WorldWideScience

Sample records for experiments primary documentation

  1. Using Primary Source Documents.

    Science.gov (United States)

    Mintz, Steven

    2003-01-01

    Explores the use of primary sources when teaching about U.S. slavery. Includes primary sources from the Gilder Lehrman Documents Collection (New York Historical Society) to teach about the role of slaves in the Revolutionary War, such as a proclamation from Lord Dunmore offering freedom to slaves who joined his army. (CMK)

  2. 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.

  3. Documentation and Development. Experience in Algeria

    Science.gov (United States)

    Tchuigoua, J. Founou

    1972-01-01

    A description of the activities of the Documentation, Library and Archives Department of the Algiers Chamber of Commerce and Industry, which is run by a small staff on a modest budget, provides documentation services for the staff of the Chamber of Commerce and also assists other centers in Algeria. (Author)

  4. User experience and compatibility in documentation standards. Summary

    International Nuclear Information System (INIS)

    Maskewitz, B.F.

    1982-01-01

    Existing guidelines for documentation of scientific computer programs or data libraries are reviewed, and the essential elements for facilitating exchange of the software are outlined. Selected case studies are made in which accepted standards were followed from the programming stage through documentation, and an analysis of user experience

  5. 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)

  6. iDocument: How Smartphones and Tablets Are Changing Documentation in Preschool and Primary Classrooms

    Science.gov (United States)

    Parnell, Will; Bartlett, Jackie

    2012-01-01

    With the increased prevalence of smartphones, laptops, tablet computers, and other digital technologies, knowledge about and familiarity with the educational uses for these devices is important for early childhood teachers documenting children's learning. Teachers can use smartphones every day to take photos, record video and audio, and make…

  7. IRPhE-HTR-ARCH-01, Archive of HTR Primary Documents

    International Nuclear Information System (INIS)

    2004-01-01

    Description: High Temperature Reactor Studies, including experiments in critical facilities or in prototypes have been carried out in the past. Information gathered, experience gained and experimental data produced are of value for the development of future advanced HTRs. For the purpose of knowledge, competence, information preservation and management, computer readable archives have been established. The present archive includes several relevant documents relative to the following: - Graphite Moderated Critical Facility, CESAR at Cadarache. Dragon Countries Physics Meetings (DCPM); - OTTO Pebble Bed Reactors; - Gulf - HTGR Experiments; - Zero Power MARIUS Reactor; - Pebble-bed KAHTER Critical Facility; - Helium Cooled Fast Reactor Assessment Studies; - Gas Cooled Reactor Technology Safety and Siting; - Initial Evaluation of the Gas-Turbine Modules HTGCR; - A report on Nuclear Graphite; - AVR Reactor Juelich (new in version 02); - HTR IAEA proceedings (new in version 02); - Studies at IRI Delft(new in version 02); - Studies and experiments at PSI Villigen (new in version 02); 2 - Related or auxiliary information: IRPHE-DRAGON-DPR, high Temperature Reactor Dragon Project, Primary Documents NEA-1726/01. 3 - Software requirements: Acrobat Reader, Microsoft Word, HTML Browser required

  8. 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.

  9. Documentation of pain care processes does not accurately reflect pain management delivered in primary care.

    Science.gov (United States)

    Krebs, Erin E; Bair, Matthew J; Carey, Timothy S; Weinberger, Morris

    2010-03-01

    Researchers and quality improvement advocates sometimes use review of chart-documented pain care processes to assess the quality of pain management. Studies have found that primary care providers frequently fail to document pain assessment and management. To assess documentation of pain care processes in an academic primary care clinic and evaluate the validity of this documentation as a measure of pain care delivered. Prospective observational study. 237 adult patients at a university-affiliated internal medicine clinic who reported any pain in the last week. Immediately after a visit, we asked patients to report the pain treatment they received. Patients completed the Brief Pain Inventory (BPI) to assess pain severity at baseline and 1 month later. We extracted documentation of pain care processes from the medical record and used kappa statistics to assess agreement between documentation and patient report of pain treatment. Using multivariable linear regression, we modeled whether documented or patient-reported pain care predicted change in pain at 1 month. Participants' mean age was 53.7 years, 66% were female, and 74% had chronic pain. Physicians documented pain assessment for 83% of visits. Patients reported receiving pain treatment more often (67%) than was documented by physicians (54%). Agreement between documentation and patient report was moderate for receiving a new pain medication (k = 0.50) and slight for receiving pain management advice (k = 0.13). In multivariable models, documentation of new pain treatment was not associated with change in pain (p = 0.134). In contrast, patient-reported receipt of new pain treatment predicted pain improvement (p = 0.005). Chart documentation underestimated pain care delivered, compared with patient report. Documented pain care processes had no relationship with pain outcomes at 1 month, but patient report of receiving care predicted clinically significant improvement. Chart review measures may not accurately

  10. 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.

  11. 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…

  12. Primary vertex reconstruction at the ATLAS experiment

    CERN Document Server

    AUTHOR|(INSPIRE)INSPIRE-00301388; The ATLAS collaboration; Casper, D.; Hooberman, B.; Gui, B.; Lee, G.; Maurer, J.; Morley, A.; Pagan Griso, S.; Petersen, B.; Prokofiev, K.; Shan, L.; Shope, D.; Wharton, A.; Whitmore, B.; Zhang, M.

    2017-01-01

    These proceedings present the method and performance of primary vertex reconstruction at the ATLAS experiment during Runs 1 and 2 at the LHC. The studies presented focus on data taken during 2012 at a centre-of-mass energy of $\\sqrt{s} = 8$ TeV, and during 2015-2016 at $\\sqrt{s} = 13$ TeV. Some predictions toward future runs are also presented. 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.

  13. 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.

  14. The Italian Geographers' Document on the University Education of Future Primary School Teachers

    Science.gov (United States)

    Giorda, Cristiano; Di Palma, Maria Teresa

    2011-01-01

    This article describes an important document compiled by a group of Italian geographers who teach in the Teaching Sciences faculty. Twenty-two university professors in an online community debated concepts and compared ideas in order to establish content, methods and didactic approaches to be applied when training Primary School teachers (pupils…

  15. 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.

  16. The promotion of olanzapine in primary care: an examination of internal industry documents.

    Science.gov (United States)

    Spielmans, Glen I

    2009-07-01

    Media reports have discussed how olanzapine was marketed off-label for dementia and subsyndromal bipolar disorder. Much of this marketing occurred in primary care settings. However, these reports have provided few details. In legal proceedings, Lilly disclosed internal documents that detail the strategies utilized to market olanzapine. The current paper addresses the marketing of olanzapine in detail based upon a review of these documents. All 358 documents released by Lilly are publicly available online. Documents were utilized for this review if they were relevant to the marketing of olanzapine in primary care settings in the United States. It was found that olanzapine was marketed off-label in primary care settings for relatively mild symptoms that were framed as bipolar disorder and schizophrenia. A key strategy in this campaign was the use of hypothetical patient profiles in detailing visits, most of which clearly failed to meet diagnostic criteria for any recognized mental disorder. Evidence emerged that olanzapine was also marketed off-label as a treatment for dementia.

  17. IRPhE-DRAGON-DPR, OECD High Temperature Reactor Dragon Project, Primary Documents

    International Nuclear Information System (INIS)

    2004-01-01

    Description: The DRAGON Reactor Experiment (DRE): The first demonstration High temperature gas reactor (HTGR) was built in the 1960's. Thirteen OECD countries began a project in 1959 to build an experimental reactor known as Dragon at Winfrith in the UK. The reactor - which operated successfully between 1966 and 1975 - had a thermal output of 20 MW and achieved a gas outlet temperature of 750 deg. C. The High Temperature Reactor concept, if it justified its expectations, was seen as having its place as an advanced thermal reactor between the current thermal reactor types such as the PWR, BWR, and AGR and the sodium cooled fast breeder reactor. It was expected that the HTR would offer better thermal efficiency, better uranium utilisation, either with low enriched uranium fuel or high enriched uranium thorium fuel, better inherent safety and lower unit power costs. In the event all these potential advantages were demonstrated to be in principle achievable. This view is still shared today. In fact Very High Temperature Reactors is one of the concepts retained for Generation IV. Projects on constructing Modular Pebble Bed Reactors are under way. Here all available Dragon Project Reports (DPR) - approximately 1000 - are collected in electronic form. An index points to the reports (PDF format); each table in the report is accessible in EXCEL format with the aim of facilitating access to the data. These reports describe the design, experiments and modelling carried out over a period of 17 years. 2 - Related or auxiliary information: IRPHE-HTR-ARCH-01, Archive of HTR Primary Documents NEA-1728/01. 3 - Software requirements: Acrobat Reader, Microsoft Word, HTML Browser required

  18. BC Hydro experiences the power of engineering document management software

    International Nuclear Information System (INIS)

    Wilkins, A.

    2000-01-01

    The recent popularity of electronic document management software (EDMS), specifically designed for engineering CAD/CAM drawings that holds the promise of reducing paper-pushing and freeing up organizational resources for more productive purposes, is discussed. To illustrate how such systems function, a document management system installed at BC Hydro, with over 2,500 users in two main engineering groups is described. The new system - FileNET - replaces several older systems that have been used as stand-alone systems in various divisions of BC Hydro for some time. Instead of integrating the entire file of some 750,000 documents, the new system has complete records of some 70,000 of the most recent CAD drawings and an on-line index to the older file that is used less frequently. Access to the entire storehouse of drawings is said to be fast, efficient and secure. Automated document control procedures during work-in-progress, viewing, redlining capabilities, seamless integration with CAD tools and Web access to drawings from anywhere within the two engineering divisions, are some of the most noteworthy characteristics of the new system. It does not completely replace paper, but it does promise significant streamlining of the paper handling function. It also ensures that BC Hydro's central computer is the prime repository of all documents and drawings, and that this valuable record of environmental. legal, regulatory and other public policy importance is instantly available, without the need to handle paper

  19. The Apollo experiment for document delivery via satellite communication

    Science.gov (United States)

    1985-03-01

    Dutch participation possibilities in the Apollo document delivery project, wishes and idea's of potential user and tender groups, and plans and activities of Dutch institutes and companies, are surveyed. The Apollo storage and transport system, demand and administration network, potential markets, and subject areas of the documents are investigated. Utilization areas (scientific, technical, administration, and business information) are listed. High tariffs and the lack of necessary provision make a direct participation strategy impossible. However, in the experimental phase, Dutch companies must be allowed to contribute in technical developments and availability of organizational and technical facilities must be stimulated.

  20. PMK-2 the Hungarian integral type test facility. Documentations, publications and archivations of experiments

    International Nuclear Information System (INIS)

    Perneczky, L.; Guba, A.; Ezsoel, G.; Toth, I.; Szabados, L.

    2002-01-01

    The PMK-2 experimental facility at the KFKI-AEKI, Budapest, is a full pressure, scaled down model of the primary and partly the secondary circuit of the Paks NPP, which is equipped with four VVER-440/213-type reactors. Since the start-up of the facility altogether 48 experiments have been performed for groups of transients as follows: one- and two-phase natural circulation, loss of coolant accidents, special plant transients and experiments in support of accident management procedures. The results have been used for the validation of thermal-hydraulic system codes for VVER applications. Following the experiments a detailed documentation and archiving activity - using an optimised data storage - was required to preserve the essential information and to assure these for a widely utilisation for the international nuclear community. In the publication list related to the facility and the experiments for the moment altogether 280 items - documents, articles in periodicals, papers in proceedings and research reports - in six languages were collected. The paper gives an overview on this activity including the participation in the EU CERTA-TN programme, where AEKI introduced representative databases of two PMK-2 tests in the STRESA Network.(author)

  1. Generating scientific documentation for computational experiments using provenance

    NARCIS (Netherlands)

    Wibisono, A.; Bloem, P.; de Vries, G.K.D.; Groth, P.; Belloum, A.; Bubak, M.; Ludäscher, B.; Plale, B.

    2015-01-01

    lectronic notebooks are a common mechanism for scientists to document and investigate their work. With the advent of tools such as IPython Notebooks and Knitr, these notebooks allow code and data to be mixed together and published online. However, these approaches assume that all work is done in the

  2. 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.

  3. 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

  4. 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...

  5. System Requirements Document for the Molten Salt Reactor Experiment

    Energy Technology Data Exchange (ETDEWEB)

    Aigner, R.D.

    2000-04-01

    The purpose of the conversion process is to convert the {sup 233}U fluoride compounds that are being extracted from the Molten Salt Reactor Experiment (MSRE) equipment to a stable oxide for long-term storage at Bldg. 3019.

  6. Rectocele repair using biomaterial augmentation: current documentation and clinical experience.

    Science.gov (United States)

    Altman, Daniel; Mellgren, Anders; Zetterström, Jan

    2005-11-01

    Although the etiology of rectocele remains debated, surgical innovations are currently promoted to improve anatomic outcome while avoiding dyspareunia and alleviating rectal emptying difficulties following rectocele surgery. Use of biomaterials in rectocele repair has become widespread in a short time, but the clinical documentation of their effectiveness and complications is limited. Medline and the Cochrane database were searched electronically from 1964 to May 2005 using the Pubmed and Ovid search engines. All English language publications including any of the search terms "rectocele," "implant," "mesh," "biomaterial," "prolapse," "synthetical," "pelvic floor," "biological," and "compatibility" were reviewed. This review outlines the basic principles for use of biomaterials in pelvic reconstructive surgery and provides a condensation of peer-reviewed articles describing clinical use of biomaterials in rectocele surgery. Historical and new concepts in rectocele surgery are discussed. Factors of importance for human in vivo biomaterial compatibility are presented together with current knowledge from clinical studies. Potential risks and problems associated with the use of biomaterials in rectocele and pelvic reconstructive surgery in general are described. Although use of biomaterials in rectocele and other pelvic organ prolapse surgery offers exciting possibilities, it raises treatment costs and may be associated with unknown and potentially severe complications at short and long term. Clinical benefits are currently unknown and need to be proven in clinical studies. Obstetricians & Gynecologists, Family Physicians After completion of this article, the reader should be able to explain that the objective of surgical treatment is to improve anatomic outcome and alleviate rectal emptying difficulties, describe the efficacy of biomaterials in rectocele repair, and summarize the potential risks and problems associated with use of biomaterials in rectocele and pelvic

  7. PBF/LOFT Lead Rod Test Program experiment predictions document

    International Nuclear Information System (INIS)

    Varacalle, D.J.; Cox, W.R.; Niebruegge, D.A.; Seiber, S.J.; Brake, T.E.; Driskell, W.E.; Nigg, D.W.; Tolman, E.L.

    1978-12-01

    The PBF/LOFT Lead Rod (LLR) Test Program is being conducted to provide experimental information on the behavior of nuclear fuel under normal and accident conditions in the Power Burst Facility (PBF) at the Idaho National Engineering Laboratory. The PBF/LLR tests are designed to simulate the test conditions for the LOFT Power Ascension Tests L2-3 through L2-5. The test program has been designed to provide a parametric evaluation of the LOFT fuel (center and peripheral modules) over a wide range of power. This report presents the experiment predictions for the three four-rod LOCA tests

  8. 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

  9. Bullying experience in primary school children

    OpenAIRE

    Farah Aulia

    2016-01-01

    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 questionnai...

  10. 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 ...

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

    International Nuclear Information System (INIS)

    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

  12. 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.

  13. Personal information documents for people with dementia: Healthcare staff 's perceptions and experiences.

    Science.gov (United States)

    Baillie, Lesley; Thomas, Nicola

    2018-01-01

    Person-centred care is internationally recognised as best practice for the care of people with dementia. Personal information documents for people with dementia are proposed as a way to support person-centred care in healthcare settings. However, there is little research about how they are used in practice. The aim of this study was to analyse healthcare staff 's perceptions and experiences of using personal information documents, mainly Alzheimer's Society's 'This is me', for people with dementia in healthcare settings. The method comprised a secondary thematic analysis of data from a qualitative study, of how a dementia awareness initiative affected care for people with dementia in one healthcare organisation. The data were collected through 12 focus groups (n = 58 participants) and 1 individual interview, conducted with a range of healthcare staff, both clinical and non-clinical. There are four themes presented: understanding the rationale for personal information documents; completing personal information documents; location for personal information documents and transfer between settings; impact of personal information documents in practice. The findings illuminated how healthcare staff use personal information documents in practice in ways that support person-centred care. Practical issues about the use of personal information documents were revealed and these may affect the optimal use of the documents in practice. The study indicated the need to complete personal information documents at an early stage following diagnosis of dementia, and the importance of embedding their use across care settings, to support communication and integrated care.

  14. Primary hyperparathyroidism: King Khalid University Hospital experience

    International Nuclear Information System (INIS)

    Fouda, Mona A.

    1999-01-01

    This study was conducted to examine the prevalence, mode of presentationand management of primary hyperparathyroidism in one of the major hospitalsin Saudi Arabia. This was a retrospective analysis of 24 cases of primaryhyperparathyroidism comprising of 21 females and three males, who were seenat King Khalid University Hospital over a period of 16 years from 1982 untilDecember 1997. The prevalence of disease was estimated to be estimated to be11.34 per 100,000 hospital population. The majority of patients presentedwith musculoskeletal complaints (62%-67%) and/or renal complications were(58%). Hyperclacemia was seen in 92% of the cases. Serum PTH was availablefor 21 patients and 20 had significantly elevated levels. Fifty percent ofthe patients had features of hyperparathyroid bone disease on plane x-ray,while 79% showed osteopenia of the femoral neck and dual x-rayabsorptiometry, and almost all the patients had lumbar osteopenia. Fiftypercent of the patients had features of metabolic bone disease on bone scan.Thallium -technetium subtraction studies proved to be the most reliable tool,with 83% sensitivity of 55%. CT scan of the neck was attempted in only inseven patients (29%), with a sensitivity of 86%. Twenty-one patients (87.5%)underwent surgical exploration and removal of the parathyroid adenoma. Singleparathyroid adenoma was identified in 85% of the cases, 5% had multipleadenomas and 5% had hyperplasia of the parathyroid gland. Our results showedthat primary hyperparathyroidism is not rare disease in Saudi Arabia. It hastendency for late presentation with complications. We believe that routinescreening for calcium, and early identification of such cases, are warrantedto reduce the morbidity of this easily treatable disorder. (author)

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

    African Journals Online (AJOL)

    The broad research aim was to investigate the lived experiences of women heading public rural primary schools in Kenya, and to explore possible strategies that may be applied to improve women's participation in educational leadership in rural primary schools in Kenya. This article is limited to the findings regarding the ...

  16. Examining the Seven-Flag "Chieu Hoi" Pass: A Primary Document from the American War in Viet Nam

    Science.gov (United States)

    Engelmann, Ted

    2006-01-01

    During the Viet Nam war, U.S. military helicopters dropped "Chieu Hoi" (safe conduct) passes over suspected enemy locations to encourage enemy soldiers to surrender. This article presents a classroom activity that encourages students to examine a "Chieu Hoi" pass as a primary historical document, identify its various elements,…

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

    International Nuclear Information System (INIS)

    Redissi, M.

    1990-05-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

    Redissi, M [ALDOC (Tunisia)

    1990-05-01

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

  19. 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.

  20. 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.

  1. 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…

  2. Carrying out Electronic Nursing Documentation : Use and Development in Primary Health Care

    OpenAIRE

    Törnvall, Eva

    2008-01-01

    Communication of care is essential in the multidisciplinary health care system and the patient record is an important tool for communication. The electronic patient record was introduced to facilitate the documentation of care, as well as the communication and evaluation of care. District nurses met the patient independently of other caregivers at the surgery or in the patient’s home. Documentation by district nurses is assumed to contribute to the view of the patient so that safe care can be...

  3. Experiences with loss of natural circulation events, performed experiments, analysis, computations and development of operational documents

    International Nuclear Information System (INIS)

    Nagy, L.; Varju, A.; Nagy, S.

    1996-01-01

    The refuelling of the unit 4 was started on 18 June, 1988. At the time of the event the reactor was in cold shutdown state, with atmospheric pressure, the reactor head was removed. On June 30 the operational personnel performed a planned switch over of natural circulation from loops 4, 6 to loops 1, 3. In the meantime the effectiveness of the core cooling by natural circulation decreased sharply for about 3 hour-period. After switching over the natural circulation among the loops the operating personnel isolated the loops 4., 6. and started to drain them. Nitrogen used to drain the loops was unintentionally injected into the loops in operation and large amount of primary coolant was pushed out from the SG primary side to the reactor vessel. The operators tried to stop the disturbance of natural circulation by starting the booster pump of make-up system periodically to the working loops. During this injection the personnel performed venting few times to take away the gas-air mixture from the top of the SG primary headers. After all the restoration of the natural circulation was achieved by continuous venting the SG headers. During 1993 annual refuelling outage of Unit 2 at Paks NPP a deterioration of natural circulation in reactor coolant system occurred. A special maintenance task was being performed to repair the cladding of the sealing bellows between the reactor vessel and reactor cavity

  4. 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.

  5. Nursing Practice in Primary Care and Patients' Experience of Care.

    Science.gov (United States)

    Borgès Da Silva, Roxane; Brault, Isabelle; Pineault, Raynald; Chouinard, Maud-Christine; Prud'homme, Alexandre; D'Amour, Danielle

    2018-01-01

    Nurses are identified as a key provider in the management of patients in primary care. The objective of this study was to evaluate patients' experience of care in primary care as it pertained to the nursing role. The aim was to test the hypothesis that, in primary health care organizations (PHCOs) where patients are systematically followed by a nurse, and where nursing competencies are therefore optimally used, patients' experience of care is better. Based on a cross-sectional analysis combining organizational and experience of care surveys, we built 2 groups of PHCOs. The first group of PHCOs reported having a nurse who systematically followed patients. The second group had a nurse who performed a variety of activities but did not systematically follow patients. Five indicators of care were constructed based on patient questionnaires. Bivariate and multivariate linear mixed models with random intercepts and with patients nested within were used to analyze the experience of care indicators in both groups. Bivariate analyses revealed a better patient experience of care in PHCOs where a nurse systematically followed patients than in those where a nurse performed other activities. In multivariate analyses that included adjustment variables related to PHCOs and patients, the accessibility indicator was found to be higher. Results indicated that systematic follow-up of patients by nurses improved patients' experience of care in terms of accessibility. Using nurses' scope of practice to its full potential is a promising avenue for enhancing both patients' experience of care and health services efficiency.

  6. Giving Women the Vote: Using Primary Source Documents to Teach about the Fight for Women's Suffrage.

    Science.gov (United States)

    Jacobsen, Margaret

    1988-01-01

    Presents a lesson in which students use primary sources to learn about the organizing strategies used in the fight for women's suffrage. These sources will provide insights into the past and help students develop appreciation for the hardships suffragists endured. Includes objectives, procedures, and suggestions for activities. (LS)

  7. 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...

  8. CVIT expert consensus document on primary percutaneous coronary intervention (PCI) for acute myocardial infarction (AMI) in 2018.

    Science.gov (United States)

    Ozaki, Yukio; Katagiri, Yuki; Onuma, Yoshinobu; Amano, Tetsuya; Muramatsu, Takashi; Kozuma, Ken; Otsuji, Satoru; Ueno, Takafumi; Shiode, Nobuo; Kawai, Kazuya; Tanaka, Nobuhiro; Ueda, Kinzo; Akasaka, Takashi; Hanaoka, Keiichi Igarashi; Uemura, Shiro; Oda, Hirotaka; Katahira, Yoshiaki; Kadota, Kazushige; Kyo, Eisho; Sato, Katsuhiko; Sato, Tadaya; Shite, Junya; Nakao, Koichi; Nishino, Masami; Hikichi, Yutaka; Honye, Junko; Matsubara, Tetsuo; Mizuno, Sumio; Muramatsu, Toshiya; Inohara, Taku; Kohsaka, Shun; Michishita, Ichiro; Yokoi, Hiroyoshi; Serruys, Patrick W; Ikari, Yuji; Nakamura, Masato

    2018-04-01

    While primary percutaneous coronary intervention (PCI) has significantly contributed to improve the mortality in patients with ST segment elevation myocardial infarction even in cardiogenic shock, primary PCI is a standard of care in most of Japanese institutions. Whereas there are high numbers of available facilities providing primary PCI in Japan, there are no clear guidelines focusing on procedural aspect of the standardized care. Whilst updated guidelines for the management of acute myocardial infarction were recently published by European Society of Cardiology, the following major changes are indicated; (1) radial access and drug-eluting stent over bare metal stent were recommended as Class I indication, and (2) complete revascularization before hospital discharge (either immediate or staged) is now considered as Class IIa recommendation. Although the primary PCI is consistently recommended in recent and previous guidelines, the device lag from Europe, the frequent usage of coronary imaging modalities in Japan, and the difference in available medical therapy or mechanical support may prevent direct application of European guidelines to Japanese population. The Task Force on Primary Percutaneous Coronary Intervention of the Japanese Association of Cardiovascular Intervention and Therapeutics (CVIT) has now proposed the expert consensus document for the management of acute myocardial infarction focusing on procedural aspect of primary PCI.

  9. 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

    Nar, CDC, MEDION, Health Technology Assessment Database, TRIP database, NTIS, ProQuest Dissertations and Theses, Google Scholar, Current Contents) were searched from their inception to September 2016. RESULTS: The results from the studies were extracted using pre-developed extraction tools to all three......) conduct a history and clinical diagnosis, physical examination and dietary assessment when assessing primarily the elderly's nutritional status in primary health care....

  10. A framework guiding critical thinking through reflective journal documentation: a Middle Eastern experience.

    Science.gov (United States)

    Simpson, Elaine; Courtney, Mary

    2007-08-01

    The purpose of this paper is to present a framework to guide critical thinking through reflective journaling, and describe how a group of 20 Middle Eastern nurses used reflective journaling to enhance their practice. Journal documentation was used during clinical practicum to foster the development of critical thinking in order to assist nurses when analysing and evaluating their clinical experiences. The findings from this study demonstrated that nurses accepted the framework for journal documentation because it provided structure for reflection, speculation, synthesis and metacognition of events experienced during clinical practice. Journaling gave nurses the opportunity to transfer thoughts onto paper and write down subjective and objective data, and created dialogue between the nurse educators and nurses. They were engaged in productive and positive activity to enhance their nursing practice. Nurses also commented that writing helped to develop their confidence in writing English.

  11. Review on experiments relating to primary containment vessel failure

    International Nuclear Information System (INIS)

    Suzuki, Hiroyuki; Okada, Hidetoshi; Uchida, Sunsuke; Naitoh, Masanori

    2015-01-01

    Experiments regarding failures of primary containment vessels (PCVs) are reviewed and remained issues to be investigated in the future are discussed. Experiments are categorized as those relating to criteria of PCV failures and to FP releases through breaches on PCV boundaries. In the experiments categorized as those relating to criteria of PCV failures, experiments with full-scale, scale models, and compounds used for sealing are surveyed. Experiments relating to an amount of radioactive fission products (FPs) trapped at breaches on PCV boundaries are also reviewed. As remained issues to be investigated in the future, two items are pointed out: Evaluating degradation behavior of PCV boundaries exposed to temperature and pressure from the failure onset criteria to far above them, and evaluating an amount of FPs trapped at breaches on PCV boundaries. (author)

  12. 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.

  13. Experience of men in the context of Primary Health Care.

    Science.gov (United States)

    de Oliveira, Patrícia Peres; dos Santos, Walquíria Jesusmara; Viegas, Selma Maria da Fonseca; da Silveira, Edilene Aparecida Araújo; Rodrigues, Andrea Bezerra

    2015-01-01

    To know the experience of male users' in the primary health care and to build data based theory that represents this experience. This is a qualitative study, in which was used the reference of Grounded Theory and Symbolic Interactionism, respectively, methodological and theoretical. We interviewed 33 male users of three units of primary health care. After comparative analysis of data was built the data based theory feeling excluded, which includes: living with prejudice; living with the limitations of infra-structure services; reflecting on the health service environment. The analysis showed the need for a change in logistics services and professionals' attitude guided in respectful and effective communication, the problem solving in readiness in attendance, in addressing gender issues. For to take care of men users of the Unified Health System and/or preserve their health, the construction of another rationality in health is imperative, based on reflection and respect for the autonomy and individuality of the male gender.

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

    International Nuclear Information System (INIS)

    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

  15. 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.

  16. Skyline: an open source document editor for creating and analyzing targeted proteomics experiments.

    Science.gov (United States)

    MacLean, Brendan; Tomazela, Daniela M; Shulman, Nicholas; Chambers, Matthew; Finney, Gregory L; Frewen, Barbara; Kern, Randall; Tabb, David L; Liebler, Daniel C; MacCoss, Michael J

    2010-04-01

    Skyline is a Windows client application for targeted proteomics method creation and quantitative data analysis. It is open source and freely available for academic and commercial use. The Skyline user interface simplifies the development of mass spectrometer methods and the analysis of data from targeted proteomics experiments performed using selected reaction monitoring (SRM). Skyline supports using and creating MS/MS spectral libraries from a wide variety of sources to choose SRM filters and verify results based on previously observed ion trap data. Skyline exports transition lists to and imports the native output files from Agilent, Applied Biosystems, Thermo Fisher Scientific and Waters triple quadrupole instruments, seamlessly connecting mass spectrometer output back to the experimental design document. The fast and compact Skyline file format is easily shared, even for experiments requiring many sample injections. A rich array of graphs displays results and provides powerful tools for inspecting data integrity as data are acquired, helping instrument operators to identify problems early. The Skyline dynamic report designer exports tabular data from the Skyline document model for in-depth analysis with common statistical tools. Single-click, self-updating web installation is available at http://proteome.gs.washington.edu/software/skyline. This web site also provides access to instructional videos, a support board, an issues list and a link to the source code project.

  17. Localization experience and future plan of NSLS primary components

    International Nuclear Information System (INIS)

    Kim, Haesoo

    1992-01-01

    Korea Heavy Industries and Construction Company is planning to obtain technical self-reliance of the component design, manufacturing and installation of the NSLS primary components as much as the target of 87% by 1995 as indicated in the technical self-reliance plan by the Korea Electric Power Company in 1988. In order to achieve this target, Koch has been involved in the component design, manufacturing and project management of the NSLS components from the early stage of the Young 3 and 4 project. In parallel, Koch has increased the self-reliance of the various fields taking full advantage of the technical documents, computer codes, training and consultation supplied by the technology transfer agreement. This paper presents the re-evaluation of the current status of technical self reliance as well as the make up plan to be implemented during the UCH 3 and 4 project for the area identified as the weakness

  18. PRIMARY SCHOOL TEACHERS’ OPINIONS ABOUT THE CURRICULAR DOCUMENTS USED FOR STUDYING THE MATHEMATICS AND ENVIRONMENTAL EXPLORATION SUBJECT

    Directory of Open Access Journals (Sweden)

    Ioana-Cristina MAGDAȘ

    2017-08-01

    Full Text Available Due to the introduction in 2013 into the new Framework Plan for the primary education of the integrated Mathematics and Environmental Exploration (MEE subject, of new textbooks and auxiliaries, we considered it necessary to find the the teachers’ opinions regarding the way in which the curriculum documents facilitate the study of the MEE subject. The present article is based on a research performed using a survey carried out voluntarily and anonymously by 131 teachers for primary education. Through the responses to the questionnaire, we identified several important issues. Regarding teachers’ sources of documentation, we found out that they prefered online sources (websites, blogs and specialized forums, which was surprising because these sources did not have the reliability of correct information. Only on the next places were placed the official documents or those elaborated by specialists. Teachers assigned scores of about four (out of a maximum of five to the clarity of all components of the school curriculum. In terms of textbooks and auxiliaries, respondents scored better auxiliaries across all the indicators considered. The biggest benefit of introducing the MEE subject identified by I.-C. MAGDAȘ, M. E. DULAMĂ, O.-R. ILOVAN, I.C. CRIȘAN 6 respondents was that activities were more attractive or motivating for learning. At the opposite end, the smallest benefits related to ensuring the rigour and learning durability of both Mathematics and Environmental Exploration. Regarding the limitations, disadvantages or problems of studying the MEE subject, the lack of support materials was the first reported by the respondents. On the next places were placed the need for specific lessons with mathematical content or the heavy design of thematic units and lessons.

  19. 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.

  20. The primary target for the hypernuclear experiment at PANDA

    Energy Technology Data Exchange (ETDEWEB)

    Bleser, Sebastian; Martinez Rojo, Marta; Sanchez Lorente, Alicia; Steinen, Marcell [Helmholtz-Institut Mainz (Germany); Iazzi, Felice [INFN, Torino (Italy); Politecnico di Torino (Italy); Pochodzalla, Josef [Helmholtz-Institut Mainz (Germany); Institut fuer Kernphysik, JGU Mainz (Germany); Rausch, Nicolas [Institut fuer Kernphysik, JGU Mainz (Germany); Collaboration: PANDA-Collaboration

    2016-07-01

    A key aspect of the PANDA experiment at the future FAIR facility is the production and spectroscopy of ΛΛ hypernuclei. The double hypernuclei are produced in a two-stage target system consisting of a primary in-beam filament to produce low momentum Ξ{sup -} hyperons which are stopped and converted into two Λ hyperons in a secondary external target. A system of piezo motors will be used to steer the primary target in two dimensions. This allows to achieve a constant luminosity by adjusting the position and provides the replacement of eventually broken target wires. The poster shows the mechanical integration of this system within the vacuum chamber attached to the beampipe. Its motion is controlled using the EPICS framework as planned for PANDA. In addition the results of radiation tests with foreseen target wires are presented.

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

    OpenAIRE

    A. V. Semenets; V. Yu. Kovalok

    2015-01-01

    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 Mi...

  2. The primary circuit of the dragon high temperature reactor experiment

    International Nuclear Information System (INIS)

    Simon, R.

    2005-01-01

    The 20 MWth Dragon Reactor Experiment was the first HTGR (High Temperature Gas-cooled Reactor) with coated particle fuel. Its purpose was to test fuel and materials for the High Temperature Reactor programmes pursued in Europe 40 years ago. This paper describes the design and construction of the primary (helium) circuit. It summarizes the main design objectives, lists the performance data and explains the flow paths of the heat removal and helium purification systems. The principal circuit accidents postulated are discussed and the choice of the main construction materials is given. (author)

  3. 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.

  4. Late Lung Metastasis of a Primary Eccrine Sweat Gland Carcinoma 10 Years after Initial Surgical Treatment: The First Clinical Documentation

    Directory of Open Access Journals (Sweden)

    R. F. Falkenstern-Ge

    2013-01-01

    Full Text Available Background. Sweat gland carcinoma is a rare malignancy with a high metastatic potential seen more commonly in elderly patients. The scalp is the most common site of occurrence and it usually spreads to regional lymph nodes. Liver, lungs, and bones are the most common sites of distant metastasis. Late lung metastasis of sweat gland adenocarcinoma after a time span of 5 years is extremely rare. Aim. We report a patient with late lung metastasis of a primary sweat gland carcinoma 10 years after initial surgical resection. Conclusion. Sweat gland carcinomas are rare cancers with a poor prognosis. Surgery in the form of wide local excision and lymph node dissection is the mainstay of treatment. Late pulmonary metastases with a latency of 10 years have never been reported in the literature. This is the first clinical documentation of late lung metastasis from sweat gland carcinoma with a latency period of 10 years.

  5. [The medical and vaccination card for children--a document for the promotion of primary preventive care in pediatrics].

    Science.gov (United States)

    Hanousek, L

    1989-07-01

    The basis of a comprehensive approach to prevention of chronic diseases of childhood is a system of uniform preventive examinations which makes it possible to examine the child in the parent's presence. This system accentuates the systematic training of parents with the aim to promote health and prevent the development of chronic disease. Part of the effort to improve the health consciousness of parents is the newly developed document, the child's health and vaccination card. This card--contrary to the basic documentation of the child--is his property and is kept by his parents at home. The card provides the parents as well as class teacher with basic information on the child's health status. This information must be used by the parents and teachers for primary preventive regime provisions. By issuing these cards to all children it will be possible to do away with examinations, necessary so far, in conjunction with issuing of certificates on the child's health status before major sports contents. This will reduce the unproductive administrative work of health community doctors and health community paediatric nurses and will save the time of parents who accompanied the children attending these examinations.

  6. Experience on Primary System Decommissioning in Jose Cabrera NPP

    Energy Technology Data Exchange (ETDEWEB)

    Paloma Molleda; Leandro Sanchez; David Rodriguez [ENSA, Cantabria (Spain)

    2015-10-15

    Primary System Decommissioning belongs to DCP(Decommissioning and Closure Plan) works and its scope includes: Steam Generator, Pressurizer, Refrigerant Circuit Pump and Primary Circuit Piping. All these dismantling activities were carried out on site, including preliminary steps before their removal (SAS installations, pre decontaminations, cutting and segmentations, segregations, etc.) and delivery to media/low activity nuclear waste disposal site. There are many cutting techniques available in market (most of them proved with positive results) as well as there are many different approaches about how to manage radioactive wastes in decommissioning projects (containers or great components disposal, containers burial, re fusion, etc.). Both issues are linked and, before starting a new project, it might be positive and quite useful to compare and study previous dismantling experiences, especially the lesson learned chapter. Primary System cut with diamond saw has been a challenge target, not only due to the methodology innovation (since until nowadays, the common use of this technology was performed in cutting concrete walls) because it has a huge range of positive aspects that, in our opinion, are attractive (apart from its mentioned versatility, in terms of cutting on site and every type of material)

  7. Experience on Primary System Decommissioning in Jose Cabrera NPP

    International Nuclear Information System (INIS)

    Paloma Molleda; Leandro Sanchez; David Rodriguez

    2015-01-01

    Primary System Decommissioning belongs to DCP(Decommissioning and Closure Plan) works and its scope includes: Steam Generator, Pressurizer, Refrigerant Circuit Pump and Primary Circuit Piping. All these dismantling activities were carried out on site, including preliminary steps before their removal (SAS installations, pre decontaminations, cutting and segmentations, segregations, etc.) and delivery to media/low activity nuclear waste disposal site. There are many cutting techniques available in market (most of them proved with positive results) as well as there are many different approaches about how to manage radioactive wastes in decommissioning projects (containers or great components disposal, containers burial, re fusion, etc.). Both issues are linked and, before starting a new project, it might be positive and quite useful to compare and study previous dismantling experiences, especially the lesson learned chapter. Primary System cut with diamond saw has been a challenge target, not only due to the methodology innovation (since until nowadays, the common use of this technology was performed in cutting concrete walls) because it has a huge range of positive aspects that, in our opinion, are attractive (apart from its mentioned versatility, in terms of cutting on site and every type of material)

  8. Experience of men in the context of Primary Health Care

    Directory of Open Access Journals (Sweden)

    Patrícia Peres de Oliveira

    2015-08-01

    Full Text Available Objectives. To know the experience of male users' in the primary health care and to build data based theory that represents this experience. Methodology. This is a qualitative study, in which was used the reference of Grounded Theory and Symbolic Interactionism, respectively, methodological and theoretical. We interviewed 33 male users of three units of primary health care. Results. After comparative analysis of data was built the data based theory feeling excluded, which includes: living with prejudice; living with the limitations of infra-structure services; reflecting on the health service environment. The analysis showed the need for a change in logistics services and professionals' attitude guided in respectful and effective communication, the problem solving in readiness in attendance, in addressing gender issues. Conclusion. For to take care of men users of the Unified Health System and/or preserve their health, the construction of another rationality in health is imperative, based on reflection and respect for the autonomy and individuality of the male gender.

  9. EXPERIENCES OF OVERCOMING THE MASTER PRIMARY TO USE THE GEOGEBRA

    Directory of Open Access Journals (Sweden)

    María Luz Fuentes-Pérez

    2016-07-01

    Full Text Available This article presents the results of the experience of two researchers in overcoming 15 primary teachers, was used for this purpose a postgraduate course, in order to be trained so that they can use the dynamic geometry software Geogebra in the process of learning that develop in their classrooms. It is an investigation that used the systematization of experiences as a methodology and as research methods participant observation to get to know the moods and difficulties of trainees during class activities, group interview to gather data on participants in the course and with directors of primary education to meet the expectations and results related to the improvement and implementation of PNI for the views after some of the educational activities considered relevant. The results show as advances are obtained in overcoming teachers to use Geogebra and mention some lessons that emerge from the systematization about conception must have a course which is intended to prepare teachers who are not digital natives use the software mentioned.

  10. Nomenclature of primary amenorrhea: A proposal document of the Japan Society of Obstetrics and Gynecology committee for the redefinition of primary amenorrhea.

    Science.gov (United States)

    Shozu, Makio; Ishikawa, Hiroshi; Horikawa, Reiko; Sakakibara, Hideya; Izumi, Shun-Ichiro; Ohba, Takashi; Hirota, Yasushi; Ogata, Tsutomu; Osuga, Yutaka; Kugu, Koji

    2017-11-01

    The aim of this study was to provide medical terms to describe the condition of a girl who should be evaluated for primary amenorrhea in order to facilitate intervention at an appropriate time. We performed a literature and clinical guidelines search for recent practices with regard to menarche and discussed relevant cases that had been experienced by committee members. Additionally, we theoretically reviewed medical terms defined in the Glossary Book of Obstetrics and Gynecology in Japan (Japan Society of Obstetrics and Gynecology, 3rd edition). The committee for the redefinition of primary amenorrhea proposed the introduction of two terms and the deletion of one term that had been defined by the Japan Society of Obstetrics and Gynecology, instead of changing the age definition of primary amenorrhea. 'Delayed menarche' was introduced to describe a condition in which a girl has never experienced cyclic menstruation (menarche) by 15-17 years of age. 'Late menarche' was also introduced to describe a condition in which a girl has experienced menarche at 15 years of age or older. 'Delayed menstruation,' which was defined as a condition in which a girl experiences menarche at 15-18 years of age, was deleted. The new terms 'delayed menarche' and 'late menarche' were introduced, and the term 'delayed menstruation' was deleted. The new system might help in the early detection and appropriate treatment of primary amenorrhea. © 2017 Japan Society of Obstetrics and Gynecology.

