WorldWideScience

Sample records for experience du centre

  1. Le Pseudomonas: Experience du Centre des Brules D’Annaba et Revue de la Litterature

    Science.gov (United States)

    Chaibdraa, A.; Medjellekh, M.S.; Saouli, A.; Bentakouk, M.C.

    2008-01-01

    Summary Le Pseudomonasest un agent pathogène à l'origine d'infections nosocomiales graves dans les centres des brûlés. Son opportunisme et sa virulence en font une préoccupation majeure. Ce travail se propose d'évaluer la place de cette bactérie dans l'écologie bactérienne locale et d'en apprécier la sensibilité aux antibiotiques. Cette étude rétrospective préliminaire porte sur la période de juin 2003 à décembre 2005. Elle intéresse l'ensemble des prélèvements bactériologiques ayant pu être réalisés au centre des brûlés d'Annaba. L'effectif est de 633 micro-organismes isolés dont 128 Pseudomonas (20,2%): 127 aeruginosa (99,2%), 1 fluorescens (0,8%); distribution selon le site de prélèvement: écouvillon (87,5%), prélèvement trachéobronchique (4,6%), hémoculture (3,1%), cathéters (1,6%), urine (1,6%) et sonde urinaire (1,6%). Le pyocyanique se situe après le staphylocoque pour les prélèvements précoces et repasse en tête après un séjour supérieur à une semaine, où 89% des pyocyaniques sont identifiés. Il est en première position dans les pneumopathies sous ventilation assistée invasive. Il se classe troisième dans les hémocultures et les cultures de cathéters. Dans les infections urinaires il est devancé par Candida et la flore périnéale. Les 128 antibiogrammes regroupent 314 réponses sensibles. La sensibilité à plus de deux antibiotiques est de 68%, à deux antibiotiques 24% et à un antibiotique 8%. Seules quatre molécules restent actives: ciprofloxacine > péfloxacine > pipéracilline > ceftazidime. Une résistance absolue est retrouvée pour trois Pseudomonas (2,4%). Le pronostic sévère des infections nosocomiales à pyocyanique et les risques d'options thérapeutiques très limitées font toute leur gravité, d'où l'intérêt de respecter des règles strictes de prescription des antibiotiques et des mesures de prévention. PMID:21991140

  2. Le Centre du Mali : épicentre du djihadisme?

    NARCIS (Netherlands)

    Sangaré, B.

    2016-01-01

    La multiplication d'épisodes violents dans le centre du Mali, depuis la moitié de l'année 2015, démontre à quel point la paix reste fragile dans ce pays. La signature des accords pour la paix et l'amorce d'un processus de réconciliation ont certes marqué une avancée pour le gouvernement, mais la

  3. Coordonnateur du bureau d'assistance | CRDI - Centre de ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    ... d'utilisation des logiciels et du matériel informatique du Centre. Il tient un inventaire exact de l'équipement distribué à chaque membre du personnel et il travaille avec le personnel de la SSC à faire en sorte que les fichiers de maintenance contenus dans l'application de gestion du Bureau d'assistance soient tenus à jour.

  4. Gestion du Centre | CRDI - Centre de recherches pour le ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    Lisa Woodward. Conseillère spéciale au Président. Ottawa, ON, Canada. Ce que nous faisons · Financement · Ressources · À propos du CRDI. Savoir. Innovation. Solutions. Carrières · Communiquez avec nous · Plan du site. Abonnez-vous à notre bulletin pour recevoir les nouvelles du CRDI chaque mois. Abonnez-vous.

  5. La Greffe de Peau dans le Traitement des Sequelles de la Main Brulee. A Propos de 152 Cas - Experience du Service de Chirurgie Plastique du Centre Hospitalier Universitaire Ibn-Sina, Rabat, Maroc

    Science.gov (United States)

    El Mazouz, S.; Fejjal, N.; Hafidi, J.; Cherkab, L.; Mejjati, H.; Belfqih, R.; Gharib, N.; Abbassi, A.

    2010-01-01

    Summary La main est fréquemment exposée aux brûlures, entraînant des séquelles esthétiques et fonctionnelles. Le traitement de ces séquelles est surtout chirurgical et consiste en la greffe de peau, dont le type dépend de la localisation de la brûlure et du type des séquelles. Dans ce travail rétrospectif, nous rapportons une série de 152 cas de brûlures des mains colligés au service de chirurgie plastique du Centre Hospitalier Universitaire Ibn-Sina de Rabat sur une période de dix ans, allant de 1998 à 2007. Les indications thérapeutiques dépendent du type de séquelles et de la localisation de la brûlure. En tout, 97 patients ont bénéficié d'une greffe cutanée, dont 76% par greffe de peau totale, 21% par greffe de peau demi-épaisse et 3% par peau fine. Les séquelles des brûlures des mains posent un problème thérapeutique majeur, malgré la diversité des procédés chirurgicaux, d'où l'intérêt de la prévention. PMID:21991196

  6. Nouvelles du Centre Aéré de l’Association du Personnel du CERN

    CERN Multimedia

    Jardin d'enfants

    2015-01-01

    Cet été 2015, durant quatre semaines d’été, le Centre Aéré a accueilli plus de 40 enfants âgés de 4 à 6 ans. Devant le succès rencontré, et à la demande des parents, il a été décidé d’en doubler la capacité maximale. A l'été 2016, du 4 au 29 juillet, la structure pourra accueillir les enfants de 4 ans révolus et de moins de 7 ans (nés après le 31/07/2009 mais avant  01/07/2012). Les inscriptions se feront à la semaine durant le mois d'Avril 2016. Les programmes sont en cours d'élaboration cependant nous pouvons déjà vous communiquer le thème conducteur du centre qui sera : à la découverte d'un continent différent chaque ...

  7. Directeur, Gestion du risque et audit interne | CRDI - Centre de ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    application de normes professionnelles, de méthodes rigoureuses et de pratiques exemplaires, et par la prise en compte des objectifs stratégiques du Centre, de ses politiques et procédures ainsi que des contextes complexes où il exerce son ...

  8. Experiences of Telebased Information Centres

    DEFF Research Database (Denmark)

    Falch, Morten

    1999-01-01

    Tele-based information community centres or just tele-centres have been seen as the killer application to empower local communities in developed and developing countries to meet the challenges of the information society. This paper will present a number of models for introducing such centres...... and discuss the different models and national strategies used for setting up tele-based information in relation to the Ghana experience....

  9. Politique sociale en Afrique de l'Ouest et du Centre | CRDI - Centre ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    Philosophe et anthropologue médical, l'auteur Hamadou Konate est de nationalité malienne. Il a participé à plusieurs études sur les soins de santé primaires et l'enfance en situation difficile en Afrique de l'Ouest et du Centre, dans certains cas en qualité de directeur. Il a été directeur national des Affaires sociales du Mali ...

  10. Gouvernance du secteur gazier au Liban | CRDI - Centre de ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    Voix de la jeunesse arabe : Défis et conséquences de l'exclusion. Les soulèvements dans les pays du Moyen-Orient pendant le « Printemps arabe » et l'instabilité continue dans la région mettent au centre de l'attention publique les difficultés que... Voir davantageVoix de la jeunesse arabe : Défis et conséquences de l' ...

  11. Urgences traumatologiques dans un centre hospitalier regional du ...

    African Journals Online (AJOL)

    Objectifs : étudier la fréquence des urgences traumatiques admises au Centre Hospitalier Régional de Tsévié (CHR TSEVIE) au cours de l'année 2008 ; décrire les causes et la nature des lésions ; évaluer le traitement administré. Méthodolgie : Une étude prospective a été conduite au service de chirurgie du CHR TSEVIE ...

  12. Du flux et du reflux de l'usage du tabac | CRDI - Centre de ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    14 déc. 2010 ... Le CRDI, grâce à des fonds de Santé Canada, appuie une étude économique qui aide le gouvernement de la Jamaïque à réfuter les arguments de ... Faculté des sciences économiques à l'Université du Cap, en collaboration avec Eva Lewis-Fuller et ses collègues du ministère de la Santé de la Jamaïque.

  13. Études par pays dans le cadre du HIV/AIDS Monitor | CRDI - Centre ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    Le HIV/AIDS Monitor a pour objectif d'accroître l'efficacité de trois grandes initiatives, à savoir celles du Fonds mondial de lutte contre le sida, la tuberculose et le paludisme, du President's Emergency Plan for Aids et de la Banque mondiale. Sous la direction du Centre for Global Development, les chercheurs examineront ...

  14. Laparoscopic adrenalectomy: Single centre experience.

    LENUS (Irish Health Repository)

    O'Farrell, N J

    2012-02-01

    BACKGROUND: Laparoscopic adrenalectomy is an attractive alternative to the traditional open approach in the surgical excision of an adrenal gland. It has replaced open adrenalectomy in our institution and we review our experience to date. METHODS: All cases of laparoscopic adrenalectomies in our hospital over eight years (from 2001 to May 2009) were retrospectively reviewed. Patient demographics, diagnosis, length of hospital stay, histology and all operative and post-operative details were evaluated. RESULTS: Fifty-five laparoscopic adrenalectomies (LA) were performed on 51 patients over eight years. The mean age was 48 years (Range 16-86 years) with the male: female ratio 1:2. Twenty-three cases had a right adrenalectomy, 24 had a left adrenalectomy and the remaining four patients had bilateral adrenalectomies. 91% were successfully completed laparoscopically with five converted to an open approach. Adenomas (functional and non functional) were the leading indication for LA, followed by phaeochromocytomas. Other indications for LA included Cushing\\'s disease, adrenal malignancies and rarer pathologies. There was one mortality from necrotising pancreatitis following a left adrenalectomy for severe Cushing\\'s disease, with subsequent death 10 days later. CONCLUSION: Laparoscopic adrenalectomy is effective for the treatment of adrenal tumours, fulfilling the criteria for the ideal minimally invasive procedure. It has replaced the traditional open approach in our centre and is a safe and effective alternative. However, in the case of severe Cushing\\'s disease, laparoscopic adrenalectomy has the potential for significant adverse outcomes and mortality.

  15. Utilisation du site Web | CRDI - Centre de recherches pour le ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    Savoir. Innovation. Solutions. Carrières · Communiquez avec nous · Plan du site. Abonnez-vous à notre bulletin pour recevoir les nouvelles du CRDI chaque mois. Abonnez-vous · Droits d'auteur · Éthique de la recherche · Politique de libre accès · Politique de confidentialité · Transparence · Utilisation du site Web. Suivez- ...

  16. Le guide du consommateur sur la concurrence | CRDI - Centre de ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    Savoir. Innovation. Solutions. Carrières · Communiquez avec nous · Plan du site. Abonnez-vous à notre bulletin pour recevoir les nouvelles du CRDI chaque mois. Abonnez-vous · Droits d'auteur · Éthique de la recherche · Politique de libre accès · Politique de confidentialité · Transparence · Utilisation du site Web. Suivez- ...

  17. Évolution des infrastructures techniques du centre de calcul en vue du LHC (2001-2009)

    CERN Document Server

    Funken, A

    2005-01-01

    Au milieu de l’année 1999, le projet de renforcement des infrastructures techniques du Centre de Calcul a été lancé afin de répondre aux besoins des Fermes de Calculs destinées au traitement et stockage des données des expériences du LHC. En 2008, première année de fonctionnement du LHC à pleine luminosité, les Fermes de Calculs devraient occuper 2500 m2 et consommer une puissance électrique de 2.5 MW. Les infrastructures techniques du bâtiment datant des années 70 ne permettaient pas de répondre aux nouvelles demandes tant en termes de puissance que de disponibilité des services. Après avoir présenté les particularités de la charge, composée exclusivement d’alimentations à découpage monophasées, cet article décrit successivement les exigences de l’utilisateur en terme de continuité de fonctionnement du Centre de Calcul, les options étudiées pour y répondre et la solution retenue. La situation du projet est ensuite présentée: les étapes réalisées, en cours et à venir.

  18. Creation du Centre Sesame un pas en avant pour la cooperation scientifique dans la region du Moyen-Orient

    CERN Multimedia

    2003-01-01

    "Le projet SESAME (Centre international de rayonnement synchrotron pour les sciences experimentales et appliquees au Moyen-Orient) vient de franchir deux etapes importantes: la pose de la premiere pierre et l'acceptation des statuts du projet par sept membres" (1 page).

  19. Secrétaire adjoint du centre (h/f) | CRDI - Centre de recherches pour ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    Soutien en matière de gouvernance et du secrétariat général au Conseil, aux comités du Conseil et au CGC : Superviser la gestion de la planification ... Superviser l'administration du portail électronique du Conseil et la diffusion des documents de la direction au Conseil et aux comités du Conseil. Examiner les divulgations ...

  20. L'Afrique, nouvel Eldorado du commerce | CRDI - Centre de ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    5 déc. 2013 ... Il est directeur du Perimeter Institute for Theoretical Physics, où il est également titulaire de la chaire Mike and Ophelia Lazaridis Niels Bohr. Thierry Zomahoun, M.B.A., M.Ph., est directeur général de l'AIMS Next Einstein Initiative (AIMS-NEI) et directeur du secrétariat mondial d'AIMS. Cet article a été publié ...

  1. La décentralisation fait du tort aux Soudanaises | CRDI - Centre de ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    5 nov. 2010 ... Au Soudan, et particulièrement au Darfour et dans d'autres États du sud, il est fréquent que des femmes meurent par suite d'un travail ou d'un accouchement difficile, précise Asha Elkarib, directrice du centre. Près de la moitié des Soudanaises (48 %) accouchent sans le soutien d'un professionnel de la ...

  2. Sud du Sahara | Page 2 | CRDI - Centre de recherches pour le ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    Le Community Work Programme (CWP) de l'Afrique du Sud vise la réduction de la pauvreté, mais des chercheurs ont constaté qu'il a aussi l'effet inattendu de ... Ces examens constituent le principal outil de reddition de comptes du Centre, car ils permettent de démontrer les résultats obtenus grâce aux dépenses de ...

  3. Afrique du Sud | CRDI - Centre de recherches pour le ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    Dans les Cape Flats, bande de terrain plat qui s'avance dans l'océan à l'extérieur de la ville du Cap, des chercheurs ont cerné de meilleures manières de faire face aux inondations. Leurs travaux ont incité la municipalité à collaborer plus étroitement avec les collectivités et les organismes de la société civile pour trouver ...

  4. Coordonnateur du Bureau d'assistance | CRDI - Centre de ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    Organiser et entretenir l'équipement affecté en prêt et classer les formulaires Autorisation d'accès aux systèmes d'information du CRDI dûment approuvés et dresser l'inventaire de l'équipement à louer (portables, logiciels exploités à domicile sous licence, disques rigides transportables, etc.), veiller à sa disponibilité et ...

  5. Calibration of the cameras of the H.E.S.S. {gamma}-ray astronomy experiment and observations of the Galactic Centre above 100 GeV; Etalonnage des cameras de l'experience d'astronomie {gamma} H.E.S.S. et observations du centre galactique au-dela de 100 GeV

    Energy Technology Data Exchange (ETDEWEB)

    Rolland, L

    2005-05-15

    The H.E.S.S. experiment (High Energy Stereoscopic System) consists of four imaging atmospheric Cherenkov telescopes to study the southern astrophysical sources above 100 GeV. This thesis presents the detector as well as the analysis chain. The calibration methods are described in details and the systematic errors on the image amplitude are derived. Then, an analysis based on a semi-analytical model of the electromagnetic shower development in the atmosphere is presented. Tools to reconstruct the energy spectrum and the morphology of the very high energy {gamma}-ray sources are presented and applied to the Crab Nebula. Systematic errors associated to the spectrum analysis are estimated. All these techniques were applied to study the Galactic Centre emission above 100 GeV. The nature of the source detected in 2003 and 2004 observations is still unknown and its spectrum, variability and morphology are studied. Various candidates are proposed, among them the supermassive black hole Sgr A* located at the dynamical centre of the Milky Way, the supernova remnant Sgr A Est or interactions of accelerated particles with the dense medium of this region. In this thesis, the signal was interpreted in terms of dark matter annihilation (neutralinos or Kaluza-Klein bosons) in a dense halo located at the Galactic Centre. This analysis showed that, in the framework of these models, dark matter annihilation alone can not explain the H.E.S.S. signal. The main component would thus come from astrophysical sources. (author)

  6. Communication du changement à la COP22 | CRDI - Centre de ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    19 déc. 2016 ... Le CRDI a organisé neuf séances dans le cadre de la 22e Conférence des Parties (COP22) à la CCNUCC qui s'est tenue du 7 au 18 novembre 2016, à Marrakech. L'Accord de Paris ayant été ratifié et son entrée en vigueur ayant été prévue pour la veille de l'ouverture de la COP 22, la Convention a ...

  7. À propos du CRDI | CRDI - Centre de recherches pour le ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    Le Centre de recherches pour le développement international (CRDI) finance des travaux de recherche dans les pays en développement afin d'y favoriser la croissance, de réduire la pauvreté et d'impulser des changements positifs à grande échelle.

  8. Anemie du Premature et Pratiques Transfusionnelles au Centre ...

    African Journals Online (AJOL)

    né prématuré. Notre étude a porté sur 2 ans de janvier 1997 à 1999. Tous nouveau-nés de moins de 37 semaines hospi- talisés au Centre Hospitalier ..... référence, les parturientes étaient adressées par les materni- tés périphériques vers le CHU pour accoucher. La rupture prolongée des membranes (35%) et de la ...

  9. Chef de cabinet, bureau du président (h/f) | CRDI - Centre de ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    Définir et recommander des activités et des interactions avec des intervenants extérieurs au Centre (ministères du gouvernement fédéral, dignitaires ... Au moyen de notes d'information verbales ou écrites, informer et conseiller le président au sujet des tendances ou des politiques qui pourraient, actuellement ou à l'avenir, ...

  10. Cartes infographiques du Symposium Afrique de l'Ouest et du Centre

    International Development Research Centre (IDRC) Digital Library (Canada)

    fdieudonne

    Moteurs d'exclusion, de criminalité et de Violence. Défis pour des Villes Sûres et inclusives en République démocratique du Congo, Côte d'Ivoire et Ghana. 2. > 4 > N. 2°. Vulnérabilité des Manque Manque d'accès Crime juvénile jeunes marginalisés | d'infrastructures à la justice et la etgangstérisme dès par la pauvreté et ...

  11. Training science centre Explainers. The Techniquest experience

    Directory of Open Access Journals (Sweden)

    Colin Johnson

    2005-12-01

    Full Text Available Techniquest was established in 1986, and in 1995 moved to its current premises at Cardiff Bay, South Wales. This was the first purpose-built science centre in the UK. It receives around 200,000 visitors every year to its exhibition, and to its programmes for schools and public audiences in the theatre, laboratory, discovery room and planetarium. The author joined the Techniquest project in 1985, became a staff member in 1990 and was the Chief Executive from 1997 until his retirement in 2004. Techniquest has three “out-stations” in Wales, and is responsible for the supply and maintenance of exhibits to the Look Out Discovery Centre in Bracknell, England. There is a Techniquest gallery at the Lisbon Pavilhão do Conhecimento - Ciência Viva, and a traveling exhibition, SciQuest, in South Africa which was also supplied by Techniquest. All these centres rely on the effective intervention of “Explainers” (at Techniquest we call them “Helpers” to provide the best possible experience for visitors. At its most demanding, the tasks of an Explainer are varied and intensive, yet there may be times when the duties are mundane or even dull. When you rely on people to act as both hosts and housekeepers, to provide both support and stimulus, and to be both welcoming and watchful, you are asking a great deal. This article raises some of the issues concerned with the recruitment and retention of Explainers, their training and management, and the way in which their role is recognized and valued by the science centre as a whole.

  12. Au milieu du monde : le centre et ses réseaux

    Directory of Open Access Journals (Sweden)

    Denise Pumain

    2001-10-01

    Full Text Available Une rentrée universitaire est toujours un temps fort pour le rassemblement des géographes. Chaque réseau se choisit un centre, temporaire ou récurrent, un lieu de rencontre qui tout ensemble matérialise et symbolise la nécessité du contact humain et de l'être là, pour la communication scientifique : Saint-Valéry-en-Caux, 12e Colloque Européen de Géographie Théorique et Quantitative, Montpellier, Ecole Thématique du CNRS sur les modèles et la simulation, Montpellier encore, journées Cassini (G...

  13. La sierra du nord et du centre en Equateur: 1830-1875

    Directory of Open Access Journals (Sweden)

    1984-01-01

    Full Text Available Après les guerres de l'indépendance, la sierra équatorienne est dans une situation catastrophique, sur le plan démographique, économique et ... politique. Les décennies qui suivent 1830 sont une période de récupération lente et mouvementée. La région septentrionale et centrale, qui se développe de façon assez autonome, voit alors les débuts de profondes transformations: l'hacienda entre en compétition avec les paysans-artisans qui tentent, sans espoir, de résister à une structure qui dispose évidemment de l'appui du pouvoir politique. Les activités traditionnelles reculent au profit de l'élevage et les prémices d'un développement industriel à partir des haciendas se laissent entrevoir. L'administration de García Moreno (1859-1875 enfin, tente de désenclaver la région et d'organiser l'Etat National. Después de las guerras de independencia, la sierra ecuatoriana se encuentra en un estado pésimo demográfica, económica y políticamente. Las décadas posteriores a 1830 aparecen como un período de recuperación lenta y atormentada. La región septentrional y central, que se desarrolla de manera bastante autónoma, conoció entonces los principios de profundas transformaciones: la hacienda compite con los campesinos - artesanos que intentan, sin grandes esperanzas, resistir a una estructura que se beneficia del apoyo gubernamental. Mientras van apareciendo las primicias de un desarrollo industrial que parte de las haciendas, las actividades tradicionales van perdiendo importancia ante la ganadería. Por fin, la administración de García Moreno (1859 - 1875 trata de sacar a la región de su enclave y de organizar el Estado Nacional.

  14. Comment meurent les pumas: du mythe au rite à Huaraz (Centre-nord du Pérou

    Directory of Open Access Journals (Sweden)

    1997-01-01

    Full Text Available Cet article présente quelques éléments ethnographiques nouveaux à propos du symbolisme du puma dans les Andes. En partant de discours recueillis en quechua dans la région de Huaraz (Centre-Nord du Pérou, nous dégageons tout d’abord la perception collective de cet animal. Ensuite, à l’aide d’un mythe, également présenté en quechua, nous montrons que le puma est une représentation symbolique des ancêtres. Ces discours nous livrent le contexte qui permet de comprendre la fonction symbolique de la graisse de puma, ainsi qu’un rite de passage occasionnel au moment de la mort. CÓMO MUEREN LOS PUMAS: DEL MITO AL RITO EN HUARAZ (CENTRO-NORTE DEL PERÚ. Este artículo presenta algunos nuevos datos etnográficos acerca del simbolismo del puma en los Andes. A partir de relatos en quechua, recogidos en la zona de Huaraz (centro-norte de Perú, sacamos a luz la percepción colectiva de este animal. Luego, un mito, también presentado en quechua, nos ayuda a mostrar que el puma es una representación simbólica de los antepasados. Estos textos ofrecen un contexto que permite entender la función simbólica de la grasa de puma, así como un ritual ocasional que se lleva a cabo en el momento de la muerte. HOW PUMAS DIE: MYTH AND RITUAL IN HUARAZ (CENTRAL NORTHERN PERU. This paper presents new ethnographic data on puma symbolism in the Andes. Through samples of speech collected in Quechua in the area of Huaraz (central-northern Peru, I first describe how the animal is collectively perceived. Next, I analyze a myth, also in Quechua, which shows that the puma is a symbolic representation of the ancestors. This above provides the key which enables us to understand the symbolic value of puma fat, as well as an infrequent ritual which is carried out at the moment of death.

  15. Préparer l'Afrique du Sud à la démocratie | CRDI - Centre de ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    27 oct. 2010 ... Ivan Head, président du CRDI à l'époque, estimait que le Centre devait porter son regard au-delà de la chute de l'apartheid et se demander quel genre de gouvernement remplacerait ce régime. La nouvelle Afrique du Sud jouerait-elle un rôle important dans une économie mondiale ouverte ?

  16. Asie du sud | Page 8 | CRDI - Centre de recherches pour le ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    Asie du sud. Asie du sud. Read more about Réglementation du marché du travail en Chine : politiques en matière de salaire minimum. Langue French. Read more about Évolution démographique asymétrique et gouvernance financière mondiale. Langue French. Read more about Asymmetric Demography and Global ...

  17. Sud du Sahara | Page 96 | CRDI - Centre de recherches pour le ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    Sud du Sahara. Sud du Sahara. Read more about Implementation of an Electronic Strategy in Bénin. Langue English. Read more about E-Stratégie du Bénin : programme de recherches multidisciplinaires d'appui à sa mise en oeuvre. Langue French. Read more about Libéralisation du commerce des biens et services TIC ...

  18. Sud du Sahara | Page 74 | CRDI - Centre de recherches pour le ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    Sud du Sahara. Sud du Sahara. Read more about Bamboo Production : Livelihood Diversification for Smallholder Tobacco Farmers in South Nyanza, Kenya - Phase II. Langue English. Read more about Culture du bambou : diversification des moyens de subsistance des petits producteurs de tabac du sud de la province ...

  19. Concomitant bid radiotherapy with cisplatin and 5-fluorouracil in unresectable carcinoma of the pharynx: 10 year's experience at the Centre Antoine Lacassagne; Radiotherapie bifractionnee et chimiotherapie par cisplatine et 5-fluoro-uracile concomitantes dans les carcinomes epidermoides localement evolues non resecables du pharynx: dix ans d'experience au centre Antoine Lacassagne

    Energy Technology Data Exchange (ETDEWEB)

    Magne, N.; Pivot, X.; Marcy, P.Y.; Chauvel, P.; Courdi, A.; Dassonville, O.; Possonnet, G.; Vallicioni, J.; Ettore, F.; Falewee, M.N.; Milano, G.; Santini, J.; Lagrange, J.L.; Schneider, M.; Demard, F.; Bensadoun, R.J. [Centre Antoine-Lacassagne, 06 - Nice (France)

    2001-08-01

    Patients suffering from locally advanced unresectable squamous cell carcinoma of the oropharynx and hypopharynx treated with radiotherapy alone have a poor prognosis. More than 70% of patients die within 5 years mainly due to local recurrences. The aim of this study was to evaluate retrospectively the Antoine Lacassagne Cancer Center's experience in a treatment by concomitant bid radiotherapy and chemotherapy. Evaluation was based on analysis of the toxicity, the response rates, the survival, and the clinical prognostic factors. From 1992 to 2000, 92 consecutive patients were treated in our single institution. All of them had stage IV, unresectable squamous cell carcinoma of the pharynx and they received continuous bid radiotherapy (two daily fractions of 1.2 Gy, 5 days a week, with a 6-h minimal internal between fractions). Total radiotherapy dose was 80.4 Gy on the oropharynx and 75.6 Gy on the hypopharynx. Two or three chemotherapy courses of cisplatin (CP)-5-fluorouracil (5FU) were given during radiotherapy at 21 -day intervals (third not delivered after the end of the radiotherapy). CP dose was 100 mg/m{sup 2} (day 1) and 5-FU was given as 6-day continuous infusion (750 mg/m{sup 2}/day at 1. course; 430 mg/m{sup 2}/day at 2. and 3. courses). Special attention was paid to supportive care, particularly in terms of enteral nutrition and mucositis prevention by low-level laser energy. Acute toxicity was marked and included WHO grade III/IV mucositis (89%, 16% of them being grade IV), WHO grade III dermatitis (72%) and grade III/IV neutropenia (61%). This toxicity was significant but manageable with optimised supportive care, and never led to interruption of treatment for more than 1 week, although there were two toxic deaths. Complete global response rate at 6 months was 74%. Overall global survival at 1 and 3 years was 72% and 50% respectively, with a median follow-up of 17 months. Prognostic factors for overall were the Karnofsky index (71% survival at 3

  20. Renouvellement urbain et revalorisation des espaces publics dans un City Improvement District du centre ville de Johannesburg

    Directory of Open Access Journals (Sweden)

    Elisabeth Peyroux

    2010-09-01

    Full Text Available Illustration 1 - Gandhi Square Auteur : Juliana Irene Smith, spectacle « Super Green Apple Girl », octobre 2006.Gandhi Square (ex-Van der Bijl Square illustre les stratégies de renouvellement urbain mises en place à Johannesburg dans le cadre de Partenariats Public-Privé. Ancien symbole de la ségrégation du système de transport sous l’apartheid, ce terminal de bus du Central Business District, affecté par le déclin économique et la dégradation du centre-ville pendant les années 1990, fait au...

  1. Le Centre de recherches pour le développement international du ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    CRDI) du Canada, Jean Lebel, a annoncé aujourd'hui que le CRDI se joindra à la délégation officielle du gouvernement du Canada qui participera à la 21e Conférence des Parties (COP21) organisée dans le cadre de la ...

  2. Student-Centred Experiments with Stream Invertebrates

    Science.gov (United States)

    Vaughan, Ian; Larsen, Stefano; Durance, Isabelle; Ormerod, Steve

    2011-01-01

    Field experiments are at the core of ecology, yet rarely find their way into education, probably due to a combination of technical challenges and risks associated with fieldwork. This may compromise student education and perception of the subject, making interesting, readily manageable experiments extremely important. We describe how the daily…

  3. The experience of work in a call centre environment

    Directory of Open Access Journals (Sweden)

    Sanet Hauptfleisch

    2006-02-01

    Full Text Available This qualitative research study explored the work experience in a call centre environment in an information technology call centre based in South Africa, which service foreign customers exclusively. Three data collection methods were used, namely narratives, in-depth interviews with call centre consultants, and observation. Following a grounded theory approach, four themes were elicited, namely the perceptions of team members, uncertainty created by a constantly changing environment, perceived distances due to management practices, and depersonalisation experienced while actually dealing with customers. In addition to this, the reported impact of these themes on work performance was explored and compared to existing research.

  4. Consanguinity in Centre d'Étude du Polymorphisme Humain (CEPH) pedigrees.

    Science.gov (United States)

    Stevens, Eric L; Heckenberg, Greg; Baugher, Joseph D; Roberson, Elisha D O; Downey, Thomas J; Pevsner, Jonathan

    2012-06-01

    A set of Centre d'Étude du Polymorphisme Humain (CEPH) cell lines serves as a large reference collection that has been widely used as a benchmark for allele frequencies in the analysis of genetic variants, to create linkage maps of the human genome, to study the genetics of gene expression, to provide samples to the HapMap and 1000 Genomes projects, and for a variety of other applications. An explicit feature of the CEPH collection is that these multigenerational families represent reference panels of known relatedness, consisting mostly of three-generation pedigrees with large sibships, two parents, and grandparents. We applied identity-by-state (IBS) and identity-by-descent (IBD) methods to high-density genotype data from 186 CEPH individuals in 13 families. We identified unexpected relatedness between nominally unrelated grandparents both within and between pedigrees. For one pair, the estimated Cotterman coefficient of relatedness k1 exceeded 0.2, consistent with one-eighth sharing (eg, first-cousins). Unexpectedly, significant IBD2 values were discovered in both second-degree and parent-child relationships. These were accompanied by regions of homozygosity in the offspring, which corresponded to blocks lacking IBS0 in purportedly unrelated parents, consistent with inbreeding. Our findings support and extend a 1999 report, based on the use of short tandem-repeat polymorphisms, that several CEPH families had regions of homozygosity consistent with autozygosity. We benchmarked our IBD approach (called kcoeff) against both RELPAIR and PREST software packages. Our findings may affect the interpretation of previous studies and the design of future studies that rely on the CEPH resource.

  5. Asie du sud | Page 72 | CRDI - Centre de recherches pour le ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    Asie du sud. Asie du sud. Read more about Toward Détente in Media Piracy. Langue English. Read more about Recherche d'une détente dans le dossier du piratage des médias. Langue French. Read more about ONI-Asia - censure et surveillance numériques. Langue French. Read more about OpenNet Initiative - Asia ...

  6. Sud du Sahara | Page 9 | CRDI - Centre de recherches pour le ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    ... 7 · 8; 9; 10 · suivant › · dernier » · Ce que nous faisons · Financement · Ressources · À propos du CRDI. Savoir. Innovation. Solutions. Carrières · Communiquez avec nous · Plan du site · Droits d'auteur · Éthique de la recherche · Politique de libre accès · Politique de confidentialité · Transparence · Utilisation du site Web.

  7. Plan stratégique du CRDI | CRDI - Centre de recherches pour le ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    Savoir. Innovation. Solutions. Le plan stratégique du CRDI, Investir dans des solutions, orientera ses efforts pendant la période allant de 2015 à 2020. Misant sur l'expérience de plus de 40 ans du CRDI, le plan stratégique réitère sa vision à l'égard de la production de connaissances, du soutien à l'innovation et de la mise ...

  8. Sud du Sahara | Page 123 | CRDI - Centre de recherches pour le ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    L'indépendance du Zimbabwe a mis fin à la ségrégation raciale et à la domination coloniale. Pourtant, les espérances et les espoirs d'une amélioration radicale des conditions de vie de la majorité noire du pays restent insatisfaits. La majeure partie du logement pour les pauvres est marginale, surpeuplée et dangereuse.

  9. Le développement du secteur privé | CRDI - Centre de recherches ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    21 déc. 2010 ... Moteurs de croissance. Nombre d'organismes du milieu du développement reconnaissent que l'entrepreneuriat peut favoriser l'efficacité, créer des emplois qui permettent de réduire la pauvreté et ainsi améliorer les choses. Le CRDI est du nombre. Il reconnaît depuis longtemps la valeur de l'industrie, des ...

  10. Justice Project en Asie du Sud | CRDI - Centre de recherches pour ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    Donner la parole aux femmes - bourse de recherche sur la militarisation et les femmes en Asie du Sud destinée aux journalistes. L'Asie du Sud est la région la plus densément peuplée du monde et, selon les indicateurs de pauvreté, la deuxième plus pauvre, après l'Afrique subsaharienne. Voir davantageDonner la parole ...

  11. Le premier régime de protection sociale du Nigeria | CRDI - Centre ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    14 juin 2017 ... Une équipe de chercheurs dirigée par Damilola Olajide, Ph. D., avec la collaboration of du ministère d'État du Travail, de la Productivité et du Développement humain, a réalisé une étude visant à mesurer deux résultats du régime de prestations : la qualité de vie et la vulnérabilité des ménages.

  12. Sud du Sahara | Page 5 | CRDI - Centre de recherches pour le ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    Sud du Sahara. Sud du Sahara. Read more about Youth Employment and Migration in West Africa. Langue English. Read more about Évolution démographique asymétrique et gouvernance financière mondiale. Langue French. Read more about Asymmetric Demography and Global Financial Governance. Langue English.

  13. Sud du Sahara | Page 95 | CRDI - Centre de recherches pour le ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    Sud du Sahara. Sud du Sahara. Read more about Modèle d'édition et autre modèle d'octroi de licences (PALM Africa). Langue French. Read more about Publishing and Alternative Licensing Model of Africa (PALM Africa). Langue English. Read more about Strategic Action Plan for ERNWACA - 2007-2011. Langue English.

  14. Asie du sud | Page 50 | CRDI - Centre de recherches pour le ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    Asie du sud. Asie du sud. Read more about Transferts intergénérationnels, vieillissement de la population et protection sociale en Asie. Langue French. Read more about Intergenerational Transfers, Aging and Social Protection in Asia. Langue English. Read more about Intégration systématique de l'évaluation (théorie et ...

  15. Sud du Sahara | Page 108 | CRDI - Centre de recherches pour le ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    Sud du Sahara. Sud du Sahara. Read more about Understanding Obstacles to Peace in the Great Lakes Region : Actors, Interests and Strategies. Langue English. Read more about Comprendre les obstacles à la paix dans la région des Grands Lacs : acteurs, intérêts et stratégies. Langue French. Read more about ...

  16. Sud du Sahara | Page 55 | CRDI - Centre de recherches pour le ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    Sud du Sahara. Sud du Sahara. Read more about Strengthening the Health System through a Maternal Death Review (Kenya and Zimbabwe). Langue English. Read more about Taxes sur les cigarettes en Tanzanie. Langue French. Read more about Cigarette Taxation in Tanzania. Langue English. Read more about AIDS ...

  17. Asie du sud | Page 5 | CRDI - Centre de recherches pour le ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    Asie du sud. Asie du sud. Read more about Alternative Measure of Wellbeing: Bhutan's Gross National Happiness 2010. Langue English. Read more about Mekong Economic Research Network (MERN). Langue English. Read more about Technologies omniprésentes et accès au savoir (A2K). Langue French. Read more ...

  18. Asie du sud | Page 11 | CRDI - Centre de recherches pour le ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    Asie du sud. Asie du sud. Read more about How Communities Deal with Traumatic Memory: Lessons from Aceh and Timor-Leste. Langue English. Read more about Réduction des pertes de fruits en Inde et au Sri Lanka grâce à la nanotechnologie (FCRSAI). Langue French. Read more about Enhanced Preservation of ...

  19. Sud du Sahara | Page 93 | CRDI - Centre de recherches pour le ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    Sud du Sahara. Sud du Sahara. Read more about Renouvellement des modes de gouvernance : industries extractives et réduction de la pauvreté en Afrique. Langue French. Read more about Renewing Modes of Governance : Extractive Industries and the Reduction of Poverty in Africa. Langue English. Read more about ...

  20. Experience Building and Operating the CMS Tier-1 Computing Centres

    CERN Document Server

    Albert, M; Bonacorsi, D; Brew, C; Charlot, C; Huang, Chih-Hao; Colling, D; Dumitrescu, C; Fagan, D; Fassi, F; Fisk, I; Flix, J; Giacchetti, L; Gomez-Ceballos, G; Gowdy, S; Grandi, C; Gutsche, O; Hahn, K; Holzman, B; Jackson, J; Kreuzer, P; Kuo, C M; Mason, D; Pukhaeva, N; Qin, G; Quast, G; Rossman, P; Sartirana, A; Scheurer, A; Schott, G; Shih, J; Tader, P; Thompson, R; Tiradani, A; Trunov, A

    2010-01-01

    The CMS Collaboration relies on 7 globally distributed Tier-1 computing centres located at large universities and national laboratories for a second custodial copy of the CMS RAW data and primary copy of the simulated data, data serving capacity to Tier-2 centres for analysis, and the bulk of the reprocessing and event selection capacity in the experiment. The Tier-1 sites have a challenging role in CMS because they are expected to ingest and archive data from both CERN and regional Tier-2 centres, while they export data to a global mesh of Tier-2s at rates comparable to the raw export data rate from CERN. The combined capacity of the Tier-1 centres is more than twice the resources located at CERN and efficiently utilizing this large distributed resources represents a challenge. In this article we will discuss the experience building, operating, and utilizing the CMS Tier-1 computing centres. We will summarize the facility challenges at the Tier-1s including the stable operations of CMS services, the ability ...

  1. Single-centre experience of allogeneic haemopoietic stem cell ...

    African Journals Online (AJOL)

    NC 4.0. Single-centre experience of allogeneic haemopoietic stem cell transplant in paediatric patients in Cape Town, South Africa. A van Eyssen,1 MB ChB, DCH (SA), FC Paed (SA), Cert Medical Oncology Paediatrics (SA); N Novitsky,2 FCP ...

  2. Simple, Concept-Centred, Innovative, Open-Ended Experiments in ...

    Indian Academy of Sciences (India)

    Home; Journals; Resonance – Journal of Science Education; Volume 8; Issue 9. Simple, Concept-Centred, Innovative, Open-Ended Experiments in Physics – 2. A W Joshi Vijay H Raybagkar F I Surve. Classroom Volume 8 Issue 9 September 2003 pp 81-87 ...

  3. Centre Régional de Télédetection des Etats de l'Afrique du Nord (CRTEAN)

    Science.gov (United States)

    Abidi, Rachid

    2005-07-01

    The creation of the "Centre Régional de Télédétection des Etats de l'Afrique du Nord" (CRTEAN) in October 1990 reflected the will of its different member states to have a structure for coordination and exchange of know-how, and also for validation of existing capabilities in the sub-region in the fields of remote sensing, GIS, mapping and their applied activities. The organisation of the CRTEAN, its missions and its programme of activities illustrate CRTEAN's continuous mandate to assure a useful and efficient complementarity in the above fields for the benefit of its member states and associated members.

  4. Sud du Sahara | Page 21 | CRDI - Centre de recherches pour le ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    Savoir. Innovation. Solutions. Carrières · Communiquez avec nous · Plan du site · Droits d'auteur · Éthique de la recherche · Politique de libre accès · Politique de confidentialité · Transparence · Utilisation du site Web. Suivez-nous; Facebook · Twitter · Youtube · Linked In · RSS Feed. © 2015 CRDI. Tous droits réservés.

  5. Asie du sud | Page 64 | CRDI - Centre de recherches pour le ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    Asie du sud. Asie du sud. Read more about Les migrantes, la sécurité économique et le défi de la réintégration. Langue French. Read more about Migrant Women, Economic Security and the Challenge of Reintegration. Langue English. Read more about Human Resources for Health in Rural China : an Assessment of the ...

  6. Administrateur du système (h/f) | CRDI - Centre de recherches pour ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    L'administrateur du système apporte aux services d'infrastructure les compétences nécessaires et une compréhension approfondie de l'architecture de l'infrastructure, qui lui permettent de recommander, de concevoir et de réaliser des améliorations de l'architecture dans l'ensemble des bureaux du CRDI.

  7. Commis, Gestion du matériel | CRDI - Centre de recherches pour le ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    Conseiller les clients au sein du CRDI sur les aspects pertinents des services de gestion du matériel et leur fournir des explications en ce sens. Utiliser des outils et des mécanismes pour l'évaluation des propositions et la sélection des fournisseurs, en fonction des données techniques fournies par les clients, de la qualité ...

  8. Assemblée publique annuelle du CRDI 2017 | CRDI - Centre de ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    Innovation. Solutions. Carrières · Communiquez avec nous · Plan du site. Abonnez-vous à notre bulletin électronique dès maintenant pour recevoir des nouvelles et des articles d'opinion du CRDI chaque mois. Abonnez-vous · Droits d'auteur · Éthique de la recherche · Politique de libre accès · Politique de confidentialité ...

  9. Sud du Sahara | Page 28 | CRDI - Centre de recherches pour le ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    Savoir. Innovation. Solutions. Carrières · Communiquez avec nous · Plan du site · Droits d'auteur · Éthique de la recherche · Politique de libre accès · Politique de confidentialité · Transparence · Utilisation du site Web. Suivez-nous; Facebook · Twitter · Youtube · Linked In · RSS Feed. © 2015 CRDI. Tous droits réservés.

  10. Etude séro-épidémiologique de la leishmaniose canine au centre du Maroc

    Science.gov (United States)

    Fellah, Hajiba; Doughmi, Oursula; Maniar, Saâd; Lalami, Abdelhakim El Ouali

    2014-01-01

    Dans le monde, la leishmaniose viscérale humaine est connue pour avoir comme principale source d'infection les Canidés domestiques et sauvages. Au centre du Maroc, les données épidémiologiques, cliniques et parasitologiques sur la leishmaniose canine, sont quasiment inexistantes. Ce travail traite une étude prospective au cours de laquelle 61 sérums canins ont été analysés par un test rapide et par l'immunofluorescence indirecte. La sensibilité du test rapide par rapport à celle de l'immunofluorescence indirecte (IFI) est de 33,33%. La fréquence de la maladie chez les chiens s’élève à 9,83% (Test Rapide) et 24,59% (IFI). 73,33% des cas canins positifs à la sérologie sont asymptomatiques. Ce sont les jeunes chiens de moins de 5 ans qui sont les plus fréquemment atteints avec une sensibilité de la race Berger Allmand à l'infection. Cette étude a permis de mettre en évidence la présence de chiens leishmaniens (15 chiens séropositifs parmi 61) et de prouver l'existence du réservoir canin. Une stratégie de prévention active doit être mise en place. PMID:25852791

  11. Immediate supervision of the coastal site at the La Hague centre; Surveillance immediate du site marin du Centre de La Hague

    Energy Technology Data Exchange (ETDEWEB)

    Scheidhauer, J. [Commissariat a l' Energie Atomique, La Hague (France)

    1968-07-01

    The disposal into the sea of the residual waters from a plant processing irradiated fuels means that a very close watch has to be kept on the corresponding coastal zone. The material organisation of such a supervision, and the sampling techniques, are described. These latter concern: flora, fauna, sediments and sea-water. Results obtained using various analytical and routine measurement methods are presented. (author) [French] L'elimination des eaux residuaires, d'un Centre de traitement de combustibles irradies, en mer, a pour consequence une surveillance particuliere de la zone cotiere correspondant a ces rejets. L'organisation materielle de cette surveillance et les techniques de prelevements sont decrites. Elles interessent la flore, la faune, les sediments et les eaux marines. Diverses methodes d'analyses et de mesures de routine ont fourni des resultats qui sont egalement exposes. (auteur)

  12. Dosage de la 25 OH vitamine D: expérience du laboratoire central de biochimie clinique du Centre Hospitalier Ibn Sina

    Science.gov (United States)

    Handor, Najat; Elalami, Sanae; Bouabdellah, Mounya; Srifi, Abdelatif; Esselmani, Hicham; Benchekroun, Laila; Chabraoui, Layachi

    2014-01-01

    La connaissance de la physiologie de la vitamine D a considérablement progressé ces dernières années, la faisant passer de simple vitamine à tropisme purement phosphocalcique et osseux à celui d'hormone jouant un rôle crucial dans de nombreux mécanismes physiologiques et dont le déficit est impliqué dans plusieurs pathologies. Nous présentons, dans ce travail, l'expérience du laboratoire central de biochimie dans le dosage de la 25 OH vitamine D. Enquête descriptive exhaustive portant sur les dosages de la 25 OH vitamine D effectués chez 350 patients du Centre Hospitalier Ibn Sina (CHIS). La méthode adoptée est un dosage immunologique par chimiluminescence sur microparticules réalisés sur l'auto-analyseur ARCHITECT 8200 (ABBOTT®) pendant une période de six mois (du 01 Juin 2011 au 31 Decembre 2011). Quatre vingt et onze pourcent des patients présentent une hypovitaminose. En effet 76,6% des patients souffrent d'une insuffisance en vitamine D, 12,3% de carence vitaminique et 2,6% d'ostéomalacie. L'hypovitaminose est associée dans 92,18% des cas à une normocalcémie, dans 76,87% des cas à une Hyperparathormone, dans 92,81% à des troubles thyroïdiens et dans 97,5% à une insuffisance rénale. Par ailleurs aucune relation statistiquement significative n'est établie entre l'hypovitaminose et le diabète. A la lumière des implications des hypovitaminoses dans plusieurs pathologies ou dans leurs complications et au vu du nombre élevé de patients présentant un déficit en vitamine D, il paraît judicieux d'envisager une étude épidémiologique sur le statut en vitamine D dans la population marocaine comme outil préventif avant d'élargir le dosage de ce marqueur biologique en vue d'une éventuelle supplémentation. PMID:25374649

  13. Location-based solutions in the Experience centre

    DEFF Research Database (Denmark)

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

    2008-01-01

    In this paper we present a prototype system for location-based guiding. A user survey has been conducted and the observations are used to support design choices. The prototype allows for both indoor and outdoor navigation at and in the vicinity of the experience centre NaturBornholm1 in Denmark u...... using a combination of Bluetooth, GPS and QRcodes. Bluetooth and GPS are used for location-based information and QR-codes are used to convey user preferences....

  14. Location-based solutions in the Experience centre

    DEFF Research Database (Denmark)

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

    In this paper we present a prototype system for location-based guiding. A user survey has been conducted and the observations are used to support design choices. The prototype allows for both indoor and outdoor navigation at and in the vicinity of the experience centre NaturBornholm1 in Denmark u...... using a combination of Bluetooth, GPS and QR-codes. Bluetooth and GPS are used for location-based information and QR-codes are used to convey user preferences....

  15. La lutte contre la malaria dans le nord du Pérou | CRDI - Centre de ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    7 sept. 2016 ... Les systèmes d'irrigation à grande échelle installés sur la côte du nord du Pérou dans les années 1960 et 1970 ont fait exploser les rendements en agriculture, de même que le nombre de cas de l'une des maladies les plus meurtrières au monde. Un projet financé par le CRDI créé des changements dans ...

  16. Sud du Sahara | Page 140 | CRDI - Centre de recherches pour le ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    La plaine de Marovoay, à Madagascar, le deuxième grenier à riz du pays avec ses quelque 15 400 hectares de rizières, est actuellement touchée par des problèmes reliés à la variabilité du climat. On constate une évolution des régimes pluviométriques dont dépend la riziculture. Cette étude de cas porte sur les solutions ...

  17. Asie du sud | Page 99 | CRDI - Centre de recherches pour le ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    Langue English. Le Dr David Butler-Jones, professeur à la Faculté de médecine de l'Université du Manitoba et ancien administrateur en chef de la santé publique du Canada, a prononcé une allocution sur les leçons tirées de la pandémie de grippe survenue au Canada en 2009. Le 10 février 2015, il a également discuté ...

  18. Asie du sud | Page 23 | CRDI - Centre de recherches pour le ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    Read more about Consolidation du journalisme scientifique en Afrique et au Moyen-Orient - SCOOP II. Langue French. Read more about Consolidating Science Journalism in Africa and the Middle East - SjCOOP-II. Langue English. Read more about Nanotechnology in South Asia : Building Capabilities and Governing the ...

  19. Sud du Sahara | Page 118 | CRDI - Centre de recherches pour le ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    Read more about Building Capacity for Feminist Research in Africa : Gender, Sexuality and Politics. Langue English. Read more about Regulation of the Private Security Sector in Africa. Langue English. Read more about Réglementation du secteur de la sécurité privé en Afrique. Langue French. Read more about Création ...

  20. Asie du sud | Page 45 | CRDI - Centre de recherches pour le ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    Langue French. Read more about Donner aux travailleurs du sexe les moyens de consigner les incidents de violence (Inde et Cambodge). Langue French. Read more about Enabling Sex Workers to Document Violence (India and Cambodia). Langue English. Read more about Drivers of Competitiveness and Strategies for ...

  1. Sud du Sahara | Page 103 | CRDI - Centre de recherches pour le ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    Read more about Improving and Securing Women's Access to Land in Sénégal. Langue English. Read more about Toward Détente in Media Piracy. Langue English. Read more about Recherche d'une détente dans le dossier du piratage des médias. Langue French. Read more about Water, Health and Climate Change ...

  2. Sud du Sahara | Page 20 | CRDI - Centre de recherches pour le ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    Read more about Capacités en science du comportement pour relever les facteurs qui entravent ou facilitent les essais d'un vaccin contre le VIH au Nigeria. Langue French. Read more about Collaboration Sud-Sud en innovation génomique. Langue French. Read more about South-to-South Collaboration on Genomics ...

  3. 91 Étude de la performance de la STEP du centre emplisseur de la ...

    African Journals Online (AJOL)

    PR BOKO

    -Un traitement chimique par coagulation par le polalumine un coagulant liquide à base de sulfate d'alumine. L'injection de ce dernier se fait à l'aide d'une pompe doseuse qui fonctionne automatiquement lorsque la pompe d'alimentation des eaux usées est en marche. L'agitateur du bassin de coagulation assure la.

  4. Sud du Sahara | Page 59 | CRDI - Centre de recherches pour le ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    flexible layoutflexible layoutflexible layoutflexible layoutflexible layoutflexible layoutflexible layoutflexible layoutflexible layout. Sud du Sahara. According to the International Land Coalition, between 2000 and 2010, foreign actors and country elites acquired an estimated 83 million hectares through large-scale land ...

  5. Asie du sud | Page 4 | CRDI - Centre de recherches pour le ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    Asie du sud. An international research team aims to protect human health and the environment by improving agricultural practices in four Asian countries. Read more about Exploring eco-health in China and Southeast Asia. Langue English. Read more about Traditional grains boost nutrition in rural India. Langue English.

  6. Sud du Sahara | Page 54 | CRDI - Centre de recherches pour le ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    Read more about Examen de la mortalité maternelle pour le renforcement du système de santé au Kenya et au Zimbabwe. Langue French. Read more about Strengthening the Health System through a Maternal Death Review (Kenya and Zimbabwe). Langue English. Read more about Taxes sur les cigarettes en Tanzanie.

  7. Sud du Sahara | Page 6 | CRDI - Centre de recherches pour le ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    Read more about Détermination des facteurs de sécrétion des muqueuses influant sur la vulnérabilité à l'infection par le VIH chez les travailleuses du sexe au Kenya. Langue French. Read more about Determination of Mucosal Secretory Factors that Influence Susceptibility to HIV Infection Among Female Sex Workers in ...

  8. Asie du sud | Page 83 | CRDI - Centre de recherches pour le ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    Read more about Multinational Tobacco Companies and Tobacco Consumption (China). Langue English. Read more about Les multinationales du tabac et le tabagisme (Chine). Langue French. Read more about Mise en oeuvre de la Convention-cadre pour la lutte antitabac au Cambodge et dans la République ...

  9. Asie du sud | Page 71 | CRDI - Centre de recherches pour le ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    Read more about Genetically Modified Organisms : Public Knowledge, Attitudes and Perceptions (India). Langue English. Read more about Connaissances, attitudes et perceptions de la population à l'égard des OGM en Inde. Langue French. Read more about Pauvreté, qualité des emplois et dynamique des marchés du ...

  10. Sud du Sahara | Page 42 | CRDI - Centre de recherches pour le ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    vous · Carrières · Communiquez avec nous · Désabonnez-vous · Plan du site. Suivez-nous; Facebook · Twitter · Youtube · Linked In · RSS Feed · Droits d'auteur · Éthique de la recherche · Politique de libre accès · Politique de confidentialité ...

  11. Articles du site CRDI.ca les plus populaires en 2016 | CRDI - Centre ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    4 janv. 2017 ... Forger les chefs de file pour appuyer l'émancipation des femmes en Amérique latine. Des scientifiques qui travaillent dans un laboratoire. Nouvelle initiative des chaires de recherche Canada-Afrique du Sud. deux hommes en Inde. Un nouveau rapport fournit des solutions pour favoriser un accès durable ...

  12. Sud du Sahara | Page 147 | CRDI - Centre de recherches pour le ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    On avance souvent que la libéralisation du commerce mondial entraînerait une hausse des revenus des travailleurs non qualifiés dans les pays en développement. Read more about Globalization, Trade and Poverty in Ghana. Langue French. The persistence of poverty in Sub-Saharan Africa (SSA), in the face of increased ...

  13. Sud du Sahara | Page 75 | CRDI - Centre de recherches pour le ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    On avance souvent que la libéralisation du commerce mondial entraînerait une hausse des revenus des travailleurs non qualifiés dans les pays en développement. Read more about Globalization, Trade and Poverty in Ghana. Langue French. The persistence of poverty in Sub-Saharan Africa (SSA), in the face of increased ...

  14. Sud du Sahara | Page 67 | CRDI - Centre de recherches pour le ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    On avance souvent que la libéralisation du commerce mondial entraînerait une hausse des revenus des travailleurs non qualifiés dans les pays en développement. Read more about Globalization, Trade and Poverty in Ghana. Langue French. The persistence of poverty in Sub-Saharan Africa (SSA), in the face of increased ...

  15. Sud du Sahara | Page 63 | CRDI - Centre de recherches pour le ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    On avance souvent que la libéralisation du commerce mondial entraînerait une hausse des revenus des travailleurs non qualifiés dans les pays en développement. Read more about Globalization, Trade and Poverty in Ghana. Langue French. The persistence of poverty in Sub-Saharan Africa (SSA), in the face of increased ...

  16. Sud du Sahara | Page 69 | CRDI - Centre de recherches pour le ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    On avance souvent que la libéralisation du commerce mondial entraînerait une hausse des revenus des travailleurs non qualifiés dans les pays en développement. Read more about Globalization, Trade and Poverty in Ghana. Langue French. The persistence of poverty in Sub-Saharan Africa (SSA), in the face of increased ...

  17. Sud du Sahara | Page 70 | CRDI - Centre de recherches pour le ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    On avance souvent que la libéralisation du commerce mondial entraînerait une hausse des revenus des travailleurs non qualifiés dans les pays en développement. Read more about Globalization, Trade and Poverty in Ghana. Langue French. The persistence of poverty in Sub-Saharan Africa (SSA), in the face of increased ...

  18. Sud du Sahara | Page 73 | CRDI - Centre de recherches pour le ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    On avance souvent que la libéralisation du commerce mondial entraînerait une hausse des revenus des travailleurs non qualifiés dans les pays en développement. Read more about Globalization, Trade and Poverty in Ghana. Langue French. The persistence of poverty in Sub-Saharan Africa (SSA), in the face of increased ...

  19. Sud du Sahara | Page 77 | CRDI - Centre de recherches pour le ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    On avance souvent que la libéralisation du commerce mondial entraînerait une hausse des revenus des travailleurs non qualifiés dans les pays en développement. Read more about Globalization, Trade and Poverty in Ghana. Langue French. The persistence of poverty in Sub-Saharan Africa (SSA), in the face of increased ...

  20. Sud du Sahara | Page 74 | CRDI - Centre de recherches pour le ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    On avance souvent que la libéralisation du commerce mondial entraînerait une hausse des revenus des travailleurs non qualifiés dans les pays en développement. Read more about Globalization, Trade and Poverty in Ghana. Langue French. The persistence of poverty in Sub-Saharan Africa (SSA), in the face of increased ...

  1. Sud du Sahara | Page 76 | CRDI - Centre de recherches pour le ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    On avance souvent que la libéralisation du commerce mondial entraînerait une hausse des revenus des travailleurs non qualifiés dans les pays en développement. Read more about Globalization, Trade and Poverty in Ghana. Langue French. The persistence of poverty in Sub-Saharan Africa (SSA), in the face of increased ...

  2. Sud du Sahara | Page 79 | CRDI - Centre de recherches pour le ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    On avance souvent que la libéralisation du commerce mondial entraînerait une hausse des revenus des travailleurs non qualifiés dans les pays en développement. Read more about Globalization, Trade and Poverty in Ghana. Langue French. The persistence of poverty in Sub-Saharan Africa (SSA), in the face of increased ...

  3. Sud du Sahara | Page 66 | CRDI - Centre de recherches pour le ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    On avance souvent que la libéralisation du commerce mondial entraînerait une hausse des revenus des travailleurs non qualifiés dans les pays en développement. Read more about Globalization, Trade and Poverty in Ghana. Langue French. The persistence of poverty in Sub-Saharan Africa (SSA), in the face of increased ...

  4. Sud du Sahara | Page 81 | CRDI - Centre de recherches pour le ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    On avance souvent que la libéralisation du commerce mondial entraînerait une hausse des revenus des travailleurs non qualifiés dans les pays en développement. Read more about Globalization, Trade and Poverty in Ghana. Langue French. The persistence of poverty in Sub-Saharan Africa (SSA), in the face of increased ...

  5. Sud du Sahara | Page 64 | CRDI - Centre de recherches pour le ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    On avance souvent que la libéralisation du commerce mondial entraînerait une hausse des revenus des travailleurs non qualifiés dans les pays en développement. Read more about Globalization, Trade and Poverty in Ghana. Langue French. The persistence of poverty in Sub-Saharan Africa (SSA), in the face of increased ...

  6. Sud du Sahara | Page 82 | CRDI - Centre de recherches pour le ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    On avance souvent que la libéralisation du commerce mondial entraînerait une hausse des revenus des travailleurs non qualifiés dans les pays en développement. Read more about Globalization, Trade and Poverty in Ghana. Langue French. The persistence of poverty in Sub-Saharan Africa (SSA), in the face of increased ...

  7. Sud du Sahara | Page 65 | CRDI - Centre de recherches pour le ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    On avance souvent que la libéralisation du commerce mondial entraînerait une hausse des revenus des travailleurs non qualifiés dans les pays en développement. Read more about Globalization, Trade and Poverty in Ghana. Langue French. The persistence of poverty in Sub-Saharan Africa (SSA), in the face of increased ...

  8. Sud du Sahara | Page 117 | CRDI - Centre de recherches pour le ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    Read more about Ghana, Afrique du Sud et Tanzanie : Stratégies de recours à des mécanismes d'assurance maladie pour combler les inégalités dans les systèmes de santé. Langue French. Read more about Developer Network : Open Source Personal Digital Assistant Software for Health Data Collection. Langue English.

  9. Le CERN: centre du monde, centre de l'univers... Une chance pour Genève!

    CERN Multimedia

    Tesnier, Grégory

    From Asia, Europa, America, Oceania, Africa, the curious have see the images or read the story of the startup of the Great Hadron Collider (LHC), new giant experiment launched last week by CERN. (1 page)

  10. La vie et la mort dans la ville: Leçons du Venezuela | CRDI - Centre ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    16 nov. 2016 ... Les villes latino-américaines captent le meilleur et le pire du potentiel humain: elles sont des sites d'une violence et d'une insécurité énormes, mais exsudent la modernité et l'espoir d'une vie meilleure. Le livre 2016 Ciudades de Vida y Muerte: La ville et le pacte social pour la contention de la violence ...

  11. Politique Sociale en Afrique de L'ouest et du Centre

    International Development Research Centre (IDRC) Digital Library (Canada)

    ... du secteur privé et des organisations non gouvernementales qui élaborent des initiatives dans les secteurs économiques et surtout sociaux – tout en mobilisant les énergies pour de nouvelles formes de solidarité. .... de la capacité des membres de la société de piloter et de gérer le système de consommation sociale ;.

  12. Le savoir au service de la démocratie du Myanmar | CRDI - Centre ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    Le nouveau salaire minimum aura des répercussions sur les travailleurs du Myanmar, y compris ceux de l'industrie de la confection. Regardez Zaw Oo discuter des industries à forte intensité de main-d'oeuvre au Myanmar lors des réunions annuelles de la Banque asiatique de développement, en mai 2015. Regardez La ...

  13. Les cybercommerçants du Sud de l'Inde | CRDI - Centre de ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    13 juil. 2011 ... Des traditions séculaires se perpétuent ainsi, comme la confection des saris et la sculpture des divinités hindous. Lancement du projet. Loyola Joseph, qui est titulaire d'une maîtrise en services sociaux et qui dirigeait sa propre fabrique avant de fonder la FOOD India, il y a 20 ans, travaille depuis sept ans ...

  14. Plan du site | CRDI - Centre de recherches pour le développement ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    Plan du site. Ce que nous faisons · Programmes · Agriculture et sécurité alimentaire · Alimentation, environnement et santé · Changements climatiques · Économies en réseaux · Emploi et croissance · Fondements pour l'innovation · Gouvernance et justice · Santé des mères et des enfants · Les régions et les pays · Canada.

