WorldWideScience

Sample records for canadian paediatric society

  1. Diagnosis and management of asthma in preschoolers: A Canadian Thoracic Society and Canadian Paediatric Society position paper.

    Science.gov (United States)

    Ducharme, Francine M; Dell, Sharon D; Radhakrishnan, Dhenduka; Grad, Roland M; Watson, Wade T A; Yang, Connie L; Zelman, Mitchell

    2015-01-01

    Asthma often starts before six years of age. However, there remains uncertainty as to when and how a preschool-age child with symptoms suggestive of asthma can be diagnosed with this condition. This delays treatment and contributes to both short- and long-term morbidity. Members of the Canadian Thoracic Society Asthma Clinical Assembly partnered with the Canadian Paediatric Society to develop a joint working group with the mandate to develop a position paper on the diagnosis and management of asthma in preschoolers. In the absence of lung function tests, the diagnosis of asthma should be considered in children one to five years of age with frequent (≥ 8 days/month) asthma-like symptoms or recurrent (≥ 2) exacerbations (episodes with asthma-like signs). The diagnosis requires the objective document of signs or convincing parent-reported symptoms of airflow obstruction (improvement in these signs or symptoms with asthma therapy), and no clinical suspicion of an alternative diagnosis. The characteristic feature of airflow obstruction is wheezing, commonly accompanied by difficulty breathing and cough. Reversibility with asthma medications is defined as direct observation of improvement with short-acting ß2-agonists (SABA) (with or without oral corticosteroids) by a trained health care practitioner during an acute exacerbation (preferred method). However, in children with no wheezing (or other signs of airflow obstruction) on presentation, reversibility may be determined by convincing parental report of a symptomatic response to a three-month therapeutic trial of a medium dose of inhaled corticosteroids with as-needed SABA (alternative method), or as-needed SABA alone (weaker alternative method). The authors provide key messages regarding in whom to consider the diagnosis, terms to be abandoned, when to refer to an asthma specialist and the initial management strategy. Finally, dissemination plans and priority areas for research are identified.

  2. Conference summaries. Canadian Nuclear Association 29. annual conference; Canadian Nuclear Society 10. annual conference

    International Nuclear Information System (INIS)

    Separate abstracts were prepared for 15 papers from the twenty-ninth Annual Conference of the Canadian Nuclear Association. Abstracts were also prepared for the 102 papers from the tenth Annual Conference of the Canadian Nuclear Society

  3. Paediatric radiation oncology in the care of childhood cancer: A position paper by the International Paediatric Radiation Oncology Society (PROS).

    Science.gov (United States)

    Kortmann, Rolf-Dieter; Freeman, Carolyn; Marcus, Karen; Claude, Line; Dieckmann, Karin; Halperin, Edward; Esiashvili, Natia; Paulino, Arnold; Mahajan, Anita; Seiersen, Klaus; Ahern, Verity; Ricardi, Umberto; Carrie, Christian

    2016-05-01

    Paediatric malignancies are a challenge for the radiation oncologist due to their rarity, the great variety of histological types, and the complexity of treatment concepts that evolve over time. The Paediatric Radiation Oncology Society (PROS) is the only internationally operating society for paediatric radiation oncology. The objectives of PROS are to set a world-wide standard of excellence with respect to radiation oncology aspects in curing children and adolescents with cancer, to provide a forum for communication between radiation oncologists, and to exchange information with all professionals involved in the management of paediatric and adolescent cancer. Challenges include the need to promote education and support practice in low and middle income countries (LMIC) as well as the cost and availability of modern treatment technologies for all but most especially these countries. Collaborations with other societies that include for example the education programmes provided jointly with ESTRO, and the upgraded technical platform of the PROS web site offer new possibilities to enhance the efficacy of PROS in education and support of paediatric radiation oncology practice world-wide. PROS has made an important contribution to the management of childhood malignancies over the past decade and new and developing collaborations between PROS and other societies or organizations will ultimately lead to a reduction in world-wide health care inequalities. PMID:27106553

  4. entering the postindustrial society: the canadian case

    OpenAIRE

    Matejko, Alexander J.

    1986-01-01

    abstract: the canadian federation is based on the substantial autonomy of the provinces constituting it, the welfare orientation of central bodies, the volunteer activities at the grass-root level, and the external policy open to the world. there are no any doubts about the genuinely democratic character of canadian internal politics or the commitment of canadians to the world peace. the economic prosperity of the country is secured by the mineral resources, good agriculture, and the intensiv...

  5. Proceedings of the Canadian Nuclear Society 15. annual conference

    International Nuclear Information System (INIS)

    The proceedings of the 15. annual conference of the Canadian Nuclear Society cover a wide range of nuclear topics, but the emphasis is on CANDU reactors and Canadian experience. The 89 papers are arranged in 17 sessions dealing with the following subjects: thermalhydraulics, fuel channels, operations, reactor physics, fuel, new technology, safety, training, waste management. The individual papers have been abstracted separately

  6. Proceedings of the Canadian Nuclear Society 12. annual conference

    International Nuclear Information System (INIS)

    This volume contains the Proceedings of the seventeen Technical Sessions from the Twelfth Annual Conference of the Canadian Nuclear Society held in Saskatoon, Saskatchewan, June 9 to 12, 1991. As in previous years, the Annual Conference of the Canadian Nuclear Society was held in conjunction with the Annual Conference of the Canadian Nuclear Association. The major topics of discussion included: reactor physics; thermal hydraulics; industrial irradiation; computer applications; fuel channel analysis; small reactors; severe accidents; fuel behaviour under accident conditions; reactor components; safety related computer software; nuclear fuel management; nuclear waste management; and, uranium mining processing

  7. Canadian Cardiovascular Society/Canadian Society of Cardiac Surgeons/Canadian Society for Vascular Surgery Joint Position Statement on Open and Endovascular Surgery for Thoracic Aortic Disease.

    Science.gov (United States)

    Appoo, Jehangir J; Bozinovski, John; Chu, Michael W A; El-Hamamsy, Ismail; Forbes, Thomas L; Moon, Michael; Ouzounian, Maral; Peterson, Mark D; Tittley, Jacques; Boodhwani, Munir

    2016-06-01

    In 2014, the Canadian Cardiovascular Society (CCS) published a position statement on the management of thoracic aortic disease addressing size thresholds for surgery, imaging modalities, medical therapy, and genetics. It did not address issues related to surgical intervention. This joint Position Statement on behalf of the CCS, Canadian Society of Cardiac Surgeons, and the Canadian Society for Vascular Surgery provides recommendations about thoracic aortic disease interventions, including: aortic valve repair, perfusion strategies for arch repair, extended arch hybrid reconstruction for acute type A dissection, endovascular management of arch and descending aortic aneurysms, and type B dissection. The position statement is constructed using Grading of Recommendations Assessment, Development and Evaluation (GRADE) methodology, and has been approved by the primary panel, an international secondary panel, and the CCS Guidelines Committee. Advent of endovascular technology has improved aortic surgery safety and extended the indications of minimally invasive thoracic aortic surgery. The combination of safer open surgery with endovascular treatment has improved patient outcomes in this rapidly evolving subspecialty field of cardiovascular surgery.

  8. Proceedings of the Canadian Nuclear Society sixth annual conference

    International Nuclear Information System (INIS)

    The proceedings of the Sixth Annual Conference of the Canadian Nuclear Society comprise 103 papers on the following subjects: fuel technology, nuclear plant safety, instrumentation, public and regulatory matters, fusion, fuel behaviour under normal and accident conditions, nuclear plant design and operations, thermal hydraulics, reactor physics, accelerators, waste management, new reactor concepts

  9. Proceedings of the seventeenth annual Canadian Nuclear Society conference

    International Nuclear Information System (INIS)

    The seventeenth annual conference of the Canadian Nuclear Society, presented in Fredericton, New Brunswick. The conference includes papers on general topics of interest on the nuclear community, waste management and the environment, instrumentation and design of Candu reactors, safety analysis, thermal hydraulics, fuel channels, plant operations and in-core instrumentation

  10. Home Mechanical Ventilation: A Canadian Thoracic Society Clinical Practice Guideline

    OpenAIRE

    McKim, Douglas A.; Jeremy Road; Monica Avendano; Steve Abdool; Fabien Côté; Nigel Duguid; Janet Fraser; François Maltais; Morrison, Debra L.; Colleen O’Connell; Petrof, Basil J.; Karen Rimmer; Robert Skomro; Canadian Thoracic Society Home Mechanical Ventilation Committee

    2011-01-01

    Increasing numbers of patients are surviving episodes of prolonged mechanical ventilation or benefitting from the recent availability of user-friendly noninvasive ventilators. Although many publications pertaining to specific aspects of home mechanical ventilation (HMV) exist, very few comprehensive guidelines that bring together all of the current literature on patients at risk for or using mechanical ventilatory support are available. The Canadian Thoracic Society HMV Guideline Committee ha...

  11. Treatment of respiratory syncytial virus bronchiolitis : 1995 poll of members of the European Society for Paediatric Infectious Diseases

    NARCIS (Netherlands)

    Kimpen, JLL; Schaad, UB

    1997-01-01

    Background. Among the lower respiratory tract infections during infancy requiring hospitalization, respiratory syncytial virus (RSV) bronchiolitis is the most frequent disease entity. Nevertheless treatment remains controversial. Methods. A poll among the European Society for Paediatric Infectious D

  12. Abstracts from the 32nd Annual Scientific Meeting of the Canadian Geriatrics Society Quebec City, April 2012

    OpenAIRE

    Morin, S.; Finch, L; Sara', A; Muir, Susan; Montero-Odasso, Manuel; Kennedy, C C; Giangregorio, L.M.; Adachi, J.D.; Morin, S. N.; Crilly, R.G.; Marr, S.; Josse, R G; Matta, J.; Dionne, I.; Payette, H

    2012-01-01

    The opinions expressed in the abstracts are those of the authors and are not to be construed as the opinion of the publisher (Canadian Geriatrics Society) or the organizers of the 32nd Annual Scientific Meeting of the Canadian Geriatrics Society. Although the publisher (Canadian Geriatrics Society) has made every effort to accurately reproduce the abstracts, the Canadian Geriatrics Society and the 32nd Annual Scientific Meeting of the Canadian Geriatrics Society assumes no responsibility and/...

  13. 2010 Canadian Cardiovascular Society/Canadian Society of Echocardiography Guidelines for Training and Maintenance of Competency in Adult Echocardiography.

    Science.gov (United States)

    Burwash, Ian G; Basmadjian, Arsene; Bewick, David; Choy, Jonathan B; Cujec, Bibiana; Jassal, Davinder S; MacKenzie, Scott; Nair, Parvathy; Rudski, Lawrence G; Yu, Eric; Tam, James W

    2011-01-01

    Guidelines for the provision of echocardiography in Canada were jointly developed and published by the Canadian Cardiovascular Society and the Canadian Society of Echocardiography in 2005. Since their publication, recognition of the importance of echocardiography to patient care has increased, along with the use of focused, point-of-care echocardiography by physicians of diverse clinical backgrounds and variable training. New guidelines for physician training and maintenance of competence in adult echocardiography were required to ensure that physicians providing either focused, point-of-care echocardiography or comprehensive echocardiography are appropriately trained and proficient in their use of echocardiography. In addition, revision of the guidelines was required to address technological advances and the desire to standardize echocardiography training across the country to facilitate the national recognition of a physician's expertise in echocardiography. This paper summarizes the new Guidelines for Physician Training and Maintenance of Competency in Adult Echocardiography, which are considerably more comprehensive than earlier guidelines and address many important issues not previously covered. These guidelines provide a blueprint for physician training despite different clinical backgrounds and help standardize physician training and training programs across the country. Adherence to the guidelines will ensure that physicians providing echocardiography have acquired sufficient expertise required for their specific practice. The document will also provide a framework for other national societies to standardize their training programs in echocardiography and will provide a benchmark by which competency in adult echocardiography may be measured.

  14. The Committee to Advise on Tropical Medicine and Travel (CATMAT) – a reference for Canadian paediatricians

    OpenAIRE

    Hui, Charles PS

    2015-01-01

    The Committee to Advise on Tropical Medicine and Travel (CATMAT) is a federal government committee with wide representation in the fields of travel medicine and infectious diseases. They produce evidence-based statements on tropical and travel medicine for Canadian clinicians, including paediatric content ensured by the involvement of paediatric experts and a liaison member from the Canadian Paediatric Society. Links to all of the active statements are provided in the present practice point, ...

  15. Conference summaries of the Canadian Nuclear Association 30. annual conference, and the Canadian Nuclear Society 11. annual conference

    International Nuclear Information System (INIS)

    This volume contains conference summaries for the 30. annual conference of the Canadian Nuclear Association, and the 11. annual conference of the Canadian Nuclear Society. Topics of discussion include: energy needs and challenges facing the Canadian nuclear industry; the environment and nuclear power; the problems of maintaining and developing industrial capacity; the challenges of the 1990's; programmes and issues for the 1990's; thermalhydraulics; reactor physics and fuel management; nuclear safety; small reactors; fuel behaviour; energy production and the environment; computer applications; nuclear systems; fusion; materials handling; and, reactor components

  16. Canadian Cardiovascular Society Quality Indicators for Heart Failure.

    Science.gov (United States)

    McKelvie, Robert S; Heckman, George A; Blais, Claudia; Cox, Jafna L; Ezekowitz, Justin A; Gong, Yanyan; Harkness, Karen; Moe, Gordon; Dai, Sulan; Dorian, Paul; Johnstone, David E; McGeachie, Erin C; Tu, Jack V; Lambert, Laurie J

    2016-08-01

    A working group was convened by the Canadian Cardiovascular Society (CCS) in 2010 to identify quality indicators (QIs) for heart failure (HF). Using the CCS "Best Practices for Developing Cardiovascular Quality Indicators" methodology, a total of 49 "long-list" QIs was identified and rated. Subsequent ranking and discussion led to the selection of an initial "short-list" of 6 QIs to evaluate quality care, including daily assessment of blood chemistry indicators, chest radiography, patient education, in-hospital use of angiotensin-converting enzyme inhibitors or angiotensin-receptor blockers, assessment of left ventricular function, and 30-day hospital readmission. The short-list QIs were selected as being important for quality assurance and because the patient information, for the most part, can be captured during the inpatient setting, which would allow these QIs to be adopted more easily. These 6 QIs were subjected to a feasibility test that found that even within the inpatient setting, there is a significant gap between the existing knowledge infrastructure and the necessary information-tracking processes to measure QIs. Only 1 QI (30-day hospital readmission) can currently be measured comparatively across Canada, although the other 5 of 6 short-list QIs can be measured using other data collected by jurisdictions. Standardization and enhancements to knowledge infrastructure are essential to provide the comprehensive patient data necessary to evaluate the quality of HF care across Canada. PMID:26968392

  17. Home Mechanical Ventilation: A Canadian Thoracic Society Clinical Practice Guideline

    Directory of Open Access Journals (Sweden)

    Douglas A McKim

    2011-01-01

    Full Text Available Increasing numbers of patients are surviving episodes of prolonged mechanical ventilation or benefitting from the recent availability of user-friendly noninvasive ventilators. Although many publications pertaining to specific aspects of home mechanical ventilation (HMV exist, very few comprehensive guidelines that bring together all of the current literature on patients at risk for or using mechanical ventilatory support are available. The Canadian Thoracic Society HMV Guideline Committee has reviewed the available English literature on topics related to HMV in adults, and completed a detailed guideline that will help standardize and improve the assessment and management of individuals requiring noninvasive or invasive HMV. The guideline provides a disease-specific review of illnesses including amyotrophic lateral sclerosis, spinal cord injury, muscular dystrophies, myotonic dystrophy, kyphoscoliosis, post-polio syndrome, central hypoventilation syndrome, obesity hypoventilation syndrome, and chronic obstructive pulmonary disease as well as important common themes such as airway clearance and the process of transition to home. The guidelines have been extensively reviewed by international experts, allied health professionals and target audiences. They will be updated on a regular basis to incorporate any new information.

  18. A British Society of Paediatric Gastroenterology, Hepatology and Nutrition survey of the effectiveness and safety of adalimumab in children with inflammatory bowel disease

    OpenAIRE

    Russell, Richard Kay; Wilson, Michelle L.; Loganathan, Sabarinathan; Bourke, Billy; Kiparissi, Fevrionia; Torrente, Franco; Mahdi, Gamal; Rodrigues, Astor; Thomas, Adrian; Akobeng, Anthony Kwaku; Fagbemi, Andrew; Hyer, Warren; Spray, Christine; McGrogan, Paraic; Heuschkel, Rob B

    2011-01-01

    Abstract Background: Adalimumab is efficacious therapy for adults with Crohn?s disease (CD). Aim: To summarise the United Kingdom and Republic of Ireland paediatric adalimumab experience. Methods: British Society of Paediatric Gastroenterology, Hepatology and Nutrition (BSPGHAN) members with Inflammatory Bowel Disease (IBD) patients

  19. European Society for Paediatric Infectious Diseases consensus recommendations for rotavirus vaccination in Europe: update 2014.

    Science.gov (United States)

    Vesikari, Timo; Van Damme, Pierre; Giaquinto, Carlo; Dagan, Ron; Guarino, Alfredo; Szajewska, Hania; Usonis, Vytautas

    2015-06-01

    The first evidence-based recommendations for rotavirus (RV) vaccination in Europe were prepared at the time of licensure of 2 live oral RV vaccines (Rotarix, GlaxoSmithKline Biologicals, and RotaTeq, Sanofi Pasteur MSD) in 2006 and published in 2008. Since then several countries in Europe and more globally have adopted universal RV vaccination of all healthy infants as part of their national immunization programs (NIPs). The experience from these NIPs has produced a wealth of post-introduction effectiveness data that, together with the evidence from prelicensure efficacy trials presented in the 2008 Recommendations, support the case of RV vaccination in Europe. The prelicensure safety trials of Rotarix and RotaTeq, each in populations of more than 60,000 infants, did not reveal risk of intussusception (IS), but postvaccination surveillance in several countries, particularly Australia and Mexico, has established that the risk of IS for both vaccines after the first dose might be between 1:50,000 and 1:80,000. Although it may be argued that the risk is acceptable vis-à-vis the great benefits of RV vaccination, this argument alone may not suffice, and every effort should be made to reduce the risk of IS. Considerable evidence, including postvaccination surveillance data from Germany, suggests that the risk of IS can be reduced by early administration of the first dose of oral RV vaccine. The previous European Society for Paediatric Infectious Diseases/European Society for Paediatric Gastroenterology, Hepatology and Nutrition recommendations held that the first dose of oral RV vaccine should be given between 6 and 12 weeks of age; this recommendation is sustained but with an emphasis toward the lower range of the recommended age, that is, preferably between 6 and 8 weeks of age. At the time of the earlier recommendations, experience of RV vaccination in premature infants and other special target groups was limited. It is now recommended with greater confidence than

  20. Proceedings of the 29th annual conference of the Canadian Nuclear Association and 10th annual conference of the Canadian Nuclear Society. V. 1-3

    International Nuclear Information System (INIS)

    The symposium was designed to highlight how the technical information for nuclear energy came to Canada, the effect this information had in Canada in the fields of Physics, Chemistry, Medicine and Nuclear Power. Volume 1 is the combined proceedings of the Canadian Nuclear Association twenty-ninth annual conference and the Canadian Nuclear Society tenth annual conference. Volume 2 is the proceedings of the Canadian Nuclear Association twenty-ninth annual conference, and volume 3 is the proceedings of the Canadian Nuclear Society tenth annual conference

  1. Standards for polysomnography in Canada. The Standards Committees of the Canadian Sleep Society and the Canadian Thoracic Society.

    OpenAIRE

    George, C F

    1996-01-01

    OBJECTIVE: To develop standards for polysomnography in Canada in order to assist in the uniform provision of diagnostic and therapeutic services related to sleep disorders. OPTIONS: Uniform testing versus no current Canadian standards. OUTCOMES: Uniform delivery of health care; reduction in number of repeat studies and their attendant costs. EVIDENCE: Availability of diagnostic laboratories and services, and survey responses (written and oral) from directors of sleep laboratories; the America...

  2. Proceedings of the 13. annual conference of the Canadian Nuclear Society. V. 2

    International Nuclear Information System (INIS)

    Volume 2 of the proceedings of the 13. annual conference of the Canadian Nuclear Society includes sessions on the following topics: compliance and licensing, fusion science and technology, Darlington assessment, plant aging and life assessment, thermalhydraulic modelling and analysis, diagnostics and data management, operator training and certification. The individual papers have been abstracted separately

  3. Proceedings of the 13. annual conference of the Canadian Nuclear Society. V. 1

    International Nuclear Information System (INIS)

    Volume 1 of the proceedings of the 13. annual conference of the Canadian Nuclear Society includes sessions on the following topics: reactor physics, new concepts and technology, fuel behaviour, reactor design, safety analysis, fuel channel behaviour, equipment and design qualification. The individual papers have been abstracted separately

  4. Summary of Canadian Guidelines for the Initial Management of Community-Acquired Pneumonia: An Evidence-Based Update by the Canadian Infectious Diseases Society and the Canadian Thoracic Society

    Directory of Open Access Journals (Sweden)

    Lionel A Mandell

    2000-01-01

    Full Text Available Community-acquired pneumonia (CAP is a serious illness with a significant impact on individual patients and society as a whole. Over the past several years, there have been significant advances in our knowledge and understanding of the etiology of the disease, and an appreciation of problems such as mixed infections and increasing antimicrobial resistance. The development of additional fluoroquinolone agents with enhanced activity against Streptococcus pneumoniae has been important as well. It was decided that the time had come to update and modify the previous CAP guidelines, which were published in 1993. The current guidelines represent a joint effort by the Canadian Infectious Disease Society and the Canadian Thoracic Society, and they address the etiology, diagnosis and initial management of CAP. The diagnostic section is based on the site of care, and the treatment section is organized according to whether one is dealing with outpatients, inpatients or nursing home patients.

  5. Summary of Canadian Guidelines for the Initial Management of Community-Acquired Pneumonia: An Evidence-Based Update by the Canadian Infectious Disease Society and the Canadian Thoracic Society

    Directory of Open Access Journals (Sweden)

    Lionel A Mandell

    2000-01-01

    Full Text Available Community-acquired pneumonia (CAP is a serious illness with a significant impact on individual patients and society as a whole. Over the past several years, there have been significant advances in the knowledge and understanding of the etiology of the disease, and an appreciation of problems such as mixed infections and increasing antimicrobial resistance. The development of additional fluoroquinolone agents with enhanced activity against Streptococcus pneumoniae has been important as well. It was decided that the time had come to update and modify the previous CAP guidelines, which were published in 1993. The current guidelines represent a joint effort by the Canadian Infectious Diseases Society and the Canadian Thoracic Society, and they address the etiology, diagnosis and initial management of CAP. The diagnostic section is based on the site of care, and the treatment section is organized according to whether one is dealing with outpatients, inpatients or nursing home patients.

  6. Proceedings of the 11th Annual Conference of the Canadian Nuclear Society

    International Nuclear Information System (INIS)

    This volume contains the proceedings of the thirteen technical sessions at the 11. annual conference of the Canadian Nuclear Society. The 68 papers presented at this conference cover the areas of programmes and issues for the 90's; thermalhydraulics; reactor physics and fuel management; nuclear safety; small reactors; fuel behaviour; energy production and the environment; computer applications; nuclear systems; fusion; reactor decommissioning, irradiated fuel and materials handling; and reactor components, (L.L.)

  7. Canadian Thoracic Society Recommendations for Management of Chronic Obstructive Pulmonary Disease – 2003

    OpenAIRE

    Denis E O’Donnell; Aaron, Shawn; Bourbeau, Jean; Hernandez, Paul; Marciniuk, Darcy D; Balter, Meyer; Ford, Gordon; Gervais, Andre; Goldstein, Roger; Hodder, Rick; Maltais, Francois; Road, Jeremy

    2003-01-01

    Chronic obstructive pulmonary disease (COPD) is a common cause of disability and death in Canada. Moreover, morbidity and mortality from COPD continue to rise and the economic burden is enormous. The main goal of the Canadian Thoracic Society (CTS) Evidence-Based Guidelines is to optimize early diagnosis, prevention and management of COPD in Canada. Targeted spirometry is strongly recommended to expedite early diagnosis in smokers and exsmokers who develop respiratory symptoms, and who are at...

  8. Canadian Thoracic Society 2012 Guideline Update: Diagnosis and Management of Asthma in Preschoolers, Children and Adults

    Directory of Open Access Journals (Sweden)

    M Diane Lougheed

    2012-01-01

    Full Text Available BACKGROUND: In 2010, the Canadian Thoracic Society (CTS published a Consensus Summary for the diagnosis and management of asthma in children six years of age and older, and adults, including an updated Asthma Management Continuum. The CTS Asthma Clinical Assembly subsequently began a formal clinical practice guideline update process, focusing, in this first iteration, on topics of controversy and/or gaps in the previous guidelines.

  9. Undernutrition in children with a neurodevelopmental disability. Nutrition Committee, Canadian Paediatric Society.

    OpenAIRE

    1994-01-01

    OBJECTIVE: To offer guidelines for optimal nutritional care in children with a neurodevelopmental disability and an associated impairment in their ability to eat and drink. OPTIONS: Assessment of nutritional status by skinfold thickness measurement, high-energy nutrition supplementation given orally and feeding by nasogastric tubes, gastrostomy tubes or gastrojejunal tubes. OUTCOMES: Children receiving adequate nourishment are generally calmer and appear more normal than those who are underno...

  10. Cerebral sinus venous thromboses in children with acute lymphoblastic leukaemia - a multicentre study from the Nordic Society of Paediatric Haematology and Oncology

    DEFF Research Database (Denmark)

    Ranta, Susanna; Tuckuviene, Ruta; Mäkipernaa, Anne;

    2015-01-01

    We present a prospective multicentre cohort of 20 children with acute lymphoblastic leukaemia (ALL) and cerebral sinus venous thrombosis (CSVT). The study covers a period of 5 years and comprises 1038 children treated according to the Nordic Society of Paediatric Haematology and Oncology (NOPHO) ...

  11. Canadian Cardiovascular Society Guidelines for Evaluation and Management of Cardiovascular Complications of Cancer Therapy.

    Science.gov (United States)

    Virani, Sean A; Dent, Susan; Brezden-Masley, Christine; Clarke, Brian; Davis, Margot K; Jassal, Davinder S; Johnson, Christopher; Lemieux, Julie; Paterson, Ian; Sebag, Igal A; Simmons, Christine; Sulpher, Jeffrey; Thain, Kishore; Thavendiranathan, Paaldinesh; Wentzell, Jason R; Wurtele, Nola; Côté, Marc André; Fine, Nowell M; Haddad, Haissam; Hayley, Bradley D; Hopkins, Sean; Joy, Anil A; Rayson, Daniel; Stadnick, Ellamae; Straatman, Lynn

    2016-07-01

    Modern treatment strategies have led to improvements in cancer survival, however, these gains might be offset by the potential negative effect of cancer therapy on cardiovascular health. Cardiotoxicity is now recognized as a leading cause of long-term morbidity and mortality among cancer survivors. This guideline, authored by a pan-Canadian expert group of health care providers and commissioned by the Canadian Cardiovascular Society, is intended to guide the care of cancer patients with established cardiovascular disease or those at risk of experiencing toxicities related to cancer treatment. It includes recommendations and important management considerations with a focus on 4 main areas: identification of the high-risk population for cardiotoxicity, detection and prevention of cardiotoxicity, treatment of cardiotoxicity, and a multidisciplinary approach to cardio-oncology. All recommendations align with the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) system. Key recommendations for which the panel provides a strong level of evidence include: (1) that routine evaluation of traditional cardiovascular risk factors and optimal treatment of preexisting cardiovascular disease be performed in all patients before, during, and after receiving cancer therapy; (2) that initiation, maintenance, and/or augmentation of antihypertensive therapy be instituted per the Canadian Hypertension Educational Program guidelines for patients with preexisting hypertension or for those who experience hypertension related to cancer therapy; and (3) that investigation and management follow current Canadian Cardiovascular Society heart failure guidelines for cancer patients who develop clinical heart failure or an asymptomatic decline in left ventricular ejection fraction during or after cancer treatment. This guideline provides guidance to clinicians on contemporary best practices for the cardiovascular care of cancer patients. PMID:27343741

  12. Do geography and resources influence the need for colostomy in Hirschsprung′s disease and anorectal malformations? A Canadian association of paediatric surgeons: Association of paediatric surgeons of Nigeria survey

    Directory of Open Access Journals (Sweden)

    Lukman O. Abdur-Rahman

    2014-01-01

    Full Text Available Background: This survey compared surgical management of Hirschsprung′s disease (HD and anorectal malformations (ARM in high and low resource settings. Materials and Methods: An online survey was sent to 208 members of the Canadian Association of Paediatric Surgeons (CAPS and the Association of Paediatric Surgeons of Nigeria (APSON. Results: The response rate was 76.8% with 127 complete surveys (APSON 34, CAPS 97. Only 29.5% of APSON surgeons had frozen section available for diagnosis of HD. They were more likely to choose full thickness rectal biopsy (APSON 70.6% vs. CAPS 9.4%, P < 0.05 and do an initial colostomy for HD (APSON 23.5% vs. CAPS 0%, P < 0.05. Experience with trans-anal pull-through for HD was similar in both groups (APSON 76.5%, CAPS 66.7%. CAPS members practising in the United States were more likely to perform a one-stage pull-through for HD during the initial hospitalization (USA 65.4% vs. Canada 28.3%, P < 0.05. The frequency of colostomy in females with vestibular fistula varied widely independent of geography. APSON surgeons were less likely to have enterostomal therapists and patient education resources. Conclusions: Local resources which vary by geographic location affect the management of HD and ARM including colostomy. Collaboration between CAPS and APSON members could address resource and educational needs to improve patient care.

  13. The Canadian Cardiovascular Society Heart Failure Companion: Bridging Guidelines to Your Practice.

    Science.gov (United States)

    Howlett, Jonathan G; Chan, Michael; Ezekowitz, Justin A; Harkness, Karen; Heckman, George A; Kouz, Simon; Leblanc, Marie-Hélène; Moe, Gordon W; O'Meara, Eileen; Abrams, Howard; Ducharme, Anique; Grzeslo, Adam; Hamilton, Peter G; Koshman, Sheri L; Lepage, Serge; McDonald, Michael; McKelvie, Robert; Rajda, Miroslaw; Swiggum, Elizabeth; Virani, Sean; Zieroth, Shelley

    2016-03-01

    The Canadian Cardiovascular Society Heart Failure (HF) Guidelines Program has generated annual HF updates, including formal recommendations and supporting Practical Tips since 2006. Many clinicians indicate they routinely use the Canadian Cardiovascular Society HF Guidelines in their daily practice. However, many questions surrounding the actual implementation of the Guidelines into their daily practice remain. A consensus-based approach was used, including feedback from the Primary and Secondary HF Panels. This companion is intended to answer several key questions brought forth by HF practitioners such as appropriate timelines for initial assessments and subsequent reassessments of patients, the order in which medications should be added, how newer medications should be included in treatment algorithms, and when left ventricular function should be reassessed. A new treatment algorithm for HF with reduced ejection fraction is included. Several other practical issues are addressed such as an approach to management of hyperkalemia/hypokalemia, treatment of gout, when medications can be stopped, and whether a target blood pressure or heart rate is suggested. Finally, elements and teaching of self-care are described. This tool will hopefully function to allow better integration of the HF Guidelines into clinical practice.

  14. Paediatrics: messages from Munich

    Directory of Open Access Journals (Sweden)

    Fabio Midulla

    2015-05-01

    Full Text Available The aim of this article is to describe paediatric highlights from the 2014 European Respiratory Society (ERS International Congress in Munich, Germany. Abstracts from the seven groups of the ERS Paediatric Assembly (Respiratory Physiology and Sleep, Asthma and Allergy, Cystic Fibrosis, Respiratory Infection and Immunology, Neonatology and Paediatric Intensive Care, Respiratory Epidemiology, and Bronchology are presented in the context of the current literature.

  15. Canadian Cancer Society Information Services: lessons learned about complementary medicine information needs.

    Science.gov (United States)

    Eng, J L; Monkman, D A; Verhoef, M J; Ramsum, D L; Bradbury, J

    2001-01-01

    The use of complementary and alternative medicine (CAM) in cancer patients is very common. However, currently valid and reliable information on CAM treatments for cancer is limited. The purpose of this study was to identify the information needs those who called the Canadian Cancer Society's Cancer Information Service (CIS) requesting information on CAM. CIS Information Specialists completed two-page questionnaires for 109 callers who inquired about CAM therapies. Findings show that the majority of callers were women between the ages of 30 and 59, and that most of their questions concerned the safety and/or effectiveness of herbs and compounds like Essiac and 714X. Information Specialists generally utilized one or more of four resources upon receiving a CAM-related call. These resources, while mostly Canadian and reviewed by content experts, are not specific to the type of cancer and are no longer the most up- to-date. To address this issue we have included an appendix that outlines some current CAM resources and websites for cancer patients.

  16. Object-oriented business process analysis of the cooperative soft tissue sarcoma trial of the german society for paediatric oncology and haematology (GPOH).

    Science.gov (United States)

    Weber, R; Knaup, P; Knietitg, R; Haux, R; Merzweiler, A; Mludek, V; Schilling, F H; Wiedemann, T

    2001-01-01

    The German Society for Paediatric Oncology and Haematology (GPOH) runs nation-wide multicentre clinical trials to improve the treatment of children suffering from malignant diseases. We want to provide methods and tools to support the centres of these trials in developing trial specific modules for the computer-based DOcumentation System for Paediatric Oncology (DOSPO). For this we carried out an object-oriented business process analysis for the Cooperative Soft Tissue Sarcoma Trial at the Olgahospital Stuttgart for Child and Adolescent Medicine. The result is a comprehensive business process model consisting of UML-diagrams and use case specifications. We recommend the object-oriented business process analysis as a method for the definition of requirements in information processing projects in the field of clinical trials in general. For this our model can serve as basis because it slightly can be adjusted to each type of clinical trial.

  17. Canadian Society of Nephrology Commentary on the 2012 KDIGO clinical practice guideline for glomerulonephritis: management of glomerulonephritis in adults.

    Science.gov (United States)

    Cybulsky, Andrey V; Walsh, Michael; Knoll, Greg; Hladunewich, Michelle; Bargman, Joanne; Reich, Heather; Humar, Atul; Samuel, Susan; Bitzan, Martin; Zappitelli, Michael; Dart, Allison; Mammen, Cherry; Pinsk, Maury; Muirhead, Norman

    2014-03-01

    The KDIGO (Kidney Disease: Improving Global Outcomes) clinical practice guideline for management of glomerulonephritis was recently released. The Canadian Society of Nephrology convened a working group to review the recommendations and comment on their relevancy and applicability to the Canadian context. A subgroup of adult nephrologists reviewed the guideline statements for management of glomerular disease in adults and agreed with most of the guideline statements developed by KDIGO. This commentary highlights areas for which there is lack of evidence and areas in need of translation of evidence into clinical practice. Areas of controversy or uncertainty, including the choice of second-line agents, are discussed in more detail. Existing practice variation also is addressed. The relevance of treatment recommendations to the Canadian practitioner is discussed.

  18. Alpha-1 Antitrypsin Deficiency Targeted Testing and Augmentation Therapy: A Canadian Thoracic Society Clinical Practice Guideline

    Directory of Open Access Journals (Sweden)

    DD Marciniuk

    2012-01-01

    Full Text Available Alpha-1 antitrypsin (A1AT functions primarily to inhibit neutrophil elastase, and deficiency predisposes individuals to the development of chronic obstructive pulmonary disease (COPD. Severe A1AT deficiency occurs in one in 5000 to one in 5500 of the North American population. While the exact prevalence of A1AT deficiency in patients with diagnosed COPD is not known, results from small studies provide estimates of 1% to 5%. The present document updates a previous Canadian Thoracic Society position statement from 2001, and was initiated because of lack of consensus and understanding of appropriate patients suitable for targeted testing for A1AT deficiency, and for the use of A1AT augmentation therapy. Using revised guideline development methodology, the present clinical practice guideline document systematically reviews the published literature and provides an evidence-based update. The evidence supports the practice that targeted testing for A1AT deficiency be considered in individuals with COPD diagnosed before 65 years of age or with a smoking history of <20 pack years. The evidence also supports consideration of A1AT augmentation therapy in nonsmoking or exsmoking patients with COPD (forced expiratory volume in 1 s of 25% to 80% predicted attributable to emphysema and documented A1AT deficiency (level ≤11 μmol/L who are receiving optimal pharmacological and nonpharmacological therapies (including comprehensive case management and pulmonary rehabilitation because of benefits in computed tomography scan lung density and mortality.

  19. 2014 Annual Meeting of the Canadian Society for History and Philosophy of Mathematics

    CERN Document Server

    Landry, Elaine

    2015-01-01

    This volume contains thirteen papers that were presented at the 2014 Annual Meeting of the Canadian Society for History and Philosophy of Mathematics/La Société Canadienne d’Histoire et de Philosophie des Mathématiques, held on the campus of Brock University in St. Catharines, Ontario, Canada. It contains rigorously reviewed modern scholarship on general topics in the history and philosophy of mathematics, as well as on the meeting’s special topic, Early Scientific Computation. These papers cover subjects such as •Physical tools used by mathematicians in the seventeenth century •The first historical appearance of the game-theoretical concept of mixed-strategy equilibrium •George Washington’s mathematical cyphering books •The development of the Venn diagram •The role of Euler and other mathematicians in the development of algebraic analysis •Arthur Cayley and Alfred Kempe’s influence on Charles Peirce's diagrammatic logic •The influence publishers had on the development of mathematical...

  20. Canadian Thoracic Society 2012 Guideline Update: Diagnosis and Management of Asthma in Preschoolers, Children and Adults: Executive Summary

    Directory of Open Access Journals (Sweden)

    M Diane Lougheed

    2012-01-01

    Full Text Available BACKGROUND: In 2010, the Canadian Thoracic Society (CTS published a Consensus Summary for the diagnosis and management of asthma in children six years of age and older, and adults, including an updated Asthma Management Continuum. The CTS Asthma Clinical Assembly subsequently began a formal clinical practice guideline update process, focusing, in this first iteration, on topics of controversy and/or gaps in the previous guidelines.

  1. SHIFTING GROUND, SOLID FOUNDATIONS: IMAGINING A NEW PARADIGM FOR CANADIAN CIVIL SOCIETY ENGAGEMENT

    Directory of Open Access Journals (Sweden)

    Nandini Ramanujam

    2016-03-01

    Full Text Available Members of civil society are increasingly decrying what they identify as an insidious trend whereby the government is targeting organizations whose mandates run contrary to the federal government’s political and economic agendas and creating a chill around public policy and advocacy work. The media as well as civil society organizations [CSOs] themselves have documented government attempts to undermine and stifle the voices of dissenting organizations, ranging from rhetorical attacks to the withdrawal of funding for ambiguous reasons. The climate of resentment and suspicion between civil society actors and the government is detrimental for safeguarding the tradition of accountability and transparency in Canada’s democratic institutions. Amidst this turbulent environment, this paper examines the often-made claim by CSO leaders in Canada that public funding is a necessary requirement for a strong civil society, with the aim of challenging and mobilizing the civil society community to not only survive but to reinvigorate its engagement to further social justice in this changing social and economic landscape. We argue that discussions of the state of civil society in Canada focus disproportionately on the question of funding and relationship-building with the government and expose the unforeseen consequences of this trade-off for CSOs, their members, and constituent communities.  We close by introducing the potential of a new paradigm of “principled engagement” that would allow Canadian CSOs to thrive as sustainable, adaptable social justice advocates in coming years.   Les membres de la société civile décrient de plus en plus ce qu’ils appellent la tendance insidieuse du gouvernement à cibler les organisations dont les mandats vont à l’encontre de ses programmes politiques et économiques et à freiner le travail de représentation et de plaidoyer lié aux politiques publiques. Tant les médias que les organisations de la soci

  2. Canadian Thoracic Society recommendations for management of chronic obstructive pulmonary disease – 2007 update

    Science.gov (United States)

    O’Donnell, Denis E; Aaron, Shawn; Bourbeau, Jean; Hernandez, Paul; Marciniuk, Darcy D; Balter, Meyer; Ford, Gordon; Gervais, Andre; Goldstein, Roger; Hodder, Rick; Kaplan, Alan; Keenan, Sean; Lacasse, Yves; Maltais, Francois; Road, Jeremy; Rocker, Graeme; Sin, Don; Sinuff, Tasmin; Voduc, Nha

    2007-01-01

    Chronic obstructive pulmonary disease (COPD) is a major respiratory illness in Canada that is both preventable and treatable. Our understanding of the pathophysiology of this complex condition continues to grow and our ability to offer effective treatment to those who suffer from it has improved considerably. The purpose of the present educational initiative of the Canadian Thoracic Society (CTS) is to provide up to date information on new developments in the field so that patients with this condition will receive optimal care that is firmly based on scientific evidence. Since the previous CTS management recommendations were published in 2003, a wealth of new scientific information has become available. The implications of this new knowledge with respect to optimal clinical care have been carefully considered by the CTS Panel and the conclusions are presented in the current document. Highlights of this update include new epidemiological information on mortality and prevalence of COPD, which charts its emergence as a major health problem for women; a new section on common comorbidities in COPD; an increased emphasis on the meaningful benefits of combined pharmacological and nonpharmacological therapies; and a new discussion on the prevention of acute exacerbations. A revised stratification system for severity of airway obstruction is proposed, together with other suggestions on how best to clinically evaluate individual patients with this complex disease. The results of the largest randomized clinical trial ever undertaken in COPD have recently been published, enabling the Panel to make evidence-based recommendations on the role of modern pharmacotherapy. The Panel hopes that these new practice guidelines, which reflect a rigorous analysis of the recent literature, will assist caregivers in the diagnosis and management of this common condition. PMID:17885691

  3. Canadian Thoracic Society Recommendations for Management of Chronic Obstructive Pulmonary Disease – 2007 Update

    Directory of Open Access Journals (Sweden)

    Denis E O’Donnell

    2007-01-01

    Full Text Available Chronic obstructive pulmonary disease (COPD is a major respiratory illness in Canada that is both preventable and treatable. Our understanding of the pathophysiology of this complex condition continues to grow and our ability to offer effective treatment to those who suffer from it has improved considerably. The purpose of the present educational initiative of the Canadian Thoracic Society (CTS is to provide up to date information on new developments in the field so that patients with this condition will receive optimal care that is firmly based on scientific evidence. Since the previous CTS management recommendations were published in 2003, a wealth of new scientific information has become available. The implications of this new knowledge with respect to optimal clinical care have been carefully considered by the CTS Panel and the conclusions are presented in the current document. Highlights of this update include new epidemiological information on mortality and prevalence of COPD, which charts its emergence as a major health problem for women; a new section on common comorbidities in COPD; an increased emphasis on the meaningful benefits of combined pharmacological and nonpharmacological therapies; and a new discussion on the prevention of acute exacerbations. A revised stratification system for severity of airway obstruction is proposed, together with other suggestions on how best to clinically evaluate individual patients with this complex disease. The results of the largest randomized clinical trial ever undertaken in COPD have recently been published, enabling the Panel to make evidence-based recommendations on the role of modern pharmacotherapy. The Panel hopes that these new practice guidelines, which reflect a rigorous analysis of the recent literature, will assist caregivers in the diagnosis and management of this common condition.

  4. Canadian Society of Nephrology Commentary on the 2012 KDIGO clinical practice guideline for glomerulonephritis: management of nephrotic syndrome in children.

    Science.gov (United States)

    Samuel, Susan; Bitzan, Martin; Zappitelli, Michael; Dart, Allison; Mammen, Cherry; Pinsk, Maury; Cybulsky, Andrey V; Walsh, Michael; Knoll, Greg; Hladunewich, Michelle; Bargman, Joanne; Reich, Heather; Humar, Atul; Muirhead, Norman

    2014-03-01

    The KDIGO (Kidney Disease: Improving Global Outcomes) clinical practice guideline for management of glomerulonephritis was recently released. The Canadian Society of Nephrology convened a working group to review the recommendations and comment on their relevancy and applicability to the Canadian context. A subgroup of pediatric nephrologists reviewed the guideline statements for management of childhood nephrotic syndrome and agreed with most of the guideline statements developed by KDIGO. This commentary highlights areas in which there is lack of evidence and areas in need of translation of evidence into clinical practice. Areas of controversy or uncertainty, including the length of corticosteroid therapy for the initial presentation and relapses, definitions of steroid resistance, and choice of second-line agents, are discussed in more detail. Existing practice variation is also addressed.

  5. Proceedings of the Canadian Solar Buildings Conference : the 31. annual conference of the Solar Energy Society of Canada Inc. and the 1. Canadian Solar Buildings Research Network conference

    International Nuclear Information System (INIS)

    The first conference organized by the newly established Canadian Solar Buildings Research Network (SBRN) was held in conjunction with the thirty-first annual conference of the Solar Energy Society of Canada Inc (SESCI). The conference was attended by top researchers from 10 Canadian Universities to promote innovative research and development in solar energy applications and to advance the awareness of solar energy in Canada. It featured special events such as trade shows, photovoltaic workshops, a course in ESP-r simulation, tours of solar houses and other events focused on the economic, environmental and socio-economic benefits of solar technology, including the potential to reduce greenhouse gas emissions. SBRN was founded on the premise that university researchers should focus on solar energy applications for buildings. Several presentations proposed action plans to accelerate the implementation of solar energy through the use of innovative building technologies and sustainable energy policies. Other major issues of interest were also discussed, including the development of the net-zero energy solar home and grid-connection issues. The sessions of the conference were entitled: solar thermal systems; solar electricity; building integrated photovoltaic systems; design issues and tools; integrating PV and solar thermal in buildings; daylighting and solar radiation modeling; fenestration and shading; PV manufacturing and solar electricity resources. The proceedings featured 41 refereed papers and 13 poster presentations, all of which have been catalogued separately for inclusion in this database. refs., tabs., figs

  6. Proceedings of the Canadian Nuclear Society international conference on containment design

    International Nuclear Information System (INIS)

    The subject of containment was discussed under the major topic headings of: USA views on containment design operation and regulation, containment structure analysis, containment envelope and energy suppression systems, European views on containment design operation and regulation, containment atmosphere control, Canadian views on containment design operation and regulation, containment analysis, and regulatory requirements, testing, and periodic inspection

  7. Pharmacological management of chronic neuropathic pain: Revised consensus statement from the Canadian Pain Society

    OpenAIRE

    Moulin, DE; Boulanger, A; AJ Clark; Clarke, H.; Dao, T; GA Finley; Furlan, A.; Gilron, I; Gordon, A.; PK Morley-Forster; BJ Sessle; Squire, P; Stinson, J; Taenzer, P.; Velly, A

    2014-01-01

    BACKGROUND: Neuropathic pain (NeP), redefined as pain caused by a lesion or a disease of the somatosensory system, is a disabling condition that affects approximately two million Canadians. OBJECTIVE: To review the randomized controlled trials (RCTs) and systematic reviews related to the pharmacological management of NeP to develop a revised evidence-based consensus statement on its management. METHODS: RCTs, systematic reviews and existing guidelines on the pharmacological management of NeP ...

  8. Proceedings of the Canadian Nuclear Society 2. international conference on radioactive waste management

    International Nuclear Information System (INIS)

    These proceedings contain 136 papers on waste management from 19 countries. An index of the delegates and their affiliations is included. Emphasis was laid on the Canadian program for geologic disposal in hard rock. Sessions dealt with the following: storage and disposal, hydrogeology and geochemistry, transportation, buffers and backfill, public attitudes, tailings, site investigations and geomechanics, concrete, economics, licensing, matrix materials and container design, durability of fuel, biosphere modelling, radioactive waste processing, and future options

  9. State of the Art Compendium: Canadian Thoracic Society Recommendations for Management of Chronic Obstructive Pulmonary Disease

    OpenAIRE

    Denis E O’Donnell; Aaron, Shawn; Bourbeau, Jean; Hernandez, Paul; Marciniuk, Darcy; Balter, Meyer; Ford, Gordon; Gervais, Andre; Goldstein, Roger; Hodder, Rick; Maltais, Francois; Road, Jeremy

    2004-01-01

    Chronic obstructive pulmonary disease (COPD) is a common cause of disability and death in Canada. Moreover, morbidity and mortality from COPD continue to rise, and the economic burden is enormous. The main goal of the Canadian Thoracic Society’s evidence-based guidelines is to optimize early diagnosis, prevention and management of COPD in Canada. The main message of the guidelines is that COPD is a preventable and treatable disease. Targeted spirometry is strongly recommended to expedite earl...

  10. Society needs MD-assisted death, Canadian-trained medical director of US right-to-die society says.

    OpenAIRE

    Williams, L S

    1995-01-01

    The growth of an American organization that supports the right to die is proof that the public wants and needs physician-assisted death, says a University of Alberta alumnus who is medical director of the Hemlock Society. Dr. Richard MacDonald says he believes individual patients have the right to decide whether they want to live with a certain quality of life. Both the American Medical Association and the CMA have spoken out against physician-assisted death, but MacDonald says this oppositio...

  11. The 2013 Canadian Cardiovascular Society Heart Failure Management Guidelines Update: focus on rehabilitation and exercise and surgical coronary revascularization.

    Science.gov (United States)

    Moe, Gordon W; Ezekowitz, Justin A; O'Meara, Eileen; Howlett, Jonathan G; Fremes, Steve E; Al-Hesayen, Abdul; Heckman, George A; Ducharme, Anique; Estrella-Holder, Estrellita; Grzeslo, Adam; Harkness, Karen; Lepage, Serge; McDonald, Michael; McKelvie, Robert S; Nigam, Anil; Rajda, Miroslaw; Rao, Vivek; Swiggum, Elizabeth; Virani, Sean; Van Le, Vy; Zieroth, Shelley; Arnold, J Malcolm O; Ashton, Tom; D'Astous, Michel; Dorian, Paul; Giannetti, Nadia; Haddad, Haissam; Isaac, Debra L; Kouz, Simon; Leblanc, Marie-Hélène; Liu, Peter; Ross, Heather J; Sussex, Bruce; White, Michel

    2014-03-01

    The 2013 Canadian Cardiovascular Society Heart Failure Management Guidelines Update provides focused discussions on the management recommendations on 2 topics: (1) exercise and rehabilitation; and (2) surgical coronary revascularization in patients with heart failure. First, all patients with stable New York Heart Association class I-III symptoms should be considered for enrollment in a tailored exercise training program, to improve exercise tolerance and quality of life. Second, selected patients with suitable coronary anatomy should be considered for bypass graft surgery. As in previous updates, the topics were chosen in response to stakeholder feedback. The 2013 Update also includes recommendations, values and preferences, and practical tips to assist the clinicians and health care workers manage their patients with heart failure.

  12. Educators of the Information Society: Information Literacy Instruction in Canadian Informational Cities

    OpenAIRE

    Maria Henkel

    2015-01-01

    As information literacy is a key competence of the information society, information literacy instruction in public as well as academic libraries is crucial. Today, librarians do not only act as providers of information but also as educators of the information society's citizens. The rapid development of information and communications technologies is constantly changing the way we interact with information, making it difficult to keep up to date with instructional trends. This study aims to as...

  13. State of the Art Compendium: Canadian Thoracic Society Recommendations for Management of Chronic Obstructive Pulmonary Disease

    Directory of Open Access Journals (Sweden)

    Denis E O’Donnell

    2004-01-01

    Full Text Available Chronic obstructive pulmonary disease (COPD is a common cause of disability and death in Canada. Moreover, morbidity and mortality from COPD continue to rise, and the economic burden is enormous. The main goal of the Canadian Thoracic Society’s evidence-based guidelines is to optimize early diagnosis, prevention and management of COPD in Canada. The main message of the guidelines is that COPD is a preventable and treatable disease. Targeted spirometry is strongly recommended to expedite early diagnosis in smokers and former smokers who develop respiratory symptoms, and who are at risk for COPD. Smoking cessation remains the single most effective intervention to reduce the risk of COPD and to slow its progression. Education, especially self-management plans, are key interventions in COPD. Therapy should be escalated on an individual basis in accordance with the increasing severity of symptoms and disability. Long-acting anticholinergics and beta-2-agonist inhalers should be prescribed for patients who remain symptomatic despite short-acting bronchodilator therapy. Inhaled steroids should not be used as first line therapy in COPD, but have a role in preventing exacerbations in patients with more advanced disease who suffer recurrent exacerbations. Acute exacerbations of COPD cause significant morbidity and mortality and should be treated promptly with bronchodilators and a short course of oral steroids; antibiotics should be prescribed for purulent exacerbations. Patients with advanced COPD and respiratory failure require a comprehensive management plan that incorporates structured end-of-life care. Management strategies, consisting of combined modern pharmacotherapy and nonpharmacotherapeutic interventions (eg, pulmonary rehabilitation and exercise training can effectively improve symptoms, activity levels and quality of life, even in patients with severe COPD.

  14. Lesbian mommy blogging in Canada: documenting subtle homophobia in Canadian society and building community online.

    Science.gov (United States)

    Hunter, Andrea

    2015-01-01

    This article analyzes how lesbian mommy bloggers in Canada are using their blogs as forums for self-expression and a means to form community, as they record their unique experiences as queer parents. Further, it argues that lesbian mommy blogging is documenting a subtle form of homophobia that exists in Canada in terms of social acceptance. Although there is legal acceptance of queer families, society has not necessarily caught up with the law. These blogs show that lesbian parents in Canada still struggle with issues of equality, including difficulties being "out," invisibility, and having to advocate for the non-birth parent.

  15. Educators of the Information Society: Information Literacy Instruction in Canadian Informational Cities

    Directory of Open Access Journals (Sweden)

    Maria Henkel

    2015-06-01

    Full Text Available As information literacy is a key competence of the information society, information literacy instruction in public as well as academic libraries is crucial. Today, librarians do not only act as providers of information but also as educators of the information society's citizens. The rapid development of information and communications technologies is constantly changing the way we interact with information, making it difficult to keep up to date with instructional trends. This study aims to assess the perceived quality of information literacy instruction in libraries of Canada's informational cities: Montreal, Toronto and Vancouver. Therefore, librarians were interviewed by means of a questionnaire inspired by the SERVQUAL diagnostic tool. The questionnaire comprises of two parts: The first part consists of questions regarding information literacy instruction, in the second part the focus is on the seven competence areas of information literacy. Based on the difference between the librarians' "Expectation" and "Experience", gap scores for all questionnaire items were calculated and are now being presented and discussed.

  16. [Current treatment strategies for paediatric burns].

    Science.gov (United States)

    Küntscher, M V; Hartmann, B

    2006-06-01

    Paediatric burns occupy the third place in the severe accident statistics in Germany after traffic injuries and drowning. The paper reviews current treatment concepts of pre-hospital management, fluid resuscitation and surgical therapy in paediatric burned patients. Specific features in the approximation of the total body surface area burn and indications for transfer of paediatric burn victims to specialized units are discussed. The therapy of severe paediatric burns requires an interdisciplinary team consisting of especially skilled plastic or paediatric surgeons,anaesthetists, psychiatrists or psychologists, specifically trained nurses, physiotherapists and social workers. The rehabilitation process starts basically with admission to the burn unit. A tight cooperation between therapists and the relatives of the paediatric burn victim is needed for psychological recovery and reintegration into society.'The adaptation to the suffered trauma resulting in life-long disability and disfigurement is the main task of psychotherapy.

  17. State of the Art Compendium: Canadian Thoracic Society recommendations for the management of chronic obstructive pulmonary disease.

    Science.gov (United States)

    O'Donnell, Denis E; Aaron, Shawn; Bourbeau, Jean; Hernandez, Paul; Marciniuk, Darcy; Balter, Meyer; Ford, Gordon; Gervais, Andre; Goldstein, Roger; Hodder, Rick; Maltais, Francois; Road, Jeremy; McKay, Valoree; Schenkel, Jennifer; Ariel, Annon; Day, Anna; Lacasse, Yves; Levy, Robert; Lien, Dale; Miller, John; Rocker, Graeme; Sinuff, Tasmin; Stewart, Paula; Voduc, Nha; Abboud, Raja; Ariel, Amnon; Becklake, Margo; Borycki, Elizabeth; Brooks, Dina; Bryan, Shirley; Calcutt, Luanne; Chapman, Ken; Choudry, Nozhat; Couet, Alan; Coyle, Steven; Craig, Arthur; Crawford, Ian; Dean, Mervyn; Grossman, Ronald; Haffner, Jan; Heyland, Daren; Hogg, Donna; Holroyde, Martin; Kaplan, Alan; Kayser, John; Lein, Dale; Lowry, Josiah; McDonald, Les; MacFarlane, Alan; McIvor, Andrew; Rea, John; Reid, Darlene; Rouleau, Michel; Samis, Lorelei; Sin, Don; Vandemheen, Katherine; Wedzicha, J A; Weiss, Karl

    2004-01-01

    Chronic obstructive pulmonary disease (COPD) is a common cause of disability and death in Canada. Moreover, morbidity and mortality from COPD continue to rise, and the economic burden is enormous. The main goal of the Canadian Thoracic Society's evidence-based guidelines is to optimize early diagnosis, prevention and management of COPD in Canada. The main message of the guidelines is that COPD is a preventable and treatable disease. Targeted spirometry is strongly recommended to expedite early diagnosis in smokers and former smokers who develop respiratory symptoms, and who are at risk for COPD. Smoking cessation remains the single most effective intervention to reduce the risk of COPD and to slow its progression. Education, especially self-management plans, are key interventions in COPD. Therapy should be escalated on an individual basis in accordance with the increasing severity of symptoms and disability. Long-acting anticholinergics and beta-2-agonist inhalers should be prescribed for patients who remain symptomatic despite short-acting bronchodilator therapy. Inhaled steroids should not be used as first line therapy in COPD, but have a role in preventing exacerbations in patients with more advanced disease who suffer recurrent exacerbations. Acute exacerbations of COPD cause significant morbidity and mortality and should be treated promptly with bronchodilators and a short course of oral steroids; antibiotics should be prescribed for purulent exacerbations. Patients with advanced COPD and respiratory failure require a comprehensive management plan that incorporates structured end-of-life care. Management strategies, consisting of combined modern pharmacotherapy and nonpharmacotherapeutic interventions (eg, pulmonary rehabilitation and exercise training) can effectively improve symptoms, activity levels and quality of life, even in patients with severe COPD. PMID:15340581

  18. State of the Art Compendium: Canadian Thoracic Society recommendations for the management of chronic obstructive pulmonary disease.

