WorldWideScience

Sample records for child guidance clinics

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

    Science.gov (United States)

    Stewart, John

    2011-01-01

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

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

    Science.gov (United States)

    Hill, Brent Mathews

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

  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. ["... so that Theo knows what he should do better". Client orientation in social-therapeutic child group work--an experiential report of quality management at a child guidance clinic].

    Science.gov (United States)

    Bobzien, Monika; Hausmann, Verena; Kornder, Theo; Manz-Gill, Brigitte

    2004-09-01

    Within the framework of internal evaluation and self-evaluation activities in a child guidance clinic, measures of success have to date been based primarily on the degree to which the delegating organisations are satisfied with the results of the counselling. The orientation of the success of counselling towards the results stems from the fact that the process of helping is not generally manifest to parents, schools, and education staff. It takes place in the context of direct contact between therapists and children, the immediate addresses of help, and therefore often remains "hidden". Since the children's perspective--their impressions and appraisals--has often been neglected in past assessment methods, it hardly plays any role at all in the discussion of quality at counselling centres. This made it all the more stimulating for all those involved to initiate improvement measures within the framework of quality management on the basis of a client survey and in this way to launch a shared learning process as to how client orientation can flow directly into everyday practice. This is certainly the first attempt of its kind in the work of child guidance clinics to develop an understanding of client orientation in line with the expectations of parents and children and to link this to the quality development of the service. In the first part of this experiential report, the external process coach provides a brief summary of the assessment method employed in connection with the introduction of internal quality management at the counselling centre. This is followed by the centre's own description of the concrete performance of the client survey with children using the example of social-therapeutic child group work. The study concludes with a discussion of the benefit drawn from this process for the improvement of this pedagogical project.

  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.

  6. [ 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.

  7. 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... retention of electronic source data in FDA-regulated clinical investigations. This guidance promotes... a guidance for industry entitled ``Electronic Source Data in Clinical Investigations.''...

  8. 76 FR 9583 - Draft Guidance for Industry on Clinical Pharmacogenomics: Premarketing Evaluation in Early Phase...

    Science.gov (United States)

    2011-02-18

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

  9. 77 FR 69632 - Draft Guidance for Industry on Electronic Source Data in Clinical Investigations; Availability

    Science.gov (United States)

    2012-11-20

    ... entitled ``Electronic Source Data in Clinical Investigations.'' This document revises and updates the draft... in FDA- regulated clinical investigations. The revised draft guidance promotes capturing source data... draft guidance for industry entitled ``Electronic Source Data in Clinical Investigations.''...

  10. 76 FR 30175 - Draft Guidance for Clinical Investigators, Industry, and FDA Staff: Financial Disclosure by...

    Science.gov (United States)

    2011-05-24

    ... Investigators, Industry, and FDA Staff: Financial Disclosure by Clinical Investigators; Availability AGENCY... FDA Staff: Financial Disclosure by Clinical Investigators.'' This draft guidance is intended to assist... governing financial disclosure by clinical investigators. This guidance provides FDA's responses to the...

  11. 78 FR 13070 - Guidance for Clinical Investigators, Industry, and Food and Drug Administration Staff: Financial...

    Science.gov (United States)

    2013-02-26

    ..., Industry, and Food and Drug Administration Staff: Financial Disclosure by Clinical Investigators..., Industry, and FDA Staff: Financial Disclosure by Clinical Investigators.'' This guidance is intended to... governing financial disclosure by clinical investigators. This guidance provides FDA's responses to the...

  12. 77 FR 76049 - Draft Guidance for Industry on Electronic Source Data in Clinical Investigations; Correction

    Science.gov (United States)

    2012-12-26

    ... guidance entitled ``Electronic Source Data in Clinical Investigations.'' The document was published with an... HUMAN SERVICES Food and Drug Administration Draft Guidance for Industry on Electronic Source Data in Clinical Investigations; Correction AGENCY: Food and Drug Administration, HHS. ACTION: Notice;...

  13. 76 FR 70151 - Draft Guidance for Industry, Clinical Investigators, Institutional Review Boards, and Food and...

    Science.gov (United States)

    2011-11-10

    ... to evaluate medical devices under FDA's IDE regulations. In an effort to promote timely clinical... available at http://www.fda.gov/MedicalDevices/DeviceRegulationandGuidance/GuidanceDocuments/default.htm... HUMAN SERVICES Food and Drug Administration Draft Guidance for Industry, Clinical...

  14. 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...

  15. International conference on harmonisation; guidance on statistical principles for clinical trials; availability--FDA. Notice.

    Science.gov (United States)

    1998-09-16

    The Food and Drug Administration (FDA) is publishing a guidance entitled "E9 Statistical Principles for Clinical Trials." The guidance was prepared under the auspices of the International Conference on Harmonisation of Technical Requirements for Registration of Pharmaceuticals for Human Use (ICH). The guidance is intended to provide recommendations to sponsors and scientific experts regarding statistical principles and methodology which, when applied to clinical trials for marketing applications, will facilitate the general acceptance of analyses and conclusions drawn from the trials.

  16. 78 FR 66941 - Design Considerations for Pivotal Clinical Investigations for Medical Devices; Guidance for...

    Science.gov (United States)

    2013-11-07

    ... for Medical Devices; Guidance for Industry, Clinical Investigators, Institutional Review Boards and... entitled ``Design Considerations for Pivotal Clinical Investigations for Medical Devices.'' This document... premarket submissions for medical devices and for FDA staff who review those submissions. This...

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

    Science.gov (United States)

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

    2011-11-01

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

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

    Science.gov (United States)

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

    2016-09-01

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

  19. 75 FR 9228 - Draft Guidance for Industry on Non-Inferiority Clinical Trials; Availability

    Science.gov (United States)

    2010-03-01

    ...The Food and Drug Administration (FDA) is announcing the availability of a draft guidance for industry entitled ``Non- Inferiority Clinical Trials.'' This draft guidance provides sponsors and review staff in the Center for Drug Evaluation and Research (CDER) and the Center for Biologics Evaluation and Research (CBER) with the agency's interpretation of the underlying principles involved in the......

  20. 76 FR 68768 - Guidance for Industry: Clinical Considerations for Therapeutic Cancer Vaccines; Availability

    Science.gov (United States)

    2011-11-07

    ... No. FDA-2009-D-0427] Guidance for Industry: Clinical Considerations for Therapeutic Cancer Vaccines... Considerations for Therapeutic Cancer Vaccines'' dated October 2011. The guidance document provides sponsors who wish to submit an Investigational New Drug application (IND) for a therapeutic cancer vaccine...

  1. EPA guidance on the early intervention in clinical high risk states of psychoses

    DEFF Research Database (Denmark)

    Schmidt, S J; Schultze-Lutter, F; Schimmelmann, B G

    2015-01-01

    This guidance paper from the European Psychiatric Association (EPA) aims to provide evidence-based recommendations on early intervention in clinical high risk (CHR) states of psychosis, assessed according to the EPA guidance on early detection. The recommendations were derived from a meta-analysi...

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

    Science.gov (United States)

    Deakin, Elisabeth Kuhn; Tiellet Nunes, Maria Lucia

    2009-01-01

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

  3. 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.

  4. Model Child Care Standards Act--Guidance to States to Prevent Child Abuse in Day Care Facilities.

    Science.gov (United States)

    Department of Health and Human Services, Washington, DC.

    The document offers guidelines to states regarding review and revision of child care statutes, standards, and policies to address the prevention of child sexual abuse in day care facilities. General information is also provided on changes in state standards in recent years. Each of six sections examines findings of the 1981 Comparative Licensing…

  5. 76 FR 50484 - Draft Guidance for Industry, Clinical Investigators, and Food and Drug Administration Staff...

    Science.gov (United States)

    2011-08-15

    ... Considerations for Pivotal Clinical Investigations for Medical Devices.'' This document is intended to provide... medical devices and for FDA staff who review those submissions. This guidance document describes different study design principles relevant to the development of medical device clinical studies that can be...

  6. 76 FR 80948 - Draft Guidance for Industry, Clinical Investigators, Institutional Review Boards, and Food and...

    Science.gov (United States)

    2011-12-27

    ... developed to promote the initiation of clinical investigations to evaluate the medical devices under FDA's... HUMAN SERVICES Food and Drug Administration Draft Guidance for Industry, Clinical Investigators, Institutional Review Boards, and Food and Drug Administration Staff; Food and Drug Administration Decisions...

  7. 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.

  8. 78 FR 69690 - Draft Guidance for Industry: Considerations for the Design of Early-Phase Clinical Trials of...

    Science.gov (United States)

    2013-11-20

    ...The Food and Drug Administration (FDA) is extending the comment period for the draft guidance for industry entitled ``Guidance for Industry: Considerations for the Design of Early-Phase Clinical Trials of Cellular and Gene Therapy Products'' that appeared in the Federal Register of July 2, 2013 (78 FR 39736). The draft guidance document provides sponsors of Investigational New Drug......

  9. 75 FR 8968 - Draft Guidance for Industry on Adaptive Design Clinical Trials for Drugs and Biologics; Availability

    Science.gov (United States)

    2010-02-26

    ... current thinking on adaptive design clinical trials for drugs and biologics. It does not create or confer... HUMAN SERVICES Food and Drug Administration Draft Guidance for Industry on Adaptive Design Clinical... entitled ``Adaptive Design Clinical Trials for Drugs and Biologics.'' The draft guidance provides...

  10. 77 FR 74670 - Draft Guidance for Industry on Enrichment Strategies for Clinical Trials to Support Approval of...

    Science.gov (United States)

    2012-12-17

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

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

    Science.gov (United States)

    Hardiker, Nicholas R; Hynes, Brenda

    2012-01-01

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

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

    NARCIS (Netherlands)

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

    2011-01-01

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

  13. Opioid-induced constipation: advances and clinical guidance

    Science.gov (United States)

    Nelson, Alfred D.; Camilleri, Michael

    2016-01-01

    Currently opioids are the most frequently used medications for chronic noncancer pain. Opioid-induced constipation is the most common adverse effect associated with prolonged use of opioids, having a major impact on quality of life. There is an increasing need to treat opioid-induced constipation. With the recent approval of medications for the treatment of opioid-induced constipation, there are several therapeutic approaches. This review addresses the clinical presentation and diagnosis of opioid-induced constipation, barriers to its diagnosis, effects of opioids in the gastrointestinal tract, differential tolerance to opiates in different gastrointestinal organs, medications approved and in development for the treatment of opioid-induced constipation, and a proposed clinical management algorithm for treating opioid-induced constipation in patients with noncancer pain. PMID:26977281

  14. 75 FR 1790 - Draft Guidance for Institutional Review Boards, Clinical Investigators, and Sponsors: IRB...

    Science.gov (United States)

    2010-01-13

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

  15. 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

    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 di...

  16. EPA guidance on the early detection of clinical high risk states of psychoses

    DEFF Research Database (Denmark)

    Schultze-Lutter, F; Michel, C; Schmidt, S J

    2015-01-01

    The aim of this guidance paper of the European Psychiatric Association is to provide evidence-based recommendations on the early detection of a clinical high risk (CHR) for psychosis in patients with mental problems. To this aim, we conducted a meta-analysis of studies reporting on conversion rat...

  17. International Conference on Harmonisation; guidance on ethnic factors in the acceptability of foreign clinical data; availability--FDA. Notice.

    Science.gov (United States)

    1998-06-10

    The Food and Drug Administration (FDA) is publishing a guidance entitled "E5 Ethnic Factors in the Acceptability of Foreign Clinical Data". The guidance was prepared under the auspices of the International Conference on Harmonisation of Technical Requirements for Registration of Pharmaceuticals for Human Use (ICH). The guidance recommends regulatory and development strategies to permit clinical data collected in one region to be used for the support of drug and biologic registrations in another region while allowing for the influence of ethnic factors.

  18. Project campus and maternal and child clinic

    Directory of Open Access Journals (Sweden)

    Fabio Aldemar Gómez Sierra

    2013-12-01

    Full Text Available This article aims to illustrate the activities of the process of cooperation between the University of Pavia , Italy and the Juan de Castellanos de Tunja University Foundation . The first involved the signing of an agreement in April 2012, related to the formulation of hypotheses to project the new University Campus and some preliminary ideas for the construction of a Mother and Child University Hospital , level IV , hinged to the campus ; projects then emerged from anthropological reflections on creating spaces provided to address structural elements in a culture in this case to: create, teach , learn and apply science with other knowledge and related health and disease. This experience , still ongoing , is part of the main aims of cooperation , which is an opportunity for scientific research and methodological experimentation and innovation , both in terms of architectural solutions and technical control of the project. In fact , it appears that any architectural project in territorial contexts (climate, soil, subsoil and culture , environmental, social and diverse climate , requires a study and knowledge of the resources and potential of the place where you go to work, to enrich and value the traditions and local identities and transformations stays mixed . Through this activity , it was possible to gather and exchange processes experiment applied between experts from different disciplines and thesis students , thus consolidating an interesting interplay of scientific competition between two universities , which enriches professional , academic and social heritage.

  19. 77 FR 35689 - Guidance for Industry on Irritable Bowel Syndrome-Clinical Evaluation of Drugs for Treatment...

    Science.gov (United States)

    2012-06-14

    ... HUMAN SERVICES Food and Drug Administration Guidance for Industry on Irritable Bowel Syndrome--Clinical Evaluation of Drugs for Treatment; Availability; Correction AGENCY: Food and Drug Administration, HHS. ACTION... guidance for industry entitled ``Irritable Bowel Syndrome--Clinical Evaluation of Drugs for...

  20. 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.

  1. Controlled outcome studies of child clinical hypnosis.

    Science.gov (United States)

    Adinolfi, Barbara; Gava, Nicoletta

    2013-09-01

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

  2. Patient reported outcomes (PROs) in clinical trials: is 'in-trial' guidance lacking? a systematic review.

    OpenAIRE

    Kyte, DG; Draper, H; Ives, J.; Liles, C; Gheorghe, A.; Calvert, M

    2013-01-01

    BACKGROUND: Patient reported outcomes (PROs) are increasingly assessed in clinical trials, and guidelines are available to inform the design and reporting of such trials. However, researchers involved in PRO data collection report that specific guidance on 'in-trial' activity (recruitment, data collection and data inputting) and the management of 'concerning' PRO data (i.e., data which raises concern for the well-being of the trial participant) appears to be lacking. The purpose of this revie...

  3. 78 FR 48173 - Guidance for Industry on Oversight of Clinical Investigations-A Risk-Based Approach to Monitoring...

    Science.gov (United States)

    2013-08-07

    ... Investigations--A Risk-Based Approach to Monitoring; Availability AGENCY: Food and Drug Administration, HHS... guidance for industry entitled ``Oversight of Clinical Investigations--A Risk-Based Approach to Monitoring.'' This guidance assists sponsors in developing risk-based monitoring strategies and plans for...

  4. 77 FR 32124 - Guidance for Industry on Irritable Bowel Syndrome-Clinical Evaluation of Drugs for Treatment...

    Science.gov (United States)

    2012-05-31

    ... HUMAN SERVICES Food and Drug Administration Guidance for Industry on Irritable Bowel Syndrome--Clinical.... SUMMARY: The Food and Drug Administration (FDA) is announcing the availability of a guidance for industry... intended to assist the pharmaceutical industry and investigators who are developing drugs for the...

  5. International Conference on Harmonisation; guidance on E11 clinical investigation of medicinal products in the pediatric population; availability. Notice.

    Science.gov (United States)

    2000-12-15

    The Food and Drug Administration (FDA) is announcing the availability of a guidance entitled "E11 Clinical Investigation of Medicinal Products in the Pediatric Population." The guidance was prepared under the auspices of the International Conference on Harmonisation of Technical Requirements for Registration of Pharmaceuticals for Human Use (ICH). The guidance sets forth critical issues in pediatric drug development and approaches to the safe, efficient, and ethical study of medicinal products in the pediatric population. The guidance is intended to encourage and facilitate the timely development of pediatric medicinal products internationally.

  6. 2015 Guidance on cancer immunotherapy development in early-phase clinical studies.

    Science.gov (United States)

    2015-12-01

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

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

    Science.gov (United States)

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

    2010-01-29

    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 what constitutes anonymised patient information do not appear to have been established. We aim to address this issue by providing practical guidance for those involved in the publication process, by proposing a minimum standard for de-identifying datasets for the purposes of publication in a peer-reviewed biomedical journal, or sharing with other researchers. Basic advice on file preparation is provided along with procedural guidance on prospective and retrospective publication of raw data, with an emphasis on randomised controlled trials.

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

    Science.gov (United States)

    Van't Hoff, William; Offringa, Martin

    2015-02-01

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

  9. 78 FR 7784 - Draft Guidance for Industry on Enrichment Strategies for Clinical Trials To Support Approval of...

    Science.gov (United States)

    2013-02-04

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

  10. Patient reported outcomes (PROs in clinical trials: is 'in-trial' guidance lacking? a systematic review.

    Directory of Open Access Journals (Sweden)

    Derek G Kyte

    Full Text Available BACKGROUND: Patient reported outcomes (PROs are increasingly assessed in clinical trials, and guidelines are available to inform the design and reporting of such trials. However, researchers involved in PRO data collection report that specific guidance on 'in-trial' activity (recruitment, data collection and data inputting and the management of 'concerning' PRO data (i.e., data which raises concern for the well-being of the trial participant appears to be lacking. The purpose of this review was to determine the extent and nature of published guidelines addressing these areas. METHODS AND FINDINGS: Systematic review of 1,362 articles identified 18 eligible papers containing 'in-trial' guidelines. Two independent authors undertook a qualitative content analysis of the selected papers. Guidelines presented in each of the articles were coded according to an a priori defined coding frame, which demonstrated reliability (pooled Kappa 0.86-0.97, and validity (<2% residual category coding. The majority of guidelines present were concerned with 'pre-trial' activities (72%, for example, outcome measure selection and study design issues, or 'post-trial' activities (16% such as data analysis, reporting and interpretation. 'In-trial' guidelines represented 9.2% of all guidance across the papers reviewed, with content primarily focused on compliance, quality control, proxy assessment and reporting of data collection. There were no guidelines surrounding the management of concerning PRO data. CONCLUSIONS: The findings highlight there are minimal in-trial guidelines in publication regarding PRO data collection and management in clinical trials. No guidance appears to exist for researchers involved with the handling of concerning PRO data. Guidelines are needed, which support researchers to manage all PRO data appropriately and which facilitate unbiased data collection.

  11. 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.

  12. 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.)

  13. 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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2009-01-01

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

  15. 77 FR 9947 - Guidance for Industry: Early Clinical Trials With Live Biotherapeutic Products: Chemistry...

    Science.gov (United States)

    2012-02-21

    ... Biotherapeutic Products: Chemistry, Manufacturing, and Control Information; Availability AGENCY: Food and Drug... Products: Chemistry, Manufacturing, and Control Information '' dated February 2012. The guidance provides... Products: Chemistry, Manufacturing, and Control Information'' dated February 2012. The guidance...

  16. American Society of Clinical Oncology guidance statement: the cost of cancer care.

    Science.gov (United States)

    Meropol, Neal J; Schrag, Deborah; Smith, Thomas J; Mulvey, Therese M; Langdon, Robert M; Blum, Diane; Ubel, Peter A; Schnipper, Lowell E

    2009-08-10

    Advances in early detection, prevention, and treatment have resulted in consistently falling cancer death rates in the United States. In parallel with these advances have come significant increases in the cost of cancer care. It is well established that the cost of health care (including cancer care) in the United States is growing more rapidly than the overall economy. In part, this is a result of the prices and rapid uptake of new agents and other technologies, including advances in imaging and therapeutic radiology. Conventional understanding suggests that high prices may reflect the costs and risks associated with the development, production, and marketing of new drugs and technologies, many of which are valued highly by physicians, patients, and payers. The increasing cost of cancer care impacts many stakeholders who play a role in a complex health care system. Our patients are the most vulnerable because they often experience uneven insurance coverage, leading to financial strain or even ruin. Other key groups include pharmaceutical manufacturers that pass along research, development, and marketing costs to the consumer; providers of cancer care who dispense increasingly expensive drugs and technologies; and the insurance industry, which ultimately passes costs to consumers. Increasingly, the economic burden of health care in general, and high-quality cancer care in particular, will be less and less affordable for an increasing number of Americans unless steps are taken to curb current trends. The American Society of Clinical Oncology (ASCO) is committed to improving cancer prevention, diagnosis, and treatment and eliminating disparities in cancer care through support of evidence-based and cost-effective practices. To address this goal, ASCO established a Cost of Care Task Force, which has developed this Guidance Statement on the Cost of Cancer Care. This Guidance Statement provides a concise overview of the economic issues facing stakeholders in the cancer

  17. Guidance from an NIH Workshop on Designing, Implementing, and Reporting Clinical Studies of Soy Interventions1–4

    Science.gov (United States)

    Klein, Marguerite A.; Nahin, Richard L.; Messina, Mark J.; Rader, Jeanne I.; Thompson, Lilian U.; Badger, Thomas M.; Dwyer, Johanna T.; Kim, Young S.; Pontzer, Carol H.; Starke-Reed, Pamela E.; Weaver, Connie M.

    2010-01-01

    The NIH sponsored a scientific workshop, “Soy Protein/Isoflavone Research: Challenges in Designing and Evaluating Intervention Studies,” July 28–29, 2009. The workshop goal was to provide guidance for the next generation of soy protein/isoflavone human research. Session topics included population exposure to soy; the variability of the human response to soy; product composition; methods, tools, and resources available to estimate exposure and protocol adherence; and analytical methods to assess soy in foods and supplements and analytes in biologic fluids and other tissues. The intent of the workshop was to address the quality of soy studies, not the efficacy or safety of soy. Prior NIH workshops and an evidence-based review questioned the quality of data from human soy studies. If clinical studies are pursued, investigators need to ensure that the experimental designs are optimal and the studies properly executed. The workshop participants identified methodological issues that may confound study results and interpretation. Scientifically sound and useful options for dealing with these issues were discussed. The resulting guidance is presented in this document with a brief rationale. The guidance is specific to soy clinical research and does not address nonsoy-related factors that should also be considered in designing and reporting clinical studies. This guidance may be used by investigators, journal editors, study sponsors, and protocol reviewers for a variety of purposes, including designing and implementing trials, reporting results, and interpreting published epidemiological and clinical studies. PMID:20392880

  18. International Conference on Harmonisation; guidance on Addendum to E2C Clinical Safety Data Management: Periodic Safety Update Reports for Marketed Drugs; availability. Notice.

    Science.gov (United States)

    2004-02-05

    The Food and Drug Administration (FDA) is announcing the availability of a guidance entitled "Addendum to E2C Clinical Safety Data Management: Periodic Safety Update Reports for Marketed Drugs" (the ICH E2C guidance). The guidance was prepared under the auspices of the International Conference on Harmonisation of Technical Requirements for Registration of Pharmaceuticals for Human Use (ICH). In the Federal Register of May 19, 1997 (62 FR 27470), FDA published the ICH E2C guidance, which recommends a unified standard for the format, content, and reporting frequency for postmarketing periodic safety update reports (PSURs) for drug and biological products. This guidance, an addendum to the ICH E2C guidance, provides additional information on the content and format of PSURs, including clarification of the objectives, general principles, and model for PSURs. This guidance is intended to help harmonize collection and submission of postmarketing clinical safety data.

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

    NARCIS (Netherlands)

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

    2009-01-01

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

  20. International Conference on Harmonisation; Guidance on M3(R2) Nonclinical Safety Studies for the Conduct of Human Clinical Trials and Marketing Authorization for Pharmaceuticals; availability. Notice.

    Science.gov (United States)

    2010-01-21

    The Food and Drug Administration (FDA) is announcing the availability of a guidance entitled "M3(R2) Nonclinical Safety Studies for the Conduct of Human Clinical Trials and Marketing Authorization for 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). The guidance, which is a revision of an existing guidance, discusses the types of nonclinical studies, their scope and duration, and their relation to the conduct of human clinical trials and marketing authorization for pharmaceuticals. The guidance is intended to facilitate the timely conduct of clinical trials and reduce the unnecessary use of animals and other drug development resources.

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

    Institute of Scientific and Technical Information of China (English)

    陈春霞; 霍江华

    2015-01-01

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

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

    Science.gov (United States)

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

    2015-02-20

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

  3. The clinical translation gap in child health exercise research: a call for disruptive innovation.

    Science.gov (United States)

    Ashish, Naveen; Bamman, Marcas M; Cerny, Frank J; Cooper, Dan M; D'Hemecourt, Pierre; Eisenmann, Joey C; Ericson, Dawn; Fahey, John; Falk, Bareket; Gabriel, Davera; Kahn, Michael G; Kemper, Han C G; Leu, Szu-Yun; Liem, Robert I; McMurray, Robert; Nixon, Patricia A; Olin, J Tod; Pianosi, Paolo T; Purucker, Mary; Radom-Aizik, Shlomit; Taylor, Amy

    2015-02-01

    In children, levels of play, physical activity, and fitness are key indicators of health and disease and closely tied to optimal growth and development. Cardiopulmonary exercise testing (CPET) provides clinicians with biomarkers of disease and effectiveness of therapy, and researchers with novel insights into fundamental biological mechanisms reflecting an integrated physiological response that is hidden when the child is at rest. Yet the growth of clinical trials utilizing CPET in pediatrics remains stunted despite the current emphasis on preventative medicine and the growing recognition that therapies used in children should be clinically tested in children. There exists a translational gap between basic discovery and clinical application in this essential component of child health. To address this gap, the NIH provided funding through the Clinical and Translational Science Award (CTSA) program to convene a panel of experts. This report summarizes our major findings and outlines next steps necessary to enhance child health exercise medicine translational research. We present specific plans to bolster data interoperability, improve child health CPET reference values, stimulate formal training in exercise medicine for child health care professionals, and outline innovative approaches through which exercise medicine can become more accessible and advance therapeutics across the broad spectrum of child health.

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

    DEFF Research Database (Denmark)

    Jacobsen, Stine Lindahl; Killén, Kari

    2015-01-01

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

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

    Science.gov (United States)

    James, Rochelle L; Roberts, Michael C

    2009-10-01

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

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

    Science.gov (United States)

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

    2015-01-01

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

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

    Science.gov (United States)

    2010-07-08

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

  8. 76 FR 32367 - Draft Guidance for Clinical Investigators, Industry, and FDA Staff: Financial Disclosure by...

    Science.gov (United States)

    2011-06-06

    ... Staff: Financial Disclosure by Clinical Investigators; Correction AGENCY: Food and Drug Administration...: Financial Disclosure by Clinical Investigators.''The document was published with an incorrect docket...

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

    NARCIS (Netherlands)

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

    2008-01-01

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

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

    NARCIS (Netherlands)

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

    2008-01-01

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

  11. International Conference on Harmonisation; guidance on E14 Clinical Evaluation of QT/QTc Interval Prolongation and Proarrhythmic Potential for Non-Antiarrhythmic Drugs; availability. Notice.

    Science.gov (United States)

    2005-10-20

    The Food and Drug Administration (FDA) is announcing the availability of a guidance entitled "E14 Clinical Evaluation of QT/QTc Interval Prolongation and Proarrhythmic Potential for Non-Antiarrhythmic Drugs." The guidance was prepared under the auspices of the International Conference on Harmonisation of Technical Requirements for Registration of Pharmaceuticals for Human Use (ICH). The guidance provides recommendations to sponsors concerning clinical studies to assess the potential of a new drug to cause cardiac arrhythmias, focusing on the assessment of changes in the QT/QTc interval on the electrocardiogram as a predictor of risk. The guidance is intended to encourage the assessment of drug effects on the QT/QTc interval as a standard part of drug development and to encourage the early discussion of this assessment with FDA.