  15. Ressources en S&E du programme ACCA | CRDI - Centre de ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    Dans le cadre de son appui en suivi-évaluation aux équipes de recherche, le programme ACCA a développé un certain nombre de ressources qui peuvent servir d'autres partenaires intéressés au suivi des contributions de la recherche à l'adaptation aux changements climatiques. Document(s)Guide du participant : Atelier ...

  16. L'accès à l'information gagne du terrain en Afrique | CRDI - Centre ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    29 mars 2012 ... Il est largement reconnu que l'accès à l'information est l'une des pierres angulaires de la bonne gouvernance ainsi qu'un important outil de lutte contre la corruption. Près d'une centaine de pays, dont 10 en Afrique, ont adopté des lois ou des décrets nationaux qui reconnaissent le droit du public à l'accès ...

  17. Protéger les mangroves du Cambodge | CRDI - Centre de ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    15 juil. 2011 ... Le Cambodge abrite quelques-unes des dernières mangroves intouchées d'Asie du Sud-Est. Ces luxuriantes forêts littorales, où dominent les palétuviers, figurent au nombre des milieux humides les plus diversifiés au monde sur le plan biologique. Pourtant, dans ce pays qui se relève d'une longue guerre ...

  18. Sud du Sahara | Page 68 | CRDI - Centre de recherches pour le ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    flexible layoutflexible layoutflexible layoutflexible layoutflexible layout. Sud du Sahara. La persistance de la pauvreté en Afrique subsaharienne, dans le contexte de progression rapide de la mondialisation et de la libéralisation des échanges commerciaux des deux dernières décennies, a suscité énormément de débats en ...

  19. Sud du Sahara | Page 78 | CRDI - Centre de recherches pour le ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    flexible layoutflexible layoutflexible layoutflexible layoutflexible layout. Sud du Sahara. La persistance de la pauvreté en Afrique subsaharienne, dans le contexte de progression rapide de la mondialisation et de la libéralisation des échanges commerciaux des deux dernières décennies, a suscité énormément de débats en ...

  20. Sud du Sahara | Page 62 | CRDI - Centre de recherches pour le ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    flexible layoutflexible layoutflexible layoutflexible layoutflexible layout. Sud du Sahara. La persistance de la pauvreté en Afrique subsaharienne, dans le contexte de progression rapide de la mondialisation et de la libéralisation des échanges commerciaux des deux dernières décennies, a suscité énormément de débats en ...

  1. marche et commercialisation du riz local au centre-ouest de la côte ...

    African Journals Online (AJOL)

    AISA

    fournir une offre répondant aux exigences de compétitivité du marché international. De fait, la filière riz en Côte d'Ivoire a fait l'objet d'investigations scientifiques ..... contrat signé par les deux parties. Certains paysans qui se sont autofinancés n'ont aucune contrainte vis à vis des tiers et vendent leur produit lorsque le prix ...

  2. 54 La Terrasse Ebebda (centre du Cameroun) : preuve d'une ...

    African Journals Online (AJOL)

    PR BOKO

    Résumé. La compréhension de la mise en place de la terrasse située à la confluence Mbam- Sanaga, et le fonctionnement de cette zone, ont conduit à certaines observations qui ont permis la reconstitution du paléochenal de cette confluence. Une étude comparative a été menée sur les différents sites afin de ressortir des ...

  3. ITT - Fonds d'activités du BRA : l'IPS | CRDI - Centre de recherches ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    Au sujet du Fonds d'activités. Le Fonds d'activités de l'ITT finance les activités visant la réalisation des objectifs à long terme des organismes subventionnés par la collaboration, l'apprentissage et l'innovation. Les projets concernés ne peuvent pas être réalisés en recourant au financement de base de l'ITT.

  4. Asie du sud | Page 97 | CRDI - Centre de recherches pour le ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    Read more about Reducing the risk of rabies in Bali. Langue English. En Asie du Sud-Est, le tourisme constitue un important moteur de la croissance économique. Toutefois, l'essor de l'industrie touristique a eu des conséquences considérables sur les populations et les écosystèmes en raison de l'urbanisation rapide, d'un ...

  5. Location-based solutions in the Experience centre

    DEFF Research Database (Denmark)

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

    2009-01-01

    In this paper we present a prototype system for location-based guiding. A user survey has been conducted and the observations are used to support design choices. The prototype allows for both indoor and outdoor navigation at and in the vicinity of the NaturBornholm' experience centre in Denmark u...... using a combination of Bluetooth, Near Field Communication (NFC), GPS and QR codes. Bluetooth, NFC and GPS are used for location-based information and QR codes are used to convey user preferences....

  6. Moyen-Orient et Afrique du Nord | CRDI - Centre de recherches pour ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    Depuis les soulèvements de 2011, la région connaît des changements sans précédent. Cela a entraîné une croissance inégale, une vulnérabilité économique, une démocratie fragile et un taux de chômage élevé, en particulier chez les femmes et les jeunes. Au Moyen-Orient et en Afrique du Nord, les économies ...

  7. Asie du sud | Page 108 | CRDI - Centre de recherches pour le ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    ... ont fait rage en Indonésie ont rejeté suffisamment de fumée dans l'atmosphère pour recouvrir toutes les régions d'un brouillard qui a atteint le sud de la Thaïlande et les Philippines au nord, la Malaisie et Singapour étant particulièrement touchés. Une superficie équivalente à celle du Costa Rica a été entièrement rasée.

  8. Pour que brûle le feu du changement | CRDI - Centre de recherches ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    7 déc. 2010 ... Le CRDI, grâce à des fonds de Santé Canada, appuie une étude économique qui aide le gouvernement de la Jamaïque à réfuter les arguments de l'industrie du tabac à l'encontre de l'augmentation des taxes sur les cigarettes prévue pour donner un nouveau souffle à la stratégie de lutte contre le ...

  9. Asie du sud | Page 105 | CRDI - Centre de recherches pour le ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    To realize this potential and influence policy-making and program design, the Singapore Internet Research Centre, supported by IDRC, created an innovative research capacity-building program, SIRCA. The program supports interdisciplinary ICTD research through the nurturing of research relationships. Read more about ...

  10. Sud du Sahara | Page 58 | CRDI - Centre de recherches pour le ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    The Stories of Change series, published by WRENmedia, shares some of the emerging gender outcomes from CIFSRF projects in nine African countries: Benin, ... 2015, the Kenya Meteorological Services (KMS) launched a resource centre and radio station in western Kenya to disseminate weather and climate information.

  11. Asie du sud | Page 110 | CRDI - Centre de recherches pour le ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    As such, it is a tremendously valuable resource for the policymakers, government leaders, and public sector managers. — Hyeun-Suk Rhee (Director, Asian and Pacific Training Centre for Information and Communication Technology for Development, Incheon, Republic of Korea). Read more about Digital Review of Asia ...

  12. Sud du Sahara | Page 129 | CRDI - Centre de recherches pour le ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    Climbing youth unemployment, unequal distribution of resources, and lack of access to justice were identified at a conference in Dakar, Senegal, as some of the main drivers of violence and crime in many of the region's urban centres. Read more about Who should claim responsibility for local crime prevention and security?

  13. S?ropr?valence des marqueurs viraux sur les dons du sang au Centre de Transfusion Sanguine, H?pital Militaire d?Instruction Mohammed V de Rabat

    OpenAIRE

    Uwingabiye, Jean; Zahid, Hafidi; Unyendje, Loubet; Hadef, Rachid

    2016-01-01

    Le but de ce travail ?tait de d?terminer la pr?valence du virus de l?immunod?ficience humaine (VIH), du virus de l?h?patite B (VHB) et C (VHC) sur les dons du sang collect?s au Centre de transfusion sanguine(CTS) de l?h?pital militaire d?instruction Mohammed V entre 2010 et 2012. Etude r?trospective men?e aupr?s des donneurs de sang militaires ?g?s de 18 ? 50 ans avec pr?dominance masculine (95%). L?entretien m?dical pr?-don constitue la premi?re barri?re de s?lection des sujets ? risque. Le ...

  14. Scaffolding Students’ Initial Self-Access Language Centre Experiences

    Directory of Open Access Journals (Sweden)

    Robert Croker

    2012-09-01

    Full Text Available As the number of self-access language centres (SALCs in Japanese universities continues to grow, so too does the challenge of successfully introducing them to first-year university students, whose initial experiences of self-access language learning may otherwise be confusing and even unsettling. One approach is to carefully scaffold students’ first SALC encounters by connecting them with their classroom learning experiences. This paper discusses one such approach developed at a private university in central Japan, which was based upon a two-stage ‘push-pull’ ‘materials-light, people-focused’ strategy. Teachers initially ‘pushed’ their students to visit the SALC by giving them speaking ‘homework’ to be done there. The SALC then also offered interesting interactive events designed to ‘pull’ learners to continue to come. These push-pull activities could be done with few or no materials, and emphasized interaction with people rather than materials. This two-stage, push-pull strategy served as a bridge between the language classroom and a SALC, helping learners make the first steps in their transition from being a ‘classroom English learner’ to becoming a ‘SALC English user’.

  15. Recognising and Managing Refractory Coeliac Disease: A Tertiary Centre Experience

    Directory of Open Access Journals (Sweden)

    Ikram Nasr

    2015-12-01

    Full Text Available Refractory coeliac disease (RCD is a rare complication of coeliac disease (CD and involves malabsorption and villous atrophy despite adherence to a strict gluten-free diet (GFD for at least 12 months in the absence of another cause. RCD is classified based on the T-cells in the intra-epithelial lymphocyte (IEL morphology into type 1 with normal IEL and type 2 with aberrant IEL (clonal by PCR (polymerase chain reaction for T cell receptors (TCR at the β/γ loci. RCD type 1 is managed with strict nutritional and pharmacological management. RCD type 2 can be complicated by ulcerative jejunitis or enteropathy associated lymphoma (EATL, the latter having a five-year mortality of 50%. Management options for RCD type 2 and response to treatment differs across centres and there have been debates over the best treatment option. Treatment options that have been used include azathioprine and steroids, methotrexate, cyclosporine, campath (an anti CD-52 monoclonal antibody, and cladribine or fluadribine with or without autologous stem cell transplantation. We present a tertiary centre’s experience in the treatment of RCD type 2 where treatment with prednisolone and azathioprine was used, and our results show good response with histological recovery in 56.6% of treated individuals.

  16. The experience of starting a poison control centre in Africa--the Ghana experience.

    Science.gov (United States)

    Clarke, E E K

    2004-05-20

    The need for a poison centre in Ghana has been well demonstrated over the years as evidenced by the occurrence of a variety of cases of poisoning. Important causes are accidental poisoning from mishandling of pesticides, accidental poisoning among children from kerosene and pesticide' ingestion due to unsafe storage methods in the home, use of herbal potions of unknown composition, overdoses of certain pharmaceuticals for illegal abortion, and accidental food poisonings. Bites from venomous animals particularly snakes are also common. Though preparations toward the establishment of a poison control centre started in mid 1999, it was not until early 2002 that the operations of a modest information centre commenced. Major roles the centre are currently performing include providing: an information service for health professionals on management advice in cases of poisoning; training for primary health personnel in the management of common poisonings; training for agricultural personnel in prevention and first aid management of pesticide poisoning; public awareness education and information programmes for prevention of poisoning. Some of the important challenges being faced include ensuring adequate sensitization on the need for centers particularly among health professionals, difficulties in acquiring adequate numbers of and appropriate training for staff of the centre, dedicated phone lines, literature and timely acquisition of toxicological data-bases. Others are poor networking among centers in the region and the absence of clinical and laboratory toxicology services dedicated to managing poisonings. The key lessons learned include the need for multi-sectoral involvement and support from the onset, the need to learn from experiences of established centers and the need to model requirements to suit local conditions without compromising the effectiveness of services.

  17. Evolution tectonothermale du massif Hercynien des Rehamna (zone centre-mesetienne, Maroc)

    Science.gov (United States)

    Aghzer, Abdel Mouhsine

    The rampant success of quantum theory is the result of applications of the 'new' quantum mechanics of Schrodinger and Heisenberg (1926-7), the Feynman-Schwinger-Tomonaga Quantum Electro-dynamics (1946-51), the electro-weak theory of Salaam, Weinberg, and Glashow (1967-9), and Quantum Chromodynamics (1973-); in fact, this success of 'the' quantum theory has depended on a continuous stream of brilliant and quite disparate mathematical formulations. In this carefully concealed ferment there lie plenty of unresolved difficulties, simply because in churning out fabulously accurate calculational tools there has been no sensible explanation of all that is going on. It is even argued that such an understanding is nothing to do with physics. A long-standing and famous illustration of this is the paradoxical thought-experiment of Einstein, Podolsky and Rosen (1935). Fundamental to all quantum theories, and also their paradoxes, is the location of sub-microscopic objects; or, rather, that the specification of such a location is fraught with mathematical inconsistency. This project encompasses a detailed, critical survey of the tangled history of Position within quantum theories. The first step is to show that, contrary to appearances, canonical quantum mechanics has only a vague notion of locality. After analysing a number of previous attempts at a 'relativistic quantum mechanics', two lines of thought are considered in detail. The first is the work of Wan and students, which is shown to be no real improvement on the iisu.al 'nonrelativistic' theory. The second is based on an idea of Dirac's - using backwards-in-time light-cones as the hypersurface in space-time. There remain considerable difficulties in the way of producing a consistent scheme here. To keep things nicely stirred up, the author then proposes his own approach - an adaptation of Feynman's QED propagators. This new approach is distinguished from Feynman's since the propagator or Green's function is not obtained

  18. Experimentarium : de jeunes chercheuses de l'INRA Dijon à la rencontre du grand public : Article rédigé par L. Piquemal et diffusé sur le site internet du Centre INRA de Dijon

    OpenAIRE

    Vidal, Elisa

    2017-01-01

    Samedi 4 février de 13h30 à 16h30, la médiathèque du Port du Canal à Dijon accueillera 3 jeunes chercheuses qui feront découvrir leurs travaux au grand public, à partir de 10 ans. Elles interviendront dans le cadre de l’Expérimentarium "en bibliothèque", auquel s’associe le centre INRA de Dijon – Bourgogne – Franche-Comté. Parmi elles, Yuko Krzyzaniak, chercheuse en biologie végétale à l’UMR Agroécologie. Yuko livrera certains résultats obtenus avec son équipe concernant les traitements à...

  19. Un nouvel habitat du Bronze final IIIb dans le Val d’Orléans et ses traces de métallurgie du fer : Bonnée, Les Terres à l’Est du Bourg (Centre, Loiret A new settlement from late Bronze IIIb in the val d’Orléans: Bonnée, Les Terres à l’Est du Bourg (lands to the east of the town (Centre, Loiret

    Directory of Open Access Journals (Sweden)

    Stéphane Joly

    2011-12-01

    Full Text Available La multiplication récente des diagnostics archéologiques autour du petit bourg actuel de Bonnée a permis la détection d’une occupation du Bronze final IIIb (circa 900-750 av. n.-e. sur environ un hectare aux Terres à l’Est du Bourg. Les limites inhérentes à ce type d’intervention réduisent l’interprétation des structures et toute approche spatiale de ce probable habitat repéré. L’étude conjointe des différents mobiliers en particulier céramique et métallurgique, mais aussi le torchis et la faune, atteste de sa culture matérielle et de son intérêt. Ces scories pourraient être parmi les plus anciennes traces en région Centre d’activité métallurgique du fer. Des activités de post-réduction sont avérées et certaines opérations de forgeage sont supposées.La découverte de cet habitat dans ce secteur du lit majeur de la Loire, apporte de nouvelles données concernant l’occupation du sol et ses problématiques évolutives dans le Val d’Orléans sur ces périodes de transition avec le Hallstatt ancien.The recent increase in the archaeological evaluations around the village of Bonnée has enabled the discovery of a final Bronze Age IIIb settlement (circa 900-750 BP on about a hectare of the Terres à l’Est du Bourg. The limits inherent in this type of work restrict the interpretation of structures and all spatial approaches to this likely dwelling. The joint study of the different furnishings, in particular ceramics and metal, but also the cob and fauna, attests to its material culture and its interest. The slag could be amongst the oldest iron metallurgy remains from the Centre region. Some activities of post-forging are proven and certain operations are guessed at. The discovery of this settlement in this sector of the major bed of the Loire, has produced new data concerning the occupation of the land and its evolutionary problems in the valley of Orleans over these periods of transition in the early

  20. Effet des Plastifiants sur la Temperature de Transition Vitreuse, Tg, du Butadiene a Terminaison Hydroxy et du Polyazoture de Glycidyle - Simulations et Experiences (Effect of the Plasticizers on the Vitreous Transition Temperature, Tg, of the Butadiene to Termination Hydroxy and the Polyazoture of Glycidyle - Simulations and Experiences)

    Science.gov (United States)

    2008-09-01

    informatique de Puniversite Laval de leur soutien precieux sur le plan informatique , ainsi que les autres membres du centre de bio- informatique . Viii DRDC...Materials Studio de Accelrys Inc., installe sur un ordinateur SGI Altix 3000 du Centre de calcul bio- informatique de l’Universite Laval. Le champ de

  1. « Petite archéologie » du Centre d’études médiévales

    Directory of Open Access Journals (Sweden)

    Christian Sapin

    2006-09-01

    Full Text Available « Chaque époque rêve la suivante ». MicheletDe décennies en décennies nous nous éloignons chaque jour du Moyen Âge tout en cherchant à mieux le saisir, restituant la photographie d’anciens « passages » dont nous craignons perdre la mémoire en poursuivant notre route. Si penser le Moyen Âge aujourd’hui n’est pas le fait du seul Centre d’études médiévales d’Auxerre, l’approche que nous y menons depuis dix ans a sa propre spécificité. Elle mêle dans sa réflexion, archéologie, histoire et histoir...

  2. Hand Mycetoma: The Mycetoma Research Centre Experience and Literature Review

    OpenAIRE

    Rowa Fathelrahman Omer; Nancy Seif El Din; Fadwa Awad Abdel Rahim; Ahmed Hassan Fahal

    2016-01-01

    Mycetoma is a devastating, neglected tropical disease characterised by extensive tissue involvement resulting in destruction, deformities and disabilities in the affected patients. The hand is commonly affected by mycetoma thus compromises its functionality and hinder the patient's daily activities of living. In this communication, we report on 533 patients with hand mycetoma managed over a period of 24 years at the Mycetoma Research Centre, University of Khartoum, Khartoum, Sudan. Eumycetoma...

  3. Protéger les collectivités côtières du nord du Maroc | CRDI - Centre ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    3 févr. 2011 ... L'équipe anime également des ateliers s'adressant aux représentants locaux afin de solliciter leurs opinions, de mettre en commun les données et de faire part du déroulement de la recherche. Les enquêtes montrent que les habitants sont conscients des changements climatiques et qu'ils établissent un ...

  4. Orientations pour l'intégration des TICE dans l'enseignement du français en Syrie. L'exemple du centre de documentation pédagogique de Damas.

    Directory of Open Access Journals (Sweden)

    Christelle Demange-Ducrot

    2005-09-01

    Full Text Available Le secteur éducatif syrien souhaite orienter son action vers les nouvelles technologies de l'information et la sensibilisation du public scolaire aux applications de l'informatique dans le domaine éducatif et en particulier dans le cadre de l'enseignement des langues. Dans l'enseignement-apprentissage des langues, les apports des TICE sont nombreux, mais là où elles apportent sans doute la plus grande plus-value, c'est lors de la mise en place de projets de classe motivants et valorisants, intégrés à des projets de communication authentique. Partant de ce constat, le Centre de Documentation Pédagogique de Damas forme les enseignants de français syriens à l'intégration des TICE dans des projets pédagogiques de classe mettant en œuvre des activités créatives et stimulantes pour communiquer en français. Jusqu'alors, les formations ont centré leurs efforts sur les bases de l'environnement informatique et de la bureautique, avec pour parti pris l'utilisation de logiciels libres. L'année 2005 marquera le lancement et l'expérimentation du dispositif de formation continue à distance destiné aux professeurs de français dans le domaine des TICE.

  5. The engineer, sustainable development craftsman at the center of the global energy challenge!; L'ingenieur, artisan du developpement durable au centre du defi energetique mondial!

    Energy Technology Data Exchange (ETDEWEB)

    Laplatte, Benjamin; Bourque, Francis; Granger, Francois P.; Dery, Gaston; Berube, Martin

    2010-09-15

    By its omnipresence in society, the energy question is at the heart of sustainable development issues. The engineer, as a central actor of human society development, is therefore tightly linked to the energy issue and he must actively contribute to resolve it by integrating to his practices the principles of sustainable development and by applying the solutions that arises. Part of these elements include as the main ones, listening to the consideration of citizens, becoming aware of the environment importance and reducing costs at all levels. The engineer is a social actor that cannot be ignored in the resolution of these issues. [French] Par son omnipresence dans la societe, la question energetique est au coeur des enjeux du developpement durable. L'ingenieur, etant un acteur central du developpement des societes humaines, est donc inextricablement lie a la question energetique qu'il doit contribuer activement a resoudre en integrant a sa pratique les principes du developpement durable et en appliquant les solutions qui en decoulent. Parmi ces elements, l'ecoute des considerations citoyennes, la prise de conscience de l'importance de l'environnement et la reduction des couts a tous les niveaux sont des elements centraux. L'ingenieur est un acteur social incontournable pour la resolution de ces enjeux.

  6. The CMS experiment inaugurated a new visitor centre at its Cessy site on 14 June

    CERN Multimedia

    2001-01-01

    The CMS visitor centre has been built on a platform overlooking CMS construction. It contains a set of clear descriptive posters describing the experiment, along with a video projection showing animations and movies about CMS construction.

  7. experience du service de medecine nucleaire sahloul sousse dans ...

    African Journals Online (AJOL)

    Mots clés : Cancers différenciés de la thyroide, Thyroglobuline, Irathérapie, Pronostic, Surveillance. Purpose: The aim of our work is to present our experience in the management of differentiated thyroid cancer (DTC) with high thy- roglobulin (Tg) , to identify parameters changing iodine effectiveness and Tg threshold with ...

  8. Les sources de l’histoire du patrimoine cultuel dans la seconde moitié du XXe siècle au Centre national des archives de l’Église de France

    Directory of Open Access Journals (Sweden)

    Bernard Barbiche

    2012-03-01

    Full Text Available Fondé en 1973, installé à Issy-les-Moulineaux, le Centre national des archives de l'Église de France, service de la Conférence des évêques de France, est l'équivalent des Archives nationales pour l'État. Ses fonds datent majoritairement de la seconde moitié du XXe siècle, à quelques exceptions près. Dépôt central des archives de la Conférence épiscopale, le CNAEF reçoit ses archives et celles des comités qui en dépendent, mais aussi des dons divers (archives de mouvements ou de personnalités.Les documents touchant à l'histoire de l'art se trouvent plus particulièrement dans la section CO, répartis essentiellement dans les fonds du Comité national des constructions d'églises, le Comité national d'art sacré et le Centre national de pastorale liturgique. Ces fonds ne sont pas classés mais des répertoires sommaires sont consultables sur place, sachant que les délais de communication des documents varient entre 50 et 70 ans.The Centre national des archives de l’Eglise de France, the national archive centre for the French church, was founded in 1973 and is located today in the Paris suburb of Issy-les-Moulineaux. For the Catholic church in France, it is the equivalent of the national archives. With a few earlier exceptions, most of its holdings date from the second half of the 20th century. It is the central repository for the papers of the Episcopal Conference, and manages the papers of this institution and of the various committees attached to it. It also receives archives and papers by way of gifts from other organisations or personalities. The documents relating to art history are to be found mainly in the CO section, in particular in the papers of the Comité national des constructions d’églises (church building, the Comité national d’art sacré (sacred art and the Centre national de pastorale liturgique (pastoral liturgy. These holdings are not well ordered and certain documents cannot be divulged for 50 or

  9. Work experiences among attendees of day centres for people with psychiatric disabilities.

    Science.gov (United States)

    Eklund, Mona; Sandlund, Mikael

    2015-01-01

    It is possible that people with psychiatric disabilities who visit day centres have previous work experiences that may be seen as resources for their current engagement in day centre activities. Research in this respect seems to lack, however. To investigate work experiences among attendees at day centres for people with psychiatric disabilities and relationships with current type of day centre (work-oriented, meeting place-oriented or mixed), engagement in day centre activities, motivation and socio-demographic and health-related factors. Seventy-seven attendees responded to questionnaires. Global Assessment of Functioning, GAF, was also used. Work was categorised into Group I (professionals, semi-professionals), Group II (clerical support, services workers) and Group III (e.g. craft workers, elementary occupations). Almost everyone had previously had open-market employment; more than half for ≥ 10 years. Group I was more common in mixed centres, Group II in meeting place-oriented ones and Group III in work-oriented ones. Group I more frequently had college degree and was rated high on GAF functioning. Women were over-represented in Group II, and men in Group III and in meeting place-oriented centres. Attending mixed centres was more likely when having a college degree, scoring high on GAF functioning and being highly engaged in activities. Attendees at work-oriented day centres were characterised by being motivated for spending time alone and reporting a diagnosis of psychosis. The participants had unused working capacity. No clear-cut relationships were found between work experiences and the investigated correlates.

  10. Établir le bien-fondé du libre accès à la recherche | CRDI - Centre ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    « La recherche devrait être un bien public », affirme Erika Malich, titulaire d'une bourse de recherche du CRDI en 2016. « Peu importe à quel point elle est rigoureuse et peu importe l'importance des conclusions, la recherche ne parle pas d'elle-même. »

  11. Head and neck mycetoma: the mycetoma research centre experience.

    Directory of Open Access Journals (Sweden)

    Ahmed Fahal

    2015-03-01

    Full Text Available Mycetoma is a unique neglected tropical disease which is endemic in what is known as the "mycetoma belt". The disease has many devastating impacts on patients and communities in endemic area and is characterised by massive deformity, destruction and disability. Mycetoma is commonly seen in the foot and hand and less frequent in other parts of the body. Mycetoma of the head and neck is a rarity and is associated with high morbidity and even mortality if not treated early. In this communication we report on 49 patients with head and neck mycetoma followed up at the Mycetoma Research Centre in Khartoum. Most of the reported patients had actinomycetoma and the majority were young adult males from mycetoma endemic areas in the Sudan. Most of them were students, farmers and workers. Prior to presentation the majority had long disease duration and the cause was multifactorial. Advanced disease with massive lesion, deformity and disability was the common presentation. There was no obvious history of local trauma, familial tendency or other predisposing factor identified in this group of patients. MRI and CT scan were the most accurate diagnostic tools to determine the disease extent. The treatment outcome was rather poor and characterised by low cure rate, poor outcome and high follows-up dropout. Such a gloomy outcome calls for structured and objective health education programs.

  12. Head and neck mycetoma: the mycetoma research centre experience.

    Science.gov (United States)

    Fahal, Ahmed; Mahgoub, El Sheikh; El Hassan, Ahmed Mohamed; Jacoub, Angom Osman; Hassan, Doaa

    2015-03-01

    Mycetoma is a unique neglected tropical disease which is endemic in what is known as the "mycetoma belt". The disease has many devastating impacts on patients and communities in endemic area and is characterised by massive deformity, destruction and disability. Mycetoma is commonly seen in the foot and hand and less frequent in other parts of the body. Mycetoma of the head and neck is a rarity and is associated with high morbidity and even mortality if not treated early. In this communication we report on 49 patients with head and neck mycetoma followed up at the Mycetoma Research Centre in Khartoum. Most of the reported patients had actinomycetoma and the majority were young adult males from mycetoma endemic areas in the Sudan. Most of them were students, farmers and workers. Prior to presentation the majority had long disease duration and the cause was multifactorial. Advanced disease with massive lesion, deformity and disability was the common presentation. There was no obvious history of local trauma, familial tendency or other predisposing factor identified in this group of patients. MRI and CT scan were the most accurate diagnostic tools to determine the disease extent. The treatment outcome was rather poor and characterised by low cure rate, poor outcome and high follows-up dropout. Such a gloomy outcome calls for structured and objective health education programs.

  13. Place de la chirurgie dans la prise en charge des cancers du sein chez la femme au Centre Hospitalier Universitaire Yalgado Ouedraogo: à propos de 81 cas

    Science.gov (United States)

    Zongo, Nayi; Millogo-Traore, Timonga Françoise Danielle; Bagre, Sidpawalmdé Carine; Bagué, Abdoul-Halim; Ouangre, Edgar; Zida, Maurice; Bambara, Aboubacar; Bambara, Tozoula Augustin; Traoré, Si Simon

    2015-01-01

    Etudier la place de la chirurgie dans la prise en charge des cancers du sein au centre hospitalier universitaire Yalgado Ouédraogo. Nous avons réalisé une étude prospective et descriptive sur dix (10) mois portant sur la place de la chirurgie dans le cancer du sein. Elle a eu pour cadre les services de gynécologie-obstétrique et de chirurgie viscérale et digestive du centre hospitalier universitaire Yalgado Ouédraogo. Ont été pris en compte les indications, les gestes et les résultats de la chirurgie. Nous avons colligé 81 cancers mammaires. Le délai moyen de consultation a été de 14,26 mois. Les tumeurs T3 à T4 représentaient 82,71% des cas. Trente-huit patientes (46,91%) ont été opérées. La chimiothérapie néo adjuvante a été réalisée dans 29,63% des cas. Trente-quatre patientes (41,97%) étaient opérables d'emblée. Il s'agissait de mastectomie selon Madden dans 94,74% des cas et de chirurgie de propreté dans 2 cas (5,26% des cas). Une chimiothérapie adjuvante a été réalisée chez 52,63% des patientes opérées. Des complications à type de lymphocèle ont été notées dans 23,68% des cas. Leur traitement a consisté en des ponctions évacuatrices. Les indications de la chirurgie sont limitées par le retard diagnostique corollaire de stades avancés des cancers du sein. L'absence de la radiothérapie rend délicate la pratique de la chirurgie conservatrice et la mastectomie occupe toujours une place importante. Un diagnostic précoce permettrait d'augmenter les indications chirurgicales. PMID:26848364

  14. Hand Mycetoma: The Mycetoma Research Centre Experience and Literature Review.

    Science.gov (United States)

    Omer, Rowa Fathelrahman; Seif El Din, Nancy; Abdel Rahim, Fadwa Awad; Fahal, Ahmed Hassan

    2016-08-01

    Mycetoma is a devastating, neglected tropical disease characterised by extensive tissue involvement resulting in destruction, deformities and disabilities in the affected patients. The hand is commonly affected by mycetoma thus compromises its functionality and hinder the patient's daily activities of living. In this communication, we report on 533 patients with hand mycetoma managed over a period of 24 years at the Mycetoma Research Centre, University of Khartoum, Khartoum, Sudan. Eumycetoma was the commonest type of mycetoma (83.3%) encountered. Males were predominately affected (69.2%) with a sex ratio of 2.2:1. The majority of the patients (84%) were young adult below the age of 40 years old at presentation. The generality of patients (86.4%) were from the Sudan mycetoma belt. Children and adolescents (28.1%), farmers (18.2%) and workers (17.4%) were more frequently affected. The majority of patients (67.4%) had disease duration of less than 5 years at presentation. The study, did not document significant history of local trauma, familial tendency, concomitant medical diseases or other predisposing cause for mycetoma in this population. Pain (23.1%) was not a disease feature in this series and 52% of patients had past surgery for mycetoma and recurrence. The right hand was affected most (60.4%), and 64% of them had small lesion at presentation. Conventional x-ray was only helpful in patients with advanced disease and the MRI accurately determined the disease extension. Cytological smears, surgical biopsies histopathological examination and grains culture were the principal diagnostic tools for causative organisms' identification. In the present series it was difficult to determine the treatment outcome due to high patients follow up dropout.

  15. Hand Mycetoma: The Mycetoma Research Centre Experience and Literature Review.

    Directory of Open Access Journals (Sweden)

    Rowa Fathelrahman Omer

    2016-08-01

    Full Text Available Mycetoma is a devastating, neglected tropical disease characterised by extensive tissue involvement resulting in destruction, deformities and disabilities in the affected patients. The hand is commonly affected by mycetoma thus compromises its functionality and hinder the patient's daily activities of living. In this communication, we report on 533 patients with hand mycetoma managed over a period of 24 years at the Mycetoma Research Centre, University of Khartoum, Khartoum, Sudan. Eumycetoma was the commonest type of mycetoma (83.3% encountered. Males were predominately affected (69.2% with a sex ratio of 2.2:1. The majority of the patients (84% were young adult below the age of 40 years old at presentation. The generality of patients (86.4% were from the Sudan mycetoma belt. Children and adolescents (28.1%, farmers (18.2% and workers (17.4% were more frequently affected. The majority of patients (67.4% had disease duration of less than 5 years at presentation. The study, did not document significant history of local trauma, familial tendency, concomitant medical diseases or other predisposing cause for mycetoma in this population. Pain (23.1% was not a disease feature in this series and 52% of patients had past surgery for mycetoma and recurrence. The right hand was affected most (60.4%, and 64% of them had small lesion at presentation. Conventional x-ray was only helpful in patients with advanced disease and the MRI accurately determined the disease extension. Cytological smears, surgical biopsies histopathological examination and grains culture were the principal diagnostic tools for causative organisms' identification. In the present series it was difficult to determine the treatment outcome due to high patients follow up dropout.

  16. Bilateral adrenal masses: a single-centre experience

    Directory of Open Access Journals (Sweden)

    Nilesh Lomte

    2016-05-01

    Full Text Available Background Bilateral adrenal masses may have aetiologies like hyperplasia and infiltrative lesions, besides tumours. Hyperplastic and infiltrative lesions may have coexisting hypocortisolism. Bilateral tumours are likely to have hereditary/syndromic associations. The data on clinical profile of bilateral adrenal masses are limited. Aims To analyse clinical, biochemical and radiological features, and management outcomes in patients with bilateral adrenal masses. Methods Retrospective analysis of 70 patients with bilateral adrenal masses presenting to a single tertiary care endocrine centre from western India (2002–2015. Results The most common aetiology was pheochromocytoma (40%, followed by tuberculosis (27.1%, primary adrenal lymphoma (PAL (10%, metastases (5.7%, non-functioning adenomas (4.3%, primary bilateral macronodular adrenal hyperplasia (4.3%, and others (8.6%. Age at presentation was less in patients with pheochromocytoma (33 years and tuberculosis (41 years compared with PAL (48 years and metastases (61 years (P<0.001. The presenting symptoms for pheochromocytoma were hyperadrenergic spells (54% and abdominal pain (29%, whereas tuberculosis presented with adrenal insufficiency (AI (95%. The presenting symptoms for PAL were AI (57% and abdominal pain (43%, whereas all cases of metastasis had abdominal pain. Mean size of adrenal masses was the largest in lymphoma (5.5cm followed by pheochromocytoma (4.8cm, metastasis (4cm and tuberculosis (2.1cm (P<0.001. Biochemically, most patients with pheochromocytoma (92.8% had catecholamine excess. Hypocortisolism was common in tuberculosis (100% and PAL (71.4% and absent with metastases (P<0.001. Conclusion In evaluation of bilateral adrenal masses, age at presentation, presenting symptoms, lesion size, and biochemical features are helpful in delineating varied underlying aetiologies.

  17. Clenbuterol toxicity: a NSW poisons information centre experience.

    Science.gov (United States)

    Brett, Jonathan; Dawson, Andrew H; Brown, Jared A

    2014-03-03

    To describe the epidemiology and toxicity of clenbuterol in exposures reported to the NSW Poisons Information Centre (NSWPIC). Retrospective observational study analysing data from all calls about clenbuterol exposure recorded in the NSWPIC database from 1 January 2004 to 31 December 2012. The NSWPIC coversthe Australian jurisdictions New South Wales, Tasmania and the Australian Capital Territory 24 hours a day and provides after-hours cover for the rest of Australia for 7 nights each fortnight. Total number of exposures, source of call (hospital, health care worker, member of the public), time from exposure to call, reasons for drug use, clinical features and advice given. Callers reported 63 exposures to clenbuterol, with a dramatic increase from three in 2008 to 27 in 2012. Of the 63 calls, 35 were from hospital, two from paramedics, one from general practice and 21 direct from the public. At least 53 patients (84%) required hospitalisation. The commonest reasons for use were bodybuilding and slimming. The most common features were tachycardia (24 patients), gastrointestinal disturbance (16) and tremor (11). Exposure was also associated with cardiotoxicity including one cardiac arrest in a 21-year-old man. Although a well recognised doping issue among elite athletes, clenbuterol use has spread out into the general public, especially during 2012, and should be considered in patients using bodybuilding or slimming products who present with protracted sympathomimetic features. The potential for misuse of this substance requires reconsideration of its current poison schedule registration and its availability.

  18. Impact du traitement antirétroviral sur le profil biologique des enfants VIH positifs suivis au Centre Hospitalier et Universitaire de Yaoundé au Cameroun

    Science.gov (United States)

    Kalla, Ginette Claude Mireille; Assoumou, Marie-Claire Okomo; Kamgaing, Nelly; Monebenimp, Francisca; Mbopi-Keou, Francois-Xavier

    2015-01-01

    Introduction L'objectif de ce travail était d’évaluer l'impact du traitement antirétroviral sur le profil biologique des enfants VIH positifs suivis au Centre Hospitalier et Universitaire de Yaoundé au Cameroun. Méthodes Il s'agissait d'une étude rétrospective réalisée de Mai 2003 à Décembre 2012 au CHU de Yaoundé au Cameroun. Pour cette étude, nous avons obtenu une clairance éthique. Résultats L’âge moyen était de 54.02±46.34 mois. The sexe ratio était de 0.96 en faveur des garçons. Le diagnostic s’était fait tardivement (74.2%) ainsi que la mise sous traitement (83.3%). Seuls 36 des 116 enfants (31%) avait pu avoir un bilan biologique à l'initiation du traitement antirétroviral et six mois après l'initiation du traitement antirétroviral. Après six mois de traitement, nous avons enregistrés une augmentation significative des paramètres biologiques suivants: taux de glycémie de 0.09g/L (0.75-0.84; p= 0.007), pourcentage de CD4 chez les enfants de moins de 5 ans de 4.62% (20.12-24.75; p = 0.022), valeur absolue de CD4 chez les enfants de plus de 5 ans de 294 cellules/mm3 (151.18-445.18; p = 0.011), le rapport CD4/CD8 de 0.35 (0.55-0.90; p = 0.000). Enfin, après six mois de traitement, on enregistrait une baisse significative de la charge virale du VIH de 3.90 log (5.85-1.95; p = 0.006). Conclusion Il ressort de cette étude que la restauration immunitaire et la suppression virologique peuvent être obtenus après six mois de traitement antirétroviral. Cependant, des efforts doivent encore être faits en ce qui concerne la prise en charge du suivi biologique, gage d'un bon suivi thérapeutique au Cameroun. PMID:26113902

  19. Le Centre Technique du Livre de l’Enseignement Supérieur: Politique Actuelle et Évolution à Long Terme

    Directory of Open Access Journals (Sweden)

    Pascal Sanz

    2001-07-01

    Full Text Available Les bibliothèques d’étude et de recherche françaises connaissent de graves problèmes de manque de place pour abriter leurs collections, depuis plusieurs décennies. Cela est particulièrement vrai en Ile-de-France qui, bien que représentant à elle seule un tiers des ressources documentaires du pays, n’a pratiquement pas bénéficié de l’effort de construction de bibliothèques universitaires entrepris depuis 1989. Cela est encore plus vrai des grandes bibliothèques patrimoniales de Paris intra-muros, aux fonds particulièrement riches, mais figées dans leurs locaux ancestraux. On avait pris la mesure exacte de cet état de fait au début des années 80 en menant une enquête précise sur les mètres linéaires encore disponibles alors dans les magasins des bibliothèques universitaires de la région parisienne. Le résultat en avait été alarmant. L’idée de construire dans cette région ce que l’on appelait alors un silo propre à accueillir une partie des collections – les moins consultées – de ces bibliothèques avait germé. Au terme d’une lente maturation, un chef de projet fut nommé sur cette question au début des années 90, puis un décret créant le „Centre technique du livre de l’enseignement supérieur (CTLes” parut en octobre 1994. La construction du CTLes fut ensuite rapide: implanté à Marne-La-Vallée, à une trentaine de kilomètres à l’est de Paris, sur un site qu’il partage avec certains services de conservation de la Bibliothèque nationale de France, dont il est cependant indépendant, le centre a commencé à fonctionner fin 1996. Aujourd’hui, le plan „Université du 3ème millénaire” (dit U3M, qui prévoit la construction ou l’extension d’équipements universitaires jusqu’en 2006, Le Centre Technique du Livre de l’Enseignement Supérieur 316 apporte un éclairage nouveau et soudain plus aigu sur certaines questions documentaires. Je vais essayer de montrer comment, se

  20. Le pilotage des centres de recherche des pôles de compétitivité : le cas du centre de recherche intégré MIRCen (CEA)

    OpenAIRE

    Schindler, Aude

    2008-01-01

    En juillet 2005, l'Etat Français a officialisé la création de 66 pôles de compétitivité. La mise en place de ces pôles a pour vocation de favoriser les synergies entre entreprises, centres de formation et unités de recherche autour de projets innovants sur un territoire donné, pour améliorer la situation de l'emploi et l'attractivité du territoire (CIADT, 2004). Cette dynamique entre dans le cadre des entreprises-réseaux, réseaux d'entreprises, pôles de compétences, districts industriels et a...

  1. L'huile d'argan du Maroc, première IGP africaine | CRDI - Centre de ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    8 oct. 2010 ... La Commission nationale des signes distinctifs d'origine et de qualité (CNSDOQ) du Maroc a attribué l'appellation IGP (indication géographique protégée) à l'huile d'argan, appréciée depuis longtemps pour ses vertus nutritives, cosmétiques et médicinales. Le roi Mohammed VI a remis au groupe ...

  2. Les péritonites par rupture d'abcès du foie au Centre Hospitalier ...

    African Journals Online (AJOL)

    antibiotique associé au métronidazole. La voie d'abord a été une médiane sus et sous ombilicale dans tous les cas . La quantité du pus aspiré était en moyenne de 1188ml avec des extrêmes de 200 et 8 000 ml. Le liquide était chocolaté dans 35 cas ...

  3. Experiences of violence, burnout and job satisfaction in Korean nurses in the emergency medical centre setting.

    Science.gov (United States)

    Yoon, Hee Sook; Sok, Sohyune R

    2016-12-01

    The aim of this study was to examine the experience of violence in relation to burnout and job satisfaction in Korean nurses in the emergency medical centre setting. Participants were 236 nurses in the emergency medical centre setting of three metropolitan areas in Korea. Measures included a general characteristics form, characteristics related to experiences of violence, the Maslach Burnout Inventory and the Minnesota Satisfaction Questionnaire. Data were collected from June 2013 to February 2014. In the prediction model, 33.4% of burnout was explained and 35.7% for job satisfaction. The greatest influence on burnout was handling violence, followed by verbal abuse. The greatest influence on job satisfaction was physical threat, followed by handling violence. The study shows that burnout and job satisfaction of Korean nurses in the emergency medical centre setting are related to experiences of violence such as verbal abuse, physical threat and physical violence, as well as handling violence. © 2016 John Wiley & Sons Australia, Ltd.

  4. Les riches heures et l’avenir incertain de la culture cotonnière en Afrique de l’Ouest et du Centre

    Directory of Open Access Journals (Sweden)

    Camille Renaudin

    2010-12-01

    Full Text Available La culture du coton a été un des rares succès de développement agricole mené dans les pays d’Afrique de l’Ouest et du Centre de la zone franc CFA dans la deuxième moitié du XXe siècle. La crise qu’elle traverse aujourd’hui engage pourtant son devenir et traduit la difficile insertion des filières cotonnières africaines sur le marché mondial. Elle met également en lumière le poids des contraintes inhérentes aux environnements des Etats africains. Autant de facteurs - exogènes et endogènes - que doivent prendre en compte les acteurs investis dans ces filières afin de s’orienter vers une amélioration durable de la production. L’enjeu est de maintenir des revenus à des millions de familles dans ces campagnes africaines.Cotton farming has been one of the rare achievements in the agricultural development of Western and Central African CFA franc countries in the second half of the twentieth century. However, the economical crisis is now facing threats that jeopardize its future and shows the difficulty for African cotton industries to integrate the global market. It also reveals the inherent constrains to African countries environments. As much factors - exogenous and endogenous – that the actors involved in these industries have to consider in order to promoting a long term improvement of their production. The stake is to maintain an income for millions of families in these African rural regions.

  5. Séroprévalence de l’AgHBs chez la femme enceinte dans le centre du Maroc

    Science.gov (United States)

    Sbiti, Mohammed; Khalki, Hanane; Benbella, Imane; louzi, Lhoussaine

    2016-01-01

    La transmission materno-fœtale du virus de l'hépatite B (VHB) est un problème qui préoccupe toujours les autorités sanitaires à travers le monde et suscite la mise en place de mesures préventives renforcées. Le statut réplicatif du virus chez la mère séropositive, évalué par la positivité de l'AgHbe et le taux de la charge virale, conditionne le risque de contamination qui est plus important en période péri-natale. Les mères porteuses chroniques du VHB constituent un véritable réservoir de la transmission verticale de cette infection. Nous avons étudié, à travers cette enquête sur 1120 femmes enceintes Marocaines, la séroprévalence de l'AgHBs qui était de 2,35%, dans le but d'alimenter les données nationales sur ce sujet. Parmi ces femmes séropositives pour l'AgHBs, 79,1% avaient un AgHBe négatif et ont bénéficié d'une recherche moléculaire qui s'est révélée positive dans 89,4% des cas. La vaccination de la femme en âge de procréer est l'un des piliers majeurs de la prévention de la transmission verticale du VHB, seulement 2,4% de nos patientes étaient vaccinées. Ceci relève l'intérêt du dépistage au cours de la grossesse, qui doit se focaliser sur la sensibilisation à la vaccination de femmes séronégatives, et le suivi par biologie moléculaire des mères séropositives dans le but d'instaurer un traitement prophylactique adéquat. PMID:27795784

  6. Heterotopic heart transplantation: a single-centre experience.

    Science.gov (United States)

    Boffini, M; Ragni, T; Pellegrini, C; Goggi, C; D'Armini, A M; Rinaldi, M; Viganò, M

    2004-04-01

    Orthotopic heart transplantation (OHTx) represents the therapy of choice for end-stage heart disease not treatable with medical or conservative surgical approach. Heterotopic heart transplantation (HHTx) is a surgical procedure in which the graft is connected to the native heart in a parallel fashion and it was especially employed in precyclosporine era. The aim of this paper is to present our experience with HHTx. From November 1985 till May 2003, 713 heart transplanted patients included 12 (1.7%) received HHTx. Eleven were male, mean age was 50.7 +/- 5.8 years. Five patients suffered from dilated cardiomyopathy and seven from ischemic cardiomyopathy. Indication for HHTx was: a body size mismatch in 11 cases and availability of a marginal organ in one case. Mean ischemic time was 149 +/- 48 minutes and mean cross-clamp time was 82.3 +/- 19.1 minutes. In four cases left ventricle aneurysm resection was associated with HHTx. Hospital mortality was 8.3% (one patient due to multiorgan failure). The actuarial survival rates were 92% and 64% at 1 and 5 years, respectively. The causes of death were: liver cancer, liver cirrosis, aortic dissection, cerebrovascular accident, and chronic rejection. In our experience, HHTx survival rate is comparable to OHTx. Because of the scarcity of donors, use of an undersized or marginal graft is a valid option to increase the number of transplanted patients. The major disadvantages of HHTx are the need for anticoagulant therapy, the more difficult hemodynamic and immunologic follow-up, and the presence of the diseased native heart.

  7. Paediatric palliative care at home: a single centre's experience.

    Science.gov (United States)

    Chong, Lee Ai; Khalid, Farah

    2016-02-01

    There is increased awareness of paediatric palliative care in Malaysia, but no local published data on home care services. We aimed to describe the paediatric experience at Hospis Malaysia, a community-based palliative care provider in Malaysia. We conducted a retrospective case note review of patients aged up to 21 years who were referred to Hospis Malaysia from 2009 to 2013. A total of 137 patients (92 male, 45 female) with a median age of 140 (3-250) months were included in this study. The majority (71.5%) had malignancies. At referral, 62 patients were still in hospital and 17 died prior to discharge. A total of 108 patients received home visits. At the first home visit, 89.8% of patients had at least one physical symptom. Pain was the most common (52.5%) symptom. Patients had various supportive devices: 39 were on feeding tubes, ten had tracheostomies, five were on bilevel positive airway pressure and ten had urinary catheters. 66 families discussed the preferred location of care at end-of-life. Among those who died, 78.9% died at home, as they preferred (p home death and age, diagnosis and number of home visits. Bereavement follow-up occurred for 93.3% of families. Community care referrals tend to occur late, with 25.5% of patients dying within two weeks of referral. At referral, patients often had untreated physical symptoms. The majority of families preferred and had a home death. Copyright © Singapore Medical Association.

  8. Approche de l’état podologique du patient diabétique hémodialysé chronique dans un centre hospitalier Marocain

    Science.gov (United States)

    Benabdellah, Nawal; Karimi, Ilham; Bentata, Yassamine; Haddiya, Intissar

    2013-01-01

    De plus en plus de patients diabétiques sont pris en charge en HDC. Les conséquences sont multiples, notamment les problèmes de pied diabétique qui demeurent mal connus du patient diabétique et des soignants ce qui retentit considérablement sur la qualité de prise en charge. Nous avons réalisé une Etude transversale en Novembre 2011 au centre d'hémodialyse de l'hôpital Al Farabi d'Oujda, incluant tous nos patients diabétiques HDC. Nous avons relevé les données démographiques, clinico-biologiques et dialytiques. Nous avons receuilli les éléments suivants: la présence ou non de douleur évalué par l’échelle visuelle analogique (EVA), le périmétre de marche, le recours ou non aux soins de pédicurie, le chaussage adapté, les antécédents de chirurgie vasculaire, l'existence ou non de troubles statiques et trophiques des pieds et la recherche d'une neuropathie par un test utilisant un brin de coton. L'analyse statistique est réalisée à l'aide du logiciel 11,5. Dans notre série, 12,9% des patients HDC sont diabétiques et présentent des troubles podologiques, aucun de nos patients n'a bénéficié de pontages ni angioplastie du membre inférieur alors que 8% ont subi des amputations. Le périmètre de marche est limité chez 75% des patients. 16,6% plaies diverses. Les diabétiques en HDC représentent une population de patients fragiles qui nécessitent une prise en charge multidisciplinaire visant d'abord la prévention, le diagnostic précoce des ulcérations du pied diabétique, le traitement adapté aussi bien de l'infection que de l’équilibre glycémique, de nombreuses amputations chez ces patients peuvent être évitées grâce à un suivi et un programme d’éducation thérapeutique adapté. PMID:24498462

  9. Kasabach-Merritt phenomenon: a single centre experience.

    LENUS (Irish Health Repository)

    Ryan, Clodagh

    2012-01-31

    OBJECTIVE: Kasabach-Merritt phenomenon (KMP) can lead to life-threatening bleeding, and its optimum treatment has not been established. We review the experience of managing KMP in a single institution. METHODS: A retrospective chart review on all children with KMP treated at the Hospital for Sick Children, Toronto, over an 18 yr period was carried out. RESULTS: All 15 patients had profound thrombocytopenia and hypofibrinogenemia at presentation, half had bleeding symptoms, and three had cardiac failure. All patients received corticosteroids. Five responded to steroids alone, given for an average of 13 wk, increasing platelets to >20 x 10(9)\\/L at a mean of 6.2 d and fibrinogen >1 g\\/dL at 25.6 d. Ten patients received at least one other therapeutic modality in addition to steroids, including vincristine, interferon, anti-platelet agents and pentoxifylline. Five patients received vincristine, for a mean of 6 wk, with two patients responding. Eight patients received interferon, for a mean of 4 months, with two patients responding. Overall, the mean time to increasing platelets >20 x 10(9)\\/L was 56 d, to >150 x 10(9)\\/L was 88 d and fibrinogen >1 g\\/dL 49 d. Ten patients showed a partial response to embolisation, with a mean of 2.8 procedures performed. Thrombotic complications occurred in 7%. Twelve patients remain alive, with relapse in six patients, all treated successfully. One patient died, and two patients have been lost to follow-up. CONCLUSION: KMP is a rare condition, with significant morbidity and mortality. The therapeutic approach should include a multidisciplinary team and consensus on guidelines.

  10. The limited worldwide opening of the electric power sector: from States pre-eminence to the relative comeback of the Centre; La mondialisation limitee du secteur electrique: de la preeminence des Etats au retour relatif du Centre

    Energy Technology Data Exchange (ETDEWEB)

    Ruet, J.

    2002-07-01

    There are at least two reasons for undertaking a study of the political economy of India's electrical sector. Given that it is placed under the joint responsibility of the Centre and the States, its evolution reflects the relations between these two levels of the Indian federal system. Besides, the recent implementation of guidelines which have found favour with a large number of foreign countries could camouflage a subtle relationship with globalization which, in the case of India, is determined largely by the power equations within the country. Indeed, the reform path chosen integrates two elements: the argument that reforms have become necessary on account of the inefficiency of public sector organisations whose modes of functioning are inherited from the Indian bureaucratic system; secondly, there are political and economic forces who demand reforms as an essential element of their political strategy. In particular, contrary to the classical view in India that with liberalization there has been an emancipation of the States with regard to the Centre and the creation of expanding markets for foreign investments, the 'globalization' of the electricity sector, understood here as the opening up to the foreign private sector, could in reality be equated to a relative strengthening of the Centre vis-a-vis the States. It could also turn out to be to the advantage of some very local components, such as consumers' associations, whether rural or of local communities. (author)

  11. Registered nurses' experiences of their decision-making at an Emergency Medical Dispatch Centre.

    Science.gov (United States)

    Ek, Bosse; Svedlund, Marianne

    2015-04-01

    To describe registered nurses' experiences at an Emergency Medical Dispatch Centre. It is important that ambulances are urgently directed to patients who are in need of immediate help and of quick transportation to a hospital. Because resources are limited, Emergency Medical Dispatch centres cannot send ambulances with high priority to all callers. The efficiency of the system is therefore dependent on triage. Nurses worldwide are involved in patient triage, both before the patient's arrival to the hospital and in the subsequent emergency care. Ambulance dispatching is traditionally a duty for operators at Emergency Medical Dispatch centres, and in Sweden this duty has become increasingly performed by registered nurses. A qualitative design was used for this study. Fifteen registered nurses with experience at Emergency Medical Dispatch centres were interviewed. The participants were asked to describe the content of their work and their experiences. They also described the most challenging and difficult situations according to the critical incidence technique. Content analysis was used. Two themes emerged during the analysis: 'Having a profession with opportunities and obstacles' and 'Meeting serious and difficult situations', with eight sub-themes. The results showed that the decisions to dispatch ambulances were both challenging and difficult. Difficulties included conveying medical advice without seeing the patient, teaching cardio-pulmonary resuscitation via telephone and dealing with intoxicated and aggressive callers. Conflicts with colleagues and ambulance crews as well as fear of making wrong decisions were also mentioned. Work at Emergency Medical Dispatch centres is a demanding but stimulating duty for registered nurses. Great benefits can be achieved using experienced triage nurses, including increased patient safety and better use of medical resources. Improved internal support systems at Emergency Medical Dispatch centres and striving for a blame

  12. Epidémiologie du cancer gastrique: expérience d'un centre hospitalier marocain

    Science.gov (United States)

    Mellouki, Ihsane; laazar, Nawal; Benyachou, Bahija; Aqodad, Nouredine; Ibrahimi, Adil

    2014-01-01

    Le cancer de l'estomac est représenté essentiellement par Les adénocarcinomes gastriques, ces derniers demeurent l'une des dix premières causes mondiales de mortalité avec un pronostic qui est péjoratif. Son incidence reste variable à travers le monde, elle est caractérisée par une importante disparité géographique. Le but de notre travail est de décrire les caractéristiques épidémiologiques de l'adénocarcinome gastrique dans notre contexte à travers une étude rétrospective, observationnelle étalée sur une période de 10 ans (Janvier 2001- Janvier 2011), incluant tous les malades admis au service d'hépato-gastroentérologie du CHU Hassan II de Fès pour prise en charge d'un adénocarcinome gastrique. Durant cette période, 343 patients étaient admis pour prise en charge d'une tumeur gastrique, dont 170 patients avaient un adénocarcinome gastrique (49.5%). L’âge moyen de ces patients était de 58±13.4 ans [16 ans-0 ans]. Dans 43.7% des cas, les patients provenaient de la région de Fès, souvent du milieu rurale. On note une nette prédominance masculine, avec une différence significative entre les 2 sexes (p < ;0.05). Les patients âgés de moins de 60ans représentaient la tranche d’âge prédominante (63%) par rapports aux patients âgés de plus de 60ans (p = 0.02). 61% des patients consultaient dans un délai allant de 1 mois à 6 mois, 30.4% des patients étaient tabagiques, ce facteur avait une relation statistiquement significative avec l'adénocarcinome gastrique (p = 0.02). la non consommation de l'alcool est inversement liée et de façon significative à l'apparition de l'adénocarcinome gastrique (p = 0.03) dans notre contexte. L'infection par Hélicobacter pylori n’était mentionnée que chez peu de malades. Les formes métastatiques au moment du diagnostic dépassaient 50% avec un taux de décès au cours de l'hospitalisation de 2.6%. Sur le plan endoscopique, la localisation antropylorique, et la forme ulc

  13. Pathologie des tortues marines en Polynésie française : exemple du centre de soins de Moorea

    OpenAIRE

    Baron, Soài

    2014-01-01

    Cette thèse a pour but de faire un bilan des affections retrouvées à la Clinique pour tortues marines de Moorea en Polynésie française. Elle fournit également un outil dans l’orientation diagnostique et les traitements des principaux symptômes. L’étude réalisée sur 339 tortues (Chelonia mydas et Eretmochelys imbricata principalement), sur une période de neuf ans (2004-2013), montre que 33,2% des tortues mortes au centre de soins ont été victimes de braconnage et 35,4% des individus reçus prés...

  14. Two experiments for the measurement of the centre of percussion of a physical pendulum

    Science.gov (United States)

    Malgieri, Massimiliano; Onorato, Pasquale; Mascheretti, Paolo; De Ambrosis, Anna

    2016-09-01

    In this article we describe two experiments, performed with instrumentation commonly available in undergraduate laboratories, to measure the position of the centre of percussion of a physical pendulum. The first one makes use of a constant external force provided by a common spring dynamometer, and allows for a straightforward analysis founded on basic concepts of rigid body dynamics. The second one is, more properly, an experiment based on a percussion, i.e. a collision involving an almost impulsive force, and displays the typical difficulties, but also the physical richness, of this type of phenomena. We provide an historical overview of the problem of the centre of percussion, starting from its first formulation given by Bernardino Baldi at the end of the 16th century, and we show how the mathematical model built for analysing the impact between a physical pendulum and a localised object is helpful in understanding that such a problem, in its original formulation, does not have a unique answer.

  15. [Characteristics of adolescent offenders receiving services in juvenile centers in Québec (Centres jeunesse du Québec, CJQ)].

    Science.gov (United States)

    Toupin, Jean; Pauzé, Robert; Lanctôt, Nadine

    2009-01-01

    This study aims at establishing a comparative psychological profile of male and female adolescents at the moment of the application of measures in juvenile centers in Québec (centres jeunesse du Québec, CJQ) as well as their family and social characteristics. The study compares 213 adolescents (12-17 years old) receiving services in CJQ in accordance with the juvenile offenders act (Loi sur les jeunes contrevenants), with 213 adolescents from high schools of impoverished neighbourhoods. Results reveal serious problems of adaptation, external disorders and interiorized disorders and a regular substance abuse among many juvenile offenders. These problems are much more frequent in CJQ than within the juvenile population. The situation of these adolescents is worrisome, given that a high prevalence of depression and sexual victimisation is also observed in females. Finally, families whose adolescent receives services in CJQ have less financial, personal and social resources, as well as more difficulty exercising their parental role compared to parents in the general population. In conclusion, recommendations are proposed concerning psychosocial services necessary for these adolescents and their families.

  16. Le Groupe d'Histoire de l'Astronomie du Centre François Viète de l'Université de Nantes, et le patrimoine astronomique

    Science.gov (United States)

    Boistel, G.; Tirard, S.

    2012-12-01

    Le Groupe d'Histoire de l'Astronomie (GHA) du Centre François Viète d'histoire et des techniques de l'Université de Nantes, travaille et publie régulièrement des travaux de recherche depuis l'année 2000 dans les domaines de l'histoire des observatoires astronomiques et des observatoires navals, civils ou militaires, et des questions liées à la sauvegarde du patrimoine. Ces recherches se font en collaboration avec des astronomes acteurs de la sauvegarde du patrimoine des observatoires (observatoires de Marseille, de Nice, de Bordeaux notamment). Au sein du Centre François Viète existe une expertise sur les questions patrimoniales qui doit permettre d'accompagner les astronomes dans la réflexion portant sur la sauvegarde des archives et des instruments des observatoires, ainsi que sur leur valorisation auprès de différents publics.

  17. The experience of two European preimplantation genetic diagnosis centres on human leukocyte antigen typing.

    Science.gov (United States)

    Van de Velde, Hilde; De Rycke, Martine; De Man, Caroline; De Hauwere, Kim; Fiorentino, Francesco; Kahraman, Semra; Pennings, Guido; Verpoest, Willem; Devroey, Paul; Liebaers, Inge

    2009-03-01

    Two European centres report on human leukocyte antigen (HLA) typing of preimplantation embryos for haematopoietic stem cell (HSC) transplantation: 'UZ Brussel' in Brussels and 'Genoma' in Rome. Both centres have 6 years' experience with technical and clinical aspects of this type of genetic analysis on single blastomeres. Both centres apply a similar technique for preimplantation HLA typing using short tandem repeats linked to the HLA locus in multiplex PCR for haplotyping. At present, a conclusive HLA diagnosis could be assured in 92.8% and 90.3% of the embryos at UZ Brussel and at Genoma, respectively. The implantation rates were 32.4% and 28.2%, respectively, and the birth rates per cycle were 9.4% and 18.6%, respectively. The HLA programme at UZ Brussel and at Genoma resulted in the birth of 9 babies and 3 successful HSC transplantations, and 42 babies and 7 successful HSC transplantations, respectively, so far. Drastic embryo selection for preimplantation HLA typing (in theory 1/4 for HLA, 1/8 for HLA in combination with sexing for X-linked recessive diseases, 3/16 for HLA in combination with autosomal recessive disorders) resulted overall in the birth of 51 babies (15.9% live birth rate per started cycle) in two European centres.

  18. Analyse de la diversité des systèmes de pratiques en cacaoculture. Cas du Centre Cameroun

    Directory of Open Access Journals (Sweden)

    Menimo T.