  11. 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.

  12. Development of mini-LIA and primary experiments

    International Nuclear Information System (INIS)

    Cheng Cheng; Liao Shuqing; Zheng Shuxin; Lin Yuzheng; Tang Chuanxiang; Jing Xiaobing; Mu Fan; Pan Haifeng; Zhang Kaizhi; Shi Jinshui; Deng Jianjun

    2009-01-01

    Mini-LIA is a miniature of a linear induction accelerator developed by China Academy of Engineering Physics and Tsinghua University in 2007. It has been constructed with a thermionic cathode in an electron injector and a metglas core in the induction accelerator cavities. A double-pulsed electron beam was produced for the first time in China on the Mini-LIA with a thermionic cathode in the electron gun and a metglas core in the induction accelerator cavities. A double-pulsed beam current of more than 1.1A was obtained on condition of 80 kV double-pulsed high voltage produced by pulsed power system supplying to the injector and accelerating modules. Some primary experiments for measuring the parameters of Mini-LIA has been performed, and some beam characterizations of Mini-LIA are presented. Further improvement is underway. (authors)

  13. Primary care providers' experiences caring for complex patients in primary care: a qualitative study.

    Science.gov (United States)

    Loeb, Danielle F; Bayliss, Elizabeth A; Candrian, Carey; deGruy, Frank V; Binswanger, Ingrid A

    2016-03-22

    Complex patients are increasingly common in primary care and often have poor clinical outcomes. Healthcare system barriers to effective care for complex patients have been previously described, but less is known about the potential impact and meaning of caring for complex patients on a daily basis for primary care providers (PCPs). Our objective was to describe PCPs' experiences providing care for complex patients, including their experiences of health system barriers and facilitators and their strategies to enhance provision of effective care. Using a general inductive approach, our qualitative research study was guided by an interpretive epistemology, or way of knowing. Our method for understanding included semi-structured in-depth interviews with internal medicine PCPs from two university-based and three community health clinics. We developed an interview guide, which included questions on PCPs' experiences, perceived system barriers and facilitators, and strategies to improve their ability to effectively treat complex patients. To focus interviews on real cases, providers were asked to bring de-identified clinical notes from patients they considered complex to the interview. Interview transcripts were coded and analyzed to develop categories from the raw data, which were then conceptualized into broad themes after team-based discussion. PCPs (N = 15) described complex patients with multidimensional needs, such as socio-economic, medical, and mental health. A vision of optimal care emerged from the data, which included coordinating care, preventing hospitalizations, and developing patient trust. PCPs relied on professional values and individual care strategies to overcome local and system barriers. Team based approaches were endorsed to improve the management of complex patients. Given the barriers to effective care described by PCPs, individual PCP efforts alone are unlikely to meet the needs of complex patients. To fulfill PCP's expressed concepts of

  14. 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

  15. 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.

  16. [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

  17. Effects of increased nurses’ workload on quality documentation of patient information at selected Primary Health Care facilities in Vhembe District, Limpopo Province

    OpenAIRE

    Rhulani C. Shihundla; Rachel T. Lebese; Maria S. Maputle

    2016-01-01

    Background: Recording of information on multiple documents increases professional nurses’ responsibilities and workload during working hours. There are multiple registers and books at Primary Health Care (PHC) facilities in which a patient’s information is to be recorded for different services during a visit to a health professional. Antenatal patients coming for the first visit must be recorded in the following documents: tick register; Prevention of Mother-ToChild Transmission (PMTCT) regis...

  18. 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.

  19. Primary water chemistry of VVERs-operating experience

    International Nuclear Information System (INIS)

    Kysela, Jan; Zmitko, Milan; Petrecky, Igor

    1998-01-01

    VVER units are operated in mixed boron-potassium-ammonia water chemistry. Several modifications of the water chemistry, differing in boron-potassium co-ordination and in the way how hydrogen concentration is produced and maintain in the coolant, is used. From the operational experience point of view VVER units do not show any significant problems connected with the primary coolant chemistry. The latest results indicate that dose rate levels are slowly returning to the former ones. An improvement of the radiation situation observed last two years is supported by the surface activity measurements. However, the final conclusion on the radiation situation can be made only after evaluation of the several following cycles. Further investigation is also needed to clarify a possible effect of modified water chemistry and shut-down chemistry on radioactivity build-up and dose rate level at Dukovany units. Structure materials composition has a significant effect on radiation situation in the units. It concerns mainly of cobalt content in SG material. There is no clear evidence of possible effect of the SG shut-down regimes on the radiation situation in the units even if the dose rate and surface activity data show wide spread for the individual reactor loops. (S.Y.)

  20. Iraqi Perspectives Project. Primary Source Materials for Saddam and Terrorism: Emerging Insights from Captured Iraqi Documents. Volume 2 (Redacted)

    National Research Council Canada - National Science Library

    Woods, Kevin M

    2007-01-01

    Captured Iraqi documents have uncovered evidence that links the regime of Saddam Hussein to regional and global terrorism, including a variety of revolutionary, liberation, nationalist, and Islamic...

  1. Iraqi Perspectives Project. Primary Source Materials for Saddam and Terrorism: Emerging Insights from Captured Iraqi Documents. Volume 5 (Redacted)

    National Research Council Canada - National Science Library

    Woods, Kevin M

    2007-01-01

    Captured Iraqi documents have uncovered evidence that links the regime of Saddam Hussein to regional and global terrorism, including a variety of revolutionary, liberation, nationalist, and Islamic...

  2. Iraqi Perspectives Project. Primary Source Materials for Saddam and Terrorism: Emerging Insights from Captured Iraqi Documents. Volume 3 (Redacted)

    National Research Council Canada - National Science Library

    Woods, Kevin M

    2007-01-01

    Captured Iraqi documents have uncovered evidence that links the regime of Saddam Hussein to regional and global terrorism, including a variety of revolutionary, liberation, nationalist, and Islamic...

  3. Iraqi Perspectives Project. Primary Source Materials for Saddam and Terrorism: Emerging Insights from Captured Iraqi Documents. Volume 4 (Redacted)

    National Research Council Canada - National Science Library

    Woods, Kevin M

    2007-01-01

    Captured Iraqi documents have uncovered evidence that links the regime of Saddam Hussein to regional and global terrorism, including a variety of revolutionary, liberation, nationalist, and Islamic...

  4. A Community Seismic Experiment in the ENAM Primary Site

    Science.gov (United States)

    Van Avendonk, H. J.

    2012-12-01

    Eastern North America (ENAM) was chosen as a GeoPRISMS Rift Initiation and Evolution primary site because it represents a mature continental margin with onshore and offshore rift basins in which the record of extension and continental break-up is preserved. The degree to which syn-rift magmatism and preexisting lithospheric weaknesses controlled the evolution of the margin can be further investigated if we image its 3-D structure at small and large length scales with active-source and earthquake seismic imaging. In the Summer of 2012 we submitted a proposal to the US National Science Foundation for an ambitious plan for data acquisition on a 400 km wide section of the mid-Atlantic East Coast margin around Cape Hatteras, from unextended continental lithosphere onshore to mature oceanic lithosphere offshore. This area includes an important along-strike transition in the morphology of the margin from the Carolina Trough to the Baltimore Canyon Trough, and two major fracture zones that are associated with significant offsets at the modern Mid-Atlantic Ridge. The study area also covers several features representing the post-rift modification of the margin by slope instability and fluid flow. As the Earthscope Transportable Array reaches the East Coast of the US in 2013 and 2014, we will have an unprecedented opportunity to image the detailed structure of the rifted margin. To make effective use of the research infrastructure, including the seismic vessel R/V Marcus Langseth, the Earthscope seismic instrumentation, and US OBS Instrument Pool, we propose to collect a suite of seismic data at the mid-Atlantic margin in the context of a community-driven experiment with completely open data access. This multi-faceted seismic experiment offers an immense opportunity for education of young scientists. We propose an integrated education effort during and after acquisition. The science and field parties for data acquisition will largely consist of young scientists, who will be

  5. Documentation and Analysis of Children's Experience: An Ongoing Collegial Activity for Early Childhood Professionals

    Science.gov (United States)

    Picchio, Mariacristina; Giovannini, Donatella; Mayer, Susanna; Musatti, Tullia

    2012-01-01

    Systematic documentation and analysis of educational practice can be a powerful tool for continuous support to the professionalism of early childhood education practitioners. This paper discusses data from a three-year action-research initiative carried out by a research agency in collaboration with a network of Italian municipal "nido"…

  6. Global Document Delivery, User Studies, and Service Evaluation: The Gateway Experience

    Science.gov (United States)

    Miller, Rush; Xu, Hong; Zou, Xiuying

    2008-01-01

    This study examines user and service data from 2002-2006 at the East Asian Gateway Service for Chinese and Korean Academic Journal Publications (Gateway Service), the University of Pittsburgh. Descriptive statistical analysis reveals that the Gateway Service has been consistently playing the leading role in global document delivery service as well…

  7. 48 CFR 752.7005 - Submission requirements for development experience documents.

    Science.gov (United States)

    2010-10-01

    ... (referenced in paragraph (a)(1) of this clause) in electronic format and hard copy (one copy) to U.S. Agency... final equivalent of the hard copy submitted. (iv) Acceptable software formats for electronic documents... paragraph (b)(1)(i) of this clause. (2) Format. (i) Descriptive information is required for all Contractor...

  8. Documentation of polio eradication initiative best practices: Experience from WHO African Region.

    Science.gov (United States)

    Okeibunor, Joseph; Nshimirimana, Deo; Nsubuga, Peter; Mutabaruka, Evariste; Tapsoba, Leonard; Ghali, Emmanuel; Kabir, Shaikh Humayun; Gassasira, Alex; Mihigo, Richard; Mkanda, Pascal

    2016-10-10

    The African Region is set to achieving polio eradication. During the years of operations, the Polio Eradication Initiative [PEI] in the Region mobilized and trained tremendous amount of manpower with specializations in surveillance, social mobilization, supplementary immunization activities [SIAs], data management and laboratory staff. Systems were put in place to accelerate the eradication of polio in the Region. Standardized, real-time surveillance and response capacity were established. Many innovations were developed and applied to reaching people in difficult and security challenged terrains. All of these resulted in accumulation of lessons and best practices, which can be used in other priority public health intervention if documented. The World Health Organization Regional Office for Africa [WHO/AFRO] developed a process for the documentation of these best practices, which was pretested in Uganda. The process entailed assessment of three critical elements [effectiveness, efficiency and relevance] five aspects [ethical soundness, sustainability, involvement of partners, community involvement, and political commitment] of best practices. A scored card which graded the elements and aspects on a scale of 0-10 was developed and a true best practice should score >50 points. Independent public health experts documented polio best practices in eight countries in the Region, using this process. The documentation adopted the cross-sectional design in the generation of data, which combined three analytical designs, namely surveys, qualitative inquiry and case studies. For the selection of countries, country responses to earlier questionnaire on best practices were screened for potential best practices. Another criterion used was the level of PEI investment in the countries. A total of 82 best practices grouped into ten thematic areas were documented. There was a correlation between the health system performances with DPT3 as proxy, level of PEI investment in countries

  9. 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.

  10. 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.

  11. Documentation Experiences for Jamaican SLOWPOKE-2 Conversion from HEU to LEU

    International Nuclear Information System (INIS)

    Warner, T.-A.; Dennis, H.; Antoine, J.

    2015-01-01

    The Jamaican SLOWPOKE–2 (JM–1) is a 20 kW research reactor manufactured by Atomic Energy of Canada Limited and has been operating since March 1984, in the department of the International Centre for Environmental and Nuclear Sciences (ICENS), at the University of the West Indies, Mona Campus in Kingston, Jamaica. The pool type reactor has been primarily used for Neutron Activation Analysis in environmental, agricultural, geochemical, health-related studies and mineral exploration. The University, assisted by the IAEA under the GTRI/RERTR program, is currently in the process of converting from HEU to LEU. Extensive documentation on policies, general requirements, elements of the conversion quality assurance (QA) system and conversion QA administrative procedures is required for the conversion. The core conversion activities are being carried out in accordance with current international standards and regulatory guidelines of the newly established Jamaican Radiation Safety Authority (RSA) with agreement between the RSA and IAEA or DOE related to Nuclear Safety and Control. The documentation structure has taken into consideration nuclear safety and licensing, LEU fuel design and conversion analysis, LEU fuel procurement and fabrication, removal of HEU fuel and reactor maintenance and conversion and commissioning, with the conversion QA manual at the apex of the structure. To a large extent, the documentation format will adhere to that of the IAEA applicable regulatory standards and guidance documents. The major challenge of the conversion activities, it is envisioned, will come from the absence of any previous regulatory framework in Jamaica; however, a timeline for the process, which includes training and equipping of regulators, will guide operation. (author)

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

    African Journals Online (AJOL)

    nrs) in Mbabane circuit, Ingwavuma. ... The findings suggest that teachers' gender, job title, teaching phase, and experience in years and qualifications had an influence on their experiences with the NRS. On the other hand, teachers' age was ...

  13. Primary care closed claims experience of Massachusetts malpractice insurers.

    Science.gov (United States)

    Schiff, Gordon D; Puopolo, Ann Louise; Huben-Kearney, Anne; Yu, Winnie; Keohane, Carol; McDonough, Peggy; Ellis, Bonnie R; Bates, David W; Biondolillo, Madeleine

    Despite prior focus on high-impact inpatient cases, there are increasing data and awareness that malpractice in the outpatient setting, particularly in primary care, is a leading contributor to malpractice risk and claims. To study patterns of primary care malpractice types, causes, and outcomes as part of a Massachusetts ambulatory malpractice risk and safety improvement project. Retrospective review of pooled closed claims data of 2 malpractice carriers covering most Massachusetts physicians during a 5-year period (January 1, 2005, through December 31, 2009). Data were harmonized between the 2 insurers using a standardized taxonomy. Primary care practices in Massachusetts. All malpractice claims that involved primary care practices insured by the 2 largest insurers in the state were screened. A total of 551 claims from primary care practices were identified for the analysis. Numbers and types of claims, including whether claims involved primary care physicians or practices; classification of alleged malpractice (eg, misdiagnosis or medication error); patient diagnosis; breakdown in care process; and claim outcome (dismissed, settled, verdict for plaintiff, or verdict for defendant). During a 5-year period there were 7224 malpractice claims of which 551 (7.7%) were from primary care practices. Allegations were related to diagnosis in 397 (72.1%), medications in 68 (12.3%), other medical treatment in 41 (7.4%), communication in 15 (2.7%), patient rights in 11 (2.0%), and patient safety or security in 8 (1.5%). Leading diagnoses were cancer (n = 190), heart diseases (n = 43), blood vessel diseases (n = 27), infections (n = 22), and stroke (n = 16). Primary care cases were significantly more likely to be settled (35.2% vs 20.5%) or result in a verdict for the plaintiff (1.6% vs 0.9%) compared with non-general medical malpractice claims (P < .001). In Massachusetts, most primary care claims filed are related to alleged misdiagnosis. Compared with malpractice

  14. 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.

  15. Filtration experiments of the KNK II primary sodium

    International Nuclear Information System (INIS)

    Stamm, H.H.

    1987-01-01

    The separated particles of the KNK primary sodium are a result of a normal corrosion rate by using ferritic and austenitic steels in sodium. Similar particle distributions and concentrations were found in primary circuits of other breeder plants (EBR-II et al). The experimental results of the particle concentration in the KNK primary sodium were lower than the theoretical calculation. Based on a corrosion rate of 0.5 micron/y for austenitic steels and a corrosion rate of 1.5 mg/square-cm y for a ferritic steel used in KNK as structure material an equilibrium particle concentration of 1.066 mg/kg Na was calculated. The experimental results of particle size are not in agreement with theoretical calculation of the BACCHUS code. (orig.)

  16. Primary care providers' lived experiences of genetics in practice.

    Science.gov (United States)

    Harding, Brittany; Webber, Colleen; Ruhland, Lucia; Dalgarno, Nancy; Armour, Christine M; Birtwhistle, Richard; Brown, Glenn; Carroll, June C; Flavin, Michael; Phillips, Susan; MacKenzie, Jennifer J

    2018-04-26

    To effectively translate genetic advances into practice, engagement of primary care providers (PCPs) is essential. Using a qualitative, phenomenological methodology, we analyzed key informant interviews and focus groups designed to explore perspectives of urban and rural PCPs. PCPs endorsed a responsibility to integrate genetics into their practices and expected advances in genetic medicine to expand. However, PCPs reported limited knowledge and difficulties accessing resources, experts, and continuing education. Rural practitioners' additional concerns included cost, distance, and poor patient engagement. PCPs' perspectives are crucial to develop relevant educational and systems-based interventions to further expand genetic medicine in primary care.

  17. 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.

  18. Design and drafting document control procedures for CPRF/ZTH experiment

    International Nuclear Information System (INIS)

    Pollat, L.L.; Kewish, R.W.

    1989-01-01

    This paper will present, in general, the control procedures for design approval, review, changes, and release of engineering documents. It will also discuss interface control for tasks so that possible design interference does not occur. A document control procedure to insure that design criteria are met and technical specifications translate into workable drawings was instituted to support the Confinement Physics Research Facility (CPRF/ZTH) construction program. Our goal, to eliminate any conflicts that might arise between various tasks as the final designs are developed, required tight control and up-to-date design information. Detailed procedure for reviews were instituted, since circumventing the process of design and drafting anywhere might have proven disastrous to the CPRF/ZTH program. Design is a process of translating technical requirements, according to established standards, into drawings that are usable for fabrication and assembly. Both the designer and engineer are responsible for adhering to standards that have been established by the Mechanical Engineering Section for the CPRF/ZTH program. 6 refs., 5 figs

  19. Re-Envisaging the Teaching of Mathematics: One Student Teacher's Experience Learning to Teach Primary Mathematics in a Manner Congruent with the New Zealand Curriculum

    Science.gov (United States)

    Bailey, Judy

    2013-01-01

    Teacher education can provide opportunities for contributing towards a re-envisaging of the teaching and learning of mathematics in the primary classroom. This study documents the experiences of one student teacher who, during her mathematics education courses, embraced a perception of mathematics as a social, creative and experiential discipline.…

  20. System Requirements Document for the Molten Salt Reactor Experiment 233U conversion system

    International Nuclear Information System (INIS)

    Aigner, R.D.

    2000-01-01

    The purpose of the conversion process is to convert the 233 U fluoride compounds that are being extracted from the Molten Salt Reactor Experiment (MSRE) equipment to a stable oxide for long-term storage at Bldg. 3019

  1. Competing Issues in Australian Primary Curriculum: Learning from International Experiences

    Science.gov (United States)

    Ewing, Robyn

    2012-01-01

    There is no doubt that the increasing politicisation of education in an economically rationalist climate is contributing to less equity, access, participation and, therefore, social justice for many Australian primary children. This article initially explores how the development of the impending national Australian curriculum replete with a high…

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

    African Journals Online (AJOL)

    The study was guided by Social Cognitive Theory, employed to examine the psycho-social environments of serving primary school teachers in Olugbo-Less City, Odeda Local Government Area of Ogun State, Nigeria. 100 rural active teachers currently undergoing in-service training in Ogun State Universal Basic Education ...

  3. English in the Primary Classroom in Vietnam: Students' Lived Experiences and Their Social and Policy Implications

    Science.gov (United States)

    Nguyen, Lan Chi; Hamid, M. Obaidul; Renshaw, Peter

    2016-01-01

    Although the teaching of English as a foreign language in primary schools has emerged as one of the major language-in-education policy decisions, students' perspectives on primary English have received very little research attention. Drawing on data from a larger study, this paper depicts primary school students' lived experiences in the English…

  4. Substance use among persons with homeless experience in primary care.

    Science.gov (United States)

    Stringfellow, Erin J; Kim, Theresa W; Gordon, Adam J; Pollio, David E; Grucza, Richard A; Austin, Erika L; Johnson, N Kay; Kertesz, Stefan G

    2016-01-01

    Community survey data suggest high prevalence of substance use disorders among currently homeless individuals. There are less data regarding illicit drug and alcohol use problems of homeless-experienced persons engaged in primary care. They may have less severe use and require different care responses from primary care teams. The authors surveyed currently and formerly homeless, i.e., homeless-experienced, persons engaged in primary care at five federally funded programs in the United States, administering the World Health Organization (WHO) Alcohol, Smoking and Substance Involvement Screening Test (ASSIST). The ASSIST definitions of lower, moderate, and high risk were used to assess a spectrum of lifetime and recent substance use, from any use to likely dependence, and to identify sociodemographic and health status characteristics associated with severity of use. Almost one half of the sample (N = 601) had recently (within the past three months) used alcohol, and one third had recently used an illicit drug. The most commonly used illicit drugs in the past three months were cannabis (19%), cocaine (16%), and opioids (7.5%). Over one half (59%) of respondents had ASSIST-defined moderate- or high-risk substance use. A significant proportion (31%) of those identified as at moderate risk had no recent substance use, but did report past problematic use. Ten percent of the lower-risk group had past problematic use of alcohol. Severity of use was associated with worse health status, but not with housing status or type of homelessness experienced. Less severe (moderate-risk) use and past problematic use, potentially indicative of remitted substance use disorders, were more common than high-risk use in this primary care, homeless-experienced sample. These findings highlight the urgency of identifying effective ways to reduce risky substance use and prevent relapse in homeless-experienced persons.

  5. Primary breast lymphoma: A single-institute experience in Taiwan

    Directory of Open Access Journals (Sweden)

    Che-Wei Ou

    2014-10-01

    Full Text Available Background: Breast is an uncommon location of lymphoma involvement. The most common type of primary breast lymphoma (PBL is diffuse large B-cell lymphoma (DLBCL. Rituximab is the widely used monoclonal antibody against CD20+ B-cell lymphoma, especially DLBCL. We aimed to analyze the clinical features, prognostic factors, and treatment outcome with or without rituximab in primary breast DLBCL. Methods: We retrospectively analyzed patients diagnosed with PBL from October 1987 to March 2012 in our hospital, excluding metastasis by whole-body computed tomography and bone marrow study. Results: Twenty-three patients were diagnosed with PBL. All were females. Eighteen patients were stage IE and five were stage IIE according to the Ann Arbor staging system. Two patients had lymphoma other than DLBCL. The median age of primary breast DLBCL patients was 48 years (range 27-79. Two were excluded from the analysis due to refusal or ineligibility for chemotherapy. No significant prognostic factor was found. Patients receiving chemotherapy with (RC or without (C rituximab were not significantly different in the 5-year overall survival (RC: 57.1%; C: 58.3%; p = 0.457 or progression-free survival (RC: 57.1%; C: 50.0%; p = 0.456. A high incidence of relapse in the central nervous system (CNS (17.6% was observed. Conclusions: In accordance with prior literature reports, our Taiwanese cohort of primary breast DLBCL seemed younger than those reported in Japan, Korea, and Western societies. Relapse in the CNS was not uncommon. The benefit of rituximab in addition to chemotherapy was not statistically significant. Treatment modality remained to be defined by further large-scale studies.

  6. Experiments in Popular Education in Portugal, 1974-1976. Education Studies and Documents, No. 29.

    Science.gov (United States)

    Melo, Alberto; Benavente, Ana

    The first in a series of studies of lifelong learning, this paper discusses educational activities undertaken in Portugal after the fall of the dictatorship in 1974 and through 1976. Intended for educational planners and for those working in popular education, the study emphasizes original strategies and experiments, particulary those encouraging…

  7. 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…

  8. 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.

  9. 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…

  10. 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. 

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

    African Journals Online (AJOL)

    Objective: The objective of this study was to determine the perception and experience of menopause among a group of educated Nigerian career women, and how menopausal symptoms affect their family relationship and work performance. Method: This was a cross sectional study.Two hundred and twenty five post ...

  12. Improving the quality of nurse clinical documentation for chronic patients at primary care clinics: A multifaceted intervention

    Directory of Open Access Journals (Sweden)

    Ozayr H. Mahomed

    2015-09-01

    Full Text Available Background: Deficiencies in record keeping practices have been reported at primary care level in the public health sector in South Africa. These deficiencies have the potential to negatively impact patient health outcomes as the break in information may hinder continuity of care. This disruption in information management has particular relevance for patients with chronic diseases. Objectives: The aim of this study was to establish if the implementation of a structured clinical record (SCR as an adjunct tool to the algorithmic guidelines for chronic disease management improved the quality of clinical records at primary care level. Method: A quasi-experimental study (before and after study with a comparison group was conducted across 30 primary health care clinics (PHCs located in three districts in South Africa. Twenty PHCs that received the intervention were selected as intervention clinics and 10 facilities were selected as comparison facilities. The lot quality assurance sampling (LQAS method was used to determine the number of records required to be reviewed per diagnostic condition per facility. Results: There was a a statistically significant increase in the percentage of clinical records achieving compliance to the minimum criteria from the baseline to six months post-intervention for both HIV patients on antiretroviral treatment and patients with non-communicable diseases (hypertension and diabetes. Conclusions: A multifaceted intervention using a SCR to supplement the educational outreach component (PC 101 training has demonstrated the potential for improving the quality of clinical records for patients with chronic diseases at primary care clinics in South Africa.

  13. Improving the quality of nurse clinical documentation for chronic patients at primary care clinics: A multifaceted intervention.

    Science.gov (United States)

    Mahomed, Ozayr H; Naidoo, Salsohni; Asmall, Shaidah; Taylor, Myra

    2015-09-25

    Deficiencies in record keeping practices have been reported at primary care level in the public health sector in South Africa. These deficiencies have the potential to negatively impact patient health outcomes as the break in information may hinder continuity of care. This disruption in information management has particular relevance for patients with chronic diseases. The aim of this study was to establish if the implementation of a structured clinical record (SCR) as an adjunct tool to the algorithmic guidelines for chronic disease management improved the quality of clinical records at primary care level. A quasi-experimental study (before and after study with a comparison group) was conducted across 30 primary health care clinics (PHCs) located in three districts in South Africa. Twenty PHCs that received the intervention were selected as intervention clinics and 10 facilities were selected as comparison facilities. The lot quality assurance sampling (LQAS) method was used to determine the number of records required to be reviewed per diagnostic condition per facility. There was a a statistically significant increase in the percentage of clinical records achieving compliance to the minimum criteria from the baseline to six months post-intervention for both HIV patients on antiretroviral treatment and patients with non-communicable diseases (hypertension and diabetes). A multifaceted intervention using a SCR to supplement the educational outreach component (PC 101 training) has demonstrated the potential for improving the quality of clinical records for patients with chronic diseases at primary care clinics in South Africa.

  14. 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...... were telephoned to enquire if the implementation of the HT Guideline had led to a new division of labour between nurses and doctors. RESULTS: Questionnaires were returned from 327 nurses (80.0%), while all senior nursing officers (n = 32) were contacted. The majority of nurses were of the opinion...

  15. 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.

  16. 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.

  17. Experiences with surgically treated primary or secondary hepatic sarcoma.

    Science.gov (United States)

    Fahrner, René; Dennler, Sandra G C; Dondorf, Felix; Ardelt, Michael; Rauchfuss, Falk; Settmacher, Utz

    2017-06-01

    Liver resection in hepatic sarcoma is rare, but other alternative treatment options are scarce. Surgery offers the only aggressive approach to achieve a tumour-free state. The aim of this investigation was to evaluate the outcome and survival of these patients at a single hepato-biliary university hospital. Between January 2004 and July 2013, 896 anatomical liver resections were performed. Eleven liver resections (1.2%) were performed due to primary hepatic sarcoma or hepatic sarcoma metastases. The demographic and clinical parameters were collected from the institutional patients' records. In eight patients (83%), liver resection was performed due to hepatic sarcoma metastases. The surgical procedures were as follows: two patients (18%) had segmentectomy, six patients (55%) had hemihepatectomy or extended hemihepatectomy and three patients (27%) had multivisceral resections. In nine patients (82%), the resection margins were tumour free. In 55% (n = 6) of the patients, the maximal tumour diameter was greater than 10 cm. The postoperative morbidity was low with a Clavien-Dindo score of 2 (range 0-5). One patient died on postoperative day 2 after multivisceral resection. During the follow-up of 932 days (range 2-2.220 days) the 1-, 2- and 3-year survival rates were 91, 63 and 45%, respectively. Tumour recurrence was detected in seven patients (63%). Liver resections in patients with primary or secondary hepatic sarcoma are rare. The main goal in these patients is to achieve complete tumour resection because chemotherapy offers no suitable alternative, but the long-term survival rates are limited because of high a recurrence rate even after aggressive surgical approaches.

  18. Experience of secondary cooling system modification at prototype fast breeder reactor MONJU (Translated document)

    International Nuclear Information System (INIS)

    Kisohara, Naoyuki; Sakamoto, Yoshihiko

    2010-09-01

    The prototype fast breeder reactor MONJU has been shut down since the secondary sodium leak accident that occurred in December 1995. After the accident, an investigation into the cause and a comprehensive safety review of the plant were conducted, and various countermeasures for sodium leak were examined. Modification work commenced in September 2005. Since sodium, a chemically active material, is used as coolant in MONJU, the modification work required work methods suitable for the handling of sodium. From this perspective, the use of a plastic bag when opening the sodium boundary, oxygen concentration control in a plastic bag, slightly-positive pressure control of cover gas in the systems, pressing and cutting with a roller cutter to prevent the incorporation of metal fillings, etc. were adopted, with careful consideration given to experience and findings from previous modification work at the experimental fast reactor JOYO and plants abroad. Owing to these work methods, the modification work proceeded close to schedule without incident. (author)

  19. PREMIX, documentation of the results of experiments PM01 to PM06

    International Nuclear Information System (INIS)

    Huber, F.; Kaiser, A.; Steinbrueck, M.; Will, H.

    1996-03-01

    A series of so-called PREMIX experiments is being performed in which the mixing behaviour is investigated of a hot alumina melt which is discharged into water. The tests are part of a multi-lateral programme carried out in support of the licencing procedure of LWR. The programme, which aims at the safety of the reactor, includes relevant experiments and the numerical simulation by computer codes. The parameters of the 1st experimental series were: Melt masses of 10 and 20 kg, released through nozzles of 40 and 56 mm in diameter, resp., the type of melt discharge, a slender size of the water pool, and the degree of sub-cooling. The phenomena of mixing can well be described by means of both high speed and video films and a variety of measurements. The results show that it is the period up to about 0.4 to 0.5 s in which the decisive processes of premixing occur. The very first material release generally occurs as single droplets. In 3 of the first 6 tests, a more or less compact stream of melt formed soon after that. In the other tests, the spray-type discharge of melt continued. A funnel-shaped interaction region is formed in the water pool. Its radial and axial growth rates are determined by the discharge mode and mass flux of the melt. A vapour explosion did not occur. The test results are well suited to be used in the verification and validation of computer models. The results of the measurements and the post-test examination of the debris give an indication of a possible inherent limitation of the masses involved in premixing. Consequently, the probability of a steam explosion to occur would also be limited. This limitation is anticipated to occur in 2 stages: 1. The bulk portion of the water is displaced far enough by the growing interaction region and is prevented from taking part immediately in the thermal interaction. Vapour is the continuous phase in the interaction region. 2. In case of a compact melt stream, the major part of the melt quickly flows down

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

    International Nuclear Information System (INIS)

    Stencel, J.R.; Parsells, R.F.

    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)

  1. Effects of increased nurses’ workload on quality documentation of patient information at selected Primary Health Care facilities in Vhembe District, Limpopo Province

    Directory of Open Access Journals (Sweden)

    Rhulani C. Shihundla

    2016-05-01

    Full Text Available Background: Recording of information on multiple documents increases professional nurses’ responsibilities and workload during working hours. There are multiple registers and books at Primary Health Care (PHC facilities in which a patient’s information is to be recorded for different services during a visit to a health professional. Antenatal patients coming for the first visit must be recorded in the following documents: tick register; Prevention of Mother-ToChild Transmission (PMTCT register; consent form for HIV and AIDS testing; HIV Counselling and Testing (HCT register (if tested positive for HIV and AIDS then this must be recorded in the Antiretroviral Therapy (ART wellness register; ART file with an accompanying single file, completion of which is time-consuming; tuberculosis (TB suspects register; blood specimen register; maternity case record book and Basic Antenatal Care (BANC checklist. Nurses forget to record information in some documents which leads to the omission of important data. Omitting information might lead to mismanagement of patients. Some of the documents have incomplete and inaccurate information. As PHC facilities in Vhembe District render twenty four hour services through a call system, the same nurses are expected to resume duty at 07:00 the following morning. They are expected to work effectively and when tired a nurse may record illegible information which may cause problems when the document is retrieved by the next person for continuity of care. Objectives: The objective of this study was to investigate and describe the effects of increased nurses’ workload on quality documentation of patient information at PHC facilities in Vhembe District, Limpopo Province. Methods: The study was conducted in Vhembe District, Limpopo Province, where the effects of increased nurses’ workload on quality documentation of information is currently experienced. The research design was explorative, descriptive and contextual in

  2. 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

  3. Effects of increased nurses' workload on quality documentation of patient information at selected Primary Health Care facilities in Vhembe District, Limpopo Province.

    Science.gov (United States)

    Shihundla, Rhulani C; Lebese, Rachel T; Maputle, Maria S

    2016-05-13

    Recording of information on multiple documents increases professional nurses' responsibilities and workload during working hours. There are multiple registers and books at Primary Health Care (PHC) facilities in which a patient's information is to be recorded for different services during a visit to a health professional. Antenatal patients coming for the first visit must be recorded in the following documents: tick register; Prevention of Mother-ToChild Transmission (PMTCT) register; consent form for HIV and AIDS testing; HIV Counselling and Testing (HCT) register (if tested positive for HIV and AIDS then this must be recorded in the Antiretroviral Therapy (ART) wellness register); ART file with an accompanying single file, completion of which is time-consuming; tuberculosis (TB) suspects register; blood specimen register; maternity case record book and Basic Antenatal Care (BANC) checklist. Nurses forget to record information in some documents which leads to the omission of important data. Omitting information might lead to mismanagement of patients. Some of the documents have incomplete and inaccurate information. As PHC facilities in Vhembe District render twenty four hour services through a call system, the same nurses are expected to resume duty at 07:00 the following morning. They are expected to work effectively and when tired a nurse may record illegible information which may cause problems when the document is retrieved by the next person for continuity of care. The objective of this study was to investigate and describe the effects of increased nurses' workload on quality documentation of patient information at PHC facilities in Vhembe District, Limpopo Province. The study was conducted in Vhembe District, Limpopo Province, where the effects of increased nurses' workload on quality documentation of information is currently experienced. The research design was explorative, descriptive and contextual in nature. The population consisted of all nurses who

  4. Enhancing Children's Success in Science Learning: An Experience of Science Teaching in Teacher Primary School Training

    Science.gov (United States)

    Ferreira, Maria Eduarda; Porteiro, Ana Cláudia; Pitarma, Rui

    2015-01-01

    The Environmental Studies curricular area, taught at primary school level in Portugal, is a challenging context for curricular interdisciplinarity and the achievement of small-scale research and creative and innovative experiences, inside and outside the classroom. From that assumption, we present, under the master course of primary teacher…

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

    International Nuclear Information System (INIS)

    Warner, T.

    2014-01-01

    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)

  6. 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)

  7. 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.

  8. Experience of Primary Care among Homeless Individuals with Mental Health Conditions

    Science.gov (United States)

    Chrystal, Joya G.; Glover, Dawn L.; Young, Alexander S.; Whelan, Fiona; Austin, Erika L.; Johnson, Nancy K.; Pollio, David E.; Holt, Cheryl L.; Stringfellow, Erin; Gordon, Adam J.; Kim, Theresa A.; Daigle, Shanette G.; Steward, Jocelyn L.; Kertesz, Stefan G

    2015-01-01

    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. PMID:25659142

  9. 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.

  10. From Students to Teachers: Investigating the Science Teaching Efficacy Beliefs and Experiences of Graduate Primary Teachers

    Science.gov (United States)

    Deehan, James; Danaia, Lena; McKinnon, David H.

    2018-03-01

    The science achievement of primary students, both in Australia and abroad, has been the subject of intensive research in recent decades. Consequently, much research has been conducted to investigate primary science education. Within this literature, there is a striking juxtaposition between tertiary science teaching preparation programs and the experiences and outcomes of both teachers and students alike. Whilst many tertiary science teaching programs covary with positive outcomes for preservice teachers, reports of science at the primary school level continue to be problematic. This paper begins to explore this apparent contradiction by investigating the science teaching efficacy beliefs and experiences of a cohort of graduate primary teachers who had recently transitioned from preservice to inservice status. An opportunity sample of 82 primary teachers responded to the science teaching efficacy belief instrument A (STEBI-A), and 10 graduate teachers provided semi-structured interview data. The results showed that participants' prior science teaching efficacy belief growth, which occurred during their tertiary science education, had remained durable after they had completed their teaching degrees and began their careers. Qualitative data showed that their undergraduate science education had had a positive influence on their science teaching experiences. The participants' school science culture, however, had mixed influences on their science teaching. The findings presented within this paper have implications for the direction of research in primary science education, the design and assessment of preservice primary science curriculum subjects and the role of school contexts in the development of primary science teachers.

  11. 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.

  12. After-hours/on-call experience during primary care nurse practitioner education utilizing standard scenarios and simulated patients.

    Science.gov (United States)

    Kelly, Michelle M; Blunt, Elizabeth; Nestor, Kelly

    2017-12-01

    Few nurse practitioner (NP) programs include an after-hours/on-call component in their clinical preparation of NP students. This role is expected in many primary and specialty care practices, and is one that students feel unprepared to competently navigate. Utilizing simulated callers as patients or parents, NP students participated in a simulated after-hours/on-call experience that included receiving the call, managing the patient, and submitting documentation of the encounter. Students completed pre- and postparticipation evaluations, and were evaluated by the simulated patient callers and faculty using standardized evaluation tools. NP students rated the experience as an educationally valuable experience despite feeling anxious and nervous about the experience. Several essential skills were identified including critical thinking, clear communication, self-confidence, and access to resources. After participation NP students were more receptive to an NP position with an on-call component. Inclusion of a simulated on-call experience is a feasible component of NP education and should be added to the NP curriculum. ©2017 American Association of Nurse Practitioners.

  13. 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.

  14. Do competing demands of physical illness in type 2 diabetes influence depression screening, documentation and management in primary care: a cross-sectional analytic study in Aboriginal and Torres Strait Islander primary health care settings.

    Science.gov (United States)

    Schierhout, Gill; Nagel, Tricia; Si, Damin; Connors, Christine; Brown, Alex; Bailie, Ross

    2013-06-06

    Relatively little is known about how depression amongst people with chronic illness is identified and managed in diverse primary health care settings. We evaluated the role of complex physical needs in influencing current practice of depression screening, documentation and antidepressant prescriptions during a 12-month period, among adults with Type 2 diabetes attending Aboriginal and Torres Strait Islander primary care health centres in Australia. We analysed clinical audit data from 44 health centres participating in a continuous quality improvement initiative, using previously reported standard sampling and data extraction protocols. Eligible patients were those with Type 2 diabetes with health centre attendance within the past 12 months. We compared current practice in depression screening, documentation and antidepressant prescription between patients with different disease severity and co-morbidity. We used random effects multiple logistic regression models to adjust for potential confounders and for clustering by health centre. Among the 1174 patients with diabetes included, median time since diagnosis was 7 years, 19% of patients had a co-existing diagnosis of Ischaemic Heart Disease and 1/3 had renal disease. Some 70% of patients had HbAc1>7.0%; 65% had cholesterol >4.0 mmol1-1 and 64% had blood pressure>130/80 mmHg. Documentation of screening for depression and of diagnosed depression were low overall (5% and 6% respectively) and lower for patients with renal disease (Adjusted odds ratio [AOR] 0.21; 95% confidence interval [CI] 0.14 to 0.31 and AOR 0.34; 95% CI 0.15 to 0.75), and for those with poorly controlled disease (HbA1c>7.00 (AOR 0.40; 95% CI 0.23 to 0.68 and AOR 0.51; 95% CI 0.30 to 84)). Screening for depression was lower for those on pharmaceutical treatment for glycaemic control compared to those not on such treatment. Antidepressant prescription was not associated with level of diabetes control or disease severity. Background levels of

  15. VVER operational experience - effect of preconditioning and primary water chemistry on radioactivity build-up

    International Nuclear Information System (INIS)

    Zmitko, M.; Kysela, J.; Dudjakova, K.; Martykan, M.; Janesik, J.; Hanus, V.; Marcinsky, P.

