WorldWideScience

Sample records for aftercare

  1. 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 ...

  2. 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 ...

  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. Iliotibial band syndrome - aftercare

    Science.gov (United States)

    IT band syndrome - aftercare; Iliotibial band friction syndrome - aftercare ... If you have iliotibial band syndrome you may notice: Mild pain on the outside of your knee when you begin to exercise, which goes ...

  5. 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 ...

  6. 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 ...

  7. 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 ...

  8. 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 ...

  9. 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)

  10. Site-specific criteria for the completion of landfill aftercare.

    Science.gov (United States)

    Laner, David; Fellner, Johann; Brunner, Paul H

    2012-09-01

    Municipal solid waste (MSW) landfills need to be managed after closure to assure long-term environmental compatibility. Aftercare can be completed when the authorities consider the landfill not likely to pose a threat to humans and the environment. In this work, a methodology for deriving site-specific aftercare completion criteria is presented and its application is illustrated via a case study. The evaluation method combines models addressing waste emission behavior, long-term barrier performance, and pollutant migration to assess the potential impact of landfill emissions on the environment. Based on the definition of acceptable impact levels at certain points of compliance, scenario- and pollutant-specific aftercare completion criteria are derived. The methodology was applied to a closed MSW landfill in Austria and potential aftercare durations were determined. While landfill gas emissions may become environmentally tolerable within decades at the site, leachate-related aftercare measures were expected to be necessary for centuries (primarily as a result of ammonium). Although the evaluation comes with large uncertainties, it allows for linking aftercare intensity and duration with respect to an environmentally compatible state of the landfill in the absence of aftercare. However, further case studies including regulatory review and acceptance are needed to use the methodology in a decision support tool on aftercare completion.

  11. Efficacy of Outpatient Aftercare for Adolescents with Alcohol Use Disorders: A Randomized Controlled Study

    Science.gov (United States)

    Kaminer, Yifrah; Burleson, Joseph A.; Burke, Rebecca H.

    2008-01-01

    The effectiveness of active aftercare for adolescents with alcohol use disorders in maintaining treatment gains is evaluated. Findings show that active aftercare interventions were effective in slowing the posttreatement relapse of alcohol use in adolescents. Impacts of active aftercare on number of drinking days and heavy drinking days are also…

  12. Male and Female Perceptions of Aftercare Services and Supports

    Science.gov (United States)

    Huscroft-D'Angelo, Jacqueline

    2012-01-01

    Youth depart residential care with many continued risk factors, unique needs, and challenges as they reintegrate into the home, school, and community settings. Currently, there is limited research on needs and best practices in aftercare services and supports for youth departing from residential settings and even less is known about how these…

  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. Aftercare Following Syndesmotic Screw Placement: A Systematic Review

    NARCIS (Netherlands)

    T. Schepers (Tim); E.M.M. van Lieshout (Esther); H.J.P. van der Linden (Hans); V.M. de Jong; J.C. Goslings (Johannes)

    2013-01-01

    textabstractFor ankle fractures, in general, several studies have been published on immobilization (e.g., cast or boot) versus early motion after surgical treatment. However, no studies have been performed to determine the best aftercare strategy for surgically treated patients with ankle fractures

  15. 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

  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. Fate of implant-retained craniofacial prostheses : Life span and aftercare

    NARCIS (Netherlands)

    Visser, Anita; Raghoebar, Gerry M.; van Oort, Robert P.; Vissink, Arjan

    2008-01-01

    Purpose: To assess the need for surgical and prosthetic aftercare of craniofacial prostheses supported by endosseous implants. Materials and Methods: A retrospective clinical study assessing the surgical and prosthetic aftercare from implant placement to last visit of follow-up was performed in cons

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

    DEFF Research Database (Denmark)

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

    2013-01-01

    INTRODUCTION. Current evidence indicates that emotional problems after intensive care are related both to subjective and objective indicators of a patient0s intensive care experience. Research of rehabilitation after critical illness has during the latest years focused on the use of diary and after...... individuals during the trajectory of intensive care and after-care. This, in relation to further develop and targeting after-care interventions in an intensive care unit (ICU) which uses diary as well as after-care as telephone consultations, nurse conversations combined with visits in the ICU at four, eight...... included. Data was obtained using individual interviews twice during after-care: nurse conversations combined with visits in the ICU at 4 months after discharge. Additionally was field notes obtained during the visit in the ICU. Data were analyzed at three levels: naive reading, structural analysis...

  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. Five years of aftercare of implant-retained mandibular overdentures and conventional dentures

    NARCIS (Netherlands)

    Visser, A.; Geertman, M.E.; Meijer, H.J.A.; Raghoebar, G.M.; Creugers, N.H.J.; Oort, R.P. van

    2002-01-01

    The purpose of this multicentre randomized clinical trial was to analyse surgical and prosthetic aftercare and clinical implant performance of edentulous patients with implant-retained mandibular overdentures and of patients with conventional dentures, either or not after pre-prosthetic vestibulopla

  3. Five years of aftercare of implant-retained mandibular overdentures and conventional dentures.

    NARCIS (Netherlands)

    Visser, A.; Geertman, M.E.; Meijer, H.J.; Raghoebar, G.M.; Kwakman, J.M.; Creugers, N.H.J.; Oort, R.P. van

    2002-01-01

    The purpose of this multicentre randomized clinical trial was to analyse surgical and prosthetic aftercare and clinical implant performance of edentulous patients with implant-retained mandibular overdentures and of patients with conventional dentures, either or not after pre-prosthetic vestibulopla

  4. 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...

  5. Fresh Start: A Meta-Analysis of Aftercare Programs for Juvenile Offenders

    Science.gov (United States)

    Weaver, Robert D.; Campbell, Derek

    2015-01-01

    Objectives: A meta-analysis was conducted in order to generate more understanding regarding the efficacy of aftercare programs in reducing the recidivism rates of juvenile offenders reentering their communities following a period of custody. Method: 30 eligible primary studies were obtained through a systematic literature review and were coded.…

  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. 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

    Background It is well documented that individuals with Alcohol Use Disorder (AUD) respond well during evidence-based psychological treatment, but also that a large proportion relapses when discharged from treatment and confronted with alcohol in real life. Cue Exposure Treatment (CET) focuses...... on 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...... as an investigator-blinded randomized controlled trial. A total of 300 consecutively enrolled alcohol use disorder individuals recruited from an alcohol outpatient clinic will be randomized into one of the three following aftercare groups after concluding primary treatment: (1) CET as a smartphone application; (2...

  8. 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 ...

  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. A novel approach in calculating site-specific aftercare completion criteria for landfills in The Netherlands: Policy developments.

    Science.gov (United States)

    Brand, Ellen; de Nijs, Ton C M; Dijkstra, Joris J; Comans, Rob N J

    2016-10-01

    As part of a more circular economy, current attention on waste is shifting from landfilling towards the prevention, re-use and recycling of waste materials. Although the need for landfills is decreasing, there are many landfills around the world that are still operational or at the point of starting the aftercare period. With traditional aftercare management, these landfills require perpetual aftercare at considerable cost due to monitoring and regular maintenance of liners. In an attempt to lower these aftercare costs, and to prevent that future generations become responsible for finding a sustainable solution of present day waste, the Dutch government takes action to explore the possibilities of sustainable landfill management. A project was started to investigate whether the use of source-oriented treatment techniques (so-called active treatment) of landfills can result in a sustainable emission reduction to soil and groundwater. During the next decade, sustainable landfill management is tested at three selected pilot landfills in the Netherlands. To enable this pilot testing and to determine its success after the experimental treatment period, a new methodology and conceptual framework was developed. The aim of this paper is to describe the development of the new methodology, and in particular the policy decisions, needed to determine whether the pilot experiments will be successful. The pilot projects are considered successful when the concentrations in the leachate of the pilot landfills have sufficiently been reduced and for longer periods of time and comply with the derived site-specific Environmental Protection Criteria (EPC). In that case, aftercare can be reduced, and it can be determined whether sustainable landfill management is economically feasible for further implementation. PMID:27497586

  13. 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

  14. 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 ...