    Science.gov (United States)

    O'Donnell, Denis E; Aaron, Shawn; Bourbeau, Jean; Hernandez, Paul; Marciniuk, Darcy; Balter, Meyer; Ford, Gordon; Gervais, Andre; Goldstein, Roger; Hodder, Rick; Maltais, Francois; Road, Jeremy; McKay, Valoree; Schenkel, Jennifer; Ariel, Annon; Day, Anna; Lacasse, Yves; Levy, Robert; Lien, Dale; Miller, John; Rocker, Graeme; Sinuff, Tasmin; Stewart, Paula; Voduc, Nha; Abboud, Raja; Ariel, Amnon; Becklake, Margo; Borycki, Elizabeth; Brooks, Dina; Bryan, Shirley; Calcutt, Luanne; Chapman, Ken; Choudry, Nozhat; Couet, Alan; Coyle, Steven; Craig, Arthur; Crawford, Ian; Dean, Mervyn; Grossman, Ronald; Haffner, Jan; Heyland, Daren; Hogg, Donna; Holroyde, Martin; Kaplan, Alan; Kayser, John; Lein, Dale; Lowry, Josiah; McDonald, Les; MacFarlane, Alan; McIvor, Andrew; Rea, John; Reid, Darlene; Rouleau, Michel; Samis, Lorelei; Sin, Don; Vandemheen, Katherine; Wedzicha, J A; Weiss, Karl

    2004-01-01

    Chronic obstructive pulmonary disease (COPD) is a common cause of disability and death in Canada. Moreover, morbidity and mortality from COPD continue to rise, and the economic burden is enormous. The main goal of the Canadian Thoracic Society's evidence-based guidelines is to optimize early diagnosis, prevention and management of COPD in Canada. The main message of the guidelines is that COPD is a preventable and treatable disease. Targeted spirometry is strongly recommended to expedite early diagnosis in smokers and former smokers who develop respiratory symptoms, and who are at risk for COPD. Smoking cessation remains the single most effective intervention to reduce the risk of COPD and to slow its progression. Education, especially self-management plans, are key interventions in COPD. Therapy should be escalated on an individual basis in accordance with the increasing severity of symptoms and disability. Long-acting anticholinergics and beta-2-agonist inhalers should be prescribed for patients who remain symptomatic despite short-acting bronchodilator therapy. Inhaled steroids should not be used as first line therapy in COPD, but have a role in preventing exacerbations in patients with more advanced disease who suffer recurrent exacerbations. Acute exacerbations of COPD cause significant morbidity and mortality and should be treated promptly with bronchodilators and a short course of oral steroids; antibiotics should be prescribed for purulent exacerbations. Patients with advanced COPD and respiratory failure require a comprehensive management plan that incorporates structured end-of-life care. Management strategies, consisting of combined modern pharmacotherapy and nonpharmacotherapeutic interventions (eg, pulmonary rehabilitation and exercise training) can effectively improve symptoms, activity levels and quality of life, even in patients with severe COPD.

  19. Treatment of non-metastatic rhabdomyosarcomas in childhood and adolescence. Results of the second study of the International Society of Paediatric Oncology: MMT84

    Energy Technology Data Exchange (ETDEWEB)

    Oberlin, O.; Terrier-Lacombe, M.-J. [Institut Gustave-Roussy, Department of Paediatric Oncology, 94805 Villejuif (France); Barrett, A. [Radiotherapy, Beatson Oncology Centre, Western Infirmary, Glasgow (United Kingdom); Martelli, H. [Paediatric Surgery, Hopital Necker, Paris (France); Habrand, J.L. [Institut Gustave-Roussy, Department of Paediatric Oncology, 94805 Villejuif (France); Voute, P.A. [Paediatric Oncology, Emma Kinderziekenhuis, Amsterdam (Netherlands); Otten, J. [Paediatric Oncology, Academisch Ziekenhuis VUB, Brussels (Belgium); Brunat-Mentigny, M. [Paediatric Oncology, Centre Leon Berard, Lyon (France); Theobald, S. [Institut Gustave-Roussy, Department of Paediatric Oncology, 94805 Villejuif (France); Quintana, E. [Paediatric Oncology, Institut Curie, Paris (France); Sommelet, D. [Paediatric Oncology, CHU Nancy (France); Praquin, M.-T.; Rey, A.; Rodary, C.; Flamant, F. [Institut Gustave-Roussy, Department of Paediatric Oncology, 94805 Villejuif (France)

    1998-06-01

    The second International Society of Paediatric Oncology (SIOP) study for rhabdomyosarcoma (MMT84) had several goals. The two principal aimswere: (1) to improve the survival of children with rhabdomyosarcoma; and (2) to reduce the late effects from therapy by restricting the indications for surgery and/or radiotherapy after good response to initial chemotherapy. A further aim was to investigate the role of high-dose chemotherapy in young patients with parameningeal primary tumours. 186 previously untreated eligible patients entered the study. Patients with completely resected primary tumour received three courses of IVA (ifosfamide, vincristine and actinomycin D). Patients with incompletely resected tumour received six to 10 courses of IVA according to stage. Patients achieving complete remission with chemotherapy alone did not usually receive radiotherapy or undergo extensive surgery, but patients remaining in partial remission received local therapy with surgery and/or radiotherapy. Only patients over 5 years of age with parameningeal disease and patients over 12 years with tumours at any site were given systematic irradiation. Complete remission was achieved in 91% (170/186) of all patients. With a median follow-up of 8 years, the 5-year overall survival was 68% ({+-}3% standard error of the mean (SEM)) and the 5-year event-free survival 53% ({+-}4% SEM). These results show an improvement over previous SIOP study (RMS75) in which survival was 52% and event-free survival was 47%. Among the 54 patients who exhibited isolated local relapse, 35% (19/54) survived in further remission longer than 2 years after retreatment, including local therapy (surgery{+-}radiotherapy). Analysis of the overall burden of therapy received by all surviving children (including primary treatment and treatment for relapse if required) showed that 24% (28/116) were treated by limited surgery followed by three courses of IVA, 29% (34/116) were treated by chemotherapy alone (after initial

  20. Treatment of non-metastatic rhabdomyosarcomas in childhood and adolescence. Results of the second study of the International Society of Paediatric Oncology: MMT84

    International Nuclear Information System (INIS)

    The second International Society of Paediatric Oncology (SIOP) study for rhabdomyosarcoma (MMT84) had several goals. The two principal aims were: (1) to improve the survival of children with rhabdomyosarcoma; and (2) to reduce the late effects from therapy by restricting the indications for surgery and/or radiotherapy after good response to initial chemotherapy. A further aim was to investigate the role of high-dose chemotherapy in young patients with parameningeal primary tumours. 186 previously untreated eligible patients entered the study. Patients with completely resected primary tumour received three courses of IVA (ifosfamide, vincristine and actinomycin D). Patients with incompletely resected tumour received six to 10 courses of IVA according to stage. Patients achieving complete remission with chemotherapy alone did not usually receive radiotherapy or undergo extensive surgery, but patients remaining in partial remission received local therapy with surgery and/or radiotherapy. Only patients over 5 years of age with parameningeal disease and patients over 12 years with tumours at any site were given systematic irradiation. Complete remission was achieved in 91% (170/186) of all patients. With a median follow-up of 8 years, the 5-year overall survival was 68% (±3% standard error of the mean (SEM)) and the 5-year event-free survival 53% (±4% SEM). These results show an improvement over previous SIOP study (RMS75) in which survival was 52% and event-free survival was 47%. Among the 54 patients who exhibited isolated local relapse, 35% (19/54) survived in further remission longer than 2 years after retreatment, including local therapy (surgery±radiotherapy). Analysis of the overall burden of therapy received by all surviving children (including primary treatment and treatment for relapse if required) showed that 24% (28/116) were treated by limited surgery followed by three courses of IVA, 29% (34/116) were treated by chemotherapy alone (after initial biopsy

  1. The imperative of strategic alignment across organizations: the experience of the Canadian Cancer Society's Centre for Behavioural Research and Program Evaluation.

    Science.gov (United States)

    Cameron, Roy; Riley, Barbara L; Campbell, H Sharon; Manske, Stephen; Lamers-Bellio, Kim

    2009-01-01

    The Canadian Cancer Society's Centre for Behavioural Research and Program Evaluation (CBRPE) is a national asset for building pan-Canadian capacity to support intervention studies that guide population-level policies and programs. This paper briefly describes CBRPE's experience in advancing this work in the field of prevention. The aim is to illuminate issues of central importance for advancing the goals of the Population Health Intervention Research Initiative for Canada. According to our experience, success in building the population intervention field will depend heavily on purposeful alignment across organizations to enable integration of research, evaluation, surveillance, policy and practice. CBRPE's capacity development roles include a) a catalytic role in shaping this aligned inter-organizational milieu and b) investing our resources in building tangible assets (teams, indicators, data systems) that contribute relevant capacities within this emerging milieu. Challenges in building capacity in this field are described.

  2. 55th Annual Canadian Society for Molecular Biosciences Conference on Epigenetics and Genomic Stability. Whistler, British Columbia, Canada, 14–18 March 2012.

    Science.gov (United States)

    Nelson, Christopher J; Ausió, Juan

    2012-06-01

    The 55th Annual Canadian Society for Molecular Biosciences Conference on Epigenetics and Genomic Stability in Whistler, Canada, 14-18 March 2012, brought together 31 speakers from different nationalities. The organizing committee, led by Jim Davie (Chair) at the University of Manitoba (Manitoba, Canada), consisted of several established researchers in the fields of chromatin and epigenetics from across Canada. The meeting was centered on the contribution of epigenetics to gene expression, DNA damage and repair, and the role of environmental factors. A few interesting talks on replication added some insightful information on the controversial issue of histone post-translational modifications as genuine epigenetic marks that are inherited through cell division.

  3. Paediatric respiratory infections

    Directory of Open Access Journals (Sweden)

    Mark L. Everard

    2016-03-01

    Full Text Available Pulmonary infections remain a major cause of infant and child mortality worldwide and are responsible for a substantial burden of morbidity. During the 2015 European Respiratory Society International Congress in Amsterdam, some of the main findings from peer-reviewed articles addressing this topic that were published in the preceding 12 months were reviewed in a Paediatric Clinical Year in Review session. The following article highlights some of the insights provided by these articles into the complex interactions of the human host with the extensive and dynamic populations of microorganisms that call an individual “home”.

  4. Review of the International Society for Heart and Lung Transplantation Practice guidelines for management of heart failure in children.

    Science.gov (United States)

    Colan, Steven D

    2015-08-01

    imaging, and strain and strain rate were either novel or non-existent and have now moved into the main stream. Cardiac magnetic resonance imaging (MRI) had very limited availability, and since that time imaging and assessment of myocardial iron content, delayed gadolinium enhancement, and extracellular volume have moved into the mainstream. The only devices discussed in the International Society for Heart and Lung Transplantation guidelines were extracorporeal membrane oxygenators, pacemakers, and defibrillators. Since that time, ventricular assist devices have become mainstream. Despite the relative lack of randomised controlled trials in paediatric heart failure, advances continue to occur. These advances warrant implementation of an update and review process, something that is best done under the auspices of the national and international cardiology societies. A joint activity that includes the International Society for Heart and Lung Transplantation, American College of Cardiology/American Heart Association, the Association for European Paediatric and Congenital Cardiology (AEPC), European Society of Cardiology, Canadian Cardiovascular Society, and others will have more credibility than independent efforts by any of these organisations.

  5. Paediatric Interventional Uroradiology

    International Nuclear Information System (INIS)

    Paediatric interventional uroradiology lies at the intersection of the disciplines of paediatric interventional radiology and paediatric endourology. Interdisciplinary collaboration has led to the development of new techniques and refinement of procedures adopted from adult practice. This article reviews the major procedures used in paediatric interventional uroradiology, with emphasis on nephrostomy, percutaneous nephrolithotomy, balloon-burst pyeloplasty, and antegrade ureteric stenting.

  6. Paediatric trauma care

    Directory of Open Access Journals (Sweden)

    Sebastian van As A

    2010-01-01

    Full Text Available Background: Childhood trauma has become a major cause of mortality and morbidity, disability and socio-economic burden and it is expected by the World Health Organization (WHO that by 2020 it will be the number 1 disease globally. The WHO and UNICEF have published their third World Report on Child Injury Prevention in December 2008. Materials and Methods: A systematic review was performed on the history and magnitude of paediatric trauma worldwide. Additionally exciting developments and new trends were assessed and summarized. Results: Paediatric trauma is a growing field of clinical expertise. New developments include total body digital imaging of children presenting with polytrauma; targeted management of head injuries; conservative management of abdominal injuries in children and diagnostic laparoscopy, including the laparoscopic management of complications following the conservative management of solid organ injuries. Conclusion: Paediatric trauma has long been neglected by the medical profession. In order to deal with it appropriately, it makes sense to adopt the public health approach, requiring that we view child injuries similarly to any other disease or health problem. The greatest gain in our clinical practice with dealing with child injuries will result from a strong focus on primary (preventing the injury, secondary (dealing with the injury in the most efficient manner as well as tertiary prevention (making sure that children treated for trauma will be appropriately reintegrated within our society. By actively promoting child safety we will not only achieve a most welcome reduction in medical cost and disability, but also the ever-so-much desired decline of avoidable childhood misery and suffering.

  7. Navigating Two Worlds: New Identity Constructions as Determinants for Successful Integration of New Black Immigrant and Refugee Youth in Canadian Society

    Directory of Open Access Journals (Sweden)

    Michael Baffoe

    2011-01-01

    Full Text Available Problem statement: The interest in immigrant children and children of immigrants has been growing recently. There is a gap in the literature on current knowledge on the integration and adaptation conditions of the new second generation of immigrants. For teenage youth growing up in diaspora settings, the issue of identity becomes paramount. Approach: They come to define themselves, as well as how others define them, had important implications for social work practice. Immigrant children and youth were the fastest growing component of child and youth population in Canada. Results: We explored the pertinent issue of identity construction as a significant variable in the integration and settlement challenges that Black immigrant youth face in Canadian society. Conclusion: The article is based on an ethnographic study of a number of Black immigrant youth in two of Canada’s largest cities, Montreal and Toronto, the popular settlement points for many new immigrants to Canada.

  8. [Recommendations of the Spanish Paediatric Endocrinology Society Working Group on Obesity on eating habits for the prevention of obesity and cardiovascular risk factors in childhood].

    Science.gov (United States)

    Palomo Atance, E; Bahíllo Curieses, P; Bueno Lozano, G; Feliu Rovira, A; Gil-Campos, M; Lechuga-Sancho, A M; Ruiz Cano, R; Vela Desojo, A

    2016-03-01

    Childhood obesity is associated with a high risk of cardiovascular disease and early mortality. This paper summarises the currently available evidence on the implications of dietary factors on the development and prevention of obesity in paediatric patients. Evidence-based recommendations are: promote the consumption of slowly absorbed carbohydrates and reduce those with a high-glycaemic-index, avoid intake of sugar-sweetened beverages. Fat may provide up to 30-35% of the daily energy intake and saturated fat should provide no more than 10% of daily energy intake; reduce cholesterol intake, avoid formula milk with a high protein content during the first year; promote higher fibre content in the diet, reduce sodium intake, and have at least four meals a day, avoiding regular consumption of fast food and snacks. PMID:26212421

  9. [Recommendations of the Spanish Paediatric Endocrinology Society Working Group on Obesity on eating habits for the prevention of obesity and cardiovascular risk factors in childhood].

    Science.gov (United States)

    Palomo Atance, E; Bahíllo Curieses, P; Bueno Lozano, G; Feliu Rovira, A; Gil-Campos, M; Lechuga-Sancho, A M; Ruiz Cano, R; Vela Desojo, A

    2016-03-01

    Childhood obesity is associated with a high risk of cardiovascular disease and early mortality. This paper summarises the currently available evidence on the implications of dietary factors on the development and prevention of obesity in paediatric patients. Evidence-based recommendations are: promote the consumption of slowly absorbed carbohydrates and reduce those with a high-glycaemic-index, avoid intake of sugar-sweetened beverages. Fat may provide up to 30-35% of the daily energy intake and saturated fat should provide no more than 10% of daily energy intake; reduce cholesterol intake, avoid formula milk with a high protein content during the first year; promote higher fibre content in the diet, reduce sodium intake, and have at least four meals a day, avoiding regular consumption of fast food and snacks.

  10. [Models of care and classification of "Children with special health care needs-CSHCN": Recommendations from the CSHCN Committee, Chilean Paediatric Society].

    Science.gov (United States)

    Flores Cano, Juan Carlos; Lizama Calvo, Macarena; Rodríguez Zamora, Natalie; Ávalos Anguita, María Eugenia; Galanti De La Paz, Mónica; Barja Yañez, Salesa; Becerra Flores, Carlos; Sanhueza Sepúlveda, Carolina; Cabezas Tamayo, Ana María; Orellana Welch, Jorge; Zillmann Geerdts, Gisela; Antilef, Rosa María; Cox Melane, Alfonso; Valle Maluenda, Marcelo; Vargas Catalán, Nelson

    2016-01-01

    "Children with special health care needs" (CSHCN) is an emerging and heterogeneous group of paediatric patients, with a wide variety of medical conditions and with different uses of health care services. There is consensus on how to classify and assess these patients according to their needs, but not for their specific diagnosis. Needs are classified into 6 areas: a) specialised medical care; b) use or need of prescription medication; c) special nutrition; d) dependence on technology; e) rehabilitation therapy for functional limitation; and f) special education services. From the evaluation of each area, a classification for CSHCN is proposed according to low, medium, or high complexity health needs, to guide and distribute their care at an appropriate level of the health care system. Low complexity CSHCN should be incorporated into Primary Care services, to improve benefits for patients and families at this level. It is critical to train health care professionals in taking care of CSHCN, promoting a coordinated, dynamic and communicated work between different levels of the health care system. Compliance with these guidelines will achieve a high quality and integrated care for this vulnerable group of children.

  11. Report from the international society for nomenclature of paediatric and congenital heart disease: creation of a visual encyclopedia illustrating the terms and definitions of the international pediatric and congenital cardiac code.

    Science.gov (United States)

    Giroud, Jorge M; Jacobs, Jeffrey P; Spicer, Diane; Backer, Carl; Martin, Gerard R; Franklin, Rodney C G; Béland, Marie J; Krogmann, Otto N; Aiello, Vera D; Colan, Steven D; Everett, Allen D; William Gaynor, J; Kurosawa, Hiromi; Maruszewski, Bohdan; Stellin, Giovanni; Tchervenkov, Christo I; Walters, Henry L; Weinberg, Paul; Anderson, Robert H; Elliott, Martin J

    2010-10-01

    Tremendous progress has been made in the field of pediatric heart disease over the past 30 years. Although survival after heart surgery in children has improved dramatically, complications still occur, and optimization of outcomes for all patients remains a challenge. To improve outcomes, collaborative efforts are required and ultimately depend on the possibility of using a common language when discussing pediatric and congenital heart disease. Such a universal language has been developed and named the International Pediatric and Congenital Cardiac Code (IPCCC). To make the IPCCC more universally understood, efforts are under way to link the IPCCC to pictures and videos. The Archiving Working Group is an organization composed of leaders within the international pediatric cardiac medical community and part of the International Society for Nomenclature of Paediatric and Congenital Heart Disease (www.ipccc.net). Its purpose is to illustrate, with representative images of all types and formats, the pertinent aspects of cardiac diseases that affect neonates, infants, children, and adults with congenital heart disease, using the codes and definitions associated with the IPCCC as the organizational backbone. The Archiving Working Group certifies and links images and videos to the appropriate term and definition in the IPCCC. These images and videos are then displayed in an electronic format on the Internet. The purpose of this publication is to report the recent progress made by the Archiving Working Group in establishing an Internet-based, image encyclopedia that is based on the standards of the IPCCC.

  12. Building on our past... building for the future. 33rd Annual Canadian Nuclear Society conference and 36th CNS/CNA student conference

    International Nuclear Information System (INIS)

    The 33rd Annual Canadian Nuclear Society Conference and 36th CNS/CNA Student Conference was held in Saskatoon, Saskatchewan, Canada on June 10-13, 2012. With the theme of the conference, 'Building on our Past... Building for the Future', the conference specifically noted the 50th anniversary of the first-nuclear-produced electricity in Canada by the small Nuclear Power Demonstration (NPD) plant on June 4, 1962 and the 60th anniversary of the creation of Atomic Energy of Canada Limited in April 1952. The conference brought together over 360 delegates for the technical sessions with very broad subject matter of: physics, environment and waste management, safety and licensing, life extension, fusion technology, fuel and advanced reactors, reactor materials, uranium mining, I and C process, and, thermalhydraulics. Two plenary sessions focussed on: Small Modular Reactors; and, radioisotopes primarily for medical applications. The student conference was well attended with plenary sessions focussing on: Nuclear Industry Power Developments: The Renaissance; and a panel discussion on the overview of the proposed refurbishment of the Darlington four-unit station.

  13. Paediatric radiopharmaceutical administration

    DEFF Research Database (Denmark)

    Lassmann, Michael; Treves, S Ted; Borgwardt, Lise

    2014-01-01

    In 2008 the EANM published their paediatric dosage card. In 2011 the North American consensus guidelines recommended a set of administered activities for paediatric nuclear medicine. During the EANM congress in 2012 a working group of the EANM and the SNMMI met to study the possibility of harmoni......In 2008 the EANM published their paediatric dosage card. In 2011 the North American consensus guidelines recommended a set of administered activities for paediatric nuclear medicine. During the EANM congress in 2012 a working group of the EANM and the SNMMI met to study the possibility...

  14. Results of a Quality Assurance Review of External Beam Radiation Therapy in the International Society of Paediatric Oncology (Europe) Neuroblastoma Group's High-risk Neuroblastoma Trial: A SIOPEN Study

    Energy Technology Data Exchange (ETDEWEB)

    Gaze, Mark N., E-mail: mark.gaze@uclh.nhs.uk [Department of Oncology, University College London Hospitals NHS Foundation Trust, London (United Kingdom); Boterberg, Tom [Department of Radiation Oncology, Ghent University Hospital, Ghent (Belgium); Dieckmann, Karin; Hoermann, Marcus [General Hospital Vienna, Medical University Vienna (Austria); Gains, Jennifer E.; Sullivan, Kevin P. [Department of Oncology, University College London Hospitals NHS Foundation Trust, London (United Kingdom); Ladenstein, Ruth [Children' s Cancer Research Institute, St. Anna Children' s Hospital, Vienna (Austria)

    2013-01-01

    Purpose: Radiation therapy is important for local control in neuroblastoma. This study reviewed the compliance of plans with the radiation therapy guidelines of the International Society of Paediatric Oncology (Europe) Neuroblastoma Group (SIOPEN) High-Risk Trial protocol. Methods and Materials: The SIOPEN trial central electronic database has sections to record diagnostic imaging and radiation therapy planning data. Individual centers may upload data remotely, but not all centers involved in the trial chose to use this system. A quality scoring system was devised based on how well the radiation therapy plan matched the protocol guidelines, to what extent deviations were justified, and whether adverse effects may result. Central review of radiation therapy planning was undertaken retrospectively in 100 patients for whom complete diagnostic and treatment sets were available. Data were reviewed and compared against protocol guidelines by an international team of radiation oncologists and radiologists. For each patient in the sample, the central review team assigned a quality assurance score. Results: It was found that in 48% of patients there was full compliance with protocol requirements. In 29%, there were deviations for justifiable reasons with no likely long-term adverse effects resulting. In 5%, deviations had occurred for justifiable reasons, but that might result in adverse effects. In 1%, there was a deviation with no discernible justification, which would not lead to long-term adverse events. In 17%, unjustified deviations were noted, with a risk of an adverse outcome resulting. Conclusions: Owing to concern over the proportion of patients in whom unjustified deviations were observed, a protocol amendment has been issued. This offers the opportunity for central review of radiation therapy plans before the start of treatment and the treating clinician a chance to modify plans.

  15. Results of a Quality Assurance Review of External Beam Radiation Therapy in the International Society of Paediatric Oncology (Europe) Neuroblastoma Group's High-risk Neuroblastoma Trial: A SIOPEN Study

    International Nuclear Information System (INIS)

    Purpose: Radiation therapy is important for local control in neuroblastoma. This study reviewed the compliance of plans with the radiation therapy guidelines of the International Society of Paediatric Oncology (Europe) Neuroblastoma Group (SIOPEN) High-Risk Trial protocol. Methods and Materials: The SIOPEN trial central electronic database has sections to record diagnostic imaging and radiation therapy planning data. Individual centers may upload data remotely, but not all centers involved in the trial chose to use this system. A quality scoring system was devised based on how well the radiation therapy plan matched the protocol guidelines, to what extent deviations were justified, and whether adverse effects may result. Central review of radiation therapy planning was undertaken retrospectively in 100 patients for whom complete diagnostic and treatment sets were available. Data were reviewed and compared against protocol guidelines by an international team of radiation oncologists and radiologists. For each patient in the sample, the central review team assigned a quality assurance score. Results: It was found that in 48% of patients there was full compliance with protocol requirements. In 29%, there were deviations for justifiable reasons with no likely long-term adverse effects resulting. In 5%, deviations had occurred for justifiable reasons, but that might result in adverse effects. In 1%, there was a deviation with no discernible justification, which would not lead to long-term adverse events. In 17%, unjustified deviations were noted, with a risk of an adverse outcome resulting. Conclusions: Owing to concern over the proportion of patients in whom unjustified deviations were observed, a protocol amendment has been issued. This offers the opportunity for central review of radiation therapy plans before the start of treatment and the treating clinician a chance to modify plans.

  16. Safety in paediatric imaging

    International Nuclear Information System (INIS)

    Those of us working in a dedicated paediatric environment are aware of the important safety issues with regard to paediatrics. Our goal when working with paediatric patients, the goal is to obtain the best quality images while keeping patients safe and their distress to a minimum. This article will discuss some of the issues regarding paediatric safety in a diagnostic imaging department, including radiation doses and the risk to paediatric patients, reducing medication errors, safe sedation practice and environmental safety. Also discussed are some conditions requiring special consideration to maintain patient safety such as epiglottitis and suspected child abuse. Promotion of a patient/family-centered care system will create an environment of trust where parents or guardians will know that their children are being well cared for in a safe, effective environment. (author)

  17. Safety in paediatric imaging

    Energy Technology Data Exchange (ETDEWEB)

    Carter, D.; Filice, I.; Murray, D.; Thomas, K. [The Hospital for Sick Children, Toronto, Ontario (Canada)

    2006-01-01

    Those of us working in a dedicated paediatric environment are aware of the important safety issues with regard to paediatrics. Our goal when working with paediatric patients, the goal is to obtain the best quality images while keeping patients safe and their distress to a minimum. This article will discuss some of the issues regarding paediatric safety in a diagnostic imaging department, including radiation doses and the risk to paediatric patients, reducing medication errors, safe sedation practice and environmental safety. Also discussed are some conditions requiring special consideration to maintain patient safety such as epiglottitis and suspected child abuse. Promotion of a patient/family-centered care system will create an environment of trust where parents or guardians will know that their children are being well cared for in a safe, effective environment. (author)

  18. Efficacy of Enhanced External Counterpulsation in Patients With Chronic Refractory Angina on Canadian Cardiovascular Society (CCS) Angina Class: An Updated Meta-Analysis.

    Science.gov (United States)

    Zhang, Chunmei; Liu, Xiangjuan; Wang, Xiaomeng; Wang, Qi; Zhang, Yun; Ge, Zhiming

    2015-11-01

    A growing number of patients with chronic artery disease suffer from angina, despite the optimal medical management (ie, β-blockers, calcium channel blockers, and long-acting nitrates) and revascularization. Currently, enhanced external counterpulsation (EECP) therapy has been verified as a noninvasive, safe therapy for refractory angina. The study was designed to evaluate the efficacy of EECP in patients with chronic refractory angina according to Canadian Cardiovascular Society (CCS) angina class.We identified systematic literature through MEDLINE, EMBASE, the Cochrane Clinical Trials Register Database, and the ClinicalTrials. gov Website from 1990 to 2015. Studies were considered eligible if they were prospective and reported data on CCS class before and after EECP treatment. Meta-analysis was performed to assess the efficacy of EECP therapy by at least 1 CCS angina class improvement, and proportion along with the 95% confidence interval (CI) was calculated. Statistical heterogeneity was calculated by I statistic and the Q statistic. Sensitivity analysis was addressed to test the influence of trials on the overall pooled results. Subgroup analysis was applied to explore potential reasons for heterogeneity.Eighteen studies were enrolled in our meta-analysis. Pooled analysis showed 85% of patients underwent EECP had a reduction by at least one CCS class (95%CI 0.81-0.88, I = 58.5%, P < 0.001). The proportion of patients enrolled at primarily different studies with chronic heart failure (CHF) improved by at least 1 CCS class was about 84% after EECP (95%CI 0.81-0.88, I = 32.7%, P = 0.1668). After 3 large studies were excluded, the pooled proportion was 82% (95%CI 0.79-0.86, I = 18%, P = 0.2528). Funnel plot indicated that some asymmetry while the Begg and Egger bias statistic showed no publication bias (P = 0.1495 and 0.2859, respectively).Our study confirmed that EECP provided an effective treatment for patients who were unresponsive to medical management and

  19. Paediatric talus fracture.

    LENUS (Irish Health Repository)

    Byrne, Ann-Maria

    2012-01-01

    Paediatric talus fractures are rare injuries resulting from axial loading of the talus against the anterior tibia with the foot in dorsiflexion. Skeletally immature bone is less brittle, with higher elastic resistance than adult bone, thus the paediatric talus can sustain higher forces before fractures occur. However, displaced paediatric talus fractures and those associated with high-energy trauma have been associated with complications including avascular necrosis, arthrosis, delayed union, neurapraxia and the need for revision surgery. The authors present the rare case of a talar neck fracture in a skeletally immature young girl, initially missed on radiological review. However, clinical suspicion on the part of the emergency physician, repeat examination and further radiographic imaging revealed this rare paediatric injury.

  20. Paediatric interventional radiology

    International Nuclear Information System (INIS)

    Paediatric interventional radiology (PIR) is a rapidly-growing subspecialty, which offers a wide range of procedures applicable to almost all areas of hospital paediatrics. There are many important differences between paediatric and adult practice in interventional radiology, including disease processes and treatment goals, anatomical considerations, periprocedural patient management, radiation exposure optimisation and legal aspects. The use of retrievable or absorbable interventional devices such as stents will probably become more widespread in PIR practice. Recent advances in the technology of imaging equipment have been accompanied by an increase in the complexity of the work done by the radiographer. These developments present challenges and opportunities related to training and maintenance of skills, staffing arrangements, and the potential for advanced practice. It is likely that specialisation in PIR will become a more common role for radiographers in the future

  1. Paediatric asthma and obesity.

    Science.gov (United States)

    Lucas, Sean R; Platts-Mills, Thomas A E

    2006-12-01

    None of the explanations proposed for the increase in paediatric asthma have been adequate. It is becoming apparent that the cause of the increase in asthma must be multi-factorial. Increasing attention has been focused on the role of lifestyle in the development of asthma. Lifestyle changes that have occurred in children are those in diet and decreased physical activity, with obesity being the product of these changes. The increase in asthma, obesity and a sedentary lifestyle have occurred together. However, a temporal relationship between asthma, obesity and decreased physical activity has not been determined in the paediatric literature. Limited data suggest that decreased physical activity could be playing a role in the aetiology of asthma independent of obesity. Furthermore, there has been substantial research on the benefits of exercise programmes for paediatric patients with asthma. Longitudinal trials monitoring physical activity, obesity and the development of asthma are needed. PMID:17098637

  2. Electrodiagnosis in paediatric ophthalmogenetics

    NARCIS (Netherlands)

    P.A. Pkarian (Patricia)

    1994-01-01

    textabstractIn the present overview, practical application of the visual evoked potential (VEP) in paediatric neuro-ophthalmology is described across a wide range of ophthalmogenetic disorders, including albinism, Pelizaeus-Merzbacher disease and spastic paraplegia. The VEP approach is based on a fo

  3. The paediatric surgeon and his working conditions in Francophone sub-Saharan Africa

    Directory of Open Access Journals (Sweden)

    K Gnassingbé

    2011-01-01

    Full Text Available Background: This study described the current conditions of work of paediatric surgeons in Francophone sub-Saharan Africa (FSSA and set the debate at the level of the humanist thinking in medicine. Patients and Methods: This was a multicentre study from 1 st May to 30 th October 2008. The African Society of paediatric surgeons′ directory was used to identify paediatric surgeons in the Francophone′s countries in Sub Saharan Africa. The parameters studied were number of surgeons per country, means of training, working conditions, remunerations, needs for continuous training and the research. Results: A total of 41 paediatric surgeons (68.33% responded. The average number of paediatric surgeons per country was 5. The means of training included government scholarships among 7 paediatric surgeons (17.07%, scholarship from a non-governmental organisations in 14 (34.15% and self-sponsorships in 20 (48.78%. The average salary was 450 Euros (€ (range: 120-1 400 Euros. Most of the paediatric surgeons (68.29% had internet services for continuous update courses and research. Thirty six paediatric surgeons (87.80% had no subscription to specialised scientific journals. Conclusion: The paediatric surgeon in FSSA faces many problems related to his working and living conditions that may have a negative impact on their competences.

  4. Canadian petroleum history bibliography

    Energy Technology Data Exchange (ETDEWEB)

    Cass, D.

    2003-09-27

    The Petroleum History Bibliography includes a list of more than 2,000 publications that record the history of the Canadian petroleum industry. The list includes books, theses, films, audio tapes, published articles, company histories, biographies, autobiographies, fiction, poetry, humour, and an author index. It was created over a period of several years to help with projects at the Petroleum History Society. It is an ongoing piece of work, and as such, invites comments and additions.

  5. Paediatric pharmacokinetics: key considerations

    Science.gov (United States)

    Batchelor, Hannah Katharine; Marriott, John Francis

    2015-01-01

    A number of anatomical and physiological factors determine the pharmacokinetic profile of a drug. Differences in physiology in paediatric populations compared with adults can influence the concentration of drug within the plasma or tissue. Healthcare professionals need to be aware of anatomical and physiological changes that affect pharmacokinetic profiles of drugs to understand consequences of dose adjustments in infants and children. Pharmacokinetic clinical trials in children are complicated owing to the limitations on blood sample volumes and perception of pain in children resulting from blood sampling. There are alternative sampling techniques that can minimize the invasive nature of such trials. Population based models can also limit the sampling required from each individual by increasing the overall sample size to generate robust pharmacokinetic data. This review details key considerations in the design and development of paediatric pharmacokinetic clinical trials. PMID:25855821

  6. Litigation in paediatrics

    LENUS (Irish Health Repository)

    Murphu, JFA

    2011-03-01

    on the issue. This is understandable. Most individuals are healthy during their childhood and have less need of and less interaction with medical services when compared with adults. However, Paediatric litigation does happen and furthermore it is likely to increase in parallel with other specialties. Carroll and Buddenbaum1 have described the pattern of Paediatric litigation in the US. The annual incidence of malpractice claims has been quoted to be as high as 6.6 claims per 100 Paediatricians per year. Almost 30% of Paediatricians have been sued with many being sued on more than one occasion. Of these cases 36% were settled out of court, 33% were dropped by the plaintiff with the remainder going before the judiciary. The authors point out that in the US medical malpractice is a hotly debated issue. Litigation has a questionable impact on health care quality, cost, and access to services. The AMA believes that rising premiums are resulting in the curtailment of medical care particularly in states with high medico-legal rates. The Physician Insurers Association of America (PIAA) is a trade organisation which insures 60% of all private practicing physicians and surgeons has been a useful source of data. In the 20 year period 1985-2005 among a total of 214,226 claims there were 6363 (2.9%) Paediatric claims which ranked it 10th among the 28 specialties covered. The claims arose in equal numbers from the hospital and Paediatrician’s office settings. Common reasons for Paediatric litigation were errors in diagnosis (32%), incorrect performance of a medical or surgical procedure (13%), failure to monitor or manage a case effectively (10%) and medication error (5%). The top five medico-legal conditions were meningitis, routine infant or child checks, newborn respiratory problems, appendicitis and brain-damaged infants as a co-defendant with Obstetrics. Good quality information about litigation is important because the discussion among doctors is frequently confused by

  7. Robotics in paediatric urology.

    Science.gov (United States)

    Olsen, Lars Henning

    2006-02-01

    After the emergence of robotically assisted systems in laparoscopic surgery more than 15 years ago, several systems have been on the market. At the time being only one system, the da Vinci surgical system (Intuitive Surgical, Sunnyvale, CA, USA), has survived in clinical use with an increasing spread particularly among adult urologists used primarily for radical prostatectomies. However, the reconstructive nature of paediatric urology makes the system interesting for the paediatric urologists, since its strength is laparoscopic suturing and difficult dissection. So far only few reports have been published about its clinical use in paediatric urology. The main advantages are the 3D magnified view, the wrist-like movements of the instruments, and the scaling and precision of instrument movements. The system has been used for upper tract reconstruction like pyeloplasties and heminephrectomies, both for the transperitoneal and, more technical challenging, the retroperitoneal approach. In the pelvic region, anti-reflux surgery (both extra- and intravesically) and surgery for malformations of the internal genitalia like utriculus cysts and gonadal streaks are feasible. More simple procedures like nephrectomies and the management of the intra-abdominal testis are not justified due to the high costs. In addition, no advantage for the patients related to standard laparoscopic procedures has been proofed yet. For the surgeon the minimally challenging invasive procedures become feasible with certainly improved ergonomics. The use of the system is much easier than standard laparoscopic surgery and its widespread will give more patients to access minimal invasive surgery. PMID:18947593

  8. Renal imaging in paediatrics

    International Nuclear Information System (INIS)

    The most frequent renal diseases in paediatrics include urinary tract infections, hydronephrosis, kidney anomalies and reflux. The main reason for performing DMSA scintigraphy in paediatrics is the detection of cortical abnormalities related to urinary tract infection. Because the amount of tracer retained in the tubular cells is associated with the distribution of functioning renal parenchyma in the kidney, it is possible, to evaluate the split renal function. In comparison to ultrasound and intravenous urography the sensitivity in the detection of acute as well as chronic inflammatory changes is very high, however less specific. An indication for a renography in neonates and children is beside an estimation of the total renal function and the calculation of the split renal function, the assessment of renal drainage in patients with unclear dilatation of the collecting system in ultrasound. The analysis of the time activity curve provides, especially for follow-up studies, a reproducible method to assess the urinary outflow. The diuretic scintigraphy allows the detection of urinary obstruction. Subsequently it is possible to image the micturition phase to detect vesico-ureteric reflux (indirect MCU) after drainage of tracer from the renal pelvis. An reflux in the ureters or the pelvicalyceal system is visible on the scintigraphic images and can be confirmed by time activity curves. A more invasive technique is the direct isotope cystography with bladder catheterization. The present paper should give an overview about the role of nuclear medicine in paediatric urology. (orig.)

  9. The EU paediatric regulation: effects on paediatric psychopharmacology in Europe.

    Science.gov (United States)

    Stoyanova-Beninska, Violeta V; Wohlfarth, Tamar; Isaac, Maria; Kalverdijk, Luuk J; van den Berg, Henk; Gispen-de Wied, Christine

    2011-08-01

    Child and adolescent psychiatry is a relatively young field and the recognition, classification, and treatment of disorders in children and adolescents lag behind those in adults. In recent years there is an increasing awareness of the differences between children and adults in psychopathology and pharmacology. Related to this new paediatric regulations have been introduced. This article reviews the regulatory and legislative measures that were adopted in the EU in 2007 and the subsequent impact of these measures on the field of paediatric psychopharmacology. The consequences of the paediatric regulation in the EU are reflected in several domains: regulatory, research aimed at drug development and clinical practices. In the regulatory domain, the consequences include: new paediatric indications, inclusion of special (class) warnings, specification of dose regimens, and information on safety specific to children and adolescents, and development of new medicinal formulations. The paediatric regulation leads to timely development of paediatric friendly formulations and better quality of the clinical evidence. In clinical practices, an increased awareness of the uniqueness of paediatric pharmacology is emerging among medical professionals, and subsequent improvement of medical care (i.e. correct doses, appropriate formulation, monitoring for expected adverse events). In addition, clinical guidelines will have to be revised more frequently in order to integrate the recently acquired knowledge. The new regulations stimulate transparency and discussions between academia, pharmaceutical industry, and regulators. The purpose is to optimize clinical research and obtain evidence for paediatric psychopharmacology, thereby providing adequate support for treatment.

  10. Theoretical Analysis of Canadian Lifelong Education Development

    Directory of Open Access Journals (Sweden)

    Mukan Natalia

    2014-12-01

    Full Text Available In the article, the problem of Canadian lifelong education development has been studied. The main objectives of the article are defined as theoretical analysis of scientific and pedagogical literature which highlights different aspects of the research problem; periods of lifelong education development; and determination of lifelong learning role and importance in modern Canadian society.

  11. Paediatric airway management: basic aspects

    DEFF Research Database (Denmark)

    Holm-Knudsen, R J; Rasmussen, L S

    2009-01-01

    children. This paper aims at providing the non-paediatric anaesthesiologist with a set of safe and simple principles for basic paediatric airway management. In contrast to adults, most children with difficult airways are recognised before induction of anaesthesia but problems may arise in all children...

  12. Creating a unique, multi-stakeholder Paediatric Oncology Platform to improve drug development for children and adolescents with cancer.

    Science.gov (United States)

    Vassal, Gilles; Rousseau, Raphaël; Blanc, Patricia; Moreno, Lucas; Bode, Gerlind; Schwoch, Stefan; Schrappe, Martin; Skolnik, Jeffrey; Bergman, Lothar; Bradley-Garelik, Mary Brigid; Saha, Vaskar; Pearson, Andy; Zwierzina, Heinz

    2015-01-01

    Seven years after the launch of the European Paediatric Medicine Regulation, limited progress in paediatric oncology drug development remains a major concern amongst stakeholders - academics, industry, regulatory authorities, parents, patients and caregivers. Restricted increases in early phase paediatric oncology trials, legal requirements and regulatory pressure to propose early Paediatric Investigation Plans (PIPs), missed opportunities to explore new drugs potentially relevant for paediatric malignancies, lack of innovative trial designs and no new incentives to develop drugs against specific paediatric targets are some unmet needs. Better access to new anti-cancer drugs for paediatric clinical studies and improved collaboration between stakeholders are essential. The Cancer Drug Development Forum (CDDF), previously Biotherapy Development Association (BDA), with Innovative Therapy for Children with Cancer Consortium (ITCC), European Society for Paediatric Oncology (SIOPE) and European Network for Cancer Research in Children and Adolescents (ENCCA) has created a unique Paediatric Oncology Platform, involving multiple stakeholders and the European Union (EU) Commission, with an urgent remit to improve paediatric oncology drug development. The Paediatric Oncology Platform proposes to recommend immediate changes in the implementation of the Regulation and set the framework for its 2017 revision; initiatives to incentivise drug development against specific paediatric oncology targets, and repositioning of drugs not developed in adults. Underpinning these changes is a strategy for mechanism of action and biology driven selection and prioritisation of potential paediatric indications rather than the current process based on adult cancer indications. Pre-competitive research and drug prioritisation, early portfolio evaluation, cross-industry cooperation and multi-compound/sponsor trials are being explored, from which guidance for innovative trial designs will be

  13. Metastatic paediatric colorectal carcinoma.

    LENUS (Irish Health Repository)

    Woods, R

    2012-03-01

    A 16-year-old girl presented to our unit with crampy abdominal pain, change in bowel habit, a subjective impression of weight loss and a single episode of haematochezia. She was found to have a rectosigmoid adenocarcinoma and proceeded to laparoscopic anterior resection, whereupon peritoneal metastases were discovered. She received chemotherapy and is alive and well ten month later with no radiological evidence of disease. Colorectal carcinoma is rare in the paediatric population but is increasing in incidence. Early diagnosis is critical to enable optimal outcomes.

  14. Hereditary angioedema: beyond international consensus - circa December 2010 - The Canadian Society of Allergy and Clinical Immunology Dr. David McCourtie Lecture

    Directory of Open Access Journals (Sweden)

    Bowen Tom

    2011-02-01

    Full Text Available Abstract Background The 2010 International Consensus Algorithm for the Diagnosis, Therapy and Management of Hereditary Angioedema was published earlier this year in this Journal (Bowen et al. Allergy, Asthma & Clinical Immunology 2010, 6:24 - http://www.aacijournal.com/content/6/1/24. Since that publication, there have been multiple phase III clinical trials published on either prophylaxis or therapy of hereditary angioedema and some of these products have changed approval status in various countries. This manuscript was prepared to review and update the management of hereditary angioedema. Objective To review approaches for the diagnosis and management of hereditary angioedema (HAE circa December 2010 and present thoughts on moving from HAE management from international evidence-based consensus to facilitate more local health unit considerations balancing costs, efficacies of treatments, and risk benefits. Thoughts will reflect Canadian and international experiences. Methods PubMed searches including hereditary angioedema and diagnosis, therapy, management and consensus were reviewed as well as press releases from various pharmaceutical companies to early December 2010. Results The 2010 International Consensus Algorithms for the Diagnosis, Therapy and Management of Hereditary Angioedema is reviewed in light of the newly published phase III Clinical trials for prevention and therapy of HAE. Management approaches and models are discussed. Conclusions Consensus approach and double-blind placebo controlled trials are only interim guides to a complex disorder such as HAE and should be replaced as soon as possible with large phase IV clinical trials, meta analyses, data base registry validation of approaches including quality of life and cost benefit analyses, safety, and head-to-head clinical trials investigating superiority or non-inferiority comparisons of available approaches. Since not all therapeutic products are available in all jurisdictions

  15. Theatre of paediatric surgery.

    Science.gov (United States)

    McBride, Craig A; Holland, Andrew J A

    2015-01-01

    In the 50 years since the first edition of this journal, operative paediatric surgery has undergone radical change. Many of the most common instruments are unchanged, both as a testament to their utility and in recognition of past surgeons remembered eponymously. Surrounding that basic core of instruments, theatre has changed radically as new tools and techniques have arisen. Surgeons have come down from their pedestals, recognising surgery as a team sport rather than a solo performance. More than half of the current paediatric surgical trainees are women, a higher proportion than in any other craft group of the Royal Australasian College of Surgeons. The appearance, and rapid development, of laparoscopy is to many observers the most notable change in surgery over the last 50 years. Placed in its context though, it is simply the most prominent example of a frameshift in surgical thinking. The patient as a whole is now the focus, rather than just the disease. Recent developments are as much about minimising harm to normal tissues as they are about extirpating pathology. As a surgical maxim, 'Primum non nocere' is even more in evidence in 2015 than it was in 1965. PMID:25586851

  16. Canadian Network for Mood and Anxiety Treatments (CANMAT) and International Society for Bipolar Disorders (ISBD) collaborative update of CANMAT guidelines for the management of patients with bipolar disorder: update 2009.

    Science.gov (United States)

    Yatham, Lakshmi N; Kennedy, Sidney H; Schaffer, Ayal; Parikh, Sagar V; Beaulieu, Serge; O'Donovan, Claire; MacQueen, Glenda; McIntyre, Roger S; Sharma, Verinder; Ravindran, Arun; Young, L Trevor; Young, Allan H; Alda, Martin; Milev, Roumen; Vieta, Eduard; Calabrese, Joseph R; Berk, Michael; Ha, Kyooseob; Kapczinski, Flávio

    2009-05-01

    The Canadian Network for Mood and Anxiety Treatments (CANMAT) published guidelines for the management of bipolar disorder in 2005, with a 2007 update. This second update, in conjunction with the International Society for Bipolar Disorders (ISBD), reviews new evidence and is designed to be used in conjunction with the previous publications. The recommendations for the management of acute mania remain mostly unchanged. Lithium, valproate, and several atypical antipsychotics continue to be first-line treatments for acute mania. Tamoxifen is now suggested as a third-line augmentation option. The combination of olanzapine and carbamazepine is not recommended. For the management of bipolar depression, lithium, lamotrigine, and quetiapine monotherapy, olanzapine plus selective serotonin reuptake inhibitor (SSRI), and lithium or divalproex plus SSRI/bupropion remain first-line options. New data support the use of adjunctive modafinil as a second-line option, but also indicate that aripiprazole should not be used as monotherapy for bipolar depression. Lithium, lamotrigine, valproate, and olanzapine continue to be first-line options for maintenance treatment of bipolar disorder. New data support the use of quetiapine monotherapy and adjunctive therapy for the prevention of manic and depressive events, aripiprazole monotherapy for the prevention of manic events, and risperidone long-acting injection monotherapy and adjunctive therapy, and adjunctive ziprasidone for the prevention of mood events. Bipolar II disorder is frequently overlooked in treatment guidelines, but has an important clinical impact on patients' lives. This update provides an expanded look at bipolar II disorder. PMID:19419382

  17. American Society for Radiation Oncology (ASTRO) Survey of Radiation Biology Educators in U.S. and Canadian Radiation Oncology Residency Programs

    International Nuclear Information System (INIS)

    Purpose: To obtain, in a survey-based study, detailed information on the faculty currently responsible for teaching radiation biology courses to radiation oncology residents in the United States and Canada. Methods and Materials: In March-December 2007 a survey questionnaire was sent to faculty having primary responsibility for teaching radiation biology to residents in 93 radiation oncology residency programs in the United States and Canada. Results: The responses to this survey document the aging of the faculty who have primary responsibility for teaching radiation biology to radiation oncology residents. The survey found a dramatic decline with time in the percentage of educators whose graduate training was in radiation biology. A significant number of the educators responsible for teaching radiation biology were not fully acquainted with the radiation sciences, either through training or practical application. In addition, many were unfamiliar with some of the organizations setting policies and requirements for resident education. Freely available tools, such as the American Society for Radiation Oncology (ASTRO) Radiation and Cancer Biology Practice Examination and Study Guides, were widely used by residents and educators. Consolidation of resident courses or use of a national radiation biology review course was viewed as unlikely by most programs. Conclusions: A high priority should be given to the development of comprehensive teaching tools to assist those individuals who have responsibility for teaching radiation biology courses but who do not have an extensive background in critical areas of radiobiology related to radiation oncology. These findings also suggest a need for new graduate programs in radiobiology.

  18. Canadian physical activity guidelines for adults: are Canadians aware?

    Science.gov (United States)

    Dale, Leila Pfaeffli; LeBlanc, Allana G; Orr, Krystn; Berry, Tanya; Deshpande, Sameer; Latimer-Cheung, Amy E; O'Reilly, Norm; Rhodes, Ryan E; Tremblay, Mark S; Faulkner, Guy

    2016-09-01

    The present study evaluated awareness of the Canadian Society for Exercise Physiology's 2011 Canadian Physical Activity Guidelines for Adults and assessed correlates. Reported awareness of the physical activity (PA) guidelines was 12.9% (204/1586) of the total sample surveyed. More than half (55%) self-reported meeting PA guidelines of ≥ 150 min of moderate to vigorous PA per week. Awareness of PA guidelines was significantly related to participants' level of PA (χ(2) (1) = 30.63, p < 0.001, φ = -0.14), but not to any demographic variables. PMID:27560541

  19. [Toxicology screening in paediatrics].

    Science.gov (United States)

    Garcia-Algar, Óscar; Cuadrado González, Ainoha; Falcon, María

    2016-09-01

    The prevalence of acute or chronic exposure to substances of abuse in paediatric patients, from the neonatal period to adolescence, is not well established as most cases go unnoticed. Regardless of clinical cases of acute poisoning leading to visits to emergency room, the exposure is usually detected by a questionnaire to the parents or children. In the last few years, new validated analytical methodologies have been developed in order to detect parent drugs and their metabolites in different biological matrices. These biological matrices have different time windows for detection of the exposure: acute (i.e., urine, blood, oral fluid), and chronic (i.e., hair, meconium or teeth). The aim of this paper was to review the scenarios where the use of biological matrices is indicated for the detection of acute or chronic exposure to substances of abuse.

  20. The use of antiviral drugs for influenza: Guidance for practitioners, 2012/2013; Paediatric summary

    OpenAIRE

    Allen, Upton D.

    2013-01-01

    This practice point summarizes the use of antiviral drugs to manage influenza illness in children and youth for the 2012/2013 season. It excerpts a recently published, full-length update of Canadian recommendations for clinicians on the use of antiviral drugs for the prevention and treatment of influenza, with a focus on paediatric antiviral therapy. Detailed information on the selective use of chemoprophylaxis can be found in the source document, which also highlights the importance of secon...

  1. Informed consent & ethical issues in paediatric psychopharmacology.

    Science.gov (United States)

    Malhotra, Savita; Subodh, B N

    2009-01-01

    Issues relating to informed consent and ethics in paediatric psychopharmacology limit research in this population. Children vary in their levels of cognitive development, and presence of psychiatric disorder may further impair their ability to give informed consent. In decisional impairment subjects, various methods used for consent are assent/dissent; inclusion of advance directives; and/or alternative decision-makers. India is emerging as a new market for clinical trials in recent years. Moreover, in India the sociocultural realities are different from those in the western countries making it necessary for professionals to be cautious in conducting drug trials. In this review, issues regarding informed consent in children and adolescent with psychiatric diagnosis are discussed for information, discussion and debate by professionals, parents, society and legal experts to create awareness and to facilitate development of guidelines that are appropriate and applicable to the Indian system.

  2. Paediatric investigation plans for pain: painfully slow!

    OpenAIRE

    Davies, Elin H.; Ollivier, Cecile M.; Saint Raymond, Agnes

    2010-01-01

    Abstract Purpose To examine the early impact of the Paediatric Regulation, which entered into force in Europe on 27 January 2007, on the development of pharmaceutical drugs in the therapeutic field of pain submitted to the Paediatric Committee (PDCO) and to the European Medicines Agency (EMA). Methods Paediatric Investigations Plans (PIPs) submitted with a Decision (outcome) reached between September 2007 ...

  3. Paediatric and adult malignant glioma

    DEFF Research Database (Denmark)

    Jones, Chris; Perryman, Lara; Hargrave, Darren

    2012-01-01

    Gliomas in children differ from their adult counterparts by their distribution of histological grade, site of presentation and rate of malignant transformation. Although rare in the paediatric population, patients with high-grade gliomas have, for the most part, a comparably dismal clinical outcome...... to older patients with morphologically similar lesions. Molecular profiling data have begun to reveal the major genetic alterations underpinning these malignant tumours in children. Indeed, the accumulation of large datasets on adult high-grade glioma has revealed key biological differences between...... the adult and paediatric disease. Furthermore, subclassifications within the childhood age group can be made depending on age at diagnosis and tumour site. However, challenges remain on how to reconcile clinical data from adult patients to tailor novel treatment strategies specifically for paediatric...

  4. Canadian Thoracic Society Guidelines for Occupational Asthma

    Directory of Open Access Journals (Sweden)

    Susan M Tarlo

    1998-01-01

    Full Text Available OBJECTIVE: To provide broad guidelines and principles to help primary care physicians, occupational physicians, allergists and respirologists with the recognition, diagnosis and management of patients with occupational asthma (OA.

  5. UK National Clinical Guidelines in Paediatric Dentistry: stainless steel preformed crowns for primary molars.

    Science.gov (United States)

    Kindelan, S A; Day, P; Nichol, R; Willmott, N; Fayle, S A

    2008-11-01

    This revised Clinical Guideline in Paediatric Dentistry replaces the previously published sixth guideline (Fayle SA. Int J Paediatr Dent 1999; 9: 311-314). The process of guideline production began in 1994, resulting in first publication in 1997. Each guideline has been circulated widely for consultation to all UK consultants in paediatric dentistry, council members of the British Society of Paediatric Dentistry (BSPD), and to people of related specialities recognized to have expertise in the subject. The final version of this guideline is produced from a combination of this input and thorough review of the published literature. The intention is to encourage improvement in clinical practice and to stimulate research and clinical audit in areas where scientific evidence is inadequate. Evidence underlying recommendations is scored according to the SIGN classification and guidelines should be read in this context. Further details regarding the process of paediatric dentistry guideline production in the UK is described in the Int J Paediatr Dent 1997; 7: 267-268.

  6. A normal paediatric amylase range.

    OpenAIRE

    Aggett, P J; Taylor, F.(Department of Physics, Massachusetts Institute of Technology, Cambridge, MA, United States of America)

    1980-01-01

    A normal paediatric range of plasma alpha-amylase activity was determined using the Phadebas blue starch method. The range for children over one year was 98--405 IU/l. Plasma amylase activity increased throughout infancy. Mature levels of activity were observed in some children by age 2 months and in most of them by 9 months.

