WorldWideScience

Sample records for experience du centre

  1. La voie du Centre

    OpenAIRE

    2017-01-01

    Après avoir quelque peu louvoyé dans un discours apparemment anarchique où les souvenirs semblent se bousculer sans autre fil conducteur que la référence obsédante au mal satanique, brusquement le narrateur annonce un événement primordial : Foi um fato que se deu, um dia, se abriu. O primeiro. Depois o senhor verá por quê, me devolvendo minha razão (79). Cette introduction situe la rencontre du Menino comme fondatrice d’un destin dont il reviendrait au narrataire de dégager les enchaînements....

  2. 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

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

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

    Le Comité de gestion du Centre (CGC) est composé des membres de la haute direction du CRDI, notamment les directeurs de nos quatre bureaux régionaux et de nos principaux secteurs de programme. Le CGC travaille en collaboration avec le président afin de soutenir la recherche pour le développement, lui fournissant ...

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

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

    Résumé des fonctions. En tant que membre de l'équipe du Bureau d'assistance au sein de la Section du service à la clientèle (SSC), le coordonnateur du Bureau d'assistance offre au personnel du Centre et aux autres utilisateurs reconnus des installations TI du Centre un soutien de première ligne en matière d'utilisation ...

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

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

    Résumé des fonctions En qualité de dirigeant principal de l'audit (DPA), ... président du Centre et au président du Comité des finances et de l'audit une assurance et des ... Il fournit des services de gestion du risque organisationnel et d'autres ...

  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. 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

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

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

    fdieudonne

    VILLES SÛRES ET INCLUSIVES | AFRIQUE DE L'OUEST ET DU CENTRE. Spécificités de violence, d'exclusion, et de lutte contre la criminalité. République démocratique du Congo: Taux de natalité par femme, en moyenne 10 enfants, très élevé. Exclusion sociale exacerbée : des jeunes enfants accusés de sorcellerie.

  9. Decontamination of material in the Marcoule plutonium producing centre (1961); La decontamination du materiel dans le centre de production du plutonium de Marcoule (1961)

    Energy Technology Data Exchange (ETDEWEB)

    Rodier, J; Bouzigues, H; Boutot, P [Commissariat a l' Energie Atomique, Centre de Production de Plutonium, Marcoule (France). Centre d' Etudes Nucleaires

    1961-07-01

    The decontamination of material in an atomic centre is an essential operation in view of the cost and the difficulties of replacement. It also makes it possible to reduce the storage of radio-active materials always an expensive task. Surfaces are contaminated by retention of radioactive products and the mechanism of the bounding forces can be explained in terms of chemical, mechanical, electrostatic and surface tension phenomena. The methods used for decontamination are either physical (section, abrasion, steam, ultrasonics) or chemical (acids, alkalis, detergents, reducing and oxidising agents). At Marcoule, chemical methods of treatment are used. This is effected in tanks, the exact composition of the liquids being regulated from a control panel. Working experience has shown that the fact of operating in humid conditions eliminates all problems of atmospheric contamination; as a result it is possible for the personnel to work without any special protective devices. Almost all the material can be re-utilized and the operations produce only a small volume of liquid waste. The decontamination workshop is operated by a small number of workers. The working costs, including capital repayment and treatment of the waste, do not exceed 15 per cent of the value of the apparatus treated. (authors) [French] La decontamination du materiel dans un centre atomique est une operation indispensable etant donne le cout et les difficultes du remplacement. Elle contribue aussi a diminuer les stockages toujours onereux des materiaux radioactifs. Les surfaces se contaminent par retention de corps radioactifs, l'origine des forces de liaison devant etre recherchee dans les phenomenes chimiques, mecaniques, electro-statiques ou de tensions superficielles. Les methodes de decontamination peuvent etre physiques (aspiration, abrasion, vapeur, ultra-sons) ou chimiques (acides, alcalins, detergents, reducteurs, oxydants). Sur le centre de Marcoule, la methode des traitements chimiques a ete

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

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

    Carrières · Possibilité de nomination · Possibilités d'emploi · Emplois pour étudiants · Ce que nous avons à offrir · Possibilité d'emploi avec le Conseil des gouverneurs du CRDI · Nouvelles et événements · Communiquez avec nous · Gouvernance · Conseil des gouverneurs · Gestion du Centre · Plan stratégique du CRDI.

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

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

    Sous la supervision du gestionnaire, Infrastructure, sécurité et documents (ISD), ... et de la maintenance courants des divers systèmes d'infrastructure du Centre, ... techniques dans les régions et des techniciens sous contrat) pour fournir des ...

  12. Sud du Sahara | Page 232 | CRDI - Centre de recherches pour le ...

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

    Sud du Sahara. Sud du Sahara. Read more about Démarches novatrices en ce qui a trait à la délégation des tâches en santé mentale. Langue French. Read more about Institutional Support: Centre for Economic and Social Research, Education and Documentation (Burkina Faso). Langue English. Read more about ...

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

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

    Dans un nouveau documentaire fascinant, des chercheurs du Centre for the Study of Violence and Reconciliation font part de leurs observations sur la façon dont un programme d'emploi public de l'Afrique du Sud contribue à rendre les villes plus sécuritaires et inclusives. Read more about Un documentaire démontre ...

  14. Sud du Sahara | Page 282 | CRDI - Centre de recherches pour le ...

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

    Dans un nouveau documentaire fascinant, des chercheurs du Centre for the Study of Violence and Reconciliation font part de leurs observations sur la façon dont un programme d'emploi public de l'Afrique du Sud contribue à rendre les villes plus sécuritaires et inclusives. Read more about Un documentaire démontre ...

  15. Sud du Sahara | Page 280 | CRDI - Centre de recherches pour le ...

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

    Dans un nouveau documentaire fascinant, des chercheurs du Centre for the Study of Violence and Reconciliation font part de leurs observations sur la façon dont un programme d'emploi public de l'Afrique du Sud contribue à rendre les villes plus sécuritaires et inclusives. Read more about Un documentaire démontre ...

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

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

    Sud du Sahara. Sud du Sahara. Read more about Health Financing and Benefit Incidence Analysis in Uganda and Zambia. Langue English. Read more about Le Centre d'innovation pour la résilience de l'Afrique de l'Est. Langue French. Read more about Climate Change and Water Adaptation Options. Langue English.

  17. Sud du Sahara | Page 200 | CRDI - Centre de recherches pour le ...

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

    Sud du Sahara. Sud du Sahara. Read more about TTI Phase 2 Institutional Support: Economic Policy Research Centre. Langue English. Read more about TTI Phase 2 Institutional Support: Science, Technology and Innovation Policy Research Organization. Langue English. Read more about Relations entre les think tanks ...

  18. 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 ...

  19. Les TIC au secours des éleveurs du Sahel | CRDI - Centre de ...

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

    7 févr. 2011 ... ... grand marché hebdomadaire des zones rurales du Sénégal. ... Comment, alors, aider les communautés rurales à pratiquer un mode d'élevage plus ... du Centre de recherches pour le développement international (CRDI). ... Enfin, certains éleveurs ont aussi été initiés à l'informatique pour accéder à ...

  20. Les héros du banc Danajon | CRDI - Centre de recherches pour le ...

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

    27 janv. 2011 ... Pourtant, on a salué partout dans le monde les efforts qu'ils ont déployés pour protéger le milieu marin du banc Danajon, au centre des Philippines. En septembre 2006, le Disney Wildlife Conservation Fund (DWCF) a fait de Kamada — le regroupement de pêcheurs du banc Danajon — un héros de la ...

  1. 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.

  2. Le futur du travail | CRDI - Centre de recherches pour le ...

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

    12 juin 2017 ... Trois hommes qui travaillent sur le projet de livraison de drone au Rwanda. Sarah Farhat / Banque mondiale. La numérisation, l'automatisation et les communications en réseau façonnent de plus en plus les sociétés, les marchés du travail et les occasions d'emploi à l'échelle mondiale. Les changements ...

  3. Centre de Recherches du Service de Sante des Armees. 1977 scientific works

    International Nuclear Information System (INIS)

    The annual report, where the scientific works of the Centre de Recherches du Service de Sante des Armees (CRSSA) carried on during 1977 are summarized as short notes, is presented. The following topics are particularly studied: biological and chemical changes induced by external irradiation; combined effects of irradiation and surgery, irradiation and burns; radioprotective substances; radiotoxicology; radiocontamination [fr

  4. 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.

  5. 73 Utilisation du SIG pour une réorganisation urbaine du centre-ville ...

    African Journals Online (AJOL)

    TOHOZIN

    restructuration des routes, du chemin de fer, des bâtis et des cours d'eaux. ... aussi la réalisation d'une mappe foncière qui est un instrument capital en matière ..... confirmer que le SIG, en tant qu'outil de décision et de planification a ...

  6. Etude s?ro-?pid?miologique de la leishmaniose canine au centre du Maroc

    OpenAIRE

    Fellah, Hajiba; Doughmi, Oursula; Maniar, Sa?d; Lalami, Abdelhakim El Ouali

    2014-01-01

    Dans le monde, la leishmaniose visc?rale humaine est connue pour avoir comme principale source d'infection les Canid?s domestiques et sauvages. Au centre du Maroc, les donn?es ?pid?miologiques, cliniques et parasitologiques sur la leishmaniose canine, sont quasiment inexistantes. Ce travail traite une ?tude prospective au cours de laquelle 61 s?rums canins ont ?t? analys?s par un test rapide et par l'immunofluorescence indirecte. La sensibilit? du test rapide par rapport ? celle de l'immunofl...

  7. 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)

  8. Nuclear research centres - The Egyptian experiment

    International Nuclear Information System (INIS)

    Abdelrazek, I.D.

    2001-01-01

    The Atomic Energy Authority of Egypt has four research centres located at two sites. Its research reactors are devoted to the production of isotopes, neutron beam experiments, activation analysis and materials research. The accelerators are devoted to the production of short lived isotopes for medical applications and materials R and D. Irradiation technology is used for sterilization of medical supplies and food preservation. High level of expertise in those centres is also useful for other developmental activities in Egypt. (author)

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

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

    Cette subvention permettra à l'Institute of Policy Studies (IPS) du Sri Lanka, bénéficiaire de l'Initiative Think Tank, de réaliser des recherches de qualité, axées sur les politiques, sur la migration économique. La recherche sera centrée sur des questions soulevées par la National Human Resources and Employment Policy ...

  10. Environmental monitoring of the Cea Valduc centre; La surveillance environnementale du site du CEAValduc

    Energy Technology Data Exchange (ETDEWEB)

    Guetat, Ph. [CEA Valduc, Dir. adjoint, 21 - Is-sur-Tille (France); Jaskula, L. [CEA Valduc, service de protection contre les rayonnements, 21 - Is-sur-Tille (France)

    2010-06-15

    This paper describes the main features of the environmental control in the vicinity of the CEA Valduc centre, explains the site specific characteristics, the surveillance policy, and some historical elements about tritium atmospheric release. Some levels of activities are given, corresponding to an exposure level below 0.02% of natural irradiation. (author)

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

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

    Initiative Think tank - Fondation Hewlett. Le CRDI et la Fondation William et Flora Hewlett unissent leurs efforts dans le cadre d'une nouvelle initiative destinée à renforcer les groupes de réflexion et centres de recherche sur les... Voir davantageInitiative Think tank - Fondation Hewlett ...

  12. Gestion intégrée du mildiou du mil en station au centre régional de ...

    African Journals Online (AJOL)

    user

    Le mil (Pennicetum glaucum) L.R.Br constitue 75% de la production céréalière du Niger. Cependant, son rendement est très faible dû à plusieurs types de contraintes. La maladie du mildiou du mil causé par un champignon Sclerospora graminicola (Sacc) Schroët, occupe une place importante. L'objectif de cette étude.

  13. Treatment of effluent at the Saclay Centre d'Etudes Nucleaires (1960); Le traitement des effluents du Centre d'Etudes Nucleaires de Saclay (1960)

    Energy Technology Data Exchange (ETDEWEB)

    Wormser, G [Commissariat a l' Energie Atomique, Saclay (France).Centre d' Etudes Nucleaires

    1960-07-01

    The Centre d'Etudes Nucleaires at Saclay possesses several installations from which liquid radioactive effluent is rejected, and it has thus been found necessary to construct a station for the purification of radioactive liquids and to settle various chemical, analytical and technological problems. This report describes, in the following order: - the disposal possibilities at the Centre d'Etudes Nucleaires, Saclay, - the effluents produced at the centre, - the set-up for collecting effluent, - treatment of the effluent, - results of these treatments. (author) [French] La presence, au Centre d'Etudes Nucleaires de Saclay, de plusieurs installations susceptibles de rejeter des effluents liquides radioactifs a necessite la construction d'une station d'epuration d'eaux radioactives et la mise au point de differents problemes chimiques, analytiques et technologiques. Dans ce rapport, nous exposerons successivement: - les possibilites de rejet du Centre d'Etudes Nucleaires de Saclay, - les effluents du centre, - le dispositif de collecte des effluents, - le traitement de ces effluents, - les resultats de ces traitements. (auteur)

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

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

    Un nouveau projet de recherche sur la prévention du VIH a conduit à la réalisation d'un essai national novateur de prévention du VIH au Botswana. Read more about Des résultats de recherche mènent à la réalisation d'essais de prévention du VIH dans l'ensemble du Botswana. Langue French. New research into HIV ...

  15. Asie du sud | Page 38 | CRDI - Centre de recherches pour le ...

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

    Asie du sud. Asie du sud. Read more about Advancing LDCs Interests in the WTO: Strengthening Participation, Securing Priorities (TTI). Langue English. Read more about Resserrement des réseaux pour la lutte contre les maladies infectieuses émergentes en Asie du Sud-Est et en Chine - 2e phase de l'APEIR. Langue ...

  16. 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

  17. Review of safety precautions derived from six-year experience of a spent fuel reprocessing plant - Centre de Marcoule; Elements de securite tires de six annees d'exploitation de l'usine de traitement de combustibles irradies du Centre de Marcoule

    Energy Technology Data Exchange (ETDEWEB)

    Rodier, J [Commissariat a l' Energie Atomique, Centre de Production de Plutonium, Marcoule (France). Centre d' Etudes Nucleaires

    1964-07-01

    an organization of the work aimed at eliminating the causes of incidents. They investigate the following points in particular: - frequency of entry into forbidden zones during normal functioning - the distribution of exceptional tasks - the prevention of criticality risks - zone contamination incidents - the volume and nature of decontaminated material and eliminated residues - the evolution and distribution of external irradiation doses received by the workers - the frequency of cases of body contamination - internal contamination fixed in the organisms of workers. Conclusions are drawn from the different incidents which have occurred during the years of operating the plant. (author) [French] Dans une usine de traitement de combustibles irradies comme dans toute autre usine, la continuite de la production ne peut etre obtenue que par une recherche constante de la securite. Les auteurs examinent les elements de securite apportes par la conception des installations tant au point de vue de la securite classique que de la securite radiologique. Dans l'industrie nucleaire, il ne suffit pas, en effet, d'adopter seulement les precautions habituelles prises contre les risques d'explosion, d'incendie...; il faut aussi apporter beaucoup d'attention aux problemes poses par le confinement des matieres, la radioactivite et les risques de criticite. Les principes generaux de la prevention technique contre les risques radioactifs sont maintenant bien connus. Leur application doit se traduire des la conception des installations par des dispositions concernant: - la conception et la realisation des installations vis-a-vis des risques deja enumeres, - la division de l'usine en zones, - la circulation du personnel et du materiel, - la ventilation et l'epuration de l'air. Les facteurs techniques de securite ne sont toutefois pas suffisants a eux seuls. Quelle que soit la qualite du materiel et le degre d'automatisme atteint, la continuite de fonctionnement d'une usine implique l

  18. Semaine du Cerveau 2018 : le CSGA mobilisé : Actualité du CSGA relative à l'experimentarium spécial cerveau, publiée le 5 mars 2018 par Ludovic Piquemal dans la newsletter du Centre INRA de Bourgogne-Franche-Comté sur inra.fr

    OpenAIRE

    2018-01-01

    Pour la 20éme édition de la Semaine du Cerveau, les chercheurs du Centre des Science du Goût et de l'Alimentation se mobilisent auprès du public dijonnais à travers une conférence à Clénay sur les maladies neurodégénératives (samedi 17 mars) et en accueillant un Expérimentarium spécial cerveau (dimanche 18 mars).

  19. 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 ...

  20. Myanmar: The Community Learning Centre Experience.

    Science.gov (United States)

    Middelborg, Jorn; Duvieusart, Baudouin, Ed.

    A community learning centre (CLC) is a local educational institution outside the formal education system, usually set up and managed by local people. CLCs were first introduced in Myanmar in 1994, and by 2001 there were 71 CLCs in 11 townships. The townships are characterized by remoteness, landlessness, unemployment, dependency on one cash crop,…

  1. Tourism potential valorisation of the old town centre in Sombor based on the Hilary Du Cros model

    Directory of Open Access Journals (Sweden)

    Igor Stamenković

    2013-01-01

    Full Text Available Cultural heritage and tourism are interconnected. As the development of tourism contributes to economic development, it is first necessary to perform an adequate valorisation of cultural heritage, in order to create a suitable tourism product. Old town centres as such, are the objects of different activities aimed at its development and adaptation to new trends. In this paper, focus is on the old town centre in Sombor, with an aim to determine its status in the competitive market of cultural tourism, whether it could be an independent motive that could attract potential tourists, as well as to determine the necessary actions needed to improve quality and competitiveness in order bring them to a higher level. With this in mind, this paper deals with the tourism valorisation of the old town centre based on the model of H. Du Cros.

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

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

    CRDI), un groupe de chercheurs du palier national et de la province du Koh Kong utilise une nouvelle approche pour gérer les ressources de la mangrove. Cette approche, qui fait appel à l'esprit d'initiative des membres de la ...

  3. Sud du Sahara | Page 188 | CRDI - Centre de recherches pour le ...

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

    ... mer dans les zones côtières du delta du Nil (Égypte). Langue French. Read more about Involvement of the Private Security Sector in African Conflicts, Peacekeeping and Humanitarian Assistance Operations. Langue English. Read more about Building Livelihood Resilience to Alleviate Poverty in Semi-arid Areas of West ...

  4. Connecter l'Afrique, du Cap au Caire | CRDI - Centre de recherches ...

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

    10 janv. 2011 ... La recherche bien appliquée. Des recherches ... d'échelle essentielles pour mener à bien des projets d'envergure à des coûts abordables. Ironie du sort ... Même les personnes qui connaissent peu les TIC pourraient regarder les cartes et comprendre les enjeux », affirme Heloise Emdon, du CRDI. Dans le ...

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

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

    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 : enjeux et implications pour la ...

  6. Sud du Sahara | Page 289 | CRDI - Centre de recherches pour le ...

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

    ensemble du pays, mais la criminalité et la violence sont à la hausse. Des chercheurs de l'université du Ghana soutenus par le CRDI ont mené une enquête pour essayer de déterminer pourquoi la réduction de la pauvreté n'aidait pas à ...

  7. Sud du Sahara | Page 228 | CRDI - Centre de recherches pour le ...

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

    Sud du Sahara. Sud du Sahara. Read more about Equinet : réappropriation des ressources aux fins de la santé - phase V. Langue French. Read more about EQUINET : Reclaiming the Resources for Health - Phase V. Langue English. Read more about Remittances to Conflict Zones : the Sudanese Diaspora in Cairo ...

  8. L'évolution du développement durable | CRDI - Centre de ...

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

    28 janv. 2011 ... Profil du domaine de programme Environnement et gestion des ressources naturelles (EGRN) du CRDILe « développement durable » est un terme largement utilisé dont la signification diffère selon qui l'emploie. Notre avenir à tous, rapport de la Commission Brundtland paru en 1987, définit le ...

  9. Sud du Sahara | Page 144 | CRDI - Centre de recherches pour le ...

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

    2015-03-31

    flexible layoutflexible layoutflexible layoutflexible layoutflexible layoutflexible layoutflexible layoutflexible layout. Sud du Sahara. The Kenya National Commission for Science, Technology and Innovation (NACOSTI), in collaboration with IDRC, launched Kenya's first Research Chair on March 31, 2015 in Nairobi. Professor ...

  10. Asie du sud | Page 12 | CRDI - Centre de recherches pour le ...

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

    8 · 9 · 10 · 11; 12; 13 · 14 · 15 · 16 … 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 ...

  11. Asie du sud | Page 39 | CRDI - Centre de recherches pour le ...

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

    35 · 36 · 37 · 38; 39; 40 · 41 · 42 · 43 … 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 ...

  12. Sud du Sahara | Page 25 | CRDI - Centre de recherches pour le ...

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

    21 · 22 · 23 · 24; 25; 26 · 27 · 28 · 29 … 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 ...

  13. Sud du Sahara | Page 264 | 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.

  14. Sud du Sahara | Page 271 | 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.

  15. Sud du Sahara | Page 253 | 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.

  16. Asie du sud | Page 58 | 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.

  17. Sud du Sahara | Page 207 | CRDI - Centre de recherches pour le ...

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    Read more about Variabilité du climat et conditions d'accès aux ressources en eau et de leur utilisation dans les quartiers informels de Ouagadougou, au Burkina Faso. Langue French. Read more about Crise du virus Ebola : Améliorer la communication scientifique et le journalisme local en période d'urgence et après une ...

  18. 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…

  19. The experience of work in a call centre environment

    Directory of Open Access Journals (Sweden)

    Sanet Hauptfleisch

    2006-10-01

    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.

  20. 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

  1. Experience building and operating the CMS Tier-1 computing centres

    Science.gov (United States)

    Albert, M.; Bakken, J.; 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.

    2010-04-01

    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 to scale to large numbers of processing requests and large volumes of data, and the ability to provide custodial storage and high performance data serving. We will also present the operations experience utilizing the distributed Tier-1 centres from a distance: transferring data, submitting data serving requests, and submitting batch processing requests.

  2. Experience building and operating the CMS Tier-1 computing centres

    International Nuclear Information System (INIS)

    Albert, M; Bakken, J; Huang, Chih-Hao; Dumitrescu, C; Fagan, D; Fisk, I; Giacchetti, L; Gutsche, O; Holzman, B; Bonacorsi, D; Grandi, C; Brew, C; Jackson, J; Charlot, C; Colling, D; Fassi, F; Flix, J; Gomez-Ceballos, G; Hahn, K; Gowdy, S

    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 to scale to large numbers of processing requests and large volumes of data, and the ability to provide custodial storage and high performance data serving. We will also present the operations experience utilizing the distributed Tier-1 centres from a distance: transferring data, submitting data serving requests, and submitting batch processing requests.

  3. The velodrome of the World Cycling Centre at Aigle, Switzerland; Centre mondial du cyclisme a Aigle. Gonfle, le velodrome

    Energy Technology Data Exchange (ETDEWEB)

    Giovanna, S.

    2002-07-01

    This article presents the construction and the architecture of the new World Cycling Centre in Aigle, Switzerland, near Lausanne. The Centre includes an indoor velodrome, a hall for gymnastics and an administrative building. The wooden cycling ring is 200 m long. The velodrome roof is the most challenging part of the construction. It is made of a double inflated translucid PVC membrane supported by a three dimensional metallic structure, which also supports the space heating system as well as the electric lighting system. The roof translucency insures comfortable daylighting. The space heating system, operated with natural gas, is running completely quiet and allows a good control of indoor air humidity. The various zones in the building have individual heat emission devices and controllers, according to specific indoor climate requirements.

  4. Au-delà du vecteur | CRDI - Centre de recherches pour le ...

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

    30 mai 2011 ... L'équipe du programme Écosystèmes et santé humaine (ÉCOSANTÉ) du CRDI travaille avec des chercheurs de pays en développement en vue de trouver des solutions aux problèmes de santé humaine reliés à l'état des écosystèmes. Regarder la vidéo sur YouTube (sélectionner le sous-titrage en ...

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

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

    premier · ‹ précédent · 1 · 2 · 3; 4; 5 · 6 · 7 · 8 · 9 … 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 ...

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

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

    14 juin 2017 ... La démarche de financement de la recherche du PEP est singulière et fort efficace, car elle vise plutôt à améliorer l'expertise des chercheurs des pays en développement ... Le modèle du PEP fonctionne bien, a-t-il ajouté, et il a une influence fort positive sur l'élaboration éclairée de politiques nationales. ».

  7. 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)

  8. 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)

  9. Asie du sud | Page 31 | CRDI - Centre de recherches pour le ...

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

    Seed Alliance). Langue English. Read more about Parer aux menaces en matière de biosécurité provenant de maladies infectieuses à fort potentiel pandémique en Asie du Sud-Est. Langue French. Read more about La transformation ...

  10. Sud du Sahara | Page 181 | CRDI - Centre de recherches pour le ...

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

    Read more about Canada-Africa Prevention Trials (CAPT) Network : renforcement des capacités en vue d'essais cliniques en matière de prévention du VIH/sida en Afrique. Langue French. Read more about Canada-Africa Prevention Trials Network : Building African Capacity for HIV/AIDS Prevention Trials. Langue English.

  11. Asie du sud | Page 194 | CRDI - Centre de recherches pour le ...

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

    Increased soil erosion, reduced water-storage capacity, changes in microclimates, and loss of nutrients have led to a decline in the productivity of marginal lands and the impoverishment of local communities. Read more about Deforestation in Viet Nam. Langue English. Au tout début du siècle, les gibbons, qui étaienttrès ...

  12. Asie du sud | Page 112 | CRDI - Centre de recherches pour le ...

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

    Increased soil erosion, reduced water-storage capacity, changes in microclimates, and loss of nutrients have led to a decline in the productivity of marginal lands and the impoverishment of local communities. Read more about Deforestation in Viet Nam. Langue English. Au tout début du siècle, les gibbons, qui étaienttrès ...

  13. 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 ...

  14. 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.

  15. Sud du Sahara | Page 256 | CRDI - Centre de recherches pour le ...

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    ... Democratic Republic of Congo : Feasibility Study and Advocacy. Langue English. Read more about Citoyens du monde : les répercussions des programmes de travail rémunéré et de travail bénévole à l'étranger. Langue French. Read more about Creating Global Citizens : Impact of Volunteer and Work Abroad Programs.

  16. Sud du Sahara | Page 105 | CRDI - Centre de recherches pour le ...

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    ... Democratic Republic of Congo : Feasibility Study and Advocacy. Langue English. Read more about Citoyens du monde : les répercussions des programmes de travail rémunéré et de travail bénévole à l'étranger. Langue French. Read more about Creating Global Citizens : Impact of Volunteer and Work Abroad Programs.

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

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

    5 nov. 2010 ... ... locale, et les États disposant de moins de ressources ont du mal à recruter des ... Ainsi, peu de femmes détiennent des postes politiques ou ... dans le cadre de la conception d'une stratégie de microcrédit et de finances à ...

  18. Sud du Sahara | Page 169 | CRDI - Centre de recherches pour le ...

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

    arides. Langue French. Read more about Pathways to Resilience in Semi-Arid Economies. Langue English. Read more about Changement climatique : vulnérabilité, impact et adaptation dans les plaines et les zones humides de l'État du Delta au ...

  19. Asie du sud | Page 10 | CRDI - Centre de recherches pour le ...

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    Langue English. Read more about Comparaison des politiques fiscales et réglementaires pour prévenir les maladies non transmissibles en Inde. Langue French. Read more about Moyens que prennent les collectivités pour faire face aux souvenirs traumatiques - enseignements tirés d'Aceh et du Timor-Leste. Langue ...

  20. Sud du Sahara | Page 194 | CRDI - Centre de recherches pour le ...

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    Read more about Child Soldiers Initiative. Langue English. Read more about Enfants soldats. Langue French. Read more about Transfert du modèle prédictif d'épidémie de paludisme aux utilisateurs de l'Afrique de l'Est. Langue French. Read more about Transferring the Malaria Epidemic Prediction Model to Users in East ...

  1. Le point sur les indices du bien-être national | CRDI - Centre de ...

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

    21 janv. 2011 ... Les indices économiques sont des outils statistiques qui résument des ... En quelques mots, le PIB correspond à la valeur totale des biens et ... copieux menu d'instruments de mesure allant du réjouissant Happy Planet Index, ...

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

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    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 ...

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

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    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 ...

  4. Sud du Sahara | Page 272 | CRDI - Centre de recherches pour le ...

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    Sud du Sahara. Read more about Decentralization, Local Politics and the Construction of Women's Citizenship (Uganda, Kenya and Tanzania) - Phase I. Langue English. Read more ... Read more about Monitoring Progress Toward the Information Society : Digital Divide Index. Langue English. Read more about Réforme ...

  5. Plantes alimentaires spontanées de la région du Fromager (Centre ...

    African Journals Online (AJOL)

    Sci-Nat

    plantes spontanées alimentaires du department d'Oumé (Côte d'Ivoire). Mémoire de D.E.A d'Ecologie tropicale (Option : Végétale). Université de Cocody Abidjan, Côte d'Ivoire, 122 pp. Lebrun J. P., Stork A. L., (1991, 1992, 1995, 1997). Enumération des plantes à fleurs d'Afrique tropicale. Genève Conservatoire et Jardin.

  6. 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 ...

  7. Sud du Sahara | Page 65 | 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 ...

  8. Sud du Sahara | Page 180 | CRDI - Centre de recherches pour le ...

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

    Read more about Renforcement de la capacité de mener des essais de prévention de la transmission du VIH au personnel de la santé. Langue French. Read more about Établissement d'une plateforme commune de recherche sur le vaccin contre le VIH et d'un programme de traitement des personnes infectées par le VIH.

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

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

    Nakacho was one of just a handful of women at this artisanal mining site who had managed to break away from the roles generally ascribed to her gender to become a ... Trouver un juste équilibre entre s'occuper des enfants et générer des revenus est un problème auquel sont confrontées les mères autour du monde.

  10. Plan d'action stratégique du ROCARE - 2007-2011 | CRDI - Centre ...

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

    Téléchargez le PDF. Articles de revue. Recherche en éducation : 21 équipes bénéficient du programme de petites subventions Rocare 2007. Téléchargez le PDF. Articles de revue. Côte d'Ivoire : le réseau ouest africain de recherche en éducation (ROCARE) organise un séminaire sur la rédaction scientifique à Abidjan.

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

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

    Langue French. Read more about Journal supplement features 10 years of West African health systems research. Langue English. Un virologiste canadien a réalisé une percée : il a créé un vaccin unique contre cinq maladies du bétail qui pourrait transformer la vie de millions de gens en Afrique et ailleurs dans le monde.

  12. Sud du Sahara | Page 158 | CRDI - Centre de recherches pour le ...

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

    Les prévisions des services météorologiques du Kenya ont gagné en fiabilité, mais les agriculteurs n'y ont guère recours pour prendre des décisions appropriées relativement à la gestion de leur exploitation, car elles ne tiennent pas compte des réalités locales. Dans le cadre de cette étude de cas, des chercheurs ont ...

  13. Sud du Sahara | Page 141 | CRDI - Centre de recherches pour le ...

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

    Les prévisions des services météorologiques du Kenya ont gagné en fiabilité, mais les agriculteurs n'y ont guère recours pour prendre des décisions appropriées relativement à la gestion de leur exploitation, car elles ne tiennent pas compte des réalités locales. Dans le cadre de cette étude de cas, des chercheurs ont ...

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

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

    3 févr. 2011 ... Élévation du niveau de la mer, ondes de tempête, inondations littorales : les ... Un plan d'action en matière de gestion intégrée du littoral et une nouvelle ... du territoire sans recourir à un guide de la dynamique du milieu côtier. ... local, et encore moins de contrôle sur les terres dont elles sont tributaires.

  15. 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)

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

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

    L'éducation dans l'hémisphère sud est confrontée à plusieurs importants défis interdépendants dont la solution semble reposer sur les ressources éducatives libres (REL). Ces défis comprennent l'accès inégal à l'éducation, la qualité variable des ressources éducatives, de l'enseignement et du rendement des étudiants, ...

  17. La commercialisation du tabac : Un écran de fumée | CRDI - Centre ...

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

    23 déc. 2010 ... Une fois de plus l'industrie du tabac a recours à la tromperie pour mettre en marché un produit qui ... pipe à eau est de plus en plus à la mode quand elles se réunissent. ... Ce traité international, le premier lié à la santé, cherchera à établir ... Tout en facilitant l'accès à la publicité sur le tabac aux jeunes qui ...

  18. 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 ...

  19. Asie du sud | Page 96 | CRDI - Centre de recherches pour le ...

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

    Dans les collines Kolli, dans l'État du Tamil Nadu, la monoculture d'une seule variété de manioc, non comestible, pour l'industrie de l'amidon s'est traduite par la prévalence accrue de maladies, l'érosion des sols et une perte de diversité des cultures locales, ce qui a eu une incidence négative sur la sécurité alimentaire et ...

  20. Asie du sud | Page 107 | CRDI - Centre de recherches pour le ...

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

    In this spirit, Viet Nam's Minister of Science, Technology and Environment approached the International Development Research Centre ( IDRC ) and the ... of social difference is needed to find answers to the questions of who participates and how, and who benefits and how from development interventions, projects, ...

  1. Asie du sud | Page 109 | CRDI - Centre de recherches pour le ...

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

    ... result of the proliferation of Internet connectivity and technologies in the region. In response to this trend, Canada's International Development Research Centre ( IDRC ) commissioned four studies to investigate the various economic, social, methodological, and security issues related to this emerging business paradigm.

  2. 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....

  3. 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....

  4. Sud du Sahara | Page 281 | CRDI - Centre de recherches pour le ...

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

    ... novel ideas, networks. Langue English. En octobre 2010, des intéressés de divers pays de l'Afrique de l'Ouest se sont réunis à Accra, au Ghana, afin de discuter de la mise en place d'un centre voué à la promotion de l'intégration régionale, de la bonne gouvernance et de la démocratie. Read more about Planification de ...

  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. MINT Incineration and Renewable Energy Centre - experience and challenge

    International Nuclear Information System (INIS)

    Mohamad Puad Abu

    2005-01-01

    MIREC is the acronym for MINT Incineration and Renewable Energy Centre which was established in the year 2000 to carry out research and provide services on matters related to incineration technology and renewable energy. Throughout this period, many challenges and experiences has been faced by MIREC. Three research contracts with the value of nearly RM 1 million have been signed. Four laboratory scale burners have been designed and fabricated. Three mathematical models have been developed. Three programs on enhancement image have been published. Three papers have been published in the international journal. In order to achieve all these, many obstacles were faced by MIREC. This paper will discuss on the experiences and challenges that could be shared together with MINT staff. (Author)

  7. Retrospective analysis of paediatric achalasia in India: Single centre experience

    Directory of Open Access Journals (Sweden)

    Sunita Singh

    2012-01-01

    Full Text Available Background: Developing countries at tertiary referral centre. The aim of this study was to share our experience of paediatric achalasia in Indian scenario. Materials and Methods: This was a retrospective analysis of children <16 years, operated for achalasia at our centre, from December 1998 to December 2011. Results: Total 40 patients (mean age 39 ± 4.29 months, including 1 patient of megaesophagus were operated over 13 years of period; 17 patients (associated congenital H-type tracheoesophageal fistula in one patient, non- responders/ lost follow-up for minimum of 3 years in 16 patients were excluded from the study. The response rate of parents in follow-up was 60.0%. Mean symptoms duration was 27.88 ± 2 months. Most common symptoms were regurgitation and failure to thrive (78.2%. Mean symptom scoring in follow-up after 3 year was 1 ± 0.7 compared to 5 ± 0.51 at the time of admission (P < 0.012. One infant expired (mediastenitis, one developed adhesive intestinal obstruction and one needed posterior re-myotomy (for megaesophagus. There were no treatment failures in mean follow-up of 40.2 ± 5.07 months. Conclusions: Cardiomyotomy with partial fundoplication is the best modality of treatment for paediatric achalasia cardia, even from parents′ perspective.

  8. 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

  9. 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

  10. Birth centre confinement at the Queen Victoria Medical Centre: four years' experience.

    Science.gov (United States)

    Morris, N; Campbell, J; Biro, M A; Lumley, J; Rao, J; Spensley, J

    1986-06-09

    A review of the first four years of the functioning of the birth centre at the Queen Victoria Medical Centre is presented. In that time, 1040 pregnant women were accepted for confinement there. Of these, 52 withdrew for non-obstetric reasons, while 470 were transferred to alternative obstetrical care--274 because of antepartum complications and 196 because of intrapartum problems. Therefore, 518 women were delivered in the birth centre. The care of the women is entrusted almost entirely to a team of midwives and this review demonstrates an enviable safety record.

  11. 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.

  12. Thyroid cancer: experiences at the Regional Cancer Centre, Trivandrum

    International Nuclear Information System (INIS)

    Pradeep, V.M.; Gangadharan, P.; Nair, Krishnan M.

    1999-01-01

    Above 300 thyroid cancers are seen at the Regional Cancer Centre annually. There has been an increase in the number of TC registered over the years. This is at least partly due to improved diagnostic services and availability of 131 I therapy. Almost 90 % of the cases seen at the Centre are well-differentiated cancers

  13. 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.

  14. Paediatric percutaneous nephrolithotomy: single-centre 10-year experience.

    Science.gov (United States)

    Bhageria, Anand; Nayak, Brusabhanu; Seth, Amlesh; Dogra, Prem Nath; Kumar, Rajeev

    2013-08-01

    Percutaneous nephrolithotomy (PCNL) is a standard management option for complex and large renal calculi. In children, there is some concern over potential perioperative complications. We reviewed our 10 years of experience of PCNL in children and present our data. Data for paediatric patients who underwent PCNL at our centre in the last decade were retrieved. PCNL was performed in standard prone position under fluoroscopic guidance. Patient characteristics, outcomes and complications were reviewed. Complications were graded according to the modified Clavien system. A comparison was also made between supracostal and infracostal accesses. 95 children underwent PCNL in our institute in the last decade. 7 patients had bilateral PCNL. The most common presentation was flank pain (85%). 83% patients were stone-free after first PCNL and overall 94% were stone free after second-look PCNL and auxillary procedures. 6 cases had clinically insignificant residual fragments. Supracostal puncture was performed in 32 cases. Complications were higher in the supracostal puncture group (16 (50%)) and included fever in 11, sepsis in 2 and hydrothorax in 3 patients. There were 7 (10%) complications in the infracostal group: fever in 5 and perinephric collection in 2 patients. 16 patients had grade 1, 9 had grade 2 and another 2 cases developed grade 3 complications. PCNL is a safe and effective procedure in children. It enables excellent stone clearance with minimal number of interventions. Copyright © 2013 Journal of Pediatric Urology Company. Published by Elsevier Ltd. All rights reserved.

