WorldWideScience

Sample records for child guidance clinics

  1. SPECIFIC DEVELOPMENTAL DISORDERS IN CHILDREN ATTENDING A CHILD-GUIDANCE CLINIC

    OpenAIRE

    Malhotra, S.; Chadda, R.

    1987-01-01

    SUMMARY This is a retrospective study of specific developmental disorders in children who attended a child guidance clinic of the department of Psychiatry, PGI over a span of 6 years. A total of twenty-eight such children were identified. Majority (22) had speech or language disorder and 10 had some associated psychiatric problem. There were no significant sex differences. Some clinical correlates are described.

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

    OpenAIRE

    Rangan Srinivasaraghavan; Subramanian Mahadevan; Shivanand Kattimani

    2013-01-01

    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...

  3. 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.

  4. 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...

  5. [Kinderpsychodrama in a child guidance centre].

    Science.gov (United States)

    Müller, Ulrike; Brüggemann, Kai

    2013-01-01

    Kinderpsychodrama allows conflicts of children to become apparent in a specific sheltered environment. These conflicts often arise when children's needs for relationship, self esteem and self efficacy either are not sufficiently recognized by their caregivers and/or cannot be answered in a helpful way. This can lead to internalizing disorders like loss of self reliance, social fear, and depressive withdrawal on the one hand or to externalizing symptoms like oppositional, impulsive and aggressive behavior disorders on the other hand which endanger socio-emotional development. Kinderpsychodrama is seen to cushion children's dysfunctional conflict solutions and solve them with the therapists' help. Therapists realize the themes set on the scene during the play of the children's group; they mirror the scenes and encourage children to act in a different way making use of children's creativity during play as well as the support of the group. Children's chosen role serves as a secure base allowing them to find solutions for their conflicts. The development of each child as well as his/her themes becoming evident during the course of the group are made transparent to their parents during accompanying counseling sessions. We illustrate this therapeutic method by casuistics of our children therapy group. PMID:23596907

  6. 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... toys or child care articles that is not accessible to a child through normal and ]...

  7. [ 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

  8. 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.

  9. 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......

  10. 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

  11. 76 FR 1173 - Draft Guidance for Industry on Electronic Source Documentation in Clinical Investigations...

    Science.gov (United States)

    2011-01-07

    ...The Food and Drug Administration (FDA) is announcing the availability of a draft guidance for industry entitled ``Electronic Source Documentation in Clinical Investigations.'' This document provides guidance to sponsors, contract research organizations (CROs), data management centers, and clinical investigators on capturing, using, and archiving electronic data in FDA-regulated clinical......

  12. 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...

  13. 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....

  14. The Hard of Hearing Child: Clinical and Educational Management.

    Science.gov (United States)

    Berg, Frederick S., Ed.; Fletcher, Samuel G., Ed.

    The chapters by various specialists presenting information on the aurally handicapped child and his clinical and educational management are divided into three sections. The brief introductory section presents an overview of the work to follow, defines the hard of hearing child, describes his prevalence, and traces the locus of educational programs…

  15. Child Language Data Exchange System Tools for Clinical Analysis.

    Science.gov (United States)

    MacWhinney, Brian; Fromm, Davida

    2016-05-01

    The Child Language Data Exchange System Project has developed methods for analyzing many aspects of child language development, including grammar, lexicon, discourse, gesture, phonology, and fluency. This article will describe the methods available for each of these six fields, and how they can be used for assessment in the clinical setting. PMID:27111267

  16. Child protection - a subject of clinical sociology

    Directory of Open Access Journals (Sweden)

    Venera Margareta BUCUR

    2012-07-01

    Full Text Available Our study aims to analyze the relationships between intervention and prevention in a child protection system which is considered to be new (the fundamental and secondary legislation that supports it is effective as of January 1st 2005 and its reconsideration from the perspective of the child’s resilience (assisted or unassisted. The study highlights the fact that the current system of child protection in Romania contains within itself the premises of continuation of maltreatment of the child on whom a measure of special protection has been adopted. At the moment, this system does not have the resources to allow an approach centred on the resources belonging to the individual and to the community in order to overcome the traumatising events, without highlighting through the re-traumatizing experience created by separating the child in difficulty from the hostile environment.

  17. 76 FR 30175 - Draft Guidance for Clinical Investigators, Industry, and FDA Staff: Financial Disclosure by...

    Science.gov (United States)

    2011-05-24

    ... HUMAN SERVICES Food and Drug Administration (Formerly FDA-1999-D-0792) Draft Guidance for Clinical Investigators, Industry, and FDA Staff: Financial Disclosure by Clinical Investigators; Availability AGENCY: Food and Drug Administration, HHS. ACTION: Notice. SUMMARY: The Food and Drug Administration (FDA)...

  18. 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....) In the Federal Register of May 24, 2011 (76 FR 30175), FDA announced the availability of the...

  19. 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

  20. 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.)

  1. Immigrant Families and Child Care Subsidies: What Federal Law and Guidance Says

    Science.gov (United States)

    Matthews, Hannah

    2010-01-01

    One in four young children in the United States lives in an immigrant family. Federal law establishes policies on immigrant eligibility for child care assistance, yet questions regarding eligibility remain at the state and local level. Most child care assistance is funded through the Child Care and Development Block Grant (CCDBG) and the Temporary…

  2. 78 FR 10503 - Children's Toys and Child Care Articles Containing Phthalates; Final Guidance on Inaccessible...

    Science.gov (United States)

    2013-02-14

    .... 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 lead... other liquid, which could facilitate phthalate migration through a fabric covering. 74 FR 39539...

  3. SPIRIT 2013 explanation and elaboration: guidance for protocols of clinical trials

    OpenAIRE

    Chan, An-Wen; Tetzlaff, Jennifer M; Gøtzsche, Peter C.; Altman, Douglas G.; Mann, Howard; Berlin, Jesse A.; Dickersin, Kay; Hróbjartsson, Asbjørn; Schulz, Kenneth F; Parulekar, Wendy R.; Krleža-Jerić, Karmela; Laupacis, Andreas; Moher, David

    2013-01-01

    High quality protocols facilitate proper conduct, reporting, and external review of clinical trials. However, the completeness of trial protocols is often inadequate. To help improve the content and quality of protocols, an international group of stakeholders developed the SPIRIT 2013 Statement (Standard Protocol Items: Recommendations for Interventional Trials). The SPIRIT Statement provides guidance in the form of a checklist of recommended items to include in a clinical trial protocol. Thi...

  4. In-Home Parent-Child Interaction Therapy: Clinical Considerations

    Science.gov (United States)

    Masse, Joshua J.; McNeil, Cheryl B.

    2008-01-01

    Parent-Child Interaction Therapy (PCIT) is an empirically-supported behavioral parent training program designed to be administered in a clinic or laboratory-based setting. Recently, an empirical investigation revealed that in-home PCIT produced comparable results as the PCIT trials conducted in more controlled environments (this issue).…

  5. 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,…

  6. 77 FR 74670 - Draft Guidance for Industry on Enrichment Strategies for Clinical Trials to Support Approval of...

    Science.gov (United States)

    2012-12-17

    ...The Food and Drug Administration (FDA) is announcing the availability of a draft guidance for industry entitled ``Enrichment Strategies for Clinical Trials to Support Approval of Human Drugs and Biological Products.'' The purpose of this document is to provide guidance to industry on enrichment strategies that can be used in clinical trials intended to support effectiveness and safety claims......

  7. The establishment of percutaneous renal access under the guidance of color Doppler ultrasonography: its clinical application

    International Nuclear Information System (INIS)

    Objective: To investigate the method of establishing the percutaneous renal channel under the guidance of color Doppler ultrasonography, to evaluate the success rate and safety of this technique, and to discuss its clinical application in percutaneous nephrolithotomy. Methods: Under the guidance of color Doppler ultrasonography, percutaneous renal channel was successfully established in 209 patients with renal and upper ureteral calculi. The clinical data were retrospectively analyzed. The whole course of the removal of stones was monitored. The initial experience and the technical points were summarized. Results: Under the guidance of color Doppler ultrasonography, an effective and safe percutaneous renal access was successfully established in all patients. The success rate of puncturing was 99% (207/209). The success rate by single puncturing was 94.7% (198/209). In 9 patients successful puncturing was accomplished with twice procedures. In two fat patients, successful puncturing was achieved with the help of C-arm radiography. No serious complications occurred during and after the treatment. Conclusion: The operation of establishing a percutaneous renal access under the guidance of color Doppler ultrasonography is technically simple, clinically safe and reliable, with high success rate. Therefore, it should be regarded as the imaging-guided localizing method of first choice. (authors)

  8. Preventing and Reporting Child Abuse and Neglect: Guidance for School Personnel.

    Science.gov (United States)

    Wakefield, Cindy

    This guide for Colorado educators and other school personnel is intended to help define child abuse and neglect and develop appropriate policy and training programs. Sections address the following topics: identifying child abuse and neglect; identifying physical abuse; identifying neglect and emotional abuse; identifying sexual abuse; responding…

  9. Do financial incentives trump clinical guidance? Hip Replacement in England and Scotland.

    Science.gov (United States)

    Papanicolas, Irene; McGuire, Alistair

    2015-12-01

    Following devolution in 1999 England and Scotland's National Health Services diverged, resulting in major differences in hospital payment. England introduced a case payment mechanism from 2003/4, while Scotland continued to pay through global budgets. We investigate the impact this change had on activity for Hip Replacement. We examine the financial reimbursement attached to uncemented Hip Replacement in England, which has been more generous than for its cemented counterpart, although clinical guidance from the National Institute for Clinical Excellence recommends the later. In Scotland this financial differential does not exist. We use a difference-in-difference estimator, using Scotland as a control, to test whether the change in reimbursement across the two countries had an influence on treatment. Our results indicate that financial incentives are directly linked to the faster uptake of the more expensive, uncemented Hip Replacement in England, which ran against the clinical guidance. PMID:26359587

  10. 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.

  11. 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

  12. 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

  13. 76 FR 18226 - Guidance for Industry on Postmarketing Studies and Clinical Trials-Implementation of Section 505...

    Science.gov (United States)

    2011-04-01

    ... Federal Register of July 15, 2009 (74 FR 34358), FDA announced the availability of a draft guidance for... HUMAN SERVICES Food and Drug Administration Guidance for Industry on Postmarketing Studies and Clinical Trials--Implementation of Section 505(o)(3) of the Federal Food, Drug, and Cosmetic Act;...

  14. Mobile phone-based clinical guidance for rural health providers in India.

    Science.gov (United States)

    Gautham, Meenakshi; Iyengar, M Sriram; Johnson, Craig W

    2015-12-01

    There are few tried and tested mobile technology applications to enhance and standardize the quality of health care by frontline rural health providers in low-resource settings. We developed a media-rich, mobile phone-based clinical guidance system for management of fevers, diarrhoeas and respiratory problems by rural health providers. Using a randomized control design, we field tested this application with 16 rural health providers and 128 patients at two rural/tribal sites in Tamil Nadu, Southern India. Protocol compliance for both groups, phone usability, acceptability and patient feedback for the experimental group were evaluated. Linear mixed-model analyses showed statistically significant improvements in protocol compliance in the experimental group. Usability and acceptability among patients and rural health providers were very high. Our results indicate that mobile phone-based, media-rich procedural guidance applications have significant potential for achieving consistently standardized quality of care by diverse frontline rural health providers, with patient acceptance. PMID:24621929

  15. 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...

  16. 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. PMID:26927005

  17. Gynecologic clinical examination of the child and adolescent.

    Science.gov (United States)

    Cheikhelard, Alaa; Chaktoura, Zeina; Thibaud, Elisabeth

    2012-01-01

    Pediatric gynecological examination is very simple, but usually unrecognized by physicians without a specific experience in pediatric gynecology. It is always necessary and most of the time sufficient in children and adolescents consulting for gynecological complaints, endocrine problems, or sexual abuse. However, accurate evidence-based data on its normality is poor in the literature, because of bias represented by the inclusion of abused patients in these studies. Our aim was to describe the preparation to a full gynecological examination, the adequate positions, and the sequence and technique required for a well-accepted and nontraumatic clinical examination. Normal findings are described depending on the age of the patient (child, newborn, adolescent), and are based on evidence from the literature. Indications for vaginoscopy and bacterial sampling are discussed according to the age of the patient. The most important factors in the achievement of a full gynecological examination and a trusting patient-physician relationship are a good anatomical and physiological knowledge of the genital system in children, and the learning of nonaggressive examination technical skills associated with good communication skills. Clinical examination is always necessary and most of the time is sufficient together with the medical history to diagnose and treat the child's gynecological problems. Evidence-based data on normal genital findings is poor in the literature, because many studies include abused children or present bias in the methods of recruitment and assessment of normal girls [1]. PMID:22846517

  18. 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...

  19. 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.)

  20. 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.)

  1. 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

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

    International Nuclear Information System (INIS)

    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

  3. 78 FR 5816 - Guidance for Industry on Clinical Pharmacogenomics: Premarket Evaluation in Early-Phase Clinical...

    Science.gov (United States)

    2013-01-28

    ... (phase 3) that are needed to support marketing approval can be efficiently designed. Across the drug... effects in specific subgroups (i.e., use in study enrichment strategies). On February 18, 2011 (76 FR 9583... and how genomic principles should be considered and applied in early-phase clinical studies to...

  4. 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

  5. Best clinical practice guidance for management of early caries lesions in children and young adults

    DEFF Research Database (Denmark)

    Kühnisch, J; Ekstrand, K R; Pretty, I;

    2016-01-01

    -invasively in the majority of cases. The spectrum of measures includes a low cariogenicity tooth-friendly diet, daily and appropriate management of the biofilm, home and within the dental office/surgery usage of fluorides as well as sealing techniques. CONCLUSION: The detection and management of non......BACKGROUND: The European Academy of Paediatric Dentistry (EAPD) encourages prevention and arrest of active dental caries. Therefore, the present guidance provides evidence- and clinically-based recommendations for detecting and diagnosing early/non-cavitated caries lesions, risk assessment and...... statements were agreed upon and, furthermore, gaps in our knowledge were identified. RESULTS: Following the systematic reviews and outcomes of the seminars, it was concluded that visual and radiographic caries detection should be utilised as a basic diagnostic approach to locate, assess and monitor non...

  6. The Private Clinic: Help for the Troubled Child and Family.

    Science.gov (United States)

    Volenski, Leonard T.

    The services and activities performed by child psychiatrists and child psychologists who engage in private practice are described. Three types of psychotherapy (child focused, family focused, and marital discord focused) are presented as representation of the approaches utilized by professionals who work with children and families. A critique of…

  7. 75 FR 14602 - Guidance for Industry on Drug-Induced Liver Injury: Premarketing Clinical Evaluation; Opening of...

    Science.gov (United States)

    2010-03-26

    ... on Drug-Induced Liver Injury: Premarketing Clinical Evaluation; Opening of Comment Period for Future Revision of Guidance Dated July 2009; Public Conference AGENCY: Food and Drug Administration, HHS. ACTION... industry published in the Federal ] Register July 30, 2009, entitled ``Drug-Induced Liver...

  8. 75 FR 8968 - Draft Guidance for Industry on Adaptive Design Clinical Trials for Drugs and Biologics; Availability

    Science.gov (United States)

    2010-02-26

    ... HUMAN SERVICES Food and Drug Administration Draft Guidance for Industry on Adaptive Design Clinical Trials for Drugs and Biologics; Availability AGENCY: Food and Drug Administration, HHS. ACTION: Notice. SUMMARY: The Food and Drug Administration (FDA) is announcing the availability of a draft...

  9. 78 FR 39736 - Draft Guidance for Industry: Considerations for the Design of Early-Phase Clinical Trials of...

    Science.gov (United States)

    2013-07-02

    ... HUMAN SERVICES Food and Drug Administration Draft Guidance for Industry: Considerations for the Design of Early-Phase Clinical Trials of Cellular and Gene Therapy Products; Availability AGENCY: Food and Drug Administration, HHS. ACTION: Notice. SUMMARY: The Food and Drug Administration (FDA) is...

  10. Percutaneous laser disk decompression under CT and fluoroscopic guidance: indications, technique, and clinical experience.

    Science.gov (United States)

    Gangi, A; Dietemann, J L; Ide, C; Brunner, P; Klinkert, A; Warter, J M

    1996-01-01

    The aim of percutaneous laser disk decompression (PLDD) is to vaporize a small portion of the nucleus pulposus of an intervertebral disk, thereby reducing the volume and pressure of a diseased disk. This minimally invasive technique can be performed in patients who need surgical intervention for disk herniation with leg pain. PLDD is usually performed under fluoroscopic guidance with or without diskoscopy. However, it can also be performed under dual computed tomographic (CT) and fluoroscopic guidance as an outpatient procedure. CT and fluoroscopic guidance increases the safety and accuracy of PLDD, with high precision of instrument guidance, direct visualization of nucleus pulposus vaporization, and reduced risk of complications. Of 119 patients with lumbar disk herniation treated with PLDD under CT and fluoroscopic guidance, 91 (76.5%) had a good or fair response. PLDD performed with CT and fluoroscopic guidance appears to be a safe and effective treatment for herniated intervertebral disks. PMID:10946692

  11. Preimplantation genetic diagnosis for mitochondrial DNA disorders: ethical guidance for clinical practice.

    Science.gov (United States)

    Bredenoord, Annelien; Dondorp, Wybo; Pennings, Guido; de Die-Smulders, Christine; Smeets, Bert; de Wert, Guido

    2009-12-01

    Although morally acceptable in theory, preimplantation genetic diagnosis (PGD) for mitochondrial DNA (mtDNA) disorders raises several ethical questions in clinical practice. This paper discusses the major conditions for good clinical practice. Our starting point is that PGD for mtDNA mutations should as far as possible be embedded in a scientific research protocol. For every clinical application of PGD for mtDNA disorders, it is not only important to avoid a 'high risk of serious harm' to the future child, but also to consider to what extent it would be possible, desirable and proportional to try to reduce the health risks and minimize harm. The first issue we discuss is oocyte sampling, which may point out whether PGD is feasible for a specific couple. The second issue is whether one blastomere represents the genetic composition of the embryo as a whole -- and how this could (or should) be investigated. The third issue regards the cutoff points below which embryos are considered to be eligible for transfer. We scrutinize how to determine these cutoff points and how to use these cutoff points in clinical practice -- for example, when parents ask to take more or less risks. The fourth issue regards the number of cycles that can (or should) justifiably be carried out to find the best possible embryo. Fifth, we discuss whether follow-up studies should be conducted, particularly the genetic testing of children born after IVF/PGD. Finally, we offer the main information that is required to obtain a truly informed consent. PMID:19471315

  12. 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)

  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. 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

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

    DEFF Research Database (Denmark)

    Jacobsen, Stine Lindahl; Killén, Kari

    2015-01-01

    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...