  15. Labyrinthitis - aftercare

    Science.gov (United States)

    ... NOT overeat. Exercise regularly, if possible. Get enough sleep. Limit caffeine and alcohol. Help ease stress by using relaxation techniques, such as: Deep breathing Guided imagery Meditation Progressive muscle relaxation Tai chi Yoga

  16. 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

  17. 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

    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......), 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...... was used to compare the groups. RESULTS: The majority of patients in both groups suffered from affective disorders, followed by personality disorders and a small number of other psychiatric diagnoses. Service use in the TA group was lower than in the RC group with fewer bed days after 10 weeks (P = 0...

  18. 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

  19. 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

  20. A novel tool for continuous fracture aftercare - Clinical feasibility and first results of a new telemetric gait analysis insole.

    Science.gov (United States)

    Braun, Benedikt J; Bushuven, Eva; Hell, Rebecca; Veith, Nils T; Buschbaum, Jan; Holstein, Joerg H; Pohlemann, Tim

    2016-02-01

    Weight bearing after lower extremity fractures still remains a highly controversial issue. Even in ankle fractures, the most common lower extremity injury no standard aftercare protocol has been established. Average non weight bearing times range from 0 to 7 weeks, with standardised, radiological healing controls at fixed time intervals. Recent literature calls for patient-adapted aftercare protocols based on individual fracture and load scenarios. We show the clinical feasibility and first results of a new, insole embedded gait analysis tool for continuous monitoring of gait, load and activity. Ten patients were monitored with a new, independent gait analysis insole for up to 3 months postoperatively. Strict 20 kg partial weight bearing was ordered for 6 weeks. Overall activity, load spectrum, ground reaction forces, clinical scoring and general health data were recorded and correlated. Statistical analysis with power analysis, t-test and Spearman correlation was performed. Only one patient completely adhered to the set weight bearing limit. Average time in minutes over the limit was 374 min. Based on the parameters load, activity, gait time over 20 kg weight bearing and maximum ground reaction force high and low performers were defined after 3 weeks. Significant difference in time to painless full weight bearing between high and low performers was shown. Correlation analysis revealed a significant correlation between weight bearing and clinical scoring as well as pain (American Orthopaedic Foot and Ankle Society (AOFAS) Score rs=0.74; Olerud-Molander Score rs=0.93; VAS pain rs=-0.95). Early, continuous gait analysis is able to define aftercare performers with significant differences in time to full painless weight bearing where clinical or radiographic controls could not. Patient compliance to standardised weight bearing limits and protocols is low. Highly individual rehabilitation patterns were seen in all patients. Aftercare protocols should be adjusted to real

  1. Care and Aftercare Related to Implant-Retained Dental Crowns in the Maxillary Aesthetic Region : A 5-Year Prospective Randomized Clinical Trial

    NARCIS (Netherlands)

    Visser, Anita; Raghoebar, Gerry M.; Meijer, Henny J. A.; Meijndert, Leo; Vissink, Arjan

    2011-01-01

    Aim: To prospectively assess surgical and prosthetic care and aftercare related to the placement of implant-retained dental crowns after local bone augmentation in patients missing one tooth in the maxillary aesthetic region. Methods: Ninety-three patients were randomly allocated to one of three loc

  2. Aftercare services for international sex trafficking survivors: informing U.S. service and program development in an emerging practice area.

    Science.gov (United States)

    Macy, Rebecca J; Johns, Natalie

    2011-04-01

    International sex trafficking into the United States appears to be a serious and growing problem, although the evidence regarding prevalence, risk, and consequences is incomplete. Nonetheless, human service providers are increasingly being asked to offer services to sex trafficking survivors. Consequently, providers need information to guide services and program development in this emerging practice area. To address this knowledge need, we systematically reviewed and synthesized 20 documents addressing the needs of and services for international survivors of sex trafficking into the United States. The main finding from the review shows the importance of a continuum of aftercare services to address survivors' changing needs as they move from initial freedom to recovery and independence. Based on our synthesis of the reviewed literature, we present a service delivery framework to guide providers' development of services for survivors. PMID:21196435

  3. 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...

  4. An art therapy intervention for cancer patients in the ambulant aftercare - results from a non-randomised controlled study.

    Science.gov (United States)

    Geue, K; Richter, R; Buttstädt, M; Brähler, E; Singer, S

    2013-05-01

    Art therapy in psycho-oncology is gaining increasing importance, but systematic evaluations of its effects are rare. The aim of this study is to investigate the effects of an art therapy intervention for cancer patients in ambulant aftercare on psychological distress and coping. The intervention consisted of 22 sessions. At three points of measurement (t1: before intervention, t2: following intervention, t3: 6 months after t2), participants responded to questionnaires (Freiburg Questionnaire on Coping with Illness, Perceived Adjustment to Chronic Illness Scale, Hospital Anxiety and Depression Scale). A group of haemato-oncological patients served as the comparison group (CG). Pre-post comparisons and analyses of variance were applied for statistical analysis. Relevant confounders were controlled. Fifty-four patients (intervention group, IG) with various cancer diagnoses completed the intervention. One hundred and twenty-nine data sets were available for the CG. Analyses of variance included group membership (IG vs. CG) and the following factors: gender, other psychosocial help and major life events. None of these variables was a predictor for changes in depression, anxiety and coping. Therefore, we could not prove intervention effects over time. Our results contradict those of preliminary studies and raise important questions. Further work on evaluating art therapy is necessary to explore which intervention concepts in which setting at which treatment stage show significant effects. Therefore, controlling for relevant confounders is needed.

  5. 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.

  6. 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.

  7. 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. ...

  8. 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 ...

  9. Dizziness and vertigo - aftercare

    Science.gov (United States)

    ... lifestyle choices to help you cope: Get enough sleep. Eat a well-balanced, healthy diet. DO NOT overeat. Exercise regularly, if possible. Learn and practice ways to relax, such as guided imagery, progressive muscle relaxation, yoga, tai chi, or meditation.

  10. 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 ...

  11. 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.

  12. 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 ...

  13. 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 ...

  14. 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 ...

  15. Kneecap dislocation - aftercare

    Science.gov (United States)

    ... Armstrong B. Rehabilitation of the knee following sports injury. Clin Sports Med . 2010;29:81-106. PMID: 19945588 www. ... gov/pubmed/22071844 . Miller RH, Azar FM. Knee injuries. In: Canale ... Medicine. 4th ed. Philadelphia, PA: Elsevier Saunders; 2015: ...

  16. Collateral ligament (CL) injury - aftercare

    Science.gov (United States)

    ... Disorders, Pain, and Rehabilitation . 3rd ed. Philadelphia, PA: Elsevier Saunders; 2015:chap 66. Miller III RH, Azar, ... Beaty: Campbell's Operative Orthopaedics . 12th ed. Philadelphia, PA: Elsevier Mosby; 2013:chap 45. Niska JA, Petrigliano FA, ...

  17. 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.).

  18. 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. ...

  19. 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

  20. 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, ...

  1. Aftercare and Rehabilitation in a Community Mental Health Center

    Science.gov (United States)

    Scoles, Pascal; Fine, Eric W.

    1971-01-01

    The community, state mental hospitals, and a community mental health center work together to provide an environment conducive to the continued well being of chronic mental patients in an area of West Philadelphia, Pennsylvania. The authors describe a program that involves day care centers and the patients' everyday living. (Author)

  2. Section 25 aftercare under supervision: the first eighteen months' experience.

    Science.gov (United States)

    Davies, S; Bruce, J; Fallows, S

    1999-07-01

    Supervised discharge was introduced, against much professional opposition, in the Mental Health (Patients in the Community) Act 1995. All patients subject to supervised discharge (SD) in a large health district were identified by medical records departments, and the outcome of their SD on 1 October 1997, eighteen months after the legislation came into effect, was assessed. In that first eighteen months, half of the general, rehabilitation and forensic psychiatrists in the trust used SD for 22 patients. Of the 12 orders in effect for over six months, six were renewed at six months and three at one year. In spite of professional hostility and scepticism about the clinical practicalities of SD, the use of the new power has gradually increased with experience. Outcomes to date seem generally positive, but further definitive research is needed.

  3. [Aftercare following distal forearm fractures and carpal trauma].