    2004-01-01

    The primary coolant technology approaches currently used in VVER units are reviewed and compared with those used in PWR units. Standard and modified water chemistries differing in boron-potassium control are discussed. Preparation of the VVER Primary Water Chemistry Guidelines in the Czech Republic is noted. Operational experience of some VVER units, operated in the Czech Republic and Slovakia, in the field of the primary water chemistry, and radioactivity transport and build-up are presented. In Mochovce and Temelin units, a surface preconditioning (passivation) procedure has been applied during hot functional tests. The main principles of the controlled primary water chemistry applied during the hot functional tests are reviewed and importance of the water chemistry, technological and other relevant parameters is stressed regarding to the quality of the passive layer formed on the primary system surfaces. The first operational experience obtained in the course of beginning of these units operation is presented mainly with respect to the corrosion products coolant and surface activities. Effect of the initial passivation performed during hot functional tests and the primary water chemistry on corrosion products radioactivity level and radiation situation is discussed. (author)

  16. Experiences from Loviisa Nuclear Power Station concerning the decontamination of steam generators and primary system components

    International Nuclear Information System (INIS)

    Jaernstroem, R.

    1989-01-01

    Loviisa 1 and 2 are 465 MWe PWR units of the Soviet type VVER-440. Loviisa 1 has been in commercial operation since spring 1977 and Loviisa 2 from the beginning of 1980. Decontamination of primary circuit components - even big ones as steam generators - can be performed in an efficient and quick way with good results and resonable expences. Total costs for decontamination of the two steam generators including planning, construction, documentation, operation, chemicals etc. did not rise above 100,000.00 dollars. (author) 6 figs., 2 tabs

  17. 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…

  18. 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,…

  19. A Professional Experience Model for Primary Pre-Service Teachers Specialising in Mathematics

    Science.gov (United States)

    McMaster, Heather; Cavanagh, Michael

    2016-01-01

    Many primary pre-service teachers (PSTs) who are enthused by tertiary courses that espouse and model a socio-constructivist approach to teaching mathematics, revert to a traditional approach when they encounter mathematics teaching during professional experience. An intervention was designed to translate the initial pedagogical intent of four…

  20. Field Experience from Li-Ion BESS Delivering Primary Frequency Regulation in the Danish Energy Market

    DEFF Research Database (Denmark)

    Swierczynski, Maciej Jozef; Stroe, Daniel Ioan; Lærke, Rasmus

    2014-01-01

    In this paper it is presented the practical experience from operating a 1.6 MW/ 0.4 MWh lithium ion battery energy storage system, which is providing primary frequency regulation service on the Danish energy market. Aspects of the battery system requirements and the used control strategy...

  1. The Effect of the Courses of School Experience and Teaching Practice on Primary School Mathematics Teachers

    Science.gov (United States)

    Huseyin, Aksu Hasan

    2015-01-01

    The aim of this study is to determine elementary mathematics teachers' thoughts and feelings on the courses of school-experience and teacher-practice. In this study was used the qualitative research method. Those involved in the study were 20 mathematics teachers employed in formal/government primary schools in the Province of Giresun and in the…

  2. Peer Observation of Teaching: Perceptions and Experiences of Teachers in a Primary School in Cyprus

    Science.gov (United States)

    Karagiorgi, Yiasemina

    2012-01-01

    This article examines teachers' perceptions of, and experiences with, professional development opportunities involving a school-based project on peer observation of teaching. The study aims to reveal the ways in which seven teachers in one primary school in Cyprus see themselves as agents improving their own and peers' teaching through informal…

  3. Primary Science Teaching--Is It Integral and Deep Experience for Students?

    Science.gov (United States)

    Timoštšuk, Inge

    2016-01-01

    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'…

  4. 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.

  5. Directing Improvements in Primary Care Patient Experience through Analysis of Service Quality.

    Science.gov (United States)

    Hudson Smith, Mel; Smith, David

    2018-06-03

    To examine the influence of dimensions of service quality on patient experience of primary care. Data from the national GP Patient Survey in England 2014/15, with responses from 858,351 patients registered at 7,918 practices. Expert panel and principal component analysis helped identify relevant dimensions of service quality. Regression was then used to examine the relationships between these dimensions and reported patient experience. Aggregated scores for each practice were used, comprising the proportion of positive responses to each element of the study. Of eight service quality dimensions identified, six have statistically significant impacts on patient experience but only two have large effects. Patient experience is highly influenced by practice responsiveness and the interactions with the physician. Other dimensions have small or even slightly negative influence. Service quality provided by nurses has negligible effect on patient experience. To improve patient experience in primary health care, efforts should focus on practice responsiveness and interactions with the physician. Other areas have little influence over patient experience. This suggests a gap in patients' perspectives on health care, which has policy implications for patient education. © Health Research and Educational Trust.

  6. 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

  7. 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 < .001). Adjusting for patient characteristics, these differences remained significant for subscales assessing the patient–clinician relationship (P < .001) and perceptions of cooperation among providers (P = .004). There were 1.5- to 3-fold increased odds of an unfavorable experience in the domains of the patient–clinician relationship, cooperation, and access or coordination for the mainstream VA sites compared with the tailored non-VA site; the tailored VA site attained intermediate results. Conclusions. Tailored primary care service design was associated with a superior service experience for patients who experienced homelessness. PMID:24148052

  8. 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.

  9. Primary healthcare nurses' experiences with motivational interviewing in health promotion practice.

    Science.gov (United States)

    Brobeck, Elisabeth; Bergh, Håkan; Odencrants, Sigrid; Hildingh, Cathrine

    2011-12-01

    The aim of the study was to describe primary healthcare nurses' experiences with motivational interviewing as a method for health promotion practice. A person's lifestyle has a major effect on his or her health. Motivational interviewing is one way of working with lifestyle changes in health promotion practice. The basic plan of motivational interviewing is to help people understand their lifestyle problems and make positive lifestyle changes. Motivational interviewing has been proven to be more effective than conventional methods in increasing patient motivation. This study has a descriptive design and uses a qualitative method. Twenty nurses who worked in primary health care and actively used motivational interviewing in their work were interviewed. Qualitative content analysis was used to process the data. The primary healthcare nurses' experiences with motivational interviewing as a method of health promotion practice demonstrate that motivational interviewing is a demanding, enriching and useful method that promotes awareness and guidance in the care relationship. The results also show that motivational interviewing is a valuable tool for primary healthcare nurses' health promotion practice. This study shows that motivational interviewing places several different demands on nurses who use this method. Those who work with motivational interviewing must make an effort to incorporate this new method to avoid falling back into the former practice of simply giving advice. Maintaining an open mind while implementing motivational interviewing in real healthcare settings is crucial for nurses to increase this method's effectiveness. The nurses in the study had a positive experience with motivational interviewing, which can contribute to the increased use, adaption and development of motivational interviewing among primary healthcare professionals. Increased motivational interviewing knowledge and skills would also contribute to promotion of health lifestyle practices

  10. Mock-up experiment and analysis for the primary shield of the N.S. MUTSU

    International Nuclear Information System (INIS)

    Miyasaka, S.; Asaoka, T.; Taji, Y.; Ise, T.; Koyama, K.; Tsutsui, T.; Takeuchi, M.; Fuse, T.; Miura, T.; Yamaji, Y.

    1977-01-01

    A series of shielding mock-up experiments was performed at JRR-4, a swimming pool type reactor, of Japan Atomic Energy Research Institute (JAERI) to obtain the necessary experimental data and the sufficiently accurate method of calculation adopted for the modification of the MUTSU primary shield. Analyses for the experiments were carried out by using of the Ssub(n) codes, ANISN and TWOTRAN. The two dimensional calculations were performed with the P 1 -S 8 approximation. The neutron streaming through the annular gap between the pressure vessel and the primary shield has been confirmed to be estimated from the present method of calculation. The agreement between the calculated and the measured values is generally in about a factor of 2 to 4. (orig.) [de

  11. Primary benign brachial plexus tumors: an experience of 115 operated cases.

    Science.gov (United States)

    Desai, Ketan I

    2012-01-01

    Primary benign brachial plexus tumors are rare. They pose a great challenge to the neurosurgeon, because the majority of patients present with minimal or no neurological deficits. Radical to complete excision of the tumor with preservation of neurological function of the involved nerve is an ideal surgical treatment option with benign primary brachial plexus tumor surgery. We present a review article of our 10-year experience with primary benign brachial plexus tumors surgically treated at King Edward Memorial Hospital and P.D. Hinduja National Hospital from 2000 to 2009. The clinical presentations, radiological features, surgical strategies, and the eventual outcome following surgery are analyzed, discussed, and compared with available series in the world literature. Various difficulties and problems faced in the management of primary benign brachial plexus tumors are analyzed. Irrespective of the tumor size, the indications for surgical intervention are also discussed. The goal of our study was to optimize the treatment of patients with benign brachial plexus tumors with minimal neurological deficits. It is of paramount importance that brachial plexus tumors be managed by a peripheral nerve surgeon with expertise and experience in this field to minimize the neurological insult following surgery.

  12. Experiments for simulating a great leak in the primary coolant circuit of a PWR type reactor

    International Nuclear Information System (INIS)

    Liebig, E.

    1977-01-01

    A loss of coolant accident is to be simulated on a high pressure test rig. The accident is initiated by an externally induced rupture of a pair of rupture-disks installed in a coolant ejection device. Several problems of simulating leaks in the primary coolant circuit of PWR type reactors are dealt with. The selection of appropriate rupture-disks for such experiments is described

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

    International Nuclear Information System (INIS)

    Weber, C.M.

    1995-01-01

    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

  14. 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.

  15. Primary pci in st elevation myocardial infarction : an experience at afic/nihd rawalpindi

    International Nuclear Information System (INIS)

    Saif, M.; Khan, H.S.; Kha, M.N.; Maken, G.R.

    2013-01-01

    Objective: To evaluate the practicability, safety, and efficacy of primary percutaneous coronary intervention as a therapeutic option in acute ST elevation Myocardial Infarction (STEMI). Study Design: Descriptive study. Place and Duration of Study: The study was carried out in Armed Forces Institute of Cardiology- National Institute of Heart Diseases (AFIC-NIHD) from 18th October 2011 to 30th November 2011. Patients and Methods: All patients presenting with acute STEMI were offered primary PCI. Patients who chose primary PCI as a mode of reperfusion were included in the study. Informed consent was taken and detailed questionnaire was filled for those patients who fulfilled the study criteria. Results: Our initial experience of primary PCI in 33 patients with ST elevation MI has revealed some favourable statistics. Only 01 (3.0%) patient died during hospital stay following the procedure. Thirty two (97%) patients had an uneventful recovery and were successfully discharged 48-72 hours following PCI. Conclusion: We have shown that primary PCI is a viable therapeutic option and can be performed in public sector tertiary care hospitals with excellent immediate, short and long term outcomes despite relatively long symptom onset to emergency room and door-to-balloon times. (author)

  16. 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.

  17. 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

    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. © 2016 R. Lie, C. Abdullah, et al. CBE—Life Sciences Education © 2016 The American Society for Cell Biology. This article is distributed by The American Society for Cell Biology under license from the author(s). It is available to the public under an Attribution–Noncommercial–Share Alike 3.0 Unported Creative Commons License (http://creativecommons.org/licenses/by-nc-sa/3.0).

  18. 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.

  19. Nursing documentation: experience of the use of the nursing process model in selected hospitals in Ibadan, Oyo State, Nigeria.

    Science.gov (United States)

    Ofi, Bola; Sowunmi, Olanrewaju

    2012-08-01

    The descriptive study was conducted to determine the extent of utilization of the nursing process for documentation of nursing care in three selected hospitals, Ibadan, Nigeria. One hundred fifty nurses and 115 discharged clients' records were selected from the hospitals. Questionnaires and checklists were used to collect data. Utilization of nursing process for care was 100%, 73.6% and 34.8% in the three hospitals. Nurses encountered difficulties in history taking, formulation of nursing diagnoses, objectives, nursing orders and evaluation. Most nurses disagreed or were undecided with the use of authorized abbreviations and symbols (34.3%, 40.3% and 69.5%), recording errors that occurred during care (37.1%, 56.1% and 52.2%) and inclusion of change in clients' condition (54.3%, 56.1% and 73.8%). Most nurses appreciated the significance of documentation. Lack of time, knowledge and need for extensive writing are the major barriers against documentation. Seventy-seven point four per cent of the 115 clients' records from one hospital showed evidence of documentation, no evidence from the other two. Study findings have implications for continuing professional education, practice and supervision. © 2012 Blackwell Publishing Asia Pty Ltd.

  20. Molten Salt Reactor Experiment Facility (Building 7503) standards/requirements identification document adherence assessment plan at Oak Ridge National Laboratory, Oak Ridge, Tennessee

    International Nuclear Information System (INIS)

    1996-02-01

    This is the Phase 2 (adherence) assessment plan for the Building 7503 Molten Salt Reactor Experiment (MSRE) Facility standards/requirements identification document (S/RID). This document outlines the activities to be conducted from FY 1996 through FY 1998 to ensure that the standards and requirements identified in the MSRE S/RID are being implemented properly. This plan is required in accordance with the Department of Energy Implementation Plan for Defense Nuclear Facilities Safety Board Recommendation 90-2, November 9, 1994, Attachment 1A. This plan addresses the major aspects of the adherence assessment and will be consistent with Energy Systems procedure QA-2. 7 ''Surveillances.''

  1. 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

  2. Medical Home Implementation Gaps for Seniors: Perceptions and Experiences of Primary Care Medical Practices.

    Science.gov (United States)

    Hoff, Timothy; DePuccio, Matthew

    2018-07-01

    The study objective was to better understand specific implementation gaps for various aspects of patient-centered medical home (PCMH) care delivered to seniors. The study illuminates the physician and staff experience by focusing on how individuals make sense of and respond behaviorally to aspects of PCMH implementation. Qualitative data from 51 in-depth, semi-structured interviews across six different National Committee for Quality Assurance (NCQA)-accredited primary care practices were collected and analyzed. Physicians and staff identified PCMH implementation gaps for their seniors: (a) performing in-depth clinical assessments, (b) identifying seniors' life needs and linking them with community resources, and (c) care management and coordination, in particular self-management support for seniors. Prior experiences trying to perform these aspects of PCMH care for older adults produced collective understandings that led to inaction and avoidance by medical practices around the first two gaps, and proactive behavior that took strategic advantage of external incentives for addressing the third gap. Greater understanding of physician and staff's PCMH implementation experiences, and the learning that accumulates from these experiences, allows for a deeper understanding of how primary care practices choose to enact the medical home model for seniors on an everyday basis.

  3. 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

    2009-05-01

    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. 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 areas of Kingston and St. Andrew, Jamaica, was conducted. Academic achievement (mathematics, reading, and spelling) was assessed using the Wide Range Achievement Test. Children's experiences of three types of violence - exposure to aggression among peers at school, physical punishment at school, and exposure to community violence - were assessed by self-report using an interviewer administered questionnaire. Fifty-eight percent of the children experienced moderate or high levels of all three types of violence. Boys had poorer academic achievement and experienced higher levels of aggression among peers and physical punishment at school than girls. Children's experiences of the three types of violence were independently associated with all three indices of academic achievement. There was a dose-response relationship between children's experiences of violence and academic achievement with children experiencing higher levels of violence having the poorest academic achievement and children experiencing moderate levels having poorer achievement than those experiencing little or none. Exposure to three different types of violence was independently associated with poor school achievement among children attending government, urban schools in Jamaica. Programs are needed in schools to reduce the levels of aggression among students and the use of physical punishment by teachers and to provide support for children exposed to community violence. Children in Jamaica and the wider Caribbean experience significant amounts of violence in their homes, communities, and schools. In this study, we demonstrate a dose-response relationship between primary school

  4. Motivational interviewing: experiences of primary care nurses trained in the method.

    Science.gov (United States)

    Östlund, Ann-Sofi; Wadensten, Barbro; Kristofferzon, Marja-Leena; Häggström, Elisabeth

    2015-03-01

    Motivational interviewing is a person-centered counseling style used to promote behavioral change regarding a wide variety of lifestyle problems. Use of motivational interview is growing worldwide and among many different healthcare professions, including primary care nursing. The study aim was to describe motivational interview trained nurses' experiences of motivational interviewing in primary care settings. The study had a qualitative descriptive design. It was carried out in Swedish primary care settings in two county council districts, with 20 primary care nurses trained in motivational interviewing. Half of them used the method in their work, half did not. Qualitative semi-structured interviews were used. Data were analyzed using qualitative content analysis. The nurses experienced that openness to the approach and an encouraging working climate are required to overcome internal resistance and to increase use of motivational interviewing. They also experienced mutual benefit: motivational interviewing elicits and develops abilities in both nurses and patients. For the nurses using it, motivational interviewing is perceived to facilitate work with patients in need of lifestyle change. Lack of training/education, support, interest and appropriate work tasks/patients are reasons for not using motivational interviewing.

  5. 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.

  6. Patient experience of access to primary care: identification of predictors in a national patient survey.

    Science.gov (United States)

    Kontopantelis, Evangelos; Roland, Martin; Reeves, David

    2010-08-28

    The 2007/8 GP Access Survey in England measured experience with five dimensions of access: getting through on the phone to a practice, getting an early appointment, getting an advance appointment, making an appointment with a particular doctor, and surgery opening hours. Our aim was to identify predictors of patient satisfaction and experience with access to English primary care. 8,307 English general practices were included in the survey (of 8,403 identified). 4,922,080 patients were randomly selected and contacted by post and 1,999,523 usable questionnaires were returned, a response rate of 40.6%. We used multi-level logistic regressions to identify patient, practice and regional predictors of patient satisfaction and experience. After controlling for all other factors, younger people, and people of Asian ethnicity, working full time, or with long commuting times to work, reported the lowest levels of satisfaction and experience of access. For people in work, the ability to take time off work to visit the GP effectively eliminated the disadvantage in access. The ethnic mix of the local area had an impact on a patient's reported satisfaction and experience over and above the patient's own ethnic identity. However, area deprivation had only low associations with patient ratings. Responses from patients in small practices were more positive for all aspects of access with the exception of satisfaction with practice opening hours. Positive reports of access to care were associated with higher scores on the Quality and Outcomes Framework and with slightly lower rates of emergency admission. Respondents in London were the least satisfied and had the worst experiences on almost all dimensions of access. This study identifies a number of patient groups with lower satisfaction, and poorer experience, of gaining access to primary care. The finding that access is better in small practices is important given the increasing tendency for small practices to combine into larger

  7. Patient experience of access to primary care: identification of predictors in a national patient survey

    Directory of Open Access Journals (Sweden)

    Kontopantelis Evangelos

    2010-08-01

    Full Text Available Abstract Background The 2007/8 GP Access Survey in England measured experience with five dimensions of access: getting through on the phone to a practice, getting an early appointment, getting an advance appointment, making an appointment with a particular doctor, and surgery opening hours. Our aim was to identify predictors of patient satisfaction and experience with access to English primary care. Methods 8,307 English general practices were included in the survey (of 8,403 identified. 4,922,080 patients were randomly selected and contacted by post and 1,999,523 usable questionnaires were returned, a response rate of 40.6%. We used multi-level logistic regressions to identify patient, practice and regional predictors of patient satisfaction and experience. Results After controlling for all other factors, younger people, and people of Asian ethnicity, working full time, or with long commuting times to work, reported the lowest levels of satisfaction and experience of access. For people in work, the ability to take time off work to visit the GP effectively eliminated the disadvantage in access. The ethnic mix of the local area had an impact on a patient's reported satisfaction and experience over and above the patient's own ethnic identity. However, area deprivation had only low associations with patient ratings. Responses from patients in small practices were more positive for all aspects of access with the exception of satisfaction with practice opening hours. Positive reports of access to care were associated with higher scores on the Quality and Outcomes Framework and with slightly lower rates of emergency admission. Respondents in London were the least satisfied and had the worst experiences on almost all dimensions of access. Conclusions This study identifies a number of patient groups with lower satisfaction, and poorer experience, of gaining access to primary care. The finding that access is better in small practices is important given

  8. Four decades of working experience of Cirus primary cooling water heat exchangers

    International Nuclear Information System (INIS)

    Dubey, P.K.; Ullas, O.P.; Rao, D.V.H.; Zope, A.K.; Kharpate, A.V.

    2006-01-01

    CIRUS is a 40 MW (Th.) research reactor, commissioned in the year 1960. The reactor has natural uranium fuel rods, heavy water as moderator, demineralised water (DM water) as primary coolant, and seawater as secondary coolant. There are six Heat Exchangers in the primary cooling water (PCW) system. Five of them are required for the normal operation of the reactor and one is kept stand by. DM water flows on the shell side of the heat exchanger in two passes. Seawater is used as coolant on the tube side of the heat exchangers in four passes. Cirus has been in operation for around 41 years excluding refurbishment period. During these four decades of reactor operation, PCW heat exchangers have experienced many failures and undergone many modifications in the circuit for ensuring better performance. This paper tries to capture the essence of working experiences with PCW heat exchangers, various problems faced, remedial measures taken during those four decades of reactor operation. (author)

  9. Comparison of patients' experiences in public and private primary care clinics in Malta.

    Science.gov (United States)

    Pullicino, Glorianne; Sciortino, Philip; Calleja, Neville; Schäfer, Willemijn; Boerma, Wienke; Groenewegen, Peter

    2015-06-01

    Demographic changes, technological developments and rising expectations require the analysis of public-private primary care (PC) service provision to inform policy makers. We conducted a descriptive, cross-sectional study using the dataset of the Maltese arm of the QUALICOPC Project to compare the PC patients' experiences provided by public-funded and private (independent) general practitioners in Malta. Seven hundred patients from 70 clinics completed a self-administered questionnaire. Direct logistic regression showed that patients visiting the private sector experienced better continuity of care with more difficulty in accessing out-of-hours care. Such findings help to improve (primary) healthcare service provision and resource allocation. © The Author 2014. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved.

  10. Revealing the Experience of Children and Teachers Even in Their Absence: Documenting in the Early Childhood Studio

    Science.gov (United States)

    Parnell, Will

    2011-01-01

    Inspired by the educational approach in the municipal pre-primary schools and infant-toddler centers of Reggio Emilia, Italy, two studio teachers and a researcher participant in Portland, Oregon capture classroom work, make investigations and interpretations in the studio as a laboratory space of learning, help children represent thinking, and…

  11. French experience concerning expansion compensating devices on the primary systems of nuclear reactors

    International Nuclear Information System (INIS)

    Vrillon, B.; Raynal, A.

    1980-01-01

    French experience in the use of large expansion bellows in the presence of hot sodium is extremely limited. This stems from the 'pool' structure of the primary circuit, adopted in France to eliminate the need to solve expansion problems affecting the primary piping of loop reactors. Furthermore, until the present time, the use of bellows on secondary circuits has neither been implemented nor considered. A few bellows nevertheless exist on the Phenix and Super-Phenix reactors, and these perform separation functions, for example, between sodium at different temperature and/or pressures, or tightness functions in gaseous environment at the component penetrations in the slabs. The dimension criteria applied to these bellows are the general rules for structural dimensioning. Since they do not form part of a circuit wall, they do not need to be discussed. Note, however, that these components have not raised any particular problems thus far. Expansion bellows exist in France on the primary circuits of certain nuclear reactors of the natural uranium/graphite/gas type. These reactors have been in operation for many years, and some lessons can be drawn from this experience in the use of bellows in representative conditions on power reactor circuits. Liquid sodium raises specific problems with respect to circuit operation and material behavior. However, many problems in the use of bellows are independent of the fluid conveyed in the circuits. This is why the experience gained with gas type power reactors appears to be useful in considering the possible future use of bellows on sodium reactor circuits

  12. 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 (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.

  13. 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.

  14. ORNL experiments to characterize fuel release from the reactor primary containment in severe LMFBR accidents

    International Nuclear Information System (INIS)

    Wright, A.L.; Kress, T.S.; Smith, A.M.

    1980-01-01

    This paper presents results from aerosol source term experiments performed in the ORNL Aerosol Release and Transport (ART) Program sponsored by the US NRC. The tests described were performed to provide information on fuel release from an LMFBR primary containment as a result of a hypothetical core-disruptive accident (HCDA). The release path investigated in these tests assumes that a fuel/sodium bubble is formed after disassembly that transports fuel and fission products through the sodium coolant and cover gas to be relased into the reactor secondary containment. Due to the excellent heat transfer characteristics of the sodium, there is potential for large attenuation of the maximum release

  15. 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 primary schooling positively affects women's literacy and spousal schooling attainment in Malawi and age of marriage and current household wealth in Uganda. However primary schooling has no effect on recent (adult) sexual behavior. Copyright © 2014 The Author. Published by Elsevier Ltd.. All rights reserved.

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

    Science.gov (United States)

    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

  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...... spectrometry (flame AAS) and graphite furnace atomic absorption spectrometry (graphite furnace AAS). Uptake and release of Pb were documented to be slow processes. For mussels transplanted from the pristine Kugnait Bay to the polluted mining site at Ivittuut, a continuous accumulation throughout...... the experiments was found. Linear uptake rates of 5.86, 6.94 and 11.62 μg Pb month−1 for small, medium and large mussels were found for a 6-week experiment, whereas exponential uptake rates of 0.26, 0.20 and 0.28 month−1 were found for a 9-month experiment. It is estimated that the transplanted mussels will reach...

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

    Directory of Open Access Journals (Sweden)

    Ibrahim Uygun

    2015-01-01

    Full Text Available Background: Isolated oesophageal atresia without tracheo-oesophageal fistula represents a major challenge for most paediatric surgeons. Here, we present our experience with six neonates with isolated oesophageal atresia who successfully underwent immediate primary anastomosis using multiple Livaditis circular myotomy. Materials and Methods: All six neonates were gross type A isolated oesophageal atresia (6%, from among 102 neonates with oesophageal atresia, treated between January 2009 and December 2013. Five neonates were female; one was male. The mean birth weight was 2300 (range 1700-3100 g. Results: All six neonates successfully underwent immediate primary anastomosis using multiple myotomies (mean 3; range 2-4 within 10 (median 3 days after birth. The gap under traction ranged from 6 to 7 cm. One neonate died of a major cardiac anomaly. Another neonate was lost to follow-up after being well for 3 months. Three anastomotic strictures were treated with balloon dilatation, and four anastomotic leaks were treated conservatively. The mean duration of follow-up was 33 months. Conclusions: To treat isolated oesophageal atresia, an immediate primary anastomosis can be achieved using multiple myotomies. Although, this approach is associated with high complication rates, as are other similar approaches, these complications can be overcome.

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

    Directory of Open Access Journals (Sweden)

    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.

  20. 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.

  1. 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.

  2. 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.

  3. Standardization Documents

    Science.gov (United States)

    2011-08-01

    Specifications and Standards; Guide Specifications; CIDs; and NGSs . Learn. Perform. Succeed. STANDARDIZATION DOCUMENTS Federal Specifications Commercial...national or international standardization document developed by a private sector association, organization, or technical society that plans ...Maintain lessons learned • Examples: Guidance for application of a technology; Lists of options Learn. Perform. Succeed. DEFENSE HANDBOOK

  4. Experiences of primary care physicians and staff following lean workflow redesign.

    Science.gov (United States)

    Hung, Dorothy Y; Harrison, Michael I; Truong, Quan; Du, Xue

    2018-04-10

    In response to growing pressures on primary care, leaders have introduced a wide range of workforce and practice innovations, including team redesigns that delegate some physician tasks to nonphysicians. One important question is how such innovations affect care team members, particularly in view of growing dissatisfaction and burnout among healthcare professionals. We examine the work experiences of primary care physicians and staff after implementing Lean-based workflow redesigns. This included co-locating physician and medical assistant dyads, delegating significant responsibilities to nonphysician staff, and mandating greater coordination and communication among all care team members. The redesigns were implemented and scaled in three phases across 46 primary care departments in a large ambulatory care delivery system. We fielded 1164 baseline and 1333 follow-up surveys to physicians and other nonphysician staff (average 73% response rate) to assess workforce engagement (e.g., job satisfaction, motivation), perceptions of the work environment, and job-related burnout. We conducted multivariate regressions to detect changes in experiences after the redesign, adjusting for respondent characteristics and clustering of within-clinic responses. We found that both physicians and nonphysician staff reported higher levels of engagement and teamwork after implementing redesigns. However, they also experienced higher levels of burnout and perceptions of the workplace as stressful. Trends were the same for both occupational groups, but the increased reports of stress were greater among physicians. Additionally, members of all clinics, except for the pilot site that developed the new workflows, reported higher burnout, while perceptions of workplace stress increased in all clinics after the redesign. Our findings partially align with expectations of work redesign as a route to improving physician and staff experiences in delivering care. Although teamwork and engagement

  5. 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 (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

  6. Isolation of primary human hepatocytes from normal and diseased liver tissue: a one hundred liver experience.

    Directory of Open Access Journals (Sweden)

    Ricky H Bhogal

    2011-03-01

    Full Text Available Successful and consistent isolation of primary human hepatocytes remains a challenge for both cell-based therapeutics/transplantation and laboratory research. Several centres around the world have extensive experience in the isolation of human hepatocytes from non-diseased livers obtained from donor liver surplus to surgical requirement or at hepatic resection for tumours. These livers are an important but limited source of cells for therapy or research. The capacity to isolate cells from diseased liver tissue removed at transplantation would substantially increase availability of cells for research. However no studies comparing the outcome of human hepatocytes isolation from diseased and non-diseased livers presently exist. Here we report our experience isolating human hepatocytes from organ donors, non-diseased resected liver and cirrhotic tissue. We report the cell yields and functional qualities of cells isolated from the different types of liver and demonstrate that a single rigorous protocol allows the routine harvest of good quality primary hepatocytes from the most commonly accessible human liver tissue samples.

  7. 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 (<12 years) with anxiety disorders. Twenty semi-structured interviews were conducted with 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.

  8. Exploring preferences for symptom management in primary care: a discrete choice experiment using a questionnaire survey.

    Science.gov (United States)

    McAteer, Anne; Yi, Deokhee; Watson, Verity; Norwood, Patricia; Ryan, Mandy; Hannaford, Philip C; Elliott, Alison M

    2015-07-01

    Symptoms are important drivers for the use of primary care services. Strategies aimed at shifting the focus away from the GP have broadened the range of primary healthcare available. To explore preferences for managing symptoms and investigate trade-offs that the public are willing to make when deciding between different primary care services. UK-wide postal questionnaire survey of 1370 adults. A discrete choice experiment examined management preferences for three symptoms of differing seriousness (diarrhoea, dizziness, and chest pain). Willingness-to-pay estimates compared preferences between symptoms, and by sex, age, and income. Preferences differed significantly between symptoms. 'Self-care' was the preferred action for diarrhoea and 'consulting a GP' for dizziness and chest pain. 'Waiting time' and 'chance of a satisfactory outcome' were important factors for all three symptoms, although their relative importance differed. Broadly, people were more prepared to wait longer and less prepared to trade a good chance of a satisfactory outcome for symptoms rated as more serious. Generally, preferences within subgroups followed similar patterns as for the whole sample, although there were differences in the relative strength of preferences. Despite increased choices in primary care, 'traditional' actions of 'self-care' for minor symptoms and 'GP consultation' for more serious symptoms were preferred. The present findings suggest, however, that people may be willing to trade between different health services, particularly for less serious symptoms. Understanding the relative importance of different factors may help inform interventions aimed at changing management behaviour or improving services. © British Journal of General Practice 2015.

  9. 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.

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

    Directory of Open Access Journals (Sweden)

    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.

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

    Directory of Open Access Journals (Sweden)

    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.

  12. Digital Story-Based Problem Solving Applications: Preservice Primary Teachers' Experiences and Future Integration Plans

    Science.gov (United States)

    Kilic, Çigdem; Sancar-Tokmak, Hatice

    2017-01-01

    This case study investigates how preservice primary school teachers describe their experiences with digital story-based problem solving applications and their plans for the future integration of this technology into their teaching. Totally 113 preservice primary school teachers participated in the study. Data collection tools included a…

  13. 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.

  14. Everyday life experiences among relatives of persons with mental disabilities represented in basic documents governing the Swedish psychiatric reform

    OpenAIRE

    Wilhelmsson, Anna-Britta; Berge, Britt-Marie

    2012-01-01

    Mental disability is one of the most serious health problems facing Europe today. The reform of psychiatric care inSweden has passed much of the rehabilitation and daily care of these people on to their families/relatives. The aim of this article is to analyze how the psychiatric reform in Sweden has affected everyday life experiences among close relatives of persons with mental disabilities. It is an explorative and descriptive study using inductive qualitative content analysis of 18 individ...

  15. [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.

  16. 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.

  17. [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.

  18. 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....

  19. Documentation Service

    International Nuclear Information System (INIS)

    Charnay, J.; Chosson, L.; Croize, M.; Ducloux, A.; Flores, S.; Jarroux, D.; Melka, J.; Morgue, D.; Mottin, C.

    1998-01-01

    This service assures the treatment and diffusion of the scientific information and the management of the scientific production of the institute as well as the secretariat operation for the groups and services of the institute. The report on documentation-library section mentions: the management of the documentation funds, search in international databases (INIS, Current Contents, Inspects), Pret-Inter service which allows accessing documents through DEMOCRITE network of IN2P3. As realizations also mentioned are: the setup of a video, photo database, the Web home page of the institute's library, follow-up of digitizing the document funds by integrating the CD-ROMs and diskettes, electronic archiving of the scientific production, etc

  20. 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

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

    Science.gov (United States)

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

    2015-01-01

    Research problem 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. Research question What are the differences between user-generated tutorials and manuals for an EMR and the official user manual from the software vendor? Literature review 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. Methodology 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. Results and discussion 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

  2. Computerising documentation

    International Nuclear Information System (INIS)

    Anon.

    1992-01-01

    The nuclear power generation industry is faced with public concern and government pressures over safety, efficiency and risk. Operators throughout the industry are addressing these issues with the aid of a new technology - technical document management systems (TDMS). Used for strategic and tactical advantage, the systems enable users to scan, archive, retrieve, store, edit, distribute worldwide and manage the huge volume of documentation (paper drawings, CAD data and film-based information) generated in building, maintaining and ensuring safety in the UK's power plants. The power generation industry has recognized that the management and modification of operation critical information is vital to the safety and efficiency of its power plants. Regulatory pressure from the Nuclear Installations Inspectorate (NII) to operate within strict safety margins or lose Site Licences has prompted the need for accurate, up-to-data documentation. A document capture and management retrieval system provides a powerful cost-effective solution, giving rapid access to documentation in a tightly controlled environment. The computerisation of documents and plans is discussed in this article. (Author)

  3. 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

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

    Directory of Open Access Journals (Sweden)

    Nokulunga H. Cele

    2015-09-01

    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.

  5. Laron syndrome (primary growth hormone resistance or insensitivity): the personal experience 1958-2003.

    Science.gov (United States)

    Laron, Zvi

    2004-03-01

    Clinical and laboratory investigations starting in 1958 of a group of dwarfed children resembling isolated GH deficiency but who had very high serum levels of GH led to the description of the syndrome of primary GH resistance or insensitivity (Laron syndrome) and subsequently to the discovery of its molecular defects residing in the GH receptor and leading to an inability of IGF-I generation. With the biosynthesis of IGF-I in 1986, therapeutic trials started. Continuously more and more patients are being diagnosed in many parts of the world with a variety of molecular defects. This syndrome proved to be a unique model that enables the study of the consequences of GH receptor defects, the physiopathology of GH-IGF-I disruption, and comparison of the GH-independent IGF-I effects. This review presents the personal experience gained from the study follow-up and treatment of the 60 patients followed up for many years in the Israeli cohort.

  6. Measurement of the Cosmic Ray primary spectrum with ARGO-YBJ experiment

    International Nuclear Information System (INIS)

    Panico, B; Iuppa, R; Di Sciascio, G

    2013-01-01

    The study of cosmic ray physic of 10 12 – 10 15 primary cosmic energy is one of the main goals of ARGO-YBJ experiment. The detector, located at the Yangbajing Cosmic Ray Laboratory (Tibet, 4300 m a.s.l., 606 g/cm 2 ), is an EAS array consisting of a continuous carpet of RPCs. The low energy threshold of the detector allows to study an energy region characterized by the transition from the direct to the indirect measurements. In this talk we will report on the measurement of the cosmic ray energy spectrum at different zenith angles. The phenomenology of horizontal air shower (θ > 70°) will be described and discussed.

  7. Simulation of the condensation experiment for the SG primary of SMART with MIDAS/SMR

    Energy Technology Data Exchange (ETDEWEB)

    Park, Jong Hwa; Kim, Dong Ha; Chung, Young Jong; Park, Sun Hee [Korea Atomic Energy Research Institute, Daejeon (Korea, Republic of); Cho, Seong Won [Korea Radiation Technology Institute Co., Daejeon (Korea, Republic of)

    2012-05-15

    SMART is new concept of reactor that all the main components such as the steam generator, the coolant pumps and the pressurizer are located inside the reactor vessel. MIDAS/SMR V1.0.3 code has been used for estimating the severe accident from SMART. SMART has the SG tube with helical shape that is different from that of PWR. MIDAS code has the condensation model for the both sides of surfaces from the various kinds of geometry. But it does not have the condensation model for the helical type of tube. In this study, the condensation experiment for the outer surface of the SG tube in SMART that was performed by Po-Hang university was simulated with MIDAS/SMR under the assumption of straight pipe. The simulation results showed well predictions of the amount of heat removal from the SG tube primary side and thermal hydraulic parameters

  8. Simulation of the condensation experiment for the SG primary of SMART with MIDAS/SMR

    International Nuclear Information System (INIS)

    Park, Jong Hwa; Kim, Dong Ha; Chung, Young Jong; Park, Sun Hee; Cho, Seong Won

    2012-01-01

    SMART is new concept of reactor that all the main components such as the steam generator, the coolant pumps and the pressurizer are located inside the reactor vessel. MIDAS/SMR V1.0.3 code has been used for estimating the severe accident from SMART. SMART has the SG tube with helical shape that is different from that of PWR. MIDAS code has the condensation model for the both sides of surfaces from the various kinds of geometry. But it does not have the condensation model for the helical type of tube. In this study, the condensation experiment for the outer surface of the SG tube in SMART that was performed by Po-Hang university was simulated with MIDAS/SMR under the assumption of straight pipe. The simulation results showed well predictions of the amount of heat removal from the SG tube primary side and thermal hydraulic parameters

  9. 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.

  10. Uniportal video assisted thoracoscopic lobectomy: primary experience from an Eastern center.

    Science.gov (United States)

    Feng, Mingxiang; Shen, Yaxing; Wang, Hao; Tan, Lijie; Mao, Xuping; Liu, Yi; Wang, Qun

    2014-12-01

    Uniportal video-assisted thoracoscopic surgery (VATS) lobectomy is an emerging technique for the surgical resection of non-small cell lung cancer (NSCLC). Besides its wide debates on safety and efficacy throughout the world, there were few report on uniportal VATS from the Eastern countries. In this article, we summarized our primary experience on uniportal VATS lobectomy in an Eastern center. From October 2013 till February 2014, 54 consecutive uniportal VATS lobectomy were performed in the Department of Thoracic Surgery, Zhongshan Hospital of Fudan University. Patients' clinical features and operative details were recorded. Post-operatively, the morbidity and mortality were recorded to analyze the safety and efficacy of uniportal VATS lobectomy for NSCLCs. Among the 54 planned uniportal VATS lobectomy, there was one conversion to mini-thoracotomy due to lymph node sticking. Extra ports were required in two patients. The uniportal VATS lobectomy was achieved in 51 out of 54 patients (94.4%). The average operation duration was 122.2±37.5 min (90-160 min). The average volume of estimated blood loss during the operation was 88.8±47.1 mL (50-200 mL). The mean chest tube duration and hospital stay were 3.2±1.9 days and 4.6±2.0 days, respectively. There was no postoperative mortality in this study. Two patients suffered from prolonged air leakage (5 and 7 days), and one atrial fibrillation was observed in this cohort. Based on our primary experience, uniportal VATS lobectomy is a safe and effective procedure for the surgical resection of NSCLCs. The surgical refinements and instrumental improvements would facilitate the technique. Further studies based on larger population are required to determine its benefits towards patients with NSCLCs.

  11. 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.

  12. 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 practices and screened positive for FI. In the interviews, we elicited parents' perceptions of screening for FI, how FI impacted the family, and recommendations for how practices could more effectively address FI. All interviews were audio recorded and transcribed. We used a modified grounded theory approach to code the interviews inductively and identified emerging themes through an iterative process. Interviews continued until thematic saturation was achieved. Of the 23 parents interviewed, all were women, with 39% white and 39% African American. Three primary themes emerged: Parents expressed initial surprise at screening followed by 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.

  13. Primary care patients' expectations regarding medical appointments and their experiences during a visit: does age matter?

    Directory of Open Access Journals (Sweden)

    Jaworski M

    2017-07-01

    Full Text Available Mariusz Jaworski,1 Marta Rzadkiewicz,1 Miroslawa Adamus,1 Joanna Chylinska,1 Magdalena Lazarewicz,1 Gørill Haugan,2 Monica Lillefjell,3 Geir Arild Espnes,2 Dorota Wlodarczyk1 1Department of Medical Psychology, Second Faculty of Medicine, Medical University of Warsaw, Warsaw, Poland; 2Department of Public Health and Nursing, 3Department of Neuromedicine and Movement Science, NTNU Center for Health Promotion Research, Norwegian University of Science and Technology, Trondheim, Norway Introduction: There is evidence that meeting patients’ expectations toward health care correlates with involvement in the treatment they receive. The most important patient expectations concern certain types of information: explanation of disease and treatment, health promotion, and improvement in quality of life. Other demands include proper rapport and emotional support. The aim of this paper was to examine different patient groups over the age of 50 years and their expectations toward medical visits, evaluated before a visit and after the visit.Patients and methods: The study group consisted of 4,921 primary health-care patients. The patients received self-administered questionnaires that they filled in before and after the appointment with the doctor. Interviews with patients were conducted individually by specially trained interviewers. The PRACTA Patient Expectations Scale was used to measure the appointment-related expectations of the patients.Results: We observed differences related to age in patients’ expectations before medical visits regarding the following factors: disease explanation, treatment explanation, quality of life, rapport, and emotional support. The same differences were not observed on health promotion. Evaluation of patients’ appointment-related experiences after the visit showed that there were significant differences between the age-groups regarding all types of expectations included in the study. Differences between previsit and

  14. Policy Levers Key for Primary Health Care Organizations to Support Primary Care Practices in Meeting Medical Home Expectations: Comparing Leading States to the Australian Experience.

