence-at small additional costs. Results are understood as encouragement to start translation to routine care accompanied by research. PMID:21465402

  13. Preferences for Aftercare Among Persons Seeking Short-Term Opioid Detoxification.

    Science.gov (United States)

    Stein, Michael D; Anderson, Bradley J; Bailey, Genie L

    2015-12-01

    Without aftercare treatment, the period following discharge from short-term inpatient detoxification for opioid dependence presents a high risk of relapse. Yet the role of patient preference in treatment selection is rarely discussed in the substance-abuse literature. We surveyed 485 persons initiating inpatient opioid detoxification who were predominantly male (71.3%) and had detoxed in the past (73.2%). When asked to choose the one treatment that would work best for them after discharge, 43% of participants selected medication-assisted treatment (MAT), 29% preferred residential, 12% selected drug-free counseling, 12% NA/AA meetings only, and 4% preferred no additional treatment. Residential treatment preference was significantly associated with homelessness, having been in a detox program within the past year, and having pending legal problems, indicating that there is a distinct profile of detox patients who prefer residential treatment despite its limited availability. Detox program staff should work with patients to understand reasons for treatment preferences to optimize aftercare services. PMID:26254317

  14. Fewer re-admissions and bed days following an intensive transitional post-discharge aftercare programme for a mixed diagnostic group of patients

    DEFF Research Database (Denmark)

    Nilsson, Maria; Mir, Shazia; Larsen, Jens Knud;

    2014-01-01

    -psychotic diagnoses are often discharged with low well-being while still symptomatic, placing high demands on aftercare. AIMS: To evaluate retrospectively the short and long-term mental healthcare service use during and after the TA programme compared with the service use of a retrospective comparison group (RC......), receiving less intensive outpatient aftercare. METHODS: Number of re-admissions, bed days and emergency visits after 10 weeks, 6 months and 1 year was retrospectively collected from electronic patient registers. Descriptive statistics, independent samples T-tests and repeated-measures analysis of variance......BACKGROUND: The organization of aftercare is important for a successful outcome; still the optimal organization has not been fully explored. An intensive transitional post-discharge aftercare (TA) programme, for a mixed group of non-psychotic patients, was recently developed. Patients with non...

  15. Motivation for treatment among women offenders in prison-based treatment and longitudinal outcomes among those who participate in community aftercare.

    Science.gov (United States)

    Grella, Christine E; Rodriguez, Luz

    2011-09-01

    Participation in aftercare may reduce risk of recidivism among women offenders with substance use problems following their release to the community. This study examines motivation to participate in aftercare among women offenders and whether their participation in both in-custody and aftercare treatment reduces their risk of recidivism. Surveys were conducted with women (N = 1,158) in prison-based substance abuse treatment programs. Return-to-prison was examined among participants in community-based aftercare (N = 1,182) over 12 months following treatment discharge. Higher treatment motivation was associated with child welfare involvement, prior treatment, and use of "harder" drugs; ethnic minority women had lower treatment motivation compared with White women. Participants who completed the aftercare program, or who had longer treatment duration, and those who had participated in an in-prison program prior to parole had reduced risk of recidivism. Study findings suggest the value of community aftercare for women offenders, particularly when combined with prior in-prison treatment. PMID:22185040

  16. Labyrinthitis - aftercare

    Science.gov (United States)

    ... dizziness. Symptoms of labyrinthitis can cause stress. Make healthy lifestyle choices to help you cope, such as: Eat a well-balanced, healthy diet. DO NOT overeat. Exercise regularly, if possible. ...

  17. Episiotomy - aftercare

    Science.gov (United States)

    ... Drugs & Supplements Videos & Tools Español You Are Here: Home → ... To use the sharing features on this page, please enable JavaScript. An episiotomy is a minor incision made during childbirth to widen the opening of the vagina. A ...

  18. Provider Experiences with Prison Care and Aftercare for Women with Co-occurring Mental Health and Substance Use Disorders: Treatment, Resource, and Systems Integration Challenges.

    Science.gov (United States)

    Johnson, Jennifer E; Schonbrun, Yael Chatav; Peabody, Marlanea E; Shefner, Ruth T; Fernandes, Karen M; Rosen, Rochelle K; Zlotnick, Caron

    2015-10-01

    Incarcerated women with co-occurring mental health and substance use disorders (COD) face complex psychosocial challenges at community reentry. This study used qualitative methods to evaluate the perspectives of 14 prison and aftercare providers about service delivery challenges and treatment needs of reentering women with COD. Providers viewed the needs of women prisoners with COD as distinct from those of women with substance use alone and from men with COD. Providers described optimal aftercare for women with COD as including contact with the same provider before and after release, access to services within 24-72 hours after release, assistance with managing multiple social service agencies, assistance with relationship issues, and long-term follow-up. Providers also described larger service system and societal issues, including systems integration and ways in which a lack of prison and community aftercare resources impacted quality of care and reentry outcomes. Practice and policy implications are provided. PMID:24595815

  19. Determination of leachate compounds relevant for landfill aftercare using FT-IR spectroscopy.

    Science.gov (United States)

    Lenz, Sabine; Böhm, Katharina; Ottner, Reinhold; Huber-Humer, Marion

    2016-09-01

    Controlling and monitoring of emissions from municipal solid waste (MSW) landfills is important to reduce environmental damage and health risks. Therefore, simple and meaningful monitoring tools are required. This paper presents how Fourier Transform Infrared (FT-IR) Spectroscopy can be used to monitor leachate from various landfill sites. The composition of percolated leachate provides information about reactivity or stability of organic matter in landfills. Chemical compounds of investigated leachate are depicted by distinct spectral pattern. Partial least squares regression (PLS-R) models, a multivariate analysis tool, were developed based on infrared spectra to determine simultaneously conventional parameters such as ammonium, nitrate, sulfate, and dissolved organic carbon. The developed models are appropriate for application in waste management practice with respect to their excellent coefficients of determination, namely R(2)=0.99, 0.99, 0.98, and 0.98, their low errors of cross-validation and their high ratios of performance to deviation (RPD=9.3, 12.5, 6.5, 7.3). Thus, FT-IR spectroscopy turned out to be a reliable, time-saving tool to determine four parameters relevant for landfill aftercare monitoring by one single easy adaptable measurement. PMID:26951718

  20. Differential effectiveness of residential versus outpatient aftercare for parolees from prison-based therapeutic community treatment programs

    Directory of Open Access Journals (Sweden)

    Messina Nena P

    2007-05-01

    Full Text Available Abstract Background Research has indicated that more intense treatment is associated with better outcomes among clients who are appropriately matched to treatment intensity level based on the severity of their drug/alcohol problem. This study examined the differential effectiveness of community-based residential and outpatient treatment attended by male and female drug-involved parolees from prison-based therapeutic community substance abuse treatment programs based on the severity of their drug/alcohol problem. Methods Subjects were 4,165 male and female parolees who received prison-based therapeutic community substance abuse treatment and who subsequently participated in only outpatient or only residential treatment following release from prison. The dependent variable of interest was return to prison within 12 months. The primary independent variables of interest were alcohol/drug problem severity (low, high and type of aftercare (residential, outpatient. Chi-square analyses were conducted to examine the differences in 12-month RTP rates between and within the two groups of parolees (residential and outpatient parolees based on alcohol/drug problem severity (low severity, high severity. Logistic regression analyses were performed to determine if aftercare modality (outpatient only vs. residential only was a significant predictor of 12-month RTP rates for subjects who were classified as low severity versus those who were classified as high severity. Results Subjects benefited equally from outpatient and residential aftercare, regardless of the severity of their drug/alcohol problem. Conclusion As states and the federal prison system further expand prison-based treatment services, the demand and supply of aftercare treatment services will also increase. As this occurs, systems and policies governing the transitioning of individuals from prison- to community-based treatment should include a systematic and validated assessment of post

  1. The view of severely burned patients and healthcare professionals on the blind spots in the aftercare process: a qualitative study

    OpenAIRE

    Christiaens, Wendy; Van de Walle, Elke; Devresse, Sophie; Van Halewyck, Dries; Benahmed, Nadia; Paulus, Dominique; Van den Heede, Koen

    2015-01-01

    Background In most Western countries burn centres have been developed to provide acute and critical care for patients with severe burn injuries. Nowadays, those patients have a realistic chance of survival. However severe burn injuries do have a devastating effect on all aspects of a person’s life. Therefore a well-organized and specialized aftercare system is needed to enable burn patients to live with a major bodily change. The aim of this study is to identify the problems and unmet care ne...

  2. The Kanker Nazorg Wijzer (Cancer Aftercare Guide) protocol: the systematic development of a web-based computer tailored intervention providing psychosocial and lifestyle support for cancer survivors

    OpenAIRE

    Willems, Roy A; Bolman, Catherine AW; Mesters, Ilse; Kanera, Iris M.; Beaulen, Audrey AJM; Lechner, Lilian

    2015-01-01

    Background After primary treatment, many cancer survivors experience psychosocial, physical, and lifestyle problems. To address these issues, we developed a web-based computer tailored intervention, the Kanker Nazorg Wijzer (Cancer Aftercare Guide), aimed at providing psychosocial and lifestyle support for cancer survivors. The purpose of this article is to describe the systematic development and the study design for evaluation of this theory and empirical based intervention. Methods/design F...

  3. Evaluation of an internet-based aftercare program to improve vocational reintegration after inpatient medical rehabilitation: study protocol for a cluster-randomized controlled trial

    OpenAIRE

    Zwerenz, Rüdiger; Gerzymisch, Katharina; Edinger, Jens; Holme, Martin; Knickenberg, Rudolf J; Spörl-Dönch, Sieglinde; Kiwus, Ulrich; Beutel, Manfred E.

    2013-01-01

    Background Mental disorders are the main reasons for rising proportions of premature pension in most high-income countries. Although inpatient medical rehabilitation has increasingly targeted work-related stress, there is still a lack of studies on the transfer of work-specific interventions into work contexts. Therefore, we plan to evaluate an online aftercare program aiming to improve vocational reintegration after medical rehabilitation. Methods Vocationally strained patients (n = 800) age...

  4. State of the art and perspectives of a after-care soil protection. Background information; Stand und Perspektiven des nachsorgenden Bodenschutzes. Hintergrund

    Energy Technology Data Exchange (ETDEWEB)

    Frauenstein, Joerg

    2010-03-15

    The purpose of the German Federal Soil Protection Act is a sustainable protection or re-establishment of the functions of the soil. Harmful changes of soils are to be avoided. Soils, contaminated sites as well as water pollutions are to be reorganized in such a way that the danger threshold permanently is remained under. The 'after-care soil protection' contains a graduated procedure. It covers the systematic work procedures acquisition, investigation and evaluation of suspected cases and surfaces suspicious to contaminated sites regarding to the potential of danger, the identification of the demand of redevelopment, the redevelopment of determined harmful changes of soil and contaminated sites as well as measures of the after-care after final acceptance of a remedial action.

  5. Bacterial vaginosis - aftercare

    Science.gov (United States)

    ... BV) is a type of vaginal infection. The vagina normally contains both healthy bacteria and unhealthy bacteria. ... when you urinate Itching inside and outside the vagina You also may not have any symptoms.

  6. Sacroiliac joint pain - aftercare

    Science.gov (United States)

    The sacroiliac joint (SIJ) is a term used to describe the place where the sacrum and the iliac bones join. The ... The main purpose of the joint is to connect the spine and the pelvis. As a result, there is very little movement at the SIJ. Major reasons ...

  7. Frozen shoulder - aftercare

    Science.gov (United States)

    ... shoulder level. Store food in cupboards, drawers, and refrigerator shelves that are between your waist and shoulder level. Get help with housecleaning, taking out the garbage, gardening, and other household tasks.

  8. Radial head fracture - aftercare

    Science.gov (United States)

    ... or sling that supports your arm, elbow, and forearm. You will probably need to wear this for ... these medicines if you have heart disease, high blood pressure, kidney disease, or have had stomach ulcers or ...

  9. Skiers thumb - aftercare

    Science.gov (United States)

    ... it in place. After surgery your hand and forearm will be in a cast or splint for ... of bleeding. If you have heart disease, high blood pressure, kidney disease, liver disease, or have had stomach ...

  10. Metatarsal fracture (acute) - aftercare

    Science.gov (United States)

    ... you can do to help increase your foot mobility and strength are: Write the alphabet in the ... Swelling , pain, numbness, or tingling in your leg, ankle, or foot that becomes worse Your leg or ...

  11. Gunshot wounds - aftercare

    Science.gov (United States)

    ... notice other symptoms as well, such as: Anxiety Nightmares or trouble sleeping Thinking about the event over ... wounds to the extremities in a level 1 trauma center: our experience and recommendations. Isr Med Assoc ...

  12. Foot sprain - aftercare

    Science.gov (United States)

    Mid-foot sprain ... There are many bones and ligaments in your foot. A ligament is a strong flexible tissue that holds bones together. When the foot lands awkwardly, some ligaments can stretch and tear. ...

  13. Broken kneecap - aftercare

    Science.gov (United States)

    ... your activity if you have a very minor fracture. More likely, your knee will be placed in a cast or removable ... any skin wounds you may have from your knee injury. If you have a severe fracture, or if your tendon is torn, you may ...

  14. Hip flexor strain - aftercare

    Science.gov (United States)

    ... such as sprinting, kicking, and changing direction while running or moving, can stretch and tear the hip flexors. Runners, people who do martial arts, and football, soccer, and hockey players are more likely to have ...

  15. Achilles tendon rupture - aftercare

    Science.gov (United States)

    ... another accident Played a sport like tennis or basketball, with a lot of stopping and starting Most ... is OK for you to play tennis, racquetball, basketball, and other sports where you stop and start ...

  16. Postherpetic neuralgia - aftercare

    Science.gov (United States)

    ... such as: Meditation Deep-breathing exercises Biofeedback Self-hypnosis Muscle-relaxing techniques A common type of talk therapy for people with chronic pain is called cognitive behavioral therapy. It may help ...

  17. Metatarsal stress fractures - aftercare

    Science.gov (United States)

    ... blood pressure, kidney disease, or have had stomach ulcers or bleeding, talk with your doctor before using ... pain. When you restart an activity after a stress fracture, build up slowly. If your foot begins ...

  18. Can we omit scintiscanning of the skeleton in follow-up aftercare of carcinoma of the breast. A prospective study of 630 cases. Ist die Skelettszintigraphie in der Nachsorge des Mammakarzinoms entbehrlich. Eine prospektive Studie ueber 630 Faelle

    Energy Technology Data Exchange (ETDEWEB)

    Schuenemann, H. (Onkologische Klinik Bad Trissl, Oberaudorf (Germany, F.R.))

    1989-08-01

    630 women patients of the Bad Trissl clinic were admitted in 1987/88 to a prospective study to find out whether scintiscanning, or radionuclide imaging, of the skeleton can be omitted completely or in part in the after care and follow-up of carcinoma of the breast. The initial criterion was a postoperative carcinoma of the breast without metastasizing in the skeleton at the time the study began or the patient was admitted to the study. Careful pain anamnesis was performed by means of prepared questions, and a detailed clinical examination conducted to detect any pain in the skeleton of the patient concerned. This was followed by whole body scintiscanning of the skeleton and complementary X-ray films, if necessary additional examinations. It was found that clinical findings and imaging methods agreed in 545 patients. In 55 cases a finding that was clinically suspicious of metastases or doubtful, could be refuted by both scintiscan and by X-ray, osseous metastasizing would have been overlooked without skeleton scintiscan in 14 patients only (2.2%), 11 of these 14 patients were high-risk patients (negative hormonal receptor status, axillary lymph node metastases). Hence, it will be sufficient to employ scintiscanning in the aftercare and follow-up of carcinoma of the breast on a risk-adapted basis provided this is preceded by careful pain analysis and clinical examination. Failure to detect metastasizing in the skeleton will then occur in only 3 of 630 patients (0.48%). In this manner 40% of scintiscans can be omitted in future. (orig.).

  19. Closed reduction of a fractured bone - aftercare

    Science.gov (United States)

    ... 53. Nettina SM. Musculoskeletal health. Lippincott Manual of Nursing Practice . 9th ed. Philadelphia, PA: Lippincott Williams & Wilkins; 2010;chap 32. General principles of fracture care. In: Eiff MP, Hatch R, ...

  20. Zika virus: emergency and aftercare of patients.

    Science.gov (United States)

    Visovsky, Constance; McGhee, Stephen; Clochesy, John M; Zambroski, Cheryl

    2016-07-01

    Zika virus, a mosquito-borne vector, is an emerging population health threat, and is linked to fetal microcephaly, pregnancy loss and neurologic symptoms like Guillain-Barré syndrome. Global travel and migration increase the risk of transmission significantly, and growing numbers of cases are expected internationally. This article describes transmission of the virus, early and late clinical manifestations, and emergency and supportive care. It also recommends interventions for prevention. PMID:27384803

  1. Posterior cruciate ligament (PCL) injury -- aftercare

    Science.gov (United States)

    ... often occur as a result of a severe knee injury. Injuring the PCL takes a lot of force. ... A.M. Editorial team. Related MedlinePlus Health Topics Knee Injuries and Disorders Browse the Encyclopedia A.D.A. ...

  2. Urinary tract infection in girls - aftercare

    Science.gov (United States)

    Symptoms of urinary tract infection (UTI) should begin to improve within 1 to 2 days in most girls. The advice below may not ... Elder JS. Urinary tract infections. In: Kliegman RM, Stanton BF, ... NF, eds. Nelson Textbook of Pediatrics . 20th ed. Philadelphia, ...

  3. [Transfer managment of postoperative acute pain therapy to outpatient aftercare].

    Science.gov (United States)

    Tank, C; Lefering, R; Althaus, A; Simanski, C; Neugebauer, E

    2014-10-01

    The significance of postoperative pain management for patients in the hospital is well known and has been a focus of research for several years. The ambulatory care after hospital discharge, however, is not well investigated. A prospective observational study was therefore conducted to study the transfer management from in-hospital patients to ambulatory care. A patient questionnaire was developed and patients were asked to fill it out at different time points after the operation: during the time in the hospital, then at 2 weeks and 6 months after hospital discharge. In addition, the responsible family doctor was approached and interviewed. The main focus of the questionnaire was the measurement of post-surgical pain (numeric rating scale NRS), patient satisfaction (Cologne patient questionnaire), and quality of life (SF 12). Of a total of 128 patients 72.9% described moderate to severe pain after the orthopaedic operations in the hospital. 90.8% of the patients had pain directly after discharge from the hospital; in 67.4% of the cases pain was ≥3 and in 23.4% of the cases pain was ≥6. Six months after discharge pain was significant in 29.4% of the patients, 60.8% of the patients were satisfied with the transfer to the home setting. 16% were not satisfied at all and 23.2% were neutral. Important factors for dissatisfaction with the transfer management were, according to stepwise logistic regeression analysis, sex (female patients), young age, a poor bodily constitution at the hospital and thereafter, and the pain management in the hospital and after discharge. The study shows the significance of the acute pain therapy not only during the hospital stay but also after discharge. There are very few data on pain therapy after discharge from the hospital. Based on the significance of the chronification of acute pain it is of the utmost importance to close this gap. PMID:24452431

  4. Patients’ narratives of lived experiences of intensive care during after-care

    DEFF Research Database (Denmark)

    Nilsson, Karen; Berner, Susanne; Hertz, Iben;

    2013-01-01

    -up dialoguepieces in the puzzle of recovery. World Crit Care Nursing 2011; 8(2):75. [(journal article - abstract) ISSN: 1748–6254]. 3. 4th EfCCNa & FSAIO Congress Copenhagen 2011 http://www.efccna.org/index.php?option=com_content&view=article&id=88&Itemid=96. 4. Storli SL, Lind R. The meaning of follow...

  5. Desalination of historic masonry. Pre-investigation and after-care

    NARCIS (Netherlands)

    Hees, R.P.J. van; Lubelli, B.A.

    2013-01-01

    salt crystallization continues one of the most widespread decay mechanisms affecting historic buildings. Desalination is a conservation treatment of growing importance in the case of historic masonry. However, it is an intervention that needs a through analysis of the situation in order to guarantee

  6. The untapped potential of smartphone sensors for stroke rehabilitation and after-care.

    Science.gov (United States)

    Zhang, Melvyn W; Chew, Poh Yim; Yeo, Leonard L; Ho, Roger C

    2016-01-01

    With the increasing incidences of cerebrovascular disease, as well as the morbidity and mortality associated with it, it is of no surprise that there have been much global governmental interest in the primary prevention of this disorder; or at least in the secondary and tertiary prevention and rehabilitation of individuals who have suffered disabilities arising from a recent cerebrovascular attack. Developers and clinicians have not considered one of the key areas in Stroke prevention and management, which is that of secondary prevention, and in particular that of tapping onto smartphone technologies for stroke rehabilitation. There has been much interest in the development of devices for rehabilitation of stroke patients instead. One of the concerns with regards to conventional bio and mechanical sensors are the costs involved in development, as well as the costs involved when stroke survivors and their caregivers are required to purchase the devices for monitoring and rehabilitation. In view of the current limitations, the S3 Rehab application, which makes use of the smartphone build in sensors, has been conceptualized and has been developed for the two major platforms (Apple and Android platforms). The authors believe that by tapping onto these sensors and by programming a smartphone application that is specifically catered for rehabilitation, it would keep costs minimal for researchers, patients and caregivers. Whilst there is a growing interest in wearable devices and sensors, it is important for developers and researchers to be cognizant that certain interventions, such as rehabilitation could still be done through a smartphone device, instead of investing in new research and development. There are various untapped potential in the smartphone that researchers and developers need to be cognizant of. PMID:26484884

  7. Outpatient pulmonary rehabilitation – rehabilitation models and shortcomings in outpatient aftercare

    Directory of Open Access Journals (Sweden)

    Dietl, Markus

    2010-01-01

    Full Text Available Background: The chronic obstructive pulmonary disease (COPD and the bronchial asthma are widespread diseases. They need long-lasting and sustainable rehabilitation. Objectives: The goal of this HTA is to describe the present supply and the economic relevance of out-patient pulmonary rehabilitation in conjunction with its social aspects. A further target is to derivate options for actions in the health-care system and possible research necessities. Methods: Relevant publications are identified by means of a structured search in 37 database accessed through the German Institute of Medical Documentation and Information (DIMDI. In addition a manual search of identified reference lists has been done. The present report includes German and English literature published from 2004 to 2009. The methodological quality was assessed by two independent researchers according to pre-defined quality criteria of evidence based medicine. Results: Among 860 publications 31 medical studies, four economic studies and 13 ethical studies meet the inclusion criteria. The studies cover rehabilitation programmes in 19 countries. The majority of them has a high level of evidence (1A to 2C. The pulmonary rehabilitation programmes differ by the setting (in-patient, out-patient, in-home, community-based, by the length of intervention (from two weeks to 36 months, by the way and the frequency of intervention and by the duration of the follow-up treatment. Overall out-patient rehabilitation programmes achieve the same positive effects for COPD patients as in-patient programmes do. This is especially true for physical performance and health related quality of life. There are only a few studies dealing with asthma. Therefore, valid statements cannot be given. The results for cost-effectiveness are not distinct enough. Discussion: Goals of pulmonary rehabilitation like prevention and adequate treatment of acute exacerbations, the minimisation of hospitalisation and the reduction of mortality are attained in out-patient as well as in in-patient pulmonary rehabilitation. Regarding the best frequency of training units per week or the duration and the content of a unit further research is needed. Final results for the ideal length of an in-patient rehabilitation are still missing. None of the studies deals with the analysis of the different treatment forms of a COPD which are frequently defined by an alteration of in-patient and out-patient treatments and participation in sports clubs or self-help groups. There are some other limitations of the studies. The results concerning self-management programmes are not distinct. (Self- Selection leads to high drop-out rates. Many studies have only small sample sizes. Confounder and long-time effects are seldom researched, relevant economic evaluations do not exist The improvement of health related quality of life is primarily obtained by an improved disease management than by an improvement of a medical parameter. Conclusion: Out-patient pulmonary rehabilitation is as effective as in-patient pulmonary rehabilitation. But there is a critical shortage of out-patient pulmonary rehabilitation supply in Germany. Domains for further research are the evaluation of models for integrated care, the length, frequency and content of training programmes, psychiatric assessments and the cost-effectiveness of out-patient pulmonary rehabilitation.

  8. First experiences with MR mammography in aftercare following plastic surgery of cancer of the breast

    International Nuclear Information System (INIS)

    To demonstrate typical MR mammographic findings after plastic surgery of breast cancer. Postoperative (7-38 months, median 13) MR mammographic examinations of 25 patients operated for breast cancer (11 latissimus dorsiflaps (LAT)), 14 rectus abdominis myocutaneous-flaps (TRAM) were reevaluated. The examinations were performed with a breast coil at 1 T. The sequences applied were a fat-suppressed 2-D turbo IR-sequence protonweighted and a T1-weighted FLASH 3-D sequence as dynamic series. Scars between the myocutaneous flap and the remaining breast tissue always appeared in form of a ligament or septum. Signal and perfusion characteristics of scar tissue and muscle stalk in this investigation were clearly different from fat necrosis was found and rectified by biopsy. MR mammography is a very valuable diagnostic method for postoperative evaluation of myocutaneous flap-based therapy of breast cancer. (orig.)

