An Exploration of Hispanic Mothers' Culturally Sustaining Experiences at an Informal Science Center

Science.gov (United States)

Weiland, Ingrid

2015-01-01

Science education reform focuses on learner-centered instruction within contexts that support learners' sociocultural experiences. The purpose of this study was to explore Hispanic mothers' experiences as accompanying adults at an informal science center within the context of culturally sustaining experiences, which include the fluidity…

Performance of a Nomogram Predicting Disease-Specific Survival After an R0 Resection for Gastric Cancer in Patients Receiving Postoperative Chemoradiation Therapy

Energy Technology Data Exchange (ETDEWEB)

Dikken, Johan L. [Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York, New York (United States); Department of Surgery, Leiden University Medical Center, Leiden (Netherlands); Coit, Daniel G. [Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York, New York (United States); Baser, Raymond E.; Gönen, Mithat [Department of Epidemiology and Biostatistics, Memorial Sloan-Kettering Cancer Center, New York, New York (United States); Goodman, Karyn A. [Department of Radiation Oncology, Memorial Sloan-Kettering Cancer Center, New York, New York (United States); Brennan, Murray F. [Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York, New York (United States); Jansen, Edwin P.M. [Department of Radiotherapy, The Netherlands Cancer Institute–Antoni van Leeuwenhoek Hospital, Amsterdam (Netherlands); Boot, Henk [Department of Gastroenterology, The Netherlands Cancer Institute–Antoni van Leeuwenhoek Hospital, Amsterdam (Netherlands); Velde, Cornelis J.H. van de [Department of Surgery, Leiden University Medical Center, Leiden (Netherlands); Cats, Annemieke [Department of Gastroenterology, The Netherlands Cancer Institute–Antoni van Leeuwenhoek Hospital, Amsterdam (Netherlands); Verheij, Marcel, E-mail: m.verheij@nki.nl [Department of Radiotherapy, The Netherlands Cancer Institute–Antoni van Leeuwenhoek Hospital, Amsterdam (Netherlands)

2014-03-01

Purpose: The internationally validated Memorial Sloan-Kettering Cancer Center (MSKCC) gastric carcinoma nomogram was based on patients who underwent curative (R0) gastrectomy, without any other therapy. The purpose of the current study was to assess the performance of this gastric cancer nomogram in patients who received chemoradiation therapy after an R0 resection for gastric cancer. Methods and Materials: In a combined dataset of 76 patients from the Netherlands Cancer Institute (NKI), and 63 patients from MSKCC, who received postoperative chemoradiation therapy (CRT) after an R0 gastrectomy, the nomogram was validated by means of the concordance index (CI) and a calibration plot. Results: The concordance index for the nomogram was 0.64, which was lower than the CI of the nomogram for patients who received no adjuvant therapy (0.80). In the calibration plot, observed survival was approximately 20% higher than the nomogram-predicted survival for patients receiving postoperative CRT. Conclusions: The MSKCC gastric carcinoma nomogram significantly underpredicted survival for patients in the current study, suggesting an impact of postoperative CRT on survival in patients who underwent an R0 resection for gastric cancer, which has been demonstrated by randomized controlled trials. This analysis stresses the need for updating nomograms with the incorporation of multimodal strategies.

Laparoscopic isthmocele treatment - single center experience.

Science.gov (United States)

Ciebiera, Michał; Ciebiera, Magdalena; Czekańska-Rawska, Magdalena; Jakiel, Grzegorz

2017-01-01

A cesarean section is the most frequently performed surgery in modern obstetrics. In case of an incorrect wound healing process there is a risk of a persistent uterine wall defect. Nowadays, due to the high frequency of cesarean sections, obstetricians have to deal with the threat of uterine rupture due to pathological wound healing. It has been proven that isthmocele can cause abnormal uterine bleeding (AUB), pelvic pain (PP), and secondary infertility (SI), and can be a place of improper pregnancy placement. This article presents our experience with isthmocele treatment. We describe our diagnostic process scheme, method of corrective surgery and main therapeutic outcomes. In this manuscript we present a single center's experience in isthmocele therapy. We have operated on 16 patients who suffered from abnormal uterine bleeding, pain disorders or secondary infertility possibly due to a cesarean scar defect. The results obtained in our center are promising. In 9 of 11 (81.8%) women with abnormal bleeding we obtained complete resolution of symptoms. We had slightly worse results in the case of pelvic pain. In 4 (66.6%) of 6 patients the pain resolved completely. We have obtained 7 pregnancies in 11 (63.6%) patients operated on due to secondary infertility. In our opinion, laparoscopic treatment seems to be currently one of the most effective methods in isthmocele therapy. Further investigation is necessary to determine the indications for surgery, suitable treatment strategies and appropriate care.

CheckMate 025 Randomized Phase 3 Study: Outcomes by Key Baseline Factors and Prior Therapy for Nivolumab Versus Everolimus in Advanced Renal Cell Carcinoma

DEFF Research Database (Denmark)

Escudier, Bernard; Sharma, Padmanee; McDermott, David F

2017-01-01

/kg every 2 wk or everolimus 10mg once daily. RESULTS AND LIMITATIONS: The minimum follow-up was 14 mo. Baseline subgroup distributions were balanced between nivolumab and everolimus arms. Nivolumab demonstrated an OS improvement versus everolimus across subgroups, including Memorial Sloan Kettering Cancer...... Center (MSKCC) and International Metastatic Renal Cell Carcinoma Database Consortium risk groups; age

Prognostic stratification of patients with advanced renal cell carcinoma treated with sunitinib: comparison with the Memorial Sloan-Kettering prognostic factors model

International Nuclear Information System (INIS)

Bamias, Aristotelis; Anastasiou, Ioannis; Stravodimos, Kostas; Xanthakis, Ioannis; Skolarikos, Andreas; Christodoulou, Christos; Syrigos, Kostas; Papandreou, Christos; Razi, Evangelia; Dafni, Urania; Fountzilas, George; Karadimou, Alexandra; Dimopoulos, Meletios A; Lampaki, Sofia; Lainakis, George; Malettou, Lia; Timotheadou, Eleni; Papazisis, Kostas; Andreadis, Charalambos; Kontovinis, Loukas

2010-01-01

The treatment paradigm in advanced renal cell carcinoma (RCC) has changed in the recent years. Sunitinib has been established as a new standard for first-line therapy. We studied the prognostic significance of baseline characteristics and we compared the risk stratification with the established Memorial Sloan Kettering Cancer Center (MSKCC) model. This is a retrospective analysis of patients treated in six Greek Oncology Units of HECOG. Inclusion criteria were: advanced renal cell carcinoma not amenable to surgery and treatment with Sunitinib. Previous cytokine therapy but no targeted agents were allowed. Overall survival (OS) was the major end point. Significance of prognostic factors was evaluated with multivariate cox regression analysis. A model was developed to stratify patients according to risk. One hundred and nine patients were included. Median follow up has been 15.8 months and median OS 17.1 months (95% CI: 13.7-20.6). Time from diagnosis to the start of Sunitinib (<= 12 months vs. >12 months, p = 0.001), number of metastatic sites (1 vs. >1, p = 0.003) and performance status (PS) (<= 1 vs >1, p = 0.001) were independently associated with OS. Stratification in two risk groups ('low' risk: 0 or 1 risk factors; 'high' risk: 2 or 3 risk factors) resulted in distinctly different OS (median not reached [NR] vs. 10.8 [95% confidence interval (CI): 8.3-13.3], p < 0.001). The application of the MSKCC risk criteria resulted in stratification into 3 groups (low and intermediate and poor risk) with distinctly different prognosis underlying its validity. Nevertheless, MSKCC model did not show an improved prognostic performance over the model developed by this analysis. Studies on risk stratification of patients with advanced RCC treated with targeted therapies are warranted. Our results suggest that a simpler than the MSKCC model can be developed. Such models should be further validated

Experience based reliability centered maintenance

International Nuclear Information System (INIS)

Haenninen, S.; Laakso, K.

1993-03-01

The systematic analysis and documentation of operating experiences should be included in a living NPP life management program. Failure mode and effects and maintenance effects analyses are suitable methods for analysis of the failure and corrective maintenance experiences of equipment. Combined use of the information on occurred functional failures and the decision tree logic of the reliability centered maintenance identifies applicable and effective preventive maintenance tasks of equipment in an old plant. In this study the electrical motor drives of closing and isolation valves (MOV) of TVO and Loviisa nuclear power plants were selected to serve as pilot study objects. The study was limited to valve drives having actuators manufactured by AUMA in Germany. The fault and maintenance history of MOVs from 1981 up to and including October 1991 in different safety and process systems at TVO 1 and 2 nuclear power units was at first analyzed in a systematic way. The scope of the components studied was 81 MOVs in safety-related systems and 127 other MOVs per each TVO unit. In the case of the Loviisa plant, the observation period was limited to three years, i.e. from February 1989 up to February 1992. The scope of the Loviisa 1 and 2 components studied was 44 respectively 95 MOVs. (25 refs., 22 figs., 8 tabs.)

History of International Workshop on Mini-Micro- and Nano- Dosimetry (MMND) and Innovation Technologies in Radiation Oncology (ITRO)

Science.gov (United States)

Rosenfeld, Anatoly B.; Zaider, Marco; Yamada, Josh; Zelefsky, Michael J.

2017-01-01

The biannual MMND (former MMD) - IPCT workshops was founded in collaboration between the Centre for Medical Radiation Physics, University of Wollongong and the Memorial Sloan Kettering Cancer Center (MSKCC) in 2001 and has become an important international multidisciplinary forum for the discussion of advanced quality assurance (QA) dosimetry technology for radiation therapy and space science, as well as advanced technologies for clinical cancer treatment.

New roles & responsibilities of hospital biomedical engineering.

Science.gov (United States)

Frisch, P H; Stone, B; Booth, P; Lui, W

2014-01-01

Over the last decade the changing healthcare environment has required hospitals and specifically Biomedical Engineering to critically evaluate, optimize and adapt their operations. The focus is now on new technologies, changes to the environment of care, support requirements and financial constraints. Memorial Sloan Kettering Cancer Center (MSKCC), an NIH-designated comprehensive cancer center, has been transitioning to an increasing outpatient care environment. This transition is driving an increase in-patient acuity coupled with the need for added urgency of support and response time. New technologies, regulatory requirements and financial constraints have impacted operating budgets and in some cases, resulted in a reduction in staffing. Specific initiatives, such as the Joint Commission's National Patient Safety Goals, requirements for an electronic medical record, meaningful use and ICD10 have caused institutions to reevaluate their operations and processes including requiring Biomedical Engineering to manage new technologies, integrations and changes in the electromagnetic environment, while optimizing operational workflow and resource utilization. This paper addresses the new and expanding responsibilities and approach of Biomedical Engineering organizations, specifically at MSKCC. It is suggested that our experience may be a template for other organizations facing similar problems. Increasing support is necessary for Medical Software - Medical Device Data Systems in the evolving wireless environment, including RTLS and RFID. It will be necessary to evaluate the potential impact on the growing electromagnetic environment, on connectivity resulting in the need for dynamic and interactive testing and the growing demand to establish new and needed operational synergies with Information Technology operations and other operational groups within the institution, such as nursing, facilities management, central supply, and the user departments.

Ecology-Centered Experiences among Children and Adolescents: A Qualitative and Quantitative Analysis

Science.gov (United States)

Orton, Judy

2013-01-01

The present research involved two studies that considered "ecology-centered experiences" (i.e., experiences with living things) as a factor in children's environmental attitudes and behaviors and adolescents' ecological understanding. The first study (Study 1) examined how a community garden provides children in an urban setting the…

The CMS experiment workflows on StoRM based storage at Tier-1 and Tier-2 centers

International Nuclear Information System (INIS)

Bonacorsi, D; Bartolome, I Cabrillo; Matorras, F; Gonzalez Caballero, I; Sartirana, A

2010-01-01

Approaching LHC data taking, the CMS experiment is deploying, commissioning and operating the building tools of its grid-based computing infrastructure. The commissioning program includes testing, deployment and operation of various storage solutions to support the computing workflows of the experiment. Recently, some of the Tier-1 and Tier-2 centers supporting the collaboration have started to deploy StoRM based storage systems. These are POSIX-based disk storage systems on top of which StoRM implements the Storage Resource Manager (SRM) version 2 interface allowing for a standard-based access from the Grid. In this notes we briefly describe the experience so far achieved at the CNAF Tier-1 center and at the IFCA Tier-2 center.

SINGLE-CENTER EXPERIENCE OF ABO-INCOMPATIBLE LIVER TRANSPLANTATION

Directory of Open Access Journals (Sweden)

S. V. Gautier

2011-01-01

Full Text Available Since 2008 up to 2010 eight ABO-incompatible liver transplantations have been performed in our center: one of them was urgent liver transplantation to adult patient from deceased donor, other seven were transplantations of left lateral segment to children from living relative donors. Own experience, as well as world one, proves, that barrier of ABO-incompatibility can be overcome more successfully in liver transplantation, particularly in pediatric population, that in other solid organs transplantation. Good results can be achieved even with less ag- gressive immunosuppressive therapy. Recipient conditioning before operation can significantly improve results of ABO-incompatible liver transplantation, but as own experience has shown, often there’s no need to hold some special preparation of children, because their anti-ABO antibodies are very low or absent before transplantation and do not increase after it. Thereby ABO-incompatible liver transplantation is reasonable in urgent cases and in pediatric population because of the limited pull of living relative donors for children. 

NASA Glenn Research Center Solar Cell Experiment Onboard the International Space Station

Science.gov (United States)

Myers, Matthew G.; Wolford, David S.; Prokop, Norman F.; Krasowski, Michael J.; Parker, David S.; Cassidy, Justin C.; Davies , William E.; Vorreiter, Janelle O.; Piszczor, Michael F.; Mcnatt, Jeremiah S.;

Airline experience with reliability-centered maintenance

International Nuclear Information System (INIS)

Matteson, T.D.

1985-01-01

Reliability-Centered Maintenance is a process for developing preventive maintenance programs. Its concepts evolved from the post WWII experience of the airline community. Its genesis was in a paper by F. Stanley Nowlan and Thomas D. Matteson of United Airlines for the American Institute of Aeronautics and Astronautics in 1967. Its first application was to the Boeing 747. It has subsequently been adopted by the FAA and the Department of Defense and applied to many new transport and military aircraft. Its objective is applicable and effective preventive maintenance and it has proven to be a highly effective replacement for the prior intuitive processes for selective preventive maintenance tasks. It focuses on system functions, functional failures, then dominant failure modes and effects. It then uses a decision tree to classify failure criticality and identify applicable and effective tasks. The result is a program focused on maintaining inherent safety and reliability at minimum cost. (orig.)

Airline experience with reliability-centered maintenance

Energy Technology Data Exchange (ETDEWEB)

Matteson, T.D.

1985-11-01

Reliability-Centered Maintenance is a process for developing preventive maintenance programs. Its concepts evolved from the post WWII experience of the airline community. Its genesis was in a paper by F. Stanley Nowlan and Thomas D. Matteson of United Airlines for the American Institute of Aeronautics and Astronautics in 1967. Its first application was to the Boeing 747. It has subsequently been adopted by the FAA and the Department of Defense and applied to many new transport and military aircraft. Its objective is applicable and effective preventive maintenance and it has proven to be a highly effective replacement for the prior intuitive processes for selective preventive maintenance tasks. It focuses on system functions, functional failures, then dominant failure modes and effects. It then uses a decision tree to classify failure criticality and identify applicable and effective tasks. The result is a program focused on maintaining inherent safety and reliability at minimum cost. (orig.).

Assessment of the Patient-Centered and Family-Centered Care Experience of Total Joint Replacement Patients Using a Shadowing Technique.

Science.gov (United States)

Marcus-Aiyeku, Ulanda; DeBari, Margaret; Salmond, Susan

2015-01-01

In 2030, when baby boomers reach 65 years of age and represent 18% of the population, it is anticipated that 67 million adults will have a diagnosis of arthritis increasing the demand for total hip and knee arthroplasty. With the growing emphasis on patient- and family-centered care, the aim of this project was to assess the patient experience of patients and families throughout the entire spectrum of the total joint replacement service line care at a university regional trauma hospital. A shadowing methodology as defined by the Institute for Health Improvement was utilized. Eight patient/family groups undergoing total joint replacements were shadowed. The mapped care experience included time, caregiver, activity, shadower observations, and impressions. Findings revealed inconsistencies in the delivery of patient- and family-centered care. Communication and interactions were predominantly provider-centric, with a focus on care routines versus the patient and family, and anticipation that care would be medically directed.

Experience with Server Self Service Center (S3C)

International Nuclear Information System (INIS)

Sucik, Juraj; Bukowiec, Sebastian

2010-01-01

CERN has a successful experience with running Server Self Service Center (S3C) for virtual server provisioning which is based on Microsoft (registered) Virtual Server 2005. With the introduction of Windows Server 2008 and its built-in hypervisor based virtualization (Hyper-V) there are new possibilities for the expansion of the current service. This paper describes the architecture of the redesigned virtual Server Self Service based on Hyper-V which provides dynamically scalable virtualized resources on demand as needed and outlines the possible implications on the future use of virtual machines at CERN.

Experience with Server Self Service Center (S3C)

CERN Multimedia

Sucik, J

2009-01-01

CERN has a successful experience with running Server Self Service Center (S3C) for virtual server provisioning which is based on Microsoft® Virtual Server 2005. With the introduction of Windows Server 2008 and its built-in hypervisor based virtualization (Hyper-V) there are new possibilities for the expansion of the current service. This paper describes the architecture of the redesigned virtual Server Self Service based on Hyper-V which provides dynamically scalable virtualized resources on demand as needed and outlines the possible implications on the future use of virtual machines at CERN.

Patient-centered medical home transformation with payment reform: patient experience outcomes.

Science.gov (United States)

Heyworth, Leonie; Bitton, Asaf; Lipsitz, Stuart R; Schilling, Thad; Schiff, Gordon D; Bates, David W; Simon, Steven R

2014-01-01

To examine changes in patient experience across key domains of the patient-centered medical home (PCMH) following practice transformation with Lean quality improvement methodology inclusive of payment reform. Pre-intervention/post-intervention analysis of intervention with a comparison group, a quasi-experimental design. We surveyed patients following office visits at the intervention (n = 2502) and control (n = 1622) practices during the 15-month period before and 14-month period after PCMH Lean transformation (April-October 2009). We measured and compared pre-intervention and post-intervention levels of patient satisfaction and other indicators of patient-centered care. Propensity weights adjusted for potential case-mix differences in intervention and control groups; propensity-adjusted proportions accounted for physician-level clustering. More intervention patients were very satisfied with their care after the PCMH Lean intervention (68%) compared with pre-intervention (62%). Among control patients, there was no corresponding increase in satisfaction (63% very satisfied pre-intervention vs 64% very satisfied post-intervention). This comparison resulted in a statistical trend (P = .10) toward greater overall satisfaction attributable to the intervention. Post-intervention, patients in the intervention practice consistently rated indicators of patient-centered care higher than patients in the control practice, particularly in the personal physician and communication domain. In this domain, intervention patients reported superior provider explanations, time spent, provider concern, and follow-up instructions compared with control participants, whereas control group ratings fell in the post-intervention period (P for difference Lean enhancement with payment reform, patient experience was sustained or improved across key PCMH domains.

Experiments with Analytic Centers: A confluence of data, tools and help in using them.

Science.gov (United States)

Little, M. M.; Crichton, D. J.; Hines, K.; Cole, M.; Quam, B. M.

2017-12-01

Traditional repositories have been primarily focused on data stewardship. Over the past two decades, data scientists have attempted to overlay a superstructure to make these repositories more amenable to analysis tasks, with limited success. This poster will summarize lessons learned and some realizations regarding what it takes to create an analytic center. As the volume of Earth Science data grows and the sophistication of analytic tools improves, a pattern has emerged that indicates different science communities uniquely apply a selection of tools to the data to produce scientific results. Infrequently do the experiences of one group help steer other groups. How can the information technology community seed these domains with tools that conform to the thought processes and experiences of that particular science group? What types of succcessful technology infusions have occured and how does technology get adopted. AIST has been experimenting with the management of this analytic center process; this paper will summarize the results and indicate a direction for future infusion attempts.

Are drowned donors marginal donors? A single pediatric center experience.

Science.gov (United States)

Kumm, Kayla R; Galván, N Thao N; Koohmaraie, Sarah; Rana, Abbas; Kueht, Michael; Baugh, Katherine; Hao, Liu; Yoeli, Dor; Cotton, Ronald; O'Mahony, Christine A; Goss, John A

2017-09-01

Drowning, a common cause of death in the pediatric population, is a potentially large donor pool for OLT. Anecdotally, transplant centers have deemed these organs high risk over concerns for infection and graft dysfunction. We theorized drowned donor liver allografts do not portend worse outcomes and therefore should not be excluded from the donation pool. We reviewed our single-center experience of pediatric OLTs between 1988 and 2015 and identified 33 drowned donor recipients. These OLTs were matched 1:2 to head trauma donor OLTs from our center. A chart review assessed postoperative peak AST and ALT, incidence of HAT, graft and recipient survival. Recipient survival at one year between patients with drowned donor vs head trauma donor allografts was not statistically significant (94% vs 97%, P=.63). HAT incidence was 6.1% in the drowned donor group vs 7.6% in the control group (P=.78). Mean postoperative peak AST and ALT was 683 U/L and 450 U/L for drowned donors vs 1119 U/L and 828 U/L in the matched cohort. These results suggest drowned donor liver allografts do not portend worse outcomes in comparison with those procured from head trauma donors. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Treatment of nasal cavity and paranasal sinus cancer with modern radiotherapy techniques in the postoperative setting-the MSKCC experience

International Nuclear Information System (INIS)

Hoppe, Bradford S.; Stegman, Lauren D.; Zelefsky, Michael J.; Rosenzweig, Kenneth E.; Wolden, Suzanne L.; Patel, Snehal G.; Shah, Jatin P.; Kraus, Dennis H.; Lee, Nancy Y.

2007-01-01

Purpose: To perform a retrospective analysis of patients with paranasal sinus (PNS) cancer treated with postoperative radiotherapy (RT) at Memorial Sloan-Kettering Cancer Center. Methods and Materials: Between January 1987 and July 2005, 85 patients with PNS and nasal cavity cancer underwent postoperative RT. Most patients had squamous cell carcinoma (49%; n = 42), T4 tumors (52%; n = 36), and the maxillary sinus (53%; n = 45) as the primary disease site. The median radiation dose was 63 Gy. Of the 85 patients, 76 underwent CT simulation and 53 were treated with either three-dimensional conformal RT (27%; n = 23) or intensity-modulated RT (35%; n = 30). Acute and late toxicities were scored according to the Radiation Therapy Oncology Group radiation morbidity scoring criteria. Results: With a median follow-up for surviving patients of 60 months, the 5-year estimates of local progression-free, regional progression-free, distant metastasis-free, disease-free, and overall survival rates were 62%, 87%, 82%, 55%, and 67%, respectively. On multivariate analysis, squamous cell histology and cribriform plate involvement predicted for an increased likelihood of local recurrence, and squamous cell histologic features predicted for worse overall survival. None of the patients who underwent CT simulation and were treated with modern techniques developed a Grade 3-4 late complication of the eye. Conclusion: Complete surgical resection followed by adjuvant RT is an effective and safe approach in the treatment of PNS cancer. Emerging tools, such as three-dimensional conformal treatment and, in particular, intensity-modulated RT for PNS tumors, may minimize the occurrence of late complications associated with conventional RT techniques. Local recurrence remains a significant problem

Evaluation of mode equivalence of the MSKCC Bowel Function Instrument, LASA Quality of Life, and Subjective Significance Questionnaire items administered by Web, interactive voice response system (IVRS), and paper.

Science.gov (United States)

Bennett, Antonia V; Keenoy, Kathleen; Shouery, Marwan; Basch, Ethan; Temple, Larissa K

2016-05-01

To assess the equivalence of patient-reported outcome (PRO) survey responses across Web, interactive voice response system (IVRS), and paper modes of administration. Postoperative colorectal cancer patients with home Web/e-mail and phone were randomly assigned to one of the eight study groups: Groups 1-6 completed the survey via Web, IVRS, and paper, in one of the six possible orders; Groups 7-8 completed the survey twice, either by Web or by IVRS. The 20-item survey, including the MSKCC Bowel Function Instrument (BFI), the LASA Quality of Life (QOL) scale, and the Subjective Significance Questionnaire (SSQ) adapted to bowel function, was completed from home on consecutive days. Mode equivalence was assessed by comparison of mean scores across modes and intraclass correlation coefficients (ICCs) and was compared to the test-retest reliability of Web and IVRS. Of 170 patients, 157 completed at least one survey and were included in analysis. Patients had mean age 56 (SD = 11), 53% were male, 81% white, 53% colon, and 47% rectal cancer; 78% completed all assigned surveys. Mean scores for BFI total score, BFI subscale scores, LASA QOL, and adapted SSQ varied by mode by less than one-third of a score point. ICCs across mode were: BFI total score (Web-paper = 0.96, Web-IVRS = 0.97, paper-IVRS = 0.97); BFI subscales (range = 0.88-0.98); LASA QOL (Web-paper = 0.98, Web-IVRS = 0.78, paper-IVRS = 0.80); and SSQ (Web-paper = 0.92, Web-IVRS = 0.86, paper-IVRS = 0.79). Mode equivalence was demonstrated for the BFI total score, BFI subscales, LASA QOL, and adapted SSQ, supporting the use of multiple modes of PRO data capture in clinical trials.

Cyberattack analysis through Malaysian Nuclear Agency experience as nuclear research center

International Nuclear Information System (INIS)

Mohd Dzul Aiman Aslan; Mohd Fauzi Haris; Saaidi Ismail; Nurbahyah Hamdan

2011-01-01

As a nuclear research center, Nuclear Malaysia is one of the Critical National Information Infrastructure (CNII) in the country. One of the easiest way to launch a malicious attack is through the online system, whether main web site or online services. Recently, we also under port scanning and hack attempts from various sources. This paper will discuss on analysis based on Nuclear Malaysia experience regarding these attempts which keep arising nowadays. (author)

Effects of Patient-centered Medical Home Transformation on Child Patient Experience.

Science.gov (United States)

Harder, Valerie S; Krulewitz, Julianne; Jones, Craig; Wasserman, Richard C; Shaw, Judith S

2016-01-01

Patient experience, 1 of 3 aims for improving health care, is rarely included in studies of patient-centered medical home (PCMH) transformation. This study examines the association between patient experience and National Committee on Quality Assurance (NCQA) PCMH transformation. This was a cross-sectional study of parent-reported child patient experience from PCMH and non-PCMH practices. It used randomly sampled experience surveys completed by 2599 patients at 29 pediatric and family medicine PCMH (n = 21) and non-PCMH (n = 8) practices in Vermont from 2011 to 2013. Patient experiences related to child development and prevention were assessed using the Consumer Assessment of Health care Providers and Systems (CAHPS). A 10-point increase in NCQA score at PCMH practices is associated with a 3.1% higher CAHPS child prevention score (P = .004). Among pediatric practices, PCMH recognition is associated with 7.7% (P child development and prevention composite scores, respectively. Among family medicine practices, PCMH recognition is associated with 7.4% (P = .001) and 11.0% (P child development and prevention composite scores, respectively. Our results suggest that PCMH recognition may improve child patient experience at pediatric practices and worsen experience at family medicine practices. These findings warrant further investigation into the differential influence of NCQA PCMH transformation on family medicine and pediatric practices. © Copyright 2016 by the American Board of Family Medicine.

The Memorial Sloan Kettering Cancer Center Recommendations for Prostate Cancer Screening.

Science.gov (United States)

Vickers, Andrew J; Eastham, James A; Scardino, Peter T; Lilja, Hans

2016-05-01

The Memorial Sloan Kettering Cancer Center (MSKCC) recommendations on prostate cancer screening were developed in response to three limitations of previous screening guidelines: insufficient evidence base, failure to link screening with treatment, and lack of risk stratification. The objective of the recommendations is to provide a schema for prostate cancer screening that maximizes the benefits, in terms of reduction in prostate cancer-specific mortality, and minimizes the harms, in terms of overdiagnosis and overtreatment. We recommend the following schema for men choosing to be screened following informed decision-making: starting at age 45, prostate-specific antigen (PSA) without digital rectal examination. If PSA ≥ 3 ng/mL: consider prostate biopsy; if PSA ≥ 1 but decision to biopsy a man with a PSA > 3 ng/mL should be based on a variety of factors including repeat blood draw for confirmatory testing of the PSA level, digital rectal examination results, and workup for benign disease. Additional reflex tests in blood such as a free-to-total PSA ratio, the Prostate Health Index, or 4Kscore, or urinary testing of PCA3, can also be informative in some patients. The best evidence suggests that more restricted indication for prostate biopsy and a more focused approach to pursue screening in men at highest risk of lethal cancer would retain most of the mortality benefits of aggressive screening schema, while importantly reducing harms from overdetection and overtreatment. Copyright © 2016 Elsevier Inc. All rights reserved.

Organizational Processes and Patient Experiences in the Patient-centered Medical Home.

Science.gov (United States)

Aysola, Jaya; Schapira, Marilyn M; Huo, Hairong; Werner, Rachel M

2018-06-01

There is increasing emphasis on the use of patient-reported experience data to assess practice performance, particularly in the setting of patient-centered medical homes. Yet we lack understanding of what organizational processes relate to patient experiences. Examine associations between organizational processes practices adopt to become PCMH and patient experiences with care. We analyzed visit data from patients (n=8356) at adult primary care practices (n=22) in a large health system. We evaluated the associations between practice organizational processes and patient experience using generalized estimating equations (GEE) with an exchangeable correlation structure to account for patient clustering by practice in multivariate models, adjusting for several practice-level and patient-level characteristics. We evaluated if these associations varied by race/ethnicity, insurance type, and the degree of patient comorbidity MEASURES:: Predictors include overall PCMH adoption and adoption of six organizational processes: access and communications, patient tracking and registry, care management, test referral tracking, quality improvement and external coordination. Primary outcome was overall patient experience. In our full sample, overall PCMH adoption score was not significantly associated with patient experience outcomes. However, among subpopulations with higher comorbidities, the overall PCMH adoption score was positively associated with overall patient experience measures [0.2 (0.06, 0.4); P=0.006]. Differences by race/ethnicity and insurance type in associations between specific organizational processes and patient experience were noted. Although some organizational processes relate to patients' experiences with care irrespective of the background of the patient, further efforts are needed to align practice efforts with patient experience.

Advanced Life Support Project: Crop Experiments at Kennedy Space Center

Science.gov (United States)

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

2004-01-01

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

Transcriptional diversity of long-term glioblastoma survivors.

Science.gov (United States)

Gerber, Naamit K; Goenka, Anuj; Turcan, Sevin; Reyngold, Marsha; Makarov, Vladimir; Kannan, Kasthuri; Beal, Kathryn; Omuro, Antonio; Yamada, Yoshiya; Gutin, Phillip; Brennan, Cameron W; Huse, Jason T; Chan, Timothy A

2014-09-01

Glioblastoma (GBM) is a highly aggressive type of glioma with poor prognosis. However, a small number of patients live much longer than the median survival. A better understanding of these long-term survivors (LTSs) may provide important insight into the biology of GBM. We identified 7 patients with GBM, treated at Memorial Sloan-Kettering Cancer Center (MSKCC), with survival >48 months. We characterized the transcriptome of each patient and determined rates of MGMT promoter methylation and IDH1 and IDH2 mutational status. We identified LTSs in 2 independent cohorts (The Cancer Genome Atlas [TCGA] and NCI Repository for Molecular Brain Neoplasia Data [REMBRANDT]) and analyzed the transcriptomal characteristics of these LTSs. The median overall survival of our cohort was 62.5 months. LTSs were distributed between the proneural (n = 2), neural (n = 2), classical (n = 2), and mesenchymal (n = 1) subtypes. Similarly, LTS in the TCGA and REMBRANDT cohorts demonstrated diverse transcriptomal subclassification identities. The majority of the MSKCC LTSs (71%) were found to have methylation of the MGMT promoter. None of the patients had an IDH1 or IDH2 mutation, and IDH mutation occurred in a minority of the TCGA LTSs as well. A set of 60 genes was found to be differentially expressed in the MSKCC and TCGA LTSs. While IDH mutant proneural tumors impart a better prognosis in the short-term, survival beyond 4 years does not require IDH mutation and is not dictated by a single transcriptional subclass. In contrast, MGMT methylation continues to have strong prognostic value for survival beyond 4 years. These findings have substantial impact for understanding GBM biology and progression. © The Author(s) 2014. Published by Oxford University Press on behalf of the Society for Neuro-Oncology. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Leaders' Experiences with High School-College Writing Center Collaborations: A Qualitative Multiple-Case Study

Science.gov (United States)

Story, Julie A.

2014-01-01

The purpose of this qualitative multiple-case study was to explore academic leaders' experiences with the organizational elements of their own high school-college writing center collaborations. Conjoining theories framed this study: collaborative leadership theory, Kenneth Bruffee's notion of social constructionism and collaborative learning…

Health professionals’ experiences of person-centered collaboration in mental health care

Directory of Open Access Journals (Sweden)

Rita Sommerseth

2008-10-01

Full Text Available Rita Sommerseth, Elin DysvikUniversity of Stavanger, Faculty of Social Sciences, Department of Health Studies, Stavanger, NorwayObjective: The basic aim in this paper is to discuss health care professionals’ experiences of person-centered collaboration and involvement in mental health rehabilitation and suggest ways of improving this perspective. Furthermore, the paper explains the supportive systems that are at work throughout the process of rehabilitation.Method: The study design is a qualitative approach using three focus group interviews with a total of 17 informants with different professional backgrounds such as nurses, social workers, and social pedagogies. In addition, one nurse and one social worker participated in a semistructured in-depth interview to judge validity.Results: Our results may demonstrate deficits concerning mental health care on several levels. This understanding suggests firstly, that a person-centered perspective and involvement still are uncommon. Secondly, multidisciplinary work seems uncommon and only sporadically follows recommendations. Thirdly, family support is seldom involved. Lastly, firm leadership and knowledge about laws and regulations seems not to be systematically integrated in daily care.Conclusion: Taking these matters together, the improvement of a person-centered perspective implies cooperation between different services and levels in mental health care. In order to bring about improvement the health care workers must critically consider their own culture, coordination of competence must be increased, and leadership at an institutional and organizational level must be improved so that scarce rehabilitation resources are used to the optimal benefit of people with a mental illness.Keywords: multidisciplinary teams, person-centered collaboration, supportive systems, rehabilitation

Adrenal trauma: Elvis Presley Memorial Trauma Center experience.

Science.gov (United States)

Mehrazin, Reza; Derweesh, Ithaar H; Kincade, Matthew C; Thomas, Adam C; Gold, Robert; Wake, Robert W

2007-11-01

Adrenal gland injury is a potentially devastating event if unrecognized in the treatment course of a trauma patient. We reviewed our single-center experience and outcomes in patients with adrenal gland trauma. We performed a retrospective review of all patients presenting with trauma to the Regional Medical Center at Memphis who had adrenal gland injuries from January 1991 through March 2006. Each chart was reviewed with attention to the demographics, associated injuries, complications, and outcomes. Patients were stratified into two subgroups according to age (35 years or younger and older than 35 years) to allow for an age-based comparison between the two groups. Of 58,000 patients presenting with trauma, 130 (0.22%) were identified with adrenal injuries, of which 8 (6.2%) were isolated and 122 (93.8%) were not. Of these 130 patients, 125 (96.2%) had their injury diagnosed by computed tomography and 5 (3.8%) had their injury diagnosed during exploratory laparotomy. Right-sided injuries predominated (78.5%), with six (4.6%) bilateral. Four patients (3.1%) underwent adrenalectomy. Seven patients (5.4%) with adrenal injuries died. One patient (0.77%) required chronic steroid therapy. Patients older than 35 years were more likely to have complications such as deep venous thrombosis, pneumonia, and urinary tract infections. Patient age of 35 years or younger was associated with a significantly increased incidence of liver lacerations. Adrenal gland injury is uncommon, although mostly associated with greater injury severity. Although adding to morbidity, most are self-limited and do not require intervention.

Differentiated thyroid cancer: reclassification of the risk of recurrence based on the response to initial treatment; Carcinoma diferenciado de tiroides: reclasificación del riesgo de recurrencia según la respuesta al tratamiento inicial

Energy Technology Data Exchange (ETDEWEB)

Martínez, M. P.; Lozano Bullrich, M. P.; Rey, M.; Ridruejo, M. C.; Bomarito, M. J.; Claus Hermberg, H.; Pozzo, M.J., E-mail: mpazmartinez@yahoo.com [Hospital Alemán, Servicio de Endocrinología, Buenos Aires (Argentina)

2014-07-01

Introduction: differentiated thyroid cancer (DTC) is the most frequent endocrine tumor generally showing a favourable outcome. The American Thyroid Association (ATA) classification system is not only useful to assess the risk of recurrence but also guides tumor follow-up. However, this system shows a static image of the patient at the beginning of treatment based on clinical and pathological features, and it has not been designed to be modified along the clinical course of disease. Therefore, the Memorial Sloan-Kettering Cancer Center (MS-KCC) has designed a reclassification system after 2 years of the initial treatment (IT) thus providing a dynamic perspective of each patient. Objective: to report our experience with the MS-KCC risk of recurrence reclassification system on DTC patients. Materials and methods: retrospective observational descriptive study of the results of the reclassification system of the DCT patients after two years of IT with surgery and radioiodine ablation, between October 2004 and April 2011. Data was obtained by reviewing the charts of patients. All surgeries, laboratory determinations and nuclear medicine procedures took place at our Hospital. Patients were classified according to initial risk of recurrence based on the ATA system and they were reclassified following the system proposed by the MS-KCC 2 years after IT. Patients with antithyroglobulin antibodies > 12 IU/ml were excluded due to interference with thyroglobulin determination. Results: we reviewed data of 31 patients diagnosed with DTC. They were classified according to the ATA system as: low risk 17 (54.8 %), intermediate risk 13 (42 %) and high risk 1 (3.2 %) and they were reclassified following the MS-KCC system as having: excellent response 25 (80.6 %), acceptable response 6 (19.4 %) and incomplete response 0 (0 %). An excellent response was observed in 14 (82.4 %) and an acceptable response was observed in 3 (17.6 %) of the low-risk classified patients; an excellent

Contemporary Parenteral Antiplatelet Bridging Strategies: A Single-Center Real-World Experience at a Tertiary Care Center.

Science.gov (United States)

Stern, Gretchen; Rimsans, Jessica; Qamar, Arman; Vaduganathan, Muthiah; Bhatt, Deepak L

2018-03-13

Oral antiplatelet therapy may require interruption soon after percutaneous coronary intervention (PCI) or acute coronary syndrome. The optimal parenteral antiplatelet bridge strategy with glycoprotein IIb/IIIa inhibitors or cangrelor, a P2Y12 inhibitor, is unclear. We explore real-world use of cangrelor or eptifibatide for antiplatelet bridging at a large tertiary-care center. Thirty-one patients (9 eptifibatide, 20 cangrelor, and 2 both) received bridge therapy from October 2015 to June 2017. Primary bridge therapy indications included surgery (68%), limited enteral access/absorption (16%), and high-perceived bleed risk (16%). Median duration of bridge therapy was 61 (20-100) hours for cangrelor and 83 (19-98) hours for eptifibatide. Severe/life-threatening bleeding or stent thrombosis was not observed. GUSTO-defined bleeding occurred in 30% (cangrelor) and 27% (eptifibatide). Initial dosing errors occurred in 23% of patients. Death during hospitalization occurred in 16% of patients. Parenteral antiplatelet bridging was used for ~3 days in this single-center, tertiary care experience, commonly for unplanned surgery following PCI. Despite high-risk presentations with >15% in-hospital mortality, efficacy profiles were reassuring with no identified stent thrombosis, but bleeding and dosing errors were common. Antiplatelet bridging should only be used in well-selected patients at the appropriate dose for the minimal necessary duration.

A Qualitative Study of Information Technology Managers' Experiences and Perceptions Regarding Outsourced Data Centers

Science.gov (United States)

Reid, Eric Justin

2015-01-01

This qualitative study explored the perceptions and experiences of IT Managers in publicly traded companies within the San Antonio, Texas area about outsourced data centers. Narrative data was collected using open-ended questions and face-to-face interviews within semi-structured environments. The research questions guided the study: (1)…

Single-center experience in double kidney transplantation.

Science.gov (United States)

Fontana, I; Magoni Rossi, A; Gasloli, G; Santori, G; Giannone, A; Bertocchi, M; Piaggio, F; Bocci, E; Valente, Umberto

2010-05-01

Use of organs from marginal donors for transplantation is a current strategy to expand the organ donor pool. Its efficacy is universally accepted among data from multicenter studies. Herein, we have reviewed outcomes of double kidney transplantation (DKT) over an 9-year experience in our center. The aim of this study was to evaluate possible important differences between a monocenter versus multicenter studies. Between 1999 and 2008, we performed 59 DKT. Recipient mean age was 63 +/- 5 years. Mean HLA-A, -B, and -DR mismatches were 3.69 +/- 0.922. Donor mean age was 69 +/- 7 years and mean creatinine clearance was 69.8 +/- 30.8 mL/min. Proteinuria was detected in three donors (5%). Mean cold ischemia and warm ischemia times were 1130 +/- 216 and 48 +/- 11 minutes, respectively. The right and left kidney scores were 4.18 +/- 2 and 4.21 +/- 2, respectively. Thirty patients (51%) displayed good postoperative renal function; 22 (37%), acute tubular necrosis with postoperative dialysis; 3 (5%), acute rejection episodes; 4 (7%), single-graft transplantectomy due to vascular thrombosis; 1 (2%), a retransplantation; 5 (8%), a lymphocele; 3 (5%) vescicoureteral reflux or stenosis requiring surgical correction. Cytomegalovirus infection was detected in five patients (8%). In three patients (5%) displayed de novo neoplasia. Three patients showed chronic rejection (5%), whereas we observed a cyclosporine-related toxicity in 7 (12%). Nine patients (15%) developed iatrogenic diabetes. Patient and graft survivals after 3 years from DKT were 93% and 86.3%, respectively. In this study, we applied successfully a widespread score to allocate organs to single kidney transplantation or DKT. In our experience, the score is suitable for the organ allocation but it may be overprotective, excluding potentially suitable organs for a single transplantation. Copyright (c) 2010 Elsevier Inc. All rights reserved.

Implementation of laparoscopic approach in colorectal surgery - a single center's experience.

Science.gov (United States)

Kwiatkowski, Andrzej P; Stępińska, Gabriela; Stanowski, Edward; Paśnik, Krzysztof

2018-03-01

Implementation of the laparoscopic approach in colorectal surgery has not happened as rapidly as in cholecystectomy, because of concerns about oncological safety. The results of controlled trials in multiple centers showed the method to be safe. Consequently, surgeons decided to try the approach with colorectal surgery. This process, in our clinic, began in earnest about four years ago. To analyze and present the clinical outcomes of applying the laparoscopic approach to colorectal surgery in a single center. We retrospectively identified patients from a hospital database who underwent colorectal surgery - laparoscopic and open - between 2013 and 2016. Our focus was on laparoscopic cases. Study points included operative time, duration of the hospital stay, postoperative mortality and rates of complications, conversion, reoperation and readmission. Of 534 cases considered, the results showed that the relation between open and laparoscopic procedures had reversed, in favor of the latter method (2013: open: 82% vs. laparoscopic: 18%; 2016: open: 22.4% vs. laparoscopic: 77.6%). The most commonly performed procedure was right hemicolectomy. The total complication rate was 22%. The total rate of conversion to open surgery was 9.3%. The postoperative mortality rate was 3%. Use of the laparoscopic approach in colorectal surgery has increased in recent years world-wide - including in Poland - but the technique is still underused. Rapid implementation of the miniinvasive method in colorectal surgery, in centers with previous laparoscopic experience, is not only safe and feasible, but also highly recommended.

[Management of Grave's disease in the tropics (experience at Bouffard Army Hospital Center in Djibouti].

Science.gov (United States)

Coulet, O; Kraemer, P; Leyral, G; Cloatre, G

2004-01-01

Based on their experience in managing Grave's disease at the Bouffard Army Hospital Center within the local health care context in Djibouti, the authors advocate surgery as the first line treatment. Medical and economical factors supporting this preference are discussed so that readers can adapt them to his own local context.

[Merkel cell carcinoma experience in a reference medical center.

Science.gov (United States)

Roesch-Dietlen, Federico; Devezé-Bocardi, Raúl; Ruiz-Juárez, Isabel; Grube-Pagola, Peter; Romero-Sierra, Graciela; Remes-Troche, José María; Silva-Cañetas, Carmen Sofía; Lozoya-López Escalera, Hilda

2013-01-01

Background: Merkel cell carcinoma is a rare tumor that occurs on areas exposed to ultraviolet light. It is usually asymptomatic and it is diagnosed late often. The treatment is surgical, associated with adjuvant radiotherapy. The objective was to present the experience in the management of Merkel cell carcinoma in a reference medical center. Methods: all patients with Merkel cell carcinoma treated at the Instituto de Investigaciones Médico-Biológicas of the Universidad Veracruzana during the period 2008 to 2011 were studied. Sex, age, evolution time, tumor localization, size, metastases and treatment were analyzed. Results: of 3217 patients treated, three cases were Merkel cell carcinoma (0.09 %), their age was 52.1 ± 14.17, male predominance of 66.67 %; the evolution time was of 29.66 ± 35.36 months; the tumour localization was on inguinal region, anterior chest and left arm; the noodle size was of 6.0 ± 5.19 cm; two patients had lymph node metastases. In two cases, resection and lymphadenectomy were performed. They all received radiation therapy and chemotherapy in one case. Histologically the medium variant predominated; immunohistochemistry was positive in the three cases. One patient died ten months after the study was done. Conclusions: our experience is similar with others authors, Merkel cell carcinoma is a rare tumor, usually diagnosed late, and it has poor survival.

Some Aspects of Crystal Centering During X-ray High-throughput Protein Crystallography Experiment

Science.gov (United States)

Gaponov, Yu. A.; Matsugaki, N.; Sasajima, K.; Igarashi, N.; Wakatsuki, S.

A set of algorithms and procedures of a crystal loop centering during X-ray high-throughput protein crystallography experiment has been designed and developed. A simple algorithm of the crystal loop detection and preliminary recognition has been designed and developed. The crystal loop detection algorithm is based on finding out the crystal loop ending point (opposite to the crystal loop pin) using image cross section (digital image column) profile analysis. The crystal loop preliminary recognition procedure is based on finding out the crystal loop sizes and position using image cross section profile analysis. The crystal loop fine recognition procedure based on Hooke-Jeeves pattern search method with an ellipse as a fitting pattern has been designed and developed. The procedure of restoring missing coordinate of the crystal loop is described. Based on developed algorithms and procedures the optimal auto-centering procedure has been designed and developed. A procedure of optimal manual crystal centering (Two Clicks Procedure) has been designed and developed. Developed procedures have been integrated into control software system PCCS installed at crystallography beamlines Photon Factory BL5A and PF-AR NW12, KEK.

WORRIES OF THE CANCER PATIENTS: THE EXPERIENCE OF THE EDUCATION CENTER OF THE INSTITUTO NACIONAL DE CANCEROLOGIA

OpenAIRE

Contreras-Cruz Ana Cecilia; Castro-Camargo Gladys Juliette; Puerto-Jiménez Devi Nereira

2015-01-01

Introduction: to know the characteristics and worries of the cancer patients allows imparting an adequate attention to their needs in order to answer the experience of living with cancer. Objective: to identify the main worries of the cancer patients expressed to contact the center. Methods: selection for one year of cancer patients who attended to the education center for the patients and their families of the Instituto Nacional de Cancerología (INC). Field diaries were ...

CCSDS telemetry systems experience at the Goddard Space Flight Center

Science.gov (United States)

Carper, Richard D.; Stallings, William H., III

1990-01-01

NASA Goddard Space Flight Center (GSFC) designs, builds, manages, and operates science and applications spacecraft in near-earth orbit, and provides data capture, data processing, and flight control services for these spacecraft. In addition, GSFC has the responsibility of providing space-ground and ground-ground communications for near-earth orbiting spacecraft, including those of the manned spaceflight programs. The goal of reducing both the developmental and operating costs of the end-to-end information system has led the GSFC to support and participate in the standardization activities of the Consultative Committee for Space Data Systems (CCSDS), including those for packet telemetry. The environment in which such systems function is described, and the GSFC experience with CCSDS packet telemetry in the context of the Gamma-Ray Observatory project is discussed.

High School Students' Experiences of Bullying and Victimization and the Association with School Health Center Use

Science.gov (United States)

Lewis, Catherine; Deardorff, Julianna; Lahiff, Maureen; Soleimanpour, Samira; Sakashita, Kimi; Brindis, Claire D.

2015-01-01

Background: Bullying and victimization are ongoing concerns in schools. School health centers (SHCs) are well situated to support affected students because they provide crisis intervention, mental health care, and broader interventions to improve school climate. This study examined the association between urban adolescents' experiences of…

The Renewal Center: Time, Experience, Memory

OpenAIRE

Tennant, Mark

2005-01-01

Time, Experience, Memory Through experience we are conscious of time. Through time, our experiences become memories, influencing both conscious and unconscious thought. It is through our five senses; touch, sight, hearing, smell and taste, that these experiences are gathered. Humans are also born with inherent knowledge that our species has collected from generation to generation. This inherent knowledge, also called the collective unconscious, has a direct effect on the way we perce...

Preclinical students’ experiences in early clerkships after skills training partly offered in primary health care centers: a qualitative study from Indonesia

Science.gov (United States)

2012-01-01

Background Students may encounter difficulties when they have to apply clinical skills trained in their pre-clinical studies in clerkships. Early clinical exposure in the pre-clinical phase has been recommended to reduce these transition problems. The aim of this study is to explore differences in students' experiences during the first clerkships between students exclusively trained in a skills laboratory and peers for whom part of their skills training was substituted by early clinical experiences (ECE). Methods Thirty pre-clinical students trained clinical skills exclusively in a skills laboratory; 30 peers received part of their skills training in PHC centers. Within half a year after commencing their clerkships all 60 students shared their experiences in focus group discussions (FGDs). Verbatim transcripts of FGDs were analyzed using Atlas-Ti software. Results Clerkship students who had participated in ECE in PHC centers felt better prepared to perform their clinical skills during the first clerkships than peers who had only practiced in a skills laboratory. ECE in PHC centers impacted positively in particular on students’ confidence, clinical reasoning, and interpersonal communication. Conclusion In the Indonesian setting ECE in PHC centers reduce difficulties commonly encountered by medical students in the first clerkships. PMID:22640419

Nuclear medicine: the Philippine Heart Center experience

International Nuclear Information System (INIS)

Cancino, E.L.

1994-01-01

The following is a report of a three (3) months on-the-job training in Nuclear Medicine at the Nuclear Medicine Department of the Philippine Heart Center. The hospital has current generation nuclear medicine instruments with data processor and is capable of a full range of in vivo and in vitro procedures. Gamma camera is the principal instrument for imaging in nuclear medicine used in the Philippine Heart Center. Thyroid scanning procedure is being performed with these instruments. Also the cardiovascular procedures, the pulmonary, skeletal, renal and hepatobiliary procedures were being performed with the use of gamma camera. Special emphasis is on nuclear cardiology since the PHC attends primarily to cardiovascular patients. (auth.)

U.S. Experience and practices associated with the use of centralized rad waste processing centers

International Nuclear Information System (INIS)

Gibson, James D.

1994-01-01

This paper presents the experience and current practices employed within the United States (US) associated with the use of Centralized Rad waste Processing Centers for the processing of Low Level Radioactive Wastes (LLRW). Information is provided on the methods, technologies, and practices employed by Scientific Ecology Group, Inc. (SEG), which is the worlds largest processor of LLRW. SEG processes over 80,000 cubic meters of waste annually and achieves an overall volume reduction of 12 : 1. LLRW processing in the United States is currently performed primarily at Centralized Rad waste Processing Centers, such as SEG's Central Volume Reduction Facility (CVRF) in Oak Ridge, Tennessee. This is primarily due to the superior economical application of advanced waste processing technologies, equipment, and personnel maintained at these centers. Information is provided on how SEG uses supercompaction, incineration, metals recycling, vitrification, and various other waste processing techniques to process both dry and wet wastes from over 90 commercial nuclear power plants, government operated facilities, hospitals, universities, and various small generators of radioactive waste

National Spherical Torus Experiment (NSTX) Center Stack Upgrade

International Nuclear Information System (INIS)

Neumeyer, C.; Avasarala, S.; Chrzanowski, J.; Dudek, L.; Fan, H.; Hatcher, H.; Heitzenroeder, P.; Menard, J.; Ono, M.; Ramakrishnan, S.; Titus, P.; Woolley, R.; Zhan, H.

2009-01-01

The purpose of the NSTX Center Stack Upgrade project is to expand the NSTX operational space and thereby the physics basis for next-step ST facilities. The plasma aspect ratio (ratio of plasma major to minor radius) of the upgrade is increased to 1.5 from the original value of 1.26, which increases the cross sectional area of the center stack by a factor of ∼ 3 and makes possible higher levels of performance and pulse duration.

Patient experience in a coordinated care model featuring diabetes self-management education integrated into the patient-centered medical home.

Science.gov (United States)

Janiszewski, Debra; O'Brian, Catherine A; Lipman, Ruth D

2015-08-01

The purpose of this study is to gain insight about patient experience of diabetes self-management education in a patient-centered medical home. Six focus groups consisting of 37 people with diabetes, diverse in race and ethnicity, were conducted at 3 sites. Participants described their experience in the program and their challenges in diabetes self-management; they also suggested services to meet their diabetes care needs. The most common theme was ongoing concerns about care and support. There was much discussion about the value of the support provided by health navigators integrated in the diabetes health care team. Frequent concerns expressed by participants centered on personal challenges in engaging in healthy lifestyle behaviors. Ongoing programmatic support of self-management goals was widely valued. Individuals who received health care in a patient-centered medical home and could participate in diabetes self-management education with integrated support valued both activities. The qualitative results from this study suggest need for more formalized exploration of effective means to meet the ongoing support needs of people with diabetes. © 2015 The Author(s).

PTSD: National Center for PTSD

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Full Text Available ... Centers Regional Benefits Offices Regional Loan Centers Cemetery Locations Get help from Veterans Crisis Line Search Enter ... Experience (TEE) Tournament Wheelchair Games Winter Sports Clinic Locations Hospitals & Clinics Vet Centers Regional Benefits Offices Regional ...

[Auto-dialysis: an 11-year experience of a hemodialysis center in France].

Science.gov (United States)

Montagnac, R; Schillinger, F

1996-03-30

Report 11 years of experience with self-managed hemodialysis in patients medically apt for extra-hospital dialysis and living close enough to small outpatient hemodialysis units to become totally self-sufficient. Among the 276 patients with chronic renal failure managed at the hemodialysis center at the Troyes hospital during the 11-year study period from 1984 through 1994, self-managed hemodialysis at small outpatient units was initiated in 127 (46%). None of these 127 patients required medical assistance or specific care during dialysis sessions. At initial hospital admission, only 60/127 (47%) were totally self-sufficient: 52 (41%) were later graft recipients; and 21 (16.5%) had to return to the hospital for a medical or surgical condition incompatible with extra-hospital care but all of these 21 patients remained self-sufficient. Extra-hospital hemodialysis in units close to the patients residence offers patients a better quality of life, even when medical assistance is required. All patients who require hemodialysis can thus be treated at lower cost without compromising quality of treatment. Perfect self-sufficiency may not be a goal in itself, but self-managed hemodialysis can be a very useful technique for patients without major medical problems. Continuing contact with the organizing hemodialysis center guarantees the safety of the system.

Bituminization of radioactive wastes at the Nuclear Research Center Karlsruhe. Experience from plant operation and development work

Energy Technology Data Exchange (ETDEWEB)

Hild, W; Kluger, W; Krause, H

1976-05-01

A summary is given of the main operational experience gained at the Nuclear Research Center Karlsruhe in 4 years operation of the bituminization plant for evaporator concentrates from low- and medium level wastes. At the same time some of the essential results are compiled that have been obtained in the R + D activities on bituminization.

Moving from reclusion to partial freedom: the experience of family caregivers for disabled elderly persons assisted in a day care center.

Science.gov (United States)

Bocchi, Silvia Cristina Mangini; Cano, Karen Cristina Urtado; Baltieri, Lilian; Godoy, Daniele Cristina; Spiri, Wilza Carla; Juliani, Carmen Maria Casquel Monti

2010-09-01

This study aimed at understanding the interactional experience between family caregivers and disabled elderly persons supported in a Day Care Center according to the caregiver's perspective. It also aimed at developing a representative theoretical model for the events experienced by such caregiver. The Grounded Theory was used as methodological framework whereas Interactional Symbolism served as the theoretical framework. Observation and interviews were used for data collection. The following phenomenon arose from the results: feeling of support by the Day Care Center, by the strength of the bond with the elderly and by spirituality in order to continue playing the challenging role of a family caregiver for a disabled elderly person. The study made possible to understand that, among these three supporting cornerstones for coping with the burden generated by the family caregiver role, the care model promoted by the Day Care Center was the intervenient variable in the process of improving the quality of life of the family caregiver-disabled elderly person binomial. This allowed the identification of the main category--moving from reclusion to partial freedom: the experience of family caregivers for disabled elderly persons assisted in a Day Care Center.

Further Analyses of the NASA Glenn Research Center Solar Cell and Photovoltaic Materials Experiment Onboard the International Space Station

Science.gov (United States)

Myers, Matthew G.; Prokop, Norman F.; Krasowski, Michael J.; Piszczor, Michael F.; McNatt, Jeremiah S.

2016-01-01

Accurate air mass zero (AM0) measurement is essential for the evaluation of new photovoltaic (PV) technology for space solar cells. The NASA Glenn Research Center (GRC) has flown an experiment designed to measure the electrical performance of several solar cells onboard NASA Goddard Space Flight Center's (GSFC) Robotic Refueling Mission's (RRM) Task Board 4 (TB4) on the exterior of the International Space Station (ISS). Four industry and government partners provided advanced PV devices for measurement and orbital environment testing. The experiment was positioned on the exterior of the station for approximately eight months, and was completely self-contained, providing its own power and internal data storage. Several new cell technologies including four-junction (4J) Inverted Metamorphic Multi-Junction (IMM) cells were evaluated and the results will be compared to ground-based measurement methods.

The International Experience of the State Support for Creating the Transport and Logistics Centers

Directory of Open Access Journals (Sweden)

Zharska Iryna O.

2017-02-01

Full Text Available The article is aimed at analysis and synthesis of the international experience as to the State support for creating the transport and logistics centers (TLCs. The causes for emergence of the first TLCs in Europe (60-80-ies of XX century were considered. Values of the LPI index for the countries occupying the first 40 positions of the ranking as of 2014 and of 2016 have been provided, and the major changes during this time have been analyzed. The ranking position of Ukraine is displayed separately. Features of the logistics infrastructure of nine countries with a high value of the LPI index have been considered, degree of the State involvement in the formation of the TLC network has been analyzed. It has been substantiated that creation of the transport and logistics centers allows to reduce the logistics costs of individual producers and contributes to enhancing the efficiency of operation of the national economy in general by attracting investments in the infrastructure development, increasing the number of jobs and tax revenues. The basic motifs that determine the interest of the State authorities in providing support for creating the transportation and logistics centers have been defined. Prospect for further research in this direction will be determining the efficiency of using the different models of the State support for creation and development of TLCs

Increasing Counseling Center Utilization: Yeshiva University's Experience

Science.gov (United States)

Schwartz, Victor; Nissel, Chaim; Eisenberg, Daniel; Kay, Jerald; Brown, Joshua T.

2012-01-01

Yeshiva University established a counseling center during the 2004-2005 academic year. As a religiously based institution, the administration recognized that there would likely be significant impediments to utilization of on-campus mental health services as a result of negative attitudes about mental illness and its treatment--stigma. To combat…

Mycophenolate mofetil in pediatric renal transplantation: A single center experience.

LENUS (Irish Health Repository)

Raheem, Omer A

2011-05-01

Raheem OA, Kamel MH, Daly PJ, Mohan P, Little DM, Awan A, Hickey DP. Mycophenolate mofetil in pediatric renal transplantation: A single center experience. Pediatr Transplantation 2011: 15:240-244. © 2009 John Wiley & Sons A\\/S. Abstract:  We assessed our long-term experience with regards to the safety and efficacy of MMF in our pediatric renal transplant population and compared it retrospectively to our previous non-MMF immunosuppressive regimen. Forty-seven pediatric renal transplants received MMF as part of their immunosuppressive protocol in the period from January 1997 till October 2006 (MMF group). A previously reported non-MMF group of 59 pediatric renal transplants was included for comparative analysis (non-MMF group). The MMF group comprised 29 boys and 18 girls, whereas the non-MMF group comprised 34 boys and 25 girls. Mean age was 11.7 and 12 yr in the MMF and non-MMF groups, respectively. The incidence of acute rejection episodes was 11 (23.4%) and 14 (24%) in the MMF and non-MMF group, respectively. Two (3.3%) grafts were lost in the non-MMF group compared with one (2.1%) in the MMF group. Twenty-one (44.68%) patients in the MMF group developed post-transplant infections compared with 12 (20.33%) in the non-MMF group (p < 0.0001). In conclusion, the use of MMF in pediatric renal transplantation was not associated with a lower rejection rate or immunological graft loss. It did, however, result in a significantly higher rate of viral infections.

Electronic patient self-assessment and management (SAM): a novel framework for cancer survivorship.

Science.gov (United States)

Vickers, Andrew J; Salz, Talya; Basch, Ethan; Cooperberg, Matthew R; Carroll, Peter R; Tighe, Foss; Eastham, James; Rosen, Raymond C

2010-06-17

We propose a novel framework for management of cancer survivorship: electronic patient Self-Assessment and Management (SAM). SAM is a framework for transfer of information to and from patients in such a way as to increase both the patient's and the health care provider's understanding of the patient's progress, and to help ensure that patient care follows best practice. Patients who participate in the SAM system are contacted by email at regular intervals and asked to complete validated questionnaires online. Patient responses on these questionnaires are then analyzed in order to provide patients with real-time, online information about their progress and to provide them with tailored and standardized medical advice. Patient-level data from the questionnaires are ported in real time to the patient's health care provider to be uploaded to clinic notes. An initial version of SAM has been developed at Memorial Sloan-Kettering Cancer Center (MSKCC) and the University of California, San Francisco (UCSF) for aiding the clinical management of patients after surgery for prostate cancer. Pilot testing at MSKCC and UCSF suggests that implementation of SAM systems are feasible, with no major problems with compliance (> 70% response rate) or security. SAM is a conceptually simple framework for passing information to and from patients in such a way as to increase both the patient's and the health care provider's understanding of the patient's progress, and to help ensure that patient care follows best practice.

Electronic patient self-assessment and management (SAM: a novel framework for cancer survivorship

Directory of Open Access Journals (Sweden)

Tighe Foss

2010-06-01

Full Text Available Abstract Background We propose a novel framework for management of cancer survivorship: electronic patient Self-Assessment and Management (SAM. SAM is a framework for transfer of information to and from patients in such a way as to increase both the patient's and the health care provider's understanding of the patient's progress, and to help ensure that patient care follows best practice. Methods Patients who participate in the SAM system are contacted by email at regular intervals and asked to complete validated questionnaires online. Patient responses on these questionnaires are then analyzed in order to provide patients with real-time, online information about their progress and to provide them with tailored and standardized medical advice. Patient-level data from the questionnaires are ported in real time to the patient's health care provider to be uploaded to clinic notes. An initial version of SAM has been developed at Memorial Sloan-Kettering Cancer Center (MSKCC and the University of California, San Francisco (UCSF for aiding the clinical management of patients after surgery for prostate cancer. Results Pilot testing at MSKCC and UCSF suggests that implementation of SAM systems are feasible, with no major problems with compliance (> 70% response rate or security. Conclusion SAM is a conceptually simple framework for passing information to and from patients in such a way as to increase both the patient's and the health care provider's understanding of the patient's progress, and to help ensure that patient care follows best practice.

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Health Status and Health Care Experiences among Homeless Patients in Federally Supported Health Centers: Findings from the 2009 Patient Survey

Science.gov (United States)

Lebrun-Harris, Lydie A; Baggett, Travis P; Jenkins, Darlene M; Sripipatana, Alek; Sharma, Ravi; Hayashi, A Seiji; Daly, Charles A; Ngo-Metzger, Quyen

2013-01-01

Objective To examine health status and health care experiences of homeless patients in health centers and to compare them with their nonhomeless counterparts. Data Sources/Study Setting Nationally representative data from the 2009 Health Center Patient Survey. Study Design Cross-sectional analyses were limited to adults (n = 2,683). We compared sociodemographic characteristics, health conditions, access to health care, and utilization of services among homeless and nonhomeless patients. We also examined the independent effect of homelessness on health care access and utilization, as well as factors that influenced homeless patients' health care experiences. Data Collection Computer-assisted personal interviews were conducted with health center patients. Principal Findings Homeless patients had worse health status—lifetime burden of chronic conditions, mental health problems, and substance use problems—compared with housed respondents. In adjusted analyses, homeless patients had twice the odds as housed patients of having unmet medical care needs in the past year (OR = 1.98, 95 percent CI: 1.24–3.16) and twice the odds of having an ED visit in the past year (OR = 2.00, 95 percent CI: 1.37–2.92). Conclusions There is an ongoing need to focus on the health issues that disproportionately affect homeless populations. Among health center patients, homelessness is an independent risk factor for unmet medical needs and ED use. PMID:23134588

Measuring the three process segments of a customer's service experience for an out-patient surgery center.

Science.gov (United States)

Wicks, Angela M; Chin, Wynne W

2008-01-01

The purpose of this research is to develop an alternative method of measuring out-patient satisfaction where satisfaction is the central construct. The Gap Model operationalized by SERVQUAL is widely used to measure service quality. However, the SERVQUAL instrument only measures expectations (resulting from the pre-process segment of the service experience) and perceptions (resulting from the post-process segment). All three segments should be measured. The lack of proper segmentation and methodological criticisms in the literature motivated this study. A partial least squares (PLS) approach, a form of structural equation modeling, is used to develop a framework to evaluate patient satisfaction in three service process segments: pre-process, process, and post-process service experiences. Results indicate that each process stage mediates subsequent stages, that the process segment is the most important to the patient and that the antecedents have differing impacts on patient satisfaction depending where in the process the antecedent is evaluated. Only one out-patient surgery center was evaluated. Patient satisfaction criteria specific to hospital selection are not included in this study. Results indicate what is important to patients in each service process segment that focus where ambulatory surgery centers should allocate resources. This study is the first to evaluate patient satisfaction with all three process segments.