  15. Human-centred automation programme: review of experiment related studies

    International Nuclear Information System (INIS)

    Grimstad, Tone; Andresen, Gisle; Skjerve, Ann Britt Miberg

    2000-04-01

    Twenty-three empirical studies concerning automation and performance have been reviewed. The purposes of the review are to support experimental studies in the Human-Centred Automation (HCA) programme and to develop a general theory on HCA. Each study was reviewed with regard to twelve study characteristics: domain, type of study, purpose, definition of automation, variables, theoretical basis, models of operator performance, methods applied, experimental design, outcome, stated scope of results, strengths and limitations. Seven of the studies involved domain experts, the rest used students as participants. The majority of the articles originated from the aviation domain: only the study conducted in HAMMLAB considered process control in power plants. In the experimental studies, the independent variable was level of automation, or reliability of automation, while the most common dependent variables were workload, situation awareness, complacency, trust, and criteria of performance, e.g., number of correct responses or response time. Although the studies highlight important aspects of human-automation interaction, it is still unclear how system performance is affected. Nevertheless, the fact that many factors seem to be involved is taken as support for the system-oriented approach of the HCA programme. In conclusion, the review provides valuable input both to the design of experiments and to the development of a general theory. (Author). refs

  16. Operational experience of UNESCO centres for psychosocial rehabilitation

    International Nuclear Information System (INIS)

    Garnets, O.

    2003-01-01

    Community Centres of social and psychological rehabilitation for the population suffered from Chernobyl catastrophe have been created in Ukraine, Russia and Belarus. Objectives assigned to the Community Centres for psychosocial rehabilitation on the affected population were as follows: improving mental health of all age and social groups in the community; encouraging interactions within the community; empowering community members to take control over their lives; developing social responsibility; promoting problem-solving skills. The Community Centres network has developed psychosocial assistance models relevant to post-catastrophe period (aggravated by social and economic crisis) that might be applied to different types of crises in communities

  17. 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

  18. [The experience of a health centre undergoing an ecological transition].

    Science.gov (United States)

    Bironneau, Rémy

    2018-03-01

    A health centre and its staff have undertaken a sustainable health approach which aims to reduce the impact of the environment on health. One of the initiatives focused on the improvement of indoor air quality. A change to practices was possible thanks to a participative approach, the support of the staff and constant communication. Copyright © 2018 Elsevier Masson SAS. All rights reserved.

  19. Attempt to evaluate the cumulative deposit of strontium 90 in several French centres; Essai d'evaluation du depot cumulatif de strontium 90 dans plusieurs stations francaises

    Energy Technology Data Exchange (ETDEWEB)

    Garnier, A [Commissariat a l' Energie Atomique, Fontenay aux Roses (France). Centre d' Etudes Nucleaires

    1966-07-01

    In order to be able to interpret results of radioactivity controls of the ambient atmosphere and of the supply chain carried out in several French centres, it is necessary to know the value of the cumulative strontium-90 deposit resulting from fall-out. The estimation of the fall-out which occurred locally in the years before systematic controls were established can be made by assuming that the {sup 90}Sr concentration in rain varies little from one place to another (if they are fairly close) and that the deposit can be deduced from that measured in a single station by making corrections for differences in the rainfall. This assumption is confirmed by applying the method to the calculation of {sup 90}Sr fall-out at Ispra, Mol and at several French centres: the values calculated are compared to those obtained by measurements carried out since 1958 in some cases, and since 1960 in others. The results show that the method is valid for calculating fall-out prior to 1960 (in the absence of information) and to deduce with sufficient approximation the subsequent cumulative deposits in the French centres under consideration. (author) [French] L'evaluation du depot cumulatif de Sr 90 consecutif aux retombees est necessaire a l'interpretation des resultats du controle de la radioactivite du milieu ambiant et de la cha e alimentaire effectue en plusieurs stations francaises. L'estimation des retombees locale des annees anterieures a la mise en oeuvre systematique des moyens de surveillance peut etre faite en admettant que la concentration de Sr 90 dans la pluie varie peu d'un endroit a l'autre (dans des regions assez rapprochees) et que le depot peut etre deduit de celui mesure en une station gr e a des corrections tenant compte de la variation de pluviosite. Cette hypothese est verifiee en appliquant la methode au calcul des retombees de Sr 90 a Ispra, a Mol, et en plusieurs stations francaises: les valeurs calculees sont comparees a celles obtenues par les mesures

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

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

    27 oct. 2010 ... Conscient du fait que les périodes de transformation risquent de provoquer le chaos, mais qu'elles sont également porteuses de rapides progrès sur le plan social et économique, le CRDI est intervenu dans quelque 25 pays ayant amorcé une transition de la guerre à la paix, de la dictature à la démocratie ...

  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 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.

  3. 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

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

    OpenAIRE

    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-biologiq...

  5. Efficacité relative des grilles de correction d'un test de jugement situationnel pour la sélection du personnel de centres d'appels

    OpenAIRE

    Poirier, Sabrina

    2016-01-01

    Dans le domaine des centres d’appels, l’affectation d’agents au service à la clientèle efficaces et satisfaits représente une activité cruciale pour toute direction dédiée aux ressources humaines de ces unités d’affaires. Or, pour parvenir à prendre de bonnes décisions d’embauche et de rejet, des instruments de mesure et d’évaluation des compétences sont souvent mis à contribution. À cet effet, les tests de jugement situationnel (TJS) sont de plus en plus utilisés pour la sélection du personn...

  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. Dangers du tabac et des narguilés pour la santé | CRDI - Centre de ...

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

    18 oct. 2010 ... Résumant les travaux d'Alan Shihadeh, Rima Afifi, chercheure à l'AUB, rappelle que la fumée des pipes à eau a une forte teneur en goudron et contient en outre de la nicotine et des métaux lourds. Rima Afifi précise que le fait d'avoir réuni des données probantes sur les dangers du narguilé a ouvert la ...

  8. 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)

  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. Recipient ineligibility after liver transplantation assessment: a single centre experience.

    Science.gov (United States)

    Arya, Aman; Hernandez-Alejandro, Roberto; Marotta, Paul; Uhanova, Julia; Chandok, Natasha

    2013-06-01

    Candidacy for liver transplantation is determined through standardized evaluation. There are limited data on the frequency and reasons for denial of transplantation after assessment; analysis may shed light on the short-term utility of the assessment. We sought to describe the frequency and reasons for ineligibility for liver transplantation among referred adults. We studied all prospectively followed recipient candidates at a single centre who were deemed unsuitable for liver transplantation after assessment. Inclusion criteria were age 18 years and older and completion of a standard liver transplantation evaluation over a 3-year period. Patients were excluded if they had a history of prior assessment or liver transplantation within the study period. Demographic and baseline clinical data and reasons for recipient ineligibility were recorded. In all, 337 patients underwent their first liver transplantation evaluation during the study period; 166 (49.3%) fulfilled inclusion criteria. The mean age was 55.4 years, and 106 (63.9%) were men. The 3 most common reasons for denial of listing were patient too well (n = 82, 49.4%), medical comorbidities and/or need for medical optimization (n = 43, 25.9%) and need for addiction rehabilitation (n = 28, 16.9%). Ineligibility for transplantation after assessment was common, occurring in nearly half of the cohort. Most denied candidates could be identified with more discriminate screening before the resource-intensive assessment; however, the assessment likely provides unforeseen positive impacts on patient care.

  11. Upper gastrointestinal bleeding: Five-year experience from one centre

    Directory of Open Access Journals (Sweden)

    Jovanović Ivan

    2008-01-01

    Full Text Available Introduction Acute upper gastrointestinal bleeding is the commonest emergency managed by gastroenterologists. Objective To assess the frequency of erosive gastropathy and duodenal ulcer as a cause of upper gastrointestinal (GI bleeding as well as its relation to age, gender and known risk factors. METHOD We conducted retrospective observational analysis of emergency endoscopy reports from the records of the Emergency Department of Clinic for Gastroenterology and Hepatology, Clinical Centre of Serbia, during the period from 2000 to 2005. Data consisted of patients' demographics, endoscopic findings and potential risk factors. Results During the period 2000-2005, three thousand nine hundred and fifty four emergency upper endoscopies were performed for acute bleeding. In one quarter of cases, acute gastric erosions were the actual cause of bleeding. One half of them were associated with excessive consumption of salicylates and NSAIDs. In most of the examined cases, bleeding stopped spontaneously, while 7.6% of the cases required endoscopic intervention. Duodenal ulcer was detected as a source of bleeding in 1320 (33.4% patients and was significantly associated with a male gender (71.8% and salicylate or NSAID abuse (59.1% (χ2-test; p=0.007. Conclusion Erosive gastropathy and duodenal ulcer represent a significant cause of upper gastrointestinal bleeding accounting for up to 60% of all cases that required emergency endoscopy during the 5- year period. Consumption of NSAIDs and salicylates was associated more frequently with bleeding from a duodenal ulcer than with erosive gastropathy leading to a conclusion that we must explore other causes of erosive gastropathy more thoroughly. .

  12. 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.

  13. Bilateral adrenal masses: a single-centre experience

    Science.gov (United States)

    Bandgar, Tushar; Khare, Shruti; Jadhav, Swati; Lila, Anurag; Goroshi, Manjunath; Kasaliwal, Rajeev; Khadilkar, Kranti; Shah, Nalini S

    2016-01-01

    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. PMID:27037294

  14. 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.

  15. CoDuSe group exercise programme improves balance and reduces falls in people with multiple sclerosis: A multi-centre, randomized, controlled pilot study.

    Science.gov (United States)

    Carling, Anna; Forsberg, Anette; Gunnarsson, Martin; Nilsagård, Ylva

    2017-09-01

    Imbalance leading to falls is common in people with multiple sclerosis (PwMS). To evaluate the effects of a balance group exercise programme (CoDuSe) on balance and walking in PwMS (Expanded Disability Status Scale, 4.0-7.5). A multi-centre, randomized, controlled single-blinded pilot study with random allocation to early or late start of exercise, with the latter group serving as control group for the physical function measures. In total, 14 supervised 60-minute exercise sessions were delivered over 7 weeks. Pretest-posttest analyses were conducted for self-reported near falls and falls in the group starting late. Primary outcome was Berg Balance Scale (BBS). A total of 51 participants were initially enrolled; three were lost to follow-up. Post-intervention, the exercise group showed statistically significant improvement ( p = 0.015) in BBS and borderline significant improvement in MS Walking Scale ( p = 0.051), both with large effect sizes (3.66; -2.89). No other significant differences were found between groups. In the group starting late, numbers of falls and near falls were statistically significantly reduced after exercise compared to before ( p balance and reduced perceived walking limitations, compared to no exercise. The intervention reduced falls and near falls frequency.

  16. 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.

  17. Laparoendoscopic single site surgery in urology: A single centre experience

    Directory of Open Access Journals (Sweden)

    Arvind P Ganpule

    2012-01-01

    Full Text Available Objective : To analyze our experience of 87 cases with single port surgery, which is also known as laparoendoscopic single site surgery (LESS. Materials and Methods: Case records of all LESS procedures performed between December 2007 and June 2010 were analysed. The procedures performed were donor nephrectomy (n=45, simple nephrectomy (n=27, radical nephrectomy (n=5, pyeloplasty (n=9, and ureteroneocystostomy (n=1. Parameters analysed were operating room (OR time, estimated blood loss (EBL, visual analogue score (VAS, and complications in all patients undergoing LESS procedure and additionally, warm ischaemia time (WIT and graft outcome in patients undergoing LESS donor nephrectomy. In reconstructive procedures, the functional assessment was performed with a diuretic renogram at 6 months. Results: In LESS donor nephrectomy, the mean WIT was 6.9 ± 1.9 min. Mean serum creatinine in recipients at 1 month was 0.96 ± 0.21 mg%. We encountered one instance each of renal artery injury, renal vein injury, large bowel injury, minor cortical laceration at the upper pole and two instances of diaphragmatic injury. In LESS simple nephrectomy, the average OR time was 148.7 ± 52.2 min and hospital stay was 3.7 ± 1.2 days. There was one instance of large bowel injury during specimen retrieval. In LESS radical nephrectomy, the average OR time was 202.5 ± 35.7 min and average hospital stay was 4.2 ± 1.3 days. 6 patients of LESS pyeloplasty completed follow up with a diuretic renogram showing a good drainage. LESS ureteroneocystostomy could also be performed successfully without any complications. Conclusion: LESS surgery can be accomplished safely in nephrectomy and reconstructive procedures such as pyeloplasty and ureteroneocystostomy with equivalent outcomes as standard laparoscopy and with added benefits of cosmesis and quicker convalescence. LESS donor nephrectomy is a technically feasible procedure; current status of procedure needs to be proved with

  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. Toward common working tools: Arab League Documentation and Information Centre experience

    International Nuclear Information System (INIS)

    Redissi, M.

    1990-05-01

    The adoption of Arab common working tools in information handling has been one of the priorities of Arab League Documentation and Information Centre (ALDOC). Problems arising from the processing of Arabic language have been progressively settled. The Tunisian experience in the elimination of transliteration is worth mentioning. (author). 17 refs

  20. Toward common working tools: Arab League Documentation and Information Centre experience

    Energy Technology Data Exchange (ETDEWEB)

    Redissi, M [ALDOC (Tunisia)

    1990-05-01

    The adoption of Arab common working tools in information handling has been one of the priorities of Arab League Documentation and Information Centre (ALDOC). Problems arising from the processing of Arabic language have been progressively settled. The Tunisian experience in the elimination of transliteration is worth mentioning. (author). 17 refs.

  1. A conjoint choice experiment to study attributes related to the selection of stores in shopping centres

    NARCIS (Netherlands)

    Oppewal, H.; Louviere, J.J.; Timmermans, H.J.P.; Chias, J.; Sureda, J.

    1993-01-01

    This paper first reviews approaches to modeHing consumer choice of shopping destination and argues that models typically have included only few attributes related to the selection or variety of stores in a shopping centre. Next a conjoint choice experiment is described in which profiles of

  2. 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

  3. Trauma patient discharge and care transition experiences: Identifying opportunities for quality improvement in trauma centres.

    Science.gov (United States)

    Gotlib Conn, Lesley; Zwaiman, Ashley; DasGupta, Tracey; Hales, Brigette; Watamaniuk, Aaron; Nathens, Avery B

    2018-01-01

    Challenges delivering quality care are especially salient during hospital discharge and care transitions. Severely injured patients discharged from a trauma centre will go either home, to rehabilitation or another acute care hospital with complex management needs. This purpose of this study was to explore the experiences of trauma patients and families treated in a regional academic trauma centre to better understand and improve their discharge and care transition experiences. A qualitative study using inductive thematic analysis was conducted between March and October 2016. Telephone interviews were conducted with trauma patients and/or a family member after discharge from the trauma centre. Data collection and analysis were completed inductively and iteratively consistent with a qualitative approach. Twenty-four interviews included 19 patients and 7 family members. Participants' experiences drew attention to discharge and transfer processes that either (1) Fostered quality discharge or (2) Impeded quality discharge. Fostering quality discharge was ward staff preparation efforts; establishing effective care continuity; and, adequate emotional support. Impeding discharge quality was perceived pressure to leave the hospital; imposed transfer decisions; and, sub-optimal communication and coordination around discharge. Patient-provider communication was viewed to be driven by system, rather than patient need. Inter-facility information gaps raised concern about receiving facilities' ability to care for injured patients. The quality of trauma patient discharge and transition experiences is undermined by system- and ward-level processes that compete, rather than align, in producing high quality patient-centred discharge. Local improvement solutions focused on modifiable factors within the trauma centre include patient-oriented discharge education and patient navigation; however, these approaches alone may be insufficient to enhance patient experiences. Trauma patients

  4. Leisure-time youth centres as health-promoting settings: Experiences from multicultural neighbourhoods in Sweden.

    Science.gov (United States)

    Fredriksson, Ingela; Geidne, Susanna; Eriksson, Charli

    2018-02-01

    The aim of this paper is to advocate for the importance of meaningful leisure time for young people from a health-promotion perspective using experiences from two youth centres in multicultural neighbourhoods in Sweden. In this practice-based study, data were collected between 2012 and 2014 at two youth centres in multicultural, socially deprived suburbs in Sweden using surveys with 12- to 16-year-old adolescents ( n = 207), seven individual interviews with staff and three cooperation partners in the neighbourhoods, and six group interviews with adolescents (50% girls). Quantitative, qualitative and mixed methods were used for analysis. As part of the youth centres' strategies, they are open and inclusive, foster supportive relationships, emphasise youth empowerment, and integrate family, school and community in their work. The youth centres are health-promoting settings with regard to four of the action areas in the Ottawa Charter: build healthy public policy, create supportive environments, strengthen community actions and develop personal skills. There is a need for a variety and a combination of various structured and unstructured leisure-time activities because young people's background and life situation plays a role for their participation in leisure-time activities. We conclude that youth centres are well placed to be or to become health-promoting settings if the activities takes place in a structured environment.

  5. Les outils du CERN

    CERN Multimedia

    1999-01-01

    C'est le plus grand centre mondial de recherche en physique des particules. Les outils du Laboratoire, accélérateurs et détecteurs de particules, figurent parmi les instruments scientifiques les plus complexes au monde. Des prix Nobels ont d'ailleurs été attribués aux physiciens du CERN pour leurs développements.

  6. Description of the french graphite reactor and of the experiments performed in 1956; Presentation du premier reacteur a graphite francais et des experiences effectuees en 1956

    Energy Technology Data Exchange (ETDEWEB)

    Bussac, J; Leduc, C; Zaleski, C P [Commissariat a l' Energie Atomique, Saclay (France). Centre d' Etudes Nucleaires

    1957-07-01

    This paper is an introduction to the experiments performed on the G1 reactor, experiments fully described in the papers following (670 'B to P'). The main results are given together with some comments. The neutronic parameters of the core, a description of the most important structures, and a few words of the tests leading to normal operation of the reactor under load complete our survey. (author) [French] Ce rapport presente les experiences qui furent faites sur le reacteur G1 et dont la description en detail fait l'objet des rapports suivants (670 'B a P'). Les principaux resultats sont fournis ici et commentes. On trouvera en outre les caracteristiques neutroniques du coeur actif de la pile, une description des principales installations et une mention des essais qui ont conduit au fonctionnement normal du reacteur en puissance. (auteur)

  7. Experiences of women who planned birth in a birth centre compared to alternative planned places of birth. Results of the Dutch Birth Centre Study

    NARCIS (Netherlands)

    Hitzert, M.; Hermes, M.A.; Scheerhagen, M.; Boesveld, L.C.; Wiegers, T.A.; Akker-van Marle, M.E.; Dommelen, P. van; Pal-de Bruin, K.M. de; Graaf, J.P. de

    2016-01-01

    Objective to assess the experiences with maternity care of women who planned birth in a birth centre and to compare them to alternative planned places of birth, by using the responsiveness concept of the World Health Organization. Design this study is a cross-sectional study using the ReproQ

  8. Experiences of women who planned birth in a birth centre compared to alternative planned places of birth. Results of the Dutch Birth Centre Study.

    NARCIS (Netherlands)

    Hitzert, M.; Hermus, M.; Scheerhagen, M.; Boesveld, I.C.; Wiegers, T.; Akker-van Marle, M.E. van den; Dommelen, P. van; Pal-de Bruin, K.M. van der; Graal, J. P. de

    2016-01-01

    Objective: to assess the experiences with maternity care of women who planned birth in a birth centre and to compare them to alternative planned places of birth, by using the responsiveness concept of the World Health Organization. Design: this study is a cross-sectional study using the ReproQ

  9. National data centre preparedness exercise 2015 (NPE2015): MY-NDC progress result and experience

    Science.gov (United States)

    Rashid, Faisal Izwan Abdul; Zolkaffly, Muhammed Zulfakar

    2017-01-01

    Malaysia has established the National Data Centre (MY-NDC) in December 2005. MY-NDC is tasked to perform the Comprehensive Nuclear-Test-Ban-Treaty (CTBT) data management as well as providing relevant information for Treaty related events to the Malaysian Nuclear Agency (Nuclear Malaysia) as the CTBT National Authority. In the late 2015, MY-NDC has participated in the National Data Centre Preparedness Exercise 2015 (NPE 2015) which aims to access the level of readiness at MY-NDC. This paper aims at presenting the progress result of NPE 2015 as well as highlighting MY-NDC experience in NPE 2015 compared to previous participation in NPE 2013. MY-NDC has utilised available resources for NPE 2015. In NPE 2015, MY-NDC has performed five type of analyses compared with only two analyses in NPE 2013. Participation in the NPE 2015 has enabled MY-NDC to assess its capability and identify rooms for improvement.

  10. 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.

  11. Challenges in successfully developing three regional radiotherapy centres. The NCCI experience

    International Nuclear Information System (INIS)

    Greenham, Stuart

    2011-01-01

    Full text: This presentation will provide an overview of the processes, experience, challenges and success involved in the establishment of the North Coast Cancer Institute (NCCI). The NCCI is a network of three Integrated Oncology centres in Northern New South Wales offering integrated Medical, Radiation and Haematology outpatient services. NCCI was developed as part of the introduction of radiotherapy into a region previously without access to a local radiotherapy service and as a result with poor radiotherapy utilisation and referral rates. NCCI commenced radiotherapy services in Coffs Harbour in May 2007 followed by Port Macquarie in August of the same year and finally in Lismore in May 20 I O. Radiotherapy services commenced with Intensity Modulated Radiotherapy and Image guided radiotherapy as standard of care for some disease sites with remote access to planning systems and electronic workflow process supporting the treatment process. Forming a small team to simultaneously design, build and establish two new treatment centres to take advantage of the most contemporary treatment modalities while also planning for a third centre was a significant challenge. The challenges and successful outcomes will be discussed as part of this presentation.

  12. A Study Of The Dilution Of Radio-Active Waste In The Rhone (1961); Etude de la dilution dans le rhone des effluents radioactifs du Centre de Marcoule (1961)

    Energy Technology Data Exchange (ETDEWEB)

    Rodier, J; Scheidhauer, J; Marichal, M; Court, R [Commissariat a l' Energie Atomique, Centre de Production de Plutonium, Marcoule (France). Centre d' Etudes Nucleaires

    1961-07-01

    The discharge into the Rhone of liquid radio-active waste from the Marcoule Centre necessitates a large number of measurements, in particular chemical and radio-chemical analysis of the waste, itself and of the waters of the Rhone both above arid below the point of discharge. The results thus obtained during 1960 made it possible to evaluate the total amount of active waste discharged and its dilution in the receiving medium. A statistical study of the results of the analysis of the Rhone waters shows that a satisfactory dilution of the waste occurs rapidly; the experimental results obtained with an experimental discharge of rhodamine are thus confirmed. (authors) [French] Le rejet au Rhone des effluents radioactifs liquides produits sur le Centre de Marcoule donne lieu a un grand nombre de mesures et en particulier d'analyses chimiques et radio-chimiques des effluents eux-memes ainsi que des eaux du Rhone avant et apres rejet. Au cours de l'annee 1960, l'ensemble des resultats ainsi obtenus a permis de dresser un bilan des activites rejetees et de leur dispersion dans le milieu recepteur. Une etude statistique des resultats d'analyses des eaux du Rhone montre qu'une dilution satisfaisante des effluents s'effectue rapidement confirmant ainsi les resultats obtenus lors d'un rejet experimental de rhodamine. (auteurs)

  13. 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.

  14. 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...

  15. 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.

  16. Going private: clinicians' experience of working in UK independent sector treatment centres.

    Science.gov (United States)

    Waring, Justin; Bishop, Simon

    2012-02-01

    With increased possibility that public healthcare services in the UK will be outsourced to the private sector, this study investigates how clinicians working in Independent Sector Treatment Centres perceive the differences between public and private sectors. Qualitative interviews with 35 clinicians recruited from two ISTCs. All participants were transferred to the independent sector from the public National Health Service. Interview data were analysed to identify shared experience about the variable organisation and delivery of services. Clinicians perceived differences between public and independent sectors in the areas of 'environment and facilities', 'management', 'work organisation and care delivery', and 'patient experience'. The independent sector was described as offering a positive alternative to public services in regard to service environment and patient experience, but there were concerns about management priorities and the reconfiguration of work. Clinicians' experience of moving between sectors reveals mixed experiences. Although some improvements might legitimise the growing role of the independent sector, there remain doubts about the commercialisation of services, the motives of managers and the impact of clinical roles and capabilities. With policies looking to expand the mixed economy of public healthcare services, the study suggests clinicians will not automatically embrace a move between sectors. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

  17. Using drawings to understand the child's experience of child-centred care on admission to a paediatric high dependency unit.

    Science.gov (United States)

    Foster, Mandie; Whitehead, Lisa

    2018-01-01

    Family- and child-centred care are philosophies of care used within paediatrics where the family and/or the child are central to healthcare delivery. This study explored the lived experience of hospitalized school-aged children admitted to a paediatric high dependency unit in New Zealand to gain insight into child-centred care from a child's perspective. An interpretive thematic approach was used where the child was asked to draw a picture of 'a person in the hospital' that was further explored through interviews. The interviews were recorded and transcribed verbatim with an inductive thematic analysis completed, drawing on the child-centred care framework. Twenty-six school-aged children participated. The pictures included drawings of family, staff, children and themselves. The themes generated from the interviews were relationships with themselves, family and staff and psychosocial, emotional and physical support. Children described themselves as co-creators of their own healthcare experience, consistent with child-centred care, while drawing on the principles of family-centred care. Further exploration of the concepts of 'participation versus protection' and 'child as becoming versus child as being' will contribute to translation and integration of child-centred care and family-centred care principles into practice, theory, research and policy.

  18. Experience with procuring, deploying and maintaining hardware at remote co-location centre

    International Nuclear Information System (INIS)

    Bärring, O; Bonfillou, E; Clement, B; Santos, M Coelho Dos; Dore, V; Gentit, A; Grossir, A; Salter, W; Valsan, L; Xafi, A

    2014-01-01

    In May 2012 CERN signed a contract with the Wigner Data Centre in Budapest for an extension to CERN's central computing facility beyond its current boundaries set by electrical power and cooling available for computing. The centre is operated as a remote co-location site providing rack-space, electrical power and cooling for server, storage and networking equipment acquired by CERN. The contract includes a 'remote-hands' services for physical handling of hardware (rack mounting, cabling, pushing power buttons, ...) and maintenance repairs (swapping disks, memory modules, ...). However, only CERN personnel have network and console access to the equipment for system administration. This report gives an insight to adaptations of hardware architecture, procurement and delivery procedures undertaken enabling remote physical handling of the hardware. We will also describe tools and procedures developed for automating the registration, burn-in testing, acceptance and maintenance of the equipment as well as an independent but important change to the IT assets management (ITAM) developed in parallel as part of the CERN IT Agile Infrastructure project. Finally, we will report on experience from the first large delivery of 400 servers and 80 SAS JBOD expansion units (24 drive bays) to Wigner in March 2013. Changes were made to the abstract file on 13/06/2014 to correct errors, the pdf file was unchanged.

  19. Experiences of Everyday Occupation among People with Psychiatric Disabilities - Relationships to social interaction, the worker role and day centre attendance

    OpenAIRE

    Argentzell, Elisabeth

    2012-01-01

    The thesis aims to explore subjective experiences of everyday occupation, social interaction and the view of the worker role among people with psychiatric disabilities(PD), while also addressing the importance of day centre attendance. The thesis consists of one qualitative study, exploring which characteristics in everyday occupation provide meaning to people with PD, and three quantitative studies based on questionnaires to both day centre attendees and non-attendees. Study I showed that fe...

  20. 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

  1. Experiences and performance of the Harshaw dosimetry system at two major processing centres

    International Nuclear Information System (INIS)

    Tawil, R.A.; Olhalber, T.; Rathbone, B.

    1996-01-01

    The installations, operating practice, dose algorithms and results and maintenance experience at two major dosimetry processing centres are described. System selection considerations and a comprehensive quality programme are described in the light of the publication of testing requirements by various dosimetry regulatory organisations. Reported information from Siemens Dosimetry Services comprises their selection of dosemeters and processing equipment including service history, a description of their dose computation algorithm, and detailed results of their testing against DOELAP standards. Battelle Pacific Northwest Laboratories (PNL) provides a description of their dosemeters and equipment with service history; in addition, a discussion of their new neural network approach to a dose computation algorithm and test results from that algorithm are presented. (Author)

  2. A comparison of labour and birth experiences of women delivering in a birthing centre and at home in the Netherlands.

    NARCIS (Netherlands)

    Borquez, H.A.; Wiegers, T.A.

    2006-01-01

    OBJECTIVE: to compare the labour and birth experiences of women who delivered at home without complications with the experiences of women who delivered in a birth centre without complications. DESIGN: a descriptive study using postal questionnaires at 1-6 months after birth of a consecutive sample

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

    Science.gov (United States)

    Hunter, Andrew; Devane, Declan; Houghton, Catherine; Grealish, Annmarie; Tully, Agnes; Smith, Valerie

    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. A descriptive qualitative design. Participants (n = 31) were purposively sampled from two geographically distinct maternity units. Interviews were face-to-face or over the telephone, one-to-one or focus groups. A thematic analysis of the interview data was performed. Five major themes representing women's and clinicians' views, experiences and perspectives of women-centred care emerged from the data. These were Protecting Normality, Education and Decision Making, Continuity, Empowerment for Women-Centred Care and Building Capacity for Women-Centred Care. Within these major themes, sub-themes emerged that reflect key elements of women-centred care. These were respect, partnership in decision making, information sharing, educational impact, continuity of service, staff continuity and availability, genuine choice, promoting women's autonomy, individualized care, staff competency and practice organization. Women centred-care, as perceived by participants in this study, is not routinely provided in Ireland and women subscribe to the dominant culture that views safety as paramount. Women-centred care can best be facilitated through continuity of carer and in particular through midwife led models of care; however, there is potential to provide women-centred care within existing labour wards in terms of consistency of care, education of

  4. 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)

  5. Directeur, administration des subventions (h/f) | CRDI - Centre de ...

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

    Diriger l'élaboration de politiques régissant l'administration de projets du Centre ... Tenir à jour un aperçu stratégique des activités de projet du Centre afin d'en .... Gérer le recrutement du personnel de l'administration des subventions dans ...

  6. Injection Experiments in Jutphaas; Injection au Centre de Jutphaas; Ehksperimenty s inzhektsiej v institute fiziki plazmy v yutfaas; Experimentos de Inyeccion en Jutphaas

    Energy Technology Data Exchange (ETDEWEB)

    De Kluiver, H.; Brandt, H. B.; Strijland, W.; Huizenga, W. [Fom-Instituut voor Plasma-Fysica, Runhuizen, Jutphaas (Netherlands)

    1966-04-15

    a l'axe d'un champ magnetique a points de rebroussement en regime non adiabatique. Dans une experience type avec un faisceau d'electrons, la moitie du courant injecte est temporairement piege. La courbe du temps de confinement en fonction du champ magnetique concorde avec les resultats de l'analyse des orbites. Avec des champs electrostatiques externes, on obtient un confinement total, compte non tenu des pertes associees aux collisions avec le gaz residuel. Des courants de protons de 75 mA sous une tension de 15 kV ont ete extraits d'une source d'ions a plasma saillant, sous forme d'impulsions avec des temps de chute de 2 {mu}s. Pour un champ de 13 kG, un courant d'intensite nette de 35 mA penetre dans le champ a pointes, 15 mA atteignant l'extremite opposee. Un collecteur place dans le champ annulaire a points de rebroussement permet de mesurer les courants de pertes. Le temps de decroissance est de 50 {mu}s, ce qui est environ deux fois plus que la meilleure estimation des auteurs du temps d'echange des charges et dix fois la valeur deduite de l'analyse des orbites non adiabatiques. L'integration de ces courants sur tout le champ annulaire a points de rebroussement donne une perte de 10 a 20 mA. De ces chiffres on peut deduire une densite moyenne d'ions de 0,5 * 10{sup 9}cm{sup -3}. Une sonde ayant une geometrie particuliere, qui ne recueille que des ions chauds, permet d'obtenir la meme description generale de l'evolution du courant que les sondes ordinaires. Pour une pression de H{sub 2} de 10{sup -5} Torr, les auteurs ont observe des raies X qui sont attribues aux effets faisceau-plasma. En 10 a 20 {mu}s, ces signaux tombent a 20% de leur valeur avant que le courant ne soit coupe, puis il y a une decroissance plus faible, avec une constante de temps de 50 {mu}s. Le sondage radial du plasma accuse une augmentation considerable du courant collecte vers le centre avec une diminution du temps de decroissance. Les mesures donnent a penser que pendant l

  7. Multi-centre experience of implementing image-guided intensity-modulated radiotherapy using the TomoTherapy platform

    International Nuclear Information System (INIS)

    Dean, J.C.; Tudor, G.S.J.; Mott, J.H.; Dunlop, P.R.; Morris, S.L.; Harron, E.C.; Christian, J.A.; Sanghera, P.; Elsworthy, M.; Burnet, N.G.

    2013-01-01

    Use of image guided (IG) intensity modulated radiotherapy (IMRT) is increasing, and helical tomotherapy provides an effective, integrated solution. Practical experience of implementation, shared at a recent UK TomoTherapy Users' meeting, may help centres introducing these techniques using TomoTherapy or other platforms. Seven centres participated, with data shared from 6, varying from 2500 - 4800 new patients per year. Case selection of patients “most likely” to benefit from IG-IMRT was managed in all centres by multi-professional groups comprising clinical oncologists, physicists, treatment planners and radiographers. Radical treatments ranged from 94% to 100%. The proportions of tumour types varied substantially: head and neck: range 0%–100% (mean of centres 50%), prostate: 3%–96% (mean of centres 28%). Head and neck cases were considered most likely to benefit from IMRT, prostate cases from IGRT, or IG-IMRT if pelvic nodes were being treated. IMRT was also selected for complex target volumes, to avoid field junctions, for technical treatment difficulties, and retreatments. Across the centres, every patient was imaged every day, with positional correction before treatment. In one centre, for prostate patients including pelvic treatment, the pelvis was also imaged weekly. All centres had designed a ‘ramp up’ of patient numbers, which was similar in 5. One centre, treating 96% prostate patients, started with 3 and increased to 36 patients per day within 3 months. The variation in case mix implies wide applicability of IG-IMRT. Daily on-line IGRT with IMRT can be routinely implemented into busy departments

  8. Résultats de recherche | Page 81 | CRDI - Centre de recherches ...

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

    Gestion et valorisation des déchets ménagers et amélioration des conditions de vie en milieu urbain et périurbain en Afrique de l'Ouest et du Centre : deuxième ... Dynamiques et rôles économique et social du secteur informel des TIC en Afrique de l'Ouest et du Centre : cas du Burkina Faso, du Cameroun et du Sénégal; ...

  9. Canadian Irradiation Centre

    International Nuclear Information System (INIS)

    1987-05-01

    The Canadian Irradiation Centre is a non-profit cooperative project between Atomic Energy of Canada Limited, Radiochemical Company and Universite du Quebec, Institut Armand-Frappier, Centre for Applied Research in Food Science. The Centre's objectives are to develop, demonstrate and promote Canada's radiation processing technology and its applications by conducting applied research; training technical, professional and scientific personnel; educating industry and government; demonstrating operational and scientific procedures; developing processing procedures and standards, and performing product and market acceptance trials. This pamphlet outlines the history of radoation technology and the services offered by the Canadian Irradiation Centre

  10. 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

  11. De la frise magdalénienne in situ … au centre d’interprétation du Roc-aux-Sorciers : l’usage de la 3D

    Directory of Open Access Journals (Sweden)

    Geneviève Pinçon

    2012-04-01

    Full Text Available La base de données 3D réalisée dans le cadre de la recherche archéologique sur les sculptures pariétales magdaléniennes (il y a 15 000 ans a pu être exploitée également pour une reproduction grandeur nature des œuvres à destination du grand public dans le Centre d’interprétation du Roc-aux-Sorciers à Angles-sur-l’Anglin (Vienne, France. Cette réalisation originale est présentée par les différents acteurs du projet (maître d’ouvrage, maître d’œuvre, scientifiques, prestataire 3D offrant ainsi le déroulé de la mise en œuvre de la restitution à partir de la base de données 3D et faisant part des éléments du cahier des charges pour l’enregistrement laser tridimensionnel dont l’exploitation s’est avérée répondre à des utilités variées. Quand les problématiques de la recherche conduisent à utiliser la 3D, il paraît logique que ce même outil puisse aider à la restitution au grand public et puisse être partagé avec la communauté scientifique ou avec les restaurateurs chargés de la conservation de ce patrimoine, comme le montre cette réalisation. Les implications du choix d'un mode de restitution à partir d’une base de données 3D sont également évoquées avec l'exemple de la frise sculptée magdalénienne de la Chaire-à-Calvin (Charente, France dans le cadre d’un projet de valorisation.The creation of a 3D database within the framework of archaeological research on Magdalenian parietal sculptures (15,000 years old has also been usable for a full-size reproduction of the figures for the benefit of the general public in the Interpretation Centre of Le Roc-aux-Sorciers at Angles-sur-l'Anglin (Vienne, France. This unique production is presented by the various participants in the project (contracting authority, prime contractor, scientists, 3D provider, thus providing the whole story of the reconstruction's implementation from the 3D database, and providing information on the specifications

  12. Experience gained in two years operation of G1; Experience acquise au cours de deux ans de fonctionnement du reacteur G1

    Energy Technology Data Exchange (ETDEWEB)

    de, Rouville; Pascal, [Commissariat a l' Energie Atomique, Saclay (France). Centre d' Etudes Nucleaires; Scalliet, [Electricite de France (EDF), 75 - Paris (France)

    1958-07-01

    Technical specifications in respect of the first plutonium generating graphite reactor, the G1 at Marcoule, were stated in a paper read at the first Geneva Conference in 1955. We shall not therefore deal further with the technical characteristics of G1 in the present note, but rather propose to define - in the characteristic fields we think will be of major interest to foreign specialists - the results obtained in two and a half years operation since G1 first became critical on january 7, 1956. (author)Fren. [French] Les caracteristiques techniques du premier reacteur plutonigene, au graphite, de Marcoule, G1, ont ete donnees dans une communication presentee a la premiere conference de Geneve, en 1955. Nous n'y reviendrons donc pas dans la presente note qui a pour objet de faire le point, dans quelques domaines caracteristiques, qui nous ont paru les plus susceptibles d'interesser les specialistes etrangers, des resultats obtenus et des experiences faites au cours des deux annees et demi de fonctionnement du reacteur qui ont suivi sa divergence, le 7 janvier 1956. (auteur)

  13. 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

  14. 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 ...