  12. Child anxiety in mental health care: Closing the gaps between research and clinical practice

    NARCIS (Netherlands)

    Jongerden, L.

    2015-01-01

    In this dissertation about child anxiety in mental health care, three gaps between research and everyday clinical practice were addressed. Despite the high prevalence of anxiety disorders in children, only a minority is referred to mental health care. It was found that more severe impairment in the

  13. 75 FR 51083 - Office of Clinical and Preventive Services Maternal and Child Health Program: Project Choices...

    Science.gov (United States)

    2010-08-18

    ... HUMAN SERVICES Indian Health Service Office of Clinical and Preventive Services Maternal and Child... Alcohol Syndrome (FAS) representing the most severe condition. Children with FAS have facial abnormalities... motivation counseling intervention and a family planning consultation and services visit in a pilot study...

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

    Science.gov (United States)

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

    2011-01-01

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

  15. 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.)

  16. 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].

  17. 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)

  18. MMPI-2 Clinical Scale 6 (Paranoia and Restructured Clinical Scale 6 (Ideas of Persecution in Child Custody Litigants

    Directory of Open Access Journals (Sweden)

    Robert Semel

    2015-04-01

    Full Text Available The MMPI-2 is the most frequently used psychological test with parents undergoing child custody evaluations (CCE's. Studies of parents who completed the MMPI-2 in the CCE context have consistently found that, on average, parents portray a very favorable image of themselves as both virtuous and psychologically well-adjusted. Also, on average, Clinical Scale 6 (Paranoia and its counterpart on the Restructured Clinical Scales, RC6, have been the most frequently elevated of the clinical scales on the MMPI-2 in samples of child custody litigants, albeit, the reported scores on these scales are well within the norm. This paper examines the significance of clinically elevated scores on Scale 6 (and RC6 in parents undergoing CCE's, with consideration of both contextual and psychometric features. Based on these considerations, this writer suggests that custody evaluators may encounter the paradox that some parents whose clinical profile suggests mistrust and suspiciousness in interpersonal relations may actually trust enough to report their perceptions in a candid and forthcoming manner. At least some of these parents are not mistrustful in general and are not inclined to model or influence their children toward the development of mistrust. In contrast, other parents may respond to the test in a more defensive and deceptive manner resulting in a "normal" clinical profile, which may be specific to the evaluation context, but may also reflect moral righteousness and a more insidious tactic. The custody evaluator is advised to use caution when interpreting clinically elevated scores on the MMPI-2.

  19. Play and the older child: developmental and clinical opportunities.

    Science.gov (United States)

    Meersand, Pamela

    2009-01-01

    This paper examines the meaning and function of pretend play in older children. First, a review of the widely accepted developmental sequences, growth-promoting potential, and analytic uses of play for younger children is provided. Then the possible role for play in later childhood is explored through the presentation of Sarah, a twelve-year-old girl in analysis, whose play appeared to provide both clinical and developmental benefits. The suggestion is made to soften the existing developmental line for play in order to allow for its role with preadolescent children.

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

    Directory of Open Access Journals (Sweden)

    Paavilainen Eija

    2014-01-01

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

  2. 78 FR 39736 - Draft Guidance for Industry: Considerations for the Design of Early-Phase Clinical Trials of...

    Science.gov (United States)

    2013-07-02

    ... Persons with access to the Internet may obtain the draft guidance at either http://www.fda.gov/Biologics... of this guidance meet the definition of ``biological product'' in section 351(i) of the Public...

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

    Science.gov (United States)

    Richards, Derek

    2016-06-01

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

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

    Science.gov (United States)

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

    2015-01-01

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

  5. Practical Guidance for Implementing Predictive Biomarkers into Early Phase Clinical Studies

    Directory of Open Access Journals (Sweden)

    Matthew J. Marton

    2013-01-01

    Full Text Available The recent U.S. Food and Drug Administration (FDA coapprovals of several therapeutic compounds and their companion diagnostic devices (FDA News Release, 2011, 2013 to identify patients who would benefit from treatment have led to considerable interest in incorporating predictive biomarkers in clinical studies. Yet, the translation of predictive biomarkers poses unique technical, logistic, and regulatory challenges that need to be addressed by a multidisciplinary team including discovery scientists, clinicians, biomarker experts, regulatory personnel, and assay developers. These issues can be placed into four broad categories: sample collection, assay validation, sample analysis, and regulatory requirements. In this paper, we provide a primer for drug development teams who are eager to implement a predictive patient segmentation marker into an early clinical trial in a way that facilitates subsequent development of a companion diagnostic. Using examples of nucleic acid-based assays, we briefly review common issues encountered when translating a biomarker to the clinic but focus primarily on key practical issues that should be considered by clinical teams when planning to use a biomarker to balance arms of a study or to determine eligibility for a clinical study.

  6. 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.…

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

    OpenAIRE

    Skogmo Idar; Lindbæk Morten; Hjerkinn Bjørg; Rosvold Elin

    2010-01-01

    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 ...

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

    Science.gov (United States)

    Ollendick, Thomas H.; Horsch, Laura M.

    2007-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Andrew Peter McGovern

    2015-01-01

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

  10. 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…

  11. European Society of Clinical Microbiology and Infectious Diseases: update of the diagnostic guidance document for Clostridium difficile infection.

    Science.gov (United States)

    Crobach, M J T; Planche, T; Eckert, C; Barbut, F; Terveer, E M; Dekkers, O M; Wilcox, M H; Kuijper, E J

    2016-08-01

    In 2009 the first European Society of Clinical Microbiology and Infectious Diseases (ESCMID) guideline for diagnosing Clostridium difficile infection (CDI) was launched. Since then newer tests for diagnosing CDI have become available, especially nucleic acid amplification tests. The main objectives of this update of the guidance document are to summarize the currently available evidence concerning laboratory diagnosis of CDI and to formulate and revise recommendations to optimize CDI testing. This update is essential to improve the diagnosis of CDI and to improve uniformity in CDI diagnosis for surveillance purposes among Europe. An electronic search for literature concerning the laboratory diagnosis of CDI was performed. Studies evaluating a commercial laboratory test compared to a reference test were also included in a meta-analysis. The commercial tests that were evaluated included enzyme immunoassays (EIAs) detecting glutamate dehydrogenase, EIAs detecting toxins A and B and nucleic acid amplification tests. Recommendations were formulated by an executive committee, and the strength of recommendations and quality of evidence were graded using the Grades of Recommendation Assessment, Development and Evaluation (GRADE) system. No single commercial test can be used as a stand-alone test for diagnosing CDI as a result of inadequate positive predictive values at low CDI prevalence. Therefore, the use of a two-step algorithm is recommended. Samples without free toxin detected by toxins A and B EIA but with positive glutamate dehydrogenase EIA, nucleic acid amplification test or toxigenic culture results need clinical evaluation to discern CDI from asymptomatic carriage.

  12. 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.

  13. Anticipatory guidance through DVD.

    Science.gov (United States)

    Franz, Sandra; McMahon, Pamela M; Calongne, Laurinda; Steele-Moses, Susan K

    2014-03-01

    The major purpose of the study was to determine if a 5-minute DVD is an effective method for communicating anticipatory guidance to parents at their child's 4-month well-child visit. A total of 84 caregivers were randomly assigned to receive anticipatory guidance through standard care (written anticipatory guidance handout and free talk) or DVD (DVD format + standard care). Participants completed a brief questionnaire immediately before and after their visit. As anticipated, knowledge scores improved significantly from pre-test to post-test. There was also a significant interaction between format used for anticipatory guidance and time. Specifically, there was greater improvement in knowledge over time for parents in the DVD group as compared with the standard care group. Additionally, the mean knowledge level of those in the DVD group as compared with those in the standard care group trended toward significance. Finally, visit length was shortened by nearly 3 minutes in the DVD group, and close to 100% of all respondents, regardless of anticipatory guidance format, indicated that they were very satisfied with their visit and amount of information learned.

  14. 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.

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

    Directory of Open Access Journals (Sweden)

    V Raveenthiran

    2013-01-01

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

  16. Clinical Guidance on Screening Chronic Kidney Disease in Type 2 Diabetic Patients for Family Physicians

    Directory of Open Access Journals (Sweden)

    Seyed Esmaeil Managheb

    2015-10-01

    Full Text Available Incidence of diabetes is increasing in developing countries as well as Iran. Half of the patients are not aware of their disease so screening of diabetes is necessary. Lifestyle changes in society, high-saturated fat diet and decreased physical activity are the factors that influence the growing rate of diabetes in Iran.1 The need for addressing type 2 diabetes has been clarified for family physicians.2 Diabetes is a common disease that is associated with significant morbidity and mortality. It has an asymptomatic stage that may be present for up to several years before diagnosis.3 Diabetes is the leading cause of kidney disease.4 In a study among patients over 45 years with type 2 diabetes, these results were reported: 22% suffered from retinopathy, 7% had impaired vision, 6% had kidney diseases, 9% had clinical symptoms, and 19.1% were at risk for foot ulcers.5 Early treatment of type 2 diabetes can reduce or delay complications.6 Optimal glycemia and BP are important in the prevention of diabetic chronic kidney disease (CKD.4 Therapeutic goals in patients with complications, such as CKD, include maintaining renal function and stopping the trend of renal deterioration.5 Progression of diabetic nephropathy can be slowed through the use of some medications.4 How to screen and manage chronic kidney disease in patients with type 2 diabetes is shown in Figure 1.

  17. Evaluation of Mother-Child Agreement and Factorial Structures of the SCARED Questionnaire in an Italian Clinical Sample

    Science.gov (United States)

    Scaini, Simona; Ogliari, Anna; De Carolis, Ludovica; Bellodi, Laura; Di Serio, Clelia; Brombin, Chiara

    2017-01-01

    Background: A great part of the literature has confirmed the importance of both child and parents reports as source of factual information, especially for childhood emotional syndromes. In our study we aimed at: (i) calculating mother-child agreement and (ii) evaluating factorial structure of the Screen for Child Anxiety Related Emotional Disorders (SCARED) questionnaire in an Italian clinical sample. The novelty of this contribution is two-fold: first, from a clinical point of view, we investigated the parent-child agreement level and examined separately the factorial structures of both parent and child versions of the SCARED for the first time in an Italian clinical sample. Second, unlike previous studies, we used statistical approaches specifically suited to account for the ordinal nature of the collected variables. Method: In a clinical sample of 171 children and adolescents aged 8–18 and their mothers we evaluated inter-rater agreement using weighted kappa indices to assess agreement for each item belonging to a certain SCARED subscale. Exploratory factor analysis for ordinal data was then performed on the polychoric correlation matrix calculated on SCARED items. Differences in the numbers of symptoms reported by children and parents were evaluated as well. Results and Conclusions: Our results reveal moderate to strong mother-child agreement. A significant age effect is present. Two different factorial solutions emerged for parent and child SCARED versions (a 5 factor structure for parents and a 6 factor solution in the child version, including a new factor “Worry about Parents”). This study confirmed the importance of evaluating both child and parent reports in assessment protocols for anxiety disorders. Our findings could help clinicians to determine which information, and from which rater, must be accounted for in evaluating treatment decisions. Moreover, we find that patients characteristics, such as gender and age, should be taken into account when

  18. Clinical Factors for Prognosis and Treatment Guidance of Spinal Cord Astrocytoma

    Science.gov (United States)

    Hida, Kazutoshi; Yano, Shunsuke; Aoyama, Takeshi; Koyanagi, Izumi; Sasamori, Toru; Hamauch, Shuji; Houkin, Kiyohiro

    2016-01-01

    Study Design Retrospective study. Purpose To obtain information useful in establishing treatment guidelines by evaluating baseline clinical features and treatment outcomes of patients with spinal cord astrocytoma (SCA). Overview of Literature The optimal management of SCA remains controversial, and there are no standard guidelines. Methods The study included 20 patients with low-grade and 13 with high-grade SCA surgically treated between 1989 and 2014. Patients were classified according to the extent of surgical resection. Survival was assessed using Kaplan–Meier plots and compared between groups by log-rank tests. Neurological status was defined by the modified McCormick scale and compared between groups by Mann–Whitney U tests. Results Surgical resection was performed for 19 of 20 low-grade (95%) and 10 of 13 high-grade (76.9%) SCA patients. Only nine patients (27.3%) underwent gross total resection, all of whom had low-grade SCA. Of all patients, 51.5% showed deteriorated neurological status compared to preoperative baseline. Median overall survival was significantly longer for low-grade SCA than that (91 months, 78% at 5 years vs. 15 months, 31% at 5 years; p=0.007). Low-grade SCA patients benefited from more aggressive resection, whereas high-grade SCA patients did not. Multivariate analysis revealed histology status (hazard ratio [HR], 0.30; 95% confidence interval [CI], 0.09–0.98; p<0.05) and postoperative neurological status (HR, 0.12; CI, 0.02–0.95; p<0.05) as independent predictors of longer overall survival. Adjuvant radiotherapy had no significant impact on survival rate. However, a trend for increased survival was observed with radiation cordotomy (RCT) in high-grade SCA patients. Conclusions Aggressive resection for low-grade and RCT may prolong survival. Preservation of neurological status is an important treatment goal. Given the low incidence of SCA, establishing strong collaborative, interdisciplinary, and multi-institutional study groups

  19. Transformational Impact of Health Information Technology on the Clinical Practice of Child and Adolescent Psychiatry.

    Science.gov (United States)

    Peters, Todd E

    2017-01-01

    Compared with other medical specialties, psychiatrists have been slower adopters of health information technology (IT) practices, such as electronic health records (EHRs). This delay in implementation could compromise patient safety and impede integration into accountable care organizations and multidisciplinary treatment settings. This article focuses on optimizing use of EHRs for clinical practice, leveraging health IT to improve quality of care, and focusing on the potential for future growth in health IT in child and adolescent psychiatric practice. Aligning with other medical fields and focusing on transparency of mental health treatment will help psychiatrists reach parity with other medical specialties.

  20. Brief strategic therapy in a child community clinic. A follow-up report.

    Science.gov (United States)

    Eisenberg, J; Wahrman, O

    1994-01-01

    This paper reports the outcome of brief strategic therapy, practiced according to the model described by S. de Shazer, in an out-patient child psychiatry clinic during 4 years. Forty-two clients were interviewed in a span of 6 to 18 months after termination of therapy and asked about symptomatic improvement and satisfaction with the treatment. The results showed that brief strategic therapy achieved lasting complaint resolution in a high percentage of cases, high satisfaction rates with little relapse or need for additional interventions.

  1. How safe is our "place of safety"? Clinical guidance promoting safer medical care of patients detained under section 136 of the Mental Health Act.

    Science.gov (United States)

    Mouko, Josie; Goddard, Aurielle; Nimmo-Smith, Victoria

    2015-01-01

    A new four-bed unit was opened in Bristol, UK, in 2014, for people detained under section 136 of the Mental Health Act. Police bring individuals posing a risk to themselves or others to a Place of Safety (PoS) in order to receive a mental health assessment. Individuals may be held for up to 72 hours, but cannot receive treatment against their will, unless assessed as lacking the capacity to refuse treatment. Issues requiring medical input arose in more than a third of patients, yet there was little guidance for trainees around the PoS. We conducted a survey which confirmed that robust clinical guidance was needed for junior doctors around medical assistance in this unique environment. We identified specific concerns around patient safety in relation to alcohol withdrawal, uncertainties around legislation and lack of clarity of who to call out of hours. Trainees felt they were working outside of their expertise. We collaborated with a variety of professionals to produce clinical guidance in line with best evidence, and made this easily accessible. We also gained a consensus that more experienced core trainees (SHOs) in Psychiatry should be the first point of contact. We then conducted a survey in June 2015, and found that doctors covering the PoS now felt there was sufficient guidance on most clinical scenarios, 100% consensus on who to contact and improved confidence in their ability to manage issues arising. In August 2015 we held an informal training session for the new intake of trainees on the rota. A subsequent survey revealed similarly positive results. Through this project, we were able to identify defects in a system, provide needed guidance to enable safer and more equitable care to a vulnerable group, and foster closer collaboration between junior doctors and managers in the design and use of services.

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

    Science.gov (United States)

    US Government Accountability Office, 2005

    2005-01-01

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

  3. 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.

  4. Dual-energy compared to single-energy CT in pediatric imaging: a phantom study for DECT clinical guidance

    Energy Technology Data Exchange (ETDEWEB)

    Zhu, Xiaowei; Servaes, Sabah; Darge, Kassa [The Children' s Hospital of Philadelphia, Department of Radiology, Philadelphia, PA (United States); University of Pennsylvania, The Perelman School of Medicine, Philadelphia, PA (United States); McCullough, William P. [University of Virginia Health System, Department of Radiology and Medical Imaging, Charlottesville, VA (United States); Mecca, Patricia [The Children' s Hospital of Philadelphia, Department of Radiology, Philadelphia, PA (United States)

    2016-11-15

    Dual-energy CT technology is available on scanners from several vendors and offers significant advantages over classic single-energy CT technology in multiple clinical applications. Many studies have detailed dual-energy CT applications in adults and several have evaluated the relative radiation dose performance of dual-energy CT in adult imaging. However, little has been published on dual-energy CT imaging in the pediatric population, and the relative dose performance of dual-energy CT imaging in the pediatric population is not well described. When evaluating dual-energy CT technology for implementation into a routine clinical pediatric imaging practice, the radiation dose implications must be considered, and when comparing relative CT dose performance, image quality must also be evaluated. Therefore the purpose of this study is to develop dual-energy CT scan protocols based on our optimized single-energy scan protocols and compare the dose. We scanned the head, chest and abdomen regions of pediatric-size anthropomorphic phantoms with contrast inserts, using our optimized single-energy clinical imaging protocols on a Siemens Flash {sup registered} CT scanner. We then scanned the phantoms in dual-energy mode using matching image-quality reference settings. The effective CT dose index volume (CTDI{sub vol}) of the scans was used as a surrogate for relative dose in comparing the single- and dual-energy scans. Additionally, we evaluated image quality using visual assessment and contrast-to-noise ratio. Dual-energy CT scans of the head and abdomen were dose-neutral for all three phantoms. Dual-energy CT scans of the chest showed a relative dose increase over the single-energy scan for 1- and 5-year-old child-based age-equivalent phantoms, ranging 11-20%. Quantitative analysis of image quality showed no statistically significant difference in image quality between the single-energy and dual-energy scans. There was no clinically significant difference in image quality by

  5. Predictive value of clinical risk indicators in child development: final results of a study based on psychoanalytic theory

    OpenAIRE

    Maria Cristina Machado Kupfer; Alfredo Nestor Jerusalinsky; Leda Mariza Fischer Bernardino; Daniele Wanderley; Paulina Schmidtbauer Barbosa Rocha; Silvia Eugenia Molina; Léa Martins Sales; Regina Stellin; M. Eugênia Pesaro; Rogerio Lerner

    2010-01-01

    We present the final results of a study using the IRDI (Clinical Risk Indicators in Child Development). Based on a psychoanalytic approach, 31 risk signs for child development were constructed and applied to 726 children between the ages of 0 and 18 months. One sub-sample was evaluated at the age of three. The results showed a predictive capacity of IRDIs to indicate developmental problems; 15 indicators for the IRDI were also highlighted that predict psychic risk for the constitution of the ...

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

    OpenAIRE

    Lawan, Umar M.; Gboluwaga T Amole; Jahum, Mahmud G.; Abdullahi Sani

    2014-01-01

    Background: Appropriate infant feeding is the key to optimum infant and child development and survival. This study investigates age-appropriate infant feeding practices and nutritional status of infants attending the immunization and child welfare clinic at Aminu Kano Teaching Hospital. Materials and Methods: Using a cross-sectional descriptive design, a sample of 300 sets of infants (age ≤12 months) and caregivers was systematically selected and studied. The data were analyzed using the MINI...

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

    Science.gov (United States)

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

    2012-09-01

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

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

    Science.gov (United States)

    Meacci, Stefano

    2012-01-01

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

  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. 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.

  11. 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

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

    Institute of Scientific and Technical Information of China (English)

    杨玲

    2014-01-01

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

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

    Science.gov (United States)

    Lansdown, Gerison; Lundy, Laura; Goldhagen, Jeffrey

    2016-01-01

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

  14. Pain and nurses' emotion work in a paediatric clinic: treatment procedures and nurse-child alignments.

    Science.gov (United States)

    Rindstedt, Camilla

    2013-01-01

    In the treatment of cancer in children, treatment procedures have been reported to be one of the most feared elements, as more painful than the illness as such. This study draws on a video ethnography of routine needle procedure events, as part of fieldwork at a paediatric oncology clinic documenting everyday treatment negotiations between nurses and young children. On the basis of detailed transcriptions of verbal and nonverbal staff-child interaction, the analyses focus on ways in which pain and anxiety can be seen as phenomena that are partly contingent on nurses' emotion work. The school-age children did not display fear. In the preschool group, though, pain and fear seemed to be phenomena that were greatly reduced through nurses' emotion work. This study focuses on three preschoolers facing potentially painful treatment, showing how the nurses engaged in massive emotion work with the children, through online commentaries, interactive formats (delegation of tasks, consent sequences, collaborative 'we'-formats), as well as solidarity-oriented moves (such as praise and endearment terms). Even a young toddler would handle the distress of needle procedures, when interacting with an inventive nurse who mobilized child participation through skilful emotion work.

  15. 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.

  16. Quantifying discipline practices using absolute versus relative frequencies: clinical and research implications for child welfare.

    Science.gov (United States)

    Lindhiem, Oliver; Shaffer, Anne; Kolko, David J

    2014-01-01

    In the parent intervention outcome literatures, discipline practices are generally quantified as absolute frequencies or, less commonly, as relative frequencies. These differences in methodology warrant direct comparison as they have critical implications for study results and conclusions among treatments targeted at reducing parental aggression and harsh discipline. In this study, we directly compared the absolute frequency method and the relative frequency method for quantifying physically aggressive, psychologically aggressive, and nonaggressive discipline practices. Longitudinal data over a 3-year period came from an existing data set of a clinical trial examining the effectiveness of a psychosocial treatment in reducing parental physical and psychological aggression and improving child behavior (N = 139). Discipline practices (aggressive and nonaggressive) were assessed using the Conflict Tactics Scale. The two methods yielded different patterns of results, particularly for nonaggressive discipline strategies. We suggest that each method makes its own unique contribution to a more complete understanding of the association between parental aggression and intervention effects.

  17. MO-DE-210-07: Investigation of Treatment Interferences of a Novel Robotic Ultrasound Radiotherapy Guidance System with Clinical VMAT Plans for Liver SBRT Patients

    Energy Technology Data Exchange (ETDEWEB)

    Gong, R [Stanford University, Palo Alto, CA (United States); Bruder, R; Schweikard, A [University of Luebeck, Luebeck, Schleswig-Holstein (Germany); Schlosser, J [SoniTrack Systems Inc., Mountain View, CA (United States); Hristov, D [Stanford University Cancer Center, Palo Alto, CA (United States)

    2015-06-15

    Purpose: To evaluate the proportion of liver SBRT cases in which robotic ultrasound image guidance concurrent with beam delivery can be deployed without interfering with clinically used VMAT beam configurations. Methods: A simulation environment incorporating LINAC, couch, planning CT, and robotic ultrasound guidance hardware was developed. Virtual placement of the robotic ultrasound hardware was guided by a target visibility map rendered on the CT surface. The map was computed on GPU by using the planning CT to simulate ultrasound propagation and attenuation along rays connecting skin surface points to a rasterized imaging target. The visibility map was validated in a prostate phantom experiment by capturing live ultrasound images of the prostate from different phantom locations. In 20 liver SBRT patients treated with VMAT, the simulation environment was used to place the robotic hardware and ultrasound probe at imaging locations indicated on the visibility map. Imaging targets were either entire PTV (range 5.9–679.5 ml) or entire GTV (range 0.9–343.4 ml). Presence or absence of mechanical collisions with LINAC, couch, and patient body as well as interferences with treated beams were recorded. Results: For PTV targets, robotic ultrasound guidance without mechanical collision was possible in 80% of the cases and guidance without beam interference was possible in 60% of the cases. For the smaller GTV targets, these proportions were 95% and 85% correspondingly. GTV size (1/20), elongated shape (1/20), and depth (1/20) were the main factors limiting the availability of non-interfering imaging positions. Conclusion: This study indicates that for VMAT liver SBRT, robotic ultrasound tracking of a relevant internal target would be possible in 85% of cases while using treatment plans currently deployed in the clinic. With beam re-planning in accordance with the presence of robotic ultrasound guidance, intra-fractional ultrasound guidance may be an option for 95% of the

  18. 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.

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

    Science.gov (United States)

    2010-03-26

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

  20. 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…

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

    Science.gov (United States)

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

    2009-01-01

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

  2. 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…

  3. Impact of maternal mental health on maternal-child interaction in attendees in a community health clinic in Lagos, Nigeria

    Directory of Open Access Journals (Sweden)

    Motunrayo A Oyelohunnu

    2016-01-01

    Full Text Available Background: Maternal mental health, in particular depression, has been found to negatively impact mother-child interaction, attachment, stimulation, growth, and many important aspects of development in the young child. These early deficits if sustained and unattended may have negative immediate and long-term consequences on the outcomes in the child. The study aimed to assess psychological distress and postpartum depression in mothers, and their relationship to the mother-child interaction. Methodology: This is a descriptive clinic-based study. Eligible and consenting mothers are attending the child immunization clinic in the Lagos University Teaching Hospital, Lagos, Nigeria participated. Consecutive mothers completed the interview questionnaires independently while those who were not literate had the questionnaires administered by trained interviewers. Instruments used were a sociodemographic proforma, the General Health Questionnaire-12, Mother and Infant Attachment Scale (MIAS, and the Zung Depression Scale. Results: In total, ninety-eight women were enrolled, 66.3% were aged between 26 and 35 years, and mean age of 30.9 years (±5.1 standard deviation. Most were aged between 26 and 35 years (66.3%. Over 90% had at secondary school education or more. Over a 10 th (13.3% was unemployed and 96% married. The children were aged between 6 weeks and 1 year, males (63.1%, and females (46.9%, and the majority were born by spontaneous vaginal delivery (82.7%. A 10 th (10.2% of the women had probable psychiatric morbidity, 14.3% had scores suggestive of postpartum depression, and 18 (16.3% scored below average attachment in interaction with their children on the MIAS. There was an association found between reduced maternal-child attachment interaction and maternal depression (P ≤ 0.05. Conclusions: Emotional disorders, such as depression, in mothers can be associated reduced maternal-child interaction. It is important that integrated mental health

  4. Foundations of Child Psychiatry.

    Science.gov (United States)

    Miller, Emanuel, Ed.; And Others

    Twenty-eight papers examine basic theories and clinical methods in child psychiatry. Theories and methods discussed concern child psychiatry and the World Health Organization, pediatrics, child disturbances, observation, the psychodiagnostic approach, longitudinal research in child development, the comparative approach to early child development,…

  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.

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

    Directory of Open Access Journals (Sweden)

    Seyyed Gholamreza Nourazar

    2014-08-01

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

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

    Science.gov (United States)

    Rittner, Barbara; Wodarski, John S.