    Science.gov (United States)

    Völlinger, C; Partecke, B-D

    2003-05-01

    Rehabilitation following operative or conservative treatment of fractures of the distal forearm and carpal trauma takes effect through adequate immobilization and ought to be maximized by a differentiated application of every means of physiotherapy, ergotherapy, and physical medicine available. Rehabilitation of the fractured distal forearm and carpal trauma are presented based on the therapeutic guidelines as applied by the Department of Hand Surgery, Plastic and Microsurgery of the Berufsgenossenschaftliches Unfallkrankenhaus Hamburg. PMID:12743687

  4. 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

  5. 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.

  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

    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...

  10. 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

  11. 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

  12. 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 th...... the impact of case management on substance abuse and use of service after discharge from court-ordered institutional care....

  13. 49 CFR 40.303 - What happens if the SAP believes the employee needs additional treatment, aftercare, or support...

    Science.gov (United States)

    2010-10-01

    ... 49 Transportation 1 2010-10-01 2010-10-01 false What happens if the SAP believes the employee... the Return-to-Duty Process § 40.303 What happens if the SAP believes the employee needs additional...? (a) As a SAP, if you believe that ongoing services (in addition to follow-up tests) are needed...

  14. 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 repetition...

  15. 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

    2008-01-01

    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 repetition...

  16. Botulinum toxin assessment, intervention and aftercare for paediatric and adult niche indications including pain: international consensus statement.

    Science.gov (United States)

    Rawicki, B; Sheean, G; Fung, V S C; Goldsmith, S; Morgan, C; Novak, I

    2010-08-01

    Evidence is emerging for the use of botulinum neurotoxin type-A (BoNT-A) for niche indications including pain independent of spasticity. Pain indications such as chronic nociceptive back pain, piriformis syndrome, chronic myofascial pain, pelvic pain, complex regional pain syndrome, facial pain and neuropathic pain are outlined in this paper. Of these, class I evidence is available for the treatment of chronic nociceptive low back pain, piriformis syndrome, myofascial pain, facial pain, neuropathic pain and plantar fasciitis. Peri-operative use of BoNT-A is emerging, with indications including planning for surgery and facilitating surgery, as well as healing and improving analgesia post-operatively. Evidence is limited, although there are some reports that clinicians are successfully using BoNT-A peri-operatively. There is class I evidence showing pre-operative use of BoNT-A has a beneficial effect on outcomes following adductor-release surgery. The use of BoNT for treatment of tremor, other than neck tremor in the setting of cervical dystonia, including evidence for upper limb tremor, cranial tremor and non-dystonic neck tremor is reviewed. The evidence is variable at this stage, and further study is required to develop definitive recommendations for the clinical utility of BoNT-A for these indications.

  17. 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...

  18. 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

    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...... rate in the intervention group, where the proportion of repetitive patients fell from 34% to 14%. There were also fewer suicidal acts, in total 37 acts in 58 patients in the control group and 22 acts in 93 patients for the intervention group. We have concluded that the outreach programme has a good...... feasibility because of high acceptability and adherence, and has an acceptable effectiveness in the follow up period of 1 year. We have therefore initiated a similar study using a randomization design in order to study efficacy....

  19. 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…

  20. 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".

  1. 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

  2. 32 CFR 147.10 - Guideline H-Drug involvement.

    Science.gov (United States)

    2010-07-01

    ... above definition); (2) Illegal drug possession, including cultivation, processing, manufacture, purchase... rehabilitation and aftercare requirements, without recurrence of abuse, and a favorable prognosis by...

  3. 77 FR 58921 - Presidential Determination With Respect to Foreign Governments' Efforts Regarding Trafficking in...

    Science.gov (United States)

    2012-09-24

    ..., identification, rescue or removal, aftercare (shelter, counseling), training, and reintegration; or (c) expand... it in the Federal Register. (Presidential Sig.) THE WHITE HOUSE, Washington, September 14, 2012....

  4. 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…

  5. 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...

  6. '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

  7. 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...

  8. 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...

  9. 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...

  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. 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.

  12. 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…

  13. 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....

  14. 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…

  15. Psychosocial care and shelter following the Bijlmermeer air disaster.

    NARCIS (Netherlands)

    Kroon, M.B.R.; Overdijk, W.I.E.

    1993-01-01

    This article describes the organization of the psychosocial aid and aftercare for survivors in the context of the Bijlmermeer air disaster that took place in 1992 in Amsterdam, The Netherlands. It is based on an examination of the relevant city documents and media coverage, and on interviews with ci

  16. 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

  17. 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

  18. 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...

  19. 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)

  20. 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

  1. 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

  2. Update with level 1 studies of the European Hernia Society guidelines on the treatment of inguinal hernia in adult patients

    DEFF Research Database (Denmark)

    Miserez, M; Peeters, E; Aufenacker, T;

    2014-01-01

    PURPOSE: In 2009, the European Hernia Society published the EHS Guidelines for the Treatment of Inguinal Hernia in Adult Patients. The Guidelines contain recommendations for the treatment of inguinal hernia from diagnosis till aftercare. The guidelines expired January 1, 2012. To keep them updated...

  3. 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.

  4. From a dump to a energy park and recycling park. The Rhine-Main dump park in Floersheim-Wicker; Von der Muellkippe zum Energie- und Recyclingpark. Der Rhein-Main-Deponiepark in Floersheim-Wicker

    Energy Technology Data Exchange (ETDEWEB)

    Mehler, Gerd [Rhein-Main Deponie GmbH, Floersheim am Main (Germany)

    2008-07-01

    If dumps are shut down, aftercare measures are necessary for a time period of several decades. The question arises whether the infrastructure, operating equipment and operating personnel of dumps can be used in the aftercare phase for subsequent utilisations. Under this aspect, the author of the contribution under consideration reports on the Rhine-Main dump park in Floersheim-Wicker (Federal Republic of Germany). Subsequently to the introduction according to the subsequent utilisation of dump locations, the author reports on the concept of the Rhine Main dump park, on the power generation in the Rhine-Main dump park, on the processing of wastes to fuels for the power production and on the dump as recycling park.

  5. Total costs of ownership - a comparison between incineration plant and landfill placed in the metropolian area of Sao Paulo; Kostenvergleich einer Deponie mit einer ''Waste to Energy'' Anlage im Grossraum Sao Paulo nach der Methode des Total Costs of Ownership

    Energy Technology Data Exchange (ETDEWEB)

    Bauer, W.P. [IA GmbH - Wissensmanagement und Ingenieurleistungen (Germany); Koenig, T. [GfA - Gemeinsames Kommunalunternehmen fuer Abfallwirtschaft Anstalt des oeffentlichen Rechts der Landkreise Fuerstenfeldbruck und Dachau (Germany); Scholz, W. [Bayerisches Ministerium fuer Umwelt, Gesundheit und Verbraucherschutz (Germany). Technisches Kooperationsprojekt Bayern - Sao Paulo

    2006-11-15

    This paper describes a study which offers a decision support for executives, who compare in a draft both systems according to the method of Total Costs of Ownership (TCO), regarding the total life time and including the aftercare of landfill. Description of the proceeding to calculate the TCO of an incineration plant and a landfill. Investments and operational costs of the landfill and the incineration plant are described and the results of the calculation are shown and interpreted. (orig.)

  6. 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.).

  7. 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...

  8. 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...

  9. 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...

  10. 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.

  11. Sober-Living Houses and Changes in the Personal Networks of Individuals in Recovery

    OpenAIRE

    Mueller, David G.; Leonard A. Jason

    2014-01-01

    Social networks are an important source of support for many people in recovery from alcohol abuse. The present study investigated the role of one particular source of support for recovery in changing the personal networks of people in recovery, sober-living houses. In a randomized, longitudinal design changes in the network size, heterogeneity, and composition of usual aftercare and sober-living home residents were examined. Beneficial changes were found, such as increases in the number of re...

  12. Taking an integral and eco-contemplative perspective on the phenomenon of addiction in dislocated societies: Beyond “acceptance” and towards soul-making in non-dual awareness

    OpenAIRE

    Rabi, Shahar

    2016-01-01

    This dissertation is an attempt to think more broadly and deeply about the phenomenology of addiction in dislocated societies. It introduces integral philosophy and its approaches to recovery by bringing awareness to what needs to be addressed and added to acceptance based aftercare programs and curriculum development. Based on the proposed philosophical exploration, this dissertation examines and expands the term ‘psychological flexibility’ to include psychocultural diversity and psychosocia...

  13. 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...

  14. 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...