Group Violence and Migration Experience among Latin American Youths in Justice Enforcement Centers (Madrid, Spain).

Science.gov (United States)

Martínez García, José Manuel; Martín López, María Jesús

2015-10-30

Group violence among Latin American immigrant youth has led to ongoing debates in political, legal, and media circles, yet none of those many perspectives has arrived at a solid, empirically supported definition for the phenomenon. This study aims to explore the relationship between the immigrant experience and violent group behavior in youths from Latin America serving prison sentences in Justice Enforcement Centers in the Community of Madrid. Semi-structured interviews were conducted with 19 juveniles, and content analysis was applied to the resulting transcripts, employing Grounded Theory to create an axial codification of intra- and inter-categorical contents, and Delphi panels for quality control. The research team delved into 62 topics, addressing participants' perceptions of the immigrant experience and its effects on five socialization settings (neighborhood, school, family, peer group, and significant other), and each one's relationship to violent behavior. The results led us to believe the young people's immigration experiences had been systematically examined. Their personal and social development was influenced by negative socioeconomic conditions, ineffective parental supervision, maladjustment and conflict at school, and experiences of marginalization and xenophobia. All those conditions favored affiliation with violent groups that provided them instrumental (economic and material), expressive, or affective support.

Integration of the clinical engineering specialist at a high complexity children's hospital. Our professional experience at a surgical center

International Nuclear Information System (INIS)

Vargas Enriquez, M J; Chazarreta, B; Emilio, D G; Fernandez Sarda, E

2007-01-01

This document aims to find relating points between the current and future Clinical Engineer professional in order to discuss about the hospital environment, its characteristics and its realities which lead to our professional development. The main aim is to depict our experience through a retrospective analysis based on the underwriting experience and consequently to arrive at conclusions that will support the inclusion and active interaction of the Clinic Engineer Specialist as part of a Hospital's Surgical Center

What is the gold standard for comprehensive interinstitutional communication of perioperative information for thyroid cancer patients? A comparison of existing electronic health records with the current American Thyroid Association recommendations.

Science.gov (United States)

Dos Reis, Laura L; Tuttle, R Michael; Alon, Eran; Bergman, Donald A; Bernet, Victor; Brett, Elise M; Cobin, Rhoda; Doherty, Gerard; Harris, Jeffrey R; Klopper, Joshua; Lee, Stephanie L; Lupo, Mark; Milas, Mira; Machac, Josef; Mechanick, Jeffrey I; Orloff, Lisa; Randolph, Gregory; Ross, Douglas S; Smallridge, Robert C; Terris, David James; Tufano, Ralph P; Mehra, Saral; Scherl, Sophie; Clain, Jason B; Urken, Mark L

2014-10-01

Appropriate management of well-differentiated thyroid cancer requires treating clinicians to have access to critical elements of the patient's presentation, surgical management, postoperative course, and pathologic assessment. Electronic health records (EHRs) provide an effective method for the storage and transmission of patient information, although most commercially available EHRs are not intended to be disease-specific. In addition, there are significant challenges for the sharing of relevant clinical information when providers involved in the care of a patient with thyroid cancer are not connected by a common EHR. In 2012, the American Thyroid Association (ATA) defined the critical elements for optimal interclinician communication in a position paper entitled, "The Essential Elements of Interdisciplinary Communication of Perioperative Information for Patients Undergoing Thyroid Cancer Surgery." We present a field-by-field comparison of the ATA's essential elements as applied to three contemporary electronic reporting systems: the Thyroid Surgery e-Form from Memorial Sloan-Kettering Cancer Center (MSKCC), the Alberta WebSMR from the University of Calgary, and the Thyroid Cancer Care Collaborative (TCCC). The MSKCC e-form fulfills 21 of 32 intraoperative fields and includes an additional 14 fields not specifically mentioned in the ATA's report. The Alberta WebSMR fulfills 45 of 82 preoperative and intraoperative fields outlined by the ATA and includes 13 additional fields. The TCCC fulfills 117 of 120 fields outlined by the ATA and includes 23 additional fields. Effective management of thyroid cancer is a highly collaborative, multidisciplinary effort. The patient information that factors into clinical decisions about thyroid cancer is complex. For these reasons, EHRs are particularly favorable for the management of patients with thyroid cancer. The MSKCC Thyroid Surgery e-Form, the Alberta WebSMR, and the TCCC each meet all of the general recommendations for

Development of PET in Latin America. Experience of the first PET-Cyclotron Center

International Nuclear Information System (INIS)

Tutor, C.A.; Frias, L.

2002-01-01

Aim: Describe the experience of the first PET-Cyclotron Center in Latin America. Demonstrate the viability of running a PET Center in Argentina despite the economic crisis. Materials and Methods: For this study, we used a UGM/GE Quest 250 PET scan, a RDS 112 cyclotron and a Radiosynthesis Laboratory installed at the (FUESMEN) Nuclear Medicine School Foundation, located in Mendoza City, in the middle-west of Argentina. From January 1999 to March 2002, 741 studies were obtained, 731 were 18 FluorDeoxyGlucose-PET studies and 10 phantoms for calibration purposes. We used acquisition and imaging processing standard protocols, as well as research protocols designed according to the pathology under investigation. To better correlate anatomical and functional images, we used fusion techniques with (CT) Computed Tomography in some (WB) whole-body PET scans. Results: A total of 731 patients were retrospectively analyzed and classified according to statistics variables such as: 1-sex: 317 women and 414 men, 2-type of scan: 439 WB cases, 267 brain studies and 25 cardiac. From this data we divided them as PET indications and resulted in 17 cases as healthy volunteers, 422 oncological cases, 267 neurological studies and 25 cardiac for myocardial viability. According to the origin they were classified as patients coming from Mendoza 544, Buenos Aires 112, other argentine provinces 60 and foreign (Chile, Brazil and Uruguay) 15 cases. In terms of billing, 181 studies were done free of charge, 95 under research protocols were also done free of charge and 451 were charged. Conclusion: Not only the economical and political factors play an important role limiting the advances of PET Imaging in Latin America, but also the lack of a neighboring cyclotron that circumscribe many hospitals to have access to the radiopharmaceutical agent. FUESMEN was established in 1991 by three governmental entities: the (CONEA) National Commission of Atomic Energy, the (UNC) National University of Cuyo and

Training for life science experiments in space at the NASA Ames Research Center

Science.gov (United States)

Rodrigues, Annette T.; Maese, A. Christopher

1993-01-01

As this country prepares for exploration to other planets, the need to understand the affects of long duration exposure to microgravity is evident. The National Aeronautics and Space Administration (NASA) Ames Research Center's Space Life Sciences Payloads Office is responsible for a number of non-human life sciences payloads on NASA's Space Shuttle's Spacelab. Included in this responsibility is the training of those individuals who will be conducting the experiments during flight, the astronauts. Preparing a crew to conduct such experiments requires training protocols that build on simple tasks. Once a defined degree of performance proficiency is met for each task, these tasks are combined to increase the complexity of the activities. As tasks are combined into in-flight operations, they are subjected to time constraints and the crew enhances their skills through repetition. The science objectives must be completely understood by the crew and are critical to the overall training program. Completion of the in-flight activities is proof of success. Because the crew is exposed to the background of early research and plans for post-flight analyses, they have a vested interest in the flight activities. The salient features of this training approach is that it allows for flexibility in implementation, consideration of individual differences, and a greater ability to retain experiment information. This training approach offers another effective alternative training tool to existing methodologies.

Computed tomography-guided core-needle biopsy of lung lesions: an oncology center experience

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Guimaraes, Marcos Duarte; Fonte, Alexandre Calabria da; Chojniak, Rubens, E-mail: marcosduarte@yahoo.com.b [Hospital A.C. Camargo, Sao Paulo, SP (Brazil). Dept. of Radiology and Imaging Diagnosis; Andrade, Marcony Queiroz de [Hospital Alianca, Salvador, BA (Brazil); Gross, Jefferson Luiz [Hospital A.C. Camargo, Sao Paulo, SP (Brazil). Dept. of Chest Surgery

2011-03-15

Objective: The present study is aimed at describing the experience of an oncology center with computed tomography guided core-needle biopsy of pulmonary lesions. Materials and Methods: Retrospective analysis of 97 computed tomography-guided core-needle biopsy of pulmonary lesions performed in the period between 1996 and 2004 in a Brazilian reference oncology center (Hospital do Cancer - A.C. Camargo). Information regarding material appropriateness and the specific diagnoses were collected and analyzed. Results: Among 97 lung biopsies, 94 (96.9%) supplied appropriate specimens for histological analyses, with 71 (73.2%) cases being diagnosed as malignant lesions and 23 (23.7%) diagnosed as benign lesions. Specimens were inappropriate for analysis in three cases. The frequency of specific diagnosis was 83 (85.6%) cases, with high rates for both malignant lesions with 63 (88.7%) cases and benign lesions with 20 (86.7%). As regards complications, a total of 12 cases were observed as follows: 7 (7.2%) cases of hematoma, 3 (3.1%) cases of pneumothorax and 2 (2.1%) cases of hemoptysis. Conclusion: Computed tomography-guided core needle biopsy of lung lesions demonstrated high rates of material appropriateness and diagnostic specificity, and low rates of complications in the present study. (author)

Activities and experience of the Federal Resource Center for Organizing Comprehensive Support for Children with ASD

Directory of Open Access Journals (Sweden)

Khaustov A.V.

2016-12-01

Full Text Available This article presents basic activities and experience of the Federal Resource Center for Organizing Comprehensive Sup¬port for Children with ASD of Moscow state university of psychology & education, amassed during 22 years of practice. Some statistic data on the center’s activity are displayed. Emphasis is done on multidirectional work and developing ways of interdepartmental and networking interaction for the sake of founding a system of complex support for autistic children in Russian Federation.

The International Heat Pipe Experiment. [international cooperation zero g experiment

Science.gov (United States)

Mcintosh, R.; Ollendorf, S.; Harwell, W.

1976-01-01

The aims of the experiment are outlined. Flight experiments included in this program were provided by NASA, Goddard Space Flight Center, ESA (European Space Agency), the German Ministry of Technology, Hughes Aircraft Company and NASA, Ames Research Center.

Forging successful academic-community partnerships with community health centers: the California statewide Area Health Education Center (AHEC) experience.

Science.gov (United States)

Fowkes, Virginia; Blossom, H John; Mitchell, Brenda; Herrera-Mata, Lydia

2014-01-01

Increased access to insurance under the Affordable Care Act will increase demands for clinical services in community health centers (CHCs). CHCs also have an increasingly important educational role to train clinicians who will remain to practice in community clinics. CHCs and Area Health Education Centers (AHECs) are logical partners to prepare the health workforce for the future. Both are sponsored by the Health Resources and Services Administration, and they share a mission to improve quality of care in medically underserved communities. AHECs emphasize the educational side of the mission, and CHCs the service side. Building stronger partnerships between them can facilitate a balance between education and service needs.From 2004 to 2011, the California Statewide AHEC program and its 12 community AHECs (centers) reorganized to align training with CHC workforce priorities. Eight centers merged into CHC consortia; others established close partnerships with CHCs in their respective regions. The authors discuss issues considered and approaches taken to make these changes. Collaborative innovative processes with program leadership, staff, and center directors revised the program mission, developed common training objectives with an evaluation plan, and defined organizational, functional, and impact characteristics for successful AHECs in California. During this planning, centers gained confidence as educational arms for the safety net and began collaborations with statewide programs as well as among themselves. The AHEC reorganization and the processes used to develop, strengthen, and identify standards for centers forged the development of new partnerships and established academic-community trust in planning and implementing programs with CHCs.

GLOBE Observer and the Association of Science & Technology Centers: Leveraging Citizen Science and Partnerships for an International Science Experiment to Build Climate Literacy

Science.gov (United States)

Riebeek Kohl, H.; Chambers, L. H.; Murphy, T.

2016-12-01

For more that 20 years, the Global Learning and Observations to Benefit the Environment (GLOBE) Program has sought to increase environment literacy in students by involving them in the process of data collection and scientific research. In 2016, the program expanded to accept observations from citizen scientists of all ages through a relatively simple app. Called GLOBE Observer, the new program aims to help participants feel connected to a global community focused on advancing the scientific understanding of Earth system science while building climate literacy among participants and increasing valuable environmental data points to expand both student and scientific research. In October 2016, GLOBE Observer partnered with the Association of Science & Technology Centers (ASTC) in an international science experiment in which museums and patrons around the world collected cloud observations through GLOBE Observer to create a global cloud map in support of NASA satellite science. The experiment was an element of the International Science Center and Science Museum Day, an event planned in partnership with UNESCO and ASTC. Museums and science centers provided the climate context for the observations, while GLOBE Observer offered a uniform experience and a digital platform to build a connected global community. This talk will introduce GLOBE Observer and will present the results of the experiment, including evaluation feedback on gains in climate literacy through the event.

The Fernald Preserve Visitors Center The Fernald Experience-Revealing, Engaging, and Preserving

International Nuclear Information System (INIS)

Powell, J.; Griffiths, G.; Walpole, S.; Lutz, M.

2009-01-01

The U.S. Department of Energy (DOE) Office of Legacy Management's public involvement activities at the Fernald, Ohio, site include continued communication about groundwater remediation, the management of legacy waste, and the future of the Fernald site. The completion of the Fernald Preserve Visitors Center, in August 2008, ensures that information continues to be readily available and effectively communicated to the public. A primary goal of the Visitors Center is to function as an informational and educational center within the surrounding community, with the information available at the Visitors Center serving as an institutional control. By offering information on a variety of topics, from the site's history to its current condition, the Visitors Center increases public awareness and helps prevent unsafe disturbances to and uses of the site. The Office of Legacy Management maintains and operates the Visitors Center, continues to solicit stakeholder opinion, and will periodically reevaluate the use of the Visitors Center and its programming. (authors)

Sports hernias: experience in a sports medicine center.

Science.gov (United States)

Santilli, O L; Nardelli, N; Santilli, H A; Tripoloni, D E

2016-02-01

Chronic pain of the inguino-crural region or "pubalgia" explains the 0.5-6.2% of the consultations by athletes. Recently, areas of weakness in the posterior wall called "sports hernias," have been identified in some of these patients, capable of producing long-standing pain. Several authors use different image methods (CT, MRI, ultrasound) to identify the lesion and various techniques of repair, by open or laparoscopic approaches, have been proposed but there is no evidence about the superiority of one over others due to the difficulty for randomizing these patients. In our experience, diagnosis was based on clinical and ultrasound findings followed by laparoscopic exploration to confirm and repair the injury. The present study aims to assess the performance of our diagnostic and therapeutic management in a series of athletes affected by "pubalgia". 1450 athletes coming from the orthopedic office of a sport medicine center were evaluated. In 590 of them (414 amateur and 176 professionals) sports hernias were diagnosed through physical examination and ultrasound. We performed laparoscopic "TAPP" repair and, thirty days after, an assessment was performed to determine the evolution of pain and the degree of physical activity as a sign of the functional outcome. We used the U Mann-Whitney test for continuous scale variables and the chi-square test for dichotomous variables with p pubalgia". "Sports hernias" are often associated with adductor muscle strains and other injuries of the groin allowing speculate that these respond to a common mechanism of production. We believe that, considering the difficulty to design randomized trials, only a high coincidence among the diagnostic and therapeutic instances can ensure a rational health care.

Oligometastatic state predicts a favorable outcome for renal cell carcinoma patients with bone metastasis under the treatment of sunitinib.

Science.gov (United States)

Lu, Xiaolin; Gu, Weijie; Zhang, Hailiang; Zhu, Yao; Shi, Guohai; Ye, Dingwei

2016-05-03

The aim of the study was to investigate whether RCC patients with oligometastatic state of bone metastasis treated with sunitinib had a favorable clinical outcome. 22 patients were classified into oligometastatic state of bone metastasis with a median OS of 30.1 months (95%CI: 26.3 to 33.8 months). The 45 patients with non-oligometastatic state had a median OS of 12.7 months (95%CI: 9.43 to 16.0 months). Kaplan-Meier analysis showed significant difference between them (Log Rank test p<0.001). When we set patients with only multiple bone (at least 5 sites) metastases as a single group, there was still significant difference between oligometastatic state group and non-oligometastatic state groups. In multivariate Cox proportion hazard ratio analysis, metastatic states (p=0.012), MSKCC score (p=0.002), ECOG (p=0.001) and lymph nodes metastasis (p=0.000) were significantly associated with prognosis. The integration of metastatic state into the MSKCC risk model improved the c-index from 0.651 to 0.752. 67 patients from Fudan University Shanghai Cancer Center with bone metastatic RCC were divided into 2 metastatic states. One included those with oligometastatic state of bone metastasis with less than 5 sites of bone metastasis. The other involved those patients with multiple bone metastases (at least 5 sites) or together with other sites of metastasis. Then patients with only multiple bone (at least 5 sites) metastases were set into a single group. RCC patients with oligometastatic state of bone metastasis treated with sunitinib had a favorable clinical outcome.

Contrast Media Use in Radiation Oncology: A Prospective, Controlled Educational Intervention Study with Retrospective Analysis of Patient Outcomes

Science.gov (United States)

Barker, Christopher A.; Mutter, Robert W.; Shapiro, Lauren Q.; Zhang, Zhigang; Wolden, Suzanne L.; Yahalom, Joachim

2016-01-01

Purpose Intravenous contrast media (ICM) administration is recommended as part of radiation therapy (RT) simulation in a variety of clinical scenarios, but can cause adverse events. We sought to assess radiation oncology resident knowledge about ICM, and to determine if an educational intervention (EI) could improve this level of knowledge. In conjunction, we retrospectively analyzed risk factors and adverse events related to ICM use before and after the EI to determine whether any improvements in patient outcomes could be realized. Methods Over 2 years, 21 residents in radiation oncology at Memorial Sloan-Kettering Cancer Center (MSKCC) participated in a pretest-EI-posttest study based on the ACR’s Manual on Contrast Media. Medical and RT records were reviewed, and ICM use, risk factors and adverse events were recorded. Results There was no significant difference in resident understanding of ICM use in residents of different years of training (p=0.85). Understanding of ICM use increased in residents that attended the EI (p<0.05), but this was not sustained 1 year after the EI (p=0.48). Of the 6852 RT simulations that were performed at MSKCC, 1350 (19.7%) involved ICM. Mild adverse events occurred in a few patients (<5%) simulated with ICM, but there was no difference in the number of risk factors or adverse events before and after the EI. Conclusions The EI effectively improved short-term understanding of ICM use. However, the effect was not sustained. The frequency of adverse events related to ICM use was small and not significantly impacted by the EI. PMID:21129689

Outcomes of asymptomatic anastomotic leaks found on routine postoperative water-soluble enema following anterior resection for cancer.

Science.gov (United States)

Killeen, S; Souroullas, P; Ho Tin, H; Hunter, I A; O'Grady, H; Gunn, J; Hartley, J E

2013-11-01

The incidence and consequence of an anastomotic leak associated with low anterior resection for cancer mandates covering stoma in most cases. A water-soluble enema is often performed to assess anastomotic integrity prior to stoma reversal. The functional outcome following reversal in patients with occult radiologically detected leaks is poorly defined. The goal of the present study was to determine the functional outcome in patients with a radiologically detected anastomotic leak who subsequently underwent stoma reversal. This case control study used patients with and without radiologically detected occult anastomotic leak having undergone reversal of covering stomata. The study group was matched with controls for age, gender, procedure, tumor stage, and adjuvant/neoadjuvant therapy. Validated fecal incontinence quality of life (FIQL), Cleveland Clinic Fecal Incontinence Score (CCFIS), and the Memorial Sloan-Kettering Cancer Center (MSKCC) Bowel Function Index (BFI) were used. Patient satisfaction, medication use, and ancillary procedures prior to closure were also recorded. Thirteen patients with radiologically detected occult anastomotic leaks and 13 matched controls were identified from a prospectively maintained database. The FIQL, CCFIS, and MSKCC BFI scores were significantly reduced in those with occult leaks. The mean number of radiological and surgical interventions was significantly greater in the patients with occult leaks. Antidiarrheal and bulking agent use, as well as patient satisfaction, were the same for both groups. Only one patient in the occult leak group would not undergo stoma reversal again. Reversal of a defunctioning ileostomy in the presence of an occult radiological leak can be associated with poorer functional outcomes, but patient satisfaction is undiminished.

The patient experience of patient-centered communication with nurses in the hospital setting: a qualitative systematic review protocol.

Science.gov (United States)

Newell, Stephanie; Jordan, Zoe

2015-01-01

The objective of this systematic review is to synthesize the eligible evidence of patients' experience of engaging and interacting with nurses, in the medical-surgical ward setting.This review will consider the following questions: Communication is a way in which humans make sense of the world around them. Communication takes place as an interactive two-way process or interaction, involving two or more people and can occur by nonverbal, verbal, face-to-face or non-face-to-face methods. Effective communication is described to occur when the sender of a message sends their message in a way that conveys the intent of their message and then is understood by the receiver of the message. As a result of the communication from both the sender and the receiver of the message a shared meaning is created between both parties.Communication can therefore be viewed as a reciprocal process. In the health care literature the terms communication and interaction are used interchangeably.Communication failures between clinicians are the most common primary cause of errors and adverse events in health care. Communication is a significant factor in patient satisfaction and complaints about care. Communication plays an integral role in service quality in all service professions including health care professions.Within healthcare, quality care has been defined by the Institute of Medicine as 'care that is safe, effective, timely, efficient, equitable and patient-centred'. Patient-centered care is defined as 'care that is respectful of and responsive to individual patient preferences, needs and values, and ensuring that patient's values guide all clinical decisions. Patient centered-care encompasses the 'individual experiences of a patient, the clinical service, the organizational and the regulatory levels of health care'. At the individual patient level, patient-centered care is care that is 'provided in a respectful manner, assures open and ongoing sharing of useful information in an

Integration of the clinical engineering specialist at a high complexity children's hospital. Our professional experience at a surgical center

Energy Technology Data Exchange (ETDEWEB)

Vargas Enriquez, M J; Chazarreta, B; Emilio, D G; Fernandez Sarda, E [Surgical Center-Neurophysiology Division of Medical Tecnology Department, Garrahan Children' s Hospital, Combate de los Pozos 1881, Buenos Aires (Argentina)

2007-11-15

This document aims to find relating points between the current and future Clinical Engineer professional in order to discuss about the hospital environment, its characteristics and its realities which lead to our professional development. The main aim is to depict our experience through a retrospective analysis based on the underwriting experience and consequently to arrive at conclusions that will support the inclusion and active interaction of the Clinic Engineer Specialist as part of a Hospital's Surgical Center.

Gunshot wounds to the face: level I urban trauma center: a 10-year level I urban trauma center experience.

Science.gov (United States)

Pereira, Clifford; Boyd, J Brian; Dickenson, Brian; Putnam, Brant

2012-04-01

Gunshot wounds (GSWs) to the face are an infrequent occurrence outside of a war zone. However, when they occur, they constitute a significant reconstructive challenge. We present our 10-year experience at an urban level I trauma center to define the patterns of injury, assess the morbidity and mortality, and estimate the cost to the health care system. A retrospective review was performed on all patients admitted to Harbor-UCLA Medical Center with GSWs to the head and neck region between January 1997 and January 2007. Those who had sustained GSWs to the face requiring operative intervention were closely reviewed. Between 1997 and 2007, a total of 702 patients were admitted to the Harbor UCLA Emergency Department having sustained GSWs to the head and neck region, of which 501 patients survived. Of the survivors, 28 patients (26 male, 2 female) sustained GSWs to their face requiring operative intervention. The mean age of these patients was 28 (±8.3) years. They generally presented within a few hours of the injury, but 1 individual arrived over 24 hours later. Low-velocity single gunshots (from handguns) were predominantly involved, with facial fractures occurring in all cases. Fractures were of a localized shattering type without the major displacement of bony complexes seen in motor vehicle accidents. Most required wound debridement and fracture fixation. A few patients (14.2%) underwent free tissue transfer for reconstruction (3 fibular flaps, 1 TRAM). Tracheostomy was performed in 35.7% of patients. Mean length of hospital stay was 8.3 (±7.1) days, with 50% of cases requiring admission to the intensive care unit. Mean length of intensive care unit stay was 5.2 (±5.7) days. The average cost per patient exceeded $100,000.

Minimally invasive esophagectomy for cancer: Single center experience after 44 consecutive cases

Directory of Open Access Journals (Sweden)

Bjelović Miloš

2015-01-01

Full Text Available Introduction. At the Department of Minimally Invasive Upper Digestive Surgery of the Hospital for Digestive Surgery in Belgrade, hybrid minimally invasive esophagectomy (hMIE has been a standard of care for patients with resectable esophageal cancer since 2009. As a next and final step in the change management, from January 2015 we utilized total minimally invasive esophagectomy (tMIE as a standard of care. Objective. The aim of the study was to report initial experiences in hMIE (laparoscopic approach for cancer and analyze surgical technique, major morbidity and 30-day mortality. Methods. A retrospective cohort study included 44 patients who underwent elective hMIE for esophageal cancer at the Department for Minimally Invasive Upper Digestive Surgery, Hospital for Digestive Surgery, Clinical Center of Serbia in Belgrade from April 2009 to December 2014. Results. There were 16 (36% middle thoracic esophagus tumors and 28 (64% tumors of distal thoracic esophagus. Mean duration of the operation was 319 minutes (approximately five hours and 20 minutes. The average blood loss was 173.6 ml. A total of 12 (27% of patients had postoperative complications and mean intensive care unit stay was 2.8 days. Mean hospital stay after surgery was 16 days. The average number of harvested lymph nodes during surgery was 31.9. The overall 30-day mortality rate within 30 days after surgery was 2%. Conclusion. As long as MIE is an oncological equivalent to open esophagectomy (OE, better relation between cost savings and potentially increased effectiveness will make MIE the preferred approach in high-volume esophageal centers that are experienced in minimally invasive procedures.

Lower Savannah aging, disability & transportation resource center : regional travel management and coordination center (TMCC) model and demonstration project.

Science.gov (United States)

2014-10-01

This report details the deployed technology and implementation experiences of the Lower Savannah Aging, Disability & Transportation : Resource Center in Aiken, South Carolina, which served as the regional Travel Management and Coordination Center (TM...

A hidden Ising model for ChIP-chip data analysis

KAUST Repository

Mo, Q.; Liang, F.

2010-01-01

, our method is computationally much more efficient. Availability: A software called iChip is freely available at http://www.bioconductor.org/. Contact: moq@mskcc.org. © The Author 2010. Published by Oxford University Press. All rights reserved

Strengthening the role of universities in addressing sustainability challenges: the Mitchell Center for Sustainability Solutions as an institutional experiment

Directory of Open Access Journals (Sweden)

David D. Hart

2015-06-01

Full Text Available As the magnitude, complexity, and urgency of many sustainability problems increase, there is a growing need for universities to contribute more effectively to problem solving. Drawing upon prior research on social-ecological systems, knowledge-action connections, and organizational innovation, we developed an integrated conceptual framework for strengthening the capacity of universities to help society understand and respond to a wide range of sustainability challenges. Based on experiences gained in creating the Senator George J. Mitchell Center for Sustainability Solutions (Mitchell Center, we tested this framework by evaluating the experiences of interdisciplinary research teams involved in place-based, solutions-oriented research projects at the scale of a single region (i.e., the state of Maine, USA. We employed a multiple-case-study approach examining the experiences of three interdisciplinary research teams working on tidal energy development, adaptation to climate change, and forest vulnerability to an invasive insect. Drawing upon documents, observations, interviews, and other data sources, three common patterns emerged across these cases that were associated with more effective problem-solving strategies. First, an emphasis on local places and short-term dynamics in social-ecological systems research provides more frequent opportunities for learning while doing. Second, iterative stakeholder engagement and inclusive forms of knowledge co-production can generate substantial returns on investment, especially when researchers are dedicated to a shared process of problem identification and they avoid framing solutions too narrowly. Although these practices are time consuming, they can be accelerated by leveraging existing stakeholder relationships. Third, efforts to mobilize interdisciplinary expertise and link knowledge with action are facilitated by an organizational culture that emphasizes mutual respect, adaptability, and solutions

Uniportal video assisted thoracoscopic lobectomy: primary experience from an Eastern center.

Science.gov (United States)

Feng, Mingxiang; Shen, Yaxing; Wang, Hao; Tan, Lijie; Mao, Xuping; Liu, Yi; Wang, Qun

2014-12-01

Uniportal video-assisted thoracoscopic surgery (VATS) lobectomy is an emerging technique for the surgical resection of non-small cell lung cancer (NSCLC). Besides its wide debates on safety and efficacy throughout the world, there were few report on uniportal VATS from the Eastern countries. In this article, we summarized our primary experience on uniportal VATS lobectomy in an Eastern center. From October 2013 till February 2014, 54 consecutive uniportal VATS lobectomy were performed in the Department of Thoracic Surgery, Zhongshan Hospital of Fudan University. Patients' clinical features and operative details were recorded. Post-operatively, the morbidity and mortality were recorded to analyze the safety and efficacy of uniportal VATS lobectomy for NSCLCs. Among the 54 planned uniportal VATS lobectomy, there was one conversion to mini-thoracotomy due to lymph node sticking. Extra ports were required in two patients. The uniportal VATS lobectomy was achieved in 51 out of 54 patients (94.4%). The average operation duration was 122.2±37.5 min (90-160 min). The average volume of estimated blood loss during the operation was 88.8±47.1 mL (50-200 mL). The mean chest tube duration and hospital stay were 3.2±1.9 days and 4.6±2.0 days, respectively. There was no postoperative mortality in this study. Two patients suffered from prolonged air leakage (5 and 7 days), and one atrial fibrillation was observed in this cohort. Based on our primary experience, uniportal VATS lobectomy is a safe and effective procedure for the surgical resection of NSCLCs. The surgical refinements and instrumental improvements would facilitate the technique. Further studies based on larger population are required to determine its benefits towards patients with NSCLCs.

Encapsulating peritoneal sclerosis: experience of a tertiary referral center.

LENUS (Irish Health Repository)

Phelan, P J

2010-05-01

Encapsulating peritoneal sclerosis (EPS) is arguably the most serious complication of chronic peritoneal dialysis (PD) therapy with extremely high mortality rates. We aimed to establish the rates of EPS and factors associated with its development in a single center.

Long-term single-center experience of defibrillator therapy in children and adolescents.

Science.gov (United States)

Frommeyer, Gerrit; Feder, Sebastian; Bettin, Markus; Debus, Volker; Köbe, Julia; Reinke, Florian; Uebing, Anselm; Eckardt, Lars; Kehl, Hans Gerd

2018-06-01

Implantable cardioverter-defibrillator (ICD) systems are established therapy for prevention of sudden cardiac death. Long-term data on ICD systems in children and adolescents is rare. The present study displays a long-term single-center follow-up of children and adolescents with ICD systems. The present study represents a single-center experience of patients younger than 18 years who received an ICD (n = 58). Follow-up data included in-house follow-up as well as examinations of collaborating specialists. Mean age at implantation was 14.0 ± 3.3 years and 33 patients (56.9%) were male. A transvenous ICD system was implanted in 54 patients (93.1%). In 33 patients (56.9%) electrical heart disease or idiopathic ventricular fibrillation represented the underlying condition of ICD implantation. Median follow-up duration was 70 months (45; 94). 3 patients (5.2%) died during the observation period. None of these deaths was associated with ICD failure. Appropriate shocks occurred in 32 patients (55.2%). Inappropriate shock delivery was recorded in 17 patients (29.3%). Supraventricular tachycardia represented the most frequent cause of inappropriate shock delivery (9 patients, 52.9%). T-wave oversensing led to inappropriate shock delivery in 3 patients (17.6%). In 5 patients (29.4%), lead failure caused inappropriate shock delivery. Of note, during follow-up lead failure was reported in 15 patients (25.9%) leading to surgical revision. ICD therapy in children and adolescents is effective for prevention of sudden cardiac death. The rate of appropriate shock deliveries was significantly higher as compared with large ICD trials. Inappropriate therapies occurred frequently. In particular supraventricular tachycardia, T-wave oversensing and lead failures were responsible for these episodes. Copyright © 2017 Elsevier B.V. All rights reserved.

Bulgaria: INIS Center - 45 years experience

International Nuclear Information System (INIS)

Georgieva, Albena

2015-01-01

Bulgaria is one of 35 countries in the world operating nuclear power plants. Bulgaria's nuclear program was launched in 1956 with the construction of an IRT-2000 research reactor at the Institute for Nuclear Research and Nuclear Energy (INRNE), which was commissioned in 1961. The reactor is now under reconstruction. In 1960, construction of the first Bulgarian nuclear power plant started. At the moment, there are 6 power units at the Kozloduy NPP site; 4 of them (VVER-440/B-230) under decommissioning and 2 (VVER-1000/B-320) in operation. Several storage facilities for radioactive waste, mainly from the Kozloduy NPP and from various sources of ionizing radiation in medicine and industry are also in operation. The Kozloduy NPP, INRNE, Sofia University, the Technical University, and the State Enterprise Radioactive Waste are the main generators of nuclear information in Bulgaria and the main consumers of INIS products. The Bulgarian INIS Center, therefore, maintains continuous and effective cooperation with these Institutions

Single center experience with percutaneous and laparoscopic cryoablation of small renal masses.

Science.gov (United States)

Malcolm, John B; Berry, Tristan T; Williams, Michael B; Logan, Joshua E; Given, Robert W; Lance, Raymond S; Barone, Bethany; Shaves, Sarah; Vingan, Harlan; Fabrizio, Michael D

2009-06-01

While partial nephrectomy remains the gold standard for the management of most small renal masses, increasing experience with renal cryoablation has suggested a viable alternative with a favorable morbidity profile and good efficacy. We report intermediate-term oncologic outcomes from a single-center experience with laparoscopic and percutaneous renal cryoablation. We performed a retrospective review of our laparoscopic renal cryoablation (LRC) and percutaneous renal cryoablation (PRC) experience between January 2003 and April 2007. Patients with at least 12 months of follow-up were included in the analysis. Follow-up consisted of imaging and laboratory studies at regular intervals. Persistent mass enhancement or interval tumor growth was considered a treatment failure. Sixty-six patients (44% women/56% men; 42% African-American/58% Caucasian/other; mean body mass index, 29.7) with 72 tumors underwent either LRC (n = 52) or PRC (n = 20) with a mean follow-up of 30 months (median 25.1 mos; range 13-63 mos). Average patient age was 66.5 years (range 34-82 yrs). Mean tumor size was 2.33 cm (range 1-4.6 cm). Comorbid conditions were prevalent: 76% hypertension, 36% hyperlipidemia, 24% chronic kidney disease, 29% diabetes mellitus, 36% tobacco use, and 32% heart disease. RESULTS of pretreatment biopsy were 62% renal-cell carcinoma and 38% benign or nondiagnostic. Overall cancer-specific and cancer-free survival were 100% and 97%, respectively. There were two treatment failures (3.8%) in the LRC group and five primary failures in the PRC group (25%) (P = 0.015), four of which were salvaged with repeated PRC with no evidence of recurrence at 6 to 36 months of follow-up. There has been no significant local or metastatic progression. LRC and PRC achieved good oncologic control with minimal morbidity at a mean follow-up of 30 months in a patient cohort characterized by numerous comorbid conditions. PRC had a significantly higher primary treatment failure rate than LRC, but

Spherical Torus Center Stack Design

International Nuclear Information System (INIS)

C. Neumeyer; P. Heitzenroeder; C. Kessel; M. Ono; M. Peng; J. Schmidt; R. Woolley; I. Zatz

2002-01-01

The low aspect ratio spherical torus (ST) configuration requires that the center stack design be optimized within a limited available space, using materials within their established allowables. This paper presents center stack design methods developed by the National Spherical Torus Experiment (NSTX) Project Team during the initial design of NSTX, and more recently for studies of a possible next-step ST (NSST) device

Study of X-ray and gamma ray sources observed by the SIGNE (Prognoz 6 Satellite) experiment in the regions of the galactic center and anticenter

International Nuclear Information System (INIS)

Violes, F.

1981-12-01

Characteristics of the SIGNE II MP 6 experiment are reported and procedures to obtain the fluxes detected from all the sources are described. We next present deconvolution method used to isolate the galactic center sources. In the last chapter we present and discuss the photon spectra of the sources observed by the SIGNE II MP 6 experiment [fr

Preliminary analysis of the results and description of the meteorological experiments I and II performed at Aramar Experimental Center

International Nuclear Information System (INIS)

Molnary, L. de

1992-01-01

This paper describes the experimental program in Applied Meteorology that has been developed at Aramar Experimental Center (CEA) located in Ipero, S.P - Brazil. The program intends to study the meteorological systems and the regional circulation around Aramar to use the information in atmospheric transport and diffusion of radionuclides studies, as soon, analysis of impacts on the environment at Aramar site. The results collected during the first and second Meteorological Experiment are examined. (author)

The Amistad Research Center: Documenting the African American Experience.

Science.gov (United States)

Chepesiuk, Ron

1993-01-01

Describes the Amistad Research Center housed at Tulane University which is a repository of primary documents on African-American history. Topics addressed include the development and growth of the collection; inclusion of the American Missionary Association archives; sources of support; civil rights; and collecting for the future. (LRW)

Heidelberg Ion Therapy Center (HIT): Initial clinical experience in the first 80 patients

Energy Technology Data Exchange (ETDEWEB)

Combs, Stephanie E. (Univ. Hospital of Heidelberg, Dept. of Radiation Oncology, Heidelberg (Germany)), E-mail: Stephanie.Combs@med.uni-heidelberg.de; Ellerbrock, Malte; Haberer, Thomas (Heidelberger Ionenstrahl Therapiezentrum (HIT), Im Neuenheimer Feld 450, 69120 Heidelberg (Germany)) (and others)

2010-10-15

The Heidelberg Ion Therapy Center (HIT) started clinical operation in November 2009. In this report we present the first 80 patients treated with proton and carbon ion radiotherapy and describe patient selection, treatment planning and daily treatment for different indications. Patients and methods. Between November 15, 2009 and April 15, 2010, 80 patients were treated at the Heidelberg Ion Therapy Center (HIT) with carbon ion and proton radiotherapy. Main treated indications consisted of skull base chordoma (n = 9) and chondrosarcoma (n = 18), malignant salivary gland tumors (n=29), chordomas of the sacrum (n = 5), low grade glioma (n=3), primary and recurrent malignant astrocytoma and glioblastoma (n=7) and well as osteosarcoma (n = 3). Of these patients, four pediatric patients aged under 18 years were treated. Results. All patients were treated using the intensity-modulated rasterscanning technique. Seventy-six patients were treated with carbon ions (95%), and four patients were treated with protons. In all patients x-ray imaging was performed prior to each fraction. Treatment concepts were based on the initial experiences with carbon ion therapy at the Gesellschaft fuer Schwerionenforschung (GSI) including carbon-only treatments and carbon-boost treatments with photon-IMRT. The average time per fraction in the treatment room per patient was 29 minutes; for irradiation only, the mean time including all patients was 16 minutes. Position verification was performed prior to every treatment fraction with orthogonal x-ray imaging. Conclusion. Particle therapy could be included successfully into the clinical routine at the Dept. of Radiation Oncology in Heidelberg. Numerous clinical trials will subsequently be initiated to precisely define the role of proton and carbon ion radiotherapy in radiation oncology.

Social and Architectural Aspects of Revitalization of Historic Urban Centers: Foreign Experience

Directory of Open Access Journals (Sweden)

Indrė Gražulevičiutė-Vileniškė

2011-03-01

Full Text Available The structure and architecture of many European cities has started their development during the Middle Ages or even earlier. The historic cores gradually had become centers of contemporary cities and are constantly evolving. They are affected by the tendencies of destruction, initiatives and movements of preservation are also taking place there. The comprehensive works of rehabilitation of Lithuanian historic urban centers were carried out during the period of soviet occupation. The insularity of the Soviet empire, ideological reasons and the absence of the private property has determined certain architectural expressions and solutions for the social problems. After the restoration of the country‘s independence the problems and tendencies typical to Western city centers, such as commercialization and gentrification, started to appear in Lithuanian historic urban cores. This justifies the aim of the article which is to analyze the tendencies of revitalization of historic city centers in Western countries with the main attention to the social and architectural aspects.Article in Lithuanian

Using a Discrete Choice Conjoint Experiment to Engage Stakeholders in the Design of an Outpatient Children's Health Center.

Science.gov (United States)

Cunningham, Charles E; Niccols, Alison; Rimas, Heather; Robicheau, Randi; Anderson, Colleen; DeVries, Bart

2017-10-01

To engage users in the design of a regional child and youth health center. The perspective of users should be an integral component of a patient-centered, evidence-based approach to the design of health facilities. We conducted a discrete choice conjoint experiment (DCE), a method from marketing research and health economics, as a component of a strategy to engage users in the preconstruction planning process. A sample of 467 participants (290 staff and 177 clients or community stakeholders) completed the DCE. Latent class analysis identified three segments with different design preferences. A group we termed an enhanced design (57%) segment preferred a fully featured facility with personal contacts at the start of visits (in-person check-in, personal waiting room notification, volunteer-assisted wayfinding, and visible security), a family resource center with a health librarian, and an outdoor playground equipped with covered heated pathways. The self-guided design segment (11%), in contrast, preferred a design allowing a more independent use of the facility (e.g., self-check-in at computer kiosks, color-coded wayfinding, and a self-guided family resource center). Designs affording privacy and personal contact with staff were important to the private design segment (32%). The theme and decor of the building was less important than interactive features and personal contacts. A DCE allowed us to engage users in the planning process by estimating the value of individual design elements, identifying segments with differing views, informing decisions regarding design trade-offs, and simulating user response to design options.

Ethics in psychosocial and biomedical research – A training experience at the Interdisciplinary Center for Bioethics (CIEB) of the University of Chile1

Science.gov (United States)

Lolas, Fernando; Rodriguez, Eduardo

2012-01-01

This paper reviews the experience in training Latin American professionals and scientists in the ethics of biomedical and psychosocial research at the Interdisciplinary Center for Studies in Bioethics (CIEB) of the University of Chile, aided by a grant from Fogarty International Center (FIC) – National Institutes of Health from 2002 to 2011. In these 10 years of experience, 50 trainees have completed a 12-month training combining on-line and in-person teaching and learning activities, with further support for maintaining contact via webmail and personal meetings. The network formed by faculty and former trainees has published extensively on issues relevant in the continent and has been instrumental in promoting new master level courses at different universities, drafting regulations and norms, and promoting the use of bioethical discourse in health care and research. Evaluation meetings have shown that while most trainees did benefit from the experience and contributed highly to developments at their home institutions and countries, some degree of structuring of demand for qualified personnel is needed in order to better utilize the human resources created by the program. Publications and other deliverables of trainees and faculty are presented. PMID:22754084

Comparative analysis of stakeholder experiences with an online approach to prioritizing patient-centered research topics.

Science.gov (United States)

Khodyakov, Dmitry; Grant, Sean; Meeker, Daniella; Booth, Marika; Pacheco-Santivanez, Nathaly; Kim, Katherine K

2017-05-01

Little evidence exists about effective and scalable methods for meaningful stakeholder engagement in research. We explored patient/caregiver experiences with a high-tech online engagement approach for patient-centered research prioritization, compared their experiences with those of professional stakeholders, and identified factors associated with favorable participant experiences. We conducted 8 online modified-Delphi (OMD) panels. Panelists participated in 2 rating rounds with a statistical feedback/online discussion round in between. Panels focused on weight management/obesity, heart failure, and Kawasaki disease. We recruited a convenience sample of adults with any of the 3 conditions (or parents/guardians of Kawasaki disease patients), clinicians, and researchers. Measures included self-reported willingness to use OMD again, the panelists' study participation and online discussion experiences, the system's perceived ease of use, and active engagement metrics. Out of 349 panelists, 292 (84%) completed the study. Of those, 46% were patients, 36% were clinicians, and 19% were researchers. In multivariate models, patients were not significantly more actively engaged (Odds ratio (OR) = 1.69, 95% confidence interval (CI), 0.94-3.05) but had more favorable study participation (β = 0.49; P  ≤ .05) and online discussion (β = 0.18; P  ≤ .05) experiences and were more willing to use OMD again (β = 0.36; P  ≤ .05), compared to professional stakeholders. Positive perceptions of the OMD system's ease of use (β = 0.16; P  ≤ .05) and favorable study participation (β = 0.26; P  ≤ .05) and online discussion (β = 0.57; P  ≤ .05) experiences were also associated with increased willingness to use OMD in the future. Active engagement was not associated with online experience indices or willingness to use OMD again. Online approaches to engaging large numbers of stakeholders are a promising and efficient adjunct

The Soviet center of astronomical data

International Nuclear Information System (INIS)

Dluzhnevskaya, O.B.

1982-01-01

On the basis of the current French-Soviet cooperation in science and technology, the Astronomical Council of the U.S.S.R. Academy of Sciences and the Strasbourg Center signed in 1977 an agreement on setting up the Soviet Center of Astronomical Data as its filial branch. The Soviet Center was created on the basis of a computation center at the Zvenigorod station of the Astronomical Council of the U.S.S.R. Academy of Sciences, which had already had considerable experience of working with stellar catalogues. In 1979 the Center was equipped with a EC-1033 computer. In 1978-1979 the Soviet Center of Astronomical Data (C.A.D.) received from Strasbourg 96 of the most important catalogues. By September 1981 the list of catalogues available at the Soviet Center has reached 140 catalogues some of which are described. (Auth.)

The Comparison between Teacher Centered and Student Centered Educational Methods

Directory of Open Access Journals (Sweden)

M Anvar

2009-02-01

Full Text Available Background and Purpose: Various approaches to learning are suggested & practiced. The traditional medical education were more teacher centered oriented . In this method the students’ involvement in the process of learning is not remarkable, but the new approach to medical education supports the students involvement. This study evaluated the various method of lecturing considering students involvements.Methods: One hundred two first year medical and nursing students involved in this study and their opinion about these two methods of learning were obtained by filling of a questionnaire. The subject of the lectures was “general psychology” which was carried out 50% by the students and 50% by the teacher. The statistical analysis was carried out by SPSS program.Results: Considering students opinion in student-centered method the various aspect of learning such as mutual understanding, use of textbooks and references were significantly increased , whereasother aspects of learning such as self esteem, study time, innovation, and study attitude though were improved, but were not significant as compared with teacher centered method. In teacher-centeredmethod the understanding of the subjects was significantly increased .Other aspects of learning such as motivation and concentration were improved but not significantly as compared with studentcentered method.Conclusion: As the result showed student centered method was favored in several aspects of learning while in teacher centered method only understanding of the subject was better . Careful choice of teaching method to provide a comprehensive learning experience should take into account these differences.Key words: TEACHER CENTERED, STUDENT CENTERED, LEARNING

Pretreatment drug use characteristics and experiences among patients in a voluntary substance abuse treatment center in Malaysia: A mixed-methods approach.

Science.gov (United States)

Krishnan, Archana; Brown, Shan-Estelle; Ghani, Mansur A; Khan, Farrah; Kamarulzaman, Adeeba; Altice, Frederick L

2016-01-01

Drug use in Malaysia remains a significant public health and social problem despite implementation of harsh punitive drug policies such as forcibly placing suspected drug users into compulsory drug detention centers (CDDCs). Following criticism over human right violations in CDDCs, Malaysia has begun to transition towards voluntary drug treatment centers known as Cure & Care (C&C) centers. To best serve the needs of regional C&C centers, data on drug use are essential among patients accessing treatment. Using a mixed-methods approach, the authors examined pretreatment drug use characteristics and experiences with addiction treatment among C&C patients in Kelantan-a religiously conservative state in northeast Malaysia with high prevalence of drug use but where limited data are available on drug use patterns. A mixed-methods study utilizing surveys (n = 96) and semistructured interviews (n = 20) was conducted among a convenience sample of inpatients and outpatients at the Pengkalan Chepa C&C Center in Kelantan. Survey results showed that 89.6% of participants met screening criteria for moderate to severe addiction severity. Nearly 90% reported lifetime illicit amphetamine (syabu, meth, ice, and pil kuda) use, followed by alcohol (60.4%) and opioids (52.1%). Qualitative results pointed to the powerful influence of peer networks in drug initiation and relapse, and the positive effect of the C&C center on drug rehabilitation. The drug use profile of the Kelantan C&C center enrollees shows extensive pretreatment amphetamine use, polysubstance use, and injection drug use, including high-risk behaviors such as sharing needles, syringes, and containers. Evidence points to the need for integration of social support-oriented practices and behavioral interventions into the rehabilitation of drug users in this region.

The Manuel Lujan Jr. Neutron Scattering Center (LANSCE) experiment reports 1993 run cycle. Progress report

Energy Technology Data Exchange (ETDEWEB)

Farrer, R.; Longshore, A. [comps.

1995-06-01

This year the Manuel Lujan Jr. Neutron Scattering Center (LANSCE) ran an informal user program because the US Department of Energy planned to close LANSCE in FY1994. As a result, an advisory committee recommended that LANSCE scientists and their collaborators complete work in progress. At LANSCE, neutrons are produced by spallation when a pulsed, 800-MeV proton beam impinges on a tungsten target. The proton pulses are provided by the Clinton P. Anderson Meson Physics Facility (LAMPF) accelerator and a associated Proton Storage Ring (PSR), which can Iter the intensity, time structure, and repetition rate of the pulses. The LAMPF protons of Line D are shared between the LANSCE target and the Weapons Neutron Research (WNR) facility, which results in LANSCE spectrometers being available to external users for unclassified research about 80% of each annual LAMPF run cycle. Measurements of interest to the Los Alamos National Laboratory (LANL) may also be performed and may occupy up to an additional 20% of the available beam time. These experiments are reviewed by an internal program advisory committee. This year, a total of 127 proposals were submitted. The proposed experiments involved 229 scientists, 57 of whom visited LANSCE to participate in measurements. In addition, 3 (nuclear physics) participating research teams, comprising 44 scientists, carried out experiments at LANSCE. Instrument beam time was again oversubscribed, with 552 total days requested an 473 available for allocation.

The Manuel Lujan Jr. Neutron Scattering Center (LANSCE) experiment reports 1993 run cycle. Progress report

International Nuclear Information System (INIS)

Farrer, R.; Longshore, A.

1995-06-01

This year the Manuel Lujan Jr. Neutron Scattering Center (LANSCE) ran an informal user program because the US Department of Energy planned to close LANSCE in FY1994. As a result, an advisory committee recommended that LANSCE scientists and their collaborators complete work in progress. At LANSCE, neutrons are produced by spallation when a pulsed, 800-MeV proton beam impinges on a tungsten target. The proton pulses are provided by the Clinton P. Anderson Meson Physics Facility (LAMPF) accelerator and a associated Proton Storage Ring (PSR), which can Iter the intensity, time structure, and repetition rate of the pulses. The LAMPF protons of Line D are shared between the LANSCE target and the Weapons Neutron Research (WNR) facility, which results in LANSCE spectrometers being available to external users for unclassified research about 80% of each annual LAMPF run cycle. Measurements of interest to the Los Alamos National Laboratory (LANL) may also be performed and may occupy up to an additional 20% of the available beam time. These experiments are reviewed by an internal program advisory committee. This year, a total of 127 proposals were submitted. The proposed experiments involved 229 scientists, 57 of whom visited LANSCE to participate in measurements. In addition, 3 (nuclear physics) participating research teams, comprising 44 scientists, carried out experiments at LANSCE. Instrument beam time was again oversubscribed, with 552 total days requested an 473 available for allocation

User-Centered Design in Practice: The Brown University Experience

Science.gov (United States)

Bordac, Sarah; Rainwater, Jean

2008-01-01

This article presents a case study in user-centered design that explores the needs and preferences of undergraduate users. An analysis of LibQual+ and other user surveys, interviews with public service staff, and a formal American with Disabilities Act accessibility review served as the basis for planning a redesign of the Brown University…

Evaluating trauma center structural performance: The experience of a Canadian provincial trauma system

Directory of Open Access Journals (Sweden)

Lynne Moore

2013-01-01

Full Text Available Background: Indicators of structure, process, and outcome are required to evaluate the performance of trauma centers to improve the quality and efficiency of care. While periodic external accreditation visits are part of most trauma systems, a quantitative indicator of structural performance has yet to be proposed. The objective of this study was to develop and validate a trauma center structural performance indicator using accreditation report data. Materials and Methods: Analyses were based on accreditation reports completed during on-site visits in the Quebec trauma system (1994-2005. Qualitative report data was retrospectively transposed onto an evaluation grid and the weighted average of grid items was used to quantify performance. The indicator of structural performance was evaluated in terms of test-retest reliability (kappa statistic, discrimination between centers (coefficient of variation, content validity (correlation with accreditation decision, designation level, and patient volume and forecasting (correlation between visits performed in 1994-1999 and 1998-2005. Results: Kappa statistics were >0.8 for 66 of the 73 (90% grid items. Mean structural performance score over 59 trauma centers was 47.4 (95% CI: 43.6-51.1. Two centers were flagged as outliers and the coefficient of variation was 31.2% (95% CI: 25.5% to 37.6%, showing good discrimination. Correlation coefficients of associations with accreditation decision, designation level, and volume were all statistically significant (r = 0.61, -0.40, and 0.24, respectively. No correlation was observed over time (r = 0.03. Conclusion: This study demonstrates the feasibility of quantifying trauma center structural performance using accreditation reports. The proposed performance indicator shows good test-retest reliability, between-center discrimination, and construct validity. The observed variability in structural performance across centers and over-time underlines the importance of

A experiência social da psicose no contexto de um Centro de Atenção Psicossocial The social experience of psychosis in the context of a Psychosocial Care Center

Directory of Open Access Journals (Sweden)

Marcelo Kimati Dias

2011-04-01

Full Text Available Este estudo discute as relações existentes entre os aspectos institucionais de um Centro de Atenção Psicossocial (Caps e a experiência de pacientes psicóticos. Com o referencial da experiência social da psicose, mais ampla do que a descrição da vivência de sintomas, mas considerando aspectos culturais da experiência, foram realizados três estudos de caso em dois momentos diferentes. Todos os pacientes estudados foram entrevistados tanto em 1995 quanto em 2003. Além dos próprios sujeitos, foram realizadas entrevistas abertas com seus familiares e profissionais que os atendem, considerando assim as redes de rela��ão social dos pacientes. Enfatizaram-se três planos principais: (1 estudo da história do adoecimento; (2 estudo das representações da doença; e (3 descrição do cotidiano e das relações sociais dos pacientes. A partir de uma abordagem antropológica, foram realizadas considerações a respeito do tratamento de pacientes psicóticos inseridos nos Centros de Atenção Psicossocial.This study discusses the relations existing between the institutional aspects of a Psychosocial Care Center (Caps and the experience of psychotic patients. Using the referential base of the social experience of psychosis, which is broader in scope than a description of the experience of symptoms, while considering cultural aspects of the experience, three case studies were conducted at two different times. All of the patients studied were interviewed in 1995 and again in 2003. In addition to interviews with the subjects themselves, open interviews were conducted with their families and their professional carers, thereby taking the social relationship networks of the patients into consideration. Three central aspects were emphasized: (1 study of the history of the illness; (2 study of the representations of the disease; and (3 description of the everyday life and social relationships of the patients. Aspects with respect to the treatment

Empowering patients of a mental rehabilitation center in a low-resource context: a Moroccan experience as a case study.

Science.gov (United States)

Khabbache, Hicham; Jebbar, Abdelhak; Rania, Nadia; Doucet, Marie-Chantal; Watfa, Ali Assad; Candau, Joël; Martini, Mariano; Siri, Anna; Brigo, Francesco; Bragazzi, Nicola Luigi

2017-01-01

Mental, neurological and substance use (MNS) disorders represent a major source of disability and premature mortality worldwide. However, in developing countries patients with MNS disorders are often poorly managed and treated, particularly in marginalized, impoverished areas where the mental health gap and the treatment gap can reach 90%. Efforts should be made in promoting help by making mental health care more accessible. In this article, we address the challenges that psychological and psychiatric services have to face in a low-resource context, taking our experience at a Moroccan rehabilitation center as a case study. A sample of 60 patients were interviewed using a semi-structured questionnaire during the period of 2014-2015. The questionnaire investigated the reactions and feelings of the patients to the rehabilitation program, and their perceived psychological status and mental improvement, if any. Interviews were then transcribed and processed using ATLAS.ti V.7.0 qualitative analysis software. Frequencies and co-occurrence analyses were carried out. Despite approximately 30 million inhabitants within the working age group, Morocco suffers from a shortage of specialized health workers. Our ethnographic observations show that psychiatric treatment can be ensured, notwithstanding these hurdles, if a public health perspective is assumed. In resource-limited settings, working in the field of mental health means putting oneself on the line, exposing oneself to new experiences, and reorganizing one's own skills and expertise. In the present article, we have used our clinical experience at a rehabilitation center in Fes as a case study and we have shown how to use peer therapy to overcome the drawbacks that we are encountered daily in a setting of limited resources.

Management of complications arising from transvaginal mesh kit procedures: a tertiary referral center's experience.

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Hurtado, Eric A; Appell, Rodney A

2009-01-01

This case series' purpose is to review a referral center's experience with complications from mesh kits. A chart review of 12 patients who presented with complications associated with transvaginal mesh kit procedures was performed. All patients underwent complete surgical removal of the mesh to treat mesh exposure, pain, or vaginal bleeding/discharge followed by an anterior or posterior repair. The mean follow-up time after surgery was 3.4 months. Eight of 12 patients had mesh that had formed a fibrotic band. Six of 12 patients had complete resolution of pain. Of the nine patients with mesh exposure, all required significant resection of the vaginal wall. No further mesh exposure occurred. The use of transvaginal mesh kits may cause previously undescribed complications such as pelvic/vaginal pain or large extrusions requiring complete removal. Removal of all mesh except the arms may cure or significantly improve these problems.

Hydroxyapatite ceramic implants for cranioplasty in children: a single-center experience.

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Zaccaria, Laura; Tharakan, Sasha Job; Altermatt, Stefan

2017-02-01

The use of hydroxyapatite ceramic (HAC) implants for the treatment of skull defects in pediatric patients started 2010 at our institution. Ceramic implants facilitate osteoblast migration and therefore optimize osteointegration with the host bone. The purpose of this study is to report a single-center experience with this treatment modality. A retrospective review of all patients from July 2010 through June 2014 undergoing a cranioplasty using hydroxyapatite ceramic implant and managed at a single institution was performed. Indication for cranioplasty, the hospital course, and follow-up were reviewed. Bone density was measured in Hounsfield Units (HU) and osteointegration was calculated using Mimics Software® (Mimics Innovation Suite v17.0 Medical, Materialize, Leuven, Belgium). Over the 4-year period, six patients met criteria for the study. Five patients had an osteointegration of nearly 100%. One patient had an incomplete osteointegration with a total bone-implant contact area of 69%. The mean bone density was 2800 HU (2300-3000 HU). Bone density alone is estimated to have a Hounsfield value between 400 and 2000 HU depending on the body region and bone quality. There were no major complications, and the patients were highly satisfied with the esthetical result. Hydroxyapatite ceramic implants for cranioplasty in pediatric patients are a good choice for different indications. The implants show excellent osteointegration and esthetical results.

Reliability Centered Maintenance - Methodologies

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Kammerer, Catherine C.

2009-01-01

Journal article about Reliability Centered Maintenance (RCM) methodologies used by United Space Alliance, LLC (USA) in support of the Space Shuttle Program at Kennedy Space Center. The USA Reliability Centered Maintenance program differs from traditional RCM programs because various methodologies are utilized to take advantage of their respective strengths for each application. Based on operational experience, USA has customized the traditional RCM methodology into a streamlined lean logic path and has implemented the use of statistical tools to drive the process. USA RCM has integrated many of the L6S tools into both RCM methodologies. The tools utilized in the Measure, Analyze, and Improve phases of a Lean Six Sigma project lend themselves to application in the RCM process. All USA RCM methodologies meet the requirements defined in SAE JA 1011, Evaluation Criteria for Reliability-Centered Maintenance (RCM) Processes. The proposed article explores these methodologies.

RESOURCE TRAINING AND METHODOLOGICAL CENTER FOR THE TRAINING OF PEOPLE WITH DISABILITIES: EXPERIENCE AND DIRECTION OF DEVELOPMENT

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A. A. Fedorov

2018-01-01

Full Text Available Introduction: The presented article is devoted to the new and actual direction in the system of higher education - the development of inclusive education. The experience of creating a resource training and methodological center (RТMC of the University of Minin in 2017 is presented, the directions of its activity in 2017 and the results are described. The article outlines the role of RТMC in the development of inclusive culture.Materials and methods: The method of analyzing the literature of domestic and foreign authors was used as the basis for writing the article; the monitoring data of the state of inclusive higher education, which was implemented within the framework of the State Contract dated 07.06.2016 No. 05.020.11 007 on the project «Monitoring Information and Analytical Support of Activities regional resource centers for higher education for disabled people».Results: Analyzing the results of the RТMC activity, the authors update the problems that arose during the project implementation and suggest ways of their solution. The authors see the development of the RТMC activity through the development of forms and mechanisms of interdepartmental, interregional and inter-institutional cooperation in order to achieve coherence of actions and effectiveness of all participants in the support of inclusion in higher education, taking into account the educational needs of entrants and labor market needs throughout the fixed territory. As a special mission of the RТMC, the authors see the management of the development of inclusive culture in the university. The system of higher education is considered as an instrument of fulfilling the social order for the formation of a generation of people who tolerate and organically perceive the fact of inclusion in all spheres of life.Discussion and conclusion: The role of the resource training and methodological center in the development of inclusive higher education is determined by the identification

PTSD: National Center for PTSD

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Full Text Available ... Adaptive Sports Program Creative Arts Festival Golden Age Games Summer Sports Clinic Training - Exposure - Experience (TEE) Tournament Wheelchair Games Winter Sports Clinic Locations Hospitals & Clinics Vet Centers ...

Three Experiments Examining the Use of Electroencephalogram,Event-Related Potentials, and Heart-Rate Variability for Real-Time Human-Centered Adaptive Automation Design

Science.gov (United States)

Prinzel, Lawrence J., III; Parasuraman, Raja; Freeman, Frederick G.; Scerbo, Mark W.; Mikulka, Peter J.; Pope, Alan T.

2003-01-01

Adaptive automation represents an advanced form of human-centered automation design. The approach to automation provides for real-time and model-based assessments of human-automation interaction, determines whether the human has entered into a hazardous state of awareness and then modulates the task environment to keep the operator in-the-loop , while maintaining an optimal state of task engagement and mental alertness. Because adaptive automation has not matured, numerous challenges remain, including what the criteria are, for determining when adaptive aiding and adaptive function allocation should take place. Human factors experts in the area have suggested a number of measures including the use of psychophysiology. This NASA Technical Paper reports on three experiments that examined the psychophysiological measures of event-related potentials, electroencephalogram, and heart-rate variability for real-time adaptive automation. The results of the experiments confirm the efficacy of these measures for use in both a developmental and operational role for adaptive automation design. The implications of these results and future directions for psychophysiology and human-centered automation design are discussed.

Short-term outcomes of transcatheter closure of secundum atrial septal defect in children and adolescents: An experience of two centers in Upper Egypt

Directory of Open Access Journals (Sweden)

Safaa H. Ali

2018-01-01

Conclusions: Transcatheter closure of ASDs in children and adolescents was feasible and safe in the first 4 years experience in our centers, with good short-term outcome. Balloon sizing is not necessary for transcatheter closure of secundum ASD. Multiple defects can be safety closed by a single device.

Role of surgical treatment in breast cancer liver metastases: a single center experience.

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Bacalbasa, Nicolae; Dima, Simona Olimpia; Purtan-Purnichescu, Raluca; Herlea, Vlad; Popescu, Irinel

2014-10-01

The aim of the present study was to review a single hepatobiliary center experience, the benefit of hepatic metastasectomy in breast cancer liver metastases (BCLM) patients and to identify predictors of survival. Fifty-two female patients underwent surgery for BCLM between 2002 and 2013. Only patients with liver resections (n=43) were included in the analysis. The median survival of the 43 patients with liver resection was 32.2 months. The factors significantly associated with overall post-hepatectomy survival were estrogen/progesteron receptor (ER/PR) status (p=0.002), node involvement of the primary tumor (p=0.049), size (p=0.005) and number (p=0.006) of the metastatic lesions. The 1-, 3- and 5-year survival rates after curative liver resection were 93.02%, 74.42%, 58.14%, respectively. BCLM resection is a safe procedure and offers survival benefit, especially in patients with reduced liver metastatic burden (solitary metastases, diameter of the metastases <5 cm) and positive ER/PR status. Copyright© 2014 International Institute of Anticancer Research (Dr. John G. Delinassios), All rights reserved.

Can surgical oncologists reliably predict the likelihood for non-SLN metastases in breast cancer patients?

NARCIS (Netherlands)

Smidt, M.L.; Strobbe, L.J.; Groenewoud, J.M.M.; Wilt, G.J. van der; Zee, K.J. van; Wobbes, Th.

2007-01-01

BACKGROUND: In approximately 40% of the breast cancer patients with sentinel lymph node (SLN) metastases, additional nodal metastases are detected in the completion axillary lymph node dissection (cALND). The MSKCC nomogram can help to quantify a patient's individual risk for non-SLN metastases with

Students' Ways of Experiencing Human-Centered Design

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Zoltowski, Carla B.

2010-01-01

This study investigated the qualitatively different ways which students experienced human-centered design. The findings of this research are important in developing effective design learning experiences and have potential impact across design education. This study provides the basis for being able to assess learning of human-centered design which…

Use of CAHPS® patient experience survey data as part of a patient-centered medical home quality improvement initiative

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Quigley DD

2015-07-01

Full Text Available Denise D Quigley,1 Peter J Mendel,1 Zachary S Predmore,2 Alex Y Chen,3 Ron D Hays41RAND Corporation, Santa Monica, CA, 2RAND Corporation, Boston, MA, 3AltaMed Health Services Corporation, 4Division of General Internal Medicine and Health Services Research, UCLA, Los Angeles, CA, USAObjective: To describe how practice leaders used Consumer Assessment of Healthcare Providers and Systems (CAHPS® Clinician and Group (CG-CAHPS data in transitioning toward a patient-centered medical home (PCMH.Study design: Interviews conducted at 14 primary care practices within a large urban Federally Qualified Health Center in California.Participants: Thirty-eight interviews were conducted with lead physicians (n=13, site clinic administrators (n=13, nurse supervisors (n=10, and executive leadership (n=2.Results: Seven themes were identified on how practice leaders used CG-CAHPS data for PCMH transformation. CAHPS® was used: 1 for quality improvement (QI and focusing changes for PCMH transformation; 2 to maintain focus on patient experience; 3 alongside other data; 4 for monitoring site-level trends and changes; 5 to identify, analyze, and monitor areas for improvement; 6 for provider-level performance monitoring and individual coaching within a transparent environment of accountability; and 7 for PCMH transformation, but changes to instrument length, reading level, and the wording of specific items were suggested.Conclusion: Practice leaders used CG-CAHPS data to implement QI, develop a shared vision, and coach providers and staff on performance. They described how CAHPS® helped to improve the patient experience in the PCMH model, including access to routine and urgent care, wait times, provider spending enough time and listening carefully, and courteousness of staff. Regular reporting, reviewing, and discussing of patient-experience data alongside other clinical quality and productivity measures at multilevels of the organization was critical in maximizing the

Early experiences with big data at an academic medical center.