    1995-01-01

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

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

    Science.gov (United States)

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

    2011-03-01

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

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

    Science.gov (United States)

    2011-04-01

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

  10. 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

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

    Directory of Open Access Journals (Sweden)

    G Dastjerdi

    2010-09-01

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

  12. The use of statins in people at risk of developing diabetes mellitus: evidence and guidance for clinical practice.

    Science.gov (United States)

    Sattar, Naveed A; Ginsberg, Henry; Ray, Kausik; Chapman, M John; Arca, Marcello; Averna, Maurizio; Betteridge, D John; Bhatnagar, Deepak; Bilianou, Elena; Carmena, Rafael; Ceška, Richard; Corsini, Alberto; Erbel, Raimund; Flynn, Paul D; Garcia-Moll, Xavier; Gumprecht, Janusz; Ishibashi, Shun; Jambart, Selim; Kastelein, John J P; Maher, Vincent; da Silva, Pedro Marques; Masana, Luis; Odawara, Masato; Pedersen, Terje R; Rotella, Carlo Maria; Salti, Ibrahim; Teramoto, Tamio; Tokgozoglu, Lale; Toth, Peter P; Valensi, Paul; Vergès, Bruno

    2014-06-01

    Reducing low-density lipoprotein cholesterol (LDL-C) levels using statins is associated with significant reductions in cardiovascular (CV) events in a wide range of patient populations. Although statins are generally considered to be safe, recent studies suggest they are associated with an increased risk of developing Type 2 diabetes (T2D). This led the US Food and Drug Administration (FDA) to change their labelling requirements for statins to include a warning about the possibility of increased blood sugar and HbA1c levels and the European Medicines Agency (EMA) to issue guidance on a small increased risk of T2D with the statin class. This review examines the evidence leading to these claims and provides practical guidance for primary care physicians on the use of statins in people with or at risk of developing T2D. Overall, evidence suggests that the benefits of statins for the reduction of CV risk far outweigh the risk of developing T2D, especially in individuals with higher CV risk. To reduce the risk of developing T2D, physicians should assess all patients for T2D risk prior to starting statin therapy, educate patients about their risks, and encourage risk-reduction through lifestyle changes. Whether some statins are more diabetogenic than others requires further study. Statin-treated patients at high risk of developing T2D should regularly be monitored for changes in blood glucose or HbA1c levels, and the risk of conversion from pre-diabetes to T2D should be reduced by intensifying lifestyle changes. Should a patient develop T2D during statin treatment, physicians should continue with statin therapy and manage T2D in accordance with relevant national guidelines.

  13. Standardised Observation Analogue Procedure (SOAP) for assessing parent and child behaviours in clinical trials*

    Science.gov (United States)

    JOHNSON, CYNTHIA R.; BUTTER, ERIC M.; HANDEN, BENJAMIN L.; SUKHODOLSKY, DENIS G.; MULICK, JAMES; LECAVALIER, LUC; AMAN, MICHAEL G.; ARNOLD, L. EUGENE; SCAHILL, LAWRENCE; SWIEZY, NAOMI; SACCO, KELLEY; STIGLER, KIMBERLY A.; MCDOUGLE, CHRISTOPHER J.

    2009-01-01

    Background Observational measures of parent and child behaviours have a long history in child psychiatric and psychological intervention research, including the field of autism and developmental disability. We describe the development of the Standardised Observational Analogue Procedure (SOAP) for the assessment of parent–child behaviour before and after a structured parent training program for children with pervasive developmental disorders (PDD). We report on the use of this procedure in a pilot study of 12 participants with PDD. Results Inter-rater reliability across behaviours coded ranged from 75 to 100% agreement. Blindly scored observations of behaviour showed medium effect sizes for changes in inappropriate child behaviour. Analyses of baseline scores revealed a moderate positive correlation between inappropriate child behaviours as measured in all four SOAP conditions and parent ratings of child noncompliance (rs = .66, p .05). Conclusions As our treatment targeted compliance, these preliminary results suggest that the SOAP provides a valid measure of noncompliant behaviour in children with PDD and is sensitive to treatment effects on inappropriate child behaviours. PMID:19681003

  14. [Factors influencing the course and duration of inpatient child and adolescent psychiatric treatment: between empiricism and clinical reality].

    Science.gov (United States)

    Branik, Emil

    2003-09-01

    In the last two decades considerable changes influenced the scope of inpatient treatment in child and adolescent psychiatry. Proceeding from a literature review dilemmas between available research data and clinical practice will be pointed out. Proposals will be made to take into account the complex developmental processes, the individuality and the social context by psychic impaired children and adolescents requiring hospitalisation. This could improve the transfer of research findings into the clinical practice. It will be argued against a confusion of economical interests with research findings.

  15. Interpretion of GHTF Medical Device Clinical Evaluation Guidance%GHTF医疗器械临床评价指导原则解读

    Institute of Scientific and Technical Information of China (English)

    王亚南; 单晓晖; 迟戈

    2014-01-01

    Many new concepts and ideas of the New revision of the Regulations and related registration measures of medical device relevant laws and regulations such as ifle introduces are based on the study of GHTF medical instrument clinical evaluation guidelines . Interpretating the GHTF Medical Device Clinical Evaluation Guidance helps understanding the current medical device clinical technical review guidelines.%新修订的《医疗器械监督管理条例》及配套的注册管理办法等相关法规文件引入了很多GHTF医疗器械临床管理理念中新的概念和思路,本研究通过对GHTF医疗器械临床评价指导原则进行部分解读,利于理解我国现行的医疗器械临床技术审查指导原则。

  16. 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.

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

    Science.gov (United States)

    Babatsouli, Elena

    2016-01-01

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

  18. [Improving Access to Evidence Based Interventions for Children and Adolescents with Mental Disorders After Child Abuse and Neglect].

    Science.gov (United States)

    Ganser, Helene G; Münzer, Annika; Seitz, Diana C M; Witt, Andreas; Goldbeck, Lutz

    2015-01-01

    Victims of child abuse and neglect are more likely to develop emotional and behavioral problems than their non-abused peers. In many cases they do not receive evidence based treatments. Based on pilot studies and clinical experience, a structured and manualized case-management protocol was developed to provide child welfare professionals guidance, direction and support in helping these families find and engage in appropriate treatment. The protocol is described. A survey among child welfare workers indicates a lack of knowledge about mental disorders in victims of child abuse as well as an insufficient cooperation between the child welfare and the mental healthcare system. Child welfare workers who have applied the manual evaluate it positively. This study shows that the structured case-management can be implemented in a child welfare setting.

  19. Clinical note: childhood neurotic disorders with a sexual content need not imply child sexual abuse.

    Science.gov (United States)

    Healy, N; Fitzpatrick, C; Fitzgerald, E

    1991-07-01

    Two cases are described of childhood obsessional states in which the content of the symptomatology led parents and professionals to suspect child sexual abuse. Following assessment it was felt, on the balance of probabilities, unlikely that child sexual abuse had occurred in either case. Both children had previously engaged in "sex play" with peers. Maternal attitudes to sexuality were felt to have influenced their daughters' views about sexual behaviour and to have contributed to the children's guilt feelings. Response to appropriate treatment was rapid and has been sustained in the short-term. The importance of avoiding lengthy and possibly damaging assessment procedures in such cases is discussed.

  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...

  1. Clinical Profile of Children and Adolescents Attending the Behavioural Paediatrics Unit OPD in a Tertiary Care Set up

    Science.gov (United States)

    Jayaprakash, R.

    2012-01-01

    Background: There are limited studies on the clinical profile of children attending child guidance clinic under Paediatric background. Aims: To study clinical profile of Children & adolescents attending the Behavioural Paediatrics Unit (BPU) OPD under department of Paediatrics in a tertiary care set up. Methods: Monthly average turnover in the…

  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. Parent-Child Interaction Therapy for Mexican Americans: A Randomized Clinical Trial

    Science.gov (United States)

    McCabe, Kristen; Yeh, May

    2009-01-01

    This study compared the effectiveness of a culturally modified version of Parent-Child Interaction Therapy (PCIT), called Guiando a Ninos Activos (GANA), to the effectiveness of standard PCIT and Treatment as Usual (TAU) for young Mexican American children with behavior problems. Fifty-eight Mexican American families whose 3- to 7-year-old child…

  4. Parent development in clinical child neurological assessment process: encounters with the assimilation model.

    Science.gov (United States)

    Tikkanen, Soile; Stiles, William B; Leiman, Mikael

    2011-09-01

    Child neurological diagnostic procedures involve extensive encounters with a multi-professional team and may have therapeutic effects. This study explored the therapeutic potential of the diagnostic process using the assimilation model as the conceptual frame of reference. The process of assimilation was tracked across nine consecutive encounters during the assessment of a 4-year-old girl who was referred to the child neurological team due to contact and communication problems. All parent-professional dialogues were transcribed and analyzed using dialogical sequence analysis, which yielded a core problematic reciprocal pattern that was named "controlling in relation to defiant and uncontrolled." Parent development in finding alternative patterns to excessive control was traced using the assimilation model. We could identify assimilation stages in parent development, from disowning the impact of their own actions and mainly seeing the problem as belonging to the child into a more flexible and self-related understanding of the problem. The parents also described more accommodating ways of managing the child at the follow-up. Benefits and limitations in applying the assimilation model in a non-therapy context are discussed.

  5. The World Health Organization child growth standards: expected implications for clinical and epidemiological research.

    Science.gov (United States)

    Van den Broeck, J; Willie, D; Younger, N

    2009-02-01

    In 2006 and 2007, the World Health Organization (WHO) released two sets of child growth standards (World Health Organization, WHO Child Growth Standards. Methods and development. Length/height-for-age, weight-for-age, weight-for-length, weight-for-height and body mass index-for-age. WHO, Geneva, 2006; World Health Organization, WHO Child Growth Standards: Methods and Development. Head circumference-for-age, arm circumference-for-age, triceps skinfold-for-age and subscapular skinfold-for-age. WHO, Geneva, 2007) to replace the National Center for Health Statistics references (Hamill et al., National Center for Health Statistics, Vital and Health Statistics Series 11, No 165, 1977) as an international tool for growth and nutritional assessment. This paper explores the scope of implications for future anthropometric research, highlighting foreseeable effects on the choice of research questions, choice of nutritional indices, training of measurers, and issues of internal and external validity of research results. The conclusion drawn is that the introduction of the WHO child growth standards is expected to have wide implications for growth and nutrition research. The full scope of this effect will gradually become clear while researchers, similar to health care workers, make the transition to using the new standards, re-evaluate results of past approaches, and explore the uses and functional validity of the standards, including those for indices that were not previously available.

  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. Guidance of technical management of dialysis water and dialysis fluid for the Japan Association for Clinical Engineering Technologists.

    Science.gov (United States)

    Kawasaki, Tadayuki; Uchino, Junji; Shinoda, Toshio; Kawanishi, Hideki

    2009-01-01

    There has been remarkable medical and technological progress in Japanese dialysis therapy where more than 270 thousand patients had been treated with dialysis by the end of 2007. Clinical engineering technologists have played an important role not only in the safety treatment but also in the technological development of dialysis therapy. It is very important to supply pure dialysis fluid for both the efficacy and the safety of hemodialysis in which high permeable dialysis membranes are used. The Japanese Society for Dialysis Therapy recently issued the standard for bacterial management of fluids for hemodialysis and related therapies according to the International Organization for Standardization (ISO)/DIS 23500. In order to achieve the standard, the management of dialysis water treatment is important as well as the role of clinical engineering technologists in daily dialysis practice. Purification is defined as no contamination by chemical substances and/or microorganisms and its components. The purification consists of the design and the system structure of the water treatment equipment and dialysis fluid-supplying equipment, and the operation and management of the equipment. The guideline aims to show the minimum standard and the management method of the water treatment system and dialysis fluid-supplying equipment in order to perform hemodialysis safely. They should outline safer dialysis by the management of purification of dialysis fluid.

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

    OpenAIRE

    Holly B. LaPota; Donohue, Brad; Warren, Cortney S; Allen, Daniel N.

    2011-01-01

    Women reported to child protective service agencies frequently report problems that significantly interfere with the health and well-being of their children and themselves. Behavioral treatment programs appear to be effective in managing these co-existing problems, such as domestic violence and substance abuse. However, evidence-supported interventions are rarely exemplified in complicated clinical cases, especially within child welfare settings. Therefore, in this case example, we describe t...

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

    Directory of Open Access Journals (Sweden)

    Ying-ying SU

    2015-12-01

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

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

    Directory of Open Access Journals (Sweden)

    Александр Павлович Поздеев

    2015-09-01

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

  11. 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.

  12. 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.

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

    Directory of Open Access Journals (Sweden)

    Katharina Morant Holanda De Oliveira

    2016-01-01

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

  14. 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

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

    Science.gov (United States)

    Otto, F; Arnhold-Kerri, S

    2010-04-01

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

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

    Science.gov (United States)

    Wiley, Albert L

    2016-09-01

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

  17. 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.

  18. 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.

  19. 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...

  20. DSA辅助超声引导下PICC导管置入的临床研究%Clinical study of DSA PICC catheter placement assisted ultrasound guidance

    Institute of Scientific and Technical Information of China (English)

    孔娟; 贾春怡; 陈艳霞

    2016-01-01

    目的:探讨数字减影血管造影机(DSA)辅助超声引导在PICC置管患者中的临床应用价值。方法在DSA室采用超声引导结合改良塞丁格技术进行穿刺成功后,在DSA的Roadmap功能下沿血管鞘注入1:1浓度的非离子型碘对比剂形成血管走行途径,在DSA监视下置入PICC导管至上腔静脉中下1/3处。结果21例患者中除一例乳癌健侧手臂无名静脉闭塞的患者改股静脉置管外,其余均顺利置管。结论将DSA及超声有效的结合起来应用于PICC导管置入技术中,既提高了穿刺成功率,又可对导管异位进行及时有效的处理,从而使PICC导管置入过程快速、安全,同时减少了相应并发症的发生,值得临床推广应用。%Objective To investigate the clinical application value of digital subtraction angiography (DSA) in patients with PICC catheter placement assisted ultrasound guidance.MethodsIn DSA room with ultrasound guidance combined with modified seldinger technique of successful puncture, 1:1 concentration of non-ionic iodine contrast agent was injected under DSA roadmap function along the vascular sheath to form the vascular route. PICC catheter was placed in superior vena cava inferior 1/3 under DSA monitoring.Results In 21 patients, except for one case of breast cancer, the patients with no other side of the arm were occluded by the femoral vein.Conclusion The combination of DSA and ultrasound is effective in the treatment of PICC catheter placement. It can improve the success rate of puncture with timely and effective treatment, so that the process of PICC catheter placement is fast and safe, and it can reduce the occurrence of complications.

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

    Institute of Scientific and Technical Information of China (English)

    李利红; 刘爱军

    2012-01-01

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

  2. Epilepsy in the Classroom: Guidance for Educators.

    Science.gov (United States)

    Lassner, Lee M.

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

  3. Designing Schoolwide Programs. Non-Regulatory Guidance

    Science.gov (United States)

    US Department of Education, 2006

    2006-01-01

    This guidance offers a renewed vision for the use of the schoolwide program, both as a reform strategy and as a means of realizing the high standards for student achievement envisioned by the No Child Left Behind Act of 2001 (NCLB). It is intended to be used as a companion document to the statute and regulations, as well as a technical assistance…

  4. A proposal to revive "parent guidance": an illustration of a brief intervention with the mother of a toddler.

    Science.gov (United States)

    Sherick, Ivan

    2009-01-01

    A parent guidance intervention is illustrated. The value of such work is underscored to help parents and candidates in child analysis understand intergenerational psychopathology and its consequences for a child. Technical considerations of parent guidance are addressed. A revival of such work is advocated in child analysis training programs.

  5. The safety and clinical outcomes of chemoembolization in child-pugh class C patients with hepatocellular carcinomas

    Energy Technology Data Exchange (ETDEWEB)

    Choi, Tae Won; Kim, Hyo Cheol; Lee, Jeong Hoon; Yu, Su Jong; Kang, Beom Sik; Hur, Sae Beom; Lee, Myung Su; Jae, Hwan Jun; Chung, Jin Wook [Seoul National University College of Medicine, Seoul National University Hospital, Seoul (Korea, Republic of)

    2015-12-15

    To evaluate the safety and clinical outcomes of chemoembolization in Child-Pugh class C patients with hepatocellular carcinomas (HCC). The study comprised 55 patients with HCC who were classified as Child-Pugh class C and who underwent initial chemoembolization between January 2003 and December 2012. Selective chemoembolization was performed in all technically feasible cases to minimize procedure-related complications. All adverse events within 30 days were recorded using the Common Terminology Criteria for Adverse Events (CTCAE). The tumor response to chemoembolization was evaluated using the modified Response Evaluation Criteria In Solid Tumors. Thirty (54.5%) patients were within the Milan criteria, and 25 (45.5%) were beyond. The mortality of study subjects at 30 days was 5.5%. Major complications were observed in five (9.1%) patients who were all beyond the Milan criteria: two hepatic failures, one hepatic encephalopathy, and two CTCAE grade 3 increases in aspartate aminotransferase/alanine aminotransferase abnormality. The mean length of hospitalization was 6.3 ± 8.3 days (standard deviation), and 18 (32.7%) patients were discharged on the next day after chemoembolization. The tumor responses of the patients who met the Milan criteria were significantly higher (p = 0.014) than those of the patients who did not. The overall median survival was 7.1 months (95% confidence interval: 4.4-9.8 months). Even in patients with Child-Pugh class C, chemoembolization can be performed safely with a selective technique in selected cases with a small tumor burden.

  6. Clinical Application of PICC under the Guidance of the Modified Seldinger Technique%改良塞丁格引导的PICC临床应用

    Institute of Scientific and Technical Information of China (English)

    郑海燕; 陈桂华

    2011-01-01

    目的 探讨改良塞丁格引导的PICC临床应用效果.方法 选取2010年4-8月经蚌医一附院PICC组核心护士会诊后认为无法应用传统方法置入PICC患者7例,其中2例为传统方法置入PICC失败,形成局部血肿,2例因肥胖或先天静脉条件差,3例因长期治疗、反复穿刺致肘部静脉弹性差,视觉和触觉均难以辨认静脉深浅和走向,而中心静脉置管(CVC)无法满足疗程需要.应用改良塞丁格引导的PICC技术.结果 7例患者均一次成功,成功率100%,其中从贵要静脉置入6例,正中静脉置入1例,后拍片显示导管关端位置均在上腔静脉内,操作安全,输液通畅,导管留置期间无并发症发生.结论 应用改良塞丁格引导技术,提高了PICC的置管成功率,扩大PICC适应症,该技术能有效解决传统方法无法置入PICC管的问题,提升护理质量,减轻患者痛苦,避免资源浪费.%Objective To investigate clinical effect of PICC under guidance of the modified seldinger technique. Methods From Apr to Aug in 2010,7 patients were selected,they were considered by PICC core group of nurses in our hospital that traditional PICC placement could not be applied to them ,2 cases failed to PICC insertion by traditional methods with the formation of local hematoma,2 cases with poor conditions of obesity or congenital venous ,3 cases with long-term therapy and repeated puncture caused by poor flexibility in the elbow vein. It was difficult to identify by visual and tactile the depth and direction of the vein, and the central venous catheter( CVC ) can not met the treatment needs. PICC insertion tube was used under guidance of the modified seldinger technique. Results 7 patients were all successful at one time,the success rate was 100% ,and 6 cases were inserted from the basilic vein, 1 case from the median vein. The film showed that all catheter' s headends were in the superior vena cava,operations were safe,infusion was smooth,no complications

  7. 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.

  8. 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

  9. Imaging Guidance Improves the Results of Viscosupplementation with HANOX-M-XL in Patients with Ankle Osteoarthritis: Results of a Clinical Survey in 50 Patients Treated in Daily Practice

    Science.gov (United States)

    Bossert, Marie; Boublil, Daniel; Parisaux, Jean-Marc; Bozgan, Ana-Maria; Richelme, Emmanuel; Conrozier, Thierry

    2016-01-01

    BACKGROUND The objective of this survey was to assess retrospectively the interest of performing viscosupplementation using imaging guidance in patients suffering from ankle osteoarthritis (OA). PATIENTS AND METHODS This is a multicenter retrospective survey using a standardized questionnaire. Fifty patients suffering from ankle OA and treated, in daily clinical practice, with a single intra-articular injection of a novel viscosupplement made of a combination of a non-animal cross-linked hyaluronan and mannitol, HANOX M-XL, were included in the survey. The injection procedure (imaging or landmark guidance), demographic data, patient’s self-evaluation of pain, satisfaction, treatment efficacy, and tolerability were collected. Predictive factors of both efficacy and patient’s satisfaction were investigated. RESULTS The percentages of patients very satisfied/satisfied and not really satisfied/dissatisfied with the treatment were 68% and 32%, respectively. Efficacy was rated as very good, good, moderate, and poor by 38%, 30%, 12%, and 20% of the cases, respectively. Efficacy was unrelated to gender and age and was highly correlated with pain score (P steroidal anti-inflammatory drugs was >75% in 64% of the cases. Efficacy was significantly different with regard to imaging guidance. There was a statistically significant difference in efficacy and satisfaction between landmark-guided and imaging-guided injections (P = 0.02). The success rate was 2.3 times higher in the imaging-guided group than in the landmark-guided group. No significant difference was found between patients injected under fluoroscopy or ultrasound guidance, despite a trend favoring ultrasound (P = 0.09). Tolerability was rated as very good/good in 47 patients, moderate in two, and poor in one and was unrelated to the type of guidance. CONCLUSION This preliminary study suggests that the use of imaging guidance significantly optimizes the success rate of ankle viscosupplementation. No safety concern

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

    Science.gov (United States)

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

    2009-04-01

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

  11. 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

  12. 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.)

  13. [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.

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

    NARCIS (Netherlands)

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

    2009-01-01

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

  15. In-office rapid volumetric ablation of uterine fibroids under ultrasound imaging guidance: Preclinical and early clinical experience with the Mirabilis transabdominal HIFU treatment system

    Science.gov (United States)

    Leal, José G. Garza; León, Ivan Hernandez; Sáenz, Lorena Castillo; Aguirre, Juan M. Aguilar; Lagos, Joel J. Islas; Parsons, Jessica E.; Darlington, Gregory P.; Lau, Michael P. H.

    2017-03-01

    Mirabilis Medica, Inc. (Bothell, WA, USA) has developed a high-intensity focused ultrasound (HIFU) system for producing rapid transabdominal volumetric ablation of uterine fibroids in an office-based setting. The Mirabilis HIFU Treatment System utilizes integrated ultrasound imaging guidance and short treatment times under 15 minutes. Treatment with the Mirabilis system is generally well tolerated using only oral analgesia without anesthesia or sedation. This paper summarizes certain technical aspects of the Mirabilis HIFU technology, the preclinical development process, and the results of the first in-human clinical study using the Mirabilis system. During preclinical studies, an in vivo transcutaneous porcine lower extremity model was used in a total of 180 adult swine to develop the HIFU treatment regimen parameters. Additionally, 108 excised human uteri with fibroids obtained from scheduled hysterectomies were treated in an ex vivo experimental setup and evaluated. These preclinical activities resulted in a HIFU treatment technique referred to as Mirabilis Shell Ablation, which enables rapid volumetric fibroid ablation by directing the HIFU energy to the outer perimeter of the target volume (the `shell') without insonating its core. This method results in efficient fibroid treatment through a synergistic combination of direct tissue ablation, cooperative heating effects, and indirect ischemic necrosis in the interior of the volume. After refining this technique and performing safety testing in the in vivo porcine model, a clinical pilot study was conducted to assess the initial safety and performance of the Mirabilis HIFU Treatment System for transabdominal treatment of uterine fibroids in eligible women who were scheduled to undergo hysterectomy following treatment with the device. A total of 37 women meeting certain eligibility criteria were treated at two clinical sites in Mexico. Twenty-nine (29) of these 37 women received only prophylactic sublingual

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

    Institute of Scientific and Technical Information of China (English)

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

    1993-01-01

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

  17. 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).

  18. 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.

  19. 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.…

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

    Science.gov (United States)

    Pepin, Melanie G; Byers, Peter H

    2015-12-01

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

  1. 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.

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

    Directory of Open Access Journals (Sweden)

    Umar M Lawan

    2014-01-01

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

  3. 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.

  4. Graphical Turbulence Guidance - Composite

    Data.gov (United States)

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

  5. On guidance and volatility

    NARCIS (Netherlands)

    Billings, M.B.; Jennings, R.; Lev, B.

    2013-01-01

    Survey evidence suggests that managers voluntarily disclose information, particularly earnings guidance, with an aim toward dampening share price volatility. Yet, consultants and influential institutions advise against providing guidance — citing fears of litigation and market penalties associated w

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

    Science.gov (United States)

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

    2010-05-01

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

  7. 78 FR 12759 - Draft Guidance for Industry on Attachment to Guidance on Antiviral Product Development-Conducting...

    Science.gov (United States)

    2013-02-25

    ... Antiviral Product Development--Conducting and Submitting Virology Studies to the Agency: Guidance for... guidance for industry entitled ``Attachment to Guidance on Antiviral Product Development--Conducting and... important for supporting clinical trials of products in development for the treatment of HCV. HCV...

  8. 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.

  9. 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.

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

    Science.gov (United States)

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

    2011-02-01

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

  11. The Prevalence of Only-Child Status Among Children and Adolescents Referred to a Gender Identity Service Versus a Clinical Comparison Group.

    Science.gov (United States)

    Hughes, S Kathleen; VanderLaan, Doug P; Blanchard, Ray; Wood, Hayley; Wasserman, Lori; Zucker, Kenneth J

    2016-07-11

    Several studies indicate that homosexual males have a high proportion of older brothers compared to heterosexual males. Natal males with gender dysphoria who are likely to be homosexual also display this sibship pattern. Until recently, there was little evidence linking homosexuality and/or gender dysphoria in females to unique sibship characteristics. Two studies have indicated that natal female youth clinically referred for gender dysphoria are more likely to be only children (Schagen, Delemarre-van de Waal, Blanchard, & Cohen-Kettenis, 2012; VanderLaan, Blanchard, Wood, & Zucker, 2014). However, these studies did not include control groups of youth clinically referred for other reasons. Thus, it is unclear whether the increased likelihood of only-child status is specific to gender-referred natal females. This study compared only-child status among youth referred to a mental health service for gender dysphoria (778 males, 245 females) versus other reasons (783 males, 281 females). Prehomosexual gender-referred males were less likely to be only children than clinical controls. Contrary to previous findings, gender-referred females were not more likely to be only children, indicating that increased likelihood of only-child status is not specific to gender-referred females, but is characteristic of clinic-referred females more generally.

  12. Effectiveness of a psychoeducational parenting group on child, parent, and family behavior: a pilot study in a family practice clinic with an underserved population.

    Science.gov (United States)

    Berge, Jerica M; Law, David D; Johnson, Jennifer; Wells, M Gawain

    2010-09-01

    Although integrated care for adults in primary care has steadily increased over the last several decades, there remains a paucity of research regarding integrated care for children in primary care. To report results of a pilot study testing initial feasibility of a parenting psychoeducational group targeting child behavioral problems within a primary care clinic. The participants (n = 35) were parents representing an underserved population from an inner-city primary care clinic. Participants attended a 12-week psychoeducational parenting group and reported pre- and post-measures of family functioning, child misbehavior and dyadic functioning. Paired t-tests and effects sizes are reported. Participants reported statistically significant improvement in family functioning, child misbehavior, and couple functioning after participating in the parenting psychoeducational group. Results suggest initial feasibility of a parenting psychoeducational group within a primary care clinic with an underserved population. This intervention may be useful for other primary care clinics seeking to offer more integrative care options for children and their families.

  13. [Problems of reception in a guidance center].

    Science.gov (United States)

    Mattelaer, P

    1975-01-01

    The aim of this communication is not to criticise the work of guidance, but to analyse its efficiency and validity in order to formulate concrete proposals. One can distinguish three periods in the evolution of the work in a guidance center. In the first period, it is a methodological concern which presided to this type of work. In the second period, one thought that there was to many preliminary investigations and it was decided to take the child in treatment more rapidly. During the third period, the attention has primarily be centered on the child's problems. The author suggests some solutions. He considers it is necessary to abandon the multidisciplinary approach. He advises to always consider one case at the time within a therapeutic and diagnostic frame. Therapy has to be conducted by one person, even if this person has to treat the whole family.