    2008-01-01

    Full Text Available Analysis of the diversity of cocoa cropping systems. Case of the Central Cameroon. Little is known about the cultural practices adopted by cocoa farmers in Central Cameroon. In order to bridge that knowledge gap, 1,428 farms were surveyed in four divisions of Centre province, which differed through the prevailing type of cocoa cultivation. Farmer typologies were established, based on their cultural practices for cocoa growing. Three scales of investigation were considered: province, division and village. This study confirmed the diversity of cocoa growing systems existing in Central Cameroon. A multidimensional exploratory analysis revealed that the links between the variables considered varied substantially from one division to another, though the degree of intensification in inputs and labour were the main determinants of cocoa yields. Four to five categories of farmers, which differed from each other depending on the variables studied, were found for each scale of investigation. In methodological terms, the classification method adopted to establish the typologies confirmed its efficiency. It showed that data analysis on a village scale relativized the results observed on a division scale, by making it possible to identify the cocoa growing system dominating a given village. This approach therefore enabled a better appreciation of similarities between the study zones, similarities which administrative or geographical zoning tended to hide. It suggested that it is necessary to assist farmers taking into account the diversity of situations.

  19. Woman-centred care during pregnancy and birth in Ireland: thematic analysis of women's and clinicians' experiences.

    LENUS (Irish Health Repository)

    Hunter, Andrew

    2017-09-25

    Recent policy and service provision recommends a woman-centred approach to maternity care. Midwife-led models of care are seen as one important strategy for enhancing women\\'s choice; a core element of woman-centred care. In the Republic of Ireland, an obstetric consultant-led, midwife-managed service model currently predominates and there is limited exploration of the concept of women centred care from the perspectives of those directly involved; that is, women, midwives, general practitioners and obstetricians. This study considers women\\'s and clinicians\\' views, experiences and perspectives of woman-centred maternity care in Ireland.

  20. From the disposal center to the bio-reactor; Du centre d'enfouissement au bioreacteur?

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2003-07-01

    The bio-reactor concept, which is based on the containment and the control principles, could be an option to the storage centers if the operating parameters are well mastered. The storage center experiment of Montech is presented and analyzed. It shows that the thermal phenomena are easier to understand, simulate and control than the humidity movements. A new solution is presented: the biological and mechanical treatment of the wastes before the disposal. (A.L.B.)

  1. User experience in libraries applying ethnography and human-centred design

    CERN Document Server

    Borg, Matt

    2016-01-01

    Modern library services can be incredibly complex. Much more so than their forebears, modern librarians must grapple daily with questions of how best to implement innovative new services, while also maintaining and updating the old. The efforts undertaken are immense, but how best to evaluate their success? In this groundbreaking new book from Routledge, library practitioners, anthropologists, and design experts combine to advocate a new focus on User Experience (or UX ) research methods. Through a combination of theoretical discussion and applied case studies, they argue that this ethnographic and human-centred design approach enables library professionals to gather rich evidence-based insights into what is really going on in their libraries, allowing them to look beyond what library users say they do to what they actually do. Edited by the team behind the international UX in Libraries conference, "User Experience in Libraries" will ignite new interest in a rapidly emerging and game-changing area of resear...

  2. Tokens of trauma: The ageing experience of Shoah survivors in a Jewish support centre.

    Directory of Open Access Journals (Sweden)

    Ben Kasstan

    2015-05-01

    Full Text Available This paper explores the traumatic memories of ageing Shoah survivors who attend a Jewish social and therapeutic support facility in London (UK. The study investigates the perceived differences in trauma within a diverse group of members who partake in the day centre. The difference in Shoah experience contextualises how survivors of ghettos and concentration camps possess a salient relationship with food, notably bread which acts as an enduring symbol of catastrophe for participants. The meanings that underlie death amongst camp survivors are evaluated, where decisions regarding the end of life stage can be interpreted as a shared experience with those who perished during the Shoah. Results exemplify how religious and cultural elements of Judaism mediate the trauma that has become thoroughly embodied for participants. survival is steeped in intersubjective acts of remembrance, offering a novel contribution to the anthropological study of genocide.

  3. Queer periods: attitudes toward and experiences with menstruation in the masculine of centre and transgender community.

    Science.gov (United States)

    Chrisler, Joan C; Gorman, Jennifer A; Manion, Jen; Murgo, Michael; Barney, Angela; Adams-Clark, Alexis; Newton, Jessica R; McGrath, Meaghan

    2016-11-01

    Menstruation has long been viewed as an important aspect of women's health. However, scholars and healthcare providers have only recently begun to recognise that transgender men and people with masculine gender identities also menstruate, thus little is known about their attitudes toward and experiences with menstruation. A sample of masculine of centre and transgender individuals with a mean age of 30 years was recruited online to complete measures of attitudes toward menstruation and menstrual suppression and to answer exploratory questions about their experiences managing menstruation. Participants reported mixed attitudes toward menstruation, but generally positive attitudes toward menstrual suppression. Many participants said that they try to avoid public restrooms during menstruation because of practical and psychological concerns. Implications of our findings for the transgender health are discussed.

  4. Virtual community centre for power wheelchair training: Experience of children and clinicians.

    Science.gov (United States)

    Torkia, Caryne; Ryan, Stephen E; Reid, Denise; Boissy, Patrick; Lemay, Martin; Routhier, François; Contardo, Resi; Woodhouse, Janet; Archambault, Phillipe S

    2017-11-02

    To: 1) characterize the overall experience in using the McGill immersive wheelchair - community centre (miWe-CC) simulator; and 2) investigate the experience of presence (i.e., sense of being in the virtual rather than in the real, physical environment) while driving a PW in the miWe-CC. A qualitative research design with structured interviews was used. Fifteen clinicians and 11 children were interviewed after driving a power wheelchair (PW) in the miWe-CC simulator. Data were analyzed using the conventional and directed content analysis approaches. Overall, participants enjoyed using the simulator and experienced a sense of presence in the virtual space. They felt a sense of being in the virtual environment, involved and focused on driving the virtual PW rather than on the surroundings of the actual room where they were. Participants reported several similarities between the virtual community centre layout and activities of the miWe-CC and the day-to-day reality of paediatric PW users. The simulator replicated participants' expectations of real-life PW use and promises to have an effect on improving the driving skills of new PW users. Implications for rehabilitation Among young users, the McGill immersive wheelchair (miWe) simulator provides an experience of presence within the virtual environment. This experience of presence is generated by a sense of being in the virtual scene, a sense of being involved, engaged, and focused on interacting within the virtual environment, and by the perception that the virtual environment is consistent with the real world. The miWe is a relevant and accessible approach, complementary to real world power wheelchair training for young users.

  5. The relationship between women-centred care and women's birth experiences: a comparison between birth centres, clinics, and hospitals in Japan.

    Science.gov (United States)

    Iida, Mariko; Horiuchi, Shigeko; Porter, Sarah E

    2012-08-01

    the goal of women-centred care (WCC) is respect, safety, holism, partnership and the general well-being of women, which could lead to women's empowerment. The first step in providing WCC to all pregnant women is to describe women's perceptions of WCC during pregnancy in different health facilities. The objectives of this study were to ask (a) what are the perceptions and comparison of WCC at Japanese birth centres, clinics, and hospitals and (b) what are the relationships between WCC and three dimensions of women's birth experience: (1) satisfaction with care they received during pregnancy and birth, (2) sense of control during labour and birth, and (3) attachment to their new born babies. this was a cross-sectional study using self-completed retrospective questionnaires. three types of health facility: birth centres (n=7), clinics (n=4), and hospitals (n=2). participants were women who had a singleton birth and were admitted to one of the study settings. Women who were seriously ill were excluded. Data were analysed on 482 women. instrumentation included: a researcher-developed WCC-pregnancy questionnaire, Labour Agentry Scale, Maternal Attachment Questionnaire, and a researcher-developed Care Satisfaction Scale. among the three types of settings, women who delivered at birth centres rated WCC highly and were satisfied with care they received compared to those who gave birth at clinics and hospitals. WCC was positively associated with women's satisfaction with the care they received. women giving birth at birth centres had the most positive perceptions of WCC. This was related to the respectful communication during antenatal checkups and the continuity of care by midwives, which were the core elements of WCC. health-care providers should consider the positive correlation of WCC and women's perception of satisfaction. Every woman should be provided continuity of care with respectful communication, which is a core element of WCC. Copyright © 2011 Elsevier Ltd. All

  6. Dental students' perceptions of their experience at a residential outreach centre.

    Science.gov (United States)

    Radford, D R; Hellyer, P

    2015-08-28

    The Portsmouth Dental Academy delivers an interprofessional education to dental students on outreach placement from King's College London Dental Institute. To establish what the dental students' attitudes to the placement are and how these correlate to the perceptions of the staff who work with them. Using Delphi consensus procedures, a simple, closed, two-question questionnaire was developed. The questionnaire was completed by the students and then, to triangulate the results, was subsequently applied to staff who teach and assist them on clinic. To the question: Why do you think the experience that is commonly termed the 'Portsmouth experience' is so successful 'in the eyes of the students'?, the students ranked first the response: 'Students gain experience in primary dental care clinical practice under the current NHS contract - UDAs and KPIs'. To the second question: What do you think the students most enjoyed about working in Portsmouth?, the students ranked first: 'A sense of independence - being made to make their own decisions'. The students' major perception of the 'Portsmouth experience' centres around the placement being a realistic preparation for their future practising career. This is combined with a strong sense of belonging when studying and working at the Academy.

  7. Lundi 27 Janvier 2014 - V. Duby-Muller Député de Haute-Savoie lors de la signature du livre d'or avec F. Bordry Directeur des accélérateurs et de la technologie et lors de sa visite dans le tunnel du LHC au Point 1 avec I. Wingerter-Seez Collaboration ATLAS, Membre du Conseil exécutif, LAPP Annecy. M. Delmastro et J. Levêque Collaboration ATLAS, LAPP Annecy - Centre National de la Recherche Scientifique aussi présents

    CERN Multimedia

    Pantelia, Anna

    2014-01-01

    Lundi 27 Janvier 2014 - V. Duby-Muller Député de Haute-Savoie lors de la signature du livre d'or avec F. Bordry Directeur des accélérateurs et de la technologie et lors de sa visite dans le tunnel du LHC au Point 1 avec . I. Wingerter-Seez Collaboration ATLAS, Membre du Conseil exécutif, LAPP Annecy. M. Delmastro et J. Levêque Collaboration ATLAS, LAPP Annecy - Centre National de la Recherche Scientifique aussi présents

  8. Persons with Haemophilia in Sweden- Experiences and Strategies in Everyday Life. A Single Centre Study.

    Directory of Open Access Journals (Sweden)

    Elisabeth Brodin

    Full Text Available Haemophilia is caused by deficiency in coagulation factor VIII or IX. Treatment with the missing coagulation factors has been available in most developed countries for several decades. The aim was to explore the experiences of adults living with severe or moderate haemophilia and their coping strategies at a single centre in Sweden.The interview study had a qualitative empirical approach and was analyzed on the basis of the method empirical phenomenological psychology. The sample included 14 participants, mean age 42 (19-80 y, who met the inclusion criteria and to saturation of information.General characteristics were; All were satisfied with and grateful for access to medication. An acceptance of the disorder and willingness to live a normal life was identified among all participants. They were all content with the care provided by Haemophilia Treatment Centre (HTC and felt supported by its multidisciplinary team. Four typologies were identified; Protective adults and assertive children during up-bringing, finding a role in social context, symptoms and treatments, fear of limited resources in the future. Task-, emotional- and avoidance coping strategies were seen in the interviews. The most prominent coping strategy was task oriented.This interview study with Swedish PWH shows that they strive for normality and adaptation in social activities throughout life finding their own niche. The PWH expressed the importance of knowledge and support from the comprehensive medical team at HTC and therefore it seems important to continue comprehensive medical care at HTC in order to follow-up the haemophilia persons regularly.

  9. Charte du Conseil des Gouverneurs

    International Development Research Centre (IDRC) Digital Library (Canada)

    Office 2004 Test Drive User

    Le Centre de recherches pour le développement international (CRDI) est une société d'État créée par le Parlement du Canada en 1970. Il fait rapport au Parlement par l'entremise du ministre désigné par le gouverneur en conseil, à savoir le ministre des Affaires étrangères à l'heure actuelle. La Loi sur le Centre de ...

  10. Directeur des communications (h/f) | CRDI - Centre de recherches ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    Résumé des fonctions Conçoit, planifie et met en oeuvre une stratégie de communication qui assure un soutien au CRDI de la part des décideurs canadiens responsables de l'avenir du Centre et qui répond aux besoins du Centre auprès des partenaires du Centre, du grand public, des médias et des scientifiques, ...

  11. Electric dipole centres and colour centres in natural sodalite

    NARCIS (Netherlands)

    Brom, W.E. van den; Kerssen, J.; Volger, J.

    1974-01-01

    Experiments on an electric dipole centre, exhibiting multiple relaxation, in the natural mineral sodalite, are described. The concentration of the dipole centres is reduced upon X irradiation, whereas simultaneously colour centres and paramagnetic centres arise. Thermal bleaching restores the

  12. Observance du traitement et contrôle de la pression artérielle chez des adultes souffrant d’hypertension primaire soignés dans un centre de soins primaires d’un hôpital tertiaire à l’Est du Nigéria

    Directory of Open Access Journals (Sweden)

    Gabriel U.P. Iloh

    2013-01-01

    Full Text Available Contexte: Comme les taux de détection de cas d’hypertension augmentent chez les Nigérians d’âge adulte, le contrôle de la pression artérielle (Pa est devenu un important défi à gérer.Objectifs: Décrire l’observance du traitement et le contrôle de la Pa chez les Nigérians d’âge adulte souffrant d’hypertension primaire traités dans un centre de soins primaires d’un hôpital tertiaire dans un environnement caractérisé par la rareté des ressources à l’Est du Nigéria.Méthodes: Une étude transversale a été réalisée auprès de 140 patients adultes souffrant d’hypertension primaire traitées depuis au moins 6 mois au centre de soins primaires du Centre médical fédéral d’Umuahia. Il est considéré qu’un patient a atteint son objectif de contrôle de la Pa si celle--ci est < 140 par 90 mmHg. L’observance a été évaluée dans les 30 jours précédents en utilisant un questionnaire prétesté administré par les chercheurs sur 30 jours d’autothérapie. L’observance a été notée en utilisant un système de notation ordinal allant de 0 à 4 ; un patient suivant à son traitement se voyait accorder une note de 4 dans les 30 jours précédents. Les raisons d’une mauvaise observance ont été documentées.Résultats: Les taux d’observance du traitement et de contrôle de la Pa s’élevaient respectivement à 42,9% et 35.0%. Le contrôle de la Pa est fortement associé à l’observance du traitement (p = 0.03, la durée du traitement antihypertensif ≥ 3 ans (p = 0.042, et la prise ≥d’une forme de traitement anti hypertensif (p = 0.04. Lors de la visite de recrutement, la Pa était nettement plus élevée qu’à la fin de l’étude (p = 0.036. La raison la plus courante de la non observance du traitement est l’oubli (p = 0.046.Conclusion: Le taux de contrôle de la Pa parmi la population étudiée était faible, ce qui peut avoir un rapport avec la faible observance du traitement. Cette

  13. Particularités de la cardiomyopathie du péripartum en Afrique: le cas du Togo sur une étude prospective de 41 cas au Centre Hospitalier et Universitaire Sylvanus Olympio de Lomé

    Science.gov (United States)

    Pio, Machihude; Afassinou, Yaovi; Baragou, Soodougoua; Akue, Edem Goeh; Péssinaba, Souleymane; Atta, Borgatia; Ehlan, Koffi; Alate, Amouzou; Damorou, Findibe

    2014-01-01

    Introduction La cardiomyopathie du péripartum (CMPP) est une défaillance cardiaque dont l’étiologie demeure encore méconnue. Méthodes Il s'agit d'une étude prospective descriptive réalisée dans le service de cardiologie du CHU Sylvanus olympio de Lomé du 1er janvier 2010 au 30 avril 2012. Elle a concerné 41 patientes ayant présenté une insuffisance cardiaque entre le 8eme mois de la grossesse et les 5 premiers mois du post-partum. Résultats L’âge moyen des patientes était de 31,47 ans (extrêmes 21 et 44ans). L'incidence de la CMPP était de 1/362 grossesses. La parité moyenne était de 3,07 (extrêmes 1 et 6). Les symptômes étaient apparus dans le post-partum dans 90,24% des cas. Un retard important de diagnostic était observé. L'insuffisance cardiaque globale était le mode de décompensation dans 65,85%. Les signes électrocardiographiques étaient essentiellement la tachycardie sinusale (97,56%) et l'hypertrophie ventriculaire gauche (97,56%). L’échographie cardiaque a montré dans tous les cas une cardiomyopathie dilatée. Quatre cas de thrombus intraventriculaire gauche étaient notés. La FEVG était sévèrement altérée. L'HTAP était importante dans 56,09%. Conclusion La cardiomyopathie du péripartum est une complication cardiaque grave de la grossesse de cause inconnue, fréquente dans la population africaine. PMID:25309645

  14. Discussion on the Implementation of the Patient Centred Medical Home model - Experiences from Australia

    Directory of Open Access Journals (Sweden)

    Safa Majidi Rahbar

    2017-07-01

    adaptation of PCMH model to Australian context Trial and evaluation of tools for transitioning practices to HCHs using an action based research approach, leading to improvements in the handbook. Workshop objective: To share insights and facilitate a structured discussion about practical experience in implementing the elements of the Patient Centred Medical Home, tools that have been effective, challenges that have emerged and approaches used to overcome these challenges. Discussion generated through the workshop will be used to inform further work on the Australian Handbook for Transitioning to the Health Care Home. Workshop outcome: As a result of the workshop it is anticipated that participants will have an increased understanding of the medical home model, hear rich implementation experiences from different contexts and become aware of further tools for model implementation and refinement. Workshop structure: - Brief overview of model implementation taking place in Australia - Smaller group discussion about medical home implementation challenges and successes - Structured workshop group discussion drawing together key insights, common challenges and practical steps, resources or further research needed for address these challenges. Target audience: Policy makers, Primary Health Networks/Organisations, clinicians, practice staff and anyone interested in how to support practices to transition into Medical Homes

  15. Experiences related to the role of a cost centre manager in a public ...

    African Journals Online (AJOL)

    A cost centre in a hospital setting is an identifiable department, for example a nursing care unit, which has been practically assigned an account number in the hospital accounting system. The purpose of a cost centre is to control clinical and administrative costs, as well as accumulated expenses by that identified ...

  16. Bone Anchored Hearing Aid (BAHA) in children: Experience of a tertiary referral centre in Portugal.

    Science.gov (United States)

    Rosa, Francisco; Silva, Ana; Reis, Cláudia; Coutinho, Miguel; Oliveira, Jorge; Almeida E Sousa, Cecília

    The aim of this study is to describe the experience of a tertiary referral centre in Portugal, of the placement of BAHA in children. The authors performed a retrospective analysis of all children for whom hearing rehabilitation with BAHA was indicated at a central hospital, between January 2003 and December 2014. 53 children were included. The most common indications for placement of BAHA were external and middle ear malformations (n=34, 64%) and chronic otitis media with difficult to control otorrhea (n=9, 17%). The average age for BAHA placement was 10.66±3.44 years. The average audiometric gain was 31.5±7.20dB compared to baseline values, with average hearing threshold with BAHA of 19.6±5.79dB. The most frequent postoperative complications were related to the skin (n=15, 28%). There were no major complications. This study concludes that BAHA is an effective and safe method of hearing rehabilitation in children. Copyright © 2016 Elsevier España, S.L.U. and Sociedad Española de Otorrinolaringología y Cirugía de Cabeza y Cuello. All rights reserved.

  17. Recurrent Pneumonia in Children: A Reasoned Diagnostic Approach and a Single Centre Experience.

    Science.gov (United States)

    Montella, Silvia; Corcione, Adele; Santamaria, Francesca

    2017-01-29

    Recurrent pneumonia (RP), i.e., at least two episodes of pneumonia in one year or three episodes ever with intercritical radiographic clearing of densities, occurs in 7.7%-9% of children with community-acquired pneumonia. In RP, the challenge is to discriminate between children with self-limiting or minor problems, that do not require a diagnostic work-up, and those with an underlying disease. The aim of the current review is to discuss a reasoned diagnostic approach to RP in childhood. Particular emphasis has been placed on which children should undergo a diagnostic work-up and which tests should be performed. A pediatric case series is also presented, in order to document a single centre experience of RP. A management algorithm for the approach to children with RP, based on the evidence from a literature review, is proposed. Like all algorithms, it is not meant to replace clinical judgment, but it should drive physicians to adopt a systematic approach to pediatric RP and provide a useful guide to the clinician.

  18. A 6-YEAR EXPERIENCE OF HEART TRANSPLANTATION IN FEDERAL ALMAZOV NORTH-WEST MEDICAL RESEARCH CENTRE

    Directory of Open Access Journals (Sweden)

    E. V. Shlyakhto

    2016-01-01

    Full Text Available Aim. To estimate the results of 6-year experience of heart transplantation (HT in Federal Almazov North-West Medical Research Centre. Methods. From 2010 to 2015 we have performed 65 HT. Mean age was 44.3 ± 14 years old (from 10 to 64 years old. We used biventricular assist device (BIVAD, Berlin Heart Excor support in 7 heart transplant candidates before HT. 19 patients (29% received thymoglobulin, whereas 46 patients (71% had basiliximab to induce immunosuppression.Results. Extracorporeal membrane oxygenation machines were implanted in 5 patients (7.7% after HT due to acute right ventricular failure. Suture annuloplasty (the Batista procedure for tricuspid valve repair was carried out in 3 cases (4.6%. Venovenous hemodiafi ltration was used in 11 patients (16.9%. A total of 598 endomyocardial biopsies (EMB were performed after HT. Evidence of cellular rejection (R1 and R2 was presented in 286 biopsies (48%. The 30-day in-hospital mortality rate was 3.1%. The 6-month survival rate after HT was 92%, 1-year – 91% and overall survival for the 6-year period of observation – 89.2%. Maximum observation period was 71 months.Conclusions. The 6-year experience of HT in our Center has shown a high level of survival. BIVAD Excor support can be effectively used as a «bridge» to HT. Prevention of graft loss due to acute rejection in heart transplant recipients can be achieved only through regular EMB monitoring. The rate of viral infection increased in 2 months after HT.

  19. Splenic injuries at Bugando Medical Centre in northwestern Tanzania: a tertiary hospital experience

    Directory of Open Access Journals (Sweden)

    Chalya Phillipo L

    2012-01-01

    Full Text Available Abstract Background Splenic injuries constitute a continuing diagnostic and therapeutic challenge to the trauma or general surgeons practicing in developing countries where sophisticated imaging facilities are either not available or exorbitantly expensive. The purpose of this review was to describe our own experience in the management of the splenic injuries outlining the aetiological spectrum, injury characteristics and treatment outcome of splenic injuries in our local environment and to identify predictors of outcome among these patients. Methods A prospective descriptive study of splenic injury patients was carried out at Bugando Medical Centre in Northwestern Tanzania between March 2009 and February 2011. Statistical data analysis was done using SPSS software version 17.0. Results A total of 118 patients were studied. The male to female ratio was 6.4:1. Their ages ranged from 8 to 74 years with a median age of 22 years. The modal age group was 21-30 years. The majority of patients (89.8% had blunt trauma and road traffic accidents (63.6% were the most frequent cause of injuries. Most patients sustained grade III (39.0% and IV (38.1% splenic injuries. Majority of patients (86.4% were treated operatively with splenectomy (97.1% being the most frequently performed procedure. Postoperative complications were recorded in 30.5% of cases. The overall length of hospital stay (LOS ranged from 1 day to 120 days with a median of 18 days. Mortality rate was 19.5%. Patients who had severe trauma (Kampala Trauma Score II ≤ 6 and those with associated injuries stayed longer in the hospital (P 2000 mls, HIV infection with CD4 ≤ 200 cells/μl and presence of postoperative complications were significantly associated with mortality (P Conclusion Trauma resulting from road traffic accidents (RTAs remains the most common cause of splenic injuries in our setting. Most of the splenic injuries were Grade III & IV and splenectomy was performed in majority of

  20. Cold burn injuries in the UK: the 11-year experience of a tertiary burns centre.

    Science.gov (United States)

    Nizamoglu, Metin; Tan, Alethea; Vickers, Tobias; Segaren, Nicholas; Barnes, David; Dziewulski, Peter

    2016-01-01

    Guidance for the management of thermal injuries has evolved with improved understanding of burn pathophysiology. Guidance for the management of cold burn injuries is not widely available. The management of these burns differs from the standard management of thermal injuries. This study aimed to review the etiology and management of all cold burns presenting to a large regional burn centre in the UK and to provide a simplified management pathway for cold burns. An 11-year retrospective  analysis (1 January 2003-31 December 2014)  of all cold injuries presenting to a regional burns centre in the UK was conducted. Patient case notes were reviewed for injury mechanism, first aid administered, treatment outcomes and time to healing. An anonymized nationwide survey on aspects of management of cold burns was disseminated between 13 July 2015-5 October 2015 to British Association of Plastic Reconstructive and Aesthetic Surgeons (BAPRAS) and Plastic Surgery Trainees Association (PLASTA) members in the UK. Electronic searches of MEDLINE, EMBASE and the Cochrane Library were performed to identify relevant literature to provide evidence for a management pathway for cold burn injuries. Twenty-three patients were identified. Age range was 8 months-69 years. Total body surface area (TBSA) burn ranged from 0.25 to 5 %. Twenty cases involved peripheral limbs. Seventeen (73.9 %)cases were accidental, with the remaining six (26.1 %) cases being deliberate self-inflicted injuries. Only eight patients received first aid. All except one patient were managed conservatively. One case required skin graft application due to delayed healing. We received 52 responses from a total of 200 questionaires. Ninety percent of responders think clearer guidelines should exist. We present a simplified management pathway based on evidence identified in our literature search. Cold burns are uncommon in comparison to other types of burn injuries. In the UK, a disproportionate number of cold

  1. Kenya | IDRC - International Development Research Centre

    International Development Research Centre (IDRC) Digital Library (Canada)

    Read more about Could affordable daycare be the key to unlocking women's earning power in Africa? Language English. En juillet dernier, des membres du Conseil des gouverneurs du CRDI se sont rendus en Afrique de l'Est pour rencontrer des bénéficiaires de subventions de recherche du Centre au Kenya, ...

  2. La foret du Banco

    NARCIS (Netherlands)

    Koning, de J.

    1983-01-01

    Deze publicatie over het Nationaal Park 'La Forêt du Banco' nabij Abidjan, Ivoorkust, verschijnt als resultaat van vier jaar veldwerk (1972-1976) in dat land.

    Het Centre Néerlandais, onderzoeks- en stageverblijf van de Landbouwhogeschool, was basis en de faciliteiten verleend door

  3. Challenges in interprofessional collaboration: experiences of care providers and policymakers in a newly set-up Dutch assault centre.

    Science.gov (United States)

    Zijlstra, Elza; Lo Fo Wong, Sylvie; Teerling, Anne; Hutschemaekers, Giel; Lagro-Janssen, Antoine

    2017-08-03

    Sexual and family violence are problems that affect many women and men, and the negative health consequences of violence are numerous. As adequate acute interprofessional care can prevent negative health consequences and improve forensic medical examination, a Centre for Sexual and Family Violence was set up. We aimed to improve our understanding of the challenges in interprofessional collaboration in a newly set-up centre for sexual and family violence. We conducted a qualitative study with semi-structured interviews about the experiences with interprofessional collaboration of 16 stakeholders involved in the Centre for Sexual and Family Violence Nijmegen. Participants were selected by purposive sampling. Participants found that the interprofessional collaboration had improved communication and competences. However, there were challenges too. Firstly, the interprofessional collaboration had brought parties closer together, but the collaboration also forced professionals to strongly define their boundaries. Mutual trust and understanding needed to be built up. Secondly, a balance had to be struck between pursuing the shared vision - which was to improve quality of care for victims - and giving space to organizations' and professionals' own interest. Thirdly, care for victims of sexual and family violence could be demanding on healthcare providers in an emotional sense, which might jeopardize professional's initial motivation for joining the Centre for Sexual and Family Violence Nijmegen. The interprofessional collaboration in an assault centre improves quality of care for victims, but there are also challenges. The tasks of an assault centre are to create opportunities to discuss professional roles and professional interests, to build up good interpersonal relations in which trust and understanding can grow, to formulate a strong and shared victim-centred vision and to support care providers with training, feedback and supervision. © 2017 Nordic College of Caring

  4. Séroprévalence des marqueurs viraux sur les dons du sang au Centre de Transfusion Sanguine, Hôpital Militaire d’Instruction Mohammed V de Rabat

    Science.gov (United States)

    Uwingabiye, Jean; Zahid, Hafidi; Unyendje, Loubet; Hadef, Rachid

    2016-01-01

    Le but de ce travail était de déterminer la prévalence du virus de l’immunodéficience humaine (VIH), du virus de l’hépatite B (VHB) et C (VHC) sur les dons du sang collectés au Centre de transfusion sanguine(CTS) de l’hôpital militaire d’instruction Mohammed V entre 2010 et 2012. Etude rétrospective menée auprès des donneurs de sang militaires âgés de 18 à 50 ans avec prédominance masculine (95%). L’entretien médical pré-don constitue la première barrière de sélection des sujets à risque. Le dépistage biologique était réalisé par technique immuno-enzymatique en milieu liquide utilisant des anticorps et/ou des antigènes. L’ELISA (enzyme linked immuno-sorbent assay) combiné de quatrième génération pour VHC et VIH a été utilisé. La confirmation a été faite en réalisant la même technique en double au CTS et au laboratoire de virologie. Dans notre série de 25661 échantillons testés, la prévalence du VHB était 3,97‰ (n=102), celle de VHC était 2,45 ‰ (n=63), celle de VIH était 0,15 ‰ (n=4). Un seul cas de coïnfection (0,039 ‰) par le VHB et VHC a été noté, aucune association entre VIH-VHB, VIH-VHC ou VHB, VHC et VIH n’a été enregistrée. Les taux faibles de séroprévalence des marqueurs viraux de notre étude montrent l’amélioration des mesures préventives en ce qui concerne la sélection des donneurs et des tests de dépistage. Cette prévalence constatée incite à maintenir l’utilisation du réactif combiné qui est la seule alternative à la biologie moléculaire pour les pays en voie de développement. PMID:28292147

  5. Security and Democracy in Southern Africa | CRDI - Centre de ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    15 nov. 2007 ... Gavin Cawthra est directeur du Centre for Defence and Security Management de l'Université du Witwatersrand à Johannesburg et coordonne le ... Abillah H. Omari est directeur du Mozambique/Tanzania Centre for Foreign Relations à Dar es-Salaam, en Tanzanie, et professeur d'études stratégiques.

  6. cas de la forêt classée du Haut-Sassandra, Centre-Ouest de la Côte d

    African Journals Online (AJOL)

    Scientifique de Côte d'Ivoire dans le cadre de la mise en œuvre du Contrat de Désendettement et de. Développement (C2D) avec l'appui technique de l'Institut de ... Therefore, the presence of international forces in parts of Central and South of the classified forest of Haut-Sassandra did not prevent their infiltration and ...

  7. Surgical treatment of chronic pancreatitis using Frey's procedure: a Brazilian 16-year single-centre experience.

    Science.gov (United States)

    Gestic, Martinho Antonio; Callejas-Neto, Francisco; Chaim, Elinton Adami; Utrini, Murillo Pimentel; Cazzo, Everton; Pareja, Jose Carlos

    2011-04-01

    Surgical treatment of chronic pancreatitis is indicated for intractable pain. Frey's procedure is an accepted treatment for this disease. The aim of the present study was to describe a single-centre experience in the treatment of chronic pancreatitis using Frey's procedure. A retrospective analysis of 73 patients who underwent a Frey's procedure between 1991 to 2007 and had at least 1 year of follow-up. Demographics, indication for surgery, peri-operative complications and late outcomes were analysed. The median age was 39.9 years. Seventy out of the 73 (95.8%) patients were male. The median pre-operative body mass index (BMI) was 19.1 kg/m(2). All patients had abdominal pain, 34 (46.6%) of them daily and 13 (17.8%) weekly, with moderate or severe intensity in 98.6% (n= 72). The aetiology was secondary to alcohol in 70 patients (95.9%), with a median consumption of 278 g per day. The surgical morbidity rate was 28.7%; there were no deaths. Median post-operative follow-up was 77.0 months; 64 patients (91.4%) had complete pain relief and post-operative BMI was 22.4 kg/m(2) (P<0.001). All patients with pre-operative endocrine and exocrine insufficiencies showed no reversal of the situation. New onset insufficiencies appeared late. Frey's procedure was a safe and effective therapeutic option for the surgical treatment of patients with intractable pain caused by chronic pancreatitis. © 2011 International Hepato-Pancreato-Biliary Association.

  8. Single-centred experience with levosimendan in paediatric decompensated dilated cardiomyopathy.

    Science.gov (United States)

    Séguéla, Pierre-Emmanuel; Mauriat, Philippe; Mouton, Jean-Baptiste; Tafer, Nadir; Assy, Jana; Poncelet, Géraldine; Nubret, Karine; Iriart, Xavier; Thambo, Jean-Benoit

    2015-01-01

    Children with dilated cardiomyopathy in advanced heart failure may spend a long time awaiting heart transplantation. Consequently, mechanical circulatory support is sometimes required as a bridge to transplantation. Levosimendan, a positive inotropic agent, has been reported to be safe and efficient for the treatment of paediatric heart failure. To report our experience with levosimendan in children with decompensated dilated cardiomyopathy. Paediatric patients with dilated cardiomyopathy on the transplant waiting list and with criteria for mechanical support were included in this single-centred retrospective study. Each patient received at least one 24-hour infusion of levosimendan before mechanical circulatory support was considered. Biological and echocardiographic data were analysed. Six patients were included over a 24-month period. The median age was 25.5months (7.7-34.2months); 82 infusions were performed. Median B-type natriuretic peptide concentration decreased significantly between days 0 and 2 (2443ng/L [1458-3819ng/L] vs 1358ng/L [1025-2534ng/L]; P=0.003). While only a trend was noted in left ventricular ejection fraction improvement (P=0.054 by Simpson's method and P=0.068 by the Teicholz method), the subaortic velocity time integral rose significantly between days 0 and 8 (12.8cm/s [10-14.5cm/s] vs 15.3cm/s [14.3-16.9cm/s]; P=0.041). Levosimendan seems to improve haemodynamics in children with decompensated dilated cardiomyopathy; repeated infusions may delay the need for mechanical circulatory support while awaiting heart transplantation. This therapeutic agent should be systematically considered in this setting, in addition to conventional inotropic drugs. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

  9. Fully automated, clinical-grade bone marrow processing: a single-centre experience

    Science.gov (United States)

    Mazzanti, Benedetta; Urbani, Serena; Dal Pozzo, Simone; Bufano, Paola; Ballerini, Lara; Gelli, Alessia; Sodi, Irene; Donnini, Irene; Di Gioia, Massimo; Guidi, Stefano; Camisani, Julien; Saccardi, Riccardo

    2017-01-01

    Background Clinical grade processing of harvested bone marrow is required in various clinical situations, particularly in the management of ABO mismatching in allogeneic haematopoietic stem cell transplantation (HSCT) and in regenerative medicine. Material and methods We report a single-centre experience using a fully automated, clinical grade, closed system (Sepax, Biosafe, Switzerland). From 2003 to 2015, 125 procedures were performed in our laboratory, including buffy-coat production for HSCT (n=58), regenerative medicine in an orthopaedic setting (n=54) and density-gradient separation in a trial for treatment of critical limb ischaemia (n=13). Results Buffy coat separation resulted in a median volume reduction of 85% (range, 75–87%), providing satisfactory red blood cell depletion (69%, range 30–88%) and a median recovery of CD34 cells of 96% (range, 81–134%) in the setting of allogeneic HSCT. Significantly greater volume reduction (90%; range, 90–92%) and red blood cell depletion (88%; range, 80–93%) were achieved by the new SmartRedux software released for Sepax2, validated in the last eight allogeneic HSCT. The density gradient separation programme resulted in complete red blood cell depletion associated with high CD34 recovery (69%; range, 36–124%). No reactions related to the quality of the product were reported. Time to engraftment following allogeneic HSCT was in the normal range. No cases of microbiological contamination related to the manipulation were reported. Discussion Clinical grade, automated bone marrow manipulation with Sepax was shown to be effective, giving operator-independent results and could be used for a broad range of clinical applications. PMID:27723450

  10. Patients’ priorities for ambulatory hospital care centres. A survey and discrete choice experiment among elderly and chronically ill patients of a Dutch hospital

    Science.gov (United States)

    Albada, Akke; Triemstra, Mattanja

    2009-01-01

    Abstract Objective  This study established patients’ preferences regarding the facilities in an adjacent centre for ambulatory hospital care. It also identified determinants of patients’ choice to visit this centre instead of the regional hospital. Methods  A questionnaire survey among 1477 elderly and chronically ill people (response 72%) assessed patients’ expectations regarding (a) quality of hospital care, (b) facilities in centres for ambulatory hospital care, and (c) future use of these centres. Additionally, 75 patients participated in discrete choice experiments about their decision to visit a centre for ambulatory hospital care or the regional hospital. Results  Respondents prioritized facilities for examination and medical consultations in the ambulatory care centres. Half of the respondents also valued paramedic care, information desks and pharmacies as centre facilities. Most patients living near a future centre for ambulatory care would rather visit this centre than the regional hospital. However, they favoured seeing their familiar physician, short waiting lists and appointments scheduled consecutively on 1 day. If these aspects were not guaranteed at the adjacent centres, more patients chose to visit the hospital. Conclusions  Although patients value most facilities, they set clear priorities. Furthermore, this study showed three important conditions in the decision to visit an ambulatory care centre; (1) the possibility to see their familiar physician, (2) to have consecutive appointments, and (3) a short waiting list. These three factors were more important to patients than proximity. Thus, when choosing between a hospital and an adjacent centre for ambulatory care, quality aspects matter. PMID:19250155

  11. Patients' priorities for ambulatory hospital care centres. A survey and discrete choice experiment among elderly and chronically ill patients of a Dutch hospital.

    Science.gov (United States)

    Albada, Akke; Triemstra, Mattanja

    2009-03-01

    This study established patients' preferences regarding the facilities in an adjacent centre for ambulatory hospital care. It also identified determinants of patients' choice to visit this centre instead of the regional hospital. A questionnaire survey among 1477 elderly and chronically ill people (response 72%) assessed patients' expectations regarding (a) quality of hospital care, (b) facilities in centres for ambulatory hospital care, and (c) future use of these centres. Additionally, 75 patients participated in discrete choice experiments about their decision to visit a centre for ambulatory hospital care or the regional hospital. Respondents prioritized facilities for examination and medical consultations in the ambulatory care centres. Half of the respondents also valued paramedic care, information desks and pharmacies as centre facilities. Most patients living near a future centre for ambulatory care would rather visit this centre than the regional hospital. However, they favoured seeing their familiar physician, short waiting lists and appointments scheduled consecutively on 1 day. If these aspects were not guaranteed at the adjacent centres, more patients chose to visit the hospital. Although patients value most facilities, they set clear priorities. Furthermore, this study showed three important conditions in the decision to visit an ambulatory care centre; (1) the possibility to see their familiar physician, (2) to have consecutive appointments, and (3) a short waiting list. These three factors were more important to patients than proximity. Thus, when choosing between a hospital and an adjacent centre for ambulatory care, quality aspects matter.

  12. Measurement of the strange quark content of nucleon: G{sup 0} experiment; Mesure du contenu etrange du nucleon: experience G{sup 0}

    Energy Technology Data Exchange (ETDEWEB)

    Batigne, G

    2003-12-01

    The G{sup 0} project is a parity violation experiment dedicated to the measurement of the proton weak and axial form factors by means of electron-proton scattering. Combining these weak form factors with the electromagnetic ones makes possible the extraction of the contribution of strange quarks to the charge and magnetization distribution in the nucleon. This thesis presents the strategy used for the G{sup 0} experiment, the different subsystems and the first results from its engineering run. The counting rate asymmetries, at the order of 10-5, are measured over a large range in transferred momentum (Q{sup 2} = 0.1 to 1 (GeV/c){sup 2}) with expected precision at the level of 10{sup -7}. A deadtime correction program has been developed which allows to correct 90% of the counting losses and to reduce associated false asymmetries at the level of 10-8. A method has been defined to extract the measured values of Q{sup 2} with a precision of 1%. The first preliminary results of G{sup 0} on parity violation asymmetries are also shown. (author)

  13. Experiences from a communication training programme of paid carers in a residential rehabilitation centre for people with traumatic brain injury.

    Science.gov (United States)

    Behn, Nicholas; Togher, Leanne; Power, Emma

    2015-01-01

    To determine the impact of a communication training programme by exploring the experiences of paid carers who attended the programme in a residential rehabilitation centre for people with traumatic brain injury (TBI). Five paid carers attended a communication training programme which comprised 17 hours (across 8 weeks). Semi-structured interviews were conducted pre- and post-training. Analysis used a generic procedure with constant comparative analysis to identify categories across and within interview transcripts. Paid carers described improved knowledge and use of strategies, improved communication, positive emotional experiences and barriers and facilitators to consider for future communication training programmes. Training communication skills of paid carers in a residential rehabilitation centre had a positive impact on their conversations with people with TBI. These positive changes support quantitative findings for the effectiveness of communication training.

  14. How do people with learning disability experience the city centre? A Sheffield case study.

    Science.gov (United States)

    McClimens, Alex; Partridge, Nick; Sexton, Ed

    2014-07-01

    The use of city centre spaces by people with learning disability is not much debated in the literature. Here we include the thoughts and opinions of groups of people with learning disability as we undertook some guided walks through Sheffield city centre. We found that few of the participants had independent access to the city centre. Many cited concerns over personal safety and the most, on few occasions when they did visit, did so with family and/or paid staff for pre-planned purposes, usually linked to shopping. The need for appropriate support figured prominently. There is also a need to re-assess what we mean by social inclusion for this cohort. Copyright © 2014 Elsevier Ltd. All rights reserved.

  15. Living Lab Research Landscape: From User Centred Design and User Experience towards User Cocreation

    OpenAIRE

    Pallot, Marc; Trousse, Brigitte; Senach, Bernard; Scapin, Dominique

    2010-01-01

    International audience; New paradigms, such as Open Innovation (Chesbrough, 2003) and Web 2.0 (O'Reilly, 2004) as well as Living Labs operating as a User Centred Open Innovation Ecosystem (Pallot, 2009), promote a more proactive role of users in the R&D process. However, a number of existing methods for involving users are abundantly described in the literature, such as Lead User (Von Hippel, 2005), User Driven Innovation (Von Hippel, 1986), User Centred Design (Von Hippel, 2005) and User Cre...

  16. Aspects descriptifs du VIH/SIDA chez les sujets âgés de 50 ans et plus suivis au Centre de Traitement Agréé de Bafoussam - Cameroun

    Science.gov (United States)

    Mbopi-Kéou, François-Xavier; Djomassi, Lucienne Dempouo; Monebenimp, Francisca

    2012-01-01

    Introduction La littérature scientifique dispose de très peu de données relatives à l’épidémiologie du VIH chez les sujets âgés en Afrique subsaharienne. Au Cameroun, les caractéristiques épidémiologiques de l'infection par le VIH chez les sujets âgés de 50 ans et plus ne sont pas documentées. Méthodes Dans une étude de cohorte rétrospective et une enquête transversale, nous avons comparé les caractéristiques clinico-biologiques et la survie post thérapeutique des patients âgés de 50 ans et plus, sous traitement antirétroviral au Centre de Traitement Agrée de Bafoussam - Cameroun, aux adultes plus jeunes. Résultats L’âge moyen était de 39 ans, les extrêmes étant 17 et 88 ans. Les sujets âgés de 50 ans et plus représentaient 14,1% des cas. Les plus âgés étaient moins bien informés sur les modes de transmission du virus (p = 0,04). Leur séropositivité au VIH était le plus souvent découverte au décours d'une infection opportuniste (p = 0,02). La fréquence de comorbidité était significativement plus élevée chez les personnes âgées de 50 ans et plus (p VIH. La promotion du dépistage et les programmes d’éducation sanitaire relatifs au VIH/SIDA devraient être renforcés au sein de cette communauté déjà affaiblie par le poids de l’âge, afin de réduire l'incidence du SIDA et de leur assurer prise en charge précoce. PMID:23133707

  17. Early clinical experiences with nintedanib in three UK tertiary interstitial lung disease centres.

    Science.gov (United States)

    Toellner, Hannah; Hughes, G; Beswick, W; Crooks, M G; Donaldson, C; Forrest, I; Hart, S P; Leonard, C; Major, M; Simpson, A J; Chaudhuri, N

    2017-11-03

    Nintedanib has been shown to slow disease progression in patients with idiopathic pulmonary fibrosis (IPF). It was approved by the National Institute for Health and Care Excellence (NICE) in January 2016 for IPF patients with a forced vital capacity (FVC) of 50-80% in the United Kingdom (UK). To report real world data about our early clinical experience using nintedanib in 187 patients with a multi-disciplinary (MDT) diagnosis of IPF in a manufacturer funded patient in need scheme (three UK centres) prior to NICE approval. All patients with a MDT diagnosis of IPF from December 2014 to January 2016 commenced on nintedanib were included. Demographic details, adverse events (AEs) and where available lung function results were retrospectively collected from clinical letters. 187 patients (76% males) with a median age of 72 years (49-89) were treated with nintedanib. The average pre-treatment FVC was 81.1 ± 19.8% and diffusion capacity of the lungs for carbon monoxide was 43.9 ± 15% (n = 82). Fifty percent of patients started nintedanib because they were ineligible for pirfenidone due to an FVC > 80%. The median treatment course was 8 ± 4 months. The majority of patients experienced 1-3 AEs with nintedanib (52%, n = 97). The most frequent AEs were diarrhoea (50%), nausea (36%), reduced appetite (24%), tiredness (20%) and gastro-oesophageal reflux (18%). The majority of AEs resulted in no change in treatment (64%, n = 461). 21% (n = 150) of AEs resulted in a dose reduction and 13% (n = 94) necessitated discontinuation of treatment. 1 in 5 patients discontinued treatment either temporarily or on a permanent basis during the monitoring period. In a select cohort of patients, a statistically significant greater proportion of patients remained stable or improved and a lower proportion declined, as depicted by FVC changes of > 5% after nintedanib commencement (P Nintedanib is well tolerated and has an acceptable safety profile. Only 8% of those

  18. La matério-vigilance dans un Centre Hospitalo-Universitaire du Centre-Est tunisien: enquête auprès des médecins

    Science.gov (United States)

    Mahjoub, Mohamed; Jedidi, Maher; Masmoudi, Tasnim; Bouafia, Nabiha; Njah, Mansour

    2016-01-01

    Introduction Pour la meilleure gestion des risques en milieu hospitalier et l’amélioration de la qualité et la sécurité de nos soins, le CHU de Sousse (Tunisie), a mis en place, suite aux recommandations de l’ANCSEP (Agence Nationale de Contrôle Sanitaire et Environnementale des Produits) un système de matério-vigilance (MV). En Tunisie l’absence d’un cadre réglementaire organisant la MV est l’obstacle majeur à l’implication des soignants à ce système. L’objectif de cette étude est de déterminer les connaissances, attitudes et pratiques des médecins du CHU quant à la mise en place du système de MV. Méthodes Etude descriptive de type CAP (connaissances, attitudes et pratiques) transversale auprès de tous les médecins titulaires exerçant au CHU de Sousse (Tunisie) qui sont utilisateurs des dispositifs médicaux (DMs) lors de leur pratique d’activité de soin. Un questionnaire auto-administré, préétabli et pré-testé a été établi. Saisie et l’analysée des données par logiciel SPSS20.0. Résultats Le taux de réponse de 51,9 % (183/95), un manque des connaissances relatif à la MV a été rapporté. Plus de la moitié des répondants ne connaissent pas le correspondant local de son établissement et l’existence d’un formulaire standardisé de signalement. Concernant les attitudes, 89,5 % notifient l’intérêt de mise en place du système de MV et 37,5 % reconnaissent que le signalement doit émaner du soignant constatant l’incident. Pour les pratiques, la majorité confirment l’absence d’une gestion organisée de la maintenance des DMs dans leurs services. 90,5 % expriment leurs souhaits de recevoir une information mais peu d’entre eux expriment leurs désirs de suivre une formation (57,9 %). Conclusion Un manque d’information et de formation dans un domaine pourtant sensible et devant être lourdement réglementé est soulevé. La promulgation de textes réglementaires est nécessaire afin de promouvoir le

  19. Laparoscopic surgery for complicated diverticular disease: a single-centre experience.

    LENUS (Irish Health Repository)

    Royds, J

    2012-10-01

    The role of laparoscopic surgery in the management of patients with diverticular disease is still not universally accepted. The aim of our study was to evaluate the results of laparoscopic surgery for diverticular disease in a centre with a specialist interest in minimally invasive surgery.

  20. Grammar Correction in the Writing Centre: Expectations and Experiences of Monolingual and Multilingual Writers

    Science.gov (United States)

    Eckstein, Grant

    2016-01-01

    Although most writing centres maintain policies against providing grammar correction during writing tutorials, it is undeniable that students expect some level of grammar intervention there. Just how much students expect and receive is a matter of speculation. This article examines the grammar-correction issue by reporting on a survey of L1, L2,…

  1. Embracing Student Experience in Inclusive Design Education through Learner-Centred Instruction

    Science.gov (United States)

    Altay, Burçak; Ballice, Gülnur; Bengisu, Ebru; Alkan-Korkmaz, Sevinç; Paykoç, Eda

    2016-01-01

    This paper explores the process and outcome of using learner-centred methods to develop students' empathic design abilities during an educational workshop on inclusive design. In the first section of the paper, we suggest the significance of incorporating inclusive design within the education of design disciplines. Then, we introduce a workshop on…

  2. Can a Discrete Choice Experiment contribute to person-centred healthcare?

    DEFF Research Database (Denmark)

    Kaltoft, Mette Kjer; Nielsen, Jesper Bo; Salkeld, Glenn

    2015-01-01

    system or service decisions, but the suggestion that they have clinical relevance is a serious deterrent to the development and provision of effective means of individual preference elicitation and specification at the point of decision. Those who wish to foster person-centred care should be alert...

  3. Knowledge Translation of Interprofessional Collaborative Patient-Centred Practice: The Working Together Project Experience

    Science.gov (United States)

    MacDonald, Colla J.; Archibald, Douglas; Stodel, Emma; Chambers, Larry W.; Hall, Pippa

    2008-01-01

    The Working Together (WT) project involved the design and delivery of an online learning resource for healthcare teams in long-term care (LTC) so that knowledge regarding interprofessional collaborative patient-centred practice (ICPCP) could be readily accessed and then transferred to the workplace. The purpose of this paper is to better…

  4. How Do Quality Practices Affect the Results?: The Experience of Thalassotherapy Centres in Spain

    Directory of Open Access Journals (Sweden)

    José Álvarez-García

    2017-04-01

    Full Text Available Most thalassotherapy centres in Spain do not have any quality certification but they are carrying out several actions of quality management in an attempt to obtain better results. Consequently, the aim of this research is to study if the implementation of quality practices on thalassotherapy centres has the same impact on companies’ results as on the results of those companies that got the quality certifications. In addition, the relationships between different factors considered are going to be studied. Our sample is composed of Spanish thalassotherapy centres, and the statistical technique used is based on structural equation modelling, in particular partial least squares (PLS regression. The data were provided by the answers given by 31 managers (70.45% of the selected sample to a structured questionnaire based on previous research and statistically validated. The results of this research allow us to conclude that these kinds of organizations have implemented informal practices to improve the quality of the service in terms of leadership, personnel management, alliances, and resources and show that the practices that have been carried out by these centres to enhance the quality of the service have an impact on companies’ results. Managers of these kinds of establishments that want to improve customer results should focus their efforts on continuous improvement, whereas, if they are pursuing enhancement of other results, their efforts should be focused on process management.

  5. Observatory/data centre partnerships and the VO-centric archive: The JCMT Science Archive experience

    OpenAIRE

    Economou, Frossie; Gaudet, Severin; Jenness, Tim; Redman, Russell O.; Goliath, Sharon; Dowler, Patrick; Currie, Malcolm J.; Bell, Graham S.; Graves, Sarah F.; Ouellette, John; Johnstone, Doug; Schade, David; Chrysostomou, Antonio

    2014-01-01

    We present, as a case study, a description of the partnership between an observatory (JCMT) and a data centre (CADC) that led to the development of the JCMT Science Archive (JSA). The JSA is a successful example of a service designed to use Virtual Observatory (VO) technologies from the start. We describe the motivation, process and lessons learned from this approach.

  6. Steroid-free immunosuppression after renal transplantation-long-term experience from a single centre

    DEFF Research Database (Denmark)

    El-Faramawi, Mohamad; Rohr, Nils; Jespersen, Bente

    2006-01-01

    BACKGROUND: A steroid-free immunosuppressive protocol may improve the general well-being of patients, but long-term renal graft survival has been a concern. METHODS: In a retrospective clinical study, 329 consecutive transplantations with renal grafts at our centre during the period 1995-2004, we...

  7. Attracting foreign R&D through international centres of excellence: early experiences from Chile

    NARCIS (Netherlands)

    Klerkx, Laurens; Guimón, José

    2017-01-01

    International centres of excellence (ICE) in which foreign research organizations are attracted to developing and emerging countries via dedicated funding schemes to support technological catching-up and strengthening of innovation systems, can have benefits for both host countries and their

  8. L’implication des organisations non gouvernementales dans les systèmes de santé des pays du Sud: l’exemple du Shisong Cardiac Centre The involvement of NGOs in the health systems in developing countries: the example of Shisong Cardiac Center

    Directory of Open Access Journals (Sweden)

    Butera Gianfranco

    2009-04-01

    Full Text Available Dans le tiers monde, près de 800 000 enfants naissent chaque année avec des cardiopathies congénitales (CC. Plusieurs millions d’enfants y vivent avec des CC corrigeables et une grande majorité décède à cause de l’absence de structure médicale spécialisée dans la correction chirurgicale totale ou palliative. C’est dans cette optique que l’association Associazione bambini cardiopatici nel mondo (Association mondiale des enfants cardiopathes a été créée. Grâce aux efforts de cette association, plus de 500 enfants souffrant de CC ont pu être évacués et soignés à l’hôpital de San Donato et plus 800 dans leur pays. Près de 200 praticiens en provenance des pays du Sud ont dans cette même perspective bénéficiée d’une formation en Italie. Cent quinze missions chirurgicales ont été réalisées dans différents pays: Egypte, Tunisie, Libye, Palestine, Cameroun, Roumanie, Azerbaïdjan, Pérou, Syrie, Yémen, Kurdistan et au Mali. Plusieurs hôpitaux ont été équipés gratuitement. Actuellement, l’association œuvre ardemment pour la réalisation de trois projets essentiels dont l’un est la construction d’un centre cardiaque dans la région de Shisong au Cameroun (Shisong Cardiac Centre. Ce centre cardiaque sera équipé d’appareils de dernière génération permettant de réaliser des investigations et la chirurgie cardiaques. L’inauguration de ce centre est prévue pour Novembre 2009.

  9. User-centred health design: reflections on D4D's experiences and challenges.

    Science.gov (United States)

    Moody, Louise

    2014-01-01

    There is increasing recognition of the importance of user-centred design and testing in the healthcare technology domain. Challenges associated with user and stakeholder involvement in designing solutions for healthcare are recognized in the literature and need to be addressed to facilitate the development of new technology that is usable and acceptable to the end-user. The Devices for Dignity Health Technology Cooperative (D4D) has been involved in a range of technology development projects with an underpinning approach of addressing unmet needs through user involvement. This paper provides practical examples of some of the challenges that occur at different stages during a user-centred design process including ethical approval processes; stakeholder and user recruitment and involvement; eliciting needs from users regarding sensitive and personal issues; and interdisciplinary working. The paper will describe some of the strategies that have been employed by D4D to overcome these challenges and facilitate technology development.

  10. An exploration of physiotherapists' experiences of robotic therapy in upper limb rehabilitation within a stroke rehabilitation centre.

    Science.gov (United States)

    Stephenson, Andrew; Stephens, John

    2017-04-01

    Strokes are the world's leading cause of adult disability, with movement impairment being more common in the upper limb (UL). Robotic therapy (RT) is identified as an effective adjunct to promote movement but with limited effect on functional capabilities. There is currently limited research in user experience of RT, specifically that of physiotherapists. This study sought to explore physiotherapists' experience of using RT in rehabilitation of the UL, within a stroke rehabilitation centre in the north of England. Physiotherapists (n = 6) shared their experiences of working with the InMotion2 robot through semi-structured interviews. Thematic analysis was employed to interpret data, identify emergent themes and interdependent relationships between them. Five interdependent themes were identified focused around individualized care, influenced by evidence for practice, human relationships, skill mix, and resources and resource management. All physiotherapists valued the use of RT as an adjunct to conventional therapy, although barriers to successful implementation seemed to dominate the views of some. RT was perceived positively by physiotherapists, regarded as an adjunct to conventional therapy. A framework to summarize the relationships of participants' views and experiences is proposed in an attempt to understand the influences on the clinical use of RT. Implications for Rehabilitation Robotic therapy (RT) is valued as an adjunct to (conventional) person-centred rehabilitation. Resource management and skill mix are viewed as two key challenges to the successful implementation of RT. The production of evidence-based guidelines would be a useful development in the advancement.

  11. Experience with CO2 Eor Process in Hungary Expérience du procédé de récupération assistée du pétrole par le CO2 en Hongrie

    Directory of Open Access Journals (Sweden)

    Nemeth G.

    2006-11-01

    Full Text Available In Hungary, the CO2 injection EOR technology began in the mid 1960s. Since then, this method has achieved a wide range of field applications. Its special feature is that there is no miscibility. This article describes two types of field application: using CO2 in sandstone reservoirs and in karstic- limestone ones. The mechanism of displacement in such reservoirs is quite different. This article summarizes the exploitation technology used and its development, field experience and results, considering sandstone and the karstic reservoirs separately. La récupération assistée du pétrole par injection de CO2 a débuté en Hongrie au milieu des années 60. Depuis lors, cette méthode a été largement développée dans des applications à l'échelle du gisement. La caractéristique principale de cette méthode est qu'il n'y a pas de miscibilité. Les auteurs développent dans cet article deux types d'application sur champ : l'utilisation du CO2 dans le cas, d'une part de réservoirs gréseux et d'autre part de réservoirs karstiques-calca ires. Le mécanisme du déplacement dans ces deux types de réservoirs est assez différent. Cet article résume la technologie d'exploitation utilisée, ainsi que son développement, les expériences sur champ et les résultats obtenus, en considérant séparément les réservoirs gréseux et karstiques.

  12. Single-centre experience of 101 paediatric and adult Ross procedures: mid-term results

    OpenAIRE

    McBrien, Angela; Chaudhari, Milind; Crossland, David S.; Aspey, Helen; Heads-Baister, Alison; Griselli, Massimo; O'Sullivan, John; Hasan, Asif

    2012-01-01

    We aimed to determine outcomes for the Ross procedure in paediatric and adult patients, with particular emphasis on survival, complication and reintervention rates. A retrospective review of 101 patients who had the Ross procedure in a congenital cardiac surgical centre serving a population of approximately 2.5 million was performed. There were 69 adults and 32 children with a mean age of 24.8 ± 13.9 years. Indications for surgery were aortic stenosis (48), regurgitation (10), mixed disease (...

  13. Etat Du Magnesium Dans Quelques Sols Sales Du Sud Et Du ...

    African Journals Online (AJOL)

    étude a été réalisée sur 86 échantillons de sols provenant du Centre et du Sud de l´Irak. L\\'expérimentation a consisté, d´une part, à calculer les différents sels dominants dans les sols salés par la méthode de combinaison hypothétique et, ...

  14. Letting go of an old habit: group leaders' experiences of a client-centred multidisciplinary falls-prevention programme.

    Science.gov (United States)

    Johansson, Erika; Borell, Lena; Jonsson, Hans

    2014-03-01

    It has been suggested that the prevention of disability and falls should be conducted from a client-centred approach, especially when it includes how individuals learn new strategies in everyday life. In addition, programmes for the prevention of falls need to be multi-professional and multidisciplinary in order to be effective. In preventive work with clients, using the approach of client-centredness, the therapists work together with the clients to enable them to achieve occupational goals. There are few studies in fall prevention that have explored group leaders' experiences, i.e., studies that focus on the experiences of group leaders when working from a client-centred approach. This study aims to explore, by the use of focus-group interviews, the therapists' experiences of being group leaders in a fall-prevention programme that applied the ideas and approaches described above. The analysis revealed that a change in the role of being a group leader had taken place during the intervention process. Three primary categories pertaining to this process were identified: (i) the group leaders moved between the role of expert and the role of facilitator; the group climate (ii) facilitated the translation of expert knowledge to applied knowledge; and (iii) increased awareness as a prerequisite for change.

  15. Previous experiences and emotional baggage as barriers to lifestyle change - a qualitative study of Norwegian Healthy Life Centre participants.

    Science.gov (United States)

    Følling, Ingrid S; Solbjør, Marit; Helvik, Anne-S

    2015-06-23

    Changing lifestyle is challenging and difficult. The Norwegian Directorate of Health recommends that all municipalities establish Healthy Life Centres targeted to people with lifestyle issues. Little is known about the background, experiences and reflections of participants. More information is needed about participants to shape effective lifestyle interventions with lasting effect. This study explores how participants in a lifestyle intervention programme describe previous life experiences in relation to changing lifestyle. Semi-structured qualitative in-depth interviews were performed with 23 participants (16 women and 7 men) aged 18 - 70 years. The data were analysed using systematic text condensation searching for issues describing participants' responses, and looking for the essence, aiming to share the basis of life-world experiences as valid knowledge. Participants identified two main themes: being stuck in old habits, and being burdened with emotional baggage from their previous negative experiences. Participants expressed a wish to change their lifestyles, but were unable to act in accordance with the health knowledge they possessed. Previous experiences with lifestyle change kept them from initiating attempts without professional assistance. Participants also described being burdened by an emotional baggage with problems from childhood and/or with family, work and social life issues. Respondents said that they felt that emotional baggage was an important explanation for why they were stuck in old habits and that conversely, being stuck in old habits added load to their already emotional baggage and made it heavier. Behavioural change can be hard to perform as psychological distress from life baggage can influence the ability to change. The study participants' experience of being stuck in old habits and having substantial emotional baggage raises questions as to whether or not Healthy Life Centres are able to help participants who need to make a lifestyle

  16. Operative treatment of congenital pseudarthrosis of the clavicle: a single-centre experience.

    Science.gov (United States)

    Studer, Kathrin; Baker, Markus P; Krieg, Andreas H

    2017-05-01

    Congenital pseudarthrosis of the clavicle (CPC) is a very rare condition with a predilection for the right clavicle. Young children are often only symptomatic with activities and as they grow. Operative management in an asymptomatic child is debatable, with various techniques reported in the literature. This is a retrospective, single-centre case series study. All children with CPC treated surgically by resection, bone grafting (nonvascular iliac crest) and plate fixation between 2004 and 2012 at our centre were included. Excluded conditions were traumatic or obstetric fractures of the clavicle, children with musculoskeletal or neurological disorders and children lost to follow-up. Clinical and radiological examination was performed at 6 weeks, 3 months and between 6 and 12 months postoperatively. A total of eight clavicles in seven children (four girls and three boys), with a mean age of 7.1 years (5-8 years), were operated with a mean follow-up of 7 years (4-10 years). In six children, the right (dominant) side was affected, with one child affected bilaterally. Overall, 85% of our patients showed good functional results 6 weeks postoperatively and complete radiographic consolidation at a mean of 8.5 months (3-25 months) postoperatively. One female child showed delayed union, but without clinical deficit. There was low donor-site morbidity. We recommend early operative treatment of CPC with a nonvascularized bone graft from the iliac crest and plate fixation. IV.