  7. Methodologies to assess paediatric adiposity.

    LENUS (Irish Health Repository)

    Horan, M

    2014-05-04

    Childhood obesity is associated with increased risk of adult obesity, cardiovascular disease, diabetes and cancer. Appropriate techniques for assessment of childhood adiposity are required to identify children at risk. The aim of this review was to examine core clinical measurements and more technical tools to assess paediatric adiposity.

  8. Usage of unpublished paediatric data.

    Science.gov (United States)

    Saint-Raymond, Agnès; Pelle, Benjamin; Zaccaria, Cosimo; Sennwitz, Matthias; Branch, Sarah

    2016-01-01

    The European Paediatric Regulation (EC No 1901/2006) has three main objectives: increasing the number of appropriate medicines for children, increasing information on these medicines and stimulating high-quality ethical research with children. To contribute to the information, pharmaceutical companies were required under article 45 of the Regulation to submit existing paediatric studies to regulatory authorities for review and update of the product information. Nearly, 19 000 study reports have been identified for a thousand active substances. The data are being assessed by member states' competent authorities in collaboration with European Medicines Agency (EMA). After 7 years, 262 active substances have been assessed, all of the 62 centrally approved and nearly 200 nationally approved medicines. The review so far has led to 16 new paediatric indications, of importance in addressing previously unmet needs, in particular, in younger age groups. The information is being made publicly available in an EMA database accessible directly or through the public face of the European Clinical Trials Register. This will increase awareness of existing data that are useful to researchers and other healthcare professionals, and contribute to avoiding unnecessary duplication of paediatric trials. PMID:26543071

  9. Autoimmune paediatric liver disease

    Institute of Scientific and Technical Information of China (English)

    Giorgina Mieli-Vergani; Diego Vergani

    2008-01-01

    Liver disorders with a likely autoimmune pathogenesis in childhood include autoimmune hepatitis (AIH), autoimmune sclerosing cholangitis (ASC),and de novo AIH after liver transplantation.AIH is divided into two subtypes according to seropositivity for smooth muscle and/or antinuclear antibody (SMA/ANA,type 1) or liver kidney microsomal antibody (LKM1,type 2).There is a female predominance in both.LKM1 positive patients tend to present more acutely,at a younger age,and commonly have partial IgA deficiency,while duration of symptoms before diagnosis,clinical signs,family history of autoimmunity, presence of associated autoimmune disorders,response to treatment,and long-term prognosis are similar in both groups. The most common type of paediatric sclerosing cholangitis is ASC.The clinical,biochemical, immunological,and histological presentation of ASC is often indistinguishable from that of AIH type 1.In both,there are high IgG,non-organ specific autoantibodies,and interface hepatitis.Diagnosis is made by cholangiography.Children with ASC respond to immunosuppression satisfactorily and similarly to AIH in respect to remission and relapse rates,times to normalization of biochemical parameters, and decreased inflammatory activity on follow up liver biopsies. However,the cholangiopathy can progress.There may be evolution from AIH to ASC over the years,despite treatment.De novo AIH after liver transplantation affects patients not transplanted for autoimmune disorders and is strikingly reminiscent of classical AIH,including elevated titres of serum antibodies, hypergammaglobulinaemia,and histological findings of interface hepatitis,bridging fibrosis,and collapse.Like classical AIH,it responds to treatment with prednisolone and azathioprine.De novo AIH post liver transplantation may derive from interference by calcineurin inhibitors with the intrathymic physiological mechanisms of T-cell maturation and selection.Whether this condition is a distinct entity or a form of

  10. Paediatric surgery--a general hospital experience.

    Science.gov (United States)

    Fahy, E; Ahmed, K; Lowery, A J; Khan, W; Waldron, R; Barry, K

    2012-01-01

    Plans to centralise paediatric surgery in Ireland have potentially significant implications for service provision and surgical training. study assesses the workload of paediatric surgery in a district hospital over a five-year period. Paediatric surgical admissions and procedures at Mayo General Hospital from January 2006 - December 2010 were reviewed. Data was obtained from the Hospital inpatient enquiry (HIPE) systems and theatre logbooks. 4,255 surgical procedures were performed in 3981 paediatric patients, accounting for 7.4% of the total surgical workload. 2,578 (65%) of cases were elective and 1403 (35%) of paediatric surgery was performed in the emergency setting; paediatric appendicectomy was the most commonly performed procedure (n = 554) with a complication rate of 2.5%. There were no paediatric surgery related mortalities. Paediatric surgery represents a significant part of the surgical workload. There is a continued need for general paediatric surgical provision in this regional setting, supported by access to specialist centres for complicated paediatric surgery. PMID:23495544

  11. Effects of continuing paediatric education in interpersonal communication skills.

    NARCIS (Netherlands)

    Dulmen, A.M. van; Holl, R.A.

    2000-01-01

    Paediatric care places great demands on interpersonal communication skills, especially as regards the handling of psychosocial issues. Recent shifts in paediatric morbidity and increases in patient empowerment furthermore emphasize the need for continuing paediatric education in communication skills

  12. Universal values of Canadian astronauts

    Science.gov (United States)

    Brcic, Jelena; Della-Rossa, Irina

    2012-11-01

    Values are desirable, trans-situational goals, varying in importance, that guide behavior. Research has demonstrated that universal values may alter in importance as a result of major life events. The present study examines the effect of spaceflight and the demands of astronauts' job position as life circumstances that affect value priorities. We employed thematic content analysis for references to Schwartz's well-established value markers in narratives (media interviews, journals, and pre-flight interviews) of seven Canadian astronauts and compared the results to the values of National Aeronautics and Space Administration (NASA) and Russian Space Agency (RKA) astronauts. Space flight did alter the level of importance of Canadian astronauts' values. We found a U-shaped pattern for the values of Achievement and Tradition before, during, and after flight, and a linear decrease in the value of Stimulation. The most frequently mentioned values were Achievement, Universalism, Security, and Self-Direction. Achievement and Self Direction are also within the top 4 values of all other astronauts; however, Universalism was significantly higher among the Canadian astronauts. Within the value hierarchy of Canadian astronauts, Security was the third most frequently mentioned value, while it is in seventh place for all other astronauts. Interestingly, the most often mentioned value marker (sub-category) in this category was Patriotism. The findings have important implications in understanding multi-national crew relations during training, flight, and reintegration into society.

  13. Evidence-based paediatric nursing: paediatric early warning systems.

    Science.gov (United States)

    Gawronski, Orsola

    2016-05-01

    In hospital cardiac arrest are rare events in paediatrics. Most children receive appropriate care without experiencing undetected severe clinical deterioration during hospital admission. Outcomes of paediatric cardiac arrests are however generally poor, with high mortality rates and neurological damage at survival. A review of child mortality in the UK showed that a high proportion of unexpected deaths were preventable ( Pearsons 2008 ). Several studies of patient records of children who suffered cardiac arrests showed the presence of clear signs of clinical deterioration up to 24 hours before (Tume 2006). Appropriate recognition of clinical deterioration could have led to timely intervention to stabilise the patient. Missed deterioration may be due to lack of staff situational awareness, communication failure among professionals or between staff and families and other human factors ( Brady 2014 ). PMID:27214413

  14. Burn epidemiology and cost of medication in paediatric burn patients.

    Science.gov (United States)

    Koç, Zeliha; Sağlam, Zeynep

    2012-09-01

    Burns are common injuries that cause problems to societies throughout the world. In order to reduce the cost of burn treatment in children, it is extremely important to determine the burn epidemiology and the cost of medicines used in burn treatment. The present study used a retrospective design, with data collected from medical records of 140 paediatric patients admitted to a burn centre between 1 January 2009 and 31 December 2009. Medical records were examined to determine burn epidemiology, medication administered, dosage, and duration of use. Descriptive statistical analysis was completed for all variables; chi-square was used to examine the relationship between certain variables. It was found that 62.7% of paediatric burns occur in the kitchen, with 70.7% involving boiling water; 55.7% of cases resulted in third-degree burns, 19.3% required grafting, and mean duration of hospital stay was 27.5 ± 1.2 days. Medication costs varied between $1.38 US dollars (USD) and $14,159.09, total drug cost was $46,148.03 and average cost per patient was $329.63. In this study, the medication cost for burn patients was found to be relatively high, with antibiotics comprising the vast majority of medication expenditure. Most paediatric burns are preventable, so it is vital to educate families about potential household hazards that can be addressed to reduce the risk of a burn. Programmes are also recommended to reduce costs and the inappropriate prescribing of medication.

  15. Do We Need an Annual Canadian Respiratory Conference?

    OpenAIRE

    Louis-Philippe Boulet

    2000-01-01

    Beginning in the fall of 2001, as decided at the 1999 Annual General Meeting of the Canadian Thoracic Society (CTS), the Society's annual and scientific meeting will take place jointly with the American College of Chest Physicians (ACCP). In the past, this annual event was held in conjunction with the Royal College of Physicians' meeting. Unfortunately, attendance at the Royal College meetings was quite low, and the event did not seem to fulfil the needs and interests of the Canadian respirat...

  16. Canadian Network for Mood and Anxiety Treatments (CANMAT) and International Society for Bipolar Disorders (ISBD) collaborative update of CANMAT guidelines for the management of patients with bipolar disorder : update 2013

    NARCIS (Netherlands)

    Yatham, Lakshmi N.; Kennedy, Sidney H.; Parikh, Sagar V.; Schaffer, Ayal; Beaulieu, Serge; Alda, Martin; O'Donovan, Claire; MacQueen, Glenda; McIntyre, Roger S.; Sharma, Verinder; Ravindran, Arun; Young, L. Trevor; Milev, Roumen; Bond, David J.; Frey, Benicio N.; Goldstein, Benjamin I.; Lafer, Beny; Birmaher, Boris; Ha, Kyooseob; Nolen, Willem A.; Berk, Michael

    2013-01-01

    Yatham LN, Kennedy SH, Parikh SV, Schaffer A, Beaulieu S, Alda M, ODonovan C, MacQueen G, McIntyre RS, Sharma V, Ravindran A, Young LT, Milev R, Bond DJ, Frey BN, Goldstein BI, Lafer B, Birmaher B, Ha K, Nolen WA, Berk M. Canadian Network for Mood and Anxiety Treatments (CANMAT) and International So

  17. What's new in paediatric dentistry?

    Science.gov (United States)

    Vitale, M. C.

    2016-03-01

    Since the early 80's, the use of laser has been introduced in the daily dental practice and the technological development has also provided over time to optimize its use. Various types of lasers with different wavelengths have been developed for use in a handy, easy and ergonomic manner. In daily paediatric dentistry, laser could be a very useful medical device which can completely replace the traditional high hand-piece and bur to realize a "micro-invasive" dentistry and a "clean" surgery, without bleeding and sutures. According to the international literature and in the light of recent researches, this work could give an overview on assisted laser therapy in paediatric dentistry, highlighting advantages and disadvantages of this new technology and pointing out the high compliance of the young patient.

  18. Hypnosis in paediatric respiratory medicine.

    Science.gov (United States)

    McBride, Joshua J; Vlieger, Arine M; Anbar, Ran D

    2014-03-01

    Hypnotherapy is an often misunderstood yet effective therapy. It has been reported to be useful within the field of paediatric respiratory medicine as both a primary and an adjunctive therapy. This article gives a brief overview of how hypnotherapy is performed followed by a review of its applications in paediatric patients with asthma, cystic fibrosis, dyspnea, habit cough, vocal cord dysfunction, and those requiring non-invasive positive pressure ventilation. As the available literature is comprised mostly of case series, retrospective studies, and only a single small randomized study, the field would be strengthened by additional randomized, controlled trials in order to better establish the effectiveness of hypnosis as a treatment, and to identify the processes leading to hypnosis-induced physiologic changes. As examples of the utility of hypnosis and how it can be taught to children with respiratory disease, the article includes videos that demonstrate its use for patients with cystic fibrosis.

  19. A focus on paediatric hypertension

    Directory of Open Access Journals (Sweden)

    Pier Paolo Bassareo

    2015-04-01

    Full Text Available Hypertension can begin early in childhood, as occasional increases in blood pressure or abnormal blood pressure responses to physical or emotional stress. High blood pressure in juvenile age is defined as a blood pressure repeatedly above the 95th percentile of specific nomograms. Its worldwide prevalence ranges from 1% to about 10%. The purpose of this paper is to perform an overview about characteristics, diagnosis, risk factors, therapy, and prognosis of paediatric hypertension.

  20. A focus on paediatric hypertension

    OpenAIRE

    Pier Paolo Bassareo; Giuseppe Mercuro

    2015-01-01

    Hypertension can begin early in childhood, as occasional increases in blood pressure or abnormal blood pressure responses to physical or emotional stress. High blood pressure in juvenile age is defined as a blood pressure repeatedly above the 95th percentile of specific nomograms. Its worldwide prevalence ranges from 1% to about 10%. The purpose of this paper is to perform an overview about characteristics, diagnosis, risk factors, therapy, and prognosis of paediatric hypertension.

  1. Clostridium difficile in paediatric populations

    OpenAIRE

    Allen, Upton D

    2014-01-01

    An increase in Clostridium difficile infection incidence has been observed among hospitalized children in the United States. The present statement, targeted at clinicians caring for infants and children in community and institutional settings, summarizes the relevant information relating to the role of C difficile in childhood diarrhea and provides recommendations for diagnosis, prevention and treatment. Significant differences between adult and paediatric risk factors and disease are discuss...

  2. Asian and Pacific Migration: The Canadian Experience.

    Science.gov (United States)

    Samuel, T. John

    1994-01-01

    Examines the characteristics of landed immigrants (permanent settlers) from Asia, and explores their settlement, adaptation, and integration experience in Canada. It suggests that access to Canadian land does not always translate into equal opportunity in the economy and society, but notes that Canada may be more successful at assimilating Asian…

  3. Management of adults with paediatric-onset chronic liver disease: strategic issues for transition care.

    Science.gov (United States)

    Vajro, Pietro; Ferrante, Lorenza; Lenta, Selvaggia; Mandato, Claudia; Persico, Marcello

    2014-04-01

    Advances in the management of children with chronic liver disease have enabled many to survive into adulthood with or without their native livers, so that the most common of these conditions are becoming increasingly common in adult hepatology practice. Because the aetiologies of chronic liver disease in children may vary significantly from those in adulthood, adults with paediatric-onset chronic liver disease may often present with clinical manifestations unfamiliar to their adulthood physician. Transition of medical care to adult practice requires that the adulthood medical staff (primary physicians and subspecialists) have a comprehensive knowledge of childhood liver disease and their implications, and of the differences in caring for these patients. Pending still unavailable Scientific Society guidelines, this article examines causes, presentation modes, evaluation, management, and complications of the main paediatric-onset chronic liver diseases, and discusses key issues to aid in planning a program of transition from paediatric to adult patients.

  4. Onset symptoms in paediatric multiple sclerosis

    DEFF Research Database (Denmark)

    Boesen, Magnus Spangsberg; Sellebjerg, Finn; Blinkenberg, Morten

    2014-01-01

    INTRODUCTION: Paediatric multiple sclerosis (MS) carries a relatively higher mortality and morbidity than adult MS. Paediatric MS symptoms and paraclinical findings at the first demyelinating event have never before been characterised in a Danish setting. The aim of this study was to compare...

  5. Inequality of Paediatric Workforce Distribution in China.

    Science.gov (United States)

    Song, Peige; Ren, Zhenghong; Chang, Xinlei; Liu, Xuebei; An, Lin

    2016-01-01

    Child health has been addressed as a priority at both global and national levels for many decades. In China, difficulty of accessing paediatricians has been of debate for a long time, however, there is limited evidence to assess the population- and geography-related inequality of paediatric workforce distribution. This study aimed to analyse the inequality of the distributions of the paediatric workforce (including paediatricians and paediatric nurses) in China by using Lorenz curve, Gini coefficient, and Theil L index, data were obtained from the national maternal and child health human resource sampling survey conducted in 2010. In this study, we found that the paediatric workforce was the most inequitable regarding the distribution of children region. For different professional types, we found that, except the Central region, the level of inequality of paediatric nurses was higher than that of the paediatricians regarding both the demographic and geographic distributions. The inner-regional inequalities were the main sources of the paediatric workforce distribution inequality. To conclude, this study revealed the inadequate distribution of the paediatric workforce in China for the first time, substantial inequality of paediatric workforce distribution still existed across the nation in 2010, more research is still needed to explore the in-depth sources of inequality, especially the urban-rural variance and the inner- and inter-provincial differences, and to guide national and local health policy-making and resource allocation. PMID:27420083

  6. Transfusion therapy in paediatric trauma patients

    DEFF Research Database (Denmark)

    Nystrup, Kristin Brønnum; Stensballe, Jakob; Bøttger, Morten;

    2015-01-01

    Haemorrhage is a leading cause of death in paediatric trauma patients. Predefined massive transfusion protocols (MTP) have the potential to significantly reduce mortality by treating haemorrhagic shock and coagulopathy, in adhering to the principles of haemostatic resuscitation with rapid...... in paediatric trauma patients is challenging, and the optimal blood product ratio that will increase survival in massively bleeding paediatric trauma patients has yet to be determined. To date, only a few small descriptive studies and case reports have investigated the use of predefined MTP in paediatric trauma...... patients.MTP with increased FFP or PLT to RBC ratios combined with viscoelastic haemostatic assay (VHA) guided haemostatic resuscitation have not yet been tested in paediatric populations but based on results from adult trauma patients, this therapeutic approach seems promising.Considering the high...

  7. Effects of continuing paediatric education in interpersonal communication skills.

    OpenAIRE

    Dulmen, A.M. van; Holl, R.A.

    2000-01-01

    Paediatric care places great demands on interpersonal communication skills, especially as regards the handling of psychosocial issues. Recent shifts in paediatric morbidity and increases in patient empowerment furthermore emphasize the need for continuing paediatric education in communication skills. It is, however, debatable, whether after residency paediatric education can influence paediatrician performance. This study evaluated the effects of a 5-day experiential communication training by...

  8. Provision of general paediatric surgical services in a regional hospital.

    LENUS (Irish Health Repository)

    Zgraj, O

    2012-01-31

    BACKGROUND: In Ireland, specialist paediatric surgery is carried out in paediatric hospitals in Dublin. General surgeons\\/consultants in other surgical specialities provide paediatric surgical care in regional centres. There has been a failure to train general surgeons with paediatric skills to replace these surgeons upon retirement. AIM: To assess paediatric surgical workload in one regional centre to focus the debate regarding the future provision of general paediatric surgery in Ireland. METHODS: Hospital in-patient enquiry (HIPE) system was used to identify total number of paediatric surgical admissions and procedures. Cases assessed requiring hospital transfer. RESULTS: Of 17,478 surgical patients treated, 2,584 (14.8%) were under 14 years. A total of 2,154 procedures were performed. CONCLUSION: Regional centres without dedicated paediatric surgeons deliver care to large numbers of paediatric patients. The demand for care highlights the need for formal paediatric services\\/appropriate surgical training for general surgical trainees.

  9. Statistics in action a Canadian outlook

    CERN Document Server

    Lawless, Jerald F

    2014-01-01

    Commissioned by the Statistical Society of Canada (SSC), Statistics in Action: A Canadian Outlook helps both general readers and users of statistics better appreciate the scope and importance of statistics. It presents the ways in which statistics is used while highlighting key contributions that Canadian statisticians are making to science, technology, business, government, and other areas. The book emphasizes the role and impact of computing in statistical modeling and analysis, including the issues involved with the huge amounts of data being generated by automated processes.The first two c

  10. Treatment options for paediatric pulmonary arterial hypertension

    Directory of Open Access Journals (Sweden)

    R.M.F. Berger

    2010-12-01

    Full Text Available Pulmonary arterial hypertension (PAH is a serious, progressive condition, which can present idiopathically or secondary to conditions such as systemic sclerosis or congenital heart disease. The condition exists in both adult and paediatric forms, which possess several similar characteristics. Adult and paediatric PAH can, however, be distinguished based on underlying pathology and the presence of age-specific conditions, some of which are related to poor lung development in children. Improved knowledge of vascular biology has led to the development of several PAH-specific therapies, which have demonstrated clinical benefits in adults, including improved exercise capacity and prolonged survival. Treatment data in paediatric PAH are scarce. Although limited, the existing data indicate that current treatments for paediatric PAH are well tolerated and effective, at least in the short- and medium-term. Nevertheless, the current guidelines for clinicians, which recommend use of the adult treatment algorithm in paediatric patients, appear justified when judged according to the available evidence. However, further randomised, controlled trials are necessary to increase the evidence base for treatment of paediatric PAH, especially in relation to age-specific conditions. At present, early initiation of treatment and combination pharmacological therapy may offer the most promising courses of action to improve outcomes in paediatric PAH.

  11. Paediatric suicidal burns: A growing concern.

    Science.gov (United States)

    Segu, Smitha; Tataria, Rachana

    2016-06-01

    An alarming rise in rates of paediatric population committing self-immolation acts is a growing social and medical problem. In recent times there seems to be a rising concern in paediatric population. A study was conducted at a government tertiary care burn centre over 5 years in paediatric age group of peer pressure leaving them vulnerable. A multidisciplinary care involving medical, psychological and social support is required. Identifying children at risk and proper counselling and support can form an important strategy at prevention rather than cure. PMID:26803366

  12. Impact of the European paediatric legislation in paediatric rheumatology: past, present and future.

    Science.gov (United States)

    Ruperto, Nicolino; Vesely, Richard; Saint-Raymond, Agnes; Martini, Alberto

    2013-12-01

    Conducting clinical trials in paediatric rheumatology has been difficult mainly because of the lack of funding for academic studies and the lack of interest by pharmaceutical companies in the small and non-rewarding paediatric market. The situation changed dramatically a few years ago with the introduction of the Best Pharmaceuticals for Children Act in the USA and of specific legislation for the development of paediatric medicines (Paediatric Regulation) in the European Union (EU). The EU Paediatric Regulation had a positive impact in paediatric rheumatology-in particular, on the development of new treatments for children with juvenile idiopathic arthritis (JIA). Some problems remain, however, such as greater harmonisation of the regulatory aspects of medicines, how to handle me-too agents, how to conduct adequate pharmacokinetic studies and develop age-appropriate formulations, ethical problems in study review and implementation, and a change in the current JIA classification. The introduction of specific legislation, coupled with the existence of large international networks such as the Pediatric Rheumatology Collaborative Study Group (PRCSG at http://www.prcsg.org), covering North America, and the Paediatric Rheumatology International Trials Organisation (PRINTO at http://www.printo.it), covering more than 50 countries, has led to great advances in paediatric rheumatology. Future changes might increase the possibility of conducting trials with similar approaches in other paediatric rheumatological conditions and provide evidence-based treatments for children affected by rheumatic diseases. PMID:23962457

  13. [Guideline on the use of corticosteroids in Duchenne muscular dystrophy from paediatric neurologists, neurologists and rehabilitation physicians

    NARCIS (Netherlands)

    Groot, I.J.M. de

    2006-01-01

    A guideline on the treatment of boys with muscular dystrophy with corticosteroids has been written and is available from the Dutch patients' organization. The guideline has been approved by the Dutch Societies of Neurology, Rehabilitation and Paediatrics. Based on the available literature the advice

  14. Treatment options for paediatric pulmonary arterial hypertension

    NARCIS (Netherlands)

    Berger, R M F; Bonnet, D

    2010-01-01

    Pulmonary arterial hypertension (PAH) is a serious, progressive condition, which can present idiopathically or secondary to conditions such as systemic sclerosis or congenital heart disease. The condition exists in both adult and paediatric forms, which possess several similar characteristics. Adult

  15. Inequality of Paediatric Workforce Distribution in China

    Science.gov (United States)

    Song, Peige; Ren, Zhenghong; Chang, Xinlei; Liu, Xuebei; An, Lin

    2016-01-01

    Child health has been addressed as a priority at both global and national levels for many decades. In China, difficulty of accessing paediatricians has been of debate for a long time, however, there is limited evidence to assess the population- and geography-related inequality of paediatric workforce distribution. This study aimed to analyse the inequality of the distributions of the paediatric workforce (including paediatricians and paediatric nurses) in China by using Lorenz curve, Gini coefficient, and Theil L index, data were obtained from the national maternal and child health human resource sampling survey conducted in 2010. In this study, we found that the paediatric workforce was the most inequitable regarding the distribution of children policy-making and resource allocation. PMID:27420083

  16. Paediatric cardiac nursing education: a national collaboration.

    Science.gov (United States)

    Cook, Kerry; Daniels, Amanda; Sheehan, Karen; Langton, Helen

    2006-02-01

    Educational courses for staff working in paediatric specialties may not be financially viable because of the small numbers involved and the difficulties that potential students have in getting released from their units. The UK Paediatric Cardiac Nurses Association worked with other groups to explore the feasibility of a national multi-professional paediatric cardiac education pathway. Three options were identified, including the continuation of local in-house provision with its associated variation in standards. The relative benefits and resource implications of each option were explored and approaches made to educational institutions for support in developing the pathway. A university with an established reputation for e-learning undertook this development and a post graduate certificate in Paediatric Cardiothoracic Practice will soon be available. PMID:16518954

  17. Optimising doses in paediatric CT scanning

    International Nuclear Information System (INIS)

    Computed tomography is still extensively used in paediatric imaging. This technique remains a benchmark for bone, lung, cardiovascular exploration and for emergency imaging. The multi-slice technique has revolutionized image quality by improving spatial resolution and bringing acquisition times down to a few seconds, thus almost totally eliminating the problem of movement artefacts common with children. This technique will not therefore be abandoned any time in the near future by paediatric radiologists. However, these multi-slice CT devices today allow rapid and repetitive exploration of large volumes, which can lead to significant individual exposure [1]. A number of surveys have shown that the exposure parameters used in paediatrics are too high when compared with adult protocols [2, 3] even though a lesser dose can provide equivalent image quality [4]. These paediatric CT optimisation measures are currently the subject of an extensive campaign in the literature [5-7]. (author)

  18. Paediatric home care in the UK.

    OpenAIRE

    Tatman, M A; Woodroffe, C.

    1993-01-01

    Paediatric home care services in the UK were ascertained in 1991 and 1992. Respondents from 209 (97%) UK health districts and boards identified 62 general and 124 specialist paediatric home care services by January 1993, 15% having opened in the previous year. Of all UK children, 30% lived in a district with a general home care service. Five health regions had only specialist services. Districts differed widely in the availability of home care for different disorders. The home care services w...

  19. Markets for Canadian oil

    International Nuclear Information System (INIS)

    This conference presentation presented charts and graphs on the market for Canadian oil. Graphs included crude oil and natural gas prices and heavy oil discount differential. Graphs depicting heavy oil economics such as bitumen blending with condensate were also included along with global crude oil reserves by country. Information on oil sands projects in the Athabasca, Peace River, and Cold Lake deposits was presented along with graphs on oil sands supply costs by recovery type; Canadian production for conventional, oil sands and offshore oil; new emerging oil sands crude types; and 2003 market demand by crude type in the United States and Canada. Maps included Canada and United States crude oil pipelines; western Canadian crude oil markets; long term oil pipeline expansion projects; Canadian and United States crude oil pipeline alternatives; and potential tanker markets for Canadian oil sands production. Lastly, the presentation provided graphs on 2003 refinery crude demand and California market demand. tabs., figs

  20. Survey of Oxygen Delivery Practices in UK Paediatric Intensive Care Units

    Science.gov (United States)

    Peters, Mark J.

    2016-01-01

    Purpose. Administration of supplemental oxygen is common in paediatric intensive care. We explored the current practice of oxygen administration using a case vignette in paediatric intensive care units (PICU) in the united kingdom. Methods. We conducted an online survey of Paediatric Intensive Care Society members in the UK. The survey outlined a clinical scenario followed by questions on oxygenation targets for 5 common diagnoses seen in critically ill children. Results. Fifty-three paediatric intensive care unit members from 10 institutions completed the survey. In a child with moderate ventilatory requirements, 21 respondents (42%) did not follow arterial partial pressure of oxygen (PaO2) targets. In acute respiratory distress syndrome, cardiac arrest, and sepsis, there was a trend to aim for lower PaO2 as the fraction of inspired oxygen (FiO2) increased. Conversely, in traumatic brain injury and pulmonary hypertension, respondents aimed for normal PaO2 even as the FiO2 increased. Conclusions. In this sample of clinicians PaO2 targets were not commonly used. Clinicians target lower PaO2 as FiO2 increases in acute respiratory distress syndrome, cardiac arrest, and sepsis whilst targeting normal range irrespective of FiO2 in traumatic brain injury and pulmonary hypertension.

  1. Survey of Oxygen Delivery Practices in UK Paediatric Intensive Care Units

    Directory of Open Access Journals (Sweden)

    Sainath Raman

    2016-01-01

    Full Text Available Purpose. Administration of supplemental oxygen is common in paediatric intensive care. We explored the current practice of oxygen administration using a case vignette in paediatric intensive care units (PICU in the united kingdom. Methods. We conducted an online survey of Paediatric Intensive Care Society members in the UK. The survey outlined a clinical scenario followed by questions on oxygenation targets for 5 common diagnoses seen in critically ill children. Results. Fifty-three paediatric intensive care unit members from 10 institutions completed the survey. In a child with moderate ventilatory requirements, 21 respondents (42% did not follow arterial partial pressure of oxygen (PaO2 targets. In acute respiratory distress syndrome, cardiac arrest, and sepsis, there was a trend to aim for lower PaO2 as the fraction of inspired oxygen (FiO2 increased. Conversely, in traumatic brain injury and pulmonary hypertension, respondents aimed for normal PaO2 even as the FiO2 increased. Conclusions. In this sample of clinicians PaO2 targets were not commonly used. Clinicians target lower PaO2 as FiO2 increases in acute respiratory distress syndrome, cardiac arrest, and sepsis whilst targeting normal range irrespective of FiO2 in traumatic brain injury and pulmonary hypertension.

  2. Harvey Cushing's Canadian connections.

    Science.gov (United States)

    Feindel, William

    2003-01-01

    During his surgical career between 1896 and 1934, Harvey Cushing made eight visits to Canada. He had a broad impact on Canadian medicine and neurosurgery. Cushing's students Wilder Penfield and Kenneth McKenzie became outstanding leaders of the two major centers in Canada for neurosurgical treatment and training. On his first trip to Canada, shortly after completing his surgical internship in August 1896, Cushing traveled with members of his family through the Maritime Provinces and visited hospitals in Quebec and Montreal. Eight years later, in February 1904, as a successful young neurosurgeon at the Johns Hopkins Hospital, he reported to the Montreal Medico-Chirurgical Society on his surgical experience in 20 cases of removal of the trigeminal ganglion for neuralgia. In 1922, as the Charles Mickle Lecturer at the University of Toronto, Cushing assigned his honorarium of $1000 to support a neurosurgical fellowship at Harvard. This was awarded to McKenzie, then a general practitioner, for a year's training with Cushing in 1922-1923. McKenzie returned to initiate the neurosurgical services at the Toronto General Hospital, where he developed into a master surgeon and teacher. On Cushing's second visit to McGill University in October 1922, he and Sir Charles Sherrington inaugurated the new Biology Building of McGill's Medical School, marking the first stage of a Rockefeller-McGill program of modernization. In May 1929, Cushing attended the dedication of the Osler Library at McGill. In September 1934, responding to the invitation of Penfield, Cushing presented a Foundation Lecture-one of his finest addresses on the philosophy of neurosurgery-at the opening of the Montreal Neurological Institute. On that same trip, Cushing's revisit to McGill's Osler Library convinced him to turn over his own treasure of historical books to Yale University.

  3. Where should paediatric surgery be performed?

    Science.gov (United States)

    Arul, G S; Spicer, R D

    1998-07-01

    We have tried to review the evidence for the organisation of paediatric surgical care. Difficulties arise because of the lack of published data from district general hospitals concerning paediatric surgical conditions. Hence much of the debate about the surgical management of children is based on anecdotal evidence. However, at a time when the provision of health care is being radically reorganised to an internal market based on a system of purchasers and providers it is more important than ever to understand the issues at stake. Two separate issues have been discussed: the role of the specialist paediatric centre and the provision of non-specialist paediatric surgery in district general hospitals. There are arguments for and against large regional specialist paediatric centres. The benefits of centralisation include concentration of expertise, more appropriate consultant on call commitment, development of support services, and junior doctor training. The disadvantages include children and their families having to travel long distances for care, and the loss of expertise at a local level. If specialist paediatric emergency transport is available the benefits of centralisation far outweigh the adverse effects of having to take children to a regional paediatric intensive care centre. Specialist paediatric centres are aware of the importance of treating children and their parents as a family unit as highlighted by the Platt committee; this is an important challenge and enormous improvements have occurred to provide proper accommodation for families while their children are treated in hospital. To keep these arguments of large distances and separation from the home in context, one paediatric intensive care unit in Victoria, Australia, providing a centralised service to a region larger in are than England and with a similar admission rate, has a lower mortality rate than the decentralised paediatric intensive care provided in the Trent region of the UK. There is clear

  4. Volunteering with Newcomers: The Perspectives of Canadian- and Foreign-born Volunteers

    OpenAIRE

    Behnam Behnia

    2012-01-01

    Canadian- and foreign-born volunteers have contributed to the settlement of newcomers into Canadian society. Despite their important contribution, little has been reported about the experiences and perspectives of these volunteers. Using the information collected from face-to-face interviews with 60 Canadian- and foreign-born volunteers who support newcomers, this article discusses factors that motivate people to volunteer with newcomers. The study results revealed among other findings that (...

  5. Good long-term survival after paediatric heart transplantation

    DEFF Research Database (Denmark)

    Kruse, Charlotte Duhn; Helvind, Morten; Jensen, Tim;

    2012-01-01

    The brain-death criterion was introduced in Denmark in 1990. The first Danish paediatric heart transplantation (HTx) was performed at Copenhagen University Hospital, Rigshospitalet, in Copenhagen in 1991. We describe our experiences during the first 20 years with paediatric HTx.......The brain-death criterion was introduced in Denmark in 1990. The first Danish paediatric heart transplantation (HTx) was performed at Copenhagen University Hospital, Rigshospitalet, in Copenhagen in 1991. We describe our experiences during the first 20 years with paediatric HTx....

  6. Practical application of natriuretic peptides in paediatric cardiology

    DEFF Research Database (Denmark)

    Smith, Julie; Goetze, Jens Peter; B. Andersen, Claus;

    2010-01-01

    It is still uncertain if cardiac natriuretic peptides are useful biomarkers in paediatric cardiology. In this review we identify four clinical scenarios in paediatric cardiology, where clinical decision-making can be difficult, and where we feel the paediatric cardiologists need additional...

  7. Imaging of intractable paediatric epilepsy

    Directory of Open Access Journals (Sweden)

    Sanjay Prabhu

    2015-10-01

    Full Text Available Approximately 20% of paediatric patients with epilepsy are refractory to medical therapies. In this subgroup of patients, neuroimaging plays an important role in identifying an epileptogenic focus. Successful identification of a structural lesion results in a better outcome following epilepsy surgery. Advances in imaging technologies, methods of epileptogenic region localisation and refinement of clinical evaluation of this group of patients in epilepsy centres have helped to widen the spectrum of children who could potentially benefit from surgical treatment. In this review, we discuss ways to optimise imaging techniques, list typical imaging features of common pathologies that can cause epilepsy, and potential pitfalls to be aware of whilst reviewing imaging studies in this challenging group of patients. The importance of multidisciplinary meetings to analyse and synthesise all the non-invasive data is emphasised. Our objectives are: to describe the four phases of evaluation of children with drug-resistant localisation-related epilepsy; to describe optimal imaging techniques that can help maximise detection of epileptogenic foci; to describe a systematic approach to reviewing magnetic resonance imaging of children with intractable epilepsy; to describe the features of common epileptogenic substrates; to list potential pitfalls whilst reviewing imaging studies in these patients; and to highlight the value of multimodality and interdisciplinary approaches to the management of this group of children.

  8. Paediatric physician-researchers: coping with tensions in dual accountability.

    Science.gov (United States)

    Boydell, Katherine; Shaul, Randi Zlotnik; D'Agincourt-Canning, Lori; Da Silva, Michael; Simpson, Christy; Czoli, Christine D; Rashkovan, Natalie; Kim, Celine C; Levin, Alex V; Schneider, Rayfel

    2012-01-01

    Potential conflicts between the roles of physicians and researchers have been described at the theoretical level in the bioethics literature (Czoli, et al., 2011). Physicians and researchers are generally in mutually distinct roles, responsible for patients and participants respectively. With increasing emphasis on integration of research into clinical settings, however, the role divide is sometimes unclear. Consequently, physician-researchers must consider and negotiate salient ethical differences between clinical- and research-based obligations (Miller et al, 1998). This paper explores the subjective experiences and perspectives of 30 physician-researchers working in three Canadian paediatric settings. Drawing on qualitative interviews, it identifies ethical challenges and strategies used by physician-researchers in managing dual roles. It considers whether competing obligations could have both positive and adverse consequences for both physician-researchers and patients. Finally, we discuss how empirical work, which explores the perspectives of those engaged in research and clinical practice, can lead the way to understanding and promoting best practice. PMID:24406890

  9. Is paediatric trauma severity overestimated at triage?

    DEFF Research Database (Denmark)

    DO, H Q; Hesselfeldt, R; Steinmetz, J;

    2014-01-01

    BACKGROUND: Severe paediatric trauma is rare, and pre-hospital and local hospital personnel experience with injured children is often limited. We hypothesised that a higher proportion of paediatric trauma victims were taken to the regional trauma centre (TC). METHODS: This is an observational...... follow-up study that involves one level I TC and seven local hospitals. We included paediatric (trauma patients with a driving distance to the TC > 30 minutes. The primary end-point was the proportion of trauma patients arriving in the TC. RESULTS: We included 1934...... trauma patients, 238 children and 1696 adults. A total of 33/238 children (13.9%) vs. 304/1696 adults (17.9%) were transported to the TC post-injury (P = 0.14). Among these, children were significantly less injured than adults [median Injury Severity Score (ISS) 9 vs. 14, P 

  10. Diagnostic radiology in paediatric palliative care

    International Nuclear Information System (INIS)

    Palliative care is an expanding specialty within paediatrics, which has attracted little attention in the paediatric radiological literature. Paediatric patients under a palliative care team will have numerous radiological tests which we traditionally categorise under organ systems rather than under the umbrella of palliative medicine. The prevalence of children with life-limiting illness is significant. It has been estimated to be one per thousand, and this may be an underestimate. In this review, we will focus on our experience at one institution, where radiology has proven to be an invaluable partner to palliative care. We will discuss examples of conditions commonly referred to our palliative care team and delineate the crucial role of diagnostic radiology in determining treatment options. (orig.)

  11. Diagnostic radiology in paediatric palliative care

    Energy Technology Data Exchange (ETDEWEB)

    Patel, Preena; Koh, Michelle; Carr, Lucinda; McHugh, Kieran [Great Ormond Street Hospital, Radiology Department, London (United Kingdom)

    2014-01-15

    Palliative care is an expanding specialty within paediatrics, which has attracted little attention in the paediatric radiological literature. Paediatric patients under a palliative care team will have numerous radiological tests which we traditionally categorise under organ systems rather than under the umbrella of palliative medicine. The prevalence of children with life-limiting illness is significant. It has been estimated to be one per thousand, and this may be an underestimate. In this review, we will focus on our experience at one institution, where radiology has proven to be an invaluable partner to palliative care. We will discuss examples of conditions commonly referred to our palliative care team and delineate the crucial role of diagnostic radiology in determining treatment options. (orig.)

  12. Committing Canadian sociology: developing a Canadian sociology and a sociology of Canada.

    Science.gov (United States)

    Matthews, Ralph

    2014-05-01

    This paper is a slightly revised version of the author's "Outstanding Career Award Lecture" presented at the Annual Meeting of the Canadian Sociological Association in Victoria, British Columbia on June 6, 2013. The paper distinguishes between Canadian Sociology and the Sociology of Canada. The former involves the explanatory stance that one takes to understanding Canada. The latter addresses the significant social dimensions that underlie Canadian social organization, culture, and behavior. I make a case for a Canadian Sociology that focuses on the unique features of Canadian society rather than adopting a comparative perspective. I also argue that there is a continuing need within the Sociology of Canada to address the issues of staples development. However, I argue that "new" staples analysis must have a directional change from that of the past, in that social processes now largely determine the pattern of staples development. Moreover, new staples analysis must include issues that were never part of earlier staples analysis, such as issues of environmental impacts and of staples depletion under conditions, such as climate change. The paper concludes by analyzing four factors that provide the dominant social contexts for analyzing modern staples development: (1) the rise of neoliberal government, (2) the implementation of globalization and its social consequences, (3) the assumption of aboriginal rights and entitlement, and (4) the rise of environmentalism. These factors were generally not considered in earlier staples approaches. They are critical to understanding the role of staples development and its impact on Canada in the present time.

  13. A disjointed effort: paediatric musculoskeletal examination.

    LENUS (Irish Health Repository)

    Gill, Irwin

    2012-07-01

    Musculoskeletal (MSK) symptoms are a frequent cause of emergency department attendance for children, and while most often indicative of benign or self-limiting disease, such symptoms can occasionally be the first presentation of serious illness such as leukaemia or juvenile idiopathic arthritis. MSK examination, however, is often not included as part of the routine paediatric examination. The authors aimed to evaluate how often and how thoroughly MSK examination was performed during admissions to the paediatric ward and to compare it with the examination of other symptoms in relation to the presenting complaint and eventual diagnosis.

  14. Resuscitation of general paediatrics in the UK.

    Science.gov (United States)

    Wacogne, I; Scott-Jupp, R; Chambers, T

    2006-12-01

    "The report of my death was an exaggeration", said Mark Twain. For a dying specialty, general paediatrics has certainly been looking very healthy recently. It is timely to examine why our specialty was thought to be at such risk, and to explore why, although in many cases shocked and confused, it is well on the way to recovery. This article explores what is needed to keep it healthy to ensure that the general paediatrician is at the centre of the delivery of paediatrics in the UK.

  15. Radiological protection of paediatric patients: An overview

    International Nuclear Information System (INIS)

    Paediatric patients require special attention with respect to radiation protection, for various reasons. The difference between a 1 kg premature baby and a 100 kg teenager puts special demands on the radiographic techniques used, and the increased radiosensitivity of growing tissue and the patients' longer life expectancy put greater demands on the justification of the procedures to be carried out. The optimization procedure involves practical aspects such as immobilization, body build specific exposure parameters and body build specific anatomical knowledge. These and other aspects of paediatric radiological protection are discussed in this overview. (author)

  16. Selected Abstracts of the 1st Congress of joint European Neonatal Societies (jENS 2015); Budapest (Hungary); September 16-20, 2015; Session “Brain & Development”

    OpenAIRE

    Various Authors

    2015-01-01

    Selected Abstracts of the 1st Congress of joint European Neonatal Societies (jENS 2015); Budapest (Hungary); September 16-20, 2015ORGANIZING INSTITUTIONSEuropean Society for Neonatology (ESN), European Society for Paediatric Research (ESPR), Union of European Neonatal & Perinatal Societies (UENPS), European Foundation for the Care of Newborn Infants (EFCNI), with the local host of Hungarian Society of Perinatology and Obstetric Anesthesiology, Hungarian Society of Perinatology (MPT), supp...

  17. Selected Abstracts of the 1st Congress of joint European Neonatal Societies (jENS 2015); Budapest (Hungary); September 16-20, 2015; Session “Pharmacology”

    OpenAIRE

    Various Authors

    2015-01-01

    Selected Abstracts of the 1st Congress of joint European Neonatal Societies (jENS 2015); Budapest (Hungary); September 16-20, 2015ORGANIZING INSTITUTIONSEuropean Society for Neonatology (ESN), European Society for Paediatric Research (ESPR), Union of European Neonatal & Perinatal Societies (UENPS), European Foundation for the Care of Newborn Infants (EFCNI), with the local host of Hungarian Society of Perinatology and Obstetric Anesthesiology, Hungarian Society of Perinatology (...

  18. Selected Abstracts of the 1st Congress of joint European Neonatal Societies (jENS 2015); Budapest (Hungary); September 16-20, 2015; Session “Pulmonology”

    OpenAIRE

    Various Authors

    2015-01-01

    Selected Abstracts of the 1st Congress of joint European Neonatal Societies (jENS 2015); Budapest (Hungary); September 16-20, 2015ORGANIZING INSTITUTIONSEuropean Society for Neonatology (ESN), European Society for Paediatric Research (ESPR), Union of European Neonatal & Perinatal Societies (UENPS), European Foundation for the Care of Newborn Infants (EFCNI), with the local host of Hungarian Society of Perinatology and Obstetric Anesthesiology, Hungarian Society of Perinatology (...

  19. Selected Abstracts of the 1st Congress of joint European Neonatal Societies (jENS 2015); Budapest (Hungary); September 16-20, 2015; Session “Other”

    OpenAIRE

    Various Authors

    2015-01-01

    Selected Abstracts of the 1st Congress of joint European Neonatal Societies (jENS 2015); Budapest (Hungary); September 16-20, 2015ORGANIZING INSTITUTIONSEuropean Society for Neonatology (ESN), European Society for Paediatric Research (ESPR), Union of European Neonatal & Perinatal Societies (UENPS), European Foundation for the Care of Newborn Infants (EFCNI), with the local host of Hungarian Society of Perinatology and Obstetric Anesthesiology, Hungarian Society of Perinatology (MPT),...

  20. Virtual colonoscopy in paediatric patients

    Energy Technology Data Exchange (ETDEWEB)

    Carrascosa, Patricia [Diagnostico Maipu, Av. Maipu 1668, Vicente Lopez (B1602ABQ), Buenos Aires (Argentina)], E-mail: patriciacarrascosa@diagnosticomaipu.com.ar; Lopez, Elba Martin; Capunay, Carlos; Vallejos, Javier; Carrascosa, Jorge [Diagnostico Maipu, Av. Maipu 1668, Vicente Lopez (B1602ABQ), Buenos Aires (Argentina)

    2010-04-15

    Objective: To determine the usefulness of perspective-filet view for polypoid lesions in paediatric patients in comparison with conventional virtual colonoscopy (VC) analysis and optical colonoscopy. Methods: Sixty-one patients (mean age 5 years old) with a previous episode of rectal bleeding were studied using a 16 slices CT scanner. All patients underwent a colonic preparation. Two acquisitions were done in supine and prone positions with slices of 2 mm thickness; increment 1 mm, 30-50 mA; 90-120 kV. In a workstation an experienced radiologist reviewed images twice. The first read was done using the conventional virtual colonoscopy technique with the evaluation of two-dimensional (2D), three-dimensional (3D) and endoscopical images. Later, in a second session, perspective-filet view was used. It shows a 360 deg. unrolled visualization of the inner colon. The presence, size and location of the lesions were determined. A record of the reading time was made. Results: At per patient evaluation the conventional virtual colonoscopy analysis obtained a sensitivity of 86% and a specificity of 98%. The perspective-filet view obtained a sensitivity of 91% and a specificity of 99%. In the evaluation on a per lesion basis the conventional analysis had a sensitivity of 81% and a specificity of 88%. Perspective-filet view, had a sensitivity of 82% and specificity of 90%. The average total reading time using conventional colonoscopy technique was 18 {+-} 3 min, versus 4 {+-} 1 min using the perspective-filet view. Conclusion: Virtual colon dissection with perspective-filet view is more time-efficient than conventional virtual colonoscopy evaluation with correct correlation in results.

  1. Retinal detachment in paediatric patients

    International Nuclear Information System (INIS)

    Objective: To assess the causes of retinal detachment in children and the various operative procedures requiring vitreoretinal surgical intervention for the same. Study Design: Case series. Place and Duration of Study: Department of Ophthalmology, Al-Shifa Trust Eye Hospital, Rawalpindi, from January 2006 to May 2009. Methodology: A total of 281 eyes of 258 patients, (aged 0 - 18 years) who underwent vitreo-retinal surgical intervention for retinal detachment were included. Surgical log was searched for the type of retinal detachment and its causes. Frequencies of various interventions done in these patients viz. vitrectomy, scleral buckle, use of tamponading agents, laser photocoagulation and cryotherapy were noted. Results were described as descriptive statistics. Results: Myopia was the cause in 62 (22.1%) and trauma in 51 (18.1%) of the eyes. Total retinal detachment (RD) was treated in 94 (33.5%) eyes, sub total RD in 36 (12.8%), recurrent RD in 32 (11.4%), giant retinal tear in 28 (10%), tractional RD in 15 (5.3%) and exudative RD in 2 (0.7%). Prophylactic laser or cryotherapy was applied in 74 (26.3%) of the eyes. Pars plana vitrectomy (PPV) was carried out in 159 (56.6%) eyes while scleral buckle procedure was done in 129 (45.9%) eyes. Silicon oil was used in 149 (53%), perfluorocarbon liquid in 32 (11.4%) and gas tamponade in 20 (7.1%) eyes. Conclusion: The most common cause of retinal detachment in paediatric patients was myopia, followed by trauma. Total RD was more common as compared to the other types. The most common procedure adopted was pars plana vitrectomy followed by scleral buckle procedure. (author)

  2. Planetary Society

    Science.gov (United States)

    Murdin, P.

    2000-11-01

    Carl Sagan, Bruce Murray and Louis Friedman founded the non-profit Planetary Society in 1979 to advance the exploration of the solar system and to continue the search for extraterrestrial life. The Society has its headquarters in Pasadena, California, but is international in scope, with 100 000 members worldwide, making it the largest space interest group in the world. The Society funds a var...

  3. The delivery of general paediatric surgery in Ireland: a survey of higher surgical trainees.

    LENUS (Irish Health Repository)

    Boyle, E

    2012-12-01

    The delivery of general paediatric surgery is changing in Ireland. Fewer paediatric surgical procedures are being performed by newly appointed consultant general surgeons, resulting in increased referrals to the specialist paediatric surgeons of uncomplicated general paediatric surgical problems. We surveyed current higher surgical trainees about their views on provision of paediatric surgical services.

  4. Paediatric surveillance of pertussis in 1998

    NARCIS (Netherlands)

    Melker HE de; Neppelenbroek SN; Schellekens JFP; Suijkerbuijk AWM; Conyn- van Spaendonck MAE; CIE; LIS

    2000-01-01

    Objective: To gain insight into the severity of pertussis in hospitalised cases. Methods: In 1998, hospitalisation data were collected through paediatric surveillance. Results: From 115 hospitalisation admissions collected, 55% of the patients were younger than 3 months of age and not vaccinated; 12

  5. Recent developments in paediatric neuraxial blocks

    Directory of Open Access Journals (Sweden)

    Vrushali Chandrashekhar Ponde

    2012-01-01

    Full Text Available Paediatric anaesthesia and paediatric regional anaesthesia are intertwined. Almost all surgeries unless contradicted could be and should be supplemented with a regional block. The main objective of this review is to elaborate on the recent advances of the central neuraxial blocks, such as application of ultrasound guidance and electrical stimulation in the pursuit of safety and an objective end point. This review also takes account of the traditional technique and understand the benefits as well the risk of each as compared with the recent technique. The recent trends in choosing the most appropriate peripheral block for a given surgery thereby sparing the central neuroaxis is considered. A penile block for circumcision or a sciatic block for unilateral foot surgery, rather than caudal epidural would have a better risk benefit equation. Readers will find a special mention on the recent thoughts on continuous epidural analgesia in paediatrics, especially its rise and fall, yet its unique importance. Lastly, the issue of block placements under sedation or general anaesthesia with its implication in this special population is dealt with. We conducted searches in MEDLINE (PubMed and assessed the relevance of the abstracts of citations identified from literature searches. The search was carried out in English, for last 10 years, with the following key words: Recent advances in paediatric regional anaesthesia; ultrasound guidance for central neuraxial blocks in children; role of electrical stimulation in neuraxial blocks in children; complications in neuraxial block. Full-text articles of potentially relevant abstracts were retrieved for further review.

  6. Ingested foreign bodies in the paediatric patient.

    LENUS (Irish Health Repository)

    O'Brien, G C

    2012-02-03

    BACKGROUND: Paediatric foreign body (FB) ingestion is a common problem and while most can be managed conservatively, a sub-population require intervention. AIMS: To establish clear guidelines for management of paediatric FB ingestion. METHODS: A retrospective chart review analysing all paediatric admissions with FB ingestion over a 10-year period from 1990 to 1999. RESULTS: Of 339 patients presenting to the accident and emergency department with FB ingestion, 59 required admission. Ingestion was accidental in 93.0% of patients. The reasons for admission were as follows: large FBs; dangerous FBs; and living far from the hospital. Nineteen patients (32.2%) were discharged without intervention. Thirty-seven (62.7%) required endoscopic retrieval. In two, the FB was not identified at endoscopy. Only three (5%) required surgery. CONCLUSION: Conservative management of FB ingestion in the paediatric population is possible in the majority of cases. However, a minority require intervention. While guidelines for intervention are ill-defined, definitive indications include symptomatic patients, or dangerous objects.

  7. A review of paediatric tuberculosis in Denmark

    DEFF Research Database (Denmark)

    Hatleberg, Camilla; Prahl, Julie B; Rasmussen, Jeppe Nørgaard;

    2014-01-01

    Paediatric tuberculosis (TB) is a key indicator for recent transmission and presents a reservoir for the disease. We describe trends in epidemiology, microbiological characteristics and treatment outcome in Denmark between 2000 and 2009. Data was retrieved from the national TB surveillance system...

  8. [Czech paediatric cardiac surgery - history and presence].

    Science.gov (United States)

    Hučín, Bohumil

    2012-01-01

    The beginnings of the Paediatric Cardiac Surgery in the Czech Republic date back to the period immediately after the end of World War II. Its protagonists were Prof. Emerich Polák from the Surgical Clinic in Prague, Vinohrady, Prof. Jan Bedrna from Surgical Clinic in Hradec Kralove, Prof. Vladislav Rapant from Surgical Clinic in Olomouc and Prof. Václav Kafka from the Second Surgical Clinic in Prague. They started with operations of the patent ductus arteriosus, the Blalock-Taussig shunt in cyanotic heart defects and resection of coarctation of the aorta. Operations of congenital heart defects, on the open heart were elaborated namely by cardiosurgeons in Brno, under the leadership of Professor Jan Navrátil. On the extension of those methods participated Professor Jaroslav Procházka in Hradec Kralove and Prof. Václav Kafka at the newly opened department of Paediatric surgery in Prague. In the next period, attention of paediatric cardiac surgery was directed at operations of critical congenital heart defects in the smallest children. Palliative operations of the critical heart defects in newborns and infants were first introduced at the clinic of paediatric surgery of the Paediatric University Hospital in Prague. Radical operations of infants and newborns with extra-corporal circulation were elaborated in the Children's heart centre in Prague, Motol. Initiative in the further development of paediatric cardiac surgery was taken over by the Children's heart centre in Prague since its founding in 1977. There was concentrated all medical care of children born with a congenital heart defect in the Czech Republic. This concentration of specialized care at one institution allowed to accumulate extremely large experience with the diagnostics and surgical treatment of congenital heart defects in all age groups with the decrease of patients mortality after operations to 1% even for the smallest children and enabled continuously monitor the quality of life of patients

  9. Movement for Canadian Literacy: Statistics Show Millions Struggle with Literacy

    Science.gov (United States)

    Movement for Canadian Literacy, 2005

    2005-01-01

    The International Adult Literacy and Skills Survey (IALSS), released on November 9, takes a closer look at Canadians' ability to deal with everyday literacy demands. In today's information-based society and economy, literacy is more important than ever. IALSS defines literacy as one's capacity to "use printed and written information to function in…

  10. Educational Goal-Setting in a Native-Canadian Community.

    Science.gov (United States)

    Murphy, H. Joseph

    A revitalization of Canadian Indian culture occurred as a result of the 1967 Hawthorn Report, which advocated the integration of Canada natives into white society. On the Eskasoni Indian Reserve, home of 1700 Micma Indians in Nova Scotia, the revitalization was shown in the results of two questionnaires about local education. On the first…

  11. Canadian beef quality audit.

    OpenAIRE

    Van Donkersgoed, J; Jewison, G; M. Mann; Cherry, B; Altwasser, B; Lower, R; Wiggins, K; Dejonge, R; Thorlakson, B; Moss, E.; C. Mills; Grogan, H

    1997-01-01

    A study was conducted in 4 Canadian processing plants in 1995-96 to determine the prevalence of quality defects in Canadian cattle. One percent of the annual number of cattle processed in Canada were evaluated on the processing floor and 0.1% were graded in the cooler. Brands were observed on 37% and multiple brands on 6% of the cattle. Forty percent of the cattle had horns, 20% of which were scurs, 33% were stubs, 10% were tipped, and 37% were full length. Tag (mud and manure on the hide) wa...