    Science.gov (United States)

    Takach, Mary

    2016-10-01

    Several countries with highly ranked delivery systems have implemented locally-based, publicly-funded primary health care organizations (PHCOs) as vehicles to strengthen their primary care foundations. In the United States, state governments have started down a similar pathway with models that share similarities with international PHCOs. The objective of this study was to determine if these kinds of organizations were working with primary care practices to improve their ability to provide comprehensive, coordinated, and accessible patient-centered care that met quality, safety, and efficiency outcomes-all core attributes of a medical home. This qualitative study looked at 4 different PHCO models-3 from the United States and 1 from Australia-with similar objectives and scope. Primary and secondary data included semi-structured interviews with 26 PHCOs and a review of government documents. The study found that the 4 PHCO models were engaging practices to meet a number of medical home expectations, but the US PHCOs were more uniform in efforts to work with practices and focused on arranging services to meet the needs of complex patients. There was significant variation in level of effort between the Australian PHCOs. These differences can be explained through the state governments' selection of payment models and use of data frameworks to support collaboration and incentivize performance of both PHCOs and practices. These findings offer policy lessons to inform health reform efforts under way to better capitalize on the potential of PHCOs to support a high-functioning primary health foundation as an essential component to a reformed health system.

  15. Comparison of scintigraphy and ultrasound imaging in patients with primary, secondary and tertiary hyperparathyroidism – own experience

    Directory of Open Access Journals (Sweden)

    Małgorzata Kobylecka

    2017-03-01

    Full Text Available Background: The imaging techniques most commonly used in the diagnosis of hyperparathyroidisms are ultrasound and scintigraphy. The diagnostic algorithms vary, depending mainly on the population, and experience of physicians. Aim: Aim of the present research was to determine the usefulness of parathyroid scintigraphy and ultrasonography in patients diagnosed for hyperparathyroidism in own material. Material and method: In the present research, 96 operated patients with documented primary, secondary and tertiary hyperparathyroidism were retrospectively analyzed. All patients underwent a 99mTc hexakis- 2-methoxyisobutylisonitrile scintigraphy of the neck with the use of subtraction and twophase examinations. Ultrasonography of the neck was performed in all the patients in B mode 2D presentation. A total number of 172 parathyroid glands were analyzed. Results: The sensitivity and specificity of scintigraphy was 68% and 60%, respectively. The sensitivity of ultrasound was 49% and specificity 85%. Both techniques allowed visualization of 76 parathyroid glands. Ultrasound revealed 19 glands that were not visible in scintigraphy. Scintigraphy showed 76 parathyroid glands that were not visualized on ultrasound. Having combined the results of scintigraphy and ultrasound, the sensitivity of 76% and specificity of 50% were obtained. Considering the ability to locate the parathyroid glands in both techniques as a positive result, the sensitivity decreased to 37% and specificity rose to 95%. Conclusions: Scintigraphy showed greater sensitivity than ultrasound in the localization of enlarged parathyroid glands. Ultrasound, in turn, was characterized by a higher specificity. The combined use of scintigraphy and ultrasonography allowed to obtain the specificity of 95%. In the light of obtained results, scintigraphy and ultrasonography are complementary and should be used together.

  16. Documents on Disarmament.

    Science.gov (United States)

    Arms Control and Disarmament Agency, Washington, DC.

    This publication, latest in a series of volumes issued annually since 1960, contains primary source documents on arms control and disarmament developments during 1969. The main chronological arrangement is supplemented by both chronological and topical lists of contents. Other reference aids include a subject/author index, and lists of…

  17. 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.

  18. Parental perspectives of screening for adverse childhood experiences in pediatric primary care.

    Science.gov (United States)

    Conn, Anne-Marie; Szilagyi, Moira A; Jee, Sandra H; Manly, Jody T; Briggs, Rahil; Szilagyi, Peter G

    2018-03-01

    Pediatricians recognize a need to mitigate the negative impact that adverse childhood experiences (ACEs) can have on health and development. However, ACEs screening and interventions in primary care pediatrics may be inhibited by concerns about parental perceptions. We assessed parent perspectives of screening for ACEs in the pediatric primary care setting, to understand their views on the potential impact of their ACEs on their parenting and to identify opportunities for pediatric anticipatory guidance. We used purposive sampling to recruit parents of children <6 years receiving care at an urban, pediatric clinic. Semistructured questions guided 1:1 interviews that were later coded by multiple researchers to verify reliability. A thematic framework approach guided analysis and identified main themes and subthemes. We reached thematic saturation after 15 parent interviews, which consistently revealed 3 interrelated themes. First, parents strongly supported ACEs screening as a bridge to needed services, and they recommended using a trauma-sensitive, person-centered approach in pediatric practices. Second, parents understood the intergenerational impact of ACEs and expressed a desire to break the cycle of adversity. Finally, parents saw their child's pediatrician as a potential change-agent who could provide support to meet their parenting goals. Parents want to discuss their ACEs and receive help and guidance from pediatricians. Furthermore, they perceive their child's pediatrician as having an important role to play in meeting their parenting goals. It is important to ensure that pediatricians have the training, skills and familiarity with available resources to meet parental expectations. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

  19. 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

  20. 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.

  1. Experiences of primary care professionals providing healthcare to recently arrived migrants: a qualitative study.

    Science.gov (United States)

    Lindenmeyer, Antje; Redwood, Sabi; Griffith, Laura; Teladia, Zaheera; Phillimore, Jenny

    2016-09-22

    The main objectives of the study were to explore the experiences of primary care professionals providing care to recent migrants in a superdiverse city and to elicit barriers and facilitators to meeting migrants' care needs. This paper focuses on a strong emergent theme: participants' descriptions and understandings of creating a fit between patients and practices. An exploratory, qualitative study based on the thematic analysis of semistructured interviews. A purposive sample of 10 practices. We interviewed 6 general practitioners, 5 nurses and 6 administrative staff; those based at the same practice opted to be interviewed together. 10 interviewees were from an ethnic minority background; some discussed their own experiences of migration. Creating a fit between patients and practice was complex and could be problematic. Some participants defined this in a positive way (reaching out, creating rapport) while others also focused on ways in which patients did not fit in, for example, different expectations or lack of medical records. A small but vocal minority put the responsibility to fit in on to migrant patients. Some participants believed that practice staff and patients sharing a language could contribute to achieving a fit but others outlined the disadvantages of over-reliance on language concordance. A clearly articulated, team-based strategy to create bridges between practice and patients was often seen as preferable. Although participants agreed that a fit between patients and practice was desirable, some aimed to adapt to the needs of recently arrived migrants, while others thought that it was the responsibility of migrants to adapt to practice needs; a few viewed migrant patients as a burden to the system. Practices wishing to improve fit might consider developing strategies such as introducing link workers and other 'bridging' people; however, they could also aim to foster a general stance of openness to diversity. Published by the BMJ Publishing Group

  2. 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

  3. 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...

  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/ 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...

  5. 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...

  6. 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 ...

  7. 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...

  8. 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...

  9. 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

  10. The opinion and experiences of Dutch orthopedic surgeons and radiologists about diagnostic musculoskeletal ultrasound imaging in primary care: a survey.

    Science.gov (United States)

    Scholten-Peeters, Gwendolijne G M; Franken, Nicole; Beumer, Annechien; Verhagen, Arianne P

    2014-04-01

    The use of diagnostic musculoskeletal ultrasound (DMUS) in primary health care has increased in the recent years. Nevertheless, there are hardly any data concerning the reliability, accuracy and treatment consequences of DMUS used by physical therapists or general practitioners. Moreover, there are no papers published about how orthopedic surgeons or radiologists deal with the results of DMUS performed in primary care. Therefore, our aim is to evaluate the opinion, possible advantages or disadvantages and experiences of Dutch orthopedic surgeons and radiologists about DMUS in primary care. A cross-sectional survey in which respondents completed a self-developed questionnaire to determine their opinion, experiences, advantages, disadvantages of performing DMUS in primary care. Questionnaires were sent to 838 Dutch orthopedic surgeons and radiologists of which 213 were returned (response rate 25.4%). Our respondents saw no additional value for health care for diagnostic DMUS in primary care. DMUSs were generally repeated in secondary care. They perceived more disadvantages than advantages of performing DMUS in primary care. Mentioned disadvantages were: 'false positive results' (71.4%), 'lack of experience' (70%), 'insufficient education' (69.5%), not able to relate the outcomes of DMUS with other forms of diagnostic imaging' (65.7%), and 'false negative results' (65.3%). Radiologists and orthopedic surgeons sampled in the Netherlands show low trust in DMUS knowledge of physical therapists and general practitioners. The results should be interpreted with caution because of the small response rate and the lack of representativeness to other countries. Published by Elsevier Ltd.

  11. Defibrillator implantations for primary prevention in the United States: Inappropriate care or inadequate documentation: Insights from the National Cardiovascular Data ICD Registry.

    Science.gov (United States)

    Kaiser, Daniel W; Tsai, Vivian; Heidenreich, Paul A; Goldstein, Mary K; Wang, Yongfei; Curtis, Jeptha; Turakhia, Mintu P

    2015-10-01

    Prior studies have reported that more than 20% of implantable cardioverter-defibrillator (ICD) implantations in the United States do not adhere to trial-based criteria. We sought to investigate the patient characteristics associated with not meeting the inclusion criteria of the clinical trials that have demonstrated the efficacy of primary prevention ICDs. Using data from the National Cardiovascular Data Registry's ICD Registry, we identified patients who received ICDs for primary prevention from January 2006 to December 2008. We determined whether patients met the inclusion criteria of at least 1 of the 4 ICD primary prevention trials: Multicenter Automatic Defibrillator Implantation Trial (MADIT), MADIT-II, Sudden Cardiac Death in Heart Failure Trial (SCD-HeFT), and the Multicenter Unsustained Tachycardia Trial (MUSTT). Among 150,264 patients, 86% met criteria for an ICD implantation based on trial data. The proportion of patients who did not meet trial-based criteria increased as age decreased. In multivariate analysis, the significant predictors for not meeting trial criteria included prior cardiac transplantation (odds ratio [OR] 2.1), pediatric electrophysiology operator (OR 2.0), and high-grade atrioventricular conduction disease (OR 1.4). Among National Cardiovascular Data Registry registrants receiving first-time ICDs for primary prevention, the majority met trial-based criteria. Multivariate analyses suggested that many patients who did not meet the trial-based criteria may have had clinical circumstances that warranted ICD implantation. These findings caution against the use of trial-based indications to determine site quality metrics that could penalize sites that care for younger patients. The planned incorporation of appropriate use criteria into the ICD registry may better characterize patient- and site-level quality and performance. Published by Elsevier Inc.

  12. 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.

  13. Measurements of high energy photons in Z-pinch experiments on primary test stand

    International Nuclear Information System (INIS)

    Si, Fenni; Zhang, Chuanfei; Xu, Rongkun; Yuan, Xi; Huang, Zhanchang; Xu, Zeping; Ye, Fan; Yang, Jianlun; Ning, Jiamin; Hu, Qingyuan; Zhu, Xuebin

    2015-01-01

    High energy photons are measured for the first time in wire-array Z-pinch experiments on the Primary Test Stand (PTS) which delivers a current up to 8 MA with a rise time of 70 ns. A special designed detecting system composed of three types of detectors is used to measure the average energy, intensity, and pulse waveform of high energy photons. Results from Pb-TLD (thermoluminescence dosimeter) detector indicate that the average energy is 480 keV (±15%). Pulse shape of high energy photons is measured by the photodiode detector consisted of scintillator coupled with a photodiode, and it is correlated with soft x-ray power by the same timing signal. Intensity is measured by both TLD and the photodiode detector, showing good accordance with each other, and it is 10 10 cm −2 (±20%) at 2 m in the horizontal direction. Measurement results show that high energy photons are mainly produced in pinch regions due to accelerated electrons. PTS itself also produces high energy photons due to power flow electrons, which is one order smaller in amplitude than those from pinch region

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

    Directory of Open Access Journals (Sweden)

    Juliana Folloni Fernandes

    2011-06-01

    Full Text Available Objective: To report the experience of a tertiary care hospital withallogeneic hematopoietic stem cell transplantation in children withprimary immunodeficiencies. Methods: Seven patients with primaryimmunodeficiencies (severe combined immunodeficiency: n = 2;combined immunodeficiency: n = 1; chronic granulomatous disease:n = 1; hyper-IgM syndrome: n = 2; and IPEX syndrome: n = 1who underwent eight hematopoietic stem cell transplants (HSCTin a single center, from 2007 to 2010, were studied. Results: Twopatients received transplants from HLA-identical siblings; the othersix transplants were done with unrelated donors (bone marrow: n= 1; cord blood: n = 5. All patients had pre-existing infectionsbefore hematopoietic stem cell transplants. One patient receivedonly anti-thymocyte globulin prior to transplant, three transplantswere done with reduced intensity conditioning regimens and fourtransplants were done after myeloablative therapy. Two patientswere not evaluable for engraftment due to early death. Three patientsengrafted, two had primary graft failure and one received a secondtransplant with posterior engraftment. Two patients died of regimenrelated toxicity (hepatic sinusoidal obstruction syndrome; one patient died of progressive respiratory failure due to Parainfluenza infection diagnosed prior to transplant. Four patients are alive and well from 60 days to 14 months after transplant. Conclusion: 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.

  15. Assessment of Field Experience Related to Pressurized Water Reactor Primary System Leaks

    International Nuclear Information System (INIS)

    Ware, A.G.; Hsu, C.; Atwood, C.L.; Sattison, M.B.; Hartley, R.S.; Shah, V.N.

    1999-01-01

    This paper presents our assessment of field experience related to pressurized water reactor (PWR) primary system leaks in terms of their number and rates, how aging affects frequency of leak events, the safety significance of such leaks, industry efforts to reduce leaks, and effectiveness of current leak detection systems. We have reviewed the licensee event reports to identify the events that took place during 1985 to the third quarter of 1996, and reviewed related technical literature and visited PWR plants to analyze these events. Our assessment shows that USNRC licensees have taken effective actions to reduce the number of leak events. One main reason for this decreasing trend was the elimination or reportable leakages from valve stem packing after 1991. Our review of leak events related to vibratory fatigue reveals a statistically significant decreasing trend with age (years of operation), but not in calendar time. Our assessment of worldwide data on leakage caused by thermal fatigue cracking is that the fatigue of aging piping is a safety significant issue. Our review of leak events has identified several susceptible sites in piping having high safety significance; but the inspection of some of these sites is not required by the ASME Code. These sites may be included in the risk-informed inspection programs

  16. Assessment of Field Experience Related to Pressurized Water Reactor Primary System Leaks

    International Nuclear Information System (INIS)

    Shah, Vikram Naginbhai; Ware, Arthur Gates; Atwood, Corwin Lee; Sattison, Martin Blaine; Hartley, Robert Scott; Hsu, C.

    1999-01-01

    This paper presents our assessment of field experience related to pressurized water reactor (PWR) primary system leaks in terms of their number of rates, how aging affects frequency of leak events, the safety significance of such leaks, industry efforts to reduce leaks, and effectiveness of current leak detection systems. We have reviewed the licensee event reports to identify the events that took place during 1985 to the third quarter of 1996, and reviewed related technical literature and visited PWR plants to analyze these events. Our assessment shows that USNRC licensees have taken effective actions to reduce the number of leak events. One main reason for this decreasing trend was the elimination or reportable leakages from valve stem packing after 1991. Our review of leak events related to vibratory fatigue reveals a statistically significant decreasing trend with age (years of operation), but not in calendar time. Our assessment of worldwide data on leakage caused by thermal fatigue cracking is that the fatigue of aging piping is a safety significant issue. Our review of leak events has identified several susceptible sites in piping having high safety significance; but the inspection of some of these sites is not required by the ASME Code. These sites may be included in the risk-informed inspection programs

  17. Patients' Perceptions and Experiences of Shared Decision-Making in Primary HIV Care Clinics.

    Science.gov (United States)

    Fuller, Shannon M; Koester, Kimberly A; Guinness, Ryan R; Steward, Wayne T

    Shared decision-making (SDM) is considered best practice in health care. Prior studies have explored attitudes and barriers/facilitators to SDM, with few specific to HIV care. We interviewed 53 patients in HIV primary care clinics in California to understand the factors and situations that may promote or hinder engagement in SDM. Studies in other populations have found that patients' knowledge about their diseases and their trust in providers facilitated SDM. We found these features to be more nuanced for HIV. Perceptions of personal agency, knowledge about one's disease, and trust in provider were factors that could work for or against SDM. Overall, we found that participants described few experiences of SDM, especially among those with no comorbidities. Opportunities for SDM in routine HIV care (e.g., determining antiretroviral therapy) may arise infrequently because of treatment advances. These findings yield considerations for adapting SDM to fit the context of HIV care. Copyright © 2016 The Authors. Published by Elsevier Inc. All rights reserved.

  18. Primary Care Providers' experiences with Pharmaceutical Care-based Medication Therapy Management Services

    Directory of Open Access Journals (Sweden)

    Heather L. Maracle

    2012-01-01

    Full Text Available This study explored primary care providers' (PCPs experiences with the practice of pharmaceutical care-based medication therapy management (MTM. Qualitative, semi-structured interviews were conducted with six PCPs who have experiences working with MTM pharmacists for at least three years. The first author conducted the interviews that were audio-taped, transcribed, and coded independently. The codes were then harmonized via discussion and consensus with the other authors. Data were analyzed for themes using the hermeneutic-phenomenological method as proposed by Max van Manen. Three men and three women were interviewed. On average, the interviewees have worked with MTM pharmacists for seven years. The six (6 themes uncovered from the interviews included: (1 "MTM is just part of our team approach to the practice of medicine": MTM as an integral part of PCPs' practices; (2 "Frankly it's education for the patient but it's also education for me": MTM services as a source of education; (3 "It's not exactly just the pharmacist that passes out the medicines at the pharmacy": The MTM practitioner is different from the dispensing pharmacist; (4 "So, less reactive, cleaning up the mess, and more proactive and catching things before they become so involved": MTM services as preventative health care efforts; (5"I think that time is the big thing": MTM pharmacists spend more time with patients; (6 "There's an access piece, there's an availability piece, there's a finance piece": MTM services are underutilized at the clinics. In conclusion, PCPs value having MTM pharmacists as part of their team in ambulatory clinics. MTM pharmacists are considered an important source of education to patients as well as to providers as they are seen as having a unique body of knowledge äóñmedication expertise. All PCPs highly treasure the time and education provided by the MTM pharmacists, their ability to manage and adjust patients' medications, and their capability to

  19. Primary Care Providers’ experiences with Pharmaceutical Care-based Medication Therapy Management Services

    Directory of Open Access Journals (Sweden)

    Heather L. Maracle, Pharm.D.

    2012-01-01

    Full Text Available This study explored primary care providers’ (PCPs experiences with the practice of pharmaceutical care-based medication therapy management (MTM. Qualitative, semi-structured interviews were conducted with six PCPs who have experiences working with MTM pharmacists for at least three years. The first author conducted the interviews that were audio-taped, transcribed, and coded independently. The codes were then harmonized via discussion and consensus with the other authors. Data were analyzed for themes using the hermeneutic-phenomenological method as proposed by Max van Manen. Three men and three women were interviewed. On average, the interviewees have worked with MTM pharmacists for seven years. The six (6 themes uncovered from the interviews included: (1 “MTM is just part of our team approach to the practice of medicine”: MTM as an integral part of PCPs’ practices; (2 “Frankly it’s education for the patient but it’s also education for me”: MTM services as a source of education; (3 “It’s not exactly just the pharmacist that passes out the medicines at the pharmacy”: The MTM practitioner is different from the dispensing pharmacist; (4 “So, less reactive, cleaning up the mess, and more proactive and catching things before they become so involved”: MTM services as preventative health care efforts; (5“I think that time is the big thing”: MTM pharmacists spend more time with patients; (6 “There’s an access piece, there’s an availability piece, there’s a finance piece”: MTM services are underutilized at the clinics. In conclusion, PCPs value having MTM pharmacists as part of their team in ambulatory clinics. MTM pharmacists are considered an important source of education to patients as well as to providers as they are seen as having a unique body of knowledge –medication expertise. All PCPs highly treasure the time and education provided by the MTM pharmacists, their ability to manage and adjust patients

  20. Document Models

    Directory of Open Access Journals (Sweden)

    A.A. Malykh

    2017-08-01

    Full Text Available In this paper, the concept of locally simple models is considered. Locally simple models are arbitrarily complex models built from relatively simple components. A lot of practically important domains of discourse can be described as locally simple models, for example, business models of enterprises and companies. Up to now, research in human reasoning automation has been mainly concentrated around the most intellectually intensive activities, such as automated theorem proving. On the other hand, the retailer business model is formed from ”jobs”, and each ”job” can be modelled and automated more or less easily. At the same time, the whole retailer model as an integrated system is extremely complex. In this paper, we offer a variant of the mathematical definition of a locally simple model. This definition is intended for modelling a wide range of domains. Therefore, we also must take into account the perceptual and psychological issues. Logic is elitist, and if we want to attract to our models as many people as possible, we need to hide this elitism behind some metaphor, to which ’ordinary’ people are accustomed. As such a metaphor, we use the concept of a document, so our locally simple models are called document models. Document models are built in the paradigm of semantic programming. This allows us to achieve another important goal - to make the documentary models executable. Executable models are models that can act as practical information systems in the described domain of discourse. Thus, if our model is executable, then programming becomes redundant. The direct use of a model, instead of its programming coding, brings important advantages, for example, a drastic cost reduction for development and maintenance. Moreover, since the model is well and sound, and not dissolved within programming modules, we can directly apply AI tools, in particular, machine learning. This significantly expands the possibilities for automation and

  1. 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.

  2. UNDERSTANDING IDEA OF CURRICULUM 2013 AND ITS CONSISTENCY ON DEVELOPING CURRICULUM DOCUMENT AT LEVEL OF EDUCATION UNIT (KTSP AT PRIMARY SCHOOL LEVEL

    Directory of Open Access Journals (Sweden)

    - Prihantini

    2018-01-01

    Full Text Available Abstract:. This study is based on various issues of Curriculum 2013, both in terms of teacher readiness to accept the Curriculum 2013, an understanding of the idea of Curriculum 2013, as well as in the implementation of teaching and learning. In the curriculum development theory, curriculum ideas are an important component that the curriculum development team needs to understand, so that the development of curriculum documents composed reflects continuity with curriculum ideas. The purpose of this study is to describe and explore the understanding of principals and teachers about the idea of Curriculum 2013 and its consistency on developing Education Unit Level Curriculum (KTSP at elementary school in Sukalarang sub-district, Sukabumi regency. The research method applied is qualitative research with descriptive exploratory approach. The conclusions of the study are: (1 the understanding of principals and teachers about the idea of the  Curriculum 2013 at the know stage, the understanding that curriculum ideas have consistency in the development of the Education Unit Level Curriculum (KTSP document is not yet owned; (2 the development of KTSP document shows no consistency between the idea of Curriculum 2013 with the documents of Book I KTSP, Book II KTSP, and Book III KTSP; (3 the problems faced by school principals and teachers in relation to the Curriculum 2013 is assessment of learning, both with regard to the techniques and types of assessment and techniques of administering the results of the assessment.Recommendations are proposed to policy makers that training strategies need to be changed from "theory oriented" to "practice oriented" and need to be varied in implementation at the Kecamatan or Cluster levels and enhanced effectiveness of curriculum counseling 2013. For principals and teachers expected to disseminate the 2013 Curriculum should be supported by presenting expert resources during the workshop, Principal Working Group (K3S and

  3. GPs' experiences of diagnosing and managing childhood eczema: a qualitative study in primary care.

    Science.gov (United States)

    Le Roux, Emma; Powell, Kingsley; Banks, Jonathan P; Ridd, Mathew J

    2018-02-01

    Eczema is common among children, and in the UK the majority are managed by GPs. The most common cause of poor disease control is incorrect use of topical treatments. There is a lack of research into the challenges faced by GPs in diagnosing and managing this condition. To explore the experiences of GPs in assessing and managing children with eczema. Qualitative study in primary care in England. Semi-structured interviews with 15 GPs were audiorecorded, transcribed verbatim, and analysed thematically using the framework method. GPs described a paucity of dermatology training. Although most GPs were confident diagnosing uncomplicated eczema, they reported using a trial-and-error approach to prescribing emollients, and were uncertain about quantities of topical treatments to issue. Mild and moderate potency topical corticosteroids (TCS) were commonly used, but most GPs lacked confidence in recommending potent TCS, and viewed parents or carers to be fearful of using all strengths of TCS. GPs perceived adherence to treatments to be low, but provision of information to support self-care was variable. Routine review of medication use or disease control was uncommon, which GPs attributed to service constraints. Participants' views on the causes and management of eczema were perceived to be at odds with parents and carers, who were said to be overly focused on an underlying cause, such as allergy. GP uncertainty in managing eczema, lack of routine information and review, and perceived dissonance with parents around causation and management may be contributing to low concordance with treatments. © British Journal of General Practice 2018.

  4. 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.

  5. Clinical experience with patients with spasmodic dysphonia and primary Meige syndrome.

    Science.gov (United States)

    Pedrero-Escalas, María Fernanda; García-López, Isabel; Santiago-Pérez, Susana; Vivancos, Francisco; Gavilán, Javier

    2018-04-28

    Meige syndrome (MS) is part of the group of segmental cranial dystonias, which affect more than two cranial muscle groups. Specifically, blepharospasm is associated with another cranial dystonia (oromandibular, cervical or laryngeal). The aim of this paper was to report our experience in patients with spasmodic dysphonia (SD) associated with primary MS. A retrospective study involving 8 patients between May 2010 and June 2015. Variables recorded were: age, sex, associated dystonia, electromyographic pattern in laryngeal muscles and treatment given. Outcomes after treatment were assessed using GRBAS(i) scale and VHI-30 questionnaire, always provided by the same examiner. Fifty-six patients with MS were treated in the Neurology Department. Eight patients of 56 were diagnosed with SD (prevalence of 14%). All of our patients had adductor SD. The median age was 71years. All the patients were treated with intralaryngeal botulinum toxin under electromyographic control. Clinically relevant improvements were found after treatment on both the GRBAS(i) scale and the VHI-30 questionnaire. In the study of SD, we should always rule out an association with MS. From the point of view of otorhinolaryngology, the joint use of the GRBAS(i) scale and the VHI-30 questionnaire are useful, reliable and efficient methods for assessing progress and response to treatment. Laryngeal infiltration under electromyographic control with botulinum toxin is the therapeutic alternative that provides better results. The management of SD associated with MS does not differ from isolated SD. Copyright © 2018 Sociedad Española de Otorrinolaringología y Cirugía de Cabeza y Cuello. Publicado por Elsevier España, S.L.U. All rights reserved.

  6. Experience with wound VAC and delayed primary closure of contaminated soft tissue injuries in Iraq.

    Science.gov (United States)

    Leininger, Brian E; Rasmussen, Todd E; Smith, David L; Jenkins, Donald H; Coppola, Christopher

    2006-11-01

    Wartime missile injuries are frequently high-energy wounds that devitalize and contaminate tissue, with high risk for infection and wound complications. Debridement, irrigation, and closure by secondary intention are fundamental principles for the management of these injuries. However, closure by secondary intention was impractical in Iraqi patients. Therefore, wounds were closed definitively before discharge in all Iraqi patients treated for such injures at our hospital. A novel wound management protocol was developed to facilitate this practice, and patient outcomes were tracked. This article describes that protocol and discusses the outcomes in a series of 88 wounds managed with it. High-energy injuries were treated with rapid aggressive debridement and pulsatile lavage, then covered with negative pressure (vacuum-assisted closure [VAC]) dressings. Patients underwent serial operative irrigation and debridement until wounds appeared clean to gross inspection, at which time they were closed primarily. Patient treatment and outcome data were recorded in a prospectively updated database. Treatment and outcomes data from September 2004 through May 2005 were analyzed retrospectively. There were 88 high-energy soft tissue wounds identified in 77 patients. Surprisingly, for this cohort of patients the wound infection rate was 0% and the overall wound complication rate was 0%. This series of 88 cases is the first report of the use of a negative pressure dressing (wound VAC) as part of the definitive management of high-energy soft tissue wounds in a deployed wartime environment. Our experience with these patients suggests that conventional wound management doctrine may be improved with the wound VAC, resulting in earlier more reliable primary closure of wartime injuries.

  7. Teachers' Experience and Reflections on Game-Based Learning in the Primary Classroom: Views from England and Italy

    Science.gov (United States)

    Allsop, Yasemin; Jessel, John

    2015-01-01

    This study aims to provide a comparative account of teachers' experience and views of their role when using digital games in primary classrooms in England and Italy. Interviews and a survey administered online and in hardcopy were used to find out teachers' perceptions of game-based learning and how these impact upon their role as a teacher. This…

  8. 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…

  9. 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…

  10. Educational Policy and Children's Experience: Running Records in the Lower Primary Singaporean English Language Classroom

    Science.gov (United States)

    Jones, Sally Ann

    2011-01-01

    In this article, I report on a small project involving the use of guided reading groups, levelled texts and running records in a multilingual primary school in Singapore. I focus on running records and ask whether their use is suitable pedagogically and practically for the Singaporean context. The analysis of 22 records of primary one and primary…

  11. The Changing Experiences of Primary Teachers: Responding to Scenarios Involving Diverse Sexualities

    Science.gov (United States)

    van Leent, Lisa; Ryan, Mary

    2016-01-01

    Sex education and diverse sexualities are controversial topics within the primary school arena. Concepts of childhood innocence have influenced sex education curriculum, policy development and teaching practices within schools. However, research shows that primary school-aged students are aware of and talk about sexualities. The aim of this…

  12. Experiences of activity measurements of primary circuit materials in a WWR-SM research reactor

    International Nuclear Information System (INIS)

    Elek, A.; Toth, M.; Bakos, L.; Vizdos, G.

    1980-01-01

    The activity of water and gas samples taken from the primary circuit have been measured nondestructively for more than two years to monitor the technological parameters of the reactor. In the primary water samples 17 fission products and seven activated traces, as well as six radioactive conponents in the gas samples were determined routinely by Ge/Li gamma-spectrometry. (author)

  13. Meta-Analysis for Primary and Secondary Data Analysis: The Super-Experiment Metaphor.

    Science.gov (United States)

    Jackson, Sally

    1991-01-01

    Considers the relation between meta-analysis statistics and analysis of variance statistics. Discusses advantages and disadvantages as a primary data analysis tool. Argues that the two approaches are partial paraphrases of one another. Advocates an integrative approach that introduces the best of meta-analytic thinking into primary analysis…

  14. 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…

  15. Outdoor Primary Education in Bangladesh. Experiments and Innovations in Education No. 40.

    Science.gov (United States)

    Choudhury, M. Khashruzzaman; Obaidullah, A. K. M.

    A brief description of the development, implementation, and evaluation of the Outdoor Primary Education project in Bangladesh is presented in this booklet. A description of the development of the current primary education system in Bangladesh along with a description of the reasons that led to the development of the project are briefly provided in…

  16. Orbitmpi Documentation

    International Nuclear Information System (INIS)

    Lowe, Lisa L.

    2000-01-01

    Orbitmpi is a parallelized version of Roscoe White's Orbit code. The code has been parallelized using MPI, which makes it portable to many types of machines. The guidelines used for the parallelization were to increase code performance with minimal changes to the code's original structure. This document gives a general description of how the parallel sections of the code run. It discusses the changes made to the original code and comments on the general procedure for future additions to Orbitmpi, as well as describing the effects of a parallelized random number generator on the code's output. Finally, the scaling results from Hecate and from Puffin are presented. Hecate is a 64-processor Origin 2000 machine, with MIPS R12000 processors and 16GB of memory, and Puffin is a PC cluster with 9 dual-processor 450 MHz Pentium III (18 processors max.), with 100Mbits ethernet communication

  17. 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.…

  18. 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

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

    Czech Academy of Sciences Publication Activity Database

    Wilcox, K. R.; Shi, Z.; Gherardi, L. A.; Lemoine, N. P.; Koerner, S. E.; Hoover, D. L.; Bork, E.; Byrne, K. M.; Cahill, J.; Collins, S. L.; Evans, S.M.; Gilgen, Anna K.; Holub, Petr; Jiang, L.; Knapp, A. K.; LeCain, D.; Liang, J.; Garcia-Palacios, P.; Penuelas, J.; Pockman, W. T.; Smith, M. D.; Sun, S.; White, S. R.; Yahdjian, L.; Zhu, K.; Luo, Y.

    2017-01-01

    Roč. 23, č. 10 (2017), s. 4376-4385 ISSN 1354-1013 Institutional support: RVO:86652079 Keywords : net primary productivity * terrestrial ecosystems * temperate grassland * biomass allocation * plant-communities * tallgrass prairie * climate extremes * use efficiency * united-states * global-change * aboveground net primary productivity * belowground net primary productivity * biomass allocation * climate change * grasslands * meta-analysis * root biomass Subject RIV: EH - Ecology, Behaviour OBOR OECD: Environmental sciences (social aspects to be 5.7) Impact factor: 8.502, year: 2016

  20. Experiences with primary healthcare in Fuzhou, urban China, in the context of health sector reform: a mixed methods study.

    Science.gov (United States)

    McCollum, Rosalind; Chen, Lieping; ChenXiang, Tang; Liu, Xiaoyun; Starfield, Barbara; Jinhuan, Zheng; Tolhurst, Rachel

    2014-01-01

    China has recently placed increased emphasis on the provision of primary healthcare services through health sector reform, in response to inequitably distributed health services. With increasing funding for community level facilities, now is an opportune time to assess the quality of primary care delivery and identify areas in need of further improvement. A mixed methodology approach was adopted for this study. Quantitative data were collected using the Primary Care Assessment Tool-Chinese version (C-PCAT), a questionnaire previously adapted for use in China to assess the quality of care at each health facility, based on clients' experiences. In addition, qualitative data were gathered through eight semi-structured interviews exploring perceptions of primary care with health directors and a policy maker to place this issue in the context of health sector reform. The study found that patients attending community health and sub-community health centres are more likely to report better experiences with primary care attributes than patients attending hospital facilities. Generally low scores for community orientation, family centredness and coordination in all types of health facility indicate an urgent need for improvement in these areas. Healthcare directors and policy makers perceived the need for greater coordination between levels of health providers, better financial reimbursement, more formal government contracts and recognition/higher status for staff at the community level and more appropriate undergraduate and postgraduate training. Copyright © 2013 John Wiley & Sons, Ltd.

  1. Some experiments on the primary electron acceptor in reaction centres from Rhodopseudomanas sphaeroides

    Energy Technology Data Exchange (ETDEWEB)

    Wraight, C A; Cogdell, R J; Clayton, R K

    1975-01-01

    The bacterial reaction center absorbance change at 450 nm (A-450), assigned to an anionic semiquinone, has been suggested as a candidate for the reduced form of the primary electron acceptor in bacterial photosynthesis. In reaction centers of Rhodopseudomonas sphaeroides we have found kinetic discrepancies between the decay of A-450 and the recovery of photochemical competence. In addition, no proton uptake is measurable on the first turnover, although subsequent ones elicit one proton bound per electron. These results are taken to indicate that the acceptor reaction after a long dark period may be different for the first turnover than for subsequent ones. It is suggested that A-450 is still a likely candidate for the acceptor function but that in reaction centers, additional quinone may act as an adventitious primary acceptor when the ''true'' primary acceptor is reduced. Alternatively, the primary acceptor may act in a ''ping-pong'' fashion with respect to subsequent photoelectrons.

  2. 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.

  3. 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...

  4. Relationship between premature loss of primary teeth with oral hygiene, consumption of soft drinks, dental care, and previous caries experience.

    Science.gov (United States)

    López-Gómez, Sandra Aremy; Villalobos-Rodelo, Juan José; Ávila-Burgos, Leticia; Casanova-Rosado, Juan Fernando; Vallejos-Sánchez, Ana Alicia; Lucas-Rincón, Salvador Eduardo; Patiño-Marín, Nuria; Medina-Solís, Carlo Eduardo

    2016-02-26

    We determine the relationship between premature loss of primary teeth and oral hygiene, consumption of soft drinks, dental care and previous caries experience. This study focused on 833 Mexican schoolchildren aged 6-7. We performed an oral examination to determine caries experience and the simplified oral hygiene index. The dependent variable was the prevalence of at least one missing tooth (or indicated for extraction) of the primary dentition; this variable was coded as 0 = no loss of teeth and 1 = at least one lost primary tooth. The prevalence of at least one missing tooth was 24.7% (n = 206) (95% CI = 21.8-27.7). The variables that were associated with the prevalence of tooth loss (p oral hygiene (OR = 3.24), a lower frequency of brushing (OR = 1.60), an increased consumption of soda (OR = 1.89) and use of dental care (curative: OR = 2.83, preventive: OR = 1.93). This study suggests that the premature loss of teeth in the primary dentition is associated with oral hygiene, consumption of soft drinks, dental care and previous caries experience in Mexican schoolchildren. These data provide relevant information for the design of preventive dentistry programs.

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

    OpenAIRE

    Turgay ÖNTAŞ

    2016-01-01

    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 ...

  6. Project Experiences of the Implementation of the Primary Bleed and Feed System

    International Nuclear Information System (INIS)

    Sanz, S.; Lang, J.; Schmid, J.

    2015-01-01

    Modernization activities play a very important role in the enhancement of the safety and reliability of nuclear power plants. The main focus is on increasing the plant availability, the operational flexibility or the integration of new, additional equipment to satisfy safety requirements, as in this case with the implementation of the design modification primary circuit “Primary Bleed & Feed” (PB&F) of the primary circuit, in the consideration of a beyond design basis accident. Primary B&F prevents the high pressure core melt path and allows an additional alternative heat removal by depressurising the primary system and coolant injection with passive and/or active low pressure systems, when the normal core cooling is not available because of loss of water inventory in the steam generators. The goal of this paper is to show some general good practices gained during the implementation of the Primary Bleed and Feed, System from the project conception to the system implementation. Basically, practice shows that some of the crucial factors which contributed to a successful project execution were based on (i) good interface management between the new system and the existing plant components, (ii) a close coordination of the single engineering disciplines and simultaneous activities, (iii) safety culture and quality assurance were set as priority during the entire project development. (author)

  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. Omega documentation

    International Nuclear Information System (INIS)

    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

  9. Semiscale power loss experiment S-PL-3 with primary feed and bleed plant recovery

    International Nuclear Information System (INIS)

    Wolf, J.R.; Streit, J.E.

    1984-01-01

    This paper describes an attempt to verify the accuracy of the RELAP5 model of the S-PL-3 experiment (part of the Semiscale loss-of-offsite-power test series) by comparing the RELAP5 model with actual data obtained during the experiment. Included are a description of the experiment, an analysis of preliminary results, and the comparison of posttest RELAP5 calculations with experiment data. RELAP5 modeling of the S-PL-3 transient produced qualitative agreement with experiment data

  10. Report on the Regulatory Experience of Risk-Informed In-service Inspection of Nuclear Power Plant Components and Common Views (consensus document)

    International Nuclear Information System (INIS)

    2004-08-01

    The present report represents the work product of the activities conducted by the Task Force. The TF performed a review and inventory of the existing approaches to risk-informed inservice inspection and testing, and completed its work in 1999 with a Current Practices Document 2, titled Report on risk-informed in-service inspection and in-service testing (EUR 19153 EN). In November 2001, the NRWG held a Special session on risk-informed applications, with emphasis on risk-informed inservice inspection, where results and experiences from pilot studies on risk-informed inservice inspection (RI-ISI), performed in several European countries, were presented and discussed. As a follow-up in May 2002, the TF was reconvened with the objectives to analyse from the regulatory point of view key aspects associated with the application of risk-informed inservice inspection, and to go beyond a state of the art report, presenting a series of recommendations of good practices or common positions reached by the regulators represented in the Task Force. (author)

  11. 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.

  12. Primary radiation therapy for early breast cancer: the experience at the joint center for radiation therapy

    International Nuclear Information System (INIS)

    Harris, J.R.; Botnick, L.; Bloomer, W.D.; Chaffey, J.T.; Hellman, S.