  17. Experiences from a Community Based Substance Use Treatment Centre in an Urban Resettlement Colony in India

    Directory of Open Access Journals (Sweden)

    Yatan Pal Singh Balhara

    2014-01-01

    Full Text Available Background. There are limited community based treatment services for drug dependence in India. Rural areas and urban resettlement colonies are in particular deficient in such services. Aims. The current study aimed at preliminary assessment of substance use disorder management services at a community based substance use treatment clinic in an urban resettlement colony. Methods. The study was carried out at community based substance use treatment centre in a resettlement colony in India. The records of the centre were chart reviewed. Results. A total of 754 patients were registered at the clinic during the study period. Heroin was the primary drug of abuse for 63% of the patients. The mean duration of follow-up for the patients with opioid and alcohol dependence was 13.47 (SD±10.37; range 0–39 months. A total of 220 patients of opioid dependence were prescribed substation or abstinence directed therapy. Buprenorphine (87, slow release oral morphine (SROM (16, and dextropropoxyphene (98 were used for opioid substitution. Conclusion. It is possible to deliver substance use disorder treatment services in community setting. There is a need to develop area specific community based treatment services for substance abuse in socially disadvantaged populations such as urban resettlement colonies.

  18. Peer tutoring in patient-centred interviewing skills: experience of a project for first-year students.

    Science.gov (United States)

    Nestel, Debra; Kidd, Jane

    2003-07-01

    Peer tutoring is a potentially valuable resource in higher education. There are few published accounts of the impact of peer tutoring in medical education. College-wide experience of peer tutoring together with difficulties recruiting medical teachers for a communication programme led to the development of a peer-tutoring project. This paper reports the impact on first-year medical students of peer tutoring in patient-centred interviewing. After attending a preparatory workshop, third-year medical students co-facilitated their first-year colleagues in a session:Interviewing a Simulated Patient. First-year students completed written evaluations immediately after the session and two months later randomly selected students were assessed in patient-centred interviews. The impact of the peer-tutoring experience was evaluated by comparing these outcomes for students in groups co-facilitated by peer tutors with those who worked in groups facilitated by medical teachers. The eight learning objectives were completely met by more than 56% of students. However, there were statistically significant differences for four objectives with more students in groups facilitated by medical teachers completely meeting these objectives. Although the seven educational techniques used in the session were rated favourably by all students, two were rated as more effective in achieving the learning objectives by students in groups facilitated by medical teachers. Free-text comments revealed no differences between groups. Two months after the session, there were no differences between students in terms of interviewing skills as rated by trained observers and simulated patients, whilst simulated patients were more satisfied with interviews from students facilitated by peer tutors (p Peer tutors can support the acquisition of basic patient-centred interviewing skills in first-year medical students when contributing to one session of a structured programme. First-year students were receptive and

  19. Epidemiology and outcome of burns: early experience at the country's first national burns centre.

    Science.gov (United States)

    Iqbal, Tariq; Saaiq, Muhammad; Ali, Zahid

    2013-03-01

    This study aims to document the epidemiologic pattern and outcome of burn injuries in the country's first national burn centre. This case series study was conducted over a 2-year period at Burns Care Centre (BCC), Pakistan Institute of Medical Sciences (PIMS), Islamabad. The study included all burn injury patients who primarily presented to and were managed at the centre. Those patients who presented more than 24 h after injury or those who were initially managed at some other hospital were excluded from the study. Initial assessment and diagnosis was made by thorough history, physical examination and necessary investigations. Patients with major burns, high voltage electric burns and those needing any surgical interventions were admitted for indoor management. Patients with minor burns were discharged home after necessary emergency management, home medication and follow-up advice. The sociodemographic profile of the patients, site of sustaining burn injury, type and extent (total body surface area (TBSA), skin thickness involved and associated inhalational injury) of burn and outcome in terms of survival or mortality, etc., were all recorded on a proforma. The data were subjected to statistical analysis. Out of a total of 13,295 patients, there were 7503 (56.43%) males and 5792 (43.56%) females. The mean age for adults was 33.63±10.76 years and for children it was 6.71±3.47 years. The household environment constituted the commonest site of burns (68%). Among all age groups and both genders, scalds were the commonest burns (42.48%), followed by flame burns (39%) and electrical burns (9.96%). The affected mean TBSA was 10.64±11.45% overall, while for the hospitalised subset of patients the mean TBSA was 38.04±15.18%. Most of the burns were partial thickness (67%). Inhalation injury was found among 149 (1.12%) patients. Most of the burns were non-intentional and only 96 (0.72%) were intentional. A total of 1405 patients (10.58%) were admitted while the remainder

  20. Long-term Field Experiments as Important Source of Knowledge - Aims of the BonaRes Data Centre

    Science.gov (United States)

    Grosse, Meike; Hierold, Wilfried

    2017-04-01

    BonaRes is short for "soil as a sustainable resource for the bioeconomy". It is funded by the German Federal Ministry of Education and Research (BMBF) under the umbrella of the National Research Strategy BioEconomy 2030. BonaRes consists of ten interdisciplinary research project consortia and the 'BonaRes - Centre for Soil Research' (see also Wollschläger et al 2016). It is one task of the BonaRes Data Centre as part of the 'BonaRes - Centre for Soil Research', to collect data and meta-data of agricultural long-term field experiments (LTFE) in Germany. The definition of LTFE in the context of BonaRes is a minimum duration of twenty years and a static design. LTFE are essential research infrastructures for agricultural sciences and soil sciences amongst other disciplines. Some LTFE run since a very long time; the start of the oldest one in Germany was 1878. Therefore, in many cases valuable time series exist. Data sets of LTFE shall be compiled and made publicly available by the BonaRes Data Centre. The public availability together with an easy access will lead to an enhanced usability of the data. This probably makes the LTFE itself more valuable through an improved visibility and may also help to maintain the LTFE. Beyond the data compilation there is the possibility for every data owner to make a data publication, which offers an additional value for the data owner after his first right of use. A first step towards a joint database is a compilation of all existing LTFE in Germany with meta information to each trial. This information is shown in an interactive web map, what is completely new in that context. Besides the exact position of the LTFE the following metadata are shown: name of the LTFE, website (if available), institution, land use category, participation in existing networks, research theme, start (and maybe end) of the trial, and research parameters. Details on the meta information will be presented in the speech. Literature Wollschläger, U; Helming

  1. Assessing Quality Outcome Measures in Children with Coeliac Disease—Experience from Two UK Centres

    Directory of Open Access Journals (Sweden)

    Alexander Ross

    2013-11-01

    Full Text Available Improved diagnosis of coeliac disease has increased incidence and therefore burden on the health care system. There are no quality outcome measures (QOM in use nationally to assess hospital management of this condition. This study applied QOM devised by the East of England paediatric gastroenterology network to 99 patients reviewed at two tertiary hospitals in the Network, to assess the quality of care provided by nurse led and doctor led care models. The average performance across all QOM was 96.2% at Addenbrooke’s Hospital (AH, and 98.7% at Norfolk and Norwich Hospital (NNUH, whilst 95% (n = 18 of QOM were met. Patient satisfaction was high at both sites (uptake of questionnaire 53 of 99 patients in the study. The study showed a comparably high level of care delivered by both a nurse and doctor led service. Our quality assessment tools could be applied in the future by other centres to measure standards of care.

  2. Less equal than others? Experiences of AYUSH medical officers in primary health centres in Andhra Pradesh.

    Science.gov (United States)

    Lakshmi, J K

    2012-01-01

    The National Rural Health Mission (NRHM) includes, inter alia, the establishment of an AYUSH (Ayurveda, Yoga and Naturopathy, Unani, Siddha and Homoeopathy) component (practitioner, trained assistants, drugs and equipment) in every primary health centre (PHC). However, five years following the launch of the NRHM, the AYUSH mainstreaming scenario is below expectations, riddled with ethical and governance issues. Accounts from AYUSH practitioners at PHCs in various regions of the state of Andhra Pradesh reveal enormous lacunae in implementation: unfilled positions, inequitable emoluments, inadequate or absent infrastructure, assistance and supplies, unethical interpersonal arrangements, and limited support from non-AYUSH personnel. The widespread negative impact of these conditions undermines the value of AYUSH, demotivating both practitioners and patients, and failing to provide the intended support to the public health system.

  3. A person-centred intervention for providing information to parents of children with cancer. Experiences and effects.

    Science.gov (United States)

    Ringnér, Anders; Karlsson, Stig; Hällgren Graneheim, Ulla

    2015-06-01

    The aim of this paper is to describe the experiences of participating in a person-centred information intervention aimed at parents of children with cancer. Eight parents participated in the intervention, beginning two months after their child's diagnosis. The intervention was based upon the representational approach to patient education and a mixed method approach was employed in the study. The experiences of parents and intervention nurses were captured via qualitative interviews and the effects of the intervention on parental psychosocial measures, primarily perceived stress, were evaluated using a single-case design with web-based questionnaires. Parents expressed high satisfaction with the intervention, as reported in the follow-up interviews and on the scale measuring satisfaction. However, no changes were seen in the quantitative measures of psychosocial distress. The nurses performing the intervention felt it was useful and feasible. A representational approach to providing person-centred information to parents of children with cancer was appreciated and considered feasible by both the parents and the intervention nurses. However, further research is needed considering the lack of effect on the parents' perceived stress. Copyright © 2014 Elsevier Ltd. All rights reserved.

  4. THE MORPHOLOGICAL BASIS FOR OLFACTORY PERCEPTION OF STEROIDS DUING AGONISTIC BEHAVIOR IN LOBSTER: PRELIMINARY EXPERIMENTS

    Science.gov (United States)

    The morphological basis for olfactory perception of steroids during agonistic behavior in lobsters: preliminary experiments. Borsay Horowitz, DJ1, Kass-Simon, G2, Coglianese, D2, Martin, L2, Boseman, M2, Cromarty, S3, Randall, K3, Fini, A.3 1US EPA, NHEERL, ORD, Atlantic Ecology...

  5. Improving mortality outcomes of Stevens Johnson syndrome/toxic epidermal necrolysis: A regional burns centre experience.

    Science.gov (United States)

    Nizamoglu, M; Ward, J A; Frew, Q; Gerrish, H; Martin, N; Shaw, A; Barnes, D; Shelly, O; Philp, B; El-Muttardi, N; Dziewulski, P

    2017-10-10

    Stevens Johnson Syndrome/toxic epidermal necrolysis (SJS/TEN) are rare, potentially fatal desquamative disorders characterised by large areas of partial thickness skin and mucosal loss. The degree of epidermal detachment that occurs has led to SJS/TEN being described as a burn-like condition. These patients benefit from judicious critical care, early debridement and meticulous wound care. This is best undertaken within a multidisciplinary setting led by clinicians experienced in the management of massive skin loss and its sequelae. In this study, we examined the clinical outcomes of SJS/TEN overlap & TEN patients managed by our regional burns service over a 12-year period. We present our treatment model for other burn centres treating SJS/TEN patients. A retrospective case review was performed for all patients with a clinical diagnosis of TEN or SJS/TEN overlap admitted to our paediatric and adult burns centre between June 2004 and December 2016. Patient demographics, percentage total body surface area (%TBSA), mucosal involvement, causation, severity of illness score (SCORTEN), length of stay and survival were appraised with appropriate statistical analysis performed using Graph Pad Prism 7.02 Software. During the study period, 42 patients (M26; F: 16) with TEN (n=32) and SJS/TEN overlap (n=10) were managed within our burns service. Mean %TBSA of cutaneous involvement was 57% (range 10-100%) and mean length of stay (LOS) was 27 days (range 1-144 days). We observed 4 deaths in our series compared to 16 predicted by SCORTEN giving a standardised mortality ratio (SMR) of 24%. Management in our burns service with an aggressive wound care protocol involving debridement of blistered epidermis and wound closure with synthetic and biological dressings seems to have produced benefits in mortality when compared to predicted outcomes. Copyright © 2017 Elsevier Ltd and ISBI. All rights reserved.

  6. HIV/AIDS in ophthalmic patients: The Guinness Eye Centre Onitsha experience.

    Science.gov (United States)

    Nwosu, N N

    2008-03-01

    To determine the incidence and pattern of ocular problems of HIV/AIDS at the Guinness Eye Centre Onitsha, Nigeria. The case files of all patients who had HIV test at the Guinness Eye Centre Onitsha over a 6-year period were examined. Those who tested positive for HIV were further analysed. Information obtained included patients' demographic characteristics, clinical diagnosis, ocular and systemic co-morbidity, visual acuity and follow-up. Of 1011 patients, 100 (9.9%), 51 males and 49 females, were confirmed HIV-positive. The age range was 21 - 80 years; median -31 years. Fifty-five patients (55%) were or had been married; 45 (45%) were single. Herpetic eye disease constituted 50% of the cases with herpes zoster ophthalmicus accounting for 48%. Bilateral ocular disease occurred in 19 patients (19%) viz: cytomegalovirus (CMV) retinitis (6%); corneal ulcers (6%); uveitis (4%); ocular motor palsy (2%) and ocular gunshot injury (1%). Non-HIV ocular lesions occurred in 20 patients (20%) as follows: bacterial corneal ulcer (8%); globe laceration (6%); non-CMV associated rhegmatogenous retinal detachment, cataract, and secondary orbital tumour (2% each). Systemic co-morbidities were present in 10 patients (10%), namely, emaciation (6%), pulmonary tuberculosis and abdominal malignancy with orbital metastases (2% each). Twenty three patients (23%) had bilateral blindness; 45 (45%) had uniocular blindness; 73.4% of the affected eyes were blind at presentation with 25% having no light perception (NPL). The incidence of HIV seropositivity doubled in the hospital over nearly 10-year period. Herpes zoster ophthalmicus remains the commonest ocular manifestation although CMV retinitis is becoming common. Since 20% of the patients had non-HIV ocular lesions, eye-health workers are advised to always take universal precautions in order to prevent the spread of the infection within and outside the hospital.

  7. Swine flu outbreak 2015-Paediatric Experience in a Tertiary Care Centre.

    Directory of Open Access Journals (Sweden)

    Dr. Anuya Chauhan

    2016-12-01

    Full Text Available Background & Aim: To study and analyse the clinical profile and outcome of children admitted with Influenza A positive cases at our Tertiary Care Centre in 2015. Materials & Methods: Prospective study conducted in a tertiary care centre (Civil Hospital B. J. Medical College, Ahmedabad from Jan 2015 to March 2015. 340 Children presenting with clinical features compatible with category C were admitted and 199 patients having laboratory confirmed influenza A (H1N1 were included in our study. Details regarding clinical features, examination findings, investigations, complications and treatment were recorded and analysed in a systemic manner. Results: Study showed that highest incidence of influenza A was seen in 1-3 years age group (41.7% Male-female ratio was 1.18:1 indicating similar affection of both sexes. Maximum patients presented within first 3 days of illness (53.2% with fever (82.9% followed by dry cough (74.6% and sore throat (52.7% as presenting symptoms. Leucopenia (79.4% was the most common laboratory finding and lobar pneumonia (81.1% was the most common radiological finding followed by bronchopneumonia (18.9%. Conjunctivitis (20.1% and otitis media (6.03% were the common complications. Mortality rate in our set up was 6.5% (13 out of 199; with maximum from 1-3 year age group (46.1%, most common cause being ARDS (46.1%. Conclusion: The outbreak of influenza A (H1N1 2015 predominantly affected young population with significant morbidity and mortality. With the efforts of healthcare authorities worldwide, we have still not lost the race against fighting this virus.

  8. Gait analysis in children with haemophilia: first Italian experience at the Turin Haemophilia Centre.

    Science.gov (United States)

    Forneris, E; Andreacchio, A; Pollio, B; Mannucci, C; Franchini, M; Mengoli, C; Pagliarino, M; Messina, M

    2016-05-01

    To investigate the functional status in haemophilia patients referred to an Italian paediatric haemophilia centre using gait analysis, verifying any differences between mild, moderate or severe haemophilia at a functional level. Forty-two patients (age 4-18) presenting to the Turin Paediatric Haemophilia Centre who could walk independently were included. Therapy included prophylaxis (n = 21), on-demand (n = 17) or immune tolerance induction + inhibitor (n = 4). Patients performed a test of gait analysis. Temporal, spatial and kinematic parameters were calculated for patient subgroups by disease severity and background treatment, and compared with normal values. Moderate (35.7%) or severe (64.3%) haemophilia patients showed obvious variations from normal across a variety of temporal and spatial gait analysis parameters, including step speed and length, double support, swing phase, load asymmetry, stance phase, swing phase and speed. Kinematic parameters were characterized by frequent foot external rotation with deficient plantar flexion during the stance phase, retropelvic tilt, impaired power generation distally and reduced ground reaction forces. Both Gait Deviation Index and Gait Profile Score values for severe haemophilia patients indicated abnormal gait parameters, which were worst in patients with a history of past or current use of inhibitors and those receiving on-demand therapy. Functional evaluation identified changes in gait pattern in patients with severe and moderate haemophilia, compared with normal values. Gait analysis may be a useful tool to facilitate early diagnosis of joint damage, prevent haemophilic arthropathy, design a personalized rehabilitative treatment and monitor functional status over time. © 2016 John Wiley & Sons Ltd.

  9. Community Health Centre-Based Outreach Clinic for undergraduate dental education: Experience in Helsinki over 8 years.

    Science.gov (United States)

    Goswami, S; Karaharju-Suvanto, T; Kaila, M; Tseveenjav, B

    2017-09-30

    The University Dental Clinic of the City of Helsinki (UDC) developed a Community Health Centre-Based Outreach Clinic, with emphasis on paediatric dentistry. This study aimed to summarise the experiences and explore the student perspectives of the health centre-based outreach teaching clinic. The study data were from the years 2010 to 2016. The dental procedures carried out by the third- to fifth-year dental students were based on electronic health record of patients. The students' self-perceived benefits and free-text comments on the outreach training were collected as part of a yearly questionnaire survey. A vast majority of the paediatric dental procedures that are required for competencies of dental students were performed in the outreach clinic. The most common procedures were fillings with local anaesthesia followed by preventive procedures. The majority of the students were very motivated to participate in the outreach training and reported that it was a useful educational approach to broaden their understanding of oral diseases and clinical experience. The outreach clinic gives dental students a chance to gain valuable clinical experience through the number and diversity of the dental procedures they carry out. They gain confidence and get an opportunity to get acquainted with the primary healthcare system and social determinants of oral diseases. Outreach appears to provide complementary clinical experiences that fulfil learning outcomes. Learning objectives should be taken into account when planning the outreach programme in order to offer meaningful and motivating education. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  10. 12th Rencontres du Vietnam : High Sensitivity Experiments Beyond the Standard Model

    CERN Document Server

    2016-01-01

    The goal of this workshop is to gather researchers, theoreticians, experimentalists and young scientists searching for physics beyond the Standard Model of particle physics using high sensitivity experiments. The standard model has been very successful in describing the particle physics world; the Higgs-Englert-Brout boson discovery is its last major discovery. Complementary to the high energy frontier explored at colliders, real opportunities for discovery exist at the precision frontier, testing fundamental symmetries and tracking small SM deviations.

  11. Evaluation du traitement antirétroviral chez les femmes enceintes VIH-1 positif, sur la transmission de l'infection de la mère à l'enfant: cas du Centre Médical Saint Camille de Ouagadougou, au Burkina Faso

    Science.gov (United States)

    Soubeiga, Serge Theophile; Compaore, Rebecca; Djigma, Florencia; Zagre, Nicaise; Assengone, Elsa; Traore, Lassina; Diarra, Birama; Bisseye, Cyrille; Ouermi, Djeneba; Sagna, Tani; Karou, Simplice; Pietra, Virginio; Simpore, Jacques

    2015-01-01

    Introduction L'infection au VIH chez les nouveau-nés par leur mère peut être réduite grâce à des programmes de prévention de transmission mère-enfant du VIH (PTME). L'objectif dans cette étude était d’évaluer le traitement antirétroviral chez les femmes enceintes VIH-1 positif sur la transmission mère-enfant de l'infection au Centre Médical Saint Camille de Ouagadougou, Burkina Faso. Méthodes Des échantillons de spot de sang total ont été collectés chez 160 enfants âgés de 6 semaines, nés de mères VIH-1 positif et chez 40 enfants âgés de 2 à 13 mois provenant d'orphelinats et dont les mères étaient inconnues. Ces échantillons ont été testés avec le kit Abbott Real Time HIV-1 Qualitative. Un questionnaire a permis de connaitre les âges et les fonctions des femmes enceintes. Résultats Les femmes enceintes avaient un âge moyen global de 29,50±5,19 ans. Au total, 50,5% (101/200) ont été mises sous combinaison AZT/3TC/NVP et 29,5% (59/200) étaient sous prophylaxie (AZT/3TC). Le taux de transmission verticale du VIH-1 était de 0,0% (0/160) (p VIH-1 de la mère à l'enfant. De plus, le dépistage par PCR, des enfants orphelins infectés verticalement par le VIH, permet leur prise en charge thérapeutique précoce. PMID:26301003

  12. Intestinal obstruction in children due to Ascariasis: A tertiary health centre experience

    Directory of Open Access Journals (Sweden)

    Mishra P

    2008-01-01

    Full Text Available Background: Ascariasis is the infestation by the largest intestinal nematode of man, a common problem in the tropics attributed to poor hygienic and low socioeconomic conditions. The aim of this research is to analyse the presentation, diagnosis and management of bowel obstruction caused by Ascaris lumbricoides, with special emphasis on the role of conservative management. Materials and Methods: This is a single centre, two consultant based 5 year retrospective study of childhood intestinal obstruction due to worms. Diagnosis in the suspected patients was based on history of passage of worms per mouth or rectum and on x-ray and ultrasonography findings. Only the patients of intestinal obstruction with documented evidence of roundworm infestation were included in the study and were followed for one year. Results: One hundred and three children with intestinal obstruction due to Ascaris lumbricoides were treated in the past five years at our centre. Abdominal pain was the most common presentation seen in 96 children followed by vomiting in 77 children. 20 children had history of vomiting worms and another 43 had history of passing worms in stool. Abdominal tenderness was present in 50 children, 48 had abdominal distension of varying degree, 50 had abdominal mass due to worm bolus, and 16 had or developed abdominal guarding or rigidity. All the children were managed as for acute intestinal obstruction along with hypertonic saline enema. The aim of management was "to starve the worm and hydrate the patient". 87 patients (84.47% responded favourably and were relieved of the obstruction by the conservative management, 16 children (15.53% had abdominal guarding or rigidity and underwent emergency exploration. Conclusion: Roundworm obstruction should be considered in the differential diagnoses of all cases of intestinal obstruction in children. Clinical history and examination along with X-ray and ultrasonography are very helpful for diagnosis of this

  13. Health status of internationally adopted children. The experience of an Italian “GLNBI” paediatric centre

    Directory of Open Access Journals (Sweden)

    Piero Valentini

    2012-09-01

    Full Text Available

    Background: according to ISTAT (National Institute of Statistics-Italy, in 2011 20.7% of the foreign population in Italy is composed by children, either coming along with their families or alone, like in international adoptions. Immigrant children have some peculiarities related to their previous living conditions, although there are no significant differences between immigrant and native children’ diseases.

    Methods: in 3.5 years we evaluated every adoptee that reached our university centre, by using GLNBI (Gruppo di Lavoro Nazionale del Bambino Immigrato diagnostic – aiding protocol, in order to assess infectious diseases, nutritional deficiencies, immunization status, intestinal parasitosis or other pathologies; this protocol is actually applied only in research centres.

    Results: we evaluated 358 international adoptees from 4 different Zones of the world; average age at first visit was approximately 5 years. Health certifications concerning vaccination history records were considered “valid” in 59.2% (212/358, 49.5% (105/212 of which had a complete panel of immunization. QuantiFERON®_TB Gold In-Tube (QTF test resulted negative in 94.0% cases (313/333 and positive in 6.0% (20/333. HIV, HCV and Syphilis tests resulted in 0.3% positive test for each serology (1/358. Cysticercosis’ serology was positive in 8.9% (32/358 using immunoenzymatic assay (not confirmed by immunoblotting and Toxocariasis in 13.1% (47/358. Parasitological investigation of faeces were found positive on 42.7% (153/358 children, throat swabs in 11.5% (41/358 children. There were 82.4% (295/358 abnormal blood count, 41.9% (150/358 low ferritin, 89.9% (322/358 endocrine abnormalities and 20.4% (73/358 various pathologies evaluated by specialists.

    Conclusions: pathologies affecting our study group are the same affecting other categories of immigrant children, because they often

  14. Commercial renal transplantation: A risky venture? A single Canadian centre experience.

    Science.gov (United States)

    Kapoor, Anil; Kwan, Kevin G; Whelan, J Paul

    2011-10-01

    Canada, akin to other developed nations, faces the growing challenges of end-stage renal disease (ESRD). Even with expanded donor criteria for renal transplantation (the treatment of choice for ESRD), the supply of kidneys is outpaced by the escalating demand. Remuneration for kidney donation is proscribed in Canada. Without an option of living-related transplantation (biological or emotional donors), patients often struggle with long waiting lists for deceased donor transplantation. Accordingly, many patients are now opting for more expedient avenues to obtaining a renal transplant. Through commercial organ retrieval programs, from living and deceased donors, patients are travelling outside Canada to have the procedure performed. Between September 2001 and July 2007, 10 patients (7 males, 3 females) underwent commercial renal transplantation outside Canada. We describe the clinical outcomes of these patients managed postoperatively at our single Canadian transplant centre. Six living unrelated and 4 deceased donor renal transplantations were performed on these 10 patients (mean age 49.5 years). All procedures were performed in developing countries and the postoperative complications were subsequently treated at our centre. The mean post-transplant serum creatinine was 142 μmol/L. The average follow-up time was 29.8 months (range: 3 to 73 months). One patient required a transplant nephrectomy secondary to fungemia and subsequently died. One patient had a failed transplant and has currently resumed hemodialysis. Acute rejection was seen in 5 patients with 3 of these patients requiring re-initiation of hemodialysis. Only 1 patient had an uncomplicated course after surgery. Despite the kidney trade being a milieu of corruption and commercialization, and the high risk of unconventional complications, patients returning to Canada after commercial renal transplantation are the new reality. Patients are often arriving without any documentation; therefore, timely, goal

  15. The HILW-LL (high- and intermediate-level waste, long-lived) disposal project: working toward building the Cigeo Industrial Centre for Geological Disposal; Le projet HA-MAVL: vers la realisation du centre industriel de stockage geologique Cigeo

    Energy Technology Data Exchange (ETDEWEB)

    Labalette, Th. [Agence Nationale pour la Gestion des Dechets Radioactifs - ANDRA, Dir. des Projets, 92 - Chatenay Malabry (France)

    2011-02-15

    The French Act of 28 June 2006 identifies reversible disposal in deep geological facilities as the benchmark solution for long-term management of high-level waste (HLW) and for intermediate-level long-lived waste (ILW-LL). The Act tasks ANDRA (national agency for the management of radioactive wastes) with the pursuit of studies and research on the choice of a site and the design of the repository, with a view to examining the licence application in 2015 and, provided that the licence is granted, to make the facility operational by 2025. At the end of 2009, ANDRA submitted to the Government its proposals regarding the site and the design of the Industrial Centre for Geological Disposal, known as CIGEO. With the definition of a possible area for the construction of underground disposal facilities, one of the key stages in the project has been achieved. The choice of a surface site will be validated following the public consultation scheduled for the end of 2012. The project is now on the point of entering the definition stage (preliminary design). CIGEO will be a nuclear facility unlike any other. It will be built and operated for a period of over 100 years. For it to be successful, the project must meet certain requirements related to its integration in the local area, industrial planning, safety and reversibility, while also controlling costs. Reversibility is a very important concept that will be defined by law. It is ANDRA's responsibility to ensure that a reasonable balance is found between these different concerns. (author)

  16. Antimicrobial susceptibility testing of rapidly growing mycobacteria by microdilution - Experience of a tertiary care centre

    Directory of Open Access Journals (Sweden)

    Set R

    2010-01-01

    Full Text Available Purpose: The objective of the study was to perform antimicrobial susceptibility testing of rapidly growing mycobacteria (RGM isolated from various clinically suspected cases of extrapulmonary tuberculosis, from January 2007 to April 2008, at a tertiary care centre in Mumbai. Materials and Methods: The specimens were processed for microscopy and culture using the standard procedures. Minimum inhibitory concentrations (MIC were determined by broth microdilution, using Sensititre CA MHBT. Susceptibility testing was also carried out on Mueller Hinton agar by the Kirby Bauer disc diffusion method. Results: Of the 1062 specimens received for mycobacterial cultures, 104 (9.79% grew mycobacteria. Of the mycobacterial isolates, six (5.76% were rapid growers. M. abscessus and M. chelonae appeared to be resistant organisms, with M. chelonae showing intermediate resistance to amikacin and minocycline. However, all the six isolates showed sensitivity to vancomycin and gentamicin by the disc diffusion test. Also all three isolates of M. abscessus were sensitive to piperacillin and erythromycin. Further studies are required to test their sensitivity to these four antimicrobials by using the microbroth dilution test, before they can be prescribed to patients. Conclusions: We wish to emphasize that reporting of rapidly growing mycobacteria from clinical settings, along with their sensitivity patterns, is an absolute need of the hour.

  17. Single-centre experience of 101 paediatric and adult Ross procedures: mid-term results.

    Science.gov (United States)

    McBrien, Angela; Chaudhari, Milind; Crossland, David S; Aspey, Helen; Heads-Baister, Alison; Griselli, Massimo; O'Sullivan, John; Hasan, Asif

    2012-05-01

    We aimed to determine outcomes for the Ross procedure in paediatric and adult patients, with particular emphasis on survival, complication and reintervention rates. A retrospective review of 101 patients who had the Ross procedure in a congenital cardiac surgical centre serving a population of approximately 2.5 million was performed. There were 69 adults and 32 children with a mean age of 24.8 ± 13.9 years. Indications for surgery were aortic stenosis (48), regurgitation (10), mixed disease (35) and complex left outflow tract obstruction (8). The mean follow-up duration was 4.7 ± 3.7 years. The mini-inclusion technique was used to incorporate the autograft, and in all cases, pulmonary homografts were placed in the right ventricular outflow tract. Sub-aortic resection was also performed in six and Ross-Konno operations in eight patients. There were no early deaths and there was one late death secondary to endocarditis. Freedom from reintervention was 92% at 5 years and 77% at 10 years. Children were significantly more likely to require reintervention (16%, 5 of 32 versus 4%, 3 of 69, P = 0.05). The Ross procedure carries low early and mid-term mortality, and reintervention rates appear acceptable. The Ross procedure should be considered a feasible alternative to prosthetic valves in patients who require aortic valve replacement.

  18. Renal diseases in adults with cystic fibrosis: a 40 year single centre experience.

    Science.gov (United States)

    Wilcock, M J; Ruddick, A; Gyi, K M; Hodson, M E

    2015-10-01

    There is a sizable literature describing renal disease in patients with cystic fibrosis. Previous studies have focused on single disease processes alone, most commonly renal stone disease or acute kidney injury. In this study we report for the first time on the prevalence of all forms of renal disease in a cystic fibrosis population. A retrospective review of adult patients with cystic fibrosis attending the Adult Cystic Fibrosis Department at the Royal Brompton Hospital was carried out by searching the department's database to identify patients with renal problems and subsequently retrieving clinical information from medical notes. The prevalence of all renal diseases in our population was 5.1 %. The most commonly identified problem was renal stones. At 2.0 % the prevalence of renal stones in adult patients with cystic fibrosis was comparable to the general population. A range of other renal diseases were identified, the next most common being drug-induced acute kidney injury. A range of cystic fibrosis independent and attributable diseases has been identified but no cystic fibrosis specific disease. In contrast to other cystic fibrosis centres no increased prevalence of renal stones was found.

  19. Cleft lip and palate repair: the experience from two West African sub-regional centres.

    Science.gov (United States)

    Onah, I I; Opara, K O; Olaitan, P B; Ogbonnaya, I S

    2008-08-01

    Compliance with primary surgical treatment in people with cleft lip and palate is a well-known problem, especially in developing countries fraught with poverty and ignorance. Different protocols of treatment exist. In this paper, we retrospectively review a cohort from two centres, with a discussion on the outcome and its implications. The records of all patients with cleft lip and palate seen in the National Orthopaedic Hospital, Enugu, Nigeria, from January 1993 to December 1999, were sought, and all available case notes reviewed retrospectively. This included new cases seen in the period, and also cases operated during this period. Follow up took place until January 2005, when the data were collated. The records of all such patients seen at Ladoke Akintola University Teaching Hospital Osogbo, Nigeria, from September 2004 to June 2006 were also collated and analysed. During this period, 102 patients were seen (93 at Enugu and nine at Osogbo). Fifteen had isolated cleft palate, 42 had isolated cleft lip and 45 had combined cleft lip and palate. Presentation time ranged from 1 day to 43 years. The palate was not repaired in 20 people after lip repair; two patients with cleft lip and palate completely defaulted; and only one person with isolated cleft palate failed to undergo surgery in this period. Two patients in Osogbo absconded. The West African sub-region has a high drop out rate after lip repair.

  20. Outcome following Resection of Biliary Cystadenoma: A Single Centre Experience and Literature Review

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    M. Pitchaimuthu

    2015-01-01

    Full Text Available Background. Biliary cystadenomas (BCAs are rare, benign, potentially malignant cystic lesions of the liver, accounting for less than 5% of cystic liver tumours. We report the outcome following resection of biliary cystadenoma from a single tertiary centre. Methods. Data of patients who had resection of BCA between January 1993 and July 2014 were obtained from liver surgical database. Patient demographics, clinicopathological characteristics, operative data, and postoperative outcome were analysed. Results. 29 patients had surgery for BCA. Male : female ratio was 1 : 28. Clinical presentation was abdominal pain (74%, jaundice (20%, abdominal mass (14%, and deranged liver function tests (3%. Cyst characteristics included septations (48%, wall thickening (31%, wall irregularity (38%, papillary projections (10%, and mural nodule (3%. Surgical procedures included atypical liver resection (52%, left hemihepatectomy (34%, right hemihepatectomy (10%, and left lateral segmentectomy (3%. Median length of stay was 7 (IQ 6.5–8.5 days. Two patients developed postoperative bile leak. No patients had malignancy on final histology. Median follow-up was 13 (IQ 6.5–15.7 years. One patient developed delayed biliary stricture and one died of cholangiocarcinoma 11 years later. Conclusion. Biliary cystadenomas can be resected safely with significantly low morbidity. Malignant transformation and recurrence are rare. Complete surgical resection provides a cure.

  1. Outcome following Resection of Biliary Cystadenoma: A Single Centre Experience and Literature Review

    Science.gov (United States)

    Pitchaimuthu, M.; Aidoo-Micah, G.; Coldham, C.; Sutcliffe, R.; Roberts, J. K.; Muiesan, P.; Isaac, J.; Mirza, D.; Marudanayagam, R.

    2015-01-01

    Background. Biliary cystadenomas (BCAs) are rare, benign, potentially malignant cystic lesions of the liver, accounting for less than 5% of cystic liver tumours. We report the outcome following resection of biliary cystadenoma from a single tertiary centre. Methods. Data of patients who had resection of BCA between January 1993 and July 2014 were obtained from liver surgical database. Patient demographics, clinicopathological characteristics, operative data, and postoperative outcome were analysed. Results. 29 patients had surgery for BCA. Male : female ratio was 1 : 28. Clinical presentation was abdominal pain (74%), jaundice (20%), abdominal mass (14%), and deranged liver function tests (3%). Cyst characteristics included septations (48%), wall thickening (31%), wall irregularity (38%), papillary projections (10%), and mural nodule (3%). Surgical procedures included atypical liver resection (52%), left hemihepatectomy (34%), right hemihepatectomy (10%), and left lateral segmentectomy (3%). Median length of stay was 7 (IQ 6.5–8.5) days. Two patients developed postoperative bile leak. No patients had malignancy on final histology. Median follow-up was 13 (IQ 6.5–15.7) years. One patient developed delayed biliary stricture and one died of cholangiocarcinoma 11 years later. Conclusion. Biliary cystadenomas can be resected safely with significantly low morbidity. Malignant transformation and recurrence are rare. Complete surgical resection provides a cure. PMID:26839708

  2. Clinical and functional outcomes and treatment options for paediatric elbow dislocations: Experiences of three trauma centres.

    Science.gov (United States)

    Subasi, M; Isik, M; Bulut, M; Cebesoy, O; Uludag, A; Karakurt, L

    2015-07-01

    Although elbow dislocations are seen rarely in children, their management remains controversial. In this study, over a 7 years period, we evaluated retrospectively the clinical and functional results of paediatric elbow dislocations managed in three different trauma centres. Pure dislocations and dislocations with associated injuries were evaluated separately. In total 56 patients met the inclusion criteria. The number of patients without additional injury was 22 out of which according to the Robert's criteria, 15 children (68%) had an excellent, four (18%) a good, one (5%) a fair, and two (9%) a poor outcome. From the thirty-four patients that had associated injuries, two (6%) had an excellent, 6 (18%) a good, 10 (29%) a fair and 16 (47%) a poor result. Overall, patients with pure dislocation were found to have a better range of motion compared to patients with dislocation and associated injuries. Prolonged follow ups, and effective rehabilitation programs are required in order to expect good outcomes. Copyright © 2015 Elsevier Ltd. All rights reserved.

  3. Robotic assisted laparoscopic adrenalectomy: Initial experience from a tertiary care centre in India

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    Mrinal Pahwa

    2015-01-01

    Full Text Available Introduction: Laparoscopic adrenalectomy (LA is now considered the standard for treatment of surgically correctable adrenal disorders. Robotic adrenalectomy has been performed worldwide and has established itself as safe, feasible and effective approach. We hereby present the first study in robotic transperitoneal LA from Indian subcontinent. Materials and Methods: We conducted a retrospective evaluation of 25 patients who had undergone robotic assisted LA at a tertiary health centre by a single surgeon. Demographic, clinical, histopathological and perioperative outcome data were collected and analysed. Results: Mean age of the patients was 45 years (range: 27-65 years. Eleven male and 14 female patients were operated. Mean operative time was 139 min ± 30 min (range: 110-232 min and mean blood loss was 85 ml ± 12 ml (range: 34-313 ml. Mean hospital stay was 2.5 ± 1.05 days (range: 2-6 days. Mean visual analogue scale score was 3.2 (range: 1-6 mean analgesic requirement was 50 mg diclofenac daily (range: 0-150 mg. Histopathological evaluation revealed 11 adenomas, eight phaeochromocytomas, two adrenocortical carcinomas, and four myelolipomas. According to Clavien-Dindo classification, three patients developed Grade I post-operative complications namely hypotension and pleural effusion. Conclusion: Robotic adrenalectomy is safe, technically feasible and comfortable to the surgeon. It is easier to perform with a short learning curve.

  4. Early Experience in Da Vinci Robot-Assisted Partial Nephrectomy: An Australian Single Centre Series

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    Francis Ting

    2015-01-01

    Full Text Available Introduction and Objectives. To demonstrate the safety and efficacy of the robot-assisted partial nephrectomy (RAPN technique in an Australian setting. Methods. Between November 2010 and July 2014, a total of 76 patients underwent 77 RAPN procedures using the Da Vinci Surgical System© at our institution. 58 of these procedures were performed primarily by the senior author (PB and are described in this case series. Results. Median operative time was 4 hours (range 1.5–6 and median warm ischaemic time (WIT was 8 minutes (range 0–30 including 11 cases with zero ischaemic time. All surgical margins were clear with the exception of one patient who had egress of intravascular microscopic tumour outside the capsule to the point of the resection margin. Complications were identified in 9 patients (15.8%. Major complications included conversion to open surgery due to significant venous bleeding (n=1, reperfusion injury (n=1, gluteal compartment syndrome (n=1, DVT/PE (n=1, and readmission for haematuria (n=1. Conclusion. This series demonstrates the safety and efficacy of the RAPN technique in an Australian setting when performed by experienced laparoscopic surgeons in a dedicated high volume robotic centre.

  5. Early Experience in Da Vinci Robot-Assisted Partial Nephrectomy: An Australian Single Centre Series.

    Science.gov (United States)

    Ting, Francis; Savdie, Richard; Chopra, Sam; Yuen, Carlo; Brenner, Phillip

    2015-01-01

    Introduction and Objectives. To demonstrate the safety and efficacy of the robot-assisted partial nephrectomy (RAPN) technique in an Australian setting. Methods. Between November 2010 and July 2014, a total of 76 patients underwent 77 RAPN procedures using the Da Vinci Surgical System© at our institution. 58 of these procedures were performed primarily by the senior author (PB) and are described in this case series. Results. Median operative time was 4 hours (range 1.5-6) and median warm ischaemic time (WIT) was 8 minutes (range 0-30) including 11 cases with zero ischaemic time. All surgical margins were clear with the exception of one patient who had egress of intravascular microscopic tumour outside the capsule to the point of the resection margin. Complications were identified in 9 patients (15.8%). Major complications included conversion to open surgery due to significant venous bleeding (n = 1), reperfusion injury (n = 1), gluteal compartment syndrome (n = 1), DVT/PE (n = 1), and readmission for haematuria (n = 1). Conclusion. This series demonstrates the safety and efficacy of the RAPN technique in an Australian setting when performed by experienced laparoscopic surgeons in a dedicated high volume robotic centre.

  6. Role of clinical skill centre in undergraduate medical education: Initial experience at Rehman Medical College Peshawar.

    Science.gov (United States)

    Shafiq, Zainab; Mufti, Tariq Saeed; Qayum, Iftikhar

    2017-01-01

    To assess the performance of students on clinical skill factors and to measure the satisfaction level of students related to the training. The descriptive study was conducted at Rehman Medical College, Peshawar, Pakistan, from August 1 to September 15, 2013, and comprised all third-year medical students who had undergone clinical skill training. Their performance was evaluated through end-of-module objective structured clinical examination. Students' feedback measuring satisfaction on a five-point Likert scale was obtained on a designed validated tool. Monitoring of the clinical skills centre training programme was done by the quality enhancement cell at the college. SPSS 16 was used for statistical analysis. Of the 98 students who took the examinations, 94(96%) cleared generic stations and 70(72%) to 96(98%) discipline-based stations. Overall, 94(96%) cleared the first objective structured clinical examination, ranging from 83(84.6%) for Persian language conversation training to 98(100%) for general physical examination. In the second examination, 90(92%) students passed; ranging from 72(73%) for Gynaecology to 97(98.7%) each for Surgery and Ear, Nose and Throat. There was no significant difference between mean results of the two exams (p>0.05). Clinical skills training achieved the desired objectives and outcomes. However, continuing studies need to be done to establish reliability of the programme.

  7. Causes of prolonged jaundice in infancy: 3-year experience in a tertiary paediatric centre.

    Science.gov (United States)

    Andre, Margaret; Day, Andrew S

    2016-01-29

    Although prolonged jaundice (PJ) commonly occurs in infancy, there is not yet agreement as to the appropriate extent of investigations, particularly in otherwise well children. Significant pathologies may present with PJ in this age group and need to be considered. The aim of this retrospective study was to ascertain the causes of PJ in infants referred to a single tertiary paediatric centre. Infants referred with PJ over a 3-year period were identified. Clinical documentation, electronic notes and results of investigations performed prior to and after referral were reviewed. One hundred and sixty-seven infants with PJ were seen. Fifty-eight percent were over 28 days of age. Four patients had conjugated hyperbilirubinaemia. Eighteen percent of patients were found to have a specific medical diagnosis causing or contributing to PJ, almost half of whom had normal clinical examination. The single most common pathological cause for PJ was hypothyroidism found in six patients. This study demonstrates that normal clinical examination and exclusion of conjugated hyperbilirubinaemia are insufficient to exclude pathological causes of PJ. Overall, these children were referred late. Guidelines, in conjunction with education initiatives, are required to optimise the management of prolonged jaundice in infancy.

  8. Management of Epistaxis – A Single Centre Experience and Economic Considerations

    LENUS (Irish Health Repository)

    Keane, E

    2016-06-01

    Epistaxis represents the most common ENT emergency and its management has been a focus of audit recently, with consideration given to the associated economic burden. The aim of our study is to evaluate the management of epistaxis in terms of treatments used, duration of stay, recurrence and cost. A retrospective review of hospital inpatient enquiry (HIPE) data from a single secondary referral centre was undertaken during a four year period. Four hundrefd and thirty-four patients were identified. The majority (n= 262, 60.3%) were male and the average age was 64.2 years. The vast majority (n=362, 83.4%) were managed non-operatively. Only 15 patients (3.4%) were managed surgically. The average length of stay was 2.5 days and did not vary greatly between the treatment groups. The recurrence rate was 8.2% (n=36). Approximate costs of packing vs EUA and cautery suggest that packing alone is more economical but more data is needed to fully compare the options.

  9. Psycho-social Features of Chronic Dialysis Patients in Saudi Arabia: Experience of one Centre

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    AL-Homrany Mohammed

    2001-01-01

    Full Text Available The goals of chronic dialysis treatment for end-stage renal disease (ESRD patients include restoration of the highest achievable state of personal physical health and preservation as well as restoration and development of the highest level of psychological and social functions. We conducted this study to evaluate factors influencing the process of adaptation such as religious faith, economic status and extended family-tribal system. It was hoped that studying these factors might provide further dimension to our understanding of the psychopathology of ESRD patients, and to help offer new ideas to improve the quality of their lives. A sample comprising 54 patients with ESRD was studied in Abha hemodialysis centre in Southern Saudi Arabia. The socio-demographic characteristics, clinical and laboratory data were collected. The psychiatric status of the patients was evaluated using a structured "The Comprehensive Psychiatric Rating Scale" (CPRS clinical interview. The result indicated that the major co-morbidity (in 60% of these patients was a depressive illness due to renal failure diagnosable according to DSM-IV criteria. Our study suggests the need for specific anti-depressant treatment in order to ameliorate many distressing symptoms, which may affect the quality of these patients′ life. Concomitant social problems of poverty, absence of spouse and illiteracy, dictate a more prompt attitude in initiating support systems and attention to providing leisure activities.

  10. Transvenous extraction of cardiac rhythm device leads: a report of the experience from a single referral centre in Greece.

    Science.gov (United States)

    Sideris, Skevos; Kasiakogias, Alexandros; Pirounaki, Maria; Gatzoulis, Kostas; Sotiropoulos, Ilias; Dilaveris, Polichronis; Traxanas, Kostas; Vouliotis, Apostolos-Ilias; Voliotis, Apostolos; Manakos, Kostas; Konstantinidis, Dimitris; Trantalis, George; Lymperiadis, Dimitrios; Stavropoulos, George; Tousoulis, Dimitrios; Kallikazaros, Ioannis

    2015-01-01

    As rates of implanted cardiac electronic devices continue to rise, lead extraction procedures are crucial for the management of complications. The optimal method for such procedures has been constantly debated. We sought to review our experience of lead extraction using a conventional technique. This was a retrospective study of lead extraction procedures in a major referral centre in Greece. Leads were extracted in a series of 66 consecutive patients (69% men, age range 53-90 years) who visited our centre between August 2008 and June 2012. The extraction procedure was performed in the catheterization lab with a widely used system composed of a locking stylet and sheath. A total of 120 leads were extracted (51 atrial, 69 ventricular) including 19 defibrillator leads and 9 coronary sinus leads. The most frequent indication for lead extraction was infective endocarditis (28 patients, 42%), followed by generator pocket infection (22 patients, 33%), and lead malfunction (16 patients, 24%). Extraction was achieved through the venous entry-site approach in all procedures. The leads were completely extracted in 65 patients (98.5%). Only one complication was recorded: perforation of the right atrium in one patient (1.5%), who eventually underwent emergency cardiac surgery with a good outcome. Our data confirm that a conventional mechanical technique is highly effective for successful extraction of all types of implanted cardiac electronic device leads and is associated with very limited complications.

  11. Publications | Page 109 | CRDI - Centre de recherches pour le ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    La gestion des conflits sur les pompes à main dans les villages du Burkina Faso. Les jeunes gens de Silmiougou, village du centre du Burkina Faso, aimeraient bien se trouver des compagnes parmi les femmes des villages voisins. Ils ont toutefois un sérieux handicap qui n'a rien à voir avec leur qualité de futurs.

  12. Reliability in mechanics: the application of experience feedback; La fiabilite en mecanique: mise en pratique du retour d`experience

    Energy Technology Data Exchange (ETDEWEB)

    Coudray, R.

    1994-12-31

    After a short overview of the available methods for statistical multi-dimensional studies, an application of these methods is described using the experience feedback of French nuclear reactors. The material studied is the RCV (chemical and volumetric control system) pump of the 900 MW PWR type reactors for which data used in the study are explained. The aim of the study is to show the pertinency of the rate of failures as an indicator of the material aging. This aging is illustrated by the most significant characteristics with an indication of their significance level. The method used combines the results from a mixed classification and those from a multiple correspondences analysis in several steps or evolutions. (J.S.). 8 refs., 6 figs., 3 tabs.

  13. Decreasing incidence of coronary heart disease in extreme obesity (BMI≥40)-A single centre experience.

    Science.gov (United States)

    Barth, Sebastian; Zacher, Michael; Reinecke, Holger; Hautmann, Martina B; Kerber, Sebastian; Gietzen, Frank; Halbfass, Philipp; Schade, Anja; Deneke, Thomas; Schieffer, Bernhard; Hamm, Karsten

    The aim of our comprehensive single centre analysis was to evaluate the incidence of coronary heart disease (CHD) in extremely obese patients. Between 2005 and 2015 we investigated retrospectively 23,359 patients undergoing cardiac catheterisation in our institution. Patients were divided in six weight classes according to World Health Organization (WHO) criteria [1] (WHO, 2000). Cardiovascular risk factors, comorbidities, CCS stadium [2] (Cox and Naylor, 1992) and NYHA functional class [3] (The Criteria Committee of the New York Heart Association, 1994) were retrieved from electronic patient records. Using multivariable analysis the odds ratio for the target variable CHD with presence of >50% angiographic stenosis was ≥1 with regard to age (OR 1.049, 95% CI 1.045-1.052), male sex (OR 2.507, 95% CI 2.329-2.699), cardiovascular risk factors, atherosclerosis (OR 1.651, 95% CI 1.498-1.820), and presence of angina (OR 4.408, 95% CI 3.892-4.993). NYHA functional class I-IV, absence of angina (OR 0.818, 95% CI 0.729-0.918), and BMI≥40 (OR 0.592, 95% CI 0.494-0.709) resulted in an odds ratio of ≤1. Underweight patients had a higher (5.3%) and overweight (1.2%) and obese patients (class I 0.9% and II 1.1%) a slightly lower all-cause in-hospital mortality compared to extremely obese patients (1.6%). Severely obese patients treated in our hospital surprisingly showed a decreased incidence of CHD (46.1% in normal weight and 38.6% in extremely obese patients) while comorbidities increased CHD as expected. Although CHD burden was lower, obesity and associated comorbidities resulted in higher all-cause-in-hospital mortality. Copyright © 2016 Asia Oceania Association for the Study of Obesity. Published by Elsevier Ltd. All rights reserved.

  14. Ten-year single-centre experience with type II endoleaks: Intervention versus observation.

    Science.gov (United States)

    Haq, Ikram-Ul; Kelay, Arun; Davis, Meryl; Brookes, Jocelyn; Mastracci, Tara M; Constantinou, Jason

    2017-08-01

    Our objective was to determine the relative merits of intervention or observation of type II endoleaks (T2Ls). A retrospective analysis was performed on 386 infra-renal endovascular aneurysm repair (IR-EVAR) patients from 2006 to 2015. Annual surveillance imaging of patients undergoing EVAR at our centre were analysed, and all endoleaks were subjected to a multidisciplinary team meeting for consideration and treatment. In the 10-year time frame, 386 patients (79.5±8.7 years) underwent an IR-EVAR. Eighty-one patients (21.0%) developed a T2L and intervention was undertaken in 28 (34.6%): 17 (60.7%) were treated via a transarterial approach (TA) and 11 (39.3%) using the translumbar approach (TL). Fifty-three patients (65.4%) with T2Ls were managed conservatively. Patients who received T2L treatment had a greater proportion of recurrent T2Ls than patients who were conservatively managed ( p=0.032). T2Ls associated with aneurysmal growth were more resistant to treatment than those where there was no change or a decrease in aneurysm size during follow-up (0.033). There was no significant difference in the TA and TL approach with respect to endoleak repair success ( p=0.525). Treatment of a T2L did not confer a survival advantage compared to conservative management ( p=0.449) nor did the choice of either the TA or TL approach ( p=0.148). Our study suggests the development of a T2L associated with aneurysm growth may represent an aggressive phenotype that is resistant to treatment. However, this did not lead to an increased risk of mortality over follow-up. Neither a transarterial nor a translumbar approach to treating a T2L conferred superiority.

  15. Experience of the Irish National Centre for hereditary haemorrhagic telangiectasia 2003-2008.

    LENUS (Irish Health Repository)

    Ni Bhuachalla, C F

    2012-01-31

    Hereditary haemorrhagic telangiectasia (HHT) is a group of autosomal dominant disorders of vascular structure. The Irish National Centre for HHT at the Mercy University Hospital, Cork, Ireland was founded in 2003. From 2003 to 2008, screening of 164 patients with contrast echocardiography, thoracic computerised tomography (CT) and cerebral magnetic resonance imaging (MRI) has identified 88 patients with definite HHT, 72 (82%) of whom had epistaxis, 70 (80%) had telangiectasia and 81 (92%) had a first-degree relative with HHT. We sought to describe the manifestations of HHT in an Irish population and to determine differences between internationally reported data. The HHT patient database was analysed to describe demographics, clinical manifestations and interventional procedures performed in all referred patients. Contrast echocardiography and\\/or CT were performed in 86 patients with definite HHT, identifying 27 patients (31%) with pulmonary arteriovenous malformations (pAVMs). Nineteen patients with single or multiple pAVMs had 28 embolisation procedures performed, with 1-6 pAVMs embolised per procedure. Cerebral MRI was performed in 78 (89%) patients and 2 (2.3%) had cerebral arteriovenous malformations (cAVMs). HHT prevalence is thought to be 1 in 2500-8000, suggesting that there are many undiagnosed cases in Irish patients. Internationally published data suggest a prevalence of 15-35% for pAVMs and 10-23% for cAVMs in patients with HHT. While the prevalence of pAVMs in our group is consistent with these data, the prevalence of cAVMs is considerably lower, suggesting that Irish patients with HHT may differ genotypically and phenotypically from those in other countries.

  16. OBSERVATIONS WITH SURGICAL MANAGEMENT OF GYNAECOLOGICAL CANCERS- AH REGIONAL CANCER CENTRE EXPERIENCE

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    Jita Parija

    2017-07-01

    Full Text Available BACKGROUND Oncosurgery plays a very important role in management of gynaecological cancers. With modern anaesthetic techniques, blood transfusion services and intensive care facilities, gyn-oncosurgery in the form of primary radical/secondary cytoreductive or palliative surgery can be offered to patients in all stages of cancer. This is a retrospective analysis of gynaecologic cancer cases who underwent surgery with or without chemotherapy. The study aims at observing the response of these individual cancers to surgery alone or surgery and adjuvant therapy and calculates the 5-year disease-free survival of these cases. MATERIALS AND METHODS A total number of 2242 gynaecological cancer patients who underwent various surgical procedures during April 2006-March 2011 were taken up for studying their individual response to the particular surgery. The patients were categorised into sitespecific gynaecological cancers and the type of surgery they underwent was noted. Adjuvant treatment if given was noted. All patients were followed up for 5 years or more. RESULTS It was observed that of the total number of female genital cancers attending the gyn-oncology OPD of A.H. Regional Cancer Centre over a period of 5 years, only 11.6% were operable. In case of uterine cancers, postoperative adjuvant radiotherapy was required in 28.4% of cancer cervix and in 23.7% cancer corpus patients. All cases of cancer ovary needed adjuvant therapy (chemotherapy/chemotherapy and radiotherapy. All cases of cancer vagina required postoperative adjuvant radiotherapy, whereas none of the vulval cancers needed radiotherapy. Five-year disease-free survival was 75.4% in cancer cervix, 100% with cancer uterine corpus and vulvovaginal cancers and 66.7% with ovarian cancers. CONCLUSION This retrospective analysis reveals that surgery alone should be the primary mode of treatment for all operative gynaecological cancers. Adjuvant treatment should be offered when and wherever necessary.

  17. Prevalence of Hepatitis C among Multi-transfused Thalassaemic Patients in Oman: Single centre experience

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    Khalid Al-Naamani

    2015-01-01

    Full Text Available Objectives: Regular blood transfusions are essential for patients with thalassaemia major. However, infections with hepatotropic viruses remain a major concern. The objective of this study was to evaluate the prevalence and characteristics of hepatitis C viral (HCV infection among patients with homozygous beta thalassaemia in a single centre in Oman. Methods: A retrospective chart review of 200 patients treated at the Thalassemia Unit of Sultan Qaboos University Hospital (SQUH in Muscat, Oman, between August 1991 and December 2011 was performed. Relevant demographic and clinical characteristics were collected, including age, gender, HCV status and the presence of endocrinopathies. Results: A total of 81 patients (41% were found to be anti-HCV-antibody (anti-HCV-positive. HCV ribonucleic acid tests were performed on 65 anti-HCV-positive patients and were positive among 33 (51%; the remaining 16 patients died before these tests were available. Anti-HCV-positive patients were significantly older than anti-HCV-negative patients (P <0.001 and were more likely to be diabetic than anti-HCV-negative patients (27% versus 8%; P <0.001. A total of 100 patients had been transfused before they were transferred to SQUH in 1991; of these, 70 (70% were anti-HCV-positive. Only 11 (11.5% of the 96 patients who were seronegative in 1991, or who were transfused later, became seropositive. Conclusion: It is likely that the high prevalence of HCV among multi-transfused thalassaemic patients in Oman is due to blood transfusions dating from before the implementation of HCV screening in 1991 as the risk of HCVassociated transfusions has significantly reduced since then. Additionally, results showed that anti-HCV-positive patients were more likely to be diabetic than anti-HCV-negative patients.

  18. Laparoscopy-assisted gastrectomy in the elderly: experience from a UK centre.

    Science.gov (United States)

    Tandon, A; Rajendran, I; Aziz, M; Kolamunnage-Dona, R; Nunes, Q M; Shrotri, M

    2017-04-01

    BACKGROUND Gastric cancer has a high incidence in the elderly in the UK, with a significant number of patients aged 75 years or more. While surgery forms the mainstay of treatment, evidence pertaining to the management of gastric cancer in the Western population in this age group is scarce. METHODS We retrospectively reviewed the outcomes of laparoscopy-assisted total and distal gastrectomies at our centre from 2005 to 2015. Patients aged 70 years or above were included in the elderly group. RESULTS A total of 60 patients underwent laparoscopy-assisted gastrectomy over a 10-year period, with a predominance of male patients. There was no significant difference in the rate of overall surgical and non-surgical complications, in-hospital mortality, operation time and length of hospital stay, between the elderly and non-elderly groups. Univariate analysis, performed for risk factors relating to anastomotic leak and surgical complications, showed that age over 70 years and higher American Association of Anesthesiologists grades are associated with a higher, though not statistically significant, number of anastomotic leaks (P = 1.000 and P = 0.442, respectively) and surgical complications (P = 0.469 and P = 0.162, respectively). The recurrence rate within the first 3 years of surgery was significantly higher in the non-elderly group compared with the elderly group (Log Rank test, P = 0.002). There was no significant difference in survival between the two groups (Log Rank test, P = 0.619). CONCLUSIONS Laparoscopy-assisted gastrectomy is safe and feasible in an elderly population. There is a need for well-designed, prospective, randomised studies with quality of life data to inform our practice in future.

  19. Changing trends in the management of intertrochanteric hip fractures - A single centre experience.

    Science.gov (United States)

    Page, Piers R J; Lord, Roxana; Jawad, Ahsin; Dawe, Edward; Stott, Philip; Rogers, Benedict; Gill, Richie

    2016-07-01

    With an annual incidence greater than 65,000 in the United Kingdom, hip fractures are a common but debilitating injury predominantly affecting those over 65. Treatment is based on the anatomical location of the fracture relative to the capsule of the hip joint - fractures occurring within it are treated by arthroplasty, while extracapsular fractures are an indication for fixation. Intertrochanteric fractures are further grouped as stable (AO/OTA 31A1/A2) or unstable (31A3) which in turn governs in the current UK guidelines whether this fixation is achieved with a dynamic hip screw or intramedullary device. Anecdotally, some units are tending towards intramedullary devices for 31A2 fractures as well, a practice which from the evidence does not appear to confer benefit and carries an excess cost. We reviewed our data submitted to the National Hip Fracture Database over the last five years and identified all intertrochanteric fractures, from which cohort we identified all patients with 31A2 fractures by review of radiographs. The cohort comprised 370 patients. We then recorded age, gender, ASA grade, abbreviated mental test score, residence from where admitted, length of stay, destination on discharge and whether any further operations were required. There was no significant difference in the demographics of the groups, year-on-year, except gender mix. There was a significant, twenty-fold rise in the use of intramedullary devices between 2011 and 2015. Length of stay, length of overall episode of care, revision rates, mortality and destination on discharge were unchanged. This use is not supported by NICE guidelines and this study offers no evidence to contradict this position. We advocate all centres examine their practice to avoid a costly intervention without clinical benefit. Copyright © 2016 Elsevier Ltd. All rights reserved.