  17. 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...

  18. 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-...

  19. SOCIODEMOGRAPHIC FEATURES OF CHILD AND ADOLESCENTS ADMITTED TO KARADENIZ TECHNICAL UNIVERSITY MEDICAL FACULTY CHILD OUTPATIENT CLINIC WITH SUICIDE ATTEMPT

    OpenAIRE

    evrim AKTEPE; sema KANDİL; göker, zeynep; Kadir SARP; Topbaş, Murat; Özkorumak, Evrim

    2006-01-01

    Assesment of sociodemographic and psychiatric characteristics of attempted suicide in children and adolescents. The aim of this study is to identify risk factors and sociodemographic, psychiatric characteristics of adolescents and children who attempted suicide. Suicide attempters (range 7-15 years, fifty-eight cases) who referred to Karadeniz Technical University, School of Medicine, Department of Child and Adolescent Psychiatry outpatient clinic between January 2003 and January 2005 were an...

  20. Stereotactic Ablative Radiation Therapy for Subcentimeter Lung Tumors: Clinical, Dosimetric, and Image Guidance Considerations

    Energy Technology Data Exchange (ETDEWEB)

    Louie, Alexander V., E-mail: Dr.alexlouie@gmail.com [Department of Radiation Oncology, VU University Medical Center, Amsterdam (Netherlands); Department of Radiation Oncology, London Regional Cancer Program, University of Western Ontario, London (Canada); Department of Epidemiology, Harvard School of Public Health, Harvard University, Boston, Massachusetts (United States); Senan, Suresh; Dahele, Max; Slotman, Ben J.; Verbakel, Wilko F.A.R. [Department of Radiation Oncology, VU University Medical Center, Amsterdam (Netherlands)

    2014-11-15

    Purpose: Use of stereotactic ablative radiation therapy (SABR) for subcentimeter lung tumors is controversial. We report our outcomes for tumors with diameter ≤1 cm and their visibility on cone beam computed tomography (CBCT) scans and retrospectively evaluate the planned dose using a deterministic dose calculation algorithm (Acuros XB [AXB]). Methods and Materials: We identified subcentimeter tumors from our institutional SABR database. Tumor size was remeasured on an artifact-free phase of the planning 4-dimensional (4D)-CT. Clinical plan doses were generated using either a pencil beam convolution or an anisotropic analytic algorithm (AAA). All AAA plans were recalculated using AXB, and differences among D95 and mean dose for internal target volume (ITV) and planning target volume (PTV) on the average intensity CT dataset, as well as for gross tumor volume (GTV) on the end respiratory phases were reported. For all AAA patients, CBCT scans acquired during each treatment fraction were evaluated for target visibility. Progression-free and overall survival rates were calculated using the Kaplan-Meier method. Results: Thirty-five patients with 37 subcentimeter tumors were eligible for analysis. For the 22 AAA plans recalculated using AXB, Mean D95 ± SD values were 2.2 ± 4.4% (ITV) and 2.5 ± 4.8% (PTV) lower using AXB; whereas mean doses were 2.9 ± 4.9% (ITV) and 3.7 ± 5.1% (PTV) lower. Calculated AXB doses were significantly lower in one patient (difference in mean ITV and PTV doses, as well as in mean ITV and PTV D95 ranged from 22%-24%). However, the end respiratory phase GTV received at least 95% of the prescription dose. Review of 92 CBCT scans from all AAA patients revealed that the tumor was visualized in 82 images, and its position could be inferred in other images. The 2-year local progression-free survival was 100%. Conclusions: Patients with subcentimeter lung tumors are good candidates for SABR, given the dosimetry, ability to localize

  1. 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.

  2. 77 FR 9947 - Guidance for Industry: Early Clinical Trials With Live Biotherapeutic Products: Chemistry...

    Science.gov (United States)

    2012-02-21

    ... otherwise. In the Federal Register of October 14, 2010 (75 FR 63188), FDA announced the availability of the... Biotherapeutic Products: Chemistry, Manufacturing, and Control Information; Availability AGENCY: Food and Drug... Products: Chemistry, Manufacturing, and Control Information '' dated February 2012. The guidance...

  3. 76 FR 68768 - Guidance for Industry: Clinical Considerations for Therapeutic Cancer Vaccines; Availability

    Science.gov (United States)

    2011-11-07

    ... subsequent BLA for marketing approval. In the Federal Register of September 18, 2009 (74 FR 47947), FDA...) for marketing approval. The guidance applies to therapeutic cancer vaccines that are intended for the... (Title 21 Code of Federal Regulations (21 CFR) part 312) to support a subsequent BLA for...

  4. Exploring clinical and personality characteristics of adult male internet-only child pornography offenders.

    Science.gov (United States)

    Magaletta, Philip R; Faust, Erik; Bickart, William; McLearen, Alix M

    2014-02-01

    Despite the dramatic increase in the number of convicted child pornography offenders, little is known about their potential clinical needs. The few studies that do explore this subgroup of sex offenders suggest clinical heterogeneity compared with other sex offender subgroups. However, research designs used in many studies have limited generalizability, have examined primarily treated or treatment samples, and have not included comparisons with nontreatment, community samples of men. The current study addresses such limitations by using nontreatment samples and multiple comparison groups to examine mean scales score differences on a commonly used clinical and personality assessment, the Personality Assessment Inventory (PAI). The sample, drawn from an admissions cohort of federal offenders, those Internet-only Child Pornography Offenders (ICPOs; n = 35) and those with a history of child molesting exclusively (child molesters, n = 26). They were compared with each other and the male normative sample from the PAI. Results indicate that interpersonal deficits and depression featured most prominently in the profiles of the ICPOs. Consistent with prior research, they also obtained lower scores on aggression and dominance compared with the child molesters and the male normative sample. Implications for future research, training, and clinical practice with incarcerated ICPOs are offered. PMID:23174820

  5. 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 on...... 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...... 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...

  6. 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.

  7. 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

  8. 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.)

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

    International Nuclear Information System (INIS)

    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.)

  10. 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…

  11. 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.

  12. Angiocentric Lymphomatoid papulosis in a child: uncommon benign clinical entity with malignant histology

    OpenAIRE

    Kanthilatha Pai; Sathish Pai

    2015-01-01

    Lymphomatoid papulosis (LyP) is a rare form of chronic inflammatory skin disease with histologic features of a malignant lymphoma.It presents clinically with history of recurrent crops of pruritic papules that occur on the trunk and limbs that resolve spontaneously. We report an unusual case of angiocentric LyP in a 4 year old child and review the literature.

  13. Clinical image of tuberous sclerosis child and its parents

    International Nuclear Information System (INIS)

    Clinical findings of 20 patients with tuberous sclerosis (TS) were evaluated. Cranial CT scan revealed multiple calcification in all the cases. In 8 of the 20 TS patients, 15 parents of the patients were examined, and some symptoms of ST were found in 25%. However, the cranial CT provided no characteristic findings of TS. This suggests that checking of clinical symptoms such as adenoma sevaceum and others as well as cranial CT is important for analysis of familial occurrence of the disease and genetic counseling for that. (Ueda, J.)

  14. 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.

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

    Science.gov (United States)

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

    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 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. PMID:26934240

  16. 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)

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

    International Nuclear Information System (INIS)

    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)

  18. 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].

  19. Percutaneous transhepatic biliary drainage under fluoroscopic and ultrasound guidance for the treatment of obstructive jaundice: its clinical application

    International Nuclear Information System (INIS)

    Objective: To investigate the technical and clinical value of percutaneous transhepatic biliary drainage (PTBD) in treating patients of obstructive jaundice with the help of fluoroscopic and real-time ultrasound monitoring. Methods: A total of 78 patients with obstructive jaundice were enrolled in this study. The primary lesions included malignant diseases (n=70) and benign diseases (n=8). PTBD was carried out in all patients. Under fluoroscopic and real-time ultrasonography guidance, the biliary duct of the right hepatic lobe (n=52) or the biliary duct of the left hepatic lobe was punctured and the cholangiography was routinely performed. The drainage procedure was carried out. Results: PTBD was successfully accomplished in all patients. No severe complications, such as massive bleeding or biliary peritonitis, occurred. After the treatment the symptoms and signs of obstructive jaundice were gradually improved. The serum levels of both bilirubin and transaminase determined 1-2 weeks after the treatment were decreased, and the reductions were statistically significant when compared with the preoperative data (P<0.01). Conclusion: For the obstructive jaundice, PTBD under the guidance of fluoroscopy and real-time ultrasonography is an effective, safe, simple and economical treatment with fewer complications. (authors)

  20. Clinical and therapeutic data of a child with ecthyma gangrenosum

    Directory of Open Access Journals (Sweden)

    Ilirjana Bakalli

    2010-11-01

    Full Text Available The presence of the Pseudomonas aeruginosa infection in healthy children is very uncommon. Infants may occasionally present with community-acquired sepsis due to Pseudomonas aeruginosa, preceded by prolonged contact with contaminated bath water. Ecthyma gangrenosum is a characteristic dermatological manifestation caused most commonly by Pseudomonas aeruginosa. We describe the clinical data and therapeutic management of a 6 month-old infant with ecthyma gangrenousum caused by Pseudomonas aeruginosa, complicated with septicaemia and meningitis. The infant was immunodeficient as indicated by hypogammaglobulinemia, neutropenia, and a low level of C3 complement component.

  1. Predictors, Moderators, and Treatment Parameters of Community and Clinic-Based Treatment for Child Disruptive Behavior Disorders

    OpenAIRE

    Shelleby, Elizabeth C.; Kolko, David J.

    2013-01-01

    This study examines predictors, moderators, and treatment parameters associated with two key child outcomes in a recent clinical trial comparing the effects of a modular treatment that was applied by study clinicians in the community (COMM) or a clinic (CLINIC) for children with oppositional defiant disorder (ODD) or conduct disorder (CD). Based on a literature review, moderator and predictor variables across child, parent, and family domains were examined in relation to changes in parental r...

  2. 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.

  3. 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

  4. Off-label prescribing of psychotropic drugs in a Danish child and adolescent psychiatric outpatient clinic

    DEFF Research Database (Denmark)

    Nielsen, Eva Skovslund; Hellfritzsch, Maja; Sørensen, Merete Juul; Rasmussen, Helle; Thomsen, Per Hove; Laursen, Torben

    2015-01-01

    This study aimed to describe the level of off-label treatment with psychotropic drugs at a child and adolescent psychiatric outpatient clinic in Denmark. We performed a cross-sectional study assessing records on patients treated with medicine at two outpatient clinics at the child and adolescent...... prescriptions were off-label, which corresponds to 27.6 %. Attention deficit hyperkinetic disorder (ADHD) drugs were prescribed 450 times (73.2 %) of which 11 prescriptions were off-label (2.4 %). Other psychotropic drugs comprised 165 (26.8 %) prescriptions and of these 159 (96.4 %) were off-label. With 106...... prescriptions, melatonin was the most prescribed of these drugs; all prescriptions were off-label. The main reasons for classifying prescriptions as off-label were age and indication of treatment. This cross-sectional study reveals that medical treatment of children with other psychotropic drugs than ADHD drugs...

  5. 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…

  6. Angiocentric Lymphomatoid papulosis in a child: uncommon benign clinical entity with malignant histology

    Directory of Open Access Journals (Sweden)

    Kanthilatha Pai

    2015-01-01

    Full Text Available Lymphomatoid papulosis (LyP is a rare form of chronic inflammatory skin disease with histologic features of a malignant lymphoma.It presents clinically with history of recurrent crops of pruritic papules that occur on the trunk and limbs that resolve spontaneously. We report an unusual case of angiocentric LyP in a 4 year old child and review the literature.

  7. Evidence review and clinical guidance for the use of ziprasidone in Canada

    Directory of Open Access Journals (Sweden)

    Gardner David M

    2013-01-01

    Full Text Available Abstract While indicated for schizophrenia and acute mania, ziprasidone’s evidence base and use in clinical practice extends beyond these regulatory approvals. We, an invited panel of experts led by a working group of 3, critically examined the evidence and our collective experience regarding the effectiveness, tolerability and safety of ziprasidone across its clinical uses. There was no opportunity for manufacturer input into the content of the review. As anticipated, ziprasidone was found to be effective for its indicated uses, although its utility in mania and mixed states lacked comparative data. Beyond these uses, the available data were either unimpressive or were lacking. An attractive characteristic is its neutral effect on weight thereby providing patients with a non-obesogenic long-term treatment option. Key challenges in practice include the need for dosing on a full stomach and managing its early onset adverse effect of restlessness. Addressing these issues are critical to its long-term success

  8. 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.

  9. 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.…

  10. A novel speech prosthesis for mandibular guidance therapy in hemimandibulectomy patient: A clinical report

    OpenAIRE

    Raghavendra Adaki; Kamal Shigli; Dinshaw M Hormuzdi; Sivaranjani Gali

    2016-01-01

    Treating diverse maxillofacial patients poses a challenge to the maxillofacial prosthodontist. Rehabilitation of hemimandibulectomy patients must aim at restoring mastication and other functions such as intelligible speech, swallowing, and esthetics. Prosthetic methods such as palatal ramp and mandibular guiding flange reposition the deviated mandible. Such prosthesis can also be used to restore speech in case of patients with debilitating speech following surgical resection. This clinical re...

  11. 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...

  12. 2015 Guidance on cancer immunotherapy development in early‐phase clinical studies

    OpenAIRE

    ,; Arato, Teruyo; Daimon, Takashi; Heike, Yuji; Ishii, Ken; Itho, Kyogo; KAGEYAMA, SHINICHI; Kawakami, Yutaka; Nakayama, Eiichi; Ozawa, Keiya; Sato, Noriyuki; Shiku, Hiroshi; Takeuchi, Masahiro; Tani, Kenzaburo; Tamada, Koji

    2015-01-01

    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 check...

  13. Best Practices for Dual-Energy X-ray Absorptiometry Measurement and Reporting: International Society for Clinical Densitometry Guidance.

    Science.gov (United States)

    Lewiecki, E Michael; Binkley, Neil; Morgan, Sarah L; Shuhart, Christopher R; Camargos, Bruno Muzzi; Carey, John J; Gordon, Catherine M; Jankowski, Lawrence G; Lee, Joon-Kiong; Leslie, William D

    2016-04-01

    Dual-energy X-ray absorptiometry (DXA) is a technology that is widely used to diagnose osteoporosis, assess fracture risk, and monitor changes in bone mineral density (BMD). The clinical utility of DXA is highly dependent on the quality of the scan acquisition, analysis, and interpretation. Clinicians are best equipped to manage patients when BMD measurements are correct and interpretation follows well-established standards. Poor-quality acquisition, analysis, or interpretation of DXA data may mislead referring clinicians, resulting in unnecessary diagnostic evaluations, failure to evaluate when needed, inappropriate treatment, or failure to provide medical treatment, with potentially ineffective, harmful, or costly consequences. Misallocation of limited healthcare resources and poor treatment decisions can be minimized, and patient care optimized, through meticulous attention to DXA instrument calibration, data acquisition and analysis, interpretation, and reporting. This document from the International Society for Clinical Densitometry describes quality standards for BMD testing at DXA facilities worldwide to provide guidance for DXA supervisors, technologists, interpreters, and clinicians. High-quality DXA testing is necessary for correct diagnostic classification and optimal fracture risk assessment, and is essential for BMD monitoring. PMID:27020004

  14. 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)

  15. 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.

  16. Office of Child Care

    Science.gov (United States)

    ... 2014 OCC has a variety of resources and tools related to the law. Visit our Reauthorization site to find webinars, program instructions, and other guidance and information. > What is the Office of Child Care (OCC)? The Office of Child ...

  17. 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.

  18. 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

  19. 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

  20. SOCIODEMOGRAPHIC FEATURES OF CHILD AND ADOLESCENTS ADMITTED TO KARADENIZ TECHNICAL UNIVERSITY MEDICAL FACULTY CHILD OUTPATIENT CLINIC WITH SUICIDE ATTEMPT

    Directory of Open Access Journals (Sweden)

    Evrim AKTEPE

    2006-12-01

    Full Text Available Assesment of sociodemographic and psychiatric characteristics of attempted suicide in children and adolescents. The aim of this study is to identify risk factors and sociodemographic, psychiatric characteristics of adolescents and children who attempted suicide. Suicide attempters (range 7-15 years, fifty-eight cases who referred to Karadeniz Technical University, School of Medicine, Department of Child and Adolescent Psychiatry outpatient clinic between January 2003 and January 2005 were analyzed retrospectively, in terms of sex, age, living residence, number of suicide attempts, educational achievement and level, psychiatric examinations, method of suicide, precipitating events, psychiatric evaluations of parents, socioeconomic status in our study. The majority of subjects were girls (89.7%. The commonest age group involved was 15-16 years (46.6%. Girls, aged 15-16 years, from middle-low socioeconomic status with low achievement at school, living in urban area were found to be risky group for suicide attempt. From the view of low tolerance to problems, insufficient coping abilites in youth; acquirement of problem solving capacity and aiding in familiar problems solutions may be efficient in prevention and treatment of suicide. [TAF Prev Med Bull 2006; 5(6.000: 444-454

  1. 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.

  2. 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.

  3. [Clinical consensus statement on the care of the child with a tracheostomy].

    Science.gov (United States)

    Urrestarazu, Paula; Varón, Juan; Rodríguez, Aldana; Ton, Valeria; Vila, Fernando; Cipriani, Silvina; Moncada, Karina; Antonioli, Cintia P; Timoni, María A; Altina, Martha E; Nociti, Yamila B; Silva, Mariana L; Del Valle Rodríguez, Liliana; Rivas, Esteban; Boailchuk, Ivanna; Nieto, Mary E; Botto, Hugo A

    2016-02-01

    The care of the child with a tracheostomy deserves special attention because of the potential devastating airway compromise and because of the need of competent care by caregivers and professionals. The recommendations on tracheostomy care published are few and approaches are inconsistent among different institutions. This clinical consensus statement aims to improve care for children with tracheostomies. A literature search was conducted, reviewed and revised by this group of experts, who concurred with these statements, based on the best evidence available and taking into account the local context. PMID:26914079

  4. Guidance for the management of patients with latent tuberculosis infection requiring biologic therapy in rheumatology and dermatology clinical practice.