  15. 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, ...

  16. Size effect on deformation twinning in face-centred cubic single crystals: Experiments and modelling

    International Nuclear Information System (INIS)

    Liang, Z.Y.; De Hosson, J.T.M.; Huang, M.X.

    2017-01-01

    In addition to slip by dislocation glide, deformation twinning in small-sized metallic crystals also exhibits size effect, namely the twinning stress increases with decreasing sample size. In order to understand the underpinning mechanisms responsible for such effect, systematic experiments were carried out on the small-sized single-crystalline pillars of a twinning-induced plasticity steel with a face-centred cubic structure. The flow stress increases considerably with decreasing pillar diameter from 3 to 0.5 μm, demonstrating a substantial size effect with a power exponent of 0.43. Detailed microstructural characterization reveals that the plastic deformation of the present pillars is dominant by twinning, primarily via twin growth, indicating that the size effect should be related to deformation twinning instead of slip by dislocation glide. Subsequent modelling works indicate that twinning can be accomplished by the dissociation of the ion-radiation-induced vacancy Frank loops in the damaged subsurface layer of the pillars, and the size effect is attributed to the ion-radiation-induced compressive stress in the subsurface layer, which decreases with pillar diameter.

  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. 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.

  19. Profil étiologique des surdités neurosensorielle sévère et profonde de l'enfant dans la région du centre-nord du Maroc

    Science.gov (United States)

    Ridal, Mohammed; Outtasi, Naouar; Taybi, Zainab; Boulouiz, Redouan; Chaouki, Sanae; Boubou, Meryem; Maaroufi, Mustapha; Benmansour, Najib; Zaki, Zouheir; Ouldim, Karim; Barakat, Hamid; Hida, Mustapha; Tizniti, Siham; El Alami, Mohamed Noreddine

    2014-01-01

    Introduction Le diagnostic d'une surdité profonde est possible dès les premiers jours de vie. Or, le développement du langage et l'intégration scolaire et professionnelle ne sont pas possible que si la surdité est prise en charge précocement. L’établissement d'un diagnostc étiologique a des implications pronostiques et thérapeutiques. Méthodes C'est une étude rétrospective allant de Juin 2009 au mois de Janvier 2012 ayant recensé 250 cas d'enfants porteurs d'une surdité sévère et profonde. Résultats La moyenne d’âge au moment de l'annonce du diagnostic est de 3.7 ans. Les étiologies prédominantes sont les surdités génétiques dans 35.6% suivies des surdités acquises dans 30.8% des cas. Dans 34.4% des cas aucune étiologie n'a pu être retrouvée. Conclusion Cette étude met en évidence la prédominance éventuelle de causes génétiques de la surdité neurosensorielle de l'enfant au Maroc, et souligne la nécessité d'améliorer les politiques de prévention des maladies infectieuses et de dépistage de la surdité néonatale. Cependant, des analyses moléculaires plus ciblées et la réalisation d'un scanner des rochers systématiques sont nécessaires pour évaluer plus précisément la contribution des étiologies génétiques. PMID:25018837

  20. Early experience with open heart surgery in a pioneer private hospital in West Africa: the Biket medical centre experience.

    Science.gov (United States)

    Onakpoya, Uvie Ufuoma; Adenle, Adebisi David; Adenekan, Anthony Taiwo

    2017-01-01

    More than forty years after the first open heart surgery in Nigeria, all open heart surgeries were carried out in government-owned hospitals before the introduction of such surgeries in 2013 at Biket Medical Centre, a privately owned hospital in Osogbo, South-western Nigeria. The aim of this paper is to review our initial experience with open heart surgery in this private hospital. All patients who underwent open heart surgery between August 2013 and January 2014 were included in this prospective study. The medical records of the patients were examined and data on age, sex, diagnosis, type of surgery, cardiopulmonary bypass details, complications and length of hospital stay were extracted and the data was analysed using SPSS version 16. Eighteen patients comprising of 12 males and 6 females with ages ranging between 8 months and 52 years (mean= of 15.7 +/- 15 years) were studied. Pericardial patch closure of isolated ventricular septal defect was done in 7 patients (38.9%) while total correction of isolated tetralogy of Fallot was carried out in 5 patients (27.8%). Two patients had mitral valve repair for rheumatic mitral regurgitation. Sixty day mortality was 0%. Safe conduct of open heart surgery in the private hospital setting is feasible in Nigeria. It may be our only guarantee of hitch free and sustainable cardiac surgery.

  1. 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

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

    Science.gov (United States)

    2012-01-01

    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 trauma scores (KTS II), grade of splenic injuries, admission systolic blood pressure ≤ 90 mmHg, estimated blood loss > 2000 mls, HIV infection with CD4 ≤ 200 cells/μl and presence of postoperative complications were significantly associated with mortality (P Trauma resulting from road traffic accidents (RTAs) remains the most common cause of splenic injuries in our setting. Most

  3. La prise en charge du traumatisé crânien grave : de la littérature au centre d'éveil

    OpenAIRE

    Phelix , Laury

    2010-01-01

    Non disponible / Not available; Le traumatisme crânien est une pathologie qui se définit par une atteinte cérébrale ou du tronc cérébral suite à un choc direct ou indirect.En France, la principale étiologie recensée est les accidents de la voie publique avec comme population cible des personnes jeunes appartenant à tranche d'âge des 15-25 ans. L'incidence des traumatismes crâniens est de 281 pour 100 000 habitants.Suite à ce traumatisme, le patient peut se trouver dans le coma. Généralement, ...

  4. 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.

  5. Persons with physical disabilities’ experiences of rehabilitation services at Community Health Centres in Cape Town.

    Directory of Open Access Journals (Sweden)

    C.K. Kahonde

    2010-02-01

    Full Text Available Background: Rehabilitation is of fundamental importance for the persons with disability to achieve functional independence and have an improved quality of life. To enhance the effectiveness of rehabilitation, it  is  important  to  seek  clients’  perspectives  of  the  rehabilitation  services and  to  incorporate  these  perspectives  into  the  planning  and  delivery  of rehabilitation  services.  The  aim  of  this  study  was  to  explore  the  persons with  physical  disabilities’  experiences  of  the  rehabilitation  services  they received at Community Health Centres (CHCs. Methods: In-depth  qualitative  interviews  were  used  to  collect  data.  Ten  persons  with  physical  disabilities,  who  had  received  rehabilitation  services at CHCs participated in the in-depth interviews. The interviews were tape-recorded and transcribed verbatim.  Thematic analysis was used to analyse the data.  Results: The  clients  experienced  problems  with  accessing  transport  and  obtaining  information  from  the  service providers. Experiences regarding clients’ involvement in the rehabilitation were varied. All the clients reported positive experiences regarding their interaction with service providers and family involvement. Conclusion: The experiences of the participants who accessed CHCs for rehabilitation were positive and negative. The service providers should therefore address the aspects of rehabilitation that were negatively experienced.

  6. 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

    2018-03-01

    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

  7. A new model of collaborative research: experiences from one of Australia’s NHMRC Partnership Centres for Better Health

    Directory of Open Access Journals (Sweden)

    Sonia Wutzke

    2017-02-01

    Full Text Available There is often a disconnection between the creation of evidence and its use in policy and practice. Cross-sectoral, multidisciplinary partnership research, founded on shared governance and coproduction, is considered to be one of the most effective means of overcoming this research–policy–practice disconnect. Similar to a number of funding bodies internationally, Australia’s National Health and Medical Research Council has introduced Partnership Centres for Better Health: a scheme explicitly designed to encourage coproduced partnership research. In this paper, we describe our experiences of The Australian Prevention Partnership Centre, established in June 2013 to explore the systems, strategies and structures that inform decisions about how to prevent lifestyle-related chronic disease. We present our view on how the Partnership Centre model is working in practice. We comment on the unique features of the Partnership Centre funding model, how these features enable ways of working that are different from both investigator-initiated and commissioned research, and how these ways of working can result in unique outcomes that would otherwise not have been possible. Although not without challenges, the Partnership Centre approach addresses a major gap in the Australian research environment, whereby large-scale, research–policy–practice partnerships are established with sufficient time, resources and flexibility to deliver highly innovative, timely and accessible research that is of use to policy and practice.

  8. A new model of collaborative research: experiences from one of Australia's NHMRC Partnership Centres for Better Health.

    Science.gov (United States)

    Wutzke, Sonia; Redman, Sally; Bauman, Adrian; Hawe, Penelope; Shiell, Alan; Thackway, Sarah; Wilson, Andrew

    2017-02-15

    There is often a disconnection between the creation of evidence and its use in policy and practice. Cross-sectoral, multidisciplinary partnership research, founded on shared governance and coproduction, is considered to be one of the most effective means of overcoming this research-policy-practice disconnect. Similar to a number of funding bodies internationally, Australia's National Health and Medical Research Council has introduced Partnership Centres for Better Health: a scheme explicitly designed to encourage coproduced partnership research. In this paper, we describe our experiences of The Australian Prevention Partnership Centre, established in June 2013 to explore the systems, strategies and structures that inform decisions about how to prevent lifestyle-related chronic disease. We present our view on how the Partnership Centre model is working in practice. We comment on the unique features of the Partnership Centre funding model, how these features enable ways of working that are different from both investigator-initiated and commissioned research, and how these ways of working can result in unique outcomes that would otherwise not have been possible. Although not without challenges, the Partnership Centre approach addresses a major gap in the Australian research environment, whereby large-scale, research-policy-practice partnerships are established with sufficient time, resources and flexibility to deliver highly innovative, timely and accessible research that is of use to policy and practice.

  9. Dans une optique de développement durable, les centres-villes peuvent-ils fonctionner sur le modèle d’un « centre commercial à ciel ouvert » ?: Etude du cas de la ville de Nyon

    OpenAIRE

    Solioz, Murielle; Clivaz, Christophe

    2008-01-01

    Aborder la redynamisation de la ville de Nyon et de son activité commerciale, c’est se heurter à la problématique générale de dévitalisation des centres-villes. Le phénomène s’observe en effet dans la plupart des agglomérations européennes, voire même au-delà. L’étude de ce sujet est passionnante, car très actuelle. Le thème est également universel, puisqu’il traite en grande partie du commerce de détail, marché sur lequel nous sommes tous des acteurs. Dans ce travail, je traite largement de ...

  10. 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.

  11. Quality audits of radiotherapy centres in Latin America: a pilot experience of the International Atomic Energy Agency

    International Nuclear Information System (INIS)

    Rosenblatt, Eduardo; Zubizarreta, Eduardo; Izewska, Joanna; Binia, Sergio; Garcia-Yip, Fernando; Jimenez, Pablo

    2015-01-01

    In Latin America radiotherapy quality varies significantly among hospitals, where highly equipped academic centers coexist with others not meeting minimal requirements. In 2007, the International Atomic Energy Agency published guidelines for auditing radiotherapy centers, known as the “Quality Assurance Team for Radiation Oncology” (QUATRO) audits. The present report summarizes a pilot experience with QUATRO audits to 12 radiotherapy centres. The findings from QUATRO audits conducted in 12 radiotherapy centres in Latin America between 2008 and 2013 were analysed. Events representing weaknesses or gaps in the process of radiotherapy were recorded. Relevant data for estimating human and technological needs of visited centres were processed. The main difficulties and strengths faced by institutions were also documented. All 12 radiotherapy centres were successfully audited following the QUATRO method. IAEA provided a dosimetry kit for quality control. Forty percent of audited institutions were immersed in a health system that did not recognize cancer as a public health priority problem. With few exceptions, local training programs for physicists and technologists were scarce and research was not an activity of interest among physicians. Centres were provided with sufficient staff to meet the local demand, both in the case of radiation oncologists, physicists and radiation therapists. Three centres lacking the minimum infrastructure were identified. Three institutions did not perform gynaecological brachytherapy, and one installation delivered around 900 teletherapy treatments annually without simulation, planning or dosimetry equipment for that purpose. Recommendations to centres were classified as related to personnel, infrastructure, processes and institutional organizational aspects. Many recommendations warned governments about the evident need for allocating more budgetary resources to radiotherapy. Most recommendations pointed out different aspects related

  12. Adjoint administratif (h/f) - Politiques et planification | CRDI - Centre ...

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

    à‑d. les informer au sujet des programmes et des procédures du Centre, des systèmes et des programmes informatiques, organiser des rendez-vous avec des membres clés du personnel du Centre, réacheminer les questions aux personnes-ressources compétentes au Centre, et organiser la création de comptes de ...

  13. Operating Experience with the BR-5 Reactor; Experience acquise aupres du reacteur BR-5; Opyt ehkspluatatsii reaktora BR-5; Experiencia practica con el reactor BR-5

    Energy Technology Data Exchange (ETDEWEB)

    Lejpunskij, A. I.; Kazachkovskij, O. D.; Pinkhasik, M. S.; Aristarkhov, N. N.; Karpov, A. V.; Larin, E. P.; Efimov, I. A.

    1963-10-15

    The paper discusses the carrying-out of repair and maintenance work on the radioactive liquid-metal circuit of the BR-5 fast neutron reactor. Attention is also given to problems of reactor operation after achievement of the planned 2% fuel burn-up with some disturbance of leak-tightness in individual fuel elements. An account is given of experience in discharging the active section, examining the condition and leak-tightness of the fuel elements, and decontaminating the equipment and piping of the first radioactive circuit after reaching 5% fuel burn-up. (author) [French] Dans ce memoire les auteurs decrivent l'execution des reparations et des travaux d'entretien dans le circuit radioactif liquide-metal du reacteur a neutrons rapides BR-5. Ils etudient egalement les problemes lies au fonctionnement du reacteur au taux de combustion de 2% prevu avec quelques defauts d'etancheite dans des elements combustibles particuliers. Ils decrivent le dechargementen zone active et examinent les conditions d'etancheite des elements combustibles. Ainsi que la decontamination de l'appareillage et des tuyauteries du premier circuit radioactif apres avoir atteint un taux de combustion de 5%. (author) [Spanish] En la memoria se examinan los problemas planteados por el mantenimiento del circuito radiactivo de metal liquido del reactor de neutrones rapidos BR-5. Se tratan cuestiones relacionadas con la explotacion del reactor una vez alcanzado el grado de combustion de 2%, previsto en el proyecto y luego de producirse ciertas alteraciones de la densidad de determinados elementos combustibles. Se describen la experiencia adquirida durante la descarga del cuerpo del reactor, las investigaciones del estado general y de la hermeticidad de los elementos combustibles y las operaciones de descontaminacion de la instalacion y de las tuberias del circuito radiactivo primario despues de alcanzado un grado de combustion de 5%. (author) [Russian] V doklade rassmatrivayutsya voprosy proizvodstva

  14. 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.

  15. 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.

  16. 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...

  17. 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.

  18. 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

  19. 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…

  20. 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…

  1. 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.

  2. The visual advice centre Eindhoven, an experiment in Dutch low vision care

    NARCIS (Netherlands)

    Neve, J.J.; Jorritsma, F.F.; Kinds, G.F.; Kooijman, A.C.; Looijestijn, P.L.; Welling, J.A.; Wildt, van der G.J.

    1994-01-01

    The Visual Advice Centre Eindhoven (VAC-E) provides the partially sighted with advice and prescriptions for low vision aids and illumination on the basis of an examination of their individual needs and their residual visual abilities. In the Dutch context of low vision care the V AC-E can be

  3. 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.

  4. 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,…

  5. 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

  6. Les glomales indigènes de la forêt claire à Isoberlinia doka (Craib et Stapf à Wari-Maro au centre du Bénin

    Directory of Open Access Journals (Sweden)

    Houngnandan, P.

    2009-01-01

    Full Text Available Indigenous Glomales of Isoberlinia doka (Craib and Stapf Woodland of Wari-Maro in Centre of Benin. This study described the indigenous glomalean diversity in Isoberlinia doka (Craib et Stapf woodland of Wari-Maro for an amelioration of seedling for revegetation. To this end, the trap culture with Zea mays was undertaken using a 16 replicates and 7 treatments completely randomized design under greenhouse. The data obtained were calculated and statistically treated, at 5% of significance, and showed that the maxima of mycorrhizal root colonization and the number of spores were scored in soil under cultures. Six species of glomalean spores divided in 2 genera (Glomus and Scutellospora, 2 families (Glomaceae and Gigasporaceae were counted and identified all around the forest. Scutellospora gregaria (46.6%, 54.2%, 46.6% and Glomus aggregatum (52.3; 44.4%; 43.9% respectively in forest, field and fallow are the two most prevalent species in the rhizosphere of Isoberlinia doka. The Shannon specific index of diversity and the equitability of Pielou indicated that the lowest values are obtained at Wari-Maro on fallow and highest one at Agbassa (fields and fallow. In conclusion, the best seedlings production sites of Isoberlinia doka are in Agbassa on fallow and in the fields.

  7. Building a Multi-centre Clinical Research Facilitation Network: The ARC Experience

    Directory of Open Access Journals (Sweden)

    Ian Nicholson

    2017-06-01

    Full Text Available Introduction: In order to practice evidence-based veterinary medicine, good quality clinical evidence needs to be produced, in order that it can be apprasied systematically by the EBVM network, and used by vets. There is very little good-quality veterinary evidence for most of the veterinary procedures carried out every day across the world. Very few, if any, individuals have all the necessary qualities (case-load, time, research expertise, financial support to be able to systematically produce good-quality, and relevant, clinical research on their own, in a timely manner. The Association for Veterinary Soft Tissue Surgery (AVSTS www.avsts.org.uk is an affiliate group with the British Small Animal Veterinary Association (BSAVA, and functions as a clinical network of like-minded individuals. In 2013 AVSTS sought to create a role for itself in facilitating the production (by its members of multi-centre clinical research of relevance to its members.Materials and methods: Members of AVSTS were asked to join the AVSTS Research Cooperative (ARC, with a veterinary epidemiologist and an experienced multi-centre veterinary clinical researcher (to help with study design and statistical planning, and the Animal Health Trust clinical research ethics committee. An email list was established, and a page was set up on the AVSTS website, to allow information to be disseminated. The AVSTS spring and autumn meetings were used as a regular forum by ARC, to discuss its direction, to generate interest, to create and promote specific studies (in order to widen participation amongst different centres, and to update members about previous studies.Results: Membership of ARC has grown to 224 people, although the epidemiologist left. One multi-centre study has been published, two have been presented and await publication, one has been accepted for presentation, two other studies are gathering data at present, and further studies are in the pipeline. There has been

  8. Web server of the Centre for Photonuclear Experiments Data of the Scientific Research Institute for Nuclear Physics, Moscow State University: Hypertext version of the nuclear physics database

    Energy Technology Data Exchange (ETDEWEB)

    Boboshin, I N; Varlamov, A V; Varlamov, V V; Rudenko, D S; Stepanov, M E [D.V. Skobel' tsyn Scientific Research Institute for Nuclear Physics, M.V. Lomonosov Moscow State University, Centre for Photonuclear Experiments Data (Russian Federation)

    2001-02-01

    The nuclear databases which have been developed at the Centre for Photonuclear Experiments Data of the D.V. Skobel'tsyn Scientific Research Institute for Nuclear Physics, M.V. Lomonosov Moscow State University, and put on the Centre's web server, are presented. The possibilities for working with these databases on the Internet are described. (author)

  9. Web server of the Centre for Photonuclear Experiments Data of the Scientific Research Institute for Nuclear Physics, Moscow State University: Hypertext version of the nuclear physics database

    International Nuclear Information System (INIS)

    Boboshin, I.N.; Varlamov, A.V.; Varlamov, V.V.; Rudenko, D.S.; Stepanov, M.E.

    2001-01-01

    The nuclear databases which have been developed at the Centre for Photonuclear Experiments Data of the D.V. Skobel'tsyn Scientific Research Institute for Nuclear Physics, M.V. Lomonosov Moscow State University, and put on the Centre's web server, are presented. The possibilities for working with these databases on the Internet are described. (author)

  10. Une mesure différente du bien-être : l'indice du bonheur national ...

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

    À la lumière de ces données, le Centre for Bhutan Studies publiera, en 2011, un indice du BNB quantitatif. Cette subvention permettra à l'OPHI d'assister le Centre dans la synthèse et l'analyse des résultats de l'enquête de 2010. L'objectif : assurer la validité et la reconnaissance internationale de l'indice du BNB de sorte ...

  11. Five years' experience at a single centre of craniocerebral injury from winnowing fan blades.

    Science.gov (United States)

    Kumar, Apoorva; Shankar, Ravi; Pandey, Rajendra P; Keshri, Virendra; Singh, Kulwant; Sharma, Vivek

    2010-02-01

    India, an agriculture-based country, relies heavily on indigenous farm machinery. In our study we present 31 patients with winnowing fan blade head injury, operated on at our centre between 2004 and 2008. The mechanism and nature of the injuries, operative methods, outcome and methods of prevention are discussed with special reference to the occurrence of this type of injury in the pediatric population. Copyright 2009 Elsevier Ltd. All rights reserved.

  12. [Young first-time parents' experiences with family-centred postpartal health care in Switzerland].

    Science.gov (United States)

    Kläusler-Troxler, Marianne; Kurth, Elisabeth; Spirig, Rebecca

    2014-08-01

    Routine postnatal care normally addresses only the mother and her child. In Switzerland, counselling for all parents and their children is provided by family nurses in a community-based health care setting. We implemented a new approach to ensure father involvement within the framework of the Calgary Family Assessment (CFAM) and the Calgary Intervention Model CFIM of Wright and Leahey (2013) in the northwest of Switzerland. This qualitative study explored how mothers and fathers experienced the newly developed family-centred consultation. Data collection was performed by means of participant observation and semi- structured interviews with a sample of five first-time parents with healthy neonates. Data were analysed by using content analysis according to Mayring. Mothers and fathers experienced family-centred consultation as effective. They felt more secure and confident "to handle the new situation" and obtained trustful, concrete and professional support to take care of their baby, particularly with regard to breast feeding, crying and sleeping patterns. Fathers felt included into postnatal care from the beginning. Family nursing offers a useful framework for family-centred postnatal health care.

  13. Laparoscopic pelvic lymphadenectomy: experience of a Gynaecological Cancer Centre in the UK.

    Science.gov (United States)

    Karanjgaokar, Vrunda C; Wright, Jeremy T; Murphy, Damian J; Mann, Christopher H

    2012-04-01

    The role of laparoscopic lymphadenectomy in the management of gynaecological cancers has been established over the last two decades, having been first described in Dargent and Selvat (L'envahissement ganglionnaire pelvin. Medsi-Mcgraw Hill, Paris, 1989). It has been shown that laparoscopic lymphadenectomy can be performed in the majority of patients and is associated with a low complication rate. However, the technique continues to be undertaken in only a relatively small number of Gynaecological Cancer Centres in the UK owing to the long learning curve and wide variations in training. At the Royal Wolverhampton NHS Trust Gynaecological Cancer Centre in the Greater Midlands Cancer Network laparoscopic lymphadenectomy has been performed since 1999 in the management of early cervical and high grade endometrial cancers. We have undertaken a retrospective audit (1999-2009) of these 42 cases to assess the feasibility of the procedure as well as to assess the complication rate. We are presenting the first reported series of exclusive laparoscopic transperitoneal lymphadenectomies from a Gynaecological Cancer Centre in the UK.

  14. Bulletin #112 | CRDI - Centre de recherches pour le dévelopement ...

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

    Dans ce numéro, apprenez-en davantage sur la recherche du CRDI sur les acquisitions de terres à grande échelle en Afrique et le rôle clé du Centre dans un panel des Nations Unies sur l'autonomisation des femmes. De plus, lisez le dernier billet du blogue Sur les traces du changement. Logo du Bulletin du CRDI Bulletin ...

  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. 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.

  17. Safety and predictability of conscious sedation in dentistry -- a multi-centre regional audit: South and West Wales experience.

    Science.gov (United States)

    Muthukrishnan, A; McGregor, J; Thompson, S

    2013-10-01

    There are no previously published reports of audits in conscious sedation from a group comprising the general dental services (GDS), community dental services (CDS) and hospital dental services (HDS). The main aim of this audit was to assess current practice within the group in relation to the safety and predictability of dental treatment undertaken with the aid of conscious sedation. A total of nine centres collected data prospectively on 1,037 sedation episodes over the course of one year. Audit standards were locally agreed based on current evidence and local experience. They were set at a completion rate of 90% and an adverse incident rate of 2% or less. Based on the data collected, a completion rate of 92% and a minor adverse incident rate of 2.6% were recorded. The participating centres met the standards set locally for this audit. Current practice in the participating centres was found to be safe and predictable. The audit tool is being refined to improve the quality of data collection. Further research and service evaluation is recommended.

  18. Planning and Implementing Health Promotion in the Workplace: A Case Study of the Du Pont Company Experience.

    Science.gov (United States)

    Bertera, Robert L.

    1990-01-01

    The PRECEDE framework was used to focus planning and evaluation of key areas of health knowledge, attitudes, and behavior in designing a workplace health promotion program for Du Pont. One pilot location experienced a 47.5 percent decline in absenteeism over six years as a result of the comprehensive needs assessment and health intervention. (SK)

  19. A track chamber with controlled heat centres as a vertex detector for very high energy physics experiments

    International Nuclear Information System (INIS)

    Shcherbakov, Yu.A.

    1989-01-01

    A high-pressure vertex detector for high energy experiments is proposed on the basis of development of a new track detector of charged particles, which is a chamber with controlled centres. A possible design of this chamber is discussed. Laser illumination of a streamer chamber allows enough light for reading the information by means of a CCD device. Some characteristics of the set-up are considered in the paper. A possibility of using a new method for suppression of diffusion is discussed. 30 refs.; 7 figs.; 3 tabs

  20. Management of Hypothyroid Cases in Nuclear Medicine Centre, Dhaka-An Initial Experience

    International Nuclear Information System (INIS)

    Afroz, S; Nasreen, F; Hossain, S; Begum, R; Taslima, BDA

    2001-01-01

    Hypothyroidism is a common and well treatable disease. Regular follow up and good compliance of the patients are the main key features for a successful outcome. In our country, most of the patients come from a poor socio-economic background and are referred to the Nuclear Medicine Centre for thyroid function tests. As the referral is from either Surgeons, ENT specialists or general physicians and the cost for repeated investigations are quite expensive, the patients gradually lose interest in regular follow-ups. In addition, they do not take thyroxine regularly and the ultimate fate is disappointing. Realizing these problems we decided to threat those patients in our centre and offer them a nominal charge for the hormonal estimations and follow up managements. A total number of 174 patients were studied in 5 years (1997-2001). Out of 174 patients 48 patients were toxic patients receiving radioiodine and the rest 126 were hypothyroid due to other causes. 72.41% patients had regular follow up and amongst them, 57.14% became euthyroid. The test were improving. (author) 11 refs., 2 tabs

  1. Experiences from a community based substance use treatment centre in an urban resettlement colony in India.

    Science.gov (United States)

    Balhara, Yatan Pal Singh; Ranjan, Rajeev; Dhawan, Anju; Yadav, Deepak

    2014-01-01

    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.

  2. Omalizumab for management of refractory urticaria: Experience of a tertiary care centre in Eastern India

    Directory of Open Access Journals (Sweden)

    Shekhar Neema

    2018-01-01

    Full Text Available Aim: To study the effects of omalizumab in chronic spontaneous urticaria in Indian patients. Setting and Design: The study was conducted in a tertiary care centre and it was retrospective and descriptive in nature. Material and Methods: We analysed the data of patients who were administered omalizumab between June 2014 and June 2015 for the management of refractory chronic spontaneous urticaria at our centre. Omalizumab was used in those patients who did not respond to updosing of antihistaminics and cyclosporine. Omalizumab was used in dose of 300 mg per month for 3 doses. Results: Twenty-four patients were administered omalizumab during the study period. Average age of the patients was 36.54 years, female:male ratio was 1.4:1, mean duration of disease was 20.66 months, and autologous serum skin test was positive in 33% of studied individuals. Ninety six percent of cases showed response to treatment in our study. Remission was seen in 25% of patients, 50% showed satisfactory response, and 20.83% showed partial response. Average UAS7 scoring before starting omalizumab in preceding week was 24.4. Average UAS7, 2 weeks after starting omalizumab was 4 in responsive patients. Conclusion: Omalizumab is safe and effective treatment for the management of chronic spontaneous urticaria. It can be used in Indian setting after failure to other third-line therapies such as addition of montelukast and cyclosporine due to high cost of treatment.

  3. Encouraging choice, serendipity and experimentation: experiences from Griffith University library (G11) extension and Gumurrii Centre.

    Science.gov (United States)

    Legerton, Graham

    2013-09-01

    The refurbishment and extension of existing university buildings is a critical consideration for many universities. This article details an architect's perspective of an innovative and collaborative design approach to transforming an existing library into a futuristic and student-centric interactive learning environment. The design is responsive to people, place, the community and the environment, due, in part, to the enhanced physical permeability of the building. Associated user-group forums comprised the end user client, the university's facilities body, the builder, lead architectural consultants, the Centre for Indigenous Students (Gumurrii Centre) and architectural sub-consultants. This article discusses five key design moves--"triangulate", "unique geometries and spaces", "learning aviary", "sky lounge" and "understanding flexibility". It goes on to discuss these elements in relation to designing spaces to enhance interprofessional education and collaboration. In summary, this article identifies how it is possible to maximise the value and characteristics of an existing library whilst creating a series of innovative spaces that offer choice, encourage serendipity and embrace experimentation.

  4. 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

  5. Family-centred care: a qualitative study of Chinese and South Asian immigrant parents' experiences of care in paediatric oncology.

    Science.gov (United States)

    Watt, L; Dix, D; Gulati, S; Sung, L; Klaassen, R J; Shaw, N T; Klassen, A F

    2013-03-01

    Over the past two decades, there is increasing emphasis being placed upon providing family-centred care (FCC) in paediatric oncology settings. However, there is a lack of knowledge of FCC in paediatric oncology from the perspectives of immigrant parents. The purpose of this paper is to describe Chinese and South Asian immigrant parents' experiences of FCC in paediatric oncology settings in Canada. This study adopted a constructivist grounded theory approach. Fifty first generation Chinese and South Asian parents of children with cancer who were at least 6 months post-diagnosis were recruited from six Canadian paediatric oncology centres. Interviews were conducted in English, Cantonese, Mandarin, Urdu, Punjabi or Hindi, and transcribed into English. Analysis involved line-by-line, focused and theoretical coding, and the use of the constant comparison method. Findings indicated that overall parents were highly satisfied with the care and services they received, and their experiences were reflective of the key elements of FCC. However, there were some areas of concern identified by participants: parents not perceiving themselves as a member of the medical team; inconsistency in the quality and co-ordination of services among healthcare providers; disrespectful and mechanical manner of a few healthcare providers; and parents' discomfort with healthcare providers communicating sensitive health-related information directly with their child. In order to successfully provide family-centred services to immigrant parents of children with cancer, better communication of the elements of FCC between healthcare staff and families is needed to negotiate a clear role for the parents as partners of the healthcare team. Moreover, a better understanding of how family relationships are structured in immigrant families will assist healthcare providers to balance the best interests of the child with that of the family as a unit. © 2011 Blackwell Publishing Ltd.

  6. Four Gaucher disease type II patients with three novel mutations: a single centre experience from Turkey.

    Science.gov (United States)

    Bulut, Fatma Derya; Kör, Deniz; Şeker-Yılmaz, Berna; Hergüner, Özlem; Ceylaner, Serdar; Özkınay, Ferda; Kılavuz, Sebile; Önenli-Mungan, Neslihan

    2018-04-14

    Gaucher disease is the most common lysosomal storage disorder due to glucosylceramidase enzyme deficiency. There are three subtypes of the disease. Neurological involvement accompanies visceral and haematological findings only in type II and type III Gaucher patients. Type II is the acute progressive neuronopathic form which is the most severe and rare subtype. Clinical findings are recognized prenatally or in the first months of life and followed by death within the first two years of age. Among our 81 Gaucher patients, we identified 4 (4,9%) type II patients in our metabolic centre. This rate is significantly higher than the rate reported in the literature (Gaucher patients with three novel mutations and one perinatal lethal form with generalized ichthyosis which is a very rare disorder. Additionally, we would like to highlight the phenotypic heterogeneity not only between the subtypes, also even in the same type.

  7. Asp Viper (Vipera aspis) envenomation: experience of the Marseille Poison Centre from 1996 to 2008.

    Science.gov (United States)

    de Haro, Luc; Glaizal, Mathieu; Tichadou, Lucia; Blanc-Brisset, Ingrid; Hayek-Lanthois, Maryvonne

    2009-12-01

    A retrospective case review study of viper envenomations collected by the Marseille's Poison Centre between 1996 and 2008 was performed. 174 cases were studied (52 grade 1 = G1, 90 G2 and 32 G3). G1 patients received symptomatic treatments (average hospital stay 0.96 day). One hundred and six (106) of the G2/G3 patients were treated with the antivenom Viperfav* (2.1+/-0.9 days in hospital), while 15 of them received symptomatic treatments only (plus one immediate death) (8.1+/-4 days in hospital, 2 of them died). The hospital stay was significantly reduced in the antivenom treated group (p < 0.001), and none of the 106 antivenom treated patients had immediate (anaphylaxis) or delayed (serum sickness) allergic reactions. Viperfav* antivenom was safe and effective for treating asp viper venom-induced toxicity.

  8. Hydroxyurea therapy in UK children with sickle cell anaemia: A single-centre experience.

    Science.gov (United States)

    Phillips, Kate; Healy, Laura; Smith, Louise; Keenan, Russell

    2018-02-01

    Despite the demonstrated efficacy of hydroxyurea therapy, children with sickle cell anaemia in the UK are preferentially managed with supportive care or transfusion. Hydroxyurea is reserved for children with severe disease phenotype. This is in contrast to North America and other countries where hydroxyurea is widely used for children of all clinical phenotypes. The conservative UK practice may in part be due to concerns about toxicity, in particular marrow suppression with high doses, and growth in children. We monitored 37 paediatric patients with sickle cell anaemia who were treated with hydroxyurea at a single UK treatment centre. Therapy was well tolerated and mild transient cytopenias were the only toxicity observed. Comparative analysis of patients receiving ≥26 mg/kg/day versus hydroxyurea as a disease-modifying therapy, which we advocate for all children with sickle cell anaemia. © 2017 The Authors. Pediatric Blood & Cancer Published by Wiley Periodicals, Inc.

  9. African experiences of humanitarian cardiovascular medicine: the Cardiac Centre of St. Elizabeth Catholic General Hospital, Shisong.

    Science.gov (United States)

    Budzee, Sr Appolonia; Tchoumi, Jc Tantchou; Giamberti, Alessandro; Ambassa, Jc; Cirri, Sylvia; Butera, Gianfranco

    2012-06-01

    The cardiac centre of Shisong inaugurated few years ago is a good example of the mobilization of humanitarian resources from the north and south for the improvement of cardiovascular diagnosis and treatment in Africa. From the inauguration of the Center to December 2011, 23 surgical missions have been organized, (5 peadiatric and 18 adults) and 204 patients have been operated with the help of the partners: Associazione Bambini Cardiopatici nel Mondo and Cuore Fratello. The Catheterisation Laboratory has performed a total of 117 diagnostic and interventional procedures while 22 pace makers were implanted (12 single-chambers and 10 dual-chambers). Many problems and challenges are faced everyday but with the enthusiasm, the dynamism and the professional skills of the personnel, the help of the partners we see a bright future.

  10. 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

    In person-centred decision making the relative importance of the considerations that matter to the person is elicited and combined, at the point of decision, with the best estimates available on the performance of the available options on those criteria. Whatever procedure is used to implement...... this in a clinical decision, average preferences emerging from group or subgroup research cannot contribute directly, since they can have only a statistical relationship with the preferences of the individual person. The precise relationship is knowable by eliciting those of the individual concerned, but there would...... of how this could happen, the ambiguity often arising from the use and positioning of the apostrophe in the words persons and patients. Only when the person opts out of preference provision and asks to be treated as ‘average’, can the results of a DCE have clinical relevance in genuinely person...

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

    Science.gov (United States)

    Ross, Alexander; Shelley, Helen; Novell, Kim; Ingham, Elizabeth; Callan, Julia; Heuschkel, Robert; Morris, Mary-Anne; Zilbauer, Matthias

    2013-01-01

    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. PMID:24284612

  12. 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.

  13. 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, were......, for instance because of primary kidney disease or when calcineurin inhibitor toxicity was suspected. RESULTS: About 71% of the patients did not take steroids at all. Nevertheless, graft survival rates at 1, 5 and 7 years were 95, 77 and 72% for all grafts, including 27% living donor transplants and 27% second...... or subsequent grafts. Ten patients (3.2%) died with functioning grafts. Within the first year of transplantation there were 69 acute rejections in 63 patients (19%). Four cases (1.3%) of post-transplant lymphoproliferative disorder (PTLD) occurred with one graft loss and no deaths. Owing to a high PTLD rate...