  9. Diagnosing early onset dementia and then what? A frustrating system of aftercare resources

    Directory of Open Access Journals (Sweden)

    Chemali Z

    2012-01-01

    Full Text Available Z Chemali1–3, S Schamber2, EC Tarbi2, D Acar1,2, M Avila-Urizar21Harvard Medical School, 2Departments of Neurology and Psychiatry, Division of Cognitive and Behavioral Neurology, Brigham and Women’s Hospital, 3Departments of Psychiatry and Neurology, Massachusetts General Hospital, Boston, MA, USAAbstract: Recent studies indicate that the prevalence of early onset dementia (EOD is more common than it was once presumed. As such, and considering the substantial challenges EOD presents to the patient, caregivers, and health care providers, this study sought to investigate the mechanism of care delivered to these patients. A medical record chart review was conducted for 85 patients attending a memory disorder unit who initially presented to rule out EOD as a working diagnosis. The results suggest that while the majority of these patients received an extensive work-up and were heavily medicated, they remained at home, where they lacked adequate age-related services and could not be placed, despite the crippling caregiver burden. This manuscript is a platform to discuss our current system limitations in the care of these patients with an eye on new opportunities for this challenging group.Keywords: early onset dementia, social work, services, caregiving

  10. Abstinence versus Harm Reduction: Considering Follow-Up and Aftercare in First Nations Addictions Treatment

    Science.gov (United States)

    van der Woerd, Kimberly A.; Cox, David N.; Reading, Jeff; Kmetic, Andrew

    2010-01-01

    Research on alcohol and substance use in First Nations populations frequently describes the nature of the problem, and the severity of the risk factors, but seldom addresses possible interventions and the effectiveness of the treatments that clients do engage in. This paper reviews a participatory evaluation of the 6-week residential "Namgis…

  11. Case management in aftercare of involuntarily committed patients with substance abuse

    DEFF Research Database (Denmark)

    Lindahl, Marianne Larsson; Berglund, Mats; Tönnesen, Hanne

    2013-01-01

    Case management has since the 1970s been widely used to co-ordinate services for mental health patients. The methodology has expanded to support patients in many different types of conditions. This study is one of very few randomized trials on case management in a European setting. It examined the...... impact of case management on substance abuse and use of service after discharge from court-ordered institutional care....

  12. Diagnosing Early Onset Dementia and Then What? A Frustrating System of Aftercare Resources

    OpenAIRE

    Chemali Z; Schamber S; Tarbi EC; Acar D; Avila-Urizar M

    2012-01-01

    Z Chemali1–3, S Schamber2, EC Tarbi2, D Acar1,2, M Avila-Urizar21Harvard Medical School, 2Departments of Neurology and Psychiatry, Division of Cognitive and Behavioral Neurology, Brigham and Women’s Hospital, 3Departments of Psychiatry and Neurology, Massachusetts General Hospital, Boston, MA, USAAbstract: Recent studies indicate that the prevalence of early onset dementia (EOD) is more common than it was once presumed. As such, and considering the substantial challenges E...

  13. Diagnosing early onset dementia and then what? A frustrating system of aftercare resources

    Science.gov (United States)

    Chemali, Z; Schamber, S; Tarbi, EC; Acar, D; Avila-Urizar, M

    2012-01-01

    Recent studies indicate that the prevalence of early onset dementia (EOD) is more common than it was once presumed. As such, and considering the substantial challenges EOD presents to the patient, caregivers, and health care providers, this study sought to investigate the mechanism of care delivered to these patients. A medical record chart review was conducted for 85 patients attending a memory disorder unit who initially presented to rule out EOD as a working diagnosis. The results suggest that while the majority of these patients received an extensive work-up and were heavily medicated, they remained at home, where they lacked adequate age-related services and could not be placed, despite the crippling caregiver burden. This manuscript is a platform to discuss our current system limitations in the care of these patients with an eye on new opportunities for this challenging group. PMID:22287850

  14. Differential effectiveness of residential versus outpatient aftercare for parolees from prison-based therapeutic community treatment programs

    OpenAIRE

    Messina Nena P; Prendergast Michael L; Dang Jeff; Burdon William M; Farabee David

    2007-01-01

    Abstract Background Research has indicated that more intense treatment is associated with better outcomes among clients who are appropriately matched to treatment intensity level based on the severity of their drug/alcohol problem. This study examined the differential effectiveness of community-based residential and outpatient treatment attended by male and female drug-involved parolees from prison-based therapeutic community substance abuse treatment programs based on the severity of their d...

  15. Preventing repetition of attempted suicide--I. Feasibility (acceptability, adherence, and effectiveness) of a Baerum-model like aftercare

    DEFF Research Database (Denmark)

    Hvid, Marianne; Wang, August G

    2009-01-01

    Repetition after attempted suicide is high with only limited research been put into effect studies. The Baerum-model from Norway offers a practical and affordable intervention. Our aim was to study the acceptability and effectiveness of a Baerum-model like intervention after attempted suicide using...... a quasi-experimental design. During a period in 2004, attempted suicide patients were offered follow-up care by a rapid-response outreach programme, an intervention lasting 6 months; a control group was established prospectively from a similar period in 2002. The design was an intent......-to-treat analysis. The outcome was measured by: 1) participation by acceptance and adherence, 2) repetition of suicide attempt and suicide, and 3) including the number of repetitive acts in 1 year after the attempted suicide episode. Follow-up period was 1 year. Participation was 70%. There was a significant lower...

  16. Preventing repetition of attempted suicide-I. Feasibility (acceptability, adherence, and effectiveness) of a Baerum-model like aftercare

    DEFF Research Database (Denmark)

    Hvid, M.; Wang, August Gabriel

    Repetition after attempted suicide is high with only limited research been put into effect studies. The Baerum-model from Norway offers a practical and affordable intervention. Our aim was to study the acceptability and effectiveness of a Baerum-model like intervention after attempted suicide using...... a quasi-experimental design. During a period in 2004, attempted suicide patients were offered follow-up care by a rapid-response outreach programme, an intervention lasting 6 months; a control group was established prospectively from a similar period in 2002. The design was an intent......-to-treat analysis. The outcome was measured by: 1) participation by acceptance and adherence, 2) repetition of suicide attempt and suicide, and 3) including the number of repetitive acts in 1 year after the attempted suicide episode. Follow-up period was 1 year. Participation was 70%. There was a significant lower...

  17. Reintegration, Supervised Release, and Intensive Aftercare of juvenile Criminals in America.%美国未成年犯罪人的释放安置

    Institute of Scientific and Technical Information of China (English)

    王志亮

    2008-01-01

    基于未成年罪犯所具有的特点,对未成年罪犯执行自由刑的方式与内容也有别于成年罪犯的自由刑,在美国未成年犯罪人的释放安置是指只在监禁期后在社区里监督未成年人.释放安置是未成年人被关进行刑机关(原始刑罚)的最后成份,而不是由法官判处的刑罚,它的最基本功能是在社区里监督未成年人.紧随具有严格时间表的监禁刑之后,设计释放安置是要帮助未成年人过渡到"真正的世界".

  18. Integrating into the Mental Health System from the Criminal Justice System: Jail Aftercare Services for Persons with a Severe Mental Illness

    Science.gov (United States)

    Davis, Kristin; Fallon, John; Vogel, Sue; Teachout, Alexandra

    2008-01-01

    This article describes a mental health evidence based practice, Assertive Community Treatment (ACT). While ACT has scientific support, it has not been rigorously tested for persons with a severe mental illness and repeated forensic involvement. This article provides preliminary evidence that ACT is best suited for reentry into the mental health…

  19. A review of approaches for the long-term management of municipal solid waste landfills.

    Science.gov (United States)

    Laner, David; Crest, Marion; Scharff, Heijo; Morris, Jeremy W F; Barlaz, Morton A

    2012-03-01

    After closure, municipal solid waste (MSW) landfills must be managed and controlled to avoid adverse effects on human health and the environment (HHE). Aftercare (or post-closure care) can be brought to an end when the authorities consider the landfill to no longer pose a threat to HHE. Different approaches have been suggested for long-term landfill management and evaluation of aftercare completion. In this paper, research on aftercare and its completion is analyzed and regulatory approaches for the completion of landfill aftercare are reviewed. Approaches to aftercare could be categorized as (i) target values, (ii) impact/risk assessment, and (iii) performance based. Comparison of these approaches illustrates that each has limitations and strengths. While target values are typically used as screening indicators to be complemented with site-specific assessments, impact/risk assessment approaches address the core issue about aftercare completion, but face large uncertainties and require a high level of expertise. A performance-based approach allows for the combination of target values and impact/risk assessments in a consistent evaluation framework with the aim of sequentially reducing aftercare intensity and, ultimately, leading to the completion of aftercare. At a regulatory level, simple qualitative criteria are typically used as the primary basis for defining completion of aftercare, most likely due to the complexity of developing rigorous evaluation methodologies. This paper argues that development of transparent and consistent regulatory procedures represents the basis for defining the desired state of a landfill at the end of aftercare and for reducing uncertainty about the intensity and duration of aftercare. In this context, recently presented technical guidelines and the ongoing debate with respect to their regulatory acceptance are a valuable step towards developing strategies for the cost-effective protection of HHE at closed MSW landfills. To assess the

  20. Parental Substance Use, Family Support and Outcome Following Treatment for Adolescent Psychoactive Substance Use Disorders.

    Science.gov (United States)

    Whitney, Stephen D.; Kelly, John F.; Myers, Mark G.; Brown, Sandra A.

    2002-01-01

    Examines family variables that may influence adolescent substance use during the 6 months following inpatient treatment: parental substance use, family aftercare attendance, and adolescent ratings of family helpfulness. Results revealed no relationship between either parental substance use and family aftercare attendance or reports of family…

  1. A nested case-control study of the risk of suicide attempts after discharge from psychiatric care

    DEFF Research Database (Denmark)

    Christiansen, Erik; Jensen, Børge

    2008-01-01

    abuse with mental illness raised risk in an additive way. We found only small gender differences in risk. In order to lower the risk of suicide attempts, we need to improve after-care when discharging from psychiatric care. A differentiation between the possibilities of after-care for different mental...

  2. 76 FR 62599 - Presidential Determination With Respect to Foreign Governments' Efforts Regarding Trafficking in...

    Science.gov (United States)

    2011-10-11

    ..., identification, rescue or removal; aftercare (shelter, counseling) training and reintegration; or (c) expand.... (Presidential Sig.) THE WHITE HOUSE, Washington, September 30, 2011 [FR Doc. 2011-26333 Filed 10-7-11; 8:45...

  3. 'I could not have survived without Kelly and her team'.

    Science.gov (United States)

    Owen, Tom

    2016-08-01

    With her team of unsung heroes at Sandwell General Hospital in the West Midlands, Kelly carries out sterling work in the aftercare of patients with bowel cancer, rectal cancer and other debilitating aspects of incontinence. PMID:27484570

  4. 78 FR 49533 - Office of Direct Service and Contracting Tribes; National Indian Health Outreach and Education...

    Science.gov (United States)

    2013-08-14

    ... technical assistance related to the prevention, treatment and aftercare of methamphetamine addiction and.../ culturally relevant traditional methods issues, or program marketing challenges). The technical assistance... and evidence-based practice implementation and culturally- appropriate traditional practices...

  5. Surgical Ventricular Reconstruction

    Medline Plus

    Full Text Available ... the procedure and aftercare. 00:00:32 ROBERT E. MICHLER, MD: We then opened the heart, looking ... Now, let's go ORlive. 00:01:11 ROBERT E. MICHLER, MD: Good evening and welcome to the ...

  6. Follow-up services for stroke survivors after hospital discharge--a randomized control study

    DEFF Research Database (Denmark)

    Andersen, Hanne Elkjaer; Eriksen, Karen; Brown, Anne;

    2002-01-01

    ) follow-up home visits by a physician, (2) physiotherapist instruction in the patient's home, or (3) standard aftercare. SUBJECTS: Stroke patients with persisting impairment and disability who, after completing inpatient rehabilitation, were discharged to their homes. OUTCOME MEASURES: Six months after...... were given instructions by a physiotherapist in their home and 48 received standard aftercare only. No statistically significant differences in functional outcome six months after discharge were demonstrated between the three groups. However, all measurements showed a tendency towards higher scores...

  7. Specifika využití arteterapie v doléčovacím centru

    OpenAIRE

    PODZIMKOVÁ, Petra

    2012-01-01

    This work focuses on the concept of art therapy in Aftercare center, in the service of dealing with follow-up care for people who are recovering from addiction, especially on non-alcohol drugs. Given topic is treated in the theoretical and practical. The theoretical part of the paper summarizes the basic definitions related to drug addiction and dependent personality description, followed by an after-care services and focuses on the principles and goals of treatment of addiction. In the treat...

  8. Gender and racial/ethnic differences in addiction severity, HIV risk, and quality of life among adults in opioid detoxification: results from the National Drug Abuse Treatment Clinical Trials Network

    OpenAIRE

    Wu, Li-Tzy; Ling, Walter; Burchett, Bruce; Blazer, Dan G.; Shostak, Jack; Woody, George E.

    2010-01-01

    Purpose Detoxification often serves as an initial contact for treatment and represents an opportunity for engaging patients in aftercare to prevent relapse. However, there is limited information concerning clinical profiles of individuals seeking detoxification, and the opportunity to engage patients in detoxification for aftercare often is missed. This study examined clinical profiles of a geographically diverse sample of opioid-dependent adults in detoxification to discern the treatment nee...

  9. Imaging and characterization of heterogeneous landfills using geophysical methods

    OpenAIRE

    Konstantaki, L.A.

    2016-01-01

    Nowadays many countries use landfilling for the management of their waste or for treating old landfills. Emissions from landfills can be harmful to the environment and to human health, making the stabilization of landfills a priority for the landfill communities. Estimation of the emission potential for determination of the aftercare period and improvement of the treatment technologies for the minimization of the aftercare period are examples of problems landfill research groups are now facin...

  10. ICU-recovery in Scandinavia

    DEFF Research Database (Denmark)

    Egerod, Ingrid; Risom, Signe S; Thomsen, Thordis;

    2013-01-01

    The aim of our study was to describe and compare models of intensive care follow-up in Denmark, Norway and Sweden to help inform clinicians regarding the establishment and continuation of ICU aftercare programmes.......The aim of our study was to describe and compare models of intensive care follow-up in Denmark, Norway and Sweden to help inform clinicians regarding the establishment and continuation of ICU aftercare programmes....

  11. Do PTSD Symptoms and Course Predict Continued Substance Use for Homeless Individuals in Contingency Management for Cocaine Dependence?

    OpenAIRE

    Burns, Michelle Nicole; Lehman, Kenneth A.; Milby, Jesse B.; Wallace, Dennis; Schumacher, Joseph E.

    2010-01-01

    Homeless individuals (n = 187) entering contingency management (CM) for cocaine dependence were assessed for PTSD diagnosis, and a subset of 102 participants reporting traumatic exposure also periodically completed a self-report measure of PTSD symptoms. Patients with PTSD in full remission at 6 months (end of active treatment) and 12 months (end of aftercare) used substances much less frequently during aftercare than those with no PTSD diagnosis. Those whose PTSD diagnosis improved to full r...

  12. The Support and Aftercare System with Chinese Characteristics for Reintegrating Released Prisoners and Persons who have Completed the Re-education- through - labour Programme%有中国特色的对刑满释放、解除劳教人员的帮扶救助制度

    Institute of Scientific and Technical Information of China (English)

    李冰

    2006-01-01

    对刑满释放人员给予必要的帮扶救助是世界各国预防和减少重新违法犯罪的措施之一,有些国家还制定出台法津、法规和保护性政策,鼓励和促进刑满释放人员就业,为他们回归社会后走入正途创造条件.过渡性的安置、帮教是我国对刑满释放、解除劳教人员实行的帮扶救助政策,这项政策随着社会和经济发展,不断调整完善,并在实践中形成了具有中国特色的帮扶救助制度.

  13. Ošetřovatelská péče o pacienta v terminálním stádiu na oddělení následné péče a v hospici.

    OpenAIRE

    PETROVICOVÁ, Eva

    2013-01-01

    The bachelor thesis called "Nursing care of the patient in the terminal stage at the aftercare department and at a hospice" deals with the issue of nursing care for patients in the terminal stage at the aftercare department (AD) and at the hospice. Caring of a dying person is still a current topic, since each one will die and before the inevitable moment occurs, we will wish that it happens with dignity. The aim of the work was to examine the differences in nursing care and meeting the needs ...

  14. Sheep Stockmanship (Lambing). Youth Training Scheme. Core Exemplar Work Based Project.

    Science.gov (United States)

    Further Education Staff Coll., Blagdon (England).

    This trainer's guide is intended to assist supervisors of work-based career training projects in helping students gather and record information about sheep breeding, learn about treatment of diseases, prepare the lambing area, and assist with the aftercare of lambs and ewes. The guide is one in a series of core curriculum modules that is intended…

  15. Technology in Treatment: Are Adolescents and Counselors Interested in Online Relapse Prevention?

    Science.gov (United States)

    Trudeau, Kimberlee J.; Ainscough, Jessica; Charity, Sadaf

    2012-01-01

    Background: Approximately 75% of adolescents who receive substance abuse treatment relapse within 1 year; therefore, it is important to have effective, easily accessible aftercare resources to support them while they are in recovery. Objective: The goal of this study was twofold: (1) to find out from adolescents and counselors if an online relapse…

  16. 28 CFR 550.41 - Urine surveillance.

    Science.gov (United States)

    2010-07-01

    ... 28 Judicial Administration 2 2010-07-01 2010-07-01 false Urine surveillance. 550.41 Section 550.41 Judicial Administration BUREAU OF PRISONS, DEPARTMENT OF JUSTICE INSTITUTIONAL MANAGEMENT DRUG PROGRAMS... aftercare as a condition of release; (2) Who have a known history of drug abuse; or (3) Who are suspected...

  17. Strategies for Incorporating Women-Specific Sexuality Education into Addiction Treatment Models

    Science.gov (United States)

    James, Raven

    2007-01-01

    This paper advocates for the incorporation of a women-specific sexuality curriculum in the addiction treatment process to aid in sexual healing and provide for aftercare issues. Sexuality in addiction treatment modalities is often approached from a sex-negative stance, or that of sexual victimization. Sexual issues are viewed as addictive in and…

  18. Supportive Care Needs for Women With Gynecological Cancer and Their Relatives During the Prediagnostic Period

    DEFF Research Database (Denmark)

    Holt, Kamila Adellund; Hansen, Helle Ploug; Mogensen, Ole

    2014-01-01

    The prediagnostic process for gynecological cancer has become quite rapid. It gives the woman limited time to handle new information about her illness and make decisions. The existing support initiatives in Denmark focus on aftercare rather than on needs for support in the prediagnostic period....

  19. Surgical treatment of a comminuted articular fracture of the accessory carpal bone in a thoroughbred horse

    International Nuclear Information System (INIS)

    The clinical, radiographic and ultrasonographic findings in a case ofa comminuted articular fracture of the accessory carpal bone of a thoroughbred chaser are described, and its surgical treatment and aftercare are detailed. The horse made an uneventful recovery and successfully returned to racing

  20. Ways of Building Bridges with the Community: Prison Education in Norway.

    Science.gov (United States)

    Langelid, Torfinn

    1996-01-01

    The Norwegian government recognizes that, in order to reduce recidivism, community institutions such as schools, social services, and employment and health agencies are all responsible for postrelease care of offenders. Follow-up transition classes and cooperation with the probation service are part of a total approach to aftercare. (SK)

  1. Suicide and Deliberate Self-harm in Children and Adolescents. A Research Update. Research Review.

    Science.gov (United States)

    Kerfoot, Michael

    1996-01-01

    Reviews research on adolescent suicide and deliberate self-harm. Shows that in the UK suicide is the second most common cause of death among 15- to 24-year-olds, and that deliberate self-harm is linked to depression, substance misuse, and family functioning and precedes one-third of adolescent suicides. Discusses problems in aftercare of…

  2. 28 CFR 550.40 - Purpose and scope.

    Science.gov (United States)

    2010-07-01

    ... Drug Services (Urine Surveillance and Counseling for Sentenced Inmates in Contract CTCs) § 550.40... community treatment center (CTC) participate in a program of urine testing for drug use. An inmate who is serving a sentence in a contract CTC, and who has drug aftercare as a condition of release also...

  3. Imaging scatterers in landfills using seismic interferometry

    NARCIS (Netherlands)

    Konstantaki, L.A.; Dragnov, D.S.; Heimovaara, T.J.; Ghose, R.

    2013-01-01

    A significant problem with landfills is their aftercare period. A landfill is considered to be safe for the environment only after a relatively long period of time. Until it reaches such a condition, it has to be periodically treated. Not only are treatments very expensive, but they could be dangero

  4. Managing the weaning of a temporary tracheostomy.

    Science.gov (United States)

    Everitt, Erica

    The second article of this four-part series on tracheostomy care describes the process of weaning patients off a tracheostomy, decannulation of the tube and aftercare. The role of the multidisciplinary team is discussed, as well as the importance of psychological care of patients who may be anxious about their ability to breathe without a tube. PMID:27386708

  5. Water balance modeling for estimation of residence time of water in a full-scale landfill using a data-assimilation approach

    NARCIS (Netherlands)

    Heimovaara, T.J.; Bun, A.; Van Turnhout, A.G.

    2015-01-01

    In order to develop novel approaches for reducing the after-care of Municipal Solid Waste (MSW) sanitary landfills methods are required with which we can quantify the emission potential present in waste bodies. Currently full-scale experiments are being prepared at three Dutch landfills based on enh

  6. Collaboration between general hospitals and community health services in the care of suicide attempters in Norway: a longitudinal study

    Directory of Open Access Journals (Sweden)

    Fadum Elin

    2010-06-01

    Full Text Available Abstract Background The aim of this paper was to study the collaboration between emergency departments (EDs in general hospitals and community health services (CHS in Norway when providing psychosocial care and aftercare to patients treated in EDs following a suicide attempt. We wanted to explore the extent to which quality indicators at the hospital level measured in 1999 and 2006 could predict the presence or absence of a chain of care structure in the CHS in 2006. Methods Data were collected through structured interviews with informants from 95% of all general hospitals in Norway in 1999 and 2006, and informants from CHS, in a stratified sample of Norwegian municipalities in 2006 (n = 47. Results In 15 of the 47 municipalities (32%, the CHS reported having a chain of care structure in 2006. A discriminant function analysis revealed that the hospitals that in 1999 had: (a a collaboration agreement with aftercare providers, and (b written guidelines, including a quality assurance system, were significantly more likely to have municipalities with a chain of care structure in their catchment area in 2006. Conclusions Hospitals' and municipalities' self-reported provision of aftercare services for patients treated after a suicide attempt was markedly below the recommendations given in national standards. Systems at the hospital level for the management and care of patients admitted after a suicide attempt and systematic collaboration between hospitals and aftercare providers seem to be important elements in the long-term maintenance of continuity of care for suicide attempters.

  7. Mental Health and Native Americans: Responding to the Challenge of the Biopsychosocial Model.

    Science.gov (United States)

    Marburg, Galen Sanford

    1983-01-01

    A rural, hospital-based, community mental health program at Keams Canyon Indian Hospital (Arizona) utilizes an array of remedial, developmental, and preventive strategies to respond to the unique biopsychosocial needs of the Navajo and Hopi populations. Outpatient, outreach, and aftercare programs, and development of treatment and consulting…

  8. Efficacy of Group Motivational Interviewing (GMI) for Psychiatric Inpatients with Chemical Dependence

    Science.gov (United States)

    Santa Ana, Elizabeth J.; Wulfert, Edelgard; Nietert, Paul J.

    2007-01-01

    Dually diagnosed patients with chemical dependency and a comorbid psychiatric disorder typically show poor compliance with aftercare treatment, which may result in costly and pervasive individual and societal problems. In this study, the authors investigated the effect of adding motivational interviewing in a group format to standard treatment for…

  9. Particuliere reclassering en overheid in Nederland sinds 1823

    NARCIS (Netherlands)

    Heinrich, Jean-Paul

    1995-01-01

    This study deals with the historical development of the relationship between the Dutch Government and the private after-care and rehabilitation organisations from 1823 until today. The first chapter covers the period that starts with the foundation of The Dutch Fellowship for Moral Reformation of Pr

  10. Challenges of Imprisonment in the Nigerian Penal System: The Way Forward

    Directory of Open Access Journals (Sweden)

    Gloria D Shajobi-Ibikunle

    2014-05-01

    Full Text Available This paper traces the customary methods of dealing with offenders prior to colonial rule in Nigeria to the current state of facilities and operations in Nigerian prisons. It critically analyses the condition of the incarcerated offender, the measures put in place for their rehabilitation vis a vis the united nations standard minimum rules for the treatment of offenders. It finds that the prisons are overcrowded, conditions are deplorable with inadequate rehabilitation and aftercare provisions. This paper recommends greater use of fines by courts; restitution, mediation, probation and community service as non-custodial measures for minor and non-violent offenders. Several measures are recommended for rehabilitation and aftercare of convicts.