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

    Science.gov (United States)

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

    2014-02-01

    In paediatric pulmonary arterial hypertension (PAH), the effectiveness of add-on combination PAH-therapy has not yet been systematically studied. The purpose of this study was to determine the effect of sildenafil add-on therapy in paediatric PAH patients treated with bosentan. In this observational study within a national paediatric patient cohort, follow-up data of 24 consecutive paediatric PAH patients initially treated with bosentan monotherapy and prospectively followed at the Dutch national referral centre for paediatric PAH in 2007-2013, were reviewed. Patients received add-on sildenafil therapy in case of clinical worsening. Fifteen children received add-on sildenafil therapy; nine remained on bosentan monotherapy. Patient characteristics, 6-minute walk distance (6MWD), WHO functional class (WHO-FC), N-terminal pro-Brain Natriuretic Peptide (NT-proBNP), and haemodynamic measurements at bosentan start were similar in both patient groups. In children with clinical worsening, sildenafil add-on therapy improved 6MWD at 5, 10, 15 and 21 months of follow-up, improved WHO-FC at 10, 15 and 21 months and stabilised NT-proBNP. Patients who received add-on sildenafil therapy had more advanced disease progression during bosentan monotherapy. Despite that, they had better or, at least, no worse survival compared to patients who remained on bosentan monotherapy. In children with PAH, sildenafil add-on therapy indicated by clinical deterioration on bosentan monotherapy, was associated with a significant improvement of WHO-functional class and 6MWD. Despite clinical deterioration on bosentan monotherapy, patients receiving sildenafil add-on therapy, had either better or, at least, no worse survival than patients remaining on bosentan monotherapy.

  1. Treatment with immunosuppressive therapy in patients with pars planitis: experience of a reference centre in Mexico.

    Science.gov (United States)

    Serna-Ojeda, Juan Carlos; Pedroza-Seres, Miguel

    2014-11-01

    To evaluate the clinical course of the patients with pars planitis that received immunosuppressive drugs. We retrospectively analysed the data of 10 years from 374 patients with pars planitis in a large reference centre in Mexico City and included 49 patients (92 eyes). Median age at presentation was 8 years. 35 patients (71.4%) were male and 43 patients (87.7%) had bilateral disease. Diverse immunosuppressive medications were used, mainly methotrexate (69.4%) and azathioprine (63.3%) with 18 patients requiring more than one drug. The main indications for starting immunosuppressive therapy were lack of response to initial treatment and advance disease at presentation. The results showed good response with steroid reduction (69.3% of patients), visual acuity improvement (51% of patients) and inflammatory disease reduction (59.1% of patients). In 25 patients (51%), steroids were started previous to immunosuppressors and in 24 (49%) at the same time without significant difference in clinical improvement (p=0.210) or visual outcome (p=0.498). Thirteen patients (26.5%) presented mild adverse effects. The median of the final visual acuity was 20/40. The median follow-up time was 44 months (range 13-115 months). Immunosuppressive therapy allows an adequate control of inflammatory disease in pars planitis, with clinical and visual improvement and steroid dose reduction. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  2. Cardiopulmonary exercise testing in children with cystic fibrosis: one centre's experience.

    Science.gov (United States)

    Weir, Elise; Burns, Paul D; Devenny, Anne; Young, David; Paton, James Y

    2017-05-01

    While exercise testing is increasingly used as a prognostic indicator in cystic fibrosis (CF), it is reported to be underused in UK CF centres, particularly in children. Here, we evaluated the cardiopulmonary exercise testing (CPET) results in children and young people with CF at CF annual review and its possible clinical value. An observational study comparing CPET results using a cycle ergometer ramp test (peak oxygen uptake (Vo 2peak )) and pulmonary function (forced expiratory volume in 1 s (FEV 1 )) was performed with body mass index (BMI) used as a disease severity marker. Data were identified from clinical case notes and our CF database. Thirty-eight children and young people (mean age 11±2.4, range 7-14 years; 17 males and 21 females) completed at least one CPET with 95% achieving technically satisfactory tests allowing measurement of Vo 2peak . Mean Vo 2peak was 107 ±17.6% predicted, range 74%-150% predicted, with 8% having a reduced Vo 2peak of children and young people achieving technically satisfactory assessments starting from age 7. In this group with relatively mild CF, mean Vo 2peak was normal with no significant correlation between Vo 2peak and FEV 1 or BMI, as markers of disease severity. The majority demonstrated a normal Vo 2peak . However, 71% showed a downward trend on repeat testing 12-18 months later. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  3. A single centre experience with sequential and concomitant chemoradiotherapy in locally advanced stage IV tonsillar cancer

    Directory of Open Access Journals (Sweden)

    Coyle Catherine

    2010-12-01

    Full Text Available Abstract Background Chemo-radiotherapy offers an alternative to primary surgery and adjuvant therapy for the management of locally advanced stage IV squamous cell carcinomas of the tonsil. Methods A retrospective analysis was performed of the outcomes of 41 patients with locoregionally advanced squamous cell carcinoma of the tonsil treated non-surgically at the Yorkshire Cancer Centre between January 2004 and December 2005. Due to long radiotherapy waiting times, patients received induction chemotherapy with cisplatin and 5-fluorouracil followed by either cisplatin concurrent chemoradiotherapy or radiotherapy alone. Results Median age was 55 years (range 34-76 years and 28 (68% patients were male. 35/41 patients (85% received 2 or more cycles of induction chemotherapy. Following induction chemotherapy, 32/41 patients (78% had a clinical response. Concomitant chemotherapy was given to 30/41 (73%. All patients received the planned radiotherapy dose with no delays. There were no treatment related deaths. Six (15% patients had gastrostomy tubes placed before treatment, and 22 (54% required nasogastric tube placement during or after treatment for nutritional support. 17 patients required unplanned admissions during treatment for supportive care. At 4 months post treatment assessment 35 out of 41 (85% patients achieved complete clinical and radiographic response. Median follow-up is 38 months (8-61 months. Local and regional control rate in complete responders at 3 years was 91%. Distant metastases have been found in 4 (9.8% patients. Three year progression-free survival rate in all patients is 75%. The 3-year cause specific survival and overall survival are 75% and 66% respectively. Conclusion Cisplatin-based induction and concurrent chemoradiotherapy provides excellent tumour control with acceptable toxicity for patients with locally advanced tonsillar cancer.

  4. Coeliac disease in patients with short stature: A tertiary care centre experience.

    Science.gov (United States)

    Singh, Prashant; Sharma, Piyush Kumar; Agnihotri, Abhishek; Jyotsna, Viveka P; Das, Prasenjit; Gupta, Siddhartha Datta; Makharia, Govind K; Khadgawat, Rajesh

    2015-01-01

    We aimed to determine the prevalence of coeliac disease among children with short stature at a tertiary care centre and to define the predictors for coeliac disease, if any, in them. In this retrospective study, we reviewed the case records of children and adolescents with growth retardation attending the Paediatric Endocrinology Clinic from January 2008 to June 2011. All patients underwent the multi-tier stratified diagnostic protocol for complete evaluation of short stature. Coeliac disease was screened using IgA-anti-tissue transglutaminase antibody. The diagnosis of coeliac disease was made on the basis of the modified European Society of Paediatric Gastroenterology, Hepatology and Nutrition (ESPGHAN) criteria. Of 432 patients (238 boys) who presented with short stature, 72 (16.7%) had physiological, while 360 (83.3%) had pathological causes. Endocrine causes were growth hormone deficiency (86 patients, 19.9%), hypopituitarism (31, 7.2%), hypothyroidism (22, 5.1%) and others (7, 1.6%). The systemic causes were: coeliac disease (47, 10.9%), haematological diseases (14, 3.2%), renal diseases (11, 2.5%) and others (24, 5.6%). Chronic diarrhoea (OR 15.7, 95% CI 7.8-31.5) and anaemia (OR 4.9, 95% CI 1.9-12.7]) were significant predictors for coeliac disease in patients with short stature. There was a definite response to gluten-free diet in them and the mean (SD) growth velocity measured over at least 6 months of gluten-free diet was 8.1 (3.0) cm/year. Nearly 11% of patients presenting with short stature have coeliac disease. In these patients chronic diarrhoea and anaemia were significant predictors of coeliac disease. Copyright 2015, NMJI.

  5. Sinonasal papillomas in a private referral otorhinolaryngology centre: Review of 22 years experience.

    Science.gov (United States)

    de Sousa Fontes, Aderito; Sandrea Jiménez, Minaret; Urdaneta Lafée, Nelson; Abreu Durán, Perfecto A; Quintana Páez, Liwven E; de Sousa de Abreu, Andreina Carmina

    To evaluate the clinical presentation, treatment outcome and follow-up of all patients managed with sinonasal papillomas (SP), at a tertiary private otorhinolaryngology centre in Caracas (Venezuela). We reviewed 94 patients with SP that were treated at our otolaryngology center, from July 1st 1993 to June 31st 2015. The demographic data, clinical features, radiological findings, anatomical origin, disease extension into the adjacent structures, surgical approaches performed, histopathology outcomes, recurrent risk, malignant transformation rate and coadjuvant therapies were assessed. Sixty-five patients (69.1%) were male and 29 (30.9%) female with an average age of 44.5 years (range 9-80 years). All patients underwent endoscopic sinus surgery. The most commont histologic subtypes of SP were inverted papilloma (58 patients; 61.7%), fungiform papilloma (35 patients; 37.2%) and oncocytic papilloma (one patient; 1.1%). SP was associated in 2 patients with undifferentiated squamous cell carcinoma. Twelve patients (12.8%) had disease with extension beyond the sinus without associated malignancy. All these patients received adjuvant treatment with advanced techniques of radiotherapy. The mean duration of the follow-up period was 9 years and 2 months. Eighteen patients (19.1%) had recurrent disease during the entire course of follow-up. Complete endoscopic surgical removal of SP is the treatment of choice. In less endoscopically accessible tumours, with peripheral extension or incompletely resected, Intensity Modulated Radiotherapy and Volumetric Modulated Arc Therapy may be indicated. Timely post-operative endoscopic follow-up with biopsy of suspected lesions is important for early detection of recurrences and associated malignancy. Copyright © 2016 Elsevier España, S.L.U. and Sociedad Española de Otorrinolaringología y Cirugía de Cabeza y Cuello. All rights reserved.

  6. Congenital coronary artery anomalies in adults: review of 111 cases from a single-centre experience.

    Science.gov (United States)

    Çanga, Yiğit; Güvenç, Tolga S; Karataş, Mehmet B; Çalık, Ali N; Onuk, Tolga; Tanık, Veysel O; Güngör, Barış; Bolca, Osman

    2017-08-01

    Coronary artery anomalies are a heterogeneous group of congenital disorders presenting with a wide spectrum of symptoms, ranging from vague chest pain to sudden cardiac death. Despite available data, there is no consensus about the classification, nomenclature, and outcomes of coronary anomalies in the normally connected heart. In this study, we aimed to investigate clinical and angiographic characteristics of coronary arterial anomalies, as well as the frequency of atherosclerotic involvement in anomalous coronaries, diagnosed at a tertiary referral centre. We retrospectively reviewed coronary angiograms performed between 2011 and 2015 for the presence of a coronary anomaly. A total of 111 patients with a final diagnosis of coronary anomaly were included in the study group. We also recruited 110 age- and sex-matched patients who underwent coronary angiography because of symptomatic coronary artery disease as controls. Among 36,893 coronary angiograms, 111 (0.30%) major coronary anomalies were found. Compared with controls, the prevalence of significant atherosclerotic coronary disease was lower in patients with coronary anomalies and stable symptoms (p=0.02); however, the prevalence of significant coronary atherosclerosis was similar among patients admitted with unstable angina or myocardial infarction (p>0.05). Compared with controls, patients with an anomalous left anterior descending coronary artery had significantly less atherosclerotic involvement than those in whom the left anterior descending artery was not anomalous (p=0.005). Although coronary artery anomalies are cited as a cause for myocardial ischaemia, atherosclerotic coronary artery disease is also frequent and may offer an alternative explanation to ischaemic symptoms. No predisposition to accelerated atherosclerosis was found, however, and atherosclerotic involvement was less frequent in some anomalous vessels.

  7. Adverse reactions in blood and apheresis donors: experience from two Italian transfusion centres.

    Science.gov (United States)

    Crocco, Isabella; Franchini, Massimo; Garozzo, Giovanni; Gandini, Anna Rosa; Gandini, Giorgio; Bonomo, Pietro; Aprili, Giuseppe

    2009-01-01

    Blood and apheresis donations are widely considered to be safe with a low incidence of adverse reactions and injuries; however, data reported in the medical literature on the prevalence of adverse events in donors and studies on the predictive risk factors for donor reactions are limited and contradictory. From January 2002 to December 2006 we recorded every adverse reaction verified during 240,596 consecutive blood and apheresis donations (183,855 homologous whole blood donations, 6,669 autologous whole blood donations, 38,647 plasmapheresis, 2,641 plateletpheresis and 8,784 multicomponent donations) at the Italian Transfusion Centres of Verona and Ragusa,. Using a special, pre-arranged form within the quality system, a total of 686 adverse reactions (related to 0.28% of all donations) were recorded. Vasovagal reactions, mostly of mild intensity, were the most commonly observed adverse reactions, with a frequency of 0.20% (487/ 240,596). The frequency of the vasovagal reactions varied according to the different types of donation, being 0.19% (346/183,855) for homologous whole blood donations, 0.24% (16/6,669) for autologous whole blood donations, 0.16% (63/38,647) for plasmapheresis, 0.68% (18/2,641) for plateletpheresis and 0.49 (43/8,784) for multicomponent donations. Citrate toxicity was reported in 0.38% (189/50,072) of apheresis donations. Severe adverse reactions were very rare, as they occurred in 0.004% of the donations (10/240,596). In conclusion, the results of our 5-year survey document that apheresis and blood donation are safe procedures for the donor with a low incidence of adverse reactions; the adverse reactions that did occur were mostly mild and resolved rapidly.

  8. The scholastic experiences of the children of moroccan inmigrants at Centres of Compulsory Secundary Education

    Directory of Open Access Journals (Sweden)

    Cristóbal Ruiz Román

    2009-10-01

    Full Text Available The following work is the fruit of an investigation was developed in the Department of Educational Theory and History in the University of Málaga, which focus of attention has been to understand the experiences of these adolescents in creating their identity in a series of contexts which, culturally speaking, are extremely diverse: essentially the family, the peer group and school. This article will concentrate on the experiences of the children of Moroccan immigrants in centers of Secondary Education of Málaga and on the expectations, perceptions, difficulties and conflicts that they encounter there.

  9. Peer Mentoring Experiences of Psychology Students at the London Metropolitan University Writing Centre

    Science.gov (United States)

    Bakhshi, Savita; Harrington, Kathy; O'Neill, Peter

    2008-01-01

    "It really helps knowing that you are going to have someone around to help you..." This short article reports on research taking place into peer writing tutorials at London Metropolitan University and examines in particular, the experiences of psychology students who have taken part in the scheme. Some of the implications of this…

  10. Factors Impacting Students' Online Learning Experience in a Learner-Centred Course

    Science.gov (United States)

    Wu, Y.

    2016-01-01

    Technologies bring a new era of content presentation for online teaching and learning. With more instructors adopting new tools to design online teaching materials, students are often put into learning contexts with certain new design components. Assessing learner experience and outcome in these contexts is challenging because of the complexity…

  11. CDC Kerala 5: Developmental therapy clinic experience--use of Child Development Centre grading for motor milestones.

    Science.gov (United States)

    Nair, M K C; Resmi, V R; Krishnan, Rajee; Harikumaran Nair, G S; Leena, M L; Bhaskaran, Deepa; George, Babu; Russell, Paul Swamidhas Sudhakar

    2014-12-01

    To document the experiences of the intervention given to children who attended the developmental therapy clinic of Child Development Centre (CDC) Kerala, a specialized clinic for providing developmental intervention/therapy for babies less than two years with developmental delay/disability. All the babies referred to this speciality clinic from developmental screening/evaluation clinics of CDC were registered in the clinic and re-evaluation was done using CDC grading for head holding, sitting, standing, Amiel Tison passive angles, and Trivandrum Developmental Screening Chart (TDSC) 0-2 y. Out of a total of 600 consecutive babies below 2 y with developmental delay/disability referred to developmental therapy clinic, on comparing the test results at enrollment and after 6 mo of intervention, a statistically significant reduction was observed (i) in the 2-4 mo age group with regard to abnormal TDSC (25.5%), (ii) in the 4-8 mo age group with regard to abnormal head holding grade (87.1%) and abnormal TDSC (19.4%), (iii) in the 8-12 mo age group, with regard to abnormal sitting grade (71.7%) and (iv) in the above 12 mo age group with regard to abnormal sitting grade (35.3%) and abnormal standing grade (78.8%). The experience of organizing the developmental intervention/therapy clinic at CDC Kerala has shown that therapy services by developmental therapists in a centre and supportive therapy by mother at home is useful in improving the developmental status of children with developmental delay.

  12. Management of Cushing syndrome in children and adolescents: experience of a single tertiary centre.

    Science.gov (United States)

    Güemes, Maria; Murray, Philip G; Brain, Caroline E; Spoudeas, Helen A; Peters, Catherine J; Hindmarsh, Peter C; Dattani, Mehul T

    2016-07-01

    The diagnosis and management of paediatric Cushing syndrome (CS) is highly challenging. This study aims to characterise its presentation, diagnosis, management and outcome by a retrospective case review of 30 patients (14 females) followed at a single tertiary paediatric endocrinology centre over a 30-year period. At presentation, median age was 8.9 years (0.2-15.5) and the commonest manifestations were weight gain (23/30), hirsutism (17/30), acne (15/30) and hypertension (15/30). Growth retardation was present in 11/30. Median body mass index (BMI) was +2.1 standard deviation score (SDS) (-6.5 to +4.6). Urinary free cortisol (UFC) was abnormal in 17/18 (94 %), midnight cortisol in 27/27 (100 %) and low-dose dexamethasone suppression (LDDS) test in 20/20 (100 %). High-dose dexamethasone suppression (HDDS) test was abnormal in 6/6 (100 %) of adrenal tumours, 1/10 (10 %) of Cushing disease (CD) and 1/2 (50 %) of ectopic tumours. Bilateral inferior petrosal sinus sampling (IPSS) identified five CD cases and one ectopic tumour. All patients underwent surgery and subsequently required cortisol replacement. Final diagnoses were 16 CD, 11 adrenal disease, 2 ectopic ACTH-secreting lesions and 1 case of unidentified aetiology. One year post-diagnosis, median BMI was 0.5 SDS (-2.5 to +3.7), hypertension was present in 4/14 (28 %), and 43 % (12/30) of individuals were off hydrocortisone. The prevalence of the clinical manifestations differs from that reported in other series. Screening tests were highly sensitive, with UFC, midnight cortisol and LDDS performing well. One year post-treatment, BMI and BP normalised in the majority of patients and almost half of them were able to discontinue replacement hydrocortisone. •Cushing syndrome is an extremely rare entity in the paediatric and adolescent age groups, so not many cohort studies have been published in this population. •Several tests can be employed to firstly diagnose hypercortisolaemia and secondly identify

  13. Re: Factors Predicting Outcomes of Micropercutaneous Nephrolithotomy: Results from a Large Single-Centre Experience

    Directory of Open Access Journals (Sweden)

    Yakup Bostancı

    2016-09-01

    Full Text Available The recently developed micropercutaneous nephrolithotomy (microperc is the miniaturized version of mini-percutaneous nephrolithotomy (PCNL and standard-PCNL that allows for safe access and stone disintegration under direct vision. In this single-centre study, the authors aimed to define the role of microperc in the management of renal calculi and analyse factors predicting outcomes. A total of 139 patients, who underwent microperc between June 2010 and November 2014, were enrolled in this study. Microperc was successful in 119 (91.53% patients, while in 11 patients (8.46% some residual fragments were seen on imaging. Of the total study group, conversion to mini- or standard PCNL was required in nine patients (6.47%. Overall complication rate of 11.53%, primarily minor complications comprising renal colic and urinary tract infection. On multivariate analysis, stone density (HU, stone number and stone volume were significantly associated with the dependent variable stone clearance. Multivariate analysis showed that intra-operative complications and stone number were significantly associated with conversion to mini- or standard PCNL. Stone volume threshold of 1.000 mm3 was a significant predictor of stone clearance in univariate and multivariate analyses, regardless of the stone location. Some limitations of this study, relatively small sample size and particularly the retrospective and non-comparative design, should be highlighted. EAU guidelines recommend shockwave lithotripsy (SWL or retrograde intrarenal surgery as the primary treatment modality for stones <10 mm in size. Although microperc is presently being used for small to moderate stones, the very indication that holds for SWL as well, it is notable that SWL is influenced by stone location and pelvicalyceal anatomy, and may require multiple sessions. Nevertheless, microperc has an inherent limitation in that the stone fragments cannot be retrieved for analysis. It has been noted that the

  14. Visite du Conseil des gouverneurs du CRDI en Afrique de l'Est ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    17 oct. 2017 ... En juillet dernier, des membres du Conseil des gouverneurs du CRDI se sont rendus en Afrique de l'Est pour rencontrer des bénéficiaires de subventions de recherche du Centre au Kenya, en Ouganda et en Tanzanie. Cette visite d'une durée d'une semaine, organisée par le Bureau régional de l'Afrique ...

  15. Ce que nous faisons | Page 118 | CRDI - Centre de recherches pour ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    Dynamiques et rôle économique et social du secteur informel des TIC en Afrique de l'Ouest et du Centre : cas du Burkina Faso, Cameroun et du Sénégal. Sujet(s): INFORMAL SECTOR, FORMAL SECTOR, SMALL ENTERPRISES, MEDIUM ENTERPRISES, INFORMATION TECHNOLOGY, INFORMATION POLICY, ...

  16. European Gene Mapping Project (EUROGEM): breakpoint panels for human chromosomes based on the CEPH reference families. Centre d'Etude du Polymorphisme Humain.

    Science.gov (United States)

    Cox, S A; Attwood, J; Bryant, S P; Bains, R; Povey, S; Rebello, M; Kapsetaki, M; Moschonas, N K; Grzeschik, K H; Otto, M; Dixon, M; Sudworth, H E; Kooy, R F; Wright, A; Teague, P; Terrenato, L; Vergnaud, G; Monfouilloux, S; Weissenbach, J; Alibert, O; Dib, C; Fauré, S; Bakker, E; Pearson, N M; Spurr, N K

    1996-11-01

    Meiotic breakpoint panels for human chromosomes 2, 3, 4, 5, 6, 7, 8, 9, 10, 13, 14, 15, 17, 18, 20 and X were constructed from genotypes from the CEPH reference families. Each recombinant chromosome included has a breakpoint well-supported with reference to defined quantitative criteria. The panels were constructed at both a low-resolution, useful for a first-pass localization, and high-resolution, for a more precise placement. The availability of such panels will reduce the number of genotyping experiments necessary to order new polymorphisms with respect to existing genetic markers. This paper shows only a representative sample of the breakpoints detected. The complete data are available on the World Wide Web (URL http:/(/)www.icnet.uk/axp/hgr/eurogem++ +/HTML/data.html) or by anonymous ftp (ftp.gene.ucl.ac.uk in/pub/eurogem/maps/breakpoints).

  17. Patients' experience of a nurse-led lifestyle clinic at a Swedish health centre.

    Science.gov (United States)

    Nymberg, Peter; Drevenhorn, Eva

    2016-06-01

    In Sweden, 56% of the population aged 16-84 have an unhealthy lifestyle. The primary health care (PHC) has been instructed to offer citizens health promotion and disease-preventive actions. Very few studies have been conducted about how individuals experience interventions from the PHC intended to help them to change lifestyle. The purpose of the study was to explore patients' experiences of visiting a nurse-led lifestyle clinic. Patients (n = 137), who participated in a screening test at a lifestyle clinic, were invited to focus group interviews. Of these, 14 patients agreed to participate. The data were analysed using content analysis. The patients felt that the visit to the lifestyle clinic gave insight into their habits and diminished their fear of not being healthy. Primary health care was seen as a safe provider in this matter. Disappointment was occasioned by the unfulfilled expectations of blood tests, lack of follow-up visit and inconsistencies of approach during the visit to the lifestyle clinic. Personal chemistry was perceived to be crucial for how the encounter with the public health nurse evolved. Lifestyle clinics can give patients opportunity to change lifestyle and also to confirm the good habits. It may also be important to have follow-up visits to give the patients' support when changing lifestyle. Nurses counselling patients about lifestyle changes need to have recurrent training in Motivational Interviewing. © 2015 Nordic College of Caring Science.

  18. Professional services for child rape survivors: A child-centred perspective on helpful and harmful experiences.

    Science.gov (United States)

    Collings, Steven J

    2011-06-01

    The aim of this study was to explore child rape survivors' perceptions of helpful and harmful experiences at the hands of professional service providers. Focused interviews were conducted with a convenience sample of 20 child rape survivors who had presented for counselling services at a non-governmental organisation located in the coastal region of KwaZulu-Natal, South Africa. For each case, information was obtained regarding children's perceptions of helpful and harmful experiences at the hands of police, medical and criminal justice system personnel. A thematic analysis of children's responses indicated that the concerns expressed by respondents reflected four basic inter-related needs and rights including the need and right: to be given a voice, to be informed and consulted, to be protected from harm, and for competent and efficient service provision. Study findings provided little support to the view that the medico-legal examination or the adversarial nature of legal proceedings are likely to be experienced as particularly distressing or traumatising for the child. Study findings indicate that the professional services provided to some child rape survivors fail to adequately address the child's basic needs and rights, with there being an associated need for improved codes of practice designed to better serve the interests of child rape survivors.

  19. Patients' experiences of person-centred integrated heart failure care and palliative care at home: an interview study.

    Science.gov (United States)

    Talabani, Naghada; Ängerud, Karin Hellström; Boman, Kurt; Brännström, Margareta

    2017-07-07

    Patients with severe heart failure (HF) suffer from a high symptom burden and high mortality. European and Swedish guidelines for HF care recommend palliative care for these patients. Different models for integrated palliative care and HF care have been described in the literature. No studies were found that qualitatively evaluated these models. The purpose of this study is to describe patients' experiences of a new model of person-centred integrated HF and palliative care at home. Interviews were conducted with 12 patients with severe HF (New York Heart Association class IIIâ€"IV) and included in the research project of Palliative advanced home caRE and heart FailurE caRe (PREFER). Qualitative content analysis was used for data analysis. Two themes and a total of five categories were identified. The first theme was feeling secure and safe through receiving care at home with the categories: having access to readily available care at home, being followed up continuously and having trust in the team members' ability to help. The second theme was being acknowledged as both a person and a patient, with the following two categories: being met as a person, participating in decisions about one's care and receiving help for symptoms of both HF and comorbidities. CONCLUSIONS: Person-centred integrated HF and palliative care provides a secure environment and holistic care for patients with severe HF. This approach is a way to improve the care management in this population. NCT01304381; Results. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  20. Avoiding steroids in pediatric renal transplantation: long-term experience from a single centre

    DEFF Research Database (Denmark)

    Pedersen, Erik Bo; El-Faramawi, Mohamad; Foged, Nils

    2007-01-01

    We report our experience in pediatric renal transplantation avoiding steroids whenever possible. Immunosuppression consisted of an initial induction with antithymocyte globulin followed by maintenance therapy with a calcineurin inhibitor and MMF. Steroids were only given to selected patients......). Unfortunately PTLD occurred in three patients, but all survived with functioning grafts. Accordingly, our findings indicate that steroid avoidance in pediatric renal transplantation is possible with good results with respect to acute graft rejection as well as long-term graft survival....... because of the primary disease, recurrence, rejection, or PTLD. Thirty-four transplants grafted into 32 recipients between 1995 and 2005 were followed for a median of 3.5 yr (range 1-9.8). All patients survived. Graft rejection occurred in 10 cases during the first year post-transplantation and graft...

  1. Does Early Decompressive Craniectomy Improve Outcome? Experience from an Active UK Recruiter Centre

    Directory of Open Access Journals (Sweden)

    E. García Vicente

    2013-01-01

    Full Text Available Introduction. The results of the recent DECRA study suggest that although craniectomy decreases ICP and ICU length of stay, it is also associated with worst outcomes. Our experience, illustrated by these two striking cases, supports that early decompressive craniectomy may significantly improve the outcome in selected patients. Case Reports. The first patient, a 20-year-old man who suffered severe brain contusion and subarachnoid haemorrhage after a fall downstairs, with refractory ICP of 35 mmHg, despite maximal medical therapy, eventually underwent decompressive craniectomy. After 18 days in intensive care, he was discharged for rehabilitation. The second patient, a 23-year-old man was found at the scene of a road accident with a GCS of 3 and fixed, dilated pupils who underwent extensive unilateral decompressive craniectomy for refractory intracranial hypertension. After three weeks of cooling, paralysis, and neuroprotection, he eventually left ICU for rehabilitation. Outcomes. Four months after leaving ICU, the first patient abseiled 40 m down the main building of St. Mary’s Hospital to raise money for the Trauma Unit. He has returned to part-time work. The second patient, was decannulated less than a month later and made a full cognitive recovery. A year later, with a titanium skull prosthesis, he is back to part-time work and to playing football. Conclusions. Despite the conclusions of the DECRA study, our experience of the use of early decompressive craniectomy has been associated with outstanding outcomes. We are currently actively recruiting patients into the RESCUEicp trial and have high hopes that it will clarify the role of the decompressive craniectomy in traumatic brain injury and whether it effectively improves outcomes.

  2. Surgically managed idiopathic intracranial hypertension in adults: a single centre experience.

    Science.gov (United States)

    Matloob, Samir A; Toma, Ahmed K; Thorne, Lewis; Watkins, Laurence D

    2015-12-01

    Idiopathic intracranial hypertension (IIH) is a rare condition that is often managed conservatively. In patients with aggressive progression of the disease surgical options are considered. There are few data on the outcomes of these patients when surgically managed. We describe our experience of surgically managed IIH and the outcomes of these patients, in particular the surgical revision rate and interventions required for resolution of symptoms. A retrospective review of all patient files coded with benign intracranial hypertension, idiopathic intracranial hypertension or pseudotumour cerebri was undertaken. Files were searched with the date of diagnosis and the date these patients were referred for surgical intervention. The surgical interventions and complications were then documented and note was made of the number of inpatient admissions and days spent in hospital. From 2000-2013, 79 patients were identified as patients with IIH that had required surgical intervention; 52 % required further surgical intervention. The average number of surgical interventions was 5.6. For patients requiring further intervention the average number of surgical interventions was 8.6. On average patients with IIH also spent 42 inpatient days in neurosurgical beds, whilst those patients who required further intervention spent 63 days on average in neurosurgical beds. The length of the average individual admission was longer for patients requiring repeated surgical interventions. Based on our experience, patients that require surgical management of IIH frequently require further surgical interventions to control symptoms and manage complications of CSF diversion surgery. Those that require such further intervention on average will have six further operations and spend significantly longer in hospital. Lumboperitoneal (LP) shunting is an effective first line surgical intervention for 52 % of our patient cohort. This sub-group of patients therefore requires specialist neurosurgical

  3. Robotic-assisted laparoscopic partial nephrectomy: A single centre Indian experience

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    Arvind P Ganpule

    2015-01-01

    Full Text Available Background: We summarise our experience with RPN emphasising on learning curve, techniques and outcomes. Patients and Methods: A retrospective chart review of 57 patients was done. The preoperative workup included a triple phase CT angiography. The parameters analyzed were demographics, tumor characteristics, operative details, postoperative outcome, histopathology and follow-up. The data were compared with historical cohort of the laparoscopic partial nephrectomy (LPN. Results: 58 renal units in 57 patients (45 males and 12 females underwent RPN. The mean age was 53.08 ± 13.6 (30-71 years. The mean tumor size was 4.96 ± 2.33 (2-15.5 cm. Average operative time was 129.4 ± 29.9 (70-200 min.; mean warm ischemia time was 20.9 ± 7.34 (9-39 min. 8 renal units in 7 patients were operated with the zero ischemia technique. The average follow-up was 5.15 months (1-18. There was no recurrence. 15 patients underwent LPN. The mean tumor size was 4.3 ± 1.6 (1.6-8 cm. operative time was 230.7 ± 114.8 (150-300 min.; mean warm ischemia time was 31.8 ± 9 min. The nephromerty score in the LPN group was 7.1 ± 0.89, in the RPN group was 8.75 ± 1.21. Conclusion: Our results suggest that prior experience of LPN shortens the learning curve for RPN as seen by shorter warm ischemia time and operative time in our series. The nephrometry score in RPN were higher suggesting that complex tumour can be managed with robotic approach.

  4. Treatment of intracranial aneurysms using flow-diverting silk stents (BALT): a single centre experience.

    Science.gov (United States)

    Leonardi, M; Cirillo, L; Toni, F; Dall'olio, M; Princiotta, C; Stafa, A; Simonetti, L; Agati, R

    2011-09-01

    The Silk stent (Balt, Montmorency, France) is a retractable device designed to achieve curative reconstruction of the parent artery associated with an intracranial aneurysm. We present our initial experience with the Silk flow-diverting stent in the management and follow-up of 25 patients presenting with intracranial aneurysms.Twenty-five patients (age range, 34-81 years; 24 female) were treated with the Silk flow-diverting device. Aneurysms ranged in size from small (5), large (10) and giant (10) and included wide-necked aneurysms, multiple, nonsaccular, and recurrent intracranial aneurysms. Nine aneurysms were treated for headache, 14 for mass effect. None presented with haemorrhage. All patients were pretreated with dual antiplatelet medications for at least 72 hours before surgery and continued taking both agents for at least three months after treatment. A total of 25 Silk stents were used. Control MR angiography and/or CT angiography was typically performed prior to discharge and at one, three, six and 12 months post treatment. A follow-up digital subtraction angiogram was performed between six and 19 months post treatment.Complete angiographic occlusion or subtotal occlusion was achieved in 15 patients in a time frame from three days to 12 months. Three deaths and one major complication were encountered during the study period. Two patients, all with cavernous giant aneurysms, experienced transient exacerbations of preexisting cranial neuropathies and headache after the Silk treatment. Both were treated with corticosteroids, and symptoms resolved completely within a month.In our experience the Silk stent has proven to be a valuable tool in the endovascular treatment of intracranial giant partially thrombosed aneurysms and aneurysms of the internal carotid artery cavernous segment presenting with mass effect. The time of complete occlusion of the aneurysms and the risk of the bleeding is currently not predictable.

  5. Self-administered methoxyflurane for procedural analgesia: experience in a tertiary Australasian centre.

    Science.gov (United States)

    Gaskell, A L; Jephcott, C G; Smithells, J R; Sleigh, J W

    2016-04-01

    Methoxyflurane, an agent formerly used as a volatile anaesthetic but that has strong analgesic properties, will soon become available again in the UK and Europe in the form of a small hand-held inhaler. We describe our experience in the use of inhaled methoxyflurane for procedural analgesia within a large tertiary hospital. In a small pilot crossover study of patients undergoing burns-dressing procedures, self-administered methoxyflurane inhalation was preferred to ketamine-midazolam patient-controlled analgesia by five of eight patients. Patient and proceduralist outcomes and satisfaction were recorded from a subsequent case series of 173 minor surgical and radiological procedures in 123 patients performed using inhaled methoxyflurane. The procedures included change of dressing, minor debridement, colonoscopy and incision-and-drainage of abscess. There was a 97% success rate of methoxyflurane analgesia to facilitate these procedures. Limitations of methoxyflurane include maximal daily and weekly doses, and uncertainty regarding its safety in patients with pre-existing renal disease. © 2016 The Association of Anaesthetists of Great Britain and Ireland.

  6. Magnetic resonance neurography in the management of peripheral trigeminal neuropathy: experience in a tertiary care centre

    Energy Technology Data Exchange (ETDEWEB)

    Cox, Brian; Chhabra, Avneesh [UT Southwestern Medical Center, Department of Radiology, Dallas, TX (United States); Zuniga, John R. [UT Southwestern Medical Center, Department of Oral and Maxillofacial Surgery, Surgery, Neurology and Neurotherapeutics, Dallas, TX (United States); Panchal, Neeraj [University of Pennsylvania, Department of Oral Maxillofacial Surgery, Philadelphia, PA (United States); Cheng, Jonathan [UT Southwestern Medical Center, Department of Plastic Surgery, Dallas, TX (United States)

    2016-10-15

    This tertiary care experience examines the utility of magnetic resonance neurography (MRN) in the management of peripheral trigeminal neuropathies. Seventeen patients with clinically suspected peripheral trigeminal neuropathies (inferior alveolar nerve and lingual nerve) were imaged uniformly with 1.5-T examinations. MRN results were correlated with clinical and surgical findings in operated patients and the impact on clinical management was assessed. Clinical findings included pain (14/17), sensory changes (15/17), motor changes (2/17) and palpable masses (3/17). Inciting events included prior dental surgery (12/17), trauma (1/17) and idiopathic incidents (4/17). Non-affected side nerves and trigeminal nerves in the intracranial and skull base course were normal in all cases. Final diagnoses on affected sides were nerve inflammation (4/17), neuroma in continuity (2/17), LN transection (1/17), scar entrapment (3/17), infectious granuloma (1/17), low-grade injuries (3/17) and no abnormality (3/17). Associated submandibular gland and sublingual gland oedema-like changes were seen in 3/17 cases because of parasympathetic effects. Moderate-to-excellent MRN-surgical correlation was seen in operated (8/17) patients, and neuroma and nerve transection were prospectively identified in all cases. MRN is useful for the diagnostic work-up of suspected peripheral trigeminal neuropathy patients with significant impact on clinical management and moderate-to-excellent correlation with intra-operative findings. (orig.)

  7. Oesophageal foreign body in children: 15 years experience in a tertiary care paediatric centre

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    Amit Singh

    2014-01-01

    Full Text Available Background: The objective of this study was to report our experience and outcome in the management of oesophageal foreign body (EFB in suspected cases of foreign body (FB ingestion. Materials and Methods: Records of children with documented EFB ingestion treated in the Department of Pediatric surgery from January 1997 to December 2012 were analysed. Diagnosis was made on the basis of history, clinical examination and radiological evaluation. Stronger index of suspicion was kept in cases of sudden onset of symptoms with an inappropriate history of FB ingestion. Results: A total of 317 children underwent emergency rigid oesophagoscopy for EFB. Out of these, 206 were males and 111 were females. The most common EFB found was coins in 209 (65.9% cases, followed by food bolus obstruction in 54 (17%, metallic FB in 29 (9.1%, plastic FB in 21 (6.6%, and button batteries in 14 (4.4% cases. The most common site of FB impaction was found to be cricopharynx in 291 (92% cases. Conclusions: High index of suspicion should be kept for EFB in children who present with unavailable history of FB ingestion. The wait-and-watch policy in cases of FB oesophagus is not always the correct approach, especially when it presents as respiratory distress of sudden onset.

  8. Emergency endovascular treatment of emergent or ruptured aortic aneurysms: A single centre experience

    Energy Technology Data Exchange (ETDEWEB)

    England, Andrew [Department of Radiology, South Manchester University Hospitals NHS Trust, Southmoor Road, Wythenshawe, Manchester M23 9LT (United Kingdom)]. E-mail: andrew.england@smtr.nhs.uk; Butterfield, John S. [Department of Radiology, South Manchester University Hospitals NHS Trust, Southmoor Road, Wythenshawe, Manchester M23 9LT (United Kingdom); Nasim, Akhtar [Department of Vascular Surgery, South Manchester University Hospitals, Southmoor Road, Wythenshawe, Manchester M23 9LT (United Kingdom); Welch, Mark [Department of Vascular Surgery, South Manchester University Hospitals, Southmoor Road, Wythenshawe, Manchester M23 9LT (United Kingdom); McCollum, Charles N. [Department of Vascular Surgery, South Manchester University Hospitals, Southmoor Road, Wythenshawe, Manchester M23 9LT (United Kingdom); Ashleigh, Raymond J. [Department of Radiology, South Manchester University Hospitals NHS Trust, Southmoor Road, Wythenshawe, Manchester M23 9LT (United Kingdom)

    2007-05-15

    Objective: To report our experience with emergency endovascular repair (eEVAR) in patients with ruptured or acutely symptomatic AA. Methods: From August 1998 to June 2004, 22 high-risk patients (21 men, median age 74 years, range 15-84 years) with ruptured or acutely symptomatic aneurysms underwent eEVAR using Talent endoprostheses. All procedures were performed in the operating theatre by a surgical/radiology team. Indications for repair, co-morbidities and outcomes were recorded with follow-up by US and CT scanning. Results: Of 22 eEVARs, 13 patients had abdominal AA and nine patients had thoracic AA. Nineteen (86.4%) repairs were technically successful, there was one patient with a type I proximal endoleak treated conservatively and two patients died during their inpatient period (myocardial infarction and broncho-pneumonia). On follow-up of the 20 survivors (median 7 months, range 0-48 months), there were three further deaths, and two further endoleaks. The 1-year survival by life-table analysis is 75 {+-} 9.8% and 13 patients are free from reintervention at last follow-up. Conclusion: eEVAR had encouraging initial results in selected high-risk patients.

  9. Introduction of enhanced recovery for elective caesarean section enabling next day discharge: a tertiary centre experience.

    Science.gov (United States)

    Wrench, I J; Allison, A; Galimberti, A; Radley, S; Wilson, M J

    2015-05-01

    The widespread adoption of enhanced recovery programmes in various surgical specialties has resulted in patient benefits including reduced morbidity, reduced length of stay and an earlier return to normal activities. This evidence, along with the increased financial pressures in the UK National Health Service, has led many units to consider introducing such a programme for obstetric surgery. We report our experience in setting up an enhanced recovery programme for women undergoing elective caesarean section and a prospective analysis of factors that influence length of stay. An enhanced recovery pathway was designed by a multidisciplinary team and introduced in March 2012. Factors influencing length of stay were determined using a log normal model. The proportion of women discharged on Day 1 increased from 1.6% in the first quarter of 2012 to 25.2% in the first quarter of 2014. The 30-day readmission rate was 4.4% for those discharged on Day 1 and 5.6% for Day 2. Earlier gestation, multiple birth, intention to breast feed, longer surgery and more time in the post-anaesthesia recovery unit were all independently associated with a longer postoperative stay. Women presenting for obstetric surgery with the indication "one previous caesarean section" were more likely to leave hospital earlier compared to most other indications. An enhanced recovery programme was successfully introduced into our unit. Many of the interventions were straightforward and could be adopted easily elsewhere. Copyright © 2015 Elsevier Ltd. All rights reserved.

  10. Immediate primary anastomosis for isolated oesophageal atresia: A single-centre experience

    Directory of Open Access Journals (Sweden)

    Ibrahim Uygun

    2015-01-01

    Full Text Available Background: Isolated oesophageal atresia without tracheo-oesophageal fistula represents a major challenge for most paediatric surgeons. Here, we present our experience with six neonates with isolated oesophageal atresia who successfully underwent immediate primary anastomosis using multiple Livaditis circular myotomy. Materials and Methods: All six neonates were gross type A isolated oesophageal atresia (6%, from among 102 neonates with oesophageal atresia, treated between January 2009 and December 2013. Five neonates were female; one was male. The mean birth weight was 2300 (range 1700-3100 g. Results: All six neonates successfully underwent immediate primary anastomosis using multiple myotomies (mean 3; range 2-4 within 10 (median 3 days after birth. The gap under traction ranged from 6 to 7 cm. One neonate died of a major cardiac anomaly. Another neonate was lost to follow-up after being well for 3 months. Three anastomotic strictures were treated with balloon dilatation, and four anastomotic leaks were treated conservatively. The mean duration of follow-up was 33 months. Conclusions: To treat isolated oesophageal atresia, an immediate primary anastomosis can be achieved using multiple myotomies. Although, this approach is associated with high complication rates, as are other similar approaches, these complications can be overcome.

  11. Outcome of traumatic brain injury in elderly population: A tertiary centre experience from a developing country.

    Science.gov (United States)

    Prasad, G Lakshmi; Anmol, N; Menon, Girish R

    2017-12-16

    The increasing ratio of elderly population has contributed to increased incidence of TBI in this cohort. Authors put forward their institutional experience in the management of elderly TBI. A 3-year retrospective analysis of 73 consecutive patients aged ≥ 65 years admitted with TBI at our university hospital was performed. The following were excluded-concussion injuries, chronic subdural hematomas (SDH), patients discharged against medical advice (DAMA) and declared dead soon after arrival (within 6 hours). Mode of injury, clinico-radiological features, management and outcomes were analysed. Glasgow outcome scale (GOS) was used to assess outcome. Males predominated (82%). Mean age was 72.1 years (range 65-97 years) and 20 were aged≥75 years. There were 37 mild, 18 moderate and 18 severe head injuries (HI). Contusions constituted the majority. Fifty-five(75%) cases were managed conservatively while 18(25%) underwent surgery. There were 7 deaths(9.5%). Overall, poor outcome was 26%, while being 45% in patients aged ≥75years. Poor outcome in severe HI for the entire cohort was 83% (15/18) but was 100% (7/7) for the very elderly patients. On univariate analysis, age≥75 years, severe HI, acute SDH and surgical management were significantly associated with poor outcome while acute SDH and surgical management were significant on multilogistic regression analysis. Age ≥75 years, severe HI and acute SDH are poor prognostic factors. Benefit of surgery in such conditions is unlikely and surgery needs to be judiciously considered keeping in mind the economics involved and fate of caregivers, especially in developing countries. Copyright © 2017 Elsevier Inc. All rights reserved.

  12. Oncologic results, functional outcomes, and complication rates of transperitoneal robotic assisted radical prostatectomy: single centre's experience.

    Science.gov (United States)

    Ihsan-Tasci, A; Simsek, A; Dogukan-Torer, M B; Sokmen, D; Sahin, S; Bitkin, A; Tugcu, V

    2015-03-01

    We report the operative details and short term oncologic and functional outcome of the first 334 Robotic-assisted radical prostatectomy experiences for organ confined prostate cancer From August 2009 to December 2012, details of 334 consecutive patients were retrospectively analyzed. The analyzed parameters included: preoperative, per-operative characteristics, postoperative minor and major complications, positive surgical margin continence, potency, and biochemical progression at the follow-up period. The classical extrafascial, interfascial, intrafascial and fascia sparing radical prostatectomy were performed in 31, 41, 200, and 62 cases, respectively. The mean operation time was 213.8±90.1minutes, and the mean estimated blood loss was 116.1±58.9cc during operation. A nerve-sparing procedure was performed bilaterally in 198 (59.3%) cases and unilaterally in 126 (37.7%) cases. The catheter was removed on postoperative day 9, 1±1.9. Surgical margin was positive in 36 (10.7%) patients. The overall, pT2, pT3a and pT3b PSM rates were 8 (2.4%), 12 (3.6%), 16 (4.8%) respectively and PSM and BCR rates were not statistically different among four approach (P>.05). At the follow-up period, the continence rates were 74.4%, 80.4%, 80.5%, and 96.7% (P.05), in classic extrafascial, interfascial, intrafascial, and fascia sparing intrafascial prostatectomy, respectively. RARP is a safe and feasible technique in treatment of localized prostate cancer. Fascia sparing approach has better continence rate. This results need to be supported by new prospective, randomized studies. Copyright © 2013 AEU. Publicado por Elsevier España, S.L.U. All rights reserved.

  13. Voriconazole dosing and therapeutic drug monitoring in children: experience from a paediatric tertiary care centre.

    Science.gov (United States)

    Boast, Alison; Curtis, Nigel; Cranswick, Noel; Gwee, Amanda

    2016-07-01

    Therapeutic drug monitoring (TDM) of voriconazole is recommended to achieve trough concentrations of 1-5 mg/L. In children, this is challenging due to age-related variability in voriconazole pharmacokinetics. This study describes our experience with voriconazole, focusing on dosing regimens, dose adjustment and TDM. We reviewed the medical records of immunocompromised children who received voriconazole from July 2009 to January 2015 and had TDM. Demographic, clinical and voriconazole dosing and monitoring data were collected. Fifty-five children received 62 courses of voriconazole and had TDM, with a total of 256 samples taken. Only 71.0% of courses (44/62) had TDM at the correct time, and at least one therapeutic level was achieved in only 52.3% (23/44) of these. Twenty-six courses had at least one sub-therapeutic level and in only 61.5% was the dose adjusted. Patients aged 12 years required median intravenous doses of 8.8, 7.5 and 4.0 mg/kg twice daily, respectively (P 12 years required median doses of 4.7 and 4.3 mg/kg twice daily, respectively (P = 0.307). Levels within the target range were observed to fall below 1 mg/L in 36.4% of unchanged dosing regimens. Photosensitive skin reactions (20.0%) and hepatotoxicity (12.7%) were the most frequent adverse events and occurred in children with voriconazole levels voriconazole concentrations in children, particularly in children <6 years of age. This warrants repeated TDM throughout treatment. Standardized guidelines for TDM and dose adjustment are required in children. © The Author 2016. Published by Oxford University Press on behalf of the British Society for Antimicrobial Chemotherapy. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

  14. Experience with the SynCardia total artificial heart in a Canadian centre.

    Science.gov (United States)

    Nguyen, Anthony; Pellerin, Michel; Perrault, Louis P; White, Michel; Ducharme, Anique; Racine, Normand; Carrier, Michel

    2017-12-01

    The SynCardia total artificial heart (TAH) provides complete circulatory support by replacing both native ventricles. Accepted indications include bridge to transplantation and destination therapy. We review our experience with TAH implantation during a period when axial flow pump became available. We retrospectively analyzed the demographics, clinical characteristics and survival of all patients receiving the TAH. From September 2004 to November 2016, 13 patients (12 men, mean age 45 ± 13 yr) received the TAH for refractory cardiogenic shock secondary to idiopathic (56%) or ischemic (17%) cardiomyopathy and to other various causes (33%). Before implantation, mean ejection fraction was 14% ± 4%, 7 (54%) patients had previous cardiac surgery, 4 (31%) were on mechanical ventilation, and 3 (23%) patients were on dialysis. The mean duration of TAH support was 46 ± 40 days. Three (23%) patients died while on support after a mean of 15 days. Actuarial survival on support was 77% ± 12% at 30 days after implantation. Complications on support included stroke ( n = 1, 8%), acute respiratory distress syndrome requiring prolonged intubation ( n = 5, 38%) and acute renal failure requiring temporary dialysis ( n = 5, 38%). Ten (77%) patients survived to be transplanted after a mean of 52 ± 42 days of support. Actuarial survival rates after transplant were 67% ± 16% at 1 month and 56% ± 17% at 1 year after transplantation. The TAH provides an alternative with low incidence of neurologic events in extremely fragile and complex patients waiting for heart transplantation. Complex and unusual anatomic conditions explained the current use of TAH.

  15. Non-Hodgkin lymphoma in Romania: a single-centre experience.

    Science.gov (United States)

    Fetica, Bogdan; Achimas-Cadariu, Patriciu; Pop, Bogdan; Dima, Delia; Petrov, Ljubomir; Perry, Anamarija M; Nathwani, Bharat N; Müller-Hermelink, Hans K; Diebold, Jacques; MacLennan, Kenneth A; Fulop, Annamaria; Blaga, Mihaiela L; Coza, Daniela; Nicula, Florian Al; Irimie, Alexandru; Weisenburger, Dennis D

    2017-06-01

    Epidemiologic studies of non-Hodgkin lymphoma (NHL) in Eastern Europe are scarce in the literature. We report the experience of the "Ion Chiricuta" Institute of Oncology in Cluj-Napoca (IOCN), Romania, in the diagnosis and outcome of patients with NHL. We studied 184 consecutive NHL patients diagnosed in the Pathology Department of IOCN during the years 2004-2006. We also obtained epidemiological data from the Northwestern (NW) Cancer Registry. In the IOCN series, the most common lymphoma subtype was diffuse large B-cell lymphoma (43.5%), followed by the chronic lymphocytic leukaemia/small lymphocytic lymphoma (21.2%). T-cell lymphomas represented a small proportion (8.2%). The median age of the patients was 57 years, with a male-to-female ratio of 0.94. Patients with indolent B-cell lymphomas had the best overall survival, whereas those with mantle cell lymphoma had the worst survival. The NW Cancer Registry data showed that the occurrence of NHL in the NW region of Romania was higher in men [world age-standardized incidence rate/100 000 (ASR)-5.9; 95% CI 5.1-6.6] than in women (ASR-4.1; 95% CI 3.5-4.7) with age-standardized male-to-female ratio of 1.44 (p = 0.038). Chronic lymphocytic leukaemia/small lymphocytic lymphoma was the most common NHL in the NW region of Romania, accounting for 43% of all cases, followed by diffuse large B-cell lymphoma (36%). The 5-year, age-standardized cumulative relative survival for NHL in the County of Cluj in NW Romania, for the period of 2006-2010, was 51.4%, with 58.4% survival for men and 43.2% for women. Additional studies of NHL in Eastern Europe are needed. Copyright © 2015 John Wiley & Sons, Ltd. Copyright © 2015 John Wiley & Sons, Ltd.

  16. Bulletin du CRDI #126

    International Development Research Centre (IDRC) Digital Library (Canada)

    il y a 6 jours ... Les barrières culturelles, couplées à un système de santé inefficace restreignant l'accès des femmes aux soins de santé, expliquent la précarité de la santé et des droits génésiques des Pakistanaises. Découvrez comment le centre Shirkat Gah, avec le soutien du CRDI, mise sur la sensibilisation pour ...

  17. Narrow band imaging (NBI cystoscopy and assisted bipolar TURBT: A preliminary experience in a single centre

    Directory of Open Access Journals (Sweden)

    Roberto Giulianelli

    2017-10-01

    Full Text Available Objective: The aim of this study was to compare, in order to increase our ability to detect bladder cancer, the predictive power of narrow band imaging (NBI versus white light cystoscopy (WL. The secondary objective was to evaluate how the preoperative use of NBI cystoscopy can increase the ability to detect bladder lesions in terms of status, multi-focality and dimensions. Materials and methods: Between June 2010 and April 2012, 797 consecutive patients, 423 male and 374 female, affected by suspected bladder cancer lesions, underwent to WL plus NBI cystoscopy and subsequently to WL Bipolar Gyrus PK (Olympus, Tokyo, Japan transurethral resection of bladder tumour (WL-TURBT. The average follow-up was 24 (16-38 months. Mean age was 67.7 yrs. (range 46-88. All the patients underwent by same surgeon to WL resection (WL-TURBT of the previously identified lesions by same surgeon. All the removed tissue was sent separately for histological evaluation after mapping the areas of resection on a topographic sheet. Results: In our study we considered 797 patients that matched our inclusion criteria. Through the use of WL cystoscopy, we identified 603 patients (75.53% with suspicious lesions, instead, with the use of light NBI, we found 786 patients with suspicious lesions (98.49%.The use of NBI cystoscopy increases by approximately 30% the specific ability to detect lesions not otherwise visible with WL cystoscopy (OR 21.9 and RR 1.30, in particular for patients with lesions size < 3 cm (OR 24.00; RR 1.40, unifocal (OR: 22.28; RR 1.47 and recurrent (OR 58.4; RR 1.34. Pathology demonstrated the presence of cancer in 512 (64.2% patients, of whom 412 (51.8% were visible both with WL cystoscopy and NBI cystoscopy. In our experience, only 11 (1.38% lesions were only positive at WL cystoscopy (negative at NBI cystoscopy thus 501 (62.8%, OR 10.13; RR 1.21 patients showed bladder oncological lesions positive at NBI cystoscopy. In these patients, the use the NBI

  18. La pratique sportive comme vecteur d’expérience créative en prison Sport as a Vector of Creative Experience in Prison. The Case of Volleyball at the Rennes Detention Centre for Women

    Directory of Open Access Journals (Sweden)

    Sophie Piot

    2011-02-01

    Full Text Available Le cas du volley-ball au Centre de détention pour femmes de RennesStarting from notions and concepts developed by Goffman and the socio-anthropology of play, this article proposes an analysis of convicts' lived experiences in the area of team sports in a prison milieu. Penitentiary sociological studies generally tend to explain the conduct of detainees in terms of strategies and resistances. It is certainly undeniable that the constraints related to incarceration generate many losses for prisoners, and that they try to fabricate arrangements for bypassing obstacles and for compensation. Nevertheless, due to the installation of these arrangements, consisting in mobilizing varied objects and transitional phenomena, and under environmental conditions (topological, human and material instilling sufficient confidence in them, certain prisoners manage to have creative experiences (the impression “of escaping”, of no longer being prisoners. Despite the precarious, transitory and situated nature of these forms of experience to a certain extent they allow a suspension and attenuation of their constraints, releasing them emotionally and “lasting” over time.Cet article propose, à partir de notions et de concepts développés par Goffman et par la socio-anthropologie du jeu, une analyse de l’expérience vécue par des détenues dans l’espace du sport collectif en milieu carcéral. Les études sociologiques pénitentiaires tendent le plus souvent à expliquer les conduites des reclus en termes de stratégies et de résistances. Il est certes indéniable que les contraintes liées à l’incarcération génèrent de multiples pertes pour les prisonniers, et que ces derniers tentent de mettre en place des dispositifs de contournement et de compensation. Néanmoins, sur base de l’aménagement de ces dispositifs consistant à mobiliser des objets et phénomènes transitionnels variés, et dans des conditions environnementales (topologiques

  19. Comparison of Environmental Attitudes and Experiences of Five-Year-Old Children Receiving Preschool Education in the Village and City Centre

    Science.gov (United States)

    Durkan, Nazmi; Güngör, Hande; Fetihi, Leyla; Erol, Ahmet; Gülay Ogelman, Hülya

    2016-01-01

    The purpose of the study is to compare environmental attitudes and experiences of five-year-old children receiving preschool education in the village and city centre. The first group comprised 54 five-year-old children who received preschool education and attended kindergartens of two primary schools in the Karateke and Kocabas villages of Honaz…

  20. Student Experience and Academic Success: Comparing a Student-Centred and a Lecture-Based Course Programme

    Science.gov (United States)

    Severiens, Sabine; Meeuwisse, Marieke; Born, Marise

    2015-01-01

    Past research has shown that, under certain conditions, student-centred and small-scale course programmes result in more academic success. The present study investigates these conditions in further detail. It is examined whether, in comparison to a course programme that is relatively more lecture-based, a student-centred course programme promotes…

  1. Student experiences in learning person-centred care of patients with Alzheimer's disease as perceived by nursing students and supervising nurses.

    Science.gov (United States)

    Skaalvik, Mari W; Normann, Hans Ketil; Henriksen, Nils

    2010-09-01

    The aims and objectives of this paper are to illuminate and discuss the experiences and perceptions of nursing students and supervising nurses regarding the students' learning of person- centred care of patients with Alzheimer's disease in a teaching nursing home. This information is then used to develop recommendations as to how student learning could be improved. The clinical experiences of nursing students are an important part of learning person-centred care. Caring for patients with Alzheimer's disease may cause frustration, sadness, fear and empathy. Person-centred care can be learned in clinical practice. A qualitative study. The study was performed in 2006 using field work with field notes and qualitative interviews with seven-fifth-semester nursing students and six supervising nurses. This study determined the variation in the perceptions of nursing students and supervising nurses with regards to the students' expertise in caring for patients with Alzheimer's disease. The nursing students experienced limited learning regarding person-centred approaches in caring for patients with Alzheimer's disease. However, the supervising nurses perceived the teaching nursing home as a site representing multiple learning opportunities in this area. Nursing students perceived limited learning outcomes because they did not observe or experience systematic person-centred approaches in caring for patients with Alzheimer's disease. It is important that measures of quality improvements in the care of patients with Alzheimer's disease are communicated and demonstrated for nursing students working in clinical practices in a teaching nursing home. Introduction of person-centred approaches is vital regarding learning outcomes for nursing students caring for patients with Alzheimer's disease. © 2010 The Authors. Journal compilation © 2010 Blackwell Publishing Ltd.

  2. Single-centre experience of stereotactic radiosurgery and fractionated stereotactic radiotherapy for prolactinomas with the linear accelerator.

    Science.gov (United States)

    Wilson, Peter J; Williams, Janet Rosemary; Smee, Robert Ian

    2015-06-01

    Primary management of prolactinomas is usually medical, with surgery a secondary option where necessary. This study is a review of a single centre's experience with focused radiotherapy where benefit was not gained by medical or surgical approaches. Radiotherapy as an alternative and adjuvant treatment for prolactinomas has been performed at our institution with the linear accelerator since 1990. We present a retrospective review of 13 patients managed with stereotactic radiosurgery (SRS) and 5 managed with fractionated stereotactic radiotherapy (FSRT), as well as 5 managed with conventional radiotherapy, at the Prince of Wales Hospital. Patients with a histopathologically diagnosed prolactinoma were eligible. Those patients who had a confirmed pathological diagnosis of prolactinoma following surgical intervention, a prolactin level elevated above 500 μg/L, or a prolactin level persistently elevated above 200 μg/L with exclusion of other causes were represented in this review. At the end of documented follow-up (SRS median 6 years, FSRT median 2 years), no SRS patients showed an increase in tumour volume. After FSRT, 1 patient showed an increase in size, 2 showed a decrease in size and 2 patients showed no change. Prolactin levels trended towards improvement after SRS and FSRT, but no patients achieved the remission level of stereotactic radiation were very low in this series. © 2014 The Royal Australian and New Zealand College of Radiologists.

  3. Experiences of the return to work process after stroke while participating in a person-centred rehabilitation programme.

    Science.gov (United States)

    Öst Nilsson, Annika; Eriksson, Gunilla; Johansson, Ulla; Hellman, Therese

    2017-09-01

    In Sweden, less than 50% of those getting stroke in working age return to work (RTW). Effective rehabilitation programmes need to be developed and therapeutic aspects understood. To explore and describe how persons with stroke experience their RTW process while participating in a person-centred rehabilitation programme focusing on RTW. Seven persons with mild or moderate stroke were interviewed twice during the intervention in the vocational training phase using semi-structured interviews. Data were analysed using grounded theory. Having a coordinator by their side gave support and guidance during the RTW process. Knowledge of stroke, strategies and a straightforward communication created a structure for the RTW process. Expressing one's own wishes increased opportunities to influence and decide which path to follow in order to reach the goal. Straightforward, open and recurring communication facilitated the possibility to adapt to the situation. These aspects increased insight and awareness which facilitated the RTW process. The findings indicate that a precondition for a fruitful RTW process was that suitable platforms at work were created in which the actors involved could cooperate. This knowledge might also be valuable in the RTW process for people with other diagnosis.