  14. Prenatally Diagnosis and Outcome of Fetuses with Cardiac Rhabdomyoma – Single Centre Experience

    Science.gov (United States)

    Bejiqi, Ramush; Retkoceri, Ragip; Bejiqi, Hana

    2017-01-01

    BACKGROUND Cardiac rhabdomyoma (CRs) are the most common primary tumour of the heart in infants and children. Usually are multiple and, basing on the location can cause a haemodynamic disturbance, dysrhythmias or heart failure during the fetal and early postnatal period. CRs have a natural history of spontaneous regression and are closely associated with tuberous sclerosis complex (TSC). It has an association with tuberous sclerosis (TS), and in those, the tumour may regress and disappear completely, or remain consistent in size. AIM: We aimed to evaluate the prenatal diagnosis, clinical presentation and outcome of CRs and their association with TSC in a single centre. The median follow-up period was three years (range: 6 months - 5 years). MATERIAL AND METHODS: We reviewed medical records of all fetuses diagnosed prenatally with cardiac rhabdomyoma covering the period January 2010 to December 2016 which had undergone detailed ultrasound evaluation at a single centre with limited technical resources. RESULTS: Twelve fetuses were included in the study; mostly had multiple tumours and a total of 53 tumours were identified in all patients - the maximum was one fetus with16 tumours. All patients were diagnosed prenatally by fetal echocardiography. In two patient’s haemodynamic disturbances during the fetal period was noted and pregnancies have been terminated. After long consultation termination of pregnancy was chosen by the parents in totally 8 cases. In four continuing pregnancies during the first year of live tumours regressed. TSC was diagnosed in all patients during the follow-up. CONCLUSIONS: Cardiac rhabdomyoma are benign from the cardiovascular standpoint in most affected fetuses. An early prenatal diagnosis may help for an adequate planning of perinatal monitoring and treatment with the involvement of a multidisciplinary team. Large tumour size, the number of tumours and localisation may cause hydrops, and they are significantly associated with poor

  15. 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

    2018-05-01

    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.

  16. 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

  17. Centre of nuclear research experience in the control of personal exposition between 2002 - 2006

    International Nuclear Information System (INIS)

    Bayardo, Karina; Blanco, Daniel; Garcia, Fernando

    2008-01-01

    Full text: The control of the personal exposition in the public University is done by the Centre of Nuclear Research since 1999. A look at the last years permitted to note the increase in the Personal Dosimeter users. In this work we study the annual collective dose, the annual effective dose average and the different dose in each University area between 2002-2005. The annual effective dose limit for the Nuclear Regulatory Authority (Autoridad Reguladora Nuclear), are the suggested by the International Commission of Radiological Protection (ICRP). The actual application of the Basics Principles of Radiological Protection demand exposition levels as low as reasonable achievable (ALARA) considering economics and social factors. In this way we decrease the probability to induce illness in the expose personal and their descendants. The different dependences of the University where the service is given are: Faculty of Medicine (Radiology, Oncology, Clinical Oncology, Nuclear Medicine), Faculty of Chemistry (Radiochemistry), Faculty of Odontology (Radiology), Faculty of Veterinary (Radiology) and Faculty of Sciences (Centre of Nuclear Research). The number of users between 2002-2006 varied from 292 in year 2002 to 329 in the year 2006. We see a maximum of persons in the year 2004. The annual collective dose have been changing too, the lowest was 0.13 Sv.person in the year 2002 and the highest was 0.21 Sv.person in the year 2005. The annual collective dose permits the evaluation of the radiological impact of the radiation ionising manipulation in the University. In these 5 years the 96% of the annual effective dose average were under 4 mSv, and the 76% were smaller than the minimum detectable limit. This 76% were obtained in teach and researches areas. In the 4% higher than 4 mSv we can find areas where works with open radioactive sources like: Nuclear Medicine and Radiochemistry (Faulted de Pumice). In these places we detect annual effective doses of 15 mSv, these levels

  18. 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

  19. Relational nuclear databases upon the MSU INP CDFE Web-site and Nuclear Data Centres Network CDFE activities. P7[Centre for Photonuclear Experiments Data, Moscow, Russian Federation

    Energy Technology Data Exchange (ETDEWEB)

    Boboshin, I N; Varlamov, V V; Ivanov, E M; Ivanov, S V; Peskov, N N; Stepanov, M E; Chesnokov, V V [Centre for Photonuclear Experiments Data, Moscow (Russian Federation)

    2001-07-01

    This report contains only the short review of the work carried out by the CDFE concerning the IAEA Nuclear Reaction Data Centres Network activities for the period of time from the IAEA Advisory Group Meeting (15-19 May 2000, Obninsk, Russia) till May 2001 and the description of the main results obtained.

  20. [Periprocedural and late complications after percutaneous closure of patent foramen ovale: a single centre experience].

    Science.gov (United States)

    Węglarz, Przemysław; Konarska Kuszewska, Ewa; Spisak Borowska, Katarzyna; Machowski, Jerzy; Drzewiecka-Gerber, Agnieszka; Kuszewski, Piotr; Jackson, Christopher L; Opala, Grzegorz; Trusz Gluza, Maria

    2012-01-01

    Patent foramen ovale (PFO) is a potential risk factor for ischaemic stroke in young individuals. An interventional method of secondary stroke prevention in PFO patients is its percutaneous closure. To assess safety and effectiveness (i.e. lack of residual shunt) of percutaneous PFO closure in patients with history of cryptogenic cerebrovascular event. 149 patients (56 men/93 women), aged 39 ± 12 years, underwent percutaneous PFO closure. The implantation was performed under local anaesthesia, guided by trans-oesophageal echocardiography (TEE) and fluoroscopy. Follow-up trans-thoracic echocardiography (TTE) was performed at 1 month and follow-up TEE at 6-months. In cases of residual shunt, additional TEE was performed after ensuing 6 months. Effective PFO closure (no residual shunt) was achieved in 91.3% patients at 6 months and 95.3% patients at 12 months. In 2 patients transient atrial fibrillation was observed during the procedure. In 2 patients, a puncture site haematoma developed and in 1 patient superficial thrombophlebitis was noted. In 1 patient a small pericardial effusion was observed, which resolved at day 3 post-procedurally, after administration of non-steroidal anti-inflammatory drugs. Percutaneous PFO closure seems to be a safe procedure when performed in a centre with adequate expertise with regard to these procedures.

  1. 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.

  2. Environmental iodine intake and pattern of thyroid diseases: experience at nuclear medicine centre, Mayo Hospital (abstract)

    International Nuclear Information System (INIS)

    Elahi, S.; Khan, M.; Rasool, S.; Khalid, A.; Tasneem, A.

    2011-01-01

    To know level of iodine intake in women residing in Lahore and correlate it with pattern of thyroid diseases found in women referred to Centre for Nuclear Medicine (CENUM), Mayo Hospital. Iodine intake status was determined by urinary iodine (UI) excretion by Sandell-Kolthoff reaction. Thyroid related hormones (FT4, FT3 and TSH) were measured by radioimmunoassay. In 110 non-pregnant euthyroid women (age 20-36 year) average iodine intake was 66.3 +- 14.4 mu g/L (range: 30-98 mu g/dL). All women were iodine deficient (UI 22.0 pmol/L and TSH greater or equal to 0.1mIU/L) was detected in 580(10.8%) women and hypothyroidism (FT4 0.4mIU/L) was found in 271(5.1%) women. Thus incidence of hyperthyroidism was almost double than that of hypothyroidism. Low iodine intake is manifested as increased incidence of hyperthyroidism. (author)

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

    Directory of Open Access Journals (Sweden)

    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.

  4. 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.

  5. 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.

  6. Intentional injury against children in Sub-Saharan Africa: A tertiary trauma centre experience.

    Science.gov (United States)

    Gallaher, Jared R; Wildfire, Benjamin; Mabedi, Charles; Cairns, Bruce A; Charles, Anthony G

    2016-04-01

    Intentional injuries are the result of violence. This is an important public health issue, particularly in children, and is an unaddressed problem in sub-Saharan Africa. This study sought to describe the characteristics of intentional injury, particularly physical abuse, in children presenting to our tertiary trauma centre in Lilongwe, Malawi and how they compare to children with unintentional injuries. A retrospective analysis of children (in Lilongwe, Malawi from 2009 to 2013 was performed. Children with intentional and unintentional injuries were compared with bivariate analysis and multivariate logistic regression modelling. 67,672 patients with traumatic injuries presented to KCH of which 24,365 were children. 1976 (8.1%) patients presented with intentional injury. Intentional injury patients had a higher mean age (11.1 ± 5.0 vs. 7.1 ± 4.6, pin intentional injury patients (80.5 vs. 45.4%, pin both groups (89.2 vs 80.9%, pin both groups. Sub-Saharan African tertiary hospitals are uniquely positioned to play a pivotal role in the identification, clinical management, and alleviation of intentional injuries to children by facilitating access to social services and through prevention efforts. Copyright © 2015 Elsevier Ltd. All rights reserved.

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

    Directory of Open Access Journals (Sweden)

    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.

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

    Directory of Open Access Journals (Sweden)

    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.

  9. Occupational radiation protection experience in radioactive waste management at Bhabha Atomic Research Centre, Trombay, Mumbai, India

    International Nuclear Information System (INIS)

    Ramchandran, V.; Jauhri, G.S.

    2000-01-01

    Waste Management Facilities, Trombay (WMFT) comprises Radioactive Solid waste Management Site (RSMS), an Effluent Treatment Plant (ETP), and a Decontamination Centre (DC). Radioactive wastes from the plants and laboratories in Mumbai are handled here. The wastes are categorized and classified as per International Atomic Energy Agency (IAEA) and Atomic Energy Regulatory Board (AERB) guidelines. RSMS is a near surface disposal facility, where assorted beta gamma solid waste is disposed off in appropriate disposal facilities. ETP is a centralized low level liquid waste treatment facility, where liquid effluent is chemically treated to remove the radionuclides present in it, monitored for radioactivity, and discharged into the Mumbai Harbour Bay. In DC, plant and laboratory used clothings and personnel protective wears are decontaminated, monitored and sent for reuse. A comprehensive radiation monitoring programme is in place in these facilities from the beginning of radioactive waste management operations at BARC. The per capita radiation dose of the occupational workers and individual maximum dose has been low. Radioactivity release through liquid effluent from ETP has been kept well below Authorized Limits (AL). There has been no safety related unusual occurrences during the facility operation, that had any significant radiological impact. (author)

  10. Wilson's Disease: a challenge of diagnosis. The 5-year experience of a tertiary centre.

    Science.gov (United States)

    Gheorghe, Liana; Popescu, Irinel; Iacob, Speranta; Gheorghe, Cristian; Vaidan, Roxana; Constantinescu, Alexandra; Iacob, Razvan; Becheanu, Gabriel; Angelescu, Corina; Diculescu, Mircea

    2004-09-01

    Because molecular diagnosis is considered impractical and no patognomonic features have been described, diagnosis of Wilson's disease (WD) using clinical and biochemical findings is still challenging. We analysed predictive factors for the diagnosis in 55 patients with WD diagnosed in our centre between 1st January 1999 and 1st April 2004. All patients presented predominant liver disease classified as: 1) asymptomatic, found incidentally, 2) chronic hepatitis or cirrhosis, or 3) fulminant hepatic failure. Diagnosis was considered as classic (two out of the three following criteria: 1) serum ceruloplasmin 250 mg/g dry weight liver tissue), and non-classic (clinical manifestations plus laboratory parameters suggesting impaired copper metabolism). The association between the predictive factors and non-classic diagnosis was assessed based on the level of statistical significance (p value18 years (p=0.03), increased copper excretion (p<0.0001), Coombs-negative hemolysis (p=0.03), absence of neurological manifestations (p<0.0001). Multivariate analysis identified age over 18 years, increased urinary copper, and isolated hepatic involvement as independent predictors. In clinical practice, WD should be considered also in patients who do not fulfil classic criteria. Independent factors associated with non-classic diagnosis were age over 18 years, increased cupruresis and isolated liver disease.

  11. ESWL for difficult bile duct stones: a 15-year single centre experience.

    Science.gov (United States)

    Muratori, Rosangela; Azzaroli, Francesco; Buonfiglioli, Federica; Alessandrelli, Flavio; Cecinato, Paolo; Mazzella, Giuseppe; Roda, Enrico

    2010-09-07

    To evaluate the efficacy of extracorporeal shock wave lithotripsy (ESWL) for the management of refractory bile duct cholelithiasis in a third level referral centre. The clinical records of all patients treated with a second generation electromagnetic lithotripter (Lithostar Plus, SIEMENS) from October 1990 to April 2005 were evaluated. All patients were monitored during the procedure and antibiotics were administered in case of cholangitis. The chi(2) test and logistic regression analysis were performed as appropriate. Two hundred and fourteen patients (102 males, 112 females; mean age 74.8 +/- 0.84 years--single stone 97, multiple stones 117) underwent ESWL. The mean number of sessions and shock waves were 3.5 +/- 0.13 and 3477.06 +/- 66.17, respectively. The maximum stone size was 5 cm. Complete stone clearance was achieved in 192 (89.7%) patients. Of the remaining patients 15 required surgery, 2 a palliative stent and in 5 patients stone fragmentation led to effective bile drainage with clinical resolution despite incomplete clearance. Age, sex and stone characteristics were not related to treatment outcome. Major complications occurred in two patients (haemobilia and rectal bleeding) and minor complications in 25 (3 vomiting, 22 arrhythmias). No procedure-related deaths occurred. ESWL is a safe and effective technique for clearance of refractory bile duct stones.

  12. Wol man's disease: The King Faisal Specialist Hospital and Research Centre Experience

    International Nuclear Information System (INIS)

    Al-Essa, M.; Sakati, N.; Joshi, S.; Ozand, P.T.; Nounou, R.; Le Quesne, G.; Archibald, A.

    1998-01-01

    Wolman's disease is a rare autosomal recessive lysosomal storage disease. A recent review indicates that approximately 50 patients have reported in the world. Reports of patients from the Arabian Peninsula are rare due to lack of awareness among pediatricians. We retrospectively reviewed the clinical, radiological, biochemical and histopathological findings of four Saudi patients diagnosed with Wolman's disease at King Faisal Hospital and Research Centre. The diagnosis was confirmed by deficient acid lipase activity in the leukocytes and fibroblasts, which was measured using 4-methylumbelliferyl palmitate. All patients were failing to thrive with progressive heptasplenomegaly. Abdominal x-ray revealed calcifications which were confirmed on abdominal CT scan. Peripheral blood film showed foamy histiocytes. Liver biopsy in one patient showed marked steatosis and elliptical empty clefs predominantly in the Kupffer cells, indicating cholesterol storage in the reticulo-endothelial cells. The acid lipase activity was less than 6% in all patients. In all suspected cases of Wolman's disease, a plane abdominal x-ray should be obtained to check for the typical pattern of adrenal calcification characteristic of the disease, especially ant young infant with failure to thrive and progressive hepatosplenomegaly. (author)

  13. Experience with renal cell carcinoma-a single centre study from Khyber Pakhtunkhwa

    International Nuclear Information System (INIS)

    Khan, H. S.; Mahmood, A.

    2017-01-01

    Objective: To analyze the clinical characteristics, management and outcome of renal cell carcinoma (RCC) and its variants in patients treated at CMH Peshawar, from Aug 2011 to Aug 2014. Study Design: Retrospective descriptive. Place and Duration of Study: Combined Military Hospital (CMH) Peshawar, from Aug 2011 to Aug 2014. Material and Methods: All patients who underwent nephrectomy for renal masses at our institution between Aug 2011 and Aug 2014 were included in the study. The demographic distribution, symptoms, tumour characteristics, operative findings and histopathology reports were extracted from the hospital records and analysed via SPSS version 20.0. Results: Among 27 patients male to female ratio was 1.25:1. Mean age was 55.5 ± 11.7 years. Flank pain was the commonest symptom reported. Mean maximum diameter of the tumour was 13.6 ± 4.6 cm. All the tumours were malignant and most common histopathological type was conventional/clear cell RCC. All patients were treated by radical nephrectomy through transperitoneal approach. One patient developed post operative thrombosis of inferior vena cava. Two patients developed metastatic deposit during follow up. Conclusion: Renal tumours in the study population of Khyber Pakhtunkhwa at our centre presented late with large sizes, and incidental diagnosis is rare. Health education and availability of advanced diagnostic facilities will improve outcomes. (author)

  14. Ovarian tissue cryopreservation in girls undergoing haematopoietic stem cell transplant: experience of a single centre.

    Science.gov (United States)

    Biasin, E; Salvagno, F; Berger, M; Nesi, F; Quarello, P; Vassallo, E; Evangelista, F; Marchino, G L; Revelli, A; Benedetto, C; Fagioli, F

    2015-09-01

    Fertility after childhood haemopoietic stem cell transplant (HSCT) is a major concern. Conditioning regimens before HSCT present a high risk (>80%) of ovarian failure. Since 2000, we have proposed cryopreservation of ovarian tissue to female patients undergoing HSCT at our centre, to preserve future fertility. After clinical and haematological evaluation, the patients underwent ovarian tissue collection by laparoscopy. The tissue was analysed by histologic examination to detect any tumour contamination and then frozen following the slow freezing procedure and cryopreserved in liquid nitrogen. From August 2000 to September 2013, 47 patients planned to receive HSCT, underwent ovarian tissue cryopreservation. The median age at diagnosis was 11.1 years and at the time of procedure it was 13 years, respectively. Twenty-four patients were not pubertal at the time of storage, whereas 23 patients had already experienced menarche. The median time between laparoscopy and HSCT was 25 days. Twenty-six out of 28 evaluable patients (93%) developed hypergonadotropic hypogonadism at a median time of 23.3 months after HSCT. One patient required autologous orthotopic transplantation that resulted in one live birth. Results show a very high rate of iatrogenic hypergonadotropic hypogonadism, highlighting the need for fertility preservation in these patients.

  15. Treating TTP/HUS with plasma exchange: a single centre's 25-year experience.

    Science.gov (United States)

    Forzley, Brian R; Sontrop, Jessica M; Macnab, Jennifer J; Chen, Salina; Clark, William F

    2008-10-01

    Thrombotic thrombocytopenic purpura/Haemolytic uremic syndrome (TTP/HUS) is a thrombotic microangiopathy with a 6-month mortality rate of 16-29%. The present study described the clinical features, treatment regime and 6-month all-cause mortality rate of TTP/HUS patients at the London Health Sciences Centre (LHSC), Canada. Data for this retrospective cohort study were obtained from inpatient and outpatient records for all patients referred for plasma exchange therapy at LHSC, Canada between 1981 and 2006. Patients (n = 110) were categorized as: idiopathic primary (38%) or relapsed (16%), and secondary responsive (30%) or non-responsive (16%). Mortality data were available for all but three patients. The all-cause 6-month mortality rate was 19% overall and was 12% and 26% among idiopathic and secondary TTP/HUS patients, respectively. No mortality events occurred among the 17 idiopathic patients who relapsed. Relapsed patients had the least severe presenting characteristics, the fastest response time, and experienced significant improvement in the severity of clinical features between the first and final presentation. These findings suggest an excellent outcome for relapsed TTP/HUS patients. Patient education, surveillance, and aggressive plasma exchange therapy are hypothesized to improve the likelihood of survival: these hypotheses should be tested in a randomized controlled trial.

  16. The experience of CDTN/CNEN, Centro de Desenvolvimento da Tecnologia Nuclear: A medium size nuclear research centre in Brazil

    International Nuclear Information System (INIS)

    Sobrinho, P.

    2001-01-01

    At first a university research centre, then a captive research centre of the state owned company in charge of establishing a nuclear industry in Brazil, then a research centre of CNEN (the Brazilian Nuclear Energy Authority), nearing its 50 th anniversary, CDTN has a rich experience. even keeping the project portfolio around a number of traditional nuclear energy areas such as nuclear reactors, materials, environment, process engineering, waste management, radiological protection, the institution experienced an evolution in the substance of the proposed projects. This evolution represents the different institutional insertions, but the major changes occurred at a time when, due to a lesser demand from the nuclear sector and other factors, the explicit idea of producing outputs for the benefit of society received a large acceptance from the employees. The challenges to the institution at this time are commented upon. Retirements, coupled to the lack of job openings, work together for the decrease in the staff number, one major challenge. Up to a certain point, private companies have been hired to fill some of the organisational needs, but it is felt that a limit to this policy is being reached. It is argued that, even in the absence of a strong demand from the energy generation sector, a number of opportunities are still available to a NRC in a developing country. Maturity of nuclear energy and applications of radiation tend to transfer the focus of the activities from the fundamentals of nuclear science and technology to quality related issues, a requirement of the modern times. quality systems cannot substitute for the in depth knowledge of the fundamentals. (author)

  17. 3066 consecutive Gamma Nails. 12 years experience at a single centre

    Directory of Open Access Journals (Sweden)

    Ekholm Carl

    2010-06-01

    Full Text Available Abstract Background Fixation of trochanteric hip fractures using the Gamma Nail has been performed since 1988 and is today well established and wide-spread. However, a number of reports have raised serious concerns about the implant's complication rate. The main focus has been the increased risk of a subsequent femoral shaft fracture and some authors have argued against its use despite other obvious advantages, when this implant is employed. Through access to a uniquely large patient data base available, which is available for analysis of trochanteric fractures; we have been able to evaluate the performance of the Gamma Nail over a twelve year period. Methods 3066 consecutive patients were treated for trochanteric fractures using Gamma Nails between 1990 and 2002 at the Centre de Traumatologie et de l'Orthopedie (CTO, Strasbourg, France. These patients were retrospectively analysed. Information on epidemiological data, intra- and postoperative complications and patients' outcome was retrieved from patient notes. All available radiographs were assessed by a single reviewer (AJB. Results The results showed a low complication rate with the use of the Gamma Nail. There were 137 (4.5% intraoperative fracture-related complications. Moreover 189 (6.2% complications were detected postoperatively and during follow-up. Cut-out of the lag screw from the femoral head was the most frequent mechanical complication (57 patients, 1.85%, whereas a postoperative femoral shaft fracture occurred in 19 patients (0.6%. Other complications, such as infection, delayed healing/non-union, avascular femoral head necrosis and distal locking problems occurred in 113 patients (3.7%. Conclusions The use of the Gamma Nail in trochanteric hip fractures is a safe method with a low complication rate. In particular, a low rate of femoral shaft fractures was reported. The low complication rate reported in this series can probably be explained by strict adherence to a proper

  18. Incisional hernia in pediatric surgery - experience at a single UK tertiary centre.

    Science.gov (United States)

    Mullassery, Dhanya; Pedersen, Ami; Robb, Andrew; Smith, Nicola

    2016-11-01

    Incisional hernia (IH) is a recognized complication of open and laparoscopic visceral surgery, with reported rates of 10-50% in adult surgical literature. There is a paucity of data relating to incisional hernias in children. The aim of our study was to analyze the incidence and treatment of IH in children. Retrospective review of all patients admitted for incisional hernia repair at a tertiary pediatric surgical centre in the UK more than a 7-year period was performed. Data collected included age at initial surgery, time to IH repair, and type of IH repair and postoperative complications. Twenty one patients (14 male) underwent IH repair during the study period. The incidence of IH among children who had primary abdominal surgery in our institution less than the age of 6months was 2.3%. Median age at repair was 7.9months (range: 18days-5years). Median time from primary surgery to diagnosis of IH was 2months (range 0day-3years), with 81% (17/21) diagnosed within 1year of the preceding abdominal procedure. The most common pathology necessitating the primary operative procedure was necrotising enterocolitis (n=9) in babies of gestational age less than 30weeks. The highest rates of IH were noted in infants following closure of stoma (7.5%) and pyloromyotomy (2.52%). Primary closure was undertaken in all cases. Two children had recurrence of IH, one of which underwent surgical repair. Incidence of IH in children is low but significant. IH was most commonly diagnosed following closure of stoma for NEC in this study. Copyright © 2016. Published by Elsevier Inc.

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

    Science.gov (United States)

    Royds, J; O'Riordan, J M; Eguare, E; O'Riordan, D; Neary, P C

    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. All diverticular resections carried out between 2006 and 2010 were reviewed. Data recorded included baseline demographics, indication for surgery, operative details, length of hospital stay and complications. Complicated diverticular disease was defined as diverticulitis with associated abscess, phlegmon, fistula, stricture, obstruction, bleeding or perforation. One hundred and two patients (58 men) who had surgery for diverticular disease were identified (median age 59 years, range 49-70 years). Sixty-four patients (64%) had surgery for complicated diverticular disease. The indications were recurrent acute diverticulitis (37%), colovesical fistula (21%), stricture formation (17%) and colonic perforation (16%). Sixty-nine cases (88%) were completed by elective laparoscopy. Postoperative mortality was 0%. For elective cases there was no difference in morbidity rates between patients with complicated and uncomplicated diverticular disease. The overall anastomotic leakage rate was 1% and the wound infection rate 7%. There was a nonsignificant trend to higher conversion to open surgery in the elective group in complicated (11.4%) compared with uncomplicated patients (5.2%) (P=0.67). Electively, the rate of stoma formation was higher in the complicated (31.6%) than the uncomplicated group (5.2%) (Pdiverticular disease is associated with low rates of postoperative morbidity and relatively low conversion rates. Laparoscopic surgery is now the standard of care for complicated and uncomplicated diverticular disease in our institution. © 2011 The Authors. Colorectal Disease © 2011 The Association of Coloproctology of Great Britain and Ireland.

  20. Gastric volvulus in children: Experience of 6 years at a tertiary care centre

    Directory of Open Access Journals (Sweden)

    Pradeep S

    2010-01-01

    Full Text Available Background: The aim of the study was to review the cases of all children who had gastric volvulus from 2002 to 2007 at a tertiary care centre in India and to compare the outcome of management with the reported series on gastric volvulus in a paediatric age group. Materials and Methods: This was a retrospective study of eight children with an age range between 10 days and 2 years who were managed for gastric volvulus between 2002 and 2007. The records of these patients were reviewed for clinical features, investigations, management and outcome. Results: All patients were less than 3 years of age with female preponderance (n = 5. Three patients had acute presentation and three had acute-on-chronic symptoms, while two had chronic gastric volvulus. The commonest symptom was abdominal distension. Two patients were diagnosed by barium studies and six had clinical suspicion because of their symptoms and were confirmed intra-operatively. Seven had secondary gastric volvulus of organo axial type with associated pathologies as congenital diaphragmatic hernia (n = 5, Para oesophageal hiatus hernia (n = 2, and one had primary gastric volvulus in a postoperative period in an operated case for a tracheo-oesophageal fistula (n = 1. Seven patients were symptom free at follow-up; one patient succumbed due to septicaemia in the immediate post-operative period which was not related to the pathology of gastric volvulus. Conclusion: Gastric volvulus is a rare condition in children and requires prompt diagnosis and urgent intervention in acute presentation where it mimics acute abdomen and strong clinical suspicion.

  1. 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.

  2. 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.

  3. Experience with cleaning of sodium-wetted components and decontamination at Nuclear Research Centre Karlsruhe

    Energy Technology Data Exchange (ETDEWEB)

    Menzenhauer, P; Borgstedt, U; Stamm, H H; Dippel, Th; Kunze, S; Hentschel, D [Kernforschungszentrum Karlsruhe, Karlsruhe (Germany)

    1978-08-01

    Within the framework of the Fast Breeder Project various institutes of the KarIsruhe Nuclear Research Center operate sodium loops for corrosion studies and component tests under sodium. The operation of these loops has led to extensive experience in cleaning sodium-wetted components. This experience relates to the alcohol method, the removal of sodium by melting, storage in air, and to cleaning by means of steam. Deposition samples from radioactive sodium loops were used for decontamination experiments employing various decontaminating agents. The department concerned with the treatment of radioactive waste studied the use of molten salts and paste type cleansers for components unsuitable for mechanical decontamination, primarily with the objective to reduce the amount of radioactive waste. (author)

  4. Experience with cleaning of sodium-wetted components and decontamination at Nuclear Research Centre Karlsruhe

    International Nuclear Information System (INIS)

    Menzenhauer, P.; Borgstedt, U.; Stamm, H.H.; Dippel, Th.; Kunze, S.; Hentschel, D.

    1978-01-01

    Within the framework of the Fast Breeder Project various institutes of the KarIsruhe Nuclear Research Center operate sodium loops for corrosion studies and component tests under sodium. The operation of these loops has led to extensive experience in cleaning sodium-wetted components. This experience relates to the alcohol method, the removal of sodium by melting, storage in air, and to cleaning by means of steam. Deposition samples from radioactive sodium loops were used for decontamination experiments employing various decontaminating agents. The department concerned with the treatment of radioactive waste studied the use of molten salts and paste type cleansers for components unsuitable for mechanical decontamination, primarily with the objective to reduce the amount of radioactive waste. (author)

  5. Results of several years experiments on the absorption of radioactive strontium and caesium by cultivated plants (1962); Compte rendu d'experiences de plusieurs annees sur l'absorption du strontium et du cesium radioactifs par des plantes cultivees (1962)

    Energy Technology Data Exchange (ETDEWEB)

    Michon, M [Commissariat a l' Energie Atomique, Dept. de Protection Sanitaire, Fontenay-aux-Roses (France). Centre d' Etudes Nucleaires; Benard, M; Flanzy, M [Station Centrale de Technologie des Produits Vegetaux, 11 - Narbonne (France); Fioramonti, M; Marty, M [Station Agronomique de Toulouse, 31 (France); Barbier, M; Le Blaye, M; Brossard, M [Societe Centrale d' Agronomie, 78 - Versailles (France)

    1962-07-01

    This report follows on to the report number CEA 1860 and uses results obtained in 1960 to give more precise details concerning the data presented in the preceding report. First results obtained on the vine are given. The Sr absorption coefficient has varied very little from one year to the next and that of caesium has slightly diminished. The values obtained suggest that the concentrations of {sup 90}Sr and {sup 137}Cs in irrigation water should not exceed 1/5 of the maximum permissible concentration in drinking water. (authors) [French] Ce rapport fait suite au rapport CEA 1860 et precise grace aux resultats acquis en 1960 les donnees exprimees dans le precedent rapport. Il y est fait mention des premiers resultats obtenus pour la vigne. Le coefficient d'absorption du Sr a peu varie d'une annee sur l'autre et celui du cesium legerement diminue. Les valeurs obtenues permettent de penser qu'il serait souhaitable que la concentration en {sup 90}Sr et en {sup 137}Cs dans l'eau d'irrigation ne depasse pas le 1/5 de la concentration maxima admissible pour l'eau de boisson. (auteurs)

  6. 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…

  7. 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…

  8. 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

  9. Bariatric surgery in severely obese adolescents: a single-centre experience.

    Science.gov (United States)

    Sachdev, Pooja; Makaya, Taffy; Marven, Sean S; Ackroyd, Roger; Wales, Jerry K; Wright, Neil P

    2014-10-01

    Increasing numbers of severely obese young people undergo bariatric surgery in the USA with reports of substantial weight loss after 1 year. National Institute for Clinical Excellence 2006 suggests considering surgery for young people in 'exceptional circumstances'. We present six patients operated upon 2004-2012 at our centre in the UK. Six patients (4 male) aged 14-16 years (mean age 15.10) underwent surgery. Mean preoperative body mass index (BMI) was 62.7 kg/m(2) and BMI SDS +4.4. Comorbidities included hypertension, insulin resistance, obstructive sleep apnoea, limited mobility, benign intracranial hypertension and psychosocial issues. All six patients had prior involvement with local lifestyle weight management services and had pharmacological intervention. Four laparoscopic gastric bypass procedures, one laparoscopic gastric banding (patient had a gastric balloon prior to band) and one laparoscopic sleeve gastrectomy were performed. There were no major postoperative procedural complications (one patient had a port rotation). Mean percentage of weight loss, as a percentage of total body weight at 6 and 12 months, was 22 and 27%, respectively. Average absolute weight loss at current follow-up is 54 kg. Mean BMI at 12 months postprocedure was 46.5 kg/m(2)-a mean fall of 16.2 kg/m(2). Mean BMI SDS fell from +4.4 to +3.8 at 12 months and +3.1 at 2 years. Resolution of hypertension, improved school attendance and no progression to T2DM were the benefits noted. Recent systematic reviews and meta-analyses suggest that bariatric surgery results in sustained and clinically significant weight loss in paediatric populations. The surgical option should continue to be exercised with extreme caution only in severely obese adolescents and done so in appropriate case results in positive outcomes. 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.

  10. ASPIRE: An automated sample positioning and irradiation system for radiation biology experiments at Inter University Accelerator Centre, New Delhi

    International Nuclear Information System (INIS)

    Kothari, Ashok; Barua, P.; Archunan, M.; Rani, Kusum; Subramanian, E.T.; Pujari, Geetanjali; Kaur, Harminder; Satyanarayanan, V.V.V.; Sarma, Asitikantha; Avasthi, D.K.

    2015-01-01

    An automated irradiation setup for biology samples has been built at Inter University Accelerator Centre (IUAC), New Delhi, India. It can automatically load and unload 20 biology samples in a run of experiment. It takes about 20 min [2% of the cell doubling time] to irradiate all the 20 samples. Cell doubling time is the time taken by the cells (kept in the medium) to grow double in numbers. The cells in the samples keep growing during entire of the experiment. The fluence irradiated to the samples is measured with two silicon surface barrier detectors. Tests show that the uniformity of fluence and dose of heavy ions reaches to 2% at the sample area in diameter of 40 mm. The accuracy of mean fluence at the center of the target area is within 1%. The irradiation setup can be used to the studies of radiation therapy, radiation dosimetry and molecular biology at the heavy ion accelerator. - Highlights: • Automated positioning and irradiation setup for biology samples at IUAC is built. • Loading and unloading of 20 biology samples can be automatically carried out. • Biologicals cells keep growing during entire experiment. • Fluence and dose of heavy ions are measured by two silicon barrier detectors. • Uniformity of fluence and dose of heavy ions at sample position reaches to 2%

  11. 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

  12. ERYTHROPOIETIN TREATMENT FOR ANEMIA IN CHILDREN WITH CANCER – SINGLE CENTRE EXPERIENCES

    Directory of Open Access Journals (Sweden)

    Polona Mali

    2004-12-01

    Full Text Available Background. Anemia, a common complication during treatment of malignant disease in children, was frequently treated with red blood cell transfusions. Several studies have shown, that the introduction of recombinant human erythropoietin (rh EPO for treating anemia in patients has been effective in reducing the need for transfusions. Variable doses of EPO from 150 to 900 IU/kg body weight have been used usually three times weekly. Recently some studies showed equally effective once weekly administration of EPO with proposed doses for children of 450 to 600 IU/ kg body weight.Efficacy and safety of once weekly EPO therapy was tested in 8/10 children treated in our Unit for solid tumors and nonHodgkin’s lymphoma. In this article we would like to present our one year experience with EPO treatment.Patients and methods. Patients have subcutaneously received the EPO dose of 600 UI/ kg body weight once weekly. Hemoglobin response and transfusion needs before and during treatment with EPO were analyzed.Results. Response was seen in 7/8 of patient, with increased hemoglobin level and lower transfusion needs. Only one patient was poor responder at first, but responded perfect after twice weekly EPO application. No adverse reaction related to EPO therapy was observed.Conclusions. Our experience with treating anemia in pediatric cancer patients who undergo intensive and aggressive chemotherapy treatment regimens are good and promising. Once weekly dosage regimen is child friendly and acceptable way of treating anemia.

  13. 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).

  14. Des solutions fiscales pour une réduction optimale du tabagisme en ...

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

    Centre de recherches pour le développement international Gouvernement du Canada ... taxation du tabac, l¿insuffisance de données probantes locales constitue ... de taxes sur les recettes fiscales de leur gouvernement et sur la santé publique, et de ... Dans ce bulletin du BRAS: Faites connaissance avec Kathryn Touré, ...

  15. Laparoscopic vs. open adrenalectomy: Experience at King Faisal Specialist Hospital and Research Centre, Riyadh

    International Nuclear Information System (INIS)

    Yousuf, Husam Bin; Al-Zahrani, A. A.; Al-Sobhi, S.

    2003-01-01

    We describe our experiences of adrenalectomy and compare the results of open and laparoscopic approach. From March 1999 to March 2002 we performed 23 adrenalectomies. An anterior transabdominal approach was used for the open procedure (OP), and a lateral transperitoneal approach for the laparoscopic procedure (LP). There was no difference in tumor size or pathology between the two groups. The tumor size was smaller, operative time was longer and blood loss was was less in (LP). Mean length of hospital stay was shorter, mean time of resumption of oral intake was faster in the LP group. It was concluded that laparoscopic adrenalectomy is a safe procedure that can be performed for most adrenal pathology. It is associated with faster recovery, less postoperative pain, and shorter hospital stay. (author)

  16. 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...

  17. 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.

  18. Post procedural complications of cardiac implants done in a resource limited setting under 'C' arm: A single centre experience.

    Science.gov (United States)

    Jayachandra, A; Aggarwal, Vivek; Kumar, Sandeep; Nagesh, I V

    2018-04-01

    Cardiology interventions in peripheral hospitals is a challenging task where cardiologist have to fight against time and limited resources. Most of the sudden cardiac deaths occur due to arrhythmia and heart blocks/sinus node dysfunction. Our study is a single peripheral center experience of cardiac devices implantation using a 'C' Arm. The aim of this study was to post procedural complications of cardiac implants done in aresource limited setting under 'C' arm. This study is done at a peripheral cardiology center with no cardiac catheterization laboratory (CCL) facilities. Consecutive patients reporting to cardiology center, between Jan 2015 and Oct 2016, with a definite indication for cardiac device implant were included in the study. All the procedure of implantation was done in the operation theatre under 'C' arm under local anesthesia with continuous cardiac monitoring and critical care back up. Total 58 device implantations were done from Jan 2015 to Oct 2016. The mean age of the patients was 67.15 ± 10.85 years. Males constituted almost two third (68.9%) of patients. The commonest indication for device implantation was sinus node dysfunction in 60.34% followed by complete heart block in 25.86% and ventricular tachycardia in 12.06%. No post procedure infection was observed in our study. Device implantation constitute a major group of life saving interventions in cardiology practice. Our study has emphasised that when appropriate aseptic measures are taken during device implantation at peripheral centres, the complications rate are comparable to interventions done at advance cardiac centres.