  11. Forebyggelse og efterbehandling af suicidal adfaerd--en litteraturoversigt

    DEFF Research Database (Denmark)

    Stenager, E N

    1991-01-01

    In this review of the literature on studies concerning the prevention of suicide and the effect of after-care of patients who have attempted to take their lives it is concluded that no treatment which works has yet been discovered. Of five clinically controlled studies only one suggested that it...... affected the repetition frequency of attempts at suicide. When other effects were assessed there was an improvement in the patients' social functions and a reduction in their abuse of alcohol. The studies have shown that not only psychiatrists but also other physicians and categories of personnel can...... undertake attendance on, and after-care of patients who have attempted suicide provided that they receive the necessary training and supervision....

  12. Evolution of sulfide oxidation and attenuation mechanisms controlling acid mine drainage in decommissioned low-sulfide tailings

    OpenAIRE

    Parviainen, Annika

    2012-01-01

    Environmental hazards derived from mining have been a major concern worldwide in the past years. Understanding of the consequences of malpractice in waste management and the lack of aftercare is crucial to the sustainability of the future mining industry. Mineralogical and geochemical studies are key to predicting the generation of acid mine drainage (AMD) and to evaluating the stability of a tailings system at an advanced stage of weathering. Site-specific data also assist in selecting the r...

  13. Toezicht buiten de muren: Een systematische review van extramuraal toezicht op TBS-gestelden en vergelijkbare groepen in het buitenland

    OpenAIRE

    Gestel, B. van; Knaap, L.M. van der; Hendriks, A; Kogel, C.H. de; Nagtegaal, M.H.; Bogaerts, S.

    2006-01-01

    Dit literatuuronderzoek is hoofdzakelijk gebaseerd op publicaties over extramuraal toezicht, volgend op een intramurale straf of maatregel voor forensisch psychiatrische patiënten. Het is een inventarisatie van toezichtprogramma's, hun veronderstelde werkzame mechanismen bij de programma's en evaluatiestudies naar de programma's. Het toezicht kan in twee, elkaar niet uitsluitende, typen worden onderverdeeld. Het eerste type toezicht betreft vormen van aftercare en is mede gericht op resociali...

  14. The Dutch criminal justice system: Organization and operation - second revised edition

    OpenAIRE

    Tak, P.J.P.

    2003-01-01

    This report describes the organization and operation of the Dutch criminal justice system. Its contents are: The Dutch Criminal Code; The Dutch Code of criminal procedure; The main organs of the criminal justice system; Issues of  criminal law; Issues of procedural law; The system system of sanctions; Sentencing; The prison system; Early release, pardon and after-care of prisoners; Figures on crime and sentencing.

  15. Sinus pilonidalis in patients of German military hospitals: a review

    OpenAIRE

    Kueper, Janina; Evers, Theo; Wietelmann, Kai; Doll, Dietrich; Roffeis, Jana; Schwabe, Philipp; Märdian, Sven; Wichlas, Florian; Krapohl, Björn-Dirk

    2015-01-01

    Pilonidal sinus disease (PSD) most commonly presents in young men when hair follicles enter through damaged epithelium and cause an inflammatory reaction. This results in the formation of fistular tracts. We reviewed studies based on a shared cohort of patients who presented at German military hospitals with PSD. The effect of the morphology of the sinus, perioperative protocol, and aftercare of the surgical treatment on the recurrence of PSD were evaluated. The drainage of acute abscesses be...

  16. Charakterisierung der Biodegradation von Silikonmammaimplantaten

    OpenAIRE

    Janke, Andrea

    2009-01-01

    Focal point of plastic-aesthetic operations is the cosmetic correction of the female breast with silicone implants. Main part of them are breast augmentations. Beside the common public interest is the use of silicone imlants in reconstructive plastic intervention and tumor aftercare. The implant material silicone, considered as inert material for lots of years, causes problems and its degradation could not be explained sufficently up to now. Implantation of a silicone implant can cause the fo...

  17. Improving Parolees' Participation in Drug Treatment and Other Services through Strengths Case Management

    OpenAIRE

    Prendergast, Michael; Cartier, Jerome J.

    2008-01-01

    In an effort to increase participation in community aftercare treatment for substance-abusing parolees, an intervention based on a transitional case management (TCM) model that focuses mainly on offenders' strengths has been developed and is under testing. This model consists of completion, by the inmate, of a self-assessment of strengths that informs the development of the continuing care plan, a case conference call shortly before release, and strengths case management for three months post...

  18. A meta-analysis of prevalence rates and moderating factors for cancer-related post-traumatic stress disorder

    OpenAIRE

    Abbey, Gareth; Thompson, Simon B N; Hickish, Tamas; Heathcote, David

    2014-01-01

    Objective Systematic reviews highlight a broad range of cancer-related post-traumatic stress disorder (CR-PTSD) prevalence estimates in cancer survivors. This meta-analysis was conducted to provide a prevalence estimate of significant CR-PTSD symptoms and full diagnoses to facilitate the psychological aftercare of cancer survivors. Methods A systematic literature search was conducted for studies using samples of cancer survivors by using validated clinical interviews and questionnaires to ass...

  19. Natural attenuation of biogas in landfill covers

    International Nuclear Information System (INIS)

    In the risk evaluation of uncontrolled biogas emissions from landfills, the process of natural attenuation in landfill covers assumes a very important role. The capacity of biogas oxidation in the cover soils seems to be the most important control to mitigate the biogas emission during the aftercare period when the biogas collection system might fail. In the present paper laboratory experiences on lab columns to study the biogas oxidation are discussed

  20. Estimating Pollutant Removal Requirements for Landfills in the UK: I. Benchmark Study and Characteristics of Waste Treatment Technologies

    OpenAIRE

    Hall, D H; Drury, D.; Gronow, Jan R.; Rosevear, Alan; Pollard, Simon J. T.; Smith, Richard

    2006-01-01

    Introduction of the EU Landfill Directive is having a significant impact on waste management in the UK and in other member states that have relied on landfilling. This paper considers the length of the aftercare period required by the municipal solid waste streams that the UK will most probably generate following implementation of the Landfill Directive. Data were derived from literature to identify properties of residues from the most likely treatment processes and the prob...

  1. Leben nach dem Krebs

    OpenAIRE

    Musial-Bright, Lindy

    2012-01-01

    Purpose: To highlight the difficulties facing pediatric aftercare following the treatment of brain tumors in childhood and adolescence. In this cumulative thesis three aspects were investigated, treatment- and tumor-related sequelae, patients’ quality of life as well as eurythmy as a possible therapeutic approach. Patients and Methods: For the analysis of sequelae and quality of life following brain tumor treatment in childhood and adolescence, 24 medulloblastoma patients and 49 patients...

  2. MR imaging of the bone marrow in systemic neoplastic diseases. Diagnosis and follow-up of treatment course. MR-Tomographie des Knochenmarks bei malignen Systemerkrankungen. Diagnostik und Therapieverlaufskontrolle

    Energy Technology Data Exchange (ETDEWEB)

    Gueckel, E.; Freund, M.C.; Jaschke, W.; Georgi, M. (Klinikum Mannheim (Germany). Inst. fuer Klinische Radiologie); Brix, G.; Kaick, G. van (Deutsches Krebsforschungszentrum, Heidelberg (Germany). Forschungsschwerpunkt Radiologische Diagnostik und Therapie)

    1992-10-01

    This paper presents a short survey of the current status of bone marrow diagnosis in systemic neoplastic disease by means of MR imaging. The different patterns of bone marrow infiltration from lymphomas and leukaemias are presented and the differential diagnoses are discussed. Apart from the pimary diagnosis the relevance of conventional MRI and chemical shift imaging for therapy follow up and after-care is discussed. (orig.).

  3. Particuliere reclassering en overheid in Nederland sinds 1823

    OpenAIRE

    Heinrich, Jean-Paul

    1995-01-01

    This study deals with the historical development of the relationship between the Dutch Government and the private after-care and rehabilitation organisations from 1823 until today. The first chapter covers the period that starts with the foundation of The Dutch Fellowship for Moral Reformation of Prisoners (Het Nederlandsch Genootschap tot Zedelijke Verbetering der Gevangenen, hereafter referred to as ’the Fellow-ship’) in 1823, and ends with the introduction of the new Penal Code in 1886. Th...

  4. The Effect of Postpurchase Communication on Customer Satisfaction

    OpenAIRE

    Ward, Robert; Turley, Darach

    1996-01-01

    To most practitioners, effective marketing has invariably meant "looking after the customer". However, attention is being increasingly directed at the preposition in this expression. " Looking after the customer " is more than ever a matter of "looking to the customer afterwards". Customer aftercare can take many forms, from courtesy phone calls to special client get-togethers. It seems reasonable to suppose that each form may have a characteristic impact on customer satisfaction. This articl...

  5. Monitoring physical and psychosocial symptom trajectories in ovarian cancer patients receiving chemotherapy

    Directory of Open Access Journals (Sweden)

    Meraner Verena

    2012-02-01

    Full Text Available Abstract Background Diagnosis and treatment of ovarian cancer (OC entail severe symptom burden and a significant loss of quality of life (QOL. Somatic and psychological impairments may persist well beyond active therapy. Although essential for optimal symptom management as well as for the interpretation of treatment outcomes, knowledge on the course of QOL-related issues is scarce. This study aimed at assessing the course of depressive symptoms, anxiety, fatigue and QOL in patients with OC over the course of chemotherapy until early after-care. Methods 23 patients were assessed longitudinally (eight time points with regard to symptom burden (depression, anxiety, fatigue, and QOL by means of patient-reported outcome instruments (HADS, MFI-20, EORTC QLQ-C30/-OV28 and clinician ratings (HAMA/D at each chemotherapy cycle and at the first two aftercare visits. Results Statistically significant decrease over time was found for depressive symptoms and anxiety as well as for all fatigue scales. With regard to QOL, results indicated significant increase for 11 of 15 QOL scales, best for Social (effect size = 1.95; p p p p = 0.009 decreased, Attitudes towards Disease and Treatment (e.s. = 1.80; p Conclusions The present study underlines the importance of longitudinal assessment of QOL in order to facilitate the identification of symptom burden in OC patients. We found that patients show high levels of fatigue, anxiety and depressive symptoms and severely impaired QOL post-surgery (i.e. at start of chemotherapy but condition improves considerably throughout chemotherapy reaching nearly general population symptoms levels until aftercare.

  6. Quality control assurance plan for sanitary landfill: Proposal model for Italian situation. Piano di controllo di qualita' per una discarica controllata: Proposta di un modello per la situazione italiana

    Energy Technology Data Exchange (ETDEWEB)

    Andreottola, G. (DIIAR, Milan (Italy)); Cannas, P.; Muntoni, A. (Centro di Ingegneria Sanitaria Ambientale, Cagliari (Italy))

    In the paper, a model of a QC/QA (Quality Control/Quality Assurance) plan for a sanitary landfill is presented. The proposed QC/QA model includes different stages related to the different life phases of a sanitary landfill: design, construction, operation and aftercare. Every QC/QA plan stage includes all those planned actions that the facility designer and/or owner/operator have to follow in order to provide adequate confidence to the regulatory bodies, that the sanitary landfill will perform safely and satisfactorily, i.e., it will perform in accordance with the design, permits and legal requirements.

  7. Quality of GP-care as perceived by cancer patients in different phases of the illness.

    OpenAIRE

    Hopman, P.

    2013-01-01

    Background: Health care for cancer patients, particularly follow-up and aftercare, is more and more considered a task of general practitioners (GPs). It is therefore important to know how cancer patients in general, and in different phases of the illness, experience the quality of GP-care. Methods: We asked (by means of a survey) a heterogeneous group of 353 cancer patients of the Dutch ‘Panel Living with Cancer’ (post diagnosis time-span: 1-15 years) how they had experienced specific aspects...

  8. Vliv vybraných faktorů na kvalitu mleziva a odchov telat v období mléčné výživy

    OpenAIRE

    Dvořáková, Petra

    2015-01-01

    The basis of every breeding is successful reproduction. Without quality care for cows during pregnancy and aftercare for cows and calfs the company can not prosper. There is a series of aspects that may have negative impact on the quality of the colostrum, which affects the viabilityof the calves. The aim of this work was to literary review the effects that have an impact on the quality of the colostrum and on the calves itselves during the colostrum nutrition and the lactic nutrition. Among ...

  9. Guide book mammary glands ultrasonography. A textbook according to the DEGUM and KBV guidelines. 3. upd. ed.

    International Nuclear Information System (INIS)

    The text book on the ultrasonography of mammary glands is based on the concept of a three-step course system. The large amount of pathological indications is supposed to communicate knowledge that is required to find an adequate diagnosis based on ultrasonsographic imaging. The book includes the following chapters: Basics of ultrasonic mammography; diagnostic techniques; sono-anatomy of breast and axilla; standardized diagnosis; mastopathy; cysts and intracystic tumors; prostheses; abscesses; benign solid tumors; scars; carcinomas; lymph nodes; interventional sonography; preoperative staging; preventive diagnostics; aftercare, relapses; 3D-sonography, panorama-scan, real-time compound-scan; CARI technique; Doppler sonography; elastography; examination questions on ultrasonic mammography.

  10. Selenium supplementation in radiotherapy patients: do we need to measure selenium levels in serum or blood regularly prior radiotherapy?

    International Nuclear Information System (INIS)

    Considering the review by Puspitasari and colleagues, an additional discussion of the endpoints of the Se supplementation studies described would be helpful. In our view, selenium can safely be given to selenium-deficient cancer patients prior to and during radiotherapy. Therefore, in order to help the radiation oncologist in decision making, we strongly advocate to determine the selenium status prior to and during a potential adjuvant selenium supplementation, e.g. when trying to ease the side-effects of radiation treatment or in the aftercare situation when the selenium status may become insufficient

  11. Indicators to Identify Trafficking in Human Beings for the Purpose of Organ Removal.

    Science.gov (United States)

    de Jong, Jessica; Ambagtsheer, Frederike

    2016-02-01

    This article presents indicators to support transplant professionals, judicial and law enforcement authorities and victim support workers with the identification of trafficking in persons for the purpose of organ removal. It outlines the legal and illegal service providers that facilitate trafficking in human beings for the purpose of organ removal and guides the reader through the following criminal process: recruitment, transport, entrance, documents, housing, transplant, aftercare, and finance. Identification of illegal transplant activities by transplant professionals can support police and judiciary with the investigation, disruption, and prosecuting of trafficking networks. PMID:27500249

  12. Practical visceral surgery. Oncological surgery. 2. ed.

    International Nuclear Information System (INIS)

    The book covers the actual knowledge on diagnostic and therapeutic decisions. Modern oncological surgery is always interdisciplinary: for every therapeutic decision the surgical, chemotherapeutical and radiotherapeutical principles have to be considered. A fundamental knowledge on the oncogenesis, the molecular, functional and imaging diagnostics are a precondition; supporting therapeutical approaches and a targeting aftercare are contributing to the quality of patient's life. The book covers the basic oncological knowledge, diagnostic and therapeutical methods, a systematical presentation of all carcinomas of visceral organs and neighboring regions. Systematically structured recommendations of excellent experts concerning the method selection are included

  13. Guide book mammary glands ultrasonography. A textbook according to the DEGUM and KBV guidelines. 3. upd. ed.; Kursbuch Mammasonografie. Ein Lehratlas nach den Richtlinien der DEGUM und der KBV

    Energy Technology Data Exchange (ETDEWEB)

    Madjar, Helmut [Deutsche Klinik fuer Diagnostik, Wiesbaden (Germany). Fachbereich Gynaekologie DEGUM-Stufe III

    2012-07-01

    The text book on the ultrasonography of mammary glands is based on the concept of a three-step course system. The large amount of pathological indications is supposed to communicate knowledge that is required to find an adequate diagnosis based on ultrasonsographic imaging. The book includes the following chapters: Basics of ultrasonic mammography; diagnostic techniques; sono-anatomy of breast and axilla; standardized diagnosis; mastopathy; cysts and intracystic tumors; prostheses; abscesses; benign solid tumors; scars; carcinomas; lymph nodes; interventional sonography; preoperative staging; preventive diagnostics; aftercare, relapses; 3D-sonography, panorama-scan, real-time compound-scan; CARI technique; Doppler sonography; elastography; examination questions on ultrasonic mammography.

  14. Pilot investigations of surface parts of three closed landfills and factors affecting them.

    Science.gov (United States)

    Saarela, Jouko

    2003-05-01

    Aftercare of closed sanitary landfills in a major environmental problem. Rehabilitation of the landfill with vegetation and reducing leachate production are two issues that must be dealt. For this reason, Finnish Environment Institute has conducted several projects on closed landfills. This research aims at determining the physical and chemical properties of the soils at three closed landfills in Helsinki, Finland. Research was conducted to understand the impact by studying the following properties: Chemical, nutrient metal, gamma and radon analysis of surface soils of three closed landfills in Helsinki area. PMID:12733818

  15. Experiences of Parents and General Practitioners with End-of-Life Care in Adolescents and Young Adults with Cancer.

    Science.gov (United States)

    Kaal, Suzanne E J; Kuijken, Noortje M J; Verhagen, Constant A H H V M; Jansen, Rosemarie; Servaes, Petra; van der Graaf, Winette T A

    2016-03-01

    This study aims to analyze the experiences of Dutch bereaved parents and general practitioners (GPs) with palliative care of AYAs (18-35 years) in the terminal stage. Fifteen parents and nine GPs involved with nine deceased AYAs filled out questionnaires and were interviewed by telephone, respectively. In general, the parents were satisfied with the emotional care they themselves received and the medical care that their child received. The GPs were very satisfied with the cooperation with the palliative team. Gaps are present in the areas of symptom control, communication between hospital professionals and parents, aftercare, and transition between hospital and GP. PMID:26812457

  16. Vyhodnocení příčin a důvodů příjmu dravců a sov do záchranných stanic v ČR

    OpenAIRE

    Cichá, Markéta

    2014-01-01

    Here I deal with evaluating the income of prey and owls in the animal rescue centers in the Czech Republic. In this work are processed and analyzed data between the years 2010-2013. This data include detailed aftercare in animal rescue centers throughout the Czech Republic. The first part deals with the Czech Union for Nature Conservation and National Grid. The second part deals with the history of the birds of prey and owls and the importance of these animals for our nature and monitoring. T...

  17. Evaluation and Management of Hearing Loss in Survivors of Childhood and Adolescent Cancers: A Report From the Children's Oncology Group.

    Science.gov (United States)

    Bass, Johnnie K; Knight, Kristin R; Yock, Torunn I; Chang, Kay W; Cipkala, Douglas; Grewal, Satkiran S

    2016-07-01

    Hearing loss (HL) is common in childhood cancer survivors exposed to platinum chemotherapy and/or cranial radiation and can severely impact quality of life. Early detection and appropriate management can mitigate academic, speech, language, social, and psychological morbidity resulting from hearing deficits. This review is targeted as a resource for providers involved in aftercare of childhood cancers. The goal is to promote early identification of survivors at-risk for HL, appropriate evaluation and interpretation of diagnostic tests, timely referral to an audiologist when indicated, and to increase knowledge of current therapeutic options. PMID:26928933

  18. [Delirium].

    Science.gov (United States)

    Laurila, Jouko

    2012-01-01

    The pathophysiology of delirium is poorly known and scientific evidence of effective forms of treatment is scarce. Detection of triggering factors and their appropriate treatment still constitute the cornerstone of the treatment. If drug therapy is required, an antipsychotic drug is the first-line treatment. Only in the case of the delirium tremens syndrome benzodiazepine is chosen as the first-line treatment. The use of restraint systems should be avoided. The delirium experience is often gravely traumatizing for the patient, and the psychological aftercare of delirium must therefore not be ignored. PMID:22506327

  19. Elemental composition of erythrocytes from coronary artery bypass grafting (CABG) patients with and without type II diabetes mellitus using PIXE analysis

    International Nuclear Information System (INIS)

    A study was conducted on erythrocytes in order to determine the composition and concentration of elements from patients undergoing coronary artery bypass grafting (CABG) surgery with and without type II diabetes. Samples were taken at various timeperiods and analyzed by means of proton induced X-ray emission (PIXE) analysis. Elements detected reliably were P, S, Cl, K, Ca, Fe, Cu, Zn, Br and Rb. In particular, elements worthy of note are S, Cl and Ca, which have strong implications in surgical procedures and aftercare. (author)

  20. Mac Bride Community Nursing Unit, St. Mary's Crescent, Westport, Mayo.

    LENUS (Irish Health Repository)

    Smyth, B P

    2010-06-01

    We conducted a prospective follow-up study of consecutive opiate dependent patients admitted to a residential addiction treatment service for detoxification. We measured the rate of relapse following discharge, and sought to identify factors that were associated with early relapse (i.e., a return to daily opiate use). Follow-up interviews were conducted with 109 patients, of whom, 99 (91%) reported a relapse. The initial relapse occurred within one week in 64 (59%) cases. Multivariate survival analysis revealed that earlier relapse was significantly predicted by younger age, greater heroin use prior to treatment, history of injecting, and a failure to enter aftercare. Unexpectedly, those who were in a relationship with an opiate user had significantly delayed relapse. Those who completed the entire six-week inpatient treatment programme also had a significantly delayed relapse. In order to reduce relapse and the associated increased risk of fatal overdose, services providing residential opiate detoxification should prepare people for admission, strive to retain them in treatment for the full admission period and actively support their entry into planned aftercare in order to improve outcome.

  1. Lapse and relapse following inpatient treatment of opiate dependence.

    LENUS (Irish Health Repository)

    Smyth, B P

    2010-06-01

    We conducted a prospective follow-up study of consecutive opiate dependent patients admitted to a residential addiction treatment service for detoxification. We measured the rate of relapse following discharge, and sought to identify factors that were associated with early relapse (i.e., a return to daily opiate use). Follow-up interviews were conducted with 109 patients, of whom, 99 (91%) reported a relapse. The initial relapse occurred within one week in 64 (59%) cases. Multivariate survival analysis revealed that earlier relapse was significantly predicted by younger age, greater heroin use prior to treatment, history of injecting, and a failure to enter aftercare. Unexpectedly, those who were in a relationship with an opiate user had significantly delayed relapse. Those who completed the entire six-week inpatient treatment programme also had a significantly delayed relapse. In order to reduce relapse and the associated increased risk of fatal overdose, services providing residential opiate detoxification should prepare people for admission, strive to retain them in treatment for the full admission period and actively support their entry into planned aftercare in order to improve outcome.

  2. Diagnostics of cognitive functions of treated clients with an anamnesis of long-term drug use

    Directory of Open Access Journals (Sweden)

    Ondřej Krupčík

    2014-12-01

    Full Text Available Clients in treatment and aftercare programmes with a history of long-term abuse of substances like alcohol, cannabis, methamphetamine or heroin often exhibit serious problems while coming back to the working process and managing complex responsibilities and difficulties. It is very important to find a job in the aftercare process for many reasons. It is a source of living, it enables clients to plan their own housing, and it makes repayment of debts possible. Job is also important for establishing new social relations which are not connected with problematic drug environment. Last but not least employment contributes to a reconstruction of a healthy rhythm of life and meaningful spending of time. Thus it is very important for decreasing a probability of a relapse. This process can be disrupted by the deteriorated cognitive functioning. These problems may not be evident in an everyday life routine while talking with friends or performing automatic activities, but can be evident in demanding working tasks, because the job usually requires concentration, memory, decision making etc. The Goal of this study is an evaluation of potential benefits an individual cognitive performance assessment can have in treatment and aftercare. The paper summarizes pilot research in which a complete Neuro-psychological battery of diagnostic methods such as Auditory Verbal Learning Test (AVLT, Verbal fluency Test (FAS, Trail Making Test (TMT, Rey-Osterrieth Complex Figure (ROCF, Benton Visual Retention Test (BVRT, Stroop Colour Word Test (SCWT and Numeric square is used for assessment of cognitive functions of a small sample of treated clients (N=24. We present two case histories with detailed results. In some cases, in line with the expectations, the worsened cognitive functioning is evident. We recommend a cognitive training focused on attention and memory for three clients. In other cases, surprisingly, we can find normal cognitive functions quality, but another

  3. Gender and racial/ethnic differences in addiction severity, HIV risk, and quality of life among adults in opioid detoxification: results from the National Drug Abuse Treatment Clinical Trials Network

    Directory of Open Access Journals (Sweden)

    Bruce Burchett

    2010-12-01

    Full Text Available Li-Tzy Wu1,2, Walter Ling3, Bruce Burchett1, Dan G Blazer1,2, Jack Shostak2, George E Woody41Department of Psychiatry and Behavioral Sciences, School of Medicine, 2Duke Clinical Research Institute, Duke University Medical Center, Durham, NC, USA; 3David Geffen School of Medicine, NPI/Integrated Substance Abuse Programs, University of California, Los Angeles, CA, USA; 4Department of Psychiatry, School of Medicine, University of Pennsylvania and Treatment Research Institute, Philadelphia, PA, USAPurpose: Detoxification often serves as an initial contact for treatment and represents an opportunity for engaging patients in aftercare to prevent relapse. However, there is limited information concerning clinical profiles of individuals seeking detoxification, and the opportunity to engage patients in detoxification for aftercare often is missed. This study examined clinical profiles of a geographically diverse sample of opioid-dependent adults in detoxification to discern the treatment needs of a growing number of women and whites with opioid addiction and to inform interventions aimed at improving use of aftercare or rehabilitation.Methods: The sample included 343 opioid-dependent patients enrolled in two national multisite studies of the National Drug Abuse Treatment Clinical Trials Network (CTN001-002. Patients were recruited from 12 addiction treatment programs across the nation. Gender and racial/ethnic differences in addiction severity, human immunodeficiency virus (HIV risk, and quality of life were examined.Results: Women and whites were more likely than men and African Americans to have greater psychiatric and family/social relationship problems and report poorer health-related quality of life and functioning. Whites and Hispanics exhibited higher levels of total HIV risk scores and risky injection drug use scores than African Americans, and Hispanics showed a higher level of unprotected sexual behaviors than whites. African Americans were

  4. [Concept for a functional status and handicap-adjustment treatment and rehabilitation service chain in neurologic and neurosurgical management in Germany ("phase model")].

