WorldWideScience

Sample records for child guidance clinics

  1. "The Dangerous Age of Childhood": Child Guidance and the "Normal" Child in Great Britain, 1920-1950

    Science.gov (United States)

    Stewart, John

    2011-01-01

    British child guidance was a form of psychiatric, preventive medicine for children and young people and centred, at least in principle, on specialist clinics led by psychiatrists. From small beginnings in the aftermath of the First World War, child guidance expanded steadily, in terms of both numbers of patients and numbers of clinics, and came to…

  2. Impact of comorbidity on three month follow-up outcome of children with ADHD in a child guidance clinic: Preliminary report

    Directory of Open Access Journals (Sweden)

    Rangan Srinivasaraghavan

    2013-01-01

    Full Text Available Context: Attention deficit hyperactivity disorder (ADHD is one of the common neurodevelopmental disorders. Aims: Study objective is to report impact of comorbidities on short-term outcome in children with ADHD followed in a child guidance clinic. Settings and Design: This was done in a child guidance clinic run jointly by the pediatric and psychiatry department at a tertiary teaching hospital. This is a 3 month prospective follow-up study to assess the outcome in ADHD children. Materials and Methods: Children attending pediatric department with behavioral problems or poor scholastic performance were screened for ADHD and further confirmation of diagnosis was done by semistructured interview of the child and parent. Children functional assessment and ADHD symptom profile was compared at baseline and at follow-up. We screened for and excluded those showing autistic spectrum disorder and having worse than mild mental retardation. Baseline variables were compared between improved and not improved subgroups and impact of these variables on outcome at 3-month follow-up was analyzed. Statistical Analysis: Descriptive statistics. Results: Of the 25 children completing the study, at the end of 3 months, 15 improved (not fulfilling criteria for ADHD and 10 did not improve. Applying Kiddie-Schedule for Affective Disorders and Schizophrenia (K-SADS for diagnosis of psychiatric comorbidities, six had associated psychiatric comorbidities. This was significantly higher in those who did not improve. Conclusions: Presence of comorbidities at baseline was found to affect outcome at 3 month assessment in this preliminary study. Future studies with larger sample and longer follow-up are needed for finding the predictors of outcome in ADHD children in developing nations.

  3. Effective Child Guidance: An Educator's Guidebook.

    Science.gov (United States)

    Hill, Brent Mathews

    This guidebook is designed to assist educators in becoming more effective child guidance leaders within the school system. Sections discuss the following areas: (1) indicators of current emotional problems; (2) children's common emotional problems, including fears, separation and loss, misbehavior motivations, aggressiveness, stealing, lying,…

  4. The Guidance Clinic - An Alternative to Suspension

    Science.gov (United States)

    Stiavelli, Richard E.; Sykes, Dudley E.

    1972-01-01

    A guidance clinic program for disruptive students, based on behavior modification theory and positive reinforcement, has proven effective in dealing with junior and senior high school students who ordinarily would be suspended or excluded from school. (AN)

  5. Clinical psychology and child protection

    OpenAIRE

    O'Brien, Elaine; Carey, Sean; Carr, Alan.

    2000-01-01

    In this 1998 postal survey of 140 clinical psychologists working in eight Health Boards and Voluntary agencies in the Republic of Ireland, it was found that clinical psychologists from child mental health, adult mental health and services for people with physical and intellectual disabilities were involved in child abuse and protection work. Clinical psychologists' child protection work spanned a number of domains including validation, general assessment, risk assessment, treatment of victims...

  6. 78 FR 5816 - Guidance for Industry on Clinical Pharmacogenomics: Premarket Evaluation in Early-Phase Clinical...

    Science.gov (United States)

    2013-01-28

    ... assist the pharmaceutical industry and other investigators engaged in new drug development in evaluating... HUMAN SERVICES Food and Drug Administration Guidance for Industry on Clinical Pharmacogenomics... announcing the availability of a guidance for industry entitled ``Clinical Pharmacogenomics:...

  7. 76 FR 9583 - Draft Guidance for Industry on Clinical Pharmacogenomics: Premarketing Evaluation in Early Phase...

    Science.gov (United States)

    2011-02-18

    ... guidance for industry entitled ``Clinical Pharmacogenomics: Premarketing Evaluation in Early Phase Clinical Studies.'' The draft guidance is intended to assist the pharmaceutical industry and other investigators... HUMAN SERVICES Food and Drug Administration Draft Guidance for Industry on Clinical...

  8. [ Symptom Severity and the Role of Friendship in Children at a Child Guidance Center from Parents' Point of View].

    Science.gov (United States)

    Brüggemann, Kai

    2016-01-01

    By means of the Child Behavior Checklist (CBCL) it was assessed how much children who are attended to a child guidance center suffer from behavior problems and emotional distress. Furthermore, the interaction between straining and supporting influences was examined. Results show that symptom severity lies in the range of clinical significance. Children of divorced parents show more internalizing as well as externalizing problems than children of nuclear families. High social integration is correlated with lower psychic symptomatic - yet, this finding was dependent on family situation: While frequency to meet friends in children from nuclear families was correlated with lower symptomatic, this effect could not be found in children of divorced parents. PMID:26904930

  9. How to set and monitor goals for prevalence of child obesity: guidance for Primary Care Trusts (PCTs) and local authorities

    OpenAIRE

    Department of Health (Ireland)

    2009-01-01

    This guidance follows on from the publication of the Government's obesity strategy Healthy Weight, Healthy Lives: A Cross-Government strategy for England. The guidance provides advice to PCTs and local authorities on how to set child obesity goals as part of the Vital Signs and the National Indicator Set. This will be followed shortly with full guidance on developing local plans.

  10. 77 FR 45297 - Children's Toys and Child Care Articles Containing Phthalates; Proposed Guidance on Inaccessible...

    Science.gov (United States)

    2012-07-31

    ... Register on August 7, 2009 (74 FR 39535) and codified at 16 CFR 1500.87 (Children's products containing... COMMISSION 16 CFR Part 1199 Children's Toys and Child Care Articles Containing Phthalates; Proposed Guidance... prohibition on specified products containing phthalates does not apply to any component part of...

  11. 77 FR 9947 - Guidance for Industry: Early Clinical Trials With Live Biotherapeutic Products: Chemistry...

    Science.gov (United States)

    2012-02-21

    ... HUMAN SERVICES Food and Drug Administration Guidance for Industry: Early Clinical Trials With Live... availability of a document entitled ``Guidance for Industry: Early Clinical Trials With Live Biotherapeutic... submission of INDs for early clinical trials with live biotherapeutic products (LBPs). The guidance...

  12. 77 FR 69632 - Draft Guidance for Industry on Electronic Source Data in Clinical Investigations; Availability

    Science.gov (United States)

    2012-11-20

    ...The Food and Drug Administration (FDA) is announcing the availability of a draft guidance for industry entitled ``Electronic Source Data in Clinical Investigations.'' This document revises and updates the draft guidance entitled ``Electronic Source Documentation in Clinical Investigations.'' This revised draft document provides guidance to sponsors, contract research organizations (CROs), data......

  13. Malingering-by-proxy: need for child protection and guidance for reporting.

    Science.gov (United States)

    Chafetz, Michael; Dufrene, Melissa

    2014-11-01

    The feigning of disabling illness for compensation at the direction or pressure by others, which is called malingering by proxy (MBP), has been the subject of several spirited articles. Chafetz and Prentkowski (2011) suggested that MBP has the potential for real harm to the child. In a poster at the AACN scientific session in 2011, Chafetz and Binder (2011) pursued a case of MBP that showed the child had clearly suffered and failed to progress in the 6 years that had passed since she was first evaluated as an 11 year old. In the present article, we identify three cases that compare and contrast effects of MBP, illustrating that child abuse and/or neglect can be a serious and reportable consequence of MBP behavior. To illustrate how MBP behavior can cause child abuse, we compare MBP behavior with Munchausen Syndrome by Proxy (MSBP), another condition of volitional noncredible behavior produced in a vulnerable person at the direction or pressure by others. Guidance criteria for reporting MBP as child abuse/neglect are introduced in this article. PMID:25236718

  14. 76 FR 1173 - Draft Guidance for Industry on Electronic Source Documentation in Clinical Investigations...

    Science.gov (United States)

    2011-01-07

    ... HUMAN SERVICES Food and Drug Administration Draft Guidance for Industry on Electronic Source... industry entitled ``Electronic Source Documentation in Clinical Investigations.'' This document provides guidance to sponsors, contract research organizations (CROs), data management centers, and...

  15. 75 FR 63188 - Draft Guidance for Industry: Early Clinical Trials With Live Biotherapeutic Products: Chemistry...

    Science.gov (United States)

    2010-10-14

    ... HUMAN SERVICES Food and Drug Administration Draft Guidance for Industry: Early Clinical Trials With Live... availability of a draft document entitled ``Guidance for Industry: Early Clinical Trials with Live... submission of INDs for early clinical trials with live biotherapeutic products (LBPs). DATES: Although...

  16. 75 FR 9228 - Draft Guidance for Industry on Non-Inferiority Clinical Trials; Availability

    Science.gov (United States)

    2010-03-01

    ... ``Non- Inferiority Clinical Trials.'' This draft guidance provides sponsors and review staff in the... announcing the availability of a draft guidance for industry entitled ``Non-Inferiority Clinical Trials... clinical trials. It does not create or confer any rights for or on any person and does not operate to...

  17. 75 FR 13765 - Draft Guidance for Industry on Irritable Bowel Syndrome-Clinical Evaluation of Products for...

    Science.gov (United States)

    2010-03-23

    ... clinical trials. This guidance is intended to assist the pharmaceutical industry and other investigators... for Treatment.'' This guidance is intended to assist the pharmaceutical industry and other... HUMAN SERVICES Food and Drug Administration Draft Guidance for Industry on Irritable Bowel...

  18. 76 FR 70151 - Draft Guidance for Industry, Clinical Investigators, Institutional Review Boards, and Food and...

    Science.gov (United States)

    2011-11-10

    ... HUMAN SERVICES Food and Drug Administration Draft Guidance for Industry, Clinical Investigators, Institutional Review Boards, and Food and Drug Administration Staff; Food and Drug Administration Decisions for Investigational Device Exemption Clinical Investigations; Availability AGENCY: Food and Drug Administration,...

  19. 78 FR 13070 - Guidance for Clinical Investigators, Industry, and Food and Drug Administration Staff: Financial...

    Science.gov (United States)

    2013-02-26

    ... HUMAN SERVICES Food and Drug Administration (formerly 1999D-4396) Guidance for Clinical Investigators, Industry, and Food and Drug Administration Staff: Financial Disclosure by Clinical Investigators; Availability AGENCY: Food and Drug Administration, HHS. ACTION: Notice. SUMMARY: The Food and...

  20. StaR Child Health: developing evidence-based guidance for the design, conduct, and reporting of pediatric trials.

    Science.gov (United States)

    Hartling, L; Wittmeier, K D M; Caldwell, P H; van der Lee, J H; Klassen, T P; Craig, J C; Offringa, M

    2011-11-01

    Standards for Research in (StaR) Child Health was founded in 2009 to address the paucity and shortcomings of pediatric clinical trials. This initiative involves international experts who are dedicated to developing practical, evidence-based standards to enhance the reliability and relevance of pediatric clinical research. Through a systematic "knowledge to action" plan, StaR Child Health will make efforts to improve and expand the evidence base for child health across the world.

  1. 78 FR 57395 - Guidance for Industry on Electronic Source Data in Clinical Investigations; Availability

    Science.gov (United States)

    2013-09-18

    ... ``Electronic Source Data in Clinical Investigations.'' This document provides guidance to sponsors, contract... accurate and complete data. In the Federal Register of November 20, 2012 (77 FR 69632), FDA issued a draft... FR 76049)). Most of the comments sought clarification on the topics discussed in the guidance....

  2. Effectiveness of Child Psychoanalytic Psychotherapy in a Clinical Outpatient Setting

    Science.gov (United States)

    Deakin, Elisabeth Kuhn; Tiellet Nunes, Maria Lucia

    2009-01-01

    The objective of this study was to evaluate the outcome of child psychoanalytic psychotherapy in a clinical outpatient setting in a city in southern Brazil. Three psychological tests (Rorschach, Bender and WISC III) were administered to 23 children, aged 6-11 years old, and the Child Behaviour Check List (CBCL) was completed by the parents. All…

  3. Development of a prediction model for child maltreatment recurrence in Japan: A historical cohort study using data from a Child Guidance Center.

    Science.gov (United States)

    Horikawa, Hiroyuki; Suguimoto, S Pilar; Musumari, Patou Masika; Techasrivichien, Teeranee; Ono-Kihara, Masako; Kihara, Masahiro

    2016-09-01

    To develop a prediction model for the first recurrence of child maltreatment within the first year after the initial report, we carried out a historical cohort study using administrative data from 716 incident cases of child maltreatment (physical abuse, psychological abuse, or neglect) not receiving support services, reported between April 1, 1996 through March 31, 2011 to Shiga Central Child Guidance Center, Japan. In total, 23 items related to characteristics of the child, the maltreatment, the offender, household, and other related factors were selected as predictive variables and analyzed by multivariate logistic regression model for association with first recurrence of maltreatment. According to the stepwise selection procedure six factors were identified that include 9-13year age of child (AOR=3.43/95%CI=1.52-7.72), maltreatment during childhood (AOR=2.56/95%CI=1.31-4.99), household financial instability or poverty (AOR=1.64/95%CI=1.10-2.45), absence of someone in the community who could watch over the child (AOR=1.68/95%CI=1.16-2.44), and the organization as the referral source (AOR=2.21/95%CI=1.24-3.93). Using these six predictors, we generated a linear prediction model with a sensitivity and specificity of 45.2% and 82.4%, respectively. The model may be useful to assess the risk of further maltreatment and help the child and family welfare administrations to develop preventive strategies for recurrence. PMID:27517122

  4. Clinical practice: vegetarian infant and child nutrition.

    Science.gov (United States)

    Van Winckel, Myriam; Vande Velde, Saskia; De Bruyne, Ruth; Van Biervliet, Stephanie

    2011-12-01

    The aim of this review is to give insight on the benefits and risks of vegetarianism, with special emphasis on vegetarian child nutrition. This eating pattern excluding meat and fish is being adopted by a growing number of people. A vegetarian diet has been shown to be associated with lower mortality of ischaemic heart disease and lower prevalence of obesity. Growth in children on a vegetarian diet including dairy has been shown to be similar to omnivorous peers. Although vegetarianism in adolescents is associated with eating disorders, there is no proof of a causal relation, as the eating disorder generally precedes the exclusion of meat from the diet. A well-balanced lacto-ovo-vegetarian diet, including dairy products, can satisfy all nutritional needs of the growing child. In contrast, a vegan diet, excluding all animal food sources, has at least to be supplemented with vitamin B(12), with special attention to adequate intakes of calcium and zinc and energy-dense foods containing enough high-quality protein for young children. The more restricted the diet and the younger the child, the greater the risk for deficiencies. PMID:21912895

  5. Clinical practice: vegetarian infant and child nutrition.

    Science.gov (United States)

    Van Winckel, Myriam; Vande Velde, Saskia; De Bruyne, Ruth; Van Biervliet, Stephanie

    2011-12-01

    The aim of this review is to give insight on the benefits and risks of vegetarianism, with special emphasis on vegetarian child nutrition. This eating pattern excluding meat and fish is being adopted by a growing number of people. A vegetarian diet has been shown to be associated with lower mortality of ischaemic heart disease and lower prevalence of obesity. Growth in children on a vegetarian diet including dairy has been shown to be similar to omnivorous peers. Although vegetarianism in adolescents is associated with eating disorders, there is no proof of a causal relation, as the eating disorder generally precedes the exclusion of meat from the diet. A well-balanced lacto-ovo-vegetarian diet, including dairy products, can satisfy all nutritional needs of the growing child. In contrast, a vegan diet, excluding all animal food sources, has at least to be supplemented with vitamin B(12), with special attention to adequate intakes of calcium and zinc and energy-dense foods containing enough high-quality protein for young children. The more restricted the diet and the younger the child, the greater the risk for deficiencies.

  6. Clinical assessment of suspected child physical abuse

    International Nuclear Information System (INIS)

    Violence against children has many faces. Child physical abuse, neglect, sexual abuse and interparental violence can cause acute and permanent damage and affect children's development and their life plans in the long term. In industrialized nations almost 1 child in 10 is affected. Up to 10% of child physical abuse cases involve the central nervous system with 80% of these cases occurring during the first year of life. Worldwide more than 50,000 children die as a result of violence, abuse and neglect every year, according to the United Nations Children's Fund UNICEF. In Germany, there are about 120 cases of non-accidental head injury per year. In addition to the officially known cases there is a large grey area for all forms of violence. Recognition of these cases and the provision of help for the victims require an appropriate suspicion and understanding of the pertinent pathophysiology. Suspicion must be based on a well-documented medical history and multidisciplinary diagnostic assessment. Medical confidentiality prevents the disclosure of such information making early detection networks and guidelines for collaboration absolutely indispensable. (orig.)

  7. 78 FR 10503 - Children's Toys and Child Care Articles Containing Phthalates; Final Guidance on Inaccessible...

    Science.gov (United States)

    2013-02-14

    ... other liquid, which could facilitate phthalate migration through a fabric covering. 74 FR 39539 (August.... 2057c(d)(2). 2. Notice of Proposed Guidance In the Federal Register notice of July 31, 2012 (77 FR 45297... stated in the preamble to the proposed guidance (77 FR 45299), the Commission proposed to adopt the...

  8. 77 FR 74670 - Draft Guidance for Industry on Enrichment Strategies for Clinical Trials to Support Approval of...

    Science.gov (United States)

    2012-12-17

    ... Clinical Trials to Support Approval of Human Drugs and Biological Products; Availability AGENCY: Food and... the availability of a draft guidance for industry entitled ``Enrichment Strategies for Clinical Trials... provide guidance to industry on enrichment strategies that can be used in clinical trials intended...

  9. Guidance on Evaluating Options for Representing Clinical Data within Health Information Systems.

    Science.gov (United States)

    Hardiker, Nicholas R; Hynes, Brenda

    2012-01-01

    The health information system PlunketPlus is a clinical initiative of Plunket (the Royal New Zealand Plunket Society) with a goal of further improving the health outcomes for children in New Zealand. The success of PlunketPlus depends heavily on how data is represented within the system. The purpose of the study described in this paper was to use PlunketPlus as a case study to inform the development of guidance on evaluating options for representing clinical data within health information systems, with a particular focus on automating existing informational processes. It has been possible to take some of the lessons learned to inform the development of initial more generic guidance that might be applicable across a range of domains. This paper concludes with a description of how Plunket applied the guidance as part of the development of PlunketPlus.

  10. Multiple Regression Analyses in Clinical Child and Adolescent Psychology

    Science.gov (United States)

    Jaccard, James; Guilamo-Ramos, Vincent; Johansson, Margaret; Bouris, Alida

    2006-01-01

    A major form of data analysis in clinical child and adolescent psychology is multiple regression. This article reviews issues in the application of such methods in light of the research designs typical of this field. Issues addressed include controlling covariates, evaluation of predictor relevance, comparing predictors, analysis of moderation,…

  11. 75 FR 1790 - Draft Guidance for Institutional Review Boards, Clinical Investigators, and Sponsors: IRB...

    Science.gov (United States)

    2010-01-13

    ... of February 3, 2006 (71 FR 5861), which describes FDA's intention to update the process for... HUMAN SERVICES Food and Drug Administration Draft Guidance for Institutional Review Boards, Clinical...: Food and Drug Administration, HHS. ACTION: Notice. SUMMARY: The Food and Drug Administration (FDA)...

  12. CLINICAL-EPIDEMIOLOGICAL ISSUES OF ACQUIRED CHILD METHEMOGLOBINEMIA

    Directory of Open Access Journals (Sweden)

    Letiția-Doina DUCEAC

    2016-03-01

    Full Text Available Nowadays, intoxication with nitrates continues to represent an important aspect in child pathology. Methemoglobinemia symptoms appear when the human body is exposed to high amounts of toxic compounds.The aim of this work was to evaluate the main clinical, biological and development issues of affected patients hospitalized in a specialized clinic. Acquired methemoglobinemia cases of the ”blue child syndrome” type are more frequent than in born ones. The factors considered for the study were the environment from which patients came, a thorough clinical inspection, data on age, nutrition, methemoglobinemia values, other treatments followed, associated diseases and evolution prognosis. The conclusion of the investigation was that a low living standard, a poor health education, the climate, the presence of ground fertilizers and the type of nourishment determined a significant increase of methemoglobinemia patients.

  13. StaR Child Health: developing evidence-based guidance for the design, conduct, and reporting of pediatric trials

    NARCIS (Netherlands)

    L. Hartling; K.D.M. Wittmeier; P.H. Caldwell; J.H. van der Lee; T.P. Klassen; J.C. Craig; M. Offringa

    2011-01-01

    Standards for Research in (StaR) Child Health was founded in 2009 to address the paucity and shortcomings of pediatric clinical trials. This initiative involves international experts who are dedicated to developing practical, evidence-based standards to enhance the reliability and relevance of pedia

  14. Controlled outcome studies of child clinical hypnosis.

    Science.gov (United States)

    Adinolfi, Barbara; Gava, Nicoletta

    2013-08-01

    Background Hypnosis is defined as "as an interaction in which the hypnotist uses suggested scenarios ("suggestions") to encourage a person's focus of attention to shift towards inner experiences". Aim of the work The focus of this review is to summarize the findings of controlled outcome studies investigating the potential of clinical hypnosis in pediatric populations. We will examine the following themes: anesthesia, acute and chronic pain, chemotherapy-related distress, along with other specific medical issues. Results Hypnosis is an effective method to reduce pain and anxiety before, during and after the administration of anesthetics, during local dental treatments, invasive medical procedures and in burn children. Hypnosis can be successfully used to manage recurrent headaches, abdominal pain, irritable bowel syndrome and chemotherapy-related distress. Hypnosis has an important role in managing symptoms and improving the quality of life of children suffering from asthma and cystic fibrosis and in facilitating the treatment of insomnia in school-age children. Finally, hypnosis can be effectively used for the treatment of some habitual disorders such as nocturnal enuresis and dermatologic conditions, including atopic dermatitis and chronic eczema Conclusions Clinical hypnosis seems to be a useful, cheap and side-effects free tool to manage fear, pain and several kinds of stressful experiences in pediatric populations. Children who receive self-hypnosis trainings achieve significantly greater improvements in their physical health, quality of life, and self-esteem. PMID:24165457

  15. Controlled outcome studies of child clinical hypnosis.

    Science.gov (United States)

    Adinolfi, Barbara; Gava, Nicoletta

    2013-09-01

    Background Hypnosis is defined as "as an interaction in which the hypnotist uses suggested scenarios ("suggestions") to encourage a person's focus of attention to shift towards inner experiences". Aim of the work The focus of this review is to summarize the findings of controlled outcome studies investigating the potential of clinical hypnosis in pediatric populations. We will examine the following themes: anesthesia, acute and chronic pain, chemotherapy-related distress, along with other specific medical issues. Results Hypnosis is an effective method to reduce pain and anxiety before, during and after the administration of anesthetics, during local dental treatments, invasive medical procedures and in burn children. Hypnosis can be successfully used to manage recurrent headaches, abdominal pain, irritable bowel syndrome and chemotherapy-related distress. Hypnosis has an important role in managing symptoms and improving the quality of life of children suffering from asthma and cystic fibrosis and in facilitating the treatment of insomnia in school-age children. Finally, hypnosis can be effectively used for the treatment of some habitual disorders such as nocturnal enuresis and dermatologic conditions, including atopic dermatitis and chronic eczema Conclusions Clinical hypnosis seems to be a useful, cheap and side-effects free tool to manage fear, pain and several kinds of stressful experiences in pediatric populations. Children who receive self-hypnosis trainings achieve significantly greater improvements in their physical health, quality of life, and self-esteem.

  16. Clinical utility of ultrasound guidance for intra-articular knee injections: a review

    Directory of Open Access Journals (Sweden)

    Berkoff DJ

    2012-03-01

    Full Text Available David J Berkoff1, Larry E Miller2,3, Jon E Block31Department of Orthopedics, University of North Carolina School of Medicine, Chapel Hill, NC; 2Miller Scientific Consulting Inc, Arden, NC; 3The Jon Block Group, San Francisco, CA, USAAbstract: Intra-articular corticosteroid and hyaluronic acid injections provide short-term symptom amelioration for arthritic conditions involving structural damage or degenerative changes in the knee. Conventional palpation-guided anatomical injections frequently result in inaccurate needle placement into extra-articular tissue and adjacent structures. The purpose of this review was to determine the effect of ultrasound guidance on the accuracy of needle placement, clinical outcomes, and cost-effectiveness in comparison with anatomical landmark-guided intra-articular large joint injections, with particular emphasis on the knee. A total of 13 relevant studies were identified; five studied the knee, seven studied the shoulder, one used both the knee and shoulder, and none studied the hip. Ultrasound was used in seven studies; the remaining studies utilized air arthrography, fluoroscopy, magnetic resonance arthrography, or magnetic resonance imaging. Across all studies (using all imaging modalities and all joints, needle placement accuracy ranged from 63% to 100% with ultrasound and from 39% to 100% with conventional anatomical guidance. Imaging guidance improved the accuracy of intra-articular injections of the knee (96.7% versus 81.0%, P < 0.001 and shoulder (97.3% versus 65.4%, P < 0.001. In particular, ultrasound guidance of knee injections resulted in better accuracy than anatomical guidance (95.8% versus 77.8%, P < 0.001, yielding an odds ratio of 6.4 (95% confidence interval 2.9–14. Ultrasound guidance notably improves injection accuracy in the target intra-articular joint space of large joints including the knee. The enhanced injection accuracy achieved with ultrasound needle guidance directly improves

  17. 75 FR 8968 - Draft Guidance for Industry on Adaptive Design Clinical Trials for Drugs and Biologics; Availability

    Science.gov (United States)

    2010-02-26

    ... entitled ``Adaptive Design Clinical Trials for Drugs and Biologics.'' The draft guidance provides sponsors... Evaluation and Research (CBER) with information regarding adaptive design clinical trials when used in drug... design clinical trials (i.e., clinical, statistical, regulatory) call for special consideration, when...

  18. 2015 Guidance on cancer immunotherapy development in early-phase clinical studies.

    Science.gov (United States)

    2015-12-01

    The development of cancer immunotherapies is progressing rapidly with a variety of technological approaches. They consist of "cancer vaccines", which are based on the idea of vaccination, "effector cell therapy", classified as passive immunotherapy, and "inhibition of immunosuppression", which intends to break immunological tolerance to autoantigens or immunosuppressive environments characterizing antitumor immune responses. Recent reports showing clinical evidence of efficacy of immune checkpoint inhibitors and adoptive immunotherapies with tumor-infiltrating lymphocytes and tumor-specific receptor gene-modified T cells indicate the beginning of a new era for cancer immunotherapy. This guidance summarizes ideas that will be helpful to those who plan to develop cancer immunotherapy. The aims of this guidance are to discuss and offer important points in early phase clinical studies of innovative cancer immunotherapy, with future progress in this field, and to contribute to the effective development of cancer immunotherapy aligned with the scope of regulatory science. This guidance covers cancer vaccines, effector cell therapy, and inhibition of immunosuppression, including immune checkpoint inhibitors.

  19. 78 FR 69690 - Draft Guidance for Industry: Considerations for the Design of Early-Phase Clinical Trials of...

    Science.gov (United States)

    2013-11-20

    ... of Early-Phase Clinical Trials of Cellular and Gene Therapy Products; Extension of Comment Period... entitled ``Guidance for Industry: Considerations for the Design of Early-Phase Clinical Trials of Cellular... assist in designing early-phase clinical trials of CGT products. In the notice, we requested comments...

  20. 78 FR 7784 - Draft Guidance for Industry on Enrichment Strategies for Clinical Trials To Support Approval of...

    Science.gov (United States)

    2013-02-04

    ... Clinical Trials To Support Approval of Human Drugs and Biological Products; Extension of Comment Period... entitled ``Enrichment Strategies for Clinical Trials to Support Approval of Human Drugs and Biological... guidance to industry on enrichment strategies that can be used in clinical trials intended to...

  1. StaR Child Health: developing evidence-based guidance for the design, conduct and reporting of paediatric trials.

    Science.gov (United States)

    Van't Hoff, William; Offringa, Martin

    2015-02-01

    There has been a huge upsurge in clinical research in children in the last decade, stimulated in England by dedicated research infrastructure and support through the National Institute for Health Research. This infrastructure offering research design, expert review, trial management, research nurse, data support and dedicated facilities enables paediatricians to conduct more and better research. The challenge is how to design and conduct trials that will make a real difference to children's health. Standards for Research (StaR) in Child Health was founded in 2009 to address the paucity and shortcomings of paediatric clinical trials. This global initiative involves methodologists, clinicians, patient advocacy groups and policy makers dedicated to developing practical, evidence-based standards for enhancing the reliability and relevance of paediatric clinical research. In this overview, we highlight the contribution of StaR to this agenda, describe the international context, and suggest how StaR's future plans could be integrated with new and existing support for research.

  2. Good Clinical Practice Guidance and Pragmatic Clinical Trials: Balancing the Best of Both Worlds.

    Science.gov (United States)

    Mentz, Robert J; Hernandez, Adrian F; Berdan, Lisa G; Rorick, Tyrus; O'Brien, Emily C; Ibarra, Jenny C; Curtis, Lesley H; Peterson, Eric D

    2016-03-01

    Randomized, clinical trials are commonly regarded as the highest level of evidence to support clinical decisions. Good Clinical Practice guidelines have been constructed to provide an ethical and scientific quality standard for trials that involve human subjects in a manner aligned with the Declaration of Helsinki. Originally designed to provide a unified standard of trial data to support submission to regulatory authorities, the principles may also be applied to other studies of human subjects. Although the application of Good Clinical Practice principles generally led to improvements in the quality and consistency of trial operations, these principles have also contributed to increasing trial complexity and costs. Alternatively, the growing availability of electronic health record data has facilitated the possibility for streamlined pragmatic clinical trials. The central tenets of Good Clinical Practice and pragmatic clinical trials represent potential tensions in trial design (stringent quality and highly efficient operations). In the present article, we highlight potential areas of discordance between Good Clinical Practice guidelines and the principles of pragmatic clinical trials and suggest strategies to streamline study conduct in an ethical manner to optimally perform clinical trials in the electronic age.

  3. Reconsidering Risk for Reoffense in Intrafamilial Child Molesters: New Aspects on Clinical and Criminological Issues

    OpenAIRE

    Reinhard Eher; Thomas Ross

    2006-01-01

    Intrafamilial child molesters are generally seen to be at lower risk for reoffense than extrafamilial child molesters. There is, however, good reason to question this assumption. The literature usually does not take into account some clinical and criminological data, that might indicate a higher relative risk for reoffending in intrafamilial child molesters than generally assumed. On two groups of intrafamilial (n=157) and extrafamilial (n=131) child molesters, this study tested some of the a...

  4. Nonaccidental trauma: clinical aspects and epidemiology of child abuse

    Energy Technology Data Exchange (ETDEWEB)

    Hobbs, Christopher J. [St James' s University Hospital, Department of Community Paediatrics, Leeds (United Kingdom); Bilo, Robert A.C. [Netherlands Forensic Institute, Department of Forensic Pathology, The Hague (Netherlands)

    2009-05-15

    Radiologists play a key role in the recognition of child abuse. In the last century, radiologists pioneered the identification of nonaccidental injuries, including fractures and brain injury, and together with colleagues in paediatrics advocated the protection of children from abuse. Prevalence studies in many countries have revealed the widespread and hidden nature of child maltreatment. New and complex forms of abuse, e.g. fabricated or induced illness, have been recognized. Physical abuse affects 7-9% of children in the UK, although fewer suffer the severe or life-threatening injuries seen by radiologists. A high index of suspicion of nonaccidental trauma is required where known patterns of injury or inconsistencies of presentation and history are detected. In many cases the diagnosis is readily made, although some cases remain contentious or controversial and consume much clinical time and energy. Differences of view between doctors are tested in the courts. Adverse publicity has made this work unpopular in the UK. Knowledge of the differential diagnosis of unexplained or apparent injury is essential for accurate diagnosis, vital where errors in either direction can be disastrous. New UK radiological guidelines will assist radiologists in achieving best evidence-based practice. (orig.)

  5. Nonaccidental trauma: clinical aspects and epidemiology of child abuse

    International Nuclear Information System (INIS)

    Radiologists play a key role in the recognition of child abuse. In the last century, radiologists pioneered the identification of nonaccidental injuries, including fractures and brain injury, and together with colleagues in paediatrics advocated the protection of children from abuse. Prevalence studies in many countries have revealed the widespread and hidden nature of child maltreatment. New and complex forms of abuse, e.g. fabricated or induced illness, have been recognized. Physical abuse affects 7-9% of children in the UK, although fewer suffer the severe or life-threatening injuries seen by radiologists. A high index of suspicion of nonaccidental trauma is required where known patterns of injury or inconsistencies of presentation and history are detected. In many cases the diagnosis is readily made, although some cases remain contentious or controversial and consume much clinical time and energy. Differences of view between doctors are tested in the courts. Adverse publicity has made this work unpopular in the UK. Knowledge of the differential diagnosis of unexplained or apparent injury is essential for accurate diagnosis, vital where errors in either direction can be disastrous. New UK radiological guidelines will assist radiologists in achieving best evidence-based practice. (orig.)

  6. The first clinical treatment with kilovoltage intrafraction monitoring (KIM): A real-time image guidance method

    Energy Technology Data Exchange (ETDEWEB)

    Keall, Paul J., E-mail: paul.keall@sydney.edu.au; O’Brien, Ricky; Huang, Chen-Yu [Radiation Physics Laboratory, Sydney Medical School, University of Sydney, Camperdown, New South Wales 2006 (Australia); Aun Ng, Jin [Radiation Physics Laboratory, Sydney Medical School, University of Sydney, Camperdown, New South Wales 2006, Australia and School of Physics, University of Sydney, Camperdown, New South Wales 2006 (Australia); Colvill, Emma [Radiation Physics Laboratory, Sydney Medical School, University of Sydney, Camperdown, New South Wales 2006, Australia and Northern Sydney Cancer Centre, Royal North Shore Hospital, Sydney, New South Wales 2065 (Australia); Rugaard Poulsen, Per; Fledelius, Walther [Department of Oncology, Aarhus University Hospital, 8000 Aarhus C, Denmark and Institute of Clinical Medicine, Aarhus University, 8000 Aarhus C (Denmark); Juneja, Prabhjot; Booth, Jeremy T. [School of Physics, University of Sydney, Camperdown, New South Wales 2006, Australia and Northern Sydney Cancer Centre, Royal North Shore Hospital, Sydney, New South Wales 2065 (Australia); Simpson, Emma; Bell, Linda; Alfieri, Florencia; Eade, Thomas; Kneebone, Andrew [Northern Sydney Cancer Centre, Royal North Shore Hospital, Sydney, New South Wales 2065 (Australia)

    2015-01-15

    Purpose: Kilovoltage intrafraction monitoring (KIM) is a real-time image guidance method that uses widely available radiotherapy technology, i.e., a gantry-mounted x-ray imager. The authors report on the geometric and dosimetric results of the first patient treatment using KIM which occurred on September 16, 2014. Methods: KIM uses current and prior 2D x-ray images to estimate the 3D target position during cancer radiotherapy treatment delivery. KIM software was written to process kilovoltage (kV) images streamed from a standard C-arm linear accelerator with a gantry-mounted kV x-ray imaging system. A 120° pretreatment kV imaging arc was acquired to build the patient-specific 2D to 3D motion correlation. The kV imager was activated during the megavoltage (MV) treatment, a dual arc VMAT prostate treatment, to estimate the 3D prostate position in real-time. All necessary ethics, legal, and regulatory requirements were met for this clinical study. The quality assurance processes were completed and peer reviewed. Results: During treatment, a prostate position offset of nearly 3 mm in the posterior direction was observed with KIM. This position offset did not trigger a gating event. After the treatment, the prostate motion was independently measured using kV/MV triangulation, resulting in a mean difference of less than 0.6 mm and standard deviation of less than 0.6 mm in each direction. The accuracy of the marker segmentation was visually assessed during and after treatment and found to be performing well. During treatment, there were no interruptions due to performance of the KIM software. Conclusions: For the first time, KIM has been used for real-time image guidance during cancer radiotherapy. The measured accuracy and precision were both submillimeter for the first treatment fraction. This clinical translational research milestone paves the way for the broad implementation of real-time image guidance to facilitate the detection and correction of geometric and

  7. Dose coefficients and derived guidance and clinical decision levels for contaminated wounds

    Energy Technology Data Exchange (ETDEWEB)

    Bertelli, Luiz [Los Alamos National Laboratory; Toohey, Richard E [ORISE/ORAU; Sugarman, Steven A [ORISE/ORAU; Christensen, Doran R [ORISE/ORAU

    2009-01-01

    The NCRP Wound Model describing the retention of selected radionuclides at the site of a contaminated wound and their uptake into the transfer compartment has been combined with the ICRP element-specific systemic models for those radionuclides to derive dose coefficients for intakes via contaminated wounds. Those coefficients have been used to generate derived guidance levels (i.e., the activity in a wound that would result in an effective dose of 20 or 50 mSv, or in some cases, a committed organ equivalent dose of 500 mSv), and clinical decision levels (i.e., activity levels that would indicate the need for consideration of medical intervention to remove activity from the wound site or administration of decorporation therapy or both), typically set at 5 times the derived guidance levels. Data are provided for the radionuclides commonly encountered at nuclear power plants and nuclear weapons, fuel fabrication or recycling, waste disposal, medical and research facilities. These include: {sup 60}Co, {sup 90}Sr, {sup 99m}Tc, {sup 131}I, {sup 137}Cs, {sup 192}Ir, {sup 210}Po, {sup 226,228}Ra, {sup 228,232}Th, {sup 235,238}U, {sup 237}Np, {sup 238,239}Pu, {sup 241}Am, {sup 242,244}Cm, and {sup 252}Cf.

  8. Adjuvant bisphosphonates in early breast cancer: consensus guidance for clinical practice from a European Panel.

    Science.gov (United States)

    Hadji, P; Coleman, R E; Wilson, C; Powles, T J; Clézardin, P; Aapro, M; Costa, L; Body, J-J; Markopoulos, C; Santini, D; Diel, I; Di Leo, A; Cameron, D; Dodwell, D; Smith, I; Gnant, M; Gray, R; Harbeck, N; Thurlimann, B; Untch, M; Cortes, J; Martin, M; Albert, U-S; Conte, P-F; Ejlertsen, B; Bergh, J; Kaufmann, M; Holen, I

    2016-03-01

    Bisphosphonates have been studied in randomised trials in early breast cancer to investigate their ability to prevent cancer treatment-induced bone loss (CTIBL) and reduce the risk of disease recurrence and metastasis. Treatment benefits have been reported but bisphosphonates do not currently have regulatory approval for either of these potential indications. This consensus paper provides a review of the evidence and offers guidance to breast cancer clinicians on the use of bisphosphonates in early breast cancer. Using the nominal group methodology for consensus, a systematic review of the literature was augmented by a workshop held in October 2014 for breast cancer and bone specialists to present and debate the available pre-clinical and clinical evidence for the use of adjuvant bisphosphonates. This was followed by a questionnaire to all members of the writing committee to identify areas of consensus. The panel recommended that bisphosphonates should be considered as part of routine clinical practice for the prevention of CTIBL in all patients with a T score of 18,000 patients supports clinically significant benefits of bisphosphonates on the development of bone metastases and breast cancer mortality in post-menopausal women or those receiving ovarian suppression therapy. Therefore, the panel recommends that bisphosphonates (either intravenous zoledronic acid or oral clodronate) are considered as part of the adjuvant breast cancer treatment in this population and the potential benefits and risks discussed with relevant patients. PMID:26681681

  9. Patient-reported outcome (PRO assessment in clinical trials: a systematic review of guidance for trial protocol writers.

    Directory of Open Access Journals (Sweden)

    Melanie Calvert

    Full Text Available Evidence suggests there are inconsistencies in patient-reported outcome (PRO assessment and reporting in clinical trials, which may limit the use of these data to inform patient care. For trials with a PRO endpoint, routine inclusion of key PRO information in the protocol may help improve trial conduct and the reporting and appraisal of PRO results; however, it is currently unclear exactly what PRO-specific information should be included. The aim of this review was to summarize the current PRO-specific guidance for clinical trial protocol developers.We searched the MEDLINE, EMBASE, CINHAL and Cochrane Library databases (inception to February 2013 for PRO-specific guidance regarding trial protocol development. Further guidance documents were identified via Google, Google scholar, requests to members of the UK Clinical Research Collaboration registered clinical trials units and international experts. Two independent investigators undertook title/abstract screening, full text review and data extraction, with a third involved in the event of disagreement. 21,175 citations were screened and 54 met the inclusion criteria. Guidance documents were difficult to access: electronic database searches identified just 8 documents, with the remaining 46 sourced elsewhere (5 from citation tracking, 27 from hand searching, 7 from the grey literature review and 7 from experts. 162 unique PRO-specific protocol recommendations were extracted from included documents. A further 10 PRO recommendations were identified relating to supporting trial documentation. Only 5/162 (3% recommendations appeared in ≥50% of guidance documents reviewed, indicating a lack of consistency.PRO-specific protocol guidelines were difficult to access, lacked consistency and may be challenging to implement in practice. There is a need to develop easily accessible consensus-driven PRO protocol guidance. Guidance should be aimed at ensuring key PRO information is routinely included in

  10. Clinical Assessment of Child and Adolescent Sleep Disturbance.

    Science.gov (United States)

    Kuhn, Brett R.; Mayfield, Joan W.; Kuhn, Robert H.

    1999-01-01

    Provides guidelines for counselors interested in developing their own assessment procedure to evaluate child and adolescent sleep disturbance. Guidelines include reviewing the developmental and medical history, screening for parental psychopathology, obtaining a child behavior rating scale and sleep diary, and conducting a semistructured clinical…

  11. Origins and Clinical Relevance of Child Death Review Teams.

    Science.gov (United States)

    Durfee, Michael J.; And Others

    1992-01-01

    Discusses the origins, makeup, and activities of child death review teams (CDRTs) used in 21 states in the states' quest to solve cases involving the suspicious death of a child. Advocates the creation of CDRTs in states which do not have them. (MDM)

  12. 75 FR 51083 - Office of Clinical and Preventive Services Maternal and Child Health Program: Project Choices...

    Science.gov (United States)

    2010-08-18

    ... HUMAN SERVICES Indian Health Service Office of Clinical and Preventive Services Maternal and Child...) Morbidity and Mortality Weekly Report (MMWR) dated May 2009 cites studies showing that 0.2 to 1.5 cases of... programmatic involvement will be provided under this CA. The IHS Maternal and Child Health (MCH) Coordinator...

  13. Parent Depression and Child Anxiety: An Overview of the Literature with Clinical Implications

    OpenAIRE

    Colletti, Christina J. M.; Forehand, Rex; Garai, Emily; Rakow, Aaron; McKee, Laura; Fear, Jessica M.; Compas, Bruce E.

    2009-01-01

    The association of parental depression with child anxiety has received relatively little attention in the literature. In this paper we initially present several reasons for examining this relationship. We then summarize the empirical support for a link between these two variables. Finally, we discuss directions for future research and clinical implications of an association of parental depression with child anxiety.

  14. Evaluation of the Brief Problem Checklist: Child and Caregiver Interviews to Measure Clinical Progress

    Science.gov (United States)

    Chorpita, Bruce F.; Reise, Steven; Weisz, John R.; Grubbs, Kathleen; Becker, Kimberly D.; Krull, Jennifer L.

    2010-01-01

    Objective: To support ongoing monitoring of child response during treatment, we sought to develop a brief, easily administered, clinically relevant, and psychometrically sound measure. Method: We first developed child and caregiver forms of a 12-item Brief Problem Checklist (BPC) interview by applying item response theory and factor analysis to…

  15. Temperament and parental child-rearing style: unique contributions to clinical anxiety disorders in childhood

    NARCIS (Netherlands)

    I.E. Lindhout; M.T. Markus; T.H.G. Hoogendijk; F. de Boer

    2009-01-01

    Both temperament and parental child-rearing style are found to be associated with childhood anxiety disorders in population studies. This study investigates the contribution of not only temperament but also parental child-rearing to clinical childhood anxiety disorders. It also investigates whether

  16. 76 FR 68768 - Guidance for Industry: Clinical Considerations for Therapeutic Cancer Vaccines; Availability

    Science.gov (United States)

    2011-11-07

    ... Therapeutic Cancer Vaccines; Availability AGENCY: Food and Drug Administration, HHS. ACTION: Notice. SUMMARY... treatment of patients with an existing diagnosis of cancer. The guidance does not apply to vaccines for... patients with an existing diagnosis of cancer. The guidance does not apply to vaccines for preventative...

  17. Médecins Sans Frontières' Clinical Guidance mobile application: analysis of a new electronic health tool.

    Science.gov (United States)

    Wright, V; Dalwai, M; Smith, R Vincent; Jemmy, J-P

    2015-12-21

    Many health care workers lack access to clinical support tools in rural and resource-limited settings. To address this gap, the Médecins Sans Frontières (MSF) Clinical Guidelines manual was converted into a static mobile health reference application (app) entitled MSF Guidance. The app's utility and growth was examined, and within 6 months of its launch 150 countries had downloaded the app, with demonstrated retention among new and existing users. With over 3500 downloads and 36 000 sessions amounting to 250 000 screen views, MSF Guidance is a new mobile health platform with widely demonstrated utility, including potential use as an epidemiological tool, where clinical conditions investigated by app users were found to correlate with geographical outbreaks. These findings show that mobile apps can be used to disseminate health information effectively.

  18. Substance abuse in pregnant women. Experiences from a special child welfare clinic in Norway

    OpenAIRE

    Rosvold Elin; Lindbæk Morten; Hjerkinn Bjørg

    2007-01-01

    Background Substance abuse during pregnancy may harm the foetus and can cause neonatal abstinence syndrome. Exposure to alcohol and other substances can influence the child for the rest of its life. A special child welfare clinic was set up in 1994 in Kristiansand, Norway, targeting pregnant women with substance abuse problems in the county of Vest-Agder. Pregnancy is not an indication for opioid replacement therapy in Norway, and one of the clinic's aims was to support the...

  19. Towards an intelligent system for clinical guidance on wheelchair tilt and recline usage.

    Science.gov (United States)

    Fu, Jicheng; Wiechmann, Paul; Jan, Yih-Kuen; Jones, Maria

    2012-01-01

    We propose to construct an intelligent system for clinical guidance on how to effectively use power wheelchair tilt and recline functions. The motivations fall into the following two aspects. (1) People with spinal cord injury (SCI) are vulnerable to pressure ulcers. SCI can lead to structural and functional changes below the injury level that may predispose individuals to tissue breakdown. As a result, pressure ulcers can significantly affect the quality of life, including pain, infection, altered body image, and even mortality. (2) Clinically, wheelchair power seat function, i.e., tilt and recline, is recommended for relieving sitting-induced pressures. The goal is to increase skin blood flow for the ischemic soft tissues to avoid irreversible damage. Due to variations in the level and completeness of SCI, the effectiveness of using wheelchair tilt and recline to reduce pressure ulcer risks has considerable room for improvement. Our previous study indicated that the blood flow of people with SCI may respond very differently to wheelchair tilt and recline settings. In this study, we propose to use the artificial neural network (ANN) to predict how wheelchair power seat functions affect blood flow response to seating pressure. This is regression learning because the predicted outputs are numerical values. Besides the challenging nature of regression learning, ANN may suffer from the overfitting problem which, when occurring, leads to poor predictive quality (i.e., cannot generalize). We propose using the particle swarm optimization (PSO) algorithm to train ANN to mitigate the impact of overfitting so that ANN can make correct predictions on both existing and new data. Experimental results show that the proposed approach is promising to improve ANN's predictive quality for new data. PMID:23366964

  20. Prevalence of child abuse in child and adolescent clinical population referred to psychiatric facilities in Tabriz University of Medical Sciences, Iran

    OpenAIRE

    Seyyed Gholamreza Nourazar; Mohammad Rahim Kakaie; Fatemeh Ranjbar; Homayoun Sadeghi-Bazargani; Mostafa Farahbakhsh

    2014-01-01

    Introduction: The present study was ‎designed to evaluate the prevalence of child abuse in a child and adolescent psychiatric clinical population. Methods: This cross-sectional study was conducted in a clinical population of children and adolescents aged 8-18 years. 80 out-patients and 94 in-patients were selected according to probability proportional to size sampling. Kiddie schedule for affective disorder and schizophrenia questionnaire, a demographic questionnaire, and child abuse self-...

  1. Clinical guidance for smallpox vaccine use in a postevent vaccination program.

    Science.gov (United States)

    Petersen, Brett W; Damon, Inger K; Pertowski, Carol A; Meaney-Delman, Dana; Guarnizo, Julie T; Beigi, Richard H; Edwards, Kathryn M; Fisher, Margaret C; Frey, Sharon E; Lynfield, Ruth; Willoughby, Rodney E

    2015-02-20

    the effectiveness of the public health response. Such persons will be defined by public health authorities and should be screened for relative contraindications to smallpox vaccination. Relative contraindications include atopic dermatitis (eczema), HIV infection (CD4 cell counts of 50-199 cells/mm3), other immunocompromised states, and vaccine or vaccine-component allergies. Persons with relative contraindications should be vaccinated with Imvamune when available and authorized for use by the Food and Drug Administration. These recommendations will be updated as new data on smallpox vaccines become available and further clinical guidance for other medical countermeasures including antivirals is developed.

  2. Future directions in clinical child and adolescent psychology: a Delphi survey.

    Science.gov (United States)

    James, Rochelle L; Roberts, Michael C

    2009-10-01

    This study sought to identify the future directions in three domains: clinical practice, research, and training of clinical child and adolescent psychologists in the upcoming decade. Doctoral-level active members in the field were surveyed via a two-round Delphi survey (45 in round 1; 35 in round 2). Evidence-based practice received the greatest consensus by the participants and highest rank in each of the three domains. Other highly ranked clinical practice directions included prevention and early diagnosis and treatment, and clinical services for specific psychological problems. Research directions focused on biological and social factors interactions in the etiology and treatment and specific child and adolescent disorders. In the training domain, major directions included the pursuit of specialty training in child and adolescent psychology and training emphasizing the biological basis of behavior. Implications of these future directions are discussed.

  3. Knowledge, attitude and practice towards child adoption amongst women attending infertility clinics in Lagos State, Nigeria

    Directory of Open Access Journals (Sweden)

    Adenike O. Omosun

    2011-02-01

    Full Text Available Background: Child adoption is a recommended alternative form of infertility management. Infertility is of public health importance in Nigeria and many other developing nations. This is a result of its high prevalence and especially because of its serious social implications as the African society places a passionate premium on procreation in any family setting. Objectives: The aim of this study was to determine the knowledge, attitude and practice of child adoption amongst women attending infertility clinics in teaching hospitals in Lagos State and to determine the factors that influence their attitude and practice towards it.Method: A cross-sectional descriptive design was used. Data were collected by using a structured questionnaire which was interviewer-administered. The study was conducted in the two teaching hospitals in Lagos State (LUTH [Lagos University Teaching Hospital] and LASUTH [Lagos State University Teaching Hospital] from amongst 350 women attending the gynaecological clinics. All the patients under management for infertility at the gynaecology clinics during the period of the study were interviewed.Results: Many respondents (85.7% had heard of child adoption and 59.3% of them knew the correct meaning of the term. More than half of the respondents (68.3% said that they could love an adopted child but less than half of them (33.7% were willing to consider adoption. Only 13.9% has ever adopted a child. The major reason given for their unwillingness to adopt was their desire to have their own biological child. Factors that were favourable towards child adoption were Igbo tribe identity, an age above 40 years, duration of infertility above 15 years, and knowing the correct meaning of child adoption.Conclusion: There is a poor attitude to adoption even amongst infertile couples. Interventions need to be implemented to educate the public on child adoption, to improve their attitude towards adoption and to make it more acceptable.

  4. Clinical application of music therapy assessment within the field of child protection

    DEFF Research Database (Denmark)

    Jacobsen, Stine Lindahl; Killén, Kari

    2015-01-01

    The focus of this article is the theoretical understanding behind, and the clinical application of, a newly developed music-therapy assessment tool, Assessment of Parenting Competencies (APC). While the psychometric properties have been analyzed successfully in prior publications, the advantages...... and challenges of a nonverbal and emotional interactional medium such as music in assessing parent–child interaction and parental capacity are presented and discussed. The assessment model relates to theories of attunement, autonomy, and attachment, and clinical relevance for practice within the field of child......-service professions within the field of child protection, including level of mutual attunement, nonverbal communication skills, emotional parental response, and possibly indications of attachment behavior in the child. APC can thereby help indicate the severity of the situation and the possible therapeutic direction...

  5. Sluggish Cognitive Tempo in a Child and Adolescent Clinical Outpatient Setting.

    Science.gov (United States)

    Camprodon-Rosanas, Ester; Batlle, Santiago; Estrada-Prat, Xavier; Aceña-Díaz, Marta; Petrizan-Aleman, Araitz; Pujals, Elena; Martin-López, Luis M; Pérez-Solá, Víctor; Ribas-Fitó, Núria

    2016-09-01

    Sluggish cognitive tempo (SCT) symptoms have largely emerged from investigations of attention-deficit/hyperactivity disorder (ADHD). Recent research has demonstrated the relevance of SCT symptoms in the field of clinical child and adolescent psychiatry. The goal of this research was to study the symptoms of SCT in a clinical child and adolescent sample and to define its features and comorbid conditions. We reviewed 834 clinical records of patients referred to Child and Adolescent Mental Health Services and examined SCT symptoms and their relation with sociodemographic data, clinical diagnosis, comorbid conditions, Child Behavior Checklist dimensions, and intelligence quotient. Of the 515 patients (age range, 4 to 17 y, 62.5% male) for whom a fully completed Child Behavior Checklist for Children and Adolescents was available, 20.8% showed high levels of SCT symptoms. SCT symptoms were strongly associated with age, internalizing symptoms, learning disabilities, and ADHD inattentive subtype (ADHD-I). No significant correlations with intelligence quotient were found. We concluded that SCT symptoms are highly prevalent in a clinical sample, and that these symptoms might be related to the difficulties that some individuals have in responding to demands in their environments, such as academic or social demands, as they increase over time. PMID:27648500

  6. 孕期营养指导对妊娠结局和母婴健康的影响%Nutritional guidance during pregnancy on pregnancy outcome and influence of maternal and child health

    Institute of Scientific and Technical Information of China (English)

    陈春霞; 霍江华

    2015-01-01

    Objective:Nutritional guidance during pregnancy on pregnancy outcome and the influence of maternal and child health . Methods:To our hospital maternity clinic of pregnant women selected 180 cases, were randomly divided into two groups , 90 cases in each group, control group received conventional early detection and nursing , the experimental group on the basis of control group accepted nu-tritional guidance during pregnancy , compared two groups of pregnancy outcome and maternal and child health .Results:The experimen-tal group of cesarean section , anemia in pregnancy , gestational diabetes , premature rupture of membranes , and the incidence rate of post-partum hemorrhage were significantly lower than those of the control group and experimental group , fetal growth restriction , fetal macroso-mia, low birth weight, premature birth rate were significantly lower than the control group , the difference had statistical significance . Conclusion:in the obstetrical nursing intervening nutrition guidance during pregnancy which was propitious to the pregnant women to de -velop scientific and reasonable eating habits ,to reduce perinatal complications , so as to improve the pregnancy outcome , it might be worthy of popularization and application .%目的:探讨孕期营养指导对妊娠结局和母婴健康状况的影响。方法:选取来我院产科就诊的孕妇180例,随机为2组,每组90例,对照组接受常规早期检查与护理,实验组在对照组的基础上接受孕期营养指导,比较2组的妊娠结局与母婴健康状况。结果:实验组的剖宫产率、妊娠期贫血、妊娠期糖尿病、胎膜早破、以及产后出血发生率均显著低于对照组,同时实验组胎儿生长受限、巨大胎儿、低体重儿、早产率均显著低于对照组,差异有统计学意义。结论:在产科护理中介入孕期营养指导有利于促使孕妇养成科学合理的饮食习惯,降低围生期并发症,从而

  7. 75 FR 39263 - Guidance for Humanitarian Device Exemption Holders, Institutional Review Boards, Clinical...

    Science.gov (United States)

    2010-07-08

    ... their device. In the Federal Register of August 5, 2008 (73 FR 45460), FDA published a 60-day notice... September 30, 2009 (74 FR 50214), but republished a 30-day notice on February 18, 2010 (75 FR 7270), to... HUMAN SERVICES Food and Drug Administration Guidance for Humanitarian Device Exemption...