  19. Studying human-automation interactions: methodological lessons learned from the human-centred automation experiments 1997-2001

    International Nuclear Information System (INIS)

    Massaiu, Salvatore; Skjerve, Ann Britt Miberg; Skraaning, Gyrd Jr.; Strand, Stine; Waeroe, Irene

    2004-04-01

    This report documents the methodological lessons learned from the Human Centred Automation (HCA) programme both in terms of psychometric evaluation of the measurement techniques developed for human-automation interaction study, and in terms of the application of advanced statistical methods for analysis of experiments. The psychometric evaluation is based on data from the four experiments performed within the HCA programme. The result is a single-source reference text of measurement instruments for the study of human-automation interaction, part of which were specifically developed by the programme. The application of advanced statistical techniques is exemplified by additional analyses performed on the IPSN-HCA experiment of 1998. Special importance is given to the statistical technique Structural Equation Modeling, for the possibility it offers to advance, and empirically test, comprehensive explanations about human-automation interactions. The additional analyses of the IPSN-HCA experiment investigated how the operators formed judgments about their own performance. The issue is of substantive interest for human automation interaction research because the operators' over- or underestimation of their own performance could be seen as a symptom of human-machine mismatch, and a potential latent failure. These analyses concluded that it is the interplay between (1) the level of automation and several factors that determines the operators' bias in performance self-estimation: (2) the nature of the task, (3) the level of scenario complexity, and (4) the level of trust in the automatic system. A structural model that expresses the interplay of all these factors was empirically evaluated and was found able to provide a concise and elegant explanation of the intricate pattern of relationships between the identified factors. (Author)

  20. 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.

  1. Impact of changing trends of treatment on outcome of cerebral gliosarcoma: A tertiary care centre experience

    Directory of Open Access Journals (Sweden)

    Narendra Kumar

    2015-01-01

    Full Text Available Aim: To assess clinicopathological features and outcomes in patients of primary gliosarcoma with changing trends of treatment. Materials and Methods: Medical records were reviewed and data collected on primary gliosarcoma over a 5-year period (2009-2013 from the departmental case files. Results: A total 27 patients were included in this study. The median age of presentation was 54 years. There was a slight male preponderance, with male to female ratio of 1.25:1. The most common location of the tumor was temporal lobe (44.4%. Gross total resection was possible in 19 cases, near total excision was done in five cases, and only partial excision with decompression in three cases. Of the 27 patients, 80.8% patients received post-operative radical external beam radiotherapy of 60 Gy/30#/6 weeks. Concurrent and adjuvant temozolomide was used in 42.3% cases, depending on affordability and tolerance. Median overall survival was 9 months. On subgroup analysis, median overall survival in the radiotherapy plus temozolomide group was 10 months as compared to 9 months in the radiotherapy alone group; however, this was not statistically significant.(P = 0.244. Conclusion: Treating Gliosarcoma is a major therapeutic challenge for a clinician because of its poor prognosis, aggressive clinical behavior, rarity, and limited clinical experience. With surgery and concurrent chemoradiation, we were able to achieve a median overall survival of 9 months. Addition of temozolomide has shown a better trend in survival though it is not statistically significant.

  2. Initial experience with the Freedom Solo® stentless aortic valve in a low volume centre.

    Science.gov (United States)

    Kolseth, Solveig Moss; Nordhaug, Dag; Stenseth, Roar; Wahba, Alexander

    2010-10-01

    Freedom Solo is a stentless biological aortic valve which is implanted supra-annularly with a single suture line. An increased risk of postoperative thrombocytopenia in the early postoperative period has been reported in recent studies. In our study we evaluated postoperative haemodynamic performance and thrombocyte-levels. Thirty seven patients who underwent valve implantation of the Sorin Freedom Solo stentless valve were included. The haemodynamic performance of the valve was evaluated by transthoracic echocardiography postoperatively at the fourth day (mean) and after a median of 4.2 months. The mean gradient (mmHg) of Freedom Solo was 7.5 at four days and 8.6 at 4.2 months. Postoperatively no patient had more than grade 1 leakage. Seven percent of the patients had a reduction of thrombocytes to less than 20% of the preoperative level. Seventy six percent had a minimum postoperative thrombocyte level less than 100*10(9)/L. The 30 days mortality in our patient material was zero. Implantation of the Freedom Solo valve was uncomplicated in our experience. Favourable transvalvular gradients and no significant leaks were found. In accordance with the literature, we found a high percentage of patients having a postoperative level of thrombocytes less than 100*10(9)/L after implantation of Freedom Solo.

  3. 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.)

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

    International Nuclear Information System (INIS)

    Cox, Brian; Chhabra, Avneesh; Zuniga, John R.; Panchal, Neeraj; Cheng, Jonathan

    2016-01-01

    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.)

  5. Hazards of pentazocine for neonatal analgesia: a single-centre experience over 10 years.

    Science.gov (United States)

    Osifo, O D; Aghahowa, S E

    2008-09-01

    In developing countries, neonatal analgesia for surgical procedures is a major challenge where postoperative care is inadequate. To report experience of pentazocine for neonatal surgery in a Nigerian tertiary hospital. A retrospective study of surgical neonates who received pentazocine at the University of Benin Teaching Hospital in Benin City between January 1998 and December 2007. During the period, 2590 paediatric operations were performed including 368 (14.2%) neonates, 49 (13.3%) of whom had pentazocine. The other neonates received a variety of analgesics. Of 56 neonates who developed respiratory depression, 40 (71.4%) had pentazocine (pneonates aged between 9 hours and 28 days [mean (SD) 12 (1.2) days] died between 1 and 36 hours following 8-hourly administration of 0.5 mg/kg pentazocine. In older children who had pentazocine, over-sedation was also a problem but there were no deaths. Deaths in neonates were mainly owing to persistent respiratory depression which was compounded by the unavailability of a paediatric ventilator. However, many neonates responded to naloxone. All neonates who died had an autopsy and no lesion was found which could have compromised respiratory function. The use of pentazocine in neonates was associated with high morbidity and mortality. Caution is required when using pentazocine for neonatal analgesia where post-operative respiratory support is insufficient.

  6. Experience and outcome of ventricular-atrial shunt: a multi centre study

    International Nuclear Information System (INIS)

    Akhtar, N.; Khan, A.A.; Yousaf, M.

    2015-01-01

    Ventriculoperitoneal (VP) shunt has been widely utilized in the treatment of hydrocephalus as a safe option but there is recent literature evidence that ventricularatrial (VA) shunt is not as notorious for its complications as proclaimed, to analyse and report our success with this procedure we conducted our study. Methods: A total of 64 patients undergoing VA shunting were included in this case series study conducted at RMC and Allied hospital Rawalpindi. The data was collected over a period of 4 years from, 1st June 2010 to 1st June 2015. Result: Our study included 64 patients who underwent a VA shunt for hydrocephalus. Their age ranged from 25 to 75 years. Most of the patients were females (60%). The following complications were observed with 2 (3.12%) patients having blockage of the shunt at the neck, 3 (4.68%) suffered from glomerulonephritis, 2 (3.1%) had post-operative neck hematoma, 4 (6.25 %) had wound infection, short lower end of the tube was found in 3 (4.68%), migrated lower end (into the subclavian) was seen in 1 (1.56%). Mortality was 1(1.56%). These results were comparable to other studies. Conclusion: Neurosurgeons have been doing a VA shunt as a second procedure, after a VP shunt when the need due to a complication was encountered. We however share our experience regarding ventriculo-atrial shunting, as first choice procedure, because of its low incidence of shunt blockage unlike VP shunt, which has high rate of shunt blockage and therefore warrants repeated surgeries. (author)

  7. Cerebrospinal fluid rhinorrhoea following transsphenoidal surgery for pituitary adenoma: experience in a Chinese centre.

    Science.gov (United States)

    Zhang, C; Ding, X; Lu, Y; Hu, L; Hu, G

    2017-08-01

    The aim of this study was to elucidate the risk factors for cerebrospinal fluid (CSF) rhinorrhoea following transsphenoidal surgery and discuss its prevention and treatments. We retrospectively reviewed 474 consecutive cases of pituitary adenoma treated with 485 transsphenoidal surgical procedures from January 2008 to December 2011 in our department. We analysed the incidence of intra- and post-operative CSF leakage and outcomes of various repair strategies. Intra-operative CSF leakage was encountered in 85 cases (17.9%), and post-operative CSF rhinorrhoea in 13 cases (2.7%). Seven of the 13 patients with post-operative CSF rhinorrhoea did not experience intra-operative CSF leakage; three of these patients had adrenocorticotropic hormone-secreting adenomas. Of the remaining 6 patients with both intra- and post-operative CSF leakage, 2 were treated for giant invasive prolactinomas, and 2 had previously undergone transsphenoidal surgery. In eight patients, the leak was resolved by lumbar puncture, lumbar external drainage, resting in a semi-reclining position, or other conservative treatment. Two CSF leaks were repaired with gelatine foam and fibrin glue using a transsphenoidal approach, and two with autologous fat graft and sellar floor reconstruction using a transnasal endoscopic approach. After undergoing two transnasal endoscopic repairs, one patient with post-operative CSF rhinorrhoea was successfully treated by further lumbar subarachnoid drainage. In conclusion, procedures using gelatine foam, fibrin glue and autologous fat graft are common and effective techniques for the management of CSF rhinorrhoea after transsphenoidal surgery. When a CSF leak is detected during transsphenoidal surgery, thorough sellar reconstruction and long-term follow-up are necessary. © Copyright by Società Italiana di Otorinolaringologia e Chirurgia Cervico-Facciale, Rome, Italy.

  8. Paramedics experiences and expectations concerning advance directives: a prospective, questionnaire-based, bi-centre study.

    Science.gov (United States)

    Taghavi, Mahmoud; Simon, Alfred; Kappus, Stefan; Meyer, Nicole; Lassen, Christoph L; Klier, Tobias; Ruppert, David B; Graf, Bernhard M; Hanekop, Gerd G; Wiese, Christoph H R

    2012-10-01

    Advance directives and palliative crisis cards are means by which palliative care patients can exert their autonomy in end-of-life decisions. To examine paramedics' attitudes towards advance directives and end-of-life care. Questionnaire-based investigation using a self-administered survey instrument. Paramedics of two cities (Hamburg and Goettingen, Germany) were included. Participants were questioned as to (1) their attitudes about advance directives, (2) their clinical experiences in connection with end-of-life situations (e.g. resuscitation), (3) their suggestions in regard to advance directives, 'Do not attempt resuscitation' orders and palliative crisis cards. Questionnaires were returned by 728 paramedics (response rate: 81%). The majority of paramedics (71%) had dealt with advance directives and end-of-life decisions in emergency situations. Most participants (84%) found that cardiopulmonary resuscitation in end-of-life patients is not useful and 75% stated that they would withhold cardiopulmonary resuscitation in the case of legal possibility. Participants also mentioned that more extensive discussion of legal aspects concerning advance directives should be included in paramedic training curricula. They suggested that palliative crisis cards should be integrated into end-of-life care. Decision making in prehospital end-of-life care is a challenge for all paramedics. The present investigation demonstrates that a dialogue bridging emergency medical and palliative care issues is necessary. The paramedics indicated that improved guidelines on end-of-life decisions and the termination of cardiopulmonary resuscitation in palliative care patients may be essential. Participants do not feel adequately trained in end-of-life care and the content of advance directives. Other recent studies have also demonstrated that there is a need for training curricula in end-of-life care for paramedics.

  9. 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.

  10. 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.

  11. Management of pancreatic pseudocyst in the era of laparoscopic surgery--experience from a tertiary centre.

    Science.gov (United States)

    Palanivelu, Chinnusamy; Senthilkumar, Karuppuswamy; Madhankumar, Madathupalayam Velusamy; Rajan, Pidigu Seshiyar; Shetty, Alangar Roshan; Jani, Kalpesh; Rangarajan, Muthukumaran; Maheshkumaar, Gobi Shanmugam

    2007-12-01

    In the era of minimally invasive surgery, laparoscopy has a great role to play in the management of pseudocyst of pancreas. We present our surgical experience over the past 12 years (May 1994 to April 2006) in the management of pancreatic pseudocysts. The total number of cases was 108, with 76 male and 32 female patients. Age ranged from 18 to 70 years. Duration of symptoms ranged from 45 days to 7 months. Fifty-nine patients presented with pain abdomen. Sixty-one patients had co-morbid illness. Ten patients had abdominal mass on clinical examination. Predisposing factors were gallstones in 58 cases, alcohol in 20 cases, trauma in eight cases and post-pancreatectomy in one case. In 21 cases there are no predisposing factors. All the cases were successfully operated without any significant intraoperative complication. Laparoscopic cystogastrostomy was done in 90 cases (83.4%), laparoscopic cystojejunostomy in eight cases (7.4%), open cystogastrostomy in two cases (1.8%), and laparoscopic external drainage in eight cases (7.4%). Laparoscopic cholecystectomy was done in 47 cases along with the drainage procedure. The mean operating time was 95 minutes. Mean blood loss was 69 ml. Mean hospital stay was 5.6 days. Percutaneous tube drain to assist decompression of the cyst was kept in all the laparoscopic cystojejunostomy (LCJ) group. Two patients were re-operated for bleeding and gastric outlet obstruction. We had no mortality in the postoperative period. With mean follow up of 54 months (range 3-145 months); only one patient who underwent laparoscopic cystogastrostomy (LCG) earlier in this series had recurrence due to inadequate stoma size. This patient later underwent OCG CONCLUSION: Laparoscopy has a significant role to play in the surgical management of pseudocysts with excellent outcome. It offers all the benefits of minimally invasive surgery to the patients.

  12. Pacing in congenital heart disease - A four-decade experience in a single tertiary centre.

    Science.gov (United States)

    Midha, Disha; Chen, Zhong; Jones, David G; Williams, Howell J; Lascelles, Karen; Jarman, Julian; Clague, Jonathan; Till, Janice; Dimopoulos, Konstatinos; Babu-Narayan, Sonya V; Markides, Vias; Gatzoulis, Michael A; Wong, Tom

    2017-08-15

    The increased risk of brady- and tachy-arrhythmias in the congenital heart disease (CHD) population means that cardiac rhythm management devices are often required at an early age and expose patients to device-related complications. The present study drew upon four decades of experience at a tertiary adult congenital heart disease ACHD center and aimed to investigate the indication for cardiac implantable electronic devices (CIEDs) and predictors of late device-related complication requiring re-intervention. A retrospective review of pacing records of ACHD patients over forty years was carried out. The primary outcome measure was device related complication requiring re-intervention. Between 1970 and 2009, 238 structural CHD patients who received CIEDs with follow-up data were identified (structural group). As a comparator group, 98 patients with congenital conduction disease or long QT syndrome with a structurally normal heart (electrical group) were included in the study. During a mean follow-up of 9.6±8.5years, 72 (21%) patients (44 structural group, 28 electrical group) required ≥1 re-intervention due to device related complications. Multivariate analysis showed that age at the time of device implant was an independent predictor of late device-related complications (HR 0.77, 95% CI 0.60-0.98, p=0.04). Sub-analysis of the structural group showed that ACHD complexity (Bethesda guideline) was the only predictor late device-related complication in the structural group (HR 2.96, 95% CI: 1.67-5.26, p<0.01). Increasing age at device implant was inversely associated with late device-related complications. ACHD patients with complex anatomy are at increased risk of device-related complications at mid and long-term follow-up. Copyright © 2017 Elsevier B.V. All rights reserved.

  13. Le CRDI pleure la perte de Louis Berlinguet | CRDI - Centre de ...

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

    1 févr. 2018 ... En tant que vice-président du Conseil des gouverneurs et président du Comité de direction du Conseil de 1970 à 1976, puis à titre de vice-président principal du CRDI jusqu'en 1979, M. Berlinguet a contribué à gérer les activités du Centre et a assumé de nombreuses fonctions au sein du bureau du ...

  14. Annexe A Modalités et conditions générales du contrat

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

    acray

    exclusifs et connexes aux produits et services actuels, futurs et proposés du Centre. .... Centre et sans aucune référence audit renseignement. ... du Canada, d'assurance ou de toute autre retenue semblable requise par la loi au profit des.

  15. Thyroid carcinoma: The experience at the Oncology Centre in Nicosia, Cyprus

    International Nuclear Information System (INIS)

    Frangos, S.; Petrou, M.; Katodritis, N.

    2004-01-01

    based on ultrasonography, thyroid scintigraphy and FNA. FNA performed in 12 of the 34 patients showed 4 to be negative, 6 positive for papillary, 1 suspicious for papillary, and 1 was positive for follicular but the histopathology showed papillary. Ultrasound done in 15 patients showed one or more nodules in all. Scintigraphy performed in these 15 patients showed cold nodules in 13, normal findings in 1 and Graves' disease in 1 patient. In most of the patients direct radio ablation was done without performing a pre-therapy scan. The ablation dose ranged from 1850 to 4810 MBq. Iodine-131 whole body scan was performed 6 and 18 months after ablation in 16 patients. 11 patients were negative, 4 had residual thyroid tissue and underwent second therapy and 1 had minimal tissue. In the subsequent follow up scan 1 more patients became negative. Thyroxin substitutions in our patients varied from 125mcg to 200mcg without any correlation to body weight. The protocol of ablation was based on the SNM and EANM guidelines for therapy with iodine-131. We chose to give direct therapy without pre-therapy scan to avoid stunning effect. Our experience of iodine-131 treatment in this small number of patients of thyroid cancer showed very promising results. (author)

  16. Integrated energy efficient data centre management for green cloud computing : the FP7 GENiC project experience

    NARCIS (Netherlands)

    Torrens, J.I.; Mehta, D.; Zavrel, V.; Grimes, D.; Scherer, Th.; Birke, R.; Chen, L.; Rea, S.; Lopez, L.; Pages, E.; Pesch, D.

    2016-01-01

    Energy consumed by computation and cooling represents the greatest percentage of the average energy consumed in a data centre. As these two aspects are not always coordinated, energy consumption is not optimised. Data centres lack an integrated system that jointly optimises and controls all the

  17. 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…

  18. Endovascular Management of Acute Embolic Occlusion of the Superior Mesenteric Artery: A 12-Year Single-Centre Experience

    International Nuclear Information System (INIS)

    Raupach, J.; Lojik, M.; Chovanec, V.; Renc, O.; Strýček, M.; Dvořák, P.; Hoffmann, P.; Guňka, I.; Ferko, A.; Ryška, P.; Omran, N.; Krajina, A.; Čabelková, P.; Čermáková, E.; Malý, R.

    2016-01-01

    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 %

  19. 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.

  20. Offloading social care responsibilities: recent experiences of local voluntary organisations in a remote urban centre in British Columbia, Canada.

    Science.gov (United States)

    Hanlon, Neil; Rosenberg, Mark; Clasby, Rachael

    2007-07-01

    Services offered by voluntary organisations are an integral but often overlooked component of health and social care. Of late, there has been a renewed interest in voluntary welfare provision as a viable alternative to state and market. Recent developments in welfare provision in Canada appear to have brought greater social care roles for the voluntary sector at the same time as new and arguably more restrictive funding and accountability mechanisms are being imposed by different arms of the state. To explore these issues more closely, the present paper examines the impressions and experiences of voluntary and formal sector providers of services for senior citizens and people with disabilities in a remote urban centre (population less than 100 000) in the interior of British Columbia, Canada. Two important operational pressures provide the context of the analysis: (1) reform of provincial government funding and regulation of voluntary services; and (2) the restructuring of welfare provision, especially in the areas of health care and social services. The authors found evidence of an escalating incursion of the state into local voluntary sector affairs that needs to be understood in the context of long-standing institutional links between government and 'professional' voluntary welfare provision in British Columbia. The results point to three important directions in contemporary local voluntary provision: (1) an emerging ethos of accountability, efficiency and competition in voluntary provision; (2) increasing pressure to centralise volunteer services; and consequently, (3) the potential erosion of flexibility and personalisation that are seen to characterise the voluntary sector.

  1. 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 %.

  2. 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.

  3. 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)

  4. 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.

  5. Our experience with pre-operative haemostatic assessment of paediatric patients undergoing adenotonsillectomy at Federal Medical Centre, Makurdi

    Directory of Open Access Journals (Sweden)

    Amali Adekwu

    2016-01-01

    Full Text Available Background: In 2-4% of all patients requiring adenoidectomy, tonsillectomy or adenotonsillectomy, pre-operative screening tests for coagulation disorders are indicated to detect surgical bleeding complications. However, because of cost effect on the patients, the usefulness of these tests is being challenged. We therefore highlight our experience in paediatric patients undergoing adenoidectomy, tonsillectomy or both in our centre. Patients and Methods: This is a 3½-year analysis of the data of 165 paediatric patients who had adenoidectomy, tonsillectomy or both over the study period. The data collected included age, sex, procedure done and detailed clinical bleeding history. Results: A total of 165 children had either adenoidectomy or tonsillectomy, or both. There were 76 males and 89 females giving a male to female ratio of 1:1.2. Their ages ranged from 10 months to 18 years. Eighty-five (51.5% patients had adenotonsillectomy, 48 (29.1% and 32 (19.4% had only tonsillectomies and adenoidectomies, respectively. Only 11 (6.7% families volunteered the history of either prolonged bleeding with minor injury on the skin or occasional slight nose bleeding. Six (3.6% patients including 3 of the children with positive family history had posttonsillectomy bleed, out of which 4 (66.7% were moderate whereas the remaining 2 (33.3% were severe bleeding, which was not statistically significant (P = 0.041. The two cases of severe bleeding had fresh whole blood transfused whereas the rest that had no bleeding issues were discharged home 48 h postoperatively. Conclusion: Our experience in this study suggests that detailed bleeding history is necessary as well as pre-operative haemostatic assessment, if available and affordable for paediatric patients undergoing adenotonsillectomy.

  6. Coordonnateur, Gestion des documents | CRDI - Centre de ...

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

    Classifier, indexer, faire des références croisées et identifier les documents relatifs 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 titre appropriés de chaque dossier et les mots-clés servant à la recherche;.

  7. Développer et personnaliser les compétences info-communicationnelles des enseignants de français langue étrangère – un impératif face à une mutation des publics apprenant au Centre du Vietnam

    Directory of Open Access Journals (Sweden)

    HOANG Thi Thu Hanh

    2016-12-01

    Full Text Available Selon notre témoignage, le nombre d’apprenants de FLE au centre du Vietnam ne baisse pas mais les objectifs et les motivations ont changé et bien varié. Vu les débouchés francophones, il y a moins d’étudiants qui choisissent comme leur première option d’études universitaires les sciences du langage français et la didactique du FLE, mais de plus en plus nombreux sont ceux qui étudient le français comme un moyen de se professionnaliser et ou pour un objectif personnel (étudier ou faire un stage dans un pays francophone, consulter les documents en français, communiquer avec la clientèle francophone, participer à des réseaux sociaux, etc.. Cette situation témoigne d’une évolution des attentes où s’expriment un pouvoir d’action élargie et l’intégration dans un monde global largement numérisé. Se dessine ainsi progressivement une nouvelle voie pour l’apprentissage du FLE,résultat d’une convergence entre notre héritage culturel complexe et un milieu technique devenu un lieu de sociabilité sans précédent. Ces dernières années, plusieurs courants de pensée se sont intéressés à l’essor des TICE et à l’explosion des pratiques info-communicationnelles. Deux concepts dominent : l’information litéracy anglo-saxonne et nord-américaine et la culture de l’information francophone et européenne. La première, plus utilitariste, est centrée sur l’opérationnel dans une société de la connaissance ; la seconde propose de sortir d’une vision techniciste de la communication et vise le développement non seulement de compétences mais aussi de connaissances pour un monde ouvert. Compétences et connaissances que les enseignants doivent dorénavant maitriser avant de les transmettre.

  8. Résultats de recherche | 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 ... Entre chercheurs et entrepreneurs - pour la recherche et la promotion de l'entrepreneuriat en Afrique francophone.

  9. Design and operational experience of the centre for the collection treatment and storage of low level radioactive wastes

    International Nuclear Information System (INIS)

    Zorrilla, S.

    1986-01-01

    The activities of the Centre for Collection, Treatment and Storage of Low-Level Radioactive Wastes (CRTADRBN) are presented. The objective of this centre is the final storage of radioactive waste and radiation sources generated by medicine, industry teaching and research. Safety, storage capacity and economy are considered in the design. The types of treatment for liquid wastes are described and the containement system is specified. (M.C.K.) [pt

  10. Analyzing the Influence of Customer Experience of Call Centre Towards Brand Loyalty of Telkomsel Users in Manado

    OpenAIRE

    Item, Alwins Januard

    2013-01-01

    A fairly rapid growth in Indonesian telecommunications industry has encourages the competition among existing providers. The need to increase customer satisfaction through CRM for every company is now considered to be more important. Nowadays, call centre not only limited to provide convenience feeling to the customers in keep in touch with the company. The extended function of this service can be use to build loyalty to a brand. Telkomsel as one of the famous provider also provide call centr...

  11. 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...

  12. 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.

  13. Single-Centre Experience with Percutaneous Cryoablation of Breast Cancer in 23 Consecutive Non-surgical Patients

    International Nuclear Information System (INIS)

    Cazzato, Roberto Luigi; Lara, Christine Tunon de; Buy, Xavier; Ferron, Stéphane; Hurtevent, Gabrielle; Fournier, Marion; Debled, Marc; Palussière, Jean

    2015-01-01

    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

  14. 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.

  15. 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.

  16. 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 <20 μg/L. Seven of 13 patients in the SRS group achieved a level of <500 μg/L, whereas no patients reached this target after FSRT. A reduction in prolactin level is frequent after SRS and FSRT for prolactinomas; however, true biochemical remission is uncommon. Tumour volume control in this series was excellent, but this may be related to the natural history of the disease. Morbidity and mortality after stereotactic radiation were very low in this series. © 2014 The Royal Australian and New Zealand College of Radiologists.

  17. 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. © The Author 2017. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.

  18. Working in caseload midwifery care: the experience of midwives working in a birth centre in North Queensland.

    Science.gov (United States)

    Edmondson, Marissa C; Walker, Sandra B

    2014-03-01

    Pregnancy, birth and child rearing are significant life events for women and their families. The demand for services that are family friendly, women focused, safe and accessible is increasing. These demands and rights of women have led to increased government and consumer interest in continuity of care and the establishment in Australia of birth centres, and the introduction of caseload midwifery models of care. The aim of this research project was to uncover how birth centre midwives working within a caseload model care constructed their midwifery role in order to maintain a positive work-life balance. A Grounded Theory study using semi-structured individual interviews was undertaken with seven midwives who work at a regional hospital birth centre to ascertain their views as to how they construct their midwifery role while working in a caseload model of care. The results showed that caseload midwifery care enabled the midwives to practice autonomously within hospital policies and guidelines for birth centre midwifery practice and that they did not feel too restricted in regards to the eligibility of women who could give birth at the centre. Work relationships were found to be a key component in being able to construct their birth centre midwifery role. The midwives valued the flexibility that came with working in supportive partnerships with many feeling this enabled them to achieve a good work-life balance. The research contributes to the current body of knowledge surrounding working in a caseload model of care as it shows how the birth centre midwives construct their midwifery role. It provides information for development and improvement of these models of care to ensure that sustainability and quality of care is provided to women and their families. Copyright © 2013 Australian College of Midwives. Published by Elsevier Ltd. All rights reserved.

  19. How to manage organisational change and create practice teams: experiences of a South African primary care health centre.

    Science.gov (United States)

    Mash, B J; Mayers, P; Conradie, H; Orayn, A; Kuiper, M; Marais, J

    2008-07-01

    In South Africa, first-contact primary care is delivered by nurses in small clinics and larger community health centres (CHC). CHCs also employ doctors, who often work in isolation from the nurses, with poor differentiation of roles and little effective teamwork or communication. Worcester CHC, a typical public sector CHC in rural South Africa, decided to explore how to create more successful practice teams of doctors and nurses. This paper is based on their experience of both unsuccessful and successful attempts to introduce practice teams and reports on their learning regarding organisational change. An emergent action research study design utilised a co-operative inquiry group. The first nine months of inquiry focused on understanding the initial unsuccessful attempt to create practice teams. This paper reports primarily on the subsequent nine months (four cycles of planning, action, observation and reflection) during which practice teams were re-introduced. The central question was how more effective practice teams of doctors and nurses could be created. The group utilised outcome mapping to assist with planning, monitoring and evaluation. Outcome mapping defined a vision, mission, boundary partners, outcome challenges, progress markers and strategies for the desired changes and supported quantitative monitoring of the process. Qualitative data were derived from the co-operative inquiry group (CIG) meetings and interviews with doctors, nurses, practice teams and patients. The CIG engaged effectively with 68% of the planned strategies, and more than 60% of the progress markers were achieved for clinical nurse practitioners, doctors, support staff and managers, but not for patients. Key themes that emerged from the inquiry group's reflection on their experience of the change process dealt with the amount of interaction, type of communication, team resilience, staff satisfaction, leadership style, reflective capacity, experimentation and evolution of new

  20. Lutter contre la pollution de l'air à Mexico | CRDI - Centre de ...

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

    appui du Centre de recherches pour le développement international (CRDI) du Canada ... Le Secrétariat coordonne le projet en collaboration avec le Centre national de la ... Bien que ce type d'initiative conjointe soit nouvelle, ajoute Muñoz, elle ...

  1. Un nouveau centre de recherche soutient les efforts d'adaptation ...

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

    9 juil. 2014 ... Image satellite du delta du Nil. José Alberto Gonçalves Pereira. Entretien avec. Mohamed Abdrabo est le directeur général de l'Alexandria Research Centre for Adaptation to Climate Change (ARCA), un nouveau centre de recherche qui soutient les politiques d'adaptation adoptées par le gouvernement ...

  2. Un nouveau centre de recherche soutient les efforts d'adaptation ...

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

    9 juil. 2014 ... Mohamed Abdrabo est le directeur général de l'Alexandria Research Centre for Adaptation to Climate Change (ARCA), un nouveau centre de recherche qui soutient les politiques d'adaptation adoptées par le gouvernement égyptien au regard du delta du Nil.

  3. Diplomatie de Léopold II face aux puissances coloniales en Afrique. Contribution à l'histoire diplomatique du Congo

    OpenAIRE

    Baenda Fimbo, Zacharie

    2011-01-01

    Cet article essaie d'analyser les stratégies diplomatiques du roi Léopold II face aux grandes puissances de l'époque lors du partage du continent africains. Ces stratégies lui ont permis de gagner la Congo au centre de l'Afrique. Peer reviewed

  4. 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

    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)

  5. 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)

  6. 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

    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)

  7. La ministre Bibeau annonce la nomination du président du CRDI et ...

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

    il y a 5 jours ... ... et chargé de cours associé à l'Université Griffith de South East Queensland, en Australie. Ancien professeur adjoint auxiliaire à la School of International and Public Affairs de l'Université Columbia, à New York; et ancien chercheur du Centre international pour la recherche en agroforesterie, à Nairobi.

  8. "A small cog in a large wheel": an exploratory study into the experiences of porters, ward clerks and domestics working in an English Cancer Centre.

    Science.gov (United States)

    Mack, Hazel; Froggatt, Katherine; McClinton, Pam

    2003-09-01

    The effect of working in an oncology environment on nurses has been widely researched but the experiences of non-clinical staff such as ancillary workers in the oncology environment have rarely been examined. This exploratory study had three aims: to explore ancillary workers' understandings of cancer, their experiences of working in a Cancer Centre and their training and support needs. Working within a naturalistic paradigm, a descriptive exploratory design was utilised employing in-depth interviews and drawing on aspects of grounded theory for data analysis. Findings indicated that these ancillary workers lacked an in-depth understanding of cancer. The experience of working in a Cancer Centre appeared to bring both costs and benefits to these ancillary workers. These ancillary workers enjoyed the level of contact they have with patients in a Cancer Centre and subsequently ascribed great value to their jobs. However, they felt that health-care professional colleagues did not always value their contribution to the care of patients. There are implications for nurses and other health-care staff working in oncology alongside these ancillary staff in terms of valuing and supporting them in the work that they do.

  9. Tracheal stenosis: our experience at a tertiary care centre in India with special regard to cause and management.

    Science.gov (United States)

    Nair, Satish; Mohan, Sharad; Mandal, Ghanashyam; Nilakantan, Ajith

    2014-01-01

    Tracheal stenosis (TS), a challenging problem, is a known complication of prolonged intubation and tracheostomy. The management involves a multidisciplinary approach with multiple complex procedures. In this study we discuss our experience with severe TS with regards to patient characteristics, cause and management. A retrospective analysis of 20 patients of severe TS treated at a tertiary care centre was evaluated. Inclusion criteria were all patients with severe TS who required surgical intervention. Exclusion criteria were patients with associated laryngeal stenosis and TS due to cancer. Demographic data was recorded and findings relating to aetiology, characteristics of stenosis and the various aspects of therapeutic procedures performed are discussed with review of literature. Descriptive analysis of data were performed SPSS 18. Results of the 20 patients, 17 patients (85 %) developed TS post tracheostomy, or post intubation and subsequent tracheostomy. 13 Patients (65 %) had true stenosis of which 7 patients (35 %) had simple web or circumferential fibrosis and 6 patients (30 %) had complex stenosis. Seven patients (35 %) had granulations causing severe TS which were mostly suprastomal (5 patients), stomal (5 patients) and combined stomal and suprastomal (3 patients). The average length of stenosis was 3.57 cm (0.5-8 cm). Montgomery t tube insertion was a common procedure in 18 patients (90 %) pre or post intervention. Each patient underwent an average of 3.4 procedures during their course of treatment which included rigid bronchoscopy and mechanical debulking, Nd YAG laser, KTP laser, balloon dilatation and use of stents. Among the 7 patients with granulations 100 % successful decanulation was noted with endoscopic management whereas in 13 patients with true stenosis, 10 patients (76.9 %) required open surgical management (8 tracheal resection and anastomosis and 2 tracheoplasty) with 80 % successful decanulation, 2 patients (15.4 %) were treated

  10. 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.

  11. The association between experiences with patient-centred care and health-related quality of life in women with endometriosis

    NARCIS (Netherlands)

    Apers, Silke; Dancet, Eline A. F.; Aarts, Johanna W. M.; Kluivers, Kirsten B.; D'Hooghe, Thomas M.; Nelen, Willianne L. D. M.

    2018-01-01

    In this cross-sectional study, we investigated whether patient-centred endometriosis care (PCEC) is associated with health-related quality of life (HRQOL). Dutch-speaking women with endometriosis, treated by laparoscopy in a university clinic between 2009 and 2010, were eligible (n = 194).

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

    NARCIS (Netherlands)

    Zijlstra, J.E.; Lo Fo Wong, S.H.; Teerling, A.; Hutschemaekers, G.J.M.; Lagro-Janssen, A.

    2018-01-01

    Background: 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

  13. 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.

  14. 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

  15. 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

  16. 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

  17. Manche centre

    International Nuclear Information System (INIS)

    1997-05-01

    After a general presentation of radioactivity and radioactive wastes and of the French national agency for the management of radioactive wastes (ANDRA), this brochure gives a general overview of the Manche low- and medium-level radioactive waste disposal centre: principles of storage safety, waste containers (first confinement barrier), storage facility and cover (second confinement barrier), the underground (third confinement barrier), the impact of the centre on its environment, and the control of radioactivity in the vicinity of the centre. (J.S.)

  18. Study of dimuon spectrometer tracking chambers of the ALICE experiment at LHC; Etude des chambres de trajectoire du spectrometre dimuons de l'experience ALICE aupres du LHC

    Energy Technology Data Exchange (ETDEWEB)

    Kharmandarian, Liliane [Institut de Physique Nucleaire, CNRS - IN2P3, Universite Paris - Sud, 91406 Orsay Cedex (France)

    1999-12-16

    The ALICE (A Large Ion Collider Experiment) experiment will study ultrarelativistic heavy ion collisions at the Large Hadron Collider (LHC) in CERN as of 2005. An extensive R and D programme has been carried out on the dimuon spectrometer tracking chambers at the Nuclear Physics Institute in Orsay. Three multiwire proportional chamber prototypes with segmented cathodes, including a full-scale 1 m{sup 2} version, were constructed. In this thesis, the experimental tests are presented along with the simulations used to understand and optimize the detectors' performances. The prototypes were tested several times at the PS and SPS accelerators. The aims were to validate the choices made in terms of mechanical construction, geometrical parameters, gas mixture and read-out electronics. Analysis of the large amount of data collected has shown that the performances of this type of detector fulfill the required specifications. The results concerning the detectors' characteristics, spatial resolution efficiency, gain and homogeneity are given. Spatial resolutions of less than thirty microns were obtained. In parallel with the in-beam tests, several simulations have been developed in order to gain a better understanding of the detectors' response. They allowed, in particular, to define the segmentation of the cathode plane, to study the position reconstruction algorithm and to establish the future electronics specifications. (author)

  19. etat du magnesium dans quelques sols sales du sud et du centre

    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.

  20. Trigger system study of the dimuon spectrometer in the ALICE experiment at CERN-LHC; Etude du systeme de declenchement du spectrometre dimuons de l'experience alice au Cern-LHC

    Energy Technology Data Exchange (ETDEWEB)

    Roig, O

    1999-12-01

    This work is a contribution to the study of nucleus-nucleus collisions at the LHC with ALICE. The aim of this experiment is to search for a new phase of matter, the quark-gluon plasma (QGP). The dimuon forward spectrometer should measure one of the most promising probes of the QGP, the production of heavy quark vector mesons (J/{psi}, {gamma}, {gamma}', {gamma}'') through their muonic decays. The dimuon trigger selects the interesting events performing a cut on the transverse momentum of the tracks. The trigger decision is taken by a dedicated electronics using RPC (''Resistive Plate Chambers'') detector information. We have made our own R and D program on the RPC detector with various beam tests. We show the performances obtained during these tests of a low resistivity RPC operating in streamer mode. The ALICE requirements concerning the rate capability, the cluster size and the time resolution are fulfilled. We have optimised the trigger with simulations which include a complete description of the read-out planes and the trigger logic (algorithm). In particular, a technique of clustering is proposed and validated. A method called ''Ds reduction'' is introduced in order to limit the effects of combinatorial background on the trigger rates. The efficiencies and the trigger rates are calculated for Pb-Pb, Ca-Ca, p-p collisions at the LHC. Other more sophisticated cuts, on the invariant mass for example, using again the RPC information have been simulated but have not shown significant improvements of the trigger rates. (author)

  1. Literature survey 'Impact of the Cadarache Centre activity on the environment'. Survey performed by the CRIIRAD laboratory for the Cadarache's CLI; Etude documentaire -impact sur l'environnement de l'activite du centre de Cadarache-. Etude effectuee par le laboratoire de la CRIIRAD. Pour la CLI de Cadarache

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2008-07-01

    After a presentation of the Cadarache Centre installations and activities, this document reports a literature survey based on the documents provided by the Centre and related to dismissals and incidents since the beginning of the Centre activity, and to environment control during some critical periods. Several issues are discussed: the radioactive atmospheric effluents and their impact, the control of underground waters, the control of surface water environment (impact of liquid radioactive effluents and monitoring of run-off waters), soil and food chain monitoring. For each of these themes, control and monitoring data are analysed

  2. L'avenir du Moyen-Orient et de l'Afrique du Nord passe par la ...

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

    10 janv. 2013 ... Centre de recherches pour le développement international Gouvernement du Canada ... du Nord passe par la croissance partagée et l'économie de marché ... vivant en région éloignée aient un accès égal aux possibilités économiques. ... visant à trouver de nouveaux modes d'action pouvant contribuer au ...