    Science.gov (United States)

    Cantini, Fabrizio; Nannini, Carlotta; Niccoli, Laura; Iannone, Florenzo; Delogu, Giovanni; Garlaschi, Giacomo; Sanduzzi, Alessandro; Matucci, Andrea; Prignano, Francesca; Conversano, Michele; Goletti, Delia

    2015-06-01

    Since the introduction of biologics for the treatment of rheumatoid arthritis (RA), psoriatic arthritis (PsA), ankylosing spondylitis (AS), and psoriasis (Pso) an increased risk of tuberculosis (TB) reactivation in patients with latent tuberculosis infection (LTBI) has been recorded for anti-TNF agents, while a low or absent risk is associated with the non-anti-TNF targeted biologics. To reduce this risk several recommendation sets have been published over time, but in most of them the host-related risk, and the predisposing role to TB reactivation exerted by corticosteroids and by the traditional disease-modifying anti-rheumatic drugs has not been adequately addressed. Moreover, the management of the underlying disease, and the timing of biologic restarting in patients with TB occurrence have been rarely indicated. A multidisciplinary expert panel, the Italian multidisciplinary task force for screening of tuberculosis before and during biologic therapy (SAFEBIO), was constituted, and through a review of the literature, an evidence-based guidance for LTBI detection, identification of the individualized level of risk of TB reactivation, and practical management of patients with TB occurrence was formulated. The literature review confirmed a higher TB risk associated with monoclonal anti-TNF agents, a low risk for soluble receptor etanercept, and a low or absent risk for non-anti-TNF targeted biologics. Considering the TB reactivation risk associated with host demographic and clinical features, and previous or current non-biologic therapies, a low, intermediate, or high TB reactivation risk in the single patient was identified, thus driving the safest biologic choice. Moreover, based on the underlying disease activity measurement and the different TB risk associated with non-biologic and biologic therapies, practical indications for the treatment of RA, PsA, AS, and Pso in patients with TB occurrence, as well as the safest timing of biologic restarting, were provided

  5. 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.

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

    OpenAIRE

    Yöntem Fidan T.

    2011-01-01

    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 20...

  7. [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

  8. 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

  9. Frequency of ABO and Rh (D) Blood Groups and Hemoglobin Threshold among Pregnant Women in Family Guidance Association, Mekelle Model Clinic, North Ethiopia.

    OpenAIRE

    Megbaru Alemu; Guesh Abrha; Gessessew Bugssa; Kiros Tedla

    2014-01-01

    This study was aimed to determine the frequency of ABO and Rh blood group patterns and hemoglobin threshold among pregnant women screened at Family Guidance Association of Ethiopia, North Area Mekelle model clinic. Checklists were prepared to collect data from laboratory registration books of five years to undergo this retrospective study. Those registration books were reviewed for ABO blood group, Rh profiles and hemoglobin threshold of the pregnant women screened during the specified per...

  10. Essentials for starting a pediatric clinical study (4): Clinical pediatric safety planning based on preclinical toxicity studies and pediatric pharmacovigilance guidance.

    Science.gov (United States)

    Sheth, Neha

    2009-01-01

    Juvenile toxicology studies in animals provide useful information to guide monitoring of potential adverse effects in children especially on growth and development. In order to continue to gain knowledge and build upon these preclinical studies, recent experience has suggested that additional approaches for monitoring of safety concerns in the pediatric population may be required. Recently, pediatric guidance has become available from the health authorities which provide pharmacovigilance concepts as they specifically relate to drugs being developed for pediatric indications. Clinical trials are typically not robust enough to detect rare or delayed safety effects as the pediatric trials are relatively short-term. Furthermore, such long term or rare effects may not be detected via standard voluntary postmarketing surveillance. Safety monitoring of children with Juvenile Inflammatory Arthritis (JIA) taking nonsteroid anti-inflammatory drug (NSAID)s will be used as an example to describe a post-marketing risk management and pharmacovigilance program that serves to better evaluate safety data from various sources. The intent of this program is to identify adverse events (AE), including events with longer latency, which may be associated with NSAID use in a pediatric population. In this presentation, the 4 major components of the program are to be addressed. Such a program may serve as a model to proactively generate and monitor safety data in order to identify AEs that may be associated with new therapeutics for a pediatric population. PMID:19571487

  11. 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.

  12. 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...

  13. 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

  14. 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.

  15. 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

  16. 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)

  17. 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.

  18. 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 ...

  19. 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…

  20. 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…

  1. 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...

  2. 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…

  3. 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...

  4. 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.

  5. 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

  6. BENIGN MYOCLONIC EPILEPSY OF INFANCY IN A CHILD WITH CEREBRAL PALSY: REALITY OR DIAGNOSTIC MIS- TAKE? A CLINICAL CASE

    Directory of Open Access Journals (Sweden)

    A. E. Ponyatishin

    2015-07-01

    Full Text Available The article describes a clinical case of benign myoclonic epilepsy of infancy in a child with cerebral palsy. Prospective observation of a patient (2 years duration with perinatal pathology and development afterwards of spastic-hyperki-netic form of cerebral palsy and occurring epilepsy in infancy, corresponding of electro-clinical characteristics of idio-pathic generalized epilepsy — benign myoclonic epilepsy of infancy. Probably, it is the first description of such clinical case in literature. The author noted the necessity of correct syndrome diagnosis of different forms of epilepsy in children with cerebral palsy

  7. 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.

  8. Why Guidance Works Better than Punishment.

    Science.gov (United States)

    Gartrell, Dan

    1995-01-01

    Examines how guidance techniques address the full spectrum of intervention methods, from prevention to conflict resolution to long-term management strategies. Discusses how punishment affects both children and teachers. Suggests that to put guidance into practice teachers should: be realistic, tailor activities to each child, practice positive…

  9. 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

  10. How does a real-world child psychiatric clinic diagnose and treat attention deficit hyperactivity disorder?

    Science.gov (United States)

    Yuki, Kumi; Bhagia, Jyoti; Mrazek, David; Jensen, Peter S

    2016-01-01

    AIM: To investigate child and adolescent psychiatrists’ (CAPs) attention deficit hyperactivity disorder (ADHD) and oppositional defiant disorder (ODD) diagnoses and treatments in real-world clinical practice. METHODS: The medical records of 69 ADHD children (mean age = 9.5 years), newly referred to the ADHD clinic, were reviewed for their scores of parent- and teacher-reported Vanderbilt ADHD Diagnostic Rating Scales (VADRSs), CAPs’ diagnoses of ADHD and ODD, and CAPs’ treatment recommendations. Among 63 ADHD subjects who completed both parent and teacher VADRSs, we examined the agreement of the parent and teacher VADRSs. We also examined the concurrent validity of CAPs’ ODD diagnoses against the results from the VADRSs. In addition, we compared CAPs’ treatment recommendations against established ADHD and ODD guidelines. RESULTS: Among 63 ADHD subjects, the majority of the subjects (92%) met full ADHD diagnostic criteria at least in one setting (parent or teacher) on the VADRSs. Nearly half of the patients met full ADHD diagnostic criteria in two settings (parent and teacher). Relatively low agreement between the parent and teacher VADRSs were found (95%CI: -0.33 to 0.14). For 29 children who scored positive for ODD on the rating scales, CAPs confirmed the ODD diagnosis in only 12 of these case-positives, which is considered as a fair agreement between CAPs and VADRSs (95%CI: 0.10-0.53). For 27 children with no ODD diagnosis made by either CAP or VADRS, more than half of them were recommended for medication only. In contrast, where CAPs made the diagnosis of ODD, or where the parent or teacher VADRS was positive for ODD, almost all of the patients received recommendations for medication and behavior therapy. CONCLUSION: CAPs’ ADHD diagnoses have strong concurrent validity against valid rating scales, but ADHD’s most common comorbid condition - ODD - may be under-recognized. PMID:27014602

  11. Guidance document on delivery, treatment planning, and clinical implementation of IMRT: Report of the IMRT subcommittee of the AAPM radiation therapy committee

    International Nuclear Information System (INIS)

    Intensity-modulated radiation therapy (IMRT) represents one of the most significant technical advances in radiation therapy since the advent of the medical linear accelerator. It allows the clinical implementation of highly conformal nonconvex dose distributions. This complex but promising treatment modality is rapidly proliferating in both academic and community practice settings. However, these advances do not come without a risk. IMRT is not just an add-on to the current radiation therapy process; it represents a new paradigm that requires the knowledge of multimodality imaging, setup uncertainties and internal organ motion, tumor control probabilities, normal tissue complication probabilities, three-dimensional (3-D) dose calculation and optimization, and dynamic beam delivery of nonuniform beam intensities. Therefore, the purpose of this report is to guide and assist the clinical medical physicist in developing and implementing a viable and safe IMRT program. The scope of the IMRT program is quite broad, encompassing multileaf-collimator-based IMRT delivery systems, goal-based inverse treatment planning, and clinical implementation of IMRT with patient-specific quality assurance. This report, while not prescribing specific procedures, provides the framework and guidance to allow clinical radiation oncology physicists to make judicious decisions in implementing a safe and efficient IMRT program in their clinics

  12. 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

  13. 77 FR 75174 - Draft Guidance for Industry on Providing Submissions in Electronic Format-Summary Level Clinical...

    Science.gov (United States)

    2012-12-19

    ... submitted to and reviewed by CDER as described in the Federal Register of June 26, 2003 (68 FR 38067... regulations in 21 CFR part 314, specifically Sec. 314.50(d)(5) Clinical data section and Sec. 314.50(f) Case.... 312.120), and the clinical data section (Sec. 314.50(d)(5)) and case report forms and tabulations...

  14. Radiofrequency therapy of intractable maxillary neuralgia with the help of fine needle puncturing of foramen rotundum under X-ray guidance: a clinical study

    International Nuclear Information System (INIS)

    Objective: To investigate the feasibility and efficacy of X-ray guided needle puncturing of foramen rotundum and radiofrequency therapy of intractable maxillary neuralgia. Methods: Fine-needle puncturing of foramen rotundum under fluoroscopic guidance radiofrequency ablation of maxillary nerve stem were carried out in 11 patients with intractable maxillary neuralgia who had failed to respond to other treatment. Visual analogue scale (VAS) was used to evaluate the therapeutic efficacy, and VAS score was determined before the treatment and 72 hours after the treatment. Results: The procedure was successfully accomplished in all patients. Pain was relieved immediately after the treatment. VAS score before the operation was 5-10 (with a median of 7), which decreased to 0 at 72 hours after the operation. A follow-up lasting for 2 weeks to 8 months (mean of 15 weeks) was conducted. No recurrent pain occurred. Facial swelling was seen in 36.4% of cases (4/16). Neither corneal ulcer nor masseteric weakness was seen. Conclusion: Radiofrequency ablation of maxillary nerve stem with the help of fine needle puncturing of foramen rotundum under X-ray guidance is an effective treatment for intractable maxillary neuralgia. It is worthy popularizing this technique in clinical practice. (authors)

  15. 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

  16. Antisocial behaviour in clinically referred boys : Early identification and assessment procedures in child psychiatry

    OpenAIRE

    Enebrink, Pia

    2005-01-01

    Background: Oppositional and aggressive behaviour in children below twelve years of age is a frequent cause of concern for parents and teachers, and a common reason for referral to child and adolescent psychiatry. Whereas most children outgrow these behaviours, a small subgroup is at risk for developing a persistent antisocial lifestyle. Successfully identifying children at risk could prevent potential human and economic suffering of the child, his/her family, potential vict...

  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. 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

  19. The association between parenting stress, parenting self-efficacy, and the clinical significance of child ADHD symptom change following behavior therapy.

    Science.gov (United States)

    Heath, Corey L; Curtis, David F; Fan, Weihua; McPherson, Robert

    2015-02-01

    We examined parenting stress (PST) and self-efficacy (PSE) following participation in behavioral parent training (BPT) with regard to child treatment response. Forty-three families of children diagnosed with ADHD participated in a modified BPT program. Change in PST and PSE was evaluated using a single group, within-subjects design. Parenting outcomes based on child treatment response were evaluated based upon (1) magnitude and (2) clinical significance of change in child symptom impairment. Parents reported significant improvements in stress and self-efficacy. Parents of children who demonstrated clinically significant reduction in ADHD symptoms reported lower stress and higher self-efficacy than those of children with continued impairments. Magnitude of child impairment was not associated with parent outcomes. Clinical implications for these results include extending treatment duration to provide more time for symptom amelioration and parent-focused objectives to improve coping and stress management. PMID:24668566

  20. 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

    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...... clinic. Secondly, the paper proposes practical handling of patients in LCIG treatment for advanced PD based on experience and initiation of LCIG treatment and follow-up in forty patients.......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...

  1. 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...

  2. 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.

  3. 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 interven...... 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...

  4. Assessing the Effectiveness of Parent-Child Interaction Therapy with Language Delayed Children: A Clinical Investigation

    Science.gov (United States)

    Falkus, Gila; Tilley, Ciara; Thomas, Catherine; Hockey, Hannah; Kennedy, Anna; Arnold, Tina; Thorburn, Blair; Jones, Katie; Patel, Bhavika; Pimenta, Claire; Shah, Rena; Tweedie, Fiona; O'Brien, Felicity; Leahy, Ruth; Pring, Tim

    2016-01-01

    Parent-child interaction therapy (PCIT) is widely used by speech and language therapists to improve the interactions between children with delayed language development and their parents/carers. Despite favourable reports of the therapy from clinicians, little evidence of its effectiveness is available. We investigated the effects of PCIT as…

  5. 75 FR 51083 - Office of Clinical and Preventive Services Maternal and Child Health Program: Project Choices...

    Science.gov (United States)

    2010-08-18

    ... Implementation and Evaluation for American Indian and Alaska Native Women (CHOICES AI/AN) . This program is... Natives (AI/AN) tend to be higher than U.S. prevalence rates of FAS overall. CDC studies have reported... to support and educate AI/AN women of child bearing years in making healthy choices while...

  6. Sociodemographic Characteristics and Diagnoses of Individuals Referred to a Child and Adolescent Psychiatry Outpatient Clinic of a University Hospital

    Directory of Open Access Journals (Sweden)

    Sevcan Karakoç Demirkaya

    2015-04-01

    Full Text Available OBJECTIVE: The aim of this study is to evaluate the sociodemographic characteristics, complaints, and diagnoses of individuals who were admitted to a child and adolescent psychiatry outpatient clinic. MATERIALS AND METHODS: Medical charts of the patients who were admitted to the child and adolescent psychiatry unit of Adnan Menderes University between February 1st and July 31st, 2014 were retrospectively studied. RESULTS: The rate of girls and boys from a total of 832 cases who were referred to the child and adolescent psychiatry outpatient clinic in the six month period was 41.8% and 58.2%, respectively. The mean age of the girls and boys was 10.8±4.9 and 8.5±4.7 years, respectively. The most common age range was between 12 and 18 years. The proportion of patients who lived with both parents was 81.1%; however, the proportion of individuals brought in by institutional caregivers was 0.8%. The proportion of consanguineous marriages was 13.7%. The education level of mothers and fathers was mostly a primary school degree (47% and 45.6%, respectively. A positive psychiatric history was present in 13.7% of the mothers and 7.6% of the fathers. Reasons for child psychiatric assessments were as follows: 21.9% for disability report, 13.8% for forensic evaluation, 11.2% for consultation, and 52.9% for general psychiatric evaluation. Referral complaints were irritability/anger (15.7%, attention deficit/hyperactivity (14.8%, delay in speech (10.5%, fear/anxiety (5.9%, and poor school performance (5.7%. The diagnoses were as follows: attention deficit hyperactivity disorder (ADHD (20.6%, other disruptive behaviors (12.4%, and anxiety disorder (10.2%. CONCLUSION: We revealed that the most common referring complaint was irritability/anger and that the most common diagnosis was ADHD in our patient group, which was similar to previous studies. Our results showed that a low parental educational level and a positive history for parental psychopathology were

  7. Distribution of guidance models for cardiac resynchronization therapy in the setting of multi-center clinical trials

    Science.gov (United States)

    Rajchl, Martin; Abhari, Kamyar; Stirrat, John; Ukwatta, Eranga; Cantor, Diego; Li, Feng P.; Peters, Terry M.; White, James A.

    2014-03-01

    Multi-center trials provide the unique ability to investigate novel techniques across a range of geographical sites with sufficient statistical power, the inclusion of multiple operators determining feasibility under a wider array of clinical environments and work-flows. For this purpose, we introduce a new means of distributing pre-procedural cardiac models for image-guided interventions across a large scale multi-center trial. In this method, a single core facility is responsible for image processing, employing a novel web-based interface for model visualization and distribution. The requirements for such an interface, being WebGL-based, are minimal and well within the realms of accessibility for participating centers. We then demonstrate the accuracy of our approach using a single-center pacemaker lead implantation trial with generic planning models.

  8. Volume CT with a flat-panel detector on a mobile, isocentric C-arm: Pre-clinical investigation in guidance of minimally invasive surgery

    International Nuclear Information System (INIS)

    A mobile isocentric C-arm (Siemens PowerMobil) has been modified in our laboratory to include a large area flat-panel detector (in place of the x-ray image intensifier), providing multi-mode fluoroscopy and cone-beam computed tomography (CT) imaging capability. This platform represents a promising technology for minimally invasive, image-guided surgical procedures where precision in the placement of interventional tools with respect to bony and soft-tissue structures is critical. The image quality and performance in surgical guidance was investigated in pre-clinical evaluation in image-guided spinal surgery. The control, acquisition, and reconstruction system are described. The reproducibility of geometric calibration, essential to achieving high three-dimensional (3D) image quality, is tested over extended time scales (7 months) and across a broad range in C-arm angulation (up to 45 deg.), quantifying the effect of improper calibration on spatial resolution, soft-tissue visibility, and image artifacts. Phantom studies were performed to investigate the precision of 3D localization (viz., fiber optic probes within a vertebral body) and effect of lateral projection truncation (limited field of view) on soft-tissue detectability in image reconstructions. Pre-clinical investigation was undertaken in a specific spinal procedure (photodynamic therapy of spinal metastases) in five animal subjects (pigs). In each procedure, placement of fiber optic catheters in two vertebrae (L1 and L2) was guided by fluoroscopy and cone-beam CT. Experience across five procedures is reported, focusing on 3D image quality, the effects of respiratory motion, limited field of view, reconstruction filter, and imaging dose. Overall, the intraoperative cone-beam CT images were sufficient for guidance of needles and catheters with respect to bony anatomy and improved surgical performance and confidence through 3D visualization and verification of transpedicular trajectories and tool placement

  9. 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

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

    OpenAIRE

    Owoaje, Eme T.; Adedoyin D. Omidokun; Ige, Olusimbo K.