  8. Evaluation of Hanau's formula in determination of lateral condylar guidance: A clinical research study

    Science.gov (United States)

    Bhawsar, Sanjay Vasant; Marathe, Ashlesha Subhash; Ansari, Sadekh Abdul

    2015-01-01

    Statement of Problem: The accuracy and reliability of the methods used for programming the semi-adjustable articulators determine the accuracy in occlusion. The current recommended average settings using the Hanau's formula commonly used by clinicians is questionable, and thus reassessment is needed. This study was carried out to evaluate and compare the lateral condylar guidance: (1) Using the Hanau's formula and the computerized jaw tracking device (Kinesiograph). (2) On the right and left sides using both these methods. Materials and Methods: A total of 20 completely edentulous patients (14 male and 6 females) within 40–60 years of age were selected. Jaw relation was recorded followed by face bow transfer. Extraoral Gothic arch tracing was recorded; three protrusive records were obtained and condylar guidance was calculated. Lateral condylar guidance was then calculated using Hanau's formula, followed by the computerized jaw tracking device. A comparative evaluation was done of the obtained values. The same investigator worked with each of the study participants for the purpose of standardization. Results: The lateral condylar guidance values obtained using the Hanau's formula ranged from 14 to 17° while those obtained using the computerized K7 jaw tracking device ranged from 8 to 40°. Bennett angle values, obtained using the jaw tracking device and Hanau's formula showed statistically significant differences (P 0.05). Conclusion: Based on the results, dentist and dental technicians should consider reassessing the current recommended average settings and use of the Hanau's formula for programming the semi-adjustable articulators. PMID:26929535

  9. Reconsidering Risk for Reoffense in Intrafamilial Child Molesters: New Aspects on Clinical and Criminological Issues

    Directory of Open Access Journals (Sweden)

    Reinhard Eher

    2006-08-01

    Full Text Available Intrafamilial child molesters are generally seen to be at lower risk for reoffense than extrafamilial child molesters. There is, however, good reason to question this assumption. The literature usually does not take into account some clinical and criminological data, that might indicate a higher relative risk for reoffending in intrafamilial child molesters than generally assumed. On two groups of intrafamilial (n=157 and extrafamilial (n=131 child molesters, this study tested some of the assumptions generally made about these offender groups. We found that there are indeed differences that can not be interpreted in line with the general literature on this topic. Most importantly, the time from onset of offense until official conviction is much longer in intrafamilial than extrafamilial offenders, rendering the former considerable more opportunity to consistently recidivate that the latter. Results are discussed and interpreted in terms of treatment needs for both groups of individuals.

  10. The first clinical treatment with kilovoltage intrafraction monitoring (KIM): A real-time image guidance method

    DEFF Research Database (Denmark)

    Keall, Paul J.; Aun Ng, Jin; O'Brien, Ricky;

    2015-01-01

    Purpose: Kilovoltage intrafraction monitoring (KIM) is a real-time image guidance method that uses widely available radiotherapy technology, i.e., a gantry-mounted x-ray imager. The authors report on the geometric and dosimetric results of the first patient treatment using KIM which occurred...... system. A 120° pretreatment kV imaging arc was acquired to build the patient-specific 2D to 3D motion correlation. The kV imager was activated during the megavoltage (MV) treatment, a dual arc VMAT prostate treatment, to estimate the 3D prostate position in real-time. All necessary ethics, legal...... to be performing well. During treatment, there were no interruptions due to performance of the KIM software. Conclusions: For the first time, KIM has been used for real-time image guidance during cancer radiotherapy. The measured accuracy and precision were both submillimeter for the first treatment fraction...

  11. Child Rights and Clinical Bioethics: Historical Reflections on Modern Medicine and Ethics.

    Science.gov (United States)

    Brosco, Jeffrey P

    2016-01-01

    Why might pediatric bioethicists in the United States reject the U.N. Convention on the Rights of the Child (CRC) as a framework for resolving ethical issues? The essays in this issue present arguments and counterarguments regarding the usefulness of the CRC in various clinical and research cases. But underlying this debate are two historical factors that help explain the seeming paradox of pediatric bioethicists' arguing against child's rights. First, the profession of clinical bioethics emerged in the 1970s as one component of modern medicine's focus on improving health through the application of technologically sophisticated treatments. The everyday work of U.S. bioethicists thus usually involves emerging technologies or practices in clinical or laboratory settings; the articles of the CRC, in contrast, seem better suited to addressing broad policy issues that affect the social determinants of health. Second, U.S. child health policy veered away from a more communitarian approach in the early 20th century for reasons of demography that were reinforced by ideology and concerns about immigration. The divide between clinical medicine and public health in the United States, as well as the relatively meager social safety net, are not based on a failure to recognize the rights of children. Indeed, there is some historical evidence to suggest that "rights language" has hindered progress on child health and well-being in the United States. In today's political climate, efforts to ensure that governments pledge to treat children in accordance with their status as human beings (a child right's perspective) are less likely to improve child health than robust advocacy on behalf of children's unique needs, especially as novel models of health-care financing emerge. PMID:27157355

  12. Child Versus Family Cognitive-Behavioral Therapy in Clinically Anxious Youth : An Efficacy and Partial Effectiveness Study

    NARCIS (Netherlands)

    Bodden, Denise H. M.; Bogels, Susan M.; Nauta, Maaike H.; De Haan, Else; Ringrose, Jaap; Appelboom, Carla; Brinkman, Andries G.; Appelboom-Geerts, Karen C. M. M. J.

    2008-01-01

    Objective: The efficacy and partial effectiveness of child-focused versus family-focused cognitive-behavioral therapy (CBT) for clinically anxious youths was evaluated, in particular in relation to parental anxiety disorders and child's age. Method: Clinically referred children with anxiety disorder

  13. Child Versus Family Cognitive-Behavioral Therapy in Clinically Anxious Youth: An Efficacy and Partial Effectiveness Study

    NARCIS (Netherlands)

    Bodden, D.H.M.; Bögels, S.M.; Nauta, M.H.; Haan, E. de; Ringrose, J.; Appelboom, C.; Brinkman, A.G.; Appelboom-Geerts, K.C.M.M.J.

    2008-01-01

    Objective: The efficacy and partial effectiveness of child-focused versus family-focused cognitive-behavioral therapy (CBT) for clinically anxious youths was evaluated, in particular in relation to parental anxiety disorders and child's age. Method: Clinically referred children with anxiety disorder

  14. Treatment of an open traumatic dislocation of the thigh in a child (a clinical case)

    OpenAIRE

    Guzenko, Sergey; Gutsul, Ivan; Kutsiy, Mykola; Nikoruk, Vasyl; Getmanchuk, Yuriy

    2012-01-01

    The authors describe a casuistic case of an open traumatic dislocation of the femoral head in a 14-year-old child. The tactics of treatment is described; a good clinical result was achieved with a follow-up period of 11 months.

  15. Delivering Parent-Child Interaction Therapy in an Urban Community Clinic

    Science.gov (United States)

    Budd, Karen S.; Hella, Bryce; Bae, Hyo; Meyerson, David A.; Watkin, Sarah C.

    2011-01-01

    Extensive evidence supports the efficacy of Parent-Child Interaction Therapy (PCIT) for reducing behavior problems in young children; however, little is known about the use of PCIT in a community mental health center (CMHC). This paper provides four clinical case examples of families who were referred to and successfully completed PCIT in an urban…

  16. Social and Emotional Outcomes of Child Sexual Abuse: A Clinical Sample in Turkey

    Science.gov (United States)

    Ozbaran, Burcu; Erermis, Serpil; Bukusoglu, Nagehan; Bildik, Tezan; Tamar, Muge; Ercan, Eyyup Sabri; Aydin, Cahide; Cetin, Saniye Korkmaz

    2009-01-01

    Childhood sexual abuse is a traumatic life event that may cause psychiatric disorders such as posttraumatic stress disorder and depression. During 2003-2004, 20 sexually abused children were referred to the Child and Adolescent Psychiatry Clinic of Ege University in Izmir, Turkey. Two years later, the psychological adjustment of these children (M…

  17. Pediatric Clinical Pharmacology and Child Health:A Canadian Perspective

    Institute of Scientific and Technical Information of China (English)

    Stuart Macleod

    2011-01-01

    @@ Introduction Canadian academic centres and children's hospitals have had a longstanding interest in the improvement of drug therapy for children through research conducted across the four pillars of activity identified as being of critical importance by the Canadian Institutes of Health Research(viz,basic research,clinical research,population health research,applied health and policy research)[1].

  18. MR guidance and thermometry of percutaneous laser disc decompression in open MRI: an initial clinical investigation

    Energy Technology Data Exchange (ETDEWEB)

    Streitparth, Florian; Walter, Thula; Bucourt, Maximilian de; Freyhardt, Patrick; Maurer, Martin; Renz, Diane; Gebauer, Bernhard; Hamm, Bernd; Teichgraeber, Ulf K.M. [Charite, Humboldt-University Medical School, Department of Radiology, Berlin (Germany); Hartwig, Tony; Putzier, Michael; Strube, Patrick [Charite, Humboldt-University, Center for Musculoskeletal Surgery, Berlin (Germany); Bretschneider, Tina [University of Magdeburg, Department of Radiology, Magdeburg (Germany)

    2013-10-15

    To assess the feasibility, safety and efficacy of real-time MR guidance and thermometry of percutaneous laser disc decompression (PLDD). Twenty-four discs in 22 patients with chronic low-back and radicular pain were treated by PLDD using open 1.0-T magnetic-resonance imaging (MRI). A fluoroscopic proton-density-weighted turbo spin-echo (PDw TSE) sequence was used to position the laser fibre. Non-spoiled gradient-echo (GRE) sequences were employed for real-time thermal monitoring based on proton resonance frequency (PRF). Radicular pain was assessed over 6 months with a numerical rating scale (NRS). PLDD was technically successful in all cases, with adequate image quality for laser positioning. The PRF-based real-time temperature monitoring was found to be feasible in practice. After 6 months, 21 % reported complete remission of radicular pain, 63 % at least great pain relief and 74 % at least mild relief. We found a significant decrease in the NRS score between the pre-intervention and the 6-month follow-up assessment (P < 0.001). No major complications occurred; the single adverse event recorded, moderate motor impairment, resolved. Real-time MR guidance and PRF-based thermometry of PLDD in the lumbar spine under open 1.0-T MRI appears feasible, safe and effective and may pave the way to more precise operating procedures. (orig.)

  19. Spine radiosurgery for the local treatment of spine metastases: Intensity-modulated radiotherapy, image guidance, clinical aspects and future directions

    Directory of Open Access Journals (Sweden)

    Fabio Ynoe de Moraes

    2016-02-01

    Full Text Available Many cancer patients will develop spinal metastases. Local control is important for preventing neurologic compromise and to relieve pain. Stereotactic body radiotherapy or spinal radiosurgery is a new radiation therapy technique for spinal metastasis that can deliver a high dose of radiation to a tumor while minimizing the radiation delivered to healthy, neighboring tissues. This treatment is based on intensity-modulated radiotherapy, image guidance and rigid immobilization. Spinal radiosurgery is an increasingly utilized treatment method that improves local control and pain relief after delivering ablative doses of radiation. Here, we present a review highlighting the use of spinal radiosurgery for the treatment of metastatic tumors of the spine. The data used in the review were collected from both published studies and ongoing trials. We found that spinal radiosurgery is safe and provides excellent tumor control (up to 94% local control and pain relief (up to 96%, independent of histology. Extensive data regarding clinical outcomes are available; however, this information has primarily been generated from retrospective and nonrandomized prospective series. Currently, two randomized trials are enrolling patients to study clinical applications of fractionation schedules spinal Radiosurgery. Additionally, a phase I clinical trial is being conducted to assess the safety of concurrent stereotactic body radiotherapy and ipilimumab for spinal metastases. Clinical trials to refine clinical indications and dose fractionation are ongoing. The concomitant use of targeted agents may produce better outcomes in the future.

  20. Spine radiosurgery for the local treatment of spine metastases: Intensity-modulated radiotherapy, image guidance, clinical aspects and future directions

    Energy Technology Data Exchange (ETDEWEB)

    Moraes, Fabio Ynoe de; Neves-Junior, Wellington Furtado Pimenta; Hanna, Samir Abdallah; Carvalho, Heloisa de Andrade [Hospital Sirio-Libanes, Sao Paulo, SP (Brazil). Departamento de Radioterapia; Taunk, Neil Kanth; Yamada, Yoshiya [Memorial Sloan Kettering Cancer Center, Department of Radiation Oncology, New York, NY (United States); Laufer, Ilya, E-mail: fymoraes@gmail.com [Memorial Sloan Kettering Cancer Center, Department of Neurosurgery, New York, NY (United States)

    2016-02-15

    Many cancer patients will develop spinal metastases. Local control is important for preventing neurologic compromise and to relieve pain. Stereotactic body radiotherapy or spinal radiosurgery is a new radiation therapy technique for spinal metastasis that can deliver a high dose of radiation to a tumor while minimizing the radiation delivered to healthy, neighboring tissues. This treatment is based on intensity-modulated radiotherapy, image guidance and rigid immobilization. Spinal radiosurgery is an increasingly utilized treatment method that improves local control and pain relief after delivering ablative doses of radiation. Here, we present a review highlighting the use of spinal radiosurgery for the treatment of metastatic tumors of the spine. The data used in the review were collected from both published studies and ongoing trials. We found that spinal radiosurgery is safe and provides excellent tumor control (up to 94% local control) and pain relief (up to 96%), independent of histology. Extensive data regarding clinical outcomes are available; however, this information has primarily been generated from retrospective and non randomized prospective series. Currently, two randomized trials are enrolling patients to study clinical applications of fractionation schedules spinal Radiosurgery. Additionally, a phase I clinical trial is being conducted to assess the safety of concurrent stereotactic body radiotherapy and ipilimumab for spinal metastases. Clinical trials to refine clinical indications and dose fractionation are ongoing. The concomitant use of targeted agents may produce better outcomes in the future. (author)

  1. How Public Health Nurses Identify and Intervene in Child Maltreatment Based on the National Clinical Guideline

    Directory of Open Access Journals (Sweden)

    Paavilainen Eija

    2014-01-01

    Full Text Available Objectives. To describe how Finnish public health nurses identify and intervene in child maltreatment and how they implement the National Clinical Guideline in their work. Design and Sample. Cross-sectional survey of 367 public health nurses in Finland. Measures. A web-based questionnaire developed based on the content areas of the guideline: identifying, intervening, and implementing. Results. The respondents reported they identify child maltreatment moderately (mean 3.38, intervene in it better (4.15, and implement the guideline moderately (3.43, scale between 1 and 6. Those with experience of working with maltreated children reported they identify them better P<0.001, intervene better P<0.001, and implement the guideline better P<0.001 than those with no experience. This difference was also found for those who were aware of the guideline, had read it, and participated in training on child maltreatment, as compared to those who were not aware of the guideline, had not read it, or had not participated in such training. Conclusions. The public health nurses worked quite well with children who had experienced maltreatment and families. However, the results point out several developmental targets for increasing training on child maltreatment, for devising recommendations for child maltreatment, and for applying these recommendations systematically in practice.

  2. Healthcare Reform and Preparing the Future Clinical Child and Adolescent Psychology Workforce.

    Science.gov (United States)

    Janicke, David M; Fritz, Alyssa M; Rozensky, Ronald H

    2015-01-01

    The healthcare environment is undergoing important changes for both patients and providers, in part due to the Patient Protection and Affordable Care Act (ACA). Ultimately the healthcare delivery system will function very differently by the end of this decade. These changes will have important implications for the education, training, scientific inquiry, and practice of clinical child and adolescent psychologists. In this article we provide a brief description of the fundamental features of the ACA, with a specific focus on critical components of the act that have important, specific implications for clinical child and adolescents psychologists. We then provide recommendations to help position our field to thrive in the evolving healthcare environment to help facilitate further awareness and promote discussion of both challenges and opportunities that face our field in this evolving health care environment.

  3. Best clinical practice guidance for management of early caries lesions in children and young adults: an EAPD policy document.

    Science.gov (United States)

    Richards, Derek

    2016-06-01

    Scope and purposeThe guidance provides evidence- and clinically-based recommendations for detecting and diagnosing early/non-cavitated caries lesions, risk assessment and disease management.MethodologyThe guidance development is based on three reviews(1,2,3) and an interim seminar and workshop organised by the European Academy of Paediatric Dentistry in Brussels in May 2015.Review and updatingNo indication of a review or update schedule is given.RecommendationsSeven recommendations on caries detection and diagnosis, four recommendations on caries risk assessment and 11 on the management of the early carious lesion were made and they are briefly summarised in the table below.Research RecommendationsCaries detection and diagnosisThere is a need for more research in the primary dentition because most of the available studies consider only the permanent dentitionRadiograph subtraction studies need to be conductedOngoing evaluation of new methods and devicesThere is a need for well-designed prevention studies on early childhood caries which will provide sufficient and strong evidence of the cost-effectivenessThere is a significant need to bring the knowledge and learning to regular dental practice, to all the paediatric health care providers, the children and their parents.Caries risk assessmentClinical trials to assess the validity of models and single risk factors, as well as the role of confounding factors (eg age, lifestyle, socio-economy and socio-demography), for predicting caries.Further quantitative and qualitative health professional and parents would be helpful to identify perceptions and barriers to carrying out a CRA and to deliver a risk-based preventive care that could bridge the social inequalities in dental health.More research on the implementation of risk-based caries prevention and to establish the cost-effectiveness of such strategies.

  4. Child versus Family Cognitive-Behavioral Therapy in Clinically Anxious Youth: An Efficacy and Partial Effectiveness Study

    Science.gov (United States)

    Bodden, Denise H. M.; Bogels, Susan M.; Nauta, Maaike H.; De Hann, Else; Ringrose, Jaap; Appelboom, Carla; Brinkman, Andries G.; Appelboom-Geerts, Karen C. M. M. J.

    2008-01-01

    Child-focused and family-focused cognitive-behavioral therapy (CBT) for 128 children with clinical anxiety disorders and their parents were compared in terms of efficacy and partial effectiveness. Results indicate that 53% of the children under the child CBT became free of anxiety disorders at posttreamtent compared to only 28% under family CBT.…

  5. Epistaxis as first clinical presentation in a child with giant prolactinoma: Case report and review of literature

    OpenAIRE

    Pramod Kumar Chaurasia; Daljit Singh; Sujeet Meher; Saran, R.K.; Hukum Singh

    2011-01-01

    Pituitary tumour have a wide way of presentation. Epistaxis due to pituitary adenoma has been rarely reported. There is no report of bleeding from nose as clinical first presentation in a child. We report the first case in literature where a child had epistaxis for eight months before deterioration of vision. He was found to be having a invasive prolactinoma with normal prolactin levels.

  6. Fears in Clinic-Referred Children: Relations with Child Anxiety Sensitivity, Maternal Overcontrol, and Maternal Phobic Anxiety

    Science.gov (United States)

    Ollendick, Thomas H.; Horsch, Laura M.

    2007-01-01

    Relations among maternal phobic anxiety, maternal overcontrol, child anxiety sensitivity, and child level of fear were explored in 156 children referred to an outpatient clinic for psychological evaluation. In addition, these relations were examined separately in analyses of age, gender, and diagnostic status. Overall, age, gender, and child…

  7. Integrating Best Practices in Positive Behavior Support and Clinical Psychology for a Child with Autism and Anxiety-Related Problem Behavior: A Clinical Case Study

    Science.gov (United States)

    Neufeld, Vanessa; Law, Kimberley C. Y.; Lucyshyn, Joseph M.

    2014-01-01

    This clinical case study investigated the effectiveness of a multicomponent intervention for a child with autism and anxiety-related problem behavior that integrated components of cognitive behavior therapy (CBT) with positive behavior support (PBS). One child with autism and his family participated. The dependent variable was the number of steps…

  8. Framework and guidance for implementing patient-reported outcomes in clinical practice: evidence, challenges and opportunities.

    Science.gov (United States)

    Porter, Ian; Gonçalves-Bradley, Daniela; Ricci-Cabello, Ignacio; Gibbons, Chris; Gangannagaripalli, Jaheeda; Fitzpatrick, Ray; Black, Nick; Greenhalgh, Joanne; Valderas, Jose M

    2016-08-01

    Patient-reported outcomes (PROs) are reports of the status of a patient's health condition that come directly from the patient. While PRO measures are a well-developed technology with robust standards in research, their use for informing healthcare decisions is still poorly understood. We review relevant examples of their application in the provision of healthcare and examine the challenges associated with implementing PROs in clinical settings. We evaluate evidence for their use and examine barriers to their uptake, and present an evidence-based framework for the successful implementation of PROs in clinical practice. We discuss current and future developments for the use of PROs in clinical practice, such as individualized measurement and computer-adaptive testing. PMID:27427277

  9. A simple clinical coding strategy to improve recording of child maltreatment concerns: an audit study

    Directory of Open Access Journals (Sweden)

    Andrew Peter McGovern

    2015-01-01

    Full Text Available Background Recording concerns about child maltreatment, including minor concerns, is recommended by the General Medical Council (GMC and National Institute for Health and Clinical Excellence (NICE but there is evidence of substantial under-recording.Aim To determine whether a simple coding strategy improved recording of maltreatment-related concerns in electronic primary care records.Design and Setting Clinical audit of rates of maltreatment-related coding before January 2010–December 2011 and after January–December 2012 implementation of a simple coding strategy in 11 English family practices. The strategy included encouraging general practitioners to use, always and as a minimum, the Read code ‘Child is cause for concern’. A total of 25,106 children aged 0–18 years were registered with these practices. We also undertook a qualitative service evaluation to investigate barriers to recording.Method Outcomes were recording of 1 any maltreatment-related codes, 2 child protection proceedings and 3 child was a cause for concern.Results We found increased recording of any maltreatment-related code (rate ratio 1.4; 95% CI 1.1–1.6, child protection procedures (RR 1.4; 95% CI 1.1–1.6 and cause for concern (RR 2.5; 95% CI 1.8–3.4 after implementation of the coding strategy. Clinicians cited the simplicity of the coding strategy as the most important factor assisting implementation.Conclusion This simple coding strategy improved clinician’s recording of maltreatment-related concerns in a small sample of practices with some ‘buy-in’. Further research should investigate how recording can best support the doctor–patient relationshipHow this fits in Recording concerns about child maltreatment, including minor concerns, is recommended by the General Medical Council (GMC and National Institute for Health and Clinical Excellence (NICE, but there is evidence of substantial underrecording. We describe a simple clinical coding

  10. Preparing raw clinical data for publication: guidance for journal editors, authors, and peer reviewers

    OpenAIRE

    Vickers Andrew J; Norton Melissa L; Hrynaszkiewicz Iain; Altman Douglas G

    2010-01-01

    Abstract In recognition of the benefits of transparent reporting, many peer-reviewed journals require that their authors be prepared to share their raw, unprocessed data with other scientists and/or state the availability of raw data in published articles. But little information on how data should be prepared for publication - or sharing - has emerged. In clinical research patient privacy and consent for use of personal health information are key considerations, but agreed-upon definitions of...

  11. Substance abuse in pregnant women. Experiences from a special child welfare clinic in Norway

    Directory of Open Access Journals (Sweden)

    Rosvold Elin

    2007-11-01

    Full Text Available Abstract Background Substance abuse during pregnancy may harm the foetus and can cause neonatal abstinence syndrome. Exposure to alcohol and other substances can influence the child for the rest of its life. A special child welfare clinic was set up in 1994 in Kristiansand, Norway, targeting pregnant women with substance abuse problems in the county of Vest-Agder. Pregnancy is not an indication for opioid replacement therapy in Norway, and one of the clinic's aims was to support the drug dependent women through their pregnancy without any replacements. The object of this paper is to describe concurrent health and social problems, as well as the predictors for stopping drug abuse, in the clinic's user group. Methods Retrospective cohort study. Data was gathered from the medical records of all 102 women seen in the clinic in the period between 1992 and 2002. The study includes 59 out of 60 women that were followed until their children were two years old or placed in alternative care, and a comparison group of twice the size. Both groups were presented with a questionnaire concerning both the pregnancy and health and socio-economic issues. Results Four (4.5 percent of the women that completed their pregnancies did not manage to reduce their substance abuse. All the others reduced their substance abuse considerably. The odds ratio for stopping substance abuse within the first trimester was significantly associated with stopping smoking (O.R. 9.7 or being victims of rape (O.R. 5.3. Conclusion A low cost and low threshold initiative organised as a child welfare clinic may support women with substance abuse problems in their efforts to stop or reduce their substance abuse during pregnancy.

  12. Clinical background and its relation to results of percutaneous needle biopsy of suspected bone metastasis under guidance with CT fluoroscopy

    International Nuclear Information System (INIS)

    The purpose of this study was to investigate the clinical background of needle biopsy of suspected bone metastasis under guidance with CT fluoroscopy. During a 3-year period (from April 2000 to March 2003), 103 needle biopsies on 101 lesions of 90 patients were performed for pathological evaluation of suspected bone metastasis. The clinical course of these patients prior to biopsy and its relation to the biopsy results were retrospectively reviewed. Sixty-two patients (69% of total cases) were referred for biopsy from orthopedic surgeons, and 51 of these patients consulted orthopedic surgeons on the initial presentation. Malignancy was pathologically proved in 47 (76%) of the 62 orthopedic patients, and in 19 (68%) of the 28 patients referred from other clinicians. Thirteen (21%) of the orthopedic patients had a history of malignancy, while 22 (78%) of the non-orthopedic patients were cancer patients. Metastasis was pathologically proved in 23 (66%) of the 35 patients with a history of malignancy, while malignancy was pathologically proved in 43 (78%) of the 55 patients without known malignancy. Diagnostic accuracy of the needle bone biopsy was 96%, and its complication rate was 0.7%. In the era of CT fluoroscopy, needle biopsy for suspected bone metastasis was most frequently requested for the patients who consulted orthopedic surgeons for the occurrence of local bone pain as the initial symptom of unknown malignancy. Frequency of malignancy proved by the biopsy in those patients was as high as that in the cancer patients referred from other clinicians. (author)

  13. Human Factors for Clinical Engineering - The Realization of a Guidance Text

    Institute of Scientific and Technical Information of China (English)

    A C Easty; A L Cassano-Pich; M Griffin; Y-L Lin; P Trbovich

    2016-01-01

    Industries such as aviation and nuclear power have greatly improved their safety performance through the application of human factors methods to the design, development, selection and deployment of a range of technologies and work processes. Health care safety performance generally lags behind these industries and would benefit from a similar application of human factors methods. Clinical engineers are in an ideal position to acquire and apply this human factors knowledge, and lead its adoption in health care. This paper describes a text that has been written speciifcally for clinical engineers and others who design, develop, select and support the use of health care technologies, to enable them to learn the key methods of human factors and adopt them as part of their ongoing work. Early indications are that these approaches help to ensure that health care technologies are used more safely and effectively, and it is hoped that large-scale adoption will result in a noticeable and worthwhile improvement in overall health care safety. The described text is now ready and has been published in English on the IFMBE website. It is available as a free download in PDF format. Clinical engineers and others working around the world in the area of health technology are encouraged to learn and adopt these methods, and use them as appropriate in their local setting. At time of writing, plans are underway for a translation of this book into Spanish. Once completed, this version will also be made available online at no charge. The authors encourage readers to contact them with their experiences, and the aim is to build a worldwide community that gradually adopts these methods and helps to drive safety improvements in health care.

  14. Clinical guidance on the perioperative use of targeted agents in solid tumor oncology.

    Science.gov (United States)

    Mellor, James D; Cassumbhoy, Michelle; Jefford, Michael

    2011-06-01

    The use of targeted anti-cancer agents is increasing. It is common to utilize a multi-modal treatment approach towards solid tumors, often including surgical resection, and it has become apparent that some targeted agents can impair wound healing or cause an increased risk of perioperative complications. This article reviews targeted agents used in solid tumor oncology with an emphasis on clinically relevant details. Overall, the evidence of targeted agents causing surgical complications is limited. The greatest amount of evidence exists for bevacizumab causing perioperative complications, possibly due to its extended half-life. There are limited data for cetuximab, sorafenib and sunitinib and very little for other solid tumor targeted agents. Our findings suggest that there should be heightened pharmacovigilence around targeted agents with respect to perioperative complications and increased post-surgical support for patients to aid early detection of postoperative complications until definitive data become available. PMID:21585689

  15. Uncorrectable coagulopathy due to intestinal obstruction: A clinical dilemma of competing priorities in a child

    Directory of Open Access Journals (Sweden)

    V Raveenthiran

    2013-01-01

    Full Text Available Disseminated intravascular coagulation (DIC is a contraindication for major surgical operations. However, if surgery is required to correct the underlying cause of DIC, a clinical conflict is created. In such complex scenario, standard resources such as textbooks and journals offer very little guidance. In this communication, we report a 22-month-old boy who developed sepsis-induced DIC following intestinal obstruction. Pre-operative attempts to normalize coagulation parameters failed. Damage control laparotomy was undertaken as it was considered essential to control the underlying cause of DIC. His abnormal coagulation status reverted quickly after surgical relief of intestinal obstruction. Paradoxically intraoperative blood loss was less than anticipated amount. There are a few case reports of adult patients who have successfully undergone major surgery despite the presence of abnormal coagulation. However, this appears to be the first paediatric report of successful surgery in DIC status. Lessons learnt from this case and hypothetical speculations of clinical paradoxes are discussed.

  16. Foetal Injury in Clinical Trials and Accountability to the Child Once Born.

    Science.gov (United States)

    Sheppard, Maria K

    2016-04-01

    Sponsors of clinical trials have excluded pregnant women from trial participation mainly because of the fear of legal liability for foetal injury. Yet, to prevent untested treatments exposing foetuses generally to unwarranted risks, it is necessary that pregnant women are included in clinical trials. Despite sponsors' fears there are, however, major stumbling blocks for the child once born claiming compensation under English law. Neither the new EU Regulation 536/2014 on clinical trials nor tort law or statutory regulations have achieved a clear and fair avenue for the compensation of children injured in utero. There are also inadequacies with the voluntary pharmaceutical industry guidelines regarding such compensation. Greater clarity and fairness regarding tort and civil liability might encourage sponsors to conduct more trials in pregnant women and more pregnant women to volunteer taking part in research in the knowledge that their children will be compensated if they sustain injuries in utero. PMID:27228682

  17. Ultrasound guidance in regional anesthesia: state of the art review through challenging clinical scenarios

    Directory of Open Access Journals (Sweden)

    Brian D Sites

    2009-01-01

    Full Text Available Brian D Sites1, John G Antonakakis21Departments of Anesthesiology and Orthopedic Surgery, Dartmouth Medical School, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire, USA; 2Department of Anesthesiology, University of Virginia Health System, Charlottesville, VA, USAAbstract: Ultrasound guided regional anesthesia (UGRA for peripheral nerve blockade is becoming increasingly popular. The advantage of ultrasound technology is that it affords the anesthesiologist the real time ability to visualize neural structures, needle advancement, and local anesthetic spread. Recent data suggest that UGRA generates improved success rates and reductions in performance times in comparison to traditional approaches. Further, the use of ultrasound technology in peripheral nerve blocks has provided insight into needle–nerve interactions, revealing distinct limitations of nerve stimulator techniques. Given that UGRA requires a unique set of skills, formal standards and guidelines are currently being developed by leadership societies in order to foster education and training. This review article, in a case vignette format, highlights important techniques, concepts, and limitations regarding the use of ultrasound to facilitate regional anesthesia. Clinically relevant aspects of ultrasound physics are also discussed.Keywords: ultrasound, regional anesthesia

  18. Prevention of mother-to-child transmission in HIV audit in Xhosa clinic, Mahalapye, Botswana

    Directory of Open Access Journals (Sweden)

    Stephane Tshitenge

    2014-01-01

    Full Text Available Background: The Mahalapye district health management team (DHMT conducts regular audits to evaluate the standard of services delivered to patients, one of which is the prevention of mother-to-child-transmission (PMTCT programme. Xhosa clinic is one of the facilities in Mahalapye which provides a PMTCT programme.Aim: This audit aimed to identify gaps between the current PMTCT clinical practice in Xhosa clinic and the Botswana PMTCT national guidelines.Setting: This audit took place in Xhosa clinic in the urban village of Mahalapye, in the Central District of Botswana.Methods: This was a retrospective audit using PMTCT Xhosa clinic records of pregnant mothers and HIV-exposed babies seen from January 2013 to June 2013.Results: One hundred and thirty-three pregnant women registered for antenatal care. Twenty-five (19% knew their HIV-positive status as they had been tested before their pregnancy or had tested HIV positive at their first antenatal clinic visit. More than two-thirds of the 115 pregnant women (69% were seen at a gestational age of between 14 and 28 weeks. About two-thirds of the pregnant women (67% took antiretroviral drugs. Of the 44 HIV-exposed infants, 39 (89% were HIV DNA PCR negative at 6 weeks. Thirty-two (73% children were given cotrimoxazole prophylaxis between 6 and 8 weeks.Conclusion: The PMTCT programme service delivery was still suboptimal and could potentially increase the mother-to-child transmission of HIV. Daily monitoring mechanism to track those eligible could help to close the gap.

  19. A Comparison of Medical Birth Register Outcomes between Maternity Health Clinics and Integrated Maternity and Child Health Clinics in Southwest Finland

    Directory of Open Access Journals (Sweden)

    Miia Tuominen

    2016-07-01

    Full Text Available Introduction: Primary maternity care services are globally provided according to various organisational models. Two models are common in Finland: a maternity health clinic and an integrated maternity and child health clinic. The aim of this study was to clarify whether there is a relation between the organisational model of the maternity health clinics and the utilisation of maternity care services, and certain maternal and perinatal health outcomes. Methods: A comparative, register-based cross-sectional design was used. The data of women (N = 2741 who had given birth in the Turku University Hospital area between 1 January 2009 and 31 December 2009 were collected from the Finnish Medical Birth Register. Comparisons were made between the women who were clients of the maternity health clinics and integrated maternity and child health clinics. Results: There were no clinically significant differences between the clients of maternity health clinics and integrated maternity and child health clinics regarding the utilisation of maternity care services or the explored health outcomes. Conclusions: The organisational model of the maternity health clinic does not impact the utilisation of maternity care services or maternal and perinatal health outcomes. Primary maternity care could be provided effectively when integrated with child health services.

  20. Epistaxis as first clinical presentation in a child with giant prolactinoma: Case report and review of literature

    Directory of Open Access Journals (Sweden)

    Pramod Kumar Chaurasia

    2011-01-01

    Full Text Available Pituitary tumour have a wide way of presentation. Epistaxis due to pituitary adenoma has been rarely reported. There is no report of bleeding from nose as clinical first presentation in a child. We report the first case in literature where a child had epistaxis for eight months before deterioration of vision. He was found to be having a invasive prolactinoma with normal prolactin levels.

  1. Evidence-based guidelines for pediatric clinical trials: focus on StaR Child Health.

    Science.gov (United States)

    Sampson, Mario R; Benjamin, Daniel K; Cohen-Wolkowiez, Michael

    2012-09-01

    Clinical trials in children are challenging and filled with important ethical considerations that differ from adults. Given difficulties associated with pediatric clinical trials, off-label prescribing is a common practice in pediatrics, which can lead to adverse safety events and efficacy failures. To overcome these consequences, in the past 15 years, legislation in the USA and Europe has provided incentives to industry and increased government funding to conduct pediatric trials. Pediatric trial networks have also been formed to decrease the knowledge gap. However, challenges to performing pediatric trials and lack of standardization and guidelines regarding studies in children still exist. Standards for Research (StaR) in Child Health, begun in 2009, aims to improve the design, conduct and reporting of pediatric trials. This organization uses a consensus guideline approach involving academic, government and industry stakeholders to identify and disseminate best practices for pediatric trials. Six out of 11 planned standards are currently published.

  2. [Ehrlichia infection in a child: clinical findings and review of the literature].

    Science.gov (United States)

    Halac, Eduardo

    2016-06-01

    A 12 year old child was brought in by his parents due to persistent fever of 3 weeks duration, sore throat, malaise, chills, small joint arthralgia, myalgias, and a pink macular rash. The first clinical impression of the physicians was infectious mononucleosis but serologic testing ruled out the diagnosis. He was then treated with oral ampicillin without a favorable response. He was referred to us for a second evaluation. A detailed clinical history revealed that he had a few days of vacation in a rural area in the northern region of the province of Cordoba, in close contact with horses, dogs and cats. His parents found 2 ticks on his abdomen, and removed them with tweezers. Serology and blood count carried out in a specialized laboratory showed positive titers (> 160) for Ehrlichia chaffeensis. Further confirmation was obtained using genus-specific polymerase chain reaction. After a 3-week course of doxycicline the patient recovered and serological titers decreased. PMID:27164358

  3. [Pinocchio and the unattained identity: Jervis' contribution to child clinical psychology].

    Science.gov (United States)

    Meacci, Stefano

    2012-01-01

    Giovanni Jervis is mainly known as a psychiatrist, but he also worked on psychological methodology and tackled important issues in clinical psychology. This essay describes the concept of personal identity elaborated by Jervis and its importance in Child Clinical Psychology. The problems related to personal identity appear very early in Jervis' work, influenced by the ethnologist Ernesto De Martino. His first considerations are found in his Preface to The Adventures of Pinocchio by Carlo Collodi (1968), in which Jervis describes the unhappy upbringing, the anti-social behaviour, and the unattained identity of the wooden puppet. Subsequently, in Presenza e identith (1984), Fondamenti di Psicologia Dinamica (1993) and La conquista dell'identith (1997), Jervis dealt with the theme of identity from a Dynamic Psychology perspective, showing that the formation of personal identity is a basic aspect of the development of the individual that starts in early childhood.

  4. Predicting reoffense in pedophilic child molesters by clinical diagnoses and risk assessment.

    Science.gov (United States)

    Eher, Reinhard; Olver, Mark E; Heurix, Isabelle; Schilling, Frank; Rettenberger, Martin

    2015-12-01

    A Diagnostic and Statistical Manual of Mental Disorders (DSM)-based diagnosis of pedophilia has so far failed to predict sexual reoffense in convicted child molesters, probably because of its broad and unspecific conceptualization. In this study, therefore, we investigated the prognostic value of the subtype exclusive pedophilia and a series of customary risk assessment instruments (SSPI, Static-99, Stable-2007, VRS:SO) and the PCL-R in a sample of prison released pedophilic sexual offenders. First, we examined the convergent validity of risk assessment instruments (N = 261). Then, we calculated the predictive accuracy of the measures and diagnosis for sexual recidivism by ROC analyses and subsequent Cox regression (N = 189). Also, predictive values with more clinical immediacy were calculated (sensitivity, specificity, PPV and NPV). The VRS:SO, the SSPI, and the Static-99 significantly predicted sexual recidivism, as did a diagnosis of exclusive pedophilia. Also, the VRS:SO predicted sexual reoffense significantly better than the Stable-2007, the Static-99/Stable-2007 combined score, and the PCL-R. When used combined, only the VRS:SO and a diagnosis of exclusive pedophilia added incremental validity to each other. Our findings support that the clinical diagnosis of an exclusive pedophilia based on DSM criteria and VRS:SO defined risk factors can reliably discriminate higher from lower risk offenders, even within the select subgroup of pedophilic child molesters. PMID:26146817

  5. Uptake and Diagnostic Yield of Chromosomal Microarray in an Australian Child Development Clinic

    Directory of Open Access Journals (Sweden)

    Dylan Mordaunt

    2014-05-01

    Full Text Available Autism is an etiologically heterogeneous developmental disorder for which the range of genetic investigations has expanded considerably over the past decade. Introduction of chromosomal microarray (CMA to clinical practice has expanded the range of conditions which pediatricians are able to detect. This study reviewed the utilization, yield and cost of genetic investigations in a sample of children with pervasive developmental disorders (PDD in an Australian metropolitan child development service. Six hundred and ninety eight patients with PDD were identified from the clinic population. One hundred and ten (15.7% of the clinic population had undergone investigation with chromosomal microarray, 140 (20.0% with karyotype (KT, and 167 (23.9% with Fragile X testing (FRGX. Twelve (10.9% CMA findings were reported, of which seven (6.3% were felt to be the likely cause of the child’s clinical features. Five (3.5% KT findings were reported, of which four (2.9% were felt to be the likely cause of the child’s clinical features. Two patients (1.2% were identified with Fragile X expansions. One fifth of the clinic’s recent PDD population had undergone testing with CMA. CMA appears to have increased the diagnostic yield of the genetic investigation of autism, in line with internationally reported levels. Number needed to test (NNT and cost per incremental diagnosis, were also in line with internationally reported levels.

  6. Clinic-based screening for domestic violence: use of a child safety questionnaire

    Directory of Open Access Journals (Sweden)

    Sisk Doris J

    2004-06-01

    Full Text Available Abstract Background Domestic violence affects many women during their lifetime. Children living in homes where they are or have been exposed to violence are at increased risk for adverse outcomes. The American Academy of Pediatrics, the American Academy of Family Practice, and the American College of Obstetrics/Gynecology have recently joined in recommending routine screening of all families for the presence of domestic violence. We present our experience with an office-based domestic violence screening questionnaire. Methods A series of four child safety questionnaires (designed for parents of infant, preschool-age, school-age, and adolescent patients, which included specific questions about domestic violence, was given to all mothers presenting to a university out-patient general pediatric clinic. The questionnaires, offered in both English and Spanish, were reviewed for the presence of domestic violence exposure, usually at the time of the clinic visit. The number of women who reported either current or past exposure to domestic violence as disclosed by this active screening process was compared to the number discovered prior to the use of these questionnaires. Results Prior to the use of active screening with a child safety questionnaire, five cases of domestic violence were identified in our clinic population of approximately 5000 children over a 3 month period. Active screening of this population with a parent questionnaire resulted in the identification of 69 cases of current domestic violence exposure (2% of those screened during each of 2 years of screening. Use of the child safety questionnaire was associated with a significantly increased odds of detecting current domestic violence (OR = 3.6, 95% CI [1.4, 9.1], P = 0.007, with 72% [26–84%] of the cases identified being attributable to the use of the questionnaire. Of children screened, 2% were currently exposed to domestic violence, and 13% had been exposed to past domestic violence

  7. A Comparison of Medical Birth Register Outcomes between Maternity Health Clinics and Integrated Maternity and Child Health Clinics in Southwest Finland

    OpenAIRE

    Tuominen, Miia; Kaljonen, Anne; Ahonen, Pia; Mäkinen, Juha; Rautava, Päivi

    2016-01-01

    Introduction: Primary maternity care services are globally provided according to various organisational models. Two models are common in Finland: a maternity health clinic and an integrated maternity and child health clinic. The aim of this study was to clarify whether there is a relation between the organisational model of the maternity health clinics and the utilisation of maternity care services, and certain maternal and perinatal health outcomes.Methods: A comparative, register-based cros...

  8. Indian Child Welfare Act: Existing Information on Implementation Issues Could Be Used to Target Guidance and Assistance to States. GAO-05-290

    Science.gov (United States)

    US Government Accountability Office, 2005

    2005-01-01

    The Indian Child Welfare Act (ICWA ) created important protections to prevent state child welfare agencies and courts from inappropriately separating American Indian children from their families. This report describes (1) the factors that influence placement decisions for children subject to ICWA; (2) the extent to which, if any, placements for…

  9. The U.N. Convention on the Rights of the Child: Relevance and Application to Pediatric Clinical Bioethics.

    Science.gov (United States)

    Lansdown, Gerison; Lundy, Laura; Goldhagen, Jeffrey

    2016-01-01

    This article provides an overview of the relevance and import of the U.N. Convention on the Rights of the Child (CRC) to child health practice and pediatric bioethics. We discuss the four general principles of the CRC that apply to the implementation of all rights contained in the document, the right to health articulated in Article 24, and the important position ascribed to parents in fulfilling the rights of their children. We then examine how the CRC is implemented and monitored in law and practice. The CRC and associated principles of child rights provide strategies for rights-based approaches to clinical practice and health systems, as well as to policy design, professional training, and health services research. In light of the relevance of the CRC and principles of child rights to children's health and child health practice, it follows that there is an intersection between child rights and pediatric bioethics. Pediatric bioethicists and child rights advocates should work together to define this intersection in all domains of pediatric practice.

  10. How can clinical ethics guide the management of comorbidities in the child with Rett syndrome?

    Science.gov (United States)

    Downs, Jenny; Forbes, David; Johnson, Michael; Leonard, Helen

    2016-08-01

    Rett syndrome is a rare disorder caused by a mutation in the MECP2 gene. Those affected generally have severe functional impairments, and medical comorbidities such as scoliosis and poor growth are common. There is a paucity of information on the natural history of many rare disorders and an even greater deficit of evidence to guide best practice. The population-based and longitudinal Australian Rett Syndrome Database established in 1993 has supported investigations of the natural history of Rett syndrome and effectiveness of treatments. This paper reviews the disorder Rett syndrome and evidence for the management of scoliosis and poor growth within a clinical ethics framework. Compared with conservative management, we have shown that spinal fusion is associated with reduced mortality and better respiratory health. We have also shown that gastrostomy insertion is associated with subsequent weight gain. Family counselling for both procedures necessarily must include family perspectives and careful clinical attention to their needs and wishes. Vignettes describing family decision-making and experiences are presented to illustrate the principals of beneficence and autonomy in determining the best interests of the child and family. A blend of evidence-based practice with a strong clinical ethics framework has capacity to build existing strengths in families and reduce the negative impacts of disability and in so doing, optimise the health and wellbeing of those with Rett syndrome. PMID:27243819

  11. How can clinical ethics guide the management of comorbidities in the child with Rett syndrome?

    Science.gov (United States)

    Downs, Jenny; Forbes, David; Johnson, Michael; Leonard, Helen

    2016-08-01

    Rett syndrome is a rare disorder caused by a mutation in the MECP2 gene. Those affected generally have severe functional impairments, and medical comorbidities such as scoliosis and poor growth are common. There is a paucity of information on the natural history of many rare disorders and an even greater deficit of evidence to guide best practice. The population-based and longitudinal Australian Rett Syndrome Database established in 1993 has supported investigations of the natural history of Rett syndrome and effectiveness of treatments. This paper reviews the disorder Rett syndrome and evidence for the management of scoliosis and poor growth within a clinical ethics framework. Compared with conservative management, we have shown that spinal fusion is associated with reduced mortality and better respiratory health. We have also shown that gastrostomy insertion is associated with subsequent weight gain. Family counselling for both procedures necessarily must include family perspectives and careful clinical attention to their needs and wishes. Vignettes describing family decision-making and experiences are presented to illustrate the principals of beneficence and autonomy in determining the best interests of the child and family. A blend of evidence-based practice with a strong clinical ethics framework has capacity to build existing strengths in families and reduce the negative impacts of disability and in so doing, optimise the health and wellbeing of those with Rett syndrome.

  12. Clinical features of the head injury caused by child abuse in infants

    International Nuclear Information System (INIS)

    The diagnosis and managements of the head injury in battered children are greatly complicated by medical history and the mechanisms of injury. In the present study, we evaluated the clinical features of the head injury in battered children. Clinical signs and symptoms, the mechanisms of injury, intracranial pathology, and prognosis of 25 battered children with head injury treated between 1984 and 2003 were retrospectively analyzed. The age of 25 children was between 1 month and 2 years old. The average of the ages was 7 months old. In 68% of 25 patients, the age was 6 months or less. The medical history of head injury was unclear in 16 children. The chief complains were disturbance of consciousness, convulsion, vomiting and hypothermia. Retinal hemorrhages were recognized in 88% of the patients and these were bilateral in 68%. Acute subdural hematomas (19 cases) and chronic subdural hematomas (6 cases) were shown on CTs or MRIs. In four cases, cerebral contusions were complicated as intracranial pathology. In 44% of the patients, the hypoxic-ischemic injury was confirmed on CTs or MRIs. Fractures of limbs and ribs were recognized on skeletal survey in 40% of the patients. 71% of 17 survival cases had moderate or severe psychomotor disabilities at the end of follow-up periods. In children under 2 years of age with subdural hematomas, clinical investigations other than CT and MRI, included ophthalmoscopy by ophthalmologist and skeletal survey, are crucial and mandatory for early diagnosis of the child abuse. (author)

  13. A clinical study of the variation in horizontal condylar guidance obtained by using three anterior points of reference and two different articulator systems

    Directory of Open Access Journals (Sweden)

    Paranjay Prajapati

    2013-01-01

    Full Text Available Background and Objectives: For mounting the maxillary cast to articulator, minimum three reference points not on single line, decide the plane to which maxillary cast is mounted. Variations exist in condylar guidance when different anterior reference points are used to mount the cast. Type of articulator may have influence on condylar guidance.A clinical study was planned to evaluate the effects of different anterior points of reference and two different articulator systems on condylar guidance. Materials and Methods: Total 15 subjects were selected. Six sets of maxillary casts were obtained. Face bow record was made using orbitale as anterior point of reference and the record was transferred to the Arcon and Non-Arcon articulator. The second and third mounting on Arcon and Non-Arcon articulator were done using Superior and inferior annular groove on incisal pin of articulator. Protrusive interocclusal records were made for all the subjects. Two lateral cephalograms one in maximum intercuspation and the other in protrusion for left and right side were taken. Anatomic condylar guidance of the subject were obtained from radiograph tracing. Arcon and Non-arcon articulator were programmed with Protrusive interocclusal record of the subjects and the condylar guidance was tabulated for right and left side. The procedure was repeated for all three mountings for both the articulators. Results: The orbitale is the best reference point which mounts maxillary cast closer to anatomic position. Inferior annular groove can also be used as anterior point of the reference. The superior annular groove is not recommended anterior point of reference.

  14. One-Year Retrospective Analysis of Forensic Cases Referred to Child and Adolescent Psychiatry Outpatient Clinic in the Province of Adiyaman

    OpenAIRE

    Funda Gumustas; Yasemin Yulaf; Sebla Gokce; Sema Saglam; Emel Koyuncu Kutuk

    2014-01-01

    Purpose: This study’s aim is to investigate child and adolescent cases referred for forensic examination to our child and adolescent psychiatry outpatient clinic. Material and Methods: File informations of 121 cases who referred to Adiyaman University Training and Research Hospital, child psychiatry clinic between 01 June 2012 and 31 May 2013 were reviewed retrospectively. Socio-demographic characteristics of the children and reasons for referral determined. The study was focused on ...

  15. Nutritional Needs of the Child with a Handicap or Chronic Illness. Manual II: Clinical Nutrition. Presentations from a National Interdisciplinary Symposium.

    Science.gov (United States)

    Ekvall, Shirley M.; Wheby, Elizabeth A.

    The following papers were presented at a symposium on clinical nutrition for the child who is chronically ill or handicapped: (1) "Food Allergy"; (2) "Anemia and the Chronically Ill or Handicapped Child"; (3) "Nutrition and Neurotransmitters--Clinical Implications"; (4) "The Importance of Lipid Type in the Diet after Burn Injury"; (5) "Advances of…

  16. 小学低年级亲子阅读的问题分析与指导策略%The Problem Analysis and Guidance Strategies of Parent - Child Reading in the Primary Grades

    Institute of Scientific and Technical Information of China (English)

    杨玲

    2014-01-01

    Parent-child reading is an important way to cultivate children’s independent reading ability.But the research focuses on parent-child reading in the primary grades is not paid so much attention.After analyzing the current situation of parent-child reading in the primary grades,the author points out the problems and put forward with guidance strategies.%亲子阅读是培养儿童基本阅读能力、引导他们迈向自主阅读的重要方式。目前,专门针对小学低年级段亲子阅读活动开展研究的比较少。在深入调查小学低年级亲子阅读现状的基础上,文章梳理与剖析了当前亲子阅读存在的一些问题,并提出了相应的解决策略。

  17. Clinical Commentary by Barbara Segal, a Consultant Child and Adolescent Psychotherapist Working in University College London Hospitals

    Science.gov (United States)

    Segal, Barbara

    2010-01-01

    This moving clinical account describes the psychotherapeutic work of a child psychotherapist undertaken in a hospital room with 13-year-old Maya, after the sudden onset of a terrifying and serious illness, Guillain-Barre syndrome, leaving her with paralysis and extreme weakness. The first session takes place almost three weeks after Maya's…

  18. 入科指导在儿科临床护理教学中的应用%Application of Section Guidance in Pediatric Clinical Nursing Teaching

    Institute of Scientific and Technical Information of China (English)

    邬丽华; 刘书莲

    2014-01-01

    入科指导介于医学院和医院之间,是医学实习生正式踏入医生护理行业前最重要的环节之一,是医学上从学校走向工作岗位时,医院进行的岗前培训的主要内容,是学校理论知识与实际临床实践相结合的过程。在入科指导中不仅有医德医风和纪律规范等观念的培养,有具体岗位的专业带教指导,对儿科临床护理教学来说,更主要的是因患者的年龄特殊性而有针对性的心理和行为指导。%Section guidance is between medical schools and hospitals, is one of the most important aspects of medical interns before formally entering the care industry, is medically transition from school to work, the main contents of the hospital for the pre-service tra-ining, school of theoretical knowledge and practical process of combining clinical practice. In section guidance, not only promote the concept of ethics and disciplinary norms, there are specific positions teaching professional guidance on pediatric clinical nursing education, the more important is the special nature of the patient's age-targeted psychological and behavioral guidance.

  19. 75 FR 14602 - Guidance for Industry on Drug-Induced Liver Injury: Premarketing Clinical Evaluation; Opening of...

    Science.gov (United States)

    2010-03-26

    ... published guidance document. The purpose of the conference is to consider the effect of the recommendations.... It discussed methods of detecting DILI by periodic tests of serum enzyme activities and bilirubin concentration elevations, and how those laboratory tests might change over time, along with symptoms...

  20. Teacher-Child Interaction Therapy: Efficacy with a Clinical Preschool Population

    Science.gov (United States)

    Schaffner, Kristen Friedrich

    2013-01-01

    Teacher-Child Interaction Therapy (TCIT), which is an adaptation of the empirically-based treatment of Parent-Child Interaction Therapy (PCIT), addresses the needs of children and teachers through increasing positive teacher-child interactions while educating teachers on effective discipline techniques. The theoretical and empirical basis for PCIT…

  1. Standardised Observation Analogue Procedure (SOAP) for Assessing Parent and Child Behaviours in Clinical Trials

    Science.gov (United States)

    Johnson, Cynthia R.; Butter, Eric M.; Handen, Benjamin L.; Sukhodolsky, Denis G.; Mulick, James; Lecavalier, Luc; Aman, Michael G.; Arnold, Eugene L.; Scahill, Lawrence; Swiezy, Naomi; Sacco, Kelley; Stigler, Kimberly A.; McDougle, Christopher J.

    2009-01-01

    Background: Observational measures of parent and child behaviours have a long history in child psychiatric and psychological intervention research, including the field of autism and developmental disability. We describe the development of the Standardised Observational Analogue Procedure (SOAP) for the assessment of parent-child behaviour before…

  2. A Multitrait–Multimethod Analysis of the Construct Validity of Child Anxiety Disorders in a Clinical Sample

    OpenAIRE

    Wood, Jeffrey J.; Bergman, R. Lindsey; Piacentini, John C.; Langer, David Adam

    2010-01-01

    The present study examines the construct validity of separation anxiety disorder (SAD), social phobia (SoP), panic disorder (PD), and generalized anxiety disorder (GAD) in a clinical sample of children. Participants were 174 children, 6 to 17 years old (94 boys) who had undergone a diagnostic evaluation at a university hospital based clinic. Parent and child ratings of symptom severity were assessed using the Multidimensional Anxiety Scale for Children (MASC). Diagnostician ratings were obtai...

  3. Assessment of Mental Symptoms and Risk Factors in Children and Adolescents Who Admitted to the Child-Adolescent Psychiatry Clinic

    Directory of Open Access Journals (Sweden)

    Yöntem Fidan T.

    2011-02-01

    Full Text Available Objective: The results of the studies investigating the positive and negative factors which affect the mental health were important for developing protective, new and effective programs in prevention from psychiatric disorders.The aim of this study is to determine the demographic features, symptom distribution of children and adolescents in this region.Methods: 632 child and adolescents who attended to Karadeniz Technical University Child and Adolescent Psychiatry Clinic between 01 January 2003 and 30 June 2003 were included the study. The demographic features and first application symptoms were obtained by using interview forms to each child and adolescent and the relation between the demographic features and the first application symptoms were investigated.Results: Of the children and adolescents 63.1% were male and the frequency of the age between 6 and 11 was 40.3% and the frequency of the age between 0-3 years old was the lowest. Irritability, poor school performance, enuresis, encopresis, anxiety, attention deficit-hyperactivity, speech disorders were the most seen symptoms of child and adolescents. Depressive symptoms like crying, unhappiness, suicide attempt were most seen in girls and behavioral symptoms like hyperactivity were seen most in boys (p<0.05. According to age symptoms were specified.Conclusion: In this study, demographic features and symptom distribution between patients who applied to KTU Faculty of Medicine Child and Adolescent Psychiatry Outpatient Clinic and other Child and Adolescent Psychiatry Outpatient Clinics were found similar. In divorced and problematic families, having psychiatric disease of mother-father some specific mental symptoms were found.

  4. Evaluating clinically significant change in mother and child functioning: comparison of traditional and enhanced behavioral parent training.

    Science.gov (United States)

    Rajwan, Estrella; Chacko, Anil; Wymbs, Brian T; Wymbs, Frances A

    2014-11-01

    The Strategies to Enhance Positive Parenting (STEPP) program, an enhanced behavioral parent training (BPT) intervention, was developed to improve engagement in and outcomes following treatment for single-mother families of school-age youth with attention-deficit/hyperactivity disorder (ADHD). A previous randomized clinical trial of the STEPP program demonstrated that the intervention resulted in statistically significant improvements at the group-level in child oppositional behavior, various areas of child impairment, parental stress, and parenting behavior, relative to a wait-list control condition and a traditional BPT group. Despite benefits at the group-level, little is known about outcomes at the individual-level of enhanced BPT relative to traditional BPT for various child- and parent-level outcomes. The current study compares the extent to which traditional BPT and the STEPP program result in reliable change and recovery across various child- and parent-level outcomes in a sample of 80, 5-12 year old youth with ADHD (70 % male). Analyses demonstrated the benefit of participating in either BPT treatment; and participation in the STEPP program compared to traditional BPT was associated with only minimal incremental clinical benefit. Results, as well as clinical and research implications for assessment and treatment of high-risk families of youth with ADHD enrolled in BPT are discussed. PMID:24740438

  5. Spine radiosurgery for the local treatment of spine metastases: Intensity-modulated radiotherapy, image guidance, clinical aspects and future directions

    OpenAIRE

    Fabio Ynoe de Moraes; Neil Kanth Taunk; Ilya Laufer; Wellington Furtado Pimenta Neves-Junior; Samir Abdallah Hanna; Heloisa de Andrade Carvalho; Yoshiya Yamada

    2016-01-01

    Many cancer patients will develop spinal metastases. Local control is important for preventing neurologic compromise and to relieve pain. Stereotactic body radiotherapy or spinal radiosurgery is a new radiation therapy technique for spinal metastasis that can deliver a high dose of radiation to a tumor while minimizing the radiation delivered to healthy, neighboring tissues. This treatment is based on intensity-modulated radiotherapy, image guidance and rigid immobilization. Spinal radiosurge...