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Halamka, John D

2014-07-01

Beth Israel Deaconess Medical Center (BIDMC), an academic health care institution affiliated with Harvard University, has been an early adopter of electronic applications since the 1970s. Various departments of the medical center and the physician practice groups affiliated with it have implemented electronic health records, filmless imaging, and networked medical devices to such an extent that data storage at BIDMC now amounts to three petabytes and continues to grow at a rate of 25 percent a year. Initially, the greatest technical challenge was the cost and complexity of data storage. However, today the major focus is on transforming raw data into information, knowledge, and wisdom. This article discusses the data growth, increasing importance of analytics, and changing user requirements that have shaped the management of big data at BIDMC. Project HOPE—The People-to-People Health Foundation, Inc.

Blunt hepatic and splenic trauma. A single Center experience using a multidisciplinary protocol.

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Ruscelli, Paolo; Buccoliero, Farncesco; Mazzocato, Susanna; Belfiori, Giulio; Rabuini, Claudio; Sperti, Pierluigi; Rimini, Massimiliano

2017-01-01

The aim of this retrospective study was to describe more than 10 years experience of a single Trauma Center about non operative management of abdominal organ injuries in hemodynamically stable patients MATERIAL OF STUDY: Between January 2001 and December 2014 ,732 consecutive patients were admitted with blunt abdominal trauma, involving liver and/or spleen and/or kidney, at the Bufalini Cesena Hospital .Management of patients included a specific institutional developed protocol :hemodynamic stability was evaluated in shock room according to the patients response to fluid challenge and the patients were classified into three categories A,B,and C. Form 732 Trauma, 356(48.6%) of patients were submitted to a surgical procedure, all the other patient 376(51.4%) underwent an non operative management .Overall mortality was 9.8% (72), mortality in the surgery group was 15.4% eheras in the non operative group was 4.5%; the relative risk of mortality, measured by the odds ratio waith a 95% confidence interval, was 3.417(2.023-5.772) for rhe surgery group; patient over 40 years old has a statistically significant higher mortality. In our series the overall mortality rate of non operative management group was 4.5%, instead in unstable patients, the surgery group, the mortality was 15.3%; the overall mortality mortality rate after the application of our protocol is 9.8%, Although surgery continues to be the standard for hemodically unstable patients with blunt hepatic and splenic trauma. In our experience AAST Organ Injury Scale was useless for the therapeutic decision making process after the CT scan if a source of bleeding was detected and immediate angiography was performed in order to control and solve it. In our experience the AAST Organ Injury Scale was useless for the therapeutic decision making process, The results suggest that the only criteria of choice for therapeutici strategy was the hemodynamic stability, Nonoperative managem,ent can be applied only following

Case-mix adjustment and the comparison of community health center performance on patient experience measures.

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Johnson, M Laura; Rodriguez, Hector P; Solorio, M Rosa

2010-06-01

To assess the effect of case-mix adjustment on community health center (CHC) performance on patient experience measures. A Medicaid-managed care plan in Washington State collected patient survey data from 33 CHCs over three fiscal quarters during 2007-2008. The survey included three composite patient experience measures (6-month reports) and two overall ratings of care. The analytic sample includes 2,247 adult patients and 2,859 adults reporting for child patients. We compared the relative importance of patient case-mix adjusters by calculating each adjuster's predictive power and variability across CHCs. We then evaluated the impact of case-mix adjustment on the relative ranking of CHCs. Important case-mix adjusters included adult self-reported health status or parent-reported child health status, adult age, and educational attainment. The effects of case-mix adjustment on patient reports and ratings were different in the adult and child samples. Adjusting for race/ethnicity and language had a greater impact on parent reports than adult reports, but it impacted ratings similarly across the samples. The impact of adjustment on composites and ratings was modest, but it affected the relative ranking of CHCs. To ensure equitable comparison of CHC performance on patient experience measures, reports and ratings should be adjusted for adult self-reported health status or parent-reported child health status, adult age, education, race/ethnicity, and survey language. Because of the differential impact of case-mix adjusters for child and adult surveys, initiatives should consider measuring and reporting adult and child scores separately.

Local experience on radionuclide myocardial imaging in the Philippines at the Philippine Heart Center for Asia

International Nuclear Information System (INIS)

Villacorta, E.V.

1977-01-01

The Nuclear Medicine Department of the Philippine Heart Center has introduced the detection of coronary heart disease through myocardiac perfusion imaging. The cardiovascular procedures are availed of free-of-charge to registered PHCA patients excepting for the costly TI-201 imaging. In summary, coronary perfusion in imaging should be an integral part of coronary arteriography. Barring the expensive cost of TI-120, myocardial perfusion imaging is ideal for detection of coronary heart disease. Experience shows better sensitivity of TI-201 than exercise ECG for detection of ischemia. Another non-invasive procedure for the detection of acute infarction is the radionuclide imaging using a bone radiopharmaceutical Tc99m prophosphate. In conclusion, acute infarct imaging is a valuable adjunct to ECG and enzyme studies. (RTD)

Planning for the Mercy Center for Breast Health.

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Olivares, V Ed

2002-01-01

During the last months of 2000, administrators at the Mercy San Juan Medical Center in Carmichael, Calif., convened a steering committee to plan the Mercy Center for Breast Health. The Steering Committee was composed of the director of ancillary and support services, the oncology clinical nurse specialist, the RN manager of the oncology nursing unit, the RN surgery center manager, and me, the manager of imaging services. The committee was responsible for creating a new business with five specific objectives: to position the Center as a comprehensive diagnostic and resource center for women; to generate physician referrals to the Breast Center through various vehicles; to create awareness of the Breast Center's capabilities among area radiologists; to create awareness of the Breast Center among employees of six sister facilities; to create "brand awareness" for the Mercy Center for Breast Health among referring physicians and patients who could use competing centers in the area. The Steering Committee's charter was to design a center with a feminine touch and ambience and to provide a "one-stop shopping" experience for patients. A major component of the Breast Center is the Dianne Haselwood Resource Center, which provides patients with educational support and information. The Steering Committee brought its diverse experience and interests to bear on arranging for equipment acquisition, information and clerical systems, staffing, clinic office design, patient care and marketing. Planning the Mercy Center for Breast Health has been a positive challenge that brought together many elements of the organization and people from different departments and specialties to create a new business venture. Our charge now is to grow and to live up to our vision of offering complete breast diagnostic, education and support services in one location.

Gregory Merkel Tours Marshall Space Flight Center (MSFC)

Science.gov (United States)

1972-01-01

Gregory A. Merkel (left), high school student from Springfield, Massachusetts, is pictured here with Harry Coons of the Marshall Space Flight Center (MSFC) during a visit to the center. Merkel was among 25 winners of a contest in which some 3,500 high school students proposed experiments for the following year's Skylab mission. The nationwide scientific competition was sponsored by the National Science Teachers Association and the National Aeronautics and Space Administration (NASA). The winning students, along with their parents and sponsor teachers, visited MSFC where they met with scientists and engineers, participated in design reviews for their experiments, and toured MSFC facilities. Of the 25 students, 6 did not see their experiments conducted on Skylab because the experiments were not compatible with Skylab hardware and timelines. Of the 19 remaining, 11 experiments required the manufacture of additional equipment.

International Water Center

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The urban district of Nancy and the Town of Nancy, France, have taken the initiative of creating an International Center of Water (Centre International de l'Eau à Nancy—NAN.C.I.E.) in association with two universities, six engineering colleges, the Research Centers of Nancy, the Rhine-Meuse Basin Agency, and the Chamber of Commerce and Industry. The aim of this center is to promote research and technology transfer in the areas of water and sanitation. In 1985 it will initiate a research program drawing on the experience of 350 researchers and engineers of various disciplines who have already been assigned to research in these fields. The research themes, the majority of which will be multidisciplinary, concern aspects of hygiene and health, the engineering of industrial processes, water resources, and the environment and agriculture. A specialist training program offering five types of training aimed at university graduates, graduates of engineering colleges, or experts, will start in October 1984.

Clinical spectrum of hypopituitarism in India: A single center experience

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Gundgurthi, Abhay; Garg, M. K.; Bhardwaj, Reena; Brar, Karninder S.; Kharb, Sandeep; Pandit, Aditi

2012-01-01

Objectives: There is paucity of information regarding clinical profile of hypopituitarism from India. We report the clinical profile of hypopituitarism from a tertiary center in North India. Materials and Methods: This study was carried out in patients attending our endocrine center between January 2010 and December 2011. All new patients were studied prospectively and those registered before January 2010 retrospectively. Relevant clinical, hormonal, and imaging data were collected. Dynamic testing for pituitary functions was carried out as necessary. Hormonal deficiencies were defined as per prevailing recommendations. Results: This study included 113 subjects. The mean age was 38.6 ± 17.8 years (range, 4 – 76 years). There were 78 (69%) males and 35 females (31%). There were 22 subjects aged ≤18 years (childhood and adolescence) and 91 adults (>18 years). Visual disturbances were the most common presenting complaint (33%), though headache was the most common symptom (81%). Fifteen percent presented with pituitary apoplexy. Tumors comprised of 84% of cases. Hypogonadism (97%) was the most common abnormality seen followed by hypothyroidism (83.2%), hypoadrenalism (79.6%), growth hormone deficiency (88.1% of the 42 patients tested), and diabetes insipidus (13.3%). Panhypopituitarism was seen in 104 (92%) patients. There were no cases of hypopituitarism secondary to traumatic brain injury, subarachnoid hemorrhage, central nervous system infections, or cranial irradiation to extrasellar tumors. Conclusion: The most common cause of hypopituitarism at tertiary care center is pituitary tumors and the commonest presenting complaint is visual symptoms. Panhypopituitarism is present in 92% cases. PMID:23087868

Clinical spectrum of hypopituitarism in India: A single center experience

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Abhay Gundgurthi

2012-01-01

Full Text Available Objectives: There is paucity of information regarding clinical profile of hypopituitarism from India. We report the clinical profile of hypopituitarism from a tertiary center in North India. Materials and Methods: This study was carried out in patients attending our endocrine center between January 2010 and December 2011. All new patients were studied prospectively and those registered before January 2010 retrospectively. Relevant clinical, hormonal, and imaging data were collected. Dynamic testing for pituitary functions was carried out as necessary. Hormonal deficiencies were defined as per prevailing recommendations. Results: This study included 113 subjects. The mean age was 38.6 ± 17.8 years (range, 4 - 76 years. There were 78 (69% males and 35 females (31%. There were 22 subjects aged ≤18 years (childhood and adolescence and 91 adults (>18 years. Visual disturbances were the most common presenting complaint (33%, though headache was the most common symptom (81%. Fifteen percent presented with pituitary apoplexy. Tumors comprised of 84% of cases. Hypogonadism (97% was the most common abnormality seen followed by hypothyroidism (83.2%, hypoadrenalism (79.6%, growth hormone deficiency (88.1% of the 42 patients tested, and diabetes insipidus (13.3%. Panhypopituitarism was seen in 104 (92% patients. There were no cases of hypopituitarism secondary to traumatic brain injury, subarachnoid hemorrhage, central nervous system infections, or cranial irradiation to extrasellar tumors. Conclusion: The most common cause of hypopituitarism at tertiary care center is pituitary tumors and the commonest presenting complaint is visual symptoms. Panhypopituitarism is present in 92% cases.

On the formation of the network community of supplementary education teachers (from the experience of Children's Creativity Center with the study of applied economics)

OpenAIRE

Galina Nekrasova; Elena Shigareva; Raisa Artemova; Irina Nelyubina

2014-01-01

The online communities of teachers for professional communication and development of information and educational environment of subject teaching is actual nowadays. The authors describe the experience of Children’s Creativity Center in creation the network community for teachers of technology and educational specialists of additional education.

Characteristics of medical teachers using student-centered teaching methods.

Science.gov (United States)

Kim, Kyong-Jee; Hwang, Jee-Young

2017-09-01

This study investigated characteristics of medical teachers who have adopted student-centered teaching methods into their teaching. A 24-item questionnaire consisted of respondent backgrounds, his or her use of student-centered teaching methods, and awareness of the school's educational objectives and curricular principles was administered of faculty members at a private medical school in Korea. Descriptive statistics and chi-square analysis were conducted to compare faculty use of student-centered approaches across different backgrounds and awareness of curricular principles. Overall response rate was 70% (N=140/200), approximately 25% (n=34) of whom were using student-centered teaching methods. Distributions in the faculty use of student-centered teaching methods were significantly higher among basic sciences faculty (versus clinical sciences faculty), with teaching experiences of over 10 years (versus less than 10 years), and who were aware of the school's educational objectives and curricular principles. Our study indicates differences in medical faculty's practice of student-centered teaching across disciplines, teaching experiences, and their understanding of the school's educational objectives curricular principles. These findings have implications for faculty development and institutional support to better promote faculty use of student-centered teaching approaches.

Factor VII deficiency: a single-center experience.

Science.gov (United States)

Salcioglu, Zafer; Akcay, Arzu; Sen, Hulya Sayilan; Aydogan, Gonul; Akici, Ferhan; Tugcu, Deniz; Ayaz, Nuray Aktay; Baslar, Zafer

2012-11-01

Congenital factor VII deficiency is the most common form of rare coagulation factor deficiencies. This article presents a retrospective evaluation of 73 factor VII deficiency cases that had been followed at our center. The study consisted of 48 males and 25 females (2 months-19 years). Thirty-one (42.5%) of them were asymptomatic. Out of symptomatic patients, 17 had severe clinical symptoms, whereas 8 presented with moderate and 17 with mild symptoms. The symptoms listed in order of frequency were as follows: epistaxis, petechia or ecchymose, easy bruising, and oral cavity bleeding. The genotype was determined in 8 patients. Recombinant activated factor VII (rFVIIa) was used to treat 49 bleeding episodes in 8 patients after 2002. In 2 patients with repeated central nervous system bleeding prophylaxis with rFVIIa was administered. No allergic and thrombotic events were observed during both treatment and prophylaxis courses. Antibody occurrence was not detected in the patients during treatment.

Health care employee perceptions of patient-centered care.

Science.gov (United States)

Balbale, Salva Najib; Turcios, Stephanie; LaVela, Sherri L

2015-03-01

Given the importance of health care employees in the delivery of patient-centered care, understanding their unique perspectives is essential for quality improvement. The purpose of this study was to use photovoice to evaluate perceptions and experiences around patient-centered care among U.S. Veterans Affairs (VA) health care employees. We asked participants to take photographs of salient features in their environment related to patient-centered care. We used the photographs to facilitate dialogue during follow-up interviews. Twelve VA health care employees across two VA sites participated in the project. Although most participants felt satisfied with their work environment and experiences at the VA, they identified several areas for improvement. These included a need for more employee health and wellness initiatives and a need for enhanced opportunities for training and professional growth. Application of photovoice enabled us to learn about employees' unique perspectives around patient-centered care while engaging them in an evaluation of care delivery. © The Author(s) 2014.

Safety and treatment outcomes of first-line pazopanib in renal cell carcinoma: A prospective observational study in a single Malaysia tertiary hospital

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Azmi Nor Mohd Farez Ahmat

2017-12-01

Full Text Available Introduction: Pazopanib is the standard of care for metastatic renal cell carcinoma (mRCC. Previous studies on this indication were limited to patients who were selected on the basis of a fairly preserved performance status and normal organ function. Thus, the clinical trial population may not be representative of all patients seen in real-world practice. Based on these considerations, this prospective single-centre observational study was designed to evaluate the treatment outcomes and safety profile of pazopanib in Malaysian population. Patients and methods: Patients prescribed with pazopanib between June 2015 and June 2017 were recruited and followed up for 2-years or till death whichever comes first. Progression-free survival (PFS and overall survival (OS were evaluated. Multivariate and survival analysis were performed. Results: Twenty-seven patients were treated with pazopanib where 89% had clear cell histology.  Sixteen patients (59% were intermediate risk and 41% were poor risk based on Memorial Sloan Kettering Cancer Center (MSKCC criteria. All patients experienced at least one adverse event. The most common were cutaneous toxicity (92% followed by proteinuria, hypertension, diarrhoea and mucositis. Treatment interruption was needed in 15 patients. The median PFS and OS were 9.57 months and 15.5 months, respectively. In multivariate analysis, MSKCC risk score demonstrates strong predictive treatment outcome. The median PFS was 14.5 months in intermediate risk and 3.96 months in poor risk (OR: 0.2, p<0.001. However, the median OS is still immature to be reported since 63% of intermediate risk group is still alive at 2-years follow-up. Conclusion: In mRCC patients, treatment with pazopanib was effective in patients with intermediate risk group. In terms of safety, patient tolerated pazopanib quite well with mostly experienced grade 1 to 2 adverse events.

Involved field (IF) irradiation with or without chemotherapy in the management of children with Hodgkin's disease

International Nuclear Information System (INIS)

Jereb, B.; Tan, C.; Bretsky, S.; He, S.Q.; Exelby, P.

1984-01-01

The present policy at Memorial Sloan Kettering Cancer Center (MSKCC) of treating children with Hodgkin's disease [HD] is as follows: involved field (IF) irradiation only (3,600 rad) for Stages IA and IIA; IF irradiation (2,400 or 2,000 rad) combined with multidrug chemotherapy (MDP) protocol for all other stages. A somewhat higher recurrence rate is accepted for Stages IA and IIA in view of the good salvage rate for these recurrences and in view of side effects of more aggressive types of radiation treatment. One hundred forty-two patients with HD, 2-19 years of age, were treated at MSKCC between 1970 and 1981; 98 of these were treated according to the present policy (SP group), and 44 (NP group) were treated differently. All SP patients underwent staging laparotomy. The follow-up time was 12 to 146 months with a median of 65 months; two patients were lost to follow-up. For the SP group, all stages, 10-year disease-free survival is 77%, and 10-year survival is 93%. By comparison, in the NP group 10-year disease-free survival is 64%, and 10-year survival is 80%. The disease-free survival of SP patients in Stages IA and IIA treated with IF radiation alone is 72%, and survival is 95%. The disease-free survival of SP patients in advanced stages treated with combined radiation and chemotherapy is 87%; the salvage rate of recurrent disease in these stages is poor. The survival was apparently better in the SP group as compared to the NP group. All 6 patients of the SP group who died had a nodular sclerosing type of HD. None of the patients in the SP group have developed secondary malignancies, and no severe bone growth retardations or late effects to other organs were observed

Diversity leadership: the Rush University Medical Center experience.

Science.gov (United States)

Clapp, J R

2010-01-01

Meeting the challenges of diversity is crucial, and within healthcare organizations a particularly strong case exists for a diversity strategy. Rush University Medical Center in 2006 was at an important juncture. Since its founding, the organization had made notable progress toward advancing diversity and inclusiveness. On the other hand, many diversity-related problems continued. Rush convened a committee to review the work of the institution in this area. The committee's report called for changes, and a Diversity Leadership Group (DLG) model was established. This article documents the progress made since 2006 through implementation of the DLG model. The changes prescribed for Rush are presented as recommendations and challenges that other healthcare organizations may find applicable to their own institutions.

PTSD: National Center for PTSD

Medline Plus

Full Text Available ... America's Freedoms Special Events Adaptive Sports Program Creative Arts Festival Golden Age Games Summer Sports Clinic Training - Exposure - Experience (TEE) Tournament Wheelchair Games Winter Sports Clinic Locations Hospitals & Clinics Vet Centers Regional Benefits Offices Regional Loan ...

Therapeutic plasma exchange in a single center: Ibni Sina experience.

Science.gov (United States)

Arslan, Onder; Arat, Mutlu; Tek, Ibrahim; Ayyildiz, Erol; Ilhan, Osman

2004-06-01

The number of therapeutic procedures is increasing steadily year by year with growing collaboration of departments other than Hematology. In the aim to demonstrate our single center activity we analyzed our data since four years. Between years 1998 and 2001, 658 therapeutic plasma exchange (TPE) procedures were performed on 158 patients. Median age and male/female ratio were 37 (range, 15-87) and 80/78, respectively. Main indications were myastenia gravis (n=55, 34%), TTP (n=13, 8.5%), post ABO mismatched allogeneic hematopoietic cell transplantation aregeneratoric anemia (n=6, 7.5%), progressive systemic sclerosis (n=10, 6.5%), multiple myeloma (n=10, 6.5%), Gullian Barre Syndrome (n=9, 5.9%), multiple sclerosis (n=7, 4.6%), Waldenström Macroglobulinemia (n=5, 3.4%), polymyositis (n=4, 2.7%), sepsis and disseminated intravascular coagulation (n=4, 2.7%). Departments who referred the majority of the patients for TPE were neurology (n=199), hematology (n=153), immunology (n=78), intensive care unit (n=78) and thorax surgery (n=51). The median TPE procedure per patient was 4 (range, 1-50). All the procedures were performed on continuous flow cell separators and median plasma volume processed per cycle was 2471 ml (range 436-5000). The replacement fluids used were 3% hydroxyethylstarch (HES) (24%), 5% albumin (35%), fresh frozen plasma (25%), and HES and albumin (16%). HES was tolerated well even as a sole replacement fluid with acceptable minor side effects. In three patients with progressing hypoalbuminemia HES was replaced or combined with 5% albumin. Close monitoring of serum albumin and fibrinogen levels after repeated procedures is mandatory. In our four years of TPE experience we have increased our collaboration with other departments. 3% HES+/-5% Albumin is a feasible, well tolerated and cost effective replacement fluid combination especially for short-term plasma exchange therapy.

A User-Centered Framework for Deriving A Conceptual Design From User Experiences: Leveraging Personas and Patterns to Create Usable Designs

Science.gov (United States)

Javahery, Homa; Deichman, Alexander; Seffah, Ahmed; Taleb, Mohamed

Patterns are a design tool to capture best practices, tackling problems that occur in different contexts. A user interface (UI) design pattern spans several levels of design abstraction ranging from high-level navigation to low-level idioms detailing a screen layout. One challenge is to combine a set of patterns to create a conceptual design that reflects user experiences. In this chapter, we detail a user-centered design (UCD) framework that exploits the novel idea of using personas and patterns together. Personas are used initially to collect and model user experiences. UI patterns are selected based on personas pecifications; these patterns are then used as building blocks for constructing conceptual designs. Through the use of a case study, we illustrate how personas and patterns can act as complementary techniques in narrowing the gap between two major steps in UCD: capturing users and their experiences, and building an early design based on that information. As a result of lessons learned from the study and by refining our framework, we define a more systematic process called UX-P (User Experiences to Pattern), with a supporting tool. The process introduces intermediate analytical steps and supports designers in creating usable designs.

Academic Career Selection and Retention in Radiation Oncology: The Joint Center for Radiation Therapy Experience

International Nuclear Information System (INIS)

Balboni, Tracy A.; Chen, M.-H.; Harris, Jay R.; Recht, Abram; Stevenson, Mary Ann; D'Amico, Anthony V.

2007-01-01

Purpose: The United States healthcare system has witnessed declining reimbursement and increasing documentation requirements for longer than 10 years. These have decreased the time available to academic faculty for teaching and mentorship. The impact of these changes on the career choices of residents is unknown. The purpose of this report was to determine whether changes have occurred during the past decade in the proportion of radiation oncology trainees from a single institution entering and staying in academic medicine. Methods and Materials: We performed a review of the resident employment experience of Harvard Joint Center for Radiation Therapy residents graduating during 13 recent consecutive years (n = 48 residents). The outcomes analyzed were the initial selection of an academic vs. nonacademic career and career changes during the first 3 years after graduation. Results: Of the 48 residents, 65% pursued an academic career immediately after graduation, and 44% remained in academics at the last follow-up, after a median of 6 years. A later graduation year was associated with a decrease in the proportion of graduates immediately entering academic medicine (odds ratio, 0.78; 95% confidence interval, 0.65-0.94). However, the retention rate at 3 years of those who did immediately enter academics increased with a later graduation year (p = 0.03). Conclusion: During a period marked by notable changes in the academic healthcare environment, the proportion of graduating Harvard Joint Center for Radiation Therapy residents pursuing academic careers has been declining; however, despite this decline, the retention rates in academia have increased

A Three-Year Experience of Medical Thoracoscopy at A Tertiary Care Center of Himalayan Region

Directory of Open Access Journals (Sweden)

Rakhee Sodhi

2016-03-01

Full Text Available Introduction: Medical thoracoscopy is a minimally invasive procedure for diagnosing and treating pleural diseases. Despite its proven role in diagnostic and therapeutic purposes, it is infrequently used, which could be because of cost of equipment and lack of training. We analyzed our initial 3 years record of thoracoscopy at Himalayan Institute of Medical Sciences, a tertiary care center in Himalayan region of north India. Materials and Methods: This cross-sectional study was to analyze our experience of medical thoracoscopy which was started in Jan 2011 at our center. All patients who underwent thoracoscopy during the period between Jan 2011 to Dec 2013 were included in the study. Thoracoscopy was performed for diagnosis of undiagnosed pleural effusions. Clinical, radiological, cytological & histopathological data of the patients were collected prospectively and analysed. Results: The diagnostic yield for a pleuroscopic pleural biopsy in our study was 87.23% (41/47. Malignancy was diagnosed histopathologically in 70.2% (33/47 patients (both primary & metastatic pleural carcinoma and tuberculosis in 10.6% (5/47. There was no mortality related to procedure. Only three patients had minor complications like subcutaneous emphysema which was mild and resolved by second post-procedure day. Pain at intercostal drain site was observed in some patients. Conclusion: Thoracoscopy is an easy outpatient procedure and an excellent diagnostic tool for pleural effusion of uncertain etiology. It has low complication rate even in settings where the procedure is just started. It should be included in the armamentarium of tools for management of pleural effusion.

Survival in pediatric lung transplantation: The effect of center volume and expertise.

Science.gov (United States)

Khan, Muhammad S; Zhang, Wei; Taylor, Rachel A; Dean McKenzie, E; Mallory, George B; Schecter, Marc G; Morales, David L S; Heinle, Jeffrey S; Adachi, Iki

2015-08-01

Institutional operative volume has been shown to impact outcomes of various procedures including lung transplantation (LTx). We sought to determine whether this holds true with pediatric LTx by comparing outcomes of adult centers (with larger overall volume) to those of pediatric centers (with smaller volume but more pediatric-specific experience). A retrospective analysis of the Organ Procurement and Transplant Network data was performed. Centers were categorized as either adult (LTx volume predominantly in adult patients), high-volume pediatric (HVP, ≥4 LTxs/year), or low-volume pediatric (LVP, HVP 3 [5%], LVP 8 [13%]). Although adult centers had larger overall LTx volume, their pediatric experiences were severely limited (median 1/year). In younger children, HVP centers were significantly better than LVP centers for patient survival (half-life: 7.3 vs 2.9 years, p = 0.002). Similarly, in older children and adolescents, HVP centers were significantly better than adult centers for patient survival (half-life: 4.6 vs 2.5 years, p = 0.001). Of note, even LVP centers tended to have longer patient survival than adult centers (p = 0.064). Multivariable analysis identified adult centers as an independent risk factor for graft failure (hazard ratio: 1.5, p < 0.001) as with LVP (hazard ratio: 1.3, p = 0.0078). Despite larger overall clinical volume, outcomes among pediatric LTx recipients in adult centers are not superior to those of pediatric centers. Not only center volume but pediatric-specific experience has an impact on outcomes in pediatric LTx. Copyright © 2015 International Society for Heart and Lung Transplantation. Published by Elsevier Inc. All rights reserved.

Student teachers' perceptions about their experiences in a student centered course

Directory of Open Access Journals (Sweden)

Canan Perkan Zeki

2014-03-01

Full Text Available There is a growing need to provide curricula that meets the changing needs of students in higher education. To train pre-service teachers according to the demands of the new educational contexts, the move from teacher-centered curricula to learning-centered curricula is a must. The aim of this research is to examine the currently used curriculum of EGIT 450 Student Centered Education (SCE course to highlight suggestions for a better design and implementation of the SCE approach. A qualitative paradigm was used with an interpretive methodology. The participants of the study were the 37 third year undergraduate students enrolled in the course at one of the tertiary institutions in North Cyprus. Qualitative data were collected through end-of-the-semester reflective essays and analyzed through content analysis method. The findings revealed that SCE methodology helped improve student teachers' cognitive skills via holding an active role and their affective skills through group work activities emphasizing its effect on permanent learning and learning how to learn. Participants also pointed out the difficulty and complexity of the roles expected from the teacher and learners individually and cooperatively. The inefficiency of some of the teaching-learning activities, physical characteristics of the classroom setting and duration of the allocated time for the activities were among the weak aspects of the course.

How to Create a Learning-Centered ESL Program

Science.gov (United States)

Bista, Krishna

2011-01-01

This paper reviews the major features of learning-centered community colleges that offer educational programs and experiences for learners, based on individual need. By citing some exemplary learning colleges, the author examines the concepts and ideas of learning-centered colleges in teaching English as a Second Language (ESL) programs. An…

Safety of infliximab in Crohn's disease: a large single-center experience.

Science.gov (United States)

Hamzaoglu, H; Cooper, J; Alsahli, M; Falchuk, K R; Peppercorn, M A; Farrell, R J

2010-12-01

The aim of this study was to evaluate the short- and long-term safety experience of infliximab treatment in patients with Crohn's disease (CD) in clinical practice. The medical records of 297 consecutive patients with CD treated with infliximab at the Beth Israel Deaconess Medical Center were reviewed for demographic features and adverse events. The 297 patients received a total of 1794 infusions. Patients received a median of four infusions and had a median follow-up of 14.3 months. Forty-four patients (15%) experienced a serious adverse event, requiring the infusion to be stopped in 33 patients (11%). Acute infusion reactions occurred in 18 patients (6%) including respiratory problems in 10 patients (3%) and an anaphylactoid reaction in 1 patient (0.3%). Serum sickness-like disease occurred in one patient (0.3%) and three patients (1%) developed drug-induced lupus. One patient developed a probable new demyelination disorder. Eight patients (2.7%), all of whom were on concurrent immunosuppressants, developed a serious infection, one resulting in fatal sepsis. Six patients (2%) developed malignancies including two lymphomas and two skin cancers. A total of four (1.3%) deaths were observed (median age 72.5 years); two due to gastrointestinal bleeding, one due to sepsis, and one due to malignancy. While short- and long-term infliximab therapy was generally well tolerated, serious adverse events occurred in 15% of patients including drug-induced lupus, fatal sepsis, and malignancy. Concomitant immunosuppressants were significantly associated with infections and deaths, particularly among elderly patients. Copyright © 2010 Crohn's & Colitis Foundation of America, Inc.

Outcome of liver transplantation for hepatocellular carcinoma -- a single center experience.

Science.gov (United States)

Iacob, R; Iacob, S; Gheorghe, L; Gheorghe, C; Hrehoreţ, D; Brașoveanu, V; Croitoru, A; Herlea, V; Popescu, I

2013-01-01

Liver transplantation (LT) is a promising treatment for patients with liver cirrhosis associated with hepatocellular carcinoma (HCC). The aim of our study was to evaluate our experience regarding the clinical and pathological staging of HCC in patients who underwent LT, as well as recurrence free and overall survival. From January 2006 to December 2011, 38 patients with diagnosis of HCC, underwent LT in our Center. Demographic, clinical, imaging and pathologic information were recorded. A Cox proportional hazards survival analysis was performed in order to identify significant predictors of tumor recurrence and patient's death after LT. Eighteen patients (47.4%) in our study group were within Milan criteria. The mean follow-up was 22 months and the recurrence rate of HCC after LT was 13.2%. The 1, 3- year recurrence free survival rates were 85%, 74.3% respectively. The 1 and 3-year overall survival rates were 83.5% and 63.6% respectively. No significant predictor for HCC recurrence was identified in our study group by survival analysis, taking into account 13 different variables. As independent predictors of patient'ss death after LT for HCC however, the presence of diabetes mellitus (p=0.001), presence of more than 3 HCC nodules (p=0.03) and tumor recurrence after LT (p=0.03) were identified by multivariate Cox proportional hazards survival analysis. In our cohort HCC recurrence rate after LT was 13.2%. Diabetes mellitus, presence of more than 3 HCC nodules and HCC recurrence were significant predictors of poor overall survival after LT. Celsius.

Living Related Donor Kidney Transplantation in Libya: A Single Center Experience

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Elusta Ahmed

2008-01-01

Full Text Available The aim of this study is to report the experience from a single center in Libya, on the prevailing live-related kidney transplantation program. The results of three years work on kidney transplantation at the Tripoli Central Hospital (National Organ Transplant Program in Libya were evaluated. The transplant program was launched on 17 th August, 2004 and 135 patients have been transplanted since then till 17 th August, 2007. All donors and recipients were screened thoroughly prior to transplant and monitored closely in the post-transplant period. Our immuno-suppressive protocol was cyclosporine-based. Among the 135 accepted pairs, donors and reci-pients were genetically-related in 133 cases (98.5% and emotionally-related in two others. The mean donor age was 37 ± 9.5 years (range 18-56 years and recipient age 37 ± 13.6 years (range 7-67 years. There were 95 males (70.4% and 40 females (29.6% among the recipients while among the donors, there were 102 males (75.6% and 33 females (24.4%. Delayed graft function was seen in three patients (2.2%, acute rejection in six (4.4%, post-transplant urinary tract infection in six (4.4%, pneumonia in three (2.2%, ureteric kink in two (1.5% and urine leak in four (3.0%. Graft survival at 36 months was 93.3% while patient survival at the same period was 96.3%. This report indicates that the results of our transplant program are good and comparable with other international programs.

MILITARY CONSTRUCTION: Kaiserslautern Military Community Center Project Continues to Experience Problems

National Research Council Canada - National Science Library

Kutz, Gregory D; Causseaux, Bruce A; Dorn, Terrell G

2008-01-01

The Kaiserslautern Military Community Center (KMCC) is one of many projects initiated at Ramstein Air Base to upgrade capabilities of the base as a result of the consolidation of military bases in Europe...

High school students' experiences of bullying and victimization and the association with school health center use.

Science.gov (United States)

Lewis, Catherine; Deardorff, Julianna; Lahiff, Maureen; Soleimanpour, Samira; Sakashita, Kimi; Brindis, Claire D

2015-05-01

Bullying and victimization are ongoing concerns in schools. School health centers (SHCs) are well situated to support affected students because they provide crisis intervention, mental health care, and broader interventions to improve school climate. This study examined the association between urban adolescents' experiences of school-based bullying and victimization and their use of SHCs. Data was analyzed from 2063 high school students in 5 Northern California school districts using the 2009-2010 California Healthy Kids Survey. Chi-square tests and multivariate logistic regression were used to measure associations. Students who were bullied or victimized at school had significantly higher odds of using the SHCs compared with students who were not, and were also significantly more likely to report confidentiality concerns. The magnitude of associations was largest for Asian/Pacific Islander students, though this was likely due to greater statistical power. African American students reported victimization experiences at approximately the same rate as their peers, but were significantly less likely to indicate they experienced bullying. Findings suggest that SHCs may be an important place to address bullying and victimization at school, but confidentiality concerns are barriers that may be more common among bullied and victimized youth. © 2015, American School Health Association.

Institutional aspects of the energy centers concept

Energy Technology Data Exchange (ETDEWEB)

Esser, George H.

1977-03-01

Information is presented concerning the socio-economic impacts of nuclear energy centers; equity considerations relating to taxation and revenue distribution; report on jurisdictional authorities of state and local government related to centralized and decentralized alternative energy systems; federal-state conflicts and cooperation in the siting of nuclear energy facilities; the energy park experience in Pennsylvania; and a socio-economic institution summary of energy centers in Washington State.

Institutional aspects of the energy centers concept

International Nuclear Information System (INIS)

1977-03-01

Information is presented concerning the socio-economic impacts of nuclear energy centers; equity considerations relating to taxation and revenue distribution; report on jurisdictional authorities of state and local government related to centralized and decentralized alternative energy systems; federal-state conflicts and cooperation in the siting of nuclear energy facilities; the energy park experience in Pennsylvania; and a socio-economic institution summary of energy centers in Washington State

Major Complications of Pneumatic Dilation and Heller Myotomy for Achalasia: Single Center Experience and Systematic Review of the Literature

Science.gov (United States)

Lynch, Kristle L; Pandolfino, John E; Howden, Colin W; Kahrilas, Peter J

2013-01-01

Background & Aims Pneumatic dilation (PD) and laparoscopic Heller myotomy (LHM) can be definitive therapies for achalasia; recent data suggest comparable efficacy. However, risk must also be considered. We reviewed the major complication rate of PD and LHM in a high volume center and reviewed the corresponding literature. Methods We reviewed 12 years of our institution’s achalasia treatment experience. During this interval a consistent technique of PD was used utilizing Rigiflex dilators. Medical records were reviewed for post-procedure complications. We administered a telephone survey and examined medical records to assess efficacy of treatment. We also performed a systematic review of the literature for comparable clinical data and examined 80 reports encompassing 12,494 LHM and PD procedures. Results At our center, 463 achalasia patients underwent 567 PD or LHM procedures. 78% of the PDs used a 30 mm Rigiflex dilator. 157/184 (85%) patients underwent 1 or 2 PD without any subsequent treatment. There were seven clinically significant perforations; one from PD and 6 from LHM. There were no resultant deaths from these perforations; two deaths occurred within 30 days of LHM from unrelated causes. Complications and deaths post-PD were significantly fewer than those post-LHM (p=.02). Conclusions Esophageal perforation from PD at our high-volume center was less common than often reported and lower than that associated with LHM. We conclude that, in the hands of experienced operators using conservative technique, PD has fewer major complications and deaths than LHM. PMID:23032978

Liver transplantation utilizing old donor organs: a German single-center experience.

Science.gov (United States)

Rauchfuss, F; Voigt, R; Dittmar, Y; Heise, M; Settmacher, U

2010-01-01

Due to the current profound lack of suitable donor organs, transplant centers are increasingly forced to accept so-called marginal organs. One criterion for marginal donors is the donor age >65 years. We have presented herein the impact of higher donor age on graft and patient survival. Since 2004, 230 liver transplantations have been performed at our center, including 54 donor organs (23.5%) from individuals >65 years of age. We performed a retrospective analysis of recipient and graft survivals. The overall 1-year mortality was 22.2% (12/54) among recipients of organs from older donors versus 19.5% among recipients whose donors were donor organs were grouped according to age, the 1-year mortality in patients receiving organs from donors aged 65-69 years was 30% (6/20); 70-74 years, 29.4% (5/17); and donors >75 years, 5.9% (1/17). There was no significant correlation between mortality rate and the number of additional criteria of a marginal donor organ. The current lack of donor organs forces transplant centers to accept organs from older individuals; increasingly older patients are being recruited for the donor pool. Our results showed that older organs may be transplanted with acceptable outcomes. This observation was consistent with data from the current literature. It should be emphasized, however, that caution is advised when considering the acceptance of older organs for patients with hepatitis C-related cirrhosis.

The analytical center of INP - experience of becoming prospect of development

International Nuclear Information System (INIS)

Kadyrzhanov, K.K.; Kozhakhmetov, S.K.

2004-01-01

Full text: In 2001 in INP NNC RK the Analytical center has been organized as separate structural division. The primary goal of the Analytical center is all-round use of the scientific and technical potential, which has been saved up in INP NNC RK for the organization and carrying out of researches, actual for, first of all for the domestic companies, scientific institutes and the foreign companies working in Kazakhstan. In the report data on the equipment with which the Analytical center for performance of works is equipped are resulted. For these purposes the grants of the international organizations and funds are involved. For example, about two years it is maintained universal X-ray diffractometer Brucker D8 Advance got with support of U.S. CRDF (the project *KR2-993). Under the project *KAR2-1036-AL-03 the same fund in current of 2005 delivery of the specialized equipment for test of corrosion resistance of materials will be made. The site on preparation of materials in created and equipped with the specialized equipment. In the report results, both fundamental works, and data on the applied works executed with various partners - National Atomic Company 'KazAtomProm', Ulba Metallurgical Plant, 'Tengizchevroil' Oil Company, Pharmacological Company named 'B-clay' are discussed, etc. In the report the basic directions of the further development of works and expansions of geography of cooperation are formulated

The impact of center experience on results of reduced intensity:allogeneic hematopoietic SCT for AML. An analysis from the Acute Leukemia Working Party of the EBMT

DEFF Research Database (Denmark)

Giebel, S; Labopin, M; Mohty, M

2013-01-01

Allogeneic hematopoietic SCT with reduced-intensity conditioning (RIC-HSCT) is increasingly adopted for the treatment of older adults with AML. Our goal was to verify for the first time, if center experience influences outcome of RIC-HSCT. Results of 1413 transplantations from HLA-matched related...

VMware vCenter cookbook

CERN Document Server

Kuminsky, Konstantin

2015-01-01

If you are a system administrator who has some experience with virtualization and already uses VMware vCenter, but wishes to learn more, then this is the book for you. If you are looking for tips or shortcuts for common administration tasks as well as workarounds for pain points in vSphere administration, you'll find this guide useful.

Steering the Ark: A Cultural Center for Children

Science.gov (United States)

Drury, Martin

2006-01-01

In this article, the author reflects on his experience developing and running The Ark, a Cultural Center for Children in Dublin, Ireland. The author describes the practice and ten guiding principles behind the center. While acknowledging that arts education and arts practice for and with young people is a rich and varied landscape, within which a…

Closing the loop in person-centered care: patient experiences of a chronic kidney disease self-management intervention

Directory of Open Access Journals (Sweden)

Havas K

2017-11-01

Full Text Available Kathryn Havas,1,2 Clint Douglas,1 Ann Bonner1–3 1School of Nursing, Queensland University of Technology, 2NHMRC Chronic Kidney Disease Centre for Research Excellence, University of Queensland, 3Kidney Health Service, Metro North Hospital and Health Service, Brisbane, QLD, Australia Purpose: The provision of self-management support (SMS for people with earlier stages (1–4 of chronic kidney disease (CKD can improve patient outcomes and extend time to dialysis. However, attempts to deliver such support have often not taken patient preferences into account. After the development, implementation, and quantitative evaluation of the person-centered CKD-SMS intervention, the aim of this study was to investigate participant experiences and perceptions of the program, as well as to seek suggestions to improve future SMS attempts.Patients and methods: Semi-structured, face-to-face interviews were conducted with almost all (63/66 participants in the CKD-SMS. Deductive categories were derived from previous research into self-management from the CKD patient’s perspective, and this was supplemented by categories that emerged inductively during multiple readings of interview transcripts. Content analysis was used to analyze interview data.Results: Participants recognized self-management of CKD as complex and multifaceted. They felt that the CKD-SMS helped them develop skills to engage in necessary self-management tasks, as well as their knowledge about their condition and confidence to take an active role in their healthcare. These participants experience a healthcare environment that is characterized by complexity and inconsistency, and participation in the intervention helped them to navigate it. The benefit of participating in this research to contribute to the scientific literature was also recognized by participants. Overall, participants found the CKD-SMS useful in its current format, and made some suggestions for future interventions

Multidisciplinary Approach to Esophageal Achalasia: A Single Center Experience.

Science.gov (United States)

Schlottmann, Francisco; Andolfi, Ciro; Kavitt, Robert T; Konda, Vani J A; Patti, Marco G

2017-04-01

The treatment of achalasia is palliative. Pneumatic dilatation (PD) or laparoscopic Heller myotomy (LHM) just eliminates the outflow obstruction allowing easier emptying of the esophagus. The aim of this study was to evaluate the results of a multidisciplinary approach to esophageal achalasia. A consecutive series of patients with achalasia treated by a multidisciplinary esophageal team consisting of radiologists, gastroenterologists, and surgeons in a quaternary care center between May 2008 and April 2015 were analyzed. A total of 147 patients with achalasia underwent LHM and partial fundoplication. Sixty-two patients (42%) had been treated preoperatively with PD and/or botulinum toxin (BT). The preoperative Eckardt score (ES) was 6.4 ± 2. At a median follow-up of 22 months, 128 patients (87%) did well and required no further treatment (ES 0.1). The remaining 19 patients (13%) had recurrence of symptoms and required further treatment: 12 were treated with PD and improved (ES 0.7); 4 were treated with PD and BT and improved (ES 1.3); 3 failed PD. These 3 patients had been treated with multiple sessions of PD and BT before the myotomy. Overall, 144 patients (98%) did well with laparoscopic (87%) or laparoscopic and endoscopic treatment (11%). The results of this study show that (a) LHM is an effective treatment modality, (b) PD improved symptoms in the majority of patients with recurrent dysphagia after myotomy and (c) multiple preoperative endoscopic treatments seem to affect outcomes of LHM. Patients with achalasia should be treated in a quaternary care center by a multidisciplinary team.

Review of the High Performance Antiproton Trap (HiPAT) Experiment at the Marshall Space Flight Center

Science.gov (United States)

Pearson, J. B.; Sims, Herb; Martin, James; Chakrabarti, Suman; Lewis, Raymond; Fant, Wallace

2003-01-01

The significant energy density of matter-antimatter annihilation is attractive to the designers of future space propulsion systems, with the potential to offer a highly compact source of power. Many propulsion concepts exist that could take advantage of matter-antimatter reactions, and current antiproton production rates are sufficient to support basic proof-of-principle evaluation of technology associated with antimatter- derived propulsion. One enabling technology for such experiments is portable storage of low energy antiprotons, allowing antiprotons to be trapped, stored, and transported for use at an experimental facility. To address this need, the Marshall Space Flight Center's Propulsion Research Center is developing a storage system referred to as the High Performance Antiproton Trap (HiPAT) with a design goal of containing 10(exp 12) particles for up to 18 days. The HiPAT makes use of an electromagnetic system (Penning- Malmberg design) consisting of a 4 Telsa superconductor, high voltage electrode structure, radio frequency (RF) network, and ultra high vacuum system. To evaluate the system normal matter sources (both electron guns and ion sources) are used to generate charged particles. The electron beams ionize gas within the trapping region producing ions in situ, whereas the ion sources produce the particles external to the trapping region and required dynamic capture. A wide range of experiments has been performed examining factors such as ion storage lifetimes, effect of RF energy on storage lifetime, and ability to routinely perform dynamic ion capture. Current efforts have been focused on improving the FW rotating wall system to permit longer storage times and non-destructive diagnostics of stored ions. Typical particle detection is performed by extracting trapped ions from HiPAT and destructively colliding them with a micro-channel plate detector (providing number and energy information). This improved RF system has been used to detect various

Astrophysics related programs at center for underground physics (CUP)

Science.gov (United States)

Kim, Yeongduk

2018-04-01

We are developing experimental programs related to particle astrophysics at the Center for Underground Physics (CUP); searching for neutrino-less double beta decay (0νββ) of 100Mo nuclei and sterile neutrinos in the mass range of eV using reactor neutrinos. Expected sensitivities of AMoRE double beta decay experiment and the results from recent NEOS experiment are described. Utilizing the facilities for ultra-low radioactivity measurement at the center, we are planning to measure the decay of 180mTa which is important to the nucleosynthesis of heavy nuclei.

Experience of Client-centered Practice amongst Danish Occupational Therapists

DEFF Research Database (Denmark)

Larsen, Anette Enemark

A client-centered approach is on the health care agenda in many European countries (1), and amongst these Denmark (2). It is described as the foundation for Occupational Therapy (OT) (3), a code of professional conduct (4,5), and defined as a partnership between client and therapist (3). The goal...... is to empower a client to fulfil his/her occupational roles in a variety of environments, leading to an increase in intervention efficacy and client perception of intervention quality (3). However, it is known to be challenging (1,3). Given the importance of this approach, there has been limited exploration...

Preimplantation genetic diagnosis for cystic fibrosis: the Montpellier center's 10-year experience.

Science.gov (United States)

Girardet, A; Ishmukhametova, A; Willems, M; Coubes, C; Hamamah, S; Anahory, T; Des Georges, M; Claustres, M

2015-02-01

This study provides an overview of 10 years of experience of preimplantation genetic diagnosis (PGD) for cystic fibrosis (CF) in our center. Owing to the high allelic heterogeneity of CF transmembrane conductance regulator (CFTR) mutations in south of France, we have set up a powerful universal test based on haplotyping eight short tandem repeats (STR) markers together with the major mutation p.Phe508del. Of 142 couples requesting PGD for CF, 76 have been so far enrolled in the genetic work-up, and 53 had 114 PGD cycles performed. Twenty-nine cycles were canceled upon in vitro fertilization (IVF) treatment because of hyper- or hypostimulation. Of the remaining 85 cycles, a total of 493 embryos were biopsied and a genetic diagnosis was obtained in 463 (93.9%), of which 262 (without or with a single CF-causing mutation) were transferable. Twenty-eight clinical pregnancies were established, yielding a pregnancy rate per transfer of 30.8% in the group of seven couples with one member affected with CF, and 38.3% in the group of couples whose both members are carriers of a CF-causing mutation [including six couples with congenital bilateral absence of the vas deferens (CBAVD)]. So far, 25 children were born free of CF and no misdiagnosis was recorded. Our test is applicable to 98% of couples at risk of transmitting CF. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

[Toxicological consultation data management system based on experience of Pomeranian Center of Toxicology].

Science.gov (United States)

Kabata, Piotr Maciej; Waldman, Wojciech; Sein Anand, Jacek

2015-01-01

In this paper the structure of poisonings is described, based on the material collected from tele-toxicology consults by the Pomeranian Center of Toxicology in Gdańsk and harvested from its Electronic Poison Information Management System. In addition, we analyzed conclusions drawn from a 27-month operation of the system. Data were harvested from the Electronic Poison Information Management System developed in 2012 and used by the Pomeranian Center of Toxicology since then. The research was based on 2550 tele-toxicology consults between January 1 and December 31, 2014. Subsequently the data were electronically cleaned and presented using R programming language. The Pomeranian voivodeship was the prevalent localisation of calls (N = 1879; 73.7%). Most of the calls came from emergency rooms (N = 1495; 58.63%). In the case of 1396 (54.7%) patients the time-lag between intoxication and the consult was less than 6 h. There were no differences in the age distribution between genders. Mean age was 26.3 years. Young people predominated among intoxicated individuals. The majority of intoxications were incidental (N = 888; 34.8%) or suicidal (N = 814; 31.9%) and the most of them took place in the patient's home. Information about Poison Control Center consultations access should be better spread among medical service providers. The extent of poison information collected by Polish Poison Control Centers should be limited and unified. This should contribute to the increased percentage of properly documented consultations. Additional duties stemming from the need of digital archiving of consults provided, require the involvement of additional staff, leading to the increased operation costs incurred by Poison Control Centers. This work is available in Open Access model and licensed under a CC BY-NC 3.0 PL license.

Center Variation and the Effect of Center and Provider Characteristics on Clinical Outcomes in Kidney Transplantation: A Systematic Review of the Evidence

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Anne Tsampalieros

2017-10-01

Full Text Available Background: Kidney transplantation is the best treatment option for patients with end-stage renal disease. While patient-level factors affecting survival are established, the presence of variation in the management of transplant recipients remains unknown. Objective: The objective of this study was to examine center variation in kidney transplantation and identify center and provider characteristics that may be associated with clinical outcomes. Design: This is a systematic review. Data sources: Ovid Medline, Embase, and Cochrane library from inception to June 2016 were used. Study eligibility: Any study examining the association between center or provider characteristics and graft or patient survival, quality of life, or functional status were included. Results: We identified 6327 records and 24 studies met eligibility. Most studies used data registries. Characteristics evaluated include center volume (n = 17, provider volume (n = 2, provider experience (n = 1, center type (n = 2, and location of follow-up (n = 1. Outcomes assessed included graft survival (n = 24 and patient survival (n = 9. Significant center variation was described in 12 of 15 and 5 of 7 studies for graft and patient survival. There was a significant and positive association between center volume and graft and patient survival in 8 and 2 studies, respectively. Provider experience and volume were significantly associated with less allograft loss and provider volume with lower risk of death. There was no association between graft survival and location of follow-up or center type. Limitations: There was substantial heterogeneity in the variables assessed and methodology used to analyze associations. Conclusion: This systematic review found center variation in kidney transplantation. Future studies in the current era are necessary to better evaluate this important topic.

Axial lumbar interbody fusion: a 6-year single-center experience

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Zeilstra DJ

2013-08-01

Full Text Available Dick J Zeilstra,1 Larry E Miller,2,3 Jon E Block3 1Bergman Clinics, Naarden and NedSpine, Ede, The Netherlands; 2Miller Scientific Consulting, Inc, Arden, NC, USA; 3The Jon Block Group, San Francisco, CA, USA Introduction: The aim of this study is to report our 6-year single-center experience with L5–S1 axial lumbar interbody fusion (AxiaLIF. Methods: A total of 131 patients with symptomatic degenerative disc disease refractory to nonsurgical treatment were treated with AxiaLIF at L5–S1, and were followed for a minimum of 1 year (mean: 21 months. Main outcomes included back and leg pain severity, Oswestry Disability Index score, working status, analgesic medication use, patient satisfaction, and complications. Computed tomography was used to determine postoperative fusion status. Results: No intraoperative complications, including vascular, neural, urologic, or bowel injuries, were reported. Back and leg pain severity decreased by 51% and 42%, respectively, during the follow-up period (both P < 0.001. Back function scores improved 50% compared to baseline. Clinical success, defined as improvement ≥30%, was 67% for back pain severity, 65% for leg pain severity, and 71% for back function. The employment rate increased from 47% before surgery to 64% at final follow-up (P < 0.001. Less than one in four patients regularly used analgesic medications postsurgery. Patient satisfaction with the AxiaLIF procedure was 83%. The fusion rate was 87.8% at final follow-up. During follow-up, 17 (13.0% patients underwent 18 reoperations on the lumbar spine, including pedicle screw fixation (n = 10, total disc replacement of an uninvolved level (n = 3, facet screw fixation (n = 3, facet screw removal (n = 1, and interbody fusion at L4–L5 (n = 1. Eight (6.1% reoperations were at the index level. Conclusion: Single-level AxiaLIF is a safe and effective means to achieve lumbosacral fusion in patients with symptomatic degenerative disc disease. Keywords: Axia

A Comparison of Methods and Results in Recruiting White and Black Women into Reproductive Studies: The MMC-PSU Cooperative Center on Reproduction Experience

Science.gov (United States)

Sweet, Stephanie; Legro, Richard S; Coney, PonJola

2008-01-01

Establishing a holistic approach for the enrollment of subjects into clinical trials that includes strategies for the recruitment of non-traditional and minority populations has been an elusive task. The existence of such a design, that is understood and embraced by investigators and the target communities, would streamline the current level of commitment of time, energy and resources. This is necessary to successfully encourage individual and community participation in research studies. The Center for Research in Reproduction at Meharry set out to recruit a large number of African American women volunteers of reproductive age into clinical trials. The experience, of recruiting volunteers from the African American community for clinical trials in the Meharry Medical College/Pennsylvania State University (MMC/PSU)'s Cooperative Center for Research in Reproduction at Meharry, is presented. PMID:18082470

Endovascular Aortic Aneurysm Repair for Abdominal Aortic Aneurysm: Single Center Experience in 122 Patients

International Nuclear Information System (INIS)

Lee, Yun Young; Song, Jang Hyeon; Kim, Yong Tae; Yim, Nam Yeol; Kim, Jae Kyu; Lee, Ho Kyun; Choi, Soo Jin Na; Chung, Sang Young; Kim, Soo Hyun; Chang, Nam Kyu

2013-01-01

To analyze a single center experience of endovascular aneurysm repair (EVAR) for abdominal aortic aneurysms. Results of 122 patients who underwent EVAR were analyzed, retrospectively. Sex, age, aneurysmal morphology, hostile neck anatomy, preprocedural and postprocedural sac-diameter, technical and clinical success, postprocedural complication and need of additional procedure were analyzed. A total of 111 male and 11 female patients were included. Morphology of the aneurysms was as follows: fusiform (n = 108), saccular (n = 3) and ruptured type (n = 11). Sixty-four patients had hostile neck anatomy. The preprocedural mean sac-diameter was 52.4 mm. Postprocedural sac-diameter was decreased or stable in 110 patients (90.2%) and increased in 8 patients (6.6%). Technical success rate was 100% and clinical success rate was 86.1%. Fifty-one patients showed endoleak (41.8%) and 15 patients (12.3%) underwent secondary intervention due to type I endoleak (n = 4), type II endoleak (n = 4) and stent-graft thrombosis (n = 7). EVAR is a safe and effective therapy for abdominal aortic aneurysm, and it has high technical success and clinical success rate, and low complication rate.

OCCUPATIONAL THERAPY EXPERIENCES IN THE FAMILY HEALTH SUPPORT CENTERS (NASF IN THE DISTRITO FEDERAL

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Kelly Ranyelle Alves Araujo

2013-09-01

Full Text Available To support and expand the care attention and the health management in primary care, in particular the Family Health Strategy, it was created the Family Health Support Centers (NASF. The NASF accounts with several professionals, including occupational therapists, who develop different activities, including health promotion, holistic care and psychosocial rehabilitation. The aim of this article is to discuss from practical experience in a NASF in the metropolitan region of Brasilia how students and practitioners of occupational therapy falls within that service, identifying the main limitations and the work that advances the health care setting. Results: The students and occupational therapist service sought to develop an integrated and intersectoral. Actions were part of the home visits, group approaches with different community groups, active search for users and partnerships in the community. Thus, the work is still very limited assistance and connected to the matricial point of view, as recommended. We conclude that, despite the NASF be a new field of labor for occupational therapists, the actions of social inclusion, empowerment and citizenship developed can encourage healthy habits, but practices need to be revised to follow the proposal of this device.

Management of vestibular schwannomas with linear accelerator-based stereotactic radiosurgery: a single center experience.

Science.gov (United States)

Sager, Omer; Beyzadeoglu, Murat; Dincoglan, Ferrat; Demiral, Selcuk; Uysal, Bora; Gamsiz, Hakan; Oysul, Kaan; Dirican, Bahar; Sirin, Sait

2013-01-01

The primary goal of treatment for vestibular schwannoma is to achieve local control without comprimising regional cranial nerve function. Stereotactic radiosurgery has emerged as a viable therapeutic option for vestibular schwannoma. The aim of the study is to report our 15-year single center experience using linear accelerator-based stereotactic radiosurgery in the management of patients with vestibular schwannoma. Between July 1998 and January 2013, 68 patients with unilateral vestibular schwannoma were treated using stereotactic radiosurgery at the Department of Radiation Oncology, Gulhane Military Medical Academy. All patients underwent high-precision stereotactic radiosurgery using a linear accelerator with 6-MV photons. Median follow-up time was 51 months (range, 9-107). Median age was 45 years (range, 20-77). Median dose was 12 Gy (range, 10-13) prescribed to the 85%-95% isodose line encompassing the target volume. Local tumor control in patients with periodic follow-up imaging was 96.1%. Overall hearing preservation rate was 76.5%. Linear accelerator-based stereotactic radiosurgery offers a safe and effective treatment for patients with vestibular schwannoma by providing high local control rates along with improved quality of life through well-preserved hearing function.

Applying accreditation standards in a self-evaluation process: The experience of Educational Development Center of Tehran University of Medical Sciences

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A Mirzazadeh

2016-03-01

Full Text Available Introduction: Educational Development Centers (EDCs, as the coordinator in education development in Medical Sciences universities, in order to improve their quality should evaluate their activities. In spite of remarkable performance of Tehran University of Medical Sciences (TUMS EDC in previous national rankings, but it faces many challenges and problems. This paper provided the process, results and lessons learned from a self-evaluation experience conducted at TUMS EDC based on accreditation standards. Method: The present study is an Institutional self-evaluation study based on the national accreditation standards of EDCs (2012. Data were gathered using an open-ended questionnaire developed on the basis of the SWOT format. A directional content analysis applied to analyze the data. Results: In total, 84 point of strengths, 87 weaknesses, 15 opportunities, 24 threats and also 99 recommendations for quality improvement were reported. The most important strengths of the center were the existence of an established mechanism regarding research process in education and scholarship of education, holding various faculty development courses and training standardized patient. The most important weaknesses were the lack of specified procedures in some areas such as monitoring the planning and reviewing of educational programs in the field of educational programs and evaluation of empowerment courses. Conclusion: The present evaluation results will be useful in directing future policies of TUMS EDC such as revising its strategic planning. We hope that the current experience can be helpful for administrators in EDCs in the Ministry of Health and Medical Education and also other Medical Sciences Universities.

The Community Mental Health Center as a Matrix Organization.

Science.gov (United States)

White, Stephen L.

1978-01-01

This article briefly reviews the literature on matrix organizational designs and discusses the ways in which the matrix design might be applied to the special features of a community mental health center. The phases of one community mental health center's experience in adopting a matrix organizational structure are described. (Author)

A control center design revisited: learning from users’ appropriation

DEFF Research Database (Denmark)

Souza da Conceição, Carolina; Cordeiro, Cláudia

2014-01-01

This paper aims to present the lessons learned during a control center design project by revisiting another control center from the same company designed two and a half years before by the same project team. In light of the experience with the first project and its analysis, the designers and res...

Conducting a user-centered information needs assessment: the Via Christi Libraries' experience.

Science.gov (United States)

Perley, Cathy M; Gentry, Camillia A; Fleming, A Sue; Sen, Kristin M

2007-04-01

The research sought to provide evidence to support the development of a long-term strategy for the Via Christi Regional Medical Center Libraries. An information needs assessment was conducted in a large medical center serving approximately 5,900 physicians, clinicians, and nonclinical staff in 4 sites in 1 Midwestern city. Quantitative and qualitative data from 1,295 self-reporting surveys, 75 telephone interviews, and 2 focus groups were collected and analyzed to address 2 questions: how could the libraries best serve their patrons, given realistic limitations on time, resources, and personnel, and how could the libraries best help their institution improve patient care and outcomes? Clinicians emphasized the need for "just in time" information accessible at the point of care. Library nonusers emphasized the need to market library services and resources. Both clinical and nonclinical respondents emphasized the need for information services customized to their professional information needs, preferences, and patterns of use. Specific information needs in the organization were identified. The results of this three-part, user-centered information needs assessment were used to develop an evidence-based strategic plan. The findings confirmed the importance of promoting library services in the organization and suggested expanded, collaborative roles for hospital librarians.

Abnormal Grief: Should We Consider a More Patient-Centered Approach?

Science.gov (United States)

Moayedoddin, Babak; Markowitz, John C

2015-01-01

Grief, the psychological reaction to the loss of a significant other, varies complexly in its cause, experience, evolution, and prognosis. Although most bereaved individuals experience a normal grieving process, some develop complicated grief (CG) or major depressive disorder (MDD). The DSM-5, which controversially altered the nosology, recognizes grief-related major depression (GRMD) as a diagnostic subtype if a patient meets MDD criteria two weeks post bereavement. The (DSM-5) tries to distinguish between grief and MDD, but remains a symptom-based, centered approach to grief that is not patient centered. This article reviews grief in its normal and abnormal dimensions. Using an illustrative clinical case in which interpersonal psychotherapy (IPT) was employed, we discuss the need for a more patient-centered approach to treating abnormal grief, considering the patient's personal history, perceptions, experiences of bereavement, and interpersonal environment. Clinical studies need to better identify subgroups of individuals susceptible to abnormal grief and to evaluate their response to early interventions.

EXPERIENCE TUTORIALS IN THE GRADUATE FROM THE CENTER OF UPDATE OF THE MAGISTERIUM IN THE STATE OF DURANGO

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Diana María Espinosa Sánchez

2013-09-01

Full Text Available Following the experiences we have had in the Teacher Upgrading Center in tutorials graduate programs in the State of Durango we could detect the strengths and weaknesses, enabling us to make the diagnosis in order to reduce them and develop strengths. The biggest problem that humanity is to educate its members and society as it enters the twenty-first century requires changes and improvements to the educational systems, it is clear the need of teaching and learning for the continued existence of society, higher education institutions should strive to achieve development in man and woman, tutoring in higher education, is a complementary action to develop ethical behavior, intellectual skills and teaching skills. The study is predominantly qualitative and case study method.

Location-based solutions in the experience center

DEFF Research Database (Denmark)

Witzner Hansen, Dan; Alapetite, Alexandre; Holdgaard, Nanna

2009-01-01

In this paper we present a prototype system for location-based guiding. A user survey has been conducted and the observations are used to support design choices. The prototype allows for both indoor and outdoor navigation at and in the vicinity of the NaturBornholm [1] experience centre in Denmar...... using a combination of Bluetooth, Near field communication (NFC), GPS and QR-codes. Bluetooth, NFC, and GPS are used for location-based information and QR-codes are used to convey user preferences. [1] http://naturbornholm.dk...

Intermediate Photovoltaic System Application Experiment. Oklahoma Center for Science and Arts. Phase II. Final report

Energy Technology Data Exchange (ETDEWEB)

1984-01-01

This report presents the key results of the Phase II efforts for the Intermediate PV System Applications Experiment at the Oklahoma Center for Science and Arts (OCSA). This phase of the project involved fabrication, installation and integration of a nominal 140 kW flat panel PV system made up of large, square polycrystalline-silicon solar cell modules, each nominally 61 cm x 122 cm in size. The output of the PV modules, supplied by Solarex Corporation, was augmented, 1.35 to 1 at peak, by a row of glass reflectors, appropriately tilted northward. The PV system interfaces with the Oklahoma Gas and Electric Utility at the OCSA main switchgear. Any excess power generated by the system is fed into the utility under a one to one buyback arrangement. Except for a shortfall in the system output, presently suspected to be due to the poor performance of the modules, no serious problems were encountered. Certain value engineering changes implemented during construction and early operational failure events associated with the power conditioning system are also described. The system is currently undergoing extended testing and evaluation.

Minimized extracorporeal circulation system in coronary artery bypass surgery: a 10-year single-center experience with 2243 patients.