    2012-01-01

    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 Car...

  11. 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. PMID:27307676

  12. 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. PMID:26133890

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

    Directory of Open Access Journals (Sweden)

    Aleksander Pavlovich Pozdeev

    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.

  14. 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

  15. Frequency of ABO and Rh (D Blood Groups and Hemoglobin Threshold among Pregnant Women in Family Guidance Association, Mekelle Model Clinic, North Ethiopia.

    Directory of Open Access Journals (Sweden)

    Megbaru Alemu

    2014-12-01

    Full Text Available This study was aimed to determine the frequency of ABO and Rh blood group patterns and hemoglobin threshold among pregnant women screened at Family Guidance Association of Ethiopia, North Area Mekelle model clinic. Checklists were prepared to collect data from laboratory registration books of five years to undergo this retrospective study. Those registration books were reviewed for ABO blood group, Rh profiles and hemoglobin threshold of the pregnant women screened during the specified period. A total of 5987 pregnant women have been found to be screened and the predominant phenotype in this study was O (41.5% followed by phenotype A (28%, Phenotype B (25% and phenotype AB (5.5%. Regarding Rh (D system, 91.2% (5458/5987 women were positive for rhesus D antigen while the remaining 8.8% (529/5987 women were negative for the antigen. Blood grouping studies should be done in every region of the nation so that national transfusion policies can be drafted and supplying blood to the needy patients during emergency will be easier.

  16. SOCIODEMOGRAPHIC FEATURES OF CHILD AND ADOLESCENTS ADMITTED TO KARADENİZ TECHNICAL UNIVERSITY MEDICAL FACULTY CHILD OUTPATIENT CLINIC WITH SUICIDE ATTEMPT

    Directory of Open Access Journals (Sweden)

    evrim AKTEPE

    2006-11-01

    Full Text Available Assesment of sociodemographic and psychiatric characteristics of attempted suicide in children and adolescents. The aim of this study is to identify risk factors and sociodemographic, psychiatric characteristics of adolescents and children who attempted suicide. Suicide attempters (range 7-15 years, fifty-eight cases who referred to Karadeniz Technical University, School of Medicine, Department of Child and Adolescent Psychiatry outpatient clinic between January 2003 and January 2005 were analyzed retrospectively, in terms of sex, age, living residence, number of suicide attempts, educational achievement and level, psychiatric examinations, method of suicide, precipitating events, psychiatric evaluations of parents, socioeconomic status in our study. The majority of subjects were girls (89.7%. The commonest age group involved was 15-16 years (46.6%. Girls, aged 15-16 years, from middle-low socioeconomic status with low achievement at school, living in urban area were found to be risky group for suicide attempt. From the view of low tolerance to problems, insufficient coping abilites in youth; acquirement of problem solving capacity and aiding in familiar problems solutions may be efficient in prevention and treatment of suicide.

  17. The effect of relational continuity of care in maternity and child health clinics on parenting self-efficacy of mothers and fathers with loneliness and depressive symptoms.

    Science.gov (United States)

    Tuominen, Miia; Junttila, Niina; Ahonen, Pia; Rautava, Päivi

    2016-06-01

    This study explored the parenting self-efficacy of the parents of 18-month-old children in the context of Finnish maternity and child health clinics. This parenting self-efficacy was observed in relation with the relational continuity of care and parents' experienced loneliness and depressive symptoms. The relational continuity of care was provided by a public health nurse in maternity and child health clinics. The participating parents were drawn from the STEPS study that is being carried out by the Institute for Child and Youth Research at the University of Turku. The results showed that relational continuity of care provided by the same public health nurse in the maternity and child health clinics was associated with mothers' higher emotional loneliness and with lower scores on three dimensions of parents' parenting self-efficacy. Loneliness and depressive symptoms negatively influenced parents' parenting self-efficacy - however, in the case where the family had experienced relational continuity of care, the parents' higher levels of depressive symptoms had not weakened their parenting self-efficacy beliefs. These results are discussed in terms of organizing maternity and child health clinic services. PMID:27037491

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

    OpenAIRE

    Josefa Canals Sans; Carmen Hernández-Martínez; Sandra Cosi Muñoz; Luisa Lázaro García; Josep Toro Trallero

    2012-01-01

    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 a...

  19. 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.

  20. Health literacy and child health promotion: implications for research, clinical care, and public policy.

    Science.gov (United States)

    Sanders, Lee M; Shaw, Judith S; Guez, Ghislaine; Baur, Cynthia; Rudd, Rima

    2009-11-01

    The nation's leading sources of morbidity and health disparities (eg, preterm birth, obesity, chronic lung disease, cardiovascular disease, type 2 diabetes, mental health disorders, and cancer) require an evidence-based approach to the delivery of effective preventive care across the life course (eg, prenatal care, primary preventive care, immunizations, physical activity, nutrition, smoking cessation, and early diagnostic screening). Health literacy may be a critical and modifiable factor for improving preventive care and reducing health disparities. Recent studies among adults have established an independent association between lower health literacy and poorer understanding of preventive care information and poor access to preventive care services. Children of parents with higher literacy skills are more likely to have better outcomes in child health promotion and disease prevention. Adult studies in disease prevention have suggested that addressing health literacy would be an efficacious strategy for reducing health disparities. Future initiatives to reduce child health inequities should include health-promotion strategies that meet the health literacy needs of children, adolescents, and their caregivers. PMID:19861485

  1. The clinical spectrum and prevalence of hereditary ophthalmopathology child population in 12 districts of the Rostov region

    Directory of Open Access Journals (Sweden)

    O. L. Kireeva

    2014-07-01

    Full Text Available Purpose: to study the diversity of the clinical spectrum and prevalence of hereditary ophthalmopathology child population in 12 districts of the Rostov region.Methods: We conducted an epidemiological study of hereditary ophthalmopathology population of the Rostov region. the popula- tion surveyed 12 districts of the region — 497460 people, including 97345 children (0-18 years. Regardless of age for the selection of patients used the original protocol of genetic-epidemiological studies, developed over 30 years ago, in Genetic Epidemiology Labora- tory Medical Genetic Research Center.Results: In the group of the child population identified 84 patients from 72 families. the most commonly diagnosed congenital cataract various forms (36.1%, congenital horizontal nystagmus (18.0%, monogenic defects eyes (15.6%, congenital ptosis (15.6%, hereditary retinal dystrophy (9, 6%. the overall prevalence of hereditary eye diseases among the adult population was 2.42±0.25, children 8.63±0.94 to 10,000 people.Conclusion: Conducting genetic epidemiology studies will improve eye health and medical genetic care.

  2. 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

  3. Paradise Lost: The Neurobiological and Clinical Consequences of Child Abuse and Neglect.

    Science.gov (United States)

    Nemeroff, Charles B

    2016-03-01

    In the past two decades, much evidence has accumulated unequivocally demonstrating that child abuse and neglect is associated with a marked increase in risk for major psychiatric disorders (major depression, bipolar disorder, post-traumatic stress disorder [PTSD], substance and alcohol abuse, and others) and medical disorders (cardiovascular disease, diabetes, irritable bowel syndrome, asthma, and others). Moreover, the course of psychiatric disorders in individuals exposed to childhood maltreatment is more severe. Recently, the biological substrates underlying this diathesis to medical and psychiatric morbidity have been studied. This Review summarizes many of the persistent biological alterations associated with childhood maltreatment including changes in neuroendocrine and neurotransmitter systems and pro-inflammatory cytokines in addition to specific alterations in brain areas associated with mood regulation. Finally, I discuss several candidate gene polymorphisms that interact with childhood maltreatment to modulate vulnerability to major depression and PTSD and epigenetic mechanisms thought to transduce environmental stressors into disease vulnerability. PMID:26938439

  4. 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.)

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

    International Nuclear Information System (INIS)

    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.)

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

    Directory of Open Access Journals (Sweden)

    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

  7. [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

  8. 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.…

  9. 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).

  10. 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.

  11. 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…

  12. 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.…

  13. 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.

  14. 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

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

    Directory of Open Access Journals (Sweden)

    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.

  16. 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.

  17. 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

  18. The Antisocial Child, His Family and His Community. The Langley Porter Child Psychiatry Series -- Clinical Approaches to Problems of Childhood, Volume 4.

    Science.gov (United States)

    Szurek, S.A., Ed.; Berlin, I.N., Ed.

    Eighteen papers consider the antisocial child. The genesis of his behavior is discussed in terms of psychopathic personality trends, acting out, and sexual disorders; emotional factors in the use of authority and the contribution of controls to corrective learning are described. Efforts at psychiatric treatment are reviewed with reference to…

  19. 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.

  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. Clinical manifestation of Hurler syndrome in a 7 year old child

    Directory of Open Access Journals (Sweden)

    S Sharma

    2012-01-01

    Full Text Available Mucopolysaccharidosis type I (MPS I H, Hurler syndrome is a rare autosomal recessive inborn deficiency in the metabolism of glycosaminoglycans (GAGs heparan sulfate and dermatan sulfate, resulting from deficiency of Alpha-L-iduronidase enzyme. This condition is characterized by accumulation of incompletely degraded glycosaminoglycans into various organs of body, which leads to impairment of organs and body functions. Such children appear nearly normal at birth; however, if left untreated, show a progressive mental and physical deterioration leading to death due to cardiorespiratory failure before the second decade of life. Pedodontists have a role for early diagnosis, rendering corrective and preventive treatment to the developing dentition, and referring the patient to the concerned specialities. An interesting case of a seven year old boy with a combination of skeletal, neurological, ophthalmologic, oro-dental and radiological findings of this diverse and devastating clinical entity with MPS I-(Hurler syndrome has been presented here in this case report.

  2. 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

  3. 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

  4. Graphic Turbulence Guidance

    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...

  5. 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.

  6. 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.

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

    OpenAIRE

    Mukesh Kumar Goyal; Shelly Goyal

    2011-01-01

    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...

  8. 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

  9. 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.

  10. 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

  11. 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

  12. Planning Practice Guidance

    OpenAIRE

    Public Health England

    2014-01-01

    The Department for Communities and Local Government has published National Planning Practice Guidance which recognises the importance of local infrastructure planning in the development of healthy communities. The guidance supports the National Planning Policy Framework and now includes a section on health and wellbeing. This guidance sets out the government’s planning policies for England and how these are expected to be applied by local authorities. A significant development in the...

  13. 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.

  14. Clinical characteristics and selection of treatment modality for patients with vitreomacular traction: real-world implementation of NICE guidance (TA297)

    Science.gov (United States)

    Pritchard, Edward William James; Ilyas, Shams-Ulislam; Amar, Soha Khaled; Yang, Yit Chuin; Narendran, Nirodhini

    2016-01-01

    Aim To investigate the qualitative aspects in patient selection and the quantitative impact of disease burden in real world treatment of vitreomacular traction (VMT) and implementation of the National Institute for Health and Care Excellence (NICE) guidance (TA297). Methods A monocentric, retrospective review of consecutive patients undergoing optical coherence tomography (OCT) imaging over a 3 month period. Patients with VMT in at least one eye were identified for further data collection on laterality, visual acuity, symptoms, presence of epiretinal membrane, macular hole and treatment selection. Results A total of 3472 patients underwent OCT imaging with a total of 6878 eyes scanned. Out of 87 patients, 74 patients had unilateral VMT (38 right, 36 left) and 13 patients had bilateral VMT. Eighteen patients with unilateral VMT satisfied NICE criteria of severe sight problems in the affected eye. Eight were managed for a coexisting pathology, one refused treatment, one patient did not attend, two closed spontaneously, and one received ocriplasmin prior to the study start date. Only two patients with unilateral VMT received ocriplasmin and three underwent vitrectomy. Those failing to meet NICE criteria for unilateral VMT were predominantly asymptomatic (n=49) or had coexisting ERM (n=5) or both (n=2). Conclusion Ocriplasmin provides an alternative treatment for patients with symptomatic VMT. Our data shows that the majority of patients with VMT do not meet NICE TA297 primarily due to lack of symptoms. Those meeting NICE criteria, but not treated, tended to have coexisting macular pathology. Variation in patient selection due to subjective factors not outlined in NICE guidance suggests that real world outcomes of ocriplasmin therapy should be interpreted with caution. PMID:26834452

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

    International Nuclear Information System (INIS)

    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 cm2) 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.

  16. Feeding practices among children attending child welfare clinics in Ragama MOH area: a descriptive cross-sectional study

    Directory of Open Access Journals (Sweden)

    Perera Priyantha J

    2011-11-01

    Full Text Available Abstract Background Feeding during early childhood is important for normal physical and mental growth as well as for health in later life. Currently, Sri Lanka has adopted the WHO recommendation of exclusive breastfeeding for six months, followed by addition of complementary feeds thereafter, with continuation of breastfeeding up to or beyond two years. This study was conducted to evaluate the current feeding practices among Sri Lankan children during early childhood. Methods This study was a descriptive cross-sectional study conducted in the Ragama Medical Officer of Health (MOH area. It was conducted between 10 August 2010 and 30 October 2010. Children between the ages of 24 and 60 months, attending child welfare clinics, were included in the study on consecutive basis. An interviewer-administered questionnaire was used to collect data regarding sociodemographic characteristics and feeding practices. Results There were 208 boys and 202 girls in the study population. Of them, 255 (62.2% were exclusively breastfed up to 6 months. Younger children had a statistically significant, higher rate of exclusive breastfeeding compared to older children. Three hundred and fifty one (85.6% children had received infant formula, and it was started before the age of 6 months in 61 children, and in 212 before one year. Sugar was added to infant formula in 330 (80.4% children, and out of them 144 had sugar added within first year of life. Complementary foods were started before 4 months in 29 (7% children. Of the 410 children, 294 (71.7% were breastfed beyond 2 years and 41.6% of them were breastfed at regular intervals throughout the day. Three hundred and thirty eight (82.6% children were receiving overnight feeding of either breast milk or infant formula even after 2 years. Conclusions Though a high rate of exclusive breastfeeding was observed in this study population, there are many other issues related to feeding during the early years of life that need

  17. [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

  18. 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.

  19. 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.

  20. 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.

  1. 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)…

  2. 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…

  3. Mother-Child Agreement on the Child's Past Food Exposure

    Science.gov (United States)

    Thongudomporn, Udom; Chongsuvivatwong, Virasakdi; Geater, Alan F.

    2010-01-01

    Objective: To assess mother-child agreement on the child's past food exposure, and factors affecting response discrepancy. Methods: Twelve- to 14-year-old children and their mothers (n = 78) in an urban community, a rural community, and 2 orthodontic clinics completed a 69-item food questionnaire to determine mother-child level of agreement on the…

  4. 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…

  5. 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.

  6. "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

  7. 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 ...

  8. 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

  9. 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...

  10. Child Abuse

    Science.gov (United States)

    ... 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 ...

  11. Child Poverty and Child Outcomes.

    Science.gov (United States)

    Bradshaw, Jonathan

    2002-01-01

    Reviews the evidence on the prevalence of child poverty in Britain including: (1) how child poverty has changed over the last 20 years; (2) how child poverty in Britain compares with that in other countries; (3) characteristics of poor children; (4) impact of poverty on child well-being; and (5) government attempts to abolish child poverty. (SD)

  12. 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'…

  13. Incidence and course of child malnutrition according to clinical or anthropometrical assessment: a longitudinal study from rural DR Congo

    OpenAIRE

    Kismul, Hallgeir; Schwinger, Catherine; Chhagan, Meera; Mapatano, Mala; Van den Broeck, Jan

    2014-01-01

    Background: Longitudinal studies describing incidence and natural course of malnutrition are scarce. Studies defining malnutrition clinically [moderate clinical malnutrition (McM) marasmus, kwashiorkor] rather than anthropometrically are rare. Our aim was to address incidence and course of malnutrition among pre-schoolers and to compare patterns and course of clinically and anthropometrically defined malnutrition.Methods: Using a historical, longitudinal study from Bwamanda, DR Congo...

  14. 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,.

  15. Comparing Parent-Child Interactions in the Clinic and at Home: An Exploration of the Validity of Clinical Behavior Observations Using Sequential Analysis

    Science.gov (United States)

    Shriver, Mark D.; Frerichs, Lynae J.; Williams, Melissa; Lancaster, Blake M.

    2013-01-01

    Direct observation is often considered the "gold standard" for assessing the function, frequency, and intensity of problem behavior. Currently, the literature investigating the construct validity of direct observation conducted in the clinic setting reveals conflicting results. Previous studies on the construct validity of clinic-based…

  16. Constrained reconstructions for 4D intervention guidance

    Science.gov (United States)

    Kuntz, J.; Flach, B.; Kueres, R.; Semmler, W.; Kachelrieß, M.; Bartling, S.

    2013-05-01

    Image-guided interventions are an increasingly important part of clinical minimally invasive procedures. However, up to now they cannot be performed under 4D (3D + time) guidance due to the exceedingly high x-ray dose. In this work we investigate the applicability of compressed sensing reconstructions for highly undersampled CT datasets combined with the incorporation of prior images in order to yield low dose 4D intervention guidance. We present a new reconstruction scheme prior image dynamic interventional CT (PrIDICT) that accounts for specific image features in intervention guidance and compare it to PICCS and ASD-POCS. The optimal parameters for the dose per projection and the numbers of projections per reconstruction are determined in phantom simulations and measurements. In vivo experiments in six pigs are performed in a cone-beam CT; measured doses are compared to current gold-standard intervention guidance represented by a clinical fluoroscopy system. Phantom studies show maximum image quality for identical overall doses in the range of 14 to 21 projections per reconstruction. In vivo studies reveal that interventional materials can be followed in 4D visualization and that PrIDICT, compared to PICCS and ASD-POCS, shows superior reconstruction results and fewer artifacts in the periphery with dose in the order of biplane fluoroscopy. These results suggest that 4D intervention guidance can be realized with today’s flat detector and gantry systems using the herein presented reconstruction scheme.

  17. 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.…

  18. 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.

  19. 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...

  20. Clinical experiences derived from implementation of an easy to use concept for treatment of wound healing by secondary intention and guidance in selection of appropriate dressings.

