WorldWideScience

Sample records for experiments primary documentation

  1. 7 CFR 1710.152 - Primary support documents.

    Science.gov (United States)

    2010-01-01

    ... 7 Agriculture 11 2010-01-01 2010-01-01 false Primary support documents. 1710.152 Section 1710.152... Requirements for Loan Approval § 1710.152 Primary support documents. The following primary support documents... load forecast is required. (b) Construction work plan (CWP). The CWP shall specify and document the...

  2. Milestones and Experiences of Standardized Documentation.

    Science.gov (United States)

    Saranto, Kaija; Saba, Virginia; Dykes, Patricia; Kinnunen, Ulla-Mari; Mykkänen, Minna

    2016-01-01

    The purpose of this panel is to discuss milestones and experiences of a standardized nursing terminology for the documentation of nursing practice using Clinical Care Classification as an example. The aim is to describe the value of using the CCC as the standardized nursing terminology and framework for the multidisciplinary care plans and how its interoperability with SNOMED CT, LOINC, and other required terminologies can be used for the electronic health record systems. Further the aim is to discuss the advantages a multidisciplinary documentation system and how it impacts on nursing practice, management, and research as well as highlight the monitoring of nursing documentation. The target audience will enrich their understanding about the possibilities that a standardized multidisciplinary documentation is critical for future data analyses and datamining highlighting nursing practices.

  3. Provider Perspectives on Advance Care Planning Documentation in the Electronic Health Record: The Experience of Primary Care Providers and Specialists Using Advance Health-Care Directives and Physician Orders for Life-Sustaining Treatment.

    Science.gov (United States)

    Dillon, Ellis; Chuang, Judith; Gupta, Atul; Tapper, Sharon; Lai, Steve; Yu, Peter; Ritchie, Christine; Tai-Seale, Ming

    2017-12-01

    Advance care planning (ACP) is valued by patients and clinicians, yet documenting ACP in an accessible manner is problematic. In order to understand how providers incorporate electronic health record (EHR) ACP documentation into clinical practice, we interviewed providers in primary care and specialty departments about ACP practices (n = 13) and analyzed EHR data on 358 primary care providers (PCPs) and 79 specialists at a large multispecialty group practice. Structured interviews were conducted with 13 providers with high and low rates of ACP documentation in primary care, oncology, pulmonology, and cardiology departments. The EHR problem list data on Advance Health Care Directives (AHCDs) and Physician Orders for Life-Sustaining Treatment (POLST) were used to calculate ACP documentation rates. Examining seriously ill patients ≥65 years with no preexisting ACP documentation seen by providers during 2013 to 2014, 88.6% (AHCD) and 91.1% (POLST) of 79 specialists had zero ACP documentations. Of 358 PCPs, 29.1% (AHCD) and 62.3% (POLST) had zero ACP documentations. Interviewed PCPs often believed ACP documentation was beneficial and accessible, while specialists more often did not. Specialists expressed more confusion about documenting ACP, whereas PCPs reported standard clinic workflows. Problems with interoperability between outpatient and inpatient EHR systems and lack of consensus about who should document ACP were sources of variations in practices. Results suggest that providers desire standardized workflows for ACP discussion and documentation. New Medicare reimbursement for ACP and an increasing number of quality metrics for ACP are incentives for health-care systems to address barriers to ACP documentation.

  4. Central Equatorial Pacific Experiment (CEPEX). Design document

    Energy Technology Data Exchange (ETDEWEB)

    1993-04-01

    The Earth`s climate has varied significantly in the past, yet climate records reveal that in the tropics, sea surface temperatures seem to have been remarkably stable, varying by less than a few degrees Celsius over geologic time. Today, the large warm pool of the western Pacific shows similar characteristics. Its surface temperature always exceeds 27{degree}C, but never 31{degree}C. Heightened interest in this observation has been stimulated by questions of global climate change and the exploration of stabilizing climate feedback processes. Efforts to understand the observed weak sensitivity of tropical sea surface temperatures to climate forcing has led to a number of competing ideas about the nature of this apparent thermostat. Although there remains disagreement on the processes that regulate tropical sea surface temperature, most agree that further progress in resolving these differences requires comprehensive field observations of three-dimensional water vapor concentrations, solar and infrared radiative fluxes, surface fluxes of heat and water vapor, and cloud microphysical properties. This document describes the Central Equatorial Pacific Experiment (CEPEX) plan to collect such observations over the central equatorial Pacific Ocean during March of 1993.

  5. Accidental Government Documents Librarian: A Review of Experiences and Training Needs of Interim Documents Librarians

    Science.gov (United States)

    Yelinek, Kathryn; Hinchcliff, Marilou

    2009-01-01

    The results of a survey to determine the training needs and normative experiences of temporary government documents librarians are presented. The results indicate that temporary librarians tend to work in academia, have been in librarianship for a shorter time period, and have fewer technical processing skills than permanent documents librarians.…

  6. Whooping Crane Transplant Experiment progress reports and supporting documents : 1978

    Data.gov (United States)

    US Fish and Wildlife Service, Department of the Interior — This collection of documents support the Whooping Crane transplant experiment on Grays Lake NWR and supporting Refuges including Monte Vista, Cora, Lonetree, Jensen,...

  7. Whooping Crane Transplant Experiment progress reports and supporting documents : 1977

    Data.gov (United States)

    US Fish and Wildlife Service, Department of the Interior — This collection of documents support the Whooping Crane transplant experiment on Grays Lake NWR and supporting Refuges including Monte Vista, Cora, Lonetree, Jensen,...

  8. Whooping Crane Transplant Experiment progress reports and supporting documents : 1982

    Data.gov (United States)

    US Fish and Wildlife Service, Department of the Interior — This collection of documents support the Whooping Crane transplant experiment on Grays Lake NWR and supporting Refuges including Monte Vista, Cora, Lonetree, Jensen,...

  9. Whooping Crane Transplant Experiment progress reports and supporting documents : 1983

    Data.gov (United States)

    US Fish and Wildlife Service, Department of the Interior — This collection of documents support the Whooping Crane transplant experiment on Grays Lake NWR and supporting Refuges including Monte Vista, Cora, Lonetree, Jensen,...

  10. Whooping Crane Transplant Experiment progress reports and supporting documents : 1986

    Data.gov (United States)

    US Fish and Wildlife Service, Department of the Interior — This collection of documents support the Whooping Crane transplant experiment on Grays Lake NWR and supporting Refuges including Monte Vista, Cora, Lonetree, Jensen,...

  11. The Amistad Research Center: Documenting the African American Experience.

    Science.gov (United States)

    Chepesiuk, Ron

    1993-01-01

    Describes the Amistad Research Center housed at Tulane University which is a repository of primary documents on African-American history. Topics addressed include the development and growth of the collection; inclusion of the American Missionary Association archives; sources of support; civil rights; and collecting for the future. (LRW)

  12. Documenting resident procedure and diagnostic experience: simplifying the process.

    Science.gov (United States)

    Baldor, R A; Broadhurst, J

    1997-10-01

    The Residency Review Committee (RRC) requires documentation of family practice residents' procedural and diagnostic experiences. Further, hospital privileging is frequently based on documentation of prior clinical experience. Residency programs need a user-friendly (ie, resident-friendly) mechanism for collecting data and generating reports to document these experiences. This paper outlines a simplified, user-friendly method of documenting resident procedural and diagnostic experiences. We developed a pocket-sized, optically scannable card for data input. This is coupled with a computerized database with report generation capability. The system is based on diagnostic clusters to further simplify the data input process. The system's setup costs are about $10,000. Annual maintenance and operational fees are about $5,000. After instituting the system, the number of residents submitting documentation information increased substantially. This system meets both RRC and potential clinical privileging requirements and provides a useful tool for guiding resident evaluation and developing appropriate training opportunities during the latter half of the residency. Simplified, accurate documentation may allow for comparisons among residents at various levels--program, state, and national.

  13. Human Rights Texts: Converting Human Rights Primary Source Documents into Data

    National Research Council Canada - National Science Library

    Fariss, Christopher J; Linder, Fridolin J; Jones, Zachary M; Crabtree, Charles D; Biek, Megan A; Ross, Ana-Sophia M; Kaur, Taranamol; Tsai, Michael

    2015-01-01

    We introduce and make publicly available a large corpus of digitized primary source human rights documents which are published annually by monitoring agencies that include Amnesty International, Human...

  14. Detector Control System for an LHC experiment - User Requirements Document

    CERN Document Server

    CERN. Geneva

    1997-01-01

    The purpose of this document is to provide the user requirements for a detector control system kernel for the LHC experiments following the ESA standard PSS-05 [1]. The first issue will be used to provide the basis for an evaluation of possible development philosophies for a kernel DCS. As such it will cover all the major functionality but only to a level of detail sufficient for such an evaluation to be performed. Many of the requirements are therefore intentionally high level and generic, and are meant to outline the functionality that would be required of the kernel DCS, but not yet to the level of the detail required for implementation. The document is also written in a generic fashion in order not to rule out any implementation technology.

  15. ISAL experiment documentation of vertical tail and OMS pods

    Science.gov (United States)

    1983-01-01

    Investigation of Space Transportation System (STS) Atmospheric Luminosities (ISAL) experiment documentation includes vertical tail and orbital maneuvering system (OMS) pods with surface glow against the blackness of space. This glowing scene was provided by a long duration exposure with a 35mm camera aimed toward the tail of the Earth-orbiting Challenger, Orbiter Vehicle (OV) 099. OV-099 was maneuvered to a 120-nautical-mile altitude and flown with open payload bay (PLB) in the velocity vector for the conducting of a test titled, 'Evaluation of Oxygen Interaction with Materials (EOIM)'. Atomic oxygen within the low orbital environment is known to be extremely reactive when in contact with solid surfaces. In the darkened area between the camera and the glowing OMS pods and vertical stabilizer are two trays of test materials.

  16. Dead Documents Resurrected: Using a Tablet PC with Primary Source Materials

    Science.gov (United States)

    King, Andrew; Thomas, Matt; Nickens, Nicole

    2005-01-01

    With a multitude of primary resource materials now available on the Internet, people are able to access rich content to aid in their understanding of trends, events, and relationships across recorded history. However, understanding the content and making meaning from it is often still a struggle. Primary source documents, intrinsically powerful in…

  17. Primary School Principals' Experiences with Smartphone Apps

    Science.gov (United States)

    Çakir, Rahman; Aktay, Sayim

    2016-01-01

    Smartphones are not just pieces of hardware, they at same time also dip into software features such as communication systems. The aim of this study is to examine primary school principals' experiences with smart phone applications. Shedding light on this subject means that this research is qualitative. Criterion sampling has been intentionally…

  18. Dangerous Journey: Documenting the Experience of Tibetan Refugees

    Science.gov (United States)

    Dolma, Sonam; Singh, Sonal; Lohfeld, Lynne; Orbinski, James J.; Mills, Edward J.

    2006-01-01

    Objectives. Since the 1950 invasion of Tibet by China, Tibetan refugees have attempted to flee into Nepal over the Himalayan mountains. We documented the experiences of a group of refugees making this journey. Methods. We conducted semistructured interviews with 50 recent refugees at the Tibetan Refugee Transit Centre in Kathmandu, Nepal. Results. Participants ranged in age from 8 to 56 years, and 21 were female. The average length of their journey from Tibet to Nepal was 34 days. During their journey, a majority of the refugees encountered authorities or became involved in altercations with Nepali Maoist groups. Most of these interactions resulted in extortion and threats of expulsion. Several Tibetans were tortured, beaten with weapons, threatened with being shot, and robbed. Three women were sexually assaulted at gunpoint. Conclusions. The refugees who took part in this study experienced physical and mental hardships and, often, human rights abuses on their journey to Nepal. International pressure is needed to prevent human rights violations and reduce potential long-term physical and mental health effects associated with this dangerous crossing. PMID:17018832

  19. Obesity perceptions and documentation among primary care clinicians at a rural academic health center.

    Science.gov (United States)

    Aleem, Sohaib; Lasky, Rosalind; Brooks, W Blair; Batsis, John A

    2015-01-01

    Obesity recognition in primary care is important to address the epidemic. We aimed to evaluate primary care clinician-reported documentation, management practices, beliefs and attitudes toward obesity compared to body mass index (BMI) calculation, obesity prevalence and actual documentation of obesity as an active problem in electronic health record in a rural academic center. Our target population for previously validated clinician survey was 56 primary care providers working at 3 sites. We used calendar year 2012 data for assessment of baseline system performance for metrics of documentation of BMI in primary care visits, and proportion of visits in patients with obesity with obesity as a problem. Standard statistical methods assessed the data. Survey response rate was 91%. Average age of respondents was 48.9 years and 62.7% were females. 72.5% clinicians reported having normal BMI. The majority of clinicians reported regularly documenting obesity as an active problem, and utilized motivational interviewing and basic good nutrition and healthy exercise. Clinicians identified lack of discipline and exercise time, access to unhealthy food and psychosocial issues as major barriers. Most denied disliking weight loss discussion or patients taking up too much time. In 21,945 clinic visits and 11,208 annual preventive care visits in calendar year 2012, BMI was calculated in 93% visits but obesity documentation as an active problem only 27% of patients meeting BMI criteria for obesity. Despite high clinician-reported documentation of obesity as an active problem, actual obesity documentation rates remained low in a rural academic medical center. Copyright © 2015 Asian Oceanian Association for the Study of Obesity. Published by Elsevier Ltd. All rights reserved.

  20. Bullying experience in primary school children

    Directory of Open Access Journals (Sweden)

    Farah Aulia

    2016-12-01

    Full Text Available Bullying is still a significant problem today. Bullying occurs starting from the primary level up to college. The impact of the bullying on victims can be a lonely, difficult to adjust, insecurity, low self-esteem, depression and the worst is suicide. The earlier effort to detect bullying experienced by children will be able to prevent long-term effects caused. This study was conducted on 258 students of class 4-5 primary school in Yogyakarta. Data was collected through open-ended questionnaires associated with feelings and experiences of bullying in schools both as perpetrators and victims. The result showed that students feel negative emotions associated with bullying at school and most children experience bullying at school with a variety of forms, ranging from physical, verbal and relational from peers at school. These findings have implications related to the effort to do the school to help students cope with the impact of bullying experienced.

  1. [The document of chemical risk assessment: experiences in small companies].

    Science.gov (United States)

    Sciarra, G; Aprea, M C; Cardelli, D; Giglioli, S; Luni, S; Nanni, C; Ridoni, M; Lucietto, L; Giomarelli, A; Fantacci, M; Marianelli, E

    2010-01-01

    Were examined 60 documents of chemical risk assessment of companies from 19 municipalities in the provinces of Siena and Grosseto. The review of evaluations was conducted initially by checking the internal coherence of the documents. What emerged was subsequently analyzed together with the staff who performed the inspection. Although in 12 companies has been declared the presence of carcinogens, in only 5 the evaluation of exposure have been done using measures, others have used models or other techniques. Overall assessment showed that only 8 out of 60 (13.3%) were wrote correctly.

  2. [Experience in treating mucoceles in Primary Care].

    Science.gov (United States)

    Sabando Carranza, J A; Cortés Martinez, M; Calvo Carrasco, D

    2016-03-01

    Several cases of mucocele have been treated in our Primary Health Care centre. These are benign lesions, relatively frequent (2.5/1000), which is caused by a retention of mucous from the minor salivary glands into the oral cavity, mainly at the level of the lower lip. The experience in their treatment in this centre is presented, along with a review of the literature to see if our treatment was correct. Copyright © 2015 Sociedad Española de Médicos de Atención Primaria (SEMERGEN). Publicado por Elsevier España, S.L.U. All rights reserved.

  3. Human Rights Texts: Converting Human Rights Primary Source Documents into Data

    Science.gov (United States)

    Fariss, Christopher J.; Linder, Fridolin J.; Jones, Zachary M.; Crabtree, Charles D.; Biek, Megan A.; Ross, Ana-Sophia M.; Kaur, Taranamol; Tsai, Michael

    2015-01-01

    We introduce and make publicly available a large corpus of digitized primary source human rights documents which are published annually by monitoring agencies that include Amnesty International, Human Rights Watch, the Lawyers Committee for Human Rights, and the United States Department of State. In addition to the digitized text, we also make available and describe document-term matrices, which are datasets that systematically organize the word counts from each unique document by each unique term within the corpus of human rights documents. To contextualize the importance of this corpus, we describe the development of coding procedures in the human rights community and several existing categorical indicators that have been created by human coding of the human rights documents contained in the corpus. We then discuss how the new human rights corpus and the existing human rights datasets can be used with a variety of statistical analyses and machine learning algorithms to help scholars understand how human rights practices and reporting have evolved over time. We close with a discussion of our plans for dataset maintenance, updating, and availability. PMID:26418817

  4. Human Rights Texts: Converting Human Rights Primary Source Documents into Data.

    Science.gov (United States)

    Fariss, Christopher J; Linder, Fridolin J; Jones, Zachary M; Crabtree, Charles D; Biek, Megan A; Ross, Ana-Sophia M; Kaur, Taranamol; Tsai, Michael

    2015-01-01

    We introduce and make publicly available a large corpus of digitized primary source human rights documents which are published annually by monitoring agencies that include Amnesty International, Human Rights Watch, the Lawyers Committee for Human Rights, and the United States Department of State. In addition to the digitized text, we also make available and describe document-term matrices, which are datasets that systematically organize the word counts from each unique document by each unique term within the corpus of human rights documents. To contextualize the importance of this corpus, we describe the development of coding procedures in the human rights community and several existing categorical indicators that have been created by human coding of the human rights documents contained in the corpus. We then discuss how the new human rights corpus and the existing human rights datasets can be used with a variety of statistical analyses and machine learning algorithms to help scholars understand how human rights practices and reporting have evolved over time. We close with a discussion of our plans for dataset maintenance, updating, and availability.

  5. Nursing Minimum Data Sets for documenting nutritional care for adults in primary healthcare: a scoping review.

    Science.gov (United States)

    Håkonsen, Sasja Jul; Pedersen, Preben Ulrich; Bjerrum, Merete; Bygholm, Ann; Peters, Micah D J

    2018-01-01

    To identify all published nutritional screening instruments that have been validated in the adult population in primary healthcare settings and to report on their psychometric validity. Within health care, there is an urgent need for the systematic collection of nursing care data in order to make visible what nurses do and to facilitate comparison, quality assurance, management, research and funding of nursing care. To be effective, nursing records should accurately and comprehensively document all required information to support safe and high quality care of patients. However, this process of documentation has been criticized from many perspectives as being highly inadequate. A Nursing Minimum Data Set within the nutritional area in primary health care could therefore be beneficial in order to support nurses in their daily documentation and observation of patients. The review considered studies that included adults aged over 18 years of any gender, culture, diagnosis and ethnicity, as well as nutritional experts, patients and their relatives. The concepts of interest were: the nature and content of any nutritional screening tools validated (regardless of the type of validation) in the adult population in primary healthcare; and the views and opinions of eligible participants regarding the appropriateness of nutritional assessment were the concept of interest. Studies included must have been conducted in primary healthcare settings, both within home care and nursing home facilities. This scoping review used a two-step approach as a preliminary step to the subsequent development of a Nursing Minimum Data Set within the nutritional area in primary healthcare: i) a systematic literature search of existing nutritional screening tools validated in primary health care; and ii) a systematic literature search on nutritional experts opinions on the assessment of nutritional nursing care of adults in primary healthcare as well as the views of patients and their relatives

  6. Pharmacist-documented interventions during the dispensing process in a primary health care facility in Qatar

    Directory of Open Access Journals (Sweden)

    Richard Hooper

    2009-11-01

    Full Text Available Richard Hooper1, Abdullah Adam2, Nadir Kheir31Medical Services Department, 2Pharmacy Department, Medical Services, Qatar Petroleum, Doha, Qatar; 3Qatar University, College of Pharmacy, Doha, QatarObjectives: To characterize prescribing error interventions documented by pharmacists in four pharmacies in a primary health care service in Qatar.Methods: The study was conducted in a primary health care service in the State of Qatar in the period from January to March 2008. Pharmacists in four clinics within the service used online, integrated health care software to document all clinical interventions made. Documented information included: patient’s age and gender, drug therapy details, the intervention’s details, its category, and its outcome. Interventions were categorized according to the Pharmaceutical Care Network Europe Classification of drug-related problems (DRP.Results: The number of patients who had their prescriptions intercepted were 589 (0.71% of the total 82,800 prescriptions received. The intercepted prescriptions generated 890 DRP-related interventions (an average of 1.9% DRPs identified across the four clinics. Fifty-four percent of all interventions were classified as drug choice problems, and 42% had safety problems (dose too high, potential significant interaction. The prescriber accepted the intervention in 53% of all interventions, and the treatment was changed accordingly. Interventions as a result of transcription errors, legality and formulary issues were eliminated from this study through the use of computerized physician order entry (CPOE.Conclusions: Documenting and analyzing interventions should be a routine activity in pharmacy practice setting in primary health care services. Educational outreach visits and other strategies can improve prescribing practices and enhance patient safety.Keywords: pharmacists, interventions, prescribing errors

  7. Primary Vertex Reconstruction at the ATLAS Experiment

    CERN Document Server

    Grimm, Kathryn; The ATLAS collaboration

    2016-01-01

    Efficient and precise reconstruction of the primary vertex in an LHC collision is essential in both the reconstruction of the full kinematic properties of a hard-scatter event and of soft interactions as a measure of the amount of pile-up. The reconstruction of primary vertices in the busy, high pile-up environment of Run-2 of the LHC is a challenging task. New methods have been developed by the ATLAS experiment to reconstruct vertices in such environments. Advances in vertex seeding include methods taken from medical imaging, which allow for reconstruction of multiple vertices with small spatial separation. The adoption of this new seeding algorithm within the ATLAS adaptive vertex finding and fitting procedure will be discussed, and the first results of the new techniques from Run-2 data will be presented. Additionally, data-driven methods to evaluate vertex resolution will be presented with special focus on correct methods to evaluate the effect of the beam spot constraint; results from these methods in Ru...

  8. Using Qualitative Research to Document Variations in Student Experience

    Science.gov (United States)

    Friedensen, Rachel E.; McCrae, Byron P.; Kimball, Ezekiel

    2017-01-01

    This chapter describes a qualitative study focused on the experiences of students with disabilities within the postsecondary learning environment. Reporting unexpected findings related to athletics, it makes the case that qualitative methods are well-suited for revealing information about minoritized student populations.

  9. Nazi Medical Experiment Report: Evidence from the Nuremberg Medical Trial. Teaching with Documents.

    Science.gov (United States)

    Haverkamp, Beth; Schamel, Wynell

    1995-01-01

    Describes the historical background to the Nuremberg War Trials. Asserts that there is a wealth of evidence in the National Archives documenting atrocities committed by the Nazis. Presents primary source documents used in the Trials and provides seven suggested teaching strategies. (CFR)

  10. Nursing Minimum Data Sets for documenting nutritional care for adults in primary healthcare

    DEFF Research Database (Denmark)

    Håkonsen, Sasja Jul; Pedersen, Preben Ulrich; Bjerrum, Merete

    2018-01-01

    OBJECTIVE: To identify all published nutritional screening instruments that have been validated in the adult population in primary healthcare settings and to report on their psychometric validity. INTRODUCTION: Within health care, there is an urgent need for the systematic collection of nursing...... views were identified. CONCLUSIONS: The nutritional screening instruments have solely been validated in an over-55 population. Construct validity was the type of validation most frequently used in the validation process covering a total of 25 of the 29 tools. Two studies were identified in relation...... to the third review question. These two documents are both consensus statement documents developed by experts within the geriatric and nutritional care field. Overall, experts find it appropriate to: i) conduct a comprehensive geriatric assessment, ii) use a validated nutritional screening instrument, and iii...

  11. Documenting women's experiences: displaced women in Bweyale (central Uganda).

    Science.gov (United States)

    1999-01-01

    This paper reports experiences of displaced women in Bweyale, Central Uganda. It is noted that Bweyale is an example of a settlement that has mushroomed as a result in internally displaced people. The population is composed of the natives, the migrants from different parts of Uganda, the internally displaced people mainly from Gulu and Kitgum, and refugees from Sudan. Among this population, the internally displaced people, especially women, are the most disadvantaged and poor. Despite such a discouraging situation, the women's association of Ribbe Aye Tekko has managed to build their own office and run a self-help scheme. Included in the paper is a detailed account of the experiences of a 56-year-old woman, Mary A., who was living in Bweyale as a displaced person. Although the women's association has been noted as a success, they still need more funding for their self-help schemes in order to achieve their aim of improving the standard of living of their members.

  12. Primary Vertex Reconstruction with the ATLAS Experiment

    CERN Document Server

    Casper, David William; The ATLAS collaboration

    2017-01-01

    ATLAS reconstructs primary vertices with high efficiency and resolution. These vertices serve as input to other mission critical analysis tools, and are relied on by many physics analyses. This presentation surveys the ATLAS primary vertex reconstruction algorithms, and describes validity checks done using real data. The complications introduced by pileup are discussed, along with refinements currently under study.

  13. VET in Schools Students: Characteristics and Post-School Employment and Training Experiences. Support Document

    Science.gov (United States)

    Misko, Josie; Korbel, Patrick; Blomberg, Davinia

    2017-01-01

    This document was produced by the author based on their research for the report, "VET in Schools Students: Characteristics and Post-School Employment and Training Experiences," and is an added resource for further information. This support document presents the variables used and the findings of the supplementary analysis in the linked…

  14. User Experience document on VRC Design Guide - D6.1

    OpenAIRE

    Kale Namrata; Haug Kenneth; Moreno Pablo

    2015-01-01

    This document is a comprehensive report on the first user experience (UX) workshop hosted to ensure a user centric design and usability of the PhenoMeNal Virtual Research Environment (VRE), aka. Virtual Research Community (VRC).

  15. Continuity of Care Document (CCD) Enables Delivery of Medication Histories to the Primary Care Clinician

    Science.gov (United States)

    Simonaitis, Linas; Belsito, Anne; Cravens, Gary; Shen, Changyu; Overhage, J. Marc

    2010-01-01

    Introduction: The goal of the Enhanced Medication History (EMH) project is to provide medication histories to ambulatory primary care practices in the Indiana Network for Patient Care. Methods: Medications were aggregated from three different sources of pharmacy data (Medicaid, SureScripts, and the county health system of Indianapolis). Dispensing events were assembled into the Continuity of Care Document (CCD), and presented to clinicians as RxNorm Clinical Drugs. Results: The EMH project completed 46 weeks of operation in a community health center in Indianapolis. Medication Histories were generated for 10498 office visits for 4449 distinct patients. Seven (of nine) attending physicians responded to a written survey and found the Medication Histories useful (3.9±0.4 on a scale of 1 to 5). Conclusion: Implementation of the EMH project demonstrated the successful use (as well as the challenging aspects) of the CCD and the RxNorm terminology in the outpatient clinical setting. PMID:21347078

  16. Documenting coordination of cancer care between primary care providers and oncology specialists in Canada.

    Science.gov (United States)

    Brouwers, Melissa C; Vukmirovic, Marija; Tomasone, Jennifer R; Grunfeld, Eva; Urquhart, Robin; O'Brien, Mary Ann; Walker, Melanie; Webster, Fiona; Fitch, Margaret

    2016-10-01

    To report on the findings of the CanIMPACT (Canadian Team to Improve Community-Based Cancer Care along the Continuum) Casebook project, which systematically documented Canadian initiatives (ie, programs and projects) designed to improve or support coordination and continuity of cancer care between primary care providers (PCPs) and oncology specialists. Pan-Canadian environmental scan. Canada. Individuals representing the various initiatives provided data for the analysis. Initiatives included in the Casebook met the following criteria: they supported coordination and collaboration between PCPs and oncology specialists; they were related to diagnosis, treatment, survivorship, or personalized medicine; and they included breast or colorectal cancer or both. Data were collected on forms that were compiled into summaries (ie, profiles) for each initiative. Casebook initiatives were organized based on the targeted stage of the cancer care continuum, jurisdiction, and strategy (ie, model of care or type of intervention) employed. Thematic analysis identified similarities and differences among employed strategies, the level of primary care engagement, implementation barriers and facilitators, and initiative evaluation. The CanIMPACT Casebook profiles 24 initiatives. Eleven initiatives targeted the survivorship stage of the cancer care continuum and 15 focused specifically on breast or colorectal cancer or both. Initiative teams implemented the following strategies: nurse patient navigation, multidisciplinary care teams, electronic communication or information systems, PCP education, and multicomponent initiatives. Initiatives engaged PCPs at various levels. Implementation barriers included lack of care standardization across jurisdictions and incompatibility among electronic communication systems. Implementation facilitators included having clinical and program leaders publicly support the initiative, repurposing existing resources, receiving financial support, and

  17. Advisory Committee on human radiation experiments. Supplemental Volume 2a, Sources and documentation appendices. Final report

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1995-01-01

    This large document provides a catalog of the location of large numbers of reports pertaining to the charge of the Presidential Advisory Committee on Human Radiation Research and is arranged as a series of appendices. Titles of the appendices are Appendix A- Records at the Washington National Records Center Reviewed in Whole or Part by DoD Personnel or Advisory Committee Staff; Appendix B- Brief Descriptions of Records Accessions in the Advisory Committee on Human Radiation Experiments (ACHRE) Research Document Collection; Appendix C- Bibliography of Secondary Sources Used by ACHRE; Appendix D- Brief Descriptions of Human Radiation Experiments Identified by ACHRE, and Indexes; Appendix E- Documents Cited in the ACHRE Final Report and other Separately Described Materials from the ACHRE Document Collection; Appendix F- Schedule of Advisory Committee Meetings and Meeting Documentation; and Appendix G- Technology Note.

  18. [Experience in laser treatment of primary glaucoma].

    Science.gov (United States)

    Mel'nikov, V Ia; Osykhovskiĭ, A L; Dogadova, D P

    1995-01-01

    An Interdistrict Laser Center has been functioning in Vladivostok for 10 years. Laser exposure was used in the treatment of 749 patients with primary glaucoma. Yatagan-1, Orion-3001, YAG Pegaus-3002 lasers (Germany) were employed. In 55% cases primary glaucoma was concomitant with essential hypertension, in 12% with diabetes mellitus. Laser iridectomy, laser goniopuncture, laser trabeculoplasty were used. Hypotensive effect lasting for at least 6 months was attained in 69.1% cases. Complications presenting as hemorrhages in the anterior chamber, which spontaneously resolved on day 2 after exposure, were observed in only 4% cases. Laser therapy in patients aged 50 to 70 is the only means of reducing ophthalmic tone and preserving the visual function because of somatic diseases present at this age. Laser treatment of primary glaucoma brings about an appreciable economic effect and creates favorable conditions for subsequent microsurgery.

  19. Learning experiences of physiotherapy students during primary ...

    African Journals Online (AJOL)

    Background. Primary healthcare (PHC) is necessary to address the health needs of communities. It creates the opportunity for the attainment of curricular outcomes through community-based education. Appropriate learning opportunities are needed to enable students to develop the necessary skills to attain these outcomes ...

  20. Conducting experiments on cultural aspects of document design: Why and how?

    NARCIS (Netherlands)

    Hoeken, J.A.L.; Korzilius, H.P.L.M.

    2003-01-01

    In order to answer the question whether it is wise to adapt a document to the culture it is to be used in, one can conduct an experiment with ‘cultural difference’ as one of the main variables. In this article, we discuss three problems that researchers encounter when conducting such experiments.

  1. Primary sclerosing cholangitis - the Norwegian experience.

    Science.gov (United States)

    Schrumpf, Erik; Boberg, Kirsten Muri; Karlsen, Tom H

    2015-06-01

    Research related to primary sclerosing cholangitis (PSC) has since 1980 been a major activity at the Oslo University Hospital Rikshospitalet. The purpose of this publication is to describe the development of this research, the impact of this research on the clinical handling of the patients, and finally to describe what we believe are the most urgent, remaining problems to be solved. During the early years, our research dealt primarily with clinical aspects of the disease. The concomitant inflammatory bowel disease (IBD) seen in most patients with PSC was a major interest and we also started looking into genetic associations of PSC. Prognosis, malignancy development and treatment with special emphasis on transplantation have later been dealt with. These activities has had impact on several aspects of PSC management; when and how to diagnose PSC and variant forms of PSC, how to handle IBD in PSC and how to deal with the increased rate of malignancy? The problems remaining to be solved are many. What is the role of the gut and the gut microbiota in the development of PSC? Do the PSC patients have an underlying disturbance in the bile homeostasis? And how does the characteristic type of fibrosis in PSC develop? The genetic studies have supported a role for the adaptive immune system in the disease development, but how should this be dealt with? Importantly, the development of malignancy in PSC is still not understood, and we lack appropriate medical treatment for our patients.

  2. Glow experiment documentation of OMS/RCS pods and vertical stabilizer

    Science.gov (United States)

    1982-01-01

    Glow experiment documentation of orbital maneuvering system (OMS) reaction control system (RCS) pods and vertical stabilizer shows chemo-luminescent effect resulting from atomic oxygen impacting the spacecraft and building to the point that the atomic oxygen atoms combine to form molecules of oxygen. Image intensifier on NIKON 35mm camera was used to record glow on vertical tail and OMS pods.

  3. Glow experiment documentation of OMS/RCS pod and vertical stabilizer

    Science.gov (United States)

    1982-01-01

    Glow experiment documentation of one of the orbital maneuvering system (OMS) reaction control system (RCS) pods and a portion of the vertical stabilizer shows chemoluminescent effectresulting from atomic oxygen impacting the spacecraft and building to the point that the atomic oxygen atoms combine to form molecules of oxygen. The Image Intensifier on NIKON 35mm camera was used to record the glow.

  4. Teacher Educators: Course Experiences of Bachelor of Education Primary Students

    Science.gov (United States)

    Bentley-Williams, Robyn; Forbes, Anne

    2012-01-01

    This investigation examined the course experiences of Bachelor of Education Primary students across each year of the course. The aims of the study were to identify gaps in what we know about our students; to identify relevant domains in student experiences and to assist with course improvements. A reflective inquiry paradigm was adopted for…

  5. Exposure to primary healthcare for medical students: experiences of ...

    African Journals Online (AJOL)

    2009-12-03

    Dec 3, 2009 ... Results: The students reported that the practical experience enhanced their skills in handling patients in primary care settings. They developed an ... medical students with practical learning experiences outside the traditional .... IPC block provided the link between theory and practice. One student noted that ...

  6. Counseling Psychology Doctoral Students' Training Experiences in Primary Care Psychology

    Science.gov (United States)

    Cox, Jared

    2011-01-01

    This qualitative study focused on counseling psychology doctoral students' perspectives regarding their practicum training experience in primary care psychology. The four participants included three females and one male. Semi-structured individual and focus group interviews were used to explore participants' experiences. The participants described…

  7. Documentation of body mass index and control of associated risk factors in a large primary care network

    Directory of Open Access Journals (Sweden)

    Grant Richard W

    2009-12-01

    Full Text Available Abstract Background Body mass index (BMI will be a reportable health measure in the United States (US through implementation of Healthcare Effectiveness Data and Information Set (HEDIS guidelines. We evaluated current documentation of BMI, and documentation and control of associated risk factors by BMI category, based on electronic health records from a 12-clinic primary care network. Methods We conducted a cross-sectional analysis of 79,947 active network patients greater than 18 years of age seen between 7/05 - 12/06. We defined BMI category as normal weight (NW, 18-24.9 kg/m2, overweight (OW, 25-29.9, and obese (OB, ≥ 30. We measured documentation (yes/no and control (above/below of the following three risk factors: blood pressure (BP ≤130/≤85 mmHg, low-density lipoprotein (LDL ≤130 mg/dL (3.367 mmol/L, and fasting glucose Results BMI was documented in 48,376 patients (61%, range 34-94%, distributed as 30% OB, 34% OW, and 36% NW. Documentation of all three risk factors was higher in obesity (OB = 58%, OW = 54%, NW = 41%, p for trend Conclusions In a large primary care network BMI documentation has been incomplete and for patients with BMI measured, risk factor control has been poorer in obese patients compared with NW, even in those with obesity and CVD or diabetes. Better knowledge of BMI could provide an opportunity for improved quality in obesity care.

  8. Experiences of newly qualified professional nurses in primary health ...

    African Journals Online (AJOL)

    The purpose of this study was to explore and describe the experiences of professional nurses during their first two years of professional service, inclusive of one year of community service in Primary Health Care facilities in the Eastern Cape Province. The study followed a qualitative and exploratory approach. Its design was ...

  9. Improving skilled attendants at birth: Experience in a primary health ...

    African Journals Online (AJOL)

    Background: Skilled attendance at birth has been identified as one of the most cost-effective methods of reducing maternal and neonatal mortality, but in spite of the efforts made to address the poor access in Nigeria, utilization in some communities is surprisingly poor. This study highlighted the experience of a primary ...

  10. Primary Health Care That Works: The Costa Rican Experience.

    Science.gov (United States)

    Pesec, Madeline; Ratcliffe, Hannah L; Karlage, Ami; Hirschhorn, Lisa R; Gawande, Atul; Bitton, Asaf

    2017-03-01

    Long considered a paragon among low- and middle-income countries in its provision of primary health care, Costa Rica reformed its primary health care system in 1994 using a model that, despite its success, has been generally understudied: basic integrated health care teams. This case study provides a detailed description of Costa Rica's innovative implementation of four critical service delivery reforms and explains how those reforms supported the provision of the four essential functions of primary health care: first-contact access, coordination, continuity, and comprehensiveness. As countries around the world pursue high-quality universal health coverage to attain the Sustainable Development Goals, Costa Rica's experiences provide valuable lessons about both the types of primary health care reforms needed and potential mechanisms through which these reforms can be successfully implemented. Project HOPE—The People-to-People Health Foundation, Inc.

  11. Documentation of meteorological data from the coniferous forest biome primary station in Oregon.

    Science.gov (United States)

    R.H. Waring; H.R. Holbo; R.P. Bueb; R.L. Fredriksen

    1978-01-01

    As part of the International Biological Program, a primary meteorological station was installed in the west-central Cascade Range of Oregon. Short-wave solar radiation, air temperature, dewpoint temperature, windspeed, and precipitation are recorded continuously. Climatic data are summarized in a daily record available from May 11, 1972, to date. This report details...

  12. No Exceptions: Documenting the Abortion Experiences of US Peace Corps Volunteers.

    Science.gov (United States)

    Foster, Angel M; Arnott, Grady; Parniak, Simone; LaRoche, Kathryn J; Trussell, James

    2015-01-01

    Since 1979, US federal appropriations bills have prohibited the use of federal funds from covering abortion care for Peace Corps volunteers. There are no exceptions; unlike other groups that receive health care through US federal funding streams, including Medicaid recipients, federal employees, and women in federal prisons, abortion care is not covered for volunteers even in cases of life endangerment, rape, or incest. We interviewed 433 returned Peace Corps volunteers to document opinions of, perceptions about, and experiences with obtaining abortion care. Our results regarding the abortion experiences of Peace Corps volunteers, especially those who were raped, bear witness to a profound inequity and show that the time has come to lift the "no exceptions" funding ban on abortion coverage.

  13. Advisory Committee on human radiation experiments. Final report, Supplemental Volume 2. Sources and documentation

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1995-01-01

    This volume and its appendixes supplement the Advisory Committee`s final report by reporting how we went about looking for information concerning human radiation experiments and intentional releases, a description of what we found and where we found it, and a finding aid for the information that we collected. This volume begins with an overview of federal records, including general descriptions of the types of records that have been useful and how the federal government handles these records. This is followed by an agency-by-agency account of the discovery process and descriptions of the records reviewed, together with instructions on how to obtain further information from those agencies. There is also a description of other sources of information that have been important, including institutional records, print resources, and nonprint media and interviews. The third part contains brief accounts of ACHRE`s two major contemporary survey projects (these are described in greater detail in the final report and another supplemental volume) and other research activities. The final section describes how the ACHRE information-nation collections were managed and the records that ACHRE created in the course of its work; this constitutes a general finding aid for the materials deposited with the National Archives. The appendices provide brief references to federal records reviewed, descriptions of the accessions that comprise the ACHRE Research Document Collection, and descriptions of the documents selected for individual treatment. Also included are an account of the documentation available for ACHRE meetings, brief abstracts of the almost 4,000 experiments individually described by ACHRE staff, a full bibliography of secondary sources used, and other information.

  14. Start App: a coding experience between primary and secondary school

    Directory of Open Access Journals (Sweden)

    Filippo Bruni

    2016-04-01

    Full Text Available The paper presents a coding experience in primary school (“Colozza” in Campobasso. Within the theoretical framework offered by computational thinking, using App Inventor, it was created a calculator for smartphone in the Android environment. High school students (from a technical secondary school guided the pupils in primary school, making an interesting form of cooperation between primary and secondary schools. Start App: una esperienza di coding tra scuola primaria e scuola secondariaIl contributo presenta una esperienza di coding nella scuola primaria dell’Istituto Comprensivo statale “Colozza” di Campobasso. All’interno della cornice teorica offerta dal pensiero computazionale, utilizzando App Inventor, è stata realizzata una calcolatrice per smartphone in ambiente Android. A guidare gli allievi della primaria sono stati gli studenti dell’Istituto Tecnico Industriale “Marconi” di Campobasso realizzando una interessante forma di collaborazione tra istituti scolastici di ordine diverso.

  15. [Sharing experiences: rotation in primary care in Posadas, Argentina].

    Science.gov (United States)

    García-Garrido, A B; Caballero, L G; Basiuk, S

    2013-09-01

    Primary care should be the cornerstone of any health system. It is the first contact with the community health system of any country. The Declaration of Alma-Ata, 1978, seeks to provide the basis for the construction of a new health system that will allow the full exercise of the right to health. Carrying out an external rotation in Primary Care in Posadas, Misiones Province, Argentina, during medical training, in family medicine, offers an insight into how other health systems work, provide health care to the community in a Primary Care Center in a country with its similarities and differences like ours, follow the implementation of programs, working with family medicine residents in another country, and living a rewarding personal and professional experience. Copyright © 2013 Sociedad Española de Médicos de Atención Primaria (SEMERGEN). Publicado por Elsevier España. All rights reserved.

  16. Patients' experiences of diabetes education teams integrated into primary care.

    Science.gov (United States)

    Grohmann, Barbara; Espin, Sherry; Gucciardi, Enza

    2017-02-01

    To explore patients' perspectives on care received from diabetes education teams (a registered nurse and a registered dietitian) integrated into primary care. Qualitative study using semistructured, one-on-one interviews. Three diabetes education programs operating in 11 primary care sites in one region of Ontario. Twenty-three patients with diabetes. Purposeful sampling was used to recruit participants from each site for interviews. Educator teams invited patients with whom they had met at least once to participate in semistructured interviews. Data were analyzed using thematic analysis with NVivo 11 software. The diabetes education teams integrated into primary care exhibited many of the principles of person-centred care, as evidenced by the 2 overarching themes. The first is personalized care, with the subthemes care environment, shared decision making, and patient preference for one-on-one care. Participants described feeling included in partnerships with their health care providers, as they collaborated with physicians and diabetes educators to develop knowledge and set goals in the convenience and comfort of their usual primary care settings. Many participants also expressed a preference for one-on-one sessions. The second theme is patient-provider relationship, with the subthemes respect, supportive interaction, and facilitating patient engagement. Supportive environments created by the educators built trusting relationships, where patients expressed enhanced motivation to improve their self-care. Diabetes educators integrated into primary care can serve to enrich the experience of patients, provide key education to improve patient understanding, and support primary care physicians in providing timely and comprehensive clinical care. Diabetes patients appear to benefit from convenient access to interprofessional teams of educators in primary care to support diabetes self-management. Copyright© the College of Family Physicians of Canada.

  17. Clinical and practical requirements of online software for anesthesia documentation an experience report.

    Science.gov (United States)

    Benson, M; Junger, A; Quinzio, L; Fuchs, C; Sciuk, G; Michel, A; Marquardt, K; Hempelmann, G

    2000-07-01

    The aim of this paper is the presentation of a new version of the anesthesia documentation software, NarkoData, that has been used in routine clinical work in our department as part of an anesthesia information management system (AIMS) since 1995. The performance of this software is presented along with requirements for future development of such a system. The originally used version, NarkoData 3.0, is an online anesthesia documentation software established by the software company ProLogic GmbH. It was primarily developed as a disk-based system for the MacOS operating system (Apple Computer Inc.). Based on our routine experience with the system, a catalogue of requirements was developed that concentrated on improvement in the sequence of work, administration and data management. In 1996, the concepts developed in our department, in close co-operation with medical personnel and the software company, led to a considerable enlargement of the program functions and the subsequent release of a new version of NarkoData. Since 1997, more than 20 000 anesthesia procedures have been recorded annually with this new version at 115 decentralized work stations at our university hospital.

  18. Space Station Furnace Facility. Experiment/Facility Requirements Document (E/FRD), volume 2, appendix 5

    Science.gov (United States)

    Kephart, Nancy

    1992-01-01

    The function of the Space Station Furnace Facility (SSFF) is to support materials research into the crystal growth and solidification processes of electronic and photonic materials, metals and alloys, and glasses and ceramics. To support this broad base of research requirements, the SSFF will employ a variety of furnace modules operated, regulated, and supported by a core of common subsystems. Furnace modules may be reconfigured or specifically developed to provide unique solidifcation conditions for each set of experiments. The SSFF modular approach permits the addition of new or scaled-up furnace modules to support the evolution of the facility as new science requirements are identified. The SSFF Core is of modular design to permit augmentation for enhanced capabilities. The fully integrated configuration of the SSFF will consist of three racks with the capability of supporting up to two furnace modules per rack. The initial configuration of the SSFF will consist of two of the three racks and one furnace module. This Experiment/Facility Requirements Document (E/FRD) describes the integrated facility requirements for the Space Station Freedom (SSF) Integrated Configuration-1 (IC1) mission. The IC1 SSFF will consist of two racks: the Core Rack, with the centralized subsystem equipment, and the Experiment Rack-1, with Furnace Module-1 and the distributed subsystem equipment to support the furnace.

  19. Abusive experiences and psychiatric morbidity in women primary care attenders.

    Science.gov (United States)

    Coid, Jeremy; Petruckevitch, Ann; Chung, Wai-Shan; Richardson, Jo; Moorey, Stirling; Feder, Gene

    2003-10-01

    Abusive experiences in childhood and adulthood increase risks of psychiatric morbidity in women and independently increase risks of further abuse over the lifetime. It is unclear which experiences are most damaging. To measure lifetime prevalence of abusive experiences and psychiatric morbidity, and to analyse associations in women primary care attenders. A cross-sectional, self-report survey of 1207 women attending 13 surgeries in the London borough of Hackney, UK. Independent associations between demographic measures, abusive experiences and psychiatric outcome were established using logistic regression. Childhood sexual abuse had few associations with adult mental health measures, in contrast to physical abuse. Sexual assault in adulthood was associated with substance misuse; rape with anxiety, depression and post-traumatic stress disorder but not substance misuse. Domestic violence showed strongest associations with most mental health measures, increased for experiences in the past year. Abuse in childhood and adulthood have differential effects on mental health; effects are increased by recency and severity. Women should be routinely questioned about ongoing and recent experiences as well as childhood.

  20. Examining organizational change in primary care practices: experiences from using ethnographic methods.

    Science.gov (United States)

    Russell, Grant; Advocat, Jenny; Geneau, Robert; Farrell, Barbara; Thille, Patricia; Ward, Natalie; Evans, Samantha

    2012-08-01

    Qualitative methods are an important part of the primary care researcher's toolkit providing a nuanced view of the complexity in primary care reform and delivery. Ethnographic research is a comprehensive approach to qualitative data collection, including observation, in-depth interviews and document analysis. Few studies have been published outlining methodological issues related to ethnography in this setting. This paper examines some of the challenges of conducting an ethnographic study in primary care setting in Canada, where there recently have been major reforms to traditional methods of organizing primary care services. This paper is based on an ethnographic study set in primary care practices in Ontario, Canada, designed to investigate changes to organizational and clinical routines in practices undergoing transition to new, interdisciplinary Family Health Teams (FHTs). The study was set in six new FHTs in Ontario. This paper is a reflexive examination of some of the challenges encountered while conducting an ethnographic study in a primary care setting. Our experiences in this study highlight some potential benefits of and difficulties in conducting an ethnographic study in family practice. Our study design gave us an opportunity to highlight the changes in routines within an organization in transition. A study with a clinical perspective requires training, support, a mixture of backgrounds and perspectives and ongoing communication. Despite some of the difficulties, the richness of this method has allowed the exploration of a number of additional research questions that emerged during data analysis.

  1. ON EXPERIENCE OF THE ELECTRONIC DOCUMENT MANAGEMENT SYSTEM IMPLEMENTATION IN THE MEDICAL UNIVERSITY

    Directory of Open Access Journals (Sweden)

    A. V. Semenets

    2015-05-01

    Full Text Available An importance of the application of the electronic document management to the Ukraine healthcare is shown. The electronic document management systems market overview is presented. Example of the usage of the open-source electronic document management system in the Ternopil State Medical University by I. Ya. Horbachevsky is shown. The implementation capabilities of the electronic document management system within a cloud services are shown. The electronic document management features of the Microsoft Office 365 and Google Apps For Education are compared. Some results of the usage of the Google Apps For Education inTSMUas electronic document management system are presented.

  2. Experiment/facility requirements document for the Space Station Furnace Facility. Section 1: Integrated configuration

    Science.gov (United States)

    1992-01-01

    The function of the Space Station Furnace Facility (SSFF) is to support materials research into the crystal growth and solidification processes of electronic and photonic materials, metals and alloys, and glasses and ceramics. To support this broad base of research requirements, the SSFF will employ a variety of furnace modules which will be operated, regulated, and supported by a core of common subsystems. Furnace modules may be reconfigured or specifically developed to provide unique solidification conditions for each set of experiments. The SSFF modular approach permits the addition of new or scaled-up furnace modules to support the evolution of the facility as new science requirements are identified. The SSFF Core is of modular design to permit augmentation for enhanced capabilities. The fully integrated configuration of the SSFF will consist of three racks with the capability of supporting up to two furnace modules per rack. The initial configuration of the SSFF will consist of two of the three racks and one furnace module. This Experiment/Facility Requirements Document (E/FRD) describes the integrated facility requirements for the Space Station Freedom (SSF) Integrated Configuration-1 (IC1) mission. The IC1 SSFF will consist of two racks: the Core Rack, with the centralized subsystem equipment; and the Experiment Rack-1, with Furnace Module-1 and the distributed subsystem equipment to support the furnace. The SSFF support functions are provided by the following Core subsystems: power conditioning and distribution subsystem (SSFF PCDS); data management subsystem (SSFF DMS); thermal control Subsystem (SSFF TCS); gas distribution subsystem (SSFF GDS); and mechanical structures subsystem (SSFF MSS).

  3. Teaching America's Founding Documents.

    Science.gov (United States)

    Tucker, James

    1993-01-01

    Reflects on the author's experiences teaching a course on great documents in American history to high school students, concentrating on teaching the Declaration of Independence and the "Federalist Papers." Countering the students' tendencies toward superficial reading and encouraging deep analysis are the teacher's primary goals. (SLD)

  4. [Consensus document for the detection and management of Chagas disease in primary health care in a non-endemic areas].

    Science.gov (United States)

    Roca Saumell, Carme; Soriano-Arandes, Antoni; Solsona Díaz, Lluís; Gascón Brustenga, Joaquim

    2015-05-01

    Chagas disease is caused by the protozoan Trypanosoma cruzi. Although it is commonly transmitted by an insect vector in continental Latin-America, in recent decades, due migration, has been diagnosed in other countries such Spain, the European country with a largest immigrant population of Latin American. For a long time, the patient remains asymptomatic, but some years after this stage, the symptoms can be serious (dilated cardiomyopathy, megacolon, megaesophagus). In addition, detection in pregnant women has a high priority because of the route of vertical transmission. Several specific guidelines about Chagas disease has been developed on the Banks of blood, maternal hospitals, HIV co-infection, organ transplant. But due to the detection of lack of information to primary care professionals, we consider to will be useful this document written and agreed to by family phisicians, pediatricians and specialists in International Health. Copyright © 2014 Elsevier España, S.L.U. All rights reserved.

  5. Experience of Behvarzes (Iranian primary healthcare providers) from giving primary health services in health houses.

    Science.gov (United States)

    Keshvari, Mahrokh; Mohammadi, Eesa; Farajzadegan, Ziba; Zargham-Boroujeni, Ali

    2016-01-01

    Primary healthcare (PHC) providers play a major role in provision of public health in rural areas in Iran. They are considered as the key elements of health development in rural population. There is limited research on clarification of their experiences from provision of health services in their working conditions. This study aimed to clarify the experience of PHC providers from working conditions in giving primary health services in health houses (district branches of rural health care centers). This is a content analysis qualitative study, conducted through personal and group interviews with 12 health workers working in health care centers in rural areas in Isfahan province, 2010. Sampling continued until data saturation. Data were analyzed through conventional content analysis and constant comparative method. Data analysis led to extraction of 11 categories, and finally, four themes of "ignoring the rights," "causing tension in working climate," "pressure or overload of expectations beyond the power," and "occupational worn out" were yielded from the categories. These themes reveal the concepts and nature of PHC providers' experiences from giving health care at health houses as the first level of PHC centers. The results of the present study showed that the PHC providers work in a tense condition in health houses. Although they devote themselves to the health of society members, their own health is neglected. Policy makers and authorities should amend working conditions of PHC providers through modification of resources and making supportive and collaborative strategies to improve the quality of services and promote the health level of the service receivers.

  6. Medication documentation in a primary care network serving North Carolina medicaid patients: results of a cross-sectional chart review

    Directory of Open Access Journals (Sweden)

    Olson Matthew D

    2012-08-01

    Full Text Available Abstract Background Medical records that do not accurately reflect the patient’s current medication list are an open invitation to errors and may compromise patient safety. Methods This cross-sectional study compares primary care provider (PCP medication lists and pharmacy claims for 100 patients seen in 8 primary care practices and examines the association of congruence with demographic, clinical, and practice characteristics. Medication list congruence was measured as agreement of pharmacy claims with the entire PCP chart, including current medication list, visit notes, and correspondence sections. Results Congruence between pharmacy claims and the PCP chart was 65%. Congruence was associated with large chronic disease burden, frequent PCP visits, group practice, and patient age ≥45 years. Conclusion Agreement of medication lists between the PCP chart and pharmacy records is low. Medication documentation was more accurate among patients who have more chronic conditions, those who have frequent PCP visits, those whose practice has multiple providers, and those at least 45 years of age. Improved congruence among patients with multiple chronic conditions and in group practices may reflect more frequent visits and reviews by providers.

  7. Attributes affecting the medical school primary care experience.

    Science.gov (United States)

    Jerant, Anthony; Srinivasan, Malathi; Bertakis, Klea D; Azari, Rahman; Pan, Richard J; Kravitz, Richard L

    2010-04-01

    Favorable primary care (PC) experiences might encourage more medical students to pursue generalist careers, yet academicians know little about which attributes influence the medical school PC experience. The authors sought to identify such attributes and weight their importance. Semistructured interviews with 16 academic generalist leaders of family medicine, general internal medicine, and general pediatrics led to the development of a Web-based survey, administered to a national sample of 126 generalist faculty. Survey respondents rated (on a nine-point Likert-like scale) the importance of each interview-generated PC medical school attribute and indicated (yes/no) whether outside experts' assessment of the attributes would be valid. The authors assessed interrater agreement. Interview thematic analysis generated 58 institutional attributes in four categories: informal curriculum (23), institutional infrastructure (6), educational/curricular infrastructure (6), and specific educational experiences (23). Of these 58, 31 (53%) had median importance ratings of >7 (highly important). For 14 of these (45%), more than two-thirds of respondents indicated external expert surveys would provide a valid assessment. Of the 23 informal curriculum attributes, 20 (87%) received highly important ratings; however, more than two-thirds of respondents believed that external expert survey ratings would be valid for only 4 (20%) of them. Strong agreement occurred among respondents across the generalist fields. Academic generalist educators identified several attributes as highly important in shaping the quality of the medical school PC experience. Informal curriculum attributes appeared particularly influential, but these attributes may not be validly assessed via expert surveys, suggesting the need for other measures.

  8. Patients' preferences for primary health care - a systematic literature review of discrete choice experiments.

    Science.gov (United States)

    Kleij, Kim-Sarah; Tangermann, Ulla; Amelung, Volker E; Krauth, Christian

    2017-07-11

    Primary care is a key element of health care systems and addresses the main health problems of the population. Due to the demographic change, primary care even gains in importance. The knowledge of the patients' preferences can help policy makers as well as physicians to set priorities in their effort to make health care delivery more responsive to patients' needs. Our objective was to describe which aspects of primary care were included in preference studies and which of them were the most preferred aspects. In order to elicit the preferences for primary care, a systematic literature search was conducted. Two researchers searched three electronic databases (PubMed, Scopus, and PsycINFO) and conducted a narrative synthesis. Inclusion criteria were: focus on primary health care delivery, discrete choice experiment as elicitation method, and studies published between 2006 and 2015 in English language. We identified 18 studies that elicited either the patients' or the population's preferences for primary care based on a discrete choice experiment. Altogether the studies used 16 structure attributes, ten process attributes and four outcome attributes. The most commonly applied structure attribute was "Waiting time till appointment", the most frequently used process attribute was "Shared decision making / professional's attention paid to your views". "Receiving the 'best' treatment" was the most commonly applied outcome attribute. Process attributes were most often the ones of highest importance for patients or the population. The attributes and attribute levels used in the discrete choice experiments were identified by literature research, qualitative research, expert interviews, or the analysis of policy documents. The results of the DCE studies show different preferences for primary health care. The diversity of the results may have several reasons, such as the method of analysis, the selection procedure of the attributes and their levels or the specific research

  9. Primary Teachers and ICT: Is gender, age or experience important?

    Directory of Open Access Journals (Sweden)

    Graham Morley

    2011-12-01

    Full Text Available The research uses both qualitative and quantitative methodologies employing multiple sources of data collection. The data collection primarily used a questionnaire survey of primary schools in two English Local Authorities. The qualitative evidence of the teacher sample was through individual semi-structured interviews and a focus group interview of Local Authorities officers. There is an evidence trail which examines academic papers, HMI, QCA, Ofsted and DfES reports. The main findings from these reports indicate that teachers were becoming familiar with the use of computers. They understood the skills involved in using computers but were still uncertain as to a suitable pedagogy which made them lack confidence when using ICT in the classroom. Teachers’ major difficulty is finding time to keep pace or develop their ICT skills. The reports have a generic view of teachers, with no further analysis of gender, age or experience phenomena. The analysis of these variables concludes that teacher subject knowledge formed through teaching experience of the subject, informs teachers when computers aid teaching and learning.

  10. Experience Using the Web-Based Tool Wiki for Architecture Documentation

    National Research Council Canada - National Science Library

    Bachmann, Felix; Merson, Paulo

    2005-01-01

    In an organization that uses an architecture-centric development approach, it is the purpose of the software architecture, especially the product documentation to guide all stakeholders who contribute...

  11. [Physical therapy in pediatric primary care: a review of experiences].

    Science.gov (United States)

    de Sá, Miriam Ribeiro Calheiros; Thomazinho, Paula de Almeida; Santos, Fabiano Luiz; Cavalcanti, Nicolette Celani; Ribeiro, Carla Trevisan Martins; Negreiros, Maria Fernanda Vieira; Vinhaes, Marcia Regina

    2014-11-01

    To review pediatric physical therapy experiences described in the literature and to analyze the production of knowledge on physical therapy in the context of pediatric primary health care (PPHC). A systematic review was conducted according to the PRISMA criteria. The following databases were searched: MEDLINE, LILACS, SciELO, PubMed, Scopus and Cochrane; Brazilian Ministry of Health's CAPES doctoral dissertations database; and System for Information on Grey Literature in Europe (SIGLE). The following search terms were used: ["primary health care" and ("physical therapy" or "physiotherapy") and ("child" or "infant")] and equivalent terms in Portuguese and Spanish, with no restriction on publication year. Thirteen articles from six countries were analyzed and grouped into three main themes: professional dilemmas (three articles), specific competencies and skills required in a PPHC setting (seven articles), and practice reports (four articles). Professional dilemmas involved expanding the role of physical therapists to encompass community environments and sharing the decision-making process with the family, as well as collaborative work with other health services to identify the needs of children. The competencies and skills mentioned in the literature related to the identification of clinical and sociocultural symptoms that go beyond musculoskeletal conditions, the establishment of early physical therapy diagnoses, prevention of overmedication, and the ability to work as team players. Practice reports addressed stimulation in children with neurological diseases, respiratory treatment, and establishing groups with mothers of children with these conditions. The small number of studies identified in this review suggests that there is little knowledge regarding the roles of physical therapists in PPHC and possibly regarding the professional abilities required in this setting. Therefore, further studies are required to provide data on the field, along with a continuing

  12. The performance of diphoton primary vertex reconstruction methods in H → γγ+Met channel of ATLAS experiment

    Science.gov (United States)

    Tomiwa, K. G.

    2017-09-01

    The search for new physics in the H → γγ+met relies on how well the missing transverse energy is reconstructed. The Met algorithm used by the ATLAS experiment in turns uses input variables like photon and jets which depend on the reconstruction of the primary vertex. This document presents the performance of di-photon vertex reconstruction algorithms (hardest vertex method and Neural Network method). Comparing the performance of these algorithms for the nominal Standard Model sample and the Beyond Standard Model sample, we see the overall performance of the Neural Network method of primary vertex selection performed better than the Hardest vertex method.

  13. Counterstories about Leadership: A Latina School Principal's Experience from a Less Documented View in an Urban School Context

    Science.gov (United States)

    Hernandez, Frank; Murakami, Elizabeth

    2016-01-01

    Latina/o school leaders are receiving increasing visibility in research based on their representation in K-12 administrative ranks. However, even though they bring cultural knowledge in providing social and academic support to teachers, families, and especially students of color, their own experiences still reflect less documented histories and…

  14. Light: an experiments based learning approach with primary school children

    Science.gov (United States)

    Abreu, Cátia; Noversa, Silvana; Varela, Paulo; Costa, Manuel F.

    2014-07-01

    A pedagogical intervention project was carried out at a primary school in the municipality of Vila Verde, Braga in Portugal. In a class of the 3rd grade, composed of 16 students, a practice of inquiry-based science teaching was implemented, addressing the curricular topic "Light Experiments". Various experimental activities were planned within this topic, including: What is light? How does light travel? Does light travel through every material? How is light reflected by a mirror? This project adopted an action research methodology and had as its main objectives: a) to promote a practical and experimental approach to the science component of the Environmental Studies curricular area; b) to describe the scientific meaning construction process inherent to the topics addressed in the classroom with the children, c) to assess the learning steps and children' achievements. Class diaries were prepared, based on field notes and audio recordings taken in the classroom. Through the analysis of the class diary concerning the topic "materials that let light travel through them" we intend to illustrate the process of construction of scientific meanings promoted in the classroom with our approach.

  15. Non-Oriental primary intrahepatic lithiasis: experience with 48 cases.

    Science.gov (United States)

    Herman, Paulo; Bacchella, Telesforo; Pugliese, Vincenzo; Montagnini, André L; Machado, Marcel Autran C; da Cunha, José Eduardo M; Machado, Marcel C C

    2005-07-01

    An experience with the diagnosis and treatment of patients with non-Oriental primary intrahepatic lithiasis (PIHL) is described. A group of 48 native Brazilian patients with symptomatic PIHL were studied, and the patients' characteristics, diagnoses, treatment protocols based on the presentation of the disease, prognostic factors, and late results were analyzed. Liver resection was performed in patients with an irreversible lesion, such as parenchymal atrophy or biliary stenosis; and biliary drainage procedures were employed in patients with bilateral disease. Late results were considered good when no postoperative symptoms were observed and poor if there was pain recurrence or cholangitis. Overall good results were observed in 73.4% of the patients. Good late results were observed in 94.1% and 62.1% of the patients with unilateral and bilateral stones, respectively. None of the analyzed parameters (gender, age, previous biliary surgery, bilirubin level, serum leukocyte counts, prothrombin activity, previous history of cholangitis, stone location) predicted poor late results, but the risk for patients with bilateral stones to develop late complications was 7.2 times higher than for those with unilateral disease. Non-Oriental PIHL is a rare disease, and the patients' characteristics are similar to those of patients with Oriental PIHL. We believe that personalized treatment based on the presentation of the disease led to the high incidence of good late results in this series.

  16. Documentation of sexual partner gender is low in electronic health records: observations, predictors, and recommendations to improve population health management in primary care.

    Science.gov (United States)

    Nguyen, Giang T; Yehia, Baligh R

    2015-06-01

    The 2011 Institute of Medicine report on LGBT health recommended that sexual orientation and gender identity (SO/GI) be documented in electronic health records (EHRs). Most EHRs cannot document all aspects of SO/GI, but some can record gender of sexual partners. This study sought to determine the proportion of patients who have the gender of sexual partners recorded in the EHR and to identify factors associated with documentation. A retrospective analysis was done of EHR data for 40 family medicine (FM) and general internal medicine (IM) practices, comprising 170,570 adult patients seen in 2012. The primary outcome was EHR documentation of sexual partner gender. Multivariate logistic regression assessed the impact of patient, provider, and practice factors on documentation. In all, 76,767 patients (45%) had the gender of sexual partners recorded, 4.3% of whom had same-gender partners (3.5% of females, 5.6% of males). Likelihood of documentation was independently higher for women; blacks; those with a preventive visit; those with a physician assistant, nurse practitioner, or resident primary care provider (vs. attending); those at urban practices; those at smaller practices; and those at a residency FM practice. Older age and Medicare insurance were associated with lower documentation. Sexual partner gender documentation is important to identify patients for targeted prevention and support, and holds great potential for population health management, yet documentation in the EHR currently is low. Primary care practices should routinely record the gender of sexual partners, and additional work is needed to identify best practices for collecting and using SO/GI data in this setting.

  17. In-hospital prescription changes and documentation in the medical records of the primary care provider: results from a medical record review study.

    Science.gov (United States)

    Poldervaart, Judith M; van Melle, Marije A; Willemse, Sanne; de Wit, Niek J; Zwart, Dorien L M

    2017-11-29

    An increasing number of transitions due to substitution of care of more complex patients urges insight in and improvement of transitional medication safety. While lack of documentation of prescription changes and/or lack of information exchange between settings likely cause adverse drug events, frequency of occurrence of these causes is not clear. Therefore, we aimed at determining the frequency of in-hospital patients’ prescription changes that are not or incorrectly documented in their primary care provider’s (PCP) medical record. A medical record review study was performed in a database linking patients’ medical records of hospital and PCP. A random sample (n = 600) was drawn from all 1399 patients who were registered at a participating primary care practice as well as the gastroenterology or cardiology department in 2013 of the University Medical Center Utrecht, the Netherlands. Outcomes were the number of in-hospital prescription changes that was not or incorrectly documented in the medical record of the PCP, and timeliness of documentation. Records of 390 patients included one or more primary-secondary care transitions; in total we identified 1511 transitions. During these transitions, 408 in-hospital prescription changes were made, of which 31% was not or incorrectly documented in the medical record of the PCP within the next 3 months. In case changes were documented, the median number of days between hospital visit and documentation was 3 (IQR 0–18). One third of in-hospital prescription changes was not or incorrectly documented in the PCP’s record, which likely puts patients at risk of adverse drug events after hospital visits. Such flawed reliability of a routine care process is unacceptable and warrants improvement and close monitoring.

  18. Survey of Ontario primary care physicians’ experiences with opioid prescribing

    Science.gov (United States)

    Wenghofer, Elizabeth Francis; Wilson, Lynn; Kahan, Meldon; Sheehan, Carolynn; Srivastava, Anita; Rubin, Ava; Brathwaite, Joanne

    2011-01-01

    Abstract Objective To measure physicians’ experiences with opioid-related adverse events and their perceived level of confidence in their opioid prescribing skills and practices. Design Mailed survey. Setting The province of Ontario. Participants A total of 1000 primary care physicians randomly selected from the College of Physicians and Surgeons of Ontario registration database. Main outcome measures Opioid-related adverse events and concerns (eg, number of patients, type of opioid, cause of the event or concern); physicians’ confidence, comfort, and satisfaction with opioid prescribing; physicians’ opinions on strategies to optimize their prescribing; and physicians’ perspectives of their interactions with pharmacists and nurses. Results The response rate was close to 66%, for a total of 658 participants. Almost all respondents reported prescribing opioids for chronic pain in the past 3 months. Eighty-six percent of respondents reported being confident in their prescribing of opioids, but 42% of respondents indicated that at least 1 patient had experienced an adverse event related to opioids in the past year, usually involving oxycodone, and 16.3% of respondents did not know if their patients had experienced any opioid-related adverse events. The most commonly cited factors leading to adverse events were that the patient took more than prescribed, the prescribed dose was too high, or the patient took alcohol or sedating drugs with the opioids. Most physicians had concerns about the opioid use of 1 or more of their patients; concerns included running out of opioids early, minimal access to pain and addiction treatment, and addiction and overdose. The reported number of physicians’ patients taking opioids was positively associated with their confidence and comfort levels in opioid prescribing and negatively associated with their belief that many patients become addicted to opioids. Conclusion Most physicians have encountered opioid-related adverse events

  19. Survey of Ontario primary care physicians' experiences with opioid prescribing.

    Science.gov (United States)

    Wenghofer, Elizabeth Francis; Wilson, Lynn; Kahan, Meldon; Sheehan, Carolynn; Srivastava, Anita; Rubin, Ava; Brathwaite, Joanne

    2011-03-01

    To measure physicians' experiences with opioid-related adverse events and their perceived level of confidence in their opioid prescribing skills and practices. Mailed survey. Setting The province of Ontario. A total of 1000 primary care physicians randomly selected from the College of Physicians and Surgeons of Ontario registration database. Opioid-related adverse events and concerns (eg, number of patients, type of opioid, cause of the event or concern); physicians' confidence, comfort, and satisfaction with opioid prescribing; physicians' opinions on strategies to optimize their prescribing; and physicians' perspectives of their interactions with pharmacists and nurses. The response rate was close to 66%, for a total of 658 participants. Almost all respondents reported prescribing opioids for chronic pain in the past 3 months. Eighty-six percent of respondents reported being confident in their prescribing of opioids, but 42% of respondents indicated that at least 1 patient had experienced an adverse event related to opioids in the past year, usually involving oxycodone, and 16.3% of respondents did not know if their patients had experienced any opioid-related adverse events. The most commonly cited factors leading to adverse events were that the patient took more than prescribed, the prescribed dose was too high, or the patient took alcohol or sedating drugs with the opioids. Most physicians had concerns about the opioid use of 1 or more of their patients; concerns included running out of opioids early, minimal access to pain and addiction treatment, and addiction and overdose. The reported number of physicians' patients taking opioids was positively associated with their confidence and comfort levels in opioid prescribing and negatively associated with their belief that many patients become addicted to opioids. Most physicians have encountered opioid-related adverse events. Comprehensive strategies are required to promote safe prescribing of opioids, including

  20. Primary cardiac tumours in a paediatric population: An experience ...

    African Journals Online (AJOL)

    Background: To observe the histopathological spectrum of primary cardiac tumours in paediatric population those came in Pathology Department over a period of last 16 years. Materials and Methods: During the time period of 16 years (1995-2010), we had received 16 cases of primary cardiac tumours in paediatric patients ...