  12. Canadian Irradiation Centre

    International Nuclear Information System (INIS)

    The Canadian Irradiation Centre is a non-profit cooperative project between Atomic Energy of Canada Limited, Radiochemical Company and Universite du Quebec, Institut Armand-Frappier, Centre for Applied Research in Food Science. The Centre's objectives are to develop, demonstrate and promote Canada's radiation processing technology and its applications by conducting applied research; training technical, professional and scientific personnel; educating industry and government; demonstrating operational and scientific procedures; developing processing procedures and standards, and performing product and market acceptance trials. This pamphlet outlines the history of radoation technology and the services offered by the Canadian Irradiation Centre

  13. Paediatric UK demyelinating disease longitudinal study (PUDDLS

    Directory of Open Access Journals (Sweden)

    Likeman Marcus

    2011-07-01

    Full Text Available Abstract Background There is evidence that at least 5% of Multiple sclerosis (MS cases manifest in childhood. Children with MS present with a demyelinating episode involving single or multiple symptoms prior to developing a second event (usually within two years to then meet criteria for diagnosis. There is evidence from adult cohorts that the incidence and sex ratios of MS are changing and that children of immigrants have a higher risk for developing MS. A paediatric population should reflect the vanguard of such changes and may reflect trends yet to be observed in adult cohorts. Studying a paediatric population from the first demyelinating event will allow us to test these hypotheses, and may offer further valuable insights into the genetic and environmental interactions in the pathogenesis of MS. Methods/Design The Paediatric UK Demyelinating Disease Longitudinal Study (PUDDLS is a prospective longitudinal observational study which aims to determine the natural history, predictors and outcomes of childhood CNS inflammatory demyelinating diseases. PUDDLS will involve centres in the UK, and will establish a cohort of children affected with a first CNS inflammatory demyelinating event for long-term follow up by recruiting for approximately 5 years. PUDDLS will also establish a biological sample archive (CSF, serum, and DNA, allowing future hypothesis driven research. For example, the future discovery of a biomarker will allow validation within this dataset for the evaluation of novel biomarkers. Patients will also be requested to consent to be contacted in the future. A secondary aim is to collaborate internationally with the International Paediatric Multiple Sclerosis Study Group when future collaborative studies are proposed, whilst sharing a minimal anonymised dataset. PUDDLS is the second of two jointly funded studies. The first (UCID-SS is an epidemiological surveillance study that already received ethical approvals, and started on the 1st

  14. Paediatric radiology seen from Africa. Part I: providing diagnostic imaging to a young population.

    Science.gov (United States)

    Andronikou, Savvas; McHugh, Kieran; Abdurahman, Nuraan; Khoury, Bryan; Mngomezulu, Victor; Brant, William E; Cowan, Ian; McCulloch, Mignon; Ford, Nathan

    2011-07-01

    Paediatric radiology requires dedicated equipment, specific precautions related to ionising radiation, and specialist knowledge. Developing countries face difficulties in providing adequate imaging services for children. In many African countries, children represent an increasing proportion of the population, and additional challenges follow from extreme living conditions, poverty, lack of parental care, and exposure to tuberculosis, HIV, pneumonia, diarrhoea and violent trauma. Imaging plays a critical role in the treatment of these children, but is expensive and difficult to provide. The World Health Organisation initiatives, of which the World Health Imaging System for Radiography (WHIS-RAD) unit is one result, needs to expand into other areas such as the provision of maintenance servicing. New initiatives by groups such as Rotary and the World Health Imaging Alliance to install WHIS-RAD units in developing countries and provide digital solutions, need support. Paediatric radiologists are needed to offer their services for reporting, consultation and quality assurance for free by way of teleradiology. Societies for paediatric radiology are needed to focus on providing a volunteer teleradiology reporting group, information on child safety for basic imaging, guidelines for investigations specific to the disease spectrum, and solutions for optimising imaging in children.

  15. Canadian heavy water production

    International Nuclear Information System (INIS)

    The paper reviews Canadian experience in the production of heavy water, presents a long-term supply projection, relates this projection to the anticipated long-term electrical energy demand, and highlights principal areas for further improvement that form the bulk of our research and development program on heavy water processes

  16. Canadian hydrogen safety program

    International Nuclear Information System (INIS)

    The Canadian hydrogen safety program (CHSP) is a project initiative of the Codes and Standards Working Group of the Canadian transportation fuel cell alliance (CTFCA) that represents industry, academia, government, and regulators. The Program rationale, structure and contents contribute to acceptance of the products, services and systems of the Canadian Hydrogen Industry into the Canadian hydrogen stakeholder community. It facilitates trade through fair insurance policies and rates, effective and efficient regulatory approval procedures and accommodation of the interests of the general public. The Program integrates a consistent quantitative risk assessment methodology with experimental (destructive and non-destructive) failure rates and consequence-of-release data for key hydrogen components and systems into risk assessment of commercial application scenarios. Its current and past six projects include Intelligent Virtual Hydrogen Filling Station (IVHFS), Hydrogen clearance distances, comparative quantitative risk comparison of hydrogen and compressed natural gas (CNG) refuelling options; computational fluid dynamics (CFD) modeling validation, calibration and enhancement; enhancement of frequency and probability analysis, and Consequence analysis of key component failures of hydrogen systems; and fuel cell oxidant outlet hydrogen sensor project. The Program projects are tightly linked with the content of the International Energy Agency (IEA) Task 19 Hydrogen Safety. (author)

  17. Canadian petroleum industry review

    International Nuclear Information System (INIS)

    A wide ranging discussion about the factors that have influenced oil and natural gas prices, the differences of the Canadian market from international markets, the differences between eastern and western Canadian markets, and shareholders' perspectives on recent commodity price developments was presented. Developments in the OPEC countries were reviewed, noting that current OPEC production of 25 mmbbls is about 60 per cent higher than it was in 1985. It is expected that OPEC countries will continue to expand capacity to meet expected demand growth and the continuing need created by the UN embargo on Iraqi oil sales. Demand for natural gas is also likely to continue to rise especially in view of the deregulation of the electricity industry where natural gas may well become the favored fuel for incremental thermal generation capacity. Prices of both crude oil and natural gas are expected to hold owing to unusually low storage levels of both fuels. The inadequacy of infrastructure, particularly pipeline capacity as a key factor in the Canadian market was noted, along with the dynamic that will emerge in the next several years that may have potential consequences for Canadian production - namely the reversal of the Sarnia to Montreal pipeline. With regard to shareholders' expectations the main issues are (1) whether international markets reach back to the wellhead, hence the producer's positioning with respect to transportation capacity and contract portfolios, and (2) whether the proceeds from increased prices are invested in projects that are yielding more than the cost of capital. 28 figs

  18. Twitter and Canadian Educators

    Science.gov (United States)

    Cooke, Max

    2012-01-01

    An emerging group of leaders in Canadian education has attracted thousands of followers. They've made Twitter an extension of their lives, delivering twenty or more tweets a day that can include, for example, links to media articles, research, new ideas from education bloggers, or to their own, or simply a personal thought. At their best,…

  19. Reform in Canadian Universities.

    Science.gov (United States)

    Small, J. M.

    1994-01-01

    A survey of 67 Canadian university vice presidents and 66 deans concerning reform in recent years found that the many changes reported were modest and reactive rather than bold and proactive. Most common changes involved strategic planning, retrenchment, curriculum expansion, response to enrollment changes, administrative restructuring, and more…

  20. Peer mentoring: evaluation of a novel programme in paediatrics

    OpenAIRE

    Eisen, S; Sukhani, S.; Brightwell, A.; Stoneham, S; Long, A.

    2013-01-01

    Background Mentoring is important for personal and professional development of doctors. Peer mentoring is a core skill in the UK paediatric postgraduate curriculum. However, there is a paucity of peer mentoring programmes aimed at postgraduate doctors in training (postgraduate trainees), and there are no such schemes within paediatrics described in the literature. We developed a regional peer mentoring programme for postgraduate trainees in paediatrics to assess demand and need for peer mento...

  1. Paediatric trigger thumb: our experiences and review of the literature

    OpenAIRE

    Yuksel Kankaya; Kadri Ozer; Nezih Sungur; Ozlem Colak Aslan; Adile Turan; Ugur Kocer

    2013-01-01

    Objectives: The aim of this study is to report our experiences and surgical results in paediatric trigger thumb and to review the literature about paediatric trigger thumb. Methods: We performed a retrospective study of our paediatric trigger thumb patients who underwent open surgery. Our study includes 19 thumbs of 13 children with a mean age of 30 months. Analysis into gender, age of onset, age of surgery, family history and postoperative complications were carried out. Biopsies of A1 an...

  2. Creating and being created: the changing panorama of paediatric rehabilitation.

    Science.gov (United States)

    Helders, Paul J M; Engelbert, Raoul H H; Custers, Jan W H; Gorter, Jan Willem; Takken, Tim; van der Net, Janjaap

    2003-01-01

    Paediatric rehabilitation as a discipline is rapidly changing, especially during the last decades. In the past, paediatric rehabilitation was characterized by merely adult intervention strategies in a miniaturized form, delivered by a merely adult patients-oriented profession. Theories on childhood development, however, changed, as did the focus of interventions: from impairments to function, from the child itself to family, community and peers. The call for outcome-oriented and evidence-based medicine lastly, changed paediatric rehabilitation into a mature paediatric profession with it's own scientific framework. This is reflected among other things in the increasing number of paediatric measures and instruments specifically geared to the paediatric rehabilitation profession, for example the Gross Motor Function Measure, Paediatric Evaluation of Disability Inventory and Movement ABC. More recently, paediatric exercise physiologists are pointing to the benefits of an active lifestyle and training for patients with chronic diseases and disabilities. Several studies have evaluated the effects of such training programmes and came up with positive results. It shows that paediatric rehabilitation continues to develop as a dynamic profession, having growth, childhood development and childhood activities as it's core business.

  3. Paediatric day-case neurosurgery in a resource challenged setting: Pattern and practice

    Directory of Open Access Journals (Sweden)

    Afolabi Muyiwa Owojuyigbe

    2016-01-01

    Full Text Available Background: It has been generally observed that children achieve better convalescence in the home environment especially if discharged same day after surgery. This is probably due to the fact that children generally tend to feel more at ease in the home environment than in the hospital setting. Only few tertiary health institutions provide routine day-case surgery for paediatric neurosurgical patients in our sub-region. Objective: To review the pattern and practice of paediatric neurosurgical day-cases at our hospital. Patients and Methods: A prospective study of all paediatric day-case neurosurgeries carried out between June 2011 and June 2014. Results: A total of 53 patients (34 males and 19 females with age ranging from 2 days to 14 years were seen. Majority of the patients (77.4% presented with congenital lesions, and the most common procedure carried out was spina bifida repair (32% followed by ventriculoperitoneal shunt insertion (26.4% for hydrocephalus. Sixty-eight percentage belonged to the American Society of Anesthesiologists physical status class 2, whereas the rest (32% belonged to class 1. General anaesthesia was employed in 83% of cases. Parenteral paracetamol was used for intra-operative analgesia for most of the patients. Two patients had post-operative nausea and vomiting and were successfully managed. There was no case of emergency re-operation, unplanned admission, cancellation or mortality. Conclusion: Paediatric day-case neurosurgery is feasible in our environment. With careful patient selection and adequate pre-operative preparation, good outcome can be achieved.

  4. Recurrent abdominal pain in paediatric patients

    OpenAIRE

    Mak, VWY; Ng, WM; Chan, KL

    1999-01-01

    Recurrent abdominal pain is a common problem in the paediatric population. While functional abdominal pain accounts for the majority of cases, an organic cause for pain may be found in about 5% to 10% of children. Diagnostic evaluation depends on the clinical presentation and the presence of specific findings. Excessive testing should be avoided as this may increase parental anxiety and put the child through unnecessary stress.

  5. Imaging of accidental paediatric head trauma

    Energy Technology Data Exchange (ETDEWEB)

    Tang, Phua Hwee [KK Women' s and Children' s Hospital, Department of Diagnostic Imaging, Singapore (Singapore); Lim, Choie Cheio Tchoyoson [National Neuroscience Institute, Department of Neuroradiology, Singapore (Singapore)

    2009-05-15

    Head trauma is the most common form of injury sustained in serious childhood trauma and remains one of the top three causes of death despite improved road planning and safety laws. CT remains the first-line investigation for paediatric head trauma, although MRI may be more sensitive at picking up the full extent of injuries and may be useful for prognosis. Follow-up imaging should be tailored to answer the specific clinical question and to look for possible complications. (orig.)

  6. Imaging of accidental paediatric head trauma

    International Nuclear Information System (INIS)

    Head trauma is the most common form of injury sustained in serious childhood trauma and remains one of the top three causes of death despite improved road planning and safety laws. CT remains the first-line investigation for paediatric head trauma, although MRI may be more sensitive at picking up the full extent of injuries and may be useful for prognosis. Follow-up imaging should be tailored to answer the specific clinical question and to look for possible complications. (orig.)

  7. Paediatric CT imaging trends in Australia

    International Nuclear Information System (INIS)

    Full text: The use of CT has rapidly increased since its introduction. Although an important medical tool for diagnosis and treatment, CT is rec ognised as being among the highest contributors to population radiation exposure. As the risks associated with exposure are higher for children than for adults, this study assessed the impact of paediatric CT in Australia by analysing imaging trends. CT imaging trends were derived from Medicare data. Comparable data from a dedicated paediatric hospital (Royal Children's Hospital Melbourne (RCH)) were analysed to determine the validity of utilising Medicare statistics in the younger age groups. The resulting trends reflect the situation for paediatric CT imaging in Australia. In 2009, 2.1 million CT services were billed to Medicare in Australia for children and adults. The average annual growth in the number of CT services provided since 1994 was 8.5%, compared with population growth of 1.4%. Comparison of RCH and Medicare data revealed that only one third of pae diatric CT imaging is captured by Medicare. Combining the data sets showed that over the last 20 years, there has been an average annual increase of 5.1% in the CT imaging rate for 0 to 18-year-olds. However, in recent years, growth in the imaging rate for 11 to 18-year-olds has slowed, while for 5 to 10-year-olds the imaging rate has declined. The significant growth in CT services is attributable to increased demand from the adult demographic. Conversely, increases in the imaging rate for paediatric patients have slowed overall. In fact, for some age groups the rate has fallen.

  8. Parental involvement in paediatric cancer treatment decisions

    OpenAIRE

    McKenna, K; Collier, J; Hewitt, M.; Blake, H

    2010-01-01

    This study investigated parents' information needs and involvement in decision-making processes affecting the care of children diagnosed with cancer. Interviews and questionnaires were used to assess parental satisfaction in 50 mothers and 16 fathers responsible for 58 children in an English Paediatric Oncology Unit. Parents reported that doctors contributed almost twice as much to the decision-making process as they did, but parental satisfaction was positively correlated with the amount of ...

  9. Psychiatric disorders in general paediatric referrals.

    OpenAIRE

    Garralda, M E; Bailey, D.

    1989-01-01

    Detailed interviews with parents of 128 children aged 7 to 12 years consecutively referred to general paediatric clinics identified psychiatric disturbance in 36 (28%) of the children. Emotional disorders were the commonest psychiatric diagnoses (present in two thirds); less frequent diagnoses were conduct disorders (5/36, 14%), mixed conduct/emotional disorders (six, 17%), and hyperkinetic syndrome (three, 8%). Disturbance was related to level of energy, with disturbed children being describ...

  10. Sleep · 8: Paediatric obstructive sleep apnoea

    OpenAIRE

    Nixon, G; Brouillette, R

    2005-01-01

    In the past 25 years there has been increasing recognition of obstructive sleep apnoea (OSA) as a common condition of childhood. Morbidity includes impairment of growth, cardiovascular complications, learning impairment, and behavioural problems. Diagnosis and treatment of this condition in children differs in many respects from that in adults. We review here the key features of paediatric OSA, highlighting differences from adult OSA, and suggest future directions for research.

  11. Assessing Canadian Bank Branch Operating Efficiency Using Data Envelopment Analysis

    Science.gov (United States)

    Yang, Zijiang

    2009-10-01

    In today's economy and society, performance analyses in the services industries attract more and more attention. This paper presents an evaluation of 240 branches of one big Canadian bank in Greater Toronto Area using Data Envelopment Analysis (DEA). Special emphasis was placed on how to present the DEA results to management so as to provide more guidance to them on what to manage and how to accomplish the changes. Finally the potential management uses of the DEA results were presented. All the findings are discussed in the context of the Canadian banking market.

  12. Paediatric airway management: What is new?

    Directory of Open Access Journals (Sweden)

    S Ramesh

    2012-01-01

    Full Text Available Airway management plays a pivotal role in Paediatric Anaesthesia. Over the last two decades many improvements in this area have helped us to overcome this final frontier. From an era where intubation with a conventional laryngoscope or blind nasal intubation was the only tool for airway management, we have come a long way. Today supraglottic airway devices have pride of place in the Operating Room and are becoming important airway devices used in routine procedures. Direct and indirect fibreoptic laryngoscopes and transtracheal devices help us overcome difficult and previously impossible airway situations. These developments mean that we need to update our knowledge on these devices. Also much of our basic understanding of the physiology and anatomy of the paediatric airway has changed. This article attempts to shed light on some of the most important advances/opinions in paediatric airway management like, cuffed endotracheal tubes, supraglottic airway devices, video laryngoscopes, rapid sequence intubation, the newly proposed algorithm for difficult airway management and the role of Ex Utero Intrapartum Treatment (EXIT procedure in the management of the neonatal airway.

  13. Paediatric Virology in the Hippocratic Corpus

    Science.gov (United States)

    Mammas, Ioannis N.; Spandidos, Demetrios A.

    2016-01-01

    Hippocrates (Island of Kos, 460 B.C.-Larissa, 370 B.C.) is the founder of the most famous Medical School of the classical antiquity. In acknowledgement of his pioneering contribution to the new scientific field of Paediatric Virology, this article provides a systematic analysis of the Hippocratic Corpus, with particular focus on viral infections predominating in neonates and children. A mumps epidemic, affecting the island of Thasos in the 5th century B.C., is described in detail. ‘Herpes’, a medical term derived from the ancient Greek word ‘ἕρπειν’, meaning ‘to creep’ or ‘crawl’, is used to describe the spreading of cutaneous lesions in both childhood and adulthood. Cases of children with exanthema ‘resembling mosquito bites’ are presented in reference to varicella or smallpox infection. A variety of upper and lower respiratory tract viral infections are described with impressive accuracy, including rhinitis, pharyngitis, tonsillitis, laryngitis, bronchiolitis and bronchitis. The ‘cough of Perinthos’ epidemic, an influenza-like outbreak in the 5th century B.C., is also recorded and several cases complicated with pneumonia or fatal outcomes are discussed. Hippocrates, moreover, describes conjunctivitis, otitis, lymphadenitis, meningoencephalitis, febrile convulsions, gastroenteritis, hepatitis, poliomyelitis and skin warts, along with proposed treatment directions. Almost 2,400 years later, Hippocrates' systematic approach and methodical innovations can inspire paediatric trainees and future Paediatric Virology subspecialists. PMID:27446241

  14. Paediatric airway management: What is new?

    Science.gov (United States)

    Ramesh, S; Jayanthi, R; Archana, SR

    2012-01-01

    Airway management plays a pivotal role in Paediatric Anaesthesia. Over the last two decades many improvements in this area have helped us to overcome this final frontier. From an era where intubation with a conventional laryngoscope or blind nasal intubation was the only tool for airway management, we have come a long way. Today supraglottic airway devices have pride of place in the Operating Room and are becoming important airway devices used in routine procedures. Direct and indirect fibreoptic laryngoscopes and transtracheal devices help us overcome difficult and previously impossible airway situations. These developments mean that we need to update our knowledge on these devices. Also much of our basic understanding of the physiology and anatomy of the paediatric airway has changed. This article attempts to shed light on some of the most important advances/opinions in paediatric airway management like, cuffed endotracheal tubes, supraglottic airway devices, video laryngoscopes, rapid sequence intubation, the newly proposed algorithm for difficult airway management and the role of Ex Utero Intrapartum Treatment (EXIT) procedure in the management of the neonatal airway. PMID:23293383

  15. Selected Abstracts of the 1st Congress of joint European Neonatal Societies (jENS 2015); Budapest (Hungary); September 16-20, 2015; Session “Circulation, O2 Transport and Haematology”

    OpenAIRE

    Various Authors

    2015-01-01

    Selected Abstracts of the 1st Congress of joint European Neonatal Societies (jENS 2015); Budapest (Hungary); September 16-20, 2015ORGANIZING INSTITUTIONSEuropean Society for Neonatology (ESN), European Society for Paediatric Research (ESPR), Union of European Neonatal & Perinatal Societies (UENPS), European Foundation for the Care of Newborn Infants (EFCNI), with the local host of Hungarian Society of Perinatology and Obstetric Anesthesiology, Hungarian Society of Perinatology (MPT),...

  16. Selected Abstracts of the 1st Congress of joint European Neonatal Societies (jENS 2015); Budapest (Hungary); September 16-20, 2015; Session “Nutrition and gastroenterology”

    OpenAIRE

    Various Authors

    2015-01-01

    Selected Abstracts of the 1st Congress of joint European Neonatal Societies (jENS 2015); Budapest (Hungary); September 16-20, 2015ORGANIZING INSTITUTIONSEuropean Society for Neonatology (ESN), European Society for Paediatric Research (ESPR), Union of European Neonatal & Perinatal Societies (UENPS), European Foundation for the Care of Newborn Infants (EFCNI), with the local host of Hungarian Society of Perinatology and Obstetric Anesthesiology, Hungarian Society of Perinatology (MPT),...

  17. Unveiled Sentiments: Gendered Islamophobia and Experiences of Veiling among Muslim Girls in a Canadian Islamic School

    Science.gov (United States)

    Zine, Jasmin

    2006-01-01

    The practice of veiling has made Muslim women subject to dual oppressions--racism and Islamophobia--in society at large and patriarchal oppression and sexism from within their communities. Based on a narrative analysis of the politics of veiling in schools and society, the voices of young Muslim women attending a Canadian Islamic school speak to…

  18. Financing Canadian international operations

    International Nuclear Information System (INIS)

    A primer on financing international operations by Canadian corporations was provided. Factors affecting the availability to project finance (location, political risk), the various forms of financing (debt, equity, and combinations), the main sources of government backed financing to corporations (the International Finance Corporation) (IFC), the European Bank for Reconstruction and Development (EBRD), the Asian Development Bank (ADB), the Overseas Property Insurance Corporation (OPIC), government or agency guarantees, political risk coverage, the use of offshore financial centres, and the where, when and how these various organizations operate, were reviewed. Examples of all of the above, taken from the experiences of Canadian Occidental Petroleum of Calgary in the U.S., in South America, in the Middle and Far East, and in Kazakhstan, were used as illustrations. figs

  19. Canadian Mathematical Congress

    CERN Document Server

    1977-01-01

    For two weeks in August, 1975 more than 140 mathematicians and other scientists gathered at the Universite de Sherbrooke. The occasion was the 15th Biennial Seminar of the Canadian Mathematical Congress, entitled Mathematics and the Life Sciences. Participants in this inter­ disciplinary gathering included researchers and graduate students in mathematics, seven different areas of biological science, physics, chemistry and medical science. Geographically, those present came from the United States and the United Kingdom as well as from academic departments and government agencies scattered across Canada. In choosing this particular interdisciplinary topic the programme committee had two chief objectives. These were to promote Canadian research in mathematical problems of the life sciences, and to encourage co-operation and exchanges between mathematical scientists" biologists and medical re­ searchers. To accomplish these objective the committee assembled a stim­ ulating programme of lectures and talks. Six ...

  20. Tuberculosis in Aboriginal Canadians

    Directory of Open Access Journals (Sweden)

    Vernon H Hoeppner

    2000-01-01

    Full Text Available Endemic tuberculosis (TB was almost certainly present in Canadian aboriginal people (aboriginal Canadians denotes status Indians, Inuit, nonstatus Indians and metis as reported by Statistics Canada before the Old World traders arrived. However, the social changes that resulted from contact with these traders created the conditions that converted endemic TB into epidemic TB. The incidence of TB varied inversely with the time interval from this cultural collision, which began on the east coast in the 16th century and ended in the Northern Territories in the 20th century. This relatively recent epidemic explains why the disease is more frequent in aboriginal children than in Canadian-born nonaboriginal people. Treatment plans must account for the socioeconomic conditions and cultural characteristics of the aboriginal people, especially healing models and language. Prevention includes bacillus Calmette-Guerin vaccination and chemoprophylaxis, and must account for community conditions, such as rates of suicide, which have exceeded the rate of TB. The control of TB requires a centralized program with specifically directed funding. It must include a program that works in partnership with aboriginal communities.

  1. The Manchester Triage System in paediatric emergency care

    NARCIS (Netherlands)

    M. van Veen (Mirjam)

    2010-01-01

    textabstractIn the first part of the thesis performance of the Manchester Triage System in paediatric emergency care was evaluated. In chapter 1 we reviewed the literature to evaluate realibility and validity of triage systems in paediatric emergency care. The Manchester Triage System was used to tr

  2. Caring for paediatric patient as to broaden radiography spectrum

    International Nuclear Information System (INIS)

    The paediatric patient is a special group of patients in the hospital set up. thus their special needs contribute to about 75% of quality imaging services offered. Age, Psychological aspects, parents participation, departmental atmosphere and environmental make them special. this presentation aims at installing into Imaging Technologies a sense of Responsibility for purpose of improving the resultant quality of Imaging services offered to paediatrics

  3. Lost among the trees? The autonomic nervous system and paediatrics.

    Science.gov (United States)

    Rees, Corinne A

    2014-06-01

    The autonomic nervous system (ANS) has been strikingly neglected in Western medicine. Despite its profound importance for regulation, adjustment and coordination of body systems, it lacks priority in training and practice and receives scant attention in numerous major textbooks. The ANS is integral to manifestations of illness, underlying familiar physical and psychological symptoms. When ANS activity is itself dysfunctional, usual indicators of acute illness may prove deceptive. Recognising the relevance of the ANS can involve seeing the familiar through fresh eyes, challenging assumptions in clinical assessment and in approaches to practice. Its importance extends from physical and psychological well-being to parenting and safeguarding, public services and the functioning of society. Exploration of its role in conditions ranging from neurological, gastrointestinal and connective tissue disorders, diabetes and chronic fatigue syndrome, to autism, behavioural and mental health difficulties may open therapeutic avenues. The ANS offers a mechanism for so-called functional illnesses and illustrates the importance of recognising that 'stress' takes many forms, physical, psychological and environmental, desirable and otherwise. Evidence of intrauterine and post-natal programming of ANS reactivity suggests that neonatal care and safeguarding practice may offer preventive opportunity, as may greater understanding of epigenetic change of ANS activity through, for example, accidental or psychological trauma or infection. The aim of this article is to accelerate recognition of the importance of the ANS throughout paediatrics, and of the potential physical and psychological cost of neglecting it. PMID:24573884

  4. Perioperative tranexamic acid in day-case paediatric tonsillectomy

    Science.gov (United States)

    Thorning, G

    2014-01-01

    Introduction Tranexamic acid has been used for many years to minimise blood loss during surgery and, more recently, to reduce morbidity after major trauma. While small studies have confirmed reduction in blood loss during tonsillectomy with its use, the rate of primary haemorrhage following tonsillectomy has not been reported. In the UK, less than 50% of children having a tonsillectomy are managed as day cases, partly because of concerns about bleeding during the initial 24 hours following surgery. Methods A retrospective review of clinical records between January 2007 and January 2013 produced 476 children between the ages of 3 and 16 years who underwent Coblation™ tonsillectomy, with or without adenoidectomy and/or insertion of ventilation tubes. All children were ASA (American Society of Anesthesiologists) grade 1 or 2 and anaesthetised using a standard day surgery protocol. Following induction of anaesthesia, all received intravenous tranexamic acid at a dose of 10–15mg/kg. Results Two children (0.4%) had minor bleeding within two hours of surgery. Both returned to theatre for haemostasis and were discharged home later the same day with no further complications. The expected rate for primary haemorrhage in the UK using this technique for tonsillectomy is 1%. Conclusions Perioperative tranexamic acid in a single, parenteral dose might reduce the incidence of primary haemorrhage following paediatric tonsillectomy, facilitating discharge on the day of surgery. The results from this observational study indicate a potential benefit and need for a large, prospective, multicentre, randomised controlled trial. PMID:24780670

  5. Lost among the trees? The autonomic nervous system and paediatrics.

    Science.gov (United States)

    Rees, Corinne A

    2014-06-01

    The autonomic nervous system (ANS) has been strikingly neglected in Western medicine. Despite its profound importance for regulation, adjustment and coordination of body systems, it lacks priority in training and practice and receives scant attention in numerous major textbooks. The ANS is integral to manifestations of illness, underlying familiar physical and psychological symptoms. When ANS activity is itself dysfunctional, usual indicators of acute illness may prove deceptive. Recognising the relevance of the ANS can involve seeing the familiar through fresh eyes, challenging assumptions in clinical assessment and in approaches to practice. Its importance extends from physical and psychological well-being to parenting and safeguarding, public services and the functioning of society. Exploration of its role in conditions ranging from neurological, gastrointestinal and connective tissue disorders, diabetes and chronic fatigue syndrome, to autism, behavioural and mental health difficulties may open therapeutic avenues. The ANS offers a mechanism for so-called functional illnesses and illustrates the importance of recognising that 'stress' takes many forms, physical, psychological and environmental, desirable and otherwise. Evidence of intrauterine and post-natal programming of ANS reactivity suggests that neonatal care and safeguarding practice may offer preventive opportunity, as may greater understanding of epigenetic change of ANS activity through, for example, accidental or psychological trauma or infection. The aim of this article is to accelerate recognition of the importance of the ANS throughout paediatrics, and of the potential physical and psychological cost of neglecting it.

  6. Proceedings of the Canadian Nuclear Society ninth annual conference, 1988

    International Nuclear Information System (INIS)

    The 74 papers presented at this conference covered the following topics: operational enhancements of existing nuclear power plants; design of small reactors; accident behaviour in CANDU reactor fuel channels; fuel storage and waste management; reactor commissioning and decommissioning; nuclear safety experiments and modelling; the next generation of CANDU reactors; advances in nuclear engineering education in Canada; safety of small reactors; current position and improvements of fuel channels; current issues in nuclear safety; and, medical and industrial radiation applications

  7. Proceedings of the Canadian Nuclear Society CANDU maintenance conference

    International Nuclear Information System (INIS)

    The conference proceedings comprise 51 papers on the following aspects of maintenance of CANDU reactors: Major maintenance projects, maintenance planning and preparation, maintenance effectiveness, future maintenance issues, safety and radiation protection. The individual papers have been abstracted separately

  8. Proceedings of the Canadian Nuclear Society 7. annual conference

    International Nuclear Information System (INIS)

    This conference had as its major topics of coverage: fuel and fuel channel materials, reactor physics and radiation, safety and the environment, fusion, thermohydraulics, economic and social issues and operations

  9. Proceedings of the Canadian Nuclear Society 8. annual conference

    International Nuclear Information System (INIS)

    This conference contains papers under the major topics of plant life extension, safety and the environment, reactor physics, thermohydraulics I, development and deployment, thermohydraulics II, operations I, safety r and d post chernobyl, fuel channels, operations II, and nuclear technology developments

  10. Proceedings of the Canadian Nuclear Society fifth annual conference

    International Nuclear Information System (INIS)

    The twenty papers presented at this conference covered the areas of: modeling and analysis, emphasizing thermalhydraulics in CANDU primary heat transport systems; Nuclear technologies in general, particularly relating to the operation and performance of CANDU reactors; and tailings and reactor waste disposal

  11. Proceedings of the 19. Canadian Nuclear Society simulation symposium

    International Nuclear Information System (INIS)

    A majority of the 31 papers in this symposium on nuclear simulation deal with CANDU reactors. The sessions were organized according to the following subjects: reactor physics, hydrogen behaviour, thermalhydraulics, reactor safety and operation. The individual papers have been abstracted separately

  12. Pancreaticoduodenectomy in children: optimising outcome of uncommon paediatric procedures.

    LENUS (Irish Health Repository)

    Yeap, B H

    2012-02-01

    Contemporary surgical practice is increasingly dominated by subspecialisation in response to improved outcome from high volume centres, though uncertainties persist for uncommon paediatric procedures. Three paediatric pancreaticoduodenectomies performed at Our Lady\\'s Children\\'s Hospital, Dublin, over a period of 9 years were evaluated to substantiate their continuing performance by paediatric rather than adult pancreatic surgeons. With ages ranging from 18 months to 8 years old, the mean operating time was 263 minutes, while the average hospital stay was 12 days. There was no perioperative mortality, although complication rate was 100%. Re-operation was required in 33%. The long term outcome of this small paediatric cohort was comparable to adult series despite the low patient accrual, underscoring the advantages of a multidisciplinary approach afforded by tertiary paediatric institutions for intricate yet infrequent operations in children.

  13. European Society for Pediatric Gastroenterology, Hepatology, and Nutrition guidelines for the diagnosis of coeliac disease

    DEFF Research Database (Denmark)

    Husby, S; Koletzko, S; Korponay-Szabó, I R;

    2012-01-01

    Diagnostic criteria for coeliac disease (CD) from the European Society for Paediatric Gastroenterology, Hepatology, and Nutrition (ESPGHAN) were published in 1990. Since then, the autoantigen in CD, tissue transglutaminase, has been identified; the perception of CD has changed from that of a rather...

  14. Polish Society of Endocrinology Position statement on endocrine disrupting chemicals (EDCs).

    Science.gov (United States)

    Rutkowska, Aleksandra; Rachoń, Dominik; Milewicz, Andrzej; Ruchała, Marek; Bolanowski, Marek; Jędrzejuk, Diana; Bednarczuk, Tomasz; Górska, Maria; Hubalewska-Dydejczyk, Alicja; Kos-Kudła, Beata; Lewiński, Andrzej; Zgliczyński, Wojciech

    2015-01-01

    With the reference to the position statements of the Endocrine Society, the Paediatric Endocrine Society, and the European Society of Paediatric Endocrinology, the Polish Society of Endocrinology points out the adverse health effects caused by endocrine disrupting chemicals (EDCs) commonly used in daily life as components of plastics, food containers, pharmaceuticals, and cosmetics. The statement is based on the alarming data about the increase of the prevalence of many endocrine disorders such as: cryptorchidism, precocious puberty in girls and boys, and hormone-dependent cancers (endometrium, breast, prostate). In our opinion, it is of human benefit to conduct epidemiological studies that will enable the estimation of the risk factors of exposure to EDCs and the probability of endocrine disorders. Increasing consumerism and the industrial boom has led to severe pollution of the environment with a corresponding negative impact on human health; thus, there is great necessity for the biomonitoring of EDCs in Poland. PMID:26136137

  15. Canadian identity: Implications for international social work by Canadians

    DEFF Research Database (Denmark)

    Hiranandani, Vanmala Sunder

    2011-01-01

    This paper is in response to recent calls to conceptualize and articulate Canadian perspectives and experiences in international social work, given that the Canadian standpoint has been lacking in international social work literature. This paper contends that it is imperative, first of all...

  16. Action, prevention and epidemiology of paediatric obesity

    DEFF Research Database (Denmark)

    Lissau, Inge

    2005-01-01

    UNLABELLED: The overall aim of this paper is to describe important issues regarding paediatric obesity as a public health problem. This paper focuses on actions taken, and on the prevalence of obesity in children, teens and adults in Denmark. In addition, the paper describes some important...... increase from 1987 to 2000 (0.7 to 4.9%). Among young women aged 16-24, the increase is threefold in the same period. Among teens, the prevalence has increased by 2-3 times in recent decades. Nevertheless, compared to other European countries and the US, Denmark has a relatively low prevalence of obesity...

  17. Juvenile idiopathic arthritis: the paediatric perspective

    Energy Technology Data Exchange (ETDEWEB)

    Jordan, Alison [Birmingham Children' s Hospital, Department of Adolescent Rheumatology, Birmingham (United Kingdom); McDonagh, Janet E. [Birmingham Children' s Hospital, Institute of Child Health, Birmingham (United Kingdom)

    2006-08-15

    Paediatric rheumatology is a relatively new specialty that has developed rapidly over the last 30 years. There have been major advances, which have included improvements in the classification and management of juvenile idiopathic arthritis (JIA). The former has led to enhanced international collaboration with disease registries, multicentre research and the development of new therapeutic agents. This has resulted in improved disease control and remission induction in many. There is, however, still significant morbidity associated with JIA during childhood, adolescence and adulthood, and challenges for the future include early identification of those with a poorer prognosis, appropriate administration of safe therapies and optimizing outcomes as young people move through adolescence into adulthood. (orig.)

  18. Conservative Management of Paediatric Clavicle Fractures

    Directory of Open Access Journals (Sweden)

    Barry J. O'Neill

    2011-01-01

    Full Text Available Paediatric clavicle fractures have traditionally been treated nonoperatively. Recent studies have recommended operative management for displaced midshaft fractures. We conducted a retrospective review of all clavicle fractures in children aged one to sixteen over a two-year period. We classified fractures and evaluated followup and clinical outcome. We identified 190 fractures. There were 135 boys and 55 girls. 65% of fractures were displaced and 35% undisplaced. Mean radiographic and clinical followup was 35 days and 44 days, respectively. Clavicle fractures in children heal with nonoperative management. Radiographs of clavicle fractures in children are unnecessary in the absence of clinical symptoms.

  19. The Investigation of Proptosis in Paediatric Practice

    Directory of Open Access Journals (Sweden)

    Ms Sayantani Ghosh

    2009-08-01

    Full Text Available A retrospective review of 65 cases of paediatric proptosispresenting to a rural teaching hospital in India, from February2006 to June 2008. There were 17 cases with orbital cellulitisand 15 with retinoblastoma. We report the history, clinicalexamination, radiological findings and diagnosis. Most caseshad a characteristic history and pathognomonic eye signs.Computer Tomography (CT correlated with histopathology inmost cases. CT is widely available, even within a remotesetting, and is a convenient investigation. Thus, a detailedhistory, clinical examination and CT scan were the mostfruitful approach to the diagnosis of childhood proptosis inthis series.

  20. Paediatric procedural sedation within the emergency department.

    Science.gov (United States)

    Krieser, David; Kochar, Amit

    2016-02-01

    Procedural sedation and analgesia in children requires the use of non-pharmacological and pharmacological approaches to facilitate the management of painful procedures. The development of skills in such techniques has mirrored the development of paediatric emergency medicine as a subspecialty. Governance, education and credentialing must facilitate safe sedation practice, using a structured approach, as sedating children in the busy environment of an emergency department is not without risk. Emergency clinicians, patients and caregivers all have a role to play in developing a safe, effective sedation plan. PMID:27062624

  1. Cryptozoology Society

    Science.gov (United States)

    Richman, Barbara T.

    Reports of Loch Ness monsters, Bigfoot, and the Yeti spring u p from time to time, sparking scientific controversy about the veracity of these observations. Now an organization has been established to help cull, analyze, and disseminate information on the alleged creatures. The International Society of Cryptozoology, formed at a January meeting at the U.S. National Museum of Natural History of the Smithsonian Institution, will serve as the focal point for the investigation, analysis, publication, and discussion of animals of unexpected form or size or of unexpected occurrences in time or space.

  2. Canadian photovoltaic industry directory

    International Nuclear Information System (INIS)

    This directory has been prepared to help potential photovoltaic (PV) customers identify Canadian-based companies who can meet their needs, and to help product manufacturers and distributors identify potential new clients and/or partners within the PV industry for new and improved technologies. To assist the reader, an information matrix is provided that identifies the product and service types offered by each firm and its primary clients served. A list of companies by province or territory is also included. The main section lists companies in alphabetical order. Information presented for each includes address, contact person, prime activity, geographic area served, languages in which services are offered, and a brief company profile

  3. The Canadian safeguards program

    International Nuclear Information System (INIS)

    In support of the Treaty on the Non-Proliferation of Nuclear Weapons Canada provides technical support to the International Atomic Energy Agency for the development of safeguards relevant to Canadian designed and built nuclear facilities. Some details of this program are discussed, including the philosophy and development of CANDU safeguards systems; the unique equipment developed for these systems; the provision of technical experts; training programs; liaison with other technical organizations; research and development; implementation of safeguards systems at various nuclear facilities; and the anticipated future direction of the safeguards program

  4. On Realities of Canadian Multiculturalism

    Institute of Scientific and Technical Information of China (English)

    李梦辰

    2013-01-01

    Canada is a multicultural country which was mainly established by immigrants. Just because of that, Canadian govern⁃ment has carried out the policy of multiculturalism since1970s. However, it has encountered many problems such as policy con⁃flicts, national identity, democracy-inquiry and racial discrimination, etc. Hence the Canadian multiculturalism has been in a di⁃lemma.

  5. Developing paediatric medicines: identifying the needs and recognizing the challenges.

    Science.gov (United States)

    Ernest, Terry B; Elder, David P; Martini, Luigi G; Roberts, Matthew; Ford, James L

    2007-08-01

    There is a significant need for research and development into paediatric medicines. Only a small fraction of the drugs marketed and utilized as therapeutic agents in children have been clinically evaluated. The majority of marketed drugs are either not labelled, or inadequately labelled, for use in paediatric patients. The absence of suitable medicines or critical safety and efficacy information poses significant risks to a particularly vulnerable patient population. However, there are many challenges associated with developing medicines for the paediatric population and this review paper is intended to highlight these. The paediatric population is made up of a wide range of individuals of substantially varied physical size, weight and stage of physiological development. Experimentation on children is considered by many to be unethical, resulting in difficulties in obtaining critical safety data. Clinical trials are subject to detailed scrutiny by the various regulatory bodies who have recently recognized the need for pharmaceutical companies to invest in paediatric medicines. The costs associated with paediatric product development could result in poor or negative return on investment and so incentives have been proposed by the EU and US regulatory bodies. Additionally, some commonly used excipients may be unsuitable for use in children; and some dosage forms may be undesirable to the paediatric population. PMID:17725846

  6. The imaging of paediatric thoracic trauma

    International Nuclear Information System (INIS)

    Major chest trauma in a child is associated with significant morbidity and mortality. It is most frequently encountered within the context of multisystem injury following high-energy trauma such as a motor vehicle accident. The anatomic-physiologic make-up of children is such that the pattern of ensuing injuries differs from that in their adult counterparts. Pulmonary contusion, pneumothorax, haemothorax and rib fractures are most commonly encountered. Although clinically more serious and potentially life threatening, tracheobronchial tear, aortic rupture and cardiac injuries are seldom observed. The most appropriate imaging algorithm is one tailored to the individual child and is guided by the nature of the traumatic event as well as clinical parameters. Chest radiography remains the first and most important imaging tool in paediatric chest trauma and should be supplemented with US and CT as indicated. Multidetector CT allows for the accurate diagnosis of most traumatic injuries, but should be only used in selected cases as its routine use in all paediatric patients would result in an unacceptably high radiation exposure to a large number of patients without proven clinical benefit. When CT is used, appropriate modifications should be incorporated so as to minimize the radiation dose to the patient whilst preserving diagnostic integrity. (orig.)

  7. Clinical practice: immune thrombocytopenia in paediatrics.

    Science.gov (United States)

    Labarque, Veerle; Van Geet, Chris

    2014-02-01

    Immune thrombocytopenia (ITP) is a disease affecting both children and adults. It is defined as acquired isolated thrombocytopenia caused by the autoimmune production of anti-platelet antibodies. Childhood ITP most frequently occurs in young children who have been previously well, although a viral respiratory tract infection often precedes thrombocytopenia. A benign and self-limiting course is common, but major bleeding complications such as intracranial haemorrhage may occur. Yet one cannot predict which child will have a prolonged course of thrombocytopenia and who will develop an intracranial haemorrhage. In children without atypical characteristics, only minimal diagnostic investigations are needed, and most paediatric ITP patients do not need platelet-enhancing therapy even though various treatment options are available. A "watch and wait" strategy should be considered in paediatric patients with mild disease. Steroids, intravenous immunoglobulin G or anti-D immunoglobulin are the current first-line therapeutic measures for children at risk for severe bleeding. When life-threatening bleeding occurs, a combination of therapies is needed. In this review, we summarise the current knowledge on primary ITP in children and adolescents. PMID:24390128

  8. Paediatric halitosis and helicobacter pylori infection

    International Nuclear Information System (INIS)

    To compare the presence of Helicobacter pylori (H. pylori) infection by stool antigen test in children with and without halitosis. Study Design: Comparative study. Place and Duration of Study: Department of Paediatrics, Fatih University Hospital, Ankara, Turkey, between December 2008 and June 2009. Methodology: Fifty-three patients aged between 3-15 years who presented to paediatrics outpatient clinic with halitosis and 55 healthy children aged between 4-15 years without halitosis were included in the study. Halitosis was confirmed with organoleptic test. Stool antigen test was performed in both groups. Inter group proportions were compared using chi square and Fisher exact tests with significance at p 0.05). Two weeks eradication treatment was administered to 11 patients with H. pylori infection and halitosis. After treatment, the symptoms of 8 patients with halitosis (72.7%) completely resolved and persisted in 3 patients (27.3%). Seven of the 11 patients who were administered eradication treatment also had abdominal pain along with halitosis. Both symptoms completely resolved in all those patients after treatment. Conclusion: Although no statistically significant difference existed between the rate of H. pylori infections among those with and without halitosis. Eradication treatment was found beneficial in the treatment of children with halitosis and positive H. pylori stool antigen test. (author)

  9. A paediatric X-ray exposure chart

    International Nuclear Information System (INIS)

    The aim of this review was to develop a radiographic optimisation strategy to make use of digital radiography (DR) and needle phosphor computerised radiography (CR) detectors, in order to lower radiation dose and improve image quality for paediatrics. This review was based on evidence-based practice, of which a component was a review of the relevant literature. The resulting exposure chart was developed with two distinct groups of exposure optimisation strategies – body exposures (for head, trunk, humerus, femur) and distal extremity exposures (elbow to finger, knee to toe). Exposure variables manipulated included kilovoltage peak (kVp), target detector exposure and milli-ampere-seconds (mAs), automatic exposure control (AEC), additional beam filtration, and use of antiscatter grid. Mean dose area product (DAP) reductions of up to 83% for anterior–posterior (AP)/posterior–anterior (PA) abdomen projections were recorded postoptimisation due to manipulation of multiple-exposure variables. For body exposures, the target EI and detector exposure, and thus the required mAs were typically 20% less postoptimisation. Image quality for some distal extremity exposures was improved by lowering kVp and increasing mAs around constant entrance skin dose. It is recommended that purchasing digital X-ray equipment with high detective quantum efficiency detectors, and then optimising the exposure chart for use with these detectors is of high importance for sites performing paediatric imaging. Multiple-exposure variables may need to be manipulated to achieve optimal outcomes

  10. STUDY ABOUT CLINICAL APPLICATION OF BRAIN ATLAS IN PAEDIATRICS

    Institute of Scientific and Technical Information of China (English)

    MENG Fanhang; LIU Cuiping; RENG Xiaoping; JIANG Lian

    2002-01-01

    Objectives To explore clinical application on brain atlas in paediatrics. Methode: Brain atlas was applied in diagnosis and treatment of paediatric diseases and its clinical value was discussed in 1990 ~2001. The manifestation of these diseases in brain atlas were analysed and the manifestation of CT of 67 cases and manifestations of EEG of 37 cases with that of BA were compared. Results The changes of cerebral electrical activity of these diseases were reflected objectively and showed directly in BA. Conclusion Brain atlas not only can point out quality of disease but also define position of disease. Therefore, brain atlas has important clinical value in paediatrics.

  11. Optimization of paediatric radiation doses with CR systems

    International Nuclear Information System (INIS)

    Full text: Radiation protection of paediatric patients is a primary objective in paediatric radiology due the higher life expectance of the little patients undergoing radiology examinations and due to the higher radiosensitivity of tissues. Aim of this work is the study of the optimization process in paediatric doses needed after the recent installation of a new Computed Radiography System in the Radiology of the Meyer paediatric Hospital, in Florence, Italy. This process involves both the use of new dedicated digitizer (Agfa DX-S) and elaboration software (Agfa NX2.0). The choice of the DX-S systems has been performed in consideration of high resolution (Scanhead technology - DirectriX detector), image sharpness and portability of the cassettes that make DX-S ideal in paediatric applications as neonatal intensive care. The NX software for image processing has been installed with the 'Paediatric' licence that optimizes paediatric images especially for exposures of premature newborns. Paediatric NX automatically selects the paediatric age group, depending on the patient's birth date. Each age group contains enhanced algorithms and settings adapted to age group, for optimized visibility of fine details. All the CR system has been accepted by mean of quality control acceptance tool AGFA AutoQC2, and all the automatic exposure control devices installed on radiographic devices were previously calibrated in accordance to literature with signal to noise vs dose considerations [S. Mazzocchi et al. 'AEC set-up optimization with computed radiography imaging' Radiat. Prot. Dosim. 117, 169-173 2005]. Paediatric patients were then divided into age-weight categories and the Entrance Surface Doses (ESD) were calculated by output x-rays measurements. ESD for thorax examinations were correlated to the image evaluations performed by experienced radiologists following European Guidelines on quality criteria for diagnostic radiographic images in paediatrics (EUR 16261, European

  12. Practical application of natriuretic peptides in paediatric cardiology

    DEFF Research Database (Denmark)

    Smith, Julie; Goetze, Jens P; Andersen, Claus B;

    2010-01-01

    conclude that in premature neonates with persistent arterial ducts; in teenagers with tetralogy of Fallot and pulmonary regurgitation; and in children with heart transplants and potential allograft rejection cardiac peptides can provide the clinician with additional information, but in children with atrial......It is still uncertain if cardiac natriuretic peptides are useful biomarkers in paediatric cardiology. In this review we identify four clinical scenarios in paediatric cardiology, where clinical decision-making can be difficult, and where we feel the paediatric cardiologists need additional...

  13. Canadian beef quality audit.

    Science.gov (United States)

    Van Donkersgoed, J; Jewison, G; Mann, M; Cherry, B; Altwasser, B; Lower, R; Wiggins, K; Dejonge, R; Thorlakson, B; Moss, E; Mills, C; Grogan, H

    1997-01-01

    A study was conducted in 4 Canadian processing plants in 1995-96 to determine the prevalence of quality defects in Canadian cattle. One percent of the annual number of cattle processed in Canada were evaluated on the processing floor and 0.1% were graded in the cooler. Brands were observed on 37% and multiple brands on 6% of the cattle. Forty percent of the cattle had horns, 20% of which were scurs, 33% were stubs, 10% were tipped, and 37% were full length. Tag (mud and manure on the hide) was observed on 34% of the cattle. Bruises were found on 78% of the carcasses, 81% of which were minor in severity. Fifteen percent of the bruises were located on the round, 29% on the loin, 40% on the rib, 16% on the chuck, and 0.02% on the brisket. Grubs were observed in 0.02% of the steers, and injection sites were observed in 1.3% of whole hanging carcasses. Seventy percent of the livers were passed for human food and 14% for pet food; 16% were condemned. Approximately 71% of the liver condemnations were due to liver abscesses. Four percent of the heads, 6% of the tongues, and 0.2% of whole carcasses were condemned. The pregnancy rate in female cattle was approximately 6.7%. The average hot carcass weight was 357 kg (s = 40) in steers, 325 kg (s = 41) in heifers, 305 kg (s = 53) in cows, 388 kg (s = 62) in virgin bulls and 340 kg (s = 39) in mature bulls. The average ribeye area in all cattle was 84 cm2 (s = 12); range 29 cm2 to 128 cm2. Grade fat was highly variable and averaged 9 mm (s = 4) for steers and heifers, 6 mm (s = 6) for cows, 5 mm (s = 1) for virgin bulls, and 4 mm (s = 0.5) for mature bulls. The average lean meat yield was 59.7% in cattle (s = 3.4); range 39% to 67%. One percent of the carcasses were devoid of marbling, 1% were dark cutters, and 0.05% of the steer carcasses were staggy. Six percent of the carcasses had poor conformation, 3.7% were underfinished, and 0.7% were overfinished. Yellow fat was observed in 4% of the carcasses; 10% of carcasses were

  14. Current status of paediatric post-mortem imaging: an ESPR questionnaire-based survey

    Energy Technology Data Exchange (ETDEWEB)

    Arthurs, Owen J. [Great Ormond Street Hospital for Children NHS Foundation Trust, Department of Radiology, London (United Kingdom); University College London, Institute of Child Health, London (United Kingdom); Rijn, Rick R. van [Academic Medical Centre, Department of Radiology, Amsterdam (Netherlands); Sebire, Neil J. [Great Ormond Street Hospital for Children, Department of Pathology, London (United Kingdom); University College London, Institute of Child Health, London (United Kingdom)

    2014-03-15

    The use of post-mortem imaging, including skeletal radiography, CT and MRI, is increasing, providing a minimally invasive alternative to conventional autopsy techniques. The development of clinical guidelines and national standards is being encouraged, particularly for cross-sectional techniques. To outline the current practice of post-mortem imaging amongst members of the European Society of Paediatric Radiology (ESPR). We e-mailed an online questionnaire of current post-mortem service provisions to members of the ESPR in January 2013. The survey included direct questions about what services were offered, the population imaged, current techniques used, imaging protocols, reporting experience and intended future involvement. Seventy-one percent (47/66) of centres from which surveys were returned reported performing some form of post-mortem imaging in children, of which 81 % perform radiographs, 51% CT and 38% MRI. Eighty-seven percent of the imaging is performed within the radiology or imaging departments, usually by radiographers (75%), and 89% is reported by radiologists, of which 64% is reported by paediatric radiologists. Overall, 72% of positive respondents have a standardised protocol for radiographs, but only 32% have such a protocol for CT and 27% for MRI. Sixty-one percent of respondents wrote that this is an important area that needs to be developed. Overall, the majority of centres provide some post-mortem imaging service, most of which is performed within an imaging department and reported by a paediatric radiologist. However, the populations imaged as well as the details of the services offered are highly variable among institutions and lack standardisation. We have identified people who would be interested in taking this work forwards. (orig.)

  15. Clinical features of paediatric pulmonary hypertension : a registry study

    NARCIS (Netherlands)

    Berger, Rolf M. F.; Beghetti, Maurice; Humpl, Tilman; Raskob, Gary E.; Ivy, D. Dunbar; Jing, Zhi-Cheng; Bonnet, Damien; Schulze-Neick, Ingram; Barst, Robyn J.

    2012-01-01

    Background Paediatric pulmonary hypertension, is an important cause of morbidity and mortality, and is insufficiently characterised in children. The Tracking Outcomes and Practice in Pediatric Pulmonary Hypertension (TOPP) registry is a global, prospective study designed to provide information about

  16. A 3D digital medical photography system in paediatric medicine.

    Science.gov (United States)

    Williams, Susanne K; Ellis, Lloyd A; Williams, Gigi

    2008-01-01

    In 2004, traditional clinical photography services at the Educational Resource Centre were extended using new technology. This paper describes the establishment of a 3D digital imaging system in a paediatric setting at the Royal Children's Hospital, Melbourne.

  17. Use of complementary/alternative medicine among paediatric patients

    DEFF Research Database (Denmark)

    Madsen, Hanne; Andersen, Susie; Nielsen, Rasmus Gaardskaer;

    2003-01-01

    UNLABELLED: The use of complementary/alternative medicine (CAM) is increasing. The aim was to characterise the use of CAM among patients in a paediatric department. All patients (aged 0-18 years), out-patients or hospitalised, in contact with the Department of Paediatrics, Odense University......: Of the paediatric patients, 53% had tried complementary/alternative medicine, which was used as a supplement to conventional medicine although we did not know how long it was used. Paediatric patients should be interviewed about their use of complementary/alternative medicine with regard to side...... Hospital during a 2 week period in the autumn of 2001 were asked to participate. In total, 622 (92%) patients participated. The data were collected in an interviewer administered questionnaire during a short structured interview with the patient and parents. CAM was divided into herbal medicine (herbal...

  18. Paediatric oncology and intensive care treatments: changing trends

    OpenAIRE

    Keengwe, I.; Stansfield, F.; EDEN, O; Nelhans, N.; Dearlove, O.; Sharples, A.

    1999-01-01

    OBJECTIVES—To review the outcome of patients with childhood malignancy requiring intensive care treatment and to assess whether there is any secular trend for improved outcome.
DESIGN—Retrospective chart reviews of 74 consecutive admissions to a paediatric intensive care unit from a regional paediatric oncology centre between 1990 and 1997. During the same period there were 6419 admissions to the oncology unit, 814 of whom were new cases.
RESULTS—The overall survival a...

  19. Referral of paediatric patients follows geographic borders of administrative units

    DEFF Research Database (Denmark)

    Kofoed, Poul-Erik; Riiskjær, Erik; Ammentorp, Jette

    2011-01-01

    This observational study examines changes in paediatric hospital-seeking behaviour at Kolding Hospital in The Region of Southern Denmark (RSD) following a major change in administrative units in Denmark on 1 January 2007.......This observational study examines changes in paediatric hospital-seeking behaviour at Kolding Hospital in The Region of Southern Denmark (RSD) following a major change in administrative units in Denmark on 1 January 2007....

  20. Fast tracking in paediatric cardiac anaesthesia : an update.

    OpenAIRE

    Lake Carol

    2002-01-01

    A care plan in which cardiac surgical patients progress quickly through the perioperative course to hospital discharge is often referred to as a Fast Track. Such care plans have been used extensively in adult cardiac patients but are also applicable to paediatric patients. Although no randomised controlled trials are available to document a reduction in hospital costs and avoidance of iatrogenic complications with paediatric fast tracks, many healthcare administrators encourage their use. Fas...

  1. Paediatric Pain Management: Using Complementary and Alternative Medicine

    OpenAIRE

    Evans, Subhadra; Tsao, Jennie C. I.; Zeltzer, Lonnie K

    2008-01-01

    Children undergo acute painful procedures and many also experience chronic pain.Due to their developing systems, infants and children may be at greater risk than adults for protracted pain sensitivity.There is a need to manage acute and chronic paediatric pain to reduce children's suffering and to prevent future pain problems.Consistent with a biopsychosocial perspective, complementary and alternative medicine (CAM) should be considered in management of acute and chronic paediatric pain.Altho...