    Science.gov (United States)

    Braumann, Chris; Guenther, Nina; Menenakos, Charalambos; Muenzberg, Helga; Pirlich, Matthias; Lochs, Herbert; Mueller, Joachim M

    2011-06-01

    The main objective of this case-cohort-type observational study conducted at different Surgical Departments of the Charité-Universitätsmedizin in Berlin was to evaluate the sequential use concept first described by Systagenix Wound Management in 2007. Fifty-two patients with different wound healing by secondary intention were treated for 7 weeks at the Charité-Universitätsmedizin in Berlin. A multidisciplinary team worked together to reach consensus in wound assessment; in classification of infection status according to the criteria described by European Wound Management Association (EWMA); in treatment protocol and on dressings to be used to 'cover' wounds. Before dressing application, all wounds were cleaned from debris. Following the sequential use concept, wounds classified as stages 2 and 3 were dressed with SILVERCEL(®) and TIELLE(®) or TIELLE PLUS(®) to 'clean' the wounds. After 2-3 weeks, treatment was changed to PROMOGRAN PRISMA(®) and TIELLE(®) to 'close and cover' wounds, thus providing optimal wound healing. Wounds classified as non infected were dressed with PROMOGRAN PRISMA(®) and TIELLE(®) during the complete treatment period. Patients were asked to evaluate the treatment using a simplified questionnaire developed at the Charité-Universitätsmedizin in Berlin. Wounds comprised 37 surgical procedures, 8 chronic mixed ulcer, 4 pressure sores, 1 diabetic foot ulcer, 1 venous leg ulcer, and 1 mixed arterial/venous ulcer. At baseline, 12 wounds were classified as stage 3, 38 wounds as stage 2 and 2 wounds as stage 1. After 7 weeks of treatment, all patients showed a positive clinical response to the sequential use treatment. Results of wound size showed a high significant progression of wound healing expressed with a profound reduction of wound area (P in all measurements concept in the daily clinical practice of wound treatment. On the basis of the wound healing results, patients' evaluation of treatment and the clinicians' and staff

  1. 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

  2. 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

  3. 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.

  4. 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

  5. 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).

  6. 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…

  7. 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 i...... 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....

  8. 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.

  9. 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

  10. 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.

  11. 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

  12. Detailed molecular and clinical investigation of a child with a partial deletion of chromosome 11 (Jacobsen syndrome)

    OpenAIRE

    Peitsidis Panagiotis; Thomaidis Loretta; Papoulidis Ioannis; Louizou Eirini; Kefalas Konstantinos; Neroutsou Rosita; Orru Sandro; Manolakos Emmanouil; Sotiriou Sotirios; Kitsos George; Tsoplou Panagiota; Petersen Michael B; Metaxotou Aikaterini

    2009-01-01

    Abstract Background Jacobsen syndrome (JBS) is a rare chromosomal disorder leading to multiple physical and mental impairment. This syndrome is caused by a partial deletion of chromosome 11, especially subband 11q24.1 has been proven to be involved. Clinical cases may easily escape diagnosis, however pancytopenia or thrombocytopenia may be indicative for JBS. Results We report a 7.5 years old boy presenting with speech development delay, hearing impairment and abnormal platelet function. High...

  13. 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.)

  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. 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)

  16. Employee commute options guidance

    International Nuclear Information System (INIS)

    The Clean Air Act Amendments of 1990 (CAAA) require severe and extreme ozone nonattainment areas and serious carbon monoxide nonattainment areas to establish programs aimed at reducing commute trips to the worksites of large employers. The concerns that lead to the inclusion of the Employee Commute Options (ECO) provision in the Act are that more people are driving than ever before and they are driving longer distances. The purpose of the guidance is to inform the affected State and local jurisdictions of the Clean Air Act requirement, to provide guidance on preparing an approvable State Implementation Plan (SIP) revision, and to discuss various approaches which may help areas achieve Clean Air Act targets through implementation strategies that are the least burdensome and costly to both affected employers and employees

  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. 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.

  19. Detailed molecular and clinical investigation of a child with a partial deletion of chromosome 11 (Jacobsen syndrome

    Directory of Open Access Journals (Sweden)

    Peitsidis Panagiotis

    2009-12-01

    Full Text Available Abstract Background Jacobsen syndrome (JBS is a rare chromosomal disorder leading to multiple physical and mental impairment. This syndrome is caused by a partial deletion of chromosome 11, especially subband 11q24.1 has been proven to be involved. Clinical cases may easily escape diagnosis, however pancytopenia or thrombocytopenia may be indicative for JBS. Results We report a 7.5 years old boy presenting with speech development delay, hearing impairment and abnormal platelet function. High resolution SNP oligonucleotide microarray analysis revealed a terminal deletion of 11.4 Mb in size, in the area 11q24.1-11qter. This specific deletion encompasses around 170 genes. Other molecular techniques such as fluorescence in situ hybridization and multiplex ligation-dependent probe amplification were used to confirm the array-result. Discussion Our results suggest that the identification and detailed analysis of similar patients with abnormal platelet function and otherwise mild clinical features will contribute to identification of more patients with 11q deletion and JBS.

  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. 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

  2. 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...

  3. Child Support

    OpenAIRE

    Bradshaw, J. (Jonathan)

    2006-01-01

    Child support is a private transfer, which for many people is mediated by the government, and which mainly benefits lone parents. Children in lone parent families represented 42 per cent of all poor children in 2003/4. Therefore child support might play an important part in reducing child poverty. Although this was not an aspiration of the 1991 Child Support Act it was certainly the main aspiration of the Child Support, Pensions and Social Security Act 2000. This paper is a review of the pote...

  4. 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

  5. Evaluation of the sustainability and clinical outcome of alternatives for families: A cognitive-behavioral therapy (AF-CBT) in a child protection center

    OpenAIRE

    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 child physical abuse and family aggression/conflict that was included in the National Child Traumatic Stress Network’s initial EBT dissemination effo...

  6. 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.

  7. 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

  8. Using the Modified Checklist for Autism in Toddlers in a Well-Child Clinic in Turkey: Adapting the Screening Method Based on Culture and Setting

    Science.gov (United States)

    Kara, Bülent; Mukaddes, Nahit Motavalli; Altinkaya, Isilay; Güntepe, Dilek; Gökçay, Gülbin; Özmen, Meral

    2014-01-01

    We aimed to adapt the Modified Checklist for Autism in Toddlers to Turkish culture. The Modified Checklist for Autism in Toddlers was filled out independently by 191 parents while they were waiting for the well-child examination of their child. A high screen-positive rate was found. Because of this high false-positive rate, a second study was done…

  9. 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.

  10. 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

  11. 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.

  12. 77 FR 48989 - Draft Guidance for Industry on Suicidal Ideation and Behavior: Prospective Assessment of...

    Science.gov (United States)

    2012-08-15

    ... of Occurrence in Clinical Trials.'' The purpose of this guidance is to assist sponsors in.... Send one self-addressed adhesive label to assist that office in processing your requests. See the... Clinical Trials.'' The purpose of this guidance is to assist sponsors in prospectively assessing...

  13. Risk factors for postpartum depression in women living with HIV attending prevention of mother-to-child transmission clinic at Kenyatta National Hospital, Nairobi.

    Science.gov (United States)

    Yator, Obadia; Mathai, Muthoni; Vander Stoep, Ann; Rao, Deepa; Kumar, Manasi

    2016-07-01

    Mothers with HIV are at high risk of a range of psychosocial issues that may impact HIV disease progression for themselves and their children. Stigma has also become a substantial barrier to accessing HIV/AIDS care and prevention services. The study objective was to determine the prevalence and severity of postpartum depression (PPD) among women living with HIV and to further understand the impact of stigma and other psychosocial factors in 123 women living with HIV attending prevention of mother-to-child transmission (PMTCT) clinic at Kenyatta National Hospital located in Nairobi, Kenya. We used the Edinburgh Postnatal Depression Scale and HIV/AIDS Stigma Instrument - PLWHA (HASI - P). Forty-eight percent (N = 59) of women screened positive for elevated depressive symptoms. Eleven (9%) of the participants reported high levels of stigma. Multivariate analyses showed that lower education (OR = 0.14, 95% CI [0.04-0.46], p = .001) and lack of family support (OR = 2.49, 95% CI [1.14-5.42], p = .02) were associated with the presence of elevated depressive symptoms. The presence of stigma implied more than ninefold risk of development of PPD (OR = 9.44, 95% CI [1.132-78.79], p = .04). Stigma was positively correlated with an increase in PPD. PMTCT is an ideal context to reach out to women to address mental health problems especially depression screening and offering psychosocial treatments bolstering quality of life of the mother-baby dyad. PMID:27045273

  14. 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…

  15. 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.

  16. 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

  17. 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

  18. 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

  19. 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…

  20. Understanding of percutaneous puncture under guidance of ultrasound in treating peritoneal and perinephritic abscess

    International Nuclear Information System (INIS)

    Objective: To explore the clinical value of percutaneous puncture under guidance of ultrasound in treating peritoneal abscess. Methods: To summarize 68 patients with peritoneal abscess underwent percutaneous puncture under guidance of ultrasound to analyse the method of operation and therapeutic effect. Results: effective power of percutaneous puncture under guidance of ultrasound in treating peritoneal abscess was 96.8%. Conclusion: Percutaneous puncture under guidance of ultrasound in treating peritoneal abscess may avoid injury induced by blinded puncture, with characteristic of easier operation, slighter trauma. higher safety, significant therapeutic effect, and can be spreaded to the clinical application. (authors)

  1. 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 ...

  2. Plowshare radiation protection guidance

    International Nuclear Information System (INIS)

    The recommendations of the ICRP and the NCRP were developed primarily for occupational radiation exposures. They were later modified and applied to non-occupational exposures of populations. These, with appropriate interpretations, can be used to provide Plowshare radiation protection guidance. Exposures from Plowshare operations will tend to be acute, arising from radionuclides of relatively short half-life, but will have some chronic aspects due to small amounts of long-lived radionuclides generated. In addition, the neutron activation process of Plowshare technology will produce radionuclides not commonly encountered in routine nuclear energy programs. How these radionuclides contribute to personnel exposure is known for only a few situations that may not be representative of Plowshare exposure. Further complications arise from differences in radionuclide deposition and physiological sensitivity among individuals of different ages and states of health in the exposed population. All parameters necessary to evaluate such exposures are not available, even for good quantitative approximations, resulting in the need for interpretive experience. (author)

  3. [Prostate biopsy under magnetic resonance imaging guidance].

    Science.gov (United States)

    Kuplevatskiy, V I; CherkashiN, M A; Roshchin, D A; Berezina, N A; Vorob'ev, N A

    2016-01-01

    Prostate cancer (PC) is one of the most important problems in modern oncology. According to statistical data, PC ranks second in the cancer morbidity structure in the Russian Federation and developed countries and its prevalence has been progressively increasing over the past decade. A need for early diagnosis and maximally accurate morphological verification of the diagnosis in difficult clinical cases (inconvenient tumor location for standard transrectal biopsy; gland scarring changes concurrent with prostatitis and hemorrhage; threshold values of prostate-specific antigen with unclear changes in its doubling per unit time; suspicion of biochemical recurrence or clinical tumor progression after special treatment) leads to revised diagnostic algorithms and clinically introduced new high-tech invasive diagnostic methods. This paper gives the first analysis of literature data on Russian practice using one of the new methods to verify prostate cancer (transrectal prostate cancer under magnetic resonance imaging (MRI) guidance). The have sought the 1995-2015 data in the MEDLINE and Pubmed. PMID:27192773

  4. 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. PMID:25730921

  5. 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 ...

  6. Child Social Exclusion Risk and Child Health Outcomes in Australia

    Science.gov (United States)

    Mohanty, Itismita; Edvardsson, Martin; Abello, Annie; Eldridge, Deanna

    2016-01-01

    Introduction This paper studies the relationship between the risk of child social exclusion, as measured by the Child Social Exclusion (CSE) index and its individual domains, and child health outcomes at the small area level in Australia. The CSE index is Australia’s only national small-area index of the risk of child social exclusion. It includes five domains that capture different components of social exclusion: socio-economic background, education, connectedness, housing and health services. Methods The paper used data from the National Centre for Social and Economic Modelling (NATSEM), University of Canberra for the CSE Index and its domains and two key Australian Institute of Health and Welfare (AIHW) data sources for the health outcome measures: the National Hospital Morbidity Database and the National Mortality Database. Results The results show positive associations between rates of both of the negative health outcomes: potentially preventable hospitalisations (PPH) and avoidable deaths, and the overall risk of child social exclusion as well as with the index domains. This analysis at the small-area level can be used to identify and study areas with unexpectedly good or bad health outcomes relative to their estimated risk of child social exclusion. We show that children’s health outcomes are worse in remote parts of Australia than what would be expected solely based on the CSE index. Conclusions The results of this study suggest that developing composite indices of the risk of child social exclusion can provide valuable guidance for local interventions and programs aimed at improving children’s health outcomes. They also indicate the importance of taking a small-area approach when conducting geographic modelling of disadvantage. PMID:27152596

  7. 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

  8. 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 PlatteKansas Rivers Ecosystem Work Activity Guidance for refuge managers to review the purposes of refuges...

  9. 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.

  10. Autonomous gliding entry guidance with

    OpenAIRE

    Guo Jie; Wu Xuzhong; Tang Shengjing

    2015-01-01

    This paper presents a novel three-dimensional autonomous entry guidance for relatively high lift-to-drag ratio vehicles satisfying geographic constraints and other path constraints. The guidance is composed of onboard trajectory planning and robust trajectory tracking. For trajectory planning, a longitudinal sub-planner is introduced to generate a feasible drag-versus-energy profile by using the interpolation between upper boundary and lower boundary of entry corridor to get the desired traje...

  11. 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.

  12. 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…

  13. Varying Treatment Intensity in a Home-Based Parent and Child Therapy Program for Families Living in Poverty: A Randomized Clinic Trial

    Science.gov (United States)

    Carrasco, Jennifer M.; Fox, Robert A.

    2012-01-01

    This study addressed the question of whether increasing the intensity of a parent and child therapy program would improve results for young children with significant behavior problems from families living in poverty. Children were randomly assigned to either a standard condition or an intensity condition that provided 50% more treatment over a…

  14. 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...

  15. 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...

  16. 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, ...

  17. 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...

  18. 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.)

  19. 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.

  20. 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

  1. Guidance for External Events Analysis

    International Nuclear Information System (INIS)

    This Guidance for External Events Analysis was developed under a contract with the Nordic PSA Group, and aims at creating a common framework for analysis of external events as part of a nuclear power plant Probabilistic Safety Assessment. Thus, the purpose of this Guidance is to constitute a common methodological guidance for the analysis of external events at Nordic nuclear power plants. This will make it possible for the utilities to perform these analyses in a cost-efficient way, assuring simultaneously the quality of the analyses. The Guidance is meant to clarify the scope of the analysis of external events, to provide guidance for the performance of the analysis, and to help in defining, subcontracting and reviewing the work. The analysis procedure includes four phases, addressing project planning, identification of external events, screening of events, and probabilistic analysis. The aim is first to do as complete an identification of potential single and combined external events as possible. Thereafter, as many external events as possible are screened out as early as possible. The screening capability is increased during the project, using the continuously acquired information on the events and on their effects on the plant

  2. 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

  3. 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.

  4. 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.

  5. 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...

  6. Clinical Case Rounds in Child and Adolescent Psychiatry: Enuresis and ADHD in Older Children and an Adolescent Treated with Stimulant Medication: A Case Series

    OpenAIRE

    Williamson, Lloyda B.; Gower, Michael; Ulzen, Thaddeus

    2011-01-01

    Uncommonly, older children and adolescents can present with a history of enuresis. Resolution of enuresis followed the diagnosis and treatment of Attention Deficit Hyperactivity Disorder (ADHD) in each child in this case series. Subjects were three children with DSM-IV-TR ADHD, who presented with a history of primary nocturnal enuresis (PNE). Our results reveal that a subgroup of children with ADHD plus enuresis, when treated with stimulant medication, demonstrated resolution of enuresis as w...

  7. MS-11CLEAR CELL PETRO-CLIVAL MENINGIOMA IN A FIVE YEAR OLD CHILD – HISTOPATHOLOGICAL DIAGNOSIS AND LONG-TERM CLINICAL FOLLOW-UP

    OpenAIRE

    Juratli, Tareq; Geiger, Kathrin; Lautenschlaeger, Tim; der Hagen, Maja Von; Schackert, Gabriele; Kirsch, Matthias

    2014-01-01

    Intracranial meningiomas are rare in children. We report on a 5 year-old girl who was presented with a one-week history of cephalgia, ataxia, and left sided torticollis. Magnetic resonance imaging (MRI) revealed a dumbbell-shaped homogeneously petro-clival gadolinium-enhancing mass. A staged operative approach was chosen and a complete removal of the tumor was achieved. Due to recurrent tumor progressions, the child underwent several surgeries and two cranial radiations. None of the treatment...

  8. Information architecture. Volume 3: Guidance

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1997-04-01

    The purpose of this document, as presented in Volume 1, The Foundations, is to assist the Department of Energy (DOE) in developing and promulgating information architecture guidance. This guidance is aimed at increasing the development of information architecture as a Departmentwide management best practice. This document describes departmental information architecture principles and minimum design characteristics for systems and infrastructures within the DOE Information Architecture Conceptual Model, and establishes a Departmentwide standards-based architecture program. The publication of this document fulfills the commitment to address guiding principles, promote standard architectural practices, and provide technical guidance. This document guides the transition from the baseline or defacto Departmental architecture through approved information management program plans and budgets to the future vision architecture. This document also represents another major step toward establishing a well-organized, logical foundation for the DOE information architecture.

  9. Child CPR

    Medline Plus

    Full Text Available ... Home FIRST AID, CPR and AED LIFEGUARDING Refresher Child - CPR (1:11) QUICK LINKS Home RedCross.org Purchase Course Materials Shop Our Store Contact Us Privacy Policy Terms and Conditions All rights reserved. 2011 American National Red Cross.

  10. 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.

  11. Guidance at the educational marketplace

    DEFF Research Database (Denmark)

    Lystbæk, Christian Tang

    `agent´ on the educational "market´, assisting (potential) students into and around the `marketplace´. Consequently, guidance is also an important `agent´ for educational institutions that increasingly use marketing strategies to promote themselves on the market to attract and hold on to their “customers......” in order for the institutions to increase their ´market value´, `sales” and “turnover”. Thus, the expansion of guidance is nurtured by the expansion of the logic of marketization and consumerism. Drawing on Foucauldian perspectives in educational research, which highlight the expansion of powerful...