    Science.gov (United States)

    Schupp, W

    1995-12-01

    The German medical service and social support network for patients with neurological diseases and disabilities are publicly criticized as inadequate. However, the German social laws give everybody the legal right to be admitted not only for acute medical treatment but also for rehabilitation measures if they are going to be disabled and at risk of becoming dependent on care or of losing the ability to work. Rehabilitation beginning in the early stage of illness is required. Institutions are now being built up to close the gap between acute medical treatment and the beginning of comprehensive rehabilitation, especially in those neurologically severely disabled patients who need "rehabilitation before care". As a basis for planning to improve the situation, a study group set up by the German Pension Insurance Association (Verband Deutscher Rentenversicherer) has developed the following concept of phases in neurological and neurosurgical treatment, rehabilitation and care. The aims and tasks of each phase are defined by the patient's functional status and requirements for recovery: 1. Acute medical treatment and care in intensive care units or normal clinical wards; 2. Early rehabilitation of patients who are not really conscious or cooperative and need intermediate care services should complications arise ("early rehabilitation"); 3. Rehabilitation of patients who are conscious and able to cooperate but depend upon care for functions in activities of daily living (ADL) ("comprehensive" or "post-primary rehabilitation"); 4. Rehabilitation of patients who are independent in ADL functions but need comprehensive treatment for further recovery ("medical rehabilitation" in a traditional sense); 5. Institutional or outpatient rehabilitational aftercare for vocational and/or social reintegration ("aftercare"); 6. Private or institutional care aimed at maintaining the patients' functional status ("permanent care"). Patients with severe traumatic brain injury or cerebral

  5. Is juvenile boot camp policy effective

    Directory of Open Access Journals (Sweden)

    Kübra Gültekin

    2012-04-01

    Full Text Available Militaristic boot camps became very popular in the U.S. in the early 1990’s as an alternative to traditional prisons and probation. Less recidivism and less cost were the shibboleths of correctional boot camps. The boot camps are believed to reduce the number of repeat offenders and to lower operational costs. The rehabilitation programs and aftercare activities are thought to bring ongoing changes in inmates’ behaviors. Therefore, boot camps are strongly supported by politicians and the public. Tax dollars are spent to operate the boot camps. However, despite the fact that only two decades have passed since the existence of juvenile boot camps, numerous studies have declared that juvenile boot camp prisons are ineffective in reducing future offenses of inmates, operational costs, and in continually changing the behaviors of young offenders.

  6. Can readmission after stroke be prevented? Results of a randomized clinical study: a postdischarge follow-up service for stroke survivors

    DEFF Research Database (Denmark)

    Andersen, H E; Schultz-Larsen, K; Kreiner, S;

    2000-01-01

    BACKGROUND AND PURPOSE: About 50% of stroke survivors are discharged to their homes with lasting disability. Knowledge, however, of the importance of follow-up services that targets these patients is sparse. The purpose of the present study was to evaluate 2 models of follow-up intervention after...... discharge. The study hypothesis was that intervention could reduce readmission rates and institutionalization and prevent functional decline. We report the results regarding readmission. METHODS: This randomized study included 155 stroke patients with persistent impairment and disability who, after the...... physiotherapist in their home (INT2-PI), and 48 received standard aftercare only (controls). Baseline characteristics for the 3 groups were comparable. Six months after discharge, data were obtained on readmission and institutionalization. RESULTS: The readmission rates within 6 months after discharge were...

  7. The health of prisoners.

    Science.gov (United States)

    Fazel, Seena; Baillargeon, Jacques

    2011-03-12

    More than 10 million people are incarcerated worldwide; this number has increased by about a million in the past decade. Mental disorders and infectious diseases are more common in prisoners than in the general population. High rates of suicide within prison and increased mortality from all causes on release have been documented in many countries. The contribution of prisons to illness is unknown, although shortcomings in treatment and aftercare provision contribute to adverse outcomes. Research has highlighted that women, prisoners aged 55 years and older, and juveniles present with higher rates of many disorders than do other prisoners. The contribution of initiatives to improve the health of prisoners by reducing the burden of infectious and chronic diseases, suicide, other causes of premature mortality and violence, and counteracting the cycle of reoffending should be further examined. PMID:21093904

  8. The technique of heart plastination.

    Science.gov (United States)

    Tiedemann, K; von Hagens, G

    1982-11-01

    Plastinated hearts are natural specimens, preserved in a firm or flexible state, which thus can be grasped in the hand. They are fixed in a dilated state. Their tissue water and lipids are replaced by polymerized synthetic resins or elastomers. The final specimens show doubly injected coronary vessels, opened atria and ventricles, thus exhibiting all finer external and internal details. The procedure described consists of the removal of the heart; intermediate storage facilities; dilatation with water under hydrostatic pressure; color injection of the coronary vessels; fixation; dehydration in acetone under hydrostatic pressure; forced impregnation in a vacuum chamber; and hardening with aftercare. Technical variations and pitfalls are discussed, as well as the required equipment. PMID:6186163

  9. [Amputation and prosthesis attachment of the lower extremities].

    Science.gov (United States)

    Matthes, I; Beirau, M; Ekkernkamp, A; Matthes, G

    2015-06-01

    Approximately 61,000 amputations are performed in Germany per year. In most cases the lower limbs are affected. The reasons for amputations are arteriosclerosis, diabetes mellitus, severe infections, tumors and complex trauma to the extremities. A decision must be made concerning whether a salvage procedure or amputation is appropriate, specially after trauma. In cases where the need for amputation is clear, the site of amputation needs to be planned in advance with the aim of creating a stump which allows sufficient prosthetic attachment. Adjuvant pain therapy is mandatory, especially in order to avoid subsequent phantom pain. The type of prosthetic restoration is influenced by the grade of mobility and personal requirements of patients. Moreover, aftercare and adjusted rehabilitation are recommended. PMID:26013390

  10. [Different phases in neurologic rehabilitation. Association of German Pension Insurance Carriers].

    Science.gov (United States)

    1995-08-01

    Elaborated by the project subgroup for "Neurological Rehabilitation" of the Federation of German Pension Insurance Institutes, the phase model presented describes the phases of neurological care and rehabilitation for patients with neurological conditions (notably stroke, craniocerebral trauma, and multiple sclerosis). It deals with acute and intensive care, inpatient medical rehabilitation, as well as the phase of aftercare and the care/rehabilitation phase where long-term support, attendant and/or maintenance measures are required (outpatient or partial-hospitalization medical rehabilitation modalities are not included as yet). Based on patient characteristics, care and rehabilitation goals are specified along with the care and rehabilitation tasks that can be derived from these, with great diversity of individual management course being possible. PMID:7481060

  11. Chemical dependency and adolescent self-esteem.

    Science.gov (United States)

    Wasson, D; Anderson, M A

    1995-08-01

    The purpose of this descriptive study is to determine whether self-esteem differs between chemically dependent adolescents and adolescents from the general high school population. The Self-Esteem Inventory (Coopersmith, 1987) was completed by 119 adolescents (31 inpatient, 31 aftercare, and 57 general high school students) aged 13 to 18. Findings suggest that inpatient, chemically dependent adolescents have lower self-esteem than the other two groups. For the chemically dependent adolescent, nursing case management with communication among and between health care providers, school professionals, and family may facilitate successful, long-term recovery. For adolescents at risk for development of chemical dependence, nursing health promotion behaviors, such as early assessment and implementation of self-esteem-building activities, may assist in prevention of chemical dependency. PMID:7633338

  12. Sinus pilonidalis in patients of German military hospitals: a review

    Directory of Open Access Journals (Sweden)

    Kueper, Janina

    2015-01-01

    Full Text Available Pilonidal sinus disease (PSD most commonly presents in young men when hair follicles enter through damaged epithelium and cause an inflammatory reaction. This results in the formation of fistular tracts. We reviewed studies based on a shared cohort of patients who presented at German military hospitals with PSD. The effect of the morphology of the sinus, perioperative protocol, and aftercare of the surgical treatment on the recurrence of PSD were evaluated. The drainage of acute abscesses before surgery, the application of methylene blue during surgery and open wound treatment were generally found to reduce the recurrence rate. A positive family history, postoperative epilation and primary suture as the healing method were found to elevate the recurrence rate. Long-term follow up of over 15 years was found to be a vital component of patient care as only 60% of the overall recurrences recorded had taken place by year 5 postoperatively.

  13. Current developments in pediatric liver transplantation

    Institute of Scientific and Technical Information of China (English)

    2015-01-01

    In 1953, the pioneer of human orthotopic liver transplantation(LT), Thomas E Starzl, was the first to attemptan orthotopic liver transplant into a 3 years old patientsuffering from biliary atresia. Thus, the first LT in humanswas attempted in a disease, which, up until today,remains the main indication for pediatric LT (pLT). Duringthe last sixty years, refinements in diagnostics and surgicaltechnique, the introduction of new immunosuppressivemedications and improvements in perioperative pediatriccare have established LT as routine procedure forchildhood acute and chronic liver failure as well asinherited liver diseases. In contrast to adult recipients,pLT differs greatly in indications for LT, allocation practice,surgical technique, immunosuppression and postoperativelife-long aftercare. Many aspects are focus ofongoing preclinical and clinical research. The presentreview gives an overview of current developments andthe clinical outcome of pLT, with a focus on alternativesto full-size deceased-donor organ transplantation.

  14. Hip Fracture in Children%儿童髋部骨折

    Institute of Scientific and Technical Information of China (English)

    林清坚

    1992-01-01

    报告72例儿童髋部骨折,其中48例获得随访.讨论了并发症的发生与骨折类型、治疗时间、治疗方法及出院后护理的关系.认为及时诊断、正确治疗和出院后的保护性措施是减少并发症的关健.%Seventy-two cases of hip fracture in children are reported. Of them,48 cases here been followed up. The relationship between the complications end the relsted factors such as type of fracture, time and method of treatment, and aftercare are discussed. It is suggested that prompt diagnosis, proper trevtment,and protective home care be the triad for reducing complications.

  15. Radon therapy in the Soviet Union

    International Nuclear Information System (INIS)

    In the Soviet Union approximately one million courses of radon treatment each lasting three weeks are prescribed every year. The curative application of radon used for cardiovascular diseases, including aftercare in cases of cardiac infarction, disorders of the locomotor system and joints and muscles, the male and female sexual system, diseases of the nervous system, endocrinology and metabolic diseases. Contraindication practice is similar to that in Central Europe. Radon is given to skin stimulation by wet and above all dry baths. The radiation exposure of patients from these three-week radon treatments is relatively low. The radon effect is interpreted as 'radiation flash' stimulating the nervous system. The skin plays a particular role in this process, acting as the stimulus acceptor. (orig./MG)

  16. Women's experiences of coping with pregnancy termination for fetal abnormality.

    Science.gov (United States)

    Lafarge, Caroline; Mitchell, Kathryn; Fox, Pauline

    2013-07-01

    Pregnancy termination for fetal abnormality (TFA) can have significant psychological consequences. Most previous research has been focused on measuring the psychological outcomes of TFA, and little is known about the coping strategies involved. In this article, we report on women's coping strategies used during and after the procedure. Our account is based on experiences of 27 women who completed an online survey. We analyzed the data using interpretative phenomenological analysis. Coping comprised four structures, consistent across time points: support, acceptance, avoidance, and meaning attribution. Women mostly used adaptive coping strategies but reported inadequacies in aftercare, which challenged their resources. The study's findings indicate the need to provide sensitive, nondirective care rooted in the acknowledgment of the unique nature of TFA. Enabling women to reciprocate for emotional support, promoting adaptive coping strategies, highlighting the potential value of spending time with the baby, and providing long-term support (including during subsequent pregnancies) might promote psychological adjustment to TFA. PMID:23558712

  17. Emission model for landfills with mechanically-biologically pretreated waste, with the emphasis on modelling the gas balance; Emissionsprognosemodell fuer Deponien mit mechanisch-biologisch vorbehandelten Abfaellen - Schwerpunkt: Modellierung des Gashaushaltes

    Energy Technology Data Exchange (ETDEWEB)

    Danhamer, H.

    2001-07-01

    The objective of this work was to determine influence factors on processes going on in landfills with mechanically-biologically pretreated waste (MBP-landfills) in order to predict emissions. For this purpose a computer based model has been developed. The model allows to simulate the gas, water and heat balance as well as settlement processes and was called DESIM2005 (version MB). It is based on theoretical modeling approaches as well as data from lab and reactor experiments. The main focus of model application was to determine factors influencing the gas phase and the emissions of landfill gas and methane during operation and aftercare of MBP-landfills. By performing simulations the effects of changing parameters for the processes gas transport and biological degradation as well as the effects of different qualities in waste pretreatment and of varying landfill operation techniques were investigated. Possibilities for increasing the environmental sustainability of landfills containing mechanically-biologically pretreated waste were shown. (orig.)

  18. Landfill reduction experience in The Netherlands

    Energy Technology Data Exchange (ETDEWEB)

    Scharff, Heijo, E-mail: h.scharff@afvalzorg.nl

    2014-11-15

    Highlights: • ‘Zero waste’ initiatives never consider risks, side effects or experience of achieved low levels of landfill. • This paper provides insight into what works and what not. • Where strong gradients in regulations and tax occur between countries, waste will find its way to landfills across borders. • Strong landfill reduction can create a fierce competition over the remaining waste to be landfilled resulting in losses. • At some point a public organisation should take responsibility for the operation of a ‘safety net’ in waste management. - Abstract: Modern waste legislation aims at resource efficiency and landfill reduction. This paper analyses more than 20 years of landfill reduction in the Netherlands. The combination of landfill regulations, landfill tax and landfill bans resulted in the desired landfill reduction, but also had negative effects. A fierce competition developed over the remaining waste to be landfilled. In 2013 the Dutch landfill industry generated €40 million of annual revenue, had €58 million annual costs and therefore incurred an annual loss of €18 million. It is not an attractive option to prematurely end business. There is a risk that Dutch landfill operators will not be able to fulfil the financial obligations for closure and aftercare. Contrary to the polluter pays principle the burden may end up with society. EU regulations prohibiting export of waste for disposal are in place. Strong differentials in landfill tax rate between nations have nevertheless resulted in transboundary shipment of waste and in non-compliance with the self-sufficiency and proximity principles. During the transformation from a disposal society to a recycling society, it is important to carefully plan required capacity and to guide the reorganisation of the landfill sector. At some point, it is no longer profitable to provide landfill services. It may be necessary for public organisations or the state to take responsibility for the

  19. Landfill reduction experience in The Netherlands

    International Nuclear Information System (INIS)

    Highlights: • ‘Zero waste’ initiatives never consider risks, side effects or experience of achieved low levels of landfill. • This paper provides insight into what works and what not. • Where strong gradients in regulations and tax occur between countries, waste will find its way to landfills across borders. • Strong landfill reduction can create a fierce competition over the remaining waste to be landfilled resulting in losses. • At some point a public organisation should take responsibility for the operation of a ‘safety net’ in waste management. - Abstract: Modern waste legislation aims at resource efficiency and landfill reduction. This paper analyses more than 20 years of landfill reduction in the Netherlands. The combination of landfill regulations, landfill tax and landfill bans resulted in the desired landfill reduction, but also had negative effects. A fierce competition developed over the remaining waste to be landfilled. In 2013 the Dutch landfill industry generated €40 million of annual revenue, had €58 million annual costs and therefore incurred an annual loss of €18 million. It is not an attractive option to prematurely end business. There is a risk that Dutch landfill operators will not be able to fulfil the financial obligations for closure and aftercare. Contrary to the polluter pays principle the burden may end up with society. EU regulations prohibiting export of waste for disposal are in place. Strong differentials in landfill tax rate between nations have nevertheless resulted in transboundary shipment of waste and in non-compliance with the self-sufficiency and proximity principles. During the transformation from a disposal society to a recycling society, it is important to carefully plan required capacity and to guide the reorganisation of the landfill sector. At some point, it is no longer profitable to provide landfill services. It may be necessary for public organisations or the state to take responsibility for the

  20. Radiology and the Internet: A systematic review of patient information resources

    International Nuclear Information System (INIS)

    AIM: To determine whether the internet is a useful resource for patients seeking information on radiological procedures. MATERIALS AND METHODS: A systematic search of the world wide web was performed by means of four general search engines (AltaVista, Yahoo!, Infoseek and Excite). Twenty-eight suitable patient-directed websites on arteriography were identified for analysis. The value of this material was measured by establishing inclusion or exclusion of a number of factors relating to the procedure. Readability of the materials was evaluated using the Flesch reading ease score. RESULTS: Advice on preparation was included in 21 (75%) sites. Contraindications were found in 16 (57%) sites, risks in 6 (21%) and aftercare in 25 (89%). Result availability was discussed in 15 (54%) sites, with links to other radiology sites in 13 (46%). Visual aids were used in 6 (21%) sites and a contact address found in 27 (96%). Mean Flesch reading ease score was 57, with 46% of sites below the preferred minimum of 60. CONCLUSIONS: Few sites provide the range of information a patient needs before arriving for a procedure. In addition, the readability of the material on these sites is frequently set at a level incomprehensible to patients with lower levels of literacy. Smart, J.M. and Burling, D. (2001)

  1. A randomised comparison of cognitive behavioural therapy

    Directory of Open Access Journals (Sweden)

    Carlijn de Roos

    2011-04-01

    Full Text Available Background : Building on previous research with disaster-exposed children and adolescents, a randomised clinical trial was performed in the treatment of trauma-related symptoms. In the current study two active treatments were compared among children in a broad age range and from a wide diversity of ethnic populations. Objective : The primary aim was to compare the effectiveness and efficiency of Cognitive Behavioural Therapy (CBT and Eye Movement Desensitisation and Reprocessing (EMDR. Design : Children (n=52, aged 4–18 were randomly allocated to either CBT (n=26 or EMDR (n=26 in a disaster mental health after-care setting after an explosion of a fireworks factory. All children received up to four individual treatment sessions over a 4–8 week period along with up to four sessions of parent guidance. Blind assessment took place pre- and post-treatment and at 3 months follow-up on a variety of parent-rated and self-report measures of post-traumatic stress disorder symptomatology, depression, anxiety, and behaviour problems. Analyses of variance (general linear model repeated measures were conducted on the intention-to-treat sample and the completers. Results : Both treatment approaches produced significant reductions on all measures and results were maintained at follow-up. Treatment gains of EMDR were reached in fewer sessions. Conclusion : Standardised CBT and EMDR interventions can significantly improve functioning of disaster-exposed children.For the abstract in other languages, please see Supplementary files under Reading Tools online

  2. Guideline for radioimmunotherapy of CD20+ follicular B-cell non-Hodgkin's lymphoma

    International Nuclear Information System (INIS)

    This guideline is a prerequisite for the quality management in the treatment of non-Hodgkon-lymphomas in patients with relapsed or refractory follicular lymphoma after rituximab therapy and as consolidation therapy after first remission following CHOP like treatment using radioimmunotherapy. It is based on an interdisciplinary consensus and contains background information and definitions as well as specified indications and detailed contraindications of treatment. Essential topics are the requirements for institutions performing the therapy. For instance, presence of an expert for medical physics, intense cooperation with all colleagues committed to treatment of lymphomas, and a certificate of instruction in radiochemical labelling and quality control are required. Furthermore, it is specified which patient data have to be available prior to performance of therapy and how treatment has to be carried out technically. Here, quality control and documentation of labelling are of great importance. After treatment, clinical quality control is mandatory (work-up of therapy data and follow-up of patients). Essential elements of follow-up are specified in detail. The complete treatment inclusive after-care has to be realised in close cooperation with those colleagues (hemato-oncologists) who propose, in general, radioimmuno-therapy under consideration of the development of the disease. (orig.)

  3. The uncertain role of life cycle costing in the renewable energy debate

    International Nuclear Information System (INIS)

    The significance of 'aftercare' has struck a chord with many stake holders in the building process. None more so than clients who are mindful of inheriting a building that will incur costs long after hand-over. Energy saving has served the interest of the client as well as the global concerns of society at large. Cost savings provide a strong incentive and may not conflict with environmental objectives. Other energy conscious measures may not result in direct savings for the client. To foster these solutions, two strategic approaches apply; either make greater demands on the benevolence and responsibility of clients; or adopt an adversarial approach of legislative control over the design of facilities. The former is clearly a more desirable approach. However, the client still needs a framework for making realistic environmental decisions within the context of other competing business constraints. This paper describes how life cycle costing can be changed to meet just such a need. In this way, clients will be able to make more informed decisions concerning environmental impacts. (author)

  4. A Restricted View of Essentials of Acupuncture Treating Diabetes%管窥消渴之针灸诊治要点

    Institute of Scientific and Technical Information of China (English)

    刘京丽; 胡金凤

    2011-01-01

    For diabetes,there are no ideal treatment currently. So many people are inclined to treat the disease with acupuncture. Under the treatment with guiding theory of traditional Chinese medicine,an unambiguous diagnosis is ultimate,the combined treatment of complicating diseases is concemful method, the proper prescription is pivotal, and the proper daily aftercare is basic approach. We should consider extensively to maximize favourable factors and minimize unfavourable ones. Then take the most advantages of acupuncture.%对消渴的治疗,目前尚无理想的方法,而很多人倾向于探索应用针灸疗法治疗本病.在中医经络理论指导下,治疗过程中,明确诊断分型为根本,适当治疗处方为关键,综合治疗并发症为重要手段,合理日常调护为基本方法.应从诊断、治疗、调护等多个方面考虑,标本兼治,扬长避短,从而发挥针灸治疗疾病的优势.

  5. An effect of change in patient status on marital interaction.

    Science.gov (United States)

    Roman, M; Bauman, G; Borello, J; Meltzer, B; Ehrenberg, D B

    1976-06-01

    In the treatment of couples and families, even more so than of individuals, therapists invariably are forced to face the problem of assessment of change in the marital or family "system." The purpose of the present study was to investigate changes in marital interaction for a special population, that is, in which one member of each married pair had been, but was no longer, a hospitalized psychiatric patient. The primary question we addressed was whether changes in marital interaction could be amply detected and whether these changes could be attributed to the particular role shift that had occurred in one spouse--from "patient" to "nonpatient." Utilizing a technique called Interaction Testing, which the senior authors devised in 1960, we found that such alterations in marital interaction do indeed arise when one member of the couple moves out of a patient role and that our instrument is useful in elucidating the nature of such effects. In addition, it can be expected that a study of this kind will be of theoretical and methodological value in dealing with the general issues of problem-solving interaction in couples and families. The clinical aspect of the study may also be expected to stimulate useful thinking regarding family theapy in hospital settings, patient management, and aftercare. PMID:1026444

  6. Challenges to the rapid identification of children who have been trafficked for commercial sexual exploitation.

    Science.gov (United States)

    Rafferty, Yvonne

    2016-02-01

    Child trafficking for commercial sexual exploitation (CSE) is a complex phenomenon, requiring multifaceted programs and policies by various stakeholders. A number of publications have focused on preventing this heinous crime. Less attention, however, has been paid to the recovery and rehabilitation of children who have been traumatized as a result of being trafficked for CSE. This article focuses on the first step in the protection and recovery process, which is to ensure that procedures are in place for their identification, so that they might access timely and appropriate assistance. It highlights three situational and two child-related challenges to identification. In addition, it describes the additional victimization experienced by children who are wrongly arrested for crimes associated with prostitution or illegal border crossings, rather than being identified as victims. An extensive literature review was conducted, and included academic publications, as well as governmental and non-governmental reports. In addition, field-based qualitative research was undertaken in South and Southeast Asia, and involved interviews with representatives from United Nations and governmental agencies, non-governmental organizations (NGOs), and aftercare recovery programs. PMID:26718261

  7. Landfill mining: Development of a cost simulation model.

    Science.gov (United States)

    Wolfsberger, Tanja; Pinkel, Michael; Polansek, Stephanie; Sarc, Renato; Hermann, Robert; Pomberger, Roland

    2016-04-01

    Landfill mining permits recovering secondary raw materials from landfills. Whether this purpose is economically feasible, however, is a matter of various aspects. One is the amount of recoverable secondary raw material (like metals) that can be exploited with a profit. Other influences are the costs for excavation, for processing the waste at the landfill site and for paying charges on the secondary disposal of waste. Depending on the objectives of a landfill mining project (like the recovery of a ferrous and/or a calorific fraction) these expenses and revenues are difficult to assess in advance. This situation complicates any previous assessment of the economic feasibility and is the reason why many landfills that might be suitable for landfill mining are continuingly operated as active landfills, generating aftercare costs and leaving potential hazards to later generations. This article presents a newly developed simulation model for landfill mining projects. It permits identifying the quantities and qualities of output flows that can be recovered by mining and by mobile on-site processing of the waste based on treatment equipment selected by the landfill operator. Thus, charges for disposal and expected revenues from secondary raw materials can be assessed. Furthermore, investment, personnel, operation, servicing and insurance costs are assessed and displayed, based on the selected mobile processing procedure and its throughput, among other things. For clarity, the simulation model is described in this article using the example of a real Austrian sanitary landfill. PMID:26858240

  8. Enterprise Model for Vendor Development: A Study at Selected Technology Park

    Directory of Open Access Journals (Sweden)

    Abdul Aziz Ab. Latif

    2012-01-01

    Full Text Available The study addresses the issues of skills enhancement that need be implemented in three distinct phases of enterprise development. Phase I is the developmental phase where potential entrepreneurs are provided with skills needed for venture take-off or start-up. Phase II is the enterprise creation phase while Phase III is the market development phase. This paper also discusses the multiple roles of the Techno Center during each of these distinct phases. Based on the analysis, the study found that there are gaps across industrial sub-sectors in term of various skills needed to create sustainable enterprise and entrepreneur development. Those gaps are cognitive, interpersonal, technical, creativity, computation, communication, intrapersonal, conceptual, managerial, analytical, technological, acoustic, design, self-management, innovative, basic managerial, supervisory, and marketing. The Techno Centre Enterprise Development Model highlights the central and multiple roles required of The Techno Centre in order to effectively provide support and services during various phases of enterprise development. The services include skill development, networking and linkages services; technology transfer and consultancy services; advisory services; and after-care services have different contents at different stages of the enterprise development.Key words: technology park, sustainable enterprise, technology transfer

  9. Systematic evaluation of the clinical effects of supportive mistletoe treatment within chemo- and/or radiotherapy protocols and long-term mistletoe application in nonmetastatic colorectal carcinoma: multicenter, controlled, observational cohort study.