  4. Endovascular Management of Acute Embolic Occlusion of the Superior Mesenteric Artery: A 12-Year Single-Centre Experience

    Energy Technology Data Exchange (ETDEWEB)

    Raupach, J., E-mail: janraupach@seznam.cz; Lojik, M., E-mail: miroslav.lojik@fnhk.cz; Chovanec, V., E-mail: chovanec.v@seznam.cz; Renc, O., E-mail: ondrejrenc@seznam.cz [Faculty of Medicine at Charles University and University Hospital, Department of Radiology (Czech Republic); Strýček, M., E-mail: m.strycek@gmail.com [Faculty of Medicine at Charles University (Czech Republic); Dvořák, P., E-mail: petr.dvorak@fnhk.cz; Hoffmann, P., E-mail: hoffmpet@fnhk.cz [Faculty of Medicine at Charles University and University Hospital, Department of Radiology (Czech Republic); Guňka, I., E-mail: gunka@email.cz; Ferko, A., E-mail: a.ferko@seznam.cz [Faculty of Medicine at Charles University and University Hospital, Department of Surgery (Czech Republic); Ryška, P., E-mail: ryska@fnhk.cz [Faculty of Medicine at Charles University and University Hospital, Department of Radiology (Czech Republic); Omran, N., E-mail: nidal81@gmail.com [Faculty of Medicine at Charles University and University Hospital, Department of Cardiac Surgery (Czech Republic); Krajina, A., E-mail: krajina@fnhk.cz; Čabelková, P., E-mail: pavla.cabelkova@fnhk.cz [Faculty of Medicine at Charles University and University Hospital, Department of Radiology (Czech Republic); Čermáková, E., E-mail: cermakovae@lfhk.cuni.cz [Faculty of Medicine at Charles University, Computer Technology Center (Czech Republic); Malý, R., E-mail: malyr@volny.cz [Faculty of Medicine at Charles University and University Hospital, Department of Medicine (Czech Republic)

    2016-02-15

    PurposeRetrospective evaluation of 12-year experience with endovascular management of acute mesenteric ischemia (AMI) due to embolic occlusion of the superior mesenteric artery (SMA).Materials and methodsFrom 2003 to 2014, we analysed the in-hospital mortality of 37 patients with acute mesenteric embolism who underwent primary endovascular therapy with subsequent on-demand laparotomy. Transcatheter embolus aspiration was used in all 37 patients (19 women, 18 men, median age 76 years) with embolic occlusion of the SMA. Adjunctive local thrombolysis (n = 2) and stenting (n = 2) were also utilised.ResultsWe achieved complete recanalization of the SMA stem in 91.9 %. One patient was successfully treated by surgical embolectomy due to a failed endovascular approach. Subsequent exploratory laparotomy was performed in 73.0 % (n = 27), and necrotic bowel resection in 40.5 %. The total in-hospital mortality was 27.0 %.ConclusionPrimary endovascular therapy for acute embolic SMA occlusion with on-demand laparotomy is a recommended algorithm used in our centre to treat SMA occlusion. This combined approach for the treatment of AMI is associated with in-hospital mortality rate of 27.0 %.

  5. Factors affecting the views and experiences of women living in the city centre of Manisa, Turkey, regarding domestic violence.

    Science.gov (United States)

    Özpinar, Saliha; Dinç Horasan, Gönül; Baydur, Hakan; Canbay, Tülin

    2016-11-01

    Domestic violence against women is an important social and public health problem worldwide resulting from unequal power relationships between men and women. The purpose of the present cross-sectional descriptive study was to determine the factors affecting the views and experiences of women living in the city centre of Manisa, Turkey, regarding domestic violence. The data were collected from a representative sample of women (n=873) in 2012. The socio-demographic questionnaire and the World Health Organization's Multi-country Study on Women's Health and Domestic Violence Against Women were used for data collection. The study results revealed that of the women, 14.8% were exposed to physical violence, 7.9% to sexual violence, 20.2% to emotional violence/abuse and 11.2% to economic violence/abuse within the last 12 months. Lower income level, lower social status, lower educational level, unemployment, being exposed to parental violence during childhood and being married to husbands exposed to parental violence during childhood were associated risk factors with domestic violence. The study results indicate that domestic violence against women is a common phenomenon in Manisa.

  6. Single-centre experience of retroperitoneoscopic approach in urology with tips to overcome the steep learning curve

    Directory of Open Access Journals (Sweden)

    Aneesh Srivastava

    2016-01-01

    Full Text Available Context: The retroperitoneoscopic or retroperitoneal (RP surgical approach has not become as popular as the transperitoneal (TP one due to the steeper learning curve. Aims: Our single-institution experience focuses on the feasibility, advantages and complications of retroperitoneoscopic surgeries (RS performed over the past 10 years. Tips and tricks have been discussed to overcome the steep learning curve and these are emphasised. Settings and Design: This study made a retrospective analysis of computerised hospital data of patients who underwent RP urological procedures from 2003 to 2013 at a tertiary care centre. Patients and Methods: Between 2003 and 2013, 314 cases of RS were performed for various urological procedures. We analysed the operative time, peri-operative complications, time to return of bowel sound, length of hospital stay, and advantages and difficulties involved. Post-operative complications were stratified into five grades using modified Clavien classification (MCC. Results: RS were successfully completed in 95.5% of patients, with 4% of the procedures electively performed by the combined approach (both RP and TP; 3.2% required open conversion and 1.3% were converted to the TP approach. The most common cause for conversion was bleeding. Mean hospital stay was 3.2 ± 1.2 days and the mean time for returning of bowel sounds was 16.5 ± 5.4 h. Of the patients, 1.4% required peri-operative blood transfusion. A total of 16 patients (5% had post-operative complications and the majority were grades I and II as per MCC. The rates of intra-operative and post-operative complications depended on the difficulty of the procedure, but the complications diminished over the years with the increasing experience of surgeons. Conclusion: Retroperitoneoscopy has proven an excellent approach, with certain advantages. The tips and tricks that have been provided and emphasised should definitely help to minimise the steep learning curve.

  7. Stapled Mesh stomA Reinforcement Technique (SMART) in the prevention of parastomal hernia: a single-centre experience.

    Science.gov (United States)

    Ng, Z Q; Tan, P; Theophilus, M

    2017-06-01

    Parastomal hernia remains a frequent complication following creation of an abdominal stoma. Previous interests have centred around the exploration of methods to repair; however, prophylactic mesh placement has demonstrated its efficacy in reduction of parastomal hernia. The aim of this retrospective analysis was to evaluate the outcomes of Stapled Mesh stomA Reinforcement Technique (SMART) in terms of parastomal hernia occurrence rate and mesh-related complications. All patients operated with an abdominal perineal resection or Hartmann's procedure with SMART from November 2013 to March 2016 were included. Patient demographics, operative details and stoma-related symptoms were collected. Patients were examined clinically by the medical team and also reviewed independently by a specialist stoma care nurse for signs of stoma-related complications. As part of oncological follow-up, CT scans were available for review for evidence of parastomal herniation. 14 patients (mean age 76 years) were included in the analysis. All the SMART cases were successfully completed with no intraoperative or immediate post-operative complications. No cases of mesh-related complications such as infection, immediate stomal prolapse, stenosis, retraction, stomal obstruction, mesh erosion or fistulation were observed. No mesh removal was required. There were two cases of parastomal hernia detected on CT scan. Both cases have remained asymptomatic no intervention was required at this stage. Median follow-up was 24 months. Our medium-term experience has demonstrated the efficacy of SMART in the reduction of parastomal hernia occurrence. With appropriate learning curve, parastomal hernia can be prevented.

  8. The "basic" approach: a single-centre experience with a cost-reducing model for paediatric cardiac extracorporeal membrane oxygenation.

    Science.gov (United States)

    Padalino, Massimo A; Tessari, Chiara; Guariento, Alvise; Frigo, Anna C; Vida, Vladimiro L; Marcolongo, Andrea; Zanella, Fabio; Harvey, Michael J; Thiagarajan, Ravi R; Stellin, Giovanni

    2017-04-01

    Extracorporeal membrane oxygenation (ECMO) is a lifesaving but expensive therapy in terms of financial, technical and human resources. We report our experience with a 'basic' ECMO support model, consisting of ECMO initiated and managed without the constant presence of a bedside specialist, to assess safety, clinical outcomes and financial impact on our health system. We did a retrospective single-centre study of paediatric cardiac ECMO between January 2001 and March 2014. Outcomes included postimplant complications and survival at weaning and at discharge. We used activity based costing to compare the costs of current basic ECMO with those of a 'full optional' dedicated ECMO team (hypothesis 1); ECMO with a bedside nurse and perfusionist (hypothesis 2), and ECMO with a bedside perfusionist (hypothesis 3). Basic cardiac ECMO was required for 121 patients (median age 75 days, median weight 4.4 kg). A total of 107 patients (88%) had congenital heart disease; 37 had univentricular physiology. The median duration of ECMO was 7 days (interquartile range [IQR], 4-15 days). Overall survival at weaning and at 30 days in the neonatal and paediatric age groups was 58.6% and 30.6%, respectively; these results were not significantly different from Extracorporeal Life Support Organization data. Cost analysis revealed a saving of €30 366, €22 144 and €13 837 for each patient on basic ECMO for hypotheses 1, 2 and 3, respectively. Despite reduced human, technical and economical resources, a basic ECMO model without a bedside specialist was associated with satisfactory survival and lower costs.

  9. Epidemiological Study Of Burn Cases And Their Mortality Experiences Amongst Adults From A Tertiary Level Care Centre

    Directory of Open Access Journals (Sweden)

    Kumar P

    1997-01-01

    Full Text Available Research question: How to use hospital statistics in establishing epidemiology of burns amongst adults? Objectives: To identify epidemiological determinants for Ii Various burn injuries and ii their mortality experiences. Study design: Hospital based study carried out for a period of one year (1st January 1991 to 31st December 1991. Settings: Wards of department of Burn & Plastic Surgery, BJ Medical College, Ahmedabad. Participants: 386 adults (20 years and above admitted at the centre for burn injuries during 1991. Study variables: Epidemiological determinants (age, sex, temporal, place, etc. for various burn injuries and the determinants of mortality (type of burn, extent of burn, referral time lag etc. Outcome profile: Common profile of burn victims with relation to the epidemiological factors and other factors responsible for high mortality in burn cases. Statistical analysis: Chi- square and Z tests. Results:Burns occured more in females specially in the age group of 20-24 years. Eighty five percent were flame burns. Flame burns were more in females, while electric burns were more in males. Burns were less during monsoon (27.7% than winter (32.6% and summer (39.6%, but electric burns were twice more common during monsoon. Maximum burns (81.9% were domestic, occurring mainly either in kitchen or living room. They were seen more in late evening. Sixty two percent cases were severe as total burn surface area (TBSA was >40%. Case fatality correlated positively with TBSA and death was almost universal with TBSA >60%. Early referral reduced fatality significantly in less severe burns (TBSA<40% but failed to influence it in severe burns. Appraisal of alleged suicide cases (2.6% and of stove bursting (4.4% revealed that young females carry additional risk of burn injuries.

  10. Single-Centre Experience with Percutaneous Cryoablation of Breast Cancer in 23 Consecutive Non-surgical Patients

    Energy Technology Data Exchange (ETDEWEB)

    Cazzato, Roberto Luigi, E-mail: r.cazzato@unicampus.it [Institut Bergonié, Comprehensive Cancer Centre, Department of Medical Imaging (France); Lara, Christine Tunon de, E-mail: c.tunondelara@bordeaux.unicancer.fr [Institut Bergonié, Comprehensive Cancer Centre, Department of Surgery (France); Buy, Xavier, E-mail: x.buy@bordeaux.unicancer.fr; Ferron, Stéphane, E-mail: s.ferron@bordeaux.unicancer.fr; Hurtevent, Gabrielle, E-mail: g.hurtevent@bordeaux.unicancer.fr [Institut Bergonié, Comprehensive Cancer Centre, Department of Medical Imaging (France); Fournier, Marion, E-mail: m.fournier@bordeaux.unicancer.fr [Institut Bergonié, Comprehensive Cancer Centre, Department of Surgery (France); Debled, Marc, E-mail: m.debled@bordeaux.unicancer.fr [Institut Bergonié, Comprehensive Cancer Centre, Department of Medical Oncology (France); Palussière, Jean, E-mail: j.palussiere@bordeaux.unicancer.fr [Institut Bergonié, Comprehensive Cancer Centre, Department of Medical Imaging (France)

    2015-10-15

    AimTo present our single-centre prospective experience on the use of cryoablation (CA) applied to treat primary breast cancer (BC) in a cohort of patients unsuitable for surgical treatment.Materials and MethodsTwenty-three consecutive post-menopausal female patients (median age 85 years; range 56–96) underwent percutaneous CA of unifocal, biopsy-proven BC, under ultrasound/computed tomography (US/CT) guidance. Clinical and dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) follow-ups were systematically scheduled at 3, 12, 18 and 24 months. Local tumour control was assessed by comparing baseline and follow-up DCE-MRI.ResultsTwenty-three BC (median size 14 mm) were treated under local anaesthesia (78.3 %) or local anaesthesia and conscious sedation (21.7 %). Median number of cryo-probes applied per session was 2.0. A “dual-freezing” protocol was applied for the first ten patients and a more aggressive “triple-freezing” protocol for the remaining 13. Median follow-up was 14.6 months. Five patients recurred during follow-up and two were successfully re-treated with CA. Five patients presented immediate CA-related complications: four hematomas evolved uneventfully at 3-month follow-up and one skin burn resulted in skin inflammation and skin retraction at 3 and 12 months, respectively.ConclusionsPercutaneous CA is safe and well tolerated for non-resected elderly BC patients. Procedures can be proposed under local anaesthesia only. Given the insulation properties of the breast gland, aggressive CA protocols are required. Prospective studies are needed to better understand the potential role of CA in the local treatment of early BC.

  11. Local construction of small wind turbines : the EOLSenegal Project experience; Vers la construction locale de petits aerogenerateurs : l'experience du projet EOLSenegal

    Energy Technology Data Exchange (ETDEWEB)

    Joulain, C.; Kebe, C.M.F. [Centre International de Formation et de Recherche en Energie Solaire (Senegal); Zambeaux, N. [Agence de l' Environnement et de la Maitrise de l' Energie, Paris (France); Galy, S. [La Fondation Nicola Hulot pour la Nature et l' Homme (France)

    2008-04-15

    The Centre International de Formation et de Recherche en Energie Solaire (CIFRES) is working to set-up a local branch of manufacturers and maintenance staff for small wind turbines destined for producing electricity in Senegal. The EOLSenegal Project stipulates that a minimum of 95 per cent of local materials must be used to manufacture the wind turbines and that all production and maintenance must occur in Senegal. The purpose of the project is to demonstrate the feasibility of rural electrification projects while determining which technology among wind power, solar photovoltaic or biofuel is best suited for contributing to energy independence and the industrial development of the country through job creation. There are multiple applications for wind energy, including domestic lighting; electrification of community buildings; electrification of district housing; pumping for drinking water; the transformation and conservation of agricultural products; driving force for local crafts such as woodworking, metals, sewing, and hairdressing; and, battery recharging for small food appliances. Wind power and solar energy were touted as being the best solution for meeting the electricity needs of rural populations. The first phase of the EOLSenegal Project involves a feasibility study and site selection followed by phase 2 in which the equipment will be installed. The last industrial phase of the project will be based on the experience gained during the first 2 phases with a market study and financial estimate to draw investors. It was concluded that while small wind turbines may solve some of Senegal's electricity needs, they cannot meet the needs alone and should be used in conjunction with other forms of energy such as solar, thermal, biomass or biogas. 4 figs.

  12. Intracranial germ cell tumors. The experience of the Bordeaux University Hospital and a literature review; Les dysgerminomes du systeme nerveux central. Experience du centre hospitalier universitaire de Bordeaux et analyse de la litterature

    Energy Technology Data Exchange (ETDEWEB)

    Bonichon, N.; Dahan, O.; Maire, J.P.; Caudry, M. [Hopital Saint-Andre, 33 - Bordeaux (France); San Galli, F.; Dautheribes, M.; Perel, Y. [Hopital Pellegrin, 33 - Bordeaux (France)

    1999-08-01

    Retrospective analysis of 17 patients with intracranial germ cell tumors treated in a multidisciplinary consultation at the Bordeaux University Hospital a and literature review. Seventeen consecutive patients were treated from 1978 to 1995 for a primary intracranial germ cell tumor. Median age was 14 (range 3-29 years). There were two malignant teratoma, six proved germinoma and nine presumed germinoma (diagnostic based on biological, radiological and treatment criteria). All received radiotherapy from 30 to 60 Gy (median 40 Gy) in different volumes. Chemotherapy was administered in 15 cases, three after surgery and 12 after radiotherapy. All tumours were in complete remission after initial treatment. The two malignant teratomas recurred in non-irradiated area after nine and 48 months, and the patients died. None of the germinoma recurred within a follow-up period of two to 17 years (median 65 months). Five and 10 year actuarial overall survival rates were the same: 84 % for all histories and 100 % for germinomas. Only two patients developed school difficulties and six presented an hypopituitarism, of which one was consecutive to radiotherapy. Chemotherapy was well tolerated. This retrospective study and literature analysis are in favor of limited dose and volume of radiation therapy associated with chemotherapy. (authors)

  13. Report of blind start-up experiments carried out on the reactor Cabri between 4. and 8. July 1966; Compte rendu des experiences de demarrage en aveugle effectuees sur le reacteur cabri du 4 au 8 juillet 1966

    Energy Technology Data Exchange (ETDEWEB)

    Filipczak, N.; Filipczak, W. [Institut Basan Jadrowych Swerk pta, Otwock (Poland); Furet, J.; Kaiser, J. [Commissariat a l' Energie Atomique, Saclay (France). Centre d' Etudes Nucleaires

    1967-07-01

    The blind start-up of a reactor without any neutronic data concerning a relatively wide range of power dynamics can be necessary when difficulties arise in the positioning of the detector or in neutron-gamma discrimination near the multiplying medium. The object of the experiments carried out on the reactor Cabri was to check the very complete analysis of the start-up accident which was studied on an analogue computer. The number of experiments carried out (12) is not sufficient to allow a definite conclusion. Nevertheless the blind start-up method advocated by N. FILIPCZAK and W. FILIPCZAK does not appear to be incompatible with the security during the operational phase (on condition that its dynamic characteristics are close to that of the reactor Cabri). (authors) [French] Le demarrage en aveugle d'un reacteur sans aucune information neutronique sur une dynamique de puissance relativement etendue peut se presenter lorsqu'il y a des difficultes de positionnement de detecteur ou de discrimination neutrons-gamma a proximite du milieu multiplicateur. Les experiences effectuees sur le reacteur CABRI avaient pour but de verifier l'analyse tres poussee de l'accident de demarrage etudie sur calculateur analogique. Le nombre d'experiences effectuees (12) n'est pas suffisant pour tirer des conclusions bien nettes. Neanmoins la methode de demarrage aveugle preconisee par N. PILIPCZAK et W. FILIPCZAK ne semble pas incompatible avec la securite pendant la phase d'exploitation du reacteur (a condition que ses caracteristiques dynamiques soient voisines de celles du reacteur CABRI). (auteurs)

  14. Intensity modulated radiation therapy: Analysis of patient specific quality control results, experience of Rene-Gauducheau Centre; Radiotherapie conformationnelle avec modulation d'intensite: analyse des resultats des controles precliniques, experience du centre Rene-Gauducheau

    Energy Technology Data Exchange (ETDEWEB)

    Chiavassa, S.; Brunet, G.; Gaudaire, S.; Munos-Llagostera, C.; Delpon, G.; Lisbona, A. [Service de physique medicale, centre Rene-Gauducheau, CLCC Nantes Atlantique, site hospitalier Nord, boulevard Jacques-Monod, 44805 Nantes Saint-Herblain cedex (France)

    2011-07-15

    Purpose. - Systematic verifications of patient's specific intensity-modulated radiation treatments are usually performed with absolute and relative measurements. The results constitute a database which allows the identification of potential systematic errors. Material and methods. - We analyzed 1270 beams distributed in 232 treatment plans. Step-and-shoot intensity-modulated radiation treatments were performed with a Clinac (6 and 23 MV) and sliding window intensity-modulated radiation treatments with a Novalis (6 MV). Results. - The distributions obtained do not show systematic error and all the control meet specified tolerances. Conclusion. - These results allow us to reduce controls specific patients for treatments performed under identical conditions (location, optimization and segmentation parameters of treatment planning system, etc.). (authors)

  15. Coordonnateur, Gestion des documents | CRDI - Centre de ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    À titre de membre d'une équipe de spécialistes de la gestion de l'information, le coordonnateur en gestion des documents est le contact de première ligne pour ... aux projets et aux activités administratives du CRDI en attribuant, conformément au plan de classification des documents du Centre, le numéro de dossier et le ...

  16. Études par pays dans le cadre du HIV/AIDS Monitor | IDRC ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    Le HIV/AIDS Monitor a pour objectif d'accroître l'efficacité de trois grandes initiatives, à savoir celles du Fonds mondial de lutte contre le sida, la tuberculose et le paludisme, du President's Emergency Plan for Aids et de la Banque mondiale. Sous la direction du Centre for Global Development, les chercheurs examineront ...

  17. Changements à la tête du CERN - Robert Aymar aux commandes pour 5 ans.

    CERN Multimedia

    2003-01-01

    "Une nouvelle équipe prendra les rênes du CERN à partir du 1er janvier. Le Francais Robert Aymar, anciennement directeur du Projet de reacteur thermonucleaire experimental international (ITER), dirigera le centre de recherche pour la periode 2004-2008" (1 page).

  18. The impact of services that offer individualised funds, shared management, person-centred relationships, and self-direction on the lived experiences of consumers with mental illness.

    Science.gov (United States)

    Peterson, Sunila; Buchanan, Angus; Falkmer, Torbjorn

    2014-01-01

    Mental health service providers across Australia, including Western Australia (WA), have begun to offer individualised funds, shared management, person-centred and self-directed (SPS) services. No research exists on the impact of SPS services on the lived experiences of these particular consumers. This study explored the impact of a SPS service offered for the first time in WA to consumers with mental illness. Data on sixteen consumers' lived experiences were analysed using an abbreviated grounded theory approach. These data had been developed by the consumers, Guides (staff) and an independent evaluator, and most of it had been collected in the past prior to the commencement of the study. Three over-arching categories, and related subcategories, emerged indicating that 1) access to individualised funds enabled practical and psychological benefits to consumers; 2) consistent contact in shared management and person-centred relationships enhanced the provision of timely and meaningful staff support to consumers; and 3) high quality shared management and person-centred relationships with staff and the opportunity to self-direct enabled consumers' change and growth. SPS services enhanced consumers' lived experiences and enabled staff to provide and consumers to experience timely access to recovery resources, consistent contact, responsive and high quality support, and self-direction of services. In this, consumers changed, grew and achieved desired recovery experiences. The overall impact of the SPS service seemed to be founded on the goodness of fit between person characteristics of staff and consumers, which enabled rich support that provided for corrective emotional experiences. This enabled consumers to build meaningful and hopeful lives where they started to live with, and beyond, their mental illness.

  19. Third-Generation Cephalosporin-Resistant Spontaneous Bacterial Peritonitis: A single-Centre Experience and Summary of Existing Studies

    Directory of Open Access Journals (Sweden)

    Jennifer Chaulk

    2014-01-01

    Full Text Available BACKGROUND: Spontaneous bacterial peritonitis (SBP is the most prevalent bacterial infection in patients with cirrhosis. Although studies from Europe have reported significant rates of resistance to third-generation cephalosporins, there are limited SBP-specific data from centres in North America.

  20. More than 20 years' experience of left ventricular assist device implantation at a non-transplant Centre.

    Science.gov (United States)

    Holmberg, Erica; Ahn, Henrik; Peterzén, Bengt

    2017-12-01

    Over recent decades implantable left ventricular assist devices (LVAD) have increased the possibility of improved survival in patients with advanced heart failure who also benefit from a better quality of life. The aim of this retrospective survey was to review the clinical results of LVAD implantation at a low-volume non-transplant centre (Linköping, Sweden) between 1993 and 2016. Our aim was also to assess the mortality and morbidity rates associated with implantation of three LVAD versions at our centre, and to compare our results with those from transplant centres. A retrospective cohort study was performed examining the medical records of patients who had a HeartMate(®) (HMI, HMII, HMIII) LVAD implanted as a bridge to heart transplantation (BTT) or as destination therapy (DT) at the University Hospital, Linköping. Our main finding was a survival to heart transplantation rate of 82% among our BTT LVAD patients. The most common adverse event among our patients was infection. A higher frequency of temporary dialysis was seen in the HMII group compared to the HMI group, and the frequency of right ventricular failure was higher in our HMII material. Our data suggests that patients requiring long-term LVAD support can safely have their device implanted and cared for at a non-transplant centre.

  1. Hepatic transplantation outcomes for carefully selected cirrhotic patients with hepatocellular carcinoma: experience at a small- to medium-volume centre.

    LENUS (Irish Health Repository)

    Qasim, A

    2012-02-01

    BACKGROUND: Hepatic transplantation outcomes for cirrhotic patients with hepatocellular carcinoma (HCC) at a small- to medium-volume centre are not fully known due to relative novelty of patient selection criteria. AIM: To determine hepatic transplantation outcomes for HCC at a small- to medium-volume centre. Patients and methods Hepatocellular carcinoma patients were listed for transplantation according to the International Guideline and further categorized as those fulfilling or exceeding Milan or University of San Francisco (UCSF) criteria on explanted liver morphology. Outcomes including mortality, retransplantation, and tumour recurrence rate were analysed. RESULTS: Twenty-six patients had HCC and on explanted liver morphology, Milan and UCSF criteria met 15 and 18 patients, respectively. Patients and graft survival at 3 months, 1 and 5 years were 100, 96, 84, and 88, 84, 77%, respectively. Outcomes favoured Milan criteria but did not reach statistical significance. CONCLUSIONS: Hepatic transplantation for HCC at a small-to medium-volume transplant centre had comparable survival outcomes to high-volume centres.

  2. Student experience and academic success: comparing a student-centred and a lecture-based course programme

    NARCIS (Netherlands)

    Severiens, S.; Meeuwisse, M.; Born, M.

    2015-01-01

    Past research has shown that, under certain conditions, student-centred and small-scale course programmes result in more academic success. The present study investigates these conditions in further detail. It is examined whether, in comparison to a course programme that is relatively more

  3. Efficacité de la prévention de la transmission mère-enfant du Virus de l'Immunodéficience Humaine par le protocole 2010 de l'Organisation Mondiale de la Santé au Centre Médical Saint Camille de Ouagadougou (Burkina Faso)

    Science.gov (United States)

    OuédraogoYugbaré, Solange Odile; Zagré, Nikaise; Koueta, Fla; Dao, Lassina; Kam, Ludovic; Ouattara, Diarra Yé; Simporé, Jacques

    2015-01-01

    L’épidémie du Virus de l'Immunodéficience Humaine en milieu pédiatrique est surtout le résultat de la transmission mère-enfant. Notre étude a pour objectif de décrire l'efficacité de la prévention de la transmission mère-enfant du Virus de l'Immunodéficience Humaine par le protocole OMS 2010 (Option A et trithérapie) au centre médical saint Camille de Ouagadougou. Nous avons mené une étude d'une cohorte d'enfants suivis dans le cadre de la prévention de la transmission mère-enfant du Virus de l'Immunodéficience Humaine au centre médical saint Camille de Ouagadougou sur une période de 2 ans allant du 1er Janvier 2012 au 31 Décembre 2013. Nous avons obtenu l'accord de 4900 femmes enceintes pour le dépistage de l'infection du Virus de l'Immunodéficience Humaine et 238 gestantes ont été diagnostiquées séropositives soit 4,86% de séroprévalence. Les femmes étaient surtout infectées par le Virus de l'Immunodéficience Humaine avec de type I (95,38%)). La majorité était sous trithérapie (74,3%) et (25,7%) sous prophylaxie (option A). Les nouveau-nés (92,5%) ont reçu un traitement antirétroviral à base de névirapine dans les 72 heures après la naissance. L'allaitement sécurisé a été appliquée dans 78% des cas. Le taux global de transmission mère-enfant du VIH était de 3,6% avec 3% de transmission chez les enfants nés de mères sous trithérapie antirétrovirale et 6,3% dans les cas de prophylaxie antirétrovirale. Le facteur de risque de transmission a été le long délai du début d'administration des antirétroviraux chez le nouveau-né. La mortalité infantile à un an était de 3,5%. Cette étude a révélé l'efficacité de l'Option A et conforté celle de la trithérapie, le passage à l'Option B+ serait donc plus bénéfique. PMID:26966499

  4. Senegal : tous les projets | Page 3 | CRDI - Centre de recherches ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    Le CRDI administre l'apport de 20 millions de dollars du gouvernement du Canada à l'expansion du réseau de centre AIMS, l'objectif de l'initiative Next Einstein de l'Institut Africain des Sciences Mathématiques (AIMS-NEI). Sujet: SCIENCE. Région: North of Sahara, South of Sahara, Benin, Ethiopia, Ghana, Senegal, ...

  5. Benin : tous les projets | CRDI - Centre de recherches pour le ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    Le CRDI administre l'apport de 20 millions de dollars du gouvernement du Canada à l'expansion du réseau de centre AIMS, l'objectif de l'initiative Next Einstein de l'Institut Africain des Sciences Mathématiques (AIMS-NEI). Sujet: SCIENCE. Région: North of Sahara, South of Sahara, Benin, Ethiopia, Ghana, Senegal, ...

  6. South Africa : tous les projets | Page 3 | CRDI - Centre de ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    Le CRDI administre l'apport de 20 millions de dollars du gouvernement du Canada à l'expansion du réseau de centre AIMS, l'objectif de l'initiative Next Einstein de l'Institut Africain des Sciences Mathématiques (AIMS-NEI). Sujet: SCIENCE. Région: North of Sahara, South of Sahara, Benin, Ethiopia, Ghana, Senegal, ...

  7. tanzania : tous les projets | Page 4 | CRDI - Centre de recherches ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    Le CRDI administre l'apport de 20 millions de dollars du gouvernement du Canada à l'expansion du réseau de centre AIMS, l'objectif de l'initiative Next Einstein de l'Institut Africain des Sciences Mathématiques (AIMS-NEI). Sujet: SCIENCE. Région: North of Sahara, South of Sahara, Benin, Ethiopia, Ghana, Senegal, ...

  8. Conseiller juridique | CRDI - Centre de recherches pour le ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    Fournit des conseils sur un large éventail de questions juridiques et commerciales susceptibles d'avoir une incidence sur les activités du CRDI en examinant tous les aspects, en déterminant les pratiques juridiques et de gestion du risque applicables et appropriées et en indiquant à la direction du Centre la meilleure ligne ...

  9. Canada : tous les projets | Page 10 | CRDI - Centre de recherches ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    Le CRDI administre l'apport de 20 millions de dollars du gouvernement du Canada à l'expansion du réseau de centre AIMS, l'objectif de l'initiative Next Einstein de l'Institut Africain des Sciences Mathématiques (AIMS-NEI). Sujet: SCIENCE. Région: North of Sahara, South of Sahara, Benin, Ethiopia, Ghana, Senegal, ...

  10. Conseiller juridique principal (h/f) | CRDI - Centre de recherches ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    ... risque applicables et appropriées et en indiquant à la direction du Centre la meilleure ligne de conduite. Ce travail peut comporter la supervision du travail des avocats dont le CRDI retient les services dans d'autres territoires de compétence où il intervient, afin d'assurer la conformité à la lettre et à l'esprit des lois du pays ...

  11. Soutien institutionnel au Centre for Population and Environmental ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    Financement total. CAD$ 1,812,500. Pays. Nigéria, Nord du Sahara, Sud du Sahara, Niger. Chargé(e) de projet. Mr. Johnson E. Dudu. Chargé(e) de projet. Andrew G. Onokerhoraye. Chargé(e) de projet. Andrew G. Onokerhoraye. Institution. Centre for Population and Environmental Development. Pays d' institution. Nigeria.

  12. nigeria : tous les projets | Page 4 | CRDI - Centre de recherches ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    Le Centre for the Study of the Economies of Africa (CSEA) est un jeune centre de recherche indépendant et sans but lucratif qui a été établi en octobre 2007 à ... la vulnérabilité des systèmes ruraux-urbains du Nigeria face aux changements climatiques en diffusant les résultats du projet pilote mené dans la ville d'Aba, dans ...

  13. Spéciation du cadmium, du chrome, du cuivre et du plomb dans les ...

    African Journals Online (AJOL)

    L'exploitation du minerai de phosphate au sud-est du Togo engendre des déchets miniers qui sont déversés dans la mer sans traitement. Cette étude a pour but l'estimation de la biodisponibilité du cadmium, du chrome, du cuivre et du plomb par leur spéciation. La caractérisation physicochimique des sédiments des ...

  14. L'oreille à l'écho: Quelles ont été les raisons qui ont permis au CERN de devenir le meilleur centre de recherche fondamentale du monde?

    CERN Multimedia

    Staff Association

    2016-01-01

    La question est ambitieuse et complexe ; elle n’aura donc pas de réponses précises mais des suppositions raisonnables. Il faut commencer par la « Convention du CERN » imaginée par les fondateurs juste après la deuxième guerre mondiale, théâtre d’atrocités innommables entre nations, ethnies et systèmes politiques. Témoins de ces atrocités, les pères fondateurs de la « Convention du CERN » ont introduit plusieurs principes particulièrement efficaces pour le succès de l’Organisation naissante. PREMIER PRINCIPE : « Le CERN devra être ouvert aux scientifiques de toutes les nations indépendamment de leurs systèmes de gouvernement. » Ce principe a permis d’instaure...

  15. The Importance of Brain Banks for Molecular Neuropathological Research: The New South Wales Tissue Resource Centre Experience

    Directory of Open Access Journals (Sweden)

    Antony Harding

    2009-01-01

    Full Text Available New developments in molecular neuropathology have evoked increased demands for postmortem human brain tissue. The New South Wales Tissue Resource Centre (TRC at The University of Sydney has grown from a small tissue collection into one of the leading international brain banking facilities, which operates with best practice and quality control protocols. The focus of this tissue collection is on schizophrenia and allied disorders, alcohol use disorders and controls. This review highlights changes in TRC operational procedures dictated by modern neuroscience, and provides examples of applications of modern molecular techniques to study the neuropathogenesis of many different brain disorders.

  16. [Examples of migrant-related health education. Experiences in the development of materials by the German Federal Centre of Health Education].

    Science.gov (United States)

    Berrut, S; Blümel, S; Erath, A

    2006-09-01

    Migrants in Germany are a very heterogeneous population. This has to be taken into account when developing and distributing materials. Linguistic and cultural barriers lead to the conclusion that personal communication is the best way to approach some of the migrant groups--especially in sensitive fields like HIV and other sexually transmitted infections. The German Federal Centre of Health Education (BZgA) supports multipliers with special material for prevention and counselling. New methods for translation and distribution were developed for a family planning brochure in Turkish. Furthermore, a newsletter provides a forum for exchange of information and experiences among those working in the field of migration and health.

  17. The Case for Information Brokering During Major Change: The Experience of the Transition Support Office of the McGill University Health Centre.

    Science.gov (United States)

    Klag, Malvina; Richer, Marie-Claire

    2016-01-01

    This paper describes the emergence of an "information brokerage" in the project management office of the McGill University Health Centre (MUHC) in Montreal. This process evolved during unprecedented transformation linked to a redevelopment project. Information brokering became a core function in the MUHC's context of major change. To develop an information brokering model, the paper draws upon the literature on knowledge brokering, applies Daft and Lengel's (1986) seminal framework on information processing in organizations, and builds on the MUHC experience. The paper proposes that knowledge brokering and information brokering are related, yet distinct in content, purpose and structure.

  18. Audit of the use of IVC filters in the UK: experience from three centres over 12 years

    Energy Technology Data Exchange (ETDEWEB)

    Hammond, C.J. [Leeds General Infirmary, Leeds (United Kingdom)], E-mail: chris.hammond@doctors.org.uk; Bakshi, D.R. [Royal Liverpool University Hospital, Liverpool (United Kingdom); Currie, R.J. [Royal Devon and Exeter Hospital, Exeter (United Kingdom); Patel, J.V. [Leeds General Infirmary, Leeds (United Kingdom); Kinsella, D. [Royal Devon and Exeter Hospital, Exeter (United Kingdom); McWilliams, R.G. [Royal Liverpool University Hospital, Liverpool (United Kingdom); Watkinson, A. [Royal Devon and Exeter Hospital, Exeter (United Kingdom); Nicholson, A.A. [Leeds General Infirmary, Leeds (United Kingdom)

    2009-05-15

    Aim: To audit the use of inferior vena cava (IVC) filter insertions at three UK centres over 12 years to assess whether trends in filter use in the UK mirrored those seen elsewhere. Materials and methods: Radiology department databases were interrogated for IVC filter insertions and removals between 1994 and 2006. Reports for these interventions, along with prior and subsequent imaging reports, were analysed. Follow-up data were obtained when available. Results: Five hundred and sixteen filters were placed with a significant year-on-year trend towards increasing use. Fifty-seven percent of filters placed were for absolute indications and 37% for relative indications. The filters were used for prophylaxis in 6% of patients in the absence of proven pulmonary embolism (PE) or deep vein thrombosis (DVT). A retrievable filter was used in 74% of cases with retrieval attempted in 40% of these and no evidence of an increasing rate of retrieval over time. A significant complication related to insertion or retrieval was encountered in 0.4 and 1% of procedures, respectively. Mean 24 h and 30 day mortalities were 1 and 8%, respectively. There was an absence of organized follow-up at all three centres. Conclusion: IVC filter use in the UK is increasing. The use of retrievable filters has not resulted in increased filter retrieval. Filter insertion and retrieval is associated with a low risk of significant complication, but lack of systematic follow-up limits conclusions regarding safety and efficacy.

  19. Planificateur des activités de la haute direction | CRDI - Centre de ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    Élaborer et tenir à jour un système de classement électronique et physique efficient pour répertorier les documents du Conseil et du CHD afin de préserver le registre des documents du CRDI: Respecter les normes du Centre ainsi que les normes gouvernementales en matière de gestion des dossiers et des documents; et ...

  20. Spectrometer for cosmic and solar protons experiment S 72 aboard the satellite ESRO 2; Spectrometre pour protons cosmiques et solaires experience S 72 embarquee a bord du satellite ESRO 2

    Energy Technology Data Exchange (ETDEWEB)

    Amram, Y.; Detourne, G.; Hugot, C.; Malaval, P.; Andrejol, J.; Axisa, F.; Engelmann, J.; Koch, L. [Commissariat a l' Energie Atomique, Saclay (France). Centre d' Etudes Nucleaires

    1968-07-01

    noyaux galactiques de charge inferieure a 6. L'appareil comprend deux parties: - une sonde comportant un telescope de detecteurs a jonctions en silicium (au lithium diffuse) de grande surface et les preamplificateurs; - un boitier electronique comprenant les amplificateurs, les circuits de discrimination d'amplitude et de coincidence, le convertisseur analogique-numerique qui permet le codage de la perte d'energie d'une particule incidente dans l'une des jonctions, l'echelle de comptage du flux des particules, et l'interface de liaison avec la telemesure du satellite. L'ensemble pese 1350 g, consomme 350 mW et fonctionne normalement de - 20 C a + 50 C. Apres l'expose de l'organisation de l'experience et apres la description des circuits et de leur fonctionnement, on insiste plus particulierement sur la facon dont ont ete respectes les imperatifs propres a l'electronique spatiale: legerete, faible consommation, tenue aux vibrations, large gamme de temperature de fonctionnement et fiabilite. On decrit egalement les modifications apportees au modele de vol F-2 apres l'echec du lancement du modele F-1 en mai 1967. (auteur)

  1. Coordonnateur, Services de traduction | CRDI - Centre de ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    Résumé des fonctions. Le coordonnateur, Services de traduction coordonne les opérations globales des services de traduction au sein du Centre de recherches pour le développement international (CRDI) en agissant à titre de principale personne-ressource pour les clients internes et les fournisseurs de services externes.

  2. Some experiments on the high-low transition of quartz; Recherches experimentales sur une transformation du quartz

    Energy Technology Data Exchange (ETDEWEB)

    Mayer, G. [Commissariat a l' Energie Atomique, Saclay (France). Centre d' Etudes Nucleaires

    1959-12-15

    , nous avons rassemble un grand nombre de resultats numeriques relatifs aux proprietes elastiques, piezoelectriques et optiques du quartz. Certains ont ete collectes dans la litterature; d'autres ont ete obtenus par nous a l'aide de methodes experimentales que nous decrivons, de facon a pouvoir presenter un tableau complet de l'evolution de ces constantes dans un domaine de temperature entourant largement le point de transformation {alpha} - {beta} situe a 574 deg. C. De nouveaux phenomenes ont ete observes au cours de ces mesures. Dans la troisieme partie, nous montrons qu'une meme fonction de la temperature decrit l'evolution de la constante piezoelectrique et de la constante elastique qui s'annulent en phase {beta}. Une seule autre fonction suffit a decrire correctement l'evolution de toutes les autres constantes etudiees, depuis leur valeur en phase {alpha} jusqu'a leur valeur en phase {beta}. A l'aide d'hypotheses sur la nature de l'entropie de transformation, nous essayons enfin d'expliquer la forme de ces fonctions. (auteur)

  3. Effet combiné des feuilles de Tithonia diversifolia et des engrais inorganiques sur les rendements du maïs et les propriétés d'un sol ferralitique au Centre Cameroun

    Directory of Open Access Journals (Sweden)

    Kaho, F.

    2011-01-01

    Full Text Available Combined Effect of Thitonia diversifolia Leaves and Inorganic Fertlizers on Maize Grain Yield and Soil Properties of a Central Cameroon Acrisol. Properties of a Central Cameroon Acrisol A study was conducted on an Acrisol in Centre Cameroon in order to evaluate the combined effects of Tithonia diversifolia (FTd and inorganic fertilizers (NPK and Urea on maize grain yields and soil properties. The experimental design was a randomized completed block design with three replications and six treatments: T0 (0FTd, 0NPK and 0 Urea; T1 (0FTd, 150 kg 20-10-10 and 150 kg of Urea/ha; T2 (0FTd, 75 kg 20-10-10 and 75 kg of Urea/ha; T3 (2.5 t/ha FTd, 0NPK and 0 Urea; T4 (5 t/ha FTd, 0NPK and 0 Urea; T5 (2.5 t/ha FTd, 75 kg 20-10-10 and 75 kg of Urea. Soil and Tithonia samples were collected and analyzed for nutrients contents. Tithonia leaves (FTd were incorporated into the soil two weeks before maize sowing. Physico-chemical laboratory analyses were carried out on soil samples and Tithonia leaves. Highly significant differences (p= 0.006 and p< 0.000 respectively were observed between treatments in the first and second cropping season for maize grain yields which varied between 1.8 to 6.4 t.ha-1; with the highest values obtained in T4 and T5 and the lowest in T0. The general trend of productivity was ranked as: T5=T4 >T1>T3>T2>T0. No significant difference was observed for all the soil properties tested. However, in the general trend, most soil properties tended to increase at the end of the experiment, excepted sand content, pH and available phosphorus. With the acceptability index (IA of more than 2 in T4 (2.65 and T5 (2.53, the study has shown that Tithonia diversifolia has a potential for improving plant nutrient availability in these soils for the cultivation of maize without chemical fertilizers.

  4. Third-generation cephalosporin-resistant spontaneous bacterial peritonitis: a single-centre experience and summary of existing studies.

    Science.gov (United States)

    Chaulk, Jennifer; Carbonneau, Michelle; Qamar, Hina; Keough, Adam; Chang, Hsiu-Ju; Ma, Mang; Kumar, Deepali; Tandon, Puneeta

    2014-02-01

    Spontaneous bacterial peritonitis (SBP) is the most prevalent bacterial infection in patients with cirrhosis. Although studies from Europe have reported significant rates of resistance to third-generation cephalosporins, there are limited SBP-specific data from centres in North America. To evaluate the prevalence of, predictors for and clinical impact of third-generation cephalosporin-resistant SBP at a Canadian tertiary care centre, and to summarize the data in the context of the existing literature. SBP patients treated with both antibiotics and albumin therapy at a Canadian tertiary care hospital between 2003 and 2011 were retrospectively identified. Multivariate logistic regression was used to determine independent predictors of third-generation cephalosporin resistance and mortality. In 192 patients, 25% of infections were nosocomial. Forty per cent (77 of 192) of infections were culture positive; of these, 19% (15 of 77) were resistant to third-generation cephalosporins. The prevalence of cephalosporin resistance was 8% with community-acquired infections, 17% with health care-associated infections and 41% with nosocomial acquisition. Nosocomial acquisition of infection was the only predictor of resistance to third-generation cephalosporins (OR 4.0 [95% CI 1.04 to 15.2]). Thirty-day mortality censored for liver transplantation was 27% (50 of 184). In the 77 culture-positive patients, resistance to third-generation cephalosporins (OR 5.3 [1.3 to 22]) and the Model for End-stage Live Disease score (OR 1.14 [1.04 to 1.24]) were independent predictors of 30-day mortality. Third-generation cephalosporin-resistant SBP is a common diagnosis and has an effect on clinical outcomes. In an attempt to reduce the mortality associated with resistance to empirical therapy, high-risk subgroups should receive broader empirical antibiotic coverage.

  5. Clinical Experiences with the FRONT Formula for Pre-Operative Airway Assessment and Documentation: a Multi-Centre Study.

    Science.gov (United States)

    Mitre, Calin; Mitre, Ileana; Gyöngyösi, Zoltán; Fülesdi, Béla; Zdrehus, Claudiu; Breazu, Caius; Biro, Peter

    2017-08-01

    The prediction of difficult airway is one of the most important challenges before general anaesthesia. This study aimed to assess the clinical usefulness of the FRONT score, a recently developed scoring system to predict and document airway difficulties. This multi-centre, inter-observer, prospective and double-blinded study included 976 patients from two university centres. The pre-operative evaluation of the patients was performed by a pre-operative team of anaesthesiologists (team A) who evaluated and scored the expected difficulty of airway management. An intra-operative team of evaluators (team B) working independently of team A, performed the actual instrumentation of the airway and scored the actual findings. Both teams used the FRONT scoring system and worked independently of each other to ensure blinded assessments. The statistical analysis of the pre- and intra-operative FRONT scores was performed in an off-line blinded manner. Our results show a fair and promising association between pre-operative composite FRONT score and that observed at the induction phase (Spearman=0.43). Among the score components, the best correlation was observed for the F and R components (kappa=0.44 and 0.36, respectively), and the worse correlation was observed for the O and T components (kappa=0.25 and 0.24, respectively). The FRONT formula for the prediction and documentation of the airway status is a simple and effective method for assessing and defining airway management difficulties. Further prospective studies are required to assess the sensitivity and specificity of the system.

  6. Profil infectieux et mortalité des enfants âgés de 0 à 5 ans admis pour malnutrition aiguë sévère: étude de cohorte rétrospective au Centre Nutritionnel et Thérapeutique de Bukavu, République Démocratique du Congo

    Science.gov (United States)

    Kambale, Richard Mbusa; Kasengi, Joe Bwija; Kivukuto, John Mutendela; Cubaka, Liévin Murhula; Mungo, Bruno Masumbuko; Balaluka, Ghislain Bisimwa

    2016-01-01

    Introduction La malnutrition constitue une toile de fond sur laquelle se greffent plusieurs infections. L'objectif de ce travail est de déterminer les infections les plus létales, la durée médiane de séjour et le gain pondéral médian journalier des enfants malnutris. Méthodes Étude de cohorte rétrospective des enfants malnutris de 0 à 59 mois hospitalisés au Centre Nutritionnel et Thérapeutique de Bukavu du 1er janvier 2011 au 31 décembre 2013. L’évaluation du risque de survenue de décès par complication infectieuse a été faite par la mesure du risque relatif. Nous avons utilisé le test de Mann-Whitney pour comparer les médianes. Les Odd ratio ajustés par régression logistique et leurs intervalles de confiance à 95% du risque de mortalité ont été donnés pour chaque cause infectieuse. Résultats Au total, 574 enfants avaient été inclus. Cinq cent vingt et un (90.8%) enfants étaient sortis guéris, 10 (1.7%) avaient abandonné le traitement et 43 (7.5%) étaient décédés. La durée médiane de séjour était de 19 (13-26) jours et le gain pondéral médian journalier était de 7 (3-13) g/kg/j. Il existait une association statistiquement significative entre la mortalité et le sepsis / choc septique (p = 0,0004), la méningite (p = 0,00001), et l'infection à VIH (p = 0,02). Conclusion Une meilleure prise en charge de la malnutrition aigüe dans notre région devrait se baser sur la mise en place des unités spécialisées et bien équipées pour la prise en charge de la malnutrition associées aux infections sévères. PMID:27279964

  7. The nuclear core of sun: theoretical perspectives and characterization of the scientific performances of the GOLF / SOHO experiment detector; La region nucleaire du soleil: perspectives theoriques et caracterisation des performances scientifiques du detecteur de l`experience GOLF / SOHO

    Energy Technology Data Exchange (ETDEWEB)

    Dzitko, H.

    1995-06-23

    The subject of this thesis is the nuclear core of the sun. The first part is theoretical and concerns neutrino flux predictions. A precise description of the solar plasma is necessary to predict boron, beryllium and CNO cycle neutrinos. We treat here the nuclear reaction rates. They are mainly determined by the cross sections and the enhancement factors due to plasma particles, the co-called screening factors. We have discussed the various possible formalisms that could be used in stellar evolution and performed direct calculations of screened cross sections. We concluded that the screening prescriptions which have been used so far in stellar evolution should be replaced by the Mitler formalism. Next, we examine the cross section uncertainties and we show that it is possible to get a better agreement between theory and experiment. Discrepancies between the gallium experiments and the calculations suggest that we should go beyond the classical solar model. This has motivated our study on possible magnetic fields deeply buried in the solar core. We discuss here the influence of a magnetic pressure perturbation on solar evolution. In the experimental part of this work, we deal with the GOLF experiment, one of the three helio-seismological experiments on board the space probe SOHO. The purpose of this instrument is the study of the global oscillation modes in the frequency range 10{sup -7} to 6 10{sup -3} Hz with a sensitivity for frequencies higher than 2 10{sup -4} Hz of about 1 mm/s over 20 days of continuous integration at counting rates of 12 10{sup 6} cs/s. One part of this work was devoted to the precise characterization of the photomultipliers and their associated electronics in order to select them according to their intrinsic performances. This step was followed by long duration tests of three weeks simulating as well as possible the flight conditions. We show that the detection chain effectively meets the stability requirements of around 10{sup -7} by

  8. Administrateur de programme, Évaluation (h/f) | CRDI - Centre de ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    De concert avec d'autres membres de l'équipe, l'administrateur de programme facilite des processus d'évaluation qui visent à agir sur l'orientation, le contenu et la gestion des projets et des programmes du Centre, ainsi que sur les politiques, démarches et débats au Centre, afin d'améliorer le rendement du Centre et de ...

  9. CATERING STUDENTS' NEEDS TO PROMOTE AESTHETIC EXPERIENCE IN EFL LITERATURE CLASS WITH REFERENCE TO RESPONSE-CENTRED CURRICULUM

    National Research Council Canada - National Science Library

    Ishkak Said

    2015-01-01

    ... with. In this respect, the existing literature curricula should ideally reflect aesthetic experiences that enhance students' freedom and enjoyment with literary works assigned The present study examines...

  10. les cahiers du cread: Submissions

    African Journals Online (AJOL)

    Le nom de l'auteur (en majuscule Times New Roman", gras, taille de 12), précédé de son prénom (en minuscule), se met 2 interlignes en dessous du titre, justifié à droite et suivi d'un astérisque renvoyant en bas de page où est mentionnée le nom de l'institution dont relève l'auteur (Centre ou unité de recherche, université) ...

  11. Estonian Experience on Establishment of a Modern National Poison Information Centre: One-year Profile of Phone Calls in 2012

    Directory of Open Access Journals (Sweden)

    Mare Oder

    2013-06-01

    Full Text Available Background: Initiating a National Poisoning Information Centre (PIC in Estonia took about 12 years of challenging work on research, training and attracting governmental support and funding. In this study we described the establishment process and the profile of phone calls in the first year which the PIC started to be available full time (24h/day 7days/week.  Methods: This was a descriptive retrospective study. Relevant documents from 2000-2012 were reviewed. The documents were categorized into 5 main issues against establishment of PIC. Data of all inquiries related to toxic agent exposures regarding patient’s demographic, intention of poisoning and type of toxic substances in 2012 were collected. The data were reported with frequency and percentage. Results: During establishment process, 386 documents including governmental regulations and contracts, memorandums from meetings, professional e-mails, newspaper articles, interviews, annual reports and program sheets of other poison centres and conference presentations were collected. Funding was provided form PHARE and BTox projects (2000-2003, and government of Estonia (2004-2012. Educational programs were held to train specialists in clinical toxicology and poisoning information to direct the PIC. The active phase of establishment started in 2004; however, the services of PIC became available at the beginning of 2008. In 2012, total number of calls was 1118. 20% of calls were related to general questions about pharmaceuticals and non-toxic agents. 894 calls were related to acute poisoning cases. Most of them (87.9% were due to accidental poisoning. The most common types of substances responsible for poisoning were pharmaceutical products (30.2%, household products (29.5% and plant toxins (11.1%. Conclusion: To establish a stable PIC, it is crucial to have a wide range data backbone, clear support and direct funding from the government, assistance from collaborative PICs, active international

  12. Student-centred learning in Community Medicine: An experience from Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry.

    Science.gov (United States)

    Kar, S S; Premarajan, K C; L, Subitha; Archana, R; Iswarya, S; A, Sujiv

    2014-01-01

    Student-centred learning (SCL) places the student at the centre of policies, practices and decision-making in the teaching-learning process. SCL methodology also advocates active involvement of students in the curriculum planning, selection of teaching-learning methods and assessment process. We planned an education innovation project to assess the perception of fifth semester undergraduate medical students towards implementation of an SCL methodology. The study was done among 87 fifth semester undergraduate medical students (batch of 2010-11) in the noncommunicable disease epidemiology section of Community Medicine at the Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry. The students divided themselves into seven groups and developed the learning objectives, selected teaching-learning methods and assessment process for each session. The facilitators had 3-5 rounds of interaction with each group before the session. Qualitative analysis of feedback collected from students and external faculty after each session was done. The effect of implementing the SCL methodology was assessed by the reaction level of Kirkpatrick's training evaluation model by using a rating scale Results. Of the 87 eligible students, 73 (83.9%) returned the forms for evaluation. All seven groups were able to formulate the learning objectives. Most of the groups had used PowerPoint slides and videos as a teaching-learning tool. Innovative assessment methods such as crosswords and 'chocopati' were used by some groups. In general, the perception of students was favourable towards SCL compared to conventional methods and they felt that this methodology should be adopted more often. Time management and organization of sessions were the main problems encountered by the students. The mean (SD) score for the items 'sessions were useful', 'sessions were enjoyable' and 'sessions improved my knowledge' were 6.2 (1.8), 7.1 (1.8) and 6.3 (1.9), respectively. The

  13. ERCP in a cohort of 759 cases: A 6-year experience of a single tertiary centre in Libya.

    Science.gov (United States)

    Tumi, Ali; Magadmi, Masoud; Elfageih, Salah; Rajab, Abdul-Fatah; Azzabi, Masoud; Elzouki, Abdel-Naser

    2015-03-01

    The aim of this study was to review the indications, findings, technical success, and outcomes of endoscopic retrograde cholangiopancreatography (ERCP) procedures in a large cohort of patients admitted to a single tertiary centre in Libya. A total of 759 consecutive ERCP procedures were performed in 704 patients from January 2005 through December 2010 at the Endoscopy Unit of Central Hospital, Tripoli, Libya. The patients' demographic characteristics, clinical information, ERCP indications, laboratory parameters, and post-ERCP complications were reviewed. Formal written consent was obtained from all patients prior to each procedure. The study included 280 (36.9%) males and 479 (63.1%) females with mean age ± standard deviation (SD) of 56.8 ± 18.7 years. Papillotomy was performed in 670 (88.3%) cases of the ERCP procedures. Common bile duct (CBD) stones were reported in 389 (51.3%) cases and were more frequent in females (234 cases, 60.1%) than males (155, 39.9%) (p = 0.01). The majority of the CBD stones were successfully retrieved with balloon extraction (304 cases, 78.2%), while mechanical lithotripsy (67 cases, 17.2%) and Dormia basket (11 cases, 2.8%) were used for difficult stones. Only seven (1.8%) cases were referred for surgery. Malignancy was found in 151 (19.9%) of the cases and was significantly more common in males than females (102, 67.5% vs. 49, 32.5%, respectively, p = 0.001). Stents for bile drainage were inserted in 26 (17.2%) of these cases. The complications encountered were acute pancreatitis in 30 cases (3.9%), minor bleeding in nine cases (1.2%), major bleeding in one case (0.15%), cholangitis in four cases (0.52%), and perforation in one case (0.15). Mortality was reported in three cases (0.4%). The ERCP indications and the related complications, in our centre in Libya, are comparatively consistent with those reported data in other countries. Successful biliary cannulation was achieved in most of the patients, and post-ERCP complications

  14. Low-target tacrolimus in de novo standard risk renal transplant recipients: A single-centre experience.

    Science.gov (United States)

    Størset, Elisabet; Åsberg, Anders; Hartmann, Anders; Reisaeter, Anna V; Holdaas, Hallvard; Skauby, Morten; Bergan, Stein; Midtvedt, Karsten

    2016-10-01

    Optimal tacrolimus exposure in transplant recipients is not well established. The results from the Symphony study indicated that low-target tacrolimus (trough concentrations 3-7 µg/L) in de novo standard risk renal transplant recipients should be appropriate. The aim of this study was to evaluate real-life outcomes when applying a similar strategy in a clinical setting. A single-centre analysis was conducted in standard risk renal transplant recipients receiving low-target tacrolimus, mycophenolate mofetil, glucocorticoids and basiliximab induction. One-year estimated glomerular filtration rate (eGFR, Cockcroft-Gault), one-year biopsy-proven acute rejection rate and graft- and patient survival up to 3 years post-transplant were compared with the outcomes in the Symphony study. From 1 January 2009 to 31 March 2013, we included 406 patients. One year after transplantation, the mean ± SD eGFR was 76.8 ± 28.3 mL/min (Symphony: 65.4 ± 27.0 mL/min, P tacrolimus-based immunosuppression is safe and effective also in a standard clinical setting in de novo standard risk renal transplant recipients. © 2016 Asian Pacific Society of Nephrology.

  15. Cochlear re-implant rates in children: 20 years experience in a quaternary paediatric cochlear implant centre.

    Science.gov (United States)

    Trozzi, Marilena; Powell, Harry R F; Toma, Shamim; Ahmed, Waseem; Jephson, Christopher G; Rajput, Kaukab; Cochrane, Lesley A

    2015-10-01

    The aim of this study is to determine the incidence and causes for cochlear explantation/re-implantation in children as a retrospective case review in a Quaternary paediatric Cochlear Implant (CI) Centre. The subjects included in the study were Paediatric CI patients requiring cochlear explantation/re-implantation. Outcome measurements were incidence and aetiology of device explantation/re-implantation. Patient age at implantation, aetiology of deafness, CI manufacturer, and timing of explantation/re P implantation were the independent variables. 778 paediatric cochlear implants were performed in 653 children between 1992 and January 2013. There were a total of 40 (5.1%) failed implants in 38 patients. The most common reason for explantation was device failure in 22 (2.8%). Risk factors for device failure were known manufacturing defect/device recall. Medical/surgical issues accounted for 18 (2.3%) implant failures. The mean time to explantation was 3 years 10 months. The incidence of explantation/re-implantation in our paediatric cochlear implant population is comparable to other published studies. The most common reason for explantation was device failure, however, the aetiology of deafness, in particular meningitis, does not appear to increase the risk of explantation as described in previous series.

  16. Mortality on the Waiting List for Lung Transplantation in Patients with Idiopathic Pulmonary Fibrosis: A Single-Centre Experience.

    Science.gov (United States)

    Bennett, David; Fossi, Antonella; Bargagli, Elena; Refini, Rosa Metella; Pieroni, Maria; Luzzi, Luca; Ghiribelli, Claudia; Paladini, Piero; Voltolini, Luca; Rottoli, Paola

    2015-10-01

    Lung transplantation (LTX) is nowadays accepted as a treatment option for selected patients with end-stage pulmonary disease. Idiopathic pulmonary fibrosis (IPF) is characterized by the radiological and histologic appearance of usual interstitial pneumonia. It is associated with a poor prognosis, and LTX is considered an effective treatment to significantly modify the natural history of this disease. The aim of the present study was to analyse mortality during the waiting list in IPF patients at a single institution. A retrospective analysis on IPF patients (n = 90) referred to our Lung Transplant Program in the period 2001-2014 was performed focusing on patients' characteristics and associated risk factors. Diagnosis of IPF was associated with high mortality on the waiting list with respect to other diagnosis (p Pulmonary function tests failed to predict mortality and no other medical conditions were associated with survival. Patients newly diagnosed with IPF, especially in small to medium lung transplant volume centres and in Countries where a long waiting list is expected, should be immediately referred to transplantation, delay results in increased mortality. Early identification of IPF patients with a rapid progressive phenotype is strongly needed.

  17. etat du magnesium dans quelques sols sales du sud et du centre de ...

    African Journals Online (AJOL)

    AISA

    Jackson M. L. 1976. Analisis químico de suelos. Ediciones Omega, S. A. Barcelona, 662 p. Kovda V. 1973. Irrigation/Drainage and Salinity. International source book FAO/UNESCO,. 123 p. Laribi A. 2002. Status and Behavior of Magnesium in saline soils of Iraq. MSc thesis. College of Agriculture. Baghdad University, 107 p.

  18. ATLAS Visitors Centre

    CERN Multimedia

    claudia Marcelloni

    2009-01-01

    ATLAS Visitors Centre has opened its shiny new doors to the public. Officially launched on Monday February 23rd, 2009, the permanent exhibition at Point 1 was conceived as a tour resource for ATLAS guides, and as a way to preserve the public’s opportunity to get a close-up look at the experiment in action when the cavern is sealed.