  12. Pediatric Anthrax Clinical Management

    OpenAIRE

    Bradley, John S.; Peacock, Georgina; Krug, Steven E.; Bower, William A.; Cohn, Amanda C.; Meaney-Delman, Dana; Pavia, Andrew T.

    2014-01-01

    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 guidanc...

  13. 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

  14. 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

  15. 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.

  16. 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.

  17. 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

  18. 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.

  19. Autonomous gliding entry guidance with

    Directory of Open Access Journals (Sweden)

    Guo Jie

    2015-10-01

    Full Text Available This paper presents a novel three-dimensional autonomous entry guidance for relatively high lift-to-drag ratio vehicles satisfying geographic constraints and other path constraints. The guidance is composed of onboard trajectory planning and robust trajectory tracking. For trajectory planning, a longitudinal sub-planner is introduced to generate a feasible drag-versus-energy profile by using the interpolation between upper boundary and lower boundary of entry corridor to get the desired trajectory length. The associated magnitude of the bank angle can be specified by drag profile, while the sign of bank angle is determined by lateral sub-planner. Two-reverse mode is utilized to satisfy waypoint constraints and dynamic heading error corridor is utilized to satisfy no-fly zone constraints. The longitudinal and lateral sub-planners are iteratively employed until all of the path constraints are satisfied. For trajectory tracking, a novel tracking law based on the active disturbance rejection control is introduced. Finally, adaptability tests and Monte Carlo simulations of the entry guidance approach are performed. Results show that the proposed entry guidance approach can adapt to different entry missions and is able to make the vehicle reach the prescribed target point precisely in spite of geographic constraints.

  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. 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...

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

    Science.gov (United States)

    Shastri, Priyvadan C

    2015-01-01

    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. PMID:25838721

  3. 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.

  4. 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.

  5. 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

  6. 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…

  7. 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)

  8. 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…

  9. 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.

  10. 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,…

  11. Agent Based Individual Traffic guidance

    DEFF Research Database (Denmark)

    Wanscher, Jørgen Bundgaard

    2004-01-01

    vehicle 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 of...... the road network is aggregated. As a result the calculations reveal only what the mass of vehicles are doing and not what a single vehicle is doing. This is the crucial difference to ABIT (Agent Based Individual Trafficguidance). ABIT is based on the fact that information on the destination of each...

  12. Microfluidic control of axonal guidance

    Science.gov (United States)

    Gu, Ling; Black, Bryan; Ordonez, Simon; Mondal, Argha; Jain, Ankur; Mohanty, Samarendra

    2014-10-01

    The precision of axonal pathfinding and the accurate formation of functional neural circuitry are crucial for an organism during development as well as during adult central and peripheral nerve regeneration. While chemical cues are believed to be primarily responsible for axonal pathfinding, we hypothesize that forces due to localized fluid flow may directly affect neuronal guidance during early organ development. Here, we report direct evidence of fluid flow influencing axonal migration, producing turning angles of up to 90°. Microfluidic flow simulations indicate that an axon may experience significant bending force due to cross-flow, which may contribute to the observed axonal turning. This method of flow-based guidance was successfully used to fasciculate one advancing axon onto another, showcasing the potential of this technique to be used for the formation of in vitro neuronal circuits.

  13. 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...... 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 of the project were not previously considered. We define a special inseparable cost function and develop a solution complex capable of using this cost function. In relation to calibration and estimation of statistical models used for dynamic route guidance we worked with generating random number...

  14. Review of soil contamination guidance

    International Nuclear Information System (INIS)

    A review of existing and proposed radioactive soil contamination standards and guidance was conducted for United Nuclear Corporation (UNC), Office of Surplus Facilities Management. Information was obtained from both government agencies and other sources during a literature survey. The more applicable standards were reviewed, evaluated, and summarized. Information pertaining to soil contamination for both facility operation and facility decommissioning was obtained from a variety of sources. These sources included: the Code of Federal Regulations, regulatory guides, the Federal Register, topical reports written by various government agencies, topical reports written by national laboratories, and publications from the American National Standards Institute (ANSI). It was difficult to directly compare the standards and guidance obtained from these sources since each was intended for a specific situation and different units or bases were used. However, most of the information reviewed was consistent with the philosophy of maintaining exposures at levels as low as reasonably achievable

  15. Child sexual abuse--the interface with genitourinary medicine.

    OpenAIRE

    Rogers, D.J.; Roberts, R E

    1995-01-01

    Whenever a child is seen in a genitourinary clinic the possibility that the child is the victim of child sexual abuse must be considered. This article considers the definition and postulated prevalence of child sexual abuse in England and Wales. A proposed management plan is then detailed with a review of the significance of the medical findings. Finally consideration is given to the ethical dilemmas which such cases pose.

  16. 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.)

  17. Child Labor Law and School Work. A Guide.

    Science.gov (United States)

    Maine State Dept. of Educational and Cultural Services, Augusta.

    This guide to Maine and United States child labor laws and their relevance to school work experiences for youths aged 14 to 18 is intended to provide teachers, guidance counselors, job developers, and job coordinators with basic information on the standards and major provisions of the laws. Chapter 1 tells why the guide was developed; recommends…

  18. 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...

  19. 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...

  20. Review of soil contamination guidance

    International Nuclear Information System (INIS)

    A review of existing and proposed radioactive soil contamination standards and guidance was conducted for United Nuclear Corporation (UNC), Office of Surplus Facilities Management. The more applicable standards were reviewed, evaluated and summarized. Information pertaining to soil contamination for both facility operation and facility decommissioning was obtained from a variety of sources. Most of the information reviewed was consistent with the philosophy of maintaining exposures at levels as low as reasonably achievable

  1. Radionuclide Data Quality Evaluation Guidance

    International Nuclear Information System (INIS)

    A considerable amount of radioanalytical data is generated during various phases of the characterization and remediation of radiologically-contaminated sites and properties. It is critical that data generated from the analysis of collected samples be to a level of quality usable by the project and acceptable to stakeholders. In July 2004, the final version of a multi-agency guidance manual entitled Multi-Agency Radiological Analytical Protocols Manual (MARLAP) was issued by the Environmental Protection Agency, Department of Energy, Department of Homeland Security, Nuclear Regulatory Commission, Department of Defense, National Institute of Standards and Technology, U. S. Geological Survey, Food and Drug Administration, and the States of Kentucky and California. The authors' purpose is to introduce readers to some key elements of MARLAP as it relates to radioanalytical lab quality control, and to demonstrate how these guidance elements can be effectively incorporated into mature radioanalytical lab operations and data validation regimes. Based upon the logic and statistical methodologies presented in MARLAP, the authors have revised existing project-specific Radioanalytical Data Evaluation Guidance (RadDEG) used at the FUSRAP Maywood Site in Maywood, NJ. The RadDEG allows users to qualify data in a meaningful way by tying the usability of the data to its activity and uncertainty relative to project action levels and QC results. This exercise may be useful to other projects looking to implement a MARLAP-based approach into their project/site-specific data evaluation methodologies. (authors)

  2. The Effect of Absenteeism and Clinic Protocol on Health Outcomes: The Case of Mother-to-Child Transmission of HIV in Kenya

    OpenAIRE

    Goldstein, Markus; Graff Zivin, Joshua; Habyarimana, James; Pop-Eleches, Cristian; THIRUMURTHY, Harsha

    2013-01-01

    Absenteeism of health workers in developing countries is widespread with some estimates indicating rates of provider absence of nearly 40% (Chaudhury et. al. 2006). This is the first paper to present evidence of the impact of health provider absence combined with limitations in health clinic protocol on health outcomes. Using longitudinal data from nearly 600 ante-natal care seekers at a rural ante-natal clinic in Western Kenya, we find that nurse absence on a patient’s first visit significan...

  3. 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.

  4. 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

  5. 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 ...

  6. 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 ...

  7. Child Sexual Abuse

    Science.gov (United States)

    Sexual abuse is one form of child abuse. It includes a wide range of actions between a child ... to children or pressuring them for sex is sexual abuse. Using a child for pornography is also sexual ...

  8. Asthma - child - discharge

    Science.gov (United States)

    ... this page: //medlineplus.gov/ency/patientinstructions/000001.htm Asthma - child - discharge To use the sharing features on ... for your child. Take charge of your child's asthma at home Make sure you know the asthma ...

  9. 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.

  10. 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/

  11. Augmented reality guidance system for peripheral nerve blocks

    Science.gov (United States)

    Wedlake, Chris; Moore, John; Rachinsky, Maxim; Bainbridge, Daniel; Wiles, Andrew D.; Peters, Terry M.

    2010-02-01

    Peripheral nerve block treatments are ubiquitous in hospitals and pain clinics worldwide. State of the art techniques use ultrasound (US) guidance and/or electrical stimulation to verify needle tip location. However, problems such as needle-US beam alignment, poor echogenicity of block needles and US beam thickness can make it difficult for the anesthetist to know the exact needle tip location. Inaccurate therapy delivery raises obvious safety and efficacy issues. We have developed and evaluated a needle guidance system that makes use of a magnetic tracking system (MTS) to provide an augmented reality (AR) guidance platform to accurately localize the needle tip as well as its projected trajectory. Five anesthetists and five novices performed simulated nerve block deliveries in a polyvinyl alcohol phantom to compare needle guidance under US alone to US placed in our AR environment. Our phantom study demonstrated a decrease in targeting attempts, decrease in contacting of critical structures, and an increase in accuracy of 0.68 mm compared to 1.34mm RMS in US guidance alone. Currently, the MTS uses 18 and 21 gauge hypodermic needles with a 5 degree of freedom sensor located at the needle tip. These needles can only be sterilized using an ethylene oxide process. In the interest of providing clinicians with a simple and efficient guidance system, we also evaluated attaching the sensor at the needle hub as a simple clip-on device. To do this, we simultaneously performed a needle bending study to assess the reliability of a hub-based sensor.

  12. 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 ...

  13. 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

  14. 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.…

  15. 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 ...

  16. 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...

  17. Child Mortality, Child Labour, and Economic Development

    OpenAIRE

    Holger Strulik

    2002-01-01

    The paper presents a model where the interplay between fertility, child labour, and education can explain economic stagnation when parents live in an environment of high child mortality. If in contrast child mortality is low, the solution of the parental decision problem leads to perpetual economic growth. The two long-run states are connected by a path of demographic transition and economic take-off along which the incidence of child labour disappears. The paper also discusses alternative po...

  18. Child Care Subsidies and Child Development

    OpenAIRE

    Herbst, Chris M.; Tekin, Erdal

    2008-01-01

    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 implications of child care subsidies for child development. In this paper, we provide a systematic assessment of the impact of subsidy receipt on a wide ran...

  19. 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 ...

  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. 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)…

  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. Quality guidance and quality formation

    DEFF Research Database (Denmark)

    Poulsen, Carsten Stig; Juhl, Hans Jørn; Kristensen, Kai;

    1996-01-01

    This paper presents an extension of the quality guidance model of Steenkamp and van Trijp that includes consumer quality formation processes. Quality expectations and quality experiences are seen as antecedents of perceived overall product quality conceptual model is applied using LISREL to a data...... set on Danish butter cookies. Five plausible models of the relation between expectation, experience and perceived product quality are estimated. Finally one model is selected on the basis of three criteria: chi-square, RMSEA and AIC: The results show a model where expectations are indirectly related...... to perceived quality through experience. Udgivelsesdato: APR...

  4. 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)

  5. Anticipatory Guidance for Prevention of Childhood Obesity: Design of the MOMS Project

    OpenAIRE

    Groner, Judith A.; Skybo, Theresa; Murray-Johnson, Lisa; Schwirian, Patricia; Eneli, Ihuoma; Sternstein, Amy; Klein, Elizabeth; French, Gina

    2009-01-01

    The prevalence of childhood overweight and obesity in the United States has increased by more than 100% since 1971. Primary care clinicians have a unique opportunity to influence child health during the first year of life via anticipatory guidance (AG). However, little is known about whether AG regarding feeding and meal structure is effective in promoting optimal nutrition and eating behaviors. The purpose of this project, “Making our Mealtimes Special” (MOMS), was to assess 2 distinct metho...

  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. 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......

  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. A window into a public program for prevention of mother to child transmission of HIV: Evidence from a prospective clinical trial

    Directory of Open Access Journals (Sweden)

    M Cotton

    2009-12-01

    Full Text Available Objectives To evaluate efficacy of the antenatal, intra-partum and post-natal antiretroviral components of a public service Prevention of Mother to Child (MTCT program in infants. Design Analysis of prospectively collected screening data of demographic and MTCT-related interventions and HIV-infection status of infants identified through HIV-specific DNA polymerase chain reaction. Setting Tygerberg Children’s Hospital, Western Cape Province, South Africa. Subjects HIV-infected women and their infants identified through participation in a public service MTCT program were referred for possible participation in a prospective study of isoniazid prophylaxis. Interventions Key components of the Program include voluntary counselling and testing, zidovudine to the mother from between 28 and 34 weeks gestation and to the newborn infant for the first week, single dose nevirapine to the mother in labour and the newborn shortly after birth and free formula for 6 months. Main Outcome Measures Number and percentage of HIV-infected infants and extent of exposure to antenatal, intrapartum and post-natal antiretrovirals. Results Of 656 infants with a median age of 12.6 weeks, screened between April 1st 2005 through May 2006, 39 were HIV-infected giving a transmission rate of 5.9% (95% CI: 4.4% - 8.0%. Antenatal prophylaxis was significantly associated with reduced transmission (OR: 0.43 (95% CI: 0.21 - 0.94 as opposed to intrapartum and postpartum components (p=0.85 and p=0.84, respectively. In multivariable analysis the antenatal component remained significant (OR=0.40 (95% CI 0.19 - 0.90. Conclusions The antenatal phase is the most important antiretroviral component of the MTCT program, allowing most opportunity for intervention.

  10. 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.

  11. 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. ...

  12. Child Abuse and Neglect

    OpenAIRE

    Yaşar Tıraşçı; Süleyman Gören

    2007-01-01

    Child abuse is the physical or psychological maltreatment of a child by an adult. In recent years, the affinity and aware of child abuse have been increased in Turkey. But, it is not enough. The purpose of this article was to defined child abuse and to attract attention of population and medical worker.

  13. 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

  14. 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

  15. 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

  16. 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

  17. 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.)

  18. 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

  19. 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...

  20. ICRP guidance on radioactive waste disposal

    International Nuclear Information System (INIS)

    The International Commission on Radiological Protection (ICRP) issued recommendations for a system of radiological protection in 1991 as the 1990 Recommendations. Guidance on the application of these recommendations in the general area of waste disposal was issued in 1997 as Publication 77 and guidance specific to disposal of solid long-lived radioactive waste was issued as Publication 81. This paper summarises ICRP guidance in radiological protection requirements for waste disposal concentrating on the ones of relevance to the geological disposal of solid radioactive waste. Suggestions are made for areas where further work is required to apply the ICRP guidance. (author)

  1. 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...

  2. 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

  3. 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... manufacturing practice (cGMP) compliance specific to manufacturing, processing, and dose unit sampling and... following guidances: 1. ``Manufacturing, Processing, or Holding Active Pharmaceutical...

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

    Directory of Open Access Journals (Sweden)

    Muller Leah

    2012-06-01

    Full Text Available 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 interventions in the magnetic environment are summarized. Designs for remote control catheter guidance include a catheter tip electromagnetic microcoil design, a ferromagnetic sphere-tipped catheter design, smart material-actuated catheters, and hydraulically actuated catheters. Remote control catheter guidance systems were compared and contrasted with respect to visualization, safety, and performance. Performance is characterized by bending angles achievable by the catheter, time to achieve bending, degree of rotation achievable, and miniaturization capacity of the design. Necessary improvements for furthering catheter design, especially for use in the MRI environment, are addressed, as are hurdles that must be overcome in order to make MRI guided endovascular procedures more accessible for regular use in clinical practice. Conclusions MR-guided endovascular interventions under remote control steering are in their infancy due to issues regarding safety and reliability. Additional experimental studies are needed prior to their use in humans.

  5. Feasibility Study of Needle Placement in Percutaneous Vertebroplasty: Cone-Beam Computed Tomography Guidance Versus Conventional Fluoroscopy

    International Nuclear Information System (INIS)

    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 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

  6. 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.

  7. 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.)

  8. 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.

  9. 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.)

  10. 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.)

  11. 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...

  12. Image-Guidance for Stereotactic Body Radiation Therapy

    International Nuclear Information System (INIS)

    The term stereotactic body radiation therapy (SBRT) describes a recently introduced external beam radiation paradigm by which small lesions outside the brain are treated under stereotactic conditions, in a single or few fractions of high-dose radiation delivery. Similar to the treatment planning and delivery process for cranial radiosurgery, the emphasis is on sparing of adjacent normal tissues through the creation of steep dose gradients. Thus, advanced methods for assuring an accurate relationship between the target volume position and radiation beam geometry, immediately prior to radiation delivery, must be implemented. Such methods can employ imaging techniques such as planar (e.g., x-ray) or volumetric (e.g., computed tomography [CT]) approaches and are commonly summarized under the general term image-guided radiation therapy (IGRT). This review summarizes clinical experience with volumetric and ultrasound based image-guidance for SBRT. Additionally, challenges and potential limitations of pre-treatment image-guidance are presented and discussed

  13. Lack of a Negative Effect of BCG-Vaccination on Child Psychomotor Development: Results from the Danish Calmette Study - A Randomised Clinical Trial

    Science.gov (United States)

    Kjærgaard, Jesper; Stensballe, Lone Graff; Birk, Nina Marie; Nissen, Thomas Nørrelykke; Foss, Kim Thestrup; Thøstesen, Lisbeth Marianne; Pihl, Gitte Thybo; Andersen, Andreas; Kofoed, Poul-Erik; Pryds, Ole; Greisen, Gorm

    2016-01-01

    Objectives To assess the non-specific effect of Bacillus Calmette-Guérin (BCG) vaccination at birth on psychomotor development. Design This is a pre-specified secondary outcome from a randomised, clinical trial. Setting Maternity units and paediatric wards at three university hospitals in Denmark. Participants Children born at gestational age (GA) 32 weeks and above. All women planning to give birth at the three sites were invited during the recruitment period. Out of 4262 randomised children, 144 were premature (GA BCG and 2133 randomised (73 premature) to the control group. Interventions BCG vaccination 0.05 ml was given intradermally in the upper left arm at the hospital within seven days of birth. Children in the control group did not receive any intervention. Parents were not blinded to allocation. Main outcome measures Psychomotor development measured using Ages and Stages Questionnaire (ASQ) completed by the parents at 12 months. Additionally, parents of premature children (gestational age BCG vs. control, 95% confidence interval; -3.7 to 2.4), p = 0.67, corresponding to an effect size of Cohen’s d = -0.015 (-0.082 to 0.052). The mean difference in ASQ score for premature children at 22 months was -7.8 points (-20.6 to 5.0, p = 0.23), d = -0.23 (-0.62 to 0.15). Conclusions A negative non-specific effect of BCG vaccination at birth on psychomotor development was excluded in term children. Trial Registration ClinicalTrials.gov NCT01694108 PMID:27123570

  14. Child Poverty and Changes in Child Poverty

    OpenAIRE

    CHEN, WEN-HAO; Corak, Miles

    2008-01-01

    This article offers a cross-country overview of child poverty, changes in child poverty, and the impact of public policy in North America and Europe. Levels and changes in child poverty rates in 12 Organisation for Economic Co-operation and Development (OECD) countries during the 1990s are documented using data from the Luxembourg Income Study project, and a decomposition analysis is used to uncover the relative role of demographic factors, labor markets, and income transfers from the state i...