  6. Prevalence of child abuse in child and adolescent clinical population referred to psychiatric facilities in Tabriz University of Medical Sciences, Iran

    Directory of Open Access Journals (Sweden)

    Seyyed Gholamreza Nourazar

    2014-08-01

    Full Text Available Introduction: The present study was ‎designed to evaluate the prevalence of child abuse in a child and adolescent psychiatric clinical population. Methods: This cross-sectional study was conducted in a clinical population of children and adolescents aged 8-18 years. 80 out-patients and 94 in-patients were selected according to probability proportional to size sampling. Kiddie schedule for affective disorder and schizophrenia questionnaire, a demographic questionnaire, and child abuse self-report scale were filled for each subject. Data were analyzed by using Stata software. Results: Among the out-patient subjects, 50 were male (62.5% and 30 were female (37.5%; for in-patient these subjects numbers were 76 (80.9% and 18 (19.1%, respectively. The mean age of subjects was 15.2 years in the in-patient group and 11.7 years in the out-patient group. In 66.1% of abuse cases the perpetrators were parents, 5.2% siblings, and 28.7% someone else. Among in-patient subjects, summed up prevalence rates of severe and very severe psychological abuse, neglect, physical abuse, and sexual abuse were 11.7, 33.0, 2.1, and 0.0%, respectively; for out-patient subjects these values were 3.8, 11.2, 3.8, and 0.0%, respectively. Moreover, among in-patient subjects, prevalence rates of moderate psychological abuse, neglect, physical abuse, and sexual abuse were 27.7, 27.7, 24.5, and 4.3%, respectively; and for out-patient subjects these values were 30.0, 27.5, 11.2, and 0.0%, respectively. Subjects with attention-deficit/hyperactivity disorder (ADHD suffered a higher rate of physical abuse, whereas, subjects with bipolar mood disorder (BMD suffered a higher rate of sexual abuse. Conclusion: The prevalence of child abuse is highly prevalent in children and adolescents with psychiatric disorders. It is recommended that this population be screened routinely for child abuse.

  7. Clinical Assessment Instruments in the Treatment of Child Abuse and Neglect.

    Science.gov (United States)

    Rittner, Barbara; Wodarski, John S.

    1995-01-01

    A variety of objective measures have been developed to assess child abuse and neglect and that can be used by practitioners with minimal disruption in terms of time, energy, cost, and ease of use. Reviews instruments that child welfare workers, specifically, and practitioners involved in children's services, in general, can use in the assessment…

  8. German Screen for Child Anxiety Related Emotional Disorders (SCARED: Reliability, Validity, and Cross-Informant Agreement in a Clinical Sample

    Directory of Open Access Journals (Sweden)

    Wiegand-Grefe Silke

    2010-06-01

    Full Text Available Abstract Background The psychometric properties and cross-informant agreement of a German translation of the Screen for Child Anxiety Related Emotional Disorders (SCARED were assessed in a clinical sample Methods 102 children and adolescents in outpatient psychotherapy and their parents filled out the SCARED and Youth Self Report/Child Behaviour Checklist (YSR/CBCL. Results The German SCARED showed good internal consistency for both parent and self-report version, and proved to be convergently and discriminantly valid when compared with YSR/CBCL scales. Cross-informant agreement was moderate with children reporting both a larger number as well as higher severity of anxiety symptoms than their parents. Conclusion In conclusion, the German SCARED is a valid and reliable anxiety scale and may be used in a clinical setting

  9. 76 FR 18226 - Guidance for Industry on Postmarketing Studies and Clinical Trials-Implementation of Section 505...

    Science.gov (United States)

    2011-04-01

    ... Clinical Trials--Implementation of Section 505(o)(3) of the Federal Food, Drug, and Cosmetic Act.'' The... clinical trials for prescription drugs approved under the FD&C Act and biological products approved under... of the new provisions and a description of the types of postmarketing studies and clinical...

  10. 78 FR 39736 - Draft Guidance for Industry: Considerations for the Design of Early-Phase Clinical Trials of...

    Science.gov (United States)

    2013-07-02

    ... of Early-Phase Clinical Trials of Cellular and Gene Therapy Products; Availability AGENCY: Food and... Design of Early-Phase Clinical Trials of Cellular and Gene Therapy Products'' dated July 2013. The draft... assist in designing early-phase clinical trials of CGT products. DATES: Although you can comment on...

  11. Medical and Dental Guidance Notes. A Good Practice Guide on all Aspects of Ionising Radiation Protection in the Clinical Environment

    International Nuclear Information System (INIS)

    Institute of Physics and Engineering in Medicine York: IPEM 225 pp, ISBN: 1-903613-09-4. This book is the much awaited replacement for the old yellow 'Guidance Notes' published in 1988 by the National Radiological Protection Board (NRPB). Since then nearly all Regulations covering the use of ionising radiation have been updated. The Institute of Physics and Engineering in Medicine (IPEM) established a working group in 1999 to produce a first draft for consultation (produced in April 2000) and to consider subsequent comments to this draft. The final document, published by IPEM, is therefore the end product of numerous contributions from professionals working in healthcare and wide consultation with professional bodies, the NRPB, UK Health Departments, Environment Agencies and the HSE. The notes provide general guidance on good practice - not just legal requirements. Radiation Protection Advisers and Medical Physics Experts may well have instigated slightly different arrangements locally. The publication has been available in electronic form on the IPEM website ( www.ipem.org.uk/publications/IRR99.html) for a few months. This has been useful for quick access to advice and for searching for particular topics but is difficult to read in large sections. Although it can be downloaded, the main documented is protected so that it can not be printed and specific text can not be 'cut and pasted'. The appendices are in a separate file that can be printed. Although the chapter paragraph numbers are consistent between the electronic and papers versions, the page numbers are different. The new guidance is ring bound, so, apart from at the beginning and end of the book, it is generally easy to open it out and lay it flat. The book consists of 19 chapters and 21 appendices and, with 225 pages, is considerably more extensive than the old notes. It begins with the general measures for radiation protection followed by radiation protection of persons undergoing medical exposures

  12. Investigation of Prevalence of Child Abuse in Addicts Referring to the Addiction Withdrawal Clinic

    Directory of Open Access Journals (Sweden)

    G Dastjerdi

    2010-09-01

    Full Text Available Introduction: Child abuse includes abuse of the body, mental and sexual abuse or misbehavior against children that leads to damage to the child's heath and comfort. Therefore, the present study was done in order to determine the prevalence of child abuse in opiate addicts referring to addiction withdrawal centers. Methods: The cross sectional study included 300 participations (150 addicts and 150 non-addicts The addicted group comprised of opiate addicts referring to addiction withdrawal centers of Yazd. The non addicted group was selected randomly from healthy people. Data collection was performed via a standard questionnaire. Data assessment was done via statistical analysis (K S Results: Collected data in the addicted group showed the following results about 56 percent were child tormentors, 1- 45.3% males, 10.7% females, 2-18.7% uneducated, 3-46% with divorce history in their family and 4-38% child body abuse. The most prevalent type of the body abuse was slapping (24%, mostly because of bad training (26%. Collected data in the no addicted group showed the following results 42% were child tormentors (26% male and 15.3% female 23.4% with family divorce history, 30.4% were child body abuse and the most prevalent type of body abuse was slapping (22.79%, mostly because of bad training (33.3% Conclusion: A direct relationship was observed between child abuse and persons addicted to opiates. Factors playing an important role include illiteracy, divorce history in the family and history of child abuse in childhood period. Therefore, compilation of rules supporting children, establishment of support and parent education centers can be effective to reduce child persecution.

  13. Architecture of a high-performance surgical guidance system based on C-arm cone-beam CT: software platform for technical integration and clinical translation

    Science.gov (United States)

    Uneri, Ali; Schafer, Sebastian; Mirota, Daniel; Nithiananthan, Sajendra; Otake, Yoshito; Reaungamornrat, Sureerat; Yoo, Jongheun; Stayman, J. Webster; Reh, Douglas; Gallia, Gary L.; Khanna, A. Jay; Hager, Gregory; Taylor, Russell H.; Kleinszig, Gerhard; Siewerdsen, Jeffrey H.

    2011-03-01

    Intraoperative imaging modalities are becoming more prevalent in recent years, and the need for integration of these modalities with surgical guidance is rising, creating new possibilities as well as challenges. In the context of such emerging technologies and new clinical applications, a software architecture for cone-beam CT (CBCT) guided surgery has been developed with emphasis on binding open-source surgical navigation libraries and integrating intraoperative CBCT with novel, application-specific registration and guidance technologies. The architecture design is focused on accelerating translation of task-specific technical development in a wide range of applications, including orthopaedic, head-and-neck, and thoracic surgeries. The surgical guidance system is interfaced with a prototype mobile C-arm for high-quality CBCT and through a modular software architecture, integration of different tools and devices consistent with surgical workflow in each of these applications is realized. Specific modules are developed according to the surgical task, such as: 3D-3D rigid or deformable registration of preoperative images, surgical planning data, and up-to-date CBCT images; 3D-2D registration of planning and image data in real-time fluoroscopy and/or digitally reconstructed radiographs (DRRs); compatibility with infrared, electromagnetic, and video-based trackers used individually or in hybrid arrangements; augmented overlay of image and planning data in endoscopic or in-room video; real-time "virtual fluoroscopy" computed from GPU-accelerated DRRs; and multi-modality image display. The platform aims to minimize offline data processing by exposing quantitative tools that analyze and communicate factors of geometric precision. The system was translated to preclinical phantom and cadaver studies for assessment of fiducial (FRE) and target registration error (TRE) showing sub-mm accuracy in targeting and video overlay within intraoperative CBCT. The work culminates in

  14. Prevention of Child Maltreatment

    OpenAIRE

    Lane, Wendy Gwirtzman

    2014-01-01

    Pediatricians and other health care providers can play a number of important roles in the prevention of child maltreatment. As part of routine patient care, pediatricians can provide anticipatory guidance for effective discipline and parent-child communication, screen for maltreatment risk factors, and refer parents and families to effective community-based programs. This article will help pediatricians incorporate child abuse prevention into their practice. Resources for systematizing antici...

  15. Effects of radiation therapy for Hodgkin's disease in a child with ataxia telangiectasia: a clinical, biological and pathologic study

    International Nuclear Information System (INIS)

    Stage I lymphocyte-predominant Hodgkin's disease was diagnosed in a 44-month-old girl. Although immune deficiency was suspected and IgA deficiency demonstrated, the diagnosis of an ataxia-telangiectasia (AT)-like syndrome was not confirmed until eight weeks later when results of studies on the radiosensitivity of cultured skin fibroblasts were available. The child had none of the usual physical stigmata of AT. Severe acute radiation damage followed the treatment of this child with standard doses of radiation therapy. Clinical, pathologic, and radiobiologic correlations are drawn. The diagnosis of a malignant lymphoma disorder in children under the age of five should alert clinicians to the possibility of immune deficiency and, even in the absence of classical physical signs, to AT in particular. Suggestions for the management of future similar cases are put forward

  16. MR-guidance – a clinical study to evaluate a shuttle- based MR-linac connection to provide MR-guided radiotherapy

    International Nuclear Information System (INIS)

    The purpose of this clinical study is to investigate the clinical feasibility and safety of a shuttle-based MR-linac connection to provide MR-guided radiotherapy. A total of 40 patients with an indication for a neoadjuvant, adjuvant or definitive radiation treatment will be recruited including tumors of the head and neck region, thorax, upper gastrointestinal tract and pelvic region. All study patients will receive standard therapy, i.e. highly conformal radiation techniques like CT-guided intensity-modulated radiotherapy (IMRT) with or without concomitant chemotherapy or other antitumor medication, and additionally daily short MR scans in treatment position with the same immobilisation equipment used for irradiation for position verification and imaging of the anatomical and functional changes during the course of radiotherapy. For daily position control, skin marks and a stereotactic frame will be used for both imaging modalities. Patient transfer between the MR device and the linear accelerator will be performed with a shuttle system which uses an air-bearing patient platform for both procedures. The daily acquired MR and CT data sets will be digitally registrated, correlated with the planning CT and compared with each other regarding translational and rotational errors. Aim of this clinical study is to establish a shuttle-based approach for realising MR-guided radiotherapy for certain clinical situations. Second objectives are to compare MR-guided radiotherapy with the gold standard of CT image guidance for quality assurance of radiotherapy, to establish an appropiate MR protocol therefore, and to assess the possibility of using MR-based image guidance not only for position verification but also for adaptive strategies in radiotherapy. Compared to CT, MRI might offer the advantage of providing IGRT without delivering an additional radiation dose to the patients and the possibility of optimisation of adaptive therapy strategies due to its superior soft tissue

  17. Clinical Practice Guidance for Radiotherapy Planning After Induction Chemotherapy in Locoregionally Advanced Head-and-Neck Cancer

    International Nuclear Information System (INIS)

    Purpose: The use of induction chemotherapy (IC) for locoregionally advanced head-and-neck cancer is increasing. The response to IC often causes significant alterations in tumor volume and location and shifts in normal anatomy. Proper determination of the radiotherapy (RT) targets after IC becomes challenging, especially with the use of conformal and precision RT techniques. Therefore, a consensus conference was convened to discuss issues related to RT planning and coordination of care for patients receiving IC. Methods and Materials: Ten participants with special expertise in the various aspects of integration of IC and RT for the treatment of locoregionally advanced head-and-neck cancer, including radiation oncologists, medical oncologists, and a medical physicist, participated. The individual members were assigned topics for focused, didactic presentations. Discussion was encouraged after each presentation, and recommendations were formulated. Results: Recommendations and guidelines emerged that emphasize up-front evaluation by all members of the head-and-neck management team, high-quality baseline and postinduction planning scans with the patient in the treatment position, the use of preinduction target volumes, and the use of full-dose RT, even in the face of a complete response. Conclusion: A multidisciplinary approach is strongly encouraged. Although these recommendations were provided primarily for patients treated with IC, many of these same principles apply to concurrent chemoradiotherapy without IC. A rapid response during RT is quite common, requiring the development of two or more plans in a sizeable fraction of patients, and suggesting the need for similar guidance in the rapidly evolving area of adaptive RT.

  18. Added syllable complexity in a child's developmental speech and clinical implications.

    Science.gov (United States)

    Babatsouli, Elena

    2016-01-01

    Added syllable complexity, whereby a non-targeted consonant is added next to a targeted consonant in the syllable, has received relatively little attention in studies of children with speech sound disorders (SSD) and typically developing children. Despite the scarcity and subtlety of the pattern, evidence in child and adult data indicates universality. The present article examines the pattern in a bilingual child's longitudinal speech in English from age 2;7 to 4;0, focusing on word-initial consonant addition. The purpose is to identify phonological and psycholinguistic processes associated with the pattern. It is suggested that the complexity pattern with both legal and illegal outputs is a systemic developmental behaviour linked to the child's level of phonological acquisition, facilitating acquisition of the complex CCV rule as well as of non-acquired singleton consonants. Implications of the results for children's SSD intervention techniques and for adult degenerative speech are discussed.

  19. Addressing the Clinical Burden of Child Physical Abuse and Neglect in a Large Metropolitan Region: Improving the Evidence-Base

    Directory of Open Access Journals (Sweden)

    Shanti Raman

    2014-10-01

    Full Text Available Children at risk of abuse are more likely to be hospitalized and utilize health services according to international research. In a large metropolitan health region in New South Wales, Australia, there was little known of the clinical burden of child physical abuse and/or neglect (PAN, or of systems for clinical assessment of children presenting with abuse/neglect. We aimed to identify the number of children presenting with suspected PAN to emergency departments (EDs and paediatric services in this region, to determine enablers and barriers to assessment for children with PAN presenting to frontline services, and to identify best practices to address gaps. We collated available data on children presenting to EDs and paediatric services with suspected PAN in 2007. We interviewed 36 health professionals from nine hospitals and 12 statutory child protection professionals, across the region before undertaking relevant document analysis. Of 64,700 paediatric ED presentations, a quarter were due to injury; 2%–5% of these were due to maltreatment. Clinician estimates and assessments of PAN varied widely; health and welfare workers identified major practice gaps, as well as good local practice. We identified feasible minimum standards for improving clinical assessment and follow-up for children presenting with PAN, given the right organizational support.

  20. Parent Depression and Child Anxiety: An Overview of the Literature with Clinical Implications

    Science.gov (United States)

    Colletti, Christina J. M.; Forehand, Rex; Garai, Emily; Rakow, Aaron; McKee, Laura; Fear, Jessica M.; Compas, Bruce E.

    2009-01-01

    The association of parental depression with child anxiety has received relatively little attention in the literature. In this paper we initially present several reasons for examining this relationship. We then summarize the empirical support for a link between these two variables. Finally, we discuss directions for future research and clinical…

  1. Documentation of functional and clinical effects of infant nutrition

    DEFF Research Database (Denmark)

    Koletzko, Berthold; Szajewska, Hania; Ashwell, Margaret;

    2012-01-01

    The Early Nutrition Academy and the Child Health Foundation, in collaboration with the Committee on Nutrition, European Society for Paediatric Gastroenterology, Hepatology and Nutrition, held a workshop in March 2011 to explore guidance on acquiring evidence on the effects of nutritional...... interventions in infants and young children. The four objectives were to (1) provide guidance on the quality and quantity of evidence needed to justify conclusions on functional and clinical effects of nutrition in infants and young children aged...

  2. The relationship development assessment - research version: preliminary validation of a clinical tool and coding schemes to measure parent-child interaction in autism.

    Science.gov (United States)

    Larkin, Fionnuala; Guerin, Suzanne; Hobson, Jessica A; Gutstein, Steven E

    2015-04-01

    The aim of this project was to replicate and extend findings from two recent studies on parent-child relatedness in autism (Beurkens, Hobson, & Hobson, 2013; Hobson, Tarver, Beurkens, & Hobson, 2013, under review) by adapting an observational assessment and coding schemes of parent-child relatedness for the clinical context and examining their validity and reliability. The coding schemes focussed on three aspects of relatedness: joint attentional focus (Adamson, Bakeman, & Deckner, 2004), the capacity to co-regulate an interaction and the capacity to share emotional experiences. The participants were 40 children (20 with autism, 20 without autism) aged 6-14, and their parents. Parent-child dyads took part in the observational assessment and were coded on these schemes. Comparisons were made with standardised measures of autism severity (Autism Diagnostic Observation Schedule, ADOS: Lord, Rutter, DiLavore, & Risi, 2001; Social Responsiveness Scale, SRS: Constantino & Gruber, 2005), relationship quality (Parent Child Relationship Inventory, PCRI: Gerard, 1994) and quality of parent-child interaction (Dyadic Coding Scales, DCS: Humber & Moss, 2005). Inter-rater reliability was very good and, as predicted, codes both diverged from the measure of parent-child relationship and converged with a separate measure of parent-child interaction quality. A detailed profile review revealed nuanced areas of group and individual differences which may be specific to verbally-able school-age children. The results support the utility of the Relationship Development Assessment - Research Version for clinical practice. PMID:24366957

  3. Conflicts Between Parents and Health Professionals About a Child's Medical Treatment: Using Clinical Ethics Records to Find Gaps in the Bioethics Literature.

    Science.gov (United States)

    McDougall, Rosalind; Notini, Lauren; Phillips, Jessica

    2015-09-01

    Clinical ethics records offer bioethics researchers a rich source of cases that clinicians have identified as ethically complex. In this paper, we suggest that clinical ethics records can be used to point to types of cases that lack attention in the current bioethics literature, identifying new areas in need of more detailed bioethical work. We conducted an analysis of the clinical ethics records of one paediatric hospital in Australia, focusing specifically on conflicts between parents and health professionals about a child's medical treatment. We identified, analysed, and compared cases of this type from the clinical ethics records with cases of this type discussed in bioethics journals. While the cases from journals tended to describe situations involving imminent risk to the child's life, a significant proportion of the clinical ethics records cases involved different stakes for the child involved. These included distress, poorer functional outcome, poorer psychosocial outcome, or increased risk of surgical complications. Our analysis suggests that one type of case that warrants more detailed ethics research is parental refusal of recommended treatment, where the refusal does not endanger the child's life but rather some other aspect of the child's well-being.

  4. Clinical findings, dental treatment, and improvement in quality of life for a child with Rothmund-Thomson syndrome.

    Science.gov (United States)

    De Oliveira, Katharina Morant Holanda; Silva, Raquel Assed Bezerra; Carvalho, Fabricio Kitazono; Silva, Lea Assed Bezerra; Nelson-Filho, Paulo; Queiroz, Alexandra Mussolino

    2016-01-01

    The purpose of this study was to report the clinical findings, dental treatment, and improvement in quality of life for a child with Rothmund-Thomson syndrome. The patient had alopecia, delayed speech, low weight and height, cholestasis, and iron deficiency anemia. Furthermore, there were carious lesions and darkened spots on all primary molars. Microdontia of a premolar was observed at the radiographic examination. The patient and family had no commitment to her oral health and dental treatment at first appointments. Oral hygiene instructions, composite restorations, endodontic treatments, teeth extractions, and stainless steel crown installations were performed. The patient was followed up for 7 years through the present due to other possible future clinical findings associated with the syndrome. An improvement in social aspects was observed after removal of toothache and improved esthetics. Such patients need continuous periodic services, which contributes to improving the quality of life in both buccal and general aspects.

  5. Clinical findings, dental treatment, and improvement in quality of life for a child with Rothmund-Thomson syndrome

    Directory of Open Access Journals (Sweden)

    Katharina Morant Holanda De Oliveira

    2016-01-01

    Full Text Available The purpose of this study was to report the clinical findings, dental treatment, and improvement in quality of life for a child with Rothmund-Thomson syndrome. The patient had alopecia, delayed speech, low weight and height, cholestasis, and iron deficiency anemia. Furthermore, there were carious lesions and darkened spots on all primary molars. Microdontia of a premolar was observed at the radiographic examination. The patient and family had no commitment to her oral health and dental treatment at first appointments. Oral hygiene instructions, composite restorations, endodontic treatments, teeth extractions, and stainless steel crown installations were performed. The patient was followed up for 7 years through the present due to other possible future clinical findings associated with the syndrome. An improvement in social aspects was observed after removal of toothache and improved esthetics. Such patients need continuous periodic services, which contributes to improving the quality of life in both buccal and general aspects.

  6. Analysis on the training effect of criteria and practical guidance for determination of brain death: clinical diagnosis

    Directory of Open Access Journals (Sweden)

    Ying-ying SU

    2015-12-01

    Full Text Available Objective Clinical diagnosis is the most predominant in the criteria for determination of brain death. This paper aims to analyze the training results of clinical diagnosis for brain death determination and to improve the training program. Methods A total of 461 trainees received theoretical training, simulation skills training, bedside skills training and test analysis. The composition of trainees was analyzed and the error rates of knowledge points were calculated. Univariate and multivariate backward Logistic regression analyses were used to analyze the influence of factors including sex, age, specialty, professional qualification and hospital level, on the error rates. Results Four hundred and sixty-one trainees came from 161 hospitals. Among them, trainees of 30-49 years old occupied 77.87% (359/461, and most of them came from third grade, grade A hospitals (88.29%, 407/461. There were 200 trainees (43.39% from Department of Neurology, 109 trainees (23.64% from Department of Neurosurgery, and 88 trainees (19.09% from Intensive Care Unit. Most of them (66.59%, 307/461 had senior certificate. Total error rate of 13 knowledge points was 5.81% (1054/18 128. The error rate of corneal reflex was the highest (24.64% , 104/422, followed by deep coma (11.59% , 365/3149, oculocephalogyric reflex (9.48%, 40/422, step and time of determination (7.48%, 138/1844, and pupillary light reflex (5.10% , 90/1766. Univariate and multivariate Logistic regression analyses showed that age (OR = 1.558, 95%CI: 1.435-1.693; P = 0.000, specialty (OR = 1.080, 95%CI: 1.021-1.143; P = 0.007 and hospital level (OR = 1.395, 95%CI: 1.174-1.659; P = 0.000 were independent risk factors associated with high error rates. Conclusions The training patterns and methods of clinical diagnosis for brain death determination should be further improved, especially the individual training, to rise the training quality. DOI: 10.3969/j.issn.1672-6731.2015.12.006

  7. Chondromyxoid fibroma of the femur in a child aged 9 years (Clinical case

    Directory of Open Access Journals (Sweden)

    Александр Павлович Поздеев

    2015-09-01

    Full Text Available The article reflects the experience in the diagnosis and surgical treatment of chondromyxoid fibroma in the proximal metadiaphysis of a large femoral bone in a child in the first decade of life. We presented the family and medical history of the child complaints, orthopedic/local status, and the results of radiological methods and emphasized difficulties of nosologic identification and differential diagnosis of the bone destructive process at the stage before biopsy and surgery. Macroscopic findings during surgery were identified, and the amount of resection of the affected bone was determined. A detailed description of the results of pathological and morphological (macro- and microscopic studies is given, which could confirm the tumor process. Late results with the absence of oncological re-occurrence (7 years and good anatomical and functional results from orthopedic surgery are shown.

  8. Practical Guidance on How to Handle Levodopa/Carbidopa Intestinal Gel Therapy of Advanced PD in a Movement Disorder Clinic

    DEFF Research Database (Denmark)

    Pedersen, Stephen Wørlich; Clausen, Jesper Bøje; Gregerslund, Mie Manon

    2012-01-01

    Continuous dopaminergic delivery is recognized for the capacity to ameliorate symptoms in Parkinson's disease (PD). In advanced PD the short comings of orally administered Levodopa/Carbidopa include fluctuations resulting in unstable effect and dyskinesia. Levodopa/Carbidopa intestinal gel, LCIG......, (Duodopa®, Abbott Laboratories) is delivered continuously through a percutaneous endoscopic gastrostomy with the inner tube placed in the duodenum by means of a device (CADD legacy Duodopa pump (CE 0473)). The therapy implies continuous dopaminergic delivery directly to the duodenum and is therefore...... unaffected by gastric emptying and represents a major adjuvant in the treatment of advanced PD with significant improvement in motor and non-motor symptoms. The aim of this paper is to suggest the prerequisites for a LCIG clinic and propose a feasible set-up and lean organization of a movement disorder...

  9. Ehlers-Danlos syndrome(s) mimicking child abuse: Is there an impact on clinical practice?

    Science.gov (United States)

    Castori, Marco

    2015-12-01

    Ehlers-Danlos syndrome is a heterogeneous group of heritable connective tissue disorders characterized by increased fragility of various non-ossified tissues. It is usually ascertained due to abnormal skin texture, scarring complications, vascular fragility, or chronic symptoms, such as fatigue and musculoskeletal pain. Sometimes, Ehlers-Danlos syndrome remains undetected until the patient, usually in the pediatric age, shows extensive or severe mucocutaneous injuries after only minor traumas. In this scenario, the misdiagnosis of Ehlers-Danlos syndrome with child abuse is a possibility, as occasionally reported in the literature. Recently, more attention was posed by lay people between the possible association of Ehlers-Danlos syndrome and bone fragility. Literature and personal experience show a strong association between Ehlers-Danlos syndrome, generalized joint hypermobility and reduced bone mass density in older children and adults, especially fertile women. The existence of a true increased risk of fracture in Ehlers-Danlos syndrome is still a matter of debate in children and adults with little and conflicting evidence. In case of suspected child abuse, Ehlers-Danlos syndrome is certainly on the differential for bruising, especially in EDS types with marked cutaneous and capillary involvement. In suspected child abuse cases, careful examination of the index case and her/his extended family is routine, as well as exclusion of other disorders such as osteogenesis imperfecta. The hypothesis of Ehlers-Danlos syndrome as an alternative explanation for infantile fractures remains speculative. PMID:26452443

  10. [Quality management and practice-oriented research in a clinic-network of mother-/father-child rehabilitation centres].

    Science.gov (United States)

    Otto, F; Arnhold-Kerri, S

    2010-04-01

    The Research Network Prevention and Rehabilitation for Mothers and Children is an association of currently 24 rehabilitation centres for mothers, fathers and their children, and a scientific team at the Hannover Medical School. The Research Network combines practice-oriented research on mother and child health with the further development of treatment programmes and the implementation of internal quality management in mother-/father-child rehabilitation centres in accordance with DIN EN ISO 9001. The present paper describes the concept of the Research Network and the work contents addressed over the last three years. The advantages and disadvantages of this association and the changes initiated in practice were evaluated from the point of view of 19 quality managers of the participating clinics. The data were collected by means of semi-structured interviews, and a qualitative content analysis was performed in order to quantify the responses. The concept of the Research Network has proven successful. In the view of the quality managers of the clinics, implementation of DIN EN ISO 9001 has lead to structuring of the processes, improved internal communication, and increased motivation in the team. The major obstacles were the lack of time and human resources. In all clinics, the participation in practice-related research projects und scientifically monitored concept development has contributed to optimizing everyday practice. The exchange between the quality managers in external quality circle meetings was of central importance. The conjunction of internal quality management, practice-related research and concept development in a network can be recommended also for other associations of clinics, health centres or medical practices. PMID:20446193

  11. Use of Clinical Decision Guidance as a New Public Health Tool for the Medical Management of Internal Contamination in Radiological Mass Casualty Scenarios.

    Science.gov (United States)

    Wiley, Albert L

    2016-09-01

    This review is a discussion of special issues associated with the medical and public health management of persons at risk of internal contamination from radionuclides, following various radiological mass-casualty scenarios, as well as definition, discussion and use of the Clinical Decision Guidance (CDG) in such scenarios. Specific medical countermeasures are available for reducing the internal radiation dose and the subsequent stochastic and deterministic risks to persons internally contaminated with radionuclides from nuclear power plant, fuel processing and nuclear weapon accidents/incidents. There is a public health need for rapidly identifying and quantifying the 'source term' of such radiation exposures and assessment of the associated committed doses, so that appropriate medical countermeasure(s) can be given as soon as possible. The CDG, which was initially defined in NCRP-161, was specifically developed to be a new public health tool for facilitating the integration of local community healthcare professionals into the general medical, mass casualty, triage and treatment response of internally contaminated populations. PMID:27574325

  12. Acute Pancreatitis with Rapid Clinical Improvement in a Child with Isovaleric Acidemia

    Directory of Open Access Journals (Sweden)

    Elpis Mantadakis

    2013-01-01

    Full Text Available Isovaleric acidemia is a rare branched-chain organic acidemia. The authors describe a 3.5-year-old girl with isovaleric acidemia and acute abdominal pain associated with bilious emesis. Elevated serum amylase and abdominal ultrasonography demonstrating an enlarged and edematous pancreas, along with the presence of peripancreatic exudates, confirmed the presence of acute pancreatitis. The patient recovered quickly with intravenous hydration, pancreatic rest, and administration of intravenous L-carnitine. Pancreatitis should be ruled out in the context of vomiting in any patient with isovaleric acidemia. Conversely, branched-chain organic acidemias should be included in the differential diagnosis of any child with pancreatitis of unknown origin.

  13. Bridging the gap between laboratory and clinic in child and adolescent psychotherapy.

    Science.gov (United States)

    Weisz, J R; Donenberg, G R; Han, S S; Weiss, B

    1995-10-01

    Meta-analyses of laboratory outcome studies reveal beneficial effects of psychotherapy with children and adolescents. However, the research therapy in most of those lab studies differs from everyday clinic therapy in several ways, and the 9 studies of clinic therapy the authors have found show markedly poorer outcomes than research therapy studies. These findings suggest a need to bridge the long-standing gap between outcome researchers and clinicians. Three kinds of bridging research are proposed and illustrated: (a) enriching the research data base on treatment effects by practitioners in clinical settings--including private practice and health maintenance organizations, (b) identifying features of research therapy that account for positive outcomes and applying those features to clinical practice, and (c) exporting lab-tested treatments to clinics and assessing their effects with referred youths. If these bridging strategies were widely adopted, despite the numerous obstacles described herein, real progress might be made toward more effective treatment in clinical practice. PMID:7593861

  14. 临床医学生科研工作指导初探%An exploration about the guidance of the medical students in clinical research

    Institute of Scientific and Technical Information of China (English)

    李利红; 刘爱军

    2012-01-01

    目的 探索一条适合临床医学专业学生科研工作的指导模式,以提高该专业学生的科研能力和水平.方法 本研究拟结合国内外研究生教学模式,参照首都医科大学研究生教学大纲的要求,招募10名医学生作为研究对象.通过指导学生文献阅读、读书会及文献撰写等方式让学生逐渐接触科研,撰写论文.10名未接受培训的医学生作为对照组.结果 通过培养10名医学生均能熟练掌握文献检索、撰写论文的方法.已有4名学生撰写出综述,其中一篇已被中华系列杂志接受.结论 让医学生早期接触专业论文文献,经过系统指导可明显提高学生的科研能力.%Objective To explore the guidance mode of the clinical research work to improve the professional ability of medical students . Methods In this study, we combined domestic and foreign graduate students' teaching mode, referred to the requirements of Capital University graduates ' teaching program ,then made the recruitment of 10 medical students as research subjects . Guiding these students through literature reviewing , reading and writing that will enable students to gradually access to research and writing papers . Ten students did not take part in this training as controls . Results Guiding through the training , the ten students all can skilled grasp the methods of literature research and paper writing . And there are 4 students have written reviews , one of them was submitted by Chinese medical journals . Conclusion Giving students opportunity to get access to professional literature papers by systematic guidance early can improve their scientific research ability .

  15. Clinical assessment of suspected child physical abuse; Klinischer Verdacht auf Kindesmisshandlung

    Energy Technology Data Exchange (ETDEWEB)

    Rohrer, T. [Universitaetsklinikum des Saarlandes, Klinik fuer Allgemeine Paediatrie und Neonatologie, Homburg/Saar (Germany)

    2009-10-15

    Violence against children has many faces. Child physical abuse, neglect, sexual abuse and interparental violence can cause acute and permanent damage and affect children's development and their life plans in the long term. In industrialized nations almost 1 child in 10 is affected. Up to 10% of child physical abuse cases involve the central nervous system with 80% of these cases occurring during the first year of life. Worldwide more than 50,000 children die as a result of violence, abuse and neglect every year, according to the United Nations Children's Fund UNICEF. In Germany, there are about 120 cases of non-accidental head injury per year. In addition to the officially known cases there is a large grey area for all forms of violence. Recognition of these cases and the provision of help for the victims require an appropriate suspicion and understanding of the pertinent pathophysiology. Suspicion must be based on a well-documented medical history and multidisciplinary diagnostic assessment. Medical confidentiality prevents the disclosure of such information making early detection networks and guidelines for collaboration absolutely indispensable. (orig.) [German] Gewalt gegen Kinder hat viele Gesichter: Kindesmisshandlung, Vernachlaessigung, sexueller Missbrauch und elterliche Partnerschaftsgewalt koennen bei Kindern und Jugendlichen zu akuten und bleibenden Schaeden fuehren und ihre Entwicklung und Lebensentwuerfe nachhaltig beeinflussen. Betroffen ist in Industrienationen fast jedes zehnte Kind. Bis zu 10% der Kindesmisshandlungen betreffen das zentrale Nervensystem. Von diesen ereignen sich ca. 80% im ersten Lebensjahr. Weltweit sterben nach Angaben der Kinderhilfsorganisation UNICEF jaehrlich ueber 50.000 Kinder an den Folgen von Gewalt, Missbrauch und Vernachlaessigung. In Deutschland ereignen sich pro Jahr ca. 120 Faelle an nichtakzidentellen Kopfverletzungen. Den oeffentlich bekannten Faellen steht eine hohe Dunkelziffer aller Formen von Gewalt

  16. Vitamin D status among immigrant mothers from Pakistan, Turkey and Somalia and their infants attending child health clinics in Norway.

    Science.gov (United States)

    Madar, Ahmed A; Stene, Lars C; Meyer, Haakon E

    2009-04-01

    High prevalences of vitamin D deficiency have been reported in non-Western immigrants moving to Western countries, including Norway, but there is limited information on vitamin D status in infants born to immigrant mothers. We aimed to describe the vitamin D status and potentially correlated factors among infants aged 6 weeks and their mothers with Pakistani, Turkish or Somali background attending child health clinics in Norway. Eighty-six healthy infants and their mothers with immigrant background were recruited at the routine 6-week check-up at nine centres between 2004 and 2006. Venous or capillary blood was collected at the clinics from the mother and infant, and serum separated for analysis of 25-hydroxyvitamin D (s-25(OH)D) and intact parathyroid hormone (s-iPTH). The mean maternal s-25(OH)D was 25.8 nmol/l, with 57 % below 25 nmol/l and 15 % below 12.5 nmol/l. Of the mothers, 26 % had s-iPTH>5.7 pmol/l. For infants, mean s-25(OH)D was 41.7 nmol/l, with 47 % below 25 nmol/l and 34 % below 12.5 nmol/l. s-25(OH)D was considerably lower in the thirty-one exclusively breast-fed infants (mean 11.1 nmol/l; P < 0.0001). Use of vitamin D supplements and education showed a positive association with maternal s-25(OH)D. There was no significant association between mother's and child's s-25(OH)D, and no significant ethnic or seasonal variation in s-25(OH)D for mothers or infants. In conclusion, there is widespread vitamin D deficiency in immigrant mothers and their infants living in Norway. Exclusively breast-fed infants who did not receive vitamin D supplements had particularly severe vitamin D deficiency.

  17. Neuropsychological screening of children of substance-abusing women attending a Special Child Welfare Clinic in Norway

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    Skogmo Idar

    2010-07-01

    Full Text Available Abstract Background Exposure to alcohol and illicit substances during pregnancy can have an impact on the child for the rest of his/her life. A Special Child Welfare Clinic (SCWC in Norway provides care for pregnant women with substance abuse problems. Treatment and support are provided without replacement therapy. Methods We performed a neuropsychological screening of 40 children aged four to 11 years whose mothers had attended the SCWC during pregnancy, and of a comparison group of 80 children of women without substance abuse problems. The children were presented with tests chosen from Wechsler Intelligence Scale for Children, third version (WISC-III, Nepsy, Halstead-Reitan and Raven's Progressive Matrices, Coloured Version. The tests were grouped into five main domains; (1 learning and memory, (2 visual scanning, planning and attention, (3 executive function, (4 visuo-motor speed and dexterity and (5 general intellectual ability Results No children in the study had test results in the clinical range in any domain. Bivariate analyses revealed that children of short-term substance-abusing mothers (who stopped substance abuse within the first trimester had significantly lower test scores than the comparison group in three out of five domains (domain 2,3,4. Children of long-term substance abusers (who maintained moderate substance abuse throughout pregnancy had significantly lower test results than the comparison group in one domain of the test results (domain 1. All but one child in the long-term group were or had been in foster homes. Most children in the short-term group stayed with their mothers. Multivariate regression analyses revealed that foster care minimum 50% of life time was associated with better scores on domains (1 learning and memory, (2 visual scanning, planning and attention, and (3 executive functions, while no significant associations with test scores was found for substance abuse and birth before 38 weeks of gestation

  18. Canavan disease - unusual imaging features in a child with mild clinical presentation

    Energy Technology Data Exchange (ETDEWEB)

    Nguyen, Ho V.; Ishak, Gisele E. [University of Washington, Department of Radiology, Seattle Children' s Hospital, Seattle, WA (United States)

    2015-03-01

    Canavan disease is a rare hereditary leukodystrophy that manifests in early childhood. Associated with rapidly progressive clinical deterioration, it usually results in death by the third year of life. The predominant MRI appearance is diffuse and symmetrical white matter disease. We discuss an atypical, late presentation of Canavan disease with a benign clinical course and uncharacteristic imaging features. This case introduces a previously unreported pattern of diffuse cortical abnormality without significant white matter involvement. (orig.)

  19. [Cognitive remediation therapy for children: literature data and clinical application in a child and adolescent psychiatry department].

    Science.gov (United States)

    Doyen, C; Contejean, Y; Risler, V; Asch, M; Amado, I; Launay, C; Redon, P De Bois; Burnouf, I; Kaye, K

    2015-04-01

    remediation, and the program was applied by a clinical nurse with the supervision of a child and adolescent psychiatrist and the department's neuropsychologists. Paper-pencil tasks were adapted from the CRT program for adults; the card and board games used were geometric figures, illusions, Rush Hour(®), Set(®), Jungle Speed(®), Color Addict(®), etc. These games are available in stores and the program can be applied at home, which helps families set aside their preoccupations with their child's academic performance. Diagnostic and neuropsychological evaluations were done before the beginning of the therapy and repeated at the end of the 6-month program. This program does not ignore the metapsychological impact of the therapy, and work on self-esteem is also done. The presence of the therapist is necessary, which seems better than a computer program, which cannot encourage the young subject in the same personalized and empathetic way. We therefore conducted the first clinical feasibility trial of cognitive remediation in young subjects and present a clinical case of a 6-year-old boy with attention deficit disorder and academic disorder. The results of neuropsychological evaluations before and after therapy suggest improvement in executive functions and better self-esteem. Satisfaction for the boy and his family was high. Even if these results need to be replicated, cognitive remediation appears to be a new therapeutic tool, complementary to classical approaches used in childhood psychiatric disorders. The Department of Child and Adolescent Psychiatry will submit this program to a research program conducted by the National Health Department to study the impact of this approach in a controlled study. PMID:25736104

  20. Epilepsy in the Classroom: Guidance for Educators.

    Science.gov (United States)

    Lassner, Lee M.

    This paper for educators, school psychologists, and counselors attempts to provide guidance for meeting the needs of students with epilepsy. Stressed throughout the paper are ways to provide for the child's special needs while fostering his/her self esteem and full participation in classroom activities. The paper addresses the following topics:…

  1. Posttraumatic Child Therapy (P-TCT): Assessment and Treatment Factors in Clinical Work with Inner-City Children Exposed to Catastrophic Community Violence.

    Science.gov (United States)

    Parson, Erwin Randolph

    1997-01-01

    Discusses the psychological influence and adverse health effects of political terror and community violence on the minds and bodies of children. Claims that a posttraumatic assessment of these children is a critical dimension of clinical treatment. Proposes a treatment approach to alter the child's cognitive theories of self, trauma, and world.…

  2. Reasons for non-adherence to vaccination at mother and child care clinics (MCCs) in Lambaréné, Gabon

    NARCIS (Netherlands)

    N.G. Schwarz; M. Gysels; C. Pell; J. Gabor; M. Schlie; S. Issifou; B. Lell; P.G. Kremsner; M.P. Grobusch; R. Pool

    2009-01-01

    The aim of this paper is to explore attitudes of mothers towards childhood vaccinations and reasons for non-attendance and non-adherence to mother-child clinics (MCCs). Forty in-depth interviews with mothers of children under 5 years of age revealed positive attitudes towards vaccination that seem a

  3. Residential Treatment and the Invention of the Emotionally Disturbed Child in Twentieth-Century America.

    Science.gov (United States)

    Doroshow, Deborah Blythe

    2016-01-01

    In the 1930s, children who were violent, depressed, psychotic, or suicidal would likely have been labeled delinquent and sent to a custodial training school for punitive treatment. But starting in the 1940s, a new group of institutions embarked on a new experiment to salvage and treat severely deviant children. In the process, psychiatrists, psychologists, and social workers at these residential treatment centers (RTCs) made visible, and indeed invented, a new patient population. This article uses medical literature, popular media, and archival sources from several RTCs to argue that staff members created what they called the "emotionally disturbed" child. While historians have described the identification of the mildly "troublesome" child in child guidance clinics, I demonstrate how a much more severely ill child was identified and defined in the process of creating residential treatment and child mental health as a professional enterprise. PMID:27040027

  4. Clinical Observation on 930 Child Epilepsy Cases Treated with Anti-epilepsy Capsules

    Institute of Scientific and Technical Information of China (English)

    马融; 李少川; 李新民; 胡思源; 孙希焕; 刘玉珍; 张喜莲; 李向农; 马秀华

    2003-01-01

    1090 cases of child epilepsy were divided randomly into two groups: the treatment group (930 cases treated with anti-epilepsy capsules) and the control group (160 cases treated with luminal). The results showed that in the treatment group, 534 cases were markedly effective, 241 effective, 96 improved, 46 ineffective, and 13 aggravated, with a total effective rate of 83.33%; while in the control group, 64 cases were markedly effective, 19 effective, 38 improved, 29 ineffective, and 10 aggravated, with a total effective rate of 51.88%. The treatment group showed an obviously higher total effective rate than that in the control group (P<0.01). After treatment, cases in the two groups all had lower frequency of epilepsy attacks and shorter duration of each attack as compared with that before treatment (P<0.01), but the situation was obviously better in the treatment group. The anti-epilepsy capsules had very good effect on various types of epilepsy, especially on autonomic epilepsy and on epilepsies due to wind, phlegm, or terror as differentiated in TCM. After treatment, the recovery rate shown by EEG examination was 54.3% in the treatment group, while 38.4% in the control group, the former being obviously higher than the latter (P<0.01).

  5. Clinical treatment approach of a child with molar incisor hypomineralization (MIH combined with malocclusion.

    Directory of Open Access Journals (Sweden)

    Rossitza Kabaktchieva

    2012-04-01

    Full Text Available Introduction. Molar incisor hypomineralization (MIH was defined as "hypomineralisation of systemic origin of permanent first molars, frequently associated with affected incisors". MIH includes the presence of demarcated opacity, post eruptive enamel breakdown, atypical restoration. Тhe approach to management suggested: risk identification, early diagnosis, remineralization for prevention of caries and post eruption breakdown, restorations. The clinicians very seldom notice that children with MIH usually have both- hypomineralisation and malocclusions, and they do not discuss combine treatment plan.Aim. To present our interdisciplinary approach to a patient with MIH, combined with malocclusion.Material and methods. We are presenting 9 year old child with contusio and fractura coronae dentis noncomplicata, distal occlusion, overjet, overbite and retrusion. Two consecutive stages were defined: First stage:- Professional oral hygiene and local remineralisation therapy- Vital pulp therapy of tooth 21 - Space gaining for restoration of the lost height of the molars by the means of posterior bite-plane removable appliance- Restoration of the molars with metal inlays- Lingual tipping of the lower incisorsSecond stage:- Class II correction- Growth control Results.First phase: - The tooth 21 was restored with aesthetic composite material;- Occlusion was raised with occlusal restorations (inleys and orthodontic appliance. Second phase:Medialisation of mandible and holding maxillary growth with functional appliance and occipital EOA until class one occlusal relations.Conclusion. Children with MIH should be examined and treated complex in collaboration with orthodontist and if necessary by other specialists too.

  6. 超声引导自动组织学活检术临床应用%Clinical Applications of Automatic Biopsy Technique Under the Guidance of Ultrasound

    Institute of Scientific and Technical Information of China (English)

    张武; 冯麟增; 李志平; 吕国荣; 贾建文; 冉维强; 苗立英; 史旭东; 黄曼维; 赵蕊; 丁丽华

    1993-01-01

    本文报道110例颈、胸、腹部多种病变和肿瘤超声引导自动活检术(活检枪抢和18~20 G针)的成功经验,另将一组慢性肾病超声引导手动TRu Cut粗针(14 G)活检30例与30例自动活检组(Biopty 18 G)作对照研究.结果表明:1.自动活检装置可广泛应用于胸腹部多种内脏和前列腺、乳腺等小器官的病变和肿瘤的组织学穿刺活检,对于那些活检难度较大的脏器或病变尤为适用.2.本组100例取材成功率高达100%,而且活检标本量和质均提高,标本满意足以作出组织学诊断者达97.2%.3.慢性肾病自动活检成功率、标本长度均优于手动活检,且并发症明显减少(PO.9).但笔者认为;超声引导自动活检术简便、安全、准确、迅速,值得推广使用.%One hundred and ten biopsies of various lesions or tumors in the liver,gallbladder,kidney.prostate,lung,retroperitoneal space,intestine,etc.were performed with automatic biopsy gun under the guidance of ultrasound and 18G Or 20G needles Out of them.thirty cases of automatic renal biopsies (18G.Biopty)were prospectively compared with thirty cases of manual ones(14G,Tru-Cut)to assess the clinical effectiveness of this new method.Our results showed:1.Biopsy samples sufficient for histologic analysis were obtained in all of the 110 cases(100%),histo pathologic speciments With high quality ac-counted for 97.2%.2.Sampling success rate and the length of specimens obtaincd with automatic renalbiopsy technique(18G Biopty) had advantages over l4G Fru-Cut manual renal biopsy technique(P0.9).The authors concluded that US guided automatic biopsy is a simple,safe and valuable diagnostic tool,and could be recommended for further wide use clinically.

  7. What every clinical geneticist should know about testing for osteogenesis imperfecta in suspected child abuse cases.

    Science.gov (United States)

    Pepin, Melanie G; Byers, Peter H

    2015-12-01

    Non-accidental injury (NAI) is a major medical concern in the United States. One of the challenges in evaluation of children with unexplained fractures is that genetic forms of bone fragility are one of the differential diagnoses. Infants who present with fractures with mild forms of osteogenesis imperfecta (OI) (OI type I or OI type IV), the most common genetic form of bone disease leading to fractures might be missed if clinical evaluation alone is used to make the diagnosis. Diagnostic clinical features (blue sclera, dentinogenesis imperfecta, Wormian bones on X-rays or positive family history) may not be present or apparent at the age of evaluation. The evaluating clinician faces the decision about whether genetic testing is necessary in certain NAI cases. In this review, we outline clinical presentations of mild OI and review the history of genetic testing for OI in the NAI versus OI setting. We summarize our data of molecular testing in the Collagen Diagnostic Laboratory (CDL) from 2008 to 2014 where NAI was noted on the request for DNA sequencing of COL1A1 and COL1A2. We provide recommendations for molecular testing in the NAI versus OI setting. First, DNA sequencing of COL1A1, COL1A2, and IFITM5 simultaneously and duplication/deletion testing is recommended. If a causative variant is not identified, in the absence of a pathologic clinical phenotype, no additional gene testing is indicated. If a VUS is found, parental segregation studies are recommended.

  8. A Qualitative Study of School Social Workers' Clinical and Professional Relationships when Reporting Child Maltreatment

    Science.gov (United States)

    Chanmugam, Amy

    2009-01-01

    This qualitative study explored school social workers' relationships during instances of abuse and neglect reporting, focusing on reports made for children and adolescents already receiving school social work services. Although school social workers frequently file abuse and neglect reports, little is known about how they manage clinical and…

  9. A Mediation Model of Interparental Collaboration, Parenting Practices, and Child Externalizing Behavior in a Clinical Sample

    Science.gov (United States)

    Kjobli, John; Hagen, Kristine Amlund

    2009-01-01

    The present study examined maternal and paternal parenting practices as mediators of the link between interparental collaboration and children's externalizing behavior. Parent gender was tested as a moderator of the associations. A clinical sample consisting of 136 children with externalizing problems and their families participated in the study.…

  10. The Dutch version of the Child Posttraumatic Cognitions Inventory: validation in a clinical sample and a school sample

    Directory of Open Access Journals (Sweden)

    Julia Diehle

    2015-02-01

    Full Text Available Background: With the inclusion of trauma-related cognitions in the DSM-5 criteria for posttraumatic stress disorder (PTSD, the assessment of these cognitions has become essential. Therefore, valid tools for the assessment of these cognitions are warranted. Objective: The current study aimed at validating the Dutch version of the Child Posttraumatic Cognitions Inventory (CPTCI. Method: We included children aged 8–19 years in our study and assessed the factor structure, reliability and validity of the CPTCI in a clinical sample (n=184 and a school sample (n=318. Results: Our results supported the two-factor structure of the CPTCI and showed good internal consistency for the total scale and the two subscales. We found significant positive correlations between the CPTCI and measures of PTSD, depression, and anxiety disorder. The CPTCI correlated negatively with a measure of quality of life. Furthermore, we found significantly higher scores in the clinical sample than in the school sample. For children who received treatment, we found that a decrease in CPTCI scores was accompanied by a decrease in posttraumatic stress symptoms and comorbid problems indicating that the CPTCI is able to detect treatment effects. Conclusion: Overall, our results suggest that the Dutch CPTCI is a reliable and valid instrument.

  11. Age-appropriate feeding practices and nutritional status of infants attending child welfare clinic at a Teaching Hospital in Nigeria

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    Umar M Lawan

    2014-01-01

    Full Text Available Background: Appropriate infant feeding is the key to optimum infant and child development and survival. This study investigates age-appropriate infant feeding practices and nutritional status of infants attending the immunization and child welfare clinic at Aminu Kano Teaching Hospital. Materials and Methods: Using a cross-sectional descriptive design, a sample of 300 sets of infants (age ≤12 months and caregivers was systematically selected and studied. The data were analyzed using the MINITAB ® 12.21 (USA statistical software. Results: All the infants studied were still on breast milk. Most of the mothers demonstrated correct body positioning (89.9 and attachment (78.7% during breastfeeding, and effective suckling was demonstrated in 77.0%. Interestingly, none of the infants was either exclusively breastfed for 6 months or currently on exclusive breastfeeding. Furthermore, only 64 (58.2% of the 110 infants that were more than 6 months of age had appropriately been started on complementary feeding from 6 months of age. Overall, most caregivers (88.7% had "fair" to "good" infant feeding practices. The practices were significantly associated with their level of education, and their relationship with the infants. Up to 40.0% and 73.7% of the infants had varying degrees of wasting and stunting respectively. Infant feeding practices and the age of the infants emerged as the only factors significantly associated with stunting, while both the caregivers′ practices and age of the infants emerged as significant predictors of wasting in the infants. Conclusion and Recommendations: Barely 3 years to the 2015 target of the millennium development goals (MDGs, infant feeding and nutritional status still poses a serious threat to the dream of realizing the MDG-4. The Ministry of Health and relevant developing partners in this region should as a matter of urgency, formulate and implement a strong community-based public health intervention program to

  12. The Leyton Obsessional Inventory-Child Version: Validity and reliability in Spanish non-clinical population

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    Josefa Canals Sans

    2012-01-01

    Full Text Available El objetivo fue estudiar la estructura factorial, la validez y la fiabilidad de la versión española del Leyton Obsessional Inventory-Child Version (LOI-CV, así como determinar el mejor punto de corte para detectar el trastorno obsesivo compulsivo (TOC. Un total de 1.514 escolares (8-12 años participaron en la primera fase del estudio y 562 de estos en la segunda (participantes con riesgo de trastornos del estado de ánimo y ansiedad y controles sin riesgo. El LOI-CV fue administrado en ambas fases y el diagnóstico de TOC se obtuvo en la segunda fase. Mediante análisis factorial exploratorio se obtuvieron tres factores que explicaron el 45,84% de la variancia: Orden/ comprobación/contaminación, Preocupaciones obsesivas y Superstición/compulsión mental. La fiabilidad fue buena (0,79-0,90. Para detectar TOC, los puntos de corte seleccionados fueron 21 para la puntuación total y 10 para la interferencia, presentando ambos una sensibilidad del 82,4% y una especificidad del 84,1% y 83,8% respectivamente. Las puntuaciones del LOI-CV fueron significativamente mayores en sujetos con diagnóstico de TOC que en sujetos con diagnóstico subclínico y sin diagnóstico. No hemos hallado diferencias según sexo y edad. Nuestros resultados apoyan la validez y fiabilidad del LOI-CV como herramienta de detección del TOC en población no clínica.

  13. Burkitt's lymphoma: a child's case presenting in the maxilla. Clinical and radiological aspects.

    Science.gov (United States)

    Valenzuela-Salas, Borja; Dean-Ferrer, Alicia; Alamillos-Granados, Francisco-Jesús

    2010-05-01

    Burkitt's lymphoma (BL) is a neoplasm which, despite its very aggressive behaviour is potentially curable. It typically affects the paediatric population. BL belongs to the non-Hodgkin lymphomas group, and is the first human tumour undoubtedly related to a viral origin (Epstein-Barr virus). Two main clinical subtypes are recognized: endemic or African type, and sporadic type; HIV associated BL constitutes a third type. Although common in endemic BL, maxillary involvement is rare in sporadic cases. This, together with the clinical lack of specificity associated to this location, makes diagnosis difficult. New chemotherapeutic protocols achieve a high survival rate. Most important prognostic factors are location and tumour stage. We report a paediatric case of BL presenting in the maxilla, with a review and a description of the characteristics of the disease.

  14. Atypical Clinical and Diagnostic Features in Ménétrier's Disease in a Child

    Directory of Open Access Journals (Sweden)

    Michael Chung

    2011-01-01

    Full Text Available Ménétrier's disease is one of the rarest protein-losing gastropathies in childhood. It is characterized clinically by non-specific gastrointestinal symptoms and edema, biochemically by hypoalbuminemia, and pathologically by enlarged gastric folds. In adults, this disease can be devastating with significant morbidity and mortality. In childhood, it is a self-limiting, transient and benign illness. Its treatment is largely supportive with total parenteral nutrition (TPN while oral intake is encouraged. Acute onset of vomiting in healthy school age children can be initially explained by acute viral gastroenteritis. However, persistent vomiting associated with hematemesis and severe abdominal pain should warrant further work-up. This case report illustrates a self-limiting and rare cause of protein-losing enteropathy called Ménétrier's disease that presented with several variant clinical features not typically described in association with this entity.