    Science.gov (United States)

    Friedel, Walter E; Matthes, Harald; Bock, Paul R; Zänker, Kurt S

    2009-01-01

    In Europe, patients with colorectal carcinoma (CRC) frequently receive mistletoe extracts to improve quality of life and survival. This study was designed to evaluate supportive treatment with mistletoe extract Iscador (ISC) in nonmetastatic CRC patients under routine clinical conditions and to create well-founded hypotheses for future prospective clinical studies. The design of a multicenter, controlled, retrospective, observational cohort study with parallel groups met the Good Epidemiological Practice rules. Anonymous unselected standardized data from eligible patients with surgically treated stage I-III CRC and adjuvant therapy (AT) or conventional aftercare were included. End points were adjuvant therapy-related adverse reactions (AT-ADRs), symptoms, and disease-free survival (DFS). The results were adjusted for confounder effects. Eight hundred four (429 ISC vs 375 control) CRC patients from 26 centers were observed for a median of 58 versus 51 months; the median ISC therapy lasted 52 months. ISC patients showed fewer AT-ADRs (19% vs 48%, p controls. ISC was well tolerated without life-threatening ADRs, drug interactions, or tumor enhancement. These results suggest a beneficial effect of supportive care ISC therapy within AT protocols and long-term ISC treatment in stage I-III CRC patients, particularly improvement in AT-ADRs and symptoms and possible extension of DFS. PMID:19883529

  10. Declawing of neonatal rabbits destined for use in animal biosafety level 4 containment studies.

    Science.gov (United States)

    Perdue, K A; Shaw, R E; Mage, R G

    2000-05-01

    To protect personnel and protective outerwear from damage by scratching, rabbits to be housed in an Animal Biosafety Level 4 (ABSL4) facility are declawed routinely. The objective of the study presented here was to establish a procedure for declawing all four feet of neonatal rabbits in preparation for use in ABSL4 studies. Combining procedures conducted in private veterinary practice to remove dewclaws of canine pups with those used to declaw cats, we declawed rabbit kits at 3 to 8 days of age. Declawing neonates was believed to be advantageous because they are non-ambulatory, have soft, cartilaginous digits, and do not have extensive hair growth. These features resulted in decreased surgical preparation and surgery time, minimal bleeding, and minimal aftercare. The optimal age for declawing a litter was 6 or 7 days. Declawing of neonatal rabbits is relatively simple and efficient to perform and offers advantages over declawing of older animals. By using the method described, rabbits can be introduced into ABSL4 facilities by 12 weeks of age with confidence that nail regrowth will not occur. PMID:11178319

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

    International Nuclear Information System (INIS)

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

  12. Generating CO2-credits through landfill in situ aeration

    International Nuclear Information System (INIS)

    Landfills are some of the major anthropogenic sources of methane emissions worldwide. The installation and operation of gas extraction systems for many landfills in Europe and the US, often including technical installations for energy recovery, significantly reduced these emissions during the last decades. Residual landfill gas, however, is still continuously produced after the energy recovery became economically unattractive, thus resulting in ongoing methane emissions for many years. By landfill in situ aeration these methane emissions can be widely avoided both, during the aeration process as well as in the subsequent aftercare period. Based on model calculations and online monitoring data the amount of avoided CO2-eq. can be determined. For an in situ aerated landfill in northern Germany, acting as a case study, 83-95% (depending on the kind and quality of top cover) of the greenhouse gas emission potential could be reduced under strictly controlled conditions. Recently the United Nations Framework Convention on Climate Change (UNFCCC) has approved a new methodology on the 'Avoidance of landfill gas emissions by in situ aeration of landfills' (). Based on this methodology landfill aeration projects might be considered for generation of Certified Emission Reductions (CERs) in the course of CDM projects. This paper contributes towards an evaluation of the potential of landfill aeration for methane emissions reduction.

  13. [A comparison of multimodal programmes of patient education in the rehabilitation of chronic low back pain].

    Science.gov (United States)

    Morfeld, M; Küch, D; Greitemann, B; Dibbelt, S; Salewski, C; Franke, G H; Liebenau, A

    2010-04-01

    There is growing evidence for the effectiveness of multimodal intervention concepts for chronic low back pain in the international literature, and accordingly several German rehabilitation programmes for the treatment of chronic low back pain patients have been developed. Focus of this paper is to describe and compare frequently used German multimodal intervention programmes for in- and outpatient rehabilitation of patients with chronic low back pain. Programmes were chosen by searching the most relevant online resources as well as the online pages of Deutsche Rentenversicherung and Zentrum Patientenschulung during September 2008. Keywords guiding the search were: Patientenschulung, Rückenschmerzen, Manual, psychologische multimodale Interventionskonzepte, Rehabilitationsprogramm, psychology, intervention, low back pain, manual and therapy. By this means, six manually supported multimodal rehabilitation programmes for the in- and outpatient therapy of patients with chronic back pain could be identified: Göttinger Rücken-Intensiv-Programm (GRIP), the psychological programme for chronic head- and low back pain, the Münchner Rücken-Intensiv-Programm (MRIP), Back to Balance, Arbeiten und Leben--Back to Balance (ALEBABA) und Rückenfit: Lebenslust statt Krankheitsfrust. These programmes are depicted and compared with regard to their potentials and limitations in supporting the rehabilitation process of patients with chronic low back pain. While comparing the programmes, a number of similarities between them can be detected, as well as pronounced differences, e. g., regarding settings and complexity. In most programmes, lack of appropriate evaluation studies and lack of aftercare turn out to be critical aspects. PMID:20446189

  14. Effects of Exercise Interventions and Physical Activity Behavior on Cancer Related Cognitive Impairments: A Systematic Review

    Directory of Open Access Journals (Sweden)

    Philipp Zimmer

    2016-01-01

    Full Text Available This systematic review analyzes current data on effects of exercise interventions and physical activity behavior on objective and subjective cancer related cognitive impairments (CRCI. Out of the 19 studies which met all inclusion criteria, five RCTs investigated rodents, whereas the other 14 trials explored humans and these included six RCTs, one controlled trial, two prospective noncontrolled trials, one case series, one observational study, and three cross-sectional studies. The results from animal models revealed positive effects of exercise during and after chemotherapy or radiation on structural alterations of the central nervous system, physiological as well as neuropsychological outcomes. The overall study quality in patient studies was poor. The current data on intervention studies showed preliminary positive effects of Asian-influenced movement programs (e.g., Yoga with benefits on self-perceived cognitive functions as well as a reduction of chronic inflammation for breast cancer patients in the aftercare. Exercise potentially contributes to the prevention and rehabilitation of CRCI. Additional RCTs with standardized neuropsychological assessments and controlling for potential confounders are needed to confirm and expand preliminary findings.

  15. Elevated glucose levels in early puerperium, and association with high cortisol levels during parturition.

    Science.gov (United States)

    Risberg, Anitha; Sjöquist, Mats; Wedenberg, Kaj; Larsson, Anders

    2016-07-01

    Background Gestational diabetes is one of the commonest metabolic problems associated with pregnancy and an accurate diagnosis is critical for the care. Research has shown that pregnant women have high levels of cortisol during the last stage of parturition. As cortisol is a diabetogenic hormone causing increased glucose levels, we wanted to study the association between cortisol and glucose levels during parturition. Materials and methods Glucose and cortisol were analyzed during parturition in 50 females divided according to slow (n = 11) and normal labors (n = 39). Blood samples were analyzed three times during the parturition and four times in the first day after delivery. Glucose levels were also measured once in each trimester. Results In the normal group, the glucose concentration increased from 6.2 (IQR 5.6-8.0) mmol/L in the latency phase to 11.6 (10.0-13.3) mmol/L at aftercare (p changes associated with birth cause significant elevations of cortisol and glucose around parturition. PMID:26985979

  16. Guideline for radioimmunotherapy of rituximab relapsed or refractory CD20{sup +} follicular B-cell non-Hodgkin's lymphoma

    Energy Technology Data Exchange (ETDEWEB)

    Fischer, M.; Behr, T.; Gruenwald, F.; Knapp, W.H. [Deutsche Gesellschaft fuer Nuklearmedizin (DGN) (Germany); Truemper, L.; Schilling, C. von [Deutsche Gesellschaft fuer Haematologie und Onkologie e.V., Muenchen (Germany)

    2004-10-01

    This guideline is a prerequisite for the quality management in the treatment of non-Hodgkin-lymphomas using radioimmunotherapy. It is based on an interdisciplinary consensus and contains background information and definitions as well as specified indications and detailed contraindications of treatment. Essential topics are the requirements for institutions performing the therapy. For instance, presence of an expert for medical physics, intense cooperation with all colleagues committed to treatment of lymphomas, and a certificate of instruction in radiochemical labelling and quality control are required. Furthermore, it is specified which patient data have to be available prior to performance of therapy and how the treatment has to be carried out technically. Here, quality control and documentation of labelling are of greatest importance. After treatment, clinical quality control is mandatory (work-up of therapy data and follow-up of patients). Essential elements of follow-up are specified in detail. The complete treatment inclusive after-care has to be realised in close cooperation with those colleagues (haematology-oncology) who propose, in general, radioimmunotherapy under consideration of the development of the disease. (orig.)

  17. Therapeutic Communities for Addictions: A Review of Their Effectiveness from a Recovery-Oriented Perspective

    Directory of Open Access Journals (Sweden)

    Wouter Vanderplasschen

    2013-01-01

    Full Text Available Therapeutic communities (TCs for addictions are drug-free environments in which people with addictive problems live together in an organized and structured way to promote change toward recovery and reinsertion in society. Despite a long research tradition in TCs, the evidence base for the effectiveness of TCs is limited according to available reviews. Since most of these studies applied a selective focus, we made a comprehensive systematic review of all controlled studies that compared the effectiveness of TCs for addictions with that of a control condition. The focus of this paper is on recovery, including attention for various life domains and a longitudinal scope. We searched the following databases: ISI Web of Knowledge (WoS, PubMed, and DrugScope. Our search strategy revealed 997 hits. Eventually, 30 publications were selected for this paper, which were based on 16 original studies. Two out of three studies showed significantly better substance use and legal outcomes among TC participants, and five studies found superior employment and psychological functioning. Length of stay in treatment and participation in subsequent aftercare were consistent predictors of recovery status. We conclude that TCs can promote change regarding various outcome categories. Since recovering addicts often cycle between abstinence and relapse, a continuing care approach is advisable, including assessment of multiple and subjective outcome indicators.

  18. Guidelines for the follow-up of patients undergoing bariatric surgery.

    Science.gov (United States)

    O'Kane, Mary; Parretti, Helen M; Hughes, Carly A; Sharma, Manisha; Woodcock, Sean; Puplampu, Tamara; Blakemore, Alexandra I; Clare, Kenneth; MacMillan, Iris; Joyce, Jacqueline; Sethi, Su; Barth, Julian H

    2016-06-01

    Bariatric surgery can facilitate weight loss and improvement in medical comorbidities. It has a profound impact on nutrition, and patients need access to follow-up and aftercare. NICE CG189 Obesity emphasized the importance of a minimum of 2 years follow-up in the bariatric surgical service and recommended that following discharge from the surgical service, there should be annual monitoring as part of a shared care model of chronic disease management. NHS England Obesity Clinical Reference Group commissioned a multi-professional subgroup, which included patient representatives, to develop bariatric surgery follow-up guidelines. Terms of reference and scope were agreed upon. The group members took responsibility for different sections of the guidelines depending on their areas of expertise and experience. The quality of the evidence was rated and strength graded. Four different shared care models were proposed, taking into account the variation in access to bariatric surgical services and specialist teams across the country. The common features include annual review, ability for a GP to refer back to specialist centre, submission of follow-up data to the national data base to NBSR. Clinical commissioning groups need to ensure that a shared care model is implemented as patient safety and long-term follow-up are important. PMID:27166136

  19. [Patient education as a constituent of a patient-oriented approach in rehabilitation].

    Science.gov (United States)

    Faller, H; Reusch, A; Ströbl, V; Vogel, H

    2008-04-01

    Patient education is a central component of patient-oriented medical rehabilitation. The aim of patient education is to provide patients with the fundamentals of acting as competent partners in the rehabilitation process. Thus, the goals of educational group programmes are compliance, self-management, and empowerment, which are aspired by means of providing information, training skills, and modifying attitudes. According to expert opinions, such programmes should comply with certain minimum criteria regarding aims, methods, and frameworks, which can then be complemented by additional quality criteria. Furthermore, educational programmes should meet all the substantial requirements and standards of the respective medical area and exhibit proven effectiveness. A nationwide survey of rehabilitation institutions has shown that the implementation of patient education does not meet the quality requirements in all cases, particularly regarding patient-oriented didactics, standardisation, manual-use and evaluation. An additional quality feature is marked by the skills and qualifications of the educators. Instructors should be competent in leading and moderating groups and using various methods and media in order to fulfill the standards of modern educational concepts. As ample evidence has shown, patient participation and improved self-efficacy are indispensable when trying to promote healthy lifestyles in patients. Additional opportunities for enhancing patient orientation and optimizing patient education are provided by measures of behavioural planning and after-care as attempts to convey the behavioural changes in the patients' everyday lives. PMID:18370358

  20. Occupational disease caused by ionizing radiation

    International Nuclear Information System (INIS)

    The study investigates the course of the disease of persons whose occupational exposure to radiation had resulted in impairment of their professional ability and entitled them to damages under the current regulations. 35 receivers of damages were found who by answering the question form and partly giving permission to study their file at the insurance institution under the conditions of data protection made is possible to carry through this investigation. 14 receivers of damages were occupied in the technical industry, 21 in the sector of medicine. The radiation disease acknowledged as professional concerned in 30 cases the skin, in two cases the lungs and in one case each the haematopoietic system, the eyes and the pelvic organs. In 8 indemnified, acute radiation exposure had caused the disease, in 25 the time of exposure had ranged from one year to several decades. The investigation describes when and under what professional circumstances the radiation exposure took place, the course of the disease, what kind of diagnostic and therapeutical measures were carried through and what personal and professional consequences the indemnified sustained. It gives suggestions to set up a future, more effective documentation system on the basis of the experience gathered on the occasion of this investigation with the currently valid registration system, which is unsuitable for further scientific studies, and with the currently practised methods of after-care. (orig./HP)

  1. Stabilization of organic matter and nitrogen immobilization during mechanical-biological treatment and landfilling of residual municipal solid waste

    International Nuclear Information System (INIS)

    Synthesis of humic substances and nitrogen immobilization during mechanical-biological treatment of waste and the behavior of biologically stabilized waste under anaerobic landfill conditions were investigated. Samples were taken from a large-scale treatment plant. Anaerobic conditions were simulated in lab scale test cells. Humic substances were analyzed photometrically and gravimetrically. The nitrogen immobilization was investigated by sequential leaching tests and by analyzing the non acid hydrolyzable nitrogen. Humic acids were mainly synthesized during the beginning of the intensive rotting phase. Later on in the process no significant changes occurred. The humic acid content rose up to 6,8 % DS org. It correlated well with the stability parameters respiration activity and accumulated gas production. In the coarse of the treatment the nitrogen load emitted during the consecutive leaching tests dropped from 50 % down to less than 20 % total nitrogen. The non acid hydrolyzable nitrogen rose from 17 up to 42 % Kjeldahl nitrogen content. Nevertheless the mechanical-biological treatment is not significantly shortening the aftercare period of a landfill concerning liquid nitrogen emissions. The reduced nitrogen emission potential is released more slowly. When reactive waste material was exposed to anaerobic conditions, humic and fulvic acids were synthesized up to the point when intensive gas production started and then were remineralized. Stabilized waste materials after treatment of various intensity behaved differently under anaerobic conditions. Steady and decreasing humic acid contents were observed. (author)

  2. Dentists and cross-infection.

    Science.gov (United States)

    Naidoo, S

    1997-03-01

    A structured questionnaire was administered to a random sample of general dental practitioners in Natal, South Africa in 1994, to ascertain the precautions they use against cross-infection and to gauge the attitudes and behaviour towards the treatment of HIV-infected individuals. An interview was conducted covering 5 broad topics: demographic details, personal barrier protection, instrument sterilization and disinfection, sharps disposal and incidence of needlestick injuries and the extent of the knowledge, attitude and behaviour of the practitioners toward the treatment of HIV-infected individuals. The key findings were: routine glove wearing, for all patients, was practised by 87 per cent. The most common heat sterilization method was by autoclave (68 per cent), although a dry heat sterilizer and water boiler were used by 22 per cent of the respondents. Of the 18 respondents reporting a needlestick injury in the past 6 months only one sought after-care. 42 per cent of the respondents would continue to treat carriers of HIV in their practices. This survey shows that a significant number of dentists are using unacceptable cross-infection control procedures. Educational efforts should be made to improve their knowledge and to alleviate anxiety of health workers to treat HIV-infected patients. PMID:9461908

  3. Environmental systems in Amcoal

    International Nuclear Information System (INIS)

    The impact of Amcoal collieries on the environment is assessed and recorded in great detail in the Environmental Management Programme Reports. Before mining authorization is granted by the Department of Mineral and Energy Affairs, each mine is required by the Minerals Act of 1991 to develop an EMPR in consultation with the departments of Mineral and Energy Affairs, Water Affairs, Environment Affairs, Agriculture, and Nature Conservation, as well, as parties that are or may be affected by the mining operations. The effects mining has or will have on the topography, geology, soils, vegetation, animal life, surface and ground water, cultural resources, and the socio-economy are assessed for each mine. Detailed plans concerning how these impacts will be prevented, minimized or ameliorated are recorded in the EMPRs. Commitments made and recorded in an EMPR are legally binding. They include details of financial mechanisms required to guarantee final rehabilitation, closure and after-care of mine sites. Through experience and involvement in a broad spectrum of environmental management issues, Amcoal has nurtured environmental awareness among its staff and a commitment to excellence in environmental management. It has developed the capability and capacity to respond to current and future environmental challenges. Progress has been made in addressing environmental issues at the mines in a systematic and comprehensive manner. As well as improving the situation at mine level, these efforts will also contribute to maintaining regional land use capabilities and river quality

  4. Does mental health service integration affect compulsory admissions?

    Directory of Open Access Journals (Sweden)

    André I. Wierdsma

    2009-09-01

    Full Text Available Background: Over recent years, the number of compulsory admissions in many countries has increased, probably as a result of the shift from inpatient to outpatient mental health care. This might be mitigated by formal or collaborative relationships between services. Methods: In a retrospective record linkage study, we compared two neighboring districts, varying in level of service integration. Two periods were combined: 1991–1993 and 2001–2003. We included patients aged 18–60, who had a first emergency compulsory admission (n=830. Their psychiatric history was assessed, and service-use after admission was monitored over a 12-month follow-up. Results: Over a 10-year period, compulsory admission rates increased by 47%. Difference in relative increase between the integrated and non-integrated services was 14%. Patient characteristics showed different profiles in the two districts. Length of stay was >10 days shorter in the integrated district, where the proportion of involuntary readmissions decreased more, and where aftercare was swift and provided to about 10% more patients than in the non-integrated district. Conclusions: Services outcomes showed better results where mental healthcare was more integrated. However, limited effects were found and other factors than integration of services may be more important in preventing compulsory admissions.

  5. Bridging a clinical gap in psychogenic nonepileptic seizures: Mental health provider preferences of biopsychosocial assessment approaches.

    Science.gov (United States)

    Jimenez, Xavier F; Bautista, Jocelyn F; Tilahun, Bikat S; Fan, Youran; Ford, Paul J; Tesar, George E

    2016-03-01

    Management of psychogenic nonepileptic seizures (PNES) is complex, requiring multidisciplinary care. A standardized assessment and formulation approach to PNES is lacking, yet use of a comprehensive model may alleviate problems such as mental health aftercare noncompliance. Although a biopsychosocial (BPS) approach to PNES balancing predisposing, precipitating, and perpetuating (PPP) variables has been described and has been recently tested in pilot form, it is unclear how this assessment style is perceived among community mental health practitioners such as psychotherapists (including psychologists, counselors, and social workers). We predicted preference of a comprehensive "BPS/PPP" assessment style by those most involved in PNES care (i.e., community psychotherapists). One hundred and forty-three community-based social workers and counselors completed a survey featuring a fictional PNES case followed by assessment style options ("Multiaxial," "Narrative," and "BPS/PPP"). Respondents clearly preferred the robust BPS/PPP approach over less-comprehensive multiaxial and narrative assessments (p<0.0001). Reasons for choosing the BPS/PPP by respondents include ease of organization, clear therapeutic goals, and comprehensive nature. This assessment of acceptability of a BPS/PPP approach to PNES assessment among community mental health practitioners may provide a patient-centered mechanism to enhance referrals from the neurological to mental health setting. Implications and future directions are explored. PMID:26878459

  6. Persistent psychotic symptoms after long-term heavy use of mephedrone: A two-case series.

    Science.gov (United States)

    Barrio, Pablo; Gaskell, Matthew; Goti, Javier; Vilardell, Sergi; Fàbregas, Josep Maria

    2016-01-01

    Mephedrone (4-methylmethcathinone) is a synthetic stimulant drug of the cathinone class. Similar effects to those of cocaine and ecstasy are reported by users, with a high addictive potential. Given its increasing rate of consumption in Europe, it is getting more and more attention from the addiction field. In spite of that, little is known about the long-term consequences of prolonged heavy use. The two following cases might depict some of them. Case 1 was a middle-age man who reported three years of intravenous use of mephedrone. He used to binge for several days in a row. Psychotic symptoms appeared after a few months, especially paranoid delusions. Sent to aftercare in a therapeutic community, delusions kept reappearing after prolonged abstinence. A good response to risperidone was observed. Case 2 was a young man who used mephedrone heavily for two years, always snorted. Upon admission to the therapeutic community, the patient reported auditory hallucinations that partially remitted with olanzapine. Both cases showed a good insight and no personality deterioration. Given its similarities to other substances that are known to induce psychotic symptoms, and the increasing consumption of mephedrone around Europe, similar cases are expected in the near future. Conventional antipsychotic treatment seems a reasonable pharmacological approach. PMID:27399224

  7. A community intervention trial of multimodal suicide prevention program in Japan: A Novel multimodal Community Intervention program to prevent suicide and suicide attempt in Japan, NOCOMIT-J

    Directory of Open Access Journals (Sweden)

    Suzuki Yuriko

    2008-09-01

    Full Text Available Abstract Background To respond to the rapid surge in the incidence of suicide in Japan, which appears to be an ongoing trend, the Japanese Multimodal Intervention Trials for Suicide Prevention (J-MISP have launched a multimodal community-based suicide prevention program, NOCOMIT-J. The primary aim of this study is to examine whether NOCOMIT-J is effective in reducing suicidal behavior in the community. Methods/DesignThis study is a community intervention trial involving seven intervention regions with accompanying control regions, all with populations of statistically sufficient size. The program focuses on building social support networks in the public health system for suicide prevention and mental health promotion, intending to reinforce human relationships in the community. The intervention program components includes a primary prevention measures of awareness campaign for the public and key personnel, secondary prevention measures for screening of, and assisting, high-risk individuals, after-care for individuals bereaved by suicide, and other measures. The intervention started in July 2006, and will continue for 3.5 years. Participants are Japanese and foreign residents living in the intervention and control regions (a total of population of 2,120,000 individuals. Discussion The present study is designed to evaluate the effectiveness of the community-based suicide prevention program in the seven participating areas. Trial registration UMIN Clinical Trials Registry (UMIN-CTR UMIN000000460.