    1981-01-01

    The results of primary radiation therapy in 176 consecutive patients with clinical State I and II carcinoma of the breast were reviewed. Median follow-up time was 47 months. The overall breast relapse rate was 7%. Patients undergoing interstitial implantation had a significantly lower breast relapse rate (1%) than patients not undergoing implantation (11%). Breast relapse was more common in patients undergoing incisional or needle biopsy (17%), compared to patients treated after excisional biopsy (5%). In patients undergoing excisional biopsy, but not interstitial implantation, breast relapse was related to external beam dose. Twelve percent of the patients who received less than 1600 ret dose relapsed in the breast, compared to none of the 19 patients who received more than 1700 ret dose. These results imply that supplemental irradiation to the primary tumor area is required following excisional biopsy of a primary breast cancer when 4500-5000 rad is delivered to the entire breast

  13. Primary antibody deficiencies at Queen Rania Children Hospital in Jordan: single center experience.

    Science.gov (United States)

    Habahbeh, Zeyad M; Abu-Shukair, Mohammad E; Almutereen, Mohammad A; Alzyoud, Raed M; Wahadneh, Adel M

    2014-03-01

    Primary antibody deficiency, the most common primary immunodeficiency disorder, represents a heterogeneous spectrum of conditions caused by a defect in any critical stage of B cell development and is characterized by impaired production of normal amounts of antigen-specific antibodies. This retrospective study aimed at description and analysis of demographic, clinical, immunological features and complications of subjects diagnosed with primary antibody deficiency at a referral center in Jordan. The medical records of pediatric patients who were diagnosed as primary antibody deficiency (PAD) during the period from January 2006 to June 2013 were reviewed. Patients were diagnosed as PADs based on the Pan-American Group for Immunodeficiency (PAGID) and the European Society for Immunodeficiency (ESID) diagnostic criteria. A total number of 53 patients with PAD were identified; 37(70%) males and 16(30%) females, 16(30%) patients with congenital agammaglobulinemia, 16(30%) patients with common variable immunodeficiency, 4(7.5%) patients with IgG subclass deficiency, 10(19%) cases with transient hypogammaglobulinemia of infancy and 7(13.5%) patients as undefined PAD. The most common infection among patients was pneumonia (62%); followed by suppurative otitis media in 49% of patients. Cytopenia was the most noted autoimmune association and was found at prevalence of 22 %, other autoimmune associations (17%) including inflammatory arthritis, discoid lupus, inflammatory bowel disease, vasculitis and celiac disease. The prevalence of long-term complications was 58%, the most frequent ones were; stunted growth in 13%, bronchiectasis and lymphoproliferation in 11% for each. Our results indicated that congenital agammaglobulinemia and common variable immunodeficiency are the most frequent primary antibody deficiency in our patients. The awareness of families, general population as well as primary health physicians is crucial in the establishment of early diagnosis and prompt

  14. Older depressed Latinos' experiences with primary care visits for personal, emotional and/or mental health problems: a qualitative analysis.

    Science.gov (United States)

    Izquierdo, Adriana; Sarkisian, Catherine; Ryan, Gery; Wells, Kenneth B; Miranda, Jeanne

    2014-01-01

    To describe salient experiences with a primary care visit (eg, the context leading up to the visit, the experience and/or outcomes of that visit) for emotional, personal and/or mental health problems older Latinos with a history of depression and recent depressive symptoms and/or antidepressant medication use reported 10 years after enrollment into a randomized controlled trial of quality-improvement for depression in primary care. Secondary analysis of existing qualitative data from the second stage of the continuation study of Partners in Care (PIC). Latino ethnicity, aged > or =50 years, recent depressive symptoms and/or antidepressant medication use, and a recent primary care visit for mental health problems. Of 280 second-stage participants, 47 were eligible. Both stages of the continuation study included participants from the PIC parent study control and 2 intervention groups, and all had a history of depression. Data analyzed by a multidisciplinary team using grounded theory methodology. Five themes were identified: beliefs about the nature of depression; prior experiences with mental health disorders/treatments; sociocultural context (eg, social relationships, caregiving, the media); clinic-related features (eg, accessibility of providers, staff continuity, amount of visit time); and provider attributes (eg, interpersonal skills, holistic care approach). Findings emphasize the importance of key features for shaping the context leading up to primary care visits for help-seeking for mental health problems, and the experience and/or outcomes of those visits, among older depressed Latinos at long-term follow-up, and may help tailor chronic depression care for the clinical management of this vulnerable population.

  15. 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.

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

    Science.gov (United States)

    Stepura, Yuliia

    2017-01-01

    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 interpretation of foreign scholars' views (J. Bugental, V. Frankl, A. Maslow, R. May, J.…

  17. 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…

  18. A Foucauldian Perspective on Student Experiences of Family Discourses in Post-Primary Schools

    Science.gov (United States)

    Desmond, Ann-Marie

    2016-01-01

    This work involves researching normative family discourses which are mediated through post-primary settings. The traditional family, consisting of father, mother and children all living together in one house (nuclear) is no longer reflective of the home situation of many Irish students [Lunn, P., and T. Fahey. 2012. "Households and Family…

  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. Comparison of patients’ experiences in public and private primary care clinics in Malta.

    NARCIS (Netherlands)

    Pullicino, G.; Sciortino, P.; Calleja, N.; Schäfer, W.; Boerma, W.; Groenewegen, P.

    2015-01-01

    Demographic changes, technological developments and rising expectations require the analysis of public–private primary care (PC) service provision to inform policy makers. We conducted a descriptive, cross-sectional study using the dataset of the Maltese arm of the QUALICOPC Project to compare the

  1. Primary antegrade ureteric stenting: Prospective experience and cost-effectiveness analysis in 50 ureters

    Energy Technology Data Exchange (ETDEWEB)

    Watson, Gillian M.T.; Patel, Uday

    2001-07-01

    AIM: To evaluate the success rate and cost efficiency of primary antegrade ureteric stenting (antegrade ureteric stent insertion as a single procedure without preliminary drainage). MATERIALS AND METHODS: A policy of primary stenting was tested in 38 patients (50 ureters) with obstructive hydronephrosis, of acute or chronic onset and of benign or malignant origin. Patients with suspected pyonephrosis were excluded. Patients successfully primarily stented (group 1) were compared to a group stented as a traditional two-stage procedure (group 2). End point assessments were screening time, equipment used, procedure-related costs, bed occupancy and technical and clinical success rate. Using these cost and outcome measures, a cost-efficiency analysis was performed comparing the two strategies. RESULTS: 40/50 (80%) ureters were considered primary stent successes. The average procedure-related bed occupancy was 2 days (range 1-2 days). Simple equipment alone was successful in 16 cases. Van Andel dilatation catheters and peel-away sheaths were frequently used (23 ureters). Expensive equipment was rarely necessary (four cases) and average extra equipment cost was small (46 pounds/case). The mean screening time was similar for the two groups (13.5 min vs 15.3 min;P {>=} 0.05). There was a minimum saving of 800 pounds per successful primary stent. The cost-effectiveness of a primary antegrade stenting strategy was 1229 pounds vs 2093 pounds for secondary stenting. CONCLUSION: In carefully selected patients, the majority of obstructed ureters can be primarily stented using simple equipment. The reduced hospital stay and overall success rate significantly improves the cost competitiveness of antegrade ureteric stenting. Watson, G.M.T. and Patel, U. (2001)

  2. Primary hyperparathyroidism surgical management since the introduction of minimally invasive parathyroidectomy: Mayo Clinic experience.

    Science.gov (United States)

    Grant, Clive S; Thompson, Geoffrey; Farley, David; van Heerden, Jon

    2005-05-01

    Minimally invasive parathyroidectomy (MIP) for primary hyperparathyroidism (HPT) has equal cure and recurrence rates as standard cervical exploration. Changes in the management of primary HPT have occurred since introducing MIP including localization, anesthesia, intraoperative parathyroid hormone monitoring, and indications for parathyroidectomy. Cohort analysis of 1361 consecutive patients with primary HPT operated on at the Mayo Clinic, Rochester, Minn, from June 1998 through March 2004. Mean follow-up, 25 months. Tertiary referral center. One thousand three hundred sixty-one patients operated on for primary HPT, excluding 160 patients who were reoperated on. Standard cervical exploration MIP. Cure, recurrence, localization, anesthesia, hospitalization, intraoperative parathyroid hormone level monitoring, contraindications to MIP, surgical indications, assessment of osteoporosis and osteopenia, postoperative patient assessment of general patient health, and operative satisfaction. Cure of primary HPT for both conventional exploration and MIP was 97%; only 1 patient who underwent MIP had a potential recurrence. Imaging sensitivity and positive predictive values were as follows: sestamibi scintigraphy, 86% and 93%; ultrasonography, 61% and 87%, respectively. Usage of general vs local anesthesia with intravenous sedation was 46% and 49%, respectively, in patients w ho underwent MIP; 46% were dismissed as outpatients, 49% had single-night stays. The accuracy of intraoperative parathyroid hormone level monitoring was as follows: 98% (8% had true-negative results); the frequency of multiple gland disease was 13%. Accounting for causes precluding MIP, an estimated 60% to 70% of all patients would be eligible for MIP. By preoperative assessment, 79% had osteoporosis-osteopenia; 58% with postoperative bone mineral density measurements were improved. More than 85% were satisfied with the results of their operation. With high-quality localization and intraoperative

  3. The use of patient experience survey data by out-of-hours primary care services: a qualitative interview study.

    Science.gov (United States)

    Barry, Heather E; Campbell, John L; Asprey, Anthea; Richards, Suzanne H

    2016-11-01

    English National Quality Requirements mandate out-of-hours primary care services to routinely audit patient experience, but do not state how it should be done. We explored how providers collect patient feedback data and use it to inform service provision. We also explored staff views on the utility of out-of-hours questions from the English General Practice Patient Survey (GPPS). A qualitative study was conducted with 31 staff (comprising service managers, general practitioners and administrators) from 11 out-of-hours primary care providers in England, UK. Staff responsible for patient experience audits within their service were sampled and data collected via face-to-face semistructured interviews. Although most providers regularly audited their patients' experiences by using patient surveys, many participants expressed a strong preference for additional qualitative feedback. Staff provided examples of small changes to service delivery resulting from patient feedback, but service-wide changes were not instigated. Perceptions that patients lacked sufficient understanding of the urgent care system in which out-of-hours primary care services operate were common and a barrier to using feedback to enable change. Participants recognised the value of using patient experience feedback to benchmark services, but perceived weaknesses in the out-of-hours items from the GPPS led them to question the validity of using these data for benchmarking in its current form. The lack of clarity around how out-of-hours providers should audit patient experience hinders the utility of the National Quality Requirements. Although surveys were common, patient feedback data had only a limited role in service change. Data derived from the GPPS may be used to benchmark service providers, but refinement of the out-of-hours items is needed. 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/.

  4. [Primary lymphoma of the central nervous system: 20 years' experience in a referral hospital].

    Science.gov (United States)

    Calderón-Garcidueñas, A L; Pacheco-Calleros, J; Castelán-Maldonado, E; Nocedal-Rustrián, F C

    Primary central nervous system lymphomas (PCNSL) are rare neoplasms. AIM. To study the clinical aspects and the immuno-phenotype of all cases of PCNSL in a 20 years lapse in a referral hospital in Northeastern Mexico. From January 1986 to December 2005 all PCNSL histologically confirmed were studied. The primary lymphomas were 1% of malignant central nervous system neoplasms. 21 cases were studied (ages from 9-70 years) with male predominance (2:1). 24% patients had immuno-suppression. The more frequent clinical data were: papilledema (71%), headache (62%), paresis (48%) and seizures (33%). 33% of patients died during the first six months after diagnosis. The T lymphomas were 19% of cases and corresponded to small cell type. PCNSL are still a diagnostic challenge. Multicenter studies are required in order to determine the best treatment protocol.

  5. 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.

  6. [Challenges in primary health care: the experience in Vila Mariana District, São Paulo, Brazil].

    Science.gov (United States)

    Villela, Wilza Vieira; Araújo, Eliane Cardoso de; Ribeiro, Sandra Aparecida; Cuginotti, Aloísio Punhagui; Hayana, Eliana Tiemi; Brito, Francisco Carlos de; Ramos, Luiz Roberto

    2009-06-01

    This article presents the results of a case study aimed at identifying challenges for the delivery of primary health care in a health district in the city of São Paulo, Brazil, considering comprehensiveness as a central device for organizing work at this level of care. Five units in the district's primary care network were studied. We collected the data by observing work routines and flows, conducting interviews with managers and health professionals from different backgrounds, and through focus groups with family health teams. The analysis shows a mismatch between users' characteristics and their presumed needs and the heterogeneity of the health professionals' perceptions concerning their work. Lack of staff and time and difficulties with referrals were the main problems identified by interviewees.

  7. 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.

  8. 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.

  9. Training primary care physicians in community eye health. Experiences from India.

    Directory of Open Access Journals (Sweden)

    Gupta Sanjeev

    2002-01-01

    Full Text Available This paper describes the impact of training on primary-care physicians in community eye health through a series of workshops. 865 trainees completed three evaluation formats anonymously. The questions tested knowledge on magnitude of blindness, the most common causes of blindness, and district level functioning of the National Programme for Control of Blindness (NPCB. Knowledge of the trainers significantly improved immediately after the course (chi 2 300.16; p < 0.00001. This was independent of the timing of workshops and number of trainees per batch. Presentation, content and relevance to job responsibilities were most appreciated. There is immense value addition from training primary-care physicians in community eye health. Despite a long series of training sessions, trainer fatigue was minimal; therefore, such capsules can be replicated with great success.

  10. Experience in vibro-acoustic control of primary coolant circuit aggregates

    International Nuclear Information System (INIS)

    Sedov, V.K.; Adamenkov, K.A.

    1977-01-01

    Fundamental principles and possibilities of vibro-acoustic control of the primary coolant circuit in nuclear power plants for detecting failures (slack parts, penetration of foreign bodies, crack formation, etc.) are presented. As a result of pressure and flow rate fluctuations such failures give rise to characteristic changes in apmplitude and frequency of vibration and technological noise from the different aggregates with respect to a 'calibration' spectrum taken in the intact state. Nature and location of the failures may be determined by statistical analysis of the signals recorded from pressure and acceleration gauges. Certain parts of the primary circuit are controlled, especially the main circulation pumps. Additionally, neutron noise has been measured in order to control the core insertions. The method is illustrated by means of measurements performed in the units 1 to 4 of the Novovoronezh nuclear power plant during start-up operation and continuous operation. (author)

  11. Experience in vibro-acoustic control of primary coolant circuit aggregates

    Energy Technology Data Exchange (ETDEWEB)

    Sedov, V K; Adamenkov, K A [Nuclear power plant Novo-Voronesh (USSR)

    1977-10-01

    Fundamental principles and possibilities of vibro-acoustic control of the primary coolant circuit in nuclear power plants for detecting failures (slack parts, penetration of foreign bodies, crack formation, etc.) are presented. As a result of pressure and flow rate fluctuations such failures give rise to characteristic changes in apmplitude and frequency of vibration and technological noise from the different aggregates with respect to a 'calibration' spectrum taken in the intact state. Nature and location of the failures may be determined by statistical analysis of the signals recorded from pressure and acceleration gauges. Certain parts of the primary circuit are controlled, especially the main circulation pumps. Additionally, neutron noise has been measured in order to control the core insertions. The method is illustrated by means of measurements performed in the units 1 to 4 of the Novovoronezh nuclear power plant during start-up operation and continuous operation.

  12. 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.

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

    OpenAIRE

    Rita de Cássia SILVA; Raquel Conceição FERREIRA; Denise Vieira TRAVASSOS; Andréa Maria Duarte VARGAS

    2017-01-01

    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...

  14. [Primary intestinal lymphangiectasia: twenty years of experience at a Mexican tertiary care hospital].

    Science.gov (United States)

    Valdovinos-Oregón, D; Ramírez-Mayans, J; Cervantes-Bustamante, R; Toro-Monjaraz, E; Cázares-Méndez, M; Cadena-León, J; Zárate-Mondragón, F; Montijo-Barrios, E

    2014-01-01

    Primary intestinal lymphangiectasia is a rare congenital disease described by Waldmann in 1961 that is a consequence of obstruction of the lymphatic drainage of the small bowel with secondary lymph vessel dilation. This distorts the architecture of the villi and causes a leakage of lymph into the intestinal lumen, resulting in protein-losing enteropathy and malabsorption. To describe the clinical, biochemical, radiologic, endoscopic, and histologic characteristics in children with primary intestinal lymphangiectasia. A retrospective observational, descriptive, cross-sectional study was conducted that reviewed the case records of children diagnosed with primary intestinal lymphangiectasia that were seen at the Department of Gastroenterology and Nutrition of the Instituto Nacional de Pediatría within the time frame of January 1, 1992 to September 30, 2012. Four patients were found that presented with primary intestinal lymphangiectasia. Three of them had been diagnosed before 3 years of age. All the patients presented with chronic diarrhea, edema, lymphopenia, hypocalcemia, and hypogammaglobulinemia, and 3 patients presented with hypocholesterolemia. Bowel transit time, endoscopy, and intestinal biopsies were characteristic of this pathology. Intestinal lymphangiectasia should be suspected when there is a clinical picture of chronic diarrhea and protein-losing enteropathy accompanied with edema at any level, as well as hypoalbuminemia, hypocalcemia, lymphopenia, hypogammaglobulinemia, and hypocholesterolemia, which are the main biochemical findings of this pathology. All children presenting with intestinal lymphangiectasia should undergo an upper gastrointestinal series with bowel transit time and endoscopy with biopsies taken at the level of the duodenum. Treatment includes diet and the periodic administration of albumin and gamma globulin. Copyright © 2013 Asociación Mexicana de Gastroenterología. Published by Masson Doyma México S.A. All rights reserved.

  15. 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...

  16. Primary Germ Cell Tumors of the Mediastinum: 10 Years of Experience in a Tertiary Teaching Hospital

    Directory of Open Access Journals (Sweden)

    Chih-Jen Yang

    2005-09-01

    Full Text Available Germ cell tumors occur mostly in the gonad. Extragonadal germ cell tumors are rare, and most occur in the retroperitoneum and mediastinum. Primary mediastinal germ cell tumors are often found in the anterior portion of the mediastinum and include teratomas and non-teratomatous tumors. Non-teratomatous tumors include seminomas and malignant non-seminomatous germ cell tumors (MNSGCTs. MNSGCTs include yolk sac tumors, choriocarcinomas, embryonal carcinomas, and mixed type germ cell tumors. Teratomas are the most common germ cell tumors of the mediastinum, and seminomas are the most common non-teratomatous germ cell tumors of the mediastinum. Cases of primary mediastinal MNSGCT reported in the literature are rare. In this report, we review all primary mediastinal germ cell tumors from a 10-year period at the Chung-Ho Memorial Hospital of Kaohsiung Medical University. A total of 14 cases were reviewed, including 11 patients with mature teratomas, two with yolk sac tumors, and one with seminoma. We discuss the differences in clinical presentation, histopathologic characteristics, treatment, and prognosis.

  17. Neoadjuvant chemotherapy for primary adenocarcinomas of the urinary bladder: a single-site experience.

    Science.gov (United States)

    Yu, Bin; Zhou, Jin; Cai, Hongzhou; Xu, Ting; Xu, Zicheng; Zou, Qing; Gu, Min

    2015-01-28

    Adenocarcinoma of the urinary bladder is a rare malignancy. Radical surgery is suggested as the best available treatment for early-stage disease, but there is currently no consensus on standard chemotherapy regimen for advanced stage. We assessed the feasibility and effect of neoadjuvant chemotherapy with gemcitabine and cisplatin (GC) plus S-1 for patients with locally advanced primary adenocarcinomas of the urinary bladder. Six patients with locally advanced urachal or non-urachal (n = 3, each) primary adenocarcinoma of the bladder were treated from October 2010 to October 2013 at a single center. All the patients were treated with 3 cycles (21d, each) of GC plus S-1 (gemcitabine, 1000 mg/m2, days 1 and 8; cisplatin, 70 mg/m2, day 2; and S-1, 50 mg bid, day 1-14). After neoadjuvant chemotherapy, patients with urachal cancer were treated with en bloc radical cystectomy and umbilectomy; the remaining 3 patients were treated with cystectomy. All patients successfully completed the neoadjuvant chemotherapy without serious side effects. Two patients were assessed as complete response, 2 as partial response, 1 as stable disease and 1 as progressive disease. Despite the limitations of a small study population, the GC plus S-1 regimen for locally advanced primary adenocarcinoma of the urinary bladder was effective, and facilitated the success of surgery to a certain extent. Short follow-up time was also a limitation of our study. More studies are needed to evaluate the results.

  18. Embedding online patient record access in UK primary care: a survey of stakeholder experiences.

    Science.gov (United States)

    Pagliari, Claudia; Shand, Tim; Fisher, Brian

    2012-05-01

    To explore the integration of online patient Record Access within UK Primary Care, its perceived impacts on workload and service quality, and barriers to implementation. Mixed format survey of clinicians, administrators and patients. Telephone interviews with non-users. Primary care centres within NHS England that had offered online record access for the preceding year. Of the 57 practices initially agreeing to pilot the system, 32 had adopted it and 16 of these returned questionnaires. The 42 individual respondents included 14 practice managers, 15 clinicians and 13 patients. Follow-up interviews were conducted with one participant from 15 of the 25 non-adopter practices. Most professionals believed that the system is easy to integrate within primary care; while most patients found it easy to integrate within their daily lives. Professionals perceived no increase in the volume of patient queries or clinical consultations as a result of Record Access; indeed some believed that these had decreased. Most clinicians and patients believed that the service had improved mutual trust, communication, patients' health knowledge and health behaviour. Inhibiting factors included concerns about security, liability and resource requirements. Non-adoption was most frequently attributed to competing priorities, rather than negative beliefs about the service. Record access has an important role to play in supporting patient-focused healthcare policies in the UK and may be easily accommodated within existing services. Additional materials to facilitate patient recruitment, inform system set-up processes, and assure clinicians of their legal position are likely to encourage more widespread adoption.

  19. Experiences of nurse practitioners and medical practitioners working in collaborative practice models in primary healthcare in Australia - a multiple case study using mixed methods.

    Science.gov (United States)

    Schadewaldt, Verena; McInnes, Elizabeth; Hiller, Janet E; Gardner, Anne

    2016-07-29

    In 2010 policy changes were introduced to the Australian healthcare system that granted nurse practitioners access to the public health insurance scheme (Medicare) subject to a collaborative arrangement with a medical practitioner. These changes facilitated nurse practitioner practice in primary healthcare settings. This study investigated the experiences and perceptions of nurse practitioners and medical practitioners who worked together under the new policies and aimed to identify enablers of collaborative practice models. A multiple case study of five primary healthcare sites was undertaken, applying mixed methods research. Six nurse practitioners, 13 medical practitioners and three practice managers participated in the study. Data were collected through direct observations, documents and semi-structured interviews as well as questionnaires including validated scales to measure the level of collaboration, satisfaction with collaboration and beliefs in the benefits of collaboration. Thematic analysis was undertaken for qualitative data from interviews, observations and documents, followed by deductive analysis whereby thematic categories were compared to two theoretical models of collaboration. Questionnaire responses were summarised using descriptive statistics. Using the scale measurements, nurse practitioners and medical practitioners reported high levels of collaboration, were highly satisfied with their collaborative relationship and strongly believed that collaboration benefited the patient. The three themes developed from qualitative data showed a more complex and nuanced picture: 1) Structures such as government policy requirements and local infrastructure disadvantaged nurse practitioners financially and professionally in collaborative practice models; 2) Participants experienced the influence and consequences of individual role enactment through the co-existence of overlapping, complementary, traditional and emerging roles, which blurred perceptions of

  20. Runaway Slave Advertisements: Teaching from Primary Documents

    Science.gov (United States)

    Costa, Tom; Doyle, Brooke

    2004-01-01

    In this article, the authors discuss how children can learn from runaway slave advertisements. The advertisements for runaway slaves that masters placed in eighteenth- and nineteenth-century newspapers are among the documentary sources available to teachers for studying the lives of African-American slaves. Such advertisements often describe a…

  1. Stroke survivors' and informal caregivers' experiences of primary care and community healthcare services - A systematic review and meta-ethnography.

    Science.gov (United States)

    Pindus, Dominika M; Mullis, Ricky; Lim, Lisa; Wellwood, Ian; Rundell, A Viona; Abd Aziz, Noor Azah; Mant, Jonathan

    2018-01-01

    To describe and explain stroke survivors and informal caregivers' experiences of primary care and community healthcare services. To offer potential solutions for how negative experiences could be addressed by healthcare services. Systematic review and meta-ethnography. Medline, CINAHL, Embase and PsycINFO databases (literature searched until May 2015, published studies ranged from 1996 to 2015). Primary qualitative studies focused on adult community-dwelling stroke survivors' and/or informal caregivers' experiences of primary care and/or community healthcare services. A set of common second order constructs (original authors' interpretations of participants' experiences) were identified across the studies and used to develop a novel integrative account of the data (third order constructs). Study quality was assessed using the Critical Appraisal Skills Programme checklist. Relevance was assessed using Dixon-Woods' criteria. 51 studies (including 168 stroke survivors and 328 caregivers) were synthesised. We developed three inter-dependent third order constructs: (1) marginalisation of stroke survivors and caregivers by healthcare services, (2) passivity versus proactivity in the relationship between health services and the patient/caregiver dyad, and (3) fluidity of stroke related needs for both patient and caregiver. Issues of continuity of care, limitations in access to services and inadequate information provision drove perceptions of marginalisation and passivity of services for both patients and caregivers. Fluidity was apparent through changing information needs and psychological adaptation to living with long-term consequences of stroke. Potential limitations of qualitative research such as limited generalisability and inability to provide firm answers are offset by the consistency of the findings across a range of countries and healthcare systems. Stroke survivors and caregivers feel abandoned because they have become marginalised by services and they do not

  2. 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.

  3. 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.

  4. Transcanalicular Laser-Assisted Dacryocystorhinostomy With Endonasal Augmentation in Primary Nasolacrimal Duct Obstruction: Our Experience.

    Science.gov (United States)

    Goel, Ruchi; Nagpal, Smriti; Kumar, Sushil; Meher, Ravi; Kamal, Saurabh; Garg, Sonam

    To evaluate and compare the success rate of transcanalicular laser-assisted dacryocystorhinostomy with endonasal augmentation, with and without intubation, in patients suffering from primary acquired nasolacrimal duct obstruction, at 1 year of follow up. A prospective, randomized interventional pilot study was conducted at a tertiary care center, in accordance with the guidelines of Declaration of Helsinki. Sixty eyes of 60 adult patients with primary acquired nasolacrimal duct obstruction were included. The participants were divided randomly into 2 equal groups (A and B-without and with bicanalicular intubation, respectively). An osteotomy was first created using 980 nm diode laser (set at 8W continuous mode) transcanalicularly and then enlarged intranasally using Blakesley's nasal forceps, followed by bicanalicular silicon intubation in group B patients. The tubes were removed at the end of 8 weeks. The ostium size was assessed endoscopically at 8 weeks and again at the end of follow up, at 1 year. A successful outcome was defined in terms of ostium patency at the end of 1 year. The results were analyzed at the end of a follow up of 1 year, using various statistical tests (p < 0.05). The mean age of the patients was 35.3 ± 15.89 years, with 23 male and 37 female patients, the 2 groups having a similar male:female ratio. An overall success rate of 90% was achieved at the end of 1 year with no statistically significant difference between the groups. Postoperative complications like tube displacement and punctal, canalicular injury were more in the intubated group. The average osteotomy size was 8.06 ± 5.4 mm at the end of 1 year. Transcanalicular laser-assisted dacryocysto rhinostomy, with endonasal augmentation, is a scarless, effective, daycare procedure, for treatment of primary acquired nasolacrimal duct obstruction with no additional advantage offered by silicone intubation.

  5. 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

  6. FFTF primary heat transport system heating, ventilating and air conditioning system experience

    International Nuclear Information System (INIS)

    Umek, A.M.; Hicks, D.F.; Schweiger, D.L.

    1981-01-01

    FFTF cools its primary/in-containment sodium equipment cells by means of a forced nitrogen cooling system which exchanges heat with a water-glycol system. The nitrogen cooling system is also used to maintain an inert gas atmosphere in the cells containing sodium equipment. Sodium Piping and Components have installed electrical resistance heaters to maintain a minimum sodium temperature and stainless steel jacketed mineral insulation to reduce heat loss. Design features and test results of a comprehensive redesign of the HVAC and insulation system required to support long-term nuclear operations are discussed

  7. Viking Lander imaging investigation: Picture catalog of primary mission experiment data record

    Science.gov (United States)

    Tucker, R. B.

    1978-01-01

    All the images returned by the two Viking Landers during the primary phase of the Viking Mission are presented. Listings of supplemental information which described the conditions under which the images were acquired are included together with skyline drawings which show where the images are positioned in the field of view of the cameras. Subsets of the images are listed in a variety of sequences to aid in locating images of interest. The format and organization of the digital magnetic tape storage of the images are described. The mission and the camera system are briefly described.

  8. Maternal morbidity and mortality due to primary PPH-experience at ayub teaching hospital abbottabad

    International Nuclear Information System (INIS)

    Naz, H.; Sarwar, I.; Nisa, A.U.

    2008-01-01

    Postpartum Haemorrhage (PPH) remains a significant cause of maternal mortality and morbidity like hypovolemic shock, anaemia, multi organ failure, consumptive coagulopathy, disseminated intra vascular coagulation (DIC), blood transfusion related complications and hysterectomy leading to loss of childbearing potential. The present study was conducted to determine the frequency of PPH and the associated maternal morbidity at the Department of Gynaecology Unit B, Ayub Teaching Hospital Abbottabad. The study was carried out in the Department of Obstetrics and Gynaecology Unit B of the Ayub teaching Hospital Abbottabad from 18th April 2006 to 17 July 2006. The study population included all cases admitted with primary PPH during the study period. For calculation of frequencies, the total number of deliveries in the setting during the study period was used. All subjects underwent a complete obstetrical clinical workup comprising of history, general physical examination, abdominal and pelvic examination, relevant laboratory investigations. The maternal condition was assessed and managed according to established hospital protocols which included both pharmacological and surgical intervention. All maternal complications were noted and recorded on pre-designed proformas. Data was entered and analyzed by computer. A total of 50 cases of primary PPH were recorded during the study period. The frequency of PPH was calculated as 7.1%. The major cause of PPH was uterine atony found in 29 (58%) cases, followed by cervical, vaginal and perineal tears in 12 (24%) cases. Initially all patients were managed pharmacologically followed by surgical intervention. Subtotal (haemostatic) hysterectomy was performed in 10 (20%) cases. Maternal morbidity was detected in 31 (62%) of cases; the major morbidities were DIC in 3 (6%) cases. Acute renal failure in 3 (6%) patients and shock in 2 (9.9%) cases and anaemia in 20 (90.1%) cases. The study concludes that the frequency of primary PPH in this

  9. 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...

  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. 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…

  12. 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…

  13. Personality, basic emotions, and satisfaction: primary emotions in the mountaineering experience

    DEFF Research Database (Denmark)

    Faullant, Rita; Matzler, Kurt; Mooradian, Todd A.

    2011-01-01

    Consumption-related emotions – usually operationalized as broad, summary dimensions such as positive and negative emotions or, alternatively, pleasure and arousal – have been shown to be influenced by enduring personality traits and, in turn, to influence customer satisfaction. Experiential tourism...... activities such as mountaineering evoke powerful emotions that strongly influence tourist satisfaction. Although Zajonc (1980) proposed and more recent neurophysiological evidence confirms that emotions, especially fear, can be primary (can precede cognitions), consumption-related emotions have heretofore...... been modeled as occurring concurrently with or consequent to cognitive appraisals. Our results show that two basic consumption-related emotions, fear and joy, are influenced by neuroticism and extraversion, respectively, and in turn and in conjunction with cognitive appraisals influence tourist...

  14. Primary Stenting of Subclavian and Innominate Artery Occlusive Disease: A Single Center's Experience

    International Nuclear Information System (INIS)

    Brountzos, E. N.; Petersen, B.; Binkert, C.; Panagiotou, I.; Kaufman, J. A.

    2004-01-01

    Purpose: To review immediate and midterm results of primary stenting for innominate and subclavian artery occlusive lesions. Methods: Retrospective data were collected from 48 consecutive symptomatic patients (27 men and 21 women, median age 64 years) having 49 subclavian and innominate artery lesions treated with stenting. Of the patients 52% had concomitant ischemic heart disease, and 30% had carotid and/or vertebral artery disease. Indication for treatment was vertebrobasilar insufficiency (VBI) in 16.6% of the patients; upper limb ischemia (ULI) in 31.3%; VBI and ULI in 12.5%; transient ischemic attack in 16.7%; angina in 12.5% before or after left internal mammary artery-to-coronary artery bypass grafting; and leg claudication in 10.4% before or after axillofemoral bypass grafting. Balloon-expandable stents were used in 44 lesions and self-expandable stents in 5 lesions. In total, 53 stents were placed in 48 patients. Results: Technical success was 96%, and clinical success 94%. We encountered four complications (two puncture site hematomas, one distal hand embolization and one transient cerebral ischemia). Two patients died within 30 days from other causes, and seven patients were lost to follow-up. Mean follow-up time was 16.7 months (range 0.3 to 68.2). Five patients had recurrent lesions treated by surgical (n = 2) or endovascular (n = 3) means. Cumulative primary patency rate was 91.7% and 77% at 12 and 24 months, respectively. Cumulative secondary patency rate was 96.5% and 91.7% at 12 and 24 months, respectively. Conclusion: Stenting of subclavian and innominate artery lesions resulted in immediate resolution of patients' symptoms with durable midterm effect and few complications in a larger patient group with serious comorbid conditions

  15. Applicability of transoral endoscopic parathyroidectomy through vestibular route for primary sporadic hyperparathyroidism: A South Indian experience.

    Science.gov (United States)

    Bhargav, P R K; Sabaretnam, M; Amar, V; Devi, N Vimala

    2018-05-04

    Primary hyperparathyroidism is one of the most common endocrine disorders requiring surgical parathyroidectomy for its definitive treatment. Surgical exploration is traditionally performed through conventional open neck approach. A wide range of minimal access and minimally invasive endoscopic techniques (gas less and with gas) have been attempted in the past two decades. In this context, we evaluated the feasibility and safety of an innovative transoral endoscopic parathyroidectomy (EP) technique, which represents a paradigm shift in transluminal endocrine surgery. This is a prospective study conducted at a tertiary care Endocrine Surgery Department in South India between May 2016 and August 2017. We employed a novel transoral, lower vestibular route for EP. All the clinical, investigative, operative, pathological and post-operative data were collected from our prospectively filled database. Statistical analysis was performed with SPSS 20.0 version. Under inhalational general anaesthesia, access to the neck was obtained with 3 ports (central frenulotomy and two lateral port sites), dissected in subplatysmal plane and insufflated with 6 mm Hg CO 2 for working space. Rest of surgical steps is similar to conventional open parathyroidectomy. Out of the 38 hyperparathyroidism cases operated during the study, 12 (32%) were operated by this technique. Mean operative time was 112 ± 15 min (95-160). The post-operative course was uneventful with no major morbidity, hypocalcemia or recurrent laryngeal nerve palsy. Cure and diagnosis were confirmed by> 50% fall in intraoperative parathyroid hormone levels and histopathology (all were benign solitary adenomas). Through this study, we opine that this novel transoral vestibular route parathyroidectomy is a feasibly applicable approach for primary sporadic hyperparathyroidism, especially with solitary benign adenomas.

  16. 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.

  17. Primary care staff's views and experiences related to routinely advising patients about physical activity. A questionnaire survey

    Directory of Open Access Journals (Sweden)

    Meloni Serena

    2006-05-01

    Full Text Available Abstract Background United Kingdom public health policy has recently re-emphasised the role of primary health care professionals in tackling increasing levels of physical inactivity within the general population. However, little is known about the impact that this has had in practice. This study explores Scottish primary care staff's knowledge, attitudes and experiences associated with advising patients about physical activity during routine consultations. Methods A cross-sectional questionnaire survey of general practitioners (or family physicians, practice nurses and health visitors based in four health regions was conducted during 2004. The main outcome measures included: (i health professionals' knowledge of the current physical activity recommendations; (ii practice related to routine physical activity advising; and (iii associated attitudes. Results Questionnaires were returned by 757 primary care staff (response rate 54%. Confidence and enthusiasm for giving advice was generally high, but knowledge of current physical activity recommendations was low. In general, respondents indicated that they routinely discuss and advise patients about physical activity regardless of the presenting condition. Health visitors and practice nurses were more likely than general practitioners to offer routine advice. Lack of time and resources were more likely to be reported as barriers to routine advising by general practitioners than other professional groups. However, health visitors and practice nurses were also more likely than general practitioners to believe that patients would follow their physical activity advice giving. Conclusion If primary health care staff are to be fully motivated and effective in encouraging and supporting the general population to become more physically active, policymakers and health professionals need to engage in efforts to: (1 improve knowledge of current physical activity recommendations and population trends amongst

  18. Clouds and silver linings: positive experiences associated with primary affective disorders.

    Science.gov (United States)

    Jamison, K R; Gerner, R H; Hammen, C; Padesky, C

    1980-02-01

    Clinical psychiatry has focused almost entirely on the psychopathology of the affective disorders. The authors studied responses of 61 patients (35 bipolar. 26 unipolar) to questions about perceived short- and long-term benefits (increased sensitivity, sexuality, productivity, creativity, and social outgoingness) they attributed to their affective illness. Bipolar patients strongly indicated positive experiences associated with manic-depressive illness; few unipolar patients perceived their disorder in such a way. Significant sex differences emerged in the attributions made by bipolar patients.

  19. Noise analysis and mimic experiments for loose part accident in the primary coolant loop of PWR

    International Nuclear Information System (INIS)

    Yang Xiuzhou; Cheng Tingxiang; Zhang Bin

    1994-01-01

    The basic principle of loose part monitoring is to detect and measure the structure transfer sound generated by impacting of metal loose part with accelerators and to identify and diagnose by the micro-processor. This paper introduces the theoretical base of loose part monitoring, the location and mass estimation of loose part, and three mimic experiment applying noise analysis techniques. It provides some useful preparations for the development of loose part monitoring system

  20. Antibiotic misuse in children by the primary care physicians--an Indian experience.

    Science.gov (United States)

    Basu, S; Chatterjee, M; Chandra, P Kumar; Basu, S

    2008-03-01

    To determine the misuse of antibiotics in the Pediatric outpatients department' (OPD) of a busy teaching hospital and to ascertain the probable reasons behind it. Over a 6 months period, new cases primarily treated with antibiotics by Medical Officers (first contact physicians in Peadiatric Medicine and Surgery OPD) were recruited in the study after obtaining written consent from the parents. Various errors of antibiotic usage were noted. All Medical Officers were asked to fill up a preformed questionnaire and the parents/guardians were interviewed on their ideas about antibiotics. Data were analyzed by the statistical software SPSS 10. Antibiotics were prescribed in 2427 (84.9%) new patients. Misuse of antibiotics was documented in 36.8% patients (no indication in 35.3%, improper selection in 17.9% and incorrect dosage in 7.7%). All medical officers were aware that they overuse antibiotics. The various reasons sited were demand of the parents, reluctance to counsel due to patient overload, free supply of medicines from OPD and sympathetic grounds as follow up visits were uncertain. Majority of the parents/attendants belonged to poor socioeconomic status and did not have any idea regarding antibiotics. All parents wanted quick relief without hospitalization and only 2.3% were willing to revisit the OPD for the same illness. Both medical officers and parents felt that base line investigations were unnecessary. Antibiotic misuse is quite common in this part of the world. Irrational use was mostly seen in over-prescribing and improper selection of antibiotic. Poor socio-economic status and overcrowding of patients in OPD were the main responsible factors.

  1. 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.

  2. PKL/K9, Refill and Reflood Experiment in a Simulated PWR Primary System (PKL)

    International Nuclear Information System (INIS)

    1981-01-01

    1 - Description of test facility: PKL-facility simulates the essential primary system components of a typical West German 1300 PWR with regard to their thermohydraulic behaviour. The facility essentially consists of the pressure vessel with the heated bundle, the downcomer simulator, the primary loops with the components steam generator and pump simulator, the injection devices, the break geometry simulator, as well as the separators connected thereto, and the test containment to maintain a back-pressure at the location of break which is expected to be typical for emergency conditions. The number of heater rods and the cross-sections of the testing plant are on a reduced scale 1:134 in comparison with a typical German PWR. The elevations and locations are essentially full scale. Pressure vessel: The space between the pressure vessel and the inner core casing is sealed from the core region and the upper and lower plenum and connected with the upper plenum only by a pressure equalization line. The rod bundle surrounded by the inner core casing consists of 340 rods, 337 of which are indirect electrically heated. The test bundle cross-section as well as a heater element with the measuring elevations, the original-KWU-spacers and the axial power profile (7 power steps) are described. Downcomer: The downcomer is simulated by the downcomer nozzle region and the downcomer U-tube. The cold leg injection takes place both directly in the downcomer nozzle region and in the lines of t he intact single and double loop near to the downcomer nozzle region. A cylindrical insertion and repulsing metal sheets are installed in the downcomer nozzle region in order to avoid the emergency injection points into the broken loop. 2 - Description of test: Test K 9 out of a series PKL-IB was conducted on May 30, 1979 by Kraftwerk Union (KWU) at Erlangen (Germany). The objective of the integral cold leg injection test K 9 (double-ended 200%-break) was to investigate after a LOCA the refill and

  3. 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.

  4. 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.

  5. [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.