  15. Sibling rivalry and the new baby: anticipatory guidance and management strategies.

    Science.gov (United States)

    Sawicki, J A

    1997-01-01

    Sibling rivalry can be found in many families and frequently creates a stressful and challenging situation for parents. The arrival of a new baby often causes older siblings to feel displaced, frustrated, angry, and even unloved. Age, gender, personality and temperament, and parental behavior are factors that appear to influence the degree to which sibling rivalry occurs. Common reactions of older siblings to the birth of a new baby include aggression toward the newborn, behavioral regression, and attention seeking behavior, as well as independence and maturity. Anticipatory guidance is recommended to help parents adequately prepare their older child for the arrival of a new sibling. Strategies for managing sibling rivalry include open parent-child communication, equal treatment of siblings, non-intervention in sibling conflicts, distraction, and separation. Parents can minimize feelings of jealousy between siblings by providing a supportive, nurturing environment that allows each child to feel secure and loved. PMID:9220807

  16. Image-guidance for surgical procedures

    International Nuclear Information System (INIS)

    Contemporary imaging modalities can now provide the surgeon with high quality three- and four-dimensional images depicting not only normal anatomy and pathology, but also vascularity and function. A key component of image-guided surgery (IGS) is the ability to register multi-modal pre-operative images to each other and to the patient. The other important component of IGS is the ability to track instruments in real time during the procedure and to display them as part of a realistic model of the operative volume. Stereoscopic, virtual- and augmented-reality techniques have been implemented to enhance the visualization and guidance process. For the most part, IGS relies on the assumption that the pre-operatively acquired images used to guide the surgery accurately represent the morphology of the tissue during the procedure. This assumption may not necessarily be valid, and so intra-operative real-time imaging using interventional MRI, ultrasound, video and electrophysiological recordings are often employed to ameliorate this situation. Although IGS is now in extensive routine clinical use in neurosurgery and is gaining ground in other surgical disciplines, there remain many drawbacks that must be overcome before it can be employed in more general minimally-invasive procedures. This review overviews the roots of IGS in neurosurgery, provides examples of its use outside the brain, discusses the infrastructure required for successful implementation of IGS approaches and outlines the challenges that must be overcome for IGS to advance further. (topical review)

  17. New Tools for Guidance in Business Education.

    Science.gov (United States)

    Shimberg, Benjamin

    Several recently developed measurement instruments, the General Aptitude Test Battery (GATB), the Comparative Guidance and Placement Program (CGP), the Kuder Occupational Interest Survey (DD), the Ohio Vocational Interest Survey (OVIS), and the Gordon Occupational Check List, are considered in connection with guidance testing for occupational…

  18. 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.

  19. 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

  20. 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.

  1. Learners' Needs in College-Based Guidance.

    Science.gov (United States)

    Further Education Unit, London (England).

    Recent Further Education Unit (FEU) research has provided clear evidence of technical college students' needs for career and educational guidance throughout their program of study. Inhouse technical college guidance services to individuals and institutions offer a number of benefits to both students receiving the services and the institutions…

  2. 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…

  3. 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...

  4. 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

  5. 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...

  6. 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...

  7. 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.

  8. 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.

  9. 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.

  10. 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.

  11. 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.

  12. 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

  13. 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

  14. 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 ...

  15. 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 ... Excellent June 7, 2016 More Frank Porter Graham Child Development Institute The University of North Carolina at Chapel ...

  16. Child abuse - physical

    Science.gov (United States)

    ... this page: //medlineplus.gov/ency/article/001552.htm Child abuse - physical To use the sharing features on this page, please enable JavaScript. Physical child abuse is a serious problem. Here are some facts: ...

  17. 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 ...

  18. 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.

  19. 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 ...

  20. 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…

  1. 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.

  2. 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...

  3. Child Poverty in Canada

    OpenAIRE

    Thomas Crossley; Lori Curtis

    2003-01-01

    A 1989 all-party motion of parliament called for the elimination of child poverty in Canada by the year 2000. Despite a series of policy initiatives, recent reports suggest that the child poverty rate may now be comparable to that in 1989. The apparent persistence of child poverty in Canada might reflect socioeconomic developments, or something about the way that child poverty is measured. Using micro data covering the period 1986 to 2000 we find little support for these explanations.

  4. 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

  5. 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

  6. 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

  7. 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 ...

  8. Spleen removal - child - discharge

    Science.gov (United States)

    ... for your child to return to school or daycare. This may be as soon as 2 to 3 weeks after surgery. Your child's activity restrictions will depend on: The type of surgery (open or laparoscopic) Your child's age The reason for ...

  9. 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.

  10. [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

  11. 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.

  12. 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

  13. International guidance, evolution and trends

    International Nuclear Information System (INIS)

    Carmen Ruiz Lopez, (CSN) addressed the evolution of some of the fundamental concepts related to the objective of protecting future generations, with the intention of encouraging the discussion, and to determine whether the recent international guidance implied any change in philosophy and approach regarding the practical interpretation and implementation of such fundamental concepts. C. Ruiz presented a general overview of the ICRP and IAEA guidance developments as well as the major changes or reorientations introduced by the latest ICRP Recommendations and IAEA Safety Standards that are relevant to long-term issues of geological disposal, namely, ICRP 103 (2009), ICRP 101 (2006), IAEA Safety Fundamentals SF-1(2006) and WS-R-4. As for the ICRP developments, ICRP 103 confirms the validity of ICRP 81(1998) as the main ICRP reference for long-lived waste disposal. C. Ruiz then noted the extension of the scope of ICPR 81 mentioning some of the principles and recommendations related to the objective of protecting future generations and the view of the Commission for demonstrating compliance. ICRP 103 and ICRP 101 reinforce the importance of transparency in the decision-making process and in the demonstration of confidence in situations of increasing uncertainties about time, giving more weight to the process itself and strengthening the need for an open dialogue between regulator and implementer. In both recommendations the Commission recognises the influence of societal values in the final decision on the level of radiological protection, as well as the influence of social concerns and political aspects in the decision-making process. The evolution of internationally agreed safety fundamental objectives and principles can be observed in the changes from the IAEA's Waste Safety Fundamentals of 1995 to the new Safety Fundamentals of 2006. C Ruiz presented a comparison of both documents focussing on the differences in dealing with fundamental concepts related to the

  14. 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。

  15. Child Labor - Moral Choice

    OpenAIRE

    Lagasse, Caitlin

    2014-01-01

    In many instances, child labor is a way to exploit the cheap labor a child has to offer. Although in many situations, the exploitation of child labor is not normally the case, such as families living in a developing country. What individuals raised in Western cultures fail to realize is that in some nations and for some families, child labor is a necessary resource to survive, children act as an exceptional resource in these situations. Without the extra income a child could make working in t...

  16. Transformation of the Title V Maternal and Child Health Services Block Grant

    OpenAIRE

    Lu, Michael C.; Lauver, Cassie B.; Dykton, Christopher; Michael D. Kogan; Lawler, Michele H.; Raskin-Ramos, Lauren; Watters, Kathy; Wilson, Lee A.

    2015-01-01

    This paper describes the transformation of the Title V Maternal and Child Health (MCH) Services Block Grant. The Maternal and Child Health Bureau of the Health Resources and Services Administration led a 21-month visioning process to engage input from MCH stakeholders and other national, state and local MCH leaders, families and other partners to improve, innovate, and transform the Title V MCH Services Block Grant. The process has helped inform the development of a new grant guidance for the...

  17. 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

  18. 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…

  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. 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.

  1. 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...

  2. 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.)

  3. 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...

  4. 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

  5. Mother-to-child transmission of HIV : When a child inherits HIV from its mother

    OpenAIRE

    2004-01-01

    The thesis comprises a literature review, a histopathology study of placentas from Kenya in addition to observations and reflections from a field study in primary health care clinics in Moshi, Tanzania. Transmission of HIV from a HIV-positive woman to her unborn child or infant is defined as Mother-To-Child-Transmission, MTCT. The virus can be transmitted during pregnancy, delivery or after birth through breast milk. Ante partum transmission can take place blood borne through placenta or ...

  6. 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...

  7. 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.

  8. Parent-child aggression: association with child abuse potential and parenting styles.

    Science.gov (United States)

    Rodriguez, Christina M

    2010-01-01

    The present investigation predicted that greater use of corporal punishment as well as physical maltreatment would be associated with child abuse potential and selected parenting styles. Three independent studies were examined, two with community samples and a third with a clinical at-risk sample of parents. Parents across all studies anonymously completed the Child Abuse Potential Inventory, the Parent-Child Conflict Tactics Scale to assess physical discipline and maltreatment, as well as the Parenting Scale to measure dysfunctional parenting styles. Findings support that overall parent-child aggression, as well as physical maltreatment behaviors specifically, were associated with child abuse potential. Parent-child aggression was also related to dysfunctional parenting styles, particularly an overreactive, authoritarian parenting style. Permissive parenting was also identified as potentially associated with physical maltreatment, although the findings regarding such lax parenting styles are less clear. Intriguing findings emerged regarding the connection of psychological aggression to both child abuse potential and dysfunctional parenting style. Child abuse potential was also associated with dysfunctional parenting style, particularly harsh, overreactive approaches. Recommendations for future study with at-risk samples and additional research on permissive parenting and psychological aggression are discussed. PMID:21287963

  9. 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…

  10. 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

  11. Palliative Airway Stenting Performed Under Radiological Guidance and Local Anesthesia

    International Nuclear Information System (INIS)

    Purpose. To assess the effectiveness of airway stenting performed exclusively under radiological guidance for the palliation of malignant tracheobronchial strictures. Methods. We report our experience in 16 patients with malignant tracheobronchial stricture treated by insertion of 20 Ultraflex self-expandable metal stents performed under fluoroscopic guidance only. Three patients presented dysphagia grade IV due to esophageal malignant infiltration; they therefore underwent combined airway and esophageal stenting. All the procedures were performed under conscious sedation in the radiological room; average procedure time was around 10 min, but the airway impediment never lasted more than 40 sec. Results. We obtained an overall technical success in 16 cases (100%) and clinical success in 14 patients (88%). All prostheses were successfully placed without procedural complications. Rapid clinical improvement with symptom relief and normalization of respiratory function was obtained in 14 cases. Two patients died within 48 hr from causes unrelated to stent placement. Two cases (13%) of migration were observed; they were successfully treated with another stent. Tumor overgrowth developed in other 2 patients (13%); however, no further treatment was possible because of extensive laryngeal infiltration. Conclusions. Tracheobronchial recanalization with self-expandable metal stents is a safe and effective palliative treatment for malignant strictures. Airway stenting performed exclusively under fluoroscopic view was rapid and well tolerated

  12. 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…

  13. 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).

  14. Interviewing Child Witnesses: A Developmental Perspective.

    Science.gov (United States)

    Saywitz, Karen; Camparo, Lorinda

    1998-01-01

    Reviews suggestions derived from the clinical and experimental literatures for interviewing child witnesses to abuse. Guidelines for questioning children are provided and phases of a forensic interview are outlined in a step-by-step fashion. The suggestions presented highlight a developmental perspective designed to facilitate children's memory…

  15. Social Neuroscience of Child and Adolescent Depression

    Science.gov (United States)

    Miller, Anita

    2007-01-01

    The social neuroscience of child and adolescent depression is inherently multidisciplinary. Depressive disorders beginning early in life can have serious developmental and functional consequences. Psychopathology research has described depression's defining clinical and contextual features, and intervention research has characterized its response…

  16. Giant lumbosacral schwannoma in a child

    OpenAIRE

    Rashim Kataria; Dhruba Jyoti Kurmi; Jayanti Mehta; Virendra Deo Sinha

    2012-01-01

    Small spinal intradural extramedullary schwannoma are a common occurrence in the middle aged. However, giant schwannoma in pediatric age group is rare. We report one such case of giant extradural lumbosacral schwannoma in an 8-year-old child. Clinical features, histopathology and management of giant schwannoma is discussed and the present literature reviewed.

  17. 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)

  18. 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

  19. 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.

  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. 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...

  4. Child labor handbook

    OpenAIRE

    Cigno, Alessandro; Rosati, Furio C.; Tzannatos, Zafiris

    2002-01-01

    This paper surveys many aspects and issues of child labor, including its causes and effects as well as policies associated with it. Child labor has come to be considered an expression of poverty, both a cause and an effect of underdevelopment. Child labor cannot be viewed in isolation from educational, health, fertility, and technological issues; and is not necessarily an aberration but a rational household response to an adverse economic environment. With this in mind, the following proposit...

  5. 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…

  6. 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

  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. 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.

  9. Child health in Greenland

    DEFF Research Database (Denmark)

    Niclasen, Birgit V L; Bjerregaard, Peter

    2007-01-01

    AIM: To review the knowledge on child health and child health problems in Greenland. METHOD: The review was based on theses, national statistics, national and international reports, and a search in Pub Med, PsycINFO, Web of Science, and WHOLIB databases from 1985 to 2005. The resulting articles...... importance to the health of children in Greenland. More accurate data on child health are necessary in the future to secure better prioritization. It is suggested to construct a set of reliable indicators of child health in Greenland to monitor the health of children on a national and regional basis....

  10. Is Child Labor Inefficient?

    OpenAIRE

    Jean-Marie Baland; Robinson, James A.

    2000-01-01

    We build a model of child labor and study its implications for welfare. We assume that there is a trade-off between child labor and the accumulation of human capital. Even if parents are altruistic and child labor is socially inefficient, it may arise in equilibrium because parents fail to fully internalize its negative effects. This occurs when bequests are zero or when capital markets are imperfect. We also study the effects of a simple ban on child labor and derive conditions under which i...

  11. 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

  12. Guidance levels, achievable doses and expectation levels

    Energy Technology Data Exchange (ETDEWEB)

    Li, Lianbo [Hygiene and Anti-epidemic Station of Shandong Province, Jinan (China); Meng, Bing [Hygiene and Anti-epidemic Station of Zibo City, Zibo (China)

    2002-07-01

    The National Radiological Protection Board (NRPB), the International Atomic Energy Agency (IAEA) and the Commission of the European Communities (CEC) published their guidance levels and reference doses for typical X-ray examination and nuclear medicine in their documents in 1993, 1994 and 1996 respectively. From then on, the concept of guidance levels or reference doses have been applied to different examinations in the field of radiology and proved to be effective for reduction of patient doses. But the guidance levels or reference doses are likely to have some shortcomings and can do little to make further reduction of patient dose in the radiology departments where patient dose are already below them. For this reason, the National Radiological Protection Board (NRPB) proposed a concept named achievable doses which are based on the mean dose observed for a selected sample of radiology departments. This paper will review and discuss the concept of guidance levels and achievable doses, and propose a new concept referred to as Expectation Levels that will encourage the radiology departments where patient dose are already below the guidance levels to keep patient dose as low as reasonably achievable. Some examples of the expectation levels based on the data published by a few countries are also illustrated in this paper.

  13. 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.

  14. Policy and Education Standards & Guidelines for Child-Care Providers, Pre-School Programs, and Parents.

    Science.gov (United States)

    Anderson, Nancy; Stone, Kristin

    Standards and guidelines for child care providers in the state of Utah are delineated in this document. Several basic needs of children are briefly described, including the need for self-esteem, freedom and exploration, guidance and discipline, love and respect, learning, relationships with others, and good nutrition. Statements of standards for…

  15. 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

  16. The Effect of Child Care Characteristics on Child Development

    OpenAIRE

    Blau, David M.

    1999-01-01

    The effect of group size, staff-child ratio, training, and other characteristics of child care on child development is estimated using data from the National Longitudinal Survey of Youth. In contrast to most previous research, the sample is large and nationally representative, the data contain good measures of the home environment, and there are repeated measures of child development. Child care characteristics have little association with child development on average. Associations are found ...

  17. Do market wages influence child labor and child schooling?

    OpenAIRE

    Wahba, Jackline

    2000-01-01

    Thispaper provides empirical evidence on the joint determinants of child labor, and child schooling, using individual level data from Egypt. The main findings are as follows: 1) A ten percent increase in the illiterate male market wage decreases the probability of child labor by 21.5 percent for boys, and 13.1 percent for girls. 2) Higher local regional income inequality increases the likelihood of child labor. 3) Parents who were child laborers themselves, are more likely to send their child...

  18. Child maintenance and child poverty: A comparative analysis

    OpenAIRE

    Hakovirta, Mia

    2010-01-01

    This article uses the Luxembourg Income Study datasets from circa 2004 to analyse the contribution child maintenance makes to the reduction of child poverty. The countries compared are Canada, UK, USA, Germany, Norway, Denmark, Sweden and Finland representing countries with different child maintenance schemes. Results show that the contribution that child maintenance makes in reducing overall child poverty is minimal but it can reduce child poverty among non-widowed lone mother families if ma...