  1. Exposure to primary healthcare for medical students: experiences of ...

    African Journals Online (AJOL)

    Introduction: Recognising the importance of primary healthcare in the achievement of the 1997 White Paper for the Transformation of the Health System and the Millennium Development Goals, the Faculty of Health Sciences of the University of the Witwatersrand introduced an integrated primary care (IPC) block.

  2. From Field Work to Deliverables. Experiences on the Tin House Courtyard Documentation

    Science.gov (United States)

    Bello Caballero, L.; Mezzino, D.; Federman, A.; Santana Quintero, M.

    2017-08-01

    The Tin House Courtyard is a property of the National Capital Commission (NCC) in Ottawa, Canada. The site is located within the `Mile of History', a historical route running from Parliament Hill to the Governor General's residence. Currently, existing assets are under intervention works that include several preservation and renewal actions. Within the broader project, one of the tasks before construction works started was the documentation of the set of facades. The Carleton Immersive Media Studio (CIMS) at Carleton University in Ottawa was commissioned by NCC to conduct the recording of the area. This paper describes the process undertaken from field work to the final deliverable to the client, as well as the issues faced in between. Nowadays, up to date surveying technologies have revolutionized the methodologies for cultural heritage documentation. In this regard, the recording strategy employed encompassed the use of photogrammetry, laser scanner, total station, as well as different pre and post processing software in order to generate the desired outcomes.

  3. Results of site validation experiments. Volume II. Supporting documents 5 through 14

    Energy Technology Data Exchange (ETDEWEB)

    1983-01-01

    Volume II contains the following supporting documents: Summary of Geologic Mapping of Underground Investigations; Logging of Vertical Coreholes - ''Double Box'' Area and Exploratory Drift; WIPP High Precision Gravity Survey; Basic Data Reports for Drillholes, Brine Content of Facility Internal Strata; Mineralogical Content of Facility Interval Strata; Location and Characterization of Interbedded Materials; Characterization of Aquifers at Shaft Locations; and Permeability of Facility Interval Strate.

  4. The experiences of primary school educators with the national ...

    African Journals Online (AJOL)

    nrs) in Mbabane circuit, Ingwavuma. ... This study confirms the importance of understanding how teachers' biographical data relate to and impact on reading intervention strategies. Keywords: National Reading Strategy, primary school, ...

  5. Effects of Viewing a Presidential Primary Debate: An Experiment.

    Science.gov (United States)

    Lemert, James B.; And Others

    1983-01-01

    Studied the effects of the February 20, 1980, debate involving seven Republican candidates. Results strongly suggest that watching a televised debate early in the presidential primary season can increase respondents' interest in, and knowledge about, the campaign. (PD)

  6. Women's, midwives' and obstetricians' experiences of a structured process to document refusal of recommended maternity care.

    Science.gov (United States)

    Jenkinson, Bec; Kruske, Sue; Stapleton, Helen; Beckmann, Michael; Reynolds, Maree; Kildea, Sue

    2016-12-01

    Ethical and professional guidance for midwives and obstetricians emphasises informed consent and respect for patient autonomy; the right to refuse care is well established. However, the existing literature is largely silent on the appropriate clinical responses when pregnant women refuse recommended care, and accounts of disrespectful interactions and conflict are numerous. Policies and processes to support women and maternity care providers are rare and unstudied. To document the perspectives of women, midwives and obstetricians following the introduction of a structured process (Maternity Care Plan; MCP) to document refusal of recommended maternity care in a large tertiary maternity unit. A qualitative, interpretive study involved thematic analysis of in-depth semi-structured interviews with women (n=9), midwives (n=12) and obstetricians (n=9). Four major themes were identified including: 'Reassuring and supporting clinicians'; 'Keeping the door open'; 'Varied awareness, criteria and use of the MCP process' and 'No guarantees'. Clinicians felt protected and reassured by the structured documentation and communication process and valued keeping women engaged in hospital care. This, in turn, protected women's access to maternity care. However, the process could not guarantee favourable responses from other clinicians subsequently involved in the woman's care. Ongoing discussions of risk, perceived by women and some midwives to be pressure to consent to recommended care, were still evident. These limitations may have been attributable to the absence of agreed criteria for initiating the MCP process and fragmented care. Varying awareness and use of the process also diminished women's access to it. Copyright © 2016 Australian College of Midwives. Published by Elsevier Ltd. All rights reserved.

  7. An Experience in Cultural Heritage Documentation in Iran Using a Low-Cost Technique

    Science.gov (United States)

    Hassani, F.; Rafiee, M.

    2013-07-01

    Today, the need for preservation of cultural heritage as an important, irreplaceable resource for human is well recognized. In this regard, prior to any conservational measure, detailed documentation and recording of these precious resources should be performed; since this way, not only preservation requirements of the object will be identified, but also the existing condition will be recorded for future generations. Accordingly, since Iran is known as an ancient land possesses valuable historic resources, and due the numerousness of Iran's monuments and the high possibility of occurring natural disasters which are counted as significant threats for the monuments, the necessity of fast and appropriate documentation in this country will be clarified. This paper is in fact a part of the project entitled "Study of the application of digital technologies in recording and rehabilitation of historic buildings" in Iran. Here, the surveying process of aforesaid project's case study which is one of the two Kharraqan Tomb Towers placed in Qazvin province of Iran, using close range photogrammetry and low cost equipment will be demonstrated.

  8. AN EXPERIENCE IN CULTURAL HERITAGE DOCUMENTATION IN IRAN USING A LOW-COST TECHNIQUE

    Directory of Open Access Journals (Sweden)

    F. Hassani

    2013-07-01

    Full Text Available Today, the need for preservation of cultural heritage as an important, irreplaceable resource for human is well recognized. In this regard, prior to any conservational measure, detailed documentation and recording of these precious resources should be performed; since this way, not only preservation requirements of the object will be identified, but also the existing condition will be recorded for future generations. Accordingly, since Iran is known as an ancient land possesses valuable historic resources, and due the numerousness of Iran's monuments and the high possibility of occurring natural disasters which are counted as significant threats for the monuments, the necessity of fast and appropriate documentation in this country will be clarified. This paper is in fact a part of the project entitled "Study of the application of digital technologies in recording and rehabilitation of historic buildings" in Iran. Here, the surveying process of aforesaid project's case study which is one of the two Kharraqan Tomb Towers placed in Qazvin province of Iran, using close range photogrammetry and low cost equipment will be demonstrated.

  9. Dabigatran experience in primary and secondary prevention of cardioembolic stroke

    Directory of Open Access Journals (Sweden)

    Maksim Alekseyevich Domashenko

    2013-01-01

    Full Text Available The review of novel oral anticoagulants (dabigatran, rivaroxaban and apixaban in stroke prevention and also own data of administration of dabigatran in primary and secondary prevention of ischemic stroke in 45 patients with cerebrovascular diseases are presented. Most patients received dabigatran 14 days after the first stroke associated with nonvalvular atrial fibrillation. In other cases dabigatran was used for primary prevention of stroke in patients with chronic forms of cerebrovascular diseases and nonvalvular atrial fibrillation. Dabigatran shows good tolerability and efficacy. Recurrent strokes were diagnosed in 2 patients. The reasons for these events were arterial hypertension in one case and symptomatic atherosclerotic plaque in the other case.

  10. Physical fatigue characterises patient experience of primary Sjogren's syndrome

    NARCIS (Netherlands)

    Arends, S.; Meiners, P.; Moerman, R. V.; Kroese, F. G. M.; Brouwer, Liesbeth; Spijkervet, F. K. L.; Vissink, A.; Bootsma, H.

    2017-01-01

    Objective Besides ocular and oral dryness, fatigue is a major symptom in patients with primary Sjogren's syndrome (pSS). Our aim was to investigate the importance of fatigue in relation to other symptoms experienced as well as to evaluate the effect of rituximab treatment on fatigue in pSS patients

  11. The Experiences of Female Head Teachers in Rural Primary ...

    African Journals Online (AJOL)

    The under-representation of women in leadership positions in primary schools is common in many developing countries, raising issues of equity, social justice and sustainable development. This article presents part of an investigation for a Master's dissertation (Parsaloi, 2012). The broad research aim was to investigate the ...

  12. Arabic-speaking students' primary care experiences in Scotland.

    Science.gov (United States)

    Ahmed, Amel Ibrahim; Cameron, Shona; Dickson, Caroline; Mountain, Kristina

    2010-02-01

    Internationalisation of the higher education sector has resulted in greater ethnic and cultural diversity within the student population throughout the UK and European Union. There is limited knowledge about the burden of poor health and health care utilisation among minority ethnic groups in higher education. Scottish health policy is directed toward proactive care delivered within primary care settings. The community of one university in Scotland was chosen to explore the perceptions of accessibility and acceptability of primary care among one minority group, namely Arabic speakers. The research methodology was of an exploratory descriptive design, with a convenience sample of Arabic speakers studying at one university. Quantitative and qualitative data were provided by 20 respondents. A questionnaire elicited demographic data and information about any primary care services used, while semi-structured interviews gathered more in-depth data. Participants were generally satisfied with primary health services. The majority were satisfied with the availability of a healthcare professional of their preferred gender, and their communication with and attitudes of healthcare professionals, as well as the health information provided. Recommendations include greater availability of written information in Arabic, and further research concerning cultural competence for healthcare professionals.

  13. Exposure to primary healthcare for medical students: experiences of ...

    African Journals Online (AJOL)

    2009-12-03

    Dec 3, 2009 ... Introduction: Recognising the importance of primary healthcare in the achievement of the 1997 White Paper for the. Transformation of ..... and be support pillars for one another. The self-esteem of the students increased as they felt they had made a difference in the community. Discussion. Medical schools ...

  14. Geomedia in the primary school. An explorative study of European primary geography teachers' experience

    OpenAIRE

    Donadelli, Giovanni

    2017-01-01

    This study aims to provide further understanding on European primary geography teachers' conceptual and factual standpoint on the use of digital technologies in primary geography lessons by researching their technological, pedagogical and content knowledge (TPACK), together with their teaching praxis and their teaching context. The study includes both qualitative and quantitative methodology and consists of two research modules. The first is a large-scale survey administered online to a vo...

  15. Documenting Student Engagement Using an Intention/Reflection Exercise during an Advanced Pharmacy Practice Experience

    Science.gov (United States)

    Fierke, Kerry K.; Lepp, Gardner A.

    2015-01-01

    The article shares the outcomes of a practice called Intention/Reflection (I/R) when applied to a group of ten students in a five-week course involving an international advanced pharmacy practice experience. Developed by the authors and founded on a combination of theoretical principles, this practice is unique because of the blend of formative…

  16. Experiences and Outcomes of Preschool Physical Education: An Analysis of Developmental Discourses in Scottish Curricular Documentation

    Science.gov (United States)

    McEvilly, Nollaig

    2014-01-01

    This article provides an analysis of developmental discourses underpinning preschool physical education in Scotland's Curriculum for Excellence. Implementing a post-structural perspective, the article examines the preschool experiences and outcomes related to physical education as presented in the Curriculum for Excellence "health and…

  17. FAMINES, FIGHTS AND DEPRIVATION: THE NEOREALIST EXPERIENCE OR THE PORTUGUESE TIME DOCUMENTATION

    Directory of Open Access Journals (Sweden)

    Michele Dull Sampaio Beraldo Matter

    2014-04-01

    Full Text Available This article examines different images related to the food in literary texts and paintings of portuguese Neorealism in its configuration of missing - hunger - and its ideological conception - the hunger for freedom and dignity - thematic experience that gives inherently see the relationship of humans with their time and with his fellow man.

  18. Primary Care Providers' Perceptions of and Experiences with an Integrated Healthcare Model

    Science.gov (United States)

    Westheimer, Joshua M.; Steinley-Bumgarner, Michelle; Brownson, Chris

    2008-01-01

    Objective and Participants: The authors examined the experiences of primary care providers participating in an integrated healthcare service between mental health and primary care in a university health center. In this program, behavioral health providers work collaboratively with primary care providers in the treatment of students. Participants…

  19. Why Everyday Experience? Interpreting Primary Students' Science Discourse from the Perspective of John Dewey

    Science.gov (United States)

    Na, Jiyeon; Song, Jinwoong

    2014-01-01

    The purposes of this study were, based on John Dewey's ideas on experience, to examine how primary students used their own everyday experience and were affected by own and others' experience in science discourse, and to illuminate the implications of experience in science education. To do these, science discourses by a group of six…

  20. Documenting Community Health Worker Roles in Primary Care: Contributions to Evidence-Based Integration Into Health Care Teams, 2015.

    Science.gov (United States)

    Reinschmidt, Kerstin M; Ingram, Maia; Morales, Stephanie; Sabo, Samantha J; Blackburn, John; Murrieta, Lucy; David, Cassalyn; Carvajal, Scott C

    The Patient Protection and Affordable Care Act provided community health workers (CHWs) with new opportunities, and current efforts develop evidence-based guidelines for CHW integration into clinical teams. This qualitative study documents CHW roles and activities in 3 federally qualified health care centers in southern Arizona. Community health worker clinical roles, activities, and integration varied by health center and were in flux. Integration included complementary roles, scheduled and everyday communications with team members, and documentation in the electronic health records. These findings contribute to evidence-based guidelines for CHW integration into clinical teams that are critical to maximizing CHW contributions to patient health improvements.

  1. Documentation of Short Stack and Button Cell Experiments Performed at INL and Ceramatec during FY07

    Energy Technology Data Exchange (ETDEWEB)

    J. E. O' Brien; C. M. Stoots; J. J. Hartvigsen; J. S. Herring

    2007-09-01

    This report provides documentation of experimental research activities performed at the Idaho National Laboratory and at Ceramatec, Inc. during FY07 under the DOE Nuclear Hydrogen Initiative, High Temperature Electrolysis Program. The activities discussed in this report include tests on single (button) cells, short planar stacks and tubular cells. The objectives of these small-scale tests are to evaluate advanced electrode, electrolyte, and interconnect materials, alternate modes of operation (e.g., coelectrolysis), and alternate cell geometries over a broad range of operating conditions, with the aim of identifying the most promising material et, cell and stack geometry, and operating conditions for the high-temperature electrolysis application. Cell performance is characterized in erms of initial area-specific resistance and long-term stability in the electrolysis mode. Some of the tests were run in the coelectrolysis mode. Research into coelectrolysis was funded by Laboratory Directed Research and Development (LDRD). Coelectrolysis simultaneously converts steam to hydrogen and carbon dioxide to carbon monoxide. This process is complicated by the reverse shift reaction. An equilibrium model was developed to predict outlet compositions of steam, hydrogen, carbon dioxide, and carbon monoxide resulting from coelectrolysis. Predicted ompositions were compared to measurements obtained with a precision micro-channel gas chromatograph.

  2. Experiences of digital documentation of Carsulae on the Flaminian way in Umbria

    Directory of Open Access Journals (Sweden)

    Stefano Bertocci

    2014-04-01

    Full Text Available The Umbrian territory crossed by one track of the ancient Roman Flaminia Way,  presents settlements, monuments and art works connected with the old road network. During the centuries, the road track called Martana, which was marked in 223 a.C. by the Consul Flaminio, has coagulate an amount of settlements, like the town of Carsulae (Terni e Acquasparta, Sangemini, the settlement near S. Maria in Pantano (Massamartana, and monuments, like the Massamartana catacombs, rural churches, monasteries and castles. The conservation and the accessibility of all the sites lay down problems not only concerning merely the management of the survey, study and conservation campaign, but also, if the aim is to create a museum network, those related on one side with the improvement of a correct use of the sites, on the other with the realization of an executive program of digital documentation in order to guarantee the dissemination of the data in a Virtual Museum of the heritage itself. 

  3. Hypertension guideline implementation: experiences of Finnish primary care nurses

    DEFF Research Database (Denmark)

    Alanen, Seija; Ijäs, Jarja; Kaila, Minna

    2008-01-01

    RATIONALE, AIMS AND OBJECTIVES: Evidence-based guidelines on hypertension have been developed in many western countries. Yet, there is little evidence of their impact on the clinical practices of primary care nurses. METHOD: We assessed the style of implementation and adoption of the national...... Hypertension Guideline (HT Guideline) in 32 Finnish health centres classified in a previous study as 'disseminators' (n = 13) or 'implementers' (n = 19). A postal questionnaire was sent to all nurses (n = 409) working in the outpatient services in these health centres. Additionally, senior nursing officers...

  4. Irish Primary School Teachers' Experiences with Sport Education

    Science.gov (United States)

    Kinchin, Gary D.; MacPhail, Ann; Chroinin, Deirdre Ni

    2012-01-01

    Recent reviews illustrate the considerable literature on Sport Education. However, research on the experiences of non-specialist physical education teachers attempting Sport Education is limited. The focus of this research was to investigate non-specialist teachers' views on Sport Education and identify what possibilities might exist regarding…

  5. Psycho-social correlates of stressful experiences among primary ...

    African Journals Online (AJOL)

    Results showed among others that mentalhealth problems such as anxiety disorders, mood and substance related disorders, lack of social support, delayed promotion, family problems and job pressure are identified as major sources of stressful experiences among the participants. Secondly, the effects of the stressors on ...

  6. Perception and experience of menopause among primary school ...

    African Journals Online (AJOL)

    Background: As life expectancy increases,most women spent a larger part of their lives in the post-menopausal state,with part of this during the peak of their career for working class women. Perception, attitude and experience of the menopause and its transitional period may differ from one female population to the other.

  7. Safety assessment document (SAD) for the Princeton Beta Experiment Modification (PBX-M)

    Energy Technology Data Exchange (ETDEWEB)

    Stencel, J.R.; Parsells, R.F. (eds.)

    1988-04-01

    The Princeton Beta Experiment-Modification (PBX-M) is an experimental device of the tokamak type. A tokamak is characterized by a strong toroidal magnetic field composed of an externally driven component parallel to the torus centerline modified by the field produced by a transformer-driven current (OH) in the confined plasma. A second magnetic field parallel to the major toroidal axis is added to provide radial equilibrium for the plasma. As an advanced tokamak, PBX-M will have additional magnetic fields to reshape the plasma cross section from a circle into a kidney bean shape; it will also be equipped with 6MW or more of auxiliary heating power provided by four neutral beam injectors, with RF systems, and with an extensive set of diagnostics. Potential hazards associated with PBX-M, which are analyzed in this report, result from energy stored in the magnetic fields, high voltages necessary for the operation of some of the equipment and diagnostics, neutron radiation when the neutral beams are run with deuterium and x-rays, especially those emitted as a result of plasma-wall interaction. This report satisfies the requirements set forth in the PPPL Health and Safety Directives, specifically HSD-5003, and in DOE Order 5481.1B and its Chicago operations supplement (DOE86, DOE82).

  8. Primary myelofibrosis: own experience and news from diagnostic and treatment

    Directory of Open Access Journals (Sweden)

    K. M. Abdulkadyrov

    2015-01-01

    Full Text Available The newest advances in primary myelofibrosis (PMF pathogenesis study, diagnostic and treatment approaches are presented in this article. The JAK-STAT signal pathway activation now recognized as main pathogenesis mechanism of PMF, it caused by JAK2, CALR, MPL genes mutations. Authors demonstrate their own data about epidemiology, clinical signs, diagnostic and treatment results of 315 PMF patients. The most frequent clinical symptoms are: anemia, leukocytosis, thrombocytosis, splenomegaly, constitutional symptoms. Diagnostic criteria, prognostic scales (including cytogenetic and molecular features issues are reviewed. Intermediate-1 risk grade is in the most proportion of patients. Therecommended PMF treatment algorithm is listed. The treatment methods, target drugs (Janus kinases inhibitors trials results are discussed.

  9. Primary myelofibrosis: own experience and news from diagnostic and treatment

    Directory of Open Access Journals (Sweden)

    K. M. Abdulkadyrov

    2015-06-01

    Full Text Available The newest advances in primary myelofibrosis (PMF pathogenesis study, diagnostic and treatment approaches are presented in this article. The JAK-STAT signal pathway activation now recognized as main pathogenesis mechanism of PMF, it caused by JAK2, CALR, MPL genes mutations. Authors demonstrate their own data about epidemiology, clinical signs, diagnostic and treatment results of 315 PMF patients. The most frequent clinical symptoms are: anemia, leukocytosis, thrombocytosis, splenomegaly, constitutional symptoms. Diagnostic criteria, prognostic scales (including cytogenetic and molecular features issues are reviewed. Intermediate-1 risk grade is in the most proportion of patients. Therecommended PMF treatment algorithm is listed. The treatment methods, target drugs (Janus kinases inhibitors trials results are discussed.

  10. International classification of primary care: An Indian experience

    Directory of Open Access Journals (Sweden)

    Sajitha M. F. Rahman

    2014-01-01

    Full Text Available Background: India is in the process of transition to universal health coverage for Indian citizens. The focus is to strengthen the primary and secondary level services. Coupled with this national scenario, the development of Family medicine as a distinct discipline is in a crucial stage. There is a nation-wide urge to build family medicine training units and service centers across the country to fulfill the unmet health needs of the population. Objectives: This study aimed to bring out reasons for encounter (RFE and morbidity pattern of patients seen in a family physician run urban health center in South India. Methods: The study was conducted in an urban health center of a tertiary care hospital. Clinicians entered the data using International Classification of Primary Care (ICPC codes. Data included were demographics, 3 RFE, 3 diagnoses, 3 outcomes of care that include prescriptions, investigations, procedures, and referrals made. Results: During 47,590 patient encounters, 59,647 RFE, 62,283 diagnoses and 68269 outcomes of care were recorded. The majority of RFEs and diagnoses are in the following ICPC chapters: Endocrinology (38.6%, cardiovascular (35.91%, respiratory (20.26%, digestive (7.68% and musculo-skeletal (6.8%. The most frequent outcome of care was prescriptions, followed by counseling and nebulization. Conclusion: This study is the first to report on the RFE in India. This study demonstrated the breadth of clinical conditions seen by family physicians across all ages and in both genders. This study attempts to highlight the need for family physician based services as a training ground for trainees.

  11. Sources of Stress, Coping Strategies, Emotional Experience: Effects of the Level of Experience in Primary School Teachers in France

    Science.gov (United States)

    Carton, Annie; Fruchart, Eric

    2014-01-01

    This study attempted to determine whether the level of experience affected sources of stress, coping responses and emotional experience in primary school teachers. The first aim was to identify sources of stress and to evaluate coping strategies using the questionnaire of Graziani et al. ("Journal de Thérapie Comportementale et…

  12. Climatic summaries and documentation for the primary meteorological station, H.J. Andrews Experimental Forest, 1972 To 1984.

    Science.gov (United States)

    Frederick A. Bierlmaler; Arthur. McKee

    1989-01-01

    This report describes the primary meteorological station at the H.J. Andrews Experimental Forest (elev. 426 m, lat. 44°15' N., long. 122°10' W.) in the Willamette National Forest, the automatic digital data logger, sensors, and data-processing procedures used in measuring air temperature, dewpoint temperature, windspeed, precipitation, and solar radiation....

  13. Review of the Primary National Ambient Air Quality Standard for Sulfur Oxides: Risk and Exposure Assessment Planning Document

    Science.gov (United States)

    The U.S. Environmental Protection Agency (EPA) is conducting a review of the air quality criteria and the primary (health-based) national ambient air quality standards (NAAQS) for sulfur oxides (SOx). The major phases of the process for reviewing NAAQS include the following: (1) ...

  14. Experiences and practices of educational mediation in Primary

    Directory of Open Access Journals (Sweden)

    Marta Aguilar Moreno

    2017-09-01

    Full Text Available The responsibility of educating using sustainable models is everyone´s task. Concepts such as the environment, ecology, our surroundings, the eco-system... should be present in a child´s educaction from a very early age. For this reason Primary Education is the focus for our work with the aim of raising awareness of the deterioration of the environment whilst promoting attitudes and behaviours conducive to the attainment of sustainable development. In order to do this we propose using one of the artistic procedures less frequently  used in the classroom, engraving and etching techniques. Through processes which encourage the development of attention, perception, imagination and creativity in a responsible manner, we will  work using the technological possibilities offered by the most innovative graphic techniques which are the use of photopolymers in the classroom. The preparation of drawings to be processed using “less toxic”  procedures will allow us to achieve conducts sensitized to sustainability through environmental education.

  15. Experience with surgical treatment for primary malignant adrenal tumors

    Directory of Open Access Journals (Sweden)

    V. R. Latypov

    2016-01-01

    Full Text Available Background. Adrenal tumors occur in 3–10 % of the population and are mostly benign adrenal cortical tumors. Adrenocortical carcinoma is a very rare tumor and has an annual incidence of 1–2 cases per million people. The U.S. National Cancer Data Base registered 4275 patients with adrenocortical carcinoma in 1985 to 2007. It is extremely difficult to assess Russia’s epidemiological data, as reports on adrenocortical carcinoma are not presented separately.Materials and methods. A total of 133 patients (49 men and 84 women (1:1.7 with adrenal tumors were operated on at the clinics of the Siberian State Medical University in the period December 1998 to March 2015. The patients’ mean age was 51.3 (16–80 years (median age 51.0 years. The right and left adrenal glands were affected in 49 (36.9 % and 77 (57.9 % patients, respectively; both adrenal glands were involved in 7 (5.3 %. A group of 21 (15.8 % people with primary malignant adrenal tumors was identified among all the patients. The clinical manifestations of the disease were evaluated from the presence of hormonal activity, gastrointestinal symptoms, pain syndrome, and hypertension. All the patients were operated on under endotracheal anesthesia. The data were statistically processed using the program package Statistica 6.0. Survival rates were analyzed by the Kaplan–Meier method. The Gehan–Wilcoxon test was used to compare the groups.Results. The investigation analyzed treatment results in 21 (15.8 % patients with primary malignant adrenal lesions (Group 1. The most common morphological form was adrenocortical carcinoma in 15 (11.3 % patients (5 men and 10 women (1:2; their mean age was 48.1 years. The right, left, and both adrenal glands were affected in 4, 9, and 2 cases, respectively. In Group 2, other malignant adrenal involvements were identified from 1 case of rare malignant adrenal tumors: malignant pheochromocytoma, sarcoma, melanoma, squamous cell

  16. Experiences of Violence and Deficits in Academic Achievement among Urban Primary School Children in Jamaica

    Science.gov (United States)

    Baker-Henningham, Helen; Meeks-Gardner, Julie; Chang, Susan; Walker, Susan

    2009-01-01

    Objective: The aim of this study was to examine the relationship between children's experiences of three different types of violence and academic achievement among primary school children in Kingston, Jamaica. Methods: A cross-sectional study of 1300 children in grade 5 [mean (S.D.) age: 11 (0.5) years] from 29 government primary schools in urban…

  17. "There's No Big Book on How to Care": Primary Pre-Service Teachers' Experiences of Caring

    Science.gov (United States)

    Kemp, Hellen R.; Reupert, Andrea

    2012-01-01

    This study investigated primary, pre-service teachers' experiences regarding their caring role, and the barriers they face when caring for students. Thirteen Australian primary pre-service teachers were individually interviewed. Within a qualitative framework, transcripts were thematically analysed, alongside member checks. While results indicated…

  18. Frail older adults' experiences with a proactive, nurse-led primary care program: a qualitative study.

    NARCIS (Netherlands)

    Bleijenberg, N.; Boeije, H.R.; Onderwater, A.T.; Schuurmans, M.J.

    2015-01-01

    The aim of the current study was to explore frail older adults' perceptions and experiences with a proactive, integrated nurse-led primary care program. A qualitative study nested within a randomized trial in primary care was conducted. In total, 11 semistructured interviews were conducted in a

  19. An Integrated Management System (IMS) for JM-1 SLOWPOKE-2 research reactor in Jamaica: experiences in documentation

    Energy Technology Data Exchange (ETDEWEB)

    Warner, T., E-mail: traceyann.warner02@uwimona.edu.jm [Univ. of West Indies, Mona (Jamaica)

    2014-07-01

    Since the first criticality in March 1984, the Jamaica SLOWPOKE-2 research reactor at the University of the West Indies, Mona located in the department of the International Centre for Environmental and Nuclear Sciences (ICENS) has operated for approximately 52% of the lifetime of the existing core configuration. The 20kW pool type research reactor has been primarily used for neutron activation analysis in environmental, agricultural, geochemical, health-related studies and mineral exploration in Jamaica. The involvement of the JM-1 reactor for research and teaching activities has segued into commercial applications which, coupled with the current core conversion programme from HEU to LEU, has demanded the implementation of management systems to satisfy regulatory requirements and assure compliance with internationally defined quality standards. At ICENS, documentation related to the Quality Management System aspect of an Integrated Management System (IMS) is well underway. The quality system will incorporate operational and nuclear safety, training, maintenance, design, utilization, occupational health and safety, quality service, and environmental management for its Nuclear Analytical Laboratory, NAL. The IMS is being designed to meet the requirements of the IAEA GS-R-3 with additional controls from international standards including: ISO/IEC 17025:2005, ISO 9001:2008, ISO 14001:2004 and OHSAS 18001:2007. This paper reports on the experiences of the documentation process in a low power reactor facility characterized by limited human resource, where innovative mechanisms of system automation and modeling are included to increase productivity and efficiency. (author)

  20. Pegasus(Registered trademark) Wing-Glove Experiment to Document Hypersonic Crossflow Transition: Measurement System and Selected Flight Results

    Science.gov (United States)

    Bertelrud, Arild; delaTova, Geva; Hamory, Philip J.; Young, Ronald; Noffz, Gregory K.; Dodson, Michael; Graves, Sharon S.; Diamond, John K.; Bartlett, James E.; Noack, Robert; hide

    2000-01-01

    In a recent flight experiment to study hypersonic crossflow transition, boundary layer characteristics were documented. A smooth steel glove was mounted on the first stage delta wing of Orbital Sciences Corporation's Pegasus (R) launch vehicle and was flown at speeds of up to Mach 8 and altitudes of up to 250,000 ft. The wing-glove experiment was flown as a secondary payload off the coast of Florida in October 1998. This paper describes the measurement system developed. Samples of the results obtained for different parts of the trajectory are included to show the characteristics and quality of the data. Thermocouples and pressure sensors (including Preston tubes, Stanton tubes, and a "probeless" pressure rake showing boundary layer profiles) measured the time-averaged flow. Surface hot-films and high-frequency pressure transducers measured flow dynamics. Because the vehicle was not recoverable, it was necessary to design a system for real-time onboard processing and transmission. Onboard processing included spectral averaging. The quality and consistency of data obtained was good and met the experiment requirements.

  1. Experience of primary care among homeless individuals with mental health conditions.

    Directory of Open Access Journals (Sweden)

    Joya G Chrystal

    Full Text Available The delivery of primary care to homeless individuals with mental health conditions presents unique challenges. To inform healthcare improvement, we studied predictors of favorable primary care experience among homeless persons with mental health conditions treated at sites that varied in degree of homeless-specific service tailoring. This was a multi-site, survey-based comparison of primary care experiences at three mainstream primary care clinics of the Veterans Administration (VA, one homeless-tailored VA clinic, and one tailored non-VA healthcare program. Persons who accessed primary care service two or more times from July 2008 through June 2010 (N = 366 were randomly sampled. Predictor variables included patient and organization characteristics suggested by the patient perception model developed by Sofaer and Firminger (2005, with an emphasis on mental health. The primary care experience was assessed with the Primary Care Quality-Homeless (PCQ-H questionnaire, a validated survey instrument. Multiple regression identified predictors of positive experiences (i.e. higher PCQ-H total score. Significant predictors of a positive experience included a site offering tailored service design, perceived choice among providers, and currently domiciled status. There was an interaction effect between site and severe psychiatric symptoms. For persons with severe psychiatric symptoms, a homeless-tailored service design was significantly associated with a more favorable primary care experience. For persons without severe psychiatric symptoms, this difference was not significant. This study supports the importance of tailored healthcare delivery designed for homeless persons' needs, with such services potentially holding special relevance for persons with mental health conditions. To improve patient experience among the homeless, organizations may want to deliver services that are tailored to homelessness and offer a choice of providers.

  2. Primary care team working in Ireland: a qualitative exploration of team members' experiences in a new primary care service.

    Science.gov (United States)

    Kennedy, Norelee; Armstrong, Claire; Woodward, Oonagh; Cullen, Walter

    2015-07-01

    Team working is an integral aspect of primary care, but barriers to effective team working can limit the effectiveness of a primary care team (PCT). The establishment of new PCTs in Ireland provides an excellent opportunity to explore team working in action. The aim of this qualitative study was to explore the experiences of team members working in a PCT. Team members (n = 19) from two PCTs were interviewed from May to June 2010 using a semi-structured interview guide. All interviews were audio-recorded and transcribed. Data were analysed using NVivo (version 8). Thematic analysis was used to explore the data. We identified five main themes that described the experiences of the team members. The themes were support for primary care, managing change, communication, evolution of roles and benefits of team working. Team members were generally supportive of primary care and had experienced benefits to their practice and to the care of their patients from participation in the team. Regular team meetings enabled communication and discussion of complex cases. Despite the significant scope for role conflict due to the varied employment arrangements of the team members, neither role nor interpersonal conflict was evident in the teams studied. In addition, despite the unusual team structure in Irish PCTs - where there is no formally appointed team leader or manager - general issues around team working and its benefits and challenges were very similar to those found in other international studies. This suggests, in contrast to some studies, that some aspects of the leadership role may not be as important in successful PCT functioning as previously thought. Nonetheless, team leadership was identified as an important issue in the further development of the teams. © 2014 John Wiley & Sons Ltd.

  3. Experiences of staff members participating in primary care research activities: a qualitative study

    Directory of Open Access Journals (Sweden)

    Hange D

    2015-04-01

    Full Text Available Dominique Hange,1 Cecilia Björkelund,1 Irene Svenningsson,2 Marie Kivi,3 Maria C Eriksson,1 Eva-Lisa Petersson,1,21Department of Primary Health Care/Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, 2Närhälsan Research and Development Primary Health Care, Region Västra Götaland, 3Department of Psychology, University of Gothenburg, Gothenburg, Sweden Background: The aim of this paper was to study primary care staff members' experiences and perceptions of participating in a randomized controlled trial concerning Internet therapy. Methods: Data were collected via five focus groups, each containing four to eight nurses or general practitioners. The systematic text condensation method described by Malterud was used for thematic analysis of meaning and content of data across cases. Results: The informants believed it was important to conduct research within the primary care setting, but it was difficult to combine clinical work and research. They stressed also that there was a need for continuous information and communication between primary care centers and researchers as well as internally at each primary care center. Conclusion: Staff members’ experiences of participating in a research study were positive, although associated with various difficulties. It is important to include staff members when designing clinical studies; information should be given continuously during the study and communication facilitated between different occupational groups working at the primary care center. Keywords: primary care, research, staff participation, Sweden

  4. Decrease in the Prevalence of Pancreatitis Associated with Primary Hyperparathyroidism: Experience at a Tertiary Referral Center.

    Science.gov (United States)

    Janka-Zires, Marcela; Hernández-Calleros, Jorge; Gómez-Pérez, Francisco Javier; Uscanga-Domínguez, Luis Federico; Pelaez-Luna, Mario César; Almeda-Valdés, Paloma

    2015-01-01

    Hypercalcemia is a rare but well recognized cause of acute and chronic pancreatitis. Hypercalcemia-related pancreatitis is mainly caused by primary hyperparathyroidism. The prevalence of pancreatitis in hyperparathyroidism varies worldwide and additional disease-modifying factors may play a role in its development. In 1988 the prevalence of pancreatitis secondary to primary hyperparathyroidism at the Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán (INCMNSZ), a referral center in Mexico City, was 12.1% (95% CI: 6.7-21). To describe the current prevalence of pancreatitis secondary to primary hyperparathyroidism at the INCMNSZ. We reviewed 385 cases of primary hyperparathyroidism seen at the hospital between 1987 and 2012. 26 cases with acute or chronic pancreatitis associated with primary hyperparathyroidism were documented, with a prevalence of 6.7% (95% CI: 4.6-9.7), which was lower than the 12.1% previously reported. In the present study, 20% had a history of alcohol consumption, 10% of gallstones, and 20% of ureteral calculi, compared with the previously reported 32.0, 34.6, and 40.0%, respectively. The average calcium levels were 13.1 and 13.8 mg/dl in the previous and current series, respectively. We found a decrease in the prevalence of pancreatitis associated with primary hyperparathyroidism from 12.1% (95% CI: 6.7-21) to 6.7% (95% CI: 4.6-9.7).

  5. Why Everyday Experience? Interpreting Primary Students' Science Discourse from the Perspective of John Dewey

    Science.gov (United States)

    Na, Jiyeon; Song, Jinwoong

    2014-05-01

    The purposes of this study were, based on John Dewey's ideas on experience, to examine how primary students used their own everyday experience and were affected by own and others' experience in science discourse, and to illuminate the implications of experience in science education. To do these, science discourses by a group of six fourth-graders were observed, where they talked about their ideas related to thermal concepts. The data was collected through interviews and open-ended questions, analyzed based on Dewey's perspective, and depicted as the discourse map which was developed to illustrate students' transaction and changing process of students' ideas. The results of the analysis showed typical examples of Dewey's notions of experience, such as the principles of continuity and of transaction and of different types of experience, examples of `the expanded continuity and transaction', and science discourse as inquiry. It was also found that students' everyday experiences played several roles: as a rebuttal for changing their own ideas or others', backing for assurance of their own ideas in individual students' inner changes after discourse with others, and backing for other's ideas. Based on these observations, this study argues that everyday experience should be considered as a starting point for primary students' science learning because most of their experience comes from everyday, not school science, contexts. In addition, to evoke educative experience in science education, it is important for teachers to pay more attention to Dewey's notions of the principles of continuity and of transaction and to their educational implications.

  6. A national evaluation of homeless and nonhomeless veterans' experiences with primary care.

    Science.gov (United States)

    Jones, Audrey L; Hausmann, Leslie R M; Haas, Gretchen L; Mor, Maria K; Cashy, John P; Schaefer, James H; Gordon, Adam J

    2017-05-01

    Persons who are homeless, particularly those with mental health and/or substance use disorders (MHSUDs), often do not access or receive continuous primary care services. In addition, negative experiences with primary care might contribute to homeless persons' avoidance and early termination of MHSUD treatment. The patient-centered medical home (PCMH) model aims to address care fragmentation and improve patient experiences. How homeless persons with MHSUDs experience care within PCMHs is unknown. This study compared the primary care experiences of homeless and nonhomeless veterans with MHSUDs receiving care in the Veterans Health Administration's medical home environment, called Patient Aligned Care Teams. The sample included VHA outpatients who responded to the national 2013 PCMH-Survey of Health Care Experiences of Patients (PCMH-SHEP) and had a past-year MSHUD diagnosis. Veterans with evidence of homelessness (henceforth "homeless") were identified through VHA administrative records. PCMH-SHEP survey respondents included 67,666 veterans with MHSUDs (9.2% homeless). Compared with their nonhomeless counterparts, homeless veterans were younger, more likely to be non-Hispanic Black and nonmarried, had less education, and were more likely to live in urban areas. Homeless veterans had elevated rates of most MHSUDs assessed, indicating significant co-occurrence. After controlling for these differences, homeless veterans reported more negative and fewer positive experiences with communication; more negative provider ratings; and more negative experiences with comprehensiveness, care coordination, medication decision-making, and self-management support than nonhomeless veterans. Homeless persons with MHSUDs may need specific services that mitigate negative care experiences and encourage their continuation in longitudinal primary care services. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

  7. General practice based teaching exchanges in Europe. Experiences from the EU Socrates programme 'primary health care'.

    Science.gov (United States)

    van Weel, Chris; Mattsson, Bengt; Freeman, George K; de Meyere, Marc; von Fragstein, Martin

    2005-01-01

    This paper reviews the experience of international exchange of medical students for general practice. The experience is based on the EU Socrates programme 'Primary Health Care' that offers, since 1992, clinical attachments and research electives in primary care. This programme involves 11 university departments of general practice/primary care in eight countries: Austria - Vienna; Belgium - Gent; Germany Düsseldorf; Italy - Monza, Udine; Netherlands Nijmegen; Slovenia - Ljubljana; Sweden - Göteborg; and the UK - Edinburgh, Imperial College London and Nottingham. More than 150 students have taken part in the programme, most in the last four years. For clinical attachment communication to patients is essential, and students should be able to speak the language of the host university. A research elective in primary care is less demanding and requires students' ability to communicate in English. Despite marked differences in health care structure in the countries involved, it is quite possible to provide a valuable teaching environment in general practice, and the experience gained by students in the exchanges more than equals that what they would gain at home. The added value is in experiencing the influence of another health care system and of working in another academic primary care centre. A substantial number of research electives have been published in international peer reviewed scientific journals with the student as first (occasionally second) author and staff members of the student's host and home university as co-authors. A further benefit of the exchange programme lies in the transfer teaching innovations between universities.

  8. PLEs in Primary School: The Learners' Experience in The PIPLEP Project

    Science.gov (United States)

    Nieto Moreno de Diezmas, Esther; Dondarza Manzano, Pablo

    2016-01-01

    In this paper the experience of learners during the first phase of the PIPLEP project is explored. PIPLEP is aimed at promoting digital literacy and independent learning with the creation of personal learning environments (PLEs) as the final product. The participants were a group of 17 students enrolled in year 5 of primary school, and the main…

  9. Parents' views and experiences of childhood obesity management in primary care: a qualitative study.

    Science.gov (United States)

    Turner, Katrina M; Salisbury, Chris; Shield, Julian P H

    2012-08-01

    Primary care has been viewed as an appropriate setting for childhood obesity management. Little is known about parents' views and experiences of obesity management within this clinical setting. These views and experiences need to be explored, as they could affect treatment success. To explore parents' views and experiences of primary care as a treatment setting for childhood obesity. In-depth interviews were held with 15 parents of obese children aged 5-10 years, to explore their views and experiences of primary care childhood obesity management. Parents were contacted via a hospital-based childhood obesity clinic, general practices and Mind, Exercise, Nutrition … Do it! (MEND) groups based in Bristol, England. The interviews were audio-taped transcribed verbatim and analysed thematically. Parents viewed primary care as an appropriate setting in which to treat childhood obesity but were reluctant to consult due to a fear of being blamed for their child's weight and a concern about their child's mental well-being. They also questioned whether practitioners had the knowledge, time and resources to effectively manage childhood obesity. Parents varied in the extent to which they had found consulting a practitioner helpful, and their accounts suggested that GPs and school nurses offer different types of support. Parents need to be reassured that practitioners will address their child's weight in a non-judgemental sensitive manner and are able to treat childhood obesity effectively. A multidisciplinary team approach might benefit a child, as different practitioners may vary in the type of care they provide.

  10. The Experience of the Hidden Curriculum for Autistic Girls at Mainstream Primary Schools

    Science.gov (United States)

    Moyse, R.; Porter, J.

    2015-01-01

    This article presents the findings of ethnographic case studies of three girls on the autistic spectrum attending mainstream primary schools and illustrates the difficulties they experience and the ways in which these are often unrecognised. The observations of the girls and subsequent individual interviews with their mothers, class teachers,…

  11. Improving Learning in Primary Schools of Developing Countries: A Meta-Analysis of Randomized Experiments

    Science.gov (United States)

    McEwan, Patrick J.

    2015-01-01

    I gathered 77 randomized experiments (with 111 treatment arms) that evaluated the effects of school-based interventions on learning in developing-country primary schools. On average, monetary grants and deworming treatments had mean effect sizes that were close to zero and not statistically significant. Nutritional treatments, treatments that…

  12. Learning Motivational Interviewing: Exploring Primary Health Care Nurses' Training and Counselling Experiences

    Science.gov (United States)

    Soderlund, Lena Lindhe; Nilsen, Per; Kristensson, Margareta

    2008-01-01

    Objective: This article explores the training and counselling experiences of 20 nurses, aiming to identify key elements in the process of learning and applying motivational interviewing (MI) counselling skills with adherence to protocols. Setting/method: The nurses were recruited from 10 primary health care units in Ostergotland, Sweden. The study…

  13. Conducting Action Research in Kenyan Primary Schools: A Narrative of Lived Experiences

    Science.gov (United States)

    Otienoh, Ruth

    2015-01-01

    This paper is a narrative of my personal experiences of conducting action research in Kenyan primary schools. It highlights the opportunities, successes, challenges and dilemmas I encountered during the process: from the school hunting period, to the carrying out of the actual research in two schools, with four teachers. This study reveals that…

  14. Phenomenological Analysis of Teachers' Organizational Deviance Experiences in a Rural Primary School in Turkey

    Science.gov (United States)

    Anasiz, Burcu Türkkas; Püsküllüoglu, Elif Iliman

    2018-01-01

    The purpose of this study was to analyze organizational deviance experiences of teachers. The study was in phenomenological design among qualitative research methods. In the research convenience sampling technique was used. The research was conducted in a rural primary school in Mugla province in Turkey. Nine teachers participated in the study,…

  15. Professional experiences of international medical graduates practicing primary care in the United States.

    Science.gov (United States)

    Chen, Peggy Guey-Chi; Nunez-Smith, Marcella; Bernheim, Susannah May; Berg, David; Gozu, Aysegul; Curry, Leslie Ann

    2010-09-01

    International medical graduates (IMGs) comprise approximately 25% of the US physician workforce, with significant representation in primary care and care of vulnerable populations. Despite the central role of IMGs in the US healthcare system, understanding of their professional experiences is limited. To characterize the professional experiences of non-US born IMGs from limited-resource nations practicing primary care in the US. Qualitative study based on in-depth in-person interviews. Purposeful sample of IMGs (n = 25) diverse in country of origin, length of practice in the US, specialty (internal medicine, family medicine and pediatrics), age and gender. Participants were currently practicing primary care physicians in New York, New Jersey or Connecticut. A standardized interview guide was used to explore professional experiences of IMGs. Four recurrent and unifying themes characterize these experiences: 1) IMGs experience both overt and subtle forms of workplace bias and discrimination; 2) IMGs recognize professional limitations as part of "the deal"; 3) IMGs describe challenges in the transition to the culture and practice of medicine in the US; 4) IMGs bring unique skills and advantages to the workplace. Our data reveal that IMGs face workplace challenges throughout their careers. Despite diversity in professional background and demographic characteristics, IMGs in our study reported common experiences in the transition to and practice of medicine in the US. Findings suggest that both workforce and workplace interventions are needed to enable IMG physicians to sustain their essential and growing role in the US healthcare system. Finally, commonalities with experiences of other minority groups within the US healthcare system suggest that optimizing IMGs' experiences may also improve the experiences of an increasingly diverse healthcare workforce.

  16. Perceived Challenges in Primary Literature in a Master’s Class: Effects of Experience and Instruction

    Science.gov (United States)

    Lie, Richard; Abdullah, Christopher; He, Wenliang; Tour, Ella

    2016-01-01

    Primary literature offers rich opportunities to teach students how to “think like a scientist,” but the challenges students face when they attempt to read research articles are not well understood. Here, we present an analysis of what master’s students perceive as the most challenging aspects of engaging with primary literature. We examined 69 pairs of pre- and postcourse responses from students enrolled in a master’s-level course that offered a structured analysis of primary literature. On the basis of these responses, we identified six categories of challenges. Before instruction, “techniques” and “experimental data” were the most frequently identified categories of challenges. The majority of difficulties students perceived in the primary literature corresponded to Bloom’s lower-order cognitive skills. After instruction, “conclusions” were identified as the most difficult aspect of primary literature, and the frequency of challenges that corresponded to higher-order cognitive skills increased significantly among students who reported less experience with primary literature. These changes are consistent with a more competent perception of the primary literature, in which these students increasingly focus on challenges requiring critical thinking. Students’ difficulties identified here can inform the design of instructional approaches aimed to teach students how to critically read scientific papers. PMID:27909027

  17. A Specialist Professional Experience Learning Community for Primary Pre-Service Teachers Focussed on Mathematical Problem Solving

    Science.gov (United States)

    Cavanagh, Michael; McMaster, Heather

    2017-01-01

    Problem solving has been identified as an important approach to learning and teaching mathematics, yet many primary pre-service teachers (PSTs) struggle to implement it during their professional experience. In this paper, we report the experiences of a group of four primary PSTs who, in an additional professional experience placement, formed a…

  18. Coping with and factors impacting upon the experience of lung cancer in patients and primary carers.

    Science.gov (United States)

    Ellis, J; Lloyd Williams, M; Wagland, R; Bailey, C; Molassiotis, A

    2013-01-01

    There is a paucity of research exploring patients' and their informal carers' experience of coping with and factors impacting on the lung cancer experience. This study aims to explore how patients and their informal carers cope with a diagnosis of lung cancer and describe the key factors that mediate distress in this population in order that they may be better supported in the future. This was a qualitative study employing semi-structured interviews and framework analysis to elicit the experience of 37 patients with lung cancer and 23 primary carers regarding their coping with and factors influencing patient/carer distress. The findings illustrate that participants used both emotional- and problem-focused coping strategies, including accepting the reality of lung cancer, adopting a positive attitude/fighting spirit, denial, avoidance and distraction and information seeking. Maintaining normality was also important. Key factors that mediate the lung cancer experience were also identified including hope, social network, prior experience of cancer and other chronic illnesses, the competing coping strategies of patients and their primary carers, the unpredictable nature of patients' behaviour, changing symptomatology, the perceived attitudes of health professionals and the impact of perceived delays in diagnosis. This study provides important insights into how patients with lung cancer and their primary carers might be better supported. © 2012 Blackwell Publishing Ltd.

  19. ROMANIAN PUPILS AT THE SPANISH PRIMARY SCHOOLS: CONTINUITIES AND DISCONTINUITIES BETWEEN FORMER AND CURRENT EDUCATIONAL EXPERIENCES

    Directory of Open Access Journals (Sweden)

    Georgeta Ion

    2011-07-01

    Full Text Available During the last few years, East-Europeans, predominantly Romanians, have become the second largest cultural minority in Catalonia (Spain. Spanish educational institutions now have students from more than twenty different cultures. This paper focuses on the educational background and the factors which characterize the educational experience of Romanian students prior to attending schools in Spain, and how this affects their experiences into Catalonian primary schools. Twenty seven interviews were undertaken, of Catalonian and Romanian teachers, of experts and parents from the host primary schools where the proportion of Romanian students was highest. Two focus-group sessions were carried out with school teachers from Romania. The analysis shows that there is some consistency between educational practices and values in Romania and the practices and values of the host schools. The ability of children to assimilate into the host school is directly influenced by their previous experience in the schools in their country of origin.

  20. Multidisciplinary practice experience of nursing faculty and their collaborators for primary health care in Korea.

    Science.gov (United States)

    Kim, Mi Ja; Chung, Hyang-In Cho; Ahn, Yang Heui

    2008-03-01

    This study aimed to describe the range of participation of nursing faculty members and their collaborators in multidisciplinary primary health care in Korea and to analyze facilitators, benefits, barriers, and learned lessons. An exploratory descriptive research design was utilized. A total of 13 nursing faculty members and 13 multidisciplinary collaborators were interviewed face to face using a brief questionnaire and semi-structured interview guide. Descriptive statistics, comparative analysis, and content analysis were used for data analysis. About 43% of the nursing faculty had multidisciplinary primary health care experience. Facilitators included a government-funded research/demonstration project, personal belief and expertise in primary health care, and well-delineated role boundaries. Benefits included improved quality of life, more convenient community life, meeting multifaceted needs of community residents, and enhanced research activities. Barriers were lack of teamwork; territoriality and self-protective behaviors; lack of insight into primary health care among stakeholders; nurses undervaluing their work; and the rigid bureaucratic system of public health centers. Learned lessons were the importance of teamwork and its synergistic benefits, the importance of conducting clinically relevant research, having the government's support in the improvement of public health, developing health policies through multidisciplinary primary health care (M-D PHC) work, and respecting each other's territory and expertise. Teamwork should be included in all health professions' curricula, and nursing clinical practicums should include primary health care in all specialty areas. More faculties should engage in multidisciplinary primary health care. The benefits of a multidisciplinary approach to primary health care outweigh the difficulties experienced by multidisciplinary team members. The findings of this study may be useful for future multidisciplinary primary health

  1. Clinical undergraduate training and assessment in primary health care: Experiences gained from Crete, Greece

    Directory of Open Access Journals (Sweden)

    Fioretos Michael

    2005-05-01

    Full Text Available Abstract Background Primary Health Care (PHC is increasingly being introduced into undergraduate medical education. In Greece, the Faculty of Medicine of the University of Crete was the first to introduce a 4-week long training in primary health care. This paper presents the experiences gained from the initial implementation of the teaching of practice-based primary care in rural Crete and reports on the assessment scale that was developed. Methods 284 students' case write-ups from the 6 primary care units (PCUs where they were allocated for the period 1990 to 1994 were analysed. The demographic data of the students and patients and the number of home visits were studied. Content analysis of the students' write-ups was carried out, using an assessment scale consisting of 10 dichotomous variables, in order to quantify eight (8 primary qualitative criteria. Results Internal reliability was estimated by the index KR20 = 0.67. Face and content validity was found to conform to the standards set for the course, while logistic linear regression analysis showed that the quality criteria could be used as an assessment scale. The number of home visits carried out varied between the various different PCUs (p Conclusion The primary health care course achieved the objectives of introducing students to comprehensive, community oriented care, although there was variation between the PCUs. The assessment scale that was developed to analyse the case-write ups of the students provided data that can be used to evaluate the course.

  2. Comparing Homeless Persons’ Care Experiences in Tailored Versus Nontailored Primary Care Programs

    Science.gov (United States)

    Holt, Cheryl L.; Steward, Jocelyn L.; Jones, Richard N.; Roth, David L.; Stringfellow, Erin; Gordon, Adam J.; Kim, Theresa W.; Austin, Erika L.; Henry, Stephen Randal; Kay Johnson, N.; Shanette Granstaff, U.; O’Connell, James J.; Golden, Joya F.; Young, Alexander S.; Davis, Lori L.; Pollio, David E.

    2013-01-01

    Objectives. We compared homeless patients’ experiences of care in health care organizations that differed in their degree of primary care design service tailoring. Methods. We surveyed homeless-experienced patients (either recently or currently homeless) at 3 Veterans Affairs (VA) mainstream primary care settings in Pennsylvania and Alabama, a homeless-tailored VA clinic in California, and a highly tailored non-VA Health Care for the Homeless Program in Massachusetts (January 2011-March 2012). We developed a survey, the “Primary Care Quality-Homeless Survey," to reflect the concerns and aspirations of homeless patients. Results. Mean scores at the tailored non-VA site were superior to those from the 3 mainstream VA sites (P homelessness. PMID:24148052

  3. Comparing homeless persons' care experiences in tailored versus nontailored primary care programs.

    Science.gov (United States)

    Kertesz, Stefan G; Holt, Cheryl L; Steward, Jocelyn L; Jones, Richard N; Roth, David L; Stringfellow, Erin; Gordon, Adam J; Kim, Theresa W; Austin, Erika L; Henry, Stephen Randal; Kay Johnson, N; Shanette Granstaff, U; O'Connell, James J; Golden, Joya F; Young, Alexander S; Davis, Lori L; Pollio, David E

    2013-12-01

    We compared homeless patients' experiences of care in health care organizations that differed in their degree of primary care design service tailoring. We surveyed homeless-experienced patients (either recently or currently homeless) at 3 Veterans Affairs (VA) mainstream primary care settings in Pennsylvania and Alabama, a homeless-tailored VA clinic in California, and a highly tailored non-VA Health Care for the Homeless Program in Massachusetts (January 2011-March 2012). We developed a survey, the "Primary Care Quality-Homeless Survey," to reflect the concerns and aspirations of homeless patients. Mean scores at the tailored non-VA site were superior to those from the 3 mainstream VA sites (P homelessness.

  4. Tokamak Physics EXperiment (TPX): Toroidal field magnet design, development and manufacture. SDRL 32, Coil assembly documentation. Volume 5

    Energy Technology Data Exchange (ETDEWEB)

    Weber, C.M. [Babcock and Wilcox Co., Lynchburg, VA (United States)

    1995-08-18

    This document is intended to address the contract requirement for providing coil assembly documentation, as required in the applicable Statement of Work: `Provide preliminary procedures and preliminary design and supporting analysis of the equipment, fixtures, and hardware required to integrate and align the impregnated coil assemblies with the coil cases and intercoil structure. Each of the three major processes associated with the coil case and intercoil structure (ICS), TF Case Fabrication, Coil Preparation for Case Assembly are examined in detail. The specific requirements, processes, equipment, and technical concerns for each of these assembly processes is presented.

  5. Informing primary care reform in Greece: patient expectations and experiences (the QUALICOPC study).

    Science.gov (United States)

    Lionis, Christos; Papadakis, Sophia; Tatsi, Chrysanthi; Bertsias, Antonis; Duijker, George; Mekouris, Prodromos-Bodosakis; Boerma, Wienke; Schäfer, Willemijn

    2017-04-05

    Primary health care is the cornerstone of a high quality health care system. Greece has been actively attempting to reform health care services in order to improve heath outcomes and reduce health care spending. Patient-centered approaches to health care delivery have been increasingly acknowledged for their value informing quality improvement activities. This paper reports the quality of primary health care services in Greece as perceived by patients and aspects of health care delivery that are valued by patients. This study was conducted as part of the Quality and Costs of Primary Care in Europe (QUALICOPC) study. A cross-sectional sample of patients were recruited from general practitioner's offices in Greece and surveyed. Patients rated five features of person-focused primary care: accessibility; continuity and coordination; comprehensiveness; patient activation; and doctor-patient communication. One tenth of the patients ranked the importance of each feature on a scale of one to four, and nine tenths of patients scored their experiences of care received. Comparisons were made between patients with and without chronic disease. The sample included 220 general practitioners from both public and private sector. A total of 1964 patients that completed the experience questionnaire and 219 patients that completed the patient values questionnaire were analyzed. Patients overall report a positive experiences with the general practice they visited. Several gaps were identified in particular in terms of wait times for appointments, general practitioner access to patient medical history, delivery of preventative services, patient involvement in decision-making. Patients with chronic disease report better experience than respondents without a chronic condition, however these patient groups report the same values in terms of qualities of the primary care system that are important to them. Data gathered may be used to improve the quality of primary health care services in

  6. Morning hypertension is more common in elderly hypertensive patients with controlled documented office blood pressure in primary care clinics: the Minhang study.

    Science.gov (United States)

    Wang, Yan; Chen, Ling; Wang, Yajuan; Qain, Yuesheng; Zhang, Jin; Tang, Xiaofeng; Li, Yan; Zhu, Dingliang

    2017-11-01

    Increased morning blood pressure (BP) has been associated with fatal and nonfatal cardiovascular events, especially in Asians. To detect the control status of home BP, we performed a home BP monitoring study, including elderly patients with hypertension who had controlled documented office BP in Chinese primary care clinics. In 707 participants from Xinzhuang County Hospital in Shanghai, the home BP was measured by a memory-equipped device three times daily for seven consecutive days. The prevalence of uncontrolled hypertension was 51.3% in the morning and 42% in the evening. Uncontrolled morning hypertension was associated with age [odds ratio (OR): 1.074; 95% confidence interval (CI): 1.041-1.108], office SBP (OR: 1.027; 95% CI: 1.015-1.039), office DBP (OR: 1.042; 95% CI: 1.021-1.064), and the number of antihypertensive drugs taken (OR: 1.387; 95% CI: 1.059-1.817), whereas it was inversely associated with the use of long-acting antihypertensive drugs (OR: 0.588; 95% CI: 0.355-0.973). Compared with office BP, the home morning BP showed a more significant association with age and short-acting antihypertensive drugs. The prevalence of uncontrolled home BP is high in elderly Chinese hypertensive patients, especially in the morning, and home BP monitoring might be a feasible method for detecting it. The use of long-acting antihypertensive drugs might help to improve morning hypertension.

  7. Use of artificial primary teeth for endodontic laboratory research: experiments related to canal length determination.

    Science.gov (United States)

    Mello-Moura, Anna Carolina V; Bresolin, Carmela R; Moura-Netto, Cacio; Ito, André; Araki, Angela T; Imparato, José Carlos P; Mendes, Fausto M

    2017-11-17

    Due to the scarcity of exfoliated/extracted human primary teeth with complete roots, artificial teeth were developed as an alternative to be used for educational and laboratory research purposes. This study aimed to assess the feasibility of using artificial primary teeth for conducting laboratory research through an experiment related to canal length determination, comparing artificial teeth with natural teeth. Thirty anterior and 21 posterior artificial teeth, and the same number of natural primary teeth were selected. After preparing the access cavity, the root canal length was determined by two examiners twice using three different methods: radiography and two electronic apex locators. Then, the actual root canal length was measured by inserting a K-file up to the apical foramen (reference standard). Accuracy was calculated using Bland-Altman analysis and intraclass correlation coefficient (ICC). The inter- and intra-examiner reproducibility was also calculated using the ICC. The methods using the electronic apex locators showed better accuracy in both artificial and natural teeth. Trends observed with artificial primary teeth were similar to those observed with natural teeth, except for the results in artificial anterior teeth. The model of artificial teeth might be a good alternative for educational purposes; however, improvements are necessary to employ these teeth for research purposes when considering experiments for canal length determination.

  8. Determination of the primary vertex position in the NA36 experiment

    Energy Technology Data Exchange (ETDEWEB)

    Andersen, E.; Lovhoiden, G.; Thorsteinsen, T. (Bergen Univ. (Norway). Dept. of Physics); Barnes, P.D.; Diebold, G.E.; Franklin, G.; Quinn, B.; Schumacher, R. (Carnegie-Mellon Univ., Pittsburgh, PA (USA). Dept. of Physics); Castano, B.; Fernandez, C.; Garabatos, C.; Garzon, J.A.; Gomez, A.; Lopez-Ponte, S.; Mosquera, J.; Plo, M.; Ramil, A.; Yanez, A.; Yepes, P. (Universidad de Santiago de Compostela (Spain). Dept. de Fisica de Particulas); Cherney, M. (Creighton Univ., Omaha, NE (USA). Dept. of Physics); Cohler, M. (York Univ. (UK). Dept. of Physics); Cruz, B. de la; Ladron de Guevara, P.; Perez de los Heros, C. (Centro de Investigaciones Energeticas, Medioambientales y Tecnologicas, Madrid (Spain). Div. de Fisica de Particulas); Dulny, B. (Institute of Nuclear Physics, Krakow (Poland) Vienna Univ. (Austria). Inst. fuer Hochenergiephysik); Fruehwirth, R.; Hrubec, J.; Liko, D.; MacNaughton, J.; Neuhofer, G.; Regler, M.; Rohringer, H.; Stampfer, D.; Traxler, J. (Vienna Univ. (Aust

    1991-02-15

    A new method is described for finding the primary vertex in a relativistic heavy-ion experiment with multiple nuclear targets. Due to the large number of tracks the use of an economic algorithm is essential. The method comes from system theory and is based on an application of the Kalman filter. The small uncertainty in the vertex position obtained provides a reliable target assignment for the interaction. (orig.).

  9. Patient's experience with comorbidity management in primary care: a qualitative study of comorbid pain and obesity.

    Science.gov (United States)

    Janke, E Amy; Ramirez, Michelle L; Haltzman, Brittany; Fritz, Megan; Kozak, Andrea T

    2016-01-01

    The aim of this research is to examine perceptions of those with comorbid chronic pain and obesity regarding their experience of comorbidity management in primary care settings. Chronic pain and obesity are common comorbidities frequently managed in primary care settings. Evidence suggests individuals with this comorbidity may be at risk for suboptimal clinical interactions; however, treatment experiences and preferences of those with comorbid chronic pain and obesity have received little attention. Semi-structured interviews conducted with 30 primary care patients with mean body mass index=36.8 and comorbid persistent pain. The constant comparative method was used to analyze data. Participants discussed frustration with a perceived lack of information tailored to their needs and a desire for a personalized treatment experience. Participants found available medical approaches unsatisfying and sought a more holistic approach to management. Discussions also focused around the need for providers to initiate efforts at education and motivation enhancement and to show concern for and understanding of the unique difficulties associated with comorbidity. Findings suggest providers should engage in integrated communication regarding weight and pain, targeting this multimorbidity using methods aligned with priorities discussed by patients.

  10. Student pharmacists' preparedness to evaluate primary literature pre- and post-Advanced Pharmacy Practice Experiences.

    Science.gov (United States)

    Momary, Kathryn M; Lundquist, Lisa M

    2017-05-01

    The primary objective of this study was to assess the effect of formal primary literature evaluation (PLE) during advanced pharmacy practice experiences (APPEs) on student pharmacists' preparedness and knowledge related to literature evaluation. A perception of preparedness survey and knowledge assessment was given to student pharmacists pre- and post-APPEs. Student pharmacists were also asked to characterize their opportunities for formal PLE during APPEs. Literature evaluation experiences, knowledge base and preparedness data were compared between student pharmacists who completed two or more PLE on APPE and those who did not. A total of 211 student pharmacists completed 529 formal PLE during their APPE experiences. Quiz grades and average perception of preparedness increased significantly from pre- to post-APPE regardless of whether student pharmacists had the opportunity for formal PLE on APPE. Student pharmacists who completed two or more PLE on APPE stated they felt more confident in evaluating primary literature after APPE, had greater post-APPE preparedness scores and a trend towards higher post-APPE quiz scores. APPEs provide an important opportunity for student pharmacists to improve their PLE knowledge. Copyright © 2017 Elsevier Inc. All rights reserved.

  11. SANSMIC design document.

    Energy Technology Data Exchange (ETDEWEB)

    Weber, Paula D. [Sandia National Laboratories (SNL-NM), Albuquerque, NM (United States); Rudeen, David Keith [GRAM, Inc., Albuquerque, NM (United States)

    2015-07-01

    The United States Strategic Petroleum Reserve (SPR) maintains an underground storage system consisting of caverns that were leached or solution mined in four salt domes located near the Gulf of Mexico in Texas and Louisiana. The SPR comprises more than 60 active caverns containing approximately 700 million barrels of crude oil. Sandia National Labo- ratories (SNL) is the geotechnical advisor to the SPR. As the most pressing need at the inception of the SPR was to create and fill storage volume with oil, the decision was made to leach the caverns and fill them simultaneously (leach-fill). Therefore, A.J. Russo developed SANSMIC in the early 1980s which allows for a transient oil-brine interface (OBI) making it possible to model leach-fill and withdrawal operations. As the majority of caverns are currently filled to storage capacity, the primary uses of SANSMIC at this time are related to the effects of small and large withdrawals, expansion of existing caverns, and projecting future pillar to diameter ratios. SANSMIC was identified by SNL as a priority candidate for qualification. This report continues the quality assurance (QA) process by documenting the "as built" mathematical and numerical models that comprise this document. The pro- gram flow is outlined and the models are discussed in detail. Code features that were added later or were not documented previously have been expounded. No changes in the code's physics have occurred since the original documentation (Russo, 1981, 1983) although recent experiments may yield improvements to the temperature and plume methods in the future.

  12. Patients' and clinicians' experiences and perceptions of the primary care management of insomnia: qualitative study.

    Science.gov (United States)

    Davy, Zowie; Middlemass, Jo; Siriwardena, Aloysius N

    2015-10-01

    Insomnia is common leading to patients with sleep problems often presenting to primary care services including general practice, community pharmacies and community mental health teams. Little is known about how health professionals in primary care respond to patients with insomnia. We aimed to explore health professionals' and patients' experiences and perceptions of the management of insomnia in primary care. We used a qualitative design and thematic approach. Primary care in Nottinghamshire and Lincolnshire. We undertook focus groups and one-to-one interviews with a purposive sample of health professionals and adults with insomnia. We interviewed 28 patients and 23 health professionals. Practitioners focused on treating the cause of insomnia rather than the insomnia itself. They described providing stepped care for insomnia, but this focused on sleep hygiene which patients often disregarded, rather than cognitive behavioural therapy for insomnia (CBT-I). Practitioners were ambivalent towards hypnotic drugs but often colluded with patients to prescribe to avoid confrontation or express empathy. Patients sometimes took hypnotics in ways that were not intended, for example together with over-the-counter medication. Practitioners and patients were sometimes but not always concerned about addiction. Practitioners sometimes prescribed despite these concerns but at other times withdrew hypnotics abruptly without treating insomnia. Both patients and practitioners wanted more options and better training for the management of insomnia in primary care. A better understanding of the current approaches and difficulties in the management of insomnia will help to inform more therapeutic options and health professional training. © 2013 John Wiley & Sons Ltd.