  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. Clinical experience with RF thermotherapy for nonresectable primary and secondary liver tumors

    International Nuclear Information System (INIS)

    Yonemura, Yutaka; Fujimura, Takashi; Takegawa, Shigeru; Miyata, Ryuwa; Kamata, Toru; Miyazaki, Itsuo; Nakajima, Kazuyoshi; Hisazumi, Haruo; Saito, Yasuo

    1987-01-01

    Twenty two patients with primary or secondary liver tumors were treated by radiofrequency hyperthermia (8 MHz) combined with radiation or chemotherapy. Hyperthermia was administered twice a week for 40 - 60 minutes per session up to a total of 5 - 48 sessions. Five fractions per week of irradiation (10 MV X ray) at 180 - 200 cGy or intraarterial chemotherapy using mitomycin C, cis-diamminedichroloplatinum or adriamycine were carried out. Intratumor temperature over 42.5 deg C were obtained in 9 of 17 patients. Of the 22 patients treated, 2 (9 %) showed complete response, 8 (36 %) partial response, 3 (14 %) minor response, 7 (32 %) no change and 2 (9 %) progressive disease. 7 out of 14 tumors, heated over 42.5 deg C showed complete or partial response but only 1 out of 5 tumors, heated under 42.5 deg C was responder. Complication observed were thrombocytopenia and leukopenia in 30 % of cases. These results showed that combined treatment of hyperthermia radiation and chemotherapy appear to be useful from of therapy for the patients with liver tumor. (author)

  8. 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.

  9. 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. PMID:25786214

  10. [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.

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

    Energy Technology Data Exchange (ETDEWEB)

    Aaboud, M. [Univ. Mohamed Premier et LPTPM, Oujda (Morocco). Faculte des Sciences; Aad, G. [CPPM, Aix-Marseille Univ. et CNRS/IN2P3, Marseille (France); Abbott, B. [Oklahoma Univ., Norman, OK (United States). Homer L. Dodge Dept. of Physics and Astronomy; Collaboration: ATLAS Collaboration; and others

    2017-05-15

    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 √(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 μm is achieved for events with high multiplicity of reconstructed tracks. The transverse position resolution is better than 20 μm 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. (orig.)

  12. Patients' experiences of using a smartphone application to increase physical activity: the SMART MOVE qualitative study in primary care.

    Science.gov (United States)

    Casey, Monica; Hayes, Patrick S; Glynn, Fergus; OLaighin, Gearóid; Heaney, David; Murphy, Andrew W; Glynn, Liam G

    2014-08-01

    Regular physical activity is known to help prevent and treat numerous non-communicable diseases. Smartphone applications (apps) have been shown to increase physical activity in primary care but little is known regarding the views of patients using such technology or how such technology may change behaviour. To explore patients' views and experiences of using smartphones to promote physical activity in primary care. This qualitative study was embedded within the SMART MOVE randomised controlled trial, which used an app (Accupedo-Pro Pedometer) to promote physical activity in three primary care centres in the west of Ireland. Taped and transcribed semi-structured interviews with a purposeful sample of 12 participants formed the basis of the investigation. Framework analysis was used to analyse the data. Four themes emerged from the analysis: transforming relationships with exercise; persuasive technology tools; usability; and the cascade effect. The app appeared to facilitate a sequential and synergistic process of positive change, which occurred in the relationship between the participants and their exercise behaviour; the study has termed this the 'Know-Check-Move' effect. Usability challenges included increased battery consumption and adjusting to carrying the smartphone on their person. There was also evidence of a cascade effect involving the families and communities of participants. Notwithstanding technological challenges, an app has the potential to positively transform, in a unique way, participants' relationships with exercise. Such interventions can also have an associated cascade effect within their wider families and communities. © British Journal of General Practice 2014.

  13. 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.

  14. [The Bellagio Model: an evidence-informed, international framework for population-oriented primary care. First experiences].

    Science.gov (United States)

    Schlette, Sophia; Lisac, Melanie; Wagner, Ed; Gensichen, Jochen

    2009-01-01

    The Bellagio Model for Population-oriented Primary Care is an evidence-informed framework to assess accessible care for sick, vulnerable, and healthy people. The model was developed in spring 2008 by a multidisciplinary group of 24 experts from nine countries. The purpose of their gathering was to determine success factors for effective 21st century primary care based on state-of-the-art research findings, models, and empirical experience, and to assist with its implementation in practice, management, and health policy. Against the backdrop of "partialization", fragmentation in open health care systems, and the growing numbers of chronically ill or fragile people or those in need of any other kind of care, today's health care systems do not provide the much needed anchor point for continuing coordination and assistance prior, during and following an episode of illness. The Bellagio Model consists of ten key elements, which can make a substantial contribution to identify and overcome current gaps in primary care by using a synergetic approach. These elements are Shared Leadership, Public Trust, Horizontal and Vertical Integration, Networking of Professionals, Standardized Measurement, Research and Development, Payment Mix, Infrastructure, Programmes for Practice Improvement, and Population-oriented Management. All of these elements, which have been identified as being equally necessary, are also alike in that they involve all those responsible for health care: providers, managers, and policymakers.

  15. 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; Lopez Solis, Alvaro; Lorenz, Jeanette; Lorenzo Martinez, Narei; Losada, Marta; Lösel, Philipp Jonathan; Lou, XinChou; Lounis, Abdenour; Love, Jeremy; Love, Peter; Lu, Haonan; Lu, Nan; Lubatti, Henry; Luci, Claudio; Lucotte, Arnaud; Luedtke, Christian; Luehring, Frederick; Lukas, Wolfgang; Luminari, Lamberto; Lundberg, Olof; Lund-Jensen, Bengt; Luzi, Pierre Marc; Lynn, David; Lysak, Roman; Lytken, Else; Lyubushkin, Vladimir; Ma, Hong; Ma, Lian Liang; Ma, Yanhui; Maccarrone, Giovanni; Macchiolo, Anna; Macdonald, Calum Michael; Maček, Boštjan; Machado Miguens, Joana; Madaffari, Daniele; Madar, Romain; Maddocks, Harvey Jonathan; Mader, Wolfgang; Madsen, Alexander; Maeda, Junpei; Maeland, Steffen; Maeno, Tadashi; Maevskiy, Artem; Magradze, Erekle; Mahlstedt, Joern; Maiani, Camilla; Maidantchik, Carmen; Maier, Andreas Alexander; Maier, Thomas; Maio, Amélia; Majewski, Stephanie; Makida, Yasuhiro; Makovec, Nikola; Malaescu, Bogdan; Malecki, Pawel; Maleev, Victor; Malek, Fairouz; Mallik, Usha; 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; Pin, Arnaud Willy J; Pinamonti, Michele; Pinfold, James; Pingel, Almut; Pires, Sylvestre; Pirumov, Hayk; Pitt, Michael; Plazak, Lukas; Pleier, Marc-Andre; Pleskot, Vojtech; Plotnikova, Elena; Plucinski, Pawel; Pluth, Daniel; Poettgen, Ruth; Poggioli, Luc; Pohl, David-leon; Polesello, Giacomo; Poley, Anne-luise; Policicchio, Antonio; Polifka, Richard; Polini, Alessandro; Pollard, Christopher Samuel; Polychronakos, Venetios; Pommès, Kathy; Pontecorvo, Ludovico; Pope, Bernard; Popeneciu, Gabriel Alexandru; Popovic, Dragan; Poppleton, Alan; Pospisil, Stanislav; Potamianos, Karolos; Potrap, Igor; Potter, Christina; Potter, Christopher; Poulard, Gilbert; Poveda, Joaquin; Pozdnyakov, Valery; Pozo Astigarraga, Mikel Eukeni; Pralavorio, Pascal; Pranko, Aliaksandr; Prell, Soeren; Price, Darren; Price, Lawrence; Primavera, Margherita; Prince, Sebastien; Proissl, Manuel; Prokofiev, Kirill; Prokoshin, Fedor; Protopopescu, Serban; Proudfoot, James; Przybycien, Mariusz; Puddu, Daniele; Purohit, Milind; Puzo, Patrick; Qian, Jianming; Qin, Gang; Qin, Yang; Quadt, Arnulf; Quayle, William; Queitsch-Maitland, Michaela; Quilty, Donnchadha; Raddum, Silje; Radeka, Veljko; Radescu, Voica; Radhakrishnan, Sooraj Krishnan; Radloff, Peter; Rados, Pere; Ragusa, Francesco; Rahal, Ghita; Raine, John Andrew; Rajagopalan, Srinivasan; Rammensee, Michael; Rangel-Smith, Camila; Ratti, Maria Giulia; Rauscher, Felix; Rave, Stefan; Ravenscroft, Thomas; Ravinovich, Ilia; Raymond, Michel; Read, Alexander Lincoln; Readioff, Nathan Peter; Reale, Marilea; Rebuzzi, Daniela; Redelbach, Andreas; Redlinger, George; Reece, Ryan; Reeves, Kendall; Rehnisch, Laura; Reichert, Joseph; Reisin, Hernan; Rembser, Christoph; Ren, Huan; Rescigno, Marco; Resconi, Silvia; Rezanova, Olga; Reznicek, Pavel; Rezvani, Reyhaneh; Richter, Robert; Richter, Stefan; Richter-Was, Elzbieta; Ricken, Oliver; Ridel, Melissa; Rieck, Patrick; Riegel, Christian Johann; Rieger, Julia; Rifki, Othmane; Rijssenbeek, Michael; Rimoldi, Adele; Rimoldi, Marco; Rinaldi, Lorenzo; Ristić, Branislav; Ritsch, Elmar; Riu, Imma; Rizatdinova, Flera; Rizvi, Eram; Rizzi, Chiara; Robertson, Steven; Robichaud-Veronneau, Andree; Robinson, Dave; Robinson, James; Robson, Aidan; Roda, Chiara; Rodina, Yulia; Rodriguez Perez, Andrea; Rodriguez Rodriguez, Daniel; Roe, Shaun; Rogan, Christopher Sean; Røhne, Ole; Romaniouk, Anatoli; Romano, Marino; Romano Saez, Silvestre Marino; Romero Adam, Elena; Rompotis, Nikolaos; Ronzani, Manfredi; Roos, Lydia; Ros, Eduardo; Rosati, Stefano; Rosbach, Kilian; Rose, Peyton; Rosenthal, Oliver; Rosien, Nils-Arne; Rossetti, Valerio; Rossi, Elvira; Rossi, Leonardo Paolo; Rosten, Jonatan; Rosten, Rachel; Rotaru, Marina; Roth, Itamar; Rothberg, Joseph; Rousseau, David; Royon, Christophe; Rozanov, Alexandre; Rozen, Yoram; Ruan, Xifeng; Rubbo, Francesco; Rudolph, Matthew Scott; Rühr, Frederik; Ruiz-Martinez, Aranzazu; Rurikova, Zuzana; Rusakovich, Nikolai; Ruschke, Alexander; Russell, Heather; Rutherfoord, John; Ruthmann, Nils; Ryabov, Yury; Rybar, Martin; Rybkin, Grigori; Ryu, Soo; Ryzhov, Andrey; Rzehorz, Gerhard Ferdinand; Saavedra, Aldo; Sabato, Gabriele; Sacerdoti, Sabrina; Sadrozinski, Hartmut; Sadykov, Renat; Safai Tehrani, Francesco; Saha, Puja; Sahinsoy, Merve; Saimpert, Matthias; Saito, Tomoyuki; Sakamoto, Hiroshi; Sakurai, Yuki; Salamanna, Giuseppe; Salamon, Andrea; Salazar Loyola, Javier Esteban; Salek, David; Sales De Bruin, Pedro Henrique; Salihagic, Denis; Salnikov, Andrei; Salt, José; Salvatore, Daniela; Salvatore, Pasquale Fabrizio; Salvucci, Antonio; Salzburger, Andreas; Sammel, Dirk; Sampsonidis, Dimitrios; Sanchez, Arturo; Sánchez, Javier; Sanchez Martinez, Victoria; Sandaker, Heidi; Sandbach, Ruth Laura; Sander, Heinz Georg; Sandhoff, Marisa; Sandoval, Carlos; Sandstroem, Rikard; Sankey, Dave; Sannino, Mario; Sansoni, Andrea; Santoni, Claudio; Santonico, Rinaldo; Santos, Helena; Santoyo Castillo, Itzebelt; Sapp, Kevin; Sapronov, Andrey; Saraiva, João; Sarrazin, Bjorn; Sasaki, Osamu; Sasaki, Yuichi; Sato, Koji; Sauvage, Gilles; Sauvan, Emmanuel; Savage, Graham; Savard, Pierre; Sawyer, Craig; Sawyer, Lee; Saxon, James; Sbarra, Carla; Sbrizzi, Antonio; Scanlon, Tim; Scannicchio, Diana; Scarcella, Mark; Scarfone, Valerio; Schaarschmidt, Jana; Schacht, Peter; Schachtner, Balthasar Maria; Schaefer, Douglas; Schaefer, Ralph; Schaeffer, Jan; Schaepe, Steffen; Schaetzel, Sebastian; Schäfer, Uli; Schaffer, Arthur; Schaile, Dorothee; Schamberger, R Dean; Scharf, Veit; Schegelsky, Valery; Scheirich, Daniel; Schernau, Michael; Schiavi, Carlo; Schier, Sheena; Schillo, Christian; Schioppa, Marco; Schlenker, Stefan; Schmidt-Sommerfeld, Korbinian Ralf; Schmieden, Kristof; Schmitt, Christian; Schmitt, Stefan; Schmitz, Simon; Schneider, Basil; Schnoor, Ulrike; Schoeffel, Laurent; Schoening, Andre; Schoenrock, Bradley Daniel; Schopf, Elisabeth; Schott, Matthias; Schovancova, Jaroslava; Schramm, Steven; Schreyer, Manuel; Schuh, Natascha; Schulte, Alexandra; Schultens, Martin Johannes; Schultz-Coulon, Hans-Christian; Schulz, Holger; Schumacher, Markus; Schumm, Bruce; Schune, Philippe; Schwartzman, Ariel; Schwarz, Thomas Andrew; Schwegler, Philipp; Schweiger, Hansdieter; Schwemling, Philippe; Schwienhorst, Reinhard; Schwindling, Jerome; Schwindt, Thomas; Sciolla, Gabriella; Scuri, Fabrizio; Scutti, Federico; Searcy, Jacob; Seema, Pienpen; Seidel, Sally; Seiden, Abraham; Seifert, Frank; Seixas, José; Sekhniaidze, Givi; Sekhon, Karishma; Sekula, Stephen; Seliverstov, Dmitry; Semprini-Cesari, Nicola; Serfon, Cedric; Serin, Laurent; Serkin, Leonid; Sessa, Marco; Seuster, Rolf; Severini, Horst; Sfiligoj, Tina; Sforza, Federico; Sfyrla, Anna; Shabalina, Elizaveta; Shaikh, Nabila Wahab; Shan, Lianyou; Shang, Ruo-yu; Shank, James; Shapiro, Marjorie; Shatalov, Pavel; Shaw, Kate; Shaw, Savanna Marie; Shcherbakova, Anna; Shehu, Ciwake Yusufu; Sherwood, Peter; Shi, Liaoshan; Shimizu, Shima; Shimmin, Chase Owen; Shimojima, Makoto; Shiyakova, Mariya; Shmeleva, Alevtina; Shoaleh Saadi, Diane; Shochet, Mel; Shojaii, Seyed Ruhollah; Shrestha, Suyog; Shulga, Evgeny; Shupe, Michael; Sicho, Petr; Sickles, Anne Marie; Sidebo, Per Edvin; Sidiropoulou, Ourania; Sidorov, Dmitri; Sidoti, Antonio; Siegert, Frank; Sijacki, Djordje; Silva, José; Silverstein, Samuel; Simak, Vladislav; Simard, Olivier; Simic, Ljiljana; Simion, Stefan; Simioni, Eduard; Simmons, Brinick; Simon, Dorian; Simon, Manuel; Sinervo, Pekka; Sinev, Nikolai; Sioli, Maximiliano; Siragusa, Giovanni; Sivoklokov, Serguei; Sjölin, Jörgen; Skinner, Malcolm Bruce; Skottowe, Hugh Philip; Skubic, Patrick; Slater, Mark; Slavicek, Tomas; Slawinska, Magdalena; Sliwa, Krzysztof; Slovak, Radim; Smakhtin, Vladimir; Smart, Ben; Smestad, Lillian; Smiesko, Juraj; Smirnov, Sergei; Smirnov, Yury; Smirnova, Lidia; Smirnova, Oxana; Smith, Matthew; Smith, Russell; Smizanska, Maria; Smolek, Karel; Snesarev, Andrei; Snyder, Scott; Sobie, Randall; Socher, Felix; Soffer, Abner; Soh, Dart-yin; Sokhrannyi, Grygorii; Solans Sanchez, Carlos; Solar, Michael; Soldatov, Evgeny; Soldevila, Urmila; Solodkov, Alexander; Soloshenko, Alexei; Solovyanov, Oleg; Solovyev, Victor; Sommer, Philip; Son, Hyungsuk; Song, Hong Ye; Sood, Alexander; Sopczak, Andre; Sopko, Vit; Sorin, Veronica; Sosa, David; Sotiropoulou, Calliope Louisa; Soualah, Rachik; Soukharev, Andrey; South, David; Sowden, Benjamin; Spagnolo, Stefania; Spalla, Margherita; Spangenberg, Martin; Spanò, Francesco; Sperlich, Dennis; Spettel, Fabian; Spighi, Roberto; Spigo, Giancarlo; Spiller, Laurence Anthony; Spousta, Martin; St Denis, Richard Dante; Stabile, Alberto; Stamen, Rainer; Stamm, Soren; Stanecka, Ewa; Stanek, Robert; Stanescu, Cristian; Stanescu-Bellu, Madalina; Stanitzki, Marcel Michael; Stapnes, Steinar; Starchenko, Evgeny; Stark, Giordon; Stark, Jan; Staroba, Pavel; Starovoitov, Pavel; Stärz, Steffen; Staszewski, Rafal; Steinberg, Peter; Stelzer, Bernd; Stelzer, Harald Joerg; Stelzer-Chilton, Oliver; Stenzel, Hasko; Stewart, Graeme; Stillings, Jan Andre; Stockton, Mark; Stoebe, Michael; Stoicea, Gabriel; Stolte, Philipp; Stonjek, Stefan; Stradling, Alden; Straessner, Arno; Stramaglia, Maria Elena; Strandberg, Jonas; Strandberg, Sara; Strandlie, Are; Strauss, Michael; Strizenec, Pavol; Ströhmer, Raimund; Strom, David; Stroynowski, Ryszard; Strubig, Antonia; Stucci, Stefania Antonia; Stugu, Bjarne; Styles, Nicholas Adam; Su, Dong; Su, Jun; Suchek, Stanislav; Sugaya, Yorihito; Suk, Michal; Sulin, Vladimir; Sultansoy, Saleh; Sumida, Toshi; Sun, Siyuan; Sun, Xiaohu; Sundermann, Jan Erik; Suruliz, Kerim; Susinno, Giancarlo; Sutton, Mark; Suzuki, Shota; Svatos, Michal; Swiatlowski, Maximilian; Sykora, Ivan; Sykora, Tomas; Ta, Duc; Taccini, Cecilia; Tackmann, Kerstin; Taenzer, Joe; Taffard, Anyes; Tafirout, Reda; Taiblum, Nimrod; Takai, Helio; Takashima, Ryuichi; Takeshita, Tohru; Takubo, Yosuke; Talby, Mossadek; Talyshev, Alexey; Tan, Kong Guan; Tanaka, Junichi; Tanaka, Reisaburo; Tanaka, Shuji; Tannenwald, Benjamin Bordy; Tapia Araya, Sebastian; Tapprogge, Stefan; Tarem, Shlomit; Tartarelli, Giuseppe Francesco; Tas, Petr; Tasevsky, Marek; Tashiro, Takuya; Tassi, Enrico; Tavares Delgado, Ademar; Tayalati, Yahya; Taylor, Aaron; Taylor, Geoffrey; Taylor, Pierre Thor Elliot; Taylor, Wendy; Teischinger, Florian Alfred; Teixeira-Dias, Pedro; Temming, Kim Katrin; Temple, Darren; Ten Kate, Herman; Teng, Ping-Kun; Teoh, Jia Jian; Tepel, Fabian-Phillipp; Terada, Susumu; Terashi, Koji; Terron, Juan; Terzo, Stefano; Testa, Marianna; Teuscher, Richard; Theveneaux-Pelzer, Timothée; Thomas, Juergen; Thomas-Wilsker, Joshuha; Thompson, Emily; Thompson, Paul; Thompson, Stan; Thomsen, Lotte Ansgaard; Thomson, Evelyn; Thomson, Mark; Tibbetts, Mark James; Ticse Torres, Royer Edson; Tikhomirov, Vladimir; Tikhonov, Yury; Timoshenko, Sergey; Tipton, Paul; Tisserant, Sylvain; Todome, Kazuki; Todorov, Theodore; Todorova-Nova, Sharka; Tojo, Junji; Tokár, Stanislav; Tokushuku, Katsuo; Tolley, Emma; Tomlinson, Lee; Tomoto, Makoto; Tompkins, Lauren; Toms, Konstantin; Tong, Baojia(Tony); Torrence, Eric; Torres, Heberth; Torró Pastor, Emma; Toth, Jozsef; Touchard, Francois; Tovey, Daniel; Trefzger, Thomas; Tricoli, Alessandro; Trigger, Isabel Marian; Trincaz-Duvoid, Sophie; Tripiana, Martin; Trischuk, William; Trocmé, Benjamin; Trofymov, Artur; Troncon, Clara; Trottier-McDonald, Michel; Trovatelli, Monica; Truong, Loan; Trzebinski, Maciej; Trzupek, Adam; Tseng, Jeffrey; Tsiareshka, Pavel; Tsipolitis, Georgios; Tsirintanis, Nikolaos; Tsiskaridze, Shota; Tsiskaridze, Vakhtang; Tskhadadze, Edisher; Tsui, Ka Ming; Tsukerman, Ilya; Tsulaia, Vakhtang; Tsuno, Soshi; Tsybychev, Dmitri; Tudorache, Alexandra; Tudorache, Valentina; Tuna, Alexander Naip; Tupputi, Salvatore; Turchikhin, Semen; Turecek, Daniel; Turgeman, Daniel; Turra, Ruggero; Turvey, Andrew John; Tuts, Michael; Tyndel, Mike; Ucchielli, Giulia; Ueda, Ikuo; Ughetto, Michael; Ukegawa, Fumihiko; Unal, Guillaume; Undrus, Alexander; Unel, Gokhan; Ungaro, Francesca; Unno, Yoshinobu; Unverdorben, Christopher; Urban, Jozef; Urquijo, Phillip; Urrejola, Pedro; Usai, Giulio; Usanova, Anna; Vacavant, Laurent; Vacek, Vaclav; Vachon, Brigitte; Valderanis, Chrysostomos; Valdes Santurio, Eduardo; Valencic, Nika; Valentinetti, Sara; Valero, Alberto; Valery, Loic; Valkar, Stefan; Vallecorsa, Sofia; Valls Ferrer, Juan Antonio; Van Den Wollenberg, Wouter; Van Der Deijl, Pieter; van der Geer, Rogier; van der Graaf, Harry; van Eldik, Niels; van Gemmeren, Peter; Van Nieuwkoop, Jacobus; van Vulpen, Ivo; van Woerden, Marius Cornelis; Vanadia, Marco; Vandelli, Wainer; Vanguri, Rami; Vaniachine, Alexandre; Vankov, Peter; Vardanyan, Gagik; Vari, Riccardo; Varnes, Erich; Varol, Tulin; Varouchas, Dimitris; Vartapetian, Armen; Varvell, Kevin; Vasquez, Jared Gregory; Vazeille, Francois; Vazquez Schroeder, Tamara; Veatch, Jason; Veloce, Laurelle Maria; Veloso, Filipe; Veneziano, Stefano; Ventura, Andrea; Venturi, Manuela; Venturi, Nicola; Venturini, Alessio; Vercesi, Valerio; Verducci, Monica; Verkerke, Wouter; Vermeulen, Jos; Vest, Anja; Vetterli, Michel; Viazlo, Oleksandr; Vichou, Irene; Vickey, Trevor; Vickey Boeriu, Oana Elena; Viehhauser, Georg; Viel, Simon; Vigani, Luigi; Vigne, Ralph; Villa, Mauro; Villaplana Perez, Miguel; Vilucchi, Elisabetta; Vincter, Manuella; Vinogradov, Vladimir; Vittori, Camilla; Vivarelli, Iacopo; Vlachos, Sotirios; Vlasak, Michal; Vogel, Marcelo; Vokac, Petr; Volpi, Guido; Volpi, Matteo; von der Schmitt, Hans; von Toerne, Eckhard; Vorobel, Vit; Vorobev, Konstantin; Vos, Marcel; Voss, Rudiger; Vossebeld, Joost; Vranjes, Nenad; Vranjes Milosavljevic, Marija; Vrba, Vaclav; Vreeswijk, Marcel; Vuillermet, Raphael; Vukotic, Ilija; Vykydal, Zdenek; Wagner, Peter; Wagner, Wolfgang; Wahlberg, Hernan; Wahrmund, Sebastian; Wakabayashi, Jun; Walder, James; Walker, Rodney; Walkowiak, Wolfgang; Wallangen, Veronica; Wang, Chao; Wang, Chao; Wang, Fuquan; Wang, Haichen; Wang, Hulin; Wang, Jike; Wang, Jin; Wang, Kuhan; Wang, Rui; Wang, Song-Ming; Wang, Tan; Wang, Tingting; Wang, Wenxiao; Wang, Xiaoxiao; Wanotayaroj, Chaowaroj; Warburton, Andreas; Ward, Patricia; Wardrope, David Robert; Washbrook, Andrew; Watkins, Peter; Watson, Alan; Watson, Miriam; Watts, Gordon; Watts, Stephen; Waugh, Ben; Webb, Samuel; Weber, Michele; Weber, Stefan Wolf; Webster, Jordan S; Weidberg, Anthony; Weinert, Benjamin; Weingarten, Jens; Weiser, Christian; Weits, Hartger; Wells, Phillippa; Wenaus, Torre; Wengler, Thorsten; Wenig, Siegfried; Wermes, Norbert; Werner, Matthias; Werner, Michael David; Werner, Per; Wessels, Martin; Wetter, Jeffrey; Whalen, Kathleen; Whallon, Nikola Lazar; Wharton, Andrew Mark; White, Andrew; White, Martin; White, Ryan; Whiteson, Daniel; Wickens, Fred; Wiedenmann, Werner; Wielers, Monika; Wienemann, Peter; Wiglesworth, Craig; Wiik-Fuchs, Liv Antje Mari; Wildauer, Andreas; Wilk, Fabian; Wilkens, Henric George; Williams, Hugh; Williams, Sarah; Willis, Christopher; Willocq, Stephane; Wilson, John; Wingerter-Seez, Isabelle; Winklmeier, Frank; Winston, Oliver James; Winter, Benedict Tobias; Wittgen, Matthias; Wittkowski, Josephine; Wolter, Marcin Wladyslaw; Wolters, Helmut; Worm, Steven D; Wosiek, Barbara; Wotschack, Jorg; Woudstra, Martin; Wozniak, Krzysztof; Wu, Mengqing; Wu, Miles; Wu, Sau Lan; Wu, Xin; Wu, Yusheng; Wyatt, Terry Richard; Wynne, Benjamin; Xella, Stefania; Xu, Da; Xu, Lailin; Yabsley, Bruce; Yacoob, Sahal; Yakabe, Ryota; Yamaguchi, Daiki; Yamaguchi, Yohei; Yamamoto, Akira; Yamamoto, Shimpei; Yamanaka, Takashi; Yamauchi, Katsuya; Yamazaki, Yuji; Yan, Zhen; Yang, Haijun; Yang, Hongtao; Yang, Yi; Yang, Zongchang; Yao, Weiming; Yap, Yee Chinn; Yasu, Yoshiji; Yatsenko, Elena; Yau Wong, Kaven Henry; Ye, Jingbo; Ye, Shuwei; Yeletskikh, Ivan; Yen, Andy L; Yildirim, Eda; Yorita, Kohei; Yoshida, Rikutaro; Yoshihara, Keisuke; Young, Charles; Young, Christopher John; Youssef, Saul; Yu, David Ren-Hwa; Yu, Jaehoon; Yu, Jiaming; Yu, Jie; Yuan, Li; Yuen, Stephanie P; Yusuff, Imran; Zabinski, Bartlomiej; Zaidan, Remi; Zaitsev, Alexander; Zakharchuk, Nataliia; Zalieckas, Justas; Zaman, Aungshuman; Zambito, Stefano; Zanello, Lucia; Zanzi, Daniele; Zeitnitz, Christian; 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...

  16. [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.

  17. Search for Direct Top Squark Pair Production with the ATLAS Experiment and Studies of the Primary Vertex Reconstruction Performance

    CERN Document Server

    Abulaiti, Yiming

    The ATLAS detector is one of the two largest experiments installed at the Large Hadron Collider at CERN, the European Organization for Nuclear Research. During the first run, the ATLAS detector recorded data at centre of mass energies of 7 TeV and 8 TeV, enabling many precision measurements and new physics searches. One important task in ATLAS is measuring the primary vertex, the interaction point of the hardest proton-proton collision in an event. In this thesis, a study of the primary vertex reconstruction performance in data and simulated events using tt ̄ and Z events is presented. Within the statistics available, the performance in data and simulated events is found to be compatible. Motivated by the limitations of the Standard Model of particle physics, searches for supersymmetric particles are performed with the ATLAS experiment. No signal has been observed so far, and the results are used to set exclusion limits on the masses of the supersymmetric particles. As the exclusion limits are derived from a...

  18. The experience of being a grandmother who is the primary caregiver for her HIV-positive grandchild.

    Science.gov (United States)

    Caliandro, G; Hughes, C

    1998-01-01

    The number of grandparents assuming care for their grandchildren is increasing, and this affects grandparents both positively and negatively. The current study builds on an earlier study of the effects of social support, stress, and level of illness on caregiving of children with acquired immune deficiency syndrome (AIDS) that identified both positive and negative effects of caregiving. To identify the lived experience of African American and Latino grandmothers as the primary caregivers for their grandchildren who are human immunodeficiency virus (HIV)-infected or have AIDS and to identify the similarities and differences between the two groups. Using Van Manen's method for hermeneutical phenomenological research, the lived experiences of 10 African American and Latino grandmothers who were the primary caregivers for their HIV-positive grandchildren were investigated. Additionally, the similarities and differences between the two groups were studied. Four themes identified were (a) upholding the primacy of the family, (b) living in the child-centered present, (c) being strong as mature women, and (d) living within a constricting environment. Twelve subthemes expanded and clarified the meaning of these themes. Although there were differences related to family structure and cultural backgrounds, the grandmothers were more alike than different.

  19. 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

  20. 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/

  1. The Measurement of Performance skills of Primary Maternal Child Health Workers - An Indian Experiment

    Directory of Open Access Journals (Sweden)

    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.

  2. Outcomes of Primary Transsphenoidal Surgery in Cushing Disease: Experience of a Tertiary Center.

    Science.gov (United States)

    Keskin, Fatma Ela; Ozkaya, Hande Mefkure; Bolayirli, Murat; Erden, Secil; Kadioglu, Pınar; Tanriover, Necmettin; Gazioglu, Nurperi

    2017-10-01

    To report the initial and long-term remission rates and related factors, secondary treatments, and outcomes of a series of patients with Cushing disease (CD). We included 147 consecutive adult patients with CD who underwent primary transsphenoidal surgery (TSS) between 1998 and 2014 in this study. Eighty-two were followed up in the Cerrahpasa Medical Faculty Endocrinology and Metabolism outpatient clinic. Patients were requested to attend a long-term remission assessment; 55 could be contacted, and data for the remaining 27 patients' last visit to the outpatient clinics were reviewed for early and late remission. Six patients were excluded from the study. Magnetic resonance imaging (MRI) findings and pathologic results including mitosis, Ki-67 levels, and P53 in immunostaining of all patients were evaluated. Data of 82 patients with CD with an average age of 36 years [interquartile range: 29-47] were analyzed with a mean follow-up of 7.5 years [interquartile range: 5-10]. Overall initial remission rates were 72.3% after TSS. Among the 82 patients, 16 patients had Gamma Knife radiosurgery and 7 patients underwent adrenalectomy. After these additional treatments, the long-term remission rate was found as 69.7%. The highest remission rates were with microadenomas. Recurrence was most frequently seen in patients without tumor evidence on MRI. Patients with high Ki-67 levels had higher recurrence rates in long-term follow-up (P = 0.02). Life-long follow-up for patients with CD seems essential. Undetectable tumors on MRI before TSS and high Ki-67 immunopositivity were found as risk factors for tumor recurrence. Copyright © 2017 Elsevier Inc. All rights reserved.

  3. PWR primary system chemistry: Experience with elevated pH at Millstone Point Unit 3

    International Nuclear Information System (INIS)

    Bergmann, C.A.; McAtee, K.R.; Roesmer, J.

    1990-08-01

    The maintenance of an elevated pH of the hot reactor coolant in several plants for a fraction of their respective fuel cycles confirmed earlier laboratory findings that an elevated pH (>6.9 at temperature) resulted in reduced component radiation fields. In view of the potential radiological benefits of elevated coolant pH operation, Northeast Utilities (NU) in support of an EPRI- Westinghouse program, agreed to operate the Millstone 3 plants as a demonstration of elevated coolant pH during operation with extended fuel cycles. This report represents the data and describes the effects of operation of the Millstone 3 cycle 2 core at an elevated hot coolant pH of 7.0--7.5 on Zircaloy cladding corrosion, and on the buildup of core crud and excore radiation fields. The following preliminary conclusion were made based on an evaluation of the data obtained after one cycle of Millstone 3 elevated coolant pH operation. Although some of the measured zirconium dioxide thicknesses are greater than expected, the data does not indicate a significant lithium effect on the corrosion rate of the fuel cladding because of the relatively high variability of thickness measurements on rods of similar duty. There was no observable effect of the higher pH operation on any of the other fuel assembly components. Changes in core crude deposit thickness, chemical and radiochemical composition and apparent residence time were noted. These changes are consistent with the expected effects of a more dissolving coolant on activity and crud transport in a primary circuit. The overall radiation exposure rate trends from cycle 1 to cycle 2 indicated a favorable effect of the higher pH operation. 17 figs., 11 tabs

  4. Role of adrenal vein sampling in primary aldosteronism: the Monash Health experience.

    Science.gov (United States)

    Teng, J; Hutchinson, M E; Doery, J C G; Choy, K W; Chong, W; Fuller, P J; Yang, J

    2015-11-01

    Adrenal vein sampling (AVS) is useful for distinguishing unilateral versus bilateral hypersecretion in primary aldosteronism (PA), but is technically challenging. Furthermore, the use of adrenocorticotropic hormone (ACTH)-stimulation in AVS is controversial. We implemented a Monash Health-specific AVS protocol in 2010. The audit aimed to: (i) examine the impact of a dedicated protocol on success rates of AVS at a tertiary referral centre; (ii) evaluate the impact of AVS on sub-typing of PA; and (iii) assess the utility of ACTH stimulation in AVS. AVS was performed on patients with PA confirmed by positive saline suppression testing (aldosterone level >140 pmol/L post-saline infusion), with sequential sampling of adrenal and peripheral veins, pre- and post-ACTH infusion. Patients with unilateral aldosterone-producing adenoma diagnosed on successful AVS were referred for adrenalectomy. Between 2010 and 2014 inclusive, a total of 28 AVS procedures was performed, with complete pre- and post-ACTH data for 19 procedures. Bilateral successful cannulation rates improved post-implementation of our protocol (61% vs 41%). Of the patients, 32% had discordant imaging and AVS results: four patients with unilateral adenomas did not lateralise on AVS and were managed medically; four patients with bilateral or no adenomas on imaging, lateralised on AVS and had surgery. Overall, use of ACTH did not increase successful cannulation and tended to mask lateralisation. AVS is crucial in subtype classification of PA and should be performed by a dedicated radiologist with a standardised protocol. AVS outcomes were not improved with the use of ACTH stimulation. © 2015 Royal Australasian College of Physicians.

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

    International Nuclear Information System (INIS)

    Abdullah, Basri Johan Jeet; Yeong, Chai Hong; Goh, Khean Lee; Yoong, Boon Koon; Ho, Gwo Fuang; Yim, Carolyn Chue Wai; Kulkarni, Anjali

    2014-01-01

    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.)

  6. Radiologic appearance of primary anomalies of lung lymphatics. Review and experience

    International Nuclear Information System (INIS)

    Kirchner, J.; Jacobi, V.; Stein, A.; Berkefeld, J.; Thalhammer. A.; Kollath, J.

    1997-01-01

    Congenital disorders of the lymphatics of the lung are rare. On the basis of a literature review and our own experiences the disorders are divided into four groups and their radiographic findings are described. Pulmonary lymphangiectasia shows not typical signs. As an expression of the underlying pathophysiologic processes CT shows thickening of interlobular septs, interstitial edema and pleural effusions. Neither architectural distraction nor thickening of intralobular septs was seen. Lymphangioleiomyomatosis shows rather typical findings with multiple thin-walled bullae. In contrast to the opinion that architectural distraction is not seen in LAM we sometimes found signs of fibrosis. Disseminated pulmonary lymphangioma is characterised by proliferation of lymph vessels. CT-findings of this disorder have not been described before. CT shows multiple disseminated nodules of up to 2.5 cm accompanied by multiple bullae of similar distribution and size. (orig.) [de

  7. 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.)

  8. Policy Levers Key for Primary Health Care Organizations to Support Primary Care Practices in Meeting Medical Home Expectations: Comparing Leading States to the Australian Experience

    OpenAIRE

    Takach, Mary

    2016-01-01

    Abstract Several countries with highly ranked delivery systems have implemented locally-based, publicly-funded primary health care organizations (PHCOs) as vehicles to strengthen their primary care foundations. In the United States, state governments have started down a similar pathway with models that share similarities with international PHCOs. The objective of this study was to determine if these kinds of organizations were working with primary care practices to improve their ability to pr...

  9. Cryotherapy for conjunctival primary acquired melanosis and malignant melanoma. Experience with 62 cases.

    Science.gov (United States)

    Jakobiec, F A; Rini, F J; Fraunfelder, F T; Brownstein, S

    1988-08-01

    Sixty-two patients were treated by some combination of cryotherapy and surgery with an average follow-up of 3.3 years for one of the following diseases: focal or diffuse flat conjunctival primary acquired melanosis (PAM) with atypia but without a nodule of melanoma (10 cases); unifocal malignant melanoma with or without focal or diffuse PAM (30 cases); and multinodular/multicentric melanoma with and without PAM (22 cases). Of the ten patients who had PAM with atypia, invasive nodules of malignant melanoma did not develop. A second treatment was required to control the disease in four of the ten patients with extensive or diffuse lesions, and one has mild persistent disease. Of the 30 patients with unifocal nodules of malignant melanoma, 27 remained free of recurrence after one treatment, and 2 are asymptomatic after two treatments. One patient with a thick nodule at presentation required a parotidectomy and radical neck dissection for cervical metastases after recurrence in the conjunctival sac. In the group of 22 patients with multinodular malignant melanoma, only two did not have recurrent disease after one treatment. Of those who received multiple therapies, seven remained free of recurrence for at least 2 years after the last treatment; regional or distant metastases developed in nine; four required exenteration; and eight died. Conjunctival adjunctive cryotherapy avoids exenteration in extensive lesions of pure PAM and in unifocal melanoma, but even after multiple therapies, multinodular malignant melanoma had a 45% rate of metastasis. Metastasis was related to the presence of PAM sine pigmento in four patients (microscopically but not clinically detectable PAM); to the location of the nodules (9 of 10 patients who experienced metastases had forniceal, palpebral, and/or caruncular nodules); to the thickness or depth of invasion of the nodules (greater than 2 mm); and to the development of intralymphatic spread ("in-transit" local metastasis) within the

  10. 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.

  11. Primary experiment aimed at selecting the suitable dose to mutation induction in two soybean cultivars

    International Nuclear Information System (INIS)

    Nabulsi, I.; Mir Ali, N

    1991-07-01

    Seeds from two soybean [Glycine Max L. (Merrill)] cultivars K-25 and K-38 were irradiated with the following doses of gamma rays: 100, 150, 200, 250, 300, 350, 400 and 500 Gy. The dose rate was 9.25 Gy/minute. A week after irradiation 25 seeds were sown from each variety in pots (26.5 x 26.5 cm) with 4 replicates in a randomized complete block design under greenhouse conditions. The distance between the cotyledon and the first leaf was measured 4 weeks after sowing and the results showed stimualtion effect in the 100 and 150 Gy doses in comparison to the control whereas in the higher doses, a gradual reduction was realized in addition to the appearance of the necrotic spots on the leaves which was increased in percentages along with the dose. The results indicated that doses between 100 and 200 Gy achieved the highest rate of mutations with minimal rate of lethality hence achieving the aim of this preliminary experiment. (author). 5 refs., 2 tabs., 2 figs

  12. Living with companion animals after stroke: experiences of older people in community and primary care nursing.

    Science.gov (United States)

    Johansson, Maria; Ahlström, Gerd; Jönsson, Ann-Cathrin

    2014-12-01

    Older people often have companion animals, and the significance of animals in human lives should be considered by nurses-particularly in relation to older people's health, which can be affected by diseases. The incidence of stroke increases with age and disabilities as a result of stroke are common. This study aimed to explore older people's experiences of living with companion animals after stroke, and their life situation with the animals in relation to the physical, psychological and social aspects of recovery after stroke. The study was performed using individual interviews approximately 2 years after stroke with 17 participants (10 women and 7 men) aged 62-88 years. An overarching theme arising from the content analysis was contribution to a meaningful life. This theme was generated from four categories: motivation for physical and psychosocial recovery after stroke; someone to care for who cares for you; animals as family members; and providers of safety and protection. The main conclusion was that companion animals are experienced as physical and psychosocial contributors to recovery and a meaningful life after stroke.