  14. Portal hypertension: an uncommon clinical manifestation of Takayasu arteritis in a 9-year-old child

    Science.gov (United States)

    Herrera, Cristina N; Tomala-Haz, Javier E

    2016-01-01

    Takayasu arteritis (TA) is the third most common childhood vasculitis and its clinical manifestations depend on the arteries involved. We report a case of a 9-year-old boy with multiple aneurysms in carotid and iliac arteries, subclavian and coronary arteries, and abdominal aorta. At the age of 7 years, he presented with recurrent fever and hepatosplenomegaly. An angio-computed tomography scan showed aneurysms in the left subclavian artery, abdominal aorta, and both proximal iliac arteries. He was diagnosed with TA and was treated with corticosteroids, aspirin, and enalapril. One year later, he was admitted to Dr Roberto Gilbert Children’s Hospital because of intracranial hemorrhage. Angiography revealed enlargement of aneurysms enlargement and new aneurysms. He also developed portal hypertension. Treatment with intravenous corticosteroids, azathioprine, and monthly intravenous cyclophosphamide was begun. After 6 months of no improvement, infliximab was begun. The aim of this article was to report the concurrence of coronary involvement and portal vein hypertension in pediatric TA because there were scarce reports on this matter. PMID:27895519

  15. 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

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

    Directory of Open Access Journals (Sweden)

    Reginaldo Roque Mafetoni

    Full Text Available 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=<0.0001. This was also the case where the treatment lasted for 1 hour (p-value=0.0001. This was the case in comparison with placebo and control groups. Conclusion: the use of 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.

  17. 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.

  18. 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.

  19. 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......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...

  20. 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

  1. 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.

  2. Clinical diagnosis of metabolic and cardiovascular risks in overweight children: early development of chronic diseases in the obese child.

    Science.gov (United States)

    l'Allemand-Jander, D

    2010-12-01

    Childhood overweight (body mass index (BMI)>90th centile) poses a major public health problem in so far as adult diseases manifest themselves already during childhood. In this review, after examining the prevalence of metabolic and cardiovascular diseases, the issue of whether BMI or other clinical parameters are valid tools to predict co-morbidities in children is discussed. Data of 2001-2008 are reviewed, including several studies conducted on more than 260,000 overweight and obese children in Germany and Switzerland. Apart from non-metabolic co-morbidities, namely musculoskeletal complications and attention deficit/hyperactivity disorders in up to 74% and up to 58% of overweight children, respectively, at least one cardiovascular and metabolic risk factor was seen in 52% of the overweight children, mostly high blood pressure (35%) with increased left ventricular mass or arterial stiffness. Signs of fatty liver disease or dyslipidemia were found in up to 29 and 32% of the children, respectively. Type 2 diabetes was found in less than 0.7% of the children, and an elevated fasting glucose or glucose intolerance in 3%. Irrespective of BMI, the quality of fat and protein intake predicted hypertension or insulin resistance, and fructose predicted lower (and more atherogenic) particle size of low-density lipoprotein-cholesterol. Out of the adiposity markers, waist circumference was closely correlated with insulin resistance and the components of the metabolic syndrome. In conclusion, risk factors are found in more than half of the overweight children, most frequently high blood pressure or dyslipidemia, and were mainly related to waist circumference, but also to BMI and fat mass. Even in the presence of normal BMI, screening for cardiovascular risk factors is advocated in each child with elevated waist circumference, but its cut-off points still remain to be validated. The increased occurrence of orthopedic and psychiatric complaints may detrimentally influence health

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

    Science.gov (United States)

    Lapota, Holly B; Donohue, Brad; Warren, Cortney S; Allen, Daniel N

    2011-04-01

    Women reported to child protective service agencies frequently report problems that significantly interfere with the health and well-being of their children and themselves. Behavioral treatment programs appear to be effective in managing these co-existing problems, such as domestic violence and substance abuse. However, evidence-supported interventions are rarely exemplified in complicated clinical cases, especially within child welfare settings. Therefore, in this case example, we describe the process of adapting an evidence-supported treatment to assist in managing significant co-existing health-related problems in a mother who was referred due to child neglect and drug abuse. At the conclusion of therapy, the participant reported improvements in perceived family relationships, illicit drug use, child maltreatment potential, whereas other health-related outcomes were mixed. Most improvements were maintained at 4-month follow-up. Issues relevant to implementing evidence-based treatments within community contexts are discussed, including methods of increasing the likelihood of valid outcome assessment, managing treatment integrity, and adjusting standardized treatments to accommodate co-occurring problems.

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

    Directory of Open Access Journals (Sweden)

    Holly B. LaPota

    2014-01-01

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

  5. 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.

  6. 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.

  7. 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…

  8. Shuttle entry guidance revisited

    Science.gov (United States)

    Mease, Kenneth D.; Kremer, Jean-Paul

    1992-01-01

    The Shuttle entry guidance concept is reviewed which is aimed at tracking a reference drag trajectory that leads to the specified range and velocity for the initiation of the terminal energy management phase. An approximate method of constructing the domain of attraction is proposed, and its validity is ascertained by simulation. An alternative guidance law yielding global exponential tracking in the absence of control saturation is derived using a feedback linearization method. It is noted that the alternative guidance law does not improve on the stability and performance of the current guidance law, for the operating domain and control capability of the Shuttle. It is suggested that the new guidance law with a larger operating domain and increased lift-to-drag capability would be superior.

  9. Shuttle entry guidance

    Science.gov (United States)

    Harpold, J. C.; Graves, C. A., Jr.

    1978-01-01

    This paper describes the design of the entry guidance for the Space Shuttle Orbiter. This guidance provides the steering commands for trajectory control from initial penetration of the earth's atmosphere until the terminal area guidance is activated at an earth-relative speed of 2500 fps. At this point, the Orbiter is at a distance of about 50 nmi from the runway threshold, and at an altitude of about 80,000 ft. The entry guidance design is based on an analytic solution of the equations of motion defining the drag acceleration profile that meets the terminal criteria of the entry flight while maintaining the flight within systems and operational constraints. Guidance commands, which are based on a control law that ensures damping of oscillatory type trajectory motion, are computed to steer the Orbiter to this drag acceleration profile.

  10. Shuttle entry guidance revisited

    Science.gov (United States)

    Mease, Kenneth D.; Kremer, Jean-Paul

    1992-08-01

    The Shuttle entry guidance concept is reviewed which is aimed at tracking a reference drag trajectory that leads to the specified range and velocity for the initiation of the terminal energy management phase. An approximate method of constructing the domain of attraction is proposed, and its validity is ascertained by simulation. An alternative guidance law yielding global exponential tracking in the absence of control saturation is derived using a feedback linearization method. It is noted that the alternative guidance law does not improve on the stability and performance of the current guidance law, for the operating domain and control capability of the Shuttle. It is suggested that the new guidance law with a larger operating domain and increased lift-to-drag capability would be superior.

  11. An investigation of the clinical use of the house-tree-person projective drawings in the psychological evaluation of child sexual abuse.

    Science.gov (United States)

    Palmer, L; Farrar, A R; Valle, M; Ghahary, N; Panella, M; DeGraw, D

    2000-05-01

    Identification and evaluation of child sexual abuse is an integral task for clinicians. To aid these processes, it is necessary to have reliable and valid psychological measures. This is an investigation of the clinical validity and use of the House-Tree-Person (HTP) projective drawing, a widely used diagnostic tool, in the assessment of child sexual abuse. HTP drawings were collected archivally from a sample of sexually abused children (n = 47) and a nonabused comparison sample (n = 82). The two samples were grossly matched for gender, ethnicity, age, and socioeconomic status. The protocols were scored using a quantitative scoring system. The data were analyzed using a discriminant function analysis. Group membership could not be predicted based on a total HTP score.

  12. Military Child Care Programs: Progress Made, More Needed.

    Science.gov (United States)

    1982-06-01

    program areas such as nutri- tion, health, child growth and development, educational guidance, and remedial techniques. None of the existing service...activities weakens their programs. The child care staff should know about such things as nutri- tion, health, child growth and development

  13. 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)

  14. [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.

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

    Science.gov (United States)

    Armus, Marcela; Costa, Juan J

    2014-01-01

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

  16. 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.

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

    Science.gov (United States)

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

    2013-01-01

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

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

    Science.gov (United States)

    Gerstein, Alvin I.; And Others

    1976-01-01

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

  19. Announcement: Guidance for U.S. Laboratory Testing for Zika Virus Infection: Implications for Health Care Providers.

    Science.gov (United States)

    2016-11-25

    CDC has released updated guidance online for U.S. laboratory testing for Zika virus infection. The guidance is available at https://www.cdc.gov/zika/laboratories/lab-guidance.html. Frequently asked questions are addressed at https://www.cdc.gov/zika/laboratories/lab-guidance-faq.html. This guidance updates recommendations for testing of specimens by U.S. laboratories for possible Zika virus infection. Major updates to the guidance with clinical implications for health care providers include the following.

  20. 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'…

  1. 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.

  2. 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,.

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

    Science.gov (United States)

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

    2013-03-01

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

  4. 7岁以下社区儿童营养不良的临床保健指导与健康宣教%Clinical health guidance and health education of malnutrition in community children under 7 years old

    Institute of Scientific and Technical Information of China (English)

    顾亚玲

    2016-01-01

    目的:探讨保健指导与健康宣教在7岁以下社区儿童营养不良中的应用效果。方法:收治营养不良患儿66例,随机分为观察组与对照组各33例,对照组给予常规对症治疗,观察组在此基础上给予保健指导与健康宣教,对比两组临床疗效。结果:对照组治疗总有效率明显低于观察组;观察组治疗满意度明显高于对照组(P<0.05)。结论:7岁以下社区儿童营养不良中施加保健指导与健康宣教可改善治疗效果,提高治疗满意度。%Objective:To explore the application effect of health guidance and health education of malnutrition in community children under 7 years old.Methods:66 children with malnutrition were selected.They were randomly divided into the observation group and the control group with 33 cases in each.The control group was given conventional symptomatic treatment.The observation group was given health guidance and health education.The clinical curative effects of two groups were compared. Results:The treatment total effective rate of the control group was significantly lower than that of the observation group,and the treatment satisfaction of the observation group was significantly higher than that of the control group(P<0.05).Conclusion:The health guidance and health education of malnutrition in community children under 7 years old can improve the treatment effect and improve the treatment satisfaction.

  5. The clinical significance of R35 in IOS examination and health guidance for the preschoolers with chronic cough%学龄前慢性咳嗽患儿IOS检查中R35的临床意义

    Institute of Scientific and Technical Information of China (English)

    谭娴玲; 邹商群; 陈宏君; 黄春平; 林桂艳

    2014-01-01

    Objective:To explore the clinical significance of R35 in impulse oscillometry system( IOS) and the health guidance. Methods:240 cases of pa-tients with chronic cough used IOS examination to observe the indexes and the graphics changes. Patients with nasal itching,nasal congestion,sneezing and or position changes cough and clear voice of cough as the observation group,others as the control group. Results:The indexes of IOS of two groups has signifi-cant(P0. 05). Conclusion:IOS can re-flect the change of each part of the respiratory system disease,especially in patients with atypical clinical symptoms and early auxiliary examination,it can provide objective basis for early clinical treatment and care for health guidance,to improve the quality of life in this part of the crowd.%目的::探讨学龄前慢性咳嗽患儿强迫脉冲振荡( IOS)检查中R35的临床意义及健康指导。方法:选择我院肺功能室2013年6~12月240例诊断为慢性咳嗽患儿,有鼻塞、鼻痒等变应性鼻炎或哮喘合并鼻炎和或有早期咳嗽或体位改变咳嗽加重等上气道咳嗽综合征表现的120例患儿纳入观察组,其余没有上述综合征表现的咳嗽患儿120例纳入对照组。两组患儿均进行IOS检查,对两组5岁以上的患儿同时进行通气功能检测,观察其指标及图形变化。结果:观察组IOS各项参数与对照组比较有统计学意义(P0.05)。结论:IOS检查能很好地反应呼吸系统各部位疾病的改变,特别是临床症状不典型患儿,对其进行早期辅助检查,能为临床治疗和护理健康指导提供早期客观依据,提高生活质量。

  6. Next-Generation Molecular Histology Using Highly Multiplexed Ion Beam Imaging (MIBI) of Breast Cancer Tissue Specimens for Enhanced Clinical Guidance

    Science.gov (United States)

    2015-07-01

    situ hybridization and subcellular metabolic analysis . The extended applications of MIBI taken with the gains Angelo et al. Page 7 Nat Med. Author...clinical deployment of this technology would extend multiplexed expression analysis typically restricted to flow cytometry of cell suspensions (such as...range of quantitation. We propose to develop assays and analysis tools to evaluate breast cancer tissues using formal fixed and paraffin embedded

  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...... in new places. In this article I introduce an analytical perspective on place; I give the example of the guidance café a practice development that took place into serious consideration because it was an attempt to develop career guidance practice through relocating it....

  8. 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.

  9. 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).

  10. Psychometric Properties of the Dutch Eyberg Child Behavior Inventory (ECBI) in a Community Sample and a Multi-Ethnic Clinical Sample.

    Science.gov (United States)

    Abrahamse, Mariëlle E; Junger, Marianne; Leijten, Patty H O; Lindeboom, Robert; Boer, Frits; Lindauer, Ramón J L

    The Eyberg Child Behavior Inventory (ECBI) is an established parent rating scale to measure disruptive behavior problems in children aged between 2 and 16 years. The present study examined the psychometric properties of the Dutch translation, including analysis on the one-dimensional structure of the ECBI scales using item response theory. Data from two samples from the Netherlands were used, a community sample (N = 326; 51 % boys) and a multi-ethnic clinical sample (N = 197; 62 % boys). The one-dimensional structure of the ECBI Intensity and Problem Scales were confirmed in both of these samples. The results also indicated good internal consistency, test-retest reliability (community sample), and good convergent and divergent validity. The ECBI Intensity Scale was able to differentiate between diagnostic groups (no diagnosis, ADHD, ODD, and CD symptoms), demonstrating good discriminative validity. Findings support the use of the ECBI as a reliable measure for child disruptive behavior problems in a Dutch population. Suggestions for the optimal use of the both ECBI scales for research and screening purposes are made. Also, cultural issues regarding the use of the ECBI are discussed and additional research into the validity of the ECBI is recommended.

  11. 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.

  12. Misguided presumptions: British Medical Association (BMA) and National Institute for Health and Clinical Excellence (NICE) guidance on organ retrieval and 'opt out' or 'presumed consent'.

    Science.gov (United States)

    Randall, Fiona; Downie, Robin

    2012-12-01

    Three documents have been produced in an attempt to increase the number of organs available for transplant: a National Institute for Health and Clinical Excellence (NICE) clinical guideline, a British Medical Association (BMA) report and a Welsh Government white paper. All three are ethically flawed: NICE and the BMA recommend that whenever there is intention to withdraw life-sustaining treatment and death is expected, patients should instead be stabilised to assess for donation. This is contrary to patients' best interests, the principles of mental capacity legislation and current criteria for accessing intensive care units. Regarding consent, the BMA and Welsh Government recommend an 'opt-out' policy, but consent in law requires information and cannot be 'presumed' or 'deemed' on the basis of failure to express or register 'opting out'. The language of all three proposals is manipulative, and patient trust may be undermined because the doctor's attention must move from the interests of the patient to those of the unknown organ recipients.

  13. Clinical Management of a Child with Prader-Willi Syndrome from Maternal Uniparental Disomy (UPD) Genetic Inheritance

    Science.gov (United States)

    Bellon-Harn, Monica L.

    2005-01-01

    Prader-Willi Syndrome (PWS) is reported in 1 in 10,000-15,000 individuals. Unfortunately, many cases are missed due to clinicians' lack of familiarity with the syndrome as well as clinical and laboratory diagnostic criteria. Although common clinical characteristics are reported, variety exists in the nature and severity of dysfunction associated…

  14. 社会公益性指导下的临床医学科研%Clinical medical research under guidance of public welfare

    Institute of Scientific and Technical Information of China (English)

    黄敏; 戴慧荣; 张芳

    2010-01-01

    通过分析目前临床医学科研缺乏社会公益性的原因,根据2009年新医改坚持公共医疗卫生公益性的基本原则,提出提高临床医学科研公益性的策略.%In this paper the causes of deficiency of public welfare were analyzed in medical research,and some strategies were proposed to enhance the public welfare of public health care services according to the cardinal principles of new healthcare reform package in 2009.These were benefit to maintain the public welfare of public medical and health care services,and to reach the goal of medical research served as the clinic and the patients.

  15. 77 FR 11133 - Draft Guidance for Industry on Complicated Urinary Tract Infections: Developing Drugs for...

    Science.gov (United States)

    2012-02-24

    ...The Food and Drug Administration (FDA) is announcing the availability of a draft guidance for industry entitled ``Complicated Urinary Tract Infections: Developing Drugs for Treatment.'' The purpose of this guidance is to assist sponsors in the clinical development of drugs for the treatment of complicated urinary tract infections (cUTIs). Specifically, this guidance addresses FDA's current......

  16. 77 FR 59928 - Draft Guidance for Industry on Complicated Intra-Abdominal Infections: Developing Drugs for...

    Science.gov (United States)

    2012-10-01

    ... HUMAN SERVICES Food and Drug Administration Draft Guidance for Industry on Complicated Intra-Abdominal... guidance for industry entitled ``Complicated Intra-Abdominal Infections: Developing Drugs for Treatment.'' The purpose of this guidance is to assist sponsors in the clinical development of drugs for...

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

    Science.gov (United States)

    Grech, Victor; Buttigieg, Mark

    2012-09-01

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

  18. PROFESSIONAL GUIDANCE: EXPERIENCE REPORT

    Directory of Open Access Journals (Sweden)

    Fabiana Pinto de Almeida Bizarria

    2014-05-01

    Full Text Available This article presents an account of a career guidance with a group of five teenagers ( 16 and 19 , students of pre-university preparatory course offered by a public university in the state of Ceará . The work group dynamics was from a privileged form of performance by allowing a greater enrichment of the discussions , considering the heterogeneity and diversity of the group . To address relevant issues in career guidance based on the theory Socio-Historical , a roadmap of action process was constructed from three axes . Each axis has worked in two sessions that match a date. The first axis called " meaning of choice," worked on thematic choice process . With regard to the axis " World of Work " was discussed idealizations and representations about the professions , the labor market and the vestibular / ESMS . Emotional links with the professions , skills and ideas on skills and information professions : Finally , the " self " axis, which contains the themes was developed .

  19. Scoliosis surgery - child

    Science.gov (United States)

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

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

    NARCIS (Netherlands)

    CORNEL, MC; VANESSEN, AJ; TENKATE, LP

    1992-01-01

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

  1. 78 FR 56752 - Interim Staff Guidance Specific Environmental Guidance for Integral Pressurized Water Reactors...

    Science.gov (United States)

    2013-09-13

    ... COMMISSION Interim Staff Guidance Specific Environmental Guidance for Integral Pressurized Water Reactors Reviews AGENCY: Nuclear Regulatory Commission. ACTION: Draft Interim Staff Guidance; request for comment... comment on, draft Interim Staff Guidance (ISG) ESP/COL-ISG-027, ``Interim Staff Guidance...

  2. 注射针头导引笑靥成形术的临床效果%Clinical effects of dimple-plasty under needle guidance

    Institute of Scientific and Technical Information of China (English)

    鲍世威; 马小兵; 赵红艺; 钱文江

    2015-01-01

    Objective To explore the methods and clinical effects of dimple plasty with syringe needle guiding.Methods From February 2008 to May 2012,36 dimple plasties in 21 patients were performed with using a syringe needle guiding the absorbable suture,including 15 cases in bilateral side and 6 cases in unilateral side.There were 4 cases in unilaterally right side and 2 cases in unilaterally left side.Two patients with inborn dimple in unilateral side received the dimple plasty in the other side for facial symmetry.Results 34 dimples in 21 patients were satisfied with the results.Two dimples were re-operated after three months because of disappearance.There were scleromas in 2 cases,which was disappeared by hot compress in three months.There were no hemotoma and infection in 21 patients.Conclusions The procedure of dimple plasty under syringe neddle guiding is safe,reusable and effective.It is a minimally invasive surgery and the patients are satisfied with the dynamic results after operation.%目的 探讨注射针头导引笑靥成形术的临床效果.方法 2008年2月至2012年5月,对21例美容就医者应用注射针头导引可吸收缝线行36个笑靥成形术,其中双侧15例,单侧6例(左侧2例,右侧4例),其中2例为先天单侧笑靥,为使双侧面部对称,行对侧笑靥成形术.结果 34个笑靥术后效果满意;2个笑靥术后3个月消失,微笑及说话时亦不明显,再次以同法手术,术后笑靥未再消失,效果满意.2例3个笑靥术后1个月出现局部硬结,给予局部热敷后消散;21例均未出现血肿及感染等并发症.结论 应用注射针头导引笑靥成形术操作简单方便,安全可靠,创伤小,可重复多次手术,手术后动态效果满意.

  3. 78 FR 48175 - Retrospective Review of Draft Guidance Documents Issued Before 2010; Withdrawal of Guidances

    Science.gov (United States)

    2013-08-07

    ... changes in interpretation of policies that are of other than minor in nature, or discuss complex... assist industry with clinical evaluation and requirements for drug approval. The guidances identified for... the Division of Anti-Infective Drug Products''--issued February 1997. 6. ``Empiric Therapy of...

  4. "There has never been anything like a classical child analysis". Clinical discussions with Anna Freud, 1970-1971.

    Science.gov (United States)

    Penman, Ava Bry

    2013-01-01

    This paper reports on a series of clinical discussions with Anna Freud, faculty and trainees at the Hampstead Clinic in 1970-1971. Anna Freud's comments are published here for the first time. The meetings concerned the nature and use of relationships in work with children who do not have a well-defined neurosis. If parochial borders are erased among the domains of upbringing, education, and psychoanalysis, potential therapeutic fertility and strength can increase. The clinical material in the paper makes it possible to explore the old and new aspects of the treatment relationship, such as the transferential, the externalization of the self-representational, the developmental, and so forth. This is a personal account of a formative experience during training.

  5. 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.

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

    Directory of Open Access Journals (Sweden)

    Eme T. Owoaje

    2012-10-01

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

  7. Child Development

    Science.gov (United States)

    As children grow older, they develop in several different ways. Child development includes physical, intellectual, social, and emotional changes. Children grow and mature at very different rates. It's ...

  8. Predictors of discharge in child psychoanalytic psychotherapy

    OpenAIRE

    Izabel Cristina Paez; Maria Lucia Tiellet Nunes; Vânia Naomi Hirakata

    2015-01-01

    Introduction: This empirical study was based on the analysis of the results of a study about dropout predictors among in child psychoanalytic psychotherapy. The objectives were to characterize the sample of children discharged from psychoanalytic psychotherapy, examine the association between sociodemographic/ clinical variables and child psychoanalytic psychotherapy discharge, and determine predictors of discharge in child psychoanalytic psychotherapy.Method: This quantitative, descriptive a...

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

    Science.gov (United States)

    Aldao, Amelia; De Los Reyes, Andres

    2015-01-01

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

  10. 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.)

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

    Institute of Scientific and Technical Information of China (English)

    赵太艳

    2014-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Steppies R. Rikhotso

    2014-02-01

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

  13. Guidance of Nonlinear Systems

    Science.gov (United States)

    Meyer, George

    1997-01-01

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

  14. Partial left ventriculectomy in a child: 70-month clinical follow up Ventriculectomia parcial esquerda em criança: acompanhamento clínico por 70 meses

    Directory of Open Access Journals (Sweden)

    Eduardo Coelho de Souza

    2003-10-01

    Full Text Available We describe the 70- month follow up of a child with idiopathic dilated cardiomyopathy and end-stage congestive heart failure (NYHA III/IV who underwent partial left ventriculectomy - the Batista operation when he was two and half years old. The clinical follow up was performed in the outpatient clinic by electrocardiography, echocardiography and radionuclide ventriculography to better analyse the left ventricular ejection fraction. The left ventricular diameter increased. Echocardiograms showed enlargement mainly in the systolic left ventricular diameter and slow decrease in fractional shortening (delta D. The child was in class I (NYHA during the follow-up. His exercise endurance was better than before surgery and hospitalization was not necessary. For these reasons, we believe that this procedure can be considered as a therapeutic option in children with severe dilated cardiomiopathy who are waiting for heart transplantation, as the shortage of donors is a fact.Relatamos a evolução durante 70 meses de uma criança submetida a ventriculectomia parcial esquerda, pela técnica de Batista aos 2 anos e 6 meses de idade, em classe funcional III/IV em decorrência de cardiomiopatia dilatada idiopática, com seguimento clínico ambulatorial. Realizamos eletrocardiogramas, ecocardiogramas seriados e ventriculografia radioisotópica para melhor analisar a fração de ejeção do ventrículo esquerdo. Houve progressivo aumento deste. O ecocardiograma mostrou aumento principalmente do diâmetro sistólico do ventrículo esquerdo com queda progressiva, porém lenta, da fração de ejeção. Apesar da progressão da disfunção miocárdica, a criança manteve-se em classe funcional I durante todo o seguimento, com melhora da tolerância ao exercício e não necessitou de internações. Por isso, achamos que o método pode ser considerado opção terapêutica em crianças com cardiomiopatia dilatada avançada, aguardando a indicação mais tardia de

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

    Science.gov (United States)

    Saner, R J

    1999-03-01

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

  16. 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.

  17. 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.

  18. Saudi dental students’ perceptions of pediatric behavior guidance techniques

    OpenAIRE

    Al-Jobair, Asma M; Al-Mutairi, Manal A.

    2015-01-01

    Background Dental students receive theoretical and clinical training in pediatric behavioral guidance techniques at university. Therefore, the content of the educational course and the degree of training in behavioral techniques may have an impact on the students’ perceptions and practice of such techniques. The purpose of this study was to evaluate Saudi dental students’ perceptions of behavior guidance techniques used in pediatric dentistry, and to assess the changes in their perceptions af...

  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. Prevalence of Common Mental Disorders and its Association with Life Events and Social Support in Mothers Attending a Well-Child Clinic

    Directory of Open Access Journals (Sweden)

    Nusrat Husain

    2016-12-01

    Full Text Available Common mental disorders (CMD, such as depression and anxiety disorders that affect mothers with young children, are a major public health issue in developing countries. This study investigates the prevalence of CMD and its associated factors among mothers attending a well-child clinic in Mombasa, Kenya. In this cross-sectional study, 429 women were screened for the presence of CMD using the Self-Reporting Questionnaire–20 (SRQ-20. Social support and social stress were measured using the OSLO Social Support Scale and the Life Events Checklist. The prevalence of CMD was 20%. High SRQ scorers were more likely to be single or separated/divorced compared with low scorers. Language, neighborhood, and financial difficulties were found to be significant independent correlates of CMD through multiple logistic regression analysis. Rates of CMD among mothers with young children in Kenya are high. This is important for nurses and pediatricians whose contact offers them an opportunity to detect CMD and refer mothers for appropriate support.

  1. Practical guidance for charting ethics consultations.

    Science.gov (United States)

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

    2014-03-01

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

  2. Final OSWER Vapor Intrusion Guidance

    Science.gov (United States)

    EPA is preparing to finalize its guidance on assessing and addressing vapor intrusion, which is defined as migration of volatile constituents from contaminated media in the subsurface (soil or groundwater) into the indoor environment. In November 2002, EPA issued draft guidance o...