  13. Lesbian womens' access to healthcare, experiences with and expectations towards GPs in German primary care.

    Science.gov (United States)

    Hirsch, Oliver; Löltgen, Karina; Becker, Annette

    2016-11-21

    Lesbian women have higher rates of physical and psychiatric disorders associated with experiences of discrimination, homophobia and difficulties with coming out. Therefore, easy access to specialized healthcare in an open atmosphere is needed. We aimed to describe women's access to and experiences with healthcare in Germany, and to assess the responsibility of the general practitioner (GP) compared to other specialities providing primary health care. A questionnaire study was conducted via internet and paper-based sampling. Using current literature, we designed a questionnaire consisting of sociodemographic data, sexual orientation, access to care and reasons for encounter, disclosure of sexual orientation, experience with the German health system (discrimination, homophobia), and psychological burden. Depression was assessed using the depression screening from the Patient Health Questionnaire (PHQ-2). We obtained responses from 766 lesbian women. Although 89% had a primary care physician, only 40% had revealed their sexual orientation to their doctor. The main medical contacts were GPs (66%), gynaecologists (10%) or psychiatrists (6%). Twenty-three percent claimed they were unable to find a primary care physician. Another 12.4% had experienced discrimination. Younger lesbian women with higher education levels and who were less likely to be out to other physicians were more likely to disclose their sexual orientation to their primary care physician. GPs play an important role in healthcare for lesbian women, even in a non-gatekeeping healthcare system like Germany. Study participants suggested improvements regarding gender neutral language, flyers on homosexuality in waiting areas, involvement of partners, training of physicians, directories of homosexual physicians and labelling as a lesbian-friendly practice. GPs should create an open atmosphere and acquire the respective knowledge to provide adequate treatment. Caring for marginal groups should be incorporated

  14. GPs' experiences of children with anxiety disorders in primary care: a qualitative study.

    Science.gov (United States)

    O'Brien, Doireann; Harvey, Kate; Young, Bridget; Reardon, Tessa; Creswell, Cathy

    2017-12-01

    Anxiety disorders have a median age of onset of 11 years and are the most common emotional disorders in childhood; however, a significant proportion of those affected do not access professional support. In the UK, GPs are often the first medical professional that families see so are in a prime position to support children with anxiety disorders; however, currently there is little research available on GPs' perspectives on and experiences of supporting children with these disorders. To explore the experiences of GPs in relation to identification, management, and access to specialist services for children (GPs in primary care throughout England. GPs reflected a diverse group in relation to the ethnic and socioeconomic profile of registered patients, GP age, sex, professional status, previous engagement with research, and practice size and location. Purposive sampling was used to recruit GPs until theoretical saturation was reached. Data were analysed using a constant comparative method of thematic analysis. Data from 20 semi-structured interviews were organised into three themes: decision making, responsibility, and emotional response, with an overarching theme of GPs feeling ill equipped. These themes were retrospectively analysed to illustrate their role at different stages in the primary care process (identification, management, and access to specialist services). GPs feel ill equipped to manage and support childhood anxiety disorders, demonstrating a need for medical training to include greater emphasis on children's mental health, as well as potential for greater collaboration between primary and specialist services. © British Journal of General Practice 2017.

  15. Primary coolant technology in VVER/PWR units. Experience with preconditioning, decontamination and recontamination

    Energy Technology Data Exchange (ETDEWEB)

    Vonkova, Katerina [Nuclear Research Institute, Rez (Czech Republic); Kysela, Jan

    2012-01-15

    For the latest Czech and Slovak stations commissioned (Temelin and Mochovce) a modified hot functional test (HFT) chemistry was developed in the NRI Rez. Chromium rich surface layer formed due to modified HTF chemistry ensures lower corrosion rates and radiation field formation. Long term operation experience from both nuclear power plants are discussed in this paper. Radiation field, occupational radiation exposure and corrosion layers evolution during the first 10 years of operation are compared and presented. The operation experience from all above mentioned units showed a low level of corrosion products in the primary system as well as low dose rates. Second part of the paper deals with radiation fields that exist in nuclear power plants primarily due to the deposition of radioisotopes on the surfaces of primary components after decontamination. Large-scale crud deposition on fuel surface resulted in cases NPP Loviisa, Paks and Novovoronezh after steam generators decontamination. After decontamination higher corrosion products release occurs followed by subsequent higher radiation fields. Actual in-pile loop tests carried at the Nuclear Research Institute (NRI) Rez are focused on the study of surface preconditioning - similar to HFT chemistry - after decontamination. Effects of the decontamination on deposition formation on primary circuit surfaces are investigated under steam generator operating conditions with the model device which contains heat exchanger tube. (orig.)

  16. Employment and First Year Experience of Beginner Primary School Teachers at Private Educational Institutions

    Directory of Open Access Journals (Sweden)

    Turgay ÖNTAŞ

    2016-10-01

    Full Text Available In this study to demonstrate primary school teachers' employment process and their first year teaching in private educational organizations is aimed. The major employer of primary school teachers is public schools that are funded by state. There will be a gap between grade inflation and employment rate when all of the teacher candidates claim to be appointed to public schools. Hence private educational organizations provide alternative career opportunities for teacher candidates. Qualitative methods will be used in this study to display real evidence from the eyes of teachers and also principals. The data have been obtained through documents and interview techniques. After the data have been collected, descriptive analysis has been used. The findings of the study were given within the frame of themes and codes which were determined based on the problem statement. The first theme, career was presented in the context of choosing sector, recruitment and selecting process, professional development, leave the profession. The second theme, factors affecting first years' success was explained in the context of teaching factors, consistency and skills focus. The third theme was presented in a category of pressure, workload, complaining psychological and physical exhaustion, flexible working conditions.

  17. Evolution of Traveller Experience Quality Perception in European Level Policy Documents and the Case Study for Siauliai

    Directory of Open Access Journals (Sweden)

    Jarzemskis Andrius

    2017-09-01

    Full Text Available EU’s goal is to develop transport system which meets the economic, social and environmental requirements of society. Since first White paper on Transport in 1992 there was evolution of perception of quality and attributes of quality. The basic set of quality requirement is based on frequency, price, safety and security were dominating in 1992-2006, however since 2006 new attributes such as environment impact, and energy efficiency comes into force in European documents. However research case in Siauliai town show that it delays in user perception of quality.

  18. Frail Older Adults' Experiences With a Proactive, Nurse-Led Primary Care Program: A Qualitative Study.

    Science.gov (United States)

    Bleijenberg, Nienke; Boeije, Hennie R; Onderwater, Astrid T; Schuurmans, Marieke J

    2015-09-01

    The aim of the current study was to explore frail older adults' perceptions and experiences with a proactive, integrated nurse-led primary care program. A qualitative study nested within a randomized trial in primary care was conducted. In total, 11 semistructured interviews were conducted in a subsample of participants who received nurse-led care in the intervention group. Generally, proactive, nurse-led care was well-received and four different nursing roles were observed: (a) monitor, (b) director, (c) coach, and (d) visitor. The monitor role (i.e., observing and assessing potential risks) was perceived as the most important. The relationship with the nurse, timing of visits, and provided care, as well as tailoring the care to individual needs, were identified as conditions related to appreciation. If the care was well-regarded, older adults were more likely to accept it, which helped them anticipate changes or handle consequences of aging more easily. Copyright 2015, SLACK Incorporated.

  19. Primary Science Teaching – Is it Integral and Deep Experience For Students?

    Directory of Open Access Journals (Sweden)

    Timoštšuk Inge

    2016-12-01

    Full Text Available Integral and deep pedagogical content knowledge can support future primary teachers’ ability to follow ideas of education for sustainability in science class. Initial teacher education provides opportunity to learn what and how to teach but still the practical experiences of teaching can reveal uneven development of student teachers’ professionality. The aim of the study is to describe how future primary teachers reflect on their experiences about science teaching and what components of science pedagogical content knowledge they see as meaningful. A questionnaire and interviews were used. The results reveal the deep impact of teaching practice on students’ understanding of the role of a teacher in supporting pupils’ acquisition of scientific skills. The experiences described are related more to teaching and learning in general and less with science-specific factors. Nevertheless, students described changes in mission e.g. how they learned about their role through pupils’ achievements and thinking about science. Changes in professional identity were mentioned rarely but this could point to an underestimated resource issue for teacher education. Positive changes in professional identity may help students to decide to choose more integral strategies in science teaching and thus promote more sustainability oriented teaching.

  20. "I'm just waiting…": an exploration of the experience of living and dying with primary malignant glioma.

    Science.gov (United States)

    Philip, Jennifer; Collins, Anna; Brand, Caroline A; Moore, Gaye; Lethborg, Carrie; Sundararajan, Vijaya; Murphy, Michael A; Gold, Michelle

    2014-02-01

    Referral to supportive and palliative care services for people with high-grade primary malignant glioma (PMG) often occurs late in the illness course, despite significant care needs and overall poor prognosis. This study aimed to understand patient experience at the end of life and document supportive and palliative care needs. A qualitative study was conducted involving ten PMG patients who were at different stages in the illness course including the end of life and had varying levels of physical and cognitive function. Consecutive, eligible patients attending neurosurgery, oncology, and palliative care services of two metropolitan hospitals were recruited. In-depth interviews explored supportive and palliative care needs across the disease trajectory. Interviews were analysed independently by three investigators consistent with a grounded theory approach, and emerging ideas were compared and refined to define key patient experiences. Despite the medical treatment and supportive care available, there remains a gap in services addressing complex existential and psychosocial needs that were markedly valued by patients. Patient experience was characterised by a pervasive loss of all that encompassed their former sense of self and a focus on immediate needs. Patients in this study had substantial needs, which were often not shared and not addressed by the current medical system of care. An improved multidisciplinary care model is indicated, which proactively (1) engages care coordination and advocacy; (2) minimises patients' sense of waiting and uncertainty through mapping out a plan, including involvement of palliative care in a timely fashion; and (3) actively invites discussion around goals and preferences for care to promote patients' sense of self.

  1. Women's experiences of social support during the first year following primary breast cancer surgery.

    Science.gov (United States)

    Drageset, Sigrunn; Lindstrøm, Torill Christine; Giske, Tove; Underlid, Kjell

    2016-06-01

    The aim of this qualitative follow-up study was to describe women's individual experiences of social support during their first year after primary breast cancer surgery. Individual semi-structured interviews with 10 women 1 year after surgery analysed by Kvales' meaning condensation method. Sharing experiences, being understood as an individual, continuity, and information and explanations were themes identified. Sharing mutual experiences increased the women's knowledge regarding cancer, increased experience of support and minimised rumination. After 1 year, the women felt that the network around them had 'normalised' and was less supportive. Being seen as a person, not as 'a diagnosis being treated', and continuity of professional support were important, giving feelings of security and trust. The women felt uncertainty after loss of professional support post-treatment. Information and explanations regarding treatment and treatment-related problems were essential. Mutual sharing of experiences is an important part of social support. Continuity, availability, information and respect were essential aspects of experienced professional support. © 2015 Nordic College of Caring Science.

  2. How pupils of the second triad of the primary school in Ljubljana region experience physical education

    OpenAIRE

    Kržič, Katja

    2012-01-01

    With this diploma thesis I wanted to research how students in second triad of primary schools in Ljubljana region experience physical education. In the first part I was trying to find out who is teaching this school subject and if pupils love it. Questions were also about which school subject is considered as the most important for their lives. In the second part I was trying to research what are pupils afraid of and what are the most popular sports in physical education. The last part includ...

  3. In-service English language training for Italian Primary School Teachers An experience in syllabus design

    Directory of Open Access Journals (Sweden)

    Barbara Dawes

    2013-06-01

    Full Text Available The aim of this paper is to report on an in-service English Language Teacher Training Programme devised for the Government project to equip Italian primary school teachers  with the skills to teach English. The paper focuses on the first phase of the project which envisaged research into the best training models and the preparation of appropriate  English Language syllabuses. In  the first three sections of the paper we report on the experience of designing the language syllabus. In the last section we suggest ways of using the syllabus as a tool for self reflective professional development.

  4. Documentation of nonroutine communications of critical or significant radiology results: a multiyear experience at a tertiary hospital.

    Science.gov (United States)

    Lakhani, Paras; Langlotz, Curtis P

    2010-10-01

    The aim of this study was to determine the frequency of radiology reports that contain nonroutine communications of results and categorize the urgency of such communications. A rule-based text-query algorithm was applied to a database of 2.3 million radiology reports, which has an accuracy of 98% for classifying reports containing documentation of communications. The frequency of such communications by year, modality, and study type was then determined. Finally, 200 random reports selected by the algorithm were analyzed, and reports containing critical results were categorized according to ascending levels of urgency. Critical or noncritical results to health care providers were present in 5.09% of radiology reports (116,184 of 2,282,923). For common modalities, documentation of communications were most frequent in CT (14.34% [57,537 of 402,060]), followed by ultrasound (9.55% [17,814 of 186,626]), MRI (5.50% [13,697 of 248,833]), and chest radiography (1.57% [19,840 of 1,262,925]). From 1997 to 2005, there was an increase in reports containing such communications (3.04% in 1997, 6.82% in 2005). More reports contained nonroutine communications in single-view chest radiography (1.29% [5,533 of 428,377]) than frontal/lateral chest radiography (0.80% [1,815 of 226,837]), diagnostic mammography (9.42% [3,662 of 38,877]) than screening mammography (0.47% [289 of 61,114]), and head CT (26.21% [20,963 of 79,985]) than abdominal CT (15.05% [19,871 of 132,034]) or chest CT (5.33% [3,017 of 56,613]). All of these results were statistically significant (P radiology reports indicating nonroutine communications, 155 (78%) had critical and 45 (22%) had noncritical results. Regarding level of urgency, 94 of 155 reports (60.6%) with critical results were categorized as high urgency, 31 (20.0%) as low urgency, 26 (16.8%) as medium urgency, and 4 (2.6%) as discrepant. From 1997 to 2005, there was a significant increase in documentation of nonroutine communications, which may be due

  5. Developing a response to family violence in primary health care: the New Zealand experience.

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    Gear, Claire; Koziol-McLain, Jane; Wilson, Denise; Clark, Faye

    2016-08-20

    Despite primary health care being recognised as an ideal setting to effectively respond to those experiencing family violence, responses are not widely integrated as part of routine health care. A lack of evidence testing models and approaches for health sector integration, alongside challenges of transferability and sustainability, means the best approach in responding to family violence is still unknown. The Primary Health Care Family Violence Responsiveness Evaluation Tool was developed as a guide to implement a formal systems-led response to family violence within New Zealand primary health care settings. Given the difficulties integrating effective, sustainable responses to family violence, we share the experience of primary health care sites that embarked on developing a response to family violence, presenting the enablers, barriers and resources required to maintain, progress and sustain family violence response development. In this qualitative descriptive study data were collected from two sources. Firstly semi-structured focus group interviews were conducted during 24-month follow-up evaluation visits of primary health care sites to capture the enablers, barriers and resources required to maintain, progress and sustain a response to family violence. Secondly the outcomes of a group activity to identify response development barriers and implementation strategies were recorded during a network meeting of primary health care professionals interested in family violence prevention and intervention; findings were triangulated across the two data sources. Four sites, representing three PHOs and four general practices participated in the focus group interviews; 35 delegates from across New Zealand attended the network meeting representing a wider perspective on family violence response development within primary health care. Enablers and barriers to developing a family violence response were identified across four themes: 'Getting started', 'Building effective

  6. Clinical Experiences with the FRONT Formula for Pre-Operative Airway Assessment and Documentation: a Multi-Centre Study.

    Science.gov (United States)

    Mitre, Calin; Mitre, Ileana; Gyöngyösi, Zoltán; Fülesdi, Béla; Zdrehus, Claudiu; Breazu, Caius; Biro, Peter

    2017-08-01

    The prediction of difficult airway is one of the most important challenges before general anaesthesia. This study aimed to assess the clinical usefulness of the FRONT score, a recently developed scoring system to predict and document airway difficulties. This multi-centre, inter-observer, prospective and double-blinded study included 976 patients from two university centres. The pre-operative evaluation of the patients was performed by a pre-operative team of anaesthesiologists (team A) who evaluated and scored the expected difficulty of airway management. An intra-operative team of evaluators (team B) working independently of team A, performed the actual instrumentation of the airway and scored the actual findings. Both teams used the FRONT scoring system and worked independently of each other to ensure blinded assessments. The statistical analysis of the pre- and intra-operative FRONT scores was performed in an off-line blinded manner. Our results show a fair and promising association between pre-operative composite FRONT score and that observed at the induction phase (Spearman=0.43). Among the score components, the best correlation was observed for the F and R components (kappa=0.44 and 0.36, respectively), and the worse correlation was observed for the O and T components (kappa=0.25 and 0.24, respectively). The FRONT formula for the prediction and documentation of the airway status is a simple and effective method for assessing and defining airway management difficulties. Further prospective studies are required to assess the sensitivity and specificity of the system.

  7. Clinical Documentation and Data Transfer from Ebola and Marburg Virus Disease Wards in Outbreak Settings: Health Care Workers’ Experiences and Preferences

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    Silja Bühler

    2014-02-01

    Full Text Available Understanding human filovirus hemorrhagic fever (FHF clinical manifestations and evaluating treatment strategies require the collection of clinical data in outbreak settings, where clinical documentation has been limited. Currently, no consensus among filovirus outbreak-response organisations guides best practice for clinical documentation and data transfer. Semi-structured interviews were conducted with health care workers (HCWs involved in FHF outbreaks in sub-Saharan Africa, and with HCWs experienced in documenting and transferring data from high-risk areas (isolation wards or biosafety level 4 laboratories. Methods for data documentation and transfer were identified, described in detail and categorised by requirement for electricity and ranked by interviewee preference. Some methods involve removing paperwork and other objects from the filovirus disease ward without disinfection. We believe that if done properly, these methods are reasonably safe for certain settings. However, alternative methods avoiding the removal of objects, or involving the removal of paperwork or objects after non-damaging disinfection, are available. These methods are not only safer, they are also perceived as safer and likely more acceptable to health workers and members of the community. The use of standardised clinical forms is overdue. Experiments with by sunlight disinfection should continue, and non-damaging disinfection of impregnated paper, suitable tablet computers and underwater cameras should be evaluated under field conditions.

  8. Clinical Documentation and Data Transfer from Ebola and Marburg Virus Disease Wards in Outbreak Settings: Health Care Workers’ Experiences and Preferences

    Science.gov (United States)

    Bühler, Silja; Roddy, Paul; Nolte, Ellen; Borchert, Matthias

    2014-01-01

    Understanding human filovirus hemorrhagic fever (FHF) clinical manifestations and evaluating treatment strategies require the collection of clinical data in outbreak settings, where clinical documentation has been limited. Currently, no consensus among filovirus outbreak-response organisations guides best practice for clinical documentation and data transfer. Semi-structured interviews were conducted with health care workers (HCWs) involved in FHF outbreaks in sub-Saharan Africa, and with HCWs experienced in documenting and transferring data from high-risk areas (isolation wards or biosafety level 4 laboratories). Methods for data documentation and transfer were identified, described in detail and categorised by requirement for electricity and ranked by interviewee preference. Some methods involve removing paperwork and other objects from the filovirus disease ward without disinfection. We believe that if done properly, these methods are reasonably safe for certain settings. However, alternative methods avoiding the removal of objects, or involving the removal of paperwork or objects after non-damaging disinfection, are available. These methods are not only safer, they are also perceived as safer and likely more acceptable to health workers and members of the community. The use of standardised clinical forms is overdue. Experiments with by sunlight disinfection should continue, and non-damaging disinfection of impregnated paper, suitable tablet computers and underwater cameras should be evaluated under field conditions. PMID:24556792

  9. Clinical documentation and data transfer from Ebola and Marburg virus disease wards in outbreak settings: health care workers' experiences and preferences.

    Science.gov (United States)

    Bühler, Silja; Roddy, Paul; Nolte, Ellen; Borchert, Matthias

    2014-02-19

    Understanding human filovirus hemorrhagic fever (FHF) clinical manifestations and evaluating treatment strategies require the collection of clinical data in outbreak settings, where clinical documentation has been limited. Currently, no consensus among filovirus outbreak-response organisations guides best practice for clinical documentation and data transfer. Semi-structured interviews were conducted with health care workers (HCWs) involved in FHF outbreaks in sub-Saharan Africa, and with HCWs experienced in documenting and transferring data from high-risk areas (isolation wards or biosafety level 4 laboratories). Methods for data documentation and transfer were identified, described in detail and categorised by requirement for electricity and ranked by interviewee preference. Some methods involve removing paperwork and other objects from the filovirus disease ward without disinfection. We believe that if done properly, these methods are reasonably safe for certain settings. However, alternative methods avoiding the removal of objects, or involving the removal of paperwork or objects after non-damaging disinfection, are available. These methods are not only safer, they are also perceived as safer and likely more acceptable to health workers and members of the community. The use of standardised clinical forms is overdue. Experiments with by sunlight disinfection should continue, and non-damaging disinfection of impregnated paper, suitable tablet computers and underwater cameras should be evaluated under field conditions.

  10. Experiences of homosexual patients' access to primary health care services in Umlazi, KwaZulu-Natal.

    Science.gov (United States)

    Cele, Nokulunga H; Sibiya, Maureen N; Sokhela, Dudu G

    2015-09-28

    Homosexual patients are affected by social factors in their environment, and as a result may not have easy access to existing health care services. Prejudice against homosexuality and homosexual patients remains a barrier to them seeking appropriate healthcare. The concern is that lesbians and gays might delay or avoid seeking health care when they need it because of past discrimination or perceived homophobia within the health care thereby putting their health at risk. The aim of the study was to explore and describe the experiences of homosexual patients utilising primary health care (PHC) services in Umlazi in the province ofKwaZulu-Natal (KZN). A qualitative, exploratory, descriptive study was conducted which was contextual innature. Semi-structured interviews were conducted with 12 participants. The findings of this study were analysed using content analysis. Two major themes emerged from the data analysis, namely, prejudice against homosexual patients by health care providers and other patients at the primary health care facilities, and, homophobic behaviour from primary health care personnel. Participants experienced prejudice and homophobic behaviour in the course of utilising PHC clinics in Umlazi, which created a barrier to their utilisation of health services located there. Nursing education institutions, in collaboration with the National Department of Health, should introduce homosexuality and anti-homophobia education programmes during the pre-service and in-service education period. Such programmes will help to familiarise health care providers with the health care needs of homosexual patients and may decrease homophobic attitudes.

  11. The removable acrylic partial denture in primary care: the experience and satisfaction of dental surgeons

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    Rita de Cássia SILVA

    2017-11-01

    Full Text Available Abstract Introduction The guidelines of the National Politics of Oral Health have led to the inclusion of elemental prostheses in the list of Primary Care procedures. Objective This paper aimed to evaluate the performance and satisfaction of dental surgeons with the implementation of Acrylic Partial Dentures. Metodology The sample was composed by 159 dental surgeons (sample calculation, in Belo Horizonte, MG, Brazil, selected via raffle (simple random sampling. A structured questionnaire was built with 72 questions on the daily practice of the performance of dental surgeons, using the SurveyMonkey platform. Result The results showed that for most of dental surgeons, the inclusion on the list of primary care procedures was a positive initiative and they have enjoyed the experience of using Acrylic Partial Dentures. Dental surgeons who had graduated in private institutions reported to have had more failures than those who had graduated in public institutions. The better prepared dental surgeons reported less difficulties and failures, and the more satisfied professionals with the performance of Acrylic Partial Dentures related had also experienced fewer failures. Considering the indication, the majority of participants did it according to the protocol of the institution (only for anterior teeth but many revealed the use of dentures also for premolars. Conclusion Acrylic partial dentures have been a reality in the Brazilian social context even before their inclusion in the list of Primary Care procedures. Such inclusion indicates their relevance; however, it is necessary to have their confection systematized by a protocol in public services.

  12. Patients' experience of being triaged directly to a psychologist in primary care: a qualitative study.

    Science.gov (United States)

    Dahlöf, Linda; Simonsson, Anna; Thorn, Jörgen; Larsson, Maria Eh

    2014-10-01

    In a primary health-care centre (PHCC) situated in a segregated area with low socio-economic status, 'primary care triage' has increased efficiency and accessibility. In the primary-care triage, the nurse sorts the patient to the appropriate PHCC profession according to described symptoms. Aim The aim of this study was to examine the patients' experience of being triaged directly to a psychologist for assessment. Interviews were conducted with 20 patients and then analysed using qualitative content analysis. The results show that patients contacting the PHCC for mental health issues often are active agents with their own intent to see a psychologist, not a doctor, as a first-hand choice when contacting the PHCC. Seeking help for mental health issues is described as a sensitive issue that demands building up strength before contacting. The quick access to the preferred health-care professional is appreciated. The nurse was perceived as a caring facilitator rather than a decision maker. It is the patient's wish rather than the symptoms that directs the sorting. The patients' expectations when meeting the psychologist were wide and diverse. The structured assessment sometimes collided and sometimes united with these expectations, yielding different outcome satisfaction. The results could be seen in line with the present goal to increase patients' choice in the health-care system. The improved accessibility to the psychologist seems to meet community expectations. The results also indicate a need for providing more prior information about the assessment and potential outcomes.

  13. An evaluation of experiences and views of Scottish leadership training opportunities amongst primary care professionals.

    Science.gov (United States)

    Power, Ailsa; Allbutt, Helen; Munro, Lucy; MacLeod, Marion; Kennedy, Susan; Cameron, Donald; Scoular, Ken; Orr, Graham; Gillies, John

    2017-05-01

    To determine experiences of leadership training of six primary care professions in Scotland and consider future development. A questionnaire on previous leadership course attendance and future intentions was distributed to community pharmacists, general dental practitioners, general practitioners, practice nurses, practice managers and optometrists. Analysis comprised descriptive statistics for closed questions and management of textual data. Formal leadership training participation was fairly low except for practice managers. Leadership was perceived to facilitate development of staff, problem-solving and team working. Preference for future delivery was similar across the six professions with e-modules and small group learning being preferred. Time and financial pressures to undertake courses were common barriers for professionals. Leadership is key to improve quality, safety and efficiency of care and help deliver innovative services and transformative change. To date, leadership provision for primary care professionals has typically been patchy, uni-disciplinary in focus and undertaken outwith work environments. Future development must reflect needs of busy primary care professionals and the reality of team working to deliver integrated services at local level.

  14. Immediate primary anastomosis for isolated oesophageal atresia: A single-centre experience

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    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.

  15. Allogeneic hematopoietic stem cell transplantation in children with primary immunodeficiencies: Hospital Israelita Albert Einstein experience.

    Science.gov (United States)

    Fernandes, Juliana Folloni; Kerbauy, Fabio Rodrigues; Ribeiro, Andreza Alice Feitosa; Kutner, Jose Mauro; Camargo, Luis Fernando Aranha; Stape, Adalberto; Troster, Eduardo Juan; Zamperlini-Netto, Gabriele; Azambuja, Alessandra Milani Prandini de; Carvalho, Bruna; Dorna, Mayra de Barros; Vilela, Marluce Dos Santos; Jacob, Cristina Miuki Abe; Costa-Carvalho, Beatriz Tavares; Cunha, Jose Marcos; Carneiro-Sampaio, Magda Maria; Hamerschlak, Nelson

    2011-06-01

    To report the experience of a tertiary care hospital with allogeneic hematopoietic stem cell transplantation in children with primary immunodeficiencies. Seven pediatric patients with primary immunodeficiencies (severe combined immunodeficiency: n = 2; combined immunodeficiency: n = 1; chronic granulomatous disease: n = 1; hyper-IgM syndrome: n = 2; and IPEX syndrome: n = 1) who underwent eight hematopoietic stem cell transplants in a single center, from 2007 to 2010, were studied. Two patients received transplants from HLA-identical siblings; the other six transplants were done with unrelated donors (bone marrow: n = 1; cord blood: n = 5). All patients had pre-existing infections before hematopoietic stem cell transplants. One patient received only anti-thymocyte globulin prior to transplant, three transplants were done with reduced intensity conditioning regimens and four transplants were done after myeloablative therapy. Two patients were not evaluated for engraftment due to early death. Three patients engrafted, two had primary graft failure and one received a second transplant with posterior engraftment. Two patients died of regimen related toxicity (hepatic sinusoidal obstruction syndrome); one patient died of progressive respiratory failure due to Parainfluenza infection present prior to transplant. Four patients are alive and well from 60 days to 14 months after transplant. Patients' status prior to transplant is the most important risk factor on the outcome of hematopoietic stem cell transplants in the treatment of these diseases. Early diagnosis and the possibility of a faster referral of these patients for treatment in reference centers may substantially improve their survival and quality of life.

  16. Narrating Motherhood as Experience and Institution: Experimental Life-Writing in Mary Kelly’s Post-Partum Document (1973–79

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    Wierzchowska Justyna

    2015-12-01

    Full Text Available This article explores American visual artist Mary Kelly’s autobiographical work Post-partum document in reference to the politics of life writing. Resorting to Lacanian psychoanalysis, a pastiche of scientific narratives and other (auto-narrative strategies, in her work Kelly documented the first five years of her son’s life from his weaning from the breast until the day when he wrote his name. By documenting her child’s development, the artist also recorded the process of her own formation as a maternal subject, a formation gradually worked out through an evolving relationship with her son. In her work, the artist made vivid the incompatibility and limitations of various narrative frameworks in retelling a fundamentally relational experience that verges on the mental and bodily, and which is necessarily mediated by the patriarchal ideology. This article analyses Kelly’s conflicting narrative strategies that fail to successfully represent the mother-child formative relationship and which demonstrate the mother’s ideological alienation. It reads Kelly’s work politically, exploring the ways in which Post-partum document’s (auto-narrative voices address questions and dilemmas of the feminine/maternal subject, the subject’s formation, and the limits of its (self- representation within patriarchy. The article argues that Kelly challenges the traditional autobiographic genre by attending to her lived experience as a mother and the culturally repressed maternal desire.

  17. Review of outcomes of primary liver cancers in children: our institutional experience with resection and transplantation.

    Science.gov (United States)

    Malek, Marcus M; Shah, Sohail R; Atri, Prashant; Paredes, Jose L; DiCicco, Leigh Anne; Sindhi, Rakesh; Soltys, Kyle A; Mazariegos, George V; Kane, Timothy D

    2010-10-01

    Operative intervention plays an important role in the management of primary liver cancers in children. Recent improvements in diagnostic modalities, pre- and postoperative chemotherapy, and operative technique have all led to improved survival in these patients. Both hepatic resection and orthotopic liver transplantation are effective operations for pediatric liver tumors; which intervention is pursued is based on preoperative extent of disease. This is a review of our institution's experience with operative management of pediatric liver cancer over an 18-year period. A retrospective chart review from 1990 to 2007 identified patients who were ≤18 years old who underwent operative intervention for primary liver cancer. Demographics, type of operation, intraoperative details, pre- and postoperative management, as well as outcomes were recorded for all patients. Fifty-four patients underwent 57 operations for primary liver cancer, 30 of whom underwent resection; the remaining 27 underwent orthotopic liver transplantation. The mean age at diagnosis was 41 months. Twenty patients had stage 1 or 2 disease and 34 patients had stage 3 or 4 disease. Forty-eight (89%) patients received preoperative chemotherapy. Postoperative chemotherapy was given to 92% of patients. Mean overall and intensive care unit duration of stay were 18 and 6 days, respectively. About 45% of patients had a postoperative complication, including hepatic artery thrombosis (n = 8), line sepsis (n = 6), mild acute rejection (n = 3), biliary stricture (n = 2), pneumothorax (n = 2), incarcerated omentum (n = 1), Horner's syndrome (n = 1), and urosepsis (n = 1). Only 6 patients had a recurrence of their cancer, 5 after liver resection, 3 of whom later received a transplant. There was only 1 recurrence after liver transplantation. There was 1 perioperative mortality from cardiac arrest. Overall survival was 93%. Operative intervention plays a critical role in the management of primary liver cancer in the

  18. Documenting Learning

    Science.gov (United States)

    Ashbrook, Peggy

    2010-01-01

    Children's work documents their thinking and the details they note as they learn more. Over time, by drawing, dictating, or writing about their observations, children can reveal and deepen their understanding of science concepts. Documenting work to further understanding and sharing information is part of the National Science Education Teaching…

  19. Mental health and primary care: an experience with community health agents in Salvador-BA

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    Noêmia Aragão Casais

    2009-12-01

    Full Text Available Objective: To share an experience of a link between primary care and mental health by means of matrix support. Method: A survey conducted from March to December 2007, in Pernambués neighborhood, District of Cabula-beiru, in Salvador - Bahia. The shared knowledge construction was carried out by residents of the Multidisciplinary Residency Program in Health from the Nucleus of Mental Health, State University of Bahia, with Community Health Agents (ACS. Meetings, discussions and domiciliary visits were applyed as sharing technics and tools with phonographic recording, photographic register and report. The obtained information were evaluated regarding their content and were divided into stages and categories. Results: We determined the following stages by means of the technique: approach, ties’ strengthening, teamwork and conclusion. The results were analyzed based on the ACS’ everyday interactivity for cooperation, thus obtaining the development of a critical spirit in the assesment of the relationship between primary care and mental health. Final Considerations: The exchange of experiences produced significant learning, besides health promotion for all those involved in the process: ACS, families cared for and residents.

  20. Scaling up School-Wide Positive Behavioral Interventions and Supports: Experiences of Seven States with Documented Success

    Science.gov (United States)

    Horner, Robert H.; Kincaid, Donald; Sugai, George; Lewis, Timothy; Eber, Lucille; Barrett, Susan; Dickey, Celeste Rossetto; Richter, Mary; Sullivan, Erin; Boezio, Cyndi; Algozzine, Bob; Reynolds, Heather; Johnson, Nanci

    2014-01-01

    Scaling of evidence-based practices in education has received extensive discussion but little empirical evaluation. We present here a descriptive summary of the experience from seven states with a history of implementing and scaling School-Wide Positive Behavioral Interventions and Supports (SWPBIS) over the past decade. Each state has been…

  1. Sexual health in primary health care - a qualitative study of nurses' experiences.

    Science.gov (United States)

    Klaeson, Kicki; Hovlin, Lina; Guvå, Hanna; Kjellsdotter, Anna

    2017-06-01

    To illuminate nurses' experiences and opportunities to discuss sexual health with patients in primary health care. Sexual health is a concept associated with many taboos, and research shows that nurses feel uncomfortable talking to patients about sexual health and therefore avoid it. This avoidance forms a barrier between patient and nurse which prevents nurses from giving satisfactory health care to patients. A qualitative descriptive design. Semi-structured interviews were conducted with nine nurses in primary health care in Sweden. Data were analysed using qualitative content analysis. During the analysis phase, five subcategories and two main categories were identified. The two main categories were as follows: 'factors that influence nurses' opportunities of talking to patients about sexual health' and 'nurses' experiences of talking to patients about sexual health'. Social norms in society were an obstacle for health professionals' opportunities to feel comfortable and act professionally. The nurses' personal attitude and knowledge were of great significance in determining whether they brought up the topic of sexual health or not. The nurses found it easier to bring up the topic of sexual health with middle-aged men with, for example, diabetes. One reason for this is that they found it easier to talk to male patients. A further reason is the fact that they had received training in discussing matters of sexual health in relation to diabetes and other conditions affecting sexual health. Nurses in primary care express the necessity of additional education and knowledge on the subject of sexual health. The healthcare organisation must be reformed to put focus on sexual health. Guidelines for addressing the topic of sexual health must be implemented to establish conditions that will increase nurse's knowledge and provide them with the necessary tools for discussing sexual health with patients. © 2016 John Wiley & Sons Ltd.

  2. GPs’ experiences of children with anxiety disorders in primary care: a qualitative study

    Science.gov (United States)

    O’Brien, Doireann; Harvey, Kate; Young, Bridget; Reardon, Tessa; Creswell, Cathy

    2017-01-01

    Background Anxiety disorders have a median age of onset of 11 years and are the most common emotional disorders in childhood; however, a significant proportion of those affected do not access professional support. In the UK, GPs are often the first medical professional that families see so are in a prime position to support children with anxiety disorders; however, currently there is little research available on GPs’ perspectives on and experiences of supporting children with these disorders. Aim To explore the experiences of GPs in relation to identification, management, and access to specialist services for children (Design and setting Twenty semi-structured interviews were conducted with GPs in primary care throughout England. Method GPs reflected a diverse group in relation to the ethnic and socioeconomic profile of registered patients, GP age, sex, professional status, previous engagement with research, and practice size and location. Purposive sampling was used to recruit GPs until theoretical saturation was reached. Data were analysed using a constant comparative method of thematic analysis. Results Data from 20 semi-structured interviews were organised into three themes: decision making, responsibility, and emotional response, with an overarching theme of GPs feeling ill equipped. These themes were retrospectively analysed to illustrate their role at different stages in the primary care process (identification, management, and access to specialist services). Conclusion GPs feel ill equipped to manage and support childhood anxiety disorders, demonstrating a need for medical training to include greater emphasis on children’s mental health, as well as potential for greater collaboration between primary and specialist services. PMID:29061716

  3. Primary care nurses' experiences of how the mass media influence frontline healthcare in the UK.

    Science.gov (United States)

    van Bekkum, Jennifer E; Hilton, Shona

    2013-11-24

    Mass media plays an important role in communicating about health research and services to patients, and in shaping public perceptions and decisions about health. Healthcare professionals also play an important role in providing patients with credible, evidence-based and up-to-date information on a wide range of health issues. This study aims to explore primary care nurses' experiences of how mass media influences frontline healthcare. In-depth telephone interviews were carried out with 18 primary care nurses (nine health visitors and nine practice nurses) working in the United Kingdom (UK). Interviews were recorded and transcribed. The data was analysed using thematic analysis, with a focus on constant comparative analysis. Three themes emerged from the data. First, participants reported that their patients were frequently influenced by controversial health stories reported in the media, which affected their perceptions of, and decisions about, care. This, in turn, impinged upon participants' workloads as they had to spend additional time discussing information and reassuring patients. Second, participants also recalled times in their own careers when media reports had contributed to a decline in their confidence in current healthcare practices and treatments. Third, the participants in this study suggested a real need for additional resources to support and expand their own media literacy skills, which could be shared with patients. In an ever expanding media landscape with greater reporting on health, nurses working in the primary care setting face increasing pressure to effectively manage media stories that dispute current health policies and practices. These primary care nurses were keen to expand their media literacy skills to develop critical autonomy in relation to all media, and to facilitate more meaningful conversations with their patients about their health concerns and choices.

  4. Primary care nurses’ experiences of how the mass media influence frontline healthcare in the UK

    Science.gov (United States)

    2013-01-01

    Background Mass media plays an important role in communicating about health research and services to patients, and in shaping public perceptions and decisions about health. Healthcare professionals also play an important role in providing patients with credible, evidence-based and up-to-date information on a wide range of health issues. This study aims to explore primary care nurses’ experiences of how mass media influences frontline healthcare. Methods In-depth telephone interviews were carried out with 18 primary care nurses (nine health visitors and nine practice nurses) working in the United Kingdom (UK). Interviews were recorded and transcribed. The data was analysed using thematic analysis, with a focus on constant comparative analysis. Results Three themes emerged from the data. First, participants reported that their patients were frequently influenced by controversial health stories reported in the media, which affected their perceptions of, and decisions about, care. This, in turn, impinged upon participants’ workloads as they had to spend additional time discussing information and reassuring patients. Second, participants also recalled times in their own careers when media reports had contributed to a decline in their confidence in current healthcare practices and treatments. Third, the participants in this study suggested a real need for additional resources to support and expand their own media literacy skills, which could be shared with patients. Conclusion In an ever expanding media landscape with greater reporting on health, nurses working in the primary care setting face increasing pressure to effectively manage media stories that dispute current health policies and practices. These primary care nurses were keen to expand their media literacy skills to develop critical autonomy in relation to all media, and to facilitate more meaningful conversations with their patients about their health concerns and choices. PMID:24267614

  5. Food Safety and Sustainable Nutrition Workshops: Educational Experiences for Primary School Children in Turin, Italy.

    Science.gov (United States)

    Traversa, Amaranta; Adriano, Daniela; Bellio, Alberto; Bianchi, Daniela Manila; Gallina, Silvia; Ippolito, Clara; Romano, Angelo; Durelli, Paola; Pezzana, Andrea; Decastelli, Lucia

    2017-01-24

    European control and prevention policies are focused to guarantee a high level of protection of consumers' health. Food-borne diseases as obesity, diabetes, food allergy, and food-borne outbreaks are increasing. To prevent food-borne diseases, it is fundamental to involve consumers, in particular children, in educational experiences aimed to learn the proper behaviours to be applied. In this context, we designed and performed 5 educational workshops about food safety, hidden allergens in food and nutrition aimed to involve children attending primary and summer school. These experiences let us collect observations about children knowledge and behaviours. From May to October 2015, a total of 1708 children aged 6 to 11 years joined our workshops. Children were involved in listening activities, laboratory experiments, handling games and sensory experiences. All participants were familiar with food allergy and were interested to know how to behave with allergic people. Children showed great curiosity in discovering that many foods normally contain live bacteria. Less than 25% of children reported to skip breakfast, to have it watching TV or to spend few minutes for it. Many of them (>75%) thought that fruits and vegetables are all year-round available and are not related to a specific period. Very few participants (<25%) knew that freezing is the treatment to be applied to make fresh fish safe from parasites. Children involved in food safety and nutrition educational experiences have the opportunity to increase their awareness about the correct behaviours to prevent food-borne diseases and to improve their own critical thinking about food consumption.

  6. Food safety and sustainable nutrition workshops: educational experiences for primary school children in Turin, Italy

    Directory of Open Access Journals (Sweden)

    Amaranta Traversa

    2017-01-01

    Full Text Available European control and prevention policies are focused to guarantee a high level of protection of consumers’ health. Foodborne diseases as obesity, diabetes, food allergy, and food-borne outbreaks are increasing. To prevent food-borne diseases, it is fundamental to involve consumers, in particular children, in educational experiences aimed to learn the proper behaviours to be applied. In this context, we designed and performed 5 educational workshops about food safety, hidden allergens in food and nutrition aimed to involve children attending primary and summer school. These experiences let us collect observations about children knowledge and behaviours. From May to October 2015, a total of 1708 children aged 6 to 11 years joined our workshops. Children were involved in listening activities, laboratory experiments, handling games and sensory experiences. All participants were familiar with food allergy and were interested to know how to behave with allergic people. Children showed great curiosity in discovering that many foods normally contain live bacteria. Less than 25% of children reported to skip breakfast, to have it watching TV or to spend few minutes for it. Many of them (>75% thought that fruits and vegetables are all year-round available and are not related to a specific period. Very few participants (<25% knew that freezing is the treatment to be applied to make fresh fish safe from parasites. Children involved in food safety and nutrition educational experiences have the opportunity to increase their awareness about the correct behaviours to prevent food-borne diseases and to improve their own critical thinking about food consumption.

  7. Interprofessional learning in primary care: an exploration of the service user experience leads to a new model for co-learning.

    Science.gov (United States)

    Worswick, Louise; Little, Christine; Ryan, Kath; Carr, Eloise

    2015-01-01

    Research about service user involvement in research and education focuses on the purpose, the methods, the barriers and the impact of their involvement. Few studies report on the experience of the service users who get involved. This paper reports an exploration of the experience of service users who participated in an interprofessional educational initiative in primary care - the Learning to Improve the Management of Back Pain in the Community (LIMBIC) project. Service users attended workshops with practice teams and assisted them in developing small scale quality improvement projects to improve their provision of care for people with back pain. To explore the experience of service users involved in the LIMBIC project. Using the philosophical and methodological approaches of pragmatism this study analysed data from the wider LIMBIC project and collected primary data through semi structured interviews with service users. Secondary data were reanalysed and integrated with primary data to address the research question. The study was undertaken in the primary health care setting. Patients participated as service users in workshops and quality improvement projects with members from their practice teams. Interviews with service users were transcribed and analysed thematically. Document and thematic analyses of secondary data from the LIMBIC project included focus group transcripts, patient stories, film, emails, meeting notes, a wiki and educational material such as presentations. Themes identified through the analyses illustrated the importance, to the service users, of the sense of community, of clear communication, and of influencing change through involvement. A model for co-learning with service users resulted from the analyses. The experience of service users can be optimised by planning, preparation and support so that their wealth of expertise can be recognised and utilised. A model for co-learning was developed and is presented in this paper. Copyright © 2014

  8. [Primary care and mental health care collaboration in patients with depression: Evaluation of a pilot experience].

    Science.gov (United States)

    Calderón, Carlos; Balagué, Laura; Iruin, Álvaro; Retolaza, Ander; Belaunzaran, Jon; Basterrechea, Javier; Mosquera, Isabel

    2016-01-01

    To implement and assess a collaborative experience between Primary Care (PC) and Mental Health (MH) in order to improve the care of patients with depression. Pilot collaborative project from a participatory action research approach during 2013. Basque Country. Osakidetza (Basque Health Service). Bizkaia and Gipuzkoa. The study included 207 professionals from general practice, nursing, psychiatry, psychiatric nursing, psychology and social work of 9 health centres and 6 mental health centres of Osakidetza. Shared design and development of four axes of intervention: 1) Communication and knowledge between PC and MH professionals, 2) Improvement of diagnostic coding and referral of patients, 3) Training programmes with meetings and common Clinical Practice Guidelines, and 4) Evaluation. Intervention and control questionnaires to professionals of the centres on the knowledge and satisfaction in the PC-MH relationship, joint training activities, and assessment of the experience. Osakidetza registers of prevalences, referrals and treatments. Follow-up meetings. Improvement in the 4 axes of intervention in the participant centres compared with the controls. Identification of factors to be considered in the development and sustainability of PC-MH collaborative care. The pilot experience confirms that collaborative projects promoted by PC and MH can improve depression care and the satisfaction of professionals. They are complex projects that need simultaneous interventions adjusted to the particularities of the health services. Multidisciplinary and continuous participation and management and information system support are necessary for their implementation. Copyright © 2015 Elsevier España, S.L.U. All rights reserved.

  9. [Expectations and user experiences of older Roma women with health services in primary care].

    Science.gov (United States)

    Ramos-Morcillo, Antonio Jesús; Ruzafa-Martínez, María; Fernández-Salazar, Serafín; Del-Pino-Casado, Rafael

    2015-04-01

    To know the expectations and user experiences of older Roma women with health services in primary care (PC). Phenomenological qualitative study. Using focus groups (4-9 women/group) and semistructured interviews. Audio recorded from March to November 2011. Performed in Úbeda and Linares (Spain). Roma women over 50years. A purposive sample stratified by age and area of residence was carried out. Woman were recruited through community leaders. Process of qualitative content analysis: coding, triangulation, obtain and verify results. Supported whit the software Nvivo 8. Three focus groups and four interviews were conducted, including 23 women. The expectations for the PC are focus exclusively on their physician, being invisible other professionals. They look for a relationship with their physician based on trust. In their user experience with the PC coexist three types of user: who goes to their appointments, demands attention only in acute disease and does not attend appointments and reviews. There are socio-cultural factors related to accessibility. Older Roma women set their expectations and experiences with health service in PC around the binomial disease/physician. Expect attention based on trust and a high instrumentalization. A speech with signs of change directed towards a more active and demanding participation in PC services is observed. Copyright © 2014 Elsevier España, S.L.U. All rights reserved.

  10. Social Learning Analytics in Higher Education. An experience at the Primary Education stage

    Directory of Open Access Journals (Sweden)

    Jose Javier Díaz-Lázaro

    2017-07-01

    Full Text Available The concept of Learning Analytics, as we understand it today, is relatively new but the practice of evaluating user behavior is not innovative. For years, technological development, along with other educational aspects, have encouraged, developed and facilitated this practice as a way of providing a personalized quality experience to students. The main goal of this study, carried out in the Primary Education Degree of the University of Murcia, was to research, from the perspective of Social Learning Analytics, how students learn and collaborate in online environments, specifically through their use of social media. With the idea of improving and optimizing future teaching experiences, a pilot study was conducted using weblog, Twitter and Facebook to work with different topics on the subject. The method used in this research was a participant observation and the analysis performed was both quantitative, based mainly on the data gathered from the learning analytics, and qualitative (analyzing students’ content from comments. Results show that there was greater interaction on Facebook than weblogs, where students interacted to deal with aspects related to the learning process and the topic of the subject. This exchange of information grew during the development of the experience. In addition, learning analytics shows that there is a relationship between group members and their interaction and behavior in networks.

  11. Maury Documentation

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — Supporting documentation for the Maury Collection of marine observations. Includes explanations from Maury himself, as well as guides and descriptions by the U.S....

  12. Intertidal Sandbar Welding as a Primary Source of Sediment for Dune Growth: Evidence from a Large Scale Field Experiment

    Science.gov (United States)

    Cohn, N.; Ruggiero, P.; de Vries, S.

    2016-12-01

    Dunes provide the first line of defense from elevated water levels in low-lying coastal systems, limiting potentially major flooding, economic damages, and loss of livelihood. Despite the well documented importance of healthy dunes, our predictive ability of dune growth, particularly following erosive storm events, remains poor - resulting in part from traditionally studying the wet and dry beach as separate entities. In fact, however, dune recovery and growth is closely tied to the subtidal morphology and the nearshore hydrodynamic conditions, necessitating treating the entire coastal zone from the shoreface to the backshore as an integrated system. In this context, to further improve our understanding of the physical processes allowing for beach and dune growth during fair weather conditions, a large field experiment, the Sandbar-aEolian Dune EXchange EXperiment, was performed in summer 2016 in southwestern Washington, USA. Measurements of nearshore and atmospheric hydrodynamics, in-situ sediment transport, and morphology change provide insight into the time and space scales of nearshore-beach-dune exchanges along a rapidly prograding stretch of coast over a 6 week period. As part of this experiment, the hypothesis that dune growth is limited by the welding of intertidal sandbars to the shoreline (Houser, 2009) was tested. Using laser particle counters, bed elevation sensors (sonar altimeters and Microsoft Kinect), continuously logging sediment traps, RGB and IR cameras, and repeat morphology surveys (terrestrial lidar, kite based structure from motion, and RTK GPS), spatial and temporal trends in aeolian sediment transport were assessed in relation to the synoptic onshore migration and welding of intertidal sandbars. Observations from this experiment demonstrate that (1) the intertidal zone is the primary source of sediment to the dunes during non-storm conditions, (2) rates of saltation increase during later stages of bar welding but equivalent wind conditions

  13. [Primary care in the USA and the Peruvian experience in perspective].

    Science.gov (United States)

    Muench, John; Hoffman, Kim; Ponce, Javier; Calderón, María; Meenan, Richard T; Fiestas, Fabián

    2013-04-01

    Due to a complex payment system, the health system of the United States is fragmented, expensive, and achieves the goal of improving the health of the entire population. Excessive health costs increase the budget deficit in the US. This situation makes to the government to have greater willingness to try new approaches in the delivery of health services. Is well know that the states that have a solid system of primary health care (PC), spent less money in diseases and have lower utilization of health services (reflected in fewer days of hospitalization). This is why the AP is spreading in the US making doctors, nurses and other providers to collaborate on new proposals for team-based care, coordinated and patient-oriented generating real benefits while controlling costs. The US experience with AP support evidence-based approach to propose, from a foreign perspective, strengthening the AP in Peru.

  14. Experiences of homosexual patients’ access to primary health care services in Umlazi, KwaZulu-Natal

    Directory of Open Access Journals (Sweden)

    Nokulunga H. Cele

    2015-07-01

    Full Text Available Background: Homosexual patients are affected by social factors in their environment, and as a result may not have easy access to existing health care services. Prejudice against homosexuality and homosexual patients remains a barrier to them seeking appropriate healthcare. The concern is that lesbians and gays might delay or avoid seeking health care when they need it because of past discrimination or perceived homophobia within the health care thereby putting their health at risk.Aim of the study: The aim of the study was to explore and describe the experiences of homosexual patients utilising primary health care (PHC services in Umlazi in the province ofKwaZulu-Natal (KZN.Method: A qualitative, exploratory, descriptive study was conducted which was contextual innature. Semi-structured interviews were conducted with 12 participants. The findings of this study were analysed using content analysis.Results: Two major themes emerged from the data analysis, namely, prejudice against homosexual patients by health care providers and other patients at the primary health care facilities, and, homophobic behaviour from primary health care personnel.Conclusion: Participants experienced prejudice and homophobic behaviour in the course of utilising PHC clinics in Umlazi, which created a barrier to their utilisation of health services located there. Nursing education institutions, in collaboration with the National Department of Health, should introduce homosexuality and anti-homophobia education programmes during the pre-service and in-service education period. Such programmes will help to familiarise health care providers with the health care needs of homosexual patients and may decrease homophobic attitudes.

  15. [Application of the cultural competence model in the experience of care in nursing professionals Primary Care].

    Science.gov (United States)

    Gil Estevan, María Dolores; Solano Ruíz, María Del Carmen

    2017-11-01

    To know the experiences and perceptions of nurses in providing care and health promotion, women belonging to groups at risk of social vulnerability, applying the model of cultural competence Purnell. Phenomenological qualitative study. Department of Health Elda. A total of 22 primary care professional volunteers. Semi-structured interviews and focus groups with recording and content analysis, according to the theory model of cultural competence. Socio-cultural factors influence the relationship between professionals and users of the system. The subtle racism and historical prejudices create uncomfortable situations and mistrust. The language barrier makes it difficult not only communication, but also the monitoring and control of the health-disease process. The physical appearance and stereotypes are determining factors for primary care professionals. Although perceived misuse of health services are also talking about changes. The spiritual aspects of religious beliefs alone are taken into account in the case of Muslim women, not being considered as important in the case of Gypsy women and Romanian women. To provide quality care, consistent and culturally competent, it is necessary to develop training programs for professionals in cultural competence, to know the culture of other, and work without preconceived ideas, and ethnocentric; since the greater the knowledge of the cultural group being served, the better the quality of care provided. Copyright © 2017 Elsevier España, S.L.U. All rights reserved.

  16. Melanoma of unknown primary: experience at Massachusetts General Hospital and Dana-Farber Cancer Institute.

    Science.gov (United States)

    Katz, Kenneth A; Jonasch, Eric; Hodi, F Stephen; Soiffer, Robert; Kwitkiwski, Kimberly; Sober, Arthur J; Haluska, Frank G

    2005-02-01

    Melanoma may present metastatically without an identifiable primary lesion. To further characterize the epidemiology of melanoma of unknown primary (MUP), we report our experience with a cohort of MUP patients. We retrospectively reviewed patients seen at the Massachusetts General Hospital (MGH) and the Dana-Farber Cancer Institute (DFCI) between 1986 and 1996 with follow-up to 2002. Data were analysed using log-rank and proportional hazards analyses, with death from any cause as the main outcome measure. Of the 2485 melanoma patients seen, 65 (2.6%) had MUP; 41 patients were male [63.1%; 95% confidence interval (CI), 50.2%, 74.7%]. The median age at diagnosis was 54.1 years (interquartile range, 39.4-67.1 years). Thirty patients had lymph node metastases, 12 cutaneous or subcutaneous metastases and 23 visceral metastases. Of the 62 patients (95.4%) with at least some follow-up, there were 42 deaths from any cause. Patients with lymph node metastases survived significantly longer than patients with other metastases [5-year survival 38.7% (95% CI, 18.1%, 59.1%) vs. 13.9% (95% CI, 4.4%, 28.6%); Pdefinition of MUP, may shed light on the pathogenesis and prognosis of MUP.

  17. Abused women's experiences of a primary care identification and referral intervention: a case study analysis.

    Science.gov (United States)

    Bradbury-Jones, Caroline; Clark, Maria; Taylor, Julie

    2017-12-01

    The aim of this study was to report the findings of a qualitative case study that investigated abused women's experiences of an identification and referral intervention and to discuss the implications for nurses, specifically those working in primary and community care. Domestic violence and abuse is a significant public health issue globally but it is a hidden problem that is under-reported. In the UK, Identification and Referral to Improve Safety is a primary care-based intervention that has been found to increase referral rates of abused women to support and safety services. This paper reports on the findings of an evaluation study of two sites in England. Qualitative study with a case study design. In line with case study design, the entire evaluation study employed multiple data collection methods. We report on the qualitative interviews with women referred through the programme. The aim was to elicit their experiences of the three aspects of the intervention: identification; referral; safety. Data collection took place March 2016. Ten women took part. Eight had exited the abusive relationship but two remained with the partner who had perpetrated the abuse. Women were overwhelmingly positive about the programme and irrespective of whether they had remained or exited the relationship all reported perceptions of increased safety and improved health. Nurses have an important role to play in identifying domestic violence and abuse and in referral and safety planning. As part of a portfolio of domestic violence and abuse interventions, those that empower women to take control of their safety (such as Identification and Referral to Improve Safety) are important. © 2017 John Wiley & Sons Ltd.

  18. Improving text comprehension strategies in upper primary school children: a design experiment.

    Science.gov (United States)

    De Corte, E; Verschaffel, L; Van De Ven, A

    2001-12-01

    With respect to the acquisition of competence in reading, new standards for primary education stress more than before the importance of learning and teaching cognitive and metacognitive strategies that facilitate text comprehension. Therefore, there is a need to design a research-based instructional approach to strategic reading comprehension. The design experiment aimed at developing, implementing and evaluating a research-based, but also practically applicable learning environment for enhancing skilled strategy use in upper primary school children when reading a text. Four text comprehension strategies (activating prior knowledge, clarifying difficult words, making a schematic representation of the text, and formulating the main idea) and a metacognitive strategy (regulating one's own reading process) were trained through a variety of highly interactive instructional techniques, namely modelling, whole class discussion, and small group work in the format of reciprocal teaching. Participants in the study were four experimental 5th grade classes (79 children) and eight comparable control classes (149 pupils). The effects of the learning environment were measured using a pretest-post-test-retention design. Multilevel hierarchical linear regression models were used to analyse the quantitative data of a Reading Strategy Test, a standardised Reading Comprehension Test, a Reading Attitude Scale, a Transfer Test and an interview about strategy use during reading. The data of the Reading Strategy Test, the Transfer Test and the interviews about strategy use showed that the experimental group out-performed the control group in terms of the strategy adoption and application during text reading. Whilst the experimental group also scored higher on the Reading Comprehension Test than the control group, the difference was not significant. This design experiment shows that it is possible to foster pupils' use and transfer of strategic reading comprehension skills in regular

  19. User Manuals for a Primary Care Electronic Medical Record System: A Mixed Methods Study of User- and Vendor-Generated Documents.

    Science.gov (United States)

    Shachak, Aviv; Dow, Rustam; Barnsley, Jan; Tu, Karen; Domb, Sharon; Jadad, Alejandro R; Lemieux-Charles, Louise

    2013-06-04

    Tutorials and user manuals are important forms of impersonal support for using software applications including electronic medical records (EMRs). Differences between user- and vendor documentation may indicate support needs, which are not sufficiently addressed by the official documentation, and reveal new elements that may inform the design of tutorials and user manuals. What are the differences between user-generated tutorials and manuals for an EMR and the official user manual from the software vendor? Effective design of tutorials and user manuals requires careful packaging of information, balance between declarative and procedural texts, an action and task-oriented approach, support for error recognition and recovery, and effective use of visual elements. No previous research compared these elements between formal and informal documents. We conducted an mixed methods study. Seven tutorials and two manuals for an EMR were collected from three family health teams and compared with the official user manual from the software vendor. Documents were qualitatively analyzed using a framework analysis approach in relation to the principles of technical documentation described above. Subsets of the data were quantitatively analyzed using cross-tabulation to compare the types of error information and visual cues in screen captures between user- and vendor-generated manuals. The user-developed tutorials and manuals differed from the vendor-developed manual in that they contained mostly procedural and not declarative information; were customized to the specific workflow, user roles, and patient characteristics; contained more error information related to work processes than to software usage; and used explicit visual cues on screen captures to help users identify window elements. These findings imply that to support EMR implementation, tutorials and manuals need to be customized and adapted to specific organizational contexts and workflows. The main limitation of the study

  20. Association between health literacy and patient experience of primary care attributes: A cross-sectional study in Japan.

    Directory of Open Access Journals (Sweden)

    Takuya Aoki

    Full Text Available Primary care is regarded as a setting that potentially mitigate patient health literacy (HL related inequalities. However, there is a lack of evidence about influence of patient HL on the patients' perception of quality of primary care. We aimed to examine the association between HL and patient experience of primary care attributes. We conducted a cross-sectional survey, and sent questionnaires to adult residents who were randomly selected from a basic resident register in Yugawara Town, Kanagawa, Japan. We assessed HL using a 14-item Health Literacy Scale (HLS-14 and patient experience of primary care attributes using a Japanese version of Primary Care Assessment Tool (JPCAT, which comprises six domains: first contact, longitudinality, coordination, comprehensiveness (services available, comprehensiveness (services provided, and community orientation. We used a multivariable linear regression analyses to adjust individual covariates. Data were analyzed for 381 residents who had a usual source of care. After adjustment for patients' sociodemographic and health characteristics, patient HL was positively associated with the JPCAT total score (B = 4.49, 95% confidence interval: 0.27 to 8.65 for HLS-14 total score highest quartile, compared with the lowest quartile. Among primary care attributes, HL had significant associations with longitudinality and comprehensiveness (service provided. We found that HL was positively associated with patient experience of primary care attributes in Japanese people. Our findings indicated that greater efforts might be needed to improve patient-centered and tailored primary care to those with low HL.

  1. Association between health literacy and patient experience of primary care attributes: A cross-sectional study in Japan.

    Science.gov (United States)

    Aoki, Takuya; Inoue, Machiko

    2017-01-01

    Primary care is regarded as a setting that potentially mitigate patient health literacy (HL) related inequalities. However, there is a lack of evidence about influence of patient HL on the patients' perception of quality of primary care. We aimed to examine the association between HL and patient experience of primary care attributes. We conducted a cross-sectional survey, and sent questionnaires to adult residents who were randomly selected from a basic resident register in Yugawara Town, Kanagawa, Japan. We assessed HL using a 14-item Health Literacy Scale (HLS-14) and patient experience of primary care attributes using a Japanese version of Primary Care Assessment Tool (JPCAT), which comprises six domains: first contact, longitudinality, coordination, comprehensiveness (services available), comprehensiveness (services provided), and community orientation. We used a multivariable linear regression analyses to adjust individual covariates. Data were analyzed for 381 residents who had a usual source of care. After adjustment for patients' sociodemographic and health characteristics, patient HL was positively associated with the JPCAT total score (B = 4.49, 95% confidence interval: 0.27 to 8.65 for HLS-14 total score highest quartile, compared with the lowest quartile). Among primary care attributes, HL had significant associations with longitudinality and comprehensiveness (service provided). We found that HL was positively associated with patient experience of primary care attributes in Japanese people. Our findings indicated that greater efforts might be needed to improve patient-centered and tailored primary care to those with low HL.

  2. Primary care patient experience and cancer screening uptake among women: an exploratory cross-sectional study in a Japanese population.

    Science.gov (United States)

    Aoki, Takuya; Inoue, Machiko

    2017-01-01

    Patient experience and clinical quality, which are represented by preventive care measures such as cancer screening, are both widely used for the evaluation of primary care quality. The aim of this study was to examine the association between patient experience and cancer screening uptake among women in a Japanese population. We conducted a cross-sectional mail survey. The questionnaire was sent to 1000 adult female residents randomly selected from a basic resident register in Yugawara town, Kanagawa, Japan. We assessed patient experience of primary care using a Japanese version of Primary Care Assessment Tool (JPCAT) and uptake of breast and cervical cancer screening. The overall response rate was 46.5%. Data were analyzed for 190 female participants aged 21-74 years who had a usual source of primary care. Multivariate logistic regression analyses revealed that the JPCAT total score was significantly associated with uptake of breast cancer screening [odds ratio (OR) per 1 standard deviation increase = 1.63; 95% CI 1.11-2.41], but not with uptake of cervical cancer screening (OR per 1 standard deviation increase = 1.47; 95% CI 0.97-2.24). Patient experience of primary care was associated with uptake of breast cancer screening among Japanese women. The results of our study might support the argument that patient experience of primary care and the clinical process of preventive care, such as breast cancer screening, are linked.

  3. In-hospital prescription changes and documentation in the medical records of the primary care provider : results from a medical record review study

    NARCIS (Netherlands)

    Poldervaart, Judith M|info:eu-repo/dai/nl/413970086; van Melle, Marije A.|info:eu-repo/dai/nl/413967719; Willemse, Sanne; de Wit, Niek J|info:eu-repo/dai/nl/100525393; Zwart, Dorien L M|info:eu-repo/dai/nl/31441312X

    2017-01-01

    Background An increasing number of transitions due to substitution of care of more complex patients urges insight in and improvement of transitional medication safety. While lack of documentation of prescription changes and/or lack of information exchange between settings likely cause adverse drug

  4. Recruiting primary care physicians to qualitative research: Experiences and recommendations from a childhood cancer survivorship study.

    Science.gov (United States)

    Signorelli, Christina; Wakefield, Claire E; Fardell, Joanna E; Thornton-Benko, Elysia; Emery, Jon; McLoone, Jordana K; Cohn, Richard J

    2018-01-01

    Primary care physicians (PCPs) are essential for healthcare delivery but can be difficult to recruit to health research. Low response rates may impact the quality and value of data collected. This paper outlines participant and study design factors associated with increased response rates among PCPs invited to participate in a qualitative study at Sydney Children's Hospital, Australia. We invited 160 PCPs by post, who were nominated by their childhood cancer patients in a survey study. We followed-up by telephone, email, or fax 2 weeks later. Without any follow-up, 32 PCPs opted in to the study. With follow-up, a further 42 PCPs opted in, with email appearing to be the most effective method, yielding a total of 74 PCPs opting in (46.3%). We reached data saturation after 51 interviews. On average, it took 34.6 days from mail-out to interview completion. Nonrespondents were more likely to be male (P = 0.013). No survivor-related factors significantly influenced PCPs' likelihood of participating. Almost double the number of interviews were successfully completed if scheduled via email versus phone. Those requiring no follow-up did not differ significantly to late respondents in demographic/survivor-related characteristics. PCP factors associated with higher opt in rates, and early responses, may be of interest to others considering engaging PCPs and/or their patients in cancer-related research, particularly qualitative or mixed-methods studies. Study resources may be best allocated to email follow-up, incentives, and personalization of study documents linking PCPs to patients. These efforts may improve PCP participation and the representativeness of study findings. © 2017 Wiley Periodicals, Inc.

  5. The relationship between voice climate and patients' experience of timely care in primary care clinics.

    Science.gov (United States)

    Nembhard, Ingrid M; Yuan, Christina T; Shabanova, Veronika; Cleary, Paul D

    2015-01-01

    Aspects of the patient care experience, despite being central to quality care, are often problematic. In particular, patients frequently report problems with timeliness of care. As yet, research offers little insight on setting characteristics that contribute to patients' experience of timely care. The aims of this study were to assess the relationship between organizational climate and patients' reports of timely care in primary care clinics and to broadly examine the link between staff's work environment and patient care experiences. We test hypotheses about the relationship between voice climate--staff feeling safe to speak up about issues--and reported timeliness of care, consistency in reported voice climate across professions, and how climate differences for various professions relate to timely care. We conducted a cross-sectional study of employees (n = 1,121) and patients (n = 8,164) affiliated with 37 clinics participating in a statewide reporting initiative. Employees were surveyed about clinics' voice climate, and patients were surveyed about the timeliness of care. Hypotheses were tested using analysis of variance and generalized estimating equations. Clinical and administrative staff (e.g., nurses and office assistants) reported clinics' climates to be significantly less supportive of voice than did clinical leaders (e.g., physicians). The greater the difference in reported support for voice between professional groups, the less patients reported experiencing timely care in three respects: obtaining an appointment, seeing the doctor within 15 minutes of appointment time, and receiving test results. In clinics where staff reported climates supportive of voice, patients indicated receiving more timely care. Clinical leaders' reports of voice climate had no relationship to reported timeliness of care. Our findings suggest the importance of clinics developing a strong climate for voice, particularly for clinical and administrative staff, to support better

  6. Web-based textual analysis of free-text patient experience comments from a survey in primary care.

    Science.gov (United States)

    Maramba, Inocencio Daniel; Davey, Antoinette; Elliott, Marc N; Roberts, Martin; Roland, Martin; Brown, Finlay; Burt, Jenni; Boiko, Olga; Campbell, John

    2015-05-06

    Open-ended questions eliciting free-text comments have been widely adopted in surveys of patient experience. Analysis of free text comments can provide deeper or new insight, identify areas for action, and initiate further investigation. Also, they may be a promising way to progress from documentation of patient experience to achieving quality improvement. The usual methods of analyzing free-text comments are known to be time and resource intensive. To efficiently deal with a large amount of free-text, new methods of rapidly summarizing and characterizing the text are being explored. The aim of this study was to investigate the feasibility of using freely available Web-based text processing tools (text clouds, distinctive word extraction, key words in context) for extracting useful information from large amounts of free-text commentary about patient experience, as an alternative to more resource intensive analytic methods. We collected free-text responses to a broad, open-ended question on patients' experience of primary care in a cross-sectional postal survey of patients recently consulting doctors in 25 English general practices. We encoded the responses to text files which were then uploaded to three Web-based textual processing tools. The tools we used were two text cloud creators: TagCrowd for unigrams, and Many Eyes for bigrams; and Voyant Tools, a Web-based reading tool that can extract distinctive words and perform Keyword in Context (KWIC) analysis. The association of patients' experience scores with the occurrence of certain words was tested with logistic regression analysis. KWIC analysis was also performed to gain insight into the use of a significant word. In total, 3426 free-text responses were received from 7721 patients (comment rate: 44.4%). The five most frequent words in the patients' comments were "doctor", "appointment", "surgery", "practice", and "time". The three most frequent two-word combinations were "reception staff", "excellent service

  7. The effect of increased primary schooling on adult women's HIV status in Malawi and Uganda: Universal Primary Education as a natural experiment.