  2. A concept analysis of holistic nursing care in paediatric nursing

    OpenAIRE

    A.A. Tjale; Bruce, J

    2007-01-01

    Holistic nursing care is widely advocated and is espoused in the philosophy of the South African Nursing Council. This concept is unclear, variously interpreted and poorly understood in paediatric nursing. This study was undertaken to examine the meaning of holistic nursing care and to develop a framework for holistic nursing care, which can be utilised in nurse education settings and in clinical nursing practice in the context of paediatric nursing. A qualitative, interpretive, explorative a...

  3. Paediatric cyclical Cushing's disease due to corticotroph cell hyperplasia.

    LENUS (Irish Health Repository)

    Noctor, E

    2015-06-01

    Cushing\\'s disease is very rare in the paediatric population. Although uncommon, corticotroph hyperplasia causing Cushing\\'s syndrome has been described in the adult population, but appears to be extremely rare in children. Likewise, cyclical cortisol hypersecretion, while accounting for 15 % of adult cases of Cushing\\'s disease, has only rarely been described in the paediatric population. Here, we describe a very rare case of a 13-year old boy with cyclical cortisol hypersecretion secondary to corticotroph cell hyperplasia.

  4. Safety of fluconazole in paediatrics: a systematic review

    OpenAIRE

    Egunsola, Oluwaseun; Adefurin, Abiodun; Fakis, Apostolos; Jacqz-Aigrain, Evelyne; Choonara, Imti; Sammons, Helen

    2013-01-01

    Purpose: To determine the safety of fluconazole in neonates and other paediatric age groups by identifying adverse events (AEs) and drug interactions associated with treatment. Methods: A search of EMBASE (1950–January 2012), MEDLINE (1946–January 2012), the Cochrane database for systematic reviews and the Cumulative Index to Nursing and Allied Health Literature (1982–2012) for any clinical study about fluconazole use that involved at least one paediatric patient (≤17 years) was p...

  5. Action, prevention and epidemiology of paediatric obesity

    DEFF Research Database (Denmark)

    Lissau, Inge

    2005-01-01

    UNLABELLED: The overall aim of this paper is to describe important issues regarding paediatric obesity as a public health problem. This paper focuses on actions taken, and on the prevalence of obesity in children, teens and adults in Denmark. In addition, the paper describes some important...... prevention studies, all of which are performed outside Denmark. Thus, this paper is not a classical review but rather a highlight of some aspects that the author finds important. The latest Danish national figures show a marked increase in the prevalence of obesity, especially among young men-a sevenfold...... increase from 1987 to 2000 (0.7 to 4.9%). Among young women aged 16-24, the increase is threefold in the same period. Among teens, the prevalence has increased by 2-3 times in recent decades. Nevertheless, compared to other European countries and the US, Denmark has a relatively low prevalence of obesity...

  6. Aspects of deceased organ donation in paediatrics.

    Science.gov (United States)

    Brierley, J; Hasan, A

    2012-01-01

    Organ transplantation offers children in acute or chronic severe organ failure similar opportunities to adults. However, while the number who might benefit is relatively low, significantly fewer cadaveric donors exist for any given child compared with an adult. Incompatible organ size and relatively low donation rates mean that despite living parental donation and innovations to reduce donated organ size, children die before organs become available. The severity of the UK situation is compounded by restrictions on paediatric living donation, uncertainties over the application of brain death criteria, and ethical concerns about the use of donation after circulatory death. The UK Department of Health's Organ Donation Task Force suggested the means by which the adult donor pool might be increased, recommending that outstanding ethical and legal issues be resolved, but made no specific recommendations about children. PMID:22194438

  7. Paediatric Crohn's disease: a radiological review

    International Nuclear Information System (INIS)

    Paediatric Crohn's disease can be a serious and complex condition which is not always easy to diagnose if it presents in an atypical manner. Although the pathological processes are the same in adults and children, the clinical presentation and disease distribution can be different in children. The impact of the disease can also be much more significant in a growing and developing child than in an adult. Numerous investigations are available to establish the diagnosis, define the complications and to demonstrate the extra-intestinal manifestations. Close co-operation is required between the clinician and radiologist when investigating a child suspected of having Crohn's disease or its symptoms to minimise the radiation dose and the psychological and physical trauma. We review the clinical and radiological aspects of Crohn's disease and discuss the imaging modalities available in diagnosing Crohn's disease and its complications and suggest an investigation pathway as used in our institution. (orig.)

  8. Radiation Protection in Paediatric Computed Tomography

    International Nuclear Information System (INIS)

    The number of examinations with radiation exposure has been increasing mainly due to advances in computed tomography (CT) technology, with a rapid expansion of CT utilization. Annually, 3.6 billion diagnostic and medical and dental examinations involving radiation are performed worldwide. The contribution of CT to collective dose due to medical X rays is up to 47–59%. A 2009 report of the National Council on Radiation Protection and Measurements (NCRP) estimates that 8–10% of CT examinations in the United States of America are performed on children; the growth in CT utilization is higher in the paediatric than adult population in the USA; and there is a particularly pronounced rise in adolescents undergoing chest CT in the emergency department setting for suspected pulmonary embolism or trauma. The reasons for the growing incidence of CT are new indications for CT with the advent of multidetector CT, overcautious ordering related to medico-legal problems and probably financial incentive systems

  9. New hazards in paediatric poisoning presentations.

    LENUS (Irish Health Repository)

    Moore, C

    2015-02-01

    Accidental ingestion is an important preventable cause of childhood morbidity. All accidental ingestion presentations (n = 478) to a tertiary paediatric ED from January 2010 to December 2011 were analysed. These results were compared with a similar study in the same institution ten years previously in 2001 and showed that while accidental ingestions constituted a higher proportion of presentations (0.5% in this study v 0.45% in 2001), fewer had investigations performed (21% v 35%) and fewer were admitted (7% v 20%). Accidental ingestions account for 0.5% of presentations and are an important focus of home safety information for parents and guardians. Paracetamol (n = 67, 14%) and liquid detergent capsules (n = 44, 9.2%) were the two most common substances implicated in these presentations, and have the potential to cause severe morbidity and mortality.

  10. Eliminating paediatric infections and keeping mothers alive

    Directory of Open Access Journals (Sweden)

    Gray G

    2012-11-01

    Full Text Available The global plan of reducing the number of new child HIV infections and a reduction in the number of HIV-related maternal deaths by 2015 will require inordinate political commitment and strengthening of health systems in Sub-Saharan Africa where the burden of HIV infections in pregnant women is the highest. Preventing HIV infection in women of child-bearing age and unwanted pregnancies in HIV-positive women forms the cornerstone of long-term control of paediatric HIV infections. To achieve the goal of eliminating paediatric HIV infection by 2015, health systems strengthening to address prevention of mother-to-child HIV transmission cascade attrition and focusing on the elimination of breastmilk transmission is critical. Understanding the pathogenesis of breastmilk transmission and the mechanisms by which antiretroviral therapy impacts on transmission through this compartment will drive future interventions. Identifying and retaining HIV-positive pregnant women in care and committed to long-term antiretroviral therapy will improve maternal outcomes and concomitant reductions in maternal mortality. Research assessing the natural history of HIV infection and long-term outcomes in women who interrupt antiretroviral therapy post-weaning is urgently required. Data on the outcome of women who opt to continue the long-term use of antiretroviral therapy after initiating therapy during pregnancy will determine future policy in countries considering option B+. The prevalence of antiretroviral resistance and impact on survival in infants who sero-convert whilst receiving neonatal prophylaxis, or are exposed to maternal HAART through breastmilk at a population level, are currently unknown. In addition to the provision of biomedical interventions, healthcare workers and policy makers must address the structural, cultural and community issues that impact on treatment uptake, adherence to medication and retention in care.

  11. Fast tracking in paediatric cardiac anaesthesia : an update.

    Directory of Open Access Journals (Sweden)

    Lake Carol

    2002-01-01

    Full Text Available A care plan in which cardiac surgical patients progress quickly through the perioperative course to hospital discharge is often referred to as a Fast Track. Such care plans have been used extensively in adult cardiac patients but are also applicable to paediatric patients. Although no randomised controlled trials are available to document a reduction in hospital costs and avoidance of iatrogenic complications with paediatric fast tracks, many healthcare administrators encourage their use. Fast Track clinical guidelines usually include same day surgery, use of short- acting anaesthetic drugs, early extubation, effective pain management, and reduced intensive care unit stays. These protocols are certainly appropriate for simple procedures such as repair of atrial or ventricular septal defects or ligation of a patent ductus arteriosus. However, many paediatric cardiac anaesthesiologists consider that all paediatric patients without significant pulmonary or residual cardiac pathology can be managed using expedited postoperative protocols. Essential components in a "fast track" protocol include use of minimally invasive surgical techniques, modified ultrafiltration during cardiopulmonary bypass, transoesophageal echocardiography to evaluate the cardiac repair, and postoperative pain control. Using such techniques, 80-90% of paediatric patients can be extubated in the operating room or within 2-4 hours postoperatively. Despite the opinions of recognised experts, an appropriately sized and powered multicentre, controlled, randomised, prospective study is still needed to conclusively document the efficiency and effectiveness of the Fast Track in paediatric cardiac patients.

  12. Diagnostic reference levels for paediatric radiography in Finland

    Energy Technology Data Exchange (ETDEWEB)

    Kiljunen, T.; Jaervinen, H.; Parviainen, T.; Komppa, T. [Radiation and Nuclear Safety Authority - STUK, Helsinki, (Finland). Radiation Practices Regulation; Savolainen, S. [Helsinki University Central Hospital, Helsinki (Finland). Dept. of Radiology

    2005-09-15

    The Radiation and Nuclear Safety Authority (STUK) in Finland has responsibility to set the national Diagnostic Reference Levels (DRLs) for the most common radiological examinations. Paediatric patients deserve a special attention due to the higher radiation risk compared with adults. The purpose was to present a method which takes into account patient size when setting DRLs in paediatrics. The overall data used in the study consisted of patient doses collected from eight hospitals: for 700 chest examinations, 100 micturating cystourethography (MCU) fluoroscopy examinations and 10 - 30 other conventional or fluoroscopy examinations. The method established by the National Radiation Protection Board (UK) for setting DRLs was found to produce extra uncertainty in the procedure and it was also troublesome to use. Reference levels for paediatric chest examinations could be given as linear curve on half logarithmic scale as a function of patient projection thickness. STUK has been collecting the data on paediatric patient doses in almost 30 Finnish hospitals as the current available data is insufficient and partly outdated. The collection is carried out by a questionnaire in which hospitals record paediatric patient doses of chest, skull, sinus, abdomen, pelvis and micturating cystourethography examinations. The DRLs will be given during the year 2005 for the most common paediatric radiographic examinations.

  13. Our surgical heritage: the role of the Department of Paediatric Surgery in the development of paediatric surgery in Cape Town, in Africa, and around the world.

    Science.gov (United States)

    Rode, Heinz; Millar, Alastair J W

    2012-06-01

    The Department of Paediatric Surgery at the University of Cape Town has made a remarkable contribution to the academic body of knowledge of Paediatric Surgery both in South Africa and around the world. It has played a key role in the development of the specialty in South Africa and through the South African diaspora has trained many paediatric surgeons who have made their mark internationally. More recently it has become a major focus of teaching and training for African paediatric surgeons. This article traces this legacy through its origins in the early 1920s to its current prominent position in the world paediatric surgical community. PMID:22668921

  14. Canadian National Vegetation Classification (CNVC)

    Data.gov (United States)

    US Fish and Wildlife Service, Department of the Interior — The mandate of the CNVC is to comprehensively classify and describe natural and semi-natural Canadian vegetation in an ecologically meaningful manner. The...

  15. Initial evaluation of children admitted on the Paediatric Intensive Care Unit

    Directory of Open Access Journals (Sweden)

    Esperanza Arce Delgado

    2007-09-01

    Full Text Available The initial evaluation of the child, when admitted on the Paediatric Intensive Unit, is a essential tool and key piece as a starting point on the development of a specific Care Plan for each child. Therefore, it is necessary the existence of a protocol, according to a rigorous methodology, so that cares will have quality and thus, it will be avoided that each nursing professional will act in a different way, according to his intuition, beliefs or improvisation capacity.The initial evaluation of the child will allow us not only to coordinate the interventions, but also to give continuity to the cares.The initial evaluation of the child document is a nursing register that is part of the clinical register of the paediatric patient. Nursing registers turn to be the best approximation of what nowadays is our job’s practice, and they are, therefore, necessary for us to be judged by a professional perspective and to make it possible to classify the services we carry out to the society.

  16. Progress in paediatric parasitology: a preface to a topic focusing on ever younger subjects.

    Science.gov (United States)

    Stothard, J Russell; Chiodini, Peter; Booth, Mark

    2011-10-01

    Without realizing it perhaps, the research activities of many parasitologists are often focused upon the study of parasites most commonly found in children. Though there is little recognition of paediatric parasitology as a separate topic within medical parasitology, with the global interest in promotion of maternal and child health, alleviation of diseases associated with poverty and requirements of 'child-sized' medicines, a more formal consideration is now timely. Recent research, for example, has highlighted that defining precisely the 'first-age' at which parasites interfere with a child's health, or normal developmental processes, is being revised. Attention is now drawn towards ever younger subjects, for parasites have the capacity to also influence the health of the foetus within the in utero environment, altering immune-development. These subtle, yet evolutionary profound interactions perhaps manifest themselves as to why some children are more prone to infection(s), develop overt disease and sadly die while others do not. Here, we address the growing importance of paediatric parasitology and its applications within disease control strategies as highlighted in the 2010 Autumn Symposium of the British Society of Parasitology.

  17. The Canadian Astronomy Education and Public Outreach Initiative

    Science.gov (United States)

    Percy, J. R.

    2002-05-01

    In Canada, astronomers do not have access to science and mathematics education funding such as NSF and NASA provide in the USA. Nevertheless, the Canadian astronomical community has always been very active in education and public outreach (EPO) at the local, provincial, and national level, thanks to the initiative of astronomers -- both professional and amateur -- and their institutions and associations. In 2001, the Canadian astronomical community embarked on a major EPO initiative, led by the Canadian Astronomical Society (CAS) in partnership with the Royal Astronomical Society of Canada (RASC) and other organizations. The initiative was motivated by a new long-range plan for astronomy in Canada, by the availability of modest funding for EPO, by the appearance of astronomy in the school science curriculum in several provinces, and by a heightened national interest in science education and literacy. As Chair of the CAS Education Committee, and coordinator of the EPO initiative, I shall describe its origin, funding, goals and strategies, organization, partnerships, programs, and projects. Supported by a PromoScience grant from NSERC Canada.

  18. Canadian leadership in energy

    International Nuclear Information System (INIS)

    Canada's energy is complex and an important resource as it fuels and funds the economy. The unique character of Canada's energy production and consumption provides strength to the country. The purpose of this booklet was to highlight Canada's energy production and consumption and to demonstrate Canada's rank globally with other major global energy players. The document also presented information on the value of Canada's energy exports, Canada's relationship with the United States, and Canada's energy-related carbon dioxide emissions. Specifically, the document discussed Canada's energy in a global context; the value of Canada's energy exports; domestic value of energy; Canada's unique energy mix; Canada's electricity mix; Canada's carbon dioxide emissions; energy strategies; and the importance of energy to Canadians. It was concluded that there are 14 federal, provincial and territorial jurisdictions managing their respective energy resources. All of these regions, with the exception of Saskatchewan have produced an energy strategy document or a climate change action plan focusing on 8 areas of action, notably awareness; benefit; efficiency; development; diversification; electricity; and emissions. refs., tabs., figs.

  19. Dose estimation for paediatric cranial computed tomography

    Energy Technology Data Exchange (ETDEWEB)

    Curci Daros, K.A.; Bitelli Medeiros, R. [Sao Paulo Univ. Federal (Brazil); Curci Daros, K.A.; Oliveira Echeimberg, J. de [Centro Univ. Sao Camilo, Sao Paulo (Brazil)

    2006-07-01

    In the last ten years, the number of paediatric computed tomography (CT) scans have increased worldwide, contributing to higher population radiation dose. Technique diversification in paediatrics and different CT equipment technologies have led to various exposure levels complicating precise evaluation of doses and operational conditions necessary for good quality images. The objective of this study was to establish a quantitative relationship between absorbed dose and cranial region in children up to 6 years old undergoing CT exams. Methods: X-ray was measured on the cranial surface of 64 patients undergoing CT using thermoluminescent (T.L.) dosimeters. Forty T.L.D.100 thermoluminescent dosimeters (T.L.D.) were evenly distributed on each patients skin surface along the sagittal axis. Measurements were performed in facial regions exposed to scatter radiation and in the supratentorial and posterior fossa regions, submitted to primary radiation. T.L.D. were calibrated for 120 kV X-ray over the acrylic phantom. T.L. measurements were made with a Harshaw 4000 system. Patient mean T.L. readings were determined for position, pi, of T.L.D. and normalized to the maximum supratentorial reading. From integrating the linear T.L. density function (?) resulting from radiation distribution in each of the three exposed regions, dose fraction was determined in the region of interest, along with total dose under the technical conditions used in that specific exam protocol. For each T.L.D. position along the patient cranium, there were n T.L. measurements with 2% uncertainty due to T.L. reader, and 5% due to thermal treatment of dosimeters. Also, mean T.L. readings and their uncertainties were calculated for each patient at each position, p. Results: Mean linear T.L. density for the region exposed to secondary radiation defined by position, 0.3{<=}p{<=}6 cm, was {rho}((p)=7.9(4)x10{sup -2}+7(5)x10{sup -5}p{sup 4.5(4)} cm{sup -1}; exposed to primary X-ray for the posterior fossa

  20. Operating within the legal and ethical framework to gain co-operation when imaging paediatric patients

    International Nuclear Information System (INIS)

    This paper discusses the challenges faced by radiographers when imaging children. Using Maslow's Hierarchy of Needs as a framework it presents a logical exploration of the complex issues associated with imaging children and considers the legal and ethical framework alongside the nature of motivation and importance of gaining cooperation of the child and their carer(s). It is evident that a good knowledge of child development, child psychology and distraction techniques would enhance the family experience when attending for imaging examinations. Radiographers must continually familiarise themselves with current legislation affecting their practice and ensure that they continue to provide an optimum service for children and their carer(s). It may be advisable for post-registration courses to be offered to existing practitioners and for the Society and College of Radiographers to consider appointing a professional officer with expertise in paediatric imaging to offer legal advice and to support safe practice

  1. The influence of power in the Canadian healthcare system.

    Science.gov (United States)

    Seenandan-Sookdeo, Kendra-Ann I

    2012-01-01

    This article presents a review of the literature as it relates to the influence of the word power in the context of the Canadian healthcare system. The concept of power is used to explore issues of gender and the evolution of advanced nurse practice in the development of the Canadian healthcare system. Furthermore, issues related to the call for interprofessional collaboration are addressed. Healthcare workers, in particular nurses, are trusted in a society that seeks, promotes, and aspires for power and control. In addition, societal norms continue to shape our healthcare reform. As a consequence, the discussion centers on a call for true collaboration among our healthcare providers and concludes with implications for nursing.

  2. The use of the Statscan digital X-ray unit in paediatric polytrauma

    Energy Technology Data Exchange (ETDEWEB)

    Pitcher, Richard D. [University of Cape Town, Division of Paediatric Radiology, Red Cross War Memorial Children' s Hospital, School of Child and Adolescent Health, Cape Town (South Africa); Wilde, Jim C.H. [University of Cape Town, Division of Paediatric Surgery, Red Cross War Memorial Children' s Hospital, School of Child and Adolescent Health, Cape Town (South Africa); University of Amsterdam, Paediatric Surgical Centre of Amsterdam, Emma Children' s Hospital, Academic Medical Centre, Amsterdam (Netherlands); Douglas, Tania S. [University of Cape Town, MRC/UCT Medical Imaging Research Unit, Department of Human Biology, Cape Town (South Africa); As, Arjan Bastiaan van [University of Cape Town, Division of Paediatric Surgery, Red Cross War Memorial Children' s Hospital, School of Child and Adolescent Health, Cape Town (South Africa)

    2009-05-15

    We present a 3-year review of clinical paediatric experience with the statscan (Lodox Systems, Johannesburg, South Africa), a low-dose, digital, whole-body, slit-scanning X-ray machine. While focusing on the role of the unit in paediatric polytrauma, insight into its applications in other paediatric settings is provided. (orig.)

  3. 50 Shades of Green: An Examination of Sustainability Policy on Canadian Campuses

    Science.gov (United States)

    Vaughter, Philip; Wright, Tarah; Herbert, Yuill

    2015-01-01

    Koichiro Matsuura, Director-General of UNESCO, asserts that education is one of the most effective instruments that society can employ in the effort to adopt sustainable development. This paper is a first effort to explore the degree to which Canadian institutions of higher education, including colleges and universities, have embraced this…

  4. Using a Wider Lens to Shift the Discourse on Food in Canadian Curriculum Policies

    Science.gov (United States)

    Robertson, Lorayne; Scheidler-Benns, Joli

    2016-01-01

    Healthy eating is important to overall health, but Canadian health agencies disagree on the degree to which lifestyle or society determines healthy eating. The authors review the literature and design a policy analysis framework that captures discursive elements of both arguments. They apply this framework to education policy, analysing the…

  5. Canadian Human Rights Act. Office Consolidation = Loi canadienne sur les droits de la personne. Codification administrative.

    Science.gov (United States)

    Department of Supply and Services, Ottawa (Ontario).

    The Canadian Human Rights Act extends the laws in Canada that proscribe discrimination by establishing that each individual has the right to make the life for him- or herself that he or she is able and wishes to have, consistent with the duties and obligations of a member of society, without being hindered or prevented from doing so by…

  6. Smartphone applications in paediatric radiology: availability and authority

    Energy Technology Data Exchange (ETDEWEB)

    Shelmerdine, Susan C. [Great Ormond Street Hospital, Specialist Registrar in Clinical Radiology, Department of Clinical Radiology, London (United Kingdom); Lynch, Jeremy O. [Chelsea and Westminster Hospital, Specialist Registrar in Clinical Radiology, Department of Clinical Radiology, London (United Kingdom)

    2015-08-15

    With the widespread ownership of smartphones, many health care professionals question the degree to which medically related smartphone applications are reliable. To assess the variety of smartphone applications relating to paediatric radiology and the presence of health care professional involvement in their development. As a secondary objective, we explore whether there are gaps within the paediatric radiology app market. The most popular smartphone marketplaces (Apple iTunes App Store, Blackberry Mobile Market, Google Play Android Market, Nokia Ovi, Samsung and Microsoft Windows Marketplace) were searched for terms relating to paediatric radiology. Cost, review ratings, number of downloads, health care involvement and target audience were recorded. Nine paediatric radiology applications were found in the Apple iTunes App Store and nine in the Google Play Android Market. The target audiences for all applications were health care professionals. None were available for patients or their caregivers. All applications were reported to have medical expertise in their development. All paediatric radiology applications were developed with the aid of a health care professional. Due to the small number available online, there is a potential gap in the marketplace for further applications in this field, possibly aimed at patients and their families. (orig.)

  7. Patient Doses in Paediatric Fluoroscopic Examinations in Finland

    Energy Technology Data Exchange (ETDEWEB)

    Servomaa, A.; Komppa, T.; Heikkila, M.; Parviainen, T

    2000-07-01

    Dose-area products (DAP) in paediatric fluoroscopic examinations were measured at paediatric clinics in three university hospitals. The purpose was to provide supplementary data for development of reference doses, and for determination of relations between patient size and dose, in examinations involving both radiography and fluoroscopy for paediatric patients of various ages. The number of paediatric patients was 217. The most common fluoroscopic examinations were: micturating cystourethrography (MCU), 103 patients; barium enema (anography), 39 patients; barium meal and follow, 20 patients; and oesophagus, nine patients. Data on the patients and examination techniques, and the dose-area products are reported for various examinations and age groups. In the MCU examinations the mean DAP values were 560 mGy.cm{sup 2} for the age group of 0 years: 910 mGy.cm{sup 2} for the age group of 1-4 years; 880 mGy.cm{sup 2} for the age group of 5-9 years; and 4600 mGy.cm{sup 2} for the age group of 10-15 years. The radiation doses to which paediatric patients are exposed in fluoroscopic examinations vary over a large scale, even within narrow age bands, and comparisons between the doses are difficult because of wide ranges in patient size. This indicates the need for developing a method for taking account of the effects of patients size before deriving reference doses. (author)

  8. Smartphone applications in paediatric radiology: availability and authority

    International Nuclear Information System (INIS)

    With the widespread ownership of smartphones, many health care professionals question the degree to which medically related smartphone applications are reliable. To assess the variety of smartphone applications relating to paediatric radiology and the presence of health care professional involvement in their development. As a secondary objective, we explore whether there are gaps within the paediatric radiology app market. The most popular smartphone marketplaces (Apple iTunes App Store, Blackberry Mobile Market, Google Play Android Market, Nokia Ovi, Samsung and Microsoft Windows Marketplace) were searched for terms relating to paediatric radiology. Cost, review ratings, number of downloads, health care involvement and target audience were recorded. Nine paediatric radiology applications were found in the Apple iTunes App Store and nine in the Google Play Android Market. The target audiences for all applications were health care professionals. None were available for patients or their caregivers. All applications were reported to have medical expertise in their development. All paediatric radiology applications were developed with the aid of a health care professional. Due to the small number available online, there is a potential gap in the marketplace for further applications in this field, possibly aimed at patients and their families. (orig.)

  9. Molecular characterization of rotavirus isolates from select Canadian pediatric hospitals

    Directory of Open Access Journals (Sweden)

    McDermid Andrew

    2012-11-01

    Full Text Available Abstract Background We report the first multi-site rotavirus genotype analysis in Canada. Prior to this study, there was a dearth of rotavirus G and P genotyping data in Canada. Publically funded universal rotavirus vaccination in Canada started in 2011 and has been introduced by four provinces to date. Uptake of rotavirus vaccines in Canada prior to 2012 has been very limited. The aim of this study was to describe the genotypes of rotavirus strains circulating in Canada prior to widespread implementation of rotavirus vaccine by genotyping samples collected from selected paediatric hospitals. Secondly we identified rotavirus strains that differed genetically from those included in the vaccines and which could affect vaccine effectiveness. Methods Stool specimens were collected by opportunity sampling of children with gastroenteritis who presented to emergency departments. Samples were genotyped for G (VP7 genotypes and P (VP4 genotypes by hemi-nested multiplex PCR methods. Phylogenetic analysis was carried out on Canadian G9 strains to investigate their relationship to G9 strains that have circulated in other regions of the world. Results 348 samples were collected, of which 259 samples were rotavirus positive and genotyped. There were 34 rotavirus antigen immunoassay negative samples genotyped using PCR-based methods. Over the four rotavirus seasons, 174 samples were G1P[8], 45 were G3P[8], 22 were G2P[4], 13 were G9P[8], 3 were G4P[8] and 2 were G9P[4]. Sequence analysis showed that all Canadian G9 isolates are within lineage III. Conclusions Although a limited number of samples were obtained from a median of 4 centres during the 4 years of the study, it appears that currently approved rotavirus vaccines are well matched to the rotavirus genotypes identified at these hospitals. Further surveillance to monitor the emergence of rotavirus genotypes in Canada is warranted.

  10. Whole-body MRI in paediatric oncology.

    Science.gov (United States)

    Nievelstein, Rutger A J; Littooij, Annemieke S

    2016-05-01

    Imaging plays a crucial role in the diagnosis and follow-up of paediatric malignancies. Until recently, computed tomography (CT) has been the imaging technique of choice in children with cancer, but nowadays there is an increasing interest in the use of functional imaging techniques like positron emission tomography and single-photon emission tomography. These later techniques are often combined with CT allowing for simultaneous acquisition of image data on the biological behaviour of tumour, as well as the anatomical localisation and extent of tumour spread. Because of the small but not negligible risk of radiation induced secondary cancers and the significantly improved overall survival rates of children with cancer, there is an increasing interest in the use of alternative imaging techniques that do not use ionising radiation. Magnetic resonance imaging (MRI) is a radiation-free imaging tool that allows for acquiring images with a high spatial resolution and excellent soft tissue contrast throughout the body. Moreover, recent technological advances have resulted in fast diagnostic sequences for whole-body MR imaging (WB-MRI), including functional techniques such as diffusion weighted imaging. In this review, the current status of the technique and major clinical applications of WB-MRI in children with cancer will be discussed.

  11. Secondary surgery in paediatric facial paralysis reanimation.

    Science.gov (United States)

    Terzis, Julia K; Olivares, Fatima S

    2010-11-01

    Ninety-two children, the entire series of paediatric facial reanimation by a single surgeon over thirty years, are presented. The objective is to analyse the incidence and value of secondary revisions for functional and aesthetic refinements following the two main stages of reanimation. The reconstructive strategy varied according to the denervation time, the aetiology, and whether the paralysis was uni- or bilateral, complete or partial. Irrespective of these variables, 89% of the patients required secondary surgery. Post-operative videos were available in seventy-two cases. Four independent observers graded patients' videos using a scale from poor to excellent. The effect of diverse secondary procedures was measured computing a mean-percent-gain score. Statistical differences between treatment groups means were tested by the t-test and one-way ANOVA. Two-thirds of the corrective and ancillary techniques utilized granted significantly higher mean-scores post-secondary surgery. A comparison of pre- and post-operative data found valuable improvements in all three facial zones after secondary surgery. In conclusion, inherent to dynamic procedures is the need for secondary revisions. Secondary surgery builds in the potential of reanimation surgery, effectively augmenting functional faculties and aesthesis.

  12. Radionuclide studies in paediatric nephro-urology

    Energy Technology Data Exchange (ETDEWEB)

    Piepsz, Amy E-mail: amypiepsz@yahoo.com

    2002-08-01

    The main tool of radionuclide techniques applied to paediatric uro-nephrology is the quantitation of function, which is an information not easily obtained by other diagnostic modalities. The radiation burden is low. Drug sedation is only rarely needed, whatever the age of the patient. Accurate determination of glomerular filtration rate can be obtained by means of an intravenous injection of Cr-51 EDTA and one or two blood samples. Tc-99m DMSA scintigraphy is an accurate method for evaluation of regional cortical impairment during acute pyelonephritis and later on, for detection of permanent scarring. Tc-99m MAG3 renography is nowadays a well-standardized method for accurate estimation of the split renal function and of renal drainage with or without furosemide challenge. This technique is particularly indicated in uni- or bilateral uropathies with or without renal and/or ureteral dilatation. Direct and indirect radionuclide cystography are two alternative modalities for X-ray MCUG. Their relative place in the strategy of management of vesicoureteral reflux is discussed.

  13. Recent pharmacological advances in paediatric analgesics.

    Science.gov (United States)

    Anderson, B J; Palmer, G M

    2006-08-01

    Growth and development are two linked processes that distinguish children from adults. The use of size as the primary covariate during pharmacokinetic (PK) analyses allows exploration of the effects of age. Allometric scaling models have assisted understanding of the developmental clearance changes in common analgesic drugs such as paracetamol, morphine, tramadol and local anaesthetics agents. Single nucleotide polymorphisms (pharmacogenomics [PG]) and their impact on hepatic drug metabolism for opioids, tramadol, non-steroidal anti-inflammatory drugs (NSAIDs) and drug receptor responses are increasingly reported. Altered chemical structure or formulations of common analgesics alter pharmacodynamic (PD) effects enhancing safety and efficacy for NSAIDs by stereoselectivity and the addition of nitric oxide, for intravenous paracetamol by formulation and structural difference from propacetamol and for local anaesthetics through stereoselectivity. This article focuses upon recent data for analgesics used in paediatric pain management including paracetamol, NSAIDs, morphine, tramadol, amide local anaesthetics and ketamine. It centres on PK and clinical studies in neonates, infants and children. PG studies are acknowledged as potentially allowing individual drug therapy tailoring through a decrease in between-patient population variability, although the impact of PG in the very young is less certain. There are few data describing age-related PD changes in children despite recognition that the number, affinity and type of receptors or the availability of natural ligands changes with age. PMID:16854558

  14. Radionuclide studies in paediatric nephro-urology

    International Nuclear Information System (INIS)

    The main tool of radionuclide techniques applied to paediatric uro-nephrology is the quantitation of function, which is an information not easily obtained by other diagnostic modalities. The radiation burden is low. Drug sedation is only rarely needed, whatever the age of the patient. Accurate determination of glomerular filtration rate can be obtained by means of an intravenous injection of Cr-51 EDTA and one or two blood samples. Tc-99m DMSA scintigraphy is an accurate method for evaluation of regional cortical impairment during acute pyelonephritis and later on, for detection of permanent scarring. Tc-99m MAG3 renography is nowadays a well-standardized method for accurate estimation of the split renal function and of renal drainage with or without furosemide challenge. This technique is particularly indicated in uni- or bilateral uropathies with or without renal and/or ureteral dilatation. Direct and indirect radionuclide cystography are two alternative modalities for X-ray MCUG. Their relative place in the strategy of management of vesicoureteral reflux is discussed

  15. Paediatric analgesia in an Emergency Department.

    LENUS (Irish Health Repository)

    Hawkes, C

    2012-02-03

    Timely management of pain in paediatric patients in the Emergency Department (ED) is a well-accepted performance indicator. We describe an audit of the provision of analgesia for children in an Irish ED and the introduction of a nurse-initiated analgesia protocol in an effort to improve performance. 95 children aged 1-16 presenting consecutively to the ED were included and time from triage to analgesia, and the rate of analgesia provision, were recorded. The results were circulated and a nurse initiated analgesia protocol was introduced. An audit including 145 patients followed this. 55.6% of patients with major fractures received analgesia after a median time of 54 minutes, which improved to 61.1% (p = 0.735) after 7 minutes (p = 0.004). Pain score documentation was very poor throughout, improving only slightly from 0% to 19.3%. No child had a documented pain score, which slightly improved to 19.3%. We recommend other Irish EDs to audit their provision of analgesia for children.

  16. New insights in paediatric exercise metabolism

    Institute of Scientific and Technical Information of China (English)

    Neil; Armstrong; Alan; R.Barker

    2012-01-01

    <正>Research in paediatric exercise metabolism has been constrained by being unable to interrogate muscle in vivo.Conventionally,research has been limited to the estimation of muscle metabolism from observations of blood and respiratory gases during maximal or steady state exercise and the analysis of a few muscle biopsies taken at rest or post-exercise.The purpose of this paper is to review how the introduction of 31P-magnetic resonance spectroscopy and breath-by-breath oxygen uptake kinetics studies has contributed to current understanding of exercise metabolism during growth and maturation.Methodologically robust studies using 31P-magnetic resonance spectroscopy and oxygen uptake kinetics with children are sparse and some data are in conflict.However,it can be concluded that children respond to exercise with enhanced oxygen utilization within the myocyte compared with adults and that their responses are consistent with a greater recruitment of type I muscle fibres.Changes in muscle metabolism are age,maturation- and sex-related and dependent on the intensity of the exercise challenge.The introduction of experimental models such as "priming exercise" and "work-to-work" transitions provide intriguing avenues of research into the mechanisms underpinning exercise metabolism during growth and maturation.

  17. Diagnostic accuracy on the management of acute paediatric urinary tract infection in a general paediatric unit

    Institute of Scientific and Technical Information of China (English)

    Fahisham Taib; Bakht Jamal

    2015-01-01

    Objective: To ascertain diagnostic accuracy of paediatric urinary tract infection (UTI) in a general paediatric unit of a district hospital. Methods: Retrospective case note review and comparing to the final computerised database of Human in-Patient Enquiry (HIPE) at Portiuncula Hospital, Galway, Ireland. All children from 0-16 years of age with the diagnosis of UTI were enrolled within the 3 year study period. The information was first retrieved from HIPE system to capture list of patients. Case notes revision was followed to extract data under standardized pro-forma for demography, accuracy of diagnosis, treatment instituted and investigation ordered. Patients’ data was reviewed according to updated definition. Results: There were 85 cases treated for UTI during the 3 year period, and only 45 cases were considered as genuine UTI according to diagnostic criteria. Out of 45 cases, 16 cases were considered as suspected UTI cases. Escherichia coli was noted to be the commonest organism. Cephradine has been used as the first line treatment as per local guideline;however, different antibiotic regimes were based on physician’s preferences. The sensitivity of the current method of UTI diagnosis remained at 64%when comparing final diagnosis in the HIPE system. Conclusions: UTI can be difficult to accurately diagnosis in certain clinical cases. Decisions made should be individualized and tailored according to clinical suspicion and presentation of the patients. Improvement to ensure accurate diagnosis is vital to ensure correct data capture in the HIPE system thus giving valuable information and resource for future care.

  18. Society of Reproductive Surgeons

    Science.gov (United States)

    The Society of Reproductive Surgeons Home About Us About SRS Mission Statement Officers The Role of Reproductive Surgeons For ... Fact Sheets and Booklets SRS is an affiliated society to the American Society for Reproductive Medicine . Below ...

  19. Responsible Canadian energy progress report

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2010-07-01

    The Canadian Association of Petroleum Producers (CAPP) represents oil and gas companies throughout Canada; its members produce over 90% of Canada's natural gas and crude oil output. The aim of the Association is to improve the economics of the Canadian upstream petroleum sector in an environmentally and socially responsible way. The aim of this Responsible Canadian Energy report is to present the performance data of CAPP's members for the year 2009. Data, trends, and performance analyses are provided throughout the document. This analysis makes it possible to determine where progress has been made and where performance improvement is necessary. It also presents success stories and best practices so that other companies can learn from them how to improve their own performance. This paper provides useful information on the performance of the upstream petroleum industry in Canada and highlights where the focus should be for further improvement in its performance.

  20. Political Affiliation of Canadian Professors

    Directory of Open Access Journals (Sweden)

    M. Reza Nakhaie

    2008-01-01

    Full Text Available The social role of universities has been the subject of a lengthy debate as to whether those who teach in the academy are system-legitimizing conservatives or radicals helping to generate critical thinking that challenges the status quo. The aim of this paper is to evaluate political affiliations of Canadian university professors based on a national survey conducted in 2000. The study shows that Canadian professors’ political affiliation can be identified as either left or right depending on how the political orientation of political parties is conceptualized. University professors tend to vote more for the Liberal Party than other parties, and view it as centrist party. Moreover, the study highlights a complex and non-monolithic picture of the Canadian academy. University professors are not politically homogenous and party vote depends on the prestige of their university, their discipline, gender, ethnicity, marital status, generation, and agreement with liberalism.

  1. Chernobyl - a Canadian technical perspective

    International Nuclear Information System (INIS)

    In this report we present the design review done to date in Canada by AECL. From the Canadian point of view it covers: 1) relevant information on the Chernobyl design and the accident, both as presented by the Soviets at the Post-Accident Review Meeting (PARM) held in Vienna from August 25-29, 1986, and as deduced from publicly available Soviet documentation; and 2) details of AECL's technical review of the CANDU PHWR (Pressurized Heavy Water Reactor) against the background of the Chernobyl accident, and implications of the Chernobyl accident. Reviews of operational aspects are underway by the Canadian electrical utilities and a review by the Canadian regulatory agency (the Atomic Energy Control Board) is near completion

  2. [The way we were. On the centenary of the first Spanish Congress of Paediatrics in Palma de Mallorca (1914-2014)].

    Science.gov (United States)

    Ponte Hernando, F; Zafra Anta, M; Fernández Menéndez, J M; Gorrotxategi Gorrotxategi, P; Bassat, Q; Fernández Teijeiro, J J; de Arana Amurrio, J I; García Nieto, V

    2014-06-01

    Between the 19th and 25th April 1914, the First Spanish Congress of Paediatrics was held in Palma de Mallorca under the slogan "Protect the Children". The specialty had broken away a few years earlier from its secular connection with Obstetrics and Gynaecology, both in its teaching aspect as well as regarding healthcare. With the newly created Chairs in Childhood Diseases, in a way this Congress meant the coming-of age and debut int society of paediatrics in our country. Prof. Martínez Vargas, a university professor in Barcelona, was the Chairman, and soul of the congress. There was a need to face a very high rate of infant mortality. The Congress responded to that social and sanitary/health demand with the participation of over three hundred pediatricians, including foreign representatives from Belgium, France, Russia and Latin America. The activities were divided into four sections: Childcare, Child Medicine, Surgery and Health, and accredited lecturers gave master classes on the most pressing issues of child pathology of the time. One hundred years on, what we are today is the fruit gathered by those who preceded us. Some were brilliant figures in paediatrics and others, the majority, anonymous paediatricians. They dedicated their lives, their science and their best smile to child care. The way we were and the way we are. With legitimate pride and satisfaction, it is an honour for the Group on the History of Paediatrics and AEP Documentation to celebrate this centennial commemoration in the framework of the Annals of Paediatrics.

  3. Review of simulation in paediatrics: The evolution of a revolution

    Directory of Open Access Journals (Sweden)

    Rahul eOjha

    2015-11-01

    Full Text Available Recent changes in medical education have highlighted the importance of experiential learning. Simulation is one model that has gained significant attention in the last decade and has been widely adopted as a training and assessment tool in medical education. Paediatric simulation has been utilized to teach various skills including resuscitation and trauma management, procedural skills and team training. It is also a valuable tool for health care educators, as it allows learners to achieve competence without putting patients at risk. Recent literature demonstrates increased retention of knowledge and skills after simulation based training. Further research is required to improve current simulation curriculums, develop validated assessment tools and to demonstrate improved clinical outcomes after simulation based training. We conducted an online search of original and review articles related to simulation and paediatric medical education and provide an overview of the role and utility of simulation in paediatrics.

  4. Paediatric Pain Management: Using Complementary and Alternative Medicine.

    Science.gov (United States)

    Evans, Subhadra; Tsao, Jennie C I; Zeltzer, Lonnie K

    2008-09-01

    Children undergo acute painful procedures and many also experience chronic pain.Due to their developing systems, infants and children may be at greater risk than adults for protracted pain sensitivity.There is a need to manage acute and chronic paediatric pain to reduce children's suffering and to prevent future pain problems.Consistent with a biopsychosocial perspective, complementary and alternative medicine (CAM) should be considered in management of acute and chronic paediatric pain.Although research is limited for paediatric pain, CAM interventions receiving the most empirical attention include hypnotherapy, acupuncture and music therapy. Evidence also exists for the therapeutic benefits of yoga, massage, humor therapy and the use of certain biological based therapies. PMID:26525515

  5. Basics, principles, techniques and modern methods in paediatric ultrasonography

    Energy Technology Data Exchange (ETDEWEB)

    Riccabona, Michael, E-mail: michael.riccabona@klinikum-graz.at

    2014-09-15

    Ultrasonography (US) is the mainstay of paediatric Radiology. This review aims at revisiting basic US principles, to list specific needs throughout childhood, and to discuss the application of new and modern US methods. The various sections elude to basic US physics, technical requisites and tips for handling, diagnostically valuable applications of modern techniques, and how to properly address hazards, risks and limitations. In conclusion, US holds vast potential throughout childhood in almost all body regions and many childhood specific queries – helping to reduce the need for or to optimize more invasive or irradiating imaging. Make the most of US and offerings a dedicated paediatric US service throughout the day, the week and the year thus is and will stay a major task of Paediatric Radiology.

  6. A Topography for Canadian Curriculum Theory.

    Science.gov (United States)

    Chambers, Cynthia

    1999-01-01

    Presents challenges to Canadian curriculum theorists: (1) to create curriculum languages and genres that represent all of Canada; (2) to use Canadian scholars and indigenous languages to find these curriculum languages and genres; (3) to seek interpretive tools to understand what it means to be Canadian; and (4) to create curriculum theory that…

  7. Collaboration between paediatric surgery and other medical specialties in Nigeria

    Directory of Open Access Journals (Sweden)

    Philemon E Okoro

    2012-01-01

    Full Text Available Background: The quality of service and success of patient care and research in most fields of medicine depend on effective collaboration between different specialties. Paediatric surgery is a relatively young specialty in Nigeria and such collaborations are desirable. This survey assesses the nature and extent of collaboration between paediatric surgery and other specialties in Nigeria. Materials and Methods: This is a questionnaire survey carried out in November 2008 among paediatric surgeons and their trainees practising in Nigeria. Questionnaires were distributed and retrieved either by hand or e-mailing. The responses were then collated and analysed using the SPSS 17.0. Results: Forty-seven respondents were included in the survey. Forty-five (95.7% respondents thought that there was inadequate collaboration and that there was a need for an increased collaboration between paediatric surgery and other specialties. Anaesthesia, paediatrics and radiology are among the specialties where collaborations were most required but not adequately received. Collaboration had been required from these specialties in areas of patient care, training and research. Reasons for inadequate collaboration included the paucity of avenues for inter-specialty communication and exchange of ideas 33 (70.3%, lack of awareness of the need for collaboration 32 (68.1%, tendency to apportion blames for bad outcome 13 (27.7%, and mutual suspicion 8 (17%. Conclusion: There is presently inadequate collaboration between paediatric surgery and other specialties in Nigeria. There is a need for more inter-specialty support, communication, and exchange of ideas in order to achieve desirable outcomes.

  8. Radiographic appearances of uncommon paediatric implants and devices

    Energy Technology Data Exchange (ETDEWEB)

    Urquia, Arlen; Watson, Tom A.; Arthurs, Owen J. [Great Ormond Street Hospital NHS Foundation Trust, Department of Radiology, London (United Kingdom)

    2015-06-15

    As childhood survival of chronic illness improves, long-term implanted devices will be encountered more frequently in routine radiology. In our paediatric tertiary referral hospital, we have come across several types of implanted devices that were not confidently recognised or identified by front-line staff and were often only identified by discussion with the patient, family or clinical team. This pictorial review highlights the appearance of nonvascular devices on paediatric radiographs in order to help clinicians identify the most frequent complications and to improve awareness of these important devices. (orig.)

  9. Acceptable nationwide outcome after paediatric inguinal hernia repair

    DEFF Research Database (Denmark)

    Bisgaard, Thue; Kehlet, H; Oehlenschlager, J;

    2014-01-01

    PURPOSE: The primary objective was to describe 30-day outcomes after primary inguinal paediatric hernia repair. METHODS: Prospectively collected data from the National Patient Registry covering a 2-year study period 1 January 2005 to 31 December 2006 were collected. Unexpected outcomes were defined...... after elective repair (recurrence rate 0.3 %). Paediatric repairs were for most parts performed in surgical public hospitals, and most departments performed less than 10 inguinal hernia repairs within the 2 years study period. CONCLUSION: These nationwide results are acceptable with low numbers...

  10. Canadian contributions studies for the WFIRST instruments

    Science.gov (United States)

    Lavigne, J.-F.; Rowlands, N.; Grandmont, F. J.; Lafrenière, D.; Marois, C.; Daigle, O.; Thibault, S.; Schade, D.; Artigau, É.; Brousseau, D.; Maire, J.; Cretot-Richert, G.; Ducharme, M.-È.; Levesque, L. E.; Laurin, D.; Dupuis, J.

    2016-07-01

    WFIRST-AFTA is the NASA's highest ranked astrophysics mission for the next decade that was identified in the New World, New Horizon survey. The mission scientific drivers correspond to some of the deep questions identified in the Canadian LRP2010, and are also of great interest for the Canadian scientists. Given that there is also a great interest in having an international collaboration in this mission, the Canadian Space Agency awarded two contracts to study a Canadian participation in the mission, one related to each instrument. This paper presents a summary of the technical contributions that were considered for a Canadian contribution to the coronagraph and wide field instruments.

  11. Canadian Postcolonialism: Recovering British Roots

    Science.gov (United States)

    Doughty, Howard A.

    2005-01-01

    The field of Postcolonial Studies is one of the academic fashions that has arisen in an attempt to amend or replace radical theories of social power since the alleged discrediting of Marxism. The Canadian case is more ambiguous. Postcolonialism, already an essentially contested concept, is especially conflicted where Canada is concerned. Canada…

  12. Canadian Government Electronic Information Policy.

    Science.gov (United States)

    Nilsen, Kirsti

    1993-01-01

    Examines development and evolution of Canadian government information policy in response to issues of preservation of data, information industry involvement in government data development and marketing, role of Crown copyright, and public access to government information in electronic formats. Six key information policy instruments are also…

  13. Nuclear regulation - the Canadian approach

    International Nuclear Information System (INIS)

    Although the Atomic Energy Control Board was established 35 years ago the basic philosophy of nuclear regulation in Canada and the underlying principles of the regulatory process remain essentially unchanged. This paper outlines the Canadian approach to nuclear regulation and explains in practical terms how the principles of regulation are applied. (author)

  14. Representing Canadian Muslims: Media, Muslim Advocacy Organizations, and Gender in the Ontario Shari’ah Debate

    Directory of Open Access Journals (Sweden)

    Meena Sharify-Funk

    2009-01-01

    Full Text Available This paper analyzes a highly public conflict between two Muslim non-profit organizations, the Canadian Islamic Congress (CIC and the Muslim Canadian Congress (MCC, as it played out on the pages of Canadian newspapers and Internet websites. Sparked by profoundly divergent convictions about gender norms and fuelled by contradictory blueprints for “being Muslim in Canada”, this incendiary conflict was fanned by Canadian media coverage. Focusing especially, but not exclusively, on the 2003-2005 debate over Shari’ah-based alternative dispute resolution in Ontario, I will argue that the media have played a role in constructing internal Muslim debates and identity negotiations concerning what it means to be genuinely Canadian and authentically Muslim through controversy-driven journalism that has highlighted opposing ends of a liberal/progressive versus conservative/traditional axis in a search for “point/counter-point” views. Through short stories and commentaries on controversial topicsthat juxtapose two increasingly antagonistic organizational voices, the media have not merely reflected Muslim realities, but also helped to shape them and, more often than not, reinforce polarization between a “majority Muslim” culture seeking to secure space for itself within Canadian society and a “dissident Muslim” culture that seeks to consolidate external support for internal change.

  15. Canadian Public Libraries Are Aware of Their Role as Information Literacy Training Providers, but Face Several Challenges. A Review of: Lai, H.-J. (2011. Information literacy training in public libraries: A case from Canada. Educational Technology & Society, 14(2, 81-88.

    Directory of Open Access Journals (Sweden)

    Laura Newton Miller

    2012-03-01

    Full Text Available Objective– To explore the current state of information literacy (IL training in Canadian public libraries, and to identify strategies used for improving IL training skills for staff and patrons.Design – Mixed-methods approach, including document analysis, observations, and focus group interviews.Setting – Two libraries of a large public library system in Canada: the central library and one branch library.Subjects – Six staff members (manager, administrator, training coordinator, instructor, and computer technician who have been involved in designing and teaching information literacy courses for library patrons and staff.Methods – The researcher analyzed internal and external library documents related to information literacy, including, but not limited to, reports, posters, lesson plans, newsletters, and training scripts. He also observed interactions and behaviours of patrons during IL training sessions. Finally, he conducted a focus group with people involved in IL training, asking questions about facilities and resources, programs, patron reaction, librarian knowledge of IL theory, and impediments and benefits of IL training programs in public libraries.Main Results – Staff were aware of the importance of IL training in the library. Attracting more library patrons (including building partnerships with other organizations, improving staff IL and training skills, employing effective strategies for running training programs, and dealing with financial issues were all concerns about running IL training that were highlighted.Conclusion – Canadian public libraries are well aware of their role as IL training providers, but they still face several challenges in order to improve their effectiveness.

  16. Molecular mechanisms involved in chemoresistance in paediatric acute lymphoblastic leukaemia

    Directory of Open Access Journals (Sweden)

    Stanković Tatjana

    2008-01-01

    Full Text Available Acute lymphoblastic leukaemia (ALL is the most common paediatric cancer. Despite cure rates approaching 80%, resistance to treatment and disease relapse remain a significant clinical problem. Identification of the genes and biological pathways responsible for chemoresistance is therefore crucial for the design of novel therapeutic approaches aiming to improve patient survival. Mutations in the membrane transporter P-glycoprotein genes, genetic variations in drug-metabolising enzymes and defects in apoptotic pathways are mechanisms of chemoresistance common to a wide spectrum of cancers and also play a role in paediatric ALL. In addition, several recent microarray studies have identified transcriptional profiles specifically associated with chemoresistance and pointed to a number of potentially novel therapeutic targets. These microarray studies have shown that genes discriminating between clinically responsive and resistant leukaemias tend to be involved in cellular processes such as regulation of cell cycle, proliferation, and DNA repair. Here we review the outcomes of these microarray studies and also present our own investigations into apoptotic resistance to DNA double strand breaks (DSBs in paediatric ALL. We present stratification of paediatric ALL by the profile of DNA damage response following ionising radiation (IR in vitro. This approach allows classification of ALL tumours at presentation into IR-apoptotic sensitive and IR-apoptotic resistant. Furthermore, apoptotic resistant leukaemias exhibit abnormal response of NFkB pathway following irradiation and inhibition of this pathway can sensitise leukaemic cells to IR-induced DSBs.

  17. Adverse drug reactions in the paediatric population in Denmark

    DEFF Research Database (Denmark)

    Aagaard, Lise; Weber, Camilla Blicher; Hansen, Ebba Holme

    2010-01-01

    BACKGROUND: The potential risk of adverse drug reactions (ADRs) in the paediatric population has become a public health concern and regulatory agencies in Europe and the US have acknowledged that there is a need for more research in this area. Spontaneous reporting systems can provide important n...

  18. 3 T MRI in paediatrics: Challenges and clinical applications

    Energy Technology Data Exchange (ETDEWEB)

    Dagia, Charuta [Department of Medical Imaging, Royal Children' s Hospital and Murdoch Childrens Research Institute, Flemington Road, Parkville 3052 (Australia); Ditchfield, Michael [Department of Medical Imaging, Royal Children' s Hospital and Murdoch Childrens Research Institute, Flemington Road, Parkville 3052 (Australia)], E-mail: michael.ditchfield@rch.org.au

    2008-11-15

    3 T MRI is being increasingly performed for clinical purposes in paediatrics, primarily because of the potential to improve spatial and temporal resolution - these can assist in overcoming the unique anatomic, physiologic and behavioural challenges of imaging children. The increased spatial resolution improves the capacity to image small patients; with particular reference to smaller structures such as the inner ear, brachial plexus, biliary system and the vascular system. The challenges inherent to imaging at high field strength remain pertinent especially, the altered T1 contrast, artefacts (susceptibility, chemical shift and B1 inhomogeneity) and safety issues, including specific absorption rate - several of these are circumvented due to software and hardware advances, or by trade off of some of the increased signal. The above mentioned challenges also create opportunities at 3 T, with improvement in MR angiography, arterial spin labelling, functional MRI, susceptibility weighted imaging, and MR spectroscopy - all of which have distinctive applications in paediatrics. Whole body imaging also becomes more practical because of the capacity for faster scans. 3 T MRI has the potential to image all the systems in paediatrics. However, neonatal brain and paediatric spine imaging have specific challenges at 3 T. Several factors also limit cardiac imaging at present. Further improvements in coil technology and newer sequences may help overcome the challenges that remain.

  19. Paediatric reference values for the peripheral T cell compartment.

    NARCIS (Netherlands)

    Schatorje, E.J.H.; Gemen, E.F.A.; Driessen, G.J.A.; Leuvenink, J.; Hout, R.W. van; Vries, E. de

    2012-01-01

    Immunophenotyping of blood lymphocyte subpopulations is an important tool in the diagnosis of immunological and haematological diseases. Paediatric age-matched reference values have been determined for the major lymphocyte populations, but reliable reference values for the more recently described T

  20. Therapeutic upper gastrointestinal tract endoscopy inPaediatric Gastroenterology

    Institute of Scientific and Technical Information of China (English)

    Imdadur Rahman; Praful Patel; Philip Boger; Shahnawaz Rasheed; Mike Thomson; Nadeem Ahmad Afzal

    2015-01-01

    Since the first report of use of endoscopy in childrenin the 1970s, there has seen an exponential growthin published experience and innovation in the field. Inthis review article we focus on modern age therapeuticendoscopy practice, explaining use of traditional aswell as new and innovative techniques, for diagnosisand treatment of diseases in the paediatric uppergastrointestinal tract.

  1. Surveillance biopsies after paediatric kidney transplantation: A review.

    Science.gov (United States)

    Rose, Edward M; Kennedy, Sean E; Mackie, Fiona E

    2016-09-01

    Kidney transplantation is the most effective means of treating children with end-stage kidney disease, and yet, there continues to be a limited "life span" of transplanted kidneys in paediatric recipients. Early graft monitoring, using the surveillance biopsy, has the potential to extend renal allograft survival in paediatric recipients. The surveillance biopsy provides important and timely information about acute and chronic graft pathology, particularly SCR and calcineurin inhibitor-induced nephrotoxicity, which can subsequently guide management decisions and improve long-term graft survival. The ostensible value of the surveillance biopsy is furthered by the limitations of conventional renal functional studies. However, there is still much debate surrounding the surveillance biopsy in paediatric recipients, particularly in regard to its overall utility, safety and timing. This review discusses the current literature regarding the utility, safety, and potential predictive value of surveillance biopsies for guiding post-transplant management in paediatric renal allograft recipients, as well as the viability of other potentially newer non-invasive strategies for renal allograft monitoring. PMID:27306873

  2. The role of computed tomography in modern paediatric uroradiology

    International Nuclear Information System (INIS)

    Computed tomography (CT) has developed a well-recognised role within paediatric uroradiology, especially in imaging of trauma, malignancy (in particular Wilms' tumour), atypical infection, and congenital urogenital abnormalities. CT can also be used for problem solving in nephrolithiasis and renal transplant assessment. These applications are illustrated and discussed, with an emphasis on particular information that can be gained from the CT study

  3. Adverse drug reactions from psychotropic medicines in the paediatric population

    DEFF Research Database (Denmark)

    Aagaard, Lise; Hansen, Ebba H

    2010-01-01

    ADRs reported for psychotropic medicines in the Danish paediatric population over a decade. FINDINGS: All spontaneous ADR reports from 1998 to 2007 for children from birth to 17 years of age were included. The unit of analysis was one ADR. We analysed the distribution of ADRs per year, seriousness, age...