  3. Restructuring Guidance and Counseling Programs.

    Science.gov (United States)

    Snyder, Beverly A.; Daly, Timothy P.

    1993-01-01

    Briefly reviews counseling profession's call for revitalization and transformation in school counseling and guidance programs. Summarizes one school system's efforts during late 1980s and early 1990s to transform its program from services and crisis orientation into a comprehensive developmental model based on Myrick's developmental guidance and…

  4. Guidance in the Secondary School

    Science.gov (United States)

    Kumar, V. Jurist Lional

    2010-01-01

    Secondary School Students face a lot of problems in their body as well as in mind due to puberty that tends to adolescence stage. Adolescence has peculiar characters of their own. They need proper Guidance and Counselling to tackle their own problems. Guidance is described as a counselling service to assist the individual in achieving self…

  5. Guidance at the educational marketplace

    DEFF Research Database (Denmark)

    Lystbæk, Christian Tang

    in educational policies and institutions. As educational systems have expanded and, further, have been restructured with the expansion of choice opportunities since the 1980s, guidance has become prioritized as a form of counseling or coaching, which can support students. Thus, guidance has become an important...

  6. Interstitial guidance of cancer invasion.

    Science.gov (United States)

    Gritsenko, Pavlo G; Ilina, Olga; Friedl, Peter

    2012-01-01

    Cancer cell invasion into healthy tissues develops preferentially along pre-existing tracks of least resistance, followed by secondary tissue remodelling and destruction. The tissue scaffolds supporting or preventing guidance of invasion vary in structure and molecular composition between organs. In the brain, the guidance is provided by myelinated axons, astrocyte processes, and blood vessels which are used as invasion routes by glioma cells. In the human breast, containing interstitial collagen-rich connective tissue, disseminating breast cancer cells preferentially invade along bundled collagen fibrils and the surface of adipocytes. In both invasion types, physical guidance prompted by interfaces and space is complemented by molecular guidance. Generic mechanisms shared by most, if not all, tissues include (i) guidance by integrins towards fibrillar interstitial collagen and/or laminins and type IV collagen in basement membranes decorating vessels and adipocytes, and, likely, CD44 engaging with hyaluronan; (ii) haptotactic guidance by chemokines and growth factors; and likely (iii) physical pushing mechanisms. Tissue-specific, resticted guidance cues include ECM proteins with restricted expression (tenascins, lecticans), cell-cell interfaces, and newly secreted matrix molecules decorating ECM fibres (laminin-332, thrombospondin-1, osteopontin, periostin). We here review physical and molecular guidance mechanisms in interstitial tissue and brain parenchyma and explore shared principles and organ-specific differences, and their implications for experimental model design and therapeutic targeting of tumour cell invasion.

  7. Developing guidance for pregnancy testing of adolescents participating in research: ethical, legal and practical considerations.

    Science.gov (United States)

    Larcher, Vic; Brierley, Joe

    2016-10-01

    Adolescents need safe effective drugs that have undergone ethically approved testing in clinical trials; such studies often require pregnancy testing in 'women of childbearing age' which includes children/adolescents. There is a lack of consistent standard operating procedures for pregnancy testing in these individuals, in either research or clinical (ie, both preprocedure and clinical emergency) settings. Some harmonisation between a selective or universal testing approach based on a risk analysis of the trial drug or procedure would seem sensible. The need for pregnancy testing and the reasons for the method chosen (universal or selective) should be clearly defined in the research protocol. Research ethics committees (RECs) need to satisfy themselves that the selection of subjects to be tested, the procedures for obtaining consent and the respecting of the young person's confidentiality are appropriate and that management of any positive tests are in accord with local safeguarding policies and procedures. Researchers should have core competencies necessary to manage sensitive questioning and child safeguarding training. Clinical trials of medicinal product (CTIMP) pregnancy testing in females 13-15 years of age requires parental consent and the child's active involvement in the decision-making process ('assent') the implications of a positive test should be discussed in advance Children under 13 years should not normally be subject to pregnancy testing in CTIMPs, unless there are exceptional circumstances, for example, a trial of contraceptive agents of a high teratogenicity risk, as reviewed by a specialist paediatric REC. We analyse the ethical, legal and practical aspects of this issues and supply guidance to support those involved.

  8. 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

  9. 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.

  10. Optical technologies for intraoperative neurosurgical guidance.

    Science.gov (United States)

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

    2016-03-01

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

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

    Institute of Scientific and Technical Information of China (English)

    Mitchell R.Gore; Brent A.Senior

    2012-01-01

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

  12. American Association for Clinical Chemistry

    Science.gov (United States)

    ... Education Credits Certification Resources Career Guidance Publications Clinical Chemistry Clinical Laboratory News The Journal of Applied Laboratory Medicine Clinical and Forensic Toxicology News Clinical Laboratory Marketplace Books and Multimedia ...

  13. 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

  14. 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

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

    Institute of Scientific and Technical Information of China (English)

    陈春红; 吴树跃; 刘晓梅; 杨惜珍

    2012-01-01

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

  16. Pandemic influenza guidance for corporations.

    Science.gov (United States)

    2011-06-01

    The purpose of this guidance document is to assist members of the American College of Occupational and Environmental Medicine (ACOEM), and the organizations for which they work, in managing the impact of a pandemic of influenza or other contagious respiratory disease on patients, employees, and business. This guidance document outlines actions to take before and during an influenza pandemic on the basis of two main strategies: (1) reducing the spread of the virus within facilities; and (2) providing medical care and medical surveillance to client/patient populations. Facilities in which ACOEM members serve include government agencies and the military, universities, and corporations, which generally have multiple locations/sites and their own medical staff, with members responsible for medical care and disease control. This guidance is for organizations with outpatient occupational medicine services, to be used as appropriate. Medical centers should also use guidance that addresses additional employee and external patient care needs.1–3 The ACOEM fully supports implementation of occupational influenza programs that conform with guidance from the Centers for Disease Control and Prevention (CDC), with other guidance from the US Department of Health and Human Services (DHHS), and Occupational Safety and Health Administration (OSHA) regulations and guidance.

  17. 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.

  18. 213个遗传性耳聋家庭的产前诊断和生育指导%Prenatal genetic test and clinical guidance for 213 hereditary deaf families

    Institute of Scientific and Technical Information of China (English)

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

    2012-01-01

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

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

    Science.gov (United States)

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

    2008-01-01

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

  20. 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

  1. RH Packaging Program Guidance

    Energy Technology Data Exchange (ETDEWEB)

    Washington TRU Solutions, LLC

    2003-08-25

    The purpose of this program guidance document is to provide 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 SARP and/or 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 CFR {section} 71.11, ''Deliberate Misconduct.'' Any time a user suspects or has indications that the conditions of approval in the C of C were not met, the Carlsbad Field Office (CBFO) shall be notified immediately. CBFO will evaluate the issue and notify the NRC if required. This document details the instructions to be followed to operate, maintain, and test the RH-TRU 72-B packaging. This Program Guidance standardizes instructions for all users. Users shall follow these instructions. Following these instructions assures that operations are safe and meet the requirements of the SARP. This document is available on the Internet at: ttp://www.ws/library/t2omi/t2omi.htm. Users are responsible for ensuring they are using the current

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

    Institute of Scientific and Technical Information of China (English)

    尚剑; 罗清平; 章兰萍; 黄春华

    2016-01-01

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

  3. The Quasi-Human Child: How Normative Conceptions of Childhood Enabled Neoliberal School Reform in the United States

    Science.gov (United States)

    Sonu, Debbie; Benson, Jeremy

    2016-01-01

    This paper argues that normative conceptions of the child, as a natural quasi-human being in need of guidance, enable current school reforms in the United States to directly link the child to neoliberal aims and objectives. In using Foucault's concept of governmentality and disciplinary power, we first present how the child is constructed as a…

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

    Directory of Open Access Journals (Sweden)

    Vandana

    2015-02-01

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

  5. Response to work activity guidance

    Data.gov (United States)

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

  6. CDM Convective Forecast Planning guidance

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — The CDM Convective Forecast Planning (CCFP) guidance product provides a foreast of en-route aviation convective hazards. The forecasts are updated every 2 hours and...

  7. The Intersection of Medical Child Abuse and Medical Complexity.

    Science.gov (United States)

    Petska, Hillary W; Gordon, John B; Jablonski, Debra; Sheets, Lynn K

    2017-02-01

    Children with medical complexity and victims of medical child abuse may have similar clinical presentations. Atypical or unexplained signs and symptoms due to rare diseases may lead providers to suspect medical child abuse when not present. Conversely, medical child abuse may be the cause of or coexist with medical complexity. Careful consideration of whether or not medical child abuse is present is essential when assessing a child with medical complexity since either diagnosis has significant consequences for children and families.

  8. Guidance molecules in lung cancer

    OpenAIRE

    Nasarre, Patrick; Potiron, Vincent; Drabkin, Harry; Roche, Joëlle

    2010-01-01

    Guidance molecules were first described in the nervous system to control axon outgrowth direction. They are also widely expressed outside the nervous system where they control cell migration, tissue development and establishment of the vascular network. In addition, they are involved in cancer development, tumor angiogenesis and metastasis. This review is primarily focused on their functions in lung cancer and their involvement in lung development is also presented. Five guidance molecule fam...

  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. Guidance Systems of Fighter Aircraft

    OpenAIRE

    K.N. Rajanikanth; Rao, R S; P. S. Subramanyam; Ajai Vohra

    2005-01-01

    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 s...

  11. 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.

  12. 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, ...

  13. Playing "The Ladybug Game": Parent Guidance of Young Children's Numeracy Activities

    Science.gov (United States)

    Vandermaas-Peeler, Maureen; Ferretti, Larissa; Loving, Sara

    2012-01-01

    Parent guidance for numeracy activities and preschoolers' numeracy performance were examined in the context of playing a board game in three sessions over a two-week period. Twenty-eight parent-child dyads were randomly assigned to a numeracy awareness group in which parents were provided with suggested numeracy activities to incorporate into the…

  14. Child Laborers

    Institute of Scientific and Technical Information of China (English)

    1998-01-01

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

  15. 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...

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

    Institute of Scientific and Technical Information of China (English)

    郭刚

    2011-01-01

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

  17. The next generation of the World Health Organization's global antiretroviral guidance

    Directory of Open Access Journals (Sweden)

    Gottfried Hirnschall

    2013-06-01

    maternal and child health, TB or drug dependency clinics. There is additional guidance for programme managers on how to plan HIV programmes and use resources most efficiently.

  18. Current Trends in Tactical Missile Guidance

    Directory of Open Access Journals (Sweden)

    S. Vathsal

    2005-07-01

    Full Text Available The problem of tactical missile guidance is very challenging and has been treated using several basic metlfodologies in the past four decades. Major techniques can be grouped underclassical guidance laws, modern guidance laws, l'aws for manoeuvring targets, predictive guidance for endgame scenario, and guidance laws based on intelligent control methods. Each technique has some advantages and disadvantages while implementing in a practical system. Guidance law selection is dictated by nature of flight profile like boost, midcourse, terminal homing, etc, and also miss-distance and a single-shot kill probability. This paper presents a brief survey of the existing techniques and current trends in tactical missile guidance.

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

    Science.gov (United States)

    Zerby, Stephen A.

    2005-01-01

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

  20. 77 FR 48989 - Draft Guidance for Industry on Suicidal Ideation and Behavior: Prospective Assessment of...

    Science.gov (United States)

    2012-08-15

    ... HUMAN SERVICES Food and Drug Administration Draft Guidance for Industry on Suicidal Ideation and... availability of a draft guidance for industry entitled ``Suicidal Ideation and Behavior: Prospective Assessment... prospectively assessing the occurrence of treatment-emergent suicidal ideation and behavior in clinical...

  1. 76 FR 52958 - Draft Guidance for Industry on Neglected Tropical Diseases of the Developing World: Developing...

    Science.gov (United States)

    2011-08-24

    ...The Food and Drug Administration (FDA) is announcing the availability of a draft guidance for industry entitled ``Neglected Tropical Diseases of the Developing World: Developing Drugs for Treatment or Prevention.'' The purpose of this guidance is to assist sponsors in the clinical development of drugs for the treatment or prevention of neglected diseases of the developing world. Specifically,......

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

    OpenAIRE

    L Eugene Arnold

    2008-01-01

    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 vis...

  3. Planning a career as a children's nurse: the availability of career guidance during the nurse diploma course.

    Science.gov (United States)

    Cox, Susanne J; Robinson, Sarah; Murrells, Trevor

    2003-12-01

    The recruitment and retention of registered children's nurses is paramount to the implementation of the national service framework for children's services. In recent years there have been increased career opportunities for children's nurses and a diversity of career pathways. Career guidance has a potential contribution to make to the effective management of nurses' careers. This article presents findings on child health diplomates' experiences of career guidance during the nurse diploma course. Findings indicate a substantial unmet demand for career guidance. The implications of the findings for child health nurses' careers are discussed and considered in relation to two key questions: should efforts be directed towards ensuring greater provision of career guidance, and if so, by whom?

  4. 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.

  5. Autonomous Guidance, Navigation and Control

    Science.gov (United States)

    Bordano, A. J.; Mcswain, G. G.; Fernandes, S. T.

    1991-01-01

    The NASA Autonomous Guidance, Navigation and Control (GN&C) Bridging program is reviewed to demonstrate the program plan and GN&C systems for the Space Shuttle. The ascent CN&C system is described in terms of elements such as the general-purpose digital computers, sensors for the navigation subsystem, the guidance-system software, and the flight-control subsystem. Balloon-based and lidar wind soundings are used for operations assessment on the day of launch, and the guidance software is based on dedicated units for atmospheric powered flight, vacuum powered flight, and abort-specific situations. Optimization of the flight trajectories is discussed, and flight-control responses are illustrated for wavelengths of 500-6000 m. Alternate sensors are used for load relief, and adaptive GN&C systems based on alternate gain synthesis are used for systems failures.

  6. 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.

  7. Child Health in Portugal.

    Science.gov (United States)

    Bandeira, Teresa; Ferreira, Ricardo; Azevedo, Inês

    2016-10-01

    Portugal has experienced rapid decline of neonatal and infant mortality in the last century, similar to that of other western European states. The joint venture of pediatricians and obstetricians with adequate top-down government commissions for maternal and child health for the decision making by health administrators and a well-defined schedule of preventive and managerial measures in the community and in hospitals are the most likely explanations for this success. Another achievement of child health care services is the registry for special diseases. Education of health care workers plays a fundamental role in improving health statistics. Portugal has a reasonable number of doctors, nurses, and health technicians per capita. Quality assurance monitoring systems and implementation of evidence-based clinical guidelines with digital records, including international coding, are essential steps to improve health care systems.

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

    Science.gov (United States)

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

    2010-01-01

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

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

    Science.gov (United States)

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

    2015-01-01

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

  10. 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…

  11. B超引导下经皮穿刺留置引流管治疗肝脓肿患者的护理%Clinical nursing care for liver abscess patients treated by indwelling drainage tube after puncture under ultrasonic guidance

    Institute of Scientific and Technical Information of China (English)

    毛晓群; 许莹

    2011-01-01

    目的 探讨在B超引导下经皮穿刺留置引流管治疗肝脓肿患者的临床护理.方法 对我院2004年1月至2010年12月收治的64例脓腔直径≥5 cm的肝脓肿患者的治疗转归及护理资料进行回顾性分析.结果 64例肝脓肿患者经过B超引导下经皮穿刺留置引流管后,治愈率为100%,未发生并发症.结论 B超引导下经皮穿刺留置引流管治疗肝脓肿切实可行,而细致的护理也是提高其治愈率的一项重要措施.%Objective To discuss the clinical nursing care for liver abscess patients treated by indwelling drainage tube after puncture under ultrasonic guidance.Methods 64 liver abscess patients with diameter of the abscess longer than 5cm were treated by indwelling drainage tube after puncture under ultrasonic guidance,clinical nursing care was performed before and after the operation.Results The recovery rate of liver abscess treated by puncture was 100%,no complication occurred.Conclusions It is feasible for the liver abscess patients to perform puncture under ultrasonic guidance,and meticulous nursing is a pivotal measure to improve cure rate.

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

    Science.gov (United States)

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

    2012-01-01

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

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

    Science.gov (United States)

    2011-12-19

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

  15. Cooperative Guidance for Multimissile Salvo Attack

    Institute of Scientific and Technical Information of China (English)

    Zhao Shiyu; Zhou Rui

    2008-01-01

    Cooperative guidance problems of multiple missiles are considered in this article. A cooperative guidance scheme, where coordi-nation algorithms and local guidance laws are combined together, is proposed. This scheme actually builds up a hierarchical cooperative guidance architecture, which may provide a general solution to the multimissile cooperative guidance problems. In the case of salvo attacks which require missiles to hit the target simultaneously, both centralized and distributed coordination algorithms are derived based on the impact-time-control guidance (ITCG) law. Numerical simulations are performed to demonstrate the effectiveness of the proposed approaches.

  16. 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.

  17. 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.

  18. 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.

  19. Interstitial guidance of cancer invasion.

    NARCIS (Netherlands)

    Gritsenko, P.G.; Ilina, O.; Friedl, P.H.

    2012-01-01

    Cancer cell invasion into healthy tissues develops preferentially along pre-existing tracks of least resistance, followed by secondary tissue remodelling and destruction. The tissue scaffolds supporting or preventing guidance of invasion vary in structure and molecular composition between organs. In

  20. Abortion Information: A Guidance Viewpoint

    Science.gov (United States)

    Wolleat, Patricia L.

    1975-01-01

    A number of questions relating to providing abortion information to teenagers can be raised from legal, ethical and philosophical standpoints. The purpose of this article is to examine abortion information-giving from the perspective of counseling and guidance theory and practice. (Author)

  1. Guidance: Interim Municipal Settlement Policy

    Science.gov (United States)

    Interim guidance and fact sheets regarding settlements involving municipalities or municipal waste under Section 122 CERCLA as amended by SARA. Interim policy sets forth the criteria by which EPA generally determines whether to exercise enforcement discretion to pursue MSW generators and transporters as PRPs.

  2. Teacher Guidance of Knowledge Construction

    Science.gov (United States)

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

    2004-01-01

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

  3. 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.

  4. Atmospheric guidance techniques and performance

    Science.gov (United States)

    Harpold, J. C.; Gavert, D. E.

    1982-01-01

    The Orbiter entry guidance system controls the Space Shuttle Orbiter from the initial atmospheric penetration point to the point at which an earth relative velocity of 2500 feet/second is reached. At the latter point, control of the Orbiter is transferred to the terminal area energy management system. The entry guidance system is based on the concept that the range to be flown during entry is a unique function of the drag deceleration profile flown throughout the entry. The range prediction during entry is based on analytic equations which are simple drag deceleration functions of earth relative velocity above Mach 10.5 and energy with respect to the earth below Mach 10.5. Flight through the entry corridor is accomplished by linking these simple drag deceleration functions together in series in order to define a drag deceleration reference profile. The results of the first three Space Shuttle missions have not only verified the entry guidance concept but have also demonstrated the stability of the guidance system.

  5. 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.

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

    Science.gov (United States)

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

    2014-12-01

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

  7. Clinical and molecular characteristics of a child with juvenile Sandhoff disease%青少年型Sandhoff病一例临床特点及基因分析

    Institute of Scientific and Technical Information of China (English)

    黄永兰; 谢婷; 郑纪鹏; 赵小媛; 刘鸿圣; 刘丽

    2014-01-01

    Objective To explore the clinical features and molecular mutation of HEXB gene in a case with juvenile Sandhoff disease.Method We retrospectively reviewed the clinical,neuroimaging and biochemical findings in this Chinese child with juvenile Sandhoff disease.Hexosaminidase A and hexosaminidase A & B activities were measured in blood leukocytes by fluorometric assay.HEXB gene molecular analysis was performed by PCR and direct sequencing.Result The 9-year-old boy was admitted for psychomotor regression.He presented slowly progressive gait disorder and dysarthria during the last three years.Cranial MRI revealed a marked cerebellar atrophy with normal intensity in the thalamus and basal ganglia.Brain MRS showed normal in the thalamus and basal ganglia.Hexosaminidase A was 69.5 (mg·h) [normal controls 150-360 nmol/(mg · h)],hexosaminidase A & B activity was 119 nmol/(mg · h) [normal controls 600-3 500 nmol/(mg · h)],confirming the diagnosis of Sandhoff disease.The patient was a compound heterozygote for a novel deletion mutation c.1404delT (p.P468P fsX62) and a reported mutation c.1509-26G > A.Conclusion The clinical features of juvenile Sandhoff disease include ataxia,dysarthria and cerebellar atrophy.The enzyme assay and molecular analysis of HEXB gene can confirm the diagnosis of Sandhoff disease.The novel mutation c.1404delT(p.P468P fsX62) is a diseaserelated mutation.%目的 探讨青少年型Sandhoff病的临床及氨基己糖苷酶β-亚单位基因(HEXB)突变特点.方法 回顾性分析2012年5月广州市妇女儿童医疗中心内分泌代谢科确诊的1例青少年型Sandhoff病患儿的临床、头颅MRI及生化表现,采用荧光底物法分别测定外周血白细胞氨基己糖苷酶A(Hex A)及氨基己糖苷酶A和B(Hex A&B)酶活性,PCR-DNA直接测序法进行HEXB突变分析.结果 患儿男,9岁,主因“走路不稳、讲话变慢并进行性加重3年”就诊,病情进展缓慢.头颅MRI表现为双侧小脑半球、小脑蚓脑沟明

  8. 76 FR 70150 - Draft Guidance for Industry and Food and Drug Administration Staff; Investigational Device...

    Science.gov (United States)

    2011-11-10

    ... Staff; Investigational Device Exemptions for Early Feasibility Medical Device Clinical Studies... guidance, FDA intends to facilitate early feasibility studies of medical devices, using appropriate risk mitigation strategies, under the IDE requirements. Early feasibility studies allow for limited early...

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

    Science.gov (United States)

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

    2016-01-01

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

  10. 推拿对寒湿型小儿秋季腹泻预后影响的比较研究%Clinical Observation of Child Massage Therapy on Children Autumn Diarrhea of Hanshi Syndrome

    Institute of Scientific and Technical Information of China (English)

    何嘉莹; 周翔

    2013-01-01

      [目的]观察小儿推拿对寒湿型小儿秋季腹泻的临床疗效。[方法]将75例随机分成2组,对照组38例予以补液纠酸等对症处理;治疗组37例在对照组治疗的基础上,加用小儿推拿手法。两组均治疗7天后以患儿临床症状体征判定疗效。[结果]最终统计结果时治疗组纳入35例,临床治愈25例,显效6例,有效4例,无效0例,总有效率为100%;对照组纳入35例,临床治愈15例,显效12例,有效3例,无效5例,总有效率为85.77%。两组比较,有显著性差异(P<0.05)。[结论]小儿推拿治疗寒湿型小儿秋季腹泻的疗效优于单用西药组,未发生不良事件,具有临床推广应用价值。%  [Objective] To observe the clinical therapeutic effect of treating children autumn diarrhea of Hanshi syndrome with child massage therapy. [Methods]75 cases were randomly divided into two groups.Cases in control group were treated by symptomatic treatment;the others in treatment group were treated by combination of child massage therapy. After the treatment, clinical symptoms were used as indicators for effect evaluation and comparison. [Results] 35 cases in treatment group had 25 cases in clinical cure,6 excel ent,4 effective,0 in vain. The clinical total effective rate of Chinese medicine group was 100%.Meanwhile,35 cases' clinical total effective rate was 80.77% in control group.[Conclution] Combination of child massage therapy has bet-ter therapeutic effects on migraine.

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

    Directory of Open Access Journals (Sweden)

    Guido Biele

    2014-12-01

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

  12. Child sexual abuse.

    Science.gov (United States)

    Hymel, K P; Jenny, C

    1997-08-01

    Multiple obstacles can hinder the medical evaluation of suspected child sexual abuse in pediatric primary care. The need for diagnostic accuracy is high. Knowledge of sexual abuse risk factors, an understanding of the victimization process, and awareness of the varied clinical presentations of sexual abuse can be of assistance. Open-ended questioning of the suspected victim is the most critical component of the evaluation. Skillful medical interviewing requires time, training, patience, and practice. Pediatricians lacking any of these four requirements should defer interviewing in sexual abuse cases to other professionals. Abnormal physical findings from sexual abuse are uncommon. Colposcopy has assisted pediatricians greatly in reaching consensus regarding diagnostic physical findings. Cases of acute sexual assault require familiarity with the forensic rape examination, STD screening and prophylaxis, and pregnancy prevention. Victimization from sexual abuse continues long after the abusive acts end, often requiring long-term therapeutic intervention. An emerging standard of care for medical evaluations of suspected child sexual abuse recognizes the requirement for patience and compassion while retaining objectivity. The pediatrician's primary concern must be for the child's physical and emotional well-being.

  13. Advocacy and child neglect.

    Science.gov (United States)

    Krugman, Scott D

    2014-11-01

    Pediatricians have a unique opportunity to intervene in the lives of children to identify and to prevent neglect. While it remains important to care for individual patients affected by neglect, the ecological model of child neglect requires intervention at the parent, family, community, and societal levels. Pediatricians can improve the outcomes for children by advocating for policies and interventions at each level. Effective advocacy principally requires the willingness to tackle broader issues beyond individual clinical care. Working with local, state, and national organizations, pediatricians can contribute a unified voice to promote evidence-based policies and programs that improve the well-being of children.

  14. Fighting Child Sexual Abuse

    Directory of Open Access Journals (Sweden)

    Pesanayi Gwirayi

    2013-01-01

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

  15. Office of Child Care

    Science.gov (United States)

    ... for Children & Families Office of Child Care By Office Administration for Native Americans (ANA) Administration on Children, ... Care Partnerships. Review the profiles. > What is the Office of Child Care (OCC)? The Office of Child ...

  16. A guidance concept for hypersonic aerospacecrafts

    Science.gov (United States)

    Ishimoto, Shinji

    In this paper a guidance concept for hypersonic re-entry flights is presented. The method uses a closed-form guidance technique based on a drag acceleration reference profile. A guidance law for range control is developed. It employs a physical relation between vehicle energy and range instead of a prediction-correction technique used for Shuttle entry guidance. Simulation results show that the algorithm provides good performance.

  17. Providing Career Guidance for Young Women.

    Science.gov (United States)

    Colby, Pamela G.

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

  18. The Self in Guidance: Assumptions and Challenges.

    Science.gov (United States)

    Edwards, Richard; Payne, John

    1997-01-01

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

  19. 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,…

  20. 78 FR 53792 - Draft Guidance for Reciprocity

    Science.gov (United States)

    2013-08-30

    ...The U.S. Nuclear Regulatory Commission (NRC) is revising its licensing guidance for reciprocity. The NRC is requesting public comment on draft NUREG-1556, Volume 19, Revision 1, ``Consolidated Guidance about Materials Licenses: Guidance for Agreement State Licensees about NRC Form 241 `Report of Proposed Activities in Non- Agreement States, Areas of Exclusive Federal Jurisdiction, of Offshore......