  8. Radiology and the Internet: A systematic review of patient information resources

    Energy Technology Data Exchange (ETDEWEB)

    Smart, James M.; Burling, David

    2001-11-01

    AIM: To determine whether the internet is a useful resource for patients seeking information on radiological procedures. MATERIALS AND METHODS: A systematic search of the world wide web was performed by means of four general search engines (AltaVista, Yahoo{exclamation_point}, Infoseek and Excite). Twenty-eight suitable patient-directed websites on arteriography were identified for analysis. The value of this material was measured by establishing inclusion or exclusion of a number of factors relating to the procedure. Readability of the materials was evaluated using the Flesch reading ease score. RESULTS: Advice on preparation was included in 21 (75%) sites. Contraindications were found in 16 (57%) sites, risks in 6 (21%) and aftercare in 25 (89%). Result availability was discussed in 15 (54%) sites, with links to other radiology sites in 13 (46%). Visual aids were used in 6 (21%) sites and a contact address found in 27 (96%). Mean Flesch reading ease score was 57, with 46% of sites below the preferred minimum of 60. CONCLUSIONS: Few sites provide the range of information a patient needs before arriving for a procedure. In addition, the readability of the material on these sites is frequently set at a level incomprehensible to patients with lower levels of literacy. Smart, J.M. and Burling, D. (2001)

  9. Evaluation and selection of decision-making methods to assess landfill mining projects.

    Science.gov (United States)

    Hermann, Robert; Baumgartner, Rupert J; Vorbach, Stefan; Ragossnig, Arne; Pomberger, Roland

    2015-09-01

    For the first time in Austria, fundamental technological and economic studies on recovering secondary raw materials from large landfills have been carried out, based on the 'LAMIS - Landfill Mining Austria' pilot project. A main focus of the research - and the subject of this article - was to develop an assessment or decision-making procedure that allows landfill owners to thoroughly examine the feasibility of a landfill mining project in advance. Currently there are no standard procedures that would sufficiently cover all the multiple-criteria requirements. The basic structure of the multiple attribute decision making process was used to narrow down on selection, conceptual design and assessment of suitable procedures. Along with a breakdown into preliminary and main assessment, the entire foundation required was created, such as definitions of requirements to an assessment method, selection and accurate description of the various assessment criteria and classification of the target system for the present 'landfill mining' vs. 'retaining the landfill in after-care' decision-making problem. Based on these studies, cost-utility analysis and the analytical-hierarchy process were selected from the range of multiple attribute decision-making procedures and examined in detail. Overall, both methods have their pros and cons with regard to their use for assessing landfill mining projects. Merging these methods or connecting them with single-criteria decision-making methods (like the net present value method) may turn out to be reasonable and constitute an appropriate assessment method. PMID:26123349

  10. [Basic principles and difficulties relating to rehabilitation in diabetic patients following amputation].

    Science.gov (United States)

    Jindra, Martin; Věchtová, Bohuslava; Bielmeierová, Jana

    2015-06-01

    Vascular diseases as a result of diabetes mellitus are the most frequent indication for amputation in the Czech republic. Diabetic patients following amputation, unlike the other amputees, very frequently suffer multiple complications. These are both of general and local nature and pose a limitation to rehabilitation care as well as a prosthesis use. The main goal of therapeutic rehabilitation is the practice of locomotion with a prosthesis (artificial limb) and the patients full return to normal life. A team of closely cooperating specialists is involved. The rehabilitation care of amputees is divided into acute and aftercare. Within preoperative care we try to improve the patients physical and psychological condition. Following surgery we verticalize the patient as soon as possible depending on his/her possibilities and condition, we carry out breathing and vascular gymnastics and prevention of thromboembolic disease and we start the care of the stump. When the stump has been healed and shaped, the patient is provided with an artificial limb. The patients equipped with an artificial limb take a walking course where they learn how to handle the limb as well as walk indoors and outdoors and cope with common terrain unevenness.Key words: amputation - diabetes mellitus - walking with an artificial limb - prosthesis - lower limb prosthetics. PMID:26258981

  11. Elemental content of erythrocytes from patients undergoing Coronary Artery Bypass Grafting (CABG) surgery using PIXE analysis

    International Nuclear Information System (INIS)

    This on-going study was conducted on erythrocytes to further establish the content of elements of blood fractions from patients undergoing Coronary Artery Bypass Grafting (CABG) surgery. As the quality and quantity of elements in these samples were unknown, proton induced X-ray emission (PIXE) analysis was chosen for its multi-elemental analysis capabilities on small mass samples. Previous work demonstrated the detection of several elements using PIXE analysis and that the elemental concentrations of S, Cl, Ca and Fe were worthy of note. It is indicated that continuing analysis of these cell fractions may be significant in the study of trace element metabolism as it provides insight into understanding mechanisms for preventative, diagnostic and therapeutic purposes and hence a patient's state of health. The analysis of erythrocytes was conducted at pre, during and post-operative timepoints to investigate the changes that occur during and post-surgical intervention. Elements Na, Mg, Si, P, S, Cl, K, Ca, Fe, Cu, Zn, Br and Rb were detected in erythrocytes at all surgery timepoints and from normalized graphs, elements S, K and Fe revealed that the changes in concentration through surgery followed an almost identical pattern. It is anticipated that statistical correlation and interpretation of data may provide, in the long-term, information that could have an impact on the patients' rate of recovery or appropriate aftercare. (author)

  12. Quantification of methane and nitrous oxide emissions from various waste treatment facilities by tracer dilution method

    Science.gov (United States)

    Mønster, Jacob; Rella, Chris; Jacobson, Gloria; Kjeldsen, Peter; Scheutz, Charlotte

    2013-04-01

    Urban activities generate solid and liquid waste, and the handling and aftercare of the waste results in the emission of various compounds into the surrounding environment. Some of these compounds are emitted as gasses into the atmosphere, including methane and nitrous oxide. Methane and nitrous oxide are strong greenhouse gases and are considered to have 25 and 298 times the greenhouse gas potential of carbon dioxide on a hundred years term (Solomon et al. 2007). Global observations of both gasses have shown increasing concentrations that significantly contribute to the greenhouse gas effect. Methane and nitrous oxide are emitted from both natural and anthropogenic sources and inventories of source specific fugitive emissions from the anthropogenic sources of methane and nitrous oxide of are often estimated on the basis of modeling and mass balance. Though these methods are well-developed, actual measurements for quantification of the emissions is a very useful tool for verifying the modeling and mass balance as well as for validation initiatives done for lowering the emissions of methane and nitrous oxide. One approach to performing such measurements is the tracer dilution method (Galle et al. 2001, Scheutz et al. 2011), where the exact location of the source is located and a tracer gas is released at this source location at a known flow. The ratio of downwind concentrations of the tracer gas and the methane and nitrous oxide gives the emissions rates of the greenhouse gases. This tracer dilution method can be performed using both stationary and mobile measurements and in both cases, real-time measurements of both tracer and quantified gas are required, placing high demands on the analytical detection method. To perform the methane and nitrous oxide measurements, two robust instruments capable of real-time measurements were used, based on cavity ring-down spectroscopy and operating in the near-infrared spectral region. One instrument measured the methane and

  13. 社交媒体在医患沟通中的应用探讨%A Discussion on the Application of Social Media in Doctor-patient Communication

    Institute of Scientific and Technical Information of China (English)

    侯胜田; 王海星

    2014-01-01

    The traditional ways of doctor -patient communication , are limited by the communication time and scope , both of them have been unable to meet the patients'communication needs .With the continuous development of network , social media extends the application scope in the field of healthcare .The application of social media in doctor-patient communication has some applicability and feasibility .This paper analyzes the limitations of tradi-tional doctor-patient communication , tries to apply the experience of social media in the field of healthcare , and puts forward some new application strategies:push information initiatively and enhance the doctor -patient interac-tion;carry out pre-hospital and aftercare communication to extend communication scope; collect feedbacks from patients and handle patients'complaints.%传统的医患沟通方式受到了沟通时间短、沟通范围窄的限制,已不能满足患者对于医患沟通的需求。伴随网络技术的发展,社交媒体在医疗服务领域的应用范围扩大,借助社交媒体开展医患沟通具有一定的适用性与可行性。通过分析传统医患沟通方式的局限性,借鉴社交媒体在医疗服务领域的应用经验,提出借助社交媒体主动推送信息、加强医患互动;开展院前、院后沟通,扩展沟通范围;收集患者意见,受理患者投诉的医患沟通策略。

  14. Clinical Presentation and Microbial Analyses of Contact Lens Keratitis; an Epidemiologic Study

    Directory of Open Access Journals (Sweden)

    Seyed Ahmad Rasoulinejad

    2014-09-01

    Full Text Available Introduction: Microbial keratitis is an infective process of the cornea with a potentially and serious visual impairments. Contact lenses are a major cause of microbial keratitis in the developed countries especially among young people. Therefore, the purpose of the present study was to evaluate the frequency and microbiological characteristic of CLK in patients referred to the emergency department (ED of teaching hospitals, Babol, Iran. Methods: This is a cross-sectional study of all patients with contact lens induced corneal ulcers admitted to the teaching hospitals of Babol, Iran, from 2011- 2013. An ophthalmologist examined patients with the slit-lamp and clinical features of them were noted (including pain, redness, foreign body sensation, chemosis, epiphora, blurred vision, discomfort, photophobia, discharge, ocular redness and swelling. All suspected infectious corneal ulcers were scraped for microbial culture and two slides were prepared. Data were analyzed using SPSS software, version 18.0. Results: A total of 14 patients (17 eyes were recruited into the study (100% female. The patients’ age ranged from 16-37 years old (mean age 21.58±7.23 years. The most prevalent observed clinical signs were pain and redness. Three samples reported as sterile. The most common isolated causative organism was pseudomonas aeroginosa (78.6%, Staphylococcus aureus 14.3%, and enterobacter 7.1%, respectively. Treatment outcome was excellent in 23.5%, good in 47.1%, and poor in 29.4% of cases. Conclusion: Improper lens wear and care as well as the lack of awareness about the importance of aftercare visits have been identified as potential risk factors for the corneal ulcer among contact lens wearers. Training and increasing the awareness of adequate lens care and disinfection practices, consulting with an ophthalmologist, and frequent replacement of contact lens storage cases would greatly help reducing the risk of microbial keratitis.

  15. Optimizing risk mitigation in management of sexual offenders: a structural model.

    Science.gov (United States)

    Lamade, Raina; Gabriel, Adeena; Prentky, Robert

    2011-01-01

    Sexual violence is an insidious and pervasive problem that insinuates itself into all aspects of contemporary society. It can neither be mitigated nor adequately controlled through current socio-legal practices. A more promising approach must embrace four integrated elements: (1) public policy, (2) primary prevention, (3) statutory management, and (3) secondary intervention. In the present paper we tackle the 3rd and 4th elements by proposing an integrated model for reducing and managing sexual violence among known sex offenders. Relying on the highly effective Risk-Need-Responsivity (RNR) model as the core of our Sex Offender Risk Mitigation and Management Model (SORM(3)), we draw together evidence based practices from clinical interventions and risk assessment strategies. Developed by Andrews & Bonta (2006), RNR has a strong empirical track record of efficacy when applied to diverse samples of offenders, including sex offenders (Hanson, Bourgon, Helmus, & Hodgson, 2009). We offer a detailed structural model that seeks to provide a more seamless integration of risk assessment with management and discretionary decisions, including a primary focus on RNR-based post-release aftercare. We end with the mantra that sex offender treatment alone will never effectively mitigate sexual violence in society, since the problem is not confined to the handful of offenders who spend time in prison and are offered some limited exposure to treatment. Any truly effective model must go well beyond the management of those known to be violent and embrace a comprehensive and integrated approach that begins by recognizing the seeds of sexual violence sown by society. Such a public health paradigm places victims - not offenders - at the center, forcing society to come to address the full gamut of hazards that fuel sexual violence. PMID:21565406

  16. Patient-reported outcomes as predictors of 10-year survival in women after acute myocardial infarction

    Directory of Open Access Journals (Sweden)

    Segadal Leidulf

    2010-11-01

    Full Text Available Abstract Background Patient-reported outcomes are increasingly seen as complementary to biomedical measures. However, their prognostic importance has yet to be established, particularly in female long-term myocardial infarction (MI survivors. We aimed to determine whether 10-year survival in older women after MI relates to patient-reported outcomes, and to compare their survival with that of the general female population. Methods We included all women aged 60-80 years suffering MI during 1992-1997, and treated at one university hospital in Norway. In 1998, 145 (60% of those alive completed a questionnaire package including socio-demographics, the Sense of Coherence Scale (SOC-29, the World Health Organization Quality of Life Instrument Abbreviated (WHOQOL-BREF and an item on positive effects of illness. Clinical information was based on self-reports and hospital medical records data. We obtained complete data on vital status. Results The all-cause mortality rate during the 1998-2008 follow-up of all patients was 41%. In adjusted analysis, the conventional predictors s-creatinine (HR 1.26 per 10% increase and left ventricular ejection fraction below 30% (HR 27.38, as well as patient-reported outcomes like living alone (HR 6.24, dissatisfaction with self-rated health (HR 6.26, impaired psychological quality of life (HR 0.60 per 10 points difference, and experience of positive effects of illness (HR 6.30, predicted all-cause death. Major adverse cardiac and cerebral events were also significantly associated with both conventional predictors and patient-reported outcomes. Sense of coherence did not predict adverse events. Finally, 10-year survival was not significantly different from that of the general female population. Conclusion Patient-reported outcomes have long-term prognostic importance, and should be taken into account when planning aftercare of low-risk older female MI patients.

  17. Study of the influence of bioturbation on covers and contaminated materials on radon shielding using the lead tracing method

    International Nuclear Information System (INIS)

    For geological reasons, mining activities in Thuringia and Saxony have almost always been associated with the excavation of radioactive rock material. The legacy left behind by mining operations, such as waste heaps, industrial settling ponds, abandoned industrial areas and underground mines have posed and for some part still pose a considerable pollution burden for the environment and the population. At the present state of the art in science and technology the best possible remediation solution for these mining leftovers is to retain them in situ by means of a sealing cover(and where necessary provide seepage water retention and treatment). The purpose of such measures is to ensure that the environmental hazards emanating from abandoned mining sites are durably reduced to a tolerable level and the areas concerned can be converted for suitable subsequent uses in a manner adapted to the site in question and with relatively little aftercare required. The sealing systems to be designed and manufactured for this purpose must meet high requirements in terms of long-term effectiveness, since mining leftovers such as waste heaps and settling ponds are subject to the environmental conditions prevailing at the site and hence, over time, to changes in their properties. Having a fundamental knowledge of patterns of pollutant release behaviour is a crucial prerequisite for formulating the specifications for such sealing systems. Radon (Rn-222) is an element which in some cases attains crucial importance in this regard (Rn-222), since it can make a significant contribution to overall human radiation exposure. This has been confirmed, for example, by studies in preparation of pollution maps as well as by studies conducted by WISMUT GmbH at its Schlema-Alberoda site. In some cases sealing covers for mining leftovers involving elevated radon release rates must be dimensioned such that they effectively shield off radon radiation. Furthermore, suitable methods are needed for

  18. Thermal waste treatment in China; Die thermische Abfallbehandlung in China

    Energy Technology Data Exchange (ETDEWEB)

    Buekens, Alfons; Yan, Mi; Jiang, Xuguan; Li, Xiaodong; Lu, Shengyong; Chi, Yong; Yan, Jianhua; Cen, Kefa [Zhejiang Univ. (China). Dept. of Energy Engineering; Vehlow, Juergen [Karlsruher Institut fuer Technologie (KIT), Eggenstein-Leopoldshafen (Germany). Inst. fuer Technische Chemie

    2011-08-15

    Increasing industrialisation and urbanisation as well as fast changing consumption habits in China entail a dramatic increase in waste generation. This development goes along with a severe lack in landfill sites, especially in densely populated areas. In combination with today's growing demand for aftercare free disposal the Chinese government decided to focus on thermal treatment, preferentially with energy recovery, of all types of waste as the only environmentally compatible pre-treatment option prior to final disposal. This principle is followed by the authorities despite entailing costs and recently in few places emerging public concern over this technology. The first incineration plant for municipal solid waste in China using imported technology was commissioned in 1988. Further such plants built during the following years had severe problems with the low calorific value of Chinese waste and failed often to achieve acceptable burnout. This fact and the high costs initiated at the end of the last century the development of a circulating fluidised bed incinerator at the University of Zhejiang which burns residential waste with an addition of 20 % of coal to increase its heating value. This strategy enables a well controlled combustion with burnout as well as emission figures, including those for dioxins, which easily comply with the actual Chinese air emission limits. These are to a great extent comparable with those of the EU Incineration Directive. This technology has successfully entered the market between 2000 and 2010 and will most likely, together with a similar type developed by the Tsinghua University, become the backbone of Chinese waste incineration in future due to its moderate costs and excellent performance. (orig.)

  19. Use of complementary and alternative medicine by patients with cancer: a cross-sectional study at different points of cancer care.

    Science.gov (United States)

    Wortmann, J Kleine; Bremer, A; Eich, H T; Wortmann, H P Kleine; Schuster, A; Fühner, J; Büntzel, J; Muecke, R; Prott, F J; Huebner, J

    2016-07-01

    Complementary and alternative medicine (CAM) is widely used by cancer patients. In order to learn more on the usage of CAM, its reasons and motifs as well as sources of information along the trajectory of treatment, we decided to evaluate the prevalence and predictors for the use of CAM by cancer patients while being under active treatment with chemo- or radiotherapy or in aftercare. We distributed a standardized questionnaire among patients attending a department of radio-oncology, an ambulance for oncology and offices of general practitioners (GPs). Five hundred and six patients took part. Most attributed cancer to stress and trauma (23.7 and 16.4 %) or genes (20.8 %). Forty-four percentage reported knowing a physician with competence in CAM, and in all settings, most patients named the GP. Fifty-one percentage admitted using CAM, 35 % informed the oncologist about using CAM, 56 % informed the GP, and 26 % did not inform any physician. Most often used CAM was vitamin D (17 %) and selenium (16 %). Most important goals were to strengthen the immune system (59 %) and become active (52 %). Most patients were satisfied with the CAM methods they used. Yet, with some methods, dissatisfaction was up to 30 %. The GP has an important function concerning CAM in oncology as most patients believe the GP to have best knowledge in CAM. In order to integrate complementary medicine into evidence-based medicine, physicians should be trained on how to communicate on CAM with the patient and with each other. Explaining cancer and cancer therapies in a way lay persons are able to understand may be helpful. Physicians should actively address patients' needs of involvement not only in decision making, but also actively in the therapy. PMID:27300549

  20. Current state and future prospects of remedial soil protection. Background

    Energy Technology Data Exchange (ETDEWEB)

    Frauenstein, Joerg

    2009-08-15

    The legal basis for soil protection in the Federal Republic of Germany is: -The Act on Protection against Harmful Changes to Soil and on Rehabilitation of Contaminated Sites (Federal Soil Protection Act) (Bundes-Bodenschutzgesetz - BBodSchG) of 1998 [1] -The Federal Soil Protection and Contaminated Sites Ordinance (BBodSchV) of 1999 [2]. In Germany, the Federal Government has legislative competence in the field of soil protection. The Lander (German federal states), in turn, are responsible for enforcement of the BBodSchG and the BBodSchV; they may also issue supplementary procedural regulations. According to Article 1 BBodschG, the purpose of the Act is inter alia to protect and restore the functions of the soil on a permanent sustainable basis. These actions shall include prevention of harmful soil changes as well as rehabilitating soil, contaminated sites and waters contaminated by such sites in such a way that any contamination remains permanently below the hazard threshold. Whilst prevention aims to protect and preserve soil functions on a long-term basis, the object of remediation is mainly to avert concrete hazards in a spatial, temporal and manageable causative context. ''Remedial soil protection'' encompasses a tiered procedure in which a suspicion is verified successively and with least-possible effort and in which the circumstances of the individual case at hand are taken into account in deciding whether or not a need for remediation exists. It comprises the systematic stages of identifying, investigating and assessing suspect sites and sites suspected of being contaminated with a view to their hazard potential, determining whether remediation is necessary, remediating identified harmful soil changes and contaminated sites, and carrying out, where necessary, aftercare measures following final inspection of the remedial measure. (orig.)

  1. Implementation and scientific evaluation of rehabilitative sports groups for prostate cancer patients: study protocol of the ProRehab Study

    Directory of Open Access Journals (Sweden)

    Zopf Eva M

    2012-07-01

    Full Text Available Abstract Background Although treatment regimen have improved in the last few years, prostate cancer patients following a radical prostatectomy still experience severe disease- and treatment-related side effects, including urinary incontinence, erectile dysfunction and psychological issues. Despite high incidence rates and the common adverse effects there is a lack of supportive measures for male patients and specific physical exercise recommendations for prostate cancer patients during rehabilitation or in the aftercare are still missing. Methods/Design The ProRehab Project aims to establish rehabilitative sports groups particularly for prostate cancer patients and to evaluate the effects of the offered exercise program. Starting 8–12 weeks after prostatectomy or combination therapy, prostate cancer patients will exercise for 15 months within a patient preference randomized controlled trial. One exercise session will be conducted within a pre-established rehabilitative sports group, while the other will be completed independently. Patients in the control group will not participate in the intervention. The main outcomes of the study include aerobic fitness, quality of life, incontinence and erectile dysfunction. Discussion By combining science, practice, and public relations the first rehabilitative sports groups for prostate cancer patients in Germany have been set up and thus contribute to the care structure for prostate cancer patients. By offering a 15-month physical exercise intervention that is conducted in supervised group sessions, long-term lifestyle changes and therefore improvements in quality of life in prostate cancer patients can be expected. Trial registration German Clinical Trials Register DRKS00004184

  2. Cost-effectiveness of smoking cessation treatment initiated during psychiatric hospitalization: analysis from a randomized, controlled trial

    Science.gov (United States)

    Barnett, Paul G.; Wong, Wynnie; Jeffers, Abra; Hall, Sharon M.; Prochaska, Judith J.

    2016-01-01

    Objective We examined the cost-effectiveness of smoking cessation treatment for psychiatric inpatients. Method Smokers, regardless of intention to quit, were recruited during psychiatric hospitalization and randomized to receive stage-based smoking cessation services or usual aftercare. Smoking cessation services, quality of life, and biochemically-verified abstinence from cigarettes were assessed during 18-months of follow-up. Trial findings were combined with literature on changes in smoking status and the age and gender adjusted effect of smoking on health care cost, mortality, and quality of life in a Markov model of cost-effectiveness during a lifetime horizon. Results Among 223 smokers randomized between 2006 and 2008, the mean cost of smoking cessation services was $189 in the experimental treatment group and $37 in the usual care condition (p < 0.001). At the end of follow-up, 18.75% of the experimental group was abstinent from cigarettes, compared to 6.80% abstinence in the usual care group (p <0.05). The model projected that the intervention added $43 in lifetime cost and generated 0.101 additional Quality Adjusted Life Years (QALYs), an incremental cost-effectiveness ratio of $428 per QALY. Probabilistic sensitivity analysis found the experimental intervention was cost-effective against the acceptance criteria of $50,000/QALY in 99.0% of the replicates. Conclusions A cessation intervention for smokers identified in psychiatric hospitalization did not result in higher mental health care costs in the short-run and was highly cost-effective over the long-term. The stage-based intervention was a feasible and cost-effective way of addressing the high smoking prevalence in persons with serious mental illness. PMID:26528651

  3. [Media use and physical activity patterns of adolescent participants in obesity therapy: Analysis of the impact of selected sociodemographic factors].

    Science.gov (United States)

    Wulff, Hagen; Wagner, Petra

    2016-02-01

    To meet the challenge of obesity, effective therapeutic concepts for adolescents focusing on lifestyle changes are necessary. Particularly relevant are nutrition and physical activity patterns associated with media use, which can be influenced by sociodemographic factors. For the optimization of obesity therapy approaches, it is essential to analyze these sociodemographic factors to adjust the aims, content, and methods of interventions, and to use the potential of media in treatment concepts. Thus, the research question is: what are the media and physical activity patterns of 11- to 17-year-old participants in obesity therapy, depending on sociodemographic factors? The national multicenter study was conducted from 2012 to 2013. A questionnaire was administered to 564 participants aged 13.4 ± 1.6 (mean ± standard deviation) years. Standardized instruments were used to assess the variables physical activity, media use, and sociodemographic factors. Participants were physically active for 1 h on 3.3 ± 1.8 days per week, 8.5 % daily. Televisions, mobile phones, and computers were available in all sociodemographic groups and were used for 2 h per day. Sociodemographic differences can be seen in the extent of media usage (h/day). These differences can be found between girls and boys concerning their usage of mobile phones (2.49 vs. 1.90; p  < 0.001), between 11- to 13- and 14- to 17-year-old children concerning their usage of game consoles (0.55 vs. 1.65; p  = 0.007), and in the correlation analysis of media usage and physical activity. Compared with existing literature, the survey results reveal reduced activity and increased media use, which vary among the groups. Thus, differentiated therapy approaches appear to be reasonable. Future research needs to evaluate to what extent media, despite the risks, can contribute to the methodological support of therapy, training, and aftercare concepts. PMID:26689417

  4. "It Might Actually Work This Time": Benefits and Barriers to Adapted 12-Step Facilitation Therapy and Mutual-Help Group Attendance From the Perspective of Dually Diagnosed Individuals.