  3. Mesure de la production de di-bosons WZ auprès du LHC avec l'experience ATLAS

    CERN Document Server

    Keoshkerian, Houry

    This thesis is performed in the frame of the ATLAS experiment at the LHC. A first part of the work presented in this document consists on the time calibration of the ATLAS Liquid Argon (LAr) calorimeter. The control of the time alignment of the calorimeter is important for the goodness of the quality of the energy reconstructed in the calorimeter. The results presented in this thesis have allowed an improvement of 30% of the global time resolution of the LAr calorimeter. The Standard model of particle physics predicts, during proton collisions, the production of the $W$ and $Z$ weak bosons as a pair due to the interaction of a quark with an anti-quark. The diboson production can be sensitive to the couplings between vector bosons. An anomalous deviation of these couplings from the prediction of the SM would point to the presence of new physics. The use of the full statistics of the 2012 ATLAS data allowed us to increase the precision of the measurement of these couplings compared to previous results based on...

  4. The importance of brain banks for molecular neuropathological research: The New South Wales Tissue Resource Centre experience.

    Science.gov (United States)

    Dedova, Irina; Harding, Antony; Sheedy, Donna; Garrick, Therese; Sundqvist, Nina; Hunt, Clare; Gillies, Juliette; Harper, Clive G

    2009-01-01

    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.

  5. Incremental cost-effectiveness of trauma service improvements for road trauma casualties: experience of an Australian major trauma centre.

    Science.gov (United States)

    Dinh, Michael M; Bein, Kendall J; Hendrie, Delia; Gabbe, Belinda; Byrne, Christopher M; Ivers, Rebecca

    2016-09-01

    Objective The aim of the present study was to estimate the cost-effectiveness of trauma service funding enhancements at an inner city major trauma centre. Methods The present study was a cost-effectiveness analysis using retrospective trauma registry data of all major trauma patients (injury severity score >15) presenting after road trauma between 2001 and 2012. The primary outcome was cost per life year gained associated with the intervention period (2007-12) compared with the pre-intervention period (2001-06). Incremental costs were represented by all trauma-related funding enhancements undertaken between 2007 and 2010. Risk adjustment for years of life lost was conducted using zero-inflated negative binomial regression modelling. All costs were expressed in 2012 Australian dollar values. Results In all, 876 patients were identified during the study period. The incremental cost of trauma enhancements between 2007 and 2012 totalled $7.91million, of which $2.86million (36%) was attributable to road trauma patients. After adjustment for important covariates, the odds of in-hospital mortality reduced by around half (adjusted odds ratio (OR) 0.48; 95% confidence interval (CI) 0.27, 0.82; P=0.01). The incremental cost-effectiveness ratio was A$7600 per life year gained (95% CI A$5524, $19333). Conclusion Trauma service funding enhancements that enabled a quality improvement program at a single major trauma centre were found to be cost-effective based on current international and Australian standards. What is known about this topic? Trauma quality improvement programs have been implemented across most designated trauma hospitals in an effort to improve hospital care processes and outcomes for injured patients. These involve a combination of education and training, the use of audit and key performance indicators. What does this paper add? A trauma quality improvement program initiated at an Australian Major Trauma Centre was found to be cost-effective over 12 years with

  6. Le surpoids, l’obésité et le contrôle glycémique chez les diabétiques du centre de référence provincial de diabète (CRD), Kénitra, Maroc

    Science.gov (United States)

    Lotfi, Zeghari; Aboussaleh, Youssef; Sbaibi, Rachid; Achouri, Imane; Benguedour, Rachid

    2017-01-01

    Introduction Le diabète est définit comme un trouble de l'assimilation, de l'utilisation et du stockage des sucres apportés par l'alimentation, sa prise en charge est assurée par le suivi du surpoids et l'obésité et le contrôle glycémique régulier. L'objectif de ce travail était l'étude du surpoids, l'obésité et le contrôle glycémique chez 2227 diabétiques de différent type (type 1, 2 et gestationnel), consultants le centre de référence provincial de diabète (CRD), Kénitra-Maroc. Méthodes L'étude s'est déroulée sur une période d'une année du mois janvier au mois décembre 2015, L'évaluation du surpoids et l'obésité a été effectuée par le calcul de l'Indice de Masse Corporelle (IMC=Poids/Taille2 (Kg/m2)), elles sont définit respectivement par IMC > 25 Kg/m2, et IMC > 30 Kg/m2, le poids et la taille ont été mesurés selon les recommandations de l'organisation mondiale de santé (OMS), Le contrôle glycémique a été effectué par l'analyse sanguine de l'Hémoglobine glycosylée et de la Glycémie à jeun. Les normes sont 7% pour l'Hémoglobine glycosylée et 0,70g/l à 1,10g/l pour la Glycémie à jeun. Résultats L'intervalle d'âges des patients est compris entre 8 mois et 80 ans, avec une dominance des diabétiques provenant du milieu urbain (74%) par rapport à ceux provenant du milieu rural (26%). Le surpoids touche l'ensemble de cette population. L'IMC moyen des femmes tends vers l'obésité (IMC≈30): (29,21 Kg/m2 ± 3,1) pour le diabète gestationnel et (29,15 Kg/m2 ± 3,2) pour le diabète de type 2. Les valeurs du contrôle glycémique sont supérieures aux normes: avec 8,5% ± 2,6 > 7% pour l'hémoglobine glycosylée et 1,5 g/l ± 1,3 > 1,10g/l pour la Glycémie à jeun. La différence entre les valeurs de l'hémoglobine glycosylée entre les hommes (8,5 7% ± 2,6) et les femmes (8,1% ± 2,3) n'est pas significative (P > 0,05), même chose pour la Glycémie capillaire à jeun: pour les hommes (1,44 g/l ± 1,1) et les

  7. 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.

  8. MR imaging of bladder endometriosis and its relationship with the anterior uterine wall: Experience in a tertiary referral centre

    International Nuclear Information System (INIS)

    Busard, M.P.H.; Mijatovic, V.; Lüchinger, A.B.; Bleeker, M.C.G.; Pieters-van den Bos, I.C.; Schats, R.; Kuijk, C. van; Hompes, P.G.A.; Waesberghe, J.H.T.M. van

    2012-01-01

    Objective: Both the intraperitoneal seeding and the uterine-vesical extension theory have been proposed to explain the pathogenesis of bladder endometriosis. The aim of this study was to describe MR imaging findings of bladder endometriosis and involvement of the anterior uterine wall in a tertiary referral centre for endometriosis in a effort to improve diagnosis and help clarify the pathogenesis. Methods: In a single-centre, retrospective study (2004–2009), 463 consecutive patients analysed for deep infiltrating endometriosis (DIE) were studied independently by two experienced readers for the presence of bladder endometriosis. MR studies revealing bladder endometriosis were then analysed in consensus for: location, size, signal intensity characteristics, uterine involvement, continuity with adenomyosis and presence of cysts. There was histopathologic correlation in 9 patients who had undergone partial bladder resection. Results: Bladder endometriosis was diagnosed in 32 patients on MR imaging (k = 0.85). Most lesions showed heterogeneous isointensity compared to that of muscle on T2-weighed imaging, containing foci of high signal intensity, suggesting cystic ectopic endometrial glands. On T1-weighted imaging lesions showed heterogeneous isointensity with foci or small cysts, demonstrating high signal intensity, indicating hemorrhage, was observed. Uterine involvement was found in 94% of the lesions, with either “continuous” or “hourglass” configurations. Presence of contiguous adenomyosis was found in only 4 lesions. Conclusions: With MR imaging, uterine involvement in bladder endometriosis is frequently found and in most cases located subserosally, suggesting extensive DIE, favouring the intraperitoneal seeding theory

  9. 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.

  10. MR imaging of bladder endometriosis and its relationship with the anterior uterine wall: Experience in a tertiary referral centre

    Energy Technology Data Exchange (ETDEWEB)

    Busard, M.P.H., E-mail: m.busard@vumc.nl [VU University Medical Centre, Department of Radiology, De Boelelaan 1118, 1081 HZ Amsterdam (Netherlands); Mijatovic, V., E-mail: Mijatovic@vumc.nl [VU University Medical Centre, Department of Reproductive Medicine, De Boelelaan 1118, 1081 HZ Amsterdam (Netherlands); Lüchinger, A.B., E-mail: ab.luchinger@vumc.nl [VU University Medical Centre, Department of Reproductive Medicine, De Boelelaan 1118, 1081 HZ Amsterdam (Netherlands); Bleeker, M.C.G., E-mail: MCG.Bleeker@vumc.nl [VU University Medical Centre, Department of Pathology, De Boelelaan 1118, 1081 HZ Amsterdam (Netherlands); Pieters-van den Bos, I.C., E-mail: i.pieters@vumc.nl [VU University Medical Centre, Department of Radiology, De Boelelaan 1118, 1081 HZ Amsterdam (Netherlands); Schats, R., E-mail: r.schats@vumc.nl [VU University Medical Centre, Department of Reproductive Medicine, De Boelelaan 1118, 1081 HZ Amsterdam (Netherlands); Kuijk, C. van, E-mail: C.vanKuijk@vumc.nl [VU University Medical Centre, Department of Radiology, De Boelelaan 1118, 1081 HZ Amsterdam (Netherlands); Hompes, P.G.A., E-mail: p.hompes@vumc.nl [VU University Medical Centre, Department of Reproductive Medicine, De Boelelaan 1118, 1081 HZ Amsterdam (Netherlands); Waesberghe, J.H.T.M. van, E-mail: JHTM.vanwaesberghe@vumc.nl [VU University Medical Centre, Department of Radiology, De Boelelaan 1118, 1081 HZ Amsterdam (Netherlands)

    2012-09-15

    Objective: Both the intraperitoneal seeding and the uterine-vesical extension theory have been proposed to explain the pathogenesis of bladder endometriosis. The aim of this study was to describe MR imaging findings of bladder endometriosis and involvement of the anterior uterine wall in a tertiary referral centre for endometriosis in a effort to improve diagnosis and help clarify the pathogenesis. Methods: In a single-centre, retrospective study (2004–2009), 463 consecutive patients analysed for deep infiltrating endometriosis (DIE) were studied independently by two experienced readers for the presence of bladder endometriosis. MR studies revealing bladder endometriosis were then analysed in consensus for: location, size, signal intensity characteristics, uterine involvement, continuity with adenomyosis and presence of cysts. There was histopathologic correlation in 9 patients who had undergone partial bladder resection. Results: Bladder endometriosis was diagnosed in 32 patients on MR imaging (k = 0.85). Most lesions showed heterogeneous isointensity compared to that of muscle on T2-weighed imaging, containing foci of high signal intensity, suggesting cystic ectopic endometrial glands. On T1-weighted imaging lesions showed heterogeneous isointensity with foci or small cysts, demonstrating high signal intensity, indicating hemorrhage, was observed. Uterine involvement was found in 94% of the lesions, with either “continuous” or “hourglass” configurations. Presence of contiguous adenomyosis was found in only 4 lesions. Conclusions: With MR imaging, uterine involvement in bladder endometriosis is frequently found and in most cases located subserosally, suggesting extensive DIE, favouring the intraperitoneal seeding theory.

  11. Ampleur et impact des évènements indésirables graves liés aux soins: étude d'incidence dans un hôpital du Centre-Est tunisien

    Science.gov (United States)

    Bouafia, Nabiha; Bougmiza, Iheb; Bahri, Fathi; Letaief, Mondher; Astagneau, Pascal; Njah, Mansour

    2013-01-01

    Introduction La prévention des événements indésirables représente une priorité de santé du fait de leur fréquence et de leur gravité potentielle. Ce travail a été mené afin d'avoir un diagnostic de la situation épidémiologique relative aux événements indésirables survenant dans notre hôpital. Méthodes Une étude prospective a été menée auprès de tous les patients qui ont été hospitalisés au CHU Farhat Hached - Sousse (Tunisie) sur une période d'un mois dans quatorze services de l'hôpital. La détection d'évènement indésirable grave (EIG) était basée sur les critères adoptés dans différentes études. Les tests T et Chi 2 ont été utilisés pour identifier les facteurs contribuant à l'apparition d'évènements indésirables. Résultats Au total, 162 EIG ont été identifiés pendant la période. 45% de ces évènements étaient des infections nosocomiales. Ces EIG ont eu comme conséquences un décès chez 9,2% des patients, la mise en jeu du pronostic vital de 26% des patients et la prolongation de la durée de séjour chez 61,7% d'entre eux. L'admission dans des circonstances particulières et l'exposition à des soins invasifs étaient identifiés comme des facteurs de risque potentiels EIG. Conclusion Le renforcement de la stratégie de gestion des risques sanitaires en ciblant préférentiellement le risque infectieux constitue une étape fondamentale dans l'amélioration de la sécurité des patients au sein de notre établissement de santé. PMID:24711868

  12. Fiche technique du spermogramme et du spermocytogramme ...

    African Journals Online (AJOL)

    En Afrique la stérilité du couple constitue un drame social. Selon l'OMS, environ 8 à 12 % des couples africains sont touchés par une infertilité. La responsabilité masculine dans la stérilité est comprise entre 30 à 40%. Les causes de l'infertilité masculine peuvent être l'impuissance et/ ou l'altération du sperme. L'étude de ...

  13. Les télécentres, centres de communications polyvalents | CRDI ...

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

    12 juil. 2011 ... ... la raison de leur absence et beaucoup répondent qu'ils ont eu une ... fournisseur de service Internet du télécentre, qui se trouve à Maputo ... Le télécentre s'est révélé être un fournisseur de services utile et recherché par les ...

  14. Formes du regroupement pluriprofessionnel en soins de premiers recours. Une typologie des maisons, pôles et centres de santé participant aux Expérimentations des nouveaux modes de rémunération (ENMR)

    OpenAIRE

    Anissa Afrite; Julien Mousques

    2014-01-01

    Dans le cadre d’un programme de recherche global sur le lien entre le regroupement pluriprofessionnel en soins de premiers recours dans les sites participant aux Expérimentations des nouveaux modes de rémunération (ENMR) et la performance des médecins généralistes en matière d’activité, de productivité, d’efficacité et d’efficience de leurs pratiques, cette recherche a pour objectif d’analyser la structure, l’organisation et le fonctionnement des maisons, pôles et centres de santé participant...

  15. Glycaemic control of diabetic patients in an urban primary health care setting in Sarawak: the Tanah Puteh Health Centre experience.

    Science.gov (United States)

    Wong, J S; Rahimah, N

    2004-08-01

    Achieving glycaemic goals in diabetics has always been a problem, especially in a developing country with inadequate facilities such as in Sarawak in Malaysia. There are no reported studies on the control of diabetes mellitus in a diabetic clinic in the primary health care setting in Sarawak. This paper describes the profile of 1031 patients treated in Klinik Kesihatan Tanah Puteh Health Centre. The mean age was 59 years, the mean BMI 27 kg/m2. There was a female preponderance and mainly type-2 diabetes. Mean HbA1c was 7.4%. Glycaemic control was optimal in 28% (HbA1c 7.5%). Reasonable glycaemic control can be achieved in the primary health care setting in Sarawak.

  16. Vacuum assisted wound closure in patients with lower extremity arterial disease. The experience from two tertiary referral-centres.

    Science.gov (United States)

    Nordmyr, J; Svensson, S; Björck, M; Acosta, S

    2009-02-01

    The purpose of this investigation was to analyze predictors for wound healing, amputation and mortality after vacuum assisted closure (VAC) therapy of wounds in the lower limb in patients with arterial disease. One hundred and twenty one wounds were treated and followed for 12 months at two vascular centres in Uppsala and Malmö, Sweden. VAC therapy was applied in the wound at a topical negative pressure of 125 mmHg. Median age of the patients was 74 years and critical lower limb ischemia was present in 87% of the patients at admission. Intestinal flora was cultivated in 74% of the wounds. VAC associated bleeding occurred in four patients. Complete wound healing was achieved in 66%. Deep groin infections were associated with synthetic graft infection (Plower amputation rate (PVAC therapy of complex wounds in the lower limbs in patients with vascular disease was associated with high healing rates. Non-healed wounds after VAC therapy were predictors for amputation and death.

  17. Self-expandable metal stent placement for the palliation of malignant gastroduodenal obstruction: experience in a large, single, UK centre

    Energy Technology Data Exchange (ETDEWEB)

    Lowe, A.S. [Department of Clinical Radiology, Bradford Royal Infirmary (United Kingdom)]. E-mail: andy.lowe@bradfordhospitals.nhs.uk; Beckett, C.G. [Department of Gastroenterology, Bradford Royal Infirmary (United Kingdom); Jowett, S. [Department of Gastroenterology, Bradford Royal Infirmary (United Kingdom); May, J. [Department of Surgery, Bradford Royal Infirmary (United Kingdom); Stephenson, S. [Department of Clinical Radiology, Bradford Royal Infirmary (United Kingdom); Scally, A. [School of Health Studies, Bradford (United Kingdom); Tam, E. [Department of Clinical Radiology, Bradford Royal Infirmary (United Kingdom); Kay, C.L. [Department of Clinical Radiology, Bradford Royal Infirmary (United Kingdom)

    2007-08-15

    Aim: To assess the technical success rate, and evaluate the clinical outcome, length of hospital stay, and cost of palliative gastro-duodenal stenting in a single-centre. Materials and methods: Eight-seven patients referred for insertion of a gastroduodenal stent between April 1999 and April 2004 were recruited to a non-randomized, before and after intervention study performed in a single centre. Demographic data, diagnosis and symptoms along with clinical and technical outcomes were recorded. Results: The technical success rate was 84/87 (96.6%), with inability to traverse the stricture in three patients. No immediate complications were demonstrated. There was marked improvement after stent placement with resolution of symptoms and commencement of dietary intake in 76 patients (87%). Stenting resulted in improved quality of life as reflected by an increase in Karnofsky score from 44/100, to 63/100 post-procedure. Late complications included perforation (n = 1), migration (n = 1) and stent occlusions due to tumour ingrowth/overgrowth (n = 7; mean 165 days). Mean survival was 107 days (range 0-411 days). Median hospital stay post-stent placement was 5.5 days (range 1-55 days) with a majority of patients (75%) discharged home. The mean cost of each treatment episode was Pounds 4146 ($7132 $US, Euro 6,028 EUROS). Conclusion: The present series confirms that combined endoscopic and radiological gastroduodenal stenting is a highly favourable treatment for patients with inoperable malignant gastric outlet obstruction. The results suggest that this minimally invasive procedure has a very high technical success rate, whilst at the same time providing excellent palliation of symptoms with improved quality of life in the majority of patients.

  18. Les Cahiers du CREAD

    African Journals Online (AJOL)

    Admin

    politique de bas prix exercée par la Russie et le Qatar vient confirmer ce constat ; s'ajoute à cela l'entrée éventuelle du gaz non conven- tionnel, dont son prix actuel de 3/4 $US, offre aux USA l'opportunité d'être exportateur de ..... les compagnies à produire en matière du gaz naturel, tels le prix du gaz naturel, le prix des ...

  19. Bulletin du CRDI #124

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

    Les femmes jouent un rôle important dans les exploitations minières artisanales et à petite échelle en Afrique subsaharienne. De concert ... Couverture du livre: Une vie saine pour les femmes et les enfants vulnérables · Couverture du livre: Entre el activismo y la intervención · Couverture du livre: Revitalizing Health for All.

  20. Bulletin du CRDI #125

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

    L'IOSRS remporte le prix de la diplomatie scientifique · GrowInclusive : la plateforme tant attendue est en construction · Toutes les nouvelles. Activités à venir. Semaine du développement international 2018. Le CRDI célébrera la Semaine du développement international du 4 au 10 février 2018. Suivez-nous sur Twitter et ...

  1. Perceptions of a simulated general dental practice facility - reported experiences from past students at the Maurice Wohl General Dental Practice Centre 2001-2008.

    Science.gov (United States)

    Davies, B R; Leung, A N; Dunne, S M

    2009-10-24

    This article assesses the perceived value of a simulated general dental practice centre as reported by past undergraduates over five years. Various aspects of teaching and related outcomes are explored based on responses received from anonymous questionnaires. A team based approach to cooperative learning led by current practitioners experienced in primary dental care was seen as pivotal to the huge success of the teaching model. Moreover the role of cooperative learning and its influence on building individual clinical confidence and acumen was considered highly beneficial as part of the transition from novice to expert. An anonymous questionnaire was distributed to students six months after qualification for a period of five years. The last registered postal address held by the Institute was used for this purpose. The years surveyed were: 2001-2002, 2002-2003, 2003-2004, 2005-2006 and 2007-2008. The questionnaire provided for both qualitative aspects of feedback and a quantitative representation of the overall perception of effectiveness of the General Dental Practice Centre, as expressed by a visual analogue scale. In total 135 questionnaires were returned representing a return rate of 53%. From the responses received 99% of the students reported that they enjoyed their sessions at the Centre with 96% expressing satisfaction with the teaching regime. The mean visual analogue scale rating the centre overall was reported as 83%, with a year on year increase ranging from 76-92%. Rich qualitative data were derived from free text responses. A simulated general dental practice centre was highly rated by past dental students in terms of the overall learning experience received and its relevance to later vocational training. By far the most consistently reported attribute was the opportunity to practise close support four handed dentistry with a nurse. Training in practice management and organisational skills were viewed as important with effective teamwork and a

  2. Contributions of the CEA-Valduc Centre control to the understanding of the transfers of atmospheric tritiated water into the different parts of the environment; Apports de la surveillance du Centre CEA-Valduc sur la connaissance des transferts de l'eau tritiee atmospherique dans les differents compartiments de l'environnement

    Energy Technology Data Exchange (ETDEWEB)

    Guetat, P.; Vichot, L. [CEA Valduc, UMR, 21 - Is-sur-Tille (France); Tognelli, A. [CEA Bruyeres-le-Chatel, 91 (France)

    2009-07-01

    After a description of the geological environment of the Valduc Centre dedicated to tritium purification and tritiated waste processing and storage, this document presents the assessment of quantities of tritiated water released by the Valduc Centre and of their evolution in the hydro-geological environment. It provides in situ macroscopically observed data on the transfer mechanisms of water into the different parts of the environment and into the food chain by means. This is made possible by the exceptional traceability of tritiated water. Finally, a comparison between computational models and experimental measurements is given

  3. 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

  4. The impact of transcatheter aortic valve implantation on left ventricular performance and wall thickness – single-centre experience

    Science.gov (United States)

    Szymański, Piotr; Dąbrowski, Maciej; Zakrzewski, Dariusz; Michałek, Piotr; Orłowska-Baranowska, Ewa; El-Hassan, Kamal; Chmielak, Zbigniew; Witkowski, Adam; Hryniewiecki, Tomasz

    2015-01-01

    Introduction Transcatheter aortic valve implantation (TAVI) is a treatment alternative for the elderly population with severe symptomatic aortic stenosis (AS) at high risk for surgical aortic valve replacement (SAVR). Aim To assess the impact of TAVI on echocardiographic parameters of left ventricular (LV) performance and wall thickness in patients subjected to the procedure in a single-centre between 2009 and 2013. Material and methods The initial group consisted of 170 consecutive patients with severe AS unsuitable for SAVR. Logistic European System for Cardiac Operative Risk Evaluation (EuroSCORE) was 21.73 ±12.42% and mean age was 79.9 ±7.5 years. Results The TAVI was performed in 167 (98.2%) patients. Mean aortic gradient decreased significantly more rapidly after the procedure (from 58.6 ±16.7 mm Hg to 11.9 ±4.9 mm Hg, p < 0.001). The LV ejection fraction (LVEF) significantly increased in both short-term and long-term follow-up (57 ±14% vs. 59 ±13%, p < 0.001 and 56 ±14% vs. 60 ±12%, p < 0.001, respectively). Significant regression of interventricular septum diameter at end-diastole (IVSDD) and end-diastolic posterior wall thickness (EDPWth) was noted in early (15.0 ±2.4 mm vs. 14.5 ±2.3 mm, p < 0.001 and 12.7 ±2.1 mm vs. 12.4 ±1.9 mm, p < 0.028, respectively) and late post-TAVI period (15.1 ±2.5 mm to 14.3 ±2.5 mm, p < 0.001 and 12.8 ±2.0 mm to 12.4 ±1.9 mm, p < 0.007, respectively). Significant paravalvular leak (PL) was noted in 21 (13.1%) patients immediately after TAVI and in 13 (9.6%) patients in follow-up (p < 0.001). Moderate or severe mitral regurgitation (msMR) was seen in 24 (14.9%) patients from the initial group and in 19 (11.8%) patients after TAVI (p < 0.001). Conclusions The TAVI had an immediate beneficial effect on LVEF, LV walls thickness, and the incidence of msMR. The results of the procedure are comparable with those described in other centres. PMID:25848369

  5. Cirque du Monde as a health intervention

    Science.gov (United States)

    Fournier, Cynthia; Drouin, Mélodie-Anne; Marcoux, Jérémie; Garel, Patricia; Bochud, Emmanuel; Théberge, Julie; Aubertin, Patrice; Favreau, Gil; Fleet, Richard

    2014-01-01

    Abstract Objective To present Cirque du Soleil’s social circus program, Cirque du Monde, to explore its potential as a primary health care tool for family physicians. Data sources A review of the literature in PubMed, the Cochrane Library, PsycINFO, LaPresse, Eureka, Google Scholar, and Érudit using the key words circus, social circus, Cirque du Monde, and Cirque du Soleil; a Montreal-based initiative, Espace Transition, modeled on Cirque du Monde; and personal communication with Cirque du Soleil’s Social Circus Training Advisor. Study selection The first 50 articles or websites identified for each key word in each of the databases were examined on the basis of their titles and abstracts in the case of articles, and on the basis of their titles and page content in the case of websites. Articles and websites that explored an aspect of social circuses or that described an intervention that involved circuses were then retained for analysis. Because all literature on social circuses was searched, no criterion for year of publication was used. Synthesis No articles on the social circus as a health intervention were found. One study on the use of the circus as an intervention in schools was identified. It demonstrated an increase in self-esteem in the children who took part. One study on the use of the circus in a First Nations community was found; it contained nonspecific, qualitative findings. The other articles identified were merely descriptions of social circuses. One website was identified on the use of the social circus to help youth who had been treated in a hospital setting for major psychiatric disorders to re-enter the community. The team in the pediatric psychiatry department at Centre Hospitalier Universitaire Sainte-Justine, the children’s hospital in Montreal, Que, was contacted; they were leading this project, called Espace Transition. The unpublished preliminary findings of its pilot project demonstrate substantial improvements in overall patient

  6. Single Centre Experience – Clinical Presentation and Frequency of Paediatric Diabetic Ketoacidosis (DKA) At Diagnosis over a 5-Year Period

    LENUS (Irish Health Repository)

    McKenna, A

    2018-03-01

    Type 1 diabetes (T1D) symptoms are subtle and easily overlooked. Delayed diagnosis can result in Diabetic ketoacidosis (DKA), a life threatening complication with lasting consequences. We sought to define the presenting features of T1D and DKA frequency, in children <15 years diagnosed in a single national tertiary centre, and identify predictive factors for DKA. A review of T1D incident cases was undertaken from 2008-2012 using the National Diabetes Register (ICDNR) and clinical case notes. Data were compared with a 1997\\/8 national study. We found DKA at presentation in 28.7 % of children and 15.5% had moderate\\/severe DKA. Commonest symptoms were polydipsia, polyuria, weight loss, and lethargy. Median symptom duration was 17 days. Clinical presentation was similar and frequency of DKA at T1D diagnosis remains high. The proportion with moderate\\/severe DKA is lower than the 25% previously reported (p=0.038). National monitoring and targeted action to reduce DKA at diagnosis is required.

  7. Personnel training experience in the radioactive waste management: 10 years of Moscow SIA 'RADON' international education training centre

    International Nuclear Information System (INIS)

    Batyukhnova, Olga; Dmitriev, Sergey; Arustamov, Artur; Ojovan, Mikhael

    2007-01-01

    Available in abstract form only. Full text of publication follows: The education service for specialists dealing with radioactive waste was established in Russia (former USSR) in 1983 and was based on the capabilities of two organisations: the Moscow Scientific and Industrial Association 'Radon' (SIA 'Radon') and the Chemical Department of Lomonosov's Moscow State University. These two organizations are able to offer training programs in the science fundamentals, applied research and in practical operational areas of the all pre-disposal activities of the radioactive waste management. Since 1997 this system was upgraded to the international level and now acts as International Education Training Centre (IETC) at SIA 'Radon' under the guidance of the IAEA. During 10 years more than 300 specialists from 26 European and Asian countries enhanced their knowledge and skills in radioactive waste management. The IAEA supported specialized regional training courses and workshops, fellowships, on-the-job training, and scientific visits are additional means to assure development of personnel capabilities. Efficiency of training was carefully analysed using the structural adaptation of educational process as well as factors, which have influence on education quality. Social-psychological aspects were also taken into account in assessing the overall efficiency. The analysis of the effect of individual factors and the efficiency of education activity were carried out based on attestation results and questioning attendees. A number of analytical methods were utilised such as Ishikawa's diagram method and Pareto's principle for improving of training programs and activities. (authors)

  8. Experiences with the implementation of a national teaching qualification in university medical centres and veterinary medicine in the Netherlands.

    Science.gov (United States)

    Molenaar, Willemina M Ineke; Zanting, Anneke

    2015-02-01

    In 2008, a compulsory national basic teaching qualification was introduced for all university teachers in the Netherlands. At that time all eight University Medical Centres (UMCs) and the only Faculty of Veterinary Medicine had adopted or were setting up teacher development programmes. This study explores how these programmes relate to each other and to the basic teaching qualification. To gather information on teacher development programmes in the UMCs and the Veterinary Medicine Faculty an online survey was filled out by teacher development representatives from each of them. The programmes had main features in common (e.g. competency based and portfolio assessment), but differed somewhat in contents according to the local situation. Importantly, they had all been formally accepted as equivalent to the basic teaching qualification. We consider the freedom to tailor the qualifications to the medical context as well as to the local situation of the UMCs and the Veterinary Medicine Faculty one of the major success factors and the well-established collaboration between teacher development representatives of the UMCs and the Faculty of Veterinary Medicine as another. Challenges for the future include embedding the teacher development programmes in the institutional organizations and maintaining and further developing the programmes and the competencies of the qualified teachers, e.g. in a senior qualification.

  9. Image guided radiotherapy with the Cone Beam CT kV (ElektaTM): Experience of the Leon Berard Centre

    International Nuclear Information System (INIS)

    Pommier, P.; Gassa, F.; Lafay, F.; Claude, L.

    2009-01-01

    Image guide radiotherapy with the Cone Beam CT kV (C.B.C.T.-kV) developed by Elekta has been implemented at the centre Leon Berard in November 2006. The treatment procedure is presented and detailed for prostate cancer I.G.R.T. and non small cell lung cancer (N.S.C.L.C.) stereotactic radiotherapy (S.R.T.). C.B.C.T.-kV is routinely used for S.R.T., selected paediatric cancers, all prostate carcinomas, primitive brain tumours and head and neck cancers that do not require nodes irradiation. Thirty-five to 40 patients are treated within a daily 11-hours period. The general procedure for 3-dimensional images acquisition and their analysis is described. The C.B.C.T.-kV permitted to identify about 10% of prostate cancer patients for whom a positioning with bone-based 2-dimensional images only would have led to an unacceptable dose distribution for at least one session. S.R.T. is now used routinely for inoperable N.S.C.L.C.. The easiness of implementing C.B.C.T.-kV imaging and its expected medical benefit should lead to a rapid diffusion of this technology that is also submitted to prospective and multi centric medico-economical evaluations. (authors)

  10. Changes in the practice of environment monitoring at the Cadarache Nuclear Research Centre as a function of experience. Some examples

    International Nuclear Information System (INIS)

    Grandin, M.

    1980-09-01

    From a few examples we have seen signs of a changed attitude towards the environment monitoring of nuclear plants affecting the choice of materials and the way in which they are used. Conversely the development of technology has played its own part during the same period, though it must be said in all honesty that for reasons of cost this development is not quite finished. The changes, whether voluntary or due to the pressure of local conditions, have converged in a general tendency to substitute a degree of 'interventionism' for a relatively passive observation which involves ensuring the respect of Public Health laws and checking that the local characteristics of the biosphere are not affected abnormally by the presence of the Nuclear Establishment. This radicalization 'tends generally to replace the measurement principle by that of detection, at least at the outset. On the technical side it is sometimes necessary to take strict physical measures, as for example in the case of campaigns to establish the radiological state of the locality or of supplementary investigations following an incident. It must be emphasized moreover that the special function of a Research Centre and a certain local caution in radioprotection matters have given the situation a meaning not necessarily transposable to the monitoring of a nuclear power station for example [fr

  11. Olfactory neuroblastoma: 14-year experience at an Australian tertiary centre and the role for longer-term surveillance.

    Science.gov (United States)

    Schmidt, C; Potter, N; Porceddu, S; Panizza, B

    2017-07-01

    Olfactory neuroblastoma is a rare sinonasal malignancy, with poorly defined treatment protocols. Management at a tertiary centre was retrospectively evaluated to inform future treatment and follow up. Cases treated with curative intent (2000-2014) were included. Data were collected, and overall and disease-free survival rates were calculated. Eleven cases were identified, with a median follow up of 87 months. One patient was Kadish stage A, one was stage B, eight were stage C and one was stage D. The latter patient underwent chemoradiotherapy alone. The remaining patients proceeded to: endoscopic-assisted wide local excision (n = 2), anterior craniofacial resection (n = 4) or endoscopic craniofacial resection (n = 4). No patients had primary nodal disease or elective neck treatment. One patient had neoadjuvant chemoradiation. Six patients had post-operative radiotherapy; three received adjuvant chemotherapy. Two patients had late cervical node failure, and proceeded to neck dissection and post-operative radiotherapy. Two patients had late local recurrence. Ten-year overall and disease-free survival rates were 68.2 and 46.7 per cent, respectively. Longer-term follow up is supported given the incidence of late regional and local recurrence. Prophylactic treatment of cervical nodes in locally advanced disease is an area for further investigation.

  12. Risk Evaluation of Endoscopic Retrograde Cholangiopancreatography-Related Contrast Media Allergic-Like Reaction: A Single Centre Experience

    Directory of Open Access Journals (Sweden)

    Félix Trottier-Tellier

    2018-01-01

    Full Text Available Background and Aims. Few cases of endoscopic retrograde cholangiopancreatography- (ERCP- related contrast media (CM adverse reactions have been reported in the current literature. There is a lack of standardisation in practice regarding premedication prophylaxis for at-risk patients undergoing ERCP and there are few data to guide the practitioners. Our goal is to evaluate the risk of CM adverse reaction in a group of patients with a past history of allergic-like reaction to iodine product undergoing ERCP. Methods. A retrospective chart review study was performed of patients who underwent ERCP at our single centre from January 2010 to December 2015. Results. 2295 ERCPs were performed among 1766 patients. No anaphylactoid or severe adverse reaction occurred. One (0.04% ERCP-related CM benign reaction was reported in a patient known for penicillin allergy. Among 127 ERCPs performed on patients with a prior adverse reaction to iodine, 121 procedures were done without and 6 with a premedication prophylaxis. In both groups, no ERCP-related CM reaction occurred. Conclusions. To our knowledge, we report the largest cohort of iodine allergic patients undergoing ERCP ever published. These results suggest that ERCP-related CM adverse reactions are very rare even among patients at risk for CM reaction.

  13. Clinical types of tinea capitis and species identification in children: an experience from tertiary care centres of karachi, pakistan

    International Nuclear Information System (INIS)

    Farooqi, M.; Tabassum, S.; Rizvi, D.B.; Rahman, A.