  4. Pilot study of a paediatric emergency department oral rehydration protocol

    OpenAIRE

    Boyd, R.; Busuttil, M; Stuart, P

    2005-01-01

    Objective: To ascertain if the use of a paediatric oral rehydration protocol in the emergency department changed rates of admission, total time spent in hospital, total time spent in the emergency department, or number of unscheduled returns to the emergency department.

  5. Paediatric intensive care is feasible in a neonatal department

    DEFF Research Database (Denmark)

    Jensen, Anne-Mette Bæk; Lundstrøm, Kaare E.; Reinholdt, Jes;

    2013-01-01

    Intensive care of infants below one year of age has been centralized in a paediatric intensive care unit (PICU) related to the neonatal intensive care unit (NICU) at Rigshospitalet, the University Hospital in Copenhagen in eastern Denmark (approximately 2.5 million inhabitants) since 2002. The aim...

  6. Anti-GM-CSF antibodies in paediatric pulmonary alveolar proteinosis

    OpenAIRE

    Latzin, P; Tredano, M.; Wust, Y; J. de Blic; Nicolai, T; Bewig, B; Stanzel, F.; Kohler, D.; Bahuau, M.; Griese, M

    2005-01-01

    Background: Auto-antibodies against granulocyte-macrophage colony stimulating factor (GM-CSF) may be central to the pathogenesis of adult sporadic pulmonary alveolar proteinosis (PAP). The role of anti-GM-CSF auto-antibodies in paediatric forms of PAP is as yet unclear.

  7. 3 T MRI in paediatrics: Challenges and clinical applications

    International Nuclear Information System (INIS)

    3 T MRI is being increasingly performed for clinical purposes in paediatrics, primarily because of the potential to improve spatial and temporal resolution - these can assist in overcoming the unique anatomic, physiologic and behavioural challenges of imaging children. The increased spatial resolution improves the capacity to image small patients; with particular reference to smaller structures such as the inner ear, brachial plexus, biliary system and the vascular system. The challenges inherent to imaging at high field strength remain pertinent especially, the altered T1 contrast, artefacts (susceptibility, chemical shift and B1 inhomogeneity) and safety issues, including specific absorption rate - several of these are circumvented due to software and hardware advances, or by trade off of some of the increased signal. The above mentioned challenges also create opportunities at 3 T, with improvement in MR angiography, arterial spin labelling, functional MRI, susceptibility weighted imaging, and MR spectroscopy - all of which have distinctive applications in paediatrics. Whole body imaging also becomes more practical because of the capacity for faster scans. 3 T MRI has the potential to image all the systems in paediatrics. However, neonatal brain and paediatric spine imaging have specific challenges at 3 T. Several factors also limit cardiac imaging at present. Further improvements in coil technology and newer sequences may help overcome the challenges that remain

  8. Practical application of natriuretic peptides in paediatric cardiology

    DEFF Research Database (Denmark)

    Smith, Julie; Goetze, Jens Peter; B. Andersen, Claus;

    2010-01-01

    diagnostic tools. Natriuretic peptide measurements could be that extra tool. We discuss and suggest N-terminal pro-B-type natriuretic peptide and B-type natriuretic peptide reference intervals for children without cardiovascular disease and cut-off points for the four specific paediatric heart conditions. We...

  9. Measuring adherence to treatment of paediatric HIV/AIDS.

    Science.gov (United States)

    Naar-King, S; Frey, M; Harris, M; Arfken, C

    2005-04-01

    Parent, child, physician report and pill counts were used to measure adherence in paediatric HIV. Relationships to viral load were assessed. Pill counts were considered invalid. Adherence measures did not correlate with one another. Physicians reported lower adherence than parents, but parent and physician report correlated with viral load. The clinical and research utility of the various measures are discussed.

  10. REFLUX ESOPHAGITIS IN INFANTS AND CHILDREN - A REPORT FROM THE WORKING GROUP ON GASTROESOPHAGEAL REFLUX DISEASE OF THE EUROPEAN-SOCIETY-OF-PEDIATRIC-GASTROENTEROLOGY-AND-NUTRITION

    NARCIS (Netherlands)

    VANDENPLAS, Y; ASHKENAZI, A; BELLI, D; BLECKER, U; BOIGE, N; BOUQUET, J; CADRANEL, S; CEZARD, JP; CUCCHIARA, S; DEVREKER, T; DUPONT, C; GEBOES, K; GOTTRAND, F; HEYMANS, HSA; JASINSKI, C; KNEEPKENS, CMF; KOLETZKO, S; MILLA, P; MOUGENOT, JF; NAVARRO, J; NEWELL, SJ; NUSSLE, D; OLAFSDOTTIR, E; POLANCO, [No Value; RAVELLI, A; SANDHU, BK; TOLBOOM, J

    1994-01-01

    In this article, the Working Group on Gastro-Oesophageal Reflux of the European Society of Paediatric Gastroenterology and Nutrition presents and discusses a definition of reflux esophagitis and recommends a diagnostic approach and therapeutic management for this condition. Histologic criteria for r

  11. Survey of effective dose levels from typical paediatric CT protocols

    International Nuclear Information System (INIS)

    Concern over reported large radiation doses leading to a high cancer risk for paediatric CT patients has prompted considerable investigation in paediatric CT. The recent release of software from Germany has allowed effective doses to be calculated from CT protocol information and radiation measurement for standard paediatric patient sizes for both sexes. An initial study has been undertaken in nine radiology departments, four of which were dedicated paediatric departments, for routine chest and abdominal CT procedures. The dose calculation software is based on Monte Carlo simulation of X-ray conditions during a CT procedure and utilized a 'tomographic' phantom model of a 7-year-old child and an 8-week-old baby to allow calculation of organ dose and hence effective dose. Results of the survey indicate that effective doses were higher for females than males, and higher for abdominal procedures. Slightly higher effective doses were calculated for the child compared to the baby. All centres but one recorded lower effective doses with their current protocols than if they had used recommended CT protocols found in the literature. Analysis of the survey data indicates that scan parameters are the main cause of dose variations, although the type of scanner can affect dose by a factor of 2 (when comparing different units) as well as variation in anatomy scanned in protocols. Dose reduction appears to be most closely linked with reduced mAs and increased pitch as expected. The calculation of effective dose appears to be a key factor in assessing CT protocols, particularly for paediatric patients. Copyright (2003) Blackwell Science Pty Ltd

  12. Paediatric intensive care in Kuala Lumpur, Malaysia: a developing subspecialty.

    Science.gov (United States)

    Goh, A Y; Lum, L C; Chan, P W

    1999-12-01

    Paediatric intensive care in Malaysia is a developing subspecialty with an increasing number of specialists with a paediatric background being involved in the care of critically ill children. A part prospective and part retrospective review of 118 consecutive non-neonatal ventilated patients in University Hospital, Kuala Lumpur was carried out from 1 June 1995 to 31 December 1996 to study the clinical epidemiology and outcome in our paediatric intensive case unit (PICU). The mean age of the patients was 33.9 +/- 6.0 months (median 16 months). The main mode of admission was emergency (96.6 per cent) with an overall mortality rate of 42 per cent (50/118). The mean paediatric risk of mortality (PRISM) score was 20 +/- 0.98 SEM, with 53 per cent of patients having a score of over 30 per cent. Multiorgan dysfunction (MODS) was identified in 71 per cent of patients. Admission efficiency (mortality risk > 1 per cent) was 97 per cent. Standardized mortality rate using PRISM was an acceptable 1.06. The main diagnostic categories were respiratory (32 per cent), neurology (22 per cent), haematology-oncology (18 per cent); the aetiology of dysfunction was mainly infective. Non-survivors were older (29.5 vs. 13.8 months, p < 0.0001), had more severe illness (mean PRISM score 30 vs. 14, p < 0.0001), were more likely to develop MODS (96 vs. 53 per cent, p < 0.0001) and required more intervention and monitoring. Paediatric intensive care in Malaysia differs widely from that in developed countries in patient characteristics, severity of illness, and care modalities provided.

  13. Indications for admission, treatment and improved outcome of paediatric haematology/oncology patients admitted to a tertiary paediatric ICU.

    LENUS (Irish Health Repository)

    Owens, C

    2012-02-01

    BACKGROUND: Overall survival in paediatric cancer has improved significantly over the past 20 years. Treatment strategies have been intensified, and supportive care has made substantial advances. Historically, paediatric oncology patients admitted to an intensive care unit (ICU) have had extremely poor outcomes. METHODS: We conducted a retrospective cohort study over a 3-year period in a single centre to evaluate the outcomes for this particularly vulnerable group of patients admitted to a paediatric ICU. RESULTS: Fifty-five patients were admitted a total of 66 times to the ICU during the study period. The mortality rate of this group was 23% compared with an overall ICU mortality rate of 5%. 11\\/15 patients who died had an underlying haematological malignancy. Twenty-eight percent of children with organism-identified sepsis died. CONCLUSIONS: While mortality rates for paediatric oncology patients admitted to a ICU have improved, they are still substantial. Those with a haematological malignancy or admitted with sepsis are most at risk.

  14. The prospects for Canadian uranium

    International Nuclear Information System (INIS)

    The 1980s have seen a decline in markets for uranium concentrate, largely as a result of falling estimates for reactor fuel requirements and rising inventories. Spot market prices fell to $44 in September 1982, but have since risen back to $60. World production also fell in 1982 and is not expected to increase significantly before 1990. Some opportunities exist for Canadian producers with new low-cost deposits to replace high-cost producers in Canada and other countries, particularly the United States. There will be strong competition between Canadian producers as well as from Australia. Australia's reserves are somewhat larger than Canada's, although the reported ore grades tend to be lower than those of Saskatchewan

  15. Exporting the Canadian licensing program

    International Nuclear Information System (INIS)

    This paper deals with the problems of an overseas regulatory agency in licensing a Canadian-supplied nuclear plant which is referenced to a plant in Canada. Firstly, the general problems associated with the use of a reference plant are discussed. This is followed by a discussion of specific problems which arise from the licensing practices in Canada. The paper concludes with recommendations to simplify the task of demonstrating the licensability of an overseas CANDU plant

  16. Congestion pricing of Canadian airports

    OpenAIRE

    Joseph I. Daniel

    2011-01-01

    Under congestion pricing, Canadian airports would annually save between $72 and $105 million. Social costs per landing and takeoff decrease about $300 at Toronto and Vancouver and $50 at Calgary and Montreal. Slot constraints fail to eliminate this airport congestion. Congestion prices are lower on average than existing weight-based prices. Current airport capacity accommodates at least five more years of traffic growth before congestion reaches current levels. Substantial welfare gains occur...

  17. Canadian Content in Video Games

    OpenAIRE

    Paul, Leonard

    2005-01-01

    THEME: Internationalism: Worlds at Play Topics: Internationalism, Identity in Gaming and Learning to Play Abstract: How does Canada fit into the global cultural context of video games? This paper investigates the culture being reflected in video games being produced in Canada as Canada is one of the world's leading producers of video games. It examines the how Canadian culture is represented in current new media artistic output against the culture, or lack of culture, being represented in vid...

  18. American Society of Echocardiography

    Science.gov (United States)

    American Society of Echocardiography Join Ase Member Portal Log In Membership Member Portal Log In Join ASE Renew Benefits Rates FASE – Fellow of the American Society of Echocardiography Member Referral Program FAQs Initiatives Advocacy ...

  19. Society of Interventional Radiology

    Science.gov (United States)

    ... how interventional radiology research improves patients’ lives at Society of Interventional Radiology’s 2017 Annual Scientific Meeting; read ... comments to CMS on two MACRA coding issues; society is engaged with CMS as they develop codes ...

  20. International Transplant Nurses Society

    Science.gov (United States)

    ... 25th Annual ITNS Symposium The International Transplant Nurses Society (ITNS) cordially invites transplant nurses and other transplant ... pocket guide, developed by the International Transplant Nurses Society (ITNS), provides an overview of the interventions used ...

  1. Ehlers-Danlos Society

    Science.gov (United States)

    ... Scientific Board Staff Volunteer Leaders The Ehlers-Danlos Society Center for EDS Research & Clinical Care Our History ... Message Boards Patient Resource Library The Ehlers-Danlos Society Center for EDS Research & Clinical Care Loose Connections ...

  2. Scoliosis Research Society

    Science.gov (United States)

    Back To Top Scoliosis Research Society Close Menu Member Login Become a Member Home Find a Specialist | Calendar Contact | Donate Patients and Families ... a Member Find a Specialist Calendar Contact Donate Scoliosis Research Society Dedicated to the optimal care of ...

  3. Providing cleaner air to Canadians

    International Nuclear Information System (INIS)

    This booklet is designed to explain salient aspects of the Ozone Annex, negotiated and signed recently by Canada and the United States, in a joint effort to improve air quality in North America. By significantly reducing the transboundary flows of air pollutants that cause smog, the Ozone Annex will benefit some 16 million people in central and eastern Canada and provide an example for a future round of negotiations to address concerns of the millions of Canadians and Americans who live in the border area between British Columbia and Washington State. The brochure provide summaries of the Canadian and American commitments, focusing on transportation, monitoring and reporting. The Ozone Annex complements other air quality initiatives by the Government of Canada enacted under the Environmental Protection Act, 1999. These measures include regulations to reduce sulphur content to 30 parts per million by Jan 1, 2005; proposing to restrict toxic particulate matter (PM) to less than 10 microns; establishing daily smog forecasts in the Maritimes and committing to a national program built upon existing smog advisories and forecasts in Quebec, Ontario and British Columbia; and investing in more clean air research through the newly created Canadian Foundation for Climate and Atmospheric Sciences

  4. Canadian fusion fuels technology project

    International Nuclear Information System (INIS)

    The Canadian Fusion Fuels Technology Project was launched in 1982 to coordinate Canada's provision of fusion fuels technology to international fusion power development programs. The project has a mandate to extend and adapt existing Canadian tritium technologies for use in international fusion power development programs. 1985-86 represents the fourth year of the first five-year term of the Canadian Fusion Fuels Technology Project (CFFTP). This reporting period coincides with an increasing trend in global fusion R and D to direct more effort towards the management of tritium. This has resulted in an increased linking of CFFTP activities and objectives with those of facilities abroad. In this way there has been a continuing achievement resulting from CFFTP efforts to have cooperative R and D and service activities with organizations abroad. All of this is aided by the cooperative international atmosphere within the fusion community. This report summarizes our past year and provides some highlights of the upcoming year 1986/87, which is the final year of the first five-year phase of the program. AECL (representing the Federal Government), the Ministry of Energy (representing Ontario) and Ontario Hydro, have given formal indication of their intent to continue with a second five-year program. Plans for the second phase will continue to emphasize tritium technology and remote handling

  5. Mutual Organizations, Mutual Societies

    OpenAIRE

    Archambault, Edith

    2009-01-01

    This article is an entry to be published in an International Encyclopedia of Civil Society in 2009. Mutual organizations exist everywhere in developed and developing countreies as well. After a definition founded on social economy principles, the paper gives the historical background of mutual insurance companies, mutual benefit societies and building societies. Then we draw a panorama of the European mutual societies with international perspectives on the USA and some developing countries. S...

  6. Reclaiming Society Publishing

    Directory of Open Access Journals (Sweden)

    Philip E. Steinberg

    2015-07-01

    Full Text Available Learned societies have become aligned with commercial publishers, who have increasingly taken over the latter’s function as independent providers of scholarly information. Using the example of geographical societies, the advantages and disadvantages of this trend are examined. It is argued that in an era of digital publication, learned societies can offer leadership with a new model of open access that can guarantee high quality scholarly material whose publication costs are supported by society membership dues.

  7. Nutrition for healthy term infants

    OpenAIRE

    1998-01-01

    Nutrition for Healthy Term Infants is the new national statement on nutrition for infants from birth to 24 months, developed collaboratively by the Canadian Paediatric Society, Dietitians of Canada and Health Canada.

  8. Oral medicines for children in the European paediatric investigation plans.

    Directory of Open Access Journals (Sweden)

    Diana A van Riet-Nales

    Full Text Available INTRODUCTION: Pharmaceutical industry is no longer allowed to develop new medicines for use in adults only, as the 2007 Paediatric Regulation requires children to be considered also. The plans for such paediatric development called Paediatric Investigation Plans (PIPs are subject to agreement by the European Medicines Agency (EMA and its Paediatric Committee (PDCO. The aim of this study was to evaluate the key characteristics of oral paediatric medicines in the PIPs and the changes implemented as a result of the EMA/PDCO review. METHODS: All PIPs agreed by 31 December 2011 were identified through a proprietary EMA-database. PIPs were included if they contained an agreed proposal to develop an oral medicine for children 0 to 11 years. Information on the therapeutic area (EMA classification system; target age range (as defined by industry and pharmaceutical characteristics (active substance, dosage form(s as listed in the PIP, strength of each dosage form, excipients in each strength of each dosage form was extracted from the EMA website or the EMA/PDCO assessment reports. RESULTS: A hundred and fifty PIPs were included corresponding to 16 therapeutic areas and 220 oral dosage forms in 431 strengths/compositions. Eighty-two PIPs (37% included tablets, 44 (20% liquids and 35 (16% dosage forms with a specific composition/strength that were stored as a solid but swallowed as a liquid e.g. dispersible tablets. The EMA/PDCO review resulted in an increase of 13 (207 to 220 oral paediatric dosage forms and 44 (387 to 431 dosage forms with a specific composition/strength. For many PIPs, the target age range was widened and the excipient composition and usability aspects modified. CONCLUSION: The EMA/PDCO review realized an increase in the number of requirements for the development of oral dosage forms and a larger increase in the number of dosage forms with a specific composition/strength, both targeting younger children. Changes to their pharmaceutical

  9. Environmental catalysis: the Canadian situation

    Energy Technology Data Exchange (ETDEWEB)

    Aye, T.; Christensen, D.; Gostick, J.; Mogharei, A.; Oskin, G. O.; Won, W.; Aida, T. [Waterloo Univ. ON (Canada)

    2000-10-01

    The Canadian situation with respect to research in environmental catalysis was investigated by analyzing catalysis papers appearing in the 1999 and 2000 issues of major journals devoted to research in catalysis (Journal of Catalysis; Catalysis Today; Applied Catalysis A: General and B: Environmental). A total of 2150 papers were surveyed; of these 34 were by Canadian authors, with Canada ranking twentieth in the world in terms of research in this field. About 40 per cent of the catalysis papers were related to the environment, with nitrogen and sulphur emissions being the most important topics and energy conversion second. Hydrodesulphurization of petroleum oil, use of low sulphur coal and flue gas desulphurization are the principal processes for controlling sulfur emissions into the air, while nitrogen oxides emissions in automobiles are ccontrolled bt three-way catalysts. In power generation, selective catalytic reduction is the preferred method, although not in Canada, where installing low-NOx burners or using low nitrogen fuels such as natural gas are favored. The control of volatile organic compounds is also a serious problem. The two most promising processes for the Canadian situation are adsorption by activated carbon and catalysis using low-temperature catalysts. Water treatment of textile mill effluents, a favorite topics by Canadian authors, includes photocatalytic oxidation with titanium oxide photocatalyst, ozonation with activated carbons and a combination of photocatalysis and biological treatment. Carbon dioxide conversion was also a favoured topic by Canadian researchers; not surprising in view if the fact that Canada is the highest per capita producer of carbon dioxide emissions. Nearly two-thirds of the carbon dioxide emissions is due to the transportation and energy production sectors, therefore, any carbon dioxide mitigation strategies should be applied initially in these areas. Catalytic conversion of carbon dioxide into methanol, which then

  10. Drought, Climate Change and the Canadian Prairies

    Science.gov (United States)

    Stewart, R. E.

    2010-03-01

    employment losses exceeded 41,000 jobs for 2001 and 2002. This drought also contributed to a negative or zero net farm income for several provinces for the first time in 25 years with agricultural production over Canada dropping an estimated 3.6 billion in 2001/2002. Previously reliable water supplies such as streams, wetlands, dugouts, reservoirs, and groundwater were placed under stress and often failed. Despite their enormous economic, environmental, and societal impacts, there has never been a coordinated and integrated drought research program in Canada. To begin to address these issues related to drought, the Drought Research Initiative, DRI was established. The overall objective of DRI is "to better understand the physical characteristics of and processes influencing Canadian Prairie droughts, and to contribute to their better prediction, through a focus on the recent severe drought that began in 1999 and largely ended in 2005". DRI is focused on five research objectives: 1. Quantify the physical features of this recent drought 2. Improve the understanding of the processes and feedbacks governing the formation, evolution, cessation and structure of the drought 3. Assess and reduce uncertainties in the prediction of drought and its structure 4. Compare the similarities and differences of the recent drought to previous and future droughts 5. Apply progress to address critical issues of importance to society Major progress is being made within each of these research areas. These coordinated studies furthermore represent an essential step towards our ultimate goal which is to better assess whether there will be more droughts in the future over this region due to climate change, what features these droughts will exhibit, and how we can best prepare for them. The focus of these activities is on changes to occur over the next several decades and significant progress is being made in addressing these issues as well. The purpose of this presentation is to provide an overview

  11. Paediatric injuries at Bugando Medical Centre in Northwestern Tanzania: a prospective review of 150 cases

    OpenAIRE

    Simon, Raymond; Gilyoma, Japhet M; Dass, Ramesh M.; Mchembe, Mabula D; Chalya, Phillipo L

    2013-01-01

    Background Injuries continue to be the leading cause of death and disability for children. The is a paucity of published data on paediatric injuries in our local environment. This study describes the etiological spectrum, injury characteristics and treatment outcome of paediatric injuries in our local setting and provides baseline data for establishment of prevention strategies as well as treatment guidelines. Methods This was a descriptive cross-sectional study involving paediatric injury pa...

  12. A retrospective review of telehealth services for children referred to a paediatric nephrologist

    OpenAIRE

    Trnka, Peter; White, Megan M.; Renton, William D.; McTaggart, Steven J.; Burke, John R.; Smith, Anthony C.

    2015-01-01

    Background Telemedicine has emerged as an alternative mode of health care delivery over the last decade. To date, there is very limited published information in the field of telehealth and paediatric nephrology. The aim of this study was to review our experience with paediatric telenephrology in Queensland, Australia. Methods A retrospective audit of paediatric nephrology telehealth consultations to determine the nature of the telehealth activity, reasons for referral to telehealth, and to co...

  13. Paediatric trainees and end-of-life care: a needs assessment for a formal educational intervention

    OpenAIRE

    Arzuaga, Bonnie H; Caldarelli, Leslie

    2015-01-01

    Background: Literature suggests a paucity of formal training in end-of-life care in contemporary American medical education. Similar to trainees in adult medicine, paediatric trainees are frequently involved in end-of-life cases. Objective: To determine current experience and comfort levels among paediatric trainees when caring for dying patients with the hypothesis that more clinical experience alone would not improve comfort. Methods: Paediatric residents, subspeciality fellows and programm...

  14. Paediatric imaging radiation dose awareness and use of referral guidelines amongst radiology practitioners and radiographers

    OpenAIRE

    Portelli, Jonathan L.; McNulty, Jonathan P.; Bezzina, Paul; Rainford, Louise

    2015-01-01

    Objectives The objectives are to investigate radiology practitioners’ and radiographers’ radiation dose awareness and use of referral guidelines for paediatric imaging examinations. Methods A prospective cross-sectional survey was conducted amongst radiology practitioners and radiographers working at a primary paediatric referral centre in Malta. Part of the survey asked participants to indicate the typical effective dose (ED) for several commonly performed paediatric imaging examinations, an...

  15. A Contract Between Science and Society

    Science.gov (United States)

    Dowdeswell, Elizabeth

    2009-05-01

    Growing energy demand, global climate disruption and the prospect of a carbon-constrained world have opened the door for discussion of a potential nuclear renaissance. The fact that deployment of nuclear energy has not been fully embraced points to a number of challenges. These range from concerns about safety, security and proliferation of nuclear materials to questions of feasibiity and economics. Others cite the continuing quest for an acceptable approach to the management of long-lived wastes and uncertainty about risks to human health and the environment. Arguably public acceptance of nuclear energy will require policy makers to examine many social and ethical concerns, both real and perceived. Yet research suggests that public trust in governments and institutions is eroding while society's expectations to be involved in decision-making have become more intense and sophisticated. The recent Canadian experience of selecting an approach for the long-term management of used nuclear fuel illustrates the complexity of obtaining a ``social licence'' to proceed. A key objective was to gather and document the terms and conditions that would make such a project acceptable to society and to reflect a fundamental understanding and respect for these factors in the project's actual design and implementation. The underlying philosophy was that the analysis of scientific and technical evidence, while essential, could not be the sole determining factor. Ultimately it is society that will determine which risks it is prepared to accept. The mission of developing collaboratively with Canadians a management approach that would be socially acceptable, technically sound, environmentally responsible and economically feasible required the development of an integrated, systemic analytical framework and an interactive and transparent process of dialogue and deliberation. This investment in seeking diversity of perspectives resulted in the mergence of common ground among citizens and

  16. Society's general exposure to risk

    International Nuclear Information System (INIS)

    Canadian and world experience with accidents and disease is reviewed in order to identify risk information that might extend the societal perspective on health risk beyond daily concerns. The level of exposure to catastrophic risks is compared to that associated with commonly experienced risks. An examination of current and historical levels of Canadian mortality risk is included. The association between mortality risk and Canadian industrial activity is also examined. Some prospects for utilizing these risk benchmarks are then discussed

  17. Concepts from paediatric extracorporeal membrane oxygenation for adult intensivists.

    Science.gov (United States)

    Butt, Warwick; MacLaren, Graeme

    2016-12-01

    Over the last 5 years, there has been a dramatic increase in the use of extracorporeal membrane oxygenation (ECMO) in adult patients with severe respiratory or cardiac failure. This contrasts to the use of the technology in neonatal and paediatric intensive care units, where it has been regarded as a standard of care for a number of conditions for over 25 years. Many innovations in ECMO circuitry or clinical management evolve first in one particular discipline and it may be helpful for individual clinicians to keep abreast of developments in ECMO across the entire age range, from neonatology to older adults. This review addresses nine concepts in ECMO that are better studied or established in paediatric medicine and considers their application in adult patients. PMID:26940318

  18. The perioperative care of the paediatric neurosurgical patient.

    Science.gov (United States)

    Wheatley, R

    1994-07-01

    The Queen's Medical Centre, University of Nottingham, is one of the largest neuro-science centres in Britain and serves a population of five million people. Its catchment area covers the counties of Nottinghamshire, Leicestershire, Derbyshire and Lincolnshire though patients are often referred from other parts of Britain and from abroad. The total number of neuro-paediatric beds is 20 plus access to 12 beds in the paediatric intensive care unit and 18 beds of the neonatal unit. In the year 1992 the total number of operations was 300, a number which increased by 25% the following year and included such operations as craniostenosis, craniotomies, spinal surgery, repair of meningocele, shunts, implanting and endoscopic and stereotactic procedures. PMID:7633065

  19. Radiation dose measurement of paediatric patients in Estonia

    Energy Technology Data Exchange (ETDEWEB)

    Kepler, K. [Training Centre of Medical Physics and Biomedical Engineering, University of Tartu (Estonia); Lintrop, M. [Department of Radiology, Tartu University Hospital, Tartu (Estonia); Servomaa, A.; Parviainen, T. [STUK - Radiation and Nuclear Safety Authority, Helsinki (Finland); Eek, V.; Filippova, I. [Estonian Radiation Protection Centre, Tallinn (Estonia)

    2003-06-01

    According to the Medical Exposure Directive (97/43/Euratom) the radiation doses to patients should be measured in every hospital and doses should be compared to the reference doses established by the competent authorities. Special attention should be paid to the paediatric x-ray examinations, because the paediatric patients are more radiosensitive than adult patients. The requirement of measurements of radiation dose to patients is not yet included in the Estonian radiation act, but the purpose to join the European Communities makes the quality control in radiology very actual in Estonia. The necessity exists to introduce suitable measurement methods in the Xray departments of Estonian hospitals for establishing feedback system for radiologists, radiographers and medical physicists in optimising the radiation burden of patients and image quality. (orig.)

  20. Open for Business: On What Terms? An Analysis of 12 Collaborations between Canadian Universities and Corporations, Donors and Governments

    Science.gov (United States)

    Canadian Association of University Teachers, 2013

    2013-01-01

    The distinctive role of the university in society is always fragile and always in jeopardy. At its core, that role is primarily extending and deepening human understanding through research, scholarship, and teaching. This report presents an analysis of the following 12 collaborations between Canadian Universities and corporations, donors, and…

  1. Alan Thomas and the Canadian Association for Adult Education, 1961-1970. Occasional Papers in Continuing Education, Number 24.

    Science.gov (United States)

    Selman, Gordon R.

    Alan Thomas' vision of a learning society and its implications for public policy and adult education in Canada were the driving forces in the Canadian Association for Adult Education (CAAE) for the nine years of his directorship. The most distinctive and important idea that he contributed to the field in the 1960s was that the basic concept must…

  2. Indian Vacuum Society: The Indian Vacuum Society

    Science.gov (United States)

    Saha, T. K.

    2008-03-01

    The Indian Vacuum Society (IVS) was established in 1970. It has over 800 members including many from Industry and R & D Institutions spread throughout India. The society has an active chapter at Kolkata. The society was formed with the main aim to promote, encourage and develop the growth of Vacuum Science, Techniques and Applications in India. In order to achieve this aim it has conducted a number of short term courses at graduate and technician levels on vacuum science and technology on topics ranging from low vacuum to ultrahigh vacuum So far it has conducted 39 such courses at different parts of the country and imparted training to more than 1200 persons in the field. Some of these courses were in-plant training courses conducted on the premises of the establishment and designed to take care of the special needs of the establishment. IVS also regularly conducts national and international seminars and symposia on vacuum science and technology with special emphasis on some theme related to applications of vacuum. A large number of delegates from all over India take part in the deliberations of such seminars and symposia and present their work. IVS also arranges technical visits to different industries and research institutes. The society also helped in the UNESCO sponsored post-graduate level courses in vacuum science, technology and applications conducted by Mumbai University. The society has also designed a certificate and diploma course for graduate level students studying vacuum science and technology and has submitted a syllabus to the academic council of the University of Mumbai for their approval, we hope that some colleges affiliated to the university will start this course from the coming academic year. IVS extended its support in standardizing many of the vacuum instruments and played a vital role in helping to set up a Regional Testing Centre along with BARC. As part of the development of vacuum education, the society arranges the participation of

  3. An interprofessional approach to improving paediatric medication safety

    OpenAIRE

    Kennedy Neil; Purdy Joanna; Stewart Moira; Burns Anne

    2010-01-01

    Abstract Background Safe drug prescribing and administration are essential elements within undergraduate healthcare curricula, but medication errors, especially in paediatric practice, continue to compromise patient safety. In this area of clinical care, collective responsibility, team working and communication between health professionals have been identified as key elements in safe clinical practice. To date, there is limited research evidence as to how best to deliver teaching and learning...

  4. Trichilemmal Cyst of the Penis in a Paediatric Patient

    OpenAIRE

    Samuel Madan; Rashi Joshi

    2015-01-01

    Paediatric penile cysts are uncommon. We report a five-year-old child with an asymptomatic progressively growing cyst on the ventral aspect of the penis after a hypospadias repair. The patient presented to the Cooper Health Clinic, Dubai, United Arab Emirates, in March 2012. A complete excision of the cyst was performed. Histology results delineated a capsulated benign trichilemmal cyst. No recurrence or complications were reported in the 26 months following the excision. We recommend an earl...

  5. Learning preference and personality type: their association in paediatric residents.

    Science.gov (United States)

    Greenberg, L W; Goldberg, R M; Foley, R P

    1996-07-01

    The objective of this study was to determine if there is a relationship between the learning preferences and personality types of residents in paediatrics. As part of a study to teach residents in paediatrics how to teach, the authors administered the Learning Preference Inventory (LPI) and Fundamental Interpersonal Relationship Orientation (FIRO-B) instruments to 55 residents in paediatrics at all three levels of training. The instruments provided data that were used to provide feedback to residents on their learning preferences and interaction styles, as well as how these factors might affect teaching and learning in the clinical setting. The Pearson correlation coefficient was used to determine relationships between the LPI and the FIRO-B. Fifty-two of the 55 residents (95%) completed the instruments. The results revealed that residents' learning preferences were significantly related to their personality types. For example, residents with high inclusion and affection scores on the FIRO-B preferred learning with others, which was significantly related to their high interpersonal scores on the LPI. Residents with low inclusion and affection scores were more likely to prefer independent learning (high individual and student-structured scores on the LPI) and abstract learning at statistically significant levels. The scores obtained by residents in paediatrics on the LPI were strongly correlated with those obtained on the FIRO-B. These data may have important implications for the way in which staff recruit, counsel and teach residents. The fact that the LPI is easy to administer and does not purport to measure personality styles makes it an acceptable educational tool that can be used in many areas of training.

  6. The role of communication in paediatric drug safety

    OpenAIRE

    Stebbing, Claire; Wong, Ian C K; Kaushal, Rainu; Jaffe, Adam

    2007-01-01

    Medication errors cause substantial harm to patients, and considerable cost to healthcare systems. Evidence suggests that communication plays a crucial role in the generation, management and prevention of such incidents. This review identifies how paediatric medication errors can be managed, and in particular focuses on the pathway of steps that can operationalise the current research findings. Furthermore, the current data suggesting how communication can help to prevent errors occurring in ...

  7. Update in the treatment of paediatric ulcerative colitis.

    Science.gov (United States)

    Greifer, Melanie K; Markowitz, James F

    2006-10-01

    Ulcerative colitis is an important disease in the paediatric population. Ulcerative colitis is one of the chronic inflammatory bowel diseases, and is medically incurable. However, the arsenal of medications has grown as knowledge of the pathogenesis of this disease advances. This review looks at the classical treatments for children with ulcerative colitis, including the 5-aminosalicylates, corticosteroids and imunomodulators, as well as biological therapy and other, newer modalities. PMID:17020417

  8. The role of computed tomography in modern paediatric uroradiology

    Energy Technology Data Exchange (ETDEWEB)

    Maudgil, D.D.; McHugh, K. E-mail: kmchugh@gosh.nhs.uk

    2002-08-01

    Computed tomography (CT) has developed a well-recognised role within paediatric uroradiology, especially in imaging of trauma, malignancy (in particular Wilms' tumour), atypical infection, and congenital urogenital abnormalities. CT can also be used for problem solving in nephrolithiasis and renal transplant assessment. These applications are illustrated and discussed, with an emphasis on particular information that can be gained from the CT study.

  9. Distribution of branchial anomalies in a paediatric Asian population

    Science.gov (United States)

    Teo, Neville Wei Yang; Ibrahim, Shahrul Izham; Tan, Kun Kiaang Henry

    2015-01-01

    INTRODUCTION The objective of the present study was to review the distribution and incidence of branchial anomalies in an Asian paediatric population and highlight the challenges involved in the diagnosis of branchial anomalies. METHODS This was a retrospective chart review of all paediatric patients who underwent surgery for branchial anomalies in a tertiary paediatric hospital from August 2007 to November 2012. The clinical notes were correlated with preoperative radiological investigations, intraoperative findings and histology results. Branchial anomalies were classified based on the results of the review. RESULTS A total of 28 children underwent surgery for 30 branchial anomalies during the review period. Two children had bilateral branchial anomalies requiring excision. Of the 30 branchial anomalies, 7 (23.3%) were first branchial anomalies, 5 (16.7%) were second branchial anomalies, 3 (10.0%) were third branchial anomalies, and 4 (13.3%) were fourth branchial anomalies (one of the four patients with fourth branchial anomalies had bilateral branchial anomalies). In addition, seven children had 8 (26.7%) branchial anomalies that were thought to originate from the pyriform sinus; however, we were unable to determine if these anomalies were from the third or fourth branchial arches. There was inadequate information on the remaining 3 (10.0%) branchial anomalies for classification. CONCLUSION The incidence of second branchial anomalies appears to be lower in our Asian paediatric population, while that of third and fourth branchial anomalies was higher. Knowledge of embryology and the related anatomy of the branchial apparatus is crucial in the identification of the type of branchial anomaly. PMID:25917471

  10. Non-invasive respiratory monitoring in paediatric intensive care unit.

    OpenAIRE

    Nadkarni U; Shah A; Deshmukh C

    2000-01-01

    Monitoring respiratory function is important in a Paediatrics Intensive Care Unit (PICU), as majority of patients have cardio-respiratory problems. Non-invasive monitoring is convenient, accurate, and has minimal complications. Along with clinical monitoring, oxygen saturation using pulse oximetry, transcutaneous oxygenation (PtcO2) and transcutaneous PCO2 (PtcCO2) using transcutaneous monitors and end-tidal CO2 using capnography are important and routine measurements done in most PICUs. Cons...

  11. Reliability reconsidered: Cronbach's alpha and paediatric assessment in occupational therapy

    OpenAIRE

    Spiliotopoulou, G

    2009-01-01

    Background / aim: Using reliable outcome measures is a necessity for the occupational therapy profession in enabling valid assessments of clients. Although Cronbach’s alpha is the most widely applied index of internal consistency reliability, there are misconceptions about its use and interpretation. This paper aims to guide assessment developers in paediatric occupational therapy, as well as practitioners who are evaluating outcome measures in using and interpreting the Cronba...

  12. Endoscopic removal of nasal septum chondrosarcoma in paediatric patient

    OpenAIRE

    Muhammad Nasri Abu Bakar; Rosdi Ramli; Zulkiflee Salahuddin; Irfan Mohamad

    2014-01-01

    Chondrosarcomas of the head and neck are uncommon malignant tumours of non-epithelial origin. They rarely occur in paediatric age group. The treatment is mainly surgical and adjuvant therapy is only reserved to certain cases. We report a boy with progressive history of nasal obstruction and epistaxis. Nasal endoscopy revealed a mass arising from nasal septum. Endoscopic excision of the tumour was successfully done followed by radiotherapy. Endoscopic excision of chondrosarcoma of the nasal...

  13. Feasibility of perfusion cardiovascular magnetic resonance in paediatric patients

    OpenAIRE

    Kellenberger Christian; Schwitter Juerg; Buechel Emanuela; Balmer Christian; Bauersfeld Urs

    2009-01-01

    Abstract Aims As coronary artery disease may also occur during childhood in some specific conditions, we sought to assess the feasibility and accuracy of perfusion cardiovascular magnetic resonance (CMR) in paediatric patients. Methods and results First-pass perfusion CMR studies were performed under pharmacological stress with adenosine and by using a hybrid echo-planar pulse sequence with slice-selective saturation recovery preparation. Fifty-six perfusion CMR examinations were performed in...

  14. Long- term outcome of paediatric patients with ANCA vasculitis

    OpenAIRE

    Arulkumaran, Nishkantha; Jawad, Susan; Smith, Stuart W.; Harper, Lorraine; Brogan, Paul; Charles D. Pusey; Salama, Alan D

    2011-01-01

    Background Primary systemic vasculitis presenting in childhood is an uncommon but serious condition. As these patients transfer to adult clinics for continuing care, defining long term outcomes with emphasis on disease and treatment- related morbidity and mortality is important. The aim of this study is to describe the long- term clinical course of paediatric patients with ANCA vasculitis. Methods The adult patients in our vasculitis clinics who had presented in childhood, with a follow up ti...

  15. Long- term outcome of paediatric patients with ANCA vasculitis

    OpenAIRE

    Pusey Charles D; Brogan Paul; Harper Lorraine; Smith Stuart W; Jawad Susan; Arulkumaran Nishkantha; Salama Alan D

    2011-01-01

    Abstract Background Primary systemic vasculitis presenting in childhood is an uncommon but serious condition. As these patients transfer to adult clinics for continuing care, defining long term outcomes with emphasis on disease and treatment- related morbidity and mortality is important. The aim of this study is to describe the long- term clinical course of paediatric patients with ANCA vasculitis. Methods The adult patients in our vasculitis clinics who had presented in childhood, with a fol...

  16. Common tasks and problems in paediatric trauma radiology

    International Nuclear Information System (INIS)

    Scope of this article is to give practical hints for the most common, typical and important topics of trauma radiology in children to those radiologists who are not exclusively occupied with paediatric imaging. Due to the increased radiation sensitivity of children compared with adults balancing radiation protection and necessary image quality is of utmost importance. Outlines for this optimisation process are given. Especially in imaging of the extremities perhaps the greatest difficulties are posed by the dynamically changing face of the immature, growing, only partially ossified skeleton. Lack of experience must be compensated by meticulous comparison with the normal skeletal development as shown in standard textbooks, and by knowledge of the radiological image of the developmental variants. Besides general remarks about paediatric trauma radiology, some important topics are discussed into more detail. Especially the elbow joint poses a challenge for those less experienced with its radiological appearance in children. More than in adults, ultrasound should remain the primary imaging modality of choice especially in the assessment of abdominal trauma, and CT be tailored to radiological and clinical findings. Imaging and diagnosis of non-accidental injury (NAI) may be a less common task for the general radiologist, however, the severe social implications of physical child abuse mandate a basic knowledge about the radiological symptoms and the imaging management of this problem for all physicians occupied with paediatric radiology

  17. Donor-Recipient Size Mismatch in Paediatric Renal Transplantation

    Directory of Open Access Journals (Sweden)

    J. Donati-Bourne

    2014-01-01

    Full Text Available Introduction. End stage renal failure in children is a rare but devastating condition, and kidney transplantation remains the only permanent treatment option. The aim of this review was to elucidate the broad surgical issues surrounding the mismatch in size of adult kidney donors to their paediatric recipients. Methods. A comprehensive literature search was undertaken on PubMed, MEDLINE, and Google Scholar for all relevant scientific articles published to date in English language. Manual search of the bibliographies was also performed to supplement the original search. Results. Size-matching kidneys for transplantation into children is not feasible due to limited organ availability from paediatric donors, resulting in prolonged waiting list times. Transplanting a comparatively large adult kidney into a child may lead to potential challenges related to the surgical incision and approach, vessel anastomoses, wound closure, postoperative cardiovascular stability, and age-correlated maturation of the graft. Conclusion. The transplantation of an adult kidney into a size mismatched paediatric recipient significantly reduces waiting times for surgery; however, it presents further challenges in terms of both the surgical procedure and the post-operative management of the patient’s physiological parameters.

  18. Paediatric intraocular lens implants: accuracy of lens power calculations.

    Science.gov (United States)

    O'Gallagher, M K; Lagan, M A; Mulholland, C P; Parker, M; McGinnity, G; McLoone, E M

    2016-09-01

    PurposeThis study aims to evaluate the accuracy of lens prediction formulae on a paediatric population.MethodsA retrospective case-note review was undertaken of patients under 8 years old who underwent cataract surgery with primary lens implantation in a regional referral centre for paediatric ophthalmology, excluding those whose procedure was secondary to trauma. Biometric and refractive data were analysed for 43 eyes, including prediction errors (PE). Statistical measures used included mean absolute error (MAE), median absolute error (MedAE), Student's t-test and Lin's correlation coefficient.ResultsThe mean PE using the SRK-II formula was +0.96 D (range -2.47D to +2.41 D, SD 1.33 D, MAE 1.38 D, MedAE 1.55, n=15). The mean PE was smaller using SRK/T (-0.18 D, range -3.25 D to +3.95 D, SD 1.70 D, MAE 1.30 D, MedAE 1.24, n=27). We performed an analysis of the biometry data using four different formula (Hoffer Q, Holladay 1, SRK-II and SRK/T). Hoffer Q showed a smaller MedAE than other formulae but also a myopic bias.ConclusionOur clinical data suggest SRK/T was more accurate in predicting post-operative refraction in this cohort of paediatric patients undergoing cataract surgery. Hoffer Q may have improved accuracy further.

  19. Thyroid abnormalities in paediatric patients with vitiligo: retrospective study

    Science.gov (United States)

    Borlu, Murat; Çınar, Salih Levent; Kesikoğlu, Ayten; Utaş, Serap

    2016-01-01

    Introduction The association between vitiligo and thyroid disease is not fully investigated especially in paediatric patients. Aim To determine the incidence of vitiligo and thyroid disorders in children. This is the first report from middle Anatolia and the second report from Turkey. Material and methods A retrospective chart review was performed to examine the presence of thyroid abnormalities in paediatric patients who had been admitted to the dermatology department with vitiligo. Results A total of 155 paediatric patients, including 80 (52%) male and 75 (48%) female patients were included. The mean age was 8.6 years. Non segmental vitiligo was the most common type of the disease in 140 (90%) reviewed patients, while segmental vitiligo appeared only in 15 (10%) patients. The mean onset of vitiligo was 5.6 ±0.9 years. A family history of vitiligo was found in 14 (9%) children. Thirty-four (22%) patients had thyroid function tests and/or thyroid autoantibody abnormality. All of these patients had non segmental vitiligo. It was statistically significant (p vitiligo and thyroid disease parameters. Conclusions Our results show that it may be useful to screen thyroid in children with non segmental vitiligo.

  20. An interprofessional approach to improving paediatric medication safety

    Directory of Open Access Journals (Sweden)

    Kennedy Neil

    2010-02-01

    Full Text Available Abstract Background Safe drug prescribing and administration are essential elements within undergraduate healthcare curricula, but medication errors, especially in paediatric practice, continue to compromise patient safety. In this area of clinical care, collective responsibility, team working and communication between health professionals have been identified as key elements in safe clinical practice. To date, there is limited research evidence as to how best to deliver teaching and learning of these competencies to practitioners of the future. Methods An interprofessional workshop to facilitate learning of knowledge, core competencies, communication and team working skills in paediatric drug prescribing and administration at undergraduate level was developed and evaluated. The practical, ward-based workshop was delivered to 4th year medical and 3rd year nursing students and evaluated using a pre and post workshop questionnaire with open-ended response questions. Results Following the workshop, students reported an increase in their knowledge and awareness of paediatric medication safety and the causes of medication errors (p Conclusion This study has helped bridge the knowledge-skills gap, demonstrating how an interprofessional approach to drug prescribing and administration has the potential to improve quality and safety within healthcare.

  1. The Canadian Astronomy Data Centre

    Science.gov (United States)

    Ball, Nicholas M.; Schade, D.; Astronomy Data Centre, Canadian

    2011-01-01

    The Canadian Astronomy Data Centre (CADC) is the world's largest astronomical data center, holding over 0.5 Petabytes of information, and serving nearly 3000 astronomers worldwide. Its current data collections include BLAST, CFHT, CGPS, FUSE, Gemini, HST, JCMT, MACHO, MOST, and numerous other archives and services. It provides extensive data archiving, curation, and processing expertise, via projects such as MegaPipe, and enables substantial day-to-day collaboration between resident astronomers and computer specialists. It is a stable, powerful, persistent, and properly supported environment for the storage and processing of large volumes of data, a condition that is now absolutely vital for their science potential to be exploited by the community. Through initiatives such as the Common Archive Observation Model (CAOM), the Canadian Virtual Observatory (CVO), and the Canadian Advanced Network for Astronomical Research (CANFAR), the CADC is at the global forefront of advancing astronomical research through improved data services. The CAOM aims to provide homogeneous data access, and hence viable interoperability between a potentially unlimited number of different data collections, at many wavelengths. It is active in the definition of numerous emerging standards within the International Virtual Observatory, and several datasets are already available. The CANFAR project is an initiative to make cloud computing for storage and data-intensive processing available to the community. It does this via a Virtual Machine environment that is equivalent to managing a local desktop. Several groups are already processing science data. CADC is also at the forefront of advanced astronomical data analysis, driven by the science requirements of astronomers both locally and further afield. The emergence of 'Astroinformatics' promises to provide not only utility items like object classifications, but to directly enable new science by accessing previously undiscovered or intractable

  2. REGIONAL CHARACTERISTICS OF CANADIAN ENGLISH

    Institute of Scientific and Technical Information of China (English)

    2000-01-01

    Modern English is an international language inthe world.Besides Great Britain,English is spokenas first language in 39 countries.These countries arelocated in different regions with different naturalfeatures,history development and cultural character-istics.Thus,English used in these different regionscarries its own regional character—forming Englishregional varieties.The main English regional varieties are:BritishEnglish,American English,Canadian English andSouth African English.Canada is a rich country inNorth America with its own characteristics,which of

  3. Rural Canadian Youth Exposed to Physical Violence

    Science.gov (United States)

    Laye, Adele M.; Mykota, David B.

    2014-01-01

    Exposure to physical violence is an unfortunate reality for many Canadian youth as it is associated with numerous negative psychosocial effects. The study aims to assist in understanding resilience in rural Canadian youth exposed to physical violence. This is accomplished by identifying the importance of protective factors, as measured by the…

  4. The Canadian Hospital Executive Simulation System (CHESS).

    Science.gov (United States)

    Pink, G H; Knotts, U A; Parrish, L G; Shields, C A

    1991-01-01

    The Canadian Hospital Executive Simulation System (CHESS) is a computer-based management decision-making game designed specifically for Canadian hospital managers. The paper begins with an introduction on the development of business and health services industry-specific simulation games. An overview of CHESS is provided, along with a description of its development and a discussion of its educational benefits. PMID:10109530

  5. DATA MINING IN CANADIAN LYNX TIME SERIES

    Directory of Open Access Journals (Sweden)

    R.Karnaboopathy

    2012-01-01

    Full Text Available This paper sums up the applications of Statistical model such as ARIMA family timeseries models in Canadian lynx data time series analysis and introduces the method of datamining combined with Statistical knowledge to analysis Canadian lynx data series.

  6. An evaluation of paediatric projection radiography in Ireland

    International Nuclear Information System (INIS)

    Purpose: This study investigated common paediatric radiography examinations in Ireland and analysed any potential for improvement by considering compliance with requirements for justification, the range of doses delivered and potential Diagnostic Reference Levels, and technique approaches that enhance optimisation. Method: Referral information, Dose Area Product (DAP) dose, technique details and patient data were gathered from 568 paediatric examinations performed across several hospitals. The examinations were mobile infant chest (n = 66), chest (n = 266), abdomen (n = 96), lumbar spine (n = 14), full spine (n = 5), pelvis (n = 151) and skull (n = 28). Data were analysed to allow comment on the adequacy of justification, the range of doses being delivered and possible Diagnostic Reference Levels (DRLs), and the potential for optimisation of radiographic technique. Results/conclusions: Results indicate that the principle of justification is generally applied well in paediatric practice. Dose results indicate that age-related doses are generally comparable to published data, although dose variations exist within and between hospitals. Although differences between minimum and maximum DAP values were substantial, differences between the first and third quartile values were rarely greater than a factor of three. With regard to DRLs, age-related, 75th centile DAP values are presented for five paediatric X-ray examinations. While DAP DRLs stated as a function of age are a pragmatic approach to preliminary DRL values, size related DRLs are acknowledged as a better approach and the necessity of objective paediatric patient size measurement is emphasised. With regard to potential for optimisation, small samples limited analysis of factorial influences on DAP. However, trends indicate that objective consideration of kVp and mAs, careful collimation, and matching of exposure to baby weight in neonates and to measured patient depth in children could all

  7. Long- term outcome of paediatric patients with ANCA vasculitis

    Directory of Open Access Journals (Sweden)

    Pusey Charles D

    2011-06-01

    Full Text Available Abstract Background Primary systemic vasculitis presenting in childhood is an uncommon but serious condition. As these patients transfer to adult clinics for continuing care, defining long term outcomes with emphasis on disease and treatment- related morbidity and mortality is important. The aim of this study is to describe the long- term clinical course of paediatric patients with ANCA vasculitis. Methods The adult patients in our vasculitis clinics who had presented in childhood, with a follow up time of greater than 10 years were included. We also reviewed the literature for articles describing the clinical outcome of paediatric patients with ANCA vasculitis. Results We describe the clinical course of 8 adults who presented in childhood with ANCA vasculitis. 7 patients had Wegener's granulomatosis and 1 had microscopic polyangiitis. The median age at presentation was 11.5 years, and follow up time ranged form 11 to 30 years. Induction therapy for all patients was steroids and/or cyclophosphamide. Maintenance therapy was with azathioprine or mycophenolate mofetil. Biological agents were used in 3 patients for relapsed disease in adulthood only. Seven patients achieved complete remission. All patients experienced disease relapse, with a median of 4 episodes. Kidney function was generally well preserved, with median eGFR 76 ml/min. Only one patient developed end-stage renal failure and one patient died after 25 years of disease. Treatment-related morbidity rates were high; 7 suffered from infections, 4 were infertile, 2 had skeletal complications, and 1 developed malignancy. Conclusion Close long- term follow up of paediatric patients with ANCA vasculitis is imperative, as this patient cohort is likely to live long enough to develop significant treatment and disease- related morbidities. Prospective cohort studies with novel therapies including paediatric patients are crucial to help us determine the best approach to managing this complex group

  8. The Influence of Canadian Intellectuals’ Ideological Views on the Political Culture in Canada at the Beginning of the 20th Century

    Directory of Open Access Journals (Sweden)

    SOKOV I.A.

    2014-06-01

    Full Text Available The article analyses the political views of Canadian intellectuals which had influence on the formation of Canadian political culture at the turn of the 20th century. The author confirms that the Canadian intellectual thought was the main ideological factor in the conditions of the formation of Canadian statehood, undeveloped party and political system, the lack of deep traditions of the parliamentary system, insufficient political practice and the lack of distinct ideology of basic political parties in the process of forming the Canadian nation. On the basis of studied Canadian sources, the author makes conclusion that the most of Canadian intellectuals did not participate directly in the political process and they considered themselves its bystanders. Besides, the Canadian intellectuals promoted the British political culture of the Victorian epoch. Although all of them were familiar wih the British socialistic thought – Fabianism, they insisted that the social transformation in the Canadian society is possible only through the improvement of moral system, the education of lower social classes and the maintenance of elite monarch traditions. The American influence on Canadian political culture was peripheral at the beginning of the 20th century. The ideas of the Chicago Sociological School and the European continental thought were not used. The Victorian intellectuals understood their time as the social crisis and their political discussions were often devoted to the problems of imperialism, religion, education and feminism. They undoubtedly influenced the Canadian political elite in the matter of further development of the Canadian nation and state, but they expressed their own unique views on the contemporary society in academic press and in elite clubs discussions. They did not share the opinion of publicity about contemporary social processes, because their position was far from the direct party policy. Though some of them participated as

  9. Society for Ambulatory Anesthesia

    Science.gov (United States)

    ... Webinars Publications & Resources Clinical Practice Guidelines SAMBA Link Digital ... We Represent Ambulatory and Office-Based Anesthesia The Society for Ambulatory Anesthesia provides educational opportunities, encourages research ...

  10. Paediatric acute asthma management in Australia and New Zealand : practice patterns in the context of clinical practice guidelines

    NARCIS (Netherlands)

    Babl, F. E.; Sheriff, N.; Borland, M.; Acworth, J.; Neutze, J.; Krieser, D.; Ngo, P.; Schutz, J.; Thomson, F.; Cotterell, E.; Jamison, S.; Francis, P.

    2008-01-01

    Objectives: To compare clinical practice guideline (CPG) recommendations and reported physician management of acute paediatric asthma in the 11 largest paediatric emergency departments, all of which have CPGs, in Australia (n= 9) and New Zealand (n= 2). All 11 sites participate in the Paediatric Res

  11. PO02 - Clinical profile of children admitted to a paediatric intensive care unit due to acute clinical deterioration

    DEFF Research Database (Denmark)

    Jensen, Claus Sixtus; Aagaard, Hanne; Olesen, Hanne Vebert;

    2016-01-01

    Theme: Intensive care Background: There has been an increased number of critically ill patients admitted to paediatric departments. Only a few studies have described the various causes of unplanned admission to paediatric intensive care units (PICU) due to clinical deterioration. However, an...... critical ill children in paediatric wards....

  12. Influence of Food on Paediatric Gastrointestinal Drug Absorption Following Oral Administration: A Review

    Directory of Open Access Journals (Sweden)

    Hannah K. Batchelor

    2015-06-01

    Full Text Available The objective of this paper was to review existing information regarding food effects on drug absorption within paediatric populations. Mechanisms that underpin food–drug interactions were examined to consider potential differences between adult and paediatric populations, to provide insights into how this may alter the pharmacokinetic profile in a child. Relevant literature was searched to retrieve information on food–drug interaction studies undertaken on: (i paediatric oral drug formulations; and (ii within paediatric populations. The applicability of existing methodology to predict food effects in adult populations was evaluated with respect to paediatric populations where clinical data was available. Several differences in physiology, anatomy and the composition of food consumed within a paediatric population are likely to lead to food–drug interactions that cannot be predicted based on adult studies. Existing methods to predict food effects cannot be directly extrapolated to allow predictions within paediatric populations. Development of systematic methods and guidelines is needed to address the general lack of information on examining food–drug interactions within paediatric populations.