    Science.gov (United States)

    Hagler, Kylee J; Rice, Samara L; Muñoz, Rosa E; Salvador, Julie G; Forcehimes, Alyssa A; Bogenschutz, Michael P

    2015-01-01

    Most U.S. healthcare professionals encourage mutual-help group involvement as an adjunct to treatment or aftercare for individuals with substance use disorders, yet there are multiple challenges in engaging in these community groups. Dually diagnosed individuals (DDIs) may face additional challenges in affiliating with mutual-help groups. Twelve-step facilitation for DDIs (TSF-DD), a manualized treatment to facilitate mutual-help group involvement, was developed to help patients engage in Double Trouble in Recovery (DTR), a mutual-help group tailored to DDIs. Given the promising role that TSF-DD and DTR may have for increasing abstinence while managing psychiatric symptoms, the aim of the current study was to systematically examine reasons for TSF-DD and DTR attendance from the perspective of DDIs using focus group data. Participants were a subset (n = 15) of individuals diagnosed with an alcohol use disorder as well as a major depressive, bipolar, or psychotic disorder who participated in a parent study testing the efficacy of TSF-DD for increasing mutual-help group involvement and reducing alcohol use. Analyses of focus group data revealed that participants construed DTR and TSF-DD as helpful tools in the understanding and management of their disorders. Relative to other mutual-help groups in which participants reported feeling ostracized because of their dual diagnoses, participants reported that it was beneficial to learn about dual disorders in a safe and accepting environment. Participants also expressed aspects that they disliked. Results from this study yield helpful empirical recommendations to healthcare professionals seeking to increase DDIs' participation in DTR or other mutual-help groups. PMID:26340570

  5. The potential for aeration of MSW landfills to accelerate completion

    International Nuclear Information System (INIS)

    Landfilling is a popular waste disposal method, but, as it is practised currently, it is fundamentally unsustainable. The low short-term financial costs belie the potential long-term environmental costs, and traditional landfill sites require long-term management in order to mitigate any possible environmental damage. Old landfill sites might require aftercare for decades or even centuries, and in some cases remediation may be necessary. Biological stabilisation of a landfill is the key issue; completion criteria provide a yardstick by which the success of any new technology may be measured. In order for a site to achieve completion it must pose no risk to human health or the environment, meaning that attenuation of any emissions from the site must occur within the local environment without causing harm. Remediation of old landfill sites by aerating the waste has been undertaken in Germany, the United States, Italy and The Netherlands, with considerable success. At a pilot scale, aeration has also been used in newly emplaced waste to accelerate stabilisation. This paper reviews the use of aerobic landfill worldwide, and assesses the ways in which the use of aerobic landfill techniques can decrease the risks associated with current landfill practices, making landfill a more sustainable waste disposal option. It focuses on assessing ways to utilise aeration to enhance stabilisation. The results demonstrated that aeration of old landfill sites may be an efficient and cost-effective method of remediation and allow the date of completion to be brought forward by decades. Similarly, aeration of newly emplaced waste can be effective in enhancing degradation, assisting with completion and reducing environmental risks. However, further research is required to establish what procedure for adding air to a landfill would be most suitable for the UK and to investigate new risks that may arise, such as the possible emission of non-methane organic compounds

  6. The population-based oncological health care study OVIS – recruitment of the patients and analysis of the non-participants

    Directory of Open Access Journals (Sweden)

    Raspe Heiner

    2008-10-01

    Full Text Available Abstract Background The ageing of the population is expected to bring an enormous growth in demand for oncological health care. In order to anticipate and respond to future trends, cancer care needs to be critically evaluated. The present study explores the possibility of conducting representative and population-based research on cancer care on the basis of data drawn from the Cancer Registry. Methods A population-based state-wide cohort study (OVIS has been carried out in Schleswig-Holstein, Germany. All patients with malignant melanoma, breast, or prostate cancer were identified in the Cancer Registry. Epidemiological data were obtained for all the patients and screened for study eligibility. A postal questionnaire requesting information on diagnosis, therapy, QoL and aftercare was sent to eligible patients. Results A total of 11,489 persons diagnosed with the cancer types of interest in the period from January 2002 to July 2004 were registered in the Cancer Registry. Of the 5,354 (47% patients who gave consent for research, 4,285 (80% of consenters completed the questionnaire. In terms of relevant epidemiological variables, participants with melanoma were not found to be different from non-participants with the same diagnosis. However, participants with breast or prostate cancer were slightly younger and had smaller tumours than patients who did not participate in our study. Conclusion Population-based cancer registry data proved to be an invaluable resource for both patient recruitment and non-participant analysis. It can help improve our understanding of the strength and nature of differences between participants and non-respondents. Despite minor differences observed in breast and prostate cancer, the OVIS-sample seems to represent the source population adequately.

  7. Meniscectomy: indications, procedure, outcomes, and rehabilitation

    Directory of Open Access Journals (Sweden)

    Anetzberger H

    2013-12-01

    motion and preventing secondary damage. It is the surgical therapy that dictates the aftercare, and with regards to the latter, there are clear differences between meniscectomy and meniscal repair. Keywords: meniscectomy, osteoarthritis, meniscus pathology, meniscus function

  8. Titanium elastic nailing in pediatric femoral diaphyseal fractures

    Directory of Open Access Journals (Sweden)

    Singh Roop

    2006-01-01

    Full Text Available Background: The need for operative fixation of pediatric femoral fractures is increasingly being recognised in the present decade. The conventional traction and casting method for management of pediatric femoral fractures is giving way for the operative stabilisation of the fracture. Methods : Thirty five pediatric patients in age group 6-14 years with diaphyseal femoral fractures were stabilised with two titanium nails. Patients were followed up clinically and radiologically for two years. The final results were evaluated using the criteria of Flynn et al. Technical problems and complications associated with the procedure were also analysed. Results : Overall results observed were excellent in 25, satisfactory in 8 and poor in 2 patients. Hospital time averaged 12.30 days in the series. All the fractures healed with an average time to union of 9.6 (6-14.4 weeks. Return to school was early with an average of 7.8 weeks. The soft tissue discomfort near the knee produced by the nails ends was the most common problem encountered. Shortening was observed in three cases and restriction of knee flexion in 5 patients. There was no delayed union, infection or refractures. Per operative technical problems included failure of closed reduction in 2 cases and cork screwing of nails in one case. Conclusion : We believe that with proper operative technique and aftercare TENs may prove to be an ideal implant for pediatric femoral fracture fixation. The most of the complication associated with the procedure are infact features of inexact technique and can be eliminated by strictly adhering to the basic principles and technical aspects.

  9. Radon therapy in the Soviet Union. Report on the visit to the National Research Center for Medical Rehabilitation and Physical Therapy in Moscow, September 18-20, 1990; Radontherapie in der Sowjetunion. Bericht ueber den Besuch des Nationalen Forschungszentrums fuer Medizinische Rehabilitation und Physikalische Therapie in Moskau vom 18. bis 20. September 1990

    Energy Technology Data Exchange (ETDEWEB)

    Sansoni, B. [Forschungszentrum Juelich GmbH (Germany). Zentralabteilung fuer Chemische Analysen; Andrejew, S.V. [National Research Center for Medical Rehabilitation and Physical Therapy, Moscow (USSR). Patent and Information Div.

    1991-08-01

    In the Soviet Union approximately one million courses of radon treatment each lasting three weeks are prescribed every year. The curative application of radon used for cardiovascular diseases, including aftercare in cases of cardiac infarction, disorders of the locomotor system and joints and muscles, the male and female sexual system, diseases of the nervous system, endocrinology and metabolic diseases. Contraindication practice is similar to that in Central Europe. Radon is given to skin stimulation by wet and above all dry baths. The radiation exposure of patients from these three-week radon treatments is relatively low. The radon effect is interpreted as `radiation flash` stimulating the nervous system. The skin plays a particular role in this process, acting as the stimulus acceptor. (orig./MG). [Deutsch] Die Radontherapie ist in der Sowjetunion im Rahmen der Naturheilkunde ein Volksheilmittel. Ueber den Stand der Radontherapie in Sowjetrussland wurde im Westen erstmals durch einen Uebersichtsvortrag von Bogolubov und Andrejew auf dem Radontherapie-Symposium in Bad Muenster am Stein 1988 berichtet. In der Sowjetunion werden jaehrlich etwa eine Million Radonkuren vo jeweils drei Wochen Dauer durchgefuehrt. Die Heilanwendung des Radons umfasst Herzgefaesserkrankungen einschliesslich der Nachbehandlung von Herzinfarkt; Erkrankungen des Bewegungsapparates einschliesslich Gelenke und Muskeln; das maennliche und weibliche Geschlechtssystem; Erkrankungen des Nervensystems; Endokrinologie; Stoffwechselerkrankungen. Die Kontraindikationen werden aehnlich wie in Mitteleuropa praktiziert. Die Therapie erfolgt hauptsaechlich in Form einer Reizung der Haut durch Radonwasser- und vor allem Radonluftbaedern. Die Strahlenbelastung des Patienten durch die Radonkur ist relativ gering. Die Wirkung des Radons wird als `Strahlenreiz` fuer das Immunsystem gedeutet. Dabei kommt der Haut mit ihren Langerhansschen Zellen als Reizakzeptor besondere Bedeutung zu. (orig./MG).

  10. A review of selected foster care-adoption research from 1978 to mid-1982.

    Science.gov (United States)

    Murray, L

    1984-01-01

    What can be learned from the research conducted during this 5-year period? Although none of these studies pinpointed why it took so long to make permanent plans for children, an experiment [Stein et al. 1978] in California indicated that changes in child welfare practice can achieve permanence for more children: behavioral contracting and intensive contact with biological parents expedited return home or adoption. With regard to recent adoption research, the finding that children adopted at older ages encounter more difficulties is certainly not news to adoption workers. What may be of interest, however, is that when the effects of age are controlled for, youngsters adopted transracially or by single parents fare as well as children adopted inracially or by two-parent families. In addition, adoption workers may want to give further consideration to helping adoptive parents deal with the reactions of their extended families, since recent research has suggested that the extended family can have an important influence on a youngster's adjustment. Research on foster parents underscored the importance of training. It has been suggested that foster fathers are more likely to become involved when training provides explicit information. Other studies have indicated that social workers should be sensitive to foster parents' values regarding sex education and should be more careful in distinguishing foster care from adoption. Recent research also is beginning to show the dimensions of the problem of recidivism. Recognition that a proportion of foster children do reenter the system is a necessary first step toward developing strategies to reduce recidivism. Further research, with controls, to examine whether aftercare services can reduce recidivism is warranted, now that the characteristics of this vulnerable population have been identified. PMID:6705599

  11. Cardiac rehabilitation in Germany.

    Science.gov (United States)

    Karoff, Marthin; Held, Klaus; Bjarnason-Wehrens, Birna

    2007-02-01

    The purpose of this review is to give an overview of the rehabilitation measures provided for cardiac patients in Germany and to outline its legal basis and outcomes. In Germany the cardiac rehabilitation system is different from rehabilitation measures in other European countries. Cardiac rehabilitation in Germany since 1885 is based on specific laws and the regulations of insurance providers. Cardiac rehabilitation has predominantly been offered as an inpatient service, but has recently been complemented by outpatient services. A general agreement on the different indications for offering these two services has yet to be reached. Cardiac rehabilitation is mainly offered after an acute cardiac event and bypass surgery. It is also indicated in severe heart failure and special cases of percutaneous coronary intervention. Most patients are men (>65%) and the age at which events occur is increasing. The benefits obtained during the 3-4 weeks after an acute event, and confirmed in numerous studies, are often later lost under 'usual care' conditions. Many attempts have been made by rehabilitation institutions to improve this deficit by providing intensive aftercare. One instrument set up to achieve this is the nationwide institution currently comprising more than 6000 heart groups with approximately 120000 outpatients. After coronary artery bypass grafting or acute coronary syndrome cardiac rehabilitation can usually be started within 10 days. The multidisciplinary rehabilitation team consists of cardiologists, psychologists, exercise therapists, social workers, nutritionists and nurses. The positive effects of cardiac rehabilitation are also important economically, for example, for the improvement of secondary prevention and vocational integration. PMID:17301623

  12. Needs-oriented discharge planning and monitoring for high utilisers of psychiatric services (NODPAM: Design and methods

    Directory of Open Access Journals (Sweden)

    Steinert Tilman

    2008-07-01

    Full Text Available Abstract Background Attempts to reduce high utilisation of psychiatric inpatient care by targeting the critical time of hospital discharge have been rare. Methods This paper presents design and methods of the study "Effectiveness and Cost-Effectiveness of Needs-Oriented Discharge Planning and Monitoring for High Utilisers of Psychiatric Services" (NODPAM, a multicentre RCT conducted in five psychiatric hospitals in Germany. Inclusion criteria are receipt of inpatient psychiatric care, adult age, diagnosis of schizophrenia or affective disorder, defined high utilisation of psychiatric care during two years prior to the current admission, and given informed consent. Consecutive recruitment started in April 2006. Since then, during a period of 18 months, comprehensive outcome data of 490 participants is being collected at baseline and during three follow-up measurement points. The manualised intervention applies principles of needs-led care and focuses on the inpatient-outpatient transition. A trained intervention worker provides two intervention sessions: (a Discharge planning: Just before discharge with the patient and responsible clinician at the inpatient service; (b Monitoring: Three months after discharge with the patient and outpatient clinician. A written treatment plan is signed by all participants after each session. Primary endpoints are whether participants in the intervention group will show fewer hospital days and readmissions to hospital. Secondary endpoints are better compliance with aftercare, better clinical outcome and quality of life, as well as cost-effectiveness and cost-utility. Discussion If a needs-oriented discharge planning and monitoring proves to be successful in this RCT, a tool will be at hand to improve patient outcome and reduce costs via harmonising fragmented mental health service provision. Trial Registration ISRCTN59603527

  13. [A case of systemic scleroderma complicating pulmonary hypertension].

    Science.gov (United States)

    Kurosawa, Rumiko; Umebayashi, Hiroaki; Imagawa, Tomoyuki; Katakura, Shigeki; Mori, Masaaki; Aihara, Yuhkoh; Yokota, Shumpei

    2006-12-01

    The patient was a 7-year-old girl. At the age of 6, deposits of pigment had appeared on the skin of her face and limbs, the skin had become sclerosed, and she had developed dyspnea on exertion. Her previous physician had hospitalized her. She was diagnosed as systemic scleroderma that accompanied pulmonary hypertension by her symptoms and laboratory findings. She was referred to our hospital at 7 years of age, and she was hospitalized. At that time, the entire skin showed deposition of brown pigment, the skin of the limbs was sclerotic. And the face was mask-like, flexion of the joints of the fingers and knees was limited, and the fingertips were ulcerated. Raynaud's phenomenon was present. She was positive for antinuclear antibodies, and negative for other autoantibodies. Echocardiography revealed pulmonary hypertension. After admission, steroid pulse therapy and cyclophosphamide (CY) pulse therapy were initiated, and for aftercare, 15 mg/day of prednisolone (PSL) and mizolibin (MZB) were administered orally. After several months, the sclerosis of the skin improved and the restriction of limb flexion was almost eliminated. The pulmonary hypertension advanced temporarily (maximum: 70 mmHg), but after oral administration of a PGI2 preparation and low-flow supplemental oxygen therapy and the initiation of anticoagulant therapy, the systolic pressure of the pulmonary artery improved to 34 mmHg. The CY pulse therapy was terminated after two years, and internal use of PSL and MZB was continued. The patient's condition is now stable. This case was treated from an early stage with steroid pulse therapy and CY pulse therapy, accompanied with oral administration of a PGI2 preparation for the pulmonary hypertension. The dermal symptoms improved, and it was possible to maintain a state of remission. PMID:17202755

  14. An international validation study of two achievement goal measures in a pharmacy education context

    Directory of Open Access Journals (Sweden)

    Alrakaf S

    2014-09-01

    Full Text Available Saleh Alrakaf,1 Ahmed Abdelmageed,2 Mary Kiersma,2 Sion A Coulman,3 Dai N John,3 June Tordoff,4 Claire Anderson,5 Ayman Noreddin,6 Erica Sainsbury,1 Grenville Rose,7 Lorraine Smith11Faculty of Pharmacy, University of Sydney, Sydney, NSW, Australia; 2Faculty of Pharmacy, Manchester University, Fort Wayne, IN, USA; 3School of Pharmacy and Pharmaceutical Sciences, Cardiff University, Cardiff, UK; 4School of Pharmacy, University of Otago, Dunedin, NZ; 5School of Pharmacy, University of Nottingham, Nottingham, UK; 6School of Pharmacy, Hampton University, Hampton, VA, USA; 7Aftercare, Sydney, NSW, AustraliaBackground: Achievement goal theory helps us understand what motivates students to participate in educational activities. However, measuring achievement goals in a precise manner is problematic. Elliot and McGregor's Achievement Goal Questionnaire (AGQ and Elliot and Murayama's revised Achievement Goal Questionnaire (AGQ-R are widely used to assess students' achievement goals. Both instruments were developed and validated using undergraduate psychology students in the USA.Methods: In this study, our aims were to first of all, assess the construct validity of both questionnaires using a cohort of Australian pharmacy students and, subsequently, to test the generalizability and replicability of these tools more widely in schools of pharmacy in other English-speaking countries. The AGQ and the AGQ-R were administered during tutorial class time. Confirmatory factor analysis procedures, using AMOS 19 software, were performed to determine model fit.Results: In contrast to the scale developers' findings, confirmatory factor analysis supported a superior model fit for the AGQ compared with the AGQ-R, in all countries under study.Conclusion: Validating measures of achievement goal motivation for use in pharmacy education is necessary and has implications for future research. Based on these results, the AGQ will be used to conduct future cross-sectional and

  15. An instrument assessing patient satisfaction with day care in hospitals

    Directory of Open Access Journals (Sweden)

    Kleefstra SM

    2012-05-01

    Full Text Available Abstract Background Patient satisfaction is an important indicator of quality of care in hospitals. Reliable and valid instruments to measure clinical and outpatient satisfaction already exist. Recently hospitals have increasingly provided day care, i.e., admitting patients for one day without an overnight stay. This article describes the adaption of the ‘Core questionnaire for the assessment of Patient Satisfaction’ (COPS for general Day care (COPS-D, and the subsequent validation of the COPS-D. Methods The clinical COPS was supplemented with items to cover two new dimensions: Pre-admission visit and Operation Room. It was sent to a sample of day care patients of five general Dutch hospitals to investigate dimensionality, acceptability, reliability, construct and external validity. Construct validity was established by correlating the dimensions of the COPS-D with patients’ overall satisfaction. Results The COPS-D was returned by 3802 patients (response 46%. Factor analysis confirmed its’ structure: Pre-intake visit, Admission, Operation room, Nursing care, Medical care, Information, Autonomy and Discharge and aftercare (extraction communality 0.63-0.90. The internal consistency of the eight dimensions was good (α = 0.82-0.90; the item internal consistency corrected for overlap was satisfactory (>0.40; all inter-item correlations were higher than 0.45 but not too high (Information dimension had the strongest correlation with overall day care satisfaction. Conclusions The COPS-D is a reliable and valid instrument for measuring satisfaction with day care. It complements the model of measuring patient satisfaction with clinical and outpatient care given in hospitals. It also fulfils the conditions made while developing the clinical and outpatient COPS: a short, core instrument to screen patient satisfaction.

  16. Radiotherapy in colorectal carcinoma; Strahlentherapie beim Rektum-Ca.. Indikationen, Nebenwirkungen und Nachsorge

    Energy Technology Data Exchange (ETDEWEB)

    Seegenschmiedt, M.H.; Olschewski, T. [Alfried Krupp von Bohlen und Halbach Krankenhaus, Essen (Germany). Klinik fuer Radioonkologie, Strahlentherapie und Nuklearmedizin

    2000-08-10

    In patients at a high risk of developing a local recurrence or distant metastases, external beam radiotherapy used in combination with chemotherapy with 5-FU is indispensable. Adjuvant treatment is indicated for stage II and stage III rectal carcinoma, following tearing or cutting of the tumor, and/or following an R1 of R2 tumor resection. The neoadjuvant strategy comprises preoperative radiochemotherapy in the case of inoperable tumors or local recurrence, with the aim of enabling radical surgery. Radiation is applied to all sites likely to develop a recurrence. The fractionated radiation dose is 1,8-2 Gy/day, applied 5 times a week, for a total dose of 50 Gy at the dose reference point in the pelvis. Side effects include diarrhea, skin erosions and urological affections. Aftercare is provided on an interdisciplinary basis, initially at 6-week intervals, after 6 months at 3-month intervals, after one year every 6 months, and after 3 years once yearly. (orig.) [German] Fuer Patienten mit hohem Risiko fuer ein Lokalrezidiv oder Fernmetastasen ihres Rektumkarzinoms ist die perkutane Radiotherapie in Kombination mit einer 5-FU-Chemotherapie unverzichtbar. Die adjuvante Therapie ist indiziert beim Rektumkarzinom im Stadium II und III, nach intraoperativem Tumoreinriss bzw. -einschnitt und in therapeutischer Absicht nach einer R1- und R2-Resektion des Tumors. Als neoadjuvante Strategie kommt die praeoperative Radiochemotherapie bei primaer inoperablen Tumoren oder bei lokoregionalen Rezidiven mit dem Ziel einer radikalen Operation zum Einsatz. Die Bestrahlung erfasst alle Orte mit hoher Rezidivwahrscheinlichkeit. Die Strahlendosis betraegt 1,8 bis 2 Gy pro Tag, fuenfmal pro Woche, und als Gesamtdosis 50 Gy am Referenzpunkt im kleinen Becken. Als Nebenwirkungen zeigen sich Diarrhoeen, Hauterosionen und urologische Affektionen. Die Nachsorge wird interdisziplinaer durchgefuehrt und erfolgt zunaechst sechswoechentlich, nach einem halben Jahr dreimonatlich, nach einem Jahr

  17. Mobile phone technology: a new paradigm for the prevention, treatment, and research of the non-sheltered "street" homeless?

    Science.gov (United States)

    Eyrich-Garg, Karin M

    2010-05-01

    Individuals experiencing homelessness have disproportionately high rates of health problems. Those who perceive themselves as having greater access to their social support networks have better physical and mental health outcomes as well as lower rates of victimization. Mobile phones offer a connection to others without the physical constraints of landlines and, therefore, may make communication (e.g., access to one's social support networks) more feasible for homeless individuals. This, in turn, could lead toward better health outcomes. This exploratory study examined mobile phone possession and use among a sample of 100 homeless men and women who do not use the shelter system in Philadelphia, PA. Interviews were comprised of the Homeless Supplement to the Diagnostic Interview Schedule, a technology module created for this investigation, and the substance use and psychiatric sections of the Addiction Severity Index. Almost half (44%) of the sample had a mobile phone. In the past 30 days, 100% of those with mobile phones placed or received a call, over half (61%) sent or received a text message, and one fifth (20%) accessed the Internet via their mobile phone. Participants possessed and used mobile phones to increase their sense of safety, responsibility (employment, stable housing, personal business, and sobriety or "clean time"), and social connectedness. Mobile phones could potentially be used by public health/health care providers to disseminate information to the street homeless, to enhance communication between the street homeless and providers, and to increase access for the street homeless to prevention, intervention, and aftercare services. Finally, this technology could also be used by researchers to collect data with this transient population. PMID:20397058

  18. Multiple-tracer tests for contaminant transport process identification in saturated municipal solid waste

    International Nuclear Information System (INIS)

    Highlights: • Multiple tracers were applied to saturated MSW to test dual-porosity properties. • Lithium demonstrated to be non-conservative as a tracer. • 260 mm diameter column too small to test transport properties of MSW. • The classical advection-dispersion mode was rejected due to high dispersivity. • Characteristic diffusion times did not vary with the tracer. - Abstract: Two column tests were performed in conditions emulating vertical flow beneath the leachate table in a biologically active landfill to determine dominant transport mechanisms occurring in landfills. An improved understanding of contaminant transport process in wastes is required for developing better predictions about potential length of the long term aftercare of landfills, currently measured in timescales of centuries. Three tracers (lithium, bromide and deuterium) were used. Lithium did not behave conservatively. Given that lithium has been used extensively for tracing in landfill wastes, the tracer itself and the findings of previous tests which assume that it has behaved conservatively may need revisiting. The smaller column test could not be fitted with continuum models, probably because the volume of waste was below a representative elemental volume. Modelling compared advection-dispersion (AD), dual porosity (DP) and hybrid AD–DP models. Of these models, the DP model was found to be the most suitable. Although there is good evidence to suggest that diffusion is an important transport mechanism, the breakthrough curves of the different tracers did not differ from each other as would be predicted based on the free-water diffusion coefficients. This suggested that solute diffusion in wastes requires further study

  19. [DGRW-update: neurology--from empirical strategies towards evidence based interventions].