    2014-01-01

    Objective: To study the clinical types of Tinea Capitis and identify species in children reporting to two tertiary care centres of Karachi, Pakistan. Methods: The escriptive, cross-sectional study was conducted at the Dermatology Outpatients' Department, PNS Shifa Hospital and the Institute of Skin Diseases, Karachi, from January 1, 2008 to December 31, 2009. It comprised 202 children with clinical diagnosis of tineacapitis, confirmed by skin scrapings, showing fungal hyphae and spores in 10% potassium hydroxide on direct microscopy. Wood's lamp examination was carried out and the scrapings were cultured on Sabouraud's agar. A detailed dermatological examination was performed for evidence of fungal infection elsewhere in the body. SPSS 19 was used for data analysis. Results: Male-to-female ratio was 1.1:1 and age ranged from 1 to 14 years. The commonest clinical type gray patch was observed in 71 (35.1%) of the patients, black dot in 63 (31.2%), kerion in 50 (24.8%), favus in 10 (5.0%), diffuse pustular in 6 (3.0%), and diffuse scale in 2 (1.0%) patients. The most frequent species grown on culture was Trichophyton(T).Soudanense, followed by T.Tonsurans, T. Schoenleinii, and T.Mentagrophytes respectively. Conclusion: Most of the patients of Tineacapitis presented with gray patch and black dot variety. The most common species identified by culture was Trichophyton Soudanense. Disease was equal in both gender and predominantly affected the population belonging to low and middle socioeconomic class. (author)

  14. Clinical types of tinea capitis and species identification in children: an experience from tertiary care centres of karachi, pakistan

    Energy Technology Data Exchange (ETDEWEB)

    Farooqi, M. [Ohud Hospital (Saudi Arabia). Dept. of Dermatology; Tabassum, S. [Aga Khan Univ. Hospital, Karachi (Pakistan). Dept. of Medicine; Rizvi, D. B. [Combined Military Hospital, Multan (Pakistan). Dept. of Dermatology; Rahman, A. [Combined Military Hospital, Karachi (Pakistan). Dept. of Dermatology

    2014-03-15

    Objective: To study the clinical types of Tinea Capitis and identify species in children reporting to two tertiary care centres of Karachi, Pakistan. Methods: The escriptive, cross-sectional study was conducted at the Dermatology Outpatients' Department, PNS Shifa Hospital and the Institute of Skin Diseases, Karachi, from January 1, 2008 to December 31, 2009. It comprised 202 children with clinical diagnosis of tineacapitis, confirmed by skin scrapings, showing fungal hyphae and spores in 10% potassium hydroxide on direct microscopy. Wood's lamp examination was carried out and the scrapings were cultured on Sabouraud's agar. A detailed dermatological examination was performed for evidence of fungal infection elsewhere in the body. SPSS 19 was used for data analysis. Results: Male-to-female ratio was 1.1:1 and age ranged from 1 to 14 years. The commonest clinical type gray patch was observed in 71 (35.1%) of the patients, black dot in 63 (31.2%), kerion in 50 (24.8%), favus in 10 (5.0%), diffuse pustular in 6 (3.0%), and diffuse scale in 2 (1.0%) patients. The most frequent species grown on culture was Trichophyton(T).Soudanense, followed by T.Tonsurans, T. Schoenleinii, and T.Mentagrophytes respectively. Conclusion: Most of the patients of Tineacapitis presented with gray patch and black dot variety. The most common species identified by culture was Trichophyton Soudanense. Disease was equal in both gender and predominantly affected the population belonging to low and middle socioeconomic class. (author)

  15. 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.

  16. Recruiting ENT and Audiology patients into pharmaceutical trials: evaluating the multi-centre experience in the UK and USA.

    Science.gov (United States)

    Sanchez, Victoria A; Hall, Deborah A; Millar, Bonnie; Escabi, Celia D; Sharman, Alice; Watson, Jeannette; Thasma, Sornaraja; Harris, Peter

    2018-01-21

    Recruiting into clinical trials on time and on target is a major challenge and yet often goes unreported. This study evaluated the adjustment to procedures, recruitment and screening methods in two multi-centre pharmaceutical randomised controlled trials (RCTs) for hearing-related problems in adults. Recruitment monitoring and subsequent adjustment of various study procedures (e.g. eligibility criteria, increasing recruiting sites and recruitment methods) are reported. Participants were recruited through eight overarching methods: trial registration, posters/flyers, print publications, Internet, social media, radio, databases and referrals. The efficiency of the recruitment was measured by determining the number of people: (1) eligible for screening as a percentage of those who underwent telephone pre-screening and (2) randomised as a percentage of those screened. A total of 584 participants completed the pre-screening steps, 491 screened and 169 participants were randomised. Both RCTs completed adjustments to the participant eligibility, added new study sites and additional recruitment methods. No single recruitment method was efficient enough to serve as the only route to enrolment. A diverse portfolio of methods, continuous monitoring, mitigation strategy and adequate resourcing were essential for achieving our recruitment goals.

  17. 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)

  18. 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)

  19. 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.

  20. 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.

  1. Correlations between nuclear data and results of integral slab experiments. Case of hafnium; Correlations entre donnees nucleaires et experiences integrales a plaques: le cas du hafnium

    Energy Technology Data Exchange (ETDEWEB)

    Palau, J M

    1997-10-22

    The aim of this thesis 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 (APOLLO2 code) together with Monte Carlo- type simulations (TRIPOLI4 code) 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) 128 refs.

  2. 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.

  3. "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…

  4. 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

  5. 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.

  6. Treatment of Radioactive Effluents at the Saclay Nuclear Research Centre; Traitement des Effluents Radioactifs au Centre d'Etudes Nucleaires de Saclay; 041e 0414 ; Tratamiento de los Efluentes Radiactivos en el Centro de Energia Nuclear de Saclay

    Energy Technology Data Exchange (ETDEWEB)

    Wormser, G. [Service de Controle des Radiations et de Genie Radioactif, Commissariat a l' Energie Atomique, Saclay (France)

    1960-07-01

    The Report Gives The Account Of Four Years' Experience In Operating The Treatment Plant For Effluents From The Saclay Nuclear Research Centre. It Contains Data Relating To The Origin, Volume And Treatment Of Waste. (author) [French] Ce rapport presente un bilan d'exploitation de l'installation de traitement des effluents du Centre d'etudes nucleaires de Saclay depuis quatre ans. On donne des chiffres concernant l'origine des residus, leur volume, leur traitement. (author) [Spanish] El autor hace un balance de explotacion de la instalacion de tratamiento de efluentes del centro de Saclay desde hace cuatro anos, dando las cifras correspondientes al origen de los residuos, a su volumen y a su tratamiento. (author) [Russian] V jetom dokumente podvoditsja itog chetyrehletnej jekspluatacii ustanovki po obrabotke zhidkih othotov v Centre jadernyh issledovanij v Sakle. V doklade privodjatsja dannye o proishozhdenii othodov, jh ob'eme i obrabotke. (author)

  7. 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

  8. Contact X-ray Therapy for Rectal Cancer: Experience in Centre Antoine-Lacassagne, Nice, 2002-2006

    International Nuclear Information System (INIS)

    Gerard, Jean-Pierre; Ortholan, Cecile; Benezery, Karene; Ginot, Aurelie; Hannoun-Levi, Jean-Michel; Chamorey, Emmanuel; Benchimol, Daniel; Francois, Eric

    2008-01-01

    Purpose: To report the results of using contact X-ray (CXR), which has been used in the Centre-Lacassagne since 2002 for rectal cancer. Methods and Materials: A total of 44 patients were treated between 2002 and 2006 using four distinct clinical approaches. Patients with Stage T1N0 tumors were treated with transanal local excision (TLE) and adjuvant CXR (45 Gy in three fractions) (n = 7). The 11 inoperable (or who had refused surgery) patients with Stage T2-T3 disease were treated with CXR plus external beam radiotherapy (EBRT). Those with Stage T3N0-N2 tumors were treated with preoperative CXR plus EBRT (with or without concurrent chemotherapy) followed by surgery (n = 21). Finally, the patients with Stage T2 disease were treated with CXR plus EBRT followed by TLE (n = 5). Results: The median follow-up was 25 months. In the 7 patients who underwent TLE first, no local failure was observed, and their anorectal function was good. Of the 11 inoperable patients who underwent CXR plus EBRT alone, 10 achieved local control. In the third group (preoperative CXR plus EBRT), anterior resection was performed in 16 of 21 patients. Complete sterilization of the operative specimen was seen in 4 cases (19%). No local recurrence occurred. Finally, of the 5 patients treated with CXR plus EBRT followed by TLE, a complete or near complete clinical response was observed in all. TLE with a R0 resection margin was performed in all cases. The rectum was preserved with good function in all 5 patients. Conclusion: These early results have confirmed that CXR combined with surgery (or alone with EBRT) can play a major role in the conservative and curative treatment of rectal cancer

  9. 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

    2017-05-01

    The goal of the study is to evaluate and report on the third-generation da Vinci surgical (Si) system malfunctions. 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. 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. 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.

  10. 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

  11. Clinical characteristics of bladder cancer in patients with spinal cord injury: the experience from a single centre.

    Science.gov (United States)

    Böthig, Ralf; Kurze, Ines; Fiebag, Kai; Kaufmann, Albert; Schöps, Wolfgang; Kadhum, Thura; Zellner, Michael; Golka, Klaus

    2017-06-01

    Life expectancy for people with spinal cord injury has shown a marked increase due to modern advances in treatment methods and in neuro-urology. However, since life expectancy of people with paralysis increases, the risk of developing of urinary bladder cancer is gaining importance. Single-centre retrospective evaluation of patient data with spinal cord injuries and proven urinary bladder cancer and summary of the literature. Between 1998 and 2014, 24 (3 female, 21 male) out of a total of 6599 patients with spinal cord injury were diagnosed with bladder cancer. The average age at bladder cancer diagnosis was 57.67 years, which is well below the average for bladder cancer cases in the general population (male: 73, female: 77). All but one patient had a latency period between the onset of the spinal paralysis and tumour diagnosis of more than 10 years. The median latency was 29.83 years. The median survival for these patients was 11.5 months. Of the 24 patients, 19 (79%) had muscle invasive bladder cancer at ≥T2 at the time of diagnosis. The type of neurogenic bladder (neurogenic detrusor overactivity or acontractility) and the form of bladder drainage do not appear to influence the risk. Long-term indwelling catheter drainage played only a minor role in the investigated patients. The significantly younger age at onset and the frequency of invasive tumours at diagnosis indicate that spinal cord injury influences bladder cancer risk and prognosis as well. Early detection of bladder cancer in patients with spinal cord injury remains a challenge.

  12. A decision tree for the genetic diagnosis of deficiency of adenosine deaminase 2 (DADA2): a French reference centres experience.

    Science.gov (United States)

    Rama, Mélanie; Duflos, Claire; Melki, Isabelle; Bessis, Didier; Bonhomme, Axelle; Martin, Hélène; Doummar, Diane; Valence, Stéphanie; Rodriguez, Diana; Carme, Emilie; Genevieve, David; Heimdal, Ketil; Insalaco, Antonella; Franck, Nathalie; Queyrel-Moranne, Viviane; Tieulie, Nathalie; London, Jonathan; Uettwiller, Florence; Georgin-Lavialle, Sophie; Belot, Alexandre; Koné-Paut, Isabelle; Hentgen, Véronique; Boursier, Guilaine; Touitou, Isabelle; Sarrabay, Guillaume

    2018-04-23

    Deficiency of adenosine deaminase 2 (DADA2) is a recently described autoinflammatory disorder. Genetic analysis is required to confirm the diagnosis. We aimed to describe the identifying symptoms and genotypes of patients referred to our reference centres and to improve the indications for genetic testing. DNA from 66 patients with clinically suspected DADA2 were sequenced by Sanger or next-generation sequencing. Detailed epidemiological, clinical and biological features were collected by use of a questionnaire and were compared between patients with and without genetic confirmation of DADA2. We identified 13 patients (19.6%) carrying recessively inherited mutations in ADA2 that were predicted to be deleterious. Eight patients were compound heterozygous for mutations. Seven mutations were novel (4 missense variants, 2 predicted to affect mRNA splicing and 1 frameshift). The mean age of the 13 patients with genetic confirmation was 12.7 years at disease onset and 20.8 years at diagnosis. Phenotypic manifestations included fever (85%), vasculitis (85%) and neurological disorders (54%). Features best associated with a confirmatory genotype included fever with neurologic or cutaneous attacks (odds ratio [OR] 10.71, p = 0.003 and OR 10.9, p < 0.001), fever alone (OR 8.1, p = 0.01), and elevated C-reactive protein (CRP) level with neurologic involvement (OR 6.63, p = 0.017). Our proposed decision tree may help improve obtaining genetic confirmation of DADA2 in the context of autoinflammatory symptoms. Prerequisites for quick and low-cost Sanger analysis include one typical cutaneous or neurological sign, one marker of inflammation (fever or elevated CRP level), and recurrent or chronic attacks in adults.

  13. Experience with a bone bank operation and allograft bone infection in recipients at a medical centre in southern Taiwan.

    Science.gov (United States)

    Liu, J W; Chao, L H; Su, L H; Wang, J W; Wang, C J

    2002-04-01

    To assess the contamination rate of allograft bones at retrieval and the infection rate of the implanted allograft bone, we audited a bone bank retrospectively and reviewed the medical charts of allograft bone recipients between June 1999 and June 2000 at a medical centre in southern Taiwan. The bone bank did its utmost to minimize allograft contamination with hospital-acquired pathogens by adopting purposefully designed criteria for selection of donors. This protocol included sterilization with soaking of the retrieved allograft in a solution of a first-generation cephalosporin before storage and prophylaxis in recipients with first-generation cephalosporin. The contamination rates at allograft retrieval from living and cadaveric donors were 2.7% and 12.4%, respectively (P<0.001). Culture of 262 specimens taken at allograft implant revealed 12 (4.6%) positive for culture. Of the 12 patients implanted with allograft bones positive for culture, nine (75.0%) had allograft bone infection, while three (25.0%) did not. Among the 250 recipients with sterile allograft bones, four (1.6%) were found to have allograft infection. None of the cases of infection required removal of the allograft bones, and all cases were successfully treated with tailored antimicrobial therapy based on susceptibility tests on isolated bacteria. The overall infection rate was 5.0%, which compared favourably with those in other series. A prospective cohort study is needed to determine which of the varied sterilization methodologies gives the best and/or most cost-effective outcome. Copyright 2002 The Hospital Infection Society.

  14. Experience of the Casablanca radiotherapy-oncology centre on radiotherapy in the treatment of the adult Hodgkin lymphoma; Experience du centre de radiotherapie-oncologie de Casablanca sur la radiotherapie dans le traitement du lymphome de Hodgkin de l'adulte

    Energy Technology Data Exchange (ETDEWEB)

    Bouchbika, Z.; Benchakroun, N.; Sellai, N.; Jouhadi, H.; Tawfiq, N.; Sahraoui, S.; Benider, A. [Service radiotherapie-oncologie, CHU Ibn-Rochd, Casablanca (Morocco)

    2011-10-15

    The authors report the assessment of the local control, global survival and survival without recurrence, and also late complications, based on retrospective study over 8 years of 169 cases Hodgkin lymphoma in patients older than 18 (average age of 34) and who had been submitted to radiotherapy. Survival has been computed according to the Kaplan-Meier method. The authors notice that the recurrence rate is slightly higher than in the literature. During the considered period, radiotherapy was two-dimensional with higher doses than those corresponding to current standards. The improvement of radiotherapy techniques and the decrease of doses within the standards should improve the therapeutic results. Short communication

  15. 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 ...

  16. Centre de recherches pour le développement international ...

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

    André Lavoie

    Definitions. 5. Rôles et ... a) Le Centre de recherches pour le développement international (CRDI) est une société d'État canadienne à .... conduite éthique dans le cadre de ces activités afin que la confiance du public dans .... a) Les gouverneurs en déplacement pour le compte du CRDI ont droit à une indemnité de repas et ...

  17. 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

    2015-12-01

    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.

  18. 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.

  19. Empowerment, environment and person-centred care: A qualitative study exploring the hospital experience for adults with cognitive impairment.

    Science.gov (United States)

    Prato, Laura; Lindley, Lyndsay; Boyles, Miriam; Robinson, Louise; Abley, Clare

    2018-01-01

    It is acknowledged that there are many challenges to ensuring a positive hospital experience for patients with cognitive impairment. The study ('Improving hospital care for adults with cognitive impairment') aimed to explore the positive and negative experiences of older adults with cognitive impairment (dementia and delirium) and their relatives and/or carers, during an acute hospital stay, from admission to discharge, using a qualitative, case study methodology. Six participants with cognitive impairment, eight relatives and 59 members of the health care team were recruited. Data was collected via ethnographic, observational periods at each stage of the hospital journey and through the use of semi-structured interviews with relatives, carers and health care staff including: medical staff; nursing staff; physiotherapists and ward managers. Interpretive phenomenological analysis was used to facilitate data analysis. 52 hours 55 minutes of ethnographic observations and 18 interviews with ward staff and relatives were undertaken. Three superordinate themes emerged from the data as crucial in determining the quality of the hospital experience: valuing the person; activities of empowerment and disempowerment and the interaction of environment with patient well-being. Whether the patient's hospital experience was positive or negative was powerfully influenced by family involvement and ward staff actions and communication. Participants identified a requirement for a ward based activity service for patients with cognitive impairment. Further research must be undertaken focusing on the development of ward based activities for patients with cognitive impairment, alongside a move towards care which explores measures to improve and expand relative involvement in hospital care.

  20. Diagnosis and Outcomes of Appendicitis Complicating Pregnancy in a Tertiary Care Centre-A 10 year Experience

    Directory of Open Access Journals (Sweden)

    Vaibhav Londhe

    2017-10-01

    Full Text Available Introduction: Appendicitis in pregnancy is rare and its diagnosis is a challenge as the clinical presentation may be altered in pregnancy. Early diagnosis of appendicitis is vital for a favourable pregnancy outcome. Aim: To study clinical features, radiological findings, surgical, histopathological and pregnancy outcomes in cases of acute appendicitis complicating pregnancy. Materials and Methods: This retrospective study was conducted in Christian Medical College and Hospital, a Tertiary Care Centre in the Department of Obstetrics and Gynaecology, Tamil Nadu, India. We reviewed the medical records and computerized database of a large tertiary care center between January 2007 and December 2016 years and retrieved 34 cases of appendicitis complicating pregnancy. During this period there were 1,23,938 deliveries in the Department of Obstetrics and Gynaecology and a total of 632 women had undergone appendicectomy, in the Department of Surgery. The details of the demography, clinical presentation, lab investigations, imaging, surgical findings, treatment, pathology and pregnancy outcomes were assessed and collated from case notes. Standard clinical, radiological and laboratory diagnostic criteria were used to establish the diagnosis of appendicitis. Categorical variables were summarised as frequencies and percentages. Quantitative variables were summarised as mean and standard deviation for normally distributed variable or median and IQR for skewed variables. Diagnostic accuracy were given with 95% confidence interval. Results: Mean gestational age at diagnosis was 18 weeks. Mean duration between onset of pain to admission was 1.77±1.08 days. The average MANTRELS score comprising of symptoms, signs and laboratory findings was 5. Ultrasound imaging was done for all cases. Thirty two women underwent surgery. Two women were managed conservatively. Thirty one women had histopathological findings of the appendix. The sensitivity of ultrasound was 87

  1. Can handheld micropower impulse radar technology be used to detect pneumothorax? Initial experience in a European trauma centre.

    Science.gov (United States)

    Albers, C E; Haefeli, P C; Zimmermann, H; de Moya, M; Exadaktylos, A K

    2013-05-01

    Pneumothoraces are a common injury pattern in emergency medicine. Rapid and safe identification can reduce morbidity and mortality. A new handheld, battery powered device, the Pneumoscan (CE 561036, PneumoSonics Inc., Cleveland, OH, USA), using micropower impulse radar (MIR) technology, has recently been introduced in Europe for the rapid and reliable detection of PTX. However, this technology has not yet been tested in trauma patients. This is the first quality control evaluation to report on emergency room performance of a new device used in the trauma setting. This study was performed at a Level I trauma centre in Switzerland. All patients with thoracic trauma and undergoing chest X-ray and CT-scan were eligible for the study. Readings were performed before the chest X-ray and CT scan. The patients had eight lung fields tested (four on each side). All readings with the Pneumoscan were performed by two junior residents in our department who had previously received an instructional tutorial of 15min. The qualitative MIR results were blinded, and stored on the device. We then compared the results of the MIR to those of the clinical examination, chest X-ray and CT-scan. 50 patients were included, with a mean age of 46 (SD 17) years. Seven patients presented with PTX diagnosed by CT; six of these were detected by Pneumoscan, leading to an overall sensitivity of 85.7 (95% confidence interval 42.1-99.6)%. Only two of seven PTX were found during clinical examination and on chest X-ray (sensitivity 28.6 (95% CI 3.7-71.0)%). Of the remaining 43 of 50 patients without PTX, one false-positive PTX was found by the Pneumoscan, resulting in a specificity of 97.7 (95% CI 87.7-99.9)%. The Pneumoscan is an easy to use handheld technology with reliable results. In this series, the sensitivity to detect a PTX by the Pneumoscan was higher than by clinical examination and chest X-ray. Further studies with higher case numbers and a prospective study design are needed to confirm our

  2. 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...

  3. Changements climatiques | Page 29 | CRDI - Centre de recherches ...

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

    Mais 30 ans de guerre civile, entre 1973 et 2002, ont détruit 98% des stations météorologiques du pays et les données associées. La guerre a aussi poussé un grand nombre de familles des régions rurales à fuir le centre du pays; elles se sont installées dans les villes du littoral, dans l'ouest, la région la plus affectée par ...

  4. Ce que nous faisons | Page 174 | CRDI - Centre de recherches pour ...

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

    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 ... Taxes sur les cigarettes en Tanzanie. De 2002 à 2007, le tabagisme a connu une hausse de ...

  5. 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 ...

  6. Résultats de recherche | Page 450 | CRDI - Centre de recherches ...

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

    Scott Gilmore. Scott est entrepreneur social et rédacteur. Profile. -. Jean Lebel. Jean a été nommé président du CRDI le 1er mai 2013. À titre de président du CRDI, Jean dirige l'apport du Centre aux efforts que déploie le Canada en matière de développement, de politique étrangère et d'innovation mondiale. Pages.

  7. Russian-IAEA Education Training Centre at Moscow SIA 'Radon': 8 Years Experience in Educating Personnel to Manage Radioactive Wastes

    International Nuclear Information System (INIS)

    Batyukhnova, O.G.; Dmitriev, S.A.; Agrinenko, V.V.; Ojovan, M.I.; Sabol, J.; Efremenkov, V.M.

    2006-01-01

    The experience gained during last 8 years of educational and training activities of the IETC under the IAEA guidance was described in this paper. For that period more than 160 specialists from 26 European and Asian countries enhanced their skills. The education-training programmes were developed accounting both for the IAEA recommendations and gained experience and attendees' requests. Efficiency of education was carefully analysed using the structural adaptation of educational process as well as factors, which have influence on education quality. Social-psychological aspects were also taken into account in assessing the overall efficiency. The analysis of the effect of individual factors and the efficiency of education activity were carried out based on attestation results and questioning attendees of training courses. A number of analytical methods were utilised such as Ishikawa's diagram method and Pareto's principle for improving of training programmes and activities. (authors)

  8. 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 ).

  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. The use radioactive tracers in the study of solid transport in water streams; Emploi de traceurs radioactifs pour l'etude du transport solide dans les cours d'eau

    Energy Technology Data Exchange (ETDEWEB)

    Courtois, G [Commissariat a l' Energie Atomique, Saclay (France).Centre d' Etudes Nucleaires; Jaffry, P; Heuzel, M [Laboratoire National d' Hydraulique de Chatou, 78 (France)

    1960-07-01

    riviere, la premiere a ete consacree a l'etude du charriage des galets dans le Rhone, l'autre a l'etude des transports de sables dans le Niger. Cette derniere experience a ete doublee d'experiences identiques, effectuees sur le modele reduit du fleuve Niger exploite par le Laboratoire de Chatou: dans ces experiences, on utilise le rayonnement du {sup 56}Mn et du {sup 24}Na obtenu par activation directe du noyau d'abricot concasse representant sur le modele reduit le sediment naturel du lit du Niger. Les efforts conjugues du Laboratoire de Chatou et du Centre d'Etudes Nucleaires de Saclay portent actuellement sur l'application des traceurs radioactifs aux etudes sur modeles reduits, dans le double but: a) de disposer d'un meme moyen d'investigation en nature et sur modele reduit pour controler la fidelite du modele, dans la phase des essais d'etalonnage; b) de profiter des facilites d'observation et mesures directes offertes par les modeles reduits pour etudier les possibilites d'amelioration de la methode des traceurs, en particulier en ce qui concerne l'obtention de renseignements quantitatifs. (auteur)

  11. Résultats de recherche | Page 74 | CRDI - Centre de recherches ...

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

    Recherche transnationale : décentralisation en Afrique de l'Ouest et du Centre; apprendre des expériences locales et sectorielles - éducation, eau, santé - cas du Mali (rapport final). Published date. 1 janvier 2011. Rapports. EDUCATION ...

  12. Résultats de recherche | Page 75 | CRDI - Centre de recherches ...

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

    Recherche transnationale : décentralisation en Afrique de l'Ouest et du Centre; apprendre des expériences locales et sectorielles - éducation, eau, santé - cas du Mali (rapport final). Published date. 1 janvier 2011. Rapports. EDUCATION ...

  13. Résultats de recherche | Page 449 | CRDI - Centre de recherches ...

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

    À titre de directrice du domaine de programme Agriculture et environnement, Dominique Charron veille au bon déroulement d'activités de recherche ayant pour but d'accroître la productivité de l'agriculture et la sécurité alimentair. Profile. -. Christel Binnie. Christel Binnie est la directrice des communications du Centre.

  14. Ce que nous faisons | Page 166 | CRDI - Centre de recherches pour ...

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

    information, Gestion D'entreprises, Propriété Intellectuelle. Région(s): Amériques, Brésil, Amérique Du Sud, Afrique, Nigéria, Sud Du Sahara, Amérique Latine. Le Centro de Tecnologia e Sociedade (CTS - centre pour la technologie et la société) fait ...

  15. Briser le cercle vicieux de la pauvreté en Éthiopie | CRDI - Centre de ...

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

    Avec l'aide du Centre de recherches pour le développement international du ... sur le logement, les installations sanitaires, la nutrition et la santé de la collectivité. ... Des photographies aériennes montrent que la surface des terres cultivées a ...

  16. Transfert de responsabilités (2009) | CRDI - Centre de recherches ...

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

    25 avr. 2016 ... ... des principes directeurs susceptibles d'orienter les pratiques en matière de transfert de responsabilité. Évaluation du transfert de la responsabilité des secrétariats internationaux du Centre de recherches pour le développement international par Jim Armstrong et Alexa Khan The Governance Network ...

  17. 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.

  18. 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)

  19. 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

  20. 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 dont la structure

  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. 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

  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

    2010-08-01

    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. A magnet built on bronchoscopic suction for extraction of tracheobronchial headscarf pins: a novel technique and review of a tertiary centre experience.

    Science.gov (United States)

    Elsayed, Hany H; Mostafa, Ahmed M; Soliman, Saleh; El-Bawab, Hatem Y; Moharram, Adel A; El-Nori, Ahmed A

    2016-05-01

    Airway metal pins are one of the most commonly inhaled foreign bodies in Eastern societies in young females wearing headscarves. We innovated a modified bronchoscopic technique to extract tracheobronchial headscarf pins by the insertion of a magnet to allow an easy and non-traumatic extraction of the pins. The aim of this study was to assess the feasibility and safety of our new technique and compare it with our large previous experience with the classic bronchoscopic method of extraction of tracheobronchial headscarf pins. We performed a study comparing our retrospective experience of classic bronchoscopic extraction from February 2004 to January 2014 and prospective experience with our modified technique using the magnet from January 2014 to June 2015. An institutional review board and new device approval were obtained. Three hundred and twenty-six procedures on 315 patients were performed during our initial 10-year experience. Of them, 304 patients were females. The median age of our group was 13 (0-62). The median time from inhalation to procedure was 1 day (0-1022). After introducing our modified new technique using the magnet, 20 procedures were performed. Nineteen were females. The median time of the procedure and the need to forcefully bend the pin for extraction were in favour of the new technique in comparison with our classic approach (2 vs 6 min; P magnets was safer and simpler in comparison with our large experience with the classic approach. We advise the use of this device (or concept) in selected patients in centres dealing with this problem. © The Author 2016. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.

  5. Entretien avec Venàncio Massingue | CRDI - Centre de recherches ...

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

    3 févr. 2011 ... Il en a vite été détourné par le directeur du centre d'informatique de l'université, ... Le gouvernement de mon pays adopte des plans quinquennaux ... il nous fallait une définition du télécentre adaptée à notre situation, non à ...

  6. 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 ...

  7. La cardiomyopathie dilatee au centre hospitalier Universitaire ...

    African Journals Online (AJOL)

    But : Afin d'améliorer la prise en charge, d'éviter l'évolution rapide vers une insuffisance cardiaque réfractaire au traitement, nous avons entrepris cette étude en milieu hospitalier. Méthode : il s'est agi d'une étude rétrospective et descriptive dans le service de cardiologie du Centre Hospitalier Universitaire Tokoin de Lomé.

  8. 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

  9. 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.

  10. Is anti-platelet therapy needed in continuous flow left ventricular assist device patients? A single-centre experience.

    Science.gov (United States)

    Litzler, Pierre-Yves; Smail, Hassiba; Barbay, Virginie; Nafeh-Bizet, Catherine; Bouchart, François; Baste, Jean-Marc; Abriou, Caroline; Bessou, Jean-Paul

    2014-01-01

    We report our 5-year experience of continuous flow left ventricular assist device (LVAD) implantation without the use of anti-platelet therapy. Between February 2006 and September 2011, 27 patients (26 men; 1 woman) were implanted with a continuous flow LVAD (HeartMate II, Thoratec Corporation, Pleasanton, CA, USA). The mean age was 55.7 ± 9.9 years. The mean duration of support was 479 ± 436 (1-1555) days with 35.4 patient-years on support. Twenty-one patients were implanted as a bridge to transplantation and 6 for destination therapy. The anticoagulation regimen was fluindione for all patients, with aspirin for only 4 patients. At the beginning of our experience, aspirin was administered to 4 patients for 6, 15, 60 and 460 days. Due to gastrointestinal (GI) bleeding and epistaxis, aspirin was discontinued, and since August 2006, no patients have received anti-platelet therapy. At 3 years, the survival rate during support was 76%. The most common postoperative adverse event was GI bleeding (19%) and epistaxis (30%) (median time: 26 days) for patients receiving fluindione and aspirin. The mean International Normalized Ratio (INR) was 2.58 ± 0.74 during support. Fifteen patients have been tested for acquired Von Willebrand disease. A diminished ratio of collagen-binding capacity and ristocetin cofactor activity to Von Willebrand factor antigen was observed in 7 patients. In the postoperative period, 2 patients presented with ischaemic stroke at 1 and 8 months. One of these 2 patients had a previous history of carotid stenosis with ischaemic stroke. There were no patients with haemorrhagic stroke, transient ischaemic attack or pump thrombosis. The event rate of stroke (ischaemic and haemorrhagic) per patient-year was 0.059 among the patients without aspirin with fluindione regimen only. A fluindione regimen without aspirin in long-duration LVAD support appears to not increase thromboembolic events and could lead to a diminished risk of haemorrhagic stroke.

  11. 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.

  12. Du Pont de Nemours

    NARCIS (Netherlands)

    Ros JPM; LAE

    1994-01-01

    Dit rapport over Du Pont de Nemours (produktie van o.a. chemische stoffen) is gepubliceerd binnen het Samenwerkingsproject Procesbeschrijvingen Industrie Nederland (SPIN). In het kader van dit project is informatie verzameld over industriele bedrijven of industriele processen ter ondersteuning

  13. The use of gold markers and electronic portal imaging for radiotherapy verification in prostate cancer patients: Sweden Ghana Medical Centre experience

    Directory of Open Access Journals (Sweden)

    George Felix Acquah

    2014-02-01

    Full Text Available The success of radiotherapy cancer treatment delivery depends on the accuracy of patient setup for each fraction. A significant problem arises from reproducing the same patient position and prostate location during treatment planning for every fraction of the treatment process. To analyze the daily movements of the prostate, gold markers are implanted in the prostate and portal images taken and manually matched with reference images to locate the prostate. Geometrical and fiducial markers are annotated onto a highly quality generated digitally reconstructed radiographs, that are compared with portal images acquired right before treatment dose delivery. A 0 and 270 degree treatment fields are used to calculate prostate shifts for all prostate cancer patients undergoing treatment at the Sweden Ghana Medical Centre, using an iViewGT portal imaging device. After aligning of the marker positions onto the reference images, the set-up deviations corrections are displayed and an on-line correction procedure applied. The measured migrations of the prostate markers are below the threshold of 3 mm for the main plans and 2 mm for the boost plans. With daily electronic portal imaging combined with gold markers, provides an objective method for verifying and correcting the position of the prostate immediately prior to radiation delivery.--------------------------------------------Cite this article as: Acquah GF. The use of gold markers and electronic portal imaging for radiotherapy verification in prostate cancer patients: Sweden Ghana Medical Centre experience. Int J Cancer Ther Oncol 2014; 2(1:020112.DOI: http://dx.doi.org/10.14319/ijcto.0201.12

  14. Les Cahiers du CREAD

    African Journals Online (AJOL)

    Admin

    6 juil. 2007 ... La problématique du développement du secteur de l'artisanat en. Algérie a été très peu abordée par les chercheurs, qu'ils soient universitaires ou .... La loi a institué une taxe d'apprentissage dont le taux a été fixé à. 1% de la ...

  15. Bulletin du CRDI #127

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

    La mise à l'échelle de la recherche et de l'innovation en vue de créer un impact social constitue une priorité pour la communauté du développement. Toutefois ... Nous avons renouvelé notre soutien à la recherche auprès du gouvernement de l'Inde ... Des femmes étudient à l'École supérieure d'infotronique d'Haïti.

  16. 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 ...

  17. Treatment Outcome of Carcinoma Vulva Ten-Year Experience from a Tertiary Cancer Centre in South India

    Directory of Open Access Journals (Sweden)

    Sakthiushadevi Jeevarajan

    2017-01-01

    Full Text Available Background. Carcinoma vulva is a rare disease accounting for 1.3% of all gynaecological malignancies. The present study is a 10-year retrospective review of our experience of the surgical options, morbidity, failure pattern, and survival for invasive carcinoma vulva. Materials and Methods. Retrospective analysis of case records of 39 patients who underwent surgery for invasive vulval cancer between 2004 and 2013 in the Department of Surgical Oncology at the Government Royapettah Hospital, Chennai. Results. The median age was 55 years. Radical vulvectomy was the preferred surgery. 31 patients underwent lymphadenectomy. Seroma formation and groin skin necrosis were the most common postoperative complications. With a median follow-up of 32 months, 8 patients (20.5% developed recurrence (systemic = 1, regional = 4, and local = 3. The estimated 5-year disease-free survival (DFS was 65.4% and the overall survival (OS was 85.1%. On univariate analysis, stage and lymph node involvement significantly affected OS. Nodal involvement with extracapsular spread (ECS significantly affected both DFS and OS. Conclusion. The treatment of carcinoma vulva should be individualized with multidisciplinary cooperation. The paucity of data, especially from India, necessitates the need for more studies, preferably multicentric, keeping in mind the low prevalence.

  18. Treatment Outcome of Carcinoma Vulva Ten-Year Experience from a Tertiary Cancer Centre in South India.

    Science.gov (United States)

    Jeevarajan, Sakthiushadevi; Duraipandian, Amudhan; Kottayasamy Seenivasagam, Rajkumar; Shanmugam, Subbiah; Ramamurthy, Rajaraman

    2017-01-01

    Carcinoma vulva is a rare disease accounting for 1.3% of all gynaecological malignancies. The present study is a 10-year retrospective review of our experience of the surgical options, morbidity, failure pattern, and survival for invasive carcinoma vulva. Retrospective analysis of case records of 39 patients who underwent surgery for invasive vulval cancer between 2004 and 2013 in the Department of Surgical Oncology at the Government Royapettah Hospital, Chennai. The median age was 55 years. Radical vulvectomy was the preferred surgery. 31 patients underwent lymphadenectomy. Seroma formation and groin skin necrosis were the most common postoperative complications. With a median follow-up of 32 months, 8 patients (20.5%) developed recurrence (systemic = 1, regional = 4, and local = 3). The estimated 5-year disease-free survival (DFS) was 65.4% and the overall survival (OS) was 85.1%. On univariate analysis, stage and lymph node involvement significantly affected OS. Nodal involvement with extracapsular spread (ECS) significantly affected both DFS and OS. The treatment of carcinoma vulva should be individualized with multidisciplinary cooperation. The paucity of data, especially from India, necessitates the need for more studies, preferably multicentric, keeping in mind the low prevalence.

  19. 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.

  20. 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.

  1. 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.)

  2. 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.

  3. 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

  4. 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.

  5. 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.

  6. L'accès au savoir en Afrique : le rôle du droit d'auteur

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

    Les lois et politiques relatives au droit d'auteur couvrent de nombreuses questions ...... Le premier aspect de la stratégie relative aux dynamiques de genre du projet ...... Les responsables du centre ont finalement décidé de recruter des ...

  7. Three-year experience with interventional neuroradiology for management of cerebral aneurysms at a single Australian centre.

    Science.gov (United States)

    McLaughlin, Aden; Rice, Hal; de Viliers, Laetitia; Withers, Teresa; Pearson, David; Arnell, Moira; Walters, Kerin; Czuchwicki, Sarah; Bulmer, Andrew; Winearls, James

    2018-02-01

    Over the last decade interventional neuroradiology (NR) has become the mainstay of managing cerebral aneurysms. The aim of our study was to review our growing experiences with interventional NR and quantify morbidity and mortality associated with these procedures. The electronic medical records of all patients admitted to the Gold Coast (University) Hospital Intensive Care Unit following subarachnoid haemorrhage (SAH) or elective interventional NR management of cerebral aneurysms between January 2012 and December 2014 were retrieved. Primary outcomes of interest were death, thromboembolic and haemorrhagic events during hospital admission. One hundred and fifty-two patients underwent interventional NR procedures for cerebral aneurysms. This consisted of 92 (60.5%) elective cases and 60 (39.5%) emergency cases following SAH. The all-cause mortality rate and the rate of thromboembolic and haemorrhagic events for the entire cohort were 5.9%, 11.2% and 7.2% respectively. Intra-procedural complications occurred in 6.6% of the entire cohort. Median length of follow-up was 448 days, with 91.6% of the entire cohort followed up. At follow-up, 64.1% of patients had no neurological deficits, 29% had mild non-specific deficits and 6.9% had significant disability. Interventional NR represents the primary treatment modality for all patients presenting to our service with cerebral aneurysm. Our results are encouraging and are comparable to published data in the international literature. Reducing the burden of thromboembolism in patients undergoing endovascular treatment of their aneurysmal disease is our main research focus currently, and we aim to improve outcomes for this patient group. © 2017 The Royal Australian and New Zealand College of Radiologists.