    Science.gov (United States)

    Behrman, Julia Andrea

    2015-02-01

    This paper explores the causal relationship between primary schooling and adult HIV status in Malawi and Uganda, two East African countries with some of the highest HIV infection rates in the world. Using data from the 2010 Malawi Demographic Health Survey and the 2011 Uganda AIDS Indicator Survey, the paper takes advantage of a natural experiment, the implementation of Universal Primary Education policies in the mid 1990s. An instrumented regression discontinuity approach is used to model the relationship between increased primary schooling and adult women's HIV status. Results indicate that a one-year increase in schooling decreases the probability of an adult woman testing positive for HIV by 0.06 (p adult) sexual behavior. Copyright © 2014 The Author. Published by Elsevier Ltd.. All rights reserved.

  8. Integrating a primary oral health care approach in the dental curriculum: a Tanzanian experience.

    Science.gov (United States)

    Mumghamba, Elifuraha G

    2014-01-01

    This paper is based on a conference presentation made during the inauguration of the Faculty of Dentistry, Kuwait University, as a World Health Organization Collaborating Centre for Primary Oral Health Care (POHC) on November 27-28, 2012. The aim of this paper is to review how the POHC approach has been integrated into the dental curriculum, sharing the Tanzanian experience as a case presentation from a developing country. The burden of oral diseases worldwide is high, and the current oral health workforce is inadequate to meet the challenges. Curative oral health care is very costly and not accessible to the poor and minorities. To tackle the problem, the POHC approach rooted in primary health care that emphasizes equity, community involvement, prevention, appropriate technology and a multi-sectorial approach was developed and has been operating for more than 3 decades now. Execution of a comprehensive POHC requires a trained oral health workforce mix with essential competencies. For this case study, a literature search was done using the search engines subscribed to by the library of Muhimbili University of Health and Allied Sciences, including PubMed, Cochrane, ScienceDirect and Scopus, Wiley-Blackwell Interscience, Sage and the Health InterNetwork Access to Research Initiative (HINARI) that gives access to Scirus and Google Scholar. Challenges are discussed with an emphasis more on addressing the common risk factors and determinants of oral health. Integration of the POHC approach in the dental curriculum for training a competent workforce is crucial in attaining better oral health. Resources are still a major challenge, and the impact of the POHC approach in the curriculum is yet to be evaluated. © 2013 S. Karger AG, Basel.

  9. Parents' Expectations and Experiences of Antibiotics for Acute Respiratory Infections in Primary Care.

    Science.gov (United States)

    Coxeter, Peter D; Mar, Chris Del; Hoffmann, Tammy C

    2017-03-01

    Primary care visits for children with acute respiratory infections frequently result in antibiotic prescriptions, although antibiotics have limited benefits for common acute respiratory infections and can cause harms, including antibiotic resistance. Parental demands are often blamed for antibiotic prescription. We aimed to explore parents' beliefs about antibiotic necessity, quantify their expectations of antibiotic benefit, and report experiences of other management options and exposure to and preferences for shared decision making. We conducted computer-assisted telephone interviews in an Australia-wide community sample of primary caregivers, hereafter referred to as parents, of children aged 1 to 12 years, using random digit dialing of household landline telephones. Of the 14,505 telephone numbers called, 10,340 were eligible numbers; 589 potentially eligible parents were reached, of whom 401 were interviewed. Most believed antibiotics provide benefits for common acute respiratory infections, especially for acute otitis media (92%), although not using them, particularly for acute cough and sore throat, was sometimes acceptable. Parents grossly overestimated the mean benefit of antibiotics on illness symptom duration by 5 to 10 times, and believed they reduce the likelihood of complications. The majority, 78%, recognized antibiotics may cause harm. Recalling the most recent relevant doctor visit, 44% of parents reported at least some discussion about why antibiotics might be used; shared decision making about antibiotic use was inconsistent, while 75% wanted more involvement in future decisions. Some parents have misperceptions about antibiotic use for acute respiratory infections, highlighting the need for improved communication during visits, including shared decision making to address overoptimistic expectations of antibiotics. Such communication should be one of several strategies that is used to reduce antibiotic use. © 2017 Annals of Family Medicine, Inc.

  10. Rural-to-Urban Migrants' Experiences with Primary Care under Different Types of Medical Institutions in Guangzhou, China.

    Directory of Open Access Journals (Sweden)

    Jiazhi Zeng

    Full Text Available China is facing the unprecedented challenge of rapidly increasing rural-to-urban migration. Migrants are in a vulnerable state when they attempt to access to primary care services. This study was designed to explore rural-to-urban migrants' experiences in primary care, comparing their quality of primary care experiences under different types of medical institutions in Guangzhou, China.The study employed a cross-sectional survey of 736 rural-to-urban migrants in Guangzhou, China in 2014. A validated Chinese version of Primary Care Assessment Tool--Adult Short Version (PCAT-AS, representing 10 primary care domains was used to collect information on migrants' quality of primary care experiences. These domains include first contact (utilization, first contact (accessibility, ongoing care, coordination (referrals, coordination (information systems, comprehensiveness (services available, comprehensiveness (services provided, family-centeredness, community orientation and culturally competent. These measures were used to assess the quality of primary care performance as reported from patients' perspective. Analysis of covariance was conducted for comparison on PCAT scores among migrants accessing primary care in tertiary hospitals, municipal hospitals, community health centers/community health stations, and township health centers/rural health stations. Multiple linear regression models were used to explore factors associated with PCAT total scores.After adjustments were made, migrants accessing primary care in tertiary hospitals (25.49 reported the highest PCAT total scores, followed by municipal hospitals (25.02, community health centers/community health stations (24.24, and township health centers/rural health stations (24.18. Tertiary hospital users reported significantly better performance in first contact (utilization, first contact (accessibility, coordination (information system, comprehensiveness (service available, and cultural competence

  11. Asymmetric responses of primary productivity to precipitation extremes: A synthesis of grassland precipitation manipulation experiments.

    Science.gov (United States)

    Wilcox, Kevin R; Shi, Zheng; Gherardi, Laureano A; Lemoine, Nathan P; Koerner, Sally E; Hoover, David L; Bork, Edward; Byrne, Kerry M; Cahill, James; Collins, Scott L; Evans, Sarah; Gilgen, Anna K; Holub, Petr; Jiang, Lifen; Knapp, Alan K; LeCain, Daniel; Liang, Junyi; Garcia-Palacios, Pablo; Peñuelas, Josep; Pockman, William T; Smith, Melinda D; Sun, Shanghua; White, Shannon R; Yahdjian, Laura; Zhu, Kai; Luo, Yiqi

    2017-10-01

    Climatic changes are altering Earth's hydrological cycle, resulting in altered precipitation amounts, increased interannual variability of precipitation, and more frequent extreme precipitation events. These trends will likely continue into the future, having substantial impacts on net primary productivity (NPP) and associated ecosystem services such as food production and carbon sequestration. Frequently, experimental manipulations of precipitation have linked altered precipitation regimes to changes in NPP. Yet, findings have been diverse and substantial uncertainty still surrounds generalities describing patterns of ecosystem sensitivity to altered precipitation. Additionally, we do not know whether previously observed correlations between NPP and precipitation remain accurate when precipitation changes become extreme. We synthesized results from 83 case studies of experimental precipitation manipulations in grasslands worldwide. We used meta-analytical techniques to search for generalities and asymmetries of aboveground NPP (ANPP) and belowground NPP (BNPP) responses to both the direction and magnitude of precipitation change. Sensitivity (i.e., productivity response standardized by the amount of precipitation change) of BNPP was similar under precipitation additions and reductions, but ANPP was more sensitive to precipitation additions than reductions; this was especially evident in drier ecosystems. Additionally, overall relationships between the magnitude of productivity responses and the magnitude of precipitation change were saturating in form. The saturating form of this relationship was likely driven by ANPP responses to very extreme precipitation increases, although there were limited studies imposing extreme precipitation change, and there was considerable variation among experiments. This highlights the importance of incorporating gradients of manipulations, ranging from extreme drought to extreme precipitation increases into future climate change

  12. Palliative care for cancer patients in a primary health care setting:Bereaved relatives' experience, a qualitative group interview study

    DEFF Research Database (Denmark)

    Neergaard, Mette Asbjørn; Olesen, Frede; Jensen, Anders Bonde

    2008-01-01

    care setting to explore barriers and facilitators for delivery of good palliative home care. Methods: Three focus group interviews with fourteen bereaved relatives in Aarhus County, Denmark. Results: Three main categories of experience were identified: 1) The health professionals' management, where...... a need to optimize was found. 2) Shared care, which was lacking. 3) The relatives' role, which needs an extra focus. Conclusion: Relatives experience insufficient palliative care mainly due to organizational and cultural problems among professionals. Palliative care in primary care in general needs......Background: Knowledge about the quality and organisation of care to terminally ill cancer patients with a relatives' view in a primary health care setting is limited. The aim of the study is to analyse experiences and preferences of bereaved relatives to terminally ill cancer patients in a primary...

  13. Multidisciplinary Practice Experience of Nursing Faculty and Their Collaborators for Primary Health Care in Korea

    Directory of Open Access Journals (Sweden)

    Mi Ja Kim, PhD, RN, FAAN

    2008-03-01

    Conclusion: Teamwork should be included in all health professions' curricula, and nursing clinical practicums should include primary health care in all specialty areas. More faculties should engage in multidisciplinary primary health care. The benefits of a multidisciplinary approach to primary health care outweigh the difficulties experienced by multidisciplinary team members. The findings of this study may be useful for future multidisciplinary primary health care work worldwide.

  14. CMS DOCUMENTATION

    CERN Multimedia

    CMS TALKS AT MAJOR MEETINGS The agenda and talks from major CMS meetings can now be electronically accessed from the iCMS Web site. The following items can be found on: http://cms.cern.ch/iCMS/ Management- CMS Weeks (Collaboration Meetings), CMS Weeks Agendas The talks presented at the Plenary Sessions. Management - CB - MB - FB Agendas and minutes are accessible to CMS members through their AFS account (ZH). However some linked documents are restricted to the Board Members. FB documents are only accessible to FB members. LHCC The talks presented at the ‘CMS Meetings with LHCC Referees’ are available on request from the PM or MB Country Representative. Annual Reviews The talks presented at the 2007 Annual reviews are posted. CMS DOCUMENTS It is considered useful to establish information on the first employment of CMS doctoral students upon completion of their theses. Therefore it is requested that Ph.D students inform the CMS Secretariat about the nature of em¬pl...

  15. CMS DOCUMENTATION

    CERN Multimedia

    CMS TALKS AT MAJOR MEETINGS The agenda and talks from major CMS meetings can now be electronically accessed from the iCMS Web site. The following items can be found on: http://cms.cern.ch/iCMS/ General - CMS Weeks (Collaboration Meetings), CMS Weeks Agendas The talks presented at the Plenary Sessions. LHC Symposiums Management - CB - MB - FB - FMC Agendas and minutes are accessible to CMS members through their AFS account (ZH). However some linked documents are restricted to the Board Members. FB documents are only accessible to FB members. LHCC The talks presented at the ‘CMS Meetings with LHCC Referees’ are available on request from the PM or MB Country Representative. Annual Reviews The talks presented at the 2006 Annual reviews are posted. CMS DOCUMENTS It is considered useful to establish information on the first employment of CMS doctoral students upon completion of their theses. Therefore it is requested that Ph.D students inform the CMS Secretariat about the natur...

  16. CMS DOCUMENTATION

    CERN Multimedia

    CMS TALKS AT MAJOR MEETINGS The agenda and talks from major CMS meetings can now be electronically accessed from the iCMS Web site. The following items can be found on: http://cms.cern.ch/iCMS/ Management- CMS Weeks (Collaboration Meetings), CMS Weeks Agendas The talks presented at the Plenary Sessions. Management - CB - MB - FB Agendas and minutes are accessible to CMS members through their AFS account (ZH). However some linked documents are restricted to the Board Members. FB documents are only accessible to FB members. LHCC The talks presented at the ‘CMS Meetings with LHCC Referees’ are available on request from the PM or MB Country Representative. Annual Reviews The talks presented at the 2007 Annual reviews are posted. CMS DOCUMENTS It is considered useful to establish information on the first employment of CMS doctoral students upon completion of their theses. Therefore it is requested that Ph.D students inform the CMS Secretariat about the nature of employment and ...

  17. CMS DOCUMENTATION

    CERN Multimedia

    CMS TALKS AT MAJOR MEETINGS The agenda and talks from major CMS meetings can now be electronically accessed from the iCMS Web site. The following items can be found on: http://cms.cern.ch/iCMS/ General - CMS Weeks (Collaboration Meetings), CMS Weeks Agendas The talks presented at the Plenary Sessions. LHC Symposiums Management - CB - MB - FB - FMC Agendas and minutes are accessible to CMS members through their AFS account (ZH). However some linked documents are restricted to the Board Members. FB documents are only accessible to FB members. LHCC The talks presented at the ‘CMS Meetings with LHCC Referees’ are available on request from the PM or MB Country Representative. Annual Reviews The talks presented at the 2006 Annual reviews are posted. CMS DOCUMENTS It is considered useful to establish information on the first employment of CMS doctoral students upon completion of their theses. Therefore it is requested that Ph.D students inform the CMS Secretariat about the natu...

  18. CMS DOCUMENTATION

    CERN Multimedia

    CMS TALKS AT MAJOR MEETINGS The agenda and talks from major CMS meetings can now be electronically accessed from the iCMS Web site. The following items can be found on: http://cms.cern.ch/iCMS/ General - CMS Weeks (Collaboration Meetings), CMS Weeks Agendas The talks presented at the Plenary Sessions. LHC Symposiums Management - CB - MB - FB - FMC Agendas and minutes are accessible to CMS members through their AFS account (ZH). However some linked documents are restricted to the Board Members. FB documents are only accessible to FB members. LHCC The talks presented at the ‘CMS Meetings with LHCC Referees’ are available on request from the PM or MB Country Representative. Annual Reviews The talks presented at the 2006 Annual reviews are posted.   CMS DOCUMENTS It is considered useful to establish information on the first employment of CMS doctoral students upon completion of their theses. Therefore it is requested that Ph.D students inform the CMS Secretariat a...

  19. CMS DOCUMENTATION

    CERN Multimedia

    CMS TALKS AT MAJOR MEETINGS The agenda and talks from major CMS meetings can now be electronically accessed from the iCMS Web site. The following items can be found on: http://cms.cern.ch/iCMS/ General - CMS Weeks (Collaboration Meetings), CMS Weeks Agendas The talks presented at the Plenary Sessions. LHC Symposiums Management - CB - MB - FB - FMC Agendas and minutes are accessible to CMS members through their AFS account (ZH). However some linked documents are restricted to the Board Members. FB documents are only accessible to FB members. LHCC The talks presented at the ‘CMS Meetings with LHCC Referees’ are available on request from the PM or MB Country Representative. Annual Reviews The talks presented at the 2006 Annual reviews are posted. CMS DOCUMENTS It is considered useful to establish information on the first employment of CMS doctoral students upon completion of their theses. Therefore it is requested that Ph.D students inform the CMS Secretariat about the na...

  20. [Professor Ling Changquan's experience in treating primary liver cancer: an analysis of herbal medication].

    Science.gov (United States)

    Sun, Zhen; Su, Yong-hua; Yue, Xiao-qiang

    2008-12-01

    On the basis of outpatients' medical records concerning primary liver cancer (PLC), data of 552 patients (with 2020 effective prescriptions) from the Outpatient Department of Changhai Hospital treated by Professor Ling Changquan were collected. The nature, flavor and meridian distribution of the herbs used in the prescriptions were summarized by frequency method, and the features of the herbs used according to syndrome differentiation were analyzed by logistic regression. The couple herbs used were analyzed by cluster analysis. All the data were analyzed in combination with the experience of the specialist. It showed that most of the frequently used herbs were herbs for invigorating the spleen to promote appetite, removing toxic materials to inhibit tumor growth, and activating blood circulation to dissipate blood stasis. These herbs are mostly of plain or cool nature, and mainly of sweet, bitter, or acrid taste. It also showed that the most frequently used herbs for qi deficiency were Astragalus membranaceus, Atractylodes macrocephala, and Pseudostellariae; Caulis Spatholobi and Chinese jujube for blood asthenia; Fructus Corni and Ophiopogon japonicus for yin deficiency; Agastache rugosa, Semen Plantaginis and Poria for water-dampness; cape jasmine fruit and baikal skullcap root for heat excess; peach seed and Radix Paeoniae Rubra for blood stasis; Curcuma wenyujin, Akebia trifoliata and Bupleurum chinese for qi stagnation. A total of 19 pairs of couple herbs were summarized by the cluster analysis.

  1. Living transdisciplinary curriculum: Teachers’ experiences with the ınternational baccalaureate’s primary years programme

    Directory of Open Access Journals (Sweden)

    Michael J. Savage

    2017-09-01

    Full Text Available An integrated curriculum that is transdisciplinary in nature seems to be a good fit for 21st Century learning. There are, however, few examples of transdisciplinary curriculum at the K to 12 level. One exception is the International Baccalaureate’s Primary Years Programme (PYP which features transdisciplinary curriculum for students from ages 3 to 12 around the world. This phenomenological study explored the lived experience of 24 PYP educators to deepen understanding of what such a curriculum looks like in practice. Three main themes were identified. The first, “It’s a framework” outlines participants’ understandings of transdisciplinary teaching and learning and the freedom a transdisciplinary framework can bring. The second theme, “Get on board”, examines participants’ thoughts around what is required to successfully implement a transdisciplinary curriculum. The final theme, “Their learning journey”, discusses participants’ beliefs around the success of a transdisciplinary curriculum. In general, participants appreciated the transdisciplinarity of the program. Concerns revolved around implementation issues. Suggestions on how to implement transdisciplinary teaching and learning in other contexts are provided.

  2. Active Travel to Primary Schools in Ireland: An Opportunistic Evaluation of a Natural Experiment.

    Science.gov (United States)

    Lambe, Barry; Murphy, Niamh; Bauman, Adrian

    2017-06-01

    There is a paucity of intervention studies assessing active travel to school as a mechanism to increase physical activity. This paper describes the impact of a community-wide intervention on active travel to primary schools in 2 Irish towns. This was a repeat cross-sectional study of a natural experiment. Self-report questionnaires were completed by 5th and 6th grade students in 3 towns (n = 1038 students in 2 intervention towns; n = 419 students in 1 control town) at baseline and by a new group of students 2 years later at follow-up. The absolute change in the proportion of children walking and cycling to school (difference in differences) was calculated. There was no overall intervention effect detected for active travel to or from school. This is despite an absolute increase of 14.7% (1.6, 27.9) in the proportion of children that indicated a preference for active travel to school in the town with the most intensive intervention (town 2). Interventions designed to increase active travel to school hold some promise but should have a high-intensity mix of infrastructural and behavioral measures, be gender-specific, address car dependency and focus on travel home from school initially.

  3. The experience of primary care providers with an integrated mental health care program in safety-net clinics.

    Science.gov (United States)

    Bentham, Wayne D; Ratzliff, Anna; Harrison, David; Chan, Ya-Fen; Vannoy, Steven; Unützer, Jürgen

    2015-01-01

    Primary care providers participating in a statewide implementation of an integrated mental health care program for "safety-net" patients in primary care clinics were surveyed to elicit their experiences and level of satisfaction. Quantitative analyses were performed to identify respondent characteristics and satisfaction with the program. Qualitative analyses were done to identify common themes in response to the question "How could psychiatric consultation [in the program] be improved?" Primary care providers were generally satisfied with the integrated mental health care program and raised several concerns that suggest important principles for successful future implementations of these types of programs.

  4. Somatisation in primary care: experiences of primary care physicians involved in a training program and in a randomised controlled trial

    Directory of Open Access Journals (Sweden)

    Salazar Agustín

    2009-11-01

    Full Text Available Abstract Background A new intervention aimed at managing patients with medically unexplained symptoms (MUS based on a specific set of communication techniques was developed, and tested in a cluster randomised clinical trial. Due to the modest results obtained and in order to improve our intervention we need to know the GPs' attitudes towards patients with MUS, their experience, expectations and the utility of the communication techniques we proposed and the feasibility of implementing them. Physicians who took part in 2 different training programs and in a randomised controlled trial (RCT for patients with MUS were questioned to ascertain the reasons for the doctors' participation in the trial and the attitudes, experiences and expectations of GPs about the intervention. Methods A qualitative study based on four focus groups with GPs who took part in a RCT. A content analysis was carried out. Results Following the RCT patients are perceived as true suffering persons, and the relationship with them has improved in GPs of both groups. GPs mostly valued the fact that it is highly structured, that it made possible a more comfortable relationship and that it could be applied to a broad spectrum of patients with psychosocial problems. Nevertheless, all participants consider that change in patients is necessary; GPs in the intervention group remarked that that is extremely difficult to achieve. Conclusion GPs positively evaluate the communication techniques and the interventions that help in understanding patient suffering, and express the enormous difficulties in handling change in patients. These findings provide information on the direction in which efforts for improving intervention should be directed. Trial registration US ClinicalTrials.gov NCT00130988

  5. Rural-to-Urban Migrants' Experiences with Primary Care under Different Types of Medical Institutions in Guangzhou, China.

    Science.gov (United States)

    Zeng, Jiazhi; Shi, Leiyu; Zou, Xia; Chen, Wen; Ling, Li

    2015-01-01

    China is facing the unprecedented challenge of rapidly increasing rural-to-urban migration. Migrants are in a vulnerable state when they attempt to access to primary care services. This study was designed to explore rural-to-urban migrants' experiences in primary care, comparing their quality of primary care experiences under different types of medical institutions in Guangzhou, China. The study employed a cross-sectional survey of 736 rural-to-urban migrants in Guangzhou, China in 2014. A validated Chinese version of Primary Care Assessment Tool--Adult Short Version (PCAT-AS), representing 10 primary care domains was used to collect information on migrants' quality of primary care experiences. These domains include first contact (utilization), first contact (accessibility), ongoing care, coordination (referrals), coordination (information systems), comprehensiveness (services available), comprehensiveness (services provided), family-centeredness, community orientation and culturally competent. These measures were used to assess the quality of primary care performance as reported from patients' perspective. Analysis of covariance was conducted for comparison on PCAT scores among migrants accessing primary care in tertiary hospitals, municipal hospitals, community health centers/community health stations, and township health centers/rural health stations. Multiple linear regression models were used to explore factors associated with PCAT total scores. After adjustments were made, migrants accessing primary care in tertiary hospitals (25.49) reported the highest PCAT total scores, followed by municipal hospitals (25.02), community health centers/community health stations (24.24), and township health centers/rural health stations (24.18). Tertiary hospital users reported significantly better performance in first contact (utilization), first contact (accessibility), coordination (information system), comprehensiveness (service available), and cultural competence

  6. Comparison of primary care experiences among adults in general outpatient clinics and private general practice clinics in Hong Kong

    Directory of Open Access Journals (Sweden)

    Chung Vincent CH

    2010-07-01

    Full Text Available Abstract Background The main goal of Hong Kong's publicly-funded general outpatient clinics (GOPCs is to provide primary medical services for the financially vulnerable. The objective of the current study was to compare the primary care experiences of GOPC users and the users of care provided by private general practitioners (GPs in Hong Kong via a territory-wide telephone survey. Methods One thousand adults in Hong Kong aged 18 and above were interviewed by a telephone survey. The modified Chinese translated Primary Care Assessment Tool was used to collect data on respondents' primary care experience. Results Our results indicated that services provided by GOPC were more often used by female, older, poorer, chronically-ill and less educated population. GOPC participants were also more likely to have visited a specialist or used specialist services (69.7% vs. 52.0%; p p = 0.198. Analyses were also performed to asses the relationship between healthcare settings (GOPCs versus private GPs and primary care quality. Private GP patients achieved higher overall PCAT scores largely due to better accessibility (Mean: 6.88 vs. 8.41, p p Conclusions Our results showed that patients primarily receiving care from private GPs in Hong Kong reported better primary care experiences than those primarily receiving care from GOPCs. This was largely due to the greater accessibility and better interpersonal relationships offered by the private GPs. As most patients use both GOPCs and private GPs, their overall primary care experiences may not be as different as the findings of this study imply.

  7. Clinical-Epidemiological Pattern of Primary Immunodeficiencies in Malaysia 1987-2006: A 20 year experience in Four Malaysian Hospitals.

    Science.gov (United States)

    Noh, L M; Nasuruddin, B A; Abdul Latiff, A H; Noah, R M; Kamarul Azahar, M R; Norzila, M Z; Zulkifli, I; Gill, H K; Nik Zainal, N I; Suhaimi, A W M; Nik Khairulddin, N Y; Maraina, H; Intan, H I; Mat, I; Shahnaz, M; B H O, Azizi

    2013-01-01

    To determine the clinical and epidemiological characteristics of patients seen with primary immunodeficiencies referred at four Malaysian Hospitals between 1987 to 2007. Patient data were retrospectively obtained from patient records and supplemented by information from a standardized questionnaires taken at the time of diagnosis from 4 participating hospitals. The completed data were transferred to document records kept by the first author. The diagnoses made were based on criteria set by WHO Scientific Committee 1986. Fifty one (51) patients with completed records satisfied the criteria of primary immunodeficiencies based on WHO Scientific Committee 1986. Predominant Antibody deficiency (40.4%) is the commonest of the class of primary immunodeficiency (based on modified IUIS classification) followed by phagocytic defect (17.3%), combined immunodeficiencies (15.4%) and other cellular immunodeficiencies (11.5%). The commonest clinical presentation is pneumonia (54%) . A positive Family history with a close family relative afflicted was a strong pointer to diagnosis for PID (52.6%) Primary immnodeficiencies are seen in all the major ethnic groups of Malaysia, predominantly among Malays. As observed in other patient registries, diagnostic delay remains the major cause of morbidity and mortality. Primary immunodeficiencies is relative rare but is an emerging disease in Malaysia. Creating awareness of the disease, may reveal more cases within the community. It is sufficient to be a health issue in Malaysia as in other developing countries in the future.

  8. Do Pediatricians Ask About Adverse Childhood Experiences in Pediatric Primary Care?

    Science.gov (United States)

    Kerker, Bonnie D; Storfer-Isser, Amy; Szilagyi, Moira; Stein, Ruth E K; Garner, Andrew S; O'Connor, Karen G; Hoagwood, Kimberly E; Horwitz, Sarah M

    2016-03-01

    The stress associated with adverse childhood experiences (ACEs) has immediate and long-lasting effects. The objectives of this study were to examine 1) how often pediatricians ask patients' families about ACEs, 2) how familiar pediatricians are with the original ACE study, and 3) physician/practice characteristics, physicians' mental health training, and physicians' attitudes/beliefs that are associated with asking about ACEs. Data were collected from 302 nontrainee pediatricians exclusively practicing general pediatrics who completed the 2013 American Academy of Pediatrics Periodic Survey. Pediatricians indicated whether they usually, sometimes, or never inquired about or screened for 7 ACEs. Sample weights were used to reduce nonresponse bias. Weighted descriptive and logistic regression analyses were conducted. Only 4% of pediatricians usually asked about all 7 ACEs; 32% did not usually ask about any. Less than 11% of pediatricians reported being very or somewhat familiar with the ACE study. Pediatricians who screened/inquired about ACEs usually asked about maternal depression (46%) and parental separation/divorce (42%). Multivariable analyses showed that pediatricians had more than twice the odds of usually asking about ACEs if they disagreed that they have little effect on influencing positive parenting skills, disagreed that screening for social emotional risk factors within the family is beyond the scope of pediatricians, or were very interested in receiving further education on managing/treating mental health problems in children and adolescents. Few pediatricians ask about all ACEs. Pediatric training that emphasizes the importance of social/emotional risk factors may increase the identification of ACEs in pediatric primary care. Copyright © 2016 Academic Pediatric Association. Published by Elsevier Inc. All rights reserved.

  9. Be SMART: examining the experience of implementing the NHS Health Check in UK primary care.

    Science.gov (United States)

    Shaw, Rachel L; Pattison, Helen M; Holland, Carol; Cooke, Richard

    2015-01-22

    The NHS Health Check was designed by UK Department of Health to address increased prevalence of cardiovascular disease by identifying risk levels and facilitating behaviour change. It constituted biomedical testing, personalised advice and lifestyle support. The objective of the study was to explore Health Care Professionals' (HCPs) and patients' experiences of delivering and receiving the NHS Health Check in an inner-city region of England. Patients and HCPs in primary care were interviewed using semi-structured schedules. Data were analysed using Thematic Analysis. Four themes were identified. Firstly, Health Check as a test of 'roadworthiness' for people. The roadworthiness metaphor resonated with some patients but it signified a passive stance toward illness. Some patients described the check as useful in the theme, Health check as revelatory. HCPs found visual aids demonstrating levels of salt/fat/sugar in everyday foods and a 'traffic light' tape measure helpful in communicating such 'revelations' with patients. Being SMART and following the protocolrevealed that few HCPs used SMART goals and few patients spoke of them. HCPs require training to understand their rationale compared with traditional advice-giving. The need for further follow-up revealed disparity in follow-ups and patients were not systematically monitored over time. HCPs' training needs to include the use and evidence of the effectiveness of SMART goals in changing health behaviours. The significance of fidelity to protocol needs to be communicated to HCPs and commissioners to ensure consistency. Monitoring and measurement of follow-up, e.g., tracking of referrals, need to be resourced to provide evidence of the success of the NHS Health Check in terms of healthier lifestyles and reduced CVD risk.

  10. The Love of Sport: An Investigation into the Perceptions and Experiences of Physical Education Amongst Primary School Pupils

    Science.gov (United States)

    Hayes, Deborah

    2017-01-01

    Inactivity amongst children and adults in the UK is currently of great concern. Attitudes towards physical activity develop during childhood and may influence physical activity patterns in later life. This research investigated the experiences and perceptions of physical education (P.E.) amongst primary school pupils. The study established overall…

  11. Experiences of general practices with a participatory pay-for-performance program: a qualitative study in primary care

    NARCIS (Netherlands)

    Kirschner, K.; Braspenning, J.C.C.; Jacobs, J.E.; Grol, R.P.

    2013-01-01

    The involvement of target users in the design choices of a pay-for-performance program may enhance its impact, but little is known about the views of participants in these programs. To explore general practices' experiences with pay-for-performance in primary care we conducted a qualitative study in

  12. Habitus and Flow in Primary School Musical Practice: Relations between Family Musical Cultural Capital, Optimal Experience and Music Participation

    Science.gov (United States)

    Valenzuela, Rafael; Codina, Nuria

    2014-01-01

    Based on Bourdieu's idea that cultural capital is strongly related to family context, we describe the relations between family musical cultural capital and optimal experience during compulsory primary school musical practice. We analyse whether children from families with higher levels of musical cultural capital, and specifically with regard to…

  13. TNF-A Levels throughout the Critical Period for Experience-Dependent Plasticity in the Rat Primary Auditory Cortex

    NARCIS (Netherlands)

    Man, WH; Madeira, Caroline; Zhou, Xiaoming; Merzenich, Michael M; Panizzutti, Rogerio

    2015-01-01

    Tumor necrosis factor- alpha (TNF-α) is likely to play a role in brain plasticity. To determine whether TNF-α levels change throughout a critical period of experience-dependent brain plasticity, we assessed these levels in the primary auditory cortex of rats before, during and after the critical

  14. Experiences of adult patients using primary care services in Poland – a cross-sectional study in QUALICOPC study framework.

    NARCIS (Netherlands)

    Oleszczyk, M.; Krzton-Krolewiecka, A.; Schäfer, W.L.A.; Boerma, W.G.W.; Windak, A.

    2017-01-01

    Background: Patients as real healthcare system users are important observers of primary care and are able to provide reliable information about the quality of care. The aim of this study was to explore the patients’ experiences and their level of satisfaction with the process and outcomes of care

  15. A Cross-Cultural Comparison of Music Education Experiences and Ambitions in Two Spanish and English Primary Schools

    Science.gov (United States)

    Hardcastle, Elinor; Pitts, Stephanie; Aróstegui, José Luis

    2017-01-01

    A small-scale comparative study of music education provision in two Spanish and English primary schools was carried out in 2013-14, using questionnaires, interviews and observations. The study investigated the musical experiences of the children in the two schools, their ambitions for their musical futures, and the classroom practices and policy…

  16. Perception and Experience of Primary Care Physicians on Pap Smear Screening for Women with Intellectual Disabilities: A Preliminary Finding

    Science.gov (United States)

    Lin, Jin-Ding; Sung, Chang-Lin; Lin, Lan-Ping; Liu, Ta-Wen; Lin, Pei-Ying; Chen, Li-Mei; Chu, Cordia M.; Wu, Jia-Ling

    2010-01-01

    This study aims to establish evidence-based data to explore the perceptions and experience of primary care physicians in the Pap smear screening provision for women with intellectual disabilities (ID), and to analyze the associated factors in the delivery of screening services to women with ID in Taiwan. Data obtained by a cross-sectional survey…

  17. "The Factor that Makes Us More Effective Teachers": Two Pre-Service Primary Teachers' Experience of Bibliotherapy

    Science.gov (United States)

    Wilson, Sue; Thornton, Steve

    2008-01-01

    This paper describes the experiences of two pre-service primary teachers in a teacher education subject focusing on mathematics and learning difficulties. It describes how bibliotherapy was a powerful reflective tool that provided them with the opportunity to respond cognitively and affectively to their own schooling. By analysing readings about…

  18. Measuring primary care services performance: issues and opportunities from a home care pilot experience in the Tuscan health system.

    Science.gov (United States)

    Cinquini, Lino; Vainieri, Milena

    2008-08-01

    In recent years in Italy, as in other European countries, profound changes have been introduced in health care both at central and regional levels. Most of them were oriented towards a shift from 'hospital-centred' health care to health care based more on primary care services. This transition pursues two objectives: giving more effective responses to citizens' needs and reducing public health expenditure. Changes that involve organizational structure must also be carried out with the introduction of measurement tools that can help in planning and can control the changes. The paper provides the results obtained through the experience of modelling a measurement system for primary care carried out in 2004 and 2005 by some territorial managers and controllers in the Tuscan Health system, and the main issues in measuring primary care services emerging from this pilot experience focused on integrated home care services.

  19. Perceived Challenges in Primary Literature in a Master's Class: Effects of Experience and Instruction

    Science.gov (United States)

    Lie, Richard; Abdullah, Christopher; He, Wenliang; Tour, Ella

    2016-01-01

    Primary literature offers rich opportunities to teach students how to "think like a scientist," but the challenges students face when they attempt to read research articles are not well understood. Here, we present an analysis of what master's students perceive as the most challenging aspects of engaging with primary literature. We…

  20. Introducing National Curriculum Geography to Australia's Primary Schools: Lessons from England's Experience

    Science.gov (United States)

    Catling, Simon

    2013-01-01

    This article provides an insight into the development of primary geography since the inception of the national curriculum in England in the late 1980s. It is hoped this is informative as the "Australian Curriculum: Geography Foundation to Year 12" is introduced to and implemented in primary schools. It draws out various matters which…

  1. Psychosocial aspects of preconception consultation in primary care: Lessons from our experience in clinical genetics

    NARCIS (Netherlands)

    S.R. Riedijk (Samantha); G.G. Oudesluijs (Grétel); A. Tibben (Arend)

    2012-01-01

    textabstractTo date, little is known about the psychosocial aspects of preconception consultation (PCC) in primary care. PCC in primary care is appropriate for couples and individuals with a reproductive wish. In PCC, non-genetic and genetic risk factors may be identified. Focusing on nongenetic and

  2. Trabalho em equipe na atenção primária: a experiência de Portugal Teamwork in primary care: the experience of Portugal

    Directory of Open Access Journals (Sweden)

    Marize Barros de Souza

    2013-03-01

    Full Text Available OBJETIVO: Analisar o trabalho em equipe na atenção primária em saúde em Portugal. MÉTODOS: Foi realizada uma pesquisa avaliativa de abordagem qualitativa, com desenho de estudo de caso. Os dados foram obtidos por entrevista semiestruturada, observação direta e análise documental. Foram entrevistados gestores, profissionais e usuários de 11 unidades de saúde familiar (USF portuguesas, totalizando 71 participantes. Utilizou-se a técnica de análise de conteúdo na interpretação das entrevistas. RESULTADOS: Cada equipe era constituída por médico, enfermeiro e funcionário administrativo, atendendo entre 1 250 e 2 060 usuários. Uma característica marcante da experiência portuguesa foi a formação das equipes nas USF de forma voluntária, por meio de afinidades pessoais, com autonomia de composição. Observou-se nessas USF o desenvolvimento de "carteira básica de serviços" juntamente com intervenções de vigilância, promoção da saúde e prevenção de doença, cuidados em situação de doença aguda, acompanhamento clínico de doença crônica e de patologia múltipla, cuidados domiciliares, interligação e colaboração em rede com outros serviços (cuidados hospitalares. Foram relatadas dificuldades no atendimento domiciliar. A informatização era ampla nas USF. De acordo com os entrevistados, as mudanças advindas da implementação das USF foram maior acessibilidade dos usuários aos serviços, maior qualidade do cuidado prestado e trabalho em equipe com objetivos e metas, além da existência de um plano de ação. CONCLUSÕES: Mesmo não tendo assumido um papel de coordenação da rede de cuidados, a atenção primária em saúde organizada a partir de equipes foi avaliada positivamente em Portugal, como promotora de maior acesso, continuidade e humanização dos serviços.OBJECTIVE: To analyze the work of health care teams delivering primary care in Portugal. METHODS: We performed an evaluative research project

  3. Documenting the Engineering Design Process

    Science.gov (United States)

    Hollers, Brent

    2017-01-01

    Documentation of ideas and the engineering design process is a critical, daily component of a professional engineer's job. While patent protection is often cited as the primary rationale for documentation, it can also benefit the engineer, the team, company, and stakeholders through creating a more rigorously designed and purposeful solution.…

  4. CMS DOCUMENTATION

    CERN Multimedia

    CMS TALKS AT MAJOR MEETINGS The agenda and talks from major CMS meetings can now be electronically accessed from the ICMS Web site. The following items can be found on: http://cms.cern.ch/iCMS Management – CMS Weeks (Collaboration Meetings), CMS Weeks Agendas The talks presented at the Plenary Sessions. Management – CB – MB – FB Agendas and minutes are accessible to CMS members through Indico. LHCC The talks presented at the ‘CMS Meetings with LHCC Referees’ are available on request from the PM or MB Country Representative. Annual Reviews The talks presented at the 2008 Annual Reviews are posted in Indico. CMS DOCUMENTS It is considered useful to establish information on the first employment of CMS doctoral student upon completion of their theses.  Therefore it is requested that Ph.D students inform the CMS Secretariat about the nature of employment and name of their first employer. The Notes, Conference Reports and Theses published si...

  5. Neonatal and Pregnancy Outcome in Primary Antiphospholipid Syndrome: A 10-year Experience in One Medical Center

    Directory of Open Access Journals (Sweden)

    An-Kuo Chou

    2009-08-01

    Conclusions: This limited study suggests that neonates born to mothers with primary APS are at risk of prematurity, being small for gestational age, and having thrombocytopenia. Further large, prospective studies are required to better define the perinatal outcomes.

  6. Primary care follow-up of radical prostatectomy patients: A regional New Zealand experience

    Directory of Open Access Journals (Sweden)

    Omid Yassaie

    2016-12-01

    Conclusion: Our study identified that follow-up by GPs after RP is insufficient. Accordingly, there is a requirement for formal educational programs if primary care is to take a greater role in follow-up of these patients.

  7. Omega documentation

    Energy Technology Data Exchange (ETDEWEB)

    Howerton, R.J.; Dye, R.E.; Giles, P.C.; Kimlinger, J.R.; Perkins, S.T.; Plechaty, E.F.

    1983-08-01

    OMEGA is a CRAY I computer program that controls nine codes used by LLNL Physical Data Group for: 1) updating the libraries of evaluated data maintained by the group (UPDATE); 2) calculating average values of energy deposited in secondary particles and residual nuclei (ENDEP); 3) checking the libraries for internal consistency, especially for energy conservation (GAMCHK); 4) producing listings, indexes and plots of the library data (UTILITY); 5) producing calculational constants such as group averaged cross sections and transfer matrices for diffusion and Sn transport codes (CLYDE); 6) producing and updating standard files of the calculational constants used by LLNL Sn and diffusion transport codes (NDFL); 7) producing calculational constants for Monte Carlo transport codes that use group-averaged cross sections and continuous energy for particles (CTART); 8) producing and updating standard files used by the LLNL Monte Carlo transport codes (TRTL); and 9) producing standard files used by the LANL pointwise Monte Carlo transport code MCNP (MCPOINT). The first four of these functions and codes deal with the libraries of evaluated data and the last five with various aspects of producing calculational constants for use by transport codes. In 1970 a series, called PD memos, of internal and informal memoranda was begun. These were intended to be circulated among the group for comment and then to provide documentation for later reference whenever questions arose about the subject matter of the memos. They have served this purpose and now will be drawn upon as source material for this more comprehensive report that deals with most of the matters covered in those memos.

  8. The Effect of Primary Care Provider Turnover on Patient Experience of Care and Ambulatory Quality of Care.

    Science.gov (United States)

    Reddy, Ashok; Pollack, Craig E; Asch, David A; Canamucio, Anne; Werner, Rachel M

    2015-07-01

    Primary care provider (PCP) turnover is common and can disrupt patient continuity of care. Little is known about the effect of PCP turnover on patient care experience and quality of care. To measure the effect of PCP turnover on patient experiences of care and ambulatory care quality. Observational, retrospective cohort study of a nationwide sample of primary care patients in the Veterans Health Administration (VHA). We included all patients enrolled in primary care at the VHA between 2010 and 2012 included in 1 of 2 national data sets used to measure our outcome variables: 326,374 patients in the Survey of Healthcare Experiences of Patients (SHEP; used to measure patient experience of care) associated with 8441 PCPs and 184,501 patients in the External Peer Review Program (EPRP; used to measure ambulatory care quality) associated with 6973 PCPs. Whether a patient experienced PCP turnover, defined as a patient whose provider (physician, nurse practitioner, or physician assistant) had left the VHA (ie, had no patient encounters for 12 months). Five patient care experience measures (from SHEP) and 11 measures of quality of ambulatory care (from EPRP). Nine percent of patients experienced a PCP turnover in our study sample. Primary care provider turnover was associated with a worse rating in each domain of patient care experience. Turnover was associated with a reduced likelihood of having a positive rating of their personal physician of 68.2% vs 74.6% (adjusted percentage point difference, -5.3; 95% CI, -6.0 to -4.7) and a reduced likelihood of getting care quickly of 36.5% vs 38.5% (adjusted percentage point difference, -1.1; 95% CI, -2.1 to -0.1). In contrast, PCP turnover was not associated with lower quality of ambulatory care except for a lower likelihood of controlling blood pressure of 78.7% vs 80.4% (adjusted percentage point difference, -1.44; 95% CI, -2.2 to -0.7). In 9 measures of ambulatory care quality, the difference between patients who experienced no

  9. Patients' experience of using primary care services in the context of Indonesian universal health coverage reforms.

    Science.gov (United States)

    Ekawati, Fitriana Murriya; Claramita, Mora; Hort, Krishna; Furler, John; Licqurish, Sharon; Gunn, Jane

    2017-01-01

    The World Health Organization (WHO) recommendation on universal coverage has been implemented in Indonesia as Jaminan Kesehatan Nasional (JKN). It was designed to provide people with equitable and high-quality health care by strengthening primary care as the gate-keeper to hospitals. However, during its first year of implementation, recruitment of JKN members was slow, and the referral rates from primary to secondary care remained high. Little is known about how the public views the introduction of JKN or the factors that influence their decision to enroll in JKN. This research aimed to explore patients' views on the implementation of JKN and factors that influence a person's decision to enroll in the JKN scheme. This study was informed by interpretative phenomenological analysis (IPA) methodology to understand patients' views. The interview participants were purposively recruited using maximum variation criteria. The data were gathered using in-depth interviews and was conducted in Yogyakarta from October to December 2014. The interviews were transcribed, translated and analyzed using IPA analysis. Twenty three participants were interviewed from eight primary care clinics. Three superordinate themes: access, trust, and separation anxiety were identified which impacted on the uptake of JKN. Participants acknowledged that whilst primary care clinics were conveniently located, access was often complicated by long waiting times and short opening hours. Participants also expressed lower levels of trust with primary care doctors compared to hospital and specialist care. They also reported a sense of anxiety that the current JKN regulation might limit their ability to access the hospital service guaranteed in the past. This study identified patients' views that could challenge the implementation of the gate-keeper role of primary care in Indonesia. While the patients valued the availability of medical care close to home, their lack of trust in primary care doctors and

  10. Development and Validation of a Questionnaire to Assess Multimorbidity in Primary Care: An Indian Experience

    Directory of Open Access Journals (Sweden)

    Sanghamitra Pati

    2016-01-01

    Full Text Available Multimorbidity remains an underexplored domain in Indian primary care. We undertook a study to assess the prevalence, correlates, and outcomes of multimorbidity in primary care settings in India. This paper describes the process of development and validation of our data collection tool “Multimorbidity Assessment Questionnaire for Primary Care (MAQ-PC.” An iterative process comprising desk review, chart review, and expert consultations was undertaken to generate the questionnaire. The MAQ-PC contained items on chronic conditions, health care utilization, health related quality of life, disease severity, and sociodemographics. It was first tested with twelve adults for comprehensibility followed by test-retest reliability with 103 patients from four primary care practices. For interrater reliability, two interviewers separately administered the questionnaire to sixteen patients. MAQ-PC displayed strong internal consistency (Cronbach’s alpha: 0.69, interrater reliability (Cohen’s Kappa: 0.78–1, and test-retest reliability (ICC: 0.970–0.741. Substantial concordance between self-report and physician diagnosis (Scott Kappa: 0.59–1.0 was observed for listed chronic conditions indicating strong concurrent validity. Nearly 54% had one chronic condition and 23.3% had multimorbidity. Our findings demonstrate MAQ-PC to be a valid and reliable measure of multimorbidity in primary care practice and suggest its potential utility in multimorbidity research in India.

  11. Evidence of and experience with the use of onabotulinumtoxinA in trigeminal neuralgia and primary headaches other than chronic migraine.

    Science.gov (United States)

    Santos-Lasaosa, S; Cuadrado, M L; Gago-Veiga, A B; Guerrero-Peral, A L; Irimia, P; Láinez, J M; Leira, R; Pascual, J; Porta-Etessam, J; Sánchez Del Río, M; Viguera Romero, J; Pozo-Rosich, P

    2017-11-20

    In the field of headaches, onabotulinumtoxinA (onabotA) is well established as a treatment for chronic migraine (CM). In recent years, it has been used increasingly to treat other primary headaches (high-frequency episodic migraine, trigeminal-autonomic cephalalgias, nummular headache) and trigeminal neuralgia. As this treatment will progressively be incorporated in the management of these patients, we consider it necessary to reflect, with a fundamentally practical approach, on the possible indications of onabotA, beyond CM, as well as its administration protocol, which will differ according to the type of headache and/or neuralgia. This consensus document was drafted based on a thorough review and analysis of the existing literature and our own clinical experience. The aim of the document is to serve as guidelines for professionals administering onabotA treatment. The first part will address onabotA's mechanism of action, and reasons for its use in other types of headache, from a physiopathological and clinical perspective. In the second part, we will review the available evidence and studies published in recent years. We will add an "expert recommendation" based on our own clinical experience, showing the best patient profile for this treatment and the most adequate dose and administration protocol. Treatment with onabotA should always be individualised and considered in selected patients who have not responded to conventional therapy. Copyright © 2017 Sociedad Española de Neurología. Publicado por Elsevier España, S.L.U. All rights reserved.

  12. Medical education and primary health care in Nigeria: the Sokoto University experience.

    Science.gov (United States)

    Akpala, C O

    1991-11-01

    Despite the acknowledgement and adoption of the Alma-Ata declaration by majority of the countries of the world as a strategy for achieving Health For All, medical educational systems often remain as ivory towers from the health service system. This traditional system of medical education does not adequately prepare doctors in developing countries for their expected leadership role in meeting the health needs for their communities through primary health care. In Nigeria, primary health care forms the basis for an official health policy aimed at meeting the health care needs of the entire population particularly those in the rural areas. This article, while highlighting the need for integration of medical education and the primary health care services, also examines the structural relationships between the two components at the Sokoto University in Nigeria, a West African country with one of the oldest medical educational system in the area.

  13. Integrating mental health into primary care for displaced populations: the experience of Mindanao, Philippines

    Directory of Open Access Journals (Sweden)

    Gil Tatiana

    2011-03-01

    Full Text Available Abstract Background For more than forty years, episodes of violence in the Mindanao conflict have recurrently led to civilian displacement. In 2008, Medecins Sans Frontieres set up a mental health program integrated into primary health care in Mindanao Region. In this article, we describe a model of mental health care and the characteristics and outcomes of patients attending mental health services. Methods Psychologists working in mobile clinics assessed patients referred by trained clinicians located at primary level. They provided psychological first aid, brief psychotherapy and referral for severe patients. Patient characteristics and outcomes in terms of Self-Reporting Questionnaire (SRQ20 and Global Assessment of Functioning score (GAF are described. Results Among the 463 adult patients diagnosed with a common mental disorder with at least two visits, median SRQ20 score diminished from 7 to 3 (p Conclusions Brief psychotherapy sessions provided at primary level during emergencies can potentially improve patients' symptoms of distress.

  14. Experiences of racism, racial/ethnic attitudes, motivated fairness and mental health outcomes among primary and secondary school students.

    Science.gov (United States)

    Priest, Naomi; Perry, Ryan; Ferdinand, Angeline; Paradies, Yin; Kelaher, Margaret

    2014-10-01

    While studies investigating the health effects of racial discrimination for children and youth have examined a range of effect modifiers, to date, relationships between experiences of racial discrimination, student attitudes, and health outcomes remain unexplored. This study uniquely demonstrates the moderating effects of vicarious racism and motivated fairness on the association between direct experiences of racism and mental health outcomes, specifically depressive symptoms and loneliness, among primary and secondary school students. Across seven schools, 263 students (54.4% female), ranging from 8 to 17 years old (M = 11.2, SD = 2.2) reported attitudes about other racial/ethnic groups and experiences of racism. Students from minority ethnic groups (determined by country of birth) reported higher levels of loneliness and more racist experiences relative to the majority group students. Students from the majority racial/ethnic group reported higher levels of loneliness and depressive symptoms if they had more friends from different racial/ethnic groups, whereas the number of friends from different groups had no effect on minority students' loneliness or depressive symptoms. Direct experiences of racism were robustly related to higher loneliness and depressive symptoms in multivariate regression models. However, the association with depressive symptoms was reduced to marginal significance when students reported low motivated fairness. Elaborating on the negative health effects of racism in primary and secondary school students provides an impetus for future research and the development of appropriate interventions.

  15. Genetic education, knowledge and experiences between nurses and physicians in primary care in Brazil: A cross-sectional study.

    Science.gov (United States)

    Lopes-Júnior, Luís Carlos; Carvalho Júnior, Paulo Marcondes; de Faria Ferraz, Victor Evangelista; Nascimento, Lucila Castanheira; Van Riper, Marcia; Flória-Santos, Milena

    2017-03-01

    Recent advances in genomics and related technologies have the potential to improve health care throughout the world. In this cross-sectional study, we examine genetics education, knowledge, and genetics-related experiences among the nurses and physicians who provide primary care in a Brazilian city. Fifty-four healthcare professionals from family health units participated in the study (response rate: 90%). Data were collected using a structured 36-item questionnaire divided into five axes: sociodemographic data and academic background; genetics education; genetics knowledge; genetics-related experiences in family practice; and knowledge regarding the National Policy for Comprehensive Care in Clinical Genetics in the Unified Health System. Although most participants (85.2%) acknowledged receiving some genetic content during their undergraduate education, the majority (77.8%) advised that they did not feel prepared to deliver genomics-based health care in primary care. The results suggest that nurses and physicians often lack the knowledge to provide genomics-based health care in primary care. Therefore, continuing education in genetics/genomics should be provided to primary healthcare professionals in order to enhance family practice and compliance with national policies. © 2016 John Wiley & Sons Australia, Ltd.

  16. The challenge of contributing to policy making in primary care: The gendered experiences and strategies of nurses

    OpenAIRE

    Hughes, A.

    2010-01-01

    This paper explores nurses’ experiences as members of primary care organizations set up to develop and commission health services for local communities. Nurses, alongside GPs and other health professionals, were given a place on the governing bodies (boards) of Local Health Groups – a move widely welcomed by the nursing profession as long overdue recognition of the important contribution nurses and nursing could bring to the policy arena. \\ud \\ud Nurse board members faced a number of challeng...

  17. Palliative care for cancer patients in a primary health care setting: Bereaved relatives' experience, a qualitative group interview study

    Directory of Open Access Journals (Sweden)

    Jensen Anders

    2008-01-01

    Full Text Available Abstract Background Knowledge about the quality and organisation of care to terminally ill cancer patients with a relatives' view in a primary health care setting is limited. The aim of the study is to analyse experiences and preferences of bereaved relatives to terminally ill cancer patients in a primary care setting to explore barriers and facilitators for delivery of good palliative home care. Methods Three focus group interviews with fourteen bereaved relatives in Aarhus County, Denmark. Results Three main categories of experience were identified: 1 The health professionals' management, where a need to optimize was found. 2 Shared care, which was lacking. 3 The relatives' role, which needs an extra focus. Conclusion Relatives experience insufficient palliative care mainly due to organizational and cultural problems among professionals. Palliative care in primary care in general needs improvement and attention should be drawn to the "professionalization" of the relatives and the need to strike a balance between their needs, wishes and resources in end-of-life care and bereavement.

  18. Physical fatigue characterises patient experience of primary Sjögren's syndrome

    NARCIS (Netherlands)

    Arends, Suzanne; Meiners, Petra M; Moerman, Rada V; Kroese, Frans G M; Brouwer, Elisabeth; Spijkervet, Frederik K L; Vissink, Arjan; Bootsma, Hendrika

    2017-01-01

    OBJECTIVES: Besides ocular and oral dryness, fatigue is a major symptom in patients with primary Sjögren's syndrome (pSS). Our aim was to investigate the importance of fatigue in relation to other symptoms experienced as well as to evaluate the effect of rituximab treatment on fatigue in pSS

  19. The Emergence of Cyberbullying: A Survey of Primary School Pupils' Perceptions and Experiences

    Science.gov (United States)

    Monks, Claire P.; Robinson, Susanne; Worlidge, Penny

    2012-01-01

    There is little research that has examined cyberbullying among children under the age of 11 years. The current study explored the nature and extent of the phenomenon among primary school children aged 7- to 11-years-old (N = 220; 116 boys and 104 girls) and investigated their perceptions of the distress caused to victims, how victims would feel,…

  20. The Political Experience of Primary School Teachers in the People's Republic of China.

    Science.gov (United States)

    Glassman, Joel

    1979-01-01

    This paper examines the characteristics and status of China's primary school teachers and their ability, as members of the intelligentsia, to exert political influence in the formation of educational policy. It is concluded that, in periods when educational policy is of high concern, these teachers have little influence. (SJL)

  1. First Experiences with Reading Primary Literature by Undergraduate Life Science Students

    NARCIS (Netherlands)

    van Lacum, Edwin; Ossevoort, Miriam; Buikema, Hendrik; Goedhart, Martin

    2012-01-01

    Learning to read and understand research articles (primary literature) is an important step in the enculturation of higher education students into the scientific community. We presume, based on ideas from the field of genre analysis, that it is important for the development of reading skills to

  2. First Experiences with Reading Primary Literature by Undergraduate Life Science Students

    Science.gov (United States)

    van Lacum, Edwin; Ossevoort, Miriam; Buikema, Hendrik; Goedhart, Martin

    2012-01-01

    Learning to read and understand research articles (primary literature) is an important step in the enculturation of higher education students into the scientific community. We presume, based on ideas from the field of genre analysis, that it is important for the development of reading skills to become conscious of the rhetorical structures in…

  3. Living Transdisciplinary Curriculum: Teachers' Experiences with the International Baccalaureate's Primary Years Programme

    Science.gov (United States)

    Savage, Michael J.; Drake, Susan M.

    2016-01-01

    An integrated curriculum that is transdisciplinary in nature seems to be a good fit for 21st Century learning. There are, however, few examples of transdisciplinary curriculum at the K to 12 level. One exception is the International Baccalaureate's Primary Years Programme (PYP) which features transdisciplinary curriculum for students from ages 3…

  4. Implementing Open Source Platform for Education Quality Enhancement in Primary Education: Indonesia Experience

    Science.gov (United States)

    Kisworo, Marsudi Wahyu

    2016-01-01

    Information and Communication Technology (ICT)-supported learning using free and open source platform draws little attention as open source initiatives were focused in secondary or tertiary educations. This study investigates possibilities of ICT-supported learning using open source platform for primary educations. The data of this study is taken…

  5. Primary Health Care Theory to Practice: Experience of First-Year Nursing Students in Hong Kong.

    Science.gov (United States)

    Simpson, Peggy; Chan, Mun Che; Cheung, Lai Yin; Hui, Tze Shau; Li, Ka Ying; Tang, Hiu Tung; Tong, Hoi Ning; Wong, Sik Kwan; Wong, Po Ming

    2002-01-01

    Eight first-year nursing students in Hong Kong implemented a primary health care project involving health assessments of older adults. Clients improved health knowledge and were satisfied with assessments. Students demonstrated high competence in health assessment, needs assessment, evaluation strategies, and health promotion skills. (Contains 27…

  6. [CT urography in women with primary or recurrent pelvic tumors : background and initial experiences].

    Science.gov (United States)

    Seifert, S; Mueller-Lisse, U G; Degenhart, C; Jundt, K; Mourched, F; Stief, C G; Reiser, M F; Mueller-Lisse, U L

    2011-07-01

    Malignant tumors of the female pelvis account for 12-13% of newly diagnosed solid neoplasms among women in the USA and Germany. German guidelines advocate diagnostic imaging for local recurrence and metastasis while there are no recommendations for primary tumors. As excretory urography has been replaced by the excretory phase of computed tomography urography (CTU) in many institutions, two independent observers retrospectively evaluated CTUs of primary or recurrent female pelvic tumors to rule out associations between CTU findings and subsequent urologic measures. Among 31 CTUs of 27 women (age 29-84 years, mean 57 years) with 15 primary and 13 recurrent tumors, 83-100% of unremarkable proximal, middle and distal ureter segments were completely delineated in the excretory phase (delay 6-29 min, mean 16 min). The most common pathological findings included distal ureter obstruction (n=19, 61%), bladder compression (n=13, 42%) and bladder invasion (n=8, 26%). Out of 20 pathologically altered urinary tracts 8 were subsequently subjected to urologic measures (2-tailed Fisher exact test, p=0.0215) but none of the 10 unremarkable urinary tracts were treated. It appears that CTU is a sensible pre-therapeutic test for the urinary tract for primary and recurrent female pelvic tumors.

  7. A Summer Camp Experience of Primary Student: Let's Learn Astronomy, Explore the Space Summer Camp

    Science.gov (United States)

    Aktamis, Hilal; Acar, Esin; Unal Coban, Gul

    2015-01-01

    It is important to structure children's knowledge and arouse their interest in subjects like astronomy and space. Although we now talk of travelling to the moon, space tourism etc., knowledge about astronomy and space is limited and perceptions of these subjects do not reflect scientific reality. Primary level students often have misconceptions…

  8. Relative afferent pupillary defects in primary open-angle glaucoma--five years' experience.

    Science.gov (United States)

    Page, C J; Merritt, J C; Evans, B

    1985-12-01

    Afferent pupillary defects may accompany asymmetric primary open-angle glaucoma, though the exact incidence has not been reported. Charts were reviewed on 89 patients attending the Glaucoma/Uveitis Clinic at the North Carolina Memorial Hospital in Chapel Hill, North Carolina over a five-year period. All patients had primary open-angle glaucoma diagnosed by: (1) increased ocular tensions (22 mmHg) in the presence of open-anterior-chamber angles and (2) optic-nerve cupping and atrophy compatible with (3) pressure-dependent, visual-field loss. No subjects with secondary glaucomas, primary-angle-closure glaucoma, or ocular hypertension are included.The presence of the relative afferent pupillary defect was noted in 21 of 89 patients (23 percent). Sixteen of 70 black patients had relative afferent pupillary defect in the more severely affected eye, while five of 19 white patients demonstrated afferent pupils. Other demographic characteristics of this population are described. Two typical primary-open-angle glaucoma patients are discussed to demonstrate comparable changes within the optic nerves and Goldmann visual fields. The presence of the relative afferent pupillary defect best correlates with asymmetric, visual-field loss in the more severely affected eye.

  9. Inservice Training of Primary Teachers through Interactive Video Technology: An Indian Experience.

    Science.gov (United States)

    Raina, V. K.; Maheshwari, A. N.

    1998-01-01

    Discusses India's Special Orientation Programme for Primary School Teachers (SOPT), a new technology used to train large numbers of teachers so that the losses in transmission inherent in the "cascade model" are avoided. Responses from teachers and trainers show there is considerable potential for the exploitation of this technology.…

  10. "It's a maybe test": men's experiences of prostate specific antigen testing in primary care.

    NARCIS (Netherlands)

    Evans, R.; Edwards, A.G.; Elwyn, G.; Watson, E.; Grol, R.P.T.M.; Brett, J.; Austoker, J.

    2007-01-01

    BACKGROUND: Prostate specific antigen (PSA) testing in primary care is an important and contentious issue. Due to concerns about the test and the value of early detection, countries such as the UK advocate 'informed choice' instead of population screening. It is not known whether this policy is

  11. Languages and Mathematics Achievements among Rural and Urban Primary Four Pupils: A Malaysian Experience

    Science.gov (United States)

    Singh, Parmjit; Rahman, Arba Abdul; Hoon, Teoh Sian

    2010-01-01

    The change in the language of instruction for Mathematics under PPSMI had been opined to prejudice learners' achievements due to their weakness in the subject matter as well as in English. This study sought to analyse 186 urban and rural Primary 4 pupils' Mathematics achievements in tests using English and English/Bahasa Malaysia presentations.…

  12. Second Primary Tumors associated with Breast Cancer: Kuwait Cancer Control Center Experience.

    Science.gov (United States)

    Fayaz, Salah; Demian, Gerges Attia; Eissa, Heba El-Sayed; Abuzalouf, Sadeq

    2017-09-01

    To review the clinico-epidemiologic characteristics of patients who presented with two or more primary cancers, one of which was breast cancer (BC) and to develop a follow-up program for the high risk patients. Patients who were diagnosed with BC and one or more non breast cancer (NBC) were retrospectively reviewed. Medical files were retrieved and epidemiological as well as clinical data were analyzed. Sixty-two patients were retrieved. BC was the first primary in 26 patients while it was the second in 36 patients. Two were males and 60 were females. The median age was 48 years and the median follow-up was 11.5 years. The median interval between the 1st and 2nd primary was 6 years. The most commonly associated NBCs were colon and thyroid cancers, each accounts for 24% of cases followed by endometrial cancer, 18%; Hodgkin's disease, 6.5%; renal and ovarian neoplasm and NHL, 5% each. Others included prostate, lung, cervical and gastric cancers, soft tissue sarcoma and osteosarcoma. Thyroid cancer was more common as first cancer while endometrial cancer was more as second cancer. All patients who developed BC following Hodgkin's disease had received chest irradiation. Seven patients developed 3rd primary (4 lung cancers, 2 NHL, and 1 AML). Patients who were diagnosed with BC should be screened for colon and endometrial cancer. Similarly, patients received chest irradiation at young age, and those diagnosed with thyroid or colon cancer should be screened for BC. Protocol of surveillance needs to be defined. Genetic counseling should be offered to individuals who have experienced multiple primary cancers particularly those with family history and young age of onset.

  13. A Case Study of What Experiences Contribute to the Ideas of Energy Held by Primary School Students in Trinidad and Tobago

    Science.gov (United States)

    Maharaj-Sharma, Rawatee; Sharma, Amrit

    2014-01-01

    This case study explored what experiences contribute to the ideas of energy held by 30 purposively selected primary school students from one primary school in Trinidad and Tobago. The 30 students were selected from across all levels of the primary system. The study used the Interview About Events (IAE) approach to explore students' ideas about…

  14. Communicating with mismatch and tension: treatment provision experiences of primary care doctors treating patients with overactive bladder in Hong Kong.

    Science.gov (United States)

    Siu, Judy Yuen-Man

    2015-10-30

    Overactive bladder (OAB) is a common chronic bladder dysfunction worldwide. As the first contact point of health care, primary health care providers are often consulted by patients seeking initial consultation for OAB. The relatively short history of the existence of OAB in medicine and low public awareness of OAB in Hong Kong, however, often serve as a challenge to primary health care providers in treating patients with OAB. The experiences of patients and health care providers are often influenced by the interaction between these two groups, hence both health care providers and patients are key determinants of the entire treatment experience, and the perspectives of health care providers should not be overlooked. However, patient experiences have been the main focus of related studies, few of which have examined the treatment provision experiences and perspectives of health care providers. This research gap is notable considering that the satisfaction and morale of health care providers can influence treatment outcome. This study adopted a qualitative research approach by conducting semistructured individual interviews with 30 private practice primary care doctors in Hong Kong between November 2013 and May 2014. Lacking confidence in treating OAB patients, encountering mismatch with patients in treatment expectations and communication style, and feeling embarrassed when communicating with OAB patients were the experiences reported by the sampled doctors. The sampled doctors' treatment provision experiences revealed a general lack of knowledge about OAB among primary care doctors in Hong Kong. Furthermore, the negative stereotype of and lack of trust in private practice doctors created tension between the doctors and patients. This lack of mutual trust was particularly unfavourable for the doctors to provide long-term treatment and support to patients with OAB. The embedded distrust of private practice doctors also affected the prescribing behaviour of the doctors

  15. Primary care physicians' experiences with electronic medical records: implementation experience in community, urban, hospital, and academic family medicine.

    Science.gov (United States)

    Ludwick, Dave; Manca, Donna; Doucette, John

    2010-01-01

    To understand how remuneration and care setting affect the implementation of electronic medical records (EMRs). Semistructured interviews were used to illicit descriptions from community-based family physicians (paid on a fee-for-service basis) and from urban, hospital, and academic family physicians (remunerated via alternative payment models or sessional pay for activities pertaining to EMR implementation). Small suburban community and large urban-, hospital-, and academic-based family medicine clinics in Alberta. All participants were supported by a jurisdictional EMR certification funding mechanism. Physicians who practised in 1 or a combination of the above settings and had experience implementing and using EMRs. Purposive and maximum variation sampling was used to obtain descriptive data from key informants through individually conducted semistructured interviews. The interview guide, which was developed from key findings of our previous literature review, was used in a previous study of community-based family physicians on this same topic. Field notes were analyzed to generate themes through a comparative immersion approach. Physicians in urban, hospital, and academic settings leverage professional working relationships to investigate EMRs, a resource not available to community physicians. Physicians in urban, hospital, and academic settings work in larger interdisciplinary teams with a greater need for interdisciplinary care coordination, EMR training, and technical support. These practices were able to support the cost of project management or technical support resources. These physicians followed a planned system rollout approach compared with community physicians who installed their systems quickly and required users to transition to the new system immediately. Electronic medical records did not increase, or decrease, patient throughput. Physicians developed ways of including patients in the note-taking process. We studied physicians' procurement

  16. Foreign Experience in Using Educational Logotherapy in Professional Activities of Primary School Teachers

    Directory of Open Access Journals (Sweden)

    Stepura Yuliia

    2017-09-01

    Full Text Available The article examines the nature and importance of using aesthetic and therapeutic concept and educational logotherapy, in particular, for creating a special emotionally comfortable socioeducational environment for primary education The author has represented inteipretation of foreign scholars' views (J. Bugental, V. Frankl, A. Maslow, R. May, J. Moreno, C. Rogers et al on such terms as “communication ”, “aesthetotherapy ”, “educational logotherapy” etc. An attempt has been made to analyze the social coTitent of pedagogical activity in the context of using logotherapy in primary school based on an agogical paradigm. In the scope of the article, the specific of using the therapeutic metaphor in the educational environment of primary' school has been represented as well as the basic stages of its implementation have been determined. These stages are the following: description of the storyline, persuasion and binding. The author has defined the role of the “living metaphors” in organization of the therapeutic interaction between the teacher and primary' schoolchildren. Particular attention has been paid to formation of the humanistic competency among primary schoolchildren; this competency is to be based on their understanding of the following philosophical and pedagogical categories: a norm (as a means and a results of pupils' social activity, freedom (as a mean and a result of individual self-expression among primary schoolchildren and happiness (as an individual self-expression among primaryr schoolchildren. The author has assessed the role of deflection method and paradoxical intention for the social development of the pupil and further formation of the individual. Additional attention has been paid to determination of the socioeducational and psychological and pedagogical potential of such leading method in logotherapy as “The Socratic dialogue” (or “The Socratic circle”: as well have been highlighted the main stages of

  17. Occupational Therapy experience in family care in a primary health care service

    Directory of Open Access Journals (Sweden)

    Gisele Baissi

    2013-08-01

    Full Text Available Occupational therapy is presented as the core knowledge involved in the remodeling and strengthening of Primary Health Care in the Brazilian Unified Health Care System (Sistema Único de Saúde – SUS. In this study, we aimed to describe the interventions in the process of occupational therapy in supervised family care in a primary health care service in the municipality of Várzea Paulista, São Paulo state. In this case study, the moments of care were described and analyzed in light of narratives on the supervised practice of occupational therapy with a family. The results showed forms of intervention that characterize the process of occupational therapy focused on family health needs in favor of creativity and the role for changes in health practices in everyday life. Through the accomplishment of occupational activities directed to self-care, Occupational Therapy can aid families to cope with daily life adversity.

  18. Activity Approach and Practice-oriented Primary Teacher Training, Experience of the Siberian Federal University

    Directory of Open Access Journals (Sweden)

    Smolyaninova O.G.