  13. Sildenafil add-on therapy in paediatric pulmonary arterial hypertension, experiences of a national referral centre

    NARCIS (Netherlands)

    Douwes, Johannes M.; Roofthooft, Marcus T. R.; Van Loon, Rosa L. E.; Ploegstra, Mark-Jan; Bartelds, Beatrijs; Hillege, Hans L.; Berger, Rudolphus

    2014-01-01

    Objective In paediatric pulmonary arterial hypertension (PAH), the effectiveness of add-on combination PAH-therapy has not yet been systematically studied. The purpose of this study was to determine the effect of sildenafil add-on therapy in paediatric PAH patients treated with bosentan. Methods In

  14. BUPIVACAINE INFILTRATION VERSUS DICLOFENAC SUPPOSITORY FOR POST-TONSILLECTOMY PAIN RELIEF IN PAEDIATRIC PATIENTS

    Directory of Open Access Journals (Sweden)

    Nayna S Solanki

    2012-02-01

    Full Text Available Background: Pain management after tonsillectomy in children remains a dilemma for anaesthesiologist. The study was designed to compare the effect of pre-incisional infiltration of Bupivacaine (0.25% versus Diclofenac suppository on postoperative pain relief in children. Methodology: Fifty patients of American Society of Anaesthesiology grade – I, aged between 1 and 15 years undergoing elective tonsillectomy were selected. They were randomly divided equally into group A and B. Five minutes before incision, peritonsillar fossa were infiltrated with 5 ml Bupivacaine(0.25% in group A patients. Group B received Diclofenac suppository 2mg/kg after induction. Intra operatively all patients were observed for vital parameters. Post-operatively all the patients were observed for 24 hours for analgesia using observer pain scale, analgesic requirement, vital data and other complications. Result: Diclofenac suppository is a better option for post-operative analgesia in paediatric patients undergoing tonsillectomy as compared to bupivacaine infiltration as there were significant difference in pain score (P<0.05 after two hours onwards post operatively. Complications like bradycardia, hypotension, allergic reaction and convulsion were not found in either group. Conclusion: Diclofenac suppository is a better option as compared to pre-incisional bupivacaine infiltration because of its convenience and duration of analgesia. [National J of Med Res 2012; 2(1.000: 5-7

  15. Refractions of Civil Society

    DEFF Research Database (Denmark)

    Kuzmanovic, Daniella

    The thesis investigates various perceptions of civil society among civic activists in Turkey, and how these perceptions are produced and shaped. The thesis is an anthropological contribution to studies of civil society in general, as well as to studies on political culture in Turkey....

  16. Fieldwork in Transforming Societies

    DEFF Research Database (Denmark)

    Clark, Ed; Michailova, Snejina

    The contributors to this text discuss the personal and professional challenges of conducting fieldwork in the difficult, sometimes threatening contexts of the transforming societies of post-socialist Europe and China.......The contributors to this text discuss the personal and professional challenges of conducting fieldwork in the difficult, sometimes threatening contexts of the transforming societies of post-socialist Europe and China....

  17. Civil Society and Governance

    DEFF Research Database (Denmark)

    Hulgård, Lars

    An illustration of how important the relationship is between civil society anbd governance. A short historic journey with four snapshots of times and situations that have provided interesting evidence about the connection between civil society and governance. My goal for the short historic journe...... is to make clear and hopefully even verify that providing knowledge about the impact of civil society and citizens’ participation on governance is one of the most urgent research tasks in the current period of time.......An illustration of how important the relationship is between civil society anbd governance. A short historic journey with four snapshots of times and situations that have provided interesting evidence about the connection between civil society and governance. My goal for the short historic journey...

  18. Emerging Canadian QA standards for radiation therapy

    International Nuclear Information System (INIS)

    Full text: Canada operates a publicly funded health care system in which 70% of health care costs are paid by some level of government. Radiotherapy, indeed most cancer management, falls within the publicly funded realm of Canada's health care system. National legislation (the Canada Health Act) guarantees access to cancer services for all Canadians. However, the financial responsibility for these services is borne by the provinces. Most Canadian provinces manage the cancer management problem through central cancer agencies. In the past few decades, these provincial cancer agencies have formed the Canadian Association of Provincial Cancer Agencies (CAPCA). This association has adopted a broad mandate for cancer management in Canada (see www.capca.ca). Included in this mandate is the adoption of standards and guidelines for all aspects of cancer control. The complexity of radiation therapy has long underscored the need for cooperation at the international and national levels in defining programmes and standards. In recent decades formal quality assurance programme recommendations have emerged in the United States, Europe and Great Britain. When defining quality assurance programs, Canadian radiation treatment centres have referenced U.S. and other program standards since they have been available. Recently, under the leadership of the Canadian Association of Provincial Cancer Agencies (CAPCA), Canadian national quality assurance program recommendations are emerging. A CAPCA sponsored project to harmonize Canadian quality assurance processes has resulted in a draft document entitled 'Standards for Quality Assurance at Canadian Radiation Treatment Centres'. This document provides recommendations for the broad framework of radiation therapy quality assurance programs. In addition, detailed work is currently underway regarding equipment quality control procedures. This paper explores the historical and political landscape in which the quality assurance problem has

  19. Diversity Management in the Canadian Workplace: Towards an Antiracism Approach

    Directory of Open Access Journals (Sweden)

    Vanmala Hiranandani

    2012-01-01

    Full Text Available Most diversity management programs in Canada maintain that enhancing workforce diversity is of tremendous significance for business organizations in today’s competitive global urban markets. Since well-meaning diversity management initiatives have been largely ineffective thus far in dealing with workplace discrimination and racism in the Canadian workplace, this paper underscores the need to decenter the focus of diversity management from a business imperative to an antidiscrimination and social justice imperative. Within this latter perspective, the paper examines the strengths and limitations of the antiracism approach that has been implemented in various developed countries in recent years. The antiracism approach is an action-oriented strategy for institutional and systemic change that has at its core the interrogation of privilege, power disparities, and other forms of inequity within the organization. Drawing from the lessons of various initiatives that have utilized this approach, the present paper emphasizes the need for a nuanced antiracism approach in the multicultural Canadian society if diversity management is to attain its goal of greater inclusion of all individuals in informal networks and formal organizational programs.

  20. Physician assisted suicide: the great Canadian euthanasia debate.

    Science.gov (United States)

    Schafer, Arthur

    2013-01-01

    A substantial majority of Canadians favours a change to the Criminal Code which would make it legally permissible, subject to careful regulation, for patients suffering from incurable physical illness to opt for either physician assisted suicide (PAS) or voluntary active euthanasia (VAE). This discussion will focus primarily on the arguments for and against decriminalizing physician assisted suicide, with special reference to the British Columbia case of Lee Carter vs. Attorney General of Canada. The aim is to critique the arguments and at the same time to describe the contours of the current Canadian debate. Both ethical and legal issues raised by PAS are clarified. Empirical evidence available from jurisdictions which have followed the regulatory route is presented and its relevance to the slippery slope argument is considered. The arguments presented by both sides are critically assessed. The conclusion suggested is that evidence of harms to vulnerable individuals or to society, consequent upon legalization, is insufficient to support continued denial of freedom to those competent adults who seek physician assistance in hastening their death.

  1. Epidemiology and management of head injury in paediatric age group in North-Eastern Nigeria

    Directory of Open Access Journals (Sweden)

    J Y Chinda

    2013-01-01

    Full Text Available Background: Paediatric head injury (HI is the single most common cause of death and permanent disability in children world over, and this is increasingly becoming worrisome in our society because of increased risks and proneness to road traffic accidents on our highways and streets. The study set to determine causes and management of HI among children in our society. Patients and Methods: A retrospective review of all children aged 0-15 years with traumatic head injury (THIs who were managed at the University of Maiduguri Teaching Hospital between July, 2006 and August, 2008. Results: A total of 45 children with THIs presented to the casualty unit of the hospital; 30 (66.7% were boys and 15 (33.3% were girls. Three (6.7% children were less than 1 year of age, 21 (46.7% were between 1 years and 6 years while 16 (35.6% and 5 (11.0% were aged 7-11 years and 12-15 years respectively. Thirty six (80.0% of the children were pedestrians, 6 (13.4% fell from a height, while 2 (4.4% and 1 (2.2% were as a result of home accident and assault, respectively. Twenty one patients (46.7% had mild HI, while 53.3% had moderate to severe category. Forty one (91.1% of children were managed as in-patients, mostly (95.1% by conservative non-operative management, while 4 (8.9% were treated on the out-patient basis. The mortality rate was 17.8%. Conclusion: H1 among children is of a great concern, because of its incremental magnitude, due to increasing child labour and interstate religious discipleship among children, with attendant high mortality and permanent disabilities. Necessary laws and legislations should be formulated and implemented with organized campaigns and public enlightenment to prevent and mitigate this menace.

  2. Dental fitness classification in the Canadian forces.

    Science.gov (United States)

    Groves, Richard R

    2008-01-01

    The Canadian Forces Dental Services utilizes a dental classification system to identify those military members dentally fit for an overseas deployment where dental resources may be limited. Although the Canadian Forces Dental Services dental classification system is based on NATO standards, it differs slightly from the dental classification systems of other NATO country dental services. Data collected by dental teams on overseas deployments indicate a low rate of emergency dental visits by Canadian Forces members who were screened as dentally fit to deploy. PMID:18277717

  3. A perspective on Canadian shale gas

    Energy Technology Data Exchange (ETDEWEB)

    Johnson, Mike; Davidson, Jim; Mortensen, Paul

    2010-09-15

    In a relatively new development over just the past few years, shale formations are being targeted for natural gas production. Based on initial results, there may be significant potential for shale gas in various regions of Canada, not only in traditional areas of conventional production but also non-traditional areas. However, there is much uncertainty because most Canadian shale gas production is currently in experimental or early developmental stages. Thus, its full potential will not be known for some time. If exploitation proves to be successful, Canadian shale gas may partially offset projected long-term declines in Canadian conventional natural gas production.

  4. Tritium technology. A Canadian overview

    International Nuclear Information System (INIS)

    An overview of the various tritium research and operational activities in Canada is presented. These activities encompass tritium processing and recovery, tritium interactions with materials, and tritium health and safety. Many of these on-going activities form a sound basis for the tritium use and handling aspects of the ITER project. Tritium management within the CANDU heavy water reactor, associated detritiation facilities, research and development facilities, and commercial industry and improving the understanding of tritium behaviour in humans and the environment remain the focus of a long-standing Canadian interest in tritium. While there have been changes in the application of this knowledge and experience over time, the operating experience and the supporting research and development continue to provide for improved plant and facility operations, an improved understanding of tritium safety issues, and improved products and tools that facilitate tritium management. (author)

  5. THE CANADIAN POLITICAL BUSINESS CYCLE

    Directory of Open Access Journals (Sweden)

    Barbara Libby

    2000-01-01

    Full Text Available This paper will discuss the existence of a Canadian Political Business Cycle (PBC during the period 1946-1989. Logit analysis was used to determine if changes in the unemployment rate, growth of real GNE and the rate of inflation are significantly different in the period before an election than during the rest of the electoral term. It was found that the rate of growth in the unemployment rate declines and the rate of growth of real GNP increases in the four quarters before an election. The behavior of these variables reverses in the period after an election. These findings are consistent with a political business cycle. Policy variables, under a majority government, also behave in a manner associated with a PBC, with the government stimulating the economy approximately two years into its term so that good economic news will occur before it has to call an election. Minority governments tend to simulate the economy immediately after taking office.

  6. Chinese Feelings Cherished By Canadians

    Institute of Scientific and Technical Information of China (English)

    2008-01-01

    <正>On March 30, "The Chinese Feelings Across the Pacific-The Century Exhibition of the Old Photos Treasured by the Canadians" was open in the Lu Xun Museum in Beijing. The exhibition lasted for one week. At the exhibition some old photos taken in the early 20th century were on display, showing James G. Endicott, envoy of world peace, together with Mao Zedong and Zhou Enlai; the family of O. L. Kilborn, one of the founders of West China Union University, together with Chinese women with bound feet: O. L. Kilborn treating the wounded soldiers during the Revolution of 1911; Leslie Earl Willmott in Chinese tunic suit and his wife reluctant to bid farewell to China, as well as photos of Ashley Woodward Lindesay, founder of China’s modern

  7. Tritium technology. A Canadian overview

    Energy Technology Data Exchange (ETDEWEB)

    Hemmings, R.L. [Canatom NPM (Canada)

    2002-10-01

    An overview of the various tritium research and operational activities in Canada is presented. These activities encompass tritium processing and recovery, tritium interactions with materials, and tritium health and safety. Many of these on-going activities form a sound basis for the tritium use and handling aspects of the ITER project. Tritium management within the CANDU heavy water reactor, associated detritiation facilities, research and development facilities, and commercial industry and improving the understanding of tritium behaviour in humans and the environment remain the focus of a long-standing Canadian interest in tritium. While there have been changes in the application of this knowledge and experience over time, the operating experience and the supporting research and development continue to provide for improved plant and facility operations, an improved understanding of tritium safety issues, and improved products and tools that facilitate tritium management. (author)

  8. Advocacy--answering old mail. Canadian Association of General Surgeons.

    Science.gov (United States)

    Keith, R G

    1999-06-01

    Since its inception in 1977, the Canadian Association of General Surgeons (CAGS) has struggled with its responsibility to represent general surgeons in practices across this country. The CAGS has tended to be mute in the presentation of many of its accomplishments, which have improved the role of specialists in community practice, training programs and the subspecialties of general surgery. With the forthcoming changes in direction for the Royal College of Physicians and Surgeons of Canada, based on a recent external survey, the CAGS has a golden opportunity to advocate for a clear identity, autonomous from the Royal College for the purposes of scientific meetings, continuing professional development, scientific and practice affiliation with other surgical specialty societies, and new developments with corporate sector support for advancements in science technology and education. Advocacy for general surgery must be stressed as the priority for the CAGS into the future.

  9. Nuclear fuel waste disposal: The Canadian consultative approach

    International Nuclear Information System (INIS)

    Over the past two decades society has demanded more public participation and public input into decision-making governments. Accordingly, development of the Canadian concept for deep geological disposal of used nuclear fuel has taken into account the requirements for social acceptability as well as technical excellence. As the agency responsible for developing the disposal concept, AECL Research, the research and development arm of Atomic Energy of Canada Ltd., has included, in its program, consultation with the various publics that have an interest in the concept. This interactive and consultative process, which has been underway for some 14 years, has attempted to ensure that the public has had the opportunity to become familiar with the technical development of the concept and to provide input into it. This process will continue throughout the concept assessment and review currently in progress

  10. Congenital anomalies in paediatric surgery in North India

    Directory of Open Access Journals (Sweden)

    Babita Jangra

    2014-01-01

    Full Text Available Background: Congenitalmal formation represents defects in morphogenesis during early foetal life. Congenital anomalies account for 8-15% of perinatal deaths and 13-16% of neonatal deaths in India. The proportion of perinatal deaths due to congenital malformations is increasing as a result of reduction of mortality due to other causes owing to the improvement in perinatal and neonatal care. Materials and Methods: A retrospective record based study was conducted in the Paediatric Surgery Department of a Tertiary Care Institute of North India. The records of over a decade (2003-2012 were analysed. A total of 4305 cases of congenital anomalies were recorded in the study. All the data were entered in the excel spread sheet and analysed in SPSS version 17. (Statistical Package for the Social Sciences, a software package used for statistical analysis, officially named "IBM SPSS Statistics". Results: Over the decade, a total of 14264 children were admitted in the paediatric surgery department with various problems. Out of these about one-third children (30.18% had one or other type of congenital anomalies. This trend remained almost constant over the decade within a range of 26.8-33.6%. About half of the total congenital anomalies belonged to the gastro-intestinal tract, followed by genitourinary tract, central nervous system and other anomalies. All the anomalies were more common in males and were found in children belonging to rural communities. Conclusions: All the neonates should be examined with scrutiny for overt as well as occult congenital anomalies and Paediatric surgical care should be considered as an essential component of child health programmes in developing populations. Moreover, it is necessary to establish a registry system for congenital anomalies.

  11. Phase synchronization in electroencephalographic recordings prognosticates outcome in paediatric coma.

    Directory of Open Access Journals (Sweden)

    Vera Nenadovic

    Full Text Available Brain injury from trauma, cardiac arrest or stroke is the most important cause of death and acquired disability in the paediatric population. Due to the lifetime impact of brain injury, there is a need for methods to stratify patient risk and ultimately predict outcome. Early prognosis is fundamental to the implementation of interventions to improve recovery, but no clinical model as yet exists. Healthy physiology is associated with a relative high variability of physiologic signals in organ systems. This was first evaluated in heart rate variability research. Brain variability can be quantified through electroencephalographic (EEG phase synchrony. We hypothesised that variability in brain signals from EEG recordings would correlate with patient outcome after brain injury. Lower variability in EEG phase synchronization, would be associated with poor patient prognosis. A retrospective study, spanning 10 years (2000-2010 analysed the scalp EEGs of children aged 1 month to 17 years in coma (Glasgow Coma Scale, GCS, <8 admitted to the paediatric critical care unit (PCCU following brain injury from TBI, cardiac arrest or stroke. Phase synchrony of the EEGs was evaluated using the Hilbert transform and the variability of the phase synchrony calculated. Outcome was evaluated using the 6 point Paediatric Performance Category Score (PCPC based on chart review at the time of hospital discharge. Outcome was dichotomized to good outcome (PCPC score 1 to 3 and poor outcome (PCPC score 4 to 6. Children who had a poor outcome following brain injury secondary to cardiac arrest, TBI or stroke, had a higher magnitude of synchrony (R index, a lower spatial complexity of the synchrony patterns and a lower temporal variability of the synchrony index values at 15 Hz when compared to those patients with a good outcome.

  12. Paediatric solid tumours in Nigerian children: A changing pattern?

    Directory of Open Access Journals (Sweden)

    Tanko Na′anlep

    2009-01-01

    Full Text Available Background: Childhood cancer is fast becoming an important paediatric problem in Nigeria and several parts of Africa, with the progressive decline of infectious and nutritional diseases. The following study was a 5-year retrospective review of paediatric solid tumours as seen at the Jos University Teaching Hospital, Nigeria. Objective: To determine the relative frequencies of childhood solid malignant tumours in Jos, Central Nigeria and compare with reports of previous studies both locally and abroad. Materials and Methods: Cancer registers and medical records of patients were used to extract demographic data, specimen number and/or codes. Archival materials were retrieved from the histopathology laboratory and sections were made from paraffin embedded blocks of these specimens. Slides of these histological sections were reviewed and reclassified where necessary. The relative frequencies were then determined. Results: One hundred and eighty one solid tumours of children were diagnosed within the study period. Ninety-four (51% were benign and 87 (49% malignant. Male: Female ratio was 1.3:1. The commonest malignant tumour diagnosed was rhabdomyosarcoma which accounted for 27 (31%, comprising of 15 (55.6%, 11 (40.7% and 1 (3.7% embryonal, alveolar and pleomorphic rhabdomyosarcomas, respectively. Non Hodgkin lymphoma and Burkitt lymphoma accounted for 17 (19.5% and 12 (13.8%, respectively. Conclusion: Based on the result of our study, we conclude that the commonest solid malignancy of childhood in Jos, Nigeria is rhabdomyosarcoma. This has implications for diagnosis, management and prognosis of theses soft tissue sarcomas in our paediatric population.

  13. Forecasting paediatric malaria admissions on the Kenya Coast using rainfall

    Directory of Open Access Journals (Sweden)

    Stella Wanjugu Karuri

    2016-02-01

    Full Text Available Background: Malaria is a vector-borne disease which, despite recent scaled-up efforts to achieve control in Africa, continues to pose a major threat to child survival. The disease is caused by the protozoan parasite Plasmodium and requires mosquitoes and humans for transmission. Rainfall is a major factor in seasonal and secular patterns of malaria transmission along the East African coast. Objective: The goal of the study was to develop a model to reliably forecast incidences of paediatric malaria admissions to Kilifi District Hospital (KDH. Design: In this article, we apply several statistical models to look at the temporal association between monthly paediatric malaria hospital admissions, rainfall, and Indian Ocean sea surface temperatures. Trend and seasonally adjusted, marginal and multivariate, time-series models for hospital admissions were applied to a unique data set to examine the role of climate, seasonality, and long-term anomalies in predicting malaria hospital admission rates and whether these might become more or less predictable with increasing vector control. Results: The proportion of paediatric admissions to KDH that have malaria as a cause of admission can be forecast by a model which depends on the proportion of malaria admissions in the previous 2 months. This model is improved by incorporating either the previous month's Indian Ocean Dipole information or the previous 2 months’ rainfall. Conclusions: Surveillance data can help build time-series prediction models which can be used to anticipate seasonal variations in clinical burdens of malaria in stable transmission areas and aid the timing of malaria vector control.

  14. Non-invasive respiratory monitoring in paediatric intensive care unit.

    Directory of Open Access Journals (Sweden)

    Nadkarni U

    2000-04-01

    Full Text Available Monitoring respiratory function is important in a Paediatrics Intensive Care Unit (PICU, as majority of patients have cardio-respiratory problems. Non-invasive monitoring is convenient, accurate, and has minimal complications. Along with clinical monitoring, oxygen saturation using pulse oximetry, transcutaneous oxygenation (PtcO2 and transcutaneous PCO2 (PtcCO2 using transcutaneous monitors and end-tidal CO2 using capnography are important and routine measurements done in most PICUs. Considering the financial and maintenance constraints pulse oximetry with end tidal CO2 monitoring can be considered as most feasible.

  15. Cystic change in primary paediatric optic nerve sheath meningioma.

    Science.gov (United States)

    Narayan, Daniel; Rajak, Saul; Patel, Sandy; Selva, Dinesh

    2016-08-01

    Primary optic nerve sheath meningiomas (PONSM) are rare in children. Cystic meningiomas are an uncommon subgroup of meningiomas. We report a case of paediatric PONSM managed using observation alone that underwent cystic change and radiological regression. A 5-year-old girl presented with visual impairment and proptosis. Magnetic resonance (MR) imaging demonstrated a PONSM. The patient was left untreated and followed up with regular MR imaging. Repeat imaging at 16 years of age showed the tumour had started to develop cystic change. Repeat imaging at 21 years of age showed the tumour had decreased in size. PMID:27310300

  16. A pictorial review of imaging in paediatric stroke.

    Science.gov (United States)

    Johns, Christopher; Kolla, S; Hart, A; Sinha, S; Batty, R; Connolly, D J A

    2016-09-01

    Stroke is recognised as an important disease in adults. Paediatric stroke is less understood, yet still an important cause of morbidity and mortality, with an incidence of 5 per 100 000 children and is one of the top 10 leading causes of death in children. In adults the vast majority of strokes are ischaemic, whereas in children haemorrhage makes up half the cases. The incidence of neonatal stroke is much higher, at up to 45 per 100 000 population; however, the underlying causes are less understood. This paper acts as a guide to the different causes of stroke with the key differences on imaging discussed. PMID:27354547

  17. [Paediatric gynaecological outpatient department--a report on 600 patients].

    Science.gov (United States)

    Grünberger, W; Fischl, F

    1982-11-26

    Problems arising during the examination and treatment of paediatric gynaecological patients are described. 387 out of 600 girls seen at the outpatient department for infants and juveniles of the 1st Department of Obstetrics and Gynaecology of the University of Vienna were premenarchal and 213 were post-menarchal (average age 7.45 years). The most frequent diagnosis was vulvovaginitis (43%), followed by pathological vaginal bleeding (12%), vulval disorders (6%) and pubertas praecox (5%); about twenty additional conditions were diagnosed. Absolute and extended indications for gynaecological and vaginoscopic examinations are demonstrated. PMID:7164465

  18. Medical management of paediatric burn injuries: best practice.

    Science.gov (United States)

    Kim, Leo K P; Martin, Hugh C O; Holland, Andrew J A

    2012-04-01

    Burns commonly occur in children and their first aid remains inadequate despite burn prevention programmes. While scald injuries predominate, contact and flame burns remain common. Although typically less severe injuries overall than those in adults, hypertrophic scarring complicating both the burn wound and even donor sites occur more frequently in children. The heterogeneous nature of burn wounds, coupled with the difficulties associated with the early clinical assessment of burn depth, has stimulated the application of novel technologies to predict burn wound outcome. This review explores current best practice in the management of paediatric burns, with a focus on prevention, optimal first aid, resuscitation, burn wound prediction and wound management strategies.

  19. HISTOPATHOLOGICAL STUDY OF OVARIAN TUMORS IN PAEDIATRIC AGE GROUP

    Directory of Open Access Journals (Sweden)

    Ramani

    2013-06-01

    Full Text Available ABSTRACT: Ovarian tumors are r are in children and constitute 1% of all childhood malignancies and 8% of abdominal tumors. Large cysts and those complicated by torsion make their presence clear by their symptomatology. However, ovarian pathology is still mostly discovered at laparotomy for presumptive appendicitis. Accurate diagnosis of these tumors at such a young age is a great challenge to surgeons and pathologists. This article reviews the clinical presentation, radiological imaging, gross and histopathological findings at the Pathol ogy Department of a Paediatric Referral centre in Hyderabad

  20. Climate and Ancient Societies

    DEFF Research Database (Denmark)

    Climate, and human responses to it, have a strongly interconnected relationship. This when climate change occurs, the result of either natural or human causes, societies should react and adapt to these. But do they? If so, what is the nature of that change, and are the responses positive...... or negative for the long-term survival of social groups? In this volume, scholars from diverse disciplines including archaeology, geology and climate sciences explore scientific and material evidence for climate changes in the past, their causes, their effects on ancient societies and how those societies...

  1. Fairness in society

    CERN Document Server

    Flomenbom, Ophir

    2011-01-01

    Models that explain the economical and political realities of nowadays societies should help all the world's citizens. Yet, the last four years showed that the current models are missing. Here we develop a dynamical society-deciders model showing that the long lasting economical stress can be solved when increasing fairness in nations. fairness is computed for each nation using indicators from economy and politics. Rather than austerity versus spending, the dynamical model suggests that solving crises in western societies is possible with regulations that reduce the stability of the deciders, while shifting wealth in the direction of the people. This shall increase the dynamics among socio-economic classes, further increasing fairness.

  2. Information society studies

    CERN Document Server

    Duff, Alistair S

    2013-01-01

    We are often told that we are ""living in an information society"" or that we are ""information workers."" But what exactly do these claims mean, and how might they be verified? In this important methodological study, Alistair S. Duff cuts through the rhetoric to get to the bottom of the ""information society thesis."" Wide-ranging in coverage, this study will be of interest to scholars in information science, communication and media studies and social theory. It is a key text for the newly-unified specialism of information society studies, and an indispensable guide to the future of this disc

  3. Responsiveness of the Canadian Occupational Performance Measure

    NARCIS (Netherlands)

    I.C.J.M. Eyssen; M.P.M. Steultjens; T.A.M. Oud; E.M. Bolt; A. Maasdam; J. Dekker

    2011-01-01

    This study evaluated the responsiveness of the Canadian Occupational Performance Measure (COPM), an individualized, client-centered outcome measure for the identification and evaluation of self-perceived occupational performance problems. We recruited 152 consecutive patients with various diagnoses,

  4. Canadian Business Schools: Going out of Business?

    Science.gov (United States)

    Dobni, Dawn; Dobni, Brooke

    1996-01-01

    Using Porter's five-forces model (potential entrants, suppliers, buyers, rivalry, substitutes) to analyze competition in Canadian university business schools, the authors conclude that schools are becoming increasingly vulnerable to competitive pressures and that strategic reorientation is necessary. (SK)

  5. Canadian media representations of mad cow disease.

    Science.gov (United States)

    Boyd, Amanda D; Jardine, Cynthia G; Driedger, S Michelle

    2009-01-01

    A Canadian case of bovine spongiform encephalopathy (BSE) or "mad cow disease" was confirmed in May, 2003. An in-depth content analysis of newspaper articles was conducted to understand the portrayal of BSE and variant Creutzfeldt-Jakob disease (vCJD) in the Canadian media. Articles in the "first 10 days" following the initial discovery of a cow with BSE in Canada on May 20, 2003, were examined based on the premise that these initial stories provide the major frames that dominate news media reporting of the same issue over time and multiple occurrences. Subsequent confirmed Canadian cases were similarly analyzed to determine if coverage changed in these later media articles. The results include a prominence of economic articles, de-emphasis of health aspects, and anchoring the Canadian outbreak to that of Britain's crisis. The variation in media representations between those in Canada and those documented in Britain are explored in this study. PMID:19697246

  6. Canadian used fuel disposal concept review

    International Nuclear Information System (INIS)

    A federal government environmental assessment review of the disposal concept developed under the Canadian Nuclear Fuel Waste Management Program is currently underway. The Canadian concept is, simply stated, the placement of used fuel (or fuel waste) in long-lived containers at a depth between 500 m and 1000 m in plutonic rock of the Canadian Shield. Atomic Energy of Canada Limited submitted an Environmental Impact Statement in 1994 and the public hearing aspect of the concept review is in its final phase. A unique aspect of the Canadian situation is that government has stipulated that site selection can not commence until the concept has been approved. Hence, the safety and acceptability of the concept is being reviewed in the context of a generic site. Some comments and lessons learned to date related to the review process are discussed. (author)

  7. Canadian Law Schools: In Search of Excellence.

    Science.gov (United States)

    Trakman, Leon E.

    1980-01-01

    Academically, Canadian education is at the crossroads between formalism and functionalism, with the latter prevailing in recent years. There now arises a demand for a more integrated approach, linking legal theory with legal practice. (MSE)

  8. North American Menopause Society

    Science.gov (United States)

    ... Advertisements NAMS in the News Press Room Assistance Society Overview Top 10 reasons why NAMS is your ... fully updated and referenced 5th edition of the Society’s leading professional resource, featuring the latest comprehensive clinical ...

  9. National Multiple Sclerosis Society

    Science.gov (United States)

    ... Join the Community Stay Informed Corporate Support National Multiple Sclerosis Society Our Mission: People affected by MS can ... 10.5 Million in New Research to Stop Multiple Sclerosis, Restore Function and End MS Forever October 11, ...

  10. Valie EXPORT Society Rooseumis

    Index Scriptorium Estoniae

    2002-01-01

    Malmös Rooseumi Kaasaegse Kunsti Keskuses näitus "Baltic Babel". Projekt koosneb Läänemeremaade linnades tegutsevate innovatiivsete gruppide aktsioonidest. Kuraator Charles Esche. Esinejatest (Eestist Valie Export Society: Kadi Estland, Killu Sukmit)

  11. Changing anthropology, changing society.

    Science.gov (United States)

    Varughese, Heather

    2009-12-01

    Fifty years after the founding of the field of medical anthropology, the Society for Medical Anthropology of the American Anthropological Association held its first independent meeting on September 24-27, 2009, at Yale University.

  12. Valie EXPORT Society. Overlok

    Index Scriptorium Estoniae

    2001-01-01

    Valie EXPORT Society asutasid 23. okt. 1999. a. Frankfurdis Kadi Estland, Killu Sukmit ja Mari Laanemets, kui olid külastanud austria naiskunstniku Valie Exporti näitust. Rühmituse aktsioonide kirjeldus

  13. Society of Gynecologic Surgeons

    Science.gov (United States)

    ... December 1 – 3, 2016. This year’s course includes didactic lectures by outstanding surgeons and educators who are ... held in high esteem by other medical societies. Education Evidence-Based Medicine article published in OBG Mangement ...

  14. Pediatric Endocrinology Nurses Society

    Science.gov (United States)

    ... International Welcome to PENS The Pediatric Endocrinology Nursing Society (PENS) is committed to the development and advancement of nurses in the art and science of pediatric endocrinology nursing. Learn More ...

  15. American Society of Nephrology

    Science.gov (United States)

    ... join the conversation today. Learn More The American Society of Nephrology (ASN) leads the fight against kidney diseases by educating health professionals, sharing new knowledge, advancing research, and advocating the highest quality care ...

  16. The Tranquebarian Society

    DEFF Research Database (Denmark)

    Jensen, Niklas Thode

    2015-01-01

    of this development was the establishment of the Tranquebarian Society, the third learned society east of the Cape of Good Hope. The article examines the unique assemblage of scientific networks, people, instruments, institutions, and ideas of local and global origin that converged in Tranquebar, and it investigates...... the fusion of local problems and radical ideas of enlightenment, education, and improvement that united government, mission, and merchants in Tranquebar in the quest for ‘useful knowledge’....

  17. Consumption in the Information Society

    Science.gov (United States)

    Zherebin, V. M.; Ermakova, N. A.; Makhrova, O. N.

    2010-01-01

    The current state of the economy in the developed countries make it possible to characterize them using concepts and terms such as the postindustrial society, the new economy, the service economy, the creative economy, the posteconomic society, the information society, the knowledge society, and the consumer society. Among these terms and…

  18. How Canadians feel about nuclear energy

    International Nuclear Information System (INIS)

    A survey conducted by Decima Research in April 1989 showed that 50% of Canadians were somewhat or strongly in favour of nuclear energy, the percentage varying from 37% in British Columbia to 65% in Ontario. A majority (56%) questioned the nuclear industry's ability to handle its waste safely, but 45% believed that it was working hard to solve the problem. It was evident that an advertising campaign by the Canadian Nuclear Association had an effect

  19. Canadian National Identity and Anti-Americanism

    Institute of Scientific and Technical Information of China (English)

    谭万宏

    2015-01-01

    Canadian national identity is closely related to antiAmericanism and for Canadians,comparing with America has become the main way to identify themselves.So some scholars argue that Canada lacks a real national identity and this is the main reason of its anti-American tradition.However,the author remarks Canada has its national identity.In this paper,the author will present three reasons to support her view.

  20. Canadian National Identity and Anti-Americanism

    Institute of Scientific and Technical Information of China (English)

    谭万宏

    2015-01-01

    Canadian national identity is closely related to anti-Americanism and for Canadians,comparing with America has become the main way to identify themselves.So some scholars argue that Canada lacks a real national identity and this is the main reason of its anti-American tradition.However,the author remarks Canada has its national identity.In this paper,the author will present three reasons to support her view.

  1. Canadian experience with structured clinical examinations.

    OpenAIRE

    Grand'Maison, P.; Lescop, J; Brailovsky, C. A.

    1993-01-01

    The use of structured clinical examinations to improve the evaluation of medical students and graduates has become significantly more common in the past 25 years. Many Canadian medical educators have contributed to the development of this technique. The Canadian experience is reviewed from the introduction of simulated-standardized patients and objective-structured clinical examinations to more recent developments and the use of such examinations for licensure and certification.

  2. Canadian Art Partnership Program in Finland

    OpenAIRE

    Ketovuori, Mikko Mr.

    2011-01-01

    This article is about a multidisciplinary R&D project in which a Canadian Learning Through The Arts (LTTA) program was imported to Finland in 2003–2004. Cultural differences in arts education in Finland and Canada are discussed. While Finland has a national school curriculum with all the arts included. Canada relies more on partnerships to ensure arts education for children in the schools. Despite the fact that Canadian learning methods appeared to be quite similar to the ones Finnish teacher...

  3. Nuclear technology and society

    International Nuclear Information System (INIS)

    This special issue of Journal of the Atomic Energy Society of Japan deals with the relation between nuclear technology and society, and is composed of four papers: (1) Nuclear energy and international politics - sociotechnics around plutonium utilization; (2) Risk recognition and benefit recognition of nuclear facilities and social acceptance; (3) Environmental risk management and radioactive waste problem; and, (4) Public administration around the relation between nuclear energy and society. (1) describes the historical development of nuclear energy since its birth, focusing on how the leading countries tried to control nuclear proliferation. Peaceful utilization of nuclear energy is closely connected with the Non-proliferation problem. (1) also discusses the relation of plutonium utilization of Japan with international society. (2) discusses how nuclear facilities can be accepted by society, analyzing the background of risk recognition, in particular, of psychological character of mass society. (3) introduces an new approach (risk-based or risk-informed regulation) of environmental risk management for radioactive waste disposal problem, focusing on HLW (high-level waste). (4) explains the approach from public administration to nuclear energy and general energy policy and introduces PPA (participatory policy analysis) as a means for policy making. (M.M.)

  4. The emerging global epidemic of paediatric inflammatory bowel disease--causes and consequences.

    Science.gov (United States)

    Malmborg, P; Hildebrand, H

    2016-03-01

    Two decades ago, paediatric inflammatory bowel disease (IBD) drew only modest interest from the international paediatric community. Since then, dramatically globally increasing incidence rates have made childhood-onset IBD a priority for most paediatric gastroenterologists. The emerging pandemia of paediatric IBD has fuelled a quest to identify the recent changes in early life exposures that could explain the increasing risk for IBD amongst today's children. Treatment of children with IBD should aim for symptom control but should also target restoration of growth and prevention of pubertal delay. The paediatric IBD phenotype seems to be characterized by more extensive disease location, and some comparative studies have suggested that childhood-onset IBD also represents a more severe phenotype than the adult-onset IBD form. In this review, we analyse recent global incidence trends of paediatric IBD. We present an update on the known and suggested risk factors that could explain the emerging global epidemia of paediatric IBD. We also draw attention to differences in treatment between children and adults with IBD. Finally, we highlight latest follow-up studies that question the proposed dynamic and aggressive nature of childhood-onset IBD.

  5. Global health: A lasting partnership in paediatric surgery

    Directory of Open Access Journals (Sweden)

    Kokila Lakhoo

    2015-01-01

    Full Text Available Background: To emphasise the value of on-going commitment in Global Health Partnerships. Materials and Methods: A hospital link, by invitation, was set up between United Kingdom and Tanzania since 2002. The project involved annual visits with activities ranging from exchange of skill to training health professionals. Furthermore, the programme attracted teaching and research activities. For continuity, there was electronic communication between visits. Results: Six paediatric surgeons are now fully trained with three further in training in Africa. Paediatric surgery services are now separate from adult services. Seven trainee exchanges have taken place with four awarded fellowships/scholarships. Twenty-three clinical projects have been presented internationally resulting in eight international publications. The programme has attracted other health professionals, especially nursing and engineering. The Tropical Health and Education Trust prize was recently achieved for nursing and radiography. National Health Service has benefited from volunteering staff bringing new cost-effective ideas. A fully funded medical student elective programme has been achieved since 2008. Conclusion: Global Health Partnerships are an excellent initiative in establishing specialist services in countries with limited resources. In the future, this will translate into improved patient care as long as it is sustained and valued by long term commitment.

  6. Discrimination of paediatric brain tumours using apparent diffusion coefficient histograms

    Energy Technology Data Exchange (ETDEWEB)

    Bull, Jonathan G.; Clark, Christopher A. [UCL Institute of Child Health, Imaging and Biophysics Unit, London (United Kingdom); Saunders, Dawn E. [Great Ormond Street Hospital for Children NHS Trust, Department of Radiology, London (United Kingdom)

    2012-02-15

    To determine if histograms of apparent diffusion coefficients (ADC) can be used to differentiate paediatric brain tumours. Imaging of histologically confirmed tumours with pre-operative ADC maps were reviewed (54 cases, 32 male, mean age 6.1 years; range 0.1-15.8 years) comprising 6 groups. Whole tumour ADC histograms were calculated; normalised for volume. Stepwise logistic regression analysis was used to differentiate tumour types using histogram metrics, initially for all groups and then for specific subsets. All 6 groups (5 dysembryoplastic neuroectodermal tumours, 22 primitive neuroectodermal tumours (PNET), 5 ependymomas, 7 choroid plexus papillomas, 4 atypical teratoid rhabdoid tumours (ATRT) and 9 juvenile pilocytic astrocytomas (JPA)) were compared. 74% (40/54) were correctly classified using logistic regression of ADC histogram parameters. In the analysis of posterior fossa tumours, 80% of ependymomas, 100% of astrocytomas and 94% of PNET-medulloblastoma were classified correctly. All PNETs were discriminated from ATRTs (22 PNET and 4 supratentorial ATRTs) (100%). ADC histograms are useful in differentiating paediatric brain tumours, in particular, the common posterior fossa tumours of childhood. PNETs were differentiated from supratentorial ATRTs, in all cases, which has important implications in terms of clinical management. (orig.)

  7. Correlation of Clinicohaematological Parameters in Paediatric Dengue: A Retrospective Study

    Directory of Open Access Journals (Sweden)

    Ramakrishna Pai Jakribettu

    2015-01-01

    Full Text Available Dengue is one of the arthropod-borne (arbo viral diseases transmitted by female mosquito Aedes aegypti. Dengue fever has a wide spectrum of clinical presentation ranging from flu-like illness to severe complicated stage of dengue hemorrhagic fever leading to mortality. This was a retrospective study conducted in a tertiary care hospital in Coastal Karnataka, South India, to know the correlation between the clinical presentation and haematological parameters in the paediatric cases presented with dengue symptoms. A total of 163 paediatric cases who presented fever and dengue-like illness were included in the study. Of which, 69 were confirmed dengue patients. Critical analysis showed that there was a significant difference in the haematological parameters like total leucocyte count, percent differential leucocyte count, and platelets count, in the erythrocyte sedimentation rate (P<0.05 to 0.0001. Additionally, when compared to nondengue patients, even the liver function and renal function parameters were significantly deranged (P<0.05 to 0.0001. Stratification based on NS1, IgG, and IgM showed significant alterations in the haematological, hepatic, and renal parameters. With respect to the treatment a small percentage of patients, that is, 8% (4 patients, required platelet transfusion as their counts went below 20,000/μL. Two patients succumbed to their illness while three required ICU stay.

  8. Genetic differences between paediatric and adult Burkitt lymphomas.

    Science.gov (United States)

    Havelange, Violaine; Pepermans, Xavier; Ameye, Geneviève; Théate, Ivan; Callet-Bauchu, Evelyne; Barin, Carole; Penther, Dominique; Lippert, Eric; Michaux, Lucienne; Mugneret, Francine; Dastugue, Nicole; Raphaël, Martine; Vikkula, Miikka; Poirel, Hélène A

    2016-04-01

    Dysregulation of MYC is the genetic hallmark of Burkitt lymphoma (BL) but it is encountered in other aggressive mature B-cell lymphomas. MYC dysregulation needs other cooperating events for BL development. We aimed to characterize these events and assess the differences between adult and paediatric BLs that may explain the different outcomes in these two populations. We analysed patterns of genetic aberrations in a series of 24 BLs: 11 adults and 13 children. We looked for genomic imbalances (copy number variations), copy-neutral loss of heterozygosity (CN-LOH) and mutations in TP53, CDKN2A, ID3 (exon 1), TCF3 (exon17) and CCND3 (exon 6). Young patients displayed more frequent 13q31.3q32.1 amplification, 7q32q36 gain and 5q23.3 CN-LOH, while 17p13 and 18q21.3 CN-LOH were only detected in adult BLs. ID3 mutations were present in all adult samples, but only in 42% of childhood cases. CCND3 and ID3 double-hit mutations, as well as 18q21 CN-LOH, seemed to be associated with poorer outcome. For the first time, we report different genetic anomalies between adult and paediatric BLs, suggesting age-related heterogeneity in Burkitt lymphomagenesis. This may explain the poorer prognosis of adult BLs. Additional studies are needed to confirm these results in the setting of clinical trials. PMID:26887776

  9. Ganglion cysts in the paediatric wrist: magnetic resonance imaging findings

    International Nuclear Information System (INIS)

    The majority of published literature on ganglion cysts in children has been from a surgical perspective, with no dedicated radiologic study yet performed. Our aim was to assess the magnetic resonance (MR) imaging appearance of ganglion cysts in a series of paediatric MR wrist examinations. Ninety-seven consecutive paediatric MR wrist examinations were retrospectively reviewed for the presence of ganglion cysts. Only those studies with wrist ganglia were included. Cysts were assessed for location, size, internal characteristics and secondary effect(s). Forty-one ganglion cysts (2-32 mm in size) were seen in 35/97 (36%) patients (24 female, 11 male), mean age: 13 years 11 months (range: 6 years 3 months-18 years). The majority were palmar (63.4%) with the remainder dorsal. Of the cysts, 43.9% were related to a wrist ligament(s), 36.6% to a joint and 17.1% to the triangular fibrocartilage complex. Of the patients, 91.4% had wrist symptoms: pain (n=29, 82.9%), swelling (n=7, 20%) and/or palpable mass (n=4, 11.4%); 71.4% patients had significant additional wrist abnormalities. Ganglion cysts were frequently found in children referred for wrist MRI. (orig.)

  10. Bounded rationality alters the dynamics of paediatric immunization acceptance.

    Science.gov (United States)

    Oraby, Tamer; Bauch, Chris T

    2015-06-02

    Interactions between disease dynamics and vaccinating behavior have been explored in many coupled behavior-disease models. Cognitive effects such as risk perception, framing, and subjective probabilities of adverse events can be important determinants of the vaccinating behaviour, and represent departures from the pure "rational" decision model that are often described as "bounded rationality". However, the impact of such cognitive effects in the context of paediatric infectious disease vaccines has received relatively little attention. Here, we develop a disease-behavior model that accounts for bounded rationality through prospect theory. We analyze the model and compare its predictions to a reduced model that lacks bounded rationality. We find that, in general, introducing bounded rationality increases the dynamical richness of the model and makes it harder to eliminate a paediatric infectious disease. In contrast, in other cases, a low cost, highly efficacious vaccine can be refused, even when the rational decision model predicts acceptance. Injunctive social norms can prevent vaccine refusal, if vaccine acceptance is sufficiently high in the beginning of the vaccination campaign. Cognitive processes can have major impacts on the predictions of behaviour-disease models, and further study of such processes in the context of vaccination is thus warranted.

  11. Measurement of effective dose for paediatric scoliotic patients

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Chih-I. [School of Medical Radiation Sciences, University of Sydney, Lidcombe NSW 1825 (Australia); McLean, Donald [School of Medical Radiation Sciences, University of Sydney, Lidcombe NSW 1825 (Australia)]. E-mail: rdmc@imag.wsahs.nsw.gov.au; Robinson, John [School of Medical Radiation Sciences, University of Sydney, Lidcombe NSW 1825 (Australia)

    2005-05-01

    Purpose: Paediatric radiation dose from scoliosis X-ray examinations is of concern because of its routine nature. Few studies have calculated effective dose which is the primary indicator of radiation risk. This study reports on the use of a new flexible Monte Carlo software package PCXMC14 for such calculation from documented radiographic and patient data. Method: Patient and radiographic data were collected from 54 patient examinations for both postero-anterior (PA) and lateral X-ray projections. A spreadsheet mainly based on radiographic calibration was used to process the raw data and compute entrance air kerma for input in the PCXMC program. A partitioning model was developed to more accurately estimate the effect of an aluminium wedge filter. Results: Results showed the effective dose ranged from 81 to 123 {mu}Sv for the PA projection and 124 to 207 {mu}Sv for the lateral projection, with patient weights varying from 20 to 70 kg. Conclusions: This study demonstrates the usefulness of the PCXMC program to evaluate the effective dose in paediatric scoliosis radiography.

  12. The Extent of Consumer Product Involvement in Paediatric Injuries.

    Science.gov (United States)

    Catchpoole, Jesani; Walker, Sue; Vallmuur, Kirsten

    2016-07-07

    A challenge in utilising health sector injury data for Product Safety purposes is that clinically coded data have limited ability to inform regulators about product involvement in injury events, given data entry is bound by a predefined set of codes. Text narratives collected in emergency departments can potentially address this limitation by providing relevant product information with additional accompanying context. This study aims to identify and quantify consumer product involvement in paediatric injuries recorded in emergency department-based injury surveillance data. A total of 7743 paediatric injuries were randomly selected from Queensland Injury Surveillance Unit database and associated text narratives were manually reviewed to determine product involvement in the injury event. A Product Involvement Factor classification system was used to categorise these injury cases. Overall, 44% of all reviewed cases were associated with consumer products, with proximity factor (25%) being identified as the most common involvement of a product in an injury event. Only 6% were established as being directly due to the product. The study highlights the importance of utilising injury data to inform product safety initiatives where text narratives can be used to identify the type and involvement of products in injury cases.

  13. Ganglion cysts in the paediatric wrist: magnetic resonance imaging findings

    Energy Technology Data Exchange (ETDEWEB)

    Bracken, Jennifer; Bartlett, Murray [Royal Children' s Hospital, Medical Imaging Department, Melbourne, VIC (Australia)

    2013-12-15

    The majority of published literature on ganglion cysts in children has been from a surgical perspective, with no dedicated radiologic study yet performed. Our aim was to assess the magnetic resonance (MR) imaging appearance of ganglion cysts in a series of paediatric MR wrist examinations. Ninety-seven consecutive paediatric MR wrist examinations were retrospectively reviewed for the presence of ganglion cysts. Only those studies with wrist ganglia were included. Cysts were assessed for location, size, internal characteristics and secondary effect(s). Forty-one ganglion cysts (2-32 mm in size) were seen in 35/97 (36%) patients (24 female, 11 male), mean age: 13 years 11 months (range: 6 years 3 months-18 years). The majority were palmar (63.4%) with the remainder dorsal. Of the cysts, 43.9% were related to a wrist ligament(s), 36.6% to a joint and 17.1% to the triangular fibrocartilage complex. Of the patients, 91.4% had wrist symptoms: pain (n=29, 82.9%), swelling (n=7, 20%) and/or palpable mass (n=4, 11.4%); 71.4% patients had significant additional wrist abnormalities. Ganglion cysts were frequently found in children referred for wrist MRI. (orig.)

  14. Global child health priorities: what role for paediatric oncologists?

    Science.gov (United States)

    Kellie, Stewart J; Howard, Scott C

    2008-11-01

    Despite increasing globalisation, international mobility and economic interdependence, 9.7 million children aged less than 5 years in low income countries will die this year, almost all from preventable or treatable diseases. Diarrhoea, pneumonia and malaria account for 5 million of these deaths each year, compared to about 150,000 deaths from childhood cancer in low- and middle-income countries. In high-income countries, 80% of the 50,000 children diagnosed with cancer each year survive, yet cancer remains the leading disease-related cause of childhood death. In low- and middle-income countries, where 80% of children live, the 200,000 children diagnosed with cancer each year have limited access to curative treatment, and only about 25% survive. Some might argue that death from paediatric cancer in poor countries is insignificant compared to death from other causes, and that scarce health resources may be better used in other areas of public health. Is there a role for the treatment of children with cancer in these regions? Do international partnerships or 'twinning' programmes enhance local health care or detract from other public health priorities? What is ethical and what is possible? This review examines the health challenges faced by infants and children in low-income countries, and assesses the role and impact of international paediatric oncology collaboration to improve childhood cancer care worldwide. PMID:18799306

  15. Neonatology/Paediatrics – Guidelines on Parenteral Nutrition, Chapter 13

    Directory of Open Access Journals (Sweden)

    Fusch, C.

    2009-11-01

    Full Text Available There are special challenges in implementing parenteral nutrition (PN in paediatric patients, which arises from the wide range of patients, ranging from extremely premature infants up to teenagers weighing up to and over 100 kg, and their varying substrate requirements. Age and maturity-related changes of the metabolism and fluid and nutrient requirements must be taken into consideration along with the clinical situation during which PN is applied. The indication, the procedure as well as the intake of fluid and substrates are very different to that known in PN-practice in adult patients, e.g. the fluid, nutrient and energy needs of premature infants and newborns per kg body weight are markedly higher than of older paediatric and adult patients. Premature infants <35 weeks of pregnancy and most sick term infants usually require full or partial PN. In neonates the actual amount of PN administered must be calculated (not estimated. Enteral nutrition should be gradually introduced and should replace PN as quickly as possible in order to minimise any side-effects from exposure to PN. Inadequate substrate intake in early infancy can cause long-term detrimental effects in terms of metabolic programming of the risk of illness in later life. If energy and nutrient demands in children and adolescents cannot be met through enteral nutrition, partial or total PN should be considered within 7 days or less depending on the nutritional state and clinical conditions.

  16. Guidelines on Vaccinations in Paediatric Haematology and Oncology Patients

    Directory of Open Access Journals (Sweden)

    Simone Cesaro

    2014-01-01

    Full Text Available Objective. Vaccinations are the most important tool to prevent infectious diseases. Chemotherapy-induced immune depression may impact the efficacy of vaccinations in children. Patients and Methods. A panel of experts of the supportive care working group of the Italian Association Paediatric Haematology Oncology (AIEOP addressed this issue by guidelines on vaccinations in paediatric cancer patients. The literature published between 1980 and 2013 was reviewed. Results and Conclusion. During intensive chemotherapy, vaccination turned out to be effective for hepatitis A and B, whilst vaccinations with toxoid, protein subunits, or bacterial antigens should be postponed to the less intensive phases, to achieve an adequate immune response. Apart from varicella, the administration of live-attenuated-virus vaccines is not recommended during this phase. Family members should remain on recommended vaccination schedules, including toxoid, inactivated vaccine (also poliomyelitis, and live-attenuated vaccines (varicella, measles, mumps, and rubella. By the time of completion of chemotherapy, insufficient serum antibody levels for vaccine-preventable diseases have been reported, while immunological memory appears to be preserved. Once immunological recovery is completed, usually after 6 months, response to booster or vaccination is generally good and allows patients to be protected and also to contribute to herd immunity.

  17. Headache in the paediatrics patients, clinical-EEG Correlation.

    Directory of Open Access Journals (Sweden)

    Marcelino Lizano Rabelo

    2011-12-01

    Full Text Available A descriptive study was made, with the objective to describe to a clinical group of variables epidemiologists and of laboratory of 108 patients to whom it was made to them and EEG and whose fundamental symptom was the headache; in the period January to December of 2009. The data was taken from the registry of patients of the neurophysiology department of Paediatric Hospital. The variables of the study were: age, sex, type of headache, results of the EEG, and characteristics of pathological EEG activity. The results were expressed in graphical and analyzed tables and of percentage form. The patients of 14 to 16 years predominated (40,7%, female patient (53,7%, clinically the observed recurrent acute migraine in 60 cases was the one that prevailed, as well as normality in the EEG (81,5%, the pathological cases we observed focal paroxysms in 15 patients (75% and focal alterations in 80% of the pathological EEG. Conclusions: In our environment the migraine in the paediatric patient is a frequent pathology that motivates the accomplishment of diverse studies among them the EEG, being this normal one in most of the cases and the non-specific alterations, the recurrent acute migraine and female patients prevailed.

  18. The efficacy of an extended scope physiotherapy clinic in paediatric orthopaedics.

    LENUS (Irish Health Repository)

    O Mir, Marie

    2016-04-01

    The demand for paediatric orthopaedic care is growing, and providing the service required is an increasingly challenging task. Physiotherapist-led triage clinics are utilised in adult orthopaedics to enable the provision of care to patients who may not require a surgical consult. The Physiotherapy Orthopaedic Triage Clinic (POTC) was established in Our Lady\\'s Children\\'s Hospital Crumlin in response to increasing demands on the paediatric orthopaedic service. The clinic is run by physiotherapists working in an advanced practice role (APP), and is the first paediatric clinic of its type and scale in the Republic of Ireland.

  19. The BRACELET Study: surveys of mortality in UK neonatal and paediatric intensive care trials

    Directory of Open Access Journals (Sweden)

    Platt Martin

    2010-05-01

    Full Text Available Abstract Background The subject of death and bereavement in the context of randomised controlled trials in neonatal or paediatric intensive care is under-researched. The objectives of this phase of the Bereavement and RAndomised ControlLEd Trials (BRACELET Study were to determine trial activity in UK neonatal and paediatric intensive care (2002-06; numbers of deaths before hospital discharge; and variation in mortality across intensive care units and trials and to determine whether bereavement support policies were available within trials. These are essential prerequisites to considering the implications of future policies and practice subsequent to bereavement following a child's enrolment in a trial. Methods The units survey involved neonatal units providing level 2 or 3 care, and paediatric units providing level II care or above; the trials survey involved trials where allocation was randomized and interventions were delivered to intensive care patients, or to parents but designed to affect patient outcomes. Results Information was available from 191/220 (87% neonatal units (149 level 2 or 3 care; and 28/32 (88% paediatric units. 90/177 (51% eligible responding units participated in one or more trial (76 neonatal, 14 paediatric and 54 neonatal units and 6 paediatric units witnessed at least one death. 50 trials were identified (36 neonatal, 14 paediatric. 3,137 babies were enrolled in neonatal trials, 210 children in paediatric trials. Deaths ranged 0-278 (median [IQR interquartile range] 2 [1, 14.5] per neonatal trial, 0-4 (median [IQR] 1 [0, 2.5] per paediatric trial. 534 (16% participants died post-enrolment: 522 (17% in neonatal trials, 12 (6% in paediatric trials. Trial participants ranged 1-236 (median [IQR] 21.5 [8, 39.8] per neonatal unit, 1-53 (median [IQR] 11.5 [2.3, 33.8] per paediatric unit. Deaths ranged 0-37 (median [IQR] 3.5 [0.3, 8.8] per neonatal unit, 0-7 (median [IQR] 0.5 [0, 1.8] per paediatric unit. Three trials had a

  20. Differences in phenotype and disease course in adult and paediatric inflammatory bowel disease

    DEFF Research Database (Denmark)

    Jakobsen, Christian; Bartek, Jiri; Wewer, Anne Vibeke;

    2011-01-01

    Background Few studies have compared phenotype and disease course in children and adults with inflammatory bowel disease (IBD). Aim To compare phenotype, treatment and disease course in children (IBD. Methods Two population-based cohorts comprising paediatric...... or disease course. Cumulative 5-year surgery rates for paediatric and adult patients were 5% and 9% for UC (N.S.) and 18% and 21% for CD (N.S.), respectively. Conclusions Paediatric UC patients had more extensive disease, were more often treated with systemic steroids and AZA, had a higher frequency...