  19. EPIDEMIOLOGICAL ANALYSIS AND CLINICAL CHARACTERISTICS OF TRAUMATIC BRAIN INJURIES IN RURAL JAIPUR: THE FIRST SINGLE CENTRE EXPERIENCE

    Directory of Open Access Journals (Sweden)

    Pankaj

    2015-11-01

    Full Text Available BACKGROUND Trauma is one of the leading causes of death and disability in the Indian Population. OBJECTIVE To evaluate and describe the epidemiological and clinical characteristics of patients with traumatic brain injury and their clinical outcomes following admission to a rural tertiary care teaching hospital in India. STUDY DESIGN Retrospective, cross-sectional, hospital based analysis of 1713 patients of Traumatic Brain Injury [TBI] admitted to the Department of Neurosurgery in a tertiary health centre in Jaipur from January 2014 to August 2015. METHOD The medical records of all eligible patients were reviewed and data collected on age, sex, mechanism of injury, severity of injury Glasgow Coma Scale (GCS and Outcome (GOS score, Computed Tomography (CT scan results, modality of management and type of surgical intervention and outcome. RESULTS Among the 1713 patients admitted, age of patients varied >1 year to 92 years (mean age 21 years, majority of TBI’s were reported in the age group 20–29 years (34.38%, followed by 30–39 years (26.97%, 40–49 years (16.70%, p value <0.05. Most of the patients were male (63.46%, mostly unmarried. Majority lived in sub-urban areas (51.26% followed by rural (26.85% and urban (21.89%. Patients were mostly from middle class (46.58% and poor socio-economic background (42.62%, upper class only accounted for 10.8% of the cases. In terms of occupation, servicemen and farmers accounted for the majority (54.73%. Patients were brought to the hospital mainly by known persons (68% and rest by bystanders and policemen. The most common mechanism of injury was road traffic accidents (RTA 1199 (69.99%, followed by assault 251 (14.65%, 15.35% accounted for fall from height and fall of object on head. Mean hospital stay was 7.6±9.3 days (range <1 day to 87 days. In our study, patients were classified by GCS as mild TBI in 983(57.38% patients; moderate in 488 (28.48% and severe in 242 (14.12. 1481 (86.46% patients

  20. Analysis of risk factors in the development of bronchopleural fistula after major anatomic lung resection: experience of a single centre.

    Science.gov (United States)

    Nachira, Dania; Chiappetta, Marco; Fuso, Leonello; Varone, Francesco; Leli, Ilaria; Congedo, Maria T; Margaritora, Stefano; Granone, Pierluigi

    2017-02-01

    The bronchopleural fistula (BPF) is a rare but potentially fatal complication of major thoracic surgery. The purpose of this work is to investigate the risk factors associated with the development of fistulas after lobectomy and pneumonectomy. We retrospectively reviewed the records of 835 patients who underwent major anatomic lung resection at our centre from January 2003 to December 2013. Of these, 49 underwent pneumonectomy (P group) and 786 lobectomy (L group). A total of 18 patients (2.6%) developed a BPF in the postoperative period, of which there were 11 in the L group (1.3%) and seven in the P group (14.28%). The 30-day mortality was 0.05% (one patient after right pneumonectomy). In the L group, three patients developed a fistula after a left lobectomy and eight after a right one, of which four developed after bilobectomy. Univariate analysis showed that induction therapy, lower lobectomy, manual suture of the bronchus, 'not covered' bronchial stump, empyema, postoperative anaemia and pulmonary infections and mechanical ventilation >24 h are associated with the development of fistulas after lobectomy. Multivariate analysis confirmed that induction therapy, manual closure of the bronchus, postoperative pulmonary infections and anaemia are the main risk factors involved in our series. In the P group, four patients developed a fistula after a right pneumonectomy and three after a left one. Postoperative empyema and pulmonary infections, mechanical ventilation >24 h and female gender emerged as the main risk factors on univariate analysis, while on multivariate analysis, only the female gender presented a trend towards significance. Postoperative pulmonary infections, empyema and mechanical ventilation >24 h are strongly associated with the development of BPFs after both pneumonectomy and lobectomy in our series. © 2017 Royal Australasian College of Surgeons.

  1. Error reporting from the da Vinci surgical system in robotic surgery: A Canadian multispecialty experience at a single academic centre

    Science.gov (United States)

    Rajih, Emad; Tholomier, Côme; Cormier, Beatrice; Samouëlian, Vanessa; Warkus, Thomas; Liberman, Moishe; Widmer, Hugues; Lattouf, Jean-Baptiste; Alenizi, Abdullah M.; Meskawi, Malek; Valdivieso, Roger; Hueber, Pierre-Alain; Karakewicz, Pierre I.; El-Hakim, Assaad; Zorn, Kevin C.

    2017-01-01

    Introduction The goal of the study is to evaluate and report on the third-generation da Vinci surgical (Si) system malfunctions. Methods A total of 1228 robotic surgeries were performed between January 2012 and December 2015 at our academic centre. All cases were performed by using a single, dual console, four-arm, da Vinci Si robot system. The three specialties included urology, gynecology, and thoracic surgery. Studied outcomes included the robotic surgical error types, immediate consequences, and operative side effects. Error rate trend with time was also examined. Results Overall robotic malfunctions were documented on the da Vinci Si systems event log in 4.97% (61/1228) of the cases. The most common error was related to pressure sensors in the robotic arms indicating out of limit output. This recoverable fault was noted in 2.04% (25/1228) of cases. Other errors included unrecoverable electronic communication-related in 1.06% (13/1228) of cases, failed encoder error in 0.57% (7/1228), illuminator-related in 0.33% (4/1228), faulty switch in 0.24% (3/1228), battery-related failures in 0.24% (3/1228), and software/hardware error in 0.08% (1/1228) of cases. Surgical delay was reported only in one patient. No conversion to either open or laparoscopic occurred secondary to robotic malfunctions. In 2015, the incidence of robotic error rose to 1.71% (21/1228) from 0.81% (10/1228) in 2014. Conclusions Robotic malfunction is not infrequent in the current era of robotic surgery in various surgical subspecialties, but rarely consequential. Their seldom occurrence does not seem to affect patient safety or surgical outcome. PMID:28503234

  2. Prognostic factors for long-term infliximab treatment in Crohn's disease patients: a 20-year single centre experience.

    Science.gov (United States)

    Billiet, T; Cleynen, I; Ballet, V; Ferrante, M; Van Assche, G; Gils, A; Vermeire, S

    2016-10-01

    The long-term efficacy of infliximab in patients with Crohn's disease is suboptimal. To study prognostic factors for real-life long-term effcacy of infliximab in Crohn's disease. All consecutive Crohn's disease patients treated with infliximab at a tertiary centre were retrospectively analysed. Only patients who received scheduled infliximab maintenance treatment were considered. Patient- and disease-related factors were used to identify independent predictors of infliximab failure-free survival using Cox proportional hazards regression. Of 1031 patients with Crohn's disease, 261 were eligible for inclusion. Median time on infliximab was 2.4 [IQR 1.4-4.7] years, and 65 (24.9%) patients experienced infliximab failure. Estimated 5-year infliximab failure-free survival was 65.9% (95% CI 58.3-73.5). Multivariate Cox regression identified disease duration ≥1 year (HR 2.5 (95% CI 1.2-5.2), P = 0.02), L1 disease location [HR 2.0 (1.1-3.5), P = 0.02], prior anti-TNF use [HR 2.3 (1.1-4.8), P = 0.03], haemoglobin infliximab failure-free survival. Stratifying patients into risk groups resulted in estimated 3-year infliximab failure-free survival rates ranging from 95.3% (94.2-96.4) to 26.3% (8.6-44.0) depending on the number of risk factors (P = 8 × 10(-13) ). This study identified several easy to obtain predictors of infliximab failure in patients with Crohn's disease, and these are in line with previous reports. Those with a high-risk profile for infliximab failure in whom infliximab initiation is considered, should be treated as early as possible making use of therapeutic drug monitoring. © 2016 John Wiley & Sons Ltd.

  3. Junctional ectopic tachycardia following repair of congenital heart defects-experience in multimodal management from a West African Centre.

    Science.gov (United States)

    Entsua-Mensah, Kow; Aniteye, Ernest; Sereboe, Lawrence Agyemang; Tettey, Mark Mawutor; Edwin, Frank; Tamatey, Martin; Delia, Ibrahim; Gyan, Kofi Bafoe

    2012-01-01

    Postoperative junctional ectopic tachycardia (JET) is a rare and transient phenomenon occurring after repair of congenital heart defects. Report on this arrhythmia in the subregion is rare. We set out to determine the incidence of this arrhythmia and review the treatment and outcomes of treatment in our centre. Retrospective search of the records of all patients aged 18 years and below admitted into the intensive care unit (ICU) following repair or palliation of a congenital heart defect over 5 years, from January 1, 2006 to December 31, 2010. A review of clinical notes, operative records, anaesthetic charts, cardiopulmonary bypass (CPB) records, nursing observation charts, electrocardiograms (ECGs) and out-patient follow-up records was undertaken. 510 children under 18 years were enlisted. 7 cases of postoperative JET were recorded, (1.37%). 184 (36.1%) of these were performed under CPB. All JET cases were from cases done under CPB, 3.8%. Median age was 3 years and median weight 11.3 kg. No patient was febrile at diagnosis. 4 patients had amiodarone administration, 5 had magnesium sulphate infusion, 2 patients had direct current shock (DCS) whilst 3 patients had all three therapeutic modalities. All patients had control of the arrhythmia with conversion to sinus rhythm and no recurrence. We report a JET incidence of 1.37% among children undergoing CPB for repair of congenital heart defects. We demonstrate the therapeutic effectiveness of amiodarone, magnesium sulphate infusions and DCS alone or in combination in the management of JET on various substrates with good outcome.

  4. Challenges in the management of extremity vascular injuries: A wartime experience from a tertiary centre in Sri Lanka

    Directory of Open Access Journals (Sweden)

    Weerasinghe CW

    2011-08-01

    Full Text Available Abstract Background Management of peripheral vascular injuries often present critical challenges in resource limited settings of developing countries. The additional burden from a military conflict poses further challenges. Delays in presentation often result in the loss of limb and even life, in what is usually a young active population. The objective of this report is to analyse the early outcome of vascular intervention at a tertiary referral centre in Sri Lanka. Methods A retrospective descriptive review of eighty one consecutive extremity vascular injuries in seventy patients during a seven month period was performed with regards to the cause of injury, types of presentations, ischaemia time, interventional procedures, complications and early outcome. Results Mean age was 31.2 years (9-72 years and 96% were males. Injuries were caused by blasts in 41%, cuts in 26%, gunshots in 17% and road traffic injuries in 9%. Indications for revascularization were acute ischaemia in 44%, active bleeding in 43% and pseudo-aneurysms in 13%. Six patients underwent primary amputations due to non-viable limbs. 64 patients underwent vascular intervention. Fifty one percent needed vein grafts while 46% had direct repairs. Bleeding was often (73% from upper extremity injuries. Median time to revascularization was 5.5 (2-16 hours with all limbs salvaged. Acute ischaemia (40% was often from popliteal injuries. Median time to revascularization was 10 (5-18 hours and viability was prejudged at fasciotomy. 92% of revascularized limbs were salvaged. There was no perioperative mortality. Conclusions Results from vascular repairs are encouraging despite significant delays.

  5. Preimplantation genetic diagnosis and screening by array comparative genomic hybridisation: experience of more than 100 cases in a single centre.

    Science.gov (United States)

    Chow, J Fc; Yeung, W Sb; Lee, V Cy; Lau, E Yl; Ho, P C; Ng, E Hy

    2017-04-01

    Preimplantation genetic screening has been proposed to improve the in-vitro fertilisation outcome by screening for aneuploid embryos or blastocysts. This study aimed to report the outcome of 133 cycles of preimplantation genetic diagnosis and screening by array comparative genomic hybridisation. This study of case series was conducted in a tertiary assisted reproductive centre in Hong Kong. Patients who underwent preimplantation genetic diagnosis for chromosomal abnormalities or preimplantation genetic screening between 1 April 2012 and 30 June 2015 were included. They underwent in-vitro fertilisation and intracytoplasmic sperm injection. An embryo biopsy was performed on day-3 embryos and the blastomere was subject to array comparative genomic hybridisation. Embryos with normal copy numbers were replaced. The ongoing pregnancy rate, implantation rate, and miscarriage rate were studied. During the study period, 133 cycles of preimplantation genetic diagnosis for chromosomal abnormalities or preimplantation genetic screening were initiated in 94 patients. Overall, 112 cycles proceeded to embryo biopsy and 65 cycles had embryo transfer. The ongoing pregnancy rate per transfer cycle after preimplantation genetic screening was 50.0% and that after preimplantation genetic diagnosis was 34.9%. The implantation rates after preimplantation genetic screening and diagnosis were 45.7% and 41.1%, respectively and the miscarriage rates were 8.3% and 28.6%, respectively. There were 26 frozen-thawed embryo transfer cycles, in which vitrified and biopsied genetically transferrable embryos were replaced, resulting in an ongoing pregnancy rate of 36.4% in the screening group and 60.0% in the diagnosis group. The clinical outcomes of preimplantation genetic diagnosis and screening using comparative genomic hybridisation in our unit were comparable to those reported internationally. Genetically transferrable embryos replaced in a natural cycle may improve the ongoing pregnancy rate

  6. Implantable cardioverter defibrillator therapy in paediatric practice: a single-centre UK experience with focus on subcutaneous defibrillation.

    Science.gov (United States)

    Griksaitis, Michael J; Rosengarten, James A; Gnanapragasam, James P; Haw, Marcus P; Morgan, John M

    2013-04-01

    Sudden cardiac death (SCD) risk can be managed by implantable cardioverter defibrillators (ICD). Defibrillation shocks can be delivered via ICD generator and/or intracardiac or subcutaneous coil configurations. We present our single-centre use of childhood ICDs. Twenty-three patients had ICD implantation, with median age and weight of 12.96 years and 41.35 kg. Indications included eight long QT; four hypertrophic cardiomyopathy; three Brugada syndrome; two idiopathic ventricular fibrillation; two post-congenital heart repair; two family history of SCD with abnormal repolarization; one catecholaminergic polymorphic ventricular tachycardia; and one left ventricle non-compaction. Twelve had out of hospital cardiac arrests prior to implantation. Techniques included 13 conventional ICD implants (pre-pectoral device with endocardial leads), 7 with subcutaneous defibrillation coils (sensing via epicardial or endocardial leads tunnelled to the ICD), and 3 with exclusive subcutaneous ICD (sensing and defibrillation via the same subcutaneous lead). Satisfactory defibrillation efficacy and ventricular arrhythmia sensing was confirmed at implantation. Follow-up ranged from 0.17 to 11.08 years. One child died with the ICD in situ. Ten children received appropriate shocks; five on more than one occasion. Five received inappropriate shocks (for inappropriate recognition of sinus tachycardia or supraventricular tachycardia). Five children underwent six further interventions; all had intracardiac leads. Innovative shock delivery systems can be used in children requiring an ICD. The insertion technique and device used need to accommodate the age and weight of the child, and concomitant need for pacing therapy. We have demonstrated effective defibrillation with shocks delivered via configurations employing subcutaneous coils in children.

  7. Experiences of patients and service providers with out-patient rehabilitation services in a rehabilitation centre in the Western Cape Province

    Directory of Open Access Journals (Sweden)

    Anne Kumurenzi

    2015-02-01

    Full Text Available Background: Rehabilitation is important for persons with disabilities as it contributes to their sense of autonomy, self-worth and social participation, and improves their quality of life. Improving the quality of rehabilitation services requires the dialogue of patients’ perceptions with those of service providers, in order to recommend informed reform. Objective: The objective was to explore the experiences of persons with physical disabilities and service providers, regarding the multi-disciplinary rehabilitation services provided at a community-based out-patient rehabilitation centre. Methods: A qualitative, exploratory study design was used to collect the data. A focus group was conducted with conveniently selected persons with physical disabilities. Three in-depth interviews were conducted with purposively selected key informants. All ethical considerations were adhered to during the implementation of the study.Results: Patients and service providers had different experiences regarding accessibility to rehabilitation services, and similar experiences with patient education and intensity of rehabilitation. Although the patients experienced that the service providers had sufficient knowledge and skills to manage them, services providers expressed that they lacked certain skills.Conclusions: The experiences expressed highlighted the need to improve rehabilitation services in terms of increasing the capacity of service providers and providing transport services for persons with disabilities.

  8. formes histologiques particulieres du cancer du nasopharynx

    African Journals Online (AJOL)

    19 déc. 2007 ... paroi latérale droite du cavum et de la face postérieure du palais mou avec refoulement en bas et en dedans de l'amygdale droite sans adénopathies .... des difficultés liées à la localisation anatomique du naso- pharynx, et à la nature infiltrante et extensive de ce type de tumeur ce qui expose au risque de ...

  9. Hadron production in nuclear collisions from the NA49 experiment at 158GeV/c centre dot A

    CERN Document Server

    Siklér, F; Barna, D; Barnby, L S; Bartke, Jerzy; Barton, R A; Betev, L; Bialkowska, H; Billmeier, A; Blume, C; Blyth, C O; Boimska, B; Bracinik, J; Brady, F P; Brun, R; Buncic, P; Carr, L; Cebra, D; Cooper, G E; Cramer, J G; Csató, P; Eckardt, V; Eckhardt, F; Ferenc, D; Fischer, H G; Fodor, Z; Foka, P; Freund, P; Friese, V; Ftácnik, J; Gál, J; Ganz, R E; Gazdzicki, M; Gladysz-Dziadus, E; Grebieszkow, J; Harris, J W; Hegyi, S; Hlinka, V; Höhne, C; Igo, G; Ivanov, M; Jacobs, P; Janik, R; Jones, P G; Kadija, K; Kolesnikov, V I; Kowalski, M; Lasiuk, B; Lednicky, R; Lévai, Peter; Malakhov, A I; Margetis, S; Markert, C; Mayes, B W; Melkumov, G L; Molnár, J; Nelson, J M; Odyniec, Grazyna Janina; Oldenburg, M; Pálla, G; Panagiotou, A D; Petridis, A; Pikna, M; Pinsky, L; Poskanzer, A M; Prindle, D J; Pühlhofer, F; Reid, J G; Renfordt, R E; Retyk, W; Ritter, H G; Röhrich, D; Roland, C; Roland, G; Rybicki, A; Sammer, T; Sandoval, A; Sann, H; Semenov, A Yu; Schäfer, E; Schmitz, N; Seyboth, P; Sitár, B; Skrzypczak, E; Snellings, R; Squier, G T A; Stock, R; Strmen, P; Ströbele, H; Susa, T; Szarka, I; Szentpétery, I; Sziklai, J; Toy, M; Trainor, T A; Trentalange, S; Ullrich, T; Varga, D; Vassiliou, Maria; Veres, G I; Vesztergombi, G; Voloshin, S A; Vranic, D; Wang, F; Weerasundara, D D; Wenig, S; Whitten, C; Xu, N; Yates, T A; Yoo, I K; Zimányi, J

    1999-01-01

    With its large acceptance and particle identification coverage the NA49 experiment (Fig. 1) can study hadron production in a wide range of high energy reactions [1]. Originally aimed at examining central Pb+Pb collisions for signatures of quark-gluon plasma formation, the scope of the experiment has been enhanced with a systematic study of impact parameter and projectile size dependence, as well as the inclusion of the more elementary p+p and p+A interactions. The question is: are predicted signals of the quark-gluon plasma observed and are there discontinuities which would support the concept of hadronic phase transition?

  10. In-situ experiments for the determination of rock properties and behaviour at the Meuse/Haute Marne Centre

    Directory of Open Access Journals (Sweden)

    Conil N.

    2010-06-01

    Full Text Available Andra is in charge of studying the feasibility of a disposal facility for longlived high-level nuclear waste (LL-HLW in a deep geological environment. With this aim, dedicated experiments have been carried out for several years at the Meuse/Haute Marne Underground Research Laboratory excavated in a 500 m deep argillaceous rock formation. These experiments include determining the feasibility of the excavation of disposal cells for LL-HLW, consisting of 40 meter long, 70 cm in diameter, horizontal cased micro tunnels. The hydro mechanical impact of the excavation of such openings on the rock mass behaviour is continuously monitored as well as their mean term mechanical behaviour. Since LL-HLW produce heat, the impact of temperature on the surrounding rock mass and on the micro tunnel steel casing will also be studied. Specific instrumentation has been developed to study this impact. The first step of the microtunnel excavation tests, carried out in 2009, has led to improving the excavation method and the drilling machine. These improvements will be tested in the next step of the excavation tests planned for 2010. The THM experiment dedicated to studying the behaviour of the rock mass under thermal solicitation started early 2010. The behaviour of a steel casing in contact with the rock mass and under thermal solicitation will be studied in an experiment scheduled to start in September 2010.

  11. GSI Helmholz Centre for Heavy Ion Research - ALFA: Next generation concurrent framework for ALICE and FAIR experiments

    CERN Multimedia

    CERN. Geneva

    2015-01-01

    FAIR is a new, unique international accelerator facility for the research with antiprotons and ions. It is being built at the GSI Darmstadt in Hesse, Germany. The commonalities between the ALICE and FAIR experiments and their computing requirements led to the development of a common software framework in an experiment independent way; ALFA (ALICE-FAIR framework). ALFA is designed for high quality parallel data processing and reconstruction on heterogeneous computing systems. It provides a data transport layer and the capability to coordinate multiple data processing components. ALFA is a flexible, elastic system which balances reliability and ease of development with performance by using a message based multi-processing in addition to multi-threading. The framework allows for usage of heterogeneous computing architectures by offloading (portions of code are accelerated on the device) or natively (where the full program is executed on the device ).

  12. Cri du chat syndrome

    Science.gov (United States)

    ... this page: //medlineplus.gov/ency/article/001593.htm Cri du chat syndrome To use the sharing features on this page, please enable JavaScript. Cri du chat syndrome is a group of symptoms that result from ...

  13. Assumption Centred Modelling of Ecosystem Responses to CO2 at Six US Atmospheric CO2 Enrichment Experiments.

    Science.gov (United States)

    Walker, A. P.; De Kauwe, M. G.; Medlyn, B. E.; Zaehle, S.; Luus, K. A.; Ryan, E.; Xia, J.; Norby, R. J.

    2015-12-01

    Plant photosynthetic rates increase and stomatal apertures decrease in response to elevated atmospheric CO[2] (eCO2), increasing both plant carbon (C) availability and water use efficiency. These physiological responses to eCO2 are well characterised and understood, however the ecological effects of these responses as they cascade through a suite of plant and ecosystem processes are complex and subject to multiple interactions and feedbacks. Therefore the response of the terrestrial carbon sink to increasing atmospheric CO[2] remains the largest uncertainty in global C cycle modelling to date, and is a huge contributor to uncertainty in climate change projections. Phase 2 of the FACE Model-Data Synthesis (FACE-MDS) project synthesises ecosystem observations from five long-term Free-Air CO[2] Enrichment (FACE) experiments and one open top chamber (OTC) experiment to evaluate the assumptions of a suite of terrestrial ecosystem models. The experiments are: The evergreen needleleaf Duke Forest FACE (NC), the deciduous broadleaf Oak Ridge FACE (TN), the prairie heating and FACE (WY), and the Nevada desert FACE, and the evergreen scrub oak OTC (FL). An assumption centered approach is being used to analyse: the interaction between eCO2 and water limitation on plant productivity; the interaction between eCO2 and temperature on plant productivity; whether increased rates of soil decomposition observed in many eCO2 experiments can account for model deficiencies in N uptake shown during Phase 1 of the FACE-MDS; and tracing carbon through the ecosystem to identify the exact cause of changes in ecosystem C storage.

  14. From margins to centre: an oral history of the wartime experience of Iranian nurses in the Iran-Iraq War, 1980-1988.

    Science.gov (United States)

    Peyrovi, Hamid; Parsa-Yekta, Zohreh; Vosoughi, Mohammad Bagher; Fathyian, Nasrollah; Ghadirian, Fataneh

    2015-01-01

    The extensive nature of the Iraq-Iran war converted to a human tragedy with large casualties; it has affected nursing discipline dramatically. To analyse the history of the wartime experience of Iranian nurses in Iran-Iraq War. The current study was conducted with oral history. The study sample consisted of 13 Iranian nurses who served in the war zones during the wartime. Purposive and snowball sampling were used to recruit the participants. During the face-to-face interviews, participants were asked to describe their experience in the war zones during the war years. Data collection and analysis took place from April to August 2013, when saturation was reached. All interviews were tape recorded and transcribed and then analysed with thematic content analysis. Finally, five themes and 18 subthemes emerged from data analysis of significant statements from 17 interviews. The five emerged themes included (1) 'From margin to centre', (2) 'Development of referral care', (3) 'Personal and professional growth and development', (4) 'The emerging pillar of culture in war nursing' and (5) 'Threats to nursing at the war'. Nursing in Iran at wartime has a difficult path to development. There are powerful implications for clinical practice. It is recommended to continue collection, archiving and analysing the wartime experiences of Iranian nurses.

  15. Au fond de la logique du lieu.

    Directory of Open Access Journals (Sweden)

    Augustin Berque

    2009-03-01

    Full Text Available L’école de Kyôto ( Kyôto gakuha est cette mouvance philosophique, née dans l’entre-deux-guerres, dont le Nihonshi jiten ( Dictionnaire historique du Japon des éditions Iwanami donne la présentation suivante : 1 École centrée sur la Faculté de philosophie de l’Université de Kyôto dans les années Taishô et Shôwa. Elle débuta autour de Nishida Kitarô et de Tanabe Hajime, mais on la connaît plutôt du fait que peu après le début de la guerre du Pacifique, en 1942, ...

  16. Radiotherapy for carcinomas of the anal canal Tenon hospital experience; Traitement des cancers du canal anal par irradiation experience de l'hopital Tenon

    Energy Technology Data Exchange (ETDEWEB)

    Touboul, E.; Moureau-Zabotto, L.; Lerouge, D.; Pene, F.; Deniaud-Alexandre, E.; Schlienger, M.; Laugier, A. [Hopital Tenon, Service d' Oncologie-Radiotherapie, 75 - Paris (France); Tiret, E.; Parc, R. [Hopital Saint Antoine, Service de Chirurgie Digestive, 75 - Paris (France); Sezeur, A. [Hopital des Diaconesses, Service de Chirurgie Generale, 75 - Paris (France); Houry, S. [Hopital Tenon, Service de Chirurgie Digestive, 75 - Paris (France); Gallot, D. [Groupe Hospitalier Bichat Claude-Bernard, Service de Chirurgie Generale et Digestive B, 75 - Paris (France)

    2003-11-01

    Since 1980, curative-intent radiation therapy of epidermoid carcinoma of the anal canal is the standard first line treatment. The combined concomitant chemotherapy and radiation therapy is presently established for locally advanced tumors more than 4 cm in length and/or with nodal involvement. We report the Tenon hospital experience since 1972 concerning the long term results after radiation therapy, the modifications of the radiation technique, and the evolution of treatment strategy. (author)

  17. Localized fast neutron flux enhancement for damage experiments in a research reactor; Accroissement local du flux rapide pour des experiences de dommages dans un reacteur de recherche

    Energy Technology Data Exchange (ETDEWEB)

    Malouch, F

    2003-06-01

    In irradiation experiments on materials in the core of the Osiris reactor (CEA-Saclay) we seek to increase damage in irradiated samples and to reduce the duration of their stay in the core. Damage is essentially caused by fast neutrons (E {>=} 1 MeV); we have therefore pursued the possibility of a localized increase of their level in an irradiation experiment by using a flux converter device made up of fissile material arranged according to a suitable geometry that allows the converter to receive experiments. We have studied several parameters that are influential in the increase of fast neutron flux within the converter. We have also considered the problem of the converter's cooling in the core and its effect on the operation of the reactor. We have carried out a specific neutron calculation scheme based on the modular 2D-transport code APOLLO2 using a two-level transport method. Experimental validation of the flux calculation scheme was carried out in the ISIS reactor, the mock-up of OSIRIS, by optimizing the loading of fuel elements in the core. The experimental results show that the neutron calculation scheme computes the fluxes in close agreement with the measurements especially the fast flux. This study allows us to master the essential physical parameters needed for the design of a flux converter in an MTR reactor. (author)

  18. La collection mondiale du bananier au Centre de Transit de l'INIBAP à la KULeuven : stratégies de conservation et mode d'opération

    Directory of Open Access Journals (Sweden)

    Ines Van den houwe

    1998-01-01

    Full Text Available The world collection of Musa germplasm in the INIBAP Transit Centre at the Catholic University of Leuven conservation strategies and mode of operation.The conservation and international transfer of Musa germplasm is a core activity of the International Network for the Improvement of Banana and Plantain (INIBAP. To this end, INIBAP established a Transit Centre (ITC at the Laboratory of Tropical Crop Improvement of K.U.Leuven in Belgium, a non banana producing country. Plant material from all over the world is deposited at ITC. This global collection of banana and plantain germplasm, comprising approximately 1 100 accessions, is held under the auspices of FAO. The in vitro active collection is stored under slow growth conditions (low illumination and reduced temperature. In order to safeguard the material for the long terni, cryopreservation protocole for banana meristems have been developed. Samples of virus-tested clones are available freely and at no cost from the ITC gene batik on request. Since 1985, over 5 000 samples of accessions have been distributed worldwide to interested parties for specific research, breeding and evaluation, and production. A major constraint for the efficient use of the Musa collection is the limited information available on the genetic resources maintained. Through INIBAP's Musa Germplasm Information System (MGIS, passport, characterization and evaluation data on existing collections worldwide are being assembled to enhance the knowledge on Musa diversity, rationalize conservation and improve the use by curators, breeders and scientiste

  19. CALIBRATION ET VALIDATION DU MODULE PHOSPHORE DU ...

    African Journals Online (AJOL)

    RECOMMANDATIONS SPECIFIQUES D'ENGRAIS: CALIBRATION ET VALIDATION DU MODULE PHOSPHORE DU MODELE NuMaSS. M. D. Doumbia, A. Sidibé, A. Bagayoko, M. A. Diarra, A. Bationo, R. A. Kablan, R. S. Yost, L. R. Hossner, F. M. Hons ...

  20. Oesophageal manometry: 10-year audit from a specialist centre, and early experience with high-resolution manometry.

    Science.gov (United States)

    Moran, T; Lawlor, P; Brennan, M; Ravi, N; Reynolds, J V

    2015-06-01

    Manometry is the gold standard investigation of innate or acquired motility disorders in the oesophagus. New technology in the form of high-resolution manometry (HRM) may supplant traditional water-perfused manometry and enhance standardisation of manometric interpretation and reporting. This study reports on a 10-year experience of 5,184 consecutive patients using the traditional methods, and an early experience with HRM. Of 5,184 patients assessed, 4,509 (87%) had both pH and manometry and 675 (13%) had manometry only. 3,523 (78%) of the pH /manometry group had normal motility, 635 (14%) showed ineffective motility (IM), 213 (5%) a non-specific motility disturbance (NSMD), 42 (0.9%) achalasia, 58 (1.3%) nutcracker oesophagus, 22 (0.5%) hypertensive LOS (HLOS), 8 (0.2%) diffuse oesophageal spasm (DOS) and 8 (0.2 %) had scleroderma. For those referred solely for manometry only, 324 (48%) had normal motility, 72 (11%) IM, 51 (8%) NSMD, 175 (26%) achalasia, 16 (2%) nutcracker oesophagus, 32 (5%) HLOS, 1 (0.1%) DOS and 4 (0.6%) had scleroderma. 92 patients to date have been studied with HRM, with enhanced definition of lower oesophageal sphincter (LOS) function. For patients referred for reflux related symptoms, motility disorders are present in 22% of the cases. Conversely, of the patients referred for dysphagia, motility disturbances are detected in 52% of the cases sent for manometry. Our initial experience shows that HRM technology is adding a valuable dimension and clearer understanding of motility patterns in the dysphagic patient.

  1. COMPLICATIONS OF ENDONASAL ENDOSCOPIC TRANSSPHENOIDAL APPROACH FOR PITUITARY ADENOMAS: OUR EXPERIENCE IN 50 PATIENTS TREATED AT OUR TERTIARY CENTRE

    Directory of Open Access Journals (Sweden)

    Mani Ram

    2015-12-01

    Full Text Available INTRODUCTION Between September 2013 and October 2014, we conducted a retrospective analysis to assess the complications related to endoscopic pituitary surgery in a series of 50 patients. We analysed the complications in preoperative, postoperative and endocrinological categories. We had a follow up of 1-2 years. Endonasal endoscopic transsphenoidal surgery (ETSS is an effective option for pituitary tumors. Complications do occur, but they can be reduced with experience & expertise and there is a steep learning curve. It demands a multidisciplinary approach.

  2. Experiences and Lessons Learnt with Collaborative e-Research Infrastructure and the application of Identity Management and Access Control for the Centre for Environmental Data Analysis

    Science.gov (United States)

    Kershaw, P.

    2016-12-01

    CEDA, the Centre for Environmental Data Analysis, hosts a range of services on behalf of NERC (Natural Environment Research Council) for the UK environmental sciences community and its work with international partners. It is host to four data centres covering atmospheric science, earth observation, climate and space data domain areas. It holds this data on behalf of a number of different providers each with their own data policies which has thus required the development of a comprehensive system to manage access. With the advent of CMIP5, CEDA committed to be one of a number of centres to host the climate model outputs and make them available through the Earth System Grid Federation, a globally distributed software infrastructure developed for this purpose. From the outset, a means for restricting access to datasets was required, necessitating the development a federated system for authentication and authorisation so that access to data could be managed across multiple providers around the world. From 2012, CEDA has seen a further evolution with the development of JASMIN, a multi-petabyte data analysis facility. Hosted alongside the CEDA archive, it provides a range of services for users including a batch compute cluster, group workspaces and a community cloud. This has required significant changes and enhancements to the access control system. In common with many other examples in the research community, the experiences of the above underline the difficulties of developing collaborative e-Research infrastructures. Drawing from these there are some recurring themes: Clear requirements need to be established at the outset recognising that implementing strict access policies can incur additional development and administrative overhead. An appropriate balance is needed between ease of access desired by end users and metrics and monitoring required by resource providers. The major technical challenge is not with security technologies themselves but their effective

  3. The construction of work–life balance: The experience of Black employees in a call-centre environment

    Directory of Open Access Journals (Sweden)

    Sonia C.B. Potgieter

    2010-03-01

    Full Text Available Orientation: Work–life balance, as a crucial aspect of employee and organisational wellness, remains an interesting field of research, especially due to the changing demographic employee profile.Research purpose: The objective of the study was to explore Black employees’ construction of work–life balance in a customer care environment.Motivation for the study: The conceptual debate regarding the construct of work–life balance in general as well as limited qualitative research with regard to Black employees’ experience of work–life balance in a South African context motivated the study.Research design, approach and method: This qualitative study was designed from an interpretivist perspective. Ten employees, selected through purposeful sampling, participated in the study. Data was gathered through in-depth interviews and grounded theory was applied during data analysis.Main findings: The grounded theory analysis of the data yielded six themes central to participants’ construction of work–life balance. The findings suggest that work–life balance is conceptualised as a continuous, subjective and holistic valuation of satisfaction derived from multiple roles in relation to the importance to the individual at a given point in time.Practical/managerial implications: Findings provide valuable managerial information to guide suitable strategies enhancing the work–life balance experience and by implication employees’ general wellbeing, job satisfaction and commitment.Contributions/value-add: This study contributes to the evolving body of knowledge with regard to work–life balance and provides a unique context-specific perspective to the conceptual understanding of the construct.

  4. CATERING STUDENTS' NEEDS TO PROMOTE AESTHETIC EXPERIENCE IN EFL LITERATURE CLASS WITH REFERENCE TO RESPONSE-CENTRED CURRICULUM

    Directory of Open Access Journals (Sweden)

    Ishkak Said

    2015-02-01

    Full Text Available The success of literature instruction is dependent upon not only the teaching strategies, but also the well-developed curriculum, which accommodates student needs. Teaching practice of literature in the multicultural contexts has to do with teachers' belieft in approaching to their day-to-day practice endowed in the curriculum they are concerned with. In this respect, the existing literature curricula should ideally reflect aesthetic experiences that enhance students' freedom and enjoyment with literary works assigned The present study examines how three case High School English teachers from different sites with different multicultural entities in West Java, Indonesia, developed literature curricula in such a way that their students got 'free room' to express what they wanted and needed to say and to do. Following the traditions of a qualitative multi-case and -site study, the present study investigated the process of teaching literature in language studies streams of the three sites by occupying classroom observation and interview, and administering questionnaires as well. The findings revealed that, in their classroom practices, the three cases endeavored to cater their students' needs through developing negotiated response-based literature curriculum that led to varied and unique activities in the forms of celebrations showing their personal engagements in responding to.Jiterature assigned. Yet, their different schooling systems and contextual factors, and the subjects' perspectives in literature pedagogy and their lived-through literary. reading experiences, have made each case indicate typical and unique phenomena, which is in accordance with the spirit of school-based curriculum.

  5. Undergraduates' self-reported clinical experience, confidence and perspectives of hospital and outreach paediatric dentistry: a three-year multi-centre evaluation.

    Science.gov (United States)

    Walley, S; Bailey, J R; Albadri, S; Mackie, I C; Gilchrist, F; Rodd, H D

    2014-03-01

    A variety of educational approaches exist within U.K. dental schools, and institutions are constantly striving to improve the quality of their graduates. This study aimed to evaluate the self-reported confidence in, and clinical exposure to, paediatric dentistry at three U.K. dental schools (Liverpool, Manchester and Sheffield) over a three year period. Seventy-five percent of final year BDS undergraduates at the three dental schools completed an anonymous questionnaire capturing student self-reported clinical experience in seven core paediatric dentistry treatment skills, both in hospital and outreach settings. Visual analogue scales were used to record self-assessed confidence levels in aspects of paediatric dentistry and students were also asked to provide a written reflection of both their hospital and outreach placements. The results revealed that despite the variety of educational approaches taken, undergraduates reported very similar levels of clinical experience and confidence. Significant interschool differences in student experience were found with respect to the management of carious primary molars, believed to be a result of individual schools favouring different treatment regimes. Although outreach placements were seen as essential for gaining adequate student experience, the need to improve the consistency of teaching between hospital and outreach centres was highlighted. The study also emphasises the need to take care when using clinical targets in undergraduate teaching and identifies the potential benefits of undergraduate training in inhalation sedation. Finally, despite changes to the paediatric programmes with respect to dental trauma management, students remained lacking in confidence suggesting the need for further development.

  6. The ideal Atomic Centre; Le Centre Atomique ideal

    Energy Technology Data Exchange (ETDEWEB)

    Mas, R. [Commissariat a l' Energie Atomique, Saclay (France). Centre d' Etudes Nucleaires

    1965-07-01

    The author presents considerations which should prove to be of interest to all those who have to design, to construct and to operate a nuclear research centre. A large number of the ideas presented can also be applied to non-nuclear scientific research centres. In his report the author reviews: various problems with which the constructor is faced: ground-plan, infrastructure, buildings and the large units of scientific equipment in the centre, and those problems facing the director: maintenance, production, supplies, security. The author stresses the relationship which ought to exist between the research workers and the management. With this aim in view he proposes the creation of National School for Administration in Research which would train administrative executives for public or private organisations; they would be specialised in the fields of fundamental or applied research. (author) [French] L'auteur propose une base de reflexions a tous ceux qui doivent concevoir, realiser et faire vivre un Centre d'Etudes Nucleaires. Un grand nombre des idees exprimees peut d'ailleurs s'appliquer a un Centre d'Etudes Scientifiques non nucleaires. Dans son ouvrage, l'auteur passe en revue les differents problemes qui se posent au constructeur: plan, masse, infrastructure, batiments et grands appareils du Centre, et ceux qu'a a resoudre le directeur: entretien, fabrication, approvisionnements, securite. L'auteur insiste sur l'aspect des rapports qui doivent exister entre les chercheurs et ceux qui les administrent. Il propose a cette fin la creation d'une Ecole Nationale d'Administration de la Recherche qui formerait des cadres administratifs pour les organismes publics ou prives, specialises dans la Recherche fondamentale ou appliquee. (auteur)

  7. Interprofessional experiences of recent healthcare graduates: A social psychology perspective on the barriers to effective communication, teamwork, and patient-centred care.

    Science.gov (United States)

    Thomson, Krist; Outram, Sue; Gilligan, Conor; Levett-Jones, Tracy

    2015-01-01

    Achieving safe, quality health care is highly dependent on effective communication between all members of the healthcare team. This study explored the attitudes and experiences of recent healthcare graduates regarding interprofessional teamwork and communication within a clinical setting. A total of 68 pharmacy, nursing, and medicine graduates participated in 12 semi-structured focus group discussions in clinical workplaces across three Australian states. Discussion focussed on graduates' experiences of interprofessional education and its impact on their capacity for interprofessional teamwork and communication. The Social Identity and Realistic Conflict theories were used as a framework for qualitative data analysis. A consistent pattern of profession-focussed, rather than patient- or team-focussed goals was revealed along with reports of negative stereotyping, hierarchical communication, and competition for time with the patient. Graduates acknowledged the importance of communication, teamwork, and patient-centred care and felt a better understanding of the roles of other health professionals would assist them to work together for patients' wellbeing. Identifying workplace identities and differential goals has uncovered possible motivations underlying health professionals' behaviour. These insights may help improve interprofessional collaboration by focusing attention on common team goals, increasing feelings of worth and being valued among different professionals, and decreasing the need for competition.

  8. Organ retrieval and banking in brain dead trauma patients: Our experience at level-1 trauma centre and current views

    Science.gov (United States)

    Sawhney, Chhavi; Kaur, Manpreet; Lalwani, Sanjeev; Gupta, Babita; Balakrishnan, Ira; Vij, Aarti

    2013-01-01

    Background: Organ retrieval from brain dead patients is getting an increased attention as the waiting list for organ recipients far exceeds the organ donor pool. In our country, despite a large population the number of brain dead donors undergoing organ donation is very less (2% in our study). Aims: The present study was undertaken to address issues related to organ donation and share our experience for the same. Methods: A retrospective case record analysis of over 5 years from September 2007 to August 2012 was performed and the patients fulfilling brain death criterion as per Transplantation of Human Organs and Tissue (Amendment) Act were included. Patient demographics (age, sex), mode of injury, time from injury to the diagnosis of brain death, time from diagnosis of brain death to organ retrieval and complications were analysed. Statistics Analysis: Student's t test was used for parametric data and Chi square was used for categorical data. Results: Out of 205 patients who were identified as brain dead, only 10 patients became potential organ donors. Conclusion: Aggressive donor management, increasing public awareness about the concept of organ donation, good communication between clinician and the family members and a well-trained team of transplant coordinators can help in improving the number of organ donations. PMID:23983281

  9. Mycophenolate mofetil in low-risk renal transplantation in patients receiving no cyclosporine: a single-centre experience.

    LENUS (Irish Health Repository)

    2012-02-01

    BACKGROUND: We assess our long-term experience with regards the safety and efficacy of Mycophenolate Mofetil (MMF) in our low risk renal transplant population and compared it retrospectively to Azathioprine (AZA) immunosuppressive regimen. Patients and methods. Between January 1999 and December 2005, 240 renal transplants received MMF as part of their immunosuppressive protocol (MMF group). AZA group of 135 renal transplants was included for comparative analysis (AZA group). Patients received Cyclosporine was excluded from this study. RESULTS: The incidence of biopsy proven 3-month acute rejections was 30 (12.5%) in MMF group and 22 (16%) in AZA group respectively (P = 0.307). Patient survival rates at 1 and 5 years for the MMF group were 97 and 94%, respectively, compared to 100% and 91% at 1 and 5 years respectively for the AZA group (P = 0.61). Graft survival rates at 1 and 5 years for the MMF group were 95 and 83%, respectively, compared to 97 and 84% at 1 and 5 years, respectively for the AZA group (P = 0.62). CONCLUSION: There was no difference in acute rejection episodes between MMF and AZA based immunotherapy. Additionally, we observed no significant difference concerning graft survival in the MMF group when compared to AZA group.

  10. Multi-disciplinary management of complex pressure sore reconstruction: 5-year review of experience in a spinal injuries centre.

    Science.gov (United States)

    Thomson, C H; Choudry, M; White, C; Mecci, M; Siddiqui, H

    2017-02-01

    INTRODUCTION In our regional spinal injuries unit, complex pressure ulcer reconstruction is facilitated by a monthly multidisciplinary team clinic. This study reviews a series of the more complex of these patients who underwent surgery as a joint case between plastics and other surgical specialties, aiming to provide descriptive data as well as share the experience of treating these complex wounds. MATERIALS AND METHODS Patients operated on as a joint case from 2010 to 2014 were identified through a locally held database and hospital records were then retrospectively reviewed for perioperative variables. Descriptive statistics were collected. RESULTS 12 patients underwent 15 procedures as a joint collaboration between plastic surgery and other surgical specialties: one with spinal surgery, 12 with orthopaedic and two with both orthopaedic and urology involvement. Ischial and trochanteric wounds accounted for 88% of cases with five Girdlestone procedures being performed and 12 requiring soft-tissue flap reconstruction. Mean operative time was 3.8hours. Four patients required high-dependency care and 13 patients received long-term antibiotics. Only three minor complications (20%) were seen with postoperative wound dehiscence. DISCUSSION The multidisciplinary team clinic allows careful assessment and selection of patients appropriate for surgical reconstruction and to help match expectations and limitations imposed by surgery, which are likely to influence their current lifestyle in this largely independent patient group. Collaboration with other specialties gives the best surgical outcome both for the present episode as well as leaving avenues open for potential future reconstruction.

  11. Our experience using primary oral antibiotics in the management of orbital cellulitis in a tertiary referral centre.

    Science.gov (United States)

    Cannon, P S; Mc Keag, D; Radford, R; Ataullah, S; Leatherbarrow, B

    2009-03-01

    Orbital cellulitis is conventionally managed by intravenous (i.v.) antibiotic therapy, followed by oral antibiotics once the infection shows signs of significant improvement. We report 4 years of experience using primary oral ciprofloxacin and clindamycin in cases of orbital cellulitis. Oral ciprofloxacin and clindamycin have a similar bioavailability to the i.v. preparations and provide an appropriate spectrum of antibiotic cover for the pathogens responsible for orbital cellulitis. A retrospective review was performed that identified all patients with orbital cellulitis and treated with primary oral antibiotic therapy admitted to the Manchester Royal Eye Hospital between March 2003 and March 2007. Age, stage of disease, surgical intervention, hospital duration, and complications were obtained. A comparison was made with patients admitted to our unit with orbital cellulitis and treated with primary i.v. antibiotics between March 2000 and March 2003. Nineteen patients were included in the review for the period March 2003 to March 2007, which comprised of 7 children and 12 adults. Five patients required surgical intervention. All patients responded to the oral regimen, 18 patients had no change to their oral antibiotic therapy. Mean hospital stay was 4.4 days. There were no complications. Empirical oral ciprofloxacin and clindamycin combination may be as safe and effective as i.v. therapy in the management of orbital cellulitis. Oral treatment can offer the advantages of rapid delivery of the first antibiotic dose, fewer interruptions in treatment, and simplified delivery of medication particularly in children.

  12. End-of-life decision making: withdrawing from dialysis: a 12-year retrospective single centre experience from the UK.

    Science.gov (United States)

    Aggarwal, Y; Baharani, J

    2014-12-01

    Withdrawal from dialysis is a common mode of death in patients undergoing dialysis. Anecdotally most patients have a physician-directed dialysis withdrawal (DW) following an acute medical precipitant, rather than a patient-narrated planned withdrawal as part of a collaborative end-of-life care plan. We report a 12-year retrospective experience of patients undergoing dialysis who died following DW, and suggest clinical parameters which can be used to identify patients who are able to direct their end-of-life care process. Retrospective 12-year review of inhouse electronic and paper records. 867 patients undergoing dialysis died during the study period. 93 patients died from DW. 9 (10%) patients electively withdrew in the absence of an acute medical precipitant and 84(90%) withdrew from dialysis for medical reasons. Patients who chose to withdraw were 10 years younger at dialysis initiation and withdrawal, had greater reported sessional difficulties/intolerances (pdialysis (pdialysis withdrawn for medical reasons (pdialysis tolerance, cognitive decline, rehabilitation post an acute medical precipitant and, place of residence are parameters which differentiate between patients who choose to withdraw from dialysis and those who have dialysis withdrawn for medical reasons. These parameters can be used to identify terminal patients on dialysis who are able to be directive in their end-of-life advanced care planning. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  13. Mycophenolate mofetil in low-risk renal transplantation in patients receiving no cyclosporine: a single-centre experience.

    LENUS (Irish Health Repository)

    Raheem, Omer A

    2011-05-28

    BACKGROUND: We assess our long-term experience with regards the safety and efficacy of Mycophenolate Mofetil (MMF) in our low risk renal transplant population and compared it retrospectively to Azathioprine (AZA) immunosuppressive regimen. Patients and methods. Between January 1999 and December 2005, 240 renal transplants received MMF as part of their immunosuppressive protocol (MMF group). AZA group of 135 renal transplants was included for comparative analysis (AZA group). Patients received Cyclosporine was excluded from this study. RESULTS: The incidence of biopsy proven 3-month acute rejections was 30 (12.5%) in MMF group and 22 (16%) in AZA group respectively (P = 0.307). Patient survival rates at 1 and 5 years for the MMF group were 97 and 94%, respectively, compared to 100% and 91% at 1 and 5 years respectively for the AZA group (P = 0.61). Graft survival rates at 1 and 5 years for the MMF group were 95 and 83%, respectively, compared to 97 and 84% at 1 and 5 years, respectively for the AZA group (P = 0.62). CONCLUSION: There was no difference in acute rejection episodes between MMF and AZA based immunotherapy. Additionally, we observed no significant difference concerning graft survival in the MMF group when compared to AZA group.

  14. An evaluation of multimodal spinal cord monitoring in scoliosis surgery: a single centre experience of 354 operations.

    Science.gov (United States)

    Bhagat, S; Durst, A; Grover, H; Blake, J; Lutchman, L; Rai, A S; Crawford, R

    2015-07-01

    To evaluate the effectiveness of multimodal intraoperative neuromonitoring in the early detection of impending spinal cord injury during surgery for spinal deformity. A retrospective review of prospectively collected data in 354 consecutive spinal deformity operations from June 2003 to October 2013. Patients were sub-grouped according to demographics, diagnosis and operative features. Post-operative neurological deficit was defined as either spinal cord, nerve root or transient deficit. Combined monitoring with SSEPs and MEPs was possible in 315 cases. The overall incidence of significant alerts was 7.1 % and overall permanent neurological deficit was 1.6 %. When results were collated, the overall combined sensitivity of multimodal monitoring was 100 % with a specificity of 99.3 %. Multimodal monitoring allows early detection of impending neurological deficit that is superior to a single monitoring modality. To achieve optimal use of monitoring, continuous communication between surgical, anaesthetic and neurophysiology teams are required. As a result of our experience we have incorporated in our consent procedure the discussion of monitoring and the possibility of needing to abandon the procedure, and completing in a staged fashion at a later date. We believe multimodal monitoring is the current gold standard for complex spinal deformity surgery.

  15. Short-term side-effects of brain MR examination at 7 T: a single-centre experience

    Energy Technology Data Exchange (ETDEWEB)

    Cosottini, M. [University of Pisa, Department of Translational Research and New Technologies in Medicine and Surgery, Pisa (Italy); Frosini, D. [Santa Chiara Hospital, Unit of Neurology, Pisa (Italy); Biagi, L.; Tosetti, M. [IRCCS Stella Maris, Pisa (Italy); Pesaresi, I. [Santa Chiara Hospital, Unit of Neuroradiology, Pisa (Italy); Costagli, M.; Tiberi, G. [IMAGO7 Research Foundation, Pisa (Italy); Symms, M. [General Electric ASL Scientist (EMEA), Pisa (Italy)

    2014-08-15

    To study patient tolerability of brain imaging that employs an ultrahigh field (7 T) MR system We examined 180 subjects that underwent brain MR examination at 7 T. A tolerability test consisting of two parts (during patient table motion and during the examination) was administered to all subjects in order to monitor their discomfort. The scores range from 0 to 5 for the first part, and from 0 to 10 for the second part, the total score of each subject therefore ranging from 0 (no side effects reported) to 15 (lowest tolerability) A total of 51 % of subjects reported at least one side effect but all were mild in intensity and did not require examination interruption. No serious adverse event was reported. The total score (mean ± standard deviation) was 1.1 ± 1.5 out of 15 (mean score 0.4 ± 0.7 out of 5 during patient table motion and 0.7 ± 1.1 out of 10 during MR). Patient discomfort was not related to gender or health status, but it was reduced with time after system installation with increasing operator experience in performing UHF MR examinations. Ultrahigh field MRI is well tolerated without excessive discomfort to subjects. (orig.)

  16. Organ retrieval and banking in brain dead trauma patients: Our experience at level-1 trauma centre and current views

    Directory of Open Access Journals (Sweden)

    Chhavi Sawhney

    2013-01-01

    Full Text Available Background: Organ retrieval from brain dead patients is getting an increased attention as the waiting list for organ recipients far exceeds the organ donor pool. In our country, despite a large population the number of brain dead donors undergoing organ donation is very less (2% in our study. Aims: The present study was undertaken to address issues related to organ donation and share our experience for the same. Methods: A retrospective case record analysis of over 5 years from September 2007 to August 2012 was performed and the patients fulfilling brain death criterion as per Transplantation of Human Organs and Tissue (Amendment Act were included. Patient demographics (age, sex, mode of injury, time from injury to the diagnosis of brain death, time from diagnosis of brain death to organ retrieval and complications were analysed. Statistics Analysis: Student′s t test was used for parametric data and Chi square was used for categorical data. Results: Out of 205 patients who were identified as brain dead, only 10 patients became potential organ donors. Conclusion: Aggressive donor management, increasing public awareness about the concept of organ donation, good communication between clinician and the family members and a well-trained team of transplant coordinators can help in improving the number of organ donations.

  17. Cancer du sein sur tissu mammaire ectopique: à propos de 2 cas ...

    African Journals Online (AJOL)

    Le cancer du sein sur tissu mammaire ectopique est une tumeur rare qui représente 0,2 à 0,6% de l´ensemble des cancers du sein. Les auteurs en rapportent 2 cas pris en charge dans 2 centres d´oncologie marocains. Il s´agit de 2 patientes âgées de 31 ans et 47 ans présentant un cancer du sein sur tissu mammaire ...

  18. Le Conseil des gouverneurs | CRDI - Centre de recherches pour le ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    2 nov. 2010 ... La composition du Conseil aide à faire en sorte que les programmes et activités du Centre répondent de façon efficace aux besoins des pays en développement, respectent les bonnes pratiques de gouvernance et servent l'intérêt public. La Loi sur le CRDI précise qu'au moins 11 des gouverneurs doivent ...

  19. Publications | Page 51 | CRDI - Centre de recherches pour le ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    Aux fins de l'élaboration de sa prochaine stratégie quinquennale, le CRDI a organisé... Agents de changement : la philanthropie dans certains pays d'Asie du Sud-Est. Ce rapport du Lien Centre for Social Innovation examine le rôle que jouent des facteurs tels que les politiques publiques pour ce qui est de modeler le style ...

  20. Examens externes des programmes (2015) | CRDI - Centre de ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    4 mai 2016 ... Le CRDI commande un examen externe vers la fin du cycle d'exécution de chaque programme. Ces examens constituent le principal outil de reddition de comptes du Centre, car ils permettent de démontrer les résultats obtenus grâce aux dépenses de programme, et donc l'efficacité et la pertinence de ces ...

  1. Spécialiste des programmes principal | CRDI - Centre de ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    Principales tâches ou responsabilités 1. Élaboration de l'initiative Cerner les possibilités qui contribueront à l'atteinte des objectifs du programme de Gouvernance pour l'équité dans les systèmes de santé et de l'initiative du Centre d'excellence pour le renforcement des systèmes d'enregistrement des statistiques de l'état ...

  2. Publications | Page 151 | CRDI - Centre de recherches pour le ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    Philosophe et anthropologue médical, l'auteur Hamadou Konate est de nationalité malienne. Il a participé à plusieurs études sur les soins de santé primaires et l'enfance en situation difficile en Afrique de l'Ouest et du Centre, dans certains cas en qualité de directeur. Il a été directeur... La guerre du tabac : L'expérience ...

  3. Publications | Page 154 | CRDI - Centre de recherches pour le ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    Philosophe et anthropologue médical, l'auteur Hamadou Konate est de nationalité malienne. Il a participé à plusieurs études sur les soins de santé primaires et l'enfance en situation difficile en Afrique de l'Ouest et du Centre, dans certains cas en qualité de directeur. Il a été directeur... La guerre du tabac : L'expérience ...

  4. Examens externes des programmes (2012) | CRDI - Centre de ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    24 juin 2016 ... Le CRDI commande un examen externe vers la fin du cycle d'exécution de chaque programme. Ces examens constituent le principal outil de reddition de comptes du Centre, car ils permettent de démontrer les résultats obtenus grâce aux dépenses de programme, et donc l'efficacité et la pertinence de ces ...

  5. African Institute for Mathematical Sciences | CRDI - Centre de ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    À la recherche du prochain Einstein en Afrique L'Institut africain des sciences mathématiques forme les étudiants africains les plus brillants Le CRDI administre l'apport de 44,6 millions de dollars du Canada visant à élargir le réseau de centres mis sur pied par l'African Institute for Mathematical Sciences (AIMS) et grâce ...

  6. First multifragmentation experiments with the 4{pi} INDRA multidetector; Premieres experiences de multifragmentation a l`aide du multidetecteur 4{pi} INDRA

    Energy Technology Data Exchange (ETDEWEB)

    Ecomard, P.

    1995-03-01

    This work is a contribution to the study of the formation and decay of excited nuclei produced in heavy ion collisions at intermediate energies. The experiments have been carried out at GANIL (Caen, France) with the 4{pi} => 4{pi} multidetector INDRA. This is a detector of charged particles and fragments with a high granularity, an excellent space coverage, low detection thresholds, and a large dynamic range in charge and in energy. The calibration of the Silicon detectors have been performed with light particles and heavy projectiles. Usual methods which calculate the pulse height defect are criticized and a new method is proposed. We also give experimental results about the charge carriers collection in partially depleted detectors. Data analysis needs a comparison between experimental results and phenomenological codes. We describe in chapter III the physical ingredients contained in two of this codes. In the last part, we show the first experimental results obtained with the Xe + Sn system, between 25 MeV/u and 50 MeV/u. Studies on fragment multiplicity distributions show that physical mechanisms with product this fragments are different from those observed at low bombarding energies. (author). 60 refs.

  7. Measurement of R{sub l} ratio by ALEPH experiment at LEP 1; Mesure du raport R{sub l} avec l`experience ALEPH a LEP 1

    Energy Technology Data Exchange (ETDEWEB)

    Tournefier, Edwige [Universite de Paris Sud, 91 - Orsay (France)

    1998-05-04

    The work described by this thesis ranges among the high precision measurements at LEP. The data recorded by the ALEPH experiment at energies near the mass of the gage Z boson were utilized. The accurate cross section measurements of e{sup +}e{sup -} {yields} ff-bar allows extracting the parameters describing the resonance of Z as well as to make a very accurate verification of the Standard Model. One of these parameters, the ratio R{sub l}, is defined by the ratio of the hadron and lepton widths of Z:R{sub l}{Gamma}{sub had}/{Gamma}{sub l}. For the measurement of R{sub l}, a global selection of di-lepton events without flavor discrimination (e, {mu} or {tau}) was developed. This selection allows tackling the problems raised by the migration of the events from one flavor to another, so that the systematic uncertainty of R{sub l} arising from the lepton channel is reduced at 0.08% while the statistical uncertainty is 0.15%. The value obtained through the measurements of cross section is R{sub l} = 20.735 {+-} 0.039. Given the R{sub l} dependence on {alpha}{sub s}, through the corrections introduced by the strong interaction, the value of {alpha}{sub s} can be extracted from this measurement of R{sub l}. One finds {alpha}{sub s} = 0.119 {+-} 0.007 59 refs., 73 figs., 58 tabs.

  8. Correlations between nuclear data and integral slab experiments: the case of hafnium; Correlations entre donnees nucleaires et experiences integrales a plaques: le cas du hafnium

    Energy Technology Data Exchange (ETDEWEB)

    Palau, J.M

    1999-07-01

    The aim of this work was to evaluate how much integral slab experiments can both reduce discrepancies between experimental results and calculations, and improve the knowledge of hafnium isotopes neutronic parameters by an adapted sensitivity and uncertainty method. A statistical approach, based on the generalized least squares method and perturbation theory, has been incorporated into our calculation system in order to deduce microscopic cross-section adjustments from observed integral measurements on this particular 'mock-up' reactor.In this study it has been established that the correlations between integral parameters and hafnium capture cross-sections enable specific variations in the region of resolved resonances at the level of multigroup and punctual cross-sections recommended data (JEF-2.2 evaluation) to be highlighted. The use of determinist methods together with Monte Carlo- type simulations enabled a depth analysis of the modelling approximations to be carried out. Furthermore, the sensitivity coefficient validation technique employed leads to a reliable assessment of the quality of the new basic nuclear data. In this instance, the adjustments proposed for certain isotope {sup 177}Hf resonance parameters reduce, after error propagation, by 3 to 5 per cent the difference between experimental results and calculations related to this absorbent's efficiency. Beyond this particular application, the qualification methodology integrated in our calculation system should enable other basic sizing parameters to be treated (chemical / geometric data or other unexplored nuclear data) to make technological requirements less stringent. (author)

  9. Management and clinical outcome of posterior fossa arteriovenous malformations: report on a single-centre 15-year experience.

    Science.gov (United States)

    da Costa, L; Thines, L; Dehdashti, A R; Wallace, M C; Willinsky, R A; Tymianski, M; Schwartz, M L; ter Brugge, K G

    2009-04-01

    Posterior fossa brain arteriovenous malformations (PFbAVMs) are rare lesions. Management is complicated by eloquence of adjacent neurological structures, multimodality treatment is often necessary, and obliteration is not always possible. We describe a 15-year experience in the management of posterior fossa brain AVMs with a focus on clinical outcome. From 1989 to 2004, prospectively collected information on 106 patients with diagnosis of a PFbAVMs was obtained. Clinical and angioarchitectural characteristics, management options and complications are described and reviewed to evaluate their impact on final outcome as measured by the Modified Rankin Score (mRS). Ninety-eight patients were followed for an average of 3.3 years (1-14.6). The male-to-female ratio was 1:1. Ninety-five out of 98 patients (96.9%) were symptomatic at presentation, with 61 (62.2%) intracranial haemorrhages. Sixty-two patients were treated (46 cerebellar, 16 brainstem). Ten haemorrhages occurred in follow-up (4.1%/year). The mRS was obtained in 62 patients and was classified as low (good, mRSor=3). Haemorrhage was the only predictor of poor mRS at presentation (p = 0.0229). A poor clinical outcome was correlated with the presence of AA (p = 0.0276), a poor initial mRS (p<0.0001) and the number of treatments needed (p = 0.0434). Patients were significantly more likely to improve than to deteriorate over time (p = 0.0201). The final clinical outcome in PFbAVMs relates directly with the presence of associated aneurysms, number of treatments needed to obliterate the AVM and mRS at presentation. Despite the fact that patients tend to improve after brain AVM haemorrhage, the relationship of MRS at presentation and final outcome suggests that an expedited, more definitive treatment is probably a better choice, especially in patients with good grades after the initial bleeding.