    2015-11-01

    Full Text Available Current issue was done under the Federal Target Education Development Program from 2011 to 2015, with the aim of networking development in vocational secondary education for teacher training based on new modules of applied bachelor programs focused on strengthening the practical orientation of future teacher training. This is considered as a basis of improvement of the federal higher educational standards, the development of new basic exemplary educational programs and finding new ways of educational outcomes assess according to the teacher professional standard. The authors believe that the successful activity in this area will improve the quality of primary school teachers training and will reduce the shortage of personnel in primary education and in secondary vocational education in Russia and Krasnoyarsk Territory in particular.

  19. Personality Characteristics Of Teachers Involved In The Delivery Of Primary Healthy Care (Sevagram Experiment

    Directory of Open Access Journals (Sweden)

    Singh D

    1990-01-01

    Full Text Available An attempt was made to study the personality traits influencing the performance of 17 primary school teachers selected under ICMR project in Wardha district, to investigate feasibility and effectiveness of their involvement as primary health care workers vis-Ã -vis the 19 community health volunteers introduced by the State Government in the non-teacher villages of the project at the same time. The results indicated that both the teachers and community health volunteers preferred preventive and promotive health tasks and they showed no significant difference on the motivation and leadership orientation scale. The teachers, because of their job security and promotional avenues were satisfied with their achievements and were full of hopes and aspirations but the same was not true with the community health volunteers. This was due to their comparatively poor economic conditions and unstable sources of livelihood.

  20. Multidisciplinary Practice Experience of Nursing Faculty and Their Collaborators for Primary Health Care in Korea

    OpenAIRE

    Kim, Mi Ja; Chung, Hyang-In Cho; Ahn, Yang Heui

    2008-01-01

    This study aimed to describe the range of participation of nursing faculty members and their collaborators in multidisciplinary primary health care in Korea and to analyze facilitators, benefits, barriers, and learned lessons. Methods: An exploratory descriptive research design was utilized. A total of 13 nursing faculty members and 13 multidisciplinary collaborators were interviewed face to face using a brief questionnaire and semi-structured interview guide. Descriptive statistics, compa...

  1. Adult visual experience promotes recovery of primary visual cortex from long-term monocular deprivation

    OpenAIRE

    Fischer, Quentin S.; Aleem, Salman; Zhou, Hongyi; Pham, Tony A.

    2007-01-01

    Prolonged visual deprivation from early childhood to maturity is believed to cause permanent visual impairment. However, there have been case reports of substantial improvement of binocular vision in human adults following lifelong visual impairment or deprivation. These observations, together with recent findings of adult ocular dominance plasticity in rodents, led us to re-examine whether adult primary visual cortex (V1) is capable of any recovery following long-term monocular deprivation s...

  2. Tertiary center experience with primary endoscopic laryngoplasty in pediatric acquired subglottic stenosis and literature review

    Directory of Open Access Journals (Sweden)

    Jaber Alshammari

    2017-03-01

    Conclusion: Our study showed that primary endoscopic management was successful in 82.3% of cases of acquired subglottic stenosis including those with high grade stenosis and long segment of more than 12 mm in terms of the craniocaudal length. CO2 laser was an important tool to convert mature hard stenotic segment into a soft one. The latter yielded to the lateral pressure created by balloon dilatation better.

  3. First Experiences with Reading Primary Literature by Undergraduate Life Science Students

    Science.gov (United States)

    van Lacum, Edwin; Ossevoort, Miriam; Buikema, Hendrik; Goedhart, Martin

    2012-08-01

    Learning to read and understand research articles (primary literature) is an important step in the enculturation of higher education students into the scientific community. We presume, based on ideas from the field of genre analysis, that it is important for the development of reading skills to become conscious of the rhetorical structures in research articles. So, we determined how well science students are able to identify 2 important elements of this rhetorical structure: conclusions and grounds. First-year undergraduate life science students who followed a course called 'Biomedical Research' made assignments in which they had to identify these 2 elements. We analysed the answers of 20 students in detail and compared their answers with 2 expert readers. Furthermore, we conducted task-based interviews with 4 students to gain more insight into their reading strategies and to determine how they identify conclusions and grounds. Our results show that students and experts defined conclusions and grounds in different ways. Students and experts agreed on the most important conclusion of the articles. However, students identified a wide range of sentences which were not seen as conclusions by the experts. The grounds students mentioned mostly matched their conclusions. Students sometimes failed to mention important grounds for a particular conclusion. In conclusion, our study shows the differences between student and expert readers of primary literature. Based on our results, we formulated criteria for the design of a teaching strategy that aims to improve students' skills for reading primary literature.

  4. Clinical profile of orofacial infections: An experience from two primary care dental practices

    Science.gov (United States)

    Hollinshead, Frank

    2012-01-01

    Objectives: Orofacial infections are common reasons for dental consultations worldwide. However, there is scarcity of data on clinico-epidemiological profiles reported from primary care dental practices. To address this issue, a study was done to characterize the clinical pattern, age groups affected and sex predilection of orofacial infections in the primary care dental practice. Study design: Clinical data was evaluated from random electronic files of patients for whom antimicrobials were prescribed at two Dental Practices in UK between January 2009 and December 2010. Results: 200 case records were studied. 104 (52%) cases were females. Mean age was 37.2 (+/-15.1) years. 107 (53.5%) cases belonged to age group 21-40 years. Posterior teeth were involved in 112 (56%) cases. Types of disease were as follows: dentoalveolar abscess 63(31.5%), pulpitis 27(13.5%), apical periodontitis 21(10.5%), pericoronitis 21(10.5%), dry socket 13(6.5%), periodontitis 9(4.5%) infected root stump 5(2.5%), facial swelling 5(2.5%) and infections unspecified 36(18%) cases. Conclusions: Orofacial infections affect both sexes equally. 21-40 years is the commonest age-group affected. Dentoalveolar abscess is the commonest infection followed by unspecified infections and pulpitis. Key words:Orofacial infections, primary care dental practice, dentoalveolar abscess and pulpitis. PMID:22322492

  5. Investigating the relationship between consultation length and patient experience: a cross-sectional study in primary care.

    Science.gov (United States)

    Elmore, Natasha; Burt, Jenni; Abel, Gary; Maratos, Frances A; Montague, Jane; Campbell, John; Roland, Martin

    2016-12-01

    Longer consultations in primary care have been linked with better quality of care and improved health-related outcomes. However, there is little evidence of any potential association between consultation length and patient experience. To examine the relationship between consultation length and patient-reported communication, trust and confidence in the doctor, and overall satisfaction. Analysis of 440 videorecorded consultations and associated patient experience questionnaires from 13 primary care practices in England. Patients attending a face-to-face consultation with participating GPs consented to having their consultations videoed and completed a questionnaire. Consultation length was calculated from the videorecording. Linear regression (adjusting for patient and doctor demographics) was used to investigate associations between patient experience (overall communication, trust and confidence, and overall satisfaction) and consultation length. There was no evidence that consultation length was associated with any of the three measures of patient experience (P >0.3 for all). Adjusted changes on a 0-100 scale per additional minute of consultation were: communication score 0.02 (95% confidence interval [CI] = -0.20 to 0.25), trust and confidence in the doctor 0.07 (95% CI = -0.27 to 0.41), and satisfaction -0.14 (95% CI = -0.46 to 0.18). The authors found no association between patient experience measures of communication and consultation length, and patients may sometimes report good experiences from very short consultations. However, longer consultations may be required to achieve clinical effectiveness and patient safety: aspects also important for achieving high quality of care. Future research should continue to study the benefits of longer consultations, particularly for patients with complex multiple conditions. © British Journal of General Practice 2016.

  6. Healthcare professional experiences with patients who participate in multimodal pain rehabilitation in primary care - a qualitative study.

    Science.gov (United States)

    Stenberg, Gunilla; Pietilä Holmner, Elisabeth; Stålnacke, Britt-Marie; Enthoven, Paul

    2016-10-01

    Exploring healthcare professional experiences of Multimodal rehabilitation (MMR) in primary care. Fourteen healthcare professionals (11 women, 3 men) were individually interviewed about their work with MMR in primary care. Interviews covered experiences of assessing patients and work with patients in the programme. Transcribed interviews were analysed by qualitative content analysis. The analysis resulted in four categories: select patients for success; a multilevel challenge; ethical dilemmas and considering what is a good result. MMR work was experienced as useful and efficient, but also challenging because of patient complexity. Preconceptions about who is a suitable patient for MMR influenced the selection of patients (e.g. gender, different culture). Interviewees were conflicted about not to being able to offer MMR to patients who were not going to return to work. They thought that there were more factors to evaluate MMR than by the proportion that return to work. Healthcare professionals perceive MMR as a helpful method for treating chronic pain patients. At the same time, they thought that only including patients who would return to work conflicted with their ethical views on equal healthcare for all patients. Preconceptions can influence selection for, and work with, MMR. Implications for rehabilitation Multimodal pain rehabilitation in primary healthcare is challenging because of the complexity of the patients. Healthcare professionals must deal with conflicting emotions in regard to different commitments from healthcare legislation and the goals of multimodal rehabilitation. Healthcare professionals should be aware that stereotypes regarding gender and immigrants can lead to bias when selecting patients for multimodal rehabilitation.

  7. Fiber hodoscope in the COMPASS experiment for the detection of particle tracks within the primary beam

    CERN Document Server

    Nahle, Ole Jens; Hinterberger, F.

    2002-01-01

    Für das COMPASS-Experiment am CERN wurden Hodoskope aus szintillierenden Fasern entwickelt, getestet und in das Experiment integriert. Die Spurrekonstruktion im oder in unmittelbarer Nähe des Primärstrahls stellt hohe Anforderungen in Bezug auf Ratenfestigkeit, Zeitauflösung, Nachweiseffizienz und Strahlenhärte aller Detektorkomponenten. Vorstudien zur Eignung von szintillierenden Fasern und Lichtleitern in Verbindung mit Vielkanal-Photomultipliern führten zur Fertigung eines Prototyps, der bei nominalen Bedingungen intensiv getestet wurde. Mit den hieraus gewonnen Erfahrungen wurden insgesamt vier Faserhodoskope realisiert und im Rahmen des COMPASS-Experiments betrieben. Hierbei wurde eine intrinsische Detektoreffizienz von nahezu 100% erreicht. Mit einer Zeitauflösung von etwa 450 ps bei gleichzeitig geringen Treffermultiplizitäten ist eine eindeutige Rekonstruktion von Teilchenspuren auch bei Strahlraten von bis zu 100 MHz möglich. Im Dauerbetrieb über 250 Tage während zweier Strahlzeiten zeigte...

  8. Clinicopathological and immunohistochemical features of primary central nervous system germ cell tumors: a 24-years experience.

    Science.gov (United States)

    Gao, Yuping; Jiang, Jiyao; Liu, Qiang

    2014-01-01

    Primary central nervous system (CNS) germ cell tumors (GCTs) are a rare heterogeneous group of lesions, which the clinicopathological features have a marked degree of heterogeneity comparing with that of gonadal GCTs. Accurately diagnosing CNS GCTs might be extremely difficult and requires immunohistochemical verification. This study was to investigate the biological feature of CNS GCTs and diagnostic value of immunohistochemical markers OCT3/4, C-kit, PLAP, and CD30 in CNS GCTs. A retrospective study was performed on 34 patients with CNS germ cell tumors between 1990 and 2014. 34 CNS GCTs account for 9.2% of all primary CNS neoplasms. The sellar region (35.3%) and pineal gland (17.6%) were the most common sites of intracranial GCTs. Hydrocephalus (82.4%) and diplopia (46.9%) were the two most common clinical presentations. The most common histological subtypes were germinoma (67.6%). PLAP, c-kit, OCT3/4 were highly expressed in gernimomas. CD30 and CK AE1/3 stainings were positive in embryonal carcinoma. Yolk sac tumor component showed positive staining for AFP and CK AE1/3. β-HCG staining was positive in choriocarcinoma and STGC. Patients with mature teratomas and germinomas had a better prognosis (a 5-year survival rate) than those with embryonal carcinoma and choriocarcinoma (a 5-year survival rates were 0). Our finding suggest that the incidences of primary CNS GCTs are higher in South China than in the West, but mixed GCTs are uncommon in our study. The judicious use of a panel of selected markers is helpful in diagnosing and predicting the prognosis for CNS GCTs.

  9. Treatment of uncommon sites of focal primary hyperhidrosis: experience with pharmacological therapy using oxybutynin

    Directory of Open Access Journals (Sweden)

    Marcelo Passos Teivelis

    2014-09-01

    Full Text Available OBJECTIVES: Primary hyperhidrosis usually affects the hands, armpits, feet and cranio-facial region. Sweating in other areas is common in secondary hyperhidrosis (after surgery or in specific clinical conditions. Oxybutynin has provided good results and is an alternative for treating hyperhidrosis at common sites. Our aim was to evaluate the efficacy of oxybutynin as a treatment for primary sweating at uncommon sites (e.g., the back and groin. METHODS: This retrospective study analyzed 20 patients (10 females who received oxybutynin for primary focal hyperhidrosis at uncommon sites. The subjects were evaluated to determine quality of life before beginning oxybutynin and six weeks afterward and they were assigned grades (on a scale from 0 to 10 to measure their improvement at each site of excessive sweating after six weeks and at the last consult. RESULTS: The median follow-up time with oxybutynin was 385 days (133-1526 days. The most common sites were the back (n = 7 and groin (n = 5. After six weeks, the quality of life improved in 85% of the subjects. Dry mouth was very common and was reported by 16 patients, 12 of whom reported moderate/severe dry mouth. Five patients stopped treatment (two: unbearable dry mouth, two: excessive somnolence and one: palpitations. At the last visit, 80% of patients presented with moderate/great improvement at the main sites of sweating. CONCLUSION: After six weeks, more than 80% of the patients presented with improvements in their overall quality of life and at the most important site of sweating. Side effects were common (80% reported at least one side effect and caused 25% of the patients to discontinue treatment. Oxybutynin is effective for treating bothersome hyperhidrosis, even at atypical locations and most patients cope well with the side effects.

  10. Experiences of nurses working in a rural primary health-care setting in Mopani district, Limpopo Province

    Directory of Open Access Journals (Sweden)

    MP Mohale

    2008-09-01

    Full Text Available Professional nurses working in rural, primary health-care settings are experiencing burnout due to serious shortages of personnel. This is exacerbated by the brain drain of nurses leaving the country. Rural settings are resource constrained in terms of personnel and equipment. This results in dissatisfaction among nurses due to the unbearable working conditions which result in stress and frustration. A qualitative, explorative, descriptive study was conducted to explore and describe the experiences of nurses working in a rural primary health-care setting in the greater Letaba sub district in Limpopo Province. Purposive sampling was used to identify the participants. Data was collected in the form of in-depth interviews. The study revealed that nurses working in primary health-care settings were experiencing emotional and physical strain as a result of the shortage of human resources. It was recommended that policies that meet the health-care needs of rural communities be developed, and that strategies to retain professional nurses in primary health-care settings be formulated.

  11. An experience in Language Teaching Seminar of Primary Education Degree through the Seventh Art

    Directory of Open Access Journals (Sweden)

    Ángela GARCÍA-MANSO

    2018-01-01

    Full Text Available This study describes the Seminar «Language Skills and Seventh Art» developed at the University of Extremadura in the course 2015-2016. Through the analysis of ten films, we deal with professional competences of future Primary teachers from unique situations, for example disabilities such as blind and deaf people, autism or dyslexia, questions about the origin of the language and artificial languages, or cultural issues such as the wild child or within situations of isolation or loneliness. In addition to the specific considerations of each film, the active use of Cinema in different areas of learning foreign languages and ELE (Spanish as Foreign Language is postulated

  12. Surgery as the primary management of proliferative vitreoretinopathy: a history reflecting my experiences and biases.

    Science.gov (United States)

    Aaberg, Thomas M

    2010-08-01

    Although attempts were made ot reattach retinas using proliferative vitreoretinopathy by various techniques before the 1970s, it was the development and subsequent refinement of closed-eye, mechanized pars plana vitrectomy that initiated the rapid rise in the surgical success rate. This article presents a personal history of the milestone accomplishments that facilitated the strong possibility of success that patients with proliferative vitreoretinopathy can now anticipate. Currently, various gasses, chemical compounds, and pharmaceutical agents serve adjunctively to advance surgical techniques with the expectation that they may be the primary curative procedure in the future. As in the past, what is unconventional today may be common tomorrow.

  13. Social Learning Analytics in Higher Education. An Experience at the Primary Education Stage

    Science.gov (United States)

    Díaz-Lázaro, José Javier; Fernández, Isabel M. Solano; del Mar Sánchez Vera, María

    2017-01-01

    The concept of Learning Analytics, as we understand it today, is relatively new but the practice of evaluating user behavior is not innovative. For years, technological development, along with other educational aspects, have encouraged, developed and facilitated this practice as a way of providing a personalized quality experience to students. The…

  14. Primary Preservice Teachers' Understandings of Volume: The Impact of Course and Practicum Experiences

    Science.gov (United States)

    Zevenbergen, Robyn

    2005-01-01

    Mathematics teacher education programs are designed with an intention, explicit or implicit, to produce graduates who are competent in both pedagogic knowledge and discipline knowledge. This paper explores students' experiences in coming to learn mathematics and mathematics education. Using an example from a quiz question, supplemented with…

  15. Inclusive Education for Students with Refugee Experience: Whole School Reform in a South Australian Primary School

    Science.gov (United States)

    Pugh, Karen; Every, Danielle; Hattam, Robert

    2012-01-01

    In recent years, there has been an increase in students with refugee experience in the UK, the US, Europe and Australia. These students face many barriers to education, and appropriately educating this diverse student population presents many challenges to schools and education departments. We argue that a whole of school approach that includes…

  16. A Qualitative Exploration of Primary School Students' Experience and Utilisation of Mindfulness

    Science.gov (United States)

    Bannirchelvam, Bavani; Bell, Karen L.; Costello, Shane

    2017-01-01

    Despite the increasing utilisation of mindfulness-based interventions in children, research investigating the impact of these interventions in children is still in its infancy. One significant gap in the literature is the general omission of the child's voice in how they experience and benefit from mindfulness-based intervention. Therefore, the…

  17. Children's Construction and Experience of Racism and Nationalism in Greek-Cypriot Primary Schools

    Science.gov (United States)

    Zembylas, Michalinos

    2010-01-01

    This article presents findings that highlight children's construction and experience of racism and nationalism among a sample of Greek-Cypriot (the majority) and Turkish-speaking (the minority) children in Greek-Cypriot schools through the lens of intersectionality theory. The article first reviews previous work in relation to children, racism and…

  18. Coping Strategies and Experiences in Women with a Primary Breast Cancer Diagnosis

    Science.gov (United States)

    Hajian, Sepideh; Mehrabi, Esmat; Simbar, Masoomeh; Houshyari, Mohammad

    2017-01-01

    Background: Women with breast cancer experience problems in multiple aspects of their lives, but applying effective strategies can result in enhancing their quality of life and their psychosocial adaptation to the disease. However, there is little information about the strategies that women use to cope with complications associated with their experiences following a breast cancer diagnosis. Objectives: The aim of this study was to explore the experience of coping behavior and the main strategies that women use in dealing with a breast cancer diagnosis. Methods: This study was conducted according to a qualitative phenomenological design to investigate women’s experiences in living with breast cancer and the related complications and how they cope with these issues. Purposive sampling was used for recruiting participants with breast cancer, and data collection was conducted by semi-structured, in-depth interviews with 22 patients. The transcribed interviews were analyzed using Van Manen’s thematic approach. Results: The age range of the women was 32-68. Most were married and received adjuvant therapy (i.e., mastectomy surgery and chemo-radiation). Three dominant themes that emerged from the interviews were emotional turmoil, avoidance, and logical efforts. Conclusion: The findings highlight the importance of addressing psycho-oncology intervention programs to address the unmet pyscho-social and palliative care needs of patients suffering from breast cancer. Creative Commons Attribution License

  19. Analysis of sentinel node positivity in primary cutaneous melanoma: an 8-year single institution experience.

    Science.gov (United States)

    Joyce, K M; McInerney, N M; Piggott, R P; Martin, F; Jones, D M; Hussey, A J; Kerin, M J; Kelly, J L; Regan, P J

    2017-11-01

    Sentinel lymph node biopsy (SLNB) is a standard method for determining the pathologic status of the regional lymph nodes. The aim of our study was to determine the incidence and clinicopathologic factors predictive of SLN positivity, and to evaluate the prognostic importance of SLNB in patients with cutaneous melanoma. We performed a retrospective analysis of a prospectively maintained database of all patients who underwent SLNB for primary melanoma at our institution from 2005 to 2012. Statistical analysis was performed using χ 2 and Fischer exact test. In total, 318 patients underwent SLNB, of which 65 were for thin melanoma (≤1 mm). There were 36 positive SLNB, 278 negative SLNB and in four cases the SLN was not located. The incidence rate for SLNB was 11.3% overall and 1.5% in thin melanomas alone. Statistical analysis identified Breslow thickness >1 mm (P = 0.006), Clark level ≥ IV (P = 0.004) and age <75 years (P = 0.035) as the strongest predictors of SLN positivity. Our overall false negativity rate was 20% (9/45) with one case of false-negative SLNB in thin melanomas. Breslow thickness of the primary tumour remains the strongest predictor of SLN positivity. Our findings point to a possible limited role for SLNB in thin melanoma due to its low positivity rate, associated false-negative rate and related morbidity.

  20. Primary explosives

    Energy Technology Data Exchange (ETDEWEB)

    Matyas, Robert; Pachman, Jiri [Pardubice Univ. (Czech Republic). Faculty of Chemical Technology

    2013-06-01

    The first chapter provides background such as the basics of initiation and differences between requirements on primary explosives used in detonators and igniters. The authors then clarify the influence of physical characteristics on explosive properties, focusing on those properties required for primary explosives. Furthermore, the issue of sensitivity is discussed. All the chapters on particular groups of primary explosives are structured in the same way, including introduction, physical and chemical properties, explosive properties, preparation and documented use.

  1. Effects of water fluoridation on caries experience in the primary dentition in a high caries risk community in Queensland, Australia.

    Science.gov (United States)

    Koh, Rongzhen; Pukallus, Margaret L; Newman, Bruce; Foley, Michael; Walsh, Laurence J; Seow, W Kim

    2015-01-01

    In December 2008, artificial water fluoridation was introduced for the first time to the Logan-Beaudesert district in the state of Queensland, Australia. The aim of this study was to evaluate the effects of water fluoridation in the primary dentition in this community after a period of 36 months. Children aged 4-9 years with clinical examinations and bitewing radiographs (BWs) taken before water fluoridation (pre-F) were randomly selected as comparison controls for age matched children who had been exposed to a mean period of 36 months of water fluoridation (post-F). A total of 201 sets of pre-F BWs from children (mean age 6.95 ± 1.05 years) and 256 sets of post-F BWs from children (mean age 7.19 ± 1.23 years) attending schools in the district were randomly selected. Caries experience in the primary dentition was determined as decayed, missing or filled teeth/surfaces (dmft/dmfs). The caries prevalence for the pre-F group was 87% compared to 75% in the post-F group (Odds ratio (OR): 0.44, 95% CI: 0.27-0.72). Overall, there was a 19 percent reduction of mean dmft from 4.54 in the pre-F group to 3.66 in the post-F group (p = 0.005). After fluoridation, the dmfs was reduced from 6.68 to 5.17 (p = 0.0056). The distal surfaces of maxillary first primary molars experienced the greatest reduction (26%) in caries experience after water fluoridation (p water fluoridation there was a significant drop in caries prevalence from 87 to 75% and a 19% reduction in caries experience in a community with one of the highest caries rates in Australia.

  2. Document delivery services contrasting views

    CERN Document Server

    1999-01-01

    Design and maintain document delivery services that are ideal for academic patrons! In Document Delivery Services: Contrasting Views, you'll visit four university library systems to discover the considerations and challenges each library faced in bringing document delivery to its clientele. This book examines the questions about document delivery that are most pressing in the profession of library science. Despite their own unique experiences, you'll find common practices among all four?including planning, implementation of service, and evaluation of either user satisfaction and/or vendor per

  3. Suburban Families' Experience With Food Insecurity Screening in Primary Care Practices.

    Science.gov (United States)

    Palakshappa, Deepak; Doupnik, Stephanie; Vasan, Aditi; Khan, Saba; Seifu, Leah; Feudtner, Chris; Fiks, Alexander G

    2017-07-01

    Food insecurity (FI) remains a major public health problem. With the rise in suburban poverty, a greater understanding of parents' experiences of FI in suburban settings is needed to effectively screen and address FI in suburban practices. We conducted 23 semistructured interviews with parents of children comfort discussing their unmet food needs; parents experience shame, frustration, and helplessness regarding FI, but discussing FI with their clinician helped alleviate these feelings; parents suggested practices could help them more directly access food resources, which, depending on income, may not be available to them through government programs. Although most parents were comfortable discussing FI, they felt it was important for clinicians to acknowledge their frustrations with FI and facilitate access to a range of food resources. Copyright © 2017 by the American Academy of Pediatrics.

  4. The role of surgical management in primary small bowel lymphoma: A single-center experience.

    Science.gov (United States)

    Hong, Y-W; Kuo, I-M; Liu, Y-Y; Yeh, T-S

    2017-10-01

    Information on primary small intestinal lymphoma is more limited than for gastric lymphoma because most of the previous studies did not focus on the former. Few prognostic indicators in primary intestinal lymphoma have been reliably established because of limited patient numbers and variations in criteria for patient selection. In this study, we retrospectively reviewed the clinical and pathological characteristics of small intestinal lymphoma cases from our hospital, to determine prognostic factors and to clarify the effect of surgical resection on prognosis. Eighty-two patients were enrolled in this retrospective study between January 1997 and December 2012. Patients were divided into two groups based on whether or not they underwent surgical management. Gross resection was defined as complete removal of the primary lesion(s), as confirmed by the naked eye. Combined therapy refers to concurrent surgery and chemotherapy. The clinicopathological characteristics and long-term outcomes of patients were analyzed and compared between the two groups. Most of the patients had abdominal pain (75.6%), and some had loss of body weight (29.3%) and bowel perforation (22.0%). Sixty-two patients (75.6%) underwent surgical management. Patients in the surgery group presented with fewer B symptoms (fever, night sweats, and weight loss; P = 0.035) but more bulky disease (P = 0.009). The ileocecal region was the most common site of solitary involvement (34.1%). The most common reason for surgery was for tumor-related complications (61.3%). Seven patients (11.3%) developed major complications of surgery, but these were not related to the indication, timing, or type of surgery. Only major surgical complications were statistically significant in relation to early mortality (P = 0.004). The estimated 5-year progression-free survival (PFS) was 35.1% and 5-year overall survival (OS) was 43.2%. Univariate analysis revealed that patients in the surgery group had improved 5-year PFS

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

    Science.gov (United States)

    Lakshmi, J K

    2012-01-01

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

  6. Women's experiences of referral to a domestic violence advocate in UK primary care settings: a service-user collaborative study.

    Science.gov (United States)

    Malpass, Alice; Sales, Kim; Johnson, Medina; Howell, Annie; Agnew-Davies, Roxane; Feder, Gene

    2014-03-01

    Women experiencing domestic violence and abuse (DVA) are more likely to be in touch with health services than any other agency, yet doctors and nurses rarely ask about abuse, often failing to identify signs of DVA in their patients. To understand women's experience of disclosure of DVA in primary care settings and subsequent referral to a DVA advocate in the context of a DVA training and support programme for primary care clinicians: Identification and Referral to Improve Safety (IRIS). A service-user collaborative study using a qualitative study design. Recruitment was from across IRIS trial settings in Bristol and Hackney, London. Twelve women who had been referred to one of two specialist DVA advocates (based at specialist DVA agencies) were recruited by a GP taking part in IRIS. Women were interviewed by a survivor of DVA and interviews were recorded and transcribed verbatim. Analysis was thematic using constant comparison. GPs and nurses can play an important role in identifying women experiencing DVA and referring them to DVA specialist agencies. GPs may also have an important role to play in helping women maintain any changes they make as a result of referral to an advocate, by asking about DVA in subsequent consultations. A short time interval between a primary care referral and initial contact with an advocate was valued by some women. For the initial contact with an advocate to happen as soon as possible after a primary care referral has been made, a close working relationship between primary care and the third sector needs to be cultivated.

  7. Clinicopathological Features and Outcomes in Primary Central Nervous System Lymphoma: A 10-year Experience.

    Science.gov (United States)

    Puligundla, Chaitanya Krishna; Bala, Stalin; Karnam, Ashok Kumar; Gundeti, Sadashivudu; Paul, Tara Roshni; Uppin, Megha S; Maddali, Lakshmi Srinivas

    2017-01-01

    Primary central nervous system lymphoma (PCNSL) is a variant of extranodal lymphoma, accounting for 4% of primary central nervous system tumors. PCNSL was more common in immunocompetent individuals. International Extranodal Lymphoma Study Group (IELSG) scoring was used for prognostication. High-dose methotrexate regimens along with radiotherapy improved outcomes in PCNSL. The aim of this study is to analyze the clinical and pathological features, progression-free survival (PFS), and overall survival (OS) in patients with PCNSL. Data of patients with PCNSL between 2005 and 2016 were retrospectively analyzed. Outcome was analyzed in patients who received chemotherapy. GraphPad Prism software for Windows Version 6 was used to plot the Kaplan-Meier curves for PFS and OS. Log-rank test was used to calculate P values. P < 0.05 was considered as statistically significant. A total of 42 patients were available for analysis. Of these, 34 patients who received chemotherapy were evaluable for outcome parameters. The median age at presentation was 46 years (range, 10-75) with male-to-female ratio of 2.2:1. Only 2 (4.7%) patients were HIV positive. Diffuse large B-cell lymphoma (DLBCL) was the most common histology seen in 41 (97.6%) patients. Using IELSG risk scoring, scores of 8 (19%), 19 (45.2%), and 15 (35.8%) were stratified into low, intermediate, and high risk. The median PFS and OS were 11 months (range, 2-72) and 15.9 months (2.4-80.4), respectively. The median OS was 36.2 months (range, 8.8-72), 15.6 months (2-36), and 6.1 months (2.6-12.7) in low-, intermediate-, and high-risk groups, respectively, which was statistically significant (P = 0.0002). Immunocompetent patients with PCNSL outnumber immunocompromised patients. DLBCL was the most common histology, and IELSG risk stratification significantly predicts the outcome in PCNSL.

  8. Establishment of research in primary health care in Greece. Experiences of Greek-Swedish collaboration.

    Science.gov (United States)

    Fioretos, M; Scherstén, B

    1991-12-01

    The last few decades have seen great changes in health care and medical care in Greece, as well as in the Greek university system. A new law on health care and medical care has come into force, a new university hospital and new health centres have been built, and a faculty of medicine has been established at Heraklion in Crete. People are speaking of a change of paradigm. Simultaneous with the introduction of the new national health care system, the Department of Family and Social Medicine (DFSM) in Crete started a major project on public health, known as the Primary Health Care and Nutrition Programs (abbreviated as PPD). The purpose was to chart the state of health and living conditions of the Cretan population in the period 1986-1990. Cooperation in research and training began between DFSM and the Dalby Health Sciences Centre, Lund University in 1987. This was natural since there was a shared interest in research into family medicine and social medicine. In addition, a new Health Care Act had come into force in Sweden in 1982. The establishment phase of primary health care started in Sweden at the end of the 1960s. In the 1970s health centres were established, along with research and training in family medicine, in a way that is comparable in many respects to the situation in which Crete found itself a decade later. This paper concerns the organization and implementation of PPD and the research cooperation between Greek and Swedish institutions. This can be seen as an expression of the internationalization of research for which the two universities have striven.

  9. Primary healthcare-based integrated care with opioid agonist treatment: First experience from Ukraine.

    Science.gov (United States)

    Morozova, Olga; Dvoriak, Sergey; Pykalo, Iryna; Altice, Frederick L

    2017-04-01

    Ukraine's HIV epidemic is concentrated among people who inject drugs (PWID), however, coverage with opioid agonist therapies (OATs) available mostly at specialty addiction clinics is extremely low. OAT integrated into primary healthcare clinics (PHCs) provides an opportunity for integrating comprehensive healthcare services and scaling up OAT. A pilot study of PHC-based integrated care for drug users conducted in two Ukrainian cities between 2014 and 2016 included three sub-studies: 1) cross-sectional treatment site preference assessment among current OAT patients (N=755); 2) observational cohort of 107 PWID who continued the standard of care versus transition of stabilized and newly enrolled PWID into PHC-based integrated care; and 3) pre/post analysis of attitudes toward PWID and HIV patients by PHC staff (N=26). Among 755 OAT patients, 53.5% preferred receiving OAT at PHCs, which was independently correlated with convenience, trust in physician, and treatment with methadone (vs. buprenorphine). In 107 PWID observed over 6 months, retention in treatment was high: 89% in PWID continuing OAT in specialty addiction treatment settings (standard of care) vs 94% in PWID transitioning to PHCs; and 80% among PWID newly initiating OAT in PHCs. Overall, satisfaction with treatment, subjective self-perception of well-being, and trust in physician significantly increased in patients prescribed OAT in PHCs. Among PHC staff, attitudes towards PWID and HIV patients significantly improved over time. OAT can be successfully integrated into primary care in low and middle-income countries and improves outcomes in both patients and clinicians while potentially scaling-up OAT for PWID. Copyright © 2017 Elsevier B.V. All rights reserved.

  10. Using diaries to explore the work experiences of primary health care nursing managers in two South African provinces

    OpenAIRE

    Munyewende, Pascalia O.; Rispel, Laetitia C.

    2014-01-01

    Background: South Africa is on the brink of another wave of major health system reforms that underscore the centrality of primary health care (PHC). Nursing managers will play a critical role in these reforms. Objective: The aim of the study was to explore the work experiences of PHC clinic nursing managers through the use of reflective diaries, a method hitherto under-utilised in health systems research in low- and middle-income countries. Design: During 2012, a sub-set of 22 PHC nursing man...

  11. How do longitudinal clerkships in general practice/primary care impact on student experience and career intention? A cross-sectional study of student experience.

    Science.gov (United States)

    O'Donoghue, Sinead; McGrath, Deidre; Cullen, Walter

    2015-05-01

    Internationally, the amount of time that medical students spend in community settings has increased in recent years. 'Longitudinal clerkships', which involve a prolonged exposure, are now common. In Ireland, medical education policy has promoted community-based education across medical schools, including one with a longitudinal clerkship of one semester duration. To examine medical students' experience of a longitudinal clerkship in general practice/primary care, its impact on career preference and the factors which students find most important in supporting their learning. Quantitative cross-sectional study of students who had recently completed a longitudinal clerkship at the Graduate-Entry Medical School at University of Limerick involving an online survey. Most students agreed the intended learning outcomes of the clerkship had been achieved. Activity such as two-way feedback with GP tutors, assisting with procedural skills and parallel consulting were rated as of greatest educational value. Students identified internet access, a safe/unthreatening learning environment, and feeling part of the clinical team as the practice attributes most important in supporting their learning. Twenty-six (41%) intended to pursue a career in general practice/primary care and 46 (72%) indicated they were more likely to pursue a career in general practice/primary care after the clerkship. The clerkship was a positive influence on career intentions, with 63% of those who indicated that general practice/primary care was not their current preferred career option reporting they were significantly more likely to pursue this option after the clerkship (χ(2) = 3.52, P < 0.05). Our findings indicate that longitudinal clerkships are effective in helping students to achieve their intended learning outcomes and identify the student activity and practice attributes that are most important in promoting their learning.

  12. [Photography as analysis document, body and medicine: theory, method and criticism--the experience of Museo Nacional de Medicina Enrique Laval].

    Science.gov (United States)

    Robinson, César Leyton; Caballero, Andrés Díaz

    2007-01-01

    This article is an experimental methodological reflection on the use of medical images as useful documents for constructing the history of medicine. A method is used that is based on guidelines or analysis topics that include different ways of viewing documents, from aesthetic, technical, social and political theories to historical and medical thinking. Some exercises are also included that enhance the proposal for the reader: rediscovering the worlds in society that harbor these medical photographical archives to obtain a new theoretical approach to the construction of the history of medical science.

  13. Experiences with online consultation systems in primary care: case study of one early adopter site.

    Science.gov (United States)

    Casey, Michael; Shaw, Sara; Swinglehurst, Deborah

    2017-11-01

    There is a strong policy drive towards implementing alternatives to face-to-face consultations in general practice to improve access, efficiency, and cost-effectiveness. These alternatives embrace novel technologies that are assumed to offer potential to improve care. To explore the introduction of one online consultation system (Tele-Doc) and how it shapes working practices. Mixed methods case study in an inner-city general practice. The study was conducted through interviews with IT developers, clinicians, and administrative staff, and scrutiny of documents, websites, and demonstrator versions of Tele-Doc, followed by thematic analysis and discourse analysis. Three interrelated themes were identified: online consultation systems as innovation, managing the 'messiness' of general practice consultations, and redistribution of the work of general practice. These themes raise timely questions about what it means to consult in contemporary general practice. Uptake of Tele-Doc by patients was low. Much of the work of the consultation was redistributed to patients and administrators, sometimes causing misunderstandings. The 'messiness' of consultations was hard to eliminate. In-house training focused on the technical application rather than associated transformations to practice work that were not anticipated. GPs welcomed varied modes of consulting, but the aspiration of improved efficiency was not realised in practice. Tele-Doc offers a new kind of consultation that is still being worked out in practice. It may offer convenience for patients with discrete, single problems, and a welcome variation to GPs' workload. Tele-Doc's potential for addressing more complex problems and achieving efficiency is less clear, and its adoption may involve unforeseeable consequences. © British Journal of General Practice 2017.

  14. The return of the Pholela experiment: medical history and primary health care in post-Apartheid South Africa.

    Science.gov (United States)

    Phillips, Howard

    2014-10-01

    I examine why South Africa's pioneering Pholela model of primary health care, dating from the 1940s, held such appeal for the country's new policymakers after 1994, and why those policymakers have failed to make it the basis of an effective public health care system since then. In the 1940s, the innovative Pholela experiment had served as such a model, to be replicated gradually throughout the country until a new health care system in its image was finally in place. However, this vision was dashed by the hostility of the mainstream medical profession and, after 1948, even more so by the new apartheid government, causing the idea to wither and become no more than a vanishing memory. In the 1990s, the model resurfaced as part of the country's transition to democracy, eliciting great enthusiasm among a new generation of health policymakers. I conclude by looking at the fate to date of this second coming of the Pholela experiment.

  15. [Epidemiological and clinical characteristics of primary ocular cancers in blacks: our experience with 111 cases].

    Science.gov (United States)

    Seck, S M; Agboton, G; Gueye, N N; Diop, J; Seck, C M; Lam, A

    2015-01-01

    In this work, the authors aim to study clinical and epidemiological characteristics of ocular and orbital primary cancers in sub-Saharan African. This is a retrospective study over a period of 21 years, from 1984 to 2004, including all cases of ocular cancer, histologically proven after surgery of the globe or the orbit. For each patient, we studied the following parameters: age, sex, reason(s) for consultation, the affected eye, and histological result of the operative specimen. These data were collected by studying the departmental surgical registry, patient medical records and the tumor registry of the anatomicopathology laboratory of a tertiary care hospital in sub-Saharan Africa. We collected data on 111 black patients, among whom 15 cases (13.5%) presented with bilateral involvement, for a total of 126 eyes. The sex ratio was 1.17. Presenting signs showed a predominance of leukocoria (30.2%) followed by proptosis (21.7%) and in third place, protruding conjunctival mass (10.8%). Retinoblastoma was found most frequently, representing 66.6% of the oculo-orbital tumors and 95.45% of the tumors of the globe; followed by epidermoid carcinoma, representing 15.08% of cases. Malignant melanoma was third most common, representing 4.76%, with 83% arising in the anterior uvea and 7% in the choroid. Basal cell carcinoma and rhabdomyosarcoma follow in fourth place. Basal cell carcinoma constituted half (50%) of the eyelid tumors. Rhabdomyosarcoma was the most common orbital tumor in our series (57%). Next were lymphomas with conjunctival localization (2.38%), acute leukemia with orbital localization (1.59%) and rare tumors, palpebral dermatofibrosarcoma (0.79%), an orbital angiosarcoma (0.79%), a glioblastoma of the globe (0.79%) and a malignant solitary fibrous tumor of the orbit (0.79%). Ocular and orbital primary cancers in blacks remain tumors of the young, equally distributed between the sexes. Retinoblastoma is the most frequent, followed by epidermoid carcinoma. The

  16. Quantitative and qualitative changes in primary and secondary stem organization of Aristolochia macrophylla during ontogeny: functional growth analysis and experiments.

    Science.gov (United States)

    Masselter, Tom; Speck, Thomas

    2008-01-01

    The anatomy of young and old stems of Aristolochia macrophylla has been investigated for a better understanding of how secondary growth processes cause changes in the stem anatomy of a lianescent plant. In A. macrophylla, following an increase in volume of secondary vascular tissues, the cortical tissues are deformed and the outer sclerenchymatous cylinder ruptures. Morphometric measurements prove that the inner zone of the cortical parenchymatous tissue is compressed prior to the rupture of the outer sclerenchymatous cylinder. After the rupture has occurred, the radial width of the inner primary cortex slightly increases again. This could be caused by strain relaxation, suggesting that the inner primary cortex mechanically behaves similarly to cellular technical foam rubbers. Two different experiments were undertaken to test the outer cortical cylinders mechanically. The outer cortical cylinders comprise the outer sclerenchymatous cortical tissue and a collenchymatous sheath underneath the epidermis and the epidermis. In a first experiment, transverse compression loads were applied to the outside of the cortical cylinders causing ovalization of the cylinder until failure. This experiment allowed the Young's Modulus of the outer cortical cylinders to be determined. In a second set of experiments, radial hydraulic pressure was applied to the inside of the cortical cylinders, mimicking the mechanical effects of internal growth processes. The increase of the internal pressure finally led to rupture of the cortical cylinders. The circumferential stresses acting on the inner surface of the cortical cylinders were calculated. These data allow quantitative estimates of the radial and circumferential pressures effected by vascular secondary growth processes during ontogeny in A. macrophylla stems. The experimental results further indicate that the outer sclerenchymatous cylinder is the main contributor to mechanical stability of young A. macrophylla stems.

  17. Relationship preferences and experience of primary care patients in continuity of care: a case study in Beijing, China.

    Science.gov (United States)

    Liu, Chaojie; Wu, Yeqing; Chi, Xueyang

    2017-08-22

    Continuity of care can bring a wide range of benefits to consumers, providers and health care systems. This study aimed to understand the relationship preferences of primary care patients and their associations with patient experience of continuity of care. A questionnaire survey was conducted on 700 patients who sought medical care from a community health organisation in Beijing. The survey contained four items examining the relationship preferences of the respondents, and a modified Questionnaire of Continuity between Care Levels (CCAENA) measuring patient experience of continuity of care based on a three dimensional (relational, informational and managerial) model. The associations between the relationship preferences and the experience of respondents in continuity of care was tested using a linear regression model controlling for age, sex, education, medical insurance, personal income and servicing facilities. The respondents experienced relatively lower levels of informational and managerial continuity compared with relational continuity of care. More than 80% of respondents preferred free choice and a continuing relationship with doctors, compared with 59% who endorsed community facility control over hospital appointments. A preference for a continuing relationship with doctors was associated with all aspects of continuity of care. A preference in favour of community facility control over hospital appointments was a strong predictor of managerial continuity (β = 0.333, p Patient preference for free choice of doctors was positively associated with relational continuity with specialists (p care providers (p > 0.08). Perceived importance of information exchange was associated with relational and managerial continuity (p Patients prefer a high level of freedom of choice and sustained individual relationship with doctors. Relationship preferences of patients are associated with their experience of continuity of care. But patient strong preference for

  18. [Primary mediastinal germs cells tumors: a twenty years experience in a comprehensive cancer center].

    Science.gov (United States)

    Joly, Charlotte; Deblock, Mathilde; Desandes, Emmanuel; Geoffrois, Lionnel

    2014-12-01

    The aim of this study is to report treatments results of patients with primary germ cell tumors (GCTs) of mediastinum. A retrospective review was done of 19 consecutive patients with mediastinal GCTs treated in "Institut de cancérologie de Lorraine" between 1990 and 2012. A total of 19 patients were enrolled in this study. Three patients had pure seminoma and 16 patients had non-seminomatous germ cell tumors. All patients were treated with cisplatinum based chemotherapy at a dose of 33.48 mg/m(2)/week. At the end of chemotherapy, three patients (15.8%) had complete response and negative marker, seven of them (36.8%) had partial response and negative marker, five of them (26.32%) had partial response and positive marker, three of them (15.8%) had progressive disease (refractory disease) and one patient died because of the disease during treatment. The 1-year and 5-year overall survival rates were respectively 78 and 36% and the progression-free survival rate was 43%. When relapse occurred, this happened within a 13 month period. Our study confirmed the good management of mediastinal GCTs in our institute with similar results compared to literature.

  19. Training Primary Health Professionals in Breast Cancer Prevention: Evidence and Experience from Mexico.

    Science.gov (United States)

    Magaña-Valladares, Laura; González-Robledo, María Cecilia; Rosas-Magallanes, Cynthia; Mejía-Arias, Miguel Ángel; Arreola-Ornelas, Héctor; Knaul, Felicia M

    2018-02-01

    To analyze the key successful factors of a national educational strategy for early breast cancer detection developed in Mexico for primary health care personnel from 2008 to 2014, an educational strategy to train physicians, nurses, health promoters, and medical students from local ministries of health with a competency-based approach was developed and implemented using diverse educational modalities, face-to-face, blended, and a massive open online course (MOOC). Formative and summative evaluations were used during the implementation of the course. A total of 19,563 health professionals were trained from 2008 to 2014. The graduation rate, an average of all educational modalities, was 91 %, much higher than those previously reported in the literature. The factors that might have influenced this success were (1) the training strategy, which was designed according to the characteristics and specific needs of the target groups; (2) the political will and commitment of the country's health authorities; (3) the technological and educational models used; and (4) the punctual follow-up of participants. This study shows that carefully designed educational interventions can improve service professionals' competencies and that regardless of the modality, face-to-face, blended learning, or MOOC, high graduation rates can be achieved. Further evaluation is required to demonstrate that the competencies remained in all target groups after 6 months of the intervention and that the women served by the trained personnel were provided accurate information and timely diagnoses of breast cancer.

  20. Non-Hodgkin Lymphoma in Children with Primary Immunodeficiencies: Clinical Manifestations, Diagnosis, and Management, Belarusian Experience

    Directory of Open Access Journals (Sweden)

    Alina Fedorova

    2015-01-01

    Full Text Available Introduction. Non-Hodgkin lymphoma (NHL is the most frequent malignancy associated with primary immune deficiency disease (PID. We aimed to present the clinical characteristics and outcomes of Belarusian children with PID who developed NHL. Procedure. We reviewed 16 patients with PID and NHL. Eight patients had combined PID: 5—Nijmegen breakage syndrome, 1—Bloom syndrome, 1—Wiskott-Aldrich syndrome, and 1—Х-linked lymphoproliferative syndrome. Results. In 75% cases PID was diagnosed simultaneously or after the NHL was confirmed. PID-associated NHL accounted for 5.7% of all NHL and was characterized by younger median age (6.3 versus 10.0 years, P<0.05 and by prevalence of large-cell types (68.8% versus 24.5%, P<0.001. Children with combined PID had median age of 1.3 years; 5 of them developed EBV-associated diffuse large B-cell lymphoma with lung involvement. Five of 6 patients with chromosomal breakage syndrome developed T-NHL. Six patients died of infections; two died after tumor progression; one child had early relapse; two died of second NHL and one of secondary hemophagocytic syndrome. Overall, 4 children are alive and disease-free after a follow-up from 1.4 to 5.7 years. Conclusions. PID needs to be diagnosed early. Individualized chemotherapy, comprehensive supportive treatment, and hematopoietic stem cell transplantation may improve survival of children with PID and NHL.

  1. Rapid intraoperative determination of intact parathyroid hormone during surgery for primary hyperparathyroidism. Experience at our center.

    Science.gov (United States)

    García-Santos, Esther Pilar; Martín-Fernández, Jesús; Gil-Rendo, Aurora; Menchén-Trujillo, Bruno; Martínez de Paz, Fernando; Manzanares-Campillo, M Carmen; Muñoz-Atienza, Virginia; Sánchez-García, Susana

    2014-01-01

    Primary hyperparathyroidism (PHPT) is due to a single adenoma in 85%-95% of cases, and is often cured after adenoma removal. Intraoperative rapid determination of intact parathyroid hormone (PTHio) may be a tool for monitoring the effectiveness of PHPT surgery. The main objective of our study was to evaluate PTHio determination and to establish whether its successful implementation contributed to achieve minimally invasive surgery (MIS) and major ambulatory surgery (MAS) in the treatment of PHPT. Retrospective study of a consecutive series of patients diagnosed and operated on for PHPT at the University General Hospital of Ciudad Real between January 2005 and January 2012. In the study period, 91 patients underwent surgery. 39 (42.9%) under general anesthesia, while 52 (57.1%) were candidates for regional anesthesia by cervical block. Seventy-six of all patients (83.5%) were amenable to MIS using a unilateral approach. Classical cervicotomy was performed in all other patients. PTHio determination was done in 75 patients, showing cure in the same surgery in 68 of them. MAS was performed in 70.3% (64) of patients. Determination of PTHio may allow for changing the surgical approach to PHPT at our department, allowing for performance of MIS on an outpatient basis in a significant proportion of patients with some cosmetic improvement, probably less pain, shorter hospital stay, and less potential complications than bilateral cervical exploration. Copyright © 2013 SEEN. Published by Elsevier Espana. All rights reserved.

  2. Primary biliary cirrhosis in antimitochondrial antibody-negative patients: Chang Gung Memorial Hospital experience.

    Science.gov (United States)

    Tsou, Yung-Kuan; Yeh, Chau-Ting

    2003-05-01

    It is known that some patients with clinical, histological, and laboratory features of primary biliary cirrhosis (PBC) lack serum antimitochondrial antibodies (AMAs). In Asian countries, clinical information regarding AMA-negative PBC is still limited. In this report, we reviewed our patients with AMA-negative PBC in order to further understand this disease. Clinical features of 36 patients with PBC diagnosed by the histopathologic characteristics of the liver at Chung Gung Memorial Hospital-Lin Kou Medical Center from 1985 to 2000 were reviewed. Of them, 15 were negative and 21 were positive for serum AMAs at presentation. Clinical, biochemical, immunological, and histological parameters were compared between these 2 groups. There were only a few differences between the AMA-negative and -positive groups. Significantly more asymptomatic patients (p=0.0017) and a higher positive rate of serum antinuclear antibodies (ANA) (p=0.0323) were observed in the AMA-negative group. Otherwise, there were no significant differences with regard to clinical, biochemical, immunological, or histological parameters. Interestingly, 4 of the 15 patients with AMA-negative PBC became AMA positive during 10, 23, 47, and 56 (mean, 34) months of follow-up. The results show that patients with AMA-negative PBC tend to be asymptomatic and ANA positive. Some patients may develop positive AMA during follow-up. Our data imply that AMA-negative PBC might be a variant of AMA-positive PBC, rather than a separate disease.

  3. [Community vegetable gardens as a health promotion activity: an experience in Primary Healthcare Units].

    Science.gov (United States)

    Costa, Christiane Gasparini Araújo; Garcia, Mariana Tarricone; Ribeiro, Silvana Maria; Salandini, Marcia Fernanda de Sousa; Bógus, Cláudia Maria

    2015-10-01

    Urban and peri-urban agriculture (UPA) is being practiced in different settings, contributing to the improvement of health in communities and healthier environments. In order to identify the meanings and implications of the practice of UPA in Primary Healthcare Units (PHU) as an activity of health promotion (HP), and to what extent its therapeutic dimension characterizes it as an activity aligned with complementary and integrative practices (CIP), a qualitative cross-sectional study was performed in Embu das Artes, State of São Paulo. From the analysis, the following main themes arose: health concept, health outcomes, the return to traditional practices and habits and the reorientation of health services. It was possible to identify the close link between the cultivation of vegetable gardens and HP guidelines and fields of action, such as creating healthier environments, boosting community actions, developing personal skills, stimulating autonomy and empowerment and demands for the reorientation of services. The garden activities, set up in PHU areas, proved to be an implementation strategy of CIP. The conclusion reached is that vegetable gardening activities in community gardens are seen to be health promotion practices that integrate key elements of CIP.

  4. Optimizing psychosocial support during office-based buprenorphine treatment in primary care: Patients' experiences and preferences.

    Science.gov (United States)

    Fox, Aaron D; Masyukova, Mariya; Cunningham, Chinazo O

    2016-01-01

    Buprenorphine maintenance treatment is effective and has been successfully integrated into human immunodeficiency virus (HIV) and primary care settings. However, one key barrier to providers prescribing buprenorphine is their perception that they are unable to provide adequate counseling or psychosocial support to patients with opioid addiction. This qualitative study investigated supportive elements of office-based buprenorphine treatment that patients perceived to be most valuable. The authors conducted five focus groups with 33 buprenorphine treatment-experienced participants. Focus groups were audio-recorded and transcribed. Iterative readings of transcripts and grounded theory analysis revealed common themes. Overall, participants perceived that buprenorphine treatment helped them to achieve their treatment goals and valued the flexibility, accessibility, and privacy of treatment. Participants identified interpersonal and structural elements of buprenorphine treatment that provided psychosocial support. Participants desired good physician-patient relationships, but also valued care delivery models that were patient-centered, created a safe place for self-disclosure, and utilized coordinated team-based care. Participants derived psychosocial support from their prescribing physician, but were also open to collaborative or team-based models of care, as long as they were voluntary and confidential. Buprenorphine-prescribing physicians without access to referral options for psychosocial counseling could focus on maintaining nonjudgmental attitudes and shared decision-making during patient encounters. Adding structure and psychosocial support to buprenorphine treatment through coordinated team-based care also seems to have great promise.

  5. Outcome of primary cutaneous anaplastic large cell lymphoma: a 20-year British Columbia Cancer Agency experience.

    Science.gov (United States)

    Hapgood, Greg; Pickles, Tom; Sehn, Laurie H; Villa, Diego; Klasa, Richard; Scott, David W; Gerrie, Alina S; Gascoyne, Randy D; Slack, Graham W; Parsons, Christina; Morris, James W; Connors, Joseph M; Savage, Kerry J

    2017-01-01

    Primary cutaneous anaplastic large cell lymphoma (PCALCL) is a rare CD30+ lymphoproliferative disorder with excellent outcomes reported despite frequent cutaneous relapses. Limited information exists on the development of systemic lymphoma. The British Columbia Cancer Agency (BCCA) Lymphoid Cancer Database was searched to identify all adults diagnosed with PCALCL from 1993 to 2013. From 2005, the BCCA endorsed radiotherapy (RT) alone for limited stage with data failing to support chemotherapy. Forty-seven patients were identified with a male predominance (n = 31, 66%), median age of 64 years and predominantly limited stage (n = 40, 85%). Median follow-up was 8·4 years. The 5-year time to progression (TTP) was 58% (64% limited versus 29% advanced stage). The 5-year disease-specific survival (DSS) and overall survival was 86% and 75%, respectively. In an as-treated analysis, the 5-year DSS for limited stage patients was similar comparing RT to combined modality treatment or chemotherapy alone but the 5-year TTP favoured RT (82% vs. 33%, P = 0·004). The 5-year cumulative risk of developing systemic lymphoma was 14%. Our results confirm the favourable prognosis of PCALCL despite a high relapse rate. Limited stage patients treated with RT alone have excellent outcomes. There is a small risk of systemic lymphoma in PCALCL. © 2016 John Wiley & Sons Ltd.

  6. Child maltreatment experience among primary school children: a large scale survey in Selangor state, Malaysia.

    Science.gov (United States)

    Ahmed, Ayesha; Wan-Yuen, Choo; Marret, Mary Joseph; Guat-Sim, Cheah; Othman, Sajaratulnisah; Chinna, Karuthan

    2015-01-01

    Official reports of child maltreatment in Malaysia have persistently increased throughout the last decade. However there is a lack of population surveys evaluating the actual burden of child maltreatment, its correlates and its consequences in the country. This cross sectional study employed 2 stage stratified cluster random sampling of public primary schools, to survey 3509 ten to twelve year old school children in Selangor state. It aimed to estimate the prevalence of parental physical and emotional maltreatment, parental neglect and teacher- inflicted physical maltreatment. It further aimed to examine the associations between child maltreatment and important socio-demographic factors; family functioning and symptoms of depression among children. Logistic regression on weighted samples was used to extend results to a population level. Three quarters of 10-12 year olds reported at least one form of maltreatment, with parental physical maltreatment being most common. Males had higher odds of maltreatment in general except for emotional maltreatment. Ethnicity and parental conflict were key factors associated with maltreatment. The study contributes important evidence towards improving public health interventions for child maltreatment prevention in the country.

  7. Child maltreatment experience among primary school children: a large scale survey in Selangor state, Malaysia.

    Directory of Open Access Journals (Sweden)

    Ayesha Ahmed

    Full Text Available Official reports of child maltreatment in Malaysia have persistently increased throughout the last decade. However there is a lack of population surveys evaluating the actual burden of child maltreatment, its correlates and its consequences in the country. This cross sectional study employed 2 stage stratified cluster random sampling of public primary schools, to survey 3509 ten to twelve year old school children in Selangor state. It aimed to estimate the prevalence of parental physical and emotional maltreatment, parental neglect and teacher- inflicted physical maltreatment. It further aimed to examine the associations between child maltreatment and important socio-demographic factors; family functioning and symptoms of depression among children. Logistic regression on weighted samples was used to extend results to a population level. Three quarters of 10-12 year olds reported at least one form of maltreatment, with parental physical maltreatment being most common. Males had higher odds of maltreatment in general except for emotional maltreatment. Ethnicity and parental conflict were key factors associated with maltreatment. The study contributes important evidence towards improving public health interventions for child maltreatment prevention in the country.