  1. Augmented Reality Image Guidance in Minimally Invasive Prostatectomy

    Science.gov (United States)

    Cohen, Daniel; Mayer, Erik; Chen, Dongbin; Anstee, Ann; Vale, Justin; Yang, Guang-Zhong; Darzi, Ara; Edwards, Philip'eddie'

    This paper presents our work aimed at providing augmented reality (AR) guidance of robot-assisted laparoscopic surgery (RALP) using the da Vinci system. There is a good clinical case for guidance due to the significant rate of complications and steep learning curve for this procedure. Patients who were due to undergo robotic prostatectomy for organ-confined prostate cancer underwent preoperative 3T MRI scans of the pelvis. These were segmented and reconstructed to form 3D images of pelvic anatomy. The reconstructed image was successfully overlaid onto screenshots of the recorded surgery post-procedure. Surgeons who perform minimally-invasive prostatectomy took part in a user-needs analysis to determine the potential benefits of an image guidance system after viewing the overlaid images. All surgeons stated that the development would be useful at key stages of the surgery and could help to improve the learning curve of the procedure and improve functional and oncological outcomes. Establishing the clinical need in this way is a vital early step in development of an AR guidance system. We have also identified relevant anatomy from preoperative MRI. Further work will be aimed at automated registration to account for tissue deformation during the procedure, using a combination of transrectal ultrasound and stereoendoscopic video.

  2. Guidance document for structured reporting of diuresis renography.

    Science.gov (United States)

    Taylor, Andrew T; Blaufox, M Donald; De Palma, Diego; Dubovsky, Eva V; Erbaş, Belkis; Eskild-Jensen, Anni; Frøkiær, Jørgen; Issa, Muta M; Piepsz, Amy; Prigent, Alain

    2012-01-01

    This Guidance Document for structured reporting of diuresis renography in adults was developed by the International Scientific Committee of Radionuclides in Nephro-urology (ISCORN; http://www.iscorn.org). ISCORN chose diuresis renography for its first structured report Guidance Document because suspected obstruction is the most common reason for referral, most radionuclide renal studies are conducted at institutions that perform fewer than 3 studies per week, and a large percentage of studies are interpreted by physicians with limited training in nuclear medicine. Ten panelists were asked to categorize specific reporting elements as essential, recommended, optional (without sufficient data to support a higher ranking), and unnecessary (does not contribute to scan interpretation or quality assurance). The final document was developed through an iterative series of comments and questionnaires with a majority vote required to place an element in a specific category. The Guidance Document recommends a reporting structure organized into indications, clinical history, study procedure, findings and impression and specifies the elements considered essential or recommended in each category. The Guidance Document is not intended to be restrictive but, rather, to provide a basic structure and rationale so that the diuresis renography report will: (1) communicate the results to the referring physician in a clear and concise manner designed to optimize patient care; (2) contain the essential elements required to evaluate and interpret the study; (3) clearly document the technical components of the study necessary for accountability, quality assurance and reimbursement; and (4) encourage clinical research by facilitating better comparison and extrapolation of results between institutions.

  3. Agent Based Individual Traffic guidance

    DEFF Research Database (Denmark)

    Wanscher, Jørgen Bundgaard

    2004-01-01

    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...... 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...... of the paper is the possibilities of using ABIT when disruptions occur (accidents, congestion, and roadwork). The discussion will be based on realistic case studies....

  4. Teleautonomous guidance for mobile robots

    Science.gov (United States)

    Borenstein, J.; Koren, Y.

    1990-01-01

    Teleautonomous guidance (TG), a technique for the remote guidance of fast mobile robots, has been developed and implemented. With TG, the mobile robot follows the general direction prescribed by an operator. However, if the robot encounters an obstacle, it autonomously avoids collision with that obstacle while trying to match the prescribed direction as closely as possible. This type of shared control is completely transparent and transfers control between teleoperation and autonomous obstacle avoidance gradually. TG allows the operator to steer vehicles and robots at high speeds and in cluttered environments, even without visual contact. TG is based on the virtual force field (VFF) method, which was developed earlier for autonomous obstacle avoidance. The VFF method is especially suited to the accommodation of inaccurate sensor data (such as that produced by ultrasonic sensors) and sensor fusion, and allows the mobile robot to travel quickly without stopping for obstacles.

  5. Review of soil contamination guidance

    Energy Technology Data Exchange (ETDEWEB)

    Mueller, M.A.; Kennedy, W.E. Jr.; Soldat, J.K.

    1981-08-01

    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 (ALARA).

  6. Reentry guidance for Space Shuttle

    Science.gov (United States)

    Causey, W.; Sohoni, V.

    1973-01-01

    An explicit guidance scheme is outlined which provides the appropriate energy management in order for the shuttle orbiter to reach any location within the required footprint. Considering the orbiter as entering the earth's atmosphere, expressions for the downrange, crossrange, and the time of the termination of the entry phase as functions of the control variables are developed. Performing an order-of-magnitude analysis of the terms in these expressions, only dominant terms are retained. Analytical expressions for the elements of the sensitivity matrix which represents the partial derivatives of the desired range with respect to control variables are formulated. Using the Gauss-Jordan inversion technique, the required change in guidance commands as a function of the deviations in the downrange and crossrange are explicitly computed.

  7. 2011 Army Strategic Planning Guidance

    Science.gov (United States)

    2011-03-25

    TESI ) of 22,000 Soldiers, the Army’s total force by the end of the mid-term period is programmed to be 520K (AC). We will achieve a more...dwell ratios, extending TESI authority to adequately man deploying units and sustain the All-Volunteer Force, right-sizing the generating force, and... TESI Temporary End-Strength Increase WMD Weapons of Mass Destruction 2011 ARMY STRATEGIC PLANNING GUIDANCE Page 19 2011

  8. 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.

  9. Clinical Study on Drainage of Tunnel with High Anal Abscess by Ultrasound Guidance%超声引导下高位肛门脓肿隧道拖线引流术的临床研究

    Institute of Scientific and Technical Information of China (English)

    吴彬; 丁敏; 徐伟; 应光耀

    2015-01-01

    目的: 通过多中心、 随机、 对照方法, 研究超声引导下高位肛门脓肿隧道拖线引流术的临床疗效. 方法: 120例高位肛门脓肿患者, 随机分为治疗组和对照组, 治疗组采用超声引导下高位肛门脓肿隧道拖线引流术,对照组采用常规隧道拖线引流术. 对两组的治愈率、 术后疼痛评分、 尿潴留、 出血发生率、 肛门形态、 肛门功能、复发率、 术后不良反应、 满意度、 住院时间、 住院费用等指标进行比较. 结果: 两组在治愈率、 术后出血、 肛门形态、 肛门功能、 术后不良反应、 病人满意度方面差异无显著性; 治疗组复发率显著低于对照组; 治疗组在降低术后疼痛、 尿潴留方面优于对照组; 治疗组在住院时间及费用的经济学指标方面, 明显优于对照组. 结论: 超声引导下高位肛门脓肿隧道拖线引流术可以减少术后疼痛、 尿潴留的发生率, 降低术后复发率, 缩短病程, 降低住院费用. 是临床治疗高位肛门脓肿的有效、 安全、 微创的新方法.%Objective:to study the curative effect of drainage of tunnel with high anal abscess by ultrasound guidance through mul-ticenter, random and contrast methods. Methods: 120 cases with high anal abscess were randomly divided into treatment group and control group, the former treated with the drainage of tunnel with high anal abscess by ultrasound guidance while the latter with the common drainage of tunnel. Compare their recovery rate, postoperative pain score, urinary retention, bleeding incidence, anal form, anal function, recurrence rate, postoperative adverse reaction, degree of satisfaction, length of stay, cost of hospitalization, etc. Re-sults:There was no significant difference between the indexes such as recovery rate, postoperative bleeding, anal form, anal function, postoperative adverse reaction and degree of satisfaction;the recurrence rate of treatment group was

  10. Clinical observation of PICC placement under ultrasound guidance with modified Seldinger technique%超声引导下使用改良 Seldinger 技术置入PICC 导管的临床观察

    Institute of Scientific and Technical Information of China (English)

    张云; 吴志娟; 徐文藻

    2014-01-01

    Objective To evaluate the operation methods of PICC placement under ultra-sound guidance with modified Seldinger technique.Methods 140 PICC patients with cancer chemotherapy from were randomly divided into seldinger group and control group.In the seldinger group,83 patients were treated with modified seldinger technique to place PICC under ultrasound guidance.In the control group,57 patients were treated with conventional PICC.Success rate of PICC,puncture site bleeding,retention time,extubation reason,and incidence rate of complica-tion were detected.Results The retention time was higher in the seldinger group than that in the control group and the complication rate was lower in the seldinger group than that in the control group.The results revealed that the difference was statistically significant(P 0.05).Conclusion PICC placement under ultrasound guidance with modi-fied Seldinger technique is a secure and reliable method.It could overcome the difficulties of the poor condition of the blood vessels,improve the patient comfort,reduce the incidence of complica-tions,increase PICC retention time and improve the quality of life of cancer patients.%目的:探讨经超声引导下使用改良 Seldinger 技术置入 PICC 导管的规范操作方法,以减少 PICC 置管并发症发生。方法将行 PICC 置管的140例肿瘤化疗患者随机分成2组,采用超声引导下使用改良 Seldinger 技术置入 PICC 导管83例患者设为实验组,常规行 PICC 置管的57例患者设为对照组,比较2组患者1次 PICC 置管成功率、穿刺点出血情况、留置时间、拔管原因、并发症发生率。结果实验组留置时间长于对照组、并发症发生率低于对照组,2组比较差异具有统计学意义(P <0.05)。在拔管原因方面,实验组虽低于对照组,但2组差异无统计学意义(P >0.05)。结论超声引导下使用改良Seldinger 技术置入 PICC 导管是肿瘤患者化疗较安全可靠的给

  11. 78 FR 76297 - Social Media: Consumer Compliance Risk Management Guidance

    Science.gov (United States)

    2013-12-17

    .../or sex or use data ] mining technology to obtain such information from social media sites, the... INSTITUTIONS EXAMINATION COUNCIL Social Media: Consumer Compliance Risk Management Guidance AGENCY: Federal... supervisory guidance entitled ``Social Media: Consumer Compliance Risk Management Guidance'' (Guidance)....

  12. 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.

  13. 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.…

  14. QT interval variability in body surface ECG : measurement, physiological basis, and clinical value: position statement and consensus guidance endorsed by the European Heart Rhythm Association jointly with the ESC Working Group on Cardiac Cellular Electrophysiology

    NARCIS (Netherlands)

    Baumert, Mathias; Porta, Alberto; Vos, Marc A; Malik, Marek; Couderc, Jean-Philippe; Laguna, Pablo; Piccirillo, Gianfranco; Smith, Godfrey L; Tereshchenko, Larisa G; Volders, Paul G A

    2016-01-01

    This consensus guideline discusses the electrocardiographic phenomenon of beat-to-beat QT interval variability (QTV) on surface electrocardiograms. The text covers measurement principles, physiological basis, and clinical value of QTV. Technical considerations include QT interval measurement and the

  15. Guidance for peptide vaccines for the treatment of cancer

    OpenAIRE

    Yamaguchi, Yoshiyuki; Yamaue, Hiroki; Okusaka, Takuji; Okuno, Kiyotaka; Suzuki, Hiroyuki; Fujioka, Tomoaki; Otsu, Atsushi; Ohashi, Yasuo; Shimazawa, Rumiko; Nishio, Kazuto; Furuse, Junji; Minami, Hironobu; Tsunoda, Takuya; Hayashi, Yuzo; Nakamura, Yusuke

    2014-01-01

    Recent progress in fundamental understanding of tumor immunology has opened a new avenue of cancer vaccines. Currently, the development of new cancer vaccines is a global topic and has attracted attention as one of the most important issues in Japan. There is an urgent need for the development of guidance for cancer vaccine clinical studies in order to lead to drug development. Peptide vaccines characteristically have the effect of indirectly acting against cancer through the immune system – ...

  16. Phenotypic variations of cartilage hair hypoplasia: granulomatous skin inflammation and severe T cell immunodeficiency as initial clinical presentation in otherwise well child with short stature.

    Science.gov (United States)

    McCann, Liza J; McPartland, Jo; Barge, Dawn; Strain, Lisa; Bourn, David; Calonje, Eduardo; Verbov, Julian; Riordan, Andrew; Kokai, George; Bacon, Chris M; Wright, Michael; Abinun, Mario

    2014-01-01

    We report a child with short stature since birth who was otherwise well, presenting at 2.8 years with progressive granulomatous skin lesions when diagnosed with severe T cell immunodeficiency. When previously investigated for short stature, and at the time of current investigations, she had no radiological skeletal features characteristics for cartilage hair hypoplasia, but we found a disease causing RMRP (RNase mitochondrial RNA processing endoribonuclease) gene mutation. Whilst search for HLA matched unrelated donor for haematopoietic stem cell transplantation (HSCT) was underway, she developed rapidly progressive EBV-related lymphoproliferative disorder requiring laparotomy and small bowel resection, and was treated with anti-B cell monoclonal antibody and eventually curative allogeneic HSCT. Screening for RMRP gene mutations should be part of immunological evaluation of patients with 'severe and/or combined' T cell immunodeficiency of unknown origin, especially when associated with short stature and regardless of presence or absence of radiological skeletal features.

  17. Precision optical navigation guidance system

    Science.gov (United States)

    Starodubov, D.; McCormick, K.; Nolan, P.; Johnson, D.; Dellosa, M.; Volfson, L.; Fallahpour, A.; Willner, A.

    2016-05-01

    We present the new precision optical navigation guidance system approach that provides continuous, high quality range and bearing data to fixed wing aircraft during landing approach to an aircraft carrier. The system uses infrared optical communications to measure range between ship and aircraft with accuracy and precision better than 1 meter at ranges more than 7.5 km. The innovative receiver design measures bearing from aircraft to ship with accuracy and precision better than 0.5 mRad. The system provides real-time range and bearing updates to multiple aircraft at rates up to several kHz, and duplex data transmission between ship and aircraft.

  18. Orthobiologic Interventions Using Ultrasound Guidance.

    Science.gov (United States)

    Malanga, Gerard; Abdelshahed, Dena; Jayaram, Prathap

    2016-08-01

    The application of regenerative therapies for the treatment of musculoskeletal conditions has emerged over the last decade with recent acceleration. These include prolotherapy, platelet-rich plasma, and mesenchymal stem cell therapy. These strategies augment the body's innate physiology to heal pathologic processes. This article presents an overview of platelet-rich plasma and mesenchymal stem cell therapy for the treatment of musculoskeletal injuries. A brief literature review is included, as are techniques for the use of ultrasound guidance to assist with these procedures.

  19. 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...

  20. Agent Based Individual Traffic Guidance

    DEFF Research Database (Denmark)

    Wanscher, Jørgen

    This thesis investigates the possibilities in applying Operations Research (OR) to autonomous vehicular traffic. The explicit difference to most other research today is that we presume that an agent is present in every vehicle - hence Agent Based Individual Traffic guidance (ABIT). The next...... evolutionary step for the in-vehicle route planners is the introduction of two-way communication. We presume that the agent is capable of exactly this. Based on this presumption we discuss the possibilities and define a taxonomy and use this to discuss the ABIT system. Based on a set of scenarios we conclude...

  1. Clinical application analysis of breast intraductal papilloma resection under localization and guidance of breast fiberoptic ductoscopy%乳管镜定位及引导下行乳腺导管内乳头状瘤切除术的临床应用分析

    Institute of Scientific and Technical Information of China (English)

    李元庆; 徐红

    2011-01-01

    [ Objective ] To investigate the clinical therapeutic efficacy of breast intraductal papilloma resection under the localization and guidance of breast fiberoptic ductoscopy. [Methods] From July 2008 to January 2010, 79 patients with single breast intraductal papilloma were admitted to our department, we divided these patients into 2 groups randomly, the observation group included 41 patients, and the breast intraductal papilloma in these patients were resected under the localization and guidance of breast fiberoptic ductoscopy; The control group included 38 patients, and the breast intraductal papilloma in these patients were resected by routine partial gland resection. The clinical therapeutic efficacy was compared between the observation group and the control group. [ Results ] ①Under the localization and guidance of breast fiberoptic ductoscopy, all neoplastic tissues in the observation group were resected, and the operation time was (52.3±5.1)min, the incision length (2.6±0.3)cm, the quality of resected specimens (10.2±1.4)g, the pathological detection rate 95.1%. Moreover, all patients in the observation group have no operative complication. ②There were significant differences in incision length, resected specimens, pathological detection rate, operation time between the observation group and the control group (P <0.05). [ Conclusion ] Under the localizationand guidance of breast fiberoptic ductoscopy, the breast intraductal papilloma resection is of convenience, accurate localization, small lesion, good cosmetic effective, high pathological detection rate, so this technology is worthy of clinical popularization and application.%目的 探讨乳管镜定位及引导下进行乳腺导管内乳头状瘤切除术的临床疗效.方法 2009年7月~2010年5月,该科共收治拟诊为单发乳腺导管内乳头状瘤患者79例,将这些患者随机分成观察组和对照组,观察组41例,进行乳管镜定位及引导下的乳腺导管内

  2. The clinical outcome of childhood masturbation.

    Science.gov (United States)

    Unal, F

    2000-01-01

    This study was performed to investigate the clinical outcome of childhood masturbation. For this purpose 50 children (mean age = 48.7 +/- 24.5 months, 34 girls females and 16 boys males) with masturbation symptoms were examined at first visit to the Department of Child Psychiatry and two years thereafter with psychiatric interviews. The mean masturbation frequency at the initial interview was significantly decreased after two years. It was noted that 39 children (78%) were completely recovered and 11 children (22%) continued to masturbate after two years. Children who did not recover were significantly younger, began to masturbate earlier and masturbated more frequently than others at the time of initial evaluation. It was concluded that the findings about the beneficial effect of sedative drugs in combination with parental guidance, education and means for behavior modification were promising.

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

    Science.gov (United States)

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

    2015-12-01

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

  4. Flight Guidance System Requirements Specification

    Science.gov (United States)

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

    2003-01-01

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

  5. Optimal terminal guidance for exoatmospheric interception

    Institute of Scientific and Technical Information of China (English)

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

    2016-01-01

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

  6. International governmental agencies and career guidance

    OpenAIRE

    Conger, Stuart

    1999-01-01

    The international Organization for Economic Cooperation and Development (OECD), like many national and international organizations concerned with economic development believes that career guidance has an important role in promoting the development of a country's human resources. (Mapping the future: Young People and career guidance OECD, 1996). Generally the economic development agencies always recommend that career guidance services should be strengthened. Too frequently, however, they do no...

  7. International Conference on Harmonisation; guidance on S7A safety pharmacology studies for human pharmaceuticals; availability. Notice.

    Science.gov (United States)

    2001-07-13

    The Food and Drug Administration (FDA) is announcing the availability of a guidance entitled "S7A Safety Pharmacology Studies for Human 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). The guidance provides a definition, general principles, and recommendations for the nonclinical safety pharmacology studies. The guidance is intended to help protect clinical trial participants and patients receiving marketed products from potential adverse effects of pharmaceuticals, while avoiding unnecessary use of animals and other resources.

  8. 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...

  9. European guidance for the diagnosis and management of osteoporosis in postmenopausal women

    OpenAIRE

    Kanis, J. A.; McCloskey, E. V.; Johansson, H.; Cooper, C.; Rizzoli, René; Reginster, J.-Y.

    2012-01-01

    Summary Guidance is provided in a European setting on the assessment and treatment of postmenopausal women at risk of fractures due to osteoporosis. Introduction The International Osteoporosis Foundation and European Society for Clinical and Economic Aspects of Osteoporosis and Osteoarthritis published guidance for the diagnosis and management of osteoporosis in 2008. This manuscript updates these in a European setting. Methods Systematic literature reviews. Results The following areas are re...

  10. 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

  11. [Interval CTG monitoring in labor; a contribution to family-oriented labor in the clinic or a danger to the child?].

    Science.gov (United States)

    Behrens, O; Goeschen, K; Schneider, J

    1987-10-01

    Instead of continuous CTG monitoring lasting from the onset of labor to delivery, various obstetricians recommend interval monitoring in cases designated "likely to be free of complications". This enables the mother to move freely from time to time without being permanently confronted by technological apparatus. In the study reported here the authors therefore investigated whether-and if so what-risks interval monitoring involves. In order to answer this question 436 cardiotokograms recorded during labor with externally and internally attached leads were analyzed, evaluated 30 CTG minutes after the Hammacher Score in each case, and the number of points thus obtained was assigned to the corresponding cervical widths. As labor progressed from 3 to 10 cm cervix dilatation, there was a fourfold increase (p less than 0.0001) in particular in tentatively pathologic and prepathologic CTG patterns. No statistically significant difference was found between no-risk and risk patients. A check was also made as to whether the results of interval monitoring are as good as those of continuous monitoring. On the basis of two patient populations with different interval monitoring frequencies (17% versus 6.4%) it was established that with high interval monitoring frequencies the perinatal results were poorer: early morbidity of the newborns was twice as high when interval monitoring was used more often (21.4% versus 10.8%) (p less than 0.0001). From this the authors conclude that for the sake of the child, continuous monitoring during labor ought not to be dispensed with.

  12. 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...

  13. A child with narcolepsy

    Directory of Open Access Journals (Sweden)

    Silvério Macedo

    2016-02-01

    Full Text Available Introduction: Narcolepsy is a chronic disease characterized by sleep attacks, excessive daytime sleepiness and nocturnal sleep fragmentation. It can be associated cataplexy and other disturbance of REM sleep (sleep paralysis and hypnagogic hallucinations and hypnopompic. Case report: A 10-year old boy was referred to Pedopsychiatry because of behavioural disturbance, irritability, sleepiness and distraction, being interpreted as an “ill-mannered child.” After clinical evaluation and comprehensive laboratory studies we concluded that he presented narcolepsy with cataplexy. Discussion/conclusion: Patients with narcolepsy face several problems due to the disease which, if left untreated or ineffectively treated, cause embarrassing or distressing symptoms, affecting their quality of life. The purpose of this paper is to draw attention to this problem since it is a rare condition and therefore seldom not recognized by the general public or even by health professionals.

  14. Missed opportunities in child healthcare

    Directory of Open Access Journals (Sweden)

    Linda Jonker

    2014-01-01

    Full Text Available Background: Various policies in health, such as Integrated Management of Childhood Illnesses, were introduced to enhance integrated service delivery in child healthcare. During clinical practice the researcher observed that integrated services may not be rendered.Objectives: This article describes the experiences of mothers that utilised comprehensive child health services in the Cape Metropolitan area of South Africa. Services included treatment for diseases; preventative interventions such as immunisation; and promotive interventions, such as improvement in nutrition and promotion of breastfeeding.Method: A qualitative, descriptive phenomenological approach was applied to explore the experiences and perceptions of mothers and/or carers utilising child healthcare services. Thirty percent of the clinics were selected purposively from the total population. A convenience purposive non-probability sampling method was applied to select 17 mothers who met the criteria and gave written consent. Interviews were conducted and recorded digitally using an interview guide. The data analysis was done using Tesch’s eight step model.Results: Findings of the study indicated varied experiences. Not all mothers received information about the Road to Health book or card. According to the mothers, integrated child healthcare services were not practised. The consequences were missed opportunities in immunisation, provision of vitamin A, absence of growth monitoring, feeding assessment and provision of nutritional advice.Conclusion: There is a need for simple interventions such as oral rehydration, early recognition and treatment of diseases, immunisation, growth monitoring and appropriate nutrition advice. These services were not offered diligently. Such interventions could contribute to reducing the incidence of child morbidity and mortality.

  15. 78 FR 37231 - Guidance for Industry; Guidance on Abbreviated New Drug Applications: Stability Testing of Drug...

    Science.gov (United States)

    2013-06-20

    ... HUMAN SERVICES Food and Drug Administration Guidance for Industry; Guidance on Abbreviated New Drug... the availability of a guidance for industry entitled ``ANDAs: Stability Testing of Drug Substances and... generic drug review, FDA is recommending that the generic drug industry follow the approach in...

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

    Directory of Open Access Journals (Sweden)

    Xavier Bosch-Capblanch

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

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

    Science.gov (United States)

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

    2013-11-01

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

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

    Institute of Scientific and Technical Information of China (English)

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

    2013-01-01

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

  19. FPG Child Development Institute

    Science.gov (United States)

    ... Early Childhood Development, Teaching, and Learning The Frank Porter Graham Child Development Institute will partner with Zero ... Children with Disabilities October 12, 2016 More Frank Porter Graham Child Development Institute The University of North ...

  20. Well-child visits

    Science.gov (United States)

    ... who has questions about issues such as feeding, circumcision , and general child health issues. After the baby ... deep tendon reflexes as the child gets older Neonatal jaundice -- first few visits only Palpation Percussion Standard ...

  1. Cholesterol and Your Child

    Science.gov (United States)

    ... Old Feeding Your 1- to 2-Year-Old 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 ...

  2. Child abuse - physical

    Science.gov (United States)

    ... way Uses harsh discipline Was abused as a child Alcohol or drug problems Emotional problems or mental illness ... Physical abuse - children References Berkowitz CD, Stewart ST. Child maltreatment. In: Marx JA, Hockberger RS, Walls RM, eds. ...

  3. 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 ...

  4. Child-to-Child programme in Malaysia.

    Science.gov (United States)

    Kasim, M S; Abraham, S

    1982-09-01

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

  5. 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…

  6. Child poverty and changes in child poverty.

    Science.gov (United States)

    Chen, Wen-Hao; Corak, Miles

    2008-08-01

    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 in determining the magnitude and direction of the changes. Child poverty rates fell noticeably in only three countries and rose in three others. In no country were demographic factors a force for higher child poverty rates, but these factors were also limited in their ability to cushion children from adverse shocks originating in the labor market or the government sector. Increases in the labor market engagement of mothers consistently lowered child poverty rates, while decreases in the employment rates and earnings of fathers were a force for higher rates. Finally, there is no single road to lower child poverty rates. Reforms to income transfers intended to increase labor supply may or may not end up lowering the child poverty rate.

  7. Child involvement in interparental conflict and child adjustment problems: a longitudinal study of violent families.

    Science.gov (United States)

    Jouriles, Ernest N; Rosenfield, David; McDonald, Renee; Mueller, Victoria

    2014-01-01

    This study examined whether child involvement in interparental conflict predicts child externalizing and internalizing problems in violent families. Participants were 119 families (mothers and children) recruited from domestic violence shelters. One child between the ages of 7 and 10 years in each family (50 female, 69 male) completed measures of involvement in their parents' conflicts, externalizing problems, and internalizing problems. Mothers completed measures of child externalizing and internalizing problems, and physical intimate partner violence. Measures were completed at three assessments, spaced 6 months apart. Results indicated that children's involvement in their parents' conflicts was positively associated with child adjustment problems. These associations emerged in between-subjects and within-subjects analyses, and for child externalizing as well as internalizing problems, even after controlling for the influence of physical intimate partner violence. In addition, child involvement in parental conflicts predicted later child reports of externalizing problems, but child reports of externalizing problems did not predict later involvement in parental conflicts. These findings highlight the importance of considering children's involvement in their parents' conflicts in theory and clinical work pertaining to high-conflict families.

  8. 75 FR 76079 - Sound Incentive Compensation Guidance

    Science.gov (United States)

    2010-12-07

    ... Office of Thrift Supervision Sound Incentive Compensation Guidance AGENCY: Office of Thrift Supervision... collection. Title of Proposal: Sound Incentive Compensation Guidance. OMB Number: 1550-0129. Form Number: N/A... compensation arrangements at a financial institution do not encourage employees to take excessive risks....

  9. 75 FR 22679 - Sound Incentive Compensation Guidance

    Science.gov (United States)

    2010-04-29

    ... Office of Thrift Supervision Sound Incentive Compensation Guidance AGENCY: Office of Thrift Supervision... collection. Title of Proposal: Sound Incentive Compensation Guidance. OMB Number: 1550-0NEW. Form Number: N/A... compensation arrangements at a financial institution do not encourage employees to take excessive risks....

  10. 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.

  11. 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

  12. 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.

  13. Decreased levels of repulsive guidance molecule A in association with beneficial effects of repeated intrathecal triamcinolone acetonide application in progressive multiple sclerosis patients.