  8. Single-centre experience with the frozen elephant trunk technique in 251 patients over 15 years.

    Science.gov (United States)

    Shrestha, Malakh; Martens, Andreas; Kaufeld, Tim; Beckmann, Erik; Bertele, Sebastian; Krueger, Heike; Neuser, Julia; Fleissner, Felix; Ius, Fabio; Abd Alhadi, Firas; Hanke, Jasmin; Schmitto, Jan D; Cebotari, Serghei; Karck, Matthias; Haverich, Axel; Chavan, Ajay

    2017-11-01

    Our goal was to present our 15-year experience (2001-2015) with the frozen elephant trunk (FET) technique. A total of 251 patients (82 with aortic aneurysms, 96 with acute aortic dissection type A, 4 with acute type B dissections, 52 with chronic aortic dissection type A, 17 with chronic type B dissection and 67 redo cases) underwent FET implantation with either the custom-made Chavan-Haverich (n = 66), the Jotec E-vita (n = 31) or the Vascutek Thoraflex hybrid (n = 154) prosthesis. The cases were assigned to an early period (2001-2011) and a contemporary period (2012-present). Mean cardiopulmonary bypass time, aortic cross-clamp time, circulatory arrest time and selective antegrade cerebral perfusion time were 241 ± 72, 125 ± 59, 56 ± 30 and 81 ± 34 min, respectively. Incidence of rethoracotomy for bleeding, stroke, spinal cord injury, prolonged ventilatory support (>96 h) and long-term dialysis were 18, 14, 2, 24 and 2%, respectively. The in-hospital mortality rate was 11% (in acute aortic dissection type A, 12%). Of the 2 patients with graft infections, 1 died and the other had a protracted hospital stay. There were 49 second-stage procedures in the downstream aorta: either open surgical [n = 25 (thoraco-abdominal, n = 15; descending, n = 6; infrarenal, n = 4)] or transfemoral endovascular (n = 23). Elective thoracic endovascular aneurysm repair R implantation was successful in all 23 cases. FET results are comparable with those of the published results of the conventional elephant trunk technique. FET is an ideal landing zone for subsequent transfemoral endovascular completion. Patients with graft infections may have dismal results. © The Author 2017. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.

  9. Pilot study on diffusive ground heat storage in the SUVA 'D4' building complex in Root, Switzerland; Etude pilote pour le stockage diffusif des batiments du centre D4 de la SUVA a Root, Lucerne. Analyse de 2 tests de reponse geothermique et integration du stockage diffusif dans le systeme

    Energy Technology Data Exchange (ETDEWEB)

    Pahud, D.

    2001-07-01

    This report for the Swiss Federal Office of Energy (SFOE) presents, in a first part, the results of two thermal response tests made on a geothermal heat storage system that forms part of a heating and cooling system for a complex of buildings comprising the 'D4' centre of the Swiss Accident Insurance Institution (SUVA) in Root, near Lucerne, Switzerland. These in situ response tests on two borehole heat exchangers confirmed the laboratory measurements, indicating that no significant ground water flow is present. In a second part the heat storage dimensioning and the heating/cooling system evaluation by means of computerized simulation are described, which used simulated data for the heating and cooling requirements of the new buildings and the ground heat storage parameters. The PILESIM thermal simulation tool is described, a computer code used to simulate heating and cooling systems that use heat-exchanger piles or borehole heat exchangers. The evaluations made on three system concepts are discussed that permitted the optimal design of the diffusive ground storage system. The construction of the actual system is also described.

  10. Initial Operating Experience with the ''NPD'' Reactor; Experience recueillie pendant les premiers mois de fonctionnement du reacteur NPD; Pervyj opyt po ehkspluatatsii reaktora NPD; Experiencia inicial de funcionamiento del reactor NPD

    Energy Technology Data Exchange (ETDEWEB)

    McConnell, L. G. [Hydro-Electric Power Commission of Ontario, Toronto, Ontario (Canada)

    1963-10-15

    'y apporter des perfectionnements pendant les periodes d'arret complet. Les resultats obtenus jusqu'a present ont ete positifs; la premiere experience de fonctionnement, qui a dure six semaines, a permis d'obtenir un facteur de puissance de 70%. Les perfectionnements deja apportes ont permis d'augmenter la securite, d'ameliorer les performances et ont montre en meme temps qu*il etait possible de reduire les depenses d'investissement pour les centrales futures. On a, par exemple, modifie les joints d'arbre des pompes du circuit primaire de refroidissement pour obtenir de meilleures performances; les appareils de recuperation de la vapeur, a congelation', ont ete remplaces par des colonnes d'absorption de facon a reduire les pertes de vapeur d'eau lourde; des regulateurs de debit sont installes en certains points pour reduire les pertes d'eau lourde pour le cas ou des joints cederaient. En decembre 1962, deux fuites simultanees dans l'appareil de rechargement en puissance ont entraihe une serie inhabituelle d'incidents; une quantite importante d'eau lourde a haute pression et haute temperature a ete projetee dans l'enceinte du reacteur ou sa purete isotopique a ete legerement alteree. On a redonne a l'eau lourde la purete voulue et le reacteur a pu recommencer a fonctionner a la fin du mois. Touslesdispositift de securite, notamment ceux destines a parer aux fuites d'eau lourde, ont fonctionne correctement pendant l'accident. (author) [Spanish] La primera central nucleoelectrica del Canada, NPD, constituye una instalacion de demostracion, destinada a comprobar el funcionamiento de los reactores alimentados con uranio natural y moderados y refrigerados por agua pesada. Alcanzo su regimen normal de potencia el 28 de junio de 1962. Aunque ha sido disenada como central para la carga basica, en las primeras fases funcionara en parte como central para la carga de cresta, lo que permitira introducir mejoras durante los periodos de paro. Los resultados obtenidos hasta el presente

  11. Total aortic arch replacement with the frozen elephant trunk technique: 10-year follow-up single-centre experience.

    Science.gov (United States)

    Ius, Fabio; Fleissner, Felix; Pichlmaier, Maximilian; Karck, Matthias; Martens, Andreas; Haverich, Axel; Shrestha, Malakh

    2013-11-01

    Since August 2001, the frozen elephant trunk (FET) technique has been used at our institution to treat degenerative or dissecting aneurysms involving the aortic arch and descending aorta as a potential 'single-stage' procedure. The aim of this study was to review our FET experience and to present the 10-year results. Between August 2001 and January 2012, 131 patients underwent FET implant with three different prostheses: the custom-made Chavan-Haverich (n = 66), the Jotec E-vita (n = 30) and the Vascutek Thoraflex (n = 35) prostheses. Concomitant procedures included aortic valve-sparing operations (David, n = 17) and aortic root replacement (Bentall, n = 25). Patient records and the first postoperative and last available computer tomography (CT) were retrospectively reviewed. Incidence of rethoracotomy for bleeding, stroke, spinal cord injury, prolonged ventilatory support (>96 h) and acute renal failure requiring dialysis were 18, 11, 1, 41 and 16%, respectively. In-hospital mortality was 15%. The mean follow-up was 42 ± 37 (range 1-134 months). At 1, 5 and 10 years, survivals were 82 ± 3, 72 ± 5 and 58 ± 8%, respectively. Freedoms from distal aortic operation were 81 ± 4, 67 ± 5 and 43 ± 13%, respectively. Thirty-six patients underwent 40 distal aortic operations, either open surgical (n = 22, 55%) or endovascular (n = 18, 45%). Chronic aortic dissection was identified as an independent risk factor for distal aortic operation (odds ratio = 3.8; 95% confidence interval 1.5-9.3; P = 0.004). At last CT control, false-lumen thrombosis rates up to 93% were achieved around the stent graft. An FET concept adds to the armament of the surgeon in the treatment of complex and diverse aortic arch pathologies. The preoperative patient risk profile explains the postoperative morbidity and in-hospital mortality. The FET can potentially be still a 'one-stage' procedure in selected patients. However, the extension of FET to patients with extensive aortic aneurysms has led

  12. Une estimation de la précarité des patients recourant à la médecine générale en centres de santé. Le cas des centres de santé du projet Epidaure-CDS

    OpenAIRE

    Anissa Afrite; Julien Mousques; Yann Bourgueil

    2015-01-01

    Le projet exploratoire Epidaure-CDS a pour objectif principal d’analyser la spécificité des centres de santé (CDS) dans l’offre de soins et de déterminer s’ils jouent un rôle particulier dans la réduction des inégalités sociales de santé, notamment en facilitant l’accès aux soins primaires pour les personnes en situation de précarité ou de vulnérabilité sociale, ce qui n’a été que peu exploré jusqu’à présent. Il s’agit ici d’estimer en quoi la population recourant à la médecine générale dans ...

  13. Presentation of the CEA's crisis national organization: coordination centre in case of crisis, crisis technical teams, intervention means, and so on; Presentation de l'organisation nationale de crise du CEA: centre de coordination en cas de crise, equipes techniques de crise, moyens d'intervention...

    Energy Technology Data Exchange (ETDEWEB)

    Pectorin, X. [CEA Fontenay-aux-Roses, MR/DCS/DIR, 92 (France)

    2010-07-01

    After having briefly recalled the existence of a legal framework for crisis management organisation, this report briefly describes how the CEA plans the crisis management. This management is based on the definition of critical scenarios, on the building up of a crisis management team, and on the elaboration of crisis management operational documents. It evokes the alert organisation and the triggering of crisis management. Then, it describes the CEA's national crisis organisation with its main crisis management structures, the role and the operation of the Crisis Coordination Centre (CCC, the decision body), the role and operation of the Central Crisis Technical Teams (ETC-C, Equipes Techniques de Crise Centrales), the role of field interveners (various rescue, protection, health care and technical teams) and of other additional intervention actors. It evokes the objectives of the various exercises which are organised every year at the internal, national or international level

  14. A Phenomenological Research of the Lived Experiences of Runaway Girls Who Live in Correction and Rehabilitation Centre in Tehran about Subjective Experiences

    Directory of Open Access Journals (Sweden)

    Maryam Falahatpishe

    2016-03-01

    Full Text Available Background and Objective: According to the high prevalence of running away from home by the teenager girls in Iran and the negative consequences of this issue in the society, this study aimed to investigate the phenomenon of running away from home by studying the lived experience about subjective experiences in girls who had been referred to correction and rehabilitation center in Tehran.Materials and Methods: 12 girls were chosen based on data saturation and they were interviewed by semi-structured interviews. The data were analyzed by interpretative phenomenology and Van Manen approach. Finally 5 main Themes were achieved.Results: The thematic analysis resulted in three sub-themes for subjective experiences including entanglement in negative emotions, being dehumanized, and feminine identity.Conclusion: The results emphasize the need for assessment of experiencing the negative emotions, being dehumanized, and identity crisis as the risk factors of running in teenagers to prevent the possibility of running away from home by teenagers.

  15. Characterization of the tensile behaviour of argillaceous soils for the barriers of waste disposal facilities; Caracterisation du comportement en traction des sols argileux pour les barrieres de centres de stockage de dechets

    Energy Technology Data Exchange (ETDEWEB)

    Madjoudj Guessasma, N

    2001-12-01

    Compacted clay beds are traditionally used for the covering of radioactive waste repositories. Their implementation is a delicate task which requires to take into consideration the type of waste and the environment properties: climate, hydrology, topography and sociology. Several works have been performed on the mechanical behaviour of such soils with respect to their elastic or compression rupture properties. However, their sensibility with respect to the cracking generated by an hydric change or by a flexural strength (differential compaction of the wastes) remains badly known. The aim of this work is to propose a laboratory test for the characterization of the suitability of these materials with respect to their tensile extensibility. This test has been performed on two types of argillaceous materials. The document is structured as follows: after a synthesis of the main causes of alteration of cover materials, a characterization of two natural fine soils which could be used as cover material is presented. Their tensile properties is analyzed, in particular their deformation during cracking and rupture. Different direct or indirect tensile tests are analyzed in order to define a simple test for the characterization of the tensile properties of soils. The influence of the compacting mode on the cracking and rupture is also studied. Finally, a real scale experiment simulating the bending of an argillaceous cover above a cavity has been performed in-situ. The results are compared with those obtained at the laboratory in order to validate the choices proposed for an application to waste repository covers. (J.S.)

  16. 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

  17. Effet du Pediococcus acidilactici sur le bilan lipidique sanguin du ...

    African Journals Online (AJOL)

    Les résultats relatifs aux performances zootechniques ont montré que l'addition du probiotique a amélioré significativement le gain de poids pendant la phase de croissance se traduisant par un indice de consommation meilleur. Les dosages du cholestérol total, des triglycérides, du HDL et du LDL ont été déterminés à la ...

  18. Tuberculose du col utérin simulant un cancer du col utérin : à propos ...

    African Journals Online (AJOL)

    Tuberculose du col utérin simulant un cancer du col utérin : à propos d'un cas, au Centre Hospitalier Universitaire Souro Sanou de Bobo-Dioulasso, Burkina Faso. A. Dembélé, V. Konségré, E. Birba, D.A. Somé, H. Zamané, A.S. Ouédraogo, S. Kiemtoré, S. Ouattara, A. Lamien-Sanou, M. Bambara, B. Bonané/Thiéba ...

  19. Intraperitoneal chemotherapy for advanced ovarian and peritoneal cancers in patients following interval debulking surgery or primary cytoreductive surgery: Tom Baker Cancer Centre experience from 2006 to 2009.

    Science.gov (United States)

    Nelson, Gregory; Lucero, Carlos Aspe; Chu, Pamela; Nation, Jill; Ghatage, Prafull

    2010-03-01

    To describe our experience with cisplatin- and paclitaxel-based IP chemotherapy in patients treated initially with either neoadjuvant chemotherapy and interval debulking surgery (IDS) or primary cytoreductive surgery (PCRS). We performed a retrospective review of the records of 67 patients (38 IDS, 29 PCRS) enrolled in the intraperitoneal (IP) chemotherapy program at the Tom Baker Cancer Centre between 2006 and 2009. Information pertaining to patient demographics, IP chemotherapy toxicity, and catheter complications was extracted, and the median time to recurrence was calculated. Most patients in the study were aged 50 to 70 years and had a diagnosis of stage III serous ovarian cancer. Overall, 295/393 IP cycles (75%) were successfully administered. The proportion of patients completing six cycles of chemotherapy in the IDS and PCRS groups was 53% and 59%, respectively. Frequent (> 25%) Grade 1 to 2 chemotherapy toxicities included fatigue, peripheral neuropathy, and nausea. Catheter complications were observed in 34% of patients (23/67). The recurrence rates for patients completing four or more cycles of IP chemotherapy in the IDS and PCRS groups were 58% and 35%, respectively, with the median time to recurrence approximately one year. Although IP chemotherapy is well tolerated in both IDS and PCRS patients, the median time to recurrence is shorter than expected.

  20. Clinical outcomes of modified minimally invasive approach and de-rotation of symptomatic chronic gastric volvulus – A tertiary centre experience

    Directory of Open Access Journals (Sweden)

    Bin Chet Toh

    Full Text Available Introduction: Gastric volvulus is a surgical condition that should be recognised promptly to prevent life-threatening gastric ischaemia and perforation in acute setting. There are two peak age group of incidence with children less than one year old and at fifth decade.1 The mortality rates for acute gastric volvulus remain high with reported range from 30% to 50% signifying the need of early diagnosis and treatment.2 These case series reported modified minimal invasive approach for symptomatic chronic gastric volvulus in a tertiary upper gastrointestinal unit in Singapore. Methods: Retrospective case series reviewed in single centre from 1st May 2016 to 1st May 2017 of clinical outcomes of modified minimally invasive approach and de-rotation of symptomatic chronic gastric volvulus. Results: Three symptomatic patients with evidence of gastric volvulus on CT-scan underwent minimally invasive repair with the aids of GastriSail™ Gastric positioning system. GastriSail™ was used for gastric volvulus de-rotation prior to repair definitely. Two patients had fundoplication done and one patient had gastropexy performed successfully. All patients started on blended diet post-operative day 1 and discharged well. Patient remained asymptomatic and nil recurrence at 3 months follow-up post-operation. Conclusion: Based on our experience, we advocate modified minimally invasive repair of chronic gastric volvulus as an alternative to traditional open surgical technique with acceptable good clinical outcomes. Keywords: Chronic gastric volvulus, Minimal invasive surgery, Upper gastrointestinal tract

  1. 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.

  2. 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

  3. The practicality of including the systemic inflammatory response syndrome in the definition of polytrauma: experience of a level one trauma centre.

    Science.gov (United States)

    Butcher, Nerida E; Balogh, Zsolt J

    2013-01-01

    The systemic inflammatory response syndrome (SIRS) has been advocated as a significant predictor of outcome in trauma. Recent trauma literature has proposed SIRS as a surrogate for physiological derangements characteristic of polytrauma with some authors recommending its inclusion into the definition of polytrauma. The practicality of daily SIRS collection outside of specifically designed prospective trials is unknown. The purpose of this study was to assess the availability of SIRS variables and its appropriateness for inclusion into a definition of polytrauma. We hypothesised SIRS variables would be readily available and easy to collect, thus represent an appropriate inclusion into the definition of polytrauma. A prospective observational study of all trauma team activation patients over 7-months (August 2009 to February 2010) at a University affiliated level-1 urban trauma centre. SIRS data (temperature>38°C or 90 bpm; RR>20/min or a PaCO(2)12.0×10(9)L(-1), or 10 immature bands) collected from presentation, at 24 h intervals until 72 h post injury. Inclusion criteria were all patients generating a trauma team activation response age >16. 336 patients met inclusion criteria. In 46% (155/336) serial SIRS scores could not be calculated due to missing data. Lowest rates of missing data observed on admission [3% (11/336)]. Stratified by ISS>15 (132/336), in 7% (9/132) serial SIRS scores could not be calculated due to missing data. In 123 patients ISS>15 with complete data, 81% (100/123) developed SIRS. For Abbreviated Injury Scale (AIS)>2 in at least 2 body regions (64/336) in 5% (3/64) serial SIRS scores could not be calculated, with 92% (56/61) of patients with complete data developing SIRS. For Direct ICU admissions [25% (85/336)] 5% (4/85) of patients could not have serial SIRS calculated [mean ISS 15(±11)] and 90% (73/81) developed SIRS at least once over 72 h. Based on the experience of our level-1 trauma centre, the practicability of including SIRS into the

  4. Au fil du temps (1976 ou la loi du seuil

    Directory of Open Access Journals (Sweden)

    Isabelle Singer

    2010-04-01

    Full Text Available Ayant choisi de vivre dans un camion, les héros d’Au fil du temps (film de Wim Wenders de 1976 font du seuil une expérience particulière. Celle de la rupture avec toute idée de foyer et celle du refus d’appartenance à la terre natale, cette terre allemande traversée par une frontière le long de laquelle ils vont voyager, et qui les renvoie à chaque instant aux traumatismes de l’Histoire. Sur le pare-brise du camion, l’extérieur (campagnes indifférenciées, villes à l’abandon… et l’intérieur se superposent. Au fil du temps questionne le paysage : il s’agit d’en décoller un à un les mythes qui le recouvrent. L’image alors n’est plus surface mais volume à traverser, à lacérer et découvrir ce qui est tissé dans le paysage. La démarche de Wenders est alors proche de celle d’un de ses contemporains : Anselm Kiefer. Le paysage allemand provoque le rejet parce qu’il y a là toujours plus que le visible : des strates et des strates de culpabilité que le mythe - et c’est sa fonction - a recouvert. Et qu’il s’agira ici, de soulever. Le choix du nomadisme, c’est celui d’un état de l’humanité antérieur à l’idée de patrie. Et c’est aussi celui de la solitude, comme prix à payer à ce refus d’appartenance et à cette mise à jour des mythes. L’appartenance à la terre allemande et à son Histoire est profondément problématique parce que les pères sont fondamentalement coupables. On se reconnaîtra alors des pères de substitution : des pères de cinéma (Nicholas Ray ou Fritz Lang. Et l’on substituera l’Histoire du cinéma à l’Histoire. Bruno est réparateur ambulant de projecteurs et Au fil du temps dressera, au gré de ses pérégrinations, un état des lieux du cinéma allemand des années soixante-dix : déliquescent, colonisé par les images hollywoodiennes. Il faut que cela change : état du cinéma ; état des protagonistes solitaires en quête d’une identit

  5. Primary care clinicians' experiences prescribing HIV pre-exposure prophylaxis at a specialized community health centre in Boston: lessons from early adopters.

    Science.gov (United States)

    Krakower, Douglas S; Maloney, Kevin M; Grasso, Chris; Melbourne, Katherine; Mayer, Kenneth H

    2016-01-01

    An estimated 1.2 million Americans have indications for using antiretroviral pre-exposure prophylaxis (PrEP) to prevent HIV acquisition. For many of these at-risk individuals, the best opportunity to learn about and receive PrEP will be during routine visits to their generalist primary care clinicians. However, few generalist clinicians have prescribed PrEP, primarily because of practical concerns about providing PrEP in primary care settings. The experiences of specialized primary care clinicians who have prescribed PrEP can inform the feasibility of PrEP provision by generalists. During January to February 2015, 35 primary care clinicians at a community health centre in Boston that specializes in the care of sexual and gender minorities completed anonymous surveys about their experiences and practices with PrEP provision. Responses were analyzed with descriptive statistics. Thirty-two clinicians (response rate=91%) completed the surveys. Nearly all clinicians (97%) had prescribed PrEP (median 20 patients, interquartile range 11-33). Most clinicians reported testing and risk-reduction counselling practices concordant with U.S. Centers for Disease Control and Prevention guidelines for PrEP. Clinicians indicated that patients using PrEP experienced medication toxicities infrequently and generally reported high adherence. However, some clinicians' practices differed from guideline recommendations, and some clinicians observed patients with increased risk behaviours. Most clinicians (79%) rated PrEP provision as easy to accomplish, and 97% considered themselves likely to prescribe PrEP in the future. In a primary care clinic with specialized expertise in HIV prevention, clinicians perceived that PrEP provision to large numbers of patients was safe, feasible and potentially effective. Efforts to engage generalist primary care clinicians in PrEP provision could facilitate scale-up of this efficacious intervention.

  6. Les mots du jazz

    OpenAIRE

    Roueff, Olivier

    2007-01-01

    L’ouvrage d’André Schaeffner constitue la première analyse savante du jazz (1926). Il a marqué une étape importante dans le processus de réinvention du jazz en France en contribuant notamment, par sa réception et les polémiques qu’il a suscitées, à transformer l’identification du jazz d’une musique « américaine » à une musique « noire-américaine » (c’est-à-dire aux « racines » africaines). Les analyses proposées dans cet ouvrage, alors qu’elles désignaient des musiques que la critique de jazz...

  7. India | Page 83 | IDRC - International Development Research Centre

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

    Language French. 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 ...

  8. Transnational Corporations and Local Innovation | CRDI - Centre de ...

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

    25 sept. 2013 ... ... les ressources humaines, les structures du marché et l'innovation et le développement ... Dinesh Abrol est scientifique en chef au National Institute of Science, ... Le Centre de recherches pour le développement international est ... ont conclu un accord de coopération scientifique et technologique en ...

  9. Des statistiques essentielles | CRDI - Centre de recherches pour le ...

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

    un programme de recherche sur le terrain mené pour le compte du Centre international de recherche sur les maladies diarrhéiques. Au début, les accoucheuses traditionnelles faisaient état de variations démographiques hebdomadaires dans ...

  10. Entretien avec Susan Holtz | CRDI - Centre de recherches pour le ...

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

    26 nov. 2010 ... ... Centre de recherches pour le développement international comme l'un des ... Toutefois, le discours public sur l'intégration d'objectifs environnementaux et .... très conservatrice des experts du droit commercial international, ...

  11. Food Security and Climate Change in Cambodia | CRDI - Centre de ...

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

    Given the country's dependence on agriculture and natural resources, tackling climate change and food security together is essential. ... L'honorable Chrystia Freeland, ministre du Commerce international, a annoncé le lancement d'un nouveau projet financé par le Centre de recherches pour le développement international ...

  12. Reforming Security Sector Governance South Asia | CRDI - Centre ...

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

    In South Asia, security discourse has traditionally been confined to government circles, with no room for voices from civil society. ... L'honorable Chrystia Freeland, ministre du Commerce international, a annoncé le lancement d'un nouveau projet financé par le Centre de recherches pour le développement international ...

  13. fibrosarcome du larynx

    African Journals Online (AJOL)

    pie du lit tumoral est employée comme complément thé- rapeutique [9] alors que la chimiothérapie est générale- ment indiquée dans les formes métastatiques. Le pronos- tic dépend essentiellement du degré de différentiation his- tologique. En fait, le fibrosarcome bien différencié est caractérisé par la fréquence de récidive ...

  14. du Chott Marouane

    African Journals Online (AJOL)

    plancton de 90 µm de vide de maille. Ils ont été conservés dans du formol à 5%. L'identification de l'espèce est basée sur des critères morphologiques [20]: la forme des furcas, les lobes frontaux des antennes des mâles, de l'organe copulateur (pénis) et du sac ovigère. Le comptage des soies furcales a été réalisé. L'étude ...

  15. Soutien organisationnel pour la phase 2 de l'ITT : Centre for Budget ...

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

    Soutien organisationnel pour la phase 2 de l'ITT : Centre for Budget and Governance Accountability. Ce financement contribuera à renforcer le rôle du Centre for Budget and Governance Accountability (CBGA) en tant qu'organisme crédible de recherche sur les politiques publiques en Inde en renforçant sa capacité à ...

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

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

    Ce site Web fournit des espaces de discussion et donne accès à divers mécanismes de communication. L'utilisateur s'engage à en faire un usage approprié et pertinent à l'objet des discussions. Il s'engage en outre à ne diffuser aucun message diffamatoire, illégal, obscène ou menaçant et à ne pas télécharger ou joindre ...

  17. Nouveaux centres de cyberpolitique pour les pays du Sud | IDRC ...

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

    13 avr. 2018 ... L'appel ouvert avait pour but de cibler les organismes indépendants voués à la recherche sur les politiques qui s'appuient sur la recherche pour éclairer et influencer les politiques nationales dans les domaines des droits numériques, de la cybersécurité et des politiques d'innovation. Parmi les 59 ...

  18. La revendication des hautes terres du Cambodge | CRDI - Centre ...

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

    23 févr. 2011 ... À Ratanakiri, les villageois ont établi le genre de plan dont nous avons besoin, selon la classification des divers types de sol qu'on trouve dans la forêt. » « Nous voulons aider la collectivité à protéger ses ressources naturelles », ajoute-t-il. « Nous avons bien vu que la forêt est son moyen de subsistance.

  19. 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 ...

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

    African Journals Online (AJOL)

    à la spoliation sanguine due aux prélèvements à visée diagnostique et les anémies secondaires précoces ... étaient d'au moins 2mL à chaque prélèvement. Les frais d'hospitalisation incluant les bilans et ..... [11] H. Hume, Red blood cell transfusions for preterm infants: the role of evidence-based medicine, Semin Perinatol, ...

  1. Les chemins du savoir | CRDI - Centre de recherches pour le ...

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

    . Autrefois, les politiciens, parfois conseillés par des personnes infl uentes pouvaient gouverner simplement en se laissant guider par leurs principes personnels, leur inclinaison idéologique et, à l'occasion, en acquiesçant à des demandes ...

  2. Nouveaux centres de cyberpolitique pour les pays du Sud | CRDI ...

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

    13 avr. 2018 ... L'Association internationale de ressources en eau (IWRA), en étroite collaboration avec le CRDI, organise un webinaire intitulé "Changements climatiques et gestion adaptive de l'eau: des... Voir davantageNouveau webinaire IWRA/CRDI sur les changements climatiques et la gestion adaptive de l'eau ...

  3. Le budget du CNRS de 1969 à 2000.

    OpenAIRE

    Marnot, Bruno

    2011-01-01

    Après avoir abordé l’évolution du budget du CNRS au cours « des années fastes » allant de la Libération à 1968 dans le précédent numéro de cette revue, Bruno Marnot poursuit ici son étude des budgets du Centre sur les trois décennies suivantes. Au cours de cette période, marquée par une conjoncture économique beaucoup moins brillante, les insuffisances budgétaires entraînent une importante diminution des moyens mis à la disposition des laboratoires et mènent à la crise de trésorerie qui sévit...

  4. 29 August 2013 - J.-F. Jauslin, Directeur de l’Office fédéral de la culture (OFC) Ambassadeur suisse auprès de l’UNESCO et de l’OIF au 1er septembre 2013 Confédération suisse visite le centre visiteurs de l’expérience ATLAS ainsi que la caverne expérimentale d'ATLAS avec P. Jenny, ancien Porte-parole d'ATLAS. M. Bona, Conseiller du Directeur général pour les relations avec les Organisations internationales présent tout au long.

    CERN Multimedia

    Jean-Claude Gadmer

    2013-01-01

    29 August 2013 - J.-F. Jauslin, Directeur de l’Office fédéral de la culture (OFC) Ambassadeur suisse auprès de l’UNESCO et de l’OIF au 1er septembre 2013 Confédération suisse visite le centre visiteurs de l’expérience ATLAS ainsi que la caverne expérimentale d'ATLAS avec P. Jenny, ancien Porte-parole d'ATLAS. M. Bona, Conseiller du Directeur général pour les relations avec les Organisations internationales présent tout au long.

  5. Inhalative steroids as an individual treatment in symptomatic lung cancer patients with radiation pneumonitis grade II after radiotherapy – a single-centre experience

    International Nuclear Information System (INIS)

    Henkenberens, C.; Janssen, S.; Lavae-Mokhtari, M.; Leni, K.; Meyer, A.; Christiansen, H.; Bremer, M.; Dickgreber, N.

    2016-01-01

    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

  6. 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.

  7. les cahiers du cread

    African Journals Online (AJOL)

    Our Journal “les cahiers du cread” is a quarterly economic review publishing original findings of empirical research and theoretical debates on fields pertaining to our mission coverage (Macro Economics, Industrial Economics and Firms, Human Development & Social Economics, Agriculture & Environment). Other websites ...

  8. Le Flaubert de Charles Du Bos

    Directory of Open Access Journals (Sweden)

    Jacques Neefs

    2009-01-01

    Full Text Available Charles Du Bos a porté une attention constante à l’œuvre de Flaubert (à l’exclusion de Bouvard et Pécuchet qui semble ne pas exister pour lui, à Madame Bovary et à L’Éducation sentimentale en particulier. La mise en relation de son étude : « Sur le milieu intérieur chez Flaubert », écrite en 1921, avec des textes du Journal de 1923 et de 1937, les rapprochements avec Gogol, Thomas Hardy, Tolstoï, Baudelaire, Henry James qui traversent les écrits de Du Bos, permettent de suivre ce que celui-ci décrit comme « l’expérience spirituelle » d’une matérialité comprise dans la conquête de la triple exigence du Beau, du Vivant et du Vrai. Du Bos décèle la force de l’œuvre de Flaubert dans la « disproportion » du style, et dans la puissance d’absorption qui fait la densité de cette prose, et qui désigne un extraordinaire travail de conversion. L’obscure expérience spirituelle ainsi poursuivie est celle d’un absolu de l’art, expérience paradoxale d’un « mystique qui ne croit à rien » (comme se désignait Flaubert lui-même, que le critique lie à une interrogation sur sa propre conversion.Charles Du Bos devoted an unflagging attention to Flaubert’s work (except for Bouvard et Pécuchet, which, apparently, according to him did not exist, to Madame Bovary and in particular L’Éducation sentimentale. The connection between his essay “Sur le milieu intérieur chez Flaubert”, written in 1921, and extracts from his Journal, from 1923 to 1937, the comparisons with Gogol, Thomas Hardy, Tolstoy, Baudelaire, and Henry James that run through the writings of Du Bos, allow us to follow what he terms “the spiritual experience” of a materiality encompassed in the conquest of the triple demand of the Beautiful, the Living, the Truth. Du Bos detects the power of Flaubert’s work in the “disproportion” of his style, and the power of absorption that forms the density of his prose, showing an

  9. La neurotoxoplasmose congenitale du nourrisson : a propos d'une ...

    African Journals Online (AJOL)

    Les auteurs rapportent un cas isolé d'une Toxoplasmose cérébrale congénitale chez un enfant de 02 ans hospitalisé dans le service de neurologie du centre hospitalouniversitaire (C.H.U) Campus de Lomé. La revue de la littérature permet d'insister sur les formes cliniques, l'imagerie médicale, la biologie ainsi que les ...

  10. Cours National de Paludologie du Niger : Bilan de cinq ans.

    African Journals Online (AJOL)

    SARAH

    31 août 2017 ... Centre de Recherche Médicale et Sanitaire. ... l'andragogie et utilisant les nouvelles technologies de l'information et de la communication (NTIC). Cent ... La moyenne générale au pré test était de 9,2/20 (α=6,2, [3 ; 16,5]) contre 14,9/20 (α=8,3 ; .... bio-écologie, (IV) la clinique du paludisme, (V) Diagnostic.

  11. Comparaison du filtre adaptatif RIF et du filtre a base de reseau de ...

    African Journals Online (AJOL)

    Comparaison du filtre adaptatif RIF et du filtre a base de reseau de neurones pour le filtrage du courant de reference pour la commande du filtre actif parallele. C Benachaiba, A Bassou, B Mazari ...

  12. DGNB certified Healthcare Centres

    DEFF Research Database (Denmark)

    Brunsgaard, Camilla; Larsen, Tine Steen

    2015-01-01

    for sustainability and wants a certification. This research investigates the decision‐making and design process (DMaDP) behind four DGNB certified Healthcare Centres (HCC) in Northern Jutland in Denmark. In general, knowledge about the DMaDP is important. However it is important to know what part DGNB plays...... a dialog about DGNB and energy concept is important even before anyone start sketching. Experiences with the different approaches will be further outlined in the paper.Future research has the intention to collect further knowledge about DGNB and DMaDP in practise. This project was limited to Healthcare...

  13. Town Centre Redevelopment Strategies

    DEFF Research Database (Denmark)

    Vagnby, Bo Hellisen

    After many years of urban growth Danish downtowns are facing some important choices. Shall the stake one-sidedly be on the town centres as driving forces for growth and 'city marketing', or do they still have a role to play in a broader socio-economic context? In the paper we look back on eight...... 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...

  14. Activité antérieure – Évaluation faite par le CRDI à la Conférence du ...

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

    15 avr. 2016 ... Le groupe d'experts a invité des collaborateurs, notamment Miguel Jaramillo, du groupe pour l'analyse du développement, et Natalia Aquilino, du Centro de Implementación de Políticas Públicas para la Equidad y el Crecimiento (Centre de mise en oeuvre des politiques publiques pour l'équité et la ...

  15. Évaluation de l'incidence du libre accès au droit sur la compétence ...

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

    Le domaine de programme Technologies de l'information et de la communication au service du développement (TIC-D) du CRDI a soutenu des centres ... Bien que plusieurs projets de libre diffusion du droit aient vu le jour de par le monde, jusqu'à maintenant, aucune recherche n'a visé à mieux comprendre les incidences ...

  16. Results of several years experiments on the absorption of radioactive strontium and caesium by cultivated plants (1962); Compte rendu d'experiences de plusieurs annees sur l'absorption du strontium et du cesium radioactifs par des plantes cultivees (1962)

    Energy Technology Data Exchange (ETDEWEB)

    Michon, M. [Commissariat a l' Energie Atomique, Dept. de Protection Sanitaire, Fontenay-aux-Roses (France). Centre d' Etudes Nucleaires; Benard, M.; Flanzy, M. [Station Centrale de Technologie des Produits Vegetaux, 11 - Narbonne (France); Fioramonti, M.; Marty, M. [Station Agronomique de Toulouse, 31 (France); Barbier, M.; Le Blaye, M.; Brossard, M. [Societe Centrale d' Agronomie, 78 - Versailles (France)

    1962-07-01

    This report follows on to the report number CEA 1860 and uses results obtained in 1960 to give more precise details concerning the data presented in the preceding report. First results obtained on the vine are given. The Sr absorption coefficient has varied very little from one year to the next and that of caesium has slightly diminished. The values obtained suggest that the concentrations of {sup 90}Sr and {sup 137}Cs in irrigation water should not exceed 1/5 of the maximum permissible concentration in drinking water. (authors) [French] Ce rapport fait suite au rapport CEA 1860 et precise grace aux resultats acquis en 1960 les donnees exprimees dans le precedent rapport. Il y est fait mention des premiers resultats obtenus pour la vigne. Le coefficient d'absorption du Sr a peu varie d'une annee sur l'autre et celui du cesium legerement diminue. Les valeurs obtenues permettent de penser qu'il serait souhaitable que la concentration en {sup 90}Sr et en {sup 137}Cs dans l'eau d'irrigation ne depasse pas le 1/5 de la concentration maxima admissible pour l'eau de boisson. (auteurs)

  17. The answers are within me. An evaluation of a person centred counselling service for men at HMP Doncaster who have had experience of domestic violence 2005-2007

    OpenAIRE

    Hamilton, P.; Wilkinson, K.; Meadows, L.; Cadet, N.

    2008-01-01

    This report is the second year evaluation of the person centred counselling service for male victims and perpetrators of domestic violence at HMP Doncaster in 2006/7. This report follows on from the previous year's evaluation, Raging Anger Within Me, which evaluated this project in 2005/6. Initiated by the Doncaster Rape and Sexual Abuse Counselling Centre (DRSACC), the second year of counselling service delivery was also funded by Lloyds TSB and the Tudor Trust.\\ud The report provides a back...

  18. Le ministre du Commerce international du Canada rencontre des ...

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

    17 juil. 2017 ... La promotion de l'entrepreneuriat, la façon dont le commerce peut profiter aux femmes et à leur famille, et la création d'emplois pour les plus vulnérables étaient au coeur de la discussion en table ronde du ministre du Commerce international du Canada, l'honorable François-Philippe Champagne, et des ...

  19. 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

  20. Portage vaginal du streptocoque du groupe B chez la femme ...

    African Journals Online (AJOL)

    Introduction: le streptocoque du groupe B est le principal agent impliqué dans les infections materno-fœtales, les septicémies et les méningites du nouveau-né à terme. L'objectif est de déterminer le taux de portage maternel du streptocoque du groupe B (SGB) à terme. Méthodes: un prélèvement vaginal a été réalisé de ...