  15. A randomized clinical trial of home-based telepsychiatric outpatient care via videoconferencing: design, methodology, and implementation

    Directory of Open Access Journals (Sweden)

    Ines Hungerbuehler

    2015-06-01

    Full Text Available Background Healthcare providers are continuously challenged to find innovative, cost-effective alternatives and to scale up existent services to meet the growing demand upon mental health care delivery. Due to continuous advances in technologies, telepsychiatry has become an effective tool for psychiatric care. In 2012, the Institute of Psychiatry of the University of São Paulo Medical School started a randomized clinical trial of home-based telepsychiatric outpatient care via videoconferencing. Objective The objective of this article is to describe the design, methodology and implementation of a pilot project, which aimed to verify the applicability and efficiency of psychiatric attendance via Internet-based videoconferencing in a resource-constrained environment. Methods The project consisted of a 12 months follow-up study with a randomized clinical trial, which compared various quality indicators between home-based telepsychiatric aftercare via videoconferencing and face-to-face aftercare. Results The final sample comprised 107 outpatients (53 in the telepsychiatry group and 54 in the control group. Among 1,227 realized consultations, 489 were held by videoconferencing. Satisfaction with the aftercare by videoconferencing and the medication delivery was high among patients. Attending psychiatrists were satisfied with the assistance by videoconferencing. Discussion The experiences during this pilot project have overall been very positive and psychiatric outpatient care by videoconferencing seems viable to treat patients even in a resource-constrained environment.

  16. 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.

  17. 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

  18. 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.

  19. 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

  20. 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...

  1. 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

  2. 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...

  3. 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.

  4. Utilization of outpatient mental health services after inpatient alcoholism treatment.

    Science.gov (United States)

    Booth, B M; Cook, C A; Blow, F C; Bunn, J Y

    1992-01-01

    It is generally agreed that use of aftercare services following discharge from alcoholism treatment is optimum for patients to achieve long-term recovery. However, the quantity and duration of utilization of such services in non-experimental settings are generally unknown. Using secondary data sources, we studied 5,635 alcoholics completing formal extended inpatient treatment and 1,860 alcoholics discharged from brief inpatient hospitalizations in Department of Veterans Affairs medical centers. Weekly use of outpatient mental health services (OPMH) prior to hospital admission was equally low for both patient groups (approximately 2-3% of patients) until four weeks prior to admission, at which time OPMH use increased, particularly for the extended treatment group. In the four weeks after discharge, use of OPMH services was substantially higher for patients with extended treatment compared to those with brief hospitalizations (40% vs. 18%), with 22% of patients completing treatment utilizing such services in the first week after discharge. Utilization steadily decreased until only 8% and 4% of both groups, respectively, were using OPMH services at the end of six months after discharge. Study results suggest the need to examine barriers to outpatient mental health utilization after discharge as well as interventions to increase compliance with long-term aftercare.

  5. A designated centre for people with disabilities operated by Muiriosa Foundation, Kildare

    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.

  6. 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.

  7. 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

  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

    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

  9. 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.)

  10. [Cardiac rehabilitation in Germany: a successful model with promising prospects].

    Science.gov (United States)

    Korsukéwitz, C; Falk, J; Lindow, B

    2012-02-01

    Over the past 20 years the German Pension Insurance has rehabilitated nearly 800,000 patients with coronary heart disease. In particular, phase-II rehabilitation has been established as an integral part of cardiac patient care. However, the decreasing number of participants in phase-III must be seen critically. Today's cardiac rehabilitation is characterised by evidence-based treatment modules and a sophisticated quality assurance system that ensures quality orientation in all aspects, from access to rehabilitation through to aftercare. Future developments such as vocationally-oriented medical rehabilitation and the use of new technologies will further improve cardiac rehabilitation. Positive patient feedback and scientific evidence of the effectiveness of cardiac rehabilitation are further incentives to maintain this forward-looking approach. PMID:22190191

  11. 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

  12. SSUES OF THE CARE OF PATIENTS WITH SYNDROM OF DEMENTIA

    Directory of Open Access Journals (Sweden)

    Jedlinská Martina

    2013-12-01

    Full Text Available This article aims to acquaint the reader with the characteristics and problems of care for patients with dementia and options selected inpatient care for these patients in the Pardubice region. The theoretical part provides an overview of the issue of care for patients with dementia or dementia. The empirical part focuses on the description of selected characteristics of clients in the health-care facility, which is an example of good practice care for the elderly. In these age group is the greatest prevalence of dementia and syndrom of dementia as diagnosed disease. The discussion paper presents a reflection on the possible reasons for placing these clients in various types of inpatient facilities after discharge from aftercare and the circumstances of care for these clients.

  13. Health care transition in Germany – standardization of procedures and improvement actions

    Directory of Open Access Journals (Sweden)

    Pieper C

    2011-07-01

    Full Text Available Claudia Pieper, Izabela KolankowskaInstitute for Medical Informatics, Biometry and Epidemiology, University Hospital of Essen, Essen, North Rhine-Westphalia, GermanyAbstract: Previous studies have assessed an increase in the number of people in need and emphasized the advantages of structured discharge management and health care transition. Therefore, our study evaluated the status quo of transition in a major German city after standardization of procedures and implementation of standard forms. Satisfaction with handling of standard forms and improvement of procedures was evaluated. Additionally, patients who had recently been hospitalized were asked about the hospital discharge process. The results show that the recent efforts of standardization helped to improve interface management for health care workers and patients and showed further improvement options.Keywords: hospital discharge process, standard forms, long-term care, aftercare

  14. Rituximab for subcutaneous delivery: Clinical management principles from a nursing perspective.

    Science.gov (United States)

    Carlson, Julia; Cox, Keith; Bedwell, Kylie; Ku, Mathew

    2015-12-01

    Nurses play an integral role in administering treatments to patients with non-Hodgkin's lymphomas. Intravenous (IV) rituximab was approved by the Australian Therapeutic Goods Administration in 1998, and a novel subcutaneous (SC) formulation was approved in 2014. Fixed-dose SC rituximab is highly concentrated; co-formulation with a fully human recombinant vorhyaluronidase alfa enzyme helps overcome the physiological barriers of the SC space, facilitating drug dispersion. Despite a different pharmacokinetic profile to the IV preparation, SC rituximab demonstrates a comparable efficacy/safety profile. Most frequently occurring rituximab-related adverse events include neutropenia, nausea and constipation, and administration-related reactions are more frequent with the SC preparation. Compared with IV, SC delivery reduces treatment times and nurse workload, and patients report greater comfort and convenience. This article sets out nursing considerations for optimal administration of SC rituximab, including premedication, drug handling/preparation, injection technique, after-care and management of adverse events, particularly administration-related reactions.

  15. Bringing Innovation to the Health Care Sector

    DEFF Research Database (Denmark)

    Günzel, Franziska; Tomcyzk, David

    One of the growing trends for healthcare is the rate of innovation. Telestroke, a cost- effective, new innovation, is one of those innovations but its implementation in Germany is hampered due to a lack of long-term financial support. Currently, the parties involved in the investment are not the ......One of the growing trends for healthcare is the rate of innovation. Telestroke, a cost- effective, new innovation, is one of those innovations but its implementation in Germany is hampered due to a lack of long-term financial support. Currently, the parties involved in the investment...... are not the parties that save money in the aftercare process. Using a Stackelberg model, this paper introduces an alternative model for determining how much each participant contributes to the cost of implementing the innovation using a value-based, rather than cost-based, decision- making process. We conclude...

  16. 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.

  17. [Dutch Preventive Youth Health Care Service guideline on children born too early and/or too small for gestational age].

    Science.gov (United States)

    van der Pal, Sylvia M; Heerdink, Nen; Kamphuis, Mascha; Pols, Margreet A

    2014-01-01

    In children who are born prematurely or whose birth weight is too low for gestational age (small for gestational age (SGA)) intensive care and follow up are desirable.However, obstacles include the shared care of children born very preterm (care service (and other professionals) and the identification of possible late onset health problems in children born late preterm (32-37 weeks of gestation). This guideline is multidisciplinary and evidence based and is relevant to all professionals involved in the care of this group of children. The main recommendations are: (a) timely and complete transfer of information after discharge from hospital; (b) structured exchange of information in aftercare; (c) assigning a case manager to each child; (d) monitoring growth and development by adjusting age for preterm birth, and (e) using special growth charts for children born preterm to evaluate growth and development.