  19. 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

  20. HUMAN FACTORS GUIDANCE FOR CONTROL ROOM EVALUATION

    International Nuclear Information System (INIS)

    The Human-System Interface Design Review Guideline (NUREG-0700, Revision 1) was developed by the US Nuclear Regulatory Commission (NRC) to provide human factors guidance as a basis for the review of advanced human-system interface technologies. The guidance consists of three components: design review procedures, human factors engineering guidelines, and a software application to provide design review support called the ''Design Review Guideline.'' Since it was published in June 1996, Rev. 1 to NUREG-0700 has been used successfully by NRC staff, contractors and nuclear industry organizations, as well as by interested organizations outside the nuclear industry. The NRC has committed to the periodic update and improvement of the guidance to ensure that it remains a state-of-the-art design evaluation tool in the face of emerging and rapidly changing technology. This paper addresses the current research to update of NUREG-0700 based on the substantial work that has taken place since the publication of Revision 1

  1. 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.

  2. 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: ...

  3. 76 FR 78670 - Draft Guidance for Industry and Food and Drug Administration Staff; Evaluation of Sex Differences...

    Science.gov (United States)

    2011-12-19

    ... quality and consistency of available data regarding the performance of medical devices in women. This... Staff; Evaluation of Sex Differences in Medical Device Clinical Studies; Availability AGENCY: Food and... Clinical Studies.'' This document provides guidance on the study and evaluation of sex differences...

  4. 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.

  5. Aerospace plane guidance using geometric control theory

    Science.gov (United States)

    Van Buren, Mark A.; Mease, Kenneth D.

    1990-01-01

    A reduced-order method employing decomposition, based on time-scale separation, of the 4-D state space in a 2-D slow manifold and a family of 2-D fast manifolds is shown to provide an excellent approximation to the full-order minimum-fuel ascent trajectory. Near-optimal guidance is obtained by tracking the reduced-order trajectory. The tracking problem is solved as regulation problems on the family of fast manifolds, using the exact linearization methodology from nonlinear geometric control theory. The validity of the overall guidance approach is indicated by simulation.

  6. The Economics of Child Trafficking

    OpenAIRE

    Sylvain Dessy; Stéphane Pallage

    2003-01-01

    In this paper, we highlight the economic effects of the existence of child trafficking. We show that the risk of child trafficking on the labor market acts as a deterrent to supply child labor, unless household survival is at stake. An imperfectly enforceable legislation aiming at fighting child trafficking, by raising the expected gains parents derive from sending their children to work, will cause a rise in the number of child laborers. We show that it can even cause the incidence of child ...

  7. 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…

  8. 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 ...

  9. 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

  10. Child Transportation Safety Tips.

    Science.gov (United States)

    National Highway Traffic Safety Administration (DOT), Washington, DC.

    This document presents nine tips regarding safe infant and child transportation, each tip explained in one to two pages. The tips are as follows: (1) quick safety seat checkup; (2) where should your child ride? (3) how to protect your new baby in the car; (4) what safety seat to use for a big baby or toddler? (5) how should preschool and school…

  11. 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. ...

  12. 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 ...

  13. Introduction: Understanding Child Labour.

    Science.gov (United States)

    Miljeteig, Per

    1999-01-01

    Explores contributions from the Urban Childhood Conference for the purpose of developing the child-labor discourse further and indicating the implications of the new understandings for further research and policy development. Highlights the nine articles in this issue, which address child labor at the international level, children's viewpoints,…

  14. 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.

  15. 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 ...

  16. 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. ...

  17. Healthy Weight, Healthy Child

    Science.gov (United States)

    ... page please turn Javascript on. Feature: Reducing Childhood Obesity Healthy Weight, Healthy Child Past Issues / Spring - Summer 2010 Table of Contents ... Summer_flyer_508.pdf Read More "Reducing Childhood Obesity" Articles Healthy Weight, Healthy Child / Get Involved How Parents and Kids Can Get ...

  18. Child Schooling and Child Work in India

    OpenAIRE

    Malathy Duraisamy

    2000-01-01

    In India, about 62 percent of the children in the age group of 5-14 are currently enrolled in schools, and 4 percent of children are reported to be working. The remaining 34 percent of children in this age group are neither enrolled in school nor reported as participating in work. The twin problems of child schooling and child work in India have not been adequately addressed in the literature. Another important dimension to this problem is the gender disparity in school enrollment. Available ...

  19. 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.)

  20. WPA guidance on the protection and promotion of mental health in children of persons with severe mental disorders.

    Science.gov (United States)

    Brockington, Ian; Chandra, Prabha; Dubowitz, Howard; Jones, David; Moussa, Suaad; Nakku, Juliet; Quadros Ferre, Isabel

    2011-06-01

    This guidance details the needs of children, and the qualities of parenting that meet those needs. Parental mental disorders can damage the foetus during pregnancy through the action of drugs, prescribed or abused. Pregnancy and the puerperium can exacerbate or initiate mental illness in susceptible women. After their birth, the children may suffer from the social disadvantage associated with severe mental illness. The parents (depending on the disorder, its severity and its persistence) may have intermittent or prolonged difficulties with parenting, which may sometimes result in childhood psychological disturbance or child maltreatment. This guidance considers ways of preventing, minimizing and remedying these effects. Our recommendations include: education of psychiatrists and related professions about the effect of parental mental illness on children; revision of psychiatric training to increase awareness of patients as caregivers, and to incorporate relevant assessment and intervention into their treatment and rehabilitation; the optimum use of pharmacological treatment during pregnancy; pre-birth planning when women with severe mental illness become pregnant; development of specialist services for pregnant and puerperal women, with assessment of their efficacy; community support for parenting by mothers and fathers with severe mental disorders; standards of good practice for the management of child maltreatment when parents suffer from mental illness; the importance of multi-disciplinary teamwork when helping these families, supporting their children and ensuring child protection; the development of child and adolescent mental health services worldwide. PMID:21633678

  1. 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.

  2. Applicable value of real time interventional ultrasound guidance in family planning reproduction operation

    International Nuclear Information System (INIS)

    Objective: To determine the clinical value of real time interventional ultrasound guidance in family planning reproduction operation. Methods: Under the guidance of ultrasound monitoring, 522 cases with high risk and difficult uterine operation were undertaken in our department. Results: The abdominal endoscopic contraceptive uterine operation under real time ultrasound monitoring was carried out for 522 cases in 4 years, with successful rates for high risk pregnancy as 287/289 cases, high risk troublesome withdrawal of contraceptive ring as 129/130 cases and puzzling uterine operation as 103/103 cases. The total successful rate reached 99.42%, without uterine rupture and other complications. Conclusion: The former complex, blind and difficult uterine operations turn to be simple, safe and reliable under the guidance of real time ultrasound. (authors)

  3. Cannabinoid receptor CB2 modulates axon guidance

    DEFF Research Database (Denmark)

    Duff, Gabriel; Argaw, Anteneh; Cecyre, Bruno; Cherif, Hosni; Tea, Nicolas; Zabouri, Nawal; Casanova, Christian; Ptito, Maurice; Bouchard, Jean-François

    2013-01-01

    Navigation of retinal projections towards their targets is regulated by guidance molecules and growth cone transduction mechanisms. Here, we present in vitro and in vivo evidences that the cannabinoid receptor 2 (CB2R) is expressed along the retino-thalamic pathway and exerts a modulatory action ...

  4. Autonomous gliding entry guidance with geographic constraints

    Institute of Scientific and Technical Information of China (English)

    Guo Jie; Wu Xuzhong; Tang Shengjing

    2015-01-01

    This paper presents a novel three-dimensional autonomous entry guidance for relatively high lift-to-drag ratio vehicles satisfying geographic constraints and other path constraints. The guidance is composed of onboard trajectory planning and robust trajectory tracking. For trajectory planning, a longitudinal sub-planner is introduced to generate a feasible drag-versus-energy profile by using the interpolation between upper boundary and lower boundary of entry corridor to get the desired trajectory length. The associated magnitude of the bank angle can be specified by drag profile, while the sign of bank angle is determined by lateral sub-planner. Two-reverse mode is utilized to satisfy waypoint constraints and dynamic heading error corridor is utilized to satisfy no-fly zone constraints. The longitudinal and lateral sub-planners are iteratively employed until all of the path constraints are satisfied. For trajectory tracking, a novel tracking law based on the active disturbance rejection control is introduced. Finally, adaptability tests and Monte Carlo simulations of the entry guidance approach are performed. Results show that the proposed entry guidance approach can adapt to different entry missions and is able to make the vehicle reach the prescribed target point precisely in spite of geographic constraints.

  5. Modern control theory for Army missile guidance

    Science.gov (United States)

    Travassos, R. H.; Levari, H.; Gupta, N. K.

    1982-11-01

    A Singular perturbation guidance law has been developed for medium-range surface-to-air missiles. This guidance law is a significant extension of a previously developed guidance law for short-range missiles; in medium-range intercepts, the problem of energy management should be addressed in addition to homing guidance. The mathematical formulation has been simplified by introducing separation of time scales. Target Trajectory Estimation: A recursive algorithm for estimation of autoregressive moving average (ARMA) model parameters from noisy samples has been developed. Application of this algorithm to parameter estimation problems has exhibited its fast convergence and unbiasedness in the presence of noise, even with short data records. The algorithm has two versions, a Recursive Maximum Likelihood (RML) form and a Recursive Prediction Error (RPE) form, both of which possess a parallel structure that makes them highly suitable for parallel-processing implementation. Adaptive autopilots: Lattice-form algorithms have been developed for fast, recursive identification and control of time-varying systems. These algorithms have excellent numerical properties and a modular structure that makes them suitable for on-board real-time implementation.

  6. 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 ...

  7. 75 FR 76011 - Annual Guidance Agenda

    Science.gov (United States)

    2010-12-07

    .... SUPPLEMENTARY INFORMATION: I. Background In the Federal Register of September 19, 2000 (65 FR 56468), FDA issued... existing guidance documents (65 FR 56468 at 56477; 21 CFR 10.115(f)(5)). The Agency is neither bound by...--Adulteration With Hypoglycin Administration, 5100 Paint A. Branch Pkwy., College Park, MD 20740,...

  8. 36 CFR 1290.7 - Additional guidance.

    Science.gov (United States)

    2010-07-01

    ... Section 1290.7 Parks, Forests, and Public Property NATIONAL ARCHIVES AND RECORDS ADMINISTRATION JFK... ASSASSINATION RECORDS COLLECTION ACT OF 1992 (JFK ACT) § 1290.7 Additional guidance. (a) A government agency, office, or entity includes, for purposes of interpreting and implementing the JFK Act, all current,...

  9. Patterns of Guidance in Inquiry Learning

    Science.gov (United States)

    Veermans, Marjaana; Lallimo, Jiri; Hakkarainen, Kai

    2005-01-01

    The purpose of this case study was to examine a teacher's guidance of an inquiry learning project in an ordinary elementary-school classroom. The participants in the study were 21 Finnish, grade 4 students (10 years old), from which four students were selected for intensive observation. The technical infrastructure of the study was Computer…

  10. A Four-Year Career Guidance Program.

    Science.gov (United States)

    Sherrell, C. Eleanor; Spaulding, Barbara G.

    The counseling staff at a suburban, comprehensive, four-year high school in southern California developed and implemented a Career Guidance program for grades nine through twelve. With assistance and cooperation from teachers, students participated in exploration of vocational interests, personal values, and individual aptitudes in Grades 9 and…

  11. Neighboring optimal guidance theory and computer program

    Science.gov (United States)

    Powers, W. F.

    1974-01-01

    Developments of the linear quadratic optimal control problem are discussed. The theory is applicable to the development of neighboring optimal feedback guidance gains, and is useful as a tool for synthesizing feedback control laws. A computer program which requires only the pertinent matrices of the linear quadratic problem is described.

  12. Laser radar for spacecraft guidance applications

    Science.gov (United States)

    Liebe, C. C.; Abramovici, A.; Bartman, R. K.; Bunker, R. L.; Chapsky, J.; Chu, C. C.; Clouse, D.; Dillon, J. W.; Hausmann, B.; Hemmati, H.; Kornfeld, R. P.; Kwa, C.; Mobasser, S.; Newell, M.; Padgett, C.; Roberts, W. T.; Spiers, G.; Warfield, Z.; Wright, M.

    2003-01-01

    A flight qualified laser radar called LAMP (LAser MaPper) is under development at JPL. LAMP is a guidance and control sensor that can form 3 dimensional images of its field of regard. This paper describes the detailed design of the LAMP sensor.

  13. Athletics Guidance Aims for Level Field

    Science.gov (United States)

    Samuels, Christina A.

    2013-01-01

    A document from the U.S. Department of Education intended to clarify schools' responsibility to make sure students with disabilities have access to extracurricular sports has drawn sharply different opinions. Disability-rights advocates welcome the guidance, while critics say federal officials are pushing requirements that could place new…

  14. Museum Personnel's Opinions on Mobile Guidance Systems

    Science.gov (United States)

    Yoshimura, Hirokazu; Sekiguchi, Hiromi; Yabumoto, Yoshitaka

    2007-01-01

    While opinions from the general public are certainly important, opinions from the museum staff are also necessary to improve user service systems. this article introduces two groups of museum staff who have evaluated the usability of mobile guidance systems in Japanese museums. One group is the research team who used the PDA system in the National…

  15. Development and validation of a new guidance device for lateral approach stereotactic breast biopsy.

    Science.gov (United States)

    Ma, K; Kornecki, A; Bax, J; Mundt, Y; Fenster, A

    2009-06-01

    Stereotactic breast biopsy (SBB) is the gold standard for minimally invasive breast cancer diagnosis. Current systems rely on one of two methods for needle insertion: A vertical approach (perpendicular to the breast compression plate) or a lateral approach (parallel to the compression plate), While the vertical approach is more frequently used, it is not feasible in patients with thin breasts (new design of lateral guidance device for SBB, which addresses the limitations of the vertical approach and provides improvements over the existing lateral guidance hardware. Specifically, the new device provides (1) an adjustable rigid needle support to minimize needle deflection within the breast and (2) an additional degree of rotational freedom in the needle trajectory, allowing the radiologist to sample multiple targets through a single skin incision. This device was compared to a commercial lateral guidance device in a series of phantom experiments. Needle placement error using each device was measured in agar phantoms for needle insertions at lateral depths of 2 and 5 cm. The biopsy success rate for each device was then estimated by performing biopsy procedures in commercial SBB phantoms. SBB performed with the new lateral guidance device provided reduced needle placement error relative to the commercial lateral guidance device (0.89 +/- 0.22 vs 1.75 +/- 0.35 mm for targets at 2 cm depth; 1.94 +/- 0.20 vs 3.21 +/- 0.31 mm for targets at 5 cm depth). The new lateral guidance device also provided improved biopsy accuracy in SBB procedures compared to the commercial lateral guidance device (100% vs 58% success rate). Finally, experiments were performed to demonstrate that the new device can accurately sample lesions within thin breast phantoms and multiple lesions through a single incision point. This device can be incorporated directly into the clinical SBB procedural workflow, with no additional electrical hardware, software, postprocessing, or image analysis. PMID

  16. 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.

  17. Advances in spacecraft atmospheric entry guidance

    Science.gov (United States)

    Benito Manrique, Joel

    In order to advance entry guidance technology two different research areas have been explored with the objective of increasing the reachable landing area and the landing accuracy for future Mars missions. Currently only the northern hemisphere of Mars is available for landing due to its low elevation. Only low elevation landing sites have the necessary atmospheric density to allow landing using current Entry, Descent and Landing (EDL) technology. In order to reach most of the Ancient Highlands, the majority of the southern hemisphere, advanced EDL technology is needed in multiple fields, including entry guidance. The first research area is the definition and applications of reachable and controllable sets for entry. The definition of the reachable and controllable sets provides a framework for the study of the capabilities of an entry vehicle in a given planet. Reachable and controllable sets can be used to comprehensively characterize the envelope of trajectories that a vehicle can fly, the sites it can reach and the entry states that can be accommodated. The sets can also be used for the evaluation of trajectory planning algorithms and to assist in the selection of the entry or landing sites. In essence, the reachable and controllable sets offer a powerful vehicle and trajectory analysis and design framework that allows for better mission design choices. In order to illustrate the use of the sets, they are computed for a representative Mars mission using two different vehicle configurations. The sets characterize the impact of the vehicle configuration on the entry capability. Furthermore, the sets are used to find the best skip-entry trajectory for a return from the Moon mission, highlighting the utility of the sets in atmospheric maneuvers other than entry. The second research area is the development of the components of an entry guidance algorithm that allow high elevation landing and provide as well high landing accuracy. The approach taken follows the

  18. 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...

  19. MR guidance of laser disc decompression: preliminary in vivo experience

    International Nuclear Information System (INIS)

    The purpose of this study was to perform percutaneous laser disc decompression (PLDD) under MR guidance in an open configuration 0.5-T MR system. Following failed conservative treatment for 6 months, eight patients with contained disc herniations were enrolled in the study. Following MR guided introduction of the laser fiber into the targeted disc space, the laser-induced temperature distribution was visualized using a color-coded subtraction technique based on a T1-weighted GRE sequence. In seven patients PLDD could be performed. In all cases laser effects were depicted by MR. In this regard the color-coded technique was found to be superior to conventional magnitude images. Whereas no apparent decrease in the extent of herniation was discovered immediately following PLDD, T2-weighted FSE images showed signal intensity alterations in two of the seven patients. Clinical evaluation, obtained 3-4 months after PLDD, revealed a fair (n = 2) or good (n = 4) response to the treatment. One patient showed no change in symptoms. MR guidance and monitoring of PLDD is feasible within an open 0.5-T system and seems to render PLDD more safe and controllable. (orig.)

  20. Parental tobacco consumption and child development

    Directory of Open Access Journals (Sweden)

    Nadine F. Santos

    2015-08-01

    Full Text Available OBJECTIVE: To analyze the association between parental tobacco consumption and the prevalence of psychomotor development disorders in children between 6 and 22 months of age.METHOD: One hundred and nine mothers, fathers, and their babies participated in the study. The sociodemographic and clinical conditions were assessed using questionnaires. Tobacco consumption was assessed using the Fagerström Test for Nicotine Dependence (FTND. Child development was evaluated using the Scale of Psychomotor Development in Early Childhood.RESULTS: There was a significant negative correlation between the father's morning smoking (FTND and the child's language development quotient; r = -0.41, p = 0.005, r2 =0.15. The children of mothers without nicotine dependence had a higher mean language development quotient than children of mothers with nicotine dependence; F(1, 107 = 5.51, p = 0.021, ?p2 = 0.05.CONCLUSION: Parental smoking appears to have a detrimental effect on child development.