Science.gov (United States)

Puehler, Thomas; Haneya, Assad; Philipp, Alois; Zausig, York A; Kobuch, Reinhard; Diez, Claudius; Birnbaum, Dietrich E; Schmid, Christof

2011-04-01

Coronary artery bypass grafting (CABG) is the gold standard for the surgical therapy of multivessel coronary artery disease. To reduce the side effects, associated with standard extracorporeal circulation (ECC), a concept of minimal extracorporeal circulation (MECC) was devised in our center. We report on our 10-year experience with the MECC for coronary revascularization. From January 1998 to August 2009, 2243 patients underwent CABG with MECC in our center. In a retrospective observational study, we analyzed indication, preoperative patient co-morbidity, postoperative clinical course, and perioperative outcome of all patients operated on with MECC. Furthermore, the risk factors for mortality in the MECC group were assessed. Patients showed a mean logistic European System for Cardiac Operative Risk Evaluation (EuroSCORE) of 4.5±0.1%. The mean age of the patients was 66.8±9.1 years. The overall 30-day mortality after CABG with MECC was 2.3%, ranging from 1.1% for elective to 13.0% for emergent patients and was significantly better than standard ECC. Only 15.3% (n=344) of patients with MECC required intra-operative blood transfusion. Postoperative catecholamine support, red blood cell transfusion, need for hemodialysis, release of creatinine kinase, incidence of stroke, and postoperative delirium were low after MECC revascularization. Ejection fraction below 30% (odds ratio (OR): 5.1), emergent operation (OR: 9.4), and high-dose catecholamine therapy (OR: 2.6) were associated predictors for mortality. MECC until now is an established concept and has become an alternative for ECC in routine CABG in our center. The use of the MECC system is associated with low mortality and conversion rate. Excellent survival rates and low transfusion requirements in the perioperative course were achieved. Copyright © 2010 European Association for Cardio-Thoracic Surgery. Published by Elsevier B.V. All rights reserved.

Supporting learner-centered technology integration through situated mentoring

Science.gov (United States)

Rosenberg, Marian Goode

Situated mentoring was used as a professional development method to help 11 high school science teachers integrate learner-centered technology. The teachers' learner-centered technology beliefs and practices as well as their perception of barriers to learner-centered technology integration were explored before and after participating in the mentoring program. In addition, the participants' thoughts about the effectiveness of various components of the mentoring program were analyzed along with the mentor's observations of their practices. Situated mentoring can be effective for supporting learner-centered technology integration, in particular decreasing the barriers teachers experience. Goal setting, collaborative planning, reflection, and onsite just-in-time support were thought to be the most valuable components of the mentoring program.

Center for Momentum Transport and Flow Organization (CMTFO). Final technical report

International Nuclear Information System (INIS)

Tynan, George R.; Diamond, P. H.; Ji, H.; Forest, C. B.; Terry, P. W.; Munsat, T.; Brummell, N.

2013-01-01

The Center for Momentum Transport and Flow Organization (CMTFO) is a DOE Plasma Science Center formed in late 2009 to focus on the general principles underlying momentum transport in magnetic fusion and astrophysical systems. It is composed of funded researchers from UCSD, UW Madison, U. Colorado, PPPL. As of 2011, UCSD supported postdocs are collaborating at MIT/Columbia and UC Santa Cruz and beginning in 2012, will also be based at PPPL. In the initial startup period, the Center supported the construction of two basic experiments at PPPL and UW Madison to focus on accretion disk hydrodynamic instabilities and solar physics issues. We now have computational efforts underway focused on understanding recent experimental tests of dynamos, solar tachocline physics, intrinsic rotation in tokamak plasmas and L-H transition physics in tokamak devices. In addition, we have the basic experiments discussed above complemented by work on a basic linear plasma device at UCSD and a collaboration at the LAPD located at UCLA. We are also performing experiments on intrinsic rotation and L-H transition physics in the DIII-D, NSTX, C-Mod, HBT EP, HL-2A, and EAST tokamaks in the US and China, and expect to begin collaborations on K-STAR in the coming year. Center funds provide support to over 10 postdocs and graduate students each year, who work with 8 senior faculty and researchers at their respective institutions. The Center has sponsored a mini-conference at the APS DPP 2010 meeting, and co-sponsored the recent Festival de Theorie (2011) with the CEA in Cadarache, and will co-sponsor a Winter School in January 2012 in collaboration with the CMSO-UW Madison. Center researchers have published over 50 papers in the peer reviewed literature, and given over 10 talks at major international meetings. In addition, the Center co-PI, Professor Patrick Diamond, shared the 2011 Alfven Prize at the EPS meeting. Key scientific results from this startup period include initial simulations of the

Center for Momentum Transport and Flow Organization (CMTFO). Final technical report

Energy Technology Data Exchange (ETDEWEB)

Tynan, George R. [University of California, San Diego, CA (United States); Diamond, P. H. [University of California, San Diego, CA (United States); Ji, H. [Princeton Plasma Physics Lab., NJ (United States); Forest, C. B. [Univ. of Wisconsin, Madison, WI (United States); Terry, P. W. [Univ. of Wisconsin, Madison, WI (United States); Munsat, T. [Univ. of Colorado, Boulder, CO (United States); Brummell, N. [Univ. of California, Santa Cruz (United States)

2013-07-29

The Center for Momentum Transport and Flow Organization (CMTFO) is a DOE Plasma Science Center formed in late 2009 to focus on the general principles underlying momentum transport in magnetic fusion and astrophysical systems. It is composed of funded researchers from UCSD, UW Madison, U. Colorado, PPPL. As of 2011, UCSD supported postdocs are collaborating at MIT/Columbia and UC Santa Cruz and beginning in 2012, will also be based at PPPL. In the initial startup period, the Center supported the construction of two basic experiments at PPPL and UW Madison to focus on accretion disk hydrodynamic instabilities and solar physics issues. We now have computational efforts underway focused on understanding recent experimental tests of dynamos, solar tachocline physics, intrinsic rotation in tokamak plasmas and L-H transition physics in tokamak devices. In addition, we have the basic experiments discussed above complemented by work on a basic linear plasma device at UCSD and a collaboration at the LAPD located at UCLA. We are also performing experiments on intrinsic rotation and L-H transition physics in the DIII-D, NSTX, C-Mod, HBT EP, HL-2A, and EAST tokamaks in the US and China, and expect to begin collaborations on K-STAR in the coming year. Center funds provide support to over 10 postdocs and graduate students each year, who work with 8 senior faculty and researchers at their respective institutions. The Center has sponsored a mini-conference at the APS DPP 2010 meeting, and co-sponsored the recent Festival de Theorie (2011) with the CEA in Cadarache, and will co-sponsor a Winter School in January 2012 in collaboration with the CMSO-UW Madison. Center researchers have published over 50 papers in the peer reviewed literature, and given over 10 talks at major international meetings. In addition, the Center co-PI, Professor Patrick Diamond, shared the 2011 Alfven Prize at the EPS meeting. Key scientific results from this startup period include initial simulations of the

Dynamic centering of liquid shells

International Nuclear Information System (INIS)

Tsamopoulos, J.A.; Brown, R.A.

1987-01-01

The moderate-amplitude axisymmetric oscillations of an inviscid liquid shell surrounding an incompressible gas bubble are calculated by a multiple-time-scale expansion for initial deformations composed of two-lobed perturbations of the shell and a displacement of the bubble from the center of mass of the liquid. Two types of small-amplitude motion are identified and lead to very different nonlinear dynamic interactions, as described by the results valid up to second order in the amplitude of the initial deformation. In the ''bubble mode,'' the oscillations of the captive bubble and the liquid shell are exactly in phase and the bubble vibrates about its initial eccentric location. The bubble moves toward the center of the drop when the shell is perturbed into a ''sloshing mode'' of oscillation where both interfaces move out of phase. These results explain the centering of liquid shells observed in several experiments

Collaborative engagement experiment

Science.gov (United States)

Mullens, Katherine; Troyer, Bradley; Wade, Robert; Skibba, Brian; Dunn, Michael

2006-05-01

Unmanned ground and air systems operating in collaboration have the potential to provide future Joint Forces a significant capability for operations in complex terrain. Collaborative Engagement Experiment (CEE) is a consolidation of separate Air Force, Army and Navy collaborative efforts within the Joint Robotics Program (JRP) to provide a picture of the future of unmanned warfare. The Air Force Research Laboratory (AFRL), Material and Manufacturing Directorate, Aerospace Expeditionary Force Division, Force Protection Branch (AFRL/MLQF), The Army Aviation and Missile Research, Development and Engineering Center (AMRDEC) Joint Technology Center (JTC)/Systems Integration Laboratory (SIL), and the Space and Naval Warfare Systems Center - San Diego (SSC San Diego) are conducting technical research and proof of principle experiments for an envisioned operational concept for extended range, three dimensional, collaborative operations between unmanned systems, with enhanced situational awareness for lethal operations in complex terrain. This paper describes the work by these organizations to date and outlines some of the plans for future work.

Implementing the patient-centered medical home in complex adaptive systems: Becoming a relationship-centered patient-centered medical home.

Science.gov (United States)

Flieger, Signe Peterson

This study explores the implementation experience of nine primary care practices becoming patient-centered medical homes (PCMH) as part of the New Hampshire Citizens Health Initiative Multi-Stakeholder Medical Home Pilot. The purpose of this study is to apply complex adaptive systems theory and relationship-centered organizations theory to explore how nine diverse primary care practices in New Hampshire implemented the PCMH model and to offer insights for how primary care practices can move from a structural PCMH to a relationship-centered PCMH. Eighty-three interviews were conducted with administrative and clinical staff at the nine pilot practices, payers, and conveners of the pilot between November and December 2011. The interviews were transcribed, coded, and analyzed using both a priori and emergent themes. Although there is value in the structural components of the PCMH (e.g., disease registries), these structures are not enough. Becoming a relationship-centered PCMH requires attention to reflection, sensemaking, learning, and collaboration. This can be facilitated by settings aside time for communication and relationship building through structured meetings about PCMH components as well as the implementation process itself. Moreover, team-based care offers a robust opportunity to move beyond the structures to focus on relationships and collaboration. (a) Recognize that PCMH implementation is not a linear process. (b) Implementing the PCMH from a structural perspective is not enough. Although the National Committee for Quality Assurance or other guidelines can offer guidance on the structural components of PCMH implementation, this should serve only as a starting point. (c) During implementation, set aside structured time for reflection and sensemaking. (d) Use team-based care as a cornerstone of transformation. Reflect on team structures and also interactions of the team members. Taking the time to reflect will facilitate greater sensemaking and learning and

Environmental center for integrated waste management: an experience in the Amazon

Energy Technology Data Exchange (ETDEWEB)

Jaramillo V, Jairo; Banalcazar, Fernando L.; Noboa Garcia, Gabriel [EnCanEcuador S.A., Houston, TX (United States)

2004-07-01

The creation of a large amount of both solid and liquid waste within the petroleum industry should be the reason for providing a facility that makes it possible to apply proper treatment to the waste matter, depending on the degree of complexity, especially if these operations are taking place within or in the area of influence of a national park or a biosphere reserve. EnCanEcuador has invested $1 200,000 in the construction of facilities and equipment for an integrated environmental management center, which will allow us to create in-house resources for the management of waste control. Organic waste is grinded, homogenized with sawdust and placed in a dynamic sanitary fill to form fertilizer. The leachates material will be used as foliage fertilizer. Inorganic waste is classified, grinded, compacted, packed and sent to different recycling companies or in some cases incinerated in a low emission incinerator. Drilling waste: Drilling mud water based potassium nitrate is treated through a de-nitrification process using bioremediation methods. Liquid waste: from well completion, washing vehicles, drains from production stations, is passed through an API separator system into two physical-chemical treatment pits for its later re-injection. Contaminated soil: that may be caused by petroleum activity is treated in a pit where the greatest possible amount of hydrocarbon is recovered by means of hot hydro-washing and is then treated with native bacteria in two land farming centers. Dangerous solid waste is transported to a secure fill for its confinement. Laboratory and Meteorological Station: For the control and monitoring of petroleum activities and to determine climatic variations. Plant nursery: it will have a capacity to produce 300,000 plants a year. Community Cooperatives will manage the center, enforcing our Social responsibility in our daily activities. (author)

A Culture of Learning: Inside a Living-Learning Center

Science.gov (United States)

Kranzow, Jeannine; Hinkle, Sara E.; Muthiah, Richard; Davis, Colin

2015-01-01

Exploring the culture of a living-learning center, this study examines the educational practices that aim to link in- and out-of-class experiences. Through a cultural lens, the authors offer a glimpse into a living-learning center located within a state institution in the Midwest that models a way of effectively connecting the curricular and…

An overview of Pazopanib in metastatic renal cell carcinoma (mRCC in Ministry of Health (MOH, Malaysia: A multicentre experience

Directory of Open Access Journals (Sweden)

May Feng Chen

2017-12-01

Full Text Available Background: Pazopanib was listed in MOH, Malaysia’s drug formulary on July 2013 for the treatment of mRCC. Two landmark trials were used to support the listing i.e. VEG105192 and COMPARZ which showed a median progression free survival (PFS of 9.2 and 8.4 months respectively. The efficacy and tolerability of Pazopanib in patients with mRCC have been found to differ in Western and Asian populations. Due to the difference in tolerability, dose adjustment in Asian patients is required. In most MOH hospitals in Malaysia, we tend to start mRCC patients with a lower dose as most patients can’t tolerate 800 mg of Pazopanib. We aim to prognosticate and evaluate PFS in patients with mRCC treated in MOH, Malaysia. We also aim to correlate PFS of patients on different doses of Pazopanib. Methods: The largest referral centre in central and southern Malaysia was selected namely Hospital Kuala Lumpur and Hospital Sultan Ismail. A retrospective analysis was done for patients using hospital supply of Pazopanib from 2010 to 2016. PFS is defined as the time of Pazopanib initiation till 1st documented disease progression. Prognostic variables such as age, sex, race, histology, common sites of metastasis, number of organs involved, ECOG, modified MSKCC risk category, prior history of nephrectomy or systemic treatment and initial dose of Pazopanib was analysed. Results: There was a total of 87 patients with mRCC registered. Median time since diagnosis to initiation of Pazopanib was 5 months. PFS for the overall study population was 8.0 months (95%CI, 5.6–10.4 months. PFS based on dose showed 400 mg vs. 800 mg of Pazopanib was 9.0 months (95%CI 4.5–13.4 months vs. 6.0 months (95%CI 1.9–10.1 months respectively (p = 0.209. Modified MSKCC risk category was a significant prognostic variable (p = 0.045. Conclusion: This retrospective review shows no significant difference in PFS between 400 mg vs. 800 mg of Pazopanib. MOH hospitals in Malaysia have similar PFS

Marginal ulcer perforation: a single center experience.

Science.gov (United States)

Natarajan, S K; Chua, D; Anbalakan, K; Shelat, V G

2017-10-01

Marginal ulcer (MU) is defined as ulcer on the jejunal side of the gastrojejunostomy (GJ) anastomosis. Most MUs are managed medically but those with complications like bleeding or perforation require intervention. It is recommended that GJ anastomosis be revised in patients with MU perforation (MUP). The aim of this case series is to study the clinical presentation and management of MUP. Three hundred and thirty-two patients who underwent emergency surgery for perforated peptic ulcer at a single center were studied over a period of 5 years. Nine patients (2.7 %) presented with MUP. GJ was previously done for either complicated peptic ulcer (n = 4) or for suspected gastric malignancy (n = 5). Two patients had previously completed H. pylori therapy. None of the patients presented with septic shock. MU was on the jejunal side of GJ in all patients. The median MUP size was 10 mm. Four patients (44.4 %) had omental patch repair, three (33.3 %) had primary closure, and one each had revision of GJ and jejunal serosal patch repair. There were no leaks, intra-abdominal abscess or reoperation and no malignancies. MUP patients do not present with septic shock. Omental patch repair or primary closure is sufficient enough. Revision of Billroth-II-GJ into Roux-en-Y-GJ is not mandatory.

Analysis of differences in outcome of two European liver transplant centers

NARCIS (Netherlands)

Nemes, B; Polak, W; Ther, G; Hendriks, H; Kobori, L; Porte, RJ; Sarvary, E; de Jong, KP; Doros, A; Gerlei, Z; van den Berg, AP; Fehervari, [No Value; Gorog, D; Peeters, PM; Jaray, J; Slooff, MJH

Authors analyzed the differences in the outcome of two European liver transplant centers differing in case volume and experience. The first was the Transplantation and Surgical Clinic, Semmelweis University, Budapest, Hungary (SEB) and the second the University Medical Center Groningen, Groningen,

Moving from reclusion to partial freedom: the experience of family caregivers for disabled elderly persons assisted in a day care center Movendo-se da reclusão à liberdade parcial: a experiência do cuidador familiar de idoso dependente assistido num centro-dia

Directory of Open Access Journals (Sweden)

Silvia Cristina Mangini Bocchi

2010-09-01

Full Text Available This study aimed at understanding the interactional experience between family caregivers and disabled elderly persons supported in a Day Care Center according to the caregiver's perspective. It also aimed at developing a representative theoretical model for the events experienced by such caregiver. The Grounded Theory was used as methodological framework whereas Interactional Symbolism served as the theoretical framework. Observation and interviews were used for data collection. The following phenomenon arose from the results: feeling of support by the Day Care Center, by the strength of the bond with the elderly and by spirituality in order to continue playing the challenging role of a family caregiver for a disabled elderly person. The study made possible to understand that, among these three supporting cornerstones for coping with the burden generated by the family caregiver role, the care model promoted by the Day Care Center was the intervenient variable in the process of improving the quality of life of the family caregiver-disabled elderly person binomial. This allowed the identification of the main category - moving from reclusion to partial freedom: the experience of family caregivers for disabled elderly persons assisted in a Day Care Center.O estudo teve como objetivos: compreender a experiência interacional cuidador familiar-idoso dependente apoiada por um Centro-Dia (CD, segundo a perspectiva do cuidador familiar, e desenvolver um modelo teórico representativo da experiência vivida por ele. Utilizou-se como referencial metodológico a Grounded Theory e como referencial teórico o Interacionismo Simbólico. As estratégias para a obtenção dos dados foram a observação e a entrevista. Dos resultados emergiu o fenômeno: sentindo-se apoiado pelo CD, pela força do vínculo com o idoso e pela espiritualidade para continuar desempenhando o papel desafiante de cuidador familiar de idoso dependente. O trabalho permitiu

Photoconversion of F+ centers in neutron-irradiated MgO

International Nuclear Information System (INIS)

Monge, M.A.; Gonzalez, R.; Munoz Santiuste, J.E.; Pareja, R.; Chen, Y.; Kotomin, E.A.; Popov, A.I.

2000-01-01

In neutron-irradiated MgO crystals, experiments and theory demonstrate that photon excitation of the positively charged anion vacancies (F + centers) at 5.0 eV releases holes that are subsequently trapped at V-type centers, which are cation vacancies charge-compensated by impurities, such as Al 3+ , F - , and OH - ions. A photoconversion mechanism occurs very likely via electron transfer to F + centers from the quasi-local states which are induced in the valence band. INDO quantum chemical simulations of F + centers confirmed the appearance of two induced quasi-local states located at 1.2 and 2.0 eV below the top of the valence band

Nuclear Criticality Experimental Research Center (NCERC) Overview

Energy Technology Data Exchange (ETDEWEB)

Goda, Joetta Marie [Los Alamos National Lab. (LANL), Los Alamos, NM (United States); Grove, Travis Justin [Los Alamos National Lab. (LANL), Los Alamos, NM (United States); Hayes, David Kirk [Los Alamos National Lab. (LANL), Los Alamos, NM (United States); Myers, William L. [Los Alamos National Lab. (LANL), Los Alamos, NM (United States); Sanchez, Rene Gerardo [Los Alamos National Lab. (LANL), Los Alamos, NM (United States)

2017-03-03

The mission of the National Criticality Experiments Research Center (NCERC) at the Device Assembly Facility (DAF) is to conduct experiments and training with critical assemblies and fissionable material at or near criticality in order to explore reactivity phenomena, and to operate the assemblies in the regions from subcritical through delayed critical. One critical assembly, Godiva-IV, is designed to operate above prompt critical. The Nuclear Criticality Experimental Research Center (NCERC) is our nation’s only general-purpose critical experiments facility and is only one of a few that remain operational throughout the world. This presentation discusses the history of NCERC, the general activities that makeup work at NCERC, and the various government programs and missions that NCERC supports. Recent activities at NCERC will be reviewed, with a focus on demonstrating how NCERC meets national security mission goals using engineering fundamentals. In particular, there will be a focus on engineering theory and design and applications of engineering fundamentals at NCERC. NCERC activities that relate to engineering education will also be examined.

[Cocaine base paste: experience from the Montevideo Poison Control Center].

Science.gov (United States)

Pascale, Antonio; Negrin, Alba; Laborde, Amalia

2010-01-01

In Uruguay, cocaine base paste (CBP, pasta base) is a widely used form of cocaine. The aim of our study is to determine the main clinical characteristics of CBP abusers. Retrospective, single-center study of consultations at the Montevideo Poison Control Center between January 1, 2004 and December 31, 2005. One hundred and thirteen consultations were included, with an average age of 22 years (+ - 0.5 years) and a female-male sex ratio of 1:4.3. The consultations were related to drug overdose (77%), suicide attempt (16.8%), and wanting to give up CBP use (6.2%). In 48.1% the time elapsed since inhalation of CBP was less than 6 hours. Doses varied between 0.5 gr. and 25 gr. Use of other drugs at the same time, such as alcohol, marijuana or benzodiazepines, was common (51 cases). The symptoms most frequently observed were neuropsychiatric and cardiovascular, followed by respiratory symptoms. In 16.8% of patients, reason for the consultation was intentional acute ingestion of drugs, considered as a suicide attempt, occurring within a few hours of drug consumption. CBP users are mostly young males. Although clinical findings are compatible with those for cocaine abuse, euphoria is a major clinical feature in CBP abusers. The presence of respiratory symptoms reflects the complications associated with the ingestion route. Suicide attempts occurring within a few hours of CBP confirm the high prevalence of suicidal ideation reported by other authors. cocaine base paste, clinical features, suicide attempts.

A Human-Centered Design Methodology to Enhance the Usability, Human Factors, and User Experience of Connected Health Systems: A Three-Phase Methodology

Science.gov (United States)

Harte, Richard; Glynn, Liam; Rodríguez-Molinero, Alejandro; Baker, Paul MA; Scharf, Thomas; ÓLaighin, Gearóid

2017-01-01

Background Design processes such as human-centered design, which involve the end user throughout the product development and testing process, can be crucial in ensuring that the product meets the needs and capabilities of the user, particularly in terms of safety and user experience. The structured and iterative nature of human-centered design can often present a challenge when design teams are faced with the necessary, rapid, product development life cycles associated with the competitive connected health industry. Objective We wanted to derive a structured methodology that followed the principles of human-centered design that would allow designers and developers to ensure that the needs of the user are taken into account throughout the design process, while maintaining a rapid pace of development. In this paper, we present the methodology and its rationale before outlining how it was applied to assess and enhance the usability, human factors, and user experience of a connected health system known as the Wireless Insole for Independent and Safe Elderly Living (WIISEL) system, a system designed to continuously assess fall risk by measuring gait and balance parameters associated with fall risk. Methods We derived a three-phase methodology. In Phase 1 we emphasized the construction of a use case document. This document can be used to detail the context of use of the system by utilizing storyboarding, paper prototypes, and mock-ups in conjunction with user interviews to gather insightful user feedback on different proposed concepts. In Phase 2 we emphasized the use of expert usability inspections such as heuristic evaluations and cognitive walkthroughs with small multidisciplinary groups to review the prototypes born out of the Phase 1 feedback. Finally, in Phase 3 we emphasized classical user testing with target end users, using various metrics to measure the user experience and improve the final prototypes. Results We report a successful implementation of the

Patient Experience Assessment is a Requisite for Quality Evaluation: A Discussion of the In-Center Hemodialysis Consumer Assessment of Health Care Providers and Systems (ICH CAHPS) Survey.

Science.gov (United States)

Cavanaugh, Kerri L

2016-01-01

Patient experience surveys provide a critical and unique perspective on the quality of patient-centered healthcare delivery. These surveys provide a mechanism to systematically express patients' voice on topics valued by patients to make decisions about choices in care. They also provide an assessment to healthcare organizations about their service that cannot be obtained from any other source. Regulatory agencies have mandated the assessment of patients' experience as part of healthcare value based purchasing programs and weighted the results to account for up to 30% of the total scoring. This is a testimony to the accepted importance of this metric as a fundamental assessment of quality. After more than a decade of rigorous research, there is a significant body of growing evidence supporting specifically the validity and use of the Consumer Assessment of Healthcare Providers and Systems (CAHPS) surveys, including a version specific to in-center hemodialysis (ICH CAHPS). This review will focus on the ICH CAHPS survey including a review of its development, content, administration, and also a discussion of common criticisms. Although it is suggested that the survey assesses activities and experiences that are not modifiable by the healthcare organization (or the dialysis facility in our case) emerging evidence suggests otherwise. Dialysis providers have an exclusive opportunity to lead the advancement of understanding the implications and serviceability of the evaluation of the patient experience in health care. © 2016 Wiley Periodicals, Inc.

A Single Center Experience on the Management of Placental Invasion Abnormalities

Directory of Open Access Journals (Sweden)

Alper Biler

2016-03-01

Full Text Available Objective: The aim of this study is to investigate our management of placental invasion abnormalities. Methods: A retrospective study was conducted on pa­tients admitted to a tertiary referral center with a diagno­sis of placental invasion abnormalities between 2011 and 2015. Risk factors and perinatal outcomes associated with placental invasion abnormalities were identified. Results: The overall incidence of placental invasion ab­normalities during the 5-year period was 8.3/10000 de­liveries, which showed an increasing trend. Ultrasonog­raphy and magnetic resonance imaging correctly identi­fied placental invasion abnormality in 36.7% and 68.7% cases, respectively. Majority of patients (55.1% with ad­herent placenta were diagnosed at the time of delivery. Of these patients, 22.4% underwent hysterectomy, 83.8% required at least one of the additional surgical procedures and 55% were transfused at least four units of packed red blood cell. Conclusion: Since placental invasion abnormalities are associated with significant morbidity, delivery should be scheduled in a tertiary center with appropriate expertise and facilities. J Clin Exp Invest 2016; 7 (1: 14-18

Plasma Science and Innovation Center (PSI-Center) at Washington, Wisconsin, and Utah State, ARRA Supplement

Energy Technology Data Exchange (ETDEWEB)

Sovinec, Carl [Univ. of Wisconsin-Madison, Madison, WI (United States)

2018-03-14

The objective of the Plasma Science and Innovation Center (PSI-Center) is to develop and deploy computational models that simulate conditions in smaller, concept-exploration plasma experiments. The PSIC group at the University of Wisconsin-Madison, led by Prof. Carl Sovinec, uses and enhances the Non-Ideal Magnetohydrodynamics with Rotation, Open Discussion (NIMROD) code, to simulate macroscopic plasma dynamics in a number of magnetic confinement configurations. These numerical simulations provide information on how magnetic fields and plasma flows evolve over all three spatial dimensions, which supplements the limited access of diagnostics in plasma experiments. The information gained from simulation helps explain how plasma evolves. It is also used to engineer more effective plasma confinement systems, reducing the need for building many experiments to cover the physical parameter space. The ultimate benefit is a more cost-effective approach to the development of fusion energy for peaceful power production. The supplemental funds provided by the American Recovery and Reinvestment Act of 2009 were used to purchase computer components that were assembled into a 48-core system with 256 Gb of shared memory. The system was engineered and constructed by the group's system administrator at the time, Anthony Hammond. It was successfully used by then graduate student, Dr. John O'Bryan, for computing magnetic relaxation dynamics that occur during experimental tests of non-inductive startup in the Pegasus Toroidal Experiment (pegasus.ep.wisc.edu). Dr. O'Bryan's simulations provided the first detailed explanation of how the driven helical filament of electrical current evolves into a toroidal tokamak-like plasma configuration.

Single-Center Experience Using Marginal Liver Grafts in Korea.

Science.gov (United States)

Park, P-J; Yu, Y-D; Yoon, Y-I; Kim, S-R; Kim, D-S

2018-05-01

Liver transplantation (LT) is an established therapeutic modality for patients with end-stage liver disease. The use of marginal donors has become more common worldwide due to the sharp increase in recipients, with a consequent shortage of suitable organs. We analyzed our single-center experience over the last 8 years in LT to evaluate the outcomes of using so-called "marginal donors." We retrospectively analyzed the database of all LTs performed at our institution from 2009 to 2017. Only patients undergoing deceased-donor LTs were analyzed. Marginal grafts were defined as livers from donors >60 years of age, livers from donors with serum sodium levels >155 mEq, graft steatosis >30%, livers with cold ischemia time ≥12 hours, livers from donors who were hepatitis B or C virus positive, livers recovered from donation after cardiac death, and livers split between 2 recipients. Patients receiving marginal grafts (marginal group) were compared with patients receiving standard grafts (standard group). A total of 106 patients underwent deceased-donor LT. There were 55 patients in the standard group and 51 patients in the marginal group. There were no significant differences in terms of age, sex, Model for End-Stage Liver Disease score, underlying liver disease, presence of hepatocellular carcinoma, and hospital stay between the 2 groups. Although the incidence of acute cellular rejection, cytomegalovirus infection, and postoperative complications was similar between the 2 groups, the incidence of early allograft dysfunction was higher in the marginal group. With a median follow-up of 26 months, the 1-, 3-, and 5-year overall and graft (death-censored) survivals in the marginal group were 85.5%, 75%, and 69.2% and 85.9%, 83.6%, and 77.2%, respectively. Patient overall survival and graft survival (death-censored) were significantly lower in the marginal group (P = .023 and P = .048, respectively). On multivariate analysis, receiving a marginal graft (hazard ratio [HR

Congenital bronchopulmonary malformations: A single-center experience and a review of literature

Directory of Open Access Journals (Sweden)

Kumar Basant

2008-01-01

Full Text Available Purpose: To present a single-center experience with 25 cases of bronchopulmonary malformations and the review the literature. Materials and Methods: We conducted a retrospective analysis of the medical records of patients with congenital bronchopulmonary malformations who were operated between July 1997 and July 2007 in our institute; we examined the modes of presentations, management, and outcome. Outcome of all patients was assessed over a short follow-up period (average 1.8 months. Results: Out of 25 patients, 18 (72% were male and 7 (28% were female. Age of patients ranged from 1 day to 11 years. The histopathological diagnosis was congenital cystic adenomatoid malformations [CCAM; n = 14 (56%], congenital lobar emphysema [CLE; n = 5 (20%], pulmonary sequestrations [PS; n = 3 (12%], and bronchogenic cysts [BC; n = 3 (12%]. Antenatal diagnosis was available in only 2 (8% patients. The common presenting symptoms were respiratory distress and chest infections. Lobectomy was the procedure of choice . Mortality was 16% (n = 4; M: F = 3: 1. Two patients died because of overwhelming sepsis, one from compromised cardiac function, and one from aspiration which might possibly have been prevented. Conclusion: Patients with progressive respiratory distress due to these anomalies may require urgent surgical intervention regardless of age. The surgical outcome is favorable, with manageable complications. Plain x-ray chest and CT of thorax are usually sufficient for diagnosis and planning of treatment. Pathological diagnosis may differ from the imaging diagnosis. Mortality is found to be more in neonates. Apart from initial stabilization, resection of lesion and careful postoperative care is necessary to reduce mortality and morbidity.

Management of Type II Odontoid Fractures: Experience from Latin American Spine Centers.

Science.gov (United States)

Falavigna, Asdrubal; Righesso, Orlando; da Silva, Pedro Guarise; Siri, Carlos Rocca; Daniel, Jefferson W; Esteves Veiga, José Carlos; de Azevedo, Gustavo Borges Laurindo; Carelli, Luis Eduardo; Yurac, Ratko; Sanchez Chavez, Felix Adolfo; Sfreddo, Ericson; Cecchini, Andre; do Reis, Marcelo Martins; Jiménez Avila, Jose Maria; Riew, K Daniel

2017-02-01

To analyze characteristics of type II odontoid fracture (TII-OF), including clinical and radiographic factors, that influence surgical planning in 8 Latin American centers. Retrospective chart review was performed of 88 patients with TII-OF between 2004 and 2015 from 8 Latin American centers. Parameters studied included 1) demographic data and causes of TII-OF, 2) clinical and neurologic presentation, 3) characteristics of fracture (degree of odontoid displacement, displacement of odontoid relative to C2 body, anatomy of fracture line, distance between fragments, presence of comminution, contact area between odontoid and C2 body), 4) type of treatment, and 5) clinical and radiographic outcome. Bone fusion was assessed using computed tomography. Mean patient age was 45.33 years ± 23.54; 78.4% of patients were male. Surgery was the primary treatment in 65 patients (73.8%), with an anterior approach in 64.6%. Surgery was usually preferred in patients with posterior or horizontal oblique fracture lines, local pain, and a smaller bone contact surface between the odontoid and the body of C2. A posterior approach was chosen when distance between the fractured bone fragments was >2 mm or after failed conservative or anterior odontoid screw treatment in a symptomatic patient. The treatment of choice for TII-OF in 8 Latin American trauma centers was surgery through an anterior approach using screw fixation. Posterior segmental C1-C2 fixation was indicated when distance between bone fragments was >2 mm and in symptomatic patients with nonunion. Copyright © 2016 Elsevier Inc. All rights reserved.

Identifying Androgen Receptor-Independent Mechanisms of Prostate Cancer Resistance to Second-Generation Antiandrogen Therapy

Science.gov (United States)

2016-08-01

topics in descriptive and inferential statistics including hypothesis testing, regression, and multivariate analysis. I look forward to continuing my...analysis, and CRISPR/Cas9 gene editing. To facilitate my clinical-translational skills, I took part in a statistics seminar course that covered... statistics and data science training with further coursework this year offered at MSKCC and through massive open online courses (MOOCs

Targeting Signaling to YAP for the Therapy of NF2

Science.gov (United States)

2016-12-01

confocal microscopy for beta- arrestin-green fluorescent protein translocation G protein-coupled receptor assays using the Evotec Opera. Methods...Facility of MSKCC along the lines described in Accomplishments below. Notably, this Facility is equipped for High Throughput Confocal Imaging and...interacts through its coiled-coil segment with the central coiled-coil segment of AMOT proteins, which localize to Adherens Junctions (AJs) and

Stern-Center Potsdam; Stern-Center Potsdam

Energy Technology Data Exchange (ETDEWEB)

Anon.

1999-07-01

The ''Stern-Center Potsdam'' is a star-shaped shopping mall in the city center. [German] Das Stern-Center in Potsdam bietet als Einkaufszentrum vor den Toren Berlins Platz fuer eine Vielzahl von Geschaeften. Die sternfoermige Gebaeudestruktur des Centers bildet den Mittelpunkt des Stadtviertels 'Am Stern'. (orig.)

Observations of galactic center for annihilation line at 0.511 MeV

International Nuclear Information System (INIS)

Jayanthi, U.B.; Martin, I.M.; Braga, J.; Neri, J.A.C.F.; Jardim, M.V.A.; Rao, K.R.

1983-10-01

The presence of the 0.511 MeV gamma line emission from galactic center is well-established from various balloon experiments. Recent results in 1980-82 from balloon and satellite experiments show significant decrease in this line intensity. To confirm these results a fly on balloon is performed with a large area sodium iodide detector to measure 0.511 MeV line from galactic center. The preliminary results indicate flux -3 photons cm -2 s -1 . (Author) [pt

Innovation in Innovation Management: The Experience of Petrobras Centers and Networks of Excellence Program

Directory of Open Access Journals (Sweden)

Ana Maria de Britto Pires

2013-04-01

Full Text Available Since 1996, Petrobras – Petróleo Brasileiro S.A., the biggest company in Latin America, has supported the development of a method to structure networks of partnerships called Centers and Networks of Excellence Practice (PCREX. It aims to support the establishment of centers and networks of excellence in areas in which innovation depends heavily on the articulation of various players from outside the company and different internal areas. This article presents the results of the analysis of the PCREX method, including its characterization and field research carried out in eight Centers and Networks of Excellence developed by Petrobras. The field research and subsequent analysis helped identify (i the alignment between the PCREX method and the best innovation management practices and (ii the difficulties faced by new management models based on resource and knowledge sharing, which highlights that organizational innovations need to be able to count on strong institutional support to succeed.

Health Care Employee Perceptions of Patient-Centered Care: A Photovoice Project

Science.gov (United States)

Balbale, Salva Najib; Turcios, Stephanie; LaVela, Sherri L.

2015-01-01

Given the importance of health care employees in the delivery of patient-centered care, understanding their unique perspective is essential for quality improvement. The purpose of this study was to use photovoice to evaluate perceptions and experiences around patient-centered care among Veterans Affairs (VA) health care employees. We asked participants to take photographs of salient features in their environment related to patient-centered care. We used the photographs to facilitate dialogue during follow-up interviews. Twelve VA health care employees across two VA sites participated in the project. Although most participants felt satisfied with their work environment and experiences at the VA, several areas for improvement were identified. These included a need for more employee health and wellness initiatives and a need for enhanced opportunities for training and professional growth. Application of photovoice enabled us to learn about employees' unique perspectives around patient-centered care while engaging them in an evaluation of care delivery. PMID:25274626

Safety of atrial fibrillation ablation with novel multi-electrode array catheters on uninterrupted anticoagulation-a single-center experience.

LENUS (Irish Health Repository)

Hayes, Christopher Ruslan

2012-02-01

INTRODUCTION: A recent single-center report indicated that the performance of atrial fibrillation ablation in patients on uninterrupted warfarin using a conventional deflectable tip electrode ablation catheter may be as safe as periprocedural discontinuation of warfarin and bridging with heparin. Novel multi-electrode array catheters for atrial fibrillation ablation are currently undergoing clinical evaluation. While offering the possibility of more rapid atrial fibrillation ablation, they are stiffer and necessitate the deployment of larger deflectable transseptal sheaths, and it remains to be determined if they increase the risk of cardiac perforation and vascular injury. Such potential risks would have implications for a strategy of uninterrupted periprocedural anticoagulation. METHOD AND RESULTS: We audited the safety outcomes of our atrial fibrillation ablation procedures using multi-electrode array ablation catheters in patients on uninterrupted warfarin (CHADS2 score>or=2) and in patients not on warfarin (uninterrupted aspirin). Two bleeding complications occurred in 49 patients on uninterrupted warfarin, both of which were managed successfully without longterm sequelae, and no bleeding complication occurred in 32 patients not on warfarin (uninterrupted aspirin). There were no thromboembolic events or other complication with either anticoagulant regimen. CONCLUSION: Despite the larger diameter and increased stiffness of multi-electrode array catheters and their deflectable transseptal sheaths, their use for catheter ablation in patients with atrial fibrillation on uninterrupted warfarin in this single-center experience does not appear to be unsafe, and thus, an adequately powered multicenter prospective randomized controlled trial should be considered.

Introducing sexual orientation and gender identity into the electronic health record: one academic health center's experience.

Science.gov (United States)

Callahan, Edward J; Sitkin, Nicole; Ton, Hendry; Eidson-Ton, W Suzanne; Weckstein, Julie; Latimore, Darin

2015-02-01

Many U.S. populations experience significant health disparities. Increasing health care providers' awareness of and education about sexual orientation (SO) and gender identity (GI) diversity could help reduce health disparities among lesbian, gay, bisexual, and transgender (LGBT) patients. The authors share the University of California, Davis, Health System's (UCDHS's) experience as it became the first U.S. academic health center to formally introduce patient SO/GI demographic data into its electronic health record (EHR) as a step toward reducing LGBT health disparities. Adding these data to the EHR initially met with resistance. The authors, members of the UCDHS Task Force for Inclusion of SO/GI in the EHR, viewed this resistance as an invitation to educate leaders, providers, and staff about LGBT health disparities and to expose providers to techniques for discussing SO/GI with patients. They describe the strategies they employed to effect institutional culture change, including involvement of senior leadership, key informant interviews, educational outreach via grand rounds and resident workshops, and creation of a patient safety net through inviting providers to self-identify as welcoming LGBT patients. The ongoing cultural change process has inspired spin-off projects contributing to an improved climate for LGBT individuals at UCDHS, including an employee organization supporting SO/GI diversity, support for and among LGBT medical learners through events and listservs, development and implementation of an LGBT health curriculum, and creation of peer navigator programs for LGBT patients with cancer. The authors reflect on lessons learned and on institutional pride in and commitment to providing quality care for LGBT patients.

The ten-year single-center experience with 6-mercaptopurine in the treatment of inflammatory bowel disease.

Science.gov (United States)

Glazier, Kenneth D; Palance, Adam L; Griffel, Louis H; Das, Kiron M

2005-01-01

To report the 10-year experience of a single center in treating patients with refractory inflammatory bowel disease (IBD) with relatively lower dose of 6-mercaptopurine (6-MP). The charts of 285 patients with IBD (Crohn's disease 160 and ulcerative colitis 125) receiving 6-MP were reviewed. Clinical response, subsequent breakthrough while taking 6-MP, and relapse rates when 6-MP was discontinued and side effects were assessed. Ninety-three percent of the patients were taking 50 to 75 mg/day of 6-MP. Complete remission was achieved in 62%, partial remission in 14.5%, and failure to achieve remission in 23.5% of the patients. Of complete responders, 27.5% had breakthrough while continuing 6-MP. Nine percent of those that achieved a complete remission experienced a relapse after 6-MP was discontinued. Side effects included leukopenia (11.2%), abnormal liver function tests (3.8%), various infections, including pneumonia (3.1%), pancreatitis (2.5%), nausea (2.1%), headache (2.8%), fever (1.4%), hair loss (1%), and rash (0.7%). Two cancers occurred while taking 6-MP: melanoma on the finger and a fatal colonic lymphoma. Four patients continued 6-MP throughout pregnancies and had normal outcomes. In our experience 6-MP is relatively safe and appears to be as effective at a lower dosage (0.84 mg/kg per day) compared with the recommended higher dosage (1-1.5 mg/kg per day), when leukopenia was more frequent. Serious side effects, although rare, need to be monitored.

Recent Experiences of the NASA Engineering and Safety Center (NESC) GN and C Technical Discipline Team (TDT)

Science.gov (United States)

Dennehy, Cornelius J.

2010-01-01

The NASA Engineering and Safety Center (NESC), initially formed in 2003, is an independently funded NASA Program whose dedicated team of technical experts provides objective engineering and safety assessments of critical, high risk projects. The GN&C Technical Discipline Team (TDT) is one of fifteen such discipline-focused teams within the NESC organization. The TDT membership is composed of GN&C specialists from across NASA and its partner organizations in other government agencies, industry, national laboratories, and universities. This paper will briefly define the vision, mission, and purpose of the NESC organization. The role of the GN&C TDT will then be described in detail along with an overview of how this team operates and engages in its objective engineering and safety assessments of critical NASA projects. This paper will then describe selected recent experiences, over the period 2007 to present, of the GN&C TDT in which they directly performed or supported a wide variety of NESC assessments and consultations.

Volvulus without malposition--a single-center experience.

Science.gov (United States)

Kargl, Simon; Wagner, Oliver; Pumberger, Wolfgang

2015-01-01

This is a single-center case series about the rare condition of volvulus without malposition and/or malrotation (VWM) in preterm babies. We focus on diagnostic difficulties, and our results should help to distinguish VWM as a distinct entity different from classical volvulus and segmental volvulus. Medical chart review of infants with VWM from 2003-2012 was used. A total of 15 patients were identified. All of them had volvulus in the absence of intestinal malposition or other associated intestinal pathologies. All patients were born prematurely. Emergency laparotomy was necessary in all 15 patients. Two groups were identified. Group 1 includes four patients with typical signs of meconium obstruction of prematurity (MOP). Small bowel resection was only necessary in one of these four patients, all survived without residual intestinal lesions. Group 2 consists of 11 patients without signs of MOP-small bowel resection and temporary enterostomy were necessary in all these children. Four patients presented with pneumatosis intestinalis on the abdominal plain film, suggesting necrotizing enterocolitis. Although two infants died, the survivors showed complete recovery. VWM is a distinct disease of prematurity. When associated with MOP, VWM has a favorable outcome of treatment. In contrast, VWM occurring in the absence of signs of meconium obstruction requires small bowel resection. VWM primarily affects the top of the midgut (ileum). Because of absent malposition, presentation of VWM may be uncharacteristic. Pneumatosis intestinalis in advanced VWM may lead to diagnostic difficulties and a delay in treatment. Copyright © 2015 Elsevier Inc. All rights reserved.

Multiliteracies, Social Futures, and Writing Centers

Science.gov (United States)

Trimbur, John

2010-01-01

In this article, the author mentions his experience at Worcester Polytechnic Institute (WPI) because he thinks it is fairly indicative of recent trends in writing center theory and practice to see literacy as a multimodal activity in which oral, written, and visual communication intertwine and interact. He says this notion of multiliteracies has…

Experience report: a training center for health response

International Nuclear Information System (INIS)

Maurmo, Alexandre M.; Leite, Teresa C.S.B.

2009-01-01

The Professor Nelson Valverde Training Center was created within FEAM (The ELETRONUCLEAR Medical Assistance Foundation) with the objective of capacitating Radio Nuclear Accident Responders for the Health Area in the Almirante Alvaro Alberto Nuclear Central (Angra dos Reis - RJ - Brazil). The first step was structuring the contents for this training using IAEA's Manuals as base (EPR Medical - 2005, EPR First Responders - 2006 and TMT - Handbook - 2009) and data from REAC/TS. The second step was to capacitate instructors. The third step was the integration with the Company's Radiological Protection Division, giving radiological assessment. Finally, the development of training applications, ending with Drills, Tests and Assessment, gathering data and suggestions, objectifying the constant improvement. Training Programs with pre and post evaluations have been started. Since 2004 training internal courses were ministered for 125 professionals with annual re-training and were ministered to 130 professionals from several external institutions. During the same period training courses were ministered to 140 trainees from the Radiological Protection Division of The Nuclear Power Plant of Angra dos Reis, as First Lay Responders, objectifying the improvement of the quality of the emergency response. (author)

The Effect of Dining Room Physical Environmental Renovations on Person-Centered Care Practice and Residents' Dining Experiences in Long-Term Care Facilities.

Science.gov (United States)

Hung, Lillian; Chaudhury, Habib; Rust, Tiana

2016-12-01

This qualitative study evaluated the effect of dining room physical environmental changes on staff practices and residents' mealtime experiences in two units of a long-term care facility in Edmonton, Canada. Focus groups with staff (n = 12) and individual interviews with unit managers (n = 2) were conducted. We also developed and used the Dining Environment Assessment Protocol (DEAP) to conduct a systematic physical environmental evaluation of the dining rooms. Four themes emerged on the key influences of the renovations: (a) supporting independence and autonomy, (b) creating familiarity and enjoyment, (c) providing a place for social experience, and (d) challenges in supporting change. Feedback from the staff and managers provided evidence on the importance of physical environmental features, as well as the integral nature of the role of the physical environment and organizational support to provide person-centered care for residents. © The Author(s) 2015.

Study of the fluorescence blinking behavior of single F2 color centers in LiF crystal

International Nuclear Information System (INIS)

Boichenko, S V; Koenig, K; Zilov, S A; Dresvianskiy, V P; Rakevich, A L; Kuznetsov, A V; Bartul, A V; Martynovich, E F; Voitovich, A P

2014-01-01

Using confocal fluorescence microscopy technique, we observed experimentally the luminescence of single F 2 color centers in LiF crystal. It is disclosed that the fluorescence shows blinking behavior. It is shown that this phenomenon is caused by the F 2 center reorientation occurring during the experiment. The ratio of luminescence intensities of differently oriented centers is assessed theoretically for two different experiment configurations. The calculated ratios are in fine agreement with experimental result

OPERATIONAL EXPERIENCE OF THE MUCOVISCIDOSIS CENTER IN THE REPUBLIC OF BASHKORTOSTAN

Directory of Open Access Journals (Sweden)

E.N. Akhmadeeva

2008-01-01

Full Text Available The article highlights the results of the long term observations over the children, residing in the republic of Bashkortostan and suffering from cystic fibrosis. They particularly dwells on the arrangement of the comprehensive diagnostics, first results of the neonatal screening, peculiar properties of the clinical presentation, issues of the medicated support and social rehabilitation at the republican center of cystic fibrosis.Key words: cystic fibrosis, treatment, social rehabilitation, children, teenagers.

Causes of amenorrhea in Korea: Experience of a single large center

OpenAIRE

Kwon, Su-Kyoung; Chae, Hee-Dong; Lee, Kyung-Hee; Kim, Sung-Hoon; Kim, Chung-Hoon; Kang, Byung-Moon

2014-01-01

Objective To investigate the causes of amenorrhea in Korean women. Methods Medical records from 1,212 women with amenorrhea who visited the Department of Obstetrics and Gynecology, Asan Medical Center, between January 1989 and December 2011 were retrospectively reviewed. Amenorrhea was categorized as either primary or secondary. Results Primary amenorrhea was identified in 132 of the patients (10.9%) and secondary amenorrhea in 1,080 (89.1%). The most frequent causes of primary amenorrhea wer...

Post–Endoscopic Retrograde Cholangiopancreaticography complications in liver transplanted patients, a single-center experience

DEFF Research Database (Denmark)

Ambrus, R B; Svendsen, Lars Bo; Hillingsø, J G

2015-01-01

BACKGROUND: Complications in the biliary tract occur in 5%-30% after liver transplantation and the main part of the complications is successfully managed with endoscopic retrograde cholangiopancreaticography (ERCP). The incidence and risk factors for post-ERCP complications in liver transplantation...... patients are not well described. Our objective was to define the frequency of post-ERCP complications in liver transplantation patients at the Abdominal Center, Rigshospitalet, the only Liver Transplantation Center in Denmark. METHODS: Retrospective study of all ERCPs performed in liver transplantation...... and cholangitis occurred after two procedures, respectively. Multivariate analysis concerning overall complications identified biliary sphincterotomy (p = 0.006) and time since liver transplantation within 90 days postoperatively (p = 0.044) as risk factors for post-ERCP complications. Specifically concerning...

Lessons Learned from Delayed Versus Immediate Microsurgical Reconstruction of Complex Maxillectomy and Midfacial Defects: Experience in a Tertiary Center in Mexico.

Science.gov (United States)

Santamaria, Eric; de la Concha, Erika

2016-10-01

Microsurgical reconstruction of complex midfacial and maxillectomy defects is among the most challenging procedures in plastic surgery, and it often requires composite flaps to improve functional and aesthetic results. Various factors have been identified as having influence in the outcome of microsurgical reconstruction. In this article, the authors present their experience with immediate and delayed reconstruction of complex maxillectomy defects in a tertiary center in Mexico. The authors present a total of 37 patients with microsurgical reconstruction of a complex maxillectomy defect; 13 patients had immediate and 24 had delayed reconstructions. The authors recommend doing immediate reconstruction when feasible. Copyright © 2016 Elsevier Inc. All rights reserved.

The double luminescence of Color Centers

International Nuclear Information System (INIS)

Baldacchini, Giuseppe

2015-01-01

An experiment on the luminescence of Color Centers (CCs) carried out in 1987 at the ENEA Laboratories in Frascati had a negative result, but subsequent investigations showed that it was not a failure but rather a discovery of a new phenomenon. Since the coming of lasers, CCs in alkali halides have been successfully used as optically active materials, in particular FA Centers. One of these centers, well known for its medium infrared laser emission at 77 K, cooled further to 2 K emitted in the near infrared and without laser effect. Further investigations showed that the double luminescence was a fundamental property unknown until that time. This important discovery was achieved in Frascati because of the existence since 1973 of a solid and extensive expertise in the field of CCs, which continued over time and later on applied to the modern miniaturized photonic devices [it

Use of APTIMA Combo 2: The Experience of a Child Advocacy Center

Science.gov (United States)

Leder, M. Ranee; Leber, Amy L.; Marcon, Mario J.; Scribano, Philip V.

2013-01-01

The Centers for Disease Control and Prevention recommends nucleic acid amplification testing for chlamydia and gonorrhea in sexually abused girls. No studies describe performance of APTIMA Combo 2 Assay with second target confirmation on the same testing platform. This nucleic acid amplification testing is evaluated within a large child advocacy…

Capturing User Needs to Improve Processes at EOSDIS Data Centers

Science.gov (United States)

Sofinowski, E. J.; Boquist, C. L.

2009-12-01

Since 2004 the Earth Observing System Data and Information System (EOSDIS) has conducted an annual comprehensive survey of user satisfaction using the American Customer Satisfaction Index (ACSI). Customer satisfaction ratings for EOSDIS consistently rate better than the overall government ratings. As part of the survey users are asked to submit comments concerning their experiences and interests. These user comments provide valuable insight into the effect of data center processes on users' experiences. Although user satisfaction has remained high, their preferences have changed with the rapid advances in web-based services. This analysis investigates the correlation between user comments, process changes or capability improvements at the individual data centers, and whether the changes at the data centers and web sites show a corresponding increase in user satisfaction. We will evaluate the comments in the areas of Product Search, Product Selection and Order, Delivery, Product Quality and Customer Support.

Comparison of optimal cardiovascular risk factor management in patients with Type 2 diabetes who attended urban medical health center with those attended a tertiary care center: Experiences from Tehran, Iran

Directory of Open Access Journals (Sweden)

Sedighe Moradi

2016-01-01

Conclusions: Both centers have failure in target achievement in some risk factors; however, the inability of the primary care center in controlling hyperlipidemia in comparison with the tertiary center is a serious warning to provide training about managing dyslipidemia in these centers.

The Beamline X28C of the Center for Synchrotron Biosciences: a National Resource for Biomolecular Structure and Dynamics Experiments Using Synchrotron Footprinting

International Nuclear Information System (INIS)

Gupta, S.; Sullivan, M.; Toomey, J.; Kiselar, J.; Chance, M.

2007-01-01

Structural mapping of proteins and nucleic acids with high resolution in solution is of critical importance for understanding their biological function. A wide range of footprinting technologies have been developed over the last ten years to address this need. Beamline X28C, a white-beam X-ray source at the National Synchrotron Light Source of Brookhaven National Laboratory, functions as a platform for synchrotron footprinting research and further technology development in this growing field. An expanding set of user groups utilize this national resource funded by the National Institute of Biomedical Imaging and Bioengineering of the National Institutes of Health. The facility is operated by the Center for Synchrotron Biosciences and the Center for Proteomics of Case Western Reserve University. The facility includes instrumentation suitable for conducting both steady-state and millisecond time-resolved footprinting experiments based on the production of hydroxyl radicals by X-rays. Footprinting studies of nucleic acids are routinely conducted with X-ray exposures of tens of milliseconds, which include studies of nucleic acid folding and their interactions with proteins. This technology can also be used to study protein structure and dynamics in solution as well as protein-protein interactions in large macromolecular complexes. This article provides an overview of the X28C beamline technology and defines protocols for its adoption at other synchrotron facilities. Lastly, several examples of published results provide illustrations of the kinds of experiments likely to be successful using these approaches

Women's experiences accessing a women-centered cardiac rehabilitation program: a qualitative study.

Science.gov (United States)

Rolfe, Danielle E; Sutton, Erica J; Landry, Mireille; Sternberg, Len; Price, Jennifer A D

2010-01-01

The health benefits of cardiac rehabilitation (CR) for women living with heart disease are well documented, yet women remain underrepresented in traditionally structured CR programs. This health service delivery gap has been attributed to a number of sex-related factors experienced by women, including lower rates of physician referral, travel-related barriers, competing work and caregiving responsibilities, greater cardiovascular disease severity, and number of comorbid health conditions. Whether a program specifically designed for women is able to address these barriers and facilitate women's participation is a question that has seldom been explored in the CR literature. As part of a larger study exploring whether 6 predefined principles of women's health (empowerment of women, accessible programs, broad definition of health care, high-quality of care, collaborative planning, and innovative and creative approaches) are reflected in the practices of the Women's Cardiovascular Health Initiative (WCHI) (a comprehensive CR and primary prevention program designed for women), the objective of this analysis was to explore how the principle of "accessible programs" is experienced by women participating in the WCHI. Fourteen women previously enrolled in the WCHI program participated in a single, in-person qualitative interview. Transcripts were analyzed using a constant-comparative approach to identify relevant themes related to program accessibility. Key themes identified included participants' experiences with acquiring physician referral, negotiating transportation issues, and navigating program schedules. Women discussed how peer support and staff members' willingness to address their health-related concerns facilitated their participation. While a women-centered CR/primary prevention program may facilitate and encourage women's participation by providing flexible program schedules as well as peer and professional support, efforts are still required to address

Using generalized equivalent uniform dose atlases to combine and analyze prospective dosimetric and radiation pneumonitis data from 2 non-small cell lung cancer dose escalation protocols.

Science.gov (United States)

Liu, Fan; Yorke, Ellen D; Belderbos, José S A; Borst, Gerben R; Rosenzweig, Kenneth E; Lebesque, Joos V; Jackson, Andrew

2013-01-01

To demonstrate the use of generalized equivalent uniform dose (gEUD) atlas for data pooling in radiation pneumonitis (RP) modeling, to determine the dependence of RP on gEUD, to study the consistency between data sets, and to verify the increased statistical power of the combination. Patients enrolled in prospective phase I/II dose escalation studies of radiation therapy of non-small cell lung cancer at Memorial Sloan-Kettering Cancer Center (MSKCC) (78 pts) and the Netherlands Cancer Institute (NKI) (86 pts) were included; 10 (13%) and 14 (17%) experienced RP requiring steroids (RPS) within 6 months after treatment. gEUD was calculated from dose-volume histograms. Atlases for each data set were created using 1-Gy steps from exact gEUDs and RPS data. The Lyman-Kutcher-Burman model was fit to the atlas and exact gEUD data. Heterogeneity and inconsistency statistics for the fitted parameters were computed. gEUD maps of the probability of RPS rate≥20% were plotted. The 2 data sets were homogeneous and consistent. The best fit values of the volume effect parameter a were small, with upper 95% confidence limit around 1.0 in the joint data. The likelihood profiles around the best fit a values were flat in all cases, making determination of the best fit a weak. All confidence intervals (CIs) were narrower in the joint than in the individual data sets. The minimum P value for correlations of gEUD with RPS in the joint data was .002, compared with P=.01 and .05 for MSKCC and NKI data sets, respectively. gEUD maps showed that at small a, RPS risk increases with gEUD. The atlas can be used to combine gEUD and RPS information from different institutions and model gEUD dependence of RPS. RPS has a large volume effect with the mean dose model barely included in the 95% CI. Data pooling increased statistical power. Copyright © 2013 Elsevier Inc. All rights reserved.

Validation and head-to-head comparison of three nomograms predicting probability of lymph node invasion of prostate cancer in patients undergoing extended and/or sentinel lymph node dissection

Energy Technology Data Exchange (ETDEWEB)

Grivas, Nikolaos; Wit, Esther; Tillier, Corinne; Muilekom, Erik van; Poel, Henk van der [The Netherlands Cancer Institute, Antoni van Leeuwenhoek Hospital, Department of Urology, Amsterdam (Netherlands); Pos, Floris [The Netherlands Cancer Institute, Antoni van Leeuwenhoek Hospital, Department of Radiation Oncology, Amsterdam (Netherlands); Winter, Alexander [School of Medicine and Health Sciences, Carl von Ossietzky University, University Hospital for Urology, Klinikum Oldenburg, Oldenburg (Germany)

2017-12-15

The updated Winter nomogram is the only nomogram predicting lymph node invasion (LNI) in prostate cancer (PCa) patients based on sentinel node (SN) dissection (sLND). The aim of the study was to externally validate the Winter nomogram and examine its performance in patients undergoing extended pelvic lymph node dissection (ePLND), ePLND combined with SN biopsy (SNB) and sLND only. The results were compared with the Memorial Sloan Kettering Cancer Center (MSKCC) and updated Briganti nomograms. This retrospective study included 1183 patients with localized PCa undergoing robot-assisted laparoscopic radical prostatectomy (RARP) combined with pelvic lymphadenectomy and 224 patients treated with sLND and external beam radiotherapy (EBRT), aiming to offer pelvic radiotherapy only in case of histologically positive SNs. In the RARP population, ePLND was applied in 956 (80.8%) patients,while 227 (19.2%) patients were offered ePLND combined with additional SNB. The median numbers of removed nodes were 10 (interquartile range, IQR = 6-14), 15 (IQR = 10-20) and 7 (IQR = 4-10) in the ePLND, ePLND + SNB, and sLND groups, respectively. Corresponding LNI rates were 16.6%, 25.5% and 42%. Based on the AUC, the performance of the Briganti nomogram (0.756) in the ePLND group was superior to both the MSKCC (0.744) and Winter nomogram (0.746). The Winter nomogram, however, was the best predictor of LNI in both the ePLND + SNB (0.735) and sLND (0.709) populations. In the calibration analysis, all nomograms showed better accuracy in the low/intermediate risk patients, while in the high-risk population, an overestimation of the risk for LNI was observed. The SN-based updated nomogram showed better prediction in the SN population. The results were also comparable, relative to predictive tools developed with (e)PLND, suggesting a difference in sampling accuracy between SNB and non-SNB. Patients who benefit most from the nomogram would be those with a low/intermediate risk of LN metastasis

Experience of organizing and management of experimental researches on animals in V.I. Shumakov National Medical Research Center of Transplantology and Artificial Organs

Directory of Open Access Journals (Sweden)

M. Yu. Shagidulin

2017-01-01

Full Text Available This review briefl y discusses the experience of organizing and carrying out experimental studies in our center in order to increase the validity of the researches. The rules of organizational and methodological approaches aimed at increasing the suitability of the results of experimental studies are also given. Each research work in which experiments on laboratory animals are supposed to be carried out should be organized, planned and carried out in accordance with national and international ethical standards. Discussion and publication of both planned and conducted experimental work makes it possible to make the research process more open and objective. The experimental investigation is carried out in the following algorithm: the formulation of the problem and the hypothesis on the basis of the literature data; development of the purpose and objectives of the study with adequate methods and selection of equipment; distribution of material to control and trial groups; creation of a plan for monitoring the indicators during the experiment; processing and interpretation of results; preparation of a scientifi c report. 

Left-right correlation in coupled F-center defects.

Science.gov (United States)

Janesko, Benjamin G

2016-08-07

This work explores how left-right correlation, a textbook problem in electronic structure theory, manifests in a textbook example of electrons trapped in crystal defects. I show that adjacent F-center defects in lithium fluoride display symptoms of "strong" left-right correlation, symptoms similar to those seen in stretched H2. Simulations of UV/visible absorption spectra qualitatively fail to reproduce experiment unless left-right correlation is taken into account. This is of interest to both the electronic structure theory and crystal-defect communities. Theorists have a new well-behaved system to test their methods. Crystal-defect groups are cautioned that the approximations that successfully model single F-centers may fail for adjacent F-centers.

Left-right correlation in coupled F-center defects

International Nuclear Information System (INIS)

Janesko, Benjamin G.

2016-01-01

This work explores how left-right correlation, a textbook problem in electronic structure theory, manifests in a textbook example of electrons trapped in crystal defects. I show that adjacent F-center defects in lithium fluoride display symptoms of “strong” left-right correlation, symptoms similar to those seen in stretched H 2 . Simulations of UV/visible absorption spectra qualitatively fail to reproduce experiment unless left-right correlation is taken into account. This is of interest to both the electronic structure theory and crystal-defect communities. Theorists have a new well-behaved system to test their methods. Crystal-defect groups are cautioned that the approximations that successfully model single F-centers may fail for adjacent F-centers.

First Indian single center experience with pipeline embolization device for complex intracranial aneurysms.

Science.gov (United States)

Cherian, Mathew P; Yadav, Manish Kumar; Mehta, Pankaj; Vijayan, K; Arulselvan, V; Jayabalan, Suresh

2014-01-01

Flow diversion is a novel method of therapy wherein an endoluminal sleeve, the flow diverter stent is placed across the neck of complex aneurysms to curatively reconstruct abnormal vasculature. We present the first Indian single center experience with the pipeline embolization device (PED) and 6 months follow-up results of 5 patients. Five complex or recurrent intracranial aneurysms in five patients were treated with PED. The patients were followed-up with magnetic resonance angiography (MRA) after 4 weeks and conventional angiography after 6 months. Feasibility, complications, clinical outcome, early 1-month MRA and 6 months conventional angiographic follow-up results were analyzed. Of the five aneurysms treated, four were in the anterior circulation and one in the posterior circulation. All five patients were treated with a single PED in each, and additionally coils were used in one patient. At 1-month MRA follow-up, complete occlusion was seen in 2 (40%) of the five cases. Post 6 months conventional angiography showed complete occlusion of the aneurysm sac in all five cases (100%). Side branch ostia were covered in three patients, all of which were patent (100%). There was no incidence of major neurological morbidity or mortality. One patient (20%) who had basilar top aneurysm experienced minor neurological disability after 5 days which partially improved. Pipeline embolization device for complex and recurrent aneurysms is technically feasible, safe, offers low complication rate, and definitive vascular reconstruction. PED can be used without fear of occlusion of covered eloquent side branches and perforators.

Information sharing guidebook for transportation management centers, emergency operations centers, and fusion centers

Science.gov (United States)

2010-06-01

This guidebook provides an overview of the mission and functions of transportation management centers, emergency operations centers, and fusion centers. The guidebook focuses on the types of information these centers produce and manage and how the sh...

Information sharing guidebook for transportation management centers, emergency operations centers, and fusion centers.

Science.gov (United States)

2010-06-01

This guidebook provides an overview of the mission and functions of transportation management centers, emergency operations centers, and fusion centers. The guidebook focuses on the types of information these centers produce and manage and how the sh...

Viewer-centered and body-centered frames of reference in direct visuomotor transformations.

Science.gov (United States)

Carrozzo, M; McIntyre, J; Zago, M; Lacquaniti, F

1999-11-01

It has been hypothesized that the end-point position of reaching may be specified in an egocentric frame of reference. In most previous studies, however, reaching was toward a memorized target, rather than an actual target. Thus, the role played by sensorimotor transformation could not be disassociated from the role played by storage in short-term memory. In the present study the direct process of sensorimotor transformation was investigated in reaching toward continuously visible targets that need not be stored in memory. A virtual reality system was used to present visual targets in different three-dimensional (3D) locations in two different tasks, one with visual feedback of the hand and arm position (Seen Hand) and the other without such feedback (Unseen Hand). In the Seen Hand task, the axes of maximum variability and of maximum contraction converge toward the mid-point between the eyes. In the Unseen Hand task only the maximum contraction correlates with the sight-line and the axes of maximum variability are not viewer-centered but rotate anti-clockwise around the body and the effector arm during the move from the right to the left workspace. The bulk of findings from these and previous experiments support the hypothesis of a two-stage process, with a gradual transformation from viewer-centered to body-centered and arm-centered coordinates. Retinal, extra-retinal and arm-related signals appear to be progressively combined in superior and inferior parietal areas, giving rise to egocentric representations of the end-point position of reaching.