  15. Clinical indicators of child development in the capitals of nine Brazilian states: the influence of regional cultural factors

    Directory of Open Access Journals (Sweden)

    André Laranjeira de Carvalho

    2008-01-01

    Full Text Available OBJECTIVE: Evaluating the interaction between mother or caregiver and infant through the Clinical Indicators of Risks in Infant Development and investigating whether local and cultural influences during infant development affect these clinical indicators. INTRODUCTION: The Clinical Indicators of Risks in Infant Development was created in order to fully assess infants' development and the subjective relationship between the babies and their caregivers. The absence of two or more Clinical Indicators of Risks in Infant Developments suggests a possibly inadequate mental development. Given the continental size of Brazil and its accentuated cultural differences, one might question how trustworthy these indicators can be when applied to each of the geographical regions of the country. METHODS: This was a cross-sectional study with 737 infants from the capitals of 9 Brazilian states. The size of the initial sample population was based on a pilot study carried out in the cities of São Paulo and Brasília. The ages of children were grouped: 0-3 months, 4-7 months, 8-11 months and 12-18 months. The chi-square test was used together with analyses by the statistical software SPSS 13.0. RESULTS: Statistical analysis of results from the different municipalities against the total sample did not reveal any statistically significant differences. Municipalities represented were Belém (p=0.486, Brasília (p=0.371, Porto Alegre (p=0.987, Fortaleza (p=0.259, Recife (p=0.630, Salvador (0.370, São Paulo (p=0.238, Curitiba (p=0.870, and Rio de Janeiro (p= 0.06. DISCUSSION: Care for mental development should be considered a public health issue. Its evaluation and follow-up should be part of the already available mother-child assistance programs, which would then be considered to provide "full" care to children. CONCLUSIONS: Local habits and culture did not affect the results of the Clinical Indicators of Risks in Infant Development indicators. Clinical Indicators of

  16. MAJEWSKI OSTEODYSPLASTIC PRIMORDIAL DWARFISM TYPE II: CLINICAL FINDINGS AND DENTAL MANAGEMENT OF A CHILD PATIENT

    Directory of Open Access Journals (Sweden)

    Arslan Terlemez

    2015-01-01

    Full Text Available Majewski osteodysplastic primordial dwarfism type II (MOPD II is an unusual autosomal recessive inherited form of primordial dwarfism, which is characterized by a small head diameter at birth, but which also progresses to severe microcephaly, progressive bony dysplasia, and characteristic facies and personality. This report presents a case of a five-year-old girl with MOPD II syndrome. The patient was referred to our clinic with the complaint of severe tooth pain at the left mandibular primary molar teeth. Clinical examination revealed that most of the primary teeth had been decayed and all primary teeth were hypoplastic. Patient’s history revealed delayed development in the primary dentition and radiographic examination showed rootless primary molar teeth and short-rooted incisors. The treatment was not possible due to the lack of root of the left mandibular primary molars; so the teeth were extracted. Thorough and timely dental evaluation is crucial for the prevention of dental problems and the maintenance of oral health in patients with MOPD II syndrome is of utmost importance.

  17. Finnish families' need for special support as evaluated by public health nurses working in maternity and child welfare clinics.

    Science.gov (United States)

    Häggman-Laitila, Arja; Euramaa, Katri-Ina

    2003-01-01

    The purpose of this study was to describe public health nurses' views of the everyday problems of families and their needs for special support. Seventy-four nurses filled in a tripartite questionnaire. The needs varied by region and were seen in 4% to 23% of all families expecting a baby or with a child younger than 3 age in the nurses' clientele. Approximately one-third of the families were considered to have a pressing need for support. More than half of families (54%) had difficulties coping with parenthood and family structure, almost one-third (30%) with raising their children and with childcare, and nearly one-third (27%) with their social network. In 20% of the families, the parents experienced problems relating to their relationship as a couple; 20% of the families had problems connected to the children's development, growth, and health; and in 19% of the families, the parents had health problems. Special needs were also caused by the parents' use of alcohol (15%) and by disputes over the children's custody and visiting rights (7%). The information provided by the study can be used in developing clinical services and the family work supporting them. PMID:12823793

  18. Child behaviour checklist emotional dysregulation profiles in youth with disruptive behaviour disorders: clinical correlates and treatment implications.

    Science.gov (United States)

    Masi, Gabriele; Muratori, Pietro; Manfredi, Azzurra; Pisano, Simone; Milone, Annarita

    2015-01-30

    Two Child Behaviour Checklist (CBCL) profiles were correlated to poor self-regulation, Deficient Emotional Self-Regulation (DESR) (elevation between 1 and 2 Standard Deviations (SD) in Anxiety/Depression, Aggression, Attention subscales), and Dysregulation Profile (DP) (elevation of 2 Standard Deviations or more). We explored youths with Oppositional Defiant Disorder (ODD) and Conduct Disorder (CD) whether these profiles are associated with specific clinical features. The sample included 57 patients with DESR profile and 41 with DP profile, ages 9 to 15 years, all assigned to a non-pharmacological Multimodal Treatment Program. No differences resulted between groups in demographic features, diagnosis ratio, and comorbidities with Attention Deficit Hyperactivity Disorder (ADHD), Bipolar Disorder (BD), and Anxiety Disorder. The DP group was associated with higher scores in Withdrawn, Social Problem, Thought, Rule Breaking, and Somatic CBCL subscales, and higher scores in Narcissism and Impulsivity (but not Callous-Unemotional (CU)), according to the Antisocial Process Screening Device (APSD). After treatment, patients with DESR improved their personality traits (Narcissistic and Callous-Unemotional, but not Impulsivity), while changes in CBCL scales were modest. Patients with DP improved scales of Attention, Aggression, Anxiety-Depression, Rule Breaking, Withdrawal, Social Problem and Thought, while personality features did not change. These results suggest diagnostic implications of CBCL profiles, and indications for targeted treatment strategies. PMID:25480545

  19. Complete clinical recovery of a central pontine and extrapontine myelinolysis delayed onset in a child with acute myeloblastic leukemia.

    Science.gov (United States)

    Yilmaz, D; Karapinar, B; Balkan, C; Ay, Y; Kavakli, K

    2011-02-01

    Central pontine myelinolysis (CPM) is a demyelinating disease of the pons often associated with the demyelination of extrapontine areas of the central nervous system. It typically occurs 0.5-7 days after a rapid increment in serum Na level in hyponatremic patients and may lead to death. A 2.5-year-old child with a diagnosis of acute myeloblastic leukemia developed febril neutropenia, diarrhea, gastrointestinal hemorrhage followed by pulmonary aspergillosis. He could not tolerate enteral nutrition. He was given broad spectrum antibiotics and antifungal treatment. Laboratory tests showed electrolyte abnormalities including hyponatremia, hypokalemia and hypophosphatemia in a chronic course. Twenty three days after a rapid correction of hyponatremia (16 mEq/L/24 h) he revealed flask quadriparesis, disphagia, mutism, irregular respiratory pattern and loss of cough and gag reflex. Cranial magnetic resonance showed central pontine and extrapontine myelinolysis. He required mechanical ventilation and then he regained his neurologic functions. He completed chemotherapy protocol and underwent hematopoietic stem cell transplantation. After 2.5 years of the occurrence of CPM he is in completely normal physical and neurological status. CPM is a very severe but rare disorder in children with underlying disease. In the presence of multiple etiologic factors it may reveal a delayed onset and optimum outcome can be seen even in the severe clinical presentation with adequate intensive support.

  20. Self-Expandable Metallic Stent for the Palliative Treatment of Obstructing Left-Sided Colorectal Cancer under Fluoroscopic Guidance: A Comparison of the Clinical Results according to Stent Diameter

    Energy Technology Data Exchange (ETDEWEB)

    Kang, Pyeong Guk; Hong, Hyun Pyo; Choi, Yoon Jung; Lee, Min Hee; Park, Hae Won; Chung, Eun Chul [Kangbuk Samsung Hospital, Seoul (Korea, Republic of); Kim, Sam Soo [Kangwon National University College of Medicine, Chuncheon (Korea, Republic of)

    2010-03-15

    To evaluate the feasibility, effectiveness, and safety of self-expandable metallic stent for the palliative treatment of obstructing left-sided colorectal cancer under fluoroscopic guidance, and to compare results according to the stent diameter. Under fluoroscopic guidance, 31 self-expandable metallic stents were placed into 25 patients for palliative purposes. The rates of technical success, clinical success, complications associated with stent insertion, patient survival, and primary stent patency were evaluated. The results were also compared between two groups: 13 patients using stents with a diameter of 22 mm and 12 patients using stents with a diameter of 26 mm. The technical and clinical success rates were 93.5 and 90.3%, respectively. The complications included severe abdominal pain (6.5%), minor rectal bleeding (9.7%), stent migration (9.7%), and tumor ingrowth or overgrowth (9.7%). No statistical differences in technical were detected between the two groups for the clinical success rate and complication rates. The mean survival time was 5.5 +- 1.4 months. The primary stent patency rates were 91.3% at 5 months, 85.2% at 10 months, and 77.4% at 15 months. The mean period of stent patency was 12.4 +- 2.6 months. The mean period of primary stent patency was 16.4 +- 2.6 months in the 26 mm stent group, and significantly higher than 5.4 +- 1.4 months in the 22 mm stent group (p=0.031). A self-expandable metallic stent under fluoroscopic guidance, for the palliative treatment of obstructing left-sided colorectal cancer, was feasible and effective, and yielded good clinical results. The period of primary stent patency of the 26 mm stent group was longer than the 22 mm stent group, and the complication rate was not significantly different between the two stent groups

  1. The effects of acupressure on labor pains during child birth: randomized clinical trial 1

    Science.gov (United States)

    Mafetoni, Reginaldo Roque; Shimo, Antonieta Keiko Kakuda

    2016-01-01

    ABSTRACT Objective: to analyze the effects of acupressure on the sanyinjiao point for pregnant women in labor at public maternity wards. Method: single-blind controlled clinical trial, randomly done employing a pragmatic profile. We selected 156 pregnant women in their ≥ 37 week/s, who had cervical dilations of ≥ 4 cm and with two or more contractions in 10 minutes. The pregnant women were randomly divided into three groups at a university hospital in the suburbs of Sao Paulo, Brazil, in order to receive either acupressure treatment, a placebo or participate as part of a control group. The acupressure was applied on the sanyinjiao point during the contractions for 20 minutes. Then the intensity of the pain was evaluated using the Visual Analogue Scale (VAS). Results: The averages for the pain measured using the VAS were not different for the three groups that were a part of the study (p-value=0.0929), however they were less in the acupressure groups immediately after receiving the treatment (p-value=acupressure on the sanyinjiao point is a useful way to alleviate pain in a non-invasive manner. It can improve the quality of care given to pregnant women in labor. Register: RBR-9mhs8r. PMID:27508910

  2. Graphical Turbulence Guidance - Composite

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — Forecast turbulence hazards identified by the Graphical Turbulence Guidance algorithm. The Graphical Turbulence Guidance product depicts mid-level and upper-level...

  3. The Clinical Manifestations, Treatment Efficacy and Adverse Drug Reactions in 62 Iranian Child with Wilson Disease

    Directory of Open Access Journals (Sweden)

    Mehri Najafi

    2014-09-01

    Full Text Available Introduction: The Wilson disease is an autosomal recessive disease in which the liver, central nervous system, eyes, blood and other parts of the body involved. Timely diagnosis and appropriate treatment of the disease requires awareness of the clinical presentations of this disease in children.Methods: This case series study included 62 patients with Wilson disease who admitted to children's Medical Center in the years 2012-2003.Results: 56% of patients were male. The average age of diagnosis was 9.73 years old (5-17 years and this was higher in patients with early neurologic symptoms (P = 0.85.( 64.5% of the patients had the hepatic symptoms at the time of diagnosis and the most common type of hepatic involvement was cirrhosis (39.3% and hepatitis (17.5% respectively. 17.7% of the patients also had early neurological symptoms. A positive family history for the Wilson Disease were found in 27.4% of patients. 74.2% of patients had KF ring and the frequency of these symptom was higher in patients with early neurological involvement. 83.9% of patients were treated successfully with D-penicillamine and In 30% of patients, adverse drug reactions were seen.Conclusion: Children with unknown liver disease should be evaluated for Wilson disease and the first-degree relatives of patients should be screened. . D-penicillamine have important side effects, but due to the low cost and the availability is an appropriate drug to treat the Wilson disease..Key words: Wilson Disease, Hepatic Involvement, Neurologic Involvement , KF ring ,D-Penicillamine.

  4. A orientação profissional como rito preliminar de passagem: sua importância clínica Vocational guidance as a preliminary rite of passage: its clinical importance

    Directory of Open Access Journals (Sweden)

    André Luiz Picolli da Silva

    2001-12-01

    Full Text Available Este estudo se propõe a analisar a orientação profissional como uma perspectiva de trabalho mais ampla. Os autores demonstram que a orientação profissional pode, dentro de uma abordagem clínica, ser entendida como uma representação moderna dos antigos rituais de passagem, servindo como elemento auxiliador no amadurecimento do indivíduo, que parte do "mundo infantil", visando à entrada no "mundo adulto". A orientação profissional pode ter a função de atuar como um ritual moderno, objetivando a promoção da saúde, e permitindo ao jovem vivenciar experiências primordiais que gradativamente foram sendo postas de lado pela civilização.This paper intends to analyze the practice of vocational guidance in a larger work perspective. The authors show how vocational guidance can, in a clinical approach, be understood as a modern representation of old rites of passage, and it also helps the maturation of the individual, who aims to leave the "world of childhood" for the "adult world". Vocational guidance can function as a modern rite promoting health and allowing the teenager to have experiences that have been discarded by Western civilization.

  5. Infant feeding practice and associated factors of HIV positive mothers attending prevention of mother to child transmission and antiretroviral therapy clinics in Gondar Town health institutions, Northwest Ethiopia

    Directory of Open Access Journals (Sweden)

    Muluye Dagnachew

    2012-03-01

    Full Text Available Abstract Background It has been estimated that 430,000 children under 15 years of age were newly infected with HIV in 2008, and more than 71% are living in sub-Saharan Africa. In the absence of intervention to prevent mother-to-child transmission, 30-45% of infants born to HIV-positive mothers in developing countries become infected during pregnancy, delivery and breastfeeding. The aim of this study was to assess infant feeding practice and associated factors of HIV positive mothers attending prevention of mother to child transmission and antiretroviral therapy clinics of Northwest Ethiopia. Methods Institution based cross sectional study was conducted from January to May 2011 among all HIV positive mothers with less than two years old child attending prevention of mother to child transmission and antiretroviral therapy clinics in Gondar Town health institutions. A structured pre-tested questionnaire using interview technique was used for data collection. The data was entered and analyzed using SPSS version 16 statistical package. Results A total of 209 HIV positive mothers were included in the study. Of these, 187 (89.5% had followed the recommended way of infant feeding practice while significant percentage (10.5% had practiced mixed breast feeding. In multivariate analysis, disclosure of HIV status with their spouse, insufficient breast milk and occupational status were found to be independently associated (p-value of Conclusions Higher proportion of respondents used the recommended way of infant feeding practice by WHO as well as by Ethiopian Ministry of Health. However, mixed feeding in the first 6 months of age, an undesirable practice in infant feeding, were reported in this study. Infant feeding education that is aligned to national policy should be strengthened in primary health care, particularly in situations where prevention of mother to child transmission of HIV is prioritized.

  6. A comparative study to evaluate the discrepancy in condylar guidance values between two commercially available arcon and non-arcon articulators: A clinical study

    Directory of Open Access Journals (Sweden)

    Mukesh Kumar Goyal

    2011-01-01

    Full Text Available Aim: The purpose of this study was comparative evaluation of sagittal condylar values of arcon and non-arcon articulators with cephalometric readings and to determine the amount of discrepancy in sagittal condylar guidance values between arcon and non-arcon articulators using same protrusive record. Materials and Methods: Twenty subjects in the age group of 19-35 years, free from temporomandibular joint dysfunction, and occlusal disharmony, with healthy dentition participated in the study. Hanau H2 (non-arcon type and Hanau Wide-Vue (arcon type articulators were programmed for sagittal condylar guidance values using the same protrusive record made in polysiloxane bite registration material with edge to edge degree of protrusion. The resultant values for both the articulators on either side were compared with values obtained from tracing of digital lateral cephalogram using Kodak Dental imaging Window software 6.6.3.0-C program. The tabulated data were subjected to statistical analysis, ANOVA (Fishers ′F′ test for group comparison, Tukey′s HSD test for inter-comparison, student′s unpaired ′t′ test for intra-group comparison, and level of significance (P was calculated using the same. Results: The mean sagittal condylar guidance values of the three different groups were found to be very highly significant (P=0.001 and highly significant (P=0.002 on the right and left sides respectively. There was a very highly significant difference (P=0.001 and highly significant difference (P=0.003 between the arcon and non-arcon group on the right and left side respectively. No significant difference was found between the arcon and cephalometric group (P=0.284 right, P=0.853 left and a statistically significant difference was found between the non-arcon and cephalometric group (P=0.049 right, P=0.015 left. On intragroup comparison there was no statistically significant difference in sagittal condylar values on the right and left sides. Conclusion

  7. Incorporating a Healthy Living Curriculum within Family Behavior Therapy: A Clinical Case Example in a Woman with a History of Domestic Violence, Child Neglect, Drug Abuse, and Obesity

    Directory of Open Access Journals (Sweden)

    Holly B. LaPota

    2014-01-01

    Full Text Available Women reported to child protective service agencies frequently report problems that significantly interfere with the health and well-being of their children and themselves. Behavioral treatment programs appear to be effective in managing these co-existing problems, such as domestic violence and substance abuse. However, evidence-supported interventions are rarely exemplified in complicated clinical cases, especially within child welfare settings. Therefore, in this case example, we describe the process of adapting an evidence-supported treatment to assist in managing significant co-existing health-related problems in a mother who was referred due to child neglect and drug abuse. At the conclusion of therapy, the participant reported improvements in perceived family relationships, illicit drug use, child maltreatment potential, whereas other health-related outcomes were mixed. Most improvements were maintained at 4-month follow-up. Issues relevant to implementing evidence-based treatments within community contexts are discussed, including methods of increasing the likelihood of valid outcome assessment, managing treatment integrity, and adjusting standardized treatments to accommodate co-occurring problems. This research was supported by a grant from the National Institute on Drug Abuse (1R01DA020548-01A1 awarded to Brad Donohue. The authors wish to thank Sally K. Miller, PhD, APN, FAANP and Associate Professor, UNLV School of Nursing for her work in completing the initial in-home health evaluation/physical for the current project.

  8. Transthoracic echocardiography as an alternative major guidance to angiography during transcatheter closure of patent ductus arteriosus: technical feasibility and clinical relevance.

    Science.gov (United States)

    Chen, Wanhua; Yan, Xiaoping; Huang, Yu; Sun, Xudong; Zhong, Ling; Li, Jinguo; Chen, Hua; Zhong, Huiying; Chen, Lianglong

    2015-01-01

    The conventional transcatheter closure of patent ductus arteriosus (PDA) requires femoral artery puncture and angiography for duct anatomic and shunting estimation. If such estimation can be replaced by transthoracic echocardiography (TTE), the procedure will be further simplified, with fewer invasions. This study aimed to examine whether TTE can serve as an alternative to aorta angiography and as a major guidance for transcatheter duct closure. The study enrolled 298 consecutive patients (71 males and 227 females) with PDA. In the study, TTE with combined two-dimensional echocardiography (2DE) imaging and color-coded flow imaging (CDFI) was performed to measure the minimal shunting width (MSW) as the estimated minimal duct size for selection of an Amplatzer duct occluder (ADO) and to monitor the transcatheter duct closure intraprocedurally. The MSW was validated against the duct-stretched diameter (SDD), against the minimal waist diameter of the conical part of a released occluder measured by X-ray spot picture after successful duct closure (SDC), and against the size of the finally used ADO (SADO). Good correlation was found between MSW and SDD [SDD (mm) = 1.31 MSW; r = 0.89; p MSW and SADO [SADO (mm) = 1.71 MSW; r = 0.88; p MSW as the reference for selection of the occluder, SDC was attained in 288 (97.3%), 5 (1.7%), and 2 (0.7%) patients, respectively, at the first, second (1 ADO replacement), and third (2 ADO replacements) occluding attempt. Acute occluder dislodgement occurred in one patient (0.3%). At the 12-month follow-up assessment, no major complications were found, and the total immediate or 12-month SDC was 99.7%. Echocardiography as an alternative major guidance to angiography for transcatheter duct closure is technically feasible, and TTE guidance can further simplify the procedure, with fewer invasions and potential complications. PMID:25070385

  9. 78 FR 48175 - Retrospective Review of Draft Guidance Documents Issued Before 2010; Withdrawal of Guidances

    Science.gov (United States)

    2013-08-07

    ... ``Administrative Practices and Procedures; Good Guidance Practices'' (GGP) (65 FR 56468; September 19, 2000). The..., and vuvlovaginal candidiasis; Clinical trials for developing antimicrobial drugs and packaging of... Infections--Developing Antimicrobial Drugs for Treatment''--issued July 1998. 12. ``Vulvovaginal...

  10. RESTORING SAFETY: AN ATTACHMENT-BASED APPROACH TO CLINICAL WORK WITH A TRAUMATIZED TODDLER.

    Science.gov (United States)

    Ribaudo, Julie

    2016-01-01

    This clinical case study explores the integration of infancy research, brain development, attachment theory, and models of infant-parent/child-parent psychotherapy to address the needs of abused and neglected young children placed in foster or adoptive homes. Traumatized children employ defensive strategies to survive when there is no "good enough" caregiver (D.W. Winnicott, 1953, p. 94), and helping professionals can provide therapeutic experiences to develop or restore a child's sense of safety. With the case example of Anthony and his foster/adoptive parents, I illustrate how to manage and contain a traumatized child's terror, rage, and grief through therapeutic sessions with the parent and child together, and supportive parental guidance. I promote attention to the child's ability to self-integrate and to regulate his own affect, and encourages secure-base parental responses that facilitate a child's shift toward secure attachment behavior. PMID:26714611

  11. Child Wellness and Happiness

    Science.gov (United States)

    Rettew, David C.

    2009-01-01

    Wellness and happiness should be considered in the clinical treatment of child and adolescent psychiatry, in addition with thinking about illness. Meanwhile, various studies on child and adolescent psychiatry,which includes an article from the "Journal of Happiness Studies," are discussed.

  12. [The value of a child abuse observation clinic. Report of an experience in the area of Grenoble].

    Science.gov (United States)

    Bost, M; Nalpas, D; Menon, M

    1990-01-01

    In France the epidemiology of child abuse is badly known, because of the lack of connexion between different institutions. We present a child abuse observatory set up in Grenoble in May 1987. The social, educational, judicial and medical department's services are working together. In the first 20 months, 87 cases were recorded: 57 physical abuse, 26 sexual abuse and 5 cases of abuses due to negligence. Precise information was collected concerning the victims, their siblings, the family's risk factor and the offenders, the method by which the information was obtained and the prosecution undertaken. A 10 July 1989 law enforced each Department's governor to set up a service for collecting information about child abuse. Our observatory will serve as a model for this law application. PMID:2175421

  13. [Between the exaggerated and the exasperated clinic. Bridges, differences and rupture in child and youth mental care].

    Science.gov (United States)

    Armus, Marcela; Costa, Juan J

    2014-01-01

    This article intends to approach a series of contrasting concepts regarding different relevant issues for the Child and Youth Mental Health. Diagnosis as a temporary and unstable assessment method. Early detection and treatment as opposed to the possibility of premature diagnoses. The possible or impossible dialogues between psychoanalysis, neuroscience and cognitive sciences. The problems associated with autism and its different theoretical approach models. The development of each of these complex aspects of the practice considers the risk of treating the child as a mere "pathological entity" and dehumanizing him and his condition from the different perspectives, disciplines and discourses, which intend to address the child and his condition. Finally this proposal aims at building bridges of dialogue, overcoming differences in order to avoid rupture.

  14. C-arm cone-beam CT combined with a new electromagnetic navigation system for guidance of percutaneous needle biopsies. Initial clinical experience

    Energy Technology Data Exchange (ETDEWEB)

    Kickuth, R.; Reichling, C.; Bley, T.; Hahn, D.; Ritter, C. [University Hospital of Wuerzburg (Germany). Inst. of Diagnostic and Interventional Radiology

    2015-07-15

    To evaluate the feasibility and efficacy of C-arm fluoroscopic cone-beam computed tomography (CACT) in combination with a new electromagnetic tracking (EMT) system for needle guidance during percutaneous biopsies. 53 patients were referred for biopsy of thoracic (n = 19) and abdominal (n = 34) lesions. CT-like images of the anatomical region of interest (ROI) were generated using a flat panel-based angiographic system. These images were transmitted to an EMT system. A coaxial puncture needle with a sensor in its tip was connected with the navigation system and tracked into an electromagnetic field created via a field generator. Data generated within this field were merged with the CACT images. On a monitor both the anatomical ROI and needle tip position were displayed to enable precise needle insertion into the target. Through the coaxial needle, biopsy specimens for the histologic evaluation were extracted. Number of representative biopsy samples, number of core biopsies/patient, total procedure time, dose-area product, fluoroscopic time, and complications were recorded. 53 CACT/EMT-guided biopsy procedures were performed, 48 of which (91 %) yielded representative tissue samples. Four core biopsies were obtained from each patient. 40 (75 %) lesions were malignant and 13 (25 %) lesions were benign. The total procedure time was 9 ± 5 min (range, 3 - 23 min), fluoroscopic time was 0.8 ± 0.4 min (range, 0.4 - 2 min). The mean dose-area product (cGy cm{sup 2}) was 7373 (range, 895 - 26 904). The rate of complications (1 pneumothorax, 2 hemoptyses) was 6 %. CACT combined with EMT appears to be a feasible and effective technique for the guidance of percutaneous biopsies with a low rate of therapeutically relevant complications.

  15. Family Interactions and Child Psychopathology.

    Science.gov (United States)

    Donenberg, Geri R.; Nelson, Dana

    Previous research has not correlated parent-child interaction patterns with different forms of child psychopathology. This study examined whether parent-child interaction corresponded with childhood depression/anxiety and childhood aggression. Forty-two clinically-referred children and adolescents, 8 to 16 years old, were classified into four…

  16. Corporate information management guidance

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1997-08-01

    At the request of the Department of Energy`s (DOE) Information Management (IM) Council, IM representatives from nearly all Headquarters (HQ) organizations have been meeting over the past year as the Corporate Guidance Group (CGG) to develop useful and sound corporate information management (IM) guidance. The ability of the Department`s IM community to develop such unified guidance continues to be critical to the success of future Departmental IM planning processes and the establishment of a well-coordinated IM environment between Headquarters and field organizations. This report, with 26 specific corporate IM guidance items documented and unanimously agreed to, as well as 12 items recommended for further development and 3 items deferred for future consideration, represents a highly successful effort by the IM community. The effort has proven that the diverse DOE organizations can put aside individual preferences and work together towards a common and mutually beneficial goal. In examining most areas and issues associated with information management in the Department, they have developed specific, far-reaching, and useful guidance. The IM representatives recommend that the documented guidance items provided in this report and approved by the DOE IM Council be followed by all IM organizations. The representatives also strongly recommend that the guidance process developed by the CGG be the single process for developing corporate IM guidance.

  17. Predicting Outcomes Following Cognitive Behaviour Therapy in Child Anxiety Disorders: The Influence of Genetic, Demographic and Clinical Information

    Science.gov (United States)

    Hudson, Jennifer L.; Lester, Kathryn J.; Lewis, Cathryn M.; Tropeano, Maria; Creswell, Cathy; Collier, David A.; Cooper, Peter; Lyneham, Heidi J.; Morris, Talia; Rapee, Ronald M.; Roberts, Susanna; Donald, Jennifer A.; Eley, Thalia C.

    2013-01-01

    Background: Within a therapeutic gene by environment (G × E) framework, we recently demonstrated that variation in the Serotonin Transporter Promoter Polymorphism; "5HTTLPR" and marker rs6330 in Nerve Growth Factor gene; "NGF" is associated with poorer outcomes following cognitive behaviour therapy (CBT) for child anxiety…

  18. Parenting Stress and Child Behavior Problems among Clinic-Referred Youth: Cross-Cultural Differences across the US and Korea

    Science.gov (United States)

    Chung, Kyong-Mee; Ebesutani, Chad; Bang, Hye Min; Kim, Joohee; Chorpita, Bruce F.; Weisz, John R.; Suh, Dongsoo; Byun, Heejung

    2013-01-01

    Due to increased multiculturalism in the US and abroad, there is a need for increased understanding of the different ways in which parenting stress is related to child problems across cultures. In the present study, we investigated (a) differences in reported parenting stress and childhood problem behaviors across a Korean (n = 71) and US (n = 71)…

  19. A Psychometric Analysis of the Revised Child Anxiety and Depression Scale-Parent Version in a Clinical Sample

    Science.gov (United States)

    Ebesutani, Chad; Bernstein, Adam; Nakamura, Brad J.; Chorpita, Bruce F.; Weisz, John R.

    2010-01-01

    The Revised Child Anxiety and Depression Scale-Parent Version (RCADS-P) is a 47-item parent-report questionnaire of youth anxiety and depression, with scales corresponding to the DSM-IV categories of Separation Anxiety Disorder, Social Phobia, Generalized Anxiety Disorder (GAD), Panic Disorder, Obsessive-Compulsive Disorder, and Major Depressive…

  20. 个体化饮食指导在妊娠期糖尿病治疗中的临床价值分析%Clinical value evaluation of individualized diet guidance in the treatment of gestational diabetes mellitus

    Institute of Scientific and Technical Information of China (English)

    蒋秀; 李彩霞

    2011-01-01

    目的 探讨个体化饮食指导在妊娠期糖尿病治疗中的临床应用.方法 将焦作市妇幼保健院2008年1月至2010年1月诊断为妊娠期糖尿病的158例产妇随机分为干预组(100例)和对照组(58例),干预组对其进行个体化饮食指导(应用实物交换份的方法),对照组给予口头指导饮食,比较两组产妇的妊娠结局,包括母婴并发症如妊娠高血压综合征、羊水过多、胎膜早破、早产、胎儿窘迫、剖宫产率、新生儿低血糖、死胎、巨大儿等.结果 158例妊娠期糖尿病孕妇中干预组的母婴并发症明显低于对照组.结论 对妊娠期糖尿病产妇进行个体化饮食指导,适时终止妊娠,能明显降低母婴并发症的发生.%Objective To investigate the clinical application of individualized diet guidance in the treatment of gestational diabetes mellitus (GDM).Methods One hundred and fifty - eight puerperants,who were diagnosed as GDM from Jan,2008 to Jan,2010 in our hospital,were randomized to treatment group (n =100) and control group( n =58 ).The puerperants in the treatment group were given individualized diet guidance.And the ones in the control group were given oral diet guidance.The gestational outcomes,including the complications such as hypertensive disorders in pregnancy,polyhydramnios,premature rupture of membrane,premature delivery,fetal distress,cesarean rate,hypoglycemia of newborn,fetal death,fetal macrosomia,of the two groups were compared.Results The incidence of complications in the treatment groups is lower than that in the control group.Conclusions The individualized diet guidance to the GDM puerperants and terminating the gestation at the right moment can reduce the occurrence of complications obviously.

  1. Perceptual Integration on the Rorschach as an Indicator of Cognitive Capacity: A Developmental Study of Racial Differences in a Clinic Population

    Science.gov (United States)

    Gerstein, Alvin I.; And Others

    1976-01-01

    Rorschach protocols of both black and white children from 7 to 14 years of age, who had been evaluated at a child guidance clinic, were rescored with respect to developmental level of perceptual integration. It was found that black children had higher perceptual-integration scores in comparison to their white counterparts. (Author)

  2. A child's nightmare. Mum comes and comforts her child. Attachment evaluation as a guide in the assessment and treatment in a clinical case study

    Directory of Open Access Journals (Sweden)

    Silvia eSalcuni

    2014-08-01

    Full Text Available There is a gap between proposed theoretical attachment theory frameworks, measures of attachment in the assessment phase and their relationship with changes in outcome after a psychodynamic oriented psychotherapy. Based on a clinical case study of a young woman with Panic Attack Disorder, this paper examined psychotherapy outcome findings comparing initial and post-treatment assessments, according to the mental functioning in S and M-axis of the Psychodynamic Diagnostic Manual (PDM. Treatment planning and post-treatment changes were described with the main aim to illustrate from a clinical point of view why a psycho-dynamic approach, with specific attention to an attachment theory stance, was considered the treatment of choice for this patient. The Symptom Check List 90 Revised (SCL-90-R and the Shedler-Westen Assessment Procedure (SWAP–200 were administered to detect patient’s symptomatic perception and clinician’s diagnostic points of view, respectively; the Adult Attachment Interview (AAI and the Adult Attachment Projective Picture System (AAP were also administered as to pay attention to patient’s unconscious internal organization and changes in defense processes. A qualitative description of how the treatment unfolded was included. Findings highlight the important contribution of attachment theory in a 22-month psychodynamic psychotherapy framework, promoting resolution of patient’s symptoms and adjustment.

  3. "A child's nightmare. Mum comes and comforts her child." Attachment evaluation as a guide in the assessment and treatment in a clinical case study.

    Science.gov (United States)

    Salcuni, Silvia; Di Riso, Daniela; Lis, Adriana

    2014-01-01

    There is a gap between proposed theoretical attachment theory frameworks, measures of attachment in the assessment phase and their relationship with changes in outcome after a psychodynamic oriented psychotherapy. Based on a clinical case study of a young woman with Panic Attack Disorder, this paper examined psychotherapy outcome findings comparing initial and post-treatment assessments, according to the mental functioning in S and M-axis of the psychodynamic diagnostic manual. Treatment planning and post-treatment changes were described with the main aim to illustrate from a clinical point of view why a psycho-dynamic approach, with specific attention to an "attachment theory stance," was considered the treatment of choice for this patient. The Symptom Check List 90 Revised (SCL-90-R) and the Shedler-Westen Assessment Procedure (SWAP-200) were administered to detect patient's symptomatic perception and clinician's diagnostic points of view, respectively; the Adult Attachment Interview and the Adult Attachment Projective Picture System (AAP) were also administered as to pay attention to patient's unconscious internal organization and changes in defense processes. A qualitative description of how the treatment unfolded was included. Findings highlight the important contribution of attachment theory in a 22-month psychodynamic psychotherapy framework, promoting resolution of patient's symptoms and adjustment. PMID:25191293

  4. 绘画治疗在儿童情绪障碍中的疗效分析%Clinical observation of painting in treatment of child emotional disorder

    Institute of Scientific and Technical Information of China (English)

    黄雪竹; 杜姝昱; 任冬梅; 杨勤; 李光明

    2013-01-01

    Objective:To observe the clinical ef ects of painting in treatment of child emotional disorder.Methods:40 children with emotional disorders received the painting therapy for 4 months.The screen for child anxiety related emotional disorders(SCARED)were used to assess the ef ects before and after the treatment.Results:After 4 months treat-ment,thescore of SCARED decre asedsignificantly(P<0.05).Conclusion:Painting therapy is efective to improve and stabilize the emotion of child emotional disorder and worthy of clinical use.%目的:分析探讨绘画治疗在儿童情绪障碍中的效果。方法:将40例符合儿童情绪障碍诊断标准的儿童作为研究对象,进行为期4个月的绘画治疗。于治疗前及治疗后使用儿童焦虑性情绪障碍筛查量表(SCARED)对患儿进行评估。结果:治疗4个月后,SCARED评分明显低于治疗前,治疗前后比较差异有统计学意义(P<0.05)。结论:绘画治疗儿童情绪障碍临床有效,绘画治疗能够有效改善和稳定情绪障碍儿童的情绪,值得临床应用。

  5. Only complementary voices tell the truth: a reevaluation of validity in multi-informant approaches of child and adolescent clinical assessments.

    Science.gov (United States)

    Kaurin, Aleksandra; Egloff, Boris; Stringaris, Argyris; Wessa, Michèle

    2016-08-01

    Multi-informant approaches are thought to be key to clinical assessment. Classical theories of psychological measurements assume that only convergence among different informants' reports allows for an estimate of the true nature and causes of clinical presentations. However, the integration of multiple accounts is fraught with problems because findings in child and adolescent psychiatry do not conform to the fundamental expectation of convergence. Indeed, reports provided by different sources (self, parents, teachers, peers) share little variance. Moreover, in some cases informant divergence may be meaningful and not error variance. In this review, we give an overview of conceptual and theoretical foundations of valid multi-informant assessment and discuss why our common concepts of validity need revaluation. PMID:27118025

  6. Van Mother-Child Health and Family Planning Center Pap Smear Clinics of Information, Evaluation of Applicants

    OpenAIRE

    Sebahat Gucuk; Servet Alkan; Secil Arica; Aysegul Ates

    2011-01-01

    Objective: In this study of women admitted to our center with information on pap smear test, to evaluate the attitudes and behavior. Materials and Methods: This descriptive study of Van Mother-Child Health and Family Planning Center on a voluntary basis, women aged 15-49 were admitted to the control. The education level of participants, age at first marriage, before the presence of vaginal infection, the story, and motivations pap smear level of information availability, and a family history ...

  7. On mixed reality environments for minimally invasive therapy guidance: systems architecture, successes and challenges in their implementation from laboratory to clinic.

    Science.gov (United States)

    Linte, Cristian A; Davenport, Katherine P; Cleary, Kevin; Peters, Craig; Vosburgh, Kirby G; Navab, Nassir; Edwards, Philip Eddie; Jannin, Pierre; Peters, Terry M; Holmes, David R; Robb, Richard A

    2013-03-01

    Mixed reality environments for medical applications have been explored and developed over the past three decades in an effort to enhance the clinician's view of anatomy and facilitate the performance of minimally invasive procedures. These environments must faithfully represent the real surgical field and require seamless integration of pre- and intra-operative imaging, surgical instrument tracking, and display technology into a common framework centered around and registered to the patient. However, in spite of their reported benefits, few mixed reality environments have been successfully translated into clinical use. Several challenges that contribute to the difficulty in integrating such environments into clinical practice are presented here and discussed in terms of both technical and clinical limitations. This article should raise awareness among both developers and end-users toward facilitating a greater application of such environments in the surgical practice of the future.

  8. Laser Guidance Analysis Facility

    Data.gov (United States)

    Federal Laboratory Consortium — This facility, which provides for real time, closed loop evaluation of semi-active laser guidance hardware, has and continues to be instrumental in the development...

  9. Child Abuse

    Science.gov (United States)

    ... or puts a child at risk of harm. Child abuse can be physical, sexual or emotional. Neglect, or not providing for a child's needs, is also a form of abuse. Most abused children suffer greater emotional than physical damage. An abused child may become ...

  10. Research in guidance demand of different levels of nursing students in initial stage of clinical practice%不同层次护生临床实习初期指导需求的研究

    Institute of Scientific and Technical Information of China (English)

    赵骄蓉; 关红; 王秋节; 王丽娜

    2014-01-01

    Objective To analyze the guidance demands of different levels of nursing students in initial stage of clinical practice,and implement student-development-centered and targeted teaching philosophy.Methods Scales and a home-made questionnaire were used to investigate 178 nursing students at different levels and the results underwent statistical analysis.Results In the early internships,guidance needs of psychology and basic knowledge were of consistency in undergraduate and college nursing students.There were some differences in guidance needs between secondary school students and undergraduate and college nursing students.The total average score of stress and all the subscale scores were at low and middle levels.The total average score of communication skills and all the subscale scores were above 2.5 points.The was statistically significant difference in joint participation dimension and verifying dimension.Conclusions Different levels of nursing students at the beginning of practice had different needs of guidance.Teachers should guide nursing students to face and deal with problems,relieve stress,improve communication skills,and handle interpersonal relationships well.Targeted guidance,management and meeting the specific needs of students can improve the effectiveness of teaching.%目的 分析研究不同层次护理实习生在临床实习初期的指导需求,有的放矢地实施以学生发展为中心的教学理念.方法 运用量表及自制问卷对178名不同层次护生针对临床实习初期的指导需求进行调查与统计分析.结果在实习初期,本科、大专护生有关心理、知识的指导需求基本具有一致性,中专护生与本科、大专的指导需求存在一定的差异性.不同层次护生压力水平总均分及各维度得分都在低中等水平,差异有统计学意义.不同层次护生沟通能力总均分及各维度得分都在25分以上;共同参与维度、验证感受维度不同层次的护生的评分比

  11. Cultural Patterns of Metacognitive Guidance in Australian Homes

    Science.gov (United States)

    Sanagavarapu, Prathyusha

    2008-01-01

    This article provides insight into the cultural patterns of metacognitive guidance that occurs among children and mothers in selected Australian homes. Fourteen Anglo Australian and eight immigrant Indian (Telugu) mothers' interactions with their 4-year-old male and female children on a puzzle-solving task were videotaped. Mother-child dyads'…

  12. My view on occupation guidance

    Institute of Scientific and Technical Information of China (English)

    2012-01-01

    Occupation instruction needs to the support of theories,in the case of the occupation guidance theory is not very developed in our country,It has very important sense that absorbing and drawing lessons from the advanced occupation guidance theory,and targeting guidance to occupation guidance work,.

  13. Child passenger safety.

    Science.gov (United States)

    Durbin, Dennis R

    2011-04-01

    Despite significant reductions in the number of children killed in motor vehicle crashes over the past decade, crashes continue to be the leading cause of death for children 4 years and older. Therefore, the American Academy of Pediatrics continues to recommend inclusion of child passenger safety anticipatory guidance at every health-supervision visit. This technical report provides a summary of the evidence in support of 5 recommendations for best practices to optimize safety in passenger vehicles for children from birth through adolescence that all pediatricians should know and promote in their routine practice. These recommendations are presented in the revised policy statement on child passenger safety in the form of an algorithm that is intended to facilitate their implementation by pediatricians with their patients and families. The algorithm is designed to cover the majority of situations that pediatricians will encounter in practice. In addition, a summary of evidence on a number of additional issues that affect the safety of children in motor vehicles, including the proper use and installation of child restraints, exposure to air bags, travel in pickup trucks, children left in or around vehicles, and the importance of restraint laws, is provided. Finally, this technical report provides pediatricians with a number of resources for additional information to use when providing anticipatory guidance to families. PMID:21422094

  14. The clinical effectiveness of a brief consultation and advisory approach compared to treatment as usual in child and adolescent mental health services.

    LENUS (Irish Health Repository)

    McGarry, Joan

    2008-07-01

    A brief consultation and advice (BCA) approach to dealing with routine referrals was introduced into a child and adolescent mental health service (CAMHS) over an 18-month period. This is a time-limited, client-centred and solution-focused approach to dealing with common non-complex referrals. The model proposes that all families are seen for an initial \\'consultation\\' appointment followed by a maximum of two further appointments. A randomized controlled study compared the clinical effectiveness of BCA treatment with treatment as usual (TAU) over a 6-month period. The parents of children referred to CAMHS were eligible to participate if their child was deemed \\'non-complex\\'. Ethical approval was granted by the relevant ethics committee. Families who consented to participate in the study were randomly allocated to either the BCA or TAU group. Sixty children enrolled in the study. Both groups showed improvements on a number of variables at 3 months post treatment, but only those receiving BCA showed continued improvement at 6 months. Participants in both groups showed high levels of satisfaction with the treatment received. Participants in the TAU group expressed dissatisfaction with long waiting times and had a higher drop out rate than the BCA treatment group. During the time frame studied, the introduction of the BCA approach did not lead to a decrease in overall mean waiting time. These results and the usefulness of a BCA model are discussed.

  15. A Multitrait-Multimethod Analysis of the Construct Validity of Child Anxiety Disorders in a Clinical Sample

    Science.gov (United States)

    Langer, David A.; Wood, Jeffrey J.; Bergman, R. Lindsey; Piacentini, John C.

    2010-01-01

    The present study examines the construct validity of separation anxiety disorder (SAD), social phobia (SoP), panic disorder (PD), and generalized anxiety disorder (GAD) in a clinical sample of children. Participants were 174 children, 6 to 17 years old (94 boys) who had undergone a diagnostic evaluation at a university hospital based clinic.…

  16. Supporting the Grieving Child and Family.

    Science.gov (United States)

    Schonfeld, David J; Demaria, Thomas

    2016-09-01

    The death of someone close to a child often has a profound and lifelong effect on the child and results in a range of both short- and long-term reactions. Pediatricians, within a patient-centered medical home, are in an excellent position to provide anticipatory guidance to caregivers and to offer assistance and support to children and families who are grieving. This clinical report offers practical suggestions on how to talk with grieving children to help them better understand what has happened and its implications and to address any misinformation, misinterpretations, or misconceptions. An understanding of guilt, shame, and other common reactions, as well an appreciation of the role of secondary losses and the unique challenges facing children in communities characterized by chronic trauma and cumulative loss, will help the pediatrician to address factors that may impair grieving and children's adjustment and to identify complicated mourning and situations when professional counseling is indicated. Advice on how to support children's participation in funerals and other memorial services and to anticipate and address grief triggers and anniversary reactions is provided so that pediatricians are in a better position to advise caregivers and to offer consultation to schools, early education and child care facilities, and other child congregate care sites. Pediatricians often enter their profession out of a profound desire to minimize the suffering of children and may find it personally challenging when they find themselves in situations in which they are asked to bear witness to the distress of children who are acutely grieving. The importance of professional preparation and self-care is therefore emphasized, and resources are recommended. PMID:27573086

  17. 75 FR 6209 - Guidance for Industry and Food and Drug Administration; Guidance for the Use of Bayesian...

    Science.gov (United States)

    2010-02-08

    ... HUMAN SERVICES Food and Drug Administration (formerly Docket No. 2006D-0191) Guidance for Industry and Food and Drug Administration; Guidance for the Use of Bayesian Statistics in Medical Device Clinical Trials; Availability AGENCY: Food and Drug Administration, HHS. ACTION: Notice. SUMMARY: The Food...

  18. Creating a novel mock clinical examination for the Membership of the Royal College of Paediatrics and Child Health in Malta.

    Science.gov (United States)

    Grech, Victor; Buttigieg, Mark

    2012-09-01

    Clinical medical examinations are difficult. Courses that attempt to instil such clinical examination skills are expensive, and this is even more so for Maltese graduates who must perforce travel by air from the island of Malta to such venues. This year (2012) was a landmark year with a record seven Maltese candidates planning to take the MRCPCH examination, and it was therefore decided to set up a mock clinical exam under true examination conditions in Malta. This was done successfully and this paper describes the modus operandi and the requirements for such a process.

  19. COMPARISON OF COUPLES REFERRED AND NOT REFERRED FOR GENETIC-COUNSELING IN A GENETIC CLINIC AFTER THE BIRTH OF A CHILD WITH A CONGENITAL ANOMALY - A STUDY IN A POPULATION IN THE NORTHEASTERN NETHERLANDS

    NARCIS (Netherlands)

    CORNEL, MC; VANESSEN, AJ; TENKATE, LP

    1992-01-01

    After the birth of a child with a congenital anomaly, parents have many questions about cause, prognosis, and recurrence risk. An important means of transmitting such information is referral to a genetic clinic. We were interested in knowing what determines whether or not parents are referred for ge

  20. Regulatory guidance document

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1994-05-01

    The Office of Civilian Radioactive Waste Management (OCRWM) Program Management System Manual requires preparation of the OCRWM Regulatory Guidance Document (RGD) that addresses licensing, environmental compliance, and safety and health compliance. The document provides: regulatory compliance policy; guidance to OCRWM organizational elements to ensure a consistent approach when complying with regulatory requirements; strategies to achieve policy objectives; organizational responsibilities for regulatory compliance; guidance with regard to Program compliance oversight; and guidance on the contents of a project-level Regulatory Compliance Plan. The scope of the RGD includes site suitability evaluation, licensing, environmental compliance, and safety and health compliance, in accordance with the direction provided by Section 4.6.3 of the PMS Manual. Site suitability evaluation and regulatory compliance during site characterization are significant activities, particularly with regard to the YW MSA. OCRWM`s evaluation of whether the Yucca Mountain site is suitable for repository development must precede its submittal of a license application to the Nuclear Regulatory Commission (NRC). Accordingly, site suitability evaluation is discussed in Chapter 4, and the general statements of policy regarding site suitability evaluation are discussed in Section 2.1. Although much of the data and analyses may initially be similar, the licensing process is discussed separately in Chapter 5. Environmental compliance is discussed in Chapter 6. Safety and Health compliance is discussed in Chapter 7.

  1. PIV Logon Configuration Guidance

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Glen Alan [Los Alamos National Lab. (LANL), Los Alamos, NM (United States)

    2016-03-04

    This document details the configurations and enhancements implemented to support the usage of federal Personal Identity Verification (PIV) Card for logon on unclassified networks. The guidance is a reference implementation of the configurations and enhancements deployed at the Los Alamos National Laboratory (LANL) by Network and Infrastructure Engineering – Core Services (NIE-CS).

  2. The Counseling & Guidance Curriculum.

    Science.gov (United States)

    Ediger, Marlow

    Counseling and guidance services are vital in any school curriculum. Counselors may themselves be dealing with students of diverse abilities and handicaps. Counselors may have to work with students affected by drug addiction, fetal alcohol syndrome, homelessness, poverty, Acquired Immune Deficiency Syndrome (AIDS) and divorce. Students may present…

  3. Regulatory guidance document

    International Nuclear Information System (INIS)

    The Office of Civilian Radioactive Waste Management (OCRWM) Program Management System Manual requires preparation of the OCRWM Regulatory Guidance Document (RGD) that addresses licensing, environmental compliance, and safety and health compliance. The document provides: regulatory compliance policy; guidance to OCRWM organizational elements to ensure a consistent approach when complying with regulatory requirements; strategies to achieve policy objectives; organizational responsibilities for regulatory compliance; guidance with regard to Program compliance oversight; and guidance on the contents of a project-level Regulatory Compliance Plan. The scope of the RGD includes site suitability evaluation, licensing, environmental compliance, and safety and health compliance, in accordance with the direction provided by Section 4.6.3 of the PMS Manual. Site suitability evaluation and regulatory compliance during site characterization are significant activities, particularly with regard to the YW MSA. OCRWM's evaluation of whether the Yucca Mountain site is suitable for repository development must precede its submittal of a license application to the Nuclear Regulatory Commission (NRC). Accordingly, site suitability evaluation is discussed in Chapter 4, and the general statements of policy regarding site suitability evaluation are discussed in Section 2.1. Although much of the data and analyses may initially be similar, the licensing process is discussed separately in Chapter 5. Environmental compliance is discussed in Chapter 6. Safety and Health compliance is discussed in Chapter 7

  4. Career guidance on the move

    DEFF Research Database (Denmark)

    Thomsen, Rie

    2013-01-01

    This article is about how the notion of place can be used in an analysis of career guidance practices and their development. It is about how a focus on the context of career guidance can develop an awareness of the place where guidance is practiced and support the development of career guidance...... in new places. In this article I introduce an analytical perspective on place; I give the example of the guidance café a practice development that took place into serious consideration because it was an attempt to develop career guidance practice through relocating it....

  5. Psychometric properties of the child and parent versions of Spence children's anxiety scale in a Danish community and clinical sample.

    Science.gov (United States)

    Arendt, Kristian; Hougaard, Esben; Thastum, Mikael

    2014-12-01

    This study examined the psychometric properties and norms of the Spence Children's Anxiety Scale (SCAS) and the associated parent version (SCAS-P) in a Danish community and a clinical sample. The total sample consisted of 1240 children (972 from community sample), age 7-17 years, and 805 parents (537 from community sample). Results indicated that SCAS and SCAS-P had good internal consistency on the total scale and all subscales, with exception of the subscale for fear of physical injury. Both scales showed satisfactory 2-week and 3-month retest stability. All subscales and total scales of the SCAS and SCAS-P discriminated between the clinical and community sample. A comparison with the Beck Youth Inventories and the Strength and Difficulty Questionnaire in the clinical sample supported the scales' convergent and divergent validity. Results of confirmatory factor analyses for SCAS and SCAS-P were in favor of the original model with six correlated factors.

  6. Pathways to child and adolescent psychiatric clinics: a multilevel study of the significance of ethnicity and neighbourhood social characteristics on source of referral

    Directory of Open Access Journals (Sweden)

    Rydelius Per-Anders

    2011-03-01

    Full Text Available Abstract Background In the Swedish society, as in many other societies, many children and adolescents with mental health problems do not receive the help they need. As the Swedish society becomes increasingly multicultural, and as ethnic and economic residential segregation become more pronounced, this study utilises ethnicity and neighbourhood context to examine referral pathways to child and adolescent psychiatric (CAP clinics. Methods The analysis examines four different sources of referrals: family referrals, social/legal agency referrals, school referrals and health/mental health referrals. The referrals of 2054 children aged 11-19 from the Stockholm Child-Psychiatric Database were studied using multilevel logistic regression analyses. Results Results indicate that ethnicity played an important role in how children and adolescents were referred to CAP-clinics. Family referrals were more common among children and adolescents with a Swedish background than among those with an immigrant background. Referrals by social/legal agencies were more common among children and adolescents with African and Asian backgrounds. Children with Asian or South American backgrounds were more likely to have been referred by schools or by the health/mental health care sector. A significant neighbourhood effect was found in relation to family referrals. Children and adolescents from neighbourhoods with low levels of socioeconomic deprivation were more likely to be referred to CAP-clinics by their families in comparison to children from other neighbourhoods. Such differences were not found in relation in relation to the other sources of referral. Conclusions This article reports findings that can be an important first step toward increasing knowledge on reasons behind differential referral rates and uptake of psychiatric care in an ethnically diverse Swedish sample. These findings have implications for the design and evaluation of community mental health outreach

  7. APPLICATION OF SINGLE PHOTON EMMISSION COMPUTED TOMOGRAPHY TO CLINICAL STUDY ON THE THERAPEUTIC EFFECT OF ACUPUNCTURE IN TREATMENT OF CHILD CEREBRAL PARALYSIS

    Institute of Scientific and Technical Information of China (English)

    于海波; 鞠琰莉; 贾少微

    2001-01-01

    Subjective: To identify the practicability and clinical values of acupuncture in the treatment of child cerebral paralysis, try to provide visualized evidence and mechanisms for acupuncture treatment of this disease. Methods: 13 cerebral palsy children including 9 cases of spasmodic type, 2 cases of ataxia type and 2 cases of mixed type, 9 males and 4 females were subjected into this study. Acupoints used were Hegu (LI 4), Quchi (LI 11 ), Zusanli (ST 36) and Sanyinjiao (SP 6) that were punctured and stimulated electrically with parameters of frequency 2/15 Hz, electric current 5 mA, and duration of stimulation 30 min. Under monitoring of Siemens ECAM/ICON SPECT System, blood flow volumes of different brain regions were observed before, during and after elctroacupuncture (EA) stimulation of the above-mentioned acupoints. Results: SPECT revealed that in these 13 infantile patients, 18 regions of the brain in-cluding 12 in the frontal lobe and 6 in the temporal lobe presented insufficiency of blood perfusion and hypofunction; during EA, these cerebral regions and parietal lobe, visual cortex, thalamus, basal ganglion and cerebellum showed improvement in blood perfusion and function in different degrees. Results of the quantitative analysis on blood flow function changing rate (BFCR)% showed a significant increase in 83.3 % of the focal regions during EA. Conclusion: Acupuncture therapy can effectively improve cerebral blood perfusion of the focus and is of clinical value in treatment of infantile cerebral paralysis.

  8. Knowledge and perception of Prevention of Mother to Child services amongst pregnant women accessing antenatal clinic in a Primary Health Care centre in Nigeria

    Directory of Open Access Journals (Sweden)

    Eme T. Owoaje

    2012-10-01

    Full Text Available Background: Few studies have assessed pregnant women’s perceptions regarding prevention of mother to child of HIV and the available services at the primary health care level in Nigeria.Objective: Assessment of knowledge and perception of antenatal clinic (ANC attendees regarding Prevention of Mother to Child Transmission (PMTCT of HIV at primary health care facilities in south-west Nigeria.Method: A cross-sectional survey was conducted amongst 400 antenatal attendees in a Primary Health Care centre in Ibadan, Nigeria.Results: Known methods of PMTCT were: use of anti-retroviral treatment (ART during pregnancy (75.0%, ART at birth (65.8% and not breastfeeding (61.8%. Previous HIV Counselling and Testing (HCT was reported by 71%, significantly higher proportions of thosewho were married, in the third trimester of pregnancy or engaged in professional and/or skilled occupations had been tested. Regarding the HCT services provided, 92.2% understood the HIV-related health education provided, 89.7.2% reported that the timing was appropriate, 92.6% assessed the nurses’ approach as acceptable but 34.0% felt the test was forced upon them. Majority (79.6% were aware of non-breastfeeding options of infant feeding, but only 3.5% were aware of exclusive breastfeeding for a stipulated period as an infant feeding option. Nevertheless, the majority of the women found the non-breast feeding option culturally unacceptable.Conclusion: Women in this survey were knowledgeable about the methods of PMTCT, but had negative perceptions regarding certain aspects of the HCT services and the recommended non-breastfeeding infant feeding option. Health workers should provide client friendly services and infant feeding counselling that is based on current WHO recommendations and culturally acceptable.

  9. 提高药房药学服务水平搞好临床用药指导工作%Improving the quality of clinical pharmacy service and enhancing the guidance of clinical medication

    Institute of Scientific and Technical Information of China (English)

    刘冠军; 谭永梅

    2014-01-01

    随着我国医疗体制改革的深入和发展,医院药学服务模式的改变,药剂人员面临着新形势下的机遇和挑战。结合药房工作的具体实践及体会,探讨如何提高药房窗口药学服务水平、搞好药学服务指导工作,更好地为病人服务。开展药学服务,保证药品质量,全力维护公众用药安全有效。%With the development of medical system reform in our country and the change in mode of hospital pharmacy services, pharmacy staff are facing opportunities and challenges under the new situation. combining the practice of pharmacy and the experience, we explored how to improve the quality of pharmaceutical care in pharmacy and enhance the guidance of pharmacy service in order to provide better services for patients. Besides we should develop pharmaceutical services and ensure the quality of drugs to maintain public safety and effectiveness of drugs.