  18. An empirical description of phases of maintenance following treatment for alcohol dependence.

    Science.gov (United States)

    Murphy, S A; Hoffman, A L

    1993-01-01

    This article reports two longitudinal prospective studies conducted sequentially to describe participants' maintenance of abstinence experiences up to 36 months posttreatment. Study 1 reports responses of 102 subjects who maintained alcohol abstinence following treatment and who were assessed for duration and intensity of symptoms associated with postacute withdrawal at baseline, 3, 6, and 12 months. A decreasing linear trend of symptoms was found as time of alcohol abstinence increased. Study 2 obtained interview and survey data from 23 successful abstainers from Study 1 at 12, 18, and 36 months posttreatment to describe coping strategies, perceptions of relapse risk, extent and duration of "aftercare," and substitute addictions as these phenomena developed and changed over time. Multiple occasions of data collection supported the description of three phases of maintenance: symptom stabilization/management accompanied by a cognitive paradigm shift, distancing self from alcohol-dependent behavior, and normalization of life processes.

  19. A social work contribution to suicide prevention through assertive brief psychotherapy and community linkage: use of the Manchester Short Assessment of Quality of Life (MANSA).

    Science.gov (United States)

    Petrakis, Melissa; Joubert, Lynette

    2013-01-01

    There is a striking absence of literature articulating and evaluating clinical social work contributions to suicide prevention, despite considerable practice in this important field. This article reports on a model of assertive brief psychotherapeutic intervention and facilitated linkage to community services utilized in a prospective cohort study of emergency department suicide attempt aftercare. A key outcome measure, the Manchester Short Assessment of Quality of Life (MANSA), was used with 65 patients to assess psychosocial domains at initial presentation, 4-weeks, 3-months, and 6-months. There were significant improvements in the domains of work, finance, leisure, social life, living situation, personal safety and health by 3 months. There were highly significant correlations between psychosocial improvements and improved depression scores.

  20. 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.

  1. 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.

  2. 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.

  3. 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

  4. A comparison of four telephone-based counseling styles for recovering stimulant users.

    Science.gov (United States)

    Farabee, David; Cousins, Sarah J; Brecht, Mary-Lynn; Antonini, Valerie P; Lee, Anne B; Brummer, Julie; Hemberg, Jordana; Karno, Mitchell; Rawson, Richard A

    2013-03-01

    The continuing development and refinement of empirically supported interventions to increase participation in posttreatment care and promote sustained abstinence from illicit drug use is a priority for the addictions field. The purpose of this study was to assess the combined and relative effectiveness of four types of counseling styles, delivered by telephone, relative to a no call control condition. Stimulant users (N = 302) were randomized to one of four low-cost, telephone support protocols (unstructured/nondirective, unstructured/directive, structured/nondirective, structured/directive) or a standard referral to aftercare without telephone counseling (control). All of the study participants were nearing the completion of (or had completed) an intensive phase of structured, outpatient stimulant abuse treatment. Drug use and aftercare participation were assessed at 3 and 12 months following randomization. Intent-to-treat analyses showed no significant time-by-group interactions for these primary outcomes. Subsequent analyses, however, revealed a significant difference between the aggregated call groups and the control group at the time of the 3-month follow-up. The mean ASI drug use severity composite score for subjects in the call conditions declining from .058 at baseline to .048 at 3 months, whereas the no call/control group average score increased from .053 to .062 (χ (1) = 4.95, p = .026). A similar-and slightly stronger-effect was found when the study sample was restricted to those reporting any use during the month prior to the baseline interview (n = 152). This study provides modest support for the telephone-based counseling approaches strategies examined in this project. Subsequent research will assess interactions between patient characteristics and counseling styles, and improved identification of which treatment graduates might be more likely to benefit from this type of continuing support. (PsycINFO Database Record (c) 2013 APA, all rights reserved).

  5. Holistic assessment of a landfill mining pilot project in Austria: Methodology and application.

    Science.gov (United States)

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

    2016-07-01

    Basic technical and economic examinations of Austrian mass waste landfills, concerning the recovery of secondary raw materials, have been carried out by the 'LAMIS - Landfill Mining Austria' pilot project for the first time in Austria. A main focus of the research - the subject of this article - was the first devotion of a pilot landfill to an integrated ecological and economic assessment so that its feasibility could be verified before a landfill mining project commenced. A Styrian mass waste landfill had been chosen for this purpose that had been put into operation in 1979 and received mechanically-biologically pre-treated municipal waste till 2012. The whole assessment procedure was divided into preliminary and main assessment phases to evaluate the general suitability of a landfill mining project with little financial and human resource expense. A portfolio chart, based on a questionnaire, was created for the preliminary assessment that, as a result, has provided a recommendation for subsequent investigation - the main assessment phase. In this case, specific economic criteria were assessed by net present value calculation, while ecological or socio-economic criteria were rated by utility analysis, transferring the result into a utility-net present value chart. In the case of the examined pilot landfill, assessing the landfill mining project produced a higher utility but a lower net present value than a landfill leaving-in for aftercare. Since no clearly preferable scenario could be identified this way, a cost-revenue analysis was carried out in addition that determined a dimensionless ratio: the 'utility - net present value quotient' of both scenarios. Comparing this quotient showed unmistakably that in the overall assessment, 'leaving the landfill in aftercare' was preferable to a 'landfill mining project' in that specific case. PMID:27170192

  6. Use and Appreciation of a Tailored Self-Management eHealth Intervention for Early Cancer Survivors: Process Evaluation of a Randomized Controlled Trial

    Science.gov (United States)

    Willems, Roy A; Bolman, Catherine A W; Mesters, Ilse; Zambon, Victor; Gijsen, Brigitte CM; Lechner, Lilian

    2016-01-01

    Background A fully automated computer-tailored Web-based self-management intervention, Kanker Nazorg Wijzer (KNW [Cancer Aftercare Guide]), was developed to support early cancer survivors to adequately cope with psychosocial complaints and to promote a healthy lifestyle. The KNW self-management training modules target the following topics: return to work, fatigue, anxiety and depression, relationships, physical activity, diet, and smoking cessation. Participants were guided to relevant modules by personalized module referral advice that was based on participants’ current complaints and identified needs. Objective The aim of this study was to evaluate the adherence to the module referral advice, examine the KNW module use and its predictors, and describe the appreciation of the KNW and its predictors. Additionally, we explored predictors of personal relevance. Methods From the respondents (N=231; mean age 55.6, SD 11.5; 79.2% female [183/231]), 98.3% (227/231) were referred to one or more KNW modules (mean 2.9, SD 1.5), and 85.7% (198/231) of participants visited at least one module (mean 2.1, SD 1.6). Significant positive associations were found between the referral to specific modules (range 1-7) and the use of corresponding modules. The likelihoods of visiting modules were higher when respondents were referred to those modules by the module referral advice. Predictors of visiting a higher number of modules were a higher number of referrals by the module referral advice (β=.136, P=.009), and having a partner was significantly related with a lower number of modules used (β=-.256, P=.044). Overall appreciation was high (mean 7.5, SD 1.2; scale 1-10) and was significantly predicted by a higher perceived personal relevance (β=.623, P=.000). None of the demographic and cancer-related characteristics significantly predicted the perceived personal relevance. Results The KNW in general and more specifically the KNW modules were well used and highly appreciated by

  7. 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

  8. 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

  9. 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

  10. 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

  11. Elevated bladder cancer risk due to colorants--a statewide case-control study in North Rhine-Westphalia, Germany.

    Science.gov (United States)

    Golka, Klaus; Heitmann, Peter; Gieseler, Frank; Hodzic, Jasmin; Masche, Nicolas; Bolt, Hermann M; Geller, Frank

    2008-01-01

    Occupational exposure to aromatic amines is a known bladder cancer risk factor, whereas the impact of exposure to azo dyes, which may release aromatic amines in humans, is at present controversial. Therefore, the impact of occupational exposures to colorants was investigated in 156 bladder cancer cases and 336 controls in the state of North Rhine-Westphalia. All bladder cancer cases and controls (diagnosed with prostate cancer) requested after-care treatment. The subjects were investigated using a questionnaire for all occupations ever performed for more than 6 mo and for exposures to several possible occupational and nonoccupational bladder carcinogens. The relative bladder cancer risk was adjusted for age and smoking. The adjusted odds ratio (OR) for bladder cancer was elevated in 7 painters (OR 1.98, 95% CI 0.64-6.11), 4 hairdressers (OR 4.9, 95% CI 0.85-28.39), and 16 cases who reported a wood processing occupation (OR 1.19, 95% CI 0.58-2.41). Ten of these 16 cases reported chronic exposure to colorants (OR 1.84, 95% CI 0.68-4.95). The results of this epidemiological study confirm the hypothesis that individuals exposed to colorants show an elevated bladder cancer risk.