A Human-Centered Design Methodology to Enhance the Usability, Human Factors, and User Experience of Connected Health Systems: A Three-Phase Methodology.

Science.gov (United States)

Harte, Richard; Glynn, Liam; Rodríguez-Molinero, Alejandro; Baker, Paul Ma; Scharf, Thomas; Quinlan, Leo R; ÓLaighin, Gearóid

2017-03-16

Design processes such as human-centered design, which involve the end user throughout the product development and testing process, can be crucial in ensuring that the product meets the needs and capabilities of the user, particularly in terms of safety and user experience. The structured and iterative nature of human-centered design can often present a challenge when design teams are faced with the necessary, rapid, product development life cycles associated with the competitive connected health industry. We wanted to derive a structured methodology that followed the principles of human-centered design that would allow designers and developers to ensure that the needs of the user are taken into account throughout the design process, while maintaining a rapid pace of development. In this paper, we present the methodology and its rationale before outlining how it was applied to assess and enhance the usability, human factors, and user experience of a connected health system known as the Wireless Insole for Independent and Safe Elderly Living (WIISEL) system, a system designed to continuously assess fall risk by measuring gait and balance parameters associated with fall risk. We derived a three-phase methodology. In Phase 1 we emphasized the construction of a use case document. This document can be used to detail the context of use of the system by utilizing storyboarding, paper prototypes, and mock-ups in conjunction with user interviews to gather insightful user feedback on different proposed concepts. In Phase 2 we emphasized the use of expert usability inspections such as heuristic evaluations and cognitive walkthroughs with small multidisciplinary groups to review the prototypes born out of the Phase 1 feedback. Finally, in Phase 3 we emphasized classical user testing with target end users, using various metrics to measure the user experience and improve the final prototypes. We report a successful implementation of the methodology for the design and development

Role of vacuum assisted suction drainage in management of deep sternal wound infection: Experience in one center

Directory of Open Access Journals (Sweden)

Abd-Allah Ibrahim Badr

2017-03-01

Conclusions: The incidence of DSWI was similar in our center to that in other cardiothoracic centers. Various risk factors were found to be associated with DSWI. The DSWI pathogens in our center are similar to those in other reports most of our patients were treated successfully with this technique with excellent wound healing. So, vacuum therapy is safe and effective method for treating DSWI.

Final Technical Report for the Center for Momentum Transport and Flow Organization (CMTFO)

Energy Technology Data Exchange (ETDEWEB)

Forest, Cary B. [University of Wisconsin-Madison; Tynan, George R. [University of California San Diego

2013-07-29

The Center for Momentum Transport and Flow Organization (CMTFO) is a DOE Plasma Science Center formed in late 2009 to focus on the general principles underlying momentum transport in magnetic fusion and astrophysical systems. It is composed of funded researchers from UCSD, UW Madison, U. Colorado, PPPL. As of 2011, UCSD supported postdocs are collaborating at MIT/Columbia and UC Santa Cruz and beginning in 2012, will also be based at PPPL. In the initial startup period, the Center supported the construction of two basic experiments at PPPL and UW Madison to focus on accretion disk hydrodynamic instabilities and solar physics issues. We now have computational efforts underway focused on understanding recent experimental tests of dynamos, solar tacholine physics, intrinsic rotation in tokamak plasmas and L-H transition physics in tokamak devices. In addition, we have the basic experiments discussed above complemented by work on a basic linear plasma device at UCSD and a collaboration at the LAPD located at UCLA. We are also performing experiments on intrinsic rotation and L-H transition physics in the DIII-D, NSTX, C-Mod, HBT EP, HL-2A, and EAST tokamaks in the US and China, and expect to begin collaborations on K-STAR in the coming year. Center funds provide support to over 10 postdocs and graduate students each year, who work with 8 senior faculty and researchers at their respective institutions. The Center has sponsored a mini-conference at the APS DPP 2010 meeting, and co-sponsored the recent Festival de Theorie (2011) with the CEA in Cadarache, and will co-sponsor a Winter School in January 2012 in collaboration with the CMSO-UW Madison. Center researchers have published over 50 papers in the peer reviewed literature, and given over 10 talks at major international meetings. In addition, the Center co-PI, Professor Patrick Diamond, shared the 2011 Alfven Prize at the EPS meeting. Key scientific results from this startup period include initial simulations of the

Role stress in call centers: Its effects on employee performance and satisfaction

NARCIS (Netherlands)

Ruyter, de J.C.; Wetzels, M.G.M.; Feinberg, R.A.

2001-01-01

Call centers have become an important customer access channel as well as an important source of customer-related information. Frequently, call center employees experience role stress as a result of the conflicting demands of the company, supervisors, and customers. In this article, antecedents and

Lewis Research Center R and D Facilities

Science.gov (United States)

1991-01-01

The NASA Lewis Research Center (LeRC) defines and develops advanced technology for high priority national needs. The work of the Center is directed toward new propulsion, power, and communications technologies for application to aeronautics and space, so that U.S. leadership in these areas is ensured. The end product is knowledge, usually in a report, that is made fully available to potential users--the aircraft engine industry, the energy industry, the automotive industry, the space industry, and other NASA centers. In addition to offices and laboratories for almost every kind of physical research in such fields as fluid mechanics, physics, materials, fuels, combustion, thermodynamics, lubrication, heat transfer, and electronics, LeRC has a variety of engineering test cells for experiments with components such as compressors, pumps, conductors, turbines, nozzles, and controls. A number of large facilities can simulate the operating environment for a complete system: altitude chambers for aircraft engines; large supersonic wind tunnels for advanced airframes and propulsion systems; space simulation chambers for electric rockets or spacecraft; and a 420-foot-deep zero-gravity facility for microgravity experiments. Some problems are amenable to detection and solution only in the complete system and at essentially full scale. By combining basic research in pertinent disciplines and generic technologies with applied research on components and complete systems, LeRC has become one of the most productive centers in its field in the world. This brochure describes a number of the facilities that provide LeRC with its exceptional capabilities.

Use of electroroentgenography in a traumatology center

International Nuclear Information System (INIS)

Mil'ko, V.I.; Kostyuchenko, A.N.; Litvinenko, V.P.

1986-01-01

5-year experience of the use of electroroentgenography in a traumatology center for the diagnosis of bone traumatic injuries had been described. Some proposals to decrease radiation exposure and to create optimum working conditions for the medical personnel of an X-ray unit had been made

A Smart Home Center Platform Solution Based on Smart Mirror

Directory of Open Access Journals (Sweden)

Deng Xibo

2017-01-01

Full Text Available With the popularization of the concept of smart home, people have raised requirements on the experience of smart living. A smart home platform center solution is put forward in order to solve the intelligent interoperability and information integration of smart home, which enable people to have a more intelligent and convenient life experience. This platform center is achieved through the Smart Mirror. The Smart Mirror refers to a smart furniture, on the basis of the traditional concept of mirror, combining Raspberry Pi, the application of one-way mirror imaging principle, the touch－enabled design, voice and video interaction. Smart Mirror can provide a series of intelligent experience for the residents, such as controlling all the intelligent furniture through Smart Mirror; accessing and displaying the weather, time, news and other life information; monitoring the home environment; remote interconnection operation.

Building the Southern California Earthquake Center

Science.gov (United States)

Jordan, T. H.; Henyey, T.; McRaney, J. K.

2004-12-01

Kei Aki was the founding director of the Southern California Earthquake Center (SCEC), a multi-institutional collaboration formed in 1991 as a Science and Technology Center (STC) under the National Science Foundation (NSF) and the U. S. Geological Survey (USGS). Aki and his colleagues articulated a system-level vision for the Center: investigations by disciplinary working groups would be woven together into a "Master Model" for Southern California. In this presentation, we will outline how the Master-Model concept has evolved and how SCEC's structure has adapted to meet scientific challenges of system-level earthquake science. In its first decade, SCEC conducted two regional imaging experiments (LARSE I & II); published the "Phase-N" reports on (1) the Landers earthquake, (2) a new earthquake rupture forecast for Southern California, and (3) new models for seismic attenuation and site effects; it developed two prototype "Community Models" (the Crustal Motion Map and Community Velocity Model) and, perhaps most important, sustained a long-term, multi-institutional, interdisciplinary collaboration. The latter fostered pioneering numerical simulations of earthquake ruptures, fault interactions, and wave propagation. These accomplishments provided the impetus for a successful proposal in 2000 to reestablish SCEC as a "stand alone" center under NSF/USGS auspices. SCEC remains consistent with the founders' vision: it continues to advance seismic hazard analysis through a system-level synthesis that is based on community models and an ever expanding array of information technology. SCEC now represents a fully articulated "collaboratory" for earthquake science, and many of its features are extensible to other active-fault systems and other system-level collaborations. We will discuss the implications of the SCEC experience for EarthScope, the USGS's program in seismic hazard analysis, NSF's nascent Cyberinfrastructure Initiative, and other large collaboratory programs.

Extracorporeal life support as a bridge to lung transplantation-experience of a high-volume transplant center.

Science.gov (United States)

Hoetzenecker, Konrad; Donahoe, Laura; Yeung, Jonathan C; Azad, Sassan; Fan, Eddy; Ferguson, Niall D; Del Sorbo, Lorenzo; de Perrot, Marc; Pierre, Andrew; Yasufuku, Kazuhiro; Singer, Lianne; Waddell, Thomas K; Keshavjee, Shaf; Cypel, Marcelo

2018-03-01

Extracorporeal life support (ECLS) is increasingly used to bridge deteriorating patients awaiting lung transplantation (LTx), however, few systematic descriptions of this practice exist. We therefore aimed to review our institutional experience over the past 10 years. In this case series, we included all adults who received ECLS with the intent to bridge to LTx. Data were retrieved from patient charts and our institutional ECLS and transplant databases. Between January 2006 and September 2016, 1111 LTx were performed in our institution. ECLS was used in 71 adults with the intention to bridge to LTx; of these, 11 (16%) were bridged to retransplantation. The median duration of ECLS before LTx was 10 days (range, 0-95). We used a single dual-lumen venous cannula in 23 patients (32%). Nine of 13 patients (69%) with pulmonary hypertension were bridged by central pulmonary artery to left atrium Novalung. Twenty-five patients (35%) were extubated while on ECLS and 26 patients (37%) were mobilized. Sixty-three patients (89%) survived to LTx. Survival by intention to treat was 66% (1 year), 58% (3 years) and 48% (5 years). Survival was significantly shorter in patients undergoing ECLS bridge to retransplantation compared with first LTx (median survival, 15 months (95% CI, 0-31) versus 60 months (95% CI, 37-83); P = .041). In our center experience, ECLS bridge to first lung transplant leads to good short-term and long-term outcomes in carefully selected patients. In contrast, our data suggest that ECLS as a bridge to retransplantation should be used with caution. Copyright © 2017 The American Association for Thoracic Surgery. All rights reserved.

Mental health and solidarity economy: the experience of users and workers of a Psychosocial Care Center

Directory of Open Access Journals (Sweden)

Ioneide de Oliveira Campos

2015-07-01

Full Text Available This work is within the context of discussions on mental health and solidarity economy. It is an account of the experience lived at the Tabatinga II Psychosocial Care Center (CAPS in the Federal District, Brazil, where projects designed to generate employment and income in the mental health area reaffirm their ability, as tools for social inclusion, to incorporate the principles and values of solidarity economy aiming at the empowerment and autonomy of citizens in mental distress. This work intended to support and encourage reflections on the possibilities for social inclusion arising from the generation of jobs and income through collective and cooperative actions developed and elaborated with the participation of users, family members, and workers of this service. Emphasis on participatory methodology guided the development of the experience, and the proposition of triggering actions on mental health and solidarity economy at different times, under the coordination of the performing team, afforded, concurrently, the realization of two actions/interventions: a group activity designed to service users and their relatives who gathered to learn and reflect on collective work and supportive venture; and three monthly training sessions, from August to December 2013, on cooperativism, solidarity economy, and mental health addressed to the professionals of that CAPS. At the end of these interventions, it was possible to observe that the involvement of people under mental distress in these projects contributes to overcome their current state of subordination and weakness. It is worth mentioning that, in general, the development of these actions favored reflections on the world of collective work and aggregated methodological knowledge on solidarity ventures.

Adopting the Quadruple Aim: The University of Rochester Medical Center Experience: Moving from Physician Burnout to Physician Resilience.

Science.gov (United States)

Anandarajah, Allen P; Quill, Timothy E; Privitera, Michael R

2018-05-16

The high rates of burnout among medical professionals in the United States are well documented. The reasons for burnout and the factors that contribute to physician resilience among health care providers in academic centers, however, are less well studied. Health care providers at a large academic center were surveyed to measure their degree of burnout and callousness and identify associated factors. Additional questions evaluated features linked to resilience. The survey assessed demographic variables, work characteristics, qualifications, experience, and citizenship. A total of 528 surveys were sent out; 469 providers responded, and 444 (84%) completed the survey. High burnout was reported by 214 providers (45.6%), and callousness was noted among 163 (34.8%). Rates of burnout and callousness were higher among advanced practice providers than physicians. Lack of support, lack of respect, and problems with work-life balance were themes significantly associated with a risk for burnout. Rates of burnout (P < .05) and callousness (P < .001) were also significantly higher among those who spent more than 80% of their time in patient care. Participation in patient care was the most sustaining factor, followed by teamwork, scholarly activities, autonomy, and medicine as a calling. Academic physicians enjoy patient care and value scholarly activities, but lack of support, lack of respect, workload, and problems with work-life balance prevent them from finding a sense of meaning in their professional work. Changes at the organizational level are needed to overcome these impediments and recreate joy in the practice of medicine. Copyright © 2018. Published by Elsevier Inc.

The Brave New World of GEC Evaluation: The Experience of the Rhode Island Geriatric Education Center

Science.gov (United States)

Filinson, Rachel; Clark, Phillip G.; Evans, Joann; Padula, Cynthia; Willey, Cynthia

2012-01-01

In 2007, the Health Resources Services Administration introduced new mandates that raised the standards on program evaluation for Geriatric Education Centers. Described in this article are the primary and secondary evaluation efforts undertaken for one program within the Rhode Island Geriatric Education Center (RIGEC), the findings from these…

Multilevel Botulinum Toxin A (Abobotulinum Toxin A Injections in Spastic Forms of Cerebral Palsy: Retrospective Analysis of 8 Russian Centers Experience

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O. A. Klochkova

2016-01-01

Full Text Available Background: The contemporary application of Botulinum toxin A (BTA in cerebral palsy (CP implies multilevel injections both in on-label and off-label muscles. However, there is no single international opinion on the effective and safe dosages, target muscles, and intervals between the injections.Objective: Our aim was to analyze the Russian multicenter independent experience of single and repeated multilevel injections of Abobotulinum toxin А in patients with spastic forms of CP.Methods: 8 independent referral CP-centers (10 hospitals in different regions of Russia. Authors evaluated intervals between the injections, dosages of the BTA for the whole procedure, for the body mass, for the each muscle, and functional segment of the extremities.Results: 1872 protocols of effective BTA injections (1–14 repeated injections for 724 patients with spastic CP were included. The age of the patients was between 8 months to 17 years 4 months at the beginning of the treatment (with a mean of 3 years 10 months. Multilevel BTA injections were indicated for the majority (n = 634, 87.6% of the patients in all the centers. The medians of the dosages for the first BTA injection were between 30–31 U/kg (500 U, the repeated injections doses up to 45 U/kg (1000 U (in most centers. The median intervals between the repeated injections were 180–200 days in 484 (66.9% patients and 140–180 days in 157 (24.7% patients. In 2 centers, children with GMFCS IV–V were injected more often than others.Conclusion: Multilevel BTA injections were indicated for the most patients. The initial dose of Abobotulinum toxin A was 30–31 U/kg. The repeated injections dose could increase up to 40 U/kg. The repeated injections were done in 140–200 days after the previous injection.

Criticality Experiments Performed in Saclay and Valduc Centers, France (1958-2002)

International Nuclear Information System (INIS)

Barbry, F.; Grivot, P.; Girault, E.; Fouillaud, P.; Cousinou, P.; Poullot, G.; Anno, J.; Bordy, J.M.; Doutriaux, D.

2003-01-01

Since 1958, the Commissariat a l'Energie Atomique and then the Institut de Radioprotection et de Surete Nucleaire (previously the Institut de Protection et de Surete Nucleaire) have carried out criticality experiments first in Saclay and then in the Valduc criticality laboratory. This paper is a survey of the programs conducted during the last 45 yr with the different apparatuses. This paper also gives information about plans for the future. Programs are presented following the chronology and the International Criticality Safety Benchmark Evaluation Project classification. Among the numerous series of experiments, now 22 series (corresponding to 407 configurations) have been included in the 'International Handbook of Evaluated Criticality Safety Benchmark Experiments'

Health Services OutPatient Experience questionnaire: factorial validity and reliability of a patient-centered outcome measure for outpatient settings in Italy

Directory of Open Access Journals (Sweden)

Coluccia A

2014-09-01

Full Text Available Anna Coluccia, Fabio Ferretti, Andrea PozzaDepartment of Medical Sciences, Surgery and Neurosciences, Santa Maria alle Scotte University Hospital, University of Siena, Siena, ItalyPurpose: The patient-centered approach to health care does not seem to be sufficiently developed in the Italian context, and is still characterized by the biomedical model. In addition, there is a lack of validated outcome measures to assess outpatient experience as an aspect common to a variety of settings. The current study aimed to evaluate the factorial validity, reliability, and invariance across sex of the Health Services OutPatient Experience (HSOPE questionnaire, a short ten-item measure of patient-centeredness for Italian adult outpatients. The rationale for unidimensionality of the measure was that it could cover global patient experience as a process common to patients with a variety of diseases and irrespective of the phase of treatment course.Patients and methods: The HSOPE was compiled by 1,532 adult outpatients (51% females, mean age 59.22 years, standard deviation 16.26 receiving care in ten facilities at the Santa Maria alle Scotte University Hospital of Siena, Italy. The sample represented all the age cohorts. Twelve percent were young adults, 57% were adults, and 32% were older adults. Exploratory and confirmatory factor analyses were conducted to evaluate factor structure. Reliability was evaluated as internal consistency using Cronbach’s α. Factor invariance was assessed through multigroup analyses.Results: Both exploratory and confirmatory analyses suggested a clearly defined unidimensional structure of the measure, with all the ten items having salient loadings on a single factor. Internal consistency was excellent (α=0.95. Indices of model fit supported a single-factor structure for both male and female outpatient groups. Young adult outpatients had significantly lower scores on perceived patient-centeredness relative to older adults. No

Iowa Water Center | Iowa Water Center

Science.gov (United States)

Home Iowa State University Extension Iowa Water Center Submitted by mollyd on April 24, 2012 - 09 :42 Advancing the state of water knowledge and management The Iowa Water Center is a part of a nationwide network of university-based water centers created to encourage interdisciplinary water research

User-Centered Design through Learner-Centered Instruction

Science.gov (United States)

Altay, Burçak

2014-01-01

This article initially demonstrates the parallels between the learner-centered approach in education and the user-centered approach in design disciplines. Afterward, a course on human factors that applies learner-centered methods to teach user-centered design is introduced. The focus is on three tasks to identify the application of theoretical and…

The National Criticality Experiments Research Center at the Device Assembly Facility, Nevada National Security Site: Status and Capabilities, Summary Report

International Nuclear Information System (INIS)

Bragg-Sitton, S.; Bess, J.; Werner, J.

2011-01-01

The National Criticality Experiments Research Center (NCERC) was officially opened on August 29, 2011. Located within the Device Assembly Facility (DAF) at the Nevada National Security Site (NNSS), the NCERC has become a consolidation facility within the United States for critical configuration testing, particularly those involving highly enriched uranium (HEU). The DAF is a Department of Energy (DOE) owned facility that is operated by the National Nuclear Security Agency/Nevada Site Office (NNSA/NSO). User laboratories include the Lawrence Livermore National Laboratory (LLNL) and Los Alamos National Laboratory (LANL). Personnel bring their home lab qualifications and procedures with them to the DAF, such that non-site specific training need not be repeated to conduct work at DAF. The NNSS Management and Operating contractor is National Security Technologies, LLC (NSTec) and the NNSS Safeguards and Security contractor is Wackenhut Services. The complete report provides an overview and status of the available laboratories and test bays at NCERC, available test materials and test support configurations, and test requirements and limitations for performing sub-critical and critical tests. The current summary provides a brief summary of the facility status and the method by which experiments may be introduced to NCERC.

Nanophotonic quantum interface for nitrogen vacancy centers in diamond

International Nuclear Information System (INIS)

Yiwen Chu

2014-01-01

Nitrogen vacancy (NV) centers in diamond have emerged as a promising solid-state platform for quantum communication, quantum information processing and nanoscale sensing with optical read-out. Engineering light-matter interactions is crucial for the practical realization of these systems. I will present our work toward realizing individual NV centers embedded in nanofabricated hybrid photonic crystal cavities consisting of single crystal diamond and PMMA based Bragg structures. Devices with quality factors up to 3,000 coupled to NV centers have been implemented, leading to substantial Purcell enhancement of zero-phonon line. We investigate the optical coherence properties of NV centers inside these nanoscale structures and report on first cavity QED experiments with such systems. Applications of diamond nanophotonic devices for quantum networks and nonlinear optics with single photons will be discussed. (author)

Recombination luminescence from H centers and conversion of H centers into I centers in alkali iodides

International Nuclear Information System (INIS)

Berzina, B.J.

1981-01-01

The study is aimed at the search for H-plus-electron centers of luminescence and the investigation of the conversion of H- into I centers by the luminescence of H-plus-electron centers in alkali iodide crystals. KI, RbI and NaI crystals were studied at 12 K. H and F centers were created by irradiation with ultraviolet light corresponding to the absorption band of anion excitons. Then the excitation of electron centers by red light irradiation was followed. The spectra of stimulated recombination luminescence were studied. The luminescence of H-plus- electron centers had been observed and the conclusion was made that this center was formed on immobile H centers. In case of stable H centers the optically stimulated conversion of H centers into I centers occurs. The assumption is advanced on the spontaneous annihilation of near placed unstable F, H centers which leads to the creation of H-plus-electron luminescence centers and to the spontaneous H-I-centers conversion [ru

MSSM A-funnel and the galactic center excess: prospects for the LHC and direct detection experiments

Energy Technology Data Exchange (ETDEWEB)

Freese, Katherine [Nordita (Nordic Institute for Theoretical Physics),KTH Royal Institute of Technology and Stockholm University,Roslagstullsbacken 23, SE-106 91 Stockholm (Sweden); The Oskar Klein Center for Cosmoparticle Physics, AlbaNova University Center,University of Stockholm,10691 Stockholm (Sweden); Michigan Center for Theoretical Physics, Department of Physics, University of Michigan,Ann Arbor, MI 48109 (United States); López, Alejandro [Michigan Center for Theoretical Physics, Department of Physics, University of Michigan,Ann Arbor, MI 48109 (United States); Shah, Nausheen R. [Michigan Center for Theoretical Physics, Department of Physics, University of Michigan,Ann Arbor, MI 48109 (United States); Department of Physics and Astronomy, Wayne State University,Detroit, Michigan 48201 (United States); Shakya, Bibhushan [Michigan Center for Theoretical Physics, Department of Physics, University of Michigan,Ann Arbor, MI 48109 (United States)

2016-04-11

The pseudoscalar resonance or “A-funnel' in the Minimal Supersymmetric Standard Model (MSSM) is a widely studied framework for explaining dark matter that can yield interesting indirect detection and collider signals. The well-known Galactic Center excess (GCE) at GeV energies in the gamma ray spectrum, consistent with annihilation of a ≲40 GeV dark matter particle, has more recently been shown to be compatible with significantly heavier masses following reanalysis of the background. In this paper, we explore the LHC and direct detection implications of interpreting the GCE in this extended mass window within the MSSM A-funnel framework. We find that compatibility with relic density, signal strength, collider constraints, and Higgs data can be simultaneously achieved with appropriate parameter choices. The compatible regions give very sharp predictions of 200–600 GeV CP-odd/even Higgs bosons at low tan β at the LHC and spin-independent cross sections ≈10{sup −11} pb at direct detection experiments. Regardless of consistency with the GCE, this study serves as a useful template of the strong correlations between indirect, direct, and LHC signatures of the MSSM A-funnel region.

Improving coordination of care centers for the elderly through IT support

DEFF Research Database (Denmark)

Johansen, Andreas Kaas; Lauridsen, Frederik Vahr Bjarnø; Manea, Vlad

2015-01-01

In Denmark, care of elderly people involves numerous and relatively autonomous care providers, including care centers, activity centers, physiotherapists, doctors, and other specialists. However, due to a poor coordination of activities, many elderly experience a lack of continuity of care, misse...... the disruptions in the existing routines, minimize the inherent articulation work, and coherently unify their coordination mechanisms....

High intensity proton accelerator and its application (Proton Engineering Center)

International Nuclear Information System (INIS)

Tanaka, Shun-ichi

1995-01-01

A plan called PROTON ENGINEERING CENTER has been proposed in JAERI. The center is a complex composed of research facilities and a beam shape and storage ring based on a proton linac with an energy of 1.5 GeV and an average current of 10 mA. The research facilities planned are OMEGA·Nuclear Energy Development Facility, Neutron Facility for Material Irradiation, Nuclear Data Experiment Facility, Neutron Factory, Meson Factory, Spallation Radioisotope Beam Facility, and Medium Energy Experiment Facility, where high intensity proton beam and secondary particle beams such as neutrons, π-mesons, muons, and unstable isotopes originated from the protons are available for promoting the innovative research of nuclear energy and basic science and technology. (author)

Centers for permanent healthcare education: an analysis on the experience of social players in the north of the state of Paraná¹

Directory of Open Access Journals (Sweden)

Sônia Cristina Stefano Nicoletto

2010-01-01

Full Text Available The policy of continuing healthcare education (CHE aims to develop healthcare workers. With the objective of analyzing the process of implementing and developing the policy in Paraná, a qualitative study involving the six regions of this state is being concluded. This paper relates to the results from the northern region, focusing on the "experiencing CHE" category. In December 2006, two focus groups were conducted involving representatives from management, training, attendance and participation. The data underwent thematic content analysis. The first CHE encounters aroused feelings of mistrust and resistance, and the center was understood as a means of enabling courses and funding sources. There was a diversity of interests and little negotiating capacity. During the process, the study participants began to talk, reflect and participate. Their teamwork was a positive experience. This experience allowed them to recognize the power of CHE for linking and mobilizing different players.

Congenital heart defects: the 10-year experience at a single center.

Science.gov (United States)

Aydin, Emine; Aypar, Ebru; Oktem, Ahmet; Ozyuncu, Ozgur; Yurdakok, Murat; Guvener, Murat; Demircin, Metin; Beksac, M Sinan

2018-06-18

We aimed to evaluate congenital heart disease (CHD) cases according to EUROCAT subgroup classification that were diagnosed during the prenatal period in our center. CHDs that were prenatally diagnosed using ultrasonography and confirmed by fetal echocardiography were reviewed over a 10-year period. Subgroup classification was finalized at the post-partum period in terms of the EUROCAT guide 1.3. Congenital heart defect subtypes and obstetric outcomes (gestational week at delivery, birth weight, gender, extracardiac structural abnormalities, karyotype results if performed) were analyzed. The data of 180 cases with CHD was examined. Left ventricular outflow tract obstruction (LVOT) was the most common CHD subtype (57/180; 31.6%), which included 48, five, and four cases of hypoplastic left heart syndrome (HLHS), coarctation of the aorta, and aortic valve atresia/stenosis, respectively. Eighteen pregnancies were terminated; the most common CHD subtype among patients of terminated pregnancies was hypoplastic left heart syndrome (HLHS) (n = 7, 38.8%). The most common extracardiac malformations were a single umbilical artery, esophageal atresia, and situs inversus in our study group. Eighteen of the 96 (18.75%) neonates with CHD died during the neonatal period. The most common CHD subtype was HLHS (7/18; 38%) among the newborns who died after birth. Prenatal diagnosis of a CHD and subgroup classification is very important for clinical decision making, including prenatal management, recommendations for termination of the pregnancy, postnatal management of the patient, and for early referral to pediatric cardiology and cardiovascular surgery centers.

Always Be Closing: Experiencing and theorizing time and wage in a UK call center

OpenAIRE

Pitts, Frederick

2015-01-01

This article reports the author's experience of working in telesales. Through a call center, the case study company sells home improvements. The article describes the everyday organizational life of the telesales unit. Using this autoethnographic experience, the article analyses the organization of work-timein call centers. In particular, the article probes how commission constitutes a form of piece-wage. This piece-wage assists the manipulation of working hours. It does so by masking their e...

Understanding Preschool Teachers’ Emotional Support as a Function of Center Climate

Directory of Open Access Journals (Sweden)

Katherine M. Zinsser

2014-11-01

Full Text Available There is great emphasis recently on improving the quality of early childhood education in the United States. Within quality rating improvement systems, classroom quality is often reported at the center or program levels. Yet little is known about teaching quality at the center level or the influence of center characteristics on teaching quality. Specifically, this study examines the extent to which the quality of emotional support provided by the teacher is associated with characteristics of the center (e.g., prior turnover rates and center director (e.g., education, management practices. Findings from Head Start Family and Child Experiences Survey (FACES 2009 data indicated that emotional support dimensions were differentially predicted by characteristics of the center and the director, including prior teacher turnover rate and director job satisfaction. However, highly regulated indicators of center quality (e.g., student:teacher ratio did not substantially explain emotional support.

Outcome of deceased donor renal transplantation - A single-center experience from developing country

Directory of Open Access Journals (Sweden)

Himanshu V Patel

2013-01-01

Full Text Available Renal transplantation (RTx is considered as the best therapeutic modality for patient suffering from end-stage renal disease (ESRD. Dearth of donor kidneys is a major problem everywhere, and deceased donor renal transplantation (DDRTx is seen as at least a partial solution. Even so, DDRTx accounts for only less than 4% of RTx in India. We report our 6-year single-center experience on DDRTx vis-à-vis patient/graft survival, graft function in terms of serum creatinine (SCr, rejection episodes, and delayed graft function (DGF. Between January 2005 and March 2011, 236 DDRTx were performed. Majority of the donors were those with brain death due to road traffic/cerebrovascular accidents. The commonest recipient diseases leading to ESRD were chronic glomerulonephritis (42.8%, diabetes (12.7%, and hypertension (10.6%. Mean recipient age was 36.2 ± 14.2 years; 162 were males and 74 were females. Mean donor age was 45.3 ± 17.13 years; 144 were males and 92 were females. Mean dialysis duration pre-transplantation was 18.5 ± 2.5 months. All recipients received single-dose rabbit-anti-thymocyte globulin induction and steroids, calcinueurin inhibitor, and mycophenolate mofetil/azathioprine for maintenance immunosuppression. Delayed graft function was observed in 29.6% patients and 22% had biopsy-proven acute rejection. Over the mean follow-up of 2.18 ± 1.75 years, patient and graft survival rates were 74.57% and 86.8%, respectively, with mean SCr of 1.42 ± 0.66 mg%. DDRTx achieves acceptable graft function with patient/graft survival, encouraging the use of this approach in view of organ shortage.

Neuro-Oncology Branch patient experience and expertise | Center for Cancer Research

Science.gov (United States)

Experience and Expertise We have more than 20 years of experience working with patients and their physicians to offer a comprehensive approach to patient care. Patients travel from all over the world to be evaluated and treated by our clinical team. The Brain Tumor Clinic sees hundreds of new patients and 2,000–3,000 follow-up patients each year. 

Evolution of the Virtualized HPC Infrastructure of Novosibirsk Scientific Center

International Nuclear Information System (INIS)

Adakin, A; Chubarov, D; Nikultsev, V; Anisenkov, A; Belov, S; Kaplin, V; Korol, A; Skovpen, K; Sukharev, A; Zaytsev, A; Kalyuzhny, V; Kuchin, N; Lomakin, S

2012-01-01

Novosibirsk Scientific Center (NSC), also known worldwide as Akademgorodok, is one of the largest Russian scientific centers hosting Novosibirsk State University (NSU) and more than 35 research organizations of the Siberian Branch of Russian Academy of Sciences including Budker Institute of Nuclear Physics (BINP), Institute of Computational Technologies, and Institute of Computational Mathematics and Mathematical Geophysics (ICM and MG). Since each institute has specific requirements on the architecture of computing farms involved in its research field, currently we've got several computing facilities hosted by NSC institutes, each optimized for a particular set of tasks, of which the largest are the NSU Supercomputer Center, Siberian Supercomputer Center (ICM and MG), and a Grid Computing Facility of BINP. A dedicated optical network with the initial bandwidth of 10 Gb/s connecting these three facilities was built in order to make it possible to share the computing resources among the research communities, thus increasing the efficiency of operating the existing computing facilities and offering a common platform for building the computing infrastructure for future scientific projects. Unification of the computing infrastructure is achieved by extensive use of virtualization technology based on XEN and KVM platforms. This contribution gives a thorough review of the present status and future development prospects for the NSC virtualized computing infrastructure and the experience gained while using it for running production data analysis jobs related to HEP experiments being carried out at BINP, especially the KEDR detector experiment at the VEPP-4M electron-positron collider.

Target marketing for the hospital-based wellness center.

Science.gov (United States)

Cangelosi, J D

1997-01-01

The American population is aging, medical technology is advancing, and life expectancies are on the rise. At the same time hospitals are looking for additional sources of income due to the pressures of government regulations and managed care. One of the options for hospitals looking for additional sources of income is the hospital-based but free-standing comprehensive wellness and fitness center. Such centers go beyond the facilities, programs and services offered by traditional health and fitness centers. In addition to physical fitness programs, hospital-based wellness centers offer programs in CPR, nutrition, weight control and many other programs of interest to an aging but active American populace. This research documents the hospital industry, wellness industry and the prospects of success or failure for he hospital attempting such a venture. The focus of the research is the experience of a particular hospital with regard to the programs, facilities and services deemed most important by its target market.

Center for Applied Linguistics, Washington DC, USA

Science.gov (United States)

Sugarman, Julie; Fee, Molly; Donovan, Anne

2015-01-01

The Center for Applied Linguistics (CAL) is a private, nonprofit organization with over 50 years' experience in the application of research on language and culture to educational and societal concerns. CAL carries out its mission to improve communication through better understanding of language and culture by engaging in a variety of projects in…

Portability and the National Energy Software Center

International Nuclear Information System (INIS)

Butler, M.K.

1978-01-01

The software portability problem is examined from the viewpoint of experience gained in the operation of a software exchange and information center. First, the factors contributing to the program interchange to date are identified, then major problem areas remaining are noted. The import of the development of programing language and documentation standards is noted, and the program packaging procedures and dissemination practices employed by the Center to facilitate successful software transport are described. Organization, or installation, dependencies of the computing environment, often hidden from the program author, and data interchange complexities are seen as today's primary issues, with dedicated processors and network communications offering an alternative solution

The BLAST experiment

NARCIS (Netherlands)

Hasell, D.; Botto, T.; van den Brand, J.F.J.

2009-01-01

The Bates large acceptance spectrometer toroid (BLAST) experiment was operated at the MIT-Bates Linear Accelerator Center from 2003 until 2005. The detector and experimental program were designed to study, in a systematic manner, the spin-dependent electromagnetic interaction in few-nucleon systems.

Next generation neutron scattering at Neutron Science Center project in JAERI

International Nuclear Information System (INIS)

Yamada, Yasusada; Watanabe, Noboru; Niimura, Nobuo; Morii, Yukio; Katano, Susumu; Aizawa, Kazuya; Suzuki, Jun-ichi; Koizumi, Satoshi; Osakabe, Toyotaka.

1997-01-01

Japan Atomic Energy Research Institute (JAERI) has promoted neutron scattering researches by means of research reactors in Tokai Research Establishment, and proposes 'Neutron Science Research Center' to develop the future prospect of the Tokai Research Establishment. The scientific fields which will be expected to progress by the neutron scattering experiments carried out at the proposed facility in the Center are surveyed. (author)

Synthesis centers as critical research infrastructure

Science.gov (United States)

Baron, Jill S.; Specht, Alison; Garnier, Eric; Bishop, Pamela; Campbell, C. Andrew; Davis, Frank W.; Fady, Bruno; Field, Dawn; Gross, Louis J.; Guru, Siddeswara M.; Halpern, Benjamin S; Hampton, Stephanie E.; Leavitt, Peter R.; Meagher, Thomas R.; Ometto, Jean; Parker, John N.; Price, Richard; Rawson, Casey H.; Rodrigo, Allen; Sheble, Laura A.; Winter, Marten

2017-01-01

investment to maximize benefits to science and society is justified. In particular, we argue that synthesis centers represent community infrastructure more akin to research vessels than to term-funded centers of science and technology (e.g., NSF Science and Technology Centers). Through our experience running synthesis centers and, in some cases, developing postfederal funding models, we offer our perspective on the purpose and value of synthesis centers. We present case studies of different outcomes of transition plans and argue for a fundamental shift in the conception of synthesis science and the strategic funding of these centers by government funding agencies.

Optical determination and magnetic manipulation of a single nitrogen-vacancy color center in diamond nanocrystal

International Nuclear Information System (INIS)

Diep Lai, Ngoc; Zheng, Dingwei; Treussart, François; Roch, Jean-François

2010-01-01

The controlled and coherent manipulation of individual quantum systems is fundamental for the development of quantum information processing. The nitrogen-vacancy (NV) color center in diamond is a promising system since its photoluminescence is perfectly stable at room temperature and its electron spin can be optically read out at the individual level. We review here the experiments currently realized in our laboratory concerning the use of a single NV color center as the single photon source and the coherent magnetic manipulation of the electron spin associated with a single NV color center. Furthermore, we demonstrate a nanoscopy experiment based on the saturation absorption effect, which allows to optically pin-point a single NV color center at sub-λ resolution. This offers the possibility to independently address two or multiple magnetically coupled single NV color centers, which is a necessary step towards the realization of a diamond-based quantum computer

What makes or mars the facility-based childbirth experience: thematic analysis of women's childbirth experiences in western Kenya.

Science.gov (United States)

Afulani, Patience A; Kirumbi, Leah; Lyndon, Audrey

2017-12-29

Sub-Saharan Africa accounts for approximately 66% of global maternal deaths. Poor person-centered maternity care, which emphasizes the quality of patient experience, contributes both directly and indirectly to these poor outcomes. Yet, few studies in low resource settings have examined what is important to women during childbirth from their perspective. The aim of this study is to examine women's facility-based childbirth experiences in a rural county in Kenya, to identify aspects of care that contribute to a positive or negative birth experience. Data are from eight focus group discussions conducted in a rural county in western Kenya in October and November 2016, with 58 mothers aged 15 to 49 years who gave birth in the preceding nine weeks. We recorded and transcribed the discussions and used a thematic approach for data analysis. The findings suggest four factors influence women's perceptions of quality of care: responsiveness, supportive care, dignified care, and effective communication. Women had a positive experience when they were received well at the health facility, treated with kindness and respect, and given sufficient information about their care. The reverse led to a negative experience. These experiences were influenced by the behavior of both clinical and support staff and the facility environment. This study extends the literature on person-centered maternity care in low resource settings. To improve person-centered maternity care, interventions need to address the responsiveness of health facilities, ensure women receive supportive and dignified care, and promote effective patient-provider communication.

Present status of the Nuclear Maintenance Training Center

International Nuclear Information System (INIS)

Kotani, Fumio

1995-01-01

The education and training to keep and improve the knowledge and skills of the maintenance personnel and to hand down the skills undoubtedly play important roles in safe operation and increased reliability to a nuclear power station. The Nuclear Maintenance Training Center (hereafter called the Center) provides a variety of education and training curriculums based on the levels and abilities of the trainees. The Center aims to enhance the personnel's maintenance technique by offering the curriculums on maintenance basic education for operators and supporting education and training for the personnel of contractors. The Center has two main features: first, it has the actual components or the equipment similar to the actual components which will enable the practical training; second, we regard the past troubles as valuable experiences and, therefore, focuses on the education to prevent recurrence of troubles by teaching the trainees the meaning and necessity of the training they take. For eleven years since the establishment of the Center, it has been utilized by the total number of about 60,000 people. As for the tasks in the future, the Center is expected to vitalize itself to give attractive education and training and become more actively involved in development of the maintenance personnel with the adequate knowledge and skills. (author)

FBR Plant Engineering Center annual report 2012

International Nuclear Information System (INIS)

2013-12-01

This annual report shows the last year's R and D activities of currently-reorganized FBR Plant Engineering Center, which was established on April 1, 2009. FBR Safety Technology Center was founded on April 1, 2013 by the consolidation of both the activities of 'former FBR Plant Engineering Center' and a portion of 'FBR Safety Evaluation Unit, Advanced Nuclear System Research and Development Directorate', especially concentrating on safety evaluations and analyses for severe accidents. As for FBR safety technology, it is necessary to continuously make an effort for compliance with new safety regulations in preparation for 'Monju' to restart, for safety enhancement evaluation and for safety technology upgrading. In this context, the new organization was founded in order to reinforce the safety evaluation capability, which will surely and steadily promote FBR safety-technology related activities. As a result, FBR Plant Engineering Center was abolished. This report summarizes the R and D activities at the former FBR Plant Engineering Center, aiming at contributing to the commercialization by using operation experiences and technology development results derived from the actual reactor 'Monju'. The activities are divided into five areas of operation-and-maintenance engineering, sodium engineering, reactor-core-and-fuel engineering, plant engineering, and safety engineering. This annual report is intended for a report of the activities of individual researcher in the center rather than that of the progress of the center as a whole. This will clarify the individual themes, progresses and problems of each researcher, which will, hopefully, facilitate communication with the outside researchers. (author)

Effects of organizational scheme and labeling on task performance in product-centered and user-centered retail Web sites.

Science.gov (United States)

Resnick, Marc L; Sanchez, Julian

2004-01-01

As companies increase the quantity of information they provide through their Web sites, it is critical that content is structured with an appropriate architecture. However, resource constraints often limit the ability of companies to apply all Web design principles completely. This study quantifies the effects of two major information architecture principles in a controlled study that isolates the incremental effects of organizational scheme and labeling on user performance and satisfaction. Sixty participants with a wide range of Internet and on-line shopping experience were recruited to complete a series of shopping tasks on a prototype retail shopping Web site. User-centered labels provided a significant benefit in performance and satisfaction over labels obtained through company-centered methods. User-centered organization did not result in improved performance except when the label quality was poor. Significant interactions suggest specific guidelines for allocating resources in Web site design. Applications of this research include the design of Web sites for any commercial application, particularly E-commerce.

Integrated Support Center for Nuclear Nonproliferation and Security

International Nuclear Information System (INIS)

Kimura, Naohito; Naoi, Yosuke

2010-01-01

In April 2010, at the Nuclear Security Summit, Japan demonstrated its commitment to the strengthening of nuclear non-proliferation and nuclear security and announced the establishment of the Integrated Comprehensive Support Center for Nuclear Non-proliferation and Nuclear Security in the Japan Atomic Energy Agency (JAEA), under the guidance and authority of the Ministry of Education, Culture, Sports and Science and Technology (MEXT), and in cooperation with other ministries. The goal of the Center is to strengthen nuclear non-proliferation and security in emerging nuclear power countries by sharing Japan's accumulated experiences in its peaceful use of nuclear energy. To achieve its goal, the Center serves three functions: (1) human resource and capacity building, (2) infrastructure development and technical assistance and (3) international coordination and cooperation. The Center will offer three types of training courses to strengthen human resources and capacity building in emerging nuclear power countries. In the Training Course on Nuclear Security, the participants will learn the design and evaluation process for physical protection and detection of and response to illegal or unauthorized acts related to nuclear materials. They will learn these issues not only through lectures and training but also using mockup facilities and virtual reality systems. Second, in the Training Course on Safeguards and State System of Accounting for and Control of Nuclear Material (SSAC), the Center will teach the experience of advanced safeguards activities in Japan for its full-scale nuclear fuel cycle facilities as a non-nuclear weapon state. The participants will learn the IAEA and national safeguards systems, the material accounting system and inspector activities. Third, in the Training on the International Nuclear Nonproliferation Framework, the participants will learn the international framework of nuclear non-proliferation including the IAEA safeguards system and

New Mexico center for particle physics: Studies of fundmental interactions

International Nuclear Information System (INIS)

1997-01-01

This report summarizes the results of the research program in the New Mexico Center during the last year and presents our program of proposed research for the next year. The majority of the New Mexico Center group's research involves the CDF experiment at the Tevatron pp collider at Fermilab. Our group is a leader in all of the SVX vertex detector upgrades for CDF. These vertex detectors are of critical importance to the pursuit of our physics interests at the Tevatron; they are also an imposing instrumentation challenge. Our group is also deeply involved in several CDF B-physics analyses and in an exotics search. Our research also includes important contributions to R ampersand D for the ATLAS experiment at the LHC

Retinoblastoma: experience of a referral center in the North Region of Portugal

Directory of Open Access Journals (Sweden)

Rocha-Bastos R

2014-05-01

Full Text Available RA da Rocha-Bastos,1 JR Araújo,1 RS Silva,2 MJ Gil-da-Costa,2 E Brandão,1 NJ Farinha,2,3 F Falcão-Reis,1,4 T Dinah-Bragança1 1Department of Ophthalmology, Hospital São João, 2Hematology and Oncology Unit, Pediatric Hospital, Hospital São João, 3Pediatrics Department, Faculty of Medicine, University of Porto, 4Department of Sense Organs, Faculty of Medicine, University of Porto, Porto, Portugal Purpose: To describe the experience of the Ophthalmology Department of Hospital São João (HSJ, a tertiary health care center in North Region, Portugal, in terms of the diagnosis, treatment, and follow-up of retinoblastoma. Methods: This was a retrospective study of patients diagnosed with retinoblastoma in Hospital São João, between 1978 and 2012. Results: Fifty patients with retinoblastoma were evaluated in our institution between 1978 and 2012. Four patients were excluded due to loss of follow-up. Among the 46 retinoblastoma cases, 33 (71.7% were unilateral and 13 (28.3% bilateral, with a mean age at diagnosis of 22.19 months and 6.92 months, respectively (P<0.001. Leukocoria was the most common presenting sign (36.9%, followed by strabismus (19.6%, a combination of leukocoria and strabismus (8.7%, and buphthalmia (2.2%. Between 1978 and 1992, nine retinoblastoma cases were referred to our hospital, all of them unilateral, and, in each case, enucleation was performed, with or without salvage therapy. Between 1993 and 2012, 18 eyes with retinoblastoma were successfully managed with conservative treatment. Conclusion: Demographic results were generally coincident with previous reports. It is crucial to screen leukocoria in pediatric practice, even in asymptomatic children. The outcome of retinoblastoma treatment in our hospital is similar to other series in developed countries. Keywords: retinoblastoma, leukocoria, strabismus, enucleation, pediatric cancer

Through the patient's eyes: the value of a comprehensive brain tumor center.

Science.gov (United States)

Robin, Adam M; Walbert, Tobias; Mikkelsen, Tom; Kalkanis, Steven N; Rock, Jack; Lee, Ian; Rosenblum, Mark L

2014-09-01

Since the founding of the Tumor Section of the American Association of Neurological Surgeons (AANS) and the Congress of Neurological Surgeons (CNS) in 1984 much in neurosurgical oncology has changed. More than 40,000 papers have been published on glioma since the arrival of the AANS/CNS Tumor Section. Increasingly, research is focusing on more patient-centered care and quality of life. Preliminary work suggests that a greater emphasis on the patient and caregiver's experience of disease is crucial. Also, the provision of hope and appropriate information and communication with health care providers helps to lessen anxiety and promote improved quality of life. Lastly, our patients need a mechanism for continued symptom control and psychosocial support throughout their experience of this disease. An excellent venue for providing these facets of neurooncological patient care is the multidisciplinary brain tumor board and symptom management team. Herein, we present the philosophy and practice of the Hermelin Brain Tumor Center at the Henry Ford Health System as one type of approach to caring for the patient with a malignant glioma. The authors are aware of several brain tumor centers that share our philosophy and approach to patient care. Our comments are not meant to be exclusive to our experience and should be interpreted as representative of the growing movement in neurosurgery to provide comprehensive, multidisciplinary, patient-centered care.

Treatment planning for permanent and temporary percutaneous implants with custom made templates

International Nuclear Information System (INIS)

Osian, A.D.; Anderson, L.L.; Linares, L.A.; Nori, D.; Hilaris, B.S.

1989-01-01

Nine patients who were presented at MSKCC with primary or recurrent pelvic or head and neck tumors and for whom surgery or further external radiation were excluded, were treated with percutaneous permanent or temporary implants, with individual pre-treatment planning and custom made templates. The tumor dose distributions achieved were as good as for implants performed at the time of surgical exploration. No serious complications have been encountered

Assessing the integration of health center and community emergency preparedness and response planning.

Science.gov (United States)

Wineman, Nicole V; Braun, Barbara I; Barbera, Joseph A; Loeb, Jerod M

2007-11-01

To assess the state of health center integration into community preparedness, we undertook a national study of linkages between health centers and the emergency preparedness and response planning initiatives in their communities. The key objectives of this project were to gain a better understanding of existing linkages in a nationally representative sample of health centers, and identify health center demographic and experience factors that were associated with strong linkages. The objectives of the study were to gain a baseline understanding of existing health center linkages to community emergency preparedness and response systems and to identify factors that were associated with strong linkages. A 60-item questionnaire was mailed to the population of health centers supported by the Health Resources and Services Administration's Bureau of Primary Health Care in February 2005. Results were aggregated and a chi square analysis identified factors associated with stronger linkages. Overall performance on study-defined indicators of strong linkages was low: 34% had completed a hazard vulnerability analysis in collaboration with the community emergency management agency, 30% had their role documented in the community plan, and 24% participated in community-wide exercises. Stronger linkages were associated with experience responding to a disaster and a perception of high risk for experiencing a disaster. The potential for health centers to participate in an integrated response is not fully realized, and their absence from community-based planning leaves an already vulnerable population at greater risk. Community planners should be encouraged to include health centers in planning and response and centers should receive more targeted resources for community integration.

Selection and construction of nuclear and radiation emergency medical center in a region

International Nuclear Information System (INIS)

Wang Guojun; He Xu; Liao Li; Gao Dong

2014-01-01

Three level of first-class comprehensive hospital is an important force of nuclear and radiation accident rescue, has a very rich experience in response to nuclear and radiation accidents and deal with large quantities of the sick and wounded. With the foundation and the ability of the construction and operation of medical emergency rescue center. This paper according to the median model location theory of emergency center, combined with the specific situation of the nuclear and radiation accident in Hunan Province, reference location, rescue experience, emergency allocation of resources, teaching and research capacity, establish regional medical emergency center of nuclear and radiation accidents based on three level of first-class comprehensive hospital, break the traditional concept that the center must be provincial capital,form a multi-level, three-dimensional, network of emergency hospital rescue system. The main duties of the center are accident emergency response, on-site treatment and technical guidance of accident, psychological grooming. The author propose building measures according to the duties of the center: increase national and provincial financial investment, carry out training, drills and first aid knowledge missionaries regularly, innovative materials management, speed up the construction of information platform, establish and improve the hospital rescue system, improve organization institution and system of plans, reengineering rescue process. (authors)

Women's Center Volunteer Intern Program: Building Community While Advancing Social and Gender Justice

Science.gov (United States)

Murray, Margaret A.; Vlasnik, Amber L.

2015-01-01

This program description explores the purpose, structure, activities, and outcomes of the volunteer intern program at the Wright State University Women's Center. Designed to create meaningful, hands-on learning experiences for students and to advance the center's mission, the volunteer intern program builds community while advancing social and…

Dragons, Ladybugs, and Softballs: Girls' STEM Engagement with Human-Centered Robotics

Science.gov (United States)

Gomoll, Andrea; Hmelo-Silver, Cindy E.; Šabanovic, Selma; Francisco, Matthew

2016-01-01

Early experiences in science, technology, engineering, and math (STEM) are important for getting youth interested in STEM fields, particularly for girls. Here, we explore how an after-school robotics club can provide informal STEM experiences that inspire students to engage with STEM in the future. Human-centered robotics, with its emphasis on the…

Intensity-Modulated Radiotherapy in the Treatment of Oropharyngeal Cancer: An Update of the Memorial Sloan-Kettering Cancer Center Experience

Energy Technology Data Exchange (ETDEWEB)

Setton, Jeremy; Caria, Nicola; Romanyshyn, Jonathan; Koutcher, Lawrence; Wolden, Suzanne L.; Zelefsky, Michael J.; Rowan, Nicholas [Department of Radiation Oncology, Memorial Sloan-Kettering Cancer Center, New York, NY (United States); Sherman, Eric J.; Fury, Matthew G.; Pfister, David G. [Department of Medicine, Memorial Sloan-Kettering Cancer Center, New York, NY (United States); Wong, Richard J.; Shah, Jatin P.; Kraus, Dennis H. [Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York, NY (United States); Shi Weiji; Zhang Zhigang [Department of Epidemiology and Biostatistics, Memorial Sloan-Kettering Cancer Center, New York, NY (United States); Schupak, Karen D.; Gelblum, Daphna Y.; Rao, Shyam D. [Department of Radiation Oncology, Memorial Sloan-Kettering Cancer Center, New York, NY (United States); Lee, Nancy Y., E-mail: Leen2@mskcc.org [Department of Radiation Oncology, Memorial Sloan-Kettering Cancer Center, New York, NY (United States)

2012-01-01

Purpose: To update the Memorial Sloan-Kettering Cancer Center's experience with intensity-modulated radiotherapy (IMRT) in the treatment of oropharyngeal cancer (OPC). Methods and Materials: Between September 1998 and April 2009, 442 patients with histologically confirmed OPC underwent IMRT at our center. There were 379 men and 63 women with a median age of 57 years (range, 27-91). The disease was Stage I in 2%, Stage II in 4%, Stage III in 21%, and Stage IV in 73% of patients. The primary tumor subsite was tonsil in 50%, base of tongue in 46%, pharyngeal wall in 3%, and soft palate in 2%. The median prescription dose to the planning target volume of the gross tumor was 70 Gy for definitive (n = 412) cases and 66 Gy for postoperative cases (n = 30). A total 404 patients (91%) received chemotherapy, including 389 (88%) who received concurrent chemotherapy, the majority of which was platinum-based. Results: Median follow-up among surviving patients was 36.8 months (range, 3-135). The 3-year cumulative incidence of local failure, regional failure, and distant metastasis was 5.4%, 5.6%, and 12.5%, respectively. The 3-year OS rate was 84.9%. The incidence of late dysphagia and late xerostomia {>=}Grade 2 was 11% and 29%, respectively. Conclusions: Our results confirm the feasibility of IMRT in achieving excellent locoregional control and low rates of xerostomia. According to our knowledge, this study is the largest report of patients treated with IMRT for OPC.

Work Experiences of Patients Receiving Palliative Care at a Comprehensive Cancer Center: Exploratory Analysis.

Science.gov (United States)

Glare, Paul A; Nikolova, Tanya; Alickaj, Alberta; Patil, Sujata; Blinder, Victoria

2017-07-01

Employment-related issues have been largely overlooked in cancer patients needing palliative care. These issues may become more relevant as cancer evolves into more of a chronic illness and palliative care is provided independent of stage or prognosis. To characterize the employment situations of working-age palliative care patients. Cross-sectional survey setting/subjects: Consecutive sample of 112 patients followed in palliative care outpatient clinics at a comprehensive cancer center. Thirty-seven-item self-report questionnaire covering demographics, clinical status, and work experiences since diagnosis. The commonest cancer diagnoses were breast, colorectal, gynecological, and lung. Eighty-one percent had active disease. Seventy-four percent were on treatment. Eighty percent recalled being employed at the time of diagnosis, with 65% working full time. At the time of the survey, 44% were employed and 26% were working full time. Most participants said work was important, made them feel normal, and helped them feel they were "beating the cancer". Factors associated with being employed included male gender, self-employed, and taking less than three months off work. Respondents with pain and/or other symptoms were significantly less likely to be working. On multivariate analysis, only pain (odds ratio [OR] 8.16, p gender (OR 2.07), self-employed (OR 3.07), and current chemotherapy (OR 1.81) were included in the model, but were not statistically significant in this small sample. Work may be an important issue for some palliative care patients. Additional research is needed to facilitate ongoing employment for those who wish or need to continue working.

Image-guided chemoport insertion by interventional radiologists: A single-center experience on periprocedural complications

International Nuclear Information System (INIS)

Yaacob, Yazmin; Nguyen, Dang V; Mohamed, Zahiah; Ralib, A Razali A; Zakaria, Rozman; Muda, Sobri

2013-01-01

To report our early experience in image-guided chemoport insertions by interventional radiologists. This was a cross-sectional study conducted in a tertiary center with 161 chemoport insertions done from June 2008 to June 2010. The chemoports were inserted either at the angiography suite or at the mobile operation theater unit. Ninety percent of the chemoports had right internal jugular vein (IJV) as the entry site. Other entry sites included the left IJV, subclavian veins and the inferior vena cava. Immediate and early complications were recorded. All insertions were performed under image guidance with the aid of ultrasound and fluoroscopy. The technical success rate was 99.4%. In terms of immediate complications, there were only two cases of arterial puncture that resolved with local compression. No pneumothorax or air embolism was documented. Twenty-six early complications were recorded. The most common early complication was catheter blockage (12/161; 7.4%), followed by catheter-related infection (9/161; 5.6%). Other complications were catheter malposition, venous thrombosis and catheter dislodgement or leak. A total of 11 (6.8%) chemoports had to be removed within 30 days; most of them were due to infections that failed to respond to systemic antibiotic therapy. In terms of place of procedure, there were no significant differences in complication rates between the angiography suite and the mobile operation theater unit. Image-guided chemoport insertion by interventional radiologist gives low periprocedural complication rates. Using right IJV as the entry site, the image guidance gives good success rate with least complication

47. A cardiac center experience with Brugada syndrome who survived sudden cardiac death

Directory of Open Access Journals (Sweden)

I. Suliman

2016-07-01

Full Text Available Brugada syndrome is a heritable arrhythmia syndrome that is characterized by an electrocardiographic pattern consisting of coved-type ST-segment elevation (2 mm followed by a negative T wave in the right precordial leads, V1 through V3 (often referred to as type 1 Brugada electrocardiographic pattern, here we describe 3 cases of Brugada who survived sudden cardiac death (SCD cardiac center experience with survived Brugada syndrome patients – case series. First Case: The Father 45 years old male, presented in 2005 after involvement in unprovoked motor vehicle accident, the patient was the driver who lost consciousness and rushed to the hospital. On arrival to our ER and putting the patient on the bed, the ER doctor observed a brief episode of VF on the monitor. The patient was taken to the catheterization Lab , his coronaries were normal. The diagnosis of Brugada was established and the patient received a defibrillator. At That Time all family members were screened and were negative. Second Case: The Son of the first patient 5 years later his 23 years old male rushed to our ER after he lost consciousness, he was passenger in the car of his friend. Third Case: The pilot A military pilot aged a male 35 years old was in very good health when he lost consciousness and brought to the hospital after resuscitation in 2005. He had full invasive cardiac evaluation, subsequently he received a defibrillator in the same admission period, till 2015 he is doing fine. Brugada syndrome is associated with high tendency for sudden cardiac death. In our three cases the first clinical presentation was survived sudden cardiac death (SCD and all three male patients survived. We did not encounter a female patient who survived sudden cardiac death.

Robotic surgery for rectal cancer: a single center experience of 100 consecutive cases.

Science.gov (United States)

Stănciulea, O; Eftimie, M; David, L; Tomulescu, V; Vasilescu, C; Popescu, I

2013-01-01

Minimally invasive techniques have revolutionized the field of general surgery over the few last decades. Despite its advantages, in complex procedures such as rectal surgery, laparoscopy has not achieved a high penetration rate because of its steep learning curve, its relatively high conversion rate and technical challenges. The aim of this study was to present a single center experience with robotic surgery for rectal cancer focusing mainly on early and mid-term postoperative outcome. A series of 100 consecutive patients who underwent robotic rectal surgery between January 2008 and June 2012 was analyzed retrospectively in terms of demographics, pathological data, surgical and oncological outcomes. Seventy-seven patients underwent robotic sphincter-saving resection, and 23 patients underwent robotic abdominoperineal resection. There were 4 conversions. The median operative time for sphincter-saving procedures was 180 min. The median time for robotic abdominoperineal resection was 160 min. The median distal resection margin of the operative specimen was 3 cm. The median number of retrieved lymph nodes was 14. The median hospital stay was 10 days. In-hospital mortality was nil. The overall morbidity was 30%. Four patients presented transitory postoperative urinary dysfunction. Severe erectile dysfunction was reported by 3 patients. The median length of follow-up was 24 months. The 3-year overall survival rate was 90%. Robotic surgery is advantageous for both surgeons (in that it facilitates dissection in a narrow pelvis) and patients (in that it affords a very good quality of life via the preservation of sexual and urinary function in the vast majority of patients and it has low morbidity and good midterm oncological outcomes). In rectal cancer surgery, the robotic approach is a promising alternative and is expected to overcome the low penetration rate of laparoscopy in this field. Celsius.

42 CFR 482.80 - Condition of participation: Data submission, clinical experience, and outcome requirements for...

Science.gov (United States)

2010-10-01

..., clinical experience, and outcome requirements for initial approval of transplant centers. 482.80 Section... Hospitals Transplant Center Data Submission, Clinical Experience, and Outcome Requirements § 482.80 Condition of participation: Data submission, clinical experience, and outcome requirements for initial...

[Implementation of the EndoCert system for certification of arthroplasty centers. Experiences from the pilot phase].

Science.gov (United States)

Haas, H; Mittelmeier, W

2014-06-01

EndoCert is an initiative of the Deutschen Gesellschaft für Orthopädie und Orthopädische Chirurgie (DGOOC, German Society for Orthopedics and Orthopedic Surgery) which has been available since October 2012 and is the first system worldwide for certification of specialized arthroplasty centers. Before implementation of this certification concept two sequential pilot phases were carried out with representative treatment institutions. The results from these pilot clinics are presented with respect to quality improvement effects. Early effects on the quality of treatment have been achieved by rectification of nonconformities determined in the audit with respect to structural and process quality. A total of 172 nonconformities found in the 23 participating pilot clinics could be rectified. Long-term effects on the quality of results will in future be analyzed in cooperation with the German endoprosthesis register (EPRD) and by accompanying evaluations. A close feedback of the collated experiences and results to the certification committee, which is responsible for the procedure together with the DGOOC, allows continuous further development of the system EndoCert represents a substantial step towards a nationwide safety and improvement of the quality in arthroplasty treatment within the preoperative, perioperative and postoperative framework and can in future represent a decisive tool together with the EPRD in quality management.

Blood blister-like aneurysms: Single center experience and systematic literature review

International Nuclear Information System (INIS)

Gonzalez, Ana Marcos; Narata, Ana Paula; Yilmaz, Hasan; Bijlenga, Philippe; Radovanovic, Ivan; Schaller, Karl; Lovblad, Karl-Olof; Pereira, Vitor Mendes

2014-01-01

Blood blister-like aneurysms (BBAs) are a controversial entity. They arise from non-branching sites on the supraclinoid internal carotid artery (ICA) and are suspected to originate from a dissection. Our aim is to describe the BBA cases seen in our center and to present a systematic review of the literature on BBAs. We analyzed the eleven cases of BBA admitted to our center from 2003 to 2012. We assessed the medical history, treatment modality (endovascular and/or surgery), complications and clinical outcome. The cohort included 8 women and 4 men with a mean age of 53.16 years. Treatment of the BBA consisted of stenting and coiling in 5 patients, stenting only in 4 patients, coiling and clipping in 1 patient, clipping only in 1 patient, and conservative treatment in 1 patient. A good outcome was found in 10 patients, as defined by a modified Rankin Scale (mRS) less than or equal to two at three months. A systematic review of the literature was performed, and 314 reported patients were found: 221 patients were treated with a primarily surgical approach, and 87 patients were treated with a primarily endovascular approach. A rescue or second treatment was required in 46 patients (21%). The overall estimated treatment morbidity rate was 17%, and the mortality rate was 15%. BBAs exhibit more aggressive behavior compared to saccular aneurysms, and more intra-operative complications occur with BBAs, independent of the treatment type offered. They are also significantly more likely to relapse and rebleed after treatment. Endovascular treatment offers a lower morbidity–mortality compared with surgical approaches. Multilayer flow-diverting stents appear to be a promising strategy

Diabetes Stories: Use of Patient Narratives of Diabetes to Teach Patient-Centered Care

Science.gov (United States)

Kumagai, Arno K.; Murphy, Elizabeth A.; Ross, Paula T.

2009-01-01

A critical component to instituting compassionate, patient-centered diabetes care is the training of health care providers. Our institution developed the Family Centered Experience (FCE), a comprehensive 2-year preclinical program based on longitudinal conversations with patients about living with chronic illness. The goal of the FCE is to explore…

Sociopolitical ramifications of nuclear energy centers

International Nuclear Information System (INIS)

Meier, P.M.

1977-01-01

The sociopolitical ramifications of nuclear energy centers, as emerging from a case study in Ocean County, New Jersey, are examined from the standpoint of identifying key issues of public controversy, and with emphasis on implications for national energy planning and the course of nuclear debate. Various dimensions of institutional tension are analyzed, including interstate issues and federal preemption, and the ability of the institutional and political framework to address the many equity issues that are exacerbated by clustered siting. The evolution of public attitudes, and the subsequent mobilization of effective political channels in opposition to proposed NEC's are discussed in light of New Jersey experience. The degree to which energy centers affect public attitudes to nuclear power is identified as the key issue requiring further analysis before widespread implementation of the concept can be advocated

Aligning business strategy of incubator center and tenants

Science.gov (United States)

Prasetyawan, Yudha; Agustiani, Elly; Jumayla, Sari

2017-06-01

Incubator center is developed to help a particular group of small business players to achieve the expected business growth. In this center, business players often called as tenants will get assistances in pertaining with space, professional network, marketing, investment or funding, and training to improve their business capability. There are three types of incubator center, namely universities that help their alumni or business people in their surrounded area, company that supports small business as the corporate social responsibility, and independent organizations that have specialties in the business development. Some might success in increasing the capacity of the tenants, while other can have difficulties to increase the simplest business capability, e.g., to define the production cost to measure the profit. This study was intended to propose a model to align the business strategy between incubator center and its tenants. The sales and profit growth are the main priorities for the tenants together with their business capability and sustainability. The proposed alignment model provides measurement tools that link the motivation of tenants for joining the incubation process with the mission of incubator center. The linkage covered the key performance indicators (KPI), steps to achieve the target and evaluation tools to improve the current handicaps. An experiment on 4 (four) diverse business fields of the tenants of an incubator center was performed to test the model. As a result, the increase of KPI of incubator center will simultaneously yield a higher value of the tenants' sales.