  10. Van Mother-Child Health and Family Planning Center Pap Smear Clinics of Information, Evaluation of Applicants

    Directory of Open Access Journals (Sweden)

    Sebahat Gucuk

    2011-10-01

    Full Text Available Objective: In this study of women admitted to our center with information on pap smear test, to evaluate the attitudes and behavior. Materials and Methods: This descriptive study of Van Mother-Child Health and Family Planning Center on a voluntary basis, women aged 15-49 were admitted to the control. The education level of participants, age at first marriage, before the presence of vaginal infection, the story, and motivations pap smear level of information availability, and a family history of cancer, administered a questionnaire asking the state to have a regular income. Results: The study included 362 women with age and hear the pap smear test was significantly increased (p = 0.01. Working women and pap smear level of knowledge (p = 0.04 and pap smears than women not working for International rates significantly higher (p = 0.02. Treatment of vaginal infection at least once before to get there was a significant relationship between the pap smear motivations (p>0.05. Family history of gynecologic cancer or non-gynecologic cancer smears have significantly increased the level of motivations (p = 0.0001. Pap smear information, regular the economic income of those levels, significantly higher than those without regular income (p = 0.0001. Conclusion: We serve the region, with low socio-economic characteristics that are considered, gynecological examination by health workers or women from the home visits, pap smear test for what purpose and how often you get the work done and the importance of explaining and giving more space to this issue suggest that the written and visual media. Keywords: Pap smears, health care, education [TAF Prev Med Bull 2011; 10(5.000: 527-532

  11. Mother-Child Disagreement in Reports of Child Anxiety: Effects of Child Age and Maternal Anxiety

    OpenAIRE

    Niditch, Laura A.; Varela, R. Enrique

    2010-01-01

    The present study examined effects of maternal anxiety, child age, and their interaction on mother-child anxiety reporting disagreement while taking into account the direction of each informant's report relative to the other. Participants were 41 dyads of mothers and clinically anxious children aged 7-13. A hierarchical regression revealed a significant interaction between maternal anxiety and child age (β = .30, p < .05). A graph of this interaction indicated that when maternal anxiety is hi...

  12. Commentary: a practical guide for translating basic research on affective science to implementing physiology in clinical child and adolescent assessments.

    Science.gov (United States)

    Aldao, Amelia; De Los Reyes, Andres

    2015-01-01

    The National Institute of Mental Health recently launched the Research Domain Criteria (RDoC). RDoC is a framework that facilitates the dimensional assessment and classification of processes relevant to mental health (e.g., affect, regulation, cognition, social affiliation), as reflected in measurements across multiple units of analysis (e.g., physiology, circuitry, genes, self-reports). A key focus of RDoC involves opening new lines of research examining patients' responses on biological measures, with the key goal of developing new therapeutic techniques that effectively target mechanisms of mental disorders. Yet applied researchers and practitioners rarely use biological measures within mental health assessments, which may present challenges in translating RDoC-guided research into improvements in patient care. Thus, if RDoC is to result in research that yields clinical tools that reduce the burden of mental illness and improve public health, we ought to develop strategies for effectively implementing biological measures in the context of clinical assessments. In this special issue, we sought to provide an initial step in this direction by assembling a collection of articles from leading research teams carrying out pioneering work on implementing multimodal assessments (biological, subjective, behavioral) of affective processes in applied settings. In this commentary, we expand upon the work presented in this special issue by making a series of suggestions for how to most parsimoniously conduct multimodal assessments of affective processes in applied research and clinical settings. We hope that this approach will facilitate translations of the RDoC framework into applied research and clinic settings.

  13. New Interpretations of Guidance Role

    Science.gov (United States)

    Kerlan, Julius H.; Ryan, Charles W.

    1972-01-01

    A panoramic view of Guidance Division general sessions and workshops covering some exemplary career guidance programs, as well as such topics as career choice, leadership, evaluation, and program development and management. Presented at the Guidance division session of the American Vocational Association 1971 annual meeting. (Editor/MU)

  14. The incidental pulmonary nodule in a child. Part 2: Commentary and suggestions for clinical management, risk communication and prevention

    International Nuclear Information System (INIS)

    The incidental detection of small lung nodules in children is a vexing consequence of an increased reliance on CT. We present an algorithm for the management of lung nodules detected on CT in children, based on the presence or absence of symptoms, the presence or absence of elements in the clinical history that might explain these nodules, and the imaging characteristics of the nodules (such as attenuation measurements within the nodule). We provide suggestions on how to perform a thoughtfully directed and focused search for clinically occult extrathoracic disease processes (including malignant disease) that may present as an incidentally detected lung nodule on CT. This algorithm emphasizes that because of the lack of definitive information on the natural history of small solid nodules that are truly detected incidentally, their clinical management is highly dependent on the caregivers' individual risk tolerance. In addition, we present strategies to reduce the prevalence of these incidental findings, by preventing unnecessary chest CT scans or inadvertent inclusion of portions of the lungs in scans of adjacent body parts. Application of these guidelines provides pediatric radiologists with an important opportunity to practice patient-centered and evidence-based medicine. (orig.)

  15. The incidental pulmonary nodule in a child. Part 2: Commentary and suggestions for clinical management, risk communication and prevention

    Energy Technology Data Exchange (ETDEWEB)

    Westra, Sjirk J. [Massachusetts General Hospital, Division of Pediatric Radiology, Boston, MA (United States); Thacker, Paul G. [Medical University of South Carolina, Department of Radiology, Charleston, SC (United States); Podberesky, Daniel J. [Nemours Children' s Hospital, Department of Radiology, Orlando, FL (United States); Lee, Edward Y. [Boston Children' s Hospital, Department of Pediatric Radiology, Boston, MA (United States); Iyer, Ramesh S. [Seattle Children' s Hospital, Department of Radiology, Seattle, WA (United States); Hegde, Shilpa V. [Arkansas Children' s Hospital, Department of Radiology, Little Rock, AR (United States); Guillerman, R.P. [Texas Children' s Hospital, Department of Radiology, Houston, TX (United States); Mahani, Maryam Ghadimi [University of Michigan Health System, Section of Pediatric Radiology, C. S. Mott Children' s Hospital, Department of Radiology, Ann Arbor, MI (United States)

    2015-05-01

    The incidental detection of small lung nodules in children is a vexing consequence of an increased reliance on CT. We present an algorithm for the management of lung nodules detected on CT in children, based on the presence or absence of symptoms, the presence or absence of elements in the clinical history that might explain these nodules, and the imaging characteristics of the nodules (such as attenuation measurements within the nodule). We provide suggestions on how to perform a thoughtfully directed and focused search for clinically occult extrathoracic disease processes (including malignant disease) that may present as an incidentally detected lung nodule on CT. This algorithm emphasizes that because of the lack of definitive information on the natural history of small solid nodules that are truly detected incidentally, their clinical management is highly dependent on the caregivers' individual risk tolerance. In addition, we present strategies to reduce the prevalence of these incidental findings, by preventing unnecessary chest CT scans or inadvertent inclusion of portions of the lungs in scans of adjacent body parts. Application of these guidelines provides pediatric radiologists with an important opportunity to practice patient-centered and evidence-based medicine. (orig.)

  16. Scoliosis surgery - child

    Science.gov (United States)

    Spinal curvature surgery - child; Kyphoscoliosis surgery - child; Video-assisted thoracoscopic surgery - child; VATS - child ... Before surgery, your child will receive general anesthesia. This will make your child unconscious and unable to feel pain ...

  17. Environmental guidance regulatory bulletin

    International Nuclear Information System (INIS)

    This document describes the background on expanding public participation in the Resource Conservation and Recovery Act and DOE's response. The bulletin also describes the changes made by the final rule to existing regulations, guidance provided by EPA in the preamble and in the revised RCRA Public Participation Manual, the relationship between public participation and environmental justice, and DOE's recent public participation and environmental justice initiatives

  18. 儿童糖尿病临床分析及护理难点和对策%Nursing difficulties and countermeasures and clinical analysis of child diabetes

    Institute of Scientific and Technical Information of China (English)

    赵太艳

    2014-01-01

    目的:探讨儿童糖尿病的临床特征以及对儿童糖尿病的临床护理对策和要点。方法:收治儿童糖尿病患者80例作为研究对象,分成观察组和对照组,每组40例。对照组给予常规护理,观察组在对照组的基础上分析患儿的临床疾病特征、首发症状、发病季节、发病年龄等,给予一定的护理对策,包括计划饮食、健康教育和心理护理、运动疗法护理、自我监测和随访。比较护理后两组的缓解出院率、患者家属满意度、患儿并发症发生率。结果:观察组的缓解出院率、患者家属满意度均高于对照组,两组比较差异有统计学意义(P<0.05);观察组并发症发生率低于对照组,差异有统计学意义(P<0.05)。结论:科学有效的护理对策在儿童糖尿病治疗中起到重要作用。%Objective:To explore the clinical features of child diabetes and the clinical nursing countermeasures and points of child diabetes. Methods: 80 cases of diabetes in children patients were divided into the observation group and the control group, with 40 cases in each.The control group were given conventional nursing.On the basis of the control group,we analyzed the patient's clinical disease characteristics, the first symptoms, onset age and season of the observation group,and offered certain nursing countermeasures,including plans to diet,health education and psychological nursing,exercise therapy,self-monitoring and follow-up.The relief discharge rate,the degree of patients' families and complications rate of children were compared.Results:The relief discharge rate and the degree of patients' families of the observation group were higher than those of the control group, and the difference was statistically significant(P<0.05).The complication rate of observation group was lower than that of the control group,and the difference was statistically significant(P<0.05).Conclusion:The scientific and effective

  19. Predoctoral and postdoctoral students' perspectives about pediatric dental behavior guidance.

    Science.gov (United States)

    Bimstein, Enrique; Azari, Amir F; Riley, Joseph L

    2011-05-01

    This study compared acceptability scores of pediatric dental behavior guidance between predoctoral senior dental students and postdoctoral pediatric dentistry graduates. The scores were obtained with an anonymous survey that included twenty-five items related to behavior guidance techniques or situations, with the degree of acceptability of each being marked on a visual analog scale. Demographic data collected included year of graduation from the postdoctoral program, type of employment, being board-certified or not, gender, marital and parental status, previously receiving dental or medical treatment, and degree of unpleasantness from these treatments. Thirty-nine predoctoral and fifty-one postdoctoral surveys were compared. Analysis of variance (ANOVA) indicated that the predoctoral acceptability scores were statistically significantly higher than the postdoctoral scores for not allowing the child to speak during treatment, voice control, hand over mouth, active immobilization, and providing an exact explanation to the child. The predoctoral scores were lower than the postdoctoral scores for not using local anesthetic when the child does not want it, parent's presence in the operatory during treatment, or talking with the dentist during treatment. ANOVA of the predoctoral and postdoctoral scores combined indicated statistically significant differences between scores from male and females respondents for parent talking with the dentist during treatment; between married and not married respondents for hand over mouth, encouraging the child not to be a coward, the child being allowed to stop the treatment, and the parent being in the operatory during treatment; and between parents and not parents respondents for child not allowed to speak during the treatment, voice control, and hand over mouth. This study found that perspectives about pediatric dental behavior guidance are influenced by pre- and postdoctoral education and postgraduate experience. PMID:21546595

  20. Folie à Deux – A Clinical Case of Folie Imposée in a Mother/Child Relationship

    Directory of Open Access Journals (Sweden)

    Marta Nascimento

    2013-11-01

    Full Text Available Background: Even though the origin of the concept of shared delusion is not consensual, the term folie a deux was introduced in 1877 by two french researchers – Lasègue and Falret. According to the original concept, a person (inductor, cognitively dominant, develops a delusional idea that progressively imposes to a second person (induced, with whom he keeps a close relationship. The four psychopathologic subtypes known – folie imposée, folie simultanée, folie communiquée and folie induite, were described in the final of the XIX century, but its classification and conceptualization was assigned to the american researcher Gralnick (1942. Aim, materials and methods: It is intended to highlight some clinical aspects of the shared delusion disorder, its epidemiological and psycopathogenic characterization and therapeutical approach. In order to achieve it, the authors presented a clinical case report and respective non systematic literature review. Results: It is a case of shared delusion of the type folie imposée in a pair mother/son. The inductor (son suffers from bipolar disorder and asperger syndrome and shared with his mother (induced and carer a persecutory delusion. Conclusions: It is highlighted the importance of a social isolation context and close contact between both members in the genesis of the disease; it is discussed the subject of the cognitive dominance between the inductor and the induced and the implications of the separation of the pair mother/son, as primary therapeutic action.

  1. Folie à Deux – A Clinical Case of Folie Imposée in a Mother/Child Relationship

    Directory of Open Access Journals (Sweden)

    Marta Nascimento

    2012-12-01

    Full Text Available Background: Even though the origin of the concept of shared delusion is not consensual, the term folie a deux was introduced in 1877 by two french researchers – Lasègue and Falret. According to the original concept, a person (inductor, cognitively dominant, develops a delusional idea that progressively imposes to a second person (induced, with whom he keeps a close relationship. The four psychopathologic subtypes known – folie imposée, folie simultanée, folie communiquée and folie induite, were described in the final of the XIX century, but its classification and conceptualization was assigned to the american researcher Gralnick (1942. Aim, materials and methods: It is intended to highlight some clinical aspects of the shared delusion disorder, its epidemiological and psycopathogenic characterization and therapeutical approach. In order to achieve it, the authors presented a clinical case report and respective non systematic literature review. Results: It is a case of shared delusion of the type folie imposée in a pair mother/son. The inductor (son suffers from bipolar disorder and asperger syndrome and shared with his mother (induced and carer a persecutory delusion. Conclusions: It is highlighted the importance of a social isolation context and close contact between both members in the genesis of the disease; it is discussed the subject of the cognitive dominance between the inductor and the induced and the implications of the separation of the pair mother/son, as primary therapeutic action.

  2. Student nurses’ perceptions of guidance and support in rural hospitals

    Directory of Open Access Journals (Sweden)

    Steppies R. Rikhotso

    2014-02-01

    Full Text Available Background: Clinical guidance and support of nursing students in rural hospitals is a challenge for novice nurses, who rotate amongst accredited hospitals throughout the province for clinical exposure, and fid themselves in an unfamiliar environment. Theory learned at the training college is integrated with clinical exposure at hospitals and supplemented through teaching by hospital staff. Nursing students complain about lack of support and guidance from professional nurses within the hospital, some feeling restricted in execution of their nursing tasks by professional nurses and other staff. Students perceived negative attitudes from clinical staff, a lack of clinical resources, inadequate learning opportunities and a lack of support and mentoring during their clinical exposure.Objectives: This article describes perceptions of guidance and support of nursing students by professional nurses in a rural hospital and suggests guidelines for clinical guidance and support of nursing students.Method: A qualitative, explorative, descriptive and contextual design was used. Two focus group interviews were employed to collect data from a sample drawn from level II nursing students from one training college in Limpopo Province, South Africa, on different days (n = 13; n = 10. Qualitative content analysis was used to analyse data.Results: Three themes (mutual distrust and disrespect, hospital environment, and clinical guidance and support and subthemes (student behaviour and staff behaviour emerged.Conclusion: Failure to support and guide nursing students professionally may lead to high turnover and absenteeism, resulting in students’ refusal to be allocated to a rural hospital for clinical exposure. Proposed guidelines have been formulated for clinical guidance and support of nursing students at the selected rural hospital. The college and hospital management should foster collaboration between the college tutors and professional nurses

  3. Instructional design and practice of early exposure to clinical activities under the guidance of con- structivism%建构主义视角下的早期接触临床教学设计与实践

    Institute of Scientific and Technical Information of China (English)

    王颖; 王莉红; 汪辉; 高淑敏; 王玉燕; 杨尹默; 李海潮; 刘玉村

    2014-01-01

    目的运用建构主义理论,探索八年制医学生合理的“早期接触临床”的教学内容与教学形式。方法“早期接触临床”活动分为两个阶段:第一阶段按照北京大学医学部课程内容安排,为学生提供多种临床场景和医疗工作。第二阶段依据第一阶段后的学生自我设想,教师设定备选教学内容,由学生进行自由选择,自己参与设计见习内容、完成相关知识准备及小组之间的分工合作。分别在2008级八年制临床医学专业63名学生两个阶段早期接触临床教学活动后,对其进行问卷调查,分析和比较学生对“早期接触临床”活动目的的认识,学习态度、学习能力和学习收获等方面的情况,评价“早期接触临床”教学活动的效果。结果学生对早期接触临床教学活动的目的更为明确,学习兴趣和积极性更高,与医护人员以及患者的沟通能力明显增强。学生小组合作式学习的主动性有了明显提高。此外,学生在第二阶段的早期接触临床教学活动中的收获也比以前明显增加,反映在对临床医学的感性认识和兴趣、临床医疗流程、医院管理等多个方面。绝大多数学生对医德医风和爱伤观念感受更深,对将来进入临床课程学习有了更充分的心理准备。结论将建构主义理论融于“早期接触临床”教学活动中,能够培养学生“自主学习”和“合作式学习”的能力,不仅有利于增加学生的感性认识和激发学生的学习兴趣,贯彻全程医学职业精神教育理念,同时也为今后临床医学课程体系的教学改革做好了准备。%Objective To explore the reasonable “early exposure to clinical practice” teaching form and content of 8-year medical students under the guidance of constructivism. Methods Early exposure to clinical activities is divided into two parts:The first stage was arranged in accordance

  4. Child morbidity of salmonellosis and the level of resistance of clinical isolates of salmonella to antibacterial preparations in saint Petersburg

    Directory of Open Access Journals (Sweden)

    N. V. Gonchar

    2015-01-01

    Full Text Available The aim of the study was to study the dynamics of the incidence of salmonellosis children in St. Petersburg and phenotypic resistance of clinical isolates of S. Enteritidis and S. Typhimurium to antibiotics in recent years. Materials and methods. The incidence of salmonellosis children studied according to the report for the first nine months of Rospotrebnadzor in 2013–2014. Incidence of salmonellosis in the structure of bacterial intestinal infections caused by pathogens in children hospitalized in the Department of intestinal infections in 2013–2014, studied according to annual reports. Antibiotic sensitivity was studied 86 Salmonella isolates (S. Enteritidis strain 64 and strain 22 S. Typhimurium, isolated from patients in children 2010–2014. Used the method of serial microdilution broth. Salmonella isolates were divided into sensitive, resistant, intermediate sensitivity to antibiotics. The Results. Analysis of the incidence of salmonellosis children of St. Petersburg has revealed its decline in 2014 (109.2 compared to 2013 (123,9 but relatively long-term average level was an increase in incidence (107,6. In the structure of salmonellosis in children prevailed salmonellosis Group D. In hospitalized children in the structure of bacterial intestinal infections detected Excess of share of salmonellosis in 2014 (36,9±3,4% compared to 2013 (24,5±2,4%; p <0,01. A reduction in the frequency sensitivity of S. Enteritidis to ampicillin, cefepime, ceftazidime and chloramphenicol. Compared to S. Enteritidis S. Typhimurium isolates were more resistant to ceftazidime and ampicillin, but more sensitive to ciprofloxacin. Conclusion. Morbidity of salmonellosis in recent years characterized by a relatively long-term average increase of the level. In the structure of salmonellosis in children prevailed salmonellosis Group D. There was a reduction of sensitivity S. Enteritidis isolates to cephalosporins new generations, and S. Typhimurium isolates

  5. Chinese Pediatrician Attitudes and Practices Regarding Child Exposure to Secondhand Smoke (SHS and Clinical Efforts against SHS Exposure

    Directory of Open Access Journals (Sweden)

    Kaiyong Huang

    2015-05-01

    Full Text Available Background: Secondhand Smoke (SHS exposure is a leading cause of childhood illness and premature death. Pediatricians play an important role in helping parents to quit smoking and reducing children’s SHS exposure. This study examined Chinese pediatricians’ attitudes and practices regarding children’s exposure to SHS and clinical efforts against SHS exposure. Methods: A cross-sectional survey of pediatricians was conducted in thirteen conveniently selected hospitals in southern China, during September to December 2013. Five hundred and four pediatricians completed self-administered questionnaires with a response rate of 92%. χ2 tests were used to compare categorical variables differences between smokers and non-smokers and other categorical variables. Results: Pediatricians thought that the key barriers to encouraging parents to quit smoking were: lack of professional training (94%, lack of time (84%, resistance to discussions about smoking (77%. 94% of the pediatricians agreed that smoking in enclosed public places should be prohibited and more than 70% agreed that smoking should not be allowed in any indoor places and in cars. Most of the pediatricians thought that their current knowledge on helping people to quit smoking and SHS exposure reduction counseling was insufficient. Conclusions: Many Chinese pediatricians did not have adequate knowledge about smoking and SHS, and many lacked confidence about giving cessation or SHS exposure reduction counseling to smoking parents. Lack of professional training and time were the most important barriers to help parents quit smoking among the Chinese pediatricians. Intensified efforts are called for to provide the necessary professional training and increase pediatricians’ participation in the training.

  6. Guidance of Nonlinear Systems

    Science.gov (United States)

    Meyer, George

    1997-01-01

    The paper describes a method for guiding a dynamic system through a given set of points. The paradigm is a fully automatic aircraft subject to air traffic control (ATC). The ATC provides a sequence of way points through which the aircraft trajectory must pass. The way points typically specify time, position, and velocity. The guidance problem is to synthesize a system state trajectory which satisfies both the ATC and aircraft constraints. Complications arise because the controlled process is multi-dimensional, multi-axis, nonlinear, highly coupled, and the state space is not flat. In addition, there is a multitude of possible operating modes, which may number in the hundreds. Each such mode defines a distinct state space model of the process by specifying the state space coordinatization, the partition of the controls into active controls and configuration controls, and the output map. Furthermore, mode transitions must be smooth. The guidance algorithm is based on the inversion of the pure feedback approximations, which is followed by iterative corrections for the effects of zero dynamics. The paper describes the structure and modules of the algorithm, and the performance is illustrated by several example aircraft maneuvers.

  7. Third-party biller compliance guidance emphasizes risk awareness.

    Science.gov (United States)

    Saner, R J

    1999-03-01

    The voluntary compliance guidance for third-party billing companies released by the HHS Office of Inspector General (OIG) in December 1998, like the OIG's previously released guidance directed at hospitals, home health agencies, and clinical laboratories, identifies seven minimum elements for an effective corporate compliance program: written compliance policies, designation of a compliance officer, ongoing training, open lines of communication, guidelines to ensure the enforcement of compliance standards, internal monitoring and auditing of compliance activity, and procedures to respond to and correct errors. Three areas of concern for third-party billing companies are emphasized in the new guidance document: compliance risk, claims documentation, and disclosure of suspected misconduct or fraud.

  8. Non-cable vehicle guidance

    Energy Technology Data Exchange (ETDEWEB)

    Daugela, G.C.; Willott, A.M.; Chopiuk, R.G.; Thornton, S.E.

    1988-06-01

    The purpose is to determine the most promising driverless mine vehicle guidance systems that are not dependent on buried cables, and to plan their development. The project is presented in two phases: a preliminary study and literature review to determine whether suitable technologies exist to justify further work; and an in-depth assessment and selection of technologies for vehicle guidance. A large number of guidance elements are involved in a completely automated vehicle. The technologies that hold the best potential for development of guidance systems for mine vehicles are ultrasonics, radar, lasers, dead reckoning, and guidance algorithms. The best approach to adaptation of these technologies is on a step by step basis. Guidance modules that are complete in themselves and are designed to be integrated with other modules can provide short term benefits. Two modules are selected for development: the dragline operations monitor and automated machine control for optimized mining (AMCOM). 99 refs., 20 figs., 40 tabs.

  9. Does Interpersonal Psychotherapy improve clinical care for adolescents with depression attending a rural child and adolescent mental health service? Study protocol for a cluster randomised feasibility trial

    Directory of Open Access Journals (Sweden)

    Villanueva Elmer V

    2007-10-01

    Full Text Available Abstract Background Depression amongst adolescents is a costly societal problem. Little research documents the effectiveness of public mental health services in mapping this problem. Further, it is not clear whether usual care in such services can be improved via clinician training in a relevant evidence based intervention. One such intervention, found to be effective and easily learned amongst novice clinicians, is Interpersonal Psychotherapy (IPT. The study described in the current paper has two main objectives. First, it aims to investigate the impact on clinical care of implementing Interpersonal Psychotherapy for Adolescents for the treatment of adolescent depression within a rural mental health service compared with Treatment as Usual (TAU. The second objective is to record the process and challenges (i.e. feasibility, acceptability, sustainability associated with implementing and evaluating an evidence-based intervention within a community service. This paper outlines the study rationale and design for this community based research trial. Methods/design The study involves a cluster randomisation trial to be conducted within a Child and Adolescent Mental Health Service in rural Australia. All clinicians in the service will be invited to participate. Participating clinicians will be randomised via block design at each of four sites to (a training and delivery of IPT, or (b TAU. The primary measure of impact on care will be a clinically significant change in depressive symptomatology, with secondary outcomes involving treatment satisfaction and changes in other symptomatology. Participating adolescents with significant depressive symptomatology, aged 12 to 18 years, will complete assessment measures at Weeks 0, 12 and 24 of treatment. They will also complete a depression inventory once a month during that period. This study aims to recruit 60 adolescent participants and their parent/guardian/s. A power analysis is not indicated as an intra

  10. Pulmonary tuberculosis among women with cough attending clinics for family planning and maternal and child health in Dar Es Salaam, Tanzania

    Directory of Open Access Journals (Sweden)

    Wandwalo Eliud R

    2009-08-01

    Full Text Available Abstract Background Tuberculosis (TB case detection in women has remained low in developing world. This study was conducted to determine the proportion of smear positive TB among women with cough regardless of the duration attending family Planning (FP and Maternal and child health (MCH clinics in Dar es Salaam. Methods We conducted a cross sectional study in all three municipal hospitals of Dar es Salaam, between October 2007 and June 2008. All women with cough attending FP and MCH clinics were screened for TB by smear microscopy. Pearson chi-square was used to compare group difference for categorical variables. Risk factors for smear positive were estimated by logistics regression with 95% confidence intervals (CI given for odds ratios indicating statistically significant relationship if the CI did not include one. Results We enrolled a total of 749 TB suspects. Five hundred and twenty nine patients (70.6% were from MCH clinics. Mean (SD age was 27.6 (5.2 years. A total of 616 (82.2% patients were coughing for less than two weeks as compared to 133 (17.8%, who coughed for two or more weeks. Among 616 TB suspects, 14 (2.3% were smear positive TB patients, and of the 133 who had coughed for two or more weeks, 13 (9.8% were smear positive TB patients. Risk factors associated with smear positive results were having attended more than one visit to any facility prior to diagnosis (OR = 6.8; 95%CI 2.57–18.0 and having HIV/AIDS (OR = 4.4; 95%CI 1.65–11.96. Long duration of cough was not a risk factor for being smear positive (OR = 1.6; 95%CI 0.59–4.49. Conclusion The proportion of smear positive TB patients among women with cough attending MCH and FP was 3.8%. Visits to any health facility prior to Diagnosis and HIV infection were risk for having a smear positive TB.

  11. Social Media Use in Child Welfare Practice

    Directory of Open Access Journals (Sweden)

    Todd Edward Sage

    2016-04-01

    Full Text Available The scholarly child welfare literature offers little information about the use of social media by child welfare workers. We conducted a study of 171 child welfare workers across several states using an online survey. The resulting data offer insights from workers about current practices related to social media use in a child welfare work setting. Most respondents see social media as an acceptable tool for conducting child welfare assessments. Respondents describe strains and benefits of social media use. It is recommended that agencies provide guidance on ethical decision-making for using social media as a work-related tool. Agencies should also provide policy clearly defining social media use and misuse.

  12. Study on personality and clinical characteristics of the only child schizophrenia patients%独生子女精神分裂症患者个性和临床特征研究

    Institute of Scientific and Technical Information of China (English)

    陈春红; 吴树跃; 刘晓梅; 杨惜珍

    2012-01-01

    Objective To study personality and clinical characteristics of the only child schizophrenia patients.Methods The Eysenck personality (adult) questionnaire (EPQ) and nurses observation scale (NOSIE) to 45 cases of the only child patients with schizophrenia and to 60 patients with non-only child were conducted and compared with each other Results The only child schizophrenia patients were found to have obvious neurosis,psychoticism and mentality covering up,as well as the reducing social competence and social interest in clinical,easy irritation and ease depression,psychotic symptoms also experienced.Compared with the non-only child patients,there were significant differences (P < 0.05).Conclusion A correct understanding to only child personality characteristics and clinical features in patients with schizophrenia helps to guide clinical treatment and evaluation to prognosis.%目的 了解研究独生子女精神分裂症患者的个性特征和临床特点.方法 用艾森克个性(成人)问卷(EPQ)和护士观察量表(NOSIE)对45例独生子女精神分裂症患者和60例非独生子女患者进行调查比较.结果 独生子女精神分裂症患者中以神经症(56.33±11.23)、精神质(54.82±11.65)及心理掩饰(47.27±12.51)明显,而且临床中独生子女精神分裂症患者社会能力(3.87±1.44)和社会兴趣(6.77±3.32)降低,易激惹(3.99±2.65)和易抑郁(2.88±1.44),精神病性症状(2.55±1.56)丰富.与非独生子女患者相比,差异有显著性(P<0.05).结论 正确认识独生子女精神分裂症个性特征和临床特征,有利于指导临床护理和评估预后.

  13. Practical guidance for charting ethics consultations.

    Science.gov (United States)

    Bruce, Courtenay R; Smith, Martin L; Tawose, Olubukunola Mary; Sharp, Richard R

    2014-03-01

    It is generally accepted that appropriate documentation of activities and recommendations of ethics consultants in patients' medical records is critical. Despite this acceptance, the bioethics literature is largely devoid of guidance on key elements of an ethics chart note, the degree of specificity that it should contain, and its stylistic tenor. We aim to provide guidance for a variety of persons engaged in clinical ethics consultation: new and seasoned ethics committee members who are new to ethics consultation, students and trainees in clinical ethics, and those who have significant experience with ethics consultation so that they can reflect on their practice. Toward the goal of promoting quality charting practices in ethics consultations, we propose recommendations on a broad array of questions concerning clinical ethics consultation chart notes, including whether and when to write a chart note, and practical considerations for the tenor, purpose, and content of a chart note. Our broader aim is to promote discussion about good charting practices in clinical ethics, with the hope of contributing to clear standards of excellence in clinical ethics consultation.

  14. Child Care and Child Nutrition

    Science.gov (United States)

    Karolak, Eric

    2009-01-01

    The weak economy is challenging the child care program budget. Fluctuations in enrollment come up against rising costs making every penny count. So for many reasons a federal program that helps defray the costs of snacks and meals in child care programs is particularly important and timely. In this article, the author pushes for the…

  15. Optical technologies for intraoperative neurosurgical guidance.

    Science.gov (United States)

    Valdés, Pablo A; Roberts, David W; Lu, Fa-Ke; Golby, Alexandra

    2016-03-01

    Biomedical optics is a broadly interdisciplinary field at the interface of optical engineering, biophysics, computer science, medicine, biology, and chemistry, helping us understand light-tissue interactions to create applications with diagnostic and therapeutic value in medicine. Implementation of biomedical optics tools and principles has had a notable scientific and clinical resurgence in recent years in the neurosurgical community. This is in great part due to work in fluorescence-guided surgery of brain tumors leading to reports of significant improvement in maximizing the rates of gross-total resection. Multiple additional optical technologies have been implemented clinically, including diffuse reflectance spectroscopy and imaging, optical coherence tomography, Raman spectroscopy and imaging, and advanced quantitative methods, including quantitative fluorescence and lifetime imaging. Here we present a clinically relevant and technologically informed overview and discussion of some of the major clinical implementations of optical technologies as intraoperative guidance tools in neurosurgery.

  16. Linking child maltreatment history with child abuse potential: Relative roles of maltreatment types

    OpenAIRE

    Mitkovic-Voncina Marija; Lecic-Tosevski Dusica; Pejovic-Milovancevic Milica; Popovic-Deusic Smiljka

    2014-01-01

    The independent roles of each childhood maltreatment type on child abuse potential in adults have been insufficiently explored and are inconsistent, with dissociation as one of the possible suggested mediators of intergenerational child abuse. We investigated these effects among 164 non-clinical adult parents, who filled in general questionnaires: Childhood Trauma Questionnaire (CTQ), Child Abuse Potential Inventory (CAPI) and Dissociative Experience Scale ...

  17. 213个遗传性耳聋家庭的产前诊断和生育指导%Prenatal genetic test and clinical guidance for 213 hereditary deaf families

    Institute of Scientific and Technical Information of China (English)

    韩明昱; 戴朴; 卢彦平; 边旭明; 汪龙霞; 黄莎莎; 王国建; 王毅; 康东洋; 张昕

    2012-01-01

    Objective To summarize the workflow,strategy and experience of prenatal genetic test for deafness based on the 6-year clinical practice.Methods There were 213 famihes who received prenatal test from 2005 to 2011.Among the 213 families,205 families had had one deaf child,including 204 couples with normal hearing and one couple of the deaf husband and normal wife,8 families including 6 couples with normal hearing and 2 deaf couples,had no child before test. Genomic and mitochondrial DNA of each subject was extracted from whole blood.The etiology and recurrent risks in 212 families were confirmed by means of the genetic test of GJB2,SLC26A4 and mtDNA 12sRNA,but one family carried POU3F4 c.647G > A heterozygous mutation causing X-linked hereditary hearing impairment confirmed by pedigree study.The prenatal test was carried out during the pregnancy of all mothers from 11 to 30 weeks,and the following genetic information and counseling were supplied based on the results.Results The recurrent risk was 25%in 209 families,including 204 families with one deaf child and 5 families without child,among which all couples were GJB2 or SLC26A4 mutation carriers and deaf children were caused by homozygous or compound GJB2/SLC26A4 mutations; The recurrent risk was 50% in 3 families,the father and his child in one family had compound SLC26A4 mutations and the mother with heterozygous SLC26A4 mutation,the wife had POU3F4 c.647G > A heterozygous mutation in another one family,and the husband with compound SLC26A4 mutations and the wife with mtDNA A1555G mutation and heterozygous SLC26A4 mutation simultaneously happened in the rest one family; The recurrent risk was 100% in one family of the deaf couple who were both found to carry homozygous or compound GJB2 mutations,and the deaf wife got pregnant by artificial insemination with the sperm from the local Human Sperm Bank.226 times of prenatal test were applied in all 213 families that 11 families of them received prenatal

  18. AWARENESS ABOUT EMERGENCY CONTRACEPTIVE PILLS VERSUS CONVENTIONAL CONTRACEPTIVE METHODS AMONG MOTHERS ATTENDING MATERNAL AND CHILD HEALTH (MCH CLINIC, BAPUJI HOSPITAL, DAVANGERE, KARNATAKA

    Directory of Open Access Journals (Sweden)

    Vandana

    2015-02-01

    Full Text Available BACKGROUND: Unwanted pregnancies are a major public health problem for both developing and developed nations, which generally results from ineffective use of contraceptives and end up in induced abortions. Emergency contraception sometimes called “morning after”, “postcoital” or “second chance pills” can be used to prevent pregnancy after an unprotected sex. Attention has been focused on the potential for emergency contraception to reduce the number of unwanted pregnancies and thus abortion rate. OBJECTIVES: 1 . To compare the awareness about emergency contraceptive pills and conventional contraceptive methods among mothers attending MCH clinic, Bapuji Hospital, Davangere. 2. To study the socio - demographic profile of the above group. METHODS: A pre - tested, semi - structured questionnaire was used to know the awareness about emergency contraceptive pills versus conventional contraceptive methods among mothers attending MCH clinic, Bapuji hospital, Davangere from 1 st October 2011 to 31 st December 2011. Data was entered into Excel sheet and was analysed using SPSS software version 17. Data was described as proportions, categorical data using chi square test. RESULTS: A total of 500 mothers were included in the study for duration of 3months. Approximately 80% of the respondents were in the age group of 21 - 30yrs, 72.8% from urban background, 83.4% were Hindus, 55% were from joint family. Approximately 49% belonged to socioeconomic class II and III, 97.2% were literate and 86.6% were housewives. 31.8% had knowledge about emergency contraception which is very less when compared to 84.2% of conventional methods. 6.2% have practiced emergency contraception which is very poor when compared to 47.5% of conventional methods. 77.8% were aware of female sterilization. The most common known temporary method of contrac eption was Cu - T (71% followed by OCP (60.6%. Most common method used by couples was condom (21.8% followed by Cu - T (19

  19. Discussing Diverse Perspectives on Guidance

    Science.gov (United States)

    Gonzalez-Mena, Janet; Shareef, Intisar

    2005-01-01

    Ideas about discipline and guidance get extremely complex when they intersect with culture and oppression. Some groups of people who are targets of racism have to protect their children from the oppressive practices of racist individuals and institutions. Their methods of guidance and discipline may be different from those of groups for whom…

  20. Disobedient Child

    Science.gov (United States)

    ... of their parents' rules and of their own self-control. Sometimes, however, these conflicts are more than occasional ... a timeout until he calms down and regains self-control. When your child is obedient and respectful, compliment ...

  1. Parents with co-occurring mental health and substance abuse conditions involved in Child Protection Services: clinical profile and treatment needs.

    Science.gov (United States)

    Stromwall, Layne K; Larson, Nancy C; Nieri, Tanya; Holley, Lynn C; Topping, Diane; Castillo, Jason; Ashford, José B

    2008-01-01

    This article reports findings of an exploratory study of 71 parents with substance abuse conditions involved in a child dependency court. Over half (59%) of the parents had a co-occurring mental health condition. Parents with co-occurring conditions (PWCC) differed in several important ways from those with only substance abuse conditions. PWCC were also more likely than their case managers were to report a need for mental health treatment. Implications for child welfare practice and research are offered.

  2. 多元化教育实习模式在产科临床带教中的创建研究%The creation and research of diverse education practice mode on clinical obstetric ' s guidance and teaching

    Institute of Scientific and Technical Information of China (English)

    尚剑; 罗清平; 章兰萍; 黄春华

    2016-01-01

    Objective To study the creation and effect of diverse education practice model in obstetric's clini-cal guidance and teaching. Methods A total of 240 obstetric practice nurses in our hospital form January 2013 to De-cember 2014 were selected as the research objects, and the intern students in the group were all women. 120 interns in the hospital in 2013 were taken as a control group, receiving traditional education during the internship and 120 interns in 2014 as the observation group, receiving diverse education during the internship. Results Practice self-assessment, evaluation from teachers and evaluation and satisfaction from patients of the students in the two groups were compared and analyzed, and it was found that the self-evaluation satisfaction of the observation group was up to 96. 67%, the clin-ical teacher gave the students (93. 47±4. 92) marks, and patient satisfaction was 95. 00%. The difference was statisti-cally significant ( P<0. 05 ) . This study analyzed and compared the assessments of the clinical teachers from the two groups of students, and found that the students in the observation group were more satisfied with the clinical teacher's re-sponsibility, service attitude, medical ethics, concern for students, theoretical knowledge, teaching level, operating a-bility, teaching methods and student satisfaction scores had a higher satisfaction than that of the control group, the differ-ence was statistically significant ( P<0. 05 ) . Conclusions Diverse educational practice mode intern can not only im-prove interns with the phenomenon of culture shock, but also help students adapt to the environment quickly and improve their theoretical knowledge and operating skills. Students, clinical teachers and patients were quite satisfied with the ap-plication of the model, for it enables interns to adapt to obstetric care, worthy of clinical reference.%目的:研究多元化教育实习模式在产科临床带教中的创建及

  3. Guidance at the educational marketplace

    DEFF Research Database (Denmark)

    Lystbæk, Christian Tang

    in educational policies and institutions. As educational systems have expanded and, further, have been restructured with the expansion of choice opportunities since the 1980s, guidance has become prioritized as a form of counseling or coaching, which can support students. Thus, guidance has become an important...... institution of power in terms of choice opportunities and ´self-develoåment practices” in educational systems, the paper will discuss how the relationship between guidance and consumerism can be conceptualized in order to evaluate (and critically discuss) the consequences of the expansion of consumerism......The paper presents a conceptual framework for the relationship between guidance and consumerism, which can be applied in evaluating (and critically discussing) the consequences of this development for students, institutions and professionals. Guidance has moved from the margins to the center...

  4. Image guidance in endoscopic sinus surgery and skull base surgery

    Institute of Scientific and Technical Information of China (English)

    Mitchell R.Gore; Brent A.Senior

    2012-01-01

    Objective The objective of this study was to review the current clinical applications and impact of intraoperative imaging on endoscopic sinonasal and skull base procedures in adult and pediatric patients.Methods The PubMed database was searched for articles related to the use of image guidance in otolaryngology using the search terms "image guidance otolaryngology".This was supplemented by the authors′ experience utilizing image guidance in nearly 3000 endoscopic sinus and skull base procedures.Results The literature demonstrates that intraoperative image guidance has utility in primary and revision endoscopic sinus surgery,as well as endoscopic surgery of the skull base.Image guidance also has applications in pediatric endoscopic surgery,such as pediatric sinus surgery and repair of choanal atresia.Conclusions Intraoperative image guidance,when combined with a thorough knowledge of paranasal sinus and skull base anatomy and technical proficiency,can provide improved safety when performing otolaryngologic procedures from endoscopic sinus surgery to endoscopic skull base surgery.While not a substitute for knowledge of anatomy,the increased availability and usability of image guidance systems make them a useful tool in the armamentarium of the otolaryngologist/head and neck surgeon and neurosurgeon.

  5. RH Packaging Program Guidance

    Energy Technology Data Exchange (ETDEWEB)

    Washington TRU Solutions LLC

    2006-11-07

    The purpose of this program guidance document is to provide the technical requirements for use, operation, inspection, and maintenance of the RH-TRU 72-B Waste Shipping Package and directly related components. This document complies with the requirements as specified in the RH-TRU 72-B Safety Analysis Report for Packaging (SARP), and Nuclear Regulatory Commission (NRC) Certificate of Compliance (C of C) 9212. If there is a conflict between this document and the SARP and/or C of C, the C of C shall govern. The C of C states: "...each package must be prepared for shipment and operated in accordance with the procedures described in Chapter 7.0, Operating Procedures, of the application." It further states: "...each package must be tested and maintained in accordance with the procedures described in Chapter 8.0, Acceptance Tests and Maintenance Program of the Application." Chapter 9.0 of the SARP tasks the Waste Isolation Pilot Plant (WIPP) Management and Operating (M&O) Contractor with assuring the packaging is used in accordance with the requirements of the C of C. Because the packaging is NRC-approved, users need to be familiar with 10 Code of Federal Regulations (CFR) §71.8, "Deliberate Misconduct." Any time a user suspects or has indications that the conditions of approval in the C of C were not met, the U.S. Department of Energy (DOE) Carlsbad Field Office (CBFO) shall be notified immediately. CBFO will evaluate the issue and notify the NRC if required. In accordance with 10 CFR Part 71, "Packaging and Transportation of Radioactive Material," certificate holders, packaging users, and contractors or subcontractors who use, design, fabricate, test, maintain, or modify the packaging shall post copies of (1) 10 CFR Part 21, "Reporting of Defects and Noncompliance," regulations, (2) Section 206 of the Energy Reorganization Act of 1974, and (3) NRC Form 3, Notice to Employees. These documents must be posted in a conspicuous location where the activities subject to

  6. RH Packaging Program Guidance

    Energy Technology Data Exchange (ETDEWEB)

    Washington TRU Solutions LLC

    2008-01-12

    The purpose of this program guidance document is to provide the technical requirements for use, operation, inspection, and maintenance of the RH-TRU 72-B Waste Shipping Package (also known as the "RH-TRU 72-B cask") and directly related components. This document complies with the requirements as specified in the RH-TRU 72-B Safety Analysis Report for Packaging (SARP), and Nuclear Regulatory Commission (NRC) Certificate of Compliance (C of C) 9212. If there is a conflict between this document and the SARP and/or C of C, the C of C shall govern. The C of C states: "...each package must be prepared for shipment and operated in accordance with the procedures described in Chapter 7.0, Operating Procedures, of the application." It further states: "...each package must be tested and maintained in accordance with the procedures described in Chapter 8.0, Acceptance Tests and Maintenance Program of the Application." Chapter 9.0 of the SARP tasks the Waste Isolation Pilot Plant (WIPP) Management and Operating (M&O) Contractor with assuring the packaging is used in accordance with the requirements of the C of C. Because the packaging is NRC-approved, users need to be familiar with Title 10 Code of Federal Regulations (CFR) §71.8, "Deliberate Misconduct." Any time a user suspects or has indications that the conditions of approval in the C of C were not met, the U.S. Department of Energy (DOE) Carlsbad Field Office (CBFO) shall be notified immediately. The CBFO will evaluate the issue and notify the NRC if required.In accordance with 10 CFR Part 71, "Packaging and Transportation of Radioactive Material," certificate holders, packaging users, and contractors or subcontractors who use, design, fabricate, test, maintain, or modify the packaging shall post copies of (1) 10 CFR Part 21, "Reporting of Defects and Noncompliance," regulations, (2) Section 206 of the Energy Reorganization Act of 1974, and (3) NRC Form 3, Notice to Employees. These documents must be posted in a

  7. 急诊输尿管镜下尿道会师术治疗尿道骑跨伤的临床观察%Clinical observation for emergency realignment of urethra with straddle injury under the guidance of ureteroscope

    Institute of Scientific and Technical Information of China (English)

    李传章

    2014-01-01

    clinical results of 39 patients with urethra straddle injury having the failure of inputting a urethral catheter from August 2007 to August 2013 in Central People's Hospital of Tengzhou City,Shandong province were retrospectively investigated,and according to the difference in method of operation,the patients were divided into two groups. In group A,there were 27 patients who underwent the first stage perineal urethra repair and anastomosis operation,and in group B,there were 12 patients who underwent urethral realignment operation and insertion of a catheter under the guidance of ureteroscope. The operation time, amount of bleeding in operation,incidence of complications such as urethral stricture,erectile dysfunction,as well as postoperative hospital stay were compared between the two groups. In addition,we searched PubMed/MEDLINE, EMBASE,Wanfang database,China journal full-text database(CNKI),VIP database and China outstanding master's/doctoral dissertation database from which we selected research literatures from 2000 to 2013 on emergency realignment of urethra with straddle injury and conducted Meta-analysis by Revman 5.2 software. Results Compared to group A, the operation time and postoperative hospital stay were significantly shortened in group B〔operation time(minutes):26±15 vs. 71±18,postoperative hospital stay(days):2.6±1.2 vs. 5.2±1.9,both P0.05〕. And patients suffering from urethral stenosis were treated with postoperative transurethral expansion and followed up for 6 to 12 months,including 1 case of urethra expansion invalid to switch to open surgery. Related literatures were researched for Meta-analysis,and 4 literatures were enrolled. Meta-analysis results further confirmed that urethral realignment was more effective than urethral anastomosis for urethral injury〔odds ratio(OR)=2.30,95% confidence interval(95%CI)1.07 - 4.95,P=0.03〕. Conclusion Performing urethral realignment operation under the guidance of ureteroscopy is a better operation in

  8. International Conference on Harmonisation; S10 Photosafety Evaluation of Pharmaceuticals; guidance for industry; availability. Notice.

    Science.gov (United States)

    2015-01-27

    The Food and Drug Administration (FDA) is announcing the availability of a guidance for industry entitled "S10 Photosafety Evaluation of Pharmaceuticals.'' The guidance was prepared under the auspices of the International Conference on Harmonisation of Technical Requirements for Registration of Pharmaceuticals for Human Use (ICH). This guidance outlines details on when photosafety testing is warranted and on possible assessment strategies; it should be read in conjunction with the ICH M3(R2) guidance, section XIV(14) Photosafety Testing. The purpose of the guidance is to recommend international standards for photosafety assessment and to harmonize such assessments that support human clinical trials and marketing authorization for pharmaceuticals. This guidance finalizes the draft guidance issued on February 4, 2013.

  9. CAREER GUIDANCE EXPERIENCE ABROAD

    Directory of Open Access Journals (Sweden)

    Sergey N. Tolstoguzov

    2015-01-01

    Full Text Available The aim of this paper is to describe the experience of careeroriented activities carried out with students of schools in developed and developing countries. Career Guidance in Russia, despite the vast experience of its implementation, is experiencing serious difficulties. In this regard, it is important to take into account the international experience career-oriented activities, such as in the developed countries of North America and the European Union as well as in several Asian countries with rapidly growing economies and a large demographic potential, taking into account the best variants for the Russian education system. Methods. The experience of career-oriented work undertaken with pupils of the USA, Canada, Israel, France, UK, Germany, Denmark, Sweden, Japan, Singapore, China and India is shown on the basis of the comparative analysis of different publications and information sources. The author has made an attempt to generalize the principles of psycho-pedagogical and administrative assistance in professional self-determination of senior pupils abroad. Scientific novelty. The approaches to career-oriented activities in countries with different levels of economic development are compared for the first time. Some principles are revealed. Firstly, the higher the income level per capita in the country, the greater attention is given to vocational guidance. The politics in the developed countries is based on interests of the individual: children’s acquaintance with the world of professions begins already at younger school and the moment of definitive selfdetermination is postponed till the end of their senior stage of education; the possibility of direction change of professional preparation in case of detection of discrepancy of qualities of the pupil to originally selected profile is provided. Career-oriented activity in developing countries, on the contrary, is rigidly coordinated to requirements of economy and a labour market

  10. 从络病论治系统性硬皮病417例临床观察%Clinical Observation of 417 Cases of Systemic Scleroderm Treated Under Guidance of the Theory of Collateral Disease

    Institute of Scientific and Technical Information of China (English)

    郭刚

    2011-01-01

    Objective: To discuss clinical curative effect of treatment for systemic scleroderma typed under guidance of the theory of collateral disease.Methods: treated recent 3 -year 417 in -patients based on differentiation of syndromes ,divided them into five types:type of cold obstructing collaterals and failure of releasing stagnated lung - energy,type of cold stasis in striae of skin,insufficiency of both the spleen and the kidney, type of stagnation in collaterals , stagnation in collaterals due to ropy phlegm and blood stasis,type of deficienty of both qi and blood ,failure in nourishing collaterals stagnation in collaterals due to cold and heat.Expectant treatment of drip and oral western medicine was combined.Observe total effective rate and the change of microcirculation of nail fold and articular function before and after treatment.Results: the total effective rate is 94.24%.There are significant differences in both microcirculation of nail fold (morphologic integral, hydrokinetic integral, integral)and articular function (pain index, swell index, function index)before and after treatment (P < 0.01 ).Conclusion:There is positive curative effect of treatment of the theory of collateral disease for systemic scleroderma.The diagnosis and treatment of systemic scleroderma based on collaterals should de used as principle throughout the treatment.%目的:探讨以络病理论为指导辨分型治疗系统性硬皮病的临床疗效.方法:将近3年来住院的417例患者分5个证型采用中药辨证治疗,分别为寒邪阻络、肺卫不宣型,寒凝腠理、脾肾阳虚型,痰浊血瘀阻络型,气血两虚、脉络失荣型和湿热阻络型,并结合对症输液及口服西药治疗,观察其总有效率及患者甲襞微循环和关节功能治疗前后的变化.结果:总有效率94.24%,甲襞微循环(形态积分、流态积分、袢周积分)和关节功能(疼痛指数、肿胀指数、功能指数)治疗前后均有显著性差异(P<0.01).结论:络

  11. Response to work activity guidance

    Data.gov (United States)

    US Fish and Wildlife Service, Department of the Interior — This memorandum is concerning the request from the FY95 Platte-Kansas Rivers Ecosystem Work Activity Guidance for refuge managers to review the purposes of refuges...

  12. Child labor

    OpenAIRE

    Udry, Christopher

    2007-01-01

    In recent years, there has been an astonishing proliferation of empirical work on child labor. An Econlit search of keywords "child lab*r" reveals a total of 6 peer reviewed journal articles between 1980 and 1990, 65 between 1990 and 2000, and 143 in the first five years of the present decade. The purpose of this essay is to provide a detailed overview of the state of the recent empirical literature on why and how children work as well as the consequences of that work. Section 1 defines terms...

  13. CHILD ALLOWANCE

    CERN Multimedia

    Human Resources Division

    2001-01-01

    HR Division wishes to clarify to members of the personnel that the allowance for a dependent child continues to be paid during all training courses ('stages'), apprenticeships, 'contrats de qualification', sandwich courses or other courses of similar nature. Any payment received for these training courses, including apprenticeships, is however deducted from the amount reimbursable as school fees. HR Division would also like to draw the attention of members of the personnel to the fact that any contract of employment will lead to the suppression of the child allowance and of the right to reimbursement of school fees.

  14. Child abuse

    International Nuclear Information System (INIS)

    Child abuse is common in most, if not all, Western nations; it probably occurs worldwide. It may be a major factor in the increase in violence throughout much of the world. Radiologists who treat children should think of the possibilitys of abuse whenever they diagnose a fracture, intracranial bleed, ar visceral injury, especially when the history is not compatible with their findings. Metaphyseal 'corner' fractures in infants usually are caused by abuse. Less than 20% of abused children, however, present injuries that can be recognized by radiologic techniques. Consequently normal roentgenograms, nuclear medicine scans, ultrasound studies, and computed tomograms do not exclude child abuse. (orig.)

  15. Prevent Child Abuse America

    Science.gov (United States)

    ... call the police . Crisis and support contacts For Child Abuse Reporting Numbers in your State please visit: Child ... suspected child abuse and neglect. Parent Resources Prevent Child Abuse America (800) CHILDREN A resource for tips, referrals, ...

  16. Guidance Systems of Fighter Aircraft

    Directory of Open Access Journals (Sweden)

    K.N. Rajanikanth

    2005-07-01

    Full Text Available Mission performance of a fighter aircraft is crucial for survival and strike capabilities in todays' aerial warfare scenario. The guidance functions of such an aircraft play a vital role inmeeting the requirements and accomplishing the mission success. This paper presents the requirements of precision guidance for various missions of a fighter aircraft. The concept ofguidance system as a pilot-in-loop system is pivotal in understanding and designing such a system. Methodologies of designing such a system are described.

  17. Clinical research design technical points on child anorexia treated by new TCM drugs%中药新药治疗小儿厌食临床研究设计技术要点

    Institute of Scientific and Technical Information of China (English)

    王卉; 胡思源

    2012-01-01

    Through literature and practice search, the author puts forward ideas on new TCM drugs in the treatment of child anorexia clinical research, including test purpose and design, diagnosis and the standard of TCM syndromes, the choice of subjects, exit criteria, choice of control drugs, test process, effectiveness evaluation, safety indicators, combination therapy and quality control of test. New ideas of design and evaluation method on child anorexia clinical research , as well as new TCM drugs clinical research are provided for reference.%本文立足国内研究进展和实践经验,对中药新药治疗小儿厌食临床研究方案设计过程中的关键问题,从试验目的与总体设计、诊断标准、中医辨证标准、受试者的选择、对照药的选择、导入期、疗程及随访、有效性评价、安全性评价、合并用药、质量控制等各个方面,阐述了作者的认识,为中药新药治疗小儿厌食的临床研究设计提出了具体的思路,也为中药新药的临床研究设计与评价方法提供了借鉴.

  18. Using the Science Fiction Film "Invaders from Mars" in a Child Psychiatry Seminar

    Science.gov (United States)

    Zerby, Stephen A.

    2005-01-01

    Objective: The science fiction film "Invaders From Mars" is used to teach principles of child development; clinical features of separation anxiety and nightmares; and clinical interventions, including child psychotherapy, child protective issues, and crisis management. Methods: Commercial films have been used as teaching aids in child psychiatry…

  19. Child abuser stereotypes: consensus among clinicians.

    Science.gov (United States)

    Krowchuk, H V

    1989-02-01

    This article reports the results of an investigation of nurses' stereotypes of child abusers. Ninety-four registered nurses completed a questionnaire that measured subjects' knowledge of child abuse; professional contact with perpetrators and victims of abuse; knowledge of the causes of child abuse; and child abuser stereotypes. Results reveal a consensus among the subjects as to the stereotypes associated with child abusers. This study supports the notion that nurses stereotype individuals on the basis of demographic characteristics. This study also raises questions regarding the bias that may result from the use of child abuser stereotypes. Clinical decision-making processes could become compromised if biased judgements are used in planning nursing care for clients diagnosed as child abusers. PMID:2930179

  20. Parent-Child Interactions among Low-Income Mexican American Parents and Preschoolers: Do Clinic-Referred Families Differ from Nonreferred Families?

    Science.gov (United States)

    McCabe, Kristen; Yeh, May; Lau, Anna; Argote, Carolina Bertely; Liang, June

    2010-01-01

    This study compared low-income Mexican American parents of young children referred for behavior problems to their nonreferred counterparts on an observational measure of parent-child interactions. Referred Mexican American parents demonstrated more negative behaviors than their nonreferred counterparts in both nondirective and highly directive…

  1. When They Call, Will They Come? A Contextually Responsive Approach for Engaging Multistressed Families in an Urban Child Mental Health Center: A Randomized Clinical Trial

    Science.gov (United States)

    Stern, Susan B.; Walsh, Margaret; Mercado, Micaela; Levene, Kathryn; Pepler, Debra J.; Carr, Ashley; Heppell, Allison; Lowe, Erin

    2015-01-01

    Objective: This study examines the effect of an ecological and contextually responsive approach, during initial intake call, on engagement for multistressed families seeking child mental health services in an urban setting. Methods: Using a randomized design, parents were allocated to phone Intake As Usual (IAU) or Enhanced Engagement Phone Intake…

  2. Evaluation of the Sustainability and Clinical Outcome of Alternatives for Families: A Cognitive-Behavioral Therapy (AF-CBT) in a Child Protection Center

    Science.gov (United States)

    Kolko, David J.; Iselin, Anne-Marie R.; Gully, Kevin J.

    2011-01-01

    This paper examines the sustainability and outcome of Alternatives for Families: A Cognitive-Behavioral Therapy (AF-CBT) as delivered by practitioners in a community-based child protection program who had received training in the model several years earlier. Formerly described as Abuse-Focused CBT, AF-CBT is an evidence-based treatment (EBT) for…

  3. CHILD TRAFFICKING

    OpenAIRE

    Pallavi Chincholkar

    2016-01-01

    Human trafficking is the third biggest beneficial industry on the planet. Child trafficking unlike many other issues is found in both developed and developing nations. NGOs evaluate that 12,000 - 50,000 ladies and kids are trafficked into the nation every year from neighboring states for the sex exchange.