  8. Reconstruction of primary vertices at the ATLAS experiment in Run 1 proton--proton collisions at the LHC

    CERN Document Server

    Aaboud, Morad; Abbott, Brad; Abdallah, Jalal; Abdinov, Ovsat; Abeloos, Baptiste; Aben, Rosemarie; AbouZeid, Ossama; Abraham, Nicola; Abramowicz, Halina; Abreu, Henso; Abreu, Ricardo; Abulaiti, Yiming; Acharya, Bobby Samir; Adamczyk, Leszek; Adams, David; Adelman, Jahred; Adomeit, Stefanie; Adye, Tim; Affolder, Tony; Agatonovic-Jovin, Tatjana; Agricola, Johannes; Aguilar-Saavedra, Juan Antonio; Ahlen, Steven; Ahmadov, Faig; Aielli, Giulio; Akerstedt, Henrik; Åkesson, Torsten Paul Ake; Akimov, Andrei; Alberghi, Gian Luigi; Albert, Justin; Albrand, Solveig; Alconada Verzini, Maria Josefina; Aleksa, Martin; Aleksandrov, Igor; Alexa, Calin; Alexander, Gideon; Alexopoulos, Theodoros; Alhroob, Muhammad; Ali, Babar; Aliev, Malik; Alimonti, Gianluca; Alison, John; Alkire, Steven Patrick; Allbrooke, Benedict; Allen, Benjamin William; Allport, Phillip; Aloisio, Alberto; Alonso, Alejandro; Alonso, Francisco; Alpigiani, Cristiano; Alstaty, Mahmoud; Alvarez Gonzalez, Barbara; Άlvarez Piqueras, Damián; Alviggi, Mariagrazia; Amadio, Brian Thomas; Amako, Katsuya; Amaral Coutinho, Yara; Amelung, Christoph; Amidei, Dante; Amor Dos Santos, Susana Patricia; Amorim, Antonio; Amoroso, Simone; Amundsen, Glenn; Anastopoulos, Christos; Ancu, Lucian Stefan; Andari, Nansi; Andeen, Timothy; Anders, Christoph Falk; Anders, Gabriel; Anders, John Kenneth; Anderson, Kelby; Andreazza, Attilio; Andrei, George Victor; Angelidakis, Stylianos; Angelozzi, Ivan; Anger, Philipp; Angerami, Aaron; Anghinolfi, Francis; Anisenkov, Alexey; Anjos, Nuno; Annovi, Alberto; Antel, Claire; Antonelli, Mario; Antonov, Alexey; Anulli, Fabio; Aoki, Masato; Aperio Bella, Ludovica; Arabidze, Giorgi; Arai, Yasuo; Araque, Juan Pedro; Arce, Ayana; Arduh, Francisco Anuar; Arguin, Jean-Francois; Argyropoulos, Spyridon; Arik, Metin; Armbruster, Aaron James; Armitage, Lewis James; Arnaez, Olivier; Arnold, Hannah; Arratia, Miguel; Arslan, Ozan; Artamonov, Andrei; Artoni, Giacomo; Artz, Sebastian; Asai, Shoji; Asbah, Nedaa; Ashkenazi, Adi; Åsman, Barbro; Asquith, Lily; Assamagan, Ketevi; Astalos, Robert; Atkinson, Markus; Atlay, Naim Bora; Augsten, Kamil; Avolio, Giuseppe; Axen, Bradley; Ayoub, Mohamad Kassem; Azuelos, Georges; Baak, Max; Baas, Alessandra; Baca, Matthew John; Bachacou, Henri; Bachas, Konstantinos; Backes, Moritz; Backhaus, Malte; Bagiacchi, Paolo; Bagnaia, Paolo; Bai, Yu; Baines, John; Baker, Oliver Keith; Baldin, Evgenii; Balek, Petr; Balestri, Thomas; Balli, Fabrice; Balunas, William Keaton; Banas, Elzbieta; Banerjee, Swagato; Bannoura, Arwa A E; Barak, Liron; Barberio, Elisabetta Luigia; Barberis, Dario; Barbero, Marlon; Barillari, Teresa; Barisits, Martin-Stefan; Barklow, Timothy; Barlow, Nick; Barnes, Sarah Louise; Barnett, Bruce; Barnett, Michael; Barnovska-Blenessy, Zuzana; Baroncelli, Antonio; Barone, Gaetano; Barr, Alan; Barranco Navarro, Laura; Barreiro, Fernando; Barreiro Guimarães da Costa, João; Bartoldus, Rainer; Barton, Adam Edward; Bartos, Pavol; Basalaev, Artem; Bassalat, Ahmed; Bates, Richard; Batista, Santiago Juan; Batley, Richard; Battaglia, Marco; Bauce, Matteo; Bauer, Florian; Bawa, Harinder Singh; Beacham, James; Beattie, Michael David; Beau, Tristan; Beauchemin, Pierre-Hugues; Bechtle, Philip; Beck, Hans~Peter; Becker, Kathrin; Becker, Maurice; Beckingham, Matthew; Becot, Cyril; Beddall, Andrew; Beddall, Ayda; Bednyakov, Vadim; Bedognetti, Matteo; Bee, Christopher; Beemster, Lars; Beermann, Thomas; Begel, Michael; Behr, Janna Katharina; Belanger-Champagne, Camille; Bell, Andrew Stuart; Bella, Gideon; Bellagamba, Lorenzo; Bellerive, Alain; Bellomo, Massimiliano; Belotskiy, Konstantin; Beltramello, Olga; Belyaev, Nikita; Benary, Odette; Benchekroun, Driss; Bender, Michael; Bendtz, Katarina; Benekos, Nektarios; Benhammou, Yan; Benhar Noccioli, Eleonora; Benitez, Jose; Benjamin, Douglas; Bensinger, James; Bentvelsen, Stan; Beresford, Lydia; Beretta, Matteo; Berge, David; Bergeaas Kuutmann, Elin; Berger, Nicolas; Beringer, Jürg; Berlendis, Simon; Bernard, Nathan Rogers; Bernius, Catrin; Bernlochner, Florian Urs; Berry, Tracey; Berta, Peter; Bertella, Claudia; Bertoli, Gabriele; Bertolucci, Federico; Bertram, Iain Alexander; Bertsche, Carolyn; Bertsche, David; Besjes, Geert-Jan; Bessidskaia Bylund, Olga; Bessner, Martin Florian; Besson, Nathalie; Betancourt, Christopher; Bethke, Siegfried; Bevan, Adrian John; Bhimji, Wahid; Bianchi, Riccardo-Maria; Bianchini, Louis; Bianco, Michele; Biebel, Otmar; Biedermann, Dustin; Bielski, Rafal; Biesuz, Nicolo Vladi; Biglietti, Michela; Bilbao De Mendizabal, Javier; Bilokon, Halina; Bindi, Marcello; Binet, Sebastien; Bingul, Ahmet; Bini, Cesare; Biondi, Silvia; Bjergaard, David Martin; Black, Curtis; Black, James; Black, Kevin; Blackburn, Daniel; Blair, Robert; Blanchard, Jean-Baptiste; Blanco, Jacobo Ezequiel; Blazek, Tomas; Bloch, Ingo; Blocker, Craig; Blum, Walter; Blumenschein, Ulrike; Blunier, Sylvain; Bobbink, Gerjan; Bobrovnikov, Victor; Bocchetta, Simona Serena; Bocci, Andrea; Bock, Christopher; Boehler, Michael; Boerner, Daniela; Bogaerts, Joannes Andreas; Bogavac, Danijela; Bogdanchikov, Alexander; Bohm, Christian; Boisvert, Veronique; Bokan, Petar; Bold, Tomasz; Boldyrev, Alexey; Bomben, Marco; Bona, Marcella; Boonekamp, Maarten; Borisov, Anatoly; Borissov, Guennadi; Bortfeldt, Jonathan; Bortoletto, Daniela; Bortolotto, Valerio; Bos, Kors; Boscherini, Davide; Bosman, Martine; Bossio Sola, Jonathan David; Boudreau, Joseph; Bouffard, Julian; Bouhova-Thacker, Evelina Vassileva; Boumediene, Djamel Eddine; Bourdarios, Claire; Boutle, Sarah Kate; Boveia, Antonio; Boyd, James; Boyko, Igor; Bracinik, Juraj; Brandt, Andrew; Brandt, Gerhard; Brandt, Oleg; Bratzler, Uwe; Brau, Benjamin; Brau, James; Braun, Helmut; Breaden Madden, William Dmitri; Brendlinger, Kurt; Brennan, Amelia Jean; Brenner, Lydia; Brenner, Richard; Bressler, Shikma; Bristow, Timothy Michael; Britton, Dave; Britzger, Daniel; Brochu, Frederic; Brock, Ian; Brock, Raymond; Brooijmans, Gustaaf; Brooks, Timothy; Brooks, William; Brosamer, Jacquelyn; Brost, Elizabeth; Broughton, James; Bruckman de Renstrom, Pawel; Bruncko, Dusan; Bruneliere, Renaud; Bruni, Alessia; Bruni, Graziano; Bruni, Lucrezia Stella; Brunt, Benjamin; Bruschi, Marco; Bruscino, Nello; Bryant, Patrick; Bryngemark, Lene; Buanes, Trygve; Buat, Quentin; Buchholz, Peter; Buckley, Andrew; Budagov, Ioulian; Buehrer, Felix; Bugge, Magnar Kopangen; Bulekov, Oleg; Bullock, Daniel; Burckhart, Helfried; Burdin, Sergey; Burgard, Carsten Daniel; Burghgrave, Blake; Burka, Klaudia; Burke, Stephen; Burmeister, Ingo; Burr, Jonathan Thomas Peter; Busato, Emmanuel; Büscher, Daniel; Büscher, Volker; Bussey, Peter; Butler, John; Buttar, Craig; Butterworth, Jonathan; Butti, Pierfrancesco; Buttinger, William; Buzatu, Adrian; Buzykaev, Aleksey; Cabrera Urbán, Susana; Caforio, Davide; Cairo, Valentina; Cakir, Orhan; Calace, Noemi; Calafiura, Paolo; Calandri, Alessandro; Calderini, Giovanni; Calfayan, Philippe; Callea, Giuseppe; Caloba, Luiz; Calvente Lopez, Sergio; Calvet, David; Calvet, Samuel; Calvet, Thomas Philippe; Camacho Toro, Reina; Camarda, Stefano; Camarri, Paolo; Cameron, David; Caminal Armadans, Roger; Camincher, Clement; Campana, Simone; Campanelli, Mario; Camplani, Alessandra; Campoverde, Angel; Canale, Vincenzo; Canepa, Anadi; Cano Bret, Marc; Cantero, Josu; Cantrill, Robert; Cao, Tingting; Capeans Garrido, Maria Del Mar; Caprini, Irinel; Caprini, Mihai; Capua, Marcella; Caputo, Regina; Carbone, Ryne Michael; Cardarelli, Roberto; Cardillo, Fabio; Carli, Ina; Carli, Tancredi; Carlino, Gianpaolo; Carminati, Leonardo; Caron, Sascha; Carquin, Edson; Carrillo-Montoya, German D; Carter, Janet; Carvalho, João; Casadei, Diego; Casado, Maria Pilar; Casolino, Mirkoantonio; Casper, David William; Castaneda-Miranda, Elizabeth; Castelijn, Remco; Castelli, Angelantonio; Castillo Gimenez, Victoria; Castro, Nuno Filipe; Catinaccio, Andrea; Catmore, James; Cattai, Ariella; Caudron, Julien; Cavaliere, Viviana; Cavallaro, Emanuele; Cavalli, Donatella; Cavalli-Sforza, Matteo; Cavasinni, Vincenzo; Ceradini, Filippo; Cerda Alberich, Leonor; Cerio, Benjamin; Santiago Cerqueira, Augusto; Cerri, Alessandro; Cerrito, Lucio; Cerutti, Fabio; Cerv, Matevz; Cervelli, Alberto; Cetin, Serkant Ali; Chafaq, Aziz; Chakraborty, Dhiman; Chan, Stephen Kam-wah; Chan, Yat Long; Chang, Philip; Chapman, John Derek; Charlton, Dave; Chatterjee, Avishek; Chau, Chav Chhiv; Chavez Barajas, Carlos Alberto; Che, Siinn; Cheatham, Susan; Chegwidden, Andrew; Chekanov, Sergei; Chekulaev, Sergey; Chelkov, Gueorgui; Chelstowska, Magda Anna; Chen, Chunhui; Chen, Hucheng; Chen, Karen; Chen, Shenjian; Chen, Shion; Chen, Xin; Chen, Ye; Cheng, Hok Chuen; Cheng, Huajie; Cheng, Yangyang; Cheplakov, Alexander; Cheremushkina, Evgenia; Cherkaoui El Moursli, Rajaa; Chernyatin, Valeriy; Cheu, Elliott; Chevalier, Laurent; Chiarella, Vitaliano; Chiarelli, Giorgio; Chiodini, Gabriele; Chisholm, Andrew; Chitan, Adrian; Chizhov, Mihail; Choi, Kyungeon; Chomont, Arthur Rene; Chouridou, Sofia; Chow, Bonnie Kar Bo; Christodoulou, Valentinos; Chromek-Burckhart, Doris; Chudoba, Jiri; Chuinard, Annabelle Julia; Chwastowski, Janusz; Chytka, Ladislav; Ciapetti, Guido; Ciftci, Abbas Kenan; Cinca, Diane; Cindro, Vladimir; Cioara, Irina Antonela; Ciocca, Claudia; Ciocio, Alessandra; Cirotto, Francesco; Citron, Zvi Hirsh; Citterio, Mauro; Ciubancan, Mihai; Clark, Allan G; Clark, Brian Lee; Clark, Michael; Clark, Philip James; Clarke, Robert; Clement, Christophe; Coadou, Yann; Cobal, Marina; Coccaro, Andrea; Cochran, James H; Coffey, Laurel; Colasurdo, Luca; Cole, Brian; Colijn, Auke-Pieter; Collot, Johann; Colombo, Tommaso; Compostella, Gabriele; Conde Muiño, Patricia; Coniavitis, Elias; Connell, Simon Henry; Connelly, Ian; Consorti, Valerio; Constantinescu, Serban; Conti, Geraldine; Conventi, Francesco; Cooke, Mark; Cooper, Ben; Cooper-Sarkar, Amanda; Cormier, Kyle James Read; Cornelissen, Thijs; Corradi, Massimo; Corriveau, Francois; Corso-Radu, Alina; Cortes-Gonzalez, Arely; Cortiana, Giorgio; Costa, Giuseppe; Costa, María José; Costanzo, Davide; Cottin, Giovanna; Cowan, Glen; Cox, Brian; Cranmer, Kyle; Crawley, Samuel Joseph; Cree, Graham; Crépé-Renaudin, Sabine; Crescioli, Francesco; Cribbs, Wayne Allen; Crispin Ortuzar, Mireia; Cristinziani, Markus; Croft, Vince; Crosetti, Giovanni; Cuhadar Donszelmann, Tulay; Cummings, Jane; Curatolo, Maria; Cúth, Jakub; Cuthbert, Cameron; Czirr, Hendrik; Czodrowski, Patrick; D'amen, Gabriele; D'Auria, Saverio; D'Onofrio, Monica; Da Cunha Sargedas De Sousa, Mario Jose; Da Via, Cinzia; Dabrowski, Wladyslaw; Dado, Tomas; Dai, Tiesheng; Dale, Orjan; Dallaire, Frederick; Dallapiccola, Carlo; Dam, Mogens; Dandoy, Jeffrey Rogers; Dang, Nguyen Phuong; Daniells, Andrew Christopher; Dann, Nicholas Stuart; Danninger, Matthias; Dano Hoffmann, Maria; Dao, Valerio; Darbo, Giovanni; Darmora, Smita; Dassoulas, James; Dattagupta, Aparajita; Davey, Will; David, Claire; Davidek, Tomas; Davies, Merlin; Davison, Peter; Dawe, Edmund; Dawson, Ian; Daya-Ishmukhametova, Rozmin; De, Kaushik; de Asmundis, Riccardo; De Benedetti, Abraham; De Castro, Stefano; De Cecco, Sandro; De Groot, Nicolo; de Jong, Paul; De la Torre, Hector; De Lorenzi, Francesco; De Maria, Antonio; De Pedis, Daniele; De Salvo, Alessandro; De Sanctis, Umberto; De Santo, Antonella; De Vivie De Regie, Jean-Baptiste; Dearnaley, William James; Debbe, Ramiro; Debenedetti, Chiara; Dedovich, Dmitri; Dehghanian, Nooshin; Deigaard, Ingrid; Del Gaudio, Michela; Del Peso, Jose; Del Prete, Tarcisio; Delgove, David; Deliot, Frederic; Delitzsch, Chris Malena; Deliyergiyev, Maksym; Dell'Acqua, Andrea; Dell'Asta, Lidia; Dell'Orso, Mauro; Della Pietra, Massimo; della Volpe, Domenico; Delmastro, Marco; Delsart, Pierre-Antoine; DeMarco, David; Demers, Sarah; Demichev, Mikhail; Demilly, Aurelien; Denisov, Sergey; Denysiuk, Denys; Derendarz, Dominik; Derkaoui, Jamal Eddine; Derue, Frederic; Dervan, Paul; Desch, Klaus Kurt; Deterre, Cecile; Dette, Karola; Deviveiros, Pier-Olivier; Dewhurst, Alastair; Dhaliwal, Saminder; Di Ciaccio, Anna; Di Ciaccio, Lucia; Di Clemente, William Kennedy; Di Donato, Camilla; Di Girolamo, Alessandro; Di Girolamo, Beniamino; Di Micco, Biagio; Di Nardo, Roberto; Di Simone, Andrea; Di Sipio, Riccardo; Di Valentino, David; Diaconu, Cristinel; Diamond, Miriam; Dias, Flavia; Diaz, Marco Aurelio; Diehl, Edward; Dietrich, Janet; Diglio, Sara; Dimitrievska, Aleksandra; Dingfelder, Jochen; Dita, Petre; Dita, Sanda; Dittus, Fridolin; Djama, Fares; Djobava, Tamar; Djuvsland, Julia Isabell; Barros do Vale, Maria Aline; Dobos, Daniel; Dobre, Monica; Doglioni, Caterina; Dohmae, Takeshi; Dolejsi, Jiri; Dolezal, Zdenek; Dolgoshein, Boris; Donadelli, Marisilvia; Donati, Simone; Dondero, Paolo; Donini, Julien; Dopke, Jens; Doria, Alessandra; Dova, Maria-Teresa; Doyle, Tony; Drechsler, Eric; Dris, Manolis; Du, Yanyan; Duarte-Campderros, Jorge; Duchovni, Ehud; Duckeck, Guenter; Ducu, Otilia Anamaria; Duda, Dominik; Dudarev, Alexey; Duffield, Emily Marie; Duflot, Laurent; Duguid, Liam; Dührssen, Michael; Dumancic, Mirta; Dunford, Monica; Duran Yildiz, Hatice; Düren, Michael; Durglishvili, Archil; Duschinger, Dirk; Dutta, Baishali; Dyndal, Mateusz; Eckardt, Christoph; Ecker, Katharina Maria; Edgar, Ryan Christopher; Edwards, Nicholas Charles; Eifert, Till; Eigen, Gerald; Einsweiler, Kevin; Ekelof, Tord; El Kacimi, Mohamed; Ellajosyula, Venugopal; Ellert, Mattias; Elles, Sabine; Ellinghaus, Frank; Elliot, Alison; Ellis, Nicolas; Elmsheuser, Johannes; Elsing, Markus; Emeliyanov, Dmitry; Enari, Yuji; Endner, Oliver Chris; Endo, Masaki; Ennis, Joseph Stanford; Erdmann, Johannes; Ereditato, Antonio; Ernis, Gunar; Ernst, Jesse; Ernst, Michael; Errede, Steven; Ertel, Eugen; Escalier, Marc; Esch, Hendrik; Escobar, Carlos; Esposito, Bellisario; Etienvre, Anne-Isabelle; Etzion, Erez; Evans, Hal; Ezhilov, Alexey; Fabbri, Federica; Fabbri, Laura; Facini, Gabriel; Fakhrutdinov, Rinat; Falciano, Speranza; Falla, Rebecca Jane; Faltova, Jana; Fang, Yaquan; Fanti, Marcello; Farbin, Amir; Farilla, Addolorata; Farina, Christian; Farina, Edoardo Maria; Farooque, Trisha; Farrell, Steven; Farrington, Sinead; Farthouat, Philippe; Fassi, Farida; Fassnacht, Patrick; Fassouliotis, Dimitrios; Faucci Giannelli, Michele; Favareto, Andrea; Fawcett, William James; Fayard, Louis; Fedin, Oleg; Fedorko, Wojciech; Feigl, Simon; Feligioni, Lorenzo; Feng, Cunfeng; Feng, Eric; Feng, Haolu; Fenyuk, Alexander; Feremenga, Last; Fernandez Martinez, Patricia; Fernandez Perez, Sonia; Ferrando, James; Ferrari, Arnaud; Ferrari, Pamela; Ferrari, Roberto; Ferreira de Lima, Danilo Enoque; Ferrer, Antonio; Ferrere, Didier; Ferretti, Claudio; Ferretto Parodi, Andrea; Fiedler, Frank; Filipčič, Andrej; Filipuzzi, Marco; Filthaut, Frank; Fincke-Keeler, Margret; Finelli, Kevin Daniel; Fiolhais, Miguel; Fiorini, Luca; Firan, Ana; Fischer, Adam; Fischer, Cora; Fischer, Julia; Fisher, Wade Cameron; Flaschel, Nils; Fleck, Ivor; Fleischmann, Philipp; Fletcher, Gareth Thomas; Fletcher, Rob Roy MacGregor; Flick, Tobias; Floderus, Anders; Flores Castillo, Luis; Flowerdew, Michael; Forcolin, Giulio Tiziano; Formica, Andrea; Forti, Alessandra; Foster, Andrew Geoffrey; Fournier, Daniel; Fox, Harald; Fracchia, Silvia; Francavilla, Paolo; Franchini, Matteo; Francis, David; Franconi, Laura; Franklin, Melissa; Frate, Meghan; Fraternali, Marco; Freeborn, David; Fressard-Batraneanu, Silvia; Friedrich, Felix; Froidevaux, Daniel; Frost, James; Fukunaga, Chikara; Fullana Torregrosa, Esteban; Fusayasu, Takahiro; Fuster, Juan; Gabaldon, Carolina; Gabizon, Ofir; Gabrielli, Alessandro; Gabrielli, Andrea; Gach, Grzegorz; Gadatsch, Stefan; Gadomski, Szymon; Gagliardi, Guido; Gagnon, Louis Guillaume; Gagnon, Pauline; Galea, Cristina; Galhardo, Bruno; Gallas, Elizabeth; Gallop, Bruce; Gallus, Petr; Galster, Gorm Aske Gram Krohn; Gan, KK; Gao, Jun; Gao, Yanyan; Gao, Yongsheng; Garay Walls, Francisca; García, Carmen; García Navarro, José Enrique; Garcia-Sciveres, Maurice; Gardner, Robert; Garelli, Nicoletta; Garonne, Vincent; Gascon Bravo, Alberto; Gatti, Claudio; Gaudiello, Andrea; Gaudio, Gabriella; Gaur, Bakul; Gauthier, Lea; Gavrilenko, Igor; Gay, Colin; Gaycken, Goetz; Gazis, Evangelos; Gecse, Zoltan; Gee, Norman; Geich-Gimbel, Christoph; Geisen, Marc; Geisler, Manuel Patrice; Gemme, Claudia; Genest, Marie-Hélène; Geng, Cong; Gentile, Simonetta; Gentsos, Christos; George, Simon; Gerbaudo, Davide; Gershon, Avi; Ghasemi, Sara; Ghazlane, Hamid; Ghneimat, Mazuza; Giacobbe, Benedetto; Giagu, Stefano; Giannetti, Paola; Gibbard, Bruce; Gibson, Stephen; Gignac, Matthew; Gilchriese, Murdock; Gillam, Thomas; Gillberg, Dag; Gilles, Geoffrey; Gingrich, Douglas; Giokaris, Nikos; Giordani, MarioPaolo; Giorgi, Filippo Maria; Giorgi, Francesco Michelangelo; Giraud, Pierre-Francois; Giromini, Paolo; Giugni, Danilo; Giuli, Francesco; Giuliani, Claudia; Giulini, Maddalena; Gjelsten, Børge Kile; Gkaitatzis, Stamatios; Gkialas, Ioannis; Gkougkousis, Evangelos Leonidas; Gladilin, Leonid; Glasman, Claudia; Glatzer, Julian; Glaysher, Paul; Glazov, Alexandre; Goblirsch-Kolb, Maximilian; Godlewski, Jan; Goldfarb, Steven; Golling, Tobias; Golubkov, Dmitry; Gomes, Agostinho; Gonçalo, Ricardo; Goncalves Pinto Firmino Da Costa, Joao; Gonella, Giulia; Gonella, Laura; Gongadze, Alexi; González de la Hoz, Santiago; Gonzalez Parra, Garoe; Gonzalez-Sevilla, Sergio; Goossens, Luc; Gorbounov, Petr Andreevich; Gordon, Howard; Gorelov, Igor; Gorini, Benedetto; Gorini, Edoardo; Gorišek, Andrej; Gornicki, Edward; Goshaw, Alfred; Gössling, Claus; Gostkin, Mikhail Ivanovitch; Goudet, Christophe Raymond; Goujdami, Driss; Goussiou, Anna; Govender, Nicolin; Gozani, Eitan; Graber, Lars; Grabowska-Bold, Iwona; Gradin, Per Olov Joakim; Grafström, Per; Gramling, Johanna; Gramstad, Eirik; Grancagnolo, Sergio; Gratchev, Vadim; Gravila, Paul Mircea; Gray, Heather; Graziani, Enrico; Greenwood, Zeno Dixon; Grefe, Christian; Gregersen, Kristian; Gregor, Ingrid-Maria; Grenier, Philippe; Grevtsov, Kirill; Griffiths, Justin; Grillo, Alexander; Grimm, Kathryn; Grinstein, Sebastian; Gris, Philippe Luc Yves; Grivaz, Jean-Francois; Groh, Sabrina; Grohs, Johannes Philipp; Gross, Eilam; Grosse-Knetter, Joern; Grossi, Giulio Cornelio; Grout, Zara Jane; Guan, Liang; Guan, Wen; Guenther, Jaroslav; Guescini, Francesco; Guest, Daniel; Gueta, Orel; Guido, Elisa; Guillemin, Thibault; Guindon, Stefan; Gul, Umar; Gumpert, Christian; Guo, Jun; Guo, Yicheng; Gupta, Ruchi; Gupta, Shaun; Gustavino, Giuliano; Gutierrez, Phillip; Gutierrez Ortiz, Nicolas Gilberto; Gutschow, Christian; Guyot, Claude; Gwenlan, Claire; Gwilliam, Carl; Haas, Andy; Haber, Carl; Hadavand, Haleh Khani; Haddad, Nacim; Hadef, Asma; Haefner, Petra; Hageböck, Stephan; Hajduk, Zbigniew; Hakobyan, Hrachya; Haleem, Mahsana; Haley, Joseph; Halladjian, Garabed; Hallewell, Gregory David; Hamacher, Klaus; Hamal, Petr; Hamano, Kenji; Hamilton, Andrew; Hamity, Guillermo Nicolas; Hamnett, Phillip George; Han, Liang; Hanagaki, Kazunori; Hanawa, Keita; Hance, Michael; Haney, Bijan; Hanke, Paul; Hanna, Remie; Hansen, Jørgen Beck; Hansen, Jorn Dines; Hansen, Maike Christina; Hansen, Peter Henrik; Hara, Kazuhiko; Hard, Andrew; Harenberg, Torsten; Hariri, Faten; Harkusha, Siarhei; Harrington, Robert; Harrison, Paul Fraser; Hartjes, Fred; Hartmann, Nikolai Marcel; Hasegawa, Makoto; Hasegawa, Yoji; Hasib, A; Hassani, Samira; Haug, Sigve; Hauser, Reiner; Hauswald, Lorenz; Havranek, Miroslav; Hawkes, Christopher; Hawkings, Richard John; Hayden, Daniel; Hays, Chris; Hays, Jonathan Michael; Hayward, Helen; Haywood, Stephen; Head, Simon; Heck, Tobias; Hedberg, Vincent; Heelan, Louise; Heim, Sarah; Heim, Timon; Heinemann, Beate; Heinrich, Jochen Jens; Heinrich, Lukas; Heinz, Christian; Hejbal, Jiri; Helary, Louis; Hellman, Sten; Helsens, Clement; Henderson, James; Henderson, Robert; Heng, Yang; Henkelmann, Steffen; Henriques Correia, Ana Maria; Henrot-Versille, Sophie; Herbert, Geoffrey Henry; Hernández Jiménez, Yesenia; Herten, Gregor; Hertenberger, Ralf; Hervas, Luis; Hesketh, Gavin Grant; Hessey, Nigel; Hetherly, Jeffrey Wayne; Hickling, Robert; Higón-Rodriguez, Emilio; Hill, Ewan; Hill, John; Hiller, Karl Heinz; Hillier, Stephen; Hinchliffe, Ian; Hines, Elizabeth; Hinman, Rachel Reisner; Hirose, Minoru; Hirschbuehl, Dominic; Hobbs, John; Hod, Noam; Hodgkinson, Mark; Hodgson, Paul; Hoecker, Andreas; Hoeferkamp, Martin; Hoenig, Friedrich; Hohn, David; Holmes, Tova Ray; Homann, Michael; Hong, Tae Min; Hooberman, Benjamin Henry; Hopkins, Walter; Horii, Yasuyuki; Horton, Arthur James; Hostachy, Jean-Yves; Hou, Suen; Hoummada, Abdeslam; Howarth, James; Hrabovsky, Miroslav; Hristova, Ivana; Hrivnac, Julius; Hryn'ova, Tetiana; Hrynevich, Aliaksei; Hsu, Catherine; Hsu, Pai-hsien Jennifer; Hsu, Shih-Chieh; Hu, Diedi; Hu, Qipeng; Huang, Yanping; Hubacek, Zdenek; Hubaut, Fabrice; Huegging, Fabian; Huffman, Todd Brian; Hughes, Emlyn; Hughes, Gareth; Huhtinen, Mika; Huo, Peng; Huseynov, Nazim; Huston, Joey; Huth, John; Iacobucci, Giuseppe; Iakovidis, Georgios; Ibragimov, Iskander; Iconomidou-Fayard, Lydia; Ideal, Emma; Idrissi, Zineb; Iengo, Paolo; Igonkina, Olga; Iizawa, Tomoya; Ikegami, Yoichi; Ikeno, Masahiro; Ilchenko, Yuriy; Iliadis, Dimitrios; Ilic, Nikolina; Ince, Tayfun; Introzzi, Gianluca; Ioannou, Pavlos; Iodice, Mauro; Iordanidou, Kalliopi; Ippolito, Valerio; Ishijima, Naoki; Ishino, Masaya; Ishitsuka, Masaki; Ishmukhametov, Renat; Issever, Cigdem; Istin, Serhat; Ito, Fumiaki; Iturbe Ponce, Julia Mariana; Iuppa, Roberto; Iwanski, Wieslaw; Iwasaki, Hiroyuki; Izen, Joseph; Izzo, Vincenzo; Jabbar, Samina; Jackson, Brett; Jackson, Matthew; Jackson, Paul; Jain, Vivek; Jakobi, Katharina Bianca; Jakobs, Karl; Jakobsen, Sune; Jakoubek, Tomas; Jamin, David Olivier; Jana, Dilip; Jansen, Eric; Jansky, Roland; Janssen, Jens; Janus, Michel; Jarlskog, Göran; Javadov, Namig; Javůrek, Tomáš; Jeanneau, Fabien; Jeanty, Laura; Jeng, Geng-yuan; Jennens, David; Jenni, Peter; Jentzsch, Jennifer; Jeske, Carl; Jézéquel, Stéphane; Ji, Haoshuang; Jia, Jiangyong; Jiang, Hai; Jiang, Yi; Jiggins, Stephen; Jimenez Pena, Javier; Jin, Shan; Jinaru, Adam; Jinnouchi, Osamu; Johansson, Per; Johns, Kenneth; Johnson, William Joseph; Jon-And, Kerstin; Jones, Graham; Jones, Roger; Jones, Sarah; Jones, Tim; Jongmanns, Jan; Jorge, Pedro; Jovicevic, Jelena; Ju, Xiangyang; Juste Rozas, Aurelio; Köhler, Markus Konrad; Kaczmarska, Anna; Kado, Marumi; Kagan, Harris; Kagan, Michael; Kahn, Sebastien Jonathan; Kajomovitz, Enrique; Kalderon, Charles William; Kaluza, Adam; Kama, Sami; Kamenshchikov, Andrey; Kanaya, Naoko; Kaneti, Steven; Kanjir, Luka; Kantserov, Vadim; Kanzaki, Junichi; Kaplan, Benjamin; Kaplan, Laser Seymour; Kapliy, Anton; Kar, Deepak; Karakostas, Konstantinos; Karamaoun, Andrew; Karastathis, Nikolaos; Kareem, Mohammad Jawad; Karentzos, Efstathios; Karnevskiy, Mikhail; Karpov, Sergey; Karpova, Zoya; Karthik, Krishnaiyengar; Kartvelishvili, Vakhtang; Karyukhin, Andrey; Kasahara, Kota; Kashif, Lashkar; Kass, Richard; Kastanas, Alex; Kataoka, Yousuke; Kato, Chikuma; Katre, Akshay; Katzy, Judith; Kawagoe, Kiyotomo; Kawamoto, Tatsuo; Kawamura, Gen; Kazama, Shingo; Kazanin, Vassili; Keeler, Richard; Kehoe, Robert; Keller, John; Kempster, Jacob Julian; Kawade, Kentaro; Keoshkerian, Houry; Kepka, Oldrich; Kerševan, Borut Paul; Kersten, Susanne; Keyes, Robert; Khader, Mazin; Khalil-zada, Farkhad; Khanov, Alexander; Kharlamov, Alexey; Khoo, Teng Jian; Khovanskiy, Valery; Khramov, Evgeniy; Khubua, Jemal; Kido, Shogo; Kim, Hee Yeun; Kim, Shinhong; Kim, Young-Kee; Kimura, Naoki; Kind, Oliver Maria; King, Barry; King, Matthew; King, Samuel Burton; Kirk, Julie; Kiryunin, Andrey; Kishimoto, Tomoe; Kisielewska, Danuta; Kiss, Florian; Kiuchi, Kenji; Kivernyk, Oleh; Kladiva, Eduard; Klein, Matthew Henry; Klein, Max; Klein, Uta; Kleinknecht, Konrad; Klimek, Pawel; Klimentov, Alexei; Klingenberg, Reiner; Klinger, Joel Alexander; Klioutchnikova, Tatiana; Kluge, Eike-Erik; Kluit, Peter; Kluth, Stefan; Knapik, Joanna; Kneringer, Emmerich; Knoops, Edith; Knue, Andrea; Kobayashi, Aine; Kobayashi, Dai; Kobayashi, Tomio; Kobel, Michael; Kocian, Martin; Kodys, Peter; Koffas, Thomas; Koffeman, Els; Koi, Tatsumi; 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Kruchonak, Uladzimir; Krüger, Hans; Krumnack, Nils; Kruse, Amanda; Kruse, Mark; Kruskal, Michael; Kubota, Takashi; Kucuk, Hilal; Kuday, Sinan; Kuechler, Jan Thomas; Kuehn, Susanne; Kugel, Andreas; Kuger, Fabian; Kuhl, Andrew; Kuhl, Thorsten; Kukhtin, Victor; Kukla, Romain; Kulchitsky, Yuri; Kuleshov, Sergey; Kuna, Marine; Kunigo, Takuto; Kupco, Alexander; Kurashige, Hisaya; Kurochkin, Yurii; Kus, Vlastimil; Kuwertz, Emma Sian; Kuze, Masahiro; Kvita, Jiri; Kwan, Tony; Kyriazopoulos, Dimitrios; La Rosa, Alessandro; La Rosa Navarro, Jose Luis; La Rotonda, Laura; Lacasta, Carlos; Lacava, Francesco; Lacey, James; Lacker, Heiko; Lacour, Didier; Lacuesta, Vicente Ramón; Ladygin, Evgueni; Lafaye, Remi; Laforge, Bertrand; Lagouri, Theodota; Lai, Stanley; Lammers, Sabine; Lampl, Walter; Lançon, Eric; Landgraf, Ulrich; Landon, Murrough; Lanfermann, Marie Christine; Lang, Valerie Susanne; Lange, J örn Christian; Lankford, Andrew; Lanni, Francesco; Lantzsch, Kerstin; Lanza, Agostino; Laplace, Sandrine; Lapoire, Cecile; Laporte, Jean-Francois; Lari, Tommaso; Lasagni Manghi, Federico; Lassnig, Mario; Laurelli, Paolo; Lavrijsen, Wim; Law, Alexander; Laycock, Paul; Lazovich, Tomo; Lazzaroni, Massimo; Le, Brian; Le Dortz, Olivier; Le Guirriec, Emmanuel; Le Quilleuc, Eloi; LeBlanc, Matthew Edgar; LeCompte, Thomas; Ledroit-Guillon, Fabienne Agnes Marie; Lee, Claire Alexandra; Lee, Shih-Chang; Lee, Lawrence; Lefebvre, Guillaume; Lefebvre, Michel; Legger, Federica; Leggett, Charles; Lehan, Allan; Lehmann Miotto, Giovanna; Lei, Xiaowen; Leight, William Axel; Leisos, Antonios; Leister, Andrew Gerard; Leite, Marco Aurelio Lisboa; Leitner, Rupert; Lellouch, Daniel; Lemmer, Boris; Leney, Katharine; Lenz, Tatjana; Lenzi, Bruno; Leone, Robert; Leone, Sandra; Leonidopoulos, Christos; Leontsinis, Stefanos; Lerner, Giuseppe; Leroy, Claude; Lesage, Arthur; Lester, Christopher; Levchenko, Mikhail; Levêque, Jessica; Levin, Daniel; Levinson, Lorne; Levy, Mark; Lewis, Dave; Leyko, Agnieszka; Leyton, Michael; Li, Bing; Li, Haifeng; Li, Ho Ling; Li, Lei; Li, Liang; Li, Qi; Li, Shu; Li, Xingguo; Li, Yichen; Liang, Zhijun; Liberti, Barbara; Liblong, Aaron; Lichard, Peter; Lie, Ki; Liebal, Jessica; Liebig, Wolfgang; Limosani, Antonio; Lin, Simon; Lin, Tai-Hua; Lindquist, Brian Edward; Lionti, Anthony Eric; Lipeles, Elliot; Lipniacka, Anna; Lisovyi, Mykhailo; Liss, Tony; Lister, Alison; Litke, Alan; Liu, Bo; Liu, Dong; Liu, Hao; Liu, Hongbin; Liu, Jian; Liu, Jianbei; Liu, Kun; Liu, Lulu; Liu, Miaoyuan; Liu, Minghui; Liu, Yanlin; Liu, Yanwen; Livan, Michele; Lleres, Annick; Llorente Merino, Javier; Lloyd, Stephen; Lo Sterzo, Francesco; Lobodzinska, Ewelina Maria; Loch, Peter; Lockman, William; Loebinger, Fred; Loevschall-Jensen, Ask Emil; Loew, Kevin Michael; Loginov, Andrey; Lohse, Thomas; Lohwasser, Kristin; Lokajicek, Milos; Long, Brian Alexander; Long, Jonathan David; Long, Robin Eamonn; Longo, Luigi; Looper, Kristina Anne; Lopes, Lourenco; Lopez Mateos, David; Lopez Paredes, Brais; Lopez Paz, Ivan; 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Malon, David; Malone, Caitlin; Maltezos, Stavros; Malyukov, Sergei; Mamuzic, Judita; Mancini, Giada; Mandelli, Beatrice; Mandelli, Luciano; Mandić, Igor; Maneira, José; Manhaes de Andrade Filho, Luciano; Manjarres Ramos, Joany; Mann, Alexander; Manousos, Athanasios; Mansoulie, Bruno; Mansour, Jason Dhia; Mantifel, Rodger; Mantoani, Matteo; Manzoni, Stefano; Mapelli, Livio; Marceca, Gino; March, Luis; Marchiori, Giovanni; Marcisovsky, Michal; Marjanovic, Marija; Marley, Daniel; Marroquim, Fernando; Marsden, Stephen Philip; Marshall, Zach; Marti-Garcia, Salvador; Martin, Brian Thomas; Martin, Tim; Martin, Victoria Jane; Martin dit Latour, Bertrand; Martinez, Mario; Martinez Outschoorn, Verena; Martin-Haugh, Stewart; Martoiu, Victor Sorin; Martyniuk, Alex; Marx, Marilyn; Marzin, Antoine; Masetti, Lucia; Mashimo, Tetsuro; Mashinistov, Ruslan; Masik, Jiri; Maslennikov, Alexey; Massa, Ignazio; Massa, Lorenzo; Mastrandrea, Paolo; Mastroberardino, Anna; Masubuchi, Tatsuya; Mättig, Peter; Mattmann, Johannes; Maurer, Julien; Maxfield, Stephen; Maximov, Dmitriy; Mazini, Rachid; Mazza, Simone Michele; Mc Fadden, Neil Christopher; Mc Goldrick, Garrin; Mc Kee, Shawn Patrick; McCarn, Allison; McCarthy, Robert; McCarthy, Tom; McClymont, Laurie; McDonald, Emily; Mcfayden, Josh; Mchedlidze, Gvantsa; McMahon, Steve; McPherson, Robert; Medinnis, Michael; Meehan, Samuel; Mehlhase, Sascha; Mehta, Andrew; Meier, Karlheinz; Meineck, Christian; Meirose, Bernhard; Melini, Davide; Mellado Garcia, Bruce Rafael; Melo, Matej; Meloni, Federico; Mengarelli, Alberto; Menke, Sven; Meoni, Evelin; Mergelmeyer, Sebastian; Mermod, Philippe; Merola, Leonardo; Meroni, Chiara; Merritt, Frank; Messina, Andrea; Metcalfe, Jessica; Mete, Alaettin Serhan; Meyer, Carsten; Meyer, Christopher; Meyer, Jean-Pierre; Meyer, Jochen; Meyer Zu Theenhausen, Hanno; Miano, Fabrizio; Middleton, Robin; Miglioranzi, Silvia; Mijović, Liza; Mikenberg, Giora; Mikestikova, Marcela; Mikuž, Marko; Milesi, Marco; Milic, Adriana; Miller, David; Mills, Corrinne; Milov, Alexander; Milstead, David; Minaenko, Andrey; Minami, Yuto; Minashvili, Irakli; Mincer, Allen; Mindur, Bartosz; Mineev, Mikhail; Ming, Yao; Mir, Lluisa-Maria; Mistry, Khilesh; Mitani, Takashi; Mitrevski, Jovan; Mitsou, Vasiliki A; Miucci, Antonio; Miyagawa, Paul; Mjörnmark, Jan-Ulf; Moa, Torbjoern; Mochizuki, Kazuya; Mohapatra, Soumya; Molander, Simon; Moles-Valls, Regina; Monden, Ryutaro; Mondragon, Matthew Craig; Mönig, Klaus; Monk, James; Monnier, Emmanuel; Montalbano, Alyssa; Montejo Berlingen, Javier; Monticelli, Fernando; Monzani, Simone; Moore, Roger; Morange, Nicolas; Moreno, Deywis; Moreno Llácer, María; Morettini, Paolo; Morgenstern, Stefanie; Mori, Daniel; Mori, Tatsuya; Morii, Masahiro; Morinaga, Masahiro; Morisbak, Vanja; Moritz, Sebastian; Morley, Anthony Keith; Mornacchi, Giuseppe; Morris, John; Mortensen, Simon Stark; Morvaj, Ljiljana; Mosidze, Maia; Moss, Josh; Motohashi, Kazuki; Mount, Richard; Mountricha, Eleni; Mouraviev, Sergei; Moyse, Edward; Muanza, Steve; Mudd, Richard; Mueller, Felix; Mueller, James; Mueller, Ralph Soeren Peter; Mueller, Thibaut; Muenstermann, Daniel; Mullen, Paul; Mullier, Geoffrey; Munoz Sanchez, Francisca Javiela; Murillo Quijada, Javier Alberto; Murray, Bill; Musheghyan, Haykuhi; Muškinja, Miha; Myagkov, Alexey; Myska, Miroslav; Nachman, Benjamin Philip; Nackenhorst, Olaf; Nagai, Koichi; Nagai, Ryo; Nagano, Kunihiro; Nagasaka, Yasushi; Nagata, Kazuki; Nagel, Martin; Nagy, Elemer; Nairz, Armin Michael; Nakahama, Yu; Nakamura, Koji; Nakamura, Tomoaki; Nakano, Itsuo; Namasivayam, Harisankar; Naranjo Garcia, Roger Felipe; Narayan, Rohin; Narrias Villar, Daniel Isaac; Naryshkin, Iouri; Naumann, Thomas; Navarro, Gabriela; Nayyar, Ruchika; Neal, Homer; Nechaeva, Polina; Neep, Thomas James; Nef, Pascal Daniel; Negri, Andrea; Negrini, Matteo; Nektarijevic, Snezana; Nellist, Clara; Nelson, Andrew; Nemecek, Stanislav; Nemethy, Peter; Nepomuceno, Andre Asevedo; Nessi, Marzio; Neubauer, Mark; Neumann, Manuel; Neves, Ricardo; Nevski, Pavel; Newman, Paul; Nguyen, Duong Hai; Nguyen Manh, Tuan; Nickerson, Richard; Nicolaidou, Rosy; Nielsen, Jason; Nikiforov, Andriy; Nikolaenko, Vladimir; Nikolic-Audit, Irena; Nikolopoulos, Konstantinos; Nilsen, Jon Kerr; Nilsson, Paul; Ninomiya, Yoichi; Nisati, Aleandro; Nisius, Richard; Nobe, Takuya; Nomachi, Masaharu; Nomidis, Ioannis; Nooney, Tamsin; Norberg, Scarlet; Nordberg, Markus; Norjoharuddeen, Nurfikri; Novgorodova, Olga; Nowak, Sebastian; Nozaki, Mitsuaki; Nozka, Libor; Ntekas, Konstantinos; Nurse, Emily; Nuti, Francesco; O'grady, Fionnbarr; O'Neil, Dugan; O'Rourke, Abigail Alexandra; O'Shea, Val; Oakham, Gerald; Oberlack, Horst; Obermann, Theresa; Ocariz, Jose; Ochi, Atsuhiko; Ochoa, Ines; Ochoa-Ricoux, Juan Pedro; Oda, Susumu; Odaka, Shigeru; Ogren, Harold; Oh, Alexander; Oh, Seog; Ohm, Christian; Ohman, Henrik; Oide, Hideyuki; Okawa, Hideki; Okumura, Yasuyuki; Okuyama, Toyonobu; Olariu, Albert; Oleiro Seabra, Luis Filipe; Olivares Pino, Sebastian Andres; Oliveira Damazio, Denis; Olszewski, Andrzej; Olszowska, Jolanta; Onofre, António; Onogi, Kouta; Onyisi, Peter; Oreglia, Mark; Oren, Yona; Orestano, Domizia; Orlando, Nicola; Orr, Robert; Osculati, Bianca; Ospanov, Rustem; Otero y Garzon, Gustavo; Otono, Hidetoshi; Ouchrif, Mohamed; Ould-Saada, Farid; Ouraou, Ahmimed; Oussoren, Koen Pieter; Ouyang, Qun; Owen, Mark; Owen, Rhys Edward; Ozcan, Veysi Erkcan; Ozturk, Nurcan; Pachal, Katherine; Pacheco Pages, Andres; Pacheco Rodriguez, Laura; Padilla Aranda, Cristobal; Pagáčová, Martina; Pagan Griso, Simone; Paige, Frank; Pais, Preema; Pajchel, Katarina; Palacino, Gabriel; Palazzo, Serena; Palestini, Sandro; Palka, Marek; Pallin, Dominique; Palma, Alberto; Panagiotopoulou, Evgenia; Pandini, Carlo Enrico; Panduro Vazquez, William; Pani, Priscilla; Panitkin, Sergey; Pantea, Dan; Paolozzi, Lorenzo; Papadopoulou, Theodora; Papageorgiou, Konstantinos; Paramonov, Alexander; Paredes Hernandez, Daniela; Parker, Adam Jackson; Parker, Michael Andrew; Parker, Kerry Ann; Parodi, Fabrizio; Parsons, John; Parzefall, Ulrich; Pascuzzi, Vincent; Pasqualucci, Enrico; Passaggio, Stefano; Pastore, Francesca; Pásztor, Gabriella; Pataraia, Sophio; Pater, Joleen; Pauly, Thilo; Pearce, James; Pearson, Benjamin; Pedersen, Lars Egholm; Pedersen, Maiken; Pedraza Lopez, Sebastian; Pedro, Rute; Peleganchuk, Sergey; Pelikan, Daniel; Penc, Ondrej; Peng, Cong; Peng, Haiping; Penwell, John; Peralva, Bernardo; Perego, Marta Maria; Perepelitsa, Dennis; Perez Codina, Estel; Perini, Laura; Pernegger, Heinz; Perrella, Sabrina; Peschke, Richard; Peshekhonov, Vladimir; Peters, Krisztian; Peters, Yvonne; Petersen, Brian; Petersen, Troels; Petit, Elisabeth; Petridis, Andreas; Petridou, Chariclia; Petroff, Pierre; Petrolo, Emilio; Petrov, Mariyan; Petrucci, Fabrizio; Pettersson, Nora Emilia; Peyaud, Alan; Pezoa, Raquel; Phillips, Peter William; Piacquadio, Giacinto; Pianori, Elisabetta; Picazio, Attilio; Piccaro, Elisa; Piccinini, Maurizio; Pickering, Mark Andrew; Piegaia, Ricardo; Pilcher, James; Pilkington, Andrew; 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Zeman, Martin; Zemla, Andrzej; Zeng, Jian Cong; Zeng, Qi; Zengel, Keith; Zenin, Oleg; Ženiš, Tibor; Zerwas, Dirk; Zhang, Dongliang; Zhang, Fangzhou; Zhang, Guangyi; Zhang, Huijun; Zhang, Jinlong; Zhang, Lei; Zhang, Rui; Zhang, Ruiqi; Zhang, Xueyao; Zhang, Zhiqing; Zhao, Xiandong; Zhao, Yongke; Zhao, Zhengguo; Zhemchugov, Alexey; Zhong, Jiahang; Zhou, Bing; Zhou, Chen; Zhou, Lei; Zhou, Li; Zhou, Mingliang; Zhou, Ning; Zhu, Cheng Guang; Zhu, Hongbo; Zhu, Junjie; Zhu, Yingchun; Zhuang, Xuai; Zhukov, Konstantin; Zibell, Andre; Zieminska, Daria; Zimine, Nikolai; Zimmermann, Christoph; Zimmermann, Stephanie; Zinonos, Zinonas; Zinser, Markus; Ziolkowski, Michael; Živković, Lidija; Zobernig, Georg; Zoccoli, Antonio; zur Nedden, Martin; Zwalinski, Lukasz

    2017-05-19

    This paper presents the method and performance of primary vertex reconstruction in proton--proton collision data recorded by the ATLAS experiment during Run 1 of the LHC. The studies presented focus on data taken during 2012 at a centre-of-mass energy of $\\sqrt{s} = 8$ TeV. The performance has been measured as a function of the number of interactions per bunch crossing over a wide range, from one to seventy. The measurement of the position and size of the luminous region and its use as a constraint to improve the primary vertex resolution are discussed. A longitudinal vertex position resolution of about $30 \\mu{\\rm m}$ is achieved for events with high multiplicity of reconstructed tracks. The transverse position resolution is better than $20 \\mu{\\rm m}$ and is dominated by the precision on the size of the luminous region. An analytical model is proposed to describe the primary vertex reconstruction efficiency as a function of the number of interactions per bunch crossing and of the longitudinal size of the lu...

  9. Reconstruction of primary vertices at the ATLAS experiment in Run 1 proton-proton collisions at the LHC.

    Science.gov (United States)

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Tojo, J; Tokár, S; Tokushuku, K; Tolley, E; Tomlinson, L; Tomoto, M; Tompkins, L; Toms, K; Tong, B; Torrence, E; Torres, H; Pastor, E Torró; Toth, J; Touchard, F; Tovey, D R; Trefzger, T; Tricoli, A; Trigger, I M; Trincaz-Duvoid, S; Tripiana, M F; Trischuk, W; Trocmé, B; Trofymov, A; Troncon, C; Trottier-McDonald, M; Trovatelli, M; Truong, L; Trzebinski, M; Trzupek, A; Tseng, J C-L; Tsiareshka, P V; Tsipolitis, G; Tsirintanis, N; Tsiskaridze, S; Tsiskaridze, V; Tskhadadze, E G; Tsui, K M; Tsukerman, I I; Tsulaia, V; Tsuno, S; Tsybychev, D; Tudorache, A; Tudorache, V; Tuna, A N; Tupputi, S A; Turchikhin, S; Turecek, D; Turgeman, D; Turra, R; Turvey, A J; Tuts, P M; Tyndel, M; Ucchielli, G; Ueda, I; Ughetto, M; Ukegawa, F; Unal, G; Undrus, A; Unel, G; Ungaro, F C; Unno, Y; Unverdorben, C; Urban, J; Urquijo, P; Urrejola, P; Usai, G; Usanova, A; Vacavant, L; Vacek, V; Vachon, B; Valderanis, C; Santurio, E Valdes; Valencic, N; Valentinetti, S; Valero, A; Valéry, L; Valkar, S; Vallecorsa, S; Ferrer, J A Valls; Van Den Wollenberg, W; Van Der Deijl, P C; van der Geer, R; van der Graaf, H; van Eldik, N; van Gemmeren, P; Van Nieuwkoop, J; van Vulpen, I; van Woerden, M C; Vanadia, M; Vandelli, W; Vanguri, R; Vaniachine, A; Vankov, P; Vardanyan, G; Vari, R; Varnes, E W; Varol, T; Varouchas, D; Vartapetian, A; Varvell, K E; Vasquez, J G; Vazeille, F; Schroeder, T Vazquez; Veatch, J; Veloce, L M; Veloso, F; Veneziano, S; Ventura, A; Venturi, M; Venturi, N; Venturini, A; Vercesi, V; Verducci, M; Verkerke, W; Vermeulen, J C; Vest, A; Vetterli, M C; Viazlo, O; Vichou, I; Vickey, T; Boeriu, O E Vickey; Viehhauser, G H A; Viel, S; Vigani, L; Vigne, R; Villa, M; Perez, M Villaplana; Vilucchi, E; Vincter, M G; Vinogradov, V B; Vittori, C; Vivarelli, I; Vlachos, S; Vlasak, M; Vogel, M; Vokac, P; Volpi, G; Volpi, M; von der Schmitt, H; von Toerne, E; Vorobel, V; Vorobev, K; Vos, M; Voss, R; Vossebeld, J H; Vranjes, N; Milosavljevic, M Vranjes; Vrba, V; Vreeswijk, M; Vuillermet, R; Vukotic, I; 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Zhu, J; Zhu, Y; Zhuang, X; Zhukov, K; Zibell, A; Zieminska, D; Zimine, N I; Zimmermann, C; Zimmermann, S; Zinonos, Z; Zinser, M; Ziolkowski, M; Živković, L; Zobernig, G; Zoccoli, A; Nedden, M Zur; Zwalinski, L

    2017-01-01

    This paper presents the method and performance of primary vertex reconstruction in proton-proton collision data recorded by the ATLAS experiment during Run 1 of the LHC. The studies presented focus on data taken during 2012 at a centre-of-mass energy of [Formula: see text] TeV. The performance has been measured as a function of the number of interactions per bunch crossing over a wide range, from one to seventy. The measurement of the position and size of the luminous region and its use as a constraint to improve the primary vertex resolution are discussed. A longitudinal vertex position resolution of about [Formula: see text] is achieved for events with high multiplicity of reconstructed tracks. The transverse position resolution is better than [Formula: see text] and is dominated by the precision on the size of the luminous region. An analytical model is proposed to describe the primary vertex reconstruction efficiency as a function of the number of interactions per bunch crossing and of the longitudinal size of the luminous region. Agreement between the data and the predictions of this model is better than 3% up to seventy interactions per bunch crossing.

  10. 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.

  11. Long-term opioid contract use for chronic pain management in primary care practice. A five year experience.

    Science.gov (United States)

    Hariharan, Jaishree; Lamb, Geoffrey C; Neuner, Joan M

    2007-04-01

    The use of opioid medications to manage chronic pain is complex and challenging, especially in primary care settings. Medication contracts are increasingly being used to monitor patient adherence, but little is known about the long-term outcomes of such contracts. To describe the long-term outcomes of a medication contract agreement for patients receiving opioid medications in a primary care setting. Retrospective cohort study. All patients placed on a contract for opioid medication between 1998 and 2003 in an academic General Internal Medicine teaching clinic. Demographics, diagnoses, opiates prescribed, urine drug screens, and reasons for contract cancellation were recorded. The association of physician contract cancellation with patient factors and medication types were examined using the Chi-square test and multivariate logistic regression. A total of 330 patients constituting 4% of the clinic population were placed on contracts during the study period. Seventy percent were on indigent care programs. The majority had low back pain (38%) or fibromyalgia (23%). Contracts were discontinued in 37%. Only 17% were cancelled for substance abuse and noncompliance. Twenty percent discontinued contract voluntarily. Urine toxicology screens were obtained in 42% of patients of whom 38% were positive for illicit substances. Over 60% of patients adhered to the contract agreement for opioids with a median follow-up of 22.5 months. Our experience provides insight into establishing a systematic approach to opioid administration and monitoring in primary care practices. A more structured drug testing strategy is needed to identify nonadherent patients.

  12. [Health workers' experiences in dealing with the neoliberal logic: a study of primary care in Colombia and Brazil].

    Science.gov (United States)

    Garrido-Pinzón, Johanna; Bernardo, Marcia Hespanhol

    2017-09-28

    : The aim of this study was to analyze the experiences of primary healthcare workers in the public health systems in Colombia and Brazil in relation to the neoliberal logic. These two cases are relevant to public health research, as examples of health systems that emerged from opposing guidelines: the Colombian system was created at the government level with a marked private-sector influence, while the Brazilian system was an important conquest by social movements. Based on the Social Psychology of Work, this was a qualitative and empirical study. In-depth reflexive interviews were conducted with two groups of primary healthcare and administrative workers: one in Bucaramanga, Colombia, and the other in Campinas (São Paulo State), Brazil. Content analysis was used in the analytical process. According to the study, in both countries the main experiences of healthcare workers involve the changes in working conditions, relations, and organization. In the Colombian context, we identified the central problems in the transition induced by the reform that established the country's current health system. These problems are expressed in the deterioration of relations with health system users, as well as in the configuration of healthcare teams, marked by conflicting employment arrangements in the healthcare staff. The latter condition also appears in the Brazilian context, as a result of outsourcing, which appears to have become an effective mechanism for undermining the Brazilian Unified National Health System (SUS), facilitating its dismantlement and pointing it in the same direction as the Colombian system.

  13. Robot-assisted radiofrequency ablation of primary and secondary liver tumours: early experience

    Energy Technology Data Exchange (ETDEWEB)

    Abdullah, Basri Johan Jeet [University of Malaya, Department of Biomedical Imaging, Faculty of Medicine, Kuala Lumpur (Malaysia); Yeong, Chai Hong [University of Malaya, University of Malaya Research Imaging Centre, Faculty of Medicine, Kuala Lumpur (Malaysia); Goh, Khean Lee [University of Malaya, Department of Internal Medicine, Faculty of Medicine, Kuala Lumpur (Malaysia); Yoong, Boon Koon [University of Malaya, Department of Surgery, Faculty of Medicine, Kuala Lumpur (Malaysia); Ho, Gwo Fuang [University of Malaya, Department of Oncology, Faculty of Medicine, Kuala Lumpur (Malaysia); Yim, Carolyn Chue Wai [University of Malaya, Department of Anesthesia, Faculty of Medicine, Kuala Lumpur (Malaysia); Kulkarni, Anjali [Perfint Healthcare Corporation, Florence, OR (United States)

    2014-01-15

    Computed tomography (CT)-compatible robots, both commercial and research-based, have been developed with the intention of increasing the accuracy of needle placement and potentially improving the outcomes of therapies in addition to reducing clinical staff and patient exposure to radiation during CT fluoroscopy. In the case of highly inaccessible lesions that require multiple plane angulations, robotically assisted needles may improve biopsy access and targeted drug delivery therapy by avoidance of the straight line path of normal linear needles. We report our preliminary experience of performing radiofrequency ablation of the liver using a robotic-assisted CT guidance system on 11 patients (17 lesions). Robotic-assisted planning and needle placement appears to have high accuracy, is technically easier than the non-robotic-assisted procedure, and involves a significantly lower radiation dose to both patient and support staff. (orig.)

  14. Influence of operator's experience level on lifespan of the WaveOne Primary file in extracted teeth

    Directory of Open Access Journals (Sweden)

    Abdulrahman Mohammed Saleh

    2013-11-01

    Full Text Available Objectives The aim of this study was to assess the influence of operator experience level on the lifespan of the WaveOne Primary file (Dentsply Maillefer, Ballaigues, Switzerland in extracted teeth. Materials and Methods Moderately curved canals of extracted maxillary and mandibular molars were randomly distributed into 2 groups: experienced and inexperienced operators. Ten files were allocated to each group (n = 10. Each canal was prepared until the working length was reached, and the same file was used to prepare additional canals until it separated. The number of canals prepared before file separation was recorded. The fragment length of each file was measured, and the location of the fragment in the canal was determined. Data were statistically analysed using the independent 2-sample t-test. Results The 2 operators prepared a total of 324 moderately curved canals of maxillary and mandibular molars. There was no significant intergroup difference in the mean number of canals prepared (p = 0.27. The average lifespan of the WaveOne Primary file was 17.1 and 15.3 canals, and the longest lifespan was 25 and 20 canals, when used by experienced and inexperienced operators, respectively. There were no statistically significant intergroup differences in separated fragment length and location. Conclusions Within the limitations of this study, operator experience level appears to have no effect on the lifespan of the WaveOne Primary file in preparation of moderately curved canals. Single teeth with multiple canals can be prepared safely even by a novice operator by using a single file.

  15. US primary care physicians' opinions about conscientious refusal: a national vignette experiment.

    Science.gov (United States)

    Brauer, Simon G; Yoon, John D; Curlin, Farr A

    2016-02-01

    Previous research has found that physicians are divided on whether they are obligated to provide a treatment to which they object and whether they should refer patients in such cases. The present study compares several possible scenarios in which a physician objects to a treatment that a patient requests, in order to better characterise physicians' beliefs about what responses are appropriate. We surveyed a nationally representative sample of 1504 US primary care physicians using an experimentally manipulated vignette in which a patient requests a clinical intervention to which the patient's physician objects. We used multivariate logistic regression models to determine how vignette and respondent characteristics affected respondent's judgements. Among eligible respondents, the response rate was 63% (896/1427). When faced with an objection to providing treatment, referring the patient was the action judged most appropriate (57% indicated it was appropriate), while few physicians thought it appropriate to provide treatment despite one's objection (15%). The most religious physicians were more likely than the least religious physicians to support refusing to accommodate the patient's request (38% vs 22%, OR=1.75; 95% CI 1.06 to 2.86). This study indicates that US physicians believe it is inappropriate to provide an intervention that violates one's personal or professional standards. Referring seems to be physicians' preferred way of responding to requests for interventions to which physicians object. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  16. EVALUATION OF TWO SURGICAL TREATMENTS OF PRIMARY VESICOURETERAL REFLUX AMONG CHILDREN: A 15 YEARS EXPERIENCE

    Directory of Open Access Journals (Sweden)

    Memeti Shaban

    2016-07-01

    Full Text Available Aim: aim of the study was to evaluate the efficiency of two different surgical treatments of vesicoureteral reflux (VUR on succesfull rate and patient outcome. Methods: Retrospective study on children with primary VUR and their surgical treatment from 1999 to 2014 in the University Clinic for Pediatric Surgery in Skopje. A total of 76 children (114 ureters with VUR ranging from second to fifth grade were treated surgically, 44 patients (67 ureters with an open surgical technique and 32 patients (47 ureters with endoscopic treatment ”STING” procedure. The following parameters were analyzed: duration of the intervention, duration of the hospitalization, the need for antibiotics and analgesic therapy and the need for blood and blood derivatives transfusion. The result of the surgical treatment was also validated. A good result was considered when reduction of VUR by 2 degrees with the endoscopic method or by 3 degrees in the open surgical technique was noticed. Results: Using open surgical technique, patients were hospitalized for an average of 9 days (range from 5 to 13 days. All children received double antibiotic therapy. The need for analgesics lasted for 3 to 4 days. 90% of treated children needed blood and/or blood derivatives transfusion. Success rate with this method was 93.8%. Endoscopic procedure was performed as a one-day surgical procedure. The average duration was 15 minutes. Single, prophylactic dose of antibiotic was ordinated. There was no need for blood and/or blood derivatives transfusion. The overall success of the treatment was about 70%. Conclusion: Open surgical procedure is used for more complicated cases, VUR grade IV-V or by previously failed. Endoscopic, “STING” procedure was commonly used for patients with VUR grade greater than 2, after previously failed conservative treatment, febrile urinary infection despite antibiotic prophylaxis and/or emergence of new scarring in the renal parenchyma. Patient assessment and

  17. How to integrate social care services into primary health care? An experience from Iran

    Science.gov (United States)

    Montazeri, Ali; Riazi-Isfahani, Sahand; Damari, Behzad

    2016-01-01

    Background: Social issues have prominent effects on the peoples' physical and mental health and on the health risk factors. In Iran, many organizations provide social care services to their target population. This study aimed to explore the roles and functions of Primary Health Care (PHC) system in providing social care services in Iran. Methods: This was a qualitative study, for which data were collected via three sources: A review of the literature, in-depth interviews and focus group discussions with experts and stakeholders. The main objective was to find a way to integrate social care into the Iranian PHC system. A conventional content analysis was performed to explore the data. Results: Overall, 20 experts were interviewed and the acquired data were classified into four major categories including priorities, implementation, requirements and stewardship. The main challenges were the existing controversies in the definition of social care, social service unit disintegration, multiple stewards for social care services, weaknesses of rules and regulations and low financing of the public budget. Social care services can be divided into two categories: Basic and advanced. Urban and rural health centers, as the first level of PHC, could potentially provide basic social care services for their defined population and catchment areas such as detecting social harms in high risk individuals and families and providing counseling for people in need. They can also refer the individuals to receive advanced services. Conclusion: Iran has a successful history of establishing the PHC System especially in rural areas. This network has an invaluable capacity to provide social health services. Establishing these services needs some prerequisites such as a reform PHC structure, macro support and technical intersectoral collaboration. They should also be piloted and evaluated before they could be implemented in the whole country. PMID:27683649

  18. The Measurement of Performance skills of Primary Maternal Child Health Workers - An Indian Experiment

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    Mohanty N

    1994-01-01

    Full Text Available Research Questions: 1. What are the cognitive and psychomotor levels of Anganwadi Workers (AWW regarding important aspects of maternal and child health? 2. Can these skills be improved by training with a self learning communication module? Objectives: (i Identify and evaluate the level of intellectual and practical skills acquired by the AWWs on some areas of primary. health care like : detection of low birth weight (LBW babies, weight of the baby, measurement of body temperature by thermometer, identification of diarrhoea and preparation of ORS, detection of high risk cases and referral. (ii Develop and test a self learning communication module capable of improving the psychomotor domains involved in provision of care. (iii Measure the improvement in the knowledge and specific skill components of the AWWs with the self learning communication module. Design : Intervention study. Setting : Integrated Child Development Scheme Blocks of Varanasi District. Participants : Anganwadi workers belonging to two ICDS Blocks, one was the intervention group and the control group. Study Variable : Self learning communication module. Outcome Variable : Improvement in the cognitive and psychomotor skills of those workers who were administered the module in comparison with the control group. Statistical Analysis : Students ‘t’ test and paired ‘t’ test. Results: There was a significant improvement (p less than 0.001 in the performance skills between the intervention and the control groups. Conclusion: The training modules was effective in improving the overall performance of the workers. However, repeated inservice training is essential to maintain the levels of improvement.

  19. Primary immunodeficiency diseases in children: 15 year experience in a tertiary care medical center in Qatar.

    Science.gov (United States)

    Ehlayel, Mohammad S; Bener, Abdulbari; Laban, Mohammad Abu

    2013-02-01

    Primary immunodeficiency diseases (PID) are a group of heterogeneous, rare, genetic, mainly childhood disorders that affect specific components of immune system leading to serious complications. This study is aimed at describing the prevalence and the categories of PID, the ages of onset and the diagnosis, the clinical presentations, the treatment modalities and the overall outcome of affected patients. A retrospective study was conducted on 131 pediatric patients (aged 0-14 years) diagnosed with PID at Hamad General Hospital during a 15-year period (1998-2012). Data of 131 patients (75 males & 56 females) was analyzed with an estimated prevalence of 4.7 PID patients per 100,000 children younger than 14 years of age. The most common type of PID was predominantly antibody deficiency (23.7 %), followed by other well-defined immunodeficiency syndromes (22.9 %), 19.1 % combined T and B cell immunodeficiency, but rare CVID, and no cases of complement deficiency. The mean onset age was 24.01 months and diagnosis age was 42.2 months. Recurrent infections, particularly pneumonia (48.9 %), failure to thrive (34.4 %), otitis media (26 %), sepsis (23.7 %), and chronic diarrhoea (21.4 %) were commonest presenting conditions. P. aeruginosa (15.7 %), Salmonella species (13.2 %), and Non-TB mycobacteria (13.2 %) were the most common bacterial isolates. The overall mortality rate was 21.4 % with combined immunodeficiency's accounting for 53.4 % of deaths. This study reveals that PIDs are not rare in children in Qatar; and like other studies predominantly antibody deficiencies are the most common. Strategies that reinforce awareness and education of practicing physicians, bone marrow transplantation, and establishing PID national registry should be adopted to reduce mortality and morbidity of PID patients in Qatar.

  20. Rare multiple primary malignancies among surgical patients-a single surgical unit experience.

    Science.gov (United States)

    Carlomagno, Nicola; Santangelo, Michele L; Mastromarino, Rossella; Calogero, Armando; Dodaro, Concetta; Renda, Andrea

    2014-01-01

    A remarkable number of patients presents with multiple primary malignancies (MPM) over their lifetimes. In most cases inherited syndromes, iatrogenic, or viral factors are implicated, while in some cases it is not possible to ascertain a clear aetiopathogenesis. Starting from a series of 315 patients with MPM, we focused our attention on those with extremely infrequent combinations of tumours. We retrospectively analysed patients' characteristics, type of first and second tumour and the interval between the two tumours. We made a comparison between our own data and data from surveillance, epidemiology, and end results cancer registries, the largest global series on this topic. Six patients presented with unusual associations, namely, central nervous system (CNS)/colon, testis/stomach, colon/CNS, CNS/kidney, uterus/soft tissue, and bone/breast. The median age was 50.5 years at the diagnosis of second neoplasm and the male:female ratio was 1:1. All six patients underwent surgery for both tumours. The median interval between the first and the second tumour was 11.3 years (range 1-36 years). Five patients were given chemotherapy as adjuvant systemic treatment, and two of them with CNS tumours also received radiotherapy. We analysed the behaviour of these rare tumours as first and second neoplasms. More frequent combinations and possible aetiological factors were evaluated. Follow-up for patients recovering from a first tumour must be strict, as there is the risk of developing MPM, even after a long time period. Advancement in biomolecular knowledge and cooperation among different specialists are strongly needed to reduce mortality related to MPM and to foresee their occurrence.

  1. Rare multiple primary malignancies among surgical patients—a single surgical unit experience

    Science.gov (United States)

    Carlomagno, Nicola; Santangelo, Michele L; Mastromarino, Rossella; Calogero, Armando; Dodaro, Concetta; Renda, Andrea

    2014-01-01

    Background A remarkable number of patients presents with multiple primary malignancies (MPM) over their lifetimes. In most cases inherited syndromes, iatrogenic, or viral factors are implicated, while in some cases it is not possible to ascertain a clear aetiopathogenesis. Methods Starting from a series of 315 patients with MPM, we focused our attention on those with extremely infrequent combinations of tumours. We retrospectively analysed patients’ characteristics, type of first and second tumour and the interval between the two tumours. We made a comparison between our own data and data from surveillance, epidemiology, and end results cancer registries, the largest global series on this topic. Results Six patients presented with unusual associations, namely, central nervous system (CNS)/colon, testis/stomach, colon/CNS, CNS/kidney, uterus/soft tissue, and bone/breast. The median age was 50.5 years at the diagnosis of second neoplasm and the male:female ratio was 1:1. All six patients underwent surgery for both tumours. The median interval between the first and the second tumour was 11.3 years (range 1–36 years). Five patients were given chemotherapy as adjuvant systemic treatment, and two of them with CNS tumours also received radiotherapy. Discussion We analysed the behaviour of these rare tumours as first and second neoplasms. More frequent combinations and possible aetiological factors were evaluated. Conclusions Follow-up for patients recovering from a first tumour must be strict, as there is the risk of developing MPM, even after a long time period. Advancement in biomolecular knowledge and cooperation among different specialists are strongly needed to reduce mortality related to MPM and to foresee their occurrence. PMID:24966890

  2. Primary Immunodeficiency Diseases in Oman: 10-Year Experience in a Tertiary Care Hospital.

    Science.gov (United States)

    Al-Tamemi, Salem; Naseem, Shafiq Ur Rehman; Al-Siyabi, Nabila; El-Nour, Ibtisam; Al-Rawas, Abdulhakim; Dennison, David

    2016-11-01

    Primary immunodeficiency (PID) diseases are rare, complex medical disorders that often are overlooked in clinical settings. There are emerging reports of PID from Middle Eastern populations. This study describes the features of PID patients in a tertiary care setting in Oman and compares them with regional and worldwide reports. Sultan Qaboos University Hospital (SQUH) is an academic tertiary care-level hospital for specialized healthcare, including PID patients. At the time of diagnosis, patients' sociodemographics, clinical features, laboratory investigations, and management were entered in electronic form. This study included patients seen between August 2005 and July 2015. One hundred forty patients were registered with a minimum estimated population prevalence of 7.0/100,000. The male/female ratio was 1.6:1, the median age of onset of symptoms was 8 months, and diagnosis was 21 months with a delay of 13 months. Family history was positive in 44 %, consanguinity was present in 76 %, death of a previous sibling was present in 36 %, and there was an overall mortality in 18 %, with an 85 % probability of survival 10 years following diagnosis. The most common type of immunodeficiency was phagocytic disorders (35.0 %), followed by predominantly antibody disorders (20.7 %), combined immunodeficiency (17.8 %), other well-defined PID syndromes (15.0 %), immune dysregulation syndromes (3.5 %), complement deficiencies (3.5 %), and unclassified immunodeficiency (4.2 %). The commonest presenting infection was pneumonia (47.1 %). PID is not a rare condition in Oman. The prevalence is in concordance with reports from the region but higher than in Western populations. The findings of the current study would help to improve the awareness and management of, and policy making for PID.

  3. Primary intracranial germ cell tumours: experience of a single South-East Asian institution.

    Science.gov (United States)

    Foo, Aaron S C; Lim, Cindy; Chong, Dawn Q Q; Tan, Daniel Y H; Tham, Chee Kian

    2014-10-01

    Primary intracranial germ cell tumours (ICGCT) are a rare group of brain tumours arising predominantly in the paediatric and pre-adult population, accounting for up to 9.5% of paediatric brain tumours in East Asia. The National Cancer Centre Singapore (NCCS) is a tertiary referral centre for patients from all over South-East Asia. Our study aims to describe the characteristics of ICGCT patients in South-East Asia. Data on all patients with ICGCT who were seen at the Therapeutic Radiology Department of NCCS from 2000 to 2013 were collected retrospectively. Patient demographics, disease characteristics and treatment outcomes were analysed. Characteristics and survival of our patients were similar to other centres. Pure germinomas demonstrated 5 year overall survival (OS) and disease-free survival (DFS) rates of 89.2% (95% confidence interval [CI] 60.2-97.5) and 85.2% (95%CI 60.8-95.0) respectively. Secreting germinomas, non-germinomatous germ cell tumours and mixed germ cell tumours were evaluated together and demonstrated 5 year OS of 70.6% (95%CI 41.0-87.3) and DFS of 61.4% (95%CI 31.9-81.3). Patients ⩽ 12 years had marginally better 5 year OS than their older counterparts (81.0% [95%CI 49.5-93.9] versus 77.9% [95%CI 47.3-92.0], respectively). Patients who underwent extended field radiotherapy had longer OS and DFS than those who received local field irradiation. Treatment outcomes of our ICGCT patients are comparable with those in other Asian and Western centres. Extended field radiotherapy is a pivotal component of ICGCT treatment. Adding chemotherapy confers no extra survival benefit in treating germinomas. Treatment of mixed germ cell tumours and non-germinomatous germ cell tumours involves a multidisciplinary approach that varies for each histological subtype. Copyright © 2014 Elsevier Ltd. All rights reserved.

  4. How to integrate social care services into primary health care? An experience from Iran.

    Science.gov (United States)

    Montazeri, Ali; Riazi-Isfahani, Sahand; Damari, Behzad

    2016-01-01

    Social issues have prominent effects on the peoples' physical and mental health and on the health risk factors. In Iran, many organizations provide social care services to their target population. This study aimed to explore the roles and functions of Primary Health Care (PHC) system in providing social care services in Iran. This was a qualitative study, for which data were collected via three sources: A review of the literature, in-depth interviews and focus group discussions with experts and stakeholders. The main objective was to find a way to integrate social care into the Iranian PHC system. A conventional content analysis was performed to explore the data. Overall, 20 experts were interviewed and the acquired data were classified into four major categories including priorities, implementation, requirements and stewardship. The main challenges were the existing controversies in the definition of social care, social service unit disintegration, multiple stewards for social care services, weaknesses of rules and regulations and low financing of the public budget. Social care services can be divided into two categories: Basic and advanced. Urban and rural health centers, as the first level of PHC, could potentially provide basic social care services for their defined population and catchment areas such as detecting social harms in high risk individuals and families and providing counseling for people in need. They can also refer the individuals to receive advanced services. Iran has a successful history of establishing the PHC System especially in rural areas. This network has an invaluable capacity to provide social health services. Establishing these services needs some prerequisites such as a reform PHC structure, macro support and technical intersectoral collaboration. They should also be piloted and evaluated before they could be implemented in the whole country.

  5. EFFECT OF CARICA PAPAYA L LEAF ON MENSTRUAL PAIN AND PROSTAGLANDIN LEVEL IN ADOLESCENT WITH PRIMARY DYSMENORRHEA: A TRUE EXPERIMENT

    Directory of Open Access Journals (Sweden)

    Siska Nurul Abidah

    2017-07-01

    Full Text Available Background: Primary dysmenorrhea occurs because of the excessive amount of prostaglandins in the blood. Papaya leaf extract is considered to be able to reduce prostaglandin and menstrual pain. Objective: This study aims to prove that papaya leaf extract (Carica Papaya L. can decrease the level of menstrual pain and prostaglandin levels in primary dysmenorrhea. Methods: A true experimental study with randomized pretest posttest control group design. There were 32 samples recruited using simple random sampling, with 16 each assigned to an experiment and control group. Numerical Rating Scale (NRS was used to measure menstrual pain, and the level of prostaglandin was measured using the enzyme-linked immunosorbent assay (ELISA method. Independent t-test and paired t-test were performed for data analysis. Results: There was statistically significant differencec of menstrual pain and prostaglandin level before and after intervention with p-value 0.000 (<0.005, which indiciated that papaya leaf extract had a significant effect on reducing menstrual pain. The decrease of menstrual pain in the experimental group was -3.375 and in the control group was -3.438; while the decrease of prostaglandin level in the experimental group was -56.971 and in the control group was -57.557. Conclusion: Provision of papaya leaf extract (Carica Papaya L. significantly decreased the level of menstrual pain and prostaglandin levels in primary dysmenorrhea. Papaya leaf extract can be used as a safe and effective herbal medicine for primary dysmenorrhoea which has almost the same efficacy as mefenamic acid.

  6. Integration of eye health into primary care services in Tanzania: a qualitative investigation of experiences in two districts.

    Science.gov (United States)

    Jolley, Emma; Mafwiri, Milka; Hunter, Joanna; Schmidt, Elena

    2017-12-13

    Visual impairment is a public health problem in sub-Saharan Africa, affecting nearly 5% of the population. Efforts to combat avoidable causes have been hampered by weak health systems and little evidence exists to suggest what interventions may be effective to improve the situation. Despite this, there are calls to promote some specific interventions, one of which being the closer integration of eye health services into health systems, often focusing on training primary health workers to deliver basic eye health services. This study seeks to understand how eye health services are delivered by primary health workers who have received training and what constraints remain to effective service provision. This was a qualitative investigation into the experiences of 20 primary health workers trained in primary eye care and eight key informants working within specialist eye health services or regional and district health management positions in two districts in Tanzania. Despite feeling confident in their own eye care skills, most primary health workers felt constrained in the services they could provide to their communities by insufficient resources needed for diagnosis and treatment, and by lack of systematic supportive supervision to their work. Specialist ophthalmic staff were aware of this issue, although for the most part they felt it was not within their capacity to remedy and that it fell within the remit of general health managers. Many participants discussed the low support to eye health from the national government, evidenced through the lack of dedicated funding to the area and traditional reliance on outside funds including international charities. Although training of primary health workers is useful, it is recognised that is not sufficient to address the burden of eye health disease present in rural communities in Tanzania. It is likely that broader engagement with the general health system, and most likely with the private sector, will be necessary to

  7. What experience is exchange activity between preschool and primary school for preschool children? : From the analysis of the interview before and after the exchange

    OpenAIRE

    濱田,祥子

    2010-01-01

    There is an exchange activity between preschool and primary school as one of the approaches of preschool and primary school cooperation. The research that searches for an exchange activity from preschool children's aspect is a little. Therefore, this investigation aimed to search what experience exchange activity between preschool and primary school was for preschool children. The interview was executed to preschool children before and after the exchange activity. As a result, it was shown th...