[Congenital bilateral absence of vas deferens: From diagnosis to assisted reproductive techniques - the experience of three centers].

Science.gov (United States)

Beauvillard, D; Perrin, A; Drapier, H; Ravel, C; Fréour, T; Férec, C; De Braekeleer, M; Amice, V

2015-05-01

To review the management with assisted reproductive technologies (ART) of men with congenital bilateral absence of vas deferens (CBAVD), associated with cystic fibrosis or not, after surgical retrieval [epididymal aspiration (MESA) or testicular biopsy (TESE)]. Multicenter retrospective study made of 2 groups: CBAVD and cystic fibrosis (CF) or CBAVD only (CF-RD). Two centers performed MESA (Brest and Nantes) and one TESE (Rennes). Sperm numeration, motility, vitality, morphology and nuclear maturity were measured in both centers performing MESA. Fertilization rate (TF) and cumulated progressive pregnancy rate by retrieved oocyte (TGC) were compared between centers following ART. Ninety patients underwent surgical retrieval between January 1996 and March 2013, 30 in the CF group and 60 in the CF-RD group. Semen parameters were comparable between groups and centers. Fifty-eight (22 in the CF group and 36 in the CF-RD group) patients received ART between April 1996 and October 2014. TF was 50% and 52% and TGC 26% and 32% in the CF group and CF-RD groups, respectively. The results did not differ between groups but TGC was higher in Rennes than in the other two centers. Both semen parameters and ART results are comparable and similar to those reported in the literature. As shown by the results obtained in Rennes, TESE seems to be more effective. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

The Practice of Learner-Centered Method in Upper Primary Schools ...

African Journals Online (AJOL)

user

Department of Pedagogy, Faculty of Education, Jimma University , Jimma Ethiopia. E-mail: .... teacher used one of the 33 Learner-centered methods or not. .... Sex. No. of teachers in selected schools. Teaching Experience. Male. Female.

The Manuel Lujan, Jr. Neutron Scattering Center (LANSCE) experiment reports, 1991 run cycle

International Nuclear Information System (INIS)

DiStravolo, M.A.

1992-12-01

This report briefly discusses experiments conducted at the Lansce neutron source facility. The experiments were conducted on the following instruments: high intensity powder diffractometer; neutron powder diffractometer; single crystal diffractometer; low-q diffractometer; surface profile analysis reflectometer; filter difference spectrometer; experiment reports, and pharos

Individual Supervision to Enhance Reflexivity and the Practice of Patient-Centered Care: Experience at the Undergraduate Level.

Science.gov (United States)

Berney, Alexandre; Bourquin, Céline

2017-12-22

This article reports on what is at work during individual supervision of medical students in the context of teaching breaking bad news (BBN). Surprisingly, there is a relative lack of research and report on the topic of supervision, even though it is regularly used in medical training. Building on our research and teaching experience on BBN at the undergraduate level, as well as interviews of supervisors, the following key elements have been identified: learning objectives (e.g., raising student awareness of structural elements of the interview, emotion (patients and students) handling), pedagogical approach (being centered on student's needs and supportive to promote already existing competences), essentials (e.g., discussing skills and examples from the clinical practice), and enhancing reflexivity while discussing specific issues (e.g., confusion between the needs of the patient and those of the student). Individual supervision has been identified as crucial and most satisfactory by students to provide guidance and to foster a reflexive stance enabling them to critically apprehend their communication style. Ultimately, the challenge is to teach medical students to not only connect with the patient but also with themselves.

Service of Remembrance: a comprehensive cancer center's response to bereaved family members.

Science.gov (United States)

Knight, Louise; Cooper, Rhonda S; Hypki, Cinder

2012-01-01

Comprehensive cancer centers that offer an array of clinical trials and treatment options often experience significant patient mortality rates. Bereavement resources may not be routinely incorporated into the service delivery model in these specialty hospitals. In response, an interdisciplinary team at one cancer center proposed, planned, and implemented an annual Service of Remembrance. The incorporation of music, poetry, and visual arts was important in designing a program that would provide a meaningful, spiritual experience. A community artist who designed an interactive memorial art piece played a pivotal role. This article outlines the process of institutional culture change and describes future challenges in the implementation of this type of bereavement service.

The National Space Science Data Center guide to international rocket data

Science.gov (United States)

Dubach, L. L.

1972-01-01

Background information is given which briefly describes the mission of the National Space Science Data Center (NSSDC), including its functions and systems, along with its policies and purposes for collecting rocket data. The operation of a machine-sensible rocket information system, which allows the Data Center to have convenient access to information and data concerning all rocket flights carrying scientific experiments, is also described. The central feature of this system, an index of rocket flights maintained on magnetic tape, is described. Standard outputs for NSSDC and for the World Data Center A (WDC-A) for Rockets and Satellites are described.

Family Centered Intervention with Infant Failure to Thrive.

Science.gov (United States)

Drotar, Dennis

The experience of consultants in a pediatric hospital indicates that infant failure to thrive is almost always associated with strain in the relationships of the infant's caregivers. Consequently, a nontraditional, long-term, home-based, and family-centered model of evaluation and treatment of failure to thrive has been developed which involves…

A knowledge-centered paradigm for operations and design

International Nuclear Information System (INIS)

Perin, C.

2005-01-01

A paradigm premised on the reactor design basis and on its systems, structures, and components also governs nuclear power plant operations. This machine-centered paradigm emphasizes a functional and discipline-based division of responsibilities, which can create hierarchical 'silos' and 'stovepipes' inhibiting the development and lateral exchange of knowledge about safety-critical system interactions. A knowledge-centered paradigm instead encourages the timely development, analysis, and exchange of information about system conditions and their likely consequences. This new paradigm puts operational focus on the importance of operating experience, informative root cause analyses, effective corrective actions, and cross-discipline exchange and cooperation. Although the knowledge-centered paradigm is already central to three main strategies of risk reduction, it is less likely to be recognized as such in terms of priorities, resources, and training: configuration control, control room operations, and root cause analysis. To maintain the capacity for safe shutdown and to preserve public trust, the knowledge-centered paradigm places as high a priority on interactions of safety-critical knowledge as it does on interactions of safety-critical systems, structures, and components. (author)

How do I provide leukapheresis products? Blood center experience and evidence for process improvement.

Science.gov (United States)

Ginzburg, Yelena; Kessler, Debra; Narici, Manlio; Caltabiano, Melinda; Rebosa, Mark; Strauss, Donna; Shaz, Beth

2013-10-01

The past few decades have seen a resurgence of interest in leukapheresis products to improve the survival of infected patients with neutropenia. These products have a short shelf life and require donor stimulation with dexamethasone before collection. Additionally, a system with good communications and logistical support is essential. A recent survey of blood centers in North America revealed that the majority of centers collecting leukapheresis products use steroid-stimulated donors. The survey results suggested that an analysis of the process and potential process improvement would be of interest to the transfusion medicine community. Data from 2008 to 2011 regarding donor selection, donor dexamethasone stimulation, leukapheresis collection, and correlations between potentially pertinent variables for process improvement were analyzed. Results from an analysis of cost are also included. We evaluate 432 leukapheresis donations and demonstrate correlations between 1) pre- and poststimulation white blood cell (WBC) count (pproduct granulocyte yield (pimprovement in granulocyte quality and yield can be accomplished in dexamethasone-stimulated donors, by selecting eligible donors with relatively high normal prestimulation WBC counts and/or previously good responses to dexamethasone, increasing the duration between dexamethasone stimulation and granulocyte collection, and maintaining optimal hematocrit (5%-10%) in granulocyte collections. Because the majority of surveyed blood centers collecting stimulated granulocytes use steroids alone, modifications presented here may prove useful. Further assessment of correlation between granulocyte yield and clinical outcome will await results of additional studies. © 2012 American Association of Blood Banks.

Activity report of Computing Research Center

Energy Technology Data Exchange (ETDEWEB)

1997-07-01

On April 1997, National Laboratory for High Energy Physics (KEK), Institute of Nuclear Study, University of Tokyo (INS), and Meson Science Laboratory, Faculty of Science, University of Tokyo began to work newly as High Energy Accelerator Research Organization after reconstructing and converting their systems, under aiming at further development of a wide field of accelerator science using a high energy accelerator. In this Research Organization, Applied Research Laboratory is composed of four Centers to execute assistance of research actions common to one of the Research Organization and their relating research and development (R and D) by integrating the present four centers and their relating sections in Tanashi. What is expected for the assistance of research actions is not only its general assistance but also its preparation and R and D of a system required for promotion and future plan of the research. Computer technology is essential to development of the research and can communize for various researches in the Research Organization. On response to such expectation, new Computing Research Center is required for promoting its duty by coworking and cooperating with every researchers at a range from R and D on data analysis of various experiments to computation physics acting under driving powerful computer capacity such as supercomputer and so forth. Here were described on report of works and present state of Data Processing Center of KEK at the first chapter and of the computer room of INS at the second chapter and on future problems for the Computing Research Center. (G.K.)

[Health centers: history and future prospects.].

Science.gov (United States)

Colin, Marie-Pierre; Acker, Dominique

2009-03-29

Health houses and health centers are often hailed as specifically modern forms of medical practice in mobile healthcare provision. Yet the concept of health center emerged in the seventeenth century. The founding principles of these institutions were to promote access to good-quality universal healthcare and to practice a form of healthcare that treated patients in their globality (i.e. within their social and environmental context) based on public healthcare measures. Though they constitute a response to a specific healthcare project, healthcare centers face a number of specific difficulties that pose a challenge to their durability and development. Payment per consultation is ill-adapted to the remuneration of their services, and methods of remuneration that may be applicable to independent medical practitioners do not apply in the context of health centers, which may struggle to survive without the support of territorial collectivities (i.e. regional and local authorities) or associations. Health houses face similar difficulties in terms of their structural expenses. Expectations are high for trying out new methods of remuneration. The perspective and experience of healthcare centers will likely prove to be essential in this context. Their future needs to be envisaged alongside health houses and medical hubs. The growth of precarity and the increasing difficulties affecting access to healthcare provision need to be taken into account. The choice of the specific type of structure will depend on local realities, on the political will of regional authorities and on the specific projects of healthcare professionals. Yet whatever solution is envisaged, it will not be possible without public funding.

Experiences of CFD simulations at Foster Wheeler Energia Oy`s Karhula R and D center

Energy Technology Data Exchange (ETDEWEB)

Hyppaenen, T. [Foster Wheeler Energia Oy, Karhula (Finland). Karhula R and D Center

1996-12-31

Karhula R and D Center is specialized in the research of solid fuel combustion based on circulating fluidized bed technology. Since the 1970`s, numerical models have been utilized in process development to enhance fundamental understanding of the technology. Both own and commercial computer models have been used. Until now, a special problem in circulating fluidized beds has been the modeling of dense phase multiphase flow, especially for industrial solid-fuel boilers. This has prevented the Karhula R and D Center from using commercial codes, and as a consequence, own modeling approaches have been necessary. This presentation describes some main points of the modeling activities in circulating fluidized bed boilers. (author)

Experiences of CFD simulations at Foster Wheeler Energia Oy`s Karhula R and D center

Energy Technology Data Exchange (ETDEWEB)

Hyppaenen, T [Foster Wheeler Energia Oy, Karhula (Finland). Karhula R and D Center

1997-12-31

Karhula R and D Center is specialized in the research of solid fuel combustion based on circulating fluidized bed technology. Since the 1970`s, numerical models have been utilized in process development to enhance fundamental understanding of the technology. Both own and commercial computer models have been used. Until now, a special problem in circulating fluidized beds has been the modeling of dense phase multiphase flow, especially for industrial solid-fuel boilers. This has prevented the Karhula R and D Center from using commercial codes, and as a consequence, own modeling approaches have been necessary. This presentation describes some main points of the modeling activities in circulating fluidized bed boilers. (author)

Building a High Performance Computing Infrastructure for Novosibirsk Scientific Center

International Nuclear Information System (INIS)

Adakin, A; Chubarov, D; Nikultsev, V; Belov, S; Kaplin, V; Sukharev, A; Zaytsev, A; Kalyuzhny, V; Kuchin, N; Lomakin, S

2011-01-01

Novosibirsk Scientific Center (NSC), also known worldwide as Akademgorodok, is one of the largest Russian scientific centers hosting Novosibirsk State University (NSU) and more than 35 research organizations of the Siberian Branch of Russian Academy of Sciences including Budker Institute of Nuclear Physics (BINP), Institute of Computational Technologies (ICT), and Institute of Computational Mathematics and Mathematical Geophysics (ICM and MG). Since each institute has specific requirements on the architecture of the computing farms involved in its research field, currently we've got several computing facilities hosted by NSC institutes, each optimized for the particular set of tasks, of which the largest are the NSU Supercomputer Center, Siberian Supercomputer Center (ICM and MG), and a Grid Computing Facility of BINP. Recently a dedicated optical network with the initial bandwidth of 10 Gbps connecting these three facilities was built in order to make it possible to share the computing resources among the research communities of participating institutes, thus providing a common platform for building the computing infrastructure for various scientific projects. Unification of the computing infrastructure is achieved by extensive use of virtualization technologies based on XEN and KVM platforms. The solution implemented was tested thoroughly within the computing environment of KEDR detector experiment which is being carried out at BINP, and foreseen to be applied to the use cases of other HEP experiments in the upcoming future.

Changing structure to improve function: one academic health center's experience.

Science.gov (United States)

Alexander, B; Davis, L; Kohler, P O

1997-04-01

Academic health centers (AHCs) have been under siege for the past few years, with decreased federal and state funding for educational and research programs and increasing competition in the health care marketplace. In addition, many AHCs are burdened with the bureaucratic red tape of large educational institutions, which makes agility in responding to a demanding health care market difficult. The authors describe the response to these threats by Oregon Health Sciences University (OHSU), an approach that has been different from those of most similar institutions. OHSU chose to change its structure from being part of the state system of higher education to being an independent public corporation. The authors outline the political process of building widespread support for the legislation passed in 1995, the key features of the restructuring, the challenges faced before and after the transition to a public corporation, and lessons learned in this metamorphosis to a new form.

Race and association with disease manifestations and mortality in scleroderma: a 20-year experience at the Johns Hopkins Scleroderma Center and review of the literature.

Science.gov (United States)

Gelber, Allan C; Manno, Rebecca L; Shah, Ami A; Woods, Adrianne; Le, Elizabeth N; Boin, Francesco; Hummers, Laura K; Wigley, Fredrick M

2013-07-01

Experience suggests that African Americans may express autoimmune disease differently than other racial groups. In the context of systemic sclerosis (scleroderma), we sought to determine whether race was related to a more adverse expression of disease. Between January 1, 1990, and December 31, 2009, a total of 409 African American and 1808 white patients with scleroderma were evaluated at a single university medical center. While the distribution by sex was virtually identical in both groups, at 82% female, African American patients presented to the center at a younger mean age than white patients (47 vs. 53 yr; p scleroderma-specific autoantibody status, and for the socioeconomic measures of educational attainment and health insurance status, diminished these risk estimates (RR, 1.3; 95% CI, 1.0-1.6). The heightened risk of mortality persisted in strata defined by age at disease onset, diffuse cutaneous disease, anticentromere seropositivity, decade of care at the center, and among women. These findings support the notion that race is related to a distinct phenotypic profile in scleroderma, and a more unfavorable prognosis among African Americans, warranting heightened diagnostic evaluation and vigilant care of these patients. Further, we provide a chronologic review of the literature regarding race, organ system involvement, and mortality in scleroderma; we furnish synopses of relevant reports, and summarize findings.

Cyclotron Produced Radionuclides for Diagnosis and Therapy of Human Neoplasms

Energy Technology Data Exchange (ETDEWEB)

Steven Larson MD

2009-09-21

This project funded since 1986 serves as a core project for cancer research throughout MSKCC, producing key radiotracers as well as basic knowledge about thel physics of radiation decay and imaging, for nuclear medicine applications to cancer diagnosis and therapy. In recent years this research application has broadened to include experiments intended to lead to an improved understanding of cancer biology and into the discovery and testing of new cancer drugs. Advances in immune based radiotargeting form the basis for this project. Both antibody and cellular based immune targeting methods have been explored. The multi-step targeting methodologies (MST) developed by NeoRex (Seattle,Washington), have been adapted for use with positron emitting isotopes and PET allowing the quantification and optimization of targeted delivery. In addition, novel methods for radiolabeling immune T-cells with PET tracers have advanced our ability to track these cells of prolonged period of time.

Building for consumption: an institutional analysis of peripheral shopping center development in northwest Europe

NARCIS (Netherlands)

Evers, D.V.H.

2004-01-01

In West Europe, one of the most contested kinds of urban development is the out-of-town shopping center. Pointing to the US experience, these are viewed as threats to the vitality of traditional town centers, and are often actively discouraged by planning legislation. This notwithstanding,

Community health centers' impact on the political and economic environment: the Massachusetts example.

Science.gov (United States)

Hunt, James W

2005-01-01

Since their inception in 1965, community health centers have thrived against tough odds, including patchwork funding, an unpredictable public policy environment, and a volatile healthcare marketplace. Much of this long-term success has been attributed to the centers' ability to affect their economic and political environment. Massachusetts provides an excellent example of this outward orientation. It was here that the centers first took hold, grew rapidly as a result of grassroots activity, and came together as a group for advocacy and mutual assistance. This article examines the Massachusetts experience in light of the health centers' ability to survive and grow.

Load Management of Data Centers as Regulation Capacity in Denmark

DEFF Research Database (Denmark)

Clausen, Anders; Ghatikar, Girish; Jørgensen, Bo Nørregaard

2014-01-01

are of special interest as they account for 500 GWh of consumption in Denmark or nearly 2% of the total electricity consumption. This paper performs an analysis on load management capabilities of data centers in Denmark based on the experiences in the U.S. We characterize the load management capabilities...... for transmission system operators and distribution system operators and balance errors in forecasts made by balance responsible parties. By enabling the demand-side to adapt consumption to match power generation, we can address this in a cost-effective and environmental sound way. In this context, data centers...... of the data centers based on their types, technology, and their application as grid management resources. Further, we identify demand-side entry barriers towards market participation. Our findings suggest that groups of data centers can offer dynamic load flexibility as virtual power plants, and thereby...

TCT-82 Evaluation of Current Practices in Transcatheter Aortic Valve Replacement: The WRITTEN (WoRldwIde TAVR ExperieNce) Survey

DEFF Research Database (Denmark)

Nombela-Franco, Luis; Cerrato, Enrico; Nazif, Tamim

2016-01-01

the main areas of consensus and divergence between centers. Methods An online questionnaire was distributed in centers performing TAVR irrespective of the number of procedures and valve type. The questionnaire was divided in 3 main blocks: pre-procedural evaluation, procedural practices and post......-procedural management. Regional experts were recruited to distribute the survey in each country or region. Results The survey was completed by 250 TAVR centers (with a cumulative experience of nearly 70,000 procedures) from 38 different countries. Heart team meetings were regularly scheduled in most (>95%) centers...

Experiences of Power and Violence in Mexican Men Attending Mutual-Aid Residential Centers for Addiction Treatment.

Science.gov (United States)

Lozano-Verduzco, Ignacio; Marín-Navarrete, Rodrigo; Romero-Mendoza, Martha; Tena-Suck, Antonio

2016-05-01

Fundamental elements of hegemonic masculinity such as power and violence are analyzed through characteristics of 12-step programs and philosophy immersed in Mutual-Aid Residential Centers for Addiction Treatment (CRAMAAs). CRAMAAs are a culturally specific form of substance abuse treatment in Mexico that are characterized by control and violence. Fifteen interviews were carried out with men of varied sociodemographic characteristics, and who resided in at least two of these centers. Results identify that power is expressed through drug abuse and leads them to subsequent biopsychosocial degradation. Residency in CRAMAAs is motivated by women, but men do not seek the residency and are usually admitted unwillingly. Power through violence is carried out inside CRAMAAs where men are victims of abuse. From a 12-step philosophy, this violence is believed to lead them to a path of recovery but instead produces feelings of anger and frustration. The implications of these centers on Mexican public health are discussed. © The Author(s) 2015.

The Advanced Technology Environmental Education Center Summer Fellows Institute.

Science.gov (United States)

Depken, Diane E.; Zeman, Catherine L.; Lensch, Ellen Kabat; Brown, Edward J.

2002-01-01

Describes the background, activities, and outcomes of the Advanced Technology Environmental Education Center (ATEEC) and its Summer Fellows Institutes as a model for disciplinary and cross-disciplinary infusion of environmental science and technology content, curriculum, and methods into the classroom. Presents experiences, themes, and activities…

Harmonizing the MSSM with the Galactic Center excess

Science.gov (United States)

Butter, Anja; Murgia, Simona; Plehn, Tilman; Tait, Tim M. P.

2017-08-01

The minimal supersymmetric setup offers a comprehensive framework to interpret the Fermi-LAT Galactic Center excess. Taking into account experimental, theoretical, and astrophysical uncertainties we can identify valid parameter regions linked to different annihilation channels. They extend to dark matter masses above 250 GeV. There exists a very mild tension between the observed relic density and the annihilation rate in the center of our Galaxy for specific channels. The strongest additional constraints come from the new generation of direct detection experiments, ruling out much of the light and intermediate dark matter mass regime and giving preference to heavier dark matter annihilating into a pair of top quarks.

[Experiment studies of electron-positron interactions at the Stanford Linear Accelerator Center

International Nuclear Information System (INIS)

Hertzbach, S.S.; Kofler, R.R.

1993-01-01

The High Energy Physics group at the University of Massachusetts has continued its' program of experimental studies of electron-positron interactions at the Stanford Linear Accelerator Center (SLAC). The group activities have included: analysis of data taken between 1982 and 1990 with the TPC detector at the PEP facility, continuing data collection and data analysis using the SLC/SLD facility, planning for the newly approved B-factory at SLAC, and participation in design studies for future high energy linear colliders. This report will briefly summarize these activities

The three-dimensional structures of bacterial reaction centers.

Science.gov (United States)

Olson, T L; Williams, J C; Allen, J P

2014-05-01

This review presents a broad overview of the research that enabled the structure determination of the bacterial reaction centers from Blastochloris viridis and Rhodobacter sphaeroides, with a focus on the contributions from Duysens, Clayton, and Feher. Early experiments performed in the laboratory of Duysens and others demonstrated the utility of spectroscopic techniques and the presence of photosynthetic complexes in both oxygenic and anoxygenic photosynthesis. The laboratories of Clayton and Feher led efforts to isolate and characterize the bacterial reaction centers. The availability of well-characterized preparations of pure and stable reaction centers allowed the crystallization and subsequent determination of the structures using X-ray diffraction. The three-dimensional structures of reaction centers revealed an overall arrangement of two symmetrical branches of cofactors surrounded by transmembrane helices from the L and M subunits, which also are related by the same twofold symmetry axis. The structure has served as a framework to address several issues concerning bacterial photosynthesis, including the directionality of electron transfer, the properties of the reaction center-cytochrome c 2 complex, and the coupling of proton and electron transfer. Together, these research efforts laid the foundation for ongoing efforts to address an outstanding question in oxygenic photosynthesis, namely the molecular mechanism of water oxidation.

She's supporting them; who's supporting her? Preschool center-level social-emotional supports and teacher well-being.

Science.gov (United States)

Zinsser, Katherine M; Christensen, Claire G; Torres, Luz

2016-12-01

Preschool teachers across the country have been charged to prepare children socially and emotionally for kindergarten. Teachers working in preschool centers are supporting children's social and emotional learning (SEL) within a rich ecology of emotion and social relationships and the present study considers how the supports implemented for children's SEL at the center-level are associated with teachers' psychological health and workplace experiences. Hierarchical linear models were constructed using data from the Head Start Family and Child Experiences Survey 2009 cohort. Results indicate that although teachers work in individual classrooms, they share common perceptions at the center-level of their workplace climate, access to support, and, although to a lesser extent, experience commonalities in psychological health and job satisfaction. Furthermore, in centers that had implemented more supports for children's SEL (including access to mental health consultants, classroom curriculum, and training and resources for teachers) teachers were less depressed, more satisfied with their jobs, felt more supported in managing challenging behavior, and viewed the workplace climate of their center as more positive. Findings are discussed in light of the national efforts to increase and retain a high-quality early childhood workforce. Copyright © 2016 Society for the Study of School Psychology. Published by Elsevier Ltd. All rights reserved.

Collected world and single center experience with endovascular treatment of ruptured abdominal aortic aneurysms.

NARCIS (Netherlands)

Veith, F.J.; Lachat, M.; Mayer, D.; Malina, M.; Holst, J.; Mehta, M.; Verhoeven, E.L.; Larzon, T.; Gennai, S.; Coppi, G.; Lipsitz, E.C.; Gargiulo, N.J.; Vliet, J.A. van der; Blankensteijn, J.D.; Buth, J.; Lee, W.A.; Biasiol, G.; Deleo, G.; Kasirajan, K.; Moore, R.; Soong, C.V.; Cayne, N.S.; Farber, M.A.; Raithel, D.; Greenberg, R.K.; Sambeek, M.R. van; Brunkwall, J.S.; Rockman, C.B.; Hinchliffe, R.J.

2009-01-01

BACKGROUND: Case and single center reports have documented the feasibility and suggested the effectiveness of endovascular aneurysm repair (EVAR) of ruptured abdominal aortic aneurysms (RAAAs), but the role and value of such treatment remain controversial. OBJECTIVE: To clarify these we examined a

Collected World and Single Center Experience With Endovascular Treatment of Ruptured Abdominal Aortic Aneurysms

NARCIS (Netherlands)

Veith, Frank J.; Lachat, Mario; Mayer, Dieter; Malina, Martin; Holst, Jan; Mehta, Manish; Verhoeven, Eric L. G.; Larzon, Thomas; Gennai, Stefano; Coppi, Gioacchino; Lipsitz, Evan C.; Gargiulo, Nicholas J.; van der Vliet, J. Adam; Blankensteijn, Jan; Buth, Jacob; Lee, W. Anthony; Biasi, Giorgio; Deleo, Gaetano; Kasirajan, Karthikeshwar; Moore, Randy; Soong, Chee V.; Cayne, Neal S.; Farber, Mark A.; Raithel, Dieter; Greenberg, Roy K.; van Sambeek, Marc R. H. M.; Brunkwall, Jan S.; Rockman, Caron B.; Hinchliffe, Robert J.

2009-01-01

Background: Case and single center reports have documented the feasibility and suggested the effectiveness of endovascular aneurysm repair (EVAR) of ruptured abdominal aortic aneurysms (RAAAs), but the role and value of such treatment remain controversial. Objective: To clarify these we examined a

Ongoing experiments: diagnostics requirements

International Nuclear Information System (INIS)

Dickerman, C.E.

1976-01-01

The paper reviews the fuel motion diagnostics needs for ongoing LMFBR safety experiments over approximately the next five years, with the discussion centered on TREAT. Brief comments on the direction in which clad motion diagnostics requirements are expected to develop are also presented

Determination of aberration center of Ronchigram for automated aberration correctors in scanning transmission electron microscopy

Energy Technology Data Exchange (ETDEWEB)

Sannomiya, Takumi, E-mail: sannomiya@mtl.titech.ac.jp [Tokyo Institute of Technology, Ookayama, Tokyo (Japan); Sawada, Hidetaka; Nakamichi, Tomohiro; Hosokawa, Fumio [JEOL Limited, Akishima, Tokyo (Japan); Nakamura, Yoshio; Tanishiro, Yasumasa; Takayanagi, Kunio [Tokyo Institute of Technology, Ookayama, Tokyo (Japan)

2013-12-15

A generic method to determine the aberration center is established, which can be utilized for aberration calculation and axis alignment for aberration corrected electron microscopes. In this method, decentering induced secondary aberrations from inherent primary aberrations are minimized to find the appropriate axis center. The fitness function to find the optimal decentering vector for the axis was defined as a sum of decentering induced secondary aberrations with properly distributed weight values according to the aberration order. Since the appropriate decentering vector is determined from the aberration values calculated at an arbitrary center axis, only one aberration measurement is in principle required to find the center, resulting in /very fast center search. This approach was tested for the Ronchigram based aberration calculation method for aberration corrected scanning transmission electron microscopy. Both in simulation and in experiments, the center search was confirmed to work well although the convergence to find the best axis becomes slower with larger primary aberrations. Such aberration center determination is expected to fully automatize the aberration correction procedures, which used to require pre-alignment of experienced users. This approach is also applicable to automated aperture positioning. - Highlights: • A generic method to determine the aberration center is established for (S)TEM. • Decentering induced secondary aberrations are utilized to find the center. • The method is tested on Ronchigrams both in simulation and experiment. • Proper weighting of the aberration gives a good convergence. • Larger primary aberration results in a slower convergence.

A conceptual framework for patient-centered fertility treatment.

Science.gov (United States)

Duthie, Elizabeth A; Cooper, Alexandra; Davis, Joseph B; Schoyer, Katherine D; Sandlow, Jay; Strawn, Estil Y; Flynn, Kathryn E

2017-09-07

Patient-centered care is a pillar of quality health care and is important to patients experiencing infertility. In this study we used empirical, in-depth data on couples' experiences of infertility treatment decision making to inform and revise a conceptual framework for patient-centered fertility treatment that was developed based on health care professionals' conceptualizations of fertility treatment, covering effectiveness, burden, safety, and costs. In this prospective, longitudinal mixed methods study, we collected data from both members (separately) of 37 couples who scheduled an initial consult with a reproductive specialist. Data collection occurred 1 week before the initial consultation, 1 week after the initial consultation, and then roughly 2, 4, 8, and 12 months later. Data collection included semi-structured qualitative interviews, self-reported questionnaires, and medical record review. Interviews were recorded, transcribed, and content analyzed in NVivo. A single coder analyzed all transcripts, with > 25% of transcripts coded by a second coder to ensure quality control and consistency. Content analysis of the interview transcripts revealed 6 treatment dimensions: effectiveness, physical and emotional burden, time, cost, potential risks, and genetic parentage. Thus, the revised framework for patient-centered fertility treatment retains much from the original framework, with modification to one dimension (from safety to potential risks) and the addition of two dimensions (time and genetic parentage). For patients and their partners making fertility treatment decisions, tradeoffs are explicitly considered across dimensions as opposed to each dimension being considered on its own. Patient-centered fertility treatment should account for the dimensions of treatment that patients and their partners weigh when making decisions about how to add a child to their family. Based on the lived experiences of couples seeking specialist medical care for

42 CFR 482.82 - Condition of participation: Data submission, clinical experience, and outcome requirements for re...

Science.gov (United States)

2010-10-01

..., clinical experience, and outcome requirements for re-approval of transplant centers. 482.82 Section 482.82... Hospitals Transplant Center Data Submission, Clinical Experience, and Outcome Requirements § 482.82 Condition of participation: Data submission, clinical experience, and outcome requirements for re-approval...

The Alabama Space and Rocket Center: The Second Decade.

Science.gov (United States)

Buckbee, Edward O.

1983-01-01

The Alabama Space and Rocket Center in Huntsville, the world's largest rocket and space museum, includes displays illustrating American rocket history, exhibits and demonstrations on rocketry principles and experiences, and simulations of space travel. A new project includes an integrated recreational-educational complex, described in the three…

Experience in procurement and processing of heart valves at the Northwest Tissue Center

International Nuclear Information System (INIS)

Strong, M.; O'Neal, P.D.; Gage, H.N.; Moogk, M.

1999-01-01

The Northwest Tissue Center established a human heart valve program in 199 1. It is one of four non-profit tissue banks and one for-profit program that recover and process heart valves in the United States. During the eight years in which the Northwest Tissue Center has been involved in heart valve banking, there have been a total of 673 hearts procured for processing. The age of the donors ranged from <1 to 44 years with a mean of 26.2 years, 66% werw male,and 6.5% of the hearts procered were discarded due to a variety of medical and criteria reason. The primary reasons for differal were questions of possible cancer and questions of high risk behavior/social history. Of the 1,264 cardiovascular tissues processed, 6% were lost because of donor history, 17% were lost because of microbiology results, and 5% were lost because of donor serology . There were total a total of 190 aortic valves and 48 pulmonic conduits transplanted over this time period. The mean age of the recipients was 23.4 with a median or 23 years; 102 of the recipients were less than one year of age. Males comprised 62% of the recipients. Since 1993, there has been a clear shift towards more use of pulmonic valves over aortic valves as a results of the acceptance of the Ross procedure. Early in the program, reports were received from surgeons that some heart valves appeared to have cracks in the conduits. Experimentations in the laboratory led to the discovery that thawing too rapidly would result in cracking of these materials. Packaging was designed to reduce the rate of thawing and this has resolved the problem with cracking. The heart valve program at the Northwest Tissue Center has been very successful in providing the necessary valves for patients in the Northwest Region of the United States

The Centre de l'Aube repository. The Public Information Center

International Nuclear Information System (INIS)

Fernique, J.C.

1993-01-01

The Centre de l'Aube repository, second French final disposal site for low activity short lived wastes, started operating in january 1992. Since the beginning of the Project public reception and information were among ANDRA's main concern. Open to public one year before disposal operations, the Public Information Center received many visitors coming as well from the regional as from national and international origin. The two years experience will be presented as well as the modifications of the information center taking into account ANDRA's evolution. (author)

Training center of Rovenskaya NPP. The experience of creation

International Nuclear Information System (INIS)

Fedorov, O.M.; Aristov, B.N.

1991-01-01

Experience in creation of a teaching-training centre at the Rovno NPP, which uses means available at unified NPPs, at most is discussed. The centre hardware complex functions include the event filing and providing for user-friendly interface with NPP technical personnel under training. The system of personnel training at the Rovno NPP teaching-training centre gives an opportunity to analyze accidents and emergency conditions more completely and carefully. The taching analysis of failures and accidents by a NPP operators using the complex of the teaching-training centre hardware sufficiently improves knowledge of particular accidents

Measuring the User Experience

Directory of Open Access Journals (Sweden)

Harry B. Santoso

2016-01-01

Full Text Available The aim of the current study is to develop an adapted version of User Experience Questionnaire (UEQ and evaluate a learning management system. Although there is a growing interest on User Experience, there are still limited resources (i.e. measurement tools or questionnaires available to measure user experience of any products, especially learning management systems. Two hundreds and thirteen computer science students participated and completed the adapted version of UEQ. In the study, the researchers used a learning management system named Student Centered e-Learning Environment (SCELE. Several types of learning materials are posted in SCELE such as audio files, simulations, PowerPoint slides, multimedia contents, and webpage links. Most of the lecturers use discussion forums in their courses to encourage students to participate in active learning setting. Staff and lecturers sometimes post academic-related announcements on the SCELE homepage. Two hundred thirteen students enrolled in Computer Science program were invited to evaluate the SCELE. This study will benefit UX practitioners, HCI educators, program and center of learning resources administrators, and learning management system developers. Findings of the present study may also be valuable for universities and high schools which are using computer-based learning environments.

Work Centered Support System Design: Using Frames to Reduce Work Complexity

National Research Council Canada - National Science Library

Eggleston, Robert G; Whitaker, Randall D

2002-01-01

.... Based on our experience implementing the design of three WCSSs we have distilled a set of three form-based design principles that help insure a work-centered perspective is expressed in the interface...

Person-Centered Expressive Arts: An Alternative Path to Counseling and Education. An interview with Natalie Rogers

OpenAIRE

Laura Guadiana Martínez

2003-01-01

In this interview, Natalie Rogers PhD, expounds on how art and expression serve personal and group growth in Person Centered Expressive Arts Therapy. Adding to the legacy of her father Carl Rogers, creator of the Person Centered Approach, she describes the interweaving of her experiences as a therapist and woman, and how she afforded extra room in the process for intuition, creativity, emotions and the fascinating exploration of the human experience. Using modeling, sculpting, dance, p...

Solitary fibrous tumor: A center's experience and an overview of the symptomatology, the diagnostic and therapeutic procedures of this rare tumor

Directory of Open Access Journals (Sweden)

Wolfgang Hohenforst-Schmidt

2017-01-01

Full Text Available Solitary Fibrous Tumor of the Pleura (SFTP is a rare tumor of the pleura. Worldwide about 800 patients diagnosed with this oncological entity have been described in the existing literature. We report our center's 13 year experience. During this time three patients suffering from this rare disease have been treated in our department. All patients were asymptomatic and their diagnosis was initially triggered by a random finding in a routine chest x-ray. The diagnosis was set preoperatively through a needle biopsy under computer tomography (CT guidance. The tumors were resected surgically though video-assisted thoracoscopic surgery (VATS or thoracotomy. Because of the lack of specific guidelines due to the rarity of the disease a long-term, systematic follow-up was recommended and performed. Parallel an overview of the diagnostic and therapeutic procedures of the rare tumor is made.

Diagnosis, Treatment and Long-Term Follow Up of Patients with ADA Deficiency: a Single-Center Experience.

Science.gov (United States)

Baffelli, Renata; Notarangelo, Lucia D; Imberti, Luisa; Hershfield, Michael S; Serana, Federico; Santisteban, Ines; Bolda, Federica; Porta, Fulvio; Lanfranchi, Arnalda

2015-10-01

We carried out a retrospective analysis of 27 patients with Adenosine Deaminase (ADA) deficiency diagnosed in a single center from 1997 to the 2013, for evaluating whether data regarding types of disease-inducing mutations, biochemical and immunological features as well as clinical outcomes of patients treated with enzyme replacement or transplantation, were comparable to those obtained in multicenter studies. The ADA deficiency diagnosis was performed with biochemical, immunological and molecular techniques. Ten patients treated with hematopoietic stem cell transplantation and three in treatment with enzyme replacement were followed up in our center. Twenty-four different mutations were identified and five were not previously reported. Identical mutations were found among patients from the same Romani ethnic group or from the same geographical region. A more rapid recovery was observed in enzyme replacement treated patients in comparison with those transplanted that, however, showed a continuous and long-lasting improvement both in terms of immune and metabolic recovery. The data obtained in our single center are comparable with those that have been reported in multicenter surveys.

Off-center Jahn-Teller ion: coupled polar and tetragonal deformations

International Nuclear Information System (INIS)

Vikhnin, V.S.; Sochava, L.S.

1979-01-01

Models of the off-center Jahn-Teller ions are considered, i.e. Ni + in SrO and Cu 27 in SrO studied earlier. Models of the off-center Jahn-Teller ion are proposed, in which mutual effect of dipole-active deformations conditioning off-centering and the Jahn-Teller tetragonal deformations takes place. Manifestations of a new type of multipit potential XY 24 of an off-center ion are considered. The Jahn-Teller effect (JTE) is studied for a duplicate in cubic environment, unharmonism of the fourth order being taken into account. In such a model of Exe of JTE, the position and quantity of minima of adiabatic potential are changed as compared with Exe of JTE taking account of unharmonism of the third order or the square Jahn-Teller interaction. While using models of the off-center Jahn-Teller ion which take account of the effect of two tetragonal Jahn-Teller deformations occurring in the Exe problem considering unharmonism of the fourth order produced on dipole-active deformations, it becomes possible to explain the experiment for SrO:Ni +

Empowering patients of a mental rehabilitation center in a low-resource context: a Moroccan experience as a case study

Directory of Open Access Journals (Sweden)

Khabbache H

2017-04-01

Full Text Available Hicham Khabbache,1 Abdelhak Jebbar,2,* Nadia Rania,3,* Marie-Chantal Doucet,4 Ali Assad Watfa,5 Joël Candau,6 Mariano Martini,7 Anna Siri,8,* Francesco Brigo,9,10,* Nicola Luigi Bragazzi1,2,4–8,11,* 1Faculty of Literature and Humanistic Studies, Sais, Sidi Mohamed Ben Abdellah University, Fez, 2Faculty of Art and Humanities, Sultan Moulay Slimane University, Beni-Mellal, Morocco; 3School of Social Sciences, Department of Education Sciences, University of Genoa, Genova, Italy; 4Faculty of Human Sciences, School of Social Work, University of Québec-Montréal, Montreal, QC, Canada; 5Faculty of Education, Kuwait University, Kuwait City, Kuwait; 6Laboratory of Anthropology and Cognitive and Social Psychology, University of Nice Sophia Antipolis, Nice, France; 7Department of Health Sciences (DISSAL, Section of Bioethics, University of Genoa, 8UNESCO Chair “Health Anthropology, Biosphere and Healing Systems”, Genova, 9Department of Neurology, Franz Tappeiner Hospital, Merano, 10Department of Neurological, Biomedical, and Movement Sciences, University of Verona, Verona, 11School of Public Health, Department of Health Sciences (DISSAL, University of Genoa, Genova, Italy *These authors contributed equally to this work Abstract: Mental, neurological and substance use (MNS disorders represent a major source of disability and premature mortality worldwide. However, in developing countries patients with MNS disorders are often poorly managed and treated, particularly in marginalized, impoverished areas where the mental health gap and the treatment gap can reach 90%. Efforts should be made in promoting help by making mental health care more accessible. In this article, we address the challenges that psychological and psychiatric services have to face in a low-resource context, taking our experience at a Moroccan rehabilitation center as a case study. A sample of 60 patients were interviewed using a semi-structured questionnaire during the period of

Financing Public Higher Education: The Impact of Responsibility Center Management on a Public Research University

Science.gov (United States)

Pappone, David J.

2016-01-01

To explore the impacts on public universities of implementing an incentive-based budgeting system, this dissertation focuses on one university's extensive experience with Responsibility Center Management. The financial and non-financial impacts of Responsibility Center Management will be considered by examining the extent to which commonly held…

The US-CMS Tier-1 Center Network Evolving toward 100Gbps

International Nuclear Information System (INIS)

Bobyshev, A; DeMar, P

2011-01-01

Fermilab hosts the US Tier-1 Center for the LHC's Compact Muon Collider (CMS) experiment. The Tier-1s are the central points for the processing and movement of LHC data. They sink raw data from the Tier-0 at CERN, process and store it locally, and then distribute the processed data to Tier-2s for simulation studies and analysis. The Fermilab Tier-1 Center is the largest of the CMS Tier-1s, accounting for roughly 35% of the experiment's Tier-1 computing and storage capacity. Providing capacious, resilient network services, both in terms of local network infrastructure and off-site data movement capabilities, presents significant challenges. This article will describe the current architecture, status, and near term plans for network support of the US-CMS Tier-1 facility.

Patient-centered Fertility Care: From Theory to Practice

Directory of Open Access Journals (Sweden)

Fatemeh Jafarzadeh-Kenarsari

2016-07-01

Full Text Available Background & aim: Healthcare areas, especially fertility care (commonly accompanied with high emotions, as well as long-term and recurring treatment periods could exclusively benefit from patient-centered care (PCC. Despite evident advantages of PCC, this approach has not been practiced as a routine procedure in current clinical environments yet, even in western developed countries. Therefore, this review aimed to evaluate the significance and different aspects of PCC, while emphasizing on patient-centered fertility care, its challenges, and applicable recommendations in this regard. Methods: This narrative review was conducted on 29 relevant medical and clinical papers (published during 1990-2015 collected using various national and international databases (e.g., SID, Magiran, Medlib, Google scholar, Proquest, Pubmed, Wiley, Science direct, and Scopus. Key words and phrases used in this review were “infertility”, “fertility care”, “childlessness”, “patient-centered care”, “patient-centered fertility care” “shared decision-making”, “infertile patient preferences”, and “patient involvement in fertility care”. Results: According to the literature, implementation challenges of patient-centered fertility care were reported as different individual and organizational factors. These factors include lack of professional motivation to change, underestimating the significance of patient-centeredness by healthcare professionals, difficulty in translation of feedback into concrete measures, lack of time and financial resources, insufficient experience of healthcare professionals with regard to identification of needs and preferences of patients, traditional organizational culture, and common misconceptions. Conclusion: Promotion of patient-centered fertility services requires the identification of infertile needs and priorities of individuals, designation of interventional and supportive programs based on sociocultural

HIV-associated hematologic malignancies: Experience from a Tertiary Cancer Center in India.

Science.gov (United States)

Reddy, Rakesh; Gogia, Ajay; Kumar, Lalit; Sharma, Atul; Bakhshi, Sameer; Sharma, Mehar C; Mallick, Saumyaranjan; Sahoo, Ranjit

2016-01-01

Data on HIV associated hematologic malignancies is sparse from India. This study attempts to analyze the spectrum and features of this disease at a tertiary cancer center in India. Retrospective study from case records of patients registered with a diagnosis of hematologic malignancy and HIV infection between January 2010 and June 2015. Thirteen cases of HIV associated hematologic malignancies were identified, six of them pediatric. HIV diagnosis was concurrent to diagnosis of cancer in 12 and preceded it in one of them. ECOG PS at presentation was >1 in all of them. All patients, except one, had B symptoms. Six of the patients had bulky disease and six are stage 4. Predominant extranodal disease was seen in 67% of them. NHL accounted for 10 of 13 patients and DLBCL-Germinal center was the most common subtype. Mean CD4+ cell count was 235/μL (range, 32-494). HAART could be given along with chemotherapy to 11 patients. Two-thirds of patients received standard doses of therapy. Chemo-toxicity required hospitalization in 58%. CR was achieved in 45% and 36% had progressive disease with first-line therapy. At the time of last follow up, 3 patients were alive with responsive disease, 2 in CR and 1 in PR. None of the pediatric patients were long time responders. These malignancies were of advanced stage and higher grade. Goal of therapy, in the HAART era, is curative. Pediatric patients had dismal outcome despite good chemotherapy and HAART. There is an urgent need to improve data collection for HIV related cancers in India.

Non-albicans Candida Vulvovaginitis: Treatment Experience at a Tertiary Care Vaginitis Center.

Science.gov (United States)

Powell, Anna M; Gracely, Edward; Nyirjesy, Paul

2016-01-01

The aims of this study are to analyze a cohort of women with vulvovaginal symptoms and positive cultures for non-albicans Candida (NAC) to determine whether yeast was responsible for their symptoms and to evaluate the mycological effectiveness of various regimens. This observational study was performed from retrospective chart review of patients with positive NAC cultures between April 1, 2008, and January 31, 2011, at a tertiary care vaginitis center. Patient intake demographics were entered into a database. Follow-up visits were analyzed for data about patient treatments and outcomes. Patients were considered a clinical cure if their symptoms were significantly improved and mycologic cure (MC) if later yeast cultures were negative. If clinical symptoms improved at the same time as MC, the isolate was considered the proximate cause for the symptoms. One hundred eight patients meeting entry criteria were analyzed. Boric acid was effective at obtaining MC in 32 (78%) of 41 patients with C. glabrata, 3 of 3 patients with C. tropicalis, and 3 of 3 patients with C. lusitaniae. Fluconazole was effective as initial treatment for 3 (60%) of 5 patients with C. glabrata and 13 (81%) of 16 patients with C. parapsilosis. In 52.7% of C. glabrata, 66.7% of C. parapsilosis, and 57.1% of C. tropicalis cases, effective antifungal therapy led to symptom improvement. In a tertiary care vaginitis center, NAC, when isolated on culture, caused clinically significant infections in approximately half of symptomatic patients. A majority of infections can be effectively treated with boric acid or fluconazole regardless of the non-albicans Candida species.

Shuttle Laser Technology Experiment Facility (LTEF)-to-airplane lasercom experiment: Airplane considerations

Science.gov (United States)

Kalil, Ford

1990-01-01

NASA is considering the use of various airplanes for a Shuttle Laser Technology Experiment Facility (LTEF)-to-Airplane laser communications experiment. As supporting documentation, pertinent technical details are included about the potential use of airplanes located at Ames Research Center and Wallops Flight Facility. The effects and application of orbital mechanics considerations are also presented, including slant range, azimuth, elevation, and time. The pros and cons of an airplane equipped with a side port with a bubble window versus a top port with a dome are discussed.

Barriers to implementing the World Health Organization's Trauma Care Checklist: A Canadian single-center experience.

Science.gov (United States)

Nolan, Brodie; Zakirova, Rimma; Bridge, Jennifer; Nathens, Avery B

2014-11-01

Management of trauma patients is difficult because of their complexity and acuity. In an effort to improve patient care and reduce morbidity and mortality, the World Health Organization developed a trauma care checklist. Local stakeholder input led to a modified 16-item version that was subsequently piloted. Our study highlights the barriers and challenges associated with implementing this checklist at our hospital. The checklist was piloted over a 6-month period at St. Michael's Hospital, a Level 1 trauma center in Toronto, Canada. At the end of the pilot phase, individual, semistructured interviews were held with trauma team leaders and nursing staff regarding their experiences with the checklist. Axial coding was used to create a typology of attitudes and barriers toward the checklist, and then, vertical coding was used to further explore each identified barrier. Checklist compliance was assessed for the first 7 months. Checklist compliance throughout the pilot phase was 78%. Eight key barriers to implementing the checklist were identified as follows: perceived lack of time for the use of the checklist in critically ill patients, unclear roles, no memory trigger, no one to enforce completion, not understanding its importance or purpose, difficulty finding physicians at the end of resuscitation, staff/trainee changes, and professional hierarchy. The World Health Organization Trauma Care Checklist was a well-received tool; however, consideration of barriers to the implementation and staff adoption must be done for successful integration, with special attention to its use in critically ill patients. Therapeutic/care management, level V.

The brave new world of GEC evaluation: the experience of the Rhode Island Geriatric Education Center.

Science.gov (United States)

Filinson, Rachel; Clark, Phillip G; Evans, Joann; Padula, Cynthia; Willey, Cynthia

2012-01-01

In 2007, the Health Resources Services Administration introduced new mandates that raised the standards on program evaluation for Geriatric Education Centers. Described in this article are the primary and secondary evaluation efforts undertaken for one program within the Rhode Island Geriatric Education Center (RIGEC), the findings from these efforts, and the modifications to assessment that ensued in response to the increased accountability requirements. The evaluation focused on RIGEC's series of continuing education, day-long workshops for health and social service professionals, the completion of all seven of which leads to a Certificate in Interdisciplinary Practice in Geriatrics.

User-Centered Design of Serious Games for Older Adults Following 3 Years of Experience With Exergames for Seniors: A Study Design.

Science.gov (United States)

Brox, Ellen; Konstantinidis, Stathis Th; Evertsen, Gunn

2017-01-11

Seniors need sufficient balance and strength to manage in daily life, and sufficient physical activity is required to achieve and maintain these abilities. This can be a challenge, but fun and motivational exergames can be of help. However, most commercial games are not suited for this age group for several reasons. Many usability studies and user-centered design (UCD) protocols have been developed and applied, but to the best of our knowledge none of them are focusing on seniors' use of games for physical activity. In GameUp, a European cofunded project, some prototype Kinect exergames to enhance the mobility of seniors were developed in a user-centered approach. In this paper we aim to record lessons learned in 3 years of experience with exergames for seniors, considering both the needs of older adults regarding user-centered development of exergames and participation in UCD. We also provide a UCD protocol for exergames tailored to senior needs. An initial UCD protocol was formed based on literature of previous research outcomes. Senior users participated in UCD following the initial protocol. The users formed a steady group that met every second week for 3 years to play exergames and participate in the UCD during the 4 phases of the protocol. Several methods were applied in the 4 different phases of the UCD protocol; the most important methods were structured and semistructured interviews, observations, and group discussions. A total of 16 seniors with an average age above 80 years participated for 3 years in UCD in order to develop the GameUp exergames. As a result of the lessons learned by applying the different methodologies of the UCD protocol, we propose an adjusted UCD protocol providing explanations on how it should be applied for seniors as users. Questionnaires should be turned into semistructured and structured interviews while user consultation sessions should be repeated with the same theme to ensure that the UCD methods produce a valid outcome. By

Phase I/II clinical trial of dendritic-cell based immunotherapy (DCVAC/PCa) combined with chemotherapy in patients with metastatic, castration-resistant prostate cancer.

Science.gov (United States)

Podrazil, Michal; Horvath, Rudolf; Becht, Etienne; Rozkova, Daniela; Bilkova, Pavla; Sochorova, Klara; Hromadkova, Hana; Kayserova, Jana; Vavrova, Katerina; Lastovicka, Jan; Vrabcova, Petra; Kubackova, Katerina; Gasova, Zdenka; Jarolim, Ladislav; Babjuk, Marek; Spisek, Radek; Bartunkova, Jirina; Fucikova, Jitka

2015-07-20

We conducted an open-label, single-arm Phase I/II clinical trial in metastatic CRPC (mCRPC) patients eligible for docetaxel combined with treatment with autologous mature dendritic cells (DCs) pulsed with killed LNCaP prostate cancer cells (DCVAC/PCa). The primary and secondary endpoints were safety and immune responses, respectively. Overall survival (OS), followed as a part of the safety evaluation, was compared to the predicted OS according to the Halabi and MSKCC nomograms. Twenty-five patients with progressive mCRPC were enrolled. Treatment comprised of initial 7 days administration of metronomic cyclophosphamide 50 mg p.o. DCVAC/PCa treatment consisted of a median twelve doses of 1 × 107 dendritic cells per dose injected s.c. (Aldara creme was applied at the site of injection) during a one-year period. The initial 2 doses of DCVAC/PCa were administered at a 2-week interval, followed by the administration of docetaxel (75 mg/m2) and prednisone (5 mg twice daily) given every 3 weeks until toxicity or intolerance was observed. The DCVAC/PCa was then injected every 6 weeks up to the maximum number of doses manufactured from one leukapheresis. No serious DCVAC/PCa-related adverse events have been reported. The median OS was 19 months, whereas the predicted median OS was 11.8 months with the Halabi nomogram and 13 months with the MSKCC nomogram. Kaplan-Meier analyses showed that patients had a lower risk of death compared with both MSKCC (Hazard Ratio 0.26, 95% CI: 0.13-0.51) and Halabi (Hazard Ratio 0.33, 95% CI: 0.17-0.63) predictions. We observed a significant decrease in Tregs in the peripheral blood. The long-term administration of DCVAC/PCa led to the induction and maintenance of PSA specific T cells. We did not identify any immunological parameter that significantly correlated with better OS. In patients with mCRPC, the combined chemoimmunotherapy with DCVAC/PCa and docetaxel was safe and resulted in longer than expected survival. Concomitant chemotherapy

Measurements of the center-of-mass energies at BESIII via the di-muon process

NARCIS (Netherlands)

Ablikim, M.; Achasov, M. N.; Ai, X. C.; Albayrak, O.; Albrecht, M.; Ambrose, D. J.; Amoroso, A.; An, F. F.; An, Q.; Bai, J. Z.; Ferroli, R. Baldini; Ban, Y.; Bennett, D. W.; Bennett, J. V.; Bertani, M.; Bettoni, D.; Bian, J. M.; Bianchi, F.; Boger, E.; Boyko, I.; Briere, R. A.; Cai, H.; Cai, X.; Cakir, O.; Calcaterra, A.; Cao, G. F.; Cetin, S. A.; Chang, J. F.; Chelkov, G.; Chen, G.; Chen, H. S.; Chen, H. Y.; Chen, J. C.; Chen, M. L.; Chen, S. J.; Chen, X.; Chen, X. R.; Chen, Y. B.; Cheng, H. P.; Chu, X. K.; Cibinetto, G.; Dai, H. L.; Dai, J. P.; Dbeyssi, A.; Dedovich, D.; Deng, Z. Y.; Denig, A.; Denysenko, I.; Destefanis, M.; De Mori, F.; Ding, Y.; Dong, C.; Dong, J.; Dong, L. Y.; Dong, M. Y.; Du, S. X.; Duan, P. F.; Fan, J. Z.; Fang, J.; Fang, S. S.; Fang, X.; Fang, Y.; Fava, L.; Feldbauer, F.; Felici, G.; Feng, C. Q.; Fioravanti, E.; Fritsch, M.; Fu, C. D.; Gao, Q.; Gao, X. L.; Gao, X. Y.; Gao, Y.; Gao, Z.; Garzia, I.; Goetzen, K.; Gong, W. X.; Gradl, W.; Greco, M.; Gu, M. H.; Gu, Y. T.; Guan, Y. H.; Guo, A. Q.; Guo, L. B.; Guo, Y.; Guo, Y. P.; Haddadi, Z.; Hafner, A.; Han, S.; Hao, X. Q.; Harris, F. A.; He, K. L.; Held, T.; Heng, Y. K.; Hou, Z. L.; Hu, C.; Hu, H. M.; Hu, J. F.; Hu, T.; Hu, Y.; Huang, G. M.; Huang, G. S.; Huang, J. S.; Huang, X. T.; Huang, Y.; Hussain, T.; Ji, Q.; Ji, Q. P.; Ji, X. B.; Ji, X. L.; Jiang, L. W.; Jiang, X. S.; Jiang, X. Y.; Jiao, J. B.; Jiao, Z.; Jin, D. P.; Jin, S.; Johansson, T.; Julin, A.; Kalantar-Nayestanaki, N.; Kang, X. L.; Kang, X. S.; Kavatsyuk, M.; Ke, B. C.; Kiese, P.; Kliemt, R.; Kloss, B.; Kolcu, O. B.; Kopf, B.; Kornicer, M.; Kuhn, W.; Kupsc, A.; Lange, J. S.; Lara, M.; Larin, P.; Leng, C.; Li, C.; Li, Cheng; Li, D. M.; Li, F.; Li, F. Y.; Li, G.; Li, H. B.; Li, J. C.; Li, Jin; Li, K.; Li, K.; Li, Lei; Li, P. R.; Li, T.; Li, W. D.; Li, W. G.; Li, X. L.; Li, X. M.; Li, X. N.; Li, X. Q.; Li, Z. B.; Liang, H.; Liang, Y. F.; Liang, Y. T.; Liao, G. R.; Lin (Lin), D. X.; Liu, B. J.; Liu, C. X.; Liu, D.; Liu, F. H.; Liu, Fang; Liu, Feng; Liu, H. B.; Liu, H. H.; Liu, H. H.; Liu, H. M.; Liu, J.; Liu, J. B.; Liu, J. P.; Liu, J. Y.; Liu, K.; Liu, K. Y.; Liu, L. D.; Liu, P. L.; Liu, Q.; Liu, S. B.; Liu, X.; Liu, Y. B.; Liu, Z. A.; Liu, Zhiqing; Loehner, H.; Lou, X. C.; Lu, H. J.; Lu, J. G.; Lu, Y.; Lu, Y. P.; Luo, C. L.; Luo, M. X.; Luo, T.; Luo, X. L.; Lyu, X. R.; Ma, F. C.; Ma, H. L.; Ma, L. L.; Ma, Q. M.; Ma, T.; Ma, X. N.; Ma, X. Y.; Maas, F. E.; Maggiora, M.; Mao, Y. J.; Mao, Z. P.; Marcello, S.; Messchendorp, J. G.; Min, J.; Mitchell, R. E.; Mo, X. H.; Mo, Y. J.; Morales, C. Morales; Moriya, K.; Muchnoi, N. Yu.; Muramatsu, H.; Nefedov, Y.; Nerling, F.; Nikolaev, I. B.; Ning, Z.; Nisar, S.; Niu, S. L.; Niu, X. Y.; Olsen, S. L.; Ouyang, Q.; Pacetti, S.; Pan, Y.; Patteri, P.; Pelizaeus, M.; Peng, H. P.; Peters, K.; Pettersson, J.; Ping, J. L.; Ping, R. G.; Poling, R.; Prasad, V.; Qi, M.; Qian, S.; Qiao, C. F.; Qin, L. Q.; Qin, N.; Qin, X. S.; Qin, Z. H.; Qiu, J. F.; Rashid, K. H.; Redmer, C. F.; Ripka, M.; Rong, G.; Rosner, Ch.; Ruan, X. D.; Santoro, V.; Sarantsev, A.; Savrie, M.; Schoenning, K.; Schumann, S.; Shan, W.; Shao, M.; Shen, C. P.; Shen, P. X.; Shen, X. Y.; Sheng, H. Y.; Song, W. M.; Song, X. Y.; Sosio, S.; Spataro, S.; Sun, G. X.; Sun, J. F.; Sun, S. S.; Sun, Y. J.; Sun, Y. Z.; Sun, Z. J.; Sun, Z. T.; Tang, C. J.; Tang, X.; Tapan, I.; Thorndike, E. H.; Tiemens, M.; Ullrich, M.; Uman, I.; Varner, G. S.; Wang, B.; Wang, D.; Wang, D. Y.; Wang, K.; Wang, L. L.; Wang, L. S.; Wang, M.; Wang, P.; Wang, P. L.; Wang, S. G.; Wang, W.; Wang, W. P.; Wang, X. F.; Wang, Y. D.; Wang, Y. F.; Wang, Y. Q.; Wang, Z.; Wang, Z. G.; Wang, Z. H.; Wang, Z. Y.; Weber, T.; Wei, D. H.; Wei, J. B.; Weidenkaff, P.; Wen, S. P.; Wiedner, U.; Wolke, M.; Wu, L. H.; Wu, Z.; Xia, L.; Xia, L. G.; Xia, Y.; Xiao, D.; Xiao, H.; Xiao, Z. J.; Xie, Y. G.; Xiu, Q. L.; Xu, G. F.; Xu, L.; Xu, Q. J.; Xu, X. P.; Yan, L.; Yan, W. B.; Yan, W. C.; Yan, Y. H.; Yang, H. J.; Yang, H. X.; Yang, L.; Yang, Y.; Yang, Y. X.; Ye, M.; Ye, M. H.; Yin, J. H.; Yu, B. X.; Yu, C. X.; Yu, J. S.; Yuan, C. Z.; Yuan, W. L.; Yuan, Y.; Yuncu, A.; Zafar, A. A.; Zallo, A.; Zeng, Y.; Zeng, Z.; Zhang, B. X.; Zhang, B. Y.; Zhang, C.; Zhang, C. C.; Zhang, D. H.; Zhang, H. H.; Zhang, H. Y.; Zhang, J. J.; Zhang, J. L.; Zhang, J. Q.; Zhang, J. W.; Zhang, J. Y.; Zhang, J. Z.; Zhang, K.; Zhang, L.; Zhang, X. Y.; Zhang, Y.; Zhang, Y. N.; Zhang, Y. H.; Zhang, Y. T.; Zhang, Yu; Zhang, Z. H.; Zhang, Z. P.; Zhang, Z. Y.; Zhao, G.; Zhao, J. W.; Zhao, J. Y.; Zhao, J. Z.; Zhao, Lei; Zhao, Ling; Zhao, M. G.; Zhao, Q.; Zhao, Q. W.; Zhao, S. J.; Zhao, T. C.; Zhao, Y. B.; Zhao, Z. G.; Zhemchugov, A.; Zheng, B.; Zheng, J. P.; Zheng, W. J.; Zheng, Y. H.; Zhong, B.; Zhou, L.; Zhou, X.; Zhou, X. K.; Zhou, X. R.; Zhou, X. Y.; Zhu, K.; Zhu, K. J.; Zhu, S.; Zhu, S. H.; Zhu, X. L.; Zhu, Y. C.; Zhu, Y. S.; Zhu, Z. A.; Zhuang, J.; Zotti, L.; Zou, B. S.; Zou, J. H.

From 2011 to 2014, the BESIII experiment collected about 5 fb(-1) data at center-of-mass energies around 4 GeV for the studies of the charmonium-like and higher excited charmonium states. By analyzing the di-muon process e(+)e(-)->gamma ISR/FSR mu(+)mu(-), the center-of-mass energies of the data

Massachusetts Institute of Technology, Plasma Fusion Center, Technical Research Programs

International Nuclear Information System (INIS)

1980-08-01

A review is given of the technical programs carried out by the Plasma Fusion Center. The major divisions of work areas are applied plasma research, confinement experiments, fusion technology and engineering, and fusion systems. Some objectives and results of each program are described

Surgical treatment of the giant hiatal hernia - A single-center experience

DEFF Research Database (Denmark)

Jensen, Jonas Sanberg

Introduction All symptomatic giant hiatal hernias, defined as any hiatal hernia where more than 30% of the stomach is placed intrathoracically, should be addressed with elective surgery, significantly reducing the risk of complications. Symptoms of incarceration require immediate emergency surgery...... and occur in less than 2% per year. The purpose of this study was to evaluate perioperative data, outcome and patient satisfaction in patients undergoing emergency or planned surgery for giant hiatal hernia in a Danish centre. Methods and Procedures This retrospective study was performed using patient...... records of all patients undergoing emergency (E) or planned (P) primary laparoscopic repair for giant hiatal hernia at a single center over a six-year period. Demographics and characteristics of hiatal hernia and surgery were registered. Admission length, complications and readmission within 30 days were...

Quality management and accreditation of research tissue banks: experience of the National Center for Tumor Diseases (NCT) Heidelberg.

Science.gov (United States)

Herpel, Esther; Röcken, Christoph; Manke, Heike; Schirmacher, Peter; Flechtenmacher, Christa

2010-12-01

Tissue banks are key resource and technology platforms in biomedical research that address the molecular pathogenesis of diseases as well as disease prevention, diagnosis, and treatment. Due to the central role of tissue banks in standardized collection, storage, and distribution of human tissues and their derivatives, quality management and its external assessment is becoming increasingly relevant for the maintenance, acceptance, and funding of tissue banks. Little experience exists regarding formalized external evaluation of tissue banks, especially regarding certification and accreditation. Based on the accreditation of the National Center of Tumor Diseases (NCT) tissue bank in Heidelberg (Germany), criteria, requirements, processes, and implications were compiled and evaluated. Accreditation formally approved professional competence and performance of the tissue bank in all steps involved in tissue collection, storage, handling as well as macroscopic and histologic examination and final (exit) examination of the tissue and transfer supervised by board-certified competent histopathologists. Thereby, accreditation provides a comprehensive measure to evaluate and document the quality standard of tissue research banks and may play a significant role in the future assessment of tissue banks. Furthermore, accreditation may support harmonization and standardization of tissue banking for biomedical research purposes.