  4. Child Laborers

    Institute of Scientific and Technical Information of China (English)

    1998-01-01

    "When I was 12, I started working in a cotton mill as a child laborer." Fan Xiaofeng, the former vice-director of the Labor Protection Department of the All-China Federation of Trade Unions, wrote this sentence in one of her books. In 1932, she came to

  5. Overprotective parenting and child anxiety: the role of co-occurring child behavior problems.

    Science.gov (United States)

    Gere, Martina K; Villabø, Marianne A; Torgersen, Svenn; Kendall, Philip C

    2012-08-01

    The relationship between overprotective parenting and child anxiety has been examined repeatedly because theories emphasize its role in the maintenance of child anxiety. No study has yet tested whether this relationship is unique to child anxiety, by controlling for commonly co-occurring behavior problems within the same children. The current study examined 190 children (age 7-13, 118 [corrected] boys) referred to mental health clinics and their parents. Results revealed that significant correlations between overprotective parenting and child anxiety symptoms disappear after controlling for co-occurring child behavior symptoms. It appears that overprotection is not uniquely related to child anxiety. Furthermore, overprotective parenting was significantly and uniquely related to child behavior symptoms. Researchers and practitioners need to consider co-occurring child behavior problems when working with the parents of anxious children. PMID:22659077

  6. Battered Child Syndrome; a Case Study

    OpenAIRE

    Arastoo Pezeshki; Farzad Rahmani; Hanieh Ebrahimi Bakhtavar; Sanaz Fekri

    2015-01-01

    One of the important and usual missed causes of pediatric traumas is child abuse. This ominous phenomenon, which can be presented physically, psychologically, sexually, and emotionally has grown significantly in recent years. Many children are not diagnosed in the early stages of evaluation. Battered Child Syndrome is used to describe the clinical condition of the child serious physical abuse by parents or caregivers. Medical staff should always keep the syndrome in their mind for those broug...

  7. Quality in career guidance: The Danish case

    DEFF Research Database (Denmark)

    Plant, Peter

    2011-01-01

    Quality assurance systems are introduced in career guidance to monitor, control and develop guidance interventions. The Danish case represents at centrally driven, top-down approach......Quality assurance systems are introduced in career guidance to monitor, control and develop guidance interventions. The Danish case represents at centrally driven, top-down approach...

  8. 75 FR 73109 - Guidance for Industry on Antibacterial Drug Products: Use of Noninferiority Trials to Support...

    Science.gov (United States)

    2010-11-29

    ...The Food and Drug Administration (FDA) is announcing the availability of a guidance for industry entitled ``Antibacterial Drug Products: Use of Noninferiority Trials to Support Approval.'' The purpose of this guidance is to provide information on FDA's current thinking regarding appropriate use of noninferiority (NI) clinical trial designs to evaluate antibacterial drug products. The Agency's......

  9. 76 FR 63303 - Guidance for Industry on Warnings and Precautions, Contraindications, and Boxed Warning Sections...

    Science.gov (United States)

    2011-10-12

    ... (71 FR 3999), FDA issued final guidances on the content and format of the ``Adverse Reactions'' and ``Clinical Studies'' sections of labeling. In the Federal Register of October 19, 2009 (74 FR 53507), FDA... Register of March 3, 2009 (74 FR 9250), FDA issued a draft guidance on the content and format of...

  10. 78 FR 56752 - Interim Staff Guidance Specific Environmental Guidance for Integral Pressurized Water Reactors...

    Science.gov (United States)

    2013-09-13

    ... COMMISSION Interim Staff Guidance Specific Environmental Guidance for Integral Pressurized Water Reactors... and operate integral pressurized water reactors (iPWR). This guidance applies to environmental reviews... Environmental Guidance for iPWR Reviews.'' The purpose of this ISG is to clarify the NRC guidance...

  11. Convergent and discriminant validity of psychiatric symptoms reported in The Norwegian Mother and Child Cohort Study at age 3 years with independent clinical assessment in the Longitudinal ADHD Cohort Study

    Directory of Open Access Journals (Sweden)

    Guido Biele

    2014-12-01

    Full Text Available Epidemiological studies often use parent questionnaires to assess children's development and mental health. To date, few studies have investigated the validity of parent questionnaires with standardized clinical assessments as criterion. The current study examines discriminant and convergent validity of parent questionnaires for symptoms of Attention Deficit Hyperactivity Disorder (ADHD, Oppositional Defiance Disorder (ODD, and Conduct Disorder (CD as well as symptoms of Separation Anxiety employed in the Norwegian Mother and Child Cohort Study by using structured clinical interviews performed 5 months later in the Longitudinal ADHD Cohort Study as a criterion. The comparison of confirmatory factor analysis models and examination of factor correlations indicate convergent and discriminant validity of MoBa parent questionnaires for preschool children, especially for the assessment of ADHD and ODD/CD. Future research should attempt to further improve parent questionnaires, examine their validity in representative samples, and explicitly test their utility for screening.

  12. 临床药师在1例儿童心脏术后抗凝治疗中的作用%Intervention of clinical pharmacists on the anticoagulation after cardiac surgery in one child patient

    Institute of Scientific and Technical Information of China (English)

    梁培

    2011-01-01

    文中报道临床药师全程参与1例儿童心脏术后抗凝的治疗,根据血浆凝血酶原时间和国际标准化比值调整抗凝药物剂量,实施药学监护,并进行分析总结.临床药师与医生共同组成治疗团队,有利于提高药物治疗水平,促进合理用药.%A child patient receiving anticoagulation after cardiac surgery was reported. The clinical pharmacists helped the doctor to adjust the dose of warfarin according to prothrombin time (PT) and international normalized ratio (INR). The experience in the treatment was summarized and analyzed. The participation of clinical pharmacists improves the therapy, which is beneficial for the patients.

  13. A clinically suspected case of Anaphylactoid reaction to vitamin K injection in a child – a case report and review of literature

    Science.gov (United States)

    Choudhary, Bharat; Kumari, Sweta; Dhingra, Bhavna; Jhaj, Ratinder

    2016-01-01

    Vitamin K is commonly indicated in pediatric patients with coagulopathies. Its commercial preparations are available in the market since long. Minor complications are very well-known, but life-threatening events are rarely reported in children. We present a case of 8-year-old child who developed life-threatening event following intravenous Vitamin K injection. She was survived after cardiopulmonary resuscitation. The reaction was most probably due to anaphylactoid reaction to Vitamin K.

  14. Musings: What child and adolescent psychiatry means to me

    Directory of Open Access Journals (Sweden)

    L. Eugene Arnold

    2008-01-01

    Full Text Available I have been a grandfather for only 12 years, but for 37 years I have lived a grandparent's dream: people pay me to tell them how to raise their children. This is only one of the many rewards child and adolescent psychiatry has offered me. Table 1 lists some more of them.Probably the greatest satisfaction in child psychiatry is the wide selection of options for specialization: psychotherapy, psychopharmacology, nutrition, biochemistry, genetics, family therapy, parent guidance, custody and visitation advice, epidemiology, disorder specialization, research, consultation, public education and best of all, the chance to integrate it all and play at being a comprehensive physician. The myriad challenges provoke learning and continued development that keep one young at heart and mind. Sometimes I think I should pay to practice child psychiatry.It should be obvious by now to even the casual reader that I enjoy the privilege of being a child and adolescent psychiatrist and that enjoyment manifests in a playful attitude. That playful attitude includes not taking myself too seriously. In fact, I'm proud of my humility! It was earned at the expense of repeated humbling experiences in two ways:Confronting tragic situations that I could not help, where all my education, training, experience and brilliant diagnostic insight seemed useless; and Witnessing real heroism by some parents who struggle with sick children's difficult problems without complaining and with indefatigable hope. They outshine any professional pretensions of mine. By showing me my limitations and forcing me to compare myself to patients and parents (and occasional colleagues of superior moral caliber, child psychiatry has made a better, more honest person of me and for this I'm grateful.On the other hand, there is the mind-blowing exhilaration of watching a child improve after some prescription, potion or psychotherapeutic intervention and being allowed to believe that I had something to

  15. Child pornography

    OpenAIRE

    Pavlović, Zoran S.; Petković, Nikola; Matijašević Obradović, Jelena

    2014-01-01

    The abuse of children for pornographic purposes is a serious sociological, criminological and victimological problem of today which, despite all preventive and restrictive activities on an international level, shows a tendency of global expansion. The fact that the Republic of Serbia has only recently actively joined the fight against child pornography on the Internet indicates the need for critical analysis of the existing national, penal, and legal solutions and their harmonization with the...

  16. Agent Based Individual Traffic guidance

    DEFF Research Database (Denmark)

    Wanscher, Jørgen Bundgaard

    2004-01-01

    can be obtained through cellular phone tracking or GPS systems. This information can then be used to provide individual traffic guidance as opposed to the mass information systems of today -- dynamic roadsigns and trafficradio. The goal is to achieve better usage of road and time. The main topic......When working with traffic planning or guidance it is common practice to view the vehicles as a combined mass. >From this models are employed to specify the vehicle supply and demand for each region. As the models are complex and the calculations are equally demanding the regions and the detail...

  17. 76 FR 78670 - Draft Guidance for Industry and Food and Drug Administration Staff; Evaluation of Sex Differences...

    Science.gov (United States)

    2011-12-19

    ... Staff; Evaluation of Sex Differences in Medical Device Clinical Studies; Availability AGENCY: Food and... the availability of the draft guidance entitled ``Evaluation of Sex Differences in Medical Device Clinical Studies.'' This document provides guidance on the study and evaluation of sex differences...

  18. Spina Bifida Clinic Directory

    Science.gov (United States)

    ... Bifida Clinic Children’s Hospital New Orleans 200 Henry Clay Avenue (Pediatric-22) New Orleans, LA 70118 504- ... www.reach-clinic.org Back to top Oregon Child Development & Rehabilitation Center Oregon Health & Science University (pediatric ...

  19. Battered Child Syndrome; a Case Study

    Directory of Open Access Journals (Sweden)

    Arastoo Pezeshki

    2015-05-01

    Full Text Available One of the important and usual missed causes of pediatric traumas is child abuse. This ominous phenomenon, which can be presented physically, psychologically, sexually, and emotionally has grown significantly in recent years. Many children are not diagnosed in the early stages of evaluation. Battered Child Syndrome is used to describe the clinical condition of the child serious physical abuse by parents or caregivers. Medical staff should always keep the syndrome in their mind for those brought to the emergency department with trauma. In this report, we described a patient complained of dysphagia following a falling from a height and multiple epidural hematomas and final diagnosis of battered child syndrome.

  20. Practice parameter for the assessment and management of youth involved with the child welfare system.

    Science.gov (United States)

    Lee, Terry; Fouras, George; Brown, Rachel

    2015-06-01

    This Practice Parameter presents principles for the mental health assessment and management of youth involved with the child welfare system. Important definitions, background, history, epidemiology, mental health care use, and functional outcomes are described. Practical guidance regarding child welfare-related considerations for evaluation and management are discussed. PMID:26004666

  1. Guidance for evidence-informed policies about health systems: rationale for and challenges of guidance development.

    Science.gov (United States)

    Bosch-Capblanch, Xavier; Lavis, John N; Lewin, Simon; Atun, Rifat; Røttingen, John-Arne; Dröschel, Daniel; Beck, Lise; Abalos, Edgardo; El-Jardali, Fadi; Gilson, Lucy; Oliver, Sandy; Wyss, Kaspar; Tugwell, Peter; Kulier, Regina; Pang, Tikki; Haines, Andy

    2012-01-01

    In the first paper in a three-part series on health systems guidance, Xavier Bosch-Capblanch and colleagues examine how guidance is currently formulated in low- and middle-income countries, and the challenges to developing such guidance.

  2. Child: A Learning Model and a Bi-directional Phenomenon

    Directory of Open Access Journals (Sweden)

    Priyvadan C Shastri

    2015-01-01

    Full Text Available Forty-five years of work with children has enriched my knowledge. Child development and psychology has made basic concepts of general psychology and abnormal psychology clearer. ′Meanings′ have become more meaningful. It has made me a better professional; large number of communication and teaching skill has been the end result of such a long association with diverse groups of children who needed special care. Apart from professional skills as a clinician and as a teacher, it has made me a better person and a better parent. I have been fortunate to work with a large number and different groups of children who were in some way very special. Some were classified under various disabilities or diagnosed under different categories. I also had the privilege of working with different institutions, e.g., child guidance clinics run by a paediatrics department and a psychiatry department of a general hospital and a teaching hospital. Years of association with College of Special Work and Institute of Social Science have made me understand the very important facet of sociocultural influence on the development of human behaviour. I was further fortunate to work with children in closed and open institutions, residential care units and day care units, institutions where court committed children were observed, treated, trained and cared for, destitute children and delinquent children in remand homes, rescue homes and custodial care homes. I was fortunate to be part of the group which dealt with children who were in conflict with the law, belonging to diverse categories like street children, working children, child sex workers and sexually abused children. This paper is a reflection on experience gained over the decades.

  3. The MAGEC system for spinal lengthening in children with scoliosis: A NICE Medical Technology Guidance.

    Science.gov (United States)

    Jenks, Michelle; Craig, Joyce; Higgins, Joanne; Willits, Iain; Barata, Teresa; Wood, Hannah; Kimpton, Christine; Sims, Andrew

    2014-12-01

    Scoliosis-structural lateral curvature of the spine-affects around four children per 1,000. The MAGEC system comprises a magnetically distractible spinal rod implant and an external remote controller, which lengthens the rod; this system avoids repeated surgical lengthening. Rod implants brace the spine internally and are lengthened as the child grows, preventing worsening of scoliosis and delaying the need for spinal fusion. The Medical Technologies Advisory Committee at the National Institute for Health and Care Excellence (NICE) selected the MAGEC system for evaluation in a NICE medical technologies guidance. Six studies were identified by the sponsor (Ellipse Technologies Inc.) as being relevant to the decision problem. Meta-analysis was used to compare the clinical evidence results with those of one conventional growth rod study, and equal efficacy of the two devices was concluded. The key weakness was selection of a single comparator study. The External Assessment Centre (EAC) identified 16 conventional growth rod studies and undertook meta-analyses of relevant outcomes. Its critique highlighted limitations around study heterogeneity and variations in baseline characteristics and follow-up duration, precluding the ability to draw firm conclusions. The sponsor constructed a de novo costing model showing that MAGEC rods generated cost savings of £9,946 per patient after 6 years, compared with conventional rods. The EAC critiqued and updated the model structure and inputs, calculating robust cost savings of £12,077 per patient with MAGEC rods compared with conventional rods over 6 years. The year of valuation was 2012. NICE issued a positive recommendation as supported by the evidence (Medical Technologies Guidance 18). PMID:25172432

  4. Teacher Guidance of Knowledge Construction

    Science.gov (United States)

    Schwarz, Baruch; Dreyfus, Tommy; Hadas, Nurit; Hershkowitz, Rina

    2004-01-01

    This paper focuses on how teachers guide construction of knowledge in classrooms. We suggest that guidance hinges on the kind of dialogue teachers choose to engage students in. We propose several classroom dialogue types relevant for the construction of knowledge and suggest that critical dialogue is particularly effective for knowledge…

  5. DOE Waste Treatability Group Guidance

    International Nuclear Information System (INIS)

    This guidance presents a method and definitions for aggregating U.S. Department of Energy (DOE) waste into streams and treatability groups based on characteristic parameters that influence waste management technology needs. Adaptable to all DOE waste types (i.e., radioactive waste, hazardous waste, mixed waste, sanitary waste), the guidance establishes categories and definitions that reflect variations within the radiological, matrix (e.g., bulk physical/chemical form), and regulated contaminant characteristics of DOE waste. Beginning at the waste container level, the guidance presents a logical approach to implementing the characteristic parameter categories as part of the basis for defining waste streams and as the sole basis for assigning streams to treatability groups. Implementation of this guidance at each DOE site will facilitate the development of technically defined, site-specific waste stream data sets to support waste management planning and reporting activities. Consistent implementation at all of the sites will enable aggregation of the site-specific waste stream data sets into comparable national data sets to support these activities at a DOE complex-wide level

  6. DOE Waste Treatability Group Guidance

    Energy Technology Data Exchange (ETDEWEB)

    Kirkpatrick, T.D.

    1995-01-01

    This guidance presents a method and definitions for aggregating U.S. Department of Energy (DOE) waste into streams and treatability groups based on characteristic parameters that influence waste management technology needs. Adaptable to all DOE waste types (i.e., radioactive waste, hazardous waste, mixed waste, sanitary waste), the guidance establishes categories and definitions that reflect variations within the radiological, matrix (e.g., bulk physical/chemical form), and regulated contaminant characteristics of DOE waste. Beginning at the waste container level, the guidance presents a logical approach to implementing the characteristic parameter categories as part of the basis for defining waste streams and as the sole basis for assigning streams to treatability groups. Implementation of this guidance at each DOE site will facilitate the development of technically defined, site-specific waste stream data sets to support waste management planning and reporting activities. Consistent implementation at all of the sites will enable aggregation of the site-specific waste stream data sets into comparable national data sets to support these activities at a DOE complex-wide level.

  7. Systematic policy and forward guidance

    OpenAIRE

    Plosser, Charles I.

    2014-01-01

    Money Marketeers of New York University, Inc., Down Town Association, March 25, 2014, New York, NY President Charles Plosser discusses the relationship between systematic policy and forward guidance. He explains how understanding both practices can provide insights into effective monetary policy in normal and unusual times, or in extreme conditions when policy is constrained by the zero lower bound on nominal interest rates.

  8. Phase contrast image guidance for synchrotron microbeam radiotherapy

    Science.gov (United States)

    Pelliccia, Daniele; Crosbie, Jeffrey C.; Larkin, Kieran G.

    2016-08-01

    Recent image guidance developments for preclinical synchrotron microbeam radiotherapy represent a necessary step for future clinical translation of the technique. Image quality can be further improved using x-ray phase contrast, which is readily available at synchrotron facilities. We here describe a methodology for phase contrast image guidance at the Imaging and Medical Beamline at the Australian Synchrotron. Differential phase contrast is measured alongside conventional attenuation and used to improve the image quality. Post-processing based on the inverse Riesz transform is employed on the measured data to obtain noticeably sharper images. The procedure is extremely well suited for applications such as image guidance which require both visual assessment and sample alignment based on semi automatic image registration. Moreover, our approach can be combined with all other differential phase contrast imaging techniques, in all cases where a quantitative evaluation of the refractive index is not required.

  9. Phase contrast image guidance for synchrotron microbeam radiotherapy.

    Science.gov (United States)

    Pelliccia, Daniele; Crosbie, Jeffrey C; Larkin, Kieran G

    2016-08-21

    Recent image guidance developments for preclinical synchrotron microbeam radiotherapy represent a necessary step for future clinical translation of the technique. Image quality can be further improved using x-ray phase contrast, which is readily available at synchrotron facilities. We here describe a methodology for phase contrast image guidance at the Imaging and Medical Beamline at the Australian Synchrotron. Differential phase contrast is measured alongside conventional attenuation and used to improve the image quality. Post-processing based on the inverse Riesz transform is employed on the measured data to obtain noticeably sharper images. The procedure is extremely well suited for applications such as image guidance which require both visual assessment and sample alignment based on semi automatic image registration. Moreover, our approach can be combined with all other differential phase contrast imaging techniques, in all cases where a quantitative evaluation of the refractive index is not required. PMID:27436750

  10. The Young Handicapped Child: Educational Guidance for the Young Cerebral Palsied, Deaf, Blind, and Autistic Child.

    Science.gov (United States)

    Bowley, Agatha H.; Gardner, Leslie

    The different classes of handicaps, the size of the problem, the causes, and the principles and methods of psychological and educational care concerning children with partial and total blindness, cerebral palsy, deafness, or autism are discussed. Concepts treated include incidence, etiology, diagnosis, learning difficulties, social and emotional…

  11. The Child and Adolescent Psychiatry Trials Network

    Science.gov (United States)

    March, John S.; Silva, Susan G.; Compton, Scott; Anthony, Ginger; DeVeaugh-Geiss, Joseph; Califf, Robert; Krishnan, Ranga

    2004-01-01

    Objective: The current generation of clinical trials in pediatric psychiatry often fails to maximize clinical utility for practicing clinicians, thereby diluting its impact. Method: To attain maximum clinical relevance and acceptability, the Child and Adolescent Psychiatry Trials Network (CAPTN) will transport to pediatric psychiatry the practical…

  12. Intracranial vertebral artery dissection with subarachnoid hemorrhage following child abuse

    International Nuclear Information System (INIS)

    Child abuse is often suspected based on particular patterns of injury. We report a case of intracranial vertebral artery dissection with subarachnoid hemorrhage (SAH) in a 3-month-old boy following child abuse. The mechanisms of injury and the clinical and imaging findings are discussed. This particular pattern of injury has rarely been reported in association with child abuse. We hope to raise physician awareness of child abuse when faced with these imaging findings. (orig.)

  13. FAQ: Child Sexual Exploitation

    Science.gov (United States)

    ... Support FAQ: Child Sexual Exploitation What is child pornography? Federal law (18 U.S.C. §2256(8)) defines ... person under the age of 18. Is child pornography a crime? It is a federal crime to ...

  14. My Child Is Stealing

    Science.gov (United States)

    ... might do so anyway because they lack enough self-control . Preteens and teens know they're not supposed ... About a Child Who Steals? Teaching Your Child Self-Control Disciplining Your Child Childhood Stress Nine Steps to ...

  15. Fighting Child Sexual Abuse

    Directory of Open Access Journals (Sweden)

    Pesanayi Gwirayi

    2013-01-01

    Full Text Available This study investigated secondary school pupils’ views on strategies that can be used to prevent child sexual abuse (CSA. A survey design was adopted as the operational framework for data gathering. Data were collected from three secondary schools, all in the Gweru district of Zimbabwe. The sample comprised 268 secondary pupils (50% female; M age = 15.42, SD = 1.376. Each participant was asked to write down three main strategies that can be used to fight CSA on a given questionnaire. The responses were then analyzed using the thematic content analysis technique. The study revealed that most pupils believed that CSA can be prevented through teaching them about it and also reporting to the police. Another significant finding was that pupils’ responses tended to vary with gender and level of education. Whereas female respondents suggested that CSA can be fought by avoiding strangers, saying no to sexual advances, and having reliable friends, their male counterparts suggested teaching the community about CSA, forming new clubs, and enacting life imprisonment for perpetrators, among other suggestions. In terms of level of education, Form 2 participants suggested avoiding strangers, staying home at night, whereas their Form 4 counterparts suggested lessons for Guidance and Counseling, saying no to sexual advances, and having reliable friends. These findings unequivocally demonstrate the need to vigorously engage secondary school pupils in activities aimed at fighting CSA to safeguard their inalienable human rights.

  16. Psychometric Properties of the Screen for Child Anxiety Related Emotional Disorders (SCARED) in a Non-Clinical Sample of Children and Adolescents in Saudi Arabia.

    Science.gov (United States)

    Arab, Arwa; El Keshky, Mogeda; Hadwin, Julie A

    2016-08-01

    This paper examined the reliability, convergent validity and factor structure of the self-report Screen for Child Anxiety Disorders (SCARED; Birmaher et al. in J Am Acad Child Adolesc Psychiatry 36:545-553, 1997) in a large community sample of children and adolescents in Saudi Arabia. The questionnaire showed moderate to high internal consistency and satisfactory test-retest reliability over a 2 week period. In addition, there were significant positive correlations between reported anxiety symptoms with parent report behavioural difficulties. The five factor structure model of the SCARED also had a good model fit in this population. The results showed that self-report anxiety symptoms decreased with age (for boys and not girls) and were higher in adolescent girls. The results suggest that the SCARED could be useful in this population to identify individuals who are at risk of developing anxiety disorders in childhood with a view to implementing prevention and intervention methods to ensure positive developmental outcome over time. PMID:26424720

  17. Psychometric Properties of the Screen for Child Anxiety Related Emotional Disorders (SCARED) in a Non-Clinical Sample of Children and Adolescents in Saudi Arabia.

    Science.gov (United States)

    Arab, Arwa; El Keshky, Mogeda; Hadwin, Julie A

    2016-08-01

    This paper examined the reliability, convergent validity and factor structure of the self-report Screen for Child Anxiety Disorders (SCARED; Birmaher et al. in J Am Acad Child Adolesc Psychiatry 36:545-553, 1997) in a large community sample of children and adolescents in Saudi Arabia. The questionnaire showed moderate to high internal consistency and satisfactory test-retest reliability over a 2 week period. In addition, there were significant positive correlations between reported anxiety symptoms with parent report behavioural difficulties. The five factor structure model of the SCARED also had a good model fit in this population. The results showed that self-report anxiety symptoms decreased with age (for boys and not girls) and were higher in adolescent girls. The results suggest that the SCARED could be useful in this population to identify individuals who are at risk of developing anxiety disorders in childhood with a view to implementing prevention and intervention methods to ensure positive developmental outcome over time.

  18. Engineering Guidance: A Human Resource Development.

    Science.gov (United States)

    Snarponis, Joseph M.; Prien, John D.

    1979-01-01

    Describes the role of The National Society of Professional Engineers (NSPE) in providing guidance activities for students. Discusses structional organization, goals, and guidance activities for engineering and technical and professional societies. (MA)

  19. Helping Your Child through Early Adolescence -- Helping Your Child Series

    Science.gov (United States)

    ... CHILD'S ACADEMIC SUCCESS Helping Your Child Through Early Adolescence -- Helping Your Child Series PDF (1 MB) For ... Acknowledgements Tips to Help Your Child through Early Adolescence No Child Left Behind < Previous page | ^ Top ^ | Next ...

  20. Image guidance improves localization of sonographically occult colorectal liver metastases

    Science.gov (United States)

    Leung, Universe; Simpson, Amber L.; Adams, Lauryn B.; Jarnagin, William R.; Miga, Michael I.; Kingham, T. Peter

    2015-03-01

    Assessing the therapeutic benefit of surgical navigation systems is a challenging problem in image-guided surgery. The exact clinical indications for patients that may benefit from these systems is not always clear, particularly for abdominal surgery where image-guidance systems have failed to take hold in the same way as orthopedic and neurosurgical applications. We report interim analysis of a prospective clinical trial for localizing small colorectal liver metastases using the Explorer system (Path Finder Technologies, Nashville, TN). Colorectal liver metastases are small lesions that can be difficult to identify with conventional intraoperative ultrasound due to echogeneity changes in the liver as a result of chemotherapy and other preoperative treatments. Interim analysis with eighteen patients shows that 9 of 15 (60%) of these occult lesions could be detected with image guidance. Image guidance changed intraoperative management in 3 (17%) cases. These results suggest that image guidance is a promising tool for localization of small occult liver metastases and that the indications for image-guided surgery are expanding.

  1. Quality Assurance in University Guidance Services

    Science.gov (United States)

    Simon, Alexandra

    2014-01-01

    In Europe there is no common quality assurance framework for the delivery of guidance in higher education. Using a case study approach in four university career guidance services in England, France and Spain, this article aims to study how quality is implemented in university career guidance services in terms of strategy, standards and models,…

  2. Providing Career Guidance for Young Women.

    Science.gov (United States)

    Colby, Pamela G.

    This module is directed at personnel working or planning to work in the areas of guidance, counseling, placement and follow-through in junior and senior high school settings, grades 7-12. The module topic is career guidance for young women of junior and senior high school age, aand the focus will be on providing nonbiased career guidance which…

  3. The Self in Guidance: Assumptions and Challenges.

    Science.gov (United States)

    Edwards, Richard; Payne, John

    1997-01-01

    Examines the assumptions of "self" made in the professional and managerial discourses of guidance. Suggests that these assumptions obstruct the capacity of guidance workers to explain their own practices. Drawing on contemporary debates over identity, modernity, and postmodernity, argues for a more explicit debate about the self in guidance. (RJM)

  4. Guidance manual for constructed wetlands.

    OpenAIRE

    Ellis, John Bryan; Shutes, R. Brian E.; Revitt, D. Mike

    2003-01-01

    This Guidance Manual was produced to provide up to date information on the design, costs, construction, operation and maintenance of constructed wetlands used for the treatment of highway runoff. Information is provided on the different types of wetlands and their mode of operation, the design and planting of a wetland system and the retrofitting of treatment structures, the performance and costs of wetlands and their operation and maintenance requirements. The benefits of wetlands in encoura...

  5. Current materiality guidance for auditors

    OpenAIRE

    McKee, Thomas E.; Eilifsen, Aasmund

    2000-01-01

    Auditors have to make materiality judgments on every audit. This is a difficult process, as both quantitative and qualitative factors have to be evaluated. Additionally, there is no formal guidance for how to implement the materiality concepts discussed in the auditing standards. Although they are sometimes difficult to make, good materiality judgments are crucial for the conduct of a successful audit as poor judgments can result in an audit that is ineffective and/or inefficient. This report...

  6. Preventing Child Abuse and Neglect

    Science.gov (United States)

    ... Abuse & Neglect Fatalities Preventing Child Abuse & Neglect National Child Abuse Prevention Month Overview Promoting Child & Family Well-Being Public ... Abuse & Neglect Preventing Child Abuse & Neglect Resources on child abuse prevention, protecting children from risk of abuse, and strengthening ...

  7. Addressing the Impact of Trauma before Diagnosing Mental Illness in Child Welfare

    Science.gov (United States)

    Griffin, Gene; McClelland, Gary; Holzberg, Mark; Stolbach, Bradley; Maj, Nicole; Kisiel, Cassandra

    2011-01-01

    Congress set requirements for child welfare agencies to respond to emotional trauma associated with child maltreatment and removal. In meeting these requirements, agencies should develop policies that address child trauma. To assist in policy development, this study analyzes more than 14,000 clinical assessments from child welfare in Illinois.…

  8. Screening of newborns for congenital hypothyroidism. Guidance for developing programmes

    International Nuclear Information System (INIS)

    Congenital hypothyroidism is a condition that, if left untreated, can cause lifelong human suffering as a result of severe mental retardation and deficiency of growth. With the involvement of the IAEA, screening programmes to detect congenital hypothyroidism in newborn infants have been introduced successfully in a large number of countries. The cornerstone of these programmes is accurate and reliable screening methods involving isotope techniques and simple medical treatment. The suffering - and heavy social and economic burden - caused by congenital hypothyroidism prompted many countries to institute a formalized screening programme directed at newborns, just as a vaccination programme has become an integral part of child health care. In many other countries however, this type of formalized service has not yet been established. For these countries, the implementation of a neonatal screening programme will bring about a considerable improvement in child health care. It is hoped that the guidance in this publication will be especially useful to the signatories of the United Nations Convention on the Rights of the Child. Several factors that prevail in a country - the climate, political environment, economic development, level of health care and the transportation system - have an influence on the overall operational systems, design and implementation of a screening programme. As such, the design of such a programme will differ greatly from country to country. Nevertheless, neonatal screening programmes have many elements in common. This book draws on the IAEA's experience in this area over more than a decade, and on the results of a regional technical cooperation programme on neonatal screening for congenital hypothyroidism in East Asia (IAEA Project RAS6032). This publication provides guidance aimed specifically at implementing and sustaining programmes for the screening of newborn infants

  9. Fever in the returning child traveller: approach to diagnosis and management.

    Science.gov (United States)

    Halbert, J; Shingadia, D; Zuckerman, Jane N

    2014-10-01

    During the last half century there has been an exponential increase in international travel including to more exotic and long-haul destinations. The assessment of febrile returning child travellers presents diagnostic challenges and is often performed poorly. A detailed travel and medical history, clinical examination and appropriate first-line investigations are essential. While the majority of children will have a common self-limiting or easily treatable infection, it is important to consider other causes, including imported infections, which may be life-threatening or highly contagious. In this article, we provide guidance on the initial assessment and management of such children with a focus on some of the more important imported infections, including malaria, dengue, typhoid fever, travellers' diarrhoea, respiratory infections, tuberculosis, schistosomiasis and rickettsial diseases. PMID:24667950

  10. Clinical analysis of liver transplant from a child of brain death to an adult%脑死亡儿童供肝成人移植临床分析

    Institute of Scientific and Technical Information of China (English)

    时军; 罗文峰; 丁利民; 徐志丹; 王永刚; 李新长; 罗来邦; 龙成美

    2011-01-01

    目的 探讨脑死亡儿童供肝成人移植的临床可行性,总结1例脑死亡儿童供肝成人移植的临床体会.方法 受者为39岁女性,诊断为原发性肝癌,肝炎后肝硬化(失代偿期).供者为脑肿瘤脑死亡的8岁儿童,供肝采用快速联合脏器切取方法获取.手术方式为经典原位肝移植.术后常规给予免疫抑制、防治感染、护肝、支持等治疗.结果 移植手术历时6 h.术后无严重并发症发生,受者健康存活,门诊随访肝功能正常.结论 儿童供肝成人移植技术是可行的.系统化的供肝评估、良好的手术技巧及完善的术后处理是确保手术成功的关键.%Objective To explore clinical feasibility of liver transplant from child of brain death to adult, to summarize the clinical experiences that a child of brain death transplants liver to an adult. Methods The recipient was a 39-year-old woman patient with primary hepatic carcinoma and posthepatitis cirrhosis (decompensation stage); while the donor was a 8-old-year child of brain death because of brain neoplasms. Donated liver was gained by the method of en bloc multivisceral procurement in a short time; the operative method was classic orthotopic liver transplantation. The postoperative managements included immunosuppression, prevention of infection, hepatic protection, and other relevant supports etc. Results The transplantation operative duration was 6 hours, after which not only did the recipient survive but also her body functioned well including the liver part, with no severe postoperative complications. Conclusions The technology of transplanting livers from children to adults is feasible. The key to ensure the success of transplant operation is systematic preoperative evaluation, excellent operative technique, and perfect postoperative treatment.

  11. Optimum PN Guidance Law for Maneuvering Target

    Institute of Scientific and Technical Information of China (English)

    SUN Bao-cai; QI Zai-kang

    2007-01-01

    An optimum PN guidance law for maneuvering target is developed using optimal control theory. By estimating the target position and setting the cost function, the guidance law can be deduced even without knowing the missile lateral acceleration. Since the quadratic cost function can make a compromise between the miss distance andthe control constraint, the optimum guidance law obtained is more general. Also, introduced line of sight rate as the input, a practical form of this guidance law is derived. The simulation results show the effectiveness of the guidance laws.

  12. Can ultrasound guidance reduce the risk of pneumothorax following thoracentesis?

    Directory of Open Access Journals (Sweden)

    Alessandro Perazzo

    2014-01-01

    Full Text Available OBJECTIVE: Thoracentesis is one of the bedside procedures most commonly associated with iatrogenic complications, particularly pneumothorax. Various risk factors for complications associated with thoracentesis have recently been identified, including an inexperienced operator; an inadequate or inexperienced support team; the lack of a standardized protocol; and the lack of ultrasound guidance. We sought to determine whether ultrasound-guided thoracentesis can reduce the risk of pneumothorax and improve outcomes (fewer procedures without fluid removal and greater volumes of fluid removed during the procedures. In our comparison of thoracentesis with and without ultrasound guidance, all procedures were performed by a team of expert pulmonologists, using the same standardized protocol in both conditions. METHODS: A total of 160 participants were randomly allocated to undergo thoracentesis with or without ultrasound guidance (n = 80 per group. The primary outcome was pneumothorax following thoracentesis. Secondary outcomes included the number of procedures without fluid removal and the volume of fluid drained during the procedure. RESULTS: Pneumothorax occurred in 1 of the 80 patients who underwent ultrasound-guided thoracentesis and in 10 of the 80 patients who underwent thoracentesis without ultrasound guidance, the difference being statistically significant (p = 0.009. Fluid was removed in 79 of the 80 procedures performed with ultrasound guidance and in 72 of the 80 procedures performed without it. The mean volume of fluid drained was larger during the former than during the latter (960 ± 500 mL vs. 770 ± 480 mL, the difference being statistically significant (p = 0.03. CONCLUSIONS: Ultrasound guidance increases the yield of thoracentesis and reduces the risk of post-procedure pneumothorax. (Chinese Clinical Trial Registry identifier: ChiCTR-TRC-12002174 [http://www.chictr.org/en/

  13. Child Emotional Aggression and Abuse: Definitions and Prevalence

    Science.gov (United States)

    Slep, Amy M. Smith; Heyman, Richard E.; Snarr, Jeffery D.

    2011-01-01

    Objective: Research on and intervention for child emotional abuse and emotional aggression toward children have been severely hampered because there have been no agreed-upon, clinically usable definitions. Methods: We have (a) proposed and field-tested a set of criteria to operationally define child emotional abuse for clinical settings and (b)…

  14. Causes of Child Abuse

    OpenAIRE

    Deveci, S. Erhan; Açık, Yasemin

    2003-01-01

    Child abuse is an important public health problem that is present almost in every society and environment at different level and intensities. For implementation of child abuse protection measures it is necessary to investigate its causes. In this review, causes of child abuse was attempted to investigate with respects to the society and institution, family and individual and child related factors.

  15. Toilet Training Your Child

    Science.gov (United States)

    ... to be present when you go to the bathroom and make your child feel comfortable in the bathroom. Allow your child to see urine and bowel ... begin teaching your child to go to the bathroom. Keep your child in loose, easily removable pants. ...

  16. Guidance for the management of venous thrombosis in unusual sites

    OpenAIRE

    Ageno, Walter; Beyer-Westendorf, Jan; Garcia, David A.; Lazo-Langner, Alejandro; McBane, Robert D.; Paciaroni, Maurizio

    2016-01-01

    Venous thromboembolism (VTE) is a serious and often fatal medical condition with an increasing incidence. The treatment of VTE is undergoing tremendous changes with the introduction of the new direct oral anticoagulants and clinicians need to understand new treatment paradigms. This manuscript, initiated by the Anticoagulation Forum, provides clinical guidance based on existing guidelines and consensus expert opinion where guidelines are lacking. In this chapter, we address the management of ...

  17. Remote control catheter navigation: options for guidance under MRI

    OpenAIRE

    Muller Leah; Saeed Maythem; Wilson Mark W; Hetts Steven W

    2012-01-01

    Abstract Background Image-guided endovascular interventions have gained increasing popularity in clinical practice, and magnetic resonance imaging (MRI) is emerging as an attractive alternative to X-ray fluoroscopy for guiding such interventions. Steering catheters by remote control under MRI guidance offers unique challenges and opportunities. Methods In this review, the benefits and limitations of MRI-guided remote control intervention are addressed, and the tools for guiding such intervent...

  18. Who Owns Child Abuse?

    OpenAIRE

    Gerald Cradock

    2014-01-01

    Expectations of contemporary child protection apparatuses are strongly influenced by beliefs inherited from the nineteenth century child rescue movement. In particular, the belief that child abuse determination is obvious. However, this assumption fails to make a distinction between nineteenth century’s emphasis on impoverished environments and the twentieth century introduction of the pathological child abuser. Moreover, the proliferation of kinds of child abuse, and the need to distinguis...

  19. The relationship between parents with a history of childhood problems and incidence of consequent child abuse.

    Science.gov (United States)

    Hashimoto, Hiroko; Tani, Hiroe; Ninomiya, Tsuneo; Mori, Kenji

    2016-01-01

    The purpose of this study was to determine the factors related to the need for cooperation with child guidance centers with a focus on the presence or absence of a history of childhood problems in at-risk parents receiving support from their municipality. Among the 1890 parents who received child care support from public health nurses in the municipalities, 164 parents (8.7%) had a history of childhood problems. Among these, 50 parents (30.5%) received support from child guidance centers. The parents with a history of childhood problems had a higher incidence rate for receiving support from child guidance centers than other parents. Multiple logistic regression analysis showed that "marital strife or domestic violence", and "financial problems" were associated with consultations with child guidance centers among parents with a history of childhood problems. The results showed that family situations of parents who had a history of childhood problems may, in time, become more severe, even if they have received support from public health nurses in the municipalities. Therefore, parents with a history of childhood problems need support as early as possible. In addition, those parents with "marital strife or domestic violence" and "financial problems" also need guidance and early nursing care interventions. J. Med. Invest. 63: 209-215, August, 2016. PMID:27644560

  20. Percutaneous needle placement using laser guidance: a practical solution

    Science.gov (United States)

    Xu, Sheng; Kapoor, Ankur; Abi-Jaoudeh, Nadine; Imbesi, Kimberly; Hong, Cheng William; Mazilu, Dumitru; Sharma, Karun; Venkatesan, Aradhana M.; Levy, Elliot; Wood, Bradford J.

    2013-03-01

    In interventional radiology, various navigation technologies have emerged aiming to improve the accuracy of device deployment and potentially the clinical outcomes of minimally invasive procedures. While these technologies' performance has been explored extensively, their impact on daily clinical practice remains undetermined due to the additional cost and complexity, modification of standard devices (e.g. electromagnetic tracking), and different levels of experience among physicians. Taking these factors into consideration, a robotic laser guidance system for percutaneous needle placement is developed. The laser guidance system projects a laser guide line onto the skin entry point of the patient, helping the physician to align the needle with the planned path of the preoperative CT scan. To minimize changes to the standard workflow, the robot is integrated with the CT scanner via optical tracking. As a result, no registration between the robot and CT is needed. The robot can compensate for the motion of the equipment and keep the laser guide line aligned with the biopsy path in real-time. Phantom experiments showed that the guidance system can benefit physicians at different skill levels, while clinical studies showed improved accuracy over conventional freehand needle insertion. The technology is safe, easy to use, and does not involve additional disposable costs. It is our expectation that this technology can be accepted by interventional radiologists for CT guided needle placement procedures.

  1. Guidance on accidents involving radioactivity

    International Nuclear Information System (INIS)

    This annex contains advice to Health Authorities on their response to accidents involving radioactivity. The guidance is in six parts:-(1) planning the response required to nuclear accidents overseas, (2) planning the response required to UK nuclear accidents a) emergency plans for nuclear installations b) nuclear powered satellites, (3) the handling of casualties contaminated with radioactive substances, (4) background information for dealing with queries from the public in the event of an accident, (5) the national arrangements for incident involving radioactivity (NAIR), (6) administrative arrangements. (author)

  2. A Parent-Mediated Intervention to Increase Responsive Parental Behaviors and Child Communication in Children with ASD: A Randomized Clinical Trial

    Science.gov (United States)

    Siller, Michael; Hutman, Ted; Sigman, Marian

    2013-01-01

    Longitudinal research has demonstrated that responsive parental behaviors reliably predict subsequent language gains in children with autism spectrum disorder. To investigate the underlying causal mechanisms, we conducted a randomized clinical trial of an experimental intervention (Focused Playtime Intervention, FPI) that aims to enhance…

  3. Parent-child relationship disorders. Part II. The vulnerable child syndrome and its relation to parental overprotection.

    Science.gov (United States)

    Thomasgard, M; Shonkoff, J P; Metz, W P; Edelbrock, C

    1995-08-01

    Parents who are excessively concerned about their child's health are often characterized as being overprotective. We hypothesized that parental overprotection is independent of parental perception of child vulnerability to illness or injury despite their presumed interchangeability. A community-based sample of 892 parents (92% white, 84% married, 88% middle-upper socioeconomic status, 90% mothers) completed a three-part protocol (clinical background data, the Child Vulnerability Scale, and the Parent Protection Scale). Correlates of high parental perception of child vulnerability included a medical condition in the child, a history of life-threatening illness or injury, and the child being seen for a sick visit. Correlates of high parental overprotection included younger age of child and parent. Only 20% of those parents who considered their child vulnerable were also considered overprotective. PMID:7593660

  4. Clinical study on Reduning injection and antibiotic treatment with the care and guidance of 64 cases with acute purulent tonsillitis%热毒宁联合抗生素配合护理指导治疗64例急性化脓性扁桃体炎的临床研究

    Institute of Scientific and Technical Information of China (English)

    杨丽; 谢娅琳; 贺萌

    2012-01-01

      目的观察热毒宁联合抗生素配合护理指导治疗急性化脓性扁桃体炎的临床疗效.方法将64例急性化脓性扁桃体炎患者随机的分成两组.对照组32例,予以常规补液及抗生素(均为青霉素或头孢类)治疗;治疗组32例,在对照组西医治疗的基础上,加用热毒宁注射液静滴治疗,同时结合护理指导.结果治疗组和对照组总有效率分别为93.75%和78.13%,两组比较,差异有统计学意义(P <0.05).结论热毒宁联合抗生素配合护理指导对急性化脓性扁桃体炎的治疗具有显著的疗效.%  Objective To observe Reduning injection and antibiotic treatment with the care and guidance with acute purulent tonsillitis in clinical efficacy studies. Methods 64 patients with acute purulent tonsillitis were randomly divided into 2 groups. Control group of 32 patients,to conventional rehydration and antibiotics (penicillin or cephalosporins) treatment;treatment group,32 patients in the control group on the basis of Western medicine therapy,plus intravenous infusion of Reduning Injection treatment,combined with care and guidance. Results The total effective rates of treatment group and control group were 93.75% and 78.13%, the difference between the two groups was significant difference (P <0.05). Conclusion Reduning injection and antibiotic treatment with the care and guidance on the treatment of acute suppurative tonsillitis have a significant effect.

  5. Hands-Free System for Bronchoscopy Planning and Guidance.

    Science.gov (United States)

    Khare, Rahul; Bascom, Rebecca; Higgins, William E

    2015-12-01

    Bronchoscopy is a commonly used minimally invasive procedure for lung-cancer staging. In standard practice, however, physicians differ greatly in their levels of performance. To address this concern, image-guided intervention (IGI) systems have been devised to improve procedure success. Current IGI bronchoscopy systems based on virtual bronchoscopic navigation (VBN), however, require involvement from the attending technician. This lessens physician control and hinders the overall acceptance of such systems. We propose a hands-free VBN system for planning and guiding bronchoscopy. The system introduces two major contributions. First, it incorporates a new procedure-planning method that automatically computes airway navigation plans conforming to the physician's bronchoscopy training and manual dexterity. Second, it incorporates a guidance strategy for bronchoscope navigation that enables user-friendly system control via a foot switch, coupled with a novel position-verification mechanism. Phantom studies verified that the system enables smooth operation under physician control, while also enabling faster navigation than an existing technician-assisted VBN system. In a clinical human study, we noted a 97% bronchoscopy navigation success rate, in line with existing VBN systems, and a mean guidance time per diagnostic site = 52 s. This represents a guidance time often nearly 3 min faster per diagnostic site than guidance times reported for other technician-assisted VBN systems. Finally, an ergonomic study further asserts the system's acceptability to the physician and long-term potential.

  6. Reducing lost to follow-up in a large clinical trial of prevention of mother-to-child transmission of HIV: The Breastfeeding, Antiretrovirals and Nutrition (BAN) study experience

    Science.gov (United States)

    Sellers, Christopher J; Lee, Hana; Chasela, Charles; Kayira, Dumbani; Soko, Alice; Mofolo, Innocent; Ellington, Sascha; Hudgens, Michael G; Kourtis, Athena P; King, Caroline C; Jamieson, Denise J; van der Horst, Charles

    2014-01-01

    Background/Aims Retaining patients in prevention of mother-to-child transmission of HIV studies can be challenging in resource limited settings, where high lost to follow-up (LTFU) rates have been reported. In this paper, we describe the effectiveness of methods used to encourage retention in the Breastfeeding, Antiretrovirals, and Nutrition (BAN) study and analyze factors associated with LTFU in the study. Methods The BAN clinical trial was designed to evaluate the efficacy of 3 different mother-to-child HIV transmission prevention strategies. Lower than expected participant retention prompted enhanced efforts to reduce LTFU during the conduct of the trial. Following study completion, we employed regression modeling to determine predictors of perfect attendance and variables associated with being LTFU. Results During the study, intensive tracing efforts were initiated after the first 1686 mother-infant pairs had been enrolled, and 327 pairs were missing. Sixty of these pairs were located and had complete data obtained. Among the 683 participants enrolling after initiation of intensive tracing efforts, the LTFU rate was 3.4%. At study's end, 290 (12.2%) of the 2369 mother-infant pairs were LTFU. Among successfully traced missing pairs, relocation was common and three were deceased. Log-binomial regression modeling revealed higher maternal hemoglobin and older maternal age to be significant predictors of perfect attendance. These factors and the presence of food insecurity were also significantly associated with lower rates of LTFU. Conclusions In this large HIV prevention trial, intensive tracing efforts centered on reaching study participants at their homes succeeded in finding a substantial proportion of LTFU participants, and were very effective in preventing further LTFU during the remainder of the trial. The association between food insecurity and lower rates of LTFU is likely related to the study's provision of nutritional support, including a family maize

  7. WHO 2010 guidelines for prevention of mother-to-child HIV transmission in Zimbabwe: modeling clinical outcomes in infants and mothers.

    Directory of Open Access Journals (Sweden)

    Andrea L Ciaranello

    Full Text Available BACKGROUND: The Zimbabwean national prevention of mother-to-child HIV transmission (PMTCT program provided primarily single-dose nevirapine (sdNVP from 2002-2009 and is currently replacing sdNVP with more effective antiretroviral (ARV regimens. METHODS: Published HIV and PMTCT models, with local trial and programmatic data, were used to simulate a cohort of HIV-infected, pregnant/breastfeeding women in Zimbabwe (mean age 24.0 years, mean CD4 451 cells/µL. We compared five PMTCT regimens at a fixed level of PMTCT medication uptake: 1 no antenatal ARVs (comparator; 2 sdNVP; 3 WHO 2010 guidelines using "Option A" (zidovudine during pregnancy/infant NVP during breastfeeding for women without advanced HIV disease; lifelong 3-drug antiretroviral therapy (ART for women with advanced disease; 4 WHO "Option B" (ART during pregnancy/breastfeeding without advanced disease; lifelong ART with advanced disease; and 5 "Option B+:" lifelong ART for all pregnant/breastfeeding, HIV-infected women. Pediatric (4-6 week and 18-month infection risk, 2-year survival and maternal (2- and 5-year survival, life expectancy from delivery outcomes were projected. RESULTS: Eighteen-month pediatric infection risks ranged from 25.8% (no antenatal ARVs to 10.9% (Options B/B+. Although maternal short-term outcomes (2- and 5-year survival varied only slightly by regimen, maternal life expectancy was reduced after receipt of sdNVP (13.8 years or Option B (13.9 years compared to no antenatal ARVs (14.0 years, Option A (14.0 years, or Option B+ (14.5 years. CONCLUSIONS: Replacement of sdNVP with currently recommended regimens for PMTCT (WHO Options A, B, or B+ is necessary to reduce infant HIV infection risk in Zimbabwe. The planned transition to Option A may also improve both pediatric and maternal outcomes.

  8. A systematic approach to implementing and evaluating clinical guidelines: The results of fifteen years of Preventive Child Health Care guidelines in the Netherlands.

    Science.gov (United States)

    Fleuren, Margot A H; van Dommelen, Paula; Dunnink, Trudy

    2015-07-01

    Preventive Child Health Care (PCHC) services are delivered to all children in the Netherlands by approximately 5500 doctors, nurses and doctor's assistants. In 1996, The Dutch Ministry of Health, Welfare and Sports asked for the development of evidence-based PCHC guidelines. Since 1998, twenty-five guidelines have been published. Levels of implementation affect outcomes and so implementation and evaluation of the actual use of guidelines are essential. At the outset, there was a national implementation plan with six main activities: a) determinant analysis before the implementation of a guideline, b) innovation strategies tailored to the determinants, c) dissemination to all professionals, d) ongoing evaluation of the awareness and use of the guidelines, e) trained implementation coordinator(s) in each PCHC organization and f) a national help desk. The awareness and use of the guidelines in random samples of doctors, nurses and doctor's assistants were surveyed using questionnaires. The respondents stated (on a 7-point scale) the proportion of all children they had exposed to given core elements in a guideline. The aim is for at least 90% of the professionals to be aware of the guideline and for 80% to perform the core elements for all (or nearly all) children. The six main activities, with the exception of ongoing evaluation, were gradually put into place, albeit only gradually, between 1998 and 2015 for all guidelines. In 2012, the use of individual core elements in all guidelines, dating from before 2012, varied from 28% to 100%. One guideline met both criteria of 90% awareness and 80% use, and three guidelines nearly met these criteria. Looking back on fifteen years of PCHC guidelines, we may conclude that the guidelines produced recently are implemented in accordance with the national implementation plan. Unfortunately, the evaluation of guideline use continues to be a difficulty. PMID:25982867

  9. Diagnostic imaging in child abuse

    International Nuclear Information System (INIS)

    Diagnostic imaging in child abuse plays an important role and includes the depiction of skeletal injuries, soft tissue lesions, visceral injuries in ''battered child syndrome'' and brain injuries in ''shaken baby syndrome''. The use of appropriate imaging modalities allows specific fractures to be detected, skeletal lesions to be dated and the underlying mechanism of the lesion to be described. The imaging results must be taken into account when assessing the clinical history, clinical findings and differential diagnoses. Computed tomography (CT) and magnetic resonance imaging (MRI) examinations must be performed in order to detect lesions of the central nervous system (CNS) immediately. CT is necessary in the initial diagnosis to delineate oedema and haemorrhages. Early detection of brain injuries in children with severe neurological symptoms can prevent serious late sequelae. MRI is performed in follow-up investigations and is used to describe residual lesions, including parenchymal findings. (orig.)

  10. 舍曲林治疗儿童情绪障碍的临床观察%Clinical observation of sertraline in treatment of child emotional disorder

    Institute of Scientific and Technical Information of China (English)

    杨凤美; 贾美香

    2011-01-01

    目的 了解舍曲林在儿童情绪障碍治疗中的有效性、安全性、起效时间及有效剂量.方法 对147例应用舍曲林治疗的儿童情绪障碍患儿进行回顾性分析,项目包括有效率、舍曲林用量、起效时间及不良反应.结果 137例患儿遵医嘱定期复诊.治疗后2个月,有效率为80.3%(110/137),不良反应发生率为5.8%(8/137).舍曲林有效剂量为(47.9±19.0)mg/d,起效时间为(20.4±13.2)d;儿童强迫症舍曲林有效剂量[(58.7±26.2)mg/d)]显著高于抑郁障碍[(43.6±14.0)mg/d]、广泛性焦虑障碍[(44.4±10.6)mg/d]及恐怖性焦虑障碍[(43.5±15.5)mg/d](P值均<0.01);抑郁障碍起效时间[(14.0±6.1)d]较儿童强迫症[(26.6±16.3)d]、广泛性焦虑障碍[(22.3±13.9)d]和恐怖性焦虑障碍[(21.4±12.8)d]短(P值均<0.01).结论 舍曲林是治疗儿童情绪障碍的有效药物,起效时间在2~3周,不良反应轻,多数患儿能耐受.对抑郁障碍起效较快,对儿童强迫症有效剂量较大.%Objective To explore the efficacy, safety,time of drug taking effect and therapeutic dosage of sertraline in treatment of child emotional disorder. Method One hundred and forty-seven patientswith child emotional disorder were treated by sertraline and the efficacy rate, therapeutic dosage, the time of drug taking effect and adverse reaction was analyzed retrospectively. Results One hundred and thirty-seven patients were regular visited under supervision of a physician. Two months after treatment, the efficacy rate was 80.3%(110/137) and the rate of adverse reaction was 5.8%(8/137). The therapeutic dosage of sertraline was (47.9 + 19.0) mg/d. The time of drug taking effect was (20.4±13.2) d. The therapeutic dosage of sertraline in obsessive-compulsive disorder [(58.7±26.2) mg/d] was significantly higher than that in depression[(43.6±14.0) mg/d],anxiety disorder[(44.4±10.6) mg/d] and phobia[(43.5±15.5) mg/d](P < 0.01 ). The time of drug taking effect in depression[( 14.0±6

  11. The clinical study of percutaneous renal biopsy by automatic gun under real time color doppler ultrasound guidance%彩色多普勒超声引导下经皮肾活检术的临床应用

    Institute of Scientific and Technical Information of China (English)

    席春生; 李亚妹; 王谨涵; 关怀; 李芸; 高健; 刘冬梅; 张萌

    2013-01-01

    目的探讨彩色多普勒超声引导下斜角进针经皮肾穿刺活检术的安全性和成功率及其影响因素。方法回顾分析了兰州军区兰州总医院226例经临床诊断的慢性肾脏病患者在彩色多普勒超声引导下用美国BARD MAGNUM自动活检枪斜角进针行经皮肾穿刺活检术,对影响穿刺成功率的有关因素进行分析,并与普通超声引导下经皮肾活检术对比。结果穿刺成功222例,成功率为98.4%,有4例未取得足够病理诊断的肾组织标本,活检标本长度为(10.5±4.5)mm,获取肾小球数目为(16.7±6.3)个。本研究中所有病例均未发现严重并发症。肉眼血尿发生率为0.4%(1/226),肾周血肿发生率0.9%(2/226)。在获取肾小球数目和穿刺成功率与文献报道一致,而术后并发症方面,明显低于文献报道。结论彩色多普勒超声引导下斜角进针经皮肾活检术成功率高,并发症少,值得进一步观察和推广。%Objective To investigate the safety and efficacy of color doppler ultrasound-guided renal biopsy using an automated biopsy gun, analysis the related risk factor. Methods The retrospective analysis method were used. Two hundred twenty-six patients with proveded chronic kidney diseases admited Lanzhou General Hospital were performed renal biopsy using an automated BARD biopsy gun made in America. The successful rate and complications were analyzed, and compared with common ultrasound guidance. Results Adequate renal tissue for histologic diagnosis was obtained by BARD MAGNUM biopsy gun was 98.4% of the patients, the average length of renal tissue sample was(10.5±4.5) milimeter, the average number of glomeruli was(16.7±6.3), the rate of gross hematuria was 0.4%. The total of complication was 0.9%(2/226). Conclusion Ultrasound guided percutanous renal biopsy with BARD MAGNUM automated biopsy gun is a kind of safe and accurate method of performing renal biopsy for kidney disease.

  12. Flight Guidance System Requirements Specification

    Science.gov (United States)

    Miller, Steven P.; Tribble, Alan C.; Carlson, Timothy M.; Danielson, Eric J.

    2003-01-01

    This report describes a requirements specification written in the RSML-e language for the mode logic of a Flight Guidance System of a typical regional jet aircraft. This model was created as one of the first steps in a five-year project sponsored by the NASA Langley Research Center, Rockwell Collins Inc., and the Critical Systems Research Group of the University of Minnesota to develop new methods and tools to improve the safety of avionics designs. This model will be used to demonstrate the application of a variety of methods and techniques, including safety analysis of system and subsystem requirements, verification of key properties using theorem provers and model checkers, identification of potential sources mode confusion in system designs, partitioning of applications based on the criticality of system hazards, and autogeneration of avionics quality code. While this model is representative of the mode logic of a typical regional jet aircraft, it does not describe an actual or planned product. Several aspects of a full Flight Guidance System, such as recovery from failed sensors, have been omitted, and no claims are made regarding the accuracy or completeness of this specification.