  8. Gaia DR1 documentation

    Science.gov (United States)

    van Leeuwen, F.; de Bruijne, J. H. J.; Arenou, F.; Comoretto, G.; Eyer, L.; Farras Casas, M.; Hambly, N.; Hobbs, D.; Salgado, J.; Utrilla Molina, E.; Vogt, S.; van Leeuwen, M.; Abreu, A.; Altmann, M.; Andrei, A.; Babusiaux, C.; Bastian, U.; Biermann, M.; Blanco-Cuaresma, S.; Bombrun, A.; Borrachero, R.; Brown, A. G. A.; Busonero, D.; Busso, G.; Butkevich, A.; Cantat-Gaudin, T.; Carrasco, J. M.; Castañeda, J.; Charnas, J.; Cheek, N.; Clementini, G.; Crowley, C.; Cuypers, J.; Davidson, M.; De Angeli, F.; De Ridder, J.; Evans, D.; Fabricius, C.; Findeisen, K.; Fleitas, J. M.; Gracia, G.; Guerra, R.; Guy, L.; Helmi, A.; Hernandez, J.; Holl, B.; Hutton, A.; Klioner, S.; Lammers, U.; Lecoeur-Taïbi, I.; Lindegren, L.; Luri, X.; Marinoni, S.; Marrese, P.; Messineo, R.; Michalik, D.; Mignard, F.; Montegriffo, P.; Mora, A.; Mowlavi, N.; Nienartowicz, K.; Pancino, E.; Panem, C.; Portell, J.; Rimoldini, L.; Riva, A.; Robin, A.; Siddiqui, H.; Smart, R.; Sordo, R.; Soria, S.; Turon, C.; Vallenari, A.; Voss, H.

    2017-12-01

    94000 Hipparcos stars in the primary data set, the proper motion standard errors are much smaller, at about 0.06 mas yr^-1. For the secondary astrometric data set, the typical standard error on the positions is 10 mas. The median standard errors on the mean G-band magnitudes range from the milli-magnitude level to 0.03 mag over the magnitude range 5 to 20.7. The DPAC undertook an extensive validation of Gaia DR1 which confirmed that this data release represents a major advance in the mapping of the skies and the availability of basic stellar data that form the foundation of observational astrophysics. However, as a consequence of the very preliminary nature of this first Gaia data release, there are a number of important limitations to the data quality. These limitations are documented in the Astronomy & Astrophysics papers that accompany Gaia DR1, with further information provided in this documentation. The reader is strongly encouraged to read about these limitations and to carefully consider them before drawing conclusions from the data. This Gaia DR1 documentation complements the peer-reviewed papers that accompany the release in a Special Issue of Astronomy & Astrophysics. The papers form the primary documentation for the data release and they are frequently referenced throughout the text.

  9. Patients’ Experiences with Specialist Care via Video Consultation in Primary Healthcare in Rural Areas

    Directory of Open Access Journals (Sweden)

    Annette M. Johansson

    2014-01-01

    Full Text Available Introduction. Video consultation (VC can improve access to specialist care, especially for individuals who live in rural areas that are long distances from specialist clinics. Aim. The aim of this study was to describe patients’ experiences with specialist care via VC encounters. Method. Interviews were conducted with 26 patients who had participated in a VC encounter. The data were analysed using thematic content analysis. Result. The analysis resulted in two themes. The theme “confident with the technology” was constructed from the categories “possibilities and obstacles in using VC encounters” and “advantages and disadvantages of the technology.” The theme “personal satisfaction with the VC encounters” was constructed from the categories “support from the healthcare personnel,” “perceived security,” and “satisfaction with the specialist consultation.” Conclusion. The patients who did not think that the VC was the best care still considered that the visit was adequate because they did not have to travel. An important finding was that the patients’ perceived even short distances to specialty care as expensive journeys because many patients had low incomes. Among the patients who had more than one VC, the second encounter was perceived as safer. Additionally, good communication was essential for the patient’s perception of security during the VC encounter.

  10. Patients' Experiences with Specialist Care via Video Consultation in Primary Healthcare in Rural Areas

    Science.gov (United States)

    Johansson, Annette M.; Lindberg, Inger; Söderberg, Siv

    2014-01-01

    Introduction. Video consultation (VC) can improve access to specialist care, especially for individuals who live in rural areas that are long distances from specialist clinics. Aim. The aim of this study was to describe patients' experiences with specialist care via VC encounters. Method. Interviews were conducted with 26 patients who had participated in a VC encounter. The data were analysed using thematic content analysis. Result. The analysis resulted in two themes. The theme “confident with the technology” was constructed from the categories “possibilities and obstacles in using VC encounters” and “advantages and disadvantages of the technology.” The theme “personal satisfaction with the VC encounters” was constructed from the categories “support from the healthcare personnel,” “perceived security,” and “satisfaction with the specialist consultation.” Conclusion. The patients who did not think that the VC was the best care still considered that the visit was adequate because they did not have to travel. An important finding was that the patients' perceived even short distances to specialty care as expensive journeys because many patients had low incomes. Among the patients who had more than one VC, the second encounter was perceived as safer. Additionally, good communication was essential for the patient's perception of security during the VC encounter. PMID:25243009

  11. Which deceives us more, memories or documents? Experiences of Freinet’s pedagogy in the rural school in the 1970s

    Directory of Open Access Journals (Sweden)

    Tamar Groves

    2010-11-01

    Full Text Available Analyzing classroom practices applied in the 1970s requires the researcher to combine the use of oral and written sources. However, it is not always possible to examine in a systematic way the contribution of each one of them to the investigation. Taking advantage of the existence of both types of sources related to the educative work of the militants of Freinet’s movement, in this article I will try to compare the historical reconstruction based on memories with conclusions founded on the analysis of documents. This comparison is carried out in a very constricted and controllable social context – a couple of rural schools – that allows one to observe in a very clear way how both the memories and the documents can distort or illuminate the phenomenon which interests us: the consequences of the usage of Freint’s pedagogy in the rural school in Salamanca.

  12. The Teacher as Co-Creator of Drama: A Phenomenological Study of the Experiences and Reflections of Irish Primary School Teachers

    Science.gov (United States)

    McDonagh, Fiona; Finneran, Michael

    2017-01-01

    Classroom drama in the Irish primary school context remains a relatively new endeavour and is largely under-researched. The knowledge base for all aspects of teacher education should be informed by rigorous reflection on teachers' experiences in the classroom. This paper reports on a phenomenological study conducted with seven Irish primary school…

  13. Transumbilical laparo-endoscopic single site surgery for adrenal cortical adenoma inducing primary aldosteronism: initial experience

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    Kikuchi Eiji

    2011-09-01

    Full Text Available Abstract Background We have started using laparo-endoscopic single-site surgery (LESS in urologic surgery, although its use has not gained momentum due to its level of difficulty. We here report our initial experience with transumbilical LESS for adrenal cortical adenoma by using a single port with a multichannel cannula (SILS port and bent laparoscopic instrumentation. Findings A multichannel port (SILS port, bent laparoscopic instrument (Roticulator Endo Mini-Shears and Opti4 laparoscopic electrodes were used in all cases. The intraperitoneal space was approached through the umbilicus. The SILS port was placed through a 2 cm incision at the inner edge of the umbilicus. A 5 mm flexible laparoscope was introduced to keep the laparoscope outside, and surgical specimens were extracted using an Endocatch bag. In addition, as a case control study, we compared perioperative data of LESS adrenalectomy (LESS-A with that of conventional laparoscopic adrenalectomy (LA. We performed transumbilical LESS-A for adrenal cortical adenoma in 12 cases, beginning in December, 2009. All procedures were successfully completed, with only one incision through the umbilicus, and without conversion to a standard laparoscopic approach. Mean operative time for LESS-A was 121.2 ± 7.8 min, which was slightly longer than LA (110.2 ± 7.3 min. For right adrenal tumors, we used a miniport (2 mm port in addition to a SILS port, and were able to successfully perform adrenalectomy "with no visible scaring". Tumor laterality and patient BMI did not affect surgical morbidity in these procedures. Moreover, there was no significant difference between LESS-A and LA in blood loss, analgesic requirement, hospital stay, and scar satisfaction. Conclusions The transumbilical approach in LESS for adrenalectomy is safe and feasible and also improves cosmetic outcome compared with standard laparoscopic procedures. Improvements in surgical devices may aid the further development of this

  14. The High Resolution Imaging Science Experiment (HiRISE) during MRO's Primary Science Phase (PSP)

    Science.gov (United States)

    McEwen, A.S.; Banks, M.E.; Baugh, N.; Becker, K.; Boyd, A.; Bergstrom, J.W.; Beyer, R.A.; Bortolini, E.; Bridges, N.T.; Byrne, S.; Castalia, B.; Chuang, F.C.; Crumpler, L.S.; Daubar, I.; Davatzes, A.K.; Deardorff, D.G.; DeJong, A.; Alan, Delamere W.; Dobrea, E.N.; Dundas, C.M.; Eliason, E.M.; Espinoza, Y.; Fennema, A.; Fishbaugh, K.E.; Forrester, T.; Geissler, P.E.; Grant, J. A.; Griffes, J.L.; Grotzinger, J.P.; Gulick, V.C.; Hansen, C.J.; Herkenhoff, K. E.; Heyd, R.; Jaeger, W.L.; Jones, D.; Kanefsky, B.; Keszthelyi, L.; King, R.; Kirk, R.L.; Kolb, K.J.; Lasco, J.; Lefort, A.; Leis, R.; Lewis, K.W.; Martinez-Alonso, S.; Mattson, S.; McArthur, G.; Mellon, M.T.; Metz, J.M.; Milazzo, M.P.; Milliken, R.E.; Motazedian, T.; Okubo, C.H.; Ortiz, A.; Philippoff, A.J.; Plassmann, J.; Polit, A.; Russell, P.S.; Schaller, C.; Searls, M.L.; Spriggs, T.; Squyres, S. W.; Tarr, S.; Thomas, N.; Thomson, B.J.; Tornabene, L.L.; Van Houten, C.; Verba, C.; Weitz, C.M.; Wray, J.J.

    2010-01-01

    The High Resolution Imaging Science Experiment (HiRISE) on the Mars Reconnaissance Orbiter (MRO) acquired 8 terapixels of data in 9137 images of Mars between October 2006 and December 2008, covering ???0.55% of the surface. Images are typically 5-6 km wide with 3-color coverage over the central 20% of the swath, and their scales usually range from 25 to 60 cm/pixel. Nine hundred and sixty stereo pairs were acquired and more than 50 digital terrain models (DTMs) completed; these data have led to some of the most significant science results. New methods to measure and correct distortions due to pointing jitter facilitate topographic and change-detection studies at sub-meter scales. Recent results address Noachian bedrock stratigraphy, fluvially deposited fans in craters and in or near Valles Marineris, groundwater flow in fractures and porous media, quasi-periodic layering in polar and non-polar deposits, tectonic history of west Candor Chasma, geometry of clay-rich deposits near and within Mawrth Vallis, dynamics of flood lavas in the Cerberus Palus region, evidence for pyroclastic deposits, columnar jointing in lava flows, recent collapse pits, evidence for water in well-preserved impact craters, newly discovered large rayed craters, and glacial and periglacial processes. Of particular interest are ongoing processes such as those driven by the wind, impact cratering, avalanches of dust and/or frost, relatively bright deposits on steep gullied slopes, and the dynamic seasonal processes over polar regions. HiRISE has acquired hundreds of large images of past, present and potential future landing sites and has contributed to scientific and engineering studies of those sites. Warming the focal-plane electronics prior to imaging has mitigated an instrument anomaly that produces bad data under cold operating conditions. ?? 2009 Elsevier Inc.

  15. Master's level in primary health care education - students' and preceptors' perceptions and experiences of the alteration in the clinical areas

    Directory of Open Access Journals (Sweden)

    Mamhidir Anna-Greta

    2010-06-01

    Full Text Available Abstract Background Many Western European countries are undergoing reforms with changes in higher education according to the Bologna declaration for Higher European Education Area. In accordance with these changes, the Master's degree was introduced in specialist nurse education in Sweden in 2007, and as a result changed the curriculum and modified theoretical and clinical areas. The aim of this study was to investigate students' and preceptors' perceptions and experiences of Master's level education in primary health care with a focus on the clinical area. Methods A descriptive design and qualitative approach was used. Interviews with ten students and ten preceptors were performed twice, before and after the clinical practice period. Interviews were audio-recorded, transcribed verbatim and themes formulated. Results Students perceived alteration in the content of the education at the Master's level such as more independence and additional assignments. The preceptors perceived benefits with the Master's level but were unsure of how to transform theoretical and abstract knowledge into practice. Writing the Master's thesis was seen by students to take time away from clinical practice. For some students and preceptors the content of the Master's level clinical practice area was experienced as vague and indistinct. The students had not expected supervision to be different from earlier experiences, while preceptors felt higher demands and requested more knowledge. Both students and preceptors perceived that education at the Master's level might lead to a higher status for the nurses' profession in primary health care. Conclusions Students and preceptors experienced both advantages and disadvantages concerning the change in specialist nurse education in primary health care at the Master's level. The altered educational content was experienced as a step forward, but they also questioned how the new knowledge could be used in practice. The relevance of

  16. Master's level in primary health care education - students' and preceptors' perceptions and experiences of the alteration in the clinical areas

    Science.gov (United States)

    2010-01-01

    Background Many Western European countries are undergoing reforms with changes in higher education according to the Bologna declaration for Higher European Education Area. In accordance with these changes, the Master's degree was introduced in specialist nurse education in Sweden in 2007, and as a result changed the curriculum and modified theoretical and clinical areas. The aim of this study was to investigate students' and preceptors' perceptions and experiences of Master's level education in primary health care with a focus on the clinical area. Methods A descriptive design and qualitative approach was used. Interviews with ten students and ten preceptors were performed twice, before and after the clinical practice period. Interviews were audio-recorded, transcribed verbatim and themes formulated. Results Students perceived alteration in the content of the education at the Master's level such as more independence and additional assignments. The preceptors perceived benefits with the Master's level but were unsure of how to transform theoretical and abstract knowledge into practice. Writing the Master's thesis was seen by students to take time away from clinical practice. For some students and preceptors the content of the Master's level clinical practice area was experienced as vague and indistinct. The students had not expected supervision to be different from earlier experiences, while preceptors felt higher demands and requested more knowledge. Both students and preceptors perceived that education at the Master's level might lead to a higher status for the nurses' profession in primary health care. Conclusions Students and preceptors experienced both advantages and disadvantages concerning the change in specialist nurse education in primary health care at the Master's level. The altered educational content was experienced as a step forward, but they also questioned how the new knowledge could be used in practice. The relevance of the Master's thesis was

  17. Master's level in primary health care education - students' and preceptors' perceptions and experiences of the alteration in the clinical areas.

    Science.gov (United States)

    Löfmark, Anna; Mamhidir, Anna-Greta

    2010-06-16

    Many Western European countries are undergoing reforms with changes in higher education according to the Bologna declaration for Higher European Education Area. In accordance with these changes, the Master's degree was introduced in specialist nurse education in Sweden in 2007, and as a result changed the curriculum and modified theoretical and clinical areas. The aim of this study was to investigate students' and preceptors' perceptions and experiences of Master's level education in primary health care with a focus on the clinical area. A descriptive design and qualitative approach was used. Interviews with ten students and ten preceptors were performed twice, before and after the clinical practice period. Interviews were audio-recorded, transcribed verbatim and themes formulated. Students perceived alteration in the content of the education at the Master's level such as more independence and additional assignments. The preceptors perceived benefits with the Master's level but were unsure of how to transform theoretical and abstract knowledge into practice. Writing the Master's thesis was seen by students to take time away from clinical practice. For some students and preceptors the content of the Master's level clinical practice area was experienced as vague and indistinct. The students had not expected supervision to be different from earlier experiences, while preceptors felt higher demands and requested more knowledge. Both students and preceptors perceived that education at the Master's level might lead to a higher status for the nurses' profession in primary health care. Students and preceptors experienced both advantages and disadvantages concerning the change in specialist nurse education in primary health care at the Master's level. The altered educational content was experienced as a step forward, but they also questioned how the new knowledge could be used in practice. The relevance of the Master's thesis was questioned. Supervision was seen by students

  18. Experience-dependent emergence of beta and gamma band oscillations in the primary visual cortex during the critical period.

    Science.gov (United States)

    Chen, Guang; Rasch, Malte J; Wang, Ran; Zhang, Xiao-hui

    2015-12-09

    Neural oscillatory activities have been shown to play important roles in neural information processing and the shaping of circuit connections during development. However, it remains unknown whether and how specific neural oscillations emerge during a postnatal critical period (CP), in which neuronal connections are most substantially modified by neural activity and experience. By recording local field potentials (LFPs) and single unit activity in developing primary visual cortex (V1) of head-fixed awake mice, we here demonstrate an emergence of characteristic oscillatory activities during the CP. From the pre-CP to CP, the peak frequency of spontaneous fast oscillatory activities shifts from the beta band (15-35 Hz) to the gamma band (40-70 Hz), accompanied by a decrease of cross-frequency coupling (CFC) and broadband spike-field coherence (SFC). Moreover, visual stimulation induced a large increase of beta-band activity but a reduction of gamma-band activity specifically from the CP onwards. Dark rearing of animals from the birth delayed this emergence of oscillatory activities during the CP, suggesting its dependence on early visual experience. These findings suggest that the characteristic neuronal oscillatory activities emerged specifically during the CP may represent as neural activity trait markers for the experience-dependent maturation of developing visual cortical circuits.

  19. Autism and primary care dentistry: parents' experiences of taking children with autism or working diagnosis of autism for dental examinations.

    Science.gov (United States)

    Thomas, Nicole; Blake, Sharon; Morris, Christopher; Moles, David R

    2017-10-26

    Accessing and receiving preventative dental treatment can be difficult for children with autism due to sensory processing disorders and/or challenging behaviours coupled with a reported reluctance by dentists to treat these children. To gather dental experiences of UK parents of children with autism or working diagnosis of autism and explore how they feel primary care dental services can be improved. A total of 17 parents of children with a diagnosis or working diagnosis of autism took part in semi-structured interviews. Data were analysed thematically. Key themes identified were flexibility of the dental team and environment, confidence of the parents to advocate for their children's needs, continuity of services and clear referral pathways to specialist services. Cross-cutting all themes was the value of clear communication. The experiences provide greater understanding of issues such as hyper-empathy, the dental chair, challenges of the waiting room, perceived medical authority, and the importance of continuation of care. In line with previous research about the importance of family-centred care, a strong relationship between parents and the whole dental team is essential for children with autism to access dental examinations and have satisfactory experience of care. © 2017 BSPD, IAPD and John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  20. Everolimus as primary immunosuppression in kidney transplantation: experience in conversion from calcineurin inhibitors.

    Science.gov (United States)

    Sánchez-Fructuoso, Ana I; Ruiz, Juan C; Calvo, Natividad; Rodrigo, Emilio; Perez-Flores, Isabel; Gómez-Alamillo, Carlos; Fernández-Pérez, Cristina; Arias, Manuel; Barrientos, Alberto

    2012-02-27

    We analyzed our clinical experience with everolimus (EVL) and identified prognostic factors for a successful conversion. Retrospective study of 220 kidney recipients consecutively converted to EVL with calcineurin inhibitor elimination. We studied risk factors for proteinuria at 1 year after conversion, decline in renal function, and graft survival. Baseline creatinine clearance was 52.4±17.8 mL/min vs. 53.4±20.1 mL/min 1 year after conversion (P=0.150). Median proteinuria increased from 304 mg/day (interquartile range 160-507) to 458 mg/day (interquartile range 238-892; Pproteinuria ≥900 mg/day (P75) at 1-year postconversion were creatinine clearance less than 60 mL/min (odds ratio [OR] 3.37; 95% confidence interval [CI]: 1.15-9.89), serum triglycerides ≥150 mg/day (OR 4.35; 95% CI: 1.70-11.17), no treatment with prednisone (OR 3.04; 95% CI: 1.22-7.59), baseline proteinuria ≥550 mg/day (OR 10.37; 95% CI: 3.99-26.99), and conversion ≥3 years after transplant (OR 5.77; 95% CI: 1.89-17.59). An interaction was observed between baseline proteinuria and time to conversion: in patients with baseline proteinuria ≥550 mg/day, the risk of developing proteinuria ≥900 mg/day was 77.1% if they were converted after ≥3 years posttransplant. However, this risk was 29.8% in the subgroup converted before (P=0.02). Actuarial graft survival at 1 and 4 years postconversion was 98.2% and 86.5%, respectively. Baseline proteinuria ≥550 mg/day was a risk factor for graft loss in patients converted after the third year but not in patients converted before this time. EVL discontinuation rate was 24% in the first year postconversion. Conversion to EVL and elimination of calcineurin inhibitors is safe. Success depends on not making late conversions and not converting patients with high baseline proteinuria.

  1. Primary School Teachers' Understanding of Science Process Skills in Relation to Their Teaching Qualifications and Teaching Experience

    Science.gov (United States)

    Shahali, Edy H. M.; Halim, Lilia; Treagust, David F.; Won, Mihye; Chandrasegaran, A. L.

    2017-04-01

    This study investigated the understanding of science process skills (SPS) of 329 science teachers from 52 primary schools selected by random sampling. The understanding of SPS was measured in terms of conceptual and operational aspects of SPS using an instrument called the Science Process Skills Questionnaire (SPSQ) with a Cronbach's alpha reliability of 0.88. The findings showed that the teachers' conceptual understanding of SPS was much weaker than their practical application of SPS. The teachers' understanding of SPS differed by their teaching qualifications but not so much by their teaching experience. Emphasis needs to be given to both conceptual and operational understanding of SPS during pre-service and in-service teacher education to enable science teachers to use the skills and implement inquiry-based lessons in schools.

  2. MANAGEMENT COMPETENCES IN AN EMERGENCY SITUATION IN PRIMARY CARE: EXPERIENCE OF A NURSING CURRICULUM ORIENTED BY COMPETENCE

    Directory of Open Access Journals (Sweden)

    Luís Carlos Lopes-Júnior

    2013-09-01

    Full Text Available This study aimed to report the experience of last year undergraduate nursing students from Brazilian college pioneer in the use of active teaching-learning methods, in emergency care to a patient in primary care. This assistance which was methodologically problematized triggered by health team, comprised of nurse, physician, nursing assistants and community health worker, a reflection on the organization of the work process. To this end, we used permanent education as a tool guided by the Altadir Method Popular Planning, which contributed to the development of management competence of nurse. A team of health identified problems during assistance, analyzed its causes and consequences, and proposed interventions for the management and organization of the work process to qualify this practice. This report can be useful for the design and implementation of a management exercise that aims to problematize the reality, with a view to linking theory and practice.

  3. Experiences of doctors and nurses implementing nurse-delivered cardiovascular prevention in primary care: a qualitative study.

    Science.gov (United States)

    Voogdt-Pruis, Helene R; Beusmans, George H M I; Gorgels, Anton P M; van Ree, Jan W

    2011-08-01

    This paper reports on a study of the experiences of general practitioners and practice nurses implementing nurse-delivered cardiovascular prevention to high risk patients in primary care. Difficulties may arise when innovations are introduced into routine daily practice. Whether or not implementation is successful is determined by different factors related to caregivers, patients, type of innovation and context. A qualitative study nested in a randomized trial (2006-2008) to evaluate the effectiveness of nurse-delivered cardiovascular prevention. Six primary health care centres in the Netherlands (25 general practitioners, 6 practice nurses) participated in the trial. Interviews were held on two occasions: at 3 and at 18 months after commencement of consultation. The first occasion was a group interview with six practice nurses. The second consisted of semi-structured interviews with one general practitioner and one practice nurse from each centre. Main barriers to the implementation included: lack of knowledge about the guideline, attitudes towards treatment targets, lack of communication, insufficient coaching by doctors, content of life style advice. At the start of the consultation project, practice nurses expressed concern of losing nursing tasks. Other barriers were related to patients (lack of motivation), the guideline (target population) and organizational issues (insufficient patient recording and computer systems). Both general practitioners and practice nurses were positive about nurse-delivered cardiovascular prevention in primary care. Nurses could play an important role in successive removal of barriers to implementation of cardiovascular prevention. Mutual confidence between care providers in the healthcare team is necessary. © 2011 The Authors. Journal of Advanced Nursing © 2011 Blackwell Publishing Ltd.

  4. Experiences of primary health care nurses in implementing integrated management of childhood illnesses strategy at selected clinics of Limpopo Province.

    Science.gov (United States)

    Vhuromu, E N; Davhana-Maselesele, M

    2009-09-01

    Treatment of the under five years is a national priority as an attempt in curbing deaths and deformities affecting children. Primary health care was implemented in the clinics in order to help in the treatment of illnesses affecting the community, including children. As a result of childhood illnesses; the World Health Organization (WHO) and United Nation Children's Fund (UNICEF) came up with Integrated Management of Childhood illnesses (IMCI) strategy to enhance treatment of such illnesses in developing countries. Primary health care nurses (PHCNS) in Limpopo Province were also trained to implement the strategy. This study is intended to explore and describe the experiences of PHCNS in implementing the IMCI strategy at selected clinics in Vhembe District in the Limpopo Province. A qualitative, explorative, descriptive and contextual design was used. In-depth interviews were conducted with PHCNS who are IMCI trained and have implemented the strategy for a period of not less than two years. Data analysis was done through using Tesch 's method of open coding for qualitative analysis. Findings revealed that PHCNS had difficulty in rendering IMCI services due to lack of resources and poor working conditions. Recommendations address the difficulties experienced by PHCNS when implementing the IMCI strategy.

  5. Yoga - a laborious way to well-being: patients' experiences of yoga as a treatment for hypertension in primary care.

    Science.gov (United States)

    Wolff, Moa; Brorsson, Annika; Midlöv, Patrik; Sundquist, Kristina; Strandberg, Eva Lena

    2017-12-01

    The aim of the study was to describe patients' experience of yoga as a treatment for hypertension, as well as their experience of living with hypertension. Qualitative interview study Method and materials: In 2013-2014, in southern Sweden, patients with hypertension from three health care centres were invited to participate in a randomised controlled trial on yoga for hypertension. After completion of the study, eight women and five men (aged 35-79), who had practiced the yoga intervention, were interviewed about their experiences. We used a semi-structured interview guide according to Kvale. Qualitative analysis was conducted by systematic text condensation inspired by Malterud. Two main themes emerged during the analysis process: Yoga - a laborious way to well-being and hypertension - a silent disease. The positive experiences of doing yoga were described in terms of tranquillity and increased agility. The drawbacks were mainly linked to the time required to perform the exercises. Living with high blood pressure and having to take medication can imply a stigma and cause concerns for future cardiovascular events. Most patients that we interviewed expressed a wish to find alternative ways to treat their high blood pressure. Participating in the yoga study was seen as a good possibility to try such an alternative way. Many patients with hypertension in Swedish primary care seem to be interested in trying alternative treatments to control blood pressure. The patients in our study experienced several benefits from doing yoga, but they also pointed out difficulties in implementing yoga as a regular and permanent lifestyle change.

  6. Do patients prefer mesh or anterior colporrhaphy for primary correction of anterior vaginal wall prolapse: a labelled discrete choice experiment.

    Science.gov (United States)

    Notten, K J B; Essers, B A; Weemhoff, M; Rutten, A G H; Donners, J J A E; van Gestel, I; Kruitwagen, R F P M; Roovers, J P W R; Dirksen, C D

    2015-05-01

    We investigated patients' preferences for anterior colporrhaphy or mesh surgery as surgical correction of anterior vaginal wall prolapse. Labelled discrete choice experiment. Three Dutch teaching hospitals. Women with anterior vaginal wall prolapse Pelvic Organ Prolapse Quantification stage 2 or more, indicated for anterior colporrhaphy (n = 100). Discrete choice experiments are an attribute-based survey method for measuring preferences. In this experiment, women were asked to choose between two treatment scenarios, mesh surgery or anterior colporrhaphy. These surgical treatments differed in four treatment attributes: (i) recurrence rate, (ii) exposure rate, (iii) infection rate, (iv) dyspareunia. Data were analysed using a multinomial logit model. Women's preferences for anterior colporrhaphy or mesh surgery for the repair of vaginal wall prolapse. All treatment attributes, i.e. recurrence, exposure, infection and dyspareunia, proved to be significant in the woman's decision to choose mesh surgery (P experiment, anterior colporrhaphy was preferred in 74% as a primary correction of anterior vaginal wall prolapse, followed by a preference for mesh in 26% of all choices. This study showed that next to the risk of recurrence, other aspects like risk of infection, dyspareunia and exposure play a role in the woman's preference for a surgical treatment. In addition, our results indicate that anterior colporrhaphy is preferred in the majority of the choices, followed by a preference for mesh surgery in a quarter of all choice sets. However, these results represent the average preference of a sample of women and cannot be taken as the preference of each individual. In the medical decision-making context, information from the current study should be personalised to fit patient's unique circumstances. For patients to construct their own, individual preferences, they should be well informed about the existence and magnitude of the potential benefits and risks related to

  7. I'd rather they did Experiments with us…. Than just Talking: Irish Children's Views of Primary School Science

    Science.gov (United States)

    Murphy, Clíona; Varley, Janet; Veale, Órlaith

    2012-06-01

    This paper reports on a national study that explored primary pupils' attitudes towards and experiences of school science in the Republic of Ireland. The study focussed on collecting data from children and in doing so recognises the importance of children's views as an essential part of reviewing curriculum implementation. The findings of this large-scale study are based on an analysis of data gathered from observations of 15 primary classrooms, 1,149 children's questionnaires and 11 group interviews. In this paper the findings regarding the extent to which the children appear to be engaging in `deductive' (didactic) and `inductive' (inquiry-based) approaches in their science classes, and their attitudes towards school science are presented. Encouragingly, evidence from all parts of the study revealed that in general Irish children are very positive towards learning science in school and are being provided with some opportunities to engage in hands-on inquiry in science, commonly via group work. However, there were also indications that, for some pupils, hands-on science experiences were infrequent, and for a few did not appear to be happening at all. It was not especially evident that pupils were being afforded opportunities to lead their own scientific investigations. Teacher explanation, teacher demonstration, reading and writing featured frequently in pupils' responses and while the pupils expressed mixed feelings about these methodologies, one thing was apparent: hands-on inquiry based approaches to science had far greater appeal to the children. The significance of the findings of this study are considered in light of the findings and recommendations from recent national and international reports on inquiry-based approaches in science education.

  8. The influence of registered nurses and nurse practitioners on patient experience with primary care: results from the Canadian QUALICO-PC study.

    Science.gov (United States)

    Ammi, Mehdi; Ambrose, Sarah; Hogg, Bill; Wong, Sabrina

    2017-12-01

    Nurses, whether registered nurses (RNs) or nurse practitioners (NPs), are becoming key providers of primary care services. While evidence for the influence of NPs on patient experience in primary care is mounting, this is less so for RNs. We use the Canadian component of the international Quality and Costs of Primary Care 2013/14 survey to investigate the mechanisms by which nurses can affect patients' experience in primary care, focusing on accessibility and appropriateness of care. The data allow us to distinguish between family practice RNs, specialised RNs and NPs, and covers all types of patients visiting a primary care clinic in a variety of contexts in all Canadian provinces. In addition to the types of nurses and full-time equivalent (FTE) numbers, we explore the role of nurse autonomy and collaboration. Our regression results show that one of the most important predictors of patient experience is the collaboration between health professionals, whereas nurse staffing in terms of FTE numbers has little influence by itself. Different types of nurses influence different dimensions of accessibility, and the association between patient experience and nurse staffing depends on the number of physicians in the clinic. Our results can inform decision-makers on how to strengthen primary care provision, and particularly in Canadian context, the adaptation of the recently implemented interprofessional primary care teams. Copyright © 2017 Elsevier B.V. All rights reserved.

  9. Informative document waste plastics

    NARCIS (Netherlands)

    Nagelhout D; Sein AA; Duvoort GL

    1989-01-01

    This "Informative document waste plastics" forms part of a series of "informative documents waste materials". These documents are conducted by RIVM on the indstruction of the Directorate General for the Environment, Waste Materials Directorate, in behalf of the program of

  10. Informative document packaging waste

    NARCIS (Netherlands)

    Joosten JM; Nagelhout D; Duvoort GL; Weerd M de

    1989-01-01

    This "informative document packaging waste" forms part of a series of "informative documents waste materials". These documents are conducted by RIVM on the instructions of the Direcotrate General for the Environment, Waste Materials Directorate, in behalf of the program of

  11. Experiences and Attitudes of Primary Care Providers Under the First Year of ACA Coverage Expansion: Findings from the Kaiser Family Foundation/Commonwealth Fund 2015 National Survey of Primary Care Providers.

    Science.gov (United States)

    2015-06-01

    A new survey from The Kaiser Family Foundation and The Commonwealth Fund asked primary care providers--physicians, nurse practitioners, and physician assistants--about their views of and experiences with the Affordable Care Act (ACA) and other changes in health care delivery and payment, as well as their thoughts on the future of primary care. In this first brief based on the survey, many providers reported seeing an increased number of patients since the coverage expansions went into effect, but not an accompanying compromise in quality of care. A large majority of primary care providers are satisfied with their medical practice, but a substantial percentage of physicians expressed pessimism about the future of primary care. Similar to the population overall, providers' views of the ACA are divided along party lines. A second brief will report on providers' reactions to other changes occurring in primary care delivery and payment.

  12. Transition of care: experiences and preferences of patients across the primary/secondary interface – a qualitative study

    Directory of Open Access Journals (Sweden)

    Dekker Janny H

    2009-04-01

    Full Text Available Abstract Background Coordination between care providers of different disciplines is essential to improve the quality of care, in particular for patients with chronic diseases. The way in which general practitioners (GP's and medical specialists interact has important implications for any healthcare system in which the GP plays the role of gatekeeper to specialist care. Patient experiences and preferences have proven to be increasingly important in discussing healthcare policy. The Dutch government initiated the development of a special website with information for patients on performance indicators of hospitals as well as information on illness or treatment. In the present study we focus on the transition of care at the primary – secondary interface with reference to the impact of patients' ability to make choices about their secondary care providers. The purpose of this study is to (a explore experiences and preferences of patients regarding the transition between primary and secondary care, (b study informational resources on illness/treatment desired by patients and (c determine how information supplied could make it easier for the patient to choose between different options for care (hospital or specialist. Methods We conducted a qualitative study using semi-structured focus group interviews among 71 patients referred for various indications in the north and west of The Netherlands. Results Patients find it important that they do not have to wait, that they are taken seriously, and receive adequate and individually relevant information. A lack of continuity from secondary to primary care was experienced. The patient's desire for free choice of type of care did not arise in any of the focus groups. Conclusion Hospital discharge information needs to be improved. The interval between discharge from specialist care and the report of the specialist to the GP might be a suitable performance indicator in healthcare. Patients want to receive

  13. Undergraduate dental sudents' perspectives about experiences in primary care for their education in the field of health

    Directory of Open Access Journals (Sweden)

    Pedro Augusto Thiene Leme

    2015-04-01

    Full Text Available Supervised training periods in primary care have been used as spaces for teaching and extension in the area of health, making it feasible to include undergraduates in concrete teaching-learning scenarios. The aim of this study was to analyze the perceptions of dental students about the importance of supervised training periods in Family Health Units to their professional education. The sample consisted of 185 students who answered the question: What is your opinion about the importance of this training period in SUS to your professional education? Comment on this experience and its positive and negative aspects The responses were analyzed by the quali-quantitative Collective Subject Discourse (CSD technique. The students appreciated learning through practice in the service; contact with professionals from other areas; opportunity for technical-operative improvement and demonstrated sensitivity in the face of social reality, although they appeared to be concerned about being absent from the faculty, arguing that they were being prejudiced as regards their intramural clinical productivity, exhaustively demanded of them. It was concluded that students placed value on the extramural experience, however, it was perceived that there was still a predominant influence of focus on intramural clinical training.

  14. Experiences of Fast Queue health care users in primary health care facilities in eThekwini district, South AfricaExperiences of Fast Queue health care users in primary health care facilities in eThekwini district, South Africa

    Directory of Open Access Journals (Sweden)

    Dudu G. Sokhela

    2013-07-01

    Full Text Available Background: Comprehensive Primary Health Care (PHC, based on the principles of accessibility, availability, affordability, equity and acceptability, was introduced in South Africa to address inequalities in health service provision. Whilst the Fast Queue was instrumental in the promotion of access to health care, a major goal of the PHC approach, facilities were not prepared for the sudden influx of clients. Increased access resulted in long waiting times and queues contributing to dissatisfaction with the service which could lead to missed appointments and non-compliance with established treatment plans.Objectives: Firstly to describe the experiences of clients using the Fast Queue strategy to access routine healthcare services and secondly, to determine how the clients’ experiences led to satisfaction or dissatisfaction with the Fast Queue service.Method: A descriptive qualitative survey using content analysis explored the experiences of the Fast Queue users in a PHC setting. Setting was first identified based on greatest number using the Fast Queue and geographic diversity and then a convenience sample of health care users of the Fast Queue were sampled individually along with one focus group of users who accessed the Queue monthly for medication refills. The same interview guide questions were used for both individual interviews and the one focus group discussion. Five clinics with the highest number of attendees during a three month period and a total of 83 health care users of the Fast Queue were interviewed. The average participant was female, 31 years old, single and unemployed.Results: Two themes with sub-themes emerged: health care user flow and communication, which highlights both satisfaction and dissatisfaction with the fast queue and queue marshals, could assist in directing users to the respective queues, reduce waiting time and keep users satisfied with the use of sign posts where there is a lack of human resources

  15. Using diaries to explore the work experiences of primary health care nursing managers in two South African provinces

    Directory of Open Access Journals (Sweden)

    Pascalia O. Munyewende

    2014-12-01

    Full Text Available Background: South Africa is on the brink of another wave of major health system reforms that underscore the centrality of primary health care (PHC. Nursing managers will play a critical role in these reforms. Objective: The aim of the study was to explore the work experiences of PHC clinic nursing managers through the use of reflective diaries, a method hitherto under-utilised in health systems research in low- and middle-income countries. Design: During 2012, a sub-set of 22 PHC nursing managers was selected randomly from a larger nurses’ survey in two South African provinces. After informed consent, participants were requested to keep individual diaries for a period of 6 weeks, using a clear set of diary entry guidelines. Reminders consisted of weekly short message service reminders and telephone calls. Diary entries were analysed using thematic content analysis. A diary feedback meeting was held with all the participants to validate the findings. Results: Fifteen diaries were received, representing a 68% response rate. The majority of respondents (14/15 were female, each with between 5 and 15 years of nursing experience. Most participants made their diary entries at home. Diaries proved to be cathartic for individual nursing managers. Although inter-related and not mutually exclusive, the main themes that emerged from the diary analysis were health system deficiencies; human resource challenges; unsupportive management environment; leadership and governance; and the emotional impact of clinic management. Conclusions: Diaries are an innovative method of capturing the work experiences of managers at the PHC level, as they allow for confidentiality and anonymity, often not possible with other qualitative research methods. The expressed concerns of nursing managers must be addressed to ensure the success of South Africa's health sector reforms, particularly at the PHC level.

  16. Automated document analysis system

    Science.gov (United States)

    Black, Jeffrey D.; Dietzel, Robert; Hartnett, David

    2002-08-01

    A software application has been developed to aid law enforcement and government intelligence gathering organizations in the translation and analysis of foreign language documents with potential intelligence content. The Automated Document Analysis System (ADAS) provides the capability to search (data or text mine) documents in English and the most commonly encountered foreign languages, including Arabic. Hardcopy documents are scanned by a high-speed scanner and are optical character recognized (OCR). Documents obtained in an electronic format bypass the OCR and are copied directly to a working directory. For translation and analysis, the script and the language of the documents are first determined. If the document is not in English, the document is machine translated to English. The documents are searched for keywords and key features in either the native language or translated English. The user can quickly review the document to determine if it has any intelligence content and whether detailed, verbatim human translation is required. The documents and document content are cataloged for potential future analysis. The system allows non-linguists to evaluate foreign language documents and allows for the quick analysis of a large quantity of documents. All document processing can be performed manually or automatically on a single document or a batch of documents.

  17. Pollution from mining in South Greenland: Uptake and release of Pb by blue mussels (Mytilus edulis L.) documented by transplantation experiments

    DEFF Research Database (Denmark)

    Zimmer, L.A.; Asmund, G.; Johansen, P.

    2011-01-01

    Long-term impact of former mining activities on the marine sub-Arctic ecosystem in the Ivittuut area, Arsuk Fjord, South Greenland, was studied by transplantation experiments with the blue mussel Mytilus edulis. Measurements of metal concentration in mussels were conducted using atomic absorption...

  18. Scholars in the Humanities Are Reluctant to Cite E-Texts as Primary Materials. A Review of: Sukovic, S. (2009. References to e-texts in academic publications. Journal of Documentation, 65(6, 997-1015.

    Directory of Open Access Journals (Sweden)

    Deena Yanofsky

    2011-03-01

    collections as well as ‘electronically born’ documents, works of art and popular culture artifacts. Of the 22 works resulting from the research projects examined during the study period, half did not cite e-texts as primary materials. The 11 works that made at least one reference to an e-text included 4 works in which the only reference was to e-texts created by the actual author. In total, only 7 works referred to e-texts created by outside authors. These 7 final works were written by 5 participants, representing 31 percent of the total number of study participants.Analysis of the participants’ citation practices revealed that decisions to cite an electronic source or omit it from publication were based on two important factors: (1 the perceived trustworthiness of an e-text and (2 a sense of what was acceptable practice.Participants established trustworthiness through a process of verification. To confirm the authenticity and reliability of an e-text, most participants compared electronic documents against a print version to verify provenance, context, and details. Even when digitized materials were established as trustworthy sources, however, hard copies were often cited because they were considered more authoritative or accurate.Traditions of a particular discipline also had a strong influence on a participant’s willingness to cite e-texts. Participants working on traditional historical topics were more reluctant to cite electronic resources, while researchers who worked on topics that explored relatively new fields were more willing to acknowledge the use of e-texts in published works. Traditional practices also influenced participants’ decisions about how to cite materials. Some participants always cited original works in hard copy, regardless of electronic access because it was accepted scholarly practice.Conclusions – The results of this study suggest that the small number of citations to electronic sources in publications in the humanities is directly

  19. Continuing Professional Development of physiotherapists based in community primary care trusts: a qualitative study investigating perceptions, experiences and outcomes.

    Science.gov (United States)

    Gunn, Hilary; Goding, Lois

    2009-09-01

    To provide an insight into individual physiotherapists' experiences of Continuing Professional Development (CPD), and to gain an understanding of the challenges of undertaking CPD in a geographically dispersed primary healthcare setting. A qualitative phenomenological methodology using a one-to-one semi-structured interview technique to achieve an in-depth exploration of this complex area of study. Data analysis was conducted by data transcription, immersion, coding and generation of themes using a pragmatic five-step process. Eleven participants were identified from a study population of physiotherapists working in two local primary care trusts following the principle of maximum variation sampling. Four main themes emerged: CPD processes; motivation for undertaking CPD; enabling CPD; and outcomes of CPD. Participants felt that CPD should include a range of activities and learning behaviours. However, there was a preference for active learning styles and formal course-based learning. Engagement in reflective practice and portfolio keeping was generally poor, with participants identifying lack of skills in these areas. Factors motivating CPD engagement included a strong sense of professional obligation and wishing to provide the best possible service to patients. There was frustration over the impact of external issues including political and organisational change on CPD, and anxiety over forthcoming regulatory changes affecting physiotherapy. The study also identified issues around CPD planning and needs identification. There was evidence of change in individuals' practice and internal perceptions as outcomes of CPD, although issues around the application and maintenance of change were identified. There is evidence that CPD has an effect on clinical practice in this small group of physiotherapists working in community National Health Service settings. Significantly, undertaking CPD improves confidence as well as competence, enabling individuals to form effective

  20. Primary crustal melt compositions: Insights into the controls, mechanisms and timing of generation from kinetics experiments and melt inclusions

    Science.gov (United States)

    Acosta-Vigil, Antonio; London, David; Morgan, George B.; Cesare, Bernardo; Buick, Ian; Hermann, Jörg; Bartoli, Omar

    2017-08-01

    We explore the controls, mechanisms and timing of generation of primary melts and their compositions, and show that the novel studies of melt inclusions in migmatites can provide important insights into the processes of crustal anatexis of a particular rock. Partial melting in the source region of granites is dependent on five main processes: (i) supply of heat; (ii) mineral-melt interface reactions associated with the detachment and supply of mineral components to the melt, (iii) diffusion in the melt, (iv) diffusion in minerals, and (v) recrystallization of minerals. As the kinetics of these several processes vary over several orders of magnitude, it is essential to evaluate in Nature which of these processes control the rate of melting, the composition of melts, and the extent to which residue-melt chemical equilibrium is attained under different circumstances. To shed light on these issues, we combine data from experimental and melt inclusion studies. First, data from an extensive experimental program on the kinetics of melting of crustal protoliths and diffusion in granite melt are used to set up the necessary framework that describes how primary melt compositions are established during crustal anatexis. Then, we use this reference frame and compare compositional trends from experiments with the composition of melt inclusions analyzed in particular migmatites. We show that, for the case of El Hoyazo anatectic enclaves in lavas, the composition of glassy melt inclusions provides important information on the nature and mechanisms of anatexis during the prograde suprasolidus history of these rocks, including melting temperatures and reactions, and extent of melt interconnection, melt homogenization and melt-residue equilibrium. Compositional trends in several of the rehomogenized melt inclusions in garnet from migmatites/granulites in anatectic terranes are consistent with diffusion in melt-controlled melting, though trace element compositions of melt inclusions

  1. 4.5 years of experience with an electronic patient record system at the University of Munich: PADS (Patient Archiving & Documentation System).

    Science.gov (United States)

    Hohnloser, J H; Pürner, F; Dusek, R; Zitek, M

    1995-01-01

    We demonstrate an Ethernet based local area network (LAN) with clinical workstations (Apple Macintosh). The patient archiving and documentation system (PADS) represents a computerized patient record system presently used in a university hospital's ICU, CCU, and oncology unit [1]. Since 1990, over 100 users have documented more than 6,000 patient admissions, equaling 30% of all inpatient admission in our hospital. Taking full advantage of the macintosh based graphical user interface (GUI), our system enables nurses and doctors to perform the following tasks: admission, medical history taking, physical examination, generation of problem lists and follow up notes, access to laboratory data and reports, and the semiautomatic generation of a discharge summary including full word processor capabilities. Furthermore, the system offers rapid, consistent, and complete automatic encoding of diagnoses following the International Classification of Disease (ICD - 9 CM; WHO). The system has links to other educational programs such as cardiac auscultation and image analysis. A MEDLINE literature search through a CD-ROM based system can be performed from within the system. CD-ROM based medical textbooks can be accessed as well. Users can customize their working environment and use any commercially available macintosh programs from within the main application. Additional options include: automatic background monitoring of users learning behavior, analyses and graphical display of numerous epidemiological, and healthcare related problems. Furthermore, sound and digital video can be recorded in our system. E had initially developed a relational database 4GL development tool in the rapid prototyping phase, and have since completed the next step of development: rewriting the complete application using C++ and Oracle. The user interface has hardly changed, maintaining the "look & feel" of the initial application and introducing the performance of a professional relational database

  2. Experiences of a student-run clinic in primary care: a mixed-method study with students, patients and supervisors.

    Science.gov (United States)

    Fröberg, Maria; Leanderson, Charlotte; Fläckman, Birgitta; Hedman-Lagerlöf, Erik; Björklund, Karin; Nilsson, Gunnar H; Stenfors, Terese

    2018-03-01

    To explore how a student-run clinic (SRC) in primary health care (PHC) was perceived by students, patients and supervisors. A mixed methods study. Clinical learning environment, supervision and nurse teacher evaluation scale (CLES + T) assessed student satisfaction. Client satisfaction questionnaire-8 (CSQ-8) assessed patient satisfaction. Semi-structured interviews were conducted with supervisors. Gustavsberg PHC Center, Stockholm County, Sweden. Students in medicine, nursing, physiotherapy, occupational therapy and psychology and their patients filled in questionnaires. Supervisors in medicine, nursing and physiotherapy were interviewed. Mean values and medians of CLES + T and CSQ-8 were calculated. Interviews were analyzed using content analysis. A majority of 199 out of 227 student respondents reported satisfaction with the pedagogical atmosphere and the supervisory relationship. Most of the 938 patient respondents reported satisfaction with the care given. Interviews with 35 supervisors showed that the organization of the SRC provided time and support to focus on the tutorial assignment. Also, the pedagogical role became more visible and targeted toward the student's individual needs. However, balancing the student's level of autonomy and the own control over care was described as a challenge. Many expressed the need for further pedagogical education. High student and patient satisfaction reported from five disciplines indicate that a SRC in PHC can be adapted for heterogeneous student groups. Supervisors experienced that the SRC facilitated and clarified their pedagogical role. Simultaneously their need for continuous pedagogical education was highlighted. The SRC model has the potential to enhance student-centered tuition in PHC. Key Points Knowledge of student-run clinics (SRCs) as learning environments within standard primary health care (PHC) is limited. We report experiences from the perspectives of students, their patients and supervisors

  3. Ranking documents with a thesaurus.

    Science.gov (United States)

    Rada, R; Bicknell, E

    1989-09-01

    This article reports on exploratory experiments in evaluating and improving a thesaurus through studying its effect on retrieval. A formula called DISTANCE was developed to measure the conceptual distance between queries and documents encoded as sets of thesaurus terms. DISTANCE references MeSH (Medical Subject Headings) and assesses the degree of match between a MeSH-encoded query and document. The performance of DISTANCE on MeSH is compared to the performance of people in the assessment of conceptual distance between queries and documents, and is found to simulate with surprising accuracy the human performance. The power of the computer simulation stems both from the tendency of people to rely heavily on broader-than (BT) relations in making decisions about conceptual distance and from the thousands of accurate BT relations in MeSH. One source for discrepancy between the algorithms' measurement of closeness between query and document and people's measurement of closeness between query and document is occasional inconsistency in the BT relations. Our experiments with adding non-BT relations to MeSH showed how these non-BT non-BT relations to MeSH showed how these non-BT relations could improve document ranking, if DISTANCE were also appropriately revised to treat these relations differently from BT relations.

  4. Experiences of Fast Queue health care users in primary health care facilities in eThekwini district, South Africa

    Directory of Open Access Journals (Sweden)

    Dudu G. Sokhela

    2013-01-01

    Full Text Available Background: Comprehensive Primary Health Care (PHC, based on the principles of accessibility, availability, affordability, equity and acceptability, was introduced in South Africa to address inequalities in health service provision. Whilst the Fast Queue was instrumental in the promotion of access to health care, a major goal of the PHC approach, facilities were not prepared for the sudden influx of clients. Increased access resulted in long waiting times and queues contributing to dissatisfaction with the service which could lead to missed appointments and non-compliance with established treatment plans. Objectives: Firstly to describe the experiences of clients using the Fast Queue strategy to access routine healthcare services and secondly, to determine how the clients’ experiences led to satisfaction or dissatisfaction with the Fast Queue service.Method: A descriptive qualitative survey using content analysis explored the experiences of the Fast Queue users in a PHC setting. Setting was first identified based on greatest number using the Fast Queue and geographic diversity and then a convenience sample of health care users of the Fast Queue were sampled individually along with one focus group of users who accessed the Queue monthly for medication refills. The same interview guide questions were used for both individual interviews and the one focus group discussion. Five clinics with the highest number of attendees during a three month period and a total of 83 health care users of the Fast Queue were interviewed. The average participant was female, 31 years old, single and unemployed.Results: Two themes with sub-themes emerged: health care user flow and communication, which highlights both satisfaction and dissatisfaction with the fast queue and queue marshals, could assist in directing users to the respective queues, reduce waiting time and keep users satisfied with the use of sign posts where there is a lack of human resources

  5. Experiences of Fast Queue health care users in primary health care facilities in eThekwini district, South Africa.

    Science.gov (United States)

    Sokhela, Dudu G; Makhanya, Nonhlanhla J; Sibiya, Nokuthula M; Nokes, Kathleen M

    2013-07-05

    Comprehensive Primary Health Care (PHC), based on the principles of accessibility, availability, affordability, equity and acceptability, was introduced in South Africa to address inequalities in health service provision. Whilst the Fast Queue was instrumental in the promotion of access to health care, a major goal of the PHC approach, facilities were not prepared for the sudden influx of clients. Increased access resulted in long waiting times and queues contributing to dissatisfaction with the service which could lead to missed appointments and non-compliance with established treatment plans. Firstly to describe the experiences of clients using the Fast Queue strategy to access routine healthcare services and secondly, to determine how the clients' experiences led to satisfaction or dissatisfaction with the Fast Queue service. A descriptive qualitative survey using content analysis explored the experiences of the Fast Queue users in a PHC setting. Setting was first identified based on greatest number using the Fast Queue and geographic diversity and then a convenience sample of health care users of the Fast Queue were sampled individually along with one focus group of users who accessed the Queue monthly for medication refills. The same interview guide questions were used for both individual interviews and the one focus group discussion. Five clinics with the highest number of attendees during a three month period and a total of 83 health care users of the Fast Queue were interviewed. The average participant was female, 31 years old, single and unemployed. Two themes with sub-themes emerged: health care user flow and communication, which highlights both satisfaction and dissatisfaction with the fast queue and queue marshals, could assist in directing users to the respective queues, reduce waiting time and keep users satisfied with the use of sign posts where there is a lack of human resources. Effective health communication strategies contribute to positive

  6. [Video documentation in forensic practice].

    Science.gov (United States)

    Schyma, C; Schyma, P

    1995-01-01

    The authors report in part 1 about their experiences with the Canon Ex1 Hi camcorder and the possibilities of documentation with the modern video technique. Application examples in legal medicine and criminalistics are described autopsy, scene, reconstruction of crimes etc. The online video documentation of microscopic sessions makes the discussion of findings easier. The use of video films for instruction produces a good resonance. The use of the video documentation can be extended by digitizing (Part 2). Two frame grabbers are presented, with which we obtained good results in digitizing of images captured from video. The best quality of images is achieved by online use of an image analysis chain. Corel 5.0 and PicEd Cora 4.0 allow complete image processings and analysis. The digital image processing influences the objectivity of the documentation. The applicabilities of image libraries are discussed.

  7. "I just have to move on": Women's coping experiences and reflections following their first year after primary breast cancer surgery.

    Science.gov (United States)

    Drageset, Sigrunn; Lindstrøm, Torill Christine; Underlid, Kjell

    2016-04-01

    The purpose of this qualitative follow-up study was to describe women's individual coping experiences and reflections following their first year after primary breast cancer surgery. Using a qualitative descriptive design, we collected data through individual interviews with ten women at a Norwegian university hospital between August 2007 and April 2008. We employed Kvale's method of qualitative meaning condensation analysis. Themes identified were: existential concerns and finding meaning, ways of thinking and feeling about the disease, taking action, and returning to normal life. Most women experienced an increased appreciation of life and greater confidence in themselves, were more caring and compassionate towards others, and focused more on their life priorities. Their family and close relationships became more important. They accepted their situation and made the best of it. Positive thinking, physical activity, self-care, nature, hobbies and work helped. Generally, they were optimistic despite a fear of cancer recurrence and uncertainty about their future. The women wanted to return to a "normal" and healthy life by distancing themselves from both the cancer environment and information about cancer. Uncertainty and anxiety about a potential future cancer relapse was a major undercurrent one year following surgery. Our findings emphasize the richness in these women's coping strategies, their different coping profiles and different needs, as well as some general adaptive strategies, which all fluctuated over time. Not all managed to cope equally well. Through awareness of these women's individual experiences and coping strategies, healthcare professionals can enhance these women's coping endeavours. Copyright © 2015 Elsevier Ltd. All rights reserved.

  8. People and teams matter in organizational change: professionals' and managers' experiences of changing governance and incentives in primary care.

    Science.gov (United States)

    Allan, Helen T; Brearley, Sally; Byng, Richard; Christian, Sara; Clayton, Julie; Mackintosh, Maureen; Price, Linnie; Smith, Pam; Ross, Fiona

    2014-02-01

    To explore the experiences of governance and incentives during organizational change for managers and clinical staff. Three primary care settings in England in 2006-2008. Data collection involved three group interviews with 32 service users, individual interviews with 32 managers, and 56 frontline professionals in three sites. The Realistic Evaluation framework was used in analysis to examine the effects of new policies and their implementation. Integrating new interprofessional teams to work effectively is a slow process, especially if structures in place do not acknowledge the painful feelings involved in change and do not support staff during periods of uncertainty. Eliciting multiple perspectives, often dependent on individual occupational positioning or place in new team configurations, illuminates the need to incorporate the emotional as well as technocratic and system factors when implementing change. Some suggestions are made for facilitating change in health care systems. These are discussed in the context of similar health care reform initiatives in the United States. © Health Research and Educational Trust.

  9. People and Teams Matter in Organizational Change: Professionals’ and Managers’ Experiences of Changing Governance and Incentives in Primary Care

    Science.gov (United States)

    Allan, Helen T; Brearley, Sally; Byng, Richard; Christian, Sara; Clayton, Julie; Mackintosh, Maureen; Price, Linnie; Smith, Pam; Ross, Fiona

    2014-01-01

    ObjectivesTo explore the experiences of governance and incentives during organizational change for managers and clinical staff. Study SettingThree primary care settings in England in 2006–2008. Study DesignData collection involved three group interviews with 32 service users, individual interviews with 32 managers, and 56 frontline professionals in three sites. The Realistic Evaluation framework was used in analysis to examine the effects of new policies and their implementation. Principal FindingsIntegrating new interprofessional teams to work effectively is a slow process, especially if structures in place do not acknowledge the painful feelings involved in change and do not support staff during periods of uncertainty. ConclusionsEliciting multiple perspectives, often dependent on individual occupational positioning or place in new team configurations, illuminates the need to incorporate the emotional as well as technocratic and system factors when implementing change. Some suggestions are made for facilitating change in health care systems. These are discussed in the context of similar health care reform initiatives in the United States. PMID:23829292

  10. Non-Aqueous Primary Li-Air Flow Battery and Optimization of its Cathode through Experiment and Modeling.

    Science.gov (United States)

    Kim, Byoungsu; Takechi, Kensuke; Ma, Sichao; Verma, Sumit; Fu, Shiqi; Desai, Amit; Pawate, Ashtamurthy S; Mizuno, Fuminori; Kenis, Paul J A

    2017-09-22

    A primary Li-air battery has been developed with a flowing Li-ion free ionic liquid as the recyclable electrolyte, boosting power capability by promoting superoxide diffusion and enhancing discharge capacity through separately stored discharge products. Experimental and computational tools are used to analyze the cathode properties, leading to a set of parameters that improve the discharge current density of the non-aqueous Li-air flow battery. The structure and configuration of the cathode gas diffusion layers (GDLs) are systematically modified by using different levels of hot pressing and the presence or absence of a microporous layer (MPL). These experiments reveal that the use of thinner but denser MPLs is key for performance optimization; indeed, this leads to an improvement in discharge current density. Also, computational results indicate that the extent of electrolyte immersion and porosity of the cathode can be optimized to achieve higher current density. © 2017 Wiley-VCH Verlag GmbH & Co. KGaA, Weinheim.

  11. PrEP Awareness, Familiarity, Comfort, and Prescribing Experience among US Primary Care Providers and HIV Specialists.

    Science.gov (United States)

    Petroll, Andrew E; Walsh, Jennifer L; Owczarzak, Jill L; McAuliffe, Timothy L; Bogart, Laura M; Kelly, Jeffrey A

    2017-05-01

    HIV pre-exposure prophylaxis (PrEP) was FDA approved in 2012, but uptake remains low. To characterize what would facilitate health care providers' increased PrEP prescribing, we conducted a 10-city, online survey of 525 primary care providers (PCPs) and HIV providers (HIVPs) to assess awareness, knowledge, and experience with prescribing PrEP; and, comfort with and barriers to PrEP-related activities. Fewer PCPs than HIVPs had heard of PrEP (76 vs 98%), felt familiar with prescribing PrEP (28 vs. 76%), or had prescribed it (17 vs. 64%). PCPs were less comfortable than HIVPs with PrEP-related activities such as discussing sexual activities (75 vs. 94%), testing for acute HIV (83 vs. 98%), or delivering a new HIV diagnosis (80 vs. 95%). PCPs most frequently identified limited knowledge about PrEP and concerns about insurance coverage as prescribing barriers. PCPs and HIVPs differ in needs that will facilitate their PrEP prescribing. Efforts to increase PrEP uptake will require interventions to increase the knowledge, comfort, and skills of providers to prescribe PrEP.

  12. The challenge of contributing to policy making in primary care: the gendered experiences and strategies of nurses.

    Science.gov (United States)

    Hughes, Alison

    2010-11-01

    This paper explores nurses' experiences as members of primary care organisations set up to develop and commission health services for local communities. Nurses, alongside GPs and other health professionals, were given a place on the governing bodies (boards) of Local Health Groups - a move widely welcomed by the nursing profession as long overdue recognition of the important contribution nurses and nursing could bring to the policy arena. Nurse board members faced a number of challenges in their attempts to contribute to and influence local health policy. This ethnographic study (which involved non-participant observation of 33 board meetings and interviews with 29 board members including nurses) suggests that medical authority and control, and hierarchical power relations between doctors and nurses on the board, were seen by nurses as significant obstacles to their participation in this new policy arena. In response to their perceived lack of power and subordinate status, nurses employed a number of strategies to negotiate their participation as board members - these included 'getting it right', 'achieving the right balance', 'self-presentation' and 'unassertiveness'. These strategies reflected and reproduced gendered identities and relations of power and raise important questions regarding the influence of nurses and nursing within policy making. © 2010 The Author. Sociology of Health & Illness © 2010 Foundation for the Sociology of Health & Illness/Blackwell Publishing Ltd.

  13. Registration document 2005; Document de reference 2005

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2005-07-01

    This reference document of Gaz de France provides information and data on the Group activities in 2005: financial informations, business, activities, equipments factories and real estate, trade, capital, organization charts, employment, contracts and research programs. (A.L.B.)

  14. 2002 reference document; Document de reference 2002

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2002-07-01

    This 2002 reference document of the group Areva, provides information on the society. Organized in seven chapters, it presents the persons responsible for the reference document and for auditing the financial statements, information pertaining to the transaction, general information on the company and share capital, information on company operation, changes and future prospects, assets, financial position, financial performance, information on company management and executive board and supervisory board, recent developments and future prospects. (A.L.B.)

  15. Multiple Irradiation Capsule Experiment (MICE)-3B Irradiation Test of Space Fuel Specimens in the Advanced Test Reactor (ATR) - Close Out Documentation for Naval Reactors (NR) Information

    Energy Technology Data Exchange (ETDEWEB)

    M. Chen; CM Regan; D. Noe

    2006-01-09

    Few data exist for UO{sub 2} or UN within the notional design space for the Prometheus-1 reactor (low fission rate, high temperature, long duration). As such, basic testing is required to validate predictions (and in some cases determine) performance aspects of these fuels. Therefore, the MICE-3B test of UO{sub 2} pellets was designed to provide data on gas release, unrestrained swelling, and restrained swelling at the upper range of fission rates expected for a space reactor. These data would be compared with model predictions and used to determine adequacy of a space reactor design basis relative to fission gas release and swelling of UO{sub 2} fuel and to assess potential pellet-clad interactions. A primary goal of an irradiation test for UN fuel was to assess performance issues currently associated with this fuel type such as gas release, swelling and transient performance. Information learned from this effort may have enabled use of UN fuel for future applications.

  16. Documentation and knowledge acquisition

    Science.gov (United States)

    Rochowiak, Daniel; Moseley, Warren

    1990-01-01

    Traditional approaches to knowledge acquisition have focused on interviews. An alternative focuses on the documentation associated with a domain. Adopting a documentation approach provides some advantages during familiarization. A knowledge management tool was constructed to gain these advantages.

  17. Web document engineering

    Energy Technology Data Exchange (ETDEWEB)

    White, B.

    1996-05-01

    This tutorial provides an overview of several document engineering techniques which are applicable to the authoring of World Wide Web documents. It illustrates how pre-WWW hypertext research is applicable to the development of WWW information resources.

  18. Subject (of documents)

    DEFF Research Database (Denmark)

    Hjørland, Birger

    2017-01-01

    such as concepts, aboutness, topic, isness and ofness are also briefly presented. The conclusion is that the most fruitful way of defining “subject” (of a document) is the documents informative or epistemological potentials, that is, the documents potentials of informing users and advance the development......This article presents and discuss the concept “subject” or subject matter (of documents) as it has been examined in library and information science (LIS) for more than 100 years. Different theoretical positions are outlined and it is found that the most important distinction is between document......-oriented views versus request-oriented views. The document-oriented view conceive subject as something inherent in documents, whereas the request-oriented view (or the policy based view) understand subject as an attribution made to documents in order to facilitate certain uses of them. Related concepts...

  19. Historical Documents Modernization

    Directory of Open Access Journals (Sweden)

    Domingo Miguel

    2017-06-01

    Full Text Available Historical documents are mostly accessible to scholars specialized in the period in which the document originated. In order to increase their accessibility to a broader audience and help in the preservation of the cultural heritage, we propose a method to modernized these documents. This method is based in statistical machine translation, and aims at translating historical documents into a modern version of their original language. We tested this method in two different scenarios, obtaining very encouraging results.

  20. Gully monitoring at two locations in the Grand Canyon National Park, Arizona, 1996-2010, with emphasis on documenting effects of the March 2008 high-flow experiment

    Science.gov (United States)

    Schott, Nathan D.; Hazel, Joseph E.; Fairley, Helen C.; Kaplinski, Matt; Parnell, Roderic A.

    2014-01-01

    Many archeological sites in the Grand Canyon are being impacted by gully incision. In March 2008, a high-flow experiment (2008 HFE) was conducted with the intention of redistributing fine sediment (sand, silt, and clay) from the bed of the Colorado River to higher elevations along the channel margin. Deposition of fine sediment in gully mouths has been hypothesized to slow gully erosion rates and lessen impacts to archeological sites. The effects of the 2008 HFE on gullies were evaluated by comparing the topographic changes of three gullies at two study sites before and after the 2008 HFE. Comparison results indicated that sediment was deposited in gully mouths during the 2008 HFE, and that the inundated areas nearest to the river can be extensively altered by mainstream flow during high-flow events. Additionally, the history of gully evolution at the two study sites was examined between 1996 and 2010 and indicated that gullies have been subjected to thalweg incision and gully widening processes over a decadal timescale. Although the small sample size precludes extrapolating the results to other gullies, the findings contribute to the understanding of gully erosion in archeologically significant areas and have implications for future monitoring of gully erosion and evaluating the effectiveness of check dams intended to mitigate that erosion at archaeological sites in the Grand Canyon National Park.

  1. Scheme Program Documentation Tools

    DEFF Research Database (Denmark)

    Nørmark, Kurt

    2004-01-01

    This paper describes and discusses two different Scheme documentation tools. The first is SchemeDoc, which is intended for documentation of the interfaces of Scheme libraries (APIs). The second is the Scheme Elucidator, which is for internal documentation of Scheme programs. Although the tools...

  2. Dinitrogen fixation and dissolved organic nitrogen fueled primary production and particulate export during the VAHINE mesocosm experiment (New Caledonia lagoon)

    Science.gov (United States)

    Berthelot, H.; Moutin, T.; L'Helguen, S.; Leblanc, K.; Hélias, S.; Grosso, O.; Leblond, N.; Charrière, B.; Bonnet, S.

    2015-07-01

    In the oligotrophic ocean characterized by nitrate (NO3-) depletion in surface waters, dinitrogen (N2) fixation and dissolved organic nitrogen (DON) can represent significant nitrogen (N) sources for the ecosystem. In this study, we deployed large in situ mesocosms in New Caledonia in order to investigate (1) the contribution of N2 fixation and DON use to primary production (PP) and particle export and (2) the fate of the freshly produced particulate organic N (PON), i.e., whether it is preferentially accumulated and recycled in the water column or exported out of the system. The mesocosms were fertilized with phosphate (PO43-) in order to prevent phosphorus (P) limitation and promote N2 fixation. The diazotrophic community was dominated by diatom-diazotroph associations (DDAs) during the first part of the experiment for 10 days (P1) followed by the unicellular N2-fixing cyanobacteria UCYN-C for the last 9 days (P2) of the experiment. N2 fixation rates averaged 9.8 ± 4.0 and 27.7 ± 8.6 nmol L-1 d-1 during P1 and P2, respectively. NO3- concentrations ( 0.05) during P1 (9.0 ± 3.3 %) and P2 (12.6 ± 6.1 %). However, the e ratio that quantifies the efficiency of a system to export particulate organic carbon (POCexport) compared to PP (e ratio = POCexport/PP) was significantly higher (p sustained by UCYN-C was more efficient at promoting C export than the production sustained by DDAs. During P1, PON was stable and the total amount of N provided by N2 fixation (0.10 ± 0.02 μmol L-1) was not significantly different (p > 0.05) from the total amount of PON exported (0.10 ± 0.04 μmol L-1), suggesting a rapid and probably direct export of the recently fixed N2 by the DDAs. During P2, both PON concentrations and PON export increased in the mesocosms by a factor 1.5-2. Unlike in P1, this PON production was not totally explained by the new N provided by N2 fixation. The use of DON, whose concentrations decreased significantly (p < 0.05) from 5.3 ± 0.5 μmol L-1 to 4.4

  3. Dinitrogen fixation and dissolved organic nitrogen fueled primary production and particulate export during the VAHINE mesocosms experiment (New Caledonia lagoon)

    Science.gov (United States)

    Berthelot, H.; Moutin, T.; L'Helguen, S.; Leblanc, K.; Hélias, S.; Grosso, O.; Leblond, N.; Charrière, B.; Bonnet, S.