  13. 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

  14. 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.

  15. 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.

  16. When parents won't vaccinate their children: a qualitative investigation of australian primary care providers' experiences.

    Science.gov (United States)

    Berry, Nina J; Henry, Alexandra; Danchin, Margie; Trevena, Lyndal J; Willaby, Harold W; Leask, Julie

    2017-01-17

    Increasingly, the experiences and perceptions of parents who decline vaccination are the subject of investigation. However, the experiences of clinicians who encounter these parents in the course of their work has received little academic attention to date. This study aimed to understand the challenges faced and strategies used when general practitioners and immunising nurses encounter parents who choose not to vaccinate their children. Primary care providers were recruited from regions identified through the Australian Childhood Immunisation Register (ACIR) as having higher than national average rates of registered objection to childhood vaccination. Interviews began with an exploration of provider experiences with parents who accept, are hesitant towards, and who decline vaccination. Participants were asked specifically about how they addressed any difficulties they encountered in their interactions. Thematic analysis focused on encounters with parents - challenges and strategies. Twenty-six general practitioners (GPs), community and practice nurses (PNs) were interviewed across two regions in NSW, Australia. Providers' sense of professional identity as health advocates and experts became conflicted in their encounters with vaccine objecting parents. Providers were dissatisfied when such consultations resulted in a 'therapeutic roadblock' whereby provider-parent communication came to a standstill. There were mixed views about being asked to sign forms exempting parents from vaccinating their children. These ranged from a belief that completing the forms rewarded parents for non-conformity to seeing it as a positive opportunity for engagement. Three common strategies were employed by providers to navigate through these challenges; 1) to explore and inform, 2) to mobilise clinical rapport and 3) to adopt a general principle to first do no harm to the therapeutic relationship. Many healthcare providers find consultations with vaccine objecting parents challenging

  17. Qualitative interview study of parents' perspectives, concerns and experiences of the management of lower respiratory tract infections in children in primary care

    NARCIS (Netherlands)

    Halls, Amy; Van'T Hoff, Catherine; Little, Paul; Verheij, Theo; Leydon, Geraldine M.

    2017-01-01

    Objective To explore parents' perspectives, concerns and experiences of the management of lower respiratory tract infections (LRTIs) in children in primary care. Design Qualitative semistructured interview study. Setting UK primary care. Participants 23 parents of children aged 6 months to 10 years

  18. 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…

  19. The South China Sea Mesoscale Eddy Experiment (S-MEE) and Its Primary Findings

    Science.gov (United States)

    Zhang, Z.; Tian, J.; Zhao, W.; Qiu, B.

    2016-02-01

    South China Sea (SCS), the largest marginal sea in the northwestern Pacific, have strong eddy activities as revealed by both satellite and in situ observations. The 3D structures of the SCS mesoscale eddies and their lifecycles, including the generation and dissipation processes, are, however, still not well understood at present because of the lack of well-designed field observations. In order to address the above two scientific issues (3D structure and lifecycle of SCS mesoscale eddies), the SCS Mesoscale Eddy Experiment (S-MEE for short) was designed and conducted in the period from October 2013 to June 2014. As part of S-MEE, two bottom-anchored subsurface mooring arrays with one consisting of 10 moorings and the other 7 moorings, were deployed along the historical pathway of the mesoscale eddies in the northern SCS. All the moorings were equipped with ADCPs, RCMs, CTDs and temperature chains to make continues measurements of horizontal current velocity and temperature/salinity in the whole water column. During the S-MEE, a total of 5 distinct mesoscale eddies were observed to cross the mooring arrays, among which one anticyclonic and cyclonic eddy pair was fully captured by the mooring arrays. In addition to moored observations, we also conducted two transects across the center of the anticyclonic eddy and made high-resolution hydrographic and turbulent mixing measurements. Based on the data collected by the S-MEE and concurrent satellite-derived observations, we constructed the full-depth 3D structure of the eddy pair and analyzed its generation and dissipation mechanisms. We found that the eddies extend from the surface to the sea bottom and display prominent tilted structures in the vertical. By conducting an eddy energy budget analysis, we further identified that generation of submesoscale motions constitutes the dominant mechanism for the oceanic eddy dissipation.

  20. 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.

  1. 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

    2018-03-01

    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.

  2. Predicting ion exchange resins decontamination factors. Experiments on synthetic primary coolant containing Ni, Co and Ag and modeling results

    International Nuclear Information System (INIS)

    Bachet, Martin; Schneider, Hélène; Jauberty, Loïc; Windt, Laurent De; Dieuleveult, Caroline de; Tevissen, Etienne

    2014-01-01

    Experiments performed under chemical and flow conditions representative of pressurized water reactors (PWR) primary fluid purification by ion exchange resins (Amberlite IRN9882) are modeled with the OPTIPUR code, considering 1D reactive transport in the mixed-bed column with convective/dispersive transport between beads and electro-diffusive transport within the boundary film around the beads. The effectiveness of the purification in these dilute conditions is highly related to film mass transfer restrictions, which are accounted for by adjustment of a common mass transfer coefficient (MTC) on the experimental initial leakage or modeling of species diffusion through the bead film by the Nernst-Planck equation. A detailed analysis of the modeling against experimental data shows that the Nernst-Planck approach with no adjustable parameters performs as well as, or better, than the MTC approach, particularly to simulate the chromatographic elution of silver by nickel and the subsequent enrichment of the solution in the former metal. (author)

  3. 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.

  4. 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.

  5. District nurses' experience of supervising nursing students in primary health care: A pre- and post-implementation questionnaire study.

    Science.gov (United States)

    Bos, Elisabeth; Löfmark, Anna; Törnkvist, Lena

    2009-11-01

    Nursing students go through clinical supervision in primary health care settings but district nurses' (DNs) circumstances when supervising them are only briefly described in the literature. The aim of this study was to investigate DNs experience of supervising nursing students before and after the implementation of a new supervision model. Ninety-eight (74%) DNs answered a questionnaire before and 84 (65%) after implementation of the new supervision model. The study showed that DNs in most cases felt that conditions for supervision in the workplace were adequate. But about 70% lacked training for the supervisory role and 20% had no specialist district nurse training. They also experienced difficulty in keeping up-to-date with changes in nurse education programmes, in receiving support from the university and from their clinic managers, and in setting aside time for supervision. Improvements after the implementation of a new model chiefly concerned organisation; more DNs stated that one person had primary responsibility for students' clinical practice, that information packages for supervisors and students were available at the health care centres, and that conditions were in place for increasing the number of students they supervised. DNs also stated that supervisors and students benefited from supervision by more than one supervisor. To conclude, implementation of a new supervision model resulted in some improvements.

  6. 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.

  7. Towards unity for health in the Barceloneta: an innovative experience in community-based primary health care.

    Science.gov (United States)

    Segura, Andreu; Miller, Frederick A; Foz, Goncal; Oriol y Bosch, Albert

    2007-08-01

    This paper describes a unique experience in community-based primary care in the Barceloneta, an economically deprived neighbourhood in Barcelona, Spain. The paper analyzes the reasons for the successes and failures of the project in light of TUFH principles. The Primary Care Team (PCT) that staffed and ran the Health Centre in the Barceloneta facilitated the active participation of entities and individuals from the neighbourhood in deciding questions of care provision and resource allocation. They also collaborated with other service providers in the neighbourhood including pharmacists, with whom the PCT developed a program for monitoring diabetic and hypertensive patients in the local pharmacies. The health centre registered some of the best outcomes in Barcelona, including: time spent with each patient; capacity for the physicians to resolve patient visits without a referral; and patient satisfaction. Outcomes for patients followed by their local pharmacists were equivalent to those seen in the clinic, with lower costs. Despite these impressive results, conflicts among and between various stakeholders led to the project's termination. Innovations in any system can lead to conflicts of interest between stakeholders, derailing even demonstrably effective programs. A stable partnership with other stakeholders, particularly the community and health care administrators, in this case, is key. However, the community is not monolithic, and efforts must be made to ensure that other stakeholders do not widen intercommunity disputes. Effective dissemination of information on the impact of the project on the population is important to maintain relationships with the various stakeholders.

  8. CT-guided thin needles percutaneous cryoablation (PCA) in patients with primary and secondary lung tumors: A preliminary experience

    Energy Technology Data Exchange (ETDEWEB)

    Pusceddu, Claudio, E-mail: clapusceddu@gmail.com [Division of Interventional Radiology, Department of Oncological Radiology, Businco Hospital, Regional Referral Center for Oncologic Diseases, Cagliari, Zip code 09100 (Italy); Sotgia, Barbara, E-mail: barbara.sotgia@gmail.com [Department of Oncological Radiology, Businco Hospital, Regional Referral Center for Oncological Diseases, Cagliari, Zip code 09100 (Italy); Fele, Rosa Maria, E-mail: rosellafele@tiscali.it [Department of Oncological Radiology, Businco Hospital, Regional Referral Center for Oncological Diseases, Cagliari, Zip code 09100 (Italy); Melis, Luca, E-mail: doclucamelis@tiscali.it [Department of Oncological Radiology, Businco Hospital, Regional Referral Center for Oncological Diseases, Cagliari, Zip code 09100 (Italy)

    2013-05-15

    Purpose: To report the data of our initial experience with CT-guided thin cryoprobes for percutaneous cryoablation (PCA) in patients with primary and secondary pulmonary tumors. Material and methods: CT-guided thin needles PCA was performed on 34 lung masses (11 NSCLC = 32%; 23 secondary lung malignancies = 68%) in 32 consecutive patients (24 men and 8 women; mean age 67 ± 10 years) not suitable for surgical resection. Lung masses were treated using two types of cryoprobes: IceRod and IceSeed able to obtain different size of iceball. The number of probes used ranged from 1 to 5 depending on the size of the tumor. After insertion of the cryoprobes into the lesion, the PCA were performed with two 2 (91%) or 3 (9%) cycles each of 12 min of freezing followed by a 4 min active thawing phase and a 4 min passive thawing phase for each one for all treatments. Results: All cryoablation sessions were successfully completed. All primary and metastatic lung tumors were ablated. No procedure-related deaths occurred. Morbidity consisted of 21% (7 of 34) pneumothorax and 3% (1 of 34) cases asymptomatic small pulmonary hemorrhage, respectively, all of CTCAE grade 1 (Common Terminology Criteria for Adverse Events). Low density of entire lesion, central necrosis and solid mass appearance were identify in 21 (62%), 7 (21%) and 6 (17%) of cryoablated tumors, respectively. No lymphadenopathy developed in the region of treated lesions. Technical success (complete lack of enhancement) was achieved in 82%, 97% and 91% of treated lesions at 1-, 3- and 6-months CT follow-up scan, respectively (p < .000). Comparing the tumor longest diameter between the baseline and at 6 month CT images, technical success was revealed in 92% cases (p < .000). Conclusion: Our preliminary experience suggests that PCA is a feasible treatment option. Well-designed clinical trials with a larger patient population are necessary to further investigate the long-term results and prognostic factors.

  9. Maximum utilization of primary reformer catalyst tubes careful assessment of remaining life-An experience at an ammonia plant

    International Nuclear Information System (INIS)

    Malik, M.A.

    2005-01-01

    Condition evaluation and residual life assessment of Reformer Catalyst Tubes has always been a point of concern for Ammonia and Methanol Plant operators. Failure of catalyst tubes results in total plant shutdown and consequent production loss. On the other hand, replacement of these tubes entails major cost impact on the company's budget, being a capital expenditure. A careful Residual Life Assessment of the tubes is therefore of utmost importance for maximum utilization of these tubes without jeopardizing plant operational reliability. This paper presents an experience of extracting maximum service life from the catalyst tubes of Primary Reformer of an Ammonia Plant. Fauji Fertilizer Company (FFC) has been operating the plant since 1982, having a designed capacity of 1100 MTPD. Its Primary Reformer has 288 catalyst tubes of IN-519 material (24Cr-24Ni-Nb). The design temperature and pressures are 925 degree C and 38kg/Cm respectively. Thanks to the optimum operating conditions, regular inspections and careful assessment of the residual life, the tubes have achieved more than double of the designed life and are still operating reliably. To evaluate the tube's health, Ultrasonic Inspection (UT) was carried out in 1987 and 1994 using attenuation technique. The tubes with maximum attenuation were marked for further evaluation. Accelerated Creep Rupture Test was carried out on sample tubes periodically (1996, 2001 and 2004). Tubes were selected on the basis of UT results, TMT (Tube Metal Temperature) monitoring and Inspection findings. Based on the combined results of DT, NDT, equipment history and foreseen operational parameters, the life of these tubes was carefully assessed periodically. The tubes have been in service for more than 23 years (design life: 11 years) and a further life of 04 years has been predicted as per last assessment.The experience of successful health evaluation and residual life assessment has saved substantial cost involved in tubes replacement

  10. 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.

  11. 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

  12. Generic safety documentation model

    International Nuclear Information System (INIS)

    Mahn, J.A.

    1994-04-01

    This document is intended to be a resource for preparers of safety documentation for Sandia National Laboratories, New Mexico facilities. It provides standardized discussions of some topics that are generic to most, if not all, Sandia/NM facilities safety documents. The material provides a ''core'' upon which to develop facility-specific safety documentation. The use of the information in this document will reduce the cost of safety document preparation and improve consistency of information

  13. Strengthening "the Foundations" of the Primary School Curriculum

    Science.gov (United States)

    Duncombe, Rebecca; Cale, Lorraine; Harris, Jo

    2018-01-01

    The low status of the foundation subjects (e.g. Music and Physical Education (PE)) in English primary schools is well documented. Using PE as an illustrative example, a thematic analysis of 51 PE trainee students' assignments, based on their perceptions of a two-week experience in a primary school, highlighted a number of areas of concern (e.g.…

  14. A Pb-TLD spectrometer to measure high energy photons in z-pinch experiments on the primary test stand

    International Nuclear Information System (INIS)

    Si, Fenni; Yang, Jianlun; Xu, Rongkun; Yuan, Xi; Huang, Zhanchang; Ye, Fan; Wang, Dong; Zhang, Chuanfei

    2017-01-01

    Highlights: • A Pb-TLD spectrometer has been developed to measure spectra of high energy photons in wire-array z pinches on PTS. • Energy spectra of high energy photons on PTS has been firstly obtained by unfolding programs developed with MATLAB code. • The energy of high energy x-ray on PTS is obtained to be mainly within the region of 100 keV to 1.3 MeV. - Abstract: A Pb-TLD spectrometer has been developed based on attenuation techniques to measure high energy photons in wire-array z-pinch experiments on the primary test stand (PTS). It is composed of a stack of 18 lead filters interspersed with 19 thermoluminescent dosimeters (TLD). A shield is constructed for the spectrometer and scattered radiation is reduced to less than 5% by the shield. Response functions of the spectrometer are calculated by MCNP5 for 0–2 MeV photons. Based on response functions and 19 dose data measured in experiments, energy spectra of high energy photons on PTS has been firstly obtained by unfolding programs developed with MATLAB code using iterative least square fit. Results show that energy peak locates within 200 keV and 300 keV, and the fluence decreases to background level at energy higher than 1.3 MeV.

  15. A Pb-TLD spectrometer to measure high energy photons in z-pinch experiments on the primary test stand

    Energy Technology Data Exchange (ETDEWEB)

    Si, Fenni; Yang, Jianlun; Xu, Rongkun; Yuan, Xi; Huang, Zhanchang; Ye, Fan; Wang, Dong; Zhang, Chuanfei, E-mail: sifenni@163.com

    2017-05-15

    Highlights: • A Pb-TLD spectrometer has been developed to measure spectra of high energy photons in wire-array z pinches on PTS. • Energy spectra of high energy photons on PTS has been firstly obtained by unfolding programs developed with MATLAB code. • The energy of high energy x-ray on PTS is obtained to be mainly within the region of 100 keV to 1.3 MeV. - Abstract: A Pb-TLD spectrometer has been developed based on attenuation techniques to measure high energy photons in wire-array z-pinch experiments on the primary test stand (PTS). It is composed of a stack of 18 lead filters interspersed with 19 thermoluminescent dosimeters (TLD). A shield is constructed for the spectrometer and scattered radiation is reduced to less than 5% by the shield. Response functions of the spectrometer are calculated by MCNP5 for 0–2 MeV photons. Based on response functions and 19 dose data measured in experiments, energy spectra of high energy photons on PTS has been firstly obtained by unfolding programs developed with MATLAB code using iterative least square fit. Results show that energy peak locates within 200 keV and 300 keV, and the fluence decreases to background level at energy higher than 1.3 MeV.

  16. Experience-induced plasticity of cutaneous maps in the primary somatosensory cortex of adult monkeys and rats.

    Science.gov (United States)

    Xerri, C; Coq, J O; Merzenich, M M; Jenkins, W M

    1996-01-01

    In a first study, the representations of skin surfaces of the hand in the primary somatosensory cortex, area 3b, were reconstructed in owl monkeys and squirrel monkeys trained to pick up food pellets from small, shallow wells, a task which required skilled use of the digits. Training sessions included limited manual exercise over a total period of a few hours of practice. From an early clumsy performance in which many retrieval attempts were required for each successful pellet retrieval, the monkeys exhibited a gradual improvement. Typically, the animals used various combinations of digits before developing a successful retrieval strategy. As the behavior came to be stereotyped, monkeys consistently engaged surfaces of the distal phalanges of one or two digits in the palpation and capture of food pellets from the smallest wells. Microelectrode mapping of the hand surfaces revealed that the glabrous skin of the fingertips predominantly involved in the dexterity task was represented over topographically expanded cortical sectors. Furthermore, cutaneous receptive fields which covered the most frequently stimulated digital tip surfaces were less than half as large as were those representing the corresponding surfaces of control digits. In a second series of experiments, Long-Evans rats were assigned to environments promoting differential tactile experience (standard, enriched, and impoverished) for 80 to 115 days from the time of weaning. A fourth group of young adult rat experienced a severe restriction of forepaw exploratory movement for either 7 or 15 days. Cortical maps derived in the primary somatosensory cortex showed that environmental enrichment induced a substantial enlargement of the cutaneous forepaw representation, and improved its spatial resolution (smaller glabrous receptive fields). In contrast, tactile impoverishment resulted in a degradation of the forepaw representation that was characterized by larger cutaneous receptive fields and the emergence of

  17. Primary, new and export production in the NW Pacific subarctic gyre during the vertigo K2 experiments

    Science.gov (United States)

    Elskens, M.; Brion, N.; Buesseler, K.; Van Mooy, B. A. S.; Boyd, P.; Dehairs, F.; Savoye, N.; Baeyens, W.

    2008-07-01

    This paper presents results on tracer experiments using 13C and 15N to estimate uptake rates of dissolved inorganic carbon (DIC) and nitrogen (DIN). Experiments were carried out at station K2 (47°N, 161°E) in the NW Pacific subarctic gyre during July-August 2005. Our goal was to investigate relationships between new and export production. New production was inferred from the tracer experiments using the f ratio concept (0-50 m); while export production was assessed with neutrally buoyant sediment traps (NBSTs) and the e ratio concept (at 150 m). During trap deployments, K2 was characterized both by changes in primary production (523-404 mg C m -2 d -1), new production (119-67 mg C m -2 d -1), export production (68-24 mg C m -2 d -1) and phytoplankton composition (high to low proportion of diatoms). The data indicate that 17-23% of primary production is exportable to deeper layers ( f ratio) but only 6-13% collected as a sinking particle flux at 150 m ( e ratio). Accordingly, >80% of the carbon fixed by phytoplankton would be mineralized in the upper 50 m (1- f), while <11% would be within 50-150 m ( f- e). DIN uptake flux amounted to 0.5 mM m -2 h -1, which was equivalent to about 95% particulate nitrogen (PN) remineralized and/or grazed within the upper 150 m. Most of the shallow PN remineralization occurred just above the depth of the deep chlorophyll maximum (DCM), where a net ammonium production was measured. Below the DCM, while nitrate uptake rates became negligible because of light limitation, ammonium uptake did continue to be significant. The uptake of ammonium by heterotrophic bacteria was estimated to be 14-17% of the DIN assimilation. Less clear are the consequences of this uptake on the phytoplankton community and biogeochemical processes, e.g. new production. It was suggested that competition for ammonium could select for small cells and may force large diatoms to use nitrate. This implies that under Fe stress as observed here, ammonium uptake is

  18. 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

  19. 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.

  20. Using Participatory Learning & Action (PLA) research techniques for inter-stakeholder dialogue in primary healthcare: an analysis of stakeholders' experiences.

    Science.gov (United States)

    de Brún, T; O'Reilly-de Brún, M; Van Weel-Baumgarten, E; Burns, N; Dowrick, C; Lionis, C; O'Donnell, C; Mair, F S; Papadakaki, M; Saridaki, A; Spiegel, W; Van Weel, C; Van den Muijsenbergh, M; MacFarlane, A

    2017-01-01

    It is important for health care workers to know the needs and expectations of their patients. Therefore, service users have to be involved in research. To achieve a meaningful dialogue between service users, healthcare workers and researchers, participatory methods are needed. This paper describes how the application of a specific participatory methodology, Participatory Learning and Action (PLA) can lead to such a meaningful dialogue. In PLA all stakeholders are regarded as equal partners and collaborators in research.During 2011-2015, a European project called RESTORE used PLA in Austria, Greece, Ireland, The Netherlands and the UK to investigate how communication between primary health care workers and their migrant patients could be improved.Seventy eight migrants, interpreters, doctors, nurses and other key stakeholders (see Table 2) participated in 62 PLA sessions. These dialogues (involving discussions, activities, PLA techniques and evaluations) were generally 2-3 h long and were recorded and analysed by the researchers.Participants reported many positive experiences about their dialogues with other stakeholders. There was a positive, trusting atmosphere in which all stakeholders could express their views despite differences in social power. This made for better understanding within and across stakeholder groups. For instance a doctor changed her view on the use of interpreters after a migrant explained why this was important. Negative experiences were rare: some doctors and healthcare workers thought the PLA sessions took a lot of time; and despite the good dialogue, there was disappointment that very few migrants used the new interpreting service. Background In order to be effective, primary healthcare must understand the health needs, values and expectations of the population it serves. Recent research has shown that the involvement of service users and other stakeholders and gathering information on their perspectives can contribute positively to many

  1. 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

    2018-01-01

    experiences from the perspectives of students, their patients and supervisors, representing five healthcare disciplines. Students particularly valued the pedagogical atmosphere and the supervisory relationship. Patients expressed high satisfaction with the care provided. Supervisors expressed that the structure of the SRC supported the pedagogical assignment and facilitated student-centered tuition – simultaneously the altered learning environment highlighted the need for further pedagogical education. Student-run clinics in primary health care have great potential for student-regulated learning. PMID:29368978

  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. 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

  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

    2013-07-01

    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

  5. Clinician perceptions and patient experiences of antiretroviral treatment integration in primary health care clinics, Tshwane, South Africa

    Directory of Open Access Journals (Sweden)

    Maphuthego D. Mathibe

    2015-10-01

    Full Text Available Background: Primary Health Care (PHC clinicians and patients are major role players in the South African antiretroviral treatment programme. Understanding their perceptions and experiences of integrated care and the management of people living with HIV and AIDS in PHC facilities is necessary for successful implementation and sustainability of integration. Objective: This study explored clinician perceptions and patient experiences of integration of antiretroviral treatment in PHC clinics. Method: An exploratory, qualitative study was conducted in four city of Tshwane PHC facilities. Two urban and two rural facilities following different models of integration were included. A self-administered questionnaire with open-ended items was completed by 35 clinicians and four focus group interviews were conducted with HIV-positive patients. The data were coded and categories were grouped into sub-themes and themes. Results: Workload, staff development and support for integration affected clinicians’ performance and viewpoints. They perceived promotion of privacy, reduced discrimination and increased access to comprehensive care as benefits of service integration. Delays, poor patient care and patient dissatisfaction were viewed as negative aspects of integration. In three facilities patients were satisfied with integration or semi-integration and felt common queues prevented stigma and discrimination, whilst the reverse was true in the facility with separate services. Single-month issuance of antiretroviral drugs and clinic schedule organisation was viewed negatively, as well as poor staff attitudes, poor communication and long waiting times. Conclusion: Although a fully integrated service model is preferable, aspects that need further attention are management support from health authorities for health facilities, improved working conditions and appropriate staff development opportunities.

  6. Clinician perceptions and patient experiences of antiretroviral treatment integration in primary health care clinics, Tshwane, South Africa.

    Science.gov (United States)

    Mathibe, Maphuthego D; Hendricks, Stephen J H; Bergh, Anne-Marie

    2015-10-02

    Primary Health Care (PHC) clinicians and patients are major role players in the South African antiretroviral treatment programme. Understanding their perceptions and experiences of integrated care and the management of people living with HIV and AIDS in PHC facilities is necessary for successful implementation and sustainability of integration. This study explored clinician perceptions and patient experiences of integration of antiretroviral treatment in PHC clinics. An exploratory, qualitative study was conducted in four city of Tshwane PHC facilities. Two urban and two rural facilities following different models of integration were included. A self-administered questionnaire with open-ended items was completed by 35 clinicians and four focus group interviews were conducted with HIV-positive patients. The data were coded and categories were grouped into sub-themes and themes. Workload, staff development and support for integration affected clinicians' performance and viewpoints. They perceived promotion of privacy, reduced discrimination and increased access to comprehensive care as benefits of service integration. Delays, poor patient care and patient dissatisfaction were viewed as negative aspects of integration. In three facilities patients were satisfied with integration or semi-integration and felt common queues prevented stigma and discrimination, whilst the reverse was true in the facility with separate services. Single-month issuance of antiretroviral drugs and clinic schedule organisation was viewed negatively, as well as poor staff attitudes, poor communication and long waiting times. Although a fully integrated service model is preferable, aspects that need further attention are management support from health authorities for health facilities, improved working conditions and appropriate staff development opportunities.

  7. Memória e patrimônio documental: a experiência no tratamento arquivístico do acervo da UFV sob guarda do Arquivo Central e Histórico da UFV

    Directory of Open Access Journals (Sweden)

    Aline Maria de Aguiar da Silva

    2015-08-01

    Full Text Available Este trabalho tem por objetivo relatar a experiência com o tratamento e organização do acervo documental sob posse do Arquivo Central e Histórico da UFV, que congrega uma vasta documentação relativa à trajetória da Universidade, desde sua fundação em 1926 até os dias atuais. A partir do trabalho de extensão, foram desenvolvidas atividades de conservação preventiva do acervo, além de possibilitar um espaço de interlocução entre teoria e prática histórica. Palavras chave: Arquivo Central e Histórico da UFV, conservação documental, memória institucional. Áreas temáticas: Comunicação, cultura e educação.

  8. Vietnamese Document Representation and Classification

    Science.gov (United States)

    Nguyen, Giang-Son; Gao, Xiaoying; Andreae, Peter

    Vietnamese is very different from English and little research has been done on Vietnamese document classification, or indeed, on any kind of Vietnamese language processing, and only a few small corpora are available for research. We created a large Vietnamese text corpus with about 18000 documents, and manually classified them based on different criteria such as topics and styles, giving several classification tasks of different difficulty levels. This paper introduces a new syllable-based document representation at the morphological level of the language for efficient classification. We tested the representation on our corpus with different classification tasks using six classification algorithms and two feature selection techniques. Our experiments show that the new representation is effective for Vietnamese categorization, and suggest that best performance can be achieved using syllable-pair document representation, an SVM with a polynomial kernel as the learning algorithm, and using Information gain and an external dictionary for feature selection.

  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. Primary non-refluxive megaureter in children: single-center experience and follow-up of 212 patients.

    Science.gov (United States)

    Rubenwolf, P; Herrmann-Nuber, J; Schreckenberger, M; Stein, R; Beetz, R

    2016-11-01

    Primary non-refluxing megaureter (pMU) is a multifaceted and challenging congenital pathology of the urinary tract. We report our 23-year experience with this anomaly in terms of presentation, diagnostic work-up and management. We retrospectively reviewed the medical records of 212 children diagnosed with pMU between 1986 and 2009 at our institution. Mean follow-up was 45.17 (0-192) months. Of the total, 168 (79 %) children presented with upper urinary tract dilation on perinatal ultrasound screening. In 44 (21 %) patients, the diagnosis was made following diagnostic work-up of a urinary tract infection (UTI, 18 %) or flank pain (3 %). In total, 203 of 254 pMUs (79.9 %) were successfully treated conservatively during the 23-year observation period. Forty-eight children (23 %) underwent ureteric reimplantation. UTIs occurred in 91 of 212 children (43 %). Of these, 41 (45 %) occurred despite antibacterial infection prophylaxis. Within the past three decades, there has been a marked shift from surgical toward conservative therapy at our institution. Neonatal renal ultrasound is the method of choice to timely identify children with pMU and, alongside dynamic renography, to monitor the clinical course. Nowadays, only a minor subset of children with asymptomatic course requires surgical correction. Antibacterial prophylaxis has the potential to reduce the risk of febrile UTIs. Prospective randomized studies are warranted to provide evidence of the beneficial effect of antibacterial prophylaxis.

  11. Providing Telehealth Services to a Public Primary Care Network: The Experience of RedeNUTES in Pernambuco, Brazil.

    Science.gov (United States)

    Diniz, Paula Rejane Beserra; Ribeiro Sales, Fernando José; de Araújo Novaes, Magdala

    2016-08-01

    Information technologies have been applied in primary care domains to improve the delivery of health services. This article reports the telehealth network experience in Pernambuco, Brazil. Five different data sets were used, one by each service and the structural aspects of the network, collected from 2008 until August 2015. The data include solicited themes for educational activities, users' evaluation of services, numbers of sites, municipalities participating, participants in tele-education activities, teleconsultations, telediagnosis, and remote screenings. The analysis was done in absolute and percentage values using Microsoft Excel (version 2007). The indicators show high utilization of tele-education resources, followed by the teleconsultation service. The synchronous modality was the most used and the general clinical question was the most frequent type of question. Nurses are the professional category that most used the teleconsultation services (36%). Telediagnosis of electrocardiography has growth utilization, overcoming teleconsulting more recently. The satisfaction rate was 89%, and 68.5% of professionals changed their planning to patients' referrals to specialists. Telehealth has been considered effective since it avoids inappropriate referrals of the patient and provides continuous actualization to health professionals. Our results provide evidence of the feasibility and importance of using telehealth as a tool to ensure the universality, equality, and completeness in the health system.

  12. Parents’ Experience and Views of Vaccinating Their Child against Influenza at Primary School and at the General Practice

    Directory of Open Access Journals (Sweden)

    Pauline Paterson

    2018-03-01

    Full Text Available The purpose of this study was to gain an in-depth understanding of parents’ experience and views of vaccinating their four to six-year-old child against influenza at school and at the general practice (GP. A cross-sectional qualitative study was conducted between March–June 2016 with parents of children in Reception and Year 1 in four randomly selected schools in Bury, Leicestershire, and Surrey, England. Twenty-five outreach forms were completed and returned, and seven interviews were conducted. Interview transcripts were coded by theme in NVivo (version 11, QSR International Pty Ltd., Melbourne, Australia. The primary reason parents gave for vaccinating their child was to prevent their child from contracting influenza. Parents’ perceived benefits of vaccinating in schools were to avoid the inconvenience of having to take their child to the GP, and that their child would behave better at school. Parents viewed that accompanying their child for the vaccination at school would undermine the convenience and peer-pressure advantages of the school as a venue. No parents expressed concern about their child being too young to be vaccinated in school. This research suggests that the school is a desirable venue for childhood influenza vaccination, both from the parents’ view and given that influenza vaccination coverage is higher when delivered through schools than GPs.

  13. Parents’ Experience and Views of Vaccinating Their Child against Influenza at Primary School and at the General Practice

    Science.gov (United States)

    Schulz, Will; Larson, Heidi J.

    2018-01-01

    The purpose of this study was to gain an in-depth understanding of parents’ experience and views of vaccinating their four to six-year-old child against influenza at school and at the general practice (GP). A cross-sectional qualitative study was conducted between March–June 2016 with parents of children in Reception and Year 1 in four randomly selected schools in Bury, Leicestershire, and Surrey, England. Twenty-five outreach forms were completed and returned, and seven interviews were conducted. Interview transcripts were coded by theme in NVivo (version 11, QSR International Pty Ltd., Melbourne, Australia). The primary reason parents gave for vaccinating their child was to prevent their child from contracting influenza. Parents’ perceived benefits of vaccinating in schools were to avoid the inconvenience of having to take their child to the GP, and that their child would behave better at school. Parents viewed that accompanying their child for the vaccination at school would undermine the convenience and peer-pressure advantages of the school as a venue. No parents expressed concern about their child being too young to be vaccinated in school. This research suggests that the school is a desirable venue for childhood influenza vaccination, both from the parents’ view and given that influenza vaccination coverage is higher when delivered through schools than GPs. PMID:29597341

  14. Parents' Experience and Views of Vaccinating Their Child against Influenza at Primary School and at the General Practice.

    Science.gov (United States)

    Paterson, Pauline; Schulz, Will; Utley, Martin; Larson, Heidi J

    2018-03-28

    The purpose of this study was to gain an in-depth understanding of parents' experience and views of vaccinating their four to six-year-old child against influenza at school and at the general practice (GP). A cross-sectional qualitative study was conducted between March-June 2016 with parents of children in Reception and Year 1 in four randomly selected schools in Bury, Leicestershire, and Surrey, England. Twenty-five outreach forms were completed and returned, and seven interviews were conducted. Interview transcripts were coded by theme in NVivo (version 11, QSR International Pty Ltd., Melbourne, Australia). The primary reason parents gave for vaccinating their child was to prevent their child from contracting influenza. Parents' perceived benefits of vaccinating in schools were to avoid the inconvenience of having to take their child to the GP, and that their child would behave better at school. Parents viewed that accompanying their child for the vaccination at school would undermine the convenience and peer-pressure advantages of the school as a venue. No parents expressed concern about their child being too young to be vaccinated in school. This research suggests that the school is a desirable venue for childhood influenza vaccination, both from the parents' view and given that influenza vaccination coverage is higher when delivered through schools than GPs.

  15. 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.)

  16. 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.)

  17. A chart review of morbidity patterns among adult patients attending primary care setting in urban Odisha, India: An International Classification of Primary Care experience

    Directory of Open Access Journals (Sweden)

    Subhashisa Swain

    2017-01-01

    Full Text Available Introduction: Disease burden estimations based on sound epidemiological research provide the foundation for designing health services. Patients visiting a primary care often present with symptoms and signs. Understanding the burden is crucial for developing countries including India. The project aimed to record the reasons for encounter (RFE at primary care settings for estimating the burden at the health-care facility. Methodology: This cross-sectional study was undertaken at four urban health dispensaries of Bhubaneswar, Odisha, with the aim to explore the prevailing patterns of diseases among patients attending these facilities. Data collection spanned from May to October 2012. At each center, patients' information on age, sex, religion, and presenting illness was extracted from the outpatient records over these time period. Data were entered and analyzed in SPSS version 20, and the International Classification of Primary Care-2 was used for coding the illnesses. Results: In total, 2249 patient's records were extracted over 12 weeks. Out of them, 1241 (55.2% were male with mean age of 41.8 (±15.8 years vis-à -vis 38.2 (±14.1 years for females. Around 151 (6.7% had 2 or more symptoms or conditions. Overall, the most common categories were general and unspecified followed by digestive-related symptoms in both sexes. The most common symptoms among males were fever (11.4%, heart burn (8.1%, and vertigo or dizziness (3.6%. Similar pattern was seen among females. Respiratory (17.0% and cardiovascular (10.2% problems were the most common RFEs among males and females. The most common RFEs for acute care among males and females were fever, allergic rhinitis, upper respiratory tract infection, and acute bronchitis. Leading RFEs for chronic care among males were hypertension uncomplicated, heart burn, low back pain, whereas among females, hypertension and heartburn were mostly seen. Conclusion: Primary care settings are experiencing both communicable

  18. Defense Transuranic Waste Program Strategy Document

    International Nuclear Information System (INIS)

    1984-01-01

    The Defense Transuranic Waste Program (DTWP) Strategy Document presents the general strategy for managing transuranic (TRU) waste materials generated during defense and research activities regulated by the US Department of Energy. The Strategy Document includes discussion of objectives and activities relating to the entire Defense Transuranic Waste Program. However, the primary focus is on the specific management responsibilities of the Transuranic Waste Lead Organization (TLO). The document also includes an updated summary of progress on TLO-managed activities over the past year

  19. 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.

  20. A methodology for software documentation

    OpenAIRE

    Torres Júnior, Roberto Dias; Ahlert, Hubert

    2000-01-01

    With the growing complexity of window based software and the use of object-oriented, the development of software is getting more complex than ever. Based on that, this article intends to present a methodology for software documentation and to analyze our experience and how this methodology can aid the software maintenance

  1. Maximization of primary energy savings of solar heating and cooling systems by transient simulations and computer design of experiments

    International Nuclear Information System (INIS)

    Calise, F.; Palombo, A.; Vanoli, L.

    2010-01-01

    In this paper, the simulation of the performance of solar-assisted heating and cooling systems is analyzed. Three different plant layouts are considered: (i) the first one consists of evacuated solar collectors and a single-stage LiBr-H 2 O absorption chiller; here in order to integrate the system in case of insufficient solar radiation, an electric water-cooled chiller is activated; (ii) configuration of the secondly considered system is similar to the first one, but the absorption chiller and the solar collector area are sized for balancing about 30% of the building cooling load only; (iii) the layout of the thirdly considered system differs from the first one since the auxiliary electric chiller is replaced by a gas-fired heater. Such system configurations also include: circulation pumps, storage tanks, feedback controllers, mixers, diverters and on/off hysteresis controllers. All such devices are modelled for maximizing the system energy efficiency. In order to simulate the systems' performance for dynamic heating/cooling loads, a single-lumped capacitance building is also modelled and implemented in the computer code. A cost model is also developed in order to calculate the systems' operating and capital costs. All the models and the relative simulations are carried out by TRNSYS. A design of experiment procedure is also included. By such tool the effects of the system operating parameters' variation on the relative energy efficiency are analyzed. In addition, the set of synthesis/design variables maximizing the system's energetic performance can be also identified. The annual primary energy saving is chosen as the optimization objective function, whereas collector slope, pump flows, set-point temperatures and tank volume are selected as optimizing system design variables. A case study was developed for an office building located in South Italy. Here, the energetic and the economic analysis for all the three considered system layouts are carried out. The

  2. Introduction on KPS's maintenance experience of the swirl vane assemblies of primary separators for SG model F in Korea

    International Nuclear Information System (INIS)

    Kim, Yong tae

    2003-01-01

    Recently, we had experienced to replace the Swirl Vane Assemblies of primary moisture separator for SG model F in Korea because of serious degradation (Thinning) in carbon steel swirl vane blades and carbon steel separator barrel wall adjacent to swirl vane blades. When the symptom was observed by us at the first time on the swirl vane assemblies, there were small or a bit clear erosion / or corrosion marks on the edge regions of the blades but within 3 cycles of operation, we found that those marks became holes which penetrated the most of swirl vane assemblies and even more seriously, some parts of the assemblies were worn-out. Therefore, we concluded that the speed of degradation would be very rapid and serious from the beginning stage. It had been assumed that these kinds of thinning problems would be due to FAC(Flow Accelerated Corrosion) because the plants having these problems are using a highly concentrated hydrazine for the water treatment of secondary side which lead to reduce the oxygen and pH in the water. What are more serious reasons will be that the swirl vane assemblies are very weak to FAC because they were made by a low concentrated chromium carbon steel and the assemblies would have to be under the operation conditions of the highly turbulent steam-water mixed fluid with the operating temperature of higher than 280 .deg. C. Potentially, the damaged swirl vane assemblies of the primary moisture separator may create bad influences for the plant operation because it may cause the rupture of SG Tubes and over-exceed fluid influx onto the turbine and etc. KPS had successfully performed the replacement of the degraded swirl vane assemblies through our own planning and preparation. This was the unique case in all over the world and I would like to introduce you about our unique repair experience to prepare an expected future situation as we see the similar problems in other model F SGs operating in Korea

  3. Web document engineering

    International Nuclear Information System (INIS)

    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

  4. Enterprise Document Management

    Data.gov (United States)

    US Agency for International Development — The function of the operation is to provide e-Signature and document management support for Acquisition and Assisitance (A&A) documents including vouchers in...

  5. WIPP documentation plan

    International Nuclear Information System (INIS)

    Plung, D.L.; Montgomery, T.T.; Glasstetter, S.R.