  13. 76 FR 20689 - Guidance for Industry on Influenza: Developing Drugs for Treatment and/or Prophylaxis; Availability

    Science.gov (United States)

    2011-04-13

    ...The Food and Drug Administration (FDA) is announcing the availability of a guidance for industry entitled ``Influenza: Developing Drugs for Treatment and/or Prophylaxis.'' This guidance is intended to assist sponsors in the clinical development of drugs and therapeutic biological products for the treatment and/or prophylaxis of illness caused by influenza viruses A and B, including both......

  14. 临床药师参与1例难治性哮喘患儿治疗的药学实践%Pharmacy practice of clinical pharmacist participating in the treatment of 1 child with refractory asthma

    Institute of Scientific and Technical Information of China (English)

    沙美娟

    2014-01-01

    To investigate the pharmaceutical care key points of clinical pharmacist participating in the treatment of child with refractory asthma, in order to guide clinical rational drug use. Clinical pharmacist took part in the treatment process of refractory asthma, so as to analyze pathogenesis of refractory asthma and explore the relation between medicine, dose and curative effect for formulating rational use of drug and dose. Clinical effects and condition changes of disease were needed to be considered for adjusting pharmacy scheme timely, and providing individualized pharmacy service. Through joining the pharmaceutical care for refractory asthma, clinical pharmacist could enhance safety and curative effect of pharmacy for children. The participation of clinical pharmacist in formulation of treating refractory asthma can make the treatment become standard and rational, and provide reference for the control and treatment of refractory asthma.%探讨临床药师参与难治性哮喘患儿治疗药学监护要点,以指导临床合理用药。临床药师参与难治性哮喘的治疗过程,分析产生难治性哮喘原因,寻找疗效与药物、剂量与疗效的关系,制定合理药物及合适剂量,并根据药物的临床疗效和病情变化及时调整用药方案,提供个体化的药学服务。临床药师通过对难治性哮喘的药学监护,可提高患儿的用药安全性及治疗效果。临床药师参与难治性哮喘的治疗的制定,使治疗更加规范、合理,为难治性哮喘的控制治疗提供参考。

  15. Child abuse. Diagnostic imaging of skeletal injuries

    International Nuclear Information System (INIS)

    Diagnostic imaging, besides medical history and clinical examination, is a major component in assessment of cases of suspected physical child abuse. Performance of proper imaging technique, and knowledge of specific injury patterns is required for accurate image interpretation by the radiologist, and serves protection of the child in case of proven abuse. On the other side, it is essential to protect the family in unjustified accusations. The reader will be familiarised with essentials of the topic 'Physical child abuse', in order to be able to correctly assess quality, completeness, and results of X-ray films. Moreover, opportunities and limitations of alternative diagnostic modalities will be discussed. (orig.)

  16. Pediatric radiological diagnostics in suspected child abuse

    International Nuclear Information System (INIS)

    Advanced and specialized radiological diagnostics are essential in the case of clinical suspicion of pediatric injuries to the head, thorax, abdomen, and extremities when there is no case history or when ''battered child syndrome'' is assumed on the basis of inadequate trauma. In particular, the aim of this sophisticated diagnostic procedure is the detection of lesions of the central nervous system (CNS) in order to initiate prompt medical treatment. If diagnostic imaging shows typical findings of child abuse, accurate documented evidence of the diagnostic results is required to prevent further endangerment of the child's welfare. (orig.)

  17. Glutamine supplementation in a child with inherited GS deficiency improves the clinical status and partially corrects the peripheral and central amino acid imbalance

    Directory of Open Access Journals (Sweden)

    Häberle Johannes

    2012-07-01

    Full Text Available Abstract Glutamine synthetase (GS is ubiquitously expressed in mammalian organisms and is a key enzyme in nitrogen metabolism. It is the only known enzyme capable of synthesising glutamine, an amino acid with many critical roles in the human organism. A defect in GLUL, encoding for GS, leads to congenital systemic glutamine deficiency and has been described in three patients with epileptic encephalopathy. There is no established treatment for this condition. Here, we describe a therapeutic trial consisting of enteral and parenteral glutamine supplementation in a four year old patient with GS deficiency. The patient received increasing doses of glutamine up to 1020 mg/kg/day. The effect of this glutamine supplementation was monitored clinically, biochemically, and by studies of the electroencephalogram (EEG as well as by brain magnetic resonance imaging and spectroscopy. Treatment was well tolerated and clinical monitoring showed improved alertness. Concentrations of plasma glutamine normalized while levels in cerebrospinal fluid increased but remained below the lower reference range. The EEG showed clear improvement and spectroscopy revealed increasing concentrations of glutamine and glutamate in brain tissue. Concomitantly, there was no worsening of pre-existing chronic hyperammonemia. In conclusion, supplementation of glutamine is a safe therapeutic option for inherited GS deficiency since it corrects the peripheral biochemical phenotype and partially also improves the central biochemical phenotype. There was some clinical improvement but the patient had a long standing severe encephalopathy. Earlier supplementation with glutamine might have prevented some of the neuronal damage.

  18. Glutamine supplementation in a child with inherited GS deficiency improves the clinical status and partially corrects the peripheral and central amino acid imbalance.

    Science.gov (United States)

    Häberle, Johannes; Shahbeck, Noora; Ibrahim, Khalid; Schmitt, Bernhard; Scheer, Ianina; O'Gorman, Ruth; Chaudhry, Farrukh A; Ben-Omran, Tawfeg

    2012-07-25

    Glutamine synthetase (GS) is ubiquitously expressed in mammalian organisms and is a key enzyme in nitrogen metabolism. It is the only known enzyme capable of synthesising glutamine, an amino acid with many critical roles in the human organism. A defect in GLUL, encoding for GS, leads to congenital systemic glutamine deficiency and has been described in three patients with epileptic encephalopathy. There is no established treatment for this condition.Here, we describe a therapeutic trial consisting of enteral and parenteral glutamine supplementation in a four year old patient with GS deficiency. The patient received increasing doses of glutamine up to 1020 mg/kg/day. The effect of this glutamine supplementation was monitored clinically, biochemically, and by studies of the electroencephalogram (EEG) as well as by brain magnetic resonance imaging and spectroscopy.Treatment was well tolerated and clinical monitoring showed improved alertness. Concentrations of plasma glutamine normalized while levels in cerebrospinal fluid increased but remained below the lower reference range. The EEG showed clear improvement and spectroscopy revealed increasing concentrations of glutamine and glutamate in brain tissue. Concomitantly, there was no worsening of pre-existing chronic hyperammonemia.In conclusion, supplementation of glutamine is a safe therapeutic option for inherited GS deficiency since it corrects the peripheral biochemical phenotype and partially also improves the central biochemical phenotype. There was some clinical improvement but the patient had a long standing severe encephalopathy. Earlier supplementation with glutamine might have prevented some of the neuronal damage.

  19. Collective cell migration: guidance principles and hierarchies.

    Science.gov (United States)

    Haeger, Anna; Wolf, Katarina; Zegers, Mirjam M; Friedl, Peter

    2015-09-01

    Collective cell migration results from the establishment and maintenance of collective polarization, mechanocoupling, and cytoskeletal kinetics. The guidance of collective cell migration depends on a reciprocal process between cell-intrinsic multicellular organization with leader-follower cell behavior and results in mechanosensory integration of extracellular guidance cues. Important guidance mechanisms include chemotaxis, haptotaxis, durotaxis, and strain-induced mechanosensing to move cell groups along interfaces and paths of least resistance. Additional guidance mechanisms steering cell groups during specialized conditions comprise electrotaxis and passive drift. To form higher-order cell and tissue structures during morphogenesis and cancer invasion, these guidance principles act in parallel and are integrated for collective adaptation to and shaping of varying tissue environments. We review mechanochemical and electrical inputs and multiparameter signal integration underlying collective guidance, decision making, and outcome. PMID:26137890

  20. Optimal terminal guidance for exoatmospheric interception

    Institute of Scientific and Technical Information of China (English)

    Yu Wenbin; Chen Wanchun; Yang Liang; Liu Xiaoming; Zhou Hao

    2016-01-01

    In this study, two optimal terminal guidance (OTG) laws, one of which takes into account the final velocity vector constraint, are developed for exoatmospheric interception using optimal control theory. In exoatmospheric interception, because the proposed guidance laws give full consideration to the effect of gravity, they consume much less fuel than the traditional guidance laws while requiring a light computational load. In the development of the guidance laws, a unified optimal guidance problem is put forward, where the final velocity vector constraint can be consid-ered or neglected by properly adjusting a parameter in the cost function. To make this problem ana-lytically solvable, a linear model is used to approximate the gravity difference, the difference of the gravitational accelerations of the target and interceptor. Additionally, an example is provided to show that some achievements of this study can be used to significantly improve the fuel efficiency of the pulsed guidance employed by the interceptor whose divert thrust level is fixed.

  1. Child abuse in panic disorder

    OpenAIRE

    Bonevski Dimitar; Novotni Antoni

    2008-01-01

    Introduction Numerous authors associate child abuse with serious long-term consequences to the general and psychological well-being in particular. Clinical research to date reveals strong correlation between childhood abuse and neglect and anxiety disorders, especially panic disorder. Material and Methods This study was conducted in order to assess the level of emotional, physical and sexual childhood abuse as well as the physical and emotional childhood neglect in 40 adult patients suffering...

  2. Practicing from Theory: Thinking and Knowing to “Do” Child Protection Work

    Directory of Open Access Journals (Sweden)

    Susan Young

    2014-11-01

    Full Text Available Child protection practice in much of the Western world is performed using some specific models with limited attention paid to the underpinning of informing worldviews, theories for practice (explanatory theories and theories of practice (intervention theories. Over the past few years we have explored how child protection practice may be undertaken using a child rights perspective and community development principles and practices. From this we have developed a model which we here seek to support with worldviews, explanatory and intervention theories. We hope this theoretical framework answers some of the complexity found in the “wicked problem” of child abuse and provides guidance to the practice of protecting children.

  3. Do improvements in outreach, clinical, and family and community-based services predict improvements in child survival? An analysis of serial cross-sectional national surveys

    Directory of Open Access Journals (Sweden)

    Simen-Kapeu Aline

    2011-06-01

    Full Text Available Abstract Background There are three main service delivery channels: clinical services, outreach, and family and community. To determine which delivery channels are associated with the greatest reductions in under-5 mortality rates (U5MR, we used data from sequential population-based surveys to examine the correlation between changes in coverage of clinical, outreach, and family and community services and in U5MR for 27 high-burden countries. Methods Household survey data were abstracted from serial surveys in 27 countries. Average annual changes (AAC between the most recent and penultimate survey were calculated for under-five mortality rates and for 22 variables in the domains of clinical, outreach, and family- and community-based services. For all 27 countries and a subset of 19 African countries, we conducted principal component analysis to reduce the variables into a few components in each domain and applied linear regression to assess the correlation between changes in the principal components and changes in under-five mortality rates after controlling for multiple potential confounding factors. Results AAC in under 5-mortality varied from 6.6% in Nepal to -0.9% in Kenya, with six of the 19 African countries all experiencing less than a 1% decline in mortality. The strongest correlation with reductions in U5MR was observed for access to clinical services (all countries: p = 0.02, r2 = 0.58; 19 African countries p 2 = 0.67. For outreach activities, AAC U5MR was significantly correlated with antenatal care and family planning services, while AAC in immunization services showed no association. In the family- and community services domain, improvements in breastfeeding were associated with significant changes in mortality in the 30 countries but not in the African subset; while in the African countries, nutritional status improvements were associated with a significant decline in mortality. Conclusions Our findings support the importance of

  4. Health Service use of ionising radiations: Guidance

    International Nuclear Information System (INIS)

    This booklet gives outline guidance on the use of ionising radiations in the Health Service in the United Kingdom. Extensive reference is made to documents where more detailed information may be found. The guidance covers general advice on the medical use of ionising radiations, statutory requirements, and guidance on selected Health Service issues such as patient identification procedures, information management systems, deviations from prescribed radiation dose, imaging and radiotherapy. (57 references) (U.K.)

  5. StaR Child Health: improving global standards for child health research.

    Science.gov (United States)

    Offringa, Martin; Needham, Allison C; Chan, Winnie W Y

    2013-11-01

    Standards for Research (StaR) in Child Health, founded in 2009, addresses the current scarcity of and deficiencies in pediatric clinical trials. StaR Child Health brings together leading international experts devoted to developing practical, evidence-based standards to enrich the reliability and relevance of pediatric clinical research. Through a systematic "knowledge to action" plan, StaR Child Health creates opportunities to improve the evidence base for child health across the world. To date, six standards have been published and four more are under development. It is now time to use these standards. Improving the design, conduct and reporting of pediatric clinical trials will ultimately advance the quality of health care provided to children across the globe.

  6. SU-E-J-185: A Systematic Review of Breathing Guidance in Radiation Oncology and Radiology

    Energy Technology Data Exchange (ETDEWEB)

    Pollock, S; Keall, P [University of Sydney, Sydney (Australia); Keall, R [Hammond Care Palliative and Supportive Care Service, Sydney, NSW (Australia)

    2015-06-15

    Purpose: The advent of image-guided radiation therapy (IGRT) has led to dramatic improvements in the accuracy of treatment delivery in radiotherapy. Such advancements have highlighted the deleterious impact tumor motion can have on both image quality and radiation treatment delivery. One approach to reducing tumor motion is the use of breathing guidance systems during imaging and treatment. A review of such research had not yet been performed, it was therefore our aim to perform a systematic review of breathing guidance interventions within the fields of radiation oncology and radiology. Methods: Results of online database searches were filtered in accordance to a set of eligibility criteria. The search, filtration, and analysis of articles were conducted in accordance with the PRISMAStatement reporting standard (Preferred Reporting Items for Systematic reviews and Meta-Analyses) utilizing the PICOS approach (Participants, Intervention, Comparison, Outcome, Study design). Participants: Cancer patients, healthy volunteers. Intervention: Biofeedback breathing guidance systems. Comparison: No breathing guidance of the same breathing type. Outcome: Regularity of breathing signal and anatomic/tumor motion, medical image quality, radiation treatment margins and coverage, medical imaging and radiation treatment times. Study design: Quantitative and controlled prospective or retrospective trials. Results: The systematic search yielded a total of 479 articles, which were filtered down to 27 relevant articles in accordance to the eligibility criteria. The vast majority of investigated outcomes were significantly positively impacted by the use of breathing guidance; however, this was dependent upon the nature of the breathing guidance system and study design. In 25/27 studies significant improvements from the use of breathing guidance were observed. Conclusion: The results found here indicate that further clinical studies are warranted which quantify more comprehensively the

  7. SU-E-J-185: A Systematic Review of Breathing Guidance in Radiation Oncology and Radiology

    International Nuclear Information System (INIS)

    Purpose: The advent of image-guided radiation therapy (IGRT) has led to dramatic improvements in the accuracy of treatment delivery in radiotherapy. Such advancements have highlighted the deleterious impact tumor motion can have on both image quality and radiation treatment delivery. One approach to reducing tumor motion is the use of breathing guidance systems during imaging and treatment. A review of such research had not yet been performed, it was therefore our aim to perform a systematic review of breathing guidance interventions within the fields of radiation oncology and radiology. Methods: Results of online database searches were filtered in accordance to a set of eligibility criteria. The search, filtration, and analysis of articles were conducted in accordance with the PRISMAStatement reporting standard (Preferred Reporting Items for Systematic reviews and Meta-Analyses) utilizing the PICOS approach (Participants, Intervention, Comparison, Outcome, Study design). Participants: Cancer patients, healthy volunteers. Intervention: Biofeedback breathing guidance systems. Comparison: No breathing guidance of the same breathing type. Outcome: Regularity of breathing signal and anatomic/tumor motion, medical image quality, radiation treatment margins and coverage, medical imaging and radiation treatment times. Study design: Quantitative and controlled prospective or retrospective trials. Results: The systematic search yielded a total of 479 articles, which were filtered down to 27 relevant articles in accordance to the eligibility criteria. The vast majority of investigated outcomes were significantly positively impacted by the use of breathing guidance; however, this was dependent upon the nature of the breathing guidance system and study design. In 25/27 studies significant improvements from the use of breathing guidance were observed. Conclusion: The results found here indicate that further clinical studies are warranted which quantify more comprehensively the

  8. Child Abuse in India

    OpenAIRE

    Mohammad Reza Iravani

    2011-01-01

    Child abuse is harm to, or neglect of, a child by another person, whether adult or child. Child abuse happens in all cultural, ethnic, and income groups. Child abuse can be physical, emotional - verbal, sexual or through neglect. Abuse may cause serious injury to the child and may even result in death. A problem that is only beginning to come into light in India rape, sexual abuse, and sexual harassment are worldwide issues of gender violence. There is very little research done in this area i...

  9. National Child Abuse and Neglect Data System (NCANDS) Child File

    Data.gov (United States)

    U.S. Department of Health & Human Services — The National Child Abuse and Neglect Data System (NCANDS) Child File data set consists of child-specific data of all reports of maltreatment to State child...

  10. Triple-antiretroviral prophylaxis to prevent mother-to-child HIV transmission through breastfeeding--the Kisumu Breastfeeding Study, Kenya: a clinical trial.

    Directory of Open Access Journals (Sweden)

    Timothy K Thomas

    2011-03-01

    Full Text Available BACKGROUND: Effective strategies are needed for the prevention of mother-to-child HIV transmission (PMTCT in resource-limited settings. The Kisumu Breastfeeding Study was a single-arm open label trial conducted between July 2003 and February 2009. The overall aim was to investigate whether a maternal triple-antiretroviral regimen that was designed to maximally suppress viral load in late pregnancy and the first 6 mo of lactation was a safe, well-tolerated, and effective PMTCT intervention. METHODS AND FINDINGS: HIV-infected pregnant women took zidovudine, lamivudine, and either nevirapine or nelfinavir from 34-36 weeks' gestation to 6 mo post partum. Infants received single-dose nevirapine at birth. Women were advised to breastfeed exclusively and wean rapidly just before 6 mo. Using Kaplan-Meier methods we estimated HIV-transmission and death rates from delivery to 24 mo. We compared HIV-transmission rates among subgroups defined by maternal risk factors, including baseline CD4 cell count and viral load. Among 487 live-born, singleton, or first-born infants, cumulative HIV-transmission rates at birth, 6 weeks, and 6, 12, and 24 mo were 2.5%, 4.2%, 5.0%, 5.7%, and 7.0%, respectively. The 24-mo HIV-transmission rates stratified by baseline maternal CD4 cell count <500 and ≥500 cells/mm(3 were 8.4% (95% confidence interval [CI] 5.8%-12.0% and 4.1% (1.8%-8.8%, respectively (p = 0.06; the corresponding rates stratified by baseline maternal viral load <10,000 and ≥10,000 copies/ml were 3.0% (1.1%-7.8% and 8.7% (6.1%-12.3%, respectively (p = 0.01. None of the 12 maternal and 51 infant deaths (including two second-born infants were attributed to antiretrovirals. The cumulative HIV-transmission or death rate at 24 mo was 15.7% (95% CI 12.7%-19.4%. CONCLUSIONS: This trial shows that a maternal triple-antiretroviral regimen from late pregnancy through 6 months of breastfeeding for PMTCT is safe and feasible in a resource-limited setting. These

  11. Hybrid Guidance System for Relative Navigation Project

    Data.gov (United States)

    National Aeronautics and Space Administration — Future NASA architectures and missions will involve many distributed platforms that must work together. This in turn requires guidance, navigation and control...

  12. Sex inequality, high transport costs, and exposed clinic location: reasons for loss to follow-up of clients under prevention of mother-to-child HIV transmission in eastern Uganda – a qualitative study

    Directory of Open Access Journals (Sweden)

    Lubega M

    2013-05-01

    Full Text Available Muhamadi Lubega,1–4 Ibrahim A Musenze,3 Gukiina Joshua,2 George Dhafa,2 Rose Badaza,3 Christopher J Bakwesegha,3 Steven J Reynolds41District Health Office, Iganga District Administration, Iganga, Uganda; 2Research Institute, 3School of Graduate Studies and Research, Busoga University, Iganga, Uganda; 4National Institutes of Health/NIAID-ICER American Embassy, Kampala, UgandaBackground: In Iganga, Uganda, 45% of women who tested HIV-positive during antenatal care between 2007 and 2010 were lost to follow-up (LTFU. We explored reasons for LTFU during prevention of mother-to-child transmission (PMTCT from a client perspective in eastern Uganda, where antiretroviral therapy (ART awareness is presumably high.Methods: Seven key informant interviews and 20 in-depth interviews, including both clients who had been retained under PMTCT care and those LTFU during PMTCT were held. Ten focus-group discussions involving a total of 112 participants were also conducted with caretakers/relatives of the PMTCT clients. Content analysis was performed to identify recurrent themes.Results: Our findings indicate that LTFU during PMTCT in eastern Uganda was due to sex inequality, high transport costs to access the services, inadequate posttest counseling, lack of HIV status disclosure, and the isolated/exposed location of the ART clinic, which robs the clients of their privacy.Conclusion: There is a need for approaches that empower women with social capital, knowledge, and skills to influence health-seeking practices. There is also a need to train low-ranking staff and take PMTCT services closer to the clients at the lower-level units to make them affordable and accessible to rural clients. Posttest counseling should be improved to enable PMTCT clients to appreciate the importance of PMTCT services through increasing the number of staff in antenatal care to match the client numbers for improved quality. The counseling should emphasize HIV status disclosure to

  13. Adaptive Guidance based on Context Profile for Software Process Modeling

    Directory of Open Access Journals (Sweden)

    Hamid Khemissa

    2012-07-01

    Full Text Available This paper aims to define an adaptive guidance for software process modeling. The proposed guidance approach is based on development’s profile context (actor’s role in the process, actor’s qualification and related activities in progress. We introduce new guidance concepts through adaptive guidance meta-model (AGM allowing specific assistance interventions (corrective, constructive and automatic guidance. We illustrate our guidance approach using SPEM formalism extended with these new guidance concepts.

  14. High-frequency ultrasound imaging for breast cancer biopsy guidance.

    Science.gov (United States)

    Cummins, Thomas; Yoon, Changhan; Choi, Hojong; Eliahoo, Payam; Kim, Hyung Ham; Yamashita, Mary W; Hovanessian-Larsen, Linda J; Lang, Julie E; Sener, Stephen F; Vallone, John; Martin, Sue E; Kirk Shung, K

    2015-10-01

    Image-guided core needle biopsy is the current gold standard for breast cancer diagnosis. Microcalcifications, an important radiographic finding on mammography suggestive of early breast cancer such as ductal carcinoma in situ, are usually biopsied under stereotactic guidance. This procedure, however, is uncomfortable for patients and requires the use of ionizing radiation. It would be preferable to biopsy microcalcifications under ultrasound guidance since it is a faster procedure, more comfortable for the patient, and requires no radiation. However, microcalcifications cannot reliably be detected with the current standard ultrasound imaging systems. This study is motivated by the clinical need for real-time high-resolution ultrasound imaging of microcalcifications, so that biopsies can be accurately performed under ultrasound guidance. We have investigated how high-frequency ultrasound imaging can enable visualization of microstructures in ex vivo breast tissue biopsy samples. We generated B-mode images of breast tissue and applied the Nakagami filtering technique to help refine image output so that microcalcifications could be better assessed during ultrasound-guided core biopsies. We describe the preliminary clinical results of high-frequency ultrasound imaging of ex vivo breast biopsy tissue with microcalcifications and without Nakagami filtering and the correlation of these images with the pathology examination by hematoxylin and eosin stain and whole slide digital scanning. PMID:26693167

  15. Agent Based Individual Traffic Guidance

    DEFF Research Database (Denmark)

    Wanscher, Jørgen

    This thesis investigates the possibilities in applying Operations Research (OR) to autonomous vehicular traffic. The explicit difference to most other research today is that we presume that an agent is present in every vehicle - hence Agent Based Individual Traffic guidance (ABIT). The next...... evolutionary step for the in-vehicle route planners is the introduction of two-way communication. We presume that the agent is capable of exactly this. Based on this presumption we discuss the possibilities and define a taxonomy and use this to discuss the ABIT system. Based on a set of scenarios we conclude...... that the system can be divided into two separate constituents. The immediate dispersion, which is used for small areas and quick response, and the individual alleviation, which considers the longer distance decision support. Both of these require intrinsicate models and cost functions which at the beginning...

  16. Caregiver-fabricated illness in a child: a manifestation of child maltreatment.

    Science.gov (United States)

    Flaherty, Emalee G; Macmillan, Harriet L

    2013-09-01

    Caregiver-fabricated illness in a child is a form of child maltreatment caused by a caregiver who falsifies and/or induces a child's illness, leading to unnecessary and potentially harmful medical investigations and/or treatment. This condition can result in significant morbidity and mortality. Although caregiver-fabricated illness in a child has been widely known as Munchausen syndrome by proxy, there is ongoing discussion about alternative names, including pediatric condition falsification, factitious disorder (illness) by proxy, child abuse in the medical setting, and medical child abuse. Because it is a relatively uncommon form of maltreatment, pediatricians need to have a high index of suspicion when faced with a persistent or recurrent illness that cannot be explained and that results in multiple medical procedures or when there are discrepancies between the history, physical examination, and health of a child. This report updates the previous clinical report "Beyond Munchausen Syndrome by Proxy: Identification and Treatment of Child Abuse in the Medical Setting" The authors discuss the need to agree on appropriate terminology, provide an update on published reports of new manifestations of fabricated medical conditions, and discuss approaches to assessment, diagnosis, and management, including how best to protect the child from further harm. PMID:23979088

  17. FPG Child Development Institute

    Science.gov (United States)

    ... Development, Teaching, and Learning The Frank Porter Graham Child Development Institute will partner with Zero to Three to ... Education October 4, 2016 More Frank Porter Graham Child Development Institute The University of North Carolina at Chapel ...

  18. Child Dental Health

    Science.gov (United States)

    Healthy teeth are important to your child's overall health. From the time your child is born, there are things you can do to promote healthy teeth and prevent cavities. For babies, you should clean ...

  19. Cholesterol and Your Child

    Science.gov (United States)

    ... Tropical Delight: Melon Smoothie Pregnant? Your Baby's Growth Cholesterol and Your Child KidsHealth > For Parents > Cholesterol and ... child's risk of developing heart disease later. About Cholesterol Cholesterol is a waxy substance produced by the ...

  20. Your Child's Habits

    Science.gov (United States)

    ... or working on a craft. Reward and praise self-control . For example, allow your little girl to use ... Aid: Nosebleeds Obsessive-Compulsive Disorder Teaching Your Child Self-Control Temper Tantrums How Can I Stop My Child ...

  1. Who Owns Child Abuse?

    Directory of Open Access Journals (Sweden)

    Gerald Cradock

    2014-11-01

    Full Text Available Expectations of contemporary child protection apparatuses are strongly influenced by beliefs inherited from the nineteenth century child rescue movement. In particular, the belief that child abuse determination is obvious. However, this assumption fails to make a distinction between nineteenth century’s emphasis on impoverished environments and the twentieth century introduction of the pathological child abuser. Moreover, the proliferation of kinds of child abuse, and the need to distinguish child abusers from non-abusers, means knowledge is now spread across an array of disciplines and professions, which necessarily destabilizes the definition of child abuse. The increasing exposure of alternate care systems as potentially abusive has similarly destabilized the old common sense solution to neglected children—namely removal. Finally, as uncertainty increases, and definitions become more divergent, the question of what child abuse is, and what should be done about it, becomes increasingly politicized.

  2. Child Care Subsidies and Child Development

    Science.gov (United States)

    Herbst, Chris M.; Tekin, Erdal

    2010-01-01

    Child care subsidies are an important part of federal and state efforts to move welfare recipients into employment. One of the criticisms of the current subsidy system, however, is that it overemphasizes work and does little to encourage parents to purchase high-quality child care. Consequently, there are reasons to be concerned about the…

  3. Child-to-Child programme in Malaysia.

    Science.gov (United States)

    Kasim, M S; Abraham, S

    1982-09-01

    Even though Malaysia is a relatively prosperous country amongst the developing nations, it is still be set by problems of a rapidly increasing population. The economic cake is also unevenly distributed and there are pockets of poverty in the slums surrounding the towns as well as in the rural areas. Added to that is the problem of ignorance and superstition especially amongst its adult population. It is due to these problems that the Child-to-Child programme has found special application in Malaysia. The Child-to-Child has been introduced through either the government agencies or the voluntary organizations. Through the Ministry of Education, the concept has found its ways through the schools and the state department of education. The Ministry of Information and Broadcasting has also introduced the concept of Child-to-Child in the media. The voluntary organizations have also introduced the concept of Child-to-Child in their projects. The Sang Kancil project has to some extent used the idea in the running of its activities. The Health and Nutrition Education House have found that by applying the concept and using older children to help in running its activities, its over all objective which is the improvement of the health of the children in the slums could be reached more easily.

  4. What makes a child a 'competent' child?

    Science.gov (United States)

    van Rooyen, Amanda; Water, Tineke; Rasmussen, Shayne; Diesfeld, Kate

    2015-12-01

    Competence is a vital component of the informed consent process. The perceived level of a child's competence may influence their degree of participation in health decisions that affect them. It is the responsibility of the health professional to gauge a child's level of competence. Child competence, however, is not a static attribute that is linked to age. Rather, it is dynamic, changing in nature and dependent on a child's previous experiences, personal attributes, network of relationships around them and cultural and environmental context. Consequently, there is no single verified assessment tool to assist in the recognition of competence for New Zealand children. Adding to this complexity are the unclear interpretations of New Zealand health legislation and policy regarding whether or not a child can legally consent or refuse healthcare advice and treatment without the consent of a legal guardian. Under the Care of Children Act 2004 and the Code of Health and Disability Services Consumers' Rights 1996, the Health and Disability Commissioner states "a child may consent themselves [to health treatment] if and when the child achieves sufficient understanding and maturity to understand fully what is proposed". This paper poses the question: What is 'competency' and how is this decided? For the purpose of this article, 'child' pertains to those under the age of 16 years. PMID:26913912

  5. 78 FR 37231 - Guidance for Industry; Guidance on Abbreviated New Drug Applications: Stability Testing of Drug...

    Science.gov (United States)

    2013-06-20

    ... HUMAN SERVICES Food and Drug Administration Guidance for Industry; Guidance on Abbreviated New Drug... Administration, HHS. ACTION: Notice. SUMMARY: The Food and Drug Administration (FDA or Agency) is announcing the...) review process more efficient. DATES: Submit either electronic or written comments on Agency guidances...

  6. Economics of child labour

    OpenAIRE

    Fatima, Ambreen

    2013-01-01

    The dissertation aims to explore the supply and demand side determinant of child labour at macro, meso and micro level. At macro level it explores the effect of globalization (defined as openness to trade and inflow of foreign direct investment) and credit market imperfections on child labour. At meso level it explores the effect of labour market conditions on child labour. As the above two levels of analysis are mainly concerned with the demand for child labour, the micro level analysis expl...

  7. Causes of Child Abuse

    OpenAIRE

    S. Erhan Deveci; Yasemin Acik

    2003-01-01

    Child abuse is an important public health problem that is present almost in every society and environment at different level and intensities. For implementation of child abuse protection measures it is necessary to investigate its causes. In this review, causes of child abuse was attempted to investigate with respects to the society and institution, family and individual and child related factors. [Archives Medical Review Journal 2003; 12(4.000): 396-405

  8. Causes of Child Abuse

    Directory of Open Access Journals (Sweden)

    S. Erhan Deveci

    2003-08-01

    Full Text Available Child abuse is an important public health problem that is present almost in every society and environment at different level and intensities. For implementation of child abuse protection measures it is necessary to investigate its causes. In this review, causes of child abuse was attempted to investigate with respects to the society and institution, family and individual and child related factors. [Archives Medical Review Journal 2003; 12(4.000: 396-405

  9. Disciplining Your Child

    Science.gov (United States)

    ... are ways to ease frustration and avoid unnecessary conflict with your child. Be Aware of What Your Child Can and ... moment, wait to cool down, apologize to your child, and explain how you will handle the situation in the future. Be sure to keep your ...

  10. [Autism and child protection].

    Science.gov (United States)

    Coron, Guillaume

    2014-01-01

    The fostering of an autistic child deemed to be a child at risk leads one to question one's professional practices. In a children's home, an approach guided by psychoanalysis can recognise the benefits of behavioural or cognitive approaches. The aim of the professional's particular educational position is therefore to construct a relationship with each child.

  11. Driving change : sustainable development action plans Guidance

    OpenAIRE

    Sustainable Development Commission

    2008-01-01

    This guidance builds upon the Sustainable Development Commission’s previous guidance, Getting Started (August 2005), which set out the basic elements that the Sustainable Development Commission would expect to see in a good Sustainable Development Action Plan. Publisher PDF Original published August 2005.

  12. Minimum variation guidance laws for interceptor missiles

    NARCIS (Netherlands)

    Weiss, M.; Shima, T.

    2014-01-01

    This paper introduces a new approach to guidance law design using linear quadratic optimal control theory, minimizing throughout the engagement the variation of the control input as well as the integral control effort. The guidance law is derived for arbitrary order missile dynamics and target maneu

  13. 75 FR 76079 - Sound Incentive Compensation Guidance

    Science.gov (United States)

    2010-12-07

    ... Office of Thrift Supervision Sound Incentive Compensation Guidance AGENCY: Office of Thrift Supervision... collection. Title of Proposal: Sound Incentive Compensation Guidance. OMB Number: 1550-0129. Form Number: N/A... compensation arrangements at a financial institution do not encourage employees to take excessive risks....

  14. 75 FR 53023 - Sound Incentive Compensation Guidance

    Science.gov (United States)

    2010-08-30

    ... Office of Thrift Supervision Sound Incentive Compensation Guidance AGENCY: Office of Thrift Supervision... collection. Title of Proposal: Sound Incentive Compensation Guidance. OMB Number: 1550-0129. Form Number: N/A... compensation arrangements at a financial institution do not encourage employees to take excessive risks....

  15. 75 FR 22679 - Sound Incentive Compensation Guidance

    Science.gov (United States)

    2010-04-29

    ... Office of Thrift Supervision Sound Incentive Compensation Guidance AGENCY: Office of Thrift Supervision... collection. Title of Proposal: Sound Incentive Compensation Guidance. OMB Number: 1550-0NEW. Form Number: N/A... compensation arrangements at a financial institution do not encourage employees to take excessive risks....

  16. Guidance for performing preliminary assessments under CERCLA

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1991-09-01

    EPA headquarters and a national site assessment workgroup produced this guidance for Regional, State, and contractor staff who manage or perform preliminary assessments (PAs). EPA has focused this guidance on the types of sites and site conditions most commonly encountered. The PA approach described in this guidance is generally applicable to a wide variety of sites. However, because of the variability among sites, the amount of information available, and the level of investigative effort required, it is not possible to provide guidance that is equally applicable to all sites. PA investigators should recognize this and be aware that variation from this guidance may be necessary for some sites, particularly for PAs performed at Federal facilities, PAs conducted under EPA`s Environmental Priorities Initiative (EPI), and PAs at sites that have previously been extensively investigated by EPA or others. The purpose of this guidance is to provide instructions for conducting a PA and reporting results. This guidance discusses the information required to evaluate a site and how to obtain it, how to score a site, and reporting requirements. This document also provides guidelines and instruction on PA evaluation, scoring, and the use of standard PA scoresheets. The overall goal of this guidance is to assist PA investigators in conducting high-quality assessments that result in correct site screening or further action recommendations on a nationally consistent basis.

  17. Career Guidance in the Elementary School

    Science.gov (United States)

    Leonard, George E.

    1971-01-01

    The purpose of this column is to discuss, describe and disseminate information regarding career guidance principles and practices in the elementary schools. Specifically the activities of the Developmental Career Guidance Projects in inner city Detroit are described. The activities emphasize action involvement of children while didactic learning…

  18. How Effective Is Central Bank Forward Guidance?

    NARCIS (Netherlands)

    Kool, C.J.M.; Thornton, D.L.

    2012-01-01

    In this paper, we use survey forecasts to investigate the impact of forward guidance on the predictability of future short- and long-term interest rates in four countries: New Zealand, Norway, Sweden, and the United States. New Zealand began providing forward guidance in 1997, Norway in 2005, and Sw

  19. 78 FR 57450 - State Rail Plan Guidance

    Science.gov (United States)

    2013-09-18

    ... authorized in the Act and available under the High-Speed Intercity Passenger Rail program. This guidance... qualifies States to receive grants for high-speed rail only. Response: Operational information about all... Federal Railroad Administration State Rail Plan Guidance AGENCY: Federal Railroad Administration...

  20. Maternal and child reflective functioning in the context of child sexual abuse: pathways to depression and externalising difficulties

    Directory of Open Access Journals (Sweden)

    Karin Ensink

    2016-01-01

    Full Text Available Background: Sexual abuse is a well-recognised risk factor for child psychopathology. Little is known regarding whether child and maternal mentalization can be considered a potential resource or protective factor in this context, respectively, mediating or moderating the relationship between sexual abuse and psychopathology. Objective: The aims of this study were (1 to explore the relationships between child and maternal mentalizing, measured as reflective functioning (RF, and child depressive symptoms and externalising difficulties; and (2 to examine whether child mentalizing mediates the relationship between child sexual abuse (CSA and psychopathology. Method: A total of 168 children aged 7–12 years and their mothers participated in the study. The sample included 74 dyads where children had experienced sexual abuse. The Child Attachment Interview was rated by using the Child Reflective Functioning Scale to assess children's mentalization, and the Child Depression Inventory was used to assess depressive symptoms. Mothers completed the Parent Development Interview to assess maternal RF and the Child Behavior Checklist to assess their child's externalising difficulties. A model involving direct and indirect paths from CSA, child and maternal RF to child psychopathology was examined using Mplus software. Results: Child mentalization partially mediated the relationships between CSA and depressive symptoms, as well as the relationship between CSA and externalising difficulties. Maternal mentalization was an independent predictor of child externalising difficulties, with higher maternal RF associated with less externalising difficulties. Discussion: The findings indicate that by ages 7–12, child mentalization is an important inner resource associated with lower depression and externalising. In addition, this study provides new evidence of the importance of the parent's mentalizing stance for the development of self-regulation and externalising

  1. Maternal and child reflective functioning in the context of child sexual abuse: pathways to depression and externalising difficulties

    Science.gov (United States)

    Ensink, Karin; Bégin, Michaël; Normandin, Lina; Fonagy, Peter

    2016-01-01

    Background Sexual abuse is a well-recognised risk factor for child psychopathology. Little is known regarding whether child and maternal mentalization can be considered a potential resource or protective factor in this context, respectively, mediating or moderating the relationship between sexual abuse and psychopathology. Objective The aims of this study were (1) to explore the relationships between child and maternal mentalizing, measured as reflective functioning (RF), and child depressive symptoms and externalising difficulties; and (2) to examine whether child mentalizing mediates the relationship between child sexual abuse (CSA) and psychopathology. Method A total of 168 children aged 7–12 years and their mothers participated in the study. The sample included 74 dyads where children had experienced sexual abuse. The Child Attachment Interview was rated by using the Child Reflective Functioning Scale to assess children's mentalization, and the Child Depression Inventory was used to assess depressive symptoms. Mothers completed the Parent Development Interview to assess maternal RF and the Child Behavior Checklist to assess their child's externalising difficulties. A model involving direct and indirect paths from CSA, child and maternal RF to child psychopathology was examined using Mplus software. Results Child mentalization partially mediated the relationships between CSA and depressive symptoms, as well as the relationship between CSA and externalising difficulties. Maternal mentalization was an independent predictor of child externalising difficulties, with higher maternal RF associated with less externalising difficulties. Discussion The findings indicate that by ages 7–12, child mentalization is an important inner resource associated with lower depression and externalising. In addition, this study provides new evidence of the importance of the parent's mentalizing stance for the development of self-regulation and externalising difficulties in both

  2. Morte, luto e organização familiar: à escuta da criança na clínica psicanalítica Death, mourning and family structure: observation of the child in clinical psychoanalysis

    Directory of Open Access Journals (Sweden)

    Leônia Cavalcante Teixeira

    2006-01-01

    Full Text Available As especificidades da clínica com crianças pequenas interrogam os conhecimentos já estabelecidos sobre os sintomas e as possibilidades de abordagem psicanalítica. Quando se trata de crianças, a clínica se constitui no entrecruzamento de subjetividades, imprimindo impasses e possibilidades para o paciente, seus pais e o analista. Objetivou-se investigar os efeitos da clínica com crianças no processo de re-configuração da organização familiar. O estudo de um caso clínico foi privilegiado, tendo sido focalizadas as experiências do luto e seus destinos na malha familiar. A articulação dos sinais que a criança pequena apresenta em uma rede simbólica que possibilite os deslocamentos das manifestações psicossomáticas em direção a alternativas outras de reconstituição subjetiva indica-nos que muito há para ser feito numa análise no campo da prevenção, no qual as intervenções precoces já constituem tratamento propriamente dito.The specificity of clinical work with small children questions the established knowledge about the symptoms and the possibilities of the psychoanalytic approach. When children are concerned, clinical work have in view the crossing of subjectivities, the difficulties and possibilities of the patient, his/her parents and the analyst. The aim of this study is to investigate the effects of clinical work with children in the process of reconfiguring the family structure. The study of a clinical case was favored, focusing on the experience of mourning and its destinies in the family fabric. The articulation of the signs that the small child presents in a symbolic network which makes the displacement of the psychosomatic manifestations possible in the direction of the other alternatives of subjective reconstruction indicate to us that there is much to be done in an analysis in the field of prevention, in which early interventions already constitute the treatment itself.

  3. Improving rehabilitation exercise performance through visual guidance.

    Science.gov (United States)

    Lam, Agnes W K; HajYasien, Ahmed; Kulic, Dana

    2014-01-01

    In current physical rehabilitation protocols, patients typically perform exercises without feedback or guidance following the initial demonstrations from the physiotherapist. This paper proposes a system providing continuous visual feedback and guidance to patients to improve quality of motion performance and adherence to instructions. The system consists of body-worn inertial measurement units which continuously measure the patient's pose. The measured pose is overlaid with the instructed motion on a visual display shown to the user during exercise performance. Two user studies were conducted with healthy participants to evaluate the usability of the visual guidance tool. Motion data was collected by the inertial measurement sensors and used to evaluate quality of motion, comparing user performance with and without visual feedback and with or without exercise guidance. The quantitative and qualitative results of the studies confirm that performing the exercises with the visual guidance tool promotes more consistent exercise performance and proper technique. PMID:25570311

  4. An Adaptive Weighted Differential Game Guidance Law

    Institute of Scientific and Technical Information of China (English)

    ZHANG Ping; FANG Yangwang; ZHANG Fengming; XIAO Bingsong; HU Shiguo; ZONG Shuning

    2012-01-01

    For intercepting modern high maneuverable targets,a novel adaptive weighted differential game guidance law based on the game theory of mixed strategy is proposed,combining two guidance laws which are derived from the perfect and imperfect information pattem,respectively.The weights vary according to the estimated error of the target's acceleration,the guidance law is generated by directly using the estimation of target's acceleration when the estimated error is small,and a differential game guidance law with adaptive penalty coefficient is implemented when the estimated error is large.The adaptive penalty coefficients are not constants and they can be adjusted with current target maneuverability.The superior homing performance of the new guidance law is verified by computer simulations.

  5. An adaptive guidance algorithm for aerospace vehicles

    Science.gov (United States)

    Bradt, J. E.; Hardtla, J. W.; Cramer, E. J.

    The specifications for proposed space transportation systems are placing more emphasis on developing reusable avionics subsystems which have the capability to respond to vehicle evolution and diverse missions while at the same time reducing the cost of ground support for mission planning, contingency response and verification and validation. An innovative approach to meeting these goals is to specify the guidance problem as a multi-point boundary value problen and solve that problem using modern control theory and nonlinear constrained optimization techniques. This approach has been implemented as Gamma Guidance (Hardtla, 1978) and has been successfully flown in the Inertial Upper Stage. The adaptive guidance algorithm described in this paper is a generalized formulation of Gamma Guidance. The basic equations are presented and then applied to four diverse aerospace vehicles to demonstrate the feasibility of using a reusable, explicit, adaptive guidance algorithm for diverse applications and vehicles.

  6. 75 FR 59268 - Draft Guidance for Industry: Acidified Foods; Availability

    Science.gov (United States)

    2010-09-27

    ... HUMAN SERVICES Food and Drug Administration Draft Guidance for Industry: Acidified Foods; Availability...) is announcing the availability of a draft guidance entitled ``Guidance for Industry: Acidified Foods... requests for single copies of the draft guidance entitled ``Guidance for Industry: Acidified Foods'' to...

  7. Abandono do atendimento em uma clínica-escola de psicologia infantil: variáveis associadas Abandono en una clínica-escuela de psicología infantil Dropout in a school-clinic of child psychology

    Directory of Open Access Journals (Sweden)

    Carina Cella Panaia Mantovani

    2010-09-01

    menor y la familia estaba más expuesta a estrés psicosocialThis retrospective study aimed at investigating the rates of treatment nonattendance and dropout at a university-affiliated child guidance clinic and identifying socio demographic, clinical and family risk factors that contribute to them. We obtained archival data of 258 children. Sixteen percent of the families did not return after their intake interview. Among families that returned, forty-nine percent dropped out of treatment. Groups were compared with respect to risk factors for self-termination: nonattenders (clients who did not return after intake versus attenders (clients who returned; dropouts (clients that attended at least one session before interrupting treatment versus completers (clients that persisted until treatment conclusion. Children from nonnattender families attended earlier school grades and had less behavior problems. Children in the dropout group had lower scores in intelligence assessment, their fathers were younger and their families were more exposed to psychosocial stress, as compared to completers.

  8. Linking child maltreatment history with child abuse potential: Relative roles of maltreatment types

    Directory of Open Access Journals (Sweden)

    Mitkovic-Voncina Marija

    2014-01-01

    Full Text Available The independent roles of each childhood maltreatment type on child abuse potential in adults have been insufficiently explored and are inconsistent, with dissociation as one of the possible suggested mediators of intergenerational child abuse. We investigated these effects among 164 non-clinical adult parents, who filled in general questionnaires: Childhood Trauma Questionnaire (CTQ, Child Abuse Potential Inventory (CAPI and Dissociative Experience Scale (DES. Among all maltreatment types (emotional, physical and sexual abuse, emotional and physical neglect, emotional abuse was the only independent predictor in the regression model of child abuse potential. The relationship between emotional abuse history and child abuse potential was partially mediated by dissociation. The findings could speak in favor of the potentially unique detrimental role of emotional abuse in intergenerational maltreatment, with dissociation as one of the possible mechanisms.

  9. Shallowly discussed the child coughs variability asthma clinical treatment%浅谈儿童咳嗽变异性哮喘的临床治疗

    Institute of Scientific and Technical Information of China (English)

    沈文真; 张浩云

    2010-01-01

    目的 观察氨茶碱联合酮替芬治疗小儿咳嗽变异性哮喘的疗效,探讨儿童咳嗽变异性哮喘的治疗方法.方法 将64例符合诊断标准的患儿随机分为两组,治疗组32例,采用氨茶碱联合酮替芬治疗;对照组32例,采用口服消炎药物及止咳糖浆治疗.观察两组近期疗效,并进行比较.结果 经氨茶碱联合酮替芬进行治疗有效率达到93.8%.结论 氨茶碱酮替芬治疗小儿咳嗽变异性哮喘疗效显著,值得临床应用.%Objective To observe the aminophylline combineel Ketotifen cough variant asthma in children' s treatment. Methods 64 cases met the diagnostic criteria were randomly divided into two groups, the treatment group 32 cases, combined with Ketotifen treatment of aminophylline; control group, 32 patients with oral inflammatory drugs and Cough syrup. Curative effect were observed and compared. Results Ketotifen by aminophylline treatment efficiency reached 93.8%. Conclusion Use of aminophylline and ketotifen treatment of children with cough variant asthma and worthy of clinical application.

  10. Acting and Feeling Like a Vulnerable Child, an Internalized "Bad" Parent, or a Healthy Person: The Assessment of Schema Modes in Non-Clinical Adolescents.

    Science.gov (United States)

    Roelofs, Jeffrey; Muris, Peter; Lobbestael, Jill

    2016-08-01

    Schema modes are strong, predominant, momentary (state-like) emotional and cognitive states, and maladaptive coping responses that occur when underlying personality schemas are activated by emotional events. The current study employed the Schema Mode Inventory for Adolescents (SMI-A) to assess such schema modes in a sample of non-clinical adolescents (n = 530). Confirmatory factor analysis revealed that the hypothesized model of the SMI-A with 14 separate schema modes provided a good fit for the data. Reliability coefficients for the various schema modes were all in the adequate to good range. Finally, the validity of the SMI-A was supported by significant and meaningful relations between schema modes on the one hand and early maladaptive schema domains, symptoms of psychopathology, and quality of life on the other. Taken together, the psychometric properties of the SMI-A are promising, and the SMI-A can be considered a viable instrument to assess schema modes in adolescents. PMID:26305395

  11. [HOW TO EXPLORE BIPOLARITY IN CHILD PSYCHIATRY: A DIMENSIONAL SEMIOLOGY].

    Science.gov (United States)

    Scholl, J-M

    2016-02-01

    Despite its high frequency, bipolarity in childhood is little understood and is often diagnosed only after several years of development, and this during a time when the child's psychosocial future is at stake. A proper diagnosis requires recognition of accurate clinical signs. It is therefore essential to furnish clinicians with precise semiological markers. This paper presents a dimensional semiology for use in anamnesis and in clinical observation of the child. These clinical signs enable the identification of a bipolar manic temperament in the child and/or the identification of various different forms of childhood bipolar and depressive disorder. The relevant differential diagnoses and comorbidities are also presented. PMID:27141653

  12. Observation on Nursing Effect of Health Care Education in Child Health Clinics%健康教育在儿童保健门诊中的护理效果观察

    Institute of Scientific and Technical Information of China (English)

    司冬梅

    2015-01-01

    Objective To explore the effect of health education and nursing in children health care in the outpatient service. Methods From December 2012 to December 2013,240 children admitted to our hospital were chosen for research object,and randomly divided into experimental group and control group,the control group was given conventional nursing,the experimental group was given child care health education,comparative analysed two groups of children with anxiety,uncertainty and nursing satisfaction. Results In the experimental group,parents in the degree of anxiety,uncertainty were lower than that of the control group,and better than the control group on nursing satisfaction,P<0.05,with significant difference. Conclusion Health education has a good effect in the child health clinic nursing.%目的:探讨健康教育在儿童保健门诊中的护理效果及方法。方法以2012年12月~2013年12月本院儿童保健门诊收治的240例患儿为研究对象,将其随机分为实验组和对照组,对照组给予常规护理,实验组在此基础上加强儿童保健健康教育,对比分析两组患儿家长的焦虑程度、不确定感及护理满意度。结果实验组患儿家长在焦虑程度、不确定感上均低于对照组,且在护理满意度上优于对照组,P<0.05,差异具有统计学意义。结论健康教育在儿童保健门诊护理中有着良好效果。

  13. From child to child: children as communicators.

    Science.gov (United States)

    Phinney, R; Evans, J

    1993-01-01

    Older children commonly care for their younger siblings while parents work to provide for the household. Through play, dance, and talk, children tend to interact with each other more intensely than do adults. In so doing, messages and awareness are exchanged more effectively. Child-to-Child is an active, child-centered learning approach which aims to capitalize on this phenomenon by training older siblings to be effective communicators. This approach has been formally practiced in over 70 countries since 1979. Child-to-Child encourages children to learn the meaning and importance of health messages on their own. Children will then be most likely to retain and communicate information throughout the family, to neighbors, and to the general community. No blueprint exists, however, on which program planners may base the design of new programs. Programs should instead be adapted by those living within the community and culture to fit local needs and circumstances. Nonetheless, the Aga Khan Foundation supported the study of 7 highly different Child-to-Child projects over 3 years in India to obtain some sense of which program elements are successful and potentially useful in other settings. The study revealed that all of the programs helped increase the health knowledge of children and teachers. Little information was obtained on the extent to which information was diffused by children within the community. Overall, the study produced the following results: planners should consider using Child-to-Child projects in schools; teacher training should be made a priority; administrative support should be provided; entire staffs should be made to feel involved in the decision making process; obstacles to changing teaching methods should not be underestimated; teaching materials should be locally made; projects should be integrated into official curricula; program topics should be relevant to local realities; respected authorities should be called upon to reinforce the validity

  14. 76 FR 63676 - Final Division of Safety Systems Interim Staff Guidance DSS-ISG-2010-01: Staff Guidance Regarding...

    Science.gov (United States)

    2011-10-13

    ... COMMISSION Final Division of Safety Systems Interim Staff Guidance DSS-ISG- 2010-01: Staff Guidance Regarding... final Division of Safety Systems Interim Staff Guidance, (DSS-ISG) DSS- ISG-2010-01, ``Staff Guidance... guidance to the NRC staff reviewer to address the increased complexity of recent spent fuel pool...

  15. Augmented Reality Repair Guidance System

    Directory of Open Access Journals (Sweden)

    Sidharth Bhatia

    2012-07-01

    Full Text Available The daily life of a common man revolves around various forms of appliances/gadgets he uses throughout the day such as a mobile phone, laptop, printer, microwave oven, washing machine, etc. Although these appliances/gadgets are taken by most of the people for granted, the problem occurs when any of these things do not work as they are expected to. Getting them to the repair shops for every small glitch is expensive as well as time consuming. Although most of the companies which produce these appliances/gadgets do supply them with basic manuals, which deal with how to solve these minor issues, but reading them and at the same time repairing the corresponding appliance/gadget can be a frustrating task at times. These problems can be reduced to a large extent if some kind of live guidance is available. In this paper we propose a method to do so with the help of an augmented reality based system that will guide the user to carry out small scale repair jobs on these gadgets. All that is required is a decent webcam and a computing device, with a processor of 1 GHz or more and a display screen.

  16. Pediatric anthrax clinical management.

    Science.gov (United States)

    Bradley, John S; Peacock, Georgina; Krug, Steven E; Bower, William A; Cohn, Amanda C; Meaney-Delman, Dana; Pavia, Andrew T

    2014-05-01

    Anthrax is a zoonotic disease caused by Bacillus anthracis, which has multiple routes of infection in humans, manifesting in different initial presentations of disease. Because B anthracis has the potential to be used as a biological weapon and can rapidly progress to systemic anthrax with high mortality in those who are exposed and untreated, clinical guidance that can be quickly implemented must be in place before any intentional release of the agent. This document provides clinical guidance for the prophylaxis and treatment of neonates, infants, children, adolescents, and young adults up to the age of 21 (referred to as "children") in the event of a deliberate B anthracis release and offers guidance in areas where the unique characteristics of children dictate a different clinical recommendation from adults.

  17. State of Washington radiation guidance for Hanford

    International Nuclear Information System (INIS)

    Cleanup of the U.S. Department of Energy's Hanford site is being managed through the Hanford Federal Facility Agreement and Consent Order known as the Tri-Party Agreement. The participants are the U.S. Department of Energy, the U.S. Environmental Protection Agency, and the State of Washington, with the Department of Ecology being the lead for the State of Washington. Through a memorandum of understanding the Department of Health is designated as the primary state agency for protection of human health and the environment from ionizing radiation. As part of this responsibility, the Department of Health is developing radiation cleanup guidance for Hanford cleanup. Another reason for developing State guidance is that there are no federal regulations that provide guidance on residual radioactivity on lands that will be released for public use. The U.S. Nuclear Regulatory Commission and the U.S. Environmental Protection Agency both have prepared draft regulations, but the issuance of these is uncertain. The state guidance is compatible with draft federal guidance and includes numerical guidance for residual contamination, modeling parameters, look-up tables, and land use categories. This guidance will apply until such a time as they are superseded by applicable federal regulations or the state environmental radiation standard

  18. Child Maltreatment Prevention and the Scope of Child and Adolescent Psychiatry.

    Science.gov (United States)

    Constantino, John N

    2016-04-01

    Child maltreatment is one of the most deleterious known influences on the mental health and development of children. This article briefly reviews a complement of methods that are ready to incorporate into child and adolescent psychiatric practice, by having been validated either with respect to the prevention of child maltreatment or with respect to adverse outcomes associated with maltreatment (and primarily focused on enhancing the caregiving environment); they are feasible for integration into clinical decision making, and most importantly, can be included in the training of the next generation of clinicians. PMID:26980121

  19. Spontaneous resolution of a small extradural haematoma in a child.

    LENUS (Irish Health Repository)

    Sinha, A K

    2009-02-01

    We report the rapid spontaneous resolution of a small extradural haematoma (EDH) in a 19-month-old child. The haematoma was managed conservatively. The child went on to make a full recovery. The authors discuss the significance of this surprising clinical finding.

  20. Looking into a Deaf Child's Future: A Brief Treatment Approach.

    Science.gov (United States)

    Harvey, Michael A.; Green, Christine L.