    2015-03-01

    In the oligotrophic ocean characterized by nitrate (NO3-) depletion in surface waters, dinitrogen (N2) fixation and dissolved organic nitrogen (DON) can represent significant nitrogen (N) sources for the ecosystem. Here we deployed in New Caledonia large in situ mesocosms in order to investigate (1) the contribution of N2 fixation and DON use to primary production (PP) and particle export and (2) the fate of the freshly produced particulate organic N (PON) i.e. whether it is preferentially accumulated and recycled in the water column or exported out of the system. The mesocosms were fertilized with phosphate (P) in order to prevent P-limitation and promote N2 fixation. The diazotrophic community was dominated by diatoms-diazotrophs associations (DDAs) during the first part of the experiment for 10 days (P1) followed by the unicellular N2-fixing cyanobacteria UCYN-C the 9 last days (P2) of the experiment. N2 fixation rates averaged 9.8 ± 4.0 and 27.7 ± 8.6 nM d-1 during P1 and P2, respectively. NO3- concentrations ( 0.05) during P1 (9.0 ± 3.3%) and P2 (12.6 ± 6.1%). However, the e ratio that quantifies the efficiency of a system to export particulate organic carbon (POCexport) compared to PP (e ratio = POCexport/PP) was significantly higher (p sustained by UCYN-C was more efficient at promoting C export than the production sustained by DDAs. During P1, PON was stable and the total amount of N provided by N2 fixation (0.10 ± 0.02 μM) was not significantly different (p > 0.05) from the total amount of PON exported (0.10 ± 0.04 μM), suggesting a rapid and probably direct export of the recently fixed N2 by the DDAs. During P2, both PON concentrations and PON export increased in the mesocosms by a factor 1.5-2. Unlike in P1, this PON production was not totally explained by the new N provided by N2 fixation. The use of DON, whose concentrations decreased significantly (p < 0.05) from 5.3 ± 0.5 μM to 4.4 ± 0.5 μM, appeared to be the missing N source. The DON

  4. Adopting electronic medical records in primary care: lessons learned from health information systems implementation experience in seven countries.

    Science.gov (United States)

    Ludwick, D A; Doucette, John

    2009-01-01

    The adoption of health information systems is seen world wide as one method to mitigate the widening health care demand and supply gap. The purpose of this review was to identify the current state of knowledge about health information systems adoption in primary care. The goal was to understand factors and influencers affecting implementation outcomes from previous health information systems implementations experiences. A comprehensive systematic literature review of peer reviewed and grey literature was undertaken to identify the current state of knowledge regarding the implementation of health information systems. A total of 6 databases, 27 journal websites, 20 websites from grey sources, 9 websites from medical colleges and professional associations as well as 22 government/commission websites were searched. The searches returned almost 3700 article titles. Eighty-six articles met our inclusion and exclusion criteria. Articles show that systems' graphical user interface design quality, feature functionality, project management, procurement and users' previous experience affect implementation outcomes. Implementers had concerns about factors such as privacy, patient safety, provider/patient relations, staff anxiety, time factors, quality of care, finances, efficiency, and liability. The review showed that implementers can insulate the project from such concerns by establishing strong leadership, using project management techniques, establishing standards and training their staff to ensure such risks do not compromise implementation success. The review revealed the concept of socio-technical factors, or "fit" factors, that complicate health information systems deployment. The socio-technical perspective considers how the technical features of a health information system interact with the social features of a health care work environment. The review showed that quality of care, patient safety and provider/patient relations were not, positively or negatively

  5. Ethics Issues of Digital Contents for Pre-Service Primary Teachers: A Gamification Experience for Self-Assessment with Socrative

    Directory of Open Access Journals (Sweden)

    Adolfina Pérez-Garcias

    2016-09-01

    Full Text Available The knowledge society has brought many possibilities for open education practices and, simultaneously, deep ethical challenges related to the use, sharing and reuse of digital content. In fact, even at university level, many undergraduate students do not respect the licences of digital resources. As part of the contents of a third-year educational technology course for primary teacher training at the University of the Balearic Islands (Spain, prospective teachers learned about these ethics issues. During the 2015/16 academic year, 125 pre-service teachers from two groups of this course were involved in a gamification experience, using Socrative in real-time in the classroom, in which they had to answer different questions related to digital ethics. Its aim was not only to find out what they knew before working directly with the topic – an initial self-assessment – but also to arouse interest and encourage dynamic participation and interaction. At the end of the course, the participants answered a questionnaire in which they were asked about their perceptions of the use of this kind of educational strategy and their transfer in the future. Data were also collected from the same Socrative quiz and the final exam results related to digital ethics. Overall, the assessment from pre-service teachers was highly positive, as well as the scores of the questions related to digital ethics in the final test, and the conclusions of this study highlight both the importance of using more interactive educational strategies in the classroom and the need for training on digital ethics issues in teacher studies.

  6. Early experience with the Incisionless Operating Platform™ (IOP) for the treatment of obesity : the Primary Obesity Surgery Endolumenal (POSE) procedure.

    Science.gov (United States)

    Espinós, J C; Turró, R; Mata, A; Cruz, M; da Costa, M; Villa, V; Buchwald, J N; Turró, J

    2013-09-01

    We report our initial experience and 6-month outcomes in a single center using the per-oral Incisionless Operating Platform™ (IOP) (USGI Medical) to place transmural plications in the gastric fundus and distal body using specialized suture anchors (the Primary Obesity Surgery Endolumenal [POSE] procedure). A prospective observational study was undertaken with institutional Ethics Board approval in a private hospital in Barcelona, Spain. Indicated patients were WHO obesity class I-II, or III, where patients refused a surgical approach. Between February 28, 2011 and March 23, 2012, the POSE procedure was successfully performed in 45 patients: 75.6 % female; mean age 43.4 ± 9.2 SD (range 21.0-64.0). At baseline: mean absolute weight (AW, kg), 100.8 ± 12.9 (75.5-132.5); body mass index (BMI, kg/m(2)), 36.7 ± 3.8 (28.1-46.6). A mean 8.2 suture-anchor plications were placed in the fundus, 3.0 along the distal body wall. Mean operative time, 69.2 ± 26.6 min (32.0-126.0); patients were discharged in treatment by discharge. Patients reported less hunger and earlier satiety post procedure. Liquid intake began 12 h post procedure with full solids by 6 weeks. At 6-month follow-up of a prospective case series, the POSE procedure appeared to provide safe and effective weight loss without the scarring, pain, and recovery issues of open and laparoscopic bariatric surgery. Long-term follow-up and further study are required.

  7. Injection of Compressed Diced Cartilage in the Correction of Secondary and Primary Rhinoplasty: A New Technique with 12 Years' Experience.

    Science.gov (United States)

    Erol, O Onur

    2017-11-01

    There are instances where small or large pockets are filled with diced cartilage in the nose, without use of wrapping materials. For this purpose, 1-cc commercial syringes were used. The obtained results were partial and incomplete. For better and improved results, the author designed new syringes, with two different sizes, which compress the diced cartilage for injection. The author presents his experience accrued over the past 12 years with 2366 primary, 749 secondary, 67 cleft lip and nose, and a total of 3182 rhinoplasties, using his new syringe design, which compresses diced cartilage and injects the diced cartilages as a conglutinate mass, simulating carved costal cartilage, but a malleable one. In 3125 patients, the take of cartilage graft was complete (98.2 percent) and a smooth surface was obtained, giving them a natural appearance. In 21 patients (0.65 percent), there was partial resorption of cartilage. Correction was performed with touch-up surgery by reinjection of a small amount of diced cartilage. In 36 patients (1.13 percent), there was overcorrection that, 1 year later, was treated by simple rasping. Compared with diced cartilage wrapped with Surgicel or fascia, the amount of injected cartilage graft is predictable because it consists purely of cartilage. The injected diced cartilage, because it is compressed and becomes a conglutinated mass, resembles a wood chip and simulates carved cartilage. It is superior to carved cartilage in that it is moldable, time saving, and gives a good result with no late show or warping. The injection takes only a few minutes.

  8. Starlink Document Styles

    Science.gov (United States)

    Lawden, M. D.

    This document describes the various styles which are recommended for Starlink documents. It also explains how to use the templates which are provided by Starlink to help authors create documents in a standard style. This paper is concerned mainly with conveying the ``look and feel" of the various styles of Starlink document rather than describing the technical details of how to produce them. Other Starlink papers give recommendations for the detailed aspects of document production, design, layout, and typography. The only style that is likely to be used by most Starlink authors is the Standard style.

  9. Types of health care facilities and the quality of primary care: a study of characteristics and experiences of Chinese patients in Guangdong Province, China.

    Science.gov (United States)

    Hu, Ruwei; Liao, Yu; Du, Zhicheng; Hao, Yuantao; Liang, Hailun; Shi, Leiyu

    2016-08-02

    In China, most people tend to use hospitals rather than health centers for their primary care generally due to the perception that quality of care provided in the hospital setting is superior to that provided at the health centers. No studies have been conducted in China to compare the quality of primary care provided at different health care settings. The purpose of this study is to compare the quality of primary care provided in different types of health care facilities in China. A cross-sectional survey with patients was conducted in Guangdong province of China, using the validated Chinese Primary Care Assessment Tool (PCAT). ANOVA was performed to compare the overall and 10 domains of primary care quality for patients in tertiary, secondary, and primary health care settings. Multivariate analyses were used to assess the association between types of facility and quality of primary care attributes while controlling for sociodemographic and health care characteristics. The final number of respondents was 864 including 161 from county hospitals, 190 from rural community health centers (CHCs), 164 from tertiary hospitals, 80 from secondary hospitals, and 269 from urban CHCs. Type of health care facilities was significantly associated with total PCAT score and domain scores. CHC was associated with higher total PCAT score and scores for first contact-access, ongoing care, comprehensiveness-services available, and community orientation than secondary and/or tertiary hospitals, after controlling for patients' demographic and health characteristics. Higher PCAT score was associated with greater satisfaction with primary care received. CHC patients were more likely to report satisfactory experiences compared to patients from secondary and tertiary facilities. The study demonstrated that CHCs provided better quality primary care when compared with secondary and tertiary health care facilities, justifying CHCs as a model of primary care delivery.

  10. Diabetes Case Management in Primary Care: The New Brunswick Experience and Expanding the Practice of the Certified Diabetes Educator Nurse into Primary Care.

    Science.gov (United States)

    Jones, Shelley L

    2015-08-01

    The role of the outreach diabetes case manager in New Brunswick, Canada, was first developed in the Moncton Area of Horizon Health Network in response to a physician-identified gap between patients' diagnoses of diabetes and their attendance at the local diabetes education centre. This model of collaborative interprofessional practice increases support for primary care providers and people living with diabetes in that they are being provided the services of certified diabetes educators who can address knowledge gaps with respect to evidence-based guidelines and best practice, promote advancement of diabetes and chronic-disease management therapies and support adherence to treatment plans and self-management practices. This report chronicles a review of the implementation, expansion and evaluation of the outreach diabetes case manager model in the province of New Brunswick, Canada, along with the rationale for development of the role for registered nurses in other jurisdictions. Crown Copyright © 2015. Published by Elsevier Inc. All rights reserved.

  11. Primary Teachers' Professional Training in the System of Postgraduate Education in the Light of Differentiating Teaching: Irish Experience

    Science.gov (United States)

    Gotsuliak, Kateryna

    2015-01-01

    Different information sources, namely National Strategy for Higher Education to 2030 (Ireland), Introduction to Primary School Curriculum (1999), (Ireland), Primary Professional Development Service--Differentiation in Action, Ireland's official postgraduate study website, the Strategic Plan 2012-2016 of Mary Immaculate College, Limerick…

  12. The correlation between global health experiences in low-income countries on choice of primary care residencies for graduates of an urban US medical school.

    Science.gov (United States)

    Bruno, Denise Marie; Imperato, Pascal James; Szarek, Michael

    2014-04-01

    This study sought to determine whether medical students who participate in a global health elective in a low-income country select residencies in primary care at higher rates compared with their classmates and US medical graduates in general. Given the projected increase in demand for primary care physicians, particularly in underserved areas, understanding possible factors that encourage training in primary care or enhance interest in the care of underserved populations may identify opportunities in medical school training. The authors used data from the Office of Student Affairs, SUNY Downstate College of Medicine and the National Residency Matching Program to compare rates of primary care residency selection from 2004 to 2012. Residency selections for students who participated in the SUNY Downstate School of Public Health Global Health Elective were compared with those of their classmates and with residency match data for US seniors. In 7 of the 8 years reviewed, students who participated in the SUNY Downstate School of Public Health Global Health Elective selected primary care residencies at rates higher than their classmates. Across years, 57% of the students who completed the elective matched to primary care residences, which was significantly higher than the 44% for the remainder of Downstate's medical student class (p = 0.0023). In 6 of the 8 years, Downstate students who participated in the Global Health Elective selected primary care residencies at rates higher than US medical school seniors in general; rates were the same for both Downstate Global Health Elective students and US medical school seniors in 2009. Students who participated in a global health experience in a low-income country selected primary care residencies at higher rates than their classmates and US medical school graduates in general. Understanding how these experiences correlate with residency selection requires further investigation; areas of future study are discussed.

  13. "The acceptance" of living with chronic pain - an ongoing process: A qualitative study of patient experiences of multimodal rehabilitation in primary care.

    Science.gov (United States)

    Pietilä Holmner, Elisabeth; Stålnacke, Britt-Marie; Enthoven, Paul; Stenberg, Gunilla

    2018-01-10

    To explore patient experiences of participating in multimodal pain rehabilitation in primary care. Twelve former patients (7 women and 5 men) in multimodal rehabilitation in primary care were interviewed about their experiences of multimodal rehabilitation. The interviews were analysed using qualitative content analysis. Analysis resulted in 4 categories: (i) from discredited towards obtaining redress; (ii) from uncertainty towards knowledge; (iii) from loneliness towards togetherness; and (iv) "acceptance of pain": an ongoing process. The results show that having obtained redress, to obtain knowledge about chronic pain, and to experience fellowship with others with the same condition were helpful in the acceptance process. However, there were patients who found it difficult to reconcile themselves with a life with chronic pain after multimodal rehabilitation. To find what was "wrong" and to have a medical diagnosis and cure were important. Patients in primary care multimodal rehabilitation experience a complex, ongoing process of accepting chronic pain. Four important categories were described. These findings will help others to understand the experience and perspective of patients with chronic pain who engage in multimodal rehabilitation.

  14. A Systematic Review of Patients' Experiences in Communicating with Primary Care Physicians: Intercultural Encounters and a Balance between Vulnerability and Integrity.

    Science.gov (United States)

    Rocque, Rhea; Leanza, Yvan

    2015-01-01

    Communication difficulties persist between patients and physicians. In order to improve care, patients' experiences of this communication must be understood. The main objective of this study is to synthesize qualitative studies exploring patients' experiences in communicating with a primary care physician. A secondary objective is to explore specific factors pertaining to ethnic minority or majority patients and their influence on patients' experiences of communication. Pertinent health and social sciences electronic databases were searched systematically (PubMed, Cinahl, PsychNet, and IBSS). Fifty-seven articles were included in the review on the basis of being qualitative studies targeting patients' experiences of communication with a primary care physician. The meta-ethnography method for qualitative studies was used to interpret data and the COREQ checklist was used to evaluate the quality of included studies. Three concepts emerged from analyses: negative experiences, positive experiences, and outcomes of communication. Negative experiences related to being treated with disrespect, experiencing pressure due to time constraints, and feeling helpless due to the dominance of biomedical culture in the medical encounter. Positive experiences are attributed to certain relational skills, technical skills, as well as certain approaches to care privileged by the physician. Outcomes of communication depend on patients' evaluation of the consultation. Four categories of specific factors exerted mainly a negative influence on consultations for ethnic minorities: language barriers, discrimination, differing values, and acculturation. Ethnic majorities also raised specific factors influencing their experience: differing values and discrimination. Findings of this review are limited by the fact that more than half of the studies did not explore cultural aspects relating to this experience. Future research should address these aspects in more detail. In conclusion, all

  15. A Systematic Review of Patients’ Experiences in Communicating with Primary Care Physicians: Intercultural Encounters and a Balance between Vulnerability and Integrity

    Science.gov (United States)

    Rocque, Rhea; Leanza, Yvan

    2015-01-01

    Communication difficulties persist between patients and physicians. In order to improve care, patients’ experiences of this communication must be understood. The main objective of this study is to synthesize qualitative studies exploring patients’ experiences in communicating with a primary care physician. A secondary objective is to explore specific factors pertaining to ethnic minority or majority patients and their influence on patients’ experiences of communication. Pertinent health and social sciences electronic databases were searched systematically (PubMed, Cinahl, PsychNet, and IBSS). Fifty-seven articles were included in the review on the basis of being qualitative studies targeting patients’ experiences of communication with a primary care physician. The meta-ethnography method for qualitative studies was used to interpret data and the COREQ checklist was used to evaluate the quality of included studies. Three concepts emerged from analyses: negative experiences, positive experiences, and outcomes of communication. Negative experiences related to being treated with disrespect, experiencing pressure due to time constraints, and feeling helpless due to the dominance of biomedical culture in the medical encounter. Positive experiences are attributed to certain relational skills, technical skills, as well as certain approaches to care privileged by the physician. Outcomes of communication depend on patients’ evaluation of the consultation. Four categories of specific factors exerted mainly a negative influence on consultations for ethnic minorities: language barriers, discrimination, differing values, and acculturation. Ethnic majorities also raised specific factors influencing their experience: differing values and discrimination. Findings of this review are limited by the fact that more than half of the studies did not explore cultural aspects relating to this experience. Future research should address these aspects in more detail. In conclusion

  16. Development of the Korean primary care assessment tool--measuring user experience: tests of data quality and measurement performance.

    Science.gov (United States)

    Lee, Jae Ho; Choi, Yong-Jun; Sung, Nak Jin; Kim, Soo Young; Chung, Seol Hee; Kim, Jaiyong; Jeon, Tae-Hee; Park, Hoon Ki

    2009-04-01

    To develop a tool for assessing the performance of primary care services in South Korea from the patient's perspective and to test the validity of the tool under the conceptual framework of the recently developed definition of primary care in Korea. Item development for questionnaire and a cross-sectional survey for tool validation at 16 primary care clinics. All family physicians included in this study were required to have practiced at their current clinic for at least 2 years. A nine expert panel was assembled for tool development and patients (or guardians) who had visited their primary care clinic on six or more occasions over a period of more than 6 months participated in the survey. Scores corresponding to each domain of primary care. A total of 722 effective data sets were used for the analysis. Five items were eliminated from the preliminary 30-item tool after expert discussions at two seminars. Another four items were eliminated by principle component analysis. For each of the four domains (comprehensiveness, coordination function, personalized care, and family/community orientation), tests of scaling assumptions were well satisfied by all Likert-scaled measures. On the other hand, 'first contact' turned out to be a composite domain with five independent single-item scales. The Korean primary care assessment tool (version 1) consists of four multi-item scales and one composite scale. Widespread application of this tool will provide an empirical basis for the measurement, monitoring and continuous improvement of primary care in South Korea.

  17. ELECTRICAL POWER SYSTEM DESCRIPTION DOCUMENT

    Energy Technology Data Exchange (ETDEWEB)

    M. Maniyar

    2004-06-22

    The purpose of this revision of the System Description Document (SDD) is to establish requirements that drive the design of the electrical power system and their bases to allow the design effort to proceed to License Application. This SDD is a living document that will be revised at strategic points as the design matures over time. This SDD identifies the requirements and describes the system design as they exist at this time, with emphasis on those attributes of the design provided to meet the requirements. This SDD has been developed to be an engineering tool for design control. Accordingly, the primary audience are design engineers. This type of SDD leads and follows the design process. It leads the design process with regard to the flow down of upper tier requirements onto the system. Knowledge of these requirements is essential to performing the design process. This SDD follows the design with regard to the description of the system. The description provided in the SDD is a reflection of the results of the design process to date. Functional and operational requirements applicable to this system are obtained from ''Project Functional and Operational Requirements'' (F&OR) (Siddoway, 2003). Other requirements to support the design process have been taken from higher level requirements documents such as ''Project Design Criteria Document'' (PDC) (Doraswamy 2004), the fire hazards analyses, and the preclosure safety analysis. The above mentioned low-level documents address ''Project Requirements Document'' (PRD) (Canori and Leitner 2003) requirements. This SDD includes several appendices with supporting information. Appendix B lists key system charts, diagrams, drawings, and lists; and Appendix C is a list of system procedures.

  18. Introducing a Primary Health Care nurse training course at the University of Limpopo: Experiences and views of trainees

    Directory of Open Access Journals (Sweden)

    Peter A. Delobelle

    2011-02-01

    Full Text Available Background: A new post-basic Primary Health Care (PHC nurse training was piloted at the University of Limpopo in rural South Africa in order to reinforce PHC services and to address the backlog of trained PHC nurses. The training comprised residential and decentralised training modules based on the principles of problem based learning and community based education, and a patient-centred care approach developed in the field of family medicine was applied for acquiring consultation skills. Clinical reasoning was improved through on-site supervision by individual preceptors. Objective: The aim of the study was to describe the satisfaction, experiences and views of trainees in the first year of implementing the new PHC nurse training programme.Method: The study had a descriptive, exploratory and cross-sectional design, and used quantitative and qualitative methods for data collection that included a semi-structured survey questionnaire and focus group discussion. A purposive sample of trainees enrolled in the pilot programme (n = 15 was recruited for this study. Results were analysed quantitatively for the survey questionnaire and content analysis was used for qualitative data.Results: Results revealed trainee satisfaction with the quality of community based visits and classroom lectures and dissatisfaction with on-site supervision and training material. Qualitative findings indicated a need to improve information and communication of supervisors and preceptors, and to provide more training material. Factors related to the work environment were identified as barriers to implement learning, but the use of tools developed in family medicine curricula was perceived as beneficial. Lessons learnt included the need for strong programme coordination and stakeholder commitment, as well as the need to develop a competence framework for PHC nursing.Conclusion: The implementation of a pilot programme for PHC nurse training had the outcomes of trainee

  19. Tobacco documents research methodology.

    Science.gov (United States)

    Anderson, Stacey J; McCandless, Phyra M; Klausner, Kim; Taketa, Rachel; Yerger, Valerie B

    2011-05-01

    Tobacco documents research has developed into a thriving academic enterprise since its inception in 1995. The technology supporting tobacco documents archiving, searching and retrieval has improved greatly since that time, and consequently tobacco documents researchers have considerably more access to resources than was the case when researchers had to travel to physical archives and/or electronically search poorly and incompletely indexed documents. The authors of the papers presented in this supplement all followed the same basic research methodology. Rather than leave the reader of the supplement to read the same discussion of methods in each individual paper, presented here is an overview of the methods all authors followed. In the individual articles that follow in this supplement, the authors present the additional methodological information specific to their topics. This brief discussion also highlights technological capabilities in the Legacy Tobacco Documents Library and updates methods for organising internal tobacco documents data and findings.

  20. The Life and Times of Emma Goldman: A Curriculum for Middle and High School Students. Primary Historical Documents on: Immigration, Freedom of Expression, Women's Rights, Anti-Militarism, Art and Literature of Social Change.

    Science.gov (United States)

    Falk, Candace; And Others

    The documents in this curriculum unit are drawn from the massive archive collected by the Emma Goldman Papers Project at the University of California (Berkeley). They are linked to the standard social studies and humanities curriculum themes of art and literature, First Amendment rights, labor, progressive politics, and Red Scare, the rise of…

  1. CFO Payment Document Management

    Data.gov (United States)

    US Agency for International Development — Paperless management will enable the CFO to create, store, and access various financial documents electronically. This capability will reduce time looking for...

  2. Brain metastases in patients diagnosed with a solid primary cancer during childhood: experience from a single referral cancer center.

    Science.gov (United States)

    Suki, Dima; Khoury Abdulla, Rami; Ding, Minming; Khatua, Soumen; Sawaya, Raymond

    2014-10-01

    Metastasis to the brain is frequent in adult cancer patients but rare among children. Advances in primary tumor treatment and the associated prolonged survival are said to have increased the frequency of brain metastasis in children. The authors present a series of cases of brain metastases in children diagnosed with a solid primary cancer, evaluate brain metastasis trends, and describe tumor type, patterns of occurrence, and prognosis. Patients with brain metastases whose primary cancer was diagnosed during childhood were identified in the 1990-2012 Tumor Registry at The University of Texas M.D. Anderson Cancer Center. A review of their hospital records provided demographic data, history, and clinical data, including primary cancer sites, number and location of brain metastases, sites of extracranial metastases, treatments, and outcomes. Fifty-four pediatric patients (1.4%) had a brain metastasis from a solid primary tumor. Sarcomas were the most common (54%), followed by melanoma (15%). The patients' median ages at diagnosis of the primary cancer and the brain metastasis were 11.37 years and 15.03 years, respectively. The primary cancer was localized at diagnosis in 48% of patients and disseminated regionally in only 14%. The primary tumor and brain metastasis presented synchronously in 15% of patients, and other extracranial metastases were present when the primary cancer was diagnosed. The remaining patients were diagnosed with brain metastasis after initiation of primary cancer treatment, with a median presentation interval of 17 months after primary cancer diagnosis (range 2-77 months). At the time of diagnosis, the brain metastasis was the first site of systemic metastasis in only 4 (8%) of the 51 patients for whom data were available. Up to 70% of patients had lung metastases when brain metastases were found. Symptoms led to the brain metastasis diagnosis in 65% of cases. Brain metastases were single in 60% of cases and multiple in 35%; 6% had only

  3. Shared care between specialized psychiatric services and primary care: the experiences and expectations of consultant psychiatrists in Ireland.

    Science.gov (United States)

    Agyapong, Vincent I O; Conway, Catherine; Guerandel, Allys

    2011-01-01

    Internationally, there has been a growing interest in the pursuit of collaborative forms of care for patients with enduring mental health difficulties. The study aims to explore the views of consultant psychiatrists in Ireland on shared care between specialized psychiatric services and primary care for patients with mental health difficulties. A self-administered questionnaire was designed and posted to 470 consultant psychiatrists who are members of the College of Psychiatry of Ireland. Stamped self-addressed envelopes were included for the return of completed questionnaires. Overall, 213 questionnaires were returned, giving a response rate of 45%. Of the respondents, 194 (91%) reported that they would support a general policy on shared care between primary care and specialized psychiatric services for patients who are stable on their treatment. However, 181 (85%) reported that they foresaw difficulties for patients in implementing such a policy including: increased financial burden on some patients (141, 66%); some patients may lack confidence in GP care (100, 47%); primary care is not adequately resourced with allied health professionals to support provision of psychiatric care (128, 60%); primary care providers are not adequately trained to provide psychiatric care (111, 52%); and lack of adequate cooperation between primary care and specialized mental health services (96, 45%). The Irish government and the Colleges of General Practitioners and Psychiatrists in Ireland need to work together to remove the bottlenecks that hinder the active involvement of primary care in the management of patients with enduring mental health difficulties. Also, the health care systems need to be organized along a shared care model to facilitate effective collaboration between primary and specialized psychiatric services.

  4. Documents, Practices and Policy

    Science.gov (United States)

    Freeman, Richard; Maybin, Jo

    2011-01-01

    What are the practices of policy making? In this paper, we seek to identify and understand them by attending to one of the principal artefacts--the document--through which they are organised. We review the different ways in which researchers have understood documents and their function in public policy, endorsing a focus on content but noting that…

  5. IDC System Specification Document.

    Energy Technology Data Exchange (ETDEWEB)

    Clifford, David J.

    2014-12-01

    This document contains the system specifications derived to satisfy the system requirements found in the IDC System Requirements Document for the IDC Reengineering Phase 2 project. Revisions Version Date Author/Team Revision Description Authorized by V1.0 12/2014 IDC Reengineering Project Team Initial delivery M. Harris

  6. Searching for text documents

    NARCIS (Netherlands)

    Hiemstra, Djoerd; Blanken, Henk; de Vries, A.P.; Blok, H.E.; Feng, L.

    2007-01-01

    Many documents contain, besides text, also images, tables, and so on. This chapter concentrates on the text part only. Traditionally, systems handling text documents are called information storage and retrieval systems. Before the World-Wide Web emerged, such systems were almost exclusively used by

  7. Contextualising aircraft maintenance documentation

    NARCIS (Netherlands)

    Koornneef, H.; Verhagen, W.J.C.; Curran, Ricky

    2017-01-01

    The use of documentation for task support in aircraft line maintenance is still mostly paper-based, which is slow, burdensome and prone to error. This paper provides an overview of the issues associated with the use of paper-based documentation in aircraft line maintenance and describes the

  8. IMPORTANCE, STRUCTURE AND OUTCOMES OF THE MUSIC PROGRAM IN THE PRIMARY SCHOOL: THE EXPERIENCE OF CROATIA, MONTENEGRO, AND SERBIA

    Directory of Open Access Journals (Sweden)

    Sabina Vidulin

    2015-06-01

    Full Text Available In an effort to look into the importance and structure of the program through a simultaneous analysis of the achievement outcomes for the Music course in three countries – Croatia, Montenegro, and Serbia, the authors have performed a detailed analysis of a number of documents covering the topic in these countries. A comparative analysis of the contents of these documents has provided us with the opportunity to assess the speed at which the educational systems in the three countries are being reformed, the differences in the approach to individual areas, but also the need to provide joint theoretical efforts whose goal would be to foster what is the common denominator for us all – a promoted process of teaching music which would provide a simultaneous development of students’ artistic identity.

  9. Shared care between specialised psychiatric services and primary care: The experiences and expectations of General Practitioners in Ireland.

    LENUS (Irish Health Repository)

    Agyapong, Vincent Israel Opoku

    2012-04-17

    Objective. The study aims to explore the views of General Practitioners in Ireland on shared care between specialised psychiatric services and primary care. Method. A self-administered questionnaire was designed and posted to 400 randomly selected General Practitioners working in Ireland. Results. Of the respondents, 189 (94%) reported that they would support a general policy on shared care between primary care and specialised psychiatric services for patients who are stable on their treatment. However, 124 (61.4%) reported that they foresaw difficulties for patients in implementing such a policy including: a concern that primary care is not adequately resourced with allied health professionals to support provision of psychiatric care (113, 53.2%); a concern this would result in increased financial burden on some patients (89, 48.8%); a lack of adequate cooperation between primary care and specialised mental health services (84, 41.8%); a concern that some patients may lack confidence in GP care (55, 27.4%); and that primary care providers are not adequately trained to provide psychiatric care (29, 14.4% ). Conclusion. The majority of GPs in Ireland would support a policy of shared care of psychiatric patients; however they raise significant concerns regarding practical implications of such a policy in Ireland.

  10. Shared care between specialised psychiatric services and primary care: the experiences and expectations of General Practitioners in Ireland.

    Science.gov (United States)

    Agyapong, Vincent Israel Opoku; Jabbar, Faiza; Conway, Catherine

    2012-10-01

    Objective. The study aims to explore the views of General Practitioners in Ireland on shared care between specialised psychiatric services and primary care. Method. A self-administered questionnaire was designed and posted to 400 randomly selected General Practitioners working in Ireland. Results. Of the respondents, 189 (94%) reported that they would support a general policy on shared care between primary care and specialised psychiatric services for patients who are stable on their treatment. However, 124 (61.4%) reported that they foresaw difficulties for patients in implementing such a policy including: a concern that primary care is not adequately resourced with allied health professionals to support provision of psychiatric care (113, 53.2%); a concern this would result in increased financial burden on some patients (89, 48.8%); a lack of adequate cooperation between primary care and specialised mental health services (84, 41.8%); a concern that some patients may lack confidence in GP care (55, 27.4%); and that primary care providers are not adequately trained to provide psychiatric care (29, 14.4% ). Conclusion. The majority of GPs in Ireland would support a policy of shared care of psychiatric patients; however they raise significant concerns regarding practical implications of such a policy in Ireland.

  11. DETECTION OF A CHANGE OF SLOPE IN THE SPECTRUM OF HEAVY MASS COSMIC RAYS PRIMARIES BY THE KASCADE-GRANDE EXPERIMENT

    Directory of Open Access Journals (Sweden)

    A. Chiavassa

    2013-12-01

    Full Text Available KASCADE-Grande is an extensive air shower experiment devoted to the study of cosmic rays in the 1016 ÷ 1018 eV energy range. The array is composed by different detectors allowing independent measurements of the number of muons (Nμ and charged particles (Nch of extensive air showers (EAS. These two observables are then used to study the primary energy spectrum, separating the events in two samples, on the basis of the shower size ratio, corrected for attenuation in the atmosphere, lnNμ/ lnNch. The two samples represent the light and heavy mass groups of the primaries. In the studied energy range only the spectrum of heavy primaries shows a significant change of slope, the energy (estimated using the QGSJET II hadronic interaction model of this feature is in agreeement with the expectations of a rigidity dependent knee feature.

  12. [An experience of collaboration between primary health care and mental health care in La Ribera Department of Health (Valencia, Spain)].

    Science.gov (United States)

    Morera-Llorca, Miquel; Romeu-Climent, José Enrique; Lera-Calatayud, Guillem; Folch-Marín, Blanca; Palop-Larrea, Vicente; Vidal-Rubio, Sonia

    2014-01-01

    Despite the high prevalence of mental health problems among patients attending primary care, diagnosis and treatment of these disorders remain inadequate. Sound training of primary care physicians in how to manage mental health problems is needed to reduce the health, economic and social impact associated with these disorders. Among other elements, there is a need for cooperation between primary care physicians and mental health services. Distinct models are available for such collaboration. In 2006, our health department started a collaboration between these two levels of heath care, using a liaison model. Delays until the first specialist visit were reduced and satisfaction among health professionals increased, although these results should be interpreted with caution. Evidence has recently accumulated on the usefulness of the collaborative model, but evaluation of this model and extrapolation of its results are complex. We intend to evaluate our model more thoroughly, similar to other projects in our environment. Copyright © 2014 SESPAS. Published by Elsevier Espana. All rights reserved.

  13. Patients' experiences of a computerised self-help program for treating depression - a qualitative study of Internet mediated cognitive behavioural therapy in primary care.

    Science.gov (United States)

    Holst, Anna; Nejati, Shabnam; Björkelund, Cecilia; Eriksson, Maria C M; Hange, Dominique; Kivi, Marie; Wikberg, Carl; Petersson, Eva-Lisa

    2017-03-01

    The objective of this study was to explore primary care patients' experiences of Internet mediated cognitive behavioural therapy (iCBT) depression treatment. Qualitative study. Data were collected from focus group discussions and individual interviews. Primary care. Data were analysed by systematic text condensation by Malterud. Thirteen patients having received iCBT for depression within the PRIM-NET study. Analysis presented different aspects of patients' experiences of iCBT. The informants described a need for face-to-face meetings with a therapist. A therapist who performed check-ups and supported the iCBT process seemed important. iCBT implies that a responsibility for the treatment is taken by the patient, and some patients felt left alone, while others felt well and secure. This was a way to work in privacy and freedom with a smoothly working technology although there was a lack of confidence and a feeling of risk regarding iCBT. iCBT is an attractive alternative to some patients with depression in primary care, but not to all. An individual treatment design seems to be preferred, and elements of iCBT could be included as a complement when treating depression in primary care. Such a procedure could relieve the overall treatment burden of depression. Key points Internet mediated cognitive behavioural therapy (iCBT) can be effective in treating depression in primary care, but patients' experiences of iCBT are rarely studied • Most patients express a need for human contact, real-time interaction, dialogue and guidance when treated for depression. • The patient's opportunity to influence the practical circumstances about iCBT is a success factor, though this freedom brings a large responsibility upon the receiver. • An individual treatment design seems to be crucial, and elements of iCBT could be included as a complement to face-to-face meetings.

  14. One Year Primary Patency of Infrapopliteal Angioplasty Using Drug- Eluting Balloons: Single Center Experience at King Hussein Medical Center

    Directory of Open Access Journals (Sweden)

    Sizeph Edward Haddad

    2017-01-01

    Full Text Available Objective: Conventional percutaneous transluminal angioplasty (PTA for long lesions in the below the knee (BTK arteries in patients presenting with critical limb ischemia (CLI has high restenosis rates at 1 year. Our goal is to evaluate whether paclitaxel drug eluting balloons (DEB have higher 1 year primary patency rates compared to conventional PTA. Methods: This is a single center, prospective, randomized trial that was conducted from June 2013 to December 2015. The aim of the study was to compare 1 year primary patency rates of DEB and PTA in BTK arteries in CLI patients. Inclusion criteria were patients presenting with CLI (Rutherford class 4 or greater, stenosis or occlusion ≥30 mm of at least one tibial artery, and agreement to 12 month evaluation. Exclusion criteria were life expectancy <1 year, allergy to paclitaxel, and contraindication to combined antiplatelet treatment. Follow up was performed by clinical assessment, ankle brachial pressure index, Doppler ultrasound imaging, and conventional angiogram if indicated. Primary end point was 1 year primary patency, and secondary end points were target lesion revascularization (TLR and major amputation. Statistical analysis was performed using Fischer's exact test. Results: Ninety three patients with 106 lesions in the BTK arteries were enrolled in this study. One year primary patency was achieved in 26 (65% and seven (17% in the DEB and PTA groups (P = 0.006, respectively. TLR was performed in nine lesions (23% and 29 lesions (71% in DEB and PTA groups (P = 0.009, respectively. Major amputations occurred in one limb (2% and two limbs (4% in DEB and PTA groups (P = 0.6, respectively. Conclusion: Paclitaxel DEB has significantly higher 1 year primary patency rate associated with significantly less TLR than conventional PTA, following endovascular recanalization of BTK arteries in patients presenting with CLI.

  15. Belgian experience in applying the {open_quotes}leak-before-break{close_quotes} concept to the primary loop piping

    Energy Technology Data Exchange (ETDEWEB)

    Gerard, R.; Malekian, C.; Meessen, O. [Tractebel Energy Engineering, Brussels (Belgium)

    1997-04-01

    The Leak Before Break (LBB) concept allows to eliminate from the design basis the double-ended guillotine break of the primary loop piping, provided it can be demonstrated by a fracture mechanics analysis that a through-wall flaw, of a size giving rise to a leakage still well detectable by the plant leak detection systems, remains stable even under accident conditions (including the Safe Shutdown Earthquake (SSE)). This concept was successfully applied to the primary loop piping of several Belgian Pressurized Water Reactor (PWR) units, operated by the Utility Electrabel. One of the main benefits is to permit justification of supports in the primary loop and justification of the integrity of the reactor pressure vessel and internals in case of a Loss Of Coolant Accident (LOCA) in stretch-out conditions. For two of the Belgian PWR units, the LBB approach also made it possible to reduce the number of large hydraulic snubbers installed on the primary coolant pumps. Last but not least, the LBB concept also facilitates the steam generator replacement operations, by eliminating the need for some pipe whip restraints located close to the steam generator. In addition to the U.S. regulatory requirements, the Belgian safety authorities impose additional requirements which are described in details in a separate paper. An novel aspect of the studies performed in Belgium is the way in which residual loads in the primary loop are taken into account. Such loads may result from displacements imposed to close the primary loop in a steam generator replacement operation, especially when it is performed using the {open_quote}two cuts{close_quotes} technique. The influence of such residual loads on the LBB margins is discussed in details and typical results are presented.

  16. Experience in Training of Primary Health Care Specialists in the Context of the Integrated Management of Childhood Illness in the Teaching of Pediatrics to Junior Students

    Directory of Open Access Journals (Sweden)

    O.D. Fofanov

    2013-09-01

    Full Text Available The article describes an overview of the basic principles of the integrated management of childhood illness (IMCI strategy, which is designed to improve the quality of care for children up to 5 years at the level of primary health care. The first experience of the implementation of this strategy in the educational process while studying of pediatrics at the junior courses within the curriculum is described. A considerable attention is paid to the method of mastering communication skills by the junior students’ and applying them in the collection of medical history, communicating with parents and relatives of children. According to IMCI recommendations all health care professionals, who work in primary health care, must master the methodology of counseling family about care for healthy and sick children, feeding, providing optimal conditions for the physical and neuropsychological development. Our first experience demonstrates the feasibility of implementing IMCI individual issues in the educational process while studying pediatrics for the junior classes.

  17. Primary marine aerosol physical flux and chemical composition during a nutrient enrichment experiment in mesocosms in the Mediterranean Sea

    Science.gov (United States)

    Schwier, Allison N.; Sellegri, Karine; Mas, Sébastien; Charrière, Bruno; Pey, Jorge; Rose, Clémence; Temime-Roussel, Brice; Jaffrezo, Jean-Luc; Parin, David; Picard, David; Ribeiro, Mickael; Roberts, Greg; Sempéré, Richard; Marchand, Nicolas; D'Anna, Barbara

    2017-12-01

    While primary marine aerosol (PMA) is an important part of global aerosol total emissions, its chemical composition and physical flux as a function of the biogeochemical properties of the seawater still remain highly uncharacterized due to the multiplicity of physical, chemical and biological parameters that are involved in the emission process. Here, two nutrient-enriched mesocosms and one control mesocosm, both filled with Mediterranean seawater, were studied over a 3-week period. PMA generated from the mesocosm waters were characterized in term of chemical composition, size distribution and size-segregated cloud condensation nuclei (CCN), as a function of the seawater chlorophyll a (Chl a) concentration, pigment composition, virus and bacteria abundances. The aerosol number size distribution flux was primarily affected by the seawater temperature and did not vary significantly from one mesocosm to the other. The aerosol number size distribution flux was primarily affected by the seawater temperature and did not vary significantly from one mesocosm to the other. Particle number and CCN aerosol fluxes increase by a factor of 2 when the temperature increases from 22 to 32 °C, for all particle submicron sizes. This effect, rarely observed in previous studies, could be specific to oligotrophic waters and/or to this temperature range. In all mesocosms (enriched and control mesocosms), we detected an enrichment of calcium (+500 %) and a deficit in chloride (-36 %) in the submicron PMA mass compared to the literature inorganic composition of the seawater. There are indications that the chloride deficit and calcium enrichment are linked to biological processes, as they are found to be stronger in the enriched mesocosms. This implies a non-linear transfer function between the seawater composition and PMA composition, with complex processes taking place at the interface during the bubble bursting. We found that the artificial phytoplankton bloom did not affect the CCN

  18. Primary marine aerosol physical flux and chemical composition during a nutrient enrichment experiment in mesocosms in the Mediterranean Sea

    Directory of Open Access Journals (Sweden)

    A. N. Schwier

    2017-12-01

    Full Text Available While primary marine aerosol (PMA is an important part of global aerosol total emissions, its chemical composition and physical flux as a function of the biogeochemical properties of the seawater still remain highly uncharacterized due to the multiplicity of physical, chemical and biological parameters that are involved in the emission process. Here, two nutrient-enriched mesocosms and one control mesocosm, both filled with Mediterranean seawater, were studied over a 3-week period. PMA generated from the mesocosm waters were characterized in term of chemical composition, size distribution and size-segregated cloud condensation nuclei (CCN, as a function of the seawater chlorophyll a (Chl a concentration, pigment composition, virus and bacteria abundances. The aerosol number size distribution flux was primarily affected by the seawater temperature and did not vary significantly from one mesocosm to the other. The aerosol number size distribution flux was primarily affected by the seawater temperature and did not vary significantly from one mesocosm to the other. Particle number and CCN aerosol fluxes increase by a factor of 2 when the temperature increases from 22 to 32 °C, for all particle submicron sizes. This effect, rarely observed in previous studies, could be specific to oligotrophic waters and/or to this temperature range. In all mesocosms (enriched and control mesocosms, we detected an enrichment of calcium (+500 % and a deficit in chloride (−36 % in the submicron PMA mass compared to the literature inorganic composition of the seawater. There are indications that the chloride deficit and calcium enrichment are linked to biological processes, as they are found to be stronger in the enriched mesocosms. This implies a non-linear transfer function between the seawater composition and PMA composition, with complex processes taking place at the interface during the bubble bursting. We found that the artificial phytoplankton bloom

  19. ELECTRICAL SUPPORT SYSTEM DESCRIPTION DOCUMENT

    Energy Technology Data Exchange (ETDEWEB)

    S. Roy

    2004-06-24

    The purpose of this revision of the System Design Description (SDD) is to establish requirements that drive the design of the electrical support system and their bases to allow the design effort to proceed to License Application. This SDD is a living document that will be revised at strategic points as the design matures over time. This SDD identifies the requirements and describes the system design as they exist at this time, with emphasis on those attributes of the design provided to meet the requirements. This SDD has been developed to be an engineering tool for design control. Accordingly, the primary audience/users are design engineers. This type of SDD both ''leads'' and ''trails'' the design process. It leads the design process with regard to the flow down of upper tier requirements onto the system. Knowledge of these requirements is essential in performing the design process. The SDD trails the design with regard to the description of the system. The description provided in the SDD is a reflection of the results of the design process to date. Functional and operational requirements applicable to electrical support systems are obtained from the ''Project Functional and Operational Requirements'' (F&OR) (Siddoway 2003). Other requirements to support the design process have been taken from higher-level requirements documents such as the ''Project Design Criteria Document'' (PDC) (Doraswamy 2004), and fire hazards analyses. The above-mentioned low-level documents address ''Project Requirements Document'' (PRD) (Canon and Leitner 2003) requirements. This SDD contains several appendices that include supporting information. Appendix B lists key system charts, diagrams, drawings, and lists, and Appendix C includes a list of system procedures.

  20. Manipulation of BDNF signaling modifies the experience-dependent plasticity induced by pure tone exposure during the critical period in the primary auditory cortex.

    Science.gov (United States)

    Anomal, Renata; de Villers-Sidani, Etienne; Merzenich, Michael M; Panizzutti, Rogerio

    2013-01-01

    Sensory experience powerfully shapes cortical sensory representations during an early developmental "critical period" of plasticity. In the rat primary auditory cortex (A1), the experience-dependent plasticity is exemplified by significant, long-lasting distortions in frequency representation after mere exposure to repetitive frequencies during the second week of life. In the visual system, the normal unfolding of critical period plasticity is strongly dependent on the elaboration of brain-derived neurotrophic factor (BDNF), which promotes the establishment of inhibition. Here, we tested the hypothesis that BDNF signaling plays a role in the experience-dependent plasticity induced by pure tone exposure during the critical period in the primary auditory cortex. Elvax resin implants filled with either a blocking antibody against BDNF or the BDNF protein were placed on the A1 of rat pups throughout the critical period window. These pups were then exposed to 7 kHz pure tone for 7 consecutive days and their frequency representations were mapped. BDNF blockade completely prevented the shaping of cortical tuning by experience and resulted in poor overall frequency tuning in A1. By contrast, BDNF infusion on the developing A1 amplified the effect of 7 kHz tone exposure compared to control. These results indicate that BDNF signaling participates in the experience-dependent plasticity induced by pure tone exposure during the critical period in A1.

  1. Manipulation of BDNF signaling modifies the experience-dependent plasticity induced by pure tone exposure during the critical period in the primary auditory cortex.

    Directory of Open Access Journals (Sweden)

    Renata Anomal

    Full Text Available Sensory experience powerfully shapes cortical sensory representations during an early developmental "critical period" of plasticity. In the rat primary auditory cortex (A1, the experience-dependent plasticity is exemplified by significant, long-lasting distortions in frequency representation after mere exposure to repetitive frequencies during the second week of life. In the visual system, the normal unfolding of critical period plasticity is strongly dependent on the elaboration of brain-derived neurotrophic factor (BDNF, which promotes the establishment of inhibition. Here, we tested the hypothesis that BDNF signaling plays a role in the experience-dependent plasticity induced by pure tone exposure during the critical period in the primary auditory cortex. Elvax resin implants filled with either a blocking antibody against BDNF or the BDNF protein were placed on the A1 of rat pups throughout the critical period window. These pups were then exposed to 7 kHz pure tone for 7 consecutive days and their frequency representations were mapped. BDNF blockade completely prevented the shaping of cortical tuning by experience and resulted in poor overall frequency tuning in A1. By contrast, BDNF infusion on the developing A1 amplified the effect of 7 kHz tone exposure compared to control. These results indicate that BDNF signaling participates in the experience-dependent plasticity induced by pure tone exposure during the critical period in A1.

  2. Repertoire of demonstrations, experiments and practices focused on biology of water invertebrates in the work of a primary- and grammar school teacher

    OpenAIRE

    MATOUŠKOVÁ, Jitka

    2014-01-01

    The thesis analyses how often the teachers in primary schools and in lower classes of multi-year grammar schools integrate practical exercises and experiments into the biology lessons in the issue of water invertebrates. A proposal of laboratory and field practices has also been created and carried out in the school practice in pursuance of water invertebrates with the use of stimulating educational methods, so called Inquiry-based science education.

  3. Teacher Experiences of Delivering an Obesity Prevention Programme (The WAVES Study Intervention) in a Primary School Setting

    Science.gov (United States)

    Griffin, Tania L; Clarke, Joanne L; Lancashire, Emma R; Pallan, Miranda J; Passmore, Sandra; Adab, Peymane

    2015-01-01

    Objective: There has been a wealth of childhood obesity prevention studies in school-based settings. However, few have investigated the experiences of school staff charged with delivery of such programmes. This study aimed to elicit teachers' experiences of delivering a childhood obesity prevention programme for children aged 6-7 years. Design:…

  4. Investigating the Relationship among the Level of Mobbing Experience, Job Satisfaction and Burnout Levels of Primary and Secondary School Teachers

    Science.gov (United States)

    Okçu, Veysel; Çetin, Hakan

    2017-01-01

    The aim of this study is to examine the level of mobbing experienced by primary and secondary school teachers and to determine how and to what extent this affects their job satisfaction and burnout levels. This research used a relational survey model. As a result of the study, it has been determined that there is a negative and medium-level…

  5. Dinitrogen fixation and dissolved organic nitrogen fueled primary production and particulate export during the VAHINE mesocosm experiment (New Caledonia lagoon

    Directory of Open Access Journals (Sweden)

    H. Berthelot

    2015-07-01

    suggest that while DDAs mainly rely on N2 fixation for their N requirements, both N2 fixation and DON can be significant N sources for primary production and particulate export following UCYN-C blooms in the New Caledonia lagoon and by extension in the N-limited oceans where similar events are likely to occur.

  6. An Experience of Social Rising of Logical Tools in a Primary School Classroom: The Role of Language

    Science.gov (United States)

    Coppola, Cristina; Mollo, Monica; Pacelli, Tiziana

    2011-01-01

    In this paper we explore the relationship between language and developmental processes of logical tools through the analysis at different levels of some "linguistic-manipulative" activities in a primary school classroom. We believe that this kind of activities can spur in the children a reflection and a change in their language…

  7. Definition and documentation of engineering processes

    Energy Technology Data Exchange (ETDEWEB)

    McDonald, G.W. [Sandia National Labs., Albuquerque, NM (United States)

    1997-11-01

    This tutorial is an extract of a two-day workshop developed under the auspices of the Quality Engineering Department at Sandia National Laboratories. The presentation starts with basic definitions and addresses why processes should be defined and documented. It covers three primary topics: (1) process considerations and rationale, (2) approach to defining and documenting engineering processes, and (3) an IDEFO model of the process for defining engineering processes.

  8. Methodological Aspects of Architectural Documentation

    Directory of Open Access Journals (Sweden)

    Arivaldo Amorim

    2011-12-01

    Full Text Available This paper discusses the methodological approach that is being developed in the state of Bahia in Brazil since 2003, in architectural and urban sites documentation, using extensive digital technologies. Bahia has a vast territory with important architectural ensembles ranging from the sixteenth century to present day. As part of this heritage is constructed of raw earth and wood, it is very sensitive to various deleterious agents. It is therefore critical document this collection that is under threats. To conduct those activities diverse digital technologies that could be used in documentation process are being experimented. The task is being developed as an academic research, with few financial resources, by scholarship students and some volunteers. Several technologies are tested ranging from the simplest to the more sophisticated ones, used in the main stages of the documentation project, as follows: work overall planning, data acquisition, processing and management and ultimately, to control and evaluate the work. The activities that motivated this paper are being conducted in the cities of Rio de Contas and Lençóis in the Chapada Diamantina, located at 420 km and 750 km from Salvador respectively, in Cachoeira city at Recôncavo Baiano area, 120 km from Salvador, the capital of Bahia state, and at Pelourinho neighbourhood, located in the historic capital. Part of the material produced can be consulted in the website: < www.lcad.ufba.br>.

  9. Industrial Sector Technology Use Model (ISTUM): industrial energy use in the United States, 1974-2000. Volume 1: primary model documentation, Book 2, Chapters IV, V, VI, and VII

    Energy Technology Data Exchange (ETDEWEB)

    Bohn, R.E.; Herod, J.S.

    1978-06-19

    The Industrial Sector Technology Use Model provides a single framework for integrating all of the information and analysis into a set of predictions of industrial energy use. Given this volume of information which must be considered, this requires a set of computerized engineering-economic models. The design of these models is the subject of Chapter IV. The environmental factors in ISTUM are developed and presented in Chapter V. Chapter VI discusses the work accomplished by DATA Resources, Inc. in support of the ISTUM. A glossary, briefly defining special terms used in the ISTUM documentation, is given in Chapter VII. (MCW)

  10. Informational system. Documents management

    Directory of Open Access Journals (Sweden)

    Vladut Iacob

    2009-12-01

    Full Text Available Productivity growing, as well as reducing of operational costs in a company can be achieved by adopting a document management solutions. Such application will allow management and structured and efficient transmission of information within the organization.

  11. CWA Scientific Documents

    Science.gov (United States)

    Summaries and links to scientific documents relevant to the Clean Water Act (CWA) and the protection of wetlands and aquatic resources in the United States, including the National Wetlands Inventory Report, National Resources Inventory Report and others.

  12. Transportation System Requirements Document

    Energy Technology Data Exchange (ETDEWEB)

    1993-09-01

    This Transportation System Requirements Document (Trans-SRD) describes the functions to be performed by and the technical requirements for the Transportation System to transport spent nuclear fuel (SNF) and high-level radioactive waste (HLW) from Purchaser and Producer sites to a Civilian Radioactive Waste Management System (CRWMS) site, and between CRWMS sites. The purpose of this document is to define the system-level requirements for Transportation consistent with the CRWMS Requirement Document (CRD). These requirements include design and operations requirements to the extent they impact on the development of the physical segments of Transportation. The document also presents an overall description of Transportation, its functions, its segments, and the requirements allocated to the segments and the system-level interfaces with Transportation. The interface identification and description are published in the CRWMS Interface Specification.

  13. Geochemistry Technical Basis Document

    Energy Technology Data Exchange (ETDEWEB)

    Benedict, Jr., F. Christopher [Nevada Site Office, Las Vegas, NV (United States); Rose, Timothy P. [Nevada Site Office, Las Vegas, NV (United States); Thomas, James M. [Nevada Site Office, Las Vegas, NV (United States); Waddell, Richard [Nevada Site Office, Las Vegas, NV (United States); Jacobson, Roger [Nevada Site Office, Las Vegas, NV (United States)

    2003-12-01

    This document presents a methodology whereby geochemical data can more effectively contribute to the development , calibration, and verification of groundwater flow and slute transport models for the Underground Test Area (UGTA) Project.

  14. NCDC Archive Documentation Manuals

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — The National Climatic Data Center Tape Deck Documentation library is a collection of over 400 manuals describing NCDC's digital holdings (both historic and current)....

  15. Integrated Criteria Document Chromium

    OpenAIRE

    Slooff W; Cleven RFMJ; Janus JA; van der Poel P; van Beelen P; Boumans LJM; Canton JH; Eerens HC; Krajnc EI; de Leeuw FAAM; Matthijsen AJCM; van de Meent D; van der Meulen A; Mohn GR; Wijland GC

    1990-01-01

    Betreft de engelse versie van rapport 758701001
    Bij dit rapport behoort een appendix onder hetzelfde nummer getiteld: "Integrated Criteria Document Chromium: Effects" Auteurs: Janus JA; Krajnc EI
    (appendix: see 710401002A)

  16. Are PDF Documents Accessible?

    Directory of Open Access Journals (Sweden)

    Mireia Ribera Turró

    2008-09-01

    Full Text Available Adobe PDF is one of the most widely used formats in scientific communications and in administrative documents. In its latest versions it has incorporated structural tags and improvements that increase its level of accessibility. This article reviews the concept of accessibility in the reading of digital documents and evaluates the accessibility of PDF according to the most widely established standards.

  17. Iridium-192 implants for primary breast cancer: experience with placement at the time of wide local excision

    Energy Technology Data Exchange (ETDEWEB)

    McCormick, B.; Wesson, M.F.; Cox, L.; Osborne, M.P.; Petrek, J.A.; Kinne, D.W.

    1988-09-01

    An Ir-192 boost is a technique frequently used to deliver an additional dose of radiation therapy to the tumor bed following breast conserving surgery and combined with external beam radiation therapy to the entire breast for patients with early breast cancer. Traditionally these catheters are placed following completion of 4500-5000 cGy, as a separate procedure. This paper described a Pilot Study identifying placement of the catheters at the time of primary wide local excision, or re-excision in 52 patients. The key to the success of this technique is the achievement of complete hemostasis in the primary cavity, the presence of the radiation oncologist during the surgical procedure itself, and closure of the wound prior to placement of the catheters. Details of the technique, and preliminary patient results are presented.

  18. The measurement of the cosmic ray primary energy spectrum at 10{sup 16}-10{sup 18} eV with the KASCADE-Grande experiment

    Energy Technology Data Exchange (ETDEWEB)

    Cantoni, Elena [Istituto di Fisica dello Spazio Interplanetario INAF, Torino (Italy); Dipartimento di Fisica Generale dell' Universita, Torino (Italy); Institut fuer Kernphysik, Karlsruher Institut fuer Technologie (Germany); Apel, W.D.; Arteaga-Velazquez, J.C.; Bekk, K. [Institut fuer Kernphysik, Karlsruher Institut fuer Technologie (Germany); Bertaina, M. [Dipartimento di Fisica Generale dell' Universita, Torino (Italy); Bluemer, J. [Institut fuer Kernphysik, Karlsruher Institut fuer Technologie (Germany); Institut fuer Experimentelle Kernphysik, Karlsruher Institut fuer Technologie (Germany); Bozdog, H. [Institut fuer Kernphysik, Karlsruher Institut fuer Technologie (Germany); Brancus, I.M. [National Institute of Physics and Nuclear Engineering, Bucharest (Romania); Buchholz, P. [Fachbereich Physik, Universitaet Siegen (Germany); Chiavassa, A. [Dipartimento di Fisica Generale dell' Universita, Torino (Italy); Cossavella, F. [Institut fuer Experimentelle Kernphysik, Karlsruher Institut fuer Technologie (Germany); Daumiller, K. [Institut fuer Kernphysik, Karlsruher Institut fuer Technologie (Germany); Souza, V. de [Institut fuer Experimentelle Kernphysik, Karlsruher Institut fuer Technologie (Germany); Di Pierro, F. [Dipartimento di Fisica Generale dell' Universita, Torino (Italy); Doll, P.; Engel, R.; Engler, J.; Finger, M. [Institut fuer Kernphysik, Karlsruher Institut fuer Technologie (Germany); Fuhrmann, D. [Fachbereich Physik, Universitaet Wuppertal (Germany); Ghia, P.L. [Istituto di Fisica dello Spazio Interplanetario INAF, Torino (Italy)

    2011-03-15

    The KASCADE-Grande experiment operates at Karlsruhe Institute of Technology (KIT) in Germany. It's aim is the study of the primary cosmic radiation, through Extensive Air Shower detection, in the range 10{sup 16}-10{sup 18} eV. Here, measurements are of main interest to understand the high energy evolution of cosmic radiation: a change in the slope of the heavy primary spectrum is expected (as measured at lower energies for lighter primaries) as a possible confirmation of the predicted astrophysical mechanisms; moreover, in this range the transition from galactic to extragalactic radiation is supposed to take place and the observations could clarify the features of this transition, putting the basis for the interpretation of the data at the highest energies. For these tasks KASCADE-Grande fulfills very well the requirements, both concerning the acceptance and the experimental performances. The experiment is constituted by two co-operating arrays of detectors: the KASCADE array, with its 252 detectors in a dense grid of 200x200 m{sup 2} and the Grande array, made of 37 detectors arranged on a wider area of 700x700 m{sup 2}. The Grande array samples the total charged particles size of the air shower, while the KASCADE array provides the muon size In this contribution, KASCADE-Grande measurement of the cosmic ray primary energy spectrum is presented. The exploited technique, calibrated with simulations, combines the charged particles component and muon component on a shower by shower basis, performing the energy estimation of each primary event. Other techniques are also performed, for a better evaluation of systematics and a check of consistency of the hadronic interaction model used in simulations.

  19. Radiation Therapy for Primary Cutaneous Anaplastic Large Cell Lymphoma: An International Lymphoma Radiation Oncology Group Multi-institutional Experience

    Energy Technology Data Exchange (ETDEWEB)

    Million, Lynn, E-mail: lmillion@stanford.edu [Stanford Cancer Institute, Stanford, California (United States); Yi, Esther J.; Wu, Frank; Von Eyben, Rie [Stanford Cancer Institute, Stanford, California (United States); Campbell, Belinda A. [Department of Radiation Oncology and Cancer Imaging, Peter MacCallum Cancer Centre, East Melbourne (Australia); Dabaja, Bouthaina [The University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Tsang, Richard W. [Department of Radiation Oncology, Princess Margaret Cancer Centre, Toronto, Ontario (Canada); Ng, Andrea [Department of Radiation Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts (United States); Wilson, Lynn D. [Department of Therapeutic Radiology/Radiation Oncology, Yale School of Medicine, Yale Cancer Center, New Haven, Connecticut (United States); Ricardi, Umberto [Department of Oncology, University of Turin, Turin (Italy); Kirova, Youlia [Institut Curie, Paris (France); Hoppe, Richard T. [Stanford Cancer Institute, Stanford, California (United States)

    2016-08-01

    Purpose: To collect response rates of primary cutaneous anaplastic large cell lymphoma, a rare cutaneous T-cell lymphoma, to radiation therapy (RT), and to determine potential prognostic factors predictive of outcome. Methods and Materials: The study was a retrospective analysis of patients with primary cutaneous anaplastic large cell lymphoma who received RT as primary therapy or after surgical excision. Data collected include initial stage of disease, RT modality (electron/photon), total dose, fractionation, response to treatment, and local recurrence. Radiation therapy was delivered at 8 participating International Lymphoma Radiation Oncology Group institutions worldwide. Results: Fifty-six patients met the eligibility criteria, and 63 tumors were treated: head and neck (27%), trunk (14%), upper extremities (27%), and lower extremities (32%). Median tumor size was 2.25 cm (range, 0.6-12 cm). T classification included T1, 40 patients (71%); T2, 12 patients (21%); and T3, 4 patients (7%). The median radiation dose was 35 Gy (range, 6-45 Gy). Complete clinical response (CCR) was achieved in 60 of 63 tumors (95%) and partial response in 3 tumors (5%). After CCR, 1 tumor recurred locally (1.7%) after 36 Gy and 7 months after RT. This was the only patient to die of disease. Conclusions: Primary cutaneous anaplastic large cell lymphoma is a rare, indolent cutaneous lymphoma with a low death rate. This analysis, which was restricted to patients selected for treatment with radiation, indicates that achieving CCR was independent of radiation dose. Because there were too few failures (<2%) for statistical analysis on dose response, 30 Gy seems to be adequate for local control, and even lower doses may suffice.

  20. BESMEX: Bering Sea marine mammal experiment. [with the primary target species being the walrus and bowhead whale

    Science.gov (United States)

    Ray, G. C.; Wartzok, D.

    1974-01-01

    Predictive ecological models are being studied for the management and conservation of the walrus, and the bowhead whale in the Bering Sea. The influence of sea ice on the distribution, and carrying capacity of the area for these two mammals is to be investigated with the primary target species being the walrus. Remote sensing and radio tracking is considered a requirement for assessing the walrus ecosystem.

  1. Effectiveness of a Federal Healthy Start program in reducing primary and repeat teen pregnancies: our experience over the decade.

    Science.gov (United States)

    Salihu, Hamisu M; August, Euna M; Jeffers, Delores F; Mbah, Alfred K; Alio, Amina P; Berry, Estrellita

    2011-06-01

    To evaluate the effectiveness of a Federal Healthy Start program in reducing primary and repeat teen pregnancies in a disadvantaged community. An ecological study that compares trends in teen pregnancy in the catchment area in which the community-based intervention was administered with two ecologic controls: the county (Hillsborough) and the state (Florida). Our catchment area is East Tampa, a socio-economically disadvantaged community in Hillsborough County, Florida. Preconception care targeted teenagers between the ages of 10 and 19 years. Interconception care involved young mothers under the age of 20 with a previous birth. The population was comprised primarily of African Americans. Preconception care services for primary teen pregnancy reduction offered sex education, family planning, drug and violence prevention education, and communication and negotiation skills acquisition. Interconception care service offered young women health education through monthly home visitation or monthly peer support group meetings addressing a range of topics using the life course perspective as framework. Reduction in primary teen pregnancy and repeat teen pregnancy among adolescents. The decline in primary teen pregnancy in the catchment area was 60% and 80% greater than the reduction experienced at the county level and at the state level respectively over the period of the study. However, efforts to prevent repeat pregnancy were not successful. The Federal Healthy Start Preconception Care program, in collaboration with community partners, contributed to the prevention of first-time teen pregnancy in a community faced with significant social and economic challenges. Copyright © 2011 North American Society for Pediatric and Adolescent Gynecology. Published by Elsevier Inc. All rights reserved.

  2. Aspirin prescribing patterns for primary prevention of cardiovascular disease in geriatric patients with diabetes: Survey of prescribers based on experience

    OpenAIRE

    Lianne Kokoska, PharmD; Dana El Masri, BS; Helen Berlie, PharmD, CDE; Candice Garwood, PharmD, FCCP, BCPS

    2016-01-01

    Evidence and guidelines provide conflicting recommendations regarding the use of aspirin for primary prevention of cardiovascular disease, particularly in geriatric patients with diabetes. The objective of this study is to identify aspirin-prescribing patterns and determine if it is consistent with the 2013 American Diabetes Association and American Geriatrics Association guidelines. A survey was distributed to attending physicians, fellow physicians, and mid-level practitioners in internal m...

  3. Cervical lymph node metastases from unknown primary cancer: a single-institution experience with intensity-modulated radiotherapy.

    Science.gov (United States)

    Villeneuve, Hugo; Després, Philippe; Fortin, Bernard; Filion, Edith; Donath, David; Soulières, Denis; Guertin, Louis; Ayad, Tarek; Christopoulos, Apostolos; Nguyen-Tan, Phuc Felix

    2012-04-01

    To determine the effectiveness and rate of complications of intensity-modulated radiotherapy (IMRT) in the treatment of cervical lymph node metastases from unknown primary cancer. Between February 2005 and November 2008, 25 patients with an unknown primary cancer underwent IMRT, with a median radiation dose of 70 Gy. The bilateral neck and ipsilateral putative pharyngeal mucosa were included in the target volume. All patients had squamous cell carcinoma, except for 1 patient who had adenosquamous differentiation. They were all treated with curative intent. Of the 25 included patients, 20 were men and 5 were women, with a median age of 54 years. Of these patients, 3 had Stage III, 18 had Stage IVa, and 4 had Stage IVb. Of the 25 patients, 18 (72%) received platinum-based chemotherapy in a combined-modality setting. Neck dissection was reserved for residual disease after definitive IMRT. Overall survival, disease-free survival, and locoregional control were calculated using the Kaplan-Meier method. With a median follow-up of 38 months, the overall survival, disease-free survival, and locoregional control rates were all 100% at 3 years. No occurrence of primary cancer was observed during the follow-up period. The reported rates of xerostomia reduced with the interval from the completion of treatment. Nine patients (36%) reported Grade 2 or greater xerostomia at 6 months, and only 2 (8%) of them reported the same grade of salivary function toxicity after 24 months of follow-up. In our institution, IMRT for unknown primary cancer has provided good overall and disease-free survival in all the patients with an acceptable rate of complications. IMRT allowed us to address the bilateral neck and ipsilateral putative pharyngeal mucosa with minimal late salivary function toxicity. The use of concurrent chemotherapy and IMRT for more advanced disease led to good clinical results with reasonable toxicities. Copyright © 2012 Elsevier Inc. All rights reserved.

  4. Cervical Lymph Node Metastases From Unknown Primary Cancer: A Single-Institution Experience With Intensity-Modulated Radiotherapy

    Energy Technology Data Exchange (ETDEWEB)

    Villeneuve, Hugo, E-mail: hugo.villeneuve@umontreal.ca [Department of Radiation Oncology, Centre hospitalier de l' Universite de Montreal, Montreal, QC (Canada); Despres, Philippe; Fortin, Bernard; Filion, Edith; Donath, David [Department of Radiation Oncology, Centre hospitalier de l' Universite de Montreal, Montreal, QC (Canada); Soulieres, Denis [Department of Medical Oncology, Centre hospitalier de l' Universite de Montreal, Montreal, QC (Canada); Guertin, Louis; Ayad, Tarek; Christopoulos, Apostolos [Department of Head and Neck Surgery, Centre hospitalier de l' Universite de Montreal, Montreal, QC (Canada); Nguyen-Tan, Phuc Felix [Department of Radiation Oncology, Centre hospitalier de l' Universite de Montreal, Montreal, QC (Canada)

    2012-04-01

    Purpose: To determine the effectiveness and rate of complications of intensity-modulated radiotherapy (IMRT) in the treatment of cervical lymph node metastases from unknown primary cancer. Methods and Materials: Between February 2005 and Novembe