Lived Experience of Caregivers of Family-Centered Care in the Neonatal Intensive Care Unit: “Evocation of Being at Home”

Science.gov (United States)

Hadian Shirazi, Zahra; Sharif, Farkhondeh; Rakhshan, Mahnaz; Pishva, Narjes; Jahanpour, Faezeh

2016-01-01

Background In recent decades, family-centered care (FCC) has come to be known, accepted, and reported as the best care strategy for admitted children and their families. However, in spite of the increasing application of this approach, the experiences of the caregivers have not yet been studied. Objectives The present study aimed at the description and interpretation of the FCC experience in two neonatal intensive care units (NICU) at Shiraz University of Medical Sciences. Methods This study was conducted through the hermeneutic phenomenological approach. Semi-structured interviews were conducted with 17 professional and familial caregivers, and their interactions were observed in three work shifts. The interviews were audiotaped and transcribed verbatim. After observations, field notes were also written. Finally, the data were analyzed through van Manen’s methodology. Results One of the essential themes that emerged in this study was the “evocation of being at home” among familial and even professional caregivers. This theme had three subthemes: i.e., “meta-family interaction,” “comprehensive support,” and “reconstruction of a normal family.” Accordingly, FCC eliminated borders between professional and non-professional caregivers and built close relationships among them in the NICU. It also provided for the needs of neonates, their families, and even professional caregivers through perceived and received support. Conclusions Parents of the neonates admitted to the NICU experience hard moments. They not only play the role of primary caregivers, but they also receive the care. Focusing on the different meanings of this care from the caregivers’ points of view and having managers provide certain requirements can guarantee the establishment of comprehensive care for clients and proper support for the staff in this unit. PMID:28203324

Challenge of Private Rehabilitation Centers and Welfare Organization (Behzisti

Directory of Open Access Journals (Sweden)

Roghiye Akbari

2011-10-01

Full Text Available Objectives: Studying the situation of providing services for people with disability are very important and in current situation which is dominate on system providing rehabilitation services in Iran, private rehabilitation centers can be the best and the most important focus for this study. Methods: This research performed by qualitative method and with phenomenology type, and purposeful sampling did as purposeful and based on similar samples. The samples of this study consisted of 14 managers of private rehabilitation centers who had especial experiences about the theme of research and providing rehabilitation services. The method of executing research was base on deep and open semi-structured interview that use from method focus group discussion which is a type of semi-structure interview for collecting data from samples. Results: Collected data were analyzed by written analyze method and used from suggested Van Manen suggestion method. Managers of private rehabilitation centers meet different problems and confront with different situations in their centers. General problem which appear as a frame of problems related to private politic, especial problems related to private rehabilitation centers activities, and intra/extra communication. Discussion: The delivery of services to private sector does not mean depriving the responsibility from Welfare Organization and its rehabilitation deputy. The organization should issue establishment license for private rehabilitation centers and administer it.

Laser spectroscopy of highly doped NV- centers in diamond

Science.gov (United States)

Subedi, Shova D.; Fedorov, Vladimir V.; Peppers, Jeremy; Martyshkin, Dmitry V.; Mirov, Sergey B.; Shao, Linbo; Loncar, Marko

2018-02-01

In this paper, prospects of using diamond with NV- centers as a gain medium have been studied. Spectroscopic characterization of NV- centers in diamond as well as absorption saturation and pump-probe experiments have been carried out. Absorption and emission cross-sections were estimated to be 2.8 × 10-17 cm2 and 4.3 × 10-17 cm2 at the maximum of absorption and emission bands, respectively. It was observed from emission spectra under pulse excitation that some NV- are photoionized to NV0 centers with ZPL at 575 nm. Room temperature luminescence lifetime of NV- centers was measured to be 12ns, which is close to the previously reported lifetime in bulk diamond ( 13ns). Saturated transmission was only about 11% of calculated values even at energy fluence much higher than the saturation flux. Two excited state absorptions (ESAs) with different relaxation times ("fast-decay" and "slow-decay with relaxation times of 500 ns and several tens of microseconds, respectively) were revealed in transmission decay kinetics at 632 nm. Kinetics of transmission at 670 nm was dominated by "slow-decay" ESA process. Kinetics of dk/k0 in shorter wavelength were strongly dominated by "fast-decay" ESA process. These results definitively indicate that stimulated emission of NV- centers is suppressed by photoionization and ESAs and the possibility of diamond lasers based on NV- centers is low.

Development and Testing of the Glenn Research Center Visitor's Center Grid-Tied Photovoltaic Power System

Science.gov (United States)

Eichenberg, Dennis J.

2009-01-01

The NASA Glenn Research Center (GRC) has developed, installed, and tested a 12 kW DC grid-tied photovoltaic (PV) power system at the GRC Visitor s Center. This system utilizes a unique ballast type roof mount for installing the photovoltaic panels on the roof of the Visitor s Center with no alterations or penetrations to the roof. The PV system has generated in excess of 15000 kWh since operation commenced in August 2008. The PV system is providing power to the GRC grid for use by all. Operation of the GRC Visitor s Center PV system has been completely trouble free. A grid-tied PV power system is connected directly to the utility distribution grid. Facility power can be obtained from the utility system as normal. The PV system is synchronized with the utility system to provide power for the facility, and excess power is provided to the utility. The project transfers space technology to terrestrial use via nontraditional partners. GRC personnel glean valuable experience with PV power systems that are directly applicable to various space power systems, and provides valuable space program test data. PV power systems help to reduce harmful emissions and reduce the Nation s dependence on fossil fuels. Power generated by the PV system reduces the GRC utility demand, and the surplus power aids the community. Present global energy concerns reinforce the need for the development of alternative energy systems. Modern PV panels are readily available, reliable, efficient, and economical with a life expectancy of at least 25 years. Modern electronics has been the enabling technology behind grid-tied power systems, making them safe, reliable, efficient, and economical with a life expectancy of at least 25 years. Based upon the success of the GRC Visitor s Center PV system, additional PV power system expansion at GRC is under consideration. The GRC Visitor s Center grid-tied PV power system was successfully designed and developed which served to validate the basic principles

New Mexico Center for Particle Physics: Studies of fundamental interactions

International Nuclear Information System (INIS)

Matthews, J.A.J.

1992-01-01

The New Mexico Center/UNM group research program includes the CDF experiment at Fermilab and the SDC experiment at the SSC. In both experiments the UNM group research focuses on silicon strip tracking systems. The present research goals are to develop and utilize precision silicon tracking to increase significantly the physics reach of the Tevatron, and to make possible the study of high-P t physics at the SSC. The search for the t-quark in CDF is the primary goal of the upcoming Tevatron runs. This Progress Report summarizes our research accomplishments from the last year

ORNL's Controlled Fusion Atomic Data Center

International Nuclear Information System (INIS)

Barnett, C.F.; Gregory, D.C.

1983-01-01

The Data Center maintains a detailed bibliography of atomic data measurements and calculations for processes of interest to the fusion community. One hundred nineteen journals are regularly searched for papers of interest, including back issues to 1950. Entries are categorized by author, process, reactants, energy range, and theory/experiment. Complete bibliographies have been published since 1978 and a computerized data retrieval system is available. In addition, an updated and extended multi-volume critical compilation of cross sections (the ORNL Redbooks) is under way

Is the Distance Worth It? Patients With Rectal Cancer Traveling to High-Volume Centers Experience Improved Outcomes.

Science.gov (United States)

Xu, Zhaomin; Becerra, Adan Z; Justiniano, Carla F; Boodry, Courtney I; Aquina, Christopher T; Swanger, Alex A; Temple, Larissa K; Fleming, Fergal J

2017-12-01

It is unclear whether traveling long distances to high-volume centers would compensate for travel burden among patients undergoing rectal cancer resection. The purpose of this study was to determine whether operative volume outweighs the advantages of being treated locally by comparing the outcomes of patients with rectal cancer treated at local, low-volume centers versus far, high-volume centers. This was a population-based study. The National Cancer Database was queried for patients with rectal cancer. Patients with stage II or III rectal cancer who underwent surgical resection between 2006 and 2012 were included. The outcomes of interest were margins, lymph node yield, receipt of neoadjuvant chemoradiation, adjuvant chemotherapy, readmission within 30 days, 30-day and 90-day mortality, and 5-year overall survival. A total of 18,605 patients met inclusion criteria; 2067 patients were in the long-distance/high-volume group and 1362 in the short-distance/low-volume group. The median travel distance was 62.6 miles for the long-distance/high-volume group and 2.3 miles for the short-distance/low-volume group. Patients who were younger, white, privately insured, and stage III were more likely to have traveled to a high-volume center. When controlled for patient factors, stage, and hospital factors, patients in the short-distance/low-volume group had lower odds of a lymph node yield ≥12 (OR = 0.51) and neoadjuvant chemoradiation (OR = 0.67) and higher 30-day (OR = 3.38) and 90-day mortality (OR = 2.07) compared with those in the long-distance/high-volume group. The short-distance/low-volume group had a 34% high risk of overall mortality at 5 years compared with the long-distance/high-volume group. We lacked data regarding patient and physician decision making and surgeon-specific factors. Our results indicate that when controlled for patient, tumor, and hospital factors, patients who traveled a long distance to a high-volume center had improved lymph node yield

Nuclear power experience

International Nuclear Information System (INIS)

1983-01-01

The International Conference on Nuclear Power Experience, organized by the International Atomic Energy Agency, was held at the Hofburg Conference Center, Vienna, Austria, from 13 to 17 September 1982. Almost 1200 participants and observers from 63 countries and 20 organizations attended the conference. The 239 papers presented were grouped under the following seven main topics: planning and development of nuclear power programmes; technical and economic experience of nuclear power production; the nuclear fuel cycle; nuclear safety experience; advanced systems; international safeguards; international co-operation. The proceedings are published in six volumes. The sixth volume contains a complete Contents of Volume 1 to 5, a List of Participants, Authors and Transliteration Indexes, a Subject Index and an Index of Papers by Number

Experiences of multidisciplinary development team members during user-centered design of telecare products and services: a qualitative study.

Science.gov (United States)

Vermeulen, Joan; Verwey, Renée; Hochstenbach, Laura M J; van der Weegen, Sanne; Man, Yan Ping; de Witte, Luc P

2014-05-19

User-centered design (UCD) methodologies can help take the needs and requirements of potential end-users into account during the development of innovative telecare products and services. Understanding how members of multidisciplinary development teams experience the UCD process might help to gain insight into factors that members with different backgrounds consider critical during the development of telecare products and services. The primary objective of this study was to explore how members of multidisciplinary development teams experienced the UCD process of telecare products and services. The secondary objective was to identify differences and similarities in the barriers and facilitators they experienced. Twenty-five members of multidisciplinary development teams of four Research and Development (R&D) projects participated in this study. The R&D projects aimed to develop telecare products and services that can support self-management in elderly people or patients with chronic conditions. Seven participants were representatives of end-users (elderly persons or patients with chronic conditions), three were professional end-users (geriatrician and nurses), five were engineers, four were managers (of R&D companies or engineering teams), and six were researchers. All participants were interviewed by a researcher who was not part of their own development team. The following topics were discussed during the interviews: (1) aim of the project, (2) role of the participant, (3) experiences during the development process, (4) points of improvement, and (5) what the project meant to the participant. Experiences of participants related to the following themes: (1) creating a development team, (2) expectations regarding responsibilities and roles, (3) translating user requirements into technical requirements, (4) technical challenges, (5) evaluation of developed products and services, and (6) valorization. Multidisciplinary team members from different backgrounds often

Project Portal User-Centered Design and Engineering Report

Science.gov (United States)

2016-06-01

TECHNICAL REPORT 3013 June 2016 Project Portal User-Centered Design and Engineering Report Deborah Gill-Hesselgrave Veronica Higgins Sarah...Design and Engineering Branch Under authority of Chris Raney, Head Command and Control Technology and Experiments Division iii EXECUTIVE...navy.mil  Christian Szatkowski christian.szatkowski@navy.mil  Roni Higgins roni.higgins@navy.mil  Jake Viraldo jacob.viraldo@navy.mil B

Based on Intelligent Robot of E-business Distribution Center Operation Mode Research

Directory of Open Access Journals (Sweden)

Li Juntao

2016-01-01

Full Text Available According to E-business distribution center operation mode in domestic and advanced experience drawing lessons at home and abroad, this paper based on intelligent robot researches E-business distribution center operation mode. And it proposes the innovation logistics storage in E-business and sorting integration system, and elaborates its principle, characteristics, as well as studies its business mode and logistics process, and its parameters and working mode of AGV equipment.

The Precarious Question of Black Cultural Centers Versus Multicultural Centers.

Science.gov (United States)

Princes, Carolyn D. W.

This paper discusses the role of black cultural centers on university campuses, focusing on whether black cultural centers or multicultural centers best meet the needs of an increasingly diverse student body and society. It examines the historical role of black cultural centers as vehicles to promote educational opportunity, student retention, and…

Massachusetts Institute of Technology, Plasma Fusion Center, Technical Research Programs

Energy Technology Data Exchange (ETDEWEB)

Davidson, Ronald C.

1980-08-01

A review is given of the technical programs carried out by the Plasma Fusion Center. The major divisions of work areas are applied plasma research, confinement experiments, fusion technology and engineering, and fusion systems. Some objectives and results of each program are described. (MOW)

Spent fuel storage facility at science and technical center 'Sosny': Experience of ten years activity

International Nuclear Information System (INIS)

Chigrinov, S.; Goulo, V.; Lunev, A.; Belousov, N.; Salnikov, L.; Boiko, L.

2000-01-01

Spent fuel storage of the Academic Science and Technical Center in Minsk is in operation already more then 10 years. In the paper aspects of its design, operation practice, problems and decisions for future are discussed. (author)

Lessons Learned from an LGBTQ Senior Center: A Bronx Tale.

Science.gov (United States)

McGovern, Justine; Brown, Dwayne; Gasparro, Vita

This article describes an interdisciplinary pilot study exploring the impact of LGBTQ senior centers on the lives of center members. Many LGBTQ adults face the future having experienced stigma and bias, restricted rights, and rejection from family of origin, and are now growing older without the support of a partner and adult children. As a result, older LGBTQ adults experience higher rates of depression, loneliness and isolation, and shortened life expectancy as compared to non-LGBTQ peers. Findings from focus group and key informant interviews highlight features of LGBTQ senior center experiences that can significantly improve members' quality of life. These include providing family, acceptance and a home, which can have an impact on outlook and outcomes. Moreover, findings suggest the need for re-thinking hetero-normative definitions of "community" in the context of LGBTQ aging. Beyond sharing findings from the study, suggesting a conceptual framework for deepening understanding about LGBTQ aging, and identifying lines of future inquiry, the article articulates implications for social work research, practice and education. Ultimately, the article argues that social work is well positioned to improve quality of life for this under-served population when it adopts a cultural humility stance in research, practice and education.

Dangers faced by emergency staff: experience in urban centers in southern Turkey.

Science.gov (United States)

Gülalp, Betül; Karcioğlu, Ozgür; Köseoğlu, Zikret; Sari, Azade

2009-05-01

The aim of this study was to investigate the incidence and characteristics of aggression, threat and physical violence directed towards the staff in emergency departments. A questionnaire was completed by the emergency staff. The individualized data collected included the pattern and incidence of violence, sex, age, profession, and years of experience of the emergency staff, and the behavioral characteristics of the assailants, together with outcome of incidents. Data regarding incidences occurring between May 1-31, 2006 were abstracted. A total of 109 staff were evaluated. There was a statistically significant relationship between aggression and profession (p=0.000), but no relation was determined with sex, age or years of experience (p values 0.464, 0.692, and 0.298, respectively). The relationship of incidences of threat with sex, age, profession, and experience was insignificant (p values 0.311, 0.278, 0.326, 0.994, respectively). On the other hand, significant relationships were identified between physical assault and sex, age, profession, and experience (p values 0.042, 0.000, 0.000, 0.011). Violence directed towards the emergency staff is common. Aggression occurs towards the emergency physician distinctively. Otherwise, there is no significant relationship between aggression or threat and personal characteristics. However, male sex, > or =31 years of age, being an emergency physician, and having worked for longer than five years in the emergency department are the risk factors for physical violence.

Paradoxical embolism: Experiences from a single center

Directory of Open Access Journals (Sweden)

Hong-Liang Zhang

2017-06-01

Full Text Available Objective: To present our treatment experiences and the follow-up data of patients with paradoxical embolism (PDE. Methods: The clinical characteristics, management, and follow-up data of all included patients who were diagnosed with PDE at Fuwai Hospital from January 1994 to October 2015 were recorded. Results: Twelve patients were included; all had a pulmonary embolism, and 8 had deep venous thrombosis. The artery embolisms involved the cerebral artery (7 patients, renal artery (2 patients, mesentery artery (2 patients, popliteal artery (1 patient, descending aorta thrombus (1 patient, and thrombus-straddled patent foramen ovale (PFO (1 patient. PFO was found in 3 cases. One patient underwent thrombectomy and PFO closure; Six patients received thrombolysis; and 3 patients were implanted with a vena cava filter. Long-term anticoagulation with warfarin was recommended for each patient. One patient died from ventricular fibrillation despite cardiopulmonary resuscitation. Eleven patients were discharged with improvements. No late mortality occurred in 8 patients with a complete follow-up of 10.6–17.7 years. One had a recurrent deep venous thrombosis. No patient had a recurrent pulmonary or arterial embolism. Two patients changed their treatment from warfarin to aspirin; others remained on warfarin. Only 1 case had an occasional gum bleeding. Conclusions: PDE treatment including thrombolysis, anticoagulation, and embolectomy should be individualized. We recommend long-term anticoagulation therapy to prevent the recurrence of PDE, especially to those with an intracardiac communication or persistent risk factors for re-thrombosis. Keywords: Paradoxical embolism, Pulmonary embolism, Deep venous thrombosis, Patent foramen ovale

Centers of Excellence Contribution to Knowledge Augmentation

International Nuclear Information System (INIS)

Mignone, O.

2016-01-01

Full text: Knowledge management is a key need of the nuclear industry to cope with the knowledge limited augmentation and the risks of knowledge loss due to a number of reasons, such as: staff attrition, organizational changes, upgraded technologies, new projects implementation, and the nuclear power evolution in recent years (i.e., post-Fukushima upgrades). This document describes the contribution of nuclear centers of excellence to knowledge augmentation. The effective implementation of nuclear centers of excellence is a key success factor for the knowledge management programme of nuclear organizations. This document, is based on a real example of operating organization approach in launching such initiative for staff knowledge augmentation and performance improvement. Eventually, any type of organizations in the nuclear sector could apply the proposed technique to reach better knowledge usage. The nuclear centers of excellence are a key knowledge management initiative for the learning organizations that are caring about organizational intellectual capital and striving for performance improvement. The nuclear centers of excellence can be realized as a forum to exchange ideas, knowledge, information, experiences; to collect lessons learned; and to identify areas for improvement where further organizational competence building is needed. Usual realization of this initiative is going through an active staff involvement in knowledge sharing in a form of different technical communities of practice focusing on specific knowledge domains. (author

The satellite situation center

International Nuclear Information System (INIS)

Teague, M.J.; Sawyer, D.M.; Vette, J.I.

1982-01-01

Considerations related to the early planning for the International Magnetospheric Study (IMS) took into account the desirability of an establishment of specific entities for generating and disseminating coordination information for both retrospective and predictive periods. The organizations established include the IMS/Satellite Situation Center (IMS/SSC) operated by NASA. The activities of the SSC are related to the preparation of reports on predicted and actually achieved satellite positions, the response to inquiries, the compilation of information on satellite experiments, and the issue of periodic status summaries. Attention is given to high-altitude satellite services, other correlative satellite services, non-IMS activities of the SSC, a summary of the SSC request activity, and post-IMS and future activities

Bullying and Discrimination Experiences among Korean-American Adolescents

Science.gov (United States)

Shin, Jin Y.; D'Antonio, Emily; Son, Haein; Kim, Seong-A.; Park, Yeddi

2011-01-01

The bullying experiences of Korean-American adolescents (N = 295) were explored in relation to discrimination and mental health outcomes. Bullying experiences were assessed by the "Bully Survey" (Swearer, 2005), discrimination by the "Perceived Ethnic and Racial Discrimination Scale" (Way, 1997) and depression by the "Center for Epidemiological…

Role of a database-driven web site in the immediate disaster response and recovery of Academic Health Center: the Katrina experience.

Science.gov (United States)

Fordis, Michael; Alexander, J Douglas; McKellar, Julie

2007-08-01

In the wake of Hurricane Katrina's landfall on August 29, 2005, and the subsequent levee failures, operations of Tulane University School of Medicine became unsustainable. As New Orleans collapsed, faculty, students, residents, and staff were scattered nationwide. In response, four Texas medical schools created an alliance to assist Tulane in temporarily relocating operations to south Texas. Resuming operations in a three- to four-week time span required developing and implementing a coordinated communication plan in the face of widespread communication infrastructure disruptions. A keystone of the strategy involved rapidly creating a "recovery Web site" to provide essential information on immediate recovery plans, mechanisms for reestablishing communications with displaced persons, housing relocation options (over 200 students, faculty, and staff were relocated using Web site resources), classes and residency training, and other issues (e.g., financial services, counseling support) vitally important to affected individuals. The database-driven Web site was launched in four days on September 11, 2005, by modifying an existing system and completing new programming. Additional functions were added during the next week, and the site operated continuously until March 2006, providing about 890,000 pages of information in over 100,000 visitor sessions. The site proved essential in disseminating announcements, reestablishing communications among the Tulane family, and supporting relocation and recovery. This experience shows the importance of information technology in collaborative efforts of academic health centers in early disaster response and recovery, reinforcing recommendations published recently by the Association of Academic Health Centers and the National Academy of Sciences.

The Bridge: Experiments in Science and Art, Experiences from the 2017 SciArt Center Cross-Disciplinary Residency Program

Science.gov (United States)

Shipman, J. S.; Chalmers, R.; Buntaine, J.

2017-12-01

Cross-disciplinary programs create the opportunity to explore new realms for scientists and artists alike. Through the collaborative process, artistic insights enable innovative approaches to emotionally connect to and visualize the world around us. Likewise, engagement across the art-science spectrum can lead to shifts in scientific thinking that create new connections in data and drive discoveries in research. The SciArt Center "The Bridge Residency Program" is a four-month long virtual residency open internationally for professionals in the arts and sciences to facilitate cross-disciplinary work and to bring together like-minded participants. The SciArt Center provides a virtual space to record and showcase the process and products of each collaboration. The work is facilitated with biweekly Skype calls and documented with weekly blog posts. Residents create either digital or physical products and share via video, images, or direct mailing with their collaborators. Past projects have produced call and response discussion, websites, skills and conference presentations, science-art studies, virtual exhibits, art shows, dance performances, and research exchange. Here we present the creative process and outcomes of one of the four collaborative teams selected for the 2017 residency. Jill Shipman, a Ph.D. Candidate in Volcanology who is also active in filmmaking and theatrical productions and Rosemary Chalmers, a UK-based lecturer, concept artist, and illustrator with a specialty in creature design. They were paired together for their shared interest in storytelling, illustration, and unique geological and environmental habitats and the life that occupies them. We will discuss the collaborative project developed by this team during their recent residency and illustrate how a virtual program can bridge the distance between geographical location to foster science and art collaboration. To follow the progress of the residency please visit: http://www.sciartcenter.org/the-bridge.html

Laparoscopic treatment for esophageal achalasia: experience at a single center.

Science.gov (United States)

Agrusa, A; Romano, G; Bonventre, S; Salamone, G; Cocorullo, G; Gulotta, G

2013-01-01

Achalasia is a not frequent esophageal disorder characterized by the absence of esophageal peristalsis and incomplete relaxation of the lower esophageal sphincter (LES). Its cause is unknown. The aim of treatment is to improve the symptoms. We report the results of the treatment of this condition achieved in one center. We conducted a retrospective study of patients with esophageal achalasia. In the period 2010-2012 we observed 64 patients, of whom 19 were referred for medical treatment. Three of the remaining patients underwent botulinum toxin injection, 17 underwent multiple endoscopic dilation procedures and 25 underwent laparoscopic surgery. There were no complications in the group undergoing endoscopic therapy, but symptom remission was only temporary. Patients undergoing surgery showed a significant improvement in symptoms and no recurrence throughout the follow-up period, that is still ongoing (3 years). There were no major complications in any case and no morbidity or mortality. Surgical treatment of esophageal achalasia with laparoscopic Heller myotomy and Dor fundoplication gives the best and longest-lasting results in suitably selected patients. The extension of the myotomy and reduction in LES pressure are the most important parameters to achieve a good result.

Adrenalectomy for metastases from hepatocellular carcinoma - a single center experience.

Science.gov (United States)

Popescu, Irinel; Alexandrescu, Sorin; Ciurea, Silviu; Brasoveanu, Vlad; Hrehoret, Doina; Gangone, Eliza; Boros, Mirela; Herlea, Vlad; Croitoru, Adina

2007-05-01

Adrenal metastases (AM) from hepatocellular carcinoma (HCC) are rarely seen in clinical practice. The treatment is not standardized, the indications and efficacy of different therapeutic approaches being still controversial. Between January 1995 and December 2005, 174 patients underwent liver resection for HCC in our center. AM were detected in four patients (2.3%): three of them had HCC and synchronous AM, and the remaining one developed AM 10 months after liver resection. All the patients with AM were treated by adrenalectomy (simultaneously with liver resection in synchronous metastases), followed by systemic chemotherapy. Non-resectable multifocal liver recurrences occurred in two patients, one of them having also a contralateral adrenal metastasis; these two patients are presently alive 26 and 43 months after adrenalectomy, respectively. Another patient died by liver recurrence 27 months postoperatively. The fourth patient is disease-free at 17 months after the initial operation. Adrenalectomy for AM from HCC should be performed whenever the primary tumor is well therapeutically controlled and the patient has a good performance status. Adrenalectomy offers the chance of more than 2 years survival in many patients. However, once AM are detected, the prognosis remains poor.

Postpercutaneous Nephrolithotomy Nephrostogram: Is It Mandatory? A Single Center Experience

Directory of Open Access Journals (Sweden)

Abdul Rouf Khawaja

2014-01-01

Full Text Available Aims and Objective. “Postpercutaneous nephrolithotomy nephrostogram” (PPNN is routinely performed in most of the centers. No published series could be found in the literature without post percutaneous nephrolithotomy nephrostogram. Hence, the aim of our study is to highlight that post percutaneous nephrolithotomy nephrostogram is not mandatory and it only adds to cost and morbidity without adding any information in the management of such patients. Methods. It was a prospective study from 2005 to 2012, conducted in our institute. It included 119 patients of renal stones who underwent percutaneous nephrolithotomy performed under the guidance of a single surgeon. Postoperative nephrostogram was not done in any of the patients. Results. Complete stone clearance was achieved in 97.5% of patients and 2.5% of patients needed two to three sessions of ESWL later on. None of the patients needed second look percutaneous nephrolithotomy or nephrostogram. Conclusion. Postpercutaneous nephrolithotomy nephrostogram increases chances of infection, inconvenience, contrast related complications, and cost, with no added advantage over plain X-ray KUB, and it should not be done as a routine investigation prior to the removal of PCN tube in patients with complete stone clearance.

Hypopharyngeal carcinoma: King Faisal Specialist Hospital and Research Center experience

International Nuclear Information System (INIS)

Mahasin, Z.; Khan, B.

1996-01-01

From 1975 to 1985, 202 patients with hypopharyngeal cancer were seen at King Faisal Specialist Hospital and Research Center (KFSHRC). The endoscopic investigation showed that 28.3% of these patients had postcricoid carcinoma; 19.85% had pyriform fossa carcinoma and 52.9% had involvement of both sites. The pathological diagnosis of all cases was squamous cell carcinoma type. The majority of the patients (62.98%) had T4 lesions, which showed a late presentation to KFSHRC. Information related to survival was available for a smaller number of patients to many lost-to-follow-up cases. The overall median survival time was 8.5 months (1-110 months). The survival rate for each site was calculated, as well as the staging of the disease and treatment modality used. It appeared that pyriform fossa (median 21 months) had the best survival rate. In addition the earlier the lesion was detected and the more aggressive the treatment applied, the better the survival rate. Fifty percent of the patients receiving radiation therapy and surgery had a five year survival arte. Factors other than smoking and/on drinking should be looked for in our community as predisposing to this disease in our population. (author)

Occupational toxicant inhalation injury: the World Trade Center (WTC) experience.

Science.gov (United States)

de la Hoz, Rafael E; Shohet, Michael R; Chasan, Rachel; Bienenfeld, Laura A; Afilaka, Aboaba A; Levin, Stephen M; Herbert, Robin

2008-02-01

Clinical descriptive data is presented on a group of 554 former workers and volunteers (with more than 90 different occupations) at the World Trade Center (WTC) disaster site. A subsample of 168 workers (30% of the group) was selected to examine lower airway disease risk in relation to smoking and WTC exposure variables. Five diagnostic categories clearly predominate: upper airway disease (78.5%), gastroesophageal reflux disease (57.6%), lower airway disease (48.9%), psychological (41.9%) and chronic musculoskeletal illnesses (17.8%). The most frequent pattern of presentation was a combination of the first three of those categories (29.8%). Associations were found between arrival at the WTC site within the first 48 h of the terrorist attack and lower airway and gastroesophageal reflux disease, and between past or present cigarette smoking and lower airway disease. Occupational exposures at the WTC remain consistently associated with a disease profile, which includes five major diagnostic categories. These conditions often coexist in different combinations, which (as expected) mutually enhances their clinical expression, complicates medical management, and slows recovery. Cigarette smoking and early arrival at the WTC site appear to be risk factors for lower airway disease diagnosis.

Ultraviolet A1 phototherapy: One center's experience

Directory of Open Access Journals (Sweden)

Sasi Kiran Attili

2017-01-01

Full Text Available Background: Ultraviolet A1(UVA1 phototherapy is increasingly being used in the treatment of morphea, atopic dermatitis, lupus and some other recalcitrant dermatoses. We present a retrospective review of our experience with this modality. Aim: To evaluate the treatment response rates for various dermatoses and adverse effects of UVA1 phototherapy. Methods: We reviewed phototherapy notes along with electronic and/or paper case records for all patients treated with UVA1 phototherapy from October 1996 to December 2008. Results: A total of 269 patients (outcomes available for 247 had 361 treatment courses (treatment data available for 317 courses over this period. We found phototherapy to be beneficial in 28 (53% of 53 patients with atopic dermatitis and 19 (51% of 37 patients with morphea. A beneficial outcome was recorded in all six (100% cases of urticaria and six (85.7% of seven patients treated for a polymorphic light eruption. Benefit was also recorded in systemic lupus erythematosus (8 (44.4% of 18, lichen sclerosus (6 (42.9% of 14, mastocytosis (2 (33.3% of 6, necrobiosis lipoidica (4 (30.8% of 13, granuloma annulare (2 (25% of 8, scleroderma (2 (22.2% of 9 and keloids (1 (7.7% of 13. Overall, treatment was well tolerated with no patients having to stop treatment due to adverse effects. Limitations: This is a retrospective study with no control group. Subjective/recall bias is quite possible as a number of patients were followed up over the phone. Conclusions: Our data suggest that ultraviolet A1 can be considered for the treatment of selected dermatoses. However, long-term malignancy risk is as yet unknown.

Pattern and Survival of Biliary Atresia Patients; Experience in ...

African Journals Online (AJOL)

experience of the teams managing these patients. There may be need to establish regional biliary surgery centers where all babies suspected of BA are referred and managed by teams specially dedicated to management of BA. This concept of regional biliary centers has been put into practice in some advanced countries.

NCERA-101 Station Report from Kennedy Space Center, FL, USA

Science.gov (United States)

Massa, Gioia D.; Wheeler, Raymond M.

2014-01-01

This is our annual report to the North Central Extension Research Activity, which is affiliated with the USDA and Land Grant University Agricultural Experiment Stations. I have been a member of this committee for 25 years. The presentation will be given by Dr. Gioia Massa, Kennedy Space Center

Microsoft System Center Data Protection Manager 2012 R2 cookbook

CERN Document Server

Hedblom, Robert

2015-01-01

If you are a DPM administrator, this book will help you verify your knowledge and provide you with everything you need to know about the 2012 R2 release. No prior knowledge about System Center DPM is required, however some experience of running backups will come in handy.

Center for computer security: Computer Security Group conference. Summary

Energy Technology Data Exchange (ETDEWEB)

None

1982-06-01

Topics covered include: computer security management; detection and prevention of computer misuse; certification and accreditation; protection of computer security, perspective from a program office; risk analysis; secure accreditation systems; data base security; implementing R and D; key notarization system; DOD computer security center; the Sandia experience; inspector general's report; and backup and contingency planning. (GHT)

Micro-cathode Arc Thruster PhoneSat Experiment

Data.gov (United States)

National Aeronautics and Space Administration — The Micro-cathode Arc Thruster Phonesat Experiment  was a joint project between George Washington University and NASA Ames Research Center that successfully...

Oncology nurse communication barriers to patient-centered care.

Science.gov (United States)

Wittenberg-Lyles, Elaine; Goldsmith, Joy; Ferrell, Betty

2013-04-01

Although quality communication has been identified as a necessary component to cancer care, communication skills training programs have yet to focus on the unique role of nurses. This study explored communication barriers as reported by seven nurse managers to better identify communication skills needed for oncology nurses to practice patient-centered care. Thematic analysis of transcripts was used to identify barriers to patient and family communication and desirable patient-centered nursing communication skills. Overall, the nurse managers reported that nurses experience patient and family communication difficulties as a result of inconsistent messages to patients and family from other healthcare staff. Physician assumptions about nursing left nurses feeling uncomfortable asking for clarification, creating a barrier to team communication processes. Patient-centered communication and care cannot be actualized for nurses unless team roles are clarified and nurses receive training in how to communicate with physicians, patients, and family. Therefore, the authors of this article created the COMFORT communication training protocol, and key concepts and resources for nurse communication training through COMFORT are detailed in this article.

2014 Mid-Atlantic Telehealth Resource Center Annual Summit

Directory of Open Access Journals (Sweden)

Katharine Hsu Wibberly

2013-12-01

Full Text Available The Mid-Atlantic Resource Center (MATRC; http://www.matrc.org/ advances the adoption and utilization of telehealth within the MATRC region and works collaboratively with the other federally funded Telehealth Resource Centers to accomplish the same nationally. MATRC offers technical assistance and other resources within the following mid-Atlantic states: Delaware, District of Columbia, Kentucky, Maryland, North Carolina, Pennsylvania, Virginia and West Virginia.   The 2014 MATRC Summit “Adding Value through Sustainable Telehealth” will be held March 30-April 1, 2014, at the Fredericksburg Expo & Conference Center, Fredericksburg, VA. The Summit will explore how telehealth adds value to patients, practitioners, hospitals, health systems, and other facilities. Participants will experience a highly interactive program built around the case history of “Mr. Doe” as he progresses through the primary care, inpatient hospitalization, and post-discharge environments. The Summit will conclude with a session on financial and business models for providing sustainable telehealth services.   For further information and registration, visit: http://matrc.org/component/content/article/2-uncategorised/80-mid-atlantic-telehealth-resource-summit-2014    

Data Curation Education in Research Centers (DCERC)

Science.gov (United States)

Marlino, M. R.; Mayernik, M. S.; Kelly, K.; Allard, S.; Tenopir, C.; Palmer, C.; Varvel, V. E., Jr.

2012-12-01

Digital data both enable and constrain scientific research. Scientists are enabled by digital data to develop new research methods, utilize new data sources, and investigate new topics, but they also face new data collection, management, and preservation burdens. The current data workforce consists primarily of scientists who receive little formal training in data management and data managers who are typically educated through on-the-job training. The Data Curation Education in Research Centers (DCERC) program is investigating a new model for educating data professionals to contribute to scientific research. DCERC is a collaboration between the University of Illinois at Urbana-Champaign Graduate School of Library and Information Science, the University of Tennessee School of Information Sciences, and the National Center for Atmospheric Research. The program is organized around a foundations course in data curation and provides field experiences in research and data centers for both master's and doctoral students. This presentation will outline the aims and the structure of the DCERC program and discuss results and lessons learned from the first set of summer internships in 2012. Four masters students participated and worked with both data mentors and science mentors, gaining first hand experiences in the issues, methods, and challenges of scientific data curation. They engaged in a diverse set of topics, including climate model metadata, observational data management workflows, and data cleaning, documentation, and ingest processes within a data archive. The students learned current data management practices and challenges while developing expertise and conducting research. They also made important contributions to NCAR data and science teams by evaluating data management workflows and processes, preparing data sets to be archived, and developing recommendations for particular data management activities. The master's student interns will return in summer of 2013

MENGATASI MASALAH LOW SELF ESTEEM SISWA MELALUI KONSELING INDIVIDU MODEL PERSON CENTERED THERAPHY

Directory of Open Access Journals (Sweden)

Azmi Hanifah

2017-03-01

Full Text Available This research applied based on the phenomenon in SMPN 25 Semarang which indicates several students who have low self-esteem, through the results of the DCM’s analysis distributed to the students of 9th grade. This research used to show the students’ self-esteem before and after having individual counseling model of person-centered Therapy and whether the model of person-centered Therapy counseling can overcome the problem of low self-esteem students. This research design is experimental research which using one group pretest-posttest design. The participants of this study were six students. The writer use Wilcoxon test as Hypothesis testing by comparing the level of the smallest of the pre and posttest. Obtained results Zcount 2,206 > Z table = 1.645, which means Ha accepted and Ho rejected. The research findings showed that (1 the pretest of the experiment of sixth counselees was 48.45% (2 In another hand the posttest result of the experiment sixth counselees was 75.65% (3 The problem of low self-esteem students can be solved through counseling models centered person theraphy. The result of the study shows that there is positive result and significant improvement of students’ self-esteem when teacher using Person Centered Therapy to solve low self-esteem problem.

Job satisfaction survey among health centers staff

OpenAIRE

Shahnazi, Hossein; Daniali, Seyede Shahrbanoo; Sharifirad, Gholamreza

2014-01-01

Background: Due to the importance of health care organizations with significant responsibility for prevention and care, assessment of job satisfaction among health care staff is essential. Quality of health services will be decreased provided they are not satisfied. Materials and Methods: This study was a cross-sectional analysis of health care staff in Khomeinishahr (centers, buildings, and networks) If they had at least 6 months work experience, they could enter the study. Data included a t...

Designing the user experience of game development tools

CERN Document Server

Lightbown, David

2015-01-01

The Big Green Button My Story Who Should Read this Book? Companion Website and Twitter Account Before we BeginWelcome to Designing the User Experience of Game Development ToolsWhat Will We Learn in This Chapter?What Is This Book About?Defining User ExperienceThe Value of Improving the User Experience of Our ToolsParallels Between User Experience and Game DesignHow Do People Benefit From an Improved User Experience?Finding the Right BalanceWrapping UpThe User-Centered Design ProcessWhat Will We

The benefits of cancer screening in kidney transplant recipients: a single-center experience.

Science.gov (United States)

Kato, Taigo; Kakuta, Yoichi; Abe, Toyofumi; Yamanaka, Kazuaki; Imamura, Ryoichi; Okumi, Masayoshi; Ichimaru, Naotsugu; Takahara, Shiro; Nonomura, Norio

2016-02-01

The frequency of malignancy is increasing in kidney transplant recipients. Posttransplant malignancy (PTM) is a major cause of long-term graft survival inhibition. In this study, we evaluated the frequency and prognosis of PTM at our center and examined the efficacy of cancer screening. Between 1972 and 2013, 750 patients were followed-up at our center. Annual physical examinations and screenings were performed to detect PTM. We investigated the detail of two distinctive cancer groups: screening-detected cancers and symptom-detected cancers. Seventy-seven PTM were identified during the follow-up period. The mean age at the initial PTM detection was 43.6 ± 12.8 years. The mean interval from transplantation to cancer diagnosis was 134.5 ± 11.3 months. Among the 77 patients, posttransplant lymphoproliferative disease (PTLD) was the most common cancer (19.5%, 15/77), followed by renal cell carcinoma (15.6%, 12/77). Of the cancer cases, 46.8% (36/77) were detected via screening. The most frequently screening-detected cancer was renal cell carcinoma of the native kidney and breast cancer (22.2%, 8/36). However, it was difficult to detect PTLD, urothelial carcinoma, and colorectal cancer via screening. Interestingly, Cox proportional regression analyses revealed nonscreened recipients to be a significant prognostic factor for PTM (P kidney transplant recipients. These findings support the provision of long-term appropriate screening for kidney transplant recipients. © 2015 The Authors. Cancer Medicine published by John Wiley & Sons Ltd.

Collaborative engagement experiment (CEE)

Science.gov (United States)

Wade, Robert L.; Reames, Joseph M.

2005-05-01

Unmanned ground and air systems operating in collaboration have the potential to provide future Joint Forces a significant capability for operations in complex terrain. Ground and air collaborative engagements potentially offer force conservation, perform timely acquisition and dissemination of essential combat information, and can eliminate high value and time critical targets. These engagements can also add considerably to force survivability by reducing soldier and equipment exposure during critical operations. The Office of the Secretary of Defense, Joint Robotics Program (JRP) sponsored Collaborative Engagement Experiment (CEE) is a consolidation of separate Air Force, Army and Navy collaborative efforts to provide a Joint capability. The Air Force Research Laboratory (AFRL), Material and Manufacturing Directorate, Aerospace Expeditionary Force Division, Force Protection Branch (AFRLMLQF), The Army Aviation and Missile Research, Development and Engineering Center (AMRDEC) Joint Technology Center (JTC)/Systems Integration Laboratory (SIL), and the Space and Naval Warfare Systems Center-San Diego (SSC San Diego) are conducting technical research and proof of principle for an envisioned operational concept for extended range, three dimensional, collaborative operations between unmanned systems, with enhanced situational awareness for lethal operations in complex terrain. This program will assess information requirements and conduct experiments to identify and resolve technical risks for collaborative engagements using Unmanned Ground Vehicles (UGVs) and Unmanned Aerial Vehicles (UAVs). It will research, develop and physically integrate multiple unmanned systems and conduct live collaborative experiments. Modeling and Simulation systems will be upgraded to reflect engineering fidelity levels to greater understand technical challenges to operate as a team. This paper will provide an update of a multi-year program and will concentrate primarily on the JTC

Data Protection for Virtual Data Centers

CERN Document Server

Buffington, Jason

2010-01-01

Essential information on how to protect data in virtual environments!. Virtualization is changing the data center architecture and as a result, data protection is is quickly evolving as well. This unique book, written by an industry expert with over eighteen years of data storage/backup experience, shows you how to approach, protect, and manage data in a virtualized environment. You'll get up to speed on data protection problems, explore the data protection technologies available today, see how to adapt to virtualization, and more. The book uses a "good, better, best" approach, explo

[The AMY experiment

International Nuclear Information System (INIS)

1989-01-01

The AMY experiment is one of three major experiments at TRISTAN which is studying the states the matter produced in electron positron annihilations in the center of mass energy range of 50--65GeV. It provides information between the lower energy facilities such as PEP and PETRA and the new facilities SLC and LEP which are designed to operate in the region of the Z 0 mass near 90GeV. In the region of the AMY experiment, interaction cross sections are near their minimum of about 100pb, making it difficult to acquire large data samples during typical running cycles. This last year has seen an accumulation of about 10---12pb -1 of integrated luminosity in the energy range from 58 to 61.7GeV. Despite this limited data sample, the AMY experiment has been extremely active in attempting to extract the minimum amount of information from the data. Some of the most significant results are discussed in this paper. 9 refs

The program of the ALARA Center at Brookhaven National Laboratory

International Nuclear Information System (INIS)

Khan, T.A.; Baum, J.W.

1993-01-01

In 1984 the Brookhaven National Laboratory was asked by the Nuclear Regulatory Commission to set up a Center to monitor dose-reduction efforts in the US and abroad and to focus the industry's attention on ALARA. The paper summarizes the main work of the ALARA Center between 1984 and 1992. The Center maintains nine data bases for the NRC and the Nuclear Power Industry. These databases are constantly updated and access to them is provided through a personal computer and a modem and by periodic publications in the form of a newsletter and NUREG reports. Also described briefly are eight other projects related to dose-reduction at nuclear power plants that the Center has carried out for the NRC. Among these are projects that analyze the cost-effectiveness of engineering modifications, look at worldwide activities at dose reduction and compare US and foreign dose experience, examine high-dose worker groups and high-dose jobs, develop optimum techniques to control contamination at nuclear plants, and look at the doses being received by men and women in all sectors of the nuclear industry

The Structure and Functioning of a Low-Budget Center for Applied Linguistics: The Brazilian Experience.

Science.gov (United States)

Gomes de Matos, Francisco

1980-01-01

Describes the structure and functioning of the "Centro de Linguistica Aplicada do Instituto de Idiomas Yazigi" of Sao Paulo and comments on its role in promoting applied linguistics studies in Latin America. Also outlines the Center's historical background and its educational services, particularly those related to the teaching of…

Electronically stimulated deep-center reactions in electron-irradiated InP: Comparison between experiment and recombination-enhancement theories

International Nuclear Information System (INIS)

Sibille, A.

1987-01-01

We present a detailed study of the recombination enhancement of several defect reactions involving the main deep centers in low-temperature electron-irradiated InP. A fairly good agreement is obtained with the Weeks-Tully-Kimerling theory for the activation energies of the enhanced process. On the other hand, a thorough investigation of a thermally and electronically stimulated defect transformation shows evidence that one major approximation (local vibrational equilibrium) fails, and that the recently proposed [H. Sumi, Phys. Rev. B 29, 4616 (1984)] mechanism of coherent recombination on deep centers is responsible for altered reaction rates at high injection levels

A 5-year retrospective analysis of Necrotizing fasciitis: A single center experiences

Directory of Open Access Journals (Sweden)

Kiralj Aleksandar I

2015-01-01

Full Text Available Background/Aim. Necrotizing fasciitis (NF is usually an acute infection of superficial fascia with rapid progression in around soft tissue. If not promptly recognized and aggressively treated NF usualy leads to sepsis and multiorgan failure with fatal outcome, thus early diagnosis and prompt surgical treatment are crucial for healing of these patients. The aim of this article was to evaluate the clinical presentation of all patients with acute NF diagnosed and treated in surgical clinics of Clinical Center of Vojvodina, Novi Sad, Serbia. Methods. The medical records of patients treated for acute NF localized on a different parts of the body in Clinical Center of Vojvodina, Novi Sad, Serbia, during a 5- year period (from January 2008 to December 2012 were retrospectively evaluated. This study enrolled patients admitted via Emergency Center of Vojvodina with the diagnosis of acute NF either as the primary diagnosis or with the diagnosis at discharge after surgical treatment. Results. During a 5-year period there were 216 patients with final diagnosis of acute NF. Most of our patients (140 - 64.81% were admitted with the initial diagnosis of cellulitis, abscesses, phlegmons or sepsis. Unfortunately, the clinical symptoms of acute NF were atypical at time of initial examination. Pain and swelling of the affected localization were the most presented bias of symptoms (183 - 84.72%. The majority of our patients were male (164 - 75.92%. Among the 216 patients, the most common pre-existing single factor was drug abuse (39 - 18.05%, followed by obesity (38 - 17.59% and diabetes mellitus (31 - 14.35%. Trauma was most common etiological factor (22 - 10.8% in infected wounds, followed by abdominal (15 - 6.94% and orthopedic (11 - 5.09% surgical intervention. In the present study idiopathic acute NF was diagnosed in 22 (10.18% patients and more than one etiological factor were diagnosed in 20 (9.25% patients. The majority of our patients had type I acute NF

The National Center for Biomedical Ontology: Advancing Biomedicinethrough Structured Organization of Scientific Knowledge

Energy Technology Data Exchange (ETDEWEB)

Rubin, Daniel L.; Lewis, Suzanna E.; Mungall, Chris J.; Misra,Sima; Westerfield, Monte; Ashburner, Michael; Sim, Ida; Chute,Christopher G.; Solbrig, Harold; Storey, Margaret-Anne; Smith, Barry; Day-Richter, John; Noy, Natalya F.; Musen, Mark A.

2006-01-23

The National Center for Biomedical Ontology (http://bioontology.org) is a consortium that comprises leading informaticians, biologists, clinicians, and ontologists funded by the NIH Roadmap to develop innovative technology and methods that allow scientists to record, manage, and disseminate biomedical information and knowledge in machine-processable form. The goals of the Center are: (1) to help unify the divergent and isolated efforts in ontology development by promoting high quality open-source, standards-based tools to create, manage, and use ontologies, (2) to create new software tools so that scientists can use ontologies to annotate and analyze biomedical data, (3) to provide a national resource for the ongoing evaluation, integration, and evolution of biomedical ontologies and associated tools and theories in the context of driving biomedical projects (DBPs), and (4) to disseminate the tools and resources of the Center and to identify, evaluate, and communicate best practices of ontology development to the biomedical community. The Center is working toward these objectives by providing tools to develop ontologies and to annotate experimental data, and by developing resources to integrate and relate existing ontologies as well as by creating repositories of biomedical data that are annotated using those ontologies. The Center is providing training workshops in ontology design, development, and usage, and is also pursuing research in ontology evaluation, quality, and use of ontologies to promote scientific discovery. Through the research activities within the Center, collaborations with the DBPs, and interactions with the biomedical community, our goal is to help scientists to work more effectively in the e-science paradigm, enhancing experiment design, experiment execution, data analysis, information synthesis, hypothesis generation and testing, and understand human disease.

Canadian ATLAS data center to support CERN's LHC

CERN Multimedia

2006-01-01

"The biggest science experiment in history is currently underway at the world-famous CERN labs in Switzerland, and Canada is poised to play a critical role in its success. Thanks to a $10.5 million investment announced by the Canada Foundation for Innovation (CFI), an ultra-sophisticated computing facility -- the ATLAS Data Center -- will be created to support the ATLAS project at CERN's Large Hadron Collider (LHC)." (1 page)

Patient Engagement in Community Health Center Leadership: How Does it Happen?

Science.gov (United States)

Sharma, Anjana E; Huang, Beatrice; Knox, Margae; Willard-Grace, Rachel; Potter, Michael B

2018-05-18

Patient engagement in primary care leadership is an important means to involve community voices at community health centers. Federally qualified health centers (FQHCs) are mandated to have patient representation within their governing boards, while practices seeking patient-centered medical home certification receive credit for implementing patient advisory councils (PACs). Our objective was to compare and contrast how community health centers engage patients in clinic management, decision-making and planning within governing boards versus PACs. Qualitative study conducted from August 2016 to June 2017 at community health centers in California, Arizona and Hawaii. We interviewed practice leaders of patient engagement programs at their site. Eligible clinics had patient representatives within their governing board, PAC, or both. We assessed patient demographics, roles and responsibilities of patients participating, and extent of involvement in quality improvement among governing boards versus PACs. We interviewed 19 sites, of which 17 were FQHCs that had governing boards. Of the 17 FQHCs, 11 had also implemented PACs. Two non-FQHC safety-net sites had PACs but did not have governing boards. Governing board members had formal, structured membership responsibilities such as finances and hiring personnel. PAC roles were more flexible, focusing on day-to-day clinic operations. Clinics tended to recruit governing board patient members for their skill set and professional experience; PAC member recruitment focused more on demographic representation of the clinic's patient population. Both groups worked on quality improvement, but governing boards tended to review clinic performance metrics, while PAC members were involved in specific project planning and implementation to improve clinical outcomes and patient experience. Patient involvement in clinic improvement in CHCs includes higher-level decision-making and governance through mechanisms such as governing boards, as

Annual report of nuclear technology and education center. April 1, 2002 - March 31, 2003

International Nuclear Information System (INIS)

2003-10-01

This report summarizes the activities of Nuclear Technology and Education Center (NuTEC) in Japan Atomic Energy Research Institute in FY 2002. It includes the domestic educational activities in Tokyo Education Center in Komagome Tokyo for RI and radiation engineers and Tokai Education Center in Tokai for nuclear engineers, and the international training activities for Asia-Pacific region which were planned and administrated by International Technology Transfer Division. The new course so called 'Introductory Course for the Use and the Experiment of Neutron' was started with good appreciation by the participants. All scheduled course plan in Tokyo Education Center and Tokai Education Center was accomplished and the total number of the trainee of both Center was 1,297. The courses for RI and radiation engineers implemented in Tokyo Education Center were closed in this FY and transferred to Tokai Establishment in next FY where the course will be integrated with the ones at Tokai Education Center. The land of Tokyo Education Center will be returned to land-owner by the end of FY 2003 after dismantlement of the facilities. The equipments and instruments used in Tokyo Education Center were transferred to Tokai Education Center after finishing all courses in Tokyo in this FY. The improvement and re-arrangement of the facilities in Tokyo Education Center were proceeded to prepare the courses from Tokyo Education Center. (author)

Electrodynamic Dust Shield for Lunar/ISS Experiment

Data.gov (United States)

National Aeronautics and Space Administration — The Electrostatics and Surface Physics Laboratory at Kennedy Space Center is developing a dust mitigation experiment and testing it on the lunar surface and on the...

The Zeus Copper/Uranium Critical Experiment at NCERC

International Nuclear Information System (INIS)

Sanchez, Rene G.; Hayes, David K.; Bounds, John Alan; Jackman, Kevin R.; Goda, Joetta M.

2012-01-01

A critical experiment was performed to provide nuclear data in a non-thermal neutron spectrum and to reestablish experimental capability relevant to Stockpile Stewardship and Technical Nuclear Forensic programs. Irradiation foils were placed at specific locations in the Zeus all oralloy critical experiment to obtain fission ratios. These ratios were compared with others from other critical assemblies to assess the degree of softness in the neutron spectrum. This critical experiment was performed at the National Criticality Experiments Research Center (NCERC) in Nevada.

Aortic Root Surgery in Marfan Syndrome: Medium-Term Outcome in a Single-Center Experience.

Science.gov (United States)

Attenhofer Jost, Christine H; Connolly, Heidi M; Scott, Christopher G; Ammash, Naser M; Bowen, Juan M; Schaff, Hartzell V

2017-01-01

The study aim was to analyze the authors' experience with aortic root surgery in Marfan syndrome (MFS), and to expand the surgical outcome data of patients meeting the Ghent criteria (Marfan registry). Analyses were performed of data acquired from MFS patients (who met the Ghent criteria), including an aortic root surgery and Kaplan-Meier survival. Between April 2004 and February 2012, a total of 59 MFS patients (mean age at surgery 36 ± 13 years) underwent 67 operations for aortic root aneurysm (n = 52), aortic valve (AV) regurgitation (n = 15), acute aortic dissection (n = 2), and/or mitral valve (MV) regurgitation resulting from MV prolapse (n = 7). Of 59 initial operations, 21 (36%) involved AV-replacing root surgery, 38 (64%) AV-sparing root surgery, seven (12%) aortic arch or hemi-arch repair, and five (8%) simultaneous MV surgery. There were no early mortalities. The mean follow up was 6.8 ± 1.2 years, with five deaths (8%) and a relatively low reoperation rate (10 reoperations in nine patients; 14%). Seven reoperations involved AV or aortic root surgery (including four for AV regurgitation following failed AV-sparing surgery), two MV repair/replacements, and one coronary artery bypass graft. Eight patients (21%) with AV-sparing surgery had moderate/severe AV regurgitation at the last follow up before re-intervention. The mean five-year freedom from postoperative death was 91.2 ± 8.8%, from cardiac reoperation 86.3 ± 4.5%, and more-than-moderate AV regurgitation 90.3 ± 4.8%. Prophylactic aortic surgery in MFS patients with AV-replacing root or AV-sparing root surgery carries a low risk of operative morbidity and death when performed at an experienced center. AV-sparing root surgery increases the risk of AV regurgitation and, possibly, of re-intervention. Regular clinical follow up is important after any aortic root surgery in MFS patients, with a delineation of risk factors for AV regurgitation after AV rootsparing surgery.

Factors affecting successful colonoscopy procedures: Single-center experience.

Science.gov (United States)

Kozan, Ramazan; Yılmaz, Tonguç Utku; Baştuğral, Uygar; Kerimoğlu, Umut; Yavuz, Yücel

2018-01-01

Colonoscopy is a gold standard procedure for several colon pathologies. Successful colonoscopy means demonstration of the ileocecal valve and determination of colon polyps. Here we aimed to evaluate our colonoscopy success and results. This retrospective descriptive study was performed in İstanbul Eren hospital endoscopy unit between 2012 and 2015. Colonoscopy results and patient demographics were obtained from the hospital database. All colonoscopy procedures were performed under general anesthesia and after full bowel preparation. In all, 870 patients were included to the study. We reached to the cecum in 850 (97.8%) patients. We were unable to reach the cecum in patients who were old and obese and those with previous lower abdominal operations. Angulation, inability to move forward, and tortuous colon were the reasons for inability to reach the cecum. Total 203 polyp samplings were performed in 139 patients. We performed 1, 2, and 3 polypectomies in 97, 28, and 10 patients, respectively. There were 29 (3.3%) colorectal cancers in our series. There was no mortality or morbidity in our study. General anesthesia and full bowel preparation may be the reason for increased success of colonoscopy. Increased experience and patient-endoscopist cooperation increased the rate of cecum access and polyp resection and decreased the complication rate.

International telepathology consultation: Three years of experience between the University of Pittsburgh Medical Center and KingMed Diagnostics in China

Directory of Open Access Journals (Sweden)

Chengquan Zhao

2015-01-01

Full Text Available Background: Telepathology is increasingly being employed to support diagnostic consultation services. Prior publications have addressed technology aspects for telepathology, whereas this paper will address the clinical telepathology experience of KingMed Diagnostics, the largest independent pathology medical laboratory in China. Beginning in 2012 the University of Pittsburgh Medical Center (UPMC and KingMed Diagnostics partnered to establish an international telepathology consultation service. Materials and Methods: This is a retrospective study that summarizes the telepathology experience and diagnostic consultation results between UPMC and KingMed over a period of 3 years from January 2012 to December 2014. Results: A total of 1561 cases were submitted for telepathology consultation including 144 cases in 2012, 614 cases in 2013, and 803 in 2014. Most of the cases (61.4% submitted were referred by pathologists, 36.9% by clinicians, and 1.7% by patients in China. Hematopathology received the most cases (23.7%, followed by bone/soft tissue (21.0% and gynecologic/breast (20.2% subspecialties. Average turnaround time (TAT per case was 5.4 days, which decreased from 6.8 days in 2012 to 5.0 days in 2014. Immunostains were required for most of the cases. For some difficult cases, more than one round of immunostains was needed, which extended the TAT. Among 855 cases (54.7% where a primary diagnosis or impression was provided by the referring local hospitals in China, the final diagnoses rendered by UPMC pathologists were identical in 25.6% of cases and significantly modified (treatment plan altered in 50.8% of cases. Conclusion: These results indicate that international telepathology consultation can significantly improve patient care by facilitating access to pathology expertise. The success of this international digital consultation service was dependent on strong commitment and support from leadership, information technology expertise, and

Nature sunlight bleaching of Ti center ESR signal in quartz

International Nuclear Information System (INIS)

Yin Gongming; Liu Chunru; Li Jianping; Fang Jiahu; Gao Lu; Lin Min

2009-01-01

Quartz grains were extracted from granite. Bleaching was carried out in four different area chosen for their different altitudes (Beijing, Yinchuan, Germu, Lhasa), in order to observe their behavior under different intensities of the UV (Ultra violet) component of sunlight. The result of our experiments indicate that the Ti center signal is totally bleachable by the natural sunlight and show that the Ti center signal was reduced to zero after about 128 h in Beijing and after 56 h for Lhasa. We can speculate that different intensity of the UV component of sunlight lead to different minimal time necessary to obtain the total bleaching of the quartz sample. (authors)

Stephenson Cancer Center

Science.gov (United States)

Stephenson Cancer Center at the University of Oklahoma in Oklahoma City is an NCI-designated cancer center at the forefront of NCI-supported cancer research. Learn more about the Stephenson Cancer Center's mission.

Lionfish string experiences of an inland poison center: a retrospective study of 23 cases.

Science.gov (United States)

Trestrail, J H; al-Mahasneh, Q M

1989-04-01

From January 1979 through March 1988, our regional poison center, located many hundreds of miles from the nearest coastal salt water, documented 23 cases of envenomation by "Lionfish" (members of genus Pterois). All cases involved specimens which were maintained in the homes of amateur aquarists. A study of patient epidemiology showed the following: patient's sex 91.3% male, 8.7% female; patients ages ranged from 17 to 50 years with an average age for males of 29.8 years and 35 years for females; the site of the envenomation accident was always in the home; the only part of the body envenomated was the hand or finger; and all of the patients were symptomatic. Symptoms noted included sharp pain, swelling, redness, bleeding, nausea, numbness, joint pain, anxiety, headache, disorientation, and dizziness. One patient had a complication of cellulitis. Treatment provided included immersion of the effected area in hot water at 40 C for 60 to 90 min, analgesics, tetanus toxoid, and antibiotics. There were no deaths noted and treatment proved effective in all cases. This paper also discusses the natural history, clinical effects, and current treatment for envenomations from these beautiful but dangerous venomous fish, which can cause poisoning exposures that are likely to be encountered by poison centers anywhere in the world.

Management of Placenta Invasion Anomaly and Cesarean Hysterectomy: Eight-year Experience of A Tertiary Center

Directory of Open Access Journals (Sweden)

İbrahim Kalelioğllu

2013-09-01

Full Text Available Objective: We aimed to present our experience with the management of placenta invasion anomaly by reviewing clinical and operative features of the cases of cesarean hysterectomy performed due to placenta invasion anomaly. Methods: In this retropective study, the charts of all patients who underwent cesarean hysterectomy with an indication of placenta invasion anomaly in Istanbul Faculty of Medicine Department of Obstetrics and Gynecology between 2005 and 2012 were reviewed. Results: In this period a total of 85 patients underwent cesarean hysterectomy. 81 (95.3% cases had experienced at least one cesarean delivery before. Majority of the operations (82.4% were performed in elective conditions. In 16 (18.8% cases bilateral hypogastric artery ligation was carried out because of profuse bleeding. There were no mortalities in the intra- or postoperative period. In 18 (21.2% cases, intraoperative urology consultation was needed. Full- thickness bladder laceration occured in 17 patients, and partial cyctectomy was performed in one patient due to the placenta percreata invading posterior wall of the bladder. Transfusion was needed in 72 (84.7% cases during and 50 (58.8% patients after operation. Dilutional trombocytopenia developed in 17 (20% patients due to massive transfusion. Histopathologically the diganosis was placenta accreata in 55 (64.7%, placenta increata in 1 (1.2% and placenta percreata in 25 (29.4% patients. The incidence of placenta invasion anomaly rose from 0.2% (7/3435 in 2005-2006 up to 0.8% (37/4344 in 2011-2012. Conclusion: The incidence of placenta invasion anomaly is increasing progressively. Cesarean hysterectomy being its classical treatment is an operation with a high risk of morbidity and it should be performed by experienced teams after appropriate preparations in tertiary centers where multidiciplinary approach is possible.

Image-guided cryoablation for the treatment of painful musculoskeletal metastatic disease: a single-center experience

Energy Technology Data Exchange (ETDEWEB)

Prologo, J.D. [Emory University Hospital, Department of Radiology and Imaging Sciences, Division of Interventional Radiology and Image-Guided Medicine, Atlanta, GA (United States); Passalacqua, Matthew; Patel, Indravadan; Bohnert, Nathan [University Hospitals Case Medical Center, Department of Radiology, Cleveland, OH (United States); Corn, David J. [University Hospitals Case Medical Center, Departments of Radiology and Biomedical Engineering, Cleveland, OH (United States)

2014-11-15

The role of image-guided thermal ablation techniques for the nonoperative local management of painful osseous metastatic disease has expanded during recent years, and several advantages of cryoablation in this setting have emerged. The purpose of this study is to retrospectively evaluate and report a single-center experience of CT-guided percutaneous cryoablation in the setting of painful musculoskeletal metastatic disease. This study was approved by the institutional review board and is compliant with the Health Insurance Portability and Accountability Act. Electronic medical records of all patients who underwent percutaneous image-guided palliative cryoablation at our institution were reviewed (n = 61). An intent-to-treat analysis was performed. Records were reviewed for demographic data and anatomical data, primary tumor type, procedure details, and outcome - including change in analgesic requirements (expressed as morphine equivalent dosages), pain scores (utilizing the clinically implemented visual analog scale), subsequent therapies (including radiation and/or surgery), and complications during the 24 h following the procedure and at 3 months. Patients were excluded (n = 7) if data were not retrospectively identifiable at the defined time points. Fifty-four tumors were ablated in 50 patients. There were statistically significant decreases in the median VAS score and narcotic usage at both 24 h and 3 months (p < 0.000). Six patients (11 %) incurred complications related to their therapy. Two patients had no relief at 24 h, of which both reported worsened pain at 3 months. One patient had initial relief but symptom recurrence at 3 months. Four patients went on to have radiation therapy of the ablation site at some point following the procedure. CT-guided cryoablation is a safe, effective, reproducible procedural option for the nonoperative local treatment of painful musculoskeletal metastatic disease. (orig.)

HydroSoft coil versus HydroCoil for endovascular aneurysm occlusion study: A single center experience

International Nuclear Information System (INIS)

Guo Xinbin; Fan Yimu; Zhang Jianning

2011-01-01

Background and purpose: The HydroCoil Embolic System (HES) was developed to reduce recurrences of aneurysms relative to platinum coils. But the HydroCoil Embolic System was characterized with many limitations. The manufacturer had recognized the challenge and recently a new design of hydrogel-coated coil-HydroSoft has become available in the market as the new generation HydroCoil. We reported our initial experience using HydroSoft coil versus HydroCoil in our center. Methods: 75 aneurysms embolized primarily using HydroSoft Coils from July 2008 to May 2009 were compared with 66 volume- and shape-matched aneurysms treated with HydroCoils from March 2006 to August 2008. Outcome measures included length and number of coils used, contrast volume, and length of hospital stay. During embolization, a stable framework was first established with bare coils, and hydrogel-coated coils were used subsequently to increase the packing density. Follow-up angiographic results 6 months after treatment were evaluated among some of the patients. Results: Successful coil embolization was achieved in all patients. There were no differences in average total coil length used per aneurysm. There were no differences in length of hospital stay and packing density. HydroSoft coils were more suitable using as the finishing or final coil. HydroSoft coil decreased the procedure-related retreated rates, and aneurysm packing was finished with soft, flexible HydroSoft coil and decreased the neck remnant rates. Follow-up angiography in HydroSoft-treated patients at 6 months revealed aneurysm stability without significant residual neck. Conclusions: HydroSoft coil allowed us to deploy coated coils with good packing density. A slight expansion of these coils at the neck can be expected to reduce neck remnant and potentially inhibit recurrence.

Image-guided cryoablation for the treatment of painful musculoskeletal metastatic disease: a single-center experience

International Nuclear Information System (INIS)

Prologo, J.D.; Passalacqua, Matthew; Patel, Indravadan; Bohnert, Nathan; Corn, David J.