  12. 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

  13. Use of dialectical behavior therapy in a partial hospital program for women with borderline personality disorder.

    Science.gov (United States)

    Simpson, E B; Pistorello, J; Begin, A; Costello, E; Levinson, J; Mulberry, S; Pearlstein, T; Rosen, K; Stevens, M

    1998-05-01

    Dialectical behavior therapy, an outpatient psychosocial treatment for chronically suicidal women with borderline personality disorder, has been adapted for use in a partial hospital program for women. Patients attend the program for a minimum of five days of individual and group therapy, and full census is 12 women. About 65 percent of participants meet at least three criteria for borderline personality disorder, and most have suicidal and self-injurious behavior. Their comorbid diagnoses include trauma-related diagnoses and anxiety disorders, severe eating disorders, substance abuse, and depression. The partial hospital program is linked to an aftercare program offering six months of outpatient skills training based on dialectical behavior therapy. Both programs focus on teaching patients four skills: mindfulness (attention to one's experience), interpersonal effectiveness, emotional regulation, and distress tolerance. Two years of operation of the women's partial hospital program provides promising anecdotal evidence that dialectical behavioral therapy, an outpatient approach, can be effectively modified for partial hospital settings and a more diverse population.

  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. 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

  16. 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.

  17. 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

  18. 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.

  19. 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.

  20. 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

  1. [Assumption of medical risks and the problem of medical liability in ancient Roman law].

    Science.gov (United States)

    Váradi, Agnes

    2008-11-01

    The claim of an individual to assure his health and life, to assume and compensate the damage from diseases and accidents, had already appeared in the system of the ancient Roman law in the form of many singular legal institutions. In lack of a unified archetype of regulation, we have to analyse the damages caused in the health or corporal integrity of different personal groups: we have to mention the legal interpretation of the diseases or injuries suffered by serves, people under manus or patria potestas and free Roman citizens. The fragments from the Digest od Justinian do not only demonstrate concrete legal problems, but they can serve as a starting point for further theoretical analyses. For example: if death is the consequence of a medical failure, does the doctor have any kind of liability? Was after-care part of the healing process according to the Roman law? Examining these questions, we should not forget to talk about the complex liability system of the Roman law, the compensation of the damages caused in a contractual or delictual context and about the lex Aquilia. Although these conclusions have no direct relation with the present legal regulation of risk assumption, we have to see that analysing the examples of the Roman law can be useful for developing our view of a certain theoretical problem, like that of the modern liability concept in medicine as well.

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

    Energy Technology Data Exchange (ETDEWEB)

    Fischer, M.; Gruenwald, F.; Knapp, W.H. [Deutsche Gesellschaft fuer Nuklearmedizin, Kassel (Germany); Truemper, L.; Schilling, C. v.; Dreyling, M. [Deutsche Gesellschaft fuer Haematologie und Onkologie, Kassel (Germany)

    2009-07-01

    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. 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.)

  4. Follow-up after treatment for breast cancer

    Science.gov (United States)

    Sisler, Jeffrey; Chaput, Genevieve; Sussman, Jonathan; Ozokwelu, Emmanuel

    2016-01-01

    Objective To offer FPs a summary of evidence-based recommendations to guide their follow-up survivorship care of women treated for breast cancer. Quality of evidence A literature search was conducted in MEDLINE from 2000 to 2016 using the search words breast cancer, survivorship, follow-up care, aftercare, guidelines, and survivorship care plans, with a focus on review of recent guidelines published by national cancer organizations. Evidence ranges from level I to level III. Main message Survivorship care involves 4 main tasks: surveillance and screening, management of long-term effects, health promotion, and care coordination. Surveillance for recurrence involves only annual mammography, and screening for other cancers should be done according to population guidelines. Management of the long-term effects of cancer and its treatment addresses common issues of pain, fatigue, lymphedema, distress, and medication side effects, as well as longer-term concerns for cardiac and bone health. Health promotion emphasizes the benefits of active lifestyle change in cancer survivors, with an emphasis on physical activity. Survivorship care is enhanced by the involvement of various health professionals and services, and FPs play an important role in care coordination. Conclusion Family physicians are increasingly the main providers of follow-up care after breast cancer treatment. Breast cancer should be viewed as a chronic medical condition even in women who remain disease free, and patients benefit from the approach afforded other chronic conditions in primary care. PMID:27737976

  5. Prospective associations between brain activation to cocaine and no-go cues and cocaine relapse*

    Science.gov (United States)

    Prisciandaro, James J.; Myrick, Hugh; Henderson, Scott; McRae-Clark, Aimee L.; Brady, Kathleen T.

    2013-01-01

    Background The ability to predict potential for relapse to substance use following treatment could be very useful in targeting aftercare strategies. Recently, a number of investigators have focused on using neural activity measured by fMRI to predict relapse propensity. The purpose of the present study was to use fMRI to investigate prospective associations between brain reactivity to cocaine and response inhibition cues and relapse to cocaine use. Methods Thirty cocaine-dependent participants with clean cocaine urine drug screens (UDS) completed a baseline fMRI scan, including a cocaine-cue reactivity task and a go/no-go response inhibition task. After participating in a brief clinical trial of D-cycloserine for the facilitation of cocaine cue extinction, they returned for a one-week follow-up UDS. Associations between baseline activation to cocaine and inhibition cues and relapse to cocaine use were explored. Results Positive cocaine UDS was significantly associated with cocaine cue activation in the right putamen and insula, as well as bilateral occipital regions. Associations between positive cocaine UDS and activation to no-go cues were concentrated in the postcentral gyri, a region involved in response execution. Conclusions Although preliminary, these results suggest that brain imaging may be a useful tool for predicting risk for relapse in cocaine-dependent individuals. Further, larger-scale naturalistic studies are needed to corroborate and extend these findings. PMID:23683790

  6. [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.

  7. 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

  8. Recent data on the radon problem in Umhausen/Tyrolia; Neuere Daten zum Radonproblem in Umhausen/Tirol

    Energy Technology Data Exchange (ETDEWEB)

    Ennemoser, O. [Innsbruck Univ. (Austria). Inst. fuer Medizinische Physik; Ambach, W. [Innsbruck Univ. (Austria). Inst. fuer Medizinische Physik; Auer, T. [Innsbruck Univ. (Austria). Inst. fuer Medizinische Physik; Brunner, P. [Innsbruck Univ. (Austria). Versuchsstelle fuer Strahlenschutz und Kerntechnik; Schneider, P. [Innsbruck Univ. (Austria). Versuchsstelle fuer Strahlenschutz und Kerntechnik; Oberaigner, W. [Nachsorgeregister Tirol, Innsbruck (Austria); Purtscheller, F. [Innsbruck Univ. (Austria). Inst. fuer Mineralogie; Stingl, V. [Innsbruck Univ. (Austria). Inst. fuer Geologie

    1995-12-31

    In the village of Umhausen/Tyrolia (approx. 2.600 inhabitants), the annual dose commitment of the population was determined from the annual mean radon concentrations measured at the first floor in 328 houses. From the median annual values of radon concentrations, the relative lung cancer lifetime risk was calculated in compliance with ICRP 50. Data obtained from an oncological aftercare documentation established for Tyrolia were used for determining the sex and age-related, standardized lung cancer mortality rate, and for comparison with the data obtained in the village. The sex and age-related lung cancer mortality rates and the relative lung cancer lifetime risks derived for the two areas are of the same order of magnitude (according to CRP 50). (orig./HP) [Deutsch] Zur Berechnung der jaehrlichen Exposition wurden die Jahresmittelwerte der Radonkonzentration fuer 328 Haeuser im Erdgeschoss in der Gemeinde Umhausen/Tirol (circa 2.600 Einwohner) ermittelt. Fuer die medianen Jahresmittelwerte der Radonkonzentration wurde das relative Lungenkrebs-Lebenszeit-Risiko nach ICRP 50 berechnet. Zum Vergleich wurde aus Daten des Nachsorgeregisters Tirol die geschlechts- und altersstandardisierte Lungenkrebs-Sterblichkeitsrate erhoben. Fuer beide Gebiete liegen die beobachtete geschlechts- und altersstandardisierte Lungenkrebs-Sterblichkeitsrate und das relative Lungenkrebs-Lebenszeit-Risiko in der gleichen Groessenordnung (nach ICRP 50). (orig./HP)