    1990-01-01

    A hearing mother who reported obsessional thoughts about her deaf child's future underwent brief psychotherapy. Clinical hypnosis modified the mother's negative images of her child's future, and meetings attended by the mother, a vocational counselor, and deaf adults affirmed the more positive images. Theoretical descriptions and personal…

  1. Symptom diagnostics based on clinical records

    NARCIS (Netherlands)

    de Jong, Marianne; Punt, Marja; de Groot, Erik; Hielkema, Tjitske; Struik, Marianne; Minderaa, Ruud B.; Hadders-Algra, Mijna

    2009-01-01

    Child psychiatric diagnoses are generally based on a clinical examination and not on standardized questionnaires. The present study assessed whether symptom diagnostics based on clinical records facilitates the use of non-standardized clinical material for research. Six hundred and eighty-five child

  2. Optimal care of the infant, child, and adolescent on dialysis: 2014 update.

    Science.gov (United States)

    Warady, Bradley A; Neu, Alicia M; Schaefer, Franz

    2014-07-01

    Providing optimal care to the infant, child, and adolescent patient who is treated with long-term dialysis therapy mandates that attention be directed to a variety of clinical issues in addition to those related to solute removal and fluid management. Therapeutic plans must be formulated by a multidisciplinary team of pediatric specialists to address the clinical parameters of growth, anemia and osteodystrophy management, cardiovascular health, nutritional adequacy, education, cognitive development, quality of life, preparation for transplantation, and transition to adult care. This review highlights key components of current management recommendations based on a combination of published guidelines, pediatric registry data, and the combined clinical experience of the authors. Whereas some components of this review reflect a modification of the content and recommendations contained in the original publication from more than a decade ago, the contrast emphasizes the advances in understanding and therapeutics of many aspects of pediatric dialysis care that have taken place in the interim. In turn, the content of this article should provide the reader with valuable guidance toward the goal of providing optimal care to patients receiving dialysis. PMID:24717681

  3. Feasibility Study of Needle Placement in Percutaneous Vertebroplasty: Cone-Beam Computed Tomography Guidance Versus Conventional Fluoroscopy

    Energy Technology Data Exchange (ETDEWEB)

    Braak, Sicco J., E-mail: sjbraak@gmail.com [St. Antonius Hospital, Department of Radiology (Netherlands); Zuurmond, Kirsten, E-mail: kirsten.zuurmond@philips.com; Aerts, Hans C. J., E-mail: hans.cj.aerts@philips.com [Philips Medical, Department of Clinical Development (Netherlands); Leersum, Marc van, E-mail: m.van.leersum@antoniusziekenhuis.nl; Overtoom, Timotheus T. Th., E-mail: overtm@knoware.nl; Heesewijk, Johannes P. M. van, E-mail: j.heesewijk@antoniusziekenhuis.nl; Strijen, Marco J. L. van, E-mail: m.van.strijen@antoniusziekenhuis.nl [St. Antonius Hospital, Department of Radiology (Netherlands)

    2013-08-01

    ObjectiveTo investigate the accuracy, procedure time, fluoroscopy time, and dose area product (DAP) of needle placement during percutaneous vertebroplasty (PVP) using cone-beam computed tomography (CBCT) guidance versus fluoroscopy.Materials and MethodsOn 4 spine phantoms with 11 vertebrae (Th7-L5), 4 interventional radiologists (2 experienced with CBCT guidance and two inexperienced) punctured all vertebrae in a bipedicular fashion. Each side was randomization to either CBCT guidance or fluoroscopy. CBCT guidance is a sophisticated needle guidance technique using CBCT, navigation software, and real-time fluoroscopy. The placement of the needle had to be to a specific target point. After the procedure, CBCT was performed to determine the accuracy, procedure time, fluoroscopy time, and DAP. Analysis of the difference between methods and experience level was performed.ResultsMean accuracy using CBCT guidance (2.61 mm) was significantly better compared with fluoroscopy (5.86 mm) (p < 0.0001). Procedure time was in favor of fluoroscopy (7.39 vs. 10.13 min; p = 0.001). Fluoroscopy time during CBCT guidance was lower, but this difference is not significant (71.3 vs. 95.8 s; p = 0.056). DAP values for CBCT guidance and fluoroscopy were 514 and 174 mGy cm{sup 2}, respectively (p < 0.0001). There was a significant difference in favor of experienced CBCT guidance users regarding accuracy for both methods, procedure time of CBCT guidance, and added DAP values for fluoroscopy.ConclusionCBCT guidance allows users to perform PVP more accurately at the cost of higher patient dose and longer procedure time. Because procedural complications (e.g., cement leakage) are related to the accuracy of the needle placement, improvements in accuracy are clinically relevant. Training in CBCT guidance is essential to achieve greater accuracy and decrease procedure time/dose values.

  4. Hunger strike among detainees: guidance for good medical practice.

    Science.gov (United States)

    Gétaz, Laurent; Rieder, Jean-Pierre; Nyffenegger, Laurent; Eytan, Ariel; Gaspoz, Jean-Michel; Wolff, Hans

    2012-09-17

    Hunger strike is a regularly reported problem in prison. Although clinical situations are rarely severe, hospitalisation is often considered. In consequence, it is not only physicians working in prisons, but also hospital medical teams who face challenges related to hunger strike, involving somatic, psychological, legal and human rights aspects. Furthermore, deontological rules must be strictly respected when delivering care, particularly in prison setting. Starvation involves metabolic changes and can cause severe, and sometimes even irreversible or fatal complications. Moreover, the phase of re-alimentation should not be trivialised, as re-feeding syndrome is a potentially fatal phenomenon. This article provides guidance for monitoring and management of patients on hunger strike.

  5. Clinical services in environmental pediatrics.

    Science.gov (United States)

    Paulson, Jerome A; Gordon, Lauren

    2011-01-01

    Pediatric healthcare providers are confronted with environmental health problems frequently: the child with asthma exacerbated by the odor of paint in school or mouse antigen at home, the family who wants to know the risks and benefits of using different types of sunblock, or the community that asks the provider for advice on the potential health impacts of building the new elementary school next to the on-ramp to the interstate highway. Pediatric providers have not been well trained to deal with these questions in medical or nursing schools, residency training, or continuing-education settings. This article provides guidance on history taking, the physical examination, laboratory evaluations of patients and the environment, and making an assessment about and managing environmental health problems. Pediatric Environmental Health Specialty Units are discussed as a source of consultation and referral. The identification and utilization of evidence-based resources are stressed and clinicians are cautioned about non-evidence-based assessments such as clinical ecology and hair analysis and non-evidence-based management strategies such as chelation for autism.

  6. Child neurology: past, present, and future: part 3: the future.

    Science.gov (United States)

    Ridel, Keith R; Gilbert, Donald L

    2010-10-12

    This is the last of a 3-part series exploring the past, present, and future of the field of child neurology. This article addresses the 2 fundamental challenges facing child neurology. The most important challenge is our inadequate workforce; based on current numbers, recruitment patterns, and projected retirement, the child neurology clinical and research workforce shortage will likely worsen. The second challenge involves adapting our training to prepare child neurologists for changes ahead. We propose that these 2 issues are related, and that solutions need to include consideration of career options in research, education, and patient care.

  7. Sustainability guidance pack for suppliers: May 2011

    OpenAIRE

    2013-01-01

    This document provides guidance on specific sustainability topics to inform and support suppliers in meeting sustainability obligations. Suppliers are any organisation providing services, overlay and equipment for or on behalf of LOCOG, including at venues.

  8. Integrated Entry Guidance for Reusable Launch Vehicle

    Institute of Scientific and Technical Information of China (English)

    NING Guo-dong; ZHANG Shu-guang; FANG Zhen-ping

    2007-01-01

    A method for the implementation of integrated three-degree-of-freedom constrained entry guidance for reusable launch vehicle is presented. Given any feasible entry conditions, terminal area energy management interface conditions, and the reference trajectory generated onboard then, the method can generate a longitudinal guidance profile rapidly, featuring linear quadratic regular method and a proportional-integral-derivative tracking law with time-varying gains, which satisfies all the entry corridor constraints and meets the requirements with high precision. Afterwards, by utilizing special features of crossrange parameter, establishing bank-reversal corridor,and determining bank-reversals according to dynamically adjusted method, the algorithm enables the lateral entry guidance system to fly a wide range of missions and provides reliable and good performance in the presence of significant aerodynamic modeling uncertainty.Fast trajectory guidance profiles and simulations with a reusable launch vehicle model for various missions and aerodynamic uncertainties are presented to demonstrate the capacity and reliability of this method.

  9. 7 CFR 1794.7 - Guidance.

    Science.gov (United States)

    2010-01-01

    ... Analysis, Stop 1522, 1400 Independence Avenue, SW., Washington, DC 20250-1522. (b) Water and waste program... appropriate State Director. State Directors may provide supplemental guidance to meet state and local laws...

  10. Drill machine guidance using natural occurring radiation

    International Nuclear Information System (INIS)

    A drilling machine guidance system is described which uses only the naturally occuring radiation within the seam or stratum of interest. The apparatus can be used for guiding horizontal drilling machines through coal seams and the like. (U.K.)

  11. RCRA Programmatic Information Policy and Guidance

    Data.gov (United States)

    U.S. Environmental Protection Agency — This asset includes program policy and guidance documents that are used by the EPA regions, states, tribes and private parties to implement the hazardous waste...

  12. Impact of Play Therapy on Parent-Child Relationship Stress at a Mental Health Training Setting

    Science.gov (United States)

    Ray, Dee C.

    2008-01-01

    This study investigated the impact of Child-Centred Play Therapy (CCPT)/Non-Directive Play Therapy on parent-child relationship stress using archival data from 202 child clients divided into clinical behavioural groups over 3-74 sessions in a mental health training setting. Results demonstrated significant differences between pre and post testing…

  13. What can psychiatry learn from the Munro Review of Child Protection?

    Science.gov (United States)

    Cohen, Mark

    2016-02-01

    The Munro Review of Child Protection approached the problem of child protection from an understanding based upon systems analysis. Risk assessment in psychiatry has similarities to the assessment by social workers of child protection issues. Psychiatry as a profession could learn from the Review, and, in doing so, be supported in recovering and communicating the requirements for good clinical practice.

  14. Academic Training in a Child and Adolescent Psychiatry Fellowship: A Curriculum Based on Leadership Experience

    Science.gov (United States)

    Ivany, Christopher G.; Russell, Robert K.; Vanessa, Venezia A.; Saito, Albert Y.

    2008-01-01

    Objective: The authors describe how one child and adolescent psychiatry fellowship program responded to emerging trends in clinical practice which increasingly demand that child and adolescent psychiatrists lead their colleagues through instruction and supervision. Methods: Data from surveys of recent graduates of child and adolescent training…

  15. Effect of Sleeping Positions Guidance on Deformational Plagiocephaly and/or Brachycephaly in Prematures%睡姿指导对早产儿扁头综合征发生率的影响

    Institute of Scientific and Technical Information of China (English)

    马良; 李青; 孟令丹; 邴卫卫; 李玲; 董荣芝

    2016-01-01

    Objective To investigate the effect of sleep position guidance on deformational plagiocephaly and/or brachycephaly (DPB) in the prematures. Methods 321 preterm infants in neonatal intensive care unit from October, 2012 to September, 2015 were divided into sleep positions guidance group (n=159) and control group (n=162). The sleep positions guidance group accepted sleeping positions guidance when they were in neonatal intensive care unit and followed up in child care clinic, and the control group accepted routine treatment and nursing. The incidences of DPB were compared. Results The incidences of mild (χ2=6.591, P=0.010), moderate (χ2=4.862, P=0.027) and se-vere (χ2=11.261, P=0.001) DPB were less in the sleep positions guidance group than in the control group. Conclusion Sleeping positions guidance may reduce the incidence of DPB in prematures.%目的:探讨睡姿指导对早产儿扁头综合征发生率的影响。方法2012年10月~2015年9月,321例入住新生儿重症监护室(NICU)的早产儿随机分为睡姿指导组(n=159)和对照组(n=162)。睡姿指导组在婴儿入住NICU后及出院后儿保门诊随访时给予睡姿指导,对照组给予常规治疗。比较两组婴儿6月龄时扁头综合征发生率。结果睡姿指导组轻度(χ2=6.591, P=0.010)、中度(χ2=4.862, P=0.027)、重度(χ2=11.261, P=0.001)扁头综合征发生率均少于对照组。结论睡姿指导可降低早产儿扁头综合征的发生率。

  16. Canine guidance via Biogeneric Copy: a clinical report.

    Science.gov (United States)

    Kunkel, Thomas C; Engelmeier, Robert L

    2016-01-01

    The advent of computer-aided design/computer-aided manufacturing (CAD/CAM) technology in dentistry has enabled a wide range of applications. The Cerec Acquisition Center (Cerec AC, Sirona Dental Systems Inc., Charlotte, NC) allows for the construction of all-porcelain restorations, either in-office or through a remote dental laboratory. One feature of the Cerec AC is its ability to duplicate the dental morphology of an existing tooth onto a new CAD/CAM ceramic restoration designed for that tooth. This design mode capability of the Cerec AC is termed Biogeneric Copy. This function has been discussed in the literature where it has been utilized to fabricate a CAD/CAM ceramic crown to fit an existing removable partial denture (RPD).1-3 There are occasions in dentistry where the exact anatomy and position of an existing tooth, not associated with an RPD, should ideally be replicated in a definitive restoration. This case report describes such an occasion. PMID:27027104

  17. Vocational guidance: origin, evolution and current state

    OpenAIRE

    Di Doménico, Cristina; Vilanova, Alberto

    2000-01-01

    The socio-professional sources of the vocational guidance are reviwed, in the world and in Latin America. It stands out that psychology, as science and as a profession, possesses vigorous links to this practice that, however, tends to its epistemic and praxic emancipation in some nations. The contemporary prob- lems of the guidance are presented in their economic, politics, cultural and pro-fessional dimensions.

  18. ROUTE PLAN DESIGNER FOR TRACTOR GUIDANCE SYSTEMS

    DEFF Research Database (Denmark)

    Sveistrup, Daniel; Jørgensen, Rasmus Nyholm; Green, Ole;

    2010-01-01

    Earlier works have shown field trial designs to be very labor extensive, even when combining autoguidancesystems with conventional machinery.Designing routes for semi-automated systems in a controlled manner is both resource demandingand complicated. Different types of auto-guidance systems vary...... was outlined, it took less thanone hour entering the design into the software and generating the auto-guidance files.KeywordsGIS, Auto steering systems, plot trial design, full-scale field trials, Java...

  19. International child health

    DEFF Research Database (Denmark)

    Kruse, Alexandra Y; Høgh, Birthe

    2007-01-01

    diseases and neonatal complications, over half associated with malnutrition. Conditions we could prevent and treat. One of UN's Millennium Development Goals is to reduce child mortality. However child health is more than mortality and morbidity indicators, it includes growth and development. Udgivelsesdato......International child health has improved. Better healthcare strategies, like IMCI, have contributed implementing basic interventions: vaccinations, nutrition supplement, oral rehydration and antibiotics. But 11 million children still die every year before they turn five, most from infectious...

  20. Measuring child marriage

    OpenAIRE

    Minh Cong Nguyen; Quentin Wodon

    2012-01-01

    Child or early marriage is recognized as an important development and human rights issue that affects girls especially in many developing countries. The practice has been linked to psychological, health, and education risks. These negative impacts explain why in many countries child marriage has been prohibited by law but often with little effect. While child marriage has been recognized as a major issue, its measurement has remained unsophisticated. Existing studies tend to simply report the...

  1. Child Labor and Globalization

    OpenAIRE

    Elias Dinopoulos; Laixun Zhao

    2006-01-01

    The paper embeds child labor in a standard two-sector general-equilibrium model of a small open economy facing perfectly competitive markets, efficiency wages, and free-trade. The modern sector produces a homogeneous good using skilled adult labor and capital, and offers effort-based efficiency wages. The agrarian (traditional) sector produces a homogeneous good using unskilled (child and adult) labor and skilled adult labor, and offers nutritional efficiency wages to child workers. Nutrition...

  2. Towards understanding child abuse

    OpenAIRE

    Clara Inés Carreño; Alicia Rey

    2010-01-01

    This research is a contribution to the understanding of childhood andthe child maltreatment within the framework of the state of the art of the knowledge produced in the experiences of research / intervention carried out under the Specialization Program on Child Maltreatment Prevention of Javeriana University, between 2002 to 2006. The article recreates the outstanding of this concern in Colombia, offers reinterpretations to the speech built and poses some bases to analyze the child maltreatm...

  3. Parenting stress and child physical health among a low-income sample: The moderating role of child anxiety.

    Science.gov (United States)

    Kidwell, Katherine M; Nelson, Timothy D; Van Dyk, Tori

    2015-11-01

    This study examined child anxiety as a potential moderator of the relationship between parenting stress and child physical health. Low-income youth (N = 109, M = 9.51 years old) and their parents completed measures of anxiety, health-related quality of life, and parenting stress in an outpatient clinic. As an objective measure of physical health, medical service utilization was extracted from medical records. Parenting stress was associated significantly with worse health-related quality of life and higher service utilization. Child anxiety moderated the relationship between stress and health. Health psychologists should target both family stress and child anxiety in promoting better health outcomes among low-income families.

  4. 社区家庭医生参与用药指导对提高临床安全用药效果的研究%Study on the effect of drug guidance from family doctors in community on improvement of clinical safety medication

    Institute of Scientific and Technical Information of China (English)

    胡宴杰

    2015-01-01

    Objective:To investigate the effect of drug guidance from family doctors in community on the rational use of drugs. Methods:118 patients with hypertension were selected.They were divided into the control group with 57 cases and the intervention group with 61 cases according to the individual wishes.The control group taken routine outpatient prescription drug,while the intervention group received medicine knowledge education and individualized medication guide from community family doctor when they taken medicine in clinic.Results:After 2 months of management,the correct answer rate of hypertension and commonly used drug knowledge in the intervention group improved than before the intervention,in addations,medication nonadherence behavior,trust and willing to accept the doctor guidance also improved than before intervention(P<0.05),and the changes of those indexs in the intervention group were more significantly than in the control group(P<0.05).Conclusion:Community family physicians participate in medication guide can improve the correct medication cognitive,medication compliance and the doctor's satisfaction and trust degree,and promote clinical medication safety and rationality.%目的:探讨社区家庭医生参与临床用药指导对患者合理用药的影响。方法:收治高血压患者118例,按个人意愿分为对照组57例和干预组61例。对照组常规门诊处方取药,干预组在门诊就诊取药时社区家庭医生给予用药常识教育和个性化的用药指导。结果:管理2个月后,干预组在高血压及常用中成药物知识正答率、改善服药不依从行为和信任并愿意接受医生指导方面较干预前提高(P<0.05),组间比较干预组也较对照组变化更明显(P<0.05)。结论:社区家庭医生参与用药指导,能够较好地提高患者正确用药的认知、服药依从性及对医生的满意度和信任度,并促进临床用药的安全和合理性。

  5. Medical Diagnosis of the Sexually Abused Child.

    Science.gov (United States)

    Bays, Jan; Chadwick, David

    1993-01-01

    This article on medical diagnosis of the sexually abused child summarizes clinical research on physical findings in nonabused children, abused children, and abused children with independent confirmation of abuse. A classification of physical findings is proposed along a continuum of certainty that sexual abuse has occurred. (Author/JDD)

  6. Towards understanding child abuse

    Directory of Open Access Journals (Sweden)

    Clara Inés Carreño

    2010-02-01

    Full Text Available This research is a contribution to the understanding of childhood andthe child maltreatment within the framework of the state of the art of the knowledge produced in the experiences of research / intervention carried out under the Specialization Program on Child Maltreatment Prevention of Javeriana University, between 2002 to 2006. The article recreates the outstanding of this concern in Colombia, offers reinterpretations to the speech built and poses some bases to analyze the child maltreatment from the perspective of the adult-child relationships.

  7. Cranial imaging in child abuse

    International Nuclear Information System (INIS)

    Serious head injury in children less than 2 years old is often the result of child abuse. The role of the different neuroimaging modalities in child abuse is reviewed. Skull X-ray and cranial CT are mandatory. Repeat or serial imaging may be necessary and brain MR imaging may contribute to the diagnostic work-up, particularly in the absence of characteristic CT findings. The radiologist plays an important role in accurately identifying non-accidental cranial trauma. The clinical presentation can be non-specific or misleading. The possibility should be considered of a combined mechanism, i.e., an underlying condition with superimposed trauma. In this context, the radiologist is in the front line to suggest the possibility of child abuse. It is therefore important to know the spectrum of, sometimes subtle, imaging findings one may encounter. Opthalmological examination is of the greatest importance and is discussed here, because the combination of retinal hemorrhages and subdural hematoma is very suggestive of non-accidental cranial trauma. (orig.)

  8. Child abuse, a case report

    Directory of Open Access Journals (Sweden)

    Andri M.T. Lubis

    2004-03-01

    Full Text Available Child abuse is a pervasive social and medical problem that remains a major cause of disability and death among children. The annual incidence of abuse is estimated to be 15 to 42 cases per 1,000 children and appears to be increasing. Fractures are the second most common presentation of physical abuse after skin lesions, and approximately one third of abused children will eventually be seen by an orthopedic surgeon. We report a 7-month-old boy who was suspected to be abused. Our diagnosis was based on findings of multiple fractures, delay in seeking medical treatment and discrepancy between the history of illness and the clinical findings. He sustained multiple fractures in variety of healing, namely fractures on left supracondylar humeri, left radius and ulna, right radius and ulna, both femora, right tibia, and left tibia and fibula. Radiological examination was an important modality in revealing the possibility of abuse on this child. He had received medical treatment, protection, consultation team for the parents and an underway police investigation. (Med J Indones 2004; 13: 59-65 Keywords: child, abuse

  9. 78 FR 11207 - Clinical Study Designs for Surgical Ablation Devices for Treatment of Atrial Fibrillation...

    Science.gov (United States)

    2013-02-15

    ... Treatment of Atrial Fibrillation; Guidance for Industry and Food and Drug Administration Staff; Availability... Ablation Devices for Treatment of Atrial Fibrillation.'' This guidance provides FDA's recommendations on clinical trial designs for surgical ablation devices intended for the treatment of atrial...

  10. ETHICAL, SOCIO-PSYCHOLOGICAL AND MEDICAL ASPECTS OF CHILD NEGLECT

    Directory of Open Access Journals (Sweden)

    Smaranda Diaconescu

    2015-11-01

    Full Text Available Child neglect was and continues to be a matter of both professional and public interest, thoroughly debated by child protection researchers and specialists, sociologists, psychologists and social workers, specialists in education and health. Drawing on some examples encountered in current medical practice, we tried to identify the causal factors of child neglect from a medical point of view and the attitude that healthcare professionals should adopt towards such situations. The correct and efficient management of medical neglect cases requires an assessment of the child’s needs, the identification of the parents’ resources and guidance of their efforts so as to properly cater to the child’s needs for the purpose of ensuring the optimum health of the latter.

  11. Loss of a child - resources

    Science.gov (United States)

    Child death - resources; Resources - loss of a child ... The following organizations are good resources for information on the loss of a child: The Compassionate Friends -- www.compassionatefriends.org Bereaved Parents of the USA -- www.bereavedparentsusa. ...

  12. Child neglect and psychological abuse

    Science.gov (United States)

    ... or neglect, call 911. Call the Childhelp National Child Abuse Hotline (1-800-4-A-CHILD). Know that ... can/identifying/. Accessed November 21, 2014. Read More Child abuse - physical Update Date 11/20/2014 Updated by: ...

  13. The Development of a Lifelong Guidance System in Hungary

    Science.gov (United States)

    Watts, A. G.; Borbely-Pecze, Bors Tibor

    2011-01-01

    The development of a lifelong guidance system in Hungary Systematic work is currently being undertaken in Hungary to develop a lifelong guidance system, in line with principles outlined by leading international organisations. The origins of career guidance in Hungary, and the nature of the current career guidance system, are outlined. The main…

  14. Earlier Guidance Opportunities: Priorities for the 1970's.

    Science.gov (United States)

    Nemec, William E., Ed.

    "Earlier Guidance Opportunities (EGO): Priorities for the 1970's" was the topic for this Ohio Elementary Guidance Conference. In his keynote address entitled "New Perspectives on the Guidance of Younger Children - Can We Afford to Delay Vocational Guidance?" Dr. George E. Hill used EGO to say, "Education Gives Opportunity,""Ego's Grow on…

  15. The voice of users in adult career guidance

    DEFF Research Database (Denmark)

    Plant, Peter

    2012-01-01

    Is the voice of users heard in adult career guidance? Pan-Nordic Research shows that users are seen as recipients rather than agents i adult career guidance.......Is the voice of users heard in adult career guidance? Pan-Nordic Research shows that users are seen as recipients rather than agents i adult career guidance....

  16. Clinical significance and changes of platelet parameter in child patients with pneumonia%肺炎患儿血小板参数的变化及其临床意义

    Institute of Scientific and Technical Information of China (English)

    蒲秀红; 孔春新; 郭晓清; 安涛; 邱萌; 李茜; 吴琼

    2012-01-01

    目的 观察细菌、病毒、支原体所致轻、重症肺炎患儿血小板参数的变化并分析其临床意义.方法 回顾性研究2010年11月-2012年3月我科收治的180例细菌性、病毒性及支原体肺炎(各60例,其中重症肺炎62例,轻症肺炎118例)急性期和恢复期血小板计数(PLT)、血小板压积(PCT)、平均血小板体积(MPV)、血小板宽度(PDW)的变化,并与50例对照组进行比较.结果 三组肺炎患儿血小板参数均高于对照组,细菌性肺炎组患儿血小板参数明显高于病毒性肺炎组和支原体肺炎组(P<0.01);急性期重症肺炎患儿血小板参数明显高于轻症肺炎者(P<0.01),且两者均明显高于对照组;恢复期重症及轻症肺炎患儿血小板参数均明显降低,与对照组无差异.结论 肺炎患儿血小板数量及功能状态通常异常,以细菌性肺炎更易于发生;血小板参数的变化可作为肺炎严重程度及病情变化的一项参考指标.%Objective To investigate the changes and analyze the clinical significance of platelet parameter in child patients with pneumonia caused by microbe, virus and mycoplasma. Methods The medical records of 180 child patients ( including 62 cases of severe pneumonia, 118 cases of mild pneumonia) with microbial, viral and mycoplasma pneumonia from December 2010 to March 2011 were retrospectively reviewed ( including 60 cases of microbial pneumonia, 60 cases of viral pneumonia and 60 cases of mycoplasma pneumonia). The changes of platelet parameters such as platelet count ( PLT) , platelet hematocrit (PCT) , mean platelet volume (MPV) and platelet distribution width (PDW) in acute stage and in convalescence stage of patients with pneumonia were observed and compared with 50 cases normal control group. Results The platelet parameters of microbial pneumonia group, viral pneumonia group and mycoplasma pneumonia group were significantly higher than those of normal control group ( P < 0. 01 ) . The

  17. Evaluation of low-dose limits in 3D-2D rigid registration for surgical guidance

    Science.gov (United States)

    Uneri, A.; Wang, A. S.; Otake, Y.; Kleinszig, G.; Vogt, S.; Khanna, A. J.; Gallia, G. L.; Gokaslan, Z. L.; Siewerdsen, J. H.

    2014-09-01

    An algorithm for intensity-based 3D-2D registration of CT and C-arm fluoroscopy is evaluated for use in surgical guidance, specifically considering the low-dose limits of the fluoroscopic x-ray projections. The registration method is based on a framework using the covariance matrix adaptation evolution strategy (CMA-ES) to identify the 3D patient pose that maximizes the gradient information similarity metric. Registration performance was evaluated in an anthropomorphic head phantom emulating intracranial neurosurgery, using target registration error (TRE) to characterize accuracy and robustness in terms of 95% confidence upper bound in comparison to that of an infrared surgical tracking system. Three clinical scenarios were considered: (1) single-view image + guidance, wherein a single x-ray projection is used for visualization and 3D-2D guidance; (2) dual-view image + guidance, wherein one projection is acquired for visualization, combined with a second (lower-dose) projection acquired at a different C-arm angle for 3D-2D guidance; and (3) dual-view guidance, wherein both projections are acquired at low dose for the purpose of 3D-2D guidance alone (not visualization). In each case, registration accuracy was evaluated as a function of the entrance surface dose associated with the projection view(s). Results indicate that images acquired at a dose as low as 4 μGy (approximately one-tenth the dose of a typical fluoroscopic frame) were sufficient to provide TRE comparable or superior to that of conventional surgical tracking, allowing 3D-2D guidance at a level of dose that is at most 10% greater than conventional fluoroscopy (scenario #2) and potentially reducing the dose to approximately 20% of the level in a conventional fluoroscopically guided procedure (scenario #3).

  18. Your Child's Vision

    Science.gov (United States)

    ... Things to Know About Zika & Pregnancy Your Child's Vision KidsHealth > For Parents > Your Child's Vision Print A A A Text Size What's in ... La vista de su hijo Healthy eyes and vision are a critical part of kids' development. Their ...

  19. Media and child development

    NARCIS (Netherlands)

    J. Piotrowski; H.G.M. Vossen; P.M. Valkenburg

    2015-01-01

    Decades of research have shown that the relationship between media and childhood is not unidirectional but reciprocal. In this article, both directions of the media-child development relationship are presented. We discuss how child development predisposes children's media use and preferences by revi

  20. Child Sexual Abuse

    Science.gov (United States)

    ... example, by a friend, neighbor, child care person, teacher, or stranger. When sexual abuse has occurred, a child can develop many distressing ... t tell children to 'always do everything the teacher or baby-sitter tells you to ... of guilt about the abuse, and begin the process of overcoming the trauma. ...

  1. The Child Welfare Cartel

    Science.gov (United States)

    Stoesz, David

    2016-01-01

    The probity of the Children's Bureau's National Child Welfare Workforce Institute (NCWWI) is examined with respect to the status of child welfare as well as the performance of social work education. By requiring that funding go only to accredited schools of social work, which is not authorized by relevant provisions of the Social Security Act,…

  2. Choosing Child Care

    Science.gov (United States)

    ... a parent, you want to ensure that your child is safe and happy in a childcare environment that is fun, educational, and nurturing. Here are ... person or program? Do you believe that your child will be happy and have the ... in this environment? If none of the caregivers or childcare centers ...

  3. Child Poverty & Public Policy.

    Science.gov (United States)

    Chafel, Judith A., Ed.

    This collection documents how far we still are in the United States from putting our knowledge about child well being and policy into practice. It provides an overview of the changing nature of child poverty in the United States through the contributions of authors who use a number of qualitative and quantitative approaches to look at children in…

  4. Weaning Your Child

    Science.gov (United States)

    ... baby and makes it possible to leave your child with a caregiver. It's important to remember that infants over 6 months should have solid foods as well as breast milk. After 1 year, breast milk alone does not provide all the nutrients a growing child needs; solid foods must become a regular part ...

  5. Divorce Child Custody Disputes.

    Science.gov (United States)

    Houlgate, Laurence D.

    1987-01-01

    Examines ethical issues in making policy decisions regarding divorce child custody disputes. Suggests dilemma occurs when legislator must decide between discretionary standard promoting best interest of child and nondiscretionary arbitrary assignment of custody. Advocates normative analysis of various types of dispute-settling processes and…

  6. Child Care at CERN

    CERN Document Server

    CERN, Child Care Initiative

    2008-01-01

    This is a document summarizing a survey of child care needs of CERN staff and users which was performed in February 2008 by the CERN Child Care Initiative. The document presents the analysis of this data. Conclusions on the minimal facilities size are derived and possible funding source at the European Union are discussed.

  7. Ileostomy and your child

    Science.gov (United States)

    ... Now your child has an opening called a stoma in their belly. Waste will pass through the stoma into a pouch that collects it. You and ... child will need to take care of the stoma and empty the pouch many times a day. ...

  8. Headstart for Every Child.

    Science.gov (United States)

    Butler, Annie L.

    An early learning kit provides a booklet of ten articles on educational head starts for children along with an activity packet for classroom use. The articles deal with: the crucial early school years; emotional preparation of the child; broadening a child's background; selecting toys and games; reading readiness; mathematical skills; learning to…

  9. 76 FR 52958 - Draft Guidance for Industry on Neglected Tropical Diseases of the Developing World: Developing...

    Science.gov (United States)

    2011-08-24

    ... HUMAN SERVICES Food and Drug Administration Draft Guidance for Industry on Neglected Tropical Diseases... sponsors in the clinical development of drugs for the treatment or prevention of neglected diseases of the... same as for approval of drugs for diseases endemic in the United States; and (4) FDA is committed...

  10. Student Perceptions of the Use of a Laser Pointer for Intra-Operative Guidance in Feline Castration.

    Science.gov (United States)

    Badman, Märit; Höglund, Katja; Höglund, Odd V

    2016-01-01

    In veterinary clinical education, students perform surgery under guided supervision. This study aimed to determine if students' perception of how well they understood verbal guidance could be improved by using a laser pointer during feline castration. It was assumed that a teacher's use of a laser pointer could help students identify structures of importance during surgery. The hypothesis was that use of a laser pointer would improve student understanding of verbal guidance during surgery. Eighteen privately owned male cats were electively neutered by fourth- and fifth-year veterinary students at the Swedish University of Agricultural Sciences, Uppsala, Sweden. Each student performed orchiectomy on one cat. One testis was removed while the student received verbal guidance combined with a laser pointer, and the other testis was removed while the student received only verbal guidance. The use of a laser pointer alternated between first and second testis. After surgery, students rated how well they understood verbal guidance on a visual-analog scale (100 mm) for each instructional method. The two ratings were compared in a student's two-sided t-test. The median score with or without guidance with a laser pointer was 81 (59-96) and 54 (25-86), respectively (p<.001). This study showed that laser pointers enhanced verbal guidance given to students during surgery. The suggested mechanism of explanation is that the technology enabled a more precise guidance of location and identification of anatomic structures. PMID:27128854

  11. Exploring the relationships between maternal and child metacognitions and child anxiety.

    Science.gov (United States)

    Esbjørn, Barbara Hoff; Normann, Nicoline; Lønfeldt, Nicole Nadine; Tolstrup, Marie; Reinholdt-Dunne, Marie Louise

    2016-06-01

    Research has shown that anxiety may be transmitted through verbal information pathways, for example, when parents share their anxious cognitions with their child. Less is known about the influence of parental metacognitions, that is, beliefs regarding thoughts, on child anxiety. We explored the relations between metacognitions in mothers and their children and anxiety in the children. Our study included 111 non-clinical children aged 8 to 12 years and their mothers. Children rated their metacognitions, worry and anxiety, and mothers rated their metacognitions. Results indicated agreement between maternal and child metacognitions. Maternal metacognitions were positively associated with children's anxiety symptoms and worry, and this relation was mediated by the children's metacognitions. Our results warrant further examination of the role of parental metacognitions in child anxiety.

  12. Launch flexibility using NLP guidance and remote wind sensing

    Science.gov (United States)

    Cramer, Evin J.; Bradt, Jerre E.; Hardtla, John W.

    1990-01-01

    This paper examines the use of lidar wind measurements in the implementation of a guidance strategy for a nonlinear programming (NLP) launch guidance algorithm. The NLP algorithm uses B-spline command function representation for flexibility in the design of the guidance steering commands. Using this algorithm, the guidance system solves a two-point boundary value problem at each guidance update. The specification of different boundary value problems at each guidance update provides flexibility that can be used in the design of the guidance strategy. The algorithm can use lidar wind measurements for on pad guidance retargeting and for load limiting guidance steering commands. Examples presented in the paper use simulated wind updates to correct wind induced final orbit errors and to adjust the guidance steering commands to limit the product of the dynamic pressure and angle-of-attack for launch vehicle load alleviation.

  13. The battered child syndrome

    International Nuclear Information System (INIS)

    The recognition of a battered child represents a challenge for all groups of adults dealing with children. Radiology plays a special role in this setting. By detection typical injuries, imaging is able to confirm the suspicion of a battered child. Recognition of those injuries on films, taken for other reasons, gives the caretaker an important hint, thus maybe preventing a fatal outcome for the child. One of the most important injury types is represented by the so called ''shakin baby syndrome''. The infant is held by the thorax and shaken. Thus causing a repetitive acceleration-deceleration trauma, which leads to the typical paravertebral rib fractures, intracranial bleeding and eye injuries. After shaking the child is thrown away, with subsequent injuries. The aim of this article is the presentation of an overview regarding the radiology of the battered child. Typical examples will be shown. (orig.)

  14. Child prostitution in Thailand.

    Science.gov (United States)

    Lau, Carmen

    2008-06-01

    Child prostitution is an old, global and complex phenomenon, which deprives children of their childhood, human rights and dignity. Child prostitution can be seen as the commercial sexual exploitation of children involving an element of forced labour, and thus can be considered as a contemporary form of slavery. Globally, child prostitution is reported to be a common problem in Central and South America and Asia. Of all the south-east Asian nations, the problem is most prolific in Thailand. In Thailand, there appears to be a long history of child prostitution, and this article explores the factors that underpin the Thai child sex industry and the lessons and implications that can be drawn for health care and nursing around the world.

  15. Raising the Profile of Career Guidance: Educational and Vocational Guidance Practitioner

    Science.gov (United States)

    Hiebert, Bryan

    2009-01-01

    In 2007 the International Association for Educational and Vocational Guidance (IAEVG) launched the Educational and Vocational Guidance Practitioner credential (EVGP) as one means of formally acknowledging the knowledge, skills, and personal attributes that practitioners need in order to provide quality career development services to clients. This…

  16. Safety of magnetic fusion facilities: Guidance

    International Nuclear Information System (INIS)

    This document provides guidance for the implementation of the requirements identified in DOE-STD-6002-96, Safety of Magnetic Fusion Facilities: Requirements. This guidance is intended for the managers, designers, operators, and other personnel with safety responsibilities for facilities designated as magnetic fusion facilities. While the requirements in DOE-STD-6002-96 are generally applicable to a wide range of fusion facilities, this Standard, DOE-STD-6003-96, is concerned mainly with the implementation of those requirements in large facilities such as the International Thermonuclear Experimental Reactor (ITER). Using a risk-based prioritization, the concepts presented here may also be applied to other magnetic fusion facilities. This Standard is oriented toward regulation in the Department of Energy (DOE) environment as opposed to regulation by other regulatory agencies. As the need for guidance involving other types of fusion facilities or other regulatory environments emerges, additional guidance volumes should be prepared. The concepts, processes, and recommendations set forth here are for guidance only. They will contribute to safety at magnetic fusion facilities

  17. Safety of magnetic fusion facilities: Guidance

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1996-05-01

    This document provides guidance for the implementation of the requirements identified in DOE-STD-6002-96, Safety of Magnetic Fusion Facilities: Requirements. This guidance is intended for the managers, designers, operators, and other personnel with safety responsibilities for facilities designated as magnetic fusion facilities. While the requirements in DOE-STD-6002-96 are generally applicable to a wide range of fusion facilities, this Standard, DOE-STD-6003-96, is concerned mainly with the implementation of those requirements in large facilities such as the International Thermonuclear Experimental Reactor (ITER). Using a risk-based prioritization, the concepts presented here may also be applied to other magnetic fusion facilities. This Standard is oriented toward regulation in the Department of Energy (DOE) environment as opposed to regulation by other regulatory agencies. As the need for guidance involving other types of fusion facilities or other regulatory environments emerges, additional guidance volumes should be prepared. The concepts, processes, and recommendations set forth here are for guidance only. They will contribute to safety at magnetic fusion facilities.

  18. 78 FR 48201 - Japan Lessons-Learned Project Directorate Interim Staff Guidance JLD-ISG-2013-01; Guidance for...

    Science.gov (United States)

    2013-08-07

    ... COMMISSION Japan Lessons-Learned Project Directorate Interim Staff Guidance JLD-ISG-2013-01; Guidance for... Lessons-Learned Project Directorate Interim Staff Guidance (JLD-ISG), JLD-ISG-2013-01, ``Guidance for... to http://www.nrc.gov/reading-rm/doc-collections/isg/japan-lessons-learned.html and refer to...

  19. Measuring Integrated Socioemotional Guidance at School: Factor Structure and Reliability of the Socioemotional Guidance Questionnaire (SEG-Q)

    Science.gov (United States)

    Jacobs, Karen; Struyf, Elke

    2013-01-01

    Socioemotional guidance of students has recently become an integral part of education, however no instrument exists to measure integrated socioemotional guidance. This study therefore examines the factor structure and reliability of the Socioemotional Guidance Questionnaire. Psychometric properties of the Socioemotional Guidance Questionnaire and…

  20. 78 FR 12761 - Guidance for Industry: Guidance on the Labeling of Certain Uses of Lecithin Derived From Soy...

    Science.gov (United States)

    2013-02-25

    ... of May 2, 2006 (71 FR 25844), we announced the availability of a guidance entitled ``Guidance on the... Labeling of Certain Uses of Lecithin Derived From Soy Under Section 403(w) of the Federal Food, Drug, and... ``Guidance for Industry: Guidance on the Labeling of Certain Uses of Lecithin Derived From Soy Under...

  1. Stabilization and commitment : forward guidance in economies with rational expectations

    OpenAIRE

    Hughes Hallett, Andrew; Acocella, Nicola

    2016-01-01

    We construct a theory of forward guidance in economic policy making in order to provide a framework for explaining the role and strategic advantages of including forward guidance as an explicit part of policy design. We do this by setting up a general policy problem in which forward guidance plays a role, and then examine the consequences for performance when that guidance is withdrawn. We show that forward guidance provides enhanced controllability and stabilizability—especially where such p...

  2. The Ambulatorium: Freud's free clinic in Vienna.

    Science.gov (United States)

    Danto, E A

    1998-04-01

    At the close of World War I, Freud proposed the creation of clinics providing free treatment, in the first of a series of politically liberal statements promoting the development of a kind of institution that is rarely associated with psychoanalysis today. Using archival and oral history research methods, this study offers a descriptive and statistical history of the Vienna Ambulatorium, the free psychoanalytic clinic and child guidance centre created--we can now surmise--under Freud's direction. Presented within the cultural context of central Europe's inter-war rush of progressivism in 'Red Vienna' and in Germany's Weimar Republic, little-known aspects of the history of psychoanalysis emerge. From 1922 to 1936, the staff of the Ambulatorium treated gratis patients of all ages and social classes, ranging from professional to unemployed. Candidates too were analysed at no cost. Reflecting the urban energy of his era, Freud believed that psychoanalysis could be both productive and free of cost. What emerges is an unexpectedly activist, community-oriented profile of some of the earliest participants in the psychoanalytic movement. PMID:9651752

  3. The Ambulatorium: Freud's free clinic in Vienna.

    Science.gov (United States)

    Danto, E A

    1998-04-01

    At the close of World War I, Freud proposed the creation of clinics providing free treatment, in the first of a series of politically liberal statements promoting the development of a kind of institution that is rarely associated with psychoanalysis today. Using archival and oral history research methods, this study offers a descriptive and statistical history of the Vienna Ambulatorium, the free psychoanalytic clinic and child guidance centre created--we can now surmise--under Freud's direction. Presented within the cultural context of central Europe's inter-war rush of progressivism in 'Red Vienna' and in Germany's Weimar Republic, little-known aspects of the history of psychoanalysis emerge. From 1922 to 1936, the staff of the Ambulatorium treated gratis patients of all ages and social classes, ranging from professional to unemployed. Candidates too were analysed at no cost. Reflecting the urban energy of his era, Freud believed that psychoanalysis could be both productive and free of cost. What emerges is an unexpectedly activist, community-oriented profile of some of the earliest participants in the psychoanalytic movement.

  4. The reliability of pediatric clinical anthropometric data collected by child primary health care nurses%儿童保健专科护士体格测量数据的可信度研究

    Institute of Scientific and Technical Information of China (English)

    尹华英; 谢小芬; 黎海芪; 刘友学

    2011-01-01

    Objective To assess the reliability of pediatric clinical anthropometric data collected hy child primary health care nurses in Chongqing, China.Methods Children's anthropometric measurements including head circumference, length ( height ) , crown-rump length( sitting-height ) and chest circumference were analyzed.Two primary health care nurses obtained the four measurements twice using conventional methods in clinic and they were masked each others ' measurements.Children were grouped into younger than one year old, one to three years old and older than three years old.The interexaminer mean absolute differences( MAD ) , technical error of measurements ( TEM ) , coefficient of reliahility( R ) and intraclass correlation of coefficients ( ICC ) were calculated.Results Five hundred and forty-nine c:hildren aged 0 to 12 years were enrolled.The total MAD for head circumference, length ( height ), crown-rump length ( sitting-height ) and chest circumference were 0.17,0.35 , 0.49 and 0.64 cm, respectively.The TEMs were 0.16, 0.34, 0.46 and 0.59 cm, respectively.The total R was 1.00, and ICC ranged 0.95 1.00.The MADs for head circumference and chest circumference were not significantly different among age groups.There was significant difference in MAD of length ( height ) between younger than one year old and older than three years old groups.There was significant difference in MAD of crown-rump length ( sitting-height ) between younger than 1 year old group and 3 years old group and older than 3 years old group.Conclusions These findings indicated that the anthropometric data collected by child primary health care nurses were under good in quality control.These findings also suggested that head circumference was the most reliable measurement, followed by length ( height ), whereas chest circumference was the least reliable measurement.In order to obtain more reliahle anthropometric data, it is important to use the standard anthropometric equipments and measurement

  5. Child labor, schooling, and child ability

    OpenAIRE

    Akresh, Richard; Bagby, Emilie; de Walque, Damien; Kazianga, Harounan

    2012-01-01

    Using data collected in rural Burkina Faso, this paper examines how children's cognitive abilities influence households' decisions to invest in their education. To address the endogeneity of child ability measures, the analysis uses rainfall shocks experienced in utero or early childhood to instrument for ability. Negative shocks in utero lead to 0.24 standard deviations lower ability z-sc...

  6. VTOL shipboard letdown guidance system analysis

    Science.gov (United States)

    Phatak, A. V.; Karmali, M. S.

    1983-01-01

    Alternative letdown guidance strategies are examined for landing of a VTOL aircraft onboard a small aviation ship under adverse environmental conditions. Off line computer simulation of shipboard landing task is utilized for assessing the relative merits of the proposed guidance schemes. The touchdown performance of a nominal constant rate of descent (CROD) letdown strategy serves as a benchmark for ranking the performance of the alternative letdown schemes. Analysis of ship motion time histories indicates the existence of an alternating sequence of quiescent and rough motions called lulls and swells. A real time algorithms lull/swell classification based upon ship motion pattern features is developed. The classification algorithm is used to command a go/no go signal to indicate the initiation and termination of an acceptable landing window. Simulation results show that such a go/no go pattern based letdown guidance strategy improves touchdown performance.

  7. Pre-service teachers’ awareness of child abuse

    Directory of Open Access Journals (Sweden)

    Nihal TUNCA

    2015-12-01

    Full Text Available The purpose of this study is to determine the awareness of pre-service teachers from different departments related to the concept of child abuse. This study aims to determine pre-service teachers’ awareness of child abuse as a qualitative study, conducted in line with phenomenological design. In the study, one of the purposeful sampling methods, maximum diversity sampling method, was employed. The participants of the study are 15 pre-service teachers attending the departments of Psychological Counseling and Guidance, Teacher Education for the Intellectually Disabled, Pre-school Teacher Education, Social Studies, Art Teaching, Computer and Instructional Technologies, German Language Teaching, French Language Teaching, and Teacher Education for the Hearing Impaired, all within the Education Faculty of Anatolian University, Turkey. The data of the study was collected through the focus-group interview technique. The data collected from two different focus-group interviews were analyzed by content analysis technique using the NVivo 8 data analysis program. As a result of the analysis of the data, it was concluded that the pre-service teachers explained the concept of child abuse by most strongly emphasizing emotional abuse and least strongly by emphasizing economic abuse. In light of the pre-service teachers’ opinions, it was also concluded that the culture constructed by society through the meanings attached to genders, society’s view of sexuality, child marriage, proverbs and idioms specific to the local society and superstitions lead to incidences of child abuse. The current study revealed that child abuse can be prevented by providing training to raise the awareness of child abuse primarily for families then children, teachers and other concerned people. It was also found that the majority of pre-service teachers do not have enough information about how to act in the face of an incidence of child abuse.

  8. Child maltreatment in India.

    Science.gov (United States)

    Singhi, Pratibha; Saini, Arushi Gahlot; Malhi, Prabhjot

    2013-11-01

    Child maltreatment is a global problem but is more difficult to assess and manage in developing countries such as India where one-fifth of the world's total child population resides. Certain forms of maltreatment such as feticide, infanticide, abandonment, child labour, street-begging, corporal punishment and battered babies are particularly prevalent in India. Most physicians still need to be sensitized in order to suspect child abuse on the basis of unexplained trauma, multiple fractures, parental conflict and other corroborative evidence. This article summarizes the various aspects of this major problem in resource-poor settings in the hope that it will assist in the planning of services addressing child physical and sexual abuse and neglect in India and in other developing countries. A culture of non-violence towards children needs to be built into communities in order to provide an environment conducive to the overall development of the child. Rehabilitation of abused children and their families requires a multi-disciplinary service including paediatricians, child psychologists and social workers, and the training of police forces in how to tackle the problem. PMID:24070123

  9. Ship motion pattern directed VTOL letdown guidance

    Science.gov (United States)

    Phatak, A. V.; Karmali, M. S.; Paulk, C. H., Jr.

    1983-01-01

    This paper examines ship motion pattern directed letdown guidance strategies for landing a VTOL aircraft onboard a small aviation ship under adverse environmental conditions. Off-line computer simulation of the shipboard landing task is utilized for assessing the relative merits of the proposed guidance schemes. A sum of seventy sinusoids representation is used to model the ship motion time histories. The touchdown performance of a nonimal constant-rate-of-descent (CROD) letdown strategy serves as a benchmark for ranking the performance of the alternative letdown schemes.

  10. SonixGPS影像穿刺定位系统在经皮肾镜取石术中应用的早期经验%Initial clinical experience of real-time ultrasound-guided percutaneous nephrolithotomy using the SonixGPS guidance positioning system

    Institute of Scientific and Technical Information of China (English)

    江伟凡; 吴勇; 邹高德; 胡红林; 鲁雄兵; 刘芳明; 黄红卫; 熊建华; 潘正跃

    2013-01-01

    Objective To evaluate the feasibility and safety of SonixGPS guidance positioning system in PCNL.Methods In May 2012,a total of 15 patients with upper urinary tract calculi underwent PCNL by combining pneumatic and ultrasonic power (fourth generations of EMS) with the navigation of SonixGPS guidance positioning system.A 16 G proprietary needle was inserted into the fornix of targeted calyx under the navigation of SonixGPS,needle-beam alignment and correct trajectory were maintained by observing the indicator on the screen of SonixTouch ultrasound system.Preoperative imaging,including plain abdominal film of kidney,ureter,and bladder (KUB),ultrasonography,computed tomography with or without intravenous urography.Eleven patients had different degree of hydronephrosis.Four patients had urinary infection and received antibiotic treatment before operation.Of the 15 patients,7 had multiple calculi,3 had staghorn calculi,3 had upper ureteral calculi,and 2 had renal and ureteral calculi.Results The percutaneous renal access was successfully established in 15 patients and followed with phase Ⅰ lithotripsy.The mean operative time was 45 minutes,and the mean time of making a successful percutaneous access to the renal collecting system from an appropriate calyx was 4 minutes.Postoperative KUB demonstrated stone-free after primary procedure in 14 patients (93%),and 1 patient need extracorporeal shock wave lithotripsy.No severe complication was detected in all 15 patients.Conclusions Real-time ultrasound-guided PCNL using the SonixGPS guidance positioning system appears to be safe and efficacious.SonixGPS helps predict and clearly observe the needle's trajectory during invasive procedures.It helps improve skills in performing percutaneous access and reduces the learning curve for PCNL.The major limitation of this study was that it was a case controlled study and not a randomized double-blind study.These results should be proved by further large-scale and multi

  11. Cyber child sexual exploitation.

    Science.gov (United States)

    Burgess, Ann Wolbert; Mahoney, Meghan; Visk, Julie; Morgenbesser, Leonard

    2008-09-01

    A 2-year review of 285 child cyber crime cases reported in the newspaper revealed how the Internet offenders were apprehended, the content of child pornography, and crime classification. A subsample of 100 cases with data on offender occupation revealed 73% of cases involved people in positions of authority. The dynamics of child cyber crime cases direct the implications for nursing practice in terms of evidence-based suspicion for reporting, categorizing the content of Internet images, referral of children for counseling, and treatment of offenders. PMID:18822999

  12. Clinical manifestation of child-onset relapsing polychondritis%儿童期发病的复发性多软骨炎11例临床分析

    Institute of Scientific and Technical Information of China (English)

    王振刚; 崔莉; 高圆; 陈楠

    2014-01-01

    Objective To investigate the clinical features of child-onset relapsing polychondritis (CORP). Methods The clinical manifestations of 11 CORP cases were analyzed retrospectively. Results Eleven cases of CORP were collected with Male to Female ratio of 5 ∶6; the mean age of disease onset was (11±4)(3-15) years; and the mean age of final diagnosis was(16±5)(6-22) years-old. The mean time of delay of diagnosis was(55±46)(2-144) month. Nine cases were simple CORP and 2 cases were concurred with SLE and pSS respectively. Laryngotracheal symptoms as initial presentation was seen in 7/11(64%) of cases, followed by rhinitis, eye involvement and arthritis. Laryngotracheal involvement occurred in 10/11 (91%) cases and 6/11(55%) underwent trachectomy when the diagnosis was made, followed by eye and nose involvement (saddle nose)(46% each), involvement of auricular cartilage,vestibule disorder and arthritis (36% each). Elevation of ESR or CRP(36%) were observed and positive autoantibody(18%) were detected in serology study; 9/11 (82%) were treated with steroid combined immunosuppressant. All cases were improvedor stable except 2 cases with exacerbation after upper respiratory infection during the follow-up of mean(27±15)(4-48) month. Conclusion Laryngopharyngeal involvement is the most common phenomenon in CORP and is associated with poor prognosis due to diagnosis delay. Imaging investigation may provide useful evidence for early diagnosis. Aggressive treatment is helpful in improving outcome.%目的:了解儿童期发病的复发性多软骨炎(CORP)发病情况及临床特点。方法回顾性分析11例 CORP 的临床特点及预后。结果11例患者中男性5例,女性6例;发病年龄3~15岁,平均(11±4)岁。确诊年龄6~22岁,平均(16±5)岁;诊断延误2~144个月,平均(55±45)个月。9例单纯性 CORP、2例分别与 SLE、pSS 伴发。首发症状以喉气管受累多见(7/11,64%),其次为鼻炎、眼受累和关

  13. Evaluations of Child Sexual Abuse: Recognition of Overt and Latent Family Concerns

    Science.gov (United States)

    Leventhal, John M.; Murphy, Janet L.; Asnes, Andrea G.

    2010-01-01

    Objective: To describe a clinical approach to the recognition of overt and latent concerns of parents and children when children are evaluated for suspected sexual abuse by medical examiners. Method: Description of a clinical approach. Results: We describe 10 concerns-six of parents: (1) should we believe our child?; (2) worries about the child's…

  14. Father-Child Play Behaviors and Child Emotion Regulation

    OpenAIRE

    Hagman, Amanda

    2014-01-01

    This study uses the father-child activation theory, which identifies the father-child relationship as a source for self-regulation learning. Father-child play behaviors during toddlerhood were examined for their contribution to self-regulation skills, specifically emotion regulation and aggression. This study examined father-child play behaviors of emotion amplification, intrusiveness, positive regard, and child emotion regulation seeking in the National Early Head Start (EHS) Evaluation. Fat...

  15. 市级妇幼保健院儿童心理行为专科初建资料分析%Analysis of the data collected in the first three years since the foundation of Out-patient Clinic of Child Psychological and Behavioral Pediatrics

    Institute of Scientific and Technical Information of China (English)

    邓成; 顾莉萍; 何淑华; 施玉麒

    2013-01-01

    Objective To discuss the feasibility and the future direction of the out-patient clinic for child psychological and behavioral problems. Methods Data of the first three years since the foundation of Out-patient Clinic of Child Psychological and Behavioral Pediatrics were collected and analyzed. Results A total of 993 pieces of file were established in the first three years. Patients of the out-patient clinic increased year by year, who aged from 1 to 18 and came from local and outside region. The main behavioral problems included attention deficit hyperactivity disorder, speech and language disorder, autism spectrum disorder, and the advisory of child care and emotional problems. Conclusion It is necessary to set up the out-patient clinic of child psychological and behavioral pediatrics. More attention should be paid to the common or sub-psychological and behavioral problems, the standardization of the consultation -diagnosis-treatment-further consultation process, and introduction of further psychological treatment.%目的 探讨市级妇幼保健院儿童心理行为专科工作开展初期的临床特点及后续工作方向.方法 分 析本院儿童心理行为专科初建3年资料,发现其中的规律.结果 3年间共建立儿童病历993份.所建病历数逐年明显增长;来诊儿童年龄范围广,涉及9个月~18岁6个月的多个年龄段;来源地有本地区的,也有外地区的;就诊儿童的心理行为问题多种多样,其中以多动障碍、言语及语言发育障碍、广泛性发育障碍、教养咨询和情绪问题为多.结论 设立地区性的儿童心理行为专科是必要的,其发展需要一个过程,今后应重点关注常见多发心理行为问题诊治以及心理亚健康儿童的心理保健,建立咨询-诊断-治疗-再咨询的规范化工作流程,并进一步开展心理行为治疗.

  16. Your Child's Cough

    Science.gov (United States)

    ... and when to go to the doctor. "Barky" Cough Barky coughs are usually caused by a swelling ... happens when the child inhales (breathes in). Whooping Cough Whooping cough is another name for pertussis, an ...

  17. Surviving Your Child's Suicide

    Science.gov (United States)

    ... of your child that will never be answered. Depression Lack of energy, sleep problems, inability to concentrate, ... a zip code. Search Connect with us on Facebook Find Support Video Online Support Community Connect, share ...

  18. CDC Child Growth Charts

    Data.gov (United States)

    U.S. Department of Health & Human Services — CDC child growth charts consist of a series of percentile curves that illustrate the distribution of selected body measurements in U.S. children. Pediatric growth...

  19. Understanding Child Traumatic Stress

    Science.gov (United States)

    ... Public Awareness Sustainability Policy Issues Understanding Child Traumatic Stress Page Contents: Responding to Danger When Danger Turns ... malevolence, and human accountability. Back to Top Posttraumatic Stress Responses For reasons that are basic to survival, ...

  20. Asthma - child - discharge

    Science.gov (United States)

    Pediatric asthma - discharge; Wheezing - discharge; Reactive airway disease - discharge ... Your child has asthma , which causes the airways of the lungs to swell and narrow. In the hospital, the doctors and nurses helped ...