2014-01-01

The role of image-guided thermal ablation techniques for the nonoperative local management of painful osseous metastatic disease has expanded during recent years, and several advantages of cryoablation in this setting have emerged. The purpose of this study is to retrospectively evaluate and report a single-center experience of CT-guided percutaneous cryoablation in the setting of painful musculoskeletal metastatic disease. This study was approved by the institutional review board and is compliant with the Health Insurance Portability and Accountability Act. Electronic medical records of all patients who underwent percutaneous image-guided palliative cryoablation at our institution were reviewed (n = 61). An intent-to-treat analysis was performed. Records were reviewed for demographic data and anatomical data, primary tumor type, procedure details, and outcome - including change in analgesic requirements (expressed as morphine equivalent dosages), pain scores (utilizing the clinically implemented visual analog scale), subsequent therapies (including radiation and/or surgery), and complications during the 24 h following the procedure and at 3 months. Patients were excluded (n = 7) if data were not retrospectively identifiable at the defined time points. Fifty-four tumors were ablated in 50 patients. There were statistically significant decreases in the median VAS score and narcotic usage at both 24 h and 3 months (p < 0.000). Six patients (11 %) incurred complications related to their therapy. Two patients had no relief at 24 h, of which both reported worsened pain at 3 months. One patient had initial relief but symptom recurrence at 3 months. Four patients went on to have radiation therapy of the ablation site at some point following the procedure. CT-guided cryoablation is a safe, effective, reproducible procedural option for the nonoperative local treatment of painful musculoskeletal metastatic disease. (orig.)

A cross-case analysis of three Native Science Field Centers

Science.gov (United States)

Augare, Helen J.; Davíd-Chavez, Dominique M.; Groenke, Frederick I.; Little Plume-Weatherwax, Melissa; Lone Fight, Lisa; Meier, Gene; Quiver-Gaddie, Helene; Returns From Scout, Elvin; Sachatello-Sawyer, Bonnie; St. Pierre, Nate; Valdez, Shelly; Wippert, Rachel

2017-06-01

Native Science Field Centers (NSFCs) were created to engage youth and adults in environmental science activities through the integration of traditional Native ways of knowing (understanding about the natural world based on centuries of observation including philosophy, worldview, cosmology, and belief systems of Indigenous peoples), Native languages, and Western science concepts. This paper focuses on the Blackfeet Native Science Field Center, the Lakota Native Science Field Center, and the Wind River Native Science Field Center. One of the long-term, overarching goals of these NSFCs was to stimulate the interest of Native American students in ways that encouraged them to pursue academic and career paths in science, technology, engineering, and mathematics (STEM) fields. A great deal can be learned from the experiences of the NSFCs in terms of effective educational strategies, as well as advantages and challenges in blending Native ways of knowing and Western scientific knowledge in an informal science education setting. Hopa Mountain—a Bozeman, Montana-based nonprofit—partnered with the Blackfeet Community College on the Blackfeet Reservation, Fremont County School District #21 on the Wind River Reservation, and Oglala Lakota College on the Pine Ridge Reservation to cooperatively establish the Native Science Field Centers. This paper presents a profile of each NSFC and highlights their program components and accomplishments.

Epidemiology and management of chronic thromboembolic pulmonary hypertension: experience from two expert centers

Directory of Open Access Journals (Sweden)

Maria Anna Bazmpani

2018-01-01

Full Text Available Objectives: Chronic thromboembolic pulmonary hypertension (CTEPH is a rare, distinct pulmonary vascular disease, and therefore, there is a lack of data regarding its clinical presentation, diagnosis, and management at a national basis. We aimed to describe the demographics and management of patients with CTEPH in Northern Greece. Methods: We conducted a retrospective, observational study by a joint collaboration between two pulmonary hypertension expert centers in Greece, and the study included patients diagnosed with CTEPH. The patient population was divided into two groups depending on their operability. Results: Overall, 27 consecutive patients were included (59% female, mean age 59.3±15.1 years. Dyspnea and fatigue were the most common presenting symptoms. History of pulmonary embolism was present in 82%. Of patients, 18 (67% were assessed as operable, of whom 10 (55% finally underwent pulmonary endarterectomy (PEA. There were no differences in symptoms, WHO functional class, 6-min walking test distance, and hemodynamics between the operable and nonoperable groups. At the end of follow-up, all non-operable and operable patients who did not receive surgical treatment were treated with at least one pulmonary hypertension-specific drug. Conclusion: This is the first report that presents data of patients diagnosed with CTEPH in Greece. The percentage of patients who underwent surgical treatment is lower but approaches the reported rates in large registries. Considering that PEA is a relatively safe and potentially curative surgical procedure, we emphasize the need for establishing a designated PEA center in Greece. Keywords: Chronic thromboembolic pulmonary hypertension, pulmonary endarterectomy, registry, riociguat

Experiences in the management of plutonium-containing solid-wastes at the Nuclear Research Center Karlsruhe

International Nuclear Information System (INIS)

Baehr, W.; Hild, W.; Scheffler, K.

1974-10-01

Solid-plutonium-containing wastes from a fuel production plant, a reprocessing plant and several research laboratories are treated at the decontamination department of the Karlsruhe Nuclear Research Center for disposal in the Asse salt mine. Conditioning as well as future aspects in α-waste management are the subject of this Paper. (orig.) [de

Preventing traumatic childbirth experiences: 2192 women's perceptions and views

NARCIS (Netherlands)

Hollander, M.H.; Hastenberg, E. van; Dillen, J. van; Pampus, M.G. van; Miranda, E. de; Stramrood, C.A.I.

2017-01-01

The purpose of this study is to explore and quantify perceptions and experiences of women with a traumatic childbirth experience in order to identify areas for prevention and to help midwives and obstetricians improve woman-centered care. A retrospective survey was conducted online among 2192 women

An office or a bedroom? Challenges for family-centered care in the pediatric intensive care unit.

Science.gov (United States)

Macdonald, Mary Ellen; Liben, Stephen; Carnevale, Franco A; Cohen, S Robin

2012-09-01

Although the modern pediatric intensive care unit (PICU) has followed general pediatrics and adopted the family-centered care model, little is known about how families prospectively experience PICU care. The authors' goal was to better understand the experiences of families whose child was hospitalized in a PICU. They conducted a 12-month prospective ethnographic study in a PICU in a tertiary care hospital in a large North American urban center. Data were obtained via participant-observation and formal and informal interviews with 18 families and staff key informants. Findings revealed a disconnect between the espoused model of family-centered care and quotidian professional practices. This divergence emerged in the authors' analysis as a heuristic that contrasts a professional "office" to a sick child's "bedroom." PICU practices and protocols transformed the child into a patient and parents into visitors; issues such as noise, visitation, turf, and privacy could favor staff comfort and convenience over that of the child and family. The authors' discussion highlights suggestions to overcome this divergence in order to truly make the PICU family centered.

Far infrared observations of the galactic center

International Nuclear Information System (INIS)

Gatley, I.

1977-01-01

Maps of a region 10' in diameter around the galactic center made simultaneously in three wavelength bands at 30 μm, 50 μm, and 100 μm with approximately 1' resolution are presented, and the distribution of far infrared luminosity and color temperature across this region is derived. The position of highest far infrared surface brightness coincides with the peak of the late-type stellar distribution and with the H II region Sgr A West. The high spatial and temperature resolution of the data is used to identify features of the far infrared maps with known sources of near infrared, radio continuum, and molecular emission. The emission mechanism and energy sources for the far infrared radiation are anslyzed qualitatively, and it is concluded that all of the observed far infrared radiation from the galactic center region can be attributed to thermal emission from dust heated both by the late-type stars and by the ultraviolet sources which ionize the H II regions. A self-consistent model for the far infrared emission from the galactic center region is presented. It is found that the visual extinction across the central 10 pc of the galaxy is only about 3 magnitudes, and that the dust density is fairly uniform in this region. An upper limit of 10 7 L/sub mass/ is set on the luminosity of any presently unidentified source of 0.1 to 1 μm radiation at the galactic center. Additional maps in the vicinity of the source Sgr B2 and observations of Sgr C bring the total number of H II regions within 1 0 of the galactic center studied by the present experiment to nine. The far infrared luminosity, color temperature and optical depth of these regions and the ratio of infrared flux to radio continuum flux lie in the range characteristic of spiral arm H II regions. The far infrared results are therefore consistent with the data that the galactic center H II regions are ionized by luminous, early type stars

Male victims of sexual assault; 10 years' experience from a Danish Assault Center

DEFF Research Database (Denmark)

Larsen, Mie-Louise; Hilden, Malene

2016-01-01

This study aims to provide descriptive data regarding male victims of sexual assault seen at the Centre for Victims of Sexual Assault in Copenhagen, Denmark. All 55 male victims attending the center in the time period of March 2001 until December 2010 underwent a standardized data collection. Data...... by another man is considered a taboo subject and it is likely that the dark figure of men exposed to sexual assault is much higher than it is for women. Strengthening our knowledge regarding male victims of sexual assault is necessary to improve both primary and secondary preventive measures in order to make...

Engineer Research and Development Center's Materials Testing Center (MTC)

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Federal Laboratory Consortium — The Engineer Research and Development Center's Materials Testing Center (MTC) is committed to quality testing and inspection services that are delivered on time and...

Perilaku Kreatif Pekerja Call Center: Peran Komunikasi dan Dukungan Training Center

Directory of Open Access Journals (Sweden)

Nugroho J. Setiadi

2013-11-01

Full Text Available Call center business in Indonesia is growing rapidly worldwide. This condition has had repercussions for a growing number of call center workers needed. They are forced to be more creative in performing their duties. This study aims to determine the role of communication and training center in supporting the creative performance of workers in call centers. The survey was conducted by distributing questionnaires to 100 respondents (employees of the 3 major companies in the field of telecommunication services in Indonesia. Regression analysis was used to analyze the data to examine the role of communication and training support center on creative performance. The results indicated that communication and training support center significantly influence the creative behavior in call center workers. Communication quality shown in the telecommunication service provider companies, such as the media quality, simplicity of information, dissemination of information, loads of information, and accuracy of messages, has shown good quality. In addition, the training program has shown its support for call center workers in the form of program effectiveness through research and data collection, determining the materials, training methods, choosing a coach, preparing facilities, selecting and implementing the program.

Trauma Center Staffing, Infrastructure, and Patient Characteristics that Influence Trauma Center Need

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Faul, Mark

2014-11-01

Full Text Available Introduction: The most effective use of trauma center resources helps reduce morbidity and mortality, while saving costs. Identifying critical infrastructure characteristics, patient characteristics and staffing components of a trauma center associated with the proportion of patients needing major trauma care will help planners create better systems for patient care.   Methods: We used the 2009 National Trauma Data Bank-Research Dataset to determine the proportion of critically injured patients requiring the resources of a trauma center within each Level I-IV trauma center (n=443. The outcome variable was defined as the portion of treated patients who were critically injured. We defined the need for critical trauma resources and interventions (“trauma center need” as death prior to hospital discharge, admission to the intensive care unit, or admission to the operating room from the emergency department as a result of acute traumatic injury. Generalized Linear Modeling (GLM was used to determine how hospital infrastructure, staffing Levels, and patient characteristics contributed to trauma center need.     Results: Nonprofit Level I and II trauma centers were significantly associated with higher levels of trauma center need. Trauma centers that had a higher percentage of transferred patients or a lower percentage of insured patients were associated with a higher proportion of trauma center need.  Hospital infrastructure characteristics, such as bed capacity and intensive care unit capacity, were not associated with trauma center need. A GLM for Level III and IV trauma centers showed that the number of trauma surgeons on staff was associated with trauma center need. Conclusion: Because the proportion of trauma center need is predominantly influenced by hospital type, transfer frequency, and insurance status, it is important for administrators to consider patient population characteristics of the catchment area when planning the

Cerebral angioplasty practice at major medical centers in the United States

International Nuclear Information System (INIS)

Chaturvedi, S.; St Pierre, M.E.; Bertasio, B.

2000-01-01

Concern has been expressed recently regarding the proliferation of angioplasty and/or stenting of cerebral vessels. However, little is known about the volume of angioplasties being performed or the number of experienced interventionalists. A questionnaire was mailed to directors of accredited radiology residency programs in the United States, to define the level of expertise available at teaching hospitals in terms of angioplasty and/or stenting. Of 200 programs surveyed, 111 responded (56 %). Of 111 program directors 47 (42 %) indicated that cerebral angioplasty was being performed at their center. The greatest experience is currently for angioplasty of post-subarachnoid hemorrhage vasospasm (mean 16 procedures performed) and the least experience for dilation of basilar artery atherosclerosis (mean five procedures performed). The reported stroke and/or death rate in centers performing angioplasty of the extracranial carotid system is 1.5 %. Comparisons with other medical specialties (e. g., cardiologists, neurologists, neurosurgeons) are necessary to determine the full scope of extracranial neurovascular procedures being performed and the corresponding complication rates. (orig.)

User-centered design

International Nuclear Information System (INIS)

Baik, Joo Hyun; Kim, Hyeong Heon

2008-01-01

The simplification philosophy, as an example, that both of EPRI-URD and EUR emphasize is treated mostly for the cost reduction of the nuclear power plants, but not for the simplification of the structure of user's tasks, which is one of the principles of user-centered design. A user-centered design is a philosophy based on the needs and interests of the user, with an emphasis on making products usable and understandable. However, the nuclear power plants offered these days by which the predominant reactor vendors are hardly user-centered but still designer-centered or technology-centered in viewpoint of fulfilling user requirements. The main goal of user-centered design is that user requirements are elicited correctly, reflected properly into the system requirements, and verified thoroughly by the tests. Starting from the user requirements throughout to the final test, each requirement should be traceable. That's why requirement traceability is a key to the user-centered design, and main theme of a requirement management program, which is suggested to be added into EPRI-URD and EUR in the section of Design Process. (author)

Online Digital Archives Technology That Supports Rich, Student-Centered Learning Experiences

Science.gov (United States)

Hofer, Mark

2004-01-01

Today's students watch the newest movie trailers on the Web, share music files, play video games with other players over the Internet, and swap digital pictures of the latest teen idols. Donald Tapscott points out in his book Growing Up Digital that as this rich multimedia experience becomes more a part of students' lives outside of school, they…

Transportable Payload Operations Control Center reusable software: Building blocks for quality ground data systems

Science.gov (United States)

Mahmot, Ron; Koslosky, John T.; Beach, Edward; Schwarz, Barbara

1994-01-01

The Mission Operations Division (MOD) at Goddard Space Flight Center builds Mission Operations Centers which are used by Flight Operations Teams to monitor and control satellites. Reducing system life cycle costs through software reuse has always been a priority of the MOD. The MOD's Transportable Payload Operations Control Center development team established an extensive library of 14 subsystems with over 100,000 delivered source instructions of reusable, generic software components. Nine TPOCC-based control centers to date support 11 satellites and achieved an average software reuse level of more than 75 percent. This paper shares experiences of how the TPOCC building blocks were developed and how building block developer's, mission development teams, and users are all part of the process.

WE-G-BRE-07: Proton Therapy Enhanced by Tumor-Targeting Gold Nanoparticles: A Pilot in Vivo Experiment at The Proton Therapy Center at MD Anderson Cancer Center

Energy Technology Data Exchange (ETDEWEB)

Wolfe, T; Grant, J; Wolfe, A; Gillin, M; Krishnan, S [MD Anderson Cancer Ctr., Houston, TX (United States)

2014-06-15

Purpose: Assess tumor-growth delay and survival in a mouse model of prostate cancer treated with tumor-targeting gold nanoparticles (AuNPs) and proton therapy. Methods: We first examined the accumulation of targeting nanoparticles within prostate tumors by imaging AuNPs with ultrasound-guided photoacoustics at 24h after the intravenous administration of goserelin-conjugated AuNPs (gAuNP) in three mice. Nanoparticles were also imaged at the cellular level with TEM in PC3 cells incubated with gAuNP for 24h. Pegylated AuNPs (pAuNP) were also imaged in vivo and in vitro for comparison. PC3 cells were then implanted subcutaneously in nude mice; 51mice with 8–10mm tumors were included. AuNPs were injected intravenously at 0.2%w/w final gold concentration 24h before irradiation. A special jig was designed to facilitate tumor irradiation perpendicular to the proton beam. Proton energy was set to 180MeV, the radiation field was 18×18cm{sup 2}, and 9cm or 13.5cm thick solid-water compensators were used to position the tumors at either the beam entrance (BE) or the SOBP. Physical doses of 5Gy were delivered to all tumors on a patient beam line at MD Anderson's Proton Therapy Center. Results: The photoacoustic experiment reveled that our nanoparticles leak from the tumor-feeding vasculature and accumulate within the tumor volume over time. Additionally, TEM images showed gAuNP are internalized in cancer cells, accumulating within the cytoplasm, whereas pAuNP are not. Tumor-growth was delayed by 11 or 32days in mice receiving gAuNP irradiated at the BE or the SOBP, relative to proton radiation alone. Survival curves (ongoing experiment) reveal that gAuNPs improved survival by 36% or 74% for tumors irradiated at the BE or SOBP. Conclusion: These important, albeit preliminary, in vivo findings reveal nanoparticles to be potent sensitizers to proton therapy. Further, conjugation of AuNPs to tumor-specific antigens that promote enhanced cellular internalization improved

Analysis of the learning curve for peroral endoscopic myotomy for esophageal achalasia: Single-center, two-operator experience.

Science.gov (United States)

Lv, Houning; Zhao, Ningning; Zheng, Zhongqing; Wang, Tao; Yang, Fang; Jiang, Xihui; Lin, Lin; Sun, Chao; Wang, Bangmao

2017-05-01

Peroral endoscopic myotomy (POEM) has emerged as an advanced technique for the treatment of achalasia, and defining the learning curve is mandatory. From August 2011 to June 2014, two operators in our institution (A&B) carried out POEM on 35 and 33 consecutive patients, respectively. Moving average and cumulative sum (CUSUM) methods were used to analyze the POEM learning curve for corrected operative time (cOT), referring to duration of per centimeter myotomy. Additionally, perioperative outcomes were compared among distinct learning curve phases. Using the moving average method, cOT reached a plateau at the 29th case and at the 24th case for operators A and B, respectively. CUSUM analysis identified three phases: initial learning period (Phase 1), efficiency period (Phase 2) and mastery period (Phase 3). The relatively smooth state in the CUSUM graph occurred at the 26th case and at the 24th case for operators A and B, respectively. Mean cOT of distinct phases for operator A were 8.32, 5.20 and 3.97 min, whereas they were 5.99, 3.06 and 3.75 min for operator B, respectively. Eckardt score and lower esophageal sphincter pressure significantly decreased during the 1-year follow-up period. Data were comparable regarding patient characteristics and perioperative outcomes. This single-center study demonstrated that expert endoscopists with experience in esophageal endoscopic submucosal dissection reached a plateau in learning of POEM after approximately 25 cases. © 2016 Japan Gastroenterological Endoscopy Society.

Technical and clinical success of infrarenal endovascular abdominal aortic aneurysm repair: A 10-year single-center experience

International Nuclear Information System (INIS)

Steingruber, I.E.; Neuhauser, B.; Seiler, R.; Greiner, A.; Chemelli, A.; Kopf, H.; Walch, C.; Waldenberger, P.; Jaschke, W.; Czermak, B.

2006-01-01

Objective: The aim of our retrospective study was to review our single-center experience with aortic abdominal aneurysm (AAA) repair retrospectively. Material and methods: From 1995 to 2005, 70 consecutive patients affected by AAA were treated by endovascular stent-graft repair. Mean follow-up was 23.9 months. Follow-up investigations were performed at 6 and 12 months and yearly thereafter. Five different stent-graft designs were compared to each other. Primary technical success (PTS), assisted primary technical success (APTS), primary clinical success (PCS) and secondary clinical success (SCS) were evaluated. Results: All over PTS was achieved in 94.3%, APTS in 97.1%, PCS in 61.4%, APCS in 64.3% and SCS in 70%. There were 3 type I endoleaks, 25 type II endoleaks, 4 type III endoleaks, 8 limb problems, 5 conversions to open surgery, 10 aneurysm sac expansions and 14 device migrations. Patients with newer generation devices showed better results than patients with first generation prosthesis. In addition results were better for grafts with suprarenal fixation (versus infrarenal fixation) and grafts with barbs and hooks (versus grafts without barbs and hooks). Patients with bad anatomic preconditions showed a higher complication rate. Conclusion: Contrary to first generation products, new stent-graft designs show acceptable technical and clinical results in endovascular AAA aneurysm repair. However, this therapy still should be reserved only for patients with significant comorbities and suitable anatomic conditions

Technical and clinical success of infrarenal endovascular abdominal aortic aneurysm repair: A 10-year single-center experience

Energy Technology Data Exchange (ETDEWEB)

Steingruber, I.E. [Department of Radiology, University Hospital Innsbruck, Anichstr. 35, A-6020 Innsbruck (Austria)]. E-mail: iris.steingruber@uibk.ac.at; Neuhauser, B. [Department of Vascular Surgery, University Hospital Innsbruck, Anichstr. 35, A-6020 Innsbruck (Austria); Seiler, R. [Department of Vascular Surgery, University Hospital Innsbruck, Anichstr. 35, A-6020 Innsbruck (Austria); Greiner, A. [Department of Vascular Surgery, University Hospital Innsbruck, Anichstr. 35, A-6020 Innsbruck (Austria); Chemelli, A. [Department of Radiology, University Hospital Innsbruck, Anichstr. 35, A-6020 Innsbruck (Austria); Kopf, H. [Department of Radiology, University Hospital Innsbruck, Anichstr. 35, A-6020 Innsbruck (Austria); Walch, C. [Department of Radiology, University Hospital Innsbruck, Anichstr. 35, A-6020 Innsbruck (Austria); Waldenberger, P. [Department of Radiology, University Hospital Innsbruck, Anichstr. 35, A-6020 Innsbruck (Austria); Jaschke, W. [Department of Radiology, University Hospital Innsbruck, Anichstr. 35, A-6020 Innsbruck (Austria); Czermak, B. [Department of Radiology, University Hospital Innsbruck, Anichstr. 35, A-6020 Innsbruck (Austria)

2006-09-15

Objective: The aim of our retrospective study was to review our single-center experience with aortic abdominal aneurysm (AAA) repair retrospectively. Material and methods: From 1995 to 2005, 70 consecutive patients affected by AAA were treated by endovascular stent-graft repair. Mean follow-up was 23.9 months. Follow-up investigations were performed at 6 and 12 months and yearly thereafter. Five different stent-graft designs were compared to each other. Primary technical success (PTS), assisted primary technical success (APTS), primary clinical success (PCS) and secondary clinical success (SCS) were evaluated. Results: All over PTS was achieved in 94.3%, APTS in 97.1%, PCS in 61.4%, APCS in 64.3% and SCS in 70%. There were 3 type I endoleaks, 25 type II endoleaks, 4 type III endoleaks, 8 limb problems, 5 conversions to open surgery, 10 aneurysm sac expansions and 14 device migrations. Patients with newer generation devices showed better results than patients with first generation prosthesis. In addition results were better for grafts with suprarenal fixation (versus infrarenal fixation) and grafts with barbs and hooks (versus grafts without barbs and hooks). Patients with bad anatomic preconditions showed a higher complication rate. Conclusion: Contrary to first generation products, new stent-graft designs show acceptable technical and clinical results in endovascular AAA aneurysm repair. However, this therapy still should be reserved only for patients with significant comorbities and suitable anatomic conditions.

Aerial view of the Kennedy Space Center Visitor Center

Science.gov (United States)

1998-01-01

The Kennedy Space Center Visitor Center, shown in this aerial view looking south, sprawls across 70 acres on Florida's Space Coast , and is located off State Road 405, NASA Parkway, six miles inside the Space Center entrance. SR 405 can be seen at the bottom of the photo. Just above the roadway, from left can be seen the Shuttle/Gantry mockup; the Post Show Dome; the Astronaut Memorial; and to the far right, the Center for Space Education. Behind the Memorial are a cluster of buildings that include the Theater Complex, Cafeteria, Space Flight Exhibit Building, Souvenir Sales Building, Spaceport Central, and Ticket Pavilion. At the upper right are various rockets that have played a significant role in the growth of the space program.

Wound care centers

Science.gov (United States)

Pressure ulcer - wound care center; Decubitus ulcer - wound care center; Diabetic ulcer - wound care center; Surgical wound - wound ... Common types of non-healing wounds include: Pressure sores Surgical ... flow, or swollen legs Certain wounds may not heal well due to: ...

Patient-centered care in chronic disease management: a thematic analysis of the literature in family medicine.

Science.gov (United States)

Hudon, Catherine; Fortin, Martin; Haggerty, Jeannie; Loignon, Christine; Lambert, Mireille; Poitras, Marie-Eve

2012-08-01

The objective was to provide a synthesis of the results of the research and discourse lines on main dimensions of patient-centered care in the context of chronic disease management in family medicine, building on Stewart et al.'s model. We developed search strategies for the Medline, Embase, and Cochrane databases, from 1980 to April 2009. All articles addressing patient-centered care in the context of chronic disease management in family medicine were included. A thematic analysis was performed using mixed codification, based on Stewart's model of patient-centered care. Thirty-two articles were included. Six major themes emerged: (1) starting from the patient's situation; (2) legitimizing the illness experience; (3) acknowledging the patient's expertise; (4) offering realistic hope; (5) developing an ongoing partnership; (6) providing advocacy for the patient in the health care system. The context of chronic disease management brings forward new dimensions of patient-centered care such as legitimizing the illness experience, acknowledging patient expertise, offering hope and providing advocacy. Chronic disease management calls for the adaptation of the family physician's role to patients' fluctuating needs. Literature also suggests the involvement of the family physician in care transitions as a component of patient-centered care. Crown Copyright © 2012. Published by Elsevier Ireland Ltd. All rights reserved.

Causes of amenorrhea in Korea: Experience of a single large center

Science.gov (United States)

Kwon, Su-Kyoung; Lee, Kyung-Hee; Kim, Sung-Hoon; Kim, Chung-Hoon; Kang, Byung-Moon

2014-01-01

Objective To investigate the causes of amenorrhea in Korean women. Methods Medical records from 1,212 women with amenorrhea who visited the Department of Obstetrics and Gynecology, Asan Medical Center, between January 1989 and December 2011 were retrospectively reviewed. Amenorrhea was categorized as either primary or secondary. Results Primary amenorrhea was identified in 132 of the patients (10.9%) and secondary amenorrhea in 1,080 (89.1%). The most frequent causes of primary amenorrhea were gonadal dysgenesis (28.0%, 37/132); Mayer-Rokitansky-Küster-Hauser syndrome (20.0%, 27/132); and constitutional delay and androgen insensitivity syndrome (8.3%, 11/132; 8.3%, 11/132, respectively). Secondary amenorrhea was due to polycystic ovary syndrome (48.4%, 523/1,080); premature ovarian insufficiency (14.0%, 151/1,080); and nutrition-related hypogonadotropic hypogonadism (8.3%, 90/1,080). Conclusion In this retrospective study, gonadal dysgenesis was the most common cause of primary amenorrhea and polycystic ovary syndrome was the most common cause of secondary amenorrhea in Korean women. PMID:24693495

Sports hernia: the experience of Baylor University Medical Center at Dallas

Science.gov (United States)

2011-01-01

Groin injuries in high-performance athletes are common, occurring in 5% to 28% of athletes. Athletic pubalgia syndrome, or so-called sports hernia, is one such injury that can be debilitating and sport ending in some athletes. It is a clinical diagnosis of chronic, painful musculotendinous injury to the medial inguinal floor occurring with athletic activity. Over the past 12 years, we have operated on >100 patients with this injury at Baylor University Medical Center at Dallas. These patients have included professional athletes, collegiate athletes, competitive recreational athletes, and the occasional “weekend warrior.” The repair used is an open technique using a lightweight polypropylene mesh. Patient selection is important, as is collaboration with other experienced and engaged sports health care professionals, including team trainers, physical therapists, team physicians, and sports medicine and orthopedic surgeons. Of the athletes who underwent surgery, 98% have returned to competition. After a minimum of 6 weeks for recovery and rehabilitation, they have usually returned to competition within 3 months. PMID:21566750

Trends in Publications in Radiology Journals Designated as Relating to Patient-Centered Care.

Science.gov (United States)

Rosenkrantz, Andrew B; Rawson, James V

2017-05-01

To assess trends in publications in radiology journals designated as dealing with patient-centered care. PubMed was searched for articles in radiology journals for which the article's record referenced patient-centered/patient-centric care. Among these, original research articles were identified and assigned major themes. Trends were assessed descriptively. A total of 115 articles in radiology journals designated as dealing with patient-centered care were identified, including 40 original research articles. The number of articles annually ranged from 0 to 4 in 2000-2008, 5 to 9 in 2010-2012, 14 to 15 in 2013-2014, and 25 in 2015. Only four radiology journals had published more than one of the original research articles. Original research articles' most common themes were: optimization of patients' access to reports and images (n=7); patients' examination experience (5); image evaluation (n=4); radiologists meeting with patients (n=4); improving patients' knowledge of imaging (n=3); examination wait times/efficiency (n=3); examination utilization/appropriateness (n=3); and IT enhancements (n=3). A total of 13 of 40 original research articles solicited opinions from patients. One study involved patients in educating trainees regarding patient-centered care. No study involved patients in system-level decisions regarding health care design and delivery. Articles dealing with patient-centered care in radiology are increasing, though they remain concentrated in a limited number of journals. Though major themes included image/report access, patient experiences, and radiologists meeting with patients, many studies dealt with less clearly patient-centric topics such as examination interpretation, while inclusion of patients in systems design was lacking. Further research in radiology is encouraged to target a broader range of ideals of patient-centered care, such as diversity, autonomy, and compassion, and to incorporate greater patient engagement. Copyright © 2016

A patient-centered perspective on cancer survivorship.

Science.gov (United States)

Zebrack, Brad

2015-04-15

Survivorship is a complicated notion because people often confuse a process of survivorship with a mythic identity of being a cancer survivor. This confusion may be a distraction to addressing the real-life struggles and challenges experienced by all people diagnosed with cancer. A more expansive perspective of survivorship, one that attends to patients' physical, psychological, social, spiritual, and existential challenges throughout a continuum of care, would be more in line with what is known empirically about people's experiences with cancer. In an effort to gain a patient-centered perspective on cancer, and one that emphasizes multiple dimensions of cancer survivorship, the author reports findings from a non-scientific social media poll (via Facebook and personal emails) in which survivors and colleagues working in the field of cancer survivorship answered the question: What does cancer survivorship mean to you? The comments are enlightening and useful for guiding the development of a patient-centered, and, thus, more comprehensive, approach to caring for people affected by cancer.

Positioning of microtubule organizing centers by cortical pushing and pulling forces

International Nuclear Information System (INIS)

Pavin, Nenad; Ma Rui; Jülicher, Frank; Laan, Liedewij; Dogterom, Marileen

2012-01-01

Positioning of microtubule (MT) organizing centers with respect to the confining geometry of cells depends on pushing and/or pulling forces generated by MTs that interact with the cell cortex (Dogterom et al 2005 Curr. Opin. Cell Biol. 17 67–74). How, in living cells, these forces lead to proper positioning is still largely an open question. Recently, it was shown by in vitro experiments using artificial microchambers that in a square geometry, MT asters center more reliably by a combination of pulling and pushing forces than by pushing forces alone (Laan et al 2012a Cell 148 502–14). These findings were explained by a physical description of aster mechanics that includes slipping of pushing MT ends along chamber boundaries. In this paper, we extend that theoretical work by studying the influence of the shape of the confining geometry on the positioning process. We find that pushing and pulling forces can have centering or off-centering behavior in different geometries. Pushing forces center in a one-dimensional and a square geometry, but lead to off-centering in a circle if slipping is sufficiently pronounced. Pulling forces, however, do not center in a one-dimensional geometry, but improve centering in a circle and a square. In an elongated stadium geometry, positioning along the short axis depends mainly on pulling forces, while positioning along the long axis depends mainly on pushing forces. Our theoretical results suggest that different positioning strategies could be used by different cell types. (paper)

Bituminization of radioactive wastes at the Nuclear Research Center Karlsruhe

International Nuclear Information System (INIS)

Hild, W.; Kluger, W.; Krause, H.

1976-05-01

A summary is given of the main operational experience gained at the Nuclear Research Center Karlsruhe in 4 years operation of the bituminization plant for evaporator concentrates from low- and medium level wastes. At the same time some of the essential results are compiled that have been obtained in the R + D activities on bituminization. (orig.) [de

Lessons for the new CMS innovation center from the Medicare health support program.

Science.gov (United States)

Barr, Michael S; Foote, Sandra M; Krakauer, Randall; Mattingly, Patrick H

2010-07-01

The Patient Protection and Affordable Care Act establishes a new Center for Medicare and Medicaid Innovation in the Centers for Medicare and Medicaid Services (CMS). The center is intended to enhance the CMS's role in promoting much-needed improvements in payment and service delivery. Lessons from the Medicare Health Support Program, a chronic care pilot program that ran between 2005 and 2008, illustrate the value of drawing on experience in planning for the center and future pilot programs. The lessons include the importance of strong leadership; collaboration and flexibility to foster innovation; receptivity of beneficiaries to care management; and the need for timely data on patients' status. The lessons also highlight pitfalls to be avoided in planning future pilot programs, such as flawed strategies for selecting populations to target when testing payment and service delivery reforms.

Person-Centered Expressive Arts: An Alternative Path to Counseling and Education. An interview with Natalie Rogers

Directory of Open Access Journals (Sweden)

Laura Guadiana Martínez

2003-11-01

Full Text Available In this interview, Natalie Rogers PhD, expounds on how art and expression serve personal and group growth in Person Centered Expressive Arts Therapy. Adding to the legacy of her father Carl Rogers, creator of the Person Centered Approach, she describes the interweaving of her experiences as a therapist and woman, and how she afforded extra room in the process for intuition, creativity, emotions and the fascinating exploration of the human experience. Using modeling, sculpting, dance, painting, music, etc. she created a model which furthers the person’s genuine expression and self knowledge. She sketches a profile of a facilitator who takes special care in creating an ambience where s/he not only does not judge the work, person, experience or results, but is on the contrary, empathetic and acceptant of the person and her experiences. Lastly, she discusses the applications of this approach to traditional educational settings, as well as some of the key training issues.

The use of random-effects models to identify health care center-related characteristics modifying the effect of antipsychotic drugs.

Science.gov (United States)

Nordon, Clementine; Battin, Constance; Verdoux, Helene; Haro, Josef Maria; Belger, Mark; Abenhaim, Lucien; van Staa, Tjeerd Pieter

2017-01-01

A case study was conducted, exploring methods to identify drugs effects modifiers, at a health care center level. Data were drawn from the Schizophrenia Outpatient Health Outcome cohort, including hierarchical information on 6641 patients, recruited from 899 health care centers from across ten European countries. Center-level characteristics included the following: psychiatrist's gender, age, length of practice experience, practice setting and type, countries' Healthcare System Efficiency score, and psychiatrist density in the country. Mixed multivariable linear regression models were used: 1) to estimate antipsychotic drugs' effectiveness (defined as the association between patients' outcome at 3 months - dependent variable, continuous - and antipsychotic drug initiation at baseline - drug A vs other antipsychotic drug); 2) to estimate the similarity between clustered data (using the intra-cluster correlation coefficient); and 3) to explore antipsychotic drug effects modification by center-related characteristics (using the addition of an interaction term). About 23% of the variance found for patients' outcome was explained by unmeasured confounding at a center level. Psychiatrists' practice experience was found to be associated with patient outcomes ( p =0.04) and modified the relative effect of "drug A" ( p <0.001), independent of center- or patient-related characteristics. Mixed models may be useful to explore how center-related characteristics modify drugs' effect estimates, but require numerous assumptions.

DX centers in indium aluminum arsenide heterostructures

Science.gov (United States)

Sari, Huseyin

and the grand canonical ensemble (GCE) the energy levels of the DX centers relative to the conduction band edge were estimated. The optical properties of the DX centers were also investigated using a 1.0 mum thick, Si-doped bulk-like GaAlAs epitaxial layer grown by MBE on a GaAs substrate. A conductivity modulation experiment using a stripe-patterned mask has been performed at 77°K. A conductivity difference, up to 10 4 along parallel and perpendicular directions relative to the stripes, has been measured. The difference in conductivity is a result of the large PPC effect of the DX centers and clearly indicates the localized nature of these deep levels.

The International Center for Integrated Water Resources Management (ICIWaRM): The United States' Contribution to UNESCO IHP's Global Network of Water Centers

Science.gov (United States)

Logan, W. S.

2015-12-01

The concept of a "category 2 center"—i.e., one that is closely affiliated with UNESCO, but not legally part of UNESCO—dates back many decades. However, only in the last decade has the concept been fully developed. Within UNESCO, the International Hydrological Programme (IHP) has led the way in creating a network of regional and global water-related centers.ICIWaRM—the International Center for Integrated Water Resources Management—is one member of this network. Approved by UNESCO's General Conference, the center has been operating since 2009. It was designed to fill a niche in the system for a center that was backed by an institution with on-the-ground water management experience, but that also had strong connections to academia, NGOs and other governmental agencies. Thus, ICIWaRM is hosted by the US Army Corps of Engineers' Institute for Water Resources (IWR), but established with an internal network of partner institutions. Three main factors have contributed to any success that ICIWaRM has achieved in its global work: A focus on practical science and technology which can be readily transferred. This includes the Corps' own methodologies and models for planning and water management, and those of our university and government partners. Collaboration with other UNESCO Centers on joint applied research, capacity-building and training. A network of centers needs to function as a network, and ICIWaRM has worked together with UNESCO-affiliated centers in Chile, Brazil, Paraguay, the Dominican Republic, Japan, China, and elsewhere. Partnering with and supporting existing UNESCO-IHP programs. ICIWaRM serves as the Global Technical Secretariat for IHP's Global Network on Water and Development Information in Arid Lands (G-WADI). In addition to directly supporting IHP, work through G-WADI helps the center to frame, prioritize and integrate its activities. With the recent release of the United Nation's 2030 Agenda for Sustainable Development, it is clear that

The ontology supported intelligent system for experiment search in the scientific Research center

Directory of Open Access Journals (Sweden)

Cvjetković Vladimir

2014-01-01

Full Text Available Ontologies and corresponding knowledge bases can be quite successfully used for many tasks that rely on domain knowledge and semantic structures, which should be available for machine processing and sharing. Using SPARQL queries for retrieval of required elements from ontologies and knowledge bases, can significantly simplify modeling of arbitrary structures of concepts and data, and implementation of required functionalities. This paper describes developed ontology for support of Research Centre for testing of active substances that conducts scientific experiments. According to created ontology corresponding knowledge base was made and populated with real experimental data. Developed ontology and knowledge base are directly used for an intelligent system of experiment search which is based on many criteria from ontology. Proposed system gets the desired search result, which is actually an experiment in the form of a written report. Presented solution and implementation are very flexible and adaptable, and can be used as kind of a template by similar information system dealing with biological or similar complex system.

Cytomegalovirus pp65 antigenemia-guided pre-emptive treatment with ganciclovir after allogeneic stem transplantation: a single-center experience.

Science.gov (United States)

Manteiga, R; Martino, R; Sureda, A; Labeaga, R; Brunet, S; Sierra, J; Rabella, N

1998-11-01

The optimal prophylactic strategy for cytomegalovirus (CMV) disease after allogeneic hematopoietic stem cell transplantation has not yet been established. The aim of this study was to analyze our single-center experience with a uniform protocol of CMV antigenemia-guided pre-emptive treatment with ganciclovir (GCV) after allografting. Fifty-two consecutive adult patients, 48 of them transplanted from HLA-identical matched related donors were included. T cell-depleted marrow or peripheral blood were used in 21 cases. After engraftment, weekly blood samples were tested for CMV pp65 antigenemia and viremia (conventional cultures) until day +100. GCV was started if CMV antigenemia and/or CMV viremia were detected. CMV infection (CMV-I) was found in 19 patients (37%). Seven patients suffered from CMV disease (CMV-D), three colitis and four pneumonias. There was one death directly related to CMV-D and three further cases died from refractory GVHD with CMV-D. Only one patient developed CMV pneumonia without any previous positive antigenemia and/or viremia. Multivariate analysis identified grades II-IV acute GVHD (P = 0.02) and peripheral blood stem cell transplantation (P = 0.03) to be risk factors for developing CMV-I. In conclusion, this monitoring protocol allowed early treatment of CMV-I without progression to CMV-D. Pre-emptive therapy had the additional advantage of avoiding GCV administration in most of our allograft recipients.

Lessons Learned from Engineering a Multi-Mission Satellite Operations Center

Science.gov (United States)

Madden, Maureen; Cary, Everett, Jr.; Esposito, Timothy; Parker, Jeffrey; Bradley, David

2006-01-01

NASA's Small Explorers (SMEX) satellites have surpassed their designed science-lifetimes and their flight operations teams are now facing the challenge of continuing operations with reduced funding. At present, these missions are being re-engineered into a fleet-oriented ground system at Goddard Space Flight Center (GSFC). When completed, this ground system will provide command and control of four SMEX missions and will demonstrate fleet automation and control concepts. As a path-finder for future mission consolidation efforts, this ground system will also demonstrate new ground-based technologies that show promise of supporting longer mission lifecycles and simplifying component integration. One of the core technologies being demonstrated in the SMEX Mission Operations Center is the GSFC Mission Services Evolution Center (GMSEC) architecture. The GMSEC architecture uses commercial Message Oriented Middleware with a common messaging standard to realize a higher level of component interoperability, allowing for interchangeable components in ground systems. Moreover, automation technologies utilizing the GMSEC architecture are being evaluated and implemented to provide extended lights-out operations. This mode of operation will provide routine monitoring and control of the heterogeneous spacecraft fleet. The operational concepts being developed will reduce the need for staffed contacts and is seen as a necessity for fleet management. This paper will describe the experiences of the integration team throughout the re-enginering effort of the SMEX ground system. Additionally, lessons learned will be presented based on the team's experiences with integrating multiple missions into a fleet-automated ground system.

The BaBar experiment's distributed computing model

International Nuclear Information System (INIS)

Boutigny, D.

2001-01-01

In order to face the expected increase in statistics between now and 2005, the BaBar experiment at SLAC is evolving its computing model toward a distributed multitier system. It is foreseen that data will be spread among Tier-A centers and deleted from the SLAC center. A uniform computing environment is being deployed in the centers, the network bandwidth is continuously increased and data distribution tools has been designed in order to reach a transfer rate of ∼100 TB of data per year. In parallel, smaller Tier-B and C sites receive subsets of data, presently in Kanga-ROOT format and later in Objectivity format. GRID tools will be used for remote job submission

The BaBar Experiment's Distributed Computing Model

International Nuclear Information System (INIS)

Gowdy, Stephen J.

2002-01-01

In order to face the expected increase in statistics between now and 2005, the BaBar experiment at SLAC is evolving its computing model toward a distributed multi-tier system. It is foreseen that data will be spread among Tier-A centers and deleted from the SLAC center. A uniform computing environment is being deployed in the centers, the network bandwidth is continuously increased and data distribution tools has been designed in order to reach a transfer rate of ∼100 TB of data per year. In parallel, smaller Tier-B and C sites receive subsets of data, presently in Kanga-ROOT[1] format and later in Objectivity[2] format. GRID tools will be used for remote job submission

Pancreas transplantation with grafts from donors deceased after circulatory death (DCD) : 5 years single center experience

NARCIS (Netherlands)

Kopp, Wouter H; Lam, Hwai-Ding; Schaapherder, Alexander F M; Huurman, Volkert A L; van der Boog, Paul; de Koning, Eelco; de Fijter, Johan W; Baranski, Andrzej; Braat, Andries E

2017-01-01

INTRODUCTION: Donation after circulatory death (DCD) pancreas transplantation has been shown to be an additional way to deal with donor organ shortages. The results of 5-year DCD pancreas transplantation are presented. METHODS: A retrospective, single center analysis (2011 - 2015) was performed to

Meningitis and Meningoencephalitis among Israel Defense Force Soldiers: 20 Years Experience at the Hadassah Medical Centers.

Science.gov (United States)

Pikkel, Yoav Y; Ben-Hur, Tamir; Eliahou, Ruth; Honig, Asaf

2015-11-01

Meningitis and meningoencephalitis pose major risks of morbidity and mortality. To describe 20 years of experience treating infections of the central nervous system in Israel Defense Force (IDF) soldiers, including the common presentations, pathogens and sequelae, and to identify risk groups among soldiers. All soldiers who were admitted to the Hadassah University Medical Center (both campuses: Ein Kerem and Mt. Scopus) due to meningitis and meningoencephalitis from January 1993 to January 2014 were included in this retrospective study. Clinical, laboratory and radiologic data were reviewed from their hospital and army medical corps files. Attention was given to patients' military job description, i.e., combat vs. non-combat soldier, soldiers in training, and medical personnel. We identified 97 cases of suspected meningitis or meningoencephalitis. Six were mistakenly filed and these patients were found to have other disorders. Four soldiers were diagnosed with epidural abscess and five with meningitis due to non-infectious in flammatory diseases. Eighty-two soldiers in active and reserve duty had infectious meningitis or meningoencephalitis. Of these, 46 (56.1%) were combat soldiers and 31 (37.8%) non-combat; 20 (29.2%) were soldiers in training, 10 (12.2%) were training staff and 8 (9.8%) were medical staff. The main pathogens were enteroviruses, Epstein-Barr virus an d Neisseria meningitidis. In our series, soldiers in training, combat soldiers and medical personnel had meningitis and meningoencephalitis more than other soldiers. Enteroviruses are highly infectious pathogens and can cause outbreaks. N. meningitidis among IDF soldiers is still a concern. Early and aggressive treatment with steroids should be considered especially in robust meningoencephalitis cases.

Predictors of clinical outcome in fibromyalgia after a brief interdisciplinary fibromyalgia treatment program: single center experience.

Science.gov (United States)

Oh, Terry H; Hoskin, Tanya L; Luedtke, Connie A; Weingarten, Toby N; Vincent, Ann; Kim, Chul H; Thompson, Jeffrey M

2012-04-01

To determine which patient characteristics are closely associated with a positive response to a brief interdisciplinary fibromyalgia treatment program (FTP). A prospective cohort study. FTP at a tertiary medical center. A total of 536 patients with a confirmed diagnosis of fibromyalgia who underwent the FTP and completed the Fibromyalgia Impact Questionnaire (FIQ) at baseline and 6-12 months after treatment. A brief 1.5-day interdisciplinary FTP, which included evaluation with a registered nurse and a physician for a diagnosis or confirmation of fibromyalgia, fibromyalgia education, interactive self management session, and physical and occupational therapy. The responder definition was an improvement of 14% or more in the FIQ total score from their baseline to 6-12 months after treatment. Mean (standard deviation) age of our patients was 50.3 ± 13.0 years; 515 women (96%) and 23 men (4%). Two hundred forty-eight patients (46%) met the responder definition at 6-12 months follow-up. In an univariate analysis, younger age (P = .008), college or higher education (P = .02), fewer tender points (P = .048), and higher FIQ depression subscore (P = .02) significantly predicted positive response. In a multivariate analysis, these factors all remained statistically significant. In addition, a positive abuse history became significant (P = .03). There was no significant association for gender, duration of symptoms, marital status, employment, smoking status, or 3 numeric rating scale pain scores. Patients with younger age, more years of education (with college or graduate degree), higher baseline FIQ depression score, lower tender point count, and absent abuse history experience greater benefit from a brief FTP. Copyright © 2012 American Academy of Physical Medicine and Rehabilitation. Published by Elsevier Inc. All rights reserved.

Profile of European proton and carbon ion therapy centers assessed by the EORTC facility questionnaire.

Science.gov (United States)

Weber, Damien C; Abrunhosa-Branquinho, André; Bolsi, Alessandra; Kacperek, Andrzej; Dendale, Rémi; Geismar, Dirk; Bachtiary, Barbara; Hall, Annika; Heufelder, Jens; Herfarth, Klaus; Debus, Jürgen; Amichetti, Maurizio; Krause, Mechthild; Orecchia, Roberto; Vondracek, Vladimir; Thariat, Juliette; Kajdrowicz, Tomasz; Nilsson, Kristina; Grau, Cai

2017-08-01

We performed a survey using the modified EORTC Facility questionnaire (pFQ) to evaluate the human, technical and organizational resources of particle centers in Europe. The modified pFQ consisted of 235 questions distributed in 11 sections accessible on line on an EORTC server. Fifteen centers from 8 countries completed the pFQ between May 2015 and December 2015. The average number of patients treated per year and per particle center was 221 (range, 40-557). The majority (66.7%) of centers had pencil beam or raster scanning capability. Four (27%) centers were dedicated to eye treatment only. An increase in the patients-health professional FTE ratio was observed for eye tumor only centers when compared to other centers. All centers treated routinely chordomas/chondrosarcomas, brain tumors and sarcomas but rarely breast cancer. The majority of centers treated pediatric cases with particles. Only a minority of the queried institutions treated non-static targets. As the number of particle centers coming online will increase, the experience with this treatment modality will rise in Europe. Children can currently be treated in these facilities in a majority of cases. The majority of these centers provide state of the art particle beam therapy. Copyright © 2017 Elsevier B.V. All rights reserved.

Experiments with the SUR 100 training reactor

International Nuclear Information System (INIS)

Milicic, B.

1984-06-01

This paper contains a compilation of various experiments using the SUR - 100 reactor for training purposes, which have been widly proved in practical work at the School for Nuclear Technology of the Karlsruhe Research Center. (orig.) [de

Data Center Tasking.

Science.gov (United States)

Temares, M. Lewis; Lutheran, Joseph A.

Operations tasking for data center management is discussed. The original and revised organizational structures of the data center at the University of Miami are also described. The organizational strategy addresses the functions that should be performed by the data center, anticipates the specialized skills required, and addresses personnel…

How to Conduct Clinical Qualitative Research on the Patient's Experience

Science.gov (United States)

Chenail, Ronald J.

2011-01-01

From a perspective of patient-centered healthcare, exploring patients' (a) preconceptions, (b) treatment experiences, (c) quality of life, (d) satisfaction, (e) illness understandings, and (f) design are all critical components in improving primary health care and research. Utilizing qualitative approaches to discover patients' experiences can…

Career and Technology Center Honors Julie Hartman | Poster

Science.gov (United States)

By Carolynne Keenan, Contributing Writer On May 7, Julie Hartman was honored by the Frederick County Career and Technology Center (CTC) for her support of the CTC’s Biomedical Sciences Program. As an education program specialist for Outreach and Special Programs at NCI at Frederick, Hartman is responsible for NCI at Frederick’s participation in the program, which is designed to offer Frederick County high school students hands-on, practical laboratory experience beyond the typical classroom setting. 

Acute Renal Replacement Therapy in Children with Diarrhea-Associated Hemolytic Uremic Syndrome: A Single Center 16 Years of Experience

Directory of Open Access Journals (Sweden)

Silviu Grisaru

2011-01-01

Full Text Available Acute kidney injury (AKI is becoming more prevalent among hospitalized children, its etiologies are shifting, and new treatment modalities are evolving; however, diarrhea-associated hemolytic uremic syndrome (D+HUS remains the most common primary disease causing AKI in young children. Little has been published about acute renal replacement therapy (ARRT and its challenges in this population. We describe our single center's experience managing 134 pediatric patients with D+HUS out of whom 58 (43% required ARRT over the past 16 years. In our cohort, all but one patient were started on peritoneal dialysis (PD. Most patients, 47 (81%, received acute PD on a pediatric inpatient ward. The most common recorded complications in our cohort were peritoneal fluid leaks 13 (22%, peritonitis 11 (20%, and catheter malfunction 5 (9%. Nine patients (16% needed surgical revision of their PD catheters. There were no bleeding events related to PD despite a mean platelets count of 40.9 (±23.5 × 103/mm3 and rare use of platelets infusions. Despite its methodological limitations, this paper adds to the limited body of evidence supporting the use of acute PD as the primary ARRT modality in children with D+HUS.

On-demand provisioning of HEP compute resources on cloud sites and shared HPC centers

Science.gov (United States)

Erli, G.; Fischer, F.; Fleig, G.; Giffels, M.; Hauth, T.; Quast, G.; Schnepf, M.; Heese, J.; Leppert, K.; Arnaez de Pedro, J.; Sträter, R.

2017-10-01

This contribution reports on solutions, experiences and recent developments with the dynamic, on-demand provisioning of remote computing resources for analysis and simulation workflows. Local resources of a physics institute are extended by private and commercial cloud sites, ranging from the inclusion of desktop clusters over institute clusters to HPC centers. Rather than relying on dedicated HEP computing centers, it is nowadays more reasonable and flexible to utilize remote computing capacity via virtualization techniques or container concepts. We report on recent experience from incorporating a remote HPC center (NEMO Cluster, Freiburg University) and resources dynamically requested from the commercial provider 1&1 Internet SE into our intitute’s computing infrastructure. The Freiburg HPC resources are requested via the standard batch system, allowing HPC and HEP applications to be executed simultaneously, such that regular batch jobs run side by side to virtual machines managed via OpenStack [1]. For the inclusion of the 1&1 commercial resources, a Python API and SDK as well as the possibility to upload images were available. Large scale tests prove the capability to serve the scientific use case in the European 1&1 datacenters. The described environment at the Institute of Experimental Nuclear Physics (IEKP) at KIT serves the needs of researchers participating in the CMS and Belle II experiments. In total, resources exceeding half a million CPU hours have been provided by remote sites.

Usage Center

DEFF Research Database (Denmark)

Kleinaltenkamp, Michael; Plewa, Carolin; Gudergan, Siegfried

2017-01-01

Purpose: The purpose of this paper is to advance extant theorizing around resourceintegration by conceptualizing and delineating the notion of a usage center. Ausage center consists of a combination of interdependent actors that draw onresources across their individual usage processes to create v...

Launch of patient-centered website is associated with reduced health care utilization: a nationwide natural experiment.

NARCIS (Netherlands)

Spoelman, W.; Bonten, T.; Waal, M. de; Drenthen, T.; Smeele, I.; Nielen, M.; Chavannes, N.

2016-01-01

Background: Health care costs and utilization are rising. High quality patient-centered online information may reduce health care utilization, but evidence of the effect of online health information on health care utilization is scarce. We hypothesized that the release of a nationwide evidence-based

The role of nuclear research centers for the introduction of a nuclear power programme

International Nuclear Information System (INIS)

Perovic, B.; Frlec, B.; Kundic, V.

1977-01-01

Full development of nuclear energy has imposed a new role on nuclear energy centers. Nuclear technology for different reactor concepts is also now in a phase of high development. Several reactor concepts have been developed for industrial use and electric power production. Development of fast reactors is still under way and needs further research efforts. Having in mind these two main guidelines, research programmes in nuclear energy centers should be geared to the development of the activities vital to the implementation of national nuclear energy programmes. In this respect, national nuclear centers should devote their attention to three major tasks. First, to establish a background for the introduction of nuclear energy into the national energy system and to support a national safety system. Second, to support the national programme by skilled manpower, to provide the basic training in nuclear technology for future staff of nuclear power stations and to assist the universities in establishing the necessary educational programme in nuclear energy. Third, to follow the development of nuclear energy technology for the fast breeder reactor concepts. This paper describes some experience in introducing a new programme to the national nuclear energy centers in Yugoslavia. Recently, Yugoslavia has started building its first nuclear power station. Further introduction of nuclear power stations in the national electric energy system is also planned. This implies the need to reconsider the current nuclear energy programme in the nuclear energy centers. It has been decided to evaluate past experience and further needs for research activities regarding the nuclear power programme. Yugoslavia has three main nuclear energy centers whose activities are devoted to the development of national manpower in the field of nuclear sciences. Besides these three organizations, there are several others whose activities are concentrated on specific tasks in nuclear technology. In the

Pandemic Influenza Preparedness Among Child Care Center Directors in 2008 and 2016.

Science.gov (United States)

Shope, Timothy R; Walker, Benjamin H; Aird, Laura D; Southward, Linda; McCown, John S; Martin, Judith M

2017-06-01

Children in child care centers represent an important population to consider in attempts to mitigate the spread of an influenza pandemic. This national survey, conducted in 2008 and 2016, assessed directors' reports of their child care centers' pandemic influenza preparation before and after the 2009 H1N1 novel influenza pandemic. This was a telephone-based survey of child care center directors randomly selected from a national database of licensed US child care centers who were queried about their preparedness for pandemic influenza. We grouped conceptually related items in 6 domains into indexes: general infection control, communication, seasonal influenza control, use of health consultants, quality of child care, and perceived barriers. These indexes, along with other center and director characteristics, were used to predict pandemic influenza preparedness. Among 1500 and 518 child care center directors surveyed in 2008 and 2016, respectively, preparation for pandemic influenza was low and did not improve. Only 7% of directors had taken concrete actions to prepare their centers. Having served as a center director during the 2009 influenza pandemic did not influence preparedness. After adjusting for covariates, child care health consultation and years of director's experience were positively associated with pandemic influenza preparation, whereas experiencing perceived barriers such as lack of knowing what to do in the event of pandemic influenza, was negatively associated with pandemic influenza preparedness. Pandemic influenza preparedness of child care center's directors needs to improve. Child care health consultants are likely to be important collaborators in addressing this problem. Copyright © 2017 by the American Academy of Pediatrics.

Rewards and challenges of community health center practice.

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Cole, Allison M; Chen, Frederick M; Ford, Paul A; Phillips, William R; Stevens, Nancy G

2014-04-01

More than 1100 community health centers (CHCs) in the United States provide primary care to 20 million underserved patients annually. CHCs have struggled to recruit and retain qualified physicians. To understand physicians' work experiences in CHCs and identify major sources of satisfaction and dissatisfaction. Using purposeful sampling, we conducted semistructured interviews with 12 family physicians practicing in CHCs. Interview questions assessed physicians' experiences in CHCs and sources of satisfaction and dissatisfaction. Interview notes were coded and analyzed by 2 investigators using a grounded theory approach to identify key themes. Though family physicians feel tremendous satisfaction from care of underserved patients, they are frustrated with the overwhelming workload they experience. Family physicians also report poor administrative management while working in CHCs. Implementation of the Affordable Care Act, which relies on expansion of CHC services, may be adversely affected by family physicians' frustrations with CHC practice. Further research to explore and potentially improve the CHC work environment may be needed.

Total retinal detachments due to retinoblastoma: Outcomes following intra-arterial chemotherapy/ophthalmic artery chemosurgery.

Directory of Open Access Journals (Sweden)

Megan A Rowlands

Full Text Available To report on the rate and timing of retinal reattachment and outcomes for retinoblastoma children who have total retinal detachments at presentation to our center and were treated with intra-arterial chemotherapy (ophthalmic artery chemosurgery, OAC.Single-center retrospective review of retinoblastoma patients who presented with total retinal detachments and were subsequently treated with OAC at MSKCC between May 2006 and July 2016. Endpoints were retinal detachment resolution, visual function, ERG amplitude, ocular survival, and patient survival from metastases.87 eyes of 84 retinoblastoma patients were included. Using a survival multistate model, by 36 months of follow-up, there was a 54% cumulative probability of complete retinal reattachment and a 76% probability of partial reattachment. 24% of eyes that completely reattached received only OAC without any prior or adjuvant treatments. Eyes that completely reattached were significantly more likely to have been diagnosed at a younger age (p<0.0001 and to have greater initial ERG values (p = 0.006. At final follow-up, 14% of eyes had gained at least 25 μV of ERG activity, and 8.0% had achieved hand motion vision or better, including one to 20/60. 13% of eyes were enucleated. No patient died from metastatic disease, and only one developed metastases.OAC can successfully treat previously considered "non-salvageable" retinoblastoma eyes with total retinal detachments, promote retinal reattachment in the majority of eyes, and preserve ocular and patient survival.

Quality Management Procedures Influence the Food Safety Practices at Childcare Centers

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Enke, Allison A.; Briley, Margaret E.; Curtis, Suzanne R.; Greninger, Sue A.; Staskel, Deanna M.

2007-01-01

Childcare in the United States (US) has become a necessary part of life for most working parents with the increased use of center-based childcare over the past three decades. Approximately 13 million preschoolers attend some form of childcare. Literature indicates the main predictors of quality childcare programs are adequate experience and…

Improved custom statistics visualization for CA Performance Center data

CERN Document Server

Talevi, Iacopo

2017-01-01

The main goal of my project is to understand and experiment the possibilities that CA Performance Center (CA PC) offers for creating custom applications to display stored information through interesting visual means, such as maps. In particular, I have re-written some of the network statistics web pages in order to fetch data from new statistics modules in CA PC, which has its own API, and stop using the RRD data.

A Data Analysis Center for Electromagnetic and Hadronic Interaction

Energy Technology Data Exchange (ETDEWEB)

Briscoe, William John [George Washington Univ., Washington, DC (United States). Inst. for Nuclear Studies; Strakovsky, Igor I. [George Washington Univ., Washington, DC (United States). Inst. for Nuclear Studies; Workman, Ronald L. [George Washington Univ., Washington, DC (United States). Inst. for Nuclear Studies

2015-05-31

The GW Data Analysis Center (DAC) has made significant progress in its program to enhance and expand the partial-wave and multipole analyses of fundamental reactions, while maintaining and expanding each associated database. These efforts provide guidance to national and international experimental and theoretical efforts, and are an important link between theory and experiment. Our principal goals are focused on baryon and meson physics programs and related topics.

Sunitinib treatment in patients with advanced renal cell cancer: the Brazilian National Cancer Institute (INCA) experience.

Science.gov (United States)

Coelho, Rafael Corrêa; Reinert, Tomás; Campos, Franz; Peixoto, Fábio Affonso; de Andrade, Carlos Augusto; Castro, Thalita; Herchenhorn, Daniel

2016-01-01

The aim of this study was to assess the impact of sunitinib treatment in a non-screened group of patients with metastatic renal cell cancer (mRCC) treated by the Brazilian Unified Health System (SUS) at a single reference institution. Retrospective cohort study, which evaluated patients with mRCC who received sunitinib between May 2010 and December 2013. Fifty-eight patients were eligible. Most patients were male 41 (71%), with a median age of 58 years. Nephrectomy was performed in 41 (71%) patients with a median interval of 16 months between the surgery and initiation of sunitinib. The most prevalent histological subtype was clear cell carcinoma, present in 52 (91.2%) patients. In 50 patients (86%), sunitinib was the first line of systemic treatment. The main adverse effects were fatigue (57%), hypothyroidism (43%), mucositis (33%) and diarrhea (29%). Grade 3 and 4 adverse effects were infrequent: fatigue (12%), hypertension (12%), thrombocytopenia (7%), neutropenia (5%) and hand-foot syndrome (5%). Forty percent of patients achieved a partial response and 35% stable disease, with a disease control rate of 75%. Median progression free survival was 7.6 months and median overall survival was 14.1 months. Sunitinib treatment was active in the majority of patients, especially those with low and intermediate risk by MSKCC score, with manageable toxicity. Survival rates were inferior in this non-screened population with mRCC treated in the SUS. Copyright© by the International Brazilian Journal of Urology.

Sunitinib treatment in patients with advanced renal cell cancer: the Brazilian National Cancer Institute (INCA experience

Directory of Open Access Journals (Sweden)

Rafael Corrêa Coelho

Full Text Available ABSTRACT Purpose: The aim of this study was to assess the impact of sunitinib treatment in a non-screened group of patients with metastatic renal cell cancer (mRCC treated by the Brazilian Unified Health System (SUS at a single reference institution. Material and Methods: Retrospective cohort study, which evaluated patients with mRCC who received sunitinib between May 2010 and December 2013. Results: Fifty-eight patients were eligible. Most patients were male 41 (71%, with a median age of 58 years. Nephrectomy was performed in 41 (71% patients with a median interval of 16 months between the surgery and initiation of sunitinib. The most prevalent histological subtype was clear cell carcinoma, present in 52 (91.2% patients. In 50 patients (86%, sunitinib was the first line of systemic treatment. The main adverse effects were fatigue (57%, hypothyroidism (43%, mucositis (33% and diarrhea (29%. Grade 3 and 4 adverse effects were infrequent: fatigue (12%, hypertension (12%, thrombocytopenia (7%, neutropenia (5% and hand-foot syndrome (5%. Forty percent of patients achieved a partial response and 35% stable disease, with a disease control rate of 75%. Median progression free survival was 7.6 months and median overall survival was 14.1 months. Conclusion: Sunitinib treatment was active in the majority of patients, especially those with low and intermediate risk by MSKCC score, with manageable toxicity. Survival rates were inferior in this non-screened population with mRCC treated in the SUS.

A modified fast-track program for pancreatic surgery: a prospective single-center experience.

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di Sebastiano, Pierluigi; Festa, Leonardina; De Bonis, Antonio; Ciuffreda, Andrea; Valvano, Maria Rosa; Andriulli, Angelo; di Mola, F Francesco

2011-03-01

The objective of this study is to evaluate the impact of a fast-track protocol in a high-volume center for patients with pancreatic disorders. The concept of fast-track surgery allowing accelerated postoperative recovery is accepted in colorectal surgery, but efficacy data are only preliminary for patients undergoing major pancreatic surgery. We aimed to evaluate the impact of a modified fast-track protocol in a high-volume center for patients with pancreatic disorders. Between February 2005 and January 2010, 145 subjects had resective pancreatic surgery and were enrolled in the program. Essential features of the program were no preanaesthetic medication, upper and lower air-warming device, avoidance of excessive i.v. fluids perioperatively, effective control of pain, early reinstitution of oral feeding, and immediate mobilization and restoration of bowel function following surgery. Outcome measures were postoperative complications such as pancreatic fistula, delayed gastric emptying, biliary leak, intra-abdominal abscess, post-pancreatectomy hemorrhage, acute pancreatitis, wound infection, 30-day mortality, postoperative hospital stay, and readmission rates. On average, patients were discharged on postoperative day 10 (range 6-69), with a 30-day readmission rate of 6.2%. Percentage of patients with at least one complication was 38.6%. Pancreatic anastomotic leakage occurred in seven of 101 pancreatico-jejunostomies, and biliary leak in three of 109 biliary jejunostomies. Postoperative hemorrhage occurred in ten (6.9%) patients and wound infection in nine (6.2%) cases. In-hospital mortality was 2.7%. Fast-track parameters, such as normal food and first stool, correlated significantly with early discharge (jaundice, and resumption of normal diet by the 5th postoperative day were independent factors of early discharge. Fast-track programs are feasible, easy, and also applicable for patients undergoing a major surgery such as pancreatic resection.

The Regional Autopsy Center: The University of Alabama at Birmingham Experience.