  9. Substance use treatment barriers for patients with frequent hospital admissions.

    Science.gov (United States)

    Raven, Maria C; Carrier, Emily R; Lee, Joshua; Billings, John C; Marr, Mollie; Gourevitch, Marc N

    2010-01-01

    Substance use (SU) disorders adversely impact health status and contribute to inappropriate health services use. This qualitative study sought to determine SU-related factors contributing to repeated hospitalizations and to identify opportunities for preventive interventions. Fifty Medicaid-insured inpatients identified by a validated statistical algorithm as being at high-risk for frequent hospitalizations were interviewed at an urban public hospital. Patient drug/alcohol history, experiences with medical, psychiatric and addiction treatment, and social factors contributing to readmission were evaluated. Three themes related to SU and frequent hospitalizations emerged: (a) barriers during hospitalization to planning long-term treatment and follow-up, (b) use of the hospital as a temporary solution to housing/family problems, and (c) unsuccessful SU aftercare following discharge. These data indicate that homelessness, brief lengths of stay complicating discharge planning, patient ambivalence regarding long-term treatment, and inadequate detox-to-rehab transfer resources compromise substance-using patients' likelihood of avoiding repeat hospitalization. Intervention targets included supportive housing, detox-to-rehab transportation, and postdischarge patient support.

  10. 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

  11. [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

  12. 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)

  13. 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)

  14. 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

    2016-06-15

    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.

  15. 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

  16. 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

  17. 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

  18. [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  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.

  19. Filmless versus film-based systems in radiographic examination costs: an activity-based costing method

    Directory of Open Access Journals (Sweden)

    Sase Yuji

    2011-09-01

    Full Text Available Abstract Background Since the shift from a radiographic film-based system to that of a filmless system, the change in radiographic examination costs and costs structure have been undetermined. The activity-based costing (ABC method measures the cost and performance of activities, resources, and cost objects. The purpose of this study is to identify the cost structure of a radiographic examination comparing a filmless system to that of a film-based system using the ABC method. Methods We calculated the costs of radiographic examinations for both a filmless and a film-based system, and assessed the costs or cost components by simulating radiographic examinations in a health clinic. The cost objects of the radiographic examinations included lumbar (six views, knee (three views, wrist (two views, and other. Indirect costs were allocated to cost objects using the ABC method. Results The costs of a radiographic examination using a filmless system are as follows: lumbar 2,085 yen; knee 1,599 yen; wrist 1,165 yen; and other 1,641 yen. The costs for a film-based system are: lumbar 3,407 yen; knee 2,257 yen; wrist 1,602 yen; and other 2,521 yen. The primary activities were "calling patient," "explanation of scan," "take photographs," and "aftercare" for both filmless and film-based systems. The cost of these activities cost represented 36.0% of the total cost for a filmless system and 23.6% of a film-based system. Conclusions The costs of radiographic examinations using a filmless system and a film-based system were calculated using the ABC method. Our results provide clear evidence that the filmless system is more effective than the film-based system in providing greater value services directly to patients.

  20. 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

  1. 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.)

  2. 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.)

  3. 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

  4. 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

  5. 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

  6. 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。

  7. 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.

  8. 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.

  9. Appropriate interventions for the prevention and management of self-harm: a qualitative exploration of service-users' views

    Directory of Open Access Journals (Sweden)

    Platt Stephen

    2007-01-01

    Full Text Available Abstract Background The engagement of service-users in exploring appropriate interventions for self-harm has been relatively neglected in comparison with clinical studies focusing on the management and prevention of self-harm. The purpose of this study was to investigate perceptions of interventions for self-harm (formal and informal, prevention and treatment among people who have first-hand experience as a result of their own behaviour. Methods Semi-structured interviews were undertaken with 14 patients admitted to hospital following a repeat act of self-harm. Data analysis was undertaken thematically, drawing broadly on some of the principles and techniques of grounded theory Results The patients were a heterogeneous group with respect to their personal characteristics and the nature of their self-harm. Thirteen of the 14 patient accounts could be assigned to one or more of three overlapping experiential themes: the experience of psychiatric illness, the experience of alcohol dependency, and the experience of traumatic life events and chronic life problems. These themes were related to the nature of patients' self-harm and their experiences of, and attitudes towards, interventions for self-harm and their attitudes towards these. There was a clear preference for specialist community-based interventions, which focus on the provision of immediate aftercare and acknowledge that the management of self-harm may not necessarily involve its prevention. The findings generate the preliminary hypothesis that personal circumstances and life history are major influences on the choice of interventions for self-harm. Conclusion This study attests to the importance of recognising differences within the self-harming population, and acknowledging patients' personal circumstances and life history. These may provide clues to the antecedents of their self-harm, and lead to more acceptable and appropriate treatments.

  10. 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.

  11. 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

  12. Suicide attempt in young people: A signal for long-term healthcare and social needs

    Science.gov (United States)

    Goldman-Mellor, Sidra J.; Caspi, Avshalom; Harrington, HonaLee; Hogan, Sean; Nada-Raja, Shyamala; Poulton, Richie; Moffitt, Terrie E.

    2013-01-01

    recession, additional suicide prevention efforts and long-term monitoring and after-care services are needed. PMID:24306041

  13. 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

  14. 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

  15. A pan-European study of capabilities to manage mass casualties from the release of chemical agents: the MASH project.

    Science.gov (United States)

    Baker, David J; Murray, Virginia S G; Carli, Pierre A

    2013-01-01

    The European Union (EU) Mass Casualties and Health (MASH) project that ran between 2008 and 2010 was designed to study the management of mass casualties from chemical and radiological releases and associated health implications. One area of study for this project concerned arrangements within EU Member States for the management of mass casualties following a chemical release. This was undertaken via a confidential online questionnaire that was sent to selected points of contact throughout the EU. Responses were obtained from 18 states from respondents holding senior positions in chemical planning and incident response. Information gathered shows a lack of uniformity within the EU about the organization of responses to chemical releases and the provision of medical care. This article presents the overall findings of the study demonstrating differences between countries on planning and organization, decontamination, prehospital emergency medical responses, clinical diagnoses, and therapy and aftercare. Although there may be an understandable reluctance from national respondents to share information on security and other grounds, the findings, nevertheless, revealed substantial differences between current planning and operational responses within the EU states for the management of mass chemical casualties. The existing international networks for response to radiation incidents are not yet matched by equivalent networks for chemical responses yet sufficient information was available from the study to identify potential deficiencies, identify common casualty management pathways, and to make recommendations for future operations within the EU. Improvements in awareness and training and the application of modern information and communications will help to remedy this situation. Specialized advanced life support and other medical care for chemical casualties appear lacking in some countries. A program of specialized training and action are required to apply the findings

  16. 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

  17. [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

  18. 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.