  1. Canadian Attitudes toward Labour Market Issues: A Survey of Canadian Opinion. Final Report

    Science.gov (United States)

    Human Resources and Social Development Canada, 2008

    2008-01-01

    In 2007, Human Resources and Social Development Canada commissioned Environics Research Group Limited to conduct a public opinion survey on labour market issues among 3,000 adult Canadians. The objective of the public opinion survey was to better understand the perceptions of Canadians regarding labour market challenges and opportunities in order…

  2. Canadian photovoltaic industry directory --1998

    International Nuclear Information System (INIS)

    The directory is intended to help potential PV customers identify Canadian-based companies who can meet their needs, and to help product manufacturers and distributors identify potential new clients and/or partners within the PV industry for new and improved technologies leading to greater end-use customer satisfaction. The principal feature of the directory is an information matrix that identifies the product and service types offered by each firm and the primary clients served. There is also a list of companies by province and territory, followed by an alphabetical listing of all companies, with detailed information including, mailing address, contact person, prime activity, geographic area served, languages in which services are provided, and a brief company profile. Additional information provided by the companies themselves, dealing with items such as number of systems sold, the total installed capacity, etc., is included in an 'experience matrix' for each firm. Sources of additional information on photovoltaic systems are included in a list at the end of the directory

  3. Canadian landmine detection research program

    Science.gov (United States)

    McFee, John E.; Das, Yogadhish; Faust, Anthony A.

    2003-09-01

    Defence R&D Canada (DRDC), an agency within the Department of National Defence, has been conducting research and development (R&D) on the detection of landmines for countermine operations and of unexploded ordnance (UXO) for range clearance since 1975. The Canadian Centre for Mine Action Technologies (CCMAT), located at DRDC Suffield, was formed in 1998 to carry out R&D related to humanitarian demining. The lead group responsible for formulating and executing both countermine and humanitarian R&D programs in detection is the Threat Detection Group at DRDC Suffield. This paper describes R&D for both programs under the major headings of remote minefield detection, close-in scanning detection, confirmation detection and teleoperated systems. Among DRDC's achievements in landmine and UXO detection R&D are pioneering work in electromagnetic and magnetic identification and classification; the first military-fielded multisensor, teleoperated vehicle-mounted landmine detection system; pioneering use of confirmation detectors for multisensor landmine detection systems; the first fielded thermal neutron activation landmine confirmation sensor; the first detection of landmines using a real-time hyperspectral imager; electrical impedance imaging detection of landmines and UXO and a unique neutron backscatter landmine imager.

  4. A comparison of traditional vs. Canadian tailored prophylaxis dosing of prophylactic factor infusions in children with haemophilia A and B in a single hemophilia treatment center.

    Science.gov (United States)

    Dodd, C; Watts, R G

    2012-07-01

    Prophylactic infusion of clotting factor concentrates is a developing standard of care for individuals with haemophilia. The ideal schedule and techniques of prophylactic infusions remain incompletely defined. Our aim was to determine the optimal techniques and schedules for factor prophylaxis in paediatric patients. A retrospective electronic medical record review of all children treated with prophylactic factor infusions in a single Haemophilia Treatment Center was conducted. Comparison of traditional vs. Canadian dosing regimens and primary vs. secondary prophylaxis was made. Failure of prophylaxis was defined as the first serious bleed. A total of 58 children were identified for review. Five cases were excluded (four due to high titre inhibitors and one due to repeated non-compliance), thus there were 53 total cases: 46 with severe haemophilia, 2 with moderate haemophilia, 5 with mild haemophilia, 44 with haemophilia A and 9 with haemophilia B; 32 Traditional dosing and 21 Canadian dosing regimens. Patients on primary prophylaxis had a decreased failure rate (25%) compared to children treated with secondary prophylaxis (67%) regardless of technique of prophylaxis. When compared to a 'Traditional' factor prophylaxis schedule, the 'Canadian' tailored prophylaxis protocol was comparable with the exception of a decreased use of implanted venous devices in the 'Canadian' group. Ongoing bleeding (primarily joint bleeds) occurs with all prophylactic regimens. The lowest incidence of treatment failure was noted in children who began primary prophylaxis at a young age and before initial joint bleeds. Primary prophylaxis is superior to secondary prophylaxis regardless of dosing regimen. Traditional and Canadian dosing regimens were equivalent in outcome when measured over several years of follow-up.

  5. Civil society sphericules

    DEFF Research Database (Denmark)

    Tufte, Thomas

    2014-01-01

    the organization strategizes about and seeks to articulate amongst Tanzanian youth. Situated in the ‘perverse confluence’ (Dagnino, 2011) between neoliberal and radical democratic agendas in the communicative practices of civil society-driven media platforms, Femina navigates between identities as an NGO, a social...... movement and a media initiative. In the context of the growing literature on social networking sites and their affordances, dynamics and structures, the case of Femina illustrates how a civil society sphericule emerges within the dynamic co-evolution of new and old media platforms. The study is furthermore...... an example of the difficult shift in civil society practice, from service provision to an agenda of public service monitoring, social accountability and community engagement....

  6. Science and Society Colloquium

    CERN Multimedia

    Randi, J

    1991-01-01

    Mr. Randi will give an update of his lecture to the American Physical Society on the occasion of his award of the 1989 Forum Prize. The citation said: "for his unique defense of Science and the scientific method in many disciplines, including physics, against pseudoscience, frauds and charlatans. His use of scientific techniques has contributed to refuting suspicious and fraudulent claims of paranormal results. He has contributed significantly to public understanding of important issues where science and society interact". He is a professional magician and author of many books. He worked with John Maddox, the Editor of Nature to investigate the claims of "water with memory".

  7. Canadian environmental sustainability indicators: highlights 2005

    International Nuclear Information System (INIS)

    Canadians' health and their social and economic well-being are fundamentally linked to the quality of their environment. Recognizing this, in 2004 the Government of Canada committed to establishing national indicators of freshwater quality, air quality and greenhouse gas emissions. The goal of these new indicators is to provide Canadians with more regular and reliable information on the state of their environment and how it is linked with human activity. Canadians need clearly defined environmental indicators - measuring sticks that can track the results that have been achieved through the efforts of governments, industries and individuals to protect and improve the environment. Environment Canada, Statistics Canada and Health Canada are working together to further develop and communicate these indicators. Reflecting the joint responsibility for environmental management in Canada, this effort has benefited from the cooperation and input of the provinces and territories. The indicators are: air quality; greenhouse gas emissions; and, freshwater quality. Air quality tracks Canadians' exposure to ground-level ozone - a key component of smog. The indicator measures one of the most common, harmful air pollutants to which people are exposed. The use of the seasonal average of ozone concentrations reflects the potential for long-term health effects. Greenhouse gas emissions tracks the annual releases of the six greenhouse gases that are the major contributors to climate change. The indicator comes directly from the greenhouse gas inventory report prepared by Environment Canada for the United Nations Framework Convention on Climate Change (UNFCCC) and the Kyoto Protocol. The data are widely used to report on progress toward Canada's Kyoto target for reduced emissions. Freshwater quality reports the status of surface water quality at selected monitoring sites across the country. For this first report, the focus of the indicator is on the protection of aquatic life, such as

  8. Optimising doses in paediatric CT scanning; Optimisation des doses en scanographie pediatrique

    Energy Technology Data Exchange (ETDEWEB)

    Brisse, Herve [Departement d' Imagerie, Institut Curie, 26 rue d' Ulm, 75248 Paris (France)

    2011-07-15

    Computed tomography is still extensively used in paediatric imaging. This technique remains a benchmark for bone, lung, cardiovascular exploration and for emergency imaging. The multi-slice technique has revolutionized image quality by improving spatial resolution and bringing acquisition times down to a few seconds, thus almost totally eliminating the problem of movement artefacts common with children. This technique will not therefore be abandoned any time in the near future by paediatric radiologists. However, these multi-slice CT devices today allow rapid and repetitive exploration of large volumes, which can lead to significant individual exposure [1]. A number of surveys have shown that the exposure parameters used in paediatrics are too high when compared with adult protocols [2, 3] even though a lesser dose can provide equivalent image quality [4]. These paediatric CT optimisation measures are currently the subject of an extensive campaign in the literature [5-7]. (author)

  9. 1H magnetic resonance spectroscopy of the brain in paediatrics: The diagnosis of creatine deficiencies

    NARCIS (Netherlands)

    Sijens, P.E.; Oudkerk, M.

    2005-01-01

    The diagnosis of creatine deficiencies, a paediatric application of magnetic resonance spectroscopy that has already become a diagnostic tool in clinical practice, is reviewed and illustrated with results from recent examinations

  10. Radiation burden to paediatric patients due to micturating cystourethrography examinations in a Dutch children's hospital

    NARCIS (Netherlands)

    Schultz, F.W.; Geleijns, J.; Holscher, H.C.; Weststrate, J.; Zonderland, H.M.; Zoetelief, J.

    1999-01-01

    Micturating cystourethrography (MCU) examinations of paediatric patients in a major Dutch children's hospital (JKZ) were evaluated to generate quantitative information on effective dose (E). A standard examination involves three radiographs plus fluoroscopy. Observed total dose-area product (DAP) fo

  11. Application of SIRS Criteria to a Paediatric Surgical Population in Malawi

    OpenAIRE

    Samuel, Jonathan C.; Varela, Carlos; Cairns, Bruce A.; Charles, Anthony G.

    2014-01-01

    Introduction: Little is known regarding systemic inflammatory response syndrome (SIRS) criteria and mortality in developing countries. We evaluated the utility of the SIRS criteria to predict death among a paediatric surgical population in Lilongwe, Malawi.

  12. VLF propagation measurements in the Canadian Arctic

    Science.gov (United States)

    Lauber, Wilfred R.; Bertrand, Jean M.

    1993-05-01

    For the past three years, during a period of high sun spot numbers, propagation measurements were made on the reception of VLF signals in the Canadian Arctic. Between Aug. and Dec. 1989, the received signal strengths were measured on the Canadian Coast Guard icebreaker, John A. MacDonald in the Eastern Canadian Arctic. Between Jul. 1991 and Jun. 1992, the received signal strengths were measured at Nanisivik, Baffin Island. The purposes of this work were to check the accuracy and estimate variances of the Naval Ocean Systems Center's (NOSC) Long Wave Propagation Capability (LWPC) predictions in the Canadian Arctic and to gather ionospheric storm data. In addition, the NOSC data taken at Fort Smith and our data at Nanisivik were used to test the newly developed Longwave Noise Prediction (LNP) program and the CCIR noise predictions, at 21.4 and 24.0 kHz. The results of the work presented and discussed in this paper show that in general the LWPC predicts accurate values of received signal strength in the Canadian Arctic with standard deviations of 1 to 2 dB over several months. Ionospheric storms can gauge the received signal strengths to decrease some 10 dB for a period of several hours or days. However, the effects of these storms are highly dependent on the propagation path. Finally the new LNP atmospheric noise model predicts lower values of noise in the Arctic than the CCIR model and our limited measurements tend to support these lower values.

  13. JUDGING SELECTION: APPOINTING CANADIAN JUDGES

    Directory of Open Access Journals (Sweden)

    Peter McCormick

    2015-05-01

    Full Text Available Since the 1970s, the appointment of trial judges in Canada has generally involved an arms-length committee of professionals, although the structure of these committees and their role in the process has varied from province to province, as well as evolving over time. Yet these “new” structures and “new” processes did not prevent a major judicial appointment scandal in the province of Quebec in 2010, culminating in the formation of the Bastarache Committee to recommend changes. This paper summarizes the forty-year history of Canadian judicial appointment committees, identifies the major challenges that face those committees, and suggests the basic values toward which reforms to the appointment process might be directed. Depuis les années 1970, la nomination des juges de première instance au Canada a généralement mis à contribution un comité de professionnels indépendants, bien que la structure de ce comité et son rôle dans le processus de nomination aient varié d’une province à l’autre et évolué avec le temps. Ces « nouvelles » structures et « nouveaux » processus n’ont certes pas empêché l’éclatement du scandale sur la nomination des juges au Québec en 2010. Ce scandale a donné lieu à la formation de la Commission Bastarache qui avait notamment le mandat de recommander des changements. La présent document résume les quarante ans d’histoire des comités canadiens de nomination des juges, recense les principaux défis que ces comités doivent relever, et propose les valeurs fondamentales qui devraient inspirer les réformes du processus de nomination.

  14. Paediatric nurses’ attitudes towards the promotion of healthy eating in children and their families.

    OpenAIRE

    Patterson, Joanna Charlotte

    2013-01-01

    Background Obesity is a significant public health issue causing many ill-effects. Arguably nurses should be advocates and role models for healthy eating promotion as part of obesity prevention. However, there is limited research available relating specifically to paediatric nurses as health promoters, their promotion of healthy eating or their attitudes towards being role models for health behaviours. Objectives To investigate paediatric nurses’ attitudes towards the promotion of hea...

  15. Emerging issues in paediatric health research consent forms in Canada: working towards best practices

    OpenAIRE

    Dove Edward S; Avard Denise; Black Lee; Knoppers Bartha M

    2013-01-01

    Abstract Background Obtaining a research participant’s voluntary and informed consent is the bedrock of sound ethics practice. Greater inclusion of children in research has led to questions about how paediatric consent operates in practice to accord with current and emerging legal and socio-ethical issues, norms, and requirements. Methods Employing a qualitative thematic content analysis, we examined paediatric consent forms from major academic centres and public organisations across Canada d...

  16. Examining Interrater Reliability and Validity of a Paediatric Cardiopulmonary Physiotherapy Discharge Tool

    OpenAIRE

    Lati, Jamil; Pellow, Vanessa; Sproule, Jeannine; Brooks, Dina; Ellerton, Cindy

    2014-01-01

    Purpose: To determine the interrater reliability (IRR) of the individual items in the Paediatric Cardiopulmonary Physiotherapy (CPT) Discharge Tool. This tool identifies six critical items that physiotherapists should consider when determining a paediatric patient's readiness for discharge from CPT after upper-abdominal, cardiac, or thoracic surgery: oxygen saturation, mobility, secretion retention, discharge planning, auscultation, and signs of respiratory distress. Methods: A total of 33 pa...

  17. Study the outpatients′ prescription pattern of antibiotics in paediatric populations of two hospitals

    OpenAIRE

    Katta Venkatesh Ramanath; B. V. B. Balaji

    2013-01-01

    Objective: To assess the outpatients prescription pattern of antibiotics in paediatric population of a rural and an urban hospital. Materials and Methods: A prospective, cross-sectional and interventional study was carried out in the paediatric departments of Adichunchanagiri Hospital and Research Centre and Jabilli Children HospitalRajahmundry for a period of 7 months, after taking permission from the ethics committee. The consent/assent of the patients was taken, and their data and pres...

  18. Identifying paediatric nursing-sensitive outcomes in linked administrative health data

    OpenAIRE

    Wilson Sally; Bremner Alexandra P; Hauck Yvonne; Finn Judith

    2012-01-01

    Abstract Background There is increasing interest in the contribution of the quality of nursing care to patient outcomes. Due to different casemix and risk profiles, algorithms for administrative health data that identify nursing-sensitive outcomes in adult hospitalised patients may not be applicable to paediatric patients. The study purpose was to test adult algorithms in a paediatric hospital population and make amendments to increase the accuracy of identification of hospital acquired event...

  19. Seroprevalence of occult hepatitis B among Egyptian paediatric hepatitis C cancer patients.

    Science.gov (United States)

    Raouf, H E; Yassin, A S; Megahed, S A; Ashour, M S; Mansour, T M

    2015-02-01

    Occult hepatitis B infection is characterized by the presence of hepatitis B virus (HBV) DNA in the serum in the absence of hepatitis B surface antigen (HBsAg). Prevalence of hepatitis C virus (HCV) infections in Egypt is among the highest in the world. In this study, we aim at analysing the rates of occult HBV infections among HCV paediatric cancer patients in Egypt. The prevalence of occult HBV was assessed in two groups of paediatric cancer patients (HCV positive and HCV negative), in addition to a third group of paediatric noncancer patients, which was used as a general control. All groups were negative for HBsAg and positive for HCV antibody. HBV DNA was detected by nested PCR and real-time PCR. HCV was detected by real-time PCR. Sequencing was carried out in order to determine HBV genotypes to all HBV patients as well as to detect any mutation that might be responsible for the occult phenotype. Occult hepatitis B infection was observed in neither the non-HCV paediatric cancer patients nor the paediatric noncancer patients but was found in 31% of the HCV-positive paediatric cancer patients. All the detected HBV patients belonged to HBV genotype D, and mutations were found in the surface genome of HBV leading to occult HBV. Occult HBV infection seems to be relatively frequent in HCV-positive paediatric cancer patients, indicating that HBsAg negativity is not sufficient to completely exclude HBV infection. These findings emphasize the importance of considering occult HBV infection in HCV-positive paediatric cancer patients especially in endemic areas as Egypt.

  20. Complication rate after circumcision in a paediatric surgical setting should not be neglected

    DEFF Research Database (Denmark)

    Thorup, Jørgen; Thorup, Sebastian Cortes; Ifaoui, Inge Botker Rasmussen

    2013-01-01

    As a consequence of the discussion on whether the health benefits of newborn male circumcision outweigh the risks and the discrepancies in reported figures of complications, we evaluated our results from a paediatric surgical department.......As a consequence of the discussion on whether the health benefits of newborn male circumcision outweigh the risks and the discrepancies in reported figures of complications, we evaluated our results from a paediatric surgical department....

  1. An observational study of cancer treatment-induced dental abnormalities in paediatric cancer patients

    OpenAIRE

    Kaberi Das; Munlima Hazarika; Manigreeva Krishnatreya; Amal Chandra Kataki

    2015-01-01

    Background: Paediatric cancer patients who receive radiation and chemotherapy (CT) suffer from various risks of oral complications and odontogenesis. Materials and Methods: This study was conducted at a regional cancer centre of North East India from 2010 to 2013. The impact of cancer treatment by CT and radiation on orodental health was studied on a total of 100 paediatric cancer patients. Results: The common dental abnormalities were microdontia, hypodontia, root abnormalities, abnorm...

  2. What Evidence Underlies Clinical Practice in Paediatric Surgery? A Systematic Review Assessing Choice of Study Design.

    Directory of Open Access Journals (Sweden)

    Benjamin Allin

    Full Text Available Identify every paediatric surgical article published in 1998 and every paediatric surgical article published in 2013, and determine which study designs were used and whether they were appropriate for robustly assessing interventions in surgical conditions.A systematic review was conducted according to a pre-specified protocol (CRD42014007629, using EMBASE and Medline. Non-English language studies were excluded. Studies were included if meeting population criteria and either condition or intervention criteria.Children under the age of 18, or adults who underwent intervention for a condition managed by paediatric surgeons when they were under 18 years of age.One managed by general paediatric surgeons.Used for treatment of a condition managed by general paediatric surgeons.Studies were classified according to whether the IDEAL collaboration recommended their design for assessing surgical interventions or not. Change in proportions between 1998 and 2013 was calculated.1581 paediatric surgical articles were published in 1998, and 3453 in 2013. The most commonly used design, accounting for 45% of studies in 1998 and 46.8% in 2013, was the retrospective case series. Only 1.8% of studies were RCTs in 1998, and 1.9% in 2013. Overall, in 1998, 9.8% of studies used a recommended design. In 2013, 11.9% used a recommended design (proportion increase 2.3%, 95% confidence interval 0.5% increase to 4% increase, p = 0.017.A low proportion of published paediatric surgical manuscripts utilise a design that is recommended for assessing surgical interventions. RCTs represent fewer than 1 in 50 studies. In 2013, 88.1% of studies used a less robust design, suggesting the need for a new way of approaching paediatric surgical research.

  3. Evaluation of radiation dose to anthropomorphic paediatric models from positron-emitting labelled tracers

    Science.gov (United States)

    Xie, Tianwu; Zaidi, Habib

    2014-03-01

    PET uses specific molecules labelled with positron-emitting radionuclides to provide valuable biochemical and physiological information. However, the administration of radiotracers to patients exposes them to low-dose ionizing radiation, which is a concern in the paediatric population since children are at a higher cancer risk from radiation exposure than adults. Therefore, radiation dosimety calculations for commonly used positron-emitting radiotracers in the paediatric population are highly desired. We evaluate the absorbed dose and effective dose for 19 positron-emitting labelled radiotracers in anthropomorphic paediatric models including the newborn, 1-, 5-, 10- and 15-year-old male and female. This is achieved using pre-calculated S-values of positron-emitting radionuclides of UF-NCI paediatric phantoms and published biokinetic data for various radiotracers. The influence of the type of anthropomorphic model, tissue weight factors and direct human- versus mouse-derived biokinetic data on the effective dose for paediatric phantoms was also evaluated. In the case of 18F-FDG, dosimetry calculations of reference paediatric patients from various dose regimens were also calculated. Among the considered radiotracers, 18F-FBPA and 15O-water resulted in the highest and lowest effective dose in the paediatric phantoms, respectively. The ICRP 103 updated tissue-weighting factors decrease the effective dose in most cases. Substantial differences of radiation dose were observed between direct human- versus mouse-derived biokinetic data. Moreover, the effect of using voxel- versus MIRD-type models on the calculation of the effective dose was also studied. The generated database of absorbed organ dose and effective dose for various positron-emitting labelled radiotracers using new generation computational models and the new ICRP tissue-weighting factors can be used for the assessment of radiation risks to paediatric patients in clinical practice. This work also contributes

  4. Evaluation of paediatric nursing-sensitive outcomes in an Australian population using linked administrative hospital data

    OpenAIRE

    Wilson, Sally; Bremner, Alexandra P.; Hauck, Yvonne; Finn, Judith

    2013-01-01

    Background Research into nursing-sensitive outcomes using administrative health data has focussed on hospitalised adults. However, we developed algorithms for the identification of 13 paediatric nursing-sensitive outcomes, which we seek to examine for clinical utility. The aims were to determine the rates of paediatric nursing-sensitive outcomes in a Western Australian hospital and ascertain sociodemographic and clinical characteristics associated with a greater risk of developing nursing-sen...

  5. Antibiotic prescribing in paediatric populations: a comparison between Viareggio, Italy and Funen, Denmark

    DEFF Research Database (Denmark)

    Lusini, Gaia; Lapi, Francesco; Sara, Benocci;

    2009-01-01

    High rates of antibiotic prescribing in paediatric populations represent a major issue because of the problem of antibiotic resistance. North European countries reported an appropriate use of antibiotics in general population; few studies on this issue have been conducted until now, especially...... in Italy. Therefore a comparison concerning paediatric antibiotic prescribing rates between an Italian administrative area in Tuscany (Viareggio) and the county of Funen (Denmark) was conducted....

  6. Guidelines for 18F-FDG PET and PET-CT imaging in paediatric oncology

    DEFF Research Database (Denmark)

    Stauss, J.; Franzius, C.; Pfluger, T.;

    2008-01-01

    by the EANM Paediatric Committee, do not intend to compete with the existing guidelines, but rather aim at providing additional information on issues particularly relevant to PET imaging of children with cancer. CONCLUSION: The guidelines summarize the views of the Paediatric Committee of the European...... not be deemed inclusive of all proper procedures or exclusive of other procedures reasonably directed to obtaining the same results Udgivelsesdato: 2008/8...

  7. Science, technology and society

    CERN Document Server

    Giacomelli, G

    2005-01-01

    We shall discuss some aspects of science and technology, their increasing role in the society, the fast advances in modern science, the apparent decrease of interest of the young generation in basic sciences, the importance of proper science popularization for better public education and awareness in scientific fields.

  8. Italian Society of Physics

    International Nuclear Information System (INIS)

    The abstracts of most of the papers read at the 53 National Congress of the Italian Society of Physics are presented. The Congress developed in ten sessions: high energy and elementary particle physics, physics of nuclei, condensed matter, quantum electronics, cosmic physics, geophysics, general physics, electronics and applied physics, health physics and hystory of physics. An author index is also included

  9. MARX EMBRYOLOGY OF SOCIETY

    NARCIS (Netherlands)

    WOUTERS, A

    1993-01-01

    This article presents a new interpretation of Marx's dialectical method. Marx conceived dialectics as a method for constructing a model of society. The way this model is developed is analogous to the way organisms develop according to the German embryologist Karl Ernst von Baer, and, indeed, Marx's

  10. Connecting Science with Society

    DEFF Research Database (Denmark)

    awareness of the important questions of our society reflected in scientific research and of the answers produced by these research activities. The CRIS2010 conference, entitled “Bringing Science to Society”, therefore seeks to highlight the role of Current Research Information Systems for communicating...

  11. Exploratory of society

    Science.gov (United States)

    Cederman, L.-E.; Conte, R.; Helbing, D.; Nowak, A.; Schweitzer, F.; Vespignani, A.

    2012-11-01

    A huge flow of quantitative social, demographic and behavioral data is becoming available that traces the activities and interactions of individuals, social patterns, transportation infrastructures and travel fluxes. This has caused, together with innovative computational techniques and methods for modeling social actions in hybrid (natural and artificial) societies, a qualitative change in the ways we model socio-technical systems. For the first time, society can be studied in a comprehensive fashion that addresses social and behavioral complexity. In other words we are in the position to envision the development of large data and computational cyber infrastructure defining an exploratory of society that provides quantitative anticipatory, explanatory and scenario analysis capabilities ranging from emerging infectious disease to conflict and crime surges. The goal of the exploratory of society is to provide the basic infrastructure embedding the framework of tools and knowledge needed for the design of forecast/anticipatory/crisis management approaches to socio technical systems, supporting future decision making procedures by accelerating the scientific cycle that goes from data generation to predictions.

  12. Multiethnic Societies and Regions.

    Science.gov (United States)

    Stanfield, John H., II

    1996-01-01

    Maintains that sociology must reconceptualize the meaning of multiethnic societies and regions and also advance theories about how such social organizations came into being and transform themselves through conflicting and peaceful processes. Briefly reviews traditional approaches and outlines new areas of study. (MJP)

  13. [Use of inflammatory markers for monitoring paediatric asthma].

    Science.gov (United States)

    Vidal G, Alberto

    2015-01-01

    The assessment of asthma control takes into account the symptoms, quality of life, lung function, and inflammatory markers. In the last few years, there has been a large increase in the number of publications related to the study of biomarkers in the management of paediatric asthma. Despite the large variety of inflammatory markers described in research studies, only a small group has shown to be useful in monitoring the disease. Induced sputum eosinophils offer the most solid evidence in assessing asthma control. Exhaled breath condensate and urinary leucotrienes could be useful in the future if there is standardisation in their procedures and interpretation of the results. Nitric oxide, basic eosinophil cationic protein, and bronchial biopsy with bronchoalveolar lavage, only appeared to be useful in a reduced group of patients.

  14. Health-e-Child a grid platform for european paediatrics

    CERN Document Server

    Skaburskas, K; Shade, J; Manset, D; Revillard, J; Rios, A; Anjum, A; Branson, A; Bloodsworth, P; Hauer, T; McClatchey, R; Rogulin, D

    2008-01-01

    The Health-e-Child (HeC) project [1], [2] is an EC Framework Programme 6 Integrated Project that aims to develop a grid-based integrated healthcare platform for paediatrics. Using this platform biomedical informaticians will integrate heterogeneous data and perform epidemiological studies across Europe. The resulting Grid enabled biomedical information platform will be supported by robust search, optimization and matching techniques for information collected in hospitals across Europe. In particular, paediatricians will be provided with decision support, knowledge discovery and disease modelling applications that will access data in hospitals in the UK, Italy and France, integrated via the Grid. For economy of scale, reusability, extensibility, and maintainability, HeC is being developed on top of an EGEE/gLite [3] based infrastructure that provides all the common data and computation management services required by the applications. This paper discusses some of the major challenges in bio-medical data integr...

  15. Normal perinatal and paediatric postmortem magnetic resonance imaging appearances

    Energy Technology Data Exchange (ETDEWEB)

    Arthurs, Owen J. [Department of Radiology, Great Ormond Street Hospital for Children NHS Foundation Trust, London (United Kingdom); UCL Institute of Child Health, London (United Kingdom); Barber, Joy L. [Department of Radiology, Great Ormond Street Hospital for Children NHS Foundation Trust, London (United Kingdom); Taylor, Andrew M. [Cardiorespiratory Division, Great Ormond Street Hospital for Children NHS Foundation Trust, London (United Kingdom); UCL Institute of Cardiovascular Science, Centre for Cardiovascular Imaging, London (United Kingdom); Sebire, Neil J. [UCL Institute of Child Health, London (United Kingdom); Department of Histopathology, Great Ormond Street Hospital for Children NHS Foundation Trust, London (United Kingdom)

    2015-04-01

    As postmortem imaging becomes more widely used following perinatal and paediatric deaths, the correct interpretation of images becomes imperative, particularly given the increased use of postmortem magnetic resonance imaging. Many pathological processes may have similar appearances in life and following death. A thorough knowledge of normal postmortem changes is therefore required within postmortem magnetic resonance imaging to ensure that these are not mistakenly interpreted as significant pathology. Similarly, some changes that are interpreted as pathological if they occur during life may be artefacts on postmortem magnetic resonance imaging that are of limited significance. This review serves to illustrate briefly those postmortem magnetic resonance imaging changes as part of the normal changes after death in fetuses and children, and highlight imaging findings that may confuse or mislead an observer to identifying pathology where none is present. (orig.)

  16. Defective Natural Killer cell antiviral capacity in paediatric HBV infection

    DEFF Research Database (Denmark)

    Heiberg, Ida Louise; Laura J., Pallett; Winther, Thilde Nordmann;

    2015-01-01

    Natural Killer (NK) cells exhibit dysregulated effector function in adult chronic HBV infection (CHB), which may contribute to virus persistence. The role of NK cells in children infected perinatally with HBV is less studied. Access to a unique cohort enabled the cross-sectional evaluation of NK...... cell frequency, phenotype and function in HBV-infected children relative to uninfected children. We observed a selective defect in NK cell IFN-γ production, with conserved cytolytic function, mirroring the functional dichotomy observed in adult infection. Reduced expression of NKp30 on NK cells...... suggests a role of impaired NK-Dendritic Cell (DC) cellular interactions as a potential mechanism leading to reduced IFN-γ production. The finding that NK cells are already defective in paediatric CHB, albeit less extensively than in adult CHB, has potential implications for the timing of antiviral therapy...

  17. The potential of proton beam therapy in paediatric cancer

    Energy Technology Data Exchange (ETDEWEB)

    Bjoerk-Eriksson, Thomas [Sahlgrenska Univ. Hospital, Goeteborg (Sweden). Dept. of Oncology; Glimelius, Bengt [Karolinska Inst., Stockholm (Sweden). Dept. of Oncology and Pathology; Akademiska sjukhuset, Uppsala (Sweden). Dept. of Oncology, Radiology and Clinical Immunology

    2005-12-01

    A group of Swedish oncologists and hospital physicists have estimated the number of patients in Sweden suitable for proton beam therapy. The estimations have been based on current statistics of tumour incidence, number of patients potentially eligible for radiation treatment, scientific support from clinical trials and model dose planning studies and knowledge of the dose-response relations of different tumours and normal tissues. It is estimated that in paediatric cancers, proton beams are of potential importance in 80-100 children annually in Sweden. About 20 of the patients have medulloblastoma. The main purpose is to reduce late sequelae, but these are also increased chances to avoid myelosupression during e.g. concomitant chemo-radiation and to further intensify the chemotherapy.

  18. Leucocyte esterase in the rapid diagnosis of paediatric septic arthritis.

    LENUS (Irish Health Repository)

    Kelly, E G

    2013-02-01

    Septic arthritis may affect any age group but is more common in the paediatric population. Infection is generally bacterial in nature. Prompt diagnosis is crucial, as delayed treatment is associated with lifelong joint dysfunction. A clinical history and application of Kocher\\'s criteria may indicate that there is a septic arthritis. However, definitive diagnosis is made on culture of septic synovial fluid. The culture process can take over 24h for the initial culture to yield bacterial colonies. Leucocyte esterase is released by leucocytes at the site of an infection. We hypothesise that leucocyte esterase can be utilized in the rapid diagnosis of septic arthritis and shorten the time to decisive treatment whilst simultaneously decreasing unnecessary treatment of non-septic joints.

  19. Combined PET/MRI in cerebral and paediatric diagnostics

    International Nuclear Information System (INIS)

    The aim of this overview is presentation of MRI and PET as synergistic modalities for combined analysis of morphology and function. For operative planning in epilepsy surgery, definition of the epileptogenic focus based on functional PET diagnostics and morphological MRI is decisive. For staging and follow-up examinations in oncology, MRI should be complemented by PET for the assessment of tumor vitality. In paediatric oncology patients we could demonstrate a therapy relevant increase of sensitivity/specificity with combined PET/MRI in contrast to single modalities. In the brain, full spectrum of digital image registration and three-dimensional reconstruction should be used. In extracranial cases, image fusion is disturbing due to a partial loss of image information of single modalities by the fusion process. (orig.)

  20. Paediatric male circumcision and penile hygiene: a Japanese mothers' view.

    Science.gov (United States)

    Castro-Vázquez, Genaro

    2013-01-01

    This paper analyses the views of 20 Japanese mothers concerning paediatric male circumcision and penile hygiene. In Japan, routine male circumcision has never been implemented for newborns and children, and adult males are mostly circumcised at aesthetic clinics. However, media reports indicate a trend of Japanese mothers willing to have their sons circumcised. In discussing penile hygiene and male circumcision, the construct of a 'sexual script' becomes relevant to understanding how linguistic and gender barriers made references to male genitalia and penile hygiene largely appear as 'vulgar' and 'unfeminine' in daily life conversations. Peers were often identified as the main source of information and only mothers who have struggled with their children's penile infections have learnt about male genital hygiene, a domain of knowledge largely transmitted by men. Male circumcision becomes a double-edged sword that could help prevent penile infections but also an embarrassing conversational topic that could elicit discrimination because most Japanese children are uncircumcised. PMID:24152018

  1. Paediatric biepicondylar elbow fracture dislocation - a case report

    Directory of Open Access Journals (Sweden)

    Miller David

    2010-10-01

    Full Text Available Abstract Paediatric elbow biepicondylar fracture dislocations are very rare injuries and have been only published in two independent case reviews. We report a case of 13 years old boy, who sustained this unusual injury after a fall on outstretched hand resulting in an unstable elbow fracture dislocation. Closed reduction was performed followed by delayed ORIF (Open Reduction and Internal Fixation with K wires. Final follow-up at 14 weeks revealed a stable elbow and satisfactory function with full supination-pronation, range of motion from 0°-120° of flexion and normal muscle strength. This type of injury needs operative treatment and fixation to restore stability and return to normal or near normal elbow function. The method of fixation (screws or K wires may depend on size and number of fracture fragments.

  2. Hospital to home paediatric enteral nutrition--parents need support.

    LENUS (Irish Health Repository)

    Shortall, C

    2015-02-01

    This study assessed the provision of education and support to parents of children on home enteral nutrition (HEN), current dietetic support available and perceived challenges facing parents and carers. From the 39 responses (13%), 29 (83%, n = 35) parents suggested services for HEN need improvement. 29 (74%, n = 39) parents wanted more structured follow up and 22 (56%) would like one person to co-ordinate HEN, education and discharge. 7 parents (18%) reported a need for further education of health care professionals (HCP). Hospital dietitians were the most common HCPs reported to provide support to patients following discharge. Specialist paediatric HEN dietetic services working in a dedicated HEN team, who would provide accurate training and education and liaise with both parents and community care services post discharge should be in place. This would facilitate transfer to community care, reduce hospital re-admissions, outpatient department attendances and costs.

  3. Pseudomonas aeruginosa diversity in distinct paediatric patient groups

    DEFF Research Database (Denmark)

    Tramper-Stranders, G.A.; Ent, C.K. van der; Wolfs, T.F.;

    2008-01-01

    -CF patients and whether clonality of isolates occurs in other patient groups. The aim of this study was to investigate P. aeruginosa diversity and the occurrence of clones within five distinct paediatric patient groups susceptible to P. aeruginosa infection. P. aeruginosa isolates were cultured from 157...... and further typed by pulsed-field gel electrophoresis. Simpson's diversity index was calculated for the five groups. CF-chronic patients carried the highest number of distinct P. aeruginosa phenotypes and genotypes per culture. Isolates from the CF-chronic group were significantly less diverse than those from...... patients (CF first infection (CF-1 group) (29); CF chronic infection (CF-chronic group) (27); urinary tract infection (34); chronic suppurative otitis media (43); and intensive-care hospitalization/immunodeficiency (24)). All 202 phenotypically different isolates were tested for antimicrobial resistance...

  4. PET/CT in paediatric malignancies - An update

    Directory of Open Access Journals (Sweden)

    Subramanyam Padma

    2016-01-01

    Full Text Available 18F-fluorodeoxyglucose positron emission tomography (FDG-PET is a well-established imaging modality in adult oncological practice. Its role in childhood malignancies needs to be discussed as paediatric malignancies differ from adults in tumor subtypes and they have different tumor biology and FDG uptake patterns. This is also compounded by smaller body mass, dosimetric restrictions, and physiological factors that can affect the FDG uptake. It calls for careful planning of the PET study, preparing the child, the parents, and expertise of nuclear physicians in reporting pediatric positron emission tomography/computed tomography (PET/CT studies. In a broad perspective, FDG-PET/CT has been used in staging, assessment of therapy response, identifying metastases and as a follow-up tool in a wide variety of pediatric malignancies. This review outlines the role of PET/CT in childhood malignancies other than hematological malignancies such as lymphoma and leukemia.

  5. Trichilemmal Cyst of the Penis in a Paediatric Patient

    Directory of Open Access Journals (Sweden)

    Samuel Madan

    2015-01-01

    Full Text Available Paediatric penile cysts are uncommon. We report a five-year-old child with an asymptomatic progressively growing cyst on the ventral aspect of the penis after a hypospadias repair. The patient presented to the Cooper Health Clinic, Dubai, United Arab Emirates, in March 2012. A complete excision of the cyst was performed. Histology results delineated a capsulated benign trichilemmal cyst. No recurrence or complications were reported in the 26 months following the excision. We recommend an early and complete excision of all penile cysts to prevent the risk of urethral obstruction, infection, inflammation and rare malignant changes. This is the first reported case of a penile trichilemmal cyst in a child.

  6. Educating for a High Skills Society? The Landscape of Federal Employment, Training and Lifelong Learning Policy in Canada

    Science.gov (United States)

    Gibb, Tara; Walker, Judith

    2011-01-01

    Government reports and documents claim that building a knowledge economy and innovative society are key goals in Canada. In this paper, we draw on critical policy analysis to examine 10 Canadian federal government training and employment policies in relation to the government's espoused priorities of innovation and developing a high skills society…

  7. Impact of community-acquired paediatric rotavirus gastroenteritis on family life: data from the REVEAL study

    Directory of Open Access Journals (Sweden)

    Talayero José MP

    2010-03-01

    Full Text Available Abstract Background Rotavirus is the leading cause of acute gastroenteritis (AGE and the most frequent cause of severe diarrhoea in children aged less than 5 years. Although the epidemiology of rotavirus gastroenteritis (RVGE is well documented, there are few data on the impact of RVGE on the families of affected children. Methods Data associated with the burden of RVGE, including number of working days lost, levels of parental stress, the need for alternative childcare arrangements and additional nappies used, were extracted from questionnaires completed by parents of children participating in a prospective, multicentre, observational study (Rotavirus gastroenteritis Epidemiology and Viral types in Europe Accounting for Losses in public health and society, REVEAL, conducted during 2004-2005 in selected areas of Belgium, France, Germany, Italy, Spain, Sweden, and the United Kingdom to estimate the incidence of RVGE in children aged less than 5 years seeking medical care as a result of AGE. Results 1102 children with RVGE were included in the present analysis. The proportion of RVGE cases that required at least one parent or other person to be absent from work was 39%-91% in the hospital setting, 44%-64% in the emergency department, and 20%-64% in primary care. Self-reported levels of parental stress were generally high (mean stress levels, ≥ 5 on a 10-point visual analogue scale. Additional childcare arrangements were required in up to 21% of RVGE episodes. The mean number of nappies used per day during RVGE episodes was approximately double that used when the child was not ill. Conclusions Paediatric RVGE cases cause disruption to families and parental stress. The burden of RVGE on children and their families could be substantially reduced by routine rotavirus vaccination of infants.

  8. Quality of life in paediatric population from 8 to 12 years with asthma

    Directory of Open Access Journals (Sweden)

    Gabriela Maldonado Guzmán

    2007-09-01

    Full Text Available The quality of life in patients with chronic problems as the asthma, at present performs major importance in view of the increase of the life expectancy. Nevertheless, often this one does not accompany of conditions biopsicosocial acceptable, that allow to the person to enjoy good emotional condition, as well as the accomplishment of his or her physical, social and school activities. The objective of this study is to know the quality life of the physical, emotional, social, and scholar valuation. Methodology: This study was realized with a number of 124 children sample in ages of 8 to 12 years old with asthma diagnostic.Results: The most damage aspects within quality life dimension were run, work out; lower energy and feeling pain. Emotional aspects were be worried about the future and insomnia, respect to social dimension the problem was children can’t keep in the same condition than others while they are playing; and about school dimension the problem was school absence because of their need of going to the doctor or hospital. Discussion: The aspects of the physical dimension that were more affected to are the follow: run, to do exercise, to have little energy, and to feel pain. Both first ones have relation with the (reported by the Spanish Society of Neumología and Paediatrics (s.f., Where they brought (reported that the children more affected because of the asthma to were those that run and to do exercise. With regard to having little energy and feeling pain, this can owe to persistent accesses of cough, that really they cause weakness and pain in the thoracic box. Conclusions: These results suggest that it is important to stimulate the self-esteem of the children who endure asthma across his participation in an equipment or group.

  9. Peer Teaching in der Pädiatrie - Evaluation eines studentischen Tutoriats im Blockpraktikum Kinderheilkunde [Peer Teaching in Paediatrics - Medical Students as Learners and Teachers on a Paediatric Course

    Directory of Open Access Journals (Sweden)

    Karay, Yassin

    2010-11-01

    Full Text Available [english] Background: Peer assisted learning is known as an effective educational strategy in medical teaching. We established a peer assisted teaching program by student tutors with a focus on clinical competencies for students during their practical training on paediatric wards. It was the purpose of this study to investigate the effects of a clinical skills training by tutors, residents and consultants on students evaluations of the teaching quality and the effects of a peer teaching program on self assessed clinical competencies by the students.Methods: Medical student peers in their 6 year were trained by an intensive instruction program for teaching clinical skills by paediatric consultants, doctors and psychologists. 109 students in their 5 year (study group participated in a peer assisted teaching program for training clinical skills in paediatrics. The skills training by student peer teachers were supervised by paediatric doctors. 45 students (control group participated in a conventional paediatric skills training by paediatric doctors and consultants. Students from both groups, which were consecutively investigated, completed a questionnaire with an evaluation of the satisfaction with their practical training and a self assessment of their practical competencies. Results: The paediatric skills training with student peer teachers received significantly better ratings than the conventional skills training by paediatric doctors concerning both the quality of the practical training and the support by the teaching medical staff. Self assessed learning success in practical skills was higher rated in the peer teaching program than in the conventional training. Conclusions: The peer assisted teaching program of paediatric skills training was rated higher by the students regarding their satisfaction with the teaching quality and their self assessment of the acquired skills. Clinical skills training by student peer teachers have to be supervised

  10. Paediatric femur fractures at the emergency department: accidental or not?

    Science.gov (United States)

    Hoytema van Konijnenburg, Eva M M; Vrolijk-Bosschaart, Thekla F; Bakx, Roel; Van Rijn, Rick R

    2016-01-01

    Only a small proportion of all paediatric fractures is caused by child abuse or neglect, especially in highly prevalent long bone fractures. It can be difficult to differentiate abusive fractures from non-abusive fractures. This article focuses on femoral fractures in young children. Based on three cases, this article presents a forensic evidence-based approach to differentiate between accidental and non-accidental causes of femoral fractures. We describe three cases of young children who were presented to the emergency department because of a suspected femur fracture. Although in all cases, the fracture had a similar location and appearance, the clinical history and developmental stage of the child led to three different conclusions. In the first two cases, an accidental mechanism was a plausible conclusion, although in the second case, neglect of parental supervision was the cause for concern. In the third case, a non-accidental injury was diagnosed and appropriate legal prosecution followed. Any doctor treating children should always be aware of the possibility of child abuse and neglect in children with injuries, especially in young and non-mobile children presenting with an unknown trauma mechanism. If a suspicion of child abuse or neglect arises, a thorough diagnostic work-up should be performed, including a full skeletal survey according to the guidelines of the Royal College of Radiologists and the Royal College of Paediatrics and Child Health. In order to make a good assessment, the radiologist reviewing the skeletal survey needs access to all relevant clinical and social information. PMID:26642309

  11. Radiation dose and image quality for paediatric interventional cardiology

    Science.gov (United States)

    Vano, E.; Ubeda, C.; Leyton, F.; Miranda, P.

    2008-08-01

    Radiation dose and image quality for paediatric protocols in a biplane x-ray system used for interventional cardiology have been evaluated. Entrance surface air kerma (ESAK) and image quality using a test object and polymethyl methacrylate (PMMA) phantoms have been measured for the typical paediatric patient thicknesses (4-20 cm of PMMA). Images from fluoroscopy (low, medium and high) and cine modes have been archived in digital imaging and communications in medicine (DICOM) format. Signal-to-noise ratio (SNR), figure of merit (FOM), contrast (CO), contrast-to-noise ratio (CNR) and high contrast spatial resolution (HCSR) have been computed from the images. Data on dose transferred to the DICOM header have been used to test the values of the dosimetric display at the interventional reference point. ESAK for fluoroscopy modes ranges from 0.15 to 36.60 µGy/frame when moving from 4 to 20 cm PMMA. For cine, these values range from 2.80 to 161.10 µGy/frame. SNR, FOM, CO, CNR and HCSR are improved for high fluoroscopy and cine modes and maintained roughly constant for the different thicknesses. Cumulative dose at the interventional reference point resulted 25-45% higher than the skin dose for the vertical C-arm (depending of the phantom thickness). ESAK and numerical image quality parameters allow the verification of the proper setting of the x-ray system. Knowing the increases in dose per frame when increasing phantom thicknesses together with the image quality parameters will help cardiologists in the good management of patient dose and allow them to select the best imaging acquisition mode during clinical procedures.

  12. Radiation dose and image quality for paediatric interventional cardiology

    Energy Technology Data Exchange (ETDEWEB)

    Vano, E [Radiology Department, Medicine School, Complutense University and San Carlos University Hospital, 28040 Madrid (Spain); Ubeda, C [Clinical Sciences Department, Faculty of the Science of Health, Tarapaca University, 18 de Septiembre 2222, Arica (Chile); Leyton, F [Institute of Public Health of Chile, Marathon 1000, Nunoa, Santiago (Chile); Miranda, P [Hemodynamic Department, Cardiovascular Service, Luis Calvo Mackenna Hospital, Avenida Antonio Varas 360, Providencia, Santiago (Chile)], E-mail: eliseov@med.ucm.es

    2008-08-07

    Radiation dose and image quality for paediatric protocols in a biplane x-ray system used for interventional cardiology have been evaluated. Entrance surface air kerma (ESAK) and image quality using a test object and polymethyl methacrylate (PMMA) phantoms have been measured for the typical paediatric patient thicknesses (4-20 cm of PMMA). Images from fluoroscopy (low, medium and high) and cine modes have been archived in digital imaging and communications in medicine (DICOM) format. Signal-to-noise ratio (SNR), figure of merit (FOM), contrast (CO), contrast-to-noise ratio (CNR) and high contrast spatial resolution (HCSR) have been computed from the images. Data on dose transferred to the DICOM header have been used to test the values of the dosimetric display at the interventional reference point. ESAK for fluoroscopy modes ranges from 0.15 to 36.60 {mu}Gy/frame when moving from 4 to 20 cm PMMA. For cine, these values range from 2.80 to 161.10 {mu}Gy/frame. SNR, FOM, CO, CNR and HCSR are improved for high fluoroscopy and cine modes and maintained roughly constant for the different thicknesses. Cumulative dose at the interventional reference point resulted 25-45% higher than the skin dose for the vertical C-arm (depending of the phantom thickness). ESAK and numerical image quality parameters allow the verification of the proper setting of the x-ray system. Knowing the increases in dose per frame when increasing phantom thicknesses together with the image quality parameters will help cardiologists in the good management of patient dose and allow them to select the best imaging acquisition mode during clinical procedures.

  13. Profile of urinary tract infections in paediatric patients

    Directory of Open Access Journals (Sweden)

    Palak Gupta

    2015-01-01

    Full Text Available Background & objectives: This cross-sectional study was conducted at a tertiary care centre in Puducherry, south India, with the aim of finding the profile of the paediatric urinary tract infection (UTI, bacterial pathogens involved, and also to observe vesicoureteric reflux (VUR and renal scarring in these patients. Methods: A total of 524 paediatric patients ≤13 yr, suspected to have UTI, were included in the study. Urine samples were collected, processed for uropathogen isolation and antibiotic susceptibility test was performed as per the Clinical and Laboratory Standards Institute (CLSI guidelines. Thirty two culture proven children with UTI underwent micturating cysto-urethrography (MCU and dimercaptosuccinic acid (DMSA scanning was done for 69 children. Results: o0 f the 524 children, 186 (35.4% had culture proven UTI with 105 (56.4% being infants, 50 (27.4% between 1-5 yr, 30 (16.12% between 5-13 yr and 129 (69.35% males. Posterior urethral valve (PUV was noted in three, hydronephrosis in one, VUR in 18 and renal scarring in 33. VUR as well as renal scarring were more in males >1 yr of age. A significant association (P=0.0054 was noted with a combined sensitivity and specificity of these investigations being 83 and 90 per cent, respectively of the MCU and DMSA scans for detecting VUR. Escherichia coli was the most common pathogen isolated, sensitive to nitrofurantoin, followed by cefoperazone-sulbactam, aminoglycosides and meropenem. Interpretation & conclusions: Our results indicate that UTI varies with age and gender and extensive evaluation is required in boys under one year of age with UTI. This study also highlights the better efficacy of aminoglycosides, cefoperazone-sulbactam and nitrofurantoin in vitro compared with meropenem in Gram-negative uropathogens.

  14. ELASTIC INTRAMEDULLARY NAILING IN PAEDIATRIC DIAPHYSEAL FOREARM FRACTURES

    Directory of Open Access Journals (Sweden)

    Amit Kumar

    2016-03-01

    Full Text Available BACKGROUND The majority of paediatric diaphyseal fractures of the radius and ulna can be treated well with closed reduction and cast immobilization. The most common indications for surgery are failure of closed reduction, open fractures and fracture instability. Over recent years the forearm fractures are increasingly being treated with intramedullary elastic nails to prevent displacement during the healing phase. OBJECTIVE Recently, there has been an increased interest in determining which method provides superior results, but the optimal treatment remains controversial. This article analyses the results of 22 diaphyseal forearm fractures in children who underwent flexible intramedullary nail fixation. MATERIAL AND METHODS A prospective study was conducted from January 2012 to December 2015, on the patients with both-bone forearm fractures. Inclusion criteria of study were age between 5 and 15 years, closed displaced fractures, unacceptable closed reduction and open displaced fractures (Type 1 and 2. A single nail was used for each forearm bone. RESULTS The results of the 22 patients (16 males and 6 females who were treated in our institution with closed elastic nails were studied systematically with a follow-up period from 4 months to 15 months. At follow-up clinics, all patients went on to osseous union and regained a full range of movement after rehabilitation. There were no cases of delayed union, non-union or mal-union. All implants were routinely removed within average time of 8 months (Range: 6-10 after nailing. There were no complications after implant removal in our patients. CONCLUSION Conservative management is still the first line of treatment for paediatric forearm fractures, especially in children less than 10 years old. Treatment with an elastic intramedullary nail is indicated for unstable, irreducible or open fractures when non-operative management fails.

  15. Magnetic resonance cholangiography - feasibility and application in the paediatric population

    Energy Technology Data Exchange (ETDEWEB)

    Chan, Y.; Lam, W.W.M.; Metreweli, C. [Department of Diagnostic Radiology and Organ Imaging, Chinese University of Hong Kong, Prince of Wales Hospital, Shatin (Hong Kong); Yeung Chungkwong [Department of Surgery, Chinese University of Hong Kong, Prince of Wales Hospital, Shatin (Hong Kong); Fok Taifai [Department of Paediatrics, Chinese University of Hong Kong, Prince of Wales Hospital, Shatin (Hong Kong)

    1998-05-01

    Objective. To assess the feasibility of magnetic resonance cholangiography (MRC) in paediatrics. Materials and methods. MRC was attempted in 41 children from 1 week to 14-years. There were three groups: (1) children studied with MRI for non-biliary problems as controls; (2) infants with jaundice; and (3) older children suspected of biliary disease. The examination was successfully performed in 35 children, which included 12 children studied for non-biliary problems, 12 infants with jaundice, and 11 older children with suspected biliary disease. Results. In group 1, the entire common duct was visualised in all 12 children. In group 2, successful demonstration of the common duct was achieved in two of the ten infants with subsequent confirmation of normal bile duct patency. In the last group of patients with suspected biliary disease, MRC gave good anatomical display of six choledochal cysts but failed to demonstrate the anomalous choledochopancreatic channel. It helped to confirm the diagnosis of two cases of pancreatic head cysts, and one case of Caroli`s disease. Conclusion. MRC can be applied to the paediatric population, but its value depends on the type of problem to be evaluated. With current spatial resolution, its value in the diagnosis of biliary atresia is probably limited because it cannot reliably demonstrate the bile ducts in young infants with non-obstructive jaundice. In older children, it could provide a non-invasive anatomical display of the biliary tree and its disease. It has a potential role in addressing problematic cases encountered during ultrasonography. (orig.) With 5 figs., 1 tab., 8 refs.

  16. The establishment of local diagnostic reference levels for paediatric interventional cardiology

    International Nuclear Information System (INIS)

    Background: There is a paucity of information worldwide on radiation exposure in paediatric interventional cardiology. At present Nationally established Diagnostic Reference Levels exist for adult interventional cardiology procedures in the UK but little data is available for paediatrics. In addition, interventional cardiology has been identified as one the highest contributors to medical exposure to ionising radiation and children are more radiosensitive than adults. Objective: This study sought to determine current radiation dose levels in paediatric interventional cardiology (IC) with a view to establishing local diagnostic reference levels (LDRL). Methods: Radiation dose and examination details were recorded for 354 paediatric patients examined by IC in a specialised paediatric centre in Europe. Radiation doses were recorded using a Dose Area Product meter along with examination details. Procedures were categorised as either diagnostic (A) or therapeutic (B). Data was further sub-divided into five age ranges; (1) newborn <1 year (2) 1 <5 years (3) 5 <10 years (4) 10 <15 years (5) 15 years and over. Proposed LDRL were calculated from the mean dose area product readings. Results: The mean patient age was 2.6 years (range 0.0 days–16 years) and weight was 14.9 kg (range 2.4–112 kg). LDRL for the five age groupings were calculated as 190, 421, 582, 1289 and 1776 cGycm² respectively. Conclusion: Local dose reference levels have been proposed for paediatric IC and can be used as a benchmark for other hospitals to compare against their own radiation doses

  17. Canadian Petroleum Products Inst. annual report, 1991

    International Nuclear Information System (INIS)

    The Canadian Petroleum Products Institute (CPPI) was created in 1989 as a nonprofit association of Canadian refiners and marketers of petroleum products. In 1991, the Atlantic Petroleum Association, the Quebec Petroleum Association, the Ontario Petroleum Association, the Canada West Petroleum Association, and the Petroleum Association for Conservation of the Canadian Environment (PACE) were integrated into the CPPI. The objective of the CPPI is to serve and represent the refining and marketing sectors of the petroleum industry with respect to environment, health and safety, and business issues. An industry overview is provided, as well as highlights of environmental achievements and challenges, and economics and operations for the year. Lists of CPPI publications, standing committees, and officers are also included. 9 figs

  18. A Roadmap for Canadian Submillimetre Astronomy

    CERN Document Server

    Webb, Tracy; Di Francesco, James; Matthews, Brenda; Murray, Norm; Scott, Douglas; Wilson, Christine

    2013-01-01

    We survey the present landscape in submillimetre astronomy for Canada and describe a plan for continued engagement in observational facilities to ~2020. Building on Canada's decadal Long Range Plan process, we emphasize that continued involvement in a large, single-dish facility is crucial given Canada's substantial investment in ALMA and numerous PI-led submillimetre experiments. In particular, we recommend: i) an extension of Canadian participation in the JCMT until at least the unique JCMT Legacy Survey program is able to realize the full scientific potential provided by the world-leading SCUBA-2 instrument; and ii) involvement of the entire Canadian community in CCAT, with a large enough share in the partnership for Canadian astronomers to participate at all levels of the facility. We further recommend continued participation in ALMA development, involvement in many focused PI-led submillimetre experiments, and partnership in SPICA.

  19. Open Access Funds: A Canadian Library Survey

    Directory of Open Access Journals (Sweden)

    Leila Fernandez

    2011-07-01

    Full Text Available A survey of Canadian research libraries was conducted to determine the extent of funding support for open access publications in these institutions. Results indicate that there is substantial support for open access publishing, and a diversity of approaches is being used to fund open access resources. The reasons for funding support along with policy and promotional issues are explored. The broader implications of funding open access are discussed in the context of a changing scholarly publishing landscape. This paper will be especially relevant to Canadian academic libraries that are exploring options for funding open access publications.

  20. Women in the Canadian Economy: A Teaching Unit.

    Science.gov (United States)

    Post, Sylvia; Staunton, Ted, Ed.

    One of a series of teaching units designed to introduce secondary school students to the Canadian economy, this handbook contains activities on the economic status and roles of Canadian women. The first of 4 sections presents a profile of male and female occupations. Section 2 contains statistics on females in the Canadian labor force. Section 3,…