  10. Place de la chirurgie dans la prise en charge des cancers du sein ...

    African Journals Online (AJOL)

    Etudier la place de la chirurgie dans la prise en charge des cancers du sein au centre hospitalier universitaire Yalgado Ouédraogo. Nous avons réalisé une étude prospective et descriptive sur dix (10) mois portant sur la place de la chirurgie dans le cancer du sein. Elle a eu pour cadre les services de ...

  11. Diversite génétique du manioc ( Manihot esculenta crants ...

    African Journals Online (AJOL)

    Le manioc (Manihot esculenta Crantz) est une plante à multiplication végétative, introduite dans les années 1850 par le Nord-Est de la République Centrafricaine (Tisserant, 1953). Des accessions sont mises en collection dans la station du Centre de Recherche Polyvalent Régional du village Boukoko (CRPR-Boukoko).

  12. Impact du deversement direct des eaux usees et de drainage dans ...

    African Journals Online (AJOL)

    matims en suspension (MES) pour l'annee. 2007, au laboratoire du d6partement de. Geologie de l'Universit6 de Constantine pour l'annee 2010 et au laboratoire central du Centre de Rechcrchc Scienti.fique et Technique sur les. Region Aridcs (CRSTRA) pour l'a.nnCe 2012. Nous rcmarquons une grande variabilitC: des.

  13. Établissement d'un réseau de télécentres communautaires au ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    Le gouvernement du Mozambique a l'intention d'ouvrir un centre communautaire de technologies de l'information et de la communication (TIC), ou télécentre, dans chacun des 128 districts du pays dans le but de favoriser l'accès universel. Depuis 1997, le nombre de télécentres est en forte croissance. Cependant, ils ...

  14. Performances of the Si microstrip detector of the STAR experiment at RHIC; Performances du detecteur en silicium a micropistes de l'experience STAR a RHIC

    Energy Technology Data Exchange (ETDEWEB)

    Bouchet, J

    2007-10-15

    The Silicon Strip Detector (SSD) is the fourth layer of detector using a double-sided microstrip technology of the STAR experiment at RHIC, completing STAR's inner tracking device. The goal of STAR is to study heavy ions collisions in order to probe the existence of the quark gluon plasma (QGP), a deconfined state of nuclear matter. Strangeness enhancement, such as {kappa}{sub S}{sup 0}, {lambda}, {xi} and {omega}, for particles production, has been proposed to sign the formation of QGP. Then precise measurement of secondary vertices is needed. The SSD will also permit an attempt to use the inner tracking device to measure charm and beauty with direct topological identification. It was proposed to enhance the STAR tracking capabilities by providing a better connection between reconstructed tracks in the main tracking device (TPC) and the initial vertex detector (SVT). In this thesis, we will present the intrinsic performances of the SSD and its impact on the inner tracking system performances by studying Cu-Cu collisions occurred at RHIC in 2005. We show that the SSD detector has excellent performances in terms of resolution: (945 {+-} 18) {mu}m in azimuth and (1021 {+-} 13) {mu}m along the beam axis. For the final result when SSD is associated to the SVT the resolutions are (281 {+-} 1) {mu}m and (213 {+-} 0.8) {mu}m in azimuth and along the beam axis respectively. The resolution reached by the addition of the Silicon Vertex detectors of STAR will allow the search for rare particles like charm and beauty, which have a decay-length of the order of hundred microns.

  15. Measuring the mass of the W{sup {+-}} boson in the ALEPH experiment; Mesure de la masse du boson W{sup {+-}} dans l'experience ALEPH

    Energy Technology Data Exchange (ETDEWEB)

    Boumediene, D.E

    2002-05-01

    The W boson plays an important role in the standard model of weak interactions, its mass is predictable and its measurement is an efficient way to test the theory and to challenge experimental data. This thesis is dedicated to the measurement of the W mass (m{sub W}) through the ALEPH experiment. 3 important points are treated: measuring techniques, systematic effects and impact of the value measured on the standard model. As for measuring techniques: all the decay products of W have been reconstructed, this reconstruction is dependent on the decay way and has an impact on the determination of the mass. For the decay W{sup +}W{sup -} {yields} {tau}{nu}qq-bar, a specific reconstruction has been studied and used for every step of the measurement (selection, kinematic adjustment, adjustment of m{sub W}), this technique has improved the resolution of m{sub W}. For the leptonic decay W{sup +}W{sup -} {yields} l{nu}l{nu}, we have focused on the adjustment technique of m{sub W}, for the decays W{sup +}W{sup -} {yields} l{nu}qq-bar and W{sup +}W{sup -} {yields} qq-bar qq-bar, the standard measurement technique of ALEPH has been used. As for systematic effects, the statistical precision of the measurement campaign is high so it is necessary to understand the systematic effects that have an impact on the measured value. 2 effects have been thoroughly studied: the colour interconnection effect that concerns only the hadronic decay with 4 jets, the second effect appears in the simulation of showers in calorimeter-detectors. 2 values for m{sub W} are proposed, one that was obtained by only measuring the direction and the energy of the jet and the second one by discarding all the problematic events that were reconstructed in the detector. We obtain: m{sub W} = (80,392 {+-} 0,053) GeV/c{sup 2} and m{sub W} = (80,358 {+-} 0,050) GeV/c{sup 2}. By combining these values to the internationally agreed data, it has been possible to adjust the mass of the Higgs' boson and to give

  16. Développement durable : pourquoi l’homme ne peut pas être seul au centre du concept de "sustainability". Le point de vue d’écologues marins

    Directory of Open Access Journals (Sweden)

    Jean-Claude Dauvin

    2010-05-01

    Full Text Available La traduction française « développement durable » de l’anglais "sustainable development" définie comme un mode de développement répondant aux besoins présents sans compromettre la capacité des générations futures de répondre aux leurs, nous paraît très tendancieuse. L’objectif de cette note est de donner le point de vue d’écologues marins sur le concept de développement durable. Sont successivement explorés :  la définition des auteurs comparée à celle favorisée dans les sciences humaines ; l’identification des mers côtières, leurs problèmes, les risques et les enjeux auxquelles elles sont confrontées ; les conditions requises pour un développement soutenable des écosystèmes marins côtiers. En conclusion, il est insisté sur les difficultés rencontrées pour rencontrer un développement soutenable en mer, en raison de l’insuffisance des connaissances et du trop relatif intérêt porté à la mer par les responsables politiques et institutionnels français.The French translation, “développement durable”, of the English expression, “sustainable development”, defines a mode of development intended to meet the needs of the present generations without compromising the ability of future generations to meet their own needs. This definition appears to us to be very biased. The objective of this paper is to provide the point of view of marine ecologists on the concept of sustainable development. In this paper, we explore in succession: the authors’ own definition compared with the one used in the social sciences, the identification of the coastal seas, their problems, and risks and stakes that confront them, and the requirements for a sustainable development of the coastal marine ecosystems. In conclusion, we highlight the difficulties encountered in meeting the requirements of sustainable development at sea, due to insufficient knowledge and the very relative interest given the sea by the French

  17. An Investigative Study into Perspectives and Experiences of Incubates at the Chandaria Business Innovation and Incubation Centre at the Kenyatta University

    Science.gov (United States)

    Munyanyiwa, Takaruza; Mutsau, Morgen; Rudhumbu, Norman; Svotwa, Douglas

    2016-01-01

    The study presents results from an investigative study undertaken at the Kenyatta University (KU) Chandaria Business Innovation and Incubation Centre. A total of 10 incubates representing 10 projects were engaged in face to face interviews. The incubates were appreciative of the value that incubation centre such as the one at KU contributed to…

  18. Patients' priorities for ambulant hospital care centres: a survey and discrete choice experiment among elderly and chronically ill patients of a Dutch hospital.

    NARCIS (Netherlands)

    Albada, A.; Triemstra, M.

    2009-01-01

    Objective: This study established patients' preferences regarding the facilities in an adjacent centre for ambulatory hospital care. It also identified determinants of patients' choice to visit this centre instead of the regional hospital. Methods: A questionnaire survey among 1477 elderly and

  19. DAY CARE CENTRES | IDRC - International Development ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    DAY CARE CENTRES. CRECHES. Colour. #1BAEA7. Juliet Nyambura se souvient du jour où elle a perdu son emploi comme si c'était hier. Alors privée de son revenu, elle se rappelle qu'elle craignait le pire pour sa famille et se souvient de la honte qu'elle ressentait de ne pas pouvoir subvenir aux besoins de ses enfants ...

  20. Ghana : tous les projets | Page 3 | CRDI - Centre de recherches pour ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    Le CRDI administre l'apport de 20 millions de dollars du gouvernement du Canada à l'expansion du réseau de centre AIMS, l'objectif de l'initiative Next Einstein de l'Institut Africain des Sciences Mathématiques (AIMS-NEI). Sujet: SCIENCE. Région: North of Sahara, South of Sahara, Benin, Ethiopia, Ghana, Senegal, ...

  1. Directeur de domaine de programme (h/f) | CRDI - Centre de ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    ... Programmes et partenariats;; Obtenir, produire la synthèse et communiquer des éléments d'intelligence stratégique et de programme et promouvoir leur utilisation efficace dans la conception et l'exécution des actions du domaine de programme et du Cadre générale des stratégies et des programmes (CGSP) du Centre; ...

  2. Ce que nous faisons | Page 167 | CRDI - Centre de recherches pour ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    Modèles commerciaux libres (Amérique latine). Le Centro de Tecnologia e Sociedade (CTS - centre pour la technologie et la société) fait partie de la Faculté de droit de la Fundação Getulio Vargas à Rio de Janeiro. Brésil, Amérique Du Sud, Nigéria, Nord Du Sahara, Sud Du Sahara, Amérique Nord Et Centrale. PROJECT ...

  3. : tous les projets | Page 157 | CRDI - Centre de recherches pour le ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    Le CRDI administre l'apport de 20 millions de dollars du gouvernement du Canada à l'expansion du réseau de centre AIMS, l'objectif de l'initiative Next Einstein de l'Institut Africain des Sciences Mathématiques (AIMS-NEI). Sujet: SCIENCE. Région: North of Sahara, South of Sahara, Benin, Ethiopia, Ghana, Senegal, ...

  4. : tous les projets | Page 156 | CRDI - Centre de recherches pour le ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    Le CRDI administre l'apport de 20 millions de dollars du gouvernement du Canada à l'expansion du réseau de centre AIMS, l'objectif de l'initiative Next Einstein de l'Institut Africain des Sciences Mathématiques (AIMS-NEI). Sujet: SCIENCE. Région: North of Sahara, South of Sahara, Benin, Ethiopia, Ghana, Senegal, ...

  5. Directeur régional | CRDI - Centre de recherches pour le ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    Principales tâches et responsabilités Gestion organisationnelle En qualité de membre du Comité de la haute direction (CHD) et d'autres organes décisionnels du CRDI, et en collaboration avec le Groupe des politiques et de la planification, contribuer à l'élaboration des politiques qui s'appliquent à l'ensemble du Centre de ...

  6. Fiche technique du spermogramme et du spermocytogramme ...

    African Journals Online (AJOL)

    Les causes de l'infertilité masculine peuvent être l'impuissance et/ ou l'altération du sperme. L'étude de l'altération du sperme est appréciée par le spermogramme et le spermocytogramme. Ces analyses doivent être réalisées par des laboratoires de biologie de la reproduction. Vu la rareté ou l'absence des laboratoires de ...

  7. Increase in the neutron yield from a dense plasma-focus experiment performed with a conical tip placed in the centre of the anode end

    Science.gov (United States)

    Kubes, P.; Paduch, M.; Cikhardt, J.; Cikhardtova, B.; Klir, D.; Kravarik, J.; Rezac, K.; Zielinska, E.; Sadowski, M. J.; Szymaszek, A.; Tomaszewski, K.; Zaloga, D.

    2017-09-01

    The paper describes the evolution of self-organized structures inside a pinched plasma column during the phase of the effective production of fusion neutrons, as observed in the mega-ampere plasma focus experiment performed with a conical tip placed in the centre of the anode face. In a comparison with the plane anode face configuration, the described anode shape facilitated transformations in the pinch column during the neutron production and increased the neutron yield several times. Simultaneously, it decreased the minimal diameter and the length of the pinched column, and it depressed the first neutron pulse. It also induced shorter pulses of X-rays and neutrons, which enabled the determination of a temporal difference between the emission of electron and deuteron beams. The fast electrons were produced mainly during a disruption of the pinch constriction, while the fast deuterons - during the formation and explosion of plasmoids. The paper also presents the temporal evolution of a current distribution in the plasmoid during the neutron production, as well as the appearance and stable positions of current filaments traces upon the surface of the conical anode tip.

  8. Recherche | CRDI - Centre de recherches pour le développement ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    Retourner au menu principal. Centre de recherches pour le développement international Gouvernement du Canada Toggle Menu. Main menu. Ce que nous faisons · Financement · Ressources · À propos du CRDI. Languages. English · Français. Formulaire de demande. Recherche. Mobile Nav Footer Links. Carrières ...

  9. Adoption and Impact of OER in the Global South | CRDI - Centre de ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    12 déc. 2017 ... Cheryl Hodgkinson-Williams est professeure agrégée au Centre for Innovation in Learning and Teaching (CILT) de la University of Cape Town, en Afrique du Sud, et chercheure principale du projet Research on Open Educational Resources for Development in the Global South (ROER4D), financé par le ...

  10. Traducteur / réviseur (h/f) | CRDI - Centre de recherches pour le ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    Traduire divers textes souvent complexes, urgents et importants, selon les normes professionnelles reconnues, à l'intention de groupes externes et internationaux ou du personnel du Centre, et garantir l'excellence de la qualité linguistique et terminologique. Réviser les textes de traducteurs autonomes. Faire de la ...

  11. La mise à l'échelle de la science | CRDI - Centre de recherches pour ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    identification et l'essai d'idées et d'innovations évolutives, comme le démontre le premier objectif du plan stratégique du Centre. Dans cette optique, nous cherchons à mieux comprendre comment la mise en oeuvre de projets de ...

  12. Kenya | CRDI - Centre de recherches pour le développement ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    Le Kenya est depuis longtemps le centre économique de l'Afrique de l'Est. Cependant, malgré des progrès économiques considérables au cours de la dernière décennie, la pauvreté et des inégalités persistent. Le bureau du CRDI à Nairobi est le point central des efforts du Centre en Afrique subsaharienne et il supervise ...

  13. Establishment of an endobronchial ultrasound-guided transbronchial fine needle aspiration service with rapid on-site evaluation: 2 years experience of a single UK centre.

    Science.gov (United States)

    Thiryayi, S A; Rana, D N; Narine, N; Najib, M; Bailey, S

    2016-10-01

    Endobronchial ultrasound (EBUS)-guided transbronchial fine needle aspiration (TBFNA) is now well established as a minimally invasive, effective investigation which can provide information on both diagnosis and stage of lung cancer and is also useful in the investigation of mediastinal lymphadenopathy of uncertain aetiology. The service can be provided with or without rapid on-site evaluation (ROSE) for specimen triage and provisional diagnosis. We outline our experience from the first 2 years of providing an EBUS service with ROSE, highlighting the practicalities of service provision, pitfalls encountered and lessons learned. Aspirates from all EBUS procedures performed during the first 2 years of our service from 16 October 2012 to 15 October 2014 are included. We describe the activities undertaken prior to each EBUS list, the EBUS TBFNA procedure, specimen handling and procedure for ROSE. A total of 591 aspirates were performed from 352 patients, including 573 (97%) lymph node aspirates, 17 (2.9%) lung mass samples and one aspirate from a retrosternal thyroid cyst (0.1%). There were 498 (84.1%) adequate samples at ROSE, 82 (13.9%) inadequate, one (0.2%) abandoned and 11 (1.9%) where ROSE was not performed. Four hundred and seventy (79.5%) samples showed concordance between the ROSE and final diagnoses. No adequate samples were obtained for 11 patients (3.1%) after final cytological analysis, resulting in a final adequacy rate of 96.9%. In our experience, ROSE provides a clear advantage in providing a patient-centred EBUS service by facilitating specimen triage, ensuring adequate sampling and providing a rapid provisional diagnosis, however, there is a learning curve for both the clinicians and cytopathologists involved. © 2016 John Wiley & Sons Ltd.

  14. Virtual patients design and its effect on clinical reasoning and student experience: a protocol for a randomised factorial multi-centre study

    Directory of Open Access Journals (Sweden)

    Bateman James

    2012-08-01

    Full Text Available Abstract Background Virtual Patients (VPs are web-based representations of realistic clinical cases. They are proposed as being an optimal method for teaching clinical reasoning skills. International standards exist which define precisely what constitutes a VP. There are multiple design possibilities for VPs, however there is little formal evidence to support individual design features. The purpose of this trial is to explore the effect of two different potentially important design features on clinical reasoning skills and the student experience. These are the branching case pathways (present or absent and structured clinical reasoning feedback (present or absent. Methods/Design This is a multi-centre randomised 2x2 factorial design study evaluating two independent variables of VP design, branching (present or absent, and structured clinical reasoning feedback (present or absent.The study will be carried out in medical student volunteers in one year group from three university medical schools in the United Kingdom, Warwick, Keele and Birmingham. There are four core musculoskeletal topics. Each case can be designed in four different ways, equating to 16 VPs required for the research. Students will be randomised to four groups, completing the four VP topics in the same order, but with each group exposed to a different VP design sequentially. All students will be exposed to the four designs. Primary outcomes are performance for each case design in a standardized fifteen item clinical reasoning assessment, integrated into each VP, which is identical for each topic. Additionally a 15-item self-reported evaluation is completed for each VP, based on a widely used EViP tool. Student patterns of use of the VPs will be recorded. In one centre, formative clinical and examination performance will be recorded, along with a self reported pre and post-intervention reasoning score, the DTI. Our power calculations indicate a sample size of 112 is required for

  15. Nurses' experiences of caring for the suddenly bereaved in adult acute and critical care settings, and the provision of person-centred care: A qualitative study.

    Science.gov (United States)

    Walker, Wendy; Deacon, Kate

    2016-04-01

    To explore nursing interventions for person-centred bereavement care in adult acute and critical care settings. A descriptive exploratory study, involving focused, face-to-face interviews. Participants comprised nine registered nurses and one auxiliary nurse, working in environments where sudden death was known to occur, i.e. emergency, cardiac and critical care. Interviews were transcribed verbatim and data subjected to directed content analysis. The provision of person-centred care was examined by applying a validated Person-Centred Nursing Framework. Five main themes were identified. Participants' accounts contained descriptions of bereavement care and the presence of person-centred interventions. Contextual, professional and attitudinal factors influenced the degree to which person-centred care operated. Caring for suddenly bereaved families was important to nurses, but also a source of tension and unrest. An important consideration for person-centred practice is movement away from sudden bereavement as a 'here and now' event, towards a pathway of supportive care that envisions the longer-term. Further research is required to gain a deeper understanding of person-centred care for the suddenly bereaved and the perceived effectiveness of nursing interventions. Copyright © 2016 Elsevier Ltd. All rights reserved.

  16. Renouvellement des eaux du fjord du Saguenay

    Science.gov (United States)

    Belzile, Melany

    Le fjord du Saguenay, localise dans la region subarctique de l'est du Canada, ala particularite d' etre connecte a un estuaire tres energetique plutot que directement a 1' ocean. L'embouchure du fjord est situee ala rencontre d'un chenal profond et d'un seuil de 20m de profondeur qui limite les echanges d'eau entre le fjord et l'estuaire du Saint-Laurent. Cependant, les grandes amplitudes de maree a son embouchure ont le potentiel d'entrainer des eaux denses du Saint-Laurent a l'interieur du fjord renouvelant ainsi les eaux des differents bassins. Dans le but d' a voir une meilleure comprehension de la dynamique et de la saisonnalite des renouvellements dans le bassin interne, deux mouillages y ont ete deployes pour recolter les premieres donnees de courant, sur toute la colonne d' eau et sur plusieurs mois, ainsi que des observations de temperature et de salinite a differentes profondeurs. L'un de ces mouillages n' a malheureusement pas pu etre analyse en detail dfi a la complexite de ses resultats et au manque de temps. Des profils ont ete recoltes le long de section transversales (transects), couvrant plusieurs saisons et plusieurs annees, ce qui a contribue a une meilleure comprehension de la distribution spatiale des masses d'eau dans le fjord. Les resultats montrent que ladynamique du fjord est plus complexe que ce qui avait ete precedemment presente dans la litterature. Un changement saisonnier abrupte dans la circulation du fjord a ete observe a la rni-fevrier. De plus, des renouvellements non-anticipes juste en-dessous de la thermohalocline (˜ 10 m de profondeur) ont ete observes entre la fin de 1' hiver et le milieu de 1' ete. En fonction des saisons, trois types de renouvellement peuvent etre observes : renouvellements profonds a l'automne et au debut de l'hiver suivis des renouvellements de sous-surface et enfin les renouvellements a des profondeurs intermediaires pendant l'ete. Le changement saisonnier abrupte observe au milieu de l'hiver ainsi que la

  17. Bitumen coating of the radio-active sludges from the effluent treatment plant at the Marcoule centre. Review of the progress reports 1, 2, 3 and 4 (1963); Enrobage par le bitume des boues radioactives de la station de traitement des effluents du centre de Marcoule. Mise au point des etats d'avancement 1, 2, 3 et 4. (1963)

    Energy Technology Data Exchange (ETDEWEB)

    Rodier, J.; Lefillatre, G.; Scheidhauer, J. [Commissariat a l' Energie Atomique, Centre de Production de Plutonium, Marcoule (France). Centre d' Etudes Nucleaires

    1963-07-01

    Besides the very high activity liquids containing fission products, the chemical treatment of irradiated fuels produces a large volume of aqueous effluents and solid waste of relatively low radioactivity. These weakly active products can be eliminated in the ground, in a hydrographic land system or in the sea. Techniques of evaporation, of resin concentration, and of coprecipitation give rise to inorganic sludges with a high water content. All these residues occupy a large volume and represent a far from negligible weight. In the case of the sludge, their relative fluidity necessitates a conditioning guaranteeing safe storage. The solution to the problem will consist in passing directly from a liquid or a suspension, to a solid whose structure is homogeneous and whose matter is inert with respect to the storage medium (soil, sea, etc. ). We have proposed to coat the radioactive products with bitumen. This article is designed to give a review of the studies undertaken on this method. It consists of a progress report rather than a final assessment. (authors) [French] En dehors des liquides de tres haute activite contenant des produits de fission, le traitement chimique des combustibles irradies produit un volume important d'effluents aqueux et de residus solides de radioactivite relativement faible. Ces produits, faiblement actifs, peuvent etre elimines dans le sol, dans un systeme hydrographique terrestre ou dans la mer. Les techniques d'evaporation, de concentration sur resine, de coprecipitation, permettent la decontamination prealable des liquides. La coprecipitation donne naissance a des boues minerales dont la teneur en eau est elevee. Tous ces residus occupent un volume important et representent un poids non negligeable. Dans le cas des boues, leur fluidite relative exige un conditionnement donnant toutes garanties de securite au stockage. La solution du probleme consistera a passer directement d'un liquide ou d'une suspension a un solide

  18. Study of a reconstruction algorithm for electrons in the ATLAS experiment in LHC; Etude d'un algorithme de reconstruction des electrons dans l'experience Atlas aupres du LHC

    Energy Technology Data Exchange (ETDEWEB)

    Kerschen, N

    2006-09-15

    The ATLAS experiment is a general purpose particle physics experiment mainly aimed at the discovery of the origin of mass through the research of the Higgs boson. In order to achieve this, the Large Hadron Collider at CERN will accelerate two proton beams and make them collide at the centre of the experiment. ATLAS will discover new particles through the measurement of their decay products. Electrons are such decay products: they produce an electromagnetic shower in the calorimeter by which they lose all their energy. The calorimeter is divided into cells and the deposited energy is reconstructed using an algorithm to assemble the cells into clusters. The purpose of this thesis is to study a new kind of algorithm adapting the cluster to the shower topology. In order to reconstruct the energy of the initially created electron, the cluster has to be calibrated by taking into account the energy lost in the dead material in front of the calorimeter. Therefore. a Monte-Carlo simulation of the ATLAS detector has been used to correct for effects of response modulation in position and in energy and to optimise the energy resolution as well as the linearity. An analysis of test beam data has been performed to study the behaviour of the algorithm in a more realistic environment. We show that the requirements of the experiment can be met for the linearity and resolution. The improvement of this new algorithm, compared to a fixed sized cluster. is the better recovery of Bremsstrahlung photons emitted by the electron in the material in front of the calorimeter. A Monte-Carlo analysis of the Higgs boson decay in four electrons confirms this result. (author)

  19. Study of the electron-positron annihilation in the galactic center region with the Integral/SPI spectrometer; Etude de l'annihilation electron-positon dans la region du centre galactique avec le spectrometre INTEGRAL/SPI

    Energy Technology Data Exchange (ETDEWEB)

    Sizun, P

    2007-04-15

    A spectral feature was detected in 1970 in the gamma-ray emission from the central regions of the Milky Way, during balloon flight observations. Located near 511 keV, this feature was soon attributed to the gamma-ray line tracing the annihilation of electrons with their anti-particles, positrons. However, none of the multiple astrophysical scenarios contemplated to explain the production of positrons in the Galactic bulge has been able to reproduce the high injection rate deduced from the flux of the 511 keV line, close to 10{sup 43} positrons per second. Launched in 2002, the European gamma-ray satellite INTEGRAL was provided with a spectrometer, SPI, whose unprecedented imaging and spectral capabilities in this energy range enable us to further study the source of the 511 keV line detected in the Galactic centre region. Indeed, a better determination of the spatial extent of the source, the intrinsic width of the line and the fraction of positrons annihilating in-flight, directly or via the formation of ortho-Positronium atoms would improve our knowledge of both the annihilation medium and the initial source of positrons, and could allow us to discriminate between the various explanatory scenarios. The first part of this thesis deals with a key ingredient in the extraction of the annihilation spectrum: the optimization of the instrumental background model. New data screening and tracer selection procedures are presented. Classical multi-linear models are compared to neural and Bayesian networks. Finally, three years of observation are used to constrain the width of the source and derive its spectrum. The second part of the thesis focuses on one of the possible scenarios explaining the high positron injection rate deduced from the flux of the 511 keV line: the annihilation of light dark matter particles into electron-positron pairs. The various radiation mechanisms involved are modeled and confronted to observations in order to set an upper limit on the injection

  20. Micro-Trottoir à Genève à propos du CERN et du LHC

    CERN Multimedia

    CERN Video Productions

    2009-01-01

    Questions : Qu'est-ce-que le LHC? Quelle est la fonction du LHC? Qu'est-ce-que le CERN? D'après vous, les recherches engendrées pour le LHC peuvent-elles ?tre bénéfiques, utiles pour la société? Où a été inventé le Web? Lieux : Forum Meyrin Université de Genève Genève Centre

  1. Cours National de Paludologie du Niger : Bilan de cinq ans.

    African Journals Online (AJOL)

    SARAH

    31 août 2017 ... RESUME. Le Cours National de Paludologie (CNP) est une formation organisée depuis 2011 par le Centre de Recherche. Médicale et Sanitaire (CERMES) de Niamey en collaboration avec le Programme National de Lutte contre le. Paludisme (PNLP) du Niger, la Faculté des Sciences de la Santé (FSS) ...

  2. Determination of the LEP beam energy through {zeta}{gamma} events and the measurements of 3 neutral gauge bosons in the ALEPH experiment; Determination de l'energie du faisceau du LEP a l'aide des evenements {zeta}{gamma} et mesures de couplages a trois bosons de jauge neutres dans l'experience ALEPH

    Energy Technology Data Exchange (ETDEWEB)

    Trocme, B

    2001-04-01

    After six years of data taking at Z peak, LEP beam energy continuously raised to finally reach 104.5 GeV, allowing notably W pairs production. Z resonance remains however important trough radiative return process; a hard photon being emitted in initial state, the centre of mass energy is reduced to an effective value close to Z mass. These events taken by Aleph experiment between 1998 and 2000 have been analysed following two distinct approaches, that are detailed in this thesis. With nearly 700 pb{sup -1} taken by each experiment, it is obvious that final W mass measurement- one major goal of LEP2 program- will be dominated by systematic error, with a large contribution from the uncertainty on the LEP beam energy. A fit of the radiative return peak position allows an original determination of the latter. Being not only a single measurement, this method is also a powerful tool to check techniques used in W mass measurement. Moreover, Z{gamma} events final states are similar to processes with a vertex involving three neutral gauge bosons. Anomalous production cross section, as well as deformed kinematic distributions, can be a probe of new physic that lies at much higher energy scales. A search for such phenomena has also been performed. (author)

  3. Création d'une académie nationale des télécentres aux Philippines ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    Ces dernières années, le mouvement des télécentres a pris de l'ampleur dans les Philippines, principalement à cause du Réseau des centres électroniques communautaires des Philippines (PhilCeCNet) mis sur pied grâce au soutien financier et technique octroyé dans le cadre du programme telecentre.org du CRDI ...

  4. Inhalative steroids as an individual treatment in symptomatic lung cancer patients with radiation pneumonitis grade II after radiotherapy - a single-centre experience.

    Science.gov (United States)

    Henkenberens, C; Janssen, S; Lavae-Mokhtari, M; Leni, K; Meyer, A; Christiansen, H; Bremer, M; Dickgreber, N

    2016-02-02

    To assess efficacy of our single-centre experience with inhalative steroids (IS) in lung cancer patients with symptomatic radiation pneumonitis (RP) grade II. Between 05/09 and 07/10, 24 patients (female, n = 8; male, n = 16) with lung cancer (non-small cell lung carcinoma [NSCLC]: n = 19; small cell lung cancer [SCLC]: n = 3; unknown histology: n = 2) and good performance status (ECOG ≤1) received definitive radiotherapy to the primary tumour site and involved lymph nodes with concurrent chemotherapy (n = 18), sequential chemotherapy (n = 2) or radiation only (n = 4) and developed symptomatic RP grade II during follow-up. No patient presented with oxygen requiring RP grade III. The mean age at diagnosis was 66 years (range: 50-82 years). Nine patients suffered from chronic obstructive pulmonary disease (COPD) before treatment, and 18 patients had a smoking history (median pack years: 48). The mean lung dose was 15.5 Gy (range: 3.0-23.1 Gy). All patients were treated with IS. If a patient's clinical symptoms did not significantly improve within two weeks of IS therapy initiation, their treatment was switched to oral prednisolone. All 24 patients were initially treated with a high dose IS (budesonide 800 μg 1-0-1) for 14 days. Of the patients, 18 showed a significant improvement of clinical symptoms and 6 patients did not show significant improvement of clinical symptoms and were classified as non-responders to IS. Their treatment was switched to oral steroids after two weeks (starting with oral prednisolone, 0.5 mg/kg bodyweight; at least 50 mg per day). All of these patients responded to the prednisolone. None of non-responders presented with increased symptoms of RP and required oxygen and / or hospitalization (RP grade III). The median follow-up after IS treatment initiation was 18 months (range: 4-66 months). The median duration of IS treatment and prednisolone treatment was 8.2 months (range: 3.0-48.3 months) and 11.4 months (range: 5.0-44.0 months

  5. Safety and effectiveness of percutaneous sacroplasty: a single-centre experience in 58 consecutive patients with tumours or osteoporotic insufficient fractures treated under fluoroscopic guidance.

    Science.gov (United States)

    Pereira, Licia Pacheco; Clarençon, Frédéric; Cormier, Evelyne; Rose, Michèle; Jean, Beatrix; Le Jean, Lise; Chiras, Jacques

    2013-10-01

    To report our experience in percutaneous sacroplasty (PSP) for tumours and insufficiency fractures of the sacrum. Single-centre retrospective analysis of 58 consecutive patients who underwent 67 PSPs for intractable pain from sacral tumours (84.5 %) or from osteoporotic fractures (15.5 %). The following data were assessed: visual analogue scale (VAS) before and after the procedure for global pain; short-term (1-month) clinical follow-up using a four-grade patient satisfaction scale (worse, unchanged, mild improvement and significant improvement); modification in analgesics consumption; referred short-term walking mobility. Minor and major complications were systematically assessed. The mean VAS score was 5.3 ± 2.0 in pre-procedure and 1.7 ± 1.8 in post-procedure. At 1-month follow-up, 34/58 (58.5 %) patients experienced a mild improvement; 15/58 (26 %) presented a significant improvement while 4/58 (7 %) and 5/58 (8.5 %) patients had unchanged or worse pain, respectively. Decreased analgesic consumption was observed in 34 % (20/58) of the patients. Eighty percent of patients with walking limitation experienced improvement, 16 % remained unchanged and 4 % were worse. We noted minor complications in 2/58 patients (3.4 %) and major complications in 2/58 patients (3.4 %). Percutaneous sacroplasty for metastatic and osteoporotic fractures is a safe and effective technique in terms of pain relief and functional outcome. • Percutaneous sacroplasty provides pain relief and functional improvement for insufficiency sacral fractures. • Percutaneous sacroplasty provides pain relief and function improvement for sacral tumours. • The major complication rate is acceptable (3.4 %), and is higher in sacral tumours. • Posterior wall/cortical sacral bone disruption is not statistically associated with more complications. • However, osteolytic tumours seem to be associated with higher risk of complications.

  6. Surgery for Conditions of Infectious Etiology in Resource-Limited Countries Affected by Crisis: The Médecins Sans Frontières Operations Centre Brussels Experience.

    Science.gov (United States)

    Sharma, Davina; Hayman, Kate; Stewart, Barclay T; Dominguez, Lynette; Trelles, Miguel; Saqeb, Sanaulhaq; Kasonga, Cheride; Hangi, Theophile Kubuya; Mupenda, Jerome; Naseer, Aamer; Wong, Evan; Kushner, Adam L

    2015-12-01

    Surgery for infection represents a substantial, although undefined, disease burden in low- and middle-income countries (LMICs). Médecins Sans Frontières-Operations Centre Brussels (MSF-OCB) provides surgical care in LMICs and collects data useful for describing operative epidemiology of surgical need otherwise unmet by national health services. This study aimed to describe the experience of MSF-OCB operations for infections in LMICs. By doing so, the results might aid effective resource allocation and preparation of future humanitarian staff. Procedures performed in operating rooms at facilities run by MSF-OCB from July 2008 through June 2014 were reviewed. Projects providing specialty care only were excluded. Procedures for infection were described and related to demographics and reason for humanitarian response. A total of 96,239 operations were performed at 27 MSF-OCB sites in 15 countries between 2008 and 2014. Of the 61,177 general operations, 7,762 (13%) were for infections. Operations for skin and soft tissue infections were the most common (64%), followed by intra-abdominal (26%), orthopedic (6%), and tropical infections (3%). The proportion of operations for skin and soft tissue infections was highest during natural disaster missions (pcrisis. This study found that infections require greater than expected surgical input given frequent need for serial operations to overcome contextual challenges and those associated with limited resources in other areas (e.g., ward care). Furthermore, these results demonstrate that the pattern of operations for infections is related to nature of the crisis. Incorporating training into humanitarian preparation (e.g., surgical sepsis care, ultrasound-guided drainage procedures) and ensuring adequate resources for the care of surgical infections are necessary components for providing essential surgical care during crisis.

  7. Living through conflict and post-conflict: experiences of health workers in northern Uganda and lessons for people-centred health systems.

    Science.gov (United States)

    Namakula, Justine; Witter, Sophie

    2014-09-01

    Providing people-centred health systems--or any systems at all--requires specific measures to protect and retain healthcare workers during and after the conflict. This is particularly important when health staff are themselves the target of violence and abduction, as is often the case. This article presents the perspective of health workers who lived through conflict in four districts of northern Uganda--Pader, Gulu, Amuru, and Kitgum. These contained more than 90% of the people displaced by the decades of conflict, which ended in 2006. The article is based on 26 in-depth interviews, using a life history approach. This participatory tool encouraged participants to record key events and decisions in their lives, and to explore areas such as their decision to become a health worker, their employment history, and their experiences of conflict and coping strategies. These were analyzed thematically to develop an understanding of how to protect and retain staff in these challenging contexts. During the conflict, many health workers lost their lives or witnessed the death of their friends and colleagues. They also experienced abduction, ambush and injury. Other challenges included disconnection from social and professional support systems, displacement, limited supplies and equipment, increased workload and long working days and lack of pay. Health workers were not passive in the face of these challenges, however. They adopted a range of safety measures, such as mingling with community members, sleeping in the bush, and frequent change of sleeping place, in addition to psychological and practical coping strategies. Understanding their motivation and their views provides an important insight how to maintain staffing and so to continue to offer essential health care during difficult times and in marginalized areas. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine © The Author 2014; all rights reserved.

  8. Implementation of new Healthy Conversation Skills to support lifestyle changes - what helps and what hinders? Experiences of Sure Start Children's Centre staff.

    Science.gov (United States)

    Tinati, Tannaze; Lawrence, Wendy; Ntani, Georgia; Black, Christina; Cradock, Sue; Jarman, Megan; Pease, Anna; Begum, Rufia; Inskip, Hazel; Cooper, Cyrus; Baird, Janis; Barker, Mary

    2012-07-01

    Effective communication is necessary for good relationships between healthcare practitioners and clients. This study examined barriers and facilitators to implementing new communication skills. One hundred and ten Sure Start Children's Centre staff attended one of 13 follow-up workshops in Southampton, UK between May 2009 and February 2011 to reflect on the use of new skills following a training course in communication, reflection and problem-solving. Barriers and facilitators were assessed with an adapted Problematic Experiences of Therapy scale (PETS). Staff reported frequency of skill use, and described what made it more difficult or easier to use the skills. Complete data were available for 101 trainees. The PETS indicated that staff had confidence in using the skills, but felt that there were practical barriers to using them, such as lack of time. Skills were used less often when staff perceived parents not to be engaging with them (Spearman's correlation r(s) = -0.42, P PETS, content analysis of free text responses suggested that the main barrier was a perceived lack of time to implement new skills. Facilitators included seeing the benefits of using the skills, finding opportunities and having good relationships with parents. Understanding the range of barriers and facilitators to implementation is essential when developing training to facilitate ongoing support and sustain skill use. Special attention should be given to exploring trainees' perceptions of time, to be able to address this significant barrier to skill implementation. Staff training requires a multi-faceted approach to address the range of perceived barriers. © 2012 Blackwell Publishing Ltd.

  9. Radioactive waste storage at the CEA Centre in Cadarache; transfer from the -storage yard- to the CEDRA facility: an illustration of changes in the safety requirements; L'entreposage de dechets nucleaires sur le Centre CEA de Cadarache: du -Parc d'entreposage- vers l'installation CEDRA: une illustration de l'evolution des exigences de surete

    Energy Technology Data Exchange (ETDEWEB)

    Verrhiest-Leblanc, G. [Autorite de Surete Nucleaire, Chargee d' Affaires, 75 - Paris (France); Tord, Ch. [Autorite de Surete Nucleaire, adjoint au chef de la Division de Marseille, 75 - Paris (France)

    2011-02-15

    A lot of changes have been made to the nuclear waste storage and disposal strategy over the last few years thanks to technological progress and changes in the requirements applicable in the sector. In this article, the authors present a concrete example of the actions undertaken, at the request of the French Nuclear Safety Authority (ASN), by the CEA Centre at Cadarache, regarding the Cadarache Centre waste storage facility (BNI 56), a facility which was originally intended as a permanent repository for solid waste. Commissioned in 1969, BNI 56 is made up of various trenches and pits which no longer meet current ASN requirements. To clean up these trenches, a legacy from the past, now requires considerable resources and involves many problems, especially due to uncertainty surrounding the nature, activity levels, packaging and volume of this waste. ASN ensures that the CEA will fully assume its overriding responsibility in the matter and implement safe, rigorous and transparent management solutions for all the waste. The BNI 56 trenches are an ongoing and concrete example of the difficulties inherent in recovering waste from storage and dismantling former facilities the design of which failed to take such aspects into account. This waste is now being repackaged so that it can be stored at a new basic nuclear installation called CEDRA (packaging and storage of radioactive waste) which complies with the safety requirements currently in force. This facility, commissioned in 2006, is intended for the storage of Type B solid radioactive waste for a period of 50 years pending construction of a deep geological repository or long-term storage facility. (authors)

  10. Les Cahiers du CREAD

    African Journals Online (AJOL)

    Admin

    information sur certaines d'entre elles, elles ont été exclues de facto du calcul. 2. La description du modèle MIMIC. Comme mentionné plus haut, le modèle MIMIC comprend deux ensembles d'équations: l'équation structurelle et l'équation de ...

  11. "Cirque du Freak."

    Science.gov (United States)

    Rivett, Miriam

    2002-01-01

    Considers the marketing strategies that underpin the success of the "Cirque du Freak" series. Describes how "Cirque du Freak" is an account of events in the life of schoolboy Darren Shan. Notes that it is another reworking of the vampire narrative, a sub-genre of horror writing that has proved highly popular with both adult and…

  12. Communication du Service juridique et du Département HR à l'attention des membres du personnel domiciliés en France

    CERN Multimedia

    HR Department

    2007-01-01

    Déclaration de revenus 2006 Les membres du personnel trouveront ci-après les informations nécessaires sur la manière de remplir la déclaration de revenus 2006, qui doit être retournée au plus tard le 31 mai 2007. Qui doit remplir la déclaration? Comment l'obtenir? Tous les membres du personnel1) domiciliés en France2), qu'ils soient ou non de nationalité française, doivent remplir la déclaration de revenus 2006 sur la base des présentes instructions et la renvoyer signée, au plus tard le 31 mai 2007, au centre des impôts de leur domicile. Les membres du personnel devraient recevoir la déclaration de revenus 2006 fin avril - début mai. Ceux qui ne la recevraient pas directement devront la retirer au centre des impôts, à la trésorerie ou à la mairie de leur domicile ou bien encore la télécharger sur le site internet du Ministère des Finances (www.finances.gouv.fr). Comment remplir la déclaration Les membres du personnel doivent remplir la DECLARATION PAPIER uniquement. Dé...

  13. L’Asie mystérieuse : premier numéro du Bulletin du Club Verne

    Directory of Open Access Journals (Sweden)

    Alain Chiron

    2012-02-01

    Full Text Available Depuis 2007 l’Association des Amis du Roman populaire a son siège et son centre de documentation à Vignacourt près d’Amiens. Si la revue Le Rocambole qu’elle produit perdure, cette association a souhaité replacer dans des objectifs de vulgarisation l’œuvre de Jules Verne dans le contexte de production de romans populaires pour la période allant des débuts du XIXe siècle à la Grande Guerre. D’où la création du nouveau périodique le Bulletin du Club Verne. Il est nécessaire de distinguer ce der...

  14. Teachers' Centres.

    Science.gov (United States)

    Thornbury, Robert, Ed.

    Teacher centers in England are professional laboratories where inservice teachers (freed from their classrooms by a release program) can share ideas, experiences, and problems with their colleagues and participate in the development and testing of teaching materials. The evolution of the teacher centers, their functioning, their projects, and…

  15. Livres | Page 31 | CRDI - Centre de recherches pour le ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    s) d'édition : CRDI. ISBN: Épuisé. Couverture du livre Telecommunications and Universal Service : International Experience in the Context of South African. Telecommunications and Universal Service : International Experience in the Context of ...

  16. Study of {Lambda}{sup +}{sub c} production and Pentaquark search in WA89 CERN experiment data; Etude de la production du {Lambda}{sup +}{sub c} et recherche du Pentaquark dans les donnees de l`experience WA89 du CERN

    Energy Technology Data Exchange (ETDEWEB)

    Charignon, F.

    1995-01-01

    This thesis is dedicated to the study of the {Lambda}{sub c}{sup +} charmed baryon and to the ``Pentaquark`` search, within the framework of the CERN WA89 experiment. This fixed target experiment is using a 330 GeV/c hyperon beam. Its aim is the production and the study of baryons carrying charm and strangeness as well as the search of multiquarks. The experimental setup is built around the CERN Omega spectrometer. Production and decay vertices of charmed particles are reconstructed by means of microstrip detectors. Multiwire proportional chambers reconstruct the trajectories in the Omega magnetic field and particle identification is provided by a Ring Imaging Cherenkov detector. An invariant mass signal has been obtained for the {Lambda}{sub c}{sup +} in the proton-kaon-pion decay channel. Distorsion effects occurring in the event reconstruction have been taken into account in the estimation of the {Lambda}{sub c}{sup +} lifetime and production cross-section. Finally, the exotic multiquark state ``Pentaquark`` was investigated in the channel proton-phi-pion but no signal was observed. (author). 86 refs., 56 figs.

  17. Publications | Page 102 | CRDI - Centre de recherches pour le ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    L'action du CRDI L'adaptation aux changements climatiques. De nouvelles connaissances pour un avenir incertain. Bien avant que l'expression « réchauffement de la planète » ne fasse la manchette, le Centre de recherches pour le développement international (CRDI), organisme.

  18. Publications | Page 101 | CRDI - Centre de recherches pour le ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    L'action du CRDI L'adaptation aux changements climatiques. De nouvelles connaissances pour un avenir incertain. Bien avant que l'expression « réchauffement de la planète » ne fasse la manchette, le Centre de recherches pour le développement international (CRDI), organisme.

  19. Kenya | Page 60 | IDRC - International Development Research Centre

    International Development Research Centre (IDRC) Digital Library (Canada)

    Bien avant que l'expression « réchauffement de la planète » ne fasse la manchette, le Centre de recherches pour le développement international (CRDI), organisme canadien, finançait des recherches sur les changements climatiques. Read more about L'action du CRDI L'adaptation aux changements climatiques.

  20. Inclusion in the Information Society in Asia | CRDI - Centre de ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    While the divide in terms of simple e-connectivity has narrowed, those at BOP face a problem of being excluded from the rich potential of services and applications .... L'honorable Chrystia Freeland, ministre du Commerce international, a annoncé le lancement d'un nouveau projet financé par le Centre de recherches pour le ...

  1. India | Page 52 | IDRC - International Development Research Centre

    International Development Research Centre (IDRC) Digital Library (Canada)

    Read more about Toward Détente in Media Piracy. Language English. Read more about Recherche d'une détente dans le dossier du piratage des médias. Language French. Read more about Startup : Philippine Community eCentres Network. Language English. Read more about Mise sur pied d'un réseau philippin de ...

  2. Colombia : tous les projets | Page 5 | CRDI - Centre de recherches ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    Sujet: INFORMATION CENTRES, COMMUNITY FACILITIES, MANAGEMENT TRAINING, INFORMATION TECHNOLOGY. Région: Americas, Colombia, South America. Financement total : CA$ 126,617.00. Psychologie sociale dans une Colombie se relevant d'un conflit. Project. Les traumatismes psychosociaux résultant du ...

  3. Child Soldiers Initiative | CRDI - Centre de recherches pour le ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    A number of militaries, human rights organizations, humanitarian groups, and peace and security actors have been grappling with the issue for some time, acting ... L'honorable Chrystia Freeland, ministre du Commerce international, a annoncé le lancement d'un nouveau projet financé par le Centre de recherches pour le ...

  4. South Africa : tous les projets | Page 11 | CRDI - Centre de ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    ... AGRICULTURAL WORKERS, SMALL FARMS, AGROINDUSTRY, FOOD SECURITY. Région: South Africa, South of Sahara. Programme: Alimentation, environnement et santé. Financement total : CA$ 40,000.00. Programme du Centre international pour la justice transitionnelle concernant Israël et les territoires occupés.

  5. Résidence du Corpus Troporum

    Directory of Open Access Journals (Sweden)

    Gunilla Iversen

    2005-11-01

    Full Text Available Les membres du Corpus Troporum, animé depuis des années par Gunilla Iversen (Stockholm, sont invités en résidence au Centre d’études médiévales d’Auxerre. Ce court séjour est destiné à mettre au point la publication du projet Sapientia- eloquentia. Il a été demandé au groupe d’organiser une journée sur les séquences et tropes de dédicace d’église (dimanche 23 octobre 2005.Presentation of the research project Corpus TroporumThe research project Corpus Troporum (formerly “Projektet Troper” h...

  6. Town Centre Redevelopment Strategies

    DEFF Research Database (Denmark)

    Vagnby, Bo Hellisen

    urban planning and design strategieswhich have been practised in most of the larger Danish towns: pedestrian streets, shopping centres, preservation of historic features, waterfronts, concentration of offices, conference and sports facilities, improvement og traffic and transport conditions as well...... as slum clearence and urban renewal. To a certain extent parallels are drawn to international experiences, especially where these are of such a nature that they can be assumed transferred to Danish connctions. Conclusively, the strategies are discussed in the light of the turn of Danish urban planning...

  7. Preliminary results of proton therapy in choroidal melanoma at the centre de proton therapy d`Orsay (C.P.O.): 464 initial cases; Resultats preliminaires de la protontherapie du melanome de la choroide au centre de protontherapie d`Orsay (CPO): les 464 premiers cas

    Energy Technology Data Exchange (ETDEWEB)

    Desjardins, L.; Levy, C.; D`hermies, F.; Frau, E.; Schlienger, P.; Habrand, J.L.; Mammar, H.; Schwartz, L.; Mazal, A.; Delacroix, S.; Nauraye, C.; Ferrand, R.; Asselain, B. [Centre de protontherapie d`Orsay, 91 - Orsay (France)

    1997-06-01

    Retrospective analysis of the treatment of choroidal melanoma with proton-therapy at the Centre de protontherapie d`Orsay, France. Between September 1991 and September 1995, 612 patients presenting with choroidal melanoma were treated by proton-therapy in Orsay. Following initial management of the first 464 patients, results were analyzed, as were results after a 1-year follow up for 305 patients, a 2-year follow-up for 169 patients, and a 3-year follow-up for 59 patients. Univariate analysis showed that the actuarial local recurrence rate was 5 %, the 3-year survival rate 88 %, and the overall metastatic rate 5%. The initial tumor volume was the most significant predictive factor for visual results and metastases. Multivariate analysis revealed that visual results were significantly related to the initial tumor volume, initial retinal detachment, and total dose delivered to the optic nerve and macula. Proton-therapy of choroidal melanoma allows in most cases conservation of the eye without modification of survival. Visual results mainly depend on the site and size of the tumor. (author) 16 refs.

  8. Development of gastrointestinal endoscopy in Malaysia: a historical perspective with special reference to the experience at the University of Malaya Medical Centre.

    Science.gov (United States)

    Goh, Khean-Lee

    2011-05-01

    Gastrointestinal endoscopy started in the early 1970s in Malaysia with the help of Japanese doctors. It has evolved over the past 30 years. The gastrointestinal endoscopy unit at the University of Malaya Medical Centre has been in the forefront in providing endoscopy services to patients as well as training doctors in endoscopy in the country. In recent years, trainees have included those from neighboring countries in South-East Asia. Among our most significant achievements is the organization of regular international therapeutic endoscopy workshops since 1993 where leading endoscopists from throughout the world have accepted our invitation as teaching faculty. In 2008, the World Organization of Digestive Endoscopy accorded the high distinction of Centre of Excellence to the endoscopy unit of the University of Malaya Medical Centre. © 2011 The Author. Digestive Endoscopy © 2011 Japan Gastroenterological Endoscopy Society.

  9. Ecologie du phytoplancton du lac Kivu

    Directory of Open Access Journals (Sweden)

    Sarmento, H.

    2008-01-01

    Full Text Available Speciation within the African Coffee Pathogen. Cet article analyse s'il est avantageux d'utiliser le compost au lieu de l'engrais minéral pour produire la laitue dans la zone urbaine et péri-urbaine de Yaoundé. Les résultats de terrain montrent l'obtention de rendements et profits plus élevés lorsqu'on utilise le compost. Les résultats de la fonction de production Cobb-Douglas prouvent que l'utilisation du compost est statistiquement significative pour expliquer la variation de rendement de la laitue et que le compost est l'intrant le plus productif. D'autres résultats montrent que le compost fournit la matière organique utile au sol et que les besoins d'irrigation en eau de la culture sont réduits grâce à l'utilisation du compost. Par conséquent, malgré le fait que l'application du compost demande une main-d'oeuvre beaucoup plus élevée, son utilisation est généralement bénéfique pour les agriculteurs vivant aux alentours de Yaoundé. Les programmes de vulgarisation de cet intrant pour encourager son adoption devraient donc figurer parmi les points prioritaires dans la politique agricole du gouvernement camerounais.

  10. Etude acoustique du systeme vocalique du chichewa

    African Journals Online (AJOL)

    le yao (10 %), le tumbuka (6,4 %), le nyakyusa-ngonde (2,9 %), le sena. (2,4 %) et le tonga (2, 1 %). Les langues pratiquees par ces .... Tisfyeni tip(1te kwambfri. Laissez-les beaucoup provoquer. Le deuxieme ..... rencontrer Jes cinq phonemes du chichewa : /a e i o ul. Rappelons que Jes elements stables de la phrase ...

  11. A brief overview of the Chemistry-Aerosol Mediterranean Experiment (ChArMEx) database and campaign operation centre (ChOC)

    Science.gov (United States)

    Ferré, Hélène; Dulac, François; Belmahfoud, Nizar; Brissebrat, Guillaume; Cloché, Sophie; Descloitres, Jacques; Fleury, Laurence; Focsa, Loredana; Henriot, Nicolas; Ramage, Karim; Vermeulen, Anne

    2016-04-01

    Initiated in 2010 in the framework of the multidisciplinary research programme MISTRALS (Mediterranean Integrated Studies at Regional and Local Scales; http:www.mistrals-home.org), the Chemistry-Aerosol Mediterranean Experiment (ChArMEx, http://charmex.lsce.ipsl.fr/) aims at federating the scientific community for an updated assessment of the present and future state of the atmospheric environment in the Mediterranean Basin, and of its impacts on the regional climate, air quality, and marine biogeochemistry. The project combines mid- and long-term monitoring, intensive field campaigns, use of satellite data, and modelling studies. In this presentation we provide an overview of the campaign operation centre (http://choc.sedoo.fr/) and project database (http://mistrals.sedoo.fr/ChArMEx), at the end of the first experimental phase of the project that included a series of large campaigns based on airborne means (including balloons and various aircraft) and a network of surface stations. Those campaigns were performed mainly in the western Mediterranean basin in the summer of 2012, 2013 and 2014 with the help of the ChArMEx Operation Centre (ChOC), an open web site that has the objective to gather and display daily quick-looks from model forecasts and near-real time in situ and remote sensing observations of physical and chemical weather conditions relevant for the everyday campaign operation decisions. The ChOC is also useful for post campaign analyses and can be completed with a number of quick-looks of campaign results obtained later in order to offer an easy access to, and comprehensive view of all available data during the campaign period. The items included are selected according to the objectives and location of the given campaigns. The second experimental phase of ChArMEx from 2015 on is more focused on the eastern basin. In addition, the project operation centre is planned to be adapted for a joint MERMEX-ChArMEx oceanographic cruise (PEACETIME) for a study at

  12. L'accès au savoir en Afrique : Le rôle du droit d'auteur | CRDI ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    12 déc. 2011 ... Les directeurs. Chris Armstrong, directeur de la recherche au projet D2ASA, est chercheur invité au LINK Centre de la Graduate School of Public and Development Management de l'Université du Witwatersrand, à Johannesburg, en Afrique du Sud. Jeremy de Beer, chercheur principal au projet D2ASA, est ...

  13. Bangladesh : tous les projets | Page 4 | CRDI - Centre de ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    Affichage 31 - 35 de 35. Lancement d'un réseau de télécentres au Bangladesh - Mission 2011. Project. La deuxième vague de télécentres a suscité l'avènement de réseaux nationaux dans plusieurs régions du monde, dont le réseau de télécentres de l'Ouganda, Mission 2007 en Inde et Mission Swaabhimaan au Népal.

  14. Search for the scalar partner of the top quark and contribution to the improvement of the calorimetry of the experiment D zero for the phase 2 of Tevatron; Recherche du partenaire supersymetrique du quark top et contribution a l'amelioration de la calorimetrie de l'experience D zero pour la phase 2 du tevatron

    Energy Technology Data Exchange (ETDEWEB)

    Olivier, B

    2001-04-01

    Supersymmetry could be the most natural extension of the Standard Model. In this thesis we present a new search for the sTop, the hypothetical scalar partner of the Top quark, that we performed in the framework of the Minimal Supersymmetric Standard Model (MSSM), using the Run I data of the DO experiment, which corresponds to an integrated luminosity of 108 pb{sup -1}. We selected events with one electron, one muon and missing transverse energy in the final state, which can be the decay product of pair of sTop quarks in 3 (t-tilde {yields} bl{nu}-tilde), or 4-body (t-tilde {yields} b{chi}-tilde{sub 1}{sup 0}l{nu}{sub l}). No signal is seen and the results are interpreted in terms of limits on the sTop production cross-section and exclusion regions in the parameter space (m{sub t}-tilde,m{sub {chi}}-tilde{sub 1{sup 0}}) or (m{sub t}-tilde,m{sub {nu}}-tilde). This new type of selection at the Tevatron for the search of the sTop allowed us to put stronger constraints than those previously published at LEP or at the Tevatron in the t-tilde {yields} bl{nu}-tilde channel, and the first limits ever set in the 4-body decay channel. For the 3-body channel, assuming that the sneutrino is the lightest supersymmetric particle (LSP), the excluded region at 95% confidence level extends up to a sTop mass of 142 (130) GeV if the sneutrino mass (m{sub {nu}}-tilde) is 43 (86) GeV. If the 4-body decay channel dominates, assuming that the neutralino is the LSP, the limit depends on the sneutrino mass. If it is light enough (m{sub {nu}}-tilde {approx}< 100 GeV) this limit reaches a sTop mass of 132 GeV for a neutralino mass of 60 GeV. In all searches for new particles, the calorimetry plays a crucial role from the experimental point of view. The expected increase in integrated luminosity in the Run II which started on the 1. of March 2001, and the detector upgrade which has been achieved over the last three years will allow to extend these exclusion domains or to discover the sTop. We

  15. Reflective Dialogues in Community Music Engagement: An Exploratory Experience in a Singapore Nursing Home and Day-Care Centre for Senior Citizens

    Science.gov (United States)

    Lum, Chee-Hoo

    2011-01-01

    This study documents a reflective journey of a community music programme initiated by a university music education faculty member and an occupational therapist within the setting of a nursing home and day-care centre in Singapore. Weekly music interaction sessions in conjunction with reminiscence therapy were conducted over a period of five…

  16. Developing a Patient Care Co-ordination Centre in Trafford, England: lessons from the International Foundation for Integrated Care (IFIC/Advancing Quality Alliance integrated care fellowship experience

    Directory of Open Access Journals (Sweden)

    Michael Gregory

    2015-05-01

    Full Text Available The NHS and Social Care in England are facing one of the biggest financial challenges for a generation. Commissioners and providers need to work on collaborative schemes to manage the increasing demand on health and social care within a period of financial constraint. Different forms of care co-ordination have been developed at different levels across the world.In the north-west of England, the Trafford health and social care economy have been working through a competitive dialogue process with industry to develop an innovative and dynamic solution to deliver seamless co-ordination for all patients and service users. The strategy is to develop a new Patient Care Co-ordination Centre, which will be responsible for the delivery of co-ordinated, quality care. The Patient Care Co-ordination Centre will work at clinical, service, functional and community levels across multiple providers covering risk stratification, preventative, elective and unscheduled care.I am the clinical lead for the Patient Care Co-ordination Centre and during my year as an Advancing Quality Alliance Integrated Care Fellow, I have had the opportunity to study examples of care coordination from UK and international sites. The learning from these visits has been assimilated into the design process of the Patient Care Co-ordination Centre.

  17. La procédure d'inscription du bassin minier du Nord-Pas de Calais sur la liste du Patrimoine mondial de l'Unesco. : Les paysages de la mine, un patrimoine contesté.

    OpenAIRE

    O'Miel, Catherine; de Pablo, Elisabeth; Stockinger, Peter; Winkler, Lisette; Bonnemazou, Camille

    2008-01-01

    Corpus "MemoMines"; Communication dans le cadre du colloque "Les paysages de la mine, un patrimoine contesté". Ce colloque organisé par le CILA (Comité d’Information et de Liaison pour l’Archéologie, l’étude et la mise en valeur du patrimoine industriel) et le Centre Historique Minier s’adresse aux universitaires (historiens, géographes, etc.), responsables politiques, ingénieurs, industriels, aménageurs, urbanistes, architectes, paysagistes, acteurs du patrimoine, étudiants... Là où la mine ...

  18. Les Cahiers du CREAD

    African Journals Online (AJOL)

    Admin

    Cet article est un produit du projet PNR 27 portant sur entrepreneuriale féminine en. Algérie. *. Professeur, Directeur du ... financement, réseaux, styles de gestion et performance (Brush, 1992; Bruin, Brush & Welter, 2007; ... tions et ses besoins, sa perception et la prise de risque), qu'à l'envi- ronnement, ses spécificités, ses ...

  19. Heavy quark resonances as a probe of quark-gluon plasma: optimization of the muon spectrometer of ALICE experiment and study of the J/{psi} production in the NA60 experiment; Les resonances de quarks lourds comme sonde du plasma de quarks et de gluons: optimisation du spectrometre a muons de l'experience ALICE et etude de la production du J/{psi} dans l'experience NA60

    Energy Technology Data Exchange (ETDEWEB)

    Pillot, Ph

    2005-05-15

    The study of heavy quark production such as J/{psi} (cc-bar resonance) and {upsilon} (bb-bar resonance) in heavy ion collisions at high incident energies has been proposed as a tool to investigate the formation of a Quark Gluon Plasma. Experimentally, these resonances can be detected through their decay channel into a muon pair, using a muon spectrometer. The optimal resolution of a muon spectrometer cannot be reached unless the position of the different tracking detectors are accurately known. In the first part of the work reported in this thesis are presented the design and performances of the Geometry Monitoring System of the ALICE experiment's muon spectrometer at LHC. This system, which is composed of several hundreds of RASNIK derived optical devices, allows to measure displacements and deformations of the chambers with a precision better than a hundred of microns. Thanks to its muon spectrometer associated with a vertex telescope, the NA60 experiment studies the dimuon production in nucleus-nucleus collisions at CERN SPS. The second part of the work reported in this thesis is related to the analysis of the data collected in indium-indium collisions at 158 GeV/c/nucleon. More specifically, the J/{psi} production together with its transverse momentum and transverse mass distributions are studied as a function of the centrality of the collision. The different results arising from our analysis are then compared to those obtained previously by NA38 and NA50, allowing a better understanding of the ultrarelativistic heavy ion collisions. (author)

  20. Bourse de recherche 2018 du CRDI | CRDI - Centre de recherches ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    Agriculture et sécurité alimentaire, Changements climatiques, Initiative de recherche concertée sur l'adaptation en Afrique et en Asie, Emploi et croissance, Alimentation, environnement et santé, Fondements pour l'innovation, Gouvernance et justice, Fonds d'innovation en vaccins pour le bétail, Santé des mères et des ...