  19. Experience in the Treatment of Pernicious Placenta Previa%凶险性前置胎盘的治疗体会

    Institute of Scientific and Technical Information of China (English)

    石淑颖

    2016-01-01

    Objective To explore treatment methods and the clinical effect of the pernicious placenta previa patients, to improve and perfect measures of placenta previa.Methods 10 cases of placenta previa patients were selected from our hospital, the pernicious placenta previa patients were treated from Prepare the preoperative, intraoperative and postoperative care.Results There were 8 cases of patients with placenta implantation in 10 cases of placenta previa patients, 6 cases occurred postoperative bleeding, 2 cases treated with topical hemostatic suture hemostasis, retained the uterus, the other 4 cases were Bleeding shock, treated with performing a hysterectomy and aftercare back to normal.Conclusion The risk of dangerous placenta previa is great, should strength the medical staff awareness, rational preoperative assessment, timely effective hemostasis and postoperative effective nursing may give a timely and effective treatment for patients with pernicious placenta previa.%目的探讨凶险性前置胎盘的治疗方法及临床效果,提高并完善凶险性前置胎盘的应对措施。方法对我院接收的10例凶险性前置胎盘患者进行分析,从术前准备、术中处理和术后护理三方面对凶险性前置胎盘患者进行干预。结果10例凶险性前置胎盘患者中8例伴有胎盘植入,其中6例患者在术后发生大出血,2例通过局部缝扎止血成功止血,保留住子宫,其他4例出现大失血休克,通过子宫切除手术和后期护理恢复正常。结论凶险性前置胎盘危险性极大,要加强医务人员的重视程度,术前的整体合理评估、术中及时有效止血和术后有效护理可以对凶险性前置胎盘患者予以及时、有效救治。

  20. 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

  1. 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.

  2. 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

  3. 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

  4. 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

  5. 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

  6. 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

  7. Comparison of FDG-PET/CT and bone scintigraphy for detection of bone metastases in breast cancer

    Energy Technology Data Exchange (ETDEWEB)

    Hahn, Steffen; Heusner, Till; Forsting, Michael; Antoch, Gerald (Dept. of Diagnostic and Interventional Radiology and Neuroradiology, Univ. Hospital Essen, Univ. Duisburg-Essen, Essen (Germany)), email: steffen.hahn@uk-essen.de; Kuemmel, Sherko; Koeninger, Angelika (Dept. of Gynecology and Obstetrics, Univ. Hospital Essen, Univ. Duisburg-Essen, Essen (Germany)); Nagarajah, James; Mueller, Stefan; Boy, Christian; Bockisch, Andreas; Stahl, Alexander (Dept. of Nuclear Medicine, Univ. Hospital Essen, Univ. Duisburg-Essen, Essen (Germany))

    2011-11-15

    Background Bone scintigraphy is the standard procedure for the detection of bone metastases in breast cancer patients. FDG-PET/CT has been reported to be a sensitive tool for tumor staging in different malignant diseases. However, its accuracy for the detection of bone metastases has not been compared to bone scintigraphy. Purpose To compare whole-body FDG-PET/CT and bone scintigraphy for the detection of bone metastases on a lesion basis in breast cancer patients. Material and Methods Twenty-nine consecutive women (mean age 58 years, range 35-78 years) with histologically proven breast cancer were assessed with bone scintigraphy and whole-body FDG-PET/CT. Twenty-one patients (72%) were suffering from primary breast cancer and eight patients (28%) were in aftercare with a history of advanced breast cancer. Both imaging procedures were assessed for bone metastases by a radiologist and a nuclear medicine physician. Concordant readings between bone scintigraphy and FDG-PET/CT were taken as true. Discordant readings were verified with additional MRI imaging in all patients and follow-up studies in most patients. Results A total of 132 lesions were detected on bone scintigraphy, FDG-PET/CT or both. According to the reference standard, 70/132 lesions (53%) were bone metastases, 59/132 lesions (45%) were benign, and three lesions (2%) remained unclear. The sensitivity of bone scintigraphy was 76% (53/70) compared to 96% (67/70) for FDG-PET/CT. The specificity of bone scintigraphy and FDG-PET/CT was 95% (56/59) and 92% (54/59), respectively. According to the reference standard bone metastases were present in eight out of the 29 patients (28%), whereas 20 patients (69%) were free of bone metastases. One (3%) patient had inconclusive readings on both modalities as well as on MRI and follow-up studies. Bone scintigraphy and FDG-PET/CT correctly identified seven out of eight patients with bone metastases and 20 out of 20 patients free of metastases. Conclusion On a lesion

  8. Systemic Case Formulation, Individualized Process Monitoring, and State Dynamics in a Case of Dissociative Identity Disorder

    Science.gov (United States)

    Schiepek, Günter K.; Stöger-Schmidinger, Barbara; Aichhorn, Wolfgang; Schöller, Helmut; Aas, Benjamin

    2016-01-01

    Objective: The aim of this case report is to demonstrate the feasibility of a systemic procedure (synergetic process management) including modeling of the idiographic psychological system and continuous high-frequency monitoring of change dynamics in a case of dissociative identity disorder. The psychotherapy was realized in a day treatment center with a female client diagnosed with borderline personality disorder (BPD) and dissociative identity disorder. Methods: A three hour long co-creative session at the beginning of the treatment period allowed for modeling the systemic network of the client's dynamics of cognitions, emotions, and behavior. The components (variables) of this idiographic system model (ISM) were used to create items for an individualized process questionnaire for the client. The questionnaire was administered daily through an internet-based monitoring tool (Synergetic Navigation System, SNS), to capture the client's individual change process continuously throughout the therapy and after-care period. The resulting time series were reflected by therapist and client in therapeutic feedback sessions. Results: For the client it was important to see how the personality states dominating her daily life were represented by her idiographic system model and how the transitions between each state could be explained and understood by the activating and inhibiting relations between the cognitive-emotional components of that system. Continuous monitoring of her cognitions, emotions, and behavior via SNS allowed for identification of important triggers, dynamic patterns, and psychological mechanisms behind seemingly erratic state fluctuations. These insights enabled a change in management of the dynamics and an intensified trauma-focused therapy. Conclusion: By making use of the systemic case formulation technique and subsequent daily online monitoring, client and therapist continuously refer to detailed visualizations of the mental and behavioral network and

  9. 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

  10. 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

  11. 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)

  12. Stable isotope signatures for characterising the biological stability of landfilled municipal solid waste

    Energy Technology Data Exchange (ETDEWEB)

    Wimmer, Bernhard, E-mail: bernhard.wimmer@ait.ac.at [AIT Austrian Institute of Technology GmbH, Health and Environment Department, Environmental Resources and Technologies, Konrad-Lorenz-Strasse 24, 3430 Tulln (Austria); Hrad, Marlies; Huber-Humer, Marion [Institute of Waste Management, Department of Water-Atmosphere-Environment, University of Natural Resources and Life Sciences, Muthgasse 107, 1190 Vienna (Austria); Watzinger, Andrea; Wyhlidal, Stefan; Reichenauer, Thomas G. [AIT Austrian Institute of Technology GmbH, Health and Environment Department, Environmental Resources and Technologies, Konrad-Lorenz-Strasse 24, 3430 Tulln (Austria)

    2013-10-15

    Highlights: ► The isotopic signature of δ{sup 13}C-DIC of leachates is linked to the reactivity of MSW. ► Isotopic signatures of leachates depend on aerobic/anaerobic conditions in landfills. ► In situ aeration of landfills can be monitored by isotope analysis in leachate. ► The isotopic analysis of leachates can be used for assessing the stability of MSW. ► δ{sup 13}C-DIC of leachates helps to define the duration of landfill aftercare. - Abstract: Stable isotopic signatures of landfill leachates are influenced by processes within municipal solid waste (MSW) landfills mainly depending on the aerobic/anaerobic phase of the landfill. We investigated the isotopic signatures of δ{sup 13}C, δ{sup 2}H and δ{sup 18}O of different leachates from lab-scale experiments, lysimeter experiments and a landfill under in situ aeration. In the laboratory, columns filled with MSW of different age and reactivity were percolated under aerobic and anaerobic conditions. In landfill simulation reactors, waste of a 25 year old landfill was kept under aerobic and anaerobic conditions. The lysimeter facility was filled with mechanically shredded fresh waste. After starting of the methane production the waste in the lysimeter containments was aerated in situ. Leachate and gas composition were monitored continuously. In addition the seepage water of an old landfill was collected and analysed periodically before and during an in situ aeration. We found significant differences in the δ{sup 13}C-value of the dissolved inorganic carbon (δ{sup 13}C-DIC) of the leachate between aerobic and anaerobic waste material. During aerobic degradation, the signature of δ{sup 13}C-DIC was mainly dependent on the isotopic composition of the organic matter in the waste, resulting in a δ{sup 13}C-DIC of −20‰ to −25‰. The production of methane under anaerobic conditions caused an increase in δ{sup 13}C-DIC up to values of +10‰ and higher depending on the actual reactivity of the MSW

  13. 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

  14. 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

  15. 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