    Science.gov (United States)

    Müller, Thomas; Barghorn, Stefan; Lütge, Sven; Haas, Thomas; Mueller, Reinhold; Gerlach, Bjoern; Öhm, Gabi; Eilert, Katrin; Trommer, Isabel; Mueller, Bernhard K

    2015-06-01

    Repeated intrathecal application of the sustained release steroid triamcinolone acetonide is beneficial in progressive multiple sclerosis patients. Its putative regenerative effect may involve regulation of the repulsive guidance molecule A synthesis. This protein inhibits axonal regeneration and functional recovery. Objectives were to demonstrate the efficacy of four triamcinolone applications every other day in association with repulsive guidance molecule A levels in cerebrospinal fluid. Clinical evaluation was performed at baseline and on each day after a triamcinolone administration in 25 progressive multiple sclerosis patients. Repulsive guidance molecule A concentrations were determined before each triamcinolone application by western blot analysis with quantification. Clinical scores for multiple sclerosis improved, and the maximum walking distance and speed ameliorated in 17 patients. Repulsive guidance molecule A levels declined in these responders. The remaining patients showed no prompt clinical benefit and no decrease of repulsive guidance molecule A concentrations. Decline of repulsive guidance molecule A may reflect regeneration and functional recovery by triamcinolone in progressive multiple sclerosis patients.

  14. 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.

  15. Your Child's Immunizations

    Science.gov (United States)

    ... the number of shots a child receives. The Vaccines Your Child Needs The following vaccinations and schedules are recommended ... are developed. Your doctor will determine the best vaccinations and schedule for your child. Recommended vaccinations: Chickenpox (varicella) vaccine Diphtheria, tetanus, and ...

  16. Supporting Each Child's Spirit

    Science.gov (United States)

    Baumgartner, Jennifer J.; Buchanan, Teresa

    2010-01-01

    In using developmentally appropriate practices, teachers should intentionally address all aspects of a child's being, the spiritual along with the physical and the cognitive. Because spirituality is a vital part of human nature, a whole-child teaching approach must include the part of the child some call spirituality. Many have attempted to…

  17. Child Care Services Handbook.

    Science.gov (United States)

    Duval County School Board, Jacksonville, FL.

    A companion document to the curriculum guide for a secondary level child care services curriculum, this handbook contains a variety of administrative and program resources for the teacher: The vocational curriculum outline for child care services; a calendar of suggested public relations activities; procedures for building child care services…

  18. [Autism and child protection].

    Science.gov (United States)

    Coron, Guillaume

    2014-01-01

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

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

    DEFF Research Database (Denmark)

    Kjærgaard, Jesper; Stensballe, Lone Graff; Birk, Nina Marie;

    2016-01-01

    MEASURES: Psychomotor development measured using Ages and Stages Questionnaire (ASQ) completed by the parents at 12 months. Additionally, parents of premature children (gestational age Developmental assessment was available for 3453/4262 (81%). RESULTS......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...... 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....

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

    Institute of Scientific and Technical Information of China (English)

    沙美娟

    2014-01-01

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

  1. Clinical Analysis on 18 Cases of Child Herpes Zoster and Review the Literature%儿童带状疱疹18例及文献复习

    Institute of Scientific and Technical Information of China (English)

    杨珊; 迪丽努尔·阿布都热依木; 普雄明

    2013-01-01

    目的 探讨儿童带状疱疹的临床特征.方法 回顾性分析2008年1月-2011年12月本科收治的18例儿童带状疱疹的临床资料并进行文献复习.结果 儿童带状疱疹有轻微的前驱症状,皮疹少且散在分布,神经痛轻微,病程短(2 ~7d),且不发生后遗神经痛.结论 儿童带状疱疹临床少见、症状轻微,发病诱因以感染常见.%Objective To discuss the clinical features of children herpes zoster. Methods The pathogenesis,symptoms, experiences and treatments of eighteen children with herpes zoster were analysised. Results The children herpes zoster had minor precursory symptoms. The skin rash on children was few and scattered, neuralgia was slight in children, and course in children was short(2 ~7d). No PHN happened in children. Conclusion Children herpes zoster is rare in the clinic,clinical symptoms is minor. Infection was the common predisposing factor.

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

    Directory of Open Access Journals (Sweden)

    Häberle Johannes

    2012-07-01

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

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

    Science.gov (United States)

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

    2012-07-25

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

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

    Directory of Open Access Journals (Sweden)

    Timothy K Thomas

    2011-03-01

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

  5. Space shuttle guidance, navigation, and control design equations. Volume 3: Guidance

    Science.gov (United States)

    1973-01-01

    Space shuttle guidance, navigation, and control design equations are presented. The space-shuttle mission includes three relatively distinct guidance phases which are discussed; atmospheric boost, which is characterized by an adaptive guidance law; extra-atmospheric activities; and re-entry activities, where aerodynamic surfaces are the principal effectors. Guidance tasks include pre-maneuver targeting and powered flight guidance, where powered flight is defined to include the application of aerodynamic forces as well as thruster forces. A flow chart which follows guidance activities throughout the mission from the pre-launch phase through touchdown is presented. The main guidance programs and subroutines used in each phase of a typical rendezvous mission are listed. Detailed software requirements are also presented.

  6. 76 FR 63676 - Final Division of Safety Systems Interim Staff Guidance DSS-ISG-2010-01: Staff Guidance Regarding...

    Science.gov (United States)

    2011-10-13

    ... COMMISSION Final Division of Safety Systems Interim Staff Guidance DSS-ISG- 2010-01: Staff Guidance Regarding... final Division of Safety Systems Interim Staff Guidance, (DSS-ISG) DSS- ISG-2010-01, ``Staff Guidance... guidance to the NRC staff reviewer to address the increased complexity of recent spent fuel pool...

  7. 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

  8. 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

  9. 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

  10. 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...

  11. From child to child: children as communicators.

    Science.gov (United States)

    Phinney, R; Evans, J

    1993-01-01

    Older children commonly care for their younger siblings while parents work to provide for the household. Through play, dance, and talk, children tend to interact with each other more intensely than do adults. In so doing, messages and awareness are exchanged more effectively. Child-to-Child is an active, child-centered learning approach which aims to capitalize on this phenomenon by training older siblings to be effective communicators. This approach has been formally practiced in over 70 countries since 1979. Child-to-Child encourages children to learn the meaning and importance of health messages on their own. Children will then be most likely to retain and communicate information throughout the family, to neighbors, and to the general community. No blueprint exists, however, on which program planners may base the design of new programs. Programs should instead be adapted by those living within the community and culture to fit local needs and circumstances. Nonetheless, the Aga Khan Foundation supported the study of 7 highly different Child-to-Child projects over 3 years in India to obtain some sense of which program elements are successful and potentially useful in other settings. The study revealed that all of the programs helped increase the health knowledge of children and teachers. Little information was obtained on the extent to which information was diffused by children within the community. Overall, the study produced the following results: planners should consider using Child-to-Child projects in schools; teacher training should be made a priority; administrative support should be provided; entire staffs should be made to feel involved in the decision making process; obstacles to changing teaching methods should not be underestimated; teaching materials should be locally made; projects should be integrated into official curricula; program topics should be relevant to local realities; respected authorities should be called upon to reinforce the validity

  12. 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.

  13. 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.

  14. Child protection: a 50-year perspective.

    Science.gov (United States)

    Skellern, Catherine Yvette

    2015-01-01

    It has been 50 years since Kempe et al. published 'The Battered Child Syndrome', describing harm from inflicted injury mechanisms derived from parents and care givers. Since then, there has emerged a rapidly expanding literature on paediatric forensic medicine and child protection, which has offered new insights into injury mechanisms, informed us of the sequelae of abuse and neglect, aided diagnosis and guided clinical practice in the treatment and management of children who become involved in the child protection system. Through the scrutiny of government inquiries and at times uncomfortable media exposure, there have been improvements in child protection and forensic practices resulting in recognition of need for specialised forensic training, improved funding, development of resources and development of professional standards that support accountable, objective, safe and robust practice. From the perspective of an Australian child protection paediatrician, this paper chronicles some of the most significant and at times controversial research in the last 50 years in child protection that have played a key role in shaping our current understanding of child abuse and neglect.

  15. Analysis of the Detection Results of Trace Elements in Child Health Clinic Physical Examination in 75 Cases%75例儿童保健门诊体检中的微量元素检测结果分析

    Institute of Scientific and Technical Information of China (English)

    韩崔君

    2015-01-01

    Objective:To investigate the detection results of trace elements and trace elements deficiency condition of children in the child health clinic examination.Method:75 children in our hospital outpatient departments for examination of trace elements from January 2012 to June 2012 were selected as research objects,according to the age of children,they were divided into the infant group for 12 cases,the child group for 19 cases,the preschool group for 25 cases and the school-age group for 19 cases.The trace elements in children were detected by electrochemical analysis.Result:In 75 children,calcium deficiency in 57 cases,accounting for 76.0%,zinc deficiency in 46 cases,accounting for 60.0%,iron deficiency in 35 cases, accounting for 46.7%,copper deficiency in 33 cases,accounting for 44.0%,magnesium deficiency in 25 cases,accounting for 33.3%,no cadmium high,lead high in 31 cases,accounting for 41.3%.Conclusion:The results of the study confirm,the phenomenon of widespread lack of trace element in child health clinic medical patients,in order to effectively improve the quality of children's body,the need for a reasonable balance diet,appropriate to add complementary,develop good eating habits.%目的:探讨儿童保健门诊体检中的微量元素检测结果以及儿童微量元素缺乏情况。方法:选取2012年1-6月在笔者所在医院门诊体检部门接受微量元素检测的75例儿童作为观察对象,根据患儿年龄将其划分为婴儿组12例、幼儿组19例、学龄前组25例以及学龄组19例,运用电化学分析法对儿童体内的微量元素进行检测。结果:75例患儿中,缺钙57例,占76.0%,缺锌46例,占60.0%,缺铁35例,占46.7%,缺铜33例,占44.0%,缺镁25例,占33.3%,镉高0例,铅高31例,占41.3%。结论:研究结果证实,儿童保健门诊体检患者中普遍存在微量元素缺乏现象,为有效全面提高儿童体身体质量,需要合理平衡膳食,适当添加辅食

  16. The "child size medicines" concept

    DEFF Research Database (Denmark)

    Nsabagasani, Xavier; Okeng, Jasper Ogwal; Mbonye, Anthony

    2015-01-01

    causes of morbidity and mortality among children in Uganda- diseases that were also emphasized in the MMCS campaign. Asthma and epilepsy were included as conditions that require long term care. Schistomiasis was included as a neglected tropical disease. Content analysis was used to assess evidence...... solid dosage formulations like dispersible tablets, pellets and granules- indicating limited adherence to MMCS recommendations. Some of the medicines recommended in the clinical guidelines as first line treatment for malaria and pneumonia among children were not evidence-based. Conclusion The Ugandan...... health policy documents reflected limited adherence to the MMCS recommendations. This and failure to use evidence based medicines may result into treatment failure and or death. A revision of the current policies and guidelines to better reflect ‘child size’, child appropriate and evidence based...

  17. Significant Guidance Issued by the Federal Aviation Administration

    Data.gov (United States)

    Department of Transportation — A list of Significant Guidance documents, which include guidance document disseminated to regulated entities or the general public that may reasonably be anticipated...

  18. Significant Guidance Issued by the Federal Transit Administration

    Data.gov (United States)

    Department of Transportation — A list of Significant Guidance documents, which include guidance document disseminated to regulated entities or the general public that may reasonably be anticipated...

  19. Significant Guidance Issued by the Federal Motor Carrier Safety Administration

    Data.gov (United States)

    Department of Transportation — A list of Significant Guidance documents, which include guidance document disseminated to regulated entities or the general public that may reasonably be anticipated...

  20. Significant Guidance Issued by the Federal Highway Administration

    Data.gov (United States)

    Department of Transportation — A list of Significant Guidance documents, which include guidance document disseminated to regulated entities or the general public that may reasonably be anticipated...

  1. [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.

  2. 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.

  3. 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.

  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.

  5. X线透视联合超声引导行经皮肝穿胆道引流术治疗梗阻性黄疸的临床应用%Percutaneous transhepatic biliary drainage under fluoroscopic and ultrasound guidance for the treatment of obstructive jaundice: its clinical application

    Institute of Scientific and Technical Information of China (English)

    王建雄; 刘维; 窦晓霞; 王健; 宋莉; 佟小强; 邹英华

    2012-01-01

    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 realtime 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 bitirubin 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 realtime ultrasonography is an effective, safe, simple and economical treatment with fewer complications. (J Intervent Radiol, 2012, 21: 309-313)%目的 分析X线透视联合超声实时引导下经皮肝穿胆道引流术(PTBD)治疗阻塞性黄疸的操作技术及其应用价值.方法 78例阻塞性黄疸患者,其中70例为恶性阻塞性病变,8例为良性阻塞性病变,在超声实时引导结合X线透视下行PTBD术,穿刺右叶胆管52例,穿刺左叶胆管26例,并常规造影.结果所有患者手术均获得成功,未出现大出血及胆汁性腹膜炎等并发症,术后梗阻性黄疸症状逐渐改善,术后1~2周血清胆红素及转氨酶水平较术前明显下降(P<0.01).结论 X线透视结合超声实时引导下PTBD是一种治疗阻

  6. Review of Child and Adolescent Refugee Mental Health

    Science.gov (United States)

    Lustig, Stuart L.; Kia-Keating, Maryam; Knight, Wanda Grant; Geltman, Paul; Ellis, Heidi; Kinzie, J. David; Keane, Terence; Saxe, Glenn N.

    2004-01-01

    Objective: To review stressful experiences and stress reactions among child and adolescent refugees, as well as interventions and ethical considerations in research and clinical work, within the framework of the chronological experiences of child refugees; namely, the phases of preflight, flight, and resettlement. Highlighted are special refugee…

  7. Predicting relapse of problematic child-rearing situations

    NARCIS (Netherlands)

    van der Put, C.E.; Assink, M.; Stams, G.J.J.M.

    2016-01-01

    Background The development and evaluation of risk assessment instruments for child maltreatment is still in its infancy, both in the Netherlands and internationally. The aim of this study was to examine the predictive validity of a structured clinical judgement instrument - the Check List of Child S

  8. 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.

  9. Teacher-Child Relationships: Contribution of Teacher and Child Characteristics

    Science.gov (United States)

    Choi, Ji Young; Dobbs-Oates, Jennifer

    2016-01-01

    This study investigates potential predictors of teacher-child relationships (i.e., closeness and conflict) focusing on child gender, teacher-child ethnicity match, and teacher education. Additionally, the study explores the possible moderation effect of teacher education on the associations between teacher-child relationships and child gender or…

  10. Integrated Entry Guidance for Reusable Launch Vehicle

    Institute of Scientific and Technical Information of China (English)

    NING Guo-dong; ZHANG Shu-guang; FANG Zhen-ping

    2007-01-01

    A method for the implementation of integrated three-degree-of-freedom constrained entry guidance for reusable launch vehicle is presented. Given any feasible entry conditions, terminal area energy management interface conditions, and the reference trajectory generated onboard then, the method can generate a longitudinal guidance profile rapidly, featuring linear quadratic regular method and a proportional-integral-derivative tracking law with time-varying gains, which satisfies all the entry corridor constraints and meets the requirements with high precision. Afterwards, by utilizing special features of crossrange parameter, establishing bank-reversal corridor,and determining bank-reversals according to dynamically adjusted method, the algorithm enables the lateral entry guidance system to fly a wide range of missions and provides reliable and good performance in the presence of significant aerodynamic modeling uncertainty.Fast trajectory guidance profiles and simulations with a reusable launch vehicle model for various missions and aerodynamic uncertainties are presented to demonstrate the capacity and reliability of this method.

  11. Beyond Black: An Alternative to Ethnocentric Guidance

    Science.gov (United States)

    Goldman, Robert C.

    1977-01-01

    This article is a clarification of the author's personal philosophy in the guidance and counseling of youth and adults, and clarification of commonalities that form the raison d'etre of all student personnel services. (Author)

  12. 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...

  13. Optimal guidance for the space shuttle transition

    Science.gov (United States)

    Stengel, R. F.

    1974-01-01

    A guidance method for the space shuttle's transition from hypersonic entry to subsonic cruising flight is presented. The method evolves from a numerical trajectory optimization technique in which kinetic energy and total energy (per unit weight) replace velocity and time in the dynamic equations. This allows the open end-time problem to be transformed to one of fixed terminal energy. In its ultimate form, E-Guidance obtains energy balance (including dynamic-pressure-rate damping) and path length control by angle-of-attack modulation and cross-range control by roll angle modulation. The guidance functions also form the basis for a pilot display of instantaneous maneuver limits and destination. Numerical results illustrate the E-Guidance concept and the optimal trajectories on which it is based.

  14. Hunger strike among detainees: guidance for good medical practice.

    Science.gov (United States)

    Gétaz, Laurent; Rieder, Jean-Pierre; Nyffenegger, Laurent; Eytan, Ariel; Gaspoz, Jean-Michel; Wolff, Hans

    2012-09-17

    Hunger strike is a regularly reported problem in prison. Although clinical situations are rarely severe, hospitalisation is often considered. In consequence, it is not only physicians working in prisons, but also hospital medical teams who face challenges related to hunger strike, involving somatic, psychological, legal and human rights aspects. Furthermore, deontological rules must be strictly respected when delivering care, particularly in prison setting. Starvation involves metabolic changes and can cause severe, and sometimes even irreversible or fatal complications. Moreover, the phase of re-alimentation should not be trivialised, as re-feeding syndrome is a potentially fatal phenomenon. This article provides guidance for monitoring and management of patients on hunger strike.

  15. 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.

  16. E2C(R2) Periodic Benefit-Risk Evaluation Report and E2C(R2) Periodic Benefit-Risk Evaluation Report--Questions and Answers; International Council for Harmonisation; Guidances for Industry; Availability. Notice.

    Science.gov (United States)

    2016-07-19

    The Food and Drug Administration (FDA or Agency) is announcing the availability of guidances for industry entitled ``E2C(R2) Periodic Benefit-Risk Evaluation'' (E2C(R2) guidance) and ``E2C(R2) Periodic Benefit-Risk Evaluation Report--Questions and Answers'' (E2C(R2) Q&A guidance). These guidances were prepared under the auspices of the International Council for Harmonisation (ICH), formerly the International Conference on Harmonisation. The E2C(R2) draft guidance, issued April 11, 2012, updated and combined two ICH guidances, ``E2C Clinical Safety Data Management: Periodic Safety Update Reports for Marketed Drugs'' (E2C guidance) and ``Addendum to E2C Clinical Safety Data Management: Periodic Safety Update Reports for Marketed Drugs'' (addendum to the E2C guidance). The E2C(R2) guidance is intended to describe the format, content, and timing of a Periodic Benefit-Risk Evaluation Report (PBRER) for an approved drug or biologic, and it finalizes the draft guidance. The E2C(R2) Q&A guidance is a supplementary guidance that is intended to clarify key issues in the E2C(R2) guidance.

  17. Breathing guidance in radiation oncology and radiology: A systematic review of patient and healthy volunteer studies

    Energy Technology Data Exchange (ETDEWEB)

    Pollock, Sean, E-mail: sean.pollock@sydney.edu.au; Keall, Paul [Radiation Physics Laboratory, University of Sydney, Sydney 2050 (Australia); Keall, Robyn [Central School of Medicine, University of Sydney, Sydney 2050, Australia and Hammond Care, Palliative Care and Supportive Care Service, Greenwich 2065 (Australia)

    2015-09-15

    Purpose: The advent of image-guided radiation therapy 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 irregularities is the use of breathing guidance systems during imaging and treatment. These systems aim to facilitate regular respiratory motion which in turn improves image quality and radiation treatment accuracy. A review of such research has yet to be performed; it was therefore their aim to perform a systematic review of breathing guidance interventions within the fields of radiation oncology and radiology. Methods: From August 1–14, 2014, the following online databases were searched: Medline, Embase, PubMed, and Web of Science. Results of these searches were filtered in accordance to a set of eligibility criteria. The search, filtration, and analysis of articles were conducted in accordance with preferred reporting items for systematic reviews and meta-analyses. Reference lists of included articles, and repeat authors of included articles, were hand-searched. Results: The systematic search yielded a total of 480 articles, which were filtered down to 27 relevant articles in accordance to the eligibility criteria. These 27 articles detailed the intervention of breathing guidance strategies in controlled studies assessing its impact on such outcomes as breathing regularity, image quality, target coverage, and treatment margins, recruiting either healthy adult volunteers or patients with thoracic or abdominal lesions. In 21/27 studies, significant (p < 0.05) improvements from the use of breathing guidance were observed. Conclusions: There is a trend toward the number of breathing guidance studies increasing with time, indicating a growing clinical interest. The results found here indicate that further clinical studies are warranted that quantify the

  18. Guidance for industry: patient-reported outcome measures: use in medical product development to support labeling claims: draft guidance

    Directory of Open Access Journals (Sweden)

    2006-10-01

    Full Text Available Abstract This guidance describes how the FDA evaluates patient-reported outcome (PRO instruments used as effectiveness endpoints in clinical trials. It also describes our current thinking on how sponsors can develop and use study results measured by PRO instruments to support claims in approved product labeling (see appendix point 1. It does not address the use of PRO instruments for purposes beyond evaluation of claims made about a drug or medical product in its labeling. By explicitly addressing the review issues identified in this guidance, sponsors can increase the efficiency of their endpoint discussions with the FDA during the product development process, streamline the FDA's review of PRO endpoint adequacy, and provide optimal information about the patient's perspective of treatment benefit at the time of product approval. A PRO is a measurement of any aspect of a patient's health status that comes directly from the patient (i.e., without the interpretation of the patient's responses by a physician or anyone else. In clinical trials, a PRO instrument can be used to measure the impact of an intervention on one or more aspects of patients' health status, hereafter referred to as PRO concepts, ranging from the purely symptomatic (response of a headache to more complex concepts (e.g., ability to carry out activities of daily living, to extremely complex concepts such as quality of life, which is widely understood to be a multidomain concept with physical, psychological, and social components. Data generated by a PRO instrument can provide evidence of a treatment benefit from the patient perspective. For this data to be meaningful, however, there should be evidence that the PRO instrument effectively measures the particular concept that is studied. Generally, findings measured by PRO instruments may be used to support claims in approved product labeling if the claims are derived from adequate and well-controlled investigations that use PRO

  19. The unintended consequences of clinical trials regulations.

    Directory of Open Access Journals (Sweden)

    Alex D McMahon

    2009-11-01

    Full Text Available Alex McMahon and colleagues critique the International Conference on Harmonisation (ICH guidance on good clinical practice (GCP, arguing that it is having a disastrous effect on noncommerical randomized clinical trials in Europe.

  20. The unintended consequences of clinical trials regulations

    OpenAIRE

    Alex D McMahon; Conway, David I; MacDonald, Tom M; McInnes, Gordon T

    2009-01-01

    Alex McMahon and colleagues critique the International Conference on Harmonisation (ICH) guidance on good clinical practice (GCP), arguing that it is having a disastrous effect on noncommerical randomized clinical trials in Europe.

  1. Clinical Analysis of 50 Cases of Child Herpes Zoster%儿童带状疱疹50例临床分析

    Institute of Scientific and Technical Information of China (English)

    杨凤琼; 谢雪冰; 邓骥

    2011-01-01

    Objective To discuss the clinical features of children herpes zoster. Methods Fifty children with herpes zoster were compared with 50 cases of adults herpes zoster on their symptoms, experiences and treatments.Result The children herpes zoster had minor precursory symptoms(24% ). The skin rash on children was few and scattered while on adlut heavy. Neuralgia was slight in children but obvious in adult. and course in children was (7.5 ± 1. 8 d) and in adult was ( 18 ±2.5 d) respectively. No PHN happened in children but about 56% in adult patients. Discussion The incidence rate of children herpes zoster is low, and most of them have inducement.%目的 探讨儿童带状疱疹的临床特征.方法 分析50例儿童带状疱疹的诱因、症状、体征及治疗,并与同期50例成人带状疱疹患者临床资料相对照.结果 儿童带状疱疹有轻微前驱症状(24%),皮疹少且散在.神经痛轻微,病程短(7.5±1.8 d),且不发生后遗神经痛;而成人带状疱疹则皮疹重,神经痛明显,病程长(18±2.5d),有后遗神经痛(56%).讨论相对于成年人,儿童带状疱疹发病率低,发病多有诱因.

  2. International child health

    DEFF Research Database (Denmark)

    Kruse, Alexandra Y; Høgh, Birthe

    2007-01-01

    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...... 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...

  3. Child neurology: past, present, and future: part 3: the future.

    Science.gov (United States)

    Ridel, Keith R; Gilbert, Donald L

    2010-10-12

    This is the last of a 3-part series exploring the past, present, and future of the field of child neurology. This article addresses the 2 fundamental challenges facing child neurology. The most important challenge is our inadequate workforce; based on current numbers, recruitment patterns, and projected retirement, the child neurology clinical and research workforce shortage will likely worsen. The second challenge involves adapting our training to prepare child neurologists for changes ahead. We propose that these 2 issues are related, and that solutions need to include consideration of career options in research, education, and patient care.

  4. 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.

  5. International Conference on Harmonisation; draft guidance on E2F Development Safety Update Report; availability. Notice.

    Science.gov (United States)

    2008-08-05

    The Food and Drug Administration (FDA) is announcing the availability of a draft guidance entitled "E2F Development Safety Update Report." The draft guidance was prepared under the auspices of the International Conference on Harmonisation of Technical Requirements for Registration of Pharmaceuticals for Human Use (ICH). The draft guidance describes the format, content, and timing of a development safety update report (DSUR) for an investigational drug. The DSUR would serve as a harmonized, annual clinical trial safety report that would be standard among the three ICH regions. The DSUR could be submitted in the United States in place of an annual report for an investigational new drug application (IND). The harmonized DSUR is intended to promote a consistent approach to annual clinical safety reporting among the ICH regions and enhance efficiency by reducing the number of reports generated for submission to the regulatory authorities.

  6. What can psychiatry learn from the Munro Review of Child Protection?

    Science.gov (United States)

    Cohen, Mark

    2016-02-01

    The Munro Review of Child Protection approached the problem of child protection from an understanding based upon systems analysis. Risk assessment in psychiatry has similarities to the assessment by social workers of child protection issues. Psychiatry as a profession could learn from the Review, and, in doing so, be supported in recovering and communicating the requirements for good clinical practice.

  7. Academic Training in a Child and Adolescent Psychiatry Fellowship: A Curriculum Based on Leadership Experience

    Science.gov (United States)

    Ivany, Christopher G.; Russell, Robert K.; Vanessa, Venezia A.; Saito, Albert Y.

    2008-01-01

    Objective: The authors describe how one child and adolescent psychiatry fellowship program responded to emerging trends in clinical practice which increasingly demand that child and adolescent psychiatrists lead their colleagues through instruction and supervision. Methods: Data from surveys of recent graduates of child and adolescent training…

  8. 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…

  9. ETHICAL, SOCIO-PSYCHOLOGICAL AND MEDICAL ASPECTS OF CHILD NEGLECT

    Directory of Open Access Journals (Sweden)

    Smaranda Diaconescu

    2015-11-01

    Full Text Available Child neglect was and continues to be a matter of both professional and public interest, thoroughly debated by child protection researchers and specialists, sociologists, psychologists and social workers, specialists in education and health. Drawing on some examples encountered in current medical practice, we tried to identify the causal factors of child neglect from a medical point of view and the attitude that healthcare professionals should adopt towards such situations. The correct and efficient management of medical neglect cases requires an assessment of the child’s needs, the identification of the parents’ resources and guidance of their efforts so as to properly cater to the child’s needs for the purpose of ensuring the optimum health of the latter.