    1986-01-01

    In support of the programs at the Waste Isolation Pilot Plant (WIPP), the Publications and Procedures Section developed a documentation plan that provides an integrated document hierarchy; further, this plan affords several unique features: 1) the format for procedures minimizes the writing responsibilities of the technical staff and maximizes use of the writing and editing staff; 2) review cycles have been structured to expedite the processing of documents; and 3) the numbers of documents needed to support the program have been appreciably reduced

  6. Documenting Employee Conduct

    Science.gov (United States)

    Dalton, Jason

    2009-01-01

    One of the best ways for a child care program to lose an employment-related lawsuit is failure to document the performance of its employees. Documentation of an employee's performance can provide evidence of an employment-related decision such as discipline, promotion, or discharge. When properly implemented, documentation of employee performance…

  7. Documents preparation and review

    International Nuclear Information System (INIS)

    1999-01-01

    Ignalina Safety Analysis Group takes active role in assisting regulatory body VATESI to prepare various regulatory documents and reviewing safety reports and other documentation presented by Ignalina NPP in the process of licensing of unit 1. The list of main documents prepared and reviewed is presented

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

    Science.gov (United States)

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

    2008-07-01

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

  9. 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.

  10. Losing connections and receiving support to reconnect: experiences of frail older people within care programmes implemented in primary care settings.

    Science.gov (United States)

    Bindels, Jill; Cox, Karen; De La Haye, Jean; Mevissen, Ger; Heijing, Servé; van Schayck, Onno C P; Widdershoven, Guy; Abma, Tineke A

    2015-09-01

    The objective of this study was to evaluate whether care provided in the care programmes matched the needs of older people. Care programmes were implemented in primary-care settings in the Netherlands to identify frail older people and to prevent further deterioration of health. In total, 23 older people participated in in-depth interviews. Within this study, three older people participated as co-researchers; they gathered and analysed the data together with the academic researchers. Content analysis was used to analyse the data. Two categories emerged from the data: 'Losing connections' and 'Receiving support to reconnect.' 'Losing connections' reflects the needs of older people and 'Receiving support to reconnect' reflects their experience and the appreciated aspects of the provided care. A relationship of trust with the practice nurse (PN) appeared to be an important aspect of care, as it fostered the sharing of feelings and issues other than physical or medical problems that could not be shared with the general practitioner. The PNs are experienced as connectors, who help to restore feelings of connectedness and older peoples' access to resources in the community. The relationship with the PN was experienced as valuable because of the feelings of 'connectedness' it created. Through this connectedness, older people could discuss feelings of loneliness, depression and frustration in receiving and acquiring the appropriate resources and services with the PNs. Furthermore, the relationship with the PN helped the older people to gain access to other health professionals and services. The results imply that care for frail older people should include an awareness of the importance of the trusting relationship. Nurses can play a vital role in creating a trusting relationship and are able to bridge the gap between older people and other professionals and services. © 2014 John Wiley & Sons Ltd.

  11. Primary non-Hodgkin's lymphomas of the breast: 23 years of experience at the Colombian national cancer institute

    International Nuclear Information System (INIS)

    Rodriguez, Myriam; Grajales, Marco; Londono, Sonia; Ortiz, Natascha

    2004-01-01

    Primary non- Hodgkin's lymphomas of the breast (PNHLB) are an infrequent malignancy. In a review of the literature, in which six Latin American journals are included, approximately 450 cases have been reported during the past two decades. in this paper we present the experience of the national cancer institute of Colombia during the last 23 years. Objective: to carry out a retrospective analysis of the characteristics, natural history, prognostic factors, and outcome of patients with PNHLB at the NCI of Colombia. Methods: the medical histories of patients diagnosed with PNHLB between 1980 and 2003 were reviewed; likewise, the clinical characteristics, treatment protocols, and final outcomes were analyzed. Results: 25 patients were identified as PNHLB. The average follow-up was 57 months. The medium age was 58, ranging from 26 to 83. 84% had diffused large cell lymphoma. The Karnofsky index was over 80 in 92% of the patients. 72% received chop chemotherapy. Two patients received a combination without doxorubicin. 68% received combined chemo- and radiation therapy. Two patients refused therapy. Two patients died before receiving any type of treatment. CNS compromise was observed in 20% of patients during the evolution of their disease. The youngest patient, whose case deserves special comment, obtained a second complete remission with simple mastectomy, after having relapsed after conventional chemotherapy, radiotherapy, and autologous bone marrow transplant. No significant prognostic variables were found using the univariate analysis. Conclusions: a high rate of complete remission can be achieved by using combined treatment in patients with PNHLB. The medium overall survival was not reached after 71 months of follow-up. The most frequent relapse site was the CNS

  12. A retrospective analysis of early experience with modified complete primary repair of exstrophy bladder (CPRE in neonates and children

    Directory of Open Access Journals (Sweden)

    Santosh B Kurbet

    2013-01-01

    Full Text Available Objective: To study the problems faced during the surgery and follow-up of modified complete primary repair of exstrophy (CPRE technique. Initial experience with CPRE and its short- and long-term outcomes with respect to continence status and psychosocial impact are reported. Materials and Methods: A retrospective review of the hospital case records from March 2008 to September 2012 was performed. Data of patients with bladder exstrophy managed by a single paediatric surgeon using modified CPRE technique were analysed. Quality of life and psychosocial impact of the surgery were assessed using Pediatric Quality of Life Inventory (PedsQL 4.0 and compared with those of typical peers. Results: Eight children (age 4 days-12 years underwent CPRE using modified Mitchell′s technique. Two patients (25% experienced early postoperative complications, with infection and fistula developing in one each. All the patients were doing well on follow-up, with variable continence rates and good cosmesis. Mean duration of follow-up was 18.5 months (range 6 months-4 years. Five out of seven (71% children were continent or partially continent. One case was lost to follow-up. PedsQL scores were comparable with those of age-matched peers in all domains except the social functioning domain in 8-12 years age group (83.53 ± 9.70 vs. 77.86 ± 10.22, P < 0.05. Conclusion: Our preliminary results with modified CPRE in neonates and children have been encouraging. No major complications were observed. Continence rate was satisfactory and cosmetic results were good. Though the technique is being practiced at several Indian centres, there is a paucity of comprehensive Indian data on CPRE.

  13. 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.

  14. 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.

  15. 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.

  16. Subject (of documents)

    DEFF Research Database (Denmark)

    Hjørland, Birger

    2017-01-01

    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...

  17. "They're Telling Me What I Already Know Instead of What I Don't Know": Dyslexic Pupils' Experiences of Withdrawal Tuition during the Later Primary Years

    Science.gov (United States)

    Anderson, Rosemary

    2009-01-01

    This article reports findings from a qualitative case study whose main focus was on how four 10-11-year-old dyslexic pupils coped with the demands of classroom reading during their final two years (Years 5-6) at a primary school in the north of England. Data were also collected on more general issues associated with the pupils' experiences of…

  18. The effects of financial education on financial literacy and savings behavior : Evidence from a controlled field experiment in Dutch primary schools

    NARCIS (Netherlands)

    Kalwij, A.S.; Alessie, Rob; Dinkova, M.; Schonewille, Gea; van der Schors, Anna; van der Werf, Minou

    In this paper, we report the results of a controlled field experiment designed to estimate the short-term effects of a 45-minute financial education program on financial literacy and savings behavior in Dutch primary schools. Among fifth and sixth graders, the program led to a pre- to posttest

  19. "Give Me a Lesson and I'll Deliver It": Teaching Assistants' Experiences of Leading Primary Mathematics Lessons in England

    Science.gov (United States)

    Houssart, Jenny

    2013-01-01

    Teaching Assistants (TAs) in primary schools in England have a growing pedagogic role. For some, this sometimes includes responsibility for the whole class instead of the teacher. This article draws on 24 interview transcripts to examine the practice in the context of primary mathematics lessons and from TAs' viewpoints. Emergency cover is often…

  20. 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…

  1. Risk scoring and thromboprophylactic treatment of patients with atrial fibrillation with and without access to primary healthcare data: experience from the Stockholm health care system.

    Science.gov (United States)

    Forslund, Tomas; Wettermark, Björn; Wändell, Per; von Euler, Mia; Hasselström, Jan; Hjemdahl, Paul

    2013-12-10

    Earlier validation studies of risk scoring by CHA2DS2VASc for assessments of appropriateness of warfarin treatment in patients with atrial fibrillation have been performed solely with diagnoses recorded in hospital based care, even though many patients to a large extent are managed in primary care. Cross-sectional registry study of all 43 353 patients with a diagnosis of non-valvular atrial fibrillation recorded in inpatient care, specialist ambulatory care or primary care in the Stockholm County during 2006-2010. The mean CHA2DS2VASc score was 3.82 (4.67 for women and 3.14 for men). 64% of the entire cohort of patients with atrial fibrillation had the diagnosis in primary care (12% only there). The mean CHA2DS2VASc score of patients with a diagnosis only in inpatient care or specialist ambulatory care increased from 3.63 to 3.83 when comorbidities registered in primary care were added. In 2010 warfarin prescriptions were claimed by 47.2%, and ASA by 41.6% of the entire cohort. 34% of patients with CHA2DS2VASc=1 and 20% with CHA2DS2VASc=0 had warfarin treatment. ASA was more frequently used instead of warfarin among women and elderly patients. Registry CHA2DS2VASc scores were underestimated without co-morbidity data from primary care. Many individuals with scores 0 and 1 were treated with warfarin, despite poor documentation of clinical benefit. In contrast, warfarin appears to be underused and ASA overused among high risk atrial fibrillation patients. Lack of diagnoses from primary care underestimated CHA2DS2VASc scores and may thereby have overestimated treatment benefits in low-risk patients in earlier studies. © 2013.

  2. 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

  3. 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.

  4. Process evaluation of a stepped-care program to prevent depression in primary care: patients' and practice nurses' experiences.

    Science.gov (United States)

    Pols, Alide D; Schipper, Karen; Overkamp, Debbie; van Dijk, Susan E; Bosmans, Judith E; van Marwijk, Harm W J; Adriaanse, Marcel C; van Tulder, Maurits W

    2017-02-23

    Depression is common in patients with diabetes type 2 (DM2) and/or coronary heart disease (CHD), with high personal and societal burden and may even be preventable. Recently, a cluster randomized trial of stepped care to prevent depression among patients with DM2 and/or CHD and subthreshold depression in Dutch primary care (Step-Dep) versus usual care showed no effectiveness. This paper presents its process evaluation, exploring in-depth experiences from a patient and practice nurse perspective to further understand the results. A qualitative study was conducted. Using a purposive sampling strategy, data were collected through semi-structured interviews with 24 participants (15 patients and nine practice nurses). All interviews were audiotaped and transcribed verbatim. Atlas.ti 5.7.1 software was used for coding and structuring of themes. A thematic analysis of the data was performed. The process evaluation showed, even through a negative trial, that Step-Dep was perceived as valuable by both patients and practice nurses; perceived effectiveness on improving depressive symptoms varied greatly, but most felt that it had been beneficial for patients' well-being. Facilitators were: increased awareness of mental health problems in chronic disease management and improved accessibility and decreased experienced stigma of receiving mental health care. The Patient Health Questionnaire 9 (PHQ-9), used to determine depression severity, functioned as a useful starting point for the conversation on mental health and patients gained more insight into their mental health by regularly filling out the PHQ-9. However, patients and practice nurses did not widely support its use for monitoring depressive symptoms or making treatment decisions. Monitoring mental health was deemed important in chronically ill patients by both patients and practice nurses and was suggested to start at the time of diagnosis of a chronic disease. Appointed barriers were that patients were primarily

  5. Primary treatment of endometrial carcinoma with high-dose-rate brachytherapy: results of 12 years of experience with 280 patients

    International Nuclear Information System (INIS)

    Knocke, Tomas H.; Kucera, Herwig; Weidinger, Barbara; Hoeller, Walpurga; Poetter, Richard

    1997-01-01

    Purpose: This study aimed to evaluate the efficacy of high-dose-rate brachytherapy (HDRB) in the primary treatment of endometrial carcinoma. The results of 12 years of experience (1981-1992) covering 280 patients (mean age 72 years) and their follow-up over 10 years (mean 55 months) are reported. Methods and Materials: Staging was based on clinical examination and fractionated curettage. There were 116 patients in clinical Stage Ia, 119 in Stage Ib, 37 in Stage II, and 8 in Stage III. HDRB was performed four to five times (8.5 Gy) with a one-channel intracavitary applicator and one to two times (7 Gy) with an intravaginal cylinder applicator. Overall and disease-specific survival, local control according to stage and histology, and late side effects were analyzed retrospectively (actuarial method). Results: At 5 years, overall survival, disease-specific survival, and local control were 52.7%, 76.6%, and 75.4% (Stage Ia: 63.9%, 84.9%, and 86.0%; Stage Ib: 47.3%, 73.3%, and 68.8%; and Stage II: 40.2%, 68.6%, and 60.5%) according to histopathologic Grade 1: 65.1%, 83.5%, and 77.7%; for Grade 2: 44.7%, 75.4%, and 75.8%; and for Grade 3: 37.7%, 63.9%, and 74.1%. Eight patients showed progressive disease, 64 developed recurrence after a median of 13 months (45 of whom had a local recurrence only, and 6 of whom had a local recurrence with distant metastases), 6 developed a lymph node recurrence only, and 7 developed distant metastases only. The calculated probability for developing a Grade III late side effect was 5.2% at 5 years. Conclusion: At Stages Ia, Ib, and II in endometrial carcinoma, HDRB is a very effective treatment modality with acceptable local control rates and disease-specific survival for patients who are not fit for surgery. During the time frame of 12 years and in 280 patients the method has proven to have a low risk of acute complications and an acceptable risk of long-term side effects

  6. Scheme Program Documentation Tools

    DEFF Research Database (Denmark)

    Nørmark, Kurt

    2004-01-01

    are separate and intended for different documentation purposes they are related to each other in several ways. Both tools are based on XML languages for tool setup and for documentation authoring. In addition, both tools rely on the LAML framework which---in a systematic way---makes an XML language available...... as named functions in Scheme. Finally, the Scheme Elucidator is able to integrate SchemeDoc resources as part of an internal documentation resource....

  7. Health physics documentation

    International Nuclear Information System (INIS)

    Stablein, G.

    1980-01-01

    When dealing with radioactive material the health physicist receives innumerable papers and documents within the fields of researching, prosecuting, organizing and justifying radiation protection. Some of these papers are requested by the health physicist and some are required by law. The scope, quantity and deposit periods of the health physics documentation at the Karlsruhe Nuclear Research Center are presented and rationalizing methods discussed. The aim of this documentation should be the application of physics to accident prevention, i.e. documentation should protect those concerned and not the health physicist. (H.K.)

  8. CAED Document Repository

    Data.gov (United States)

    U.S. Environmental Protection Agency — Compliance Assurance and Enforcement Division Document Repository (CAEDDOCRESP) provides internal and external access of Inspection Records, Enforcement Actions, and...

  9. 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...

  10. Fuel Handling Facility Description Document

    International Nuclear Information System (INIS)

    M.A. LaFountain

    2005-01-01

    The purpose of the facility description document (FDD) is to establish the requirements and their bases that drive the design of the Fuel Handling Facility (FHF) to allow the design effort to proceed to license application. This FDD is a living document that will be revised at strategic points as the design matures. It identifies the requirements and describes the facility design as it currently exists, with emphasis on design attributes provided to meet the requirements. This FDD was developed as an engineering tool for design control. Accordingly, the primary audience and users are design engineers. It leads the design process with regard to the flow down of upper tier requirements onto the facility. Knowledge of these requirements is essential to performing the design process. It trails the design with regard to the description of the facility. This description is a reflection of the results of the design process to date

  11. Association between women veterans' experiences with VA outpatient health care and designation as a women's health provider in primary care clinics.

    Science.gov (United States)

    Bastian, Lori A; Trentalange, Mark; Murphy, Terrence E; Brandt, Cynthia; Bean-Mayberry, Bevanne; Maisel, Natalya C; Wright, Steven M; Gaetano, Vera S; Allore, Heather; Skanderson, Melissa; Reyes-Harvey, Evelyn; Yano, Elizabeth M; Rose, Danielle; Haskell, Sally

    2014-01-01

    Women veterans comprise a small percentage of Department of Veterans Affairs (VA) health care users. Prior research on women veterans' experiences with primary care has focused on VA site differences and not individual provider characteristics. In 2010, the VA established policy requiring the provision of comprehensive women's health care by designated women's health providers (DWHPs). Little is known about the quality of health care delivered by DWHPs and women veterans' experience with care from these providers. Secondary data were obtained from the VA Survey of Healthcare Experience of Patients (SHEP) using the Consumer Assessment of Healthcare Providers and Systems (CAHPS) patient-centered medical home (PCMH) survey from March 2012 through February 2013, a survey designed to measure patient experience with care and the DWHPs Assessment of Workforce Capacity that discerns between DWHPs versus non-DWHPs. Of the 28,994 surveys mailed to women veterans, 24,789 were seen by primary care providers and 8,151 women responded to the survey (response rate, 32%). A total of 3,147 providers were evaluated by the SHEP-CAHPS-PCMH survey (40%; n = 1,267 were DWHPs). In a multivariable model, patients seen by DWHPs (relative risk, 1.02; 95% CI, 1.01-1.04) reported higher overall experiences with care compared with patients seen by non-DWHPs. The main finding is that women veterans' overall experiences with outpatient health care are slightly better for those receiving care from DWHPs compared with those receiving care from non-DWHPs. Our findings have important policy implications for how to continue to improve women veterans' experiences. Our work provides support to increase access to DWHPs at VA primary care clinics. Published by Elsevier Inc.

  12. Experiment data report for semiscale Mod-2A primary feed and bleed experiment series (Tests S-SR-1 and S-SR-2)

    International Nuclear Information System (INIS)

    Fogdall, S.P.

    1982-10-01

    This report presents test data recorded for Tests S-SR-1 and S-SR-2 of the Semiscale Mod-2A Primary Feed and Bleed Tests. These tests are part of a series of Semiscale tests that investigate the thermal-hydraulic phenomena resulting from a hypothesized loss-of-coolant accident (LOCA) or abnormal operating transient. These tests provide experimental data for assessing the analytical capability of computer codes used in LOCA and operational transient analysis. The primary objectives of Tests S-SR-1 and -2 were to provide data on primary system recovery through the use of primary feed and bleed cooling, with no heat transfer to the secondaries. Data was obtained using high- and low-head pump curves for the safety injection (SI) pumps. This report presents the uninterpreted data from Tests S-SR-1 and -2 for analysis. The data, presented as graphs in engineering units, have been analyzed only to the extent necessary to ensure that they are reasonable and consistent

  13. 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.

  14. 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

  15. INFCE plenary conference documents

    International Nuclear Information System (INIS)

    This document consists of the reports to the First INFCE Plenary Conference (November 1978) by the Working Groups a Plenary Conference of its actions and decisions, the Communique of the Final INFCE Plenary Conference (February 1980), and a list of all documents in the IAEA depository for INFCE

  16. Human Document Project

    NARCIS (Netherlands)

    de Vries, Jeroen; Abelmann, Leon; Manz, A; Elwenspoek, Michael Curt

    2012-01-01

    “The Human Document Project‿ is a project which tries to answer all of the questions related to preserving information about the human race for tens of generations of humans to come or maybe even for a future intelligence which can emerge in the coming thousands of years. This document mainly

  17. Reactive documentation system

    Science.gov (United States)

    Boehnlein, Thomas R.; Kramb, Victoria

    2018-04-01

    Proper formal documentation of computer acquired NDE experimental data generated during research is critical to the longevity and usefulness of the data. Without documentation describing how and why the data was acquired, NDE research teams lose capability such as their ability to generate new information from previously collected data or provide adequate information so that their work can be replicated by others seeking to validate their research. Despite the critical nature of this issue, NDE data is still being generated in research labs without appropriate documentation. By generating documentation in series with data, equal priority is given to both activities during the research process. One way to achieve this is to use a reactive documentation system (RDS). RDS prompts an operator to document the data as it is generated rather than relying on the operator to decide when and what to document. This paper discusses how such a system can be implemented in a dynamic environment made up of in-house and third party NDE data acquisition systems without creating additional burden on the operator. The reactive documentation approach presented here is agnostic enough that the principles can be applied to any operator controlled, computer based, data acquisition system.

  18. Documenting the Experiences of Special Education Advocates

    Science.gov (United States)

    Burke, Meghan M.; Goldman, Samantha E.

    2017-01-01

    Many parents struggle to advocate for their children with disabilities to obtain services at school. Subsequently, parents may turn to special education advocates to help ensure that their children receive appropriate services. However, it is unclear how special education advocates support families and secure services for children with…

  19. Documentation: Records and Reports.

    Science.gov (United States)

    Akers, Michael J

    2017-01-01

    This article deals with documentation to include the beginning of documentation, the requirements of Good Manufacturing Practice reports and records, and the steps that can be taken to minimize Good Manufacturing Practice documentation problems. It is important to remember that documentation for 503a compounding involves the Formulation Record, Compounding Record, Standard Operating Procedures, Safety Data Sheets, etc. For 503b outsourcing facilities, compliance with Current Good Manufacturing Practices is required, so this article is applicable to them. For 503a pharmacies, one can see the development and modification of Good Manufacturing Practice and even observe changes as they are occurring in 503a documentation requirements and anticipate that changes will probably continue to occur. Copyright© by International Journal of Pharmaceutical Compounding, Inc.

  20. The responsibility continuum: never primary, coresident and caregiver--heterogeneity in the African-American grandmother experience.

    Science.gov (United States)

    Lee, Rosalyn D; Ensminger, Margaret E; LaVeist, Thomas A

    2005-01-01

    This article examines diversity among 542 African-American grandmothers from the Woodlawn Longitudinal Study. Women were categorized on the basis of their household composition, degree of care provided to grandchildren, and status of primary caregiver to grandchildren during lifetime. Overall, 67.7% of the sample engaged in parenting and exchange behaviors at high or moderate levels. Twenty-seven percent of the sample coresided with and provided care to grandchildren, 28% did not coreside but had been primary caregivers in the past, and 45% did not coreside and had never been primarily responsible for a grandchild. Heterogeneity was found among seven grandmother types on economic measures, life events, and grandchild characteristics. Grandmothers with earlier primary responsibility and those currently in homes of three or more generations were associated with poor outcomes. Policy and practice can be informed by additional research on status, context, and timing of assumption of responsibilities for grandchildren.

  1. [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.

  2. 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.

  3. Belgian experience in applying the open-quotes leak-before-breakclose quotes concept to the primary loop piping

    International Nuclear Information System (INIS)

    Gerard, R.; Malekian, C.; Meessen, O.

    1997-01-01

    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 cutsclose quotes technique. The influence of such residual loads on the LBB margins is discussed in details and typical results are presented

  4. CNEA's quality system documentation

    International Nuclear Information System (INIS)

    Mazzini, M.M.; Garonis, O.H.

    1998-01-01

    Full text: To obtain an effective and coherent documentation system suitable for CNEA's Quality Management Program, we decided to organize the CNEA's quality documentation with : a- Level 1. Quality manual. b- Level 2. Procedures. c-Level 3. Qualities plans. d- Level 4: Instructions. e- Level 5. Records and other documents. The objective of this work is to present a standardization of the documentation of the CNEA's quality system of facilities, laboratories, services, and R and D activities. Considering the diversity of criteria and formats for elaboration the documentation by different departments, and since ultimately each of them generally includes the same quality management policy, we proposed the elaboration of a system in order to improve the documentation, avoiding unnecessary time wasting and costs. This will aloud each sector to focus on their specific documentation. The quality manuals of the atomic centers fulfill the rule 3.6.1 of the Nuclear Regulatory Authority, and the Safety Series 50-C/SG-Q of the International Atomic Energy Agency. They are designed by groups of competent and highly trained people of different departments. The normative procedures are elaborated with the same methodology as the quality manuals. The quality plans which describe the organizational structure of working group and the appropriate documentation, will asses the quality manuals of facilities, laboratories, services, and research and development activities of atomic centers. The responsibilities for approval of the normative documentation are assigned to the management in charge of the administration of economic and human resources in order to fulfill the institutional objectives. Another improvement aimed to eliminate unnecessary invaluable processes is the inclusion of all quality system's normative documentation in the CNEA intranet. (author) [es

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

    Science.gov (United States)

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

    2016-01-01

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

  6. 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.

  7. SNF AGING SYSTEM DESCRIPTION DOCUMENT

    International Nuclear Information System (INIS)

    L.L. Swanson

    2005-01-01

    The purpose of this system description document (SDD) is to establish requirements that drive the design of the spent nuclear fuel (SNF) aging system and associated bases, which will allow the design effort to proceed. This SDD will be revised at strategic points as the design matures. This SDD identifies the requirements and describes the system design, as it currently exists, with emphasis on attributes of the design provided to meet the requirements. This SDD is an engineering tool for design control; accordingly, the primary audience and users are design engineers. This SDD is part of an iterative 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 follows the design with regard to the description of the system. The description provided in the SDD reflects the current results of the design process. Throughout this SDD, the term aging cask applies to vertical site-specific casks and to horizontal aging modules. The term overpack is a vertical site-specific cask that contains a dual-purpose canister (DPC) or a disposable canister. Functional and operational requirements applicable to this system were obtained from ''Project Functional and Operational Requirements'' (F andOR) (Curry 2004 [DIRS 170557]). Other requirements that support the design process were taken from documents such as ''Project Design Criteria Document'' (PDC) (BSC 2004 [DES 171599]), ''Site Fire Hazards Analyses'' (BSC 2005 [DIRS 172174]), and ''Nuclear Safety Design Bases for License Application'' (BSC 2005 [DIRS 171512]). The documents address requirements in the ''Project Requirements Document'' (PRD) (Canori and Leitner 2003 [DIRS 166275]). This SDD includes several appendices. Appendix A is a Glossary; Appendix B is a list of key system charts, diagrams, drawings, lists and additional supporting information; and Appendix C is a list of

  8. ELECTRICAL SUPPORT SYSTEM DESCRIPTION DOCUMENT

    International Nuclear Information System (INIS)

    Roy, S.

    2004-01-01

    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 andOR) (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

  9. 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.

  10. Recovery, work-life balance and work experiences important to self-rated health: A questionnaire study on salutogenic work factors among Swedish primary health care employees.

    Science.gov (United States)

    Ejlertsson, Lina; Heijbel, Bodil; Ejlertsson, Göran; Andersson, Ingemar

    2018-01-01

    There is a lack of information on positive work factors among health care workers. To explore salutogenic work-related factors among primary health care employees. Questionnaire to all employees (n = 599) from different professions in public and private primary health care centers in one health care district in Sweden. The questionnaire, which had a salutogenic perspective, included information on self-rated health from the previously validated SHIS (Salutogenic Health Indicator Scale), psychosocial work environment and experiences, recovery, leadership, social climate, reflection and work-life balance. The response rate was 84%. A multivariable linear regression model, with SHIS as the dependent variable, showed three significant predictors. Recovery had the highest relationship to SHIS (β= 0.34), followed by experience of work-life balance (β= 0.25) and work experiences (β= 0.20). Increased experience of recovery during working hours related to higher self-rated health independent of recovery outside work. Individual experiences of work, work-life balance and, most importantly, recovery seem to be essential areas for health promotion. Recovery outside the workplace has been studied previously, but since recovery during work was shown to be of great importance in relation to higher self-rated health, more research is needed to explore different recovery strategies in the workplace.

  11. 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.

  12. 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.

  13. Losing connections and receiving support to reconnect: experiences of frail older people within care programmes implemented in primary care settings

    NARCIS (Netherlands)

    Bindels, J.; Cox, K.; De La Haye, J.; Mevissen, G.; Heijing, S.; van Schayck, O.C.P.; Widdershoven, G.; Abma, T.A.

    2015-01-01

    Aims and objectives: The objective of this study was to evaluate whether care provided in the care programmes matched the needs of older people. Background: Care programmes were implemented in primary-care settings in the Netherlands to identify frail older people and to prevent further

  14. Reconstruction of primary vertices at the ATLAS experiment in Run 1 proton–proton collisions at the LHC

    Czech Academy of Sciences Publication Activity Database

    Aaboud, M.; Aad, G.; Abbott, B.; Chudoba, Jiří; Havránek, Miroslav; Hejbal, Jiří; Jakoubek, Tomáš; Kepka, Oldřich; Kupčo, Alexander; Kůs, Vlastimil; Lokajíček, Miloš; Lysák, Roman; Marčišovský, Michal; Mikeštíková, Marcela; Němeček, Stanislav; Penc, Ondřej; Šícho, Petr; Staroba, Pavel; Svatoš, Michal; Taševský, Marek; Vrba, Václav

    2017-01-01

    Roč. 77, č. 5 (2017), s. 1-35, č. článku 332. ISSN 1434-6044 Institutional support: RVO:68378271 Keywords : vertex: primary * track data analysis * p p: scattering * spatial resolutio * performance * ATLAS * efficiency Subject RIV: BF - Elementary Particles and High Energy Physics OBOR OECD: Particles and field physics Impact factor: 5.331, year: 2016

  15. Experiences of a High-Risk Population with Prenatal Hemoglobinopathy Carrier Screening in a Primary Care Setting: a Qualitative Study

    NARCIS (Netherlands)

    Holtkamp, Kim C. A.; Lakeman, Phillis; Hader, Hind; Jans, Suze M. J. P.; Hoenderdos, Maria; Playfair, Henna A. M.; Cornel, Martina C.; Peters, Marjolein; Henneman, Lidewij

    2017-01-01

    Carrier screening for hemoglobinopathies (HbPs; sickle cell disease and thalassemia) aims to facilitate autonomous reproductive decision-making. In the absence of a Dutch national HbP carrier screening program, some primary care midwives offer screening on an ad hoc basis. This qualitative

  16. 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…

  17. 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:…

  18. TRANSPORTATION SYSTEM REQUIREMENTS DOCUMENT

    International Nuclear Information System (INIS)

    2004-01-01

    This document establishes the Transportation system requirements for the U.S. Department of Energy's (DOE's) Civilian Radioactive Waste Management System (CRWMS). These requirements are derived from the Civilian Radioactive Waste Management System Requirements Document (CRD). The Transportation System Requirements Document (TSRD) was developed in accordance with LP-3.1Q-OCRWM, Preparation, Review, and Approval of Office of National Transportation Level-2 Baseline Requirements. As illustrated in Figure 1, the TSRD forms a part of the DOE Office of Civilian Radioactive Waste Management (OCRWM) Technical Baseline

  19. 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.

  20. Data report of ROSA/LSTF experiment TR-LF-07. Loss-of-feedwater transient with primary feed-and-bleed operation

    International Nuclear Information System (INIS)

    Takeda, Takeshi

    2016-07-01

    An experiment TR-LF-07 was conducted on June 23, 1992 using the Large Scale Test Facility (LSTF) in the Rig of Safety Assessment-IV (ROSA-IV) Program. The ROSA/LSTF experiment TR-LF-07 simulated a loss-of-feedwater transient in a pressurized water reactor (PWR) under assumptions of primary feed-and-bleed operation and total failure of auxiliary feedwater system. A safety injection (SI) signal was generated when steam generator (SG) secondary-side collapsed liquid level decreased to 3 m. Primary depressurization was initiated by fully opening a power-operated relief valve (PORV) of pressurizer (PZR) 30 min after the SI signal. High pressure injection (HPI) system was started in loop with PZR 12 s after the SI signal, while it was initiated in loop without PZR when the primary pressure decreased to 10.7 MPa. The primary and SG secondary pressures were kept almost constant because of cycle opening of the PZR PORV and SG relief valves. The PZR liquid level began to drop steeply following the PORV full opening, which caused liquid level formation at the hot leg. The PZR and hot leg liquid levels recovered due to the HPI actuation in both loops. The primary pressure became lower than the SG secondary pressure, which resulted in the actuation of accumulator (ACC) system in both loops. The PZR and hot legs became full of liquid again after the ACC actuation. The primary feed-and-bleed operation by use of the PORV, HPI and ACC systems was effective to core cooling because of no core uncovery. The experiment was terminated when the continuous core cooling was confirmed due to the successive coolant injection from the HPI system even after the ACC termination. The obtained data would be useful to study operator actions and procedures in the PWR multiple fault events which behaviors in the PZR affect. This report summarizes the test procedures, conditions and major observation in the ROSA/LSTF experiment TR-LF-07. (author)

  1. EDF operational experience of primary circuit filter usage. Analysis of results and strategy for optimizing filtration and reducing solid wastes

    International Nuclear Information System (INIS)

    Mascarenhas, Darren; Moleiro, Edgar; Bancelin, Estelle; Bretelle, Jean-Luc

    2014-01-01

    Pleated fibreglass media filter cartridges are used throughout the auxiliary systems at nuclear power plants across the 58 reactors of EDF fleet. The main role of these filters is to remove suspended solids from coolant to prevent them accumulating in circuits or in equipments. In the primary circuit, these filters therefore limit the deposition of solids that are active or could become active if allowed to recirculate throughout the primary circuit, avoiding potential consequences such as an increase in dose rates, axial offset anomalies, demineralisers fouling, higher pressure losses in primary loop, and clogging of the primary pumps. Since 2008, a steady increase in the consumption of filters has been noticed, and therefore an increase in the amount of solid waste to treat. Preliminary studies have identified the primary circuit high-flow filters of the 1300/1450 MWe reactors as the main source of this increase. Not only has this stretched of solid waste containers production to the limit, as well as strained site resources and increased risks of operational errors during periods of frequent filter changes; it has also suggested that there is an underlying problem that could pose a serious risk to the primary circuit if untreated. Further studies have been carried out to identify more precisely the impact of possible causes, including increased quality surveillance of the filters, correlation of consumption data with the concentrations of various conditioning products and typical pollutants, and an impact analysis of events such as steam generator replacements or new practices like zinc injection. Work has been done with the filter manufacturer to improve their service lifetime and a simulation tool has been developed in order to understand and optimise filtration. We are also working with sites on creating good practices and avoiding bad ones. These actions should reduce the consumption in the short term while still assuring a high quality of filtration and

  2. 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>.

  3. The effects of autonomy-supportive and controlling teaching behaviour in biology lessons with primary and secondary experiences on students' intrinsic motivation and flow-experience

    Science.gov (United States)

    Hofferber, Natalia; Basten, Melanie; Großmann, Nadine; Wilde, Matthias

    2016-09-01

    Self-Determination Theory and Flow Theory propose that perceived autonomy fosters the positive qualities of motivation and flow-experience. Autonomy-support can help to maintain students' motivation in very interesting learning activities and may lead to an increase in the positive qualities of motivation in less interesting learning activities. This paper investigates whether autonomy-supportive or controlling teaching behaviour influence students' motivation and flow-experience in biology class. In study 1, 158 students of grade six worked on the adaptations of Harvest Mice (Micromys minutus) with living animals. The 153 sixth graders of study 2 dealt with the same content but instead worked with short films on laptops. Previous studies have shown that students perceive film sequences as less interesting than working with living animals. Students' intrinsic motivation and flow-experience were measured at the end of the first and the third lesson. In study 1, autonomy-supportive teaching behaviour led to significant differences in students' intrinsic motivation and flow-experience when compared to controlling teaching behaviour. In study 2, motivation and flow-experience were not always in line with theory. The positive effects of autonomy-supportive and the non-beneficial effects of the controlling teaching behaviour seem to be dependent on the interestingness of the teaching material.

  4. Applications for electronic documents

    International Nuclear Information System (INIS)

    Beitel, G.A.

    1995-01-01

    This paper discusses the application of electronic media to documents, specifically Safety Analysis Reports (SARs), prepared for Environmental Restoration and Waste Management (ER ampersand WM) programs being conducted for the Department of Energy (DOE) at the Idaho National Engineering Laboratory (INEL). Efforts are underway to upgrade our document system using electronic format. To satisfy external requirements (DOE, State, and Federal), ER ampersand WM programs generate a complement of internal requirements documents including a SAR and Technical Safety Requirements along with procedures and training materials. Of interest, is the volume of information and the difficulty in handling it. A recently prepared ER ampersand WM SAR consists of 1,000 pages of text and graphics; supporting references add 10,000 pages. Other programmatic requirements documents consist of an estimated 5,000 pages plus references

  5. 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.

  6. Transportation System Requirements Document

    International Nuclear Information System (INIS)

    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

  7. Integrated Criteria Document Chromium

    NARCIS (Netherlands)

    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; de Bruijn PJ; van Keulen A; Verburgh JJ; van der Woerd KF

    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)

  8. 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)....

  9. Registration document 2005

    International Nuclear Information System (INIS)

    2005-01-01

    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.)

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

    Science.gov (United States)

    Wong, J S; Rahimah, N

    2004-08-01

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

  11. Medium-term experiences with in-situ gamma-spectrometry of the primary loop transport processes at Paks NPP

    International Nuclear Information System (INIS)

    Raics, P.; Sztaricskai, T.; Szabo, J.; Szegedi, S.

    2001-01-01

    Surface activity of 15 corrosion/erosion and fission products was determined by in-situ gamma-spectrometry for 2-2 locations on the hot and cold legs of each loop, respectively. Gamma-dosimetry in the assay points was performed. Activity profiles of ion exchange columns were analyzed. Combined measurements along the steam generators completed the characterization of the primary circuits. Most of this technique was regularly included into all maintenance periods. Data evaluation was performed for the surface contaminations as well as coolant activities and reactor operation features for years 1985-2001. Trends and tendencies were investigated in the time behavior of the specific activities. Asymmetry in the surface contamination at the primary loop points, cold-leg activity inversion, water chemistry effects, isotope selectivity were observed. Correlations in different parameters have been calculated and analyzed. (R.P.)

  12. 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.

  13. 2002 reference document

    International Nuclear Information System (INIS)

    2002-01-01

    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.)

  14. Endoscopic Endonasal Transsphenoidal Surgery, A Reliable Method for Treating Primary and Recurrent/Residual Craniopharyngiomas: Nine Years of Experience.

    Science.gov (United States)

    Bal, Ercan; Öge, Kamil; Berker, Mustafa

    2016-10-01

    Craniopharyngioma resection is one of the most challenging surgical procedures. Herein, we describe our extended endoscopic endonasal transsphenoidal surgery (EETS) technique, and the results of 9 years of use on primary and recurrent/residual craniopharyngiomas. This study reviewed 28 EETSs in 25 patients with craniopharyngiomas between January 2006 and September 2015. The patients were divided into 2 groups, newly diagnosed patients (group A, n = 15), and patients having residual or recurrent tumors (group B, n = 10). There was no significant difference between the groups in terms of the largest tumor diameter (P = 0.495), and all patients underwent EETS. The clinical and ophthalmologic examinations, imaging studies, endocrinologic studies, and operative findings for these cases were reviewed retrospectively. The number of gross total resections in group A was 13/15, and 7/10 in group B. Three of the patients developed postoperative cerebrospinal fluid leakage (all in group A). There were no neurovascular or ophthalmologic complications, and no meningitis or mortality was observed. There has been a notable increase in the use of EETS in the treatment of craniopharyngiomas during the last decade. Despite its increased use in the treatment of primary craniopharyngiomas, its implementation for recurrent or residual craniopharyngiomas has been viewed with suspicion. In this study, the results have been presented separately for primary and recurrent/residual craniopharyngiomas, so that the results can be compared. Overall, EETS is a reliable and successful surgical treatment method for primary and recurrent/residual craniopharyngiomas. Copyright © 2016 Elsevier Inc. All rights reserved.

  15. 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 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. Results: 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. Conclusion: 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.

  16. 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.

  17. LCS Content Document Application

    Science.gov (United States)

    Hochstadt, Jake

    2011-01-01

    My project at KSC during my spring 2011 internship was to develop a Ruby on Rails application to manage Content Documents..A Content Document is a collection of documents and information that describes what software is installed on a Launch Control System Computer. It's important for us to make sure the tools we use everyday are secure, up-to-date, and properly licensed. Previously, keeping track of the information was done by Excel and Word files between different personnel. The goal of the new application is to be able to manage and access the Content Documents through a single database backed web application. Our LCS team will benefit greatly with this app. Admin's will be able to login securely to keep track and update the software installed on each computer in a timely manner. We also included exportability such as attaching additional documents that can be downloaded from the web application. The finished application will ease the process of managing Content Documents while streamlining the procedure. Ruby on Rails is a very powerful programming language and I am grateful to have the opportunity to build this application.

  18. Documentation of spectrom-32

    International Nuclear Information System (INIS)

    Callahan, G.D.; Fossum, A.F.; Svalstad, D.K.

    1989-01-01

    SPECTROM-32 is a finite element program for analyzing two-dimensional and axisymmetric inelastic thermomechanical problems related to the geological disposal of nuclear waste. The code is part of the SPECTROM series of special-purpose computer programs that are being developed by RE/SPEC Inc. to address many unique rock mechanics problems encountered in analyzing radioactive wastes stored in geologic formations. This document presents the theoretical basis for the mathematical models, the finite element formulation and solution procedure of the program, a description of the input data for the program, verification problems, and details about program support and continuing documentation. The computer code documentation is intended to satisfy the requirements and guidelines outlined in the document entitled Final Technical Position on Documentation of Computer Codes for High-Level Waste Management. The principal component models used in the program involve thermoelastic, thermoviscoelastic, thermoelastic-plastic, and thermoviscoplastic types of material behavior. Special material considerations provide for the incorporation of limited-tension material behavior and consideration of jointed material behavior. Numerous program options provide the capabilities for various boundary conditions, sliding interfaces, excavation, backfill, arbitrary initial stresses, multiple material domains, load incrementation, plotting database storage and access of results, and other features unique to the geologic disposal of radioactive wastes. Numerous verification problems that exercise many of the program options and illustrate the required data input and printed results are included in the documentation

  19. Technical approach document

    International Nuclear Information System (INIS)

    1988-04-01