    Science.gov (United States)

    Schupp, W

    2011-12-01

    Stroke, Multiple Sclerosis (MS), traumatic brain injuries (TBI) and neuropathies are the most important diseases in neurological rehabilitation financed by the German Pension Insurance. The primary goal is vocational (re)integration. Driven by multiple findings of neuroscience research the traditional holistic approach with mainly empirically derived strategies was developed further and improved by new evidence-based interventions. This process had been, and continues to be, necessary to meet the health-economic pressures for ever shorter and more efficient rehab measures. Evidence-based interventions refer to symptom-oriented measures, to team-management concepts, as well as to education and psychosocial interventions. Drug therapy and/or neurophysiological measures can be added to increase neuroregeneration and neuroplasticity. Evidence-based aftercare concepts support sustainability and steadiness of rehab results.Mirror therapy, robot-assisted training, mental training, task-specific training, and above all constraint-induced movement therapy (CIMT) can restore motor arm and hand functions. Treadmill training and robot-assisted training improve stance and gait. Botulinum toxine injections in combination with physical and redressing methods are superior in managing spasticity. Guideline-oriented management of associated pain syndromes (myofascial, neuropathic, complex-regional=dystrophic) improve primary outcome and quality of life. Drug therapy with so-called co-analgetics and physical therapy play an important role in pain management. Swallowing disorders lead to higher mortality and morbidity in the acute phase; stepwise diagnostics (screening, endoscopy, radiology) and specific swallowing therapy can reduce these risks and frequently can restore normal eating und drinking.In our modern industrial societies communicative and cognitive disturbances are more impairing than the above mentioned disorders. Speech and language therapy (SLT) is dominant in

  20. Assessment of the methane oxidation capacity of compacted soils intended for use as landfill cover materials

    International Nuclear Information System (INIS)

    The microbial oxidation of methane in engineered cover soils is considered a potent option for the mitigation of emissions from old landfills or sites containing wastes of low methane generation rates. A laboratory column study was conducted in order to derive design criteria that enable construction of an effective methane oxidising cover from the range of soils that are available to the landfill operator. Therefore, the methane oxidation capacity of different soils was assessed under simulated landfill conditions. Five sandy potential landfill top cover materials with varying contents of silt and clay were investigated with respect to methane oxidation and corresponding soil gas composition over a period of four months. The soils were compacted to 95% of their specific proctor density, resulting in bulk densities of 1.4-1.7 g cm-3, reflecting considerably unfavourable conditions for methane oxidation due to reduced air-filled porosity. The soil water content was adjusted to field capacity, resulting in water contents ranging from 16.2 to 48.5 vol.%. The investigated inlet fluxes ranged from 25 to about 100 g CH4 m-2 d-1, covering the methane load proposed to allow for complete oxidation in landfill covers under Western European climate conditions and hence being suggested as a criterion for release from aftercare. The vertical distribution of gas concentrations, methane flux balances as well as stable carbon isotope studies allowed for clear process identifications. Higher inlet fluxes led to a reduction of the aerated zone, an increase in the absolute methane oxidation rate and a decline of the relative proportion of oxidized methane. For each material, a specific maximum oxidation rate was determined, which varied between 20 and 95 g CH4 m-2 d-1 and which was positively correlated to the air-filled porosity of the soil. Methane oxidation efficiencies and gas profile data imply a strong link between oxidation capacity and diffusive ingress of atmospheric air

  1. Multimodal document management in radiotherapy

    International Nuclear Information System (INIS)

    workflow via continuous processes. Since the completion of the concepts and the implementation in our test environment 15,000 documents were introduced into the departmental workflow following routine approval. Furthermore approximately 5000 appointment letters for patient aftercare per year were automatically generated by the BAS. In addition patient record extracts in the form of PDF files for the medical services of the healthcare insurer can be generated. (orig.)

  2. Diagnosis of Fetal Anomaly and the Increased Maternal Psychological Toll Associated with Pregnancy Termination.

    Science.gov (United States)

    Coleman, Priscilla K

    2015-01-01

    comfortable and free of pain until death. The approach is realistic without shattering hope that the diagnosis was wrong or that a miracle will take place as there is recognition that hope keeps parents going. There is also recognition that building memories is essential to the grieving process and frequent use of ultrasound is designed to provide visualization experience. Perinatal hospice teams assist in the development of birth plans, address the type and location of the delivery as well as aftercare of the mother and infant. PMID:26103706

  3. Lasers for vascular lesions: Standard guidelines of care

    Directory of Open Access Journals (Sweden)

    C R Srinivas

    2011-01-01

    Full Text Available Introduction: Lasers are a good therapeutic tool for congenital and acquired vascular lesions. Technological advances in lasers have reduced the adverse effects and increased the efficacy. Machines: Among the various lasers used for treating vascular lesions, pulsed dye laser (PDL has the best efficacy and safety data. The other machines that are widely available are Nd:YAG laser and intense pulse light (IPL. Rationale and scope of guideline: Much variation exists in different machines and techniques, and therefore, establishing standard guidelines has limitations. The guidelines recommended here indicate minimum standards of care for lasers on vascular lesions based on current evidence. Physician Qualification: Laser may be administered by a dermatologist, who has received adequate background training in lasers during post-graduation or later at a center that provides education and training in lasers, or in focused workshops, which provide such trainings. He/she should have adequate knowledge of the lesions being treated, machines, parameters, cooling systems, and aftercare. Facility: The procedure may be performed in the physician′s minor procedure room with adequate laser safety measures. Indications: PWS, hemangioma, facial telangiectasia, rosacea, spider angioma, pyogenic granuloma, venous lakes, leg veins. Contraindications: Absolute: Active local infection, photo-aggravated skin diseases, and medical conditions. Relative: Unstable vitiligo, psoriasis, keloid and keloidal tendencies, patient on isotretinoin, patient who is not cooperative or has unrealistic expectation. Patient Selection: Patient selection should be done after detailed counseling with respect to the course of lesions, different treatment options, possible results, cost, need for multiple treatments, and possible postoperative complications. Treatment Sessions: The number of treatments per lesion varies from 2 to 12 or more at 6-8 week intervals. All lesions may not clear

  4. Science Base and Tools for Evaluating Stream Restoration Project Proposals.

    Science.gov (United States)

    Cluer, B.; Thorne, C.; Skidmore, P.; Castro, J.; Pess, G.; Beechie, T.; Shea, C.

    2008-12-01

    and geomorphic contexts; questioning perceived constraints on project design; reducing the use of hard structures and encouraging deformability; promoting designs that address both risk and uncertainty in applying engineering design standards; allowing for future climate and land use changes; and encouraging post-project monitoring, appraisal and project aftercare.

  5. Impact of intermittent aerations on leachate quality and greenhouse gas reduction in the aerobic-anaerobic landfill method.

    Science.gov (United States)

    Nag, Mitali; Shimaoka, Takayuki; Komiya, Teppei

    2016-09-01

    leachate pollutants and the emission of GHGs. Furthermore, the occurrence of simultaneous nitrification-denitrification presents the prospect that intermittent aeration could reduce landfill aftercare and energy costs. PMID:26514311

  6. Independent Pre-Transplant Recipient Cancer Risk Factors after Kidney Transplantation and the Utility of G-Chart Analysis for Clinical Process Control.

    Directory of Open Access Journals (Sweden)

    Harald Schrem

    Full Text Available The aim of this study is to identify independent pre-transplant cancer risk factors after kidney transplantation and to assess the utility of G-chart analysis for clinical process control. This may contribute to the improvement of cancer surveillance processes in individual transplant centers.1655 patients after kidney transplantation at our institution with a total of 9,425 person-years of follow-up were compared retrospectively to the general German population using site-specific standardized-incidence-ratios (SIRs of observed malignancies. Risk-adjusted multivariable Cox regression was used to identify independent pre-transplant cancer risk factors. G-chart analysis was applied to determine relevant differences in the frequency of cancer occurrences.Cancer incidence rates were almost three times higher as compared to the matched general population (SIR = 2.75; 95%-CI: 2.33-3.21. Significantly increased SIRs were observed for renal cell carcinoma (SIR = 22.46, post-transplant lymphoproliferative disorder (SIR = 8.36, prostate cancer (SIR = 2.22, bladder cancer (SIR = 3.24, thyroid cancer (SIR = 10.13 and melanoma (SIR = 3.08. Independent pre-transplant risk factors for cancer-free survival were age 62.6 years (p = 0.001, HR: 1.29, polycystic kidney disease other than autosomal dominant polycystic kidney disease (ADPKD (p = 0.001, HR: 0.68, high body mass index in kg/m2 (p<0.001, HR: 1.04, ADPKD (p = 0.008, HR: 1.26 and diabetic nephropathy (p = 0.004, HR = 1.51. G-chart analysis identified relevant changes in the detection rates of cancer during aftercare with no significant relation to identified risk factors for cancer-free survival (p<0.05.Risk-adapted cancer surveillance combined with prospective G-chart analysis likely improves cancer surveillance schemes by adapting processes to identified risk factors and by using G-chart alarm signals to trigger Kaizen events and audits for root-cause analysis of relevant detection rate changes

  7. Conservative treatment, plate fixation, or prosthesis for proximal humeral fracture. A prospective randomized study

    Directory of Open Access Journals (Sweden)

    Launonen Antti P

    2012-09-01

    presents a prospective, randomized, national multi-center trial. It gives details of patient flow, randomization, aftercare and also ways of analysis of the material and ways to present and publish the results. Trial registration ClinicalTrials.gov identifier: NCT01246167

  8. Assessment of the methane oxidation capacity of compacted soils intended for use as landfill cover materials.

    Science.gov (United States)

    Rachor, Ingke; Gebert, Julia; Gröngröft, Alexander; Pfeiffer, Eva-Maria

    2011-05-01

    The microbial oxidation of methane in engineered cover soils is considered a potent option for the mitigation of emissions from old landfills or sites containing wastes of low methane generation rates. A laboratory column study was conducted in order to derive design criteria that enable construction of an effective methane oxidising cover from the range of soils that are available to the landfill operator. Therefore, the methane oxidation capacity of different soils was assessed under simulated landfill conditions. Five sandy potential landfill top cover materials with varying contents of silt and clay were investigated with respect to methane oxidation and corresponding soil gas composition over a period of four months. The soils were compacted to 95% of their specific proctor density, resulting in bulk densities of 1.4-1.7 g cm(-3), reflecting considerably unfavourable conditions for methane oxidation due to reduced air-filled porosity. The soil water content was adjusted to field capacity, resulting in water contents ranging from 16.2 to 48.5 vol.%. The investigated inlet fluxes ranged from 25 to about 100g CH(4)m(-2)d(-1), covering the methane load proposed to allow for complete oxidation in landfill covers under Western European climate conditions and hence being suggested as a criterion for release from aftercare. The vertical distribution of gas concentrations, methane flux balances as well as stable carbon isotope studies allowed for clear process identifications. Higher inlet fluxes led to a reduction of the aerated zone, an increase in the absolute methane oxidation rate and a decline of the relative proportion of oxidized methane. For each material, a specific maximum oxidation rate was determined, which varied between 20 and 95 g CH(4)m(-2)d(-1) and which was positively correlated to the air-filled porosity of the soil. Methane oxidation efficiencies and gas profile data imply a strong link between oxidation capacity and diffusive ingress of

  9. Recovery post treatment: plans, barriers and motivators

    Directory of Open Access Journals (Sweden)

    Duffy Paul

    2013-01-01

    Full Text Available Abstract Background The increasing focus on achieving a sustained recovery from substance use brings with it a need to better understand the factors (recovery capital that contribute to recovery following treatment. This work examined the factors those in recovery perceive to be barriers to (lack of capital or facilitators of (presence of capital sustained recovery post treatment. Methods A purposive sample of 45 participants was recruited from 11 drug treatment services in northern England. Semi-structured qualitative interviews lasting between 30 and 90 minutes were conducted one to three months after participants completed treatment. Interviews examined key themes identified through previous literature but focused on allowing participants to explore their unique recovery journey. Interviews were transcribed and analysed thematically using a combination of deductive and inductive approaches. Results Participants generally reported high levels of confidence in maintaining their recovery with most planning to remain abstinent. There were indications of high levels of recovery capital. Aftercare engagement was high, often through self referral, with non substance use related activity felt to be particularly positive. Supported housing was critical and concerns were raised about the ability to afford to live independently with financial stability and welfare availability a key concern in general. Employment, often in the substance use treatment field, was a desire. However, it was a long term goal, with substantial risks associated with pursuing this too early. Positive social support was almost exclusively from within the recovery community although the re-building of relationships with family (children in particular was a key motivator post treatment. Conclusions Addressing internal factors and underlying issues i.e. ‘human capital’, provided confidence for continued recovery whilst motivators focused on external factors such as family and

  10. Body piercing: complications and prevention of health risks.

    Science.gov (United States)

    Holbrook, Jaimee; Minocha, Julia; Laumann, Anne

    2012-02-01

    Body and earlobe piercing are common practices in the USA today. Minor complications including infection and bleeding occur frequently and, although rare, major complications have been reported. Healthcare professionals should be cognizant of the medical consequences of body piercing. Complications vary depending on the body-piercing site, materials used, experience of the practitioner, hygiene regimens, and aftercare by the recipient. Localized infections are common. Systemic infections such as viral hepatitis and toxic shock syndrome and distant infections such as endocarditis and brain abscesses have been reported. Other general complications include allergic contact dermatitis (e.g. from nickel or latex), bleeding, scarring and keloid formation, nerve damage, and interference with medical procedures such as intubation and blood/organ donation. Site-specific complications have been reported. Oral piercings may lead to difficulty speaking and eating, excessive salivation, and dental problems. Oral and nasal piercings may be aspirated or become embedded, requiring surgical removal. Piercing tracts in the ear, nipple, and navel are prone to tearing. Galactorrhea may be caused by stimulation from a nipple piercing. Genital piercings may lead to infertility secondary to infection, and obstruction of the urethra secondary to scar formation. In men, priapism and fistula formation may occur. Women who are pregnant or breastfeeding and have a piercing or are considering obtaining one need to be aware of the rare complications that may affect them or their child. Though not a 'complication' per se, many studies have reported body piercing as a marker for high-risk behavior, psychopathologic symptoms, and anti-social personality traits. When it comes to piercing complications, prevention is the key. Body piercers should take a complete medical and social history to identify conditions that may predispose an individual to complications, and candidates should choose a

  11. Standard guidelines of care: Lasers for tattoos and pigmented lesions

    Directory of Open Access Journals (Sweden)

    Aurangabadkar Sanjeev

    2009-08-01

    Full Text Available Introduction: Lasers have revolutionized the treatment of pigmentary disorders and have become the mainstay of therapy for many of them. Machines: Though different laser machines are used, Quality-switched (QS lasers are considered as the gold standard for treatment of pigmented lesions. Proper knowledge of the physics of laser machine, methodology, dosage schedules, etc., is mandatory. Physician Qualification: Laser may be administered by a dermatologist, who has received adequate background training in lasers during postgraduation or later at a center that provides education and training in lasers, or in focused workshops which provide such trainings. He should have adequate knowledge of the machines, parameters, cooling systems, and aftercare. Facility: The procedure may be performed in the physician′s minor procedure room. Indications: Epidermal lesions: Cafι au lait macules (CALM, lentigines, freckles, solar lentigo, nevus spilus, pigmented seborrheic keratosis, dermatosis papulosa nigra (DPN. Dermal lesions: Nevus of Ota, Blue nevus, Hori′s nevus (acquired bilateral nevus of Ota-like macules. Tattoos: Amateur, professional, cosmetic, medicinal, and traumatic. Mixed epidermal and dermal lesions: Postinflammatory hyperpigmentation (PIH, nevus spilus, periorbital and perioral pigmentation, acquired melanocytic nevi (moles, melasma and Becker′s Nevus. Contraindications: Absolute: Active local infection, photo-aggravated skin diseases and medical conditions, tattoo granuloma, allergic reactions to tattoo pigment, unstable vitiligo and psoriasis. Relative: Keloid and keloidal tendencies, patient on isotretinoin, history of herpes simplex, patient who is not co-operative or has unrealistic expectation. Patient selection: Proper patient selection is important. Investigations to identify any underlying cause for pigmentation are important; concurrent topical and systemic drug therapy may be needed. History of scarring, response to previous

  12. How Patients Recovering From Alcoholism Use a Smartphone Intervention.

    Science.gov (United States)

    McTavish, Fiona M; Chih, Ming-Yuan; Shah, Dhavan; Gustafson, David H

    2012-01-01

    OBJECTIVE: Mobile technology has the potential to radically improve addiction treatment and continuing care by offering emotional and instrumental support anywhere and just in time. This is particularly important in addiction because timing is critical to preventing relapse. Although most experts consider alcoholism to be a chronic disease, providers do not typically offer ongoing support for relapse prevention after patients complete treatment, even though a central characteristic of alcoholism and other addictive behaviors is their chronically relapsing nature. A-CHESS is a smartphone-based system for preventing relapse to heavy drinking among people leaving active alcohol dependence treatment. A-CHESS is designed to improve competence, social relatedness, and motivation, the three tenets of Self-Determination Theory. This paper reports on the relative impact and use of A-CHESS four months after patients entered the study and discusses implications of the results on treating addiction and chronic diseases generally. METHODS: A total of 349 individuals with alcohol dependence leaving residential treatment were randomly assigned to either receive A-CHESS+Treatment as Usual or Treatment as Usual (standard aftercare). Patients came from two treatment agencies, one in the Midwest and one in the Northeast. Patients assigned to A-CHESS received a smartphone for 8 months and were followed for 12. The authors analyzed use patterns during the first 4 months of use by those receiving A-CHESS. RESULTS: Participants used A-CHESS heavily and sustained their use over time. Ninety-four percent of A-CHESS participants used the application during the first week after residential treatment. At week 16, almost 80% continued to access A-CHESS. Participants with alcohol and drug-dependence showed higher levels of system use than those with alcohol dependence only. Participants with a mental health diagnosis had slightly lower levels of use at the end of the intervention period (week

  13. Aggression and violence against health care workers in Germany - a cross sectional retrospective survey

    Directory of Open Access Journals (Sweden)

    Kuhnert Saskia

    2010-02-01

    health care. The present study highlights differences between various areas of health care in Germany and the aggravating effect of prevention neglect such as missing social support at the workplace. Therefore our data suggest the need for improved target group specific prevention of aggressive incidents towards care workers and the need for effective aftercare in Germany.

  14. Assessment of Chernobyl health consequences under the influence of public and other interests

    International Nuclear Information System (INIS)

    is outlined that competition among scientific groups should be avoided, that the study of the pathology and molecular biology of thyroid cancer should include the role of isotopes of iodine and of other factors influencing cancer incidence including exposure to other carcinogens, genetic factors etc.. All data are collected in Great Britain. Also of great interest is the 'BelAm Project' in Belarus and 'UkrAm Project' in Ukraine. In this project in Belarus, which started in 1996, a cohort of about 12 000 persons will be monitored for 30 years in order to see how many thyroid cancer cases would appear. Recent articles in the international press criticise that the project would only serve investigation on Belarus while after the detection of cancer cases the treatment and aftercare would be left to the patients and to the health system in Belarus, which is not ready to give all patients the appropriate treatment. Merely in Gomel region about 400 000 people being children or adolescents at the time of the accident, have high risk of developing thyroid cancer and deserve regular checks, and not only the group necessary for the statistical significance of the interests of the USA. Research projects by international organisations on the health consequences for the citizens and patients of NIS countries after the Chernobyl catastrophe should be made dependant on the obligation that these organisations guarantee at the same time therapy and aftercare to a substantial part of the population at risk. (Authors)

  15. Study of the influence of bioturbation on covers and contaminated materials on radon shielding using the lead tracing method; Untersuchung des Einflusses der Bioturbation von Abdeckungen und kontaminierten Materialien auf Radondaemmwirkung mittels Bleispurmethode

    Energy Technology Data Exchange (ETDEWEB)

    Schulz, H.; Funke, L.; Schellenberger, A. [IAF-Radiooekologie GmbH, Dresden (Germany); Loebner, W.; Leichsenring, B.; Regner, J. [Wismuth GmbH, Chemnitz (Germany)

    2004-07-01

    For geological reasons, mining activities in Thuringia and Saxony have almost always been associated with the excavation of radioactive rock material. The legacy left behind by mining operations, such as waste heaps, industrial settling ponds, abandoned industrial areas and underground mines have posed and for some part still pose a considerable pollution burden for the environment and the population. At the present state of the art in science and technology the best possible remediation solution for these mining leftovers is to retain them in situ by means of a sealing cover(and where necessary provide seepage water retention and treatment). The purpose of such measures is to ensure that the environmental hazards emanating from abandoned mining sites are durably reduced to a tolerable level and the areas concerned can be converted for suitable subsequent uses in a manner adapted to the site in question and with relatively little aftercare required. The sealing systems to be designed and manufactured for this purpose must meet high requirements in terms of long-term effectiveness, since mining leftovers such as waste heaps and settling ponds are subject to the environmental conditions prevailing at the site and hence, over time, to changes in their properties. Having a fundamental knowledge of patterns of pollutant release behaviour is a crucial prerequisite for formulating the specifications for such sealing systems. Radon (Rn-222) is an element which in some cases attains crucial importance in this regard (Rn-222), since it can make a significant contribution to overall human radiation exposure. This has been confirmed, for example, by studies in preparation of pollution maps as well as by studies conducted by WISMUT GmbH at its Schlema-Alberoda site. In some cases sealing covers for mining leftovers involving elevated radon release rates must be dimensioned such that they effectively shield off radon radiation. Furthermore, suitable methods are needed for

  16. Needs and challenges in implementing key directives. Waste-to-energy progress

    Energy Technology Data Exchange (ETDEWEB)

    Vehlow, J.; Bergfeldt, B. [Forschungszentrum Karlsruhe GmbH Technik und Umwelt (Germany). Inst. fuer Technische Chemie; Wilen, C. [VTT Technical Research Centre of Finnland, Espoo (Finland); Visser, H.J.M. [ECN Energy Research Centre of the Netherlands, Petten (Netherlands)

    2007-12-15

    Finnish strategy. Hence co-treatment, either by direct addition of waste fuel or by utilisation of synthesis gas from waste gasification will only be possible for well separated and clean waste fractions and with that the disposal of the more or less polluted residual waste fractions is yet an unsolved problem. The situation in the eastern new EU member states is ought to be similar to that in Finland. These got a longer time for adaptation than the 15 old EU members. Basic information available to the authors on other EU countries shows a rather fragmented picture. Austria e.g. has already today fulfilled the goals of 65 % reduction set in the directive for 2016. The question to be answered is whether that much compost has the quality to be utilised and whether such strategy is in line with the intention of the Landfill Directive: to establish an aftercare free waste disposal. The UK is currently far behind any schedule to meet the targets of the Landfill Directive.

  17. Regarding the Content and Goals of UIM/EJU.

    Science.gov (United States)

    Seitz, K

    2015-12-01

    profession.Considered retrospectively, contents of recent volumes of UiM/EJU - apart from the large block of obstetrical articles - were dominated by CEUS, elastography, the breast and "small parts".Although CEUS has been established scientifically 1 2 3 4, but not really employed everywhere, additional articles are needed in order to help integrate the use of contrast agents in routine practice apart from examination of the liver 5 6 7 8 9 10. Likewise, we have endeavored to support elastography as a new technical feature of sonography. Examples of this are publications regarding its use in diagnosing diseases of the liver 11 12 13 14 15, breast 16 17 18 19 and the thyroid 20, as well as its use in examining the pancreas 21 and gastrointestinal tract 22.In addition, for the benefit of sonographers, who are used to observing associated fields from the sidelines, we have presented unexpected highlights, such as articles on peripheral nerves 23 24 25.The contents of this year's final edition present the common interdisciplinary perspective of the editorial team. In addition to a CME article on elastography in the diagnosis of breast cancer 26, we would particularly refer you to two prospective articles: on the importance of CEUS in the aftercare of colon cancer 27 and the value of high-frequency examination of the liver surface compared to elastography and laparoscopy when cirrhosis is suspected 28.Further articles on elastography 29 30 31 32 indicate that the possibilities and limitations of this technology have yet to be reached.As editors, we will be satisfied if the publication interests as many readers as possible, be it online or in the print version, and that they are able to read about new as well as established techniques. We are certain that the societies for ultrasound in medicine, UiM/EJU, and "our sonographic community" are excited to learn about scientific advancements, and we are pleased when, thanks to submissions by our active and innovative authors together

  18. EDITORIAL: Deep brain stimulation, deontology and duty: the moral obligation of non-abandonment at the neural interface Deep brain stimulation, deontology and duty: the moral obligation of non-abandonment at the neural interface

    Science.gov (United States)

    Fins, Joseph J.; MD; FACP

    2009-10-01

    fiscal responsibility for any associated costs. It is a breach of professional ethics to do otherwise. Such enduring covenants must be articulated in clinical protocols and be determinative in regulatory decisions by local Institutional Review Boards (IRBs) to reject or approve investigative protocols. The articulation of such `after-care' provisions should also be expected in any new IDE application to the Food and Drug Administration. To sustain clinical progress and investigative momentum, the neuromodulation community must embrace its ethical responsibility for comprehensive and on-going follow-up care. We need to populate a clinical infrastructure that can support patients and research subjects in their communities, especially as their conditions deteriorate and travel becomes more difficult. We need to disseminate our sequestered expertise more widely to primary care specialties. This ethical mandate transcends the clinical assessors, operators, and sponsors of clinical trials. It also applies to engineers who are well-positioned to help lessen the burden for patients and subjects. On the engineering side of this equation, innovation is the key. The development of better batteries with longer shelf lives or power management systems that optimize utilization of available capacitance will be a tremendous boon in streamlining follow-up care. So too will be the development of simplified device control systems to manipulate basic functions that would be operable by generalist physicians. Imagine a universal wand that could deactivate a device, and perform some rudimentary functions, that every Emergency Department could stock. Making such a basic parallel low-tech system universal amongst many device manufacturers would provide additional access to care in the community and a degree of safety in an emergency. Engineers might also work towards the development of mechanisms to give patients and subjects greater control over their devices, which are after all extrinsic