  10. Constituent Aspects of Workplace Guidance in Secondary VET

    Science.gov (United States)

    Swager, Robert; Klarus, Ruud; van Merriënboer, Jeroen J. G.; Nieuwenhuis, Loek F. M.

    2015-01-01

    Purpose: This paper aims to present an integrated model of workplace guidance to enhance awareness of what constitutes good guidance, to improve workplace guidance practices in vocational education and training. Design/methodology/approach: To identify constituent aspects of workplace guidance, a systematic search of Web of Science was conducted,…

  11. The voice of users in adult career guidance

    DEFF Research Database (Denmark)

    Plant, Peter

    2012-01-01

    Is the voice of users heard in adult career guidance? Pan-Nordic Research shows that users are seen as recipients rather than agents i adult career guidance.......Is the voice of users heard in adult career guidance? Pan-Nordic Research shows that users are seen as recipients rather than agents i adult career guidance....

  12. The Development of a Lifelong Guidance System in Hungary

    Science.gov (United States)

    Watts, A. G.; Borbely-Pecze, Bors Tibor

    2011-01-01

    The development of a lifelong guidance system in Hungary Systematic work is currently being undertaken in Hungary to develop a lifelong guidance system, in line with principles outlined by leading international organisations. The origins of career guidance in Hungary, and the nature of the current career guidance system, are outlined. The main…

  13. 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

  14. [Music therapy and child care].

    Science.gov (United States)

    Chang, Shu-Min; Sung, Huei-Chuan

    2005-12-01

    Music therapy was shown many years ago to have positive effects in various age groups of patients in the Western world. Music can produce physiological and psychological effects, including changes in the vital signs, reductions in anxiety, improvements in the immune system, decreases in cortisol levels, the reduction of stress and the promotion of well-being. Music therapy is an inexpensive and effective intervention for nurses to apply to patients. The application of such therapy to children, however, is different from that to adults due to their limited cognitive and language development. In Taiwan, nurses' knowledge of music therapy is limited, and it is rarely used in child care. This article introduces music therapy and its effects in child care, such as in premature infants, children in emergency care, handicapped children, and children receiving surgery. Music therapy is often used as an assisted intervention for patient care in clinical settings. Health care professionals can perform some of the music therapy activities for patients appropriately even if they have not been trained in music. This article aims to improve nurses' knowledge of music therapy and to provide a useful reference for those involved in child care.

  15. The Function of Ambiguity in Child Crises

    Science.gov (United States)

    Stein, Myron

    1970-01-01

    Discusses the function of ambiguity" (an attitude of hatibual uncertainty, vagueness, and imprecision of communication) in crisis situations involving adult-child interchanges. Makes suggestions for medical and psychiatric counselors. Paper was presented at the meeting of the American Association of Psychiatric Clinics for Children, Boston,…

  16. Robotics in child neurosurgery.

    Science.gov (United States)

    Giorgi, C; Sala, R; Riva, D; Cossu, A; Eisenberg, H

    2000-11-01

    We felt there was a need for a new device with "minimal invasive" tracking hardware, to be used in image-guided neurosurgery, and the system we designed to fill this need is now presented. It combines precision of movement, stability and self-positioning capabilities together with optically tracked registration and procedural control within the structure of a surgical microscope. The results are reduced setup time and minimal "distraction" from the procedure itself, factors of special relevance in child neurosurgery. The system is composed of a six-axis industrial robot suitable for use in the operating room, carrying a surgical microscope. Three progressive scan-synchronized infrared cameras mounted around the lenses of the scope are used to register the patient's position and track surgical instruments with reference to the registered space. Orientation of the microscope during surgery is obtained with a six-axis joystick used as a microscope handle. The system has been clinically used in 14 cases, and it has proven itself to be reliable, providing the expected performance advantages. The implementation of a tracked ultrasound or endoscope intraoperative imaging source is also described.

  17. Pediatric anthrax clinical management.

    Science.gov (United States)

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

    2014-05-01

    Anthrax is a zoonotic disease caused by Bacillus anthracis, which has multiple routes of infection in humans, manifesting in different initial presentations of disease. Because B anthracis has the potential to be used as a biological weapon and can rapidly progress to systemic anthrax with high mortality in those who are exposed and untreated, clinical guidance that can be quickly implemented must be in place before any intentional release of the agent. This document provides clinical guidance for the prophylaxis and treatment of neonates, infants, children, adolescents, and young adults up to the age of 21 (referred to as "children") in the event of a deliberate B anthracis release and offers guidance in areas where the unique characteristics of children dictate a different clinical recommendation from adults.

  18. Computerizing clinical practice guidelines

    DEFF Research Database (Denmark)

    Lyng, Karen Marie

    . The analysis focuses on the emergence of general clinical work practice demands on guidance • An analysis of guidance demands from clinical work practice and business strategy, focusing on implications for the design of computerised CPGs. In my research, I have applied observation studies, interviews...... is comprised by fieldwork in three oncology departments and a case study of advanced life support. Although close to all patients within oncology are treated according to a CPG, I found limited application of physical CPGs and web-based CPG portals. However, I found comprehensive application of activity...... feasible • Designed in a way that provides room for local adaptations of guidance • Designed with focus on specific business strategic aims Further, based on my findings, I will suggest that design of computerized CPGs should be based on: 1) scrutinization of the clinical work practice, 2) articulation...

  19. 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).

  20. Child Abuse or Osteogenesis Imperfecta?

    Science.gov (United States)

    Child Abuse or Osteogenesis Imperfecta? 804 W. Diamond Ave., Ste. 210 Gaithersburg, MD 20878 (800) 981-2663 (301) ... welfare services to report a suspected case of child abuse. The child is taken away from the parents ...

  1. Talking to Your Child's Doctor

    Science.gov (United States)

    ... to 2-Year-Old Talking to Your Child's Doctor KidsHealth > For Parents > Talking to Your Child's Doctor ... an important role in your child's health? The Doctor-Patient Relationship Today, doctors are pressured to see ...

  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 Review Date 11/20/2014 Updated by: ...

  3. 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.

  4. 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…

  5. Towards clinically translatable NIR fluorescence molecular guidance for colonoscopy

    NARCIS (Netherlands)

    Garcia-Allende, P. Beatriz; Glatz, Juergen; Koch, Maximilian; Tjalma, Jolien J.; Hartmans, Elmire; Terwisscha Van Scheltinga, Anton G. T.; Symvoulidis, Panagiotis; van Dam, Gooitzen M.; Nagengast, Wouter B.; Ntziachristos, Vasilis

    2014-01-01

    White-light surveillance colonoscopy is the standard of care for the detection and removal of premalignant lesions to prevent colorectal cancer, and the main screening recommendation following treatment for recurrence detection. However, it lacks sufficient diagnostic yield, exhibits unacceptable ad

  6. Guidance on the diagnosis and clinical management of acne.

    Science.gov (United States)

    Archer, C B; Cohen, S N; Baron, S E

    2012-05-01

    This article discusses the effects of acne (sometimes referred to as acne vulgaris), how to diagnose it confidently and how to distinguish it from rosacea, and the options available for treatment, especially in primary care. We also suggest when referral to dermatology should be considered, and try to anticipate some frequently asked questions.

  7. Severe combined immunodeficiency: recent developments and guidance on clinical management.

    Science.gov (United States)

    Rivers, Lizzy; Gaspar, H Bobby

    2015-07-01

    Severe combined immunodeficiency (SCID) is a rare but important condition. Affected infants are born with profound abnormalities of immune cell function that lead to severe and recurrent infection that are almost always fatal in the first year of life without treatment. Infants with SCID are often initially seen by general paediatricians in the hospital care setting, and the recognition of the cardinal features of the disease and alertness to specific laboratory parameters are important in making an early diagnosis. There is also increasing interest in newborn screening for SCID, which has the potential to significantly improve outcome through early diagnosis and implementation of prophylactic medications. Definitive treatments such as haematopoietic stem cell transplantation and gene therapy have also made major advances over the last decade and again promise to improve the overall outcome for SCID with reduced long-term toxicities. In this review, we highlight some of the major advances in diagnosis and management of the disease, but we also want to emphasise the important role of the general paediatrician in making an early diagnosis and in ongoing management.

  8. Measuring Integrated Socioemotional Guidance at School: Factor Structure and Reliability of the Socioemotional Guidance Questionnaire (SEG-Q)

    Science.gov (United States)

    Jacobs, Karen; Struyf, Elke

    2013-01-01

    Socioemotional guidance of students has recently become an integral part of education, however no instrument exists to measure integrated socioemotional guidance. This study therefore examines the factor structure and reliability of the Socioemotional Guidance Questionnaire. Psychometric properties of the Socioemotional Guidance Questionnaire and…

  9. 78 FR 48201 - Japan Lessons-Learned Project Directorate Interim Staff Guidance JLD-ISG-2013-01; Guidance for...

    Science.gov (United States)

    2013-08-07

    ... COMMISSION Japan Lessons-Learned Project Directorate Interim Staff Guidance JLD-ISG-2013-01; Guidance for... Lessons-Learned Project Directorate Interim Staff Guidance (JLD-ISG), JLD-ISG-2013-01, ``Guidance for... to http://www.nrc.gov/reading-rm/doc-collections/isg/japan-lessons-learned.html and refer to...

  10. The Child Welfare Cartel

    Science.gov (United States)

    Stoesz, David

    2016-01-01

    The probity of the Children's Bureau's National Child Welfare Workforce Institute (NCWWI) is examined with respect to the status of child welfare as well as the performance of social work education. By requiring that funding go only to accredited schools of social work, which is not authorized by relevant provisions of the Social Security Act,…

  11. Child Psychology Experiences Program.

    Science.gov (United States)

    Walla Walla Coll., WA.

    Recognizing the need for trained teachers to enter the classroom with confidence and professional capacity, Walla Walla College introduced a Child Psychology Experience program. Personnel from several departments contribute to this program. In connection with the child psychology courses, the project features a laboratory/demonstration center…

  12. 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…

  13. Divorce Child Custody Disputes.

    Science.gov (United States)

    Houlgate, Laurence D.

    1987-01-01

    Examines ethical issues in making policy decisions regarding divorce child custody disputes. Suggests dilemma occurs when legislator must decide between discretionary standard promoting best interest of child and nondiscretionary arbitrary assignment of custody. Advocates normative analysis of various types of dispute-settling processes and…

  14. Clinical observation of ganciclovir treatment for the young child viral encephalitis%更昔洛韦治疗小儿病毒性脑炎的临床观察

    Institute of Scientific and Technical Information of China (English)

    孙晓宝; 吴小平; 李文君

    2008-01-01

    Objective To observe effect of ganciclovir on the treatment of the young child viral encephalitis. Methods 68 cases of viral encephalitis were randomly divided into treatment group(45 cases) and the control group (23 cases), the two groups of children with clinical manifestations and treatment effects were observed. Results Headache, vomiting, convulsions symptoms and the resumption of the time was obviously shorter in treatment group than that of the control group, fever symptoms persisted despite the shortened time, but the difference was not statis- tically significant. Conclusion Ganciclovir in children with viral encephalitis have significant effect.%目的 观察更昔洛韦治疗小儿病毒性脑炎的临床疗效.方法 子将68例病毒性脑炎患儿随机分为治疗组(45例)和对照组(23例),对两组患儿的临床表现及治疗效果进行观察.结果 治疗组头痛、呕吐及抽搐症状和恢复神志的时间明显较对照组缩短,发热症状消退的时间虽有所缩短,但两者比较差异无统计学意义.结论 更昔洛韦对小儿病毒性脑炎有明显疗效,值得临床推广.

  15. Guidance Trade-off for Aerocapture Missions

    Science.gov (United States)

    Vernis, P.; Gelly, G.; Ferreira, E.; da Costa, R.; Ortega, G.

    In the very late 90's, EADS-ST began home funded studies on aerocapture problems. The objectives of these studies were at that time to prepare a possible cooperation within the NASA/Cnes MSR-Orbiter program by investigating this new orbital insertion technique studying different algorithmic solutions from a guidance point of view. According to these preliminary studies, EADS-ST was retained in 2002 by ESA to study insertion techniques such as aerocapture, aero-gravity assist or aerobraking techniques within the frame of Technological Research Program able to bring solutions to Aurora program. In the frame of the ATPE (Aeroassist Technologies for Planetary Exploration) TRP program, EADS-ST, led by Astrium-Gmbh (now part of EADS-ST), developed and implemented an efficient and simple guidance scheme able to cope with mission requirements for aerocapture on Mars, Venus or the Earth: the Feedback Trajectory Control, or FTC. The development of this guidance scheme was made according to a preliminary trade-off analysis using different guidance schemes. Among those ones was an original predictor-corrector guidance scheme, already analyzed within the frame of the MSR-O mission. But, the FTC algoritm was prefered because of its good results and high simplicity. This paper presents an upgrade of the original Apoapsis Predictor, or AP, with the improvement of its robustness woth respect to off-nomonal flight conditions and its process simplification. A new trade-off analysis is then detailed on a Mars Sample return mission.

  16. 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.

  17. Child prostitution in Thailand.

    Science.gov (United States)

    Lau, Carmen

    2008-06-01

    Child prostitution is an old, global and complex phenomenon, which deprives children of their childhood, human rights and dignity. Child prostitution can be seen as the commercial sexual exploitation of children involving an element of forced labour, and thus can be considered as a contemporary form of slavery. Globally, child prostitution is reported to be a common problem in Central and South America and Asia. Of all the south-east Asian nations, the problem is most prolific in Thailand. In Thailand, there appears to be a long history of child prostitution, and this article explores the factors that underpin the Thai child sex industry and the lessons and implications that can be drawn for health care and nursing around the world.

  18. The management of anterior tooth wear using gold palatal veneers in canine guidance.

    Science.gov (United States)

    Eliyas, S; Martin, N

    2013-03-01

    Localised anterior tooth wear can be managed using minimally invasive techniques with conservation of tooth structure and preservation of pulp vitality. This article describes and illustrates with two clinical cases, the management of localised tooth wear, with the restoration of canine guidance by a combination of gold palatal veneers and direct composite restorations.

  19. Child, parent, and parent-child emotion narratives: implications for developmental psychopathology.

    Science.gov (United States)

    Oppenheim, David

    2006-01-01

    Studies using narratives with children and parents offer ways to study affective meaning-making processes that are central in many theories of developmental psychopathology. This paper reviews theory regarding affective meaning making, and argues that narratives are particularly suited to examine such processes. The review of narrative studies and methods is organized into three sections according to the focus on child, parent, and parent-child narratives. Within each focus three levels of analysis are considered: (a) narrative organization and coherence, (b) narrative content, and (c) the behavior/interactions of the narrator(s). The implications of this research for developmental psychopathology and clinical work are discussed with an emphasis on parent-child jointly constructed narratives as the meeting point of individual child and parent narratives.

  20. 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...

  1. DIAGNOSTIC PROFILE IN CHILDREN PRESENTING WITH POOR SCHOLASTIC PERFORMANCE—A CLINIC BASED STUDY

    Directory of Open Access Journals (Sweden)

    Jayaprakash

    2013-02-01

    Full Text Available ABSTRACT: BACKGROUND: Learning is not a unitary process involving teacher and student. It also depends on the relationship and interplay of fami lial, psychological, educational, social and economical atmosphere in and around the child. AIM: The present study was done to formulate a diagnostic profile and compare the co-morbidity sta tus in children presenting with poor scholastic performance in a Child Guidance Clinic s et up. SETTINGS AND DESIGN: A sample of 100 children from the age of 4 years to 12 years at tending the Child Guidance Clinic under the department of Paediatrics in a medical college set u p with history of poor scholastic performance was collected. The study design was case study method. METHODS AND MATERIALS: Detailed psychological analysis was done and diagno sis was made by using the ICD – 10 diagnostic guidelines and multi axial diag nostic system. The study population was divided in to failure (group II and non failure (gr oup I groups based on the repetition of grade and the psychiatric morbidity was compared. STATISTICAL ANALYSIS: Statistical analysis was done by SPSS (Statistical Package for the Social Sc iences and chi square test. RESULTS AND CONCLUSIONS: Psychiatric morbidity was present in 42%, developmen tal disorders in 34%, Non psychiatric medical diagnosis in 25% and abnorma l psychosocial situation in 31% of the sample population. Multiple diagnoses were present in 1 6%. Comparison shows that Prevalence of psychiatric co morbidity was more in the failure group than the non failure group. Scholastic backwardness in children is a complex issue, having various causes. Each child’s problem is unique in nature. So a multi disciplinary interventi on is needed at Paediatric level itself.

  2. Child Development Associate. Child Growth and Development.

    Science.gov (United States)

    Oscar Rose Junior Coll., Midwest City, OK.

    The purpose of this Child Development Associate (CDA) training module, one of a series of 18, is to help the CDA intern understand the factors and principles which affect the total growth and development of children. Early sections of the module stipulate the module's competency-based objectives, define terms, and suggest procedures by which…

  3. Virtual Ultrasound Guidance for Inexperienced Operators

    Science.gov (United States)

    Caine, Timothy; Martin, David

    2012-01-01

    Medical ultrasound or echocardiographic studies are highly operator-dependent and generally require lengthy training and internship to perfect. To obtain quality echocardiographic images in remote environments, such as on-orbit, remote guidance of studies has been employed. This technique involves minimal training for the user, coupled with remote guidance from an expert. When real-time communication or expert guidance is not available, a more autonomous system of guiding an inexperienced operator through an ultrasound study is needed. One example would be missions beyond low Earth orbit in which the time delay inherent with communication will make remote guidance impractical. The Virtual Ultrasound Guidance system is a combination of hardware and software. The hardware portion includes, but is not limited to, video glasses that allow hands-free, full-screen viewing. The glasses also allow the operator a substantial field of view below the glasses to view and operate the ultrasound system. The software is a comprehensive video program designed to guide an inexperienced operator through a detailed ultrasound or echocardiographic study without extensive training or guidance from the ground. The program contains a detailed description using video and audio to demonstrate equipment controls, ergonomics of scanning, study protocol, and scanning guidance, including recovery from sub-optimal images. The components used in the initial validation of the system include an Apple iPod Classic third-generation as the video source, and Myvue video glasses. Initially, the program prompts the operator to power-up the ultrasound and position the patient. The operator would put on the video glasses and attach them to the video source. After turning on both devices and the ultrasound system, the audio-video guidance would then instruct on patient positioning and scanning techniques. A detailed scanning protocol follows with descriptions and reference video of each view along with

  4. Active evacuation guidance using sensor agent robot

    Science.gov (United States)

    Ise, Daiki; Mita, Akira

    2012-04-01

    Evacuation systems for buildings are designed based on event scenarios, so they are not prepared for unexpected events that are not included in the scenarios. In this paper, we propose a new active evacuation guidance system using sensor agent robots. We first introduce a Structural Health Monitoring (SHM) system to be used in conjunction with sensor agent robots for active evacuation guidance. Then the role of sensor agent robots is explained. An algorithm to immediately access the safety of the building after a large earthquake is also proposed using only the information taken by a sensor agent robot.

  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. Enhanced mission performance from autonomous instrument guidance

    DEFF Research Database (Denmark)

    Jørgensen, John Leif; Jørgensen, Peter Siegbjørn; Betto, Maurizio;

    2006-01-01

    examples of such autonomous space instrumentation. With its full autonomy, this star tracker is capable of providing, in real-time, the absolute orientation with respect to the celestial reference frame with an accuracy of a few arc seconds. This high accuracy along with the robust operations, low weight...... acquisition and pointing (PROBA). Here three applications of the mu ASC as an autonomous onboard precision guide for precision vector instrumentation are presented. These are autonomous onboard antenna guidance, telescope guidance and tracking and high accuracy and wide range laser rangers....

  7. Estudo clínico dos nevos melanocíticos congênitos na criança e no adolescente Clinical study of the congenital melanocytic naevi in the child and adolescent

    Directory of Open Access Journals (Sweden)

    Nurimar Conceição Fernandes

    2009-04-01

    Full Text Available FUNDAMENTOS: a classificação dos nevos melanocíticos congênitos (NMC e a magnitude do risco de transformação em melanoma são ainda polêmicos. OBJETIVOS: Analisar o perfil dos NMC em crianças e adolescentes no IPPMG-UFRJ segundo sexo, cor, idade, tipo clínico, localização e evolução. MATERIAL E MÉTODOS: Estudo longitudinal de coorte retrospectivo e prospectivo de 1994 a 2007; amostra de demanda espontânea e referida. RESULTADOS: 30 crianças e 30 adolescentes apresentaram 74 NMC: 60,8% (pequenos, 27% (médios, 5,4% (grandes e 6,7% (gigantes, sendo que 45,9% no sexo masculino e 54% no sexo feminino e 45,9% em brancos e 54,% em não brancos. Sexo e cor não influenciaram o tipo clínico. Dentre os pequenos e médios, 27,1% apresentaram-se no tórax e 23% na cabeça e pescoço; os grandes e gigantes no pólo cefálico, região cervical, linha média posterior e membros; 28,3% foram seguidos por mais de 10 anos, 47,3% entre três e nove anos e 24,3% por tempo inferior a três anos. Os NMC pequenos e médios se mantiveram inalterados; um grande e dois gigantes mostraram clareamento; nenhum caso desenvolveu melanoma. CONCLUSÃO: distribuição homogênea entre brancos/não brancos e sexo masculino/ feminino. O sexo e a cor não tiveram relação com o tipo clínico; os NMC pequenos predominaram com localização preferencial no tronco.BACKGROUND: The classification of the congenital melanocytic nevus (CMN and the magnitude of the risk of transformation into melanoma are still controversal. OBJECTIVE: To analyse the profile of the CMN in the child and teenager at IPPMG-UFRJ according to sex, skin colour, age, clinical type, locations and evolution. METHODS: Longitudinal study of retrospective and prospective cohort from 1994 to 2007. Aleatoric sample from spontaneous or referal demand. RESULTS: 30 children and 30 teenagers showed 74 nevi: 60,8% (small, 27% (medium, 5,4% (large and 6,7% (giant; from these, 45,9% were in the male sex and

  8. 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.

  9. Child maltreatment in India.

    Science.gov (United States)

    Singhi, Pratibha; Saini, Arushi Gahlot; Malhi, Prabhjot

    2013-11-01

    Child maltreatment is a global problem but is more difficult to assess and manage in developing countries such as India where one-fifth of the world's total child population resides. Certain forms of maltreatment such as feticide, infanticide, abandonment, child labour, street-begging, corporal punishment and battered babies are particularly prevalent in India. Most physicians still need to be sensitized in order to suspect child abuse on the basis of unexplained trauma, multiple fractures, parental conflict and other corroborative evidence. This article summarizes the various aspects of this major problem in resource-poor settings in the hope that it will assist in the planning of services addressing child physical and sexual abuse and neglect in India and in other developing countries. A culture of non-violence towards children needs to be built into communities in order to provide an environment conducive to the overall development of the child. Rehabilitation of abused children and their families requires a multi-disciplinary service including paediatricians, child psychologists and social workers, and the training of police forces in how to tackle the problem.

  10. Clinical significance and changes of platelet parameter in child patients with pneumonia%肺炎患儿血小板参数的变化及其临床意义

    Institute of Scientific and Technical Information of China (English)

    蒲秀红; 孔春新; 郭晓清; 安涛; 邱萌; 李茜; 吴琼

    2012-01-01

    目的 观察细菌、病毒、支原体所致轻、重症肺炎患儿血小板参数的变化并分析其临床意义.方法 回顾性研究2010年11月-2012年3月我科收治的180例细菌性、病毒性及支原体肺炎(各60例,其中重症肺炎62例,轻症肺炎118例)急性期和恢复期血小板计数(PLT)、血小板压积(PCT)、平均血小板体积(MPV)、血小板宽度(PDW)的变化,并与50例对照组进行比较.结果 三组肺炎患儿血小板参数均高于对照组,细菌性肺炎组患儿血小板参数明显高于病毒性肺炎组和支原体肺炎组(P<0.01);急性期重症肺炎患儿血小板参数明显高于轻症肺炎者(P<0.01),且两者均明显高于对照组;恢复期重症及轻症肺炎患儿血小板参数均明显降低,与对照组无差异.结论 肺炎患儿血小板数量及功能状态通常异常,以细菌性肺炎更易于发生;血小板参数的变化可作为肺炎严重程度及病情变化的一项参考指标.%Objective To investigate the changes and analyze the clinical significance of platelet parameter in child patients with pneumonia caused by microbe, virus and mycoplasma. Methods The medical records of 180 child patients ( including 62 cases of severe pneumonia, 118 cases of mild pneumonia) with microbial, viral and mycoplasma pneumonia from December 2010 to March 2011 were retrospectively reviewed ( including 60 cases of microbial pneumonia, 60 cases of viral pneumonia and 60 cases of mycoplasma pneumonia). The changes of platelet parameters such as platelet count ( PLT) , platelet hematocrit (PCT) , mean platelet volume (MPV) and platelet distribution width (PDW) in acute stage and in convalescence stage of patients with pneumonia were observed and compared with 50 cases normal control group. Results The platelet parameters of microbial pneumonia group, viral pneumonia group and mycoplasma pneumonia group were significantly higher than those of normal control group ( P < 0. 01 ) . The

  11. 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.

  12. Guidance for performing site inspections under CERCLA

    Energy Technology Data Exchange (ETDEWEB)

    1992-09-01

    This guidance presents EPA`s site inspection (SI) strategy. The strategy discusses procedural guidelines to investigate potential Superfund (CERCLA) sites for evaluation pursuant to the Hazard Ranking System (HRS), revised in accordance with the Superfund Amendments and Reauthorization Act of 1986. The HRS is the primary means by which EPA evaluates sites for superfund`s National Priorities List (NPL).

  13. 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 ...

  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. Cannabinoid receptor CB2 modulates axon guidance

    DEFF Research Database (Denmark)

    Duff, Gabriel; Argaw, Anteneh; Cecyre, Bruno

    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 ...

  16. MR Thermometry for guidance of thermal therapy

    NARCIS (Netherlands)

    Sprinkhuizen, S.M.

    2010-01-01

    The research described in this thesis has aimed to further investigate magnetic resonance (MR) thermometry (MRT) techniques as to become a reliable guidance tool for thermal therapy. The various physical processes allowing for temperature measurements based upon the MR signal are described. It is de

  17. 33 CFR 385.5 - Guidance memoranda.

    Science.gov (United States)

    2010-07-01

    ... 33 Navigation and Navigable Waters 3 2010-07-01 2010-07-01 false Guidance memoranda. 385.5 Section 385.5 Navigation and Navigable Waters CORPS OF ENGINEERS, DEPARTMENT OF THE ARMY, DEPARTMENT OF DEFENSE PROGRAMMATIC REGULATIONS FOR THE COMPREHENSIVE EVERGLADES RESTORATION PLAN General...

  18. Guidance on Port Biological Baseline Surveys (PBBS)

    Digital Repository Service at National Institute of Oceanography (India)

    Awad, A.; Haag, F.; Anil, A.C.; Abdulla, A.

    This publication has been prepared by GBP, IOI, CSIR-NIO and IUCN in order to serve as guidance to those who are planning to carry out a port biological baseline survey, in particular in the context of Ballast Water Management. It has been drafted...

  19. 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.

  20. Hypermedia Authoring with Writing Process Guidance

    Science.gov (United States)

    Chang, Kuo-En; Sung, Yao-Ting; Zheng, Jie-Wen

    2007-01-01

    A writing process of five stages, setting the topic and goals, planning the outline, organising the structure, building the content, and reviewing, is proposed to guide hypermedia authoring. To explore the effects of the system designed with writing-process guidance, this study enrolled 108 seventh graders at